ORCID Profile
0000-0002-7265-5407
Current Organisations
Hunter New England Local Health District
,
The University of Newcastle
Does something not look right? The information on this page has been harvested from data sources that may not be up to date. We continue to work with information providers to improve coverage and quality. To report an issue, use the Feedback Form.
Related Links
Publications
Older people playing ball: What is the risk of falling and injury?
Publisher: Elsevier BV
Date: 2009
DOI: 10.1016/J.JSAMS.2007.12.007
Abstract: Increasing physical activity amongst seniors is important for public health, yet guidance is needed to minimise injury risks. To describe the incidence of falls/injuries in a walking team ball game (Lifeball) designed for seniors, a prospective cohort study was undertaken amongst community dwelling Lifeball participants in Australia. Players completed a telephone survey soon after commencing Lifeball (2004) and 12 months later (2005). Attendance and incident records were audited for the period. Subjects joined a Lifeball group with opportunity to play at least once per week. Baseline was completed by 284 players aged between 40 and 96 years (mean 67 years), with most (83.8%, 238/284) female. Of 263 followed up, the average attendances was 25, with 19.3% attending on fewer than 4 occasions and 14.3% attending 52 or more times. Most (93.9%) reported no injuries requiring medical attention. However, 16 (6.1%) had injuries requiring medical attention and their 27 injuries represent an injury rate of 3.3 per 1000hours of participation. Twenty participants (7.6%) had a Lifeball fall equating to a fall rate of 2.8 per 1000hours of participation. Falls in Lifeball were not associated with measured predictors (age, gender, falls history, perceived falls risk or hours played). Incident records showed a trip/stumble involving rushing, walking backwards, or overextending (all against rules) as common falling causes. Lifeball is not 'risk free' however due to a lack of comparative data it is difficult to compare injury rate to relevant activities. Prevention of injury should concentrate on enforcing safety rules.
5-year follow-up of a telephone intervention to increase fruit and vegetable consumption in preschoolers: The ‘healthy habits’ cluster randomised trial
Publisher: MDPI AG
Date: 30-11-2020
DOI: 10.3390/NU12123702
Abstract: Little is known about the long-term impact of telephone-based interventions to improve child diet. This trial aimed to assess the long-term effectiveness (after 5 years) of a telephone-based parent intervention in increasing children’s fruit and vegetable consumption. Parents of 3–5 year olds were recruited from 30 Australian preschools to participate in a cluster randomised controlled trial. Intervention parents received four, weekly, 30-min support calls aimed at modifying the home food environment. Control parents received printed materials. Consumption was assessed using the Fruit and Vegetable subscale of the Children’s Dietary Questionnaire (F& V-CDQ) (children) and daily servings of fruit and vegetables (children and parents) via parent telephone interview. Of the 394 parents who completed baseline, 57% (99 intervention, 127 control) completed follow-up. After 5-years, higher intervention F& V-CDQ scores, bordering on significance, were found in complete-case (+1.1, p = 0.06) and sensitivity analyses (+1.1, p = 0.06). There was no difference in parent or child consumption of daily fruit servings. Complete-case analysis indicated significantly higher consumption of child vegetable servings (+0.5 servings p = 0.02), which was not significant in sensitivity analysis (+0.5 servings p = 0.10). This telephone-based parent intervention targeting the family food environment may yield promising improvements in child fruit and vegetable consumption over a 5-year period.
Economic evaluation of telephone-based weight loss support for patients with knee osteoarthritis: a randomised controlled trial
Publisher: Springer Science and Business Media LLC
Date: 12-2018
Randomised controlled trial of referral to a telephone-based weight management and healthy lifestyle programme for patients with knee osteoarthritis who are overweight or obese: a study protocol
Publisher: BMJ
Date: 03-2016
Prevalence of responsible hospitality policies in licensed premises that are associated with alcohol-related harm
Publisher: Informa UK Limited
Date: 06-2002
DOI: 10.1080/09595230220138993B
Abstract: This study aimed to determine the prevalence of responsible hospitality policies in a group of licensed premises associated with alcohol-related harm. During March 1999, 108 licensed premises with one or more police-identified alcohol-related incidents in the previous 3 months received a visit from a police officer. A 30-item audit checklist was used to determine the responsible hospitality policies being undertaken by each premises within eight policy domains: display required signage (three items) responsible host practices to prevent intoxication and under-age drinking (five items) written policies and guidelines for responsible service (three items) discouraging inappropriate promotions (three items) safe transport (two items) responsible management issues (seven items) physical environment (three items) and entry conditions (four items). No premises were undertaking all 30 items. Eighty per cent of the premises were undertaking 20 of the 30 items. All premises were undertaking at least 17 of the items. The proportion of premises undertaking in idual items ranged from 16% to 100%. Premises were less likely to report having and providing written responsible hospitality documentation to staff, using door charges and having entry/re-entry rules. Significant differences between rural and urban premises were evident for four policies. Clubs were significantly more likely than hotels to have a written responsible service of alcohol policy and to clearly display codes of dress and conditions of entry. This study provides an indication of the extent and nature of responsible hospitality policies in a s le of licensed premises that are associated with a broad range of alcohol related harms. The finding that a large majority of such premises appear to adopt responsible hospitality policies suggests a need to assess the validity and reliability of tools used in the routine assessment of such policies, and of the potential for harm from licensed premises.
Correction: Associations Between Digital Health Intervention Engagement, Physical Activity, and Sedentary Behavior: Systematic Review and Meta-analysis
Publisher: JMIR Publications Inc.
Date: 29-03-2021
DOI: 10.2196/29094
A group randomised trial of two methods for disseminating a smoking cessation programme to public antenatal clinics: effects on patient outcomes
Publisher: BMJ
Date: 04-2006
The effectiveness of an intervention in increasing community health clinician provision of preventive care: a study protocol of a non-randomised, multiple-baseline trial
Publisher: Springer Science and Business Media LLC
Date: 12-2011
Smoking care provision in hospitals: A review of prevalence
Publisher: Oxford University Press (OUP)
Date: 05-2008
DOI: 10.1080/14622200802027131
Abstract: Hospitals are key settings for the provision of smoking cessation care. Limited data are available that describe the prevalence and type of such care delivered routinely in this setting. We reviewed studies conducted in hospitals and published between 1994 and 2005 that reported levels of smoking care delivery. This review describes the proportion of patients receiving, and the proportion of health professionals providing, various smoking cessation care practices. We used both descriptive and meta-analytic methods. According to the meta-analysis, smoking status was assessed in 60% of patients, 42% were advised or counseled to quit, 14% were provided with or advised to use nicotine replacement therapy (NRT), and 12% received referrals or follow-up. Significantly fewer patients received follow-up or referrals than were assessed for smoking status or received advice or counseling to quit. Some 81% of health professionals reported they assessed smoking status, 70% advised or counseled patients to quit, 13% provided NRT or advised its use, and 39% provided referrals or follow-up. Significantly fewer health professionals advised or prescribed NRT than assessed smoking status or advised or counseled patients to quit. Statistical heterogeneity was indicated for all smoking care practices. Levels of smoking cessation care are less than optimal in hospitals, and the levels of some important care practices are particularly low. Future research should identify effective methods for increasing smoking care provision in this setting. In addition, standardized measures of smoking care should be developed. Hospital organizations should enhance and continue to monitor their delivery of smoking care.
Helping hospital patients quit: What the evidence supports and what guidelines recommend
Publisher: Elsevier BV
Date: 04-2008
DOI: 10.1016/J.YPMED.2007.12.003
Abstract: The study aimed to critically appraise the extent and strength of systematic review evidence for, and guideline recommendations regarding hospital smoking cessation interventions. Systematic reviews of smoking cessation interventions were identified via an electronic search of the Cochrane Library. Meta-analyses from Cochrane reviews were categorised as those that incorporated only studies of hospital based interventions, and those which incorporated interventions which were not hospital based. Smoking cessation guidelines for hospital health professionals were identified via a search of the World Wide Web. The review found that evidence from meta-analyses restricted to hospital studies was insufficient to evaluate a number of specific intervention strategies and at times conflicted with the findings of meta-analyses without such restrictions. The majority of guidelines recommended the provision of brief advice, counseling, nicotine replacement therapy despite the absence of clear supporting evidence. Further hospital-based research addressing specific cessation strategies is required. Furthermore, smoking cessation guidelines for hospital based health professionals should more specifically reflect evidence from this setting.
Australian children are not meeting recommended physical activity levels at school: Analysis of objectively measured physical activity data from a cross sectional study
Publisher: Elsevier BV
Date: 09-2021
A randomised controlled trial of a lifestyle behavioural intervention for patients with low back pain, who are overweight or obese: study protocol
Publisher: Springer Science and Business Media LLC
Date: 11-02-2016
Smoking status in pregnant women
Publisher: Elsevier BV
Date: 2001
DOI: 10.1016/S0306-4603(00)00070-8
Abstract: Smoking according to self-report and to carbon monoxide (CO) were examined in 7,405 pregnant women who agreed to complete a breath test and questionnaire. The sensitivity and specificity of self-report against CO, and predictors of a high CO among reported nonsmokers, were examined. The prevalence of reported smoking was 23% (95% CI: 19.4-26.4), and 20% had a CO of 9 or more (95% CI: 17.0-23.1). The sensitivity and specificity against CO were 87% (95% CI: 83.1-91.6) and 93% (95% CI: 91.9-94.6). The positive predictive value was 76% (95% CI: 73.2-79.8), reflecting CO's inability to detect light smoking. The negative predictive value was 97% (95% CI: 95.6-97.8). The best predictors of high CO among reported nonsmokers were being orced/separated (9.8% had high CO), quitting during pregnancy (8.5% had high CO), being third trimester, and high passive exposure. Some pregnant women may report inaccurately despite validation. Difficulties remain in determining the contributions of passive exposure and inaccurate report to inconsistencies between biochemical and self-report measures.
Scale-up of the Physical Activity 4 Everyone (PA4E1) intervention in secondary schools: 24-month implementation and cost outcomes from a cluster randomised controlled trial
Publisher: Springer Science and Business Media LLC
Date: 23-10-2021
DOI: 10.1186/S12966-021-01206-8
Abstract: Physical Activity 4 Everyone (PA4E1) is an evidence-based program effective at increasing adolescent physical activity (PA) and improving weight status. This study aimed to determine a) the effectiveness of an adapted implementation intervention to scale-up PA4E1 at 24-month follow-up, b) fidelity and reach, and c) the cost and cost-effectiveness of the implementation support intervention. A cluster randomised controlled trial using a type III hybrid implementation-effectiveness design in 49 lower socio-economic secondary schools, randomised to a program ( n = 24) or control group ( n = 25). An adapted implementation intervention consisting of seven strategies was developed to support schools to implement PA4E1 over 24-months. The primary outcome was the proportion of schools implementing at least four of the 7 PA practices, assessed via computer assisted telephone interviews (CATI) with Head Physical Education Teachers. Secondary outcomes included the mean number of PA practices implemented, fidelity and reach, cost and cost-effectiveness. Logistic regression models assessed program effects. At baseline, no schools implemented four of the 7 PA practices. At 24-months, significantly more schools in the program group (16/23, 69.6%) implemented at least four of the 7 PA practices than the control group (0/25, 0%) ( p 0.001). At 24-months, program schools were implementing an average of 3.6 more practices than control schools (4.1 (1.7) vs. 0.5 (0.8), respectively) ( P 0.001). Fidelity and reach of the implementation intervention were high ( 75%). The total cost of the program was $415,112 AUD (2018) ($17,296 per school $117.30 per student). The adapted implementation intervention provides policy makers and researchers with an effective and potentially cost-effective model for scaling-up the delivery of PA4E1 in secondary schools. Further assessment of sustainability is warranted. Australian New Zealand Clinical Trials Registry ACTRN12617000681358 prospectively registered 12th May 2017.
A cluster randomised trial of a telephone-based intervention for parents to increase fruit and vegetable consumption in their 3- to 5-year-old children: study protocol
Publisher: Springer Science and Business Media LLC
Date: 28-04-2010
Associations between characteristics of the home food environment and fruit and vegetable intake in preschool children: A cross-sectional study
Publisher: Springer Science and Business Media LLC
Date: 12-2011
The Relative Effectiveness of Educational and Behavioral Instruction Programs for Patients With NIDDM: A Randomized Trial
Publisher: SAGE Publications
Date: 08-1996
DOI: 10.1177/014572179602200412
Abstract: In this randomized trial patients with non-insulin-dependent diabetes were allocated to one of four programs: a minimal instruction program (n=59). an education program of in idual visits (n=57), an education program incorporating a group education course (n=66), and a behavioral program (n=59). In idual and group education programs had higher attrition rates than the behavioral and minimal programs. The four programs, which involved different amounts of patient contact time, delivery format, and instructional strategies. all produced reductions in HbA atid BMI, with no significant differences between the programs. There were no differences between groups over three time periods in total cholesterol, HDL cholesterol, systolic blood pressure, or proportion of patients consulting an ophthalmologist. The behavioral program ploduced a greater reduction in diastolic blood pressure over 12 months that the education programs and a greater reduction in the cholesterol risk ratio over 3 months than the other programs. The behavioral program patients were more likely to have visited a podiatrist after 6 months and reported higher satisfaction.
The short-term effectiveness of real-time video counselling on smoking cessation among residents in rural and remote areas: An interim analysis of a randomised trial
Publisher: Elsevier BV
Date: 12-2021
DOI: 10.1016/J.JSAT.2021.108448
Abstract: Real-time video counselling for smoking cessation uses readily accessible software (e.g. Skype). This study aimed to assess the short-term effectiveness of real-time video counselling compared to telephone counselling or written materials (minimal intervention control) on smoking cessation and quit attempts among rural and remote residents. An interim analysis of a three-arm, parallel group randomised trial with participants (n = 655) randomly allocated to 1) real-time video counselling 2) telephone counselling or 3) written materials only (minimal intervention control). Participants were daily tobacco users aged 18 years or older residing in rural or remote areas of New South Wales, Australia. Video and telephone counselling conditions offered up to six counselling sessions while those in the minimal intervention control condition were mailed written materials. The study measured seven-day point prevalence abstinence, prolonged abstinence and quit attempts at 4-months post-baseline. Video counselling participants were significantly more likely than the minimal intervention control group to achieve 7-day point prevalence abstinence at 4-months (18.9% vs 8.9%, OR = 2.39 (1.34-4.26), p = 0.003), but the video (18.9%) and telephone (12.7%) counselling conditions did not differ significantly for 7-day point prevalence abstinence. The video counselling and minimal intervention control groups or video counselling and telephone counselling groups did not differ significantly for three-month prolonged abstinence or quit attempts. Given video counselling may increase cessation rates at 4 months post-baseline, quitlines and other smoking cessation services may consider integrating video counselling into their routine practices as a further mode of cessation care delivery. www.anzctr.org.au ACTRN12617000514303.
Smoking cessation interventions for in-patients: a selective review with recommendations for hospital-based health professionals
Publisher: Wiley
Date: 12-2003
Promoting a team ball game (Lifeball) to older people: Who does this game attract and who continues?
Publisher: CSIRO Publishing
Date: 2009
DOI: 10.1071/HE09120
Abstract: To describe the demographic and health-related characteristics (physical activity, self-reported health status, quality of life and falls history) of older people who enrol in a team-based game, Lifeball, and examine associations between continuation and participant characteristics. Reasons for stopping, participants' perceptions of the game and changes in health-related characteristics over 12 months were examined. Telephone surveys were conducted with a cohort of Lifeball players at: baseline, soon after commencing playing and 12 months later. At baseline, participants were aged 40 to 96 years (mean 67). Most were female (84%), in good to excellent health (86%) and reported being sufficiently (>150 minutes per week) physically active (69%). Almost half (43%) were still playing 12 months later (continuers). Continuers were more likely to perceive Lifeball had helped them to: feel fitter and healthier (91%) improve their social life (73%) and be more active (53%). No significant changes in continuers' physical activity, self-reported health status and quality of life measures were reported. The main reason for stopping playing was illness/injury unrelated to Lifeball. Lifeball mainly appealed to healthy, active older people.
