Beyond the Laws: Parental Monitoring, Perceived Acceptability of Underage Drinking and Alcohol Use Among Belgian Youth.

Parental monitoring behaviors are negatively associated with adolescent substance use. Yet, the processes explaining these associations are still unclear. The current study examined adolescents' knowledge of minimum legal drinking age laws and their perceived acceptability of underage drinking as potential mediators of the links between parental monitoring behaviors and youth alcohol use. The sample included 1154 Belgian adolescents (Mage = 16.34, SD = 1.33; 71% girls), who were recruited in Wallonia (54.9%) and in Flanders (45.1%). Path analyses revealed that higher parental rule setting, but not solicitation, was related to lower alcohol use. Acceptability of underage drinking mediated this link, but not knowledge of the laws. Results suggest that beyond laws regulating the minimum legal drinking age, alcohol use prevention programs should consider the importance of parental rule setting and youth's perceived acceptability of underage drinking.

A More Supportive Social Environment May Protect Against Nutritional Risk: A Cross-Sectional Analysis Using Data From the Canadian Longitudinal Study on Aging.

BACKGROUND: Nutritional risk has been linked to individual social factors, but the relationship with the overall social environment has not been assessed. OBJECTIVES: To evaluate associations between different support profiles of the social environment and nutritional risk using cross-sectional data from the Canadian Longitudinal Study on Aging (n = 20,206). Subgroup analyses were performed among middle-aged (range, 45-64 y; n = 12,726) and older-aged (≥65 y, n = 7480) adults. Consumption of major food groups [whole grains, proteins, dairy products, and fruits and vegetables (FV)] by social environment profile was a secondary outcome. METHODS: Latent structure analysis (LSA) classified participants into social environment profiles according to data on network size, social participation, social support, social cohesion, and social isolation. Nutritional risk and food group consumption were assessed with the SCREEN-II-AB and Short Dietary questionnaires, respectively. ANCOVA was conducted to compare SCREEN-II-AB mean scores by social environment profile, adjusted for sociodemographic and lifestyle factors. Models were repeated to compare mean food group consumption (times/day) by social environment profile. RESULTS: LSA identified 3 social environment profiles classified as low, medium, and high support (17%, 40%, and 42% of the sample, respectively). Adjusted mean SCREEN-II-AB scores significantly increased with increasing social environment support, with the low support score indicating high nutritional risk status [low, medium, high support, respectively: 37.1 (99% CI: 36.9, 37.4), 39.3 (39.2, 39.5), 40.3 (40.2, 40.5), all comparisons P < 0.0001]. Results were consistent among age subgroups. The low support social environment profile had lower consumption of protein [low, medium, high support, respectively (mean ± SD): 2.17 ± 0.09, 2.21 ± 0.07, 2.23 ± 0.08, P = 0.004], dairy (2.32 ± 0.23, 2.40 ± 0.20, 2.38 ± 0.21, P = 0.009), and FV (3.65 ± 0.23, 3.94 ± 0.20, 4.08 ± 0.21, P < 0.0001), with some variation among age subgroups. CONCLUSIONS: The low support social environment profile had the poorest nutritional outcomes. Therefore, a more supportive social environment may protect against nutritional risk among middle- and older-aged adults.

Branched-chain amino acids and sleep: a population-derived study of Australian children aged 11-12 years and their parents.

Micronutrients, particularly amino acids, are thought to play an important role in sleep regulation and maintenance. While tryptophan is a known predictor of sleep, less is known about branched-chain amino acids (BCAAs), which compete with tryptophan for transport across the blood-brain barrier. The aim of this study was to determine the association between BCAAs and actigraphy-derived sleep duration, timing and efficiency, and self-reported trouble sleeping. This study examined data on children and adults collected as part of the Child Health CheckPoint study. Linear mixed models, adjusted for geographic clustering, were used to determine the association between BCAAs and sleep characteristics. Complete-case analysis was conducted for 741 children aged 11-12 years old (51% females) and 941parents (87% mothers). While BCAAs were significantly associated with children's sleep duration, timing and self-reported trouble sleeping, no associations were observed in adults, in fully adjusted models. In children, higher levels of BCAAs are associated with shorter sleep duration, delayed sleep timing, and more frequent reports of trouble sleeping.

