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Farming is a physically and psychologically hazardous occupation and farmers face numerous attitudinal and structural barriers to accessing mainstream health and mental health services. As Internet access increases across rural Australia there is potential for online interventions to help overcome barriers and provide new avenues for improving farmers' mental health and wellbeing. However, little is known about how farmers perceive this approach which is problematic given the importance of building in their preferences, to ensure these interventions meet their interests and needs, and have maximum impact. The purpose of this study was to explore the scope of Australian farmers' current Internet use and their views and preferences on the design and delivery of online, mental health and wellbeing-focused interventions. Eighteen farmers (11 men and 7 women, with a median age of 45.5 years) from grain, sheep and/or cattle farms across four states of Australia participated. Telephone-based, semi-structured interviews were used to explore their current Internet use practices and preferences regarding new websites to promote farmers' mental health and wellbeing. Thematic Framework Analysis was used to analyze and organize the data. Eight key topics were discussed and several themes within each topic emerged. The first topic related to farmers' current Internet use practices (found to be sporadic, used for weather, banking, emails and research, they are open to using it for health and wellbeing, and they reported that Twitter and other social media reduces social isolation). Themes demonstrating farmers' specific preferences on four aspects of web-design included; preferred aesthetics (authenticity, reflective of farmer diversity, simple layout and font, colours of nature, mix of cartoons and real-life, positive, masculine imagery); preferred language (lay, casual tone, careful use of humour, positive/empowering); preferred technical aspects/capabilities (unreliable Internet connections, limited downloads, compatibility with multiple devices, easy to use, inclusion of music problematic, mixed opinion about inclusion of scientific references and chat features, include videos, case studies) and preferred content/focus for websites of this type (early intervention/prevention, where and how to seek more help). More broadly, contextual influences to consider (multiple pressures of farm life, time poverty, farmers' outlook is practical and outcome-driven, stigma about mental health decreasing but still exists); strategies to promote engagement (must feel engaged, know what is next, see benefits quickly) and marketing/promotion suggestions (women as advocates for men, use trusted sources to promote, emphasize that information can be accessed from privacy of own home/farm) were also highlighted by participants. Findings will help inform the development of new mental health and wellbeing-focused online interventions for farmers to maximize uptake, engagement and impact. In particular, these interventions need to be perceived as relevant and authentic, while also reflecting the diversity of the farming population, which farmers believe can be achieved by carefully considering their preferences for aesthetics, language, technological requirements and the unique farming context. • Authentic, positive (e.g. not drought), masculine, farming-related imagery in the colours of nature (particually green) favoured. • Videos, case studies, simple layouts and fonts preferred. • Lay language that is casual, positive, empowering and carefully humorous valued. • Ease of use, multiple device compatibility and the ability to operate with poor internet is important. • Exposure to multiple pressures, lack of time, practical and outcome-driven nature and stigma concerns require consideration. • There is a particular need for new online resources focusing on early intervention/prevention. [ABSTRACT FROM AUTHOR]

Objectives: Rural Australian adults are consistently identified as insufficiently active, likely due to challenges implementing community-based physical activity programs in rural settings. On-line strategies to promote physical activity may be particularly effective in rural settings where isolation and scarcity of qualified support are potential barriers. The Rural Environments and Community Health (REACH) study evaluated the effectiveness of an online-delivered walking intervention among South Australian rural adults.Design: Randomised controlled study design.Methods: A twelve-week intervention, with six- and twelve-month follow-up, was conducted. Participants (n=171; 50.6±12.5years), recruited through flyers, local newspapers and radio, were randomised to comparison or intervention groups and received a pedometer. The intervention group received access to the REACH website and personalised step goals based on ratings of perceived exertion and daily affect. The comparison group received a paper diary and generic step goals. Outcome measures were accelerometry-assessed sedentary, light (LPA) and moderate-to-vigorous (MVPA) physical activity. Linear mixed models assessed changes over the intervention and follow-ups.Results: Sedentary time decreased, and LPA and MVPA increased in both groups across the intervention (p<0.05). The intervention group demonstrated a larger increase in LPA at six-month follow-up relative to comparison (p<0.05). Both groups decreased sedentary time, overall and in bouts ≥30min, between baseline and twelve-month follow-up (p<0.05). From baseline to twelve-month follow-up, MVPA (total min and bouts ≥10min) declined more in the comparison group than the intervention group (p<0.05).Conclusion: While increased physical activity and decreased sedentary time were observed in both groups during the intervention period, maintenance was only observed for LPA at six-month follow-up in the intervention group. By twelve-month follow-up, post-intervention improvements had largely disappeared, suggesting that additional research is needed to identify ways to improve long-term adherence. [ABSTRACT FROM AUTHOR]

