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Purpose. To test the ability of the theory of planned behavior (TPB) in predicting the stage of change for physical activity promotion by mental health professionals. Design. Six-month prospective questionnaire study. Setting. One mental health trust in the East Midlands, United Kingdom. Subjects. Three hundred ninety-four mental health professionals (men, n = 131; women, n = 263) of an initial sample of 477 participated in the study (83% response rate). Measures. Attitudes, subjective norms, intentions, perceived behavioral control, and stage of change were measured at the first wave of data collection. Stage of change was also assessed 6 months later. Data were analyzed using structural equation modeling. Results. Intention and stage of change were successfully predicted from TPB variables. Overall, 27% of the variance in self-reported stage of promoting physical activity was explained by the model. Sixty-one percent of the variance in intention to promote physical activity was explained. When included, past behavior was the strongest predictor of both intention and stage of change and attenuated all other path coefficients. Past behavior improved the predicted variance in intention by 11% and stage by 6%. Conclusions. The TPB variables of attitude, subjective norms, perceived behavioral control, and intention predict stage of change of physical activity promotion in a health care setting. However, promoting physical activity in the past had a sizable effect on predicting subsequent promotion. Due to unequal distribution across stages, the stage model's application to understanding the behavior of health professionals may be limited.

L'effet de l'activité physique sur la santé de l'enfant et de l'adolescent est largement reconnu. Cet article répertorie les recherches actuelles sur ce thème et se centre particulièrement sur un programme réalisé à l'Université d'Exeter en Angleterre. En particulier, les travaux ont porté sur la dimension psychologique de l'activité physique (essentiellement l'amusement, le plaisir et l'estime de soi), ainsi que les composantes motivationnelles et notamment la motivation intrinsèque.

This article is closed access. ; Background: The trend of escalating obesity has prompted some armed forces to employ comprehensive health surveys to report obesity trends and prevalence, the findings of which suggest that obesity is a growing concern in these specific populations. Aim: To provide an appraisal of obesity prevalence and risk to obesity-related diseases in the British Army in relation to age, gender, military rank and employment. Subjects and method: An observational cohort study (n = 50 635) consisting of 47 173 men and 3462 women was drawn from a study sample hosted on the Fitness Information Software System (FISS) (n = 54 854). Multiple logistic regression techniques were employed separately for men and women. Results: According to BMI, 56.7% of the study population were overweight and of those individuals 12% were obese. Whilst a higher percentage of males were obese (12.2% and 8.6%, respectively), when waist circumference data were added to the BMI data, the results indicate that females displayed a higher percentage of risk to obesity-related diseases than males (30.4% and 24%, respectively). Conclusions: Armed service personnel should be made aware of the implications of obesity in regards to health and occupation. Specific focus should be given to those older individuals employed in managerial positions undertaking low levels of occupational physical activity.

This article is closed access. ; Objective: The emergence of obesity as a distinct disease could have far reaching consequences for an organisation where optimum health and physical fitness are required for personnel to perform their occupational roles effectively. The objectives of this paper are to systematically review the literature concerning correlates and treatment of obesity in military populations. Methods: Through computerised searches of English language studies, 17 papers were identified (treatment (13), correlates (4)). Results: Successful treatment interventions incorporated exercise, healthy eating information, behavioural modification, self-monitoring, relapse prevention, and structured follow-up and were supported by trained personnel. Efficacy due to physical activity was underreported. Reduction in body fat rather than body weight was the most significant outcome. The major significant correlates of obesity were being enlisted personnel, male, ≧35 years of age, African-American/Hispanic ethnicity, and married (with spouse present). Conclusion: This systematic review highlights the deficit in knowledge concerning treatment and the lack of engagement in relation to the specific correlates of obesity in military populations.

OBJECTIVE: The emergence of obesity as a distinct disease could have far reaching consequences for an organisation where optimum health and physical fitness are required for personnel to perform their occupational roles effectively. The objectives of this paper are to systematically review the literature concerning correlates and treatment of obesity in military populations. METHODS: Through computerised searches of English language studies, 17 papers were identified (treatment (13), correlates (4)). RESULTS: Successful treatment interventions incorporated exercise, healthy eating information, behavioural modification, self-monitoring, relapse prevention, and structured follow-up and were supported by trained personnel. Efficacy due to physical activity was underreported. Reduction in body fat rather than body weight was the most significant outcome. The major significant correlates of obesity were being enlisted personnel, male, ≧35 years of age, African-American/Hispanic ethnicity, and married (with spouse present). CONCLUSION: This systematic review highlights the deficit in knowledge concerning treatment and the lack of engagement in relation to the specific correlates of obesity in military populations.

