Journal Articles
Permanent URI for this collectionhttps://mro.massey.ac.nz/handle/10179/7915
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Item New Zealand Early Learning Service Menus Do Not Meet Health New Zealand Guidelines for Providing Healthy Menus and Reducing Food-Related Choking in Children(John Wiley and Sons Australia, Ltd on behalf of Australian Health Promotion Association, 2025-01-23) Hall O; Ali A; Wham C; Carmel WObjective To assess alignment of food and drinks served to New Zealand (NZ) children in early learning services (ELS) with the Health NZ (formerly known as Ministry of Health) Healthy Food and Drink (HFD) and Reducing Food Related Choking (choking) guidance. Methods Menus (271) collected remotely from 148 ELS from November 2020–March 2021 were analysed for their nutritional quality based on a ‘traffic light’ classification of ‘green’ (most nutritious), ‘amber’ (moderately nutritious) and ‘red’ (least nutritious) based on the guidance. Results Overall, 2.6% of menus met the guidance, and alignment was greater for menus for over 2-year-olds (over-2s) than under 2-year-olds (under-2s; p < 0.01). One-fifth (18.5%) of menus met the choking guidance. Services with a Healthy Heart Award (HHA) from the Heart Foundation provided more ‘green’ items to over-2s (p = 0.039) and under-2s (p = 0.01), and less ‘red’ items to over-2s (p = 0.04). Providing more green menu items was inversely correlated with providing less high choking risk foods (p < 0.01). Menu scores did not vary by service location, neighbourhood socioeconomic deprivation or type (services operating independently versus those part of an education group chain). Conclusions Alignment with Health NZ nutritional guidance is low, particularly in ELS caring for very young children (under-2s). Service characteristics, except for HHA status, are a poor predictor of nutritional quality of menus at ELS. So What Greater uptake of the HHA scheme could assist ELS to provide healthier food and drinks. Early learning services need further support from the public health sector to implement national nutritional guidelines.Item Evaluating the Accessibility and Inclusiveness of Community Playgrounds in Australia for Children with Disabilities(MDPI (Basel, Switzerland), 2024-12) Glass C; Flemmer C; Frawley P; Cordier RPlay is vital to the wellbeing of children, but playgrounds can be inaccessible to children with disabilities and limit their physical and social participation. This study evaluated the accessibility/inclusivity of twenty-five free-entry playgrounds in two Australian states and investigated whether location, construction age, and regional socioeconomic status affected accessibility/inclusivity. The New South Wales Government’s Everyone Can Play: Playspace Evaluation Checklist was used as the assessment tool with a maximum score of 156 points. Playground scores ranged from 29% to 96% of available points. The average score for destination playgrounds was significantly higher (78.0% ± 16.6%) than that for neighborhood playgrounds (54.5% ± 20.7%). Modern playgrounds generally scored higher than older playgrounds. Regional socioeconomic status did not correlate with playground score. The audit tool inadequately addresses the needs of children with disability, allocating just 24 points (15.4%) to features they need and mostly considering mobility impairment. More inclusive audit tools that capture the needs of a wide range of impairment should be developed. Main areas for improving playground accessibility include wayfinding, layout, signage (including braille, auditory, and pictorial information), and sensory and cognitive play opportunities. These findings are useful for stakeholders involved in the design, provision, and maintenance of community playgrounds.Item Community use of school grounds outside of school hours(Taylor and Francis Group, 2024-07-13) Lin E-Y; Witten K; Carroll P; Parker KPhysical activity in childhood is essential for healthy development and wellbeing and school grounds can provide neighbourhood access to safe play spaces. This study examines the relationship between school demographics (school size, school decile, ethnicity of students and population density) and whether school grounds are open or closed for community use outside school hours. Data were gathered from 391 primary and intermediate schools across Tāmaki Makaurau (Auckland), Aotearoa New Zealand (84% of Auckland schools) with 250 schools participating in the full survey. The results indicate that higher school decile and lower population density are associated with school grounds being available for community use. This result is concerning. With closed school grounds more likely to be in lower socio-economic and higher population density areas, the children most affected are the same group who have fewer opportunities and less spaces for active play. The main reason schools closed their grounds was ‘vandalism /graffiti/theft concerns’. Low decile schools whose grounds were open outside of school hours shared a similar commitment to involve their communities widely in school activities and found doing so decreased the levels of vandalism. Their approach may offer useful insights to schools that are currently closed.Item Who really decides? Feeding decisions 'made' by caregivers of children with cerebral palsy.