Search

Purpose: The aim of this research was to develop a contextually and culturally appropriate scale to assess farmers' barriers to health‐related help‐seeking. Methods: An initial pool of items was developed from the academic literature and input from an expert panel of farmers, rural academics, and rural clinicians. A draft 32‐item questionnaire was then developed and sent to farmers registered with FARMbase, which is an Australian national farmer database. Findings: Two hundred and seventy‐four farmers completed the draft questionnaire (93.7% male, 73.7% aged 56‐75 years). An exploratory factor analysis identified 6 factors; "Health Issues are a Low Priority," "Concerns about Stigma," "Structural Health System Barriers," "Minimization and Normalization," "Communication Barriers," and "Continuity of Care.". Test‐retest reliability was examined with a further 10 farmers (90% male, Mean age = 57, SD = 5.91), who completed the questionnaire twice (at 2‐ to 3‐week intervals). Results indicated moderate‐good test‐retest reliability. Conclusions: The resulting 24‐item Farmer Help‐Seeking Scale provides a measure of help‐seeking that is specifically designed to capture the unique context, culture, and attitudes that can interfere with farmers' help‐seeking, and inform the development of strategies to increase health‐service utilization in this at‐risk group. [ABSTRACT FROM AUTHOR]

Issue addressed: Due to the nature of their jobs, frontline aged care workers may be a population at risk of poor health and lifestyle habits. Support of their well‐being through the workplace is likely to be complex. The objective of this study was to assess the effectiveness of a need‐supportive program for changing physical activity and psychological well‐being via the motivational processes of behavioural regulations and perceived need satisfaction. Methods: Frontline aged care workers (n = 25) participated in a single cohort, pre–post pilot trial. The program included a Motivational Interviewing style appointment, education on goal setting and self‐management, the use of affect, exertion and self‐pacing for regulating physical activity intensity and practical support activities. Outcomes (7‐day accelerometery, 6‐min walk, K10 and AQoL‐8D), and motivational processes (BREQ‐3 and PNSE) were measured at baseline, 3 and 9 months, and analysed using linear mixed models for repeated measures. Results: There were significant increases in perceived autonomy at 3 months (Δ.43 ± SE:.20; p =.03) and 6‐min walk distance at 9 months (Δ 29.11 m ± SE: 13.75; p =.04), which appeared to be driven by the relative autonomy index (behavioural regulations in exercise questionnaire [BREQ‐3]). Amotivation increased at 3 months (Δ.23 ± SE:.12; p =.05); which may have been due to low scores at baseline. No other changes were demonstrated at any timepoint. So what?: Participants demonstrated positive changes in motivational processes and physical function, however, due to the low levels of participation in the program, the program had a negligible impact at the organisational level. Future researchers and aged care organisations should aim to address factors impacting participation in well‐being initiatives. [ABSTRACT FROM AUTHOR]

Introduction: A growing body of research has examined the physical, psychological, social and financial impacts of living kidney donation. However, little is known about the unique experiences or additional burdens faced by living donors from regional or remote locations. Objective: To explore the experiences of living kidney donors who live outside metropolitan centres and to determine how support services could be orientated to better meet their unique needs. Design/Setting/Participants: Seventeen living kidney donors participated in semistructured telephone interviews. Qualitative data were analysed using thematic analysis. Findings: Eight themes were identified: (1) donor's emotional well‐being is influenced by the recipient's outcome, (2) varied levels of access to medical support and other important services in rural areas, (3) travel takes a toll on time, finances and well‐being, (4) varied level of financial impact, (5) medical, emotional and social challenges, (6) both lay and health professional support is valued, (7) varied levels of knowledge and experiences accessing information and (8) a worthwhile experience overall. Conclusion: Despite many challenges, and travel adding to the complexity, rural living kidney donors generally consider it to be a worthwhile experience. The provision of additional emotional, practical and educational support would be welcomed by this group. [ABSTRACT FROM AUTHOR]

Objectives: Farmers are faced with many stressors, along with numerous barriers to accessing traditional forms of mental health support. The ifarmwell online intervention was co-designed with farmers and is informed by Acceptance and Commitment Therapy to equip farmers with transferable coping strategies, particularly to help them cope with circumstances beyond their control. We aimed to evaluate the effect of ifarmwell on farmers' short- and long-term distress and mental wellbeing. Methods: Australian farmers (21–73 years) who registered on completed measures at the commencement of module 1 (N = 228), the end of the intervention (N = 77) and 6-months post-intervention (N = 61). Primary outcomes included distress (Kessler Psychological Distress Scale) and mental wellbeing (Mental Health Continuum – Short Form). We also examined the relationship between distress, mental wellbeing, neuroticism (Quickscales-R) and ACT-based psychological mechanisms; psychological inflexibility (Acceptance and Action Questionnaire-II), cognitive fusion (Cognitive Fusion Questionnaire), believability of automatic thoughts (Automatic Thoughts Questionnaire-B), coping via acceptance (4 items from the situational COPE) and mindfulness (Five Facet Mindfulness Questionnaire-Short Form). Secondary outcomes of acceptability (Client Satisfaction Questionnaire-8) and usability (System Usability Scale) were also explored. Results: Pre- to post-intervention, farmers' distress decreased and mental wellbeing increased. These effects were maintained at 6-month follow-up. Changes in these outcomes were greatest for participants who entered the intervention with high baseline distress ( β ˆ = −0.59, 95%CI =[−0.70, −0.47]) and low mental wellbeing ( β ˆ = −0.33, 95%CI = [−0.47, −0.19]). Decreases in distress and increases in mental wellbeing were associated with decreases in psychological inflexibility, cognitive fusion, and believability of thoughts, and increases in coping via acceptance and mindfulness. Levels of satisfaction (M = 26.92/32) and usability (M = 84.70/100) were high, and 94.6% of participants said they would recommend ifarmwell to a friend in need of similar advice and tools. Conclusions: ifarmwell is an effective and usable intervention that is likely to help farmers reduce their levels of distress and improve their mental wellbeing, by improving their psychological flexibility, ability to focus on the present and accept things beyond their control, as well as by reducing the extent to which they believe unhelpful thoughts. [ABSTRACT FROM AUTHOR]

Background: Socio-economic position (SEP) in adolescence may influence diet quality over the life course. However, knowledge of whether individual and environmental determinants of diet quality mediate the longitudinal association between SEP and diet quality is limited. This study examined whether and to what extent food-related capabilities, opportunities and motivations of adolescents mediated the longitudinal association between SEP in adolescence and diet quality in early adulthood overall and by sex. Methods: Longitudinal data (annual surveys) from 774 adolescents (16.9 years at baseline; 76% female) from ProjectADAPT (T1 (baseline), T2, T3) were used. SEP in adolescence (T1) was operationalized as highest level of parental education and area-level disadvantage (based on postcode). The Capabilities, Opportunities and Motivations for Behaviour (COM-B) model was used as a framework to inform the analysis. Determinants in adolescence (T2) included food-related activities and skills (Capability), home availability of fruit and vegetables (Opportunity) and self-efficacy (Motivation). Diet quality in early adulthood (T3) was calculated using a modified version of the Australian Dietary Guidelines Index based on brief dietary questions on intake of foods from eight food groups. Structural equation modelling was used to estimate the mediating effects of adolescents' COM-B in associations between adolescent SEP and diet quality in early adulthood overall and by sex. Standardized beta coefficients (β) and robust 95% confidence intervals (CI) were generated, adjusted for confounders (T1 age, sex, diet quality, whether still at school, and living at home) and clustering by school. Results: There was evidence of an indirect effect of area-level disadvantage on diet quality via Opportunity (β: 0.021; 95% CI: 0.003 to 0.038), but limited evidence for parental education (β: 0.018; 95% CI: -0.003 to 0.039). Opportunity mediated 60.9% of the association between area-level disadvantage and diet quality. There was no evidence of an indirect effect via Capability or Motivation for either area-level disadvantage or parental education, or in males and females separately. Conclusions: Using the COM-B model, the home availability of fruit and vegetables (Opportunity) of adolescents explained a large proportion of the association between area-level disadvantage in adolescence and diet quality in early adulthood. Interventions to address poor diet quality among adolescents with a lower SEP should prioritize environmental determinants of diet quality. [ABSTRACT FROM AUTHOR]

