Part 2 Strategic management
Initiative no. 1: Steering the implementation of EWA and NATSINSAP
1 Develop priorities for implementing EWA;
2 Establish dedicated strategic management team with support of lead and other partners or other mechanism;
3 Establish an Aboriginal and Torres Strait Islander Steering Committee or other mechanism;
4 Address NATSINSAP ‘first phase’ priorities;
5 Establish formal mechanisms to consult with food industry and NGO representative bodies;
6 Establish working relationships with government departments responsible for agriculture, transport, community services and environment;
7 Establish working relationships with national peak bodies responsible for regulation and policy development;
8 Establish a partnership development process within and across initiatives.
Initiative no. 2: Developing nutrition policy
1 Identify policy issues for review or development;
2 NHMRC establishes a standing committee on nutrition;
3 Relevant government health agencies clarify the roles and responsibilities of each agency in relation to policy development and deliver consistent and timely health policy advice to governments;
4 ANZFA to develop a policy on the effects of regulatory changes on public health nutrition;
5 DHAC/NHMRC reviews and revises the Dietary guidelines and Recommended Dietary Intakes as needed.
Initiative no. 3: Establishing criteria for resource allocation
1 Review and expand work on ‘attributable risk’;
2 Identify and apply a range of economic measures, such as burden of disease, capacity to benefit, and Program Budgeting Marginal Analyses to planning EWA initiatives;
3 Through the Public Health Evidence Base Advisory Mechanism, investigate opportunities for assessing public health nutrition/physical activity interventions and initiatives;
4 Pilot the Public Health Planning and Practice Framework on vegetables and fruit initiatives, and further refine the methodology for other fields;
5 Disseminate the Public Health Planning and Practice Framework to public health nutrition practitioners;
6 Explore potential applications of economic modeling to Indigenous health.
Initiative no. 4: Managing partnerships
1 Review current materials and best practices in partnerships, and develop national protocols, guidelines and resources accordingly;
2 Promote the use of guidelines and resources in tertiary public health nutrition education, continuing education and professional development;
3 Disseminate partnership models and protocols to stakeholders at all levels;
4 Investigate the feasibility of developing a national nutrition promotion group to promote effective management of partnerships across sectors;
5 Disseminate partnership protocols to state and local stakeholders and public health nutrition workforce;
6 Use Framework Agreements to progress Indigenous nutrition related health measures.
Part 3 EWA Health gain initiatives
Initiative no. 1: Promoting organizational change in services
1 Review the range of existing services, identify where services impact on food and nutrition and recommend what organizational changes and training are needed to improve food and nutrition;
2 Encourage the development of partnerships at a local level to increase the nutrition capacity of welfare organizations;
3 Identify and disseminate resources and models of effective food and nutrition initiatives for vulnerable groups (such as FOOD Cent$ Program) across jurisdictions and sectors;
4 Set up a nutrition information service for welfare providers;
5 Develop nutrition guidelines for agencies that provide meal services for vulnerable groups and recommend ways to ensure they are adopted;
6 Provide expert advice on nutrition training needs to the community services training and education sector as opportunities arise.
Initiative no. 2: Influencing broad social policy
1 Account of nutrition issues in public health responses to vulnerable people;
2 Conduct feasibility studies into the potential impact of relevant non-health government policies, e.g, tax or pensions or other economic instruments, on consumption of foods that meet dietary guidelines;
3 Identify research needs around the nutritional impact of poverty and other disadvantage;
4 Develop policy positions based on the feasibility and research studies;
5 Consider policy modifications as a result of studies.
Initiative no. 3: Addressing structural barriers to safe and healthy food
1 Commission studies into non-policy based structural barriers and promoters that impact on the consumption of healthy foods by at risk groups;
2 Develop policy positions based on the feasibility and research studies’ results;
3 Bipartisan government supports for government and non-government initiatives that address structural barriers to food access;
4 Identify actions that retailers, food manufacturers and private transport can take;
5 Recognize retail, transport and food manufacturers who change their practices toward increasing the availability of affordable and nutritionally desirable food;
6 Develop and implement a remote food subsidies program in collaboration with non-health government agencies and the private sector;
7 Improve access to healthy food including traditional foods for Indigenous Australians;
8 Review and disseminate evidence to practitioners on the role of local government food policies in addressing local structural barriers and promoters which impact on the consumption of healthy food.