Social Prescription Interventions Addressing Social Isolation and Loneliness in Older Adults: Meta-Review Integrating On-the-Ground Resources.

BACKGROUND: Social prescription programs represent a viable solution to linking primary care patients to nonmedical community resources for improving patient well-being. However, their success depends on the integration of patient needs with local resources. This integration could be accelerated by digital tools that use expressive ontology to organize knowledge resources, thus enabling the seamless navigation of diverse community interventions and services tailored to the needs of individual users. This infrastructure bears particular relevance for older adults, who experience a range of social needs that impact their health, including social isolation and loneliness. An essential first step in enabling knowledge mobilization and the successful implementation of social prescription initiatives to meet the social needs of older adults is to incorporate the evidence-based academic literature on what works, with on-the-ground solutions in the community. OBJECTIVE: This study aims to integrate scientific evidence with on-the-ground knowledge to build a comprehensive list of intervention terms and keywords related to reducing social isolation and loneliness in older adults. METHODS: A meta-review was conducted using a search strategy combining terms related to older adult population, social isolation and loneliness, and study types relevant to reviews using 5 databases. Review extraction included intervention characteristics, outcomes (social [eg, loneliness, social isolation, and social support] or mental health [eg, psychological well-being, depression, and anxiety]), and effectiveness (reported as consistent, mixed, or not supported). Terms related to identified intervention types were extracted from the reviewed literature as well as descriptions of corresponding community services in Montréal, Canada, available from web-based regional, municipal, and community data sources. RESULTS: The meta-review identified 11 intervention types addressing social isolation and loneliness in older adults by either increasing social interactions, providing instrumental support, promoting mental and physical well-being, or providing home and community care. Group-based social activities, support groups with educational elements, recreational activities, and training or use of information and communication technologies were the most effective in improving outcomes. Examples of most intervention types were found in community data sources. Terms derived from the literature that were the most commonly congruent with those describing existing community services were related to telehealth, recreational activities, and psychological therapy. However, several discrepancies were observed between review-based terms and those addressing the available services. CONCLUSIONS: A range of interventions found to be effective at addressing social isolation and loneliness or their impact on mental health were identified from the literature, and many of these interventions were represented in services available to older residents in Montréal, Canada. However, different terms were occasionally used to describe or categorize similar services across data sources. Establishing an efficient means of identifying and structuring such sources is important to facilitate referrals and help-seeking behaviors of older adults and for strategic planning of resources.

Otolith-inferred patterns of marine migration frequency in Nunavik Arctic charr.

Alternative migratory tactics in salmonids reflect the large observed interindividual variation in spatial behaviour which may range from strict freshwater residency to uninterrupted anadromy. In Salvelinus, sea migrations are performed during the ice-free period as freshwater overwintering is thought to be obligatory due to physiological constraints. As a result, individuals can either migrate the next spring or remain in freshwater, as anadromy is generally considered facultative. In Arctic charr (Salvelinus alpinus), skipped migrations are known to occur, but limited data are available regarding their frequencies within and among populations. Here, the authors used an otolith microchemistry approach relying on strontium (88 Sr) to infer movements between freshwater and marine habitats, and annual oscillations in zinc (64 Zn) to help with age identification. They determined the age-at-first-migration and the occurrence of subsequent annual migrations in two Nunavik Arctic charr populations sampled in Deception Bay (Salluit) and river systems linked to Hopes Advance Bay (Aupaluk), northern Québec, Canada. The mode for age-at-first-migration was 4+ for both populations, although it exhibited large variation (range: 0+ to 8+). Skipped migrations constituted a rare event, as 97.7% and 95.6% of the examined Arctic charr at Salluit (n = 43, mean age = 10.3 ± 2.0 years) and Aupaluk (n = 45, mean age = 6.0 ± 1.9 years), respectively, were found to have performed uninterrupted annual migrations after initiation of the behaviour. The consistency of the annual migrations suggests that the tactic is sufficiently fitness rewarding to be maintained under current environmental conditions. From a fisheries management perspective, these repeated migrations combined with low site fidelity in this species may lead to large interannual variations in abundance at the local scale, which may represent a challenge for monitoring Arctic charr demographics on a river-by-river basis.