Purpose: To assess trends in South Australian children's physical activity between 1985 and 2003 and 2013 in the contexts of school active transport, organized sport, physical education, and school break times. Method: The 1985 Australian Health and Fitness Survey was administered in South Australian schools in 2004 (8 schools) and 2013 (9 schools) and was demographically matched to the 10 South Australian schools in the Australian Health and Fitness Survey. Ordinal logistic modeling was used to identify trends, stratified by older children (10–12 y) and early adolescent (13–15 y) subgroups. Results: School active transport generally declined for males and older female children (19 and 20 percentage points per decade, respectively), whereas early adolescent females increased in walking to school (11 percentage points per decade). School sport participation declined for early adolescents, and club sport participation declined in early adolescent females (23 percentage points per decade). Moderate to vigorous physical activity participation during school break times (particularly lunchtime) generally declined (16–26 percentage points per decade). Observed changes in most contexts occurred between 2004 and 2013. Conclusion: There was evidence of context-specific declines in children's physical activity participation over this time span. Early adolescent females were the subgroup of most concern, experiencing declines in most contexts. [ABSTRACT FROM AUTHOR]

Purpose: Brief classroom-based episodes of physical activity (active lesson breaks, ALBs) have improved schoolchildren's classroom behaviors in some studies, and may also increase the likelihood of children meeting the recommended daily minutes of moderate to vigorous physical activity (MVPA). However, there is emerging evidence that increases in physical activity at particular times of the day may lead to compensatory declines at other times. This study explored evidence for compensatory declines in response to a 10 min ALB during the school day. Method: Thirty-eight 12-year-old boys from a single elementary school completed intervention and control conditions in a cross-over design, with each phase lasting one week. The intervention consisted of a single 10-min active lesson break delivered on each of three days in the intervention week. Twenty-four hour accelerometry was used to quantify moderate and vigorous physical activity. Results: ALBs increased in-school MVPA by 5.8 min (p < .0001), but overall daily MVPA was similar between intervention and control conditions (77.2 vs 77.4 min/d, p > .05), However, vigorous physical activity increased significantly over the whole day (11.2 vs 8.9 min, p = .0006). Conclusion: A brief episode of classroom-based play led to a modest increase in vigorous physical activity in elementary school students, but did not increase MVPA across the day. [ABSTRACT FROM AUTHOR]

Background: Farming is physically and psychologically hazardous. Farmers face many barriers to help seeking from traditional physical and mental health services; however, improved internet access now provides promising avenues for offering support. Objective: This study aims to co-design with farmers the content and functionality of a website that helps them adopt transferable coping strategies and test its acceptability in the broader farming population. Methods: Research evidence and expert opinions were synthesized to inform key design principles. A total of 18 farmers detailed what they would like from this type of website. Intervention logic and relevant evidence-based strategies were mapped. Website content was drafted and reviewed by 2 independent mental health professionals. A total of 9 farmers provided detailed qualitative feedback on the face validity of the draft content. Subsequently, 9 farmers provided feedback on the website prototype. Following amendments and internal prototype testing and optimization, prototype usability (ie, completion rate) was examined with 157 registered website users who were (105/157, 66.9%) female, aged 21-73 years; 95.5% (149/156) residing in inner regional to very remote Australia, and 68.2% (107/157) "sheep, cattle and/or grain farmers." Acceptability was examined with a subset of 114 users who rated at least module 1. Interviews with 108 farmers who did not complete all 5 modules helped determine why, and detailed interviews were conducted with 18 purposively sampled users. Updates were then made according to adaptive trial design methodology. Results: This systematic co-design process resulted in a web-based resource based on acceptance and commitment therapy and designed to overcome barriers to engagement with traditional mental health and well-being strategies--ifarmwell. It was considered an accessible and confidential source of practical and relevant farmer-focused self-help strategies. These strategies were delivered via 5 interactive modules that include written, drawn, and audio- and video-based psychoeducation and exercises, as well as farming-related jokes, metaphors, examples, and imagery. Module 1 included distress screening and information on how to speak to general practitioners about mental health-related concerns (including a personalized conversation script). Modules were completed fortnightly. SMS text messages offered personalized support and reminders. Qualitative interviews and star ratings demonstrated high module acceptability (average 4.06/5 rating) and suggested that additional reminders, higher quality audio recordings, and shorter modules would be useful. Approximately 37.1% (52/140) of users who started module 1 completed all modules, with too busy or not got to it yet being the main reason for non-completion, and previous module acceptability not predicting subsequent module completion. Conclusions: Sequential integration of research evidence, expert knowledge, and farmers' preferences in the co-design process allowed for the development of a self-help intervention that focused on important intervention targets and was acceptable to this difficult-to-engage group. [ABSTRACT FROM AUTHOR]

This review aimed to assess the efficacy of workplace physical activity interventions; compare the efficacy of those that were and were not informed by behaviour change theory, and outline the effectiveness of different intervention components. A search was undertaken in Medline, Embase, PsycINFO, Ovid Emcare (previously CINAHL) and SportDiscus. Randomised, non-randomised and cluster-controlled trials with objectively measured physical activity and/or measured or predicted maximal oxygen uptake (VO2max) as outcomes were included in the review (83 papers from 79 trials). Random-effects meta-analyses of mean differences were undertaken. Workplace physical activity programmes demonstrated positive overall intervention effects for daily step counts (814.01 steps/day; CI: 446.36, 1181.67; p < 0.01; i2 = 88%) and measured VO2max (2.53 ml kg−1 min−1; CI: 1.69, 3.36; p < 0.01; i2 = 0%) with no sub-group differences between theory- and non-theory informed interventions. Significant sub-group differences were present for predicted VO2max (p < 0.01), with a positive intervention effect for non-theory informed studies (2.11 ml.kg−1 min−1; CI: 1.20, 3.02; p < 0.01; i2 = 78%) but not theory-informed studies (−0.63 ml kg−1 min−1; CI: −1.55, 0.30; p = 0.18; i2 = 0%). Longer-term follow-ups ranged from 24 weeks to 13 years, with significant positive effects for measured VO2max (2.84 ml kg−1 min−1; CI: 1.41, 4.27; p < 0.01; i2 = 0%). Effective intervention components included the combination of self-monitoring with a goal, and exercise sessions onsite or nearby. The findings of this review were limited by the number and quality of theory-informed studies presenting some outcomes, and confounding issues in complex interventions. Future researchers should consider rigorous testing of outcomes of theory-informed workplace physical activity interventions and incorporate longer follow-ups. [ABSTRACT FROM AUTHOR]

