Jerome N. Rachele

Practical physical activity measurement in youth: a review of contemporary approaches.

BackgroundThe accurate evaluation of physical activity levels amongst youth is critical for quantifying physical activity behaviors and evaluating the effect of physical activity interventions. The purpose of this review is to evaluate contemporary approaches to physical activity evaluation amongst youth.Data sourcesThe literature from a range of sources was reviewed and synthesized to provide an overview of contemporary approaches for measuring youth physical activity.ResultsFive broad categories are described: selfreport, instrumental movement detection, biological approaches, direct observation, and combined methods. Emerging technologies and priorities for future research are also identified.ConclusionsThere will always be a trade-off between accuracy and available resources when choosing the best approach for measuring physical activity amongst youth. Unfortunately, cost and logistical challenges may prohibit the use of “gold standard” physical activity measurement approaches such as doubly labelled water. Other objective methods such as heart rate monitoring, accelerometry, pedometry, indirect calorimetry, or a combination of measures have the potential to better capture the duration and intensity of physical activity, while self-reported measures are useful for capturing the type and context of activity.

Associations between individual socioeconomic position, neighbourhood disadvantage and transport mode: baseline results from the HABITAT multilevel study

Background Understanding how different socioeconomic indicators are associated with transport modes provide insight into which interventions might contribute to reducing socioeconomic inequalities in health. The purpose of this study was to examine associations between neighbourhood-level socioeconomic disadvantage, individual-level socioeconomic position (SEP), and usual transport mode. Methods This investigation included 11 036 residents from 200 neighbourhoods in Brisbane, Australia. Respondents self-reported their usual transport mode (car or motorbike, public transport, walking or cycling). Indicators for individual-level SEP were education, occupation and household income; and neighbourhood disadvantage was measured using a census-derived index. Data were analysed using multilevel multinomial logistic regression. High SEP respondents and residents of the most advantaged neighbourhoods who used a private motor vehicle as their usual form of transport was the reference category. Results Compared with driving a motor vehicle, the odds of using public transport were higher for white collar employees (OR 1.68, 95% CrI 1.41–2.01), members of lower income households (OR 1.71 95% CrI 1.25–2.30) and residents of more disadvantaged neighbourhoods (OR 1.93, 95% CrI 1.46–2.54); and lower for respondents with a certificate-level education (OR 0.60, 95% CrI 0.49–0.74) and blue collar workers (OR 0.63, 95% CrI 0.50–0.81). The odds of walking for transport were higher for the least educated (OR 1.58, 95% CrI 1.18–2.11), those not in the labour force (OR 1.94, 95% CrI 1.38–2.72), members of lower income households (OR 2.10, 95% CrI 1.23–3.64) and residents of more disadvantaged neighbourhoods (OR 2.73, 95% CrI 1.46–5.24). The odds of cycling were lower among less educated groups (OR 0.31, 95% CrI 0.19–0.48). Conclusions The relationships between socioeconomic characteristics and transport modes are complex, and provide challenges for those attempting to encourage active forms of transportation. Further work is required exploring the individual-level and neighbourhood-level mechanisms behind choice of transport mode, and what factors might influence individuals from different socioeconomic backgrounds to change to more active transport modes.

Child sexual abuse prevention education: A review of school policy and curriculum provision in Australia

The past four decades have seen increasing public and professional awareness of child sexual abuse. Congruent with public health approaches to prevention, efforts to eliminate child sexual abuse have inspired the emergence of prevention initiatives which can be provided to all children as part of their standard school curriculum. However, relatively little is known about the scope and nature of child sexual abuse prevention efforts in government school systems internationally. This paper assesses and compares the policies and curriculum initiatives in primary (elementary) schools across state and territory Departments of Education in Australia. Using publicly available electronic data, a deductive qualitative content analysis of policy and curriculum documents was undertaken to examine the characteristics of child sexual abuse prevention education in these school systems. It was found that the system-level provision occurs unevenly across state and territory jurisdictions. This results in the potential for substantial inequity in Australian children’s access to learning opportunities in child abuse prevention education as a part of their standard school curriculum. In this research, we have developed a strategy for generating a set of theoretically-sound empirical criteria that may be more extensively applied in comparative research about prevention initiatives internationally.

