Planning and Developing a Nutrition Intervention or Public Health Program - Essay Example

Planning and Developing a Nutrition Intervention or Public Health Program Student’s Name: Institutional Affiliation: Planning and Developing a Nutrition Intervention or Public Health Program\ Executive summary Lifestyle related chronic diseases are on the rise and disadvantaged populations and low income communities are heavily impacted. One of these areas include the suburbs of Inner North Canberra. There are a number of community health intervention programs in place and a recent addition is the BEAT IT: Physical Activity and Lifestyle program. The main purpose of this program is to help reduce the prevalence of type II diabetes and other chronic diseases through lifestyle changes Conducting planning and developing this program is crucial to its success. This document offers a plan by examining the objectives of the program as well as the theoretical perspectives that will be used. Through this, the required methods for meeting the goals and objectives of the program can be devised. The goals and objectives include reducing the prevalence of type II diabetes through improving eating habits and physical activity. Individual and environmental theoretical models were adopted for the program in order to effectively communicate with the public on their needs and how to meet them. Introduction The main problem triggering the development of this plan is that chronic diseases that have a relation to lifestyles that people have adopted are on a steady increase. This increase is most obvious and prevalent in communities with low income and other disadvantaged populations. The suburbs in inner North Canberra are among these disadvantages areas. Some programs in the area are underway to improve lifestyle including the BEAT IT program (Australian Diabetes Council, 2011). In North Canberra, about 16,222 people are obese and overweight as well. Statistics show that 1,208 people have type II diabetes in North Canberra (Australian Bureau of Statistics, 2011a). In addition, there has been a 4% increase of men with obesity while the percentage increase in women is 6% (Australian Bureau of Statistics, 2011a). Certain issues cause this obesity, the most significant being leading a sedentary lifestyle. People leading sedentary lifestyles are segmented in terms of gender. Men make up 68% of those leading sedentary lifestyles while women make up 76% of those leading this lifestyle in Australia (Australian Bureau of Statistics, 2011b). Furthermore, diabetes increases the risk of developing other co-morbidities such as chronic heart failure and other heart diseases (Simpson, Shaw & Zimmet, 2003). This increase is a problem because it has a major impact on people’s health outcomes such as morbidity and mortality (PriceWaterhouseCoopers, 2001). An individual suffering from type II diabetes is more susceptible to heart diseases, stroke and other complications related to the kidney (Simpson, Shaw & Zimmet, 2003). Another problem is the significant cost on the public health. The increase of chronic diseases causes an increase of 58 million dollars to the annual health costs in the area (Australian Bureau of Statistics, 2011b). This problem impacts particularly heavily on disadvantaged (low income) areas such as Inner North Canberra. Low-income areas account for 21% of the total percentage of obese individuals as opposed to the 16% percent of those in higher income areas (Australian Bureau of Statistics, 2011b). Therefore, there is a need to address these problems. Through evaluating the secondary information on current interventions and health issues, the gaps that need to be filled using the program can be identified and implemented as part of the objectives of the program. The health department in Australia would like to see the problem of prevailing chronic health issues solved because it is leading to greater health costs for the entire country. People are spending more money on meeting the needs of their chronic health problems and so is the health department. Health issues that are chronic in nature are affecting a vast majority of individuals in Australia. Owing to this situation, the health costs in Australia as well as the health of the entire population are significantly affected. Some of these chronic health problems include type II diabetes, obesity and being overweight. By targeting the low-income areas, this program hopes to address the popular health issues and improve the general well being of the population in North Canberra. Although many other health programs and interventions have been put in place, these problems are still persistent owing to poor comprehension of communal needs as well as poor planning of intervention programs (Holli et al., 2003). Consequently, the availability of a well laid plan for developing a health intervention program. The planning of Beat it will be dependent on the results of a needs evaluation, which precedes staged processes for meeting the identified needs (Australian Diabetes Council, 2011). Clinical trials comparing lifestyle intervention to control group have reported risk reduction for type II diabetes from 29-67% (Australian Diabetes Council, 2011). Therefore, the BEAT IT physical activity and lifestyle program was introduced and implemented in Inner North Canberra in Early March 2011 to address this public health issue. This is a new program therefore there is a need to evaluate and improve the program for more effective intervention outcomes in the future The processes and activities involved in planning and developing a nutrition intervention or public health program are extensive and heavily dependent on the needs of the particular intervention or program. Once the rationale for developing the program or intervention has been established, the planning