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Biomedical subjects

Billie Giles-Corti

Publications and source records attributed to Billie Giles-Corti.

At least 19 recordsLinked to original sources

Time spent outdoors at midday and children's body mass index.

OBJECTIVES: We investigated whether the Kidskin sun protection intervention increased children's body mass index by reducing the time spent outdoors at midday. METHODS: The Kidskin sun protection intervention involved 1614 Australian school children assigned to 1 of 3 groups: a control group, a moderate-intervention group, or a high-intervention group. Schools in the control group received the standard health curriculum and schools in the intervention groups received a multicomponent intervention. Outcomes included time spent outdoors and nevus development (a marker of melanoma risk). Height and weight were measured at 3 time points. Body mass index was transformed into age- and gender-specific z scores; z scores at each age were modeled simultaneously. Time spent outdoors at ages 10 and 12 years was analyzed using a linear mixed effects modeling. RESULTS: The proportion of children who were overweight or obese increased with age. The moderate-intervention and control groups had a minimal increase in z score over time, and the z score for the high-intervention group decreased over time. There were no differences among groups with respect to total time outdoors at any age. CONCLUSIONS: It is possible to reduce the time children spend outdoors when ultraviolet radiation is high without producing an unfavorable effect on the children's body mass index.

Body Mass Index↗

Constructing indices representing supportiveness of the physical environment for walking using the Rasch measurement model.

BACKGROUND: The objectives of this study were to use the Rasch model to 1) assess the psychometric properties of a physical environmental audit instrument and 2) to develop indices of interrelated environmental attributes that summarize environmental supportiveness for walking. METHODS: A set of items were derived representing two conceptual physical environmental constructs: 1) functional/safety, and; 2) aesthetics. Ad hoc criteria based on point-biserial and Rasch-based fit statistics were used to examine the construct validity and internal reliability of the two constructs. RESULTS: The Rasch-based fit statistics assisted in identifying 12 items that belonged to the functional/safety construct and 4 items that belonged to the aesthetic construct. The reliability of the two constructs were low to moderate (functional/safety r(beta) = 0.19 and aesthetics r(beta) = 0.35). CONCLUSION: Given the vast number of built environmental attributes, a means of developing summary indices is essential. Future studies should assess the reliability and validity of indices that summarize physical environmental characteristics conducive to walking before testing them in predictive models of physical activity. More research examining procedures for measuring the built environment and techniques for analyzing environmental data are needed to guide future research in this area.

Journal Article↗

People or places: what should be the target?

In the last decade, interest in the impact of the built environment on physical activity has grown. Policies and community and neighbourhood infrastructure provide opportunities to be active, and facilitate incidental physical activity, such as walking for transport or use of stairs. Theoretical ecological models provide a basis for physical activity research and practice, focussing attention on multiple levels of influence on behaviour (i.e., individual, social-environmental and physical environmental). However, few studies have quantified the relative contribution of these correlates on behaviour, leaving policy-makers and practitioners wondering about where to target their efforts: people or places? This paper draws on theory, evidence to date and case studies to argue that comprehensive interventions targeting both people and places are required to increase physical activity. The joint influence of place and people is discussed in the context of data showing that the likelihood of walking at recommended levels is nearly eight times higher (OR 7.84; 95% CI 4.41-13.91) in people with both a supportive environment and positive cognitions compared with those low on both. To increase physical activity requires multi-sector partnerships and comprehensive long-term multi-pronged interventions that include short-, medium- and long-term strategies aimed at bringing about cultural shifts favouring physical activity over sedentary alternatives, and the creation of a supportive built environment. The health sector can contribute by implementing public education programs, workforce development, building the evidence-base and advocating for change. However, to improve policies and infrastructure in places the commitment of sectors outside of health is critical.

Health↗

Planning and implementing a community-based public health advocacy campaign: a transport case study from Australia.

Facilitating community action is a key goal of health promotion. This paper describes a public health advocacy framework. It then presents a case study of its application for planning community action by a community alliance concerned about increased heavy traffic on roads through a small regional city in the South West region of Western Australia. The case study illustrates defining the public health problem, the solution and the target for action; and the implementation of a comprehensive range of strategies including a media advocacy strategy to attract public attention, to reframe media messages, and to provide a policy alternative to government and industry. The campaign was evaluated in terms of process and outcomes, and was successful in putting pressure on key stakeholders and achieving the alliance's two main goals. The case study demonstrates the value of a well-planned campaign and including public health advocacy in public health practice, as an important strategy to facilitate the creation of healthy environments through healthy public policy.