Promoting healthy weight
Initiative no. 1: Promoting healthy weight
1 Strategic research on issues relating to overweight and obesity;
2 Develop guidelines for the prevention, management and treatment of obesity in clinical settings and for community-based programs;
3 Develop a strategy to reduce the prevalence of childhood obesity;
4 Develop systems and tools to monitor overweight and obesity, particularly for children;
5 Design and develop model multi-strategy regional or population level interventions to guide national policy and planning on overweight and obesity;
6 Increase awareness of the health impact of overweight and obesity.
Vegetables and fruit
Initiative no. 1: Undertaking vegetables and fruit promotions
1 Establish long-term national and state-based partnerships with industry, vegetables and fruit peak groups, non-government and sector partners;
2 Parameters of social marketing and promotional programs defined by social marketing research as outlined in the National Vegetables and Fruit Action Plan;
3 Disseminate best practice models across jurisdictions, including seed funding of local initiatives;
4 Address issues of supply to remote communities;
5 Develop guidelines (recommended intake, messages) for the promotion of vegetables and fruit;
6 Public health nutrition professionals build partnerships with the community to develop local solutions and programs that support promotional campaigns.
Initiative no. 2: Addressing underlying structural factors which influence vegetables and fruit consumption
1 Research the potential impact of non-health government policies, for example tax or pensions, or of other economic instruments, on the consumption of vegetables and fruit;
2 Commission studies into non-policy based structural barriers and promoters which impact on consumption of vegetables and fruit;
3 Develop policy positions based on research results;
4 Review and disseminate evidence to practitioners on role of local government food policies in addressing local structural barriers and promoters;
5 Public health nutrition professionals build partnerships with the community to develop local solutions and programs address barriers to safe and healthy food.
Initiative no. 3: Enhancing research
1 Provide resources for systematic evaluation of campaigns;
2 Fund health promotion researchers to test interventions;
3 Disseminate research results and base funding decisions for future interventions on research;
4 Reach consensus on development of tools to assess intake of vegetables and fruit and assess quality.
Maternal and child health
Initiative no. 1: Improving nutrition for pregnant and lactating women Proposed actions
1 Report on the incidence, trends and distribution of birth weight;
2 Fund studies to document circumstances where inadequate diets are likely to contribute to the incidence of low birth weight, high birth weight and iron deficiency;
3 Develop criteria for assessing dietary interventions or programs for pregnant and lactating women at risk; identify programs for evaluation; and recommend further program development based on reviews and other new information;
4 Disseminate effective community-based programs to appropriate local health organizations and service deliverers;
5 Develop and evaluate Indigenous access and participation in antenatal and postnatal care programs;
6 Review folate fortification program and other national and international approaches to increasing folate awareness;
7 Investigate the need for dietary guidelines for pregnant and lactating women;
8 Assess the links between adult health and maternal nutrition, disseminate results and recommend further research.
Initiative no. 2: Promoting breastfeeding and improving infant nutrition
1 Evaluate and expand effective National Breastfeeding Strategy activities;
2 Review policies and practices that influence breastfeeding decisions and make practices/policies more supportive;
3 Review progress and identify ways to accelerate the uptake of the Baby-friendly Hospital initiative in all maternity hospitals;
4 Review the current status of Australia’s implementation of the WHO Code of Marketing of breast-milk substitutes;
5 Reach consensus on standard methods for measuring duration and initiation rates of breastfeeding;
6 Review and recommend growth standards for use in assessment of breastfed babies;
7 Review previous strategies (across sectors) for disseminating information on nutrition, first foods, social aspects and active lifestyles for children in early life to parents and other caregivers and recommend future directions.
