Evaluating a community lifestyle intervention: adherence and the role of perceived support

Background Interventions that increase participation in physical activity and positive dietary changes may improve the health of the community through modifying the lifestyle contribution to preventable disease. However, previous evaluations have identified concerns about inequitable and unsustainable uptake, adherence and retention within healthy lifestyle schemes.

Intervention study The intervention evaluated here was designed to be a 12-week intervention for participants, offering free testing of physiological indicators of health, one-to-one health advice and a range of exercise, activity and cookery classes, at no or reduced cost, at local venues throughout the community. This paper reports the findings from a small qualitative study undertaken to explore the experiences and reflections of those who took part in the intervention to different extents, including those who fully and partially participated as well as those who dropped out or declined to take part.

Method Sixteen respondents took part in semi-structured interviews (5 male, 11 female; 8 black, 8 white; age range 25–85).

Findings The findings suggest that participants assessed the healthy lifestyle intervention in terms of how well it met their pre-existing needs and opportunities for change, and that they selected the aspects of the scheme that suited them, interested them and were perceived as delivering salient results. There is also evidence for a stronger role of perceived support in influencing uptake and maintenance of lifestyle changes, and that support was conceptualised by participants as one of the services offered by the scheme. Perceived support and related perceptions of reliance on the scheme to sustain lifestyle changes also suggested that in some cases full adherence to a scheme is not as likely to produce long-term adherence to lifestyle changes as compared to partial, but more realistic adherence and smaller lifestyle changes. Implications for delivering and evaluating healthy lifestyle interventions are also discussed.

A tenuous belonging: international students, multiculturalism and the manifestation of cosmopolitanism in local schools

This paper is concerned with the ‘imagination of community within local/global contexts such as those of Australian schools, at the beginning of the 21st century. In particular, it explores the ways that school community representatives in urban and rural Victoria, Australia discuss the presence of international students within their school communities and the consequences of these understandings for the ways that these students can belong. The paper argues that recent and globalising changes, particularly the impact of international students within schools, have meant that school communities understand the presence of others and therefore themselves in new ways. Arguments derived from mono-cultural and multicultural thought, always ambivalent, take on new forms as school representatives are concerned with a more individualistic and market driven world shaped within a cacophony of local/ global tensions. The paper concludes that in the tenuousness of belonging within local/global communities such as those of Australian schools, understandings of community and its outsiders need to be understood in relation to the contradictory but increasingly pervasive logics of cosmopolitan discourse.

Community-based sustainability: conservation in the Ballarat region

The discourse of sustainability is promoted internationally, with the United Nations declaring 2005-2014 as a Decade for Education for Sustainable Development. There is discussion concerning the nature, status and significance of Education for Sustainability and its relationship with the somewhat established discourse of environmental education. This debate requires continuing theorising and one approach is to reflect critically on specific examples of sustainability within specific communities. This article seeks to promote further discussion about sustainability, and to contribute to ongoing theorisation about Education for Sustainability, by considering a particular instance – that of environmental sustainability in the Ballarat region of Victoria. The case study suggests that implementation of this local environmental sustainability strategy was dominated by technocratic and individualistic ideologies.

An exploration of sense of community, part 3: dimensions and predictors of psychological sense of community in geographical communities

Within the discipline of community psychology there remains considerable debate as to the latent structure of psychological sense of community (PSOC). One of the few theoretical discussions is that of McMillan and Chavis (1986), who hypothesized four dimensions: Belonging; Fulfillment of Needs; Influence; and Shared Connections. Discussion has also emerged in the literature regarding the role of identification within PSOC. However few studies have empirically investigated the role of identification in PSOC. The current study explored PSOC in a sample of residents of rural, regional and urban geographical communities (N = 669). In an endeavor to clarify the underlying dimensions of PSOC, a test battery included several measures of PSOC as well as measures of identification with the community. The study also examined the role of demographic factors in predicting PSOC. Results provided support for McMillan and Chavis' (1986) four dimensions of PSOC. Further, a fifth dimension emerged, that of Conscious Identification, suggesting that identification is separate to existing dimensions of PSOC. The demographic factors significantly associated with PSOC were type of region, with rural participants displaying higher PSOC than their urban counterparts; participation in local organizations; having children; and a vision of one’s neighborhood as broader than just a street or block. These results, and the implications for PSOC research, are discussed.

