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Objectives To assess the feasibility and efficacy of a 6-week pilot active break program (ACTI-BREAK) on academic achievement, classroom behaviour and physical activity. Design Pilot cluster randomised controlled trial. Methods 374 children in Year 3 and 4 (74% response) were recruited from six schools across Melbourne, Australia. Schools were randomised to the ACTI-BREAK intervention or usual teaching practice. The intervention involved teachers incorporating 3 × 5 min active breaks into their classroom routine daily. Academic achievement was assessed using 1-min tests in reading and mathematics; classroom behaviour at the individual and whole class level was observed by teachers; and physical activity levels were assessed using accelerometers. Multilevel mixed effects linear regression models were conducted using intention to treat (ITT) and per protocol (PP) analyses. Results Significant intervention effects were found for classroom behaviour at the individual level (ITT B = 16.17; 95% CI: 6.58, 25.76); effects were stronger for boys (B = 21.42; 95% CI: 10.34, 32.49) than girls (B = 12.23; 95% CI: 1.52, 22.92). No effect was found for classroom behaviour at the whole class level, reading, math or physical activity. PP findings were similar. Conclusions Implementing active breaks during class time may improve classroom behaviour, particularly for boys. There was no evidence to suggest that implementing active breaks had any adverse effect on academic achievement or classroom behaviour, which may encourage classroom teachers to incorporate active breaks into their routine.

This study examined cross-sectional and prospective associations between typologies of neighbourhood food environment and dietary patterns among 10-12 year-old children. Baseline data were collected in 2003 and follow-up data in 2006 from children in Melbourne or Geelong. Parents completed a food frequency questionnaire at both time points. 'Healthful' and 'energy-dense' dietary pattern scores were computed. A Geographic Information System was used to determine the presence or absence of food outlets (cafés/restaurant; fast food; supermarkets/grocery stores; convenience store; greengrocer; and butcher, seafood or poultry retailer) within an 800 m road network buffer of home. Three typologies were identified: 1-variety of food outlets, including those selling core/fresh foods (n = 96); 2-café/restaurant and convenience (n = 160); 3-few types of outlets (n = 208). Latent class analysis was used to identify underlying unobservable typologies of neighbourhood food outlet availability. Linear mixed models were fitted to determine cross-sectional (n = 439) and longitudinal (n = 173) associations between the three identified neighbourhood typologies and each (log-transformed) dietary pattern, accounting for clustering within families and schools. There was little evidence of cross-sectional associations. The longitudinal analyses showed that compared to those with a variety of food outlets, those with few types had 25% lower scores for the healthful dietary pattern (p 0.05) three years later. For optimal dietary patterns, availability of a variety of food outlets close to home, particularly those where core/fresh foods are available, may be important.

Parks are a key setting that can support the health and well-being of older adults through facilitating physical activity and social interaction. However, park use among older adults is low, therefore it is important to better understand which park features are most likely to encourage them to visit and be active and social in parks. This two-phased study examined the relative importance of park features for encouraging park visitation, park-based physical activity, and social interaction among older adults (65+ years). In Phase 1, participants (n = 258; 71.9 + 5.42 years, 52% male) completed an online survey where they rated a selection of images of 42 park features according to the importance of these features for encouraging their park visitation, physical activity and social interaction. The most highly-rated features were included in a new survey for Phase 2, where a new sample (n = 243; 71.5 + 4.91 years, 51% male) completed Adaptive Choice-Based Conjoint analyses tasks to identify relative importance scores of each park feature for all three outcomes. Overall, the two most important features for park visitation were shady trees (conjoint analysis relative importance score 19.6%; 95%CI = 18.3, 20.9) and a peaceful and relaxed setting (19.6%, 95%CI = 18.1, 21.1). The most important feature for physical activity was walking paths (19.6%; 95%CI = 17.1, 22.1) and for social interaction was a peaceful and relaxed setting (14.7%; 95%CI = 12.6, 16.9). Park designers should prioritise shady trees, a peaceful and relaxed setting, and walking paths to ensure that parks meet older adults’ needs and encourage physical activity and social interaction during their park visits.

Parks provide opportunities for people of all ages to engage in physical activity, connect socially with family and friends, and have contact with nature. Despite these benefits, park visitation among adolescents is particularly low; however, little is known about what attributes would attract adolescents to visit parks. This study examined the relative importance of park features that might influence their decision to visit a park. Adolescents were recruited in 2014–5 from four secondary schools located in Melbourne, Australia. Participants completed an adaptive choice based conjoint (ACBC) task during one school class-lesson. This methodology makes it possible to identify the relative importance of individual park features. Ten park attributes were included in the survey and part-worth utility and importance scores were estimated for each attribute with Hierarchical Bayes analyses using Sawtooth Software. Participants (n = 92) had a mean age of 14.7 years (SD = 1.0) and 57% were female. Importance scores showed that playground slides (particularly long steep slides) were the most important attribute for park visitation (16.1%; 95% CI = 15.0, 17.2), followed by an absence of rubbish/graffiti (13.0%; 95% CI = 11.2, 14.8), and the presence of swings (12.4%; 95% CI = 11.4, 13.3), walking/cycling paths (12.1%; 95% CI = 11.0, 13.2) and BMX tracks/skate bowls (10.6%; 95% CI = 9.3, 11.9). These findings can assist those involved in designing parks to identify attributes that should be prioritised to ensure visitation by adolescents is maximised. The novel methodology utilised may be transferable to other studies of the built environment among other population groups.

