Effectiveness of interventions to prevent or reverse pre-frailty and frailty in middle-aged community dwelling adults: A systematic review.

INTRODUCTION: Frailty, marked by diminished physiological capacity and higher health risks, is less understood in middle-aged individuals (40-65 years) than older adults. This review synthesises intervention studies for pre-frailty and frailty in this demographic, assessing effectiveness, feasibility, and implementation factors including participant experience and cost-effectiveness. METHOD: Registered on the Open Science Framework and adhering to the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) and the template for intervention description and replication (TIDieR) guidelines, this review searched six databases for interventions targeting middle-aged adults. Dual screening, data extraction, risk assessment, and Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) certainty evaluation were conducted. Findings were narratively synthesized due to heterogeneity. RESULTS: Eight studies (2018-2023) with 2838 participants were included. Resistance training and multicomponent exercise reduced frailty; though, not always significantly. Low-intensity exercises and education-based interventions yielded mixed results, suggesting a need for further research. Positive participant experiences and cost-effectiveness of interventions such as resistance training and educational interventions supports their feasibility. Varying quality, methodologies and levels of bias indicated a need for more rigorous future research. DISCUSSION: This review reveals an evidence gap in middle-aged frailty interventions. Multicomponent interventions and resistance training showed promise, but their comparative effectiveness remains uncertain. Educational and low-intensity interventions need further research to establish their effectiveness. The findings diverge from those in older adults, emphasising the need for age-specific approaches. Future studies should employ higher-quality methods and explore emerging technologies to enhance intervention effectiveness for pre-frailty and frailty in middle-aged adults.

Effects of traffic light labelling and increased healthy range on beverage choices from vending machines.

OBJECTIVE: To test whether traffic light labels and an increased range of healthy beverages, individually and in combination, can increase healthy beverage choices from vending machines. DESIGN: Two studies (n 558, 420) tested whether the provision of traffic light labels (green, amber and red) and an increased range of healthy beverages (from 20 % to 50 % green options), individually and in combination, could increase healthy beverage choices from a digital vending machine display. The studies used a between-subjects experimental design, and a hypothetical beverage choice, a limitation when considering real-world applicability. SETTING: Both studies utilised an online Qualtrics survey that featured a digital vending machine display. PARTICIPANTS: Both studies (n 558, 420) consisted of university students from Flinders University and individuals from a survey recruitment service. RESULTS: Featuring traffic lights did not significantly influence beverage choices (P = 0·074), while increasing the healthy range (P = 0·003, OR = 3·27), and the combination of both, did significantly increase healthier beverage choices (P < 0·001, OR = 4·83). CONCLUSIONS: The results suggest that the traffic light system and increased healthy range are not maximally effective when used on their own, and benefit greatly when combined, to increase healthy beverage choices. It was suggested that the provision of traffic light labels supplied the necessary nutritional information, and the increased healthy range offered greater opportunity to act in accordance with that information. In so doing, the present findings offer a promising pathway for reducing unhealthy beverage consumption.

I'll have what She's having (but not what They're having): The moderating role of group membership in the effect of social norms on food choice in an online environment.

The modern food-rich environment has contributed to the rise of unhealthy diets linked to noncommunicable diseases. Previous in-person research has found that the effect of social norms on food intake is greater when set by a perceived in-group member relative to an out-group member. Given recent increased social media use, we investigated whether this effect of group membership extends to food choices and to normative information presented remotely online. Participants (N = 179 female university students, 18-32 years) viewed a Facebook page pertaining to either their university (in-group) or a rival university (out-group). They were presented with either a healthy or an unhealthy norm via a post in which a student discussed their order at a café on the relevant campus. Food choice was assessed through an online menu where participants were asked to order one main, side, and dessert dish. As predicted, participants who viewed the healthy norm ordered a higher percentage of healthy items (especially in the desserts category) relative to those who viewed the unhealthy norm. However, this effect was significant only for those in the in-group condition; there was no such pattern for participants in the out-group condition. These findings provide insight into the role of group membership in the effect of social norms, and have practical implications regarding the design of identity-based social media health campaigns to promote healthier eating behaviours.

Effectiveness of visual nudges for encouraging healthier beverage choices from vending machines.