Response bias in a study of general practice
Publisher: Oxford University Press (OUP)
Date: 1988
Abstract: Response bias in quality of care research is an important, but largely neglected concern. Differences between health care professionals who consent to participate in research and those who do not may distort the conclusions and prevent the results being generalizable. This is particularly likely when response rates are low, as they often are in studies evaluating primary health care. The present study outlines a method for examining this important area. Fifty-six general practitioners who consented to participate in an observational study of general practice were compared with 52 doctors who declined to participate in the research. Comparisons were made of general characteristics including age, sex, practice size and postgraduate qualifications, as well as attitudes toward their role. This last analysis was deemed particularly important, as the attitudes expressed may have affected the behaviour of the doctor in the consultation, and therefore outcomes such as accurate diagnosis, compliance and satisfaction. Such outcomes are often the object of study in quality of care research. The only significant difference to emerge in the present study was that non-consenters were more strongly in favour of a medical system based on free enterprise and fee for service (t83 = 2.3P less than 0.05). No systematic differences were found on other general characteristics or attitudes relating to patient care. Response bias using the stated variables was therefore considered to be minimal. The results are discussed in terms of strategies aimed at increasing response rates in quality of care research.
Evaluating Digital Program Support for the Physical Activity 4 Everyone (PA4E1) School Program: Mixed Methods Study (Preprint)
Publisher: JMIR Publications Inc.
Date: 22-12-2018
Abstract: ffectively scaled-up physical activity interventions are urgently needed to address the high prevalence of physical inactivity. To facilitate scale-up of an efficacious school-based physical activity program (Physical Activity 4 Everyone [PA4E1]), provision of implementation support to physical education (PE) teachers was adapted from face-to-face and paper-based delivery modes to partial delivery via a website. A lack of engagement (usage and subjective experience) with digital delivery modes, including websites, may in part explain the typical reduction in effectiveness of scaled-up interventions that use digital delivery modes. A process evaluation focused on the PA4E1 website was undertaken. he 2 objectives were to (1) describe the usage of the PA4E1 program website by in-school ch ions (PE teachers leading the program within their schools) and PE teachers using quantitative methods (2) examine the usage, subjective experience, and usability of the PA4E1 program website from the perspective of in-school ch ions using mixed methods. he first objective used website usage data collected across all users (n=273) throughout the 9 school terms of the PA4E1 implementation support. The 4 usage measures were sessions, page views, average session duration, and downloads. Descriptive statistics were calculated and explored across the duration of the 26-month program. The second objective used mixed methods, triangulating data from the first objective with data from a think-aloud survey and usability test completed by in-school ch ions (n=13) at 12 months. Qualitative data were analyzed thematically alongside descriptive statistics from the quantitative data in a triangulation matrix, generating cross-cutting themes using the “following a thread” approach. or the first objective, in-school ch ions averaged 48.0 sessions per user, PE teachers 5.8 sessions. PE teacher sessions were of longer duration (10.5 vs 7.6 minutes) and included more page views (5.4 vs 3.4). The results from the mixed methods analysis for the second objective found 9 themes and 2 meta-themes. The first meta-theme indicated that the website was an acceptable and appropriate delivery mode, and usability of the website was high. The second meta-theme found that the website content was acceptable and appropriate, and identified specific suggestions for improvement. igital health interventions targeting physical activity often experience issues of lack of user engagement. By contrast, the findings from both the quantitative and mixed methods analyses indicate high usage and overall acceptability and appropriateness of the PA4E1 website to school teachers. The findings support the value of the website within a multidelivery mode implementation intervention to support schools to implement physical activity promoting practices. The analysis identified suggested intervention refinements, which may be adopted for future iterations and further scale-up of the PA4E1 program. ustralian New Zealand Clinical Trials Registry ACTRN12617000681358 www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=372870
Pilot of a preoperative smoking cessation intervention incorporating post-discharge support from a Quitline
Publisher: CSIRO Publishing
Date: 2008
DOI: 10.1071/HE08158
Abstract: The study sought to assess the potential efficacy of a comprehensive smoking cessation intervention for surgical patients. The study employed a modified historical controlled trial design. Participants were recruited from a preoperative clinic of an Australian hospital in 2003. Patients allocated to the experimental group received a comprehensive smoking cessation intervention incorporating preoperative computerised smoking cessation counselling, tailored self-help material, brief advice from preoperative clinical staff, NRT, telephone counselling, and proactive post-discharge telephone support from a Quitline. At the six month follow-up 12% of 66 usual care control group participants and 25% of 52 experimental group participants reported being abstinent (p=0.07). Comprehensive smoking cessation interventions initiated preoperatively and incorporating postdischarge support from a Quitline may be efficacious in increasing smoking abstinence.
A Cluster Randomised Controlled Trial of an Intervention to Increase Physical Activity of Preschool-Aged Children Attending Early Childhood Education and Care: Study Protocol for the 'Everybody Energise' Trial
Publisher: MDPI AG
Date: 04-11-2019
Abstract: The use of ‘Energisers,’ short bouts of moderate-to-vigorous physical activity (MVPA), have been shown to significantly increase children’s physical activity within the school setting but not within Early Childhood Education and Care (ECEC) centres. The aim of this study is to assess the efficacy of an intervention involving the provision of educator-led daily Energisers to increase the time children spend in MVPA while attending ECEC. Fourteen ECEC centres in the Hunter region of New South Wales, Australia, will be randomised to either an intervention or control group. The intervention group will be supported by the research team to implement three brief (5-min) educator-led Energisers each day for children aged three to six years between the hours of 9:00 a.m. to 3.00 p.m. Control ECEC centres will continue to provide ‘normal practice’ to children. The primary trial outcome is child minutes of MVPA whilst in ECEC, assessed objectively via accelerometery over three days. Outcome assessment will occur at baseline and 6 months post-baseline. Linear mixed models under an intention-to-treat framework will be used to compare differences between groups in MVPA at follow-up. This will be the first cluster randomised controlled trial to test the efficacy of Energisers in isolation on increasing the time children spend in MVPA.
Improving adolescent mental health and resilience through a resilience-based intervention in schools: study protocol for a randomised controlled trial
Publisher: Springer Science and Business Media LLC
Date: 18-07-2014
The dissemination of a smoking cessation program to 23 antenatal clinics: The predictors of initial program adoption by managers
Publisher: Elsevier BV
Date: 02-1999
DOI: 10.1111/J.1467-842X.1999.TB01214.X
Abstract: To investigate whether the method of dissemination, antenatal clinic practice norms for smoking intervention and subjective evaluation of the attributes of a new smoking cessation program are associated with a nurse unit manager's initial decision to adopt the new program. Twenty-three hospital clinics were randomly allocated to two groups which received the program either by simple or intensive dissemination methods. Simple dissemination involved a mailout of the 'Fresh Start' program and intensive dissemination involved a mailout which was enhanced by personal contact with midwifery facilitators who provided support and training for the program. It was hypothesised that intensive dissemination would improve program adoption compared to simple dissemination. It was also hypothesised that managers' perceptions of the program and clinic smoking intervention practice norms would predict program adoption. A hierarchical regression analysis was used to examine the association between these variables and the adoption of program components. The results indicated that the method of dissemination and the managers' perceptions of the program are significant predictors of program adoption. Although clinic practice norm for smoking cessation education is not a significant predictor of program adoption, it appears to mediate managers' perceptions of the program.
Physical education in secondary schools located in low-income communities: Physical activity levels, lesson context and teacher interaction
Publisher: Elsevier BV
Date: 02-2016
DOI: 10.1016/J.JSAMS.2014.12.003
Abstract: Physical education (PE) plays an important role in contributing to students' physical activity (PA) however, moderate-to-vigorous PA (MVPA) within PE is lower than recommended. Little is known about the PA levels of students from disadvantaged schools within PE. This study aimed to describe: (i) the PA levels of students from disadvantaged secondary schools during PE lessons, (ii) the lesson context and teacher interactions occurring during PE, and (iii) the associations between teacher, school or PE lesson characteristics with student physical activity levels in PE. Cross-sectional study of 100 Grade 7 PE lessons across 10 secondary schools. System for observing fitness instruction time (SOFIT) was used to assess student PA, lesson context, and teacher interaction. Teacher and school characteristics were collected via survey. Mean proportion of lesson time was used to describe PA, lesson context and teacher interaction. Associations between each outcome variable and each characteristic were examined using 2-s le t-tests, ANOVAs and linear regression. Thirty-nine percent of PE lesson was spent in MVPA, and less than 10% spent in VA. Lessons in schools in urban areas included significantly more MVPA than rural areas (P=0.04). Male teachers and more experienced teachers conducted lessons with significantly more VA than female and less experienced teachers (P=0.04 and 0.02). MVPA was also higher in lessons conducted by more experienced teachers. PA during PE lessons within disadvantaged secondary schools is below international recommendations. Male teachers, more experienced teachers and schools in urban regions teach more active lessons.
System-wide adoption of health promotion practices by schools: evaluation of a telephone and mail-based dissemination strategy in Australia
Publisher: Oxford University Press (OUP)
Date: 04-04-2006
Abstract: Schools can potentially benefit from system-wide approaches to the dissemination of health promotion practices. This intervention study undertaken in the Hunter Region of NSW, Australia, used a pre-post design to assess whether a phone and mail intervention dissemination strategy was associated with an increase in the proportion of 218 primary schools undertaking eight health promotion practices. Health promotion practices addressed the prevention of harm associated with five agreed health issues-smoking, nutrition, playground safety, asthma and infectious diseases. The study also assessed acceptability of the dissemination strategy to schools, cost and whether intervention schools' characteristics were associated with uptake of health promotion practices. Compared to baseline a significant improvement in prevalence was observed at both 1 and 2 year follow-up for seven of the eight health promotion practices addressed. The greatest improvement occurred in the first year of the project. There was a greater uptake of the practice of providing information regarding passive smoking in urban schools. The dissemination strategy was found to have a cost per adopted practice of 121 Australian dollars and to be acceptable to the large majority (>90%) of schools. The results suggest that the dissemination strategy may represent a relatively low cost method of enhancing health promotion practices in schools and of monitoring such practices. Further research addressing the methodological issues of this study is needed to confirm these findings.
Differential intervention effectiveness of a universal school-based resilience intervention in reducing adolescent substance use within student subgroups: exploratory assessment within a cluster-rando
Publisher: BMJ
Date: 08-2018
DOI: 10.1136/BMJOPEN-2017-021047
Abstract: Interventions addressing the in idual and environmental protective factors of adolescents are suggested to have potential for reducing adolescent substance use. While universally delivered school-based substance use prevention interventions are common, previous studies have suggested variable effectiveness by subgroups of students. An exploratory study was undertaken to examine the differential effectiveness of a universal school-based resilience intervention on adolescent substance use and protective factors according to their sociodemographic and previous substance use. Secondary analysis of data from a cluster-randomised controlled trial. 32 Australian secondary schools. Cohort of grade 7 students (n=3155) followed up in grade 10 (aged 15–16 years 2014 n=2105). Three-year universal school-based intervention implemented by school staff that targeted a range of student resilience protective factors (2012–2014). Primary outcomes included: tobacco (recent, number of cigarettes) and alcohol (recent, ‘risk’ and number of drinks) use, and secondary outcomes included: marijuana (recent) and other illicit substance (recent) use, and aggregate in idual and environmental protective factor scores. Generalised and linear mixed models examined interactions between treatment and student subgroups (gender socioeconomic disadvantage (low/high) geographic location (major city/inner regional/outer regional-remote) and previous substance use (non-user/user)) at follow-up (36 models). Analysis of student follow-up data showed no differential intervention effect for any substance use or protective factor outcome for any subgroup, with the exception of one differential effect found by socioeconomic status for the outcome of mean number of cigarettes smoked by recent smokers (p=0.003). There was no evidence of an intervention effect within the low (mean difference (MD) −12.89, 95% CI −26.00 to 0.23) or high (MD 16.36, 95% CI −1.03 to 33.76) socioeconomic subgroups. No evidence of an intervention effect on substance use and protective factors was found according to student subgroups defined by sociodemographic characteristics or previous substance use. ACTRN12611000606987.
Increasing smoking cessation care in a preoperative clinic: a randomized controlled trial
Publisher: Elsevier BV
Date: 07-2005
DOI: 10.1016/J.YPMED.2004.11.011
Abstract: Evidence suggests that preoperative clinics, like other hospital outpatient clinics and inpatient wards, fail to systematically provide smoking cessation care to patients having planned surgery. The aim of the study was to assess the efficacy, acceptability, and cost of a multifaceted intervention to facilitate the provision of comprehensive smoking cessation care to patients attending a preoperative clinic. Two hundred ten smoking patients attending a preoperative clinic at a major teaching hospital in Australia took part in the study. One hundred twenty-four patients were randomly assigned to an experimental group and 86 patients to a usual cessation care group. A multifaceted intervention was developed that included the use of opinion leaders, consensus processes, computer-delivered cessation care, computer-generated prompts for care provision by clinic staff, staff training, and performance feedback. Ninety-six percent of experimental group patients received behavioral counseling and tailored self-help material. Experimental group patients were significantly more likely than usual care patients to report receiving brief advice by nursing (79% vs. 47% P < 0.01) and anaesthetic (60% vs. 39% P < 0.01) staff. Experimental group patients who were nicotine dependent were also more likely to be offered preoperative nicotine replacement therapy (NRT) (82% vs. 8% P < 0.01) and be prescribed postoperative NRT (86% vs. 0% P < 0.01). The multifaceted intervention was found to be acceptable by staff. A multifaceted clinical practice change intervention may be effective in improving the delivery of smoking cessation care to preoperative surgical patients.
Provision of smoking care in NSW hospitals: opportunities for further enhancement
Publisher: The Sax Institute
Date: 2008
DOI: 10.1071/NB07102
Abstract: The provision of smoking care, including the management of nicotine withdrawal and assistance with a quitting attempt, is identified as an important part of the overall care of hospitalised patients. Levels of smoking care delivery in hospitals have been less than optimal. Increasing this care across multiple facilities and units within NSW Health represents a significant challenge. This article examines levels of smoking care delivery in NSW hospitals, and research evidence and best practice recommendations to inform potential strategies to increase such care. It also reviews statewide initiatives implemented by NSW Health to enhance the delivery of smoking care and suggests further strategies that could facilitate this.
Abstracts from the ICBM 2014 Meeting
Publisher: Springer Science and Business Media LLC
Date: 24-07-2014
A systematic review and meta-analysis of moderate-to-vigorous physical activity levels in secondary school physical education lessons
Publisher: Springer Science and Business Media LLC
Date: 24-04-2017
Who can provide antenatal care? The views of obstetricians and midwives
Publisher: Elsevier BV
Date: 08-1998
DOI: 10.1111/J.1467-842X.1998.TB01416.X
Abstract: To describe the types of antenatal services in NSW maternity hospitals and examine the views of midwives and obstetricians about who can provide adequate routine antenatal care. A mail-out questionnaire to nursing unit managers (NUMs) explored the types of antenatal services available in their hospitals. The questionnaire for 196 midwives and 114 obstetricians asked whether they believed six provider/service types could provide adequate antenatal care either alone or in conjunction with an obstetrician. 80% of hospitals had GPs providing antenatal care, 53% had obstetricians and 3% had visiting midwives 33% had a public antenatal clinic, 28% a shared care program with GPs and 26% midwives' antenatal clinics. Midwives were more likely than obstetricians to rate the following as able to provide adequate care alone: hospital antenatal clinic (4.7 times more likely) independent midwife (42.9x) and community midwives as an outreach hospital service (17x). Obstetricians were 8.2x more likely than midwives to rate private obstetricians as being able to provide adequate care. Midwives were more likely to perceive that independent midwives (24.7x more likely) and community midwives as an outreach hospital service (15.3x more likely) were able to provide adequate care either alone or in conjunction with an obstetrician. Most NSW hospitals have GPs providing care, but midwives' clinics and independent midwives are less available. While midwives and obstetricians hold similar beliefs about GPs providing care, substantial differences emerged about the midwife's role. Such disparity in opinion may be central in providing options and consistency in care for women.