Background: Some evidence suggests that higher energy intake (EI) later in the day is associated with poor diet quality and obesity. However, EI at one eating occasion (EO) is also dependent on EI at surrounding EOs. Studies that examine the distribution of EOs across the day are rare.Objective: The aim of this study was to examine associations between temporal eating patterns, nutrient intakes, diet quality, and measures of adiposity in a representative sample of Australian adults.Design: Dietary data from two 24-h recalls collected during the cross-sectional 2011-2012 Australian National Nutrition and Physical Activity Survey were analyzed (n = 4544 adults, aged ≥19 y). Temporal eating patterns, based on the distribution of EOs across the day, were determined by using latent class analysis. Diet quality estimated adherence to healthy eating recommendations and was assessed by using the 2013 Dietary Guidelines Index (DGI). Multivariate regression models assessed associations between temporal eating patterns, nutrient intakes, diet quality, and adiposity (body mass index, waist circumference, weight status, and central weight status). Models were adjusted for potential confounders and energy misreporting.Results: Three patterns, labeled "conventional," "later lunch," and "grazing," were identified. Compared with a "conventional" or "later lunch" pattern, men and women with a "grazing" pattern had lower DGI scores and higher intakes of discretionary (noncore) foods (P < 0.05). Among women, the "grazing" pattern was associated with overweight or obesity (OR: 1.57; 95% CI: 1.15, 2.13) and central overweight or obesity (OR: 1.73; 95% CI: 1.19, 2.50). These associations were attenuated after the exclusion of energy misreporters and adjustment for total EI.Conclusions: This study found that a "grazing" temporal eating pattern was modestly but significantly associated with poorer diet quality and adiposity among women, after adjustment for covariates and energy misreporting. Future research should consider the impact of energy misreporting on the relation between temporal eating patterns and adiposity. This secondary analysis was registered at anzctr.org.au as ACTRN12617001029381.

This study examined two year changes in children's active transport and independent mobility and prospective associations between individual, social and physical environmental predictors of interest and these behaviors two years later. Overall, 43.5% of children (12.0 ± 2.1 years) used active transport on the school journey at T1 and at T2 (p=0.77), and 35.3% engaged in independent mobility on the school journey at T1 and 29.6% at T2 (p=0.07). Enjoyment, parental safety concerns, and proximity to walking tracks were associated with independent mobility on the school journey. Road safety and social norms were associated with active transport and independent mobility to local destinations. These factors provide potential targets for interventions.

Background Recommendations to define eating occasions (EO) currently exist for research in adults, but not for children or adolescents. We examined how varying EO definitions affect the characterization of eating patterns in children and adolescents. Methods Cross-sectional dietary data collected using a 24-h recall data during the 2011–12 Australian National Nutrition and Physical Activity Survey (1364 boys and 1337 girls aged 2–18 years) were analyzed. Eight definitions were applied: participant-identified, time-of-day, and 6 neutral definitions (EO separated by 15- or 60-min and/or an additional energy criterion of 21 or 210 kJ). Frequency of and total energy intake from meals, snacks, and all EO were estimated. F tests stratified by gender and age-group, were used to assess differences between definitions. Agreement between definitions of meal and snack frequencies was assessed using intraclass correlation coefficients (ICC). Linear regression was used to estimate the proportion of variance in total energy intake (kJ) and BMI z-score predicted by each definition. Results Mean frequencies of meals and snacks differed between the participant-identified and time-of-day definitions, in boys and girls and for all age groups (P P 2 range = 8.1–34.8). Definitions that delineated meals and snacks better predicted variance in BMI z-score, when compared to the neutral definitions. Conclusions How eating patterns are characterized vary depending on the EO definitions employed, particularly in young children. Variance in total energy intake was best predicted by a variation of the neutral definition whereas definitions that delineated meals and snacks performed better in relation to predicting BMI variance. Further international research that compares EO definitions in children will help inform a standard approach.

Social interaction and physical activity are of paramount importance to children’s health and development and parks are one setting where children can be active and interact with others. However, the specific features of parks that promote or support physical activity and social interaction are not well-understood. The aim of this study was to examine the perceived importance of a selection of park features for encouraging park visitation, park-based physical activity and social interaction among children. Participants (n = 272, 9.6 ± 1.1 years, 51 % female) attending primary schools in Melbourne, Australia completed a survey during school time. They rated (from 1 to 10) digital images of 42 park features according to how much each feature would make them want to “visit the park”, “be active in the park” and “be with other people in the park”. Mean rating scores were calculated for the whole sample, and separately for males and females. For each condition (visit, active, social), each feature was then assigned a ranking from 1 to 42 (1 representing highest mean rating score). A large adventure playground was the highest rated image for all three outcomes. The next highest rated images were: a giant slide and interactive areas for park visitation; an obstacle course and giant slide for park-based physical activity; and interactive areas and an obstacle course for social interaction. Many differences in ratings were observed by gender, highlighting the importance of considering all demographic groups. This study reveals important perspectives from children about which park features should be prioritised in park design to encourage them to visit parks and to be active and social during their park visits. This evidence will inform planners and urban designers to create parks that better suit the needs of children, particularly in relation to social interaction and physical activity.

Parks are important public resources that offer opportunities to be physically active and connect socially. However, parks are not well attended by adolescents, and limited research exists to inform optimal park design to increase adolescents’ park visits and support active and social park use. This study aimed to gain in-depth insights into park characteristics that are important for influencing park visitation, park-based physical activity and social interaction among adolescents. Participants (n = 34, aged 13–18 years, 41.2 % female) were recruited from diverse neighbourhoods in Melbourne, Australia. Walk-along interviews were conducted in nine pre-selected parks, where researchers and participants walked together during the interview. The interviews were audio-taped, transcribed verbatim and analysed using content analysis. The most commonly mentioned characteristics for encouraging park visitation were: the presence of natural features; sports features (e.g., sports courts); playgrounds; aesthetics/condition; and location. The presence of sports features, fitness equipment, walking/cycling paths, playgrounds and green open space were the most frequently mentioned features for encouraging park-based physical activity. The most commonly mentioned features for encouraging socialising when at the park were: presence of barbecue/picnic areas; sports features; seating; organised events; and shade/shelter. Female adolescents more commonly mentioned safety and the presence of playgrounds, and males more commonly noted sports features, size and location as being important for park visitation. Adolescents also considered social factors, such as accompaniment and peer influence, as being critical for encouraging them to visit the park. Many park features were important for all behaviours. For example, sports features were most commonly mentioned as being important for encouraging adolescents’ park visitation and active and social park use. Stakeholders should consider these factors when (re)designing parks to ensure the parks appeal to this sub-population and encourage adolescents to visit and be active and social in this setting.

