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

Objective: There is limited understanding as to why children of low socio-economic position (SEP) consume poorer diets than children of high SEP. Evidence suggests that determinants of dietary intake may differ between SEP groups. The present study aimed to determine if SEP moderated associations of personal and environmental predictors with children's non-core food and sweetened drink intakes and unhealthy dietary behaviours.Design: Children completed online questionnaires and parents completed computer-assisted telephone interviews to assess intrapersonal and environmental dietary predictors. Dietary intake was measured using an FFQ. Parents reported demographic information for maternal education, occupation and employment, and household income.Setting: Twenty-six primary schools in South Australia, Australia.Subjects: Children aged 9-13 years and their parents (n 395).Results: Multiple personal and home environment factors predicted non-core food and sweetened drink intakes, and these associations were moderated by SEP. Maternal education moderated associations of girls' sweetened drink intake with self-efficacy, cooking skills and pressure to eat, and boys' non-core food intake with monitoring, parent's self-efficacy and home environment. Maternal occupation and employment moderated associations of sweetened drink intake with attitudes, self-efficacy, pressure to eat and food availability, and non-core food intake with parents' self-efficacy and monitoring. Income moderated associations with pressure to eat and home environment.Conclusions: Identifying differences in dietary predictors between socio-economic groups informs understanding of why socio-economic gradients in dietary intake may occur. Tailoring interventions and health promotion to the particular needs of socio-economically disadvantaged children may produce more successful outcomes and reduce socio-economic disparities in dietary intake. [ABSTRACT FROM AUTHOR]

Objective: During the early years, parents have a major influence on children’s diets and developing food choices. We investigated parenting styles as predictors of 2–5-year-old children’s diets and whether general nutrition knowledge (GNK) mediated these influences.Design: Cross-sectional research. Questionnaires measured demographic and lifestyle variables, family environment, parenting styles and feeding practices, child diet and GNK. Regression models tested GNK as a mediator of relationships between parenting variables and child diet (fruit/vegetable and non-core food consumption), controlling for confounders and family environment.Setting: Questionnaires were completed by main caregivers at home.Subjects: Parents of children aged 2–5 years (n 269).Results: Higher child fruit/vegetable consumption was associated with lower overreactive parenting and restriction, higher authoritative parenting and dining together as a family; with lax parenting approaching statistical significance (P50?083) and 19% of variance explained by the model. GNK was not a significant predictor. Conversely, non-core food consumption was associated with higher over-reactive and lax parenting as well as child age, increased takeaway food consumption and higher television viewing; GNK had a small effect (P = 0.043) and 28% of variance was explained by the model. GNK was a significant mediator only for authoritative parenting on non-core food (effect = -0.005).Conclusions: These findings highlight that young children’s diets may be improved by interventions targeting a range of positive and supportive parenting practices in conjunction with nutrition knowledge education for parents of young children. Further insights will come from closer attention to the nature and role of restrictive feeding practices v. laxness and longitudinal research. [ABSTRACT FROM AUTHOR]

Objective: Young children's knowledge about healthy food may influence the formation of their eating behaviours, and parents have a major influence on the development of children's knowledge in the early years.Design: We investigated the extent to which parental nutrition knowledge and attitudes around food predicted young children's knowledge of healthy foods, controlling for other influences such as socio-economic status (SES) and parent education levels in a cross-sectional research design. Children were given a healthy food knowledge activity and parents completed questionnaires.Setting: Twenty primary schools in Adelaide, Australia, stratified by SES.Subjects: We recruited 192 children aged 5-6 years and their parents.Results: Structural equation modelling showed that parent nutrition knowledge predicted children's nutrition knowledge (r = 0·30, P < 0·001) independently of attitudes, SES and education level.Conclusions: Nutrition education for parents, targeted at low-SES areas at higher risk for obesity, may contribute to the development of healthy food knowledge in young children. [ABSTRACT FROM AUTHOR]

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]

Summary: Social support is a consistent correlate of youth physical activity (PA) but few studies have examined this in cultural sub-groups. Female adolescents (n =113; 13.9±0.6years) from a metropolitan single sex private school participated in this study. PA was estimated using the 3 Day Physical Activity Recall (3dPAR), and aspects of social support using a specifically designed questionnaire. Anglo-Australians (n =74), whose parents were both born in Australia, were compared with Vietnamese-Australians (n =39), whose parents were both born in Vietnam. There were non-significant trends towards higher engagement in all measures of PA among Anglo-Australians. Anglo-Australians perceived higher levels of social support to be physically active. In the whole sample and in cultural sub-groups, support by mothers was a consistent predictor of PA. Among Vietnamese-Australians, activities shared with the mother predicted moderate to vigorous PA. Interventions targeting PA among adolescent females should consider interactions of social support and cultural background. [Copyright &y& Elsevier]