Purpose: This study aims to investigate the impact of disadvantaged neighborhoods and lifestyle factors on obesity among Australian adults. Design: Quantitative, longitudinal research design. Setting: Cohort. Sample: Data for this study came from a cohort of 10 734 adults (21 468 observations) who participated in the Household, Income and Labour Dynamics in Australia survey. The participants were interviewed at baseline in 2013 and were followed up in 2017. Measures: Generalized Estimating Equation model with logistic link function was employed to examine within-person changes in obesity due to disadvantaged neighborhoods and lifestyle factors at 2-time points over a 4-year follow-up period. Results: Adults living in the most disadvantaged area were 1.22 (odds ratio [OR]: 1.22, 95% CI: 1.08-1.38) and 1.30 (OR: 1.30, 95% CI: 1.20-1.42) times, respectively, more prone to be overweight and obese compared with peers living at least disadvantaged area. Study results also revealed that adults who consume fruits regularly and perform high levels of physical activity were 6% (OR: 0.94, 95% CI: 0.91-0.98) and 12% (OR: 0.88, 95% CI: 0.85-0.92) less likely to be obese, respectively, compared to their counterparts. Current alcohol drinkers were 1.07 (OR: 1.07, 95% CI: 1.01-1.13) times more likely to be obese compared to peers not consuming alcohol. Highly psychologically distressed adults were 1.08 times (OR: 1.08, 95% CI: 1.02-1.13) more likely to be obese than their peers. Conclusion: This study contributes to the literature regarding disadvantaged neighborhoods and lifestyle factors, which have an influence on adult obesity rates and thus help health decision-makers to formulate effective obesity prevention strategies.

Objective: This study aimed to examine the longitudinal association between 9 job-related characteristics and obesity among Australian employees using a nationally representative sample. Design: Longitudinal research design. Setting: Workplace. Participants: This study was conducted by pooling 2 cross-sectional surveys of nationally representative longitudinal data collected across 2-time points in 2013 and 2017. This study limited the sample to current employees aged 15 to 64 years. The total number of observation included in the analysis is 16 980 of 11 521 employees. Measures: The outcome variable is weight status and the main exposure variables are 9 job-related characteristics (work hours per week, work schedule, job type, employment contract type, firm size, supervisory responsibility, paid sick leave, self-perceived job stress, and self-perceived job insecurity). Generalized estimating equation logistic regression was employed to explore the association between job-related characteristics and obesity. Results: This study found that 59% of Australian employees were either overweight or obese. Employees working more than 40 hours per week were 1.11 times (odds ratio [OR]: 1.11, 95% confidence interval [CI]: 1.03-1.21) and 1.07 times (OR: 1.07, 95% CI: 1.01-1.13) more prone to become overweight and obese, respectively, compared to their counterparts who work 31 to 40 hours per week. The study also revealed that self-perceived job insecurity was positively associated with obesity (OR: 1.03, 95% CI: 1.02-1.04). However, this study did not find evidence that work schedule, job type, employment contract, firm size, supervisory role, paid sick leave, and self-perceived job stress were associated with obesity. Conclusions: Working more than 40 hours per week and self-perceived job insecurity were significantly associated with obesity among Australian employees. A better understanding of why prolonged work hours and self-perceived job insecurity are associated with obesity may help policy makers to implement workplace wellness policies and for employers to take measures to tackle the obesity problem of their employees.

