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2020 cancer prevention project

CRITERIA FOR ASSESSING POTENTIAL OUTRUN CANCER RESEARCH AND ACTIVITY GRANTS

Project Name: Healthy Lunchbox Website

Project/research description and expected outcomes: Provide an outline of the project/research that would be funded by Outrun Cancer, the objective and/or rationale and the expected outcomes or outputs that would be achieved.

Outrun Cancer has previously funded the development of CCNSW’s Healthy Lunch Box website. healthylunchbox.com.au is a one-stop-shop for everything families need to know about packing a healthy lunch box. The website features an interactive and educational, healthy lunch box builder that will plan a lunch box containing foods from the five food groups. Parents will also find information on what constitutes a healthy lunch box, sandwich alternatives, sandwich filling ideas, snack ideas, alternatives to unhealthy snack foods, recipes and tips. Recipes are packed full of fruit, vegetables and wholegrains which can help reduce cancer risk.

CCNSW commissioned the Sax Institute to conduct a rapid review of the current evidence and associated literature on digital platforms as effective health promotion tools for nutrition education with a focus on parents with children (Sax Review). The Sax Review demonstrated that digital health promotion tools targeting parents can be effective for improving dietary intake, knowledge and self-efficacy. 1

The Healthy Lunch Box website was launched in January 2018. Since launch, the website has reached 155,635 users and seen 1,364,23 page views. Feedback from our key stakeholders has been very positive. A suggestion from the NSW Ministry of Health and some Local Health Districts has been that the website would benefit from enhanced functionality and content that is appropriate for low-literacy and lower socio-economic groups. Responding to this feedback is a priority for CCNSW, as the CCNSW 2019-23 strategy aims to improve cancer outcomes for priority populations including culturally and linguistically diverse communities and lower socio-economic communities.

Funding from Outrun Cancer would be used to undertake a needs assessment of low literacy and lower socio-economic groups. The results of this study in combination with the Sax Review1 will be used to inform content development and improved functionality of the Healthy Lunch Box website. This could include:

  • Development of more visual content such as videos
  • New healthy recipes and videos for limited incomes
  • Identifying personalisation features allowing users to access information specific to their needs, for example building and saving lunch boxes for multiple children, weekly planners etc.
  • An online Healthy Lunch Box Presentation for schools and health professionals

Potential Impact of research/project: Explain how the research or project will have an important positive impact on human lives, including any of the following aspects: better understanding of lifestyle factors and their contribution to cancer, increasing awareness of healthy lifestyle in cancer prevention, improving the community’s health behaviours.

Collectively, the independent risk factors of overweight and obesity, physical inactivity, and poor diet are second only to tobacco as modifiable risk factors for cancer.2

  • Overweight and obesity is the cause of 13 cancers, including post-menopausal breast, endometrial, bowel, kidney, liver and pancreatic cancer.
  • Overweight or obesity is the cause of 5,731 cancer cases in Australia each year. Poor diet including inadequate fruit, vegetable and fibre intake, and eating too much red and processed meats is linked to 6,714 cancer cases.

At CCNSW, we believe that we can reduce cancer risk by:

  • Helping people to eat healthily,
  • Advocating for environments that make it easier to make healthier choices.

Data on eating habits and weight status of NSW adults and children shows that a significant percentage of the population is not eating in line with the Australian Dietary Guidelines and are not a healthy weight.

In NSW in 20183

  • 24% of children and 54% of adults were overweight or obese.
  • Only 51% of adults consumed the recommended two or more serves of fruit each day and only 7.5% of adults consumed the recommended five or more serves of vege­­tables each day.
  • Consumption among children is also alarmingly poor with only 6.7% of children consuming the recommended amount of vegetables and 64% eating enough fruit.

NSW School Physical Activity and Nutrition Survey (SPANS) 2015 shows that children and adolescents frequently consumed a range of energy-dense and nutrient poor foods and drinks. There is clear and consistent evidence that overweight and obesity is significantly higher among children and adolescents from low SES backgrounds, and in children from Middle Eastern cultural backgrounds, compared with their peers. 4

Community need or research gap being addressed: Explain how the project meets a need in the community; how does this address an unmet need and/or complement other projects rather than duplicating existing programs or services? Explain how the research builds on existing evidence to fill a gap in our knowledge about healthy lifestyle and cancer prevention.

