10,000 steps Rockhampton: a whole community approach to increasing levels of physical activity

10,000 Steps Rockhampton is a multi-strategy health promotion program which aims to develop sustainable community-based strategies to increase physical activity.The central coordinating focus of the project is the use of pedometers to raise awareness of and provide motivation for physical activity, around the theme of '10,000 steps/day - Every step counts.' To date, five key strategies have been implemented: (1) a media-based awareness raising campaign; (2) promotion of physical activity by health professionals; (3) improving social support for physical activity through group-based programs; (4) working with local council to improve environmental support for physical activity, and; (5) establishment of a ‘micro-grants’ fund to which community groups could apply for assistance with small, innovative physical activity enhancing projects. Strategies were introduced on a rolling basis beginning in February 2002 with 'layering' of interventions designed to address the multi-level individual social and environmental determinants of physical activity. The project was quasi-experimental in design, involving collection of baseline and two year follow-up data from community based surveys in Rockhampton and in a matched regional Queensland town. In August 2001,the baseline CATI survey (N=1281)found that 47.9% of men and 33.0% of women were meeting the national guidelines for physical activity. In August 2002, a smaller survey (N=400) found an increase in activity levels among women (39.7% active) but not in men (48.5%). Data from the two year follow up survey, to be conducted in August 2003, will be presented, with discussion of the major successes and challenges of this landmark physical activity intervention. Acknowledgement: This project is supported by a grant from Health Promotion Queensland

The topography of multiple drug use among adolescent Australians : findings from the National Drug Strategy Household Survey

Introduction and aims: Despite evidence that many Australian adolescents have considerable experience with various drug types, little is known about the extent to which adolescents use multiple substances. The aim of this study was to examine the degree of clustering of drug types within individuals, and the extent to which demographic and psychosocial predictors are related to cluster membership. Design and method: A sample of 1402 adolescents aged 12-17. years were extracted from the Australian 2007 National Drug Strategy Household Survey. Extracted data included lifetime use of 10 substances, gender, psychological distress, physical health, perceived peer substance use, socioeconomic disadvantage, and regionality. Latent class analysis was used to determine clusters, and multinomial logistic regression employed to examine predictors of cluster membership. Result: There were 3 latent classes. The great majority (79.6%) of adolescents used alcohol only, 18.3% were limited range multidrug users (encompassing alcohol, tobacco, and marijuana), and 2% were extended range multidrug users. Perceived peer drug use and psychological distress predicted limited and extended multiple drug use. Psychological distress was a more significant predictor of extended multidrug use compared to limited multidrug use. Discussion and conclusion: In the Australian school-based prevention setting, a very strong focus on alcohol use and the linkages between alcohol, tobacco and marijuana are warranted. Psychological distress may be an important target for screening and early intervention for adolescents who use multiple drugs.

Dalby Shopping Precinct Survey Report : Consumer Attitudes towards Proposed Extended Trading Hours at Dalby