Issue addressed: Australian women are less likely to participate in recommended levels of weekly physical activity compared with men. Physical activity participation rates decrease with geographical remoteness. Research suggests that a lack of social support mechanisms within the home environment may act as a barrier for rural women to engage in physical activity, along with discomfort experienced within exercise environments. The purpose of this study was to explore the social conditions that facilitate or inhibit physical activity participation amongst women from two rural South Australian communities. Methods: A qualitative descriptive approach underpinned by a phenomenological methodological orientation was applied. Participants were recruited using a purposive sampling strategy before semi‐structured interviews (N = 16) were conducted and prepared for thematic analysis. Results: Four inter‐related themes were identified: support from others, time, expectations and available opportunities. Further contextual analysis revealed interwoven notions of physical activity spaces, time and social context within the themes. Conclusions: Multiple types of regulators interact to shape the motivational pattern of an individual. The themes identified align with self‐determination, transactional and structuration theory, suggesting a need to consider human behaviour both pragmatically and conceptually. So what?: Results provide insight into social barriers and facilitators for physical activity participation and concomitantly provide the initial development of a framework for local strategic planning of health‐promoting activities, and individual reflection to increase physical activity participation amongst rural women. [ABSTRACT FROM AUTHOR]

Background: Rural Australians experience higher prevalence of several chronic diseases than metropolitan Australians and are less likely to access supportive health services. This study explored associations of sociodemographic factors and barriers to support seeking for health in a sample of rural South Australians. Methods: Participants (n = 610) from three rural regions participated in a computer-assisted telephone interview (CATI), based on the Barriers to Help Seeking Scale. Each participant reported on barriers in one of three health contexts: 'general' physical health, skin cancer, and mental health. Sociodemographic factors included gender, age, highest education, region of residence, and presence of chronic conditions. Chi-squared Automatic Interaction Detection (CHAID) determined independent associations of sociodemographic factors and barrier categories (high, medium and low importance). Results: Privacy was a high-importance barrier in the mental health context, particularly among participants of age < 63 years. The tendency to minimise and normalise health issues was also a high-importance barrier in the mental health context. In the physical health context, those with a chronic condition were more likely to perceive normalisation as a barrier than those without a chronic condition. Need for control and self-reliance was a high-importance barrier in the mental health context and a low-importance barrier in the skin cancer context, particularly among participants < 63 years. Structural factors and distrust of providers were high-importance barriers among those who did not complete secondary education, regardless of context. Conclusion: This study highlights the importance of a nuanced approach to promoting help-seeking in rural Australians, with message content and delivery tailored to specific health conditions and demographic circumstances. [ABSTRACT FROM AUTHOR]

Purpose: This research describes and evaluates the co-creation of a programme called "A Healthy Choice". Underpinned by design thinking (DT), this study aims to improve the healthfulness of food choices in supermarkets among consumers to promote their well-being. Design/methodology/approach: The research features two studies. Study 1 included five co-design workshops with consumers and staff (n = 32) to develop a consumer-centred programme. The findings supported the design and implementation of a programme evaluated in Study 2 (an ecological trial). The programme modified a supermarket environment to increase the prominence of healthier products (shelf-talkers and no discount), ran positive food experiences (cooking and label reading workshops) and was supported by a community-wide information campaign in social and local print media. Findings: A total of 15 new strategies were developed by consumers and staff to support health and well-being in supermarkets. Feasibility discussions and staff voting contributed to the development and storewide implementation of the programme. Evaluation showed that the programme was effective in increasing consumer knowledge of healthier food choices (measured via public survey). Sales analysis showed mixed results; sales increased for promoted products in some categories, but there was no effect in others. Research limitations/implications: Given the real-world setting in which this programme and its evaluation were conducted, there were several innate limitations. The co-design process generated many more ideas than could be implemented, thus creating a healthy "pipe line" for the next iterations of the programme. Practical implications: The key contribution of this work to supermarket intervention literature is the recommendation to change the paradigm of engagement between the key stakeholders who are typically involved in supermarket programs. Using the co-design and DT frameworks, the authors offer an example of stakeholders working together in close partnership to co-design and collaboratively implement a programme that promotes healthier choices. Originality/value: This project contributes to the emerging body of empirical work using DT principles in the area of healthy food choices in supermarkets. A rigorously designed evaluation of a co-designed supermarket programme contributes to scholarly evidence on food well-being programs in supermarkets. [ABSTRACT FROM AUTHOR]

Valid measurement of youth physical activity is important and self-report methods provide convenient assessments at the population level. There is evidence that the validity of physical activity self-report varies by weight category. The aim of this study was to assess the validity of the 3-Day Physical Activity Recall (3DPAR), separately between normal weight and overweight/obese Australian youth. Accelerometer-derived physical activity variables were compared with 3DPAR variables in 155 (77 females) 11- to 14-year-olds from Adelaide, South Australia. In the whole sample, validity coefficients for self-reported moderate and moderate to vigorous physical activity were modest (rs = 0.12-0.31) and similar across gender and weight status categories. Validity coefficients for self-reported vigorous physical activity were much stronger (rs = 0.59-0.73) among overweight/obese than among normal weight participants. The validity of the 3DPAR in this study was low in the whole sample but varied according to physical activity intensity and the weight status of the child. Specifically, the 3DPAR may be appropriate for describing vigorous intensity physical activity among overweight and obese youth. [ABSTRACT FROM AUTHOR]

Issue Addressed: Suicide rates in rural Australia are almost twice as high as those in urban areas. In rural communities, football clubs are often the 'hub' of the community and are being explored as an avenue to deliver mental health and well-being promotion. The aim of this study was to explore barriers and enablers for programs promoting mental health and well-being through rural Australian football clubs.Method: This qualitative descriptive study included 12 individuals of 10 rural clubs affiliated with the South Australian National Football League. Recruitment occurred via emails to club secretaries/presidents. Semi-structured telephone interviews explored mental health and well-being issues experienced in clubs, previous involvement with mental well-being programs and potential barriers/enablers for future programs. Interviews were transcribed verbatim and analysed thematically.Results: Thematic analysis identified three themes encompassing barriers and enablers: (1) more than a football club, (2) attitudes towards mental health and (3) what is needed to implement a program. The third theme had subthemes of resources, importance of timing, mental health initiatives and components of a program.Conclusion: Key barriers included difficulty getting people involved due to individual attitudes towards mental health, and not having the finances/resources to implement a program. Major enablers included the important role the football club serves in the community, the inclusion of speakers with credibility and making the program engaging. SO WHAT?: This study identifies key factors which may impact on community engagement and program effectiveness for mental health and well-being programs delivered via rural football clubs. [ABSTRACT FROM AUTHOR]

