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: Objective: To report the prevalence of healthy weight and related behaviours among Victorian Aboriginal and non‐Aboriginal children and explore associations between these factors and health‐related quality of life (HRQoL). Methods: Analysis of cross‐sectional data from two cluster randomised controlled trials using logistic and linear mixed models. The sample included Aboriginal (n=303) and non‐Aboriginal (n=3,026) children aged 8–13 years. Results: More than two‐thirds of Aboriginal children met guidelines for fruit (75.9%), sweetened drinks (66.7%), sleep (73.1%), screen time (67.7%) and objectively measured physical activity (83.6%); and 79.1% reported consuming take‐away foods less than once per week. Aboriginal children were more likely to meet vegetable consumption guidelines (OR=1.42, 95%CI: 1.05, 1.93), but less likely to have a healthy weight (OR=0.66, 95%CI: 0.52, 0.85) than non‐Aboriginal children. Mean HRQoL scores were significantly higher among non‐Aboriginal children and both Aboriginal and non‐Aboriginal children meeting health guidelines. Conclusions: Most Aboriginal children in this study met guidelines for fruit, physical activity, screen time and sleep, and those meeting these guidelines had significantly higher HRQoL. Implications for public health: Promoting nutrition, physical activity and sleep is likely to benefit all children. Aboriginal community‐controlled organisations can use these data to design culturally‐specific programs that may improve disparities in healthy weight and HRQoL., Aboriginal and Torres Strait Islander peoples have lived on the lands, now known as Australia, for over 65,000 years, and are one of the world's oldest continuous populations.[sup.1] Compared to [...]

Background: Over a quarter of children aged 2–17 years living in Australia are overweight or obese, with a higher prevalence reported in regional and remote communities. Systems thinking approaches that seek to support communities to generate and implement locally appropriate solutions targeting intertwined environmental, political, sociocultural, and individual determinants of obesity have the potential to ameliorate this. There have however been reported challenges with implementation of such initiatives, which may be strengthened by incorporating implementation science methods. Methods: This pilot randomised controlled trial protocol outlines the development and proposed evaluation of a multicomponent implementation strategy (Action-RESPOND). to increase the implementation of community-based systems thinking child obesity prevention initiatives The target of this intervention is ten rural and regional communities (or local government areas as the unit of allocation) within Northeast Victoria who were participants in a whole-of-systems intervention (RESPOND). Action-RESPOND builds on this intervention by assessing the impact of offering additional implementation strategies to five communities relative to usual care. The development of the multicomponent implementation strategy was informed by the Promoting Action on Research Implementation in Health Services (PARIHS) framework and consists of seven implementation strategies primarily delivered via 'facilitation' methods. Implementation strategies aimed to ensure initiatives implemented are i) evidence-based, ii) address community's specific needs and iii) are suitable for local context. Strategies also aimed to increase the community's capacity to implement, through iv) improving the health promotion team's implementation knowledge and skills, fostering v) leadership, vi) physical resources and vii) community culture to drive implementation. The feasibility, acceptability, potential impact, and cost of the strategy will be assessed at baseline and follow up using surveys administered to key representatives within the community and internal records maintained by the research team. Discussion: By leveraging an existing community-based whole-of-systems intervention, Action-RESPOND offers a unique opportunity to collect pilot feasibility and early empirical data on how to apply implementation and systems science approaches to support obesity prevention in rural and regional communities in Victoria. [ABSTRACT FROM AUTHOR]

Summary: Objective: This systematic review aimed to assess the effect of life course body mass index (BMI) trajectories (childhood to adulthood) on cardiovascular disease (CVD) risk factors and outcomes. Methods: Prospective or retrospective cohort studies were identified that assessed the association of BMI trajectories with CVD risks and outcomes from databases published in English. The pooled effect sizes were estimated using a random‐effects model. Findings: Seventeen eligible studies were included in this systematic review. The results revealed that a persistently overweight trajectory from childhood to adulthood was associated with a higher risk of hypertension (RR: 2.49; 95% CI: 1.9, 3.28) and type 2 diabetes (RR: 4.62; 95% CI: 2.36, 9.04) compared with a trajectory characterized by a normal BMI throughout both childhood and adulthood. Similarly, the risk of hypertension (RR: 2.38; 95% CI: 1.70, 3.33) and type 2 diabetes (RR: 3.66; 95% CI: 2.57, 5.19) was higher in those with normal‐to‐overweight trajectory compared with participants with a stable normal weight trajectory. Conclusion: The findings suggest that lifetime BMI trajectories may be influential on health outcomes, and preventive strategies should be designed accordingly. Implementing appropriate preventive strategies at all life stages may reduce CVD risks and adverse outcomes later in life. [ABSTRACT FROM AUTHOR]

