Health Promotion Approaches Research Articles

Diet and Nutrition in the Prevention of Non-Communicable Diseases (NCD)

Today, more than 50 % of adults in Germany are overweight, 20 million people are obese and 10 to 30 % suffer from non-communicable diseases (NCD). Unhealthy dietary patterns contribute to NCD, thus, NCD are at least partly avoidable. During the last decades nutrition research has changed from nutrients to foods identifying healthy food patterns characterizing healthy diets, e. g., Mediterranean diet, DASH diet and/or the New Nordic Diet. Scientifically, these diets have been shown to be effective strategies of primary and secondary prevention of NCD. Based on this evidence prevention of NCD is now urgently needed at the population level. However, effective public health strategies of prevention and health promotion go beyond daily medical practice and require re-thinking of our food system within a greater context of our environment and climate. To become sustainable, strategies and measures of behavior prevention addressing individuals have to be extended to measures against the obesogenic environment and its systemic drivers within our food system. Thus, social and political changes are needed for a better future health of the nation. Physicians may take the leadership to be prepared to add to a whole of society approach of prevention and health promotion.

Technology-Enhanced Health Promotion for College Students: A Seed Development Project.

Obesity is an issue for young adults in the U.S. This population is particularly vulnerable to weight gain as they move from adolescence to young adulthood, especially as they transition from high school to college. Adopting a health promotion approach, a university-based cluster of researchers, community advocates, and a technology partner embarked on a two-year seed development project that focused on development, implementation, and evaluation of a web-based healthy lifestyle intervention for college students. Using a mixed-method design, two convenience samples of residential university students were recruited to participate in a 4-week intervention called Eat, Move, Live, in which they interacted with a newly-created comprehensive website about management of a healthy lifestyle. Participants’ post-intervention readiness for change increased by 15% (eating and life balance behaviors) to 23% (moving behaviors). Participants reported increased awareness of eating behaviors, and feelings of engagement in tracking their fruit and vegetable consumption. Findings suggest that technology may be utilized to enhance the effectiveness and efficiency of achieving students’ individual goals related to healthy living. These preliminary findings have implications for increasing the development and implementation of technological approaches to health promotion for young adult students.

Exploring the place of spirituality in Canadian health promotion.

The field of health promotion advocates a socioecological approach to health that addresses a variety of physical, social, environmental, political and cultural factors. Encouraging a holistic approach, health promotion examines many aspects of health and wellbeing, including physical, mental, sexual, community, social and ecological health. Despite this holism, there is a noticeable absence of discussion surrounding spirituality and spiritual health. This research study explored how leading scholars in Canadian health promotion understand the place of spirituality in health promotion. Using the fourth edition of Health Promotion in Canada (Rootman et al., 2017) as the sampling frame of recognized leaders in the field, 13 semi-structured qualitative interviews were conducted with authors from the book. This study is situated within a critical health promotion approach that utilizes methodologies aiming for social justice, equity and ecological sustainability. I argue that by avoiding spirituality within health promotion frameworks and education, the secularism of health promotion and its underlying values of Eurocentric knowledge production and science remain invisible and rarely critiqued. This study intends to open up possibilities for centering spiritual and non-Western epistemologies and ways of knowing that have been marginalized, such as Indigenous understandings of health and wellbeing. Restoring right relations with Indigenous peoples in Canada has taken on new urgency with the calls to action of the Truth & Reconciliation Commission report (NCTR, 2015). This is one important way that health promotion can fulfill its promise of being inclusive, relevant and effective for human and planetary wellbeing.

Comprehensive Evaluation of Healthcare Benefits of Different Forest Types: A Case Study in Shimen National Forest Park, China

