Impact of product-based e-cigarette marketing on the attitudes and behavioural intentions of young Australians: an experimental study.

BACKGROUND: The tobacco industry has a history of using language to downplay the harms associated with cigarettes and mislead consumers and policymakers. Emerging evidence suggests similar tactics are being used in the context of e-cigarettes; however, exploration of the impact of product name on attitudes towards e-cigarettes and susceptibility to use is lacking. This experimental study explored whether attitudes towards e-cigarettes and susceptibility to use are influenced by the names used by the industry to describe and market these products. METHOD: An accredited web panel provider recruited a sample of 383 Australians aged 12-29 years who had never smoked to participate in an online survey that featured an embedded experiment. Participants were randomly allocated to one of three conditions, each of which used a different name to describe e-cigarettes (condition 1: 'e-cigarettes', condition 2: 'vapes'; condition 3: either 'IGETS', 'Puff Bars', 'HQD Cuvies' or 'Gunnpods'). The survey assessed respondents' overall opinion of the product described; attitudes towards the product; liking of the product; and curiosity, willingness and intentions to use the product. RESULTS: Those in the 'brand name' condition scored higher than those in the 'e-cigarettes' condition on all dependent variables. Those in the 'vapes' condition scored higher than those in the 'e-cigarettes' condition on product attitude. CONCLUSION: Findings indicate that the use of brand names and terms such as 'vapes' instead of 'e-cigarettes' results in more favourable attitudes towards e-cigarettes and susceptibility to use among young Australians. Results highlight the problematic influence of promotional language use favoured by industry.

Barriers and enablers to promoting grandchildren's physical activity and reducing screen time: a qualitative study with Australian grandparents.

BACKGROUND: With an increasing number of grandparents providing care to their grandchildren, calls have been made for these caregivers to be considered important stakeholders in encouraging children's engagement in health-promoting behaviors, such as physical activity. Understanding the perspectives of grandparents who provide care is crucial to informing efforts that aim to increase children's physical activity, yet little is understood about their perceptions of specific barriers and enablers to promoting children's physical activity and reducing screen time. The present study sought to explore these perceptions. METHODS: Semi-structured focus groups and individual interviews were conducted with grandparents who reported providing care to a grandchild aged 3 to 14 years. A total of 20 grandparents were sampled (mean age = 67.8 years). Data were subjected to reflexive thematic analysis. RESULTS: Key reported barriers to physical activity included (i) the effort (physical and logistical) and financial cost associated with organizing physical activities, (ii) grandparents' age and mobility issues (e.g., due to injury or illness), (iii) caring for children of different ages (e.g., older children having different physical activity interests than younger children), and (iv) a local environment that is not conducive to physical activity (e.g., lack of appropriate facilities). Barriers to reducing screen time included (i) parents sending children to care with electronic devices and (ii) children's fear of missing out on social connection that occurs electronically. Strategies and enablers of physical activity included (i) integrating activity into caregiving routines (e.g., walking the dog), (ii) involving grandchildren in decision making (e.g., asking them in which physical activities they wish to engage), (iii) encouraging grandchildren to engage in activity with other children, and (iv) creating a physical and social environment that supports activity (e.g., owning play equipment). A common strategy for reducing screen time was the creation of a home environment that is not conducive to this activity (e.g., removing electronic devices from view). CONCLUSIONS: Findings suggest that grandparents may benefit from resources that assist them to identify activities that are inexpensive and require minimal effort to organize. Activities that account for grandparents' age and health status, as well as any environmental barriers, are likely to be well-received.

The lasting impact of the Go for 2&5 campaign.

ISSUE ADDRESSED: Little is known about the executional techniques that are most likely to make healthy eating messages memorable over the longer term. The aim of this exploratory study was to identify factors contributing to the ongoing salience of the Go for 2&5 social marketing campaign among older audience members. METHODS: Interviews were conducted with 75 Western Australians aged 60+ years. A peer-interviewing method was used whereby eight older people recruited and interviewed members of their extended peer groups. The interview guide included questions about interviewees' recollections of healthy eating messages across their lifespans. RESULTS: Around one in five interviewees discussed the Go for 2&5 campaign that was on air in Western Australia between 2002 and 2011. These discussions focused on either specific advertisement features that were considered to be especially memorable (in particular, humour and the use of anthropomorphised depictions of produce) and/or their recollection of the number of daily servings of fruits and vegetables recommended in the campaign. Few were able to recall other healthy eating campaigns, and in some cases it was assumed that advertisements for specific food stores or products constituted health advice. CONCLUSIONS: Different campaign attributes may influence shorter-term attitudinal and behavioural responses versus longer-term recall. The characteristics of the Go for 2&5 campaign appear to have enabled it to achieve relatively high levels of recall among older people. SO WHAT?: The study results suggest that some advertising approaches that activate the peripheral route to persuasion may achieve recall over a longer period of time.

