Physical activity and Aboriginal and Torres Strait Islander People in Australia

Background Globally, non-communicable diseases (NCDs) such as cardiovascular disease and diabetes represent an issue of epidemic proportion, responsible for tens of millions of premature deaths annually. NCDs are also responsible for reducing quality of life and causing detrimental social and economic effects. Disparities across population groups are evident. In Australia, NCDs were a leading cause of the total burden of disease in 2011. Aboriginal and Torres Strait Islanders have a shorter life expectancy and poorer health risk factors and outcomes than non-Indigenous Australians. Much of this gap in life expectancy has been attributed to preventable NCDs. Physical activity is a key modifiable cause of the excess burden of disease and mortality. Among Aboriginal and Torres Strait Islanders, there is a lack of evidence around the associations between physical activity and health and demographic factors and the impact of strategies to increase physical activity, compared to mainstream evidence. Aims This thesis aims to contribute towards building an evidence base around the association of physical activity on the health of Aboriginal and Torres Strait Islanders. The first aim is to examine cross-sectional associations between physical activity and a range of lifestyle, environmental and social factors among adults. Subsequently, the thesis identifies and describes physical activity patterns and influencing factors among adolescents. The third aim is to describe characteristics of physical activity programs targeting Aboriginal and Torres Strait Islanders. Lastly, the thesis aims to measure the effects of a community-based physical activity program. Methods The series of studies used a range of methods. The first study examined whether achievement of national physical activity recommendations was associated with healthy lifestyle behaviours, neighbourhood environmental characteristics and social support among Aboriginal and non- Aboriginal adults in New South Wales (NSW) (Chapter 2). The second study examined cross-sectional demographic, social, psychosocial and health correlates of physical activity among Aboriginal and non- Aboriginal adolescents in NSW (Chapter 3). The third study examined age related declines in physical activity among Aboriginal and non-Aboriginal young people and their variation by season, setting and type among Aboriginal and non-Aboriginal children from between 2007/8 and 2011/12 (Chapter 4). The fourth study reviewed the scientific and grey literature for physical activity programs targeting Aboriginal and Torres Strait Islanders operating between 2012 and 2015, described their characteristics and engaged with program coordinators to verify sourced information (Chapter 5). The final study examined the health and community impacts of the Indigenous Marathon Program (IMP) in a remote Torres Strait island community, using questionnaire and semi-structured interview mixed methods (Chapter 6). Results In Chapter 2, a similar proportion of Aboriginal and non-Aboriginal adults achieved national physical activity recommendations and factors relating to achieving recommendations were similar in both groups. However, neighbourhood features and social support were less favourable among Aboriginal adults. Among Aboriginal and non-Aboriginal adolescents, physical activity levels were similarly low but some correlates differed by Aboriginality (Chapter 3). Aboriginal girls were less active than boys, as were those whose mothers were unemployed. In Chapter 4, serial physical activity declines were found in a population of Aboriginal and non-Aboriginal young people over five years, but not across all seasons, settings and types. Chapter 5, identifies 110 programs that aimed to increase physical activity for health or broader social outcomes. Around half were found to collect process or impact evaluation data but this is underrepresented in the scientific literature. In Chapter 6, impacts of Indigenous Marathon Program were the adoption of running and broader healthy lifestyle factors in a remote community with a high initial level of community readiness. Barriers to running were both personal, cultural and environmental. Conclusion The findings from this thesis make a novel contribution to building an evidence base of associations between physical activity and the health of Aboriginal and Torres Strait Islanders. A number of factors associated with physical activity in adults and children are unique to Aboriginal and Torres Strait Islanders populations; other factors are similar to those experienced by mainstream populations. It is vitally important that physical activity programs that aim to improve health or social outcomes can determine their value through evaluation

Sports sponsorship and kids\u27 health: who are the real winners?

Over the weekend, Australian children and their parents witnessed some of the country\u27s finest sportsmen display feats of strength, skill and endurance in the Australian Football League (AFL) and National Rugby League (NRL) grand finals. I\u27m sure many young people would have been inspired to emulate the actions and successes of their heroes. What spectators and viewers would also have seen was the paradoxical promotion of Carlton breweries and McDonalds in commercial advertisements during the games. The websites of the NRL, AFL reveal a similar picture of sponsorship and marketing by unhealthy food and drink companies such as Coca-Cola and Red Bull. We\u27ve also recently seen television adverts for Coles and Cadbury\u27s, where Adam Goodes, the captain of the winning Sydney Swans, and player Dale Thomas promote products that are hardly the fuel of champions. It\u27s understood, and even expected, that adults might enjoy a few beers and perhaps some pub food during these annual events (and, no doubt, at player post-match celebrations). But the impact of ever-present junk food and alcohol advertising on those of a more impressionable age is of concern

