Is the objective food environment associated with perceptions of the food environment?

Objective The present study examined whether objective measures of the food environment are associated with perceptions of the food environment and whether this relationship varies by socio-economic disadvantage.

Design The study is a cross-sectional analysis of self-report surveys and objective environment data. Women reported their perceptions on the nutrition environment. Participants’ homes and food stores were geocoded to measure the objective community nutrition environment. Data on the average price and variety of fruit and vegetables were used to measure the objective consumer nutrition environment.

Setting The study was conducted in Melbourne, Australia, in 2003–2004.

Subjects Data presented are from a sample of 1393 women aged 18–65 years.

Results Overall the match between the perceived and objective environment was poor, underscoring the limitations in using perceptions of the environment as a proxy for the objective environment. Socio-economic disadvantage had limited impact on the relationship between perceived and objective nutrition environment.

Conclusions Further research is needed to understand the determinants of perceptions of the nutrition environment to enhance our understanding of the role of perceptions in nutrition choices and drivers of socio-economic inequalities in nutrition.

Inequalities in cardiovascular disease mortality : the role of behavioural, physiological and social risk factors

Background While the relationship between socio-economic disadvantage and cardiovascular disease (CVD) is well established, the role that traditional cardiovascular risk factors play in this association remains unclear. The authors examined the association between education attainment and CVD mortality and the extent to which behavioural, social and physiological factors explained this relationship.

Methods Adults (n=38 355) aged 40–69 years living in Melbourne, Australia were recruited in 1990–1994. Subjects with baseline CVD risk factor data ascertained through questionnaire and physical measurement were followed for an average of 9.4 years with CVD deaths verified by review of medical records and autopsy reports.

Results CVD mortality was higher for those with primary education only, compared with those who had completed tertiary education, with an HR of 1.66 (95% CI 1.10 to 2.49) after adjustment for age, country of birth and gender. Those from the lowest educated group had a more adverse cardiovascular risk factor profile compared with the highest educated group, and adjustment for these risk factors reduced the HR to 1.18 (95% CI 0.78 to 1.77). In analysis of individual risk factors, smoking and waist circumference explained most of the difference in CVD mortality between the highest and lowest education groups.

Conclusions Most of the excess CVD mortality in lower socio-economic groups can be explained by known risk factors, particularly smoking and overweight. While targeting cardiovascular risk factors should not divert efforts from addressing the underlying determinants of health inequalities, it is essential that known risk factors are addressed effectively among lower socio-economic groups.

Cohort profile : The resilience for eating and activity despite inequality (READI) study

The Resilience for Eating and Activity Despite Inequality (READI) cohort was established to address the following two key aims: to investigate the pathways (personal, social and structural) by which socio-economic disadvantage influences lifestyle choices associated with obesity risk (physical inactivity, poor dietary choices) and to explore mechanisms underlying ‘resilience’ to obesity risk in socio-economically disadvantaged women and children. A total of 4349 women aged 18–46 years and 685 children aged 5–12 years were recruited from 80 socio-economically disadvantaged urban and rural neighbourhoods of Victoria, Australia, and provided baseline (T1: 2007–08) measures of adiposity, physical activity, sedentary and dietary behaviours; socio-economic and demographic factors; and psychological, social and perceived environmental factors that might impact on obesity risk. Audits of the 80 neighbourhoods were undertaken at baseline to provide objective neighbourhood environmental data. Three-year follow-up data (2010–11) have recently been collected from 1912 women and 382 children. Investigators welcome enquiries regarding data access and collaboration.

Classroom teacher effectiveness research and inquiry, and its relevance to the development of public education policy: an Australian context

This paper has as its focus an analysis of the question and problem of classroom teacher effectiveness research and inquiry. It presents an examination of what counts as valid and worthwhile research in classroom teacher effectiveness studies for the development of education policy within an Australian context, the State of Victoria. The Government’s Blueprint, the major education policy document of the Victorian State Labour Government, outlines its educational approach. Important and core features of government direction for education policy include a focus on social and economic disadvantage. A priority for the Victorian State Labour Government is tangible and measurable improvement in the performance of the public education system. A particular concern is the problem of academic underperformance within public schools, particularly those designated as low-performing and situated in socially and economically disadvantaged communities. Building the capacity of the State’s teacher workforce forms a key component of the Blueprint, and State Government direction in public education. The paper utilises a qualitative theoretical framework. Eight education policy actor/participants were interviewed and their responses analysed using a critical discourse approach. The main findings indicate that education policy actors advocate a strong belief in particular forms of evidence-based research for the development of education policy in the area of classroom teacher effectiveness.

Barriers to avoiding fast-food consumption in an environment supportive of unhealthy eating

Objective
To investigate factors (ability, motivation and the environment) that act as barriers to limiting fast-food consumption in women who live in an environment that is supportive of poor eating habits.

