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Sims HS, Blumenstein N. Dysphonia and Laryngopharyngeal Reflux. Otolaryngol Clin North Am 2025; 58:475-483. [PMID: 39855951 DOI: 10.1016/j.otc.2024.12.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2025]
Abstract
Dysphonia is a common symptom of laryngopharyngeal reflux disease (LPRD) and requires multimodal, patient-centered care to address. Challenges in diagnosing LPRD can also complicate treatment of nonspecific dysphonia symptoms. Careful history taking with sensitivity to cultural lifestyle components in each patient is critical to management. Surgical management of acid reflux is not always indicated for dysphonia and the risk to the vagus nerve during fundoplication can worsen dysphonia. There are low-risk nutraceutical therapies that have demonstrated clinical benefit in the literature, and these should be considered for patients with polypharmacy or can be used concurrently with acid suppressive medication.
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Affiliation(s)
- H Steven Sims
- Department of Otolaryngology-Head and Neck Surgery, University of Illinois Health and Hospital System, 1009 S. Wood Street, Suite 6C, Chicago, IL 60616, USA.
| | - Nicole Blumenstein
- Department of Otolaryngology-Head and Neck Surgery, University of Illinois Health and Hospital System, 1009 S. Wood Street, Suite 6C, Chicago, IL 60616, USA
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Jayasinghe S, Byrne NM, Hills AP. The culture of healthy living - The international perspective. Prog Cardiovasc Dis 2025:S0033-0620(25)00019-2. [PMID: 39921185 DOI: 10.1016/j.pcad.2025.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2025] [Accepted: 02/02/2025] [Indexed: 02/10/2025]
Abstract
A culture of health or healthy living can be envisioned as a society where well-being, including essential aspects like sleep, stress management, social connections, and leisure - is not merely an aspiration but a tangible reality for diverse communities, free from systemic inequities. However, the concept of a healthy lifestyle, and by extension a culture of healthy living, varies widely across the globe, shaped by cultural norms, government policies, and social structures. Defining a universally acceptable "culture of healthy living" for every population or subgroup is inherently complex, making it more practical to focus on addressing the barriers and leveraging the enablers associated with leading a healthy life. At its core, discussing the foundational elements of a healthy life - such as diet and nutrition, physical activity, mental health, and access to healthcare - is crucial. To ensure the sustainability of healthy living practices, a multifaceted approach is needed, emphasizing these pillars alongside equity. Existing global initiatives offer promising frameworks to tackle these challenges, highlighting the importance of collaboration, innovation, and systemic change. By fostering mutual support and collective action, we can advance toward a global culture of healthy living that benefits all individuals and communities, leaving no one behind.
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Affiliation(s)
- Sisitha Jayasinghe
- School of Health Sciences, College of Health and Medicine, University of Tasmania, Launceston, TAS, Australia
| | - Nuala M Byrne
- School of Health Sciences, College of Health and Medicine, University of Tasmania, Launceston, TAS, Australia
| | - Andrew P Hills
- School of Health Sciences, College of Health and Medicine, University of Tasmania, Launceston, TAS, Australia.
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Fauk NK, Dent E, Aylward P, Ward PR, Tyndall J, Kirwan L, Mwanri L. Protective and risk factors for social and emotional well-being of Indigenous children and adolescents: A rapid review. J Child Adolesc Ment Health 2024:1-60. [PMID: 39558629 DOI: 10.2989/17280583.2024.2385307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2024]
Abstract
Background: Indigenous children and adolescents experience life circumstances that significantly affect their social and emotional well-being (SEWB) and limit their capacity to fulfil their potential. This contributes to inequities in health, education, employment, and justice system involvement.Aim: We aimed to synthesise the existing literature to comprehensively understand the protective and risk factors for SEWB of Indigenous youth in Canada, Australia, New Zealand, and the United States (CANZUS).Methods: We conducted a systematic search of English literature using Google Scholar, Scopus, Informit, HealthInfonet, and PubMed.Results: Sixty-nine articles met the inclusion criteria. The identified risk and protective factors were mapped according to seven thematic and interconnected areas including connection to the (a) body; (b) mind and emotions; (c) family and kinship; (d) community; (e and f) culture, country, and land (place/space); and (g) ancestry and spirituality.Conclusions: Indigenous peoples' perceptions of SEWB differ from traditional Western conceptualisations of health. Their perceptions carry a culturally distinct meaning, which is largely shared by Indigenous peoples across the CANZUS societies. An understanding of risk and protective factors for SEWB can inform targeted policy and public health practice frameworks aimed at improving Indigenous youth's health and well-being.