The lived experiences of hematology healthcare providers during and beyond the COVID-19 crisis: A qualitative study.

OBJECTIVE: Amid the COVID-19 pandemic, healthcare providers (HCPs) of hematology patients face unique challenges due to the vulnerability of their patients. This study explores the lived experiences of these providers during and beyond the crisis. METHODS: Twenty-one Australian HCPs caring for hematology patients completed semi-structured interviews exploring their experiences and needs during the COVID-19 pandemic, adequacy of support and information provided by healthcare organizations, impact on hematology patients, and the benefits and challenges of telehealth care. Data were analyzed using reflexive thematic analysis. RESULTS: Four themes were identified: (1) Managing an initial state of flux (unsettling uncertainty and fear, unique needs of hematology patients, getting on with the job together); (2) Concerns about care provision (questioning care efficacy, burden of compassion); (3) Disconnect between HCP needs and system-level responses (burnout, isolation, and poor work-life balance, broadcast fatigue, protecting mental health), and; (4) Reflecting on the future (ongoing challenges for hematology patients, higher staff turnover and heavier workloads, innovation in the healthcare field). CONCLUSION: This study sheds light on the challenges that hematology HCPs face during and beyond the COVID-19 crisis, impacting their wellbeing. Addressing these challenges is paramount for the healthcare system at large. Provider-led peer support programs may be beneficial for addressing moral distress and building resilience. Additionally, specific consideration for the ongoing vulnerability of hematology patients could have positive impacts on providers' professional satisfaction.

E-cigarette product preferences of Australian adolescent and adult users: a 2022 study.

BACKGROUND: Research that comprehensively documents preferences for different types of novel nicotine products in Australia is lacking, making it difficult for policymakers to determine where public health efforts should be focused. This study thus sought to explore Australian adolescent and adult e-cigarette users' preferences for different types of e-cigarettes and e-liquids. Purchasing behaviours and sources of e-liquid were also examined. METHODS: An online survey was administered to 4,617 Australians aged 12 + years, 636 of whom had used an e-cigarette in the last 30 days and were the focus of this study. Among users, 45% also smoked tobacco cigarettes, 41% were non-smokers, and 14% had never smoked. RESULTS: The majority (82%) of e-cigarette users surveyed reported using nicotine-containing e-liquid in their devices. Fewer (60%) reported using non-nicotine e-liquid. The preference for nicotine over non-nicotine e-liquid was observed among all age and smoking groups. Most users (89%) reported using flavoured e-liquids, with adolescents (96%) significantly more likely than young adults (90%) and adults aged 25 + years (85%) to report using such e-liquids. Fruit flavours were the most popular among all subgroups. In terms of device type, disposable e-cigarettes were the most common product used among almost all groups; the exception being adults aged 25 + years who preferred systems with refillable tanks. Friends and tobacco retailers were the most frequently nominated sources of nicotine e-liquid among adolescents and young adults. Among adults aged 25 + years, tobacco retailers and the Internet were the most frequently nominated sources of these products. CONCLUSION: Disposable e-cigarettes with flavoured, nicotine-containing e-liquid are popular among users of the devices, including adolescents. Measures that restrict the accessibility and availability of flavoured e-liquids and disposable e-cigarettes, and greater enforcement of laws regarding the sale and importation of nicotine e-liquids, are urgently needed to protect youth and never smokers from these products.

Perceptions of a prescription model for accessing nicotine vaping products: an examination of submissions made by self-reported e-cigarette users to an Australian consultation.