Design
Cross-sectional study using self-reports of individual-level data and objectively measured environmental data. Multilevel logistic regression was used to assess factors associated with frequency of fast-food consumption.

Setting
Socio-economically disadvantaged areas in metropolitan Melbourne, Australia.

Subjects
Women (n 932) from thirty-two socio-economically disadvantaged neighbourhoods living within 3 km of six or more fast-food restaurants. Women were randomly sampled in 2007–2008 as part of baseline data collection for the Resilience for Eating and Activity Despite Inequality (READI) study.

Results
Consuming low amounts of fast food was less likely in women with lower perceived ability to shop for and cook healthy foods, lower frequency of family dining, lower family support for healthy eating, more women acquaintances who eat fast food regularly and who lived further from the nearest supermarket. When modelled with the other significant factors, a lower perceived shopping ability, mid levels of family support and living further from the nearest supermarket remained significant. Among those who did not perceive fruits and vegetables to be of high quality, less frequent fast-food consumption was further reduced for those with the lowest confidence in their shopping ability.

Conclusions
Interventions designed to improve women's ability and opportunities to shop for healthy foods may be of value in making those who live in high-risk environments better able to eat healthily.

Mediators of the relationship between sedentary behavior and depressive symptoms amongst disadvantaged women

Statement of problem
Associations between sedentary behavior (e.g. time spent sitting watching TV/using the computer) and physical health have been well documented, however, studies are increasingly reporting a positive relationship between certain sedentary behaviors and poor mental health (e.g. depression). Little is known about the underlying factors that may explain the link between sedentary behavior and likelihood of depression. The purpose of this study was to investigate the contribution of selected intra-personal and social factors as potential mediators of the relationship between sedentary behavior and depressive symptoms among women from disadvantaged neighborhoods.
Method
Cross-sectional survey data were provided by 4065 women (aged 18–45) living in disadvantaged neighborhoods. Women self-reported their sedentary behavior (total sitting time and screen time), depressive symptoms (CES-D 10), as well as a number of intra-personal (leisure-time physical activity, diet quality, weight status) and social (social cohesion, interpersonal trust, club membership) factors.
Results
Mediating analyses, controlling for confounders, showed that women's leisure-time physical activity partly mediated the relationship between total sitting time and increased likelihood of depressive symptoms. Women's diet quality, and social cohesion partly mediated the relationship between screen time and increased likelihood of depressive symptoms.
Conclusions
Acknowledging the cross-sectional study design, findings suggest that there may be several factors that explain the increased likelihood of depressive symptoms associated with greater sedentary time. Although future studies should test the mediating relationships longitudinally, these findings may help inform interventions aimed at reducing the likelihood of depression in disadvantaged women with high sitting time.

Longitudinal predictors of frequent vegetable and fruit consumption among socio-economically disadvantaged Australian adolescents

Adequate vegetable and fruit consumption is necessary for preventing nutrition-related diseases. Socio-economically disadvantaged adolescents tend to consume relatively few vegetables and fruits. However, despite nutritional challenges associated with socio-economic disadvantage, a minority of adolescents manage to eat vegetables and fruit in quantities that are more in line with dietary recommendations. This investigation aimed to identify predictors of more frequent intakes of fruits and vegetables among adolescents over a 2-year follow-up period. Data were drawn from 521 socio-economically disadvantaged (maternal education ≤Year 10 of secondary school) Australian adolescents aged 12–15 years. Participants were recruited from 37 secondary schools and were asked to complete online surveys in 2004/2005 (baseline) and 2006/2007 (follow-up). Surveys comprised a 38-item FFQ and questions based on Social Ecological models examining intrapersonal, social and environmental influences on diet. At baseline and follow-up, respectively, 29% and 24% of adolescents frequently consumed vegetables (≥2 times/day); 33% and 36% frequently consumed fruit (≥1 time/day). In multivariable logistic regressions, baseline consumption strongly predicted consumption at follow-up. Frequently being served vegetables at dinner predicted frequent vegetable consumption. Female sex, rarely purchasing food or drink from school vending machines, and usually being expected to eat all foods served predicted frequent fruit consumption. Findings suggest nutrition promotion initiatives aimed at improving eating behaviours among this at-risk population and should focus on younger adolescents, particularly boys; improving adolescent eating behaviours at school; and encouraging families to increase home availability of healthy foods and to implement meal time rules.