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Affiliation(s)
- Nelsensius Klau Fauk
- Centre for Public Health, Equity and Human Flourishing, Torrens University Australia, Adelaide, Australia
| | - Elsa Dent
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, Australia
| | - Paul Aylward
- Centre for Public Health, Equity and Human Flourishing, Torrens University Australia, Adelaide, Australia
| | - Paul Russell Ward
- Centre for Public Health, Equity and Human Flourishing, Torrens University Australia, Adelaide, Australia
| | - Jessica Tyndall
- Research Infrastructure and Reporting, Torrens University Australia, Adelaide, Australia
| | - Lesli Kirwan
- School of Health Sciences, Torrens University Australia, Adelaide, Australia
| | - Lillian Mwanri
- Centre for Public Health, Equity and Human Flourishing, Torrens University Australia, Adelaide, Australia
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Probst Y, McKnight A, O'Flynn G, Tillott S, Stanley RM. Describing the food choices of Aboriginal children attending an afterschool cultural program from two different knowledge systems: The importance of Country, community, and kinship. Nutr Diet 2024; 81:401-410. [PMID: 38637156 DOI: 10.1111/1747-0080.12873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Revised: 01/31/2024] [Accepted: 03/04/2024] [Indexed: 04/20/2024]
Abstract
AIMS This study describes a program co-created with Aboriginal communities to strengthen cultural ties with the children. Food data are reported from two knowledge systems (lenses): Western and Aboriginal relational, focused on Country, community, and kinship. METHODS A cultural program was undertaken with primary school children of Aboriginal heritage, on Yuin nation, over 10 weeks including culturally appropriate practices (painting, bushtucker, and dance). We report mixed method food outcomes framed by Western (quantitative) 24-h recall and Aboriginal relational methods (qualitative) captured by cultural images, yarning and continuous consultation methods to expose lessons from community and Country, to extend kinship. RESULTS In total, 111 children (79 providing food data) across three regional communities commenced the program. A storying approach to food data collection and interpretation was preferred. The number of serves of seafood products, such as fish increased, vegetable consumption improved, intakes of dairy improved in quality and energy intakes from discretionary foods decreased across the programs. Qualitative data exposed six themes: Eating with family, competing agendas, food as medicine, applying cultural practices, food choices driven by 'post-invasion tradition' and community events, which deepened our understanding of the food data. Teaching the importance of the ocean and water saw participants engage with family in practices such as fishing to improve overall awareness of culture through food. CONCLUSION The kinship system in a cultural context supported positive shifts towards accessible food choices driven by messages from Country. While the changes cannot be isolated to the program, cultural immersion drove change and strength-based reporting.
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Affiliation(s)
- Yasmine Probst
- School of Medical, Indigenous and Health Sciences, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, New South Wales, Australia
| | - Anthony McKnight
- Woolyungah Indigenous Centre, University of Wollongong, Wollongong, New South Wales, Australia
| | - Gabrielle O'Flynn
- School of Education, Faculty of Arts, Social Sciences and Humanities, University of Wollongong, Wollongong, New South Wales, Australia
| | - Sarah Tillott
- School of Medical, Indigenous and Health Sciences, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, New South Wales, Australia
- Faculty of Health, Southern Cross University, Gold Coast, Australia
| | - Rebecca M Stanley
- School of Education, Faculty of Arts, Social Sciences and Humanities, University of Wollongong, Wollongong, New South Wales, Australia
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Johnson SR, Chilibeck P, Oosman SN, Foulds HJA. A scoping review of Indigenous community-specific physical activity measures developed with and for Indigenous Peoples in Canada, Australia, and New Zealand. Appl Physiol Nutr Metab 2024; 49:599-613. [PMID: 38320254 DOI: 10.1139/apnm-2023-0380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2024]
Abstract
Historical factors including colonization and ongoing socioeconomic inequities impact Indigenous Peoples' ability to mitigate chronic disease risks such as achieving recommended physical activity (PA) levels. Reliably assessing, reflecting, and promoting PA participation among Indigenous Peoples may be impacted by a lack of culturally appropriate assessment methods and meaningful engagement with Indigenous communities throughout the research process. The objectives of this scoping review were to examine: (1) How PA research with Indigenous Peoples used community-specific PA measures developed with and/or for Indigenous Peoples in Canada, Australia, and New Zealand; and (2) How the studies utilized community-based participatory research (CBPR) principles to engage communities. A systematic search was conducted in four electronic databases (Web of Science, Medline, University of Saskatchewan Indigenous Portal, and ProQuest Dissertations and Theses Global). Thirty-one (n = 31) articles were identified and data extracted for narrative synthesis. Studies using community-specific PA measures have been increasing over time. Adapting questionnaires to traditional Indigenous activities such as cultural dances, ceremonies, and food-gathering activities were the most frequent adjustments undertaken to use community-specific measures. There are, however, gaps in research partnering with communities with only 6% of studies including all eight CBPR principles. Practical ways researchers can engage Indigenous communities and build capacity such as training and employing community members were highlighted. More needs to be done to facilitate community self-determination and develop long-term sustainable initiatives. Using culturally appropriate and relevant methodologies including partnering with Indigenous communities may help identification and implementation of culturally relevant and sustainable health-promoting initiatives.