Training medical students in HIV/AIDS test counselling: Results of a randomized trial
Publisher: Wiley
Date: 03-1996
DOI: 10.1111/J.1365-2923.1996.TB00731.X
Abstract: The study assessed the effectiveness of a programme aimed at increasing medical students' skills in counselling patients presenting for HIV testing/AIDS information. Senior medical students were randomly assigned to receive a short course in pre- and post-test counselling, or to a control group which received the usual curriculum. The students' performance in counselling simulated patients was videotaped at baseline and after 3 months. A subs le was also assessed at 12 months. Students receiving the programme showed significantly greater improvement in pre- and post-test counselling skills over 3 months than did the controls. For the sub-s le continuing to 12 months, a significant effect over time was found however, there was no significant difference between the groups. This may have been influenced by the small s le sizes used for the 12-month assessment. General interactional skills improved for the over-all s le over 3 and 12 months, but again there were no significant differences between groups. Those exposed to the programme did not show significantly greater changes in either knowledge or attitude scores over either time frame, compared with controls. When taught in addition to the usual undergraduate curriculum at Newcastle University, this short interactional skills course significantly enhanced students' ability to provide pre- or post-test counselling for HIV/AIDS.
Environmental hazards in the homes of older people
Publisher: Oxford University Press (OUP)
Date: 1997
Abstract: To investigate (i) the prevalence of environmental safety hazards in the homes of people aged 70 years and over, (ii) their knowledge of causes of injuries to older people and the safety measures they can implement to prevent such injuries and (iii) the relationship between socio-demographic characteristics of this population group and levels of home environmental hazards. A cross-sectional survey of 425 people aged 70 years and older living in a defined geographical area of Australia. Participants were recruited through their general practitioners. A structured interview completed with each participant included questions on demographics and home safety issues. A home safety inspection was also undertaken using a predetermined rating format. 80% (n = 342) of homes inspected had at least one hazard and 39% (n = 164) had > 5 hazards. The bathroom was identified as the most hazardous room, with 66% (n = 279) of bathrooms having at least one hazard. Hazards relating to floor surfaces (62% of homes had one 'flooring' hazard) and absence of appropriate grab or handrails (60% of homes had one or more hazards relating to this) were prevalent. Eighty-eight percent (n = 374) of older people were able to identify falls as the most common cause of injury and 87% (n = 368) were able to accurately name at least one safety measure. Although a significant association was found between the older people's self-assessment of their home's safety and the presence of more than 5 hazards, 30% of those rating their homes as very safe (n = 289) had more than 5 hazards. Logistic regression analysis identified one variable--contact with healthcare service providers--as predictive of the hazard level in older people's homes. Older people who were never visited by service providers were twice as likely to have more than 5 hazards as those who were visited weekly or more often (OR 2.12, 95% CI 1.104, 4.088). Many older people are living in potentially hazardous environments. As yet, a causal link between the presence of environmental hazards and falls in older people has not been established. More definitive work in this area needs to be carried out.
The association between adolescent condom use and individual and environmental resilience protective factors
Publisher: Elsevier BV
Date: 06-2018
Abstract: In idual and environmental resilience protective factors are suggested to be associated with adolescent condom use however, previous studies have not comprehensively examined such associations. This study aimed to determine the associations between condom use, and numerous in idual and environmental resilience protective factors in sexually active Australian adolescents. Participants were Grade 10 students attending 28 Australian government high schools (n=1,688). An online survey (2011) collected data regarding: sexual intercourse (past year), condom use and 14 in idual and environmental resilience protective factors. Multivariable backward stepwise logistic regression models examined associations between student condom use and protective factors (total, subscale). Only total environmental protective factors remained in the final total score model students with higher total environmental protective factors scores were 2.59 times more likely to always use a condom(95%CI:1.80-3.74). Only three of 14 protective factor subscales were associated with a higher likelihood of always using a condom in the final subscale model (in idual: goals/aspirations environmental: community participation, pro-social peers). Total environmental and three protective factor subscales demonstrated prominent associations with consistent use of condoms in sexually active adolescents. Implications for public health: Consideration of particular resilience protective factors in adolescent sexual risk behaviour prevention, such as condom use, is warranted.
The Physical Activity 4 Everyone Cluster Randomized Trial
Publisher: Elsevier BV
Date: 08-2016
DOI: 10.1016/J.AMEPRE.2016.02.020
Abstract: Few interventions have been successful in reducing the physical activity decline typically observed among adolescents. The aim of this paper is to report the 24-month effectiveness of a multicomponent school-based intervention (Physical Activity 4 Everyone) in reducing the decline in moderate to vigorous physical activity (MVPA) among secondary school students in disadvantaged areas of New South Wales, Australia. A cluster RCT was conducted in five intervention and five control schools with follow-up measures taken at 24 months post-randomization. The trial was undertaken within secondary schools located in disadvantaged communities in New South Wales, Australia. A multicomponent school-based intervention based on the Health Promoting Schools Framework was implemented. The intervention consisted of seven physical activity promotion strategies that targeted the curriculum (teaching strategies to increase physical activity in physical education lessons, student physical activity plans, and modification of school sport program) school environment (recess/lunchtime activities, school physical activity policy) parents (parent newsletters) and community (community physical activity provider promotion). Six additional strategies supported school implementation of the physical activity intervention strategies. Minutes per day spent in MVPA, objectively measured by accelerometer. Participants (N=1,150, 49% male) were a cohort of students aged 12 years (Grade 7) at baseline (March-June 2012) and 14 years (Grade 9) at follow-up (March-July 2014). At 24-month follow-up, there were significant effects in favor of the intervention group for daily minutes of MVPA. The adjusted mean difference in change in daily MVPA between groups was 7.0 minutes (95% CI=2.7, 11.4, p<0.002) (analysis conducted December 2014-February 2015). Sensitivity analyses based on multiple imputation were consistent with the main analysis (6.0 minutes, 95% CI=0.6, 11.3, p<0.031). The intervention was effective in increasing adolescents' minutes of MVPA, suggesting that implementation of the intervention by disadvantaged schools has the potential to slow the decline in physical activity. Australian New Zealand Clinical Trials Registry ACTRN12612000382875.
School-Based Nutrition Interventions in Children Aged 6 to 18 Years: An Umbrella Review of Systematic Reviews
Publisher: MDPI AG
Date: 17-11-2021
DOI: 10.3390/NU13114113
Abstract: Schools are identified as a key setting to influence children’s and adolescents’ healthy eating. This umbrella review synthesised evidence from systematic reviews of school-based nutrition interventions designed to improve dietary intake outcomes in children aged 6 to 18 years. We undertook a systematic search of six electronic databases and grey literature to identify relevant reviews of randomized controlled trials. The review findings were categorised for synthesis by intervention type according to the World Health Organisation Health Promoting Schools (HPS) framework domains: nutrition education food environment all three HPS framework domains or other (not aligned to HPS framework domain). Thirteen systematic reviews were included. Overall, the findings suggest that school-based nutrition interventions, including nutrition education, food environment, those based on all three domains of the HPS framework, and eHealth interventions, can have a positive effect on some dietary outcomes, including fruit, fruit and vegetables combined, and fat intake. These results should be interpreted with caution, however, as the quality of the reviews was poor. Though these results support continued public health investment in school-based nutrition interventions to improve child dietary intake, the limitations of this umbrella review also highlight the need for a comprehensive and high quality systematic review of primary studies.
Breaking Bad News 3: Encouraging the Adoption of Best Practices
Publisher: Informa UK Limited
Date: 1998
DOI: 10.1080/08964289809596383
Abstract: Steps to encourage clinicians to adopt the best practices for communicating bad news to patients are outlined. First, official, credible guidelines endorsed by key organizations or professional bodies, giving a clear message about the components and importance of the best practices, must be produced. Second, the guidelines should be disseminated publication in journals or mailing to clinicians is unlikely to be sufficient. Third, clinicians should be provided with feedback on whether their performance meets established standards. This requires acceptable systems to collect valid and reliable performance data. Fourth, clinicians need contingencies for providing best practice care. Fifth, barriers to improvement should be explored and strategies to address them, including interactional skills training, implemented. Continuous quality assurance, commitment, and evaluations will help clinicians use the best practices for breaking bad news to patients.
The validity and reliability of an interactive computer tobacco and alcohol use survey in general practice
Publisher: Elsevier BV
Date: 05-2010
DOI: 10.1016/J.ADDBEH.2009.12.030
Abstract: Uncertainty regarding the accuracy of the computer as a data collection or patient screening tool persists. Previous research evaluating the validity of computer health surveys have tended to compare those responses to that of paper survey or clinical interview (as the gold standard). This approach is limited as it assumes that the paper version of the self-report survey is valid and an appropriate gold standard. First, to compare the accuracy of computer and paper methods of assessing self-reported smoking and alcohol use in general practice with biochemical measures as gold standard. Second, to compare the test re-test reliability of computer administration, paper administration and mixed methods of assessing self-reported smoking status and alcohol use in general practice. A randomised cross-over design was used. Consenting patients were randomly assigned to one of four groups Group 1. C-C : completing a computer survey at the time of that consultation (Time 1) and a computer survey 4-7 days later (Time 2) Group 2. C-P: completing a computer survey at Time 1 and a paper survey at Time 2 Group 3. P-C: completing a paper survey at Time 1 and a computer survey at Time 2 and Group 4. P-P: completing a paper survey at Time 1 and 2. At Time 1 all participants also completed biochemical measures to validate self-reported smoking status (expired air carbon monoxide breath test) and alcohol consumption (ethyl alcohol urine assay). Of the 618 who were eligible, 575 (93%) consented to completing the Time 1 surveys. Of these, 71% (N=411) completed Time 2 surveys. Compared to CO, the computer smoking self-report survey demonstrated 91% sensitivity, 94% specificity, 75% positive predictive value (PPV) and 98% negative predictive value (NPV). The equivalent paper survey demonstrated 86% sensitivity, 95% specificity, 80% PPV, and 96% NPV. Compared to urine assay, the computer alcohol use self-report survey demonstrated 92% sensitivity, 50% specificity, 10% PPV and 99% NPV. The equivalent paper survey demonstrated 75% sensitivity, 57% specificity, 6% PPV, and 98% NPV. Level of agreement of smoking self-reports at Time 1 and Time 2 revealed kappa coefficients ranging from 0.95 to 0.98 in each group and hazardous alcohol use self-reports at Time 1 and Time 2 revealed kappa coefficients ranging from 0.90 to 0.96 in each group. The collection of self-reported health risk information is equally accurate and reliable using computer interface in the general practice setting as traditional paper survey. Computer survey appears highly reliable and accurate for the measurement of smoking status. Further research is needed to confirm the adequacy of the quantity/frequency measure in detecting those who drink alcohol. Interactive computer administered health surveys offer a number of advantages to researchers and clinicians and further research is warranted.
Measuring General Practitioners' Attitudes Towards Medical Care
Publisher: Oxford University Press (OUP)
Date: 1987
Abstract: The construction and development of a questionnaire which measures the attitudes of general practitioners towards their role in the medical care system is described. Factor analytic procedures identified seven reliable factor-based subscales. The subscales measured attitudes towards: a psychological orientation to patient care, government involvement in the health care system, preventive medicine, patient participation in the consultation, communication with patients, responsibility for decision making and the appropriateness of consultations. The responses of 387 randomly selected Australian general practitioners to this measure are described. Overall, there was strong support for the importance of fostering patient participation, facilitating open communication and understanding, having a psychological orientation, and implementing preventive activities in general practice. However, the s le was strongly opposed to a government regulated health care system. Age and sex of the general practitioner were shown to influence orientations on some dimensions.
Association between Australian adolescent alcohol use and alcohol use risk and protective factors in 2011 and 2014
Publisher: Wiley
Date: 21-12-2018
DOI: 10.1111/DAR.12623
Abstract: Changes in risk and protective factors of adolescent alcohol use may be contributing to the recent decline in Australian adolescents alcohol use. The study aimed to determine the: (i) prevalence of alcohol use, risk and protective factors in 2011 and 2014 and (ii) association between alcohol use and risk and protective factors in 2011 and 2014. A repeat cross-sectional study was conducted. Grade 9-10 (aged 15-17 years) students from 32 Australian secondary schools were s led in 2011 and 2014. A self-report survey collected data regarding alcohol use (ever, recent, 'binge drinking'), risk factors (e.g. alcohol use ermissive attitude to alcohol by friends/siblings arents) and protective factors (e.g. self-efficacy school/home/community support peer caring relationships). Descriptive statistics were used to determine differences in alcohol use, risk and protective factors between 2011 and 2014. Adjusted multivariable logistic regression analyses examined associations between alcohol use, risk and protective factors separately in 2011 and 2014 (six models). Fewer adolescents reported alcohol use in 2014 compared with 2011 (ever: 56.6% vs. 67.9%, recent: 17.3% vs. 21.2%, 'binge drinking': 20.0% vs. 23.5% 2011: n = 4366 2014: n = 5199). Significant differences between 2014 and 2011 were found for some risk (five lower one higher) and protective factors (four lower). Risk factors that were significantly lower in 2014 compared to 2011 were amongst variables with the strongest associations with alcohol use. The strength of associations with alcohol use, and decrease in the prevalence of certain risk factors in 2014 compared to 2011, suggests such factors may be contributing to the decline in adolescent alcohol use.
Feasibility, acceptability, and cost of referring surgical patients for postdischarge cessation support from a quitline
Publisher: Oxford University Press (OUP)
Date: 06-2008
DOI: 10.1080/14622200802097472
Abstract: The aim of the study was to assess the feasibility, acceptability, and cost of referral of smoking patients to a proactive quitline service for postdischarge cessation support. Participants were recruited from the preoperative clinic of an Australian hospital. Data were collected from project records and a telephone interview with participants 6 months after attending the preoperative clinic. The study found that 64% of the 67 participants accepted an offer of referral to the quitline by preoperative clinic staff. Some 74% of patients referred to the quitline were contacted by the quitline after discharge. Smokers contacted by the quitline and clinic staff referring patients to the quitline generally responded favorably on items assessing the acceptability of the quitline service and the process of referral to the quitline. Referral to the quitline service cost less than US$2 per patient. Referral of patients to a quitline is feasible, was generally considered acceptable by surgical patients and staff, and was inexpensive.
Clustering of chronic disease risks among people accessing community mental health services
Publisher: Elsevier BV
Date: 08-2022
Scale-up of the Physical Activity 4 Everyone (PA4E1) intervention in secondary schools: 12-month implementation outcomes from a cluster randomized controlled trial
Publisher: Springer Science and Business Media LLC
Date: 08-08-2020
DOI: 10.1186/S12966-020-01000-Y
Abstract: ‘Physical Activity 4 Everyone’ (PA4E1) was an efficacious multi-component school-based physical activity (PA) program targeting adolescents. PA4E1 has seven PA practices. It is essential to scale-up, evaluate effectiveness and assess implementation of such programs. Therefore, the aim is to assess the impact of implementation support on school practice uptake of the PA4E1 program at 12 and 24 months. A cluster randomised controlled trial, utilising a type III hybrid implementation-effectiveness design, was conducted in 49 randomly selected disadvantaged Australian Government and Catholic secondary schools. A blinded statistician randomly allocated schools to a usual practice control ( n = 25) or the PA4E1 program group ( n = 24), with the latter receiving seven implementation support strategies to support school PA practice uptake of the seven practices retained from the efficacy trial. The primary outcome was the proportion of schools adopting at least four of the seven practices, assessed via telephone surveys with Head Physical Education Teachers and analysed using exact logistic regression modelling. This paper reports the 12-month outcomes. Schools were recruited from May to November 2017. At baseline, no schools implemented four of the seven practices. At 12 months significantly more schools in the program group had implemented four of the seven practices (16/24, 66.7%) than the control group (1/25, 4%) (OR = 33.0[4.15–1556.4], p 0.001). The program group implemented on average 3.2 (2.5–3.9) more practices than the control group ( p 0.001, mean 3.9 (SD 1.5) vs 0.7 (1.0)). Fidelity and reach of the implementation support intervention were high (both 80%). Through the application of multiple implementation support strategies, secondary schools were able to overcome commonly known barriers to implement evidence based school PA practices. As such practices have been shown to result in an increase in adolescent PA and improvements in weight status, policy makers and practitioners responsible for advocating PA in schools should consider this implementation approach more broadly when working with schools. Follow-up is required to determine whether practice implementation is sustained. Australian New Zealand Clinical Trials Registry ACTRN12617000681358 registered 12th May 2017.