In response to rapid and substantial increases in rates of e-cigarette use among young people, Australia's Therapeutic Goods Administration (TGA) made changes to the regulations governing nicotine vaping products. As part of the regulatory change process, Australians were invited to comment on the proposed regulations, which featured the introduction of a prescription model for nicotine vaping products. To inform strategies to enhance compliance with the tightened regulations, this study examined submissions made by self-reported e-cigarette users to the TGA's public consultation (n = 1405). A content analysis was conducted to identify and quantify key arguments. Claims about possible negative consequences associated with the regulations (e.g. people will return to smoking, inconvenience) featured in most submissions (84%). Around half (55%) of submissions mentioned perceived benefits of e-cigarettes, including favourable health outcomes (e.g. improved breathing) and enhanced tobacco cessation. Around half (52%) featured concerns about inconsistency in treatment and the argument that e-cigarettes should not be restricted when more harmful tobacco products are readily available. Alternative approaches to a prescription model were offered in nearly one-third (31%) of submissions. One-quarter (26%) included text provided by an industry-led astroturfing campaign. The arguments made in the analysed submissions suggest a lack of appreciation of (i) the negative health outcomes associated with e-cigarette use and (ii) evidence linking these devices to smoking relapse. Results highlight the need for targeted health campaigns that address (i) gaps in consumers' knowledge and (ii) vaping-related misinformation being promulgated by the industry and its allies.

Experiences and needs of people with haematological cancers during the COVID-19 pandemic: A qualitative study.

OBJECTIVE: Haematological cancer patients are particularly vulnerable to the effects of COVID-19. In addition to being immunocompromised, pandemic-related travel restrictions have impacted access to treatments and overseas stem cell donations for patients requiring transplantation. Given this vulnerability, people with haematological cancers are at risk of experiencing heightened distress during the pandemic. This study aimed to explore haematological cancer patients' experiences and needs. METHODS: Twenty-four Australian haematological cancer patients completed semi-structured interviews exploring their concerns and worries during the pandemic, impact of pandemic on management of disease, access to information and support, lifestyle changes, and attitudes towards emerging models of healthcare during the pandemic. Interview transcripts were thematically analysed. RESULTS: Four themes reflecting the experiences of haematological cancer patients during the pandemic were identified: 'Fears about contracting COVID-19' (behaviour changes to protect health, impact on daily routine and habits, annoyance at dismissive attitude of others toward COVID-19); 'Reduced sense of connection and support' (reduced social support and access to external support services); 'New challenges' (increased financial hardship, worsened health), and; 'Underlying system and communication issues' (access to trusted information, satisfaction/dissatisfaction with care, navigating telehealth). Participants expressed a need for improved access to support services and trusted information. CONCLUSIONS: The findings emphasise the additional challenges experienced by haematological cancer patients during the COVID-19 pandemic and their impact on daily life. Results point to the importance of validation of increased distress during periods of uncertainty; reinforcing recommendations about high-quality sources of information; and facilitating access to support services when face-to-face care is limited.

The Interplay Between Strictness of Policies and Individuals' Self-Regulatory Efforts: Associations with Handwashing During the COVID-19 Pandemic.

BACKGROUND: Patterns of protective health behaviors, such as handwashing and sanitizing during the COVID-19 pandemic, may be predicted by macro-level variables, such as regulations specified by public health policies. Health behavior patterns may also be predicted by micro-level variables, such as self-regulatory cognitions specified by health behavior models, including the Health Action Process Approach (HAPA). PURPOSE: This study explored whether strictness of containment and health policies was related to handwashing adherence and whether such associations were mediated by HAPA-specified self-regulatory cognitions. METHODS: The study (NCT04367337) was conducted among 1,256 adults from Australia, Canada, China, France, Gambia, Germany, Israel, Italy, Malaysia, Poland, Portugal, Romania, Singapore, and Switzerland. Self-report data on cross-situational handwashing adherence were collected using an online survey at two time points, 4 weeks apart. Values of the index of strictness of containment and health policies, obtained from the Oxford COVID-19 Government Response Tracker database, were retrieved twice for each country (1 week prior to individual data collection). RESULTS: Across countries and time, levels of handwashing adherence and strictness of policies were high. Path analysis indicated that stricter containment and health policies were indirectly related to lower handwashing adherence via lower self-efficacy and self-monitoring. Less strict policies were indirectly related to higher handwashing adherence via higher self-efficacy and self-monitoring. CONCLUSIONS: When policies are less strict, exposure to the SARS-CoV-2 virus might be higher, triggering more self-regulation and, consequently, more handwashing adherence. Very strict policies may need to be accompanied by enhanced information dissemination or psychosocial interventions to ensure appropriate levels of self-regulation.

