Food environments in Malta: Associations with store size and area-level deprivation

Food environments are potential targets for interventions to reduce obesity prevalence, particularly in island settings that are typically dependent on food imports. This observational study aimed to characterise the availability, quality and price of foods and beverages in a nationally representative sample of grocery stores in Malta using the Nutrition Environment Measures Survey for Stores (NEMS-S) instrument, and to examine the association between area-level density of different types of food stores and the likelihood of children living in these areas being overweight or obese. Fieldwork was carried out between March and May 2014. There was a strong positive correlation between store size and NEMS-S score (p = <0.001), suggesting that smaller grocery stores generally offered a smaller range of products and fewer healthy food/beverage options than larger supermarkets. Across all stores, median prices of certain ‘healthier’ versions of foods were more expensive than their less healthy alternatives. A significant association between risk of childhood overweight, and density of confectionery stores in children’s locality of residence, was found (OR 1.19; 95% CI: 1.04, 1.37). These baseline findings highlight opportunities to improve the food environment in Malta to support more healthful eating, and may be of particular interest to public health practitioners in island settings.     

Explaining vaccination decisions: A system dynamics model of the interaction between epidemiological and behavioural factors

The WHO goal of eradicating measles is delayed by widespread scepticism of parents against the recommended MMR vaccination. In this context, a model of the prevalence of measles that incorporates behavioural aspects is desirable. Parental decisions can be influenced by epidemiological and behavioural factors. The former include vaccination coverage and its impact on the prevalence of the disease. The latter include perceptions of the risk to be infected, which affects vaccination decisions, as well as government campaigns to affect vaccination behaviour, vaccination scares or changes in disease control policies. We develop a model that incorporates both kinds of effects. In particular, we illustrate how incorporating parental response to a change in the prevalence of the disease impacts the outcome of governmental policies aiming to increase the vaccination coverage. While calibrated to measles, this model is also applicable to other childhood diseases, such as pertussis or diphtheria. Different scenarios illustrate the long-term consequences of the interaction between health policies (in particular, vaccination campaigns) or the agenda of social institutions (e.g., drawing attention to specific events to create vaccination scares) and parental reactions. Periodic ups and downs of the disease's prevalence, characteristic of epidemiological feedback, are the consequence of the interaction between parental behaviour and events such as vaccination campaigns or vaccination scares. International and national health authorities, pursuing the fight against measles, may be helped by the potential of the model to provide understanding in the way different predictors of vaccination behaviour interact.     

Providing assets in the sharing economy: Low childhood socioeconomic status as a barrier

In the past few decades, the modern marketplace has offered consumers a proliferation of models for consumption based on sharing and access. Extant literature provides systematic examinations of motives for consuming products through the sharing economy on the demand side, but factors that affect consumers' asset-providing decisions on the supply side remain understudied. The current paper explores whether the socioeconomic environment one grew up in might produce a long-lasting impact on willingness to sharing one’s unused assets. Results from the analysis of a national-level field dataset and six preregistered studies (combined N = 45,289) reveal that lower childhood socioeconomic status can hinder consumers’ asset-providing behavior, an effect that holds beyond the influence of other factors such as current SES and asset availability. We identify greater territorial feelings towards one’s assets as a central mechanism driving the decreased asset-providing behavior of consumers with a lower childhood socioeconomic background, and we show that asset providers’ closeness to potential borrowers attenuates the negative impact of lower childhood SES.     

Childhood studies and orphanage tourism in Cambodia

Interacting with children is one of the most popular activities among volunteer tourists, yet volunteer tourism research rarely is informed by insights from childhood studies. This paper shows how a greater understanding of the socially constructed nature of many assumptions about children and childhood, as well as a more accurate understanding of child development processes, can deepen understanding of the phenomenon widely referred to as orphanage tourism. Issues to be addressed include the definition and delineation of orphanage tourism, motivations for and consequences of orphanage tourism, and the anti-orphanage tourism campaign. Main points will be illustrated with excerpts from a content analysis of volunteers’ testimonials, blogs and other online sources.     

Advancing the evidence base for public policies impacting on dietary behaviour,physical activity and sedentary behaviour in Europe: The Policy Evaluation Network promoting a multidisciplinary approach

Non-communicable diseases (NCDs) are the leading cause of global mortality. As the social and economic costs of NCDs have escalated, action is needed to tackle important causes of many NCD’s: low physical activity levels and unhealthy dietary behaviours. As these behaviours are driven by upstream factors, successful policy interventions are required that encourage healthy dietary behaviours, improve physical activity levels and reduce sedentary behaviours of entire populations. However, to date, no systematic research on the implementation and evaluation of policy interventions related to these health behaviours has been conducted across Europe. Consequently, no information on the merit, gaps, worth or utility of cross-European policy interventions is available, and no guidance or recommendations on how to enhance this knowledge across European countries exists. As part of the Joint Programming Initiative “A Healthy Diet for a Healthy Life” (JPI HDHL), 28 research institutes from seven European countries and New Zealand have combined their expertise to form the Policy Evaluation Network (PEN). PEN’s aim is to advance tools to identify, evaluate, implement and benchmark policies designed to directly or indirectly target dietary behaviours, physical activity, and sedentary behaviour in Europe, as well as to understand how these policies increase or decrease health inequalities. Using well-defined evaluation principles and methods, PEN will examine the content, implementation and impact of policies addressing dietary behaviour, physical activity levels and sedentary behaviour across Europe. It will realise the first steps in a bespoke health policy monitoring and surveillance system for Europe, and refine our knowledge of appropriate research designs and methods for the quantification of policy impact. It will contribute to our understanding of how to achieve successful transnational policy implementation and monitoring of these policies in different cultural, demographic or socioeconomic settings. PEN will consider equity and diversity aspects to ensure that policy actions are inclusive and culturally sensitive. Finally, based on three policy cases, PEN will illustrate how best to evaluate the implementation and impact of such policies in order to yield healthy diets and activity patterns that result in healthier lives for all European citizens.     