Food Values, Food Purchasing, and Eating-Related Outcomes Among a Sample of Quebec Adults During the COVID-19 Pandemic.

Purpose: This investigation evaluated food values, food purchasing, and other food and eating-related outcomes during the COVID-19 pandemic in Quebec, Canada. The role of stress in eating outcomes was also examined.Methods: An online household survey was conducted among Quebec adults aged ≥18 years (n = 658). Changes in outcomes during, as compared to before, the pandemic were evaluated using descriptive statistics and thematic analysis of free text responses. Eating outcomes by daily stress level (low, some, high) were assessed using Cochran-Armitage test for trend.Results: Most respondents reported increased importance and purchasing of local food products (77% and 68%, respectively) and 60% reported increased grocery spending (mean ± standard deviation: 28% ± 23%). Respondents with a higher daily stress level had a higher frequency of reporting eating more than usual compared to before the pandemic (low stress 21%, some stress 34%, high stress 39%, p-trend <0.0001). Free text responses described more time spent at home as a reason for eating more than usual.Conclusions: To support healthy eating during and post-pandemic, dietitians should consider patients' mental/emotional well-being and time spent at home. Moreover, support of local food products may provide opportunities to promote healthy eating, sustainability, and post-pandemic resiliency of food systems.

Prospective relations between sleep in preschool years and academic achievement at school entry.

It is often assumed that adequate sleep is a key ingredient of children's school success. Research to date, however, suggests modest associations between child sleep and academic achievement. Adopting a developmental perspective, this report investigates the associations between age-related changes in sleep across the preschool period and academic achievement at school entry. Sleep was assessed by actigraphy at ages 2, 3 and 4 among 128 children from mostly White middle-class families, and their performance in reading and mathematics was tested in Grade 1. The results revealed that children whose sleep duration decreased more rapidly across the preschool period showed better performance in both reading and mathematics. These results suggest that age-related developments may be a key characteristic of sleep in the preschool years.

Dopamine D4 receptor gene polymorphism (DRD4 VNTR) moderates real-world behavioural response to the food retail environment in children.

BACKGROUND: Evidence for the impact of the food retailing environment on food-related and obesity outcomes remains equivocal, but only a few studies have attempted to identify sub-populations for whom this relationship might be stronger than others. Genetic polymorphisms related to dopamine signalling have been associated with differences in responses to rewards such as food and may be candidate markers to identify such sub-populations. This study sought to investigate whether genetic variation of the dopamine D4 receptor gene (DRD4 exon III 48 bp VNTR polymorphism) moderated the association between local exposure to food retailers on BMI and diet in a sample of 4 to12-year-old children. METHODS: Data collected from a birth cohort and a community cross-sectional study conducted in Montreal, Canada, were combined to provide DRD4 VNTR polymorphism data in terms of presence of the 7-repeat allele (DRD4-7R) for 322 children aged between 4 and 12 (M (SD): 6.8(2.8) y). Outcomes were Body Mass Index (BMI) for age and energy density derived from a Food Frequency Questionnaire. Food environment was expressed as the proportion of local food retailers classified as healthful within 3 km of participants' residence. Linear regression models adjusted for age, sex, income, cohort, and geographic clustering were used to test gene*environment interactions. RESULTS: A significant gene*food environment interaction was found for energy density with results indicating that DRD4-7R carriers had more energy dense diets than non-carriers, with this effect being more pronounced in children living in areas with proportionally more unhealthy food retailers. No evidence of main or interactive effects of DRD4 VNTR and food environment was found for BMI. CONCLUSIONS: Results of the present study suggest that a genetic marker related to dopamine pathways can identify children with potentially greater responsiveness to unhealthy local food environment. Future studies should investigate additional elements of the food environment and test whether results hold across different populations.