Longitudinal associations between formal volunteering and well-being among retired older people: follow-up results from a randomized controlled trial.

Volunteering has been identified as a potential mechanism for improving the psychosocial health of older adults. Utilizing a randomized controlled trial approach, the present study assessed the extent to which commencing volunteering can improve psychosocial health outcomes for older people. Fully retired Australian adults aged 60+ years (N= 445) were assessed at baseline and allocated to either the intervention or control arms of the trial. Those in the intervention condition were asked to participate in at least 60 min of formal volunteering per week for 6 months. Per-protocol analyses were conducted comparing psychosocial outcomes for those who complied with the intervention condition (n= 73) to outcomes for those who complied with the control condition (n= 112). Those who complied with the intervention condition demonstrated significant improvements in life satisfaction, purpose in life, and personal growth scores over a 12-month period relative to those in the control condition who did no volunteering. Findings provide evidence of a causal relationship between commencing volunteering and improvements in psychosocial health among older adults and indicate that encouraging participation in this activity could constitute an effective healthy aging intervention.

Understanding and Overcoming Barriers to Drink Counting.

Objectives: Drink counting has been found to be an effective protective behavioral strategy (PBS) to reduce alcohol consumption. However, little is known about attitudes to this strategy and barriers and facilitators to its use. The aim of this study was to explicate these factors and draw comparisons with less efficacious PBSs. Method: In Stage 1, 1,703 Australian drinkers were surveyed about their perceptions of five PBSs ("Count the number of drinks you have," "Drink slowly rather than gulping or sculling," "Refuse an alcoholic drink you are offered because you don't really want it," "Avoid trying to 'keep up' or 'outdrink' others," and "Decide not to exceed a certain number of drinks"). Respondents reported perceived believability, relevance, ease of use, effectiveness, barriers, and facilitators. In Stage 2, 10 focus groups were conducted with drinkers to identify potential methods of effectively promoting drink counting. Results: Overall, drink counting was rated less favorably than the less-efficacious PBSs, indicating a need to inform drinkers of the importance and feasibility of this strategy to encourage its use. The main identified barriers were a lack of awareness of the long-term harms associated with alcohol use, social factors (e.g., peer pressure), and difficulty counting when intoxicated. Participants suggested improving drinkers' understanding of alcohol-related harms and developing mechanisms to assist with counting. Conclusion: To encourage drink counting, information campaigns are needed to educate the community about the long-term risks of alcohol use. Evidenced-based mechanisms to facilitate drink counting may be welcomed by drinkers.

Likeability and perceived effectiveness of messages designed to encourage physical activity participation among older adults.

ISSUE ADDRESSED: Older adults are significantly less likely than their younger counterparts to engage in physical activity. Comprehensive policies to support healthy ageing thus need to include components encouraging greater participation in physical activity in later life. This study tested potential messages for use in health communication campaigns aimed at increasing physical activity among older adults. METHODS: Twelve written messages designed to encourage older adults to increase their levels of physical activity were rated by Australians aged 60-92 years (n = 369; 54% female) on the variables of likeability and perceived effectiveness. RESULTS: Ratings for all the tested messages were high across both outcome variables. The message Move more, live longer scored most favourably, with large majorities of participants liking this message (87%) and considering it effective (81%). Messages featuring rhyming or alliteration were rated significantly higher on both outcomes than messages without these attributes (all Ps < .001). CONCLUSIONS: Results provide insights into the types of messages that are likely to be accepted by older adults. Statements that use the phonological patterns of rhyming or alliteration are likely to be especially well received. SO WHAT?: Increasing participation in physical activity among older adults is critical to promoting the sustainability of health care systems and enhancing quality of life. The specific messaging attributes identified in the present study as being effective could be used by public health practitioners to inform their approach to physical activity messaging to older adults and incorporated into future health communication campaigns to increase their potential effectiveness with this target group.

A content analysis of the tweets of e-cigarette proponents in Australia.

