Rona Macniven

Fundamental movement skills among Australian preschool children.

Early childhood is a critical period for the development of fundamental movement skills (FMS). Children who do not master FMS are more likely to experience failure in the motor domain and less likely to participate in sport and games during childhood and adolescence. Studies among primary school aged children report low levels of FMS mastery indicating the need to implement FMS programs during the preschool years. Cross-sectional study of 425 children attending preschools in the Sydney, Australia in 2008. FMS were assessed using the Test of Gross Motor Development-2 including locomotor (run, gallop, hop, horizontal jump) and object control (strike, catch, kick overhand throw) skills. Data were analysed using linear regression and chi-squared analyses. Total locomotor score was higher among girls compared with boys (p<0.00); however only the hop was significantly different (p=0.01). Boys had higher total (p<0.00) and individual object control scores compared with girls, except the catch (p=0.6). The prevalence of mastery differed across each FMS. Girls generally had higher mastery of locomotor skills and boys had higher mastery of object control skills. These findings highlight the need to provide structured opportunities which facilitate childrens acquisition of FMS, which may include providing gender separated games, equipment and spaces. That mastery of FMS is low in primary school children indicates the importance of early intervention programs in preschools. Preschools and child care centers hold promise as a key setting for implementing FMS programs.

Prevalence and correlates of participation in fall prevention exercise/physical activity by older adults.

OBJECTIVE To examine older peoples participation in fall prevention exercise/physical activities. METHODS Participants comprised 5,681 randomly selected older people (≥ 65 years) who took part in the 2009 New South Wales (Australia) Fall Prevention telephone survey (61% response-rate). The instrument consisted of 11 prompted activities including two separate questions on participation in strength and balance training. Tai chi, dance, team sports, golf, bowls and specific balance training were classified as balance-challenging activities. Correlates of low participation were examined using multivariable logistic regression. RESULTS One in eight older people (12.0%, 95% CI: 11.0-13.0) participated in strength training, 6.0% (95% CI: 5.2-6.7) participated in balance training and 21.8% (95% CI: 20.5-23.0) participated in balance-challenging activities. Adherence to public health recommendations (≥ 2 days/week) for strength or balance-challenging activities was reported by 21.0% (95% CI: 9.8-22.2) with 5.3% adhering to both forms. Engagements in strength or in balance-challenging activities were lower among those who had low education (<high-school), lived in disadvantaged neighbourhoods, were obese, had fair/poor self-rated health, had problems with walking or used a walking aid or had fallen in the past year. CONCLUSION Participation in best practice exercise to prevent falls is low. Population-based approaches and targeted strategies for high-risk group are needed.

Are Sitting Occupations Associated with Increased All- Cause, Cancer, and Cardiovascular Disease Mortality Risk? A Pooled Analysis of Seven British Population Cohorts

Background There is mounting evidence for associations between sedentary behaviours and adverse health outcomes, although the data on occupational sitting and mortality risk remain equivocal. The aim of this study was to determine the association between occupational sitting and cardiovascular, cancer and all-cause mortality in a pooled sample of seven British general population cohorts. Methods The sample comprised 5380 women and 5788 men in employment who were drawn from five Health Survey for England and two Scottish Health Survey cohorts. Participants were classified as reporting standing, walking or sitting in their work time and followed up over 12.9 years for mortality. Data were modelled using Cox proportional hazard regression adjusted for age, waist circumference, self-reported general health, frequency of alcohol intake, cigarette smoking, non-occupational physical activity, prevalent cardiovascular disease and cancer at baseline, psychological health, social class, and education. Results In total there were 754 all-cause deaths. In women, a standing/walking occupation was associated with lower risk of all-cause (fully adjusted hazard ratio [HR] = 0.68, 95% CI 0.52–0.89) and cancer (HR = 0.60, 95% CI 0.43–0.85) mortality, compared to sitting occupations. There were no associations in men. In analyses with combined occupational type and leisure-time physical activity, the risk of all-cause mortality was lowest in participants with non-sitting occupations and high leisure-time activity. Conclusions Sitting occupations are linked to increased risk for all-cause and cancer mortality in women only, but no such associations exist for cardiovascular mortality in men or women.

