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Purpose: To assess trends in South Australian children's physical activity between 1985 and 2003 and 2013 in the contexts of school active transport, organized sport, physical education, and school break times. Method: The 1985 Australian Health and Fitness Survey was administered in South Australian schools in 2004 (8 schools) and 2013 (9 schools) and was demographically matched to the 10 South Australian schools in the Australian Health and Fitness Survey. Ordinal logistic modeling was used to identify trends, stratified by older children (10–12 y) and early adolescent (13–15 y) subgroups. Results: School active transport generally declined for males and older female children (19 and 20 percentage points per decade, respectively), whereas early adolescent females increased in walking to school (11 percentage points per decade). School sport participation declined for early adolescents, and club sport participation declined in early adolescent females (23 percentage points per decade). Moderate to vigorous physical activity participation during school break times (particularly lunchtime) generally declined (16–26 percentage points per decade). Observed changes in most contexts occurred between 2004 and 2013. Conclusion: There was evidence of context-specific declines in children's physical activity participation over this time span. Early adolescent females were the subgroup of most concern, experiencing declines in most contexts. [ABSTRACT FROM AUTHOR]

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

Valid measurement of youth physical activity is important and self-report methods provide convenient assessments at the population level. There is evidence that the validity of physical activity self-report varies by weight category. The aim of this study was to assess the validity of the 3-Day Physical Activity Recall (3DPAR), separately between normal weight and overweight/obese Australian youth. Accelerometer-derived physical activity variables were compared with 3DPAR variables in 155 (77 females) 11- to 14-year-olds from Adelaide, South Australia. In the whole sample, validity coefficients for self-reported moderate and moderate to vigorous physical activity were modest (rs = 0.12-0.31) and similar across gender and weight status categories. Validity coefficients for self-reported vigorous physical activity were much stronger (rs = 0.59-0.73) among overweight/obese than among normal weight participants. The validity of the 3DPAR in this study was low in the whole sample but varied according to physical activity intensity and the weight status of the child. Specifically, the 3DPAR may be appropriate for describing vigorous intensity physical activity among overweight and obese youth. [ABSTRACT FROM AUTHOR]

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

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

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

Background/aims/method To investigate causes of farmers’ stress during drought, 309 drought-affected South Australian farmers and their spouses, mainly from sheep, cattle and/or gain properties, ranging in age from 23 to 85 years (34.6% female) completed a questionnaire. Demographic and work-related details were collected and participants were asked to list their most stressful experiences in the past month and past 12 months. Results Most (73.1%) of the sources of stress reported were farm-related. A thematic analysis identified drought , financial pressure and uncertainty about the future as dominant stressors. A range of other more specific drought-related (e.g. poor crop yields, unsatisfactory conditions for livestock, overwhelming workloads) and contextual stressors (e.g. rising input costs, family involvement in the farming business, pressure to take part in community work, lack of understanding of farming from ‘outsiders’ ) were also identified. Dominant stressors were compounded by non-drought-related issues (e.g. machinery breakdowns ) and non-farm related stressors (e.g. illness and death of loved ones ). Conclusion Improved awareness of stressors may help to reduce farmers’ frustration with outsiders’ lack of understanding of their way of life, normalise stressors and thereby reduce stigma and empower farmers to seek help. These findings could also inform the development of targeted mental-health prevention and promotion initiatives for farmers in future periods of drought. [ABSTRACT FROM AUTHOR]

Rural Australians have a higher likelihood of chronic disease than urban Australians, particularly male farmers. Chronic disease has been associated with occupational sedentary time. The aim was to validate the self-report of sedentary time in men in contrasting rural occupations. Farmers (n = 29) and office workers (n = 28), age 30–65 years, were recruited from the Riverland region of South Australia. Daily sedentary time and number of breaks in sedentary time were self-reported and measured objectively using body-worn inclinometers. Correlational analyses were conducted between self-reported and objectively measured variables, separately by occupation. There was a significant correlation between self-reported and objectively measured sedentary time in the whole sample (r = 0.44,P = 0.001). The correlation among office workers was significant (r = 0.57,P = 0.003) but not among farmers (r = 0.08,P = 0.68). There were no significant correlations between self-reported and measured number of breaks in sedentary time, for the whole sample (rho = −0.03,P = 0.83), office workers (rho = 0.17,P = 0.39) and farmers (rho = −0.22,P = 0.25). In conclusion, the validity of self-report of sedentary behaviours by farmers was poor. Further research is needed to develop better performing self-report instruments or more accessible objective measures of sedentary behaviour in this population. [ABSTRACT FROM AUTHOR]

