Healthy Food Environments in Early Learning Services: An Analysis of Manager Survey Responses, Menus and Policies in Regional New Zealand Early Childhood Education and Care Centres.
Citation: McKelvie-Sebileau P, D’Souza E, Tipene-Leach D, Swinburn B, Gerritsen S. Healthy Food Environments in Early Learning Services: An Analysis of Manager Survey Responses, Menus and Policies in Regional New Zealand Early Childhood Education and Care Centres. International Journal of Environmental Research and Public Health. 2022;19(8):4709.
Abstract: Healthy food environments in early childhood play an important role in establishing health-promoting nutritional behaviours for later life. We surveyed Early Learning Services (ELS) in the Hawke’s Bay region of New Zealand and describe common barriers and facilitators to providing a healthy food environment, through descriptive survey analysis and thematic analysis of open ended questions.
We used a policy analysis tool to assess the strength and comprehensiveness of the individual centre’s nutrition policies and we report on the healthiness of menus provided daily in the centres. Sixty-two centres participated and 96.7% had policies on nutrition compared to 86.7% with policies on drinks. Of the 14 full policies provided for analysis, identified strengths were providing timelines for review and encouraging role modelling by teachers.
The main weaknesses were communication with parents and staff, lack of nutrition training for staff and absence of policies for special occasion and fundraising food. With regard to practices in the ELS, food for celebrations was more likely to be healthy when provided by the centre rather than brought from home. Food used in fundraising was more likely to be unhealthy than healthy, though <20% of centres reported using food in fundraising. Only 40% of menus analysed met the national guidelines by not including any ‘red’ (unhealthy) items. Centre Managers considered the biggest barriers to improving food environments to be a lack of parental support and concerns about food-related choking. These results highlight the need for future focus in three areas: policies for water and milk-only, celebration and fundraising food; increased nutrition-focused professional learning and development for teachers; and communication between the centre and parents, as a crucial pathway to improved nutrition for children attending NZ early childhood education and care centres.
Applying the complementary knowledge bases of System Dynamics and Indigenous knowledge in public health research in Aotearoa, New Zealand
Citation: McKelvie-Sebileau, P., Pekepo, C., Rees, D., Swinburn, B., Gerritsen, S., & Tipene-Leach, D. (2022). Applying the complementary knowledge bases of System Dynamics and Indigenous knowledge in public health research in Aotearoa, New Zealand. AlterNative: An International Journal of Indigenous Peoples, 18(4), 576–585.
Abstract: Systems Thinking is increasingly applied to address complex societal and public health issues in Aotearoa, New Zealand and has been proposed as a good fit with traditional wisdom and Mātauranga Māori (Indigenous knowledge) from Aotearoa, New Zealand.
In this article, we delve into the theoretical underpinnings of Systems Thinking approaches used in Community-Based System Dynamics research and find parallels with Indigenous narratives and knowledge.
The synergy created by combining these two knowledge systems and practices is proposed as an effective way to approach public health issues that emerge from complex adaptive systems, particularly in communities with large numbers of Indigenous peoples. Examples are given from an initiative to engage community to improve food security and nutrition in regional Aotearoa, New Zealand.
Nourishing Hawke’s Bay: He wairua tō te kai –food security, health behaviours and wellbeing in children in regional New Zealand
Citation: McKelvie-Sebileau P, Gerritsen S, Swinburn B, D’Souza E, Tipene-Leach D. Nourishing Hawke’s Bay: He wairua tō te kai – food security and wellbeing in children in regional New Zealand. Journal of the Royal Society of New Zealand. 2022;52(4):357-75.
Abstract: Our current food system is failing to deliver on equitable health outcomes, wellbeing and food security and the Hawke’s Bay region of New Zealand has high inequities and one the highest levels of childhood obesity nationally.
This article reports baseline quantitative data from 2087 students (aged 9 or 13) from 41 primary and secondary schools, including schools participating in the Ka Ora, Ka Ako Healthy School Lunch programme. Students answered an online survey covering food security, general wellbeing (WHO-5), eating behaviours and physical activity and were measured/weighed for body size.
16.8% of students experienced food insufficiency in the home and 31.3% of 13-yr olds did not eat breakfast. Overall, only 12.9% met the national vegetable intake guidelines and 39.6% met fruit intake guidelines. Students in high advantage schools (decile 8–10) were twice as likely to meet the vegetable intake guidelines. 47.1% of 13-year old girls were at risk of reduced wellbeing. 54.6% of students had a healthy weight and 44.5% experienced overweight or obesity; in low advantage (decile 1–3) schools 64.4% experienced overweight or obesity. The data form a baseline for an evaluation of multiple public health initiatives underway in Hawke’s Bay to improve food environments and nutritional wellbeing.