and developing processes must ensure that the needs of the program are met. This paper will focus on the planning and developing of the BEAT IT program, which is a physical activity and lifestyle program being developed in inner North Canberra (Australian Diabetes Council, 2011). In order to understand the details of the plans that will be made towards meeting the needs of ‘beat it’, it is important to learn of the needs that accompany this program. Findings of the needs assessment The prevalence of chronic health problems is on the rise highlighting the fact that current interventions need to be evaluated and customized for smaller geographical areas. This customization includes maintaining and promoting health and wellbeing related to nutrition. Public health nutrition programs aim to promote the health of populations using informed choices within the society and organized efforts. The plans made include improving conditions within the society using strategies that influence the entire population, an ethical framework, an evidence based approach and applying a framework of health promotion to the processes involved in planning (Lawrence & Worsley, 2007). The processes involve a needs assessment, planning the program, implementing the program, evaluating the program (which is inclusive of redesigning the program and re-implementation), assessing the evaluability, impact and outcomes. About 90% of the individuals in Australia are making poor decisions in terms of their intake of fruits. Being obese results in certain social, economic and health impacts that raise the risk of chronic diseases. Most chronic health conditions are multi-factorial (Lawrence & Worsley, 2007). Consequently, the risk factors are diverse including obesity, sedentary lifestyle and poor nutrition choices (De Vet et al., 2006). This is why the BEAT IT program is based on changing lifestyle because it encompasses all the issues that are involved in getting chronic health conditions. For these conditions, the obesity factor and being overweight as well as type II diabetes are the most significant conditions that can be modified. There are a number of physical activity and lifestyle education programs that have been introduced to counter the effect of obesity. These include the AustCyle of Cycling Australia, Heartmoves of the National Heart Foundation of Australia, HEAL of Macarthur Division of General Practices, Lift for Life of Fitness Australia, Beat It of the Australian Diabetes Council, and Heart Foundation Walking Groups of the National Heart Foundation of Australia. HEAL stands for Healthy Eating, Activity, and Lifestyle Program. It is an evidenced-based lifestyle education and physical activity program under the Macarthur Division of General Practice and Exercise & Sports Science Australia. The objective of this program is to provide an eight two-hour sessions lifestyle education to adults who are overweight or obese and at risk of developing heart disease and Type 2 diabetes. These include sessions focusing on nutrition, exercise, and behavior modification delivered by highly competent HEAL facilitator trained and accredited as either Exercise Physiologist or Practicing Dietitian. A program of Fitness Australia, Lift for Life on the other hand is also an evidence-based program under the Baker IDI Heart and Diabetes Institute but with specific target population. The Walking Group is another Heart Foundation’s initiative but this time the focus is healthy eating and active living. Part of the program educates participants on food and nutrition, food choices, facts about fats and cholesterol, and food preparation. The evaluation process for these public health interventions does not vary significantly, as they are following the National Partnership Agreement on Preventive Health and HCI Evaluation Guide as recipients of LGA grants. The guide requires two levels of evaluation – local and national. The LGAs and National Program Grant Recipients conduct local Evaluation while the National Evaluation is conducted by KPMG, an independent auditing firm. However, both evaluations employ a common quantitative measures corresponding to each domain and outcome area. Aside from the Heart Foundation’s Walking Program, national evaluation result and outcomes for most interventions is not available online thus it may be necessary to inquire directly from respective grant recipient and implementers of the programs. Heart Foundation’s Walking program was launched in 2007 when only 50% of Australians were reported doing adequate physical activity. In 2009, HFW reported a number of population groups that have been attracted and retained by the program. 80% of women are now physically active, 29% of older people aged 45-64 years and 43 % aged over 65 are now actively participating, 38% of participants are from low socio-economic group while 23% are people who live alone. Intervention In order to respond to these problems, the BEAT IT program will use support from the government to deliver and promote dietary programs and physical activities that are community based. There have been some groups in the area such as the Australian Capital Territory Health Community Initiatives that were put in place in 2010 and are meant to go on till 2013. Knowledge of these other programs is important in the planning process so as to develop the intervention around the existing programs and to build up on what other interventions have done. In addition, it is helpful in pointing out the gaps that may exist in the programs thus enabling better programming for the BEAT IT intervention. The BEAT IT campaign is a recent addition to the intervention programs in North Canberra and it will be coordinated from the Center for Health, Community and Wellbeing that is at Canberra Institute of Technology (Australian Diabetes Council, 2011). BEAT