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Issue Addressed: People with a mental health condition are at risk of developing chronic physical disease due to smoking tobacco, inadequate nutrition, high alcohol consumption, low physical activity and poor sleep (SNAPS). Community managed organisations (CMOs) represent an opportune setting to support mental health consumers to improve their health behaviours through providing preventive care. Reporting of methods used to co‐develop implementation strategies to assist CMO staff to deliver preventive care for SNAPS are scarce yet warranted. Objectives: This study aims to: (1) describe a co‐development workshop involving CMO staff and researchers to identify preferred implementation support strategies to help staff routinely provide preventive care; (2) describe the strategies that emerged from the workshop; and (3) report staff ratings of the workshop on four co‐development principles. Methods: A three‐hour co‐development workshop was conducted on two occasions with staff of one CMO in New South Wales, Australia. Twenty staff participated in the workshops. Results: Participants generated and ranked a total of seven discrete implementation strategies within five categories (training, point of care prompts, guidelines, continuous quality improvement and consumer activation). Training for staff to have difficult conversations about behaviour change was ranked highest in both workshops. Participants rated the workshops positively across four co‐development principles. Conclusions: The co‐development workshop enabled implementation strategies to be developed within the context in which they were to be delivered and tested, potentially increasing their feasibility, acceptability, appropriateness and impact. So What?: Implementation strategies selected from the workshops will inform a pilot implementation support trial to assist CMO staff to provide preventive care to people with mental health conditions. [ABSTRACT FROM AUTHOR]

Our knowledge about the role of fly‐in fly‐out (FIFO) work‐related factors on the well‐being of workers across the FIFO work cycle is limited. This study examined the within‐person effects of job demand and control on psychological states and health behaviours. The study employed a daily diary design, with 23 FIFO workers in the Australian mining industry completing a daily diary survey for 28 consecutive days across on‐shift and off‐shift periods. Multilevel analyses showed FIFO workers experienced higher positive affect and enjoyed better sleep quality, but consumed more alcohol, during off‐shift days as compared to on‐shift days. Within‐person variability in daily demand (workload) was associated with higher anxious affect, whereas job control predicted lower anxious and depressed affects, higher positive affect, more alcohol consumption, and more physical activity. The within‐person effect of demand on anxious affect was moderated by job control such that those who generally had more control over their jobs had a smaller effect of demand on anxiety than those with less control. Results suggest potentially modifiable aspects of FIFO work—particularly job control—may help alleviate the impact of workload on poorer health behaviours and mood. [ABSTRACT FROM AUTHOR]

The recurrent absence of workers from home associated with fly-in fly-out (FIFO) work practice has the potential to affect the partners of the workers. This study aimed to examine the mental and physical health of partners of FIFO workers and compare their health-related behaviours during on-and off-shift periods. Partners of FIFO workers in Australia (N=248) completed an online survey. Partners reported higher sleep duration (7.3 ± 1.4 vs 6.4 ± 1.3 hours, p < .001) and better sleep quality during offshift nights compared to on-shift nights. Among the current smokers (16.9%), partners smoked more cigarettes per day during on-shift periods than off-shift (13.1 ± 8.2 vs 11.6 ± 7.6, p = .034), but there was no difference in alcohol consumption at risky levels. Partners also consumed similar portions of fruits and vegetables and engaged in similar minutes of moderate to vigorous physical exercise per day during on-and off-shift days. Majority of partners had good physical health status (85.1%), but risk of psychological distress was high (50.4%). Interventions could target assisting multiple health behaviour changes and reducing psychological distress by supporting partners to adapt to and cope with the demands/stressors of FIFO lifestyles, particularly in the absence of workers. [ABSTRACT FROM AUTHOR]

Aims and objectives: This review aimed to demonstrate the self‐care behaviours of first‐generation Chinese immigrants with cardiovascular disease in western countries and identify related cultural factors. Background: Self‐care is the cornerstone to mitigate disease symptoms and maintain health status. Chinese immigrants to western countries, operating within a cross‐cultural context, may find self‐care to manage their cardiovascular disease challenging. Design: An integrative review was conducted. Methods: Seven databases were searched Scopus, ProQuest Health & Medicine, Medline (Ovid), Embase (Ovid), AMED (Ovid), PsycINFO and CINAHL, with output limited to peer‐reviewed studies published from 2000 to 2020 in English or Chinese. Initially, 2037 papers were screened. Six papers were retained and critiqued using the Joanna Briggs Institute critical appraisal tools. Deductive and inductive approaches were utilised to analyse the findings. The PRISMA 2020 checklist informed review reportage. Result: In general, Chinese immigrants with cardiovascular disease took an active role in management of their cardiovascular disease, including through diet and activity adaptation and adherence to western medication. Families also played a significant role in disease decision‐making and management. However, language and cultural barriers impeded their access to health information and resources in host countries. Relevance to clinical practice: Understanding self‐care behaviours and associated cultural factors among Chinese immigrants with cardiovascular disease is important to improve nurses' culturally sensitive practices and provide tailored health education interventions to promote self‐care behaviours among immigrant populations. The scarcity of literature on self‐care behaviours among Chinese first‐generation immigrants with cardiovascular disease indicates the need for further research in this area. Development of culturally and linguistically sensitive health resources and education programs is urgently needed. [ABSTRACT FROM AUTHOR]

Issue addressed: High levels of testing are crucial for minimising the spread of COVID‐19. The aim of this study is to investigate what prevents people from getting a COVID‐19 test when they are experiencing respiratory symptoms. Methods: Semi‐structured, qualitative interviews were conducted with 14 purposively sampled adults between 20 November 2020 and 3 March 2021 in two capital cities of Australia and analysed thematically. The analysis included people who reported having respiratory symptoms but who did not undergo a COVID‐19 test. Results: Participants appraised risks of having COVID‐19, of infecting others or being infected whilst attending a testing site. They often weighed these appraisals against practical considerations of knowing where and how to get tested, inconvenience or financial loss. Conclusions: Clear public health messages communicating the importance of testing, even when symptoms are minor, may improve testing rates. Increasing the accessibility of testing centres, such as having them at transport hubs is important, as is providing adequate information about testing locations and queue lengths. So what?: The findings of our study suggest that more needs to be done to encourage people to get tested for COVID‐19, especially when symptoms are minor. Clear communication about the importance of testing, along with easily accessible testing clinics, and financial support for those concerned about financial impacts may improve testing rates. [ABSTRACT FROM AUTHOR]

Background: Fly-In Fly-Out (FIFO), which entails travelling mostly from the urban areas to stay and work in remote areas for designated periods and travel back home to spend designated days of leave, has become a common work arrangement in the mining sector globally. This study examined the mental and physical health of FIFO workers and described their health-related behaviours during on-and off-shift periods. Methods: A cross-sectional study was conducted with FIFO workers (N = 216) in the mining industry in Australia who completed an online survey. Paired t-test and McNemer's analysis examined the differences in health-related behaviours during workers' on-and off-shift days. Logistic regression examined the predictors of physical health and psychological distress status of FIFO workers. Results: Workers reported longer sleep duration (7.5 ± 1.5 h vs 6.3 ± 1.2 h, p < 0.001) and better sleep quality (78.2% vs 46.3%, p < 0.001) during off-shift nights than on on-shift nights. Smoking prevalence was 26.4%, and workers reported smoking a similar number of cigarettes per day during on-and off-shift days. Most workers reported drinking alcohol (86.1%) and more often at risky levels during off-shift than on-shift days (57.9% vs 34.3%, p < 0.001). Fruits and vegetable consumption was low but with higher vegetable intake during off-shift days (2.8 ± 1.4 vs 2.3 ± 1.3 serves, p < 0.001). Workers had good physical health status (91.2%), but 71.4% were overweight/obese and 33.4% indicated high levels of psychological distress. Working on long shifts (OR 6.63, 95% CI 1.84–23.91) and smoking (OR 7.17, 95% CI 2.67–19.26) were linked to high psychological distress. Conclusions: The prevalence of psychological distress and risky health behaviours was high. Interventions should aim to reduce psychological distress and support multiple behaviour changes, considering FIFO work-related characteristics including long shift hours. [ABSTRACT FROM AUTHOR]