Objectives: Associations between objectively measured sedentary behaviour, physical activity (PA) and metabolic syndrome (MetS)-classified using three different definitions were investigated in an inactive sample of rural Australian adults.Design: Quantitative, cross-sectional.Methods: 171 adults (50.7±12.4years) from two rural South Australian regions underwent seven-day accelerometer activity monitoring and MetS classification using the National Cholesterol Education Program, the International Diabetes Federation and the Harmonized definitions. Associations between sedentary and activity variables and MetS (adjusted for age, sex, diet and smoking status) were modelled using logistic regression. In secondary modelling, associations of sedentary and activity outcomes for each MetS definition were assessed, adjusting for other activity and sedentary variables. Prediction differences across the definitions of MetS were directly compared using Akaike's Information Criterion.Results: Sedentary behaviour increased MetS risk, whereas light physical activity (LPA) and moderate-to-vigorous physical activity (MVPA) reduced MetS risk, irrespective of definition. In secondary models, LPA predicted MetS independently of MVPA and total sedentary time. Time spent in sedentary bouts (>30min) predicted MetS independently of MVPA and the number of sedentary bouts predicted MetS independently of LPA and MVPA. Prediction differences for MetS definitions failed to reach the critical threshold for difference (>10).Conclusions: This study highlights the importance of sedentary behaviour and LPA on the prevalence of MetS in an inactive sample of rural Australian adults. Studies assessing the efficacy of increasing LPA on MetS in this population are needed. Minimal predictive differences across the three MetS definitions suggest evidence from previous studies can be considered cumulative. [ABSTRACT FROM AUTHOR]

Introduction: The prevalence of chronic disease, mortality and suicide rates is higher in rural Australia than in urban centres. Understanding rural Australians' barriers to accessing health services requires urgent attention. The purpose of this study was to compare barriers to help-seeking for physical and mental health issues among rural South Australian adults. Methods: A total of 409 people from three rural and remote regions in South Australia completed a computer-assisted telephone interview. They were presented a physical or mental health scenario and rated the extent to which barriers would prevent them from seeking help for that condition. Responses ranged from 1 ('strongly disagree') to 5 ('strongly agree') and were averaged to form domain scores (higher scores representing stronger barriers to seeking support), in addition to being examined at the item level. Results: Men reported higher barriers for the mental compared with physical health scenario across four domains ('need for control and self-reliance', 'minimising the problem, resignation and normalisation', 'privacy' and 'emotional control'). Women reported higher barriers for the mental compared to physical health scenario in two domains ('need for control and self-reliance' and 'privacy'). Both men and women endorsed many items in the mental health context (eg 'I don't like feeling controlled by other people', 'I wouldn't want to overreact to a problem that wasn't serious', 'Problems like this are part of life; they're just something you have to deal with', 'I'd prefer just to put up with it rather than dwell on my problems', 'Privacy is important to me, and I don't want other people to know about my problems' and 'I don't like to get emotional about things') but in the physical health context, barriers were endorsed only by men (eg 'I wouldn't want to overreact to a problem that wasn't serious',' I'd prefer just to put up with it rather than dwell on my problems', 'Problems like this are part of life; they're just something you have to deal with', 'I like to make my own decisions and not be too influenced by others'). Conclusions: Both rural men and rural women report more barriers to help seeking for mental health issues than physical health issues across a range of domains. There is a need to educate the current and future rural health and mental health workforce about these barriers and to encourage them to test evidence-based strategies to address them, in particular to facilitate more widespread mental health help-seeking in rural Australia. [ABSTRACT FROM AUTHOR]