Identifying important and feasible policies and actions for health at community sports clubs: A consensus-generating approach

OBJECTIVES Childrens high participation in organised sport in Australia makes sport an ideal setting for health promotion. This study aimed to generate consensus on priority health promotion objectives for community sports clubs, based on informed expert judgements. DESIGN Delphi survey using three structured questionnaires. METHODS Forty-six health promotion, nutrition, physical activity and sport management/delivery professionals were approached to participate in the survey. Questionnaires used an iterative process to determine aspects of sports clubs deemed necessary for developing healthy sporting environments for children. Initially, participants were provided with a list of potential standards for a range of health promotion areas and asked to rate standards based on their importance and feasibility, and any barriers to implementation. Subsequently, participants were provided with information that summarised ratings for each standard to indicate convergence of the group, and asked to review and potentially revise their responses where they diverged. In a third round, participants ranked confirmed standards by priority. RESULTS 26 professionals completed round 1, 21 completed round 2, and 18 completed round 3. The highest ranked standards related to responsible alcohol practices, availability of healthy food and drinks at sports canteens, smoke-free club facilities, restricting the sale and consumption of alcohol during junior sporting activities, and restricting unhealthy food and beverage company sponsorship. CONCLUSIONS Identifying and prioritising health promotion areas that are relevant to childrens sports clubs assists in focusing public health efforts and may guide future engagement of sports clubs. Approaches for providing informational and financial support to clubs to operationalise these standards are proposed.

Review of the epidemiological evidence for physical activity and health from low- and middle-income countries.

Almost 80% of deaths from non-communicable diseases (NCDs) occur in low- and middle-income countries. Physical inactivity is a key risk factor for NCDs. Enhancing understanding of the scientific evidence linking physical activity and health in low- and middle-income countries is important for supporting national efforts to promote physical activity and reduce NCDs in these countries. A systematic review of three electronic databases was conducted in July 2013, including large population-based epidemiological studies with adult participants, conducted in low- and middle-income countries, and published in the past 30 years. Physical activity was consistently associated with a reduced risk of all-cause mortality, cardiovascular disease (CVD), diabetes and several types of cancer. Positive associations were also found between physical activity and body composition (including overweight and obesity), blood pressure, cholesterol, metabolic indices and bone mineral density. Overall, the results confirm that the epidemiological research into the health benefits of physical activity in low- and middle-income countries is consistent with previous research conducted in high-income countries. This summary of the available research can be used as an advocacy tool in low- and middle-income countries to support greater prominence of physical activity in NCD policies.

Revisiting lifestyle risk index assessment in a large Australian sample: Should sedentary behavior and sleep be included as additional risk factors?

OBJECTIVE Most studies on multiple health behaviors include physical inactivity, alcohol, diet, and smoking (PADS), with few including emerging lifestyle risks such as sleep or sitting. We examined whether adding sitting and sleep to a conventional lifestyle risk index improves the prediction of cross-sectional health outcomes (self-rated health, quality of life, psychological distress, and physical function). We also explored the demographic characteristics of adults with these multiple risk behaviors. METHODS We used baseline data of an Australian cohort study (n=191,853) conducted in 2006-2008 in New South Wales. Lifestyle risk index was operationalized as 1) PADS, 2) PADS+sitting, 3) PADS+sleep, and 4) PADS+sitting+sleep. We estimated receiver operating characteristic curve for self-reported binary health outcomes and calculated the area under the curve to illustrate how well each index classified the outcome. We used multiple logistic regression to determine the demographic characteristics of adults with multiple lifestyle risks. RESULTS Adding sleep duration but not sitting time to the PADS index significantly improved the classification of all health outcomes. Men, those aged 45-54years, those with 10 years of education or less, and those living in regional/remote areas had higher odds of multiple risk behaviors. CONCLUSIONS Future research on multiple health behaviors might benefit from including sleep as an additional behavior. In Australia, unhealthy lifestyles tend to cluster in adults with certain demographic characteristics.

Results from Australia’s 2014 Report Card on Physical Activity for Children and Youth

BACKGROUND Like many other countries, Australia is facing an inactivity epidemic. The purpose of the Australian 2014 Physical Activity Report Card initiative was to assess the behaviors, settings, and sources of influences and strategies and investments associated with the physical activity levels of Australian children and youth. METHODS A Research Working Group (RWG) drawn from experts around Australia collaborated to determine key indicators, assess available datasets, and the metrics which should be used to inform grades for each indicator and factors to consider when weighting the data. The RWG then met to evaluate the synthesized data to assign a grade to each indicator. RESULTS Overall Physical Activity Levels were assigned a grade of D-. Other physical activity behaviors were also graded as less than average (D to D-), while Organized Sport and Physical Activity Participation was assigned a grade of B-. The nation performed better for settings and sources of influence and Government Strategies and Investments (A- to a C). Four incompletes were assigned due to a lack of representative quality data. CONCLUSIONS Evidence suggests that physical activity levels of Australian children remain very low, despite moderately supportive social, environmental and regulatory environments. There are clear gaps in the research which need to be filled and consistent data collection methods need to be put into place.