ISSUE ADDRESSED: Social media sites have become platforms for public discourse on e-cigarettes, providing proponents with an opportunity to disseminate favourable information about the devices. Research examining the information being presented by Australian proponents of e-cigarettes is limited. Accordingly, this study explored the Twitter feeds of Australian proponents of e-cigarettes to determine the nature of the e-cigarette-related content being disseminated. METHODS: All publicly available e-cigarette-related tweets and retweets (n = 1397) disseminated over a 15-week period by five Australian e-cigarette proponents were captured and analysed. RESULTS: The main topics covered in the 1397 tweets analysed related to (a) criticism of the arguments made by public health agencies/advocates who oppose e-cigarettes (29%), (b) Australian e-cigarette policy (19%), (c) the health risks of e-cigarettes (16%) and (d) the efficacy of e-cigarettes as smoking cessation aids (13%). Proponents argued that the precautionary principle adopted by public health agencies/advocates lacks an appropriate evidence base and that legalising e-cigarettes would reduce smoking rates and smoking-related harm. Proponents minimised the risks associated with e-cigarette use and only presented evidence indicating that use facilitates smoking cessation. CONCLUSIONS: The assessed tweets have the potential to reduce the public's trust in the information being presented by authoritative public health agencies/advocates. The dissemination of information downplaying the health risks associated with e-cigarettes may distort perceptions of the devices. SO WHAT?: To assist tobacco control efforts, results highlight the need for (a) ongoing surveillance of the tweets of e-cigarette proponents and (b) provision of evidence-based counterarguments on social media.

Prevalence and correlates of psychological distress, unmet supportive care needs, and fear of cancer recurrence among haematological cancer patients during the COVID-19 pandemic.

BACKGROUND: The COVID-19 pandemic has had a disruptive effect on people with haematological cancers, who represent a high-risk population due to the nature of their disease and immunosuppressive treatments. We aimed to identify the psychological impacts of the COVID-19 pandemic on haematology patients and identify correlated factors to inform the development of appropriate supportive interventions. METHODS: Three hundred and ninety-four respondents volunteered their participation in response to a study advertisement distributed online through established haematology groups. Participants completed a self-report online survey exploring wellbeing, psychological distress, unmet supportive care needs, and fear of cancer recurrence. RESULTS: At least 1 in 3 respondents (35%) reported clinical levels of distress and nearly 1 in 3 (32%) identified at least one unmet need. Among respondents in remission (n = 134), clinical fear of cancer recurrence was reported by nearly all (95%). Unmet needs, pre-existing health conditions, younger age, financial concerns, and perceived risk of contracting COVID-19 were the dominant factors contributing to psychological distress during the pandemic. Psychological distress, lost income, perceived inadequate support from care team, perceived risk of contracting COVID-19, and being a woman were significantly associated with unmet needs. Psychological distress and concern about the impact of COVID-19 on cancer management were significantly associated with fear of cancer recurrence among respondents in remission. CONCLUSION: Results highlight the high psychological burden and unmet needs experienced by people with haematological cancers during the COVID-19 pandemic and indicate a need for innovative solutions to rapidly identify distress and unmet needs during, and beyond, pandemic times.

The trajectory of COVID-19 pandemic and handwashing adherence: findings from 14 countries.

BACKGROUND: The COVID-19 pandemic has affected people's engagement in health behaviors, especially those that protect individuals from SARS-CoV-2 transmission, such as handwashing/sanitizing. This study investigated whether adherence to the World Health Organization's (WHO) handwashing guidelines (the outcome variable) was associated with the trajectory of the COVID-19 pandemic, as measured by the following 6 indicators: (i) the number of new cases of COVID-19 morbidity/mortality (a country-level mean calculated for the 14 days prior to data collection), (ii) total cases of COVID-19 morbidity/mortality accumulated since the onset of the pandemic, and (iii) changes in recent cases of COVID-19 morbidity/mortality (a difference between country-level COVID-19 morbidity/mortality in the previous 14 days compared to cases recorded 14-28 days earlier). METHODS: The observational study (#NCT04367337) enrolled 6064 adults residing in Australia, Canada, China, France, Gambia, Germany, Israel, Italy, Malaysia, Poland, Portugal, Romania, Singapore, and Switzerland. Data on handwashing adherence across 8 situations (indicated in the WHO guidelines) were collected via an online survey (March-July 2020). Individual-level handwashing data were matched with the date- and country-specific values of the 6 indices of the trajectory of COVID-19 pandemic, obtained from the WHO daily reports. RESULTS: Multilevel regression models indicated a negative association between both accumulation of the total cases of COVID-19 morbidity (B = -.041, SE = .013, p = .013) and mortality (B = -.036, SE = .014 p = .002) and handwashing. Higher levels of total COVID-related morbidity and mortality were related to lower handwashing adherence. However, increases in recent cases of COVID-19 morbidity (B = .014, SE = .007, p = .035) and mortality (B = .022, SE = .009, p = .015) were associated with higher levels of handwashing adherence. Analyses controlled for participants' COVID-19-related situation (their exposure to information about handwashing, being a healthcare professional), sociodemographic characteristics (gender, age, marital status), and country-level variables (strictness of containment and health policies, human development index). The models explained 14-20% of the variance in handwashing adherence. CONCLUSIONS: To better explain levels of protective behaviors such as handwashing, future research should account for indicators of the trajectory of the COVID-19 pandemic. TRIAL REGISTRATION: Clinical Trials.Gov, # NCT04367337.