Studies have shown that contact with nature plays a crucial role in the amelioration of human health. Forest therapy has recently received widespread attention as a novel and subsidiary treatment approach for stress recovery and health promotion. However, there is a lack of ample research on the comprehensive evaluation of the forest healthcare benefits. Moreover, it is not entirely clear what kind of forest types and seasons are suitable for forest therapy activities and how healthcare forests should be constructed and managed. From September 2019 to January 2020 and May to August 2020., five forest types of Phyllostachys edulis forest, subtropical evergreen broad-leaved forest, Liquidambar formosana forest, Cunninghamia lanceolata forest, coniferous and broad-leaved mixed forest and a forestless control group in Shimen National Forest Park, Guangzhou City, Guangdong Province, China were selected. Variations in the character of negative air ion concentration, air oxygen content, human comfort index and phytoncide relative content were analyzed. Principal component analysis and systematic clustering were used to construct forest comprehensive healthcare index and evaluation grade in order to assess the healthcare benefits of different forest types. In terms of negative air ion concentration, the subtropical evergreen broad-leaved forest was far ahead of the other forest types throughout the year, while the forestless control group was the worst. All stands reached the annual maximum in summer, followed by spring, autumn and winter. From the perspective of air oxygen content, summer > spring > autumn > winter, among them, all forest stands clearly exceeded the normal atmospheric oxygen content (20.9%) in the first three quarters. Moreover, the air oxygen content of coniferous and broad-leaved mixed forest was the highest in five forest types; the forestless control group was the lowest. Judging from the human comfort index, in the whole year, all forest types, including the forestless group, were at the comfortable level and above. However, the five forest types still differed greatly in diverse seasons, among which Phyllostachys edulis forest and subtropical evergreen broad-leaved forest were superior to Liquidambar formosana forest, Cunninghamia lanceolata forest, coniferous and broad-leaved mixed forest in spring and summer, while it was in reverse in autumn and winter. In view of the phytoncide relative content, the subtropical evergreen broad-leaved forest was the highest, followed by the Cunninghamia lanceolata forest. The relative content of phytoncide was released more in summer, second, by spring, autumn and winter. Furthermore, establishing forest comprehensive healthcare index (FCHI = 0.1NAICi + 0.35AOCi + 0.27HCIi + 0.28PRCi), according to the FCHI value, it was divided into five rating levels. Overall, the comprehensive healthcare index of the five forest stands distinctly outperformed the forestless control group in all seasons. In addition, the five forest types were at level I in spring and summer. From the comprehensive data of the whole year, the comprehensive healthcare index of the coniferous and broad-leaved mixed forest was the best, followed by the subtropical evergreen broad-leaved forest. The forest environment has a favorable influence on the human body and mind, so it is suggested that citizens go to the forest environment regularly for healthcare and physical and mental washing. In terms of the forest healthcare benefits, the best seasons for forest therapy in Shimen National Forest Park are spring and summer; autumn is suitable as well. When planning and constructing the forest therapy bases in Shimen National Forest Park in the future, coniferous and broad-leaved mixed forests should be allocated more in the stand transformation to promote forest healthcare benefits. Protecting and developing the landscape resources of the subtropical evergreen broad-leaved forests should be paid close attention, as well as making rational use of their health activity space.

The Need for an Integrated Approach to Reducing Young People’s Risk of Homelessness and HIV in Pakistan

Background: Past research demonstrated a link between homelessness and the increased risk of HIV and other sexually transmitted infections (STIs). However, ways to reduce young people’s risk of homelessness and sexual health risks have not been adequately addressed. This paper, based on the first detailed sociological exploration into the lived experiences of homeless young people, argues for the adoption of a holistic and integrated approach to health promotion that goes beyond the health sector. Methods: In-depth interviews were conducted with twenty-nine homeless young people, aged 16-25-year-old, from Rawalpindi, Pakistan. Results: A combination of socio-structural and interpersonal forces shaped participants’ pathways to homelessness and their experiences of street life – notably regarding sex work – and produce contexts of competing risks where HIV/STIs prevention became a secondary concern. Participants had a reasonable knowledge regarding nature, transmission, prevention, and to some extent, treatment of HIV/STIs. Nevertheless, this knowledge did not help them much, as most of the participants used condoms inconsistently with clients and intimate partners. Financial considerations, fear of violence from clients, and social obligations in intimate partnerships contributed to participants inconsistent condom use, increasing their risk of HIV/STIs. Conclusion: The results indicate the importance of the Ottawa Charter of health promotion, which suggests that conventional health promotion approaches are potentially suboptimal in shaping health behaviours supportive of good health. Notably, building healthy public policies, creating supportive environments, strengthening community actions, developing personal skills, and reorienting health services can help to improve young people’s socioeconomic status, which is inextricably linked with sexual health behaviour and status.

Will an Implementation of "Joy of Life in Nursing Homes" Have Positive Effect for the Work Culture? A Comparison Between Two Norwegian Municipalities.