IT takes place on a weekly basis and it is designed in order to improve the health of those with the most risk of living with chronic diseases with type II diabetes being targeted most (Australian Diabetes Council, 2011). The program follows evidence based guidelines and processes to promote better health through physical activities and awareness. These processes are delivered to the population through the Australian Diabetes Council accredited and qualified professionals (Chapter 2, 2004). Interventions that have a basis on theoretical positions have a higher chance of being successful that those that do not. Theories are necessary for practice and there are a vast majority of theories. To ensure that different needs are addressed effectively, theories are used in a multi-factorial manner. Implementing the BEAT IT plan will use different theories with the most significant being the theory of change which outlines the stages that are involved in change (Australian Diabetes Council, 2011). These stages include pre-contemplation, contemplation, preparation, action and maintenance. Pre-contemplation involves raising consciousness and awareness among the population. Contemplation includes arousing the emotions of the population through self-reevaluation. Preparation involves a continued process of self re-evaluation, commitment and self-liberation. Action is the actual counter-conditioning that is taken to improve the health situation while the maintenance involves managing reinforcements and controlling stimulus (De Vet et al., 2006). This ensures that people do not relapse Goals (changing health outcomes and risk factors) The goal of the BEAT IT program is: To reduce the incidence of type II diabetes, and other chronic diseases, in low income areas for unemployed individuals over 18 years of age in inner North Canberra by 29%-67% by the year 2025 (De Vet et al, 2006). This goal will be evaluated by the percentage achieved in weight loss and percentage change in blood glucose levels. Objectives (aimed at changing behavior) The objectives of the BEAT IT program are to: Eliminate the sedentary lifestyle led by people in North Canberra as it leads to an increase in obesity. This reduction will be of about 20% by the year 2020 (Simpson, Shaw & Zimmet, 2003) To increase the physical activity that 30% of the adults in North Canberra engage in to a 20% increase in physical activity every week. To change the dietary intake through an increase the consumption of fruits and vegetables while decreasing the intake of energy and saturated fats (Simpson, Shaw & Zimmet, 2003) Improve exercising habits of the general population of North Canberra Sub objectives (aimed at changing the knowledge, attitudes, beliefs and the environment contributing to the problem) Increase the awareness of the at risk public in North Canberra on the connection between chronic health problems and lifestyle choices To increase awareness on different nutritional avenues that can be taken by adults in North Canberra to improve their lifestyle including teaching their children the right diets To increase awareness of the choices that people have in healthy snacking in order to avoid fatty foods and other foods that increase the risk factor of obesity and other chronic diseases (Holli et al., 2003) To increase awareness of the physical exercises that people can engage in everyday in order to reduce the levels of sedentary living in the community Rationale for goals, objectives and sub-objectives Poor nutrition has an impact on the normal development and growth of the entire society including men women and children. Adults leading a sedentary lifestyle are at risk of ill-health and they are likely to develop chronic and life threatening diseases such as type II diabetes and other obesity related health conditions (Eat well Australia, 2010). Social and economic costs that accompany poor lifestyle choices are significant and they need to be addressed effectively (PriceWaterhouseCoopers, 2001). Less physical activity accompanied by low consumption of fruits and vegetables as well as taking in higher levels of fat increase the susceptibility of more people. Consequently, interventions addressing these issues should be customized and location specific (Eat well Australia, 2010). Improving people’s lifestyle is therefore essential to the improvement of quality of life as well as cutting health costs in the society. type II diabetes is connected to factors such as obesity and leading a sedentary lifestyle. It is through changing these aspects of people’s lives that the prevalence of type II diabetes will be reduced. Literature review There are some individual level theories that explain health behavior phenomena (Levene & Donnelly, 2008). The general stipulations of these theories include that attitudes that people hold towards certain objects, behaviors and people are based on the beliefs that they hold about the particular object. In learning theories, the focus is on modeling and exposure (Worsley, 2008). Modeling is based on changing behavior. For instance, when parents eat fruits when their children are watching, their children will also be motivated to eat fruits. Exposure involves getting people to know about new food such as healthy and delicious snacking. Learning also involves reinforcement where good health behavior is rewarded (Pubmed health, 2010). This is mostly influential with children. Cognitive dissonance theory explains how people seek behavior that reinforces their existing framework (Worsley, 2008). Thus, needs assessment will aid in formulation of plans within the program that are consistent with the beliefs of a majority of the population with the consequence of changing the most behavior. Health belief models are influenced by the belief that one has of achieving self-efficacy (Nursing times, 