Australian Health Review Australian Health Review Society
Journal of the Australian Healthcare & Hospitals Association
RESEARCH ARTICLE

Readiness of communities to engage with childhood obesity prevention initiatives in disadvantaged areas of Victoria, Australia

Sheila Cyril A B G , Michael Polonsky C , Julie Green D , Kingsley Agho E and Andre Renzaho F

A School of Social Sciences and Psychology, Western Sydney University, Locked Bag 1797, Penrith, NSW 2751, Australia.

B Department of Epidemiology & Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, 99 Commercial Road, Prahran, Vic. 3004, Australia.

C Department of Marketing, Deakin Business School, Deakin University, 221 Burwood Highway, Burwood, Vic. 3125, Australia. Email: michael.polonsky@deakin.edu.au

D Murdoch Children’s Research Institute, and Department of Paediatrics, The University of Melbourne, and Parenting Research Centre, 323 Victoria Parade, East Melbourne, Vic. 3002, Australia. Email: jgreen@parentingrc.org.au

E School of Science and Health, Western Sydney University, Locked Bag 1797, Penrith, NSW 2571, Australia. Email: k.agho@westernsydney.edu.au

F School of Social Sciences and Psychology, Western Sydney University, Locked Bag 1797, Penrith, NSW 2751, Australia. Email: andre.renzaho@westernsydney.edu.au

G Corresponding author. Email: sheila.cyril@monash.edu

Australian Health Review - https://doi.org/10.1071/AH16069
Submitted: 15 February 2016  Accepted: 23 May 2016   Published online: 15 July 2016

Abstract

Objective Disadvantaged communities bear a disproportionate burden of childhood obesity and show low participation in childhood obesity prevention initiatives. This study aims to examine the level of readiness of disadvantaged communities to engage with childhood obesity prevention initiatives.

Methods Using the community readiness model, 95 semi-structured interviews were conducted among communities in four disadvantaged areas of Victoria, Australia. Community readiness analysis and paired t-tests were performed to assess the readiness levels of disadvantaged communities to engage with childhood obesity prevention initiatives.

Results The results showed that disadvantaged communities demonstrated low levels of readiness (readiness score = 4/9, 44%) to engage with the existing childhood obesity prevention initiatives, lacked knowledge of childhood obesity and its prevention, and reported facing challenges in initiating and sustaining participation in obesity prevention initiatives.

Conclusion This study highlights the need to improve community readiness by addressing low obesity-related literacy levels among disadvantaged communities and by facilitating the capacity-building of bicultural workers to deliver obesity prevention messages to these communities. Integrating these needs into existing Australian health policy and practice is of paramount importance for reducing obesity-related disparities currently prevailing in Australia.

What is known about the topic? Childhood obesity prevalence is plateauing in developed countries including Australia; however, obesity-related inequalities continue to exist in Australia especially among communities living in disadvantaged areas, which experience poor engagement in childhood obesity prevention initiatives. Studies in the USA have found that assessing disadvantaged communities’ readiness to participate in health programs is a critical initial step in reducing the disproportionate obesity burden among these communities. However, no studies in Australia have assessed disadvantaged communities’ readiness to engage in obesity prevention initiatives.

What does this paper add? This paper addresses the current gap in the knowledge of disadvantaged communities’ level of readiness to engage in childhood obesity prevention initiatives in Australia. The study also identified the key factors responsible for low readiness of disadvantaged communities to participate in current childhood obesity prevention services. By using the Community Readiness model this study shows the readiness levels specific to the various dimensions of the model; Understanding dimension-specific readiness allows us to identify strategies that are tailored to each dimension, as guided by the model.

What are the implications for practitioners? With the increasing burden of childhood obesity on disadvantaged communities, policymakers and health practitioners are facing a crisis in obesity prevention and management. Almost every year, new interventions are being planned and implemented. However if the target communities are not ready to participate in the available interventions these efforts are futile. This study exposes the key factors responsible for low readiness to participate in current obesity prevention services by disadvantaged communities. Addressing these key factors and improving readiness before designing new interventions will improve the participation of disadvantaged communities in those interventions. The study findings ultimately have the potential of reducing obesity-related disparities in Australia.

