Impact on help-seeking behaviours of a campaign perceived to decrease stigma and increase openness around mental health.

ISSUE ADDRESSED: There is considerable evidence that public stigma around mental illness inhibits help-seeking for mental health problems. Hence there have been many interventions and campaigns designed to reduce stigma around mental illness. However, as far as could be ascertained, none of these stigma reduction interventions has reported any substantial impact of reducing stigma on people's mental health help-seeking behaviours. The aim of this paper is to report on the impact of the Act-Belong-Commit positive mental health promotion Campaign on help-seeking via increasing perceived openness around mental health and reducing perceived stigma around mental illness. METHODS: State-wide computer assisted telephone interviews (CATIs) of the general adult population were undertaken in 2018 and 2019 (N = 600 adults per year). The questionnaire included measures of respondents' awareness of the Act-Belong-Commit Campaign, their beliefs about the Campaign's impact on mental illness stigma and openness around mental health issues, and whether they had sought help for or information about a mental health problem as a result of their exposure to the Campaign. RESULTS: Those who believed the Act-Belong-Commit Campaign increased openness around mental health issues were significantly more likely than those not holding this belief to have sought information about mental health and to have sought help for a mental health problem as a result of their exposure to the Campaign. Those who believed the Act-Belong-Commit Campaign decreased stigma around mental illness versus those not holding this belief were significantly more likely to have sought information, and more likely, but not significantly so, to have sought help as a result of their exposure to the Campaign. Overall, the effect was slightly greater for increased openness. CONCLUSION: As far as we are aware, these are the first reported findings of a positive impact on mental health help-seeking behaviours as a result of a population-wide mental health promotion Campaign being seen to have increased openness around mental health and decreased stigma around mental illness. SO WHAT?: These findings suggest that accompanying specific stigma reduction interventions with a broad-based, population-wide, positive mental health promotion Campaign such as the Act-Belong-Commit campaign, could amplify these interventions' impact on help-seeking by increasing openness about mental health issues.

Impact of the Act-Belong-Commit campaign on mental health help-seeking behaviour.

ISSUE ADDRESSED: Despite the high prevalence of mental ill-health amongst Australians, many people do not seek help for their mental ill-health. A delay in help-seeking is associated with poorer outcomes. This study investigated the extent to which the Act-Belong-Commit mental health promotion campaign prompted people to seek information or professional help for mental ill-health. METHODS: A sample of 1200 respondents took part in two state-wide surveys (n = 600 each). Participants aware of the Act-Belong-Commit campaign were asked questions related to information-seeking and help-seeking behaviours because of the campaign. RESULTS: Of those aware of the campaign, 8% stated that the campaign prompted them to seek information and 4% stated that the campaign prompted them to seek help for a mental health problem. Those with a mental illness experience (MIE) were significantly more likely than those without to report that the campaign prompted them to look for information (12% vs 6%) and seek help for a mental health problem (9.5% vs 1.2%). Extrapolating these results to the total adult population of Western Australia indicated that around 120 000 adults had sought mental health information, and around 60 000 had sought help as a result of the campaign. CONCLUSIONS: The campaign not only initiated the seeking of information or professional help for a mental health problem amongst those with no prior thoughts of such, but also prompted those who were already thinking about seeking information or getting help to act sooner than they otherwise would. SO WHAT?: Although previous research suggests that mental health literacy interventions have limited impact on help-seeking, the presented data show that the Act-Belong-Commit approach can have a significant impact on help-seeking, particularly amongst those with a MIE, which could yield substantial social and economic return on investment benefits if intensified at both the media and community grass roots levels.

Modern urbanization has reshaped the bacterial microbiome profiles of house dust in domestic environments.

