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Screen time and physical activity behaviours develop during the crucial early childhood period (0-5 years) and impact multiple health and developmental outcomes, including psychosocial wellbeing. Social skills, one component of psychosocial wellbeing, are vital for children's school readiness and future mental health. This study investigates potential associations of screen time and outdoor play (as a proxy for physical activity) with social skills. Cross sectional data were available for 575 mothers with a child (54% boys) aged 2-5 years. Mothers reported their child's screen time, outdoor play time and social skills (Adaptive Social Behavior Inventory; ASBI). Multiple linear regression analyses assessed associations of screen and outdoor play time (Model 1) and compliance with screen time and physical activity recommendations (Model 2) with three ASBI subscales. Boys and girls spent a mean of 2.0 and 2.2 hours per day in screen time, and 3.3 and 2.9 hours per day in outdoor play, respectively. Girls scores for express and comply skills were significantly higher than boys (p<0.005). After applying the Benjamini-Hochberg Procedure to adjust for multiple associations, children's television/DVD/video viewing was inversely associated with their compliant scores (B = -0.35 95% CI -0.26, -0.14; p = 0.001) and outdoor play time was positively associated with both expressive (B = 0.20 95% CI 0.07, 0.34; p = 0.004) and compliant (B = 0.22 95% CI 0.08, 0.36; p = 0.002) scores. Findings indicate that television/DVD/video viewing may be adversely, and outdoor play favourably, associated with preschool children's social skills. Future research is required to identify the direction of causation and explore potential mechanisms of association.

Women living in socioeconomically disadvantaged neighbourhoods are at heightened risk of experiencing psychological stress. Therefore, identifying potential risk factors for stress is important to support positive mental health. A growing body of research has linked sedentary behaviour with mental ill-health (e.g., depression and anxiety); however, little research has specifically investigated potential linkages between sedentary behaviour and stress. Therefore, the aim of this study was to investigate the association between common types of sedentary behaviour and objectively-measured stress (as measured by hair cortisol levels) amongst women living in socioeconomically disadvantaged neighbourhoods. During 2012-2013, 72 women (aged 18-46 years) living in socioeconomically disadvantaged neighbourhoods self-reported sedentary behaviour (TV viewing, computer use, overall sitting time) and provided hair samples. Hair cortisol levels were measured using enzyme-linked immunosorbent assay. Linear regression models examined cross-sectional associations between sedentary behaviour and hair cortisol levels. There was no association between any type of sedentary behaviour (TV viewing, computer use, or overall sitting time) and hair cortisol levels in either crude or adjusted models. Sedentary behaviour may not be linked to hair cortisol level (stress) in women living in socioeconomically disadvantaged neighbourhoods. Further studies utilising objective measures of both sedentary behaviour and stress are required to confirm these findings., Competing Interests: The authors declare no conflict of interest. The founding sponsors had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, and in the decision to publish the results.

Background: maternal postpartum weight retention (PPWR) has implications for short and long term weight-related health of both the mother and child. Little is known about how mothers perceive they may be best supported to achieve a healthy postpartum weight and healthy lifestyle behaviours. Evaluating existing postpartum weight focussed intervention strategies is an important step in the planning of future programs aimed at supporting new mothers., Aim: to describe the perspectives of women who completed the mums OnLiNE pilot intervention, regarding the acceptability and effectiveness of a program which aimed to limit PPWR and promote healthy diet and physical activity behaviours in new mothers., Method: descriptive qualitative research methods utilising semi-structured interview questions to explore new mothers' views regarding their participation in the mums OnLiNE intervention were used. All women who completed the intervention were invited to participate in one-on-one interviews via telephone. Interviews were digitally recorded and transcribed verbatim. Data were analysed utilising thematic analysis for common, emerging themes., Findings: twelve women participated in the interviews. Six main themes including program usefulness, intervention components, walking, self-monitoring, barriers and challenges and future recommendations described women's views of the mums OnLiNE intervention. Women felt well supported being part of the program and their reported awareness of healthy eating increased. Telephone support was the most valued and helpful component of the intervention and the smartphone application for self-monitoring was used more often than the website. Walking was by far the most preferred activity as it was considered enjoyable and achievable and some reported that their incidental walking increased as a result of being part of the program. Lack of time and motivation were the main barriers to participation in the program. Suggestions for future programs included encouraging group support and mother-baby exercise sessions., Conclusion: women perceived the mums OnLiNE intervention to be useful in promoting a healthy lifestyle and valued the support provided. Whilst barriers to participation in healthy lifestyle programs exist, well planned interventions which consider time constraints of new mothers, utilize one-on-one support and offer social engagement with other new mothers may further support women in their attainment of healthy postpartum weight and lifestyle behaviours., (Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.)

