'If you want something to happen, you have to do it yourself': Understanding rural Australian's perspectives of health volunteering.

ISSUE ADDRESSED: Rurality is associated with poorer health outcomes and access to health services, yet a strength of rural living includes community cohesion indicated by high rates of volunteering. While volunteerism is an effective means to target health needs in resource-restricted contexts, research on volunteerism to address rural Australian health needs is limited. This research aimed to explore rural adults' perspectives of volunteerism in local activities and programs that had a direct health related benefit (health volunteering). METHODS: Eight people from the Murray Mallee region of South Australia participated during April 2021, ranging in age from 32 to 75 years. Participants were invited to one-on-one interviews that occurred via a phone call or teleconference meeting, which were audio-recorded and transcribed verbatim to facilitate thematic analysis. RESULTS: Seven main themes emerged. Participants identified that (1) health volunteering takes many forms, (2) health volunteering affords local ownership and accessibility, (3) health volunteers have particular skills and values, but also (4) gain social benefits and learn new skills. Rural health volunteering was also associated with (5) a variety of personal costs, and (6) there are several environmental barriers and (7) facilitators to rural health volunteering that should be considered when designing health programs. CONCLUSION: Results provide insight into how rural communities can enhance the development and application of volunteering roles to support health volunteering. SO WHAT?: Including local champions, reducing the financial burden and developing support networks for volunteers are practical suggestions to enhance levels of volunteering for health in rural settings.

Evaluation of the 'A walk can work wonders' mass media campaign in South Australia.

ISSUE ADDRESSED: Few population-wide efforts have targeted physical activity in Australia. Mass media campaigns are used to promote physical activity and walking, and World Health Organisation recommends their linkage to broader cross-government initiatives. This project evaluates a South Australian (SA) walking mass media campaign linked to the overall SA Walking Strategy. METHODS: Between January and June 2022, Wellbeing SA (a SA government agency) conducted two waves of a mass media campaign, 'A walk can work wonders', to promote walking. The campaign was part of the SA Walking Strategy, targeting the goal to change the 'community culture towards recognising walking' as convenient, affordable and health-promoting. Evaluation was formative (pre-campaign), process (campaign implementation and delivery) and impact. Formative evaluation comprised concept and tagline testing with adult SAs to develop the campaign messages and theme. Process evaluation was comprised of media monitoring of social media, mainstream media and other media monitoring metrics. The process evaluation was dominated by social media marketing in Wave 1, with substantially more paid TV media and radio in Wave 2. The impact evaluation comprised two independent sample surveys of adult SAs (n = 800 each) following each wave of the campaign. Measures included generic and prompted campaign recall and attitudes to physical activity. An independent South Australian Population Health Survey (SAPHS) tracked walking and physical activity behaviours from 2021 to the end of 2022. RESULTS: Process evaluation showed intensive social media usage in Wave 1, and through increased paid television and radio in Wave 2. Generic recall of any walking message (23.9%) and prompted recall of the specific campaign message (27.8%) reached most socio-demographic groups, especially those with chronic health problems. Increases in intention to increase activity and increased self-reported activity were seen between the campaign Wave 1 and Wave 2 notable as the Wave 2 increase followed substantial television advertising. The SAPHS data showed increased population walking following the campaign waves, compared to the same period in 2021. CONCLUSIONS: Detailed and structured evaluation of a comprehensive mass media campaign showed good reach, and population changes in intentions and walking behaviour amongst SAs. SO WHAT?: It is likely that comprehensive approaches are needed to support mass media campaigns and amplify their effects. Serial, sustained campaigns are needed to monitor ongoing effects.

Mixed-methods evaluation of Daily Moves, a community-based physical activity program for older adults.

BACKGROUND: Although the health benefits of physical activity are well documented, most older adults are not sufficiently active. There is a need to explore approaches to physical activity promotion amongst older adults that meet the personal preferences and needs of participants, and that can be implemented on a large scale in community-based settings. The current study evaluates Daily Moves, a community-based physical activity program for older adults living in Adelaide, Australia.  METHODS: The Daily Moves program, which ran almost entirely during the COVID-19 pandemic, provided participants with personalized plans and information about suitable physical activity promoting activities available in their local area. This study used an explanatory sequential mixed-methods approach to evaluate associations between participation in the Daily Moves program and physical activity engagement, physical function and psychosocial wellbeing, and to explore the experiences of Daily Moves participants through qualitative interviews, with a particular focus on the impact of the COVID-19 pandemic on program participation and enjoyment. RESULTS: The research evaluation included 69 older adults (mean age at baseline = 73.9 ± 5.6 years; 19 male). Following Daily Moves, participants reported an increase in self-report physical activity levels (mean increase = 1.8 days, p < 0.001), improvements on several measures of physical function (left grip strength (mean increase = 1.8 kg, p < 0.001); right grip strength (mean increase = 1.3 kg, p = 0.03); Timed Up and Go (mean decrease = 1.3 s, p < 0.001)), and no significant changes in measures of psychosocial wellbeing. Qualitative interviews revealed that participants valued the supportive and flexible nature of Daily Moves, and that they felt connected with staff and other participants despite the onset of the pandemic. CONCLUSIONS: This evaluation demonstrates that physical activity programs embedded within the community can provide flexible and tailored recommendations to participants, and that this approach can promote positive change in important indicators of health in older adults.

