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Capon A.G.,Australian National University | Capon A.G.,University of New South Wales | Rissel C.E.,Health Promotion Service | Rissel C.E.,University of Sydney
New South Wales Public Health Bulletin | Year: 2010

Chronic disease and climate change are major public policy challenges facing governments around the world. An improved understanding of the relationship between chronic disease and climate change should enable improved policy formulation to support both human health and the health of the planet. Chronic disease and climate change are both unintended consequences of our way of life, and are attributable in part to the ready availability of inexpensive fossil fuel energy. There are co-benefits for health from actions to address climate change. For example, substituting physical activity and a vegetable-rich diet for motor vehicle transport and a meat-rich diet is both good for health and good for the planet. We should encourage ways of living that use less carbon as these can be healthy ways of living, for both individuals and society. Quantitative modelling of co-benefits should inform policy responses.


Voukelatos A.,Health Promotion Service | Merom D.,University of Western Sydney | Merom D.,University of Sydney | Rissel C.,University of Sydney | And 3 more authors.
BMC Public Health | Year: 2011

Background: Falls in older people continue to be a major public health issue in industrialized countries. Extensive research into falls prevention has identified exercise as a proven fall prevention strategy. However, despite over a decade of promoting physical activity, hospitalisation rates due to falls injuries in older people are still increasing. This could be because efforts to increase physical activity amongst older people have been unsuccessful, or the physical activity that older people engage in is insufficient and/or inappropriate. The majority of older people choose walking as their predominant form of exercise. While walking has been shown to lower the risk of many chronic diseases its role in falls prevention remains unclear. This paper outlines the methodology of a study whose aims are to determine: if a home-based walking intervention will reduce the falls rate among healthy but inactive community-dwelling older adults (65 + years) compared to no intervention (usual activity) and; whether such an intervention can improve risk factors for falls, such as balance, strength and reaction time. Methods/Design. This study uses a randomised controlled trial design. A total of 484 older people exercising less than 120 minutes per week will be recruited through the community and health care referrals throughout Sydney and neighboring regions. All participants are randomised into either the self-managed walking program group or the health-education waiting list group using a block randomization scheme. Outcome measures include prospective falls and falls injuries, quality of life, and physical activity levels. A subset of participants (n = 194) will also receive physical performance assessments comprising of tests of dynamic balance, strength, reaction time and lower limb functional status. Discussion. Certain types of physical activity can reduce the risk of falls. As walking is already the most popular physical activity amongst older people, if walking is shown to reduce falls the public health implications could be enormous. Conversely, if walking does not reduce falls in older people, or even puts older people at greater risk, then health resources targeting falls prevention need to be invested elsewhere. © 2011 Voukelatos et al; licensee BioMed Central Ltd.


PubMed | Health Promotion Service, University of Sydney and NSW Ministry of Health
Type: | Journal: Health & place | Year: 2016

This study assessed the impact of an outdoor gym installation on park users physical activity levels and examined the characteristics of outdoor gym users. A before-after time series design was employed, consisting of nine data collection periods: three each at baseline, post outdoor gym installation, and at 12-month follow-up. Repeated observational surveys and park intercept interviews were conducted. There was a small but significant increase in senior park users engaging in moderate to vigorous physical activity at follow-up (1.6 to 5.1%; p<0.001). There were significant increases from baseline to follow-up in the outdoor gym area for: MVPA (6 to 40%; p<0.001); and seniors use (1.4 to 6%; p<0.001). The study contributes to the limited evidence on the impact of outdoor gyms on physical activity outcomes.


Hess I.,Public Health Training and Development Branch | Borg J.,Health Promotion Service | Rissel C.,Health Promotion Service
Health Promotion Journal of Australia | Year: 2011

Issue addressed: The workplace is an effective way of reaching large numbers of adults during working hours, and increasing physical activity, promoting healthy eating or both.This paper evaluates the effectiveness of a workplace intervention in a hospital setting in Australia. Methods: A12 week program was conducted with 399 employees of Liverpool Hospital, NSW, to increase physical activity and healthy eating. Participants received a pedometer, healthy cookbook, water bottle, sandwich container and Measure Up campaign resources. A web based survey was completed at baseline and follow up. Results: Sixty six per cent of participants completed the follow up survey. Those that did not complete the follow up evaluation were not significantly different to completers. Respondents reported a significant increase in median minutes walked to 200 minutes and in vigorous physical activity to 85 minutes over the previous week. Participants consuming adequate fruit and vegetable per day increased by 24.7% and 22.7%, respectively. More participants also consumed breakfast on seven days of the week and consumed one or more litres of water per day. Conclusions: The intervention was successful for the participants. With some improvements to processes, we encourage further similar programs with the health sector workforce.


