Participation in Sports/Recreational Activities and the Occurrence of Psychological Distress in Mid-Aged Adults: Findings From the HABITAT Cohort Study.

OBJECTIVES: The aim of this study was to investigate prospective associations between participation in sports/recreational activities and the occurrence of moderate-to-severe psychological distress over 2 years in a sample of mid-aged Australians. METHODS: This prospective study used data from 6699 adults aged 40+ years, living in Brisbane in 2007, and surveyed in 2009, 2011 and 2013. Participants provided self-reported data on frequency of participation in each of 11 sports/recreational activities in past 12 months and completed the Kessler Psychological Distress 6-item Scale (K6). Generalized estimating equation (GEE) models with a 2-year lag were used to assess the associations of participation in sports/recreational activities in 2009 and 2011 with new cases of moderate-to-severe psychological distress (K6 score ≥ 5) in 2011 and 2013. RESULTS: From 2009 to 2013, 22.4% of participants without moderate-to-severe psychological distress at baseline (N = 4943) developed this outcome in at least one survey. Overall, there were no clear patterns of association between frequency of participation in sports and recreational activities and occurrence of moderate-to-severe psychological distress. In unadjusted models, weekly participation in some activities (e.g., tennis, golf, and exercise classes) was associated with reduced odds of moderate-to-severe psychological distress over the next 2 years, but these associations were attenuated in most adjusted models with sociodemographic, lifestyle, and health covariates. Participation in home-based exercise and running/jogging were associated with higher odds of psychological distress. CONCLUSION: Our findings do not provide strong evidence of beneficial associations of frequency of sport/recreational activities with psychological distress but show surprising negative associations of home-based exercise and running/jogging with occurrence of moderate-to-severe psychological distress over 2 years.

Effect of low-volume combined aerobic and resistance high-intensity interval training on vascular health in people with type 2 diabetes: a randomised controlled trial.

PURPOSE: We compared the effects of low-volume combined aerobic and resistance high-intensity interval training (C-HIIT), combined moderate-intensity continuous training (C-MICT) and waitlist control (CON) on vascular health after 8-weeks of supervised training, and an additional 10-months of self-directed training, in adults with type 2 diabetes (T2D). METHODS: Sixty-nine low active adults with T2D were randomised to 8-weeks of supervised C-HIIT (3 times/week, 78-min/week), C-MICT (current exercise guidelines, 4 times/week, 210-min/week) or CON. CON underwent usual care for 8-weeks before being re-randomised to C-HIIT or C-MICT. This was followed by 10-months of self-directed training for participants in C-HIIT and C-MICT. Vascular outcomes were evaluated at baseline, 8-weeks, and 12-months. RESULTS: After 8-weeks, supervised C-HIIT significantly improved relative flow-mediated dilation (FMD) compared with CON (mean difference [MD] 0.8% [0.1, 1.4], p = 0.025). Although not significantly different from CON, the magnitude of change in relative FMD following 8-weeks of supervised C-MICT was similar (MD 0.8% [-0.1, 1.7], p = 0.080). There were no differences in haemodynamic indices, carotid-femoral pulse wave velocity (cfPWV), or aortic reservoir pressure between groups at 8-weeks. After 12-months, there was a significant reduction in haemodynamic indices (time effect, p < 0.05) for both C-HIIT and C-MICT, with no between-group difference. The reduction in cfPWV over 12-months was significantly greater in C-MICT than C-HIIT (group × time effect, p = 0.018). There was no difference in FMD over time or between groups at 12-months. CONCLUSIONS: Short-term supervised C-HIIT and C-MICT both increased brachial artery FMD compared with CON. Long-term C-HIIT and C-MICT were beneficial for improving haemodynamic indices, but not brachial artery FMD. C-MICT was superior to C-HIIT for improving cfPWV at 12-months. TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry Identifier ACTRN12615000475549.

Utilizing technology for diet and exercise change in complex chronic conditions across diverse environments (U-DECIDE): feasibility randomised controlled trial.

