Case 2: Stakeholders’ Reactions to an Upstream Intervention to Improve Children’s Diets

  • Simone PettigrewEmail author
  • Melanie Pescud
Part of the Applying Quality of Life Research: book series (BEPR)


In an era of unprecedented child obesity, governments are attempting to improve children’s diets through a range of policy initiatives. This chapter describes how principals, teachers, and parents responded to a new West Australian Government policy that precludes the use of unhealthy foods as classroom rewards. This information is important for understanding how upstream social marketing interventions can be implemented and refined to enhance adoption and effectiveness. The study explored the issues faced by principals and teachers in implementing the rewards component of the policy and also assessed parents’ support for the policy. The findings were used by the West Australian Government to enhance the policy and refine its implementation. The study outcomes demonstrate how upstream interventions designed to improve quality of life at a population level can impact behaviours that are difficult to change with downstream strategies.


Child Obesity Food Allergy Healthy Eating Treat Food Unhealthy Food 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



This study was funded by the Western Australian Health Promotion Foundation (Healthway #16187) and the Western Australia Department of Education and Training. The authors thank Siobhain Milbourne from the Department for her advice and assistance.


  1. Australian Bureau of Statistics (2009) Australian social trends. Catalogue no. 4102.0, CanberraGoogle Scholar
  2. Belk RW, Wallendorf M, Sherry JF (1989) The sacred and the profane in consumer behavior: theodicy on the odyssey. J Consum Res 16(1):1–38CrossRefGoogle Scholar
  3. Bell A, Swinburn BA (2005) School canteens: using ripples to create a wave of healthy eating. Med J Aust 183(1):5–6Google Scholar
  4. Birch LL (1992) Children’s preferences for high-fat foods. Nutr Rev 50(9):249–255CrossRefGoogle Scholar
  5. Blass E (2003) Biological and environmental determinants of childhood obesity. Nutr Clin Care 6:13–19Google Scholar
  6. Caballero B (2007) The global epidemic of obesity: an overview. Epidemiol Rev 29:1–5CrossRefGoogle Scholar
  7. Colagiuri S, Lee CM, Colagiuri R, Magliano D, Shaw JE, Zimmet PZ, Caterson ID (2010) The cost of overweight and obesity in Australia. Med J Aust 192(5):260–264Google Scholar
  8. Commonwealth of Australia (2009) Australia – the healthiest country by 2020 – National Preventative Health Strategy – overview. Commonwealth of Australia, pp 1–60Google Scholar
  9. Fontaine KR, Barofsky I (2001) Obesity and health-related quality of life. Obes Rev 2(3):1731–82CrossRefGoogle Scholar
  10. Friedlander SL, Larkin EK, Rosen CL, Palermo TM, Redline S (2003) Decreased quality of life associated with obesity in school-aged children. Arch Pediatr Adolesc Med 157(12):1206–1211CrossRefGoogle Scholar
  11. Grier S, Bryant CA (2005) Social marketing in public health. Annu Rev Public Health 26:319–339CrossRefGoogle Scholar
  12. Hastings G, MacFayden L, Anderson S (2000) Whose behavior is it anyway? The broader potential of social marketing. Soc Mark Q 6(2):46–58CrossRefGoogle Scholar
  13. Leviton LC (2008) Children’s healthy weight and the school environment. Ann Am Acad Polit Soc Sci 615(1):38–55CrossRefGoogle Scholar
  14. Lobstein T, Baur L, Uauy R (2004) Obesity in children and young people: a crisis in public health. Obes Rev 5(Suppl):4–85CrossRefGoogle Scholar
  15. Loder RT, Aronson DD, Greenfield ML (1993) The epidemiology of bilateral slipped capital femoral epiphysis. A study of children in Michigan. J Bone Joint Surg 75(8):1141–1147Google Scholar
  16. Must A, Strauss RS (1999) Risks and consequences of childhood and adolescent obesity. Int J Obes 23(Suppl 2):S2–S11CrossRefGoogle Scholar
  17. Must A, Spadano J, Coakley EH, Field AE, Colditz G, Dietz WH (1999) The disease burden associated with overweight and obesity. J Am Med Assoc 282(16):1523–1529CrossRefGoogle Scholar
  18. Palmer E, Cantor J, Dowrick P, Kunkel D, Linn S, Wilcox B (2004) Report of the APA task force on advertising and children. Section: psychological implications of commercialism in schools, American Psychological AssociationGoogle Scholar
  19. Rigby R, Rump J (1981) Attitudes towards parents and institutional authorities during adolescence. J Psychol 109:109–118CrossRefGoogle Scholar
  20. Roberts SM, Pobocik RS, Deek R, Besgrove A, Prostine BA (2009) A qualitative study of junior high school principals’ and school food service directors; experiences with the Texas school nutrition policy. J Nutr Educ Behav 41(4):293–299CrossRefGoogle Scholar
  21. Schwimmer JB, Burwinkle TM, Varni JW (2003) Health-related quality of life of severely obese children and adolescents. J Am Med Assoc 289(14):1813–1819CrossRefGoogle Scholar
  22. Shannon C, Story M, Fulkerson J, French S (2002) Factors in the school cafeteria influencing food choices by high school students. J Sch Health 72(6):229–234CrossRefGoogle Scholar
  23. Smetana JG, Bitz B (1996) Adolescents’ conceptions of teachers’ authority and their relations to rule violations in school. Child Dev 67:1153–1172CrossRefGoogle Scholar
  24. Strauss RS (2000) Childhood obesity and self-esteem. Pediatrics 105(1):e15CrossRefGoogle Scholar
  25. Subratty A, Chan Sun M, Kassean H (2003) A need for healthy canteens in secondary schools in Mauritius. Nutr Food Sci 33(5):208–212CrossRefGoogle Scholar
  26. Sutherland R, Gill T, Binns C (2004) Do parents, teachers and health professionals support school-­based obesity prevention? Nutr Diet 61:137–144Google Scholar
  27. Swallen KC, Reither EN, Haas SA, Meier AM (2005) Overweight, obesity, and health-related quality of life among adolescents: The National Longitudinal Study of Adolescent Health. Pediatrics 115(2):340–347CrossRefGoogle Scholar
  28. Verplanken B, Wood W (2006) Interventions to break and create consumer habits. J Public Policy Mark 25(1):90–103CrossRefGoogle Scholar
  29. Williams J, Wake M, Hesketh K, Maher E, Waters E (2005) Health-related quality of life of overweight and obese children. J Am Med Assoc 293(1):70–76CrossRefGoogle Scholar
  30. Wyatt SB, Winters KP, Dubbert PM (2006) Overweight and obesity: prevalence, consequences, and causes of a growing public health problem. Am J Med Sci 331(4):166–174CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media Dordrecht 2013

Authors and Affiliations

  1. 1.UWA Business SchoolUniversity of Western AustraliaCrawleyAustralia

Personalised recommendations