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

Children of low socio-economic position (SEP) consume poorer diets than those of high SEP; however, there is limited understanding of why socio-economic gradients in diet occur. Some evidence suggests that determinants of dietary intake may differ between SEP groups. The aim of the present study was to determine whether the associations between personal and environmental variables and children's fruit and vegetable intake, and healthy dietary behaviours are moderated by SEP. A total of 395 children aged 9 to 13 years and their parents were recruited in Adelaide, South Australia. Personal and environmental dietary predictors were measured using child-completed online questionnaires and telephone interviews with parents. Dietary intake was measured using an online FFQ. First, dietary predictors were identified using correlated component regression, and subsequently tested for moderation by four SEP indicators using partial least-squares structural equation modelling. Fruit and vegetable intake and healthy behaviours were predicted by self-efficacy, attitudes and a supportive home environment. For girls, only the associations of self-efficacy with healthy behaviours were moderated by occupation. For boys, income moderated the associations of fruit and vegetable intake with attitudes, and healthy behaviours with supportive home environments. Occupation and employment moderated the associations of boys' family environments and fruit intake, and attitudes with healthy behaviours. Reducing socio-economic disparities in children's healthy dietary intake may be more successfully achieved by tailoring health promotion policies and interventions according to variables that moderate the relationships between dietary intake and SEP. [ABSTRACT FROM PUBLISHER]

Objective: To describe the rationale, development and implementation of the quantitative component of evaluation of a multi-setting, multi-strategy, community- based childhood obesity prevention project (the eat well be active (ewba) Community Programs) and the challenges associated with this process and some potential solutions. Design: ewba has a quasi-experimental design with intervention and comparison communities. Baseline data were collected in 2006 and post-intervention measures will be taken from a non-matched cohort in 2009. Schoolchildren aged 10-12 years were chosen as one litmus group for evaluation purposes. Setting: Thirty-nine primary schools in two metropolitan and two rural communities in South Australia. Subjects: A total of 1732 10-12-year-old school students completed a nutrition and/ or a physical activity questionnaire and 1637 had anthropometric measures taken; 983 parents, 286 teachers, thirty-six principals, twenty-six canteen and thirteen outof-school-hours care (OSHC) workers completed Program-specific questionnaires developed for each of these target groups. Results: The overall child response rate for the study was 49%. Sixty-five per cent, 43%, 90 %, 90% and 68% of parent, teachers, principals, canteen and OSHC workers respectively, completed and returned questionnaires. A number of practical, logistical and methodological challenges were experienced when undertaking this data collection. Conclusions: Learnings from the process of quantitative baseline data collection for the ewba Community Programs can provide insights for other researchers planning similar studies with similar methods, particularly those evaluating multi-strategy programmes across multiple settings. [ABSTRACT FROM AUTHOR]

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

Few studies have investigated physical activity changes over the transition from primary to secondary school. This study assessed change in physical activity and the psychosocial correlates across 12 months in two cohorts of adolescent girls, who were either in primary school in year 1, moving to secondary school in year 2 (Transition cohort) or an older cohort (Secondary cohort) who remained in early secondary school. Female adolescents ( n = 191; 38% response rate) in South Australia self-reported physical activity and psychosocial correlates of physical activity. Changes between baseline and 12-month follow-up were assessed using paired t-tests. Multiple regression modelling identified psychosocial predictors of physical activity change. Physical activity declined in the transition but not the secondary cohort. The decline was most pronounced during school break times. Independent predictors of physical activity change were: change in enjoyment in the transition cohort; and changes in enjoyment, perceived outcomes, and friend encouragement in the secondary cohort. Transitioning from primary to secondary school is a critical period during which physical activity typically declines, particularly among females. Effective physical activity promotion in this vulnerable group will depend on a deeper understanding of the sociocultural, curricular and environmental influences on physical activity that are unique to each school context.

