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Vouchers that reduce the cost of sport and active recreation participation have been shown to increase children’s and adolescent’s physical activity levels. Yet, the influence of government-led voucher programs on the capacity of sport and active recreation organisations is unclear. This qualitative study explored the experiences of stakeholders in the sport and recreation sector that were engaged in implementing the New South Wales (NSW) Government’s Active Kids voucher program in Australia. Semi-structured interviews were conducted with 29 sport and active recreation providers. Interview transcriptions were analysed by a multidisciplinary team using the Framework method. Overall, participants reported that the Active Kids voucher program was an acceptable intervention to address the cost barrier to participation for children and adolescents. Three main steps influenced the capacity of organisations to deliver their sport and recreation programs and the voucher program: (1) Implementation priming—alignment of the intervention aims with stakeholder priorities and early information sharing, (2) Administrative ease—enhanced technology use and establishment of simple procedures, and (3) Innovation impacts—enablement of staff and volunteers to address barriers to participation for their participants. Future voucher programs should include strategies to enhance the capacity of sport and active recreation organisations to meet program guidelines and increase innovation.

Introduction Physical activity can improve academic performance; however, much less is known about the specific association between sport participation and academic performance, and this evidence has not been synthesized. Our aim was to systematically review and combine via meta-analyses evidence of the association between sport participation and academic performance in children and adolescents. Methods We conducted searches of five electronic databases using sport and academic performance related terms. We combined evidence from eligible studies using a structural equation modeling approach to multilevel meta-analysis. Results From 115 eligible studies, most of which had a high risk of bias (k = 87), we meta-analyzed 298 effect sizes. Overall, sport participation had a small positive effect on academic performance (d = 0.26, 95% confidence interval = 0.09, 0.42). Moderator analyses indicated that sports participation was most beneficial for academic performance when it was at a moderate dose (i.e., 1–2 h·wk−1), compared with no sport or a high dose of sport (3+ h·wk−1). Conclusions Sports participation during school hours was more beneficial for academic performance compared with sport participation outside school hours. Based on mostly low-quality studies, we found some evidence that sport could positively affect academic performance in children and adolescents. It appears that sport participation of a moderate dose and at school could be used to promote academic performance. However, if this field were to inform policy, high-quality studies are needed that provide insight into the effect of dose and sport characteristics on academic performance.

Background Throughout the ecosystem of sport, women have been and continue to be underrepresented at all levels compared to men. The capacity of community-level sport is heavily reliant on the many non-player roles including governance, as well as administration, coaching and officiating. Recently there has been increased attention to improving the gender balance in sport. The aim of this study is to investigate the proportions of women engaged in non-playing roles in sport (2016–2018). Methods This study involved secondary analysis of the AusPlay survey, a national population survey, funded by Sport Australia. This study utilised data from people aged 15-years or older about their involvement in non-playing roles in sport, and their demographic data. Survey respondents were asked “During the last 12 months, have you been involved with any sports in a nonplaying role, such as official, coach, referee, administrator, etc?” Analysis of non-player role responses focussed specifically on the top four non-player role categories; coach, official, administrator and manager. Frequency analysis concentrated on the distribution of men and women involvement in a non-player capacity for the three years, with detailed analysis of the most recent year (2018). Results In this study of 61,578 Australians there was a higher proportion of men in non-player roles in sport compared to women, across each of the three years (2018: men 55 %, women 46 %). Involvement of women in coaching increased significantly from 38 % to 2016 to 44 % in 2018 (p p Conclusions Aligned with strategic policy and investment strategies, there are gradual increased representation of women in non-playing sport, coaching roles. Women are still underrepresented in terms of coaches, officials and administrators, but are more likely to be managers. It is recommended that there is continued mentoring, identification and emphasising of female role models, and further strategies to increase female presence in non-playing roles. We recommend that future research, in line with appropriate gender and cultural-change theories, investigates and discusses the progress of gender equality throughout playing and non-playing role in sport.

