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Background: Aboriginal and Torres Strait Islander people have higher rates of chronic disease and a lower life expectancy than non-Indigenous Australians. In non-urban areas these health disparities are even larger. The aim of this qualitative study was to explore perceived barriers and enablers to attending an eight-week physical activity program in a rural and regional setting which aimed to improve health outcomes, but had a low attendance rate. Methods: Thirty-four Indigenous Australians participated in the intervention from the rural (n = 12) and the regional (n = 22) community. Qualitative semi-structured individual interviews were conducted at the follow-up health assessments with 12 participants. A thematic network analysis was undertaken to examine the barriers and enablers to participation in the program. Results: Overall, there were positive attitudes to, and high levels of motivation towards, the physical activity program. Enablers to participation were the inclusion of family members, no financial cost and a good relationship with the principal investigator, which was strengthened by the community-based participatory approach to the program design. Barriers to program attendance were mostly beyond the control of the individuals, such as 'sorry business', needing to travel away from the community and lack of community infrastructure. Conclusions: More consideration is needed prior to implementation of programs to understand how community- specific barriers and enablers will affect attendance to the program. Trial registration: ACTRN12616000497404. Registered 18 April 2016. [ABSTRACT FROM AUTHOR]

Background: Indigenous Australians and New Zealanders have a significantly shorter life expectancy than non-Indigenous people, mainly due to differences in prevalence of chronic diseases. Physical activity helps in the prevention and management of chronic diseases, however, activity levels are lower in Indigenous than in non-Indigenous people. Objective: To synthesise the literature on the effects of physical activity interventions for Indigenous people in Australia and New Zealand on activity levels and health outcomes. Methods: The Cochrane Library, MEDLINE, SPORTSDiscus and PsycINFO were searched for peer-reviewed articles and grey literature was searched. Interventions targeted Indigenous people in Australia or New Zealand aged 18+ years and their primary or secondary aim was to increase activity levels. Data were extracted by one author and verified by another. Risk of bias was assessed independently by two authors. Data were synthesised narratively. Results: 407 records were screened and 13 studies included. Interventions included individual andgroupbasedexercise programs and community lifestyle interventions of four weeks to two years. Six studies assessed physical activity via subjective (n =4) or objective (n = 2) measures, with significant improvements in one study. Weight and BMI were assessed in all but one study, with significant reductions reported in seven of 12 studies. All five studies that used fitness tests reported improvements, as did four out of eight measuring blood pressure and seven out of nine in clinical markers. Conclusions: There was no clear evidence for an effect of physical activity interventions on activity levels, however, there were positive effects on activity related fitness and health outcomes. [ABSTRACT FROM AUTHOR]

Abstract: Objectives: To examine prospectively whether higher proportions of vigorous physical activity (VPA), independent of total activity volume, are associated with better outcomes in weight maintenance and physical function. Methods: We used three-year longitudinal data (2006/07–2009/10) of adults 45 and older (n=32,087; 59.5±9.3years) from New South Wales, Australia. Logistic regression models examined odds of weight gain and functional decline by volume and intensity of physical activity. Results: On average, body weight increased by 0.66kg (SD=5.83, p <0.001); a validated physical function score (MOS-PF) decreased by 4.79 (SD=12.56, p <0.001). There was a 10% reduction in the odds of weight gain for participants who reported 300min/week or more of moderate to vigorous physical activity (MVPA) compared to less than 150min of MVPA. The proportion of MVPA that was vigorous was not associated with weight change. With the physical functioning outcome, there were independent protective effects from volume and intensity of physical activity. Independent of total MVPA, each 1% increase in the proportion of total activity that was vigorous was associated with a 0.3% decrease in the odds of decline in physical function. Conclusion: These prospective findings indicate that VPA per se plays an important role in the prevention of functional decline. [Copyright &y& Elsevier]

