'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.

A latent transition analysis of physical activity and screen-based sedentary behavior from adolescence to young adulthood.

BACKGROUND: Distinct typologies of physical activity and screen-based sedentary behaviors are common during adolescence, but it is unknown how these change over time. This longitudinal study examined the stability of activity-related behavioral typologies over the transition out of secondary school. METHODS: Year 11 students (penultimate school year) completed a self-report survey (baseline), which was repeated 2 years later (follow-up) (75% female, mean baseline age: 16.9 ± 0.4 years). Latent transition analysis identified typologies of physical activity and screen time behaviors and explored changes in typology membership between baseline and follow-up among those with complete data and who were not attending secondary school at follow-up (n = 803). RESULTS: Three unique typologies were identified and labelled as: 1) Sedentary gamers (baseline: 17%; follow-up: 15%: high levels of screen behaviors, particularly video gaming); 2) Inactives (baseline: 46%; follow-up: 48%: low physical activities, average levels of screen behaviors); and 3) Actives (baseline: 37%; follow-up: 37%: high physical activities, low screen behaviors). Most participants remained in the same typology (83.2%), 8.5% transitioned to a typology with a more health-enhancing profile and 8.3% transitioned to a typology with a more detrimental behavioral profile. CONCLUSIONS: The high proportion within the 'inactive' typology and the stability of typologies over the transition period suggests that public health interventions are required to improve activity-related behavior typologies before adolescents leave secondary school.

Why are some drought-affected farmers less distressed than others? The association between stress, psychological distress, acceptance, behavioural disengagement and neuroticism.

OBJECTIVE: To identify the modifiable psychological and behavioural coping strategies associated with low levels of psychological distress, independent of more stable personality and demographic factors, in a sample of farmers who reported being exposed to a recent stressful event during an extended drought. DESIGN/SETTING/PARTICIPANTS: Three hundred and nine South Australian, drought-affected grain, sheep and/or cattle farmers completed printed or online questionnaires. Only those who reported experiencing a stressful event in the past month that they rated ≥7 on a scale ranging from 1 (not stressful at all) to 10 (extremely stressful) were included in the analyses (n = 175, 65.06%). Participants ranged in age from 24 to 85 years and 40% were female. MAIN OUTCOME MEASURES: Psychological distress was measured using the Kessler Psychological Distress Scale, and coping strategies were measured using a situational version of the COPE inventory. Five personality factors (extraversion, neuroticism, openness, conscientiousness and agreeableness) were assessed using the Quickscales-R. RESULTS: In the final multivariable model, distress was elevated among individuals reporting higher neuroticism and behavioural disengagement, and lower in individuals reporting greater use of acceptance. These 3 variables explained 44% of the variance in distress. CONCLUSION: Farmers recently exposed to a significant stressor, who used acceptance as a coping strategy, did not engage in behavioural disengagement and scored low on neuroticism, were least likely to experience distress. Given the stability of personality factors, interventions that foster farmers' use of acceptance and prevent behavioural disengagement as coping strategies might assist them with the management of future stressors, particularly in times of drought.

A pedometer based physical activity self-management program for children and adolescents with physical disability - design and methods of the StepUp study.

BACKGROUND: Physical activity affords a wide range of physiological and psychological benefits for children and adolescents, yet many children with physical disabilities are insufficiently active to achieve these benefits. The StepUp program is a newly developed 6-week pedometer-based self-management program for children and adolescents with physical disability. Participants use a pedometer to undertake a 6-week physical activity challenge, with personalised daily step count goals set in consultation with a physiotherapist. The study aims to evaluate the effectiveness of the StepUp program, using a randomised control trial design. METHODS/DESIGN: A target sample of 70 young people with physical disabilities (aged 8-17 years, ambulant with or without aid, residing in Adelaide) will be recruited. Participants will be randomly allocated to either intervention or control following completion of baseline assessments. Assessments are repeated at 8 weeks (immediately post intervention) and 20 weeks (12 weeks post intervention). The primary outcome is objective physical activity determined from 7 day accelerometry, and the secondary outcomes are exercise intention, physical self-worth, quality of life and fatigue. Analyses will be undertaken on an intention-to-treat basis using random effects mixed modelling. DISCUSSION: This study will provide information about the potential of a low-touch and low-cost physical activity intervention for children and adolescents with cerebral palsy. TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry (ANZCTR): ACTRN12613000023752.

Sex-specific correlates of adult physical activity in an Australian rural community.