Background: The after-school period is potentially a "critical window" for promoting physical activity in children. The purpose of this study was to qualitatively explore children's perceptions of the factors influencing their engagement in physical activity during the after-school period as the first phase in the development of a questionnaire. Methods: Fifty-four South Australian children age 10-13 years participated in same gender focus groups. Transcripts, field notes, and activity documents were analyzed using content analysis. Through an inductive thematic approach, data were coded and categorized into perceived barriers and facilitators according to a social ecological model. Results: Children identified a number of factors, including safety in the neighborhood and home settings, distance to and from places, weather, availability of time, perceived competence, enjoyment of physical activity, peer influence, and parent influence. New insights into bullying and teasing by peers and fear of dangerous animals and objects were revealed by the children. Conclusions: In this study, hearing children's voices allowed the emergence of factors which may not be exposed using existing surveys. These findings are grounded in children's perceptions and therefore serve as a valuable contribution to the existing literature, potentially leading to improved intervention and questionnaire design. [ABSTRACT FROM AUTHOR]

The need to undertake pilot testing and evaluation of novel health promotion programs has become increasingly apparent for the purpose of understanding the true effects of complex interventions and for testing and refining behavioral theories that these interventions are informed by. A mixed-methods process evaluation and feasibility study was undertaken for a need-supportive physical activity program that was piloted in a single-group pre–post study. The piloted program was designed to support participant needs of autonomy, competence, and relatedness through evidence-based and theory-informed behavior change strategies including a motivational interviewing style appointment, education on self-management tools (i.e., pedometers, goal setting, action and coping planning, a customized website for goal setting and self-monitoring), and self-determined methods of regulating physical activity intensity [affect, rating of perceived exertion (RPE), and self-pacing]. The program aimed to positively impact physical activity behavior, psychological well-being, and associated motivational processes. Reach, adoption, fidelity, context, change and performance objectives, and feasibility of the program were evaluated using information from survey respondents from the target population (n = 118) and implementing staff (n = 6); questionnaires from pilot study participants (n = 21); and individual semi-structured interviews with a combination of pilot study participants, non-participants, and implementing staff (n = 19). Process evaluation of the Activity for Well-Being program found that the reach of the program was moderate but adoption was low. The use of self-management tools and self-determined methods of regulating physical activity intensity appeared to be feasible. The website had mixed responses and low engagement. The element of having a support person elicited a strong positive response in the program participant interviews. Involving local implementing staff more directly into the delivery of the intervention could have potentially improved reach, adoption, and feasibility of the program. [ABSTRACT FROM AUTHOR]

Objective: Little is known about how the physical environment impacts physical activity behaviour among rural populations, who are typically less active and at higher risk of chronic disease than urban dwellers. The lack of individual-level instruments to assess the physical environment in rural areas limits advancement of this field. Among rural adults, this study aimed to evaluate (a) the test-retest reliability of a self-reported questionnaire of individual-level perceptions of the physical activity environment, and (b) the stability of a self-reported physical activity questionnaire. Design: Cross-sectional questionnaire repeated twice, 2 weeks apart. The questionnaire included 94 items relating to the perceived physical environment (representing nine summary scores), demographic characteristics and physical activity. Setting: Rural Australia. Participants: Rurally residing adults (>18 years) across three Australian states. Main outcome measures: Test-retest reliability evaluated by weighted Kappa statistics (individual items) and intra-class correlations (summary scores). Results: A total of 292 participants (20% men) completed both questionnaires, on average 22 days apart. Test-retest reliability of individual items ranged from weighted Kappa 0.37-0.85 (median: 0.59). Internal reliability for five summary scores was good to excellent (Cronbach's alpha: 0.81-0.97). Test-retest reliability was good to excellent for six summary scores (intra-class correlations: 0.67-0.77). Conclusions: The findings indicated good to excellent test-retest reliability for most items, particularly "fixed" constructs for this new questionnaire measuring the perceived physical environment in rural populations. This study represents an important step towards improving measurement of physical activity environments in rural populations, potentially leading to better tailored interventions to promote active and healthy living in rural areas. [ABSTRACT FROM AUTHOR]

Purpose: People affected by cancer who live in rural Australia experience inferior survival compared to their urban counterparts. This study determines whether self-reported physical and mental health, as well as health-promoting behaviours, also differ between rural and urban Australian adults with a history of cancer.Methods: Weighted, representative population data were collected via the South Australian Monitoring and Surveillance System between 1 January 2010 and 1 June 2015. Data for participants with a history of cancer (n = 4295) were analysed with adjustment for survey year, gender, age group, education, income, family structure, work status, country of birth and area-level relative socioeconomic disadvantage (SEIFA).Results: Cancer risk factors and co-morbid physical and mental health issues were prevalent among cancer survivors regardless of residential location. In unadjusted analyses, rural survivors were more likely than urban survivors to be obese and be physically inactive. They were equally likely to experience other co-morbidities (diabetes, chronic obstructive pulmonary disease, cardiovascular disease, arthritis or osteoporosis). With adjustment for SEIFA, rural/urban differences in obesity and physical activity disappeared. Rural survivors were more likely to have trust in their communities, less likely to report high/very high distress, but equally likely to report a mental health condition, both with and without adjustment for SEIFA.Conclusions: There is a need for deeper understanding of the impact of relative socioeconomic disadvantage on health (particularly physical activity and obesity) in rural settings and the development of accessible and culturally appropriate interventions to address rural cancer survivors' specific needs and risk factors. [ABSTRACT FROM AUTHOR]

The study aimed to establish pedometer step cut points in relation to weight status among 2,071 5-16 year old Australians. Height, weight and waist circumference were measured, and participants wore a pedometer for seven days. Pedometer values were taken as the average number of steps per day and weighted according to the ratio of weekdays to weekends. Receiver operating characteristic (ROC) curves were used to identify the optimal pedometer counts to predict overweight. Analysis of covariance (ANCOVA) was used to compare anthropometric variables across pedometer step quintiles. The ROC model for older females was nonsignificant. Optimal cut points were 12,000 for younger males, 11,000 for older males and 10,000 for younger females. These were largely confirmed by ANCOVA. The cut points were lower than previously reported for equivalent age groups. Cultural and environmental differences may necessitate population-specific guidelines to be established. [ABSTRACT FROM AUTHOR]

This study examined the convergent validity of a computerized use of time diary (MARCA) relative to pedometry. Participants aged 9-16 years wore a pedometer and completed the MARCA. Comparing pedometer data and self-report data collected for the same day (n = 297 participants), the correlation (Spearman's rho) with PAL was 0.54 and with MVPA was 0.50. Comparing mean daily step counts over 6-7 days with averaged self-report data collected on different days (n = 1713 participants) Spearman's rho for PAL was 0.45 and for MVPA was 0.44. Thus, the MARCA showed validity similar or superior to most self-report instruments for young people. [ABSTRACT FROM AUTHOR]

This study examined whether active commuting to and from school was associated with more frequent walking and cycling to other neighborhood destinations. Parents reported on free-time physical activity and frequency of active commuting among 1,643 South Australians (9-15 years), as well as their perceptions of risk associated with active commuting in the neighborhood. Groups were formed on the basis of active and motorized transport to and from school and compared on the frequency of walking and cycling to other neighborhood destinations. Those who actively commuted between home and school were approximately 30% more likely to actively commute to other neighborhood destinations, independent of age, free-time physical activity, and neighborhood risk. Active commuting to and from school is part of a broader habit of walking and cycling in the neighborhood among school age South Australians. The advantages of promoting active transport between home and school might extend beyond the energy expenditure of that journey alone. [ABSTRACT FROM AUTHOR]