ISSUES ADDRESSED: Research suggests visual nudging techniques can subtly encourage healthier consumption. Two experiments explored the effect of four visual primes for nudging drink choices from a vending machine display. METHODS: Participants (17-25 years) were randomly assigned to view vending machine advertising posters containing pictorial nudges of water, soft drink, general health (runner), or a text-only control, for nudging vending machine choices. Participants then selected an item from a vending machine display containing drinks only (Experiment 1; n = 164), or both drinks and snack foods (Experiment 2, n = 684). RESULTS: In both experiments, nudging condition predicted beverage choice. Specifically, the water image nudged healthier beverage choices in both experiments. However, there was no effect on food choice in Experiment 2. Furthermore, in both experiments, liking and habitual consumption of chosen items were also significant predictors of choice, but condition predicted beverage choice over and above these. CONCLUSION: A water prime may be an effective means of encouraging healthier beverage choices in a vending machine environment. SO WHAT?: Findings have the potential to inform strategies for encouraging healthier beverage choices from vending machine environments.

"Can you see me?" Videoconferencing and eating disorder risk during COVID-19: Anxiety, impairment, and mediators.

OBJECTIVE: The use of videoconferencing has increased during the pandemic, creating prolonged exposure to self-image. This research aimed to investigate whether eating disorder (ED) risk was associated with videoconferencing performance for work or study and to explore whether the use of safety behaviors and self-focused attention mediated the relationship between ED risk and perceived control over performance anxiety, impaired engagement, or avoidance of videoconferencing for work or study. METHOD: In 2020, an online survey was distributed within Australia to those aged over 18 years via academic and social networks, measuring: use of videoconferencing for work/study, demographics, ED risk, safety behaviors for appearance concerns, self-focused attention, perceived control over performance anxiety, perceived engagement impairment, and avoidance of videoconferencing. A total of 640 participants (77.3% female, Mage  = 26.2 years) returned complete data and were included in analyses. RESULTS: 245 participants (38.7%) were considered at-risk for EDs (SCOFF > 2). Those at-risk reported significantly more safety behaviors, self-focused attention, impaired engagement, and avoidance, plus lower perceived control over performance anxiety than those not at-risk. Multiple mediation models found the effects of ED risk on control over performance anxiety, impaired engagement, and avoidance were partially mediated by safety behaviors and self-focused attention. DISCUSSION: Our cross-sectional findings suggest videoconferencing for work/study-related purposes is associated with performance anxiety, impaired engagement, and avoidance among individuals at-risk for EDs. Poorer videoconferencing outcomes appear more strongly related to social anxiety variables than ED status. Clinicians and educators may need to provide extra support for those using videoconferencing. PUBLIC SIGNIFICANCE: Because videoconferencing often involves seeing your own image (via self-view) we wondered whether the appearance concerns experienced by those with eating disorders (EDs) might interfere with the ability to focus on or to contribute to work/study videoconferencing meetings. We found that although those with EDs experience more impairments in their videoconferencing engagement/contribution, these were linked just as strongly to social anxiety as they were to appearance concerns.

Hashtag fitspiration: credibility screening and content analysis of Instagram fitness accounts.