Accidents, Traffic↗

Correlates of distances traveled to use recreational facilities for physical activity behaviors.

BACKGROUND: Information regarding how far people are willing to travel to use destinations for different types of recreational physical activity behaviors is limited. This study examines the demographic characteristics, neighborhood opportunity and specific-physical activity behaviors associated with distances traveled to destinations used for recreational physical activity. METHODS: A secondary analysis was undertaken of data (n = 1006) from a survey of Western Australian adults. Road network distances between respondents' homes and 1) formal recreational facilities; 2) beaches and rivers; and 3) parks and ovals used for physical activity were determined. Associations between distances to destinations and demographic characteristics, neighborhood opportunity (number of destinations within 1600 meters of household), and physical activity behaviors were examined. RESULTS: Overall, 56.3% of respondents had used a formal recreational facility, 39.9% a beach or river, and 38.7% a park or oval. The mean distance traveled to all destinations used for physical activity was 5463 +/- 5232 meters (m). Distances traveled to formal recreational facilities, beaches and rivers, and parks and ovals differed depending on the physical activity undertaken. Younger adults traveled further than older adults (7311.8 vs. 6012.6 m, p = 0.03) to use beaches and rivers as did residents of socio-economically disadvantaged areas compared with those in advantaged areas (8118.0 vs. 7311.8 m, p = 0.02). Club members traveled further than non-members to use parks and ovals (4156.3 vs. 3351.6 meters, p = 0.02). The type of physical activity undertaken at a destination and number of neighborhood opportunities were also associated with distance traveled for all destination types. CONCLUSION: The distances adults travel to a recreational facility depends on the demographic characteristics, destination type, physical activity behavior undertaken at that destination, and number of neighborhood opportunities. Knowing how far adults travel to undertake physical activity will assist in designing supportive neighborhoods and designing future ecological research.

Journal Article↗

Development of a reliable measure of walking within and outside the local neighborhood: RESIDE's Neighborhood Physical Activity Questionnaire.

BACKGROUND: The RESIDential Environment project (RESIDE) is a longitudinal study evaluating the impact of a new residential design code on walking. OBJECTIVE: To develop a reliable measure of walking--undertaken within and outside the neighborhood--and overall physical activity. METHODS: A test-retest reliability study was undertaken (n = 82, mean age 39 years). The instrument was based on the International Physical Activity Questionnaire (IPAQ-short version) and Active Australia Survey. It measured usual frequency and duration of (1) recreational- and transport-related walking within and outside the neighborhood and (2) other vigorous and moderate physical activities. RESULTS: Reliability of recall of whether participants had walked within (k = 0.84) and outside (0.73) the neighborhood was acceptable. Similarly, recall of frequency and duration of transport and recreational-related walking within the neighborhood was excellent (ICC > or = 0.82), as was recall of transport-related walking trips outside the neighborhood (ICC > or = 0.84). Reliability for duration of recreational walking outside the neighborhood was fair to good (ICC = 0.55). The reliability of indices of total physical activity based on MET min/week (ICC = 0.82) and MET min/week dichotomized to 'sufficient' physical activity for health (kappa = 0.67) were both acceptable. CONCLUSIONS: The Neighborhood Physical Activity Questionnaire (NPAQ) is sufficiently reliable for studies examining environmental correlates of walking within the neighborhood.

Adult↗

Dog ownership, health and physical activity: a critical review of the literature.

This review examines the association between dog ownership and adult physical activity levels. While there is evidence to suggest that dog ownership produces considerable health benefit and provides an important form of social support that encourages dog owners to walk, there is limited evidence on the physical environmental and policy-related factors that affect dog owners walking with their dog. With the high level of dog ownership in many industrialized countries, further exploration of the relationship between dog ownership and physical activity levels may be important for preventing declining levels of physical activity and the associated detrimental health effects.

Adult↗

Personal, family, social, and environmental correlates of active commuting to school.

