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Supplementary Material 2

Supplementary Material 1

Supplementary Material 3

Additional file 2: Search terms and results.

Additional file 3: Studies included in review.

Additional file 1: PRISMA Checklist.

Additional file 5. Predicted adjusted margins for the significant interaction between wave and demographic variables for specific interventions. Figures showing adjusted predicted adjusted margins for significant two-way interactions for models with significant joint tests of two-way interactions for specific interventions (E2).

Additional file 2. Distribution of responses and variance ratio tests for responsibility for health (D1). Percentages and variance ratio test p-values for responsibility for health (D1).

Additional file 3. Results for models with significant joint tests of all two-way interactions supporting column 6, Tables 2, 3 and 4. APRs and p-values for all models with significant joint tests of two-way interactions.

Chronic and noncommunicable diseases such as diabetes, cancer and cardiovascular diseases are a major health problem in Australia and worldwide. Four risk factors contribute to two thirds of the global risk for chronic disease: tobacco use; alcohol use; unhealthy dietary patterns and practices; and physical inactivity. Other risk factors such as obesity (high body mass) also increases risk of chronic disease. Addressing these risk factors is an important strategy to reduce and prevent chronic disease in populations. However, effective prevention of chronic disease is challenging as it requires addressing complex systems that drive these risk factors as well as introducing solutions that are effective, feasible and acceptable to populations. Prevention is particularly challenging when interventions are contested by commercial entities and industry groups. This thesis focuses on an area of evidence needed for effective prevention: public opinion, community attitudes and acceptability. The views of the public or publics can directly and indirectly influence whether certain preventive interventions are introduced and sustained. The inverse also applies; public support can increase once interventions are implemented, such as in the case of tobacco control. In comparison, for other areas of chronic disease prevention there has been a more mixed picture of policy success, particularly in terms of addressing obesity, improving dietary patterns and food systems, reducing harmful alcohol use, and increasing physical activity. Understanding public opinion and acceptability of prevention that addresses these areas is an important step for implementation and sustainability of effective public health interventions that prevent disease and promote health. In my thesis, I present original research on public opinion about prevention. I first provide an integrative review and narrative synthesis of the methods used to measure and understand public opinion and acceptability of prevention. I then analyse the opinions and attitudes of different groups or ‘publics’ using four methods. One quantitative method I use is a cross-sectional, nationally representative survey, the AUStralian Perceptions Of Prevention Survey (AUSPOPS). I analyse the 2018 results to ascertain whether age and gender influence Australians’ attitudes to prevention. I also analyse the results of a cross-sectional survey of a university population regarding attitudes about sugar-sweetened beverage regulation, which includes a qualitative analysis component. I use focus groups as a qualitative method to explore young adults’ views about food choices and public health nutrition policies. I also conduct a media analysis of a contested preventive policy to reduce alcohol-related harms in Sydney, Australia. Through my thesis, I demonstrate that an improved understanding of what communities and groups think about specific policy interventions to prevent chronic disease, as well as more generally what they think are the role of different groups and sectors in responding to poor health, may assist in advancing policy and systems changes in prevention. I also demonstrate the importance of collecting both quantitative and qualitative data on public opinion to inform policy implementation. Furthermore, there is a crucial role for understanding how unhealthy commodity industries may be influencing public opinion and acceptability through strategic use of specific discourses in the public sphere, including news media. An improved understanding of public opinion about prevention, including a demonstration of how public opinion is measured and the many factors that influence people’s opinions and attitudes, will allow for more effective implementation and sustainability of preventive policies and strategies to support wider systems change for improved population health.

Additional file 8. Distribution of responses for perceptions of government intervention for health (E5, E3). Percentages and variance ratio test p-values for general attitudes towards government intervention (E3 & E5).

Additional file 6. Distribution of responses for support for specific interventions (E2). Percentages and variance ratio test p-values for specific interventions (E2).

Additional file 1. AUSPOPS survey questionnaire. Full survey questionnaire 2018 AUSPOPS.

Additional file 7. Predicted adjusted margins for the significant interactions between wave and demographic variables for general attitudes towards government intervention. Figures showing adjusted predicted adjusted margins for significant two-way interactions for models with significant joint tests of two-way interactions for general attitudes towards government intervention (E3 & E5).

Additional file 4. Predicted adjusted margins for the significant interactions between wave and demographic variables for responsibility for health outcomes. Figures showing adjusted predicted adjusted margins for significant two-way interactions for models with significant joint tests of two-way interactions for responsibility for health outcomes (D1).