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We conducted a systematic review to evaluate combinations of physical activity, sedentary behavior, and sleep duration and their associations with physical, psychological and educational outcomes in children and adolescents. MEDLINE, CINAHL, PsychINFO, SPORTDiscus, PubMed, EMBASE, and ERIC were searched in June 2020. Included studies needed to 1) quantitatively analyze the association of two or more movement behaviors with an outcome, 2) analyze a population between 5-17 years old, and 3) include at least an English abstract. We included 141 studies. Most studies included the combination of physical activity and sedentary behavior in their analyzes. Sleep was studied less frequently. In combination, high physical activity and low sedentary behavior were associated with the best physical health, psychological health, and education-related outcomes. Sleep was often in the combination that was associated with the most favorable outcomes. Sedentary behavior had a stronger influence in adolescents than children and tended to be associated more negatively with outcomes when it was defined as screen time than overall time spent being sedentary. More initiatives and guidelines combining all three movement behaviors will benefit adiposity, cardiometabolic risk factors, cardiorespiratory fitness, muscular physical fitness, well-being, health-related quality of life, mental health, academic performance, and cognitive/executive function.

ISSUE ADDRESSED: Understanding community support for obesity prevention policy is important for developing effective preventive health action. This study assessed support for a range of obesity prevention interventions, including food environment policies designed to improve healthy food and drink availability and promotion within public institutions. METHODS: An online cross-sectional survey was completed by 2006 NSW adults. Questions explored attitudes and beliefs about obesity, the importance of government-led prevention and support for eight obesity prevention interventions. Regression analyses examined associations between intervention support and sociodemographic, attitudinal and behavioural characteristics. RESULTS: Most respondents (80%) believed obesity was a large problem and that poor individual choices (86%) and the widespread availability of unhealthy food and drink (78%) contributed to the issue. There was moderate to high support for most (n = 7) initiatives. Support for food environment policies was highest for schools (76%-82%) and hospitals (67%-79%). Supporters and opponents rationalised opinions based on perceived effectiveness, the government's role and cost benefits. Opponents were a minority, but principles of autonomy were predominant. Attributing obesity to environment-related factors, and personal lower SSB consumption strongly predicted support. CONCLUSION: There is a significant recognition of the obesity issue and strong support for policies designed to improve the availability and promotion of healthy food and drink in public institutions, particularly in schools and hospitals. SO WHAT?: Substantial community support for healthy food environment policies in schools and hospitals warrants continued implementation in NSW. This may foster further acceptance for wider implementation. Our findings could inform the framing of policy advocacy messages.

Background: Cycling for transport provides many health and social benefits – including physical activity and independent access to jobs, education, social opportunities, health care and other services (accessibility). However, some population groups have less opportunity to reach everyday destinations, and public transport stops, by bicycle – owing in part to their greater aversion to riding amongst motor vehicle traffic. Health equity can therefore be improved by providing separated cycleway networks that give more people the opportunity to access places by bicycle using traffic-free routes. The aim of this study was to assess the health equity benefits of two bicycle infrastructure development scenarios – a single cycleway, and a complete network of cycleways – by examining the distributions of physical activity and accessibility benefits across gender, age and income groups. Methods: Travel survey data collected from residents in Sydney (Australia) were used to train a predictive transport mode choice model, which was then used to forecast the impact of the two intervention scenarios on transport mode choice, physical activity and accessibility. The latter was measured using a utility-based measure derived from the mode choice model. The distributions of the forecast physical activity and accessibility benefits were then calculated across gender, age and income groups. Results: The modelled physical activity and accessibility measures improve in both intervention scenarios. However, in the single cycleway scenario, the benefits are greatest for the male, high-income and older age groups. In the complete network scenario, the benefits are more equally distributed. Forecast increases in cycling time are largely offset by decreases in walking time – though the latter is typically low-intensity physical activity, which confers a lesser health benefit than moderate-intensity cycling. Conclusions: Separated cycleway infrastructure can be used to improve health equity b

