The art of aging well: a study of the relationship between recreational arts engagement, general health and mental wellbeing in cohort of Australian older adults.

Introduction: Evidence of the benefits of arts engagement to community wellbeing has been mounting since the 1990s. However, large scale, quantitative, epidemiological studies of the "arts-healthy aging" relationship, or the types of arts older adults voluntarily choose to engage in as part of their everyday life, for enjoyment, entertainment or as a hobby (vs. therapy or interventions) are limited. The aims of this study were to describe older adult recreational arts engagement via the Busselton Healthy Ageing Study (BHAS) cohort, and to determine if there was an association between arts engagement, general health and mental wellbeing. Methods: Overall, 2,843 older adults (born 1946-1964) from the BHAS cohort (n = 5,107) who had completed a supplementary arts survey (n = 3,055, 60%) and had data on required variables were included in this study (93% of those eligible). The dependent variable was general health (SF12) and subjective mental wellbeing (Warwick-Edinburgh Mental Wellbeing Scale, WEMWBS). The independent variable was hours engaged in recreational arts in the last 12 months. A descriptive analysis followed by a linear regression analysis was conducted. Results: The prevalence of recreational arts engagement in the last 12 months was 85% (mean = 132 h/year). Older adults engaged in the arts in a number of ways including attending events (79%), actively participating/making art (40%), as an arts society/club/organization member (20%), by learning about the arts (13%) or by volunteering/working in the arts (non-professional, 11%). When general health was assessed via the SF12, the average physical component score (PCS) was 50.1 (SD 8.9) and the average mental component score (MCS) was 53.6 (SD 8.3). When mental wellbeing was assessed, the average WEMWBS score was 54.9 (SD = 8.6). After adjustment for 12 demographic and lifestyle covariates, it was found that older adults who engaged in any recreational arts in the last 12 months had significantly higher WEMWBS scores and higher SF12 physical component scores than those who did not engage in the arts (0 h/year). Discussion: Evidence of an arts-health relationship was found in this study. The suitability of the arts as a population based, healthy aging strategy to influence the mental wellbeing and general health of older adults should be investigated further.

Strategies to Address the Complex Challenge of Improving Regional and Remote Children's Fruit and Vegetable Consumption.

Fruit and vegetables (F&V) are imperative for good health, yet less than one per cent of Australian children consume these food groups in sufficient quantities. As guided by Social Cognitive Theory (SCT), this paper aimed to: (i) understand key informant perspectives of the amount, types and quality of F&V consumed by rural and remote Western Australian (WA) children; and, (ii) determine strategies that could increase F&V consumption among rural and remote WA children. This qualitative study included 20 semi-structured interviews with health, school/youth and food supply workers, focusing on topics including: quantity and type of F&V consumed and strategies to increase children's consumption. A thematic analysis was conducted using NVivo qualitative data analysis software (Version 10, 2014. QSR International Pty Ltd., Doncaster, Victoria, Australia). Key informants reported children consumed energy-dense nutrient-poor foods in place of F&V. Strategy themes included: using relevant motivators for children to increase their preference for F&V (i.e., gaming approach, SCT construct of 'expectations'); empowering community-driven initiatives (i.e., kitchen gardens, SCT construct of 'environment'); increasing food literacy across settings (i.e., food literacy skills, SCT construct of 'behavioural capacity'); developing salient messages and cooking tips that resonate with parents (i.e., parent newsletters, SCT construct of 'self-control'); increasing F&V availability, safety, and convenience (i.e., school provision); and, considering the impact of role models that extend beyond the family (i.e., relatable role models, SCT construct of 'observational learning'). Overall, a comprehensive strategy that incorporates relevant motivators for children and families, supports local initiatives, reinforces the range of role models that are involved with children and creates healthier environments, is required to increase F&V consumption among children.

Which ecological determinants influence Australian children's fruit and vegetable consumption?

This study investigated determinants of fruit and vegetable (F&V) consumption among regional and remote Western Australian (WA) children, using an Ecological Model of Health Behaviour. Semi-structured interviews were conducted with 20 key informants (Health Workers, Food Supply Workers, and School/Youth Workers) purposively sampled from across regional and remote WA. Interviews were transcribed, analysed thematically using QSR-NVivo 10 software, and embedded within an Ecological Model of Health Behaviour to demonstrate the multiple levels of influence on health. Key determinants of F&V consumption at the intrapersonal level included attitude and food literacy among children. Key interpersonal level determinants included role modelling and parental food literacy. Institutional determinants included health service provision, school nutrition education and food skill programs. F&V availability, community networks and health-promoting spaces were key themes affecting families at the community level. The public policy level influencer included implementation of a store policy within local food outlets. Study findings suggested participatory programs with an emphasis on parental involvement and role modelling could increase F&V intake among children living in regional and remote areas; while school curriculum linkages were essential for school-based programs. Policy makers should consider further investment in school food literacy programs and family programs that are delivered collaboratively. Further, support of local food supply options and support for healthy food policies in food outlets are critical next steps. This study contributes new knowledge to build the evidence base and facilitate the development of targeted strategies to increase consumption of F&V among children living in regional and remote areas.

What are the determinants of food security among regional and remote Western Australian children?

