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The Still Six Lives campaign aimed to increase awareness of stillbirth among Australian women and educate people about three modifiable behaviours that pregnant women could take to reduce the risk of stillbirth. The campaign used earned media, digital advertising and social media. The aim of this study is to evaluate the impact of the campaign on Australian women's awareness of stillbirth, and knowledge of the three modifiable behaviours. The study collected process evaluation data about campaign implementation from digital platforms. The impact evaluation comprised of two components: a three-wave community survey of Australian women aged 18–50 years old, and a pre-post cross-sectional maternity service survey of pregnant women. The campaign gained significant reach, including 2,974,375 completed video views and 910,000 impressions via social media influencers. The community surveys had 1502 participants at baseline, 1517 mid-campaign and 1598 post-campaign. Participants were slightly more likely to have encountered messages about stillbirth after the campaign (aOR 1.30, 95% CI 1.09–1.55). There were increases in awareness of each behaviour after the campaign: be aware of baby's movements (aOR 1.26, 95% CI 1.08–1.47), quit smoking (aOR 1.27, 95% CI 1.10–1.47) and going-to-sleep on side (aOR 1.55, 95% CI 1.32–1.82). The antenatal clinic survey had 296 participants at baseline and 178 post-campaign. Post-campaign, there was an increased likelihood that women were aware of side-sleeping (aOR 3.11, 95% CI 1.74–5.56). The national campaign demonstrated some evidence of change in awareness of three modifiable behaviours that can reduce the risk of stillbirth. [ABSTRACT FROM AUTHOR]

Background: The UK Biobank (UKB) has been used widely to examine associations between lifestyle risk factors and mortality outcomes. It is unknown whether the extremely low UKB response rate (5.5%) and lack of representativeness materially affects the magnitude and direction of effect estimates.Methods: We used poststratification to match the UKB sample to the target population in terms of sociodemographic characteristics and prevalence of lifestyle risk factors (physical inactivity, alcohol intake, smoking, and poor diet). We compared unweighted and poststratified associations between each lifestyle risk factor and a lifestyle index score with all-cause, cardiovascular disease (CVD), and cancer mortality. We also calculated the unweighted to poststratified ratio of HR (RHR) and 95% confidence interval as a marker of effect-size difference.Results: Of 371,974 UKB participants with no missing data, 302,009 had no history of CVD or cancer, corresponding to 3,298,958 person years of follow-up. Protective associations between alcohol use and CVD mortality observed in the unweighted UKB were substantially altered after poststratification, for example, from a hazard ratio (HR) of 0.63 (0.45-0.87) unweighted to 0.99 (0.65-1.50) poststratified for drinking ≥5 times/week versus never drinking. The magnitude of the poststratified all-cause mortality hazard ratio comparing least healthy with healthiest tertile of lifestyle risk factor index was 9% higher (95% confidence interval: 4%, 14%) than the unweighted estimates.Conclusions: Lack of representativeness may distort the associations of alcohol with CVD mortality, and may underestimate health hazards among those with cumulatively the least healthy lifestyles. [ABSTRACT FROM AUTHOR]

Objectives: Investigate sociodemographic factors associated with physical activity and sport participation among Indigenous children registered in the New South Wales (NSW) government-funded Active Kids voucher program in 2018, including comparison with non-Indigenous children.Design: Cross-sectional study.Methods: The Active Kids voucher program aims to support the cost of children's sport and physical activities. All children aged 5-18 years in NSW are eligible for a voucher. To register, parent/carers report child sociodemographic characteristics, physical activity, sport participation and optional height and weight. Regression models were used to determine which sociodemographic characteristics were associated with meeting physical activity guidelines and sport participation for Indigenous and non-Indigenous children.Results: Of the 671,375 children aged 5-18 years, 36,129 (5.4%) were Indigenous. More Indigenous children than non-Indigenous children met the physical activity guidelines before registering in the Active Kids program. Indigenous children had greater odds of meeting physical activity guidelines across all socio-economic quartiles. Among non-Indigenous children, odds reduced with social disadvantage. Indigenous children (38%) were less likely to participate in organised physical activity and sport sessions at least twice a week compared to non-Indigenous children (43%). Indigenous children living in major cities had higher sport participation levels compared with those living in outer regional and remote areas.Conclusions: The Active Kids voucher program achieved population representative reach among Indigenous children, whose physical activity levels were higher than non-Indigenous children across all socioeconomic quartiles. The program has potential to supplement Indigenous children's physical activity levels using organised sessions and reduce sport drop-out among older children. [ABSTRACT FROM AUTHOR]

Objectives: In 2018, the New South Wales (NSW) Government implemented a State-wide program to reduce the cost barrier to organised sport and physical activity participation. We explored parent/carer's awareness and children's engagement in the Active Kids program across socioeconomic groups and used the NSW Population Health Survey (PHS) to validate engagement in the program.Design: Cross-sectional.Methods: Data were obtained from the 2018 NSW PHS and the Active Kids program registration database. We compared demographic characteristics of children who had registered for the program in the registration database with children in the weighted NSW PHS. Multinomial regression models were used to determine whether socioeconomic status was associated with parent/carer awareness and children's engagement in the program.Results: Parent/carer's in the most disadvantaged quartile were twice as likely to have never heard of the Active Kids program (OR: 2.04, 95% CIs 1.31, 3.16) or to have heard or the program but not registered (OR: 1.94, 95% CIs 1.26, 3.00), and more than twice as likely to have registered for a voucher, but not followed through and redeemed the voucher (OR: 2.68, 95% CIs 1.27, 5.63) compared with the least disadvantaged quartile.Conclusions: The Active Kids program has provided financial support for organised sport and physical activity to a large number of children. However, there are still a substantial proportion of socially disadvantaged groups who are unaware or have not engaged in the program. Further targeted work is required to increase the awareness and engagement in the program for socially disadvantaged groups. [ABSTRACT FROM AUTHOR]