Introduction The Active Kids voucher is a universal, state-wide voucher program, provided by the New South Wales (NSW) Government, Office of Sport. All school-aged children in NSW are eligible to receive a voucher to reduce registration costs of structured physical activity programs. This study explores reasons behind lower uptake among children who are overweight or obese, from cultural and linguistically diverse families and those living in low socio-economic areas. Methods Participants were recruited through a convenience sample of parent/carers who participated in the NSW Health Go4Fun program. Qualitative data was collected using focus groups. The Framework method was adapted for the analysis, taking an interpretive phenomenological approach. Results Study participants (n= 54) were all parents of children who were overweight or obese from both low and high socio-economic status (SES). Most reported speaking a primary language other than English at home (65%). Parents were mostly aware of the Active Kids program (91%) and reported that the voucher had a positive impact on their children's participation in structured physical activity. A range of socio-ecological factors, in addition to activity cost, influenced whether parents were able to use an Active Kids voucher and participate in structured physical activity. Conclusions The Active Kids voucher does not alleviate all barriers, particularly for families living in low socioeconomic areas. Engagement of this population in structured physical activities using the Active Kids vouchers could be strengthened through the implementation of effective interventions which comprehensively address the remaining barriers, such as access and flexibility of programs with local stakeholders and activity providers.

National strategies are needed to continue to promote the broader benefits of participating in sport and organised physical activity to reduce physical inactivity and related disease burden. This paper employs the RE-AIM framework to evaluate the impact of the federally funded $150 million Move it AUS program in engaging inactive people in sport and physical activity through the Participation (all ages) and Better Ageing (over 65 years) funding streams. A pragmatic, mixed-methods evaluation was conducted to understand the impact of the grant on both the participants, and the funded organisations. This included participant surveys, case studies, and qualitative interviews with funded program leaders. A total of 75% of participants in the Participation stream, and 65% in the Better Ageing stream, were classified as inactive. The largest changes in overall physical activity behaviour were seen among socioeconomically disadvantaged participants and culturally and linguistically diverse participants. Seven key insights were gained from the qualitative interviews: Clarity of who, Partnerships, Communication, Program delivery, Environmental impacts, Governance, and that Physical inactivity must be a priority. The Move It AUS program successfully engaged physically inactive participants. Additional work is needed to better engage inactive people that identify as culturally and linguistically diverse, Aboriginal and/or Torres Strait Islander and those that live in disadvantaged communities in sport and physical activities. Tangible actions from the seven key insights should be adopted into workforce capability planning for the sport sector to effectively engage physically inactive communities.

National strategies are needed to continue to promote the broader benefits of participating in sport and organised physical activity to reduce physical inactivity and related disease burden. This paper employs the RE-AIM framework to evaluate the impact of the federally funded $150 million Move it AUS program in engaging inactive people in sport and physical activity through the Participation (all ages) and Better Ageing (over 65 years) funding streams. A pragmatic, mixed-methods evaluation was conducted to understand the impact of the grant on both the participants, and the funded organisations. This included participant surveys, case studies, and qualitative interviews with funded program leaders. A total of 75% of participants in the Participation stream, and 65% in the Better Ageing stream, were classified as inactive. The largest changes in overall physical activity behaviour were seen among socioeconomically disadvantaged participants and culturally and linguistically diverse participants. Seven key insights were gained from the qualitative interviews: Clarity of who, Partnerships, Communication, Program delivery, Environmental impacts, Governance, and that Physical inactivity must be a priority. The Move It AUS program successfully engaged physically inactive participants. Additional work is needed to better engage inactive people that identify as culturally and linguistically diverse, Aboriginal and/or Torres Strait Islander and those that live in disadvantaged communities in sport and physical activities. Tangible actions from the seven key insights should be adopted into workforce capability planning for the sport sector to effectively engage physically inactive communities.

Purpose. This study investigated the effect of different sit–stand workstations on lumbar spine kinematics, lumbar muscle activity and musculoskeletal pain. Methods. Thirty-two office workers were ...

Objectives In 2018, the New South Wales (NSW) Government implemented a State-wide program to reduce the cost barrier to organised sport and physical activity participation. We explored parent/carer’s awareness and children’s engagement in the Active Kids program across socioeconomic groups and used the NSW Population Health Survey (PHS) to validate engagement in the program. Design Cross-sectional. Methods Data were obtained from the 2018 NSW PHS and the Active Kids program registration database. We compared demographic characteristics of children who had registered for the program in the registration database with children in the weighted NSW PHS. Multinomial regression models were used to determine whether socioeconomic status was associated with parent/carer awareness and children’s engagement in the program. Results Parent/carer’s in the most disadvantaged quartile were twice as likely to have never heard of the Active Kids program (OR: 2.04, 95% CIs 1.31, 3.16) or to have heard or the program but not registered (OR: 1.94, 95% CIs 1.26, 3.00), and more than twice as likely to have registered for a voucher, but not followed through and redeemed the voucher (OR: 2.68, 95% CIs 1.27, 5.63) compared with the least disadvantaged quartile. Conclusions The Active Kids program has provided financial support for organised sport and physical activity to a large number of children. However, there are still a substantial proportion of socially disadvantaged groups who are unaware or have not engaged in the program. Further targeted work is required to increase the awareness and engagement in the program for socially disadvantaged groups.