Maori, Pacific, Aboriginal and Torres Strait Islander Women's Cardiovascular Health: Where Are the Opportunities to Make a Real Difference?

Maori and Pacific women in New Zealand and Aboriginal and Torres Strait Islander women in Australia are recognised as nurturers and leaders within their families and communities. However, women's wellbeing, and that of their communities, are affected by a high burden of cardiovascular disease experienced at a younger age than women from other ethnic groups. There has been little focus on the cardiovascular outcomes and strategies to address heart health inequities among Maori, Pacific, Aboriginal and Torres Strait Islander women. The factors contributing to these inequities are complex and interrelated but include differences in exposure to risk and protective factors, rates of multi-morbidity, and substantial gaps within the health system, which include barriers to culturally responsive, timely and appropriate cardiovascular care. Evidence demonstrates critical treatment gaps across the continuum of risk and disease, including assessment and management of cardiovascular risk in young women and time-critical access to and receipt of acute services. Cardiovascular disease in women impacts not only the individual, but their family and community, and the burden of living with disease limits women's capacity to fulfil their roles and responsibilities which support and sustain families and communities. Our response must draw on the strengths of Maori, Pacific, Aboriginal and Torres Strait Islander women, acknowledge health and wellbeing holistically, address the health and social needs of individuals, families and communities, and recognise that Indigenous women in New Zealand, Australia and across the Pacific must be involved in the design, development and implementation of solutions affecting their own health.

Good Heart: Telling Stories of Cardiovascular Protective and Risk Factors for Aboriginal Women.

BACKGROUND: Aboriginal and Torres Strait Islander peoples' perspectives of health and cultural wellbeing encapsulate the spiritual, social and environmental health of individuals, their communities and country. Strategies designed to reduce the cardiovascular burden of Aboriginal and Torres Strait Islander people often fail to consider their unique knowledge and worldview. METHODS: This adapted, grounded theory study sought to explore Aboriginal women's views of cardiovascular protective and risk factors. RESULTS: Twenty-eight (28) women from five women's groups across Central and South Australia participated. Women distinguished the heart as core to their spiritual and physical wellbeing. Women identified six attributes that keep a woman's heart strong, four that can make the heart sick, and eight socio-ecological factors which affect a woman's capacity to care for their heart. Women described having a healthy heart when able to identify as Aboriginal women, being connected to family and community, having a healthy life and body, and being engaged in their health and health care. CONCLUSIONS: There are gaps in the provision of cardiovascular risk assessment and management, gaps in the cultural safety of primary health care services, and gaps in the communication of the sex-specific warning signs of a heart attack, all of which must be addressed.

From Early Relationships to Preacademic Knowledge: A Sociocognitive Developmental Cascade to School Readiness.

This study aimed to test a four-wave sequential mediation model linking mother-child attachment to children's school readiness through child executive functioning (EF) and prosociality in toddlerhood and the preschool years. Mother-child attachment security was assessed when children (N = 255) were aged 15 months and 2 years, child EF at age 2, prosocial behavior at age 4, and finally cognitive school readiness in kindergarten (age 6). The results revealed three indirect pathways linking attachment to school readiness: one through EF only, one through prosocial behavior only, and a last pathway involving both EF and prosocial behavior serially. These findings suggest that secure attachment may equip children with both cognitive and social skills that are instrumental to their preparedness for school.

Correction to: The long-term rate of change in lung function in urban professional firefighters: a systematic review.

Following publication of the original article [1], the authors flagged an error in Table 2; specifically, within the row beginning 'Aldrich et al. 2013' on page 11 of the article PDF.

Low birth weight is associated with increased fat intake in school-aged boys.