Objectives: The American College of Sports Medicine and Exercise and Sports Science Australia recognise the importance of gathering a client history (subjective assessment) to inform clinical decisions for clients with chronic disease and/or disability. Despite the importance of the subjective assessment in problem-oriented exercise management, there is currently no primary evidence to indicate the important domains that should be addressed during the subjective assessment to guide safe and effective clinical decisions.Design: Modified e-Delphi METHODS: A panel of 32 experts was recruited with a median of 12 years of experience (Q3=15.5 years; Q1=10 years). The panel was asked to rate the importance of each domain in guiding clinical decisions on a 9-point Likert scale with consensus for inclusion or exclusion pre-defined at 80%.Results: The panel of experts elected that best practice for conducting the subjective assessment was a semi-structured approach using a combination of prompts and follow-up questions. The Delphi process resulted in an initial list of 36 domains that was identified by the panel of which 23 domains reached consensus for agreement after Round 3.Conclusions: The subjective assessment is important for Clinical Exercise Physiologists to provide safe and effective services. Best practice for conducting the assessment is the semi-structured approach to prompt the clinician on the domains to include. Twenty three domains have been considered as important for a Clinical Exercise Physiologist to address in a subjective assessment to implement the delivery of safe and effective exercise assessment and/or prescription. [ABSTRACT FROM AUTHOR]

Objectives: Despite widespread media campaigns to encourage physical activity (PA), participation is poor among Australian adults. This study aimed to explore the prevalence of and relationships between awareness of PA recommendations and PA participation.Design: Cross-sectional study of n=2402 South Australian adults (aged≥18 years) via a computer-assisted telephone interview.Methods: PA recommendation awareness was determined by asking for the number of minutes of PA recommended for health benefits and whether PA is needed to make you 'puff and pant' to confer a health benefit. Respondents were defined as sufficiently active if they reported ≥150min/week of PA as measured by the Active Australia Survey.Results: A total of 43.0% correctly identified that 30min of PA is recommended per day (Recommendation 1) and 43.3% correctly disagreed/strongly disagreed that PA is needed to make you 'puff and pant' (Recommendation 2). Overall, 60.6% of respondents were sufficiently active. Of those who correctly identified Recommendation 1, 53.2% reported participating in sufficient PA, significantly fewer than those who did not know Recommendation 1 (69.6%) (χ(2)=64.74 (4), p<0.001). There was no difference in levels of sufficient PA between those who correctly identified Recommendation 2 and those who did not.Conclusions: There was relatively low awareness of PA recommendations among South Australian adults. More research is needed in how recommendations are promoted and how they impact PA behaviours. PA recommendations are based on the best available epidemiological evidence but largely fail to guide the choices people currently make about PA. [ABSTRACT FROM AUTHOR]

Background/aims/method To investigate causes of farmers’ stress during drought, 309 drought-affected South Australian farmers and their spouses, mainly from sheep, cattle and/or gain properties, ranging in age from 23 to 85 years (34.6% female) completed a questionnaire. Demographic and work-related details were collected and participants were asked to list their most stressful experiences in the past month and past 12 months. Results Most (73.1%) of the sources of stress reported were farm-related. A thematic analysis identified drought , financial pressure and uncertainty about the future as dominant stressors. A range of other more specific drought-related (e.g. poor crop yields, unsatisfactory conditions for livestock, overwhelming workloads) and contextual stressors (e.g. rising input costs, family involvement in the farming business, pressure to take part in community work, lack of understanding of farming from ‘outsiders’ ) were also identified. Dominant stressors were compounded by non-drought-related issues (e.g. machinery breakdowns ) and non-farm related stressors (e.g. illness and death of loved ones ). Conclusion Improved awareness of stressors may help to reduce farmers’ frustration with outsiders’ lack of understanding of their way of life, normalise stressors and thereby reduce stigma and empower farmers to seek help. These findings could also inform the development of targeted mental-health prevention and promotion initiatives for farmers in future periods of drought. [ABSTRACT FROM AUTHOR]

