Keeping connected: the design and overview of the research

The special issue Keeping Connected: Identity, Social Connection and Education for Young People opens with a paper that discusses the research design and overview of a three-year project by a Melbourne (Australia)-based multi-disciplinary team. Over 2007–2009, the Keeping Connected team of 10 researchers investigated the lives of adolescents with ongoing health conditions. The project centrally is developed by the young people's perspectives, their identity and wellbeing, relationships with others and engagement within changing contexts and their altered opportunities in the world. The research design includes image production underpinned by visual methods and a narrative-informed approach to interview and interpretation of images. The study, which crosses the health and education interface, set out to highlight differences of perspectives adopted by 31 young people, their families and the professional groups, such as teachers and health professionals. The special issue discusses key project findings and contributes a body of scholarship that expands our knowledge of evidence-based research across the education and health interface. The longitudinal study highlighted two themes of importance for education, and poorly catered for in current policies and guidelines: that the situation of these young people needs to be addressed by schools as a process over time (including prospectively); and that the young people's identity is strongly marked by a desire to be seen and treated as ‘normal’ combined with an awareness of being vulnerable.

Keeping connected: a review of the research relationship

In this paper, some key findings of the Keeping Connected project are discussed in light of the methodological challenges of developing an analytical approach in a large-scale study, particularly in starting with open-ended, participant-selected, digital still visual images as part of 31 longitudinal case studies. The paper works to clarify the methodological and epistemological discussions of the visual data, an issue of great interest in qualitative research and visuality for researchers intent on developing understandings of participatory research methods in the field of youth studies.

Embedding learning in a paediatric hospital: changing practice and keeping connected

This paper, the final paper in the Keeping Connected special issue, presents the key findings of the overall study and focuses on the challenging process of re-imagining a hospital setting as a community of learning for young people in light of these findings. The paper focuses on young people as learners within the overarching themes emanating from the Keeping Connected research such as normalcy, diversity and communication. Taking up Slee's notion of ‘the irregular school’, we describe how one setting in a large urban paediatric hospital in Victoria, Australia, is transforming the way in which children and young people are supported to maintain their connectedness to learning. We reflect on the evidence of the Keeping Connected project to inform the ways in which a hospital can respond to young people's needs as learners and offer a model of inclusion as a form of cultural change in this important out-of-school setting. Directions for future research are also offered.

Alcohol consumption, obesity, and psychological distress in farming communities — an Australian study

Purpose: Alcohol consumption patterns nationally and internationally have been identified as elevated in rural and remote populations. In the general Australian population, 20.5% of adult males and 16.9% of adult females drink at short-term, high-risk levels. Farmers are more likely to drink excessively than those living in major cities. This study seeks to explore the relationships between farmers’ physical and mental health and their alcohol consumption patterns. Our hypothesis is that farmers consume alcohol at high-risk levels more often than the Australian average and that this consumption is associated with obesity and psychological distress.

Methods: Cross-sectional descriptive data were collected within Australian farming communities from 1,792 consenting adults in 97 locations across Australia. Data on anthropometric measurements, general physical attributes and biochemical assessments were used to explore the interrelationships of self-reported alcohol consumption patterns with obesity, psychological distress, and other physical health parameters.

Findings: There was a higher prevalence of short-term, high-risk alcohol consumption (56.9% in men and 27.5% in women) reported in the study compared with national data. There was also a significant positive association between the prevalence of high-risk alcohol consumption and the prevalence of obesity and abdominal adiposity in psychologically distressed participants.

Conclusions: The prevalence of short-term, high-risk alcohol consumption practices in this cohort of farming men and women is significantly higher than the Australian average. These consumption practices are coupled with a range of other measurable health issues within the farming population, such as obesity, hypertension, psychological distress, and age.

Disaggregation of household energy consumption patterns in Australian

Improving energy efficiency is an important target to be achieved in residential building development and household behaviour. The aim of this research is to help building professionals and policy makers understand the current housing situations and householders’ behaviour regarding energy consumption. The results of a survey of energy consumption, including house situations and householder behaviour, of 504 households in New South Wales Australia are reported. Twelve features affecting household energy consumption are investigated. These features included cooking appliances, refrigerators, laundry appliances, televisions, computers, gaming consoles, hot water systems, space cooling and heating systems, glazing, insulation, lighting, and other major energy consumption facilities. The differences of these features across different households with different physical characteristics, social-demographic features and geographical areas are analyzed. Based on the disaggregate study, it is found that mandatory policy, geographical and socio-economic factors can significantly affect the selection of fixtures and appliances in the households. It is also found that the positive effect of the government’s mandatory policy implementation on household energy consumption behaviour is evidenced. The findings will be of use in sustainable residential building development policy-making, and tailoring the regulations and standards with consideration of the various geographical and socio-economic factors.

