Georgina Trapp

Increasing Children’s Physical Activity Individual, Social, and Environmental Factors Associated With Walking to and From School

Background. Efforts to increase the prevalence of children’s active school transport require evidence to inform the development of comprehensive interventions. This study used a multilevel ecological framework to investigate individual, social, and environmental factors associated with walking to and from school among elementary school-aged children, stratified by gender. Method. Boys aged 10 to 13 years (n = 617) and girls aged 9 to 13 years (n = 681) attending 25 Australian primary schools located in high or low walkable neighborhoods completed a 1-week travel diary and a parent/child questionnaire on travel habits and attitudes. Results. Boys were more likely (odds ratio [OR] = 3.37; p < .05) to walk if their school neighborhood had high connectivity and low traffic and less likely to walk if they had to cross a busy road (OR = 0.49; p < .05). For girls, confidence in their ability to walk to or from school without an adult (OR = 2.03), school encouragement (OR = 2.43), scheduling commitments (OR = 0.41), and parent-perceived convenience of driving (OR = 0.24) were significantly associated (p < .05) with walking. Irrespective of gender and proximity to school, child-perceived convenience of walking (boys OR = 2.17 and girls OR = 1.84) and preference to walk to school (child perceived, boys OR = 5.57, girls OR = 1.84 and parent perceived, boys OR = 2.82, girls OR = 1.90) were consistently associated (p < .05) with walking to and from school. Conclusion. Although there are gender differences in factors influencing children walking to and from school, proximity to school, the safety of the route, and family time constraints are consistent correlates. These need to be addressed if more children are to be encouraged to walk to and from school.

On your bike! a cross-sectional study of the individual, social and environmental correlates of cycling to school

BackgroundActive school transport (AST) has declined rapidly in recent decades. While many studies have examined walking, cycling to school has received very little attention. Correlates of cycling are likely to differ to those from walking and cycling enables AST from further distances. This study examined individual, social and environmental factors associated with cycling to school among elementary school-aged children, stratified by gender.MethodsChildren (n = 1197) attending 25 Australian primary schools located in high or low walkable neighborhoods, completed a one-week travel diary and a parent/child questionnaire on travel habits and attitudes.ResultsOverall, 31.2% of boys and 14.6% of girls cycled ≥ 1 trip/week, however 59.4% of boys and 36.7% of girls reported cycling as their preferred school transport mode. In boys (but not girls), school neighborhood design was significantly associated with cycling: i.e., boys attending schools in neighborhoods with high connectivity and low traffic were 5.58 times more likely to cycle (95% CI 1.11-27.96) and for each kilometer boys lived from school the odds of cycling reduced by 0.70 (95% CI 0.63-0.99). Irrespective of gender, cycling to school was associated with parental confidence in their childs cycling ability (boys: OR 10.39; 95% CI 3.79-28.48; girls: OR 4.03; 95% CI 2.02-8.05), parental perceived convenience of driving (boys: OR 0.42; 95% CI 0.23-0.74; girls: OR 0.40; 95% CI 0.20-0.82); and childs preference to cycle (boys: OR 5.68; 95% CI 3.23-9.98; girls: OR 3.73; 95% CI 2.26-6.17).ConclusionSchool proximity, street network connectivity and traffic exposure in school neighborhoods was associated with boys (but not girls) cycling to school. Irrespective of gender, parents need to be confident in their childs cycling ability and must prioritize cycling over driving.

Where do children travel to and what local opportunities are available? The relationship between neighborhood destinations and children’s independent mobility

Associations between access to local destinations and children’s independent mobility (IM) were examined. In 2007, 10- to 12-year-olds (n = 1,480) and their parents (n = 1,314) completed a survey. Children marked on a map the destinations they walked or cycled to (n = 1,132), and the availability of local destinations was assessed using Geographic Information Systems. More independently mobile children traveled to local destinations than other children. The odds of IM more than halved in both boys and girls whose parents reported living on a busy road (boys, OR = 0.48; girls, OR = 0.36) and in boys who lived near shopping centers (OR = 0.18) or community services (OR = 0.25). Conversely, the odds of IM more than doubled in girls living in neighborhoods with well-connected low-traffic streets (OR = 2.32) and increased in boys with access to local recreational (OR = 1.67) and retail (OR = 1.42) destinations. Creating safe and accessible places and routes may facilitate children’s IM, partly by shaping parent’s and children’s feelings of safety while enhancing their confidence in the child’s ability to use active modes without an adult.