People, places and public health : evaluating the benefits of civic environmentalism in an urban local government context

Recent political, economic and social trends pose threats to the sustainability both of ecosystems and of human health. Australia’s environmental management record is poor, and while by international standards Australians enjoy good health, this is variable (AIHW, 2000). Within developed nations, heart disease, depression, alcohol dependence and stroke are major health issues (Mathers et al. 2002). In Australia, mental disorder is the number one contributor to the disease burden (Vos & Mathers 2000). Recent research has highlighted the role of social capital as a key determinant of health (Kawachi et al., 1997). Despite this, Putnam (1995) observes that social connectedness and civic engagement are in decline. People have less time for leisure and for volunteering, as many juggle paid work and caring for children. Anecdotal evidence suggests that engagement in civic environmentalism has human health benefits, relating to a combination of exposure to natural environments and increased social capital (Maller, Brown, Townsend & St. Leger, 2002). This link is supported by Furnass (1996) who defines well-being as including: satisfactory human relationships, meaningful occupation, opportunities for contact with nature, creative expression, and making a positive contribution to human society. Research conducted by Deakin University confirms the efficacy of linking people and places through civic environmentalism for addressing both ecosystem sustainability and human health and wellbeing. The research has included a pilot study to explore the human health benefits of membership of a local parkland ‘Friends’ group, and a more detailed follow-up study. The aims of the pilot study included:- To identify the range of motivations for joining the Friends group;- To document members’ perceptions of the benefits gained from membership of the group;- To assess the potential for Friends groups to be used as an ‘upstream’ health promotion measure.Face-to-face interviews were conducted with eleven members of a ‘Friends’ group in the eastern suburbs of Melbourne. Data was analysed thematically and key findings included:- Motivations: environmental; social; and pragmatic.- General benefits: community belonging; personal satisfaction; learning opportunities; physical activity; and better environment.- Health benefits: physical health; mental health; and social support. There was unanimous support for the use of ‘Friends’ groups as a tool for health promotion.The follow-up study, in the western suburbs of Melbourne, expanded on the pilot study by measuring the group’s social capital and by collecting self-report data on levels of health service usage. Data was collected through face-to-face interviews and a questionnaire. The findings were similar to the pilot study in relation to the motivations, benefits and the health promotion potential of such groups. However, health service usage data highlighted an apparent anomaly: while respondents perceived significant health benefits, some were nevertheless utilising health services at a relatively high level. This poses some questions requiring further exploration: Is this due to the poorer baseline health of the high health service usage members compared with their fellow members? Does involvement in the group offer health benefits that enable people who would otherwise be too unhealthy to participate in community groups to continue such involvement?If this is the case, then we may do well to look to locally-based mechanisms for promoting ecological sustainability as a tool also for promoting human health. Instead of prescribing a pill, connecting people and places through engagement with a local friends group may address our health problems at the same time as addressing local environmental problems.

Measuring the walkability of local communities using geographic information systems data

Researchers are working to identify and promote environment and policy initiatives to encourage more active and healthy communities. Measuring environmental attributes through objective means can verify which physical environment factors are most important. We describe how Geographic Information Systems (GIS) may be used to measure objectively, the features of the built environment that may influence walking. We show how four key attributes currently believed to be of most relevance to walking for transport may be used to create a ‘walkability’ index. These are dwelling density (higher-density neighbourhoods support greater retail and service variety, resulting in shorter, walkable distances between facilities; driving and parking are more difficult); street connectivity (higher intersection density provides people with a greater choice of potential routes, easier access to major roads where public transport is available and shorter times to get to destinations); land use mix (the more varied the land use mix and built form, the more conducive it is to walk to various destinations); and net retail area (people who live near multiple and diverse retail opportunities are able to make more frequent and shorter shopping trips by walking and can walk to more local employment opportunities). The potential relationships between each of the objective environmental-attribute measures and walking behaviours is discussed, together with suggestions as to how such measures might be used to guide community infrastructure planning. GIS mapping can assist decision makers in where to focus transportation investments and where to guide future growth. Readily accessible GIS data can be used to guide and support urban planning and infrastructure investment decisions in both the private and public sectors, to increase walking in communities.