Background: A key feature of the global public health response to contain and slow the spread of COVID-19 has been community-based quarantine and self-isolation. As part of The Optimise Study, this research sought to understand the factors that influence people's ability to undertake home-based quarantine and isolation to contain the spread of COVID-19.Methods: Semi-structured qualitative phone interviews (n = 25) were conducted by telephone with people who participated in community-based quarantine in Australia before 31 March 2020. The Capability Opportunity Motivation Behaviour model was used to conduct a thematic analysis.Results: Participants required clear, accessible and trusted information to guide them in home-based quarantine and isolation. A sense of social responsibility and belief in the efficacy of the restrictions to reduce viral transmission aided their motivation. Access to essential needs, supportive living environments, and emotional support were required to adhere to restrictions, but few were prepared.Conclusions: Findings demonstrate that in addition to having the capability and motivation to adhere to restrictions, it is vital that people are also encouraged to prepare for the challenge to ensure access to physical, social and emotional support. Findings also illustrate the importance of engaging communities in planning and preparedness for quarantine and self-isolation public health responses. [ABSTRACT FROM AUTHOR]

Carers of veterans tend to put their own physical and psychological well‐being needs behind the needs of the person they are caring for and often do not seek assistance for their own physical and psychological well‐being. Combined, these factors lead to increased risk of acute and chronic illness and mental health issues. It is acknowledged that physical activity independently contributes to improved physical and mental health and may be a driver for mental well‐being in carers. The aim of this pilot research was to understand how movement behaviour and health behaviours of carers of veterans in Australia relate to carers' physical and psychological well‐being. Assessment occurred between February and July 2019 and included objective, validated measures to examine physical and psychological well‐being. To assess the association between physical and psychological factors, correlational analyses were performed. Twenty‐eight carers participated in the pilot study (96% female, mean age 61.6 years). Exercise capacity varied, and 84% of carers met the recommended 150 min of physical activity per week, with carers spending 8.6% of their time in moderate‐to‐vigorous physical activity; and 37.9% of the day sedentary. Psychological health outcomes reflect a population with high distress levels and lower than average mental well‐being, but with normal resilience scores. Carers with higher levels of resilience had greater exercise capacity, covering further distance in the 6‐min walk test, and as resilience increased, number of sedentary bouts decreased. This research demonstrates that there is a relationship between health behaviours and psychological well‐being in carers of veterans and serving personnel. Based on the findings of this pilot study, programmes to support family carers should include information about physical activity, reducing sedentary time, and increasing resilience. Interventions designed to improve physical and psychological well‐being should be trialled and evaluated for effectiveness. [ABSTRACT FROM AUTHOR]

Aim: To explore the health beliefs and health behaviours of older Vietnam-born people living with chronic disease in Western Australia., Design: This study was designed as a focused ethnography guided by the interpretative research paradigm and Leininger's Theory of Culture Care., Methods: Data were collected through participant observation and interviews undertaken at participants' homes in Western Australia over 7 months in 2019. Data were analysed using Wolcott's approach for transferring qualitative data, comprising three phases: description, thematic analysis and interpretation., Results: This study included 12 participants. The health perspectives and practices of older Vietnam-born Australians significantly reflected the traditional Vietnamese values. These included the stigma towards chronic disease as an inevitable consequence of ageing; self-blame thoughts about chronic disease causations and maintained traditional dietary practices. However, some aspects of their health behaviours such as beliefs and practices in traditional medicine, Western medicine and physical exercise reflected a blended approach combining both Vietnamese-oriented and Westernized-orientated practices. Individual factors were also identified as contributing to chronic disease self-care among participants., Conclusion: This study emphasizes culture played a significant role in shaping the way that older Vietnam-born Australians believed and behaved while living with chronic conditions. However, it also indicates that culture is not a stationary concept, it evolves gradually and is socially constructed., Implications: A better understanding of the health beliefs and practices of older Vietnam-born Australians is expected to contribute to the delivery of culturally safe and effective support for this population. The achievement of culturally safe care requires a systemic approach and collaboration of strategies across sectors., Patient and Public Contribution: This study encompassed the contribution of 12 older Vietnam-born Australians who offered the researcher the privilege to enter their world and the staff of social care organization who opened the gate for the researcher to approach participants., (© 2024 The Author(s). Journal of Advanced Nursing published by John Wiley & Sons Ltd.)

This paper studies multigenerational health transmission mechanisms in Australian panel data. Using inequality-of-opportunity (IOP) models, we demonstrate that grandparental socioeconomic status (SES) is an important determinant of personal health, even after controlling for health and SES at the parental level. Our findings hold over a range of health/biomarkers of individuals' physical and mental well-being and appear to be especially sensitive to educational outcomes on the father's side. Since ingrained socioeconomic (dis)advantages that persist over multiple generations may be indicative of social class, our results suggest that subtle attitudinal and behavioural characteristics associated with this variable may be a key factor driving health disparities., (© 2024. The Author(s).)

Issue addressed: Screen time, a highly prevalent behaviour, can be detrimental to adolescent health. To better understand this health‐related behaviour, this study explores the nature of adolescents' contemporary screen engagement, adding to the currently limited body of qualitative research in this area. Methods: Sixteen adolescents (9 girls and 7 boys) aged 13‐17 years from a secondary school in Queensland, Australia participated in semi‐structured one‐on‐one interviews. All interviews were transcribed verbatim, anonymised and thematically analysed using an inductive approach. Results: Smartphone use was ubiquitous, occurring mostly at home, after school, and typically used for social, entertainment and functional activities. Binge‐watching and multi‐screening emerged as common sedentary patterns of contemporary screen engagement, often performed solitary. Screen time appeared to be an important aspect of adolescents' social lives, while there were also some psychological, physical and behavioural concerns. Family and friends were thought to influence adolescents' screen time either directly (co‐participation) or indirectly (modelling), while social smartphone notifications were said to prompt habitual, frequent and prolonged screen engagement. Conclusion: This study provided several new insights into the nature, functions, patterns, and benefits and concerns of adolescents' contemporary screen engagement. On the whole, adolescents engaged in a wide variety of screen‐viewing practices, including newer digital media, mostly as a function to connect with friends and family. So what?: It might be desirable for screen time reduction interventions and policies to take into account the underlying social and psychological factors, and habitual nature of contemporary screen engagement among adolescents. [ABSTRACT FROM AUTHOR]

Background: Non-alcoholic energy drinks ('energy drinks') are high in sugar, as well as caffeine, leading to concerns regarding their suitability for children and adolescents. Despite this, marketing of energy drinks is often directed at adolescents, and there are no age restrictions on the sale of these products in Australia. The current study aimed to examine patterns in consumption of energy drinks among Australian secondary school students and identify sociodemographic and behavioural correlates associated with regular consumption.Methods: Participants were 8942 students in Years 8 to 11 (aged 12 to 17 years) who participated in the 2018 National Secondary Students' Diet and Activity (NaSSDA) cross-sectional survey. A multistage stratified random sampling procedure was used. Within the school setting, students self-completed an online questionnaire assessing their dietary, physical activity and sedentary behaviours. A multilevel logistic regression model was used to examine associations between energy drink consumption and sociodemographic and behavioural factors.Results: Overall, 8% of students reported consuming energy drinks on a weekly basis ('regular consumers'). A further 16% indicated they consume less than one cup per week of these types of drinks, while around three-quarters (76%) reported they do not consume energy drinks. Regular consumption of energy drinks was independently associated with being male, having greater weekly spending money, high intakes of snack foods, fast food, other sugar-sweetened beverages and fruit juice, as well as short sleep duration. There was no independent association with other sociodemographic characteristics (i.e., year level, level of disadvantage, geographic location), consumption of vegetables and fruit, physical activity level, or sedentary recreational screen time.Conclusions: While most Australian adolescents do not consume energy drinks, regular consumption is more prevalent among males, and consumption appears to cluster with other unhealthy dietary behaviours and short sleep duration. Findings support the need for policies that will reach identified at-risk groups (e.g., increased regulation of the marketing and sale of energy drinks), as well as suggest opportunities for interventions targeting energy drink consumption alongside other unhealthy dietary behaviours. [ABSTRACT FROM AUTHOR]

Issue Addressed: Selling alcohol to a minor is a serious offence in the New South Wales Liquor Act. However, minors report they can purchase alcohol easily. This study used an intersectoral partnership between the Central Coast Local Health District (CCLHD) Health Promotion Service, and Liquor & Gaming NSW (L&GNSW) Compliance Operations to test a site visit intervention to increase ID checks at packaged liquor outlets (PLOs)., Methods: As the current legislative framework does not allow minors to attempt to purchase alcohol from PLOs, even under compliance operations, this study employed pseudo-minors aged 18-19 years. Pseudo-minors visited all PLOs on the Central Coast, NSW in four survey rounds, attempting to purchase alcohol without ID. If a PLO sold alcohol to the pseudo-minor, they received a visit from a Health Promotion Officer and L&GNSW Inspector to inform them of the sale and that they are at risk of selling alcohol to a minor., Results: Site visits were an effective intervention to increase the rates of ID checking. Alcohol sales to pseudo-minors without ID decreased from 34% in Round 1 to 7% in Round 4. Young sales staff and independent stores were less likely to check ID., Conclusions: This intervention was associated with some of the lowest rates of underage alcohol purchasing reported to date. However, it may not be sustainable in the long term. It is recommended that: future studies randomise site visits to investigate their contribution to the observed reduction, cost effectiveness of the intervention is explored and legislative change to allow controlled purchase operations for alcohol is considered. SO WHAT?: Young people under 18 years of age should not be able to purchase alcohol from liquor licence outlets, and strong laws apply if a sale is detected. However, despite these rules, young people still report they can access alcohol in this manner. Whilst our intervention of site visits with the regulatory body saw decreases in sales to our pseudo-minors, we advocate for controlled purchase operations (similar to tobacco control) as a more sustainable and effective intervention to reduce sales to minors - while this is not yet legislated for packaged liquor outlets in Australia, it is deemed best practice in other countries., (© 2023 Australian Health Promotion Association.)