BACKGROUND: Fitspiration is a social media phenomenon purported to inspire viewers to lead healthier lifestyles but can result in negative psychological outcomes such as body dissatisfaction. This study aimed to develop a tool to audit Instagram fitspiration accounts and screen for content that could have potentially negative psychological effects. METHODS: This study developed and implemented an audit tool to (1) identify credible fitspiration accounts (i.e., accounts that do not portray potentially harmful or unhealthy content) and (2) describe the content of identified accounts. The most recent 15 posts of 100 leading Instagram fitspiration accounts were audited. Accounts were deemed non-credible and were excluded if they contained fewer than four fitness-related posts or portrayed nudity or inappropriate clothing, sexualisation or objectification, extreme body types, "thinspiration", or negative messages. RESULTS: Many accounts contained fewer than four fitness-related posts (n = 41), sexualisation or objectification (n = 26), nudity or inappropriate clothing (n = 22), and/or extreme body types (n = 15). Three accounts failed on all four criteria, while 13, 10 and 33 failed on three, two, or one criterion, respectively. Therefore, only 41% of accounts were considered credible. Inter-rater reliability (percentage agreement and Brennan and Prediger's coefficient κq) was high (Stage 1: 92% agreement [95% CI 87, 97], κq 0.84 [95% CI 0.73, 0.95]; Stage 2: 93% agreement [95% CI 83, 100], κq 0.85 [95% CI 0.67, 1.00]). Account holders of credible fitspiration accounts were predominantly female (59%), aged 25-34 (54%), Caucasian (62%), and from the United States (79%). Half held a qualification related to physical activity or physical health (e.g., personal trainer, physiotherapy; 54%). Most included accounts included an exercise video (93%) and example workout (76%). CONCLUSION: While many popular Instagram fitspiration accounts offered credible content such as example workouts, many accounts contained sexualisation, objectification or promotion of unhealthy or unrealistic body shapes. The audit tool could be used by Instagram users to ensure the accounts they follow do not portray potentially harmful or unhealthy content. Future research could use the audit tool to identify credible fitspiration accounts and examine whether exposure to these accounts positively influences physical activity.

Mental health promotion in youth sporting clubs: predictors of stakeholder participation.

BACKGROUND: Young people are disproportionately affected by poor mental health. Youth sport settings hold immense potential to improve the mental health outcomes of this demographic. Efforts to leverage youth sport settings to promote mental health are limited by the lack of knowledge pertaining to engagement with mental health interventions in these settings. Therefore, this study aimed to examine the willingness of youth sporting club stakeholders (e.g., sportspersons, coaches, support staff, parents/guardians) to engage in mental health initiatives conducted by sporting clubs and ascertain possible determinants of engagement. METHODS: This study used an observational cross-sectional design. Participants completed an online survey assessing likelihood of supporting a mental health campaign, mental health literacy (help-seeking, inclusive attitudes), and perceived club support. Perceptions pertaining to the importance of youth mental health and sporting clubs supporting youth mental health were also assessed. RESULTS: The survey was completed by 275 stakeholders of youth sporting clubs in Australia (Mage = 40.2 ± 15.8 years, 60.3% female). The findings indicated that stakeholders were willing to participate in mental health initiatives in youth sport clubs. A linear regression analysis indicated that the significant predictors of stakeholders supporting such initiatives were older age (> 25-50 and > 50 years; ß = 0.15, p = .033, ß = 0.19, p = .005, respectively), along with perceived importance of youth mental health (ß = 0.24, p = .003) and sporting clubs supporting youth mental health (ß = 0.22, p = .004). CONCLUSION: Youth sport settings have the capacity to improve the provision of mental health support among young people. There is a need for tailored approaches to enhance the engagement with, and effectiveness of, mental health resources in sport contexts.

Socio-cognitive determinants of sugar-sweetened beverage consumption among young people: A systematic review and meta-analysis.

The overconsumption of sugar sweetened beverages is an increasing public health concern. Understanding the socio-cognitive determinants that drive such consumption could inform the development of interventions to reduce sugar sweetened beverage consumption. The aim of the present review and meta-analysis was to determine the strength of associations between socio-cognitive determinants and the amount and frequency of sugar sweetened beverage consumption among young people. A systematic review was conducted in accordance with PRISMA guidelines. A search was performed using the following databases: PsycINFO, MEDLINE, Scopus, ProQuest, and PubMed. The key search terms were: (1) children, adolescents, young adults; (2) sugar sweetened beverage consumption, choice or purchasing behaviour; and (3) socio-cognitive determinants related to sugar sweetened beverage consumption. The search identified 4325 papers, with 22 papers remaining after screening. Two separate meta-analyses were performed, one for amount (n = 14) and one for frequency (n = 8) of consumption. The most strongly associated determinants with amount of sugar sweetened beverage consumed were habit, intention to consume, and attitudes, whereas the most strongly associated determinants with frequency of consumption were intentions, injunctive norms, and descriptive norms. Comparisons between the meta-analyses revealed two distinct differences: injunctive norms were more strongly correlated with frequency of consumption, and self-efficacy with amount consumed. It was suggested that interventions that focus on multiple determinants, including components of the Theory of Planned Behaviour may result in the largest reductions in consumption. Specifically, focussing on changing attitudes, norms and habits, and increasing perceived behavioural control related to sugar sweetened beverages may be maximally effective in reducing consumption behaviour.