BackgroundCurrently, we are facing a demographic shift to an older population and its consequences worldwide: in the years to come, several older people will need nursing home (NH) care. The work culture is important for care quality in NHs. Some Norwegian municipalities have implemented the Joy of Life Nursing Home (JoLNH) strategy, representing a resource-oriented health-promoting approach. Knowledge about how implementation of the JoLNH approach impacts the work culture is scarce.AimssWe hypothesized that the JoLNH strategy impacts positively on the work culture: (1) when comparing measurements at two time points (T1 and T2) and (2) when comparing two municipalities, among which one has implemented the JoLNH and the other has not.MethodWith a 1-year interval, healthcare personnel in 43 NHs located in two large Norwegian municipalities responded to a survey in two waves (T1 and T2). In total, 558 healthcare personnel participated at T1 and 515 at T2. Work culture was assessed by the Systematizing Person–Group Relations Instrument (SPGR).FindingsThe municipality implementing the JOLNH strategy experienced significant increases in SPGR dimensions, representing positive orientations towards a better work culture, whereas those working in the non-JoLNH municipality reported an increase in SPGR dimensions, signifying a worsened work culture.DiscussionThe data indicate that the implemented JoLNH strategy has endorsed positive effects in the work culture. The JoLNH strategy emphasizes on the quality of patient care, which is what healthcare personnel, in general, are much concerned about. Furthermore, attention to task orientation and independent work seem to encourage a better work culture in NHs.ConclusionThis study suggests that the JoLNH strategy impacts positively on the work culture in Norwegian NHs.

Engaging Apparel Employees to Identify and Decide Actions to Address Selected Determinants using Health Promotion Approach

Low level of employee engagement is one of the most alarming global economic problems. It declines work performance and productivity of employees. The objective of this qualitative study is to identify and decide actions to address selected probable determinants which affect employee engagement. The health promotion principals with participatory approach were implemented with sewing machine operators in an apparel factory in Sri Lanka of age 18–55 (n = 64). The duration of determinant identification took around 3 months while intervention period took around 6 months. Initiation, maintenance and continual monitoring, and re-direction toward greater effectiveness were done as the components of a health promotion process. Group discussions with employees and key informant interviews with managerial personals were recorded, transcribed, translated to English, and thematically analyzed. Without the involvement of the principal investigator, employees were able to identify eight determinants while managerial personals identified three determinants. Among those identified probable determinants, four of which corresponded with those already mentioned in published studies. After facilitation, employees could identify six determinants and they could identify determinants by conducting some interactive activities and while measuring employees’ changes using “health promotional tools” as well. From the identified determinants, employees prioritized four determinants that were addressed and nine actions were developed with the employees to address them in this process. Employees could identify the probable determinants that affect employee engagement in their own work place by themselves and they could decide actions to address selected determinants successfully with minimum guidance through a health promotion approach.

Identifying Determinants of Bullying and Deciding on Measures through Engaging Adolescents in a Rural School in Sri Lanka

Bullying is a public health concern which generates a range of harmful physical, mental, and social health consequences for both its victims and perpetrators. Role of students in finding solutions for bullying has to be improved as they are affected from this issue. The aim of this study was to identify possible determinants of bullying and to decide measures, through engaging a group of adolescents in a rural school in Sri Lanka. Community-based health promotion approach was used for the study. The process was carried out for 3 months with grade nine students (n = 68) in a rural school in Anuradhapura district, Sri Lanka. Both quantitative and qualitative data were collected through, a self-administered questionnaire and ten interactive group discussions which were conducted with the selected group of students. Quantitative and qualitative data were analyzed using descriptive statistics and thematic analysis respectively. Students were able to identify 16 possible determinants of bullying and they prioritized five determinants based on the importance and feasibility of changing. The prioritized determinants included lack of understanding of students on the range of harms of bullying, poor responses of students against bullying, poor relationships among students, students being in unhappy or angry mood throughout the day, and acceptance of bullying as a heroic act among students. Furthermore, seven measures to address the selected determinants were decided together with the students. Students are capable in identifying possible determinants of bullying and deciding on measures to address the selected determinants with comparatively small guidance.

Midwives’ provision of health promotion in antenatal care: A qualitative explorative study