OBJECTIVE: To explore how determinants of food security affect children in regional and remote Western Australia (WA), across food availability, access and utilisation dimensions. METHODS: The Determinants of Food Security framework guided the thematic analysis (using NVivo 10) of semi-structured interviews with 20 key informants. RESULTS: Food availability factors included availability, price, promotion, quality, location of outlets and variety. Food access factors included social support, financial resources, transport to food outlets, distance to food outlets and mobility. Food utilisation factors included nutrition knowledge and skills, children's food preferences, storage facilities, preparation and cooking facilities and time to purchase food. CONCLUSIONS: Key food availability recommendations include increasing local food supply options. Food access recommendations include ensuring equitable formal social support and empowering informal support options. Food utilisation recommendations include prioritising food literacy programs focusing on quick, healthy food preparation and budgeting skills. Implications for public health: Policymakers should invest in local food supply options, equitable social support services and experiential food literacy programs. Practitioners should focus child/parent programs on improving attitude, knowledge and skills.

Are regional and remote Western Australian children eating for good health? An investigation into fruit and vegetable consumption.

Issue addressed Little is known about the fruit and vegetable (F&V) habits of regional and remote Western Australian (WA) children beyond quantities consumed. This study aimed to ascertain the proportion of regional and remote WA children who met the Australian Dietary Guidelines (ADG) for F&V; the types and varieties of F&V consumed; and whether consumption behaviour was associated with remoteness. Methods Caregiver and child dyads (n=256 dyads) completed similar paper-based surveys, 196 of these children completed 24-h dietary records. Statistical analyses were conducted using IBM SPSS (version 23). Results Overall, children were less likely to adhere to vegetables (15.4%) than fruit (65.8%) guidelines. Adherence to the ADG did not significantly differ between regional and remote locations. However, a higher proportion of remote children consumed dried fruit compared with regional children, while significantly more regional children compared with remote children consumed from the 'pome, tropical and stone fruit' group and the 'starchy vegetables', 'red/orange vegetables' and 'dark green leafy vegetables' groups. Conclusions Many regional and remote WA children consumed F&V in suboptimal amounts. Further research should aim to ascertain factors that increase or decrease the likelihood of ADG adherence across regional and remote WA and determine why certain F&V variety groups and types differed in consumption across Remoteness Areas. So what This study provided closer scrutiny of WA children's F&V consumption habits, highlighting the differences in consumption behaviours due to remoteness and identifying specific areas that require further investigation.

Which Food Security Determinants Predict Adequate Vegetable Consumption among Rural Western Australian Children?

Improving the suboptimal vegetable consumption among the majority of Australian children is imperative in reducing chronic disease risk. The objective of this research was to determine whether there was a relationship between food security determinants (FSD) (i.e., food availability, access, and utilisation dimensions) and adequate vegetable consumption among children living in regional and remote Western Australia (WA). Caregiver-child dyads (n = 256) living in non-metropolitan/rural WA completed cross-sectional surveys that included questions on FSD, demographics and usual vegetable intake. A total of 187 dyads were included in analyses, which included descriptive and logistic regression analyses via IBM SPSS (version 23). A total of 13.4% of children in this sample had adequate vegetable intake. FSD that met inclusion criteria (p ≤ 0.20) for multivariable regression analyses included price; promotion; quality; location of food outlets; variety of vegetable types; financial resources; and transport to outlets. After adjustment for potential demographic confounders, the FSD that predicted adequate vegetable consumption were, variety of vegetable types consumed (p = 0.007), promotion (p = 0.017), location of food outlets (p = 0.027), and price (p = 0.043). Food retail outlets should ensure that adequate varieties of vegetable types (i.e., fresh, frozen, tinned) are available, vegetable messages should be promoted through food retail outlets and in community settings, towns should include a range of vegetable purchasing options, increase their reliance on a local food supply and increase transport options to enable affordable vegetable purchasing.

The art of being healthy: a qualitative study to develop a thematic framework for understanding the relationship between health and the arts.

OBJECTIVE: In recent years the health-arts nexus has received increasing attention; however, the relationship is not well understood and the extent of possible positive, negative and unintended outcomes is unknown. Guided by the biopsychosocial model of health and theories of social epidemiology, the aim of this study was to develop a framework pertaining to the relationship between arts engagement and population health that included outcomes, confounders and effect modifiers. A health-arts framework is of value to researchers seeking to build the evidence base; health professionals interested in understanding the health-arts relationship, especially those who use social prescribing for health promotion or to complement treatments; in teaching medical, nursing and health-science students about arts outcomes, as well as artists and health professionals in the development of policy and programmes. DESIGN: A qualitative study was conducted. Semistructured interviews were analysed thematically. SETTING: Western Australia. PARTICIPANTS: 33 Western Australian adults (18+ years). Participants were randomly selected from a pool of general population nominees who engaged in the arts for enjoyment, entertainment or as a hobby (response rate=100%). RESULTS: A thematic analysis was conducted using QSR-NVivo10. The resulting framework contained seven outcome themes and 63 subthemes. Three themes specifically related to health, that is, mental, social and physical health, while economic, knowledge, art and identity outcomes were classified as health determinants. Within each theme, positive, negative and unintended outcomes (subthemes) were identified and categorised as relating to the individual and/or to the community. A list of confounding and/or effect modifying factors, related to both the arts and health, was identified. CONCLUSIONS: Given the increasing pressure on health resources, the arts have the potential to assist in the promotion of health and healing. This framework expands on current knowledge, further defines the health-arts relationship and is a step towards the conceptualisation of a causal health-arts model.