Michelle Jongenelis

Developing cancer warning statements for alcoholic beverages

BackgroundThere is growing evidence of the increased cancer risk associated with alcohol consumption, but this is not well understood by the general public. This study investigated the acceptability among drinkers of cancer warning statements for alcoholic beverages.MethodsSix focus groups were conducted with Australian drinkers to develop a series of cancer-related warning statements for alcohol products. Eleven cancer warning statements and one general health warning statement were subsequently tested on 2,168 drinkers via an online survey. The statements varied by message frame (positive vs negative), cancer reference (general vs specific), and the way causality was communicated (‘increases risk of cancer’ vs ‘can cause cancer’).ResultsOverall, responses to the cancer statements were neutral to favorable, indicating that they are unlikely to encounter high levels of negative reaction from the community if introduced on alcoholic beverages. Females, younger respondents, and those with higher levels of education generally found the statements to be more believable, convincing, and personally relevant. Positively framed messages, those referring to specific forms of cancer, and those using ‘increases risk of cancer’ performed better than negatively framed messages, those referring to cancer in general, and those using the term ‘can cause cancer’.ConclusionCancer warning statements on alcoholic beverages constitute a potential means of increasing awareness about the relationship between alcohol consumption and cancer risk.

Self-objectification, body image disturbance, and eating disorder symptoms in young australian children

Self-objectification has been examined extensively in adult populations. Despite theoretical evidence suggesting that children may also be vulnerable to experiencing self-objectification, whether children do self-objectify has not been determined. Accordingly, the present study examined the degree to which children self-objectify. The prevalence of body image and eating disturbances in this population, and the relationship between self-objectification and these disturbances, were also investigated. Results from over 250 boys and girls aged 6-11 years revealed that young girls report levels of self-objectification that are similar to those observed among older girls and women. Self-objectification was also found to be meaningfully related to body image and eating disturbances in children. A significant proportion of children reported body dissatisfaction and a minority engaged in disordered eating behaviours in the four weeks prior to the assessment. These results suggest that children may be at risk of experiencing the negative psychological outcomes associated with self-objectification.

A comparison of the effectiveness of an adult nutrition education program for Aboriginal and non-Aboriginal Australians

BACKGROUND Adult nutrition education is an important component of broader societal efforts to address the high prevalence of nutrition-related diseases. In Australia, Aboriginal people are a critical target group for such programs because of their substantially higher rates of these diseases. OBJECTIVE The aim of this study was to assess the relative effectiveness of an adult nutrition education program for Aboriginal and non-Aboriginal participants. METHODS Pre-and post-course evaluation data were used to assess changes in confidence in ability to buy healthy foods on a budget, nutrition knowledge, and dietary behaviours among individuals attending FOODcents nutrition education courses. The total sample of 875 Western Australians included 169 who self-identified as Aboriginal or Torres Strait Islander. RESULTS Perceptions of course usefulness were very high and comparable between Aboriginal and non-Aboriginal participants. Significantly larger improvements in confidence, nutrition knowledge, and reported consumption behaviours were evident among Aboriginal participants. CONCLUSION The findings suggest that adult nutrition education programs that address specific knowledge and skill deficits that are common among disadvantaged groups can be effective for multiple target groups, and may also assist in reducing nutrition-related inequalities.

