Older adults' evaluations of the standard and modified pedometer-based Green Prescription

INTRODUCTION: The Green Prescription is a primary care programme designed to increase physical activity in individuals with low activity levels. Older adults tend to engage in insufficient physical activity to obtain health-related gain. AIM: To examine participants’ ratings of the Healthy Steps intervention and to assess how participants rated the use of a pedometer-based Green Prescription in aiding their physical activity. METHODS: In total, 330 community-dwelling older adults who have low levels of activity were randomised to receive either a standard time-based Green Prescription or a modified pedometer-based Green Prescription. Post-intervention, 259 participants completed the participant evaluation questionnaire via postal survey. Data were analysed using descriptive statistics and Chi-squared analyses. RESULTS: The standard components of the Green Prescription (general practitioner consultations and telephone counselling) received similar and higher ratings across both allocation groups than the use of print materials. A pedometer-based Green Prescription was rated as being helpful in aiding physical activity. DISCUSSION: This study supports the importance of general practitioners’ initial role in prescribing physical activity for older adults and of ongoing telephone support for longer-term adherence. Incorporating a pedometer can be effective in helping low-active older adults initiate and maintain regular physical activity

Active lifestyles related to excellent self-rated health and quality of life: cross sectional findings from 194,545 participants in The 45 and Up Study

Background: Physical activity and sitting time independently contribute to chronic disease risk, though little work has focused on aspirational health outcomes. The purpose of this study was to examine associations between physical activity, sitting time, and excellent overall health (ExH) and quality of life (ExQoL) in Australian adults. Methods: The 45 and Up Study is a large Australian prospective cohort study (n = 267,153). Present analyses are from 194,545 participants (48% male; mean age = 61.6 ± 10.7 yrs) with complete baseline questionnaire data on exposures, outcomes, and potential confounders (age, income, education, smoking, marital status, weight status, sex, residential remoteness and economic advantage, functional limitation and chronic disease). The Active Australia survey was used to assess walking, moderate, and vigorous physical activity. Sitting time was determined by asking participants to indicate number of hours per day usually spent sitting. Participants reported overall health and quality of life, using a five-point scale (excellent—poor). Binary logistic regression models were used to analyze associations, controlling for potential confounders. Results: Approximately 16.5% of participants reported ExH, and 25.7% reported ExQoL. In fully adjusted models, physical activity was positively associated with ExH (AOR = adjusted odds ratio for most versus least active = 2.22, 95% CI = 2.20, 2.47; P[subscript trend] < 0.001) and ExQoL (AOR for most versus least active = 2.30, 95% CI = 2.12, 2.49; P[subscript trend]  < 0.001). In fully adjusted models, sitting time was inversely associated with ExH (AOR for least versus most sitting group = 1.13, 95% CI = 1.09, 1.18; P[subscript trend]  < 0.001) and ExQoL (AOR for least versus most sitting group = 1.13, 95% CI = 1.10, 1.17; P[subscript trend]  < 0.001). In fully adjusted models, interactions between physical activity and sitting time were not significant for ExH (P = 0.118) or ExQoL (P = 0.296). Conclusions: Physical activity and sitting time are independently associated with excellent health and quality of life in this large diverse sample of Australian middle-aged and older adults. These findings bolster evidence informing health promotion efforts to increase PA and decrease sitting time toward the achievement of better population health and the pursuit of successful aging

Physical activity and physical function in older adults: the 45 and up study

OBJECTIVES: To determine the strength of the relationship between physical activity and physical function in older adults. DESIGN: Cross-sectional. SETTING: The 45 and Up Study baseline questionnaire, New South Wales, Australia. PARTICIPANTS: Ninety-one thousand three hundred seventy-five Australian men and women aged 65 and older from the 45 and Up Study. MEASUREMENTS: Physical activity engagement (Active Australia Survey), physical function (Medical Outcomes Study Physical Functioning), psychological distress (Kessler- 10), and self-reported age, smoking history, education, height, and weight were all measured. RESULTS: Higher levels of physical activity were associated with better physical function in older adults (correlation coefficient = 0.166, P < .001). Participants engaging in higher levels of physical activity had progressively lower likelihoods of functional limitation (middle tertile: odds ratio (OR) = 0.39, 95% confidence interval (CI) = 0.38– 0.41; highest tertile: OR = 0.28, 95% CI = 0.27–0.29). This relationship remained significant, but weakened slightly, when adjusted for age, sex, body mass index, smoking history, psychological distress, and educational attainment (middle tertile: adjusted OR (AOR) = 0.48, 95% CI = 0.46–0.50; highest tertile: AOR = 0.36, 95% CI = 0.34–0.37). CONCLUSION: There is a significant, positive relationship between physical activity and physical function in older adults, with older adults who are more physically active being less likely to experience functional limitation than their more-sedentary counterparts. Level of engagement in physical activity is an important predictor of physical function in older adults

