Suchergebnisse

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.

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: Both obesity and disability have been widely recognised as major public health challenges because they play significant roles in determining self-perceived general and mental health. Longitudinal studies of the relationship between obesity and disability with self-reported health outcomes are scarce. Therefore, the objective of the present study is to examine the relationship between obesity and disability with self-perceived general and mental health among Australian adults aged 15 years and above. Methods: Data were extracted from the most recent 14 waves (waves 6 through 19) of the annual individual person dataset of the Household, Income and Labour Dynamics in Australia (HILDA) survey. The longitudinal random-effects logistic regression model was adopted to investigate the relationships between obesity and disability with self-reported health outcomes. Results: The results revealed that obese individuals and adults with some form of disability are more likely to report poor or fair general and mental health. The odds of self-reporting poor or fair general health were 2.40 and 6.07 times higher among obese (aOR: 2.40, 95% CI: 2.22– 2.58) and adults with some form of disability (aOR: 6.07, 95% CI: 5.77– 6.39), respectively, relative to adults with healthy weight and those without disability . The results also showed that self-rated poor or fair mental health were 1.22 and 2.40 times higher among obese adults (aOR: 1.22, 95% CI: 1.15– 1.30) and adults with disability (aOR: 2.40, 95% CI: 2.30– 2.51), respectively, compared to their healthy weight peers and peers without disability. Conclusion: As governmental and non-governmental organisations seek to improve the community's physical and mental well-being, these organisations need to pay particular attention to routine health care prevention, specific interventions, and treatment practices, especially for obese and/or people with disabilities.

BACKGROUND: Both obesity and disability have been widely recognised as major public health challenges because they play significant roles in determining self-perceived general and mental health. Longitudinal studies of the relationship between obesity and disability with self-reported health outcomes are scarce. Therefore, the objective of the present study is to examine the relationship between obesity and disability with self-perceived general and mental health among Australian adults aged 15 years and above. METHODS: Data were extracted from the most recent 14 waves (waves 6 through 19) of the annual individual person dataset of the Household, Income and Labour Dynamics in Australia (HILDA) survey. The longitudinal random-effects logistic regression model was adopted to investigate the relationships between obesity and disability with self-reported health outcomes. RESULTS: The results revealed that obese individuals and adults with some form of disability are more likely to report poor or fair general and mental health. The odds of self-reporting poor or fair general health were 2.40 and 6.07 times higher among obese (aOR: 2.40, 95% CI: 2.22–2.58) and adults with some form of disability (aOR: 6.07, 95% CI: 5.77–6.39), respectively, relative to adults with healthy weight and those without disability . The results also showed that self-rated poor or fair mental health were 1.22 and 2.40 times higher among obese adults (aOR: 1.22, 95% CI: 1.15–1.30) and adults with disability (aOR: 2.40, 95% CI: 2.30–2.51), respectively, compared to their healthy weight peers and peers without disability. CONCLUSION: As governmental and non-governmental organisations seek to improve the community's physical and mental well-being, these organisations need to pay particular attention to routine health care prevention, specific interventions, and treatment practices, especially for obese and/or people with disabilities.

Background: Policy analysis is considered essential for achieving successful reforms in health promotion and public health. The only framework for physical activity (PA) policy analysis was developed at a time when the field of PA policy research was in its early stages. PA policy research has since grown, and our understanding of what elements need to be included in a comprehensive analysis of PA policy is now more refined. This study developed a new conceptual framework for PA policy analysis – the Comprehensive Analysis of Policy on Physical Activity (CAPPA) framework. Methods: The development of the CAPPA framework was based on: (i) an extensive review of literature; (ii) an open discussion between the authors; (iii) three rounds of a Delphi process; and (iv) two-rounds of consultations with PA policy stakeholders. Results: The CAPPA framework specifies 38 elements of a comprehensive analysis of PA policies in the following six categories, which comprise the building blocks of the framework: (i) purpose of analysis (including auditing and assessment of policies); (ii) policy level (including: international; national; subnational; local; and institutional policies); (iii) policy sector (including: health; sport; recreation and leisure; education; transport; environment; urban/rural planning and design; tourism; work and employment; public finance; and research sectors); (iv) type of policy (including: formal written policies; unwritten formal statements; written standards and guidelines; formal procedures; and informal policies); (v) stage of policy cycle (including: agenda setting; formulation; endorsement/legitimisation; implementation; evaluation; maintenance; termination; and succession); and (vi) scope of analysis (including availability; context; processes; actors; political will; content; and effects). Based on the CAPPA framework, we also proposed broad and inclusive definitions of PA policy and PA policy analysis. Conclusion: The CAPPA framework may be used to guide future studies related to PA ...