This study aimed to investigate the bi-directional relationship between different domains of physical activity (PA), sedentary behaviour (SB) and depressive symptoms among women living in socioeconomically disadvantaged neighbourhoods in Victoria, Australia. Women (n=1033), aged 18-46years at Wave 1 (2007/08), completed self-report measures of PA (leisure-time, transport, occupational, domestic), SB (TV viewing, computer use, overall sitting time) and depressive symptoms (CES-D 10) at each study time-point (Wave 2: 2010/11, Wave 3: 2012/13). Separate linear mixed models were fitted to examine if change in depressive symptoms differed dependent on each of the baseline PA or SB measures. Similarly, baseline depressive symptoms were used as a predictor of change in PA and SB. In secondary analyses, associations between baseline PA or SB and odds of becoming 'at risk' of depression among those not 'at risk' at baseline were examined using logistic regression. There was no evidence that change in depressive symptoms differed depending on PA or SB at baseline. In general, there was also no evidence that change in PA or SB differed depending on baseline depressive symptoms. One exception was change in leisure-time PA, which declined more among those with heightened depressive symptoms at baseline (Interaction: β=-0.003, 95% CI=-0.007, -0.0003). Transport-related PA (adjusted OR=1.06, 95% CI=1.013, 1.101) and domestic PA (adjusted OR=1.02, 95% CI=1.003, 1.040) were associated with greater odds of becoming at risk of depression at wave 3. There was limited evidence of a bi-directional relationship between PA, SB and depressive symptoms in women living in socioeconomically disadvantaged neighbourhoods., (Copyright © 2017 Elsevier Inc. All rights reserved.)

Background: Lower back pain is a global health issue affecting approximately 80% of people at some stage in their life. The current literature suggests that any exercise is beneficial for reducing back pain. However, as pain is a subjective evaluation and physical deficits are evident in low back pain, using it as the sole outcome measure to evaluate superiority of an exercise protocol for low back pain treatment is insufficient. The overarching goal of the current clinical trial is to implement two common, conservative intervention approaches and examine their impact on deficits in chronic low back pain., Methods/design: Forty participants, 25-45 years old with chronic (>3 months), non-specific low back pain will be recruited. Participants will be randomised to receive either motor control and manual therapy (n = 20) or general strength and conditioning (n = 20) exercise treatments for 6 months. The motor control/manual therapy group will receive twelve 30-min sessions, ten in the first 3 months (one or two per week) and two in the last 3 months. The general exercise group will attend two 1-hour sessions weekly for 3 months, and one or two a week for the following 3 months. Primary outcome measures are average lumbar spine intervertebral disc T2 relaxation time and changes in thickness of the transversus abdominis muscle on a leg lift using magnetic resonance imaging (MRI). Secondary outcomes include muscle size and fat content, vertebral body fat content, intervertebral disc morphology and water diffusion measured by MRI, body composition using dual energy X-ray absorptiometry, physical function through functional tests, changes in corticospinal excitability and cortical motor representation of the spinal muscles using transcranial magnetic stimulation and self-reported measure of pain symptoms, health and disability. Outcome measures will be conducted at baseline, at the 3-month follow-up and at 6 months at the end of intervention. Pain, depressive symptomology and emotions will be captured fortnightly by questionnaires., Discussion: Chronic low back pain is ranked the highest disabling disorder in Australia. The findings of this study will inform clinical practice guidelines to assist with decision-making approaches where outcomes beyond pain are sought for adults with chronic low back pain., Trial Registration: Australian New Zealand Clinical Trials Registry, ACTRN12615001270505 . Registered on 20 November 2015.