Physical activity has numerous associated benefits for cancer survivors. Compared to their urban counterparts, rural and remote Australians experience a health disadvantage, including poorer survival rate after the diagnosis of cancer. The purpose of this qualitative study was to (a) investigate factors that motivated or inhibited walking in rural participants during a 12-week intervention and (b) to investigate factors that motivated or inhibited physical activity behavior change three months post-intervention. Ten cancer survivors living in rural areas of South Australia participated in a 12-week computer-delivered walking-based intervention during which they reported daily steps, daily affect, and ratings of perceived exertion. Based on this information, individualized daily step goals were sent to them to increase walking. Following the intervention, participants engaged in face-to-face semi-structured interviews. Interviews were recorded, transcribed and coded using thematic analysis. Participants identified a range of physical, psychological, social, environmental, and organizational motivators and barriers. Participants appreciated the monitoring and support from the research team, but some voiced a need for better transition to post-program and many desired ongoing support to maintain their motivation. Future studies should incorporate strategies to help walking behavior to become more intrinsically motivated and therefore sustained.

Objectives: The present study investigated the effectiveness of a school-based sleep education programme in improving key sleep behaviours, sleep knowledge, and sleep hygiene., Design and Methods: A cross-sectional cluster-randomised controlled trial with two groups (Intervention and Control) and three assessment time points [baseline, immediately post intervention (6 weeks post baseline) and follow-up (18 weeks post baseline)] was employed. A total of 296 students (mean age = 12.2 ± 0.6 years; 59% female) from 12 schools in Adelaide, South Australia, were recruited, with 149 participants in the Intervention group and 147 in the Control group. The intervention consisted of four classroom lessons delivered at weekly intervals, followed by a group project on sleep topics, which students presented at a parental information evening. Sleep patterns were assessed objectively (actigraphy, n = 175) and subjectively (time-use recall, n = 251) at three time points. Sleep knowledge and sleep hygiene (n = 296) were also measured., Results: Generalised estimating equations were used to compare changes in the Intervention and Control groups. The programme increased time in bed by 10 min (p = 0.03) for the Intervention group relative to the Control group, due to a 10-min delay in wake time (p = 0.00). These changes were not sustained at follow-up. There was no impact on sleep knowledge or sleep hygiene., Conclusion: Investment in the sleep health of youth through sleep education is important but changes to sleep patterns are difficult to achieve. More intensive programmes, programmes with a different focus or programmes targeting different age groups may be more effective., (Copyright © 2015 Elsevier B.V. All rights reserved.)

Objective: To determine whether people with a history of cancer have a higher prevalence of chronic conditions or different lifestyle behaviour compared with controls., Design, Setting and Participants: Cross-sectional, self-reported data from a telephone survey conducted between 1 January 2010 and 31 March 2012 of adult residents of South Australia who self-reported a previous cancer diagnosis (cases) and randomly selected age- and sex-matched residents with no cancer diagnosis (controls)., Main Outcome Measures: Self-reported medically diagnosed cardiovascular disease, hypertension, hyperlipidaemia, diabetes and osteoporosis; lifestyle behaviour (smoking, physical activity and diet); body mass index (BMI); psychological distress and self-reported health., Results: A total of 2103 cases and 4185 controls were included in the analyses. For men, after adjusting for age, cancer survivors were more likely than controls to have ever had cardiovascular disease (P<0.001), high blood pressure (P=0.001), high cholesterol (P<0.001) and diabetes (P=0.04). These associations remained significant after controlling for socioeconomic status (SES), with the exception of high blood pressure (P=0.09). For women, there was an increased prevalence of high cholesterol (P=0.005), diabetes (P=0.02) and osteoporosis (P=0.005) in cancer cases, but after adjusting for SES, these associations were no longer significant. Women with a previous cancer diagnosis were more likely than controls to have ever smoked, after adjusting for SES (P=0.001). There were no other differences in lifestyle behaviour or BMI between cases and controls for men or women., Conclusion: Despite similar lifestyle habits and BMI, the prevalence of chronic conditions was significantly higher among people with a history of cancer than among controls without cancer. This supports the importance of chronic disease management as part of health care after a diagnosis of cancer.

