Investigating well-being, work limitations and preferences for self-management education and peer support among younger people with hip and knee osteoarthritis: protocol for a cross-sectional study

Introduction: 

The role of external influences in high involvement purchase behaviour

Purpose
The purpose of this paper is to discover the consumer decision-making style clusters within the context of automobile purchases in Australia. It also examines the differences between consumer decision-making styles in terms of the importance given to external influences, such as importance of dealers, importance of friends/family members, number of cars test driven, time spent researching final decision and importance of information sources (e.g. internet, magazines, TV ads, word of mouth, etc.), prior to making their final purchase decision.

Design/methodology/approach
Data were collected from 209 respondents using self-administered questionnaires. Cluster analysis and ANOVA were employed to identify and analyse the differences between consumer decision-making style clusters. Consumer Styles Inventory (CSI; Sproles and Kendall, 1986) was used to measure respondents’ consumer decision-making styles in relation to automobile purchases.

Findings
Three clusters were identified from the analysis, namely “innovative informed”, “rational confused”, and “traditional habitual”. Significant differences were found between the clusters in terms of the average time they spent with each car dealer, the time they spent on researching final decision and the importance of consulting with family members prior to making their final purchase decision.

Practical implications
The paper found that some consumers rely heavily on friends/families and dealers as the most important sources of information. Other sources of information consumers use include television advertisements, newspapers, billboards and magazines. Based on the findings, marketers should focus on providing similar types of information/messages by using these above-mentioned sources when communicating with this type of consumers. Dealers could be trained to spend time explaining product features and benefits in full with these consumers and their friends and family members whom they are likely to bring along before making the final purchase decision.

Originality/value
The findings of this study have extended the knowledge by determining the impact of external influences on consumer decision-making styles using the CSI in context of specific product which is yet to be known in relation to Australian automobile consumers.

From whence it came: understanding source effects in consumer‑generated advertising

Web 2.0 technologies are empowering consumers to co-produce online brand communications and thereby co-create brand meaning. As both consumers and marketers are increasingly using video-sharing websites to showcase their brand communication efforts, viewers of these ads are inadvertently becoming part of the co-production process as they create context around the ads (in the forms of reviews, comments and ratings). The environment in which such online advertisements are viewed has significant effects on consumer perceptions of the ad message, and ultimately impacts the persuasive properties and efficacy of the ad. This study reports on research conducted to test the source effects of consumer-generated advertising. Schlinger’s Viewer Response Profile (VRP) is used to assess the impact of three source variables: ad creator, ad popularity and motivation for creation of the ad. Findings confirm the importance of popularity ratings on consumer ad evaluation, and also suggest that certain source effects result in consumers being more critical in their evaluation of the ads.

Regulation of motor vehicle advertising: toward a framework for compliance research

There is concern that certain content within some motor vehicle television advertising may negatively influence the driving attitudes and behaviours of viewers, particularly young people, and hence have a negative impact on road safety. In recognition of this concern, many developed countries have adopted a self-regulatory approach to motor vehicle advertising. The basic elements of self-regulation are a code of practice or guiding principles governing advertising content and the establishment of a process for hearing and adjudicating complaints about alleged breaches of that code. However, as in other areas, the effectiveness of self-regulation is being questioned in that many motor vehicle advertisements in Australia and elsewhere appear non-compliant with self-regulatory codes. Applying lessons from studies of alcohol advertising, this paper first reviews the research assessing the content of motor vehicle advertising. A suggested research framework is then proposed to inform the development of motor vehicle advertising regulatory codes where they do not exist, and to better monitor compliance with codes where they do exist. The research framework suggested includes expert content analysis of ads, the impact of advertising on risk-taking cognitions and decisions in computer-simulated traffic situations, and assessing audience perceptions of, and reactions to, messages in advertisements mapped against regulatory code content. An example of audience reaction research is also presented.

