The effectiveness of living well multicultural-lifestyle management program among ethnic populations in Queensland, Australia.

ISSUE: Some migrant groups have higher risks of deaths and chronic diseases due to barriers associated with socioeconomic disadvantage, social isolation, racism, language, poor access to health services and low levels of health literacy. However, few culturally tailored interventions have targeted ethnic groups in Australia. This study evaluated the effectiveness of the Living Well Multicultural-Lifestyle Management Program (LWM-LMP) in Queensland, Australia. METHODS: The LWM-LMP was originally co-designed with the targeted communities. Participants aged ≥18 years were eligible to participate without a fee. The evaluation was a quasi-experimental design without a control group, with data collected at baseline, the end of the programme and after-programme follow-up at week 14. The programme lasted 8 weeks with one group-based session of 120 minutes delivered each week in local community venues. Each session also included time to undertake physical activity (PA). Eating and PA behaviours were self-reported. Weight, height, waist circumference and blood pressure were measured using standard protocols. RESULTS: Participants were more likely to consume ≥2 servings of fruit/day, five servings of vegetable/day, low-fat milk, processed meat, fast food, hot chips/fries, salty snacks, sweet snacks, sweet beverages less than once per week and meet the PA recommendation of ≥150 minutes/wk (P < .001) at week 8. Weight, BMI, waist circumference, waist-to-height ratio and blood pressure were also improved at week 8. Many of the changes were sustained at week 14. CONCLUSIONS: The LWM-LMP was effective in improving participants' lifestyle behaviours and cardiometabolic indicators. SO WHAT: Engaging targeted communities in designing interventions focussed on healthy personal behaviours helps with delivery and implementation. Behavioural interventions should be culturally tailored to increase their effectiveness.

Eating and physical activity behaviours among ethnic groups in Queensland, Australia.

OBJECTIVE: To examine differences in eating and physical activity behaviours among ethnic groups in Queensland, Australia, and differences in those behaviours due to the duration of residency in Australia. DESIGN: Cross-sectional study using baseline data collected for the Living Well Multicultural-Lifestyle Modification Program between October 2014 and June 2017. SETTING: Culturally and linguistically diverse communities (CALD), including Afghani, Somali, Burmese, Pacific and South Sea Islander, Sri Lankan, Sudanese and Vietnamese, living in Queensland, Australia. PARTICIPANTS: People were recruited if they were ≥18 years old and living in the targeted CALD communities. RESULTS: Burmese/Vietnamese, on average, had better eating scores in line with Australian dietary guidelines, compared with Afghani/Arabic-speaking (difference = 2·05 points, 95 % CI 1·39, 2·72), Somali/Sudanese (difference = 1·53 points, 95 % CI 0·79, 2·28) and Pacific Islander (difference = 1·46 points, 95 % CI 0·79, 2·13). Association between ethnicity and meeting the physical activity guideline was not significant. Those who stayed in Australia longer than a year were less likely to meet the physical activity guideline than those staying <1 year (OR = 0·51, 95 % CI 0·31, 0·84). There was no significant association between duration of residency in Australia and eating scores. CONCLUSIONS: Eating behaviours were significantly different among the ethnic groups in Queensland with Burmese/Vietnamese and Sri Lankan/Bhutanese having the healthiest diets. All ethnic groups were less likely to meet the physical activity guideline compared with the general Australian population. People with duration of residency of at least 1 year in Australia were less likely to meet the physical activity guideline compared with those who had shorter stays.

Melanoma Cell Colony Expansion Parameters Revealed by Approximate Bayesian Computation.

In vitro studies and mathematical models are now being widely used to study the underlying mechanisms driving the expansion of cell colonies. This can improve our understanding of cancer formation and progression. Although much progress has been made in terms of developing and analysing mathematical models, far less progress has been made in terms of understanding how to estimate model parameters using experimental in vitro image-based data. To address this issue, a new approximate Bayesian computation (ABC) algorithm is proposed to estimate key parameters governing the expansion of melanoma cell (MM127) colonies, including cell diffusivity, D, cell proliferation rate, λ, and cell-to-cell adhesion, q, in two experimental scenarios, namely with and without a chemical treatment to suppress cell proliferation. Even when little prior biological knowledge about the parameters is assumed, all parameters are precisely inferred with a small posterior coefficient of variation, approximately 2-12%. The ABC analyses reveal that the posterior distributions of D and q depend on the experimental elapsed time, whereas the posterior distribution of λ does not. The posterior mean values of D and q are in the ranges 226-268 µm2h-1, 311-351 µm2h-1 and 0.23-0.39, 0.32-0.61 for the experimental periods of 0-24 h and 24-48 h, respectively. Furthermore, we found that the posterior distribution of q also depends on the initial cell density, whereas the posterior distributions of D and λ do not. The ABC approach also enables information from the two experiments to be combined, resulting in greater precision for all estimates of D and λ.

Differences in cardiometabolic risk markers among ethnic groups in Queensland, Australia.

