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  1. Article ; Online: The shape of the New Zealand child injury prevention workforce.

    Kool, Bridget / Umali, Elaine / Hunt, Mareta / Wilson, Melissa

    Australian and New Zealand journal of public health

    2022  Volume 46, Issue 6, Page(s) 771–775

    Abstract: Objective: To describe the characteristics of the New Zealand child injury prevention workforce and the organisations they represent.: Methods: Representatives of organisations on the Safekids Aotearoa database were invited to complete an online ... ...

    Abstract Objective: To describe the characteristics of the New Zealand child injury prevention workforce and the organisations they represent.
    Methods: Representatives of organisations on the Safekids Aotearoa database were invited to complete an online survey. The standardised questionnaire asked for information about injury prevention focus and expertise, communication preferences and information access.
    Results: Of 196 respondents, the majority were female and identified as New Zealand European. For only a small proportion of respondents, child injury prevention is the main focus of their role. The key sources of child injury data and injury prevention information identified was Safekids Aotearoa, followed by the Ministry of Health. Respondents indicated that they would like to receive information on new research, training opportunities and upcoming events, and information from other organisations.
    Conclusions: Males and people of Pacific and Asian ethnicity are under-represented in the New Zealand child injury prevention workforce in New Zealand. The low engagement of the sector with Māori authorities is of concern, given the inequities in rates of child injury that exist.
    Implications for public health: There is a need to conduct a wider and more regular audit of the child injury prevention sector to determine its composition and identify areas of concern.
    MeSH term(s) Child ; Humans ; Female ; Male ; New Zealand ; Native Hawaiian or Other Pacific Islander ; Ethnicity ; Workforce ; Asians
    Language English
    Publishing date 2022-06-23
    Publishing country Australia
    Document type Journal Article
    ZDB-ID 1323548-5
    ISSN 1753-6405 ; 1326-0200
    ISSN (online) 1753-6405
    ISSN 1326-0200
    DOI 10.1111/1753-6405.13269
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Is opt-out enrolment acceptable for low-risk digital health services?

    Dobson, Rosie / Uri, Amanda / Whittaker, Robyn / Evison, Karen / Umali, Elaine / McRobbie, Hayden

    Journal of primary health care

    2022  Volume 14, Issue 4, Page(s) 368–371

    Abstract: Introduction Digital health programmes not only complement existing services, but have the potential to reach populations that existing services are not reaching. Many of these services require people to opt-in to receive them, which presents significant ...

    Abstract Introduction Digital health programmes not only complement existing services, but have the potential to reach populations that existing services are not reaching. Many of these services require people to opt-in to receive them, which presents significant barriers to access. An alternative is to make low-risk digital services opt-out, ensuring appropriate members of the target audience are signed up for a service unless they select to not receive it. Aim This study aimed to investigate how changing enrolment in a low-risk digital health programme from opt-in to opt-out would impact on enrolment and dropout rates. Methods This study involved the retrospective analysis of registration data from txtpēpi, a maternal and child health text-message programme. System-recorded data from enrolments during a 12-month period were obtained. In the first 6 months, users had to opt-in to the service (Period 1), but in the following 6 months, an opt-out process was implemented (Period 2). Results There was a 77% increase in enrolments in Period 2 (n  = 113) compared to Period 1 (n  = 64) and no significant change in the proportion of enrolments of Māori between time periods (P  = 0.508). There was no significant difference in withdrawal rates between time periods at either 2 weeks (5% vs 6%, P  = 0.676) or 1 month (9% vs 9%, P  = 0.907). Discussion This study has shown switching from an opt-in to an opt-out option resulted in an increase in enrolments in an mHealth programme, but had no impact on withdrawals. This indicates that employing opt-out enrolment for low-risk evidence-based interventions is acceptable and a potential way to make these services more accessible.
    MeSH term(s) Child ; Humans ; Retrospective Studies ; Health Promotion ; Family ; Text Messaging ; Telemedicine
    Language English
    Publishing date 2022-12-30
    Publishing country Australia
    Document type Journal Article
    ZDB-ID 2572943-3
    ISSN 1172-6156 ; 1172-6156
    ISSN (online) 1172-6156
    ISSN 1172-6156
    DOI 10.1071/HC22088
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: I Keep Looking at What I'm Doing to My Organs: Samoans' Responses to Adapted Anti-Tobacco Television Advertisements.