Objective: To examine demographic and behavioural correlates of frequent consumption of fast food among Australian secondary school students and explore the associations between fast food consumption and social/environmental factors.Design: Cross-sectional survey using a web-based self-report questionnaire.Setting: Secondary schools across all Australian states and territories.Participants: Students aged 12-17 years participating in the 2012-2013 National Secondary Students' Diet and Activity survey (n 8392).Results: Overall, 38 % of students surveyed reported consuming fast food at least weekly. Being male, residing in lower socio-economic areas and metropolitan locations, having more weekly spending money and working at a fast food outlet were all independently associated with consuming fast food once a week or more, as were several unhealthy eating (low vegetable intake and high sugary drink and snack food intake) and leisure (low physical activity and higher commercial television viewing) behaviours and short sleep duration. Frequent fast food consumption and measured weight status were unrelated. Students who agreed they go to fast food outlets with their family and friends were more likely to report consuming fast food at least weekly, as were those who usually 'upsize' their fast food meals and believe fast food is good value for money.Conclusions: These results suggest that frequent fast food consumption clusters with other unhealthy behaviours. Policy and educational interventions that reach identified at-risk groups are needed to reduce adolescent fast food consumption at the population level. Policies placing restrictions on the portion sizes of fast food may also help adolescents limit their intake. [ABSTRACT FROM AUTHOR]

Issue Addressed: This research explored the use of "fat talk" by early childhood educators and their awareness of their potential influence on the developing body image of young children.Methods: Mixed methods comprising focus groups, telephone interviews and demographic surveys with 44 early childhood educators Australia-wide.Results: Findings showed many educators in this research recognised that they had a role to play in the development of children's body image, though some were unsure when body image began to develop. Educators engaged widely in "fat talk," in the vicinity of children or other educators, and accepted such talk as normal.Discussion: "Fat talk" features in the workplace and is commonly used by early childhood educators. Its influence on the development of body image on young children did not appear to be well understood by early years' educators or of a concern to them.Conclusions: Since body image develops in children from around three years of age, the role of early childhood educators in its development should not be overlooked. SO WHAT?Relevance To Health Promotion: Body image is a misunderstood public health concern, with long-term impacts on weight, mental health and physical health. Promotion of positive body image and the early recognition of body image disturbance are crucial, as children who exhibit body dissatisfaction in their formative years have a greater risk of severe body image disturbance as they progress through childhood and adolescence. Since early childhood educators spend significant time with children, encouraging them to avoid engaging in "fat talk" and instead to promote positive body image is warranted. [ABSTRACT FROM AUTHOR]

The purpose of the research was to explore the challenges, frustrations and experiences faced by young Australian adults with type 1 diabetes. We focused on the navigation of health behaviours (e.g. eating out, consuming alcohol, physical activity), which impact blood glucose levels, posing particular challenges for people with type 1 diabetes. Semi-structured interviews were conducted with 25 young adults with type 1 diabetes, between May and August 2016. Interviews were transcribed verbatim, and coded using thematic analysis. Participants reported that the experience of type 1 diabetes made simple things complicated and involved constant vigilance and control. Difficult experiences in social situations were also mentioned; participants felt that their privacy was often threatened, that people voiced misunderstandings about type 1 diabetes, and that members of the public often judge and critique their health behaviours or lifestyle choices. Simple behaviours like eating out with friends, responsible alcohol consumption, and engaging in physical activity pose particular challenges for young people with type 1 diabetes. Public education may reduce stigma and improve health behaviour. [ABSTRACT FROM AUTHOR]

Issue Addressed: Sugar-sweetened beverages (SSB) are the leading source of free sugars in Australian children's and adults' diets. This study explores drivers of consumption among parents and young adults to inform interventions.Methods: Eight focus groups (n = 59) stratified by gender, age/life stage and SES were analysed thematically.Results: Daily SSB consumption was normalised. Participants drank SSBs to avoid perceived energy/sugar deficits, to treat themselves and as a function of familial influence. Frequent consumption was considered acceptable if "in moderation" and/or "balanced" with exercise/diet; however, there was a large disconnect between this language of moderation and actual consumption practices. Participants acknowledged that social norms had changed over time. There was little evidence of accurate knowledge of sugar content for any beverage type. Participants relied heavily on packaging and labelling, much of which conveyed a health halo effect. While participants could list health effects of excess consumption, they were considered long-term or of low personal relevance. Awareness of health recommendations was low.Conclusions: Consumers' adoption and use of concepts such as "treat," "moderation" and "balance" reflect both food and beverage industry marketing and public health messaging. However, the disconnect between this language and knowledge and consumption practices is problematic. SO WHAT?: SSB consumption is very high with serious implications for health. Curbing consumption among young adults and parents has potential to change the health trajectories for current and future generations. There is a clear need to increase health literacy around SSB consumption. Simple consumption guidelines, clearer sugar content labelling and health warnings offer potential. [ABSTRACT FROM AUTHOR]

Issue Addressed: Skin cancer affects nearly one in three Australians. As a preventable disease there have been many public awareness campaigns targeting skin cancer knowledge and sun protection in Australia in the last 30 years to increase knowledge of the disease and how to prevent it. Despite higher incidence and mortality of skin cancer in regional Australia and adults over 65 years though, little research exists examining this high-risk population's skin cancer knowledge and sun behaviours, with most previous research conducted in urban Australia or overseas. This study aimed to examine adults' skin cancer knowledge, sun behaviours and demographic factors in a regional Australian town.Methods: Cross-sectional study design was utilised. Adult patients of a Mudgee General Practice (n = 179, 18-89 years) completed a survey based on their skin cancer knowledge and sun behaviours. Chi-squared tests were used to analyse responses.Results: Poor non-melanoma skin cancer awareness, risky sun behaviours and inadequate sun protection behaviours were found. Males and those at greatest current risk of skin cancer in Australia, those over 60 years, had the poorest skin cancer knowledge and were least likely to recognise skin cancer or use some sun protection measures.Conclusions: Greater non-melanoma skin cancer and sun protection education and research is needed, particularly targeting older and male Australians. SO WHAT?: The findings suggest rural men and older Australians would benefit from more targeted campaigns and education to increase their skin cancer awareness and use of sun protection in order to minimise future skin cancer. [ABSTRACT FROM AUTHOR]

