The APPLE project: An investigation of the barriers and promoters of healthy eating and physical activity in New Zealand children aged 5-12 years

Abstract

Objective To use the Analysis Grid for Environments Linked to Obesity (ANGELO) framework to determine the barriers and promoters of healthy eating and physical activity in children aged 5-12 years, as a basis for the development of a pilot community-based programme for preventing obesity in children (APPLE project: A Pilot Programme for Lifestyle and Exercise).

Methods Semi-structured interviews were held with nine community stakeholders including doctors, school staff and food outlet operators. This information was used to develop a telephone-administered questionnaire to 101 parents of children in the intervention communities. Finally, structured interviews were undertaken with intervention school principals (n=4) regarding the school environment pertaining to physical activity and healthy eating.

Results Major barriers to physical activity identified included lack of facilities, coaches and equipment. Work commitments prevented 40 per cent of parents being physically active with their children. Shared transport would increase opportunities for activity. Socio-cultural influences included family support for sport, lack of initiative to instigate activities and preference for more sedentary options; 70 per cent of parents thought their child preferred TV or computers over sport/games. Cost prevented one-third of children being involved in activity and 45 per cent of parents buying healthier foods. Political barriers to healthy eating included the absence of parental rules regarding purchasing less healthy food options, using treat foods to coerce children to behave and the lack of fruit and vegetable advertising. Over two-thirds of parents thought banning particular foods would have a positive effect on eating habits. One third of parents said their children didn’t like healthy foods and 25 per cent thought it did not matter what their child ate as long as they were growing properly.

Conclusions The ANGELO framework used in this assessment identified potential environmental barriers to healthy eating and physical activity in children and provides the basis for an obesity prevention programme in youngsters aged 5-12 years.