Evaluation of the childhood obesity prevention program Kids - 'Go for your life'

BackgroundKids - \u27Go for your life\u27 (K-GFYL) is an award-based health promotion program being implemented across Victoria, Australia. The program aims to reduce the risk of childhood obesity by improving the socio-cultural, policy and physical environments in children\u27s care and educational settings. Membership of the K-GFYL program is open to all primary and pre-schools and early childhood services across the State. Once in the program, member schools and services are centrally supported to undertake the health promotion (intervention) activities. Once the K-GFYL program \u27criteria\u27 are reached the school/service is assessed and \u27awarded\u27. This paper describes the design of the evaluation of the statewide K-GFYL intervention program.Methods/DesignThe evaluation is mixed method and cross sectional and aims to:1) Determine if K-GFYL award status is associated with more health promoting environments in schools/services compared to those who are members only;2) Determine if children attending K-GFYL award schools/services have higher levels of healthy eating and physical activity-related behaviors compared to those who are members only;3) Examine the barriers to implementing and achieving the K-GFYL award; and4) Determine the economic cost of implementing K-GFYL in primary schoolsParent surveys will capture information about the home environment and child dietary and physical activity-related behaviors. Environmental questionnaires in early childhood settings and schools will capture information on the physical activity and nutrition environment and current health promotion activities. Lunchbox surveys and a set of open-ended questions for kindergarten parents will provide additional data. Resource use associated with the intervention activities will be collected from primary schools for cost analysis.DiscussionThe K-GFYL award program is a community-wide intervention that requires a comprehensive, multi-level evaluation. The evaluation design is constrained by the lack of a non-K-GFYL control group, short time frames and delayed funding of this large scale evaluation across all intervention settings. However, despite this, the evaluation will generate valuable evidence about the utility of a community-wide environmental approach to preventing childhood obesity which will inform future public health policies and health promotion programs internationally.Trial RegistrationACTRN12609001075279<br /

Economic Evaluation Plan (EEP) for A Very Early Rehabilitation Trial (AVERT): An international trial to compare the costs and cost-effectiveness of commencing out of bed standing and walking training (very early mobilization) within 24 h of stroke onset with usual stroke unit care

Rationale: A key objective of A Very Early Rehabilitation Trial is to determine if the intervention, very early mobilisation following stroke, is cost-effective. Resource use data were collected to enable an economic evaluation to be undertaken and a plan for the main economic analyses was written prior to the completion of follow up data collection. Aim and hypothesis To report methods used to collect resource use data, pre-specify the main economic evaluation analyses and report other intended exploratory analyses of resource use data. Sample size estimates: Recruitment to the trial has been completed. A total of 2,104 participants from 56 stroke units across three geographic regions participated in the trial. Methods and design: Resource use data were collected prospectively alongside the trial using standardised tools. The primary economic evaluation method is a cost-effectiveness analysis to compare resource use over 12 months with health outcomes of the intervention measured against a usual care comparator. A cost-utility analysis is also intended. Study outcome: The primary outcome in the cost-effectiveness analysis will be favourable outcome (modified Rankin Scale score 0-2) at 12 months. Cost-utility analysis will use health-related quality of life, reported as quality-adjusted life years gained over a 12 month period, as measured by the modified Rankin Scale and the Assessment of Quality of Life. Discussion: Outcomes of the economic evaluation analysis will inform the cost-effectiveness of very early mobilisation following stroke when compared to usual care. The exploratory analysis will report patterns of resource use in the first year following stroke

The economic benefits of reducing physical inactivity: an Australian example

Background: Physical inactivity has major impacts on health and productivity. Our aim was to estimate the health and economic benefits of reducing the prevalence of physical inactivity in the 2008 Australian adult population. The economic benefits were estimated as &lsquo;opportunity cost savings&rsquo;, which represent resources utilized in the treatment of preventable disease that are potentially available for re-direction to another purpose from fewer incident cases of disease occurring in communities.Methods: Simulation models were developed to show the effect of a 10% feasible, reduction target for physical inactivity from current Australian levels (70%). Lifetime cohort health benefits were estimated as fewer incident cases of inactivity-related diseases; deaths; and Disability Adjusted Life Years (DALYs) by age and sex. Opportunity costs were estimated as health sector cost impacts, as well as paid and unpaid production gains and leisure impacts from fewer disease events associated with reduced physical inactivity. Workforce production gains were estimated by comparing surveyed participation and absenteeism rates of physically active and inactive adults, and valued using the friction cost approach. The impact of an improvement in health status on unpaid household production and leisure time were modeled from time use survey data, as applied to the exposed and non-exposed population subgroups and valued by suitable proxy. Potential costs associated with interventions to increase physical activity were not included. Multivariable uncertainty analyses and univariate sensitivity analyses were undertaken to provide information on the strength of the conclusions.Results: A 10% reduction in physical inactivity would result in 6,000 fewer incident cases of disease, 2,000 fewer deaths, 25,000 fewer DALYs and provide gains in working days (114,000), days of home-based production (180,000) while conferring a AUD96 million reduction in health sector costs. Lifetime potential opportunity cost savings in workforce production (AUD12 million), home-based production (AUD71 million) and leisure-based production (AUD79 million) was estimated (total AUD162 million 95% uncertainty interval AUD136 million, AUD196 million).Conclusions: Opportunity cost savings and health benefits conservatively estimated from a reduction in population-level physical inactivity may be substantial. The largest savings will benefit individuals in the form of unpaid production and leisure gains, followed by the health sector, business and government.<br /