This is an open access article under the CC BY-NC-ND license (https://creativecommons.org/licenses/by-nc-nd/4.0/). ; Objective: In the British Army, fitness is assessed by a load carriage test (Annual Fitness Test, AFT) and by a three event Personal Fitness Assessment (PFA). Body composition based on body mass index (BMI) and abdominal circumference (AC) is also part of a mandatory annual assessment. This study examined the influence of BMI and AC on fitness test results within a comprehensive sample of British Army personnel. Design: Secondary analyse were carried out on data obtained from the 2011 Defence Analytical Services and Advice (DASA) database for 50,635 soldiers (47,173 men and 3,462 women). Methods: Comparisons using loglinear analysis were made between groups of individuals classified by body mass index as obese (≥30 kg/m2) and not obese (<30 kg/m2), and further classified using combined BMI and AC for obesity-related health risks to compare "no risk" with "increased risk." Results: Not obese or "no risk" soldiers had a significant relationship with success in the AFT (p < 0.01) and PFA (p < 0.01). Of those soldiers who attempted the AFT, 99% of men and 92% of women passed; for the PFA, 92% of men and 91% of women passed. Obese or "at risk" soldiers were more likely to fail and far less likely to take both tests (p < 0.05). Compared to older obese soldiers, young obese soldiers were more likely to attempt the tests. Conclusions: We conclude that BMI and AC are useful indicators of fitness test outcome in the British Army.

BACKGROUND: Health status is a crucial determinant of an individuals' labour market outcomes. The present study investigates the association between obesity and disability with perceived employment discrimination within Australia. METHODS: A total of 17,174 person-year observations from the 11,079 respondents were analysed using four waves of data from the Household, Income, and Labour Dynamics in Australia (HILDA) survey. The primary outcome examined was employment discrimination, using obesity and disability as the main exposure variables. The longitudinal random-effects regression technique was applied to investigate the between-person differences in employment discrimination associated with obesity and disability. RESULTS: The findings suggest that more than one in ten (12.68 %) Australians experienced employment discrimination. The odds of being discriminated against while applying for a job were 1.56 times (aOR: 1.56, 95 % CI: 1.15–2.11) higher for obese than their healthy weight counterparts in youngest women. Adults with a disability had 1.89 times (aOR: 1.89, 95 % CI: 1.65–2.17) higher odds of being discriminated against than peers without disability. CONCLUSION: The results provide evidence that obesity and disability contribute to employment discrimination in Australia. The findings can assist government and related agencies to consider the adequacy of existing discrimination legislation and help organisations to develop appropriate policies to address discrimination against obese and disabled people in their workplaces.

Issue addressed: Exercising outdoors provide beneficial effect on mental and physical health for all ages. However, few older people exercise outdoors other than walking. While outdoor gyms have become increasingly common in Australia, limited outdoor exercise equipment specifically designed for older people is available in public spaces. We have set up and evaluated a unique purpose-built outdoor exercise park for older people in the community setting and demonstrated positive physical and well-being outcomes associated with the provision of this unique exercise mode and social programme. Methods: This study is a reflective narrative describing this innovative exercise approach and reports challenges associated with establishment of the exercise park, conducting the randomised trial, strategies adopted to address these challenges and recommendations for future implementation of this approach in the community. Results: Many challenges were encountered, including securing appropriate land to locate the exercise park, control of environmental factors for safety (non-slippery ground and equipment) as well as logistics in running the exercise programme itself. Several adjustments in the equipment were also required to ensure safe use by older people. Conclusion: The inclusion of outdoor equipment for older people in public spaces or urban parks is important and careful consideration needs to be taken by local/public authorities to provide access, amenities and safety for all as well as activities to suit all ages. So what?: Seniors' exercise parks can be installed in public places and may provide an enjoyable and effective approach to engage older individuals in a more active and healthier lifestyle.

BACKGROUND: The physical environment has been shown to have a positive effect on the promotion of physical activity of older people. Outdoor environments that incorporate specialised exercise equipment suitable for older people are uniquely placed to promote physical activity and social connectedness amongst older people. The ENJOY project included the installation of specialised outdoor exercise equipment (the Seniors Exercise Park) and the delivery of a physical and social activity program for older people as part of a prospective pre-post research design. The installation of the specialised equipment in public sites and an aged care facility was also aimed at increasing usage of the equipment by older people from the wider community and to increase physical and social activities. METHOD: A conceptual framework for implementation and several engagement methods were utilised to guide the research and to support the participating partners throughout the project. This paper is a reflective narrative describing the collaborative process and approach utilised to engage local governments and community, and reports the challenges and the lessons learnt to inform future strategies for implementation. RESULTS: The conceptual framework for the implementation process that guided the conduct and delivery of the ENJOY project included the core elements of the Interactive Systems Framework and the ecologic framework. These models incorporate elements of research-to-practice and community-centred implementation to accommodate the unique perspectives of a range of stakeholders. CONCLUSION: Partner characteristics such as local governments' structure and policy as well as community factors can impact on implementation. Partnership with local governments with effective communication, strategic planning and community and seniors engagement approaches are recommended for successful implementation. The lessons learnt can further assist public health research design around changes to the built environment to positively impact on ...

