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Enhancing Food Security and Physical Activity for Māori, Pacific and Low-income PeoplesTable 1.1 ANGELO FrameworkSource: Swinburn et al 1999 14Table 1.2 Suggested filter criteria for stakeholder judgments on implementationFilter criteriaFeasibility:Sustainability:Effects onequity:Potentialside-effects:Acceptabilityto stakeholders:DescriptionThe ease of implementation considering such factors as: the availability ofa trained workforce; the strength of the organisations, networks, systemsand leadership involved; existing pilot or demonstration programmes.The durability of the intervention considering such factors as: the degree ofenvironmental or structural change; the level of policy support; thelikelihood of behaviours, practices, attitudes, etc, becoming normalised; thelevel of ongoing funding support needed.The likelihood that the intervention will affect the inequalities in thedistribution of obesity in relation to: socioeconomic status; ethnicity; locality;gender.The potential for the intervention to result in positive or negative sideeffectssuch as on: other health consequences; stigmatisation; theenvironment; social capital; traffic congestion; household costs; othereconomic consequences.The degree of acceptance of the intervention by the various stakeholdersincluding: parents and carers; teachers; health care professionals; thegeneral community; policy makers; the private sector; government andother third party funders.Source (Swinburn et al 2005) 15These criteria are particularly relevant in this research which was requisitioned by apolicy institution, the Ministry of Health, to provide advice about effective interventionsfor three groups who endure inequalities in relation to food security and physicalactivity.5
Enhancing Food Security and Physical Activity for Māori, Pacific and Low-income PeoplesResearch processFrom the beginning of this project the research team acknowledged that it was likelythere would be little existing research available that focused on the three populationsof interest in the New Zealand context. For this reason, the methodology focused onmarrying international research evidence with new evidence generated specific toMāori, Pacific and low-income New Zealanders.Phase 1The first phase of this research consisted of two comprehensive international literaturereviews identifying factors associated with food security and physical activity. 20 Whilesome New Zealand literature was included, as expected, there was relatively littleavailable. For this reason, a series of focus groups was also held with Māori, Pacificand low-income people. 21 The focus groups identified a range of factors that impactedon people’s decisions regarding food security and physical activity. These reports areavailable at http://www.wnmeds.ac.nz/academic/dph/research/heppru/research/foodsecurity.html.Phase 2The second phase of the research used the literature review and focus groupinformation to address the first two research questions. Descriptions of the socialsystem from which food security and physical activity practices ‘emerge’ were12 13developed. Informed by complexity theory, the system descriptions identifiedmany interacting factors contributing to food security and physical activity outcomes.Control parameters were identified within the food security and physical activitysystems; that is, the places in the system where intervention is likely to be mosteffective. Five control parameters were identified:• the money available within a household to spend on food,• the cost of healthy nutritious food,• food purchasing influences,• culturally-specific physical activity programmes, and• improving urban design to facilitate physical activity. 22The phase two report is available athttp://www.wnmeds.ac.nz/academic/dph/research/heppru/research/foodsecurity.html.The objective of subsequent phases of the research was to explore interventions toimpact on control parameters and move the social systems towards enhanced foodsecurity and physical activity for Māori, Pacific and low-income whānau/families.Phase 3Phase three of the research involved a series of seven workshops held in Wellington,Northland and Auckland with representatives of Māori, Pacific and low-incomecommunities, policy-makers, non-governmental organisations and academics todiscuss key opportunities for action and to identify appropriate interventions.Workshops were held on each of the five control parameters identified in phase two.Three workshops were held on the provision of culturally specific physical activityprogrammes, including one general workshop and two Māori specific workshops ledby Te Hotu Manawa Māori. Each workshop identified intervention options to impacton the control parameters using the filter criteria discussed above 15 and with aparticular focus on equity issues for Māori, Pacific and low-income people.6
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