Objectives It is particularly important to measure trends in physical activity to identify specific contexts where physical activity may have declined and can be targeted for intervention. The aim of this review was to summarize overall physical activity trends based on objectively measured physical activity as well as trends in specific contexts (active transport, organized sport, school physical education and school play periods) using self- or proxy-reported physical activity. Design A comprehensive literature search was completed to identify articles on the specific contexts of physical activity for inclusion in this review. Methods Journal articles for inclusion in this narrative review were sourced from the various databases and reference lists. Most studies in this review employed self-report or proxy-report methodologies. Results There is limited research on temporal trends in children's and adolescents’ physical activity. The few studies that employ objective measures to assess trends in physical activity indicate little change has occurred in the last 20 years. Other studies that employed self-report methods indicate organized sport trends are somewhat inconsistent across countries, however most studies reported an increase in participation. Within the limited physical education trend studies, inconsistent trends were noted. There have been consistent declines in active transport, particularly cycling. Few studies have investigated trends in physical activity and sedentary behaviour during school play periods, highlighting a need for further research. Conclusions Mixed results and inconsistent magnitudes of change were identified when exploring trends in different contexts of physical activity for children and adolescents over the last few decades. Taken overall, there is little evidence for a decrease in children's and adolescents’ physical activity, although consistent declines in active transport highlight this context as a suitable intervention target. [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.

Objectives: While there is consistent evidence that rural adults in Australia are less active than their urban counterparts, studies relating geographical remoteness to activity patterns in Australian adolescents have yielded inconsistent results. The aim of this study was to describe objectively and subjectively measured patterns of physical activity and sedentary behaviours across remoteness categories in a representative sample of 9-16 year old Australians.Design: Cross-sectional observational study.Methods: 2071 Australian adolescents provided self-report use of time data on four days and wore a pedometer for at least 6 days within the 2007 Australian National Children's Nutrition and Physical Activity Survey. Comparisons of activity patterns were made across four objectively-determined remoteness categories (Major City, Inner Regional, Outer Regional and Remote), adjusting for household income, parental education and age.Results: Adolescents living in major cities self-reported 11-29 min less moderate to vigorous physical activity each day than their counterparts living in geographically more remote areas, and took 150-850 fewer steps each day. While there were no differences in time spent in sport or active transport, differences in free play participation were significant. Males in major cities also reported higher levels of screen time. Differences were somewhat more marked among males than among females.Conclusions: Activity levels among Australian adolescents show contrasting patterns of geographical differences to those found in Australian adults. Higher levels of free play among rural Australian adolescents may be due to more available space and less fear of traffic and stranger risks. [ABSTRACT FROM AUTHOR]

Abstract: Objectives: To explore children''s perceptions of the factors influencing their engagement in physical activity during the “critical” lunchtime period, using a social–ecological framework. Design: This study was an in-depth descriptive qualitative design. Methods: Fifty-four South Australian children aged 10–13 years participated in same-gender focus groups. Transcripts, field notes and activity documents were analysed using content analysis. Using an inductive thematic approach, data were coded and categorised into perceived barriers and facilitators according to a social–ecological model. Results: Children identified a range of environmental, social and intrapersonal barriers and facilitators. Bullying/teasing, the school uniform and school rules were exposed as explicit barriers to lunchtime play. Other important barriers included lack of access to, and poor suitability of, space, lack of access to programs/facilities and equipment, and lack of peer and teacher support. Perceived facilitators of lunchtime physical activity centred on access to equipment, enjoyment, motivation to improve skills, and peer support and acceptance. The freedom to make up or modify rules for games was also perceived to be a facilitator of lunchtime play. Conclusions: Communicating with children has been an effective approach in uncovering perceived barriers and facilitators to lunchtime play that may not have been previously considered in the quantitative correlate literature. Lunchtime interventions targeting children''s physical activity should focus on addressing the barriers perceived to be important to lunchtime play. [Copyright &y& Elsevier]