Background: This study examined associations between alcohol outlet access and alcohol intake, depressive symptoms score and risk of depression among women residing in disadvantaged neighbourhoods in Victoria, Australia., Methods: Data on depressive symptoms, alcohol intake and socio-demographic characteristics were obtained from a sample of 995 adult women from Victoria, Australia who were surveyed as part of the Resilience in Eating and Activity Despite Inequality (READI) study. The location of all licensed alcohol outlets in Victoria was obtained from the Victorian Commission for Gambling and Liquor Regulation. Participant and alcohol outlet addresses were geocoded to calculate individual alcohol outlet access, defined as the number of outlets (all and by sub-type) within 0.4 km and 3 km of participants' homes. Separate regression models with clustered standard errors were fitted to examine associations between access and alcohol intake according to national recommended limits for short- and long-term harm, frequency of consumption above long-term harm guidelines, depressive symptoms score and risk of depression., Results: Odds of consumption within short-term harm guidelines (≤4 drinks on any day) decreased with increasing access within 3 km, irrespective of outlet type. Typically, there was no evidence to support associations between access and consumption above long-term harm guidelines (>2 drinks on any day) unless considering frequency of consumption at this level where results showed decreased odds of 'don't drink' versus frequently drinking above long-term harm guidelines (i.e., >2 drinks at least once per week) with increasing access at either distance. Although there was no evidence of an association between any of the alcohol outlet access measures and depressive symptoms score, odds of being at risk of depression decreased with increasing access within 3 km., Conclusions: This study found some evidence to support an association between increasing alcohol outlet densities of all types and harmful levels of alcohol consumption, and the association appears to be dependent on the distance threshold considered, among women residing in socioeconomically disadvantaged neighbourhoods within Victoria, Australia. However, higher numbers of alcohol outlets appear to be associated with a slightly lower risk of depression, with further research needed to identify the direction and mechanisms underlying this unintuitive association.

Background: Mental health disorders are a leading cause of disability worldwide, including in first-time mothers. Understanding the associations between diet and depressive symptoms could assist in improving mental health status in this group., Objective: Our aim was to determine the association between diet quality, fruit, vegetable, and fish consumption and depressive symptoms in first-time mothers aged 19 to 45 years., Design: We analyzed cross-sectional, baseline data (3 months postpartum) from the Melbourne InFANT (Infant Feeding, Activity, and Nutrition Trial) Extend Program., Participants/setting: Participants were first-time Australian mothers aged 19 to 45 years from the Geelong and Melbourne regions of Victoria, Australia (n=457)., Main Outcome Measures: A self-administered, 137-item food frequency questionnaire assessed dietary intake over the past year. Adherence to the 2013 Australian Dietary Guidelines was assessed using the Dietary Guideline Index as a measure of diet quality. Depressive symptoms were determined using the Center for Epidemiologic Studies Depression Scale., Statistical Analysis Performed: Relationships between diet quality, fruit, vegetable, and fish intake and depressive symptoms were investigated using linear regression adjusted for relevant covariates (age, smoking status, sleep quality, education, physical activity status, and body mass index)., Results: Better diet quality, as indicated by a higher score on the Dietary Guideline Index, was associated with lower depressive symptoms after adjusting for relevant covariates (β=-.034; 95% CI -.056 to -0.012). There were no other associations between dietary intake and depressive symptoms., Conclusions: Adherence to the Australian Dietary Guidelines was associated with better mental health status among first-time mothers. Further research, including longitudinal and intervention studies, are required to determine causality between dietary intake and depressive symptoms, which might help inform future public health nutrition programs for this target group., (Copyright © 2016 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.)

Objectives: Anxiety is a serious illness and women (including mothers with young children) are at particular risk. Although physical activity (PA) may reduce anxiety risk, little research has investigated the link between sedentary behaviour and anxiety risk. The aim of this study was to examine the association between screen-based sedentary behaviour and anxiety symptoms, independent of PA, amongst mothers with young children., Methods: During 2013-2014, 528 mothers with children aged 2-5 years completed self-report measures of recreational screen-based sedentary behaviour (TV/DVD/video viewing, computer/e-games/hand held device use) and anxiety symptoms (using the Hospital Anxiety and Depression Scale, HADS-A). Linear regression analyses examined the cross-sectional association between screen-based sedentary behaviour and anxiety symptoms., Results: In models that adjusted for key demographic and behavioural covariates (including moderate- to vigorous-intensity PA, MVPA), computer/device use (B = 0.212; 95% CI = 0.048, 0.377) and total screen time (B = 0.109; 95% CI = 0.014, 0.205) were positively associated with heightened anxiety symptoms. TV viewing was not associated with anxiety symptoms in either model., Conclusions: Higher levels of recreational computer or handheld device use and overall screen time may be linked to higher risk of anxiety symptoms in mothers with young children, independent of MVPA. Further longitudinal and intervention research is required to determine temporal associations.

