Are Perceptions of Government Intervention Related to Support for Prevention? An Australian Survey Study.

BACKGROUND: In Australia, despite the success of tobacco control policy interventions, policymakers remain resistant to policy-based approaches to diet, alcohol, physical inactivity and obesity, concerned about community perceptions of such interventions as "nanny-statist". We examined how people's general positions on government intervention related to their positions on different preventive policy options. METHODS: Data were from a 2018 nationally representative cross-sectional telephone survey of 2601 Australian adults. Survey questions related to endorsement of different conceptualisations of government intervention (nanny state, paternalistic, shared responsibility and communitarian) and support for specific health interventions, using forced-choice questions about preferences for individual/treatment measures versus population/preventive health measures. We analysed associations between scores on different conceptualisations of government intervention and support of different policy options for tobacco and diet, and preferences for prevention over treatment. RESULTS: The Nanny State Scale showed an inverse relationship with support for tobacco- and diet-related interventions, and alternative conceptualisations (paternalistic, shared responsibility and communitarian) showed a positive relationship. Effect sizes in all cases were small. Those aged 55+ demonstrated greater support for policy action on tobacco and diet, and greater preference for systemic rather than individual-level interventions. CONCLUSION: General disposition towards government intervention, although correlated with support for specific policy actions, is not deterministic.

Polite, professional, practical: What drives caller 'satisfaction' with the New South Wales Quitline, Australia.

INTRODUCTION AND AIMS: Previous studies on smoking quitlines have focused on service effectiveness and usage, describing client characteristics, referral sources and service utilisation. There is a lack of qualitative research examining callers' perspectives on service quality. The analysis aimed to describe the factors which underpin quitline callers' descriptions of their satisfaction with the service. DESIGN AND METHODS: We conducted qualitative interviews with 46 callers to the NSW Quitline's English and multilingual lines. We used an iterative, inductive, thematic approach to identify common patterns within interviewees' descriptions of what informed their level of satisfaction with the service. RESULTS: Interviewees evaluated the Quitline service format (frequency, duration and convenience of call-backs), call content and advisor competence in terms of whether these components conveyed care, developed rapport and demonstrated a general professionalism (polite, reliable and convenient service). Satisfaction rested on callers finding advice and resources personally relevant and matching prior expectations, although many did not have an accurate idea of Quitline's services prior to calling. These themes were evident across age, gender, language background and quitting status. DISCUSSION AND CONCLUSIONS: 'Satisfaction' with Quitline is complex and not wholly dependent on achieving cessation. Evaluations emerged out of dynamic interactions between callers' preconceived notions and needs of smoking cessation services and the particular service experience of the caller. While callers' descriptions of the Quitline were predominantly positive, developing specialised modules for long-term smokers and those with a strong sense of personal responsibility for quitting may broaden the utility of the service.

Composite measures quantify households' obesogenic potential and adolescents' risk behaviors.

OBJECTIVE: The aims of this study were to generate composite measures quantifying a household's obesogenic potential and to examine the relationship of the composite variables with older children's eating, physical activity (PA), and small screen recreation. METHODS: Data were from surveys with 1685 child-parent pairs in which the child was in grade 6, 8, or 10 (mean age: 14 years). Composite measures of the obesogenic household environment were generated from 11 measures using nonlinear principal components analysis. Associations between the composite measures and the children's healthy and unhealthy food intake, PA, and screen time were tested (adjusting for demographic characteristics). RESULTS: Two scales were generated: (1) obesogenic control, which clustered together factors that mitigate risk; and (2) obesogenic risk. Higher scores on the control scale were associated with higher adolescent intake of healthy foods, lower intake of unhealthy foods, higher PA, and less screen time. Higher scores on the risk scale were associated with lower adolescent intake of healthy foods, higher intake of unhealthy foods, lower PA, and more screen time. There were significant 2-way interactions between the scales for soft drink consumption and PA. CONCLUSIONS: Household obesogenic potential may be quantified as 2 factors reflecting cumulative risk and control practices. These factors have both additive associations with obesogenic behaviors and, in some cases, modify each other, suggesting that a healthy home environment requires attention to both. Health promotion messages could incorporate these 2 different but interacting factors that parents can use to modify the obesogenic potential of their household.