University smoke-free policies in Australia: lessons for Indonesia

Background: Eliminating exposure to second-hand smoke is one of the best practices to control noncommunicable diseases. Indonesia has been dealing with growing burdens of noncommunicable disease due to the high and persistent prevalence of tobacco smoking in the country. On the other hand, Australia, a neighbouring country of Indonesia, shows an impressive progress in altering its national tobacco epidemic through the establishment of smoke-free policies. In recent years, Australia has extended its smoke-free policies to higher education institutions. Meanwhile, it is assumed that the scope and implementation of university smoke-free policies in Indonesia are still limited. Objectives: This paper aims to present evidence of Australian university smoke-free policies and to find gaps in the implementation of university smoke-free policies in Indonesia. Findings from an unpublished preliminary cross-sectional study on 100% smoke-free policies at The University of Queensland, Australia were synthesised with published literature on smoke-free policies at other Australian universities and higher education institutions. An online search was also conducted on Google Scholar and PubMed to find evidence of university smoke-free policies in Indonesia. Lessons Learnt: One study indicates that all universities in Australia have implemented smoke-free policies to various degrees. The aim of such policies is to promote wellness rather than to restrict smokers. Research is integral to the development and implementation of university smoke-free policies in Australia. Support from university staff and students, policy enforcement, provision of quit service on campus, awareness-raising, and avoiding stigmatisation of smokers are some important considerations in policy development and implementation. Meanwhile, the implementation of campus smoke-free policies in Indonesian universities is inadequate. The existing evidence is also lacking in quantity and quality. Collaborative efforts involving university stakeholders, researchers, staff, and students are prerequisite to successfully adopt smoke-free policies on university campuses in Indonesia

Cigarette smoking and e-cigarette use among university students in Queensland, Australia and New Zealand: results of two cross-sectional surveys

Objectives: Examine the patterns of cigarette smoking and e-cigarette use (vaping), the perceived harm of e-cigarettes compared with tobacco cigarettes, and associations between smoking and vaping with student characteristics. Design: Cross-sectional studies. Setting: The University of Queensland (UQ), Australia and eight New Zealand (NZ) universities. Participants: Students at UQ: 4957 (70.8% aged <25 years, 63.0% women) and NZ: 1854 (82.5% aged <25 years, 60.1% women). Methods: Χ2 tests compared smoking by age and gender, and vaping by age, gender and smoking status. Two-sided p<0.05 was considered significant and 95% CIs reported where appropriate. Multinomial logistic regression examined associations between smoking and vaping (exclusive smoking, exclusive vaping, dual use and non-use) with age, gender and student type (domestic vs international). Results: Smoking (UQ vs NZ, 95% CI): ever 45.2% (43.8% to 46.6%) vs 50.0% (47.7% to 52.3%), current 8.9% (8.1% to 9.7%) vs 10.4% (9.1% to 11.9%) and daily 5.2% (4.6% to 5.8%) vs 5.6% (4.6% to 6.7%), and not smoking in indoor 98.3% vs 87.7% or outdoor smoke-free spaces 83.8% vs 65.3%. Vaping (UQ vs NZ, 95% CI): ever 20.9% (19.8% to 22.1%) vs 37.6% (35.4% to 39.9%), current 1.8% (1.5% to 2.2%) vs 6.5% (5.4% to 7.7%) and daily 0.7% (0.5% to 1.0%) vs 2.5% (1.9% to 3.4%), and not vaping in indoor 91.4% vs 79.6% or outdoor smoke-free spaces 84.4% vs 71.3%. Of respondents, 71.7% (70.3% to 73.2%) vs 75.3% (72.9% to 77.6%) perceived e-cigarettes as less harmful than tobacco cigarettes. Men were more likely than women to smoke and vape, and to believe that e-cigarettes are less harmful. Regression models containing all predictors for smoking and vaping were significant and the effect of gender was significant for dual use, exclusive smoking and exclusive vaping (all p<0.01). Men had higher odds for smoking, vaping or dual use. Conclusions: Results suggest significant differences in patterns of smoking and vaping of university students in Australia and NZ, and a strong influence of gender on smoking and vaping

Relationships of Sun-Protection Habit Strength with Sunscreen Use During Outdoor Sport and Physical Activity