Evidence suggests that both high and low birth weight children have increased the risk for obesity and the metabolic syndrome in adulthood. Previously we have found altered feeding behaviour and food preferences in pre-school children and adults born with low birth weight. In this study, we investigated if birth weight was associated with different intake of fat, carbohydrate and/or protein at 6-12 years of age. This is a cross-sectional study where 255 guardians answered online and telephone questions including anthropometrics and demographic data, parental family food rules (food control, encouragement and restriction) and a complete web-based FFQ for their children (130 boys and 125 girls). Baseline demographic and parental food rules characteristics did not differ accordingly to sex. Linear regression models were conducted separately for each sex, adjusted for income, age and maternal age. There were no differences in total energy intake, but energy density (ED, energy content/g) was negatively associated with birth weight in boys. Macronutrient analysis showed that ED intake was from a greater intake of fat. Birth weight was not a significant predictor of protein and carbohydrate intake in boys. In girls, we saw a positive correlation between fat intake and cholesterol intake v. birth weight, but no association with ED intake (results did not remain after adjustment). The study shows that low birth weight is associated with altered fat intake in childhood in a sex-specific manner. It is likely that biological factors such as fetal programming of homoeostatic and/or hedonic pathways influencing food preferences are involved in this process.

The long-term rate of change in lung function in urban professional firefighters: a systematic review.

BACKGROUND: Despite the known occupational hazards, it is not yet clear whether long-term career firefighting leads to a greater rate of decline in lung function than would normally be expected, and how this rate of change is affected by firefighting exposures and other risk/protective factors. METHODS: A systematic search of online electronic databases was conducted to identify longitudinal studies reporting on the rate of change in the forced expiratory volume in one second (FEV1) of forced vital capacity (FVC). Included studies were critically appraised to determine their risk of bias using the Research Triangle Institute Item Bank (RTI-IB) on Risk of Bias and Precision of Observational Studies. RESULTS: Twenty-two studies were identified for inclusion, from four different countries, published between 1974 and 2016. Examined separately, studies were categorised by the type of firefighting exposure. Firefighters experienced variable rates of decline in lung function, which were particularly influenced by cigarette smoking. The influence of routine firefighting exposures is unclear and limited by the methods of measurement, while firefighters exposed to 'non-routine' severe exposures unanimously experienced accelerated declines. CONCLUSIONS: The data provided by longitudinal studies provide an unclear picture of how the rate of change in lung function of firefighters relates to routine exposures and how it compares to the rate of change expected in a working-age population. Non-smoking firefighters who routinely wear respiratory protection are more likely than otherwise to have a normal rate of decline in lung function. Exposure to catastrophic events significantly increases the rate of decline in firefighter lung function but there is limited evidence detailing the effect of routine firefighting. Future studies will benefit from more robust methods of measuring exposure. TRIAL REGISTRATION: International Prospective Register of Systematic Reviews (PROSPERO), registration number ( CRD42017058499 ).

The moderating role of food cue sensitivity in the behavioral response of children to their neighborhood food environment: a cross-sectional study.

BACKGROUND: Neighborhood food cues have been inconsistently related to residents' health, possibly due to variations in residents' sensitivity to such cues. This study sought to investigate the degree to which children's predisposition to eat upon exposure to food environment and food cues (external eating), could explain differences in strength of associations between their food consumption and the type of food outlets and marketing strategies present in their neighborhood. METHODS: Data were obtained from 616 6-12 y.o. children recruited into a population-based cross-sectional study in which food consumption was measured through a 24-h food recall and responsiveness to food cues measured using the external eating scale. The proportion of food retailers within 3 km of residence considered as "healthful" was calculated using a Geographical Information System. Neighborhood exposure to food marketing strategies (displays, discount frequency, variety, and price) for vegetables and soft drinks were derived from a geocoded digital marketing database. Adjusted mixed models with spatial covariance tested interaction effects of food environment indicators and external eating on food consumption. RESULTS: In children with higher external eating scores, healthful food consumption was more positively related to vegetable displays, and more negatively to the display and variety of soft drinks. No interactions were observed for unhealthful food consumption and no main effects of food environment indicators were found on food consumption. CONCLUSIONS: Children differ in their responsiveness to marketing-related visual food cues on the basis of their external eating phenotype. Strategies aiming to increase the promotion of healthful relative to unhealthful food products in stores may be particularly beneficial for children identified as being more responsive to food cues.