Food references and marketing in popular magazines for children and adolescents in New Zealand. A content analysis

Food marketing is recognized as an important factor influencing children's food preferences and consumption. The purpose of this study was to examine the nature and extent of unhealthy food marketing and non-branded food references in magazines targeted at and popular among children and adolescents 10–17 years in New Zealand. A content analysis was conducted of all food references (branded and non-branded) found in the five magazines with the highest readership among 10–17 year olds, and the three magazines (of which two were already included among the five most popular magazines) targeted to 10–17 year olds. For each of the six magazines one issue per month (n = 72 issues in total) over a one-year period (December 2012–January 2014) was included. All foods referenced were classified into healthy/unhealthy according to the food-based Ministry of Health classification system. Branded food references (30% of total) were more frequent for unhealthy (43%) compared to healthy (25%) foods. Magazines specifically targeted to children and adolescents contained a significantly higher proportion of unhealthy branded food references (72%, n = 51/71) compared to the most popular magazines among children and adolescents (42%, n = 133/317), of which most were targeted to women. ‘Snack items’ such as chocolates and ice creams were marketed most frequently (n = 104; 36%), while ‘vegetables and fruits’ were marketed the least frequently (n = 9; 3%). Direct advertisements accounted for 27% of branded food references and 25% of those featured health or nutrition claims. Both branded and non-branded food references were common within magazines targeted at and popular among children and adolescents, and skewed toward unhealthy foods. This raises concerns about the effectiveness of self-regulation in marketing and emphasizes that government regulations are needed in order to curb children's current potential high exposures to unhealthy food marketing. In addition, magazine editors could take socially responsible editorial positions in regard to healthy eating.

Socioeconomic differences in outdoor food advertising at public transit stops across Melbourne suburbs.

To assess and compare the number and type of outdoor food advertisements at public transit stops within suburbs of varying levels of socioeconomic disadvantage.

Consumer perceptions of bundles and time-limited promotion deals: Do contracts matter?

Marketers use various types of deals to positively influence consumers' product evaluations. Across two experiments, we manipulated print advertisements to examine whether the commonly used deal content of both bundling and time-limited promotions affect consumers' perceived confusion, risk and value. In study 1, the influence of this content was tested in the context of a 2-year telecommunications (telco) contract. Here, consumers associated a three-item bundle with greater perceived value than a single item, but perceived value was reduced and risk heightened when it was only available for a limited time. We speculate that this is because of the long-term nature of the contract. Study 2 removed the contract restriction, examining the bundling of a video game console and game(s), again with a time-limited promotion. However, in this context, we failed to locate any interaction effects. It appears that consumers further appraise the drawbacks of a long-term telco contract when accompanied by a time-limited promotion and may perceive the switching costs for study 1 three-item telco bundle to be particularly risky. Our studies represent the first empirical investigation of the effect on consumers' perceptions of offering a bundle in conjunction with a time-limited promotion. Testing these effects in contract and no contract conditions adds to the contribution of our studies by delineating a boundary condition. From a managerial perspective, our findings are thought-provoking in respect to information integration, or how consumers process different deal content together.

The substantial personal burden experienced by younger people with hip or knee osteoarthritis

OBJECTIVE: To compare Health-Related Quality of Life (HRQoL) and psychological distress in younger people with hip or knee osteoarthritis (OA) to age- and sex-matched population norms, and evaluate work limitations in this group. METHOD: People aged 20-55 years with hip or knee OA were recruited from major hospitals (n = 126) and community advertisements (n = 21). HRQoL was assessed using the Assessment of Quality of Life (AQoL) instrument (minimal important difference 0.06 AQoL units) and compared to population norms. Psychological distress was assessed using the Kessler Psychological Distress Scale (K10) and the prevalence of high/very high distress (K10 score ≥22) was compared to Australian population data. Work limitations were evaluated using the Workplace Activity Limitations Scale (WALS). RESULTS: Considering most participants had a relatively recent OA diagnosis (<5 years), the extent of HRQoL impairment was unexpected. A very large reduction in HRQoL was evident for the overall sample, compared with population norms (mean difference -0.35 AQoL units, 95% CI -0.40 to -0.31). Females, people aged 40-49 years, and those with hip OA reported average HRQoL impairment of almost 40% (mean reductions -0.38 to -0.39 AQoL units). The overall prevalence of high/very high distress was 4 times higher than for the population (relative risk 4.19, 95% CI 3.53-4.98) and 67% reported moderate to considerable OA-related work disability, according to WALS scores. CONCLUSIONS: These results clearly demonstrate the substantial personal burden experienced by younger people with hip or knee OA, and support the provision of targeted services to improve HRQoL and maximise work participation in this group.