BACKGROUND: The prevalence of allergy and other common chronic diseases is higher in developed than developing countries, and higher in urban than rural regions. Urbanization through its modification of environmental microbiomes may play a predominant role in the development of these conditions. However, no studies have been conducted to compare the microbiome in house dust among areas with different urbanization levels. METHODS: House dust from Xinxiang rural area (XR, n = 74), Xinxiang urban area (XU, n = 33), and Zhengzhou urban area (ZU, n = 32) in central China, and from Australia (AU, n = 58 [with pets AUP, n = 15, without pets AUNP, n = 43]) were collected during a summer season in China and Australia. High-throughput sequencing of 16S rDNA was employed to profile house dust bacterial communities. RESULTS: Settled dust collected in China was dominant with 2 bacterial phyla: Proteobacteria and Actinobacteria, while floor dust collected in Australia had a higher proportion of phylum Proteobacteria, Firmicutes, and Actinobacteria. XR dust samples presented higher bacterial richness and diversity compared with XU or ZU samples. Urbanization level (r2 = 0.741 P < 0.001) had a significant correlation with the distribution of house dust bacterial community. At the genus level, there was a positive correlation (r coefficient > 0.5) between urbanization level and bacterial genera Streptococcus, Bartonella, Staphylococcus, Pseudomonas, Acinetobacter, Bacteroides, Corynebacterium_1 , and Enhydrobacter and a negative correlation (r coefficient < -0.5) with Rhodanobacter. CONCLUSION: There was a significant difference in house dust microbiota among different urbanization areas. The areas with a lower urbanization level presented higher dust-borne bacterial richness and diversity. Modern urbanization has a significant influence on the bacterial microbiome profiles of indoor dust.

Trends in sun-protection behaviour in Australian adults 2007-2012.

BACKGROUND: Almost all skin cancers are the result of overexposure to UV radiation and could be prevented by adhering to a number of simple behavioural guidelines to minimise exposure to the sun. The present study examined trends in sun-protection behaviour among adults living in Western Australia, a region with high levels of UV radiation. METHODS: During five summers from 2008 to 2012, 2076 Western Australian adults participated in annual, cross-sectional telephone surveys that assessed how often they engaged in a range of sun-protection behaviour (seeking shade, staying inside and wearing a hat, protective clothing, sunscreen or sunglasses). RESULTS: Apart from an increase in sunscreen use and a consistently high use of sunglasses, most sun-protection behaviour remained stable at moderate levels during the 5-year period. Seeking shade, staying inside and wearing a hat were all practised at levels ranging between 'sometimes' and 'usually' on sunny days in summer during peak UV hours, with little to no variability across the survey years. Wearing protective clothing was the least frequent behaviour across all survey years and was significantly lower in the most recent survey year relative to baseline. CONCLUSIONS: Further efforts are required to encourage greater enactment of sun-protection behaviour, especially on the use of protective clothing and seeking shade during periods of high UV radiation.

Trends in Australian adolescents' sun-protection behaviours: implications for health campaigns.

OBJECTIVE: Protecting the skin from ultraviolet (UV) radiation is critical during adolescence to reduce the risk of developing skin cancer later in life, but adolescents tend to be less likely to engage in sun-protective behaviours than adults. The present study examined changes and trends (2001/02-2011/12) in sun-protection behaviours among adolescents living in Western Australia - a region with high levels of UV radiation. METHODS: A cross-sectional survey was conducted during 10 summers between 2001/02 and 2011/12 to investigate how often adolescents engaged in various sun-protection behaviours, including outdoor protective measures (wearing a hat, wearing protective clothing, using sunscreen, wearing sunglasses, seeking shade) and avoidance of UV radiation by staying inside. RESULTS: Hat use significantly decreased between 2001/02 and 2011/12, whereas use of sunscreen and wearing covering clothes were unchanged in most survey years relative to 2001/02. Use of sunglasses peaked in 2006/07 and 2007/08, but returned to first survey year levels in 2011/12, while staying inside was more frequently reported from 2006/07 onwards. CONCLUSIONS: New approaches are needed to minimise reactance responses in adolescents while fostering favourable attitudes to sun protection. Implications and opportunities for interventions to promote better sun-protection practices among adolescents are provided.