Local descriptive body weight and dietary norms, food availability, and 10-year change in glycosylated haemoglobin in an Australian population-based biomedical cohort.

BACKGROUND: Individual-level health outcomes are shaped by environmental risk conditions. Norms figure prominently in socio-behavioural theories yet spatial variations in health-related norms have rarely been investigated as environmental risk conditions. This study assessed: 1) the contributions of local descriptive norms for overweight/obesity and dietary behaviour to 10-year change in glycosylated haemoglobin (HbA1c), accounting for food resource availability; and 2) whether associations between local descriptive norms and HbA1c were moderated by food resource availability. METHODS: HbA1c, representing cardiometabolic risk, was measured three times over 10 years for a population-based biomedical cohort of adults in Adelaide, South Australia. Residential environmental exposures were defined using 1600 m participant-centred road-network buffers. Local descriptive norms for overweight/obesity and insufficient fruit intake (proportion of residents with BMI ≥ 25 kg/m2 [n = 1890] or fruit intake of <2 serves/day [n = 1945], respectively) were aggregated from responses to a separate geocoded population survey. Fast-food and healthful food resource availability (counts) were extracted from a retail database. Separate sets of multilevel models included different predictors, one local descriptive norm and either fast-food or healthful food resource availability, with area-level education and individual-level covariates (age, sex, employment status, education, marital status, and smoking status). Interactions between local descriptive norms and food resource availability were tested. RESULTS: HbA1c concentration rose over time. Local descriptive norms for overweight/obesity and insufficient fruit intake predicted greater rates of increase in HbA1c. Neither fast-food nor healthful food resource availability were associated with change in HbA1c. Greater healthful food resource availability reduced the rate of increase in HbA1c concentration attributed to the overweight/obesity norm. CONCLUSIONS: Local descriptive health-related norms, not food resource availability, predicted 10-year change in HbA1c. Null findings for food resource availability may reflect a sufficiency or minimum threshold level of resources such that availability poses no barrier to obtaining healthful or unhealthful foods for this region. However, the influence of local descriptive norms varied according to food resource availability in effects on HbA1c. Local descriptive health-related norms have received little attention thus far but are important influences on individual cardiometabolic risk. Further research is needed to explore how local descriptive norms contribute to chronic disease risk and outcomes.

Residential proximity to urban centres, local-area walkability and change in waist circumference among Australian adults.

Consistent associations have been observed between macro-level urban sprawl and overweight/obesity, but whether residential proximity to urban centres predicts adiposity change over time has not been established. Further, studies of local-area walkability and overweight/obesity have generated mixed results. This study examined 4-year change in adults' waist circumference in relation to proximity to city centre, proximity to closest suburban centre, and local-area walkability. Data were from adult participants (n=2080) of a cohort study on chronic conditions and health risk factors in Adelaide, Australia. Baseline data were collected in 2000-03 with a follow-up in 2005-06. Multilevel regression models examined in 2015 the independent and joint associations of the three environmental measures with change in waist circumference, accounting for socio-demographic covariates. On average, waist circumference rose by 1.8cm over approximately 4years. Greater distance to city centre was associated with a greater increase in waist circumference. Participants living in distal areas (20km or further from city centre) had a greater increase in waist circumference (mean increase: 2.4cm) compared to those in proximal areas (9km or less, mean increase: 1.2cm). Counterintuitively, living in the vicinity of a suburban centre was associated with a greater increase in adiposity. Local-area walkability was not significantly associated with the outcome. Residential proximity to city centre appears to be protective against excessive increases in waist circumference. Controlled development and targeted interventions in the urban fringe may be needed to tackle obesity. Additional research needs to assess behaviours that mediate relationships between sprawl and obesity.

Place and Posttraumatic Stress Disorder.