Very little is known about the cardiometabolic risk of migrants who settle in Australia. This study investigated differences in cardiometabolic risk markers among ethnic groups attending a tailored healthy lifestyle program in Queensland, Australia; and differences in these markers between those living in Australia for shorter versus longer periods of time. Baseline data collected between October 2014 and June 2017 from the Living Well Multicultural-Lifestyle Modification Program were used. People living in ethnic communities in Queensland who were ≥18 years old, and not underweight were eligible to participate. Independent variables were ethnicity and length of time in Australia. Outcomes were cardiometabolic risk markers including BMI, waist circumference, weight-to-height ratio (WHtR) and hypertension. Analyses were done separately for each independent variable. Linear and logistic regressions were run for continuous and binary outcomes with differences/Odds ratios reported respectively. Multivariable analyses showed that Burmese/Vietnamese had an average BMI lower than Afghani/Arabic (3.7 points), Somalian/Sudanese (4.7 points) and Pacific Islander (11.6 points) (p < 0.001) respectively. Differences in waist circumference between Burmese/Vietnamese with Sri Lankan/Bhutanese, Afghani/Arabic, Somalian/Sudanese and Pacific Islander were 6.3, 8.4, 9.1 and 24.0 cm (p < 0.01) respectively. Although Burmese/Vietnamese also had lower average WHtR compared to the others, the differences were not significant for Somalian/Sudanese. Moreover, Sri Lankan/Bhutanese and Pacific Islander were more likely to be hypertensive compared to Burmese/Vietnamese (p < 0.05). Immigrants living in Australia >5years had on average 1.2 points higher BMI, 2.4cm larger waist circumference, and 0.02 points higher WHtR (p < 0.05) compared to those living for ≤5 years. Long-stay immigrants were also more likely to be hypertensive than short-stay immigrants (p < 0.01). In conclusion, cardiometabolic risk is significantly different among ethnic groups in Queensland with Pacific Islanders having the highest risk. Immigrants living in Australia >5 years had higher risks compared to those living in Australia for shorter periods of time.

Service Level Factors Associated with Cervical Screening in Aboriginal and Torres Strait Islander Primary Health Care Centres in Australia.

Aboriginal and Torres Strait Islander women have significantly higher cervical cancer incidence and mortality than other Australian women. In this study, we assessed the documented delivery of cervical screening for women attending Indigenous Primary Health Care (PHC) centres across Australia and identified service-level factors associated with between-centre variation in screening coverage. We analysed 3801 clinical audit records for PHC clients aged 20-64 years from 135 Indigenous PHC centres participating in the Audit for Best Practice in Chronic Disease (ABCD) continuous quality improvement (CQI) program across five Australian states/territories during 2005 to 2014. Multilevel logistic regression models were used to identify service-level factors associated with screening, while accounting for differences in client-level factors. There was substantial variation in the proportion of clients who had a documented cervical screen in the previous two years across the participating PHC centres (median 50%, interquartile range (IQR): 29-67%), persisting over years and audit cycle. Centre-level factors explained 40% of the variation; client-level factors did not reduce the between-centre variation. Screening coverage was associated with longer time enrolled in the CQI program and very remote location. Indigenous PHC centres play an important role in providing cervical screening to Aboriginal and Torres Strait Islander women. Thus, their leadership is essential to ensure that Australia's public health commitment to the elimination of cervical cancer includes Aboriginal and Torres Strait Islander women. A sustained commitment to CQI may improve PHC centres delivery of cervical screening; however, factors that may impact on service delivery, such as organisational, geographical and environmental factors, warrant further investigation.

Quantifying uncertainty in parameter estimates for stochastic models of collective cell spreading using approximate Bayesian computation.

Wound healing and tumour growth involve collective cell spreading, which is driven by individual motility and proliferation events within a population of cells. Mathematical models are often used to interpret experimental data and to estimate the parameters so that predictions can be made. Existing methods for parameter estimation typically assume that these parameters are constants and often ignore any uncertainty in the estimated values. We use approximate Bayesian computation (ABC) to estimate the cell diffusivity, D, and the cell proliferation rate, λ, from a discrete model of collective cell spreading, and we quantify the uncertainty associated with these estimates using Bayesian inference. We use a detailed experimental data set describing the collective cell spreading of 3T3 fibroblast cells. The ABC analysis is conducted for different combinations of initial cell densities and experimental times in two separate scenarios: (i) where collective cell spreading is driven by cell motility alone, and (ii) where collective cell spreading is driven by combined cell motility and cell proliferation. We find that D can be estimated precisely, with a small coefficient of variation (CV) of 2-6%. Our results indicate that D appears to depend on the experimental time, which is a feature that has been previously overlooked. Assuming that the values of D are the same in both experimental scenarios, we use the information about D from the first experimental scenario to obtain reasonably precise estimates of λ, with a CV between 4 and 12%. Our estimates of D and λ are consistent with previously reported values; however, our method is based on a straightforward measurement of the position of the leading edge whereas previous approaches have involved expensive cell counting techniques. Additional insights gained using a fully Bayesian approach justify the computational cost, especially since it allows us to accommodate information from different experiments in a principled way.