2009). The theory of reasoned behavior predisposes that an individual will only engage in behavior if they have intent of performing the behavior (Worsley, 2008). The presence of the behavior is predicted by the intent. Absence of intent indicates that the behavior may not be adopted. The theory of reasoned action stipulates that there are two sets of attitudes including those towards behaviors and those towards objects (Worsley, 2008). For instance, one may have a positive attitude towards healthy eating and healthy foods but a negative attitude towards cooking the healthy meal. Owing to this disconnection, the program should aim to connect the eating and cooking in some way (Worsley, 2008). Consequently, if an individual holds the belief that adoption of a lifestyle that involves activity that is more physical is beyond their control, they are less likely to do so. Environmental-level models focus on the environmental settings that are needed to change the population through health interventions. These factors are geographical, physical and social. The models at this level make suggestions on the methods that promoters of nutrition can use to influence the environment and, how they can utilize other resources like communication technology in order to bring about certain changes (Worsley, 2008). The models affect internal and external environments. Consequently, health promoters use satiety and sensory processes in promoting nutrition. Sensory processes involve the nature of the food being transferred to our brains and made appealing (NICE, 2008). The planning process involves learning what makes food good or appealing to individuals and using the information in advancing the objective of people eating healthier food. Satiety is achieved through other processes such as adding water or fibers into food (Simpson, Shaw & Zimmet, 2003). This is because the food will be different as the individual interacts with it through chewing, tasting, swallowing, releasing endocrine hormones and gastric distension. The external environment includes the geographic and physical influences such as culture, the family, purchasing and usage behavior, organizational influences, food trends and the physical influences. Interventions should ensure that all these areas are addressed so that different aspects of an individual are addressed seeing as how the intervention program involves a lifestyle change. Models and theories are chosen in such a way that they are logical, are consistent with observations made every day, bear similarity to other programs and are supported by research done in the past. Rationale for theoretical model choice In order to plan and intervention effectively, it is important to look at various literature to develop a framework for the best practices. One of the issues that need to be considered in a lifestyle change program such as BEAT IT is how theory can be used in a practical setting to promote heath. This promotion will come as a consequence of learning of the nexus between health conditions and human behavior. It is important to know that people select information that they implement and practice based on existent behaviors and beliefs. This implies that a lifestyle change program would need to appeal to the population at a level that communicated and connects with their behavior and beliefs (Worsley, 2008). Consequently, the chances of people adopting the stipulations of the program will rise significantly and, the program can then meet its objectives. Information that comes from external sources such as the program is interpreted within a predetermined context. This context is inclusive of values, experiences, background and attitudes. Behaviors that people exhibit with reference to health issues are difficult to understand. They are varied, dynamic and volatile. However, these are the same qualities that make programs like BEAT IT possible because health behavior can be manipulated. In order to understand the varying nexus between health behaviors, theories have been developed that illustrate a general overview of these relationships (De Vet et al, 2006). However, no single behavior encompasses an explanation of all these behaviors. People’s motivations to adopt certain behaviors are triggered by different issues. They include the stimuli around the environment as well as personal issues. Programs influence individuals through motivating them by changing the environment around them (McDonald & Gray-Miceli, 2007). The responses that people exhibit may not be related to health outcomes and enhancement. The only issue is that they should be appealing to the population. Utilizing theories, one can predict and explain events that occur in the future. The major issues that affect the display of certain behavior and phenomena can be explained. This includes evaluating the reasons why some people engage in physical exercises and others do not. Another issue that will be tackled is evaluating the goal, objectives and sub-objectives. Evaluation will be done using a number of activities that involve the participants. The participants will be asked to fill in questionnaires in order to assess their level of physical activity. In addition, they will provide a diet history using FFQ. Other than that, their attitudes and beliefs will be assessed to determine how they have changed from the first commencing of the program. The nature of attendance will also be used to evaluate goals as will focus groups. The groups will provide areas that the participants can talk about their views providing further information on whether they have changed and their attitudes. Personal reflection 1 Behavior is among the most challenging things to embark on as a project’s goal. However, it is also the most rewarding if done correctly and successfully. Consequently, choosing to plan the BEAT IT