Aims: Behaviour modification and mood management are essential to recovery after a cardiac event. Recent times have seen a major shift to remote delivery of cardiac services. This study assessed behavioural and psychological outcomes of the Back on Track online self-management programme, comparing the programme undertaken alone (self-directed) vs. with telephone support (supported). Relevance for people with depression was also assessed., Methods and Results: Participants with cardiac conditions (n = 122) were randomly assigned to self-directed or supported groups and given access to the online programme for 2 months. The programme addressed depression, anxiety, physical activity, and healthy eating. Supported group participants also received two telephone sessions facilitated by a trained counsellor to further enhance their self-management skills and engagement with the online modules. The Patient Health Questionnaire-9, Generalized Anxiety Disorder-7, and Active Australia Survey and Diet Quality Tool were administered at baseline, 2, and 6 months. χ2 tests were used to compare self-directed and supported groups. Cochrane's Q tests assessed changes over time in depression, anxiety, and physical activity (PA) and healthy diet guideline achievement. Participants in both groups showed reduced depression rates (self-directed, P < 0.05) and increased PA after programme completion (both groups, P < 0.05). Amongst those classified as depressed at baseline, significantly fewer were classified as depressed over time (P < 0.001) and significantly more were achieving the PA guidelines (P < 0.01) compared to those who were not depressed at baseline., Conclusions: The Back on Track telehealth programme was effective in assisting with behavioural and emotional recovery after a cardiac event. The programme may be particularly beneficial for those who are depressed early in their recovery period., Trial Registration: Australian New Zealand Clinical Trials Registry: ACTRN12620000102976., Competing Interests: Conflicts of interest: None declared., (© The Author(s) 2023. Published by Oxford University Press on behalf of the European Society of Cardiology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Issue Addressed: Evaluation of the behavioural impact of Western Australia's LiveLighter healthy weight and lifestyle campaign focussed on decreasing consumption of sugar-sweetened beverages (SSBs) using graphic imagery, as well as monitoring unintended consequences.Methods: A cohort design with pre-campaign telephone survey of Western Australian adults aged 25-49 (Time 1 May/Jun 2013: N = 1504) undertaken and repeated following the campaign (Time 2 Aug/Sep 2013: N = 822).Results: Post-campaign awareness was 67% with respondents in low socio-economic areas most likely to report viewing the campaign frequently. There was evidence of reduced SSB intake from baseline to follow-up among frequent (4+/week) SSB consumers (22% cf. 16%; P = 0.003) and some evidence among overweight (BMI 25+) weekly SSB consumers (56% cf. 48%; P = 0.013). There was also some evidence consumption of sweet food decreased (3+/week: 53% cf. 48%; P = 0.035) while fruit, vegetable and fast food consumption remained stable. Knowledge of potential health consequences of SSBs increased (70% cf. 82%; P < 0.001) with no change in knowledge of potential health consequences of overweight generally (86% cf. 89%). Importantly, there was no increase in endorsement of overweight stereotypes.Conclusions: The LiveLighter "Sugary Drinks" campaign positively impacted adults' knowledge and behaviour with regard to SSB consumption in a pattern specific to the campaign messaging and without adverse impact on weight-related stereotypes. SO WHAT?: Findings support the use of mass media for healthy lifestyle change. They suggest the public are receptive to undertaking the campaign's simple concrete lifestyle recommendation and provide an indication of the campaign dose required to achieve positive behaviour change. [ABSTRACT FROM AUTHOR]

Issues Addressed: This paper investigates the influence of mood while driving, advocates for identifying high-risk groups and detects associations between mood while driving and risky driving behaviours. While commensurate studies regarding aggressive driving have confirmed significant detriments in driving performance, little scholarly research has studied the gaps and opportunities at the intersection of mood and risky driving in young drivers.Methods: A cross-sectional design was implemented using 660 young drivers (17-25 years) from Australia (34.7%) and Colombia (65.3%), who completed the Behaviour of Young Novice Drivers Scale (BYNDS). Cluster analysis differentiated young drivers across two groups: high-risk and low-risk driving while influenced by mood. Hierarchical segmentation analysis explored the relationship between driver mood and self-reported risky driving behaviour.Results: Young drivers reported frequent driving while influenced by mood. The typical risky driving behaviours of young drivers who are emotion-affected are transient violations (eg, speeding) and risky exposure (eg, driving tired).Conclusions: Risky driving behaviours that have been found to increase the risk of road injury (speeding, fatigued driving) and to decrease the survivability of road crashes (speeding) are inextricably intertwined with the influence of driver mood upon driving behaviour at an international level. Driver mood is a neglected issue in health promotion programs for young drivers. SO WHAT?: Current health promotion interventions for young drivers safety such as Graduated Driver Licensing may not prevent driving while influenced by mood. Additional strategies are required to minimise the exposure to driving while affected by negative mood. [ABSTRACT FROM AUTHOR]

Issue Addressed: Australian surveys indicate that a large proportion of packaged liquor outlets do not check identification for young people before selling alcohol to them. There are a substantial number of presentations to Emergency Departments from young people aged 15 to 17 years. This subgroup is second only to those aged 18 to 24 years. In the 15- to 17-year-old age group, supply from direct purchase or underage friends, who have purchased alcohol, represents substantial sources of alcohol that is more likely to be consumed without parental supervision.Method: Teenagers 18-19 years of age approached a randomly selected sample of bottle shops, on the NSW Central Coast Region, to attempt to purchase alcohol without producing identification (ID). Legally we are unable to test with teens under the age of 18. If outlets do not check ID for customers 18 or 19 years of age, we propose they might not check identification for 15- to 17-year-olds. A raft of local interventions was employed over four-survey periods to attempt to reduce selling rates.Results: The lowest alcohol sales without ID occurred in 2015 when NSW Liquor and Gaming successfully prosecuted a Central Coast outlet for an underage sale. The rate of alcohol sales without checking ID each year was as follows: 2012-43.8%, 2014-37.55%, 2015-21.5% and 2016-45%.Conclusion: Alcohol sales to young customers without checking ID are common, widespread and seemingly resistant to nonpunitive interventions. The NSW Liquor Act could be modified to allow compliance testing and much more practical enforcement. While Central Coast bottle shops have a better record than other Australian areas showing some improvements with our nonpunitive industry education interventions, the results need to improve substantially to stifle primary supply. [ABSTRACT FROM AUTHOR]

Background: Leavers Festivals have become an institution for Australian youth to celebrate the completion of secondary school. Reported hazardous consumption of alcohol by leavers has focused concern on risk-taking behaviour. In response to this, campaigns such as "Don't Drink and Drown" have targeted youth to reduce alcohol consumption during aquatic activities. This research investigated intended and actual alcohol consumption, particularly during aquatic activities at a Leavers Festival located in the coastal town of Dunsborough, southern Western Australia.Method: In November 2016, 549 leavers aged 17 or 18 years completed a paper-based survey over a four-day period during the Festival.Results: Overall, 90% of leavers reported intending to drink during the Festival, with expected average daily consumption being seven to nine standard drinks; reported daily consumption was five to six standard drinks (P < 0.001). Of the 29% of leavers who consumed alcohol around water during Leavers, 47% had done so while swimming. About 91% were aware of the campaign "Don't Drink and Drown."Conclusion: Awareness of the "Don't Drink and Drown" campaign and knowledge of risks associated with alcohol consumption and swimming were relatively high. Intention and actual consumption of alcohol did not correlate, with daily consumption less than anticipated.So What: Leavers appear to have a reasonable level of awareness and knowledge of the risks associated with alcohol consumption and aquatic activities, which may reflect the impact of education campaigns. However, this knowledge is not always translated into nonrisky aquatic behaviour. [ABSTRACT FROM AUTHOR]

Objectives Fitness industry professionals (personal trainers, group instructors) may have a role in health promotion, particularly when working with subgroups with known health risks (e.g. older adults, obese). The aim of this study is to examine fitness professionals' level of interest in engaging with high-risk populations. Study design Cross-sectional evaluation of a national survey. Methods In 2014, 9100 Australian registered exercise professionals were invited to complete an online survey. Respondents reported their level of interest in engaging with nine health-risk population subgroups. A multivariable logistic regression analysis assessed the odds of being classified as having a 'low level' of interest in training high health-risk subgroups, adjusting for demographic and fitness industry-related factors. Results Of 1185 respondents (aged 17-72 years), 31.1% reported having a 'high level' of interest in training high health-risk subgroups. The highest level of interest was among 'obese clients' and 'adults (18-64 years) with chronic health conditions'. In the adjusted analysis, males (odds ratio [OR], 1.55, 95% confidence interval [CI]: 1.06-2.25) and those in urban settings (OR, 2.26, 95% CI: 1.54-3.37) were more likely to have a 'low level' of interest. Conclusions Fitness professionals have a modest level of interest in training high health-risk subgroups. In addition to the development of strategies to increase interest, research should examine whether fitness professionals are able to safely prescribe exercise to high health-risk subgroups. [ABSTRACT FROM AUTHOR]

Background: This study evaluated the associations between oral and general health behaviours, self-reported health and quality of life of adults aged 75 years or older living independently in South Australia.Methods: A cross sectional study based on a self-report mailed questionnaire was conducted in 590 independently living adults aged 75 years or older. Self-ratings of oral health and general health were assessed using single-item global ratings. Quality of life was measured using the Oral Health Impact Profile and the EuroQol instrument for health utility.Results: The overall response rate was 78%. The current analyses were restricted to 354 dentate older adults. Increasing age and being female were negatively associated with EuroQol scores. Good self-rated oral and general health were more prevalent in participants with higher social status who also had lower oral health impact and higher EuroQol scores. Good self-rated oral and general health were less prevalent while oral health impact was greater in participants who ate few fruits, vegetables or dairy products.Conclusions: Self-rated health and quality of life were poor in older adults with inadequate fruit/vegetables/dairy intake and lower social status. These findings suggest that nutrition and socioeconomic factors may be important to the oral and general health of adults aged 75 years or older. [ABSTRACT FROM AUTHOR]