Data was collected to measure shopper’s attitudes toward the proposed Sunday and limited public holiday trading in Dalby. Survey questionnaires were conducted between 29th August to 31st August at Coles Dalby and Dalby Shoppingtown Plaza. In total, 150 respondents participated in the survey. Overall, the findings suggest that most respondents, especially males, couples with children, fulltime workers and those under the age of 49 years, embrace the proposed Sunday and limited holiday trading in Dalby. While there are concerns over increasing competition for smaller retailers who already trade on Sundays, a majority of respondents indicated it would suit their lifestyle, be convenient, provide more jobs, increase trade for smaller retailers within the area, reduce queues and congestion observed on Saturdays. The majority of those shoppers that indicated they currently did some shopping on a Sunday reported they would continue to support smaller retailers who currently trade on Sundays and some public holidays, if changes came about. Those opposed to changes to trading hours indicated a belief that existing trading hours were sufficient. Most people indicated the proposed extension of trading hours would not harm the community or have a negative, detrimental effect on themselves or their family. The main findings presented in the report are as follows: - 96.8% of respondents surveyed reported to be local, permanent residents of Dalby. - Residents of Dalby visited shopping centres and stores on average 2.8 times per week. This frequency is proportionately higher than the average Australian shopping behaviour at 2.5 times per week (Roy Morgan Supermarket Monitor). - It was determined that weekday evenings (after 5 pm) were the busiest times for shopping, with Saturday the next most popular day to shop. - 68% of respondents support the proposal of the extended trading hours at supermarkets, department stores and the shopping centre in Dalby, 26% oppose and 6% are unsure. - 90% of the respondents agreed that residents of Dalby should be allowed the same choice as other regional towns and cities in supporting/opposing changes to trading hours. The remaining 10% expressed a disagreement. - A larger percentage of males supported the proposal for Sunday and limited holiday trading. Of all the males surveyed, 80% were in support, 15% were opposed and 5% unsure. 60% of female respondents support the proposal, while 33% oppose it and 5% were unsure. - The highest percentage of support exists in fulltime workers with 90% of those respondents supporting the proposal. - In contrast, the lowest percentage of support was found in the non-working (retired/unemployed) respondents, where 67% opposed the application. - It was noted that 71% of respondents employed casually also indicated opposition against proposed changes. Further questioning identified an underlying concern from casually employed persons that Sunday trade would force them onto Sunday work rosters. - 92% of shared households expressed support for Sunday and limited public holiday trading, while 83% of both couples with children and single parent with children at home also supported the application. - 72% of the respondents often find it necessary to do some grocery shopping in Dalby on a Sunday. 76% of shoppers who indicated they already undertook some shopping on Sunday, indicated would continue to shop and support smaller retailers. - Of the respondents surveyed, 44% have travelled outside of Dalby on a Sunday to shop. This indicates that such residents find it necessary to undertake some shopping on a Sunday and in order to do so, drive an hour to Toowoomba in order to access a range of retailers. - The most cited reasons for supporting Sunday and limited public holiday trade were; ‘More choice about when I shop and that is convenient’ (69%), ‘Sunday trade will create job opportunities’ (71%), ‘Sunday trade will be helpful when preparing school lunches and getting ready for the working week’ (62%), and ‘Sunday trade will reduce shopping congestion during peak shopping periods’ (62%) - The most cited reasons for opposing the proposed changes are that ‘Sunday trade may increase competition for small retailers who already trade on Sunday’ (41%), ‘Shops are already open 6 days a week which is enough’ (31%), and ‘Sunday is a day of rest or a religious day and shopping should not be allowed’ (23%). - 97% of respondents indicated they would not change their sporting or social commitment if changes to trading hours were implemented.

Mt Isa Shopping Precinct Survey Report : Consumer Attitudes towards Proposed Extended Trading Hours at Mt Isa

Data was collected to measure shopper’s attitudes toward the proposed Sunday and limited public holiday trading in Mt Isa. Survey questionnaires were conducted between 15th August to 17th August at Kmart Plaza, Woolworths, Miles St. and Mt Isa Plaza. In total, 300 respondents participated in the survey. Overall, the findings suggest that most respondents, especially males, couples with children and fulltime workers, embrace the proposed Sunday and limited holiday trading in Mt Isa. While there are concerns over increasing competition for smaller retailers who already trade on Sundays, a majority of respondents indicated it would suit their lifestyle, be convenient, provide more jobs, increase trade for smaller retailers within the area, reduce queues and congestion, and offer a less expensive grocery shopping. The majority of those shoppers that indicated they currently did some shopping on a Sunday reported they would continue to support smaller retailers who currently trade on Sundays and some public holidays, if changes came about. Those opposed to changes to trading hours also indicated a belief that existing trading hours were sufficient. Most people indicated the proposed extension of trading hours would not harm the community or have a negative, detrimental effect on themselves or their family. The main findings presented in the report are as follows: - 96% of respondents surveyed reported to be local, permanent residents of Mt Isa. - Residents of Mt Isa visited shopping centres and stores on average 2.4 times per week. This mirrors the average Australian shopping behaviour at 2.5 times per week (Roy Morgan Supermarket Monitor) - It was determined that Saturday was the busiest day for shopping with a majority of respondents indicating they visited stores on that day of the week. - 71% of respondents support the proposal of extended trading hours at shopping centres in Mt Isa, 25% oppose and 4% are unsure. - 87% of the respondents agreed that residents of Mt Isa should be allowed the same choice as other regional towns and cities in supporting/opposing changes to trading hours. The remaining 13% expressed a disagreement. - A larger percentage of males supported the proposal for Sunday and limited holiday trading. Of all the males surveyed, 81% were in support, 17% were opposed and 2% unsure. By contrast, 64% of female respondents support the proposal, while 31% oppose it and 5% are unsure. - The highest percentage of support exists in fulltime workers with 85% of those respondents supporting the proposal. In contrast, the lowest percentage of support was found in the non-working respondents, where 62% opposed the application. - 78% of couples living with children at home expressed support for Sunday and limited public holiday trading, while 60% of couples without children also supported the application. - Of the respondents surveyed, virtually none (less than 1%) have travelled outside of Mt Isa on a Sunday to shop. This indicates that due to the remote and isolated location of this town, residents do not have the option to travel reasonable distances in order to access a range of retailers. - 70% of the respondents often find it necessary to do some grocery shopping in Mt Isa on a Sunday. - Convenience is cited as the major reason for support (79%) followed by lifestyle (75%). - The most cited reasons for supporting ‘it would be convenient’ (81%), ‘It may create more jobs’ (77%), ‘It may reduce congestion during busy shopping periods’ (74%, and ‘It would make it easier for working families with kids’ (74%). - The most cited reasons for opposing the proposed changes are that ‘It will disadvantage smaller businesses’ (44%), ‘It is unnecessary’ (29%). - 72% of shoppers who indicated they already undertook some shopping on Sunday, indicated would continue to shop and support smaller retailers. - 98% of respondents indicated they would not change their sporting or social commitment if changes to trading hours were implemented.