Additional keywords: community readiness, disparities, inequalities.


References

[1]  World Health Organization. Obesity and Overweight. Fact sheet No. 311. 2015. Available at: www.who.int/mediacentre/factsheets/fs311/en/ [verified 22 September 2015].

[2]  de Onis M, Blossner M, Borghi E. Global prevalence and trends of overweight and obesity among preschool children. Am J Clin Nutr 2010; 92 1257–64.
Global prevalence and trends of overweight and obesity among preschool children.CrossRef | 1:CAS:528:DC%2BC3cXhsVWgtL7P&md5=9aa5108875c2982ce69dfe8eb2572a9aCAS | 20861173PubMed | open url image1

[3]  Peña M-M, Dixon B, Taveras EM. Are you talking to ME? The importance of ethnicity and culture in childhood obesity prevention and management. Child Obes 2012; 8 23–7.
Are you talking to ME? The importance of ethnicity and culture in childhood obesity prevention and management.CrossRef | 22799474PubMed | open url image1

[4]  Wabitsch M, Moss A, Kromeyer-Hauschild K. Unexpected plateauing of childhood obesity rates in developed countries. BMC Med 2014; 12 17
Unexpected plateauing of childhood obesity rates in developed countries.CrossRef | 24485015PubMed | open url image1

[5]  Hardy L, King L, Espinel P, Okely AD, Bauman A. Methods of the NSW schools physical activity and nutrition survey 2010 (SPANS 2010). J Sci Med Sport 2011; 14 390–6.
Methods of the NSW schools physical activity and nutrition survey 2010 (SPANS 2010).CrossRef | 1:STN:280:DC%2BC3Mjotl2mtA%3D%3D&md5=2603243855ee78374c8006337821b05eCAS | 21454126PubMed | open url image1

[6]  Olds TS, Tomkinson GR, Ferrar KE, Maher CA. Trends in the prevalence of childhood overweight and obesity in Australia between 1985 and 2008. Int J Obes 2010; 34 57–66.
Trends in the prevalence of childhood overweight and obesity in Australia between 1985 and 2008.CrossRef | 1:STN:280:DC%2BC3c%2Fhtl2itw%3D%3D&md5=2155a823f82cf01c82bdf04d80e68852CAS | open url image1

[7]  Australian Bureau of Statistics (ABS). Australian Health Survey: updated results, 2011–2012. ABS cat. no. 4364.0.55.003. Canberra: ABS; 2013.

[8]  Campbell K, Hesketh K, Crawford D, Salmon J, Ball K, McCallum Z. The Infant Feeding Activity and Nutrition Trial (INFANT) an early intervention to prevent childhood obesity: cluster-randomised controlled trial. BMC Public Health 2008; 8 103
The Infant Feeding Activity and Nutrition Trial (INFANT) an early intervention to prevent childhood obesity: cluster-randomised controlled trial.CrossRef | 18373877PubMed | open url image1

[9]  Daniels LA, Magarey A, Battistutta D, Nicholson JM, Farrell A, Davidson G, Cleghorn G. The NOURISH randomised control trial: positive feeding practices and food preferences in early childhood – a primary prevention program for childhood obesity. BMC Public Health 2009; 9 387
| 19825193PubMed | open url image1

[10]  Wen LM, Baur LA, Rissel C, Wardle K, Alperstein G, Simpson JM. Early intervention of multiple home visits to prevent childhood obesity in a disadvantaged population: a home-based randomised controlled trial (Healthy Beginnings Trial). BMC Public Health 2007; 7 76
Early intervention of multiple home visits to prevent childhood obesity in a disadvantaged population: a home-based randomised controlled trial (Healthy Beginnings Trial).CrossRef | 17490492PubMed | open url image1

[11]  Sprague Martinez LS, Freeman E, Perea FC. From engagement to action: assessing community readiness for disparities mobilization. J Health Disparities Res Pract 2012; 5 9 open url image1

[12]  Laveist T. Minority health and populations: an introduction to health disparities in the United States. San Fransisco: Jossey-Bass; 2005.