A stocktake of physical activity programs in the Pacific Islands

Population non-communicable disease (NCD) risk is among the highest in the world in the Pacific region. Increasing physical activity (PA) levels may be effective in reducing NCD risk in the developing and culturally diverse Pacific region. To describe the current practice in promoting PA in the Pacific, program information was sourced from NCD representatives from 19 countries during the Pacific NCD Forum (2009). Additional online searches were undertaken; health officials from 22 countries and NCD key informants from the Secretariat of the Pacific Community and from the World Health Organization were contacted. Eighty-four PA initiatives were identified in 20 Pacific Island countries: 26 took place in the workplace setting, 17 occurred in the school setting, 37 in the community setting and 4 in a clinical or health sector setting. Seventeen programs reached 100-500 individuals, 9 programs reached 500-1000 participants, 13 programs reached over 1000 participants and 3 programs targeted the whole population. The majority (51 of 84) of the programs commenced since 2006. There is a notable increase in the development of PA programs in multiple settings across the Pacific. Lead agencies are often the Ministry of Health offices with leadership support from high-level government positions.

Unhealthy product sponsorship of Australian national and state sports organisations

ISSUE ADDRESSED Marketing of products harmful to the health of children has been found to be prolific, and occurs across multiple media platforms and in several settings, including organised sport, thus potentially undermining the health benefits inherent in sports participation. Through website audits, this study investigated the nature and extent of unhealthy food, beverage, alcohol and gambling sponsorship across peak Australian sporting organisations. METHODS A structured survey tool identified and assessed sponsoring companies and products displayed on the websites of the 53 national and state/territory sport governing bodies in Australia receiving government funding. Identified products were categorised as healthy or unhealthy, based on criteria developed by health experts. RESULTS There was a total of 413 websites operated by the 53 sports, with 1975 company or product sponsors identified. Overall, 39 sports had at least one unhealthy sponsor, and 10% of all sponsors were rated as unhealthy. Cricket had the highest percent of unhealthy sponsors (27%) and the highest number of unhealthy food and beverage sponsors (n=19). Rugby Union (n=16) and Australian Football (n=4) had the highest numbers of alcohol and gambling sponsors respectively. CONCLUSIONS Sponsorship of Australian sport governing bodies by companies promoting unhealthy food and beverage, alcohol and gambling products is prevalent at the state/territory and national level. SO WHAT?: Regulatory guidelines should be established to limit such sponsorship and ensure that it is not translated into promotions that may reach and influence children.

Does a corporate worksite physical activity program reach those who are inactive? Findings from an evaluation of the Global Corporate Challenge

ISSUE ADDRESSED Workplace physical activity programs can motivate inactive target groups to increase daily activity levels, but it is important to determine their reach and impact. METHODS The Global Corporate Challenge (GCC) is a team-based program promoting pedometer-based self-monitoring to reach 10000 steps per day. Participants (n = 587) from an Australian university were recruited and recorded their daily step counts. Demographic, anthropometric, behavioural, self-reported physical activity and sitting time data were collected at baseline and following the 16-week program. RESULTS On average, participants self-estimated 11 638 daily steps in Week 1, increasing to measured estimates of 13 787 daily steps in Week 16 (P < 0.001). At baseline, 92% of survey completers were already meeting the physical activity recommendations, increasing to 98% (P = 0.059) at follow-up. Four month improvements in objectively assessed anthropometric measures showed small, non-significant reductions in weight (-0.12 kg; P = 0.416), body mass index (-0.06 kg/m2; P = 0.314) and waist circumference (-0.43 cm; P = 0.082). Sitting time during work decreased significantly by 21 min per day (P < 0.001) and participants with initially low levels of sitting time at work were more likely to increase their step counts during the GCC (adjusted odds ratio 1.90, 95% confidence interval 1.03-3.50). CONCLUSIONS Although this pedometer-based program resulted in increases in physical activity and reductions in occupational sedentary behaviour, most participants were already meeting physical activity recommendations at baseline. SO WHAT? Workplace interventions need to be better targeted to reach inactive employees to have population-level impacts on chronic disease risk factors.