Objectives: To identify the number of hours and days or nights of monitoring required to reliably estimate energy expenditure (EE), steps, waking sedentary time, light- (LPA), moderate- (MPA), vigorous- (VPA), moderate- to vigorous-intensity physical activity (MVPA), time in bed and total sleep time using the SenseWear Armband.Design: Cross-sectional study.Methods: One hundred and two children (50% boys) aged 8-11 years from six schools wore a SenseWear Armband (BodyMedia Inc, USA) for eight consecutive days (seven consecutive nights). Hourly increments of valid day wear time criteria were examined (days/week; 8h/day-14h/day). Intra-class correlation coefficients estimated the reliability for any individual day for each wear time criteria. The Spearman-Brown prophecy formula was used to determine the number of days/nights of monitoring needed to achieve reliability estimates of 0.7, 0.8 and 0.9.Results: Fewer monitoring days were needed as the valid day criteria became more stringent. For example, at least 12 h of wear time on at least 2 days was required to achieve a reliability of 0.7 for EE. In contrast, at least 8 h/day on 5 days resulted in reliable estimates (0.7) for MPA, VPA and MVPA. Between 6 and 7 nights of monitoring were required to reliably estimate children's time in bed and total sleep time, respectively.Conclusions: A 7-day monitoring protocol in primary school-aged children would provide acceptable reliability for the assessment of EE, waking sedentary time, LPA, MPA, VPA, MVPA, time in bed and total sleep time, as assessed by the SenseWear Armband. (C) 2016 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved. usc Refereed/Peer-reviewed

Background The RESIDential Environments (RESIDE) project is a unique longitudinal natural experiment designed to evaluate the health impacts of the “Liveable Neighbourhoods” planning policy, which was introduced by the Western Australian government to create more walkable suburbs. Objectives To summarize the RESIDE evidence of the impact of the planning policy on a range of health-supportive behaviours and wellbeing outcomes and to assess the consistency and direction of the estimates of associations. Methods An audit of 26 RESIDE research papers (from 2003 to 2012) identified the number of positive associations (statistically significant and consistent with policy expectations), negative associations (statistically significant and inconsistent with policy expectations), and null findings from multiple-exposure models between objective and perceived measures of 20 policy design requirements and 13 health-supportive behaviors and wellbeing outcomes. Results In total 332 eligible estimates of associations (n = 257 objective measures and n = 75 perceived measures) were identified. Positively significant findings were detected for: 57% of walking estimates with objectively measured policy design features (negative = 3%; null = 40%) (n = 115) and 54% perceived measures (negative = 0%; null = 33%) (n = 27); 42% of sense of community estimates with objectively measured of policy design features (negative = 8%; null = 50%) (n = 12) and 61% perceived measures (negative = 8%; null = 31%) (n = 13); 39% of safety or crime-related estimates with objectively measured of policy design features (negative = 22%; null = 39%) (n = 28) and 100% perceived measures (n = 7). All (n = 4) estimates for mental health outcomes with objectively measured policy-related design features were positively significant. Conclusions The synthesis of findings suggests that new suburban communities built in accordance with the “Liveable Neighbourhoods” policy have the potential to encourage health supportive behaviors and wellbeing outcomes including transport and recreation walking, and to create neighborhoods with a stronger sense of community where residents may feel safer., Highlights • The RESIDE study is a longitudinal natural experiment evaluating a new planning policy to create more walkable suburbs. • A process evaluation quantified how much of the policy had been implemented on-the-ground. • This review included 332 estimated associations from multiple-exposure predictor models extracted from 26 RESIDE papers. • It summarized the consistency, strength and direction of estimates of associations against the policy expectations. • New communities built to the policy principles may encourage walking and a sense of community where residents feel safer.

Limited longitudinal evidence of the predictors of physical activity (PA) patterns over time exists, particularly among high-risk groups such as women living in socioeconomically disadvantaged areas. This study aimed to: 1) describe leisure-time PA (LTPA) and transport-related PA (TRPA) patterns over time; and 2) identify individual, social and physical environmental predictors of LTPA and TRPA patterns over five years. Baseline (2007–08) data were collected and analysed (2016–18) from n = 4349 women (18–46 years) from disadvantaged areas of Victoria, Australia. Three- and five-year follow-up data were collected in 2010–11 (n = 1912) and 2012 (n = 1560). LTPA and TRPA were self-reported using the International Physical Activity Questionnaire, and patterns categorised as consistently low, persistently increasing, persistently decreasing, or inconsistent. Compared to a consistently low LTPA pattern, greater family support predicted both persistent decreases (odds ratio [OR] 1.20, 95% CI 1.05–1.36) and persistent increases (OR 1.17, 95% CI 1.04–1.32) in LTPA, while access to childcare predicted inconsistent LTPA patterns (OR 1.66, 95% CI 1.03–2.65). For both LTPA and TRPA, PA enjoyment predicted persistent increases (LTPA: OR 1.05, 95% CI 1.02–1.10; TRPA: OR 1.03, 95% CI 1.00–1.07), persistent decreases (LTPA: OR 1.04, 95% CI 1.00–1.08; TRPA OR 1.04, 95% CI 0.99–1.08), and inconsistent patterns (LTPA: OR 1.04, 95% CI 1.02–1.07; TRPA: OR 1.03, 95% CI 1.01–1.06). Although directionality was inconsistent, and the magnitude of effects were small, PA enjoyment, family social support for PA and access to childcare warrant further investigation and consideration as potentially key factors impacting PA patterns among women living in socioeconomically disadvantaged areas.

BACKGROUND: To date, many approaches have been used to define eating occasions (EOs). A standard definition for EOs is required to facilitate further research. OBJECTIVE: In this study, we examined the influence of differing definitions of EOs on the characterization of eating patterns. DESIGN: Cross-sectional dietary data from two 24-h recalls collected during the 2011-12 Australian National Nutrition and Physical Activity Survey (n = 5242 adults, aged ≥19 y) were analyzed. Eight definitions were applied: participant-identified, time-of-day, and 6 neutral definitions (individual EOs separated by different time intervals and/or an additional energy criterion of 210 kJ). Frequency of and total energy intake from meals, snacks, and all EOs were estimated, as appropriate. Differences were tested by using F tests, stratified by sex and age group. Agreement between different definitions of meal and snack frequencies was assessed by using intraclass correlation coefficients (ICCs). For each definition, linear regression was used to estimate the proportion of variance in total energy intake (kJ) and amount of food intake (g) predicted by frequency of EOs and meals and snacks. RESULTS: Among both sexes and across all age groups, mean frequencies of meals differed between the participant-identified and time-of-day definitions (mean difference range = 0.1-0.3; P < 0.001). There were statistically significant differences between mean frequencies of EOs across the 6 neutral definitions (P < 0.001). There was good agreement for snacks (men: ICC = 0.89; women: ICC = 0.87) but not meal frequencies (men: ICC = 0.38; women: ICC = 0.36) between the participant-identified and time-of-day definitions. The neutral definition (15-min time interval plus energy criterion) best predicted variance in total energy intake (R(2) range = 19.3-27.8). CONCLUSIONS: Different approaches to the definition of EOs affect how eating patterns are characterized, with the neutral definition best predicting variance in total energy intake. Further research that examines how different EO definitions affect associations with health outcomes is needed to develop consensus on a standard EO definition.