A programme for reducing smoking in pre‐operative surgical patients: randomised controlled trial*
Publisher: Wiley
Date: 10-01-2005
DOI: 10.1111/J.1365-2044.2004.04070.X
Abstract: We assessed the efficacy of a comprehensive programme for stopping smoking in 210 smokers scheduled for surgery, before admission and 3 months after attending a pre-operative clinic. Participants were randomly allocated to receive an intervention incorporating nicotine replacement therapy for patients smoking more than 10 cigarettes per day ("dependent smokers"), or to a control group to receive usual care. Dependent smokers allocated to the intervention group were more likely to report abstinence before surgery than those allocated to receive usual-care (63 (73%) vs. 29 (56%), respectively OR 2.2 (95% CI 1.0-4.8)), and 3 months after attendance (16 (18%) vs. 3 (5%), respectively OR = 3.9 (95% CI 1.0-21.7).
Clinician assessment, advice and referral for multiple health risk behaviors: Prevalence and predictors of delivery by primary health care nurses and allied health professionals
Publisher: Elsevier BV
Date: 02-2014
DOI: 10.1016/J.PEC.2013.10.017
Abstract: Primary care clinicians have considerable potential to provide preventive care. This study describes their preventive care delivery. A survey of 384 community health nurses and allied health clinicians from in New South Wales, Australia was undertaken (2010-11) to examine the assessment of client risk, provision of brief advice and referral/follow-up regarding smoking inadequate fruit and vegetable consumption, alcohol misuse, and physical inactivity the existence of preventive care support strategies and the association between supports and preventive care provision. Preventive care to 80% or more clients was least often provided for referral/follow-up (24.7-45.6% of clinicians for in idual risks, and 24.2% for all risks) and most often for assessment (34.4-69.3% of clinicians for in idual risks, and 24.4% for all risks). Approximately 75% reported having 9 or fewer of 17 supports. Provision of care was associated with: availability of a paper screening tool training GP referral letter and number of supports. The delivery of preventive care was limited, and varied according to type of care and risk. Supports were variably associated with elements of preventive care. Further research is required to increase routine preventive care delivery and the availability of supports.
Effectiveness of an intervention in increasing the provision of preventive care by community mental health services: a non-randomized, multiple baseline implementation trial
Publisher: Springer Science and Business Media LLC
Date: 12-2015
Associations between digital health intervention engagement and physical activity and sedentary behaviour: a systematic review
Publisher: Unpublished
Date: 2018
Cost effectiveness of a multi-component school-based physical activity intervention targeting adolescents: the ‘Physical Activity 4 Everyone’ cluster randomized trial
Publisher: Springer Science and Business Media LLC
Date: 22-08-2016
Telephone-based weight loss support for patients with knee osteoarthritis: a pragmatic randomised controlled trial
Publisher: Elsevier BV
Date: 04-2018
DOI: 10.1016/J.JOCA.2018.01.003
Abstract: To determine the effectiveness of telephone-based weight loss support in reducing the intensity of knee pain in patients with knee osteoarthritis, who are overweight or obese, compared to usual care. We conducted a parallel randomised controlled trial (RCT), embedded within a cohort multiple RCT of patients on a waiting list for outpatient orthopaedic consultation at a tertiary referral hospital in NSW, Australia. Patients with knee osteoarthritis, classified as overweight or obese [body mass index (BMI) between ≥27 kg/m Between May 19 and June 30 2015, 120 patients were randomly assigned to the intervention (59 analysed, one post-randomisation exclusion) or usual care (60 analysed). We found no statistically significant between group differences in pain intensity [area under the curve (AUC), mean difference 5.4, 95%CI: -13.7 to 24.5, P = 0.58] or weight change at 6 months (self-reported mean difference -0.4, 95%CI: -2.6 to 1.8, P = 0.74). Among patients with knee osteoarthritis who are overweight, telephone-based weight loss support, provided using an existing 6-month weight management and healthy lifestyle service did not reduce knee pain intensity or weight, compared with usual care. ACTRN12615000490572.
Examining service participation and outcomes from a population-level telephone-coaching service supporting changes to healthy eating, physical activity and weight: A comparison of participants with an
Publisher: Elsevier BV
Date: 12-2021
Increased Substance Use and Poorer Mental Health in Adolescents With Problematic Musculoskeletal Pain
Publisher: Journal of Orthopaedic & Sports Physical Therapy (JOSPT)
Date: 10-2017
Abstract: Study Design Cross-sectional study. Background Adolescents with musculoskeletal pain are thought to be at greater risk of modifiable health risk behaviors, but little is known about these behaviors in adolescents with problematic pain. Objective To describe the prevalence of substance use (tobacco smoking, alcohol consumption, and illicit drugs) and poor mental health in adolescents with problematic musculoskeletal pain, compared to those without such pain. Methods Data on self-reported pain, substance use, and poor mental health were collected from 1831 year 9 students (age range, 14-16 years). Participants were considered to have problematic pain if they reported experiencing pain at least monthly over a 6-month period that also required medication or impacted 1 or more of the following: school or work, daily activities, and leisure or sporting activities. Results Almost half (46%) of the participants experienced problematic pain. Adolescents with problematic pain, compared to those without pain, reported higher substance use and poorer mental health: tobacco smoking in the last 4 weeks, 12% versus 7% (odds ratio [OR] = 1.76 95% confidence interval [CI]: 1.25, 2.28) alcohol consumption in the last 4 weeks, 30% versus 20% (OR = 1.68 95% CI: 1.34, 2.11) illicit drug use, 13% versus 6% (OR = 2.18 95% CI: 1.55, 3.07) lower Mental Health Inventory scores (β = -11.43 standard error [SE], 0.96 P<.05), indicating poorer mental health and higher Strengths and Difficulties Questionnaire total scores (β = 3.67 SE, 0.29 P<.05), indicating greater difficulties. Conclusion Adolescents with problematic pain report higher smoking, alcohol use, and use of illicit drugs and poorer mental health than adolescents without problematic pain. The experience of problematic pain could be an important consideration for substance use and chronic disease prevention. This trial is registered with the Australian New Zealand Clinical Trials Registry (reference number ACTRN12611000606987). J Orthop Sports Phys Ther 2017 (10):705-711. doi:10.2519/jospt.2017.7441.
Screening for melanoma: a community survey of prevalence and predictors.
Publisher: AMPCo
Date: 03-1991
DOI: 10.5694/J.1326-5377.1991.TB112887.X
Abstract: Australian cancer councils recommend the practice of regular self screening of the skin or screening by another person for signs of melanoma and other skin cancers. They also recommend that medical practitioners screen adult patients annually. This study examined the prevalence and predictors of self screening (or screening by another person) and screening by a general practitioner in 1344 in iduals from randomly selected households. The results indicated that 48% of the s le either regularly checked their own skin or had it checked by another person (such as a spouse), and 17% had been screened by a general practitioner in the preceding 12 months. Overall, this indicates that 50% of the s le had their skin adequately screened as recommended. In iduals were less likely to have been screened if they were male of lower occupational status unemployed or too ill to work and had only a primary school education. Those who had only basic medical insurance were also less likely to have been screened. A higher prevalence of screening was reported in in iduals at greater risk of developing melanoma, in those who perceived themselves as more susceptible to developing melanoma, and in those who believed that there were greater benefits associated with the early detection of melanoma. The implications of these results for the development of effective public health education programmes, and for increasing the role of general practitioners in the education and screening of the public, are discussed.
Multi-strategic intervention to enhance implementation of healthy canteen policy: a randomised controlled trial
Publisher: Springer Science and Business Media LLC
Date: 11-01-2017
Health promotion practices of restaurants and cafes in Australia: changes from 1997 to 2000 using an annual telemarketing intervention
Publisher: Oxford University Press (OUP)
Date: 09-2002
Abstract: This study looked at whether rates of health promotion practices among restaurants and cafés in the Hunter Region of New South Wales (NSW), Australia, increased between 1997 and 2000. During the project period all restaurants and cafés in the region were offered an annual direct marketing telephone interview (1997, 1998 and 1999), during which resources were offered to assist in the adoption of health promotion practices. Owners or managers of restaurants and cafés completed phone interviews that assessed 18 health promotion practices relating to: environmental tobacco smoke (two practices) responsible service of alcohol (five practices) healthy food choices (one practice) food safety (four practices) occupational health and safety (three practices) and the prevention of infectious diseases (three practices). Changes in practices were examined by comparing data from cross-sectional s les in 1997 (before any offers of resources) and 2000 (after up to three annual telemarketing calls), and among a cohort interviewed in both 1997 and 2000. Ninety-one per cent of restaurants and cafés (321) participated in the 1997 survey and 239 (81%) participated in the 2000 survey. A cohort of 122 restaurants and cafés participated in both surveys. Significant increases were present for 14 of the 18 health promotion initiatives in the cross-sectional s le and for 10 of the 18 health promotion initiatives in the cohort. For both cross-sectional and cohort s les, a change in at least one practice in each area was evident, with the exception of nutrition. The proportion of restaurants and cafés in the project region that undertake health promotion initiatives is increasing. A telephone-based intervention may contribute to such an increase. The suggestion that the prevalence of health promotion initiatives in restaurants and cafés can be increased highlights the potential for health promotion to be more actively involved in this setting.
What Is Recommended for Healthy Women During Pregnancy? A Comparison of Seven Prenatal Clinical Practice Guideline Documents
Publisher: Wiley
Date: 03-1999
DOI: 10.1046/J.1523-536X.1999.00024.X
Abstract: Several countries have developed clinical practice guidelines for the content of prenatal care. This study examines the consistency of recommendations in clinical practice guidelines describing routine prenatal care. The recommendations for low-risk women in seven guideline documents were examined: two from Australia, two from the United States, two from Canada, and one from Germany. The recommendations were listed into the four areas of "general health screening and health promotion during pregnancy," "organization of care," "clinical tests and screening," and "education specific for pregnancy." A total of 69 recommendations were identified within the seven documents, most of which fell within the "clinical tests and screening" domain. Notable differences were identified in the number of recommendations made within the same country. Of the 69 recommendations, only four were included in all seven documents. Little consistency was demonstrated within or among countries in terms of the content of their prenatal care guidelines, suggesting a need to reexamine their content and the evidence on which such recommendations are based.
Providing comprehensive smoking cessation care to surgical patients: The case for computers
Publisher: Wiley
Date: 2009
DOI: 10.1111/J.1465-3362.2008.00003.X
Abstract: The provision of smoking cessation care to surgical patients before admission can reduce post-operative complications and encourage long-term smoking cessation. Our aim was to show how a comprehensive computer-based smoking cessation intervention, developed to enhance smoking cessation care to surgical patients, addresses barriers to care provision. Consultations with preoperative clinic staff and reviews of the scientific literature were conducted and identified the following barriers to the provision of effective smoking cessation care: a lack of organisational support, perceived patient objection, a lack of systems to identify smokers, a lack of staff time and skill, perceived inability to change care practices, a perceived lack of efficacy of cessation care and the cost of providing care. Based on positive findings of a pilot trial, a comprehensive computer-based smoking cessation intervention was implemented in a preoperative clinic. Data from previous evaluations of the intervention were used to assess the extent to which the intervention addressed clinician barriers to care. The computer-based intervention was found to provide a means to accurately and systematically identify smokers it required little clinical staff time or skill it was considered an acceptable form of care by staff and patients it was effective in encouraging patient cessation and it was inexpensive to deliver relative to other surgical costs. Furthermore, the computer-based intervention continues to operate in the preoperative clinic in the absence of ongoing research support. The implementation of such a model of care should be considered by clinical services interested in reducing the smoking related morbidity and mortality of patients.
The delivery of preventive care to clients of community health services
Publisher: Springer Science and Business Media LLC
Date: 06-05-2013
The use of portable blood glucose monitors by trained lay operators.
Publisher: AMPCo
Date: 10-1992
DOI: 10.5694/J.1326-5377.1992.TB137302.X
Abstract: To evaluate the use of Reflolux II blood glucose reflectance meters by trained lay operators in a community survey. A random household survey involving assessment of participants' blood glucose levels by Reflolux II. For a random subs le of participants an additional s le of blood was placed onto filter paper strips and stored for later examination and assay. The survey was conducted in the Newcastle and Lake Macquarie areas of New South Wales. Of the 1275 participants 15 years and over, 1229 consented to have their blood glucose assessed and 163 of these also had blood stored on filter paper strips. Data were collected by 25 interviewers. Application of blood spots to filter paper assessed the interviewers' capacity to collect s les of minimal acceptability for Reflolux II operation. S les were considered adequate if they covered at least a 6 mm soaked disk and there was no evidence that they had been smeared or applied from both sides of the paper. The Reflolux II readings obtained by the interviewers were compared with the blood glucose values from assay of the filter paper s les. Only 63% of the 163 s les collected on filter paper were of acceptable quality for adequate Reflolux II operation. The overall correlation between Reflolux II blood glucose values and those determined from the blood collected on filter paper was good (r = 0.893). However, three of the eight interviewers who had five or more readings for comparison achieved correlation coefficients of 8 mmol/L) by the filter paper assay, 58% (7 of 12) were not detected by the lay operated reflectance meters. Twenty-two per cent of the in iduals assessed by the reflectance meter, compared with 0.5% of a population s le surveyed by the National Heart Foundation, had blood glucose values of less than 3.5 mmol/L. It would appear that there may be a considerable error rate in blood glucose values obtained by lay operators using reflectance meters, resulting in underestimation of blood glucose levels. The findings have implications for community awareness programs for diabetes and highlight the need for careful training and monitoring of lay operators in their obtaining of finger-prick blood s les and their use of reflectance meters.
Important components of antenatal care: Midwives' and obstetricians' views
Publisher: Wiley
Date: 11-1996
DOI: 10.1111/J.1479-828X.1996.TB02182.X
Abstract: This study sought the views of midwives and obstetricians about what they considered to be important aspects of routine antenatal care. Midwives and obstetricians were randomly selected from the NSW membership lists of the Australian College of Midwives and the The Royal Australian College of Obstetricians and Gynaecologists, respectively. Seventy-eight percent of midwives (n = 196) and 52% of obstetricians (n = 114) completed a questionnaire which itemised components of routine care derived from the National Health and Medical Research Council's Guidelines for Antenatal Care. Participants were asked to rate each of the 77 components on a 4-point scale as either: very important desirable but not essential not necessary or, don't know. Twenty-four (31%) of the components were rated as very important by at least 90% of midwives and 19 (22%) were rated as very important by at least 90% of obstetricians. 'Recording details of previous pregnancy complications' was the component most commonly rated as being very important by both groups. On 37 (48%) of the components there was a significant difference between midwives and obstetricians in terms of whether or not they rated the component as very important (p < 0.01). There were considerable differences between midwives' and obstetricians' views about the important components of routine antenatal care and a substantial proportion of both groups did not consider many of the components listed in the guidelines to be essential in routine care. The findings suggest that a revision of the current antenatal care guidelines is necessary.