[13]  Smedley BD, Stith AY, Nelson AR. Committee on Understanding and Eliminating Racial and Ethnic Disparities in Health Care. Unequal treatment: confronting racial and ethnic disparities in health care. Washington, DC: Institute of Medicine of National Academies Press; 2003.

[14]  Edwards RW, Jumper-Thurman P, Plested BA, Oetting ER, Swanson L. Community readiness: research to practice. J Community Psychol 2000; 28 291–307.
Community readiness: research to practice.CrossRef | open url image1

[15]  Findholt N. Application of the community readiness model for childhood obesity prevention. Public Health Nurs 2007; 24 565–70.
Application of the community readiness model for childhood obesity prevention.CrossRef | 17973734PubMed | open url image1

[16]  Plested BA, Edwards RW, Thurman PJ. Disparities in community readiness for HIV/AIDS prevention. Subst Use Misuse 2007; 42 729–39.
Disparities in community readiness for HIV/AIDS prevention.CrossRef | 17558960PubMed | open url image1

[17]  Slater MD, Edwards RW, Plested BA, Thurman PJ, Kelly KJ, Comello MLG, Keefe TJ. Using community readiness key informant assessments in a randomized group prevention trial: impact of a participatory community-media intervention. J Community Health 2005; 30 39–53.
Using community readiness key informant assessments in a randomized group prevention trial: impact of a participatory community-media intervention.CrossRef | 15751598PubMed | open url image1

[18]  Plested BA, Edwards RW, Jumper-Thurman P. The Community Readiness Manual. The National Center for Community Readiness, Colorado State University, Fort Collins, Colorado; 2016.

[19]  Kennedy SB, Johnson K, Harris AO, Lincoln A, Neace W, Collins D. Evaluation of HIV/AIDS prevention resources in Liberia: strategy and implications. AIDS Patient Care STDS 2004; 18 169–80.
Evaluation of HIV/AIDS prevention resources in Liberia: strategy and implications.CrossRef | 15104877PubMed | open url image1

[20]  Brackley M, Davila Y, Thornton J, Leal C, Mudd G, Shafer J, Castillo P, Spears W. Community readiness to prevent intimate partner violence in Bexar County, Texas. J Transcult Nurs 2003; 14 227–36.
Community readiness to prevent intimate partner violence in Bexar County, Texas.CrossRef | 12861925PubMed | open url image1

[21]  Jumper-Thurman P, Plested BA, Edwards RW, Helm HM, Oetting ER. Using the community readiness model in native communities. Cult Compet Series Mono 2001; 9 129–58. open url image1

[22]  Rosas L, Stafford RS. Practical research strategies for reducing social and racial/ethnic disparities in obesity. Int J Obes Suppl 2012; 2 S16–22.
Practical research strategies for reducing social and racial/ethnic disparities in obesity.CrossRef | open url image1

[23]  Sanigorski AM, Bell A, Kremer PJ, Cuttler R, Swinburn BA. Reducing unhealthy weight gain in children through community capacity-building: results of a quasi-experimental intervention program, Be Active Eat Well. Int J Obes 2008; 32 1060–7.
Reducing unhealthy weight gain in children through community capacity-building: results of a quasi-experimental intervention program, Be Active Eat Well.CrossRef | 1:STN:280:DC%2BD1cvksVCqtQ%3D%3D&md5=a38887e5b547295f99ec28b2dfb1c6daCAS | open url image1

[24]  Kesten JM, Cameron N, Griffiths PL. Assessing community readiness for overweight and obesity prevention in pre-adolescent girls: a case study. BMC Public Health 2013; 13 1205
Assessing community readiness for overweight and obesity prevention in pre-adolescent girls: a case study.CrossRef | 24359213PubMed | open url image1

