We can close the Indigenous nutrition gap – here’s how

After years of neglect and a notable absence in last week’s Closing the Gap report, nutrition is finally being recognised as integral to closing the gap on Indigenous disadvantage. This belated realisation is puzzling, given poor diet is a major cause of type 2 diabetes, heart disease, kidney disease and some cancers. Nutrition is particularly poor in Aboriginal and Torres Strait Islander communities, where it is estimated that at least 19% of the burden of disease is due to poor diet; much more than due to smoking...

Family-based interventions in preventing children and adolescents from using tobacco: A systematic review and meta-analysis

- Background Tobacco is the main preventable cause of death and disease worldwide. Adolescent smoking is increasing in many countries with poorer countries following the earlier experiences of affluent countries. Preventing adolescents starting smoking is crucial to decreasing tobacco-related illness. - Objective To assess effectiveness of family-based interventions alone and combined with school-based interventions to prevent children and adolescents from initiating tobacco use. - Data Sources 14 bibliographic databases and the Internet, journals hand-searched, experts consulted. - Study Eligibility Criteria, Participants, and Interventions Randomised controlled trials (RCTs) with children or adolescents and families, interventions to prevent starting tobacco use, follow-up ≥ 6 months. - Study Appraisal/Synthesis methods Abstracts/titles independently assessed and data independently entered by two authors. Risk-of-bias assessed with the Cochrane Risk-of-Bias tool. - Results Twenty-seven RCTs were included. Nine trials of never-smokers compared to a control provided data for meta-analysis. Family intervention trials had significantly fewer students who started smoking. Meta-analysis of twoRCTs of combined family and school interventions compared to school only, showed additional significant benefit. The common feature of effective high intensity interventions was encouraging authoritative parenting. - Limitations Only 14 RCTs provided data for meta-analysis (about 1/3 of participants). Of the 13 RCTs which did not provide data for meta-analysis eight compared a family intervention to no intervention and one found significant effects, and five compared a family + school intervention to a school intervention and none found additional significant effects. - Conclusions and Implications of Key Findings There is moderate quality evidence that family-based interventions prevent children and adolescents starting to smoke.

An object-centred approach to encourage online participation in the context of behaviour change

Online groups rely on contributions from their members to flourish, but in the context of behaviour change individuals are typically reluctant to participate actively before they have changed successfully. We took inspiration from CSCW research on objects to address this problem by shifting the focus of online participation from the exchange of personal experiences to more incidental interactions mediated by objects that offer support for change. In this article we describe how we designed, deployed and studied a smartphone application that uses different objects, called distractions and tips, to facilitate social interaction amongst people trying to quit smoking. A field study with 18 smokers revealed different forms of interaction: purely instrumental interactions with the objects, subtle engagement with other users through receptive and covert interactions, as well as explicit interaction with other users through disclosure and mutual support. The distraction objects offered a stepping-stone into interaction, whereas the tips encouraged interaction with the people behind the objects. This understanding of interaction through objects complements existing frameworks of online participation and adds to the current discourse on object-centred sociality. Furthermore, it provides an alternative approach to the design of online support groups, which offers the users enhanced control about the information they share with other users. We conclude by discussing how researchers and practitioners can apply the ideas of interaction around objects to other domains where individuals may have a simultaneous desire and reluctance to interact.

Quitty: Using technology to persuade smokers to quit

Health is an important topic in HCI research with an increasing amount of health risks surrounding individuals and society at large. It is well known that smoking cigarettes can have serious health implications. The importance of this problem motivates investigation into the use of technology to encourage behavior change. Our study was designed to gather empirical knowledge about the role a "quitting app" can play in persuading people to quit smoking. Our purpose-built app Quitty introduces different content types from different content sources to study how they are perceived and motivate health behavior change. Findings from our field study show that tailored content and push-messages are considered the most important for persuading people to stop smoking. Based on our empirical findings, we propose six guidelines on how to design mobile applications to persuade smokers to quit.

What people talk about when they talk about quitting

As part of an ongoing project to explore the design of behaviour-change technology for smoking cessation, we analysed a successful community who come together on the popular Reddit website to discuss quitting and to encourage each other's quit attempts. We found that users remain anonymous but identify according to their quit stage. We examined the form and content of posts, finding that narratives about people and events are more common than other rhetorical forms. Many speak of ongoing struggles with quit attempts. Our analysis reveals forms of sociality spontaneously enacted in a self-managed community of quitters. We compare our results with earlier work on social media and behaviour change.