A cluster randomised trial of a school-based intervention to prevent decline in adolescent physical activity levels: study protocol for the ‘Physical Activity 4 Everyone’ trial
Publisher: Springer Science and Business Media LLC
Date: 22-01-2013
The Effectiveness and Cost of an Intervention to Increase the Provision of Preventive Care in Community Mental Health Services: Protocol for a Cluster-Randomized Controlled Trial
Publisher: MDPI AG
Date: 07-03-2022
Abstract: Preventive care to address chronic disease risk behaviours is infrequently provided by community mental health services. In this cluster-randomised controlled trial, 12 community mental health services in 3 Local Health Districts in New South Wales, Australia, will be randomised to either an intervention group (implementing a new model of providing preventive care) or a control group (usual care). The model of care comprises three components: (1) a dedicated ‘healthy choices’ consultation offered by a ‘healthy choices’ clinician (2) embedding information regarding risk factors into clients’ care plans and (3) the continuation of preventive care by mental health clinicians in ongoing consultations. Evidence-based implementation strategies will support the model implementation, which will be tailored by being co-developed with service managers and clinicians. The primary outcomes are client-reported receipt of: (1) an assessment of chronic disease risks (tobacco smoking, inadequate fruit and vegetable consumption, harmful alcohol use and physical inactivity) (2) brief advice regarding relevant risk behaviours and (3) referral to at least one behaviour change support. Resources to develop and implement the intervention will be captured to enable an assessment of cost effectiveness and affordability. The findings will inform the development of future service delivery initiatives to achieve guideline- and policy-concordant preventive care delivery.
‘Physical Activity 4 Everyone’ school-based intervention to prevent decline in adolescent physical activity levels: 12 month (mid-intervention) report on a cluster randomised trial
Publisher: BMJ
Date: 10-09-2015
Smoking and surgery: an opportunity for health improvement
Publisher: Elsevier BV
Date: 08-2007
Encouraging general practitioners to complete the four‐year‐old Healthy Kids Check and provide healthy eating and physical activity messages
Publisher: Elsevier BV
Date: 06-2014
Abstract: To describe the impact of a training and support intervention to encourage completion of the Healthy Kids Check (HKC) by general practitioners (GP) or practice nurses (PN) and provision of brief advice on diet and physical activity. The intervention (June 2008 to July 2010) was delivered by Divisions of General Practice (DGP) in the Hunter New England (HNE) region of NSW, Australia, to members in 300 practices. Intervention impact was evaluated using Medicare data on the number of HKCs completed and a post-intervention telephone survey of randomly selected parents in HNE and rest of NSW. Training reached 31% of GPs (n∼ 216/700) and 71% of PNs (n∼320/450) 31% of four-year-olds received a HKC in HNE compared to 15% in NSW 27% of HNE parents (n=162) reported a GP or PN had provided advice during their child's vaccinations visit compared to 15% of parents (n=154) in NSW (p=0.002). There was no significant difference in proportion of children who had weight or height assessed (55.6% in HNE and 54.6% in NSW). Boosting HKC claims and healthy eating and physical activity messages in general practice is feasible. More intensive strategies are required if obesity prevention and management benefits are to be achieved. General practice is an important but under-utilised source of advice for parents and data for policy makers on childhood obesity in Australia.
Corrigendum to “Clinician assessment, advice and referral for multiple health risk behaviours: Prevalence and predictors of delivery by primary health care nurses and allied health professionals” [Pat
Publisher: Elsevier BV
Date: 10-2016
Protocol for a mixed methods process evaluation of a hybrid implementation-effectiveness trial of a scaled-up whole-school physical activity program for adolescents: Physical Activity 4 Everyone (PA4E
Publisher: Springer Science and Business Media LLC
Date: 17-03-2020
DOI: 10.1186/S13063-020-4187-5
Abstract: Physical Activity 4 Everyone (PA4E1) is a physical activity program for secondary schools located in low-socioeconomic areas. Over a 24-month period, schools in the program arm of a cluster randomised controlled trial (n = up to 38 schools) will receive a multi-component implementation support strategy to embed the seven school physical activity practices of the PA4E1 program. This article describes the process evaluation of the PA4E1 hybrid implementation-effectiveness trial. The process evaluation aims to describe the fidelity and reach of the implementation support strategies using quantitative data and to describe the acceptability, appropriateness and feasibility of the implementation support strategies and physical activity practices to school stakeholders using mixed methods. Quantitative and qualitative data will be collected from participants (Physical Education teachers, in-School Ch ions, students) in the program arm. Data collection will involve semi-structured interviews, focus groups, a fidelity monitoring log, a fidelity checklist, surveys, and routinely collected administrative and website data. Quantitative data will be analysed descriptively and qualitative data will be analysed thematically within and across data sets. Triangulation between data sources will be used to synthesise findings regarding the implementation and potential mechanisms of impact of PA4E1 on school physical activity practice adoption, with respect to context. Results of the process evaluation will facilitate the interpretation of the findings of the trial outcomes. It will comprehensively describe what was actually implemented and identify the potential contribution of the various components of the implementation support strategy to the school physical activity practice adoption outcomes. Findings will inform future improvement and scale-up of PA4E1 and approaches to implementing secondary school-based physical activity programs more broadly. Australian New Zealand Clinical Trials Registry ACTRN12617000681358 registered 12 May 2017.
Accidents in older people living at home: a community-based study assessing prevalence, type, location and injuries
Publisher: Elsevier BV
Date: 12-2000
DOI: 10.1111/J.1467-842X.2000.TB00532.X
Abstract: To assess the prevalence, type, location of and injuries from home accidents, including falls and other accidents, and to explore whether variables including socio-demographic characteristics, medication use and home hazards were associated with all home accidents and falls. 657 older people were interviewed about accidents in the previous four weeks. For a subs le (n = 425), a home hazard check was completed. Of the 101 accidents reported, 51% (n = 51) were falls and 50% (n = 50) were other accidents. The most common location for all accidents was outside (30%). Most resulted in minor injury to the legs (43%) or arms (39%). Medical treatment was sought for 14% of accidents. Having more than five hazards and infrequent home visits by healthcare providers were associated with having at least one accident and at least one fall. Use of a walking aid was also associated with falling. Rates of falls and other accidents are considerable. Work is required to confirm the importance of the relationships suggested and to provide data on the burden of injury associated with non-fall accidents.
Systematic Review of Universal Resilience-Focused Interventions Targeting Child and Adolescent Mental Health in the School Setting
Publisher: Elsevier BV
Date: 10-2017
DOI: 10.1016/J.JAAC.2017.07.780
Abstract: To examine the effect of universal, school-based, resilience-focused interventions on mental health problems in children and adolescents. Eligible studies were randomized controlled trials (RCTs) of universal, school-based interventions that included strategies to strengthen a minimum of 3 internal resilience protective factors, and included an outcome measure of mental health problems in children and adolescents aged 5 to 18 years. Six databases were searched from 1995 to 2015. Results were pooled in meta-analyses by mental health outcome (anxiety symptoms, depressive symptoms, hyperactivity, conduct problems, internalizing problems, externalizing problems, and general psychological distress), for all trials (5-18 years). Subgroup analyses were conducted by age (child: 5-10 years adolescent: 11-18 years), length of follow-up (short: post-≤12 months long: >12 months), and gender (narrative). A total of 57 included trials were identified from 5,984 records, with 49 contributing to meta-analyses. For all trials, resilience-focused interventions were effective relative to a control in reducing 4 of 7 outcomes: depressive symptoms, internalizing problems, externalizing problems, and general psychological distress. For child trials (meta-analyses for 6 outcomes), interventions were effective for anxiety symptoms and general psychological distress. For adolescent trials (meta-analyses for 5 outcomes), interventions were effective for internalizing problems. For short-term follow-up, interventions were effective for 2 of 7 outcomes: depressive symptoms and anxiety symptoms. For long-term follow-up (meta-analyses for 5 outcomes), interventions were effective for internalizing problems. The findings may suggest most promise for using universal resilience-focused interventions at least for short-term reductions in depressive and anxiety symptoms for children and adolescents, particularly if a cognitive-behavioral therapy-based approach is used. The limited number of trials providing data amenable for meta-analysis for some outcomes and subgroups, the variability of interventions, study quality, and bias mean that it is not possible to draw more specific conclusions. Identifying what intervention qualities (such as number and type of protective factor) achieve the greatest positive effect per mental health problem outcome remains an important area for future research. Systematic Review of Universal Resilience Interventions Targeting Child and Adolescent Mental Health in the School Setting 0.1186/s13643-015-0172-6 PROSPERO CRD42015025908.
Breast self-examination and breast examination by a health care provider: Prevalence and predictors of screening in a randomly selected sample of Australian women
Publisher: AMPCo
Date: 06-1990
DOI: 10.5694/J.1326-5377.1990.TB125420.X
Abstract: Professional organizations recommend the practice of monthly breast self-examination (BSE), and examination of the breasts by a health care provider every three years for women up to the age of 40 and annually thereafter. These practices were examined in a randomly selected s le of 1454 women. Only 39% (95% confidence interval [CI], 36%-42%) of the s le reported monthly BSE. Women were more likely to examine their breasts each month if they had found a breast lump, believed they were likely to get breast cancer, were not single, or were frequent users of general practitioners. Only 51% (95% CI, 45%-53%) of women under the age of 40 reported receiving three-yearly breast examinations of those women aged 40 or more, 31% (CI, 27%-35%) of those with no additional risk factors and 35% (95% CI, 27%-42%) of those with at least one additional risk factor reported annual examinations. Women were more likely to have received a breast examination in the past three years if they had previously had a breast lump, were not single, had reached a higher educational level, were more frequent users of general practitioners, had private health insurance, or were described as other than ill or retired. There was a substantial association between BSE and breast examination by a health care provider with 25% (95% CI, 23%-27%) practising BSE and being screened by a health care provider. Thirty-five per cent (95% CI, 32%-38%) of women were not being screened by either method. The implications of the results for health education c aigns are discussed.
Correction: Associations Between Digital Health Intervention Engagement, Physical Activity, and Sedentary Behavior: Systematic Review and Meta-analysis (Preprint)
Publisher: JMIR Publications Inc.
Date: 25-03-2021
Abstract: EMOVE
Systematic review of universal resilience interventions targeting child and adolescent mental health in the school setting: review protocol
Publisher: Springer Science and Business Media LLC
Date: 12-2015
Associations Between Digital Health Intervention Engagement, Physical Activity, and Sedentary Behavior: Systematic Review and Meta-analysis
Publisher: JMIR Publications Inc.
Date: 19-02-2021
DOI: 10.2196/23180
Abstract: The effectiveness of digital health interventions is commonly assumed to be related to the level of user engagement with the digital health intervention, including measures of both digital health intervention use and users’ subjective experience. However, little is known about the relationships between the measures of digital health intervention engagement and physical activity or sedentary behavior. This study aims to describe the direction and strength of the association between engagement with digital health interventions and physical activity or sedentary behavior in adults and explore whether the direction of association of digital health intervention engagement with physical activity or sedentary behavior varies with the type of engagement with the digital health intervention (ie, subjective experience, activities completed, time, and logins). Four databases were searched from inception to December 2019. Grey literature and reference lists of key systematic reviews and journals were also searched. Studies were eligible for inclusion if they examined a quantitative association between a measure of engagement with a digital health intervention targeting physical activity and a measure of physical activity or sedentary behavior in adults (aged ≥18 years). Studies that purposely s led or recruited in iduals on the basis of pre-existing health-related conditions were excluded. In addition, studies were excluded if the in idual engaging with the digital health intervention was not the target of the physical activity intervention, the study had a non–digital health intervention component, or the digital health interventions targeted multiple health behaviors. A random effects meta-analysis and direction of association vote counting (for studies not included in meta-analysis) were used to address objective 1. Objective 2 used vote counting on the direction of the association. Overall, 10,653 unique citations were identified and 375 full texts were reviewed. Of these, 19 studies (26 associations) were included in the review, with no studies reporting a measure of sedentary behavior. A meta-analysis of 11 studies indicated a small statistically significant positive association between digital health engagement (based on all usage measures) and physical activity (0.08, 95% CI 0.01-0.14, SD 0.11). Heterogeneity was high, with 77% of the variation in the point estimates explained by the between-study heterogeneity. Vote counting indicated that the relationship between physical activity and digital health intervention engagement was consistently positive for three measures: subjective experience measures (2 of 3 associations), activities completed (5 of 8 associations), and logins (6 of 10 associations). However, the direction of associations between physical activity and time-based measures of usage (time spent using the intervention) were mixed (2 of 5 associations supported the hypothesis, 2 were inconclusive, and 1 rejected the hypothesis). The findings indicate a weak but consistent positive association between engagement with a physical activity digital health intervention and physical activity outcomes. No studies have targeted sedentary behavior outcomes. The findings were consistent across most constructs of engagement however, the associations were weak.
Evaluating Digital Program Support for the Physical Activity 4 Everyone (PA4E1) School Program: Mixed Methods Study
Publisher: JMIR Publications Inc.
Date: 26-07-2021
DOI: 10.2196/26690
Abstract: Effectively scaled-up physical activity interventions are urgently needed to address the high prevalence of physical inactivity. To facilitate scale-up of an efficacious school-based physical activity program (Physical Activity 4 Everyone [PA4E1]), provision of implementation support to physical education (PE) teachers was adapted from face-to-face and paper-based delivery modes to partial delivery via a website. A lack of engagement (usage and subjective experience) with digital delivery modes, including websites, may in part explain the typical reduction in effectiveness of scaled-up interventions that use digital delivery modes. A process evaluation focused on the PA4E1 website was undertaken. The 2 objectives were to (1) describe the usage of the PA4E1 program website by in-school ch ions (PE teachers leading the program within their schools) and PE teachers using quantitative methods (2) examine the usage, subjective experience, and usability of the PA4E1 program website from the perspective of in-school ch ions using mixed methods. The first objective used website usage data collected across all users (n=273) throughout the 9 school terms of the PA4E1 implementation support. The 4 usage measures were sessions, page views, average session duration, and downloads. Descriptive statistics were calculated and explored across the duration of the 26-month program. The second objective used mixed methods, triangulating data from the first objective with data from a think-aloud survey and usability test completed by in-school ch ions (n=13) at 12 months. Qualitative data were analyzed thematically alongside descriptive statistics from the quantitative data in a triangulation matrix, generating cross-cutting themes using the “following a thread” approach. For the first objective, in-school ch ions averaged 48.0 sessions per user, PE teachers 5.8 sessions. PE teacher sessions were of longer duration (10.5 vs 7.6 minutes) and included more page views (5.4 vs 3.4). The results from the mixed methods analysis for the second objective found 9 themes and 2 meta-themes. The first meta-theme indicated that the website was an acceptable and appropriate delivery mode, and usability of the website was high. The second meta-theme found that the website content was acceptable and appropriate, and identified specific suggestions for improvement. Digital health interventions targeting physical activity often experience issues of lack of user engagement. By contrast, the findings from both the quantitative and mixed methods analyses indicate high usage and overall acceptability and appropriateness of the PA4E1 website to school teachers. The findings support the value of the website within a multidelivery mode implementation intervention to support schools to implement physical activity promoting practices. The analysis identified suggested intervention refinements, which may be adopted for future iterations and further scale-up of the PA4E1 program. Australian New Zealand Clinical Trials Registry ACTRN12617000681358 www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=372870
Vegetable and fruit breaks in Australian primary schools: prevalence, attitudes, barriers and implementation strategies
Publisher: Oxford University Press (OUP)
Date: 13-05-2011
DOI: 10.1093/HER/CYR033
Abstract: School-based vegetable and fruit programs can increase student consumption of vegetables and fruit and have been recommended for adoption by Australian schools since 2005. An understanding of the prevalence and predictors of and the barriers to the adoption of school-based vegetable and fruit programs is necessary to maximize their adoption by schools and ensure that the health benefits of such programs to children are realized. The aim of this study was to determine Australian primary school Principals' attitudes and barriers to the implementation of vegetable and fruit breaks the prevalence of vegetable and fruit breaks in schools and the implementation strategies used and associated with their recommended adoption (daily in at least 80% of classes). A random s le of 384 school Principals completed a 20-min telephone interview. While Principals were highly supportive of vegetable and fruit breaks, only 44% were implementing these to a recommended level. When controlling for all school characteristics, recommended vegetable and fruit break adoption was 1.9 and 2.2 times greater, respectively, in schools that had parent communication strategies and teachers trained. A substantial opportunity exists to enhance the health of children through the adoption of vegetable and fruit breaks in schools.