Abstract: The aim of this study was to understand the experience of Chinese migrants living with type 2 diabetes in Australia and explore their culturally specific diabetes management needs, habits and expectations in the Australian context to help shape an Australian Chinese diabetes service. A case study approach was employed across two Australian cities (Melbourne and Sydney), using participant‐observations and qualitative interviews. Purposive sampling was used to find diabetes education sessions for observation and facilitators for interviews before snowball technique was used to identify relevant clinicians. Thematic analysis with pattern matching was used for data analysis. A total of 18 participant‐observations and 12 interviews were conducted. Chinese migrants appeared to experience multiple barriers in accessing the Australian diabetes care service further complicated by the mismatch between the expectations of Chinese patients and the services available. Chinese patients were observed to be collectivistic‐orientated relying on friends for diabetes management. While health professionals appeared to be perceived as a source of reputable health information, they often did not provide ongoing support. When professional support was limited, Chinese patients adopted alternative strategies to address their diabetes, which often involved seeking help and information from peers. Some of this information was non‐reputable, potentially resulting in detrimental health outcomes. In conclusion, redesigning diabetes care services in line with the principles of collectivism may more appropriately match the Chinese migrants’ expectations and needs, and better support them in their diabetes journey. [ABSTRACT FROM AUTHOR]

Issue addressed Portion size guidance strategies have been suggested as an important component of weight management; therefore, the Health Star Rating (HSR) front-of-pack labels could influence consumers' portion-size decisions. However, this has not been investigated to date. This study aims to evaluate whether presenting energy content information and HSRs influences portion size self-selection of specific foods and meals. Methods Adults were randomly assigned to one of three experimental groups in this randomised controlled experiment. Each participant was given either a kJ/100g food label or a HSR label, or was given no information on nutrient composition. They were then asked to serve themselves an adequate portion of breakfast cereal (Kellogg's Nutri-Grain), fruit salad and chocolate, plus a three-component meal (chicken, fries and mixed vegetables). Portion serves and meal weights were compared between each experimental group using ANOVA and the discretionary foods were also compared with the Australian Guide to Healthy Eating (AGHE). Results Neither the kilojoule nor HSR information influenced the self-served portion size of foods or meal components. Mean self-served portion size of the discretionary foods were significantly greater than the standard serving sizes as specified in the AGHE. Conclusion Although food labels have the potential to assist consumers in making product choices, this study indicates that presenting nutrition information does not affect portion size decisions in young adults. So what? Strategies that assist consumers to choose appropriate portion sizes should be developed as a weight management tool. [ABSTRACT FROM AUTHOR]

Issue addressed Diabetes is associated with significant depression, which can result in poorer clinical outcomes, including increased mortality. Little is known about the prevalence of depression among Torres Strait Islander adults with diabetes. Methods Self-reported depression was measured using the Patient Health Questionnaire (PHQ)-9 translated into Torres Strait Creole, and associations with socioeconomic, behavioural and clinical indicators in Torres Strait Islander adults with diabetes in five remote Torres Strait Islands were examined. Results Seventy-three men and 115 women completed interviews. The median PHQ-9 score was 5.5 (IQR 0-7); 42% of respondents scored 0-4 (none-minimal), 46% scored 5-9 (mild) and 12% scored 10+ (moderate-severe). Mean HbA1c was 8.3% (67.4mmol). HbA1c was not related to PHQ-9 scores (β=0.20, P=0.323), however exercise in hours (β=-0.34, P<0.001) and screen time in hours (β=0.11, P<0.001) were significant predictors of depression after adjusting for other study variables. Conclusions This sample of remote living Torres Strait Islanders reported relatively low rates of depression compared with national samples, and depression was not related to glycaemic control. Exercise and screen time were the strongest predictors of depression based on PHQ-9 scores. This represents an opportunity for health promotion. So what? These findings provide an indication of the health impact of physical activity in rural and remote communities. Local health and education services, councils and sporting bodies should work collaboratively to promote sustainable physical activity programs. [ABSTRACT FROM AUTHOR]

Issue Addressed: Health literacy - the degree to which people can access, understand and use health information - is essential for shared decision-making and improved health outcomes. Health consumers' ability to engage with health care professionals (HCPs) is influenced by their health literacy capabilities. This research sought to understand health literacy-related barriers and enablers to engage with non-physician HCPs as experienced by consumers., Methods: A qualitative descriptive approach was undertaken. A semi-structured interview guide was used, incorporating five health literacy domains described in the Health Literacy Questionnaire that related to consumers' engagement with health professionals. Audio- or digitally-recorded interviews were conducted with Australian health consumers, and transcribed and themed using the Patient-centred Access to Care framework as a template., Results: Interviewing 30 consumers revealed that HCPs' clinical skills often enabled consumers to seek engagement; however, during active engagement their interpersonal skills became a key enabler. Conversely, a lack of developed interpersonal skills in HCPs was frequently seen as a barrier to consumer engagement. Barriers to engagement were also created when HCPs' information did not match what consumers discovered from other sources. However, consumers self-reported that they were unable to appraise health information at least some of the time., Conclusion: Barriers and enablers to consumers' engagement with HCPs were identified across each of the five relevant health literacy domains. SO WHAT?: HCPs should be aware of the importance of interpersonal skills and clear health information suitable for consumers with lower health literacy. Additionally, time dedicated to educating consumers on information appraisal could act as a further enabler to effective engagement., (© 2022 The Authors. Health Promotion Journal of Australia published by John Wiley & Sons Australia, Ltd on behalf of Australian Health Promotion Association.)

Issue Addressed: Alzheimer's disease and dementia are recognised as critical public health priorities. This study investigated intentions and behaviours concerning brain health and dementia risk reduction among Australians.Methods: A cross-sectional survey of 1000 persons aged 20-75 years measured knowledge, beliefs, intentions and behaviours concerning brain health and dementia. The demographic, experiential and cognitive factors associated with intentions and actions were examined.Results: Around half of respondents were motivated to improve brain health. Behaviours most often reported were mental activity (19%), physical activity (9.6%) and dietary action (6.5%). Actions were most likely among women (OR 1.59, 95% CI 1.19-2.14), those aged 60 years and over (OR 3.07, 95% CI 2.01-2.58), with university education (OR 1.67, 95% CI 1.08-2.58) or with prior contact with a person with dementia (OR 1.99, 95% CI 1.12-3.56). Both intentions and actions were associated with moderate to high knowledge, and beliefs and confidence that favoured dementia risk reduction.Conclusions: A lower proportion of Australians reported taking action to improve brain health than who expressed intentions in this regard. Strategies are needed to improve knowledge about the range of behaviours that contribute to dementia risk reduction and to increase confidence that this outcome is personally achievable. SO WHAT? The burden of disease due to Alzheimer's disease and dementia is growing dramatically. It is essential to promote awareness that dementia is not an inevitable result of ageing and to increase understanding that action can be taken throughout the life course to promote brain health. [ABSTRACT FROM AUTHOR]

Issue: Chronic disease is a growing problem affecting approximately half of all Australian adults. In response to growing calls for action on chronic disease, the My health for life program was created, aimed at improving the health of individuals at high risk of developing preventable chronic disease. The preventive health program is multi-modal, cross-culturally tailored and contains complex social marketing, community engagement, risk assessment and health promotion components. Therefore, a multi-component evaluation framework is essential to understand the effectiveness of the My health for life program. This brief report details the evaluation., Methods: The evaluation design uses non-randomised, longitudinal analysis using repeated measures, observational, program goal-based and pretest-posttest design features to assess the program, its specific modalities and its program adaptations. To ensure timely and credible evaluation, different evaluative implementation frameworks and methods are considered. Quantitative and qualitative methods collect an array of program data at differing levels to assess the processes, outcomes and impacts of My health for life., Discussion: The implemented evaluation framework has allowed measurement of: (i) process impacts including uptake, retention and attrition, participant satisfaction, fidelity and program stakeholder engagement and (ii) outcomes relating to individual participant level changes in health behaviours. SO WHAT?: This evaluation is an example of an integrated evaluation approach in a large successful preventive health program. Findings from the evaluation will ultimately inform the applicability and transferability of the program and inform policy makers, stakeholders and other health professionals in preventive health practice., (© 2022 The Authors. Health Promotion Journal of Australia published by John Wiley & Sons Australia, Ltd on behalf of Australian Health Promotion Association.)