Are perceptions of the local environment related to neighbourhood satisfaction and mental health in adults?

Background: Perceptions of environmental attributes can influence satisfaction with where people live and mental health status. We examined the association between perceived environmental characteristics, neighbourhood satisfaction, and self-rated mental health.

Methods: We report cross-sectional data from the Physical Activity in Localities and Community Environments (PLACE) study in Australia (n = 2194). Self-report data included socio-demographics, perceived attributes of the environment, neighbourhood satisfaction (NS) and mental health status. Neighbourhood SES was obtained through census data. Factor analysis was used to identify dimensions of NS. Generalized linear models were used to examine associations between NS and perceived environment characteristics and whether aspects of NS were independently associated with mental health.

Results: NS factors identified were safety and walkability, access to destinations, social network, travel network, and traffic and noise. Perceived environmental characteristics of aesthetics and greenery, land use mix – diversity, street connectivity, traffic safety, infrastructure for walking, access to services and barriers to walking were found to be positively associated with these factors. Traffic load and crime were negatively associated. Three NS factors (safety and walkability, social network, and traffic and noise) were independent predictors of mental health.

Conclusions: Neighbourhood satisfaction may mediate the association between perceived environmental characteristics and measures of mental health in adults.

Interrogating 'imagined' communities : exploring the impact of international students in local schools

This paper suggests new directions understanding the impact of international students in schools. It is concerned with the ways that community representatives discuss these students and their impact on the community of the school. Recent literatures describe communities such as those of schools as ones of perception and materiality whereby some are included differently than others. Discourses such as multiculturalism and monoculturalism, which have traditionally shaped these discussions about community relations, have always been ambivalent. They take on new forms as local/global interaction, and the individualistic and market-driven changes that lead to the arrival of international students have consequences for the everyday lives of school community members. These need to be investigated if the location of international students in local school communities is to be properly described and interrogated.

Children's active free play in local neighborhoods : a behavioral mapping study

Many Australian children are more sedentary than they should be, and almost one in five are currently overweight or obese. Some children may face difficulties finding opportunities to be active, having poor access to safe public open spaces or having low independent mobility limiting their access to places to play. This study aimed to examine children's access to places in their neighborhood for active free play and how these vary by age, sex and socioeconomic status (SES). Behavioral maps of the local neighborhood were completed by children (8-12 years) from five primary schools across different areas of Melbourne. Children living in low SES outer-urban neighborhoods had to travel greater distances to access local parks compared with those in inner-urban mid and high SES areas. One-third (32%) of children reported an independent mobility range of <100 m from home. In conclusion, for some children opportunities to engage in active free play in the local neighborhood may be limited due to lack of parks in close proximity to home and restricted independent mobility. It is important to collaborate with local governments, urban planners and community groups to improve access to neighborhood parks and to promote a sense of neighborhood safety.

Socioeconomic variations in women's diets : what is the role of perceptions of the local food environment

Objectives : To test the contribution of perceived environmental factors (food availability, accessibility and affordability) to mediating socioeconomic variations in women’s fruit, vegetable and fast food consumption.

Methods : A community sample of 1580 women from 45 neighbourhoods provided survey data on their socioeconomic position (SEP) (education and income); diet (fruit, vegetable and fast food consumption); and the perceived availability of, access to and cost of healthy food in their local area.

Results : Once perceived environmental variables were considered, the associations between SEP and diet were weak and non-significant, suggesting that socioeconomic differences in diet were almost wholly explained by perceptions of food availability, accessibility and affordability.

Conclusions : Strategies to decrease socioeconomic inequalities in diet could involve promoting inexpensive ways to increase fruit and vegetable consumption, and ensuring that people of low SEP are aware that many healthy foods are available at relatively low cost. Future research should also confirm if perceptions match objective measures of food availability, accessibility and affordability, in order to address the real and/or perceived lack of healthy options in low SEP neighbourhoods.