A cluster randomised trial of a school-based resilience intervention to decrease tobacco, alcohol and illicit drug use in secondary school students: study protocol
Publisher: Springer Science and Business Media LLC
Date: 21-11-2012
DOI: 10.1186/1471-2458-12-1009
Abstract: Whilst schools provide a potentially appropriate setting for preventing substance use among young people, systematic review evidence suggests that past interventions in this setting have demonstrated limited effectiveness in preventing tobacco, alcohol and other drug use. Interventions that adopt a mental wellbeing approach to prevent substance use offer considerable promise and resilience theory provides one method to impact on adolescent mental well-being. The aim of the proposed study is to examine the efficacy of a resilience intervention in decreasing the tobacco, alcohol and illicit drug use of adolescents. A cluster randomised controlled trial with schools as the unit of randomisation will be undertaken. Thirty two schools in disadvantaged areas will be allocated to either an intervention or a control group. A comprehensive resilience intervention will be implemented, inclusive of explicit program adoption strategies. Baseline surveys will be conducted with students in Grade 7 in both groups and again three years later when the student cohort is in Grade 10. The primary outcome measures will include self-reported tobacco, alcohol, marijuana and other illicit drug use. Comparisons will be made post-test between Grade 10 students in intervention and control schools to determine intervention effectiveness across all measures. To the authors’ knowledge this is the first randomised controlled trial to evaluate the effectiveness of a comprehensive school-based resilience intervention, inclusive of explicit adoption strategies, in decreasing tobacco, alcohol and illicit drug use of adolescents attending disadvantaged secondary schools. ACTRN12611000606987
Benefits of including a prospective exercise diary in the management of NIDDM diabetes: A preliminary report
Publisher: Wiley
Date: 11-1996
Screening and intervention for cholesterol
Publisher: Wiley
Date: 08-1991
Encouraging underscreened women to have cervical cancer screening: The effectiveness of a computer strategy
Publisher: Elsevier BV
Date: 11-1997
Abstract: Computers that collect data from patients and provide both patients and practitioners with printed feedback on a range of health risks are a tool for assisting general practitioners with preventive care. This study assessed the impact of computer-generated printed feedback on cervical screening among women who were underscreened for cervical cancer. Female attenders at two Australian general practices were randomly allocated to Experimental or Control groups. Women in both groups completed a health risk survey on a touch screen computer prior to their consultation. Those in the Experimental group received printed pages summarizing their results, including their eligibility for cervical screening and last Pap test, for themselves and their doctor. The number and proportion of underscreened women who had a Pap test in the 6 months after completing the computer survey, as determined by pathology records, were examined. Of the 679 participants, 139 were classified as underscreened on the basis of self-report (74 Experimental, 65 Control) and 272 on the basis of their pathology records (148 Experimental, 124 Control). Overall about one-third of women had a test in the 6-month period, and the differences between the groups were not significant for women overall (18-70 years) or for women 18-49 years. Among women 50-70 who were underscreened based on self-report, those receiving the printout were more likely to have a Pap test in the next 6 months (P < 0.05). This pattern was also evident, but did not reach statistical significance, for older women who were underscreened based on pathology records. We are unable to draw conclusions regarding the effectiveness of the computer system due to the modest proportions of women screened, the small numbers, and the fact that the computer survey may have created an intervention effect in the Control group. As the study suggests the computer system is acceptable to women and may be effective for encouraging screening among older women, further exploration of the system is desirable.
Systematic review of interventions to increase the delivery of preventive care by primary care nurses and allied health clinicians
Publisher: Springer Science and Business Media LLC
Date: 12-2015
Patient-provider interactions and patient outcomes.
Publisher: SAGE Publications
Date: 04-1989
DOI: 10.1177/014572178901500209
Abstract: Research shows that a number of provider interactional skills are empirically related to patient adherence, making interaction skills a necessary and important part of clinical competence. These skills fall into three broad categories: techniques to elicit and modify patients' health and treatment beliefs, to aid recall of information, and to aid adherence. Specific skills in each category are discussed. Research further shows that health care providers can be taught effective communication skills, and that one of the most effective teaching techniques is audio or video feedback in which the provider's interaction with a patient is judged by tutor and peers using explicit, empirically based criteria.
Australian primary school student’s attitudes to changing from traditional school uniforms to sports uniforms and association with student characteristics
Publisher: Elsevier BV
Date: 02-2019
Mental health problems in a regional population of Australian adolescents: association with socio-demographic characteristics
Publisher: Springer Science and Business Media LLC
Date: 13-09-2016
Effects of a ‘school-based’ physical activity intervention on adiposity in adolescents from economically disadvantaged communities: secondary outcomes of the ‘Physical Activity 4 Everyone’ RCT
Publisher: Springer Science and Business Media LLC
Date: 10-06-2016
DOI: 10.1038/IJO.2016.107
A systematic review and meta-analysis of moderate-to-vigorous physical activity levels in elementary school physical education lessons.
Publisher: Elsevier BV
Date: 05-2016
DOI: 10.1016/J.YPMED.2015.11.018
Abstract: To examine elementary school students' moderate-to-vigorous physical activity (MVPA) levels during physical education (PE) lessons. A systematic search of nine electronic databases was conducted (PROSPERO2014:CRD42014009649). Studies were eligible if they were in English published between 2005-April 2014 assessed MVPA levels in PE lessons of elementary school children (aged four-12years) and used an objective MVPA measure. Two reviewers retrieved articles, assessed risk of bias, and performed data extraction. The findings were synthesised using a meta-analysis. The search yielded 5132 articles. Thirteen studies from nine countries met the inclusion criteria. Eight studies measured MVPA through observational measures, five used accelerometry and one used heart rate monitoring. The percentage of PE lesson time spent in MVPA ranged between 11.4-88.5%. Meta-analysis of seven studies (4 direct observations 4 accelerometers) found that children spent a mean (95% CI) 44.8 (28.2-61.4)% of PE lesson time in MVPA. When measured using direct observation and accelerometers, children spent 57.6 (47.3-68.2) and 32.6 (5.9-59.3)% of PE lesson time in MVPA, respectively. The review has limitations the search strategy was restricted to studies in English theses, dissertations and conference abstracts were excluded and six studies that provided insufficient data were excluded from the meta-analysis. MVPA levels during elementary school PE lessons do not meet the United States Centre for Disease Control and Prevention and the United Kingdom's Association of Physical Education recommendation (50% of lesson time), but is higher than estimated in the previous review (34.2%). Interventions to increase MVPA in PE lessons are needed.
The influence of individual and organizational factors on the reported smoking intervention practices of staff in 20 antenatal clinics
Publisher: Wiley
Date: 06-1998
DOI: 10.1080/09595239800186981
Abstract: This study investigates the factors which influence the reported use of a smoking cessation interventions in antenatal clinics. Midwives and doctors in 20 hospital antenatal clinics (n = 203) completed a survey designed to measure their perceptions, knowledge and use of brief interventions for smoking. Measures for hospital structure and work climate were also obtained. The aims of the study are: to describe the smoking intervention practice of antenatal clinic staff and to ascertain the organizational and practitioner variables which predict clinician use of smoking interventions. The results indicate that the majority of antenatal clinic staff do not use the most effective forms of brief interventions for smoking. The presence of specific procedures and training in smoking cessation intervention appear to be the most important predictors of reported smoking intervention in hospital antenatal clinics.
Effectiveness of referral to a population-level telephone coaching service for improving health risk behaviours in people with a mental health condition: study protocol for a randomised controlled tri
Publisher: Springer Science and Business Media LLC
Date: 17-01-2022
DOI: 10.1186/S13063-021-05971-6
Abstract: People with a mental health condition have a shorter life expectancy than the general population. This is largely attributable to higher rates of chronic disease and a higher prevalence of modifiable health risk behaviours including tobacco smoking, alcohol consumption, poor nutrition, and physical inactivity. Telephone support services offer a viable option to provide support to reduce these health risk behaviours at a population-level however, whilst there is some research pertaining to Quitlines, there is limited other research investigating whether telephone services may offer effective support for people with a mental health condition. This protocol describes a randomised controlled trial that aims to evaluate the referral of people with a mental health condition to a population-level telephone coaching service to increase physical activity, healthy eating, or weight management, and increase attempts to do so. A parallel-group randomised controlled trial will be conducted recruiting participants with a mental health condition through community mental health services and advertisement on social media. Participants will be randomly assigned to receive either a health information pack only (control) or a health information pack and a proactive referral to a free, government-funded telephone coaching service, the NSW Get Healthy Coaching and Information Service® (intervention), which offers up to 13 telephone coaching calls with a University Qualified Health Coach to assist with client-identified goals relating to physical activity, healthy eating, weight management, or alcohol reduction. Data will be collected via telephone surveys at baseline and 6 months post-recruitment. Primary outcomes are as follows: (1) minutes of moderate to vigorous physical activity per week, (2) serves of fruit consumed per day, (3) serves of vegetables consumed per day, and (4) a composite measure assessing attempts to change at least one health risk behaviour (any attempts to change physical activity, fruit consumption, vegetable consumption, or other parts of nutrition). Secondary outcomes include weight and body mass index. This study is the first to evaluate the effectiveness of referral to a population-level telephone support service for reducing health risk behaviours relating to physical activity, healthy eating, and weight in people with a mental health condition. Results will inform future policy and practice regarding the delivery of telephone-based behaviour change coaching services and the management of physical health for this population to reduce health inequity and the burden of chronic disease. The Australian New Zealand Clinical Trials Registry ACTRN12620000351910 . Retrospectively registered on 12 March 2020
Extent, Type and Reasons for Adaptation and Modification When Scaling-Up an Effective Physical Activity Program: Physical Activity 4 Everyone (PA4E1).
Publisher: Frontiers Media SA
Date: 17-11-2021
Abstract: Background: Few studies have described the extent, type and reasons for making changes to a program prior to and during its delivery using a consistent taxonomy. Physical Activity 4 Everyone (PA4E1) is a secondary school physical activity program that was scaled-up for delivery to a greater number of schools. We aimed to describe the extent, type and reasons for changes to the PA4E1 program (the evidence-based physical activity practices, implementation support strategies and evaluation methods) made before its delivery at scale (adaptations) and during its delivery in a scale-up trial (modifications). Methods: The Framework for Reporting Adaptations and Modifications-Enhanced (FRAME) was used to describe adaptations (planned and made prior to the scale-up trial) and modifications (made during the conduct of the trial). A list of adaptations was generated from a comparison of the efficacy and scale-up trials via published PA4E1 protocols, trial registrations and information provided by trial investigators. Monthly trial team meetings tracked and coded modifications in “real-time” during the conduct of the scale-up trial. The extent, type and reasons for both adaptations and modifications were summarized descriptively. Results: In total, 20 adaptations and 20 modifications were identified, these were to physical activity practices ( n = 8 n = 3), implementation support strategies ( n = 6 n = 16) and evaluation methods ( n = 6, n = 1), respectively. Few adaptations were “fidelity inconsistent” ( n = 2), made “unsystematically” ( n = 1) and proposed to have a “negative” impact on the effectiveness of the program ( n = 1). Reasons for the adaptations varied. Of the 20 modifications, all were “fidelity consistent” and the majority were made “proactively” ( n = 12), though most were “unsystematic” ( n = 18). Fifteen of the modifications were thought to have a “positive” impact on program effectiveness. The main reason for modification was the “available resources” ( n = 14) of the PA4E1 Implementation Team. Conclusions: Adaptations and modifications to public health programs are common. Modifications have the potential to impact the implementation and effectiveness of programs. Our findings underscore the importance of comprehensive reporting of the extent, type and reasons for modifications as part of process evaluations, as this data may be important to the interpretation of trial findings. Clinical Trial Registration: www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=372870 , Identifier ACTRN12617000681358.
Characteristics of participants utilising a telephone-based coaching service for chronic disease health risk behaviours
Publisher: Elsevier BV
Date: 09-2020
Co-development of implementation strategies to assist staff of a mental health community managed organisation provide preventive care for health behaviours
Publisher: Wiley
Date: 11-10-2023
DOI: 10.1002/HPJA.813
Chronic disease health risk behaviours amongst people with a mental illness
Publisher: SAGE Publications
Date: 19-02-2015
Abstract: Amongst people with a mental illness, modifiable health risk behaviours contribute substantially to increased chronic disease morbidity and mortality. This study examined the prevalence of and interest in changing such behaviours amongst community mental health service clients in Australia. A telephone interview was undertaken with Australian community mental health service clients. Participants reported engagement in four health risk behaviours: tobacco smoking, fruit and vegetable consumption, alcohol consumption, and physical activity. Participants were classified as at risk based upon Australian national guidelines. At-risk participants were asked whether they were considering improving their health risk behaviour within the next month. The association between psychiatric diagnosis and risk, and interest in improving health risk behaviours was examined. Risk prevalence was highest for inadequate vegetable consumption (78.3%), followed by inadequate fruit consumption (60%), smoking (50.7%), physical inactivity (46.8%), short-term alcohol risk (40.3%) and chronic alcohol risk (35.3%). A majority of at-risk participants were considering improving their health risk behaviour for smoking, physical inactivity and inadequate fruit and vegetable consumption (65.1%, 71.1%, and 53.3%, respectively). After adjusting for demographic factors, no diagnostic categories were associated with risk for any behaviour. Those with a diagnosis of depression were more likely to be interested in quitting smoking and increasing physical activity. Regardless of diagnosis, a high prevalence of chronic disease health risk behaviours was identified, with many participants expressing an interest in improving these behaviours. Such findings reinforce recommendations that preventive care addressing the chronic disease risks of clients be provided routinely by mental health clinicians. Australian New Zealand Clinical Trials Registry (ANZCTR) ACTRN12613000693729. URL: www.anzctr.org.au/
Associations Between Digital Health Intervention Engagement, Physical Activity, and Sedentary Behavior: Systematic Review and Meta-analysis (Preprint)
Publisher: JMIR Publications Inc.
Date: 04-08-2020
Abstract: he effectiveness of digital health interventions is commonly assumed to be related to the level of user engagement with the digital health intervention, including measures of both digital health intervention use and users’ subjective experience. However, little is known about the relationships between the measures of digital health intervention engagement and physical activity or sedentary behavior. his study aims to describe the direction and strength of the association between engagement with digital health interventions and physical activity or sedentary behavior in adults and explore whether the direction of association of digital health intervention engagement with physical activity or sedentary behavior varies with the type of engagement with the digital health intervention (ie, subjective experience, activities completed, time, and logins). our databases were searched from inception to December 2019. Grey literature and reference lists of key systematic reviews and journals were also searched. Studies were eligible for inclusion if they examined a quantitative association between a measure of engagement with a digital health intervention targeting physical activity and a measure of physical activity or sedentary behavior in adults (aged ≥18 years). Studies that purposely s led or recruited in iduals on the basis of pre-existing health-related conditions were excluded. In addition, studies were excluded if the in idual engaging with the digital health intervention was not the target of the physical activity intervention, the study had a non–digital health intervention component, or the digital health interventions targeted multiple health behaviors. A random effects meta-analysis and direction of association vote counting (for studies not included in meta-analysis) were used to address objective 1. Objective 2 used vote counting on the direction of the association. verall, 10,653 unique citations were identified and 375 full texts were reviewed. Of these, 19 studies (26 associations) were included in the review, with no studies reporting a measure of sedentary behavior. A meta-analysis of 11 studies indicated a small statistically significant positive association between digital health engagement (based on all usage measures) and physical activity (0.08, 95% CI 0.01-0.14, SD 0.11). Heterogeneity was high, with 77% of the variation in the point estimates explained by the between-study heterogeneity. Vote counting indicated that the relationship between physical activity and digital health intervention engagement was consistently positive for three measures: subjective experience measures (2 of 3 associations), activities completed (5 of 8 associations), and logins (6 of 10 associations). However, the direction of associations between physical activity and time-based measures of usage (time spent using the intervention) were mixed (2 of 5 associations supported the hypothesis, 2 were inconclusive, and 1 rejected the hypothesis). he findings indicate a weak but consistent positive association between engagement with a physical activity digital health intervention and physical activity outcomes. No studies have targeted sedentary behavior outcomes. The findings were consistent across most constructs of engagement however, the associations were weak.