Instagram-based priming to nudge drink choices: Subtlety is not the answer.

Instagram-based priming (e.g., subtly incorporating healthy drinks into the background of Instagram images) could potentially nudge healthier consumption behaviours. Given the negative health consequences associated with sugar-sweetened-beverage consumption, two experiments tested the effect of three sets of Instagram-based primes for nudging drink choices from a visual food and drinks display. Participants (18-25 years) were randomly assigned to view a series of Instagram advertising images (for technology, travel, or homeware products) that included a glass containing water (water prime) or cola (soft drink prime), or no drink (control). They then selected an item from the visual display containing snack foods and drinks. In Experiment 1 (n = 493) beverages were subtly incorporated into the priming images; in Experiment 2 (n = 471) beverages were made more prominent. Priming condition did not predict choice in Experiment 1 but did so in Experiment 2, where participants in the soft drink prime condition were significantly more likely to select a drink versus a food, compared to those in the water prime and control conditions. The water prime did not predict choice in either study. A greater percentage of participants noticed the beverage primes in Experiment 2 than in Experiment 1. Overall, it appears that when clearly visible, soft drinks incorporated into Instagram-style images can nudge drink choices. However, a less subtle approach may be needed to effectively encourage healthier drink choices.

The experience of women from rural Australia with a preterm infant in a neonatal intensive care unit.

INTRODUCTION: This study aimed to understand the experiences of women from rural areas who have had a preterm infant admitted to a neonatal intensive care unit. The study population comprised five women aged 29-36 years who birthed a premature infant of less than 32 weeks gestation within the previous 6 months at the time of recruitment. The setting was in rural areas of Australia, in the states of Victoria, New South Wales, Queensland and Western Australia. METHODS: Semi-structured interviews using video-conferencing explored the experiences of the women and were analysed using thematic analysis. RESULTS: Four key themes were identified from the data: emotional trauma, social displacement, external coping resources and craving continuity of care. Social displacement further impacted the emotional trauma already experienced by women who birthed a preterm infant by temporarily relocating to the city to be near to their infant in the neonatal intensive care unit. This led to the utilisation of additional socioeconomic resources including support from extended family and rural community members. The women highly valued yet struggled to find appropriate peer support and continuity of health care for their infant within their rural community after discharge from the neonatal intensive care unit. CONCLUSION: Health professionals have an opportunity to explore ways to address social displacement, particularly in relation to socioeconomic support and the involvement of extended family into a family integrated care framework within the neonatal intensive care unit. The long-term effects of this on the mother-infant dyad and the lack of appropriate community support also require further examination.

Vending machine backgrounds: nudging healthier beverage choices.

Soft drink overconsumption is a growing public health concern. The present research investigated whether priming nudges could decrease soft drink choices from a vending machine. We compared the effect of six vending machine wraps (Mount Franklin ™ logo, Coca-Cola™ logo, picture of water, picture of soft drink, blue, red) on beverage choice against a black (control) computerised vending machine display. In two studies, young adult participants (17 - 25 years) were recruited from [removed for blind review] (Study 1, n = 142, Study 2, n = 232). Participants were randomly allocated to choose a beverage from one of the wrap conditions. They also rated how much the beverage was liked and how often it was consumed (Study 1), or rated the refreshing value, healthiness, taste, and energy of each beverage in the vending machine (Study 2). We predicted that wraps referencing water would produce healthier choices and those referencing soft drink would result in unhealthier choices. Contrary to these predictions, the type of vending machine wrap did not significantly influence beverage choice in Study 1. However, viewing the black vending machine wrap resulted in significantly more caffeine-based selections in Study 2. Other significant predictors of the choice of beverage were how often the beverages were consumed and how much they were liked (Study 1), as well as their perceptions of the taste, healthiness and refreshing value (Study 2). The finding that the black vending machine produced more caffeine-based beverage choices demonstrates, in principle, that color-based priming nudges could influence beverage choices.

Level playing field: young males, masculinity and mental wellbeing through sport.

