Search

Background: A growing body of evidence suggest an association between physical activity levels and students psychological well-being. A number of research studies have evaluated playground interventions that aim to increase physical activity levels, decrease conflict and bullying, and improve students behaviour. The HAPPY Study will evaluate the success of an intervention combining environmental modifications, teacher development, and peer support that can culminate in an easy to implement, low cost and effective model for increasing physical activity, and improving psychological well-being for children.Methods/design: Data will be collected at six New South Wales (NSW) primary schools, on physical activity levels, on-task time during classes, and social support for physical activity during a 12 month Cluster Controlled Trial (CT). Three quantitative data collection tools will be used to capture student's physical activity levels during lunch and recess breaks (the SOPARC tool), student's on-task behaviour during classes following recess and lunch breaks (the BOSS tool) and where students receive the most encouragement to be physically active from (the Physical Activity Social Support Scale survey). Baseline data will be analysed against follow-up data, collected after an intervention that is rolled out in all schools as part of a stepped wedge CT design.Discussion: A review of relevant Australian and New Zealand literature suggests that playground interventions can be successful at increasing physical activity levels, increasing social and conflict resolution skills in students, and decreasing incidences of bullying. This study will investigate any correlation between physical activity levels, and student behaviour during classes following breaks.Trial Registration: Australian and New Zealand Clinical Trials Register ACTRN12616000575437 , registered May 2016. [ABSTRACT FROM AUTHOR]

Background: High-intensity interval training (HIIT) interventions are becoming more common in schools. However, limited input has been sought from end-users, which can help design interventions that are more engaging and context appropriate, therefore increasing their potential for successful implementation. One method of engaging end-users is co-design, which involves an active collaboration to design solutions to pre-specified problems. This paper aimed to: (1) describe the methodology and results of the co-design process in Making a HIIT to develop HIIT workouts for a school-based intervention; and (2) evaluate the feasibility and impact of co-designing HIIT workouts with students and teachers within the health and physical education (HPE) curriculum. Methods: The development of the HIIT workouts occurred during obligatory HPE lessons with year seven and eight students. The co-design process included: (1) identifying barriers and facilitators to exercise to create evaluation criteria for creating the HIIT workouts; (2) exploring HIIT; (3) defining HIIT parameters (intensity and interval length); (4) creating HIIT workouts using the parameters and evaluation criteria; (5) trialling and modifying the HIIT workouts based on class feedback and intensity data. To evaluate the feasibility and impact of the co-design process, a thematic analysis was completed using teacher interviews, student discussions, and student surveys. Results: Five classes comprised of 121 students (12–14 years; 49% female) and five teachers were involved in the co-design process across three schools in Queensland, Australia. A total of 33 HIIT workouts were created aimed at satisfying the HIIT parameters and variations of the following evaluation criteria: (1) fun; (2) social; (3) achievable skill level; (4) feeling accomplished; and (5) beneficial for health. From the thematic analysis, three themes (acceptability; implementation; integration) and 12 codes contributed to the overarching understanding of the feasibility of the lessons within the curriculum and a further three themes (perceived changes to lessons; educative outcomes; personal and social capabilities) and three codes contributed towards understanding their impact. Conclusion: Overall, co-designing HIIT workouts was feasible within the HPE curriculum and may have contributed to positive educative outcomes. Using this methodology could improve the implementation of HIIT interventions within HPE while supporting educative benefits. [ABSTRACT FROM AUTHOR]

Individuals' access to sport and physical activity has been hampered due to COVID-19 lockdown restrictions. In Australia participation in community sport was cancelled during lockdowns. There is limited research on the impact of sport participation restrictions on the health and wellbeing of adults.AimThe aim of this study was to investigate the perceived health and wellbeing of a sample of predominantly active Australian adults, both during COVID-19 and in comparison with one year earlier (pre COVID-19).MethodsA survey was conducted during the first COVID-19 restrictions and lockdowns in Australia in May-June 2020. It was distributed by national and state sporting organisations and through researchers' social media accounts. This particular paper focuses on adults aged 18-59 years. The survey collected information on participant demographics, the sport and physical activity patterns pre- COVID-19, and health and wellbeing outcomes during COVID-19 lockdown and compared to one year earlier. The health measures were cross-tabulated against the demographic and sport and physical activity variables, and group profiles compared with chi-square tests. Scales were derived from three wellbeing questions, and group differences were analysed by t-tests and F-tests.ResultsThe survey sample included 1279 men and 868 women aged 18-59 years. Most (67%) resided in metropolitan cities. The great majority (83%) were sport participants. During COVID-19 lockdown men were significantly more likely than women to report worse or much worse general (p = 0.014), physical (p = 0.015) and mental health (p = 0.038) and lower life satisfaction (p = 0.016). The inactive adults were significantly more likely to report poorer general health (p = 0.001) and physical health (p = 0.001) compared to active adults. The younger age cohort (18-29 years) were significantly more likely to report poorer general wellbeing (p < 0.001), and lower life satisfaction (p < 0.001) compared to the older age groups.ConclusionIt seems that the absence of playing competitive sport and training with friends, teams and within clubs has severely impacted males and younger adults in particular. Sports clubs provide an important setting for individuals' health and wellbeing which is why clubs require the capacity to deliver sport and individuals may need to regain the motivation to return. [ABSTRACT FROM AUTHOR]

Background: COVID-19 continues to represent the single biggest challenge to contemporary community sport globally. Compliance with social distancing policies, strict return-to-play protocols, and COVID-19 specific training has, perhaps, forever changed the way that children and young people engage in organised sport. Within this context, and while many children and families seek to re-engage with community sport, we (researchers and sport practitioners) have an obligation to ask questions about how the pandemic has impacted youth sport, understand the short- and long-term consequences, and explore what (if any) opportunities can be seized to assist and improve future participation and retention. The aim of this paper was to present an in-depth exploration of the impact of COVID-19 on youth sport in South Australia. Methods: Within an interpretive descriptive methodology, this qualitative investigation draws on rich, individual interview and focus group data with 39 youth (ages 15–18), parents, coaches, and sport administrators. A reflexive thematic analysis was undertaken, leading to the development of four substantive themes. Results: We conceptualised the '4 Rs' to advance theoretical understandings about the pandemic's impact on youth sport, including the themes 'recognising struggle', 'reconnection', 're-engaging after restrictions, and 'reimagining sport'. The themes captured insights about a decline in mental wellbeing and physical activity, an increase in family connectedness, the challenge for sports to attract volunteers and participants back into sport, and the opportunities to reset values and philosophies underpinning the provision of youth sport. Conclusion: The findings provide valuable insight into the youth sport setting as a result of the global pandemic and suggest that families, sporting clubs and sporting organisations require additional resources and tools (for example, support for parents to facilitate their children's training at home during lockdown) to aid recovery efforts and to ensure the survival and prosperity of youth sport into the future. [ABSTRACT FROM AUTHOR]