    Umali, Elaine / Tanielu, Helen / Whittaker, Robyn / Sugden, Cam / McCool, Judith

    Asia-Pacific journal of public health

    2021  Volume 33, Issue 6-7, Page(s) 721–726

    Abstract: There has been an increase of adapted tobacco control media campaigns in low- and middle-income countries. Adapting existing material offers many benefits especially to countries with limited resources. We adapted 3 television advertisements for ... ...

    Abstract There has been an increase of adapted tobacco control media campaigns in low- and middle-income countries. Adapting existing material offers many benefits especially to countries with limited resources. We adapted 3 television advertisements for the
    MeSH term(s) Advertising ; Health Promotion ; Humans ; Smoking Cessation ; Smoking Prevention ; Television
    Language English
    Publishing date 2021-06-02
    Publishing country China
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 1025444-4
    ISSN 1941-2479 ; 1010-5395
    ISSN (online) 1941-2479
    ISSN 1010-5395
    DOI 10.1177/10105395211020920
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Effectiveness of a Sodium-Reduction Smartphone App and Reduced-Sodium Salt to Lower Sodium Intake in Adults With Hypertension: Findings From the Salt Alternatives Randomized Controlled Trial.

    Eyles, Helen / Grey, Jacqueline / Jiang, Yannan / Umali, Elaine / McLean, Rachael / Te Morenga, Lisa / Neal, Bruce / Rodgers, Anthony / Doughty, Robert N / Ni Mhurchu, Cliona

    JMIR mHealth and uHealth

    2023  Volume 11, Page(s) e43675

    Abstract: Background: Even modest reductions in blood pressure (BP) can have an important impact on population-level morbidity and mortality from cardiovascular disease. There are 2 promising approaches: the SaltSwitch smartphone app, which enables users to scan ... ...

    Abstract Background: Even modest reductions in blood pressure (BP) can have an important impact on population-level morbidity and mortality from cardiovascular disease. There are 2 promising approaches: the SaltSwitch smartphone app, which enables users to scan the bar code of a packaged food using their smartphone camera and receive an immediate, interpretive traffic light nutrition label on-screen alongside a list of healthier, lower-salt options in the same food category; and reduced-sodium salts (RSSs), which are an alternative to regular table salt that are lower in sodium and higher in potassium but have a similar mouthfeel, taste, and flavor.
    Objective: Our aim was to determine whether a 12-week intervention with a sodium-reduction package comprising the SaltSwitch smartphone app and an RSS could reduce urinary sodium excretion in adults with high BP.
    Methods: A 2-arm parallel randomized controlled trial was conducted in New Zealand (target n=326). Following a 2-week baseline period, adults who owned a smartphone and had high BP (≥140/85 mm Hg) were randomized in a 1:1 ratio to the intervention (SaltSwitch smartphone app + RSS) or control (generic heart-healthy eating information from The Heart Foundation of New Zealand). The primary outcome was 24-hour urinary sodium excretion at 12 weeks estimated via spot urine. Secondary outcomes were urinary potassium excretion, BP, sodium content of food purchases, and intervention use and acceptability. Intervention effects were assessed blinded using intention-to-treat analyses with generalized linear regression adjusting for baseline outcome measures, age, and ethnicity.
    Results: A total of 168 adults were randomized (n=84, 50% per group) between June 2019 and February 2020. Challenges associated with the COVID-19 pandemic and smartphone technology detrimentally affected recruitment. The adjusted mean difference between groups was 547 (95% CI -331 to 1424) mg for estimated 24-hour urinary sodium excretion, 132 (95% CI -1083 to 1347) mg for urinary potassium excretion, -0.66 (95% CI -3.48 to 2.16) mm Hg for systolic BP, and 73 (95% CI -21 to 168) mg per 100 g for the sodium content of food purchases. Most intervention participants reported using the SaltSwitch app (48/64, 75%) and RSS (60/64, 94%). SaltSwitch was used on 6 shopping occasions, and approximately 1/2 tsp per week of RSS was consumed per household during the intervention.
    Conclusions: In this randomized controlled trial of a salt-reduction package, we found no evidence that dietary sodium intake was reduced in adults with high BP. These negative findings may be owing to lower-than-anticipated engagement with the trial intervention package. However, implementation and COVID-19-related challenges meant that the trial was underpowered, and it is possible that a real effect may have been missed.
    Trial registration: Australian New Zealand Clinical Trials Registry ACTRN12619000352101; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=377044 and Universal Trial U1111-1225-4471.
    MeSH term(s) Humans ; Adult ; Mobile Applications ; Sodium Chloride, Dietary ; Pandemics ; Australia ; COVID-19 ; Hypertension/therapy ; Sodium
    Chemical Substances Sodium Chloride, Dietary ; Sodium (9NEZ333N27)
    Language English
    Publishing date 2023-03-09
    Publishing country Canada
    Document type Randomized Controlled Trial ; Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2719220-9
    ISSN 2291-5222 ; 2291-5222
    ISSN (online) 2291-5222
    ISSN 2291-5222
    DOI 10.2196/43675
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article: Assessing the Cross-Cultural Adaptation and Translation of a Text-Based Mobile Smoking Cessation Program in Samoa (TXTTaofiTapaa): Pilot Study.