In Australia, and throughout the world, it is evident that the mental health and wellbeing of young males aged 15-24, is not a priority. In Australia suicide is the leading cause of death in people aged 15-24 years and 75% are male (Australian Institute of Health and Welfare. Australian hospital statistics 2011-12, 2021). It is clear young males as well as those who identify as indigenous or LGBTIQ are at risk groups with respect to self arm and suicide (Drummond, MJN, et al. 2019). It is the transition period from adolescence to adluthood that is of particular concern. Often young males must pass through this phase of life with minimal guidance or direction and without a "safe space" where they can attain emotional support. Sport is a significant part of boys' and young males' lives and offers that "safe space". Sport can play a substantial role in protective mental health through socialization and engagement in a socially endorsed activity that seemingly has far more positive outcomes than negative ones. This research is underpinned by both quantitative and qualitative research with young males involved masculinised sporting clubs. Its aim is to provide insights into how we can create safe spaces for males and influence positive forms of masculinities that can enhance mental health promotion among young males. This mixed methods research explores issues around mental health in young males involved across two male dominated sporting codes in Australian (Australian football and cricket). Surveys and interviews with young males age 15-24 as well as parents, coaches and key stakeholders underpin this research. While the data is designed to assist in the development of educational resources for males to influence positive forms of masculinities that can enhance mental health promotion among young males involved in these sporting codes, this paper reports on the exploratory nature of the data and raises important issues emerging among young males with respect to mental health and the role of the sporting club.

'There's Just Something Really Peaceful About It': a Qualitative Exploration of Mothers with Young Children and Engagement in Group-Based Physical Activity Programs.

BACKGROUND: Many mothers with young children often do not achieve recommendations of at least 150-min moderate-to-vigorous physical activity (MVPA) each week. Previous qualitative work has generally focused on getting inactive mothers with young children to be active, so the characteristics of women who are active during early postpartum period are not well understood. This research set out to capture the characteristics of mothers with young children who engage in MVPA and how these women manage barriers and harness enablers to sustain in engagement in physical activity (PA) over an extended period. METHOD: Thirty-two participants ranging in age from 27 to 42 years (35.2 ± 4.8), with age of their youngest child ranging from 6 weeks old to 5 years, participated in semi-structured interviews. RESULTS: Inductive thematic analysis revealed three overarching themes and fourteen sub-themes relating to the characteristics of active mothers with young children and the engagement and maintenance factors that recruit and sustain these women in group-based physical activity programs. Specifically, mothers with young children relish a welcoming and supportive environment that accommodates babies and young children, is affordable and convenient, focuses on building strength and functionality, and is non-judgmental. CONCLUSION: These findings advance knowledge by providing considerations and recommendations that support intervention and program designers to be able to develop group-based physical activity programs for mothers with young children.

Australian adolescents' beliefs and perceptions towards healthy eating from a symbolic and moral perspective: A qualitative study.

Unhealthy food choices among adolescents are considered a significant health concern. Current rhetoric adds a moral dimension to food and considers adolescents as moral and healthy eaters or less moral or less healthy eaters. While much research has investigated the structural barriers and facilitators to healthy eating, minimal scholarship has investigated Australian adolescents' symbolic and moral boundary beliefs and perceptions of healthy eating from different socioeconomic statuses. Using Lamont's (1992, 2000) concept of 'moral boundary work' and Sayer's (2005, 2011) ideas on the moral dimensions of social class, we explore Australian adolescents' beliefs and perceptions towards healthy eating from a symbolic and moral boundary perspective. The study consisted of seven focus groups interviews (N = 27) with Australian adolescents between the ages of 12 and 17 (10 male, 17 female) across three different socioeconomic status secondary schools. An inductive thematic analysis approach was adopted to analyse the data. Adolescents associated healthy eating with 1) beliefs and perceptions, 2) moral judgement, and 3) ethical eating and food sustainability priorities. Overall, adolescents constructed and applied their own moral and symbolic meanings to healthy eating. Furthermore, adolescents exerted their moral boundaries by comparing their food choices with their families and peers. Current research is mixed if adolescents from low socioeconomic status positions engage in moral boundary work. This study makes an original contribution by introducing how Australian adolescents interpret healthy eating across socioeconomic status positions. The findings from the study suggest that Australian adolescents across a range of socioeconomic statuses do and can be engaged in moral boundary work and demonstrated a sense of self-worth and dignity regarding their dietary practices.