Background Participation in organised sport and physical activity contributes to health-enhancing levels of leisure time physical activity. In Australia, 58% of children aged 0–14 years participated at least once a week in October 2015 – December 2017. To overcome the frequently cited cost barrier, sports voucher incentives have been widely implemented across Australia. Method The financial value of jurisdictional vouchers and the National median financial value were used to calculate the proportion of total annual expenditure on children’s participation in sport supported by sports vouchers. Participation rates using AusPlay data were estimated by age, sex and socio-economic index (SEIFA) at state and national level for children aged 0–14 years. Results Five States and Territories implemented sports vouchers from 2011 to 2018, with a median value of AU$150. Nationally, median annual expenditure for children’s sport participation was AU$447 (IQR $194.2–936), with 27% reported expenditure supported by a sports voucher. The proportion of financial support from sports vouchers increased considerably with social disadvantage, rising to over 60% of total expenditure in the most disadvantaged populations. Conclusions Socio-economic status was associated with sports-related expenditure and sports participation amongst children. Sport vouchers should target children in the most disadvantaged areas to promote participation in organised sport and physical activity.

Objective: To determine the impact of a peer-led, school-based programme (Students As LifeStyle Activists; SALSA) on energy balance–related behaviours (EBRBs) in Grade 8 students, and the cost of implementing the programme. Design: Pre–post test Setting: High schools in New South Wales, Australia. Methods: Grade 10 students (15- to 16-year-olds) were trained by university students to deliver four lessons on healthy eating and physical activity to Grade 8 students (13- to 14-year-olds). Students completed an online questionnaire pre–post lessons on EBRBs and intentions to change EBRBs over the next month. Items included fruit, vegetable and sugar-sweetened beverage (SSB) intake, frequency of eating breakfast, participation in moderate-to-vigorous physical activity (MVPA) and school-day recreational screen-time. Pre–post changes were analysed using generalised estimating equations, adjusted for clustering. Standard methods were used to estimate implementation costs. Results: In total, 2,056 Grade 8 students from 23 high schools participated. Significant changes included 5.2% increase in eating >2 fruit serves/day ( p 4 vegetable serves/day ( p Conclusion: The SALSA peer education programme had a positive impact on most of the dietary EBRBs examined. The cost evaluation showed that it is a relatively low-cost programme to implement.

The Australasian Society for Physical Activity aims to advance the science and practice of physical activity in Australia, New Zealand, the Pacific Islands, East Asia, South Asia, Southeast Asia, and Oceania. Fun, enjoyment, and cross-disciplinary discourse are important to ensure the network of physical activity professionals and our collective voice continues to grow. In May 2021, Australasian Society for Physical Activity's Early Career Network curated an engaging online Physical Activity Debate attended by 206 professionals. This commentary provides a synopsis of the debate and the central arguments presented by the affirmative and negatives teams. The authors describe the debate format and interactive design of the online Physical Activity Debate to provide insights for future online events that aim to boost interaction among physical activity professionals from various disciplines. Refereed/Peer-reviewed

OBJECTIVE Background: Regular participation in physical activity during childhood and adolescence is important for good health. There is strong evidence of the physical and psychosocial benefits associated with recreational physical activity in these age groups, specifically in the context of organised sport. Most children in New South Wales (NSW), Australia, do not meet the recommended guidelines for physical activity, with financial cost commonly cited as a barrier to the initiation and maintenance of sport. The Active Kids program is a major policy initiative introduced in 2018 that aimed to overcome this barrier by implementing a statewide sport voucher scheme, allowing all NSW school-enrolled children (1.2 million) initial access to a $100 annual contribution towards organised sport and physical activity, with concurrent evaluation over the initial 4-year phase of the program. STUDY TYPE This paper presents the protocol for evaluation of the Active Kids program, including an assessment of program impact on children's organised sport participation and recreational physical activity level, and analysis of the correlates of participation at individual, state and national levels. METHODS A quasi-experimental and mixed-method evaluation will be used to examine the patterns of organised sport and recreational physical activity behaviour and the correlates associated with sports participation, voucher uptake and program reach. Sociodemographic information will be collected for each child who registers for a voucher. The effects of this program on children's health-enhancing physical activity, engagement with the sport sector, self-efficacy and social influences on participation will be monitored through a cohort study. Acceptability, engagement and experience of the voucher program will be assessed from both user and provider perspectives. Additionally, effects of the program on families' annual sport-related expenditure will be assessed. RESULTS AND CONCLUSION It is anticipated that the implementation of the NSW Government's Active Kids program will increase participation in recreational physical activity among NSW children. The results of this evaluation will contribute to the evidence base and policy directions for sport voucher programs in Australia and internationally.