Feasibility and acceptability of a culturally tailored physical activity intervention for Arab-Australian women

Background: Despite being one of the largest migrant groups in Australia, few physical activity interventions exist for Arab-Australians. The primary aim of this study was to test the feasibility and acceptability of a 12-week culturally tailored physical activity intervention for Arab-Australian women. Methods: This study used a single-group pretest–posttest design, and was informed by extensive formative research and consultation involving the Arab-Australian community. Participants were insufficiently active Arab-Australian women aged 35–64 with no current illness or injury that would limit physical activity participation. The intervention comprised 6 face-to-face physical activity and education sessions over 12 weeks. The intervention was conducted at 2 separate intervention sites in Western Sydney, Australia. Feasibility outcomes included recruitment, session attendance, and retention. The acceptability of the intervention was assessed through a process evaluation questionnaire completed post-intervention. Accelerometers and the short-form International Physical Activity Questionnaire were used to measure physical activity at baseline and post-intervention. Descriptive statistics were used for feasibility and acceptability outcomes, and changes in physical activity were examined using Wilcoxon signed-rank tests. Results: Of the 53 women who were contacted or expressed interest, 22 were eligible and enrolled in the study. Participants were primarily recruited through direct contact by Arab-Australian community workers and by word-of-mouth. Average session attendance was 63% and the retention rate post-intervention was 68%. The culturally-related intervention components, such as the appropriateness of content, and women-only setting, were rated highly favourably (4.33 to 4.87/5). General intervention elements, such as the face-to-face delivery, knowledge and approachability of facilitators, and session structure, were also rated favourably (4.33 to 4.93/5), and the lowest scored item was the intervention session frequency (3.2/5). There were no statistically significant changes in physical activity post-intervention. Conclusions: The findings from this study highlighted factors related to recruitment and delivery that need to be considered when developing physical activity interventions for Arab-Australian women. Further research is required using a larger sample and a randomised controlled trial design to examine the longer-term impact on physical activity, and to also examine ways of increasing intervention engagement and retention among Arab-Australian women

Increasing girls’ physical activity during an organised youth sport basketball program: a randomised controlled trial protocol

Background: Participation in organised youth sports (OYS) has been recommended as an opportunity to increase young peoples’ moderate-to-vigorous physical activity (MVPA) levels. Participants, however, spend a considerable proportion of time during OYS inactive. The purpose of this study, therefore, was to investigate whether coaches who attended coach education sessions (where education on increasing MVPA and decreasing inactivity during training was delivered) can increase players’ MVPA during training sessions over a 5-day basketball program compared to coaches who did not receive coach education sessions. Methods/design: A convenience sample of 80 female players and 8 coaches were recruited into the UWS School Holiday Basketball Program in Greater Western Sydney, Australia. A two-arm, parallel-group randomised controlled trial was employed to investigate whether coaches who attended 2 coach education sessions (compared with a no-treatment control) can increase their players’ MVPA during training sessions over a 5-day basketball program. Objectively measured physical activity, directly observed lesson context and leader behaviour, player motivation, players’ perceived autonomy support, and coaching information (regarding training session planning, estimations on player physical activity and lesson context during training, perceived ability to modify training sessions, perceived importance of physical activity during training, intention to increase physical activity/reduce inactivity, and likelihood of increasing physical activity/reducing inactivity) were assessed at baseline (day 1) and at follow-up (day 5). Linear mixed models will be used to analyse between arm differences in changes from baseline to follow-up on all outcomes. Discussion: The current trial protocol describes, to our knowledge, the first trial conducted in an OYS context to investigate the efficacy of an intervention, relative to a control, in increasing MVPA. This study’s findings will provide evidence to inform strategies targeting coaches to increase MVPA in OYS, which could have major public health implications, given the high proportion of children and adolescents who participate in OYS globally