OBJECTIVE: Rural Australians have a higher likelihood of chronic disease and lower levels of physical activity than urban Australians. Little is known of the factors associated with physical activity among rural-dwelling Australians. This study sought to determine the correlates of physical activity among men and women of the South Australian Riverland region. DESIGN: Cross-sectional survey. SETTING: Regional area. PARTICIPANTS: There are 299 randomly selected 18-65 year olds. MAIN OUTCOME MEASURES: Determinations of insufficient and sufficient physical activity levels based on public health recommendations. RESULTS: Using logistic regression: in men, sufficient physical activity was associated with reporting perceived sufficient physical activity for health (odds ratio 3.194 [1.703-5.989]), and having friends who encouraged physical activity (3.641 [1.450-9.141]). Men who reported insufficient time (0.350 [0.151-0.812]) and getting enough physical activity at their job (0.374 [0.199-0.702]) were less likely to be sufficiently active. In women, sufficient physical activity was associated with not being employed (2.929 [1.063-8.066]), higher self-efficacy (2.939 [1.118-7.726]) and having a regular physical activity routine (3.404 [1.829-6.337]). Older age (0.960 [0.929-0.995]), poorer self-rated health (0.233 [0.060-0.900]) and weekend sitting time (0.823 [0.692-0.980]) were negatively associated with sufficient physical activity for women. CONCLUSIONS: Factors associated with physical activity in this rural adult population differed by sex. Sex-specific approaches to promote physical activity might have utility for this population. Strategies to enhance social connectedness among men and encourage physical activity outside of work can be warranted. Women can require programs to help them develop a regular physical activity routine and improve self-efficacy.

Testing the activitystat hypothesis: a randomised controlled trial protocol.

BACKGROUND: The activitystat hypothesis proposes that when physical activity or energy expenditure is increased or decreased in one domain, there will be a compensatory change in another domain to maintain an overall, stable level of physical activity or energy expenditure. To date, there has been no experimental study primarily designed to test the activitystat hypothesis in adults. The aim of this trial is to determine the effect of two different imposed exercise loads on total daily energy expenditure and physical activity levels. METHODS: This study will be a randomised, multi-arm, parallel controlled trial. Insufficiently active adults (as determined by the Active Australia survey) aged 18-60 years old will be recruited for this study (n=146). Participants must also satisfy the Sports Medicine Australia Pre-Exercise Screening System and must weigh less than 150 kg. Participants will be randomly assigned to one of three groups using a computer-generated allocation sequence. Participants in the Moderate exercise group will receive an additional 150 minutes of moderate to vigorous physical activity per week for six weeks, and those in the Extensive exercise group will receive an additional 300 minutes of moderate to vigorous physical activity per week for six weeks. Exercise targets will be accumulated through both group and individual exercise sessions monitored by heart rate telemetry. Control participants will not be given any instructions regarding lifestyle. The primary outcome measures are activity energy expenditure (doubly labeled water) and physical activity (accelerometry). Secondary measures will include resting metabolic rate via indirect calorimetry, use of time, maximal oxygen consumption and several anthropometric and physiological measures. Outcome measures will be conducted at baseline (zero weeks), mid- and end-intervention (three and six weeks) with three (12 weeks) and six month (24 week) follow-up. All assessors will be blinded to group allocation. DISCUSSION: This protocol has been specifically designed to test the activitystat hypothesis while taking into account the key conceptual and methodological considerations of testing a biologically regulated homeostatic feedback loop. Results of this study will be an important addition to the growing literature and debate concerning the possible existence of an activitystat. TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry ACTRN12610000248066.

The effects of gender, motor skills and play area on the free play activities of 8-11 year old school children.

Two studies were conducted to examine the interactions between gender, play area, motor skills and free play activity in 8-11 year old school children. In both studies, boys were more active than girls. In boys, but not in girls, energy expenditure was greater for high-skill than for low-skill children (p = 0.0002), and increased as play area increased (p = 0.01). These results suggest that motor skills and play space are important variables in determining the free play activity of boys, but not of girls. This may be related to widely different play styles among boys and girls.

An investigation into the protective factors for overweight among low socio-economic status children.

ISSUE ADDRESSED: In light of the current obesity epidemic, this study aimed to expand the knowledge base about the factors involved and the characteristics of children of low socio-economic status (SES) who display healthy behaviours in their eating and physical activity. METHODS: This project was conducted in two phases: a non-experimental, quantitative design was used in phase one to assess the characteristics of a sample of children in a low SES community. This phase identified children who displayed healthy eating and physical activity behaviours. Phase two used interpretive qualitative methods to investigate the perceptions of these children and their parents about the protective factors involved. Focus groups with children and interviews with their mothers were conducted. RESULTS: In phase one, 45 of 227 children assessed met a priori criteria set for healthy eating and physical activity behaviours. Central themes identified in phase two include: the influence of perceived health benefits; parental and child values regarding healthy eating and physical activity; the sense of enjoyment that children experience; the impact of child preferences and choice; and social influences. CONCLUSION: The study illustrated the complexity of factors involved in physical activity and healthy eating among children in a low socio-economic community.