Background: In 2017, the Australian Government funded the update of the National Physical Activity Recommendations for Children 0-5 years, with the intention that they be an integration of movement behaviours across the 24-h period. The benefit for Australia was that it could leverage research in Canada in the development of their 24-h guidelines for the early years. Concurrently, the Grading of Recommendations Assessment, Development and Evaluation (GRADE) working group published a model to produce guidelines based on adoption, adaption and/or de novo development using the GRADE evidence-to-decision framework. Referred to as the GRADE-ADOLOPMENT approach, it allows guideline developers to follow a structured and transparent process in a more efficient manner, potentially avoiding the need to unnecessarily repeat costly tasks such as conducting systematic reviews. The purpose of this paper is to outline the process and outcomes for adapting the Canadian 24-Hour Movement Guidelines for the Early Years to develop the Australian 24-Hour Movement Guidelines for the Early Years guided by the GRADE-ADOLOPMENT framework.Methods: The development process was guided by the GRADE-ADOLOPMENT approach. A Leadership Group and Consensus Panel were formed and existing credible guidelines identified. The draft Canadian 24-h integrated movement guidelines for the early years best met the criteria established by the Panel. These were evaluated based on the evidence in the GRADE tables, summaries of findings tables and draft recommendations from the Canadian Draft Guidelines. Updates to each of the Canadian systematic reviews were conducted and the Consensus Panel reviewed the evidence for each behaviour separately and made a decision to adopt or adapt the Canadian recommendations for each behaviour or create de novo recommendations. An online survey was then conducted (n = 302) along with five focus groups (n = 30) and five key informant interviews (n = 5) to obtain feedback from stakeholders on the draft guidelines.Results: Based on the evidence from the Canadian systematic reviews and the updated systematic reviews in Australia, the Consensus Panel agreed to adopt the Canadian recommendations and, apart from some minor changes to the wording of good practice statements, keep the wording of the guidelines, preamble and title of the Canadian Guidelines. The Australian Guidelines provide evidence-informed recommendations for a healthy day (24-h), integrating physical activity, sedentary behaviour (including limits to screen time), and sleep for infants (<1 year), toddlers (1-2 years) and preschoolers (3-5 years).Conclusions: To our knowledge, this is only the second time the GRADE-ADOLOPMENT approach has been used. Following this approach, the judgments of the Australian Consensus Panel did not differ sufficiently to change the directions and strength of the recommendations and as such, the Canadian recommendations were adopted with very minor alterations. This allowed the Guidelines to be developed much faster and at lower cost. As such, we would recommend the GRADE-ADOLOPMENT approach, especially if a credible set of guidelines, with all supporting materials and developed using a transparent process, is available. Other countries may consider using this approach when developing and/or revising national movement guidelines. [ABSTRACT FROM AUTHOR]

Background: Insufficient sleep is potentially an important modifiable risk factor for obesity and poor physical activity and sedentary behaviours among children. However, inconsistencies across studies highlight the need for more objective measures. This paper examines the relationship between sleep duration and objectively measured physical activity, sedentary time and weight status, among a sample of Victorian Primary School children.Methods: A sub-sample of 298 grades four (n = 157) and six (n = 132) Victorian primary school children (aged 9.2-13.2 years) with complete accelerometry and anthropometry data, from 39 schools, were taken from a pilot study of a larger state based cluster randomized control trial in 2013. Data comprised: researcher measured height and weight; accelerometry derived physical activity and sedentary time; and self-reported sleep duration and hypothesised confounding factors (e.g. age, gender and environmental factors).Results: Compared with sufficient sleepers (67 %), those with insufficient sleep (<10 hrs/day) were significantly more likely to be overweight (OR 1.97, 95 % CI:1.11-3.48) or obese (OR 2.43, 95 % CI:1.26-4.71). No association between sleep and objectively measured physical activity levels or sedentary time was found.Conclusion: The strong positive relationship between weight status and sleep deprivation merits further research though PA and sedentary time do not seem to be involved in the relationship. Strategies to improve sleep duration may help obesity prevention initiatives in the future. [ABSTRACT FROM AUTHOR]

Background: Participation in organised sport and physical activity contributes to health-enhancing levels of leisure time physical activity. In Australia, 58% of children aged 0-14 years participated at least once a week in October 2015 - December 2017. To overcome the frequently cited cost barrier, sports voucher incentives have been widely implemented across Australia.Method: The financial value of jurisdictional vouchers and the National median financial value were used to calculate the proportion of total annual expenditure on children's participation in sport supported by sports vouchers. Participation rates using AusPlay data were estimated by age, sex and socio-economic index (SEIFA) at state and national level for children aged 0-14 years.Results: Five States and Territories implemented sports vouchers from 2011 to 2018, with a median value of AU$150. Nationally, median annual expenditure for children's sport participation was AU$447 (IQR $194.2-936), with 27% reported expenditure supported by a sports voucher. The proportion of financial support from sports vouchers increased considerably with social disadvantage, rising to over 60% of total expenditure in the most disadvantaged populations.Conclusions: Socio-economic status was associated with sports-related expenditure and sports participation amongst children. Sport vouchers should target children in the most disadvantaged areas to promote participation in organised sport and physical activity. [ABSTRACT FROM AUTHOR]

Background: The last few years have seen renewed interest in use-of-time recalls in epidemiological studies, driven by a focus on the 24-h day [including sleep, sitting, and light physical activity (LPA)] rather than just moderate-vigorous physical activity (MVPA). This paper describes four different computerised use-of-time instruments (ACT24, PAR, MARCA and cpar24) and presents population time-use data from a collective sample of 8286 adults from different population studies conducted in Australia/New Zealand, Germany and the United States.Methods: The instruments were developed independently but showed a number of similarities: they were self-administered through the web or used computer-assisted telephone interviews; all captured energy expenditure using variants of the Ainsworth Compendium; each had been validated against criterion measures; and they used a domain structure whereby activities were aggregated under categories such as Personal Care and Work.Results: Estimates of physical activity level (average daily rate of energy expenditure in METs) ranged from 1.53 to 1.78 in the four studies, strikingly similar to population estimates derived from doubly labelled water. There was broad agreement in the amount of time spent in sleep (7.2-8.6 h), MVPA (1.6-3.1 h), personal care (1.6-2.4 h), and transportation (1.1-1.8 h). There were consistent sex differences, with women spending 28-81% more time on chores, 8-40% more time in LPA, and 3-39% less time in MVPA than men.Conclusions: Although there were many similarities between instruments, differences in operationalizing definitions of sedentary behaviour and LPA resulted in substantive differences in the amounts of time reported in sedentary and physically active behaviours. Future research should focus on deriving a core set of basic activities and associated energy expenditure estimates, an agreed classificatory hierarchy for the major behavioural and activity domains, and systems to capture relevant social and environmental contexts. [ABSTRACT FROM AUTHOR]

Background: Physical activity has numerous health benefits, but participation is lower in disadvantaged communities. 'parkrun' overcomes one of the main barriers for disadvantaged communities, the cost of activities, by providing a free, regular community-based physical activity event for walkers, runners and volunteers. This study assesses equity of access (in terms of distance to the nearest parkrun) stratified by socioeconomic deprivation, and identifies the optimal location for 100 new events to increase equity of access.Methods: We combined information about population location and socioeconomic deprivation, with information about the location of 403 existing parkrun events, to assess the current level of access by deprivation quintile. We then used a two-step location-allocation analysis (minimising the sum of deprivation-weighted distances) to identify optimal regions, then optimal towns within those regions, as the ideal locations for 100 new parkrun events.Results: Currently, 63.1% of the Australian population lives within 5 km of an event, and the average distance to an event is 14.5 km. A socioeconomic gradient exists, with the most deprived communities having the largest average distance to an event (27.0 km), and the least deprived communities having the best access (living an average 6.6 km from an event). Access improves considerably after the introduction of new event locations with around 68% of the population residing within 5 km of an event, and the average distance to the nearest event approximately 8 km. Most importantly, the improvement in access will be greatest for the most deprived communities (now an average 11 km from an event).Conclusions: There is a socioeconomic gradient in access to parkrun events. Strategic selection of new parkrun locations will improve equity of access to community physical activity events, and could contribute to enabling greater participation in physical activity by disadvantaged communities. [ABSTRACT FROM AUTHOR]