[25]  Millar L, Robertson N, Allender S, Nichols M, Bennett C, Swinburn B. Increasing community capacity and decreasing prevalence of overweight and obesity in a community based intervention among Australian adolescents. Prev Med 2013; 56 379–84.
Increasing community capacity and decreasing prevalence of overweight and obesity in a community based intervention among Australian adolescents.CrossRef | 23485797PubMed | open url image1

[26]  Frerichs L, Brittin J, Robbins R, Steenson S, Stewart C, Fisher C, Huang TT. SaludABLEOmaha: improving readiness to address obesity through healthy lifestyle in a Midwestern Latino community, 2011–2013. Prev Chronic Dis 2015; 12 140328
SaludABLEOmaha: improving readiness to address obesity through healthy lifestyle in a Midwestern Latino community, 2011–2013.CrossRef | open url image1

[27]  Gibbs L, Waters E, Magarey A, Booth M, Gibbons K, Swinburn B. Fun ’n healthy in Moreland! Final report to Victorian Department of Human Services (DHS). Melbourne: DHS; 2011.

[28]  Australian Bureau of Statistics. Census of Population and Housing: Socio-Economic Indexes for Areas (SEIFA). 2011. Available at: http://www.abs.gov.au/ausstats/abs@.nsf/mf/2033.0.55.001 [verified 20 February 2016].

[29]  Australian Bureau of Statistics. Community profiles. 2013. Available at: http://www.abs.gov.au/websitedbs/censushome.nsf/home/communityprofiles [verified 30 October 2015].

[30]  Victorian Department of Health. Victorian Public Health and Wellbeing Plan 2011–2015. Melbourne: Victorian Department of Health; 2011.

[31]  Department of Education and Early Childhood Development. Evaluation of Victorian Maternal and Child Health Service. Melbourne: Department of Education and Early Childhood Development; 2006.

[32]  Plested BA, Jumper-Thurman P, Edwards RW. Community readiness: advancing HIV/AIDS prevention in Native communities (Community Readiness Model Manual, Revised Edition). Fort Collins: Ethnic Studies Department; 2009.

[33]  Kesten JM, Griffiths PL, Cameron N. A critical discussion of the community readiness model using a case study of childhood obesity prevention in England. Health Soc Care Community 2015; 23 262–71.
A critical discussion of the community readiness model using a case study of childhood obesity prevention in England.CrossRef | 25429845PubMed | open url image1

[34]  Green J, Willis K, Hughes E, Small R, Welch N, Gibbs L. Generating best evidence from qualitative research: the role of data analysis. Aust N Z J Public Health 2007; 31 545–50.
Generating best evidence from qualitative research: the role of data analysis.CrossRef | 18081575PubMed | open url image1

[35]  Healthy Together Victoria. In your community. 2011. Available at: http://www.healthytogether.vic.gov.au/incommunity/index. Accessed 02 October 2015.

[36]  VICSEG (Victorian Cooperative on Children’s Services for Ethnic Groups). Evidence into Action: Playgroups for Diverse Communities. 2014. Available at: http://www.vicsegnewfutures.org.au/vicseg-programs/playgroups-in-diverse-communities [verified 09 June 2016].

[37]  Kostadinov I, Daniel M, Stanley L, Gancia A, Cargo M. A systematic review of community readiness tool applications: implications for reporting. Int J Environ Res Public Health 2015; 12 3453–68.
A systematic review of community readiness tool applications: implications for reporting.CrossRef | 25811769PubMed | open url image1

[38]  Millar L, Kremer P, de Silva-Sanigorski A, McCabe M, Mavoa H, Moodie M, Utter J, Bell C, Malakellis M, Mathews L, Roberts G, Robertson N, Swinburn BA. Reduction in overweight and obesity from a 3-year community-based intervention in Australia: the ‘It’s Your Move!’project. Obesity Rev 2011; 12 20–8.
Reduction in overweight and obesity from a 3-year community-based intervention in Australia: the ‘It’s Your Move!’project.CrossRef | open url image1

[39]  Ou L, Chen J, Hillman K. Health services utilisation disparities between English speaking and non-English speaking background Australian infants. BMC Public Health 2010; 10 182
Health services utilisation disparities between English speaking and non-English speaking background Australian infants.CrossRef | 20374663PubMed | open url image1


References

[1]  World Health Organization. Obesity and Overweight. Fact sheet No. 311. 2015. Available at: www.who.int/mediacentre/factsheets/fs311/en/ [verified 22 September 2015].