Borg J.,Health Promotion Service | Merom D.,University of Sydney | Rissel C.,Health Promotion Service
Health Promotion Journal of Australia | Year: 2010

Issue addressed: The Step by Step self-help walking program plus a pedometer previously motivated a community sample of adults to be physically active for up to three months. This study evaluates the effect of enhancement of this program over an additional nine months in a workplace. Methods: A quasi-experimental trial was conducted. Staff defined as inactive received the three month walking program and a pedometer (standard), or the three month program plus four maintenance newsletters over nine months (standard+maintenance). After 12 months a follow-up interview was conducted. Measures included changes in self-reported minutes walking, minutes of moderate-vigorous physical activity (MVPA), total physical activity (PA) in the past week, and the proportion meeting public health recommendations by walking and total PA. Results: Significant increases on all outcome measures were noted for all participants. There were no between group differences in walking minutes. However, the change in MVPA minutes was significantly higher in the standard+maintenance group compared with the standard group (118 min vs 69 min, P=0.029). No significant between group differences were observed for total PA (161 min vs 117 min, P=0.187). Wearing the pedometer at the month of the follow-up interview, and thinking that the pedometer was very useful, increased the likelihood of meeting public health recommendations (AOR=2.7 and 2.5) adjusting for other covariates. Conclusions: Dissemination of the Step by Step guidebook with pedometers in the workplace resulted in a long-term increase in PA of inactive employees with no extra support. Newsletters as a maintenance strategy had no additional benefits. Better outcomes were noted if the pedometer was used and was perceived as being very useful.


Merom D.,University of Western Sydney | Merom D.,University of Sydney | Delbaere K.,University of Sydney | Cumming R.,University of Sydney | And 6 more authors.
Medicine and Science in Sports and Exercise | Year: 2014

PURPOSE: This study assessed the criterion validity and responsiveness of the Incidental and Planned Exercise Questionnaire (IPEQ) specifically developed for aging research. METHODS: The sample comprised 315 community-dwelling inactive older adults (mean age = 73.2 yr) who participated in a trial investigating the effect of a walking program on falls. At baseline, a subsample (n = 177) also wore an accelerometer (ActiGraph GT1M) for 7 d, and 126 of those had four valid days or more of accelerometer data. Validity coefficients (Spearman ρ) were calculated between accelerometer counts per minute, average steps per day, average moderate-to vigorous-intensity physical activity (MVPA) using two cut points (760 and 1041 counts per minute), and IPEQ-MVPA (the sum of physical activity hours per week derived from nine IPEQ items excluding the indoor chores question). Responsiveness was the mean IPEQ change in the intervention group divided by the SD of the mean change in control group. RESULTS: The correlation coefficients between IPEQ-MVPA and counts per minute per day and steps per day were 0.33 and 0.31, respectively. The coefficients with accelerometer MVPA at low and medium cut points were 0.29 and 0.33, respectively, and 0.26 and 0.35 for walking. The Bland-Altman plot showed increased errors with higher values of IPEQ-MVPA. IPEQ incidental physical activity questions and IPEQ as a whole were significantly correlated with accelerometer light intensity (100-760 counts per minute, ρ = 0.29 and 0.23). The 12-month responsiveness of total IPEQ was 0.30 and 0.44 for the "planned walking" item. CONCLUSIONS: IPEQ provides a practical and valid measure of MVPA in surveillance and intervention studies. Incidental activities are mostly of a light-intensity nature, and their low ambulatory component may explain the lower correlation between IPEQ as a whole and accelerometer measures. © 2014 by the American college of Sports Medicine.


Rissel C.,University of Sydney | Wen L.M.,Health Promotion Service
Health Promotion Journal of Australia | Year: 2011

Issue addressed: Australia has national, state and city targets to increase levels of cycling. The possible effect of repealing mandatory bicycle helmet legislation on the frequency of cycling in Sydney is examined. Methods: A cross sectional survey by a market research company was conducted, using quota sampling, in Sydney, Australia. Participants were 600 residents aged 16 years and older. Data were collected in October 2010 using computer-assisted telephone interviews from randomly sampled households, with one respondent per household. The primary outcome measures were propensity to cycle more if a helmet was not required, how often a respondent who cycled would cycle without a helmet, and opinion on compulsory wearing of bicycle helmets. Frequency of cycling, and demographic questions were also assessed. Multiple logistic regression models were run for each of the three main outcomes. Results: One in five (22.6%, 95% CI 18.8-26.4%) respondents said they would cycle more if they did not have to wear a helmet, particularly occasional cyclists (40.4% of those who had cycled in the past week and 33.1% of those who had cycled in the past month). Almost half (47.6%) of respondents said they would never ride without a helmet, 14.4% said 'all the time', 30.4% said 'some of the time' and the rest were not sure. One third (32.7%, 95% CI 28.5-37.0%) of respondents did not support mandatory helmet legislation. Conclusions: While a hypothetical situation, if only half of the 22.6% of respondents who said they would cycle more if they did not have to wear a helmet did ride more, Sydney targets for increasing cycling would be achieved by repealing mandatory bicycle helmet legislation. A significant proportion of the population would continue to wear helmets even if they were not required to do so.