Developing an international survey of bicycle and helmet usage

The European Union‐funded collaborative network, COST Action TU1101: Towards safer bicycling through optimization of bicycle helmets and usage, aims to increase scientific knowledge about bicycle helmets in regards to traffic safety and to disseminate this knowledge to stakeholders, including cyclists, legislators, manufacturers, and the scientific community. The COST research team has developed a uniform international survey to better understand attitudinal and other factors that may influence bicycle and helmet usage, as well as crash risk. The online survey is being distributed by project partners in Europe, Israel, Australia, and potentially the US and Canada. The survey contains four types of questions: (1) biographical data, (2) frequency of cycling and amount of cycling for different purposes (e.g., commuting, health, recreation) and in different environments (e.g., bicycle trails, bike lanes, on sidewalks, in traffic), (3) frequency and circumstances for use and non‐use of helmets, attitudes and reasons for it, and; (4) crash involvement and level of reporting to the police. While the potential value of comparative data across countries with very different cycling cultures and safety levels is substantial, there are numerous challenges in developing, conducting, and analyzing the results of the survey. This presentation will focus on the scope of the international study, methodological issues and pitfalls of such a collaborative effort, and on initial results from one country (Israel). To illustrate, two findings from the preliminary Israeli survey indicate that: (1) none of the crashes were reported to the police including the ones involving hospital admission. Although underreporting of bicycle crashes by police is well documented in all countries the extent is unknown, and can be extreme. (2) Older riders tend to ride more for health/exercise reasons, while younger riders tend to ride more for commuting. Thus there is an interaction between riders’ age and the place and times of riding.

Educate Plus 2014 Benchmarking Survey

In late 2014, the fifth biennial Educate Plus benchmarking study was conducted to track educational development in Australia and New Zealand. The 2014 survey built upon the four previous studies, which began in 2005. All participants were asked questions regarding institutional information, personal information, salary information and advancement office information. Following this, they could choose to complete at least one of the following sections according to their role/s: fundraising, marketing & communications, alumni & community relations, and admissions.

Online survey of will drafters - Families and generational asset transfers: Making and challenging wills in contemporary Australia

A national online survey of private and public will drafters distributed through State/public trustee offices in seven states/territories and law societies and community legal centres across all states/territories yielded 257 responses. The survey, using questions, scales and case scenarios sought to canvas perceptions of difficulties facing will drafters and the strategies used to address them.

A survey of patients' experience of pain and other symptoms while receiving care from palliative care services

Context In Australia, patients at the end of life with complex symptoms and needs are often referred to palliative care services (PCSs), but little is known about the symptoms of patients receiving palliative care in different settings. Objective To explore patients’ levels of pain and other symptoms while receiving care from PCSs. Method PCSs registered through Australia's national Palliative Care Outcomes Collaboration (PCOC) were invited to participate in a survey between 2008 and 2011. Patients (or if unable, a proxy) were invited to complete the Palliative Care Outcome Scale. Results Questionnaires were completed for 1800 patients. One-quarter of participants reported severe pain, 20% reported severe ‘other symptoms’, 20% reported severe patient anxiety, 45% reported severe family anxiety, 66% experienced depressed feelings and 19% reported severe problems with self-worth. Participants receiving care in major cities reported higher levels of depressed feelings than participants in inner regional areas. Participants receiving care in community and combined service settings reported higher levels of need for information, more concerns about wasted time, and lower levels of family anxiety and depressed feelings when compared to inpatients. Participants in community settings had lower levels of concern about practical matters than inpatients. Conclusions Patients receiving care from Australian PCSs have physical and psychosocial concerns that are often complex and rated as ‘severe’. Our findings highlight the importance of routine, comprehensive assessment of patients’ concerns and the need for Specialist Palliative Care clinicians to be vigilant in addressing pain and other symptoms in a timely, systematic and holistic manner, whatever the care setting.