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Affiliation(s)
- Shara R Johnson
- College of Kinesiology, University of Saskatchewan, Saskatoon, SK, Canada
| | - Phil Chilibeck
- College of Kinesiology, University of Saskatchewan, Saskatoon, SK, Canada
| | - Sarah N Oosman
- Department of Community Health and Epidemiology, College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada
| | - Heather J A Foulds
- College of Kinesiology, University of Saskatchewan, Saskatoon, SK, Canada
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Stanley RM, McKnight A, Probst Y, O'Flynn G, Tillott S. Strong culture, healthy lifestyles: a mixed methods feasibility study for a co-created afterschool cultural programme for Australian Aboriginal children. Pilot Feasibility Stud 2024; 10:31. [PMID: 38360808 PMCID: PMC10868114 DOI: 10.1186/s40814-023-01422-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Accepted: 11/21/2023] [Indexed: 02/17/2024] Open
Abstract
BACKGROUND Having a strong connection to culture and Country is fundamental to the health and wellbeing of Australian Aboriginal children. The aim of the research was to evaluate the feasibility of study methods and programme implementation of a co-created afterschool cultural programme, and identify areas for improvement. METHODS Aboriginal Relational Research Methodology and mixed methods were applied to evaluate the feasibility of the implementation of the programme and study methods using a non-randomised single-group study design. Australian Aboriginal children and their siblings aged 5-13 years were recruited within regional New South Wales, Australia. The primary outcomes for feasibility included recruitment rates of children and Aboriginal programme mentors, compliance rates of outcome data collection and of the planned programme activities, programme attendance, retention rates and mean enjoyment scores. Follow-up yarning circles were conducted with the children, their parents/caregivers, programme mentors and teachers to explore aspects of feasibility, and areas for improvement. RESULTS A total of 90 caregivers consented to their children (n = 111) being part of the research. Sixteen Aboriginal mentors were recruited to deliver the programmes across the communities. Overall, 74.4% of all health outcome measures were completed across baseline (86.5%) and follow-up (55.9%). Only 61.0% of the programme activities were delivered as originally planned. The average programme attendance rate was 70.0% with a 92.0% retention rate. Eighty-nine percent of children reported a high level of enjoyment with the programmes. Follow-up yarning identified the importance of relational methodologies and flexibility within the programme design and implementation to ensure programmes were adapted to the local community, conditions and differing age groups. Considerations for future programmes included the timing of the programme and identifying health outcome assessment tools and methods that acknowledge cultural protocols and experiences. CONCLUSIONS Engaging the communities in the development, implementation and evaluation of the programmes were key to community support of the programme and conducting the feasibility study. Future programmes and evaluations need to be built on strong partnerships and embrace flexible and culturally embedded methodologies in order to be adaptive and responsive to research approaches, communities and to Country. TRIAL REGISTRATION ACTRN12619001224112. Retrospectively registered on 05 September 2019.
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Affiliation(s)
- Rebecca M Stanley
- Early Start, Faculty of the Arts, Social Sciences and Humanities, University of Wollongong, Wollongong, NSW, 2522, Australia.
- Illawarra Health and Medical Research Institute, Wollongong, NSW, 2500, Australia.
- School of Health and Society, Faculty of the Arts, Social Sciences and Humanities, University of Wollongong, Wollongong, NSW, 2522, Australia.
| | - Anthony McKnight
- School of Education, Faculty of the Arts, Social Sciences and Humanities, University of Wollongong, Wollongong, NSW, 2522, Australia
| | - Yasmine Probst
- Illawarra Health and Medical Research Institute, Wollongong, NSW, 2500, Australia
- Faculty of Health, Southern Cross University, Gold Coast Campus, Bilinga, QLD, 4225, Australia
| | - Gabrielle O'Flynn
- School of Education, Faculty of the Arts, Social Sciences and Humanities, University of Wollongong, Wollongong, NSW, 2522, Australia
| | - Sarah Tillott
- Faculty of Health, Southern Cross University, Gold Coast Campus, Bilinga, QLD, 4225, Australia
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Yang DC, Xu J, Jian L, Yu Y. Impact of angiotensin-converting enzyme inhibitors or angiotensin receptor blockers on the mortality in sepsis: A meta-analysis. World J Clin Cases 2023; 11:8498-8506. [PMID: 38188199 PMCID: PMC10768505 DOI: 10.12998/wjcc.v11.i36.8498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Revised: 11/29/2023] [Accepted: 12/05/2023] [Indexed: 12/22/2023] Open
Abstract
BACKGROUND The effect of angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin receptor blockers (ARBs) on the mortality of patients with sepsis is not well characterized. AIM To elucidate the association between prior ACEI or ARB exposure and mortality in sepsis. METHODS The PubMed, EMBASE, Web of Science, and Cochrane Library databases were searched for all studies of premorbid ACEI or ARB use and sepsis mortality until November 30 2019. Two reviewers independently assessed, selected, and abstracted data from studies reporting ACEIs or ARBs, sepsis, and mortality. The primary extracted data consisted of premorbid ACEI or ARB exposure, mortality, and general patient data. Two reviewers independently assessed the risk of bias and quality of evidence. RESULTS A total of six studies comprising 281238 patients with sepsis, including 49799 cases with premorbid ACEI or ARB exposure were eligible for analysis. Premorbid ACEIs or ARBs exposure decreased the 30-d mortality in patients with sepsis. Moreover, the use of ACEIs or ARBs was associated with approximately a 6% decreased risk of 30-d mortality. CONCLUSION The results of this systematic review suggest that ACEI or ARB exposure prior to sepsis may be associated with reduced mortality. Further high-quality cohort studies and molecular mechanism experiments are required to confirm our results.
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Affiliation(s)
- Deng-Can Yang
- Department of Anesthesiology, The Central Hospital of Shaoyang, Shaoyang 422000, Hunan Province, China
| | - Jian Xu
- Department of Critical Care Medicine, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou 510006, Guangdong Province, China
| | - Li Jian
- Department of Critical Care Medicine, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou 510006, Guangdong Province, China
| | - Yi Yu
- Department of Critical Care Medicine, Guangdong Provincial Hospital of Traditional Chinese Medicine, Guangzhou 510006, Guangdong Province, China
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Wright-Pedersen S, Vidgen H, Abigail Badejo F, Gallegos D. The extent and nature of children's involvement in food practice research: a scoping review of qualitative studies. Public Health Nutr 2023; 26:2836-2848. [PMID: 37746758 PMCID: PMC10755441 DOI: 10.1017/s1368980023001891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Revised: 08/20/2023] [Accepted: 08/29/2023] [Indexed: 09/26/2023]
Abstract
OBJECTIVE Aligning with the United Nations Convention on the Rights of the Child, amplification of children's voice in food practice research aims to inform initiatives that cater to children's needs and thus improve nutritional outcomes. The aim of this study was to describe children's (aged 6-11 years) involvement across qualitative research investigating their food practice perspectives. DESIGN A scoping review was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Scoping Reviews (PRISMA-ScR). Six electronic databases were searched up until March 2023 (Cochrane, CINAHL, Embase, ERIC, Medline and PsychInfo). The Wellcome Framework for young people's involvement in health research guided data extraction. Data were described according to inclusiveness, geography, food-related study topic, research stage and method, and child involvement. RESULTS The search identified 120 peer-reviewed studies (134 papers). Active participation was only seen within research implementation stages (i.e. data collection (n 134), analysis (n 31), dissemination (n 9) and re-design (n 7)). More passive forms of participation were identified in research design stages (i.e. agenda setting, resourcing and design). Studies that utilised participatory research methodologies and developmentally appropriate and engaging methods (e.g. PhotoVoice) saw more active participation by children. CONCLUSION This review identified a lack of opportunities for children's active participation in all stages of food practice research. Without a radical shift towards providing these opportunities, food and nutrition initiatives, policies or further research that do not meet the needs of children's food-related worlds will continue to be developed. Instead, researchers and their institutions need to advocate for and, where possible, provide voluntary opportunities for children to actively participate in food practice research.