Grandparents' perceptions of the barriers and strategies to providing their grandchildren with a healthy diet: A qualitative study.

Grandparents are playing an increasingly important role in shaping their grandchildren's nutritional environment. Evidence-based interventions tailored to grandparents thus constitute a potential means of promoting healthy eating among children. For such interventions to be effective, they must account for the unique issues encountered by grandparents. However, research examining the potential needs of grandparents is limited. The present study thus explored (i) grandparents' perceptions of the barriers to providing their grandchildren with healthy food and minimizing consumption of unhealthy food and (ii) the strategies grandparents believe help increase their grandchildren's consumption of healthy food and reduce intake of unhealthy food. Seventy-nine grandparents, each of whom provided care to at least one grandchild aged 3-12 years, participated in one of ten focus groups. Transcripts from each of the groups were imported into NVivo for qualitative coding and semantic thematic analysis. The food preferences of their grandchildren, the promotion of unhealthy food consumption by their grandchildren's parents, advertising of unhealthy food, and peer pressure were the most frequently cited barriers to healthy food consumption. Grandparents reported using multiple strategies to increase their grandchildren's fruit and vegetable consumption and minimize unhealthy food intake. The most common were disguising vegetables, making fruit and vegetables appealing, managing child eating (e.g., limiting access to unhealthy food), saying no to requests for unhealthy food, involving grandchildren in meal planning and cooking, and using rewards. Findings suggest that grandparents may need support with managing food preferences and navigating and negotiating complex relations with parents regarding child feeding.

Aspects of the volunteering experience associated with well-being in older adults.

ISSUES ADDRESSED: While the psychological health benefits of older people's engagement in formal volunteering are well-documented, there is limited research assessing how volunteering may produce these favourable outcomes. To guide the development of volunteer positions that optimise outcomes, this study examined (a) which aspects of the volunteering experience are most strongly associated with favourable psychological health among older adults and (b) whether relationships between these aspects and psychological outcomes are moderated by sociodemographic characteristics. METHODS: A sample of 293 volunteers aged 60+ years (69% female, mean age = 73.33 years) completed measures assessing their engagement in volunteering, various aspects of their volunteer experience, and their psychological health. RESULTS: Being adequately appreciated for one's contribution, perceived social and mental intensity of the volunteer role, and believing that others benefit from one's volunteering efforts were found to be associated with higher levels of psychological health. CONCLUSIONS: Ensuring the contributions of volunteers are explicitly recognised, providing opportunities for engagement in social and cognitive activities, and informing volunteers of the benefits others experience constitute potential means of enhancing volunteer outcomes and may assist with volunteer retention. SO WHAT?: This study builds upon the limited research assessing which aspects of the volunteering experience are most strongly associated with favourable psychological health among older adults. The findings point to the potential importance of four specific aspects of the volunteer experience in enhancing psychological health outcomes.

Are Australian regulatory codes adequate in scope to protect youth from alcohol advertising?

ISSUE ADDRESSED: Exposure to alcohol advertising has been found to be associated with more positive attitudes toward alcohol and heavier drinking among youth. Appropriate regulation of alcohol advertising is thus crucial for reducing use among members of this population group. To assist policy makers in their alcohol control efforts, this study explored the scope of Australian alcohol advertising codes and the extent to which they address issues relating to youth exposure. METHODS: Two researchers assessed 628 unique alcohol advertisements against youth-related provisions of the Alcohol Advertising Review Board (AARB) Code and Alcohol Beverages Advertising Code (ABAC). A third researcher resolved discrepancies. The ads sampled were those that had been the subject of formal complaints to the AARB. RESULTS: Most (94%) ads were assessed as violating at least one of the AARB Code provisions relating to youth, while 36% were found to violate at least one of the ABAC youth provisions. The most frequently violated AARB Code provision related to placement, with 88% of ads located in places or broadcast at times where young people were likely to be exposed. The most frequently violated ABAC provision related to appeal to minors (33%). CONCLUSIONS: Results indicate that self-regulation is an ineffective means of protecting youth from alcohol advertising, with the ABAC failing to capture many ads featuring content that appeals to youth. SO WHAT?: Greater efforts are required to protect youth from alcohol advertising. Findings from the present study reinforce calls for mandatory, evidence-based regulation that is administered independently of the alcohol industry. SUMMARY: An analysis of 628 unique alcohol advertisements found that the vast majority were in violation of the AARB Code's youth-related provisions whereas substantially fewer were in violation of the ABAC, supporting arguments that self-regulation is an ineffective means of protecting youth from alcohol advertising.