The effectiveness of implicit interventions in food menus to promote healthier eating behaviours: A systematic review.

Unhealthy eating and related chronic illness are serious public health concerns. Initial attempts to discourage unhealthy eating using explicit techniques have been largely unsuccessful. However, emerging implicit interventions have started to show promise. Common implicit interventions in food-choice contexts include placement, priming/cueing, defaults, naming, ratios, and signage. The present review aimed to evaluate the effectiveness of these interventions in promoting healthier eating behaviours in the context of food menus. Five electronic databases were searched. Included studies were conducted in a menu setting, used implicit interventions which were unlikely to be noticed by consumers, had a healthy-eating promotion focus, and were experimental or pre/post designs. A total of 19 papers comprising 23 individual studies were included. Overall, four of six implicit interventions effectively promoted healthier eating behaviours in one or more studies, with placement and default interventions the most promising. Priming/cueing and ratio interventions showed potential but require further investigation. Naming and signage interventions were largely unsuccessful, although this could be because they have not yet been explored in a variety of menu settings with a health-eating promotion focus. If existing findings can be extended to additional menu settings and demographics in future studies, implicit interventions could provide affordable and accessible tools to promote healthier eating.

The effect of item placement on snack food choices from physical and online menus.

Previous attempts to promote healthy eating using explicit techniques have not been consistently successful. We therefore investigated an implicit strategy (item placement techniques) to encourage healthy food choices in the context of snack menus. Two experimental studies compared presentation of healthy items in the top, middle, and bottom sections of a snack menu. Study 1 compared these presentations in a physical paper-based menu, while Study 2 used an online menu. Menus consisted of 8 unhealthy and 4 healthy items, arranged in three rows of four in Study 1, and one column of 12 in Study 2. In each study, participants selected one food item from one of the three experimental menus, before completing the Revised Restraint Scale (to determine dietary restraint status). In Study 1 (n = 172), item placement condition did not predict healthiness of food choice. In Study 2 (n = 182), healthy items were most popular from the first section of the menu, in comparison to the middle or last sections. Dietary restraint did not moderate the effect of item placement condition on food choice. In line with nudging principles, our results suggest that item placement techniques could be a potentially powerful tool in promoting healthy choices from online snack menus.

Practice-based evidence: Perspectives of effective characteristics of Australian group-based physical activity programs for postpartum women.

ISSUE ADDRESSED: Many postpartum women often do not achieve recommendations of at least 150 minutes moderate-to-vigorous physical activity (MVPA) each week. Previous qualitative work has focused on postpartum women's barriers and challenges to being active, with recent research starting to explore the characteristics of PA programs and women who are active during the postpartum period. Yet, little research has focused on the characteristics of key stakeholders and community organisations that support women to sustain their PA engagement during the postpartum period. METHODS: This research generates practice-based evidence to provide essential insights for effective implementation, strategies and actions of community group-based PA programs that recruit and retain postpartum women to ensure future interventions are scalable and sustainable. Ten participants (90% female), ranging in age from 34 to 40 years, were recruited from nine community organisations/businesses. The ten participants engaged in semi-structured interviews for an average length of 31 minutes. RESULTS: Inductive thematic analysis revealed four overarching themes (i) effective practitioners have a history of, and passion for women's health and PA; (ii) low-cost, connected approaches attract postpartum women into community group-based PA programs; (iii) inclusive, flexible, varied, and holistic approaches sustain postpartum women's participation; and (iv) utilise connections to overcome barriers to community group-based PA programs. These four themes were informed by twelve sub-themes relating to the background of stakeholders and practitioners and the approaches that they use to attract and sustain postpartum women in community group-based PA programs. CONCLUSIONS: Practice-based findings should inform future practices and the development of future real-world group-based PA interventions for postpartum women. SO WHAT?: Specifically, interventions will need to be designed and implemented by practitioners who have a history of, and passion for women's health and PA, be low-cost, connected approaches, that are inclusive, flexible, varied, and holistic that prioritise physical, emotional, and social wellbeing.