Screenieboppers and extreme screenies: the place of screen time in the time budgets of 10-13 year-old Australian children.

OBJECTIVES: Excessive 'screen time' has been associated with a range of psychosocial disturbances and increasing pediatric obesity. This study describes the magnitude, distribution, composition and time-distribution of children's screen use; examines correlates of screen use; and characterises 'extreme' screen users (top quartile). METHODS: 1,039 South Australian children aged 10-13 years old completed a multimedia 24-hour activity recall diary on 2-4 occasions in 2002, including at least one school day and one non-school day. RESULTS: The median screen time was 229 minutes.d(-1). This was higher in boys (264 vs. 196 minutes; p<0.001) and on non-school days (260 vs. 190 minutes; p<0.001), increased with age (p=0.003), and decreased with socio-economic status (SES; p=0.003). Television consumed 73% of all screen time, video games 19%, non-game computer use 6%, and cinema 2%. The top quartile of screen users were more likely to be boys (OR=3.8), have low physical activity (OR=4.3), spend >25% of screen time playing video games (OR=1.8), sleep less, and be of lower SES. CONCLUSIONS AND IMPLICATIONS: Interventions to reduce screen time should target inactive, low-SES boys, encourage earlier bedtimes, and limit video game use.

Differences in Body Fatness, Fat Patterning and Cardio-Respiratory Fitness Between Groups of Australian Children Formed on the Basis of Physical Activity and Television Viewing Guidelines.

BACKGROUND: Evidence suggests that a substantial proportion of children meet guidelines for sufficient physical activity, but also exceed TV guidelines. Health-related consequences of this combination are unknown. METHODS: 843 children, (age 10-11 y), were surveyed for health-related fitness [endurance performance (20 m MST), skinfolds, waist girth], daily TV and moderate-to-vigorous physical activity (MVPA). Children were grouped using daily TV (≤ 120 min) and MVPA (≥ 60 min) guidelines: hiTV-hiMVPA/"technoactives"'; hiTV-loMVPA/"screenies"; and loTV-hiMVPA/"sporties." Groups were compared on health-related fitness measures. RESULTS: There was a trend (P = 0.07) towards higher girls' skinfolds among "screenies" than "sporties." Boys' waist girths were higher among "technoactives" than "sporties" (P = 0.008). Male "technoactives" outperformed "screenies" on the 20 m MST (P = 0.03). Female "sporties" (P = 0.004) and "technoactives" (P = 0.0002) outperformed "screenies" on the 20 m MST. CONCLUSIONS: "Technoactives" were no different than "sporties" on endurance fitness but exhibited less favorable fat distribution among boys. Overall, "screenies" exhibited the least favorable health profiles.

Change in the prevalence of overweight and obesity among young Australians, 1969-1997.

BACKGROUND: Effective public policy requires information on the prevalence of overweight and obesity. OBJECTIVE: We determined changes in the population prevalence of overweight and obesity among young Australians (aged 7-15 y) from 1969 to 1985 to 1997. DESIGN: Data from 5 independent population surveys were analyzed: the Australian Youth Fitness Survey, 1969; the Australian Health and Fitness Survey, 1985; the South Australian Schools Fitness and Physical Activity Survey, 1997; the New South Wales Schools Fitness and Physical Activity Survey, 1997; and the Health of Young Victorians Study, 1997. Measured body mass index was used as the index of adiposity, and recently published body mass index cutoff values were used to categorize each subject as nonoverweight, overweight, obese, or either overweight or obese. RESULTS: For 1985-1997, the population prevalence of overweight increased by 60-70%, obesity increased 2-4-fold, and the combined overweight and obesity categories doubled. The findings were consistent across data sets and between the sexes. For 1969-1985, there was no change in the prevalence of overweight or obesity among girls, but among boys the prevalence of overweight increased by 35%, the prevalence of obesity trebled, and the prevalence of overweight and obesity combined increased by 60%. CONCLUSIONS: The data show that in 1985-1997, the prevalence of overweight and obesity combined doubled and that of obesity trebled among young Australians, but the increase over the previous 16 y was far smaller. These results should increase our sense of urgency in identifying and implementing effective responses to this major threat to public health.