Background: Childcare centres are important environments for promoting physical activity and healthy eating. Blended approaches to professional learning may help overcome existing challenges for educators in promoting these behaviours. This study aimed to test the effect of a blended professional learning program on healthy eating and physical activity in childcare.Methods: Cluster randomized stepped-wedge trial in 15 childcare centres in Tasmania, Australia. Children aged 2-5y who attended at least two days per week were eligible to participate. Random assignment occurred at the centre level. Centre names were drawn out of a hat and then subsequently allocated to one of the three steps. The intervention comprised a 12-week blended professional learning program for educators. The main outcome was centre-level physical activity and healthy eating, assessed using the Environment and Policy Assessment Observation System (EPAO). All data collectors were blinded to step allocation. Analyses were according to intention to treat. The trial was registered with the Australian New Zealand Clinical Trial Registry (ACTRN12618000346279, date registered: 07/03/2018).Results: Centres were recruited between January 2016 and February 2016. All centres were retained for the duration of the study. A total of 313 children were recruited with 291 analysed at the completion of the study (93%). The difference between groups for the EPAO total score was significant at the end of the maintenance period (adjusted difference = 14.63, 95% CI [1.33, 27.92], p = 0.03). Significant differences were found for the percentage of time children spent in light-intensity physical activity at the end of the intervention (adjusted difference = 0.01, 95% CI [0.00,0.01], p = 0.02) and maintenance periods (adjusted difference = 0.01, 95% CI [0.00,0.02], p = 0.04). To the best of the authors knowledge, there were no adverse events.Conclusion: This intervention achieved a sustained improvement in physical activity and healthy eating in childcare centres. Further, it can be easily integrated into existing service provision, especially among centres with limited access to professional learning.Trial Registration: The study was registered with the Australian and New Zealand Clinical Trials Registry ( ACTRN12618000346279 , date registered: 07/03/2018). [ABSTRACT FROM AUTHOR]

Background: Early childhood is a critical window for preventing obesity and chronic disease. Yet, 1 in 4 Australian children aged 5 years and under are affected by overweight or obesity; and significant proportions of children under 5 years fail to meet guidelines for diet quality, physical activity (PA), screen time, and sleep. Consequently, effective interventions to promote healthy lifestyle behaviors and prevent obesity during early childhood are needed. Community playgroups provide an opportunity for parents, carers, and children to meet in a safe and relaxed environment to play and share information. The structure, low cost and reach of playgroups provide a unique platform to engage parents in a scalable program to promote healthful lifestyle behaviors and prevent childhood obesity. However, the evidence base for the effectiveness of health promotion programs delivered in community playgroup settings is limited and lacking credible evidence from rigorously conducted randomized controlled trials.Methods: The Healthy Conversations @ Playgroup randomized controlled trial (RCT) aims to address the underlying behavioral risk factors for obesity by helping parents take effective steps to improve their child's dietary, PA, screen time, and sleep behaviors. The intervention program comprises 10 "healthy conversations" led by a trained peer facilitator, designed to increase parents' behavioral capability and self-efficacy to implement autonomy-supportive parenting practices. The program will be delivered biweekly during regularly scheduled playgroup sessions over 10-weeks. Effectiveness will be tested in a 2-arm cluster RCT involving 60 community playgroups in three states across Australia. After baseline assessments, participating playgroups will be randomly allocated to either intervention or wait-list control conditions. Primary outcomes (vegetable intake, discretionary foods, daily PA, screen time, sleep duration, and body mass index [BMI] z-score) will be assessed at baseline, immediately post-intervention (10-weeks; T2) and 6-months post-intervention (T3). Outcomes will be assessed for differential change at T2 and T3.Discussion: The Healthy Conversations @ Playgroup trial will rigorously evaluate a novel peer-led intervention program to promote healthful lifestyle behaviors and prevent obesity in children and families attending community playgroups. If effective, the program could be immediately scaled-up and delivered in community playgroups across Australia.Trial Registration: Trial registered 22nd January 2021 with the Australian and New Zealand Clinical Trials Registry ( ACTRN12621000055808 ). [ABSTRACT FROM AUTHOR]

Background: The home environment is the most important location in young children's lives, yet few studies have examined the relationship between the outdoor home environment and child physical activity levels, and even fewer have used objectively measured exposures and outcomes. This study examined relationships between objectively assessed home yard size and greenness, and child physical activity and outdoor play.Methods: Data were drawn from the HealthNuts study, a longitudinal study of 5276 children in Melbourne, Australia. We used cross-sectional data from a sample at Wave 3 (2013-2016) when participants were aged 6 years (n = 1648). A sub-sample of 391 children had valid accelerometer data collected from Tri-axial GENEActive accelerometers worn on their non-dominant wrist for 8 consecutive days. Yard area and greenness were calculated using geographic information systems. Objective outcome measures were minutes/day in sedentary, light, and moderate-vigorous physical activity (weekday and weekend separately). Parent-reported outcome measures were minutes/day playing outdoors (weekend and weekday combined). Multi-level regression models (adjusted for child's sex, mother's age at the birth of child, neighbourhood socioeconomic index, maternal education, and maternal ethnicity) estimated effects of yard size and greenness on physical activity.Results: Data were available on outdoor play for 1648 children and usable accelerometer data for 391. Associations between yard size/greenness and components of physical activity were minimal. For example, during weekdays, yard size was not associated with daily minutes in sedentary behaviour (β: 2.4, 95% CI: - 6.2, 11.0), light physical activity (β: 1.4, 95% CI: - 5.7, 8.5) or MVPA (β: -2.4, 95% CI: - 6.5, 1.7), with similar patterns at weekends. There was no relationship between median annual yard greenness and physical activity or play.Conclusion: In our study of young children residing in higher socio-economic areas of Melbourne yard characteristics did not appear to have a major impact on children's physical activity. Larger studies with greater variation in yard characteristics and identification of activity location are needed to better understand the importance of home outdoor spaces and guide sustainable city planning. [ABSTRACT FROM AUTHOR]

Background: Almost one in three Australian adults are now obese, and the rate continues to rise. The causes of obesity are multifaceted and include environmental, cultural and lifestyle factors. Emerging evidence suggests there may be temporal patterns in weight gain related, for example, to season and major festivals such as Christmas, potentially due to changes in diet, daily activity patterns or both. The aim of this study is to track the annual rhythm in body weight, 24 h activity patterns, dietary patterns, and wellbeing in a cohort of Australian adults. In addition, through data linkage with a concurrent children's cohort study, we aim to examine whether changes in children's body mass index, activity and diet are related to those of their parents.Methods: A community-based sample of 375 parents aged 18 to 65 years old, residing in or near Adelaide, Australia, and who have access to a Bluetooth-enabled mobile device or a computer and home internet, will be recruited. Across a full year, daily activities (minutes of moderate to vigorous physical activity, light physical activity, sedentary behaviour and sleep) will be measured using wrist-worn accelerometry (Fitbit Charge 3). Body weight will be measured daily using Fitbit wifi scales. Self-reported dietary intake (Dietary Questionnaire for Epidemiological Studies V3.2), and psychological wellbeing (WHOQOL-BREF and DASS-21) will be assessed eight times throughout the 12-month period. Annual patterns in weight will be examined using Lowess curves. Associations between changes in weight and changes in activity and diet compositions will be examined using repeated measures multi-level models. The associations between parent's and children's weight, activity and diet will be investigated using multi-level models.Discussion: Temporal factors, such as day type (weekday or weekend day), cultural celebrations and season, may play a key role in weight gain. The aim is to identify critical opportunities for intervention to assist the prevention of weight gain. Family-based interventions may be an important intervention strategy.Trial Registration: Australia New Zealand Clinical Trials Registry, identifier ACTRN12619001430123 . Prospectively registered on 16 October 2019. [ABSTRACT FROM AUTHOR]