Objective: School food intake makes a considerable contribution to children's overall diet, including fruit and vegetable intake. Comparing differing school food provision systems can provide novel insights for intervention and improved nutrition policy. This study compared school day food in children from Australia and England. Design: Children completed food frequency questionnaires reporting school day food intake, breakfast intake and family evening meals. Differences in school day food intake consumed between Australia and England were evaluated. Multinomial logistic regressions compared fruit and vegetable intake, family dinner frequency and breakfast in Australian and English children adjusting for confounders: Age, sex, ethnicity and parent education. Setting: 27 Primary schools in Adelaide, Australia and 32 in London, England. Subjects: N = 772 children aged 8-11 years from the Australian REACH study (n = 347) and UK RHS School Gardening Trial in England (n = 425). Results: Considerably more English children reported consuming vegetables at school than Australian children (recess/lunchtime Australian children 3.4/6.1%; English children recess/lunchtime 3.6/51.1%). However, Australian children were more likely to consume sufficient vegetables daily (OR = 4.1; 1.3, 12.5), and have family evening meals everyday [OR = 4.01; 1.88, 8.55], and were less likely to consume breakfast (OR = 0.26; 0.08, 0.79) than English children. Conclusions: Findings indicate that provision of a school lunch meal, compared to a packed lunch from home, may be more supportive of children's vegetable intake. However, without a supportive home environment that encourages vegetable intake, children will not be able to consume sufficient amounts of vegetables. [ABSTRACT FROM AUTHOR]

Objective: The purpose of the current study was to examine associations of individual and aggregated screen-based behaviours, and total sitting time, with healthy and unhealthy dietary intakes among adolescents.Design: Cross-sectional study of adolescents. Participants self-reported durations of television viewing, computer use, playing electronic games (e-games), total sitting time, daily servings of fruits and vegetables, and frequency of consumption of sugar-sweetened beverages (SSB), diet beverages, fast foods and discretionary snacks. Logistic regression models were conducted to identify associations of screen-based behaviours, total screen time and total sitting time with dietary intakes.Setting: Victoria, Australia.Subjects: Adolescents (n 939) in School Year 11 (mean age 16·8 years).Results: The results showed that watching television (≥2 h/d) was positively associated with consuming SSB and diet beverages each week and consuming discretionary snacks at least once daily, whereas computer use (≥2 h/d) was inversely associated with daily fruit and vegetable intake and positively associated with weekly fast-food consumption. Playing e-games (any) was inversely associated with daily vegetable intake and positively associated with weekly SSB consumption. Total screen (≥2 h/d) and sitting (h/d) times were inversely associated with daily fruit and vegetable consumption, with total screen time also positively associated with daily discretionary snack consumption and weekly consumption of SSB and fast foods.Conclusions: Individual and aggregated screen-based behaviours, as well as total sitting time, are associated with a number of indicators of healthy and unhealthy dietary intake. Future research should explore whether reducing recreational screen time improves adolescents' diets. [ABSTRACT FROM AUTHOR]

Objective To assess the differences between farming and non-farming rural adults in perceived barriers to mental health service use. Design A cross-sectional survey, modified from the Barriers to Help-Seeking Scale ( BHSS), was conducted using a computer-assisted telephone interview. Setting Respondents (age 52.6 ± 11.6 years) were recruited from three rural regions of South Australia. Participants Approximately, 78 non-farmers and 45 farmers were included in analyses. 78 retired and two unemployed participants were excluded from the analyses. Main outcome measure Farmers and non-farmers were compared on domain scores and individual item responses from the adapted BHSS that represent 'agrarian' attitudes to support-seeking for mental health: stoicism, self-reliance, minimisation of the problem, stigma and distrust of health professionals. Results In the analysis of domain scores, 'Need for Control and Self-Reliance' was a stronger barrier for farmers than non-farmers ( P = 0.009) with a trend ( P = 0.07) towards stronger barriers among farmers in the 'Minimising Problem and Resignation' domain. In the analysis of item-level responses, there was a difference ( P = 0.03) between farmers and non-farmers in responses to 'I find it difficult to understand my doctor/health professional', with 24.4% of the farmers agreeing that this is a barrier compared with 15.3% of the non-farmers. Conclusion Long-held stereotypes of stoicism and self-reliance among farmers were somewhat supported, in the context of mental health. Mental health services and professionals in rural Australia might need to adapt their practices to successfully engage this population. [ABSTRACT FROM AUTHOR]

Aim: To examine secular trends in Australian children's actual sleep time as well as the perceived importance of sleep between 1985, 2004 and 2013.Methods: Secular trends in children's sleep and their perception of the importance of sleep across three time points 1985 (N = 401), 2004 (N = 450) and 2013 (N = 395) were examined according to socio-economic status (SES), age and sex. The children self-reported their bedtime, wake-up time and their perceived importance of sleep, among other questions.Results: There were no significant differences in sleep duration between boys and girls in any of the survey years, nor were there differences in sleep duration between SES categories at any time point. Independent of survey year, age, sex and SES, there was a graded difference in sleep duration (minutes) across response categories for perceived importance of sleep. Overall, trends in the perceived importance of sleep appeared to match trends in actual sleep time, but not for all subgroups.Conclusion: This study indicates that the sleep duration of high SES Australian school children is returning to, or near to, baseline sleep duration observed in 1985, while the sleep duration of low SES Australian children has remained at low levels. [ABSTRACT FROM AUTHOR]

Objective To determine differences in walking for recreation and transport between Accessibility/Remoteness Index of Australia ( ARIA) categories, in South Australian adults. Design Cross-sectional self-reported data from adult telephone survey respondents between April and May in 2012 and 2013. Setting Population of South Australia. Participants A total of 4004 adults (aged over 18 years) participated: n = 1956 men and n = 2048 women. Area of residence was categorised using ARIA (major city, inner regional, outer regional and remote/very remote). Main outcome measure(s) Self-reported participation in walking for transport and recreation/exercise as the number of times and minutes per week. Data were analysed using Kruskal-Wallis test for median minutes and negative binomial regression for times walked with adjustment for socioeconomic status, age and body mass index. Results Average age was 47.8 ± 18.5 years, 51.1% were women, 70.9% lived in the major cities, 14.6% in inner regional, 10.8% in outer regional and 3.6% in remote/very remote areas. Relative to major city, times walked for recreation was lower for only remote/very remote residents (incidence rate ratio ( IRR) 0.74 (95% CI 0.59-0.92), P = 0.008). This difference was only observed for men ( IRR 0.54 (95% CI 0.39-0.73), P < 0.001). Relative to major city, times walked for transport was less for inner regional ( IRR 0.74 (95% CI 0.67-0.85), P < 0.001) and outer regional ( IRR 0.64 (95% CI 0.56-0.74), P < 0.001) only. This difference in transport walking was seen in both men and women. Conclusion Frequency of walking varied by purpose, level of remoteness and sex. As walking is the focus of population-level health promotion, more detailed understanding of the aetiology of regular walking is needed. [ABSTRACT FROM AUTHOR]

