J. Clarkson

Environmental and lifestyle factors associated with overweight and obesity in Perth, Australia

Purpose. To examine associations between environmental and lifestyle factors and overweight or obesity. Design. A cross-sectional survey and an environmental scan of recreational facilities. Setting. Metropolitan Perth, Western Australia. Subjects. Healthy sedentary workers and homemakers aged 18 to 59 years (n = 1803) living in areas within the top and bottom quintiles of social disadvantage. Measures. Four lifestyle factors, one social environmental factor, and five physical environment factors (three objectively measured). Results. After adjustment for demographic factors and other variables in the model, overweight was associated with living on a highway (odds ratio [OR], 4.24; 95% confidence interval [CI], 1.62–11.09) or streets with no sidewalks or sidewalks on one side only (OR, 1.35; 95% CI, 1.03–1.78) and perceiving no paths within walking distance (OR, 1.42; 95% CI, 1.08–1.86). Poor access to four or more recreational facilities (OR, 1.68; 95% CI, 1.11–2.55) and sidewalks (OR, 1.62; 95% CI, .98–2.68) and perceiving no shop within walking distance (OR, 1.84; 95% CI, 1.01–3.36) were associated with obesity. Conversely, access to a motor vehicle all the time was negatively associated with obesity (OR, .56; 95% CI, .32–.99). Watching 3 or more hours of television daily (ORs, 1.92 and 1.85, respectively) and rating oneself as less active than others (ORs, 1.66 and 4.05, respectively) were associated with both overweight and obesity. After adjustment for individual demographic factors and all other variables in the model, socioeconomic status of area of residence and leisure-time physical activity were not associated with overweight or obesity. Conclusion. Factors that influence overweight and obesity appear to differ, but aspects of the physical environment may be important. Objectively measured neighborhood environment factors warrant further investigation.

Creating Smoke-Free Environments in Recreational Settings

To facilitate the banning of tobacco industry sponsorship, Australian health promotion foundations were established to provide health sponsorship to sport, arts, and racing organizations. Health sponsorship dollars procure health sponsorship benefits such as naming rights, signage, personal endorsement of a (health) product by a performer or player, and structural controls such as smoke-free policies. Data are presented from surveys and observations of spectators attending events sponsored by the West Australian Health Promotion Foundation (Healthway) and surveys of Healthway-sponsored organizations and the community. The results demonstrate that by using health sponsorship, Healthway increased the prevalence of smoke-free policies in recreational settings, and there was growing support for these policies. There was evidence of good compliance with smoke-free policies, thus reducing exposure to environmental tobacco smoke. The introduction of smoke-free policies in recreational settings has involved working collaboratively with sectors outside of health, taking an incremental approach to change, and gaining the support of stakeholders by communicating evaluation results.

Increasing mouthguards usage among junior rugby and basketball players

Objective : To evaluate a Western Australian mouthguard promotion campaign, launched at the start of the 1997/98 junior rugby union and junior basketball seasons, aimed at increasing mouthguard usage at competition and training.

Evaluating the impact of repeated community-wide health surveys on cardiovascular morbidity and mortality in the busselton population.

Objective: To evaluate the impact of repeated community‐wide mass health examinations on cardiovascular mortality and hospital morbidity trends in Busselton.

Encouraging Young Western Australians to Be Smarter Than Smoking

Purpose. Smarter than Smoking is a multistrategy statewide youth smoking intervention. This article describes key strategies and results from its inception in 1995 to 2005. Design. Comprehensive evaluation included formative research and baseline and follow-up surveys. Triennial national surveys provided independent monitoring of adolescent smoking prevalence. Setting. Western Australia. Subjects. 10- to 15-year-olds. Intervention. A multipronged strategy mix, including mass media, the Internet, sponsorship, school initiatives, publications, and advocacy. Measures. Smoking prevalence, media awareness, and attitudes toward smoking and campaign messages. Analysis. Trend comparisons across the first decade of the project, along with descriptive statistics. Results. Significant attitudinal and behavioral shifts were observed following media waves and over time. There was a steady increase in the proportion who had never smoked (from 40% in 1996 to 61 % in 2005). Results also showed a significant decrease in smoking prevalence from 1996 to 2005, down from 28% to 7% among 14-year-olds and from 43% to 14% among 15-year-olds. Conclusions. Smarter than Smoking was effective in achieving positive shifts in awareness, attitudes, intentions, and behavior. Effectiveness appeared to have been enhanced by sustained long-term funding youth involvement in strategy development, and a strong research and evaluation base.

Increasing the Reach of Health Sponsorship: Using a “Sponsorship Kit” to Promote Health

In Australia, a tobacco tax provides funding for Healthway, the Western Australian Health Promotion Foundation. Healthway provides sponsorships for the arts and racing and sporting events to replace funds previously provided by tobacco companies. These sponsorships provide visibility for Healthway and positive health messages. Normally, Healthway staff attends these events to help promote health messages. To reduce Healthway staff time spent helping event organizers promote health messages, Healthway developed a sponsor kit of promotional materials which communicate health messages without requiring Healthway staff to attend events. Recognition, awareness, comprehension, and acceptance of health messages was comparable at events that featured Healthway staff versus the sponsor kits, but the average cost of the sponsorship kits was only 40% of the cost when Healthway staff was featured.

How people achieve recommended levels of physical activity and the implications for promoting walking

Issue addressed: Attempts to increase community participation in physical activity through the promotion of walking have increased in recent times. However, the contribution of walking in the achievement of sufficient levels of physical activity for health benefits has not been investigated. Methods: A telephone-administered survey on the physical activity patterns of residents in two urban areas of Western Australia (n=1,005) was conducted in November 1999, using physical activity questions derived from the Active Australia 2000 survey. Results: Among those in the sample who were insufficiently active (40%), the majority (77%) participated in only one type of exercise intensity (moderate or vigorous) and that exercise intensity was most likely walking. This compared with sufficiently active respondents who were likely to have combined walking with other moderate and vigorous activities. Conclusions: The results suggest that while walking is likely to appeal to the majority of respondents, those who combine their walking with other types of moderate and vigorous activity are the most likely to achieve sufficient levels of physical activities. (author abstract)