Issue Addressed: This paper aims to report findings of a scoping review which mapped and summarised available literature regarding Aboriginal peoples' use of Dose Administration Aids (DAAs) for improved medication management. Aboriginal and Torres Strait Islander peoples have higher rates of chronic disease than other Australians. This leads to increased numbers of prescribed medications and complex medication taking regimens. The Australian Government and Pharmacy Bodies provide programs for Aboriginal peoples with chronic conditions, including programs supporting access to DAAs to improve medication adherence., Methods: The search strings used included three key concepts: Indigeneity; DAAs and outcomes. PubMed, Medline via Ovid and the grey literature were searched., Results: After removal of duplicates, 426 papers were screened by title and abstract for inclusion. A further 407 papers were then excluded leaving a total of nineteen papers included in the review. Only three of these papers included all three concepts in the search criteria, and none of these were empirical studies., Conclusion: The lack of studies found in this review support the requirement for empirical research regarding the effects of DAAs on medication taking behaviours of Aboriginal people, and the programs that provide them. SO WHAT?: The Australian Government funds programs that provides access to DAAs as a method of improving medication taking behaviours. But what do we really know about DAAs and if or how they assist in this goal? This review scopes out what is known, in order to direct studies that will answer this question., (© 2022 The Authors. Health Promotion Journal of Australia published by John Wiley & Sons Australia, Ltd on behalf of Australian Health Promotion Association.)

Issue Addressed: Food literacy programs aim to build individuals' knowledge, skills and self-efficacy to adopt healthy food choices conducive to reducing the risk of chronic diseases, such as obesity. Foodbank WA's (FBWA) Healthy Food for All ® nutrition programs have supported the improvement of food literacy knowledge and skills among vulnerable people living in the Pilbara., Methods: A Sustainability Framework containing ten sustainability factors was overlaid with social ecological model (SEM) levels of influence to form a matrix. The use of this matrix facilitated sustainability strategy appraisal within three food literacy programs delivered in remote WA., Results: Programs included multiple sustainability strategies across levels of influence; all programs addressed all ten sustainability factors at community and organisational SEM levels of influence. Few sustainability strategies were employed at the public policy level of influence. No program employed formal governance structures to guide program direction, such as steering groups; however, school and parent program staff developed Memoranda of Understanding to ensure the continuation of program delivery between the FBWA teams' regional visits., Conclusions: This study has showcased the comprehensive assessment of food literacy program sustainability across levels of influence and identified gaps for improvement by FBWA teams. SO WHAT?: The sustainability of food literacy programs aiming to increase knowledge and skills could be enhanced by conducting a similar analysis, during program planning or at program review. Using the matrix provides the opportunity to focus resources to address sustainability; supporting health promotion practitioners to transform the impacts of short-term food literacy interventions into long-term sustained outcomes., (© 2022 Foodbank of Western Australia Inc. Health Promotion Journal of Australia published by John Wiley & Sons Australia, Ltd on behalf of Australian Health Promotion Association.)

The health behaviours related to chronic diseases experienced by South Asian immigrants are interrelated with their culture and socioeconomic conditions. South Asian immigrants experience a disproportionate burden of chronic disease compared with non-immigrants Australian-born general population. The primary aim of this study was to gain an in-depth understanding of health behaviours and healthcare access in the South Asian immigrant population of Australia. Five focus group discussions (FGDs) were conducted with South Asian immigrants (n = 29; 18 females) aged 27-50 years in Brisbane, Australia. Separate FGDs were conducted for males and females in the English language. Semi-structured guided questions related to the perception, barriers and facilitators of health behaviours. Data were analysed with Nvivo-12 following a thematic analysis. A conceptual model is proposed to provide a summarised understanding of barriers and facilitators of health behaviours in South Asian immigrants. The major reported constraints for participating in physical activity were cultural beliefs, lack of time, work stress and high fees of fitness activities, while parks and peer modelling were mentioned as a strong motivator for walking, cycling and participating in group sports activities. The cultural and religious connections, cost of cigarettes and drink driving penalties were the most mentioned facilitators for a healthy lifestyle. The important factors related to unhealthy eating habits were the traditional cooking methods, social interactions and the high cost of fruits and vegetables. Community perceptions and language barriers were also acknowledged as the main factors for the decrease in accessing health care services. This study illustrates that cultural beliefs, high cost of healthy food and facilities and social circumstances are mainly linked with the health behaviours and healthcare access in South Asian immigrant's lifestyles., (© 2022 The Authors. Health and Social Care in the Community published by John Wiley & Sons Ltd.)

Issue addressed: To examine the prevalence and socio-demographic distribution of adherence to national dietary and physical activity recommendations among Australian secondary school students. Methods: Cross-sectional survey of 12,188 students in Years 8 to 11 (aged 12-17 years). Students' self-reported eating, physical activity and sedentary behaviours were assessed using validated instruments administered via an online questionnaire. Results: Less than one-quarter of students (24%) reported meeting the daily requirement of at least four serves of vegetables, while 41% reported consuming the recommended three or more daily serves of fruit. Just 15% of students reported engaging in at least 60 minutes of moderate-to-vigorous activity every day, and only one in five students met the recommendation of spending no more than two hours per day in small screen recreation. Males were performing better than females in terms of fruit intake and physical activity, but worse in relation to frequency of consumption of sugary drinks and fast food, and time spent using electronic media. The proportion of students meeting fruit and vegetable recommendations declined with advancing year level, while lower socio-economic position (SEP) students were faring less well than those from high SEP neighbourhoods, particularly with regards to healthy eating. Conclusions: There is considerable scope for improving young people's health behaviours in line with national dietary and physical activity recommendations. [ABSTRACT FROM AUTHOR]

Background: The adoption and maintenance of healthy behaviours is essential in the primary prevention of chronic non-communicable diseases. This study evaluated the effectiveness of a minimal intervention on multiple lifestyle factors such as diet, physical activity, smoking and alcohol, delivered through general practice, using computer-tailored feedback. Methods: Adult patients visiting 21 general practitioners in Brisbane, Australia, were surveyed about ten health behaviours that are risk factors for chronic, non-communicable diseases. Those who completed the self-administered baseline questionnaire entered a randomised controlled trial, with the intervention group receiving computer-tailored printed advice, targeting those health behaviours for which respondents were not meeting current recommendations. The primary outcome was change in summary lifestyle score (Prudence Score) and individual health behaviours at three months. A repeated measures analysis compared change in these outcomes in intervention and control groups after adjusting for age and education. Results: 2306 patients were randomised into the trial. 1711 (76%) returned the follow-up questionnaire at 3 months. The Prudence Score (10 items) in the intervention group at baseline was 5.88, improving to 6.25 at 3 months (improvement = 0.37), compared with 5.84 to 5.96 (improvement = 0.12) in the control group (F = 13.3, p = 0.01). The intervention group showed improvement in meeting recommendations for all individual health behaviours compared with the control group. However, these differences were significant only for fish intake (OR 1.37, 95% CI 1.11-1.68), salt intake (OR 1.19, 95% CI 1.05-1.38), and type of spread used (OR 1.28, 95% CI 1.06-1.51). Conclusion: A minimal intervention using computer-tailored feedback to address multiple lifestyle behaviours can facilitate change and improve unhealthy behaviours. Although individual behaviour changes were modest, when implemented on a large scale through general practice, this intervention appears to be an effective and practical tool for population-wide primary prevention. Trial Registration: The Australian New Zealand Clinical Trials Registry: ACTRN12611001213932 [ABSTRACT FROM AUTHOR]

Abstract: Introduction: According to the World Health Organisation (WHO), global warming has the potential to dramatically disrupt some of life’s essential requirements for health, water, air and food. Understanding how Australians perceive the risk of global warming is essential for climate change policy and planning. The aim of this study was to determine the prevalence of, and socio-demographic factors associated with, high levels of perceived likelihood that global warming would worsen, concern for self and family and reported behaviour changes. Methods: A module of questions on global warming was incorporated into the New South Wales Population Health Survey in the second quarter of 2007. This Computer Assisted Telephone Interview (CATI) was completed by a representative sample of 2004 adults. The weighted sample was comparable to the Australian population. Bivariate and multivariate statistical analyses were conducted to examine the socio-demographic and general health factors. Results: Overall 62.1% perceived that global warming was likely to worsen; 56.3% were very or extremely concerned that they or their family would be directly affected by global warming; and 77.6% stated that they had made some level of change to the way they lived their lives, because of the possibility of global warming. After controlling for confounding factors, multivariate analyses revealed that those with high levels of psychological distress were 2.17 (Adjusted Odds Ratio (AOR)=2.17; CI: 1.16–4.03; P=0.015) times more likely to be concerned about global warming than those with low psychological distress levels. Those with a University degree or equivalent and those who lived in urban areas were significantly more likely to think that global warming would worsen compared to those without a University degree or equivalent and those who lived in the rural areas. Females were significantly (AOR=1.69; CI: 1.23–2.33; P=0.001) more likely to report they had made changes to the way they lived their lives due to the risk of global warming. Conclusions: A high proportion of respondents reported that they perceived that global warming would worsen, were concerned that it would affect them and their families and had already made changes in their lives because of it. These findings support a readiness in the population to deal with global warming. Future research and programs are needed to investigate population-level strategies for future action. [Copyright &y& Elsevier]