Australian drinkers’ perceptions of alcohol-related risk by consumption status

Abstract Background: This study investigated Australian drinkers’ alcohol-related beliefs according to their alcohol risk status. The primary aims were to assess drinkers’ awareness of the association between alcohol consumption and a range of health consequences and their understanding of the degree of risk represented by their own alcohol consumption. Method: An online survey was administered to 2168 drinkers who consume alcohol at least twice per month. Respondents reported their alcohol intake levels and their beliefs relating to the relationship between alcohol and shorter-term (proximal) risks (e.g., drink-driving) and longer-term (distal) risks (e.g., stroke and cancer). Results: Just over half (52%) of those drinking at high or very high risk levels did not perceive their drinking to be harmful. A large majority (85%) of the sample was aware of various short-term risks of excessive alcohol consumption, but only half appeared aware of the association between alcohol consumption and more distal health conditions. Conclusions: The relatively low levels of awareness of the alcohol–disease link and the weak relationship between perceived risk and alcohol consumption levels suggest that attempts to reduce current high levels of alcohol-related harm could include public education campaigns designed to (i) improve drinkers’ understanding of the prevalence of alcohol-related harms upon which current alcohol guidelines are based, (ii) prompt drinkers to review their intake levels in the light of the guidelines to assess their potential risk of harm, and (iii) make alcohol-related risks more salient to every-day consumption decisions.

Predictors of sun protection behaviours and sunburn among Australian adolescents

BackgroundExcessive sun exposure and sunburn increase individuals’ risk of skin cancer. It is especially important to prevent sunburn in childhood due to the higher relative risk of skin cancer across the life span compared to risk associated with sunburn episodes experienced later in life. This study examined demographic and attitudinal factors associated with engagement in a range of sun protection behaviours (wearing a hat, wearing protective clothing, staying in the shade, and staying indoors during the middle of the day) and the frequency of sunburn among Western Australian adolescents to provide insights of relevance for future sun protection campaigns.MethodsCross-sectional telephone surveys were conducted annually with Western Australians between 2005/06 and 2014/15. The results from 4150 adolescents aged 14–17 years were used to conduct a path analysis of factors predicting various sun protection behaviours and sunburn.ResultsSignificant primary predictors of the sun protection behaviours included in the study were skin type (sun sensitivity), gender, tanning-related attitudes and behaviours, and perceived relevance of public service advertisements that advocate sun protection. Of the four sun protection behaviours investigated, staying in the shade and staying indoors during the middle of the day were associated with a lower frequency of sunburn.ConclusionThere is a particular need to target sun protection messages at adolescent males who are less likely to engage in the most effective sun protection behaviours and demonstrate an increased propensity to experience sunburn. The results suggest that such future sun protection messages should include a focus on the importance of staying in the shade or indoors during periods of high UV radiation to increase awareness of the efficacy of these methods of avoiding skin cancer.

A psychometric examination of a modified eight-item version of the children's eating disorder examination

Eating and body image disturbances in children are typically assessed using the Childrens Eating Disorder Examination (ChEDE); however, support for the reliability and validity of scores on this measure is mixed. Furthermore, previous studies suggest that scores obtained from a simplified 8-item version of the ChEDE may be more reliable and useful for research purposes than scores obtained from the full scale. The present study sought to psychometrically evaluate the reliability and factor structure of this brief 8-item scale. Two separate community-based samples of 6- to 11-year-olds (N = 535) were administered the ChEDE as part of a broader assessment battery. The brief 8-item model provided a good fit to the data, as determined by confirmatory factor analysis. Additionally, scores obtained from the 8-item scale, as well as a global ChEDE score, provided reliable measures of a childs eating disorder symptoms, and were superior to the original 4 subscales in both healthy-weight and overweight/obese samples. The brief 8-item scale may therefore be used by researchers who want a reliable and valid index of global eating disorder psychopathology without doing a full interview.

Comparing the Cost-Effectiveness of Campaigns Delivered via Various Combinations of Television and Online Media