Trust evaluation for indirectly connected nodes using link community information

Inspired by recent empirical research on link communities, we borrow some important ideas and concepts for our own research to provide a more reasonable computation model of transitive trust. The key advantages of using link community methodology is to reflect on the nature of the social network features of Hierarchy and Overlap. Our research mainly resolves the computation of trust transitivity in which two nodes do not have any direct links to any link community. In this research, we discover a new direction analyzing trust transitivity. By using a social network game, we found that the link community methodology is a natural way to analyze trust in social networks. We also discovered, even in a small social network, trust has certain community features.

Predicting breakfast consumption: a comparison of the theory of planned behaviour and the health action process approach

Purpose: 

Increasing the frequency of breakfast consumption

Purpose – A number of interventions aimed at increasing breakfast consumption have been designed and implemented in recent years. This paper seeks to review the current research in this area with the aim of identifying common features of successful interventions and strengths and weaknesses in the current research methodology. Design/methodology/approach – A systematic review of interventions aimed at increasing breakfast-eating frequency in a non-clinical sample was conducted. Findings – A total of 11 interventions were identified and reviewed; of these, only three resulted in an increase in breakfast consumption at follow-up. The three studies that were successful in changing breakfast consumption all included a psychosocial component that was successful in increasing positive attitudes towards nutrition in the intervention protocol. Many of the breakfast-eating interventions included in this review have methodological weaknesses, including difficulties in implementing interventions, small sample sizes, and selection biases, which future researchers should consider when designing and evaluating their own interventions. Research limitations/implications – These findings highlight the importance of including psychosocial components in interventions designed to increase breakfast consumption, while also signalling issues that should be addressed when designing and reporting future interventions. Originality/value – This review was the first to investigate the efficacy of interventions aimed at increasing breakfast consumption. The identification of weaknesses in the current body of research, and of successful and unsuccessful intervention practices is an important step in developing successful interventions in the future.

The acute effects of caffeine in a sugar-sweetened beverage on energy consumption

Background: It has been suggested that those who are habitually high caffeine consumers ingest greater quantities of snack foods both in and outside the laboratory. Sugar-sweetened beverages (SSBs) are a major contributor to caffeine consumption and evidence links SSB consumption with poor dietary intake.

Objective: To determine whether varying the concentration of caffeine in SSBs influences snack food consumption and energy intake.

Methods: Caffeine taste thresholds were assessed using the International Standards Organization method for assessing taste sensitivity. In a crossover study design, participants (n=23, 26±5 years old, 58% female) were provided with a standardized meal on 4 days and simultaneously consumed SSBs with varied levels of caffeine (0, 0.67, 1.16, and 1.65 mM). The intake of food and beverage was recorded following each meal session.

Results: A one way between groups analysis of variance revealed no significant main effect of caffeine concentration on consumption of SSBs [F (3, 92)=0.154, p=0.927] or food [F (3, 92)=0.305, p=0.822]. Pearson correlation analysis identified no significant correlations between the amount of food and SSB consumed (R=−0.031–0.415, p=0.062–0.893), or the amount of food and SSB consumed with body mass index and waist circumference (R=0.000 to −0.380, p=0.073–0.999). An individual's oral sensitivity to caffeine was not associated with SSB consumption (R=0.045 to −0.309, p=0.152–0.839) or the consumption of food (R=−0.052 to −0.327, p=0.128–0.812).

Conclusions: The concentration of caffeine in SSBs did not influence the amount of food or SSB consumed.

ShopSmart 4 Health - protocol of a skills-based randomised controlled trial promoting fruit and vegetable consumption among socioeconomically disadvantaged women

Background
There is a need for evidence on the most effective and cost-effective approaches for promoting healthy eating among groups that do not meet dietary recommendations for good health, such as those with low incomes or experiencing socioeconomic disadvantage. This paper describes the ShopSmart 4 Health study, a randomised controlled trial conducted by Deakin University, Coles Supermarkets and the Heart Foundation, to investigate the effectiveness and cost-effectiveness of a skill-building intervention for promoting increased purchasing and consumption of fruits and vegetables amongst women of low socioeconomic position (SEP).