Background Sports should endeavour to provide inclusive opportunities for all people to participate. More evidence is required to understand who joins sports clubs and what keeps participants engaged throughout their lifetime. Little is known about who plays netball or what drives participation and retention of players in netball. This study aimed to identify the sociodemographic characteristics of Netball New South Wales (NSW) members, their odds of re-registering in the sport, and explore their motivations to play, experiences during participation and the perceived benefits of playing netball. Methods We used longitudinal sport registration data from all Netball NSW members in 2018 and 2019. A cross-sectional online survey was sent to all players registered during the two-year study period (n = 157,152). We used logistic regression to determine the odds of individuals returning to netball in 2019 after playing in 2018 and linked the sports registration data with the survey responses, calculating frequencies and proportions. Results Netball NSW members were mostly female (98 %) and aged less than 18 years old (69 %). Netball NSW retained 68 % of members in 2019 who played the previous year. Members who were male, aged 18–44 years old, lived in low SES areas, lived in regional/remote locations, identified as Aboriginal or Torres Strait Islander, spoke a language other than English at home or were born outside Australia had lower odds of returning to play from 2018 to 2019. Survey participants (n = 10,795) rated their experience playing netball highly and reported that playing netball improved their health and wellbeing. The main reason to play netball reported was ‘fun and enjoyment’ while the main reason to consider quitting was the ‘skill/experience of umpires and officials’. Conclusions This study highlights the strengths of netball in engaging and retaining females, who often participate in less sport than males. The positive experiences reported by netball participants should be fostered to retain current participants throughout the lifecourse. The data provided by members should be inform strategic actions to enhance netball participation for sociodemographic groups who had greatest odds of dropout. Routine surveillance using linked registration and player feedback should be utilised by sports to enhance sport delivery and increase participation.

Active Kids is a government-led, universal voucher program that aims to reduce the cost of participation in structured physical activity for all school-enrolled children in New South Wales (NSW), Australia. As part of the Active Kids program evaluation, this cross-sectional study examined the Active Kids&rsquo, program&rsquo, s reach to children in NSW and their physical activity behaviors, before voucher use. Demographic registration data from all children (4.5&ndash, 18 years old) who registered for an Active Kids voucher in 2018 (n = 671,375) were compared with Census data. Binary and multinomial regression models assessed which correlates were associated with meeting physical activity guidelines and participation in the sessions of structured physical activity. The Active Kids program attracted more than half (53%) of all eligible children in NSW. Children who spoke a primary language other than English at home, were aged 15&ndash, 18 years old, lived in the most disadvantaged areas, and girls, were less likely to register. Of the registered children, 70% had attended structured physical activity sessions at least once a week during the previous 12 months, whilst 19% achieved physical activity guidelines. Active Kids achieved substantial population reach and has the potential to improve children&rsquo, s physical activity behaviors.

ObjectivesInvestigate sociodemographic factors associated with physical activity and sport participation among Indigenous children registered in the New South Wales (NSW) government-funded Active Kids voucher program in 2018, including comparison with non-Indigenous children.DesignCross-sectional study.MethodsThe Active Kids voucher program aims to support the cost of children's sport and physical activities. All children aged 5-18 years in NSW are eligible for a voucher. To register, parent/carers report child sociodemographic characteristics, physical activity, sport participation and optional height and weight. Regression models were used to determine which sociodemographic characteristics were associated with meeting physical activity guidelines and sport participation for Indigenous and non-Indigenous children.ResultsOf the 671,375 children aged 5-18 years, 36,129 (5.4%) were Indigenous. More Indigenous children than non-Indigenous children met the physical activity guidelines before registering in the Active Kids program. Indigenous children had greater odds of meeting physical activity guidelines across all socio-economic quartiles. Among non-Indigenous children, odds reduced with social disadvantage. Indigenous children (38%) were less likely to participate in organised physical activity and sport sessions at least twice a week compared to non-Indigenous children (43%). Indigenous children living in major cities had higher sport participation levels compared with those living in outer regional and remote areas.ConclusionsThe Active Kids voucher program achieved population representative reach among Indigenous children, whose physical activity levels were higher than non-Indigenous children across all socioeconomic quartiles. The program has potential to supplement Indigenous children's physical activity levels using organised sessions and reduce sport drop-out among older children.