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Affiliation(s)
- Sophie Wright-Pedersen
- Centre for Childhood Nutrition Research, Faculty of Health, Queensland University of Technology (QUT), 62 Graham Street, South Brisbane, QLD4101, Australia
- School of Exercise and Nutrition Sciences, Faculty of Health, Queensland University of Technology (QUT), 149 Victoria Park Road, Kelvin Grove, QLD4059, Australia
| | - Helen Vidgen
- School of Exercise and Nutrition Sciences, Faculty of Health, Queensland University of Technology (QUT), 149 Victoria Park Road, Kelvin Grove, QLD4059, Australia
| | - Foluke Abigail Badejo
- Centre for Childhood Nutrition Research, Faculty of Health, Queensland University of Technology (QUT), 62 Graham Street, South Brisbane, QLD4101, Australia
| | - Danielle Gallegos
- Centre for Childhood Nutrition Research, Faculty of Health, Queensland University of Technology (QUT), 62 Graham Street, South Brisbane, QLD4101, Australia
- School of Exercise and Nutrition Sciences, Faculty of Health, Queensland University of Technology (QUT), 149 Victoria Park Road, Kelvin Grove, QLD4059, Australia
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Mizutani M, Tashiro J, Sugiarto H, Maftuhah, Riyanto, Mock J, Nakayama K. Identifying correlates of salt reduction practices among rural, middle-aged Muslim Indonesians with hypertension through structural equation modeling. Nutr Health 2023; 29:85-95. [PMID: 35014883 DOI: 10.1177/02601060211057624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background: In 2016, the World Health Organization recommended salt reduction strategies. In most low- and middle-income countries, little is known about what causes people to reduce their salt intake. Aim: In rural West Java, Indonesia, we conducted a cross-sectional survey to describe self-reported salt reduction practices among middle-aged Muslims with hypertension (n = 447) and to identify correlates of salt reduction. Methods: We developed a questionnaire with Likert scales to measure self-reported frequency of efforts to reduce salt intake, and degree of agreement/disagreement with 51 statements about variables hypothesized to influence salt reduction practices. We compared groups using t-tests and one-way ANOVAs. Through one-factor confirmatory factor analysis and structural equation modeling, we identified correlates of salt reduction practices. Results: About 45% of participants reported regularly reducing their salt intake; only 12.8% reported never attempting. Men reported higher social barriers, while women reported higher family support and spiritual support. Overall, we found that participants' frequency of effort to reduce their salt intake was associated with a constellation of six correlates. Salt reduction practices were directly positively associated with prior health/illness experiences (β = 0.25), and by seeking health information (β = 0.24). Seeking health information was in turn positively associated with prior health/illness experiences (β = 0.34), receiving support from health professionals (β = 0.23) and Islamic spiritual practice (β = 0.24). Salt reduction practices were negatively associated with environmental barriers to healthful eating practices (β = -0.14). Conclusion: In this population, reinforcing positive correlates identified in this study and mitigating against negative correlates may foster salt reduction practices.
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Affiliation(s)
- Mayumi Mizutani
- Department of Public Health Nursing, 88369Mie University Graduate School of Medicine, Tsu, Mie, Japan.,Graduate School of Nursing Science, St Luke's International University, Tokyo, Japan
| | - Junko Tashiro
- Graduate School of Nursing Science, St Luke's International University, Tokyo, Japan
| | - Heri Sugiarto
- 188408Indramayu College of Health Science, Indramayu, West Java, Indonesia
| | - Maftuhah
- 118942Syarif Hidayatullah State Islamic University Jakarta, Tangerang Selatan, Banten, Indonesia
| | - Riyanto
- 188408Indramayu College of Health Science, Indramayu, West Java, Indonesia
| | - Jeremiah Mock
- Institute for Health & Aging and Department of Social and Behavioral Sciences, University of California San Francisco, San Francisco, CA, USA
| | - Kazuhiro Nakayama
- Graduate School of Nursing Science, St Luke's International University, Tokyo, Japan
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Ahmed F, Liberda EN, Solomon A, Davey R, Sutherland B, Tsuji LJS. Indigenous Land-Based Approaches to Well-Being: The Niska (Goose) Harvesting Program in Subarctic Ontario, Canada. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3686. [PMID: 36834382 PMCID: PMC9958717 DOI: 10.3390/ijerph20043686] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 02/11/2023] [Accepted: 02/15/2023] [Indexed: 06/18/2023]
Abstract
Historically, goose harvesting provided a source of culturally significant, safe, and nutritious food for the Omushkego Cree of subarctic Ontario, Canada. Disruptions stemming from colonization and climate change have led to a decrease in harvesting, resulting in higher rates of food insecurity. The aim of the Niska program was to reconnect Elders and youth to revitalize goose harvesting activities and associated Indigenous knowledge within the community. The program and evaluation were built using a two-eyed seeing (Etuaptmumk) and community-based participatory research approach. Salivary cortisol, a biomedical measure of stress, was collected before (n = 13) and after (n = 13) participation in the spring harvest. Likewise, cortisol samples were collected before (n = 12) and after (n = 12) the summer harvest. Photovoice and semi-directed interviews were employed after the spring (n = 13) and summer (n = 12) harvests to identify key elements of well-being from an Indigenous perspective. The changes observed in cortisol levels for the spring (p = 0.782) and summer (p = 0.395) harvests were not statistically significant. However, there was a noteworthy increase in the subjective well-being observed through the qualitative measures (semi-directed interviews and photovoice), highlighting the importance of using multiple perspectives when assessing well-being, especially in Indigenous peoples. Future programs should incorporate multiple perspectives when addressing complex environmental and health issues, such as food security and environmental conservation, especially in Indigenous homelands worldwide.
