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Purpose: The aim of this research was to develop a contextually and culturally appropriate scale to assess farmers' barriers to health‐related help‐seeking. Methods: An initial pool of items was developed from the academic literature and input from an expert panel of farmers, rural academics, and rural clinicians. A draft 32‐item questionnaire was then developed and sent to farmers registered with FARMbase, which is an Australian national farmer database. Findings: Two hundred and seventy‐four farmers completed the draft questionnaire (93.7% male, 73.7% aged 56‐75 years). An exploratory factor analysis identified 6 factors; "Health Issues are a Low Priority," "Concerns about Stigma," "Structural Health System Barriers," "Minimization and Normalization," "Communication Barriers," and "Continuity of Care.". Test‐retest reliability was examined with a further 10 farmers (90% male, Mean age = 57, SD = 5.91), who completed the questionnaire twice (at 2‐ to 3‐week intervals). Results indicated moderate‐good test‐retest reliability. Conclusions: The resulting 24‐item Farmer Help‐Seeking Scale provides a measure of help‐seeking that is specifically designed to capture the unique context, culture, and attitudes that can interfere with farmers' help‐seeking, and inform the development of strategies to increase health‐service utilization in this at‐risk group. [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]

Objectives: Farmers are faced with many stressors, along with numerous barriers to accessing traditional forms of mental health support. The ifarmwell online intervention was co-designed with farmers and is informed by Acceptance and Commitment Therapy to equip farmers with transferable coping strategies, particularly to help them cope with circumstances beyond their control. We aimed to evaluate the effect of ifarmwell on farmers' short- and long-term distress and mental wellbeing. Methods: Australian farmers (21–73 years) who registered on completed measures at the commencement of module 1 (N = 228), the end of the intervention (N = 77) and 6-months post-intervention (N = 61). Primary outcomes included distress (Kessler Psychological Distress Scale) and mental wellbeing (Mental Health Continuum – Short Form). We also examined the relationship between distress, mental wellbeing, neuroticism (Quickscales-R) and ACT-based psychological mechanisms; psychological inflexibility (Acceptance and Action Questionnaire-II), cognitive fusion (Cognitive Fusion Questionnaire), believability of automatic thoughts (Automatic Thoughts Questionnaire-B), coping via acceptance (4 items from the situational COPE) and mindfulness (Five Facet Mindfulness Questionnaire-Short Form). Secondary outcomes of acceptability (Client Satisfaction Questionnaire-8) and usability (System Usability Scale) were also explored. Results: Pre- to post-intervention, farmers' distress decreased and mental wellbeing increased. These effects were maintained at 6-month follow-up. Changes in these outcomes were greatest for participants who entered the intervention with high baseline distress ( β ˆ = −0.59, 95%CI =[−0.70, −0.47]) and low mental wellbeing ( β ˆ = −0.33, 95%CI = [−0.47, −0.19]). Decreases in distress and increases in mental wellbeing were associated with decreases in psychological inflexibility, cognitive fusion, and believability of thoughts, and increases in coping via acceptance and mindfulness. Levels of satisfaction (M = 26.92/32) and usability (M = 84.70/100) were high, and 94.6% of participants said they would recommend ifarmwell to a friend in need of similar advice and tools. Conclusions: ifarmwell is an effective and usable intervention that is likely to help farmers reduce their levels of distress and improve their mental wellbeing, by improving their psychological flexibility, ability to focus on the present and accept things beyond their control, as well as by reducing the extent to which they believe unhelpful thoughts. [ABSTRACT FROM AUTHOR]

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. (Contains 2 tables and 3 figures.)