Methods/design
ShopSmart 4 Health employed a randomised controlled trial design. Women aged 18–60 years, holding a Coles store loyalty card, who shopped at Coles stores within socioeconomically disadvantaged neighbourhoods and met low-income eligibility criteria were invited to participate. Consenting women completed a baseline survey assessing food shopping and eating habits and food-related behaviours and attitudes. On receipt of their completed survey, women were randomised to either a skill-building intervention or a wait-list control condition. Intervention effects will be evaluated via self-completion surveys and using supermarket transaction sales data, collected at pre- and post-intervention and 6-month follow-up. An economic evaluation from a societal perspective using a cost-consequences approach will compare the costs and outcomes between intervention and control groups. Process evaluation will be undertaken to identify perceived value and effects of intervention components.

Discussion
This study will provide data to address the currently limited evidence base regarding the effectiveness and cost-effectiveness of skill-building intervention strategies aimed at increasing fruit and vegetable consumption among socioeconomically disadvantaged women, a target group at high risk of poor diets.

Associations between neighbourhood and household environmental variables and fruit consumption : exploration of mediation by individual cognitions and habit strength in the GLOBE study

Objective The present study examined associations of several home and neighbourhood environmental variables with fruit consumption and explored whether these associations were mediated by variables derived from the Theory of Planned Behaviour (TPB) and by habit strength.

Design Data of the Dutch GLOBE study on household and neighbourhood environment, fruit intake and related factors were used, obtained by self-administered questionnaires (cross-sectional), face-to-face interviews and audits.

Setting The city of Eindhoven in the Netherlands

Subjects Adults (n 333; mean age 58 years, 54 % female).

Results Multiple mediation analyses were conducted using regression analyses to assess the association between environmental variables and fruit consumption, as well as mediation of these associations by TPB variables and by habit strength. Intention, perceived behaviour control, subjective norm and habit strength were associated with fruit intake. None of the neighbourhood environmental variables was directly or indirectly associated with fruit intake. The home environmental variable ‘modelling behaviour by family members’ was indirectly, but not directly, associated with fruit intake. Habit strength and perceived behaviour control explained most of the mediated effect (71·9 %).

Conclusions Modelling behaviour by family members was indirectly associated with fruit intake through habit strength and perceived behaviour control. None of the neighbourhood variables was directly or indirectly, through any of the proposed mediators, associated with adult fruit intake. These findings suggest that future interventions promoting fruit intake should address a combination of the home environment (especially modelling behaviour by family members), TPB variables and habit strength for fruit intake.

Dietary sodium intake is associated with total fluid and sugar-sweetened beverage consumption in US children and adolescents aged 2 - 18 y : NHANES 2005 - 2008

Background: Increasing dietary sodium drives the thirst response. Because sugar-sweetened beverages (SSBs) are frequently consumed by children, sodium intake may drive greater consumption of SSBs and contribute to obesity risk.

Objective: We examined the association between dietary sodium, total fluid, and SSB consumption in a nationally representative sample of US children and adolescents aged 2–18 y.

Design: We analyzed cross-sectional data from NHANES 2005–2008. Dietary sodium, fluid, and SSB intakes were assessed with a 24-h dietary recall. Multiple regression analysis was used to assess associations between sodium, fluid, and SSBs adjusted for age, sex, race-ethnic group, body mass index (BMI), socioeconomic status (SES), and energy intake.

Results: Of 6400 participants, 51.3% (n = 3230) were males, and the average (±SEM) age was 10.1 ± 0.1 y. The average sodium intake was 3056 ± 48 mg/d (equivalent to 7.8 ± 0.1 g salt/d). Dietary sodium intake was positively associated with fluid consumption (r = 0.42, P < 0.001). After adjustment for age, sex, race-ethnic group, SES, and BMI, each additional 390 mg Na/d (1 g salt/d) was associated with a 74-g/d greater intake of fluid (P < 0.001). In consumers of SSBs (n = 4443; 64%), each additional 390 mg Na/d (1 g salt/d) was associated with a 32-g/d higher intake of SSBs (P < 0.001) adjusted for age, sex, race-ethnic group, SES, and energy intake.

Conclusions: Dietary sodium is positively associated with fluid consumption and predicted SSB consumption in consumers of SSBs. The high dietary sodium intake of US children and adolescents may contribute to a greater consumption of SSBs identifying a possible link between dietary sodium intake and excess energy intake.