Research on traumatic stress has focused largely on individual risk factors. A more thorough understanding of risk factors may require investigation of the contribution of neighborhood context, such as the associations between perceived neighbourhood disorder and social cohesion with reported trauma exposure (yes/no) and posttraumatic stress disorder (PTSD) diagnostic status (past-year PTSD, remitted). To examine these associations, we used a cross-sectional analysis of an epidemiological catchment area survey (N = 2,433). Visible cues, indicating a lack of order and social control in the community (neighbourhood disorder), were associated with increased trauma exposure (adjusted odds ratio [AOR] = 1.21, 95% confidence interval [CI] [1.12, 1.31]). For trauma-exposed individuals, neighbourhood disorder was associated with greater odds of lifetime PTSD (AOR = 1.38, 95% CI [1.10, 1.75]), and the willingness of residents who realize common values to intervene for the common good (social cohesion), was associated with lower likelihood of past-year PTSD (AOR = 0.64, 95% CI [0.42, 0.97]). For participants with a lifetime diagnosis of PTSD (including past-year), increased social cohesion was associated with higher odds of remission (AOR = 2.59, 95% CI [1.55, 4.30]). Environmental contexts play a role in the development and progression of PTSD. As such, traumatic stress outcomes may be better understood through a perspective that integrates individual and contextual risk factors.

Men, hearts and minds: developing and piloting culturally specific psychometric tools assessing psychosocial stress and depression in central Australian Aboriginal men.

PURPOSE: The health inequalities experienced by Aboriginal and Torres Strait Islander Australians are well documented but there are few empirical data outlining the burden, consequences, experience and expression of depressive illness. This paper seeks to address the lack of accessible, culturally specific measures of psychosocial stress, depression or quality of life developed for, and validated within, this population. METHODS: Building on an extensive qualitative phase of research, a psychosocial questionnaire comprising novel and adapted scales was developed and piloted with 189 Aboriginal men across urban and remote settings in central Australia. With a view to refining this tool for future use, its underlying structure was assessed using exploratory factor analysis, and the predictive ability of the emergent psychosocial constructs assessed with respect to depressive symptomatology. RESULTS: The latent structure of the psychosocial questionnaire was conceptually aligned with the components of the a priori model on which the questionnaire was based. Regression modelling indicated that depressive symptoms were driven by a sense of injury and chronic stress and had a non-linear association with socioeconomic position. CONCLUSIONS: This represents the first community-based survey of psychosocial stress and depression in Aboriginal men. It provides both knowledge of, and an appropriate process for, the further development of psychometric tools, including quality of life, in this population. Further research with larger and more diverse samples of Aboriginal people is required to refine the measurement of key constructs such as chronic stress, socioeconomic position, social support and connectedness. The further refinement, validation against criterion-based methods and incorporation within primary care services is essential.

Do relationships between environmental attributes and recreational walking vary according to area-level socioeconomic status?

Residents of areas with lower socioeconomic status (SES) are known to be less physically active during leisure time. Neighborhood walkability has been shown to be related to recreational walking equally in low and high SES areas. This cross-sectional study tested whether associations of specific environmental attributes, measured objectively and subjectively, with walking for recreation were moderated by area-level SES. The data of the North West Adelaide Health Study collected in 2007 (n = 1500, mean age 57) were used. Self-reported walking frequency was the outcome of the study. Environmental exposure measures included objectively measured walkability components (residential density, intersection density, land use mix, and net retail area ratio) and perceived attributes (access to destinations, neighborhood esthetics, walking infrastructure, traffic/barriers, and crime safety). Participants' suburbs were categorized into low and high SES areas using an indicator of socioeconomic disadvantage. Low SES areas had lower scores in residential density, neighborhood esthetics, walking infrastructure, traffic/barriers, and crime safety. Recreational walking was associated with residential density, access to destinations, esthetics, traffic/barriers, and crime safety. Effect modification was observed for two attributes (out of nine): residential density was associated with walking only in low SES areas, while walking infrastructure was associated with walking only in high SES areas. The associations of neighborhood environmental attributes with recreational walking were largely consistent across SES groups. However, low SES areas were disadvantaged in most perceived environmental attributes related to recreational walking. Improving such attributes in low SES neighborhoods may help close socioeconomic disparities in leisure time physical activity.