Predictors of sun protection behaviours and sunburn among Australian adolescents.

BACKGROUND: Excessive sun exposure and sunburn increase individuals' risk of skin cancer. It is especially important to prevent sunburn in childhood due to the higher relative risk of skin cancer across the life span compared to risk associated with sunburn episodes experienced later in life. This study examined demographic and attitudinal factors associated with engagement in a range of sun protection behaviours (wearing a hat, wearing protective clothing, staying in the shade, and staying indoors during the middle of the day) and the frequency of sunburn among Western Australian adolescents to provide insights of relevance for future sun protection campaigns. METHODS: Cross-sectional telephone surveys were conducted annually with Western Australians between 2005/06 and 2014/15. The results from 4150 adolescents aged 14-17 years were used to conduct a path analysis of factors predicting various sun protection behaviours and sunburn. RESULTS: Significant primary predictors of the sun protection behaviours included in the study were skin type (sun sensitivity), gender, tanning-related attitudes and behaviours, and perceived relevance of public service advertisements that advocate sun protection. Of the four sun protection behaviours investigated, staying in the shade and staying indoors during the middle of the day were associated with a lower frequency of sunburn. CONCLUSION: There is a particular need to target sun protection messages at adolescent males who are less likely to engage in the most effective sun protection behaviours and demonstrate an increased propensity to experience sunburn. The results suggest that such future sun protection messages should include a focus on the importance of staying in the shade or indoors during periods of high UV radiation to increase awareness of the efficacy of these methods of avoiding skin cancer.

Impact of a population-wide mental health promotion campaign on people with a diagnosed mental illness or recent mental health problem.

OBJECTIVES: To determine the impact of the Act-Belong-Commit mental health promotion campaign on people with a diagnosed mental illness or who had sought professional help for a mental health problem in the previous 12 months. METHOD: In 2013 and 2014, 1,200 adults in Western Australia were interviewed by telephone. The questionnaire measured campaign reach, impact on beliefs about mental health and mental illness and behavioural impact. RESULTS: Campaign impact on changing the way respondents thought about mental health was significantly higher among those with a mental illness or who had sought help (41.4% vs 24.2%; p<0.001), as was doing something for their mental health as a result of their exposure to the campaign (20.5% vs 8.7%; p<0.001). CONCLUSIONS: The campaign appears to empower people with a mental illness or who recently sought help to take steps of their own to enhance their mental health.

Accuracy of resting metabolic rate prediction in overweight and obese Australian adults.

OBJECTIVES: Predictive resting metabolic rate (RMR) equations in Australian populations are at least 10 years old, focused on males and do not commonly use overweight and obese weight categorisation. The aim of this study was to measure RMR via indirect calorimetry in overweight and obese Australian adults to develop population specific predictive equations and compare with other well-known international equations (Mifflin-St. Jeor, Owen and WHO/FAO/UNU). METHODS: Retrospective data from 278 participants (154 males, 124 females: 37% overweight, 63% obese) who had attended a weight management clinic were used to develop predictive RMR equations. These were then validated against another sample (from the same clinic) of 297 participants (150 males, 147 females: 47% overweight, 53% obese), and their accuracy compared with known standard equations. RESULTS: For the prediction sample, weight, BMI, resting VO2 and measured RMR were significantly greater in the obese than overweight. Using the validation sample, the predictive equations met a ±10% of measured RMR criterion 42% (females), 41% (total sample) and 40% (males) of the time. Prediction accuracy was not improved by using specific overweight and obese weight category equations, or by applying the known standard equations from the literature. CONCLUSIONS: In our sample of overweight and obese adults, RMR prediction to within ±10% of the measured value was only accurate ∼40% of the time, regardless of gender and weight classification. In clinical weight management settings direct measures of RMR should be made wherever possible.