BACKGROUND: Diet and exercise are important components of treatment for complex chronic conditions, however access to allied health support is limited. When available, support is often siloed and fragmented. Digital health incorporating patient choice may help to align health care services with preferences and goals. This study evaluated the implementation of a ubiquitously accessible patient-centred digital health diet and exercise service. METHODS: U-DECIDE was a single-centre, 26-week randomised controlled trial set in kidney and liver disease clinics in a tertiary hospital in Brisbane, Australia. Participants were adults with a complex chronic condition referred for dietetic consultation with at least one feature of the metabolic syndrome. All participants received a dietary consultation, an activity monitor and usual care. Intervention participants were offered one text message per week and access to additional digital health options (increased text message frequency, nutrition app, exercise app, group-based diet and/or exercise video consultations). The primary outcome of feasibility was determined by safety (study-related serious adverse events: SRSAEs), recruitment (≥ 50% eligible patients), retention (≥ 70%), exposure uptake (≥ 75% of intervention group had greater access to health professional contact than comparator) and video consultation adherence (≥ 80% attendance). Secondary outcomes included process evaluation metrics and clinical outcomes. RESULTS: Of 67 participants (intervention n = 33, comparator n = 34), 37 (55%) were men, median (IQR) age was 51 (41-58) years. The most chosen digital health options were the nutrition app (n = 29, 88%) and exercise video consultations (n = 26, 79%). Only one participant chose no additional digital health options. The intervention group had no SRSAEs. The study exceeded targets for recruitment (52%), retention (81%) and exposure uptake (94%). Video consultation adherence was 42%. Engagement across digital health options was inconsistent. CONCLUSIONS: Digital health options incorporating patient choice were feasible and can be offered to people with complex chronic disease as a service model option. TRIAL REGISTRATION: Australia and New Zealand Trials Register: Trial Registration Number: ACTRN12620001282976. Registered 27th November 2020.

Different types of screen time are associated with low life satisfaction in adolescents across 37 European and North American countries.

AIMS: Prolonged screen time (ST) is a potential concern for poor wellbeing. This study aimed to examine the associations of different types of ST with life satisfaction among adolescents. METHODS: Data were from 380,446 adolescents (aged 11-15 years, 51% girls) across 37 European and North American countries who completed the 2010 and 2014 Health Behaviour in School-Aged Children surveys. Participants reported h/day during free time spent on television, electronic games, and computer/other devices. Life satisfaction was assessed using a 10-point scale (low life satisfaction ⩽5). RESULTS: Generalized additive modelling showed non-linear associations for each ST type, with low life satisfaction increasing monotonically for >1 h/day of electronic gaming or computer/other device and >2 h/day of watching television. Multilevel multivariable modelling showed that >4 h/day of watching television was associated with 26% higher odds for boys (OR 1.26; 95% CI:1.21-1.32) and 52% higher odds for girls (1.52; 1.46-1.59) of low life satisfaction than for ⩽1 h/day of television. Electronic gaming >4 h/day was associated with low life satisfaction with odds 42% higher in boys (1.42, 1.36-1.48) and 69% higher in girls (1.69, 1.61-1.76). A similar association was found for >4 h/day of computer/other device for boys (1.43, 1.37-1.49) and girls (1.71, 1.65-1.77). CONCLUSIONS: Low levels of ST may be beneficial; however, prolonged periods are associated with low life satisfaction among adolescents, in particular among girls. Results support ⩽2 h/day restriction of ST and highlight research is needed to understand underlying mechanisms of ST and wellbeing, which may not reflect active versus passive content.

Social Support for Physical Activity Over 9 Years in Adults Aged 60-65 Years at Baseline.