    McCool, Judith / Tanielu, Helen / Umali, Elaine / Whittaker, Robyn

    JMIR mHealth and uHealth

    2018  Volume 6, Issue 8, Page(s) e173

    Abstract: Background: Samoa faces a persistently high prevalence of adult tobacco use and few existing cessation support services. Mobile phones are ubiquitous and generally affordable.: Objective: This study aimed to adopt a text message (short message ... ...

    Abstract Background: Samoa faces a persistently high prevalence of adult tobacco use and few existing cessation support services. Mobile phones are ubiquitous and generally affordable.
    Objective: This study aimed to adopt a text message (short message service, SMS) smoking cessation program designed in New Zealand (stop smoking with mobile phones, STOMP) for use in Samoa to assist national objectives in reducing the tobacco use.
    Methods: Using focus groups with smokers and ex-smokers, we explored the context for tobacco use and preferences for SMS text messages. Postintervention focus groups were held after participants received SMS text messages for 1 week. Frequent face-to-face meetings with the primary partner (Ministry of Health Samoa) and key stakeholders contributed to the adaptation process. Participatory feedback and collaboration from stakeholders became an integral part of the cultural adaptation and translation of the program. Furthermore, detailed document analyses were included as part of the formal evaluation of the initiative to explore the core determinants of success in adapting the program to the Samoan cultural context.
    Results: The SMS text messages evolved remarkably following an iterative process of consultation, in situ testing, revision, and retesting to arrive at an acceptable country-specific version of the mobile smoking cessation program. The SMS text messages retained in the final set were consistent with the theory of behavioral change but reflected both linguistic and cultural nuances appropriate for Samoa. Adapting messages required simultaneous multilevel processes, including complex high-level engagement, between the team and the stakeholders, along with crafting the precise content for (character limited) messages.
    Conclusions: Receiving cessation support messages through a mobile phone is promising and appears to be an acceptable and accessible mode of delivery for tobacco cessation, particularly in the absence of alternative support. Adapting a text-based program in Samoa requires fastidious attention to the nuances of culture, language, and sociopolitical structures in the country.
    Language English
    Publishing date 2018-08-31
    Publishing country Canada
    Document type Journal Article
    ZDB-ID 2719220-9
    ISSN 2291-5222
    ISSN 2291-5222
    DOI 10.2196/mhealth.9033
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article: Possibilities and Expectations for mHealth in the Pacific Islands: Insights From Key Informants.

