Workplace screening programs for chronic disease prevention: a rapid review

This review examined the effectiveness of workplace screening programs for chronic disease prevention based on evidence retrieved from the main databases of biomedical and health economic literature published to March 2012, supplemented with relevant reports. The review found: 1. Strong evidence of effectiveness of HRAs (when used in combination with other interventions) in relation to tobacco use, alcohol use, dietary fat intake, blood pressure and cholesterol 2. Sufficient evidence for effectiveness of worksite programs to control overweight and obesity 3. Sufficient evidence of effectiveness for workplace HRAs in combination with additional interventions to have favourable impact on the use of healthcare services (such as reductions in emergency department visits, outpatient visits, and inpatient hospital days over the longer term) 4. Sufficient evidence for effectiveness of benefits-linked financial incentives in increasing HRA and program participation 5. Sufficient evidence that for every dollar invested in these programs an annual gain of $3.20 (range$1.40 to $4.60) can be achieved 6. Promising evidence that even higher returns on investment can be achieved in programs incorporating newer technologies such as telephone coaching of high risk individuals and benefits-linked financial incentive

The rise and fall of Australian physical activity policy 1996 – 2006: a national review framed in an international context

Background: This paper provides an historical review of physical activity policy development in Australia for a period spanning a decade since the release of the US Surgeon General's Report on Physical Activity and Health in 1996 and including the 2004 WHO Global Strategy on Diet, Physical Activity and Health. Using our definition of 'HARDWIRED' policy criteria, this Australian review is compared with an international perspective of countries with established national physical activity policies and strategies (New Zealand, Canada, Brazil, Scotland, Switzerland, the Netherlands and Finland). Methods comprised a literature and policy review, audit of relevant web sites, document searches and surveys of international stakeholders. Results: All these selected countries embraced multi-strategic policies and undertook monitoring of physical activity through national surveys. Few committed to policy of more than three years duration and none undertook systematic evaluation of national policy implementation. This Australian review highlights phases of innovation and leadership in physical activity-related policy, as well as periods of stagnation and decline; early efforts were amongst the best in the world but by the mid-point of this review (the year 2000), promising attempts towards development of a national intersectoral policy framework were thwarted by reforms in the Federal Sport and Recreation sector. Several well received reviews of evidence on good practices in physical activity and public health were produced in the period but leadership and resources were lacking to implement the policies and programs indicated. Latterly, widespread publicity and greatly increased public and political interest in chronicdisease prevention, (especially in obesity and type 2 diabetes) have dominated the framework within which Australian policy deliberations have occurred. Finally, a national physical activity policy framework for the Health sector emerged, but not as a policy vision that was inclusive of the other essential sectors such as Education,Transport, Urban Planning as well as Sport and Recreation. Conclusion: Despite some progression of physical activity policy in the decade since 1995/6, this review found inconsistent policy development, both in Australia and elsewhere. Arguably, Australia has done no worse than other countries, but more effective responses to physical inactivity in populations can be built only on sustainable multi-sectoral public health policy partnerships that are well informed by evidence of effectiveness and good practice. In Australia and elsewhere prerequisites for success are political support, long-term investment and commitment to program implementation and evaluation. An urgent priority is media and political advocacy for physical activity focussed on these factors

Monitoring and Surveillance of Physical Activity in Children and Young People in Australia: Report of a National Consensus Workshop, December 2005

In April 2005 the National Public Health Partnership (NPHP) approved a project to develop a consensus approach to measurement of physical activity in children and young people (“the project”). The project related to an identified priority in Be Active Australia: A Framework for Health Sector Activity for Physical Activity 2005–2010. This priority has been endorsed by the Australian Health Ministers’ Council and by the Australia and New Zealand Food Regulation Ministerial Council. Arising from the project, a National Consensus Workshop (“the workshop”) hosted by the Chronic Disease and Injury Prevention (CDIP) Working Group of NPHP and organised by a project-specific steering committee, convened on 8–9 December 2005. At the time when the project was approved by the NPHP in April 2005, it was also known that the Australian Government was interested in establishing a National Nutrition and Physical Activity Monitoring System. The first stage, a National Children’s Nutrition and Physical Activity Survey, to commence in 2006, was announced in September 2005, with a $3M initial funding commitment ($1M from Department of Health and Ageing [DoHA], $1M from Department of Agriculture, Fisheries and Forestry [DAFF], and$1M from the Australian Food and Grocery Council); with a $1M ongoing commitment from DoHA towards the ongoing System. The workshop was intended to inform polic