[2]  de Onis M, Blossner M, Borghi E. Global prevalence and trends of overweight and obesity among preschool children. Am J Clin Nutr 2010; 92 1257–64.
Global prevalence and trends of overweight and obesity among preschool children.CrossRef | 1:CAS:528:DC%2BC3cXhsVWgtL7P&md5=9aa5108875c2982ce69dfe8eb2572a9aCAS | 20861173PubMed | open url image1

[3]  Peña M-M, Dixon B, Taveras EM. Are you talking to ME? The importance of ethnicity and culture in childhood obesity prevention and management. Child Obes 2012; 8 23–7.
Are you talking to ME? The importance of ethnicity and culture in childhood obesity prevention and management.CrossRef | 22799474PubMed | open url image1

[4]  Wabitsch M, Moss A, Kromeyer-Hauschild K. Unexpected plateauing of childhood obesity rates in developed countries. BMC Med 2014; 12 17
Unexpected plateauing of childhood obesity rates in developed countries.CrossRef | 24485015PubMed | open url image1

[5]  Hardy L, King L, Espinel P, Okely AD, Bauman A. Methods of the NSW schools physical activity and nutrition survey 2010 (SPANS 2010). J Sci Med Sport 2011; 14 390–6.
Methods of the NSW schools physical activity and nutrition survey 2010 (SPANS 2010).CrossRef | 1:STN:280:DC%2BC3Mjotl2mtA%3D%3D&md5=2603243855ee78374c8006337821b05eCAS | 21454126PubMed | open url image1

[6]  Olds TS, Tomkinson GR, Ferrar KE, Maher CA. Trends in the prevalence of childhood overweight and obesity in Australia between 1985 and 2008. Int J Obes 2010; 34 57–66.
Trends in the prevalence of childhood overweight and obesity in Australia between 1985 and 2008.CrossRef | 1:STN:280:DC%2BC3c%2Fhtl2itw%3D%3D&md5=2155a823f82cf01c82bdf04d80e68852CAS | open url image1

[7]  Australian Bureau of Statistics (ABS). Australian Health Survey: updated results, 2011–2012. ABS cat. no. 4364.0.55.003. Canberra: ABS; 2013.

[8]  Campbell K, Hesketh K, Crawford D, Salmon J, Ball K, McCallum Z. The Infant Feeding Activity and Nutrition Trial (INFANT) an early intervention to prevent childhood obesity: cluster-randomised controlled trial. BMC Public Health 2008; 8 103
The Infant Feeding Activity and Nutrition Trial (INFANT) an early intervention to prevent childhood obesity: cluster-randomised controlled trial.CrossRef | 18373877PubMed | open url image1

[9]  Daniels LA, Magarey A, Battistutta D, Nicholson JM, Farrell A, Davidson G, Cleghorn G. The NOURISH randomised control trial: positive feeding practices and food preferences in early childhood – a primary prevention program for childhood obesity. BMC Public Health 2009; 9 387
| 19825193PubMed | open url image1

[10]  Wen LM, Baur LA, Rissel C, Wardle K, Alperstein G, Simpson JM. Early intervention of multiple home visits to prevent childhood obesity in a disadvantaged population: a home-based randomised controlled trial (Healthy Beginnings Trial). BMC Public Health 2007; 7 76
Early intervention of multiple home visits to prevent childhood obesity in a disadvantaged population: a home-based randomised controlled trial (Healthy Beginnings Trial).CrossRef | 17490492PubMed | open url image1

[11]  Sprague Martinez LS, Freeman E, Perea FC. From engagement to action: assessing community readiness for disparities mobilization. J Health Disparities Res Pract 2012; 5 9 open url image1

[12]  Laveist T. Minority health and populations: an introduction to health disparities in the United States. San Fransisco: Jossey-Bass; 2005.