program is a challenge but one with great rewards. In order to ensure the best rate of success, it was important to consider all the issues that may be faced in the process of planning and executing this program. Some of the issues include outlining the goals and objectives that the program will seek to achieve. In addition, since the program will be dealing with human behavior, it was also important to use the knowledge attained from theoretical perspectives. Choosing a single model of theory is not a true representation of the nature of human behavior because internal and external issues affect people when it comes to behavior change. Accordingly, these two perspectives need to be considered in planning health interventions. Using an individual and environmental model with greater focus on the environmental model provides planners with the best chance of implementing goals that will change the entire community in a gradual and effective manner. This is because the behavior will be sustained. Being that this was a group assignment, it was important that we all participate in gathering and interpreting information. However, with this, comes the challenge of establishing stable coherency within the group throughout the process of seeking and interpreting information. Not all opinions can be accepted as part of the work in a group and, this made some of the members feel like their ideas had not been considered. We handled this issue by ensuring that each group member understood the type of information needed. Being in a group made this a simper task because, there were more people to look for relevant information. Consequently, we got different views and perspectives in our data. There was also a challenge in agreeing on what constituted some of the issues we were dealing with especially terms such as obesity and sedentary lifestyle. What some members of the group thought to be sedentary was not what others did. We dealt with this problem by settling on a standard definition from health journals since our definition was relevant to the project BEAT IT. Personal reflection 2 The persistence of type II diabetes as a health problem shows that the issue needs to be tackled in a different and more effective manner. Thus, the choice of a lifestyle change program. lifestyle change programs are the best opportunities of reducing the prevalence of chronic illnesses. One of the issues that needs to be noted when dealing with these issues is that chronic health conditions are connected to each other either from a causal point of view or from a facilitator point of view. This explains the connection between being overweight and chronic diseases. Accordingly, interventions directed at reducing the prevalence of chronic diseases like type II diabetes should not be devoid of plans to deal with lifestyle issues that cause and aggravate obesity. Nevertheless, interventions can work and produce a significant change. Their failure or success is determined by the knowledge and information that is gathered as well as the processes specified in the planning and development stage. Dealing with issues concerning health is a challenging. Accordingly, I have come to appreciate the input on a group. Working as a group allows one to focus on particular areas on interest and explain them to others within the group. Interpreting data was also a challenge because of the differences that people had in interpreting similar sets of data within the group. In addition, setting the goal and objectives was harder especially with the goal since we had to come up with a single goal that would guide the objectives. In order to establish coherency, we divided ourselves into smaller groups each dealing with a different category of research before we came together to compile the data. Other than that, we met regularly and held discussions so that each person within the group could have their opinion heard and contribute to the information pool. We chose a member of the group to compile the data after which we all read it and made necessary corrections as a group. Group work is an interesting and unique way to do work. Each member of the group brings with them a unique component that adds to the value of the group. However, with these unique components, comes the issue of dealing with different personalities and opinions. Eventually, group work proved to be useful and more successful at meeting the needs of our project. Conclusion The BEAT IT lifestyle intervention program is meant to help people in North Canberra to improve their lives and the society. The information base provided by theoretical perspectives and other evidence based literature is adequate as it will help in the evaluation of previous and current practices in interventions. In addition, the planning also involves identifying and building upon the emerging trends that have been witnessed (Chapter 2, 2004). Planning and developing of this intervention is also inclusive of the goals, objectives and sub-objectives that give the intervention a guideline that can be followed through the process of implementation and evaluation. References Australian Bureau of Statistics. (2011a). Measures of Australia’s Progress: Obesity. ABS publication 1370.0. Retrieved from http://www.abs.gov.au Australian Bureau of Statistics. (2011b). Overweight and Obesity in Adults. ABS publication 4719.0. Retrieved from: http://www.abs.gov.au Australian Diabetes Council. (2011). BEAT IT: Physical Activity and Lifestyle Program. Australia, Canberra: ADC publication. Chapter 2. (2004). The practical value of theory. Health and human behavior, 26-43 De Vet, E., De Nooijer, J., De Vries, K. K., & Brug, J. (2006). The Transtheoretical model for fruit, vegetable and fish consumption: associations between intakes, stages of change and stage transition determinants. International Journal of Behavioral Nutrition and Physical Activity, 3(13), 1-11. “Diabetes, Type 2.” NursingTimes.net, 26 February, 2009. Retrieved from http://www.nursingtimes.net/diabetes-type-2/1998966.article Eat well Australia. (2010). A strategic framework for public health. 