Body mass Index of children and adolescent participants in a voucher program designed to incentivise participation in sport and physical activity: A cross-sectional study

There has been limited population-level success in tackling overweight and obesity. The Active Kids program is a universal intervention that aims to increase participation in structured physical activity and sport among children and adolescents in New South Wales (NSW), Australia. This study examined the prevalence of overweight and obesity across subgroups and by social disadvantage in this large broadly representative sample. A cross-sectional study was conducted including all children (n = 671,375) who registered for an Active Kids Program voucher in 2018. The child’s height and weight were obtained from an online registration form. Among children and adolescents who registered in the Active Kids Program, the prevalence of overweight and obesity was 17.2% and 7.6%, respectively. A large number of children and adolescents who lived in the most disadvantaged areas (n = 99,583; 14.8%) registered for the program. There was a clear socio-economic gradient for obesity prevalence across areas of increasing disadvantage, with children and adolescents living in the most disadvantaged area being 1.87 (95% CIs 1.82, 1.93) times more likely to be overweight or obese. The Active Kids program successfully reached a substantial proportion of children who are overweight and obese from socio-economically disadvantaged areas, providing financial support and opportunities for these children to participate in structured sport and physical activity. However, the program did not reach all children, and additional physical activity promotion strategies may be needed in a comprehensive approach. Nonetheless, these findings support government investment in reaching children who are overweight or obese with large-scale programs

Trends in physical activity participation and the impact of integrated campaigns among Australian adults, 1997–99

Abstract Objectives: To determine whether awareness of the moderate physical activity message and prevalence of participation changed among Australian adults between 1997 and 1999, and if changes differed across Australia. Methods: Data were compared on awareness of the moderate physical activity message and on physical activity participation from identical national physical activity surveys in 1997 and 1999. Results: In 1999, following integrated public health efforts, recognition of the Active Australia campaign was substantially higher in NSW/ACT (61.7%) than elsewhere (29.3%). Knowledge about benefits of moderate activity increased between 1997 and 1999, more so in States with public health campaigns. National participation in ‘sufficient physical activity’ declined between 1997 and 1999, from 63% to 57%, but the decline was smaller in NSW/ACT (4.4%) than in the other States (6.0%). Conclusions and implications: Declining trends in physical activity in Australia require increased public health investments, including strategic planning and public education, such as occurred in NSW (1997/98)

From 'car-dependency' to 'desirable walking' : 15 years trend in policy relevant public health indicators derived from Household Travel Surveys

Reducing car dependency in favour of health-enhancing active travel can address the issues of prolonged sitting and physical inactivity. This study utilises transportation-sector population surveys to develop interdisciplinary policy relevant indicators for benchmarking and progress tracking. The continuous Sydney Greater Metropolitan Household Travel Survey (2000-June 2015) was analysed in 2017. The prevalence of adults (≥15 years old) who i) travelled by car for distances amenable for health-enhancing walks (≤ 1.5 km,≤2.0kms); ii) only drove a car and did not walk, including no walks that link to other modes (i.e, CD: 'car-dependency'); and iii) walked≥30 min, or≥3 kms, or>3 walking trips (i.e., DW: 'desirable walking') in the past 24 hours were examined including prevalence ratios for CD/DW by population sub-groups (e.g., age, gender, employment status, income and household structure) and by statistical districts located within short (30kms) driving distance from Sydney Central District.The adjusted yearly decline in the prevalence of CD was small (0.3%) but significant, from 40.3% (95% CI: 39.6 - 41.1) in 2000/3 to 39.3% (38.1-40.1) in 2012/14. DW remained unchanged, from 20.6% (95% CI: 20.0; 21.2) to 21.2% (95%CI: 20.6-21.9). The CD/DW prevalence ratio varied greatly by distance from Sydney city, with medians ratios 0.86, 1.86 and 3.25 in short, medium and long distance categories, respectively, and by demographic sub-group (range from 0.64 to 2.67). The yearly prevalence ratios of CD/DW presented a declining trend from 1.42 to 1.13, after adjustment for population demographic characteristics. Across all periods 21% travelled by car for≤1.5kms, of those travellers 44% were car dependent. These indicators can serve both transportation and health sectors wherever transport surveys exist, for benchmarking, monitoring and setting area- specific goals that are aligned with public health and transport policies