Influence of Hormonal Profile on Resting Metabolic Rate in Normal, Overweight and Obese Individuals.

AIMS: To investigate whether blood thyroid stimulating hormone (TSH), cortisol, insulin and glucose concentrations (plus glucose:insulin ratio; GIR) could improve the accuracy of resting metabolic rate (RMR) prediction in normal, overweight and obese persons. METHODS: Predictive equations were developed and compared against indirect calorimetry measures for RMR in 217 weight-control clinic participants (n = 128 males and n = 89 females: ∼24% normal weight, ∼39% overweight and ∼37% obese). RESULTS: Using the common accuracy criteria of the proportion of predicted RMR within ±10% of measured RMR, our equations (using age, height, weight and gender, plus the blood factors, both independently and in combination) were accurate ∼36-44% of the time, for the whole sample, and when separated by gender and weight class. Specifically, the addition of the blood hormone and glucose concentrations improved the accuracy of predicted RMR by only 1-8% (NS). CONCLUSIONS: Including blood TSH, cortisol, insulin, glucose and GIR into RMR prediction equations did not significantly improve estimation accuracy, which in any case only met a criterion of ±10% of the measured RMR ∼40% of the time. Further work to refine the prediction of RMR is still needed, and at present, direct measurements should be made wherever possible.

Public perceptions of cancer risk factors: a Western Australian study.

ISSUE ADDRESSED: People's perceptions of risk may influence health-related behaviours. The aim of this study was to investigate the perception of cancer risk factors among Western Australian adults in order to inform health promotion policies. METHODS: Cross-sectional surveys of 2094 adults were undertaken in 2007/2008 in which respondents were asked whether they thought factors increased or decreased the risk of cancer. Factors included both established and unestablished risk factors for cancer. The distribution of perceptions was compared according to age and sex. RESULTS: The study found high levels of endorsement for some unestablished risk factors (74-91%) and comparatively lower levels of endorsement for many established risk factors (33-80%). The established risk factors of smoking and asbestos received high levels of endorsement (94-98%). CONCLUSION: It appears that the alignment between scientifically established risk factors and the Western Australian public's perception of cancer risk factors could be improved. SO WHAT? Health promotion strategies are needed to improve the public's awareness of cancer risk factors. The high levels of endorsement attributed to unestablished risk factors highlight the need to dispel myths surrounding cancer and to reinforce the key factors in cancer prevention. Ongoing assessment of the alignment between community perceptions of cancer risk and the scientific evidence for cancer risk is important for guiding prioritisation within public health organisations.

Predicting attitude towards performance enhancing substance use: a comprehensive test of the Sport Drug Control Model with elite Australian athletes.

OBJECTIVES: This study presents a comprehensive examination of the Sport Drug Control Model via survey data of elite Australian athletes. DESIGN: A cross-sectional nationwide mail survey. METHODS: A mail survey of 1237 elite Australian athletes was conducted. Structural equation modelling was employed to test the model. RESULTS: Morality (personal moral stance on performance-enhancing substances use), reference group opinion (perceived moral stance of reference group on performance-enhancing substances use) and legitimacy (perceptions of the drug testing and appeals processes) evidenced significant relationships with attitude towards performance-enhancing substances use, which in turn was positively associated with doping behaviour. The model accounted for 81% and 13% of the variance in attitude towards performance-enhancing substances use and doping behaviour, respectively. CONCLUSIONS: These findings validate the usefulness of the Sport Drug Control Model for understanding influences on performance-enhancing substances use. Nevertheless, there is a need to survey athletes representing a broader range of competition levels and cross-cultural research to test the model's applicability to other populations of athletes.

Predictors of positive outcomes of a school food provision policy in Australia.