This study explores rural South Australians' barriers to help-seeking for skin cancer detection. A total of 201 randomly selected rural adults (18-94 years, 66% female) were presented with a skin-cancer-related scenario via telephone and were asked the extent to which various barriers would impede their help-seeking, based on an amended version of the Barriers to Help-Seeking Scale. Older (≥63 years) and less educated participants endorsed barriers more strongly than their younger, more educated counterparts in the following domains; "Concrete barriers and distrust of caregivers", "Emotional control", "Minimising problem and Normalisation", "Need for control and self-reliance" (every domain other than "Privacy"). Socioeconomic disadvantage, gender, and farmer status did not predict stronger overall barriers, but some gender and occupation-related differences were detected at the item level. Farmers were also more likely to endorse the "Minimising problem and normalization" domain than their non-farmer working rural counterparts. Widely endorsed barriers included the tendency to minimise the problem, a desire to remain in control/not be influenced by others, reluctance to show emotion or complain, and having concerns about privacy or waiting times. [ABSTRACT FROM AUTHOR]

Objective To explore perceptions of health among South Australian farmers. Design Descriptive qualitative study, using semi-structured interviews. Setting Two rural towns in the Riverland region of South Australia. Participants Fifteen adults involved in farming within the Riverland region of South Australia, from a variety of farming industries; age range 23-70 years old; 53% male, 47% female. Main outcome measures Perceptions and definitions of health. Results Participants described an ecological understanding of health across individual, farm, and community domains. Participants perceived health as being able to function and complete farm work. Participants reported that farm work helped to maintain fitness, but the multiple stress and hazards associated with farming had a significant influence on health. Participants described how health was influenced by community activities and social support from friends and families. Women were reported to take a lead role in health. Conclusions Health providers can frame interventions to resonate with the perceptions of health held by people, shaped and formed by the context of farming. Further research is needed to explore farmers' perceptions of health in different locations, from different industries and from a range of age groups. [ABSTRACT FROM AUTHOR]

Rural Australians have a higher likelihood of chronic disease than urban Australians, particularly male farmers. Chronic disease has been associated with occupational sedentary time. The aim was to validate the self-report of sedentary time in men in contrasting rural occupations. Farmers (n = 29) and office workers (n = 28), age 30–65 years, were recruited from the Riverland region of South Australia. Daily sedentary time and number of breaks in sedentary time were self-reported and measured objectively using body-worn inclinometers. Correlational analyses were conducted between self-reported and objectively measured variables, separately by occupation. There was a significant correlation between self-reported and objectively measured sedentary time in the whole sample (r = 0.44,P = 0.001). The correlation among office workers was significant (r = 0.57,P = 0.003) but not among farmers (r = 0.08,P = 0.68). There were no significant correlations between self-reported and measured number of breaks in sedentary time, for the whole sample (rho = −0.03,P = 0.83), office workers (rho = 0.17,P = 0.39) and farmers (rho = −0.22,P = 0.25). In conclusion, the validity of self-report of sedentary behaviours by farmers was poor. Further research is needed to develop better performing self-report instruments or more accessible objective measures of sedentary behaviour in this population. [ABSTRACT FROM AUTHOR]

Objective This study aimed to richly describe previously inactive Riverland adults' experiences of commencing and maintaining a walking routine following participation in a walking intervention. Design Qualitative description using semi-structured in-depth interviews and thematic analysis. Setting Riverland, South Australia. Participants Nine adults (four men and five women) aged between 40 and 65 years. Intervention Six-week walking intervention included issuing of pedometers, setting goals, completing logs and weekly emails to remind participants to wear their pedometers, recording of steps and provision of strategies for increasing daily steps. Main outcome measures Rich description of participants' experiences represented by four themes and a number of subthemes, supported by direct quotes. Results Four themes: taking care of me through my walk, pedometers and accountability as motivators, fitting walking in and commencing and maintaining a walking routine. Conclusions The participants' experience of commencing a walking routine differed from maintaining a walking routine. Future attempts to support maintenance of a walking routine may be strengthened through identifying and including ways to provide accountability for walking to others beyond the intervention as well as strategies that support the integration of walking into every activity. Furthermore, future walking interventions should enable participants to tailor their walks to their own preferences and mental health benefits of walking should be promoted at least as much as the physical benefits. [ABSTRACT FROM AUTHOR]

Aim: The aim was to evaluate the impact of a brief activity bout outside the classroom on boys' attention and on-task behaviour in the classroom setting.Methods: Fifty-eight boys (mean age 11.2 ± 0.6 years) were recruited from a boys' elementary school in Adelaide, South Australia. Two year 5 and, similarly, two year 6 classes were assigned using a crossover design to either four weeks of a 10 minute Active Lesson Break followed by four weeks of a 10 minute Passive Lesson Break (reading) or visa versa. Attention was quantified using a computerised psychomotor vigilance task, and on-task behaviour by direct observation.Results: Neither the Active Lesson nor the Passive Lesson condition significantly affected sustained attention or on-task behaviour, and there were no significant differences between conditions.Conclusion: There was no impact on participants' sustained attention or on-task behaviour after a short activity break between lessons. Brief activity breaks outside the classroom do not compromise participants' on-task behaviour or attention levels upon returning to the classroom, although improvement in these variables is not seen either. However, the results suggest that active breaks are effective for accruing moderate-to-vigorous physical activity without compromising classroom behaviours. [ABSTRACT FROM AUTHOR]

Objective: There is limited understanding as to why children of low socio-economic position (SEP) consume poorer diets than children of high SEP. Evidence suggests that determinants of dietary intake may differ between SEP groups. The present study aimed to determine if SEP moderated associations of personal and environmental predictors with children's non-core food and sweetened drink intakes and unhealthy dietary behaviours.Design: Children completed online questionnaires and parents completed computer-assisted telephone interviews to assess intrapersonal and environmental dietary predictors. Dietary intake was measured using an FFQ. Parents reported demographic information for maternal education, occupation and employment, and household income.Setting: Twenty-six primary schools in South Australia, Australia.Subjects: Children aged 9-13 years and their parents (n 395).Results: Multiple personal and home environment factors predicted non-core food and sweetened drink intakes, and these associations were moderated by SEP. Maternal education moderated associations of girls' sweetened drink intake with self-efficacy, cooking skills and pressure to eat, and boys' non-core food intake with monitoring, parent's self-efficacy and home environment. Maternal occupation and employment moderated associations of sweetened drink intake with attitudes, self-efficacy, pressure to eat and food availability, and non-core food intake with parents' self-efficacy and monitoring. Income moderated associations with pressure to eat and home environment.Conclusions: Identifying differences in dietary predictors between socio-economic groups informs understanding of why socio-economic gradients in dietary intake may occur. Tailoring interventions and health promotion to the particular needs of socio-economically disadvantaged children may produce more successful outcomes and reduce socio-economic disparities in dietary intake. [ABSTRACT FROM AUTHOR]