Sport as a Leisure Occupation in Occupational Therapy Literature: A Scoping Review.

IMPORTANCE: The focus of occupational therapy is often on personal care, life skills, and daily living. Sport, as a type of leisure activity, can also provide benefits to health and well-being. Occupational therapy practitioners should therefore promote the role of sport in the lives of clients. OBJECTIVE: To investigate the extent, range, and nature of peer-reviewed occupational therapy literature investigating sport as a leisure occupation. DATA SOURCES: The following databases were searched: Embase, MEDLINE, OTseeker, PsycINFO, PubMed, and SPORTDiscus. STUDY SELECTION AND DATA COLLECTION: We identified published studies investigating competitive sport in occupational therapy research or practice. Included studies investigated adult participants (age ≥18 yr) participating in sport, had a clear occupational therapy input, and were written in the English language. FINDINGS: Six studies met the inclusion criteria. Only 2 of the 6 studies identified through the search strategy were conducted after 2004, diagnosis and outcome measures varied widely, and sport as a leisure occupation was found to have positive individual outcomes. CONCLUSIONS AND RELEVANCE: Opportunities exist to investigate sport as a leisure occupation and its involvement in occupational therapy practice. Future research may contribute to positive outcomes and experiences for clients who receive occupational therapy. WHAT THIS ARTICLE ADDS: This scoping review describes literature about sport as an occupation and highlights the opportunities for practitioners and researchers to incorporate sport as a leisure occupation.

An Exploratory Study Examining the Interactive Effect of Descriptive Norm and Image Appeal Messages on Adults' Physical Activity Intentions: A Test of Deviation Regulation Theory.

This exploratory study examined the interaction between messages conveying descriptive norms and image appeals on adults' physical activity intentions. Using a pre-post experimental design, insufficiently active adults (N = 204) were randomly assigned to receive one of four messages, which included both a descriptive norm (prevalence of physical activity: high vs. low) and an image appeal (personality attributes: positive vs. negative). The results from an analysis of covariance, controlling for baseline physical activity intentions, revealed a significant interaction. Post-hoc analyses indicated that when the image appeal was positive, those who received the low descriptive norm had greater physical activity intentions than the high descriptive norm condition. No significant interaction was found for negative image appeals. Results provide preliminary evidence that physical activity intentions can be positively influenced even when physical activity is not considered the norm. Messages that include low descriptive norm information may benefit from including positive image appeals of those who do engage in physical activity, if aiming to increase physical activity intentions in insufficiently active adults.

Can Smartphone Apps Increase Physical Activity? Systematic Review and Meta-Analysis.

BACKGROUND: Smartphone apps are a promising tool for delivering accessible and appealing physical activity interventions. Given the large growth of research in this field, there are now enough studies using the "gold standard" of experimental design-the randomized controlled trial design-and employing objective measurements of physical activity, to support a meta-analysis of these scientifically rigorous studies. OBJECTIVE: This systematic review and meta-analysis aimed to determine the effectiveness of smartphone apps for increasing objectively measured physical activity in adults. METHODS: A total of 7 electronic databases (EMBASE, EmCare, MEDLINE, Scopus, Sport Discus, The Cochrane Library, and Web of Science) were searched from 2007 to January 2018. Following the Population, Intervention, Comparator, Outcome and Study Design format, studies were eligible if they were randomized controlled trials involving adults, used a smartphone app as the primary or sole component of the physical activity intervention, used a no- or minimal-intervention control condition, and measured objective physical activity either in the form of moderate-to-vigorous physical activity minutes or steps. Study quality was assessed using a 25-item tool based on the Consolidated Standards of Reporting Trials checklist. A meta-analysis of study effects was conducted using a random effects model approach. Sensitivity analyses were conducted to examine whether intervention effectiveness differed on the basis of intervention length, target behavior (physical activity alone vs physical activity in combination with other health behaviors), or target population (general adult population vs specific health populations). RESULTS: Following removal of duplicates, a total of 6170 studies were identified from the original database searches. Of these, 9 studies, involving a total of 1740 participants, met eligibility criteria. Of these, 6 studies could be included in a meta-analysis of the effects of physical activity apps on steps per day. In comparison with the control conditions, smartphone apps produced a nonsignificant (P=.19) increase in participants' average steps per day, with a mean difference of 476.75 steps per day (95% CI -229.57 to 1183.07) between groups. Sensitivity analyses suggested that physical activity programs with a duration of less than 3 months were more effective than apps evaluated across more than 3 months (P=.01), and that physical activity apps that targeted physical activity in isolation were more effective than apps that targeted physical activity in combination with diet (P=.04). Physical activity app effectiveness did not appear to differ on the basis of target population. CONCLUSIONS: This meta-analysis provides modest evidence supporting the effectiveness of smartphone apps to increase physical activity. To date, apps have been most effective in the short term (eg, up to 3 months). Future research is needed to understand the time course of intervention effects and to investigate strategies to sustain intervention effects over time.