Background: Participation in sport and physical activity could minimise the inflated risk of poor physical health outcomes for Aboriginal and Torres Strait Islander children and adolescents. This review aimed to synthesise existing quantitative and qualitative literature regarding barriers and facilitators to physical activity and sports participation in Aboriginal and Torres Strait Islander children.Methods: Literature was systematically searched to include studies reporting barriers or facilitators to physical activity and/or sports participation in Aboriginal and Torres Strait Islander children aged 0-18 years. Using a pre-established taxonomy based on the social-ecological model, a deductive analysis was performed. Quality appraisal was performed using the Mixed Methods Appraisal Tool.Results: Of 3440 unique articles, nine studies were included with n = 10,061 total participants. Of the nine included studies one reported on participants from urban areas, two from regional and three from remote areas. Three were from representative samples of the Aboriginal and Torres Strait Islander population. Barriers were reported in all nine studies: 18 individual, 9 interpersonal, 27 community and 4 at the policy level (58 total); Facilitators were reported in five studies: 12 individual, 11 interpersonal, 11 community and 3 policy level (37 total).Conclusions: Research in this area is lacking with some states in Australia not represented and small samples. Strategies for improving participation in sport and physical activity by Aboriginal and Torres Strait Islander children and adolescents need to integrate a comprehensive identification of barriers and facilitators with a social-ecological understanding of how community and cultural factors can impact individual participation. [ABSTRACT FROM AUTHOR]

Background: The new Australian 24-Hour Movement Guidelines for the Early Years recommend that, for preschoolers, a healthy 24-h includes: i) ≥180 min of physical activity, including ≥60 min of energetic play, ii) ≤1 h of sedentary screen time, and iii) 10-13 h of good quality sleep. Using an Australian sample, this study reports the proportion of preschool children meeting these guidelines and investigates associations with social-cognitive development.Methods: Data from 248 preschool children (mean age = 4.2 ± 0.6 years, 57% boys) participating in the PATH-ABC study were analyzed. Children completed direct assessments of physical activity (accelerometry) and social cognition (the Test of Emotional Comprehension (TEC) and Theory of Mind (ToM)). Parents reported on children's screen time and sleep. Children were categorised as meeting/not meeting: i) individual guidelines, ii) combinations of two guidelines, or iii) all three guidelines. Associations were examined using linear regression adjusting for child age, sex, vocabulary, area level socio-economic status and childcare level clustering.Results: High proportions of children met the physical activity (93.1%) and sleep (88.7%) guidelines, whereas fewer met the screen time guideline (17.3%). Overall, 14.9% of children met all three guidelines. Children meeting the sleep guideline performed better on TEC than those who did not (mean difference [MD] = 1.41; 95% confidence interval (CI) = 0.36, 2.47). Children meeting the sleep and physical activity or sleep and screen time guidelines also performed better on TEC (MD = 1.36; 95% CI = 0.31, 2.41) and ToM (MD = 0.25; 95% CI = -0.002, 0.50; p = 0.05), respectively, than those who did not. Meeting all three guidelines was associated with better ToM performance (MD = 0.28; 95% CI = -0.002, 0.48, p = 0.05), while meeting a larger number of guidelines was associated with better TEC (3 or 2 vs. 1/none, p < 0.02) and ToM performance (3 vs. 2, p = 0.03).Conclusions: Strategies to promote adherence to the 24-Hour Movement Behaviour Guidelines for the Early Years among preschool children are warranted. Supporting preschool children to meet all guidelines or more guidelines, particularly the sleep and screen time guidelines, may be beneficial for their social-cognitive development. [ABSTRACT FROM AUTHOR]

Background: For effective public health and surveillance it is important to document the proportion of young children who meet the new Australian Integrated 24 h Movement Guidelines for the Early Years and how these associate with health outcomes. We aimed to (i) assess compliance with the new Integrated 24 h Movement Guidelines for the Early Years in a sample of Australian toddlers; and (ii) ascertain whether compliance with the guidelines associates with weight status.Methods: The sample comprised 202 toddlers (104 girls) aged 19.74 ± 4.07 months from the GET UP!Study: Participants wore accelerometers (Actigraph GT3X+) for 24 h over 7 consecutive days to assess physical activity, sedentary time and sleep. Parents reported participants' screen time. Weight and height were measured and body mass index (BMI) z-scores by age and sex were calculated. Analysis of Covariance (ANCOVA) was performed to test differences in BMI z-scores between participants complying with (i) none or any individual guideline, (ii) any combination of meeting two guidelines, and (iii) those who met all three guidelines, adjusting for child age, gender and socioeconomic status.Results: Only 8.9% of the sample met the overall 24 h movement guidelines. Most of the sample met the physical activity (96.5%) and sleep (79.7%) guidelines but only 11.4% met the sedentary behavior guideline. Average BMI Z-scores did not significantly differ between children who complied with none or any individual guideline, any combination of meeting two guidelines, and those who met all three guidelines (p > 0.05). Although the lack of significant differences, participants who accomplished any combination of two guidelines or all three guidelines appear to have had a lower BMI Z-score than those complying with one of the guidelines or none.Conclusions: Just under 9% of our sample met the overall Australian 24 h Movement Guidelines for the Early Years. BMI was not associated with the accomplishment of any of the 24-h Movement Guidelines. Strategies to promote adherence to the 24-h movement guidelines in toddlers, particularly for screen time, are necessary, as promoting health-related behaviors in early childhood has the potential to provide children a strong foundation for lifelong physical and mental health. [ABSTRACT FROM AUTHOR]

Background: Little information is available on the movement behaviours of infants, despite evidence that these are important for development. The release of new Australian 24-hour Movement Guidelines provides an opportunity to document the current state of movement behaviours in infants relative to these guidelines. The aim of this study was to report the prevalence of 4 month old Australian infants meeting the 24-hour Movement Guidelines, individually, and in combination, and to describe associations with individual characteristics.Methods: Maternal report baseline data from the Melbourne Infant Feeding, Activity and Nutrition Trial Program were used to determine prevalence of infants meeting physical activity (30 min of tummy time per day), sedentary behaviour (no more than 1 h at a time kept restrained; zero screen time), and sleep guidelines (14-17 h for 0-3 month olds or 12-16 h for 4-11 month olds). Prevalence of infants meeting combined guidelines was also described. The odds of meeting guidelines based on infant and family characteristics was determined.Results: Data are reported for 455 infants with a mean age of 3.6 months (SD = 1.0). The proportion of infants meeting each of the guidelines was 29.7% for tummy time, 56.9% for kept restrained, 27.9% for screen time, 58.7% for sleep and 3.5% for the combined guidelines (i.e. meeting all four guidelines). A significantly higher proportion of girls than boys met the screen time guideline (32.5% versus 24.0%, p = 0.04) and the combined guidelines (5.7% versus 1.6%, p = 0.01). Few associations were observed between infant and family characteristics and proportion of infants meeting individual guidelines.Conclusions: Very few infants met all of the guidelines contained in the new Australian 24-hour Movement Guidelines suggesting there is much room for improvement in movement behaviours from early life. Fewer infants met the tummy time and screen time guidelines hence these appear to be the behaviours requiring most attention. Parents and others providing care to infants require support and strategies to assist them in adhering to the guidelines to ensure optimal health and development for the youngest in our population. [ABSTRACT FROM AUTHOR]