Approaches to weight management have traditionally focussed on caloric intake versus caloric expenditure. Despite a range of interventions based on these approaches, the proportion of overweight children and adolescents continues to rise. There are increasing indications that other factors, such as sleep duration, may be at play. This commentary on current research related to the impact of sleep duration provides an insight into the mounting evidence of its possible link to overweight in children and adolescents. Here we focus on children and adolescents as typical age cohorts in schools experiencing health and physical education programs. Children and adolescents are sleeping less than ever before, and there is now emerging evidence that sleep duration has a profound effect on weight regulating hormones leading to weight gain. It is proposed that a 24-hour view of children and adolescents be taken into account. Moreover, a reassessment of the impact of sleep deprivation may lead to extra considerations in the information and practices embodied in the HPE curricula for the growing battle against obesity. [ABSTRACT FROM AUTHOR]

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

Background: Socio-economic position (SEP) in adolescence may influence diet quality over the life course. However, knowledge of whether individual and environmental determinants of diet quality mediate the longitudinal association between SEP and diet quality is limited. This study examined whether and to what extent food-related capabilities, opportunities and motivations of adolescents mediated the longitudinal association between SEP in adolescence and diet quality in early adulthood overall and by sex. Methods: Longitudinal data (annual surveys) from 774 adolescents (16.9 years at baseline; 76% female) from ProjectADAPT (T1 (baseline), T2, T3) were used. SEP in adolescence (T1) was operationalized as highest level of parental education and area-level disadvantage (based on postcode). The Capabilities, Opportunities and Motivations for Behaviour (COM-B) model was used as a framework to inform the analysis. Determinants in adolescence (T2) included food-related activities and skills (Capability), home availability of fruit and vegetables (Opportunity) and self-efficacy (Motivation). Diet quality in early adulthood (T3) was calculated using a modified version of the Australian Dietary Guidelines Index based on brief dietary questions on intake of foods from eight food groups. Structural equation modelling was used to estimate the mediating effects of adolescents' COM-B in associations between adolescent SEP and diet quality in early adulthood overall and by sex. Standardized beta coefficients (β) and robust 95% confidence intervals (CI) were generated, adjusted for confounders (T1 age, sex, diet quality, whether still at school, and living at home) and clustering by school. Results: There was evidence of an indirect effect of area-level disadvantage on diet quality via Opportunity (β: 0.021; 95% CI: 0.003 to 0.038), but limited evidence for parental education (β: 0.018; 95% CI: -0.003 to 0.039). Opportunity mediated 60.9% of the association between area-level disadvantage and diet quality. There was no evidence of an indirect effect via Capability or Motivation for either area-level disadvantage or parental education, or in males and females separately. Conclusions: Using the COM-B model, the home availability of fruit and vegetables (Opportunity) of adolescents explained a large proportion of the association between area-level disadvantage in adolescence and diet quality in early adulthood. Interventions to address poor diet quality among adolescents with a lower SEP should prioritize environmental determinants of diet quality. [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]

Purpose: People affected by cancer who live in rural Australia experience inferior survival compared to their urban counterparts. This study determines whether self-reported physical and mental health, as well as health-promoting behaviours, also differ between rural and urban Australian adults with a history of cancer.Methods: Weighted, representative population data were collected via the South Australian Monitoring and Surveillance System between 1 January 2010 and 1 June 2015. Data for participants with a history of cancer (n = 4295) were analysed with adjustment for survey year, gender, age group, education, income, family structure, work status, country of birth and area-level relative socioeconomic disadvantage (SEIFA).Results: Cancer risk factors and co-morbid physical and mental health issues were prevalent among cancer survivors regardless of residential location. In unadjusted analyses, rural survivors were more likely than urban survivors to be obese and be physically inactive. They were equally likely to experience other co-morbidities (diabetes, chronic obstructive pulmonary disease, cardiovascular disease, arthritis or osteoporosis). With adjustment for SEIFA, rural/urban differences in obesity and physical activity disappeared. Rural survivors were more likely to have trust in their communities, less likely to report high/very high distress, but equally likely to report a mental health condition, both with and without adjustment for SEIFA.Conclusions: There is a need for deeper understanding of the impact of relative socioeconomic disadvantage on health (particularly physical activity and obesity) in rural settings and the development of accessible and culturally appropriate interventions to address rural cancer survivors' specific needs and risk factors. [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]