Background: The after-school period is potentially a "critical window" for promoting physical activity in children. The purpose of this study was to qualitatively explore children's perceptions of the factors influencing their engagement in physical activity during the after-school period as the first phase in the development of a questionnaire., Methods: Fifty-four South Australian children age 10-13 years participated in same gender focus groups. Transcripts, field notes, and activity documents were analyzed using content analysis. Through an inductive thematic approach, data were coded and categorized into perceived barriers and facilitators according to a social ecological model., Results: Children identified a number of factors, including safety in the neighborhood and home settings, distance to and from places, weather, availability of time, perceived competence, enjoyment of physical activity, peer influence, and parent influence. New insights into bullying and teasing by peers and fear of dangerous animals and objects were revealed by the children., Conclusions: In this study, hearing children's voices allowed the emergence of factors which may not be exposed using existing surveys. These findings are grounded in children's perceptions and therefore serve as a valuable contribution to the existing literature, potentially leading to improved intervention and questionnaire design.

Objectives: To explore children's perceptions of the factors influencing their engagement in physical activity during the "critical" lunchtime period, using a social-ecological framework., Design: This study was an in-depth descriptive qualitative design., Methods: Fifty-four South Australian children aged 10-13 years participated in same-gender focus groups. Transcripts, field notes and activity documents were analysed using content analysis. Using an inductive thematic approach, data were coded and categorised into perceived barriers and facilitators according to a social-ecological model., Results: Children identified a range of environmental, social and intrapersonal barriers and facilitators. Bullying/teasing, the school uniform and school rules were exposed as explicit barriers to lunchtime play. Other important barriers included lack of access to, and poor suitability of, space, lack of access to programs/facilities and equipment, and lack of peer and teacher support. Perceived facilitators of lunchtime physical activity centred on access to equipment, enjoyment, motivation to improve skills, and peer support and acceptance. The freedom to make up or modify rules for games was also perceived to be a facilitator of lunchtime play., Conclusions: Communicating with children has been an effective approach in uncovering perceived barriers and facilitators to lunchtime play that may not have been previously considered in the quantitative correlate literature. Lunchtime interventions targeting children's physical activity should focus on addressing the barriers perceived to be important to lunchtime play., (Copyright © 2011 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.)

Organised sport among youth makes a substantial contribution to daily energy expenditure. This study investigated socioeconomic gradients in sport participation and predictors of participation. A representative sample of young South Australians (10-15 y; n=1737) was surveyed on organised sport participation in the previous 12 months, and predictors derived from the Children's Physical Activity Correlates scale and a parent survey. Four constructs were derived: 'is it worth it?' (perceived outcomes); 'am I able?' (perceived competency); 'reinforcing' (parental support); and 'enabling' (perceived barriers, from the parent survey). Socioeconomic position (SEP) was operationalized by an area-level indicator, the Socioeconomic Indicator for Advantage (SEIFA), split into tertiles. Sport participation was higher among high (highest SEIFA tertile) compared with low (lowest SEIFA tertile) SEP children. All predictors except 'am I able?' were positively associated with sport participation among boys and girls. Of these predictors, the 'enabling' construct varied by SEP among both boys and girls, with high SEP children reporting fewer barriers to participation. High SEP girls reported higher scores on 'reinforcing' and 'is it worth it?' than their low SEP counterparts. Low SEP girls reported lower levels of both instrumental and affective support from parents to play sport. There are distinct SEP gradients in sport participation, as well as its psychosocial and environmental predictors among South Australian youth. Low SEP girls are the most disadvantaged in terms of parental support to participate in sport. Interventions targeting this vulnerable group are urgently required., (2009 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.)