Background: Levels of sitting among adolescents are high, especially during the school day. The acute cognitive and health consequences associated with prolonged sitting are poorly understood in adolescents. This randomized crossover design study examined the acute effects of a simulated school day with reduced sitting or usual sitting on adolescents' cognitive function and cardiometabolic biomarkers.Methods: Eighteen healthy school aged adolescents were recruited from the community to the study (11 males; 7 females; mean age [SD] = 13.5 ± 0.9 years). Two protocols were developed to simulate an adolescent school day, the amount of time spent sitting was manipulated reflecting: a 'typical' day (65% of the time spent sitting with two sitting bouts sitting >20 min) and a 'reduced sitting' day (adolescents sat for 50% less time with no bouts of sitting >20 mins). The order that participants were exposed to each condition was randomized (via random number generator). Participants were not fully blinded as they could observe the difference between conditions. Energy intake and moderate to vigorous physical activity (MVPA) were standardized for both conditions and monitored for 48 h post-condition for compensatory effects. Cognitive (working memory) and cardiometabolic outcomes (lipids, glucose, insulin, IL-6, apo-A1, apo-B, blood pressure,) were assessed pre and post for both conditions, BMI and body fat were assessed on the morning of the intervention. Data were analyzed using linear mixed models. Standardised effect sizes were calculated.Results: Compared with the typical school day, the reduced sitting day demonstrated significant positive effects for apoB/apoA-1 ratio (adjusted difference ± SD) -0.02 ± 0.03; P = 0.03; effect size [Cohen's d] = -0.67. Findings for total cholesterol -0.19 ± 0.27; P = 0.28; d = -0.71; HDL cholesterol -0.23 ± 0.50; P = 0.12 d = -0.66; and total cholesterol/HDL ratio 0.25 ± 0.53; P = 0.25; d = 0.51 and for cognition 0.64 ± 0.15; P = 0.15; d = 0.54 were non-significant. There were no compensatory changes in participant energy expenditure or energy intake for 48 h post intervention.Conclusion: Reducing school day sitting time in adolescents' resulted in significant improvements in apoB/apoA-1 ratio with medium effect sizes for total cholesterol, HDL cholesterol and total cholesterol/HDL ratio. Cognitive function results showed the equivalent of a 6 month improvement in effective mental-attentional capacity.Trial Registration: The trial was registered as a clinical trial with the Australian and New Zealand Clinical Trials Registry ( ACTRN12614001064695 ) on the 3rd of October 2014 - registered retrospectively. [ABSTRACT FROM AUTHOR]

Background: Sporting or physical recreation event participation can affect different domains of mental and social well-being if sufficiently frequent, yet previous research has focused mainly on the physical health benefits of single-location or infrequent mass-participation events. We examined overall and domain specific subjective well-being of adult participants of "parkrun", a weekly, community-based, highly accessible and widespread running event.Methods: Data were from a national online survey of 865 adult Australian parkrunners. Scores on nine individual measures and the global Personal Well-being Index (PWI) were compared to national, normative data. Regression models tested associations between personal well-being and perceived benefits of parkrun (mental health and connection to community).Results: Of 100 scores, 28% of means for parkrunners fell outside overall and age and gender subgroups normative ranges. Satisfaction with health was higher for male, those aged over 45 and overall parkrunners; only parkrunners aged 18-24 fell below their age group norm. Satisfaction with life as a whole was positively associated with perceived mental health benefits of parkrun, but not perceived community connection for women, and neither measure for men. PWI was positively associated with perceived community connection for men and with mental health benefit for women.Conclusions: Australian parkrunners mostly reflect the general population on personal well-being, except report superior satisfaction with physical health. Women's personal well-being may benefit from parkrun through improved mental health and men's from community connectedness. parkrun may facilitate positive expression of identity and continuation of healthy habits among athletes, and non-demanding, health enhancing activity and social interaction for non-athletes. [ABSTRACT FROM AUTHOR]

Background: Although regular participation in physical activity (PA) has health benefits across the life span, the proportion of people doing sufficient activity for these benefits decreases with age. The aim of this study was to identify motivating factors and context preferences for PA in people in their sixties, and to examine gender differences in these factors.Methods: Data were used from people aged 60-67 years who responded to a mail survey in Brisbane, Australia, in 2009. Respondents indicated their agreement/disagreement with seven PA motivators and 14 PA context preferences. Data were analyzed using multi-level multinomial logistic regression, adjusted for sociodemographic and health variables, and PA level.Results: Of the 1845 respondents, 59% was female. Based on self-reported PA, one in three respondents (35%) did not meet the PA guidelines of at least 150 min of moderate intensity PA per week. The three leading motivating factors for both women and men were to prevent health problems, to feel good and to lose weight. Women were more likely than men to be motivated by improving appearance (OR 2.93, 95%CI 2.07-4.15), spending time with others (1.76, 1.31-2.37), meeting friends (1.76, 1.31-2.36) or losing weight (1.74, 1.12-2.71). The three leading context preferences for both women and men were for activities close to home, at low cost and that could be done alone. Women were more likely than men to prefer activities that are with people of the same sex (OR 4.67, 95%CI 3.14-6.94), supervised (2.79, 1.94-4.02), with people the same age (2.00, 1.43-2.78) and at a fixed time (1.42, 1.06-1.91). Women were less likely than men to prefer activities that are competitive (OR 0.32, 95%CI 0.22-0.46), are vigorous (0.33, 0.24-0.47), require skill and practice (0.40, 0.29-0.55) and done outdoors (0.51, 0.30-0.86).Conclusion: Although there was overlap in motivating factors and context preferences for PA in women and men aged 60-67 years, there were also marked gender differences. These results suggest that PA options for people in their sixties should be tailored to meet gender specific interests in order to promote PA participation in this rapidly growing population group. [ABSTRACT FROM AUTHOR]

Background: Reducing automobile dependence and improving rates of active transport may reduce the impact of obesogenic environments, thereby decreasing population prevalence of obesity and other diseases where physical inactivity is a risk factor. Increasing the relative cost of driving by an increase in fuel taxation may therefore be a promising public health intervention for obesity prevention.Methods: A scoping review of the evidence for obesity or physical activity effect of changes in fuel price or taxation was undertaken. Potential health benefits of an increase in fuel excise taxation in Australia were quantified using Markov modelling to simulate obesity, injury and physical activity related health impacts of a fuel excise taxation intervention for the 2010 Australian population. Health adjusted life years (HALYs) gained and healthcare cost savings from diseases averted were estimated. Incremental cost-effectiveness ratios (ICERs) were reported and results were tested through sensitivity analysis.Results: Limited evidence on the effect of policies such as fuel taxation on health-related behaviours currently exists. Only three studies were identified reporting associations between fuel price or taxation and obesity, whilst nine studies reported associations specifically with physical activity, walking or cycling. Estimates of the cross price elasticity of demand for public transport with respect to fuel price vary, with limited consensus within the literature on a probable range for the Australian context. Cost-effectiveness modelling of a AUD0.10 per litre increase in fuel excise taxation using a conservative estimate of cross price elasticity for public transport suggests that the intervention would be cost-effective from a limited societal perspective (237 HALYs gained, AUD2.6 M in healthcare cost savings), measured against a comparator of no additional increase in fuel excise. Under "best case" assumptions, the intervention would be more cost-effective (3181 HALYs gained, AUD34.2 M in healthcare cost savings).Conclusions: Exploratory analysis suggests that an intervention to increase fuel excise taxation may deliver obesity and physical activity related benefits. Whilst such an intervention has significant potential for cost-effectiveness, potential equity and acceptability impacts would need to be minimised. A better understanding of the effectiveness and cost-effectiveness of a range of transport interventions is required in order to achieve more physically active transport environments. [ABSTRACT FROM AUTHOR]