Increasing smoking cessation care provision in hospitals: A meta-analysis of intervention effect
Publisher: Oxford University Press (OUP)
Date: 07-05-2009
DOI: 10.1093/NTR/NTP056
Abstract: Levels of hospital smoking cessation care are less than optimal. This study aimed to synthesize the evidence regarding the effectiveness of interventions in increasing smoking cessation care provision in hospitals. A review identified relevant studies published between 1994 and 2006. A description of studies, including methodological quality, was undertaken. Intervention effectiveness in increasing smoking cessation care practices was examined for controlled studies using meta-analysis. Care practices examined were assessment of smoking status advice to quit counseling or assistance to quit advising, offering, or providing nicotine replacement therapy (NRT) and follow-up or referral. Of the 25 identified studies, 18 were U.S. based and in inpatient settings. Of the 10 controlled trials, 4 addressed cardiac patients, 5 measured one smoking cessation care practice, and 9 implemented multistrategic interventions (e.g., combining educational meetings with reminders and written resources). The methodology described in these studies was generally of poor quality. Meta-analysis of controlled trials demonstrated a significant intervention effect for provision of assistance and counseling to quit (pooled risk difference = 16.6, CI = 4.9-28.3) but not for assessment of smoking status, advice to quit, or the provision or discussion of NRT. Statistical heterogeneity was indicated for all smoking cessation care practices. An insufficient number of studies precluded the use of meta-analysis for follow-up or referral for further assistance. Interventions can be effective in increasing the routine provision of hospital smoking cessation care. Future research should use more rigorous study design, examine a broader range of smoking cessation care practices, and focus on hospital-wide intervention implementation.
Smoking care provision in smoke-free hospitals in Australia
Publisher: Elsevier BV
Date: 07-2005
DOI: 10.1016/J.YPMED.2004.09.044
Abstract: The study aimed to (1) determine the current routine smoking care that smoke-free public hospitals in New South Wales (NSW), Australia, provide to inpatients who are smokers (2) determine current strategies supporting such care and (3) examine the association between smoking care provision and hospital characteristics and support strategies. A cross-sectional survey of 169 senior hospital managers was undertaken. Survey items included smoking care practices such as identification of smoking status and provision of nicotine replacement therapy as well as hospital activities such as existence of policies and staff training. Hospital characteristics such as size and geographic location were also collected. Twenty percent of respondents reported provision of minimally 'adequate' smoking care, defined as providing five or more smoking care items to 80% or more of patients. Larger hospitals were significantly less likely to provide adequate smoking care. Nurse training, the existence of signs indicating a smoke-free site and signs indicating location of designated smoking areas were also associated with smoking care provision. The existence of three or more support strategies was associated with smoking care provision. Even in the context of a smoke-free hospital site, the majority of inpatients who are smokers receive inadequate smoking care. Considered investment is required for hospitals to implement strategies to institutionalise the routine provision of appropriate smoking care.
Effectiveness of a pragmatic school‐based universal intervention targeting student resilience protective factors in reducing mental health problems in adolescents
Publisher: Wiley
Date: 03-04-2017
DOI: 10.1016/J.ADOLESCENCE.2017.03.009
Abstract: Worldwide, 10–20% of adolescents experience mental health problems. Strategies aimed at strengthening resilience protective factors provide a potential approach for reducing mental health problems in adolescents. This study evaluated the effectiveness of a universal, school‐based intervention targeting resilience protective factors in reducing mental health problems in adolescents. A cluster randomised controlled trial was conducted in 20 intervention and 12 control secondary schools located in socio‐economically disadvantaged areas of NSW, Australia. Data were collected from 3115 students at baseline (Grade 7, 2011), of whom 2149 provided data at follow up (Grade 10, 2014 enrolments in Grades 7 to 10 typically aged 12–16 years 50% male 69.0% retention). There were no significant differences between groups at follow‐up for three mental health outcomes: total SDQ, internalising problems, and prosocial behaviour. A small statistically significant difference in favour of the control group was found for externalising problems. Findings highlight the continued difficulties in developing effective, school‐based prevention programs for mental health problems in adolescents. ANZCTR (Ref no: ACTRN12611000606987).
We Are What We Do
Publisher: Elsevier BV
Date: 10-2008
DOI: 10.1016/J.AMEPRE.2008.06.039
Abstract: If public health research does not progress beyond descriptive research to testing the effectiveness of interventions that can provide causal data, its contribution to evidence-based practice will not be realized. This paper examined the number and percentage of public health research publications over three time periods (1987-1988, 1997-1998, 2005-2006) for three preventive health issues: tobacco use, alcohol use, and inadequate physical activity. A computer-based literature search was conducted, using the Medline and PsycINFO databases. A random s le of 1000 abstracts for each preventive health issue was examined per time period. The abstracts were first categorized as public health or not, and then as data-based or non-data-based public health research. Data-based publications were classified according to research type as measurement-, descriptive/epidemiologic-, or intervention-oriented. Data analysis occurred in 2007. The number of data-based public health research publications examined for each topic ranged between 180 and 346 in 1987-1988, 199 and 322 in 1997-1998, and 302 and 364 in 2005-2006. Despite a significant increase over time in the percentage of intervention publications for tobacco (from 10% in 1987-1988 to 18% in 2005-2006, p=0.008), the majority of publications in all three time periods were descriptive/epidemiologic for all topics (62%-87% in 1987-1988, 64%-85% in 1997-1998, 78%-79% in 2005-2006). There were fewer measurement (3%-7% in 1987-1988, 2%-6% in 1997-1998, 4%-10% in 2005-2006) or intervention publications (9%-31% in 1987-1988, 10%-30% in 1997-1998, 12%-18% in 2005-2006). Descriptive research does not provide optimal evidence for how to reduce preventable illness. Reasons for the lack of measurement and intervention public health research are explored.
Randomized Controlled Trial of a Computer Strategy to Increase General Practitioner Preventive Care
Publisher: Elsevier BV
Date: 12-1999
A cluster randomised trial of an intervention to increase the implementation of physical activity practices in secondary schools: study protocol for scaling up the Physical Activity 4 Everyone (PA4E1)
Publisher: Springer Science and Business Media LLC
Date: 04-07-2019
The association between the receipt of primary care clinician provision of preventive care and short term health behaviour change
Publisher: Elsevier BV
Date: 06-2019
DOI: 10.1016/J.YPMED.2019.03.046
Abstract: Primary healthcare services are recommended to provide preventive care to address chronic disease risk behaviours. However, all care elements are infrequently provided, and there is a need to understand the impact of partial care provision on behaviour change. This study examined the association between variable levels of preventive care receipt from primary care clinicians on short-term behaviour change for four risk behaviours. A survey was undertaken with 5639 Australian community health service clients (2009-2014). Clients self-reported: engagement in risk behaviours (tobacco smoking, harmful alcohol consumption, inadequate fruit and/or vegetable consumption, physical inactivity) in the month prior to and four week post their community health service appointment receipt of preventive care during appointments (assessment, advice, referral/follow-up) for each behaviour. Univariate regression models explored the association between change in risk status and preventive care received. The odds of behaviour change for those receiving all three care elements was significant for all behaviours, compared to no care, ranging from 2.02 (alcohol consumption, 95% CI 1.16-3.49) to 4.17 (inadequate fruit and/or vegetable consumption, 95% CI 2.91-5.96). Receipt of both assessment and advice increased the odds of behaviour change, compared to no care, for all behaviours except smoking, ranging from 2.32 (physical inactivity, 95% CI 1.60-3.35) to 2.83 (alcohol consumption, 95% CI 1.84-4.33). Receipt of 'assessment only' increased the odds of behaviour change, compared to no care, for inadequate fruit and/or vegetable consumption (OR = 2.40, 95% CI 1.60-3.59) and physical inactivity (OR = 2.81, 95% CI 1.89-4.17). Results highlight the importance of primary care clinicians providing best practice preventive care to maximise client behaviour change.
Increasing Preventive Care by Primary Care Nursing and Allied Health Clinicians
Publisher: Elsevier BV
Date: 10-2014
DOI: 10.1016/J.AMEPRE.2014.06.018
Abstract: Although primary care nurse and allied health clinician consultations represent key opportunities for the provision of preventive care, it is provided suboptimally. To assess the effectiveness of a practice change intervention in increasing primary care nursing and allied health clinician provision of preventive care for four health risks. Two-group (intervention versus control), non-randomized controlled study assessing the effectiveness of the intervention in increasing clinician provision of preventive care. Randomly selected clients from 17 primary healthcare facilities participated in telephone surveys that assessed their receipt of preventive care prior to (September 2009-2010, n=876) and following intervention (October 2011-2012, n=1,113). The intervention involved local leadership and consensus processes, electronic medical record system modification, educational meetings and outreach, provision of practice change resources and support, and performance monitoring and feedback. The primary outcome was differential change in client-reported receipt of three elements of preventive care (assessment, brief advice, referral/follow-up) for each of four behavioral risks in idually (smoking, inadequate fruit and vegetable consumption, alcohol overconsumption, physical inactivity) and combined. Logistic regression assessed intervention effectiveness. Analyses conducted in 2013 indicated significant improvements in preventive care delivery in the intervention compared to the control group from baseline to follow-up for assessment of fruit and vegetable consumption (+23.8% vs -1.5%) physical activity (+11.1% vs -0.3%) all four risks combined (+16.9% vs -1.0%) and for brief advice for inadequate fruit and vegetable consumption (+19.3% vs -2.0%) alcohol overconsumption (+14.5% vs -8.9%) and all four risks combined (+14.3% vs +2.2%). The intervention was ineffective in increasing the provision of the remaining forms of preventive care. The intervention's impact on the provision of preventive care varied by both care element and risk type. Further intervention is required to increase the consistent provision of preventive care, particularly referral/follow-up.
Systematic review of lifestyle interventions to improve weight, physical activity and diet among people with a mental health condition
Publisher: Springer Science and Business Media LLC
Date: 09-09-2022
DOI: 10.1186/S13643-022-02067-3
Abstract: People with a mental health condition experience an elevated risk of chronic disease and greater prevalence of health and behaviours. Lifestyle interventions aim to reduce this risk by modifying health behaviours such as physical activity and diet. Previous reviews exploring the efficacy of such interventions for this group have typically limited inclusion to in iduals with severe mental illness (SMI), with a focus of impact on weight. This review assessed the efficacy of lifestyle interventions delivered in community or outpatient settings to people with any mental health condition, on weight, physical activity and diet. Eligible studies were randomised or cluster-randomised controlled trials published between January 1999 and February 2019 aiming to improve weight, physical activity or diet, for people with any mental health condition. Two reviewers independently completed study screening, data extraction and assessment of methodological quality. Primary outcome measures were weight, physical activity and diet. Secondary outcome measures were body mass index (BMI), waist circumference, sedentary behaviour and mental health. Where possible, meta-analyses were conducted. Narrative synthesis using vote counting based on direction of effect was used where studies were not amenable to meta-analysis. Fifty-seven studies were included (49 SMI only), with 46 contributing to meta-analyses. Meta-analyses revealed significant ( 0.05) effect of interventions on mean weight loss (−1.42 kg), achieving 5% weight loss ( OR 2.48), weight maintenance (−2.05 kg), physical activity (IPAQ MET minutes: 226.82) and daily vegetable serves (0.51), but not on fruit serves (0.01). Significant effects were also seen for secondary outcomes of BMI (−0.48 units) and waist circumference (−0.87cm), but not mental health (depression: SMD −0.03 anxiety: SMD −0.49 severity of psychological symptoms: SMD 0.72). Studies reporting sedentary behaviour were not able to be meta-analysed. Most trials had high risk of bias, quality of evidence for weight and physical activity were moderate, while quality of evidence for diet was low. Lifestyle interventions delivered to people with a mental health condition made statistically significant improvements to weight, BMI, waist circumference, vegetable serves and physical activity. Further high-quality trials with greater consistency in measurement and reporting of outcomes are needed to better understand the impact of lifestyle interventions on physical activity, diet, sedentary behaviour and mental health and to understand impact on subgroups. PROSPERO CRD42019137197
Results of a systematic and theoretical approach to scaling-up an efficacious school-based physical activity intervention for adolescents: ‘Physical Activity for Everyone’
Publisher: Unpublished
Date: 2018
Online canteens: awareness, use, barriers to use, and the acceptability of potential online strategies to improve public health nutrition in primary schools
Publisher: Wiley
Date: 04-05-2016
DOI: 10.1071/HE15095
Randomized controlled trial of a telephone-based intervention for child fruit and vegetable intake: long-term follow-up
Publisher: Elsevier BV
Date: 03-2014
Abstract: Telephone-based interventions can be effective in increasing child fruit and vegetable intake in the short term (<6 mo). The long-term efficacy of such interventions, however, is unknown. The primary aim of this study was to determine whether the short-term (<6 mo) impact of a telephone-based intervention on children's fruit and vegetable intake was sustained over a longer term. A secondary aim of the study was to assess the long-term impact of the intervention on the intake of foods high in fat, salt, or sugar (noncore foods). The study used a cluster randomized controlled trial design. Parents were recruited from Australian preschools between February and August 2010 and allocated to receive an intervention consisting of print materials and 4 telephone-counseling calls delivered over 1 mo or to a print information-only control group. The primary endpoint for the trial was the 18-mo postbaseline follow-up. Linear regression models were used to assess between-group differences in child consumption of fruit and vegetables and noncore foods by subscales of the Children's Dietary Questionnaire. Fruit and vegetable subscale scores were significantly higher, indicating greater child fruit and vegetable intake, among children in the intervention group at the 12-mo (16.77 compared with 14.89 P < 0.01) but not the 18-mo (15.98 compared with 16.82 P = 0.14) follow-up. There were no significant differences between groups at either of the follow-up periods in the noncore food subscale score. Further research to identify effective maintenance strategies is required to maximize the benefits of telephone-based interventions on child diet.
Incontinence during pregnancy. Prevalence and opportunities for continence promotion
Publisher: Wiley
Date: 02-1997
DOI: 10.1111/J.1479-828X.1997.TB02220.X
Abstract: A cross-sectional study using a structure interview was conducted with 304 women in the postnatal ward of a large NSW teaching hospital. Women were asked about any incontinence experienced in the last month of pregnancy, and about advice and interventions for bladder control or incontinence they had received during pregnancy. Sixty four per cent of women reported incontinence during pregnancy. Compared to women with no prior deliveries, those with a previous forceps delivery were 10 times more likely to experience incontinence, and with prior vaginal deliveries 4 times more likely to experience incontinence. Women who reported experiencing bouts of coughing on a regular basis during pregnancy were 4 times more likely to experience incontinence than those who did not. While 68% of the women reported being examined vaginally at least once during pregnancy, only 6% of the s le reported having their pelvic floor muscles tested during routine vaginal examination. Twenty three per cent of women reported having spoken with a healthcare professional regarding loss of bladder control. The results indicate that opportunities for continence promotion are not being utilized.