BACKGROUND: Active commuting to school may be an important opportunity for children to accumulate adequate physical activity for improved cardiovascular risk factors, enhanced bone health, and psychosocial well-being. The purpose of this study was to examine personal, family, social, and environmental correlates of active commuting to school among children. METHODS: Cross-sectional study of 235 children aged 5 to 6 years and 677 children aged 10 to 12 years from 19 elementary schools in Melbourne, Australia. Self-administered questionnaires were completed by parents, and the older children. The shortest possible routes to school were examined using a geographic information system. RESULTS: Among both age groups, negative correlates of active commuting to school included parental perception of few other children in the neighborhood and no lights or crossings for their child to use, and an objectively assessed busy road barrier en route to school. In younger children, an objectively assessed steep incline en route to school was negatively associated with walking or cycling to school. Good connectivity en route to school was negatively associated with walking or cycling to school among older children. Among both age groups, children were more likely to actively commute to school if their route was <800 meters. There were no associations with perceived energy levels or enjoyment of physical activity, weight status, or family factors. CONCLUSIONS: For children, creating child-friendly communities and providing skills to safely negotiate the environment may be important. Environmental correlates of active transport in children and adults may differ and warrant further investigation.

Bicycling↗

Demographic and individual correlates of achieving 10,000 steps/day: use of pedometers in a population-based study.

ISSUES ADDRESSED: The 10,000 steps per day message has become popular, yet few studies have examined correlates associated with achieving this behaviour target. This paper examines demographic and individual factors associated with adults achieving 10,000 steps/day. METHOD: Participants in a state-wide, cross-sectional physical activity survey were invited to take part in a pedometer study (n=603, 45% response rate). A pedometer was worn for one week and daily steps recorded in a diary. Participants providing four or more days of pedometer data (n=428) were dichotomised based on achievement of > or =10,000 steps/day. RESULTS: Men performed significantly more daily steps than women on average (10,079+/-3,848 and 9,169+/-3,800, p=0.01). In males, those less likely to achieve > or =10,000 steps/day were > or =60 years of age (OR=0.21) and overweight (i.e. body mass index > or =25kgm2) (OR=0.40), while men who regularly walked in the workplace (OR=1.44), who did vigorous activity at work (OR= 3.75), or who were employed in a blue-collar occupation (OR=4.45) were more likely to report reaching this target. In women, being overweight (OR=0.55) was negatively associated with achieving > or =10,000 steps/day, while participating in > or =150 minutes of leisure-time physical activity/week (OR=2.26) was positively associated with reaching this target. CONCLUSION: Workplace physical activity and working in blue-collar occupations contributes to the achievement of 10,000 steps/day in males. People who achieve current national physical activity guidelines also achieve 10,000 steps/day. Older adults and those overweight are less likely to achieve this behaviour target.

Adolescent↗

Neighborhood environmental factors correlated with walking near home: Using SPACES.

PURPOSE: The physical environment plays an important role in influencing participation in physical activity, although the specific factors that are correlated with different patterns of walking remain to be determined. We examined correlations between physical environmental factors and self-reported walking for recreation and transport near home. METHODS: The local neighborhood environments (defined as a 400-m radius from the respondent's home) of 1678 adults were assessed for their suitability for walking. The environmental data were collected during 2000 using the Systematic Pedestrian and Cycling Environmental Scan (SPACES) instrument together with information from other sources. We used logistic regression modeling to examine the relationship between the attributes of the physical environment and the self-reported walking behavior undertaken near home. RESULTS: Functional features were correlated with both walking for recreation (odds ratio (OR) 1.62; 95% confidence interval (CI): 1.20-2.19) and for transport (OR 1.30; 95% CI: 0.97-1.73). A well-maintained walking surface was the main functional factor associated with walking for recreation (OR 2.04; 95% CI: 1.43-2.91) and for transport (OR 2.13; 95% CI: 1.53-2.96). Destination factors, such as shops and public transport, were significantly correlated with walking for transport (OR 1.80; 95% CI: 1.33-2.44), but not recreation. CONCLUSION: The findings suggest that neighborhoods with pedestrian facilities that are attractive and comfortable and where there are local destinations (such as shops and public transport) are associated with walking near home.

Adult↗

How can socio-economic differences in physical activity among women be explained? A qualitative study.