The Sax Review outlined that there are few dedicated lunch box websites or apps that are currently available at scale for use by parents, children or families to support nutrition, promotion efforts to improve children’s diets.  Furthermore, there are even fewer apps or websites reported in user-testing studies that have all the desired components, specifically credible and evidence-based nutrition information, personalisation, interactive features and practical, ‘how to’ support. The CCNSW Healthy Lunch Box website addresses this gap with its unique combination of the interactive lunch box builder, recipes, healthy swaps tips and credible nutrition information. However, opportunities still exist to optimise the CCNSW website to include features enabling personalisation and interactivity1, especially to improve its acceptability and engagement for low literacy and lower socio-economic groups.

Equity/Target group: Explain the selection of the study sample or target groups and why you have included and excluded particular groups who could potentially benefit from the outcomes of this research or project. If relevant, outline how the proposal addresses an under-­studied or under-­served population and/or a population with a high burden of disease or poorer outcomes.

There is clear and consistent evidence that the rate of overweight/obese children and adolescents is significantly higher among lower socio-economic (SES) backgrounds.5 However, at present, the Healthy Lunch Box website does not have the functionalities (usability, language used, simplified content) to meet the needs of this audience.

Content and functionalities will improve the accessibility of the website for all Australians.

 

Alignment to Outrun Cancer principles and desired outcomes: Explain how the research or project is aligned with principles and desired outcomes outlined in the Outrun Cancer research and activities guidelines?

 This project is a cancer prevention project helping the community adopt a healthy lifestyle by eating well. This clearly aligns with Outrun Cancer’s belief that prevention is the most sustainable approach to a cancer free future.

Alignment to Cancer Council strategic intent: To what extent is this project aligned with Cancer Council NSW existing strategic intent with respect to prevention and research. If this is a Cancer Council project or research, does Cancer Council currently have capacity to effectively deliver and/or manage the research or project?

This project is very closely aligned with CCNSW 2019-23 strategic intent. CCNSW’s Vision is for a cancer free future, through strategies including ‘Reducing Cancer Risk’ and ‘Improving Cancer Outcomes for Priority Populations’. The strategic intent clearly outlines CCNSW wants to increase the number of people who are physically active, eat well and are a healthy weight, which the Healthy Lunch Box website aims to do. This project will better enable the website to reach priority populations including low literacy and lower socio-economic communities.

CCNSW currently has 1 permanent FTE staff dedicated to working on the Healthy Lunch Box website. The website is a key strategy to increase the proportion of people that eat well and are a healthy weight in order to reduce cancer risk in the community. The CCNSW funding to support the day-to-day content development and website promotion will continue, however, funding provided by Outrun Cancer will enable a needs assessment for low-literacy and lower socio-economic communities, leading to additional content and functionality developments that address these needs focusing on personalisation and interactivity found to be desired components of digital health promotion tools 1. This project can be undertaken by the current CCNSW staff.

 

Pathway for realising the benefit: Provide a clear description of the steps required to reach the stated end benefits of the research. Outline a timeline for the project or research including any key milestones or deliverables. How would the results of the research or outputs of the project be impact on cancer prevention activities? How would this research or project continue to deliver benefits after the funding has ceased? How would you ensure sustainability of programs beyond Outrun Cancer funding?

This project could be delivered over 2 years. Key milestones include:

  • Needs assessment planning – 1 month
  • Stakeholder Engagement – 1 month
  • Conducting Needs Assessment – 3 months
  • Analysis of Needs Assessment results in combination with the Sax Review – 2 months.
  • Content and functionality development planning – 1 month
  • Sourcing of quotes for required content and functionality developments – 1 month
  • Content development – 4 months
  • Website functionality development – 6 months concurrent with content development
  • Implementation: including uploading content, launch of new website functionality, social and traditional marketing of new content and functionality, promotion of new content and resources to stakeholders and how they can be utilised with clients especially low literacy and lower socio-economic groups – 6 months
  • Monitoring and evaluation of new content and website functionality – 2 months

Once new content and functionality is developed it is sustainable, in that it can be uploaded onto the website and be repurposed for other uses, communications and promotions. Ongoing CCNSW funding can be used to promote the any new content that is developed. CCNSW has an ongoing marketing, PR and stakeholder engagement strategy (including regular EDMs and newsletters to all NSW schools and Local Health Districts and subscribed childcare centres, community organisations, parents, health professionals, volunteers and interested community members) for promotion of the Healthy Lunch Box website and currently delivers two 7-week social media campaigns per year, specifically promoting the HLB website (January and July). Healthy Lunch Box information, content and resources (such as, videos, recipes and blogs) are also shared across the organisation and utilised and promoted through other campaigns, events and fundraisers including, Australia’s Biggest Morning Tea, 7 Bridges walk, Relay For Life and community information talks. Once new website functionality is launched ongoing maintenance would be covered within the CCNSW Healthy Lunch Box project budget.