The large baby boomer cohort is beginning to reach retirement age. This paper reviews recent Australian literature on baby boomers' health and health behaviours. Databases were searched for peer-reviewed literature and the Internet for online studies and reports. The boomers can expect an increased life span compared to those in later life now. Boomers' health behavioural risks include physical inactivity, low vegetable consumption, obesity and rising medical risk due to increasing prevalence of diabetes. Their health will impact on workforce participation and retirement timing. There is substantial scope for health improvement and consequent quality of life as boomers age. However, little is known about health decision-making, inequalities between social groups and health information sources. Future research can yield a better understanding of the health trajectories of baby boomers in order to plan for health and service needs for an ageing Australia. [ABSTRACT FROM AUTHOR]

This study aims to identify the barriers experienced by a sample of rural Australian men, including farmers, to adhering to a healthy diet and regular physical activity, and solutions to overcoming these barriers. The major barriers to eating a healthy diet were lack of willpower (39%), lack of time (24%) and enjoying eating "unhealthy" foods (24%). Barriers to undertaking physical activity were lack of time (43%), lack of willpower (36%), tiredness (27%) and long hours in sedentary jobs (27%). Eating habits could be improved with simple weekly meal plans (49%), lower cost of healthy food (36%), and growing their own food (34%). More active recreational pursuits could improve physical activity participation (48%). These solutions target efforts to improve health outcomes for rural Australian men. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to describe differences in dental attendance and dental self-care behaviour between socioeconomic groups and to investigate the extent to which the socioeconomic gradient in oral health was explained by these behaviours. Methods: We used data from a representative sample of adults in Australia, surveyed by telephone interview and by self-complete questionnaire. The dependent variables were self-reported missing teeth and the social impact of oral conditions evaluated with the 14-item Oral Health Impact Profile (OHIP-14). Socioeconomic position was measured at the small-area level. We conducted bivariate analysis using one-way analysis of variance and 95% confidence intervals (95% CI) and adjusted for the effect of age. After adjusting for age, dental behavioural variables were entered individually into multivariate linear regression models. Results: Data were obtained for 3678 dentate adults aged 18–91 years. Missing teeth and OHIP-14 scores followed a social gradient with poorer adults experiencing poorer outcomes. Routine dental attendance and diligent dental self-care were associated with inverse monotonic gradients in missing teeth ( P < 0.05) and OHIP-14 scores ( P < 0.05). Although adults living in areas with the least disadvantage had a preventive dental attendance orientation, no socioeconomic pattern was found for dental self-care. In multivariate analysis, the slope of the socioeconomic gradient [ β estimate for Index of Relative Socioeconomic Disadvantage (IRSD)] in missing teeth was not significantly attenuated by either dental attendance or dental self-care. For OHIP-14 scores, the slope of the socioeconomic gradient was significantly attenuated by dental visiting, but not by dental self-care and not by the combined effect of both behaviours. Conclusion: The commonly held view that the poor oral health of poor people is explained by personal neglect was not supported in this study. [ABSTRACT FROM AUTHOR]

Background: Early obesity prevention research interventions in Australia generally expect participants to be able to communicate in English, but do not account for other languages. This study aimed to investigate engagement, satisfaction, retention and behavioural outcomes of linguistically diverse participants from a mainstream early childhood obesity prevention trial., Methods: Healthy Beginnings is a nurse-led intervention based in Sydney, supporting families with optimal infant feeding and active play via telephone. This secondary analysis assessed participant engagement in the nurse telephone calls (call completions), satisfaction and behavioural outcomes (6- and 12-month survey data) and retention (survey completions), in the first year of life according to participants' language spoken at home (English or other language)., Results: Of 1155 mothers, 533 (46%) spoke a language other than English at home. Significantly fewer mothers speaking a language other than English completed the 6-month survey (79%) compared to those speaking English (84%), yet mothers speaking a language other than English who completed the program were more satisfied with the program overall. Significantly fewer mothers speaking a language other than English completed the final four nurse calls (of six) (56%-65%) compared to those speaking English (70%-80%). Adjusted odds ratios showed selected behavioural outcomes were significantly more positive for participants speaking English at home., Conclusions: Healthy Beginnings trial participants who spoke a language other than English at home had less favourable engagement, retention and behavioural outcomes compared to those who spoke English. So what? Early obesity prevention interventions should consider cultural adaptations to improve engagement and effectiveness among culturally and linguistically diverse families., (© 2021 Australian Health Promotion Association.)

Issue Addressed: To describe the need for high school sleep education from the perspective of undergraduate university students., Methods: Undergraduate students who completed an online course on sleep and circadian health were surveyed 6 months after course completion. Students were asked whether a similar course would have benefited them as high school students, and about the need for sleep education in high schools. Thematic analysis of this qualitative data was carried out., Results: Eighty-nine students who had attended 71 unique high schools provided responses. Eight-one per cent thought they would have benefitted from a similar course during high school and identified domains of sleep knowledge particularly relevant to high school students. They cited environmental barriers to healthy sleep present during high school and believed that sleep education could improve students' lifestyle, sleep and performance. Nineteen per cent of students said they would not have benefited, because they perceived sleeping patterns during high school to be nonmodifiable or believed that previous sleep education was sufficient. Of the respondents who did not think students would benefit, 53% would still tell their high school principal that there was a need for sleep education., Conclusions: The findings support the need for engaging sleep education for high school students. Future studies should examine the perspectives of students in high school directly, rather than undergraduate students who have already shown an interest in sleep health. SO WHAT?: Sleep health is missing from the Australian school curriculum. Online courses may be an engaging method of promoting sleep and circadian health to high school students., (© 2021 Australian Health Promotion Association.)

Issues Addressed: Recent reductions in young people's risky alcohol use have been widely documented but have not been examined among employed youth. Young workers' risky drinking may have corresponded with increased illicit drug use. This study investigated these issues., Methods: Secondary analyses were conducted for 15-24 year old Australian workers using nationally representative data from 2007 to 2016. Frequency analyses examined alcohol and illicit drug use, Z scores assessed differences over time, and logistic regression examined predictors of illicit drug use., Results: Risky drinking decreased significantly over time whilst low-risk drinking increased. This pattern was observed for both young workers and young employed illicit drug users. Whilst "any" illicit drug use did not change over time, methamphetamine use decreased, and cannabis and hallucinogen use increased. Drinking alcohol at risky levels (monthly) was associated with illicit drug use in 2016, as were being single and having high/very high levels of psychological distress., Conclusions: Risky drinking reductions over time have not corresponded with increased illicit drug use. Nonetheless, as risky drinking remains high among young workers, and is strongly associated with illicit drug use, it warrants concerted health promotion efforts that may also help minimise illicit drug use. SO WHAT?: Despite a reduction in young workers' risky alcohol consumption, risky drinking is still high and may impact the health and safety of workers and the wider community. As risky drinking is strongly associated with illicit drug use, workplaces could potentially play a vital role in combating alcohol and illicit drug misuse., (© 2021 Australian Health Promotion Association.)

Background: Australians report consulting with a naturopaths or herbalists to improve their wellbeing, yet little is known about the associations between these consultations and the patients' health behaviours. This cross-sectional study aimed to examine the relationship between health behaviour and consultations with naturopaths or herbalists in three age cohorts of Australian women. Methods: Women aged 19–25 years, 31–36 years, and 62–67 years from the Australian Longitudinal Study on Women's Health (ALSWH) were surveyed regarding smoking, alcohol or drug use, physical activity and dietary behaviour; and whether they consulted with naturopath/herbalists in the last 12 months. Associations were analysed using multivariable logistic regression. Results: A total of 9151 (19–25 years), 8200 (31–36 years) and 11,344 (62–67 years) women were included in the analysis. Between 7.3 and 11.9% of women reported to have consulted with naturopaths/herbalists in the last 12 months. Women of all cohorts consulting with naturopath/herbalist were less likely to smoke (19-25 yrs.: Odds Ratio [OR] 0.61; 31–36 years: OR 0.58; 62–67 years: OR 0.29), more likely to report at least moderate levels of physical activity (19-25 yrs.: OR 1.41; 31–36 years: OR 1.34; 62–67 years: OR 1.34), and the use of vegetarian diets(19-25 yrs.: OR 1.40; 31–36 years: OR 1.77; 62–67 years: OR 2.28), compared to women not consulting with naturopaths/herbalists. Women consulting with naturopaths/herbalists however were also more likely to have used marijuana (19-25 yrs.: OR 1.18; 31–36 years: OR 1.42), or illicit drugs in the last 12 months (19-25 yrs.: OR 1.24; 31–36 years: OR 1.40). Conclusions: Consultations with a naturopath or herbalist are associated with positive health behaviours that are protective of internationally important non-communicable diseases. Psychoactive drug use is also reported among women visiting a naturopath or herbalist. Further research is needed to understand the role naturopaths play in advising patients with regards to health and non-healthy behaviours. [ABSTRACT FROM AUTHOR]