Energy drink consumption among young Australian adults: Associations with alcohol and illicit drug use

BACKGROUND Energy drinks are becoming increasingly popular among young people. The purpose of this study was to determine the prevalence of energy drink consumption and its associations with socio-demographic characteristics, alcohol, cigarette and illicit drug use in a population-based sample of young adults participating in the Western Australian Pregnancy Cohort (Raine) Study. METHODS We used self-administered questionnaires to assess energy drink consumption patterns, alcohol intake, cigarette and illicit drug use at the 20-year cohort follow-up. Data was also collected on socio-demographics, physical activity, body mass index (BMI) and dietary intake. Our sample included 1234 participants (47% male, mean age 20 ± 0.5 years). We considered energy-drink consumption as a categorical (users versus non-users) variable. RESULTS Overall, 48% of participants consumed energy drinks at least once per month, with an average intake of 1.31 ± 0.75 cans per day amongst energy drink users. The most significant correlates of energy drink use were being in part-time or full-time employment, being male, being a cigarette smoker, having heavier alcoholic spirit consumption patterns and being an ecstasy user (all p<0.05). No significant associations were observed with BMI or dietary intake. CONCLUSIONS Australian energy drink users tend to have heavier alcohol consumption patterns be a cigarette smoker and use illicit drugs relative to non-users. More research is needed regarding the health risks associated with energy drink use in young adults, including their possible role in the development of substance abuse problems.

Dog walking is associated with more outdoor play and independent mobility for children

OBJECTIVE Dog ownership is positively associated with childrens physical activity. It is plausible that dog-facilitated activity rather than dog ownership per se encourages childrens physical activity behaviors. We examined relationships between dog walking and childrens physical activity, and outdoor play and independent mobility. METHOD Cross-sectional survey data from the 2007 Perth (Western Australia) TRavel, Environment, and Kids (TREK) project were analyzed for 727 10-12 year olds with a family dog. Weekly minutes of overall physical activity and walking, local walking and outdoor play were collected from children and parents. Childrens weekly pedometer steps were measured. Independent mobility was determined by active independent travel to 15 local destinations. RESULTS Overall, 55% of children walked their dog. After adjustment, more dog walkers than non-dog walkers walked in the neighborhood (75% vs. 47%), played in the street (60% vs. 45%) and played in the yard (91% vs. 84%) (all p ≤ 0.05). Dog walkers were more independently mobile than non-dog walkers (p ≤ 0.001). Dog walking status was not associated with overall physical activity, walking, or pedometer steps (p>0.05). CONCLUSIONS Dog-facilitated play and physical activity can be an effective strategy for increasing childrens physical activity. Dog walking may provide a readily accessible and safe option for improving levels of independent mobility.

Individual, Social, and Environmental Correlates of Healthy and Unhealthy Eating

Background. Few studies use comprehensive ecological approaches considering multilevel factors to understand correlates of healthy (and unhealthy) dietary intake. The aim of this study was to examine the association between individual, social, and environmental factors on composite measures of healthy and unhealthy dietary intake in adults. Method. Participants (n = 565) of the Australian RESIDential Environments (RESIDE) project self-reported dietary intake, home food availability, and behavioral and perceived social and physical environmental influences on food choices. A geographic information system measured proximity of supermarkets from each participant’s home. “Healthy” and “unhealthy” eating scores were computed based on adherence to dietary guidelines. Univariate and multivariate models were constructed using linear regression. Results. After full adjustment, “healthy” eating (mean = 6.25, standard deviation [SD] = 1.95) was significantly associated with having confidence to prepare healthy meals (β = 0.34; 95% confidence interval [CI] = [0.13, 0.55]); having more healthy (β = 0.13; 95% CI = [0.09-0.16]) and fewer unhealthy (β = −0.04; 95% CI = [−0.06, −0.02]) foods available at home; and having a supermarket within 800 meters of home (β = 1.39; 95% CI = [0.37, 2.404]). “Unhealthy” eating (mean = 3.53, SD = 2.06) was associated with being male (β = 0.39; 95% CI = [0.02, 0.75]), frequently eating takeaway (β = 0.33; 95% CI = [0.21, 0.46]) and cafe or restaurant meals (β = 0.20; 95% CI = [0.06, 0.33]) and having fewer healthy (β = −0.07; 95% CI = [−0.10, −0.03]) and more unhealthy (β = 0.09; 95% CI = [0.07, 0.10]) foods available within the home. Conclusion. Initiatives to improve adherence to dietary guidelines and reduce the consumption of unhealthy foods needs to be multifaceted; addressing individual factors and access to healthy food choices in both the home and neighborhood food environment. Ensuring proximity to local supermarkets, particularly in new suburban developments, appears to be an important strategy for facilitating healthy eating.

