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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]

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]

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. (Contains 2 tables and 3 figures.)

The "Learning Trail" is an innovative application of peer-mediated instruction designed to enhance student learning in large practical classes. The strategy specifically seeks to improve participants' attention to details of protocol that are often difficult to observe during teacher-centered demonstrations to large groups. Students (n=68) at the University of South Australia trialed this strategy, in which instruction in anthropometric techniques is initiated by an instructor to a group of 3-4 students and then sent in "waves" from one student group to the next. The final group in the sequence demonstrates the techniques to the instructor, who notes any departures from technical accuracy. As each technical module is flowing from group to group, the instructor initiates the next "wave" with the first group, and the process is repeated until all of the relevant skills are processed. The final stage is a full class discussion during which sources of technical error are identified and resolved. In this trial, students taught skinfold measurement by the peer instructed method (PI; n=33) were compared with a traditionally instructed group (TI; n=35), in which the instructor was responsible for all information transfer. For each participant, technical errors of measurement (TEM) were calculated; the intra-tester TEM as a measure of reliability, and the inter-tester TEM, in which the student's measures are compared with those of a criterion anthropometrist to give an indication of validity. There were no differences between TI and PI groups on intra-tester TEM (p=0.24), but the PI group had a lower inter-tester TEM for pooled skinfold sites (p=0.006) and for one individual site (triceps; p=0.007), but not the other three sites. The time taken to complete the whole set of instructions did not differ between delivery modes. The results of this trial suggest that the peer-mediated strategy may be more effective than teacher-centered instruction in terms of technical accuracyin anthropometry.

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]

Objective: The socio-ecological milieu of children's physical activity is changing, perhaps causing perturbations within the causal 'web' that explains physical activity behaviours. It is unclear if the relative importance of parental role modelling is changing. Accordingly, this study examined associations of child-perceived parent physical activity and children's sport participation in 1985 and 2004. Methods: In 1985 (179 girls, 211 boys) and 2004 (210 girls, 218 boys), Australian schoolchildren (9-15 years) in the same eight schools were surveyed on sport participation and perceptions of parents' physical activity. Results: In the 1985 sample, girls with active fathers played more sport. In 2004, boys and girls with active fathers or active mothers reported higher sport participation. In 1985, there were no differences in sport participation between those with both, either or neither parent active. In 2004, sport participation was highest among boys and girls with both parents active. Conclusions: These results underscore the current role of parents as socialising agents for physical activity. Implications: Intervention design should be founded on the most recent evidence of children's physical activity correlates. Key words: children, physical activity, sport, role modelling, parents. doi: 10.1111/j.1753-6405.2010.00617.x

Objective: This study aimed to explore sleep duration in young Australians on different types of days across weight classes. Methods: Use of time and anthropometric data were collected on 8,866 nights from 3,884 9-18 year old Australians. The association between sleep duration and weight status was examined using factorial ANOVA for four day types: S-S (to bed and waking on school days); S-NS (to bed on school day and waking on non-school day); NS-NS (to bed and waking on non-school days); NS-S (to bed on non-school day and waking on school day). Results: Sleep duration varied with weight status when all day types were considered together (p=0.0-012). Obese adolescents slept less than normal and underweight adolescents. However, the relationship varied for different day types; with the strongest relationship for NS-S days (on which obese children slept 65 min less than very underweight children, p Conclusions: The association between weight status and sleep duration showed consistent gradients across weight categories, but only for certain day types. Implications: These patterns cast light on the direction of causation in the obesity-sleep duration relationship. Findings suggest that short sleep duration contributes to obesity, or that a third unidentified factor has an impact on both. Key words: sleep, adolescent, overweight, obese, children. Aust NZ J Public Health. 201 O; 34:165-71 doi: 10.1111/j.1753-6405.2010.00502.x