An exploratory experimental study examining the short-term effects of a public service announcement on parents' perceptions of the descriptive norm for children's outdoor play: A cautionary tale.

ISSUE ADDRESSED: Public service announcements (PSA) targeting physical activity are not always effective at enacting behaviour change. One factor that may impact message effectiveness is whether the message matches its intent (ie, what norm is being portrayed and received). The current study explored the effects of two PSAs on parents' perceptions of outdoor play. METHODS: Parents (N = 333) completed a pre/postexperimental online survey to examine the acute impact of a PSA on their perception of how often children play outdoors (ie, descriptive norms). Participants provided their descriptive norm perceptions and then were randomised to view one of two PSAs: (a) the Mr. Lonely PSA, which portrayed outdoor activity as not normative, and (b) a control message, which portrayed outdoor activity as the norm (VERB PSA). After viewing their PSA, descriptive norm perceptions were reported again. RESULTS: A two-way mixed ANOVA indicated that participants who viewed the Mr. Lonely PSA (where outdoor play was not normative) perceived that children and youth played outdoors less frequently immediately after watching the PSA compared to before viewing it (P < 0.05). No significant change occurred in the control condition. CONCLUSIONS: PSAs can alter individuals' perceptions of whether they perceive outdoor play as normative among children and youth. SO WHAT?: As individuals align their behaviour with what is typical, PSA developers should be wary of what message is being conveyed. In terms of activity, portraying that outdoor play is not normative may not have the intended outcome.

Examining the Relationship between Message Variables, Affective Reactions, and Parents' Instrumental Attitudes toward Their Child's Physical Activity: The "Mr. Lonely" Public Service Announcement.

This study examined the relationship between message variables and affective reactions with parents' attitudes after seeing a physical activity mass media public service announcement (PSA). It was hypothesized that there would be a positive relationship between message variables (i.e., personal relevance, novelty of information, and feelings toward sponsoring organization) and parents' attitudes toward their child/children's physical activity after viewing the PSA. Furthermore, we explored whether discrete affective reactions were related to attitudes, beyond the effect of message variables. A secondary data analysis was conducted with parental responses to an online campaign evaluation survey (n = 267). Hierarchical regression analyses showed an overall positive relationship between all three message variables and attitudes. Furthermore, two discrete affective reactions were positively related to attitudes. Parents who endorsed feeling motivated or guilty after viewing the advertisement had more positive attitudes toward their children's physical activity levels. This study represents an ecologically valid assessment of how message variables and affective reactions are related to attitudes within the context of a physical activity mass media campaign. The results provide guidance for the effective design of mass media physical activity campaigns.

Effect of Manipulating Descriptive Norms and Positive Outcome Expectations on Physical Activity of University Students During Exams.

This experimental study examined the interaction between messages conveying different levels of descriptive norms and positive outcome expectations on university students' engagement in moderate and vigorous physical activity over an exam period. Using a pre-post design, university students entering a final examination period (N = 74) were randomly assigned to one of four message conditions, receiving a message motivating them to exercise over the exam period. Messages included both a descriptive norm (how many others reported being active during a previous exam period; high vs. low) and a positive outcome expectation (those who exercise during exams report better grades; high vs. low). The results from an analysis of covariance (ANCOVA), controlling for baseline levels of daily physical activity, revealed a significant interaction. Post hoc analyses indicated that when the descriptive norm was high, those who received a high positive outcome expectation reported being more active during the exam period compared to those receiving the low positive outcome expectation. Results provide preliminary support for the idea that activity during an exam period can be positively influenced if individuals are presented with normative messages that (a) many others are being active during the exams and (b) many of those being active also are benefiting academically.