Objectives To examine 1) associations between life events and changes in leisure-time physical activity (LTPA) in school leavers and 2) whether these associations are moderated by psychosocial factors. Methods Final year students (n = 440) from high schools in rural Western Australia completed annual telephone interviews on three occasions; baseline (T1), one-year follow-up (T2; n = 440) and two-year follow-up (T3; n = 374). LTPA was measured using the Minnesota Leisure-time Physical Activity Questionnaire. Life events included moving out of home, working full-time and studying full-time. Psychosocial factors included enjoyment, self-efficacy, outcome expectations, club membership, and support from family and friends. Mixed linear regression models examined the effect of life events on changes in LTPA from T1 to T2 and T1 to T3. Results A decline in LTPA across all time points was observed. Those who continued full-time education had a smaller LTPA decline than those who did not. Those who were not a member of a sporting club at T1 had greater LTPA decline if they worked full-time at T2. Conclusions There is a need for interventions to prevent declines in LTPA among school leavers, especially those who do not enter tertiary education. Encouraging sporting club membership during high school might be important.

Parks typically offer opportunities for physical activity among children. Therefore, understanding features of parks that attract children is important for public health. Previous research suggests that children often visit parks other than the one closest to home, most likely because of appealing features. This study compared features present at the park children visit most often to those present at the park closest to their home. Parents in Melbourne Australia (2014–15), reported the park their child (9–11 years) visits most often. Mapping tools were used to determine park locations, sizes, and walking distances from home. The most frequently visited park and the closest park to home were audited (using a purposely created audit tool) to capture levels of access, amount of play/sport and comfort facilities, and quality and safety. Most children (59 %) usually visited parks that were not closest to home. Parks that children (n = 86) visited most often were significantly larger (3.9 ha vs 2.7 ha) and further away (1675 m vs 325 m) than the park closest to home. Additionally, they had significantly more sports facilities, playground equipment, toilets, drinking fountains, BBQ’s and landscaping. Our findings provide evidence that children are attracted to parks with particular facilities, and parents/guardians may be willing to travel further if necessary. A better understanding of the features that drive park usage will help inform park planning and design.

Involvement in meal preparation and eating meals with the family are associated with better dietary patterns in adolescents, however little research has included older children or longitudinal study designs. This 3-year longitudinal study examines cross-sectional and longitudinal associations between family food involvement, family dinner meal frequency and dietary patterns during late childhood. Questionnaires were completed by parents of 188 children from Greater Melbourne, Australia at baseline in 2002 (mean age = 11.25 years) and at follow-up in 2006 (mean age = 14.16 years). Principal components analysis (PCA) was used to identify dietary patterns. Factor analysis (FA) was used to determine the principal factors from six indicators of family food involvement. Multiple linear regression models were used to predict the dietary patterns of children and adolescents at baseline and at follow-up, 3 years later, from baseline indicators of family food involvement and frequency of family dinner meals. PCA revealed two dietary patterns, labeled a healthful pattern and an energy-dense pattern. FA revealed one factor for family food involvement. Cross-sectionally among boys, family food involvement score (β = 0.55, 95% CI: 0.02, 1.07) and eating family dinner meals daily (β = 1.11, 95% CI: 0.27, 1.96) during late childhood were positively associated with the healthful pattern. Eating family dinner meals daily was inversely associated with the energy-dense pattern, cross-sectionally among boys (β = −0.56, 95% CI: −1.06, −0.06). No significant cross-sectional associations were found among girls and no significant longitudinal associations were found for either gender. Involvement in family food and eating dinner with the family during late childhood may have a positive influence on dietary patterns of boys. No evidence was found to suggest the effects on dietary patterns persist into adolescence.

Background The afterschool period holds promise for the promotion of physical activity, yet little is known about the importance of this period as children age. Purpose To examine changes in physical activity of children aged 5–6 years and 10–12 years and their sedentary time in the afterschool period over 3 and 5 years, and to determine the contribution of this period to daily physical activity and sedentary behavior over time. Methods Data from two longitudinal studies conducted in Melbourne, Australia, were used. Accelerometer data were provided for 2053 children at baseline (Children Living in Active Neighbourhoods Study [CLAN]: 2001; Health, Eating and Play Study [HEAPS]: 2002/2003); 756 at 3-year follow-up (time point 2 [T2]); and 622 at 5-year follow-up (T3). Light (LPA), moderate (MPA) and vigorous (VPA) physical activity were determined using age-adjusted cut-points. Sedentary time was defined as≤100 counts/minute. Multilevel analyses, conducted in April 2012, assessed change in physical activity and sedentary time and the contributions of the afterschool period to overall levels. Results Afterschool MPA and VPA decreased among both cohorts, particularly in the younger cohort, who performed less than half of their baseline levels at T3 (MPA: T1=24 minutes; T3=11 minutes; VPA: T1=12 minutes; T3=4 minutes). LPA also declined in the older cohort. Afterschool sedentary time increased among the younger (T1=42 minutes; T3=64 minutes) and older cohorts (T1=57 minutes; T3=84 minutes). The contribution of the afterschool period to overall MPA and VPA increased in the older cohort from 23% to 33% over 5 years. In the younger cohort, the contribution of the afterschool period to daily MPA and VPA decreased by 3% over 5 years. Conclusions The importance of the afterschool period for children’s physical activity increases with age, particularly as children enter adolescence.