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Affiliation(s)
- Fatima Ahmed
- Department of Physical and Environmental Sciences, University of Toronto, Toronto, ON M1C 1A4, Canada
| | - Eric N. Liberda
- School of Occupation and Public Health, Faculty of Community Services, Toronto Metropolitan University, Toronto, ON M5B 2K3, Canada
| | - Andrew Solomon
- Fort Albany First Nation, Fort Albany, ON P0L 1H0, Canada
| | - Roger Davey
- Fort Albany First Nation, Fort Albany, ON P0L 1H0, Canada
| | - Bernard Sutherland
- Peetabeck Academy, Mundo Peetabeck Education Authority, Fort Albany, ON P0L 1H0, Canada
| | - Leonard J. S. Tsuji
- Department of Physical and Environmental Sciences, University of Toronto, Toronto, ON M1C 1A4, Canada
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Anderson K, Elder-Robinson E, Gall A, Ngampromwongse K, Connolly M, Letendre A, Willing E, Akuhata-Huntington Z, Howard K, Dickson M, Garvey G. Aspects of Wellbeing for Indigenous Youth in CANZUS Countries: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13688. [PMID: 36294264 PMCID: PMC9602510 DOI: 10.3390/ijerph192013688] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 10/18/2022] [Accepted: 10/19/2022] [Indexed: 06/16/2023]
Abstract
Indigenous children and young people (hereafter youth) across CANZUS nations embody a rich diversity of cultures and traditions. Despite the immense challenges facing these youth, many harness cultural and personal strengths to protect and promote their wellbeing. To support this for all youth, it is critical to understand what contributes to their wellbeing. This review aims to identify components contributing to wellbeing for Indigenous youth in CANZUS nations. Five databases were searched from inception to August 2022. Papers were eligible if they: focused on Indigenous youth in CANZUS nations; included views of youth or proxies; and focused on at least one aspect of wellbeing. We identified 105 articles for inclusion (Canada n = 42, Australia n = 27, Aotearoa New Zealand n = 8, USA n = 28) and our analysis revealed a range of thematic areas within each nation that impact wellbeing for Indigenous youth. Findings highlight the unique challenges facing Indigenous youth, as well as their immense capacity to harness cultural and personal strengths to navigate into an uncertain future. The commonalities of Indigenous youth wellbeing across these nations provide valuable insights into how information and approaches can be shared across borders to the benefit of all Indigenous youth and future generations.
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Affiliation(s)
- Kate Anderson
- School of Public Health, The University of Queensland, Herston, QLD 4006, Australia
- Menzies School of Health Research, Charles Darwin University, Casuarina, NT 0810, Australia
| | - Elaina Elder-Robinson
- School of Public Health, The University of Queensland, Herston, QLD 4006, Australia
- Menzies School of Health Research, Charles Darwin University, Casuarina, NT 0810, Australia
| | - Alana Gall
- School of Public Health, The University of Queensland, Herston, QLD 4006, Australia
- Menzies School of Health Research, Charles Darwin University, Casuarina, NT 0810, Australia
| | | | - Michele Connolly
- International Group for Indigenous Health Statistics, Columbia, MD 21045, USA
| | - Angeline Letendre
- Alberta Cancer Prevention Legacy Fund, Population, Public and Indigenous Health, Alberta Health Services, 102 Anderson Hall, 10959 102 ST NW, Edmonton, AB T5H 3V9, Canada
| | - Esther Willing
- Kōhatu–Centre for Hauora Māori, University of Otago, Dunedin 9054, New Zealand
| | | | - Kirsten Howard
- School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2006, Australia
- Menzies Centre for Health Policy and Economics, Faculty of Medicine and Health, University of Sydney, Sydney, NSW 2006, Australia
| | - Michelle Dickson
- School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2006, Australia
| | - Gail Garvey
- School of Public Health, The University of Queensland, Herston, QLD 4006, Australia
- Menzies School of Health Research, Charles Darwin University, Casuarina, NT 0810, Australia
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Tartaglia J, Giglia R, Darby J. Developing culturally appropriate food literacy resources for Aboriginal children with Foodbank WA's Superhero Foods ®. Health Promot J Austr 2022; 33 Suppl 1:150-162. [PMID: 35194892 PMCID: PMC9790422 DOI: 10.1002/hpja.584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Accepted: 02/20/2022] [Indexed: 12/30/2022] Open
Abstract
ISSUE ADDRESSED In Australia, food sovereignty of traditional landowners has been marginalised by the globalisation of food systems and resulted in limited opportunities for children to experience familiar bush tucker foods as healthy choices, particularly in a school environment. Superhero Foods® themed teaching resources focus on the development of nutrition education materials that included traditional Aboriginal foods together with contemporary foods readily available in regional/remote communities. METHODS Consultation with an Aboriginal expert and Aboriginal artist; local, regional/remote teachers and stakeholders informed the development of tailored resources including food cartoon characters, school lesson plans and a storybook. The latter was guided by a resource development model. Users of the resources were surveyed to ascertain the useability, alignment with the Australian Dietary Guidelines, cross-curricular learnings and cultural relevance. RESULTS Respondents across regional/remote and urban locations completed a lesson plan and food character (clipart) survey (N = 51) and storybook survey (N = 14). Respondents advised the resources were relevant, enjoyable, engaging and culturally appropriate for all students regardless of Aboriginality. The resources provided learning opportunities for all children to enhance knowledge about Aboriginal culture and bush foods. Independent evaluation has further indicated the translation of messaging into student's knowledge and learning. CONCLUSIONS Key enablers to the success of the resource included; free online access, the highly engaging nature of the resources and adaptability to be implemented across a number of Aboriginal language groups in WA. Ensuring visual representation of healthy choices was fundamental to reinforcing nutrition messaging. Superhero Foods resources are a positive and important inclusion in the health promotion toolbox for Aboriginal children. SO WHAT?: Superhero Foods are novel nutrition education resources depicting Aboriginal foods and Aboriginal children. These food literacy resources will engage children's understanding of Aboriginal culture, improve food literacy and strengthen equitable access for regional and remote communities.
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Affiliation(s)
| | | | - Jill Darby
- School of Medical and Health ScienceEdith Cowan UniversityJoondalupAustralia
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Indigenous Land-Based Approaches to Well-Being: The Amisk (Beaver) Harvesting Program in Subarctic Ontario, Canada. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19127335. [PMID: 35742603 PMCID: PMC9224250 DOI: 10.3390/ijerph19127335] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 06/09/2022] [Accepted: 06/10/2022] [Indexed: 11/22/2022]
Abstract
The act of decolonizing knowledge systems involves recovering and renewing traditional, non-commodified cultural patterns, such as the sustenance of intergenerational relationships and traditional practices. A decline in beaver harvesting, which was once an integral part of the Omushkego Cree culture, has resulted in an overabundance of beavers and dams, which has negatively affected communities by increasing the local flooding events and impacting the water quality. The aim of the Amisk (beaver) program was to reconnect the Elders and youth to revitalize traditional on-the-land activities and, in the present case, beaver harvesting and associated activities within the community. The program and evaluation were built using a two-eyed seeing (Etuaptmumk) and community-based participatory research approach. Salivary cortisol, a biomedical measure of stress, was collected before and after participation in the program. Photovoice, along with semi-directed interviews, were employed to identify the key elements of well-being from a First Nations’ perspective. For the beaver harvesting activities, the changes observed in the cortisol concentrations were not statistically significant (p = 0.094). However, the act of beaver dam removal was associated with a statistically significant increase in the post-participation cortisol concentration (p = 0.021). It was noteworthy that increased stress during the removal of the beaver dams–as indicated by the elevated post-activity cortisol levels–were not reflected in a decrease in the qualitative measures (semi-directed interviews and photovoice) of well-being from an Indigenous perspective. In fact, there was a noted increase in the subjective well-being of the participants, which highlights the importance of multiple perspectives when assessing well-being, especially in Indigenous peoples. However, the cortisol findings of the present pilot project need to be interpreted with caution, due to the limited sample sizes.
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Cordova-Marks FM, Carson WO, Monetathchi A, Little A, Erdrich J. Native and Indigenous Populations and Gastric Cancer: A Worldwide Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:5437. [PMID: 35564831 PMCID: PMC9100179 DOI: 10.3390/ijerph19095437] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 04/27/2022] [Indexed: 02/01/2023]
Abstract
Gastric cancer is a worldwide concern, particularly for Indigenous populations who face greater disparities in healthcare. With decreased access to screening and critical treatment delays, this group is experiencing adverse health effects. To determine what factors drive these disparities, a systematic review was performed in PubMed. This revealed a lack of research on gastric cancer specific to this population. The literature primarily focused on subset analyses and biological aspects with sparse focus on determinants of health. The results informed this presentation on factors related to Indigenous gastric cancer, which are influenced by colonialism. Indigenous populations encounter high rates of food shortage, exposure to harmful environmental agents, structural racism in the built environment, H. pylori, and compromised healthcare quality as an effect of colonialism, which all contribute to the gastric cancer burden. Putting gastric cancer into a cultural context is a potential means to respond to colonial perspectives and their negative impact on Indigenous patients. The objective of this manuscript is to examine the current state of gastric cancer literature from a global perspective, describe what is currently known based on this literature review, supplemented with additional resources due to lack of published works in PubMed, and to present a model of gastric cancer through the lens of a modified medicine wheel as a potential tool to counter colonial healthcare perspectives and to honor Indigenous culture.