A tsunami of unmet needs: Pancreatic and ampullary cancer patients’ supportive care needs and use of community and allied health services

Objective People diagnosed with pancreatic cancer have the worst survival prognosis of any cancer. No previous research has documented the supportive care needs of this population. Our objective was to describe people’s needs and use of support services and to examine whether these differed according to whether or not patients had undergone surgical resection. Methods Queensland pancreatic or ampullary cancer patients (n=136, 54% of those eligible) completed a survey which assessed 34 needs across 5 domains (SCNS-SF34) and use of health services. Differences by resection were compared with Chi-squared tests. Results Overall, 96% of participants reported having some needs. More than half reported moderate-to-high unmet physical (54%) or psychological (52%) needs whereas, health system/information (32%), patient care (21%) and sexuality needs (16%) were described less frequently. The three most frequently reported moderate-to-high needs included ‘not being able to do things they used to do’ (41%), ‘concerns about the worries of those close’ (37%), and ‘uncertainty about the future’ (30%). Patients with non-resectable disease reported greater individual information needs but their needs were otherwise similar to patients with resectable disease. Self-reported use of support was low; only 35% accessed information, 28%, 18% and 15% consulted a dietician, complementary medicine practitioner or mental health practitioner, respectively. Palliative care access was greater (59% vs 27%) among those with non-resectable disease. Conclusion Very high levels of needs were reported by people with pancreatic or ampullary cancer. Future work needs to elucidate why uptake of appropriate supportive care is low and which services are required.

Public use and perceptions of emergency departments: A population survey

Objectives To inform demand management strategies aimed at reducing congestion in EDs by: (i) identifying public use of EDs, decision-making and reasons; and (ii) measuring acceptance of alternative care models. Methods A cross-sectional telephone survey of a random sample of Queensland population aged 18 years or older residing in a dwelling unit in Queensland that could be contacted on a land-based telephone service was conducted. One person per household was selected according to a predetermined algorithm to ensure sex and regional balance were interviewed. The main outcome measures were: ED use, attitudes towards ED staff and services, and alternative models of care. Results The final sample included a total of 1256 respondents (response rate = 40.3%). Twenty-one per cent attended EDs in the preceding 12 months. The decision to attend was made by patients (51%), health and medical professionals (31%), and others (18%). The main reasons included perceived severity of the illness (47%), unavailability of alternative services (26%) and better care (11%). Most respondents agreed with more flexible care models of service delivery including incentives for general practitioners (90%), private health insurance coverage for ED use (89%), and enhanced roles for paramedics and nurses. Conclusions Main reason for attending ED is perceived severity of illness, followed by lack of alternative care. The majority of both consumers and the public are in favour of more flexible care models. However, further research is necessary to detail those alternatives and to test and validate their effectiveness.

Community participation in post-disaster reconstruction

When a community already torn by a prolonged war is subsequently subjected to being hit by a natural disaster, the combined impact of such disasters can be extremely devastating. Affected communities often face enormous challenges during the long-term reconstruction, mainly due to the lack of a viable community involvement process. In post-war settings, affected communities are often conceived as being disabled and are hardly ever consulted when reconstruction projects are instigated. This lack of community involvement often leads to poor project planning, decreased community support and an unsustainable completed project. The impact of war, coupled with the tensions created by the poor housing provisions, often hinder the affected residents from integrating permanently into their home communities. This paper identifies a number of fundamental factors that act as barriers to community participation in reconstruction projects. The paper is based on a statistical analysis of a questionnaire survey administered in 2012 in Afghanistan.