Review of physical activity among Indigenous people

Physical activity is important for all Australians, particularly in the prevention, management and treatment of chronic conditions, and for social and emotional wellbeing. Chronic health conditions, including cardiovascular conditions, endocrine conditions (such as diabetes), and certain cancers, account for 70% of the observed difference in the burden of disease between the Indigenous and non-Indigenous populations. Modifiable risk factors, particularly behavioural determinants such as physical activity, can help to reduce the extent and impact of these conditions, and assist in the prevention, management and treatment of disease. The levels and impacts of physical inactivity are greater for Indigenous people than they are for other Australians. Physical inactivity has been cited as the second leading cause of disease burden in Australia, and the third leading cause of disease burden for Indigenous people

Reported changes in cycling habits among older adults during the early months of the COVID-19 pandemic, New South Wales, Australia

The im.pact of the 2020 COVID-19 pandemic and the associated public health measures enacted by governments globally bad a significant impact on all aspects of human life including economic activity and mobility. One of the main public health measures designed to reduce the transmission of the SAR-Co V-2 vims have been the implementation ofvarious levels of lockdowns that limited mobility and resulted in almost half of the world's population UD.der som.e form of confinement. Many govemm.ents, including in Australia, UK, and Norway, enacted flexible forms oflockdowns that allowed daily outdoor exercise, while adhering to safe physical distancing, in recognition of the role of physical activity in reducing the mental and physical consequences of confinement. Australia saw first strict lockdown restrictions over March/April 2020 with progressive easing of restrictions during May and Ju.ne 2020. Emerging evidence from these countries has indicated that physical activity, particularly cycling, increased over the lockdown period and the following months as some restrictions were eased. However, many have wamed of a decline in physical activity with serious health consequences among older adults who were at a high.er risk: of m.orbidity and fatality associated with COVID-19 and were m.ore likely tobe confined to their homes for longer periods compared to younger age groups. The aim ofthis stu.dy was to investigate the impact ofCOVID-19 pandemic on cycling activity among older adults aged 50 years and over in New South Wales (NSW), Australia during the early months of the COVID-19 pandemic

Physical activity and the social and emotional wellbeing of First Nations people

For First Nations people in Australia, ‘social and emotional wellbeing’ (SEWB) is the foundation of physical and mental health. It is a term that aligns with First Nations ways of knowing, being and doing, and the concept that the self is inseparable from (and embedded within) family and community. This holistic approach is vital in addressing the significant psychological distress experienced by First Nations adults, because it acknowledges historical, cultural and societal influences. Engaging in physical activity is a part of First Nations culture, traditional customs, practices and connection to Country. It fosters cultural identity and community cohesion — integral components of SEWB for First Nations people — and offers holistic health benefits and protection against mental health issues and chronic diseases. While physical activity rates are higher among First Nations children compared with non-Indigenous children, a decline is observed in adulthood, prompting a need to understand changes and respond with effective strategies to increase participation in physical activity. This article summarises existing evidence on physical activity and First Nations SEWB. It describes the policy context and actions as well as program approaches implemented with First Nations adults and children living in Australia. It concludes with a summary of the key messages from this report that is essential information for understanding First Nations physical activity participation and SEWB

A Review of Available Information on Workplace Physical Activity and Nutrition Challenges

This review examined the evidence surrounding workplace nutrition and physical activity challenge events and the extent of these challenges in Australia, and internationally. A search of the peer-reviewed literature, grey literature and websites revealed 18 peer-reviewed studies meeting the inclusion criteria, six reports involving evaluations of workplace challenges, and a number of websites supporting challenge events

The facilitators and barriers to exercise in the Noongar Aboriginal population in Perth, Australia

Indigenous Standpoint Theory forms the epistemological foundation for this study and methodological choices were made within this theoretical framework to ensure culturally responsive research processes that engaged the Indigenous agenda of self-determination and rights. The objectives of this research were to determine: (i) Indigenous perceptions of the facilitators and barriers to exercise; (ii) The potential feasibility and sustainability of an exercise intervention. In this context, Participatory Action Research methods were used to design the data-gathering instrument for the study—a questionnaire, co-designed with the Noongar Aboriginal community of Perth, Western Australia. This self-administered questionnaire, distributed to participants by email, post and manual delivery, sought to elicit the factors that impact uptake and retention of regular exercise activities. Questionnaire data included individual demographic detail and specific question responses on labelled 5 point Likert Scales. Specific question responses were tabulated by Likert Scale label category and the response distribution for each question was enumerated. Simple descriptive statistics (measures of central tendency and variance) were used to characterize the data set and the Chi squared test was used to evaluate frequency differences between males and females. A total of 133 participants (71 females) completed the questionnaire. The results indicated that people valued exercise. The most common barriers indicated by participants were exercising with an injury (63%), changing diet (58%), finding time to exercise every day (55%) and exercising the next day with pain from exercising the day before (54%). A larger proportion of males (34%) than females (24%) reported greater ease in finding time to exercise every day (p \u3c 0.05). Facilitators mainly related to the potential social and community benefits of exercising with other people, preferably in small groups, and the importance of a culturally secure venue. These findings shed light on what a culturally secure exercise programme might involve for the Noongar community. As this may have implications for other Aboriginal and Torres Strait Islander and international First Nations’ Peoples, more focused research is needed on the place of traditional physical activities and the nature of culturally secure exercise programmes and spaces to enable wider application