[13]  Smedley BD, Stith AY, Nelson AR. Committee on Understanding and Eliminating Racial and Ethnic Disparities in Health Care. Unequal treatment: confronting racial and ethnic disparities in health care. Washington, DC: Institute of Medicine of National Academies Press; 2003.

[14]  Edwards RW, Jumper-Thurman P, Plested BA, Oetting ER, Swanson L. Community readiness: research to practice. J Community Psychol 2000; 28 291–307.
Community readiness: research to practice.CrossRef | open url image1

[15]  Findholt N. Application of the community readiness model for childhood obesity prevention. Public Health Nurs 2007; 24 565–70.
Application of the community readiness model for childhood obesity prevention.CrossRef | 17973734PubMed | open url image1

[16]  Plested BA, Edwards RW, Thurman PJ. Disparities in community readiness for HIV/AIDS prevention. Subst Use Misuse 2007; 42 729–39.
Disparities in community readiness for HIV/AIDS prevention.CrossRef | 17558960PubMed | open url image1

[17]  Slater MD, Edwards RW, Plested BA, Thurman PJ, Kelly KJ, Comello MLG, Keefe TJ. Using community readiness key informant assessments in a randomized group prevention trial: impact of a participatory community-media intervention. J Community Health 2005; 30 39–53.
Using community readiness key informant assessments in a randomized group prevention trial: impact of a participatory community-media intervention.CrossRef | 15751598PubMed | open url image1

[18]  Plested BA, Edwards RW, Jumper-Thurman P. The Community Readiness Manual. The National Center for Community Readiness, Colorado State University, Fort Collins, Colorado; 2016.

[19]  Kennedy SB, Johnson K, Harris AO, Lincoln A, Neace W, Collins D. Evaluation of HIV/AIDS prevention resources in Liberia: strategy and implications. AIDS Patient Care STDS 2004; 18 169–80.
Evaluation of HIV/AIDS prevention resources in Liberia: strategy and implications.CrossRef | 15104877PubMed | open url image1

[20]  Brackley M, Davila Y, Thornton J, Leal C, Mudd G, Shafer J, Castillo P, Spears W. Community readiness to prevent intimate partner violence in Bexar County, Texas. J Transcult Nurs 2003; 14 227–36.
Community readiness to prevent intimate partner violence in Bexar County, Texas.CrossRef | 12861925PubMed | open url image1

[21]  Jumper-Thurman P, Plested BA, Edwards RW, Helm HM, Oetting ER. Using the community readiness model in native communities. Cult Compet Series Mono 2001; 9 129–58. open url image1

[22]  Rosas L, Stafford RS. Practical research strategies for reducing social and racial/ethnic disparities in obesity. Int J Obes Suppl 2012; 2 S16–22.
Practical research strategies for reducing social and racial/ethnic disparities in obesity.CrossRef | open url image1

[23]  Sanigorski AM, Bell A, Kremer PJ, Cuttler R, Swinburn BA. Reducing unhealthy weight gain in children through community capacity-building: results of a quasi-experimental intervention program, Be Active Eat Well. Int J Obes 2008; 32 1060–7.
Reducing unhealthy weight gain in children through community capacity-building: results of a quasi-experimental intervention program, Be Active Eat Well.CrossRef | 1:STN:280:DC%2BD1cvksVCqtQ%3D%3D&md5=a38887e5b547295f99ec28b2dfb1c6daCAS | open url image1

[24]  Kesten JM, Cameron N, Griffiths PL. Assessing community readiness for overweight and obesity prevention in pre-adolescent girls: a case study. BMC Public Health 2013; 13 1205
Assessing community readiness for overweight and obesity prevention in pre-adolescent girls: a case study.CrossRef | 24359213PubMed | open url image1