Physical activity is a leading determinant of health and well-being in older adults; however, participation is low. Social support can significantly influence physical activity uptake and maintenance; however, most research is cross-sectional and does not differentiate among types of support. The current study assessed four types of social support for physical activity reported over 9 years by adults aged 60-65 at baseline (n = 1,984). Data were collected using a mail survey at four time points. Data were analyzed using linear mixed models. The most common type of support was emotional, with 25% of participants reporting this often/very often. Total support for activity declined by 16% across the 9 years (p < .001). Companionship had the greatest decline among types (17%-18%, p < .001). More work is needed to understand the factors contributing to the decline in support and how to enable access to support for physical activity in older adults.

Sources of occupational stress amongst dentistry academics.

BACKGROUND: Dentistry professionals may experience significantly higher occupational stress than other health professionals and dentistry academics may have specific work content and context sources of stress. AIMS: The aim of this study is to identify common sources of occupational stress, and how these are associated with wellbeing, in dentistry academics. MATERIALS & METHODS: A cross-sectional online survey with staff in Dentistry departments in Australia and New Zealand. Assessment included 23 items from five general domains of occupational stress from the NIOSH-Generic Job Stress Questionnaire, a 23-item list of sources of stress and the 22-item Psychological General Well-Being Index. Analyses used descriptive statistics and multiple linear regression. RESULTS: A total of 107 respondents (average age 50 ± 11.7 years, 56.8% men) completed the survey. Leading sources of occupational stress were job future, time pressure at work, work overload, and administration demands. A multiple linear regression model significantly predicted wellbeing, F(8,77) = 13.141, p = .000, adj.R2  = .53, but there were no significant associations for any of the specific sources of stress. CONCLUSION: The combination of time pressure, workload and responsibility, job dissatisfaction, low social support, and uncertain job future was inversely associated with wellbeing amongst these dentistry academics. Future studies should consider the development and evaluation of interventions to address these concerns.

Accelerometer-measured physical activity in mid-age Australian adults.

BACKGROUND: Raw data from accelerometers can provide valuable insights into specific attributes of physical activity, such as time spent in intensity-specific activity. The aim of this study was to describe physical activity assessed with raw data from triaxial wrist-worn accelerometers in mid-age Australian adults. METHODS: Data were from 700 mid-age adults living in Brisbane, Australia (mean age: 60.4; SD:7.1 years). Data from a non-dominant wrist worn triaxial accelerometer (Actigraph wGT3X-BT), expressed as acceleration in gravitational equivalent units (1 mg = 0.001 g), were used to estimate time spent in moderate-vigorous intensity physical activity (MVPA; >100 mg) using different bout criteria (non-bouted, 1-, 5-, and 10-min bouts), and the proportion of participants who spent an average of at least one minute per day in vigorous physical activity. RESULTS: Mean acceleration was 23.2 mg (SD: 7.5) and did not vary by gender (men: 22.4; women: 23.7; p-value: 0.073) or education (p-value: 0.375). On average, mean acceleration was 10% (2.5 mg) lower per decade of age from age 55y. The median durations in non-bouted, 1-min, 5-min and 10-min MVPA bouts were, respectively, 68 (25th -75th : 45-99), 26 (25th -75th : 12-46), 10 (25th -75th : 3-24) and 8 (25th -75th : 0-19) min/day. Around one third of the sample did at least one minute per day in vigorous intensity activities. CONCLUSION: This population-based cohort provided a detailed description of physical activity based on raw data from accelerometers in mid-age adults in Australia. Such data can be used to investigate how different patterns and intensities of physical activity vary across the day/week and influence health outcomes.

Individual socioeconomic position, neighbourhood disadvantage and mental well-being: a cross-sectional multilevel analysis of mid-age adults.

