Impact of a pedometer-based workplace health program on cardiovascular and diabetes risk profile

OBJECTIVE: To evaluate whether participation in a four-month, pedometer-based, physical activity, workplace health programme results in an improvement in risk factors for diabetes and cardiovascular disease. METHODS: Adults employed within Australia in primarily sedentary occupations and voluntarily enrolled in a workplace programme, the Global Corporate Challenge®, aimed at increasing physical activity were recruited. Data included demographic, behavioural, anthropometric and biomedical measurements. Measures were compared between baseline and four-months. RESULTS: 762 participants were recruited in April/May 2008 with 79% returning. Improvements between baseline and four-months amongst programme participants were observed for physical activity (an increase of 6.5% in the proportion meeting guidelines, OR(95%CI): 1.7(1.1, 2.5)), fruit intake (4%, OR: 1.7(1.0, 3.0)), vegetable intake (2%, OR: 1.3(1.0, 1.8)), sitting time (-0.6(-0.9, -0.3) hours/day), blood pressure (systolic: -1.8(-3.1, -.05) mmHg; diastolic: -1.8(-2.4, -1.3) mmHg) and waist circumference (-1.6(-2.4, -0.7) cm). In contrast, an increase was found for fasting total cholesterol (0.3(0.1, 0.4) mmol/L) and triglycerides (0.1(0.0, 0.1) mmol/L). CONCLUSION: Completion of this four-month, pedometer-based, physical activity, workplace programme was associated with improvements in behavioural and anthropometric risk factors for diabetes and cardiovascular disease. Long-term evaluation is required to evaluate the potential of such programmes to prevent the onset of chronic disease.

Does positive mental health in adolescence longitudinally predict healthy transitions in young adulthood?

The present study examined the longer-term implications of adolescent positive mental health for successful young adult transitions. Positive mental health in adolescence was defined by indicators roughly corresponding to Seligman’s positive psychology PERMA framework (positive emotional experiences, engagement, relationships, purpose, and accomplishment), with the addition of health. Data were drawn from one of Australia’s longest running studies of social and emotional development (Australian Temperament Project, est. 1983, N = 2443), which has followed a large representative community sample from infancy to 27–28 years of age. In the analyzed sample of n = 999, positive mental health at 15–16 years was associated with indicators of career progression (educational attainment and perceived competence) and taking on citizenship responsibilities (volunteering and civic activities) over a decade later at 27–28 years. Mental health problems in adolescence were more relevant to establishing romantic partnerships in young adulthood: adolescent antisocial behaviors predicted higher likelihood of being in a relationship, while depressive symptoms predicted lower quality partnerships. The results suggest that successful transitions into young adult roles and responsibilities may be facilitated by targeted mental health promotion interventions designed to both foster positive mental health and address mental health difficulties in adolescence.

Active video games - An opportunity for enhanced learning and positive health effects?

Active video games are an emerging genre of electronic games that provide engaging exercise experiences by combining physical exertion with interactive game play. As such they have attracted increased interest from health promotion professionals to reduce sedentary behavior, increase physical activity, and improve health outcomes such as body composition. However their potential for enhancing the educational experience has not been extensively explored. This paper provides a brief overview of active video game research to date and outlines opportunities for future research. Specifically, we highlight the need to develop a conceptual framework to better understand the determinants, mediators, moderators, and consequences of active video gaming and integrate learning and health outcomes. Wepropose that active video games can be a key part of a wider “digital” supportive environment where education and health researchers and professionals work with, rather than against, video game technologies to promote learning and health.

Health literacy and the determinants of obesity: a population-based survey of sixth grade school children in Taiwan

BACKGROUND: Health literacy has become an important health policy and health promotion agenda item in recent years. It had been seen as a means to reduce health disparities and a critical empowerment strategy to increase people's control over their health. So far, most of health literacy studies mainly focus on adults with few studies investigating associations between child health literacy and health status. This study aimed to investigate the association between health literacy and body weight in Taiwan's sixth grade school children.