[25]  Millar L, Robertson N, Allender S, Nichols M, Bennett C, Swinburn B. Increasing community capacity and decreasing prevalence of overweight and obesity in a community based intervention among Australian adolescents. Prev Med 2013; 56 379–84.
Increasing community capacity and decreasing prevalence of overweight and obesity in a community based intervention among Australian adolescents.CrossRef | 23485797PubMed | open url image1

[26]  Frerichs L, Brittin J, Robbins R, Steenson S, Stewart C, Fisher C, Huang TT. SaludABLEOmaha: improving readiness to address obesity through healthy lifestyle in a Midwestern Latino community, 2011–2013. Prev Chronic Dis 2015; 12 140328
SaludABLEOmaha: improving readiness to address obesity through healthy lifestyle in a Midwestern Latino community, 2011–2013.CrossRef | open url image1

[27]  Gibbs L, Waters E, Magarey A, Booth M, Gibbons K, Swinburn B. Fun ’n healthy in Moreland! Final report to Victorian Department of Human Services (DHS). Melbourne: DHS; 2011.

[28]  Australian Bureau of Statistics. Census of Population and Housing: Socio-Economic Indexes for Areas (SEIFA). 2011. Available at: http://www.abs.gov.au/ausstats/abs@.nsf/mf/2033.0.55.001 [verified 20 February 2016].

[29]  Australian Bureau of Statistics. Community profiles. 2013. Available at: http://www.abs.gov.au/websitedbs/censushome.nsf/home/communityprofiles [verified 30 October 2015].

[30]  Victorian Department of Health. Victorian Public Health and Wellbeing Plan 2011–2015. Melbourne: Victorian Department of Health; 2011.

[31]  Department of Education and Early Childhood Development. Evaluation of Victorian Maternal and Child Health Service. Melbourne: Department of Education and Early Childhood Development; 2006.

[32]  Plested BA, Jumper-Thurman P, Edwards RW. Community readiness: advancing HIV/AIDS prevention in Native communities (Community Readiness Model Manual, Revised Edition). Fort Collins: Ethnic Studies Department; 2009.

[33]  Kesten JM, Griffiths PL, Cameron N. A critical discussion of the community readiness model using a case study of childhood obesity prevention in England. Health Soc Care Community 2015; 23 262–71.
A critical discussion of the community readiness model using a case study of childhood obesity prevention in England.CrossRef | 25429845PubMed | open url image1

[34]  Green J, Willis K, Hughes E, Small R, Welch N, Gibbs L. Generating best evidence from qualitative research: the role of data analysis. Aust N Z J Public Health 2007; 31 545–50.
Generating best evidence from qualitative research: the role of data analysis.CrossRef | 18081575PubMed | open url image1

[35]  Healthy Together Victoria. In your community. 2011. Available at: http://www.healthytogether.vic.gov.au/incommunity/index. Accessed 02 October 2015.

[36]  VICSEG (Victorian Cooperative on Children’s Services for Ethnic Groups). Evidence into Action: Playgroups for Diverse Communities. 2014. Available at: http://www.vicsegnewfutures.org.au/vicseg-programs/playgroups-in-diverse-communities [verified 09 June 2016].

[37]  Kostadinov I, Daniel M, Stanley L, Gancia A, Cargo M. A systematic review of community readiness tool applications: implications for reporting. Int J Environ Res Public Health 2015; 12 3453–68.
A systematic review of community readiness tool applications: implications for reporting.CrossRef | 25811769PubMed | open url image1

[38]  Millar L, Kremer P, de Silva-Sanigorski A, McCabe M, Mavoa H, Moodie M, Utter J, Bell C, Malakellis M, Mathews L, Roberts G, Robertson N, Swinburn BA. Reduction in overweight and obesity from a 3-year community-based intervention in Australia: the ‘It’s Your Move!’project. Obesity Rev 2011; 12 20–8.
Reduction in overweight and obesity from a 3-year community-based intervention in Australia: the ‘It’s Your Move!’project.CrossRef | open url image1

[39]  Ou L, Chen J, Hillman K. Health services utilisation disparities between English speaking and non-English speaking background Australian infants. BMC Public Health 2010; 10 182
Health services utilisation disparities between English speaking and non-English speaking background Australian infants.CrossRef | 20374663PubMed | open url image1


References

[1]  World Health Organization. Obesity and Overweight. Fact sheet No. 311. 2015. Available at: www.who.int/mediacentre/factsheets/fs311/en/ [verified 22 September 2015].