BACKGROUND: Socioeconomic disadvantage is associated with mental illness, yet its relationship with mental well-being is unclear. Mental well-being is defined as feeling good and functioning well. Benefits of mental well-being include reduced mortality, improved immune functioning and pain tolerance, and increased physical function, pro-social behaviour, and academic and job performance. This study aims to explore the relationship between individual socioeconomic position (SEP), neighbourhood disadvantage and mental well-being in mid-age adults. METHODS: Multilevel modelling was used to analyse data collected from 7866 participants from the second (2009) wave of HABITAT (How Areas in Brisbane Influence healTh and activiTy), a longitudinal study (2007-2018) of adults aged 40-65 years living in Brisbane, Australia. Mental well-being was measured using the Warwick Edinburgh Mental Well-Being Scale (WEMWBS). Exposure measures were education, occupation, household income, and neighbourhood socioeconomic disadvantage. RESULTS: The lowest MWB scores were observed for the least educated (ß = - 1.22, 95%CI = - 1.74, - 0.71), those permanently unable to work (ß = - 5.50, 95%CI = - 6.90, - 4.10), the unemployed (ß = - 2.62, 95%CI = - 4.12, - 1.13), and members of low-income households (ß = - 3.77, 95%CI = - 4.59, - 2.94). Residents of the most disadvantaged neighbourhoods had lower MWB scores than those living in the least disadvantaged neighbourhoods, after adjustment for individual-level SEP (ß = - 0.96, 95%CI = - 1.66, - 0.28). CONCLUSIONS: Both individual-level SEP and neighbourhood disadvantage are associated with mental well-being although the association is stronger for individual-level SEP. This research highlights the need to address individual and neighbourhood-level socioeconomic determinants of mental well-being.

Dysfunctional beliefs, sleep hygiene and sleep quality in university students.

ISSUE ADDRESSED: Poor sleep quality is common among university students and can have negative implications for physical, emotional, cognitive and academic wellbeing. Previous research has identified that sleep beliefs and sleep behaviours are associated with poor sleep quality. However, few studies have examined these variables simultaneously. This study explored associations between dysfunctional beliefs about sleep, sleep hygiene and sleep quality in a sample of university students. METHODS: Participants were recruited from a pool of undergraduate psychology students and included 120 male students and 145 female students with an average age of 20 years (SD = 5.10). Participants completed an online survey including the Pittsburgh Sleep Quality Index, Dysfunctional Beliefs and Attitudes About Sleep Scale, Sleep Hygiene Index and demographic items. RESULTS: Overall 60.4% of participants (59.4% of women, 40.6% of men) had poor sleep quality. Logistic regression indicated a significant positive association between sleep hygiene and sleep quality, OR = 1.16, P >.001, 95% CI (1.10, 1.23), and no significant relationship between dysfunctional beliefs about sleep and sleep quality, OR = 1.03, P > .79, 95% CI (0.84, 1.26), after adjusting for covariates. CONCLUSIONS: Sleep interventions for university students are needed and could focus on common hygiene components, such as using the bed for activities other than sleeping, engaging in arousing activities before bed and how to manage thinking and worrying before bed. So What? The results of the study demonstrate poor sleep quality is common among university students and indicates that sleep interventions are warranted. The positive association found between sleep hygiene and sleep quality highlights that interventions should focus on behavioural components of sleep.

Relationship Between Disease Specific Quality of Life Measures, Physical Performance, and Activity in People with Intermittent Claudication Caused by Peripheral Artery Disease.

OBJECTIVE: The aims of this study were firstly to assess the correlation between disease specific measures of quality of life (QOL) and physical performance and activity, and secondly to identify demographic, clinical, functional, and physical activity measures independently associated with QOL in people with intermittent claudication. METHODS: This was a cross sectional observational study of 198 people with intermittent claudication caused by peripheral artery disease who were recruited prospectively. QOL was assessed with the intermittent claudication questionnaire (ICQ) and the eight-theme peripheral artery disease quality of life questionnaire. Physical performance was assessed with the six minute walk test (6MWT) and short physical performance battery (SPPB), and an accelerometer was used to measure seven day step count. The associations between QOL scores and 6MWT distance, SPPB scores and seven day step count were examined using Spearman Rho's (ρ) correlation and multivariable linear regression. RESULTS: ICQ scores were significantly correlated with 6MWT distance (ρ = 0.472, p < .001), all four SPPB scores (balance ρ = 0.207, p = .003; gait speed ρ = 0.303, p < .001; chair stand ρ = 0.167, p = .018; total ρ = 0.265, p < .001), and seven day step count (ρ = 0.254, p < .001). PADQOL social relationships and interactions (ρ = 0.343, p < .001) and symptoms and limitations in physical functioning (ρ = 0.355, p < .001) themes were correlated with 6MWT distance. The 6MWT distance was independently positively associated with ICQ and both PADQOL theme scores (ICQ: B 0.069, p < .001; PADQOL social relationships and interactions: B 0.077, p < .001; PADQOL symptoms and limitations in physical functioning: B 0.069, p < .001). CONCLUSION: Longer 6MWT distance independently predicted better physical and social aspects of QOL in people with intermittent claudication supporting its value as an outcome measure.