Objective Parks are an important setting for physical activity and specific park features have been shown to be associated with park visitation and physical activity. Most park-based research has been conducted in urban settings with few studies examining rural parks. This study examined differences in features of parks in urban compared with rural areas. Methods In 2009/10 a tool was developed to audit 433 urban and 195 rural parks located in disadvantaged areas of Victoria, Australia. Features assessed included: access; lighting/safety; aesthetics; amenities; paths; outdoor courts/ovals; informal play spaces; and playgrounds (number, diversity, age appropriateness and safety of play equipment). Results Rural parks scored higher for aesthetics compared with urban parks (5.08 vs 4.44). Urban parks scored higher for access (4.64 vs 3.89), lighting/safety (2.01 vs 1.76), and diversity of play equipment (7.37 vs 6.24), and were more likely to have paths suitable for walking/cycling (58.8% vs 40.9%) and play equipment for older children (68.2% vs 17.1%). Conclusion Although the findings cannot be generalized to all urban and rural parks, the results may be used to inform advocacy for park development in rural areas to create parks that are more supportive of physical activity for children and adults.

Objectives To examine the validity of a brief self-report questionnaire for assessing physical activity, and compliance and non-compliance with moderate-to-vigorous physical activity (MVPA) recommendations in Australian adolescents against accelerometry. Design Cross-sectional study. Methods MVPA of 203 adolescents (124 females, 79 males) aged 15–17 years was objectively assessed for 8 consecutive days using uni-axial accelerometers and calculated using age-specific cut-points. Adolescents self-reported the number of days (0–7) they were physically active for a total of at least 60 min/day (1) over the past 7 days and (2) over a typical week. Compliance with physical activity recommendations was defined as (1) 5 and (2) 7 days of self-reported MVPA (of at least 60 min/day), and (3) ≥60 min MVPA per average day, and (4) >60 min MVPA on every day according to accelerometry. Spearman's Rho correlations analysed the association between accelerometry-derived MVPA/day and self-reported MVPA days/week for the whole sample, sex and weight status. Percent agreement determined the proportion of adolescents correctly identified as not meeting physical activity recommendations (specificity) or as meeting physical activity recommendations (sensitivity) according to the self-report questionnaire. Results Moderate to large correlations were found between the self-report and accelerometer data (0.2–0.51) across population subgroups. The percent agreement between the self-report and accelerometry data was good for specificity; however, the sensitivity was low, potentially due to poor compliance with recommendations. Conclusions Compared to accelerometry, the brief MVPA self-report questionnaire appears to have acceptable validity for measuring non-compliance with physical activity recommendations in 15–17 year old adolescents.

Objective: To examine the individual, behavioral, social and built environment correlates of body mass index (BMI) in an Australian adult population. Method: Using data from 2003 to 2005 on 1151 participants in the RESIDential Environments project (RESIDE), Perth, Western Australia, linear regression was used to construct multivariate models to examine the variance in BMI explained by significant socio-demographic, environmental and health behavior variables. Both self-report and GIS-derived measures of the built environment were examined. Results: Age, gender, hours of work, total physical activity, sedentary leisure time and dietary fat were all associated with BMI (p≤ 0.05). BMI was not associated with any objective measures of the built environment or social capital, social cohesion or dog ownership but was independently associated with one perceived environment measure (perceived safety from crime). Overall, 3.3% of the variance in BMI was explained by socio-demographic factors, a further 2.7% by health behaviors and a further 1.5% by perceived environment factors. Conclusion: Whilst evidence mounts of built environment correlates to physical activity, the demonstrated translation of these effects on BMI remain more elusive. Nevertheless, built environment factors that constrain physical activity warrant further exploration.

Objective To examine the associations between potential social ecological correlates and self-reported short physical activity breaks during work hours (defined as any interruption in sitting time during a typical work hour) among a sample of employees who commonly sit for working tasks. Methods 801 employed adults aged 18–70 years from metropolitan Melbourne, Australia were surveyed in 2009 about their short physical activity breaks from sitting during work hours and potential social ecological correlates of this behaviour. Results Men reported significantly more short physical activity breaks per work hour than did women (2.5 vs. 2.3 breaks/h, p = 0.02). A multivariable linear regression analysis adjusting for clustering and meeting the public health physical activity recommendations showed that the factors associated with frequency of short physical activity breaks per work hour were perceptions of lack of time for short physical activity breaks for men (− 0.31 breaks/h, 95% confidence intervals [CI] − 0.52, − 0.09) and lack of information about taking short physical activity breaks for women (− 0.20 breaks/h, CI − 0.47, − 0.05). Conclusion These findings suggest that providing male employees with support for short physical activity breaks during work hours, and female employees with information on benefits of this behaviour may be useful for reducing workplace sedentary time.

The impact of neighborhood walkability (based on street connectivity and traffic exposure) within 2 km of public primary schools on children regularly walking to school was examined. The most (n=13) and least walkable (n=12) schools were selected using a school-specific 'walkability' index and a cross sectional study undertaken of Year 5, 6 and 7 children (n=1480) and consenting parents (n=1332). After adjustment, regularly walking to school was higher in children attending schools in high walkable neighborhoods (i.e, high street connectivity and low traffic volume) (Odds ratio (OR) 3.63; 95% Confidence Interval (CI) 2.01-6.56), and less likely in neighborhoods with high connectivity but high traffic volume (OR 0.32; 95% CI 0.22-0.47). Connected street networks provide direct routes to school but when designed for heavy traffic, the potential for children to walk to school is reduced. This highlights the importance of carefully considering school siting and, particularly, street design in school neighborhoods.

Background Ubiquitous car ownership may be negatively affecting children's activity and health. We aimed to assess the associations between household car ownership and children's inactivity and body-mass index (BMI), and between change in household car ownership and changes in children's inactivity and BMI. Methods We used pooled data from five cohort studies (UK, Australia, and Brazil) with valid exposure or outcome data and from four studies (UK, Australia) with longitudinal data within the International Children's Accelerometry Database (ICAD). Main outcome measures were average daily children's sedentary time (SED) and moderate-to-vigorous physical activity (MVPA) during 4 or more days assessed with accelerometery, and BMI z-score (and changes in these measures). Main exposure was household car ownership (none [9·0%, reference], one [29·7%], two or more [61·3%]) and change in ownership (no change [84·2% reference]), decrease [7·7%], increase [8·1%]). Associations were examined using mixed-effects linear regression with random intercepts, adjusted for sex, maternal education, country, BMI z-score (where relevant), and (change in) age and wear time. Findings Mean age of participants in the cohort studies (n=4193, 53·4% female) was 10·4 years (SD 2·0) and mean follow-up of participants in the longitudinal studies (1333, 54·5%) was 3·3 years (SD 1·1). Cross-sectionally, household car ownership was associated with higher SED (vs none): (1 car β 14·1 min per day, p=0·0002; ≥2 cars 12·8, p=0·0008), lower MVPA (−8·9, p Interpretation Children living in households with car access are more sedentary and less active than those without. However, decreasing car access was associated with a decrease in MVPA, potentially related to changes in economic or family circumstances or reduced access to activity spaces. Decreasing car access and use are important public health targets (eg, reducing air pollution), but its potential impact on children's activity opportunities should be explored. Funding The pooling of the data was funded through a grant from the National Prevention Research Initiative (grant no G0701877).