Objective The Live Life Well @ School program aims to establish, reinforce and support primary school students (aged 5-11 years) and their families to adopt healthy eating and physical activity behaviours through the implementation of an evidence-based program that focuses on the school curriculum, the school food and physical activity environment, and teacher professional development. This paper examines Live Life Well @ School monitoring data to provide practical insights into program adoption and changes in primary school environments across NSW, particularly in schools characterised as disadvantaged. Type of program: The Live Life Well @ School program provides a universally delivered, state-wide approach to childhood obesity prevention in the primary school setting. The program is a joint initiative between health and education sector agencies. Methods The program includes health promotion strategies for primary schools relating to physical activity and nutrition. Adoption of the program is indicated by achievement of evidence-based desirable practices, which are monitored routinely by local health promotion staff using a purpose-built online Population Health Information Management System. Monitoring data are used to provide feedback to schools and identify a staged approach to achieving more desirable practices. Health promotion staff tailor support locally to suit school and community needs, and have additional funding to support socio-economically disadvantaged schools. Results The program has achieved high reach to schools (82.7%percnt; of the 2570 schools in New South Wales, Australia). Adoption of desirable practices within schools participating in 2017 was 72.9%percnt;. Equitable reach was achieved for schools in areas of socio-economic disadvantage, schools in remote areas and schools with a high propotion of Aboriginal students, who are likely to have higher rates of childhood overweight and obesity. Curriculum-based strategies were more frequently adopted; environmental changes and teacher professional development components were less well adopted. Lessons learnt The desirable practice approach allows health promotion officers to tailor support by building on school strengths and taking a staged approach to change. Ongoing monitoring of the program provides useful insights that inform quality improvements to the program and implementation process, as well as information on progress towards outcomes. State-wide program targets were adjusted to strengthen impact and focus on desirable practices that were less well achieved. Intentional targeting and tailoring in areas of disadvantage are required to achieve equitable adoption of such a universal health promotion program. Strong relationships at the local level between school champions (teachers and principals) and health promotion staff characterise success.

Background: A combination of walking, other moderate physical activity, and vigorous physical activity is recommended for achieving good health. Vigorous activity has unique health benefits but may be less accessible to disadvantaged people. To reduce health inequity, we need to understand the differences in physical activity participation among socioeconomic subgroups and whether this is changing over time. Methods: Data from the 2002 to 2015 Adult New South Wales Population Health Surveys (164,652 responses) were analyzed to investigate trends in walking, moderate and vigorous physical activity participation by socioeconomic status as measured by educational attainment. Analysis used age- and sex-adjusted multivariable linear models that accounted for complex survey design. Results: In 2002, the highest socioeconomic group spent 18.5 (95% confidence interval, 8.2–28.8) minutes per week more than the lowest socioeconomic group being vigorously active. By 2015, this gap had steadily increased to 41.4 (95% confidence interval, 27.6–55.1) minutes per week. Inequity between groups was also found for duration of moderate activity but not for time spent walking. Conclusions: Low participation in vigorous activity in the lowest socioeconomic group is likely driving increasing inequities in physical activity and widening participation gaps over time. Barriers preventing the most disadvantaged people in New South Wales from engaging in vigorous activity should be addressed urgently.

Objectives: This study aimed to identify barriers, facilitators and potential intervention strategies for adolescents to use within the home to promote healthy eating and active living. Design: Cross-sectional design using semi-structured discussion groups. Setting: Peer leaders (aged 15–16 years) from five secondary schools in Sydney, Australia, were invited to participate. Methods: In groups of four to nine, peer leaders completed a worksheet focused on three priority behaviours: eating breakfast daily, avoiding sugary drinks and being physically active. Each group discussed, identified and recorded barriers, facilitators and opportunities where they could act as agents of healthy lifestyle change in their homes. The worksheets and field notes were reviewed, analysed and coded into emergent themes. Results: All peer leaders ( n = 77; 51% girls) attending school on the day of the discussion groups participated in this study. They identified a variety of barriers and facilitators for each of the priority behaviours. From the adolescent-generated strategies, such as not having sugary drinks in the fridge, making a routine and cooking or being active with the whole family, three main themes emerged: ‘improving time management’, ‘using social activities to engage family members’ and ‘changing access and availability’. Conclusion: The strategies suggested by peer leaders in this study add to the limited literature of potential low-intensity interventions which young people can use to enable healthy lifestyle change in their home environment.