Neighborhood disadvantage, individual-level socioeconomic position and physical function: A cross-sectional multilevel analysis

INTRODUCTION Understanding associations between physical function and neighborhood disadvantage may provide insights into which interventions might best contribute to reducing socioeconomic inequalities in health. This study examines associations between neighborhood-disadvantage, individual-level socioeconomic position (SEP) and physical function from a multilevel perspective. METHODS Data were obtained from the HABITAT multilevel longitudinal (2007-13) study of middle-aged adults, using data from the fourth wave (2013). This investigation included 6004 residents (age 46-71years) of 535 neighborhoods in Brisbane, Australia. Physical function was measured using the PF-10 (0-100), with higher scores indicating better function. The data were analyzed using multilevel linear regression and were extended to test for cross-level interactions by including interaction terms for different combinations of SEP (education, occupation, household income) and neighborhood disadvantage on physical function. RESULTS Residents of the most disadvantaged neighborhoods reported significantly lower physical function (men: β -11.36 95% CI -13.74, -8.99; women: β -11.41 95% CI -13.60, -9.22). These associations remained after adjustment for individual-level SEP. Individuals with no post-school education, those permanently unable to work, and members of the lowest household income had significantly poorer physical function. Cross-level interactions suggested that the relationship between household income and physical function is different across levels of neighborhood disadvantage for men; and for education and occupation for women. CONCLUSION Living in a disadvantaged neighborhood was negatively associated with physical function after adjustment for individual-level SEP. These results may assist in the development of policy-relevant targeted interventions to delay the rate of physical function decline at a community-level.

Wellness programs at firefighter and police workplaces : a systematic review

Objectives This systematic review summarizes the literature on the health effects of wellness programs at police and firefighter workplaces. The review also considers process outcomes and economic evaluations of such programs. Methods A systematic search of articles published from January 1, 2000 through September 1, 2012 in 13 databases was conducted. Data on 7 studies from 9 articles were extracted. An assessment of the methodological quality of the studies was conducted. Results Studies showed acceptable completion rates and high satisfaction with programs, but mixed results for changes in individual outcomes. Conclusion Empirical evidence for effective health and wellness programs in police and firefighter populations is scarce. Better evaluation and documentation of such programs is needed to advance this field of research.

Do active modes of transport cause lower body mass index? Findings from the HABITAT longitudinal study

Background Few studies have examined the causal relationship between transport mode and body mass index (BMI). Methods We examined between-person differences and within-person changes in BMI by transport mode over four time points between 2007 and 2013. Data were from the How Areas in Brisbane Influence HealTh and AcTivity project, a population-representative study of persons aged 40–65 in 2007 (baseline) residing in 200 neighbourhoods in Brisbane, Australia. The analytic sample comprised 9931 respondents who reported on their main transport for all travel purposes (work-related and non-work-related). Transport mode was measured as private motor vehicle (PMV), public transport, walking and cycling. Self-reported height and weight were used to derive BMI. Sex-specific analyses were conducted using multilevel hybrid regression before and after adjustment for time-varying and time-invariant confounders. Results Independent of transport mode and after adjustment for confounders, average BMI increased significantly and linearly across the four time points for both men and women. Men and women who walked or cycled had a significantly lower BMI than their counterparts who used a PMV. BMI was nearly always lower during the time men and women walked or cycled than when they used a PMV; however, few statistically significant differences were observed. For women, BMI was significantly higher during the time they used public transport than when using a PMV. Conclusion The findings suggest a causal association between transport mode and BMI and support calls from health authorities to promote walking and cycling for transport as a way of incorporating physical activity into everyday life to reduce the risk of chronic disease.