How Do Autistic Students Do in the Eyes of Their Peers? Non-Autistic Judgments About the Academic Experiences of Autistic and Non-Autistic University Students, Based on Brief Samples of Behavior

Background: Previous research has found that people can make a variety of judgments about others based on brief samples of their behavior such as judging their social favorability and whether they wish to socialize with them. Non-autistic people frequently perceive autistic people more negatively than non-autistic people, although we do not fully understand the real-world consequences of this perceptual bias. This study extends previous work by investigating these perceptual biases within a real-world context: university.Method: Non-autistic university students (n = 25) watched short, candid video clips of autistic and non-autistic people. Participants rated different aspects of the stimulus model’s academic experience, focusing on their motivation to study, academic success, grades, and happiness at university.Results: Across all measures, non-autistic participants judged the academic experience of autistic models more negatively than non-autistic models, perceiving lower academic motivation, success, grades, and happiness at university.Conclusion: These results demonstrate a consistent negative bias that autistic students may face from their peers at university. We discuss the importance of these results in terms of autism stigma and the potential consequences for improving inclusivity at university

The health and economic benefits of reducing intimate partner violence: an Australian example.

BACKGROUND: Intimate partner violence (IPV) has important impacts on the health of women in society. Our aim was to estimate the health and economic benefits of reducing the prevalence of IPV in the 2008 Australian female adult population. METHODS: Simulation models were developed to show the effect of a 5 percentage point absolute feasible reduction target in the prevalence of IPV from current Australian levels (27%). IPV is not measured in national surveys. Levels of psychological distress were used as a proxy for exposure to IPV since psychological conditions represent three-quarters of the disease burden from IPV. Lifetime cohort health benefits for females were estimated as fewer incident cases of violence-related disease and injury; deaths; and Disability Adjusted Life Years (DALYs). Opportunity cost savings were estimated for the health sector, paid and unpaid production and leisure from reduced incidence of IPV-related disease and deaths. Workforce production gains were estimated by comparing surveyed participation and absenteeism rates of females with moderate psychological distress (lifetime IPV exposure) against high or very high distress (current IPV exposure), and valued using the friction cost approach (FCA). The impact of improved health status on unpaid household production and leisure time were modelled from time use survey data. Potential costs associated with interventions to reduce IPV were not considered. Multivariable uncertainty analyses and univariable sensitivity analyses were undertaken. RESULTS: A 5 percentage point absolute reduction in the lifetime prevalence of IPV in the 2008 Australian female population was estimated to produce 6000 fewer incident cases of disease/injury, 74 fewer deaths, 5000 fewer DALYs lost and provide gains of 926,000 working days, 371,000 days of home-based production and 428,000 leisure days. Overall, AUD371 million in opportunity cost savings could be achievable. The greatest economic savings would be home-based production (AUD147 million), followed by leisure time (AUD98 million), workforce production (AUD94 million) and reduced health sector costs (AUD38 million). CONCLUSIONS: This study contributes new knowledge about the economic impact of IPV in females. The findings provide evidence of large potential opportunity cost savings from reducing the prevalence of IPV and reinforce the need to reduce IPV in Australia, and elsewhere

An RCT to evaluate the utility of a clinical protocol for staff in the management of behavioral and psychological symptoms of dementia in residential aged-care settings

Physical activity (PA) is associated with positive cardio-metabolic health and emerging evidence suggests sedentary behavior (SB) may be detrimental to children's health independent of PA. The primary aim of the Transform-Us! study is to determine whether an 18-month, behavioral and environmental intervention in the school and family settings results in higher levels of PA and lower rates of SB among 8-9 year old children compared with usual practice (post-intervention and 12-months follow-up). The secondary aims are to determine the independent and combined effects of PA and SB on children's cardio-metabolic health risk factors; identify the factors that mediate the success of the intervention; and determine whether the intervention is cost-effective