The study examined parental restriction of children's active transport and physical activity outside school hours due to safety concerns, and how this restriction was associated with perceived risk and with youth physical activity levels. We used a cross-sectional design with data from children aged 10-11 years (n=170) and adolescents aged 15-17 years (n=270) who participated in the five-year follow-up of the Children Living in Active Neighbourhoods longitudinal study in Melbourne, Australia. Walking/cycling to local destinations was survey-reported. Moderate-to-vigorous physical activity (MVPA) was recorded during non-school hours using accelerometers. Using surveys, parents reported perceived risk of their children being harmed in their neighbourhood, and restrictions they placed on their children's physical activity. Linear regression analyses examined how perceived risk, constrained behaviour, and physical activity were related. We found that perceived risk did not vary by age-group and was positively associated with constrained behaviour among adolescents but not children. Children were subject to higher levels of constrained behaviour than adolescents. Constrained behaviour was negatively associated with active transport among younger boys and among girls in both age-groups. Furthermore, it was negatively associated with younger boys' MVPA on weekends and with adolescent girls' MVPA during evenings. There were no associations between constrained behaviour and active transport or MVPA among adolescent boys. The findings demonstrate that constrained behaviour exhibited by parents may result in lower levels of active transport and of MVPA outside school hours. In particular, this was true for children and adolescent girls. Social interventions to improve perceived safety and physical interventions involving redesign of the built environment to improve actual safety may help to ease parental restriction of their children's active transport and physical activity in their neighbourhood.

Women living in socioeconomically disadvantaged neighbourhoods are at heightened risk for physical inactivity, but little is known about the correlates of physical activity among this group. Using a social-ecological framework, this study aimed to determine the individual, social and neighbourhood environmental correlates of physical activity amongst women living in such neighbourhoods. During 2007-2008 women (n = 4108) aged 18-45 years randomly selected from urban and rural neighbourhoods of low socioeconomic status in Victoria, Australia completed the International Physical Activity Questionnaire (long). They reported on individual (self-efficacy, enjoyment, intentions, outcome expectancies, skills), social (childcare, social support from family and friends/colleagues, dog ownership) and neighbourhood environmental (neighbourhood cohesion, aesthetics, personal safety, 'walking environment') factors. Multinomial logistic regression was used to examine the odds of increasing categories of leisure time physical activity (LTPA) and transport-related physical activity (TRPA) for each individual, social and environmental factor. In partially adjusted analyses, all individual, social and environmental variables were positively associated with LTPA, while all individual factors, family and friend support and the walking environment were positively associated with TRPA. In fully adjusted multivariable models, all individual and social factors remained significantly associated with LTPA, while self-efficacy, enjoyment, intentions, social support, and neighbourhood 'walking environment' variables remained significantly associated with TRPA. In conclusion, individual and social factors were most important for LTPA, while individual, social and neighbourhood environmental factors were all associated with TRPA. Acknowledging the cross-sectional design, the findings highlight the importance of different levels of potential influence on physical activity in different domains, which should be considered when developing strategies to promote physical activity amongst women living in socioeconomically disadvantaged neighbourhoods.

Background Little is known about what happens to active commuting as children get older, and less is known about influences on changes in this behavior. This study examined predictors of increases in children's and adolescents' active commuting (walking or cycling) to/from school over a 2-year period. Methods Participants were initially recruited and assessed in 2001. Follow-up data were collected in 2004 and 2006 and analyzed in 2008. Participants were 121 children (aged 9.1±0.34 years in 2004) and 188 adolescents (aged 14.5±0.65 years in 2004) from Melbourne, Australia. Parents and adolescents reported their perceptions of individual-level factors and of the neighborhood social and physical environment. Weekly active commuting (walking or cycling) to/from school, ranging from 0 to 10 trips/week was also proxy- or self-reported at the initial measurement and again 2 years later. Logistic regression analyses examined predictors of increases in active commuting over time. Results Children whose parents knew many people in their neighborhood were more likely to increase their active commuting (OR=2.6; CI=1.2, 5.9; p =0.02) compared with other children. Adolescents whose parents perceived there to be insufficient traffic lights and pedestrian crossings in their neighborhood were less likely to increase their active commuting over 2 years (OR=0.4; CI=0.2, 0.8; p =0.01), whereas adolescents of parents who were satisfied with the number of pedestrian crossings were more likely to increase their active commuting (OR=2.4; CI=1.1, 5.4; p =0.03) compared with other adolescents. Conclusions Social factors and physical environmental characteristics were the most important predictors of active commuting in children and adolescents, respectively.

Objectives This study investigated the correspondence between measures of physical activity facilities obtained through self-report and objective audits; and identified the socio-demographic, cognitive and behavioral characteristics of those who perceive their physical activity environment to be less supportive than objective measures indicate. Methods Self-report surveys were completed by 1540 women recruited from 45 neighborhoods in Melbourne, Australia. Women reported perceived access to physical activity facilities within 2 km from home, and also socio-demographic, cognitive and behavioral factors. Objective data on physical activity facilities within a 2 km pedestrian catchment area around women's homes were sourced. Results There was relatively poor agreement between measures of access to physical activity facilities obtained via self-report and objective assessment. Mismatch between perceived and objectively-assessed environments was more common amongst younger and older women, and women of low income, with low self-efficacy for physical activity, who were less active, who reported using fewer facilities and who had lived in the neighborhood for less than 2 years. Conclusions Future studies of environmental determinants of physical activity should consider incorporating objective indices of access to facilities, or accounting for the systematic bias that may result from relying on self-report perceptions as an indicator of the actual physical activity environment.