(AOSIS (Pty) Ltd., 2024-03-18) Naidoo L; Pillay M; Naidoo UBACKGROUND: There are no definitive guidelines for clinical decisions for children with cerebral palsy (CP) requiring enteral feeds. Traditionally, medical doctors made enteral feeding decisions, while patients were essentially treated passively within a paternalistic 'doctor knows best' approach. Although a more collaborative approach to decision-making has been promoted globally as the favoured model among healthcare professionals, little is known about how these decisions are currently made practically. OBJECTIVES: This study aimed to identify the significant individuals, factors and views involved in the enteral feeding decision-making process for caregivers of children with CP within the South African public healthcare sector. METHOD: A single-case research design was used in this qualitative explorative study. Data were collected using semi-structured interviews and analysed using reflexive thematic analysis. RESULTS: Four primary individuals were identified by the caregivers in the decision-making process: doctors, speech therapists, caregivers' families and God. Four factors were identified as extrinsically motivating: (1) physiological factors, (2) nutritional factors, (3) financial factors and (4) environmental factors. Two views were identified as intrinsically motivating: personal beliefs regarding enteral feeding tubes, and feelings of fear and isolation. CONCLUSION: Enteral feeding decision-making within the South African public healthcare sector is currently still dominated by a paternalistic approach, endorsed by a lack of caregiver knowledge, distinct patient-healthcare provider power imbalances and prescriptive multidisciplinary healthcare dialogues.Contribution: This study has implications for clinical practice, curriculum development at higher education training facilities, and institutional policy changes and development, thereby contributing to the current knowledge and clinical gap(s) in the area.Item Knowledge, attitudes and behaviours towards vitamin D and sun exposure of parents of infants and young children and health professionals in New Zealand.(SAGE Publications, 2023-07-02) Von Hurst P; Mazahery H; Reynolds E; Thomson A; Franklin M; Conlon CBACKGROUND: Vitamin D deficiency may result in adverse long-term health consequences in adulthood if it occurs during fetal development, infancy and childhood. To effectively improve vitamin D status of infants/toddlers, there needs to be knowledge and awareness of vitamin D among parents and health professionals. AIMS: The aim of this study was to investigate parents' and health professionals' knowledge, attitudes and behaviours towards vitamin D and sun exposure over two timepoints. METHODS: The study was an ecological study over two timepoints (Parents 2009 and 2021; Health professionals 2010 and 2019) and used an online questionnaire. RESULTS: The analysis included 9834 parents (2009 n = 8032; 2021 n = 1802) and 283 health professionals (2010 n = 193; 2019 n = 90). Parents and health professionals had good knowledge of vitamin D sources, roles and risk factors for deficiency over two timepoints. There were however some confusions regarding the vitamin D content of breast milk, exclusive breastfeeding as a risk factor for deficiency, and ineffectiveness of sun exposure through glass windows in relation to vitamin D synthesis. In 2019, only 37% of health professionals indicated giving advice on supplements for infants/toddlers. Most parents and health professionals believed there was not enough information available to parents regarding vitamin D (>90%) and that skin cancer prevention messages make it difficult to get information about vitamin D across (>70%). CONCLUSION: Although parents and health professionals had good knowledge in most areas, knowledge of some specific sources and risk factors for vitamin D deficiency was poor.Item Moe Kitenga: a qualitative study of perceptions of infant and child sleep practices among Māori whānau(SAGE Publications, 2020-06-21) George M; Theodore R; Richards R; Galland B; Taylor R; Matahaere M; Te Morenga LInsufficient sleep is a strong risk factor for unhealthy weight gain in children. Māori (the indigenous population of Aotearoa (New Zealand)) children have an increased risk of unhealthy weight gain compared to New Zealand European children. Interventions around sleep could provide an avenue for improving health and limiting excessive weight gain with other meaningful benefits for whānau (extended family) well-being. However, current messages promoting good sleep may not be realistic for many Māori whānau. Using qualitative methods, the Moe Kitenga project explored the diverse realities of sleep in 14 Māori whānau. We conclude that for infant sleep interventions to prevent obesity and improve health outcomes for Māori children, they must take into account the often pressing social circumstances of many Māori whānau that are a barrier to adopting infant sleep recommendations, otherwise sleep interventions could create yet another oppressive standard that whānau fail to live up to.Item Asthma inflammatory phenotypes on four continents: most asthma is non-eosinophilic(Oxford University Press on behalf of the International Epidemiological Association, 2023-04) Pembrey L; Brooks C; Mpairwe H; Figueiredo CA; Oviedo AY; Chico M; Ali H; Nambuya I; Tumwesige P; Robertson S; Rutter CE; van Veldhoven K; Ring S; Barreto ML; Cooper PJ; Henderson J; Cruz AA; Douwes J; Pearce N; WASP Study GroupBACKGROUND: Most studies assessing pathophysiological heterogeneity in asthma have been conducted in high-income countries (HICs), with little known about the prevalence and characteristics of different asthma inflammatory phenotypes in low-and middle-income countries (LMICs). This study assessed sputum inflammatory phenotypes in five centres, in Brazil, Ecuador, Uganda, New Zealand (NZ) and the United Kingdom (UK). METHODS: We conducted a cross-sectional study of 998 asthmatics and 356 non-asthmatics in 2016-20. All centres studied children and adolescents (age range 8-20 years), except the UK centre which involved 26-27 year-olds. Information was collected using questionnaires, clinical characterization, blood and induced sputum. RESULTS: Of 623 asthmatics with sputum results, 39% (243) were classified as eosinophilic or mixed granulocytic, i.e. eosinophilic asthma (EA). Adjusted for age and sex, with NZ as baseline, the UK showed similar odds of EA (odds ratio 1.04, 95% confidence interval 0.37-2.94) with lower odds in the LMICs: Brazil (0.73, 0.42-1.27), Ecuador (0.40, 0.24-0.66) and Uganda (0.62, 0.37-1.04). Despite the low prevalence of neutrophilic asthma in most centres, sputum neutrophilia was increased in asthmatics and non-asthmatics in Uganda. CONCLUSIONS: This is the first time that sputum induction has been used to compare asthma inflammatory phenotypes in HICs and LMICs. Most cases were non-eosinophilic, including in settings where corticosteroid use was low. A lower prevalence of EA was observed in the LMICs than in the HICs. This has major implications for asthma prevention and management, and suggests that novel prevention strategies and therapies specifically targeting non-eosinophilic asthma are required globally.Item Validating a measure of children's monitoring-blunting coping styles in dental situations(Routledge Taylor & Francis Group, 2012) Williams MN; Jones LMThe monitoring-blunting theory of coping suggests that when faced with a threatening situation, individuals can respond by either monitoring or avoiding (blunting) threatening information. The current study sought to validate a scale of children's preferences for monitoring or blunting in dental situations (the Monitoring Blunting Dental Scale or MBDS). The psychometric characteristics of the scale were assessed in a sample of 240 New Zealand children aged 11-13. Reliability was adequate for both monitoring (α = 0.74) and blunting (α = 0.76) subscale scores. Convergent validity was indicated by strong correlations (>0.6) between the measure's subscales and those of a related scale, although discriminant validity with respect to dental anxiety was problematic for the blunting subscale. Exploratory factor analysis supported a two-factor monitoring-blunting model, although confirmatory factor analysis indicated reasonable but imperfect fit for this model, SBχ²(251) = 510.7, p < 0.001, RMSEA = 0.066. We reflect on conceptual issues which may underlie the difficulties experienced here and elsewhere in developing psychometrically sound measures of Miller's blunting construct and suggest that the monitoring subscale of the study scale may be most useful to other researchers.Item Evidence-Based Class Literacy Instruction for Children With Speech and Language Difficulties(Wolters Kluwer Health Inc, 2020) Gillon G; Denston A; McNeill B; Scott A; Macfarlane AThis study investigated the response to class-wide phonological awareness and oral language teaching for 40 children who entered school with speech and language difficulties. A stepped wedge research design was adopted to compare the immediate impact of the 10-week teacher-led instruction. The progress of the children with speech and language difficulties was monitored over the first school year and compared with 110 children with language difficulties alone and 95 children with typical development. Children with speech and language needs showed a strong intervention response in phoneme awareness and vocabulary learning but needed more support to transfer skills to word decoding and spelling. Implementing the approach earlier in the school year resulted in stronger literacy performance at the year-end for all three groups. The importance of positive speech–language pathologist and teacher collaborations to support a systematic approach to evidence-based foundational literacy teaching is discussed.Item Children's knowledge, cognitions and emotions surrounding natural disasters: An investigation of Year 5 students, Wellington, New Zealand(Massey University, 2013) King TA; Tarrant RACNew Zealand schools have a responsibility to ensure that children are informed about potential natural disasters, and are prepared with protective strategies. The present study aimed to investigate children’s knowledge, cognitions, and emotions concerning natural disasters, with a particular focus on earthquakes and tsunami. Thirty Year-5 school students (aged 9-10 years) from the Wellington region of New Zealand participated in researcher-led focus groups. The children were generally well informed, demonstrating an understanding of causes, characteristics, and potential consequences of earthquakes and tsunami. Thoughts and expectations regarding natural hazards, earthquakes in particular, centred on the unpredictability of natural disasters and on the expectation that there would be significant earthquakes in their region in the future. However, the children demonstrated assurance that the school and family were prepared with emergency supplies, and that they themselves and their families knew strategies for keeping safe in a disaster event. The children discussed these reassurances as a factor in reducing their fear of disasters, fear being the predominant negative emotion discussed by the children. The children indicated that learning at school had contributed to discussions with friends and family, this finding suggesting that disaster education at school is a critical component of children’s education and that this education has a flow-on effect at home and in the wider community.