Rowa-Dewar N.,University of Edinburgh | Lumsdaine C.,Health Promotion Service | Amos A.,University of Edinburgh
Nicotine and Tobacco Research | Year: 2014

Introduction: Smokefree legislation and shifting norms in many countries have reduced secondhand smoke (SHS) exposure, but many children, particularly from disadvantaged homes, have high levels of exposure in homes and cars. We explored the particular challenges mothers who smoke face when attempting to protect their children from SHS exposure in disadvantaged homes. Methods: We conducted semi-structured interviews with 22 disadvantaged mothers of children aged 1-3 years in Scotland, using an innovative floor plan method to prompt accounts. Interviews were analyzed thematically. Results: Disadvantaged mothers reported attempting to protect their children from both SHS and becoming smokers, motivated by the perceived future health and financial burdens these entail. The variable strategies used to protect children during early childhood were constrained and/or facilitated by limited and changing living circumstances, single parenthood, increasing child mobility and awareness of parental smoking, and complex social relationships. In the context of several intersecting dimensions of disadvantage (unemployment, low income, alcohol/drug abuse, and domestic abuse), the imperative to be and to be seen to be a good mother was also key in shaping smoking practices in the home. Conclusions: Challenging and changing domestic living circumstances and relationships and the increasing mobility of children in their first few years are key barriers to creating smokefree homes for disadvantaged mothers. Key facilitators include mothers' concerns about children's increasing awareness of smoking and moving to accommodation with accessible outdoor space. Targeted public health initiatives need to acknowledge and support disadvantaged parents' existing motivations and attempts to protect children from both SHS and becoming smokers. © The Author 2015. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved.


PubMed | Health Promotion Service and University of Edinburgh
Type: Journal Article | Journal: Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco | Year: 2015

Smoke-free legislation and shifting norms in many countries have reduced secondhand smoke (SHS) exposure, but many children, particularly from disadvantaged homes, have high levels of exposure in homes and cars. We explored the particular challenges mothers who smoke face when attempting to protect their children from SHS exposure in disadvantaged homes.We conducted semi-structured interviews with 22 disadvantaged mothers of children aged 1-3 years in Scotland, using an innovative floor plan method to prompt accounts. Interviews were analyzed thematically.Disadvantaged mothers reported attempting to protect their children from both SHS and becoming smokers, motivated by the perceived future health and financial burdens these entail. The variable strategies used to protect children during early childhood were constrained and/or facilitated by limited and changing living circumstances, single parenthood, increasing child mobility and awareness of parental smoking, and complex social relationships. In the context of several intersecting dimensions of disadvantage (unemployment, low income, alcohol/drug abuse, and domestic abuse), the imperative to be and to be seen to be a good mother was also key in shaping smoking practices in the home.Challenging and changing domestic living circumstances and relationships and the increasing mobility of children in their first few years are key barriers to creating smoke-free homes for disadvantaged mothers. Key facilitators include mothers concerns about childrens increasing awareness of smoking and moving to accommodation with accessible outdoor space. Targeted public health initiatives need to acknowledge and support disadvantaged parents existing motivations and attempts to protect children from both SHS and becoming smokers.


Cully G.,Health Promotion Service
Irish Medical Journal | Year: 2010

Early and consistent intervention with pregnant smokers can reduce the incidence of adverse pregnancy outcomes associated with smoking during pregnancy. A survey of 470 pregnant women was conducted to establish the care they received in relation to smoking whilst attending routine public antenatal appointments. The overall prevalence of smoking was 23.5%. Age, level of education and nationality were associated with smoking status with younger, less educated Irish women being most likely to smoke. Women attending for their first visit were much more likely to be asked about their smoking status 71(85.5) versus 68(17.8) and advised to quit if they were smokers 11(73.3) versus 11(15.7). None of the women were offered specific assistance to help them stop smoking or had a follow-up appointment arranged specifically to do with smoking. 167 women (35.6) were exposed to passive smoking in their own homes.

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