A new variance ratio metric to detect the timescale of compensatory dynamics

Understanding the mechanisms governing ecological stability—why a property such as primary productivity is stable in some communities and variable in others—has long been a focus of ecology. Compensatory dynamics, in which anti-synchronous fluctuations between populations buffer against fluctuations at the community level, are a key theoretical mechanism of stability. Classically, compensatory dynamics have been quantified using a variance ratio approach that compares the ratio between community variance and aggregate population variance, such that a lower ratio indicates compensation and a higher ratio indicates synchrony among species fluctuations. However, population dynamics may be influenced by different drivers that operate on different timescales, and evidence from aquatic systems indicates that communities can be compensatory on some timescales and synchronous on others. The variance ratio and related metrics cannot reflect this timescale specificity, yet have remained popular, especially in terrestrial systems. Here, we develop a timescale-specific variance ratio approach that formally decomposes the classical variance ratio according to the timescales of distinct contributions. The approach is implemented in a new R package, called tsvr, that accompanies this paper. We apply our approach to a long-term, multisite grassland community dataset. Our approach demonstrates that the degree of compensation vs. synchrony in community dynamics can vary by timescale. Across sites, population variability was typically greater over longer compared to shorter timescales. At some sites, minimal timescale specificity in compensatory dynamics translated this pattern of population variability into a similar pattern of greater community variability on longer compared to shorter timescales. But at other sites, differentially stronger compensatory dynamics at longer compared to shorter timescales produced lower-than-expected community variability on longer timescales. Within every site, there were plots that exhibited shifts in the strength of compensation between timescales. Our results highlight that compensatory vs. synchronous dynamics are intrinsically timescale-dependent concepts, and our timescale-specific variance ratio provides a metric to quantify timescale specificity and relate it back to the classic variance ratio

Pesquisa nas fronteiras da comunidade-universidade: Uso da ciência pública para estudar vigilância policial no South Bronx

This article is a case study of the Morris Justice Project (MJP), a participatory action research (PAR) study in a South Bronx neighborhood of New York City (NYC) designed to understand residents’ experiences with and attitudes towards the New York Police Department (NYPD). An illustration of public science, the research was conducted in solidarity with an emerging police reform movement and in response to an ongoing and particularly aggressive set of policing policies that most heavily impacts poor communities and communities of color.  The case study describes a set of ongoing participatory, research-action, “sidewalk science” strategies, developed in 42 square blocks of the South Bronx, designed to better understand and challenge the ongoing structural violence of the carceral state. Collaboratively written with members of the Morris Justice collective, we tell our story across three sections that outline the genesis of the project, describe our major commitments, and offers PAR and public science as a possible “intervention” in traditional university practice.Este artículo es un estudio de caso del Proyecto de Morris Justice (MJP), un estudio de investigación de acción participativa (PAR) en un vecindario del South Bronx de la Ciudad de Nueva York (NYC) diseñado para comprender las experiencias y las actitudes de los residentes hacia Departamento de Policía de Nueva York (NYPD). Una ilustración de la ciencia pública, la investigación se llevó a cabo en solidaridad con un movimiento de reforma policial emergente y en respuesta a un conjunto de políticas policiales en curso y particularmente agresivo que afecta más a las comunidades pobres y las comunidades de color. El estudio de caso describe un conjunto de estrategias participativas en curso, de investigación-acción, “ciencia de acera”, desarrolladas en 42 bloques cuadrados del South Bronx, diseñadas para comprender mejor y desafiar la violencia estructural en curso del estado carceral. Escrito en colaboración con miembros del colectivo Morris Justice, contamos nuestra historia en tres secciones que resumen la génesis del proyecto, describimos nuestros principales compromisos y ofrecemos PAR y ciencia pública como una posible “intervención” en la práctica universitaria tradicional.Este artigo é um estudo de caso do Morris Justice Project (MJP), um estudo de pesquisa de ação participativa (PAR) em um bairro no South Bronx, em Nova York, projetado para entender as experiências e atitudes dos moradores em relação ao Departamento de Polícia de Nova York (NYPD). Uma ilustração da ciência pública, a pesquisa foi conduzida em solidariedade com um movimento emergente de reforma da polícia e em resposta a um conjunto de políticas policiais em andamento e particularmente agressivas que mais afetam comunidades pobres e comunidades de cor. O estudo de caso descreve um conjunto de estratégias participativas de pesquisa-ação, “ciência da calçada”, desenvolvidas em 42 quarteirões do South Bronx, destinadas a melhor compreender e desafiar a violência estrutural em curso no Estado carcerário. Escrito em colaboração com membros do coletivo Morris Justice, contamos nossa história em três seções que resumem a gênese do projeto, descrevem nossos principais compromissos e oferecem a PAR e a ciência pública como uma possível “intervenção” na prática universitária tradicional.

Researching at the Community-University Borderlands: Using Public Science to Study Policing in the South Bronx

This article is a case study of the Morris Justice Project (MJP), a participatory action research (PAR) study in a South Bronx neighborhood of New York City (NYC) designed to understand residents\u27 experiences with and attitudes towards the New York Police Department (NYPD). An illustration of public science, the research was conducted in solidarity with an emerging police reform movement and in response to an ongoing and particularly aggressive set of policing policies that most heavily impacts poor communities and communities of color. The case study describes a set of ongoing participatory, research-action, sidewalk science strategies, developed in 42 square blocks of the South Bronx, designed to better understand and challenge the ongoing structural violence of the carceral state. Collaboratively written with members of the Morris Justice collective, we tell our story across three sections that outline the genesis of the project, describe our major commitments, and offers PAR and public science as a possible intervention in traditional university practice