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Affiliation(s)
- Felina M. Cordova-Marks
- Department of Health Promotion Sciences, Zuckerman College of Public Health, University of Arizona, Tucson, AZ 85724, USA;
| | - William O. Carson
- Department of Health Promotion Sciences, Zuckerman College of Public Health, University of Arizona, Tucson, AZ 85724, USA;
| | - Angela Monetathchi
- Cellular Molecular Medicine, College of Medicine, University of Arizona, Tucson, AZ 85724, USA;
| | | | - Jennifer Erdrich
- Department of Surgery, College of Medicine, University of Arizona, Tucson, AZ 85724, USA;
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Liew S, Gwynn J, Smith J, Johnson NA, Plotnikoff R, James EL, Turner N. The Barriers and Facilitators of Sport and Physical Activity Participation for Aboriginal Children in Rural New South Wales, Australia: A Photovoice Project. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:1986. [PMID: 35206182 PMCID: PMC8871796 DOI: 10.3390/ijerph19041986] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/05/2021] [Revised: 01/20/2022] [Accepted: 01/21/2022] [Indexed: 12/10/2022]
Abstract
Participating in physical activity is beneficial for health. Whilst Aboriginal children possess high levels of physical activity, this declines rapidly by early adolescence. Low physical activity participation is a behavioral risk factor for chronic disease, which is present at much higher rates in Australian Aboriginal communities compared to non-Aboriginal communities. Through photos and 'yarning', the Australian Aboriginal cultural form of conversation, this photovoice study explored the barriers and facilitators of sport and physical activity participation perceived by Aboriginal children (n = 17) in New South Wales rural communities in Australia for the first time and extended the limited research undertaken nationally. Seven key themes emerged from thematic analysis. Four themes described physical activity barriers, which largely exist at the community and interpersonal level of children's social and cultural context: the physical environment, high costs related to sport and transport, and reliance on parents, along with individual risk factors such as unhealthy eating. Three themes identified physical activity facilitators that exist at the personal, interpersonal, and institutional level: enjoyment from being active, supportive social and family connections, and schools. Findings highlight the need for ongoing maintenance of community facilities to enable physical activity opportunities and ensure safety. Children held strong aspirations for improved and accessible facilities. The strength of friendships and the family unit should be utilized in co-designed and Aboriginal community-led campaigns.
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Affiliation(s)
- Sarah Liew
- South Western Sydney Local Health District, Sydney 2145, Australia; (S.L.); (J.S.)
| | - Josephine Gwynn
- Faculty of Medicine and Health, University of Sydney, Sydney 2006, Australia
| | - Janice Smith
- South Western Sydney Local Health District, Sydney 2145, Australia; (S.L.); (J.S.)
| | - Natalie A. Johnson
- College of Health, Medicine and Wellbeing, University of Newcastle Australia, Newcastle 2308, Australia;
- Hunter Medical Research Institute, Newcastle 2305, Australia; (R.P.); (E.L.J.)
| | - Ronald Plotnikoff
- Hunter Medical Research Institute, Newcastle 2305, Australia; (R.P.); (E.L.J.)
- College of Human and Social Futures, University of Newcastle Australia, Newcastle 2308, Australia
| | - Erica L. James
- Hunter Medical Research Institute, Newcastle 2305, Australia; (R.P.); (E.L.J.)
- College of Human and Social Futures, University of Newcastle Australia, Newcastle 2308, Australia
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Burt A, Mitchison D, Doyle K, Hay P. Eating disorders amongst Aboriginal and Torres Strait Islander Australians: a scoping review. J Eat Disord 2020; 8:73. [PMID: 33292747 PMCID: PMC7708121 DOI: 10.1186/s40337-020-00346-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Accepted: 10/23/2020] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Aboriginal and Torres Strait Islander Australians (Indigenous Australians) have poorer mental health compared to other Australians. Yet, there is a lack of research into mental disorders among this population, especially for eating disorders (ED), which are amongst the most lethal and debilitating mental disorders. AIM We aimed to answer 2 questions: 1. What is the volume and content of literature on ED among Indigenous Australians? 2. Has a screening or diagnostic tool/instrument been developed for the assessment of ED amongst Indigenous Australians? METHOD We conducted a scoping review of electronic databases (Pubmeb, Embase, PsychInfo, Proquest, Cochrane Library, Indigenous HealtInfoNet and Scopus), for studies addressing ED, body image, muscle dysmorphia, weight and shape concern among Indigenous Australians, as well as diagnostic and screening tools. All relevant studies were reviewed in full by 2 researchers. Narrative synthesis of the data was performed. RESULTS There is limited evidence for ED among Indigenous Australians, however, the evidence available strongly suggests that ED are more common among Indigenous Australians compared to other Australians. Eating disorders among Indigenous Australians are also associated with high levels of overvaluation of weight and shape. The increased risk of ED among Indigenous Australians was largely explained by factors such as poorer psychosocial wellbeing. No evidence was found for the existence of validated diagnostic or screening tools for ED in Indigenous Australians. CONCLUSION The evidence suggests ED are common among Indigenous Australians, and there are no diagnostic or screening tools available to assist clinicians in assessing them. More research is required in this field, especially towards the development of a validated and culturally specific screening or diagnostic tool for ED among Indigenous Australians.
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Affiliation(s)
- Adam Burt
- School of Medicine, Western Sydney University, Campbelltown, Australia
| | - Deborah Mitchison
- Translational Health Research Institute, School of Medicine, Western Sydney University, Campbelltown, Australia.