Objective: Physical self-concept and moderate-to-vigorous physical activity (MVPA) are fundamental components of adolescents' health and well-being. Previous research suggests that physical self-concept and MVPA share reciprocal relations whereby physical self-concept is both an antecedent (i.e., self-enhancement) and outcome (i.e., skill development) of MVPA. However, these studies rely on subjective reports of MVPA, which can produce social desirability bias and challenge youth's recall capabilities. In order to address this gap, we test a reciprocal effects model examining the interplay between adolescents' physical self-concept and its facets and 7 days of objectively measured MVPA. Method: Australian adolescents (N = 1,767) completed 4,136 time-specific observations across 3 waves of data. Structural equation modeling was used to test the reciprocal effects model. Results: After controlling for body mass index and sex, results only supported the role of MVPA as an antecedent of physical self-concept. The percentage of time adolescents spent in MVPA during school was especially important to predicting a higher physical self-concept in the future. Conclusions: Findings did not support a reciprocal effects model of physical self-concept and objectively measured MVPA. Rather, physical self-concept and facets were outcomes of school-based MVPA, suggesting emphasis be placed on promoting adolescents' physical activity participation. This study demonstrates the benefits that school MVPA provides to adolescents' development of a positive physical self-concept, which is essential to optimizing long-term health and well-being. [ABSTRACT FROM AUTHOR]

Purpose The objectives of this study were to determine whether longitudinal changes in accelerometer-assessed moderate-to-vigorous physical activity (MVPA) were associated with changes in educational outcomes (i.e., academic performance and mathematics engagement) and to examine whether the association was nonlinear. Methods Longitudinal data were collected from 2,194 Australian adolescents (mean age = 13.40 years, standard deviation = .73) at two time points (Term 1, 2014, and Term 2, 2015). To measure the total MVPA, the adolescents wore an accelerometer for seven consecutive days. The participants responded to a questionnaire to measure mathematics engagement and completed a nationally administered numeracy test to assess academic performance. Results Latent change score models indicated that increases in MVPA had a positive quadratic association with National Assessment Program—Literacy and Numeracy (NAPLAN) scores in girls ( β  = .39, p  < .001) but not boys. In comparison, cross-sectional regression analyses indicated that MVPA had a positive quadratic association with NAPLAN scores in grade 7 ( β  = .92, p  = .04) boys and in grade 9 boys ( β  = .60, p  = .06), but not in girls. There was also a positive quadratic association between MVPA and school engagement in grade 9 boys ( β  = .77, p  = .03). Conclusions Cross-sectional evidence indicated that boys who were more physically active had better educational outcomes than their less active peers, and girls who increased their regular physical activity showed improvements in academic performance. All students need to increase their physical activity levels for health and educational benefits, without compromising the time spent on study and homework. [ABSTRACT FROM AUTHOR]

Objectives: The purpose of this study was to determine whether physical activity has a positive relationship with school engagement regardless of the presence or absence of a recess or lunch break before the classroom lesson.Design: Data were collected over three ten-week periods: January-April 2014 (Time 1), October-December 2014 (Time 2), and April-June 2015 (Time 3).Methods: A cohort of 2194 adolescents (mean age=13.40years, SD=.73) wore an accelerometer during the hour before a mathematics lesson and completed a questionnaire following the mathematics lesson to assess school engagement in that lesson.Results: Linear mixed models indicated that moderate-intensity activity before a mathematics lesson had a positive linear relationship with cognitive engagement (β=.40, p<.05). Recess breaks before a mathematics lesson had a negative relationship with overall, behavioural, emotional, and cognitive engagement (β=-.18, p<.01, β=-.19, p<.01, β=-.13, p=.03, and β=-.13, p=.04, respectively).Conclusions: Promoting moderate-intensity activity prior to mathematics lessons could improve students' cognitive engagement. Educators should be aware that students tend to demonstrate the lowest levels of school engagement after recess breaks. [ABSTRACT FROM AUTHOR]

Abstract: Background: Physical education (PE) lessons and leisure-time represent two important opportunities for adolescents to accumulate moderate-to-vigorous physical activity (MVPA). Purpose: Framed by self-determination theory, this study investigated how much of the observed variation in adolescent boys' MVPA levels (during PE and leisure-time) was explained by individual- and class-level motivation. Methods: Cross-sectional design. Adolescent boys (N = 61, M = 14.36 years, SD = .48 years) completed motivation questionnaires and wore an accelerometer during a PE lesson and across 7 consecutive days. Results: Self-determined motivation toward PE predicted MVPA during PE lessons (R 2 = .31). Self-determined motivation toward leisure-time physical activity was positively associated with MVPA during leisure-time (R 2 = .08). Conclusions: Findings support the tenets of self-determination theory and suggest that motivation may be an important correlate of adolescent boys' MVPA in PE lessons and during leisure-time. Also, results indicated that teachers' behavior may be an important determinant of MVPA in PE lessons, while individual motivation may be more important in leisure-time. [Copyright &y& Elsevier]