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.

"We're Lucky to Have Doctors at All"; A Qualitative Exploration of Australian Farmers' Barriers and Facilitators to Health-Related Help-Seeking.

This study aimed to explore barriers and facilitators that impact on farmers' help-seeking behaviours for health and mental health concerns. Fifteen semi-structured interviews were conducted with farmers (12 male; age 51.7 ± 12.6 years) from three rural regions in South Australia. Interviews explored demographic and farm-related characteristics, perceptions of individual (and where relevant family) health and mental health concerns and experiences, and perceived barriers of health support-seeking. Thematic analysis was used to identify key themes. Four key themes were identified relating to help-seeking; personal attitudes and beliefs, farm-related barriers, health system barriers and the provision of support from family and friends. Dominant personal attitudes included valuing independence, strength and privacy. Farm related barriers included the 'farm comes first' and the fact that 'farm work is never done'. Health system barriers included issues relating to availability of choice and access, professionals (lack of) understanding of farm life, and time and financial costs of accessing care. Provision of support from family and friends involved informal help and advice, including facilitating access to professional support. Multiple attitudinal, structural, and farm-related issues affect farmers' help-seeking. Professionals who understand farm work practices and routines are valued by farmers and this is likely to facilitate access to care. Workforce development programs and community programs that involve farmers' perspectives as consumers and co-designers, using evidence-based strategies, may assist in strengthening these relationships.

Suggestions in Hypnosis to Aid Pain Education (SHAPE) in People with Chronic Low-Back Pain: A Pilot Feasibility Randomized, Controlled Trial.

Chronic low back pain (CLBP) is a debilitating and burdensome condition, and new treatment strategies are needed. This study aimed to evaluate (1) the feasibility of undertaking a controlled clinical trial investigating a novel intervention for people with CLBP: hypnotically reinforced pain science education, and (2) the acceptability of the intervention as rated by participants. A priori feasibility and intervention acceptability criteria were set. Twenty participants with CLBP were recruited and randomized to receive: (1) hypnotically delivered pain science education that utilizes hypnotic suggestions to enhance uptake of pain science concepts; or (2) pain science education with progressive muscle relaxation as an attention control. Twenty participants were recruited, however, not solely from the hospital waitlist as intended; community sampling was required (13 hospital, 7 community). Most criteria were met in the community sample but not the hospital sample. Protocol modifications are needed before progressing to a full scale randomized controlled trial for hypnotically reinforced pain science education. Improvements in relevant secondary outcomes paired with moderate-high treatment acceptability ratings are promising.

A RE-AIM Analysis of an Intergenerational Dementia Education Program.

Objectives: Children often have a lack of dementia understanding and poor attitudes toward people with dementia. Intergenerational programs are increasingly common, but the effects on knowledge and attitudes related to dementia are mixed, especially in the long-term (6 months). Using a RE-AIM framework, we quantitatively evaluated the effects of an educational dementia program (with and without an intergenerational program) on dementia attitudes in the short and long-term, and qualitatively, which elements of the program facilitated this change. Methods: Eighty-one children (9.63 ± 0.52 years, 35 males) from three classes participated in an 8-week dementia education program and 52 also interacted with older adults through an intergenerational experience. Program reach was measured as the percentage of children who participated in the study. The Kids Insight into Dementia Survey (KIDS) was implemented to measure dementia knowledge and attitudes: efficacy and maintenance. Qualitative interviews with all participant groups informed both adoption and implementation. Cost-benefit analysis was used as a secondary outcome measure for efficacy. Results: The program demonstrated strong levels of impact reaching 93% of school children across the three included classes. Efficacy was demonstrated by a positive change in children's dementia knowledge and attitudes immediately post program, which remained increased (as compared to baseline) 6- months post intervention; there were no differences between groups (those who interacted with older adults and those who did not). Interviews identified positive changes in children's empathy and improved community awareness. Barriers to adoption included the project scope, time constraints incurred by school terms and the management of children-to-adult ratios. Conclusions: These findings provide the first evidence that school-based dementia education improves knowledge of and attitudes toward people with dementia long-term. We demonstrated programs such as this can be successful in both primary school and wider community settings, with support from school and community partners key to the success.

A pain science education and walking program to increase physical activity in people with symptomatic knee osteoarthritis: a feasibility study.

INTRODUCTION: Nine of 10 people with knee osteoarthritis are inactive. Unhelpful pain beliefs may negatively influence physical activity levels. Targeting these unhelpful pain beliefs, through contemporary pain science education (PSE), may provide benefit. OBJECTIVES: To evaluate the feasibility of conducting a clinical trial to determine the effect of adding PSE (vs adding sham ultrasound) to an individualised, physiotherapist-led education and walking program in people with painful knee osteoarthritis. METHODS: Twenty participants were randomised (1:1) into the PSE group or Control group, each receiving 4 in-person weekly treatments, then 4 weeks of at-home activities (weekly telephone check-in). Clinical outcomes and physical activity (7 days of wrist-worn accelerometry) were assessed at baseline, 4 (clinical outcomes only), 8, and 26 weeks. A priori feasibility criteria for recruitment, intervention adherence, viability of wrist-based accelerometry, and follow-up retention were set. Perceived intervention credibility, acceptability, and usefulness from participants and clinicians were assessed (ratings, written/verbal feedback). RESULTS: Most feasibility criteria were met. On average, 7 adults/wk were eligible, with 70% recruited. Treatment compliance was high (in-person: 80% PSE; 100% Control; at-home: 78% PSE; 75% Control). Wrist-based accelerometry had >75% valid wear-time. Sufficient follow-up rates were not achieved (26 weeks: 65%). Participant and clinician feedback highlighted that PSE was too complex and did not match patient expectations of "physiotherapy", that sham ultrasound was problematic (clinician), but that both treatments had high credibility, acceptability, and usefulness. CONCLUSIONS: Progression to a full trial is warranted. Strategies to increase participant retention, refine the PSE content/delivery, and replace/remove the sham intervention are required.