Background: Because students may purchase food and drinks in and around their schools, the school food environment may be important for obesity-related eating behaviors such as soft drink and snack consumption. However, research exploring the associations between school environments and specific eating behaviors is sparse. Methods: Associations of the availability of canteen food and drinks, the presence of food stores around schools, and individual cognitions (attitudes, norms, modeling, perceived behavioral control, and intentions) with soft drink and snack consumption were examined in a cross-sectional study (2005-2006) among 1293 adolescents aged 12-15 years. Soft drink and snack consumption and related cognitions were assessed with self-administered questionnaires. The presence of food stores and the distance to the nearest food store were calculated within a 500-meter buffer around each school. Data on the availability of soft drinks and snacks in school canteens were gathered by observation. In 2007, multilevel regression models were run to analyze associations and mediation pathways between cognitions, environmental factors, and behaviors. Results: Adolescents' attitudes, subjective norms, parental and peer modeling, and intentions were positively associated with soft drink and snack consumption. There was an inverse association between the distance to the nearest store and the number of small food stores with soft drink consumption. These effects were mediated partly by cognitions. Conclusions: This study provided little evidence for associations of environmental factors in the school environment with soft drink and snack consumption. Individual cognitions appeared to be stronger correlates of intake than physical school-environmental factors. Longitudinal research is needed to confirm these findings.

Objective The role local neighbourhood environments play in influencing purpose-specific walking behaviors has not been well-explored in prospective studies. This study aimed to cross-sectionally and prospectively examine whether local physical and social environments were associated with mothers' walking for leisure and for transport. Methods In 2004, 357 mothers from Melbourne, Australia, provided information on their local physical and social neighbourhood environments, and in 2004 and 2006 reported weekly time spent walking for leisure and for transport. Environmental predictors of high levels of walking and increases in walking were examined using log binomial regression. Results Public transport accessibility and trusting many people in the neighbourhood were predictive of increases in walking for leisure, while connectivity, pedestrian crossings, a local traffic speed were predictive of increases in transport-related walking. Satisfaction with local facilities was associated with increasing both types of walking, and the social environment was important for maintaining high levels of both leisure- and transport-related walking. Conclusion The findings provide evidence of a longitudinal relationship between physical and social environments and walking behaviors amongst mothers. Enhancing satisfaction with local facilities and giving consideration to ‘walkability’, safety and public transport accessibility during environment planning processes may help mothers to increase walking.

Compared with previous generations, children spend less time playing outdoors and have lower participation rates in active transport. Many studies have identified lack of neighbourhood safety as a potential barrier to children's physical activity. This review describes concerns regarding 'stranger danger' and road safety, and discusses empirical studies that examine associations between neighbourhood safety and physical activity among youth. Variability of perceptions of safety between parents and youth are examined; 'social traps' are identified; and physical/social environmental interventions aimed at improving neighbourhood safety are discussed. A research agenda is suggested for further study of perceived and objective measures of neighbourhood safety and their associations with children's physical activity.

Objective To examine associations between availability of different types of food outlets and children's fruit and vegetable intake. Method Parents of 340 5–6 and 461 10–12 year-old Australian children reported how frequently their child ate 14 fruits and 13 vegetables in the last week in 2002/3. A geographic information system (GIS) was used to determine the availability of the following types of food outlets near home: greengrocers; supermarkets; convenience stores; fast food outlets; restaurants, cafes and takeaway outlets. Logistic regression analyses examined the likelihood of consuming fruit ≥ 2 times/day and vegetables ≥ 3 times/day, according to access to food outlets. Results Overall, 62.5% of children ate fruit ≥ 2 times/day and 46.4% ate vegetables ≥ 3 times/day. The more fast food outlets (OR = 0.82, 95%CI = 0.67–0.99) and convenience stores (OR = 0.84, 95%CI = 0.73–0.98) close to home, the lower the likelihood of consuming fruit ≥ 2 times/day. There was also an inverse association between density of convenience stores and the likelihood of consuming vegetables ≥ 3 times/day (OR = 0.84, 95%CI = 0.74–0.95). The likelihood of consuming vegetables ≥ 3 times/day was greater the farther children lived from a supermarket (OR = 1.27, 95%CI = 1.07–1.51) or a fast food outlet (OR = 1.19, 95%CI = 1.06–1.35). Conclusion Availability of fast food outlets and convenience stores close to home may have a negative effect on children's fruit and vegetable intake.

Objectives. To describe the design and baseline results of an evaluation of the Western Australian government's pedestrian-friendly subdivision design code (Liveable Neighborhood (LN) Guidelines). Methods. Baseline results (2003–2005) from a longitudinal study of people (n=1813) moving into new housing developments: 18 Liveable, 11 Hybrid and 45 Conventional (i.e., LDs, HDs and CDs respectively) are presented including usual recreational and transport related walking undertaken within and outside the neighborhood, and 7-day pedometer steps. Results. At baseline, more participants walked for recreation and transport within the neighborhood (52.6%; 36.1% respectively), than outside the neighborhood (17.7%; 13.2% respectively). Notably, only 20% of average total duration of walking (128.4 min/week (SD159.8)) was transport related and within the neighborhood. There were few differences between the groups' demographic, psychosocial and perceived neighborhood environmental characteristics, pedometer steps, or the type, amount and location of self-reported walking ( pN0.05). However, asked what factors influenced their choice of housing development, more participants moving into LDs reported aspects of their new neighborhood's walkability as important ( pb0.05). Conclusions. The baseline results underscore the desirability of incorporating behavior and context-specific measures and value of longitudinal designs to enable changes in behavior, attitudes, and urban form to be monitored, while adjusting for baseline residential location preferences.

Objective: To determine the relationship between personal, hormonal and lifestyle risk factors and surgically treated benign prostatic hyperplasia (BPH). Materials and methods: A population-based case-control study was conducted in Western Australia (WA) on men aged 40-75 years who were surgically treated at public and private hospitals for BPH during 2001-2002. Controls were recruited from the WA electoral roll Cases and controls were compared with regard to demographic and Lifestyle factors and proxy measures of hormonal status using logistic regression. Data were available for 398 cases and 471 controls. Results: No associations with BPH were found for family history of prostate cancer in father or brother, serving in the military in a combat area, pattern of baldness, smoking status, obesity, alcohol intake and occupational physical activity. The only inverse relationship was observed with heavy alcohol drinking (>30g/day), however, this was not statistically significant. An increased risk of BPH, not statistically significant, was observed for British-born men compared to Australian born and for history of vasectomy. The analysis was repeated after excluding 28% of controls with moderate and severe symptoms of BPH and 7% of cases with mild symptoms prior to surgery, and our results remained essentially unchanged. Conclusions: The results suggest that there are few risk factors for BPH although perhaps country of birth, vasectomy and heavy alcohol consumption may be considered further. (c) 2007 The Royal Institute of Public Health. Published by Elsevier Ltd. All rights reserved.