Aim This study aimed to investigate fatigue, and its correlates, in children and adolescents with physical disabilities. Method Sixty-five young people aged 8 to 17 years (35 males, 30 females; mean age 13y 2mo, SD 2y 8mo) with mild to moderate physical disabilities (Gillette Functional Assessment Questionnaire levels 7-10) were recruited. Self-reported fatigue was measured using the Peds QL Multidimensional Fatigue Scale. Physical activity was measured using 7-day hip-worn accelerometer. Associations between fatigue, physical activity, and socio-demographic characteristics were examined using analysis of covariance, with significance ( α) set at 0.05. Results were compared with normative data from other paediatric populations. Results Among children with physical disabilities, fatigue was associated with being physically inactive ( F-statistic=4.42, p=0.040), female ( F=4.37, p=0.042), and of low socio-economic status ( F=3.94, p=0.050). Fatigue was not associated with age, weight status, or functional impairment. Young people with physical disabilities experienced high levels of fatigue compared with other paediatric health populations, and comparable to the paediatric cancer population. Interpretation Fatigue is an important issue for young people with physical disabilities. Clinicians and researchers working with this group should be mindful that fatigue is likely to impact on an individual's ability to undertake new treatment regimens or interventions. Interventions aimed at reducing fatigue are warranted. Increasing physical activity might play a role in reducing fatigue. [ABSTRACT FROM AUTHOR]

Background: The purpose of this study was to identify the independent association of frequency of walking trips between home and school with daily physical activity in a sample of school-aged children. Methods: Participants were 109 children (mean age = 12.05 years [±0.71]) attending nine primary schools in Adelaide, South Australia. Physical activity was derived from accelerometers with total counts as the outcome variable. Transport patterns were self-reported for each of the previous five school days. Walking trips were summed for each day and across the school week. The relationship between the number of active transport journeys and individual school day and school week physical activity was modelled separately in boys and girls using multiple linear regression. Results: Frequency of walking was positively associated with school day and school week accelerometer counts in boys, accounting for 6% and 12% of the explained variance in total counts, respectively. There were no significant associations among girls. Conclusion: Despite sex-specific differences in associations between active transport to school and total physical activity, active transport is likely to have important ancillary benefits for development of independence and physical activity habits, and should continue to be promoted. [ABSTRACT FROM AUTHOR]

Objective The aim of this study was to compare objectively measured sedentary behaviours among rural Australian men working in desk-based offices and on farms during work hours and across the total day. Design Cross-sectional observational. Setting The Riverland, South Australia. Participants Participants in this study include 29 farmers and 29 office workers (age 30-65 years). Main outcome measures Objectively measured sedentary time (number and length of sedentary bouts) and steps taken, at work and across the total day. Results During work time, office workers were significantly more sedentary than farmers (6.6 ± 1.5 hours (mean ± SD) versus 4.3 ± 1.5 hours, P < 0.05), while breaks in sedentary behaviour among office workers were less frequent (45 ± 17 versus 49 ± 17 per day, P < 0.05) and briefer (4.7 ± 6.8 min versus 9.7 ± 6.8 min, P < 0.05). Across the total day, office workers were more sedentary than farmers (10.0 ± 1.6 hours versus 8.1 ± 1.6 hours, P < 0.05). Office workers took fewer steps at work (427 ± 282 versus 882 ± 282 steps hour−1, P < 0.05) and across the whole day (8602 ± 3486 versus 11 579 ± 3486 steps day−1, P < 0.05) than farmers. Conclusion In this study, farmers were less sedentary than rural men of similar age who work in offices. Further research is needed to identify reasons for the particularly high prevalence of chronic disease in Australian farmers. [ABSTRACT FROM AUTHOR]

A critical period when sleep is likely to be under greatest pressure is during the senior high school years when academic demands are particularly intense with an increasing emphasis on homework. Sleep habits vary with culture as do attitudes toward academic success. What is unclear is how well students from different cultural backgrounds balance the competing demands of study and sleep and the potential consequences on their mental health. In this study, 101 Asian-Australian and 297 Caucasian-Australian senior year high school students completed a standardized omnibus questionnaire examining extracurricular activity (homework, paid work, sports, exercise, and other organized activities), sleep habits, and mental health (depressive mood, study/ interpersonal stress, and coping). Analyses revealed that sleep habits and extracurricular activity varied with culture. These differences were most evident on school nights where Asian-Australian compared to Caucasian-Australian adolescents reported later bed and rise times and shorter sleep lengths. Although the total amount of time spent on extracurricular activity was similar, Asian-Australian adolescents undertook significantly more homework after school while Caucasian-Australian adolescents spent more time undertaking paid work, sports, and exercise. Regression analyses revealed that extracurricular activity including homework was not predictive of sleep length in either Asian or Caucasian adolescents. Further analyses revealed that predictors of mental health were most evident in Caucasian-Australian adolescents. In the latter group, female gender, less time spent on nonhomework activities, shorter sleep and daytime sleepiness were associated with depressed mood while female gender, increased homework time and daytime sleepiness were associated with increased study/interpersonal stress. These findings highlight the importance of culture in understanding the role of extracurricular activity on sleep and mental health in senior school students. [ABSTRACT FROM AUTHOR]

Children of low socio-economic position (SEP) consume poorer diets than those of high SEP; however, there is limited understanding of why socio-economic gradients in diet occur. Some evidence suggests that determinants of dietary intake may differ between SEP groups. The aim of the present study was to determine whether the associations between personal and environmental variables and children's fruit and vegetable intake, and healthy dietary behaviours are moderated by SEP. A total of 395 children aged 9 to 13 years and their parents were recruited in Adelaide, South Australia. Personal and environmental dietary predictors were measured using child-completed online questionnaires and telephone interviews with parents. Dietary intake was measured using an online FFQ. First, dietary predictors were identified using correlated component regression, and subsequently tested for moderation by four SEP indicators using partial least-squares structural equation modelling. Fruit and vegetable intake and healthy behaviours were predicted by self-efficacy, attitudes and a supportive home environment. For girls, only the associations of self-efficacy with healthy behaviours were moderated by occupation. For boys, income moderated the associations of fruit and vegetable intake with attitudes, and healthy behaviours with supportive home environments. Occupation and employment moderated the associations of boys' family environments and fruit intake, and attitudes with healthy behaviours. Reducing socio-economic disparities in children's healthy dietary intake may be more successfully achieved by tailoring health promotion policies and interventions according to variables that moderate the relationships between dietary intake and SEP. [ABSTRACT FROM PUBLISHER]

Background: Rural Australian adults are continually shown to be insufficiently active with higher prevalence of lifestyle-related diseases associated with physical inactivity compared to urban adults. This may, partly, be attributable to the challenges associated with implementing community-based physical activity programs in rural communities. There is a need for broadly accessible physical activity programs specifically tailored to the unique attributes of rural communities. The aim of the Rural Environments And Community Health (REACH) study is to evaluate the effectiveness of an online-delivered physical activity intervention for increasing regular walking among adults living in rural areas of South Australia. Methods/Design: This is a randomised controlled trial. The intervention is 12-weeks with a 12-month follow-up. Participants will be insufficiently active, aged 18 to 70 years and randomly assigned to either Control or Intervention group. Participants receive a pedometer, but only the Intervention group will receive access to the purpose built REACH website where they will report steps taken, affect and ratings of perceived exertion during daily walking. These variables will be used to establish individualised step goals for increasing walking. Control participants will receive a paper diary to record their variables and generic incremental step goals. The primary outcome measures are time spent in sedentary, light and moderate-to-vigorous intensity physical activity, measured by accelerometry. Secondary outcomes include 1) health measures (anthropometric and physiological), 2) psychological well-being, 3) diet quality, and 4) correlates of physical activity (exercise self-efficacy and physical activity environments). Measures will be collected at baseline, post-intervention, 6-month and 12-month follow-up. Discussion: This protocol describes the implementation of a trial testing the effectiveness of an online resource designed to assist rural Australians to become more physically active. The outcomes of this study will guide the efforts of health promotion professionals by providing evidence for a relatively inexpensive, widely accessible and effective method for increasing physical activity that can be utilized by anyone with access to the internet. Findings may indicate future directions for the implementation of physical activity and other health related interventions in rural communities. [ABSTRACT FROM AUTHOR]

The article presents a study which determined the prevalence of chronic conditions with different lifestyle behaviour from people with histories of cancer. A cross Sectional, self-reported data taken from a telephone survey from January 2010 to March 31,2012 among adult residents of South Australia was conducted. Results indicated that the prevalence of chronic conditions was significantly higher among controls without cancer.

