Alison Daly

Psychological factors and asthma quality of life: a population based study

Background: Reports of psychological conditions in asthmatic subjects have been limited to certain population groups or convenience samples. A study was undertaken of the prevalence of psychological distress in asthma in the general population and its associations with quality of life. Methods: The WANTS Health and Well-being Survey is a population household interview survey of adults (age ⩾18) in Western Australia, the Northern Territory, and South Australia. Data obtained were weighted to the closest census data to provide population representative estimates. Positive answers to two questions: “Have you ever been told by a doctor that you have asthma?” and “Do you still have asthma?” determined current doctor-diagnosed asthma. Other items included the SF-12, the Kessler-10 index of psychological distress, questions on feelings of lack of control in different areas of life, and on mental health conditions. Results: From the available sample of 10 080, 7619 interviews were completed (participation rate 74.8%), with 834 people reporting current doctor-diagnosed asthma (11.2%). Psychological distress was more frequent in those with asthma (17.9% v 12.2%, p<0.01) and a higher proportion with asthma were at higher risk for anxiety or depression (40.5% v 31.2%, p<0.01). Mental health conditions were also more common (16.2% v 10.8%, p<0.01), as was the frequency of those who sometimes or always felt a lack of control over their health (33.5% v 24.3%, p<0.01). People with both asthma and psychological distress had significantly lower scores on the SF-12 physical component summary (PCS) than those with either asthma or distress alone. Among those with psychological distress, mental component summary (MCS) scores did not differ between asthmatic and non-asthmatic respondents. In a multiple regression model the frequency of a feeling of lack of control over health—together with age, family’s financial situation, education level, and number of days partially unable to work or perform usual duties—was significantly associated with scores on the PCS (r = 0.73, adjusted r2 = 0.54). Conclusion: These results, from a representative population sample, show that psychological distress and decreased feelings of control are common in asthma and are significantly associated with physical health status.

Food consumption habits in two states of Australia, as measured by a Food Frequency Questionnaire.

BackgroundObesity is an important public health problem in Australia, and monitoring the nutritional intake of the population is an important endeavour. One way to assess food habits is via Food Frequency Questionnaires (FFQ). This pilot study used a routine telephone risk factor surveillance survey to recruit participants in South Australia (SA) and Western Australia (WA) to a postal survey investigating food consumption habits, using a FFQ. Respondents were also asked specific additional questions about their fruit and vegetable consumption and also about their height and weight so that comparisons could be made between the data collected in the risk factor surveillance system and the postal survey.FindingsIn total, 1275 respondents (65% of eligible telephone respondents) completed the postal survey. The results of the FFQ were very similar for WA and SA. Western Australians consumed statistically significantly more serves of vegetables than South Australians (t = 2.69 df = 1245 p <= 0.01), and females consumed statistically significantly more serves of both fruit and vegetables than males (t = 4.51 df = 1249 p <= 0.01 and t = 4.83 df = 1249 p <= 0.01 respectively). Less than 10% of respondents met the daily guidelines for vegetable consumption. Over half of respondents were overweight or obese.ConclusionsAlthough a wide variety of foods were consumed, guidelines for fruit and vegetable consumption were not being met and overweight and obesity continue to be issues in this population.

World Alliance for Risk Factor Surveillance White Paper on Surveillance and Health Promotion

This is not a research paper on risk factor surveillance. It is an effort by a key group of researchers and practitioners of risk factor surveillance to define the current state of the art and to identify the key issues involved in the current practice of behavioral risk factor surveillance. Those of us who are the principal authors have worked and carried out research in this area for some three decades. As a result of a series of global meetings beginning in 1999 and continuing every two years since then, a collective working group of the International Union of Health Promotion and Education (IUHPE) was formed under the name World Alliance of Risk Factor Surveillance (WARFS). Under this banner the organization sought to write a comprehensive statement on the importance of surveillance to health promotion and public health. This paper, which has been revised and reviewed by established peers in the field, is the result. It provides the reader with a clear summary of the major issues that need to be considered by any and all seeking to carry out behavioral risk factor surveillance.

Using risk factor surveillance as a basis for mixed-methodology research: an example from Australia using food intake and anthropometric measures.

ObjectivesRisk factor surveillance is an integral part of public health, and can provide a ready-made sample for further research. This study assessed the utility of mixed-methodology research using telephone and postal surveys.MethodsAdult respondents to telephone surveys in South Australia and Western Australia were recruited to a postal survey about food consumption, in particular, relating to fruit and vegetables. Responses to the two surveys were compared.ResultsAround 60% of eligible telephone survey respondents participated in the postal survey. There was fair to poor agreement between the results from the two methods for serves of fruit and vegetables consumed. There was excellent agreement between the two methods for self-reported height and weight.ConclusionsThe telephone survey was a useful way to recruit people to the postal survey; this could be due to the high level of trust gained through the telephone interview, or social desirability bias. It is difficult to ascertain why different results on fruit and vegetable intake were obtained, but it may be associated with understanding of the parameters of a ‘serve’, recall bias or the time taken to calculate an answer.