This study identified predictors of parents' and school principals' perceptions of the impact of a Western Australian school food policy. An initial qualitative phase involving focus groups with parents and interviews with school principals, teachers, canteen managers and Parents & Citizens Committee members provided general feedback on the policy and identified various factors that appeared to be related to its successful implementation. In the following quantitative phase of the study, 1200 parents responded to a telephone questionnaire and 310 principals responded to an internet-based questionnaire. The primary outcome variables were, respectively, the extent to which parents reported that their children's diets were healthier as a result of the policy, and the extent to which principals reported that their schools complied with the policy. Logistic regression models were generated for the parent and principal samples. Those parents reporting that their children's diets were healthier were more likely to agree that the policy reflected their beliefs and their children's dietary needs and preferences, that their child talked about the traffic light food classification system and that this system influenced their food choices in the supermarket. Those principals reporting full compliance with the policy were more likely to agree that implementing the policy was not overly difficult. Specific factors facilitating school compliance were canteen manager training and conducive kitchen setup. Provision of appropriate information and training prior to implementation may assist schools in implementing new food policies, thereby enhancing their impact beyond the school environment.

Impact on community organisations that partnered with the Act-Belong-Commit mental health promotion campaign.

ISSUE ADDRESSED: A primary aim of the pilot phase of the Act-Belong-Commit mental health promotion campaign was to form partnerships with community organisations. As a component of the broader campaign strategy, collaborating organisations promoted their activities under the Act-Belong-Commit banner in exchange for resources, promotional opportunities and capacity building in event management and funding. METHODS: The impact of the Act-Belong-Commit campaign on the capacity and activities of collaborating organisations during the pilot phase was evaluated using self-completed mail surveys in 2006 and 2008. RESULTS: Collaboration with the campaign had a positive impact on community organisations' capacity, including staff expertise, media publicity and funding applications. Collaborating organisations had strong positive perceptions of Act-Belong-Commit officers and all expressed a willingness to collaborate in future events and activities. CONCLUSIONS: The partnership model used during the pilot phase of the Act-Belong-Commit campaign was successful in creating mutually beneficial exchanges with collaborating organisations. So what? Community partnerships are necessary for the effective delivery of mental health promotion campaigns at a local level. Successful partnerships involve the provision of real and valuable benefits to collaborating organisations in return for their cooperation in promoting health messages.

Online advertising by three commercial breast imaging services: message takeout and effectiveness.

Mammography is widely acknowledged to be the most cost-effective technique for population screening for breast cancer. Recently in Australia, imaging modalities other than mammography, including thermography, electrical impedance, and computerised breast imaging, have been increasingly promoted as alternative methods of breast cancer screening. This study assessed the impact of three commercial breast imaging companies' promotional material upon consumers' beliefs about the effectiveness of the companies' technology in detecting breast cancer, and consumers' intentions to seek more information or consider having their breasts imaged by these modalities. Results showed 90% of respondents agreed that the companies' promotional material promoted the message that the advertised breast imaging method was effective in detecting breast cancer, and 80% agreed that the material promoted the message that the imaging method was equally or more effective than a mammogram. These findings have implications for women's preference for and uptake of alternative breast imaging services over mammography.

Perfectionistic profiles among elite athletes and differences in their motivational orientations.

Although there is an emerging body of research that has examined perfectionistic clusters in the general population, few studies have explored such profiles in athlete samples. The purposes of this research were to explore perfectionistic profiles within a sample of elite athletes and the differences between them on key motivational variables. A sample of 423 elite athletes (179 males, 244 females) aged between 14 and 66 years (M = 25.64; SD = 8.57) from a variety of team (e.g., rowing, hockey, baseball, rugby) and individual sports (e.g., cycling, athletics, triathlon, gymnastics) completed a multisection questionnaire including measures of sport perfectionism, motivation regulation, achievement goals, and fear of failure. Cluster analyses revealed the existence of three perfectionism profiles, namely, nonperfectionists, maladaptive perfectionists, and adaptive perfectionists. Subsequent analyses generally supported the robustness of these perfectionism profiles in terms of differential motivational orientations (achievement goals, fear of failure, and motivation regulation) in hypothesized directions. Overall, the differences in motivational orientations between the three clusters supported a categorical conceptualization of perfectionism.