- Centre for Emotional Health, Department of Psychology, Macquarie University, North Ryde, New South Wales, Australia.
| | - Kerrie Doyle
- School of Medicine, Western Sydney University, Campbelltown, Australia
| | - Phillipa Hay
- Translational Health Research Institute, School of Medicine, Western Sydney University, Campbelltown, Australia
- Campbelltown Hospital, SWSLHD, Campbelltown, Australia
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Health and Wellness Impacts of Traditional Physical Activity Experiences on Indigenous Youth: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17218275. [PMID: 33182405 PMCID: PMC7664942 DOI: 10.3390/ijerph17218275] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Revised: 10/30/2020] [Accepted: 11/05/2020] [Indexed: 11/17/2022]
Abstract
Traditional physical activities have numerous physiological and psychosocial benefits for Indigenous youth around the world. Little is known about the positive health and wellness impacts of traditional physical activity experiences on Indigenous youths. The aim of this systematic review is to explore the holistic health and wellness impacts of traditional physical activities on Indigenous youth from certain North American and Oceania geographic areas. A systematic search of four electronic databases (PubMed, ERIC, Scopus and Web of Science) was conducted to identify peer-reviewed publications of qualitative research exploring the diverse health experiences of traditional physical activities for Indigenous youth in Canada, the United States of America, New Zealand and Australia. A qualitative synthesis of studies between 2006 and 2018 were included, and findings were synthesized using an integrated Indigenous-ecological model, which broadly captures health and wellness impacts under intrapersonal, interpersonal, organizational, community and policy level outcomes using medicine wheel teachings. In total, nine studies were identified via this search. Overall, the literature described numerous emotional, mental and spiritual benefits of traditional physical activity, and youth experiences were affected by familial and communal relationships, and systemic factors. Among Indigenous youth, this research shows the importance of including traditional physical activity in future programs and partnerships with community expertise.
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Social Cognitive Orientations, Social Support, and Physical Activity among at-Risk Urban Children: Insights from a Structural Equation Model. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17186745. [PMID: 32947944 PMCID: PMC7558557 DOI: 10.3390/ijerph17186745] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 09/10/2020] [Accepted: 09/12/2020] [Indexed: 11/17/2022]
Abstract
This study investigates the effects of cognitive orientations associated with social cognitive theory (SCT) and exercise enjoyment on physical activity (PA) of urban at-risk children, accounting for mediating effects associated with various sources of social support. We use 2016–2017 survey data from 725 school-age children in an urban school district in Akron, Ohio in the United States (US) to inform a structural equation model, which assesses direct and indirect effects of self-efficacy, behavioral intention, and exercise enjoyment on children’s PA, using mediating variables that measure social support that children report receiving from parents, Physical Education (PE) teachers, and peers. We find that self-efficacy and exercise enjoyment have notable direct and indirect effects on the children’s PA. We also find that the support children receive from PE teachers and peers appears to have greater effects on PA than does the children’s reported social support from parents. These findings suggest that children’s social cognitive orientations may influence both sources of perceived social support and the extent to which children engage in PA. While these findings have potential implications for intervention strategies to increase PA among at-risk children, further research is appropriate to improve our understanding of the determinants of PA among at-risk urban children.
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Gifford JA, Gwynn JD, Hardy LL, Turner N, Henderson LC, Innes-Hughes C, Flood VM. Review of Short-Form Questions for the Evaluation of a Diet, Physical Activity, and Sedentary Behaviour Intervention in a Community Program Targeting Vulnerable Australian Children. CHILDREN (BASEL, SWITZERLAND) 2018; 5:E95. [PMID: 30011873 PMCID: PMC6069381 DOI: 10.3390/children5070095] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/06/2018] [Revised: 06/28/2018] [Accepted: 07/02/2018] [Indexed: 01/06/2023]
Abstract
Childhood obesity is associated with low socioeconomic status in developed countries, and community programs can deliver cost-effective obesity interventions to vulnerable children and adolescents at scale. Evaluating these programs in a low-cost, time-efficient, and culturally appropriate way with valid and reliable measures is essential to determining their effectiveness. We aimed to identify existing valid and reliable short-form instruments (≤50 items for diet, ≤15 items for physical activity) suitable for the assessment of change in diet, physical activity, and sedentary behaviour in an Australian obesity intervention program for children and adolescents aged 7⁻13 years from low socioeconomic groups, with a focus on Aboriginal and Torres Strait Islander children. Relevant electronic databases were searched, with a focus on Australian literature. Validity and/or reliability studies using diet instruments (5), physical activity/sedentary behaviour instruments (12), and diet and physical activity/sedentary behaviour instruments used with Aboriginal and Torres Strait Islander (3) children were identified. Seven questions on diet, one question on physical activity, and no questions on sedentary behaviour were recommended. These questions can be used for evaluation in community-based obesity programs among Australian children and adolescents, including those from low socioeconomic groups and Aboriginal and Torres Strait Islander children.
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Affiliation(s)
- Janelle A Gifford
- Faculty of Health Sciences, The University of Sydney, 75 East St, Lidcombe, NSW 2141, Australia.
| | - Josephine D Gwynn
- Faculty of Health Sciences, The University of Sydney, 75 East St, Lidcombe, NSW 2141, Australia.
- Charles Perkins Centre, The University of Sydney, Sydney, NSW 2005, Australia.
| | - Louise L Hardy
- Sydney School of Public Health, The University of Sydney, Sydney, NSW 2006, Australia.
| | - Nicole Turner
- Centre for Rural and Remote Mental Health, The University of Newcastle, University Drive, Callaghan, NSW 2308, Australia.
- Hunter New England Local Health District, Locked Bag 1, New Lambton, NSW 2305, Australia.
| | - Lily C Henderson
- NSW Office of Preventive Health, Liverpool, NSW 1871, Australia.
| | | | - Victoria M Flood
- Faculty of Health Sciences, The University of Sydney, 75 East St, Lidcombe, NSW 2141, Australia.
- Charles Perkins Centre, The University of Sydney, Sydney, NSW 2005, Australia.
- Western Sydney Local Health District, Westmead, NSW 2145, Australia.
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