A randomised online experimental study to compare responses to brief and extended surveys of health-related quality of life and psychosocial outcomes among women with breast cancer.

PURPOSE: Collecting patient-reported outcomes is important in informing the well-being of women with breast cancer. Consumer perceptions are important for successful implementation of monitoring systems, but are rarely formally assessed. We compared reactions to two different surveys (assessing psychosocial outcomes and/or Health-related Quality of Life (HrQoL) outcomes) among Australian women with breast cancer. METHODS: Women (18 + years) within 5 years diagnosis of breast cancer were randomly allocated to complete one of two online surveys: (i) minimum HrQoL measures or (ii) minimum HrQoL measures plus psychosocial outcomes (body image, depression, anxiety stress, fear of cancer recurrence, decisional difficulties and unmet need). Participants completed questions regarding their perceptions of the survey, including qualitative feedback. RESULTS: Data were available for 171 participants (n(i) = 89; n(ii) = 82), with 92% (n = 158) providing 95-100% complete data. Perceptions were comparable between survey groups, and high (80-100%) regarding time burden, ease of completion, comprehensible, appropriateness and willingness to participate again and moderately high (67-74%) regarding willingness to answer more questions and relevance. Qualitative feedback indicated gaps across both surveys, including financial/work-related issues, satisfaction with information and care, need for nuanced questions, and impact of side effects/treatment, and from the minimum set only, emotional well-being and support. Impairment in some HrQoL and psychosocial outcomes were observed among participants. CONCLUSIONS: Assessment of HrQoL and psychosocial outcomes was well received by consumers. Results alleviate concern regarding possible patient burden imposed by longer more in-depth surveys. The importance placed on assessment brevity should not outweigh the need to assess outcomes that consumers consider important.

The Body Confident Mums challenge: a feasibility trial and qualitative evaluation of a body acceptance program delivered to mothers using Facebook.

BACKGROUND: Motherhood is a time of intense physical, psychological, and identity transformation, and body dissatisfaction may emerge through the process of pregnancy, birth, and adaptation to parenting. We present a feasibility trial of the Body Confident Mums Challenge, a program developed by adapting existing, effective interventions that focus on self-compassion and appreciation of body functionality to be specific to mothers. METHODS: The program was delivered using the social learning function in a closed Facebook group. Qualitative evaluation of evidence of change was conducted by gathering individual written reflections posted during the challenge (n = 120). Feasibility and acceptability was determined using a feedback survey (n = 22). RESULTS: Participant's reflective posts indicated that they were embracing self-compassion, and de-prioritising body image concerns during the challenge. Feedback indicated that the program was mostly feasible and acceptable for mothers, with recommendations from some participants relating to slowing the pace of content delivery and reducing the time commitment of the Challenge. CONCLUSIONS: The social media environment may therefore be a useful setting in which to implement brief intervention programs to improve body image and wellbeing.

Acceptability of online sun exposure awareness-raising interventions among young Australian women: an exploratory mixed-methods study.

Melanoma is the most common cancer among young Australians. Despite school-based programs such as 'Sun Smart' leading to increased knowledge among children of the harmful effects of sun exposure, many young adults continue to desire a darker skin tone because of a general perception among their peers that tanned skin is attractive. This 'tanned-ideal' may be challenged through exposure to material posted on social media. This study aimed to investigate the impact of two online interventions on knowledge of skin cancer and intentions to engage in sun tanning and protective behaviours, as assessed by survey. In addition, the likelihood that the intervention would be 'shared' on social media was explored by interview during an intervention session. Eighteen women aged 18-24 years participated in this pilot, mixed-methods intervention study. Participants completed surveys 2 weeks before and 2 weeks after attending an intervention session in which they viewed a video and completed a face-aging activity, with the order of completion balanced within the sample. Two weeks after the intervention, there was a significant increase in knowledge and intended sun protection behaviours and a significant decrease in intended future tanning hours. There was no effect of intervention order. Interview data indicated that younger participants would share the ageing application with peers because it was fun; older participants reported that they would share the video because it was educational. Factors that encourage sharing on social media include being realistic, instructive or personally meaningful, and short in duration.