An examination of the Sport Drug Control Model with elite Australian athletes.

OBJECTIVE: This study presents an opportunistic examination of the theoretical tenets outlined in the Sport Drug Control Model(1) using questionnaire items from a survey of 643 elite Australian athletes. DESIGN AND METHOD: Items in the questionnaire that related to the concepts in the model were identified and structural equation modelling was employed to test the hypothesised model. RESULTS: Morality (cheating), benefit appraisal (performance), and threat appraisal (enforcement) evidenced the strongest relationships with attitude to doping, which in turn was positively associated with doping susceptibility. Self-esteem, perceptions of legitimacy and reference group opinions showed small non-significant associations with attitude to doping. The hypothesised model accounted for 30% and 11% of the variance in attitudes to doping and doping susceptibility, respectively. CONCLUSION: These present findings provide support for the model even though the questionnaire items were not constructed to specifically measure concepts contained in it. Thus, the model appears useful for understanding influences on doping. Nevertheless, there is a need to further explore individual and social factors that may influence athletes' use of performance enhancing drugs.

Using viral e-mails to distribute tobacco control advertisements: an experimental investigation.

The authors' objective was to conduct a trial of viral e-mail marketing as a distribution method for tobacco control advertisements. University students (n = 200) in the state of Western Australia were randomly allocated to receive 1 of 2 e-mails with hyperlinks to tobacco control advertisements ("Toilet" and "Rubbish") emphasizing the disgusting nature of smoking. Recipients followed a hyperlink to a Web page playing Toilet or Rubbish on endless loop. Viewers were encouraged to forward the e-mail to their friends and invited to complete an online survey about the advertisement. Unique downloads for each advertisement were identified by internet provider (IP) location and tallied by date and geographical location to assess subsequent dissemination beyond the initial 200 students. There were 826 unique viewings of the advertisements averaging 26.9 viewings per day for the first fortnight, followed by a lower average of 4.1 hits per day for the next 3.5 months. IP addresses identified hits from 3 other Australian states and 7 other countries. Online surveys were completed by 103 respondents (12.5% of total hits) but included few smokers (n = 9). Significantly more respondents rated Toilet as "funny" compared with Rubbish (40% vs. 11%; p < .05), likely explaining why the former accounted for significantly more viewings than the latter (487 vs. 339; p < .001). There was a greater than fourfold return in dissemination for each initial e-mail sent but daily hits rapidly deteriorated over time. Entertainment appears to facilitate viral e-mails being forwarded onwards but only exceptionally compelling tobacco control materials are ever likely to become self-perpetuating.

Impact of compliance on weight loss and health profile in a very low energy diet program.

BACKGROUND: Although intuitive, little data links program compliance with weight loss and health profile changes in obese Australians. METHODS: Obese males (n=308) and females (n=734) from one clinic using a very low energy diet intervention were studied over 26 weeks. Physical and health profiles were assessed. Low compliance completed 1-12 weeks, medium 13-20 weeks and high 21-26 weeks. OBJECTIVE: Overall, 52% achieved high compliance (females: 53%, males: 49%). Greater compliance was associated with greater weight loss and health profile changes in both genders. Mean male weight loss approximated 12 kg, 21 kg and 26 kg with low, medium and high compliance; mean female values were 8 kg, 15 kg and 20 kg. Body mass index, waist-hip ratios, and blood pressure, cholesterol, triglyceride and glucose changes were all more marked with high compliance. DISCUSSION: Unsuprisingly, high compliance in both genders was consistently associated with more substantial reductions (>15%) of body weight and greater health profile improvements.