ProblemStudies indicate that health promotion in antenatal care can be improved. Moreover, a schism seems to exist between health promotion and prevention in antenatal care. BackgroundAntenatal care to support and improve maternal health is a core midwifery activity in which prevention as well as HP and woman-centeredness are important. AimTo explore how Danish midwives experienced antenatal care and practiced health promotion. MethodsMidwives undertaking antenatal care were interviewed individually (n=8) and two focus groups (n=10) were created. Thematic analysis was performed inductively, and the theoretical models from Piper’s health promotion practice Framework for midwives were used to analyse the midwives’ health promotion approach. FindingsTwo major themes were highlighted. Theme 1: ‘The antenatal care context for health promotion’ described factors contributing to quality in health promotion in antenatal care, such as communication and building relationships with the pregnant women. Theme 2: ‘The health promotion approach in antenatal care’ described both midwife-focused and woman-focused approaches to pregnant women’s health. Barriers to high-quality antenatal care and a holistic health promotion approach were identified, such as shared-care issues, documentation demands and lack of time. DiscussionThe midwives’ experiences were discussed in the context of a health promotion approach. Why midwives practice using a midwife-centred approach has many explanations, but midwives need to learn and help each other understand how they can practice woman-focused care while simultaneously providing prophylactic, evidence-based care. ConclusionMidwives mainly had a midwife-focused approach. To further promote women’s health, midwives need to focus on a woman-focused approach.

Barriers and drivers to service delivery in global mental health projects

BackgroundResearch in global mental health (GMH) has previously documented how contextual factors like political instability, poverty and poorly-funded health infrastructure continue to compromise effective and equitable mental health service delivery. There is a need to develop more feasible and evidence-based solutions through implementation research. This paper, one in a series pertaining to implementation in GMH projects worldwide, focuses on implementation factors influencing mental health service delivery.MethodsThis is a qualitative study carried out as part of a Theory of Change-driven evaluation of Grand Challenges Canada’s (GCC’s) Global Mental Health portfolio. Purposive sampling was used to recruit twenty-nine GCC grantees for interviews. A semi-structured interview schedule was used to guide the interviews which were recorded and subsequently transcribed. Transcripts were double-coded and analyzed in NVivo 11 using framework analysis. This paper reports results related to detection and treatment of mental illness, mental health promotion and prevention of mental illness.Results Key barriers included: lack of appropriate human resources and expertise for service delivery; lack of culturally appropriate screening tools and interventions; and difficulties integrating services with the existing mental health system. Formative research was a key driver facilitating the cultural adaptation of mental health detection, treatment, promotion and preventative approaches. Recruiting local providers and utilizing mHealth for improving screening, monitoring and data management were also found to be successful approaches in reducing workforce burden, improving sustainability, mental health literacy, participant engagement and uptake.ConclusionsThe study identifies a number of key barriers to and drivers of successful service delivery from the perspective of grantees implementing GMH projects. Findings highlight several opportunities to mitigate common challenges, providing recommendations for strengthening systems- and project-level approaches for delivering mental health services. Further, more inclusive research is required to inform guidance around service delivery for successful implementation, better utilization of funding and improving mental health outcomes among vulnerable populations in low-resource settings.

Workplace health management in hospitals: describing the field in Austria

We examined the status and necessity of a cultural change regarding the internal health promotion perspective in the Austrian hospital sector to check how the implementation of workplace health promotion proceeded compared to the last survey. This was done by analyzing the current situation of working conditions, replicating a quantitative study by Schaffenrath-Resi et al. (Schaffenrath-Resi et al. Pflege Gesellschaft 15:145–162, 2010). A link to an online survey was sent to all hospitals in Austria. The topics covered were the internal evaluation and current status, reasons and pitfalls of workplace health promotion. While approximately 40% of the respondents state using health circles, only 18.5% report a holistic workplace health promotion (WHP) approach, though certain elements are offered by the majority (+70%). Program failure beliefs are rather focused on the employees. Evaluations of the current programs are required to clarify not only how WHP was designed but also reasons for WHP failure. In addition, future research would profit from a broader database.

Perception of musculoskeletal pain in the state of confinement: associated factors.

Objective:to describe the perception of musculoskeletal pain in the population and how the state of confinement (adopted as a measure to control contagion by COVID-19) has interfered with it, as well as identifying the sociodemographic, occupational, physical, and psychosocial factors involved.Method:an observational, cross-sectional and analytical study, with simple random probabilistic sampling, aimed at residents in Spain over 18 years old during the confinement period. An ad hoc survey was conducted, consisting in 59 items.Results:a total of 3,247 surveys were answered. Persistent musculoskeletal pain or significant episodes thereof increased 22.2% during confinement. The main location was the spine (49.5%). The related factors were decreased physical activity, increased seated position, and use of electronic devices. The psychological impact of confinement was also related to the perception of musculoskeletal pain.Conclusion:the state of confinement causes an increase in the perception of musculoskeletal pain. The identification of a particularly sensitive population profile, as well as that of the related factors, allows establishing multidisciplinary approaches in health promotion.