    Umali, Elaine / McCool, Judith / Whittaker, Robyn

    JMIR mHealth and uHealth

    2016  Volume 4, Issue 1, Page(s) e9

    Abstract: Background: The increase in mobile phone use across the globe is creating mounting interest for its application in addressing health system constraints. Although still limited, there is growing evidence of success in using mobile phones for health ( ... ...

    Abstract Background: The increase in mobile phone use across the globe is creating mounting interest for its application in addressing health system constraints. Although still limited, there is growing evidence of success in using mobile phones for health (mHealth) in low- and middle- income countries. The promise of mHealth to address key health system issues presents a huge potential for the Pacific Island countries where mobile use has radically increased. Current projections indicate an improved information and communications technology (ICT) environment to support greater access to mobile and digital devices in the Pacific region.
    Objective: The objective of the study was to explore key stakeholder perspectives on the potential for mHealth in the Pacific region.
    Methods: A series of in-depth interviews were conducted either face-to-face, via Skype or by email, with a series of key informants from the Pacific Rim region. Interviews were audio-recorded and later transcribed for detailed thematic analysis.
    Results: We found widespread support for the potential to use mobile phones as a mechanism to facilitate improved health service delivery in the region. Essential elements for the successful development and implementation of mHealth were identified by these stakeholders. These included: developing an understanding of the local context and the problems that may be usefully addressed by the addition of mHealth to existing strategies and services; consideration of local infrastructure, capability, policy, mobile literacy and engagement; learning from others, particularly other low- and middle-income countries (LMICs); the importance of building supportive environments and of evaluation to provide evidence of impact and total cost.
    Conclusions: The rapid growth of mobile phone use in the region presents a unique juxtaposition of opportunity and promise. Though the region lags behind other LMICs in the adoption of mHealth technologies, this offers the convenience of learning from past mHealth interventions and applying these learnings to achieve scale, sustainability and success. This study deepens the understanding of the potential of mHealth for the region, and offers a baseline from which discussions can be made to examine the limitations, barriers and complexities inherent in mHealth applications.
    Language English
    Publishing date 2016-01-20
    Publishing country Canada
    Document type Journal Article
    ZDB-ID 2719220-9
    ISSN 2291-5222
    ISSN 2291-5222
    DOI 10.2196/mhealth.4626
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article ; Online: Samoan Smokers Talk About Smoking and Quitting: A Focus Group Study.

    Tanielu, Helen / McCool, Judith / Umali, Elaine / Whittaker, Robyn

    Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco

    2017  Volume 20, Issue 9, Page(s) 1132–1137

    Abstract: Introduction: Samoa, like other Pacific Island countries, faces a persistent challenge to reduce smoking use with relatively limited resources. As a signatory to the WHO FCTC, Samoa is obligated to introduce measures to reduce tobacco use and is ... ...

    Abstract Introduction: Samoa, like other Pacific Island countries, faces a persistent challenge to reduce smoking use with relatively limited resources. As a signatory to the WHO FCTC, Samoa is obligated to introduce measures to reduce tobacco use and is currently trialing a text message smoking cessation programme (mCessation) to achieve this outcome. Cigarettes remain relatively cheap and are widely available, but little is known about how smoking is initiated or why and how people quit smoking in the Samoa.
    Methods: Six focus groups with smokers and ex-smokers were conducted in Apia, Samoa. Groups were homogenous according to age, gender and smoking status. Focus groups were conducted in Samoan and transcribed and translated to English for analysis.
    Results: Smoking is initiated most commonly in late teens and early twenties and most frequently in (non-family) social contexts. Smoking reflects a widely held (mis)perceptions of tangible benefits, including aiding feelings of strength and energy, relief from indigestion and as a means to accelerate the effects of alcohol. Smoking was deeply connected to social life in Samoa among friends and for some, with family members. Drivers to quit originate out of concern regarding health effects, concern for family and the costs of purchasing tobacco.
    Conclusions: Smoking is well entrenched in Samoan society; efforts to reduce smoking need to be based on implicit understanding of Samoan cultural norms and priorities around family, social networks and culture. Efforts to support quitting are important, alongside other well validated measures to reverse the trajectory of smoking related disease.
    Implications: This study offers an insight into smoking as a behavior and as cultural practice perceived by smokers and non-smokers in Samoa. A thorough understanding of smoking behaviors and cessation patterns is critical in efforts to reduce smoking especially in resource-limited settings. The results from this study was used to inform the development of a Samoan mHealth smoking cessation programme.
    MeSH term(s) Adolescent ; Adult ; Delivery of Health Care/methods ; Emotions ; Family/psychology ; Female ; Focus Groups/methods ; Friends/psychology ; Health Behavior ; Humans ; Male ; Samoa/epidemiology ; Smokers/psychology ; Smoking Cessation/methods ; Smoking Cessation/psychology ; Tobacco Smoking/psychology ; Tobacco Smoking/therapy ; Tobacco Smoking/trends ; Young Adult
    Language English
    Publishing date 2017-05-22
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 1452315-2
    ISSN 1469-994X ; 1462-2203
    ISSN (online) 1469-994X
    ISSN 1462-2203
    DOI 10.1093/ntr/ntx152
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article ; Online: Assessing the Cross-Cultural Adaptation and Translation of a Text-Based Mobile Smoking Cessation Program in Samoa (TXTTaofiTapaa)