This qualitative study investigated why women of low socio-economic status (SES) are less physically active than women of higher-SES. Semi-structured interviews were conducted with 19 high-, 19 mid- and 18 low-SES women. A social-ecological framework, taking into account intrapersonal, social and environmental level influences, was adopted to guide the development of interview questions and interpretation of data. Thematic analysis identified a number of key influences on physical activity that varied by SES. These included negative early life/ family physical activity experiences (a consistent theme among those of low-/mid-SES); participation in a wider range of physical activities in leisure time (high-SES); greater priority given to television viewing (low-SES); lack of time due to work commitments (low-SES); lack of time due to family commitments (high-SES); and neighbourhood-level barriers (low-SES). Financial costs were not perceived as a key barrier by women in any SES group. Public health strategies aimed at reducing SES inequalities in physical activity might focus on overcoming negative early experiences/attitudes to physical activity, reducing television viewing and promoting a wider variety of different types of physical activity, and addressing neighbourhood safety and other barriers to physically active lifestyles in socio-economically disadvantaged areas.

Adult↗

The impact of the kidskin sun protection intervention on summer suntan and reported sun exposure: was it sustained?

BACKGROUND: Recognition that early sun exposure is an important risk factor for cutaneous melanoma in white populations has led to efforts to reduce children's sun exposure. 'Kidskin' was a non-randomized, school-based sun protection intervention trial in Perth, Western Australia (1995-1999). Its aim was to determine the extent to which such a program could reduce children's sun exposure. METHODS: Kidskin involved 1614 children assigned to one of three groups: a Control, a 'Moderate' and a 'High' intervention group of 14, 11 and 8 schools respectively. The unit of assignment was the school. Control schools received the standard health education curriculum, while intervention schools received a multi-component intervention including a specially designed curriculum. The High intervention group received additional components. Outcomes included parent reported sun-related behaviors and objectively measured suntan at the end of summer vacation. These outcomes were observed every 2 years. Statistical analyses allowed for correlations between students within schools. RESULTS: Kidskin initially had favorable effects on reported sun exposure and measured suntan. However, at the end of the 4-year program, and again 2 years later, little evidence of a favorable effect remained. CONCLUSIONS: The benefits of childhood sun protection interventions may not last beyond the life of the program.

Child↗

The pet connection: pets as a conduit for social capital?

There is growing interest across a range of disciplines in the relationship between pets and health, with a range of therapeutic, physiological, psychological and psychosocial benefits now documented. While much of the literature has focused on the individual benefits of pet ownership, this study considered the potential health benefits that might accrue to the broader community, as encapsulated in the construct of social capital. A random survey of 339 adult residents from Perth, Western Australia were selected from three suburbs and interviewed by telephone. Pet ownership was found to be positively associated with some forms of social contact and interaction, and with perceptions of neighbourhood friendliness. After adjustment for demographic variables, pet owners scored higher on social capital and civic engagement scales. The results suggest that pet ownership provides potential opportunities for interactions between neighbours and that further research in this area is warranted. Social capital is another potential mechanism by which pets exert an influence on human health.

Adult↗

Increasing walking: how important is distance to, attractiveness, and size of public open space?

BACKGROUND: Well-designed public open space (POS) that encourages physical activity is a community asset that could potentially contribute to the health of local residents. METHODS: In 1995-1996, two studies were conducted-an environmental audit of POS over 2 acres (n =516) within a 408-km2 area of metropolitan Perth, Western Australia; and personal interviews with 1803 adults (aged 18 to 59 years) (52.9% response rate). The association between access to POS and physical activity was examined using three accessibility models that progressively adjusted for distance to POS, and its attractiveness and size. In 2002, an observational study examined the influence of attractiveness on the use of POS by observing users of three pairs of high- and low-quality (based on attractiveness) POS matched for size and location. RESULTS: Overall, 28.8% of respondents reported using POS for physical activity. The likelihood of using POS increased with increasing levels of access, but the effect was greater in the model that adjusted for distance, attractiveness, and size. After adjustment, those with very good access to large, attractive POS were 50% more likely to achieve high levels of walking (odds ratio, 1.50; 95% confidence level, 1.06-2.13). The observational study showed that after matching POS for size and location, 70% of POS users observed visited attractive POS. CONCLUSIONS: Access to attractive, large POS is associated with higher levels of walking. To increase walking, thoughtful design (and redesign) of POS is required that creates large, attractive POS with facilities that encourage active use by multiple users (e.g., walkers, sports participants, picnickers).