Coke is It: How stories in childhood memories illuminate an icon

This paper builds on consumer storytelling theory and childhood memory research by proposing that earliest childhood memory stories are useful for developing brand myths and providing relevance to iconic brands. This article investigates consumers' childhood memories with Coca-Cola and finds that memories from early childhood are more predictive and insightful for understanding current brand attitudes than memories coming from adolescence. A focus group is unable to elicit memories from as early in life as the childhood memory session. In addition, the memories elicited by the group interviewer are not as relevant and meaningful to participants. When participants read experiences coming from the childhood memory session, those who connect with the earliest childhood memory stories have the strongest attitudes toward Coca-Cola. A discussion describes how this research method aids in generating insights about iconic brands and brands aspiring to become iconic.     

Childhood obesity and the income gradient: evidence from Australia

This article examines the dynamic nature of human capital formation in the context of childhood obesity and the association of household income and childhood obesity in Australia using the first five waves of the Longitudinal Study of Australian Children. Our results show a strong evidence of dynamic nature of child obesity: the lag obesity is a significant and robust predictor of obesity in the current period. We also found that the main channel for childhood obesity is inter-generational trait: the probability of obesity in children born to an obese mother or father is 15% higher than that of other children. Other important determinants are lifestyle factors, including the consumption of drinks with a high sugar content and the amount of time watching TV. Income becomes an insignificant determinant of childhood obesity once we control for unobserved individual heterogeneity.     

Incidence,patterns and risk factors for injuries among Ugandan children

There is limited epidemiological data on childhood injuries in developing countries. This study assessed the incidence, patterns and risk factors for injuries among children aged 0–5 years in Wakiso District, Uganda. To determine differences, chi-square and Wilcoxon rank sum tests were used. Risk factors were assessed using Poisson regression. Overall, information from 359 children of mean age 32 months (SD: 18.4) was collected. Annual incidence of injuries was 69.8 per 1000 children/year (95% CI 58.8–80.8). One fatal injury due to burns was reported. Incidence of injuries was less associated with being female (IRR: 0.56, 95% CI 0.34–0.90) and increasing age of the caretaker (IRR: 0.96, 95% CI 0.92–0.99). The high incidence of childhood injuries necessitates the need for interventions to reduce injuries among children.     

Nostalgic collections

Nostalgia has been transformed by the consumer market. With the emergence of ephemeral novelty goods – popular music, TV serials, kitsch, automobiles, and especially playthings – nostalgia has become less about identification with past communities, ideologies, or regimes than associated with fast-changing consumer goods, especially those encountered in childhood and youth. Reappropriating those goods later in life in nostalgic collecting has become a big business, producing narrow cohorts of consumers sharing common consumer memories. I explore this phenomenon through the history of collecting toys, dolls, and Disney collectibles in the USA.     

Risk,responsibility and negative responses: a qualitative study of parental trust in childhood vaccinations

Abstract

Childhood vaccination programmes have benefits that far outweigh risks, in public health terms. However, some parents decide not to immunise their children. This paper explores the ways in which such parents talk about the perceived risks and benefits incurred by vaccinating (or not vaccinating) their children. Between 2013 and 2016, we undertook 29 in-depth interviews with non-vaccinating and/or ‘vaccine hesitant’ parents in Fremantle, Western Australia and Adelaide, South Australia. Our analysis of the interviews identified particular constructions of risk and responsibility. All interviews were transcribed and analysed using both inductive and deductive processes. Our analysis mirrors the chronological process through which parents navigate risk. We start with the concept of ‘responsibilisation’, which underpins parental engagement with decision-making and praxis. We then explore how responsiblisation takes the form of detailed and time-consuming ‘research’. Parents then attempt to navigate multiple and conflicting ‘risks’: the risk of vaccine-preventable diseases, risks associated with vaccination and risks associated with their own perceived lack of understanding. After engaging with risk, parents justify the decision and accept the associated ‘responsibility’. Parents use this sense of responsibility to navigate through the ‘responses’ of others, which we conceptualise as the risk of unwelcome consequences. In conclusion, parents have a reflexive understanding of the physical, psychological and socio-economic risks they incur as a consequence of their choice to either partially vaccinate, delay vaccination or reject vaccination for their children. They construct these risks with reference to particular discourses, engagement with expert opinion and lifestyle choices emblematic of late modernity. The risks they are willing to accept and the subsequent responsibility and blame they assume when choosing to abstain, or partially abstain, from vaccinating their children are, to the parents, coherent with their interpretation of best parenting practice.