METHODS: Using a population-based survey, 162,209 sixth grade (11-12 years old) school children were assessed. The response rate at school level was 83%, with 70% of all students completing the survey. The Taiwan child health literacy assessment tool was applied and information on sex, ethnicity, self-reported health, and health behaviors were also collected. BMI was used to classify the children as underweight, normal, overweight, or obese. A multinomial logit model with robust estimation was used to explore associations between health literacy and the body weight with an adjustment for covariates.

RESULTS: The sample consisted of 48.9% girls, 3.8% were indigenous and the mean BMI was 19.55 (SD = 3.93). About 6% of children self-reported bad or very bad health. The mean child health literacy score was 24.03 (SD = 6.12, scale range from 0 to 32). The overall proportion of obese children was 15.2%. Children in the highest health literacy quartile were less likely to be obese (12.4%) compared with the lowest quartile (17.4%). After controlling for gender, ethnicity, self-rated health, and health behaviors, children with higher health literacy were less likely to be obese (Relative Risk Ratio (RRR) = 0.94, p < 0.001) and underweight (RRR = 0.83, p < 0.001). Those who did not have regular physical activity, or had sugar-sweetened beverage intake (RRR > 1.10, p < 0.0001) were more likely to report being overweight or obese.

CONCLUSIONS: This study demonstrates strong links between health literacy and obesity, even after adjusting for key potential confounders, and provides new insights into potential intervention points in school education for obesity prevention. Systematic approaches to integrating a health literacy curriculum into schools may mitigate the growing burden of disease due to obesity.

The potential contribution of intermediary organizations for implementation of school mental health

Questions persist regarding implementation of mental health promotion, prevention, and early intervention initiatives in schools. To date, attention has targeted the ‘Whats’ and ‘Hows’ in design and implementation. Ongoing clarification of ‘Who’ the key proponents are working in this space receives less consideration. This paper presents outcomes from a national colloquium involving leaders from organizations committed to school-based mental health practice in Australia. The aim of the colloquium was to introduce the concept of Intermediary Organizations (IOs) examining this for its potential contribution to improved mental health and school improvement. The central challenge for IOs is implementation, that is, assisting in knowledge mobilization connecting research to policy and practice. The colloquium discussion was grounded in an understanding of public value as an organizing principle for improving public sector effectiveness. The participants evaluated the nature, role, and potential contribution of IOs. Three key issues emerged as being central to effective implementation: health promotion and prevention, relational ethics, and evidence-based practice.

An exploration of the views of Australian mothers on promoting child oral health

Background: An important role for parents and caregivers in the prevention of dental caries in children is the early establishment of health promoting behaviours. This study aimed to examine mothers' views on barriers and facilitators to promoting child and family oral health. Methods: Semi-structured interviews were undertaken with a purposive sample of mothers (n = 32) of young children. Inductive thematic analysis was conducted. Results: Parental knowledge and beliefs, past experiences and child behaviour emerged as major influences on children's oral health. Child temperament and parental time pressures were identified as barriers to good oral health with various strategies reported for dealing with uncooperative children at toothbrushing time. Parental oral health knowledge and beliefs emerged as positive influences on child oral health; however, while most mothers were aware of the common causes of dental caries, very few knew of other risk factors such as bedtime feeding. Parents' own oral health experiences were also seen to positively influence child oral health, regardless of whether these were positive or negative experiences. Conclusions: Understanding parental oral health beliefs is essential to overcoming barriers and promoting enablers for good child oral health. Improving child oral health also requires consideration of child behaviour, family influences, and increasing awareness of lesser-known influencing factors.

Understanding health behaviour trajectories of immigrants in Australia: a longitudinal investigation

This thesis investigates the differences in key health behaviour outcomes (smoking, physical activity and risky alcohol drinking) between migrants from English speaking countries (ESC) and non-English speaking countries (NESC) relative to native-born (NB) Australians over a 12 year period using the Household Income and Labour Dynamics in Australia (HILDA) survey. The thesis also explored English language proficiency and socioeconomic factors as possible mechanisms through which health behaviour changes over time post migration. The results of this thesis enhance understanding of immigrants health behaviour trajectories which have important implications for the development of public health policies.