Background: Numerous health benefits are associated with achieving optimal diet and physical activity behaviours during and after pregnancy. Understanding predictors of these behaviours is an important public health consideration, yet little is known regarding associations between clinician advice and diet and physical activity behaviours in postpartum women. The aims of this study were to compare the frequency of dietary and physical activity advice provided by clinicians during and after pregnancy and assess if this advice is associated with postpartum diet and physical activity behaviours., Methods: First time mothers (n = 448) enrolled in the Melbourne InFANT Extend trial completed the Cancer Council of Australia's Food Frequency Questionnaire when they were three to four months postpartum, which assessed usual fruit and vegetable intake (serves/day). Total physical activity time, time spent walking and time in both moderate and vigorous activity for the previous week (min/week) were assessed using the Active Australia Survey. Advice received during and following pregnancy were assessed by separate survey items, which asked whether a healthcare practitioner had discussed eating a healthy diet and being physically active. Linear and logistic regression assessed associations of advice with dietary intake and physical activity., Results: In total, 8.6% of women met guidelines for combined fruit and vegetable intake. Overall, mean total physical activity time was 350.9 ± 281.1 min/week. Time spent walking (251.97 ± 196.78 min/week), was greater than time spent in moderate (36.68 ± 88.58 min/week) or vigorous activity (61.74 ± 109.96 min/week) and 63.2% of women were meeting physical activity recommendations. The majority of women reported they received advice regarding healthy eating (87.1%) and physical activity (82.8%) during pregnancy. Fewer women reported receiving healthy eating (47.5%) and physical activity (51.9%) advice by three months postpartum. There was no significant association found between provision of dietary and/or physical activity advice, and mother's dietary intakes or physical activity levels., Conclusions: Healthy diet and physical activity advice was received less after pregnancy than during pregnancy yet no association between receipt of advice and behaviour was observed. More intensive approaches than provision of advice may be required to promote healthy diet and physical activity behaviours in new mothers., Trial Registration: Australian New Zealand Clinical Trials Registry ( ACTRN12611000386932 13/04/2011).

Background: Participant adoption and maintenance is a major challenge in strength training (ST) programs in the community-setting. In adults who were overweight or with type 2 diabetes (T2DM), the aim of this study was to compare the effectiveness of a standard ST program (SST) to an enhanced program (EST) on the adoption and maintenance of ST and cardio-metabolic risk factors and muscle strength., Methods: A 12-month cluster-randomized controlled trial consisting of a 6-month adoption phase followed by a 6-month maintenance phase. In 2008-2009, men and women aged 40-75 years (n = 318) with T2DM (n = 117) or a BMI >25 (n = 201) who had not participated in ST previously were randomized into either a SST or an EST program (which included additional motivationally-tailored behavioral counselling). Adoption and maintenance were defined as undertaking ≥ 3 weekly gym-based exercise sessions during the first 6-months and from 6-12 months respectively and were assessed using a modified version of the CHAMPS (Community Healthy Activity Models Program for Seniors) instrument., Results: Relative to the SST group, the adjusted odds ratio (OR) of adopting ST for all participants in the EST group was 3.3 (95 % CI 1.2 to 9.4). In stratified analyses including only those with T2DM, relative to the SST group, the adjusted OR of adopting ST in the EST group was 8.2 (95 % CI 1.5-45.5). No significant between-group differences were observed for maintenance of ST in either pooled or stratified analyses. In those with T2DM, there was a significant reduction in HbA1c in the EST compared to SST group during the adoption phase (net difference, -0.13 % [-0.26 to -0.01]), which persisted after 12-months (-0.17 % [-0.3 to -0.05])., Conclusions: A behaviorally-focused community-based EST intervention was more effective than a SST program for the adoption of ST in adults with excess weight or T2DM and led to greater improvements in glycemic control in those with T2DM., Trial Registration: Registered at ACTRN12611000695909 (Date registered 7/7/2011).