Initiative no. 3: Improving nutrition for children
1 Develop criteria, identify best practice programs/materials across a range of settings, issues and age groups, disseminate these programs;
2 Review research on food advertising and adequacy of TV Advertising Code for Children and recommend future directions;
3 Review food supply strategies for school canteens and identify appropriate national approaches, funding mechanisms and structures;
4 Review recommendation by state groups on preventing eating disorders and distorted body image, and fund pilot initiatives;
5 Identify specific groups in the community whose children are at high risk and fund research and programs to address the problem.
Part 4 EWA Capacity-building initiatives
Research and development
Initiative no. 1: Investing in public health nutrition research
1 Fund research to support the implementation of EWA including: identifying and setting priorities, funding key aspects of scientific and applied research relevant to EWA, developing practice based guidelines and building the capacity of government health departments in critical appraisal and evidence based approaches;
2 Conduct trials of national significance of practice guidelines and intervention programs;
3 Commission reviews of existing evidence to inform EWA nutrition promotion priorities;
4 Review range of research funding available (including overseas funding) and disseminate to researchers, practitioners and community health organizations;
5 Develop the research skills of public health nutrition workforce. Scholarships and fellowships related to the nutrition research should be evaluated, and if assessed as worthwhile, encouraged and expanded.
Initiative no. 2: Disseminating research evidence
1 Develop formal links between researchers and practitioners on an as needs basis;
2 Support biennial conferences to report progress and results of public health nutrition research and EWA initiatives;
3 Undertake reviews of evidence relating to priority initiatives and establish a process for conducting the reviews, types of evidence required and criteria for appraising evidence and setting priorities;
4 Use the reviews of evidence as a basis to develop good practice guidelines for EWA interventions;
5 Publicise completed reviews and other research such as successful intervention models and guides for best practice through established state/territory, professional and organizational networks, conferences, newsletters and by posting on SIGNAL/ NPHP website;
6 Develop policy for formal links between state-based nutrition networks and public health nutrition research consortia, eg practitioner representatives on consortia steering committees;
7 Encourage the inclusion of dissemination strategies as part of research, including progress reports and to community/Indigenous health organizations.
Initiative no. 3: Promoting private sector investment in research
1 Develop protocols for conducting joint research in consultation with stakeholders and linked to Partnership agreements;
2 Investigate the feasibility of a national foundation for nutrition which has public and private funding;
3 Establish joint research topics/areas of interests between governments, industry groups and peak NGOs;
4 Establish protocols for conducting joint research between governments, industry, NGOs and NHMRC.
Initiative no. 4: Promoting innovation
1 Undertake a scan of national and international research and practice development and disseminate results;
3 Investigate the feasibility of funding a grants program for innovative research and practice development;
4 Create and promote a national award system for innovation in public health nutrition;
5 Disseminate new successful innovative practice to public health nutrition workforce using formal networks.
Initiative no. 1: Building human resource requirements
1 Fund a needs assessment to investigate the workforce requirements and structural relationships necessary to deliver EWA initiatives and state/territory food and nutrition policies in light of current funding arrangements, workforce capacity and composition;
2 Fund adequate human resources to implement EWA initiatives;
3 Review, restructure and resource workforce infrastructure according to recommendations of needs assessment;
4 Include public health nutrition (including community level) training as part of a new monitoring system of public health workforce needs;