A comparison of barriers to mental health support-seeking among farming and non-farming adults in rural South Australia.

OBJECTIVE: To assess the differences between farming and non-farming rural adults in perceived barriers to mental health service use. DESIGN: A cross-sectional survey, modified from the Barriers to Help-Seeking Scale (BHSS), was conducted using a computer-assisted telephone interview. SETTING: Respondents (age 52.6 ± 11.6 years) were recruited from three rural regions of South Australia. PARTICIPANTS: Approximately, 78 non-farmers and 45 farmers were included in analyses. 78 retired and two unemployed participants were excluded from the analyses. MAIN OUTCOME MEASURE: Farmers and non-farmers were compared on domain scores and individual item responses from the adapted BHSS that represent 'agrarian' attitudes to support-seeking for mental health: stoicism, self-reliance, minimisation of the problem, stigma and distrust of health professionals. RESULTS: In the analysis of domain scores, 'Need for Control and Self-Reliance' was a stronger barrier for farmers than non-farmers (P = 0.009) with a trend (P = 0.07) towards stronger barriers among farmers in the 'Minimising Problem and Resignation' domain. In the analysis of item-level responses, there was a difference (P = 0.03) between farmers and non-farmers in responses to 'I find it difficult to understand my doctor/health professional', with 24.4% of the farmers agreeing that this is a barrier compared with 15.3% of the non-farmers. CONCLUSION: Long-held stereotypes of stoicism and self-reliance among farmers were somewhat supported, in the context of mental health. Mental health services and professionals in rural Australia might need to adapt their practices to successfully engage this population.

Relationships between digit ratio (2D:4D) and basketball performance in Australian men.

OBJECTIVE: To investigate relationships between the digit ratio (2D:4D) and competitive basketball performance in Australian men. METHODS: Using an observational cross-sectional design a total of 221 Australian basketball players who competed in the Olympic Games, International Basketball Federation World Championships/Cup, Australian National Basketball League, Central Australian Basketball League or socially had their 2D:4Ds measured. Analysis of variance was used to assess differences in mean 2D:4Ds between men playing at different competitive standards, with relationships between 2D:4Ds and basketball game-related statistics assessed using Pearson's product moment correlations in men playing at a single competitive standard. RESULTS: There were significant differences between competitive standards for the left 2D:4D following Bonferroni correction, but not for the right 2D:4D, with basketballers who achieved higher competitive standards tending to have lower left 2D:4Ds. No important correlations between 2D:4D and basketball game-related statistics were found, with correlations typically negligible. CONCLUSIONS: This study indicated that the 2D:4D can discriminate between basketballers competing at different standards, but not between basketballers within a single competitive standard using objective game-related statistics.

Relationships between digit ratio (2D:4D) and female competitive rowing performance.

BACKGROUND: Digit ratio (2D:4D), a measure of prenatal testosterone exposure, is weakly-to-moderately associated with increased physical performance, although the evidence is far stronger for males than females. OBJECTIVE: To examine the relationship between 2D:4D and measured on-water rowing performance in young females competing at the Australian Rowing Championships. METHODS: Using an observational, cross-sectional design, female rowers (n = 69, aged 12-30 years) who competed in single sculls events at the Australian Rowing Championships in 2007 and 2008 had numerous physical and digital anthropometric measurements taken, including 2D:4D measurements. Relationships between 2D:4Ds and race times were examined using Pearson's correlations, partial correlations and multiple regression. Partial Least Squares regression analysis determined the strength of the 2D:4D as a predictor of race time relative to 78 body dimensions plus age. RESULTS: Overall, weak to strong positive correlations between 2D:4D and race time were found; that is, females with smaller 2D:4Ds had faster race times than females with larger 2D:4Ds. Relationships were weak to moderate for all females (r = 0.29-0.32), moderate-to-strong for senior rowers (aged ≥20 years; r = 0.42-0.55), and weak for junior rowers (aged <20 years; r = 0.13-0.18), with all relationships persisting following adjustment for age. Partial Least Squares regression analysis showed that 2D:4Ds had high predictive importance relative to other body dimensions. CONCLUSIONS: Females with smaller 2D:4Ds rowed substantially faster than females with larger 2D:4Ds, with the 2D:4D possibly linked to underlying characteristics that have been optimized over time resulting in better rowing performance.