Background: Previous research has linked sedentary behaviour (SB) to adverse physical health outcomes in adults and youth. Although evidence for the relationship between SB and mental health outcomes (e.g., depression) is emerging, little is known regarding risk of anxiety., Methods: A systematic search for original research investigating the association between SB and risk of anxiety was performed using numerous electronic databases. A total of nine observational studies (seven cross-sectional and two longitudinal) were identified. Methodological quality of studies was assessed and a best-evidence synthesis was conducted., Results: One cross-sectional study demonstrated a strong methodological quality, five cross-sectional studies demonstrated a moderate methodological quality and three studies (two cross-sectional one longitudinal) received a weak methodological quality rating. Overall, there was moderate evidence for a positive relationship between total SB and anxiety risk as well as for a positive relationship between sitting time and anxiety risk. There was inconsistent evidence for the relationship between screen time, television viewing time, computer use, and anxiety risk., Conclusion: Limited evidence is available on the association between SB and risk of anxiety. However, our findings suggest a positive association (i.e. anxiety risk increases as SB time increases) may exist (particularly between sitting time and risk of anxiety). Further high-quality longitudinal/interventional research is needed to confirm findings and determine the direction of these relationships.

Background: Evidence suggests physical activity often declines during pregnancy, however explanations for the decline are not well understood. The aim of this study was to identify modifiable barriers to leisure-time physical activity among women who did not meet physical activity guidelines during pregnancy., Methods: Analyses were based on data from 133 mothers (~3-months postpartum) who were recruited from the Melbourne InFANT Extend study (2012/2013). Women completed a self-report survey at baseline in which they reported their leisure-time physical activity levels during pregnancy as well provided an open-ended written response regarding the key barriers that they perceived prevented them from meeting the physical activity guidelines during their pregnancy. Thematic analyses were conducted to identify key themes., Results: The qualitative data revealed six themes relating to the barriers of leisure-time physical activity during pregnancy. These included work-related factors (most commonly reported), tiredness, pregnancy-related symptoms, being active but not meeting the guidelines, lack of motivation, and a lack of knowledge of recommendations., Conclusion: Considering work-related barriers were suggested to be key factors to preventing women from meeting the physical activity guidelines during pregnancy, workplace interventions aimed at providing time management skills along with supporting physical activity programs for pregnant workers should be considered. Such interventions should also incorporate knowledge and education components, providing advice for undertaking leisure-time physical activity during pregnancy.

Background: Mental health conditions are among the leading non-fatal diseases in middle-aged and older adults in Australia. Proximal and distal social environmental factors and physical environmental factors have been associated with mental health, but the underlying mechanisms explaining these associations remain unclear. The study objective was to examine the contribution of different types of physical activity in mediating the relationship of social and physical environmental factors with mental health-related quality of life in middle-aged and older adults., Methods: Baseline data from the Wellbeing, Eating and Exercise for a Long Life (WELL) study were used. WELL is a prospective cohort study, conducted in Victoria, Australia. Baseline data collection took place in 2010. In total, 3,965 middle-aged and older adults (55-65 years, 47.4% males) completed the SF-36 Health Survey, the International Physical Activity Questionnaire, and a questionnaire on socio-demographic, social and physical environmental attributes. Mediation analyses were conducted using the MacKinnon product-of-coefficients test., Results: Personal safety, the neighbourhood physical activity environment, social support for physical activity from family or friends, and neighbourhood social cohesion were positively associated with mental health-related quality of life. Active transportation and leisure-time physical activity mediated 32.9% of the association between social support for physical activity from family or friends and mental health-related quality of life. These physical activity behaviours also mediated 11.0%, 3.4% and 2.3% respectively, of the relationship between the neighbourhood physical activity environment, personal safety and neighbourhood social cohesion and mental health-related quality of life., Conclusions: If these results are replicated in future longitudinal studies, tailored interventions to improve mental health-related quality of life in middle-aged and older adults should use a combined strategy, focusing on increasing physical activity as well as social and physical environmental attributes.

Emerging research suggests that prolonged sedentary behaviour (SB) is detrimental to health. Changes in SB patterns are likely to occur during particular life stages, for example at retirement age (55-65-year-old). Evidence on socio-ecological SB correlates is scarce and inconsistent in this age group. Moreover, the influence of socio-ecological correlates may vary depending on health and retirement status. This study examined social and environment correlates of overall weekend day sitting among adults at or approaching retirement age, and moderating effects of perceived physical health and retirement status. Baseline data from the Wellbeing, Eating and Exercise for a Long Life study in 2839 Australian adults (55-65-year-old) were analysed. Participants self-reported proximal social factors, neighbourhood social and physical environment, physical health and retirement status. MLwiN multilevel regression analyses were conducted. In the multivariable model, only social support from friends/colleagues to discourage sitting (B = -0.891; p = 0.036) was associated with overall weekend day sitting. No moderation of retirement status, nor physical health were found in the multivariable results. Results from this study suggest the importance of social factors in relation to weekend day sitting among 55-65-year-old adults. Health promotion initiatives in this age group should pay special attention to enhancing social interaction opportunities. Moreover, findings suggest that SB-specific correlates may need to be examined in future research.