Abstract: Objectives: While there is consistent evidence that rural adults in Australia are less active than their urban counterparts, studies relating geographical remoteness to activity patterns in Australian adolescents have yielded inconsistent results. The aim of this study was to describe objectively and subjectively measured patterns of physical activity and sedentary behaviours across remoteness categories in a representative sample of 9–16 year old Australians. Design: Cross-sectional observational study. Methods: 2071 Australian adolescents provided self-report use of time data on four days and wore a pedometer for at least 6 days within the 2007 Australian National Children''s Nutrition and Physical Activity Survey. Comparisons of activity patterns were made across four objectively-determined remoteness categories (Major City, Inner Regional, Outer Regional and Remote), adjusting for household income, parental education and age. Results: Adolescents living in major cities self-reported 11–29min less moderate to vigorous physical activity each day than their counterparts living in geographically more remote areas, and took 150–850 fewer steps each day. While there were no differences in time spent in sport or active transport, differences in free play participation were significant. Males in major cities also reported higher levels of screen time. Differences were somewhat more marked among males than among females. Conclusions: Activity levels among Australian adolescents show contrasting patterns of geographical differences to those found in Australian adults. Higher levels of free play among rural Australian adolescents may be due to more available space and less fear of traffic and stranger risks. [Copyright &y& Elsevier]

Abstract: Organised sport among youth makes a substantial contribution to daily energy expenditure. This study investigated socioeconomic gradients in sport participation and predictors of participation. A representative sample of young South Australians (10–15y; n =1737) was surveyed on organised sport participation in the previous 12 months, and predictors derived from the Children''s Physical Activity Correlates scale and a parent survey. Four constructs were derived: ‘is it worth it?’ (perceived outcomes); ‘am I able?’ (perceived competency); ‘reinforcing’ (parental support); and ‘enabling’ (perceived barriers, from the parent survey). Socioeconomic position (SEP) was operationalised by an area-level indicator, the Socioeconomic Indicator for Advantage (SEIFA), split into tertiles. Sport participation was higher among high (highest SEIFA tertile) compared with low (lowest SEIFA tertile) SEP children. All predictors except ‘am I able?’ were positively associated with sport participation among boys and girls. Of these predictors, the ‘enabling’ construct varied by SEP among both boys and girls, with high SEP children reporting fewer barriers to participation. High SEP girls reported higher scores on ‘reinforcing’ and ‘is it worth it?’ than their low SEP counterparts. Low SEP girls reported lower levels of both instrumental and affective support from parents to play sport. There are distinct SEP gradients in sport participation, as well as its psychosocial and environmental predictors among South Australian youth. Low SEP girls are the most disadvantaged in terms of parental support to participate in sport. Interventions targeting this vulnerable group are urgently required. [Copyright &y& Elsevier]

Abstract: Researchers and practitioners interested in assessing physical activity in children are often faced with the dilemma of what instrument to use. While there is a plethora of physical activity instruments to choose from, there is currently no guide regarding the suitability of common assessment instruments. The purpose of this paper is to provide a user''s guide for selecting physical activity assessment instruments appropriate for use with children and adolescents. While recommendations regarding specific instruments are not provided, the guide offers information about key attributes and considerations for the use of eight physical activity assessment approaches: heart rate monitoring; accelerometry; pedometry; direct observation; self-report; parent report; teacher report; and diaries/logs. Attributes of instruments and other factors to be considered in the selection of assessment instruments include: population (age); sample size; respondent burden; method/delivery mode; assessment time frame; physical activity information required (data output); data management; measurement error; cost (instrument and administration) and other limitations. A decision flow chart has been developed to assist researchers and practitioners to select an appropriate method of assessing physical activity. Five real-life scenarios are presented to illustrate this process in light of key instrument attributes. It is important that researchers, practitioners and policy makers understand the strengths and limitations of different methods of assessing physical activity, and are guided on selection of the most appropriate instrument/s to suit their needs. [Copyright &y& Elsevier]

Summary: Social support is a consistent correlate of youth physical activity (PA) but few studies have examined this in cultural sub-groups. Female adolescents (n =113; 13.9±0.6years) from a metropolitan single sex private school participated in this study. PA was estimated using the 3 Day Physical Activity Recall (3dPAR), and aspects of social support using a specifically designed questionnaire. Anglo-Australians (n =74), whose parents were both born in Australia, were compared with Vietnamese-Australians (n =39), whose parents were both born in Vietnam. There were non-significant trends towards higher engagement in all measures of PA among Anglo-Australians. Anglo-Australians perceived higher levels of social support to be physically active. In the whole sample and in cultural sub-groups, support by mothers was a consistent predictor of PA. Among Vietnamese-Australians, activities shared with the mother predicted moderate to vigorous PA. Interventions targeting PA among adolescent females should consider interactions of social support and cultural background. [Copyright &y& Elsevier]