"If you can have one glass of wine now and then, why are you denying that to a woman with no evidence": Knowledge and practices of health professionals concerning alcohol consumption during pregnancy.

BACKGROUND: Alcohol consumption during pregnancy has the potential to cause significant harm to the foetus and the current Australian guidelines state that it is safest not to drink alcohol while pregnant. However, conflicting messages often appear in the media and it is unclear if the message to avoid alcohol is being effectively conveyed to pregnant women. AIMS: This research aims to explore the advice that health professionals provide to pregnant women about alcohol consumption; the knowledge of health professionals regarding the effects of alcohol consumption; and their consistency with following the Australian guidelines. METHODS: Ten semi-structured face to face interviews were conducted with health professionals who regularly provide antenatal care. These include midwives, obstetricians, and shared care general practitioners. A six-stage thematic analysis framework was used to analyse the interview data in a systematic way to ensure rigour and transparency. The analysis involved coding data extracts, followed by identifying the major themes. FINDINGS: Health professionals displayed adequate knowledge that alcohol can cause physical and mental difficulties that are lifelong; however, knowledge of the term FASD and the broad spectrum of difficulties associated with alcohol consumption during pregnancy was limited. Although health professionals were willing to discuss alcohol with pregnant women, many did not make this a routine part of practice, and several concerning judgements were noted. CONCLUSION: Communication between health professionals and pregnant women needs to be improved to ensure that accurate information about alcohol use in pregnancy is being provided. Further, it is important to ensure that the national guidelines are being supported by health professionals.

A public health intervention to change knowledge, attitudes and behaviour regarding alcohol consumption in pregnancy

Aim. To evaluate the effectiveness of a public health intervention aimed at changing knowledge, attitudes and behaviour. Methods. A non-blinded parallel group randomised controlled trial of pregnant women over 18 years of age. Women were recruited in the second trimester and assigned to one of two treatment groups. Both groups completed an initial questionnaire assessing knowledge, attitudes, and practices relating to alcohol consumption during pregnancy. The intervention group then received a mocktail recipe booklet and participants were asked to share the information with their partner. The control group received standard antenatal care. A follow-up questionnaire was conducted four weeks post birth. Primary outcome measures were a knowledge score of the health risks associated with alcohol consumption during pregnancy and an attitude score toward drinking during pregnancy. Secondary outcome measures included whether or not the woman and her partner abstained from drinking. Ethical approval was granted by the Women’s and Children’s Health Network and the University of South Australia. Results. A total of 161 participants were recruited at baseline (intervention = 82, control = 79) and 96 participants completed the trial (intervention = 49, control = 47). The findings suggest that the mocktail booklet was effective at improving knowledge (p<0.001; effect size 0.80) and improving attitudes towards drinking during pregnancy (p=0.017; effect size 0.43) in the intervention group compared to the control group. Although women in the intervention group were 30% more likely to abstain from drinking than in the control group (RR=1.3, 95% CI 0.97 – 1.75), this result was not statistically significant (p=0.077). Conclusions. Knowledge regarding the effects of alcohol consumption as well as attitudes towards drinking significantly improved as a result of a mocktail recipe booklet. Improving knowledge and changing attitudes has the potential to change health behaviour. Therefore, this intervention may reduce the percentage of women who continue to drink alcohol while they are pregnant and improve outcomes for infants and children.

Creating readiness for adopting a health promoting schools framework.

Belinda’s research examined the adoption of a Health Promoting School (HPS) framework in an International School. The development of a carefully constructed and executed change message, and simultaneously using top-down and bottom-up approaches were critical to initiating change. Alternative strategies for establishing HPS in the international school context were identified.