Climate change and community response in the Borough of Queenscliffe

The Borough of Queenscliffe (BoQ) occupies a unique place among coastal Victorian locations. Situated at the tip of the Bellarine Peninsula, the Borough has approximately 3000 permanent residents, one third of who are over 60 years old. The Borough is also the smallest in Victoria, covering a total area of 13 square kilometres. BoQ is also unique because of its location. The Borough is almost totally surrounded by water and much of this is classified as maritime national park. The Swan Bay Marine Reserve is a Ramsar site and is therefore a wetland of international significance. The Borough relies heavily on tourism for its economic livelihood.

This paper begins with an overview of the BoQ in geographic, demographic and economic terms and then discusses the possible effects and impacts of climate change, as they relate to this small community. These sections are viewed from environmental, economic and social perspectives. Environmental impacts include the erosion of the coastal sand dune system and the loss of habitat for the orange-bellied parrot. Social impacts include the health effects and dangers of flooding for low-lying housing. Various indicators of community response are described, particularly the activities of the local climate change action group. Their strategy can essentially be described as a ‘push upward and downward’ approach. Innovative actions to implement this strategy are described in the paper.

Sea search : a community-based citizen science monitoring program for Victoria, Australia, Marine National Parks and Marine Sanctuaries

Community involvement in monitoring Victoria’s Marine Protected Areas (MPAs) engages coastal volunteers in looking after their marine ‘front yards”. The Management Strategy for Victoria’s System of Marine National Parks and Marine Sanctuaries dedicates an entire theme to community engagement with core key performance areas. This includes community participation. The Sea Search community based monitoring program was developed in 2003 to engage volunteers in meaningful ecological data collection for future sustainability of Victoria’s MPAs. Deakin University, an academic institute, and Parks Victoria, the management agency for Victoria’s MPAs, through a research partner program, trialled three different habitat monitoring methodologies. The trails assessed volunteer ability to collect scientific data, and social science aspects for their involvement in a community-based monitoring program. Information collected by volunteers, feeds directly into their local MPA management strategies to address issues such as climate change, introduced pests and human impacts and natural ecological variation.

The Sea Search program addresses the two action programmes, Agenda 21 and the Rio Declaration on Environment and Development, created at the United Nations Earth Summit, held in 1992. Both documents highlight the need for community engagement and capacity building for sustainability, health and integrity of the earth. Involvement in the Sea Search program builds the volunteer’s capacity by learning scientific skills, interacting with other like minded community members, and creating relationships with all organisations involved in the delivery of the program. In this regard, Sea Search is a citizen science program involving all sectors in society by promoting public-interest and research for decision making and planning of Victoria’s system of Marine National Parks and Marine Sanctuaries.

Community development and ecology : exploring the links

This paper will explore connections between the concepts of community development and ecology. Initially the tendency was to think there should be a total melding of the principles and practices of community development with those of an ecological understanding but on reflection this has not and indeed is not necessarily the case. The relative epistemological positioning of two different groups, one strongly associating with social justice and the need for people to be at the centre of our economic, environmental and social understanding; and the other clearly seeing the plant and ecology/environment being paramount. While there are a myriad of connections the focus of much community development has been around human welfare based on principles of social, political and economic justice. This has at times been to the detriment of ecological sustainability. Conversely ecology and particularly aspects of deep ecology have focussed on the 'other than human' aspects of the planet and at times seemed almost 'anti 'human and overlooking the need to work with the social almost entirely. This paper briefly outlines the historical separation of the social from the ecological then goes on to explore alternative understandings that bring together principles of community development and ecology. Three examples are used to highlight the principles and practices that are being used across diverse contexts but all informed by common norms and values that are consistent with both community development and ecology. Concepts such as subsidiarity, participation and empowerment that form the basis of community development praxis are critical to the development of local sustainability. The combination of these aspects is evidenced in the three examples. Each is very clearly located in the local context and is built on sound ecological and community development understandings but each is also well aware that the need for a broader perspective is imperative to achieving global goals.