Unbounding the interaction design problem: The contribution of HCI in three interventions for well-being

In this paper we consider HCI's role in technology interventions for health and well-being. Three projects carried out by the authors are analysed by appropriating the idea of a value chain to chart a causal history from proximal effects generated in early episodes of design through to distal health and well-being outcomes. Responding to recent arguments that favour bounding HCI's contribution to local patterns of use, we propose an unbounded view of HCI that addresses an extended value chain of influence. We discuss a view of HCI methods as mobilising this value chain perspective in multi-disciplinary collaborations through its emphasis on early prototyping and naturalistic studies of use.

Things you don't want to know about yourself: Ambivalence about tracking and sharing personal information for behaviour change

Technologies that facilitate the collection and sharing of personal information can feed people's desire for enhanced self-knowledge and help them to change their behaviour, yet for various reasons people can also be reluctant to use such technologies. This paper explores this tension through an interview study in the context of smoking cessation. Our findings show that smokers and recent ex-smokers were ambivalent about their behaviour change as well as about collecting personal information through technology and sharing it with other users. We close with a summary of three challenges emerging from such ambivalence and directions to address them.

A mobile app offering distractions and tips to cope with cigarette craving: A qualitative study

Background Despite considerable effort, most smokers relapse within a few months after quitting due to cigarette craving. The widespread adoption of mobile phones presents new opportunities to provide support during attempts to quit. Objective To design and pilot a mobile app "DistractMe" to enable quitters to access and share distractions and tips to cope with cigarette cravings. Methods A qualitative study with 14 smokers who used DistractMe on their mobiles during the first weeks of their quit attempt. Based on interviews, diaries, and log data, we examined how the app supported quitting strategies. Results Three distinct techniques of coping when using DistractMe were identified: diversion, avoidance, and displacement. We further identified three forms of engagement with tips for coping: preparation, fortification, and confrontation. Overall, strategies to prevent cravings and their effects (avoidance, displacement, preparation, and fortification) were more common than immediate coping strategies (diversion and confrontation). Tips for coping were more commonly used than distractions to cope with cravings, because they helped to fortify the quit attempt and provided opportunities to connect with other users of the application. However, distractions were important to attract new users and to facilitate content sharing. Conclusions Based on the qualitative results, we recommend that mobile phone-based interventions focus on tips shared by peers and frequent content updates. Apps also require testing with larger groups of users to assess whether they can be self-sustaining.

Diffusing research into routine midwifery practice

This research applied Greenhalgh et al's (2005) organisational change theoretical framework and a case study method approach to explore the process of implementing a smoking cessation intervention for pregnant women. The study was carried out according to the principles laid down in the National statement on ethical conduct in human research, produced by the National Health and Medical Research Council, Australia. Ethical approval for the research was sought and received from Queensland University of Technology human research ethics committee, prior to the start of the study. The sample constituted four participants who had been involved in the process of disseminating a training programme for midwives to implement a smoking cessation intervention. Eight semi-structured interviews were undertaken with these participants and the interviews and background programme data were subjected to theoretical analysis. The data were analysed through the lens of the Greenhalgh et al (2005) framework. The result was a disaggregation and (re)aggregation of data in the formation of an analytical outcome (Charmaz, 2006).

A submission to the Tasmanian Department of Health and Human Services consultation “Healthy Tasmania Five Year Strategic Plan”

This submission will address a number of questions raised in section 5.2, “Potential Future Initiatives to target smoking���, of the Healthy Tasmania Five Year Strategic Plan – Community Consultation Draft. Each question has been answered within this submission. This submission will also address the possibility of legal challenges to these proposed changes, a pivotal consideration when implementing any tobacco control laws. This is due to the aggressive nature of the tobacco industry, as illustrated by their attempts to challenge plain packaging laws in the country and through international treaties. The evidence provided in my submission illustrates that prevention of initiation of smoking during adolescence has various benefits in terms of reduction of negative smoking behaviors in later life. I argue that increasing the minimum legal age of purchasing for tobacco to 21 will benefit both the levels of underage smoking as well as the age of onset of initiation of smoking, due to the greater difficulties that those who are underage would experience in accessing tobacco products. I will also address the question of whether the minimum smoking age should be increased to 25.