Participation in sports/recreational activities and incidence of hypertension, diabetes, and obesity in adults.

Evidence of prospective associations between participation in sports and recreational activities (SRAs) and health outcomes at the population level is scarce. We investigated the associations between participation in SRAs and 6-year incidence of hypertension, diabetes, and obesity in a cohort of mid-age Australian adults. We analyzed data from the HABITAT study (n = 8784), a cohort of adults aged 40+ years living in Brisbane, Australia. Mail surveys in 2007, 2009, 2011, and 2013 were used to collect data on participation in 11 SRAs in the past 12 months, as well as self-reported hypertension, diabetes, height, and weight. Obesity was defined as BMI ≥ 30.0 kg/m2 . Logistic generalized estimating equation models with a 2-year lag were used. Participation in SRAs in 2007, 2009, and 2011 was matched with outcomes measured in 2009, 2011, and 2013. From 2007 to 2013, the cumulative incidence of hypertension, diabetes, and obesity was 14.9%, 3.2%, and 11%, respectively. Running, tennis, team sports, exercise classes, and resistance training were associated with reduced odds of hypertension. Running, cycling, resistance training, and yoga/tai chi were associated with reduced odds of diabetes. Cycling, tennis, home-based exercises, resistance training, and yoga/tai chi were associated with lower odds of obesity. Participation in SRAs was associated with lower incidence of hypertension, diabetes, and obesity in mid-age adults over six years. These findings support current efforts to promote wider and continuing participation in SRAs at this life stage.

Low physical activity and high sedentary behaviour are associated with adolescents' suicidal vulnerability: Evidence from 52 low- and middle-income countries.

AIM: To examine the relationships of physical activity (PA) and sedentary behaviour (SB) with suicidal thoughts and behaviour among adolescents in low- and middle-income countries (LMICs). METHODS: Global School-based Student Health Survey data from 206 357 students (14.6 ± 1.18 years; 51% female) in 52 LMICs were used. Students reported on suicidal ideation, suicide planning, suicide attempts, PA, leisure-time SB and socio-demographic characteristics. Multilevel mixed-effects generalised linear modelling was used to examine the associations. RESULTS: High leisure-time SB (≥3 hours/day) was independently associated with higher odds of suicidal ideation, suicide planning and suicide attempts for both male and female adolescents. Insufficient PA (<60 mins/day) was not associated with higher odds of ideation for either sex; however, it was associated with planning and attempts for male adolescents. The combination of insufficient PA and high SB, compared with sufficient PA and low SB, was associated with higher odds of suicidal ideation and suicide planning for both male and female adolescents, and suicide attempts for male adolescents. CONCLUSION: High SB may be an indicator of suicidal vulnerability among adolescents in LMICs. Low PA may be a more important risk for suicidal thoughts and behaviours among male, than female, adolescents. Promoting active lifestyle should be integrated into suicide prevention programmes in resource-poor settings.

Prevalence and correlates of depressive symptoms in secondary school children in Dhaka city, Bangladesh.