Background Health status is a crucial determinant of an individuals' labour market outcomes. The present study investigates the association between obesity and disability with perceived employment discrimination within Australia. Methods A total of 17,174 person-year observations from the 11,079 respondents were analysed using four waves of data from the Household, Income, and Labour Dynamics in Australia (HILDA) survey. The primary outcome examined was employment discrimination, using obesity and disability as the main exposure variables. The longitudinal random-effects regression technique was applied to investigate the between-person differences in employment discrimination associated with obesity and disability. Results The findings suggest that more than one in ten (12.68 %) Australians experienced employment discrimination. The odds of being discriminated against while applying for a job were 1.56 times (aOR: 1.56, 95 % CI: 1.15–2.11) higher for obese than their healthy weight counterparts in youngest women. Adults with a disability had 1.89 times (aOR: 1.89, 95 % CI: 1.65–2.17) higher odds of being discriminated against than peers without disability. Conclusion The results provide evidence that obesity and disability contribute to employment discrimination in Australia. The findings can assist government and related agencies to consider the adequacy of existing discrimination legislation and help organisations to develop appropriate policies to address discrimination against obese and disabled people in their workplaces.

Background: The physical environment has been shown to have a positive effect on the promotion of physical activity of older people. Outdoor environments that incorporate specialised exercise equipment suitable for older people are uniquely placed to promote physical activity and social connectedness amongst older people. The ENJOY project included the installation of specialised outdoor exercise equipment (the Seniors Exercise Park) and the delivery of a physical and social activity program for older people as part of a prospective pre-post research design. The installation of the specialised equipment in public sites and an aged care facility was also aimed at increasing usage of the equipment by older people from the wider community and to increase physical and social activities. Method: A conceptual framework for implementation and several engagement methods were utilised to guide the research and to support the participating partners throughout the project. This paper is a reflective narrative describing the collaborative process and approach utilised to engage local governments and community, and reports the challenges and the lessons learnt to inform future strategies for implementation. Results: The conceptual framework for the implementation process that guided the conduct and delivery of the ENJOY project included the core elements of the Interactive Systems Framework and the ecologic framework. These models incorporate elements of research-to-practice and community-centred implementation to accommodate the unique perspectives of a range of stakeholders. Conclusion: Partner characteristics such as local governments' structure and policy as well as community factors can impact on implementation. Partnership with local governments with effective communication, strategic planning and community and seniors engagement approaches are recommended for successful implementation. The lessons learnt can further assist public health research design around changes to the built environment to positively impact on older people's physical activity levels.

Background: Creating inclusive and accessible outdoor environments that provide and encourage opportunities for older adults to engage in physical activity and social interaction is important for healthy ageing. The Senior Exercise Park is outdoor exercise equipment designed specifically for use by older people that provides physical and social benefits for older people in the community, and has the potential to be used widely as a sustainable mode of physical activity. The aim of this study is to implement and evaluate the effects of sustained engagement through the use of a community-based novel outdoor physical activity program (purpose-built exercise park) for older people on physical, mental and social health and physical activity outcomes (the ENJOY project). Methods: This is a prospective pre-post design study with 12 months follow up. Adults aged ≥60 years will be recruited from the general community from the suburbs close to the Senior Exercise Parks locations in Melbourne. Participants will undergo a 12 week structured supervised physical activity program using the outdoor Senior Exercise Park equipment followed by 6 months unstructured physical activity program. Participants will be assessed at baseline, 3, 9, and 12 months. The following outcomes will be assessed: physical activity, physical function, psychosocial and mental health outcomes, falls risk and falls occurrence, participants' feedback and satisfaction, and health care resource use. Discussion: The ENJOY trial is designed to operate in a community setting with local government engagement to maximise the usage of the exercise park and provide an outdoor space for older people to be physically active. This project will evaluate the effectiveness and sustainability of the outdoor exercise park on a range of health outcomes and its long-term usability in the community. Trial registration: This trial is prospectively registered with the Australian New Zealand Clinical Trials Registry. Trial registration number ACTRN12618001727235 registered 18th of October 2018.