Psychosocial factors and excessive gestational weight gain: the effect of parity in an Australian cohort

OBJECTIVES: psychosocial variables can be protective or risk factors for excessive gestational weight gain (GWG). Parity has also been associated with GWG; however, its effect on psychosocial risk factors for GWG is yet to be determined. The aim of this study was to investigate if, and how, psychosocial factors vary in their impact on the GWG of primiparous and multiparous women. DESIGN/PARTICIPANTS: pregnant women were recruited in 2011 via study advertisements placed in hospitals, online, in parenting magazines, and at baby and children's markets, resulting in a sample of 256 women (113 primiparous, 143 multiparous). Participants completed questionnaires at 16-18 weeks' gestation and their pregravid BMI was recorded. Final weight before delivery was measured and used to calculate GWG. FINDINGS: the findings revealed that primiparous women had significantly higher feelings of attractiveness (a facet of body attitude; p=0.01) than multiparous women. Hierarchical regressions revealed that in the overall sample, increased GWG was associated significantly with lower pre-pregnancy BMI (standardised coefficient β=-0.39, p<0.001), higher anxiety symptoms (β=0.25, p=0.004), and reduced self-efficacy to eat a healthy diet (β=-0.20, p=0.02). Although higher GWG was predicted significantly by decreased feelings of strength and fitness for primiparous women (β=-0.25, p=0.04) and higher anxiety was related significantly to greater GWG for multiparous women (β=0.43, p<0.001), statistical comparison of the model across the two groups suggested the magnitude of these effects did not differ across groups (p>0.05). CONCLUSIONS/IMPLICATIONS FOR PRACTICE: the findings suggest that psychosocial screening and interventions by healthcare professionals may help to identify women who are at risk of excessive GWG, and there may be specific psychosocial factors that are more relevant for each parity group.

A conceptual classification of parents’ attributions of the role of food advertising in children’s diets

Background : High levels of child obesity are triggering growing concerns about the prevalence and effects of food advertising targeted at children. Efforts to address this advertising are confounded by the expanding repertoire of media and promotional techniques used to reach and attract children. The present study explored parents’ views on food marketing and the strategies parents employ when attempting to ameliorate its effects. As part of an online survey of Australian parents’ attitudes towards a range of food advertisements, respondents were invited to provide additional comment in an open-ended question. The question was optional and asked “Are there any other comments you would like to make?”. One in five of the survey respondents (18%; n = 235) elected to answer this question by discussing their views on food advertising and children’s diets. The responses were imported into NVivo10 for coding and analysis. A grounded approach was used to draw meaning from the data and develop a proposed conceptual classification of parents’ attributions relating to food advertising and its consequences.

Results : The majority of responses related to the negative perceived effects of unhealthy food advertising on children’s diets, with few respondents considering such advertisements to be innocuous. The responses were classified into four conceptual categories reflecting differing attitudes to advertising (negative to neutral) and varying levels of locus of control (low to high). The typical characteristics of parents allocated to the four categories exhibited variation according to weight status, television viewing habits, education level, and family size. The largest number of responses was coded to the category characterized by a negative attitude toward food advertising and a low locus of control. Parents in this category were more likely than others to be overweight/obese and heavy television viewers. Parents in the negative attitude to advertising and high locus of control category nominated a variety of parenting practices that could form the basis of parent education interventions.