    McCool, Judith / Tanielu, Helen / Umali, Elaine / Whittaker, Robyn

    JMIR mHealth and uHealth, Vol 6, Iss 8, p e

    Pilot Study

    2018  Volume 173

    Abstract: BackgroundSamoa faces a persistently high prevalence of adult tobacco use and few existing cessation support services. Mobile phones are ubiquitous and generally affordable. ObjectiveThis study aimed to adopt a text message (short message service, SMS) ... ...

    Abstract BackgroundSamoa faces a persistently high prevalence of adult tobacco use and few existing cessation support services. Mobile phones are ubiquitous and generally affordable. ObjectiveThis study aimed to adopt a text message (short message service, SMS) smoking cessation program designed in New Zealand (stop smoking with mobile phones, STOMP) for use in Samoa to assist national objectives in reducing the tobacco use. MethodsUsing focus groups with smokers and ex-smokers, we explored the context for tobacco use and preferences for SMS text messages. Postintervention focus groups were held after participants received SMS text messages for 1 week. Frequent face-to-face meetings with the primary partner (Ministry of Health Samoa) and key stakeholders contributed to the adaptation process. Participatory feedback and collaboration from stakeholders became an integral part of the cultural adaptation and translation of the program. Furthermore, detailed document analyses were included as part of the formal evaluation of the initiative to explore the core determinants of success in adapting the program to the Samoan cultural context. ResultsThe SMS text messages evolved remarkably following an iterative process of consultation, in situ testing, revision, and retesting to arrive at an acceptable country-specific version of the mobile smoking cessation program. The SMS text messages retained in the final set were consistent with the theory of behavioral change but reflected both linguistic and cultural nuances appropriate for Samoa. Adapting messages required simultaneous multilevel processes, including complex high-level engagement, between the team and the stakeholders, along with crafting the precise content for (character limited) messages. ConclusionsReceiving cessation support messages through a mobile phone is promising and appears to be an acceptable and accessible mode of delivery for tobacco cessation, particularly in the absence of alternative support. Adapting a text-based program in Samoa requires fastidious ...
    Keywords Information technology ; T58.5-58.64 ; Public aspects of medicine ; RA1-1270
    Subject code 410
    Language English
    Publishing date 2018-08-01T00:00:00Z
    Publisher JMIR Publications
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  9. Article ; Online: Possibilities and Expectations for mHealth in the Pacific Islands

    Umali, Elaine / McCool, Judith / Whittaker, Robyn

    JMIR mHealth and uHealth, Vol 4, Iss 1, p e

    Insights From Key Informants

    2016  Volume 9

    Abstract: BackgroundThe increase in mobile phone use across the globe is creating mounting interest for its application in addressing health system constraints. Although still limited, there is growing evidence of success in using mobile phones for health (mHealth) ...