Objectives: Depression is a leading contributor to the global burden of disease, and often starts at a young age. Depression in young people can increase the risk of unhealthy lifestyle behaviour and can lead to substantial disability, social problems, poor health, and suicide. Other research has examined depressive symptoms among adult populations in Bangladesh, but little is known about other age groups. The aim of this study was to assess the prevalence and socio-demographic correlates of depressive symptoms among secondary school children of Dhaka city, Bangladesh.Design: A self-completed questionnaire was administered to 898 students from eight secondary schools of Dhaka, the capital City of Bangladesh. Of the respondents, 755 (372 males, 383 females; average age 14.26 years; SD 1.15) completed the 10-item Center for Epidemiological Studies Depression Scale (CESD-10). A score of 10 or more was used to indicate depressive symptoms. Parents completed a separate questionnaire to provide individual and household/family-level data. Generalized Estimating Equations (GEE) was used to assess sociodemographic and lifestyle factors associated with adolescent depressive symptoms.Results: Among the responding adolescents, 25% reported depressive symptoms with prevalence more common among females than males (30% vs. 19%). Factors significantly associated with symptoms of depression included being female, aged 15-16 years, self-perception of non-normal weight, feeling unsafe at school, sleep disturbance, low life satisfaction, high intake of sugary drinks, and regularly skipping breakfast.Conclusion: Depressive symptoms are prevalent among secondary school children in urban Bangladesh. Interventions for adolescents with depressive symptoms could focus on lifestyle practices such as weight management, personal safety, sleep hygiene and healthy eating.

Combined Effects of Physical Inactivity and Sedentary Behaviour on Psychological Distress Among University-Based Young Adults: a One-Year Prospective Study.

Insufficient physical activity (PA) and prolonged sedentary behaviour (SB) may have deleterious psychological health consequences. Using one-year prospective data, this study examined the combined effects of PA and SB on psychological distress among university-based young adults in Dhaka, Bangladesh. During Wave 1 (September-December 2015), total 573 undergraduate students (mean age: 20.7 ± 1.35 years; 45% females) completed a self-administered survey on PA, SB, psychological distress, health and lifestyle factors and sociodemographics. During Wave 2 (October-November 2016), 395 students (retention rate = 69%) completed a sub-set of Wave 2 survey with items on PA, SB and psychological distress. PA and SB were assessed using the Global Physical Activity Questionnaire and distress with the Kessler 6 Psychological Distress scale. Generalized Estimating Equations with Gaussian family and identity link under exchangeable correlation structure was used to examine the relationships. Multivariable modeling showed that participants with insufficient PA (<150 min/week) and high SB (≥480 min/day) or insufficient PA + low SB had more distress [ß: 3.07 (95% CI: 2.12-4.01) and 2.77 (1.86-3.67), respectively] than those who had sufficient PA + low SB, after controlling for gender, sleep difficulties, perceived health, fast food and fresh fruit intake. There was no statistically significant difference for the level of distress between other PA and SB groups. In this one-year prospective study, irrespective of SB, insufficient PA was associated with high psychological distress in university-based young adults in Bangladesh. The protective role of PA should be considered in intervention programs to improve psychological health of young adults.

Shift Work and Poor Mental Health: A Meta-Analysis of Longitudinal Studies.