Effectiveness of a pragmatic school-based universal resilience intervention in reducing tobacco, alcohol and illicit substance use in a population of adolescents: cluster-randomised controlled trial
Publisher: BMJ
Date: 08-2017
DOI: 10.1136/BMJOPEN-2017-016060
Abstract: Initiation of tobacco, alcohol and illicit substance use typically occurs during adolescence, with the school setting recommended to reduce adolescent substance use. Strengthening in idual (eg, problem solving) and environmental (eg, caring relationships at school) resilience protective factors of adolescents has been suggested as a strategy for reducing substance use by adolescents however, few studies have examined this potential. A study was conducted to investigate the effectiveness of a pragmatic school-based universal ‘resilience’ intervention in reducing the prevalence of tobacco, alcohol and illicit substance use, and increasing the in idual and environmental protective factors of students. A cluster-randomised controlled trial. Thirty-two Australian secondary schools (20 intervention 12 control). Cohort of grade 7 students followed-up in grade 10 (2014 aged 15–16 years). A pragmatic intervention involving school staff selection and implementation of available programmes and resources targeting in idual and environmental ‘resilience’ protective factors for all grade 7–10 students was implemented in schools (2012–2014). School staff were provided implementation support. An online survey collected baseline and follow-up data for primary outcomes: tobacco (ever, recent) and alcohol (ever, recent, ‘risk’) use, and secondary outcomes: marijuana and other illicit substance use, and in idual (six-factor subscales, aggregate) and environmental (three-factor subscales, aggregate) protective factor scores. Generalised and linear mixed models examined follow-up differences between groups. Follow-up data from 2105 students (intervention=1261 control=844 69% of baseline cohort) were analysed. No significant differences were found between intervention and control students for any primary (ever tobacco: OR 1.25, 95% CI 0.92 to 1.68, p=0.14 recent tobacco: OR 1.39, 95% CI 0.84 to 2.31, p=0.19 recent ever alcohol: OR 1.11, 95% CI 0.83 to 1.48, p=0.46 alcohol: OR 1.13, 95% CI 0.78 to 1.62, p=0.51 ‘risk’ alcohol: OR 0.98, 95% CI 0.70 to 1.36, p=0.89) or secondary outcomes (marijuana: OR 1.12, 95% CI 0.74 to 1.68, p=0.57 other illicit substance: OR 1.19, 95% CI 0.67 to 2.10, p=0.54 in idual protective factors: MD=0, 95% CI −0.07 to 0.06, p=0.89 environmental protective factors: MD: −0.02, 95% CI −0.09 to 0.06, p=0.65). The universally implemented pragmatic school-based intervention was not effective in reducing the prevalence of tobacco, alcohol or illicit substance use, or in increasing the protective factors of students. Australia and New Zealand Clinical Trials Register reference: ACTRN12611000606987
Care Provision to Prevent Chronic Disease by Community Mental Health Clinicians
Publisher: Elsevier BV
Date: 12-2014
DOI: 10.1016/J.AMEPRE.2014.08.003
Abstract: People with a mental illness have higher prevalence of behavioral risks for chronic disease than the general population. Despite recommendations regarding the provision of preventive care by mental health services, limited research has examined the extent to which such care is provided. To examine mental health clinician provision of care for preventable chronic disease risks, and whether such care was associated with the availability of practice support strategies. A cross-sectional survey was undertaken of 151 community mental health clinicians in New South Wales, Australia regarding the provision of three elements of preventive care (i.e., assessment, brief advice, and referral/follow-up) for four health risk behaviors (i.e., tobacco smoking, inadequate fruit and vegetable consumption, harmful alcohol consumption, and inadequate physical activity). Clinicians reported the availability of 16 strategies to support such care delivery. Data were collected in 2010 and analyzed in 2012-2013. Preventive care provision varied by both care element and risk behavior. Optimal care (each care element provided to at least 80% of clients for all health behaviors) was provided by few clinicians: assessment (8.6%), brief advice (24.5%), and referral/follow-up (9.9%). Less than half of clinicians reported more than four support strategies were available (44.4%). The availability of five or more strategies was associated with increased optimal preventive care. The provision of preventive care focused on chronic disease prevention in community mental health services is suboptimal. Interventions to increase the routine provision of such care should involve increasing the availability of evidence-based strategies to support care provision.
Healthier choices in an Australian health service: a pre-post audit of an intervention to improve the nutritional value of foods and drinks in vending machines and food outlets
Publisher: Springer Science and Business Media LLC
Date: 25-11-2013
Abstract: Vending machines and shops located within health care facilities are a source of food and drinks for staff, visitors and outpatients and they have the potential to promote healthy food and drink choices. This paper describes perceptions of parents and managers of health-service located food outlets towards the availability and labelling of healthier food options and the food and drinks offered for sale in health care facilities in Australia. It also describes the impact of an intervention to improve availability and labelling of healthier foods and drinks for sale. Parents (n = 168) and food outlet managers (n = 17) were surveyed. Food and drinks for sale in health-service operated food outlets (n = 5) and vending machines (n = 90) in health care facilities in the Hunter New England region of NSW were audited pre (2007) and post (2010/11) the introduction of policy and associated support to increase the availability of healthier choices. A traffic light system was used to classify foods from least (red) to most healthy choices (green). Almost all (95%) parents and most (65%) food outlet managers thought food outlets on health service sites should have signs clearly showing healthy choices. Parents (90%) also thought all food outlets on health service sites should provide mostly healthy items compared to 47% of managers. The proportion of healthier beverage slots in vending machines increased from 29% to 51% at follow-up and the proportion of machines that labelled healthier drinks increased from 0 to 26%. No outlets labelled healthier items at baseline compared to 4 out of 5 after the intervention. No changes were observed in the availability or labelling of healthier food in vending machines or the availability of healthier food or drinks in food outlets. Baseline availability and labelling of healthier food and beverage choices for sale in health care facilities was poor in spite of the support of parents and outlet managers for such initiatives. The intervention encouraged improvements in the availability and labelling of healthier drinks but not foods in vending machines.
A randomised controlled trial of an intervention to increase the implementation of a healthy canteen policy in Australian primary schools: study protocol
Publisher: Springer Science and Business Media LLC
Date: 11-10-2014
Targeting multiple health risk behaviours among vocational education students using electronic feedback and online and telephone support: protocol for a cluster randomised trial
Publisher: Springer Science and Business Media LLC
Date: 13-06-2015
Managing nicotine dependence in NSW hospital patients
Publisher: The Sax Institute
Date: 2004
DOI: 10.1071/NB04023
A pilot study of a telephone-based parental intervention to increase fruit and vegetable consumption in 3–5-year-old children
Publisher: Cambridge University Press (CUP)
Date: 23-06-2011
DOI: 10.1017/S1368980011001170
Abstract: To examine the potential efficacy of a brief telephone-based parental intervention in increasing fruit and vegetable consumption in children aged 3–5 years and to examine the feasibility of intervention delivery and acceptability to parents. A pre–post study design with no comparison group. Telephone surveys were conducted approximately 1 week before and following intervention delivery. Participants were recruited through pre-schools in the Hunter region, New South Wales, Australia. Thirty-four parents of 3–5-year-olds received four 30-min interventional telephone calls over 4 weeks administered by trained telephone interviewers. The scripted support calls focused on fruit and vegetable availability and accessibility within the home, parental role modelling of fruit and vegetable consumption and on implementing supportive family eating routines. Following the intervention, the frequency and variety of fruit and vegetable consumption increased ( P = 0·027), as measured by a subscale of the children's dietary questionnaire. The intervention was feasible to be delivered to parents, as all participants who started the intervention completed all four calls, and all aspects of the interventional calls, including the number, length, content, format and relevance, were considered acceptable by more than 90 % of parents. A brief telephone-based parental intervention to encourage fruit and vegetable consumption in pre-school-aged children may be effective, feasible and acceptable. Further investigation is warranted in a randomised controlled trial.
Mechanism evaluation of a lifestyle intervention for patients with musculoskeletal pain who are overweight or obese: Protocol for a causal mediation analysis
Publisher: BMJ
Date: 06-2017
A cluster randomized controlled trial of a telephone-based parent intervention to increase preschoolers’ fruit and vegetable consumption
Publisher: Elsevier BV
Date: 07-2012
A randomised trial of real-time video counselling for smoking cessation in regional and remote locations: study protocol
Publisher: Elsevier BV
Date: 11-2018
DOI: 10.1016/J.CCT.2018.10.001
Abstract: Real-time video communication technology (e.g. Skype) may be an effective mode for delivering smoking cessation treatment to regional and remote residents. This randomised trial examines the effectiveness of real-time video counselling compared to: 1) telephone counselling and 2) written materials (control) in achieving smoking abstinence in regional and remote residents. A three-arm, parallel group, randomised trial will be conducted with smokers residing in regional and remote areas of New South Wales, Australia. Potential participants will complete an online screening survey and if eligible an online baseline survey. Participants will be randomly allocated into: 1) real-time video counselling 2) telephone counselling or 3) written materials (control). In the video counselling intervention an advisor will deliver up to six video sessions (e.g. via Skype) to participants. Those who nominate a quit date within a month during the initial video session will be offered sessions on the quit date, 3-, 7-, 14- and 30-days after the quit date. Those not ready to set a quit date within a month during the initial video session will be offered sessions 2-, 4- and 6-weeks later. Other than delivery mode, the video counselling and telephone counselling will be identical in content and callback schedules. Control group participants will be mailed one-off written materials. Follow-up surveys will occur at 4-months, 7-months and 13-months post-baseline. The primary outcome will be 7-day point prevalence abstinence at 13-months post-baseline. Real-time video counselling may be an effective strategy for smoking cessation that could be integrated into quitlines globally.
Indigenous health research: a critical review of outputs over time
Publisher: AMPCo
Date: 05-2006
DOI: 10.5694/J.1326-5377.2006.TB00343.X
Abstract: To determine the number and nature of publications on Indigenous health in Australia, Canada, New Zealand and the United States) in 1987-1988, 1997-1998 and 2001-2003. MEDLINE and PsychLit databases were searched using the following terms: Aborigines or Aboriginal Torres Strait Islander Maori American Indian North American Indian, or Indian, North American Alaska/an Native Native Hawaiian Native American American Samoan Eskimos or Inuit Eskimos or Aleut Metis Indigenous. Publications were included if they were concerned with the health of Indigenous people of the relevant countries. 1763 Indigenous health publications were selected. Publications were classified as either: original research reviews program descriptions discussion papers or commentaries or case reports. Research publications were further classified as either measurement, descriptive, or intervention. Intervention studies were then classified as either experimental or non-experimental. The total number of publications was highest in 1997-1998 for most countries. The most common type of publication across all time periods for all countries was research publications. In Australia only, the number of research publications was slightly higher in 2001-2003 compared with other time periods. For each country and at each time, research was predominantly descriptive (75%-92%), with very little measurement (0-11%) and intervention research (0-18%). Overall, of the 1131 research publications, 983 were descriptive, 72 measurement and 76 intervention research. The dominance of descriptive research in Indigenous health is not ideal, and our findings should be carefully considered by research organisations and researchers when developing research policies.
Increasing hospital‐wide delivery of smoking cessation care for nicotine‐dependent in‐patients: a multi‐strategic intervention trial
Publisher: Wiley
Date: 07-04-2009
DOI: 10.1111/J.1360-0443.2009.02520.X
Abstract: AIMS, DESIGN AND INTERVENTION: Smoking care provision to in-patients is important in assisting smoking cessation and for management of nicotine withdrawal. Limited studies have reported the effectiveness of interventions designed to increase the hospital-wide provision of such care. A quasi-experimental matched-pair trial, involving two intervention and two control hospitals in NSW, Australia, investigated whether a multi-strategic intervention increased hospital-wide smoking care provision. Patient surveys (n = 274-347 per experimental condition), medical notes audits (n = 181-228) and health professional surveys (n = 229-302) were used to collect outcome data at baseline and follow-up. Significantly greater increases in intervention hospitals compared to control hospitals were found for patient-reported offer of nicotine replacement therapy (NRT) (intervention 34% versus control 12%), provision of NRT (16% versus 4%) and provision of written resources (11% versus 2%), and for the recording in medical notes of smoking management discussion (13% versus 3%), offer of NRT (24% versus 3%) and provision of NRT (21% versus 5%). Intervention group health professionals reported significantly greater increases in the mean estimate of patients who: had their smoking management discussed (30% versus 17%) were offered or provided with NRT (30% versus 18%) were asked their intention to smoke post-discharge (22% versus 10%) and were provided with discharge NRT (21% versus 4%). Implementation of a multi-strategic intervention is effective in increasing hospital smoking care delivery, particularly the provision of NRT. Research is required to identify methods to increase further the delivery of this and other forms of smoking care.
Effectiveness of telephone-based interventions for managing osteoarthritis and spinal pain: a systematic review and meta-analysis
Publisher: PeerJ
Date: 30-10-2018
DOI: 10.7717/PEERJ.5846
Abstract: Osteoarthritis and spinal pain are common and burdensome conditions however, the majority of patients with these conditions do not receive care that is consistent with clinical practice guidelines. Telehealth models of care have the potential to improve care for osteoarthritis and spinal pain patients. The aim of this review was to assess the effectiveness of verbal real-time telehealth interventions, including telephone-based and videoconferencing interventions to reduce pain intensity and disability in patients with osteoarthritis of the knee or hip and spinal pain (back or neck pain). We searched seven electronic databases from inception to May 2018. Randomised controlled trials (RCTs), cluster-RCTs, and non-randomised controlled trials were included. Two review authors independently extracted data for each included study. Primary outcomes were pain intensity and disability. We conducted primary meta-analyses combining all conditions with similar interventions and comparators. Standardised mean difference (SMD) and 95% confidence intervals (CIs) were calculated using random effects models. We used the Cochrane Risk of Bias tool to assess risk of bias, and GRADE to evaluate the quality of evidence. We included 23 studies with 56 trial arms and 4,994 participants. All studies utilised telephone-based interventions. Only two studies used a telephone only approach and the remainder included educational materials and/or face-to-face components. We found no studies utilising videoconferencing. Meta-analysis showed telephone-based interventions (with educational materials) for osteoarthritis and spinal pain improved pain intensity ( n = 5 trials, n = 1,357 participants, SMD −0.27, 95% CI [−0.53, −0.01], Tau 2 = 0.06, I 2 = 74% moderate-quality evidence) and disability ( n = 7 trials, n = 1,537 participants, SMD −0.21, 95% CI [−0.40, −0.02], Tau 2 = 0.03, I 2 = 56% moderate-quality evidence) compared to usual care. Meta-analyses found telephone with face-to-face interventions does not improve pain and disability compared to usual care or face-to-face care alone. We are moderately confident that telephone-based interventions reduce pain intensity and disability in patients with osteoarthritis and spinal pain compared to usual care, but telephone plus face-to-face interventions are no more effective than usual care or face-to-face interventions alone.
Increasing the provision of preventive care by community healthcare services: a stepped wedge implementation trial
Publisher: Springer Science and Business Media LLC
Date: 22-08-2017
Telephone-delivered health behaviour change support for people with a mental health condition: the coaches’ perspective
Publisher: Springer Science and Business Media LLC
Date: 21-10-2021
DOI: 10.1186/S12913-021-07126-4
Abstract: People with a mental health condition experience a greater prevalence of chronic disease and reduced life expectancy compared to the general population. Modifiable health risk behaviours, such as physical inactivity and poor nutrition are major contributing factors. Population-level health coaching delivering behavioural change support via telephone for healthy eating, physical activity, and weight management is an opportunity utilised by this group to support improvement in healthy lifestyle behaviours. Health coaches offer a valuable perspective into the provision of services to this high-risk group. This study aims to qualitatively explore coaches’ experiences in providing support to these participants, consider factors which may contribute to engagement and outcomes and potentially inform future service improvement. A qualitative study design was employed involving semi-structured telephone interviews with six coaches employed in a telephone-based behaviour change support service in New South Wales, Australia, between April and July 2019. Interview data was analysed using an inductive thematic analysis. Coaches believed that the service was of benefit to people with a mental health condition, however making changes to health risk behaviours was potentially more difficult for this group of service users. Coaches indicated that in supporting this group there was a greater focus on building confidence and readiness to change. They noted that improvement in mental health as a result of physical health changes was an additional ‘measure of success’ of particular relevance. Coaches expressed a desire to receive more mental health training to better deliver coaching to participants with a mental health condition. Program variables such as limited call length were posed as possible barriers to care. Further training and additional support for coaches, in additon to considering variations to aspects of service delivery may assist in improving engagement and outcomes for participants with mental health conditions. Examining mental health consumers’ experiences when engaging with telephone coaching services would be an important area to address in further research.
Related Organisations
Related Funding Activities
No related grants have been discovered for Elizabeth Campbell.