The objective of this cross-sectional questionnaire study was to assess associations of a self-report index of sun protection habit strength with sunscreen use in sporting environments and outdoor physical activity. Participants (n = 234) in field hockey, soccer, tennis and surf sports in Queensland, Australia, completed a self-administered survey on sun protection during organized sport, and during general outdoor physical activity during 2005/2006. The sun protection habit strength index was dichotomized into two categories. Multinomial logistic regression analyses assessed the associations of low versus high sun protection habit strength with three categories of sunscreen use (no or rare use; inadequate use; and adequate use). Compared to participants with low sun protection habit strength, those with high sun protection habit strength had significantly greater odds of any sunscreen use during organized sport and during general outdoor physical activity. This association was strongest for adequate sunscreen use in both settings. In conclusion, this study suggests that the measure of sun protection habit strength is a potentially useful assessment tool for future sun protection studies

Correlates of pedometer use: Results from a community-based physical activity intervention trial (10,000 Steps Rockhampton)

Background: Pedometers have become common place in physical activity promotion, yet little information exists on who is using them. The multi-strategy, community-based 10,000 Steps Rockhampton physical activity intervention trial provided an opportunity to examine correlates of pedometer use at the population level. Methods: Pedometer use was promoted across all intervention strategies including: local media, pedometer loan schemes through general practice, other health professionals and libraries, direct mail posted to dog owners, walking trail signage, and workplace competitions. Data on pedometer use were collected during the 2-year follow-up telephone interviews from random population samples in Rockhampton, Australia, and a matched comparison community (Mackay). Logistic regression analyses were used to determine the independent influence of interpersonal characteristics and program exposure variables on pedometer use. Results: Data from 2478 participants indicated that 18.1% of Rockhampton and 5.6% of Mackay participants used a pedometer in the previous 18-months. Rockhampton pedometer users (n = 222) were more likely to be female (OR = 1.59, 95% CI: 1.11, 2.23), aged 45 or older (OR = 1.69, 95% CI: 1.16, 2.46) and to have higher levels of education (university degree OR = 4.23, 95% CI: 1.86, 9.6). Respondents with a BMI > 30 were more likely to report using a pedometer (OR = 1.68, 95% CI: 1.11, 2.54) than those in the healthy weight range. Compared with those in full-time paid work, respondents in 'home duties' were significantly less likely to report pedometer use (OR = 0.18, 95% CI: 0.06, 0.53). Exposure to individual program components, in particular seeing 10,000 Steps street signage and walking trails or visiting the website, was also significantly associated with greater pedometer use. Conclusion: Pedometer use varies between population subgroups, and alternate strategies need to be investigated to engage men, people with lower levels of education and those in full-time 'home duties', when using pedometers in community-based physical activity promotion initiatives

Reducing office workers' sitting time: rationale and study design for the Stand Up Victoria cluster randomized trial

Background: Excessive time spent in sedentary behaviours (sitting or lying with low energy expenditure) is associated with an increased risk for type 2 diabetes, cardiovascular disease and some cancers. Desk-based office workers typically accumulate high amounts of daily sitting time, often in prolonged unbroken bouts. The Stand Up Victoria study aims to determine whether a 3-month multi-component intervention in the office setting reduces workplace sitting, particularly prolonged, unbroken sitting time, and results in improvements in cardio-metabolic biomarkers and work-related outcomes, compared to usual practice

Moderators of health behavior initiation and maintenance in a randomized telephone counseling trial

Objective. This study compares moderators of initiation and maintenance of health behavior changes

A randomized trial of a telephone-delivered exercise intervention for non-urban dwelling women newly diagnosed with breast cancer: Exercise for health

Physical activity is important following breast cancer. Trials of non-face-to-face interventions are needed to assist in reaching women living outside major metropolitan areas. This study seeks to evaluate the feasibility and effectiveness of a telephone-delivered, mixed aerobic and resistance exercise intervention for non-urban Australian women with breast cancer. A randomized controlled trial comparing an 8-month intervention delivered by exercise physiologists (n = 73) to usual care (n = 70). Sixty-one percent recruitment rate and 96% retention at 12 months; 79% of women in the intervention group received at least 75% of calls; odds (OR, 95% CI) of meeting intervention targets favored the intervention group for resistance training (OR 3.2; 1.2, 8.9) and aerobic (OR 2.1; 0.8, 5.5) activity. Given the limited availability of physical activity programs for non-urban women with breast cancer, results provide strong support for feasibility and modest support for the efficacy of telephone-delivered interventions