Summary: Background: Childhood obesity prevention initiatives are complex interventions that aim to improve children's obesity‐related behaviors and provide health promoting environments. These interventions often impact individuals, communities, and outcomes not primarily targeted by the intervention or policy. To accurately capture the effectiveness and cost‐effectiveness of childhood obesity prevention interventions, an understanding of the broader impacts (or spillover effects) is required. This systematic review aims to assess the spillover effects of childhood obesity prevention interventions. Methods: Six academic databases and two trial registries were searched (2007–2023) to identify studies reporting quantifiable obesity‐related and other outcomes in individuals or communities not primarily targeted by an obesity prevention intervention. Critical appraisal was undertaken for studies that reported statistically significant findings, and a narrative synthesis of the data was undertaken. Results: Twenty academic studies and 41 trial records were included in the synthesis. The most commonly reported spillovers were diet or nutrition‐related, followed by BMI and physical activity/sedentary behavior. Spillovers were mostly reported in parents/caregivers followed by other family members. Nine of the 20 academic studies reported statistically significant spillover effects. Conclusion: Limited evidence indicates that positive spillover effects of childhood obesity prevention interventions can be observed in parents/caregivers and families of targeted participants. [ABSTRACT FROM AUTHOR]

Objective: Government policy guidance in Victoria, Australia, encourages schools to provide affordable, healthy foods in canteens. This study analysed the healthiness and price of items available in canteens in Victorian primary schools and associations with school characteristics. Design: Dietitians classified menu items (main, snack and beverage) using the red, amber and green traffic light system defined in the Victorian government's School Canteens and Other School Food Services Policy. This system also included a black category for confectionary and high sugar content soft drinks which should not be supplied. Descriptive statistics and regressions were used to analyse differences in the healthiness and price of main meals, snacks and beverages offered, according to school remoteness, sector (government and Catholic/independent) size, and socio-economic position. Setting: State of Victoria, Australia Participants: A convenience sample of canteen menus drawn from three previous obesity prevention studies in forty-eight primary schools between 2016 and 2019. Results: On average, school canteen menus were 21 % 'green' (most healthy – everyday), 53 % 'amber' (select carefully), 25 % 'red' (occasional) and 2 % 'black' (banned) items, demonstrating low adherence with government guidelines. 'Black' items were more common in schools in regional population centres. 'Red' main meal items were cheaper than 'green'% (mean difference –$0·48 (95 % CI –0·85, –0·10)) and 'amber' –$0·91 (–1·27, –0·57)) main meal items. In about 50 % of schools, the mean price of 'red' main meal, beverages and snack items were cheaper than 'green' items, or no 'green' alternative items were offered. Conclusion: In this sample of Victorian canteen menus, there was no evidence of associations of healthiness and pricing by school characteristics except for regional centres having the highest proportion of 'black' (banned) items compared with all other remoteness categories examined. There was low adherence with state canteen menu guidelines. Many schools offered a high proportion of 'red' food options and 'black' (banned) options, particularly in regional centres. Unhealthier options were cheaper than healthy options. More needs to be done to bring Victorian primary school canteen menus in line with guidelines. [ABSTRACT FROM AUTHOR]