Objective: Although recent cross-sectional research has suggested a positive association between sedentary behaviour and risk of depression, the direction of associations is unclear. This study aimed to investigate prospective associations between sedentary behaviour and risk of depression in both directions in socio-economically disadvantaged women., Methods: 1511 women, aged 18-45, completed self-report validated measures of sedentary behaviour (TV viewing, computer use, overall sitting time and screen time) as well as depressive symptoms (CES-D-10) in 2007/08 (T1) and 2010/11 (T2). Linear regression analyses examined associations between sedentary behaviours at T1 and depressive symptoms at T2, and multinomial logistic regression analyses examined associations between depressive symptoms at T1 and sedentary behaviours at T2., Results: Although prospective analyses indicated no association between T1 sedentary behaviours and depressive symptoms at T2, results showed that depressive symptoms at T1 were associated with higher levels of TV viewing (adjusted odds ratio: 1.032, 95% CI: 1.00, 1.07) at T2., Conclusions: Women's sedentary behaviour may not predict subsequent depressive symptoms; however, women's risk of depression may be predictive of engaging in greater amounts of TV viewing. Confirmation of these findings using further prospective and intervention study designs is required., (Copyright © 2014 Elsevier Inc. All rights reserved.)

Objectives: Little is known about how health behaviors such as physical activity (PA) and sedentary behaviors (SB) may be associated with psychosocial well-being during the crucial early childhood period. The aim of this study was to undertake a systematic review of associations between PA, SB and psychosocial well-being during early childhood., Methods: In February 2013, MEDLINE, PsycINFO, SPORTDiscus and Embase electronic databases were searched. Inclusion criteria were: 1. peer-reviewed publication since 1980 in English; 2. children aged birth-5 years; 3. PA or SB measured during early childhood; 4. an indicator of child psychosocial well-being; and 5. association between PA/SB and psychosocial well-being reported. Studies could be observational or interventions. Data were extracted by one author and entered into a standardized form in February and March 2013., Results: 19 studies were identified: four examined PA, 13 examined SB and two examined PA and SB. No interventions met the inclusion criteria; all included studies were observational. In total, 21 indicators of psychosocial well-being were examined, 13 only once with the remaining eight reported in more than one study. Some dose-response evidence was identified suggesting that PA is positively, and SB inversely, associated with psychosocial well-being., Conclusions: Too few studies exist to draw conclusions regarding associations. Future high-quality cohort and intervention studies are warranted particularly investigating dose-response associations., (Copyright © 2014 Elsevier Inc. All rights reserved.)

Background: Television (TV) viewing, a prevalent leisure-time sedentary behaviour independently related to negative health outcomes, appears to be higher in less educated and older adults. In order to tackle the social inequalities, evidence is needed about the underlying mechanisms of the association between education and TV viewing. The present purpose was to examine the potential mediating role of personal, social and physical environmental factors in the relationship between education and TV viewing among Australian 55-65 year-old adults., Methods: In 2010, self-reported data was collected among 4082 adults (47.6% men) across urban and rural areas of Victoria, for the Wellbeing, Eating and Exercise for a Long Life (WELL) study. The mediating role of personal (body mass index [BMI], quality of life), social (social support from family and friends, social participation at proximal level, and interpersonal trust, social cohesion, personal safety at distal level) and physical environmental (neighbourhood aesthetics, neighbourhood physical activity environment, number of televisions) factors in the association between education and TV viewing time was examined using the product-of-coefficients test of MacKinnon based on multilevel linear regression analyses (conducted in 2012)., Results: Multiple mediating analyses showed that BMI (p ≤ 0.01), personal safety (p < 0.001), neighbourhood aesthetics (p ≤ 0.01) and number of televisions (p ≤ 0.01) partly explained the educational inequalities in older adult's TV viewing. No proximal social factors mediated the education-TV viewing association., Conclusions: Interventions aimed to reduce TV viewing should focus on personal (BMI) and environmental (personal safety, neighbourhood aesthetics, number of televisions) factors, in order to overcome educational inequalities in sedentary behaviour among older adults.