Background: Reducing the prevalence of obesity and chronic disease are important priorities. Maori and Pacific Islander communities living in Australia have higher rates of obesity and chronic disease than the wider Australian population. This study aims to assess the effectiveness of the Good Start program, which aims to improve knowledge, attitudes and practices related to healthy eating and physical activity amongst Maori and Pacific Islander communities living in Queensland.Methods: The intervention was delivered to children aged 6-19 years (N = 375) in schools by multicultural health workers. Class activities focused on one message each term related to healthy eating and physical activity using methods such as cooking sessions and cultural dance. The evaluation approach was a quantitative uncontrolled pre-post design. Data were collected each term pre- and post-intervention using a short questionnaire.Results: There were significant increases in knowledge of correct servings of fruit and vegetables, knowledge of sugar and caffeine content of common sugar-sweetened drinks, recognition of the consequences of marketing and upsizing, and the importance of controlling portion size (all P < 0.05). There was also increases in knowledge of physical activity recommendations (P < 0.001), as well as the importance of physical activity for preventing heart disease (P < 0.001) and improving self-esteem (P < 0.001). In terms of attitudes, there were significant improvements in some attitudes to vegetables (P = 0.02), and sugar-sweetened drinks (P < 0.05). In terms of practices and behaviours, although the reported intake of vegetables increased significantly (P < 0.001), the proportion of children eating discretionary foods regularly did not change significantly, suggesting that modifying the program with an increased emphasis on reducing intake of junk food may be beneficial.Conclusion: The study has shown that the Good Start Program was effective in engaging children from Maori and Pacific Island backgrounds and in improving knowledge, and some attitudes and practices, related to healthy eating and physical activity. The evaluation contributes valuable information about components and impacts of this type of intervention, and considerations relevant to this population in order to successfully change behaviours and reduce the burden of chronic disease. [ABSTRACT FROM AUTHOR]

Background: Whether not meeting common guidelines for lifestyle behaviours is associated with weight gain is uncertain. This study examined whether 5-year weight gain was predicted by not meeting guidelines for: breakfast consumption (eating between 6 and 9 am), takeaway food consumption (<2 times/week), television viewing (<2 h/day) and daily steps (≥10,000 steps/day).Methods: One thousand one hundred and fifty-five Australian participants (43% men, 26-36 years) completed questionnaires and wore a pedometer at baseline (2004-06) and follow-up (2009-11). Weight was measured or self-reported, with a correction factor applied. For each behaviour, participants were classified according to whether they met the guideline: consistently met at baseline and follow-up (reference group); not met at baseline but met at follow-up; met at baseline but not met at follow-up; consistently not met at baseline and follow-up. For each behaviour, weight gain was calculated using linear regression. Weight gain by number of guidelines met was also examined.Results: Mean 5-year weight gain was 2.0 kg (SD:6.3). Compared to the reference group, additional weight (mean, 95% CI) was gained among those who did not meet the guideline at follow-up, or consistently did not meet the guideline, for breakfast (1.8 kg, 0.7-2.9; 1.5 kg, 0.1-2.8); takeaway food (2.2 kg, 0.7-3.6; 1.9 kg, 0.7-3.1); watching television (1.9 kg, 0.9-2.9; 1.4 kg, 0.4-2.3); and daily steps (2.6 kg, 1.1-4.04; 1.6 kg, 0.5-2.7). Those who met ≤1 guideline at follow-up gained 3.8 kg (95% CI 2.3-5.3) more than those meeting all guidelines.Conclusion: Individuals who adopted healthier behaviours between baseline and follow-up had similar weight gain to those who met the guidelines at both time points. Encouraging young adults to meet these simple guidelines may reduce weight gain. [ABSTRACT FROM AUTHOR]

Background: The disease burden due to poor nutrition, physical inactivity and obesity is high and increasing. An adequately sized and skilled workforce is required to respond to this issue. This study describes the public health nutrition and physical activity (NAPA) practice priorities and explores health managers and practitioner's beliefs regarding workforce capacity to deliver on these priorities.Methods: A workforce audit was conducted including a telephone survey of all managers and a postal survey of practitioners working in the area of NAPA promotion in Western Australia in 2004. Managers gave their perspective on workforce priorities, current competencies and future needs, with a 70 % response rate. Practitioners reported on public health workforce priorities, qualifications and needs, with a 56 % response rate.Results: The top practice priorities for managers were diabetes (35 %), alcohol and other drugs (33 %), and cardiovascular disease (27 %). Obesity (19 %), poor nutrition (15 %) and inadequate physical activity (10 %) were of lower priority. For nutrition, managers identified lack of staff (60.4 %), organisational and management factors (39.5 %) and insufficient financial resources (30.2 %) as the major barriers to adequate service delivery. For physical activity services, insufficient financial resources (41.7 %) and staffing (35.4 %) and a lack of specific physical activity service specifications (25.0 %) were the main barriers. Practitioners identified inadequate staffing as the main barrier to service delivery for nutrition (42.3 %) and physical activity (23.3 %). Ideally, managers said they required 152 % more specialist nutritionists in the workforce and 131 % specialists for physical activity services to meet health outcomes in addition to other generalist staff.Conclusion: Human and financial resources and organisational factors were the main barriers to meeting obesity, and public health nutrition and physical activity outcomes. Services were being delivered by generalists rather than specialists, which may reduce service effectiveness. Although conclusions from this research need to take into account the fact that the audit was conducted in 2004, the findings suggest that there was a need to equip health services with an adequately skilled workforce of sufficient capacity to deliver an effective public health response to the obesity epidemic, particularly addressing poor nutrition and physical inactivity. [ABSTRACT FROM AUTHOR]

Background: As people are living longer, they are being encouraged to work longer. While it is assumed that extended employment will be good for health, the evidence has been mixed. This study considers whether employment and job quality exert an influence on four indicators of health status in older workers.Methods: Data for this study came from 836 older workers (440 men and 396 women) aged 50-59 years at baseline who participated in the Household, Income and Labour Dynamics in Australia (HILDA) Survey. Using linear regression, we examine within-person change in self-rated, physical and mental health and one health behaviour (physical activity) at two time points over a nine year follow-up period.Results: There were minimal differences in the way health changed for older adults who continued working compared to those who retired voluntarily. However, when we decomposed employment in terms of job quality, health outcomes diverged. Compared to voluntary retirees, older workers who had worked in good quality jobs reported marginally better self-rated health (0.14,-0.02-0.29); but did not differ in their physical (2.31,-1.09-5.72) or mental health (0.51,-1.84-2.87). In contrast, older workers who held poor quality jobs for most of the follow-up period declined in their self-rated (-1.13,-0.28 - -0.02), physical (-4.90, 8.52- - 1.29) and mental health (-4.67, 7.69- - 1.66) relative to voluntary retirees. Older workers who held poor quality jobs for just some of the follow-up period did not differ from voluntary retirees in terms of their health. However there was evidence of a linear relationship between length of exposure to poor quality jobs and decline in health outcomes.Conclusion: Extended working lives mean that people will be 'exposed' to work for longer, and this exposure will occur at a life stage characterised by declining health for many. Our findings show that ensuring older workers have access to secure jobs which allow for control over work time, skill use and fair rewards will be essential if policy goals to boost participation and productivity, as well as reduce the health and care costs of the elderly, are to be met. [ABSTRACT FROM AUTHOR]