    Abstract BackgroundThe increase in mobile phone use across the globe is creating mounting interest for its application in addressing health system constraints. Although still limited, there is growing evidence of success in using mobile phones for health (mHealth) in low- and middle- income countries. The promise of mHealth to address key health system issues presents a huge potential for the Pacific Island countries where mobile use has radically increased. Current projections indicate an improved information and communications technology (ICT) environment to support greater access to mobile and digital devices in the Pacific region. ObjectiveThe objective of the study was to explore key stakeholder perspectives on the potential for mHealth in the Pacific region. MethodsA series of in-depth interviews were conducted either face-to-face, via Skype or by email, with a series of key informants from the Pacific Rim region. Interviews were audio-recorded and later transcribed for detailed thematic analysis. ResultsWe found widespread support for the potential to use mobile phones as a mechanism to facilitate improved health service delivery in the region. Essential elements for the successful development and implementation of mHealth were identified by these stakeholders. These included: developing an understanding of the local context and the problems that may be usefully addressed by the addition of mHealth to existing strategies and services; consideration of local infrastructure, capability, policy, mobile literacy and engagement; learning from others, particularly other low- and middle-income countries (LMICs); the importance of building supportive environments and of evaluation to provide evidence of impact and total cost. ConclusionsThe rapid growth of mobile phone use in the region presents a unique juxtaposition of opportunity and promise. Though the region lags behind other LMICs in the adoption of mHealth technologies, this offers the convenience of learning from past mHealth interventions and applying these ...
    Keywords Information technology ; T58.5-58.64 ; Public aspects of medicine ; RA1-1270
    Subject code 306
    Language English
    Publishing date 2016-01-01T00:00:00Z
    Publisher JMIR Publications
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  10. Article ; Online: Increased food energy supply as a major driver of the obesity epidemic: a global analysis.

    Vandevijvere, Stefanie / Chow, Carson C / Hall, Kevin D / Umali, Elaine / Swinburn, Boyd A

    Bulletin of the World Health Organization

    2015  Volume 93, Issue 7, Page(s) 446–456

    Abstract: Objective: We investigated associations between changes in national food energy supply and in average population body weight.: Methods: We collected data from 24 high-, 27 middle- and 18 low-income countries on the average measured body weight from ... ...

    Abstract Objective: We investigated associations between changes in national food energy supply and in average population body weight.
    Methods: We collected data from 24 high-, 27 middle- and 18 low-income countries on the average measured body weight from global databases, national health and nutrition survey reports and peer-reviewed papers. Changes in average body weight were derived from study pairs that were at least four years apart (various years, 1971-2010). Selected study pairs were considered to be representative of an adolescent or adult population, at national or subnational scale. Food energy supply data were retrieved from the Food and Agriculture Organization of the United Nations food balance sheets. We estimated the population energy requirements at survey time points using Institute of Medicine equations. Finally, we estimated the change in energy intake that could theoretically account for the observed change in average body weight using an experimentally-validated model.
    Findings: In 56 countries, an increase in food energy supply was associated with an increase in average body weight. In 45 countries, the increase in food energy supply was higher than the model-predicted increase in energy intake. The association between change in food energy supply and change in body weight was statistically significant overall and for high-income countries (P < 0.001).
    Conclusion: The findings suggest that increases in food energy supply are sufficient to explain increases in average population body weight, especially in high-income countries. Policy efforts are needed to improve the healthiness of food systems and environments to reduce global obesity.
    MeSH term(s) Adolescent ; Adult ; Body Weight ; Energy Intake ; Female ; Food Supply/statistics & numerical data ; Global Health ; Humans ; Male ; Middle Aged ; Nutrition Surveys ; Obesity/epidemiology ; Young Adult
    Language English
    Publishing date 2015-07-01
    Publishing country Switzerland
    Document type Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
    ZDB-ID 80213-x
    ISSN 1564-0604 ; 0042-9686 ; 0366-4996 ; 0510-8659
    ISSN (online) 1564-0604
    ISSN 0042-9686 ; 0366-4996 ; 0510-8659
    DOI 10.2471/BLT.14.150565
    Database MEDical Literature Analysis and Retrieval System OnLINE

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