Adolescent↗

The effect of a school-based sun protection intervention on the development of melanocytic nevi in children: 6-year follow-up.

Because nevi share risk factors with melanoma and are strong risk factors for melanoma, they are suitable biomarkers for evaluating sun protection programs. Kidskin was a trial of a school-based sun protection program in Western Australia that included high and moderate intervention groups and a control group. Schools were assigned nonrandomly to groups. The primary outcome was number of nevi on the back. Nevi were counted at baseline, after 4 years intervention and again 2 years later. Linear growth models, allowing for correlated data within schools and children were fitted to the data. The primary analysis included 639 control children, 414 in the moderate and 355 in the high intervention group. Compared with the control group, the relative increase in number of nevi on the back was 0.89 (95% confidence interval, 0.81-0.99) for the high intervention group and 0.94 (95% confidence interval, 0.86-1.04) for the moderate group (P = 0.09). In subgroup analyses of nevi on the back, the association was stronger in boys (P < 0.001) than in girls (P = 0.7), although the test for interaction was not significant (P = 0.11). For the chest, examined in boys, the associations were similar to that for nevi on the back in boys. Associations were weak for nevi on the face and arms (P = 0.2); for this site, there was weak evidence of heterogeneity by sex. Overall, there was weak evidence that the Kidskin intervention reduced the number of new nevi over a 6-year period, but there was stronger evidence of an effect on the trunk in boys.

Case-Control Studies↗

Developing a framework for assessment of the environmental determinants of walking and cycling.

The focus for interventions and research on physical activity has moved away from vigorous activity to moderate-intensity activities, such as walking. In addition, a social ecological approach to physical activity research and practice is recommended. This approach considers the influence of the environment and policies on physical activity. Although there is limited empirical published evidence related to the features of the physical environment that influence physical activity, urban planning and transport agencies have developed policies and strategies that have the potential to influence whether people walk or cycle in their neighbourhood. This paper presents the development of a framework of the potential environmental influences on walking and cycling based on published evidence and policy literature, interviews with experts and a Delphi study. The framework includes four features: functional, safety, aesthetic and destination; as well as the hypothesised factors that contribute to each of these features of the environment. In addition, the Delphi experts determined the perceived relative importance of these factors. Based on these factors, a data collection tool will be developed and the frameworks will be tested through the collection of environmental information on neighbourhoods, where data on the walking and cycling patterns have been collected previously. Identifying the environmental factors that influence walking and cycling will allow the inclusion of a public health perspective as well as those of urban planning and transport in the design of built environments.

Adult↗

The test-retest reliability of habitual incidental physical activity.

OBJECTIVE: To determine the test-retest reliability of items measuring habitual incidental physical activity, incidental physical activity behaviour and sedentary behaviours. METHODS: Eighty-four subjects aged 18-65 years were interviewed from randomly selected households within metropolitan and rural Western Australia. Subjects were administered the interview on two separate occasions 10 days apart. Subjects were asked about habitual incidental physical activity (i.e. bouts performed for 10 minutes or less) performed during the week and on weekends. RESULTS: Intraclass correlations performed for items measuring incidental physical activity were generally found to be low to moderate. The frequency of incidental physical activity was more reliably recalled than the average duration spent on short trips (ICC 0.582 to 0.872 compared with 273 to 0.551). Kappa coefficients for habitual incidental physical activity behaviour items were observed to have moderate-to-high (0.478 to 0.939) agreement between administrations. Sedentary behaviours overall showed high test-retest reliability (ICC 0.646 to 0.925). CONCLUSION: These findings demonstrate that adults can reliably recall the frequency, but not the duration, of habitual incidental physical activity. Thus, the frequency measured by these items could be used to determine the effectiveness of current Australian physical activity guidelines and possibly identify shifts in incidental physical activity behaviour over time. IMPLICATIONS: Measurement of physical activity in all domains including incidental physical activity is required to determine the effectiveness of current guidelines and implemented health promotion interventions.

Adolescent↗