A primary care approach for oral health promotion among HIV patients: An interventional study

Background: HIV-positive patients are at a greater risk for developing oral health problems, making them potentially susceptible to nutritional deficiencies, decreased adherence to treatment, and failure of highly active antiretroviral therapy. Their oral health needs are unmet due to a lack of awareness, social stigma, and other factors. The primary care workers (PCWs) are the first point of contact for health issues of these patients. Aim: The aim of the study was to assess the effectiveness of the educational intervention for the PCWs on oral health. Materials and Methods: This interventional pilot study was conducted at two residential centers for HIV patients in Mangalore. The participants included 15 PCWs working at these centers. An educational module was prepared as the intervention that included dental conditions that could compromise oral health, oral manifestations of HIV, and oral health care. A structured questionnaire was administered to the PCWs before the intervention, immediately after the intervention, and at 3 months. The PCWs were required to routinely examine the HIV patients for any dental or oral health problems and refer them to the dental hospital for treatment. The Statistical Package for the Social Sciences 20.0 software (Chicago. IL, USA) was used for analysis. p

Mental Health Prevention and Promotion for Those Who Have Had Covid-19 in Primary Care: A Case Series Study

The Covid-19 pandemic has had a negative impact upon individual’s psychological wellbeing. This case study series aimed to use a mental health prevention and promotion approach to promote positive emotional wellbeing and prevent deterioration of mental health difficulties in individuals who have had Covid-19. 573 individuals, who had recently tested positive for Covid-19, registered across two General Practices (GP), were initially screened, and 409 were contacted and offered psychological support. 9.1% accepted the offer at first but only 3.2% started the sessions. Psychometrics was used within the first and last session but also at a 6-week follow up to measure wellbeing, resiliency, low mood and anxiety. Experience of service questionnaires was also taken. Scores for wellbeing and resiliency increased at a statistically significant level. Scores for anxiety and low mood decreased at a statistically significant level, this was maintained at follow up. Qualitative feedback was positive. This service supports previous findings that mental health prevention and promotion interventions are effective. However, it is important to be mindful that given only 12 individuals finalized the sessions, the power of statistical findings are reduced. Nonetheless, this service is reasonably effective for people with a recent, positive Covid-19 test. Service scope should widen to include those who have struggled with the effects of the pandemic and not just those who received a positive diagnosis.

Community empowerment for health promotion in slums areas: A narrative review with emphasis on challenges and interventions.

Community empowerment has been proposed since the 1980s as a way to increase people's power to influence social determinants of health. However, community empowerment for health promotion in urban slums still faces challenges. The present study examined interventions, challenges, actors, scopes, and the consequences mentioned in various studies and with emphasizing interventions and executive challenges tried to create a clear understanding of empowerment programs in slums and improving their health. Narrative review method was used to conduct the study. Databases including PubMed, Scopus, Embase, Web of Science, and Cochrane were searched. The selection of studies was done according to the “community empowerment” defined by the World Health Organization, the concept of bottom–up approach for health promotion of Laverack and Labonte's study and definition of slums by UN-HABITAT. Finally, Hare and Noblit's meta-synthesis was used to analyze the studies. From 15 selected studies, the most intervention proposed for empowerment was identified to be “residents' participation in expressing problems and solutions.” The challenge of “creating a sense of trust and changing some attitudes among residents” was the greatest challenge in the studies. Moreover, “improving living conditions and health services” were the most important outcomes, “slum residents” and “governments” were the most important actors, and “sanitation” was the most important scope among the studies. Having a comprehensive view to the health and its determinants and attention to the factors beyond neighborhood and health sector would lead to fewer implementation challenges and better intervention choices to health promotion of slum dwellers.

A Scoping Review of Health Promotion in the Nursing Home Setting

Background Nursing homes in many countries continue to follow a traditional medical model of care. This study explored health promotion approaches in the nursing home setting, partly in order to move away from a medical model and to improve the well-being of residents and staff. Methods A scoping study was conducted to review the scientific literature. The Integrated Model of Population Health and Health Promotion was adapted for utilization with the literature analysis. Result A total of 64 publications met the inclusion criteria and were analysed. Five main approaches were shown to have applied health promotion in nursing homes, although gaps were present in the usage of systematically applied health promotion. Conclusion A variety of approaches do exist for the nursing home setting which apply health promotion; however, their usage is fragmented. This study revealed that a framework designed to support nursing homes in the systematic usage of health promotion, could improve the well-being for both residents and staff.