Objective: To examine trends in active transport to and from school, in school sport and physical education (PE), and in weight status among children from high and low socio-economic status (SES) areas in Melbourne, Victoria, between 1985 and 2001. Methods: Cross-sectional survey data and measured height and weight from 1985 (n=557) and 2001 (n=926) were compared for children aged between 9–13 years within high and low SES areas. Results: From 1985 to 2001, the frequency of walking to or from school declined (4.38±4.3 vs. 3.61 ± 3.8 trips/wk, p

This paper updates evidence reviewed in the first edition of Getting Australia Active on effective physical activity (PA) intervention strategies among children, adolescents and young adults. Intervention studies published between 1999 and September 2003 were identified using electronic databases and hand searching. A total of 28 discrete studies were identified (31 papers). Six of nine studies reported significant effects on child or youth PA in school settings. Those that incorporated whole-of-school approaches including curriculum, policy and environmental strategies appeared to be more effective than those that incorporated curriculum-only approaches. Five of 10 studies with children and two of five studies with adolescents reported increased PA or decreased sedentary behaviour in other settings. Interventions that included contact with families generally appeared to be most effective. One study with adolescents provided some evidence of the potential effectiveness of interventions based in primary care. Two of four papers reported modest short-term results among young adults, including increased PA stage of change or a higher likelihood of being adequately physically active, but none showed any evidence of sustained increases in PA. There is an urgent need for additional studies examining interventions aimed at young adults. Across the three life stages, future studies should include objective PA measures, longer-term follow-up, larger sample sizes, a specific focus on PA (rather than weight) and culturally-specific strategies that build evidence in Australian populations. Future studies should target high risk groups and a broad range of settings and strategies focusing on reducing sedentary behaviours as well as increasing PA.

BACKGROUND: This study examined associations between perceptions of the local neighborhood and walking and cycling among children. METHODS: Children aged 5-6 years (n=291) and 10-12 years (n=919) were recruited from 19 Australian primary schools. Parents reported their child's usual walking or cycling to local destinations and their perceptions of their neighborhood. Ten- to twelve-year-olds were asked their perceptions of traffic, strangers, road safety and sporting venues, and their perceptions of their parent's views on these issues. RESULTS: Five- to six-year-old boys whose parents believed there was heavy traffic in their area were 2.8 times more likely (95%CI=1.1-6.8), and 5- to 6-year-old girls whose parents owned more than one car were 70% less likely (95%CI=0.1-0.8), and whose parents believed that public transport was limited in their area were 60% less likely (95%CI=0.2-0.9) than other children to walk or cycle at least three times per week. Parental belief that there were no lights or crossings was associated with walking or cycling among 10- to 12-year-old boys (OR=0.4, 95%CI=0.2-0.7). Among older girls, parent's belief that their child needed to cross several roads to reach play areas (OR=0.4, 95%CI=0.2-0.8) and that there is limited public transport in their area (OR=0.7, 95%CI=0.4-0.97), and child's belief that there were no parks or sports grounds near home (OR=0.5, 95%CI=0.3-0.8) were associated with a lower likelihood of walking or cycling. CONCLUSION: Perceptions of the local neighborhood may influence children's physical activity. KW: SR2S Language: en

This study examined the validity and reliability of survey items measuring one-week recall of physical activity (PA) and examined differences by weight status. A sub-aim of the study was to objectively assess the intensity of activity that most closely matches self-report. A questionnaire was administered to adults twice, three days apart. It was again administered after subjects wore a MTI/CSA accelerometer for seven days (n = 118). Several metabolic equivalent (MET) thresholds were applied to the accelerometer data. Agreement between test and re-test estimates of sufficient physical activity for health benefits (150 min/week) was high (% agreement90%). Correlations (rho) between total reported PA (mins/day) and accelerometer data were 0.29 (p0.05) among men and 0.25 (p0.05) among women. Among men, self-reported duration of moderate PA (3-5.9 METS) and accelerometer data were significantly correlated (rho = 0.40, p0.01), with no differences by weight status. Among women, a significant relationship was found only for those who were not overweight (rho = 0.52, p0.001). A significant correlation between self-reported duration of vigorous PA (6+ METS) and accelerometer data was only found for overweight men (rho = 0.40, p0.05). When lower MET thresholds were applied to the accelerometer data, women's reported duration of moderate-intensity PA was most strongly correlated with moderate PA (accelerometer) defined as 2.0-5.9 METS (rho = 0.39, p0.01). The recall instrument provides a consistent measure of physical activity and validation coefficients were similar to those obtained for other physical activity recall questionnaires. However, the ability to measure PA by self-report may vary by weight status.

Objective To examine the tracking of children's body mass index, television viewing, and dietary intake over five-years. Methods In 2002/3 (T1) parents of children aged 5–6 years (n = 175) and 10–12 years (n = 121), from Victoria, Australia, completed measures assessing their child's frequency of fruit, vegetable, and energy-dense sweet and savory snack consumption, and their child's television (TV) viewing. Children's height and weight were measured by researchers and sex–age adjusted body mass index (BMI) calculated. All measures were repeated in 2006 (T2) and 2008 (T3). Generalized estimating equations (GEE) (standardized stability coefficients, β) were used to assess tracking and were interpreted as: β 0.6 = high. Results High standardized stability coefficients were found for BMI (β = 0.74–0.92), TV viewing (β = 0.65–0.73), and frequency of fruit consumption (β = 0.73–0.89) among younger and older children. Moderate-to-high standardized stability coefficients were found for frequency of vegetable (β = 0.52–0.86), energy-dense sweet (β = 0.41–0.65), and savory snack consumption (0.40–0.67) among younger and older children. Conclusions BMI, TV viewing and dietary intake patterns are moderate-highly stable throughout childhood and into adolescence. Further research that identifies and targets high risk groups to prevent increased BMI, reduce TV viewing and promote healthy dietary behaviors may be justified.