Genetic counseling for Indigenous Australians: an exploratory study from the perspective of genetic health professionals

Indigenous populations are thought to have particularly low levels of access to genetic health services, and cultural issues may be a contributing factor. This article presents the findings of the first study of genetic health service provision to Indigenous Australians. This qualitative study aimed to identify elements of culturally-competent genetic health service provision in Indigenous Australian contexts. Twelve semi-structured interviews were conducted with genetic counselors and clinical geneticists from around Australia who had delivered services to Indigenous Australians. Participants were asked to describe their experiences and identify any collective cultural needs of Indigenous clients, as well as comment on specific training and resources they had received or used. Interviews were audio-recorded and transcribed with thematic analysis conducted on the data. The findings show that participants were reluctant to generalize the needs of Indigenous peoples. Some participants asserted that Indigenous peoples have needs that differ from the general population, while others felt that there were no collective cultural needs, instead advocating an individualized approach. Being flexible and practical, taking time to build rapport, recognizing different family structures and decision-making processes, as well as socio-economic disadvantage were all identified as important factors in participants' interactions with Indigenous clients. Indigenous support workers and hospital liaison officers were seen as valuable resources for effective service provision. The implications of this study for training and practice are discussed.

Trends in body mass index according to educational attainment for urban Australian adults between 1980 and 2007

BackgroundWe have previously demonstrated that between the years 1980 and 2000, the mean body mass index (BMI) of the urban Australian population increased, with greater increases observed with increasing BMI. The current study aimed to quantify trends over time in BMI according to education between 1980 and 2007.MethodsWe compared data from the 1980, 1983 and 1989 National Heart Foundation Risk Factor Prevalence Studies, 1995 National Nutrition Survey, 2000 Australian Diabetes, Obesity and Lifestyle Study and the 2007 National Health Survey. For survey comparability, analyses were restricted to urban Australian residents aged 25-64 years. BMI was calculated from measured height and weight. The education variable was dichotomised at completion of secondary school. Four age-standardised BMI indicators were compared over time by sex and education: mean BMI, mean BMI of the top five percent of the BMI distribution, prevalence of obesity (BMI⩾30 kg/m(2)), prevalence of class II(+) obesity (BMI⩾35 kg/m(2)).ResultsBetween 1980 and 2007, the mean BMI among men increased by 2.5 kg/m(2) and 1.7 kg/m(2) for those with low and high education levels, respectively, corresponding to increases in obesity prevalence of 20(from 12% to 32%) and 11(10% to 21%) %-points. Among women mean BMI increased by 2.9 kg/m(2) and 2.4 kg/m(2) for those with low and high education levels respectively, corresponding to increases in obesity prevalence of 16(12% to 28%) and 12(7% to 19%) %-points. The prevalence of class II(+) obesity among men increased by 9(1% to 10%) and 4(1% to 5%) %-points for those with low and high education levels, and among women increased by 8(4% to 12%) and 4(2% to 6%) %-points. Absolute and relative differences between education groups generally increased over time.ConclusionsEducational differences in BMI have persisted among urban Australian adults since 1980 without improvement. Obesity prevention policies will need to be effective in those with greatest socio-economic disadvantage if we are to equitably and effectively address the population burden of obesity and its corollaries.International Journal of Obesity accepted article preview online, 16 March 2015. doi:10.1038/ijo.2015.27.

Social development measures associated with problem behaviours and weight status in Australian adolescents

During the adolescent years, substance use, anti-social behaviours and overweight/obesity are amongst the major public health concerns. We investigate if risk and protective factors associated with adolescent problem behaviours and substance use are also associated with weight status in young Australian adolescents. Data comes from the 2006 Healthy Neighbourhoods study, a cross-sectional survey of students attending primary (grade 6, mean age 11) and secondary (grade 8, mean age 12) schools in 30 communities across Australia. Adolescents were classified as not overweight, overweight or obese according to international definitions. Logistic and linear regression analyses, adjusted for age, gender and socio-economic disadvantage quartile, were used to quantify associations between weight status (or BMI z-score) and the cumulative number of problem behaviour risk and protective factors. Prevalence of overweight and obesity was 22.6 % (95 % confidence interval (CI), 21.2–24.0 %) and 7.2 % (CI, 6.3–8.3 %). Average number of risk and protective factors present was 4.0 (CI, 3.7–4.2) and 6.2 (CI, 6.1–6.3). Independently, total number of risk factors present was positively associated with likelihood of overweight and obesity, while number of protective factors present was inversely associated with the likelihood of being above a healthy weight. When both risk and protective factors were included in a regression model, only risk factors were associated with the likelihood of being overweight or obese. Average BMI z-score increased by 0.03 units with each additional risk factor present. Prevention programmes targeting developmental risk and protective factors in adolescents that reduce substance use and problem behaviours may also benefit physical health.

The Digital Divide: Differences in Computer Use between Home and School in Low Socio-economic Households

This article examines information and communication technologies(ICTs) practices in the home and school settings of four disadvantaged families. It reports the findings of a year-long study that investigated the nexus between computer-mediated literacy practices at home and at school and whether this inter-connectivity could make a difference in school success. The findings indicate that there was disjunction between home and school use. The ``digital divide'' exists for the families of this study, not in terms of access but in the gap between ICT practices at home and school. Schools in this study did not integrate ICT skills learned and demonstratedin the home environment into ICT practices at school. The study concludes that constructing pedagogical connections between home and school ICT practices may begin to bridge the ``digital divide''.