Conclusions : The results suggest that many Australian parents may feel disempowered in the face of high levels of advertising for unhealthy foods. The current voluntary regulatory code appears to be inadequate in scope and coverage to address this situation.

The pioneering years of Australian animation (1900–1930): from animated sketches to animation empire

This article describes the very earliest beginnings of Australian animation, detailing the events, processes, and the people who pioneered this medium from approximately 1900 to 1930. It examines these early achievements, which range from the first ‘animated lightning sketches’ to the rise and subsequent demise of a major animation studio. Much of this article focuses on the innovative work of Harry Julius (1885–1938) who is generally regarded as the chief pioneer of animation in Australia. However, as this article reveals, there were others who experimented with animation before Julius, and there were a number of artists and animators who worked alongside him in those early decades. Together, Julius and team built the very successful Sydney-based studio, Cartoon Filmads, which developed into what could only be described as an ‘animation empire’ with a robust national and international reach. This article details some of the authors’ extensive research surrounding these previously overlooked cinematic efforts, and carefully analyses these in terms of content, production, audience reception and international context.

Apps for IMproving FITness and increasing physical activity among young people: the AIMFIT pragmatic randomized controlled trial

BACKGROUND: Given the global prevalence of insufficient physical activity (PA), effective interventions that attenuate age-related decline in PA levels are needed. Mobile phone interventions that positively affect health (mHealth) show promise; however, their impact on PA levels and fitness in young people is unclear and little is known about what makes a good mHealth app. OBJECTIVE: The aim was to determine the effects of two commercially available smartphone apps (Zombies, Run and Get Running) on cardiorespiratory fitness and PA levels in insufficiently active healthy young people. A second aim was to identify the features of the app design that may contribute to improved fitness and PA levels. METHODS: Apps for IMproving FITness (AIMFIT) was a 3-arm, parallel, randomized controlled trial conducted in Auckland, New Zealand. Participants were recruited through advertisements in electronic mailing lists, local newspapers, flyers posted in community locations, and presentations at schools. Eligible young people aged 14-17 years were allocated at random to 1 of 3 conditions: (1) use of an immersive app (Zombies, Run), (2) use of a nonimmersive app (Get Running), or (3) usual behavior (control). Both smartphone apps consisted of a fully automated 8-week training program designed to improve fitness and ability to run 5 km; however, the immersive app featured a game-themed design and narrative. Intention-to-treat analysis was performed using data collected face-to-face at baseline and 8 weeks, and all regression models were adjusted for baseline outcome value and gender. The primary outcome was cardiorespiratory fitness, objectively assessed as time to complete the 1-mile run/walk test at 8 weeks. Secondary outcomes were PA levels (accelerometry and self-reported), enjoyment, psychological need satisfaction, self-efficacy, and acceptability and usability of the apps. RESULTS: A total of 51 participants were randomized to the immersive app intervention (n=17), nonimmersive app intervention (n=16), or the control group (n=18). The mean age of participants was 15.7 (SD 1.2) years; participants were mostly NZ Europeans (61%, 31/51) and 57% (29/51) were female. Overall retention rate was 96% (49/51). There was no significant intervention effect on the primary outcome using either of the apps. Compared to the control, time to complete the fitness test was -28.4 seconds shorter (95% CI -66.5 to 9.82, P=.20) for the immersive app group and -24.7 seconds (95% CI -63.5 to 14.2, P=.32) for the nonimmersive app group. No significant intervention effects were found for secondary outcomes. CONCLUSIONS: Although apps have the ability to increase reach at a low cost, our pragmatic approach using readily available commercial apps as a stand-alone instrument did not have a significant effect on fitness. However, interest in future use of PA apps is promising and highlights a potentially important role of these tools in a multifaceted approach to increase fitness, promote PA, and consequently reduce the adverse health outcomes associated with insufficient activity.