Background: Policy analysis is considered essential for achieving successful reforms in health promotion and public health. The only framework for physical activity (PA) policy analysis was developed at a time when the field of PA policy research was in its early stages. PA policy research has since grown, and our understanding of what elements need to be included in a comprehensive analysis of PA policy is now more refined. This study developed a new conceptual framework for PA policy analysis - the Comprehensive Analysis of Policy on Physical Activity (CAPPA) framework. Methods: The development of the CAPPA framework was based on: (i) an extensive review of literature; (ii) an open discussion between the authors; (iii) three rounds of a Delphi process; and (iv) two-rounds of consultations with PA policy stakeholders. Results: The CAPPA framework specifies 38 elements of a comprehensive analysis of PA policies in the following six categories, which comprise the building blocks of the framework: (i) purpose of analysis (including auditing and assessment of policies); (ii) policy level (including: international; national; subnational; local; and institutional policies); (iii) policy sector (including: health; sport; recreation and leisure; education; transport; environment; urban/rural planning and design; tourism; work and employment; public finance; and research sectors); (iv) type of policy (including: formal written policies; unwritten formal statements; written standards and guidelines; formal procedures; and informal policies); (v) stage of policy cycle (including: agenda setting; formulation; endorsement/legitimisation; implementation; evaluation; maintenance; termination; and succession); and (vi) scope of analysis (including availability; context; processes; actors; political will; content; and effects). Based on the CAPPA framework, we also proposed broad and inclusive definitions of PA policy and PA policy analysis. Conclusion: The CAPPA framework may be used to guide future studies related to PA policy and to provide a context for the analysis of its specific components. The framework could be used in the same way for sedentary behaviour policy research. Future research should examine the extent to which PA policy analysis has covered each of the elements specified in the CAPPA framework and analyse the elements for which evidence is lacking. Future studies should also determine whether the existing tools allow for auditing and assessment of all the CAPPA elements and develop new tools if needed to allow for a more comprehensive PA policy analysis.

Background: In 2018, the Australian Government updated the Australian Physical Activity and Sedentary Behaviour Guidelines for Children and Young People. A requirement of this update was the incorporation of a 24-hour approach to movement, recognising the importance of adequate sleep. The purpose of this paper was to describe how the updated Australian 24-Hour Movement Guidelines for Children and Young People (5 to 17 years): an integration of physical activity, sedentary behaviour and sleep were developed and the outcomes from this process. Methods: The GRADE-ADOLOPMENT approach was used to develop the guidelines. A Leadership Group was formed, who identified existing credible guidelines. The Canadian 24-Hour Movement Guidelines for Children and Youth best met the criteria established by the Leadership Group. These guidelines were evaluated based on the evidence in the GRADE tables, summaries of findings tables and recommendations from the Canadian Guidelines. We conducted updates to each of the Canadian systematic reviews. A Guideline Development Group reviewed, separately and in combination, the evidence for each behaviour. A choice was then made to adopt or adapt the Canadian recommendations for each behaviour or create de novo recommendations. We then conducted an online survey (n=237) along with three focus groups (n=11 in total) and 13 key informant interviews. Stakeholders used these to provide feedback on the draft guidelines. Results: Based on the evidence from the Canadian systematic reviews and the updated systematic reviews in Australia, the Guideline Development Group agreed to adopt the Canadian recommendations and, apart from some minor changes to the wording of good practice statements, maintain the wording of the guidelines, preamble, and title of the Canadian Guidelines. The Australian Guidelines provide evidence-informed recommendations for a healthy day (24-hours), integrating physical activity, sedentary behaviour (including limits to screen time), and sleep for children (5-12 years) and ...