2947 Holli, B. B., Calabrese, R. J., & Maillet, J. O. (2003). Communication and Education Skills for Dietetic Professionals, 4th Edition. Lippincott: Williams & Wilkins . Lawrence, M., & Worsley, T. (2007). Public Health Nutrition: From Principles to Practice. Crows Nest: Allen & Unwin. Levene,L. S., & Donnelly, R. (2008). Management of Type 2 Diabetes Mellitus: A Practical Guide. New York, NY: Elsevier Health Sciences. McDonald, K., & Gray-Miceli, D. (2007). Assessment and Management of Type 2 Diabetes in Older Adults with Complex Care Needs. The National Gerontological Nursing Association (NGNA). 2-15. Retrieved from http://www.hartfordign.org/uploads/File/gnec_state_of_science_papers/gnec_type_2_diabetes.pdf National Institute for Health and Clinical Excellence (NICE). (2008). Type 2 diabetes: the management of type 2 diabetes. Retrieved from http://www.nice.org.uk/nicemedia/pdf/CG66NICEGuideline.pdf PriceWaterhouseCoopers. (2001). Type 2 diabetes: Managing for better health outcomes. New Zealand: Diabetes New Zealand Inc. Pubmed health. (2010). Diabetes. Retrieved from http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002194/ Simpson, R. W., Shaw, J. E., & Zimmet, P. Z. (2003). The prevention of type 2 diabetes – lifestyle change or pharmacotherapy? A challenge for the 21st century. Diabetes Research & Clinical Practice, 59(3), 165–180. Worsley, T. (2008). Nutrition promotion: Theories and methods, systems and settings. Crows Nest: Allen & Unwin. Read More

The health department in Australia would like to see the problem of prevailing chronic health issues solved because it is leading to greater health costs for the entire country. People are spending more money on meeting the needs of their chronic health problems and so is the health department. Health issues that are chronic in nature are affecting a vast majority of individuals in Australia. Owing to this situation, the health costs in Australia as well as the health of the entire population are significantly affected.

Some of these chronic health problems include type II diabetes, obesity and being overweight. By targeting the low-income areas, this program hopes to address the popular health issues and improve the general well being of the population in North Canberra. Although many other health programs and interventions have been put in place, these problems are still persistent owing to poor comprehension of communal needs as well as poor planning of intervention programs (Holli et al., 2003). Consequently, the availability of a well laid plan for developing a health intervention program.

The planning of Beat it will be dependent on the results of a needs evaluation, which precedes staged processes for meeting the identified needs (Australian Diabetes Council, 2011). Clinical trials comparing lifestyle intervention to control group have reported risk reduction for type II diabetes from 29-67% (Australian Diabetes Council, 2011). Therefore, the BEAT IT physical activity and lifestyle program was introduced and implemented in Inner North Canberra in Early March 2011 to address this public health issue.

This is a new program therefore there is a need to evaluate and improve the program for more effective intervention outcomes in the future The processes and activities involved in planning and developing a nutrition intervention or public health program are extensive and heavily dependent on the needs of the particular intervention or program. Once the rationale for developing the program or intervention has been established, the planning and developing processes must ensure that the needs of the program are met.

This paper will focus on the planning and developing of the BEAT IT program, which is a physical activity and lifestyle program being developed in inner North Canberra (Australian Diabetes Council, 2011). In order to understand the details of the plans that will be made towards meeting the needs of ‘beat it’, it is important to learn of the needs that accompany this program. Findings of the needs assessment The prevalence of chronic health problems is on the rise highlighting the fact that current interventions need to be evaluated and customized for smaller geographical areas.

This customization includes maintaining and promoting health and wellbeing related to nutrition. Public health nutrition programs aim to promote the health of populations using informed choices within the society and organized efforts. The plans made include improving conditions within the society using strategies that influence the entire population, an ethical framework, an evidence based approach and applying a framework of health promotion to the processes involved in planning (Lawrence & Worsley, 2007).

The processes involve a needs assessment, planning the program, implementing the program, evaluating the program (which is inclusive of redesigning the program and re-implementation), assessing the evaluability, impact and outcomes. About 90% of the individuals in Australia are making poor decisions in terms of their intake of fruits. Being obese results in certain social, economic and health impacts that raise the risk of chronic diseases. Most chronic health conditions are multi-factorial (Lawrence & Worsley, 2007).

Consequently, the risk factors are diverse including obesity, sedentary lifestyle and poor nutrition choices (De Vet et al., 2006). This is why the BEAT IT program is based on changing lifestyle because it encompasses all the issues that are involved in getting chronic health conditions.

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