Branding and promotional opportunities:Outline opportunities to promote the collaboration between and Outrun Cancer and Cancer Council NSW to enhance the reputation of both organisations, demonstrate leadership in this area and raise awareness of the importance healthy lifestyle in cancer prevention.

As mentioned above CCNSW has an ongoing social marketing, PR and stakeholder engagement strategy for promotion of the Healthy Lunch Box website and healthy lifestyle in cancer prevention messages. Acknowledgement of Outrun Cancer’s funding and partnership with CCNSW including links to Outrun Cancer website could be promoted through numerous channels. Such as:

  • Acknowledgement of Outrun Cancer’s funding on the Healthy Lunch Box website, including a link to the Outrun Cancer website.
  • Acknowledgement of Outrun Cancer’s funding and on content developed as part of this project.
  • Acknowledgement of Outrun Cancer’s funding in stakeholder communications such as regular EDMs and newsletters to all NSW schools and Local Health Districts and subscribed childcare centres, community organisations, parents, health professionals, volunteers and interested community members.
  • Co-branding of resources developed as part of this project.
  • Acknowledgement of Outrun Cancer’s funding in state-wide and local media releases.
  • All content could be used by Outrun Cancer to share with their networks to promote healthy eating and cancer prevention messages e.g. videos and other campaign materials.

Proposed budget: Please provide a general outline of the required budget including staff costs, costs of resources and project material, other research costs. Please also list any in-kind contribution that would be provided.

Without having already conducted a needs assessment for this project it is very difficult to provide a required budget. Several of the project milestones will be covered by CCNSW in-kind contributions (see below). A detailed outline of costs can be provided after the needs assessment is conducted, however, funding commitment for content and website functionality development, from an organisation such as Outrun Cancer is required to enable CCNSW to begin this project and enter into a needs assessment with the ability to act on identified needs.

Based on previous content and website functionality quotes funding of $110,000 would allow for development of:

  • Website functionality (to be confirmed after needs assessment): $30,000
  • 10-15 recipe videos: $25,000
  • 15-20 recipes (including ingredients, recipe testing and photography): $20,000
  • Other resources and content (for e.g. online Healthy Lunch Box presentation): approx. $15,000
  • Social Marketing: $20,000

In-kind contribution from CCNSW

  • Nutrition Unit project management and needs assessment (0.2 – 0.4 FTE over two years) $80,000
  • Digital Team project management (0.1 FTE over 2 years) $25,000
  • Marketing and PR support (0.1 FTE over 2 years) $25,000
  • Evaluation and monitoring support (0.1 FTE over 2 years) $25,000

Total Outrun Cancer contribution: $110,000 excl GST

Total CCNSW in-kind contribution: $155,000 excl GST

TOTAL project budget: $240,000 excl GST

Once an amount of funding is known, CCNSW can plan to utilise the funds in the most appropriate way based on the needs identified in the needs assessment and the Sax Review1 and provide a detailed outline of how the money would be used.

Key milestones, in-kind vs budget required:

  • Needs assessment planning (in-kind)
  • Stakeholder Engagement (in-kind)
  • Conducting Needs Assessment (in-kind)
  • Analysis of Needs Assessment results in combination with the Sax Review (in-kind)
  • Content and functionality development planning (in-kind/budget required)
  • Sourcing of quotes for required content and functionality developments (in-kind)
  • Content development (budget required)
  • Website functionality development (budget required)
  • Implementation: including launch of new website functionality, social and traditional marketing of new content and functionality, promotion of new content and resources to stakeholders and how they can be utilised with clients especially low literacy and lower socio-economic groups. (in-kind, could be amplified with extra budget)
  • Monitoring and evaluation of new content and website functionality (in-kind)
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