Issue addressed: Children and adults in Australia are not eating the recommended amounts of fruits and vegetables. Our objective was to assess the effectiveness of a health promotion intervention to improve fruit and vegetable intake among primary school children and their families in NSW. Methods: The Cancer Council New South Wales Healthy Lunch Box sessions were a 25-minute session delivered to parents of primary school-aged children. The sessions provided information and resources about fruit and vegetables and healthy school lunch boxes. The evaluation is a quantitative uncontrolled pre-post design. Data were collected using three questionnaires, pre-intervention, 1 week post-intervention and 6 months post-intervention. Results: A total of 204 parents completed all three evaluation questionnaires to 6 months. Knowledge of recommended intakes and serving sizes of fruit and vegetables improved significantly after the intervention. There was an increase in parents reporting packing vegetables (often/always) in the child's lunch box at 1 week (47%) and 6 months post-intervention (40%) compared to pre-intervention (32%). The proportion of parents reporting that they were confident in packing a healthy lunch box increased from 45% pre-intervention to 62% after the intervention. Conclusion: The Healthy Lunch Box sessions were effective in improving parental knowledge and practices related to fruit and vegetables and parental confidence with packing a healthy lunch box. So what? This short intervention could be a useful component of a portfolio of interventions to support parents with knowledge and resources to pack a healthy lunch box for their children.

Objective: To examine the effects of different sit-stand protocols on work-time sitting and physical activity (PA) of office workers. Methods: Participants (n = 26, 77% women, mean age 42) were randomly allocated to usual sitting (control) or one of three sit-stand protocols (intervention) facilitated by height-adjustable workstations for a 4-week period between June and August 2015. Sitting, standing, and stepping time were assessed by inclinometry (activPAL); leisure-time physical activity (LTPA) by self-report. One-way analysis of covariance (ANCOVA) and post-hoc (Bonferroni) tests explored between-group differences. Results: Compared with baseline, intervention groups reduced work sitting time by 113 minutes/8-hour workday (95% confidence interval [CI] [-147,-79]) and increased work standing time by 96 minutes/8-hour workday (95% CI [67,125]) without significantly impacting LTPA/sleep time. Conclusions: Sit-stand protocols facilitated by height-adjustable workstations appear to reduce office workers' sitting time without significant adverse effects on LTPA.

Background There has been limited population-level success in tackling overweight and obesity. The Active Kids program is a state-wide intervention that aims to increase participation in organised physical activity and sport among children and adolescents in NSW, Australia. This study profiled children and adolescents who registered for the Active Kids program by examining the prevalence of overweight and obesity across subgroups and by social disadvantage in this sample. MethodsFor participating children, each parent or carer was required to complete an online registration form with information about the child’s height, weight, physical activity, sport participation, age, sex, primary language spoken at home, Aboriginality, disability status and postcode. Descriptive statistics were used to profile children and adolescents who registered in the program and multinomial regression models were used to determine which demographic characteristics were associated with an increased risk of overweight and obesity. Results In 2018, 671,375 parents registered a child or adolescent for the Active Kids Program. Among these children and adolescents, the prevalence of overweight and obesity was 17.2% and 7.6%, respectively. A large number of children and adolescents who lived in the most disadvantaged area (n = 99,583; 14.8%) registered for the program. There was a clear socio-economic gradient for obesity prevalence across areas of increasing disadvantage, with children and adolescents living in the most disadvantaged area being 1.87 (95% CIs 1.82, 1.93) times more likely to be overweight or obese compared with children and adolescents living in the least disadvantaged area. Conclusions The Active Kids program successfully reached a substantial proportion of overweight and obese children from socially disadvantaged backgrounds, providing financial support and opportunities for these children to participate in organised sport and physical activity. However, the program did not reach all children, and additional physical activity promotion strategies may be needed in a comprehensive approach. Nonetheless, these findings support government investment in reaching childhood overweight and obesity with large-scale programs.