Background: Leisure-time physical activity and strength training participation levels are low and socioeconomically distributed. Fitness trainers (e.g. gym/group instructors) may have a role in increasing these participation levels. However, it is not known whether the training location and characteristics of Australian fitness trainers vary between areas that differ in socioeconomic status.Methods: In 2014, a sample of 1,189 Australian trainers completed an online survey with questions about personal and fitness industry-related characteristics (e.g. qualifications, setting, and experience) and postcode of their usual training location. The Australian Bureau of Statistics 'Index of Relative Socioeconomic Disadvantage' (IRSD) was matched to training location and used to assess where fitness professionals trained and whether their experience, qualification level and delivery methods differed by area-level disadvantage. Linear regression analysis was used to examine the relationship between IRSD score and selected characteristics adjusting for covariates (e.g. sex, age).Results: Overall, 47 % of respondents worked in areas within the three least-disadvantaged deciles. In contrast, only 14.8 % worked in the three most-disadvantaged deciles. In adjusted regression models, fitness industry qualification was positively associated with a higher IRSD score (i.e. working in the least-disadvantaged areas) (Cert III: ref; Cert IV β:13.44 [95 % CI 3.86-23.02]; Diploma β:15.77 [95 % CI: 2.17-29.37]; Undergraduate β:23.14 [95 % CI: 9.41-36.86]).Conclusions: Fewer Australian fitness trainers work in areas with high levels of socioeconomic disadvantaged areas than in areas with low levels of disadvantage. A higher level of fitness industry qualifications was associated with working in areas with lower levels of disadvantage. Future research should explore the effectiveness of providing incentives that encourage more fitness trainers and those with higher qualifications to work in more socioeconomically disadvantaged areas. [ABSTRACT FROM AUTHOR]

Background: There is growing evidence indicating that the built environment is a determinant of physical activity. However, despite the well-established health benefits of physical activity this is rarely considered in urban planning. We summarised recent Australian evidence for the association built environment-physical activity among adults. This summary aims to inform policy makers who advocate for the consideration of health in urban planning.Methods: A combination of built environment and physical activity terms were used to systematically identify relevant peer reviewed and grey literature.Results: A total of 23 studies were included, providing 139 tests of associations between specific built environment features and physical activity. Of the total, 84 relationships using objective measures of built environment attributes were evaluated, whereas 55 relationships using self-reported measures were evaluated. Our results indicate that walkable neighbourhoods with a wide range of local destinations to go to, as well as a diverse use of land, encourage physical activity among their residents.Conclusions: This research provides a summary of recent Australian evidence on built environments that are most favourable for physical activity. Features of walkability and availability of destinations within walking distance should be accounted for in the development or redevelopment of urban areas. Our findings emphasise the importance of urban planning for health via its impact on population levels of physical activity. [ABSTRACT FROM AUTHOR]

Background: The current Australia's Physical Activity and Sedentary Behaviour Guidelines recommend that adults engage in regular moderate-to-vigorous-intensity physical activity (MVPA) and strength training (ST), and minimise time spent in sedentary behaviours (SB). However, evidence about the specific individual and concurrent distribution of these behaviours in Australia is scarce. Therefore, the aim of this study was to determine the prevalence and sociodemographic correlates of MVPA, ST and SB in a national-representative sample of Australian adults.Methods: Data were collected using face-to-face interviews, as part of the National Nutrition and Physical Activity Survey 2011-12. The population-weighted proportions meeting the MVPA (≥ 150 min/week), ST (≥ 2 sessions/week) and combined MVPA-ST guidelines, and proportions classified as having 'low levels of SB' (< 480 min/day) were calculated, and their associations with selected sociodemographic and health-related variables were assessed using multiple logistic regression analyses. This was also done for those at potentially 'high-risk', defined as insufficient MVPA-ST and 'high-sedentary' behaviour.Results: Out of 9345 participants (response rate = 77.0 %), aged 18-85 years, 52.6 % (95 % CI: 51.2 %-54.0 %), 18.6 % (95 % CI: 17.5 %-19.7 %) and 15.0 % (95 % CI: 13.9 %-16.1 %) met the MVPA, ST and combined MVPA-ST guidelines, respectively. Female gender, older age, low/medium education, poorer self-rated health, being classified as underweight or obese, and being a current smoker were independently associated with lower odds of meeting the MVPA, ST and combined MVPA-ST guidelines. A total of 78.9 % (95 % CI: 77.9 %-80.0 %) were classified as having low levels of SB. Females, older adults and those with lower education were more likely to report lower levels of SB, whilst those with poor self-rated health and obese individuals were less likely to report lower levels of SB (i.e. SB = ≥ 480 min/day). A total of 8.9 % (95 % CI: 8.1 %-9.6 %) were categorised as individuals at potentially 'high-risk'. Those with poorer self-rated health, obese individuals, those aged 25-44, and current smokers were more likely to be in the 'high risk' group.Conclusions: The large majority of Australian adults do not meet the full physical activity guidelines and/or report excessive SB. Our results call for public health interventions to reduce physical inactivity and SB in Australia, particularly among the subgroups at the highest risk of these unhealthy behaviours. [ABSTRACT FROM AUTHOR]

Background: School-based physical education is an important public health initiative as it has the potential to provide students with regular opportunities to participate in moderate-to-vigorous physical activity (MVPA). Unfortunately, in many physical education lessons students do not engage in sufficient MVPA to achieve health benefits. In this trial we will test the efficacy of a teacher professional development intervention, delivered partially via the Internet, on secondary school students' MVPA during physical education lessons. Teaching strategies covered in this training are designed to (i) maximize opportunities for students to be physically active during lessons and (ii) enhance students' autonomous motivation towards physical activity.Method: A two-arm cluster randomized controlled trial with allocation at the school level (intervention vs. usual care control). Teachers and Year 8 students in government-funded secondary schools in low socio-economic areas of the Western Sydney region of Australia will be eligible to participate. During the main portion of the intervention (6 months), teachers will participate in two workshops and complete two implementation tasks at their school. Implementation tasks will involve video-based self-reflection via the project's Web 2.0 platform and an individualized feedback meeting with a project mentor. Each intervention school will also complete two group peer-mentoring sessions at their school (one per term) in which they will discuss implementation with members of their school physical education staff. In the booster period (3 months), teachers will complete a half-day workshop at their school, plus one online implementation task, and a group mentoring session at their school. Throughout the entire intervention period (main intervention plus booster period), teachers will have access to online resources. Data collection will include baseline, post-intervention (7-8 months after baseline) and maintenance phase (14-15 months after baseline) assessments. Research assistants blinded to group allocation will collect all data. The primary outcome will be the proportion of physical education lesson time that students spend in MVPA. Secondary outcomes will include leisure-time physical activity, subjective well-being, and motivation towards physical activity.Discussion: The provision of an online training platform for teachers could help facilitate more widespread dissemination of evidence-based interventions compared with programs that rely exclusively on face-to-face training.Trial Registration: Australia and New Zealand Clinical Trials Registry- ACTRN12614000184673 . Registration date: February 19, 2014. [ABSTRACT FROM AUTHOR]

Background: Maintaining neuromotor fitness across the life course is imperative. It can reduce falls in older individuals and improve/maintain physical and cognitive functioning. Complex motor skills (CMS) are involved in many physical activities (e.g., ball games, dance), which can improve neuromotor fitness. However, few older adults participate in CMS. This study aimed to understand how older adults perceive the degree of difficulty and challenge, using Gentile's taxonomy of motor skills as a framework.Methods: Six focus groups (FGs) were conducted with older adults (aged 61-92 years; N = 36) using a semi-structured question guide, to explore older adults' perceptions of difficulty and challenges associated with physical activity types. FGs were conducted in three villages and community groups in Sydney, Australia. Verbatim transcripts were coded inductively following a grounded theory approach to analysis to discover categories and concepts based on participants' views.Results: Older adults perceived physical effort and pace as influencing difficulty where as challenging activities were not found to hinder older adults' willingness to participate. Other challenges in performing activities were attributed to: skill level, environment conditions (e.g., pool versus ocean swimming) and variations influencing complexity. Social and interpersonal issues, such as embarrassment, rapport with instructors, prior experience/ familiarity, in addition to physical effort, were other central features of older adults' perceptions of physical activities. Themes that appeared to increase the likelihood of participation in CMS were: age appropriate modification; enjoyment; social aspects; past experience; and having experienced instructors.Conclusions: This study offers recommendations for increasing participation in CMS. Modifying activities to suit ability and age and increasing exposure during the life span may help maintain participation into old age. Gentile's taxonomy provides an appropriate framework for classifying activities as simple or complex, which were recognised by participants on a descriptive level. Existing and new sports, which have been modified for old age, should be made available to older adults. Within the motor learning literature, the focus on older adults is limited. If activity complexity translates to improved cognitive abilities as well as improved individual neuromotor performance, the challenge of modifying activities to suit older adults' preferences needs to be addressed. [ABSTRACT FROM AUTHOR]