Intoxication can be a factor in unwanted sex, but research on the extent of the issue in both women and men is limited. We assessed the prevalence, correlates, and 10-year time-trends of unwanted sex due to intoxication among a representative sample of 4,279 women and 3,875 men aged 16–69 years in Australia and considered how these vary by gender. In 2012–13, 16% of women and 10% of men reported ever having had a sexual experience when they “did not want to because they were too drunk or high at the time.” For both women and men, this was associated with younger age, bisexual activity, and reports of lifetime injection drug use, sexually transmitted infections, and forced sex. Among women only, it was associated with drinking above guideline levels and ever having terminated a pregnancy. Among men only, it was associated with current tobacco smoking, elevated psychosocial distress, and poor general health. Compared with 2001–02 data, fewer men reported unwanted intoxicated sex, while there were no changes for women as a whole. Interpreting these findings through an intersectional assemblage framework supports stronger understanding of the multiple factors influencing sexuality and substance use with implications for promoting equity, safety, and sexual health.

Abstract Background Weight gain during pregnancy that is outside of recommended levels is associated with a range of adverse outcomes for the mother and child, including gestational diabetes, pre-eclampsia, preterm birth, and obesity. Internationally, 60–80% of pregnant women report gaining weight outside of recommended levels. While guideline recommendations and RCT evidence support the provision of antenatal care that supports healthy gestational weight gain, less than 10% of health professionals routinely weigh pregnant women; discuss weight gain, diet, and physical activity; and provide a referral for additional support. This study aims to determine the effectiveness of an implementation intervention in increasing the provision of recommended gestational weight gain care by maternity services. Methods A stepped-wedge controlled trial, with a staggered implementation intervention, will be conducted across maternity services in three health sectors in New South Wales, Australia. The implementation intervention will consist of evidence-based, locally-tailored strategies including guidelines and procedures, reminders and prompts, leadership support, champions, training, and monitoring and feedback. Primary outcome measures will be the proportion of women who report receiving (i) assessment of gestational weight gain; (ii) advice on gestational weight gain, dietary intake, and physical activity; and (iii) offer of referral to a telephone coaching service or local dietetics service. Measurement of outcomes will occur via telephone interviews with a random sample of women who attend antenatal appointments each week. Economic analyses will be undertaken to assess the cost, cost-consequence, cost-effectiveness, and budget impact of the implementation intervention. Receipt of all care elements, acceptance of referral, weight gain during pregn

Abstract Introduction Healthy Beginnings is an established nurse-led early childhood obesity prevention program that promotes healthy infant feeding practices and active play in the early years of life. To improve engagement with culturally and linguistically diverse populations, the Healthy Beginnings program delivered by telephone was culturally adapted and implemented with Arabic- and Chinese-speaking mothers in Sydney, Australia. The cultural adaptation process has been published separately. In this article, we aimed to evaluate the feasibility of the culturally adapted program. Methods In 2018–2019, the culturally adapted Healthy Beginnings program was implemented with Arabic- and Chinese-speaking women recruited from antenatal clinics in Sydney. At four staged timepoints (from third trimester until 6 months of age), mothers were sent culturally adapted health promotion booklets and text messages and offered four support calls from bi-cultural child and family health nurses in Arabic and Chinese. A mixed methods evaluation included a) baseline and 6-month telephone surveys, followed by b) semi-structured follow-up interviews with a subset of participating mothers and program delivery staff. Main outcomes of this feasibility study were reach (recruitment and retention), intervention dose delivered (number of nurse support calls completed) and acceptability (appropriateness based on cognitive and emotional responses). Results At recruitment, 176 mothers were eligible and consented to participate. Of 163 mothers who completed the baseline survey, 95% completed the program (n = 8 withdrew) and 83% completed the 6-month survey (n = 70 Arabic- and n =&th