Background Organized, leisure time physical activities are an important part of a population approach to increase total physical activity participation. Dancing is a type of organized leisure time activity which may be utilized to enhance public health. Individuals commonly participate in dance during childhood however few maintain participation into adulthood, dropping out of the activity while young. This study aimed to investigate who participates in an emerging dance activity, “No Lights, No Lycra”, which encourages people to participate in free-form dancing in the dark for 60 min designed as an inclusive, nonjudgmental, drug and alcohol-free community setting. This version of dance provides a modified opportunity for organized leisure time physical activity. No Lights, No Lycra has recorded increases in attendance at their events over the past decade. This popularity warrants an investigation into participant’s demographic characteristics, their total physical activity, as well as their motivations for dancing in the dark and any impacts on health and wellbeing. Methods This study invited No Lights, No Lycra participants from across Australia to complete a cross-sectional, self-report online survey. Participants were recruited while attending an organized session or through social media channels. The descriptive data provided through survey responses were analyzed using IBM SPSS Statistics. Results Participants (n = 1190, 92% Female) reported their main reason for dancing in the dark was to have fun. Most participants were insufficiently active, with 88% of responders not meeting physical activity guidelines. The No Lights, No Lycra dance sessions contributed 23% of their total annual participation in organized physical activities. Conclusion No Lights, No Lycra attracts adult women, rather than the typical dance participants – children; These women did not meet physical activity guidelines and typically had low levels of engagement in organized physical activity. Participation in No Lights, No Lycra, shows promise to increase women’s physical activity. This study into No Lights, No Lycra demonstrates how dance can be modified to engage a relatively inactive portion of the community. More should be done to understand how modifications to organized sport and physical activities can motivate and maintain engagement of typically inactive people.

Overweight and obesity in childhood and adolescence are associated with adverse health consequences throughout the lifecourse. Rates of childhood overweight and obesity have reached alarming proportions in many countries and pose an urgent and serious challenge. Policy responses across the world have been piecemeal. Evidence based policy actions and interventions are available to build a comprehensive approach to overweight and obesity but, in most countries, a narrow selection of interventions are chosen, often implemented over short time periods and typically with small-scale investment. The most cost-effective policy actions are rarely selected, or only partially adopted. Genuinely comprehensive, long-term population-wide approaches are scant. Leading-edge fiscal and regulatory strategies face aggressive, often effective, opposition from lobby groups. We outline the policy actions, governance and accountability mechanisms needed to tackle this global epidemic.

Background Few studies have reported energy balance-related behavior (EBRB) change for peer leaders delivering health promotion programs to younger students in secondary schools. Our study assessed the impact of the Students As LifeStyle Activists (SALSA) program on SALSA peer leaders’ EBRBs, and their intentions regarding these behaviors. Methods We used a pre–post study design to assess changes in EBRBs and intentions of Year 10 secondary school students (15–16 year olds) who volunteered to be peer leaders to deliver the SALSA program to Year 8 students (13–14 year olds). This research is part of a larger study conducted during 2014 and 2015 in 23 secondary schools in Sydney, Australia. We used an online questionnaire before and after program participation to assess Year 10 peer leaders’ fruit and vegetable intake, daily breakfast eating, sugar sweetened beverage (SSB) intake, moderate-to-vigorous physical activity (MVPA) participation and school-day recreational screen time behaviors and intentions regarding these EBRBs. Generalized estimating equations with a robust variance structure and exchangeable correlation structure were used to estimate the individual-level summary statistics and their 95% CIs, adjusted for clustering. We further assessed the effect of covariates on EBRB changes. Results There were significant increases in the proportion of Year 10 peer leaders (n = 415) who reported eating ≥2 serves fruit/day fruit from 54 to 63% (P

Adolescence is a critical time for developing healthy lifestyle behaviours. It is a period where young people assume a greater responsibility for their physical activity and eating habits, which often persist into adulthood.1 Schools are an ideal setting for promoting health, as most adolescents attend school and can be easily reached. There is also strong evidence demonstrating that school-based programmes can increase physical activity and improve dietary habits of students.2 3 The Students As LifeStyle Activists (SALSA) programme uses a peer educational model, driven by students, to promote physical activity and healthy eating in a supportive school environment.4 Our premise is that students not only learn through teaching their peers, but they also serve as powerful motivators and role models for others.5 Adolescents can also be effective ‘change agents’ within their family and the wider school community. The SALSA programme is underpinned by social cognitive theory and the empowerment education approach and aligns with the WHO’s health promoting schools framework.4 6 Our unique peer education model involving university and high school students as learners and educators is demonstrated in this brief animation: http://tinyurl.com/SALSAprogram-model. In summary, volunteer university students from health/education faculties, who …