Background: There is limited evidence on the directionality of the associations of sitting time with physical function. This study examined the longitudinal associations of sitting time with changes in physical function, and physical function with changes in sitting time., Methos: Data from 10,027 retirees in the Social, Economic, and Environmental Factor (SEEF) population-based cohort were collected in 2006-20008 and in 2010-2011. Daily sitting time was assessed by a single-item question. Physical function was measured with the Medical Outcomes Study Physical Functioning Scale (range 0-100) with participants categorized as: no; minor; moderate; or severe limitation. General linear regression models, adjusted for covariates, were used to assess associations of sitting time with physical function for all participants and in subgroups according to sex, and categories of body mass index, physical activity, and physical function limitations., Results: Each hour of baseline sitting was associated with declines in physical function for women (0.20 units [95% confidence interval {CI} 0.04-0.37]) and those with severe functional limitations (0.65 units [95% CI 0.20-1.12]). Each unit of baseline physical function was associated with declines in sitting time for all participants (0.009 hours/day [95% CI 0.005-0.013]) and for all subgroups., Conclusions: There was limited evidence of a bidirectional association of sitting time with physical function except in women and people with severe functional limitations. Health promotion efforts are needed to address the impact of poor physical function on increases in sitting time which result in further functional declines for these subgroups of the population.

Importance: Few studies have examined how different proportions of moderate and vigorous physical activity affect health outcomes., Objective: To examine whether the proportion of total moderate to vigorous activity (MVPA) that is achieved through vigorous activity is associated with all-cause mortality independently of the total amount of MVPA., Design, Setting, and Participants: We performed a prospective cohort study with activity data linked to all-cause mortality data from February 1, 2006, through June 15, 2014, in 204,542 adults aged 45 through 75 years from the 45 and Up population-based cohort study from New South Wales, Australia (mean [SD] follow-up, 6.52 [1.23] years). Associations between different contributions of vigorous activity to total MVPA and mortality were examined using Cox proportional hazards models, adjusted for total MVPA and sociodemographic and health covariates., Exposures: Different proportions of total MVPA as vigorous activity. Physical activity was measured with the Active Australia Survey., Main Outcomes and Measures: All-cause mortality during the follow-up period., Results: During 1,444,927 person-years of follow-up, 7435 deaths were registered. Compared with those who reported no MVPA (crude death rate, 8.34%), the adjusted hazard ratios for all-cause mortality were 0.66 (95% CI, 0.61-0.71; crude death rate, 4.81%), 0.53 (95% CI, 0.48-0.57; crude death rate, 3.17%), and 0.46 (95% CI, 0.43-0.49; crude death rate, 2.64%) for reporting 10 through 149, 150 through 299, and 300 min/wk or more of activity, respectively. Among those who reported any MVPA, the proportion of vigorous activity revealed an inverse dose-response relationship with all-cause mortality: compared with those reporting no vigorous activity (crude death rate, 3.84%) the fully adjusted hazard ratio was 0.91 (95% CI, 0.84-0.98; crude death rate, 2.35%) in those who reported some vigorous activity (but <30% of total activity) and 0.87 (95% CI, 0.81-0.93; crude death rate, 2.08%) among those who reported 30% or more of activity as vigorous. These associations were consistent in men and women, across categories of body mass index and volume of MVPA, and in those with and without existing cardiovascular disease or diabetes mellitus., Conclusions and Relevance: Among people reporting any activity, there was an inverse dose-response relationship between proportion of vigorous activity and mortality. Our findings suggest that vigorous activities should be endorsed in clinical and public health activity guidelines to maximize the population benefits of physical activity.

We examined prospectively whether persons who perceive their objectively measured high walkable environment as low walkable decrease their walking more and gain more weight than those with matched perceptions. Walkability was measured objectively using GIS. Corresponding perceptions were collected using the Neighborhood Environment Walkability Scale from 1027 urban Australian adults. Objective and perceived measures were dichotomized and categories of match and mismatch were created. Overall, walking levels decreased and BMI increased significantly over the four year follow-up period. Those who perceived high walkability, dwelling density or land use mix as low decreased their walking for transport significantly more than those with matched perceptions. Those who perceived high walkability, land use mix or retail density as low increased their BMI significantly more than those with concordant perceptions. These prospective findings corroborate recommendations from previous cross-sectional studies. Interventions to improve negative perceptions of walkability among those living in high walkable areas may be a relevant public health intervention to increase physical activity and support weight maintenance., (Copyright © 2010 Elsevier Ltd. All rights reserved.)