School environment and obesity in primary schools. An analysis of the WHO European COSI in Austria

Background

Overweight and obesity in childhood and the associated secondary diseases are constantly on the increase. Studies show that the school environment can have an influence on the weight of children. The Childhood Obesity Surveillance Initiative (COSI) of the WHO is a Europe-wide epidemiological monitoring of anthropometric sizes of school children aged six to nine, with Austria participating in COSI for the first time in 2016.

Methods

A retrospective secondary data analysis based on two standardized questionnaires was performed. On the one hand, data on determinants specific to the school field were collected, on the other hand anthropometric data of children in third grade were measured. Across Austria, data from 97 schools and 2530 children were collected and evaluated using descriptive and inductive statistical methods.

Results

In 43,3 % of the schools, an existing playground can be used outside school opening hours. 73,2 % of the schools integrate nutrition education into their school curriculum either as a separate subject or in combination with another subject. Milk and dairy products are available in 60,8 % of schools, fresh fruit in 63,9 % and vegetables in 51,5 %.

28,3 % of the examined, 8 to 9-year-old children are overweight or obese (n = 658), while boys have a significant higher BMI than girls (p < 0,001). Also, in urban areas children have a significant higher BMI on average than in rural areas (p = 0,025). No significant relationship could be identified between the duration of physical education lessons per week and the BMI. However, a significant difference in childreńs BMI became visible when school playgrounds were also accessible outside opening hours (p = 0,018).

Conclusions

The alarming number of overweight children in Austria should be diminished through policies and further interventions. Schools can make a substantial contribution to this. The course of the development could be closely observed through possible further surveys by COSI.

Key messages

73,2% of the schools include nutrition education in their curricula. Yet, about every third Austrian child aged between 8 and 9 is overweight, with boys being significantly more overweight than girls. If school playgrounds are accessible outside opening hours, the childreńs BMI is significantly lower. In urban areas, children have a significantly higher BMI than in rural areas.

Improving Health Literacy in Austrian Companies: Results from a Systematic Company Recruitment

Issue

The HL-Survey-EU-2011 showed limited health literacy (HL) among the Austrian population (51,6%), especially in the federal state of Styria (63,1%). The project “Auf Gesundheitskurs - gesundheitskompetent in Feldbach” focuses on individual and organizational HL by training and educating production and service company workforce in a rural region in Austria.

Description

The population in the target region is especially disadvantaged regarding HL due to the parameters of age, gender, education, income and ethnicity. There are several small and medium-sized businesses within this area. This project (2018-2020) aims to improve knowledge, competences and skills of multipliers from different companies concerning organizational and individual HL, based on an in-person training programme. However, in order to recruit participants for this research project, a systematic recruitment approach was used.

Results

A total of 783 companies, listed in the community database, were contacted via email in order to inform about the project and to invite for an interview. After the initial email, 40 companies were selected, based on four characteristics: industry sector, company size, distance to town centre, relevance to HL, and contacted via phone as well. However, 7 companies out of 783 confirmed the first interview and 6 out of 7 signed the project cooperation. 18 out of 40 phone contacts led to personal meetings, 9 resulted in signing the cooperation. In total, 15 companies have decided to participate in the project.

Lessons

Overall, telephone contact led to much higher response rates than email alone. The parameters which effected positive outcomes during the interaction by phone and in-person were demonstrating benefits (healthy workplace, motivated staff, positive atmosphere, new customers), explaining the practical value, clarifying costs, expenditures and time effort. Although the topic of workplace health promotion is popular in this rural region, the focus on HL is new.

Key messages

Key factors in company recruitment for HL initiatives in rural regions are telephone and personal contact. Pointing out specific benefits for companies within the recruiting process seems also crucial.

Evaluation of minimum standards for communal catering in Styrian nursing homes

Background

Nutritional standards in community catering facilities are essential for adequate quality of care. As part of the initiative GEMEINSAM G'SUND GENIESSEN of the Health Fund Styria, minimum standards for nursing homes were published. The aim was to investigate the current situation of the implementation of selected minimum standards for food and drink supply in Styrian nursing homes to create appropriate measures for healthy living for elderly people.

Methodology

Of 81 defined minimum standards, two thirds were examined in the study (n = 54; 66.6 %). To get detailed insights into the current degree of implementation, the project team worked with a mixed- methods-basis, consisting of an online survey (n = 94; 41.4% of all Styrian nursing homes), 46 guideline interviews and 169 weeks of menu analysis.

Results

Of the 54 minimum standards analysed, 34 were fulfilled (63.0%), nine were rather fulfilled (16.6%), five were rather not fulfilled (9.2%), four standards could not be fulfilled (7.4%) and two standards could not be investigated (3.7%). Nursing homes prefer seasonal and regional products, but pay less attention to the use of fair trade products or organic food. In addition, the food choice is determined by the preferences and acceptance of the residents, which are the main reasons for the low use of whole grain products and the rare offer of vegetarian dishes. With regard to the design of the menus, almost all plans are age-appropriate and attractively presented, but rarely meet the standard with regard to recommended labelling (e.g. alcohol aromas). Challenges in the daily practise are finding a way between the self-determination of the residents, the arranged diets as wells as meeting the minimum standards.

Conclusions

Results indicate that minimum standards in nursing homes are taken into account. In order to achieve a comprehensive implementation, further development of the standards as well as information and awareness-building interventions are needed.

Key messages

Challenges in the daily practise are finding a way between the self-determination of the residents, the arranged diets as wells as meeting the minimum standards. The range of vegetarian dishes, dishes with legumes and wholemeal products should be focused in the future. In addition, the provision of tools (age-and target-group- specific-menus) is recommended.