Background. Shift work is characterized by employees working outside the standard hours of 7:00 am to 6:00 pm. Because shift work includes night work, the normal sleep-wake cycle (circadian rhythm) is disrupted, with potential consequences for shift workers' physical and mental health.Objectives. To assess the pooled effects of shift work on mental health and to evaluate whether these differ in men and women.Search Methods. We searched PubMed, Scopus, and Web of Science databases for peer-reviewed or government reports published up to August 2018Selection Criteria. To be included, studies had to be longitudinal or case-control studies of shift work exposure associated with adverse mental health outcomes. For subanalyses, we grouped these outcomes as anxiety symptoms, depressive symptoms, or general poor mental health symptoms.Data Collection and Analysis. We followed the Meta-Analysis of Observational Studies in Epidemiology Group guidelines. We extracted adjusted risk estimates for each study to calculate pooled effect sizes (ESs) using random effect models and metaregression analysis to explore sources of heterogeneity.Main Results. We included 7 longitudinal studies, with 28 431 unique participants. Shift work was associated with increased overall risk of adverse mental health outcomes combined (ES = 1.28; 95% confidence interval [CI] = 1.02, 1.62; I2 = 70.6%) and specifically for depressive symptoms (ES = 1.33; 95% CI = 1.02, 1.74; I2 = 31.5%). Gender differences explained more than 90% of heterogeneity, with female shift workers more likely to experience depressive symptoms than female non-shift workers (odds ratio = 1.73; 95% CI = 1.39, 2.14).Authors' Conclusions. To our knowledge, this is the first meta-analysis to investigate the pooled effects of shift work on the risk of poor mental health, including subanalyses by type of poor mental health and gender. Shift workers, particularly women, are at increased risk for poor mental health, particularly depressive symptoms.Public Health Implications. Depression accounts for 4.3% of the global burden of disease and incidence, with mental disorders worldwide predicted to cost US $16.3 million by 2030. With 1 in 5 people in the United States and Europe doing shift work, and the increased risk of poor mental health among shift workers, shift work industries are a priority context for reducing this burden. Workplace health promotion programs and policies are needed to minimize shift workers' risk of poor mental health.

Resistance training in addition to aerobic activity is associated with lower likelihood of depression and comorbid depression and anxiety symptoms: A cross sectional analysis of Australian women.

The mental health benefits of resistance training (RT) alone or beyond those provided by aerobic physical activity (PA) are unclear. This study aimed to determine the association between meeting recommendations for aerobic PA and/or RT, and symptoms of depression and/or anxiety. Participants were Australian female members of the 10,000 Steps project (n = 5180, 50.0 ±â€¯11.5 years). Symptoms of depression and anxiety were determined using the Depression Anxiety Stress Score. Participants were grouped as 'depression only', 'anxiety only', 'co-occurring depression and anxiety' or 'neither depression nor anxiety' based on relevant subscale score (cut-points: depression≥14 points, anxiety≥10 points). The International Physical Activity Questionnaire-Long Form questionnaire was used to determine PA with an additional item to specify RT frequency. Participants were classified as adhering to 'aerobic PA only' (≥150 min PA/week), 'RT only' (RT ≥ 2 days/week), 'aerobic PA + RT' (≥150 min PA/week+RT ≥ 2 days/week), or 'neither aerobic PA nor RT' (<150 min PA/week+RT < 2 days/week). Adjusted relative risk ratios (RRR [95%CI]) were estimated using multinomial logistic regression models. Relative to the 'neither PA nor RT' (n = 2215), the probabilities of 'depression only' (n = 317) and 'co-occurring depression and anxiety' (n = 417) were lower for the 'aerobic PA only' (n = 1590) (RRR = 0.74 [0.56-0.97] and RRR = 0.76 [0.59-0.97] respectively), and 'both PA + RT' (n = 974) groups (RRR = 0.61 [0.43-0.86] and RRR = 0.47 [0.33-0.67] respectively). There were no associations between adhering to one or both recommendations and 'anxiety only' (n = 317), or between 'RT only' (n = 401) and depression and/or anxiety. Prevention and treatment strategies including both aerobic PA and RT may provide additional benefits for depression with or without comorbid anxiety.

Physical activity and sedentary behaviour in a flexible office-based workplace: Employee perceptions and priorities for change.

ISSUE ADDRESSED: Many Australian employees now regularly work from home in some capacity. This new way of working has not been widely studied in relation to the potential implications for employees' health-related behaviour or workplace health promotion. The aim of this study was to explore office-based employees' perceptions of the impact of flexible work on physical activity and sedentary behaviour; and preferences for associated interventions. METHODS: Three focus groups were conducted with office-based employees (n = 28) 6 months after the introduction of a flexible work policy. A semi-structured interview format with open-ended questions was used with summary statements to check understanding. Sessions were audiotaped, and dominant themes were identified. Findings on intervention preferences were interpreted using a social cognitive framework. An overview of results was provided to a group of managers (n = 9) for comment. RESULTS: Employees reported that physical activity was not impacted, but sedentary behaviour had increased, with flexible work. Intervention preferences focussed on occupational sedentary behaviour, self-regulation, prompts and social connections, and not the physical work environment. Managers agreed with employees' preferences and also wanted interventions to be sustainable. CONCLUSION: Self-directed interventions with social components and targeting occupational sedentary behaviour were more acceptable than physical activity interventions in this flexible workplace. SO WHAT?: Health promotion for workplaces with flexible work practices may benefit from prioritising strategies that promote self-regulation and social connections rather than being linked to the physical worksite.