Community co-design of regional actions for children’s nutritional health combining Indigenous knowledge and systems thinking.
Citation: McKelvie-Sebileau P, Rees D, Tipene-Leach D, D’Souza E, Swinburn B, Gerritsen S. Community co-design of regional actions for children’s nutritional health combining Indigenous knowledge and systems thinking. International Journal of Environmental Research and Public Health. 2022;19(9):4936
Abstract: Children’s nutrition is highly influenced by community-level deprivation and socioeconomic inequalities and the health outcomes associated, such as childhood obesity, continue to widen. Systems Thinking using community-based system dynamics (CBSD) approaches can build community capacity, develop new knowledge and increase commitments to health improvement at the community level.
We applied the formal structure and resources of a Group Model Building (GMB) approach, embedded within an Indigenous worldview to engage a high deprivation, high Indigenous population regional community in New Zealand to improve children’s nutrition. Three GMB workshops were held and the youth and adult participants created two systems map of the drivers and feedback loops of poor nutrition in the community. Māori Indigenous knowledge (mātauranga) and approaches (tikanga) were prioritized to ensure cultural safety of participants and to encourage identification of interventions that take into account social and cultural environmental factors.
While the adult-constructed map focused more on the influence of societal factors such as cost of housing, financial literacy in communities, and social security, the youth-constructed map placed more emphasis on individual-environment factors such as the influence of marketing by the fast-food industry and mental wellbeing. Ten prioritized community-proposed interventions such as increasing cultural connections in schools, are presented with the feasibility and likely impact for change of each intervention rated by community leaders. The combination of community-based system dynamics methods of group model building and a mātauranga Māori worldview is a novel Indigenous systems approach that engages participants and highlights cultural and family issues in the systems maps, acknowledging the ongoing impact of historical colonization in our communities.
Combining Cognitive Mapping and indigenous knowledge to improve food environments in regional New Zealand.
Citation: McKelvie-Sebileau P, Rees D, Swinburn B, Gerritsen S, D’Souza E, Tipene-Leach D. Combining Cognitive Mapping and indigenous knowledge to improve food environments in regional New Zealand. Health Promotion Journal of Australia: Official Journal of Australian Association of Health Promotion Professionals. 2021.
Abstract: Issue addressed: Hawke’s Bay has one of the highest rates of childhood obesity in New Zealand. While several initiatives exist aiming to decrease obesity through physical activity, there are few nutritional interventions. This study adopted a systems science and mātauranga Māori approach to identify and target underlying drivers of rising childhood obesity and engage the community to improve the food environment.
Methods: Cognitive mapping interviews (CM) with local stakeholders (school principals, Iwi and district health board representatives, education managers and local councillors) were conducted. The aim was to map participants’ mental models of the causes of rising childhood obesity and to identify key principles for engaging with the local community in a meaningful, impactful and culturally appropriate way for future action.
Results: Eleven interviews were conducted face-to-face and cognitive maps were constructed. Follow-up interviews were carried out online, due to COVID restrictions, to present the maps and for interviewees to make any adjustments. Four composite themes emerged through centrality and cluster analysis of the resulting cognitive maps: the importance of building in mātauranga Māori (Māori knowledge and ways of being), the “hauora” of children, working with the community and integrating existing initiatives. Two contextual factors are also considered: the growing need for food security in our communities and the opportunity to start interventions in the school setting.
Conclusion: Cognitive mapping can produce useful insights in the early stages of community engagement. The six “pou” (pillars) underscore the importance of incorporating indigenous knowledge when embarking on public health interventions, particularly around obesity and in regional communities.
Citation: Tipene-Leach D, McKelvie-Sebileau P. The impact of the covid-19 level 4 lockdown on food security among whānau of decile 1 schools. MAI Journal. 2021:17-20.
Abstract: Interviews with stakeholders in deprived Hawke’s Bay schools early in the COVID-19 lockdown documented exacerbated food insecurity among school whänau.
Our enquiry highlights the support role played by well-informed teacher aides and school–whänau networks, which were easily and inexpensively resourced, intuitive, proactive and collaborative, ensuring whänau access to appropriate support according to need. We expect our findings to further inform such initiatives in any further lockdown. Additionally, we posit that such school-based operations could become the nexus of a primary food-security hub, alongside the Lunches in Schools programme, working in a tailor-made fashion bespoke to whänau without a charity or welfare label.
Given the recent well-resourced COVID-19- related investment into the business world and the ongoing lack of progress in the reduction of child poverty, in the post-COVID-19-lockdown environment, simple structural rearrangements for the chronically food insecure are likely to become politically acceptable to the nation.