5 Offer training packages tied to implementation of EWA initiatives and core competency initiatives;
6 Examine outcomes of Public Health Education Research Program (PHERP) in relation to public health nutrition workforce.
Initiative no. 2: Expand and extend tertiary education
1 Conduct an annual survey of available courses, course content and disseminates on website/newsletter;
2 Review professional and tertiary studies which document levels and scope of current tertiary education of workforce as part of needs analysis of workforce requirements;
3 Identify the demand for different kinds/ modules of education;
4 Provide more PHERP funding to enhance tertiary training in public health nutrition, using a national approach;
5 Expand and extend flexible learning specialist public health nutrition courses and public health courses;
6 Further integrate effective public health nutrition approaches into existing general public health coursework;
7 Investigate the value of introducing a system of public health nutrition competencies;
8 Develop an implementation and action plan for introducing public health nutrition competencies, if warranted.
Initiative no. 3: Training primary health care professionals
1 Undertake training needs analysis for primary health care professionals when nutrition promotion action plans are being developed;
2 Develop training modules/strategies for nutrition;
3 Develop and disseminate best practice guidelines for training primary health care professionals;
4 Fund and evaluate general practice programs, which focus on EWA priorities.
Initiative no. 4: Training the non-health workforce
1 Undertake needs assessment/s of key non-health sector workforce (including food industry) which reviews current levels of involvement in public health nutrition activities and determine training needs for each health gain initiative as implemented;
2 Professional and food and other industry associations and NGOs to develop a nutrition component to on-the-job training and resource materials;
3 Audit and review nutrition course work and competencies across workforces relevant to EWA;
4 Tertiary training institutes to develop and offer short courses on EWA initiatives to food industry staff as needed;
5 Develop and provide accessible training packages for community and consumer groups such as sporting clubs.
Initiative no. 1: Disseminating the EWA strategy
1 Undertake a communications strategy;
2 Develop website that provides up-to-date information on initiatives and links to sector partner sites suitable for both professionals and the general public;
3 Facilitate a biennial national conference to report on the progress of initiatives and encourage presentations at other national forums;
4 Disseminate EWA and NATSINSAP through established professional and organizational networks and consultative groups;
5 Report regularly through NPHP channels to the Australian Health Ministers Advisory Council;
6 Disseminate information on initiatives through state-based public nutrition networks;
7 Sector partners develop
Initiative no. 2: Communicating with the public
1 Disseminate authoritative information on high profile public health nutrition issues;
2 Disseminate government nutrition guidelines and materials through professional networks and public meetings;
3 Ensure website information is consumer-friendly and linked to other credible websites;
4 Develop culturally appropriate resources based on the Australian Guide to Healthy Eating, for large ethnic minorities;
5 Gain agreement on nutrition messages and then develop consumer-friendly messages and resources for programs and general education purposes as needed;
6 Review research into effective delivery of nutrition information, and disseminate results;
7 Review education materials as needed;
8 Develop regulations relating to food in response to new scientific knowledge, particularly in relation to food labeling;
9 Develop a plan for educating the public and health practitioners on matters relating to food regulation, particularly food labeling.
Monitoring and evaluation
Initiative no. 1: A National Food and Nutrition Monitoring System (NFNMS)
1 Resource continuing evaluation of EWA over 3, 6 and 10 years;
2 Identify indicators and data sources for assessing EWA short and long term impacts and other monitoring needs;
3 Make long term plans for a national food and nutrition monitoring and surveillance system;
4 Ensure current and new monitoring and surveillance reports are developed, data is collected as required and of sufficient quality and usability to fit users needs;
5 Consult with different sectors to assess data needs;
6 Disseminate information to policy makers, the research sector, practitioners and other stakeholders as needed and interpret to fit the information needs of the specific user;
7 Maintain an updated Australian food composition database.
Initiative no. 2: Evaluating EWA
1 Develop guidelines for incorporating monitoring and evaluation activities into all initiatives;
2 Partners leading each initiative need to develop suitable evaluation plans agreed to by government health departments and other funding partners;
3 Identify priority areas for review every 3 years and commission reviews to reassess priority status;
4 Commission external evaluation of EWA after 5/6 and 10 years, and NATSINSAP on its schedule, to review overall appropriateness and effectiveness;
5 Report annually to all partners on the progress of implementation and outcomes achieved;
6 Update food and nutrition policies using evidence from EWA evaluations and reviews.