Approaches to weight management have traditionally focussed on caloric intake versus caloric expenditure. Despite a range of interventions based on these approaches, the proportion of overweight children and adolescents continues to rise. There are increasing indications that other factors, such as sleep duration, may be at play. This commentary on current research related to the impact of sleep duration provides an insight into the mounting evidence of its possible link to overweight in children and adolescents. Here we focus on children and adolescents as typical age cohorts in schools experiencing health and physical education programs. Children and adolescents are sleeping less than ever before, and there is now emerging evidence that sleep duration has a profound effect on weight regulating hormones leading to weight gain. It is proposed that a 24-hour view of children and adolescents be taken into account. Moreover, a reassessment of the impact of sleep deprivation may lead to extra considerations in the information and practices embodied in the HPE curricula for the growing battle against obesity. [ABSTRACT FROM AUTHOR]

Summary: Rising youth obesity is a serious public health concern. There is a widespread view that declining physical activity is contributing to this trend. A total of 929 young South Australians (age=9–15 years) were surveyed in 1985 and 2004 on usual physical activity in several contexts, including attitudes to physical activity. Eight of 10 South Australian schools participating in the 1985 Schools Health and Fitness Survey were revisited in 2004. Comparisons were made on: organised sport, active transport, physical education (PE), playground activity, vigorous physical activity (VPA), total leisure-time physical activity (LTPA), and attitudes to PE and school sport. The questionnaire and method of administration were identical in both surveys. There were no differences between surveys in club and school sport participation, walking to school, and reported enjoyment of PE and school sport. In 2004 fewer children rode to school, but PE classes were more frequent. The percentage of children who ‘sit and talk’ during school breaks had increased, with a decreased percentage of older girls who ‘run around’ during school breaks. There was a significantly higher LTPA in MET.min in 2004 for boys, which was particularly evident at higher percentiles. There were no changes in mean or distribution of LTPA for the whole sample or girls. The percentage of respondents reporting ≥3 bouts of VPA in the previous week rose from 51% (1985) to 76% (2004). There is no consistent evidence of declining physical activity among South Australian youth. It is apparent that physical activity in some contexts has declined, while in other contexts levels are the same or higher than in 1985. This underscores the complex nature of physical activity and the influences on this behaviour. [Copyright &y& Elsevier]

Summary: Understanding factors that influence physical activity levels of adolescents can assist the design of more effective interventions. Social support is a consistent correlate of youth physical activity but few studies have examined this in different cultural settings. Male adolescents (n =180, age=13.58±0.97 years) from a metropolitan single sex private school participated in this study. Habitual physical activity was estimated using the 3-day physical activity recall (3dPAR), and aspects of social support to be physically active using a specifically designed questionnaire. Comparisons were made between Anglo-Australians (n =118), whose parents were both born in Australia, and Vietnamese-Australians (n =62), whose parents were both born in Vietnam. There was a trend towards higher physical activity among Anglo-Australians, particularly on weekends. Anglo-Australians reported significantly more parental and peer support across most items pertaining to these constructs. Among the whole sample, social support variables explained 5–12% of the total explained variance in physical activity, with items pertaining to father and best friend support emerging as the strongest and most consistent predictors in multiple regression models. Among Anglo-Australians, the prediction models were relatively weak, explaining 0–9% of the total explained variance in physical activity. Prediction models for physical activity among Vietnamese-Australians were much stronger, explaining 11–32% of the total explained variance, with father''s support variables contributing consistently to these models. The strong paternal influence on physical activity among Vietnamese-Australians needs to be confirmed in more diverse population groups, but results from this study suggest that interventions promoting physical activity among adolescent boys need to take into account cultural background as a moderator of widely reported social influences. [Copyright &y& Elsevier]