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

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

Objective: The socio-ecological milieu of children's physical activity is changing, perhaps causing perturbations within the causal 'web' that explains physical activity behaviours. It is unclear if the relative importance of parental role modelling is changing. Accordingly, this study examined associations of child-perceived parent physical activity and children's sport participation in 1985 and 2004. Methods: In 1985 (179 girls, 211 boys) and 2004 (210 girls, 218 boys), Australian schoolchildren (9-15 years) in the same eight schools were surveyed on sport participation and perceptions of parents' physical activity. Results: In the 1985 sample, girls with active fathers played more sport. In 2004, boys and girls with active fathers or active mothers reported higher sport participation. In 1985, there were no differences in sport participation between those with both, either or neither parent active. In 2004, sport participation was highest among boys and girls with both parents active. Conclusions: These results underscore the current role of parents as socialising agents for physical activity. Implications: Intervention design should be founded on the most recent evidence of children's physical activity correlates. Key words: children, physical activity, sport, role modelling, parents. doi: 10.1111/j.1753-6405.2010.00617.x

Objective: This study aimed to explore sleep duration in young Australians on different types of days across weight classes. Methods: Use of time and anthropometric data were collected on 8,866 nights from 3,884 9-18 year old Australians. The association between sleep duration and weight status was examined using factorial ANOVA for four day types: S-S (to bed and waking on school days); S-NS (to bed on school day and waking on non-school day); NS-NS (to bed and waking on non-school days); NS-S (to bed on non-school day and waking on school day). Results: Sleep duration varied with weight status when all day types were considered together (p=0.0-012). Obese adolescents slept less than normal and underweight adolescents. However, the relationship varied for different day types; with the strongest relationship for NS-S days (on which obese children slept 65 min less than very underweight children, p Conclusions: The association between weight status and sleep duration showed consistent gradients across weight categories, but only for certain day types. Implications: These patterns cast light on the direction of causation in the obesity-sleep duration relationship. Findings suggest that short sleep duration contributes to obesity, or that a third unidentified factor has an impact on both. Key words: sleep, adolescent, overweight, obese, children. Aust NZ J Public Health. 201 O; 34:165-71 doi: 10.1111/j.1753-6405.2010.00502.x

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

Purpose: Brief classroom-based episodes of physical activity (active lesson breaks, ALBs) have improved schoolchildren's classroom behaviors in some studies, and may also increase the likelihood of children meeting the recommended daily minutes of moderate to vigorous physical activity (MVPA). However, there is emerging evidence that increases in physical activity at particular times of the day may lead to compensatory declines at other times. This study explored evidence for compensatory declines in response to a 10 min ALB during the school day. Method: Thirty-eight 12-year-old boys from a single elementary school completed intervention and control conditions in a cross-over design, with each phase lasting one week. The intervention consisted of a single 10-min active lesson break delivered on each of three days in the intervention week. Twenty-four hour accelerometry was used to quantify moderate and vigorous physical activity. Results: ALBs increased in-school MVPA by 5.8 min (p < .0001), but overall daily MVPA was similar between intervention and control conditions (77.2 vs 77.4 min/d, p > .05), However, vigorous physical activity increased significantly over the whole day (11.2 vs 8.9 min, p = .0006). Conclusion: A brief episode of classroom-based play led to a modest increase in vigorous physical activity in elementary school students, but did not increase MVPA across the day. [ABSTRACT FROM AUTHOR]

Objective: To compare rates of change in South Australian children's body composition between 1997 and 2002 in subsamples based on location of residence and socioeconomic status. Methods: Year 6 children from randomly selected South Australian schools in 1997 (32 schools, n=1,423) and 2002 (29 schools, n=992) were compared on: body mass index (BMI), sum of triceps and abdominal skinfolds (skinfold sum) and waist girth. Samples were partitioned into urban (population >20,000) and rural ( Results: Between surveys, there were significant increases in boys' waist girth (p=0.004) and skinfold sum (p=0.007), and girls' BMI (p=0.0005) and skinfold sum (p Conclusions: Secular trends in Australian children's body fatness are continuing. Further, the rates of change in girls are affected by the socio-demographic milieu. Implications: The development of targeted interventions to combat child obesity will depend on a clearer understanding of how environmental influences on weight status are distributed across the socio-demographic landscape.