A randomized controlled trial and pragmatic analysis of the effects of volunteering on the health and well-being of older people.

BACKGROUND: Volunteering among older people has the potential to deliver health benefits to the individual, along with economic and social benefits to society. However, it is not clear whether healthier people are more likely to engage in volunteering, whether volunteering improves health, or the extent to which the relationship may be reciprocal. There is an identified need for longitudinal work, especially in the form of randomized controlled trials, to establish causality. AIMS: To assess the effects of commencing volunteering among older non-volunteers utilizing a randomized controlled trial approach involving per-protocol and pragmatic analyses. METHODS: Of the 445 Australians aged 60 + years who participated in the study, 201 were assigned to an intervention arm that required them to participate in a minimum of 1 h/week of formal volunteering in a position of their choice. The remaining participants were assigned to a control condition and asked to continue their lives as usual, but were not discouraged from commencing volunteering. RESULTS: Across the assessed physical, psychological, and social variables, a significant difference in sit-to-stand scores was found in both the per-protocol and pragmatic analyses, and a further significant difference in the fast pace walk was identified in the pragmatic analyses. CONCLUSION: The results provide some support for policies and programs designed to encourage older people to engage in volunteering to maintain or improve their health. TRIAL REGISTRATION: Australian and New Zealand Clinical Trials Registry ACTRN12615000091505.

Factors Associated with Engagement in Protective Behavioral Strategies among Adult Drinkers.

Background: Protective behavioral strategies (PBSs) have been proposed as useful individual-level approaches to reducing alcohol consumption and alcohol-related harm. However, recent research suggests that few of the recommended PBSs may be effective in reducing longer-term alcohol consumption, with some appearing to result in increased intake over time. Objectives: To identify factors associated with enactment of specific PBSs to inform alcohol control efforts that aim to encourage the use of effective strategies and attenuate the effects of strategies found to be associated with increased consumption. Methods: Australian adult drinkers (n = 2,003; 50% male) completed an online survey assessing their alcohol consumption, frequency of attending drinking venues, enactment of specific PBSs, and demographic characteristics. Results: Greater enactment of the PBS that has previously been found to be associated with reduced alcohol use ('Count your drinks') was found among older respondents and those with lower levels of alcohol consumption. Older respondents were also more likely to enact two of the three PBSs that have been found to be associated with increased alcohol consumption ('Use a designated driver' and 'Leave drinking venues at a pre-determined time'). Conclusions/Importance: Results suggest that enactment of specific PBSs may differ according to the individual-level variables of gender, age, and preferred beverage type, and the environmental-level variable of attendance at licensed premises. Randomized trials investigating the effectiveness of PBS interventions among drinker subgroups are needed to determine the extent to which enactment reduces alcohol consumption and alcohol-related harm and whether effects are moderated by the variables assessed in this study.

Retirement and Physical Activity: The Opportunity of a Lifetime or the Beginning of the End?

Retirement has been identified as a life transition that is important in determining older adults' physical activity levels. The present study examined the factors associated with retirement that affect physical activity participation among older adults. Semistructured interviews were conducted with 425 retired Australians aged 60 years and older. Physical activity was assessed objectively, using accelerometers. Two categories of factors affecting physical activity participation following retirement were identified: the various physical and psychological changes in later life that can encourage or discourage physical activity and the adaptation processes undertaken by older people in response to these changes. The adoption of either a gain or loss approach to retirement and aging appeared to be the most influential adaptation factor affecting physical activity participation. The results suggest that intervention approaches should aim to foster more positive attitudes to aging and retirement and promote physical activity at all stages in life.