Alcohol advertising in sport and non-sport TV in Australia, during children's viewing times

Estimate the amount of alcohol advertising in sport vs. non-sport programming in Australian free-to-air TV and identify children's viewing audience composition at different times of the day. Alcohol advertising and TV viewing audience data were purchased for free-to-air sport and non-sport TV in Australia for 2012. We counted alcohol advertisements in sport and non-sport TV in daytime (6 am-8.29 pm) and evening periods (8.30 pm-11.59 pm) and estimated viewing audiences for children and young adults (0-4 years, 5-13 years, 14-17 years, 18-29 years). During the daytime, most of the alcohol advertising (87%) was on sport TV. In the evening, most alcohol advertising (86%) was in non-sport TV. There was little difference in the mean number of children (0-17 years) viewing TV in the evening (N = 273,989), compared with the daytime (N = 235,233). In programs containing alcohol advertising, sport TV had a greater mean number of alcohol adverts per hour (mean 1.74, SD = 1.1) than non-sport TV (mean 1.35, SD = .94). Alcohol advertising during the daytime, when large numbers of children are watching TV, is predominantly in free-to-air sport TV. By permitting day-time advertising in sport programs and in any programs from 8.30 pm when many children are still watching TV, current regulations are not protecting children from exposure to alcohol advertising.

Staging a cultural collaboration: Louise Lightfoot and Ananda Shivaram's first Indian Dance Tour of Australia, 1947-1949

One of the most highly stylized of the Indian forms of dance-drama, Kathakali has also received the greatest amount of attention on the global stage. We argue that its international exposure began with the performances of Ananda Shivaram, as managed by the Australian impresario Louise Lightfoot, in a landmark intercultural collaboration. From 1947 to 1949, Shivaram, along with an ensemble of Australian dancers, successfully toured Australia, adapting a range of Kathakali dance-dramas to performance in an international context. Lightfoot organized and publicized the tour, translated texts, and explained the art of Kathakali - virtually unknown - to excited Australian audiences. Using newspaper reports, advertisements, program brochures, and promoter's notes, we chart the performer's and the impresario's journeys, how they fostered intercultural understanding, and how Shivaram became a cultural ambassador for India.

Do cognitive, language, or physical impairments affect participation in a trial of self-management programs for stroke?

BACKGROUND: Research studies may have limited generalizability when survivors of stroke with physical, language, or cognitive impairments are excluded. AIMS: To assess whether presence of cognitive, language, or global impairments affects participation in self-management programs.

METHODS: Stroke survivors were recruited in South Australia from seven hospitals or via advertisements into a randomized controlled trial (1:1:1 ratio) of a Stroke Self-Management Program, the Stanford chronic condition self-management program, or standard care. Impairment status was measured using: Cognistat (cognition), Frenchay Aphasia assessment (language), modified Rankin Score (mRS; where score 3-5 = global disability).

PRIMARY OUTCOMES: participation (i.e. booked, accessed, and completed a program (defined as attending ≥ 50% of sessions)) and safety (i.e. adverse events). Outcomes were compared by impairment status. RESULTS: Among 315 people screened 143/149 eligible were randomized (median age 71 years; 41% male; with impairments: 62% cognitive, 34% language, 64% global disability). Participation did not differ by cognitive or language impairment status (cognitive 75%, no cognitive 68%, p = 0.54; language 78%, no language 69%, p = 0.42). However, participation did vary by global impairment status (global disability 61%, no disability 96%, p < 0.001). Participants with cognitive impairment experienced more adverse events (severe n = 9 versus no cognitive impairment n = 1).

CONCLUSION: Survivors of stroke with cognitive, language, or global impairments are able to participate in self-management programs and should be included in these types of research studies or programs. Reduced participation by those with global disability and the possibility of more adverse events in people with cognitive impairments needs to be considered.