Objectives: To determine patterns of mask wearing and other infection prevention behaviours, over two time periods of the COVID-19 pandemic, in cities where mask wearing was not a cultural norm., Methods: A cross-sectional survey of masks and other preventive behaviours in adults aged ≥18 years was conducted in five cities: Sydney and Melbourne, Australia; London, UK; and Phoenix and New York, USA. Data were analysed according to the epidemiology of COVID-19, mask mandates and a range of predictors of mask wearing., Results: The most common measures used were avoiding public areas (80.4%), hand hygiene (76.4%), wearing masks (71.8%) and distancing (67.6%). Over 40% of people avoided medical facilities. These measures decreased from March-July 2020. Pandemic fatigue was associated with younger age, low perceived severity of COVID-19 and declining COVID-19 prevalence. Predictors of mask wearing were location (US, UK), mandates, age <50 years, education, having symptoms and knowing someone with COVID-19. Negative experiences with mask wearing and low perceived severity of COVID-19 reduced mask wearing. Most respondents (98%) believed that hand washing and distancing were necessary, and 80% reported no change or stricter adherence to these measures when wearing masks., Conclusion: Pandemic mitigation measures were widely reported across all cities, but decreased between March and July 2020. Pandemic fatigue was more common in younger people. Cities with mandates had higher rates of mask wearing. Promotion of mask use for older people may be useful. Masks did not result in a reduction of other hygiene measures., (Copyright © 2021 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Purpose: Cancer survivors are at risk of comorbidities and mortality, and those living outside of metropolitan areas are particularly susceptible given poorer socioeconomic, health and support resources. As engagement in health behaviours is affected by participants' autonomous motives, investigation of the motives of cancer survivors in metropolitan and non-metropolitan areas could elucidate the values and reasons for practising health behaviours, allowing programs to be tailored to these motives., Methods: Metropolitan (n = 103) and non-metropolitan (n = 80) Australian cancer survivors completed a survey item by describing their motives for physical activity and healthy diet change. Inductive thematic analysis of responses was performed to establish themes across health behaviour motives., Results: Analyses revealed four themes: to be able to, longevity, psychological health and appearance. Survivors primarily referred to being able to enjoy family, leisure activities, travel and staying independent, with these motives often linked to longevity. Motives were similar across locations; however, those in non-metropolitan locations reported continuation of work and pain relief more frequently. Female survivors more often reported weight loss., Conclusions: A predominant motive for health behaviour change in cancer survivors across geographical location was the ability to enjoy family and engage in leisure and work activities. Programs aiming to promote health behaviours in cancer survivors might consider framing interventions accordingly by emphasizing benefits of longevity and maintaining independence.

TBS is associated with age, weight, childhood physical activity, and BMD in men and age, height, BMD, and mobility in women., Introduction: Trabecular bone score (TBS) indirectly assesses trabecular microarchitecture at the lumbar spine, providing complementary information to areal BMD. Many studies have investigated the relationships between BMD and lifestyle factors known to affect bone, but such research is limited for TBS. The aim of this study was to assess the relationship between TBS and lifestyle factors in Australian men and women., Methods: This cross-sectional study involved 894 men and 682 women (ages 24-98 years) enrolled in the Geelong Osteoporosis Study. TBS was assessed by analysis of lumbar spine DXA scans (Lunar Prodigy) using TBS iNsight software (Version 2.2). Bivariate and multivariable linear regression models were used to explore the associations between TBS and physical and lifestyle factors, including anthropometry, alcohol consumption, childhood physical activity, mobility, smoking status, prior low trauma fracture, medication use, and intakes of calcium and vitamin D., Results: In bivariate regression modelling, low mobility and the use of antiresorptive medication were associated with lower TBS in both men and women. Low childhood physical activity was also associated with lower TBS in men. Prior fracture, use of glucocorticosteroids, and total calcium intake were also associated with lower TBS in women. The final adjusted model for men included age, weight, childhood physical activity, and BMD, and for women, age, height, BMD, and mobility. No interaction terms were identified in the models., Conclusions: Lower TBS is associated with older age, increased weight, low childhood physical activity, and lower BMD in men and older age, shorter stature, lower BMD, and low mobility in women.

The degree to which foods are liked or disliked is associated with dietary intake and health behaviours. However, most food liking research has focused on single foods and nutrients and few studies have examined associations with demographics and health behaviours. Thus, this study aimed to investigate the association between food liking and socio-demographics, health behaviours, diet quality and body mass index (BMI) in a sample of young Australian adults. Data from 1728 undergraduate students (21.8 (standard deviation [SD] 6.0) years; 76% female) were used. Food liking scores and a diet quality index (Dietary Guideline Index, DGI) were estimated from a Food Liking Questionnaire and Food Frequency Questionnaire (FFQ), respectively. Multivariate linear regression analyses were used to assess the association between food liking and correlates. Young adults with higher liking for encouraged core foods were older, female, did their own food shopping, consumed less packaged foods and had better diet quality. Higher liking for discretionary foods and beverages was associated with less healthy behaviours, such as smoking, higher BMI and lower diet quality. These results suggest that food liking measures may offer an appropriate methodology for understanding influences on young adults' food choices, adding to the body of literature investigating the potential for food liking scores to assess diet-disease relationships.

Issue Addressed: Informal caregivers may experience unique barriers to engaging in healthy lifestyles, consequently increasing their risk of chronic disease. Among a convenience sample of informal caregivers, this study aimed to: (a) assess the self-reported health risk behaviours of low fruit and vegetable consumption, low physical activity, current smoking and hazardous alcohol consumption; (b) examine the demographic, caree condition and country of residence variables associated with each health risk behaviour; and (c) report the engagement in multiple health risk behaviours., Methods: An online cross-sectional survey among caregivers in Australia, Canada, New Zealand, the United Kingdom and the United States was conducted. Self-reported health risk behaviours were assessed and compared to key Australian healthy living guidelines. Logistic regression modelling identified participant factors associated with each health risk behaviour., Results: Overall, 384 caregivers were included in the analysis. Hazardous alcohol consumption was the only self-reported health risk behaviour which was much higher than in the general population (60.0%). Caregiver age (P = .018) and country of residence (P = .015) were associated with hazardous alcohol consumption. A majority of caregivers reported engaging in three health risk behaviours (55.0%)., Conclusions: Caregivers are engaging in a range of health risk behaviours; however, rates of hazardous alcohol consumption among the sample were high. Health promotion interventions targeted to address alcohol consumption should consider caregiver age and country of residence. SO WHAT?: This study highlights the health risk behaviours caregivers engage in across a number of countries, and suggests that caregivers require further support to manage alcohol consumption in particular., (© 2019 Australian Health Promotion Association.)

This study explores the associations between lifestyle and occupational factors and participation in colorectal cancer (CRC) screening among men and women aged 50 and over and living in Australia. We used weighted data from the Australian National Health Survey 2014-15 to produce population estimates. Lifestyle variables investigated were smoking, physical activity, alcohol consumption, fruit and vegetable consumption, and body mass index, while the occupational variables were labour force status, occupation, and participation in shift work. Using weighted data, 1,990,287 men (55%) and 1,898,232 women (49%) reported ever-screening for CRC. Female current smokers were less likely to report ever-screening for CRC (adjusted RR = 0.78, 95% CI 0.64-0.96), as were men who were less physically active (aRR = 0.87, 95% CI 0.78-0.97), reported no alcohol consumption (aRR = 0.73, 95% CI 0.59-0.91), and reported eating more vegetables (aRR = 0.84, 95% CI 0.72-0.99). When lifestyle behaviours were combined into a healthy lifestyle index score, a significant trend was observed for both men and women, whereby those who reported engaging in more healthy behaviours were more likely to have ever-screened for CRC (p = .027 men; p < .001 women). No associations were observed between CRC screening and occupational variables. This is the first comprehensive assessment of the lifestyle and occupational factors associated with participation in CRC screening among men and women in Australia. Participation in CRC screening was greater among those engaging in more healthy behaviours, suggesting that an individual's pattern of lifestyle behaviours may be important in determining screening participation. These results have important implications for public health strategies on improving CRC screening participation. [ABSTRACT FROM AUTHOR]