Does rising crime lead to increasing distress? Longitudinal analysis of a natural experiment with dynamic objective neighbourhood measures

Identifying ‘neighbourhood effects’ to support widespread beliefs that where we live matters for our health remains a major challenge due to the reliance upon observational data. In this study we reassess the issue of local crime rates and psychological distress by applying unobserved bias models to a sample of participants who remain in the same neighbourhoods throughout the study. Baseline data was extracted from the 45 and Up Study between 2006 and 2008 and followed up as part of the Social Economic and Environmental Factors (SEEF) Study between 2009 and 2010. Kessler 10 scores were recorded for 25 545 men and 29 299 women reported valid outcomes. Annual crime rates per 1,000 (including non-domestic violence, malicious damage, break and enter, and stealing, theft and robbery) from 2006 to 2010 inclusive were linked to the person-level data. Change in exposure to crime among participants in this study, therefore, occurs as a result of a change in the local crime rate, rather than a process of neighbourhood selection. Gender stratified unobserved bias logistic regression adjusting for sources of time-varying confounding (age, income, employment, couple status and physical functioning) indicated that an increase in the risk of experiencing psychological distress was generally associated with an increase in the level of neighbourhood crime. Effect sizes were particularly high for women, especially for an increase in malicious damage (Odds Ratio Tertile 3 vs Tertile 1 2.40, 95% Confidence Interval 1.88, 3.05), which may indicate that damage to local built environment is an important pathway linking neighbourhood crime with psychological distress. No statistically significant association was detected for an increase in non-domestic violence, although the effect was in the hypothesised direction. In summary, the application of unobserved bias models to analyse data that takes into account the temporally dynamic characteristics of where people live warrants further investigation.PostprintPeer reviewe

Do coaches perceive themselves as influential on physical activity for girls in organised youth sport?

Participation in organised youth sports (OYS) has been recommended as an opportunity to increase young peoples’ physical activity (PA) levels. While coaches can potentially influence athletes’ PA levels, what has not been explored is the question; do coaches perceive themselves as influential on PA for girls in OYS? Participants were 30 coaches of girls OYS teams aged 9–17 years in the Greater Sydney Metropolitan Area, Australia. Participants took part in a semi-structured interview that lasted approximately 30 minutes. They responded to questions regarding their perceived role as coaches, their perceptions of themselves as role models for PA, their views on their athletes’ current PA levels, their opinions on improving their athletes’ PA levels, and their perceived challenges as coaches in OYS. Many coaches considered themselves role models for PA due to their own involvement in organised sports. Coaches felt that they were conscious of girls’ PA levels during training and could accurately gauge how active girls were. Coaches perceived their training sessions to provide sufficient PA and thus, did not feel the need to try to increase PA during training. Many coaches were cautious about conducting training sessions where the PA intensity was high for prolonged periods because they believed that it could potentially result in dropout from OYS. Coaches’ perceived time commitment to OYS, variability of skill/experience amongst girls, and poor parental support as major challenges they experienced in OYS. This study provided a unique insight from the perspective of coaches in OYS. Most coaches felt that they had the potential to influence PA for girls in OYS; however, coaches may underestimate or not fully realise the impact they can have on the girls they coach. Future research should focus on educating coaches to capitalise on the opportunity they have to promote PA through OYS

Social support for youth physical activity: Importance of siblings, parents, friends and school support across a segmented school day