Objective: To describe trends in health attitudes and self-perceptions among school-age South Australians between 1985 and 2004. Methods: The questionnaire from the 1985 Australian Schools Health and Fitness Survey was administered during 2004 in those South Australian schools that participated in the 1985 survey. Using chi square, responses were compared for 10-15 year-olds (1985, n=398; 2004, n=467) on attitudes to: visiting the doctor and dentist, smoking, sleep, diet, exercise, stress, having friends, and knowledge about fitness and health. Additionally, self-perceptions of health and fitness were compared. Results: Among boys and girls between 1985 and 2004, there were significant declines in the perceived importance of regularly visiting the dentist and doctor, but improved attitudes to being a non-smoker. Among boys, the perceived importance of sleep and diet declined between surveys. A smaller percentage of boys and girls in the latter survey perceived their current health status as 'good'. In the lower SES sample, the percentage of girls rating healthy diet as 'very important' was lower in 2004. Conclusions: There have been general declines in perceived importance of many health-related behaviours among South Australian youth between 1985-2004. In contrast, the perceived importance of not smoking was higher in 2004 than 1985. Implications: The relative success of anti-smoking campaigns targeting youth suggests that health education must be accompanied by broader environmental support in order to effect positive behavioural change. Key words: children; health; health attitudes; trends.

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]

Objective: To compare rates of change in South Australian children's body composition between 1997 and 2002 in subsamples based on location of residence and socioeconomic status. Methods: Year 6 children from randomly selected South Australian schools in 1997 (32 schools, n=1,423) and 2002 (29 schools, n=992) were compared on: body mass index (BMI), sum of triceps and abdominal skinfolds (skinfold sum) and waist girth. Samples were partitioned into urban (population >20,000) and rural ( Results: Between surveys, there were significant increases in boys' waist girth (p=0.004) and skinfold sum (p=0.007), and girls' BMI (p=0.0005) and skinfold sum (p Conclusions: Secular trends in Australian children's body fatness are continuing. Further, the rates of change in girls are affected by the socio-demographic milieu. Implications: The development of targeted interventions to combat child obesity will depend on a clearer understanding of how environmental influences on weight status are distributed across the socio-demographic landscape.

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]

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]

Abstract Assessment of correlates of physical activity occurring at different times of the day, locations and contexts, is imperative to understanding children’s physical activity behaviour. The purpose of this review was to identify the correlates of children’s physical activity (aged 8–14 years) occurring during the school break time and after-school periods. A review was conducted of the peer-reviewed literature, published between 1990 and January 2011. A total of 22 studies (12 school break time studies, 10 after-school studies) were included in the review. Across the 22 studies, 17 studies were cross-sectional and five studies were interventions. In the school break time studies, 39 potential correlates were identified, of which gender and age were consistently associated with school break time physical activity in two or more studies, and family affluence, access to a gym, access to four or more physical activity programs and the condition of a playing field were all associated with school break time physical activity in only one study. Access to loose and fixed equipment, playground markings, size of and access to play space and the length of school break time were all positively associated with changes in school break time physical activity in intervention studies. Thirty-six potential correlates of after-school physical activity were identified. Gender (with boys more active), younger age, lower body mass index (for females), lower TV viewing/playing video games, and greater access to facilities were associated with higher levels of after-school physical activity in two or more studies. Parent supervision was negatively associated with females’ after-school physical activity in one study. This review has revealed a relatively small number of studies investigating the school break time and after-school periods in the specified age range and only a few correlates have demonstrated a consistent association with physical activity. This highlights the infancy of this area and a need for further investigation into time-specific physical activity behaviour so that interventions designed for these specific periods can target the important correlates.

Abstract Background Increases in chronic illness due to sedentary lifestyles and poor metabolic fitness have led to numerous intervention strategies to promote physical activity (PA). This paper describes the methodological strategies of two short-term PA interventions. Outcome measures reported are PA adherence and compliance rates during the intervention and at 3, 6 and 12-month follow-up. Methods The 40-day interventions were: a pedometer-based walking program (n = 251) and a group-based intensive program (n = 148). There was also an active control group (n = 135). Intervention subjects were prescribed PA each day and required to record all activity sessions (pedometer steps or energy expenditure from heart rate monitors). Results Compliance (≥ 150 min/wk PA) was highest post-intervention (81.1% and 64.5% for the group and pedometer subjects, respectively) and then progressively decreased across the 12-month follow-up period (final compliance rates were 53.5% and 46.6%, respectively) although they remained significantly higher than pre-intervention rates (zero %). There was significantly higher adherence to 6 months (75.0% and 64.9%), and compliance to 3 months (64.9% and 51.0%), for group versus pedometer subjects. The active control group maintained the highest adherence and compliance rates across the study. Conclusions The group-based program resulted in higher adherence and compliance rates post-intervention although both types of interventions showed long-term effectiveness to increase activity patterns.