Purpose: Physical activity has been associated with improved outcomes for cancer survivors. Compared to their urban counterparts, rural Australians experience a health disadvantage, including poorer survival rates after diagnosis of cancer. The aim of this pilot feasibility study was to gain insight into the experiences of rural cancer survivors engaging in an online resource designed to increase regular walking. Methods: A 6-week online lifestyle intervention was implemented among eight cancer survivors living in three rural regions of South Australia. Participants used a pedometer to monitor daily steps taken, reported daily steps using a specially designed website and were provided with daily step goals based on their affective state. Participants took part in semi-structured face-to-face interviews to gauge their impressions of the program. Data were analysed using qualitative description and content analysis to derive major themes from the interviews. Results: The program motivated participants to increase their walking and resulted in improvements in several self-reported physical and quality of life outcomes. The resource was clear and easy to navigate. The three-tiered step goal system reduced feelings of guilt if participants were unable to reach a goal. The step log and graph allowed participants to self-monitor their progress. The forum fostered social support; however, more interaction with intervention personnel was suggested. Conclusions: This online pedometer-based walking intervention is feasible and effectively increases motivation for walking and enhances health-related quality of life in South Australian rural cancer survivors. A randomized controlled trial of this intervention is warranted. [ABSTRACT FROM AUTHOR]

Background Cancer survivorship rates have increased in developed countries largely due to population ageing and improvements in cancer care. Survivorship is a neglected phase of cancer treatment and is often associated with adverse physical and psychological effects. There is a need for broadly accessible, non-pharmacological measures that may prolong disease-free survival, reduce or alleviate co-morbidities and enhance quality of life. The aim of the Steps TowaRd Improving Diet and Exercise (STRIDE) study is to evaluate the effectiveness of an online-delivered physical activity intervention for increasing walking in cancer survivors living in metropolitan and rural areas of South Australia. Methods/design This is a quasi-randomised controlled trial. The intervention period is 12-weeks with 3-month follow-up. The trial will be conducted at a university setting and community health services in South Australia. Participants will be insufficiently active and aged 18 years or older. Participants will be randomly assigned to either the intervention or control group. All participants will receive a pedometer but only the intervention group will have access to the STRIDE website where they will report steps, affect and ratings of perceived exertion during exercise daily. Researchers will use these variables to individualise weekly step goals to increase walking. The primary outcome measure is steps per day. The secondary outcomes are a) health measures (anthropometric and physiological), b) dietary habits (consumption of core foods and non-core foods) and c) quality of life (QOL) including physical, psychological and social wellbeing. Measures will be collected at baseline, post-intervention and 3-month follow-up. Discussion This protocol describes the implementation of a trial using an online resource to assist cancer survivors to become more physically active. It is an innovative tool that uses ratings of perceived exertion (RPE) and daily affect to create individualised step goals for cancer survivors. The research findings may be of relevance to public health policy makers as an efficacious and inexpensive online-delivered intervention can have widespread application and may improve physical and psychological outcomes among this vulnerable population. Findings may indicate directions for the implementation of future physical activity interventions with this population. Trial registration Australian New Zealand Clinical Trials Registry: ACTRN12613000473763. [ABSTRACT FROM AUTHOR]

Background: Cancer survivorship rates have increased in developed countries largely due to population ageing and improvements in cancer care. Survivorship is a neglected phase of cancer treatment and is often associated with adverse physical and psychological effects. There is a need for broadly accessible, non-pharmacological measures that may prolong disease-free survival, reduce or alleviate co-morbidities and enhance quality of life. The aim of the Steps TowaRd Improving Diet and Exercise (STRIDE) study is to evaluate the effectiveness of an online-delivered physical activity intervention for increasing walking in cancer survivors living in metropolitan and rural areas of South Australia.S Methods/Design: This is a quasi-randomised controlled trial. The intervention period is 12-weeks with 3-month follow-up. The trial will be conducted at a university setting and community health services in South Australia. Participants will be insufficiently active and aged 18 years or older. Participants will be randomly assigned to either the intervention or control group. All participants will receive a pedometer but only the intervention group will have access to the STRIDE website where they will report steps, affect and ratings of perceived exertion (RPE) during exercise daily. Researchers will use these variables to individualise weekly step goals to increase walking. The primary outcome measure is steps per day. The secondary outcomes are a) health measures (anthropometric and physiological), b) dietary habits (consumption of core foods and non-core foods) and c) quality of life (QOL) including physical, psychological and social wellbeing. Measures will be collected at baseline, post-intervention and 3-month follow-up. Discussion: This protocol describes the implementation of a trial using an online resource to assist cancer survivors to become more physically active. It is an innovative tool that uses ratings of perceived exertion and daily affect to create individualised step goals for cancer survivors. The research findings may be of relevance to public health policy makers as an efficacious and inexpensive online-delivered intervention can have widespread application and may improve physical and psychological outcomes among this vulnerable population. Findings may indicate directions for the implementation of future physical activity interventions with this population. [ABSTRACT FROM AUTHOR]

Background: The lunchtime and after-school contexts are critical windows in a school day for children to be physically active. While numerous studies have investigated correlates of children’s habitual physical activity, few have explored correlates of physical activity occurring at lunchtime and after-school from a social-ecological perspective. Exploring correlates that influence physical activity occurring in specific contexts can potentially improve the prediction and understanding of physical activity. Using a context-specific approach, this study investigated correlates of children’s lunchtime and after-school physical activity. Methods: Cross-sectional data were collected from 423 South Australian children aged 10.0–13.9 years (200 boys; 223 girls) attending 10 different schools. Lunchtime and after-school physical activity was assessed using accelerometers. Correlates were assessed using purposely developed context-specific questionnaires. Correlated Component Regression analysis was conducted to derive correlates of context-specific physical activity and determine the variance explained by prediction equations. Results: The model of boys’ lunchtime physical activity contained 6 correlates and explained 25% of the variance. For girls, the model explained 17% variance from 9 correlates. Enjoyment of walking during lunchtime was the strongest correlate for both boys and girls. Boys’ and girls’ after-school physical activity models explained 20% variance from 14 correlates and 7% variance from the single item correlate, “I do an organised sport or activity after-school because it gets you fit”, respectively. Conclusions: Increasing specificity of correlate research has enabled the identification of unique features of, and a more in-depth interpretation of, lunchtime and after-school physical activity behaviour and is a potential strategy for advancing the physical activity correlate research field. The findings of this study could be used to inform and tailor gender-specific public health messages and interventions for promoting lunchtime and after-school physical activity in children. [ABSTRACT FROM AUTHOR]