Background: The evidence surrounding the value of workplace health promotion in positively influencing employees’ health and wellbeing via changes to their health behaviours is growing. The aim of the study was to explore employers’ views on the promotion of workplace health and wellbeing and the factors affecting these views. Methods: Using a qualitative phenomenological approach, 10 focus groups were conducted with employers selected from a range of industries and geographical locations within Western Australia. The total sample size was 79. Results: Three factors were identified: employers’ conceptualization of workplace health and wellbeing; employers’ descriptions of (un)healthy workers and perceptions surrounding the importance of healthy workers; and employers’ beliefs around the role the workplace should play in influencing health. Conclusions: Progress may be viable in promoting health and wellbeing if a multifaceted approach is employed taking into account the complex factors influencing employers’ views. This could include an education campaign providing information about what constitutes health and wellbeing beyond the scope of occupational health and safety paradigms along with information on the benefits of workplace health and wellbeing aligned with perceptions relating to healthy and unhealthy workers. [ABSTRACT FROM AUTHOR]

Background: Physical activity is associated with a host of health benefits, yet many individuals do not perform sufficient physical activity to realise these benefits. One approach to rectifying this situation is through modifying the built environment to make it more conducive to physical activity, such as by building walking tracks or recreational physical activity facilities. Often, however, modifications to the built environment are not connected to efforts aimed at encouraging their use. The purpose of the Monitoring and Observing the Value of Exercise (MOVE) study is to evaluate the effectiveness of two interventions designed to encourage the ongoing use of a new, multi-purpose, community-based physical activity facility. Methods/design: A two-year, randomised controlled trial with yearly survey points (baseline, 12 months follow-up, 24 months follow-up) will be conducted among 1,300 physically inactive adult participants aged 18-70 years. Participants will be randomly assigned to one of three groups: control, intervention 1 (attendance incentives), or intervention 2 (attendance incentives and tailored support following a model based on customer relationship management). Primary outcome measures will include facility usage, physical activity participation, mental and physical wellbeing, community connectedness, social capital, friendship, and social support. Secondary outcome measures will include stages of change for facility usage and social cognitive decision-making variables. Discussion: This study will assess whether customer relationship management systems, a tool commonly used in commercial marketing settings, can encourage the ongoing use of a physical activity facility. Findings may also indicate the population segments among which the use of such systems are most effective, as well as their cost-effectiveness. [ABSTRACT FROM AUTHOR]

Background: Although insufficient sleep has emerged as a strong, independent risk factor for obesity in children, the mechanisms by which insufficient sleep leads to weight gain are uncertain. Observational research suggests that being tired influences what children eat more than how active they are, but only experimental research can determine causality. Few experimental studies have been undertaken to determine how reductions in sleep duration might affect indices of energy balance in children including food choice, appetite regulation, and sedentary time. The primary aim of this study is to objectively determine whether mild sleep deprivation increases energy intake in the absence of hunger.Methods: The Daily, Rest, Eating, and Activity Monitoring (DREAM) study is a randomized controlled trial investigating how mild sleep deprivation influences eating behaviour and activity patterns in children using a counterbalanced, cross-over design. One hundred and ten children aged 8-12 years, with normal reported sleep duration of 8-11 h per night will undergo 2 weeks of sleep manipulation; seven nights of sleep restriction by going to bed 1 hr later than usual, and seven nights of sleep extension going to bed 1 hr earlier than usual, separated by a washout week. During each experimental week, 24-h movement behaviours (sleep, physical activity, sedentary behaviour) will be measured via actigraphy; dietary intake and context of eating by multiple 24-h recalls and wearable camera images; and eating behaviours via objective and subjective methods. At the end of each experimental week a feeding experiment will determine energy intake from eating in the absence of hunger. Differences between sleep conditions will be determined to estimate the effects of reducing sleep duration by 1-2 h per night.Discussion: Determining how insufficient sleep predisposes children to weight gain should provide much-needed information for improving interventions for the effective prevention of obesity, thereby decreasing long-term morbidity and healthcare burden.Trial Registration: Australian New Zealand Clinical Trials Registry ACTRN12618001671257 . Registered 10 October 2018. [ABSTRACT FROM AUTHOR]

Background: An estimate of the prevalence of an activity derived from a sample survey is potentially subject to non-response bias, whereby people not involved in the activity are less likely to respond than those involved. Quantifying the extent of non-response bias is generally difficult, since it involves estimating differences between respondents for whom data is directly available from the survey, and non-respondents, for whom data is generally not directly or readily available. However, in the case of the Australian Exercise Recreation and Sport Survey (ERASS), comparative "gold standard" benchmarks exist for some aspects of the survey, in the form of state sporting association (SSA) registration databases, each of which purports to constitute a complete enumeration of club-based players of a particular sport.Methods: ERASS estimates of the prevalence of participation in four major club-based team sports in the Australian state of Victoria in the year 2010 were compared with prevalences based on numbers of registered participants in the corresponding SSA databases. Comparisons were made for the adult population as a whole (ERASS scope being 15+ years of age), and for strata defined by age and geographical region. Because three of the four sports investigated are strongly sex-specific, no sex breakdowns were conducted. In each case the proportion of ERASS respondents reporting participation, with associated confidence limits, was compared with the corresponding SSA count expressed as a proportion of the population, to form an ERASS/SSA prevalence ratio with associated confidence limits.Results: The 24 ERASS/SSA ratios ranged from 1.72 to 7.80. Most ratios lay in the range 2 to 3. The lower 95% confidence bound for the ratio was greater than 1.0 in 23 out of 24 cases.Conclusions: ERASS estimates of prevalence of these particular aspects of sport participation were higher than SSA estimates, to statistically significant degrees. The effect sizes (i.e. the discrepancies represented by the ratios) were large enough to be of great practical importance. It is conjectured that non-response bias is the most likely explanation for the discrepancies. [ABSTRACT FROM AUTHOR]

Background: Increasing physical activity in children is a health priority. The Healthy Active Peaceful Playgrounds for Youth (HAPPY) study aimed to examine a multi-component playground intervention designed to increase the proportion of physical activity during recess and lunch of primary school students.Methods: The 2016 Australian focused HAPPY Study was a 12-month, metropolitan primary school based intervention, which was evaluated using a stepped wedge design. The intervention combined teacher development, environmental modifications, and peer support, with the outcomes of increasing physical activity, and analysing students' sources of social support to be physically active.Results: Between baseline and follow-up, the proportion of students involved in vigorous activities during recess and lunch times increased significantly from 15 to 25% (p < 0.001). No differences were recorded in sources of social support.Conclusions: The HAPPY project demonstrated an increase in the proportion of physical activity intensity during recess and lunch times in primary schools, although further investigation is required to determine what components of the study had the greatest effect.Trial Registration: This study was retrospectively registered with the Australian and New Zealand Clinical Trials Registry ACTRN12616000575437 . Date of registration: 4 May 2016. [ABSTRACT FROM AUTHOR]