Whiriwhiria, kia ora ai te tamaiti: An exploration of mātauranga Māori to support day-to-day learning in five primary schools in regional New Zealand.
Citation: Glassey R., Swinburn B., Makirere Haerewa R., McKelvie-Sebileau P., Chote, B., Tipene-Leach D. ‘Whiriwhiria, kia ora ai te tamaiti’: An exploration of mātauranga Māori to support day-to-day learning in five primary schools in regional New Zealand. AlterNative, 2023
Abstract: This study explores how a purposively selected sample of mainstream primary schools in regional New Zealand incorporate mātauranga Māori (traditional Māori (Indigenous people of New Zealand) knowledge) into school life to support successful learning. Qualitative semi-structured interviews with five principals of low advantage schools with high Māori student populations identified six themes focused on creating a curriculum built around Te Ao Māori (Māori worldview). They were mainstream curriculum not fit for purpose for Māori learners, blending of mātauranga Māori and western knowledge, mātauranga Māori as learning and educational experiences, mātauranga ā-iwi (local Māori knowledge) and achievement fit for tamariki (children). Mātauranga Māori is incorporated into these schools’ environment to support learning, but the mainstream curriculum can be a challenge for schools wishing to promote Māori ways of being. Some schools, however, supported a He Awa Whiria (braided rivers) approach to education, the interweaving of both western practices and mātauranga Māori.
Citation: Pippa McKelvie-Sebileau, Boyd Swinburn, Rachael Glassey, David Tipene-Leach, Sarah Gerritsen
Health Promotion International, Volume 38, Issue 4, August 2023, daad093
Abstract: In 2020, a government-funded healthy school lunch program was introduced in a quarter of New Zealand schools, selected due to high levels of socio-economic barriers. This study assesses the impact of the introduction of the school lunch program from family (whānau), student and school principal perspectives. Across four schools, we conducted five focus groups (two with secondary students and three with family members) and four school principal interviews. Participating schools represented a range of contexts: primary and secondary, schools with cooks in on-site kitchens and schools receiving meals delivered by external caterers. Thematic analysis was used to develop themes describing the health, wellbeing and nutritional impact of the program. Family participants were 82% Indigenous Māori and self-identified as having ‘borderline’ (73.5%) or no financial security (8.8%). Seven positive impact themes were identified: improved food security, enhanced equity, increased appreciation of healthy foods for students, enhanced mana (wellbeing) for all, reduced financial hardship/stress for families, opportunities for nutritional learning and recognition that appreciation and uptake happen over time. Four negative impact themes were identified: low uptake that created food waste, perception that healthy food is not palatable for students, lack of knowledge of the program and loss of agency for students. This is the largest intervention in nutrition and food security for children implemented in New Zealand since the 1930’s. The first 2 years have offered wellbeing and financial benefits for students and families, particularly when school environments promote uptake. More involvement of students and family members in the program planning is essential.
Mātauranga Māori and Kai in Schools: An Exploration of Traditional Māori Knowledge and Food in Five Primary Schools in Regional New Zealand
Citation: Glassey, R., Swinburn, B., Haerewa, R.M. et al. Mātauranga Māori and Kai in Schools: An Exploration of Traditional Māori Knowledge and Food in Five Primary Schools in Regional New Zealand. Food ethics 8, 17 (2023). https://doi.org/10.1007/s41055-023-00127-5
Abstract: Māori (Indigenous people of New Zealand (NZ)) suffer food insecurity disproportionately in New Zealand. Some research suggests that Māori value mātauranga Māori (traditional Māori knowledge) when it comes to the collection, preparation and eating of kai (food). This study explores the connections between mātauranga Māori and kai in regional NZ schools for potential pathways to impact food security for children. Semi-structured interviews were undertaken with five primary school principals in the Hawke’s Bay region. Principals were purposively selected on commitments to proactively incorporating mātauranga Māori into their school environment. Reflective thematic analysis was used to analyse the data. Three main themes were identified: teaching and learning around mātauranga Māori and kai; environmental sustainability and the sustainability of kai initiatives; and school values. A strong emphasis was placed on the learning of traditional Māori values around kai and the whenua (land) and the sustainability of teaching programs. School values were invariably bound in Te Ao Māori (a Māori worldview) however, schools felt challenged in aligning their values and their mātauranga Māori-bound teaching practices with the current food provision programme in their schools (Ka Ora, Ka Ako). The programme’s strict nutritional guidelines appeared to challenge traditional Māori approaches to kai. Schools remain an ideal environment for the incorporation of mātauranga Māori to support food security and food education, and future work should explore a demonstration project that incorporates the knowledge gained in this study and ways to integrate mātauranga Māori into Ka Ora, Ka Ako.