Physical activity and self-reported metabolic syndrome risk factors in the Aboriginal population in Perth, Australia, measured using an adaptation of the global physical activity questionnaire (gpaq)

Background: Complex, ongoing social factors have led to a context where metabolic syndrome (MetS) is disproportionately high in Aboriginal Australians. MetS is characterised by insulin resistance, abdominal obesity, hypertension, hypertriglyceridemia, high blood-sugar and low HDL-C. This descriptive study aimed to document physical activity levels, including domains and intensity and sedentary behaviour, and MetS risk factors in the Perth Aboriginal (predominately Noongar) community. Methods: The Global Physical Activity Questionnaire (GPAQ), together with a questionnaire on self-reported MetS risk factors, was circulated to community members for completion during 2014 (n = 129). Results: Data were analysed using chi-squared tests. The average (SD) age was 37.8 years (14) and BMI of 31.4 (8.2) kg/m2 . Occupational, transport-related and leisure-time physical activity (PA) and sedentary intensities were reported across age categories. The median (interquartile range) daily sedentary time was 200 (78, 435), 240 (120, 420) and 180 (60, 300) minutes for the 18–25, 26–44 and 45+ year-olds, respectively (p = 0.973). Conclusions: An in-depth understanding of the types, frequencies and intensities of PA reported for the Perth Aboriginal community is important to implementing targeted strategies to reduce the prevalence of chronic disease in this context. Future efforts collaborating with community should aim to reduce the risk factors associated with MetS and improve quality of life

The association between post-migration nutrition and lifestyle transition and the risk of developing chronic diseases among sub-Saharan African migrants : a mixed method systematic review protocol

Sub-Saharan African (SSA) migrants face nutrition and lifestyle changes upon arrival in a host country. The shift in diet and lifestyle reflects post-migration acculturation and could predispose migrants to nutrition-and lifestyle-related chronic diseases. A mixed-methods systematic review of published studies and the grey literature on post-migration nutrition and lifestyle transition among SSA migrants will be undertaken. Studies published in English and conducted from 2000 to 2020 using quantitative and/or qualitative methods will be included. Ten bibliographic databases will be searched: Scopus, Ovid MEDLINE, EMBASE, Global Health, CINAHL, PubMed, ProQuest, PsycINFO, Informit and Web of Science. Data extraction will be informed by the Cochrane PROGRESS-Plus framework and the Joanna Briggs Institute manual. The quality of the included studies will be appraised for risk of bias using validated tools. An integrated approach to quantitative and qualitative data synthesis through data transformation will be undertaken, and a narrative synthesis of the findings will be provided. This protocol is guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols (PRISMA-P) guidelines and provides insight into the scope and parameters of the systematic review to be conducted. The aim of the review is to evaluate the association between post-migration nutrition and lifestyle transition and the risk of developing chronic diseases among SSA migrants in Australia. This review will provide insight into possible areas for interventions to improve the health of migrants. Systematic Review Registration: The protocol was registered with the PROSPERO international prospective register of systematic reviews CRD42020206560

Are sitting occupations associated with increased all-cause, cancer, and cardiovascular disease mortality risk? A pooled analysis of seven British population cohorts

Background: There is mounting evidence for associations between sedentary behaviours and adverse health outcomes, although the data on occupational sitting and mortality risk remain equivocal. The aim of this study was to determine the association between occupational sitting and cardiovascular, cancer and all-cause mortality in a pooled sample of seven British general population cohorts. Methods: The sample comprised 5380 women and 5788 men in employment who were drawn from five Health Survey for England and two Scottish Health Survey cohorts. Participants were classified as reporting standing, walking or sitting in their work time and followed up over 12.9 years for mortality. Data were modelled using Cox proportional hazard regression adjusted for age, waist circumference, self-reported general health, frequency of alcohol intake, cigarette smoking, nonoccupational physical activity, prevalent cardiovascular disease and cancer at baseline, psychological health, social class, and education. Results: In total there were 754 all-cause deaths. In women, a standing/walking occupation was associated with lower risk of all-cause (fully adjusted hazard ratio [HR] = 0.68, 95% CI 0.52–0.89) and cancer (HR = 0.60, 95% CI 0.43–0.85) mortality, compared to sitting occupations. There were no associations in men. In analyses with combined occupational type and leisure-time physical activity, the risk of all-cause mortality was lowest in participants with non-sitting occupations and high leisure-time activity. Conclusions: Sitting occupations are linked to increased risk for all-cause and cancer mortality in women only, but no such associations exist for cardiovascular mortality in men or women