Rising youth obesity is a serious public health concern. There is a widespread view that declining physical activity is contributing to this trend. A total of 929 young South Australians (age=9-15 years) were surveyed in 1985 and 2004 on usual physical activity in several contexts, including attitudes to physical activity. Eight of 10 South Australian schools participating in the 1985 Schools Health and Fitness Survey were revisited in 2004. Comparisons were made on: organised sport, active transport, physical education (PE), playground activity, vigorous physical activity (VPA), total leisure-time physical activity (LTPA), and attitudes to PE and school sport. The questionnaire and method of administration were identical in both surveys. There were no differences between surveys in club and school sport participation, walking to school, and reported enjoyment of PE and school sport. In 2004 fewer children rode to school, but PE classes were more frequent. The percentage of children who 'sit and talk' during school breaks had increased, with a decreased percentage of older girls who 'run around' during school breaks. There was a significantly higher LTPA in MET.min in 2004 for boys, which was particularly evident at higher percentiles. There were no changes in mean or distribution of LTPA for the whole sample or girls. The percentage of respondents reporting >/=3 bouts of VPA in the previous week rose from 51% (1985) to 76% (2004). There is no consistent evidence of declining physical activity among South Australian youth. It is apparent that physical activity in some contexts has declined, while in other contexts levels are the same or higher than in 1985. This underscores the complex nature of physical activity and the influences on this behaviour.

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

Objective: The purpose of this study was to examine differences in cardiovascular disease (CVD) risk factors across four cross-tabulated groups of cardiorespiratory fitness and body fatness in youth., Methods: Subjects included 860 males and 755 females aged 9-15 yr from the Australian Schools Health and Fitness Survey. Participants were cross-tabulated into four groups using percent body fat and estimated maximal oxygen consumption (VO2max) to split the groups. CVD risk factors included blood pressure, triglycerides (TG), fasting total cholesterol (CHOL), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), and TC:HDL-C., Results: In males, significant differences across groups were observed for blood pressure, TG, HDL-C, LDL-C, and TC:HDL-C (P < 0.05). In females, significant group differences were observed for blood pressure and HDL-C (P < 0.05). In females, a significant difference was also evident between those in the high-fat/high-fitness group compared with the high-fat/low-fitness group for all blood pressure measures. A general trend of lower blood pressure values for both males and females in the low-fat group compared with the high-fat group was also observed. This same trend was found for males in the blood lipids. There was a linear relationship across groups for the CVD risk score for both genders. There were also significant differences between the low- and high-fat subgroups within a fitness group for both genders., Conclusion: The results provide evidence for the consideration of both fatness and fitness when interpreting CVD risk factors in youth, particularly among high-fat youth.

Objective: To compare rates of change in South Australian children's body composition between 1997 and 2002 in subsamples based on location of residence and socioeconomic status., Methods: Year 6 children from randomly selected South Australian schools in 1997 (32 schools, n=1,423) and 2002 (29 schools, n=992) were compared on: body mass index (BMI), sum of triceps and abdominal skinfolds (skinfold sum) and waist girth. Samples were partitioned into urban (population >20,000) and rural (<10,000) subsamples, and low, medium and high SES. ANCOVA, controlling for boys' decimal age and girls' predicted menarcheal age, was conducted for the whole sample, and where interactions were significant, separately in socio-demographic strata., Results: Between surveys, there were significant increases in boys' waist girth (p=0.004) and skinfold sum (p=0.007), and girls' BMI (p=0.0005) and skinfold sum (p<0.0001). There were significant interactions of survey year and sociodemographic variables among girls only. While there were no significant changes in anthropometric variables among rural and high SES girls, urban girls increased in skinfold sum (p<0.0001), waist girth (p=0.033) and BMI (p=0.0007). Low (p<0.0001) and medium (p=0.001) SES girls' skinfold sum increased between surveys., Conclusions: Secular trends in Australian children's body fatness are continuing. Further, the rates of change in girls are affected by the socio-demographic milieu., Implications: The development of targeted interventions to combat child obesity will depend on a clearer understanding of how environmental influences on weight status are distributed across the sociodemographic landscape.