Background School-level socioeconomic status (SES) influences on adolescents' lifestyle behaviors is understudied. We examined how school-level SES and sex influence adolescents' health-related lifestyle behaviors and intentions. Methods Grade 8 students aged 13-14 years completed an online questionnaire regarding their sociodemographic characteristics, dietary behaviors, physical activity participation and recreational screen-time, and intentions regarding these behaviors. School-level SES, based on an Index of Community Socio-Educational Advantage (ICSEA), was categorized as low or high. Generalized estimating equations estimated individual-level summary statistics, adjusted for clustering. Results Students (N = 2538; response rate = 79%) from 23 high schools (low ICSEA = 16) participated. Compared with low ICSEA students, high ICSEA students were more likely to report eating breakfast daily (OR 1.9 [95% CI 1.5, 2.4]), not drinking sugar-sweetened beverages (SSBs) daily (2.9 [1.9, 4.3]), and were more likely to have intentions to eat breakfast (1.8 [1.3, 2.3]) and ≥ 5 vegetable serves (1.2 [1.0, 1.5]) daily. Boys were more likely than girls to meet recommendations for breakfast eating, vegetable intake, moderate-to-vigorous physical activity and screen-time, but boys were less likely to meet recommendations regarding SSB intake. Conclusions Students from low ICSEA schools would benefit from additional support to improve dietary-related behaviors and intentions. More research is required to identify what targeted approaches will address sex differences in adolescents' lifestyle behaviors.

The aim of this study was to evaluate the effect of an activity-based work (ABW) office environment on physical activity and sedentary behavior, work ability, and musculoskeletal discomfort.Eighty-eight office workers trialed ABW for 4 weeks. Accelerometer and self-reported outcomes were measured at baseline, end-intervention, and follow-up. Data were analyzed using linear mixed models.Accelerometry measured sedentary time; sedentary breaks and step count did not significantly change from baseline to end-intervention (P = 0.13, 0.09, 0.18, respectively). Self-reported sitting-time was 14% lower, with standing-time and walking 11% and 3% higher in ABW than baseline (P 0.01 for all). Low back pain was lower in ABW than baseline (odds ratio 2.0, 95% confidence interval 1.1 to 3.7). Work ability reduced from 8.4 to 7.8 points (P 0.01) at follow-up.ABW environment appears to reduce self-reported sedentary behavior and low back pain and increase standing time.

Facebook, the most widely used social media platform, has been adopted by public health organisations for health promotion and behaviour change campaigns and activities. However, limited information is available on the most effective and efficient use of Facebook for this purpose. This study sought to identify the features of Facebook posts that are associated with higher user engagement on Australian public health organisations' Facebook pages. We selected 20 eligible pages through a systematic search and coded 360-days of posts for each page. Posts were coded by: post type (e.g., photo, text only etc.), communication technique employed (e.g. testimonial, informative etc.) and use of marketing elements (e.g., branding, use of mascots). A series of negative binomial regressions were used to assess associations between post characteristics and user engagement as measured by the number of likes, shares and comments. Our results showed that video posts attracted the greatest amount of user engagement, although an analysis of a subset of the data suggested this may be a reflection of the Facebook algorithm, which governs what is and is not shown in user newsfeeds and appear to preference videos over other post types. Posts that featured a positive emotional appeal or provided factual information attracted higher levels of user engagement, while conventional marketing elements, such as sponsorships and the use of persons of authority, generally discouraged user engagement, with the exception of posts that included a celebrity or sportsperson. Our results give insight into post content that maximises user engagement and begins to fill the knowledge gap on effective use of Facebook by public health organisations.

Children’s literature is profoundly influential in the lives of students and is widespread throughout schools, libraries, and homes. However, the field of children’s literature lacks diversity across several domains, particularly race, gender, and ability. Educators must be knowledgeable on how to use diverse children’s literature as a tool to teach about diversity, as they strive to foster inclusive classroom environments. Teachers must also design their classroom libraries with intense care so as to provide a wide-ranging selection of books to meet the needs of children’s interests and reading levels. Books are a powerful tool for development, so teachers must make conscious decisions about the materials they provide to young readers. All children deserve exposure to a wide range of books, which include characters who are both similar and different from themselves. Educators have a responsibility to expose students to diversity through a well-written selection of multifaceted children’s literature.