Not Just a Free Lunch a logic model and evidence review for the Ka Ora, Ka Ako | Healthy School Lunch programme
Citation: Garton K, Riddell C, McKelvie-Sebileau P, Glassey R, Tipene-Leach D, Rees D, Swinburn B. Not just a free lunch: a logic model and evidence review for the Ka Ora, Ka Ako | Healthy School Lunch programme. Policy Quarterly, 2023;19(2):75-87.
Abstract: Ka Ora, Ka Ako provides free, healthy lunches for 220,000 learners in low-equity New Zealand schools. Costing over $260 million annually, it represents the largest government investment in child nutrition in generations. Early evaluations indicate success in achieving programme aims of delivering nutritious food, improving learners’ wellbeing, and easing financial stress for families. However, international evidence and emerging local data indicate the programme can achieve the above and more. This article presents a programme logic model drawing on local data and a review of relevant international literature on universal school food provision with the aim of identifying potential long-term outcomes and impacts at multiple levels: for learners, whānau, schools, communities, and food systems.
Findings indicate that the Ka Ora, Ka Ako programme has the potential to:
• improve children’s nutrition and educational outcomes, as well as improve child and whānau food security;
• enrich school learning environments;
• boost local economies (through creation of jobs paying a living wage) and enhance local foodscapes (including availability and affordability of healthy foods) through food system engagement in schools, with whänau and communities; and
• increase food system resilience (e.g., shorter supply chains and relationship building), and encourage broader food system transformation (e.g., reformulation, waste and packaging solutions) with leverage from new procurement models.
While Ka Ora, Ka Ako can contribute to these pathways, some implementation areas within the programme demand further attention to achieve optimal results. Recognised areas for improvement include ensuring high quality of food, providing more avenues for engagement from children and parents, addressing perceived challenges to integrate Ka Ora, Ka Ako effectively with mātauranga Māori, and improving waste management. Given the high potential for Ka Ora, Ka Ako to contribute to multiple beneficial outcomes, continued investment and expansion of the programme is warranted.
Systems Mapping of the New Zealand Free and Healthy School Lunch Programme: Perspectives from Lunch Providers.
Citation: Chote B, Rees D, Swinburn B, McKelvie-Sebileau P, Glassey R, Tipene-Leach D. Systems Mapping of the New Zealand Free and Healthy School Lunch Programme: Perspectives from Lunch Providers. Nutrients. 2022;14(20):4336.
Abstract: As part of the COVID-19 economic recovery package, the Aotearoa New Zealand Government rolled out a universal free and healthy lunch programme to the 25% least advantaged schools nationwide. This study explored experiences of school lunch providers in the Hawke’s Bay region.
The aim was to create a systems map identifying points of intervention through which the lunch programme could be improved to meet the goal of reducing child food insecurity.
Twelve lunch providers were interviewed to generate casual loop diagrams which were examined and integrated to form a single systems map. Seven themes arose during analysis: teacher support, principal support, nutrition guidelines and government support, supply chain, ingredient suppliers, student feedback and food waste.
Teacher support was important for getting students to try new foods and eat the nutritious lunches. Principal support was a strong theme impacting opportunities for broader student engagement. This study employed systems science to highlight the importance of support from different stakeholders within the lunch programme to achieve the goal of reduced child food insecurity. Further work is needed to ensure the programme meets the wider goals of the government and community, and to determine the potential broader benefits of the programme.
Culture of Healthy Eating and Food Environments, Policies, and Practices in Regional New Zealand Schools.
Citation: Chote B, McKelvie-Sebileau P, Swinburn B, Tipene-Leach D, D’Souza E. Culture of Healthy Eating and Food Environments, Policies, and Practices in Regional New Zealand Schools. International Journal of Environmental Research and Public Health. 2022;19(11):6729.
Abstract: The school food environment plays an important role in shaping students’ dietary choices, which often influence future dietary behaviours. We surveyed primary and secondary schools in Hawke’s Bay, New Zealand, to measure the comprehensiveness and strength of food policies, describe the culture of food provision, and identify barriers to improving school food environments.
Fifty-one schools were included in the final analysis, with 58.8% having a food policy, most of which used a generic template. Schools with food policies and those participating in the free and healthy lunch programme were more likely to have a strong culture around healthy eating. Common barriers to healthy eating were food outlets near school and resistance from students. Secondary schools reported facing more barriers to implementing healthy eating cultures, were more likely to use food as classroom rewards and to sell food to students, most of which was unhealthy.
Hawke’s Bay schools participating in food provision programmes are successfully improving their food environments through improved culture and delivery of healthy food; however, more action is needed to strengthen the wording and guidance in food policies and reduce the provision of unhealthy food in schools before effective change can be achieved.