Neighborhood disadvantage and body mass index: a study of residential relocation

Natural experiments, such as longitudinal observational studies that follow-up residents as they relocate, provide a strong basis to infer causation between the neighborhood environment and health. In this study, we examined whether changes in the level of neighborhood disadvantage were associated with changes in body mass index (BMI) after residential relocation. This analysis included data from 928 residents who relocated between 2007 and 2013, across 4 waves of the How Areas in Brisbane Influence Health and Activity (HABITAT) study in Brisbane, Australia. Neighborhood disadvantage was measured using a census-derived composite index. For individual-level data, participants self-reported their height, weight, education, occupation, and household income. Data were analyzed using multilevel, hybrid linear models. Women residing in less disadvantaged neighborhoods had a lower BMI, but there was no association among men. Neighborhood disadvantage was not associated with within-individual changes in BMI among men or women when moving to a new neighborhood. Despite a growing body of literature suggesting an association between neighborhood disadvantage and BMI, we found this association may not be causal among middle-aged and older adults. Observing associations between neighborhood socioeconomic disadvantage and BMI over the life course, including the impact of residential relocation at younger ages, remains a priority for future research.

Adolescent's perceptions of parental influences on physical activity.

Abstract Background: Youth physical activity engagement is a key component of contemporary health promotion strategies. Parents have potential to influence the physical activity behaviours of their children. The purpose of this study was to explore associations between adolescent self-reported physical activity, parent physical activity and perceptions of parental influence as measured by the Children’s Physical Activity Correlates (CPAC) questionnaire. Methods: This investigation included a total of 146 adolescents and their parents. Self-reported measures of physical activity were obtained using the International Physical Activity Questionnaire for Adolescents and International Physical Activity Questionnaire for adolescents and their parents respectively. Adolescent perceptions of parental role modelling, support, and encouragement were measured with the parental influences scales of the CPAC. Results: Ordinary least squares regression indicated that perceptions of parental role modelling (β=197.41, 95% CI 34.33–360.49, p=0.031) was positively associated with adolescent self-reported moderate-to-vigorous physical activity with the overall model accounting for a small amount of the variance (R2=0.076). Conclusion: These results are in agreement with previous research indicating that parents play a small, albeit vital role in the physical activity engagement of their children. Public health campaigns with the aim of promoting youth physical activity should endeavour to incorporate parents into their interventions.

Reliability of a wellness inventory for use among adolescent females aged 12–14 years

BackgroundThe wellness construct has application in a number of fields including education, healthcare and counseling, particularly with regard to female adolescents. The effective measurement of wellness in adolescents can assist researchers and practitioners in determining lifestyle behaviors in which they are lacking. Behavior change interventions can then be designed which directly aid in the promotion of these areas.MethodsThe 5-Factor Wellness Inventory (designed to measure the Indivisible Self model of wellness) is a popular instrument for measuring the broad aspects of wellness amongst adolescents. The instrument comprises 97 items contributing to 17 subscales, five dimension scores, four context scores, total wellness score, and a life satisfaction index. This investigation evaluated the test-retest (intra-rater) reliability of the 5F-Wel instrument in repeated assessments (seven days apart) among adolescent females aged 12–14 years. Percentages of exact agreement for individual items, and the number of respondents who scored within ±5, ±7.5 and ±10 points for total wellness and the five summary dimension scores were calculated.ResultsOverall, 46 (95.8%) participants responded with complete data and were included in the analysis. Item agreement ranged from 47.8% to 100% across the 97 items (median 69.9%, interquartile range 60.9%-73.9%). The percentage of respondents who scored within ±5, ±7.5 and ±10 points for total wellness at the re-assessment was 87.0%, 97.8% and 97.8% respectively. The percentage of respondents who scored within ±5, ±7.5 and ±10 for the domain scores at the reassessment ranged between 54.3-76.1%, 78.3-95.7% and 89.1-95.7% respectively across the five dimensions.ConclusionsThese findings suggest there was considerable variation in agreement between the two assessments on some individual items. However, the total wellness score and the five dimension summary scores remained comparatively stable between assessments.