Background Reflecting the increasing prevalence of online media, many mass media health campaigns are now delivered using both television (TV) and online media formats. The aim of this study was to evaluate a smoking cessation mass media campaign according to the cost-effectiveness of the various combinations of TV and online media formats to inform future media buying decisions. Methods A quasi-experimental interrupted time series approach was employed. The campaign was delivered in seven 1-week bursts using TV, online video (OV), or online display (OD) (e.g., banner ads) formats in isolation and in various combinations over a 13-week period. Campaign bursts were separated by “off-weeks” in which no campaign materials were delivered. Assessed outcomes were the number of campaign response “events” recorded (campaign web page views, calls to a smoking cessation telephone service, and registrations for smoking cessation services). The cost-effectiveness of each individual and combined media format condition in terms of these outcome variables was calculated using attributed production and broadcasting costs. Results Overall, OD alone was found to be the most cost-effective means of achieving the nominated campaign outcomes, followed by a combination of OV and OD and a combination of TV and OV. The use of TV in isolation was the least cost-effective. Conclusion The results of this evaluation indicate that online media constitute a promising means of enhancing the cost-effectiveness of smoking cessation campaigns. Future research assessing a broader range of outcomes, especially smoking cessation, is needed to provide a more comprehensive account of the cost-effectiveness of various campaign media.

Investigating Single- Versus Multiple-Source Approaches to Communicating Health Messages Via an Online Simulation:

Purpose: To assess whether exposing drinkers to information about the alcohol–cancer link via multiple and diverse sources in an online simulation produces larger improvements in attitudes and intentions relative to exposure to a single source of information. Design: Experimental; unequal randomization with respondents allocated to either the single-source (20%) or multiple-source condition (80%). Alcohol-related behavioral intentions were assessed preexposure and postexposure. Setting: Australia. Participants: A total of 2087 drinkers consuming alcohol at least twice per month. Measures: Scales were used to assess attitudes toward the messages (believability, convincingness, and personal relevance) and behavioral intentions (extent to which participants believed that they should and would reduce their alcohol consumption and their intention to consume 5 or more drinks in a single session). Analysis: Hierarchical linear regression. Results: Source condition was significantly associated with all 3 attitudinal variables (P < .001). Those exposed to an alcohol warning statement from multiple sources found the message more believable, convincing, and personally relevant compared to those exposed to a warning statement via a single source. They also reported significantly greater change preexposure to postexposure on the 2 behavioral beliefs that they should (ΔM = 0.25 vs ΔM = 0.09) and would (ΔM = 0.23 vs ΔM = 0.00) reduce their current alcohol consumption (P < .001). Further, those in the multiple-source condition reported reduced intentions to consume 5 or more standard drinks in a single sitting (ΔM = 0.21 vs ΔM = 0.14; P < .001). Conclusion: Findings from the online simulation provide support for the suggestion that integrated approaches involving the combination of multiple sources to deliver a message produce superior outcomes compared to relying on a single source (eg, warning labels on alcoholic beverages).

Predictors of the frequency of Australian children's consumption of unhealthy foods.

Child obesity interventions need to be based on a sound understanding of the factors that influence childrens diets.

Anticipating and addressing event-specific alcohol consumption among adolescents

BackgroundVarious specific events and celebrations are associated with excessive alcohol consumption and related harms. End-of-school celebrations such as Schoolies in Australia are of particular concern given high levels of documented harm among underage and young drinkers. The present study investigated high school students’ expectations of their Schoolies celebrations to inform future interventions to reduce adverse outcomes among members of this vulnerable group and other young people involved in similar rites of passage.MethodsA link to an online survey was distributed via high schools and Schoolies-related websites. The survey included qualitative questions that invited respondents to discuss (i) aspects of Schoolies they were looking forward to most and least and (ii) their perceptions of the likely consequences if they refrained from consuming alcohol during the event. In total, 435 students provided responses.ResultsRespondents discussed the role of Schoolies in marking their transition to adulthood. Their comments revealed a cross-temporal focus indicating that Schoolies is simultaneously symbolic of the past, present, and future. Through its ability to enhance social interaction, alcohol was perceived to have a vital role in realising the potential of this event to signify and facilitate this temporal progression.ConclusionsResults suggest interventions that treat Schoolies as an isolated event that occurs in specific locations may fail to appreciate the extent to which these events transcend time for those involved. Instead, harm reduction is likely to involve a reconceptualisation of the event among both participants and authority figures to facilitate the provision of alternative pastimes to drinking during Schoolies that yield similar social benefits.