Technological disadvantage of the digital age

Debates continue about the relative benefits, costs and risks of the diffusion of computer-based technologies throughout society and schooling. One area that has received considerable attention is gender equity. Early work on gender and computers focused on differences between male and female access and use (e.g. Huff, Fleming & Cooper, 1992; Kirkman, 1993; Morritt, 1997; Nelson & Cooper, 1997; Sofia, 1993), with concerns focused on the potential for girls to be disadvantaged. In some respects, it is arguable that problems of gender equity in schools with respect to computers have been overcome. For example, in a small study I conducted in two New Zealand senior primary classrooms in 2003, I found that both boys and girls were motivated to use computers and appeared to have equal opportunities to access computers in the classroom. The students in my study expressed a belief in the importance of using computers, and this belief can also be discerned from educational policy and media coverage.
In this paper I argue that, although gender by itself no longer appears to be a source of disadvantage in terms of access to and use of computers in schools, many questions about technology, schooling and power relations still remain unanswered. I present two alternative viewpoints on the new digital age. First, I explore Melanie Stewart Millar’s (1998) analysis of digital discourse as one which reproduces the power of white, middle-class, educated, well-paid males, and excludes anything else it considers ‘Other’. Second, I review arguments that the digital age has provided sites for the transcendence of traditional hierarchies and inequalities (e.g. Spender, 1995). I conclude that, despite the discrepancies between these two viewpoints, both concur that technological disadvantage will exacerbate any existing inequality that might result from intersections of identity categories, such as, gender, ethnicity, age, and socio-economic status.

Do features of public open spaces vary according to neighbourhood socio-economic status?

This study examined the relations between neighbourhood socio-economic status and features of public open spaces (POS) hypothesised to influence children's physical activity. Data were from the first follow-up of the Children Living in Active Neighbourhoods (CLAN) Study, which involved 540 families of 5–6 and 10–12-year-old children in Melbourne, Australia. The Socio-Economic Index for Areas Index (SEIFA) of Relative Socio-economic Advantage/Disadvantage was used to assign a socioeconomic index score to each child's neighbourhood, based on postcode. Participant addresses were geocoded using a Geographic Information System. The Open Space 2002 spatial data set was used to identify all POS within an 800 m radius of each participant's home. The features of each of these POS (1497) were audited. Variability of POS features was examined across quintiles of neighbourhood SEIFA. Compared with POS in lower socioeconomic neighbourhoods, POS in the highest socioeconomic neighbourhoods had more amenities (e.g. picnic tables and drink fountains) and were more likely to have trees that provided shade, a water feature (e.g. pond, creek), walking and cycling paths, lighting, signage regarding dog access and signage restricting other activities. There were no differences across neighbourhoods in the number of playgrounds or the number of recreation facilities (e.g. number of sports catered for on courts and ovals, the presence of other facilities such as athletics tracks, skateboarding facility and swimming pool). This study suggests that POS in high socioeconomic neighbourhoods possess more features that are likely to promote physical activity amongst children.

'no through road'? Disadvantage in rural education

Investigates educational disadvantage for students completing their secondary education in rural schools. For these students rural location has contributed reduced exposure to a broad range of literacy practices, and involvement in student cohorts with lower levels of socio-economic status, less extensive cultural knowledge and lower post-school aspirations.

Perceived neighborhood environment and park use as mediators of the effect of area socio-economic status on walking behaviors

Background: Access to local parks can affect walking levels. Neighborhood environment and park use may influence relationships between neighborhood socioeconomic status (SES) and walking.

Methods: Self-report data on perceived park features, neighborhood environment, park use, neighborhood walking and sociodemographics
were obtained from a sample of Australian adults, living in high/low SES areas. Surveys were mailed to 250 randomly selected households within 500m of 12 matched parks. Mediating effects of perceived environment attributes and park use on relationships between area-SES and walking were examined.

Results: Mean frequency of local park use was higher for high-SES residents (4.36 vs 3.16 times/wk, P < .01), who also reported higher levels of park safety, maintenance, attractiveness, opportunities for socialization, and neighborhood crime safety, aesthetics, and traffic safety. Safety and opportunity for socialization were independently positively related to monthly frequency of visits to a local park which, in turn, was positively associated with walking for recreation and total walking. Residents of higher SES areas reported an average 22% (95% CI: 5%, 37%) more weekly minutes of recreational walking than their low SES counterparts.

Conclusion: Residents of high-SES areas live in environments that promote park use, which positively contributes to their weekly amounts of overall and recreational walking.