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Systemic Barriers and Equitable Interventions to Improve Vegetable and Fruit Intake in Children: Interviews with National Food System Actors

Author

Listed:
  • Sarah Gerritsen

    (School of Population Health, University of Auckland, Auckland 1142, New Zealand)

  • Sophia Harré

    (School of Population Health, University of Auckland, Auckland 1142, New Zealand)

  • Boyd Swinburn

    (School of Population Health, University of Auckland, Auckland 1142, New Zealand)

  • David Rees

    (Synergia Consulting Ltd, Auckland 1011, New Zealand)

  • Ana Renker-Darby

    (School of Population Health, University of Auckland, Auckland 1142, New Zealand)

  • Ann E. Bartos

    (School of Environment, University of Auckland, Auckland 1142, New Zealand)

  • Wilma E. Waterlander

    (Department of Public Health, Amsterdam UMC, University of Amsterdam, 1105AZ Amsterdam, The Netherlands)

Abstract

Fruit and vegetable (FV) intake is declining in New Zealand, and over half of New Zealand’s children do not meet the recommendation of two serves of fruit and three serves of vegetables daily (with even lower adherence among children in high-deprivation neighbourhoods). The aim of this study was to map the potential causal pathways explaining this decline and possible actions to reverse it. Semi-structured interviews were held in April–May 2018 with 22 national actors from the produce industry, food distribution and retail sector, government, and NGO health organisations. The qualitative systems dynamics method of cognitive mapping was used to explore causal relationships within the food system that result in low FV intake among children. Barriers and solutions identified by participants were analysed using thematic analysis and according to a public health intervention framework. Participants were in agreement with the goal of improving FV intake for health and economic outcomes, and that health promotion strategies had been ineffectual to date due to multiple systemic barriers. Common barriers discussed were poverty, high food prices, low skills/knowledge, unhealthy food environments, climate change, and urbanization. Solutions with the strongest evidence of efficacy identified by the participants were subsidizing FVs and early childhood interventions to improve FV exposure.

Suggested Citation

  • Sarah Gerritsen & Sophia Harré & Boyd Swinburn & David Rees & Ana Renker-Darby & Ann E. Bartos & Wilma E. Waterlander, 2019. "Systemic Barriers and Equitable Interventions to Improve Vegetable and Fruit Intake in Children: Interviews with National Food System Actors," IJERPH, MDPI, vol. 16(8), pages 1-19, April.
    • Handle: RePEc:gam:jijerp:v:16:y:2019:i:8:p:1387-:d:223710
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    References listed on IDEAS

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    Cited by:

    1. Pippa McKelvie-Sebileau & David Rees & David Tipene-Leach & Erica D’Souza & Boyd Swinburn & Sarah Gerritsen, 2022. "Community Co-Design of Regional Actions for Children’s Nutritional Health Combining Indigenous Knowledge and Systems Thinking," IJERPH, MDPI, vol. 19(9), pages 1-14, April.
    2. Wilma E. Waterlander & Angie Luna Pinzon & Arnoud Verhoeff & Karen den Hertog & Teatske Altenburg & Coosje Dijkstra & Jutka Halberstadt & Roel Hermans & Carry Renders & Jacob Seidell & Amika Singh & M, 2020. "A System Dynamics and Participatory Action Research Approach to Promote Healthy Living and a Healthy Weight among 10–14-Year-Old Adolescents in Amsterdam: The LIKE Programme," IJERPH, MDPI, vol. 17(14), pages 1-18, July.
    3. Catherine Paquet, 2019. "Environmental Influences on Food Behaviour," IJERPH, MDPI, vol. 16(15), pages 1-4, August.

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