Gender differences in physical activity motivators and context preferences: a population-based study in people in their sixties.

BACKGROUND: Although regular participation in physical activity (PA) has health benefits across the life span, the proportion of people doing sufficient activity for these benefits decreases with age. The aim of this study was to identify motivating factors and context preferences for PA in people in their sixties, and to examine gender differences in these factors. METHODS: Data were used from people aged 60-67 years who responded to a mail survey in Brisbane, Australia, in 2009. Respondents indicated their agreement/disagreement with seven PA motivators and 14 PA context preferences. Data were analyzed using multi-level multinomial logistic regression, adjusted for sociodemographic and health variables, and PA level. RESULTS: Of the 1845 respondents, 59% was female. Based on self-reported PA, one in three respondents (35%) did not meet the PA guidelines of at least 150 min of moderate intensity PA per week. The three leading motivating factors for both women and men were to prevent health problems, to feel good and to lose weight. Women were more likely than men to be motivated by improving appearance (OR 2.93, 95%CI 2.07-4.15), spending time with others (1.76, 1.31-2.37), meeting friends (1.76, 1.31-2.36) or losing weight (1.74, 1.12-2.71). The three leading context preferences for both women and men were for activities close to home, at low cost and that could be done alone. Women were more likely than men to prefer activities that are with people of the same sex (OR 4.67, 95%CI 3.14-6.94), supervised (2.79, 1.94-4.02), with people the same age (2.00, 1.43-2.78) and at a fixed time (1.42, 1.06-1.91). Women were less likely than men to prefer activities that are competitive (OR 0.32, 95%CI 0.22-0.46), are vigorous (0.33, 0.24-0.47), require skill and practice (0.40, 0.29-0.55) and done outdoors (0.51, 0.30-0.86). CONCLUSION: Although there was overlap in motivating factors and context preferences for PA in women and men aged 60-67 years, there were also marked gender differences. These results suggest that PA options for people in their sixties should be tailored to meet gender specific interests in order to promote PA participation in this rapidly growing population group.

Physical activity and quality of life in older women with a history of depressive symptoms.

Physical activity (PA) is positively associated with health-related quality of life (HRQL) in older adults. It is not evident whether this association applies to older adults with poor mental health. This study examined associations between PA and HRQL in older women with a history of depressive symptoms. Participants were 555 Australian women born in 1921-1926 who reported depressive symptoms in 1999 on a postal survey for the Australian Longitudinal Study on Women's Health. They completed additional surveys in 2002, 2005 and 2008 that assessed HRQL and weekly minutes walking, in moderate PA, and in vigorous PA. Random effects mixed models were used to examine concurrent and prospective associations between PA and each of 10 HRQL measures (eight SF-36 subscales; two composite scales). In concurrent models, higher levels of PA were associated with better HRQL (p<0.001). The strongest associations were found for the bodily pain, physical functioning, general health perceptions, social functioning and vitality measures. Associations were attenuated in prospective models, more so for mental HRQL-related scales than for physical HRQL-related scales. However, strong associations (>3 point differences) were evident for physical functioning, general health, vitality and social functioning. For women in their 70s-80s with a history of depressive symptoms, PA is positively associated with HRQL concurrently, and to a lesser extent prospectively. This study extends previous work by showing significant associations in older women with a history of depressive symptoms. Incorporating PA into depression management of older women may improve their HRQL.