Issue Addressed: The aim of this project was to identify effective recruitment and retention strategies used by health-promotion organisations that focus on increasing physical activity and improving nutrition within the local community., Methods: Semistructured telephone or face-to-face interviews with 25 key informants from stakeholder organisations were conducted. Key informants discussed strategies used by their organisation to effectively recruit and retain participants into community-based healthy eating and/or physical activity programs. Transcribed data were analysed with NVivo software., Results: Effective recruitment strategies included word of mouth, links with organisations, dissemination of printed materials, media, referrals, cross-promotion of programs and face-to-face methods. Effective retention strategies included encouraging a sense of community ownership, social opportunities, recruiting a suitable leader and offering flexibility and support. Fees and support for recruiting and retaining participants was also identified., Conclusion: This study provides novel insights to a greatly under researched topic in the field of health promotion. There are two key take-home messages from the present study that are applicable to health practitioners as well as developers and deliverers of community health-promotion programs: (1) it is imperative that all community health organisations report on the effectiveness of their recruitment and retention, both successes and failures; and (2) there is a clear need to tailor the recruitment and retention approach to the target population and the setting the program is occurring in. SO WHAT? These findings provide important insights for the development of future community-based healthy eating and physical activity programs.

Context: Postnatal depression is highly prevalent in mothers. Although physical activity has been found to reduce the risk of depression in the general population, little is known regarding its link with postnatal depression. This review examined original research investigating the relationship between physical activity and sedentary behavior dose (frequency, intensity, and duration) and domain, and postnatal depressive symptoms., Evidence Acquisition: A systematic search for original research investigating the relationship between physical activity and sedentary behavior dose and domain, and postnatal depressive symptoms, was performed using several electronic databases in early 2012. A total of ten observational and seven intervention studies were included., Evidence Synthesis: Most studies (one cross-sectional, two longitudinal, and six intervention studies) found an inverse association between postpartum leisure-time physical activity (LTPA) and postnatal depressive symptoms. One longitudinal study found that occupational physical activity was positively associated with postnatal depressive symptoms. There was inconclusive evidence to suggest an optimal dose of postpartum physical activity for reducing postnatal depressive symptoms. Two longitudinal studies found an inverse association between antenatal LTPA and presence of postnatal depressive symptoms. One of two studies that investigated sedentary behavior found a positive cross-sectional association between sedentary behavior and presence of postnatal depressive symptoms., Conclusions: Although studies are limited, on balance, LTPA prior to, during, and after pregnancy may be important for reducing the risk of postnatal depression. Further research is required to determine the optimal dose and domain of physical activity for reducing postnatal depressive symptoms as well as to examine the link between sedentary behavior and postnatal depressive symptoms., (Copyright © 2013 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.)

Socio-economically disadvantaged (e.g., less educated) women are at a greater risk of depression compared to less disadvantaged women. However, little is known regarding the factors that may explain socioeconomic inequalities in risk of depression. This study aimed to investigate the contribution of perceived neighbourhood factors in mediating the relationship between education and women's risk of depression. Cross-sectional data were provided by 4,065 women (aged 18-45). Women self-reported their education level, depressive symptoms (CES-D 10), as well as four neighbourhood factors (i.e., interpersonal trust, social cohesion, neighbourhood safety, and aesthetics). Single and multiple mediating analyses were conducted. Clustering by neighbourhood of residence was adjusted by using a robust estimator of variance. Multiple mediating analyses revealed that interpersonal trust was the only neighbourhood characteristic found to partly explain the educational inequalities in women's depressive symptoms. Social cohesion, neighbourhood aesthetics and safety were not found to mediate this relationship. Acknowledging the cross-sectional nature of this study, findings suggest that strategies to promote interpersonal trust within socioeconomically disadvantaged neighbourhoods may help to reduce the educational inequalities in risk of depression amongst women. Further longitudinal and intervention studies are needed to confirm these findings.