Food choices of young adults in the United States of America: a scoping review

Understanding food choice is critical to developing effective health promotion efforts to counter the leading causes of morbidity and mortality in the United States. Although physiologic, environmental, and social factors influence the development of health conditions, routine decisions, such as food choice, also contribute substantially over time. Behavioral scientists believe that these routine decisions represent a key opportunity to improve population health. We conducted a scoping review of both health and business literature to identify themes in the food choices of young adults aged 19-24 y in the United States. Informed by the Joanna Briggs Institute processes for scoping reviews, we conducted a structured search of 8 health and business databases on 18 April 2017. The databases were PubMed, Business Source Complete, PsycInfo, Cochrane Library, CINAHL, Web of Science, SCOPUS, and ABI/Inform Collection. Eligible literature captured real-world dietary choices of the general population of young adults between 1 January, 2007 and 31 December, 2017. Records were screened in Covidence. Data was extracted into Excel and key findings thematically analyzed. The search returned 9085 records. Ninety-nine records met the eligibility criteria. Themes identified in the foods chosen by young adults include inadequate fruit and vegetable consumption, choosing international flavors and food formats, convenience foods, frequent snacking, the selection of healthy foods based on perceptions of what is healthy rather than the nutrient or calorie content of foods, an interest in sustainable production methods, the desire to customize/tailor foods, foods young people find interesting, and regional foods. This research identified common food choices that can help inform the tailoring of health promotion efforts; however, more research is needed to understand the underlying mechanisms and principles shaping these choices

Limiting swimming pool outbreaks of cryptosporidiosis – the roles of regulations, staff, patrons and research

Cryptosporidium is the leading cause of swimming pool outbreaks of gastroenteritis. Transmission occurs through the ingestion of oocysts that are passed in the faeces of an infected person or animal when an accidental faecal release event occurs. Cryptosporidium parasites present specific challenges for infection control as oocysts are highly resistant to chlorine levels used for pool disinfection, infected individuals can shed large numbers of oocysts, there is a long incubation period and shedding of oocysts occurs even after symptom resolution. The purposes of this review are to identify key barriers to limiting swimming poolassociated outbreaks of cryptosporidiosis and to outline needs for research and collaboration to advance co-ordinated management practices. We reviewed swimming pool-associated cryptosporidiosis outbreaks, disinfection teachniques, current regulations and the role of staff and patrons. Key barriers to limiting swimming pool-associated outbreaks of cryptosporidiosis are a lack of uniform national and international standards, poor adherence and understanding of regulations governing staff and patron behaviour, and low levels of public knowledge and awareness

The effectiveness of mHealth for self-management in improving pain, psychological distress, fatigue, and sleep in cancer survivors: a systematic review

Integrating mHealth into the cancer care continuum may be an effective strategy to improve cancer survivorship care by supporting self-management. We aim to assess the effectiveness of mHealth applications (apps) for self-management in improving pain, psychological distress, fatigue, or sleep outcomes in adult cancer survivors.Experimental quantitative studies evaluating apps aiming to support self-management for adult cancer survivors and reporting pain, psychological distress, fatigue, or sleep outcomes were included. PubMed, Web of Science, Embase, CINAHL, PsycINFO, Scopus, and CENTRAL databases were searched from inception through December 2017. Risk of bias was assessed using the Cochrane risk of bias tool (PROSPERO registration number CRD42017081182).Seven studies of six mHealth interventions (n = 949 participants) were included. Two randomized controlled trials (RCTs), one quasi-RCT, one non-RCT, and three single-arm studies involved survivors with a mix of cancer types. The most common app features were symptom questionnaires (n = 5) and progress tracking (n = 5). Four studies reported outcomes for pain, with three showing improvements. Two studies reported psychological distress outcomes, showing mixed results. Four studies reported improvements in fatigue post-intervention or in the intervention compared with control group, but the changes were not all statistically significant. Two studies reported improvements in sleep outcomes.There is emerging evidence that mHealth interventions that support self-management can improve pain and fatigue outcomes in cancer survivors, and some promise for psychological distress and sleep outcomes. Further development and investigation of mHealth is needed, incorporating targeted, evidence-based models of care into app design.mHealth interventions can improve outcomes for cancer survivors and have significant potential to benefit this growing population due to their reach