“To Be a Guy Is to Be Human”: Outcomes of the WiseGuyz Program Through Photo-Based Evaluation

Gender-transformative approaches (i.e., approaches that support male-identified individuals to critique and resist stereotypical male gender role norms that negatively affect health and well-being) are increasingly recognized as a key health promotion strategy. However, there is limited evidence to date on gender-transformative interventions for male-identified adolescents. In addition, given the dynamic and socially constructed nature of gender, methods beyond quantitative data collection are needed to gain a holistic understanding of promising gender-transformative health promotion approaches. One newer method to capture lived experiences with adolescents is photo-based evaluation, where youth program participants take pictures to represent their knowledge, attitudes, and/or behaviors before and after a program. The present study presents findings from the photo-based evaluation of a gender-transformative health promotion program called WiseGuyz. WiseGuyz is offered to mid-adolescent, male-identified youth in school and community settings, and is designed to promote mental and sexual health and prevent violence. Six youth photographers from a rural Canadian setting took part in this evaluation, taking photos to represent what being a guy in their world meant before and after WiseGuyz. Youth then participated in an individual visual storytelling interview and a group-based photovoice process. Key themes in relation to masculinities that emerged from these data were around changes to (1) social norms and (2) emotionality following program participation, and the need for a safe program space to support these changes. This study adds to literature demonstrating the promise of gender-transformative approaches with adolescents, with implications for future health promotion research and practice with male-identified youth.

Implementing Effective, Evidence-Based Older Adult Fall Prevention

Over one in four older adults (65 years and older) in the US reports falling annually with estimated medical costs of $50 billion. Evidence-based strategies exist that can reduce falls with one of the most promising being multifactorial, clinically-based initiatives such as the Centers for Disease Control and Prevention’s STEADI (Stopping Elderly Accidents, Deaths, and Injuries) Initiative. STEADI includes three core components for health care providers: screen for risk factors, assess modifiable factors, and intervene to reduce falls with evidence-based strategies. Barriers to implementation include competing patient demands and limited time during patient visits. Efficient, effective implementation of clinical fall prevention is important to increase the use of multifactorial interventions. In addition, understanding older adult attitudes about the preventability of falls is needed to increase patient adherence to prescribed interventions. This symposium will cover:1. Background data on older adult falls over time,2. Description of an initial implementation of STEADI in an outpatient, Southeastern clinical practice including lessons learned,3. Attitudes of older adults toward fall prevention with implications for health promotion,4. Process evaluation of an ongoing implementation of STEADI in New York State with lessons learned. Understanding practical methods of implementing the three core components of fall prevention into practice supports wider dissemination of evidence-based fall prevention, while understanding patient attitudes toward falls informs the design of health promotion approaches to increase patient uptake of prescribed interventions. Wider dissemination and increased patient adherence in combination can reduce older adult falls and their associated medical costs.

The potential role of nutrition in mitigating the psychological impact of COVID-19 in healthcare workers

Healthcare professionals are exposed to several stress factors, especially during health emergency situations like Covid-19. Psychological distress in the COVID-19 era adversely affects both healthcare professionals' mental and physical health, decreasing performance and efficiency at work. Nevertheless, no sufficient emphasis has been placed so far on the role of nutrition against stress and anxiety among healthcare professionals. Consequently, worksite health promotion approaches and interventions are highly recommended, but also National Health Systems are praised to develop strategies and policies to satisfy nutritional requirements in health emergencies such as Covid-19 pandemic. In this brief paper, the important role of nutrition during periods of stress is highlighted, providing nutritional advice to enhance resilience in this risk group. In addition, practical lifestyle and diet tips for stress management among healthcare professionals exposed to Covid-19 are reported in this mini review.

From individual behaviour strategies to sustainable food systems: Countering the obesity and non communicable diseases epidemic in New Zealand

New Zealand is currently facing an obesity and non communicable diseases (NCDs) epidemic. Recent studies have largely attributed these health issues to insufficient food and low-quality diets that cause micronutrient deficiencies. Improving healthy diets requires broader thinking and collaboration, particularly around maintaining sustainable food systems, which signifies a shift from individualistic/behavioural approaches in health promotion. This paper aims to extend solutions addressing increasing rates of obesity and diet-related NCDs in New Zealand while considering diet and human health in concurrence with sustainability. In particular, the three pillars of sustainability—economic, environmental, and social—will be considered, alongside application of a food systems approach to analysing the epidemic and policy developments in New Zealand. Given its proximity to smaller Pacific islands in the region, New Zealand is in a unique position to work multisectorally and be a leader in considering food system approaches to tackling obesity and NCDs in the Pacific.