The prevalence, predictors and associations of hypertension in Sri Lanka: A cross-sectional population based national survey

We studied the community prevalence, patterns and predictors of hypertension in a large sub-population of South Asian adults with a view of identifying differential risk factors. Data were collected between years 2005-2006 and 5000 adults were invited for the study. The sample size was 4485, and about 39.5% were males. Mean systolic and diastolic blood pressures were 127.1 ± 19.8 mmHg and 75.4 ± 11.3 mmHg, respectively. Age-adjusted prevalence in all adults, males and females was 23.7%, 23.4% and 23.8%, respectively. Urban adults had a significantly higher prevalence of hypertension than rural adults. In the binary logistic-regression analysis, male gender (OR: 1.2), increasing age, Sri Lankan Moor ethnicity (OR: 1.6), physical inactivity (OR: 1.7), presence of diabetes (OR: 2.2) and central obesity (OR: 2.3) all were significantly associated with hypertension. In conclusion, nearly one-third of the Sri Lankan adult population is hypertensive. Hence, public health initiatives should encourage healthier lifestyles with emphasis on preventing obesity and increasing physical activity.

Changing travel patterns and journeys to health services in Great Britain 1985-2012: An examination health service utilisation using the National Travel Survey

Background This paper examines changing patterns in the utilisation and geographic access to health services in Great Britain using National Travel Survey data (1985-2012). The National Travel Survey (NTS) is a series of household surveys designed to provide data on personal travel and monitor changes in travel behaviour over time. The utilisation rate was derived using the proportion of journeys made to access health services. Geographic access was analysed by separating the concept into its accessibility and mobility dimensions. Methods Variables from the PSU, households, and individuals datasets were used as explanatory variables. Whereas, variables extracted from the journeys dataset were used as dependent variables to identify patterns of utilisation i.e. the proportion of journeys made by different groups to access health facilities in a particular journey distance or time band or by mode of transport; and geographic access to health services. A binary logistic regression analysis was conducted to identify the utilisation rate over the different time periods between different groups. This analysis shows the Odds Ratios (ORs) for different groups making a trip to utilise health services compared to their respective counterparts. Linear multiple regression analyses were conducted to then identify patterns of change in the accessibility and mobility level. Results Analysis of the data has shown that that journey distances to health facilities were signi fi cantly shorter and also gradually reduced over the period in question for Londoners, females, those without a car or on low incomes, and older people. Although rates of utilisation of health services we re Oral Abstracts / Journal of Transport & Health 2 (2015) S5 – S63 S43 signi fi cantly lower because of longer journey times. These fi ndings indicate that the rate of utilisation of health services largely depends on mobility level although previous research studies have traditionally overlooked the mobility dimension. Conclusions This fi nding, therefore, suggests the need to improve geographic access to services together with an enhanced mobility option for disadvantaged groups in order for them to have improved levels of access to health facilities. This research has also found that the volume of car trips to health services also increased steadily over the period 1985-2012 while all other modes accounted for a smaller number of trips. However, it is dif fi cult to conclude from this research whether this increase in the volume of car trips was due to a lack of alternative transport or due to an increase in the level of car-ownership.

A methodological survey of future mobility literature: Opportunities for design research

This research establishes that the study of mobility and transportation is multi-disciplinary and highly complex, involving the diverse interplay between infrastructural and psychological factors. Coincidently, a new paradigm in personal mobility is developing. A new generation of mobility solutions is becoming widely available in the form of car and ride sharing services. These services build on the assumption that customers no longer need ownership of a product in order to benefit from it. With the emergence of this new paradigm, this paper presents a methodological review of current practises used by the wider research community. Therefore, this research piece aims to explore methodological approaches involved in the study the effect of community on an individual’s attitudes, perceptions and behaviours of future mobility solutions. The results of this review indicate that the majority of published literature uses quantitative methods as opposed to qualitative and even fewer studies have sought to understand the human factors in these new mobility solutions. This gap in knowledge is a valuable opportunity for design. Inherently qualitative and human focused, design research can fill this gap in knowledge by applying distinctly user-centred methods such as persona design, narrative storytelling, and in-depth observations to discover deeper human insights.

Community-based social marketing: Effects on social norms

Purpose This research investigates whether application of a community-based social marketing principle, namely increasing the visibility of a target behaviour in the community, can change social norms surrounding the behaviour. Design/methodology/approach A repeated measures quasi-experimental design was employed to evaluate the Victorian Health Promotion Foundation’s Walk to School 2013 programme, which increases the visibility of walking to and from school through programme participation to promote active transportation for primary school children. The target population for the survey were caregivers of primary school children aged between 5-12 years old. The final sample size across the three online surveys administered was 102 respondents. Findings The results suggest that the programme increased caregivers’ perceptions that children in their community walked to and from school and that walking to and from school is socially acceptable. Originality/value The study contributes to addressing the recent call for research examining the relationship between community-based social marketing principles and programme outcomes. Further, the results provide insight for enhancing the social norms approach, which has traditionally relied on changing social norms exclusively through media campaigns.