[2]  de Onis M, Blossner M, Borghi E. Global prevalence and trends of overweight and obesity among preschool children. Am J Clin Nutr 2010; 92 1257–64.
Global prevalence and trends of overweight and obesity among preschool children.CrossRef | 1:CAS:528:DC%2BC3cXhsVWgtL7P&md5=9aa5108875c2982ce69dfe8eb2572a9aCAS | 20861173PubMed | open url image1

[3]  Peña M-M, Dixon B, Taveras EM. Are you talking to ME? The importance of ethnicity and culture in childhood obesity prevention and management. Child Obes 2012; 8 23–7.
Are you talking to ME? The importance of ethnicity and culture in childhood obesity prevention and management.CrossRef | 22799474PubMed | open url image1

[4]  Wabitsch M, Moss A, Kromeyer-Hauschild K. Unexpected plateauing of childhood obesity rates in developed countries. BMC Med 2014; 12 17
Unexpected plateauing of childhood obesity rates in developed countries.CrossRef | 24485015PubMed | open url image1

[5]  Hardy L, King L, Espinel P, Okely AD, Bauman A. Methods of the NSW schools physical activity and nutrition survey 2010 (SPANS 2010). J Sci Med Sport 2011; 14 390–6.
Methods of the NSW schools physical activity and nutrition survey 2010 (SPANS 2010).CrossRef | 1:STN:280:DC%2BC3Mjotl2mtA%3D%3D&md5=2603243855ee78374c8006337821b05eCAS | 21454126PubMed | open url image1

[6]  Olds TS, Tomkinson GR, Ferrar KE, Maher CA. Trends in the prevalence of childhood overweight and obesity in Australia between 1985 and 2008. Int J Obes 2010; 34 57–66.
Trends in the prevalence of childhood overweight and obesity in Australia between 1985 and 2008.CrossRef | 1:STN:280:DC%2BC3c%2Fhtl2itw%3D%3D&md5=2155a823f82cf01c82bdf04d80e68852CAS | open url image1

[7]  Australian Bureau of Statistics (ABS). Australian Health Survey: updated results, 2011–2012. ABS cat. no. 4364.0.55.003. Canberra: ABS; 2013.

[8]  Campbell K, Hesketh K, Crawford D, Salmon J, Ball K, McCallum Z. The Infant Feeding Activity and Nutrition Trial (INFANT) an early intervention to prevent childhood obesity: cluster-randomised controlled trial. BMC Public Health 2008; 8 103
The Infant Feeding Activity and Nutrition Trial (INFANT) an early intervention to prevent childhood obesity: cluster-randomised controlled trial.CrossRef | 18373877PubMed | open url image1

[9]  Daniels LA, Magarey A, Battistutta D, Nicholson JM, Farrell A, Davidson G, Cleghorn G. The NOURISH randomised control trial: positive feeding practices and food preferences in early childhood – a primary prevention program for childhood obesity. BMC Public Health 2009; 9 387
| 19825193PubMed | open url image1

[10]  Wen LM, Baur LA, Rissel C, Wardle K, Alperstein G, Simpson JM. Early intervention of multiple home visits to prevent childhood obesity in a disadvantaged population: a home-based randomised controlled trial (Healthy Beginnings Trial). BMC Public Health 2007; 7 76
Early intervention of multiple home visits to prevent childhood obesity in a disadvantaged population: a home-based randomised controlled trial (Healthy Beginnings Trial).CrossRef | 17490492PubMed | open url image1

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