Conducting field research in a primary school setting: Methodological considerations for maximizing response rates, data quality and quantity

Background: Schools are an ideal setting in which to involve children in research. Yet for investigators wishing to work in these settings, there are few method papers providing insights into working efficiently in this setting. Objective: The aim of this paper is to describe the five strategies used to increase response rates, data quality and quantity in the TRansport Environment and Kids (TREK) project. Setting: The TREK project examined the association between neighbourhood urban design and active transport in Grade 5–7 school children (n = 1480) attending 25 primary schools in metropolitan Perth, Western Australia during 2007. Method: Children completed several survey components during school time (i.e. questionnaire, mapping activity, travel diary and anthropometric measurements) and at home (i.e. pedometer study, parent questionnaire). Results: Overall, 69.4% of schools and 56.6% of children agreed to participate in the study and, of these, 89.9% returned a completed travel diary, 97.8% returned their pedometer and 88.8% of parents returned their questionnaire. These return rates are superior to similar studies. Five strategies appeared important: (1) building positive relationships with key school personnel; (2) child-centred approaches to survey development; (3) comprehensive classroom management techniques to standardize and optimize group sessions; (4) extensive follow-up procedures for collecting survey items; and (5) a specially designed data management/monitoring system. Conclusion: Sharing methodological approaches for obtaining high-quality data will ensure research opportunities within schools are maximized. These methodological issues have implications for planning, budgeting and implementing future research.

Measurement of children's physical activity using a pedometer with a built-in memory

OBJECTIVES We evaluated the accuracy of the Accusplit AH120 pedometer (built-in memory) for recording step counts of children during treadmill walking against (1) observer counted steps and (2) concurrently measured steps using the previously validated Yamax Digiwalker SW-700 pedometer. DESIGN This was a cross-sectional validation study performed under controlled settings. METHODS Forty five 9-12-year-olds walked on treadmills at speeds of 42, 66 and 90m/min to simulate slow, moderate and fast walking wearing Accusplit and Yamax pedometers concurrently on their right hip. Observer counted steps were captured by video camera and manually counted. Absolute value of percent error was calculated for each comparison. Bland-Altman plots were constructed to show the distribution of the individual (criterion-comparison) scores around zero. RESULTS Both pedometers under-recorded observer counted steps at all three walk speeds. Absolute value of percent error was highest at the slowest walk speed (Accusplit=46.9%; Yamax=44.1%) and lowest at the fastest walk speed (Accusplit=8.6%; Yamax=8.9%). Bland-Altman plots showed high agreement between the pedometers for all three walk speeds. CONCLUSIONS Using pedometers with built-in memory capabilities eliminates the need for children to manually log step counts daily, potentially improving data accuracy and completeness. Step counts from the Accusplit (built-in memory) and Yamax (widely used) pedometers were comparable across all speeds, but their level of accuracy was dependent on walking pace. Pedometers should be used with caution in children as they significantly undercount steps, and this error is greatest at slower walk speeds.

What are the position and power of supermarkets in the Australian food system, and the implications for public health? A systematic scoping review: Scoping review of supermarket power

Supermarkets have been described as having unprecedented and disproportionate power in the food system. This scoping review synthesized the literature that describes the position and power of supermarkets in the Australian food system, and the implications for public health. A systematic search of peer‐reviewed and grey literature identified 68 documents that described supermarket power. Implications for public health were also recorded. Data revealed that supermarkets hold a powerful position in the Australian food system, acting as the primary gatekeepers. Supermarkets have obtained instrumental, structural and discursive power from many sources that overlap and reinforce each other. Few positive public health impacts of supermarket power were identified, providing many opportunities for improvement in the domains of food governance, the food system and public health nutrition. There is very little public health research examining the impact of supermarket power in Australia. More research is needed, and examination of supermarket own brands is of particular importance owing to their pivotal role as a source of power and their potential to improve public health outcomes, such as obesity.

Liquor landscapes: Does access to alcohol outlets influence alcohol consumption in young adults?

Abstract Few longitudinal studies have examined the impact of liquor licences on alcohol consumption, and none in young adults, the life stage when alcohol intake is at its highest. We examined associations between liquor licences (i.e., general licences, on‐premise licences, liquor stores, and club licences) and alcohol consumption at 20‐years (n=988) and 22‐years (n=893), and whether changes in the licences between time‐points influenced alcohol consumption (n=665). Only general licences were associated with alcohol consumption at 20‐years (p=0.037), but by 22‐years, all licences types were positively associated with alcohol consumption (p<0.05). Longitudinal analyses showed that for each increase in liquor stores over time, alcohol consumption increased by 1.22 g/day or 8% (p=0.030), and for each additional club licence, consumption increased by 0.90 g/day or 6% (p=0.007). Limiting liquor licences could contribute to a reduction in young adults’ alcohol intake. HighlightsWe tested the associations between liquor licences and alcohol intake in young adults.Changes in liquor licences between 20 and 22‐years impacted on alcohol intake.For each increase in liquor stores, consumption increased by 1.22 g/day (p=0.030).For each additional club licence, consumption increased by 0.91 g/day (p=0.007).Results suggest a potentially causal association between licences and alcohol intake.