Search

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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.

Background: Both reduced moderate-to-vigorous physical activity (MVPA) and increased screen time have been implicated in the aetiology of childhood overweight/obesity. This study aimed to determine which behaviour had the stronger association with overweight/obesity. Method: 2200 randomly selected 9- to 16-year-old Australians provided four 24-h use-of-time recalls. Participants were classified into weight status categories and as high or low physical active, and high or low screen time according to Australian guidelines (≥60 min MVPA; ≤120 min recreational screen time daily). Multivariate logistic regression was used to calculate the odds ratios (OR) for overweight/obesity for each screen time and MVPA category. Results: Increased likelihood of overweight or obese was often associated with high screen time (ORs, 2.13-2.55 for boys and 1.47-1.72 for girls), but only sometimes and less strongly associated with low MVPA (ORs, 0.49-2.55 for boys and 1.06-1.47 for girls). Analyses conducted for combined screen time and MVPA categories showed screen time to be a stronger indicator of weight status than physical activity, especially in boys. Conclusion: Overweight and obesity were more strongly associated with screen time than physical activity. Screen time may be an important target for interventions aimed at reducing childhood overweight and obesity. [ABSTRACT FROM AUTHOR]

The aim of this study was to determine the accuracy of dual-energy X-ray absorptiometry (DXA)-derived percentage fat estimates in obese adults by using four-compartment (4C) values as criterion measures. Differences between methods were also investigated in relation to the influence of fat-free mass (FFM) hydration and various anthropometric measurements. Six women and eight men (age 22–54 years, BMI 28.7–39.9 kg/m2, 4C percent body fat (%BF) 31.3–52.6%) had relative body fat (%BF) determined via DXA and a 4C method that incorporated measures of body density (BD), total body water (TBW), and bone mineral mass (BMM) via underwater weighing, deuterium dilution, and DXA, respectively. Anthropometric measurements were also undertaken: height, waist and gluteal girth, and anterior–posterior (A–P) chest depth. Values for both methods were significantly correlated (r2 = 0.894) and no significant difference (P = 0.57) was detected between the means (DXA = 41.1%BF, 4C = 41.5%BF). The slope and intercept for the regression line were not significantly different (P > 0.05) from 1 and 0, respectively. Although both methods were significantly correlated, intraindividual differences between the methods were sizable (4C–DXA, range = −3.04 to 4.01%BF) and significantly correlated with tissue thickness (chest depth) or most surrogates of tissue thickness (body mass, BMI, waist girth) but not FFM hydration and gluteal girth. DXA provided cross-sectional %BF data for obese adults without bias. However, individual data are associated with large prediction errors (±4.2%BF). This error appears to be associated with tissue thickness indicating that the DXA device used may not be able to accurately account for beam hardening in obese cohorts.Obesity (2009) 17 4, 821–826. doi:10.1038/oby.2008.595 [ABSTRACT FROM AUTHOR]

Aims. The overweight and obesity epidemic among children in Australia has attracted considerable attention as intervention strategies and public policy are debated. However, more information on the overweight prevalence trend is required to help understand its aetiology. In order to assist this public health crisis, we gathered every available raw dataset and other descriptive reports on the heights and weights of children over the last century. Methods. The raw datasets and datasets recreated using reported descriptive data were used to calculate the prevalence rates of overweight children aged 5 to 15 years. Results. Overweight prevalence among children was relatively low and relatively constant throughout most of the century but appears to have accelerated from about the early 1970s. Discussion. The prevalence rate for overweight and obesity among children in Australia continues to climb and we predict it will approach adult rates within the next 30 years. [ABSTRACT FROM AUTHOR]

Objective. To investigate secular trends in waist girth and skinfold measures among Australian children from 1985 and 1997/2002, matched for body size. Methods. Subjects. A total of 2604 children (10–12 years old) measured in the 1985 Australian Health and Fitness Survey and in two later surveys of South Australian schoolchildren (1997/2002), were matched for age, stature, weight and body mass index (BMI). Measurements. The matched children were compared by ANOVA on waist and hip girths, waist-to-hip ratio (WHR) and abdominal and triceps skinfolds, taken by trained anthropometrists. Results. Between the survey periods, there were significant increases in waist girth, WHR, and the two skinfold measures, but more so for abdominal skinfold. The differences in abdominal skinfold, waist girth and WHR were greater for girls than boys. Conclusions. In Australian children matched for body size, there have been increases in measures of fatness and central adiposity over the last 20 years. This suggests that reported secular trends in BMI may be under-estimating the looming public health crisis. [ABSTRACT FROM AUTHOR]

The article presents a study trialling the feasibility of an interactive software program titled HealthScreenPro that summarizes risk profile as a health age and will be used as a prompt to increase regular physical activity (PA) in rural Australian adults. Topics include the use of health status, body mass index, waist girth, and blood pressure to categorize participants and determine their health age, and participants' belief that the strategy would motivate them to increase PA.

The article offers a study attempted to fill the unique rural‐context gap by investigating the felt needs, attitudes and perceptions of rural Australians regarding a mHealth cardiac rehabilitation (CR ) maintenance program focusing on physical activity. Topics discussed include questionnaire based on technological literacy and technological use and also explored the felt needs of the participants in relation to a mHealth physical activity maintenance CR program.

A letter to the editor is presented in response to the article about an association between sleep and weight, which appeared in the previous issue.