Since women living in socioeconomically disadvantaged neighborhoods are more likely to be physically inactive and engage in higher levels of sedentary behavior than women living in more advantaged neighborhoods, it is important to develop and test the feasibility of strategies aimed to promote physical activity and reduce sedentary behavior amongst this high-risk target group. Thirty-seven women (aged 19-85) living in a disadvantaged neighborhood, and five key stakeholders, received a suite of potential intervention materials and completed a qualitative questionnaire assessing the perceived feasibility of strategies aimed to increase physical activity and reduce sedentary behavior. Thematic analyses were performed. Women perceived the use of a locally-relevant information booklet as a feasible strategy to increase physical activity and reduce sedentary behavior. Including weight-loss information was suggested to motivate women to be active. Half the women felt the best delivery method was mailed leaflets. Other suggestions included reference books and websites. Many women mentioned that an online activity calendar was motivational but too time-consuming to commit to. Most women preferred the information booklet as a strategy to increase physical activity/reduce sedentary behavior, yet several suggested that using the booklet together with the online calendar may be more effective. These findings make an important contribution to research informing the development of intervention strategies to increase physical activity and reduce sedentary behavior amongst women living in disadvantaged neighborhoods.

Background: Physically inactive lifestyles and sedentary behaviors (SB) are key contributors to ill health. Although the association between SB (e.g., watching TV/using the computer) and physical health has been well documented, increasing research has focused on the possible link between SB and mental health (e.g., depression)., Purpose: This review aims to investigate the effect of SB on the risk of depression in adults., Method: A systematic search for original research articles investigating associations between SB and depression in adults was performed using the several electronic data bases., Results: A total of seven observational and four intervention studies were included in this review. All observational studies found positive associations between SB and risk of depression, while intervention studies showed contradictory results., Conclusion: Evidence for the relationship between SB and risk of depression in adults is limited by methodological weaknesses. However, on balance, this review suggests that SB is associated with an increased risk of depression. Further studies are needed assessing different types of SB and depression; the interrelationship between physical activity, SB, and depression; causal links between SB and depression; and intervention strategies aimed at reducing SB and their effects on risk of depression.

Background: The high prevalence of depression in women is an increasing public health concern. Although studies have found associations between physical activity (PA) and depression, little is known about the optimal domain, dose and social context of PA for reducing the risk of depression. This study aimed to investigate associations between specific components of PA (domain, dose and social context) and odds of depressive symptoms in women., Methods: The sample included 1,501 women, aged 18-65. Analyses were performed using cross-sectional data collected from a mail-out survey in 2004. The survey included self-report measures of PA behaviours and depressive symptoms. Crude and adjusted (age, marital status and physical health) odds ratios (OR) and 95% confidence intervals (CI) were calculated for each component of PA and odds of depressive symptoms using logistic regression analyses., Results: Those who reported more than 3.5 hours leisure-time PA per week had lower odds of depressive symptoms when compared to those who undertook less than this. No other domains of PA (eg. work-related, transport-related or domestic activity) were associated with odds of depressive symptoms. Odds of depressive symptoms were lower among women who reported more than 1.5 hours of moderate-intensity (OR = 0.67, CI = 0.45-0.98) or more than 1.75 hours vigorous-intensity (OR = 0.60, CI = 0.42-0.84) leisure-time PA per week. Being discouraged to be active by others was associated with higher odds of depressive symptoms (OR = 2.28, CI = 1.00-5.16), whilst being active with a family member was associated with lower odds of depressive symptoms (OR = 0.61, CI = 0.43-0.87)., Conclusion: Acknowledging the cross-sectional design, these findings suggest that the domain and social context of PA may be more important for mental health among women than simply the total dose of PA.

Objective: This review examines original research which has investigated associations between physical activity (PA) dose (i.e. frequency, intensity and duration) and domain and depression or symptoms of depression in adults., Methods: A search of electronic databases and authors' own bibliographic libraries was performed between 2006 and 2007 for original research articles investigating associations between PA and depression in adults. A total of 27 observational and 40 intervention studies were included., Results: Of the studies that focused on the association between duration of PA and likelihood of depression, all five observational studies, and five of the seven intervention studies found both shorter and longer durations of PA were associated with reduced likelihood of depression. Of the studies that focused on the association between intensity of PA and likelihood of depression, four of the six observational studies found that vigorous-intensity PA was more strongly associated with decreased likelihood of depression than lower intensities. Most intervention studies showed that both intensities were effective in reducing the likelihood of depression. Two observational studies found a stronger inverse relationship of leisure-time PA with depression than PA in other domains. There is insufficient evidence regarding the importance of the PA setting on depression., Conclusion: Although the dose and domain of physical activity varied across studies reviewed, evidence suggests that even low doses of PA may be protective against depression. Further studies examining the optimal domain of PA for reducing the likelihood of depression are needed.