<p>Abstract</p> <p>Background</p> <p>Whilst evidence exists for the influence of encouragement on physical activity participation, the diversity of support sources and the type of physical activity examined previously is limited. This study examined the importance of perceived encouragement from parents, siblings/cousins, friends, and schools on participation levels across three time-specific activity opportunities that are available during a school day (after-school physical activities, lunchtime activity, and active transportation to and from school).</p> <p>Methods</p> <p>A cross-sectional sample of 12–18 year old high school students (n = 3,471) were recruited from low SES schools within South Auckland, New Zealand and categorised as either Junior (Years 9–11) or Senior (Years 12 & 13) students. Participants reported their physical activity levels and quantity of encouragement received from their parent(s), friend(s), sibling(s)/cousin(s), and school to be active. For each physical activity variable participants were dichotomized as being either "active" or "less active". For each social support source, participants were grouped into either receiving "high" or "low" levels of support. Binary logistic regression analyzes were conducted to calculate odd ratios and 95% confidence intervals.</p> <p>Results</p> <p>Low parental support (Juniors, OR: 0.47, 95% CI: 0.38–0.58; Seniors, OR: 0.41, 95% CI: 0.29–0.60) and low peer support (Juniors, OR: 0.61, 95% CI: 0.51–0.74; Seniors, OR: 0.49, 95% CI: 0.35–0.69) were associated with reduced odds of being regularly active after school. For lunchtime activity, low peer support (Juniors, OR: 0.39, 95% CI: 0.32–0.48; Seniors, OR: 0.41, 95% CI: 0.29–0.57) was associated with reduced odds of being categorized as active. While no variables were significantly related to active transportation among senior students, low peer support was associated with reduced odds of actively commuting for Junior students (OR: 0.78, 95% CI: 0.66–0.92). Irrespective of the activity examined, no significant difference was noted for students receiving high support from two parents than students reporting high support from their sole parent in a single parent family.</p> <p>Conclusion</p> <p>The importance of encouragement from parents, siblings, friends, and schools on physical activity is dependant on the time-specific activity examined. It is clear that proximal social networks need to be considered during the development of physical activity promotion strategies.</p

Psychological distress among carers and the moderating effects of social support

Background Carers provide both practical and emotional support and often play an important role in coordination of care for recipients. The demands of caring may lead to increased levels of stress for the carer, which can affect mental health and quality of life. This study examined the relationship between being a carer and psychological distress (assessed using the Kessler Psychological Distress Scale [K10]), and explored the moderating effect of social support in that relationship using a large sample. Methods The study used data from the 45 and Up study, a large cohort study of individuals aged 45 years and over in New South Wales, Australia, and applied multiple regression methods and moderation analysis. The sample for the current study comprised 267,041 participants drawn from the baseline dataset, with valid data on the primary outcome (carer status). Results The mean age of participants was 62.73 (±11.18) years, and 4.23% and 7.13% were identified as full-time and part-time carers, respectively. Compared to non-carers, full-time carers had K10 scores that were on average, higher by 1.87, while part-time carers’ K10 scores were on average higher by 1.60 points. A perception of social support reduced the strength of the relationship between carer status and psychological distress by 40% for full-time carers and 60% for part-time carers. Conclusions The findings have important implications, for both prevention and treatment of psychological problems among carers. In terms of prevention, they suggest that public health campaigns focused on increasing awareness regarding the psychological burden faced by carers would be useful. In terms of intervention, potential treatments that focus on improving social support networks may be helpful. The results are particularly important in the current context of an ageing population in Australian and other developed countries, where caregiving is likely to play an increasing role in the care and support services

The green prescription and older adults:What do general practitioners see as barriers?

Introduction: Limited research exists that has examined the barriers that older adults (those aged 65 years and older) can encounter when given a Green Prescription (GRx)). This study aimed to identify what general practitioners (GPs) perceived their older-aged patients' barriers were with regard to carrying out a GRx. This study also identified the strategies that GPs used to assist their older-aged patients in overcoming barriers to physical activity engagement. Methods: Fifteen GPs from the Auckland region of New Zealand were interviewed individually. An inductive thematic approach was used to analyse data. Findings: GPs identified chronic health conditions, fear of injury, transportation contraints, set routines and lack of confidence as being barriers that some of their older-aged patients have encountered when considering whether to become more physically active and, also, when engaging in actual physical activity. Conclusion: Physical activity interventions, such as the GRx programme, can have an important role in helping confer health-related gain for low-active older adults. To ensure that such interventions are successful on a long-term basis, practitioners need to be aware of the barriers that their older-aged patients can encounter when given a prescription for physical activity