Research into the link between food environments and health is scarce. Research in this field has progressed, and new comprehensive methods (i.e., incorporating all food retail outlets) for classifying food retail environments have been developed and are yet to be examined alongside measures of obesity. In this study, we examine the association and temporal trends between the food environment and BMI of a repeated cross-sectional sample of the adult population between 2008 and 2016. Methods: Food retail data for 264 postal areas of Greater Melbourne was collected for the years 2008, 2012, 2014, and 2016, and a container-based approach was used to estimate accessibility to supermarkets, healthy and unhealthy outlets. Data on BMI for postal areas was obtained from the Victorian Population Health Survey (n = 47,245). We estimated the association between the food environment and BMI using linear mixed models. Results indicated that BMI increased as accessibility to healthy outlets decreased by up to −0.69 kg/m2 (95%CI: −0.95, −0.44). BMI was lower with high and moderate access to supermarkets compared to low access by −0.33 kg/m2 (−0.63, −0.04) and −0.32 kg/m2 (−0.56, −0.07), and with high access to unhealthy outlets compared to low access (−0.38 kg/m2: −0.64, −0.12) and moderate access (−0.54 kg/m2: −0.78, −0.30). Conclusion: Our results show that increasing access and availability to a diverse range of food outlets, particularly healthy food outlets, should be an important consideration for efforts to support good health. This research provides evidence that Australia needs to follow suit with other countries that have adopted policies giving local governments the power to encourage healthier food environments. [ABSTRACT FROM AUTHOR]

Objective: To describe participants' lived experience of co‐creating and implementing initiatives to improve children's health. Design: This manuscript reports an embedded case study design, which aims to describe participants' lived experiences of co‐creating community‐based initiatives. Information was gathered from an online survey and two focus groups. The two transcribed discussions from the focus groups were analysed using a 6‐step phenomenological process. Setting: Mansfield, Australia, population 4787, is one of ten local government areas (LGA) participating in the Reflexive Evidence and Systems Interventions to Prevent Obesity and Non‐communicable Disease (RESPOND) project. Participants: Participants were purposively selected from established community groups previously engaged by RESPOND using a co‐creation approach. The recruitment for the focus groups was a convenient sampling from participants that provided their email addresses in the online survey. Results: Eleven participants completed the online survey. A total of ten participants attended the two focus groups of 1‐h duration: five participants in each. Participants reported feeling empowered to create unique, locally relevant and readily adaptable community‐wide change. They were supported by a strong partnership that mobilised funding for a part‐time health promotion employee. Strengthened social connections were an unexpected though highly valued outcome. Conclusion: Co‐creation processes may assist stakeholders in delivering prevention strategies in ways that are empowering for them, responsive to the changing needs of the community, strengthen organisational partnerships and enhance community participation, social inclusion and engagement. [ABSTRACT FROM AUTHOR]

Background: Calls for the adoption of a systems approach to chronic disease prevention date back at least ten years because of the potential to empower communities to identify and address the complex causes of overnutrition, undernutrition and climate change. Australia, like many countries, has high levels of obesity and extreme climate events. The Reflexive Evidence and Systems interventions to Prevent Obesity and Non-communicable Disease (RESPOND) trial aims to prevent unhealthy weight gain in children in 10 intervention and two pilot communities in north-east Victoria, Australia using community-based participatory approaches informed by systems science. Intervention activities co-designed in 2019 were disrupted by COVID-19 and bushfires. This paper explores the impacts of these 'shocks' on the local prevention workforce to implement actions within communities. Methods: A case study design involving one-hour online focus groups and an on-line survey (November 2021-February 2022). Purposive sampling was used to achieve diverse representation from RESPOND stakeholders including local council, health services, primary care partnerships and department of health. The focus group interview schedule and survey questions were based on Durlak and DuPre's implementation factors. Results: Twenty-nine participants from seven different communities participated in at least one of nine focus groups to discuss the impacts of COVID-19 and bushfires on localised implementation. Twenty-eight participants (97% of focus group sample) also completed the on-line survey. Implementation of RESPOND stalled or stopped in most communities due to bushfires and/or COVID-19. These shocks resulted in organisational priorities changing, loss of momentum for implementation, redeployment of human resources, culminating in fatigue and exhaustion. Participants reported adaptation of RESPOND, but implementation was slowed due to limited resources. Conclusion: Further research is needed to advance risk management strategies and protect resources within health promotion. System shocks such as bushfires and COVID-19 are inevitable, and despite multiple adaptation opportunities, this intervention approach was not 'shock proof'. [ABSTRACT FROM AUTHOR]

Objective: To determine whether primary school children's weight status and dietary behaviours vary by remoteness as defined by the Australian Modified Monash Model (MMM). Design: A cross-sectional study design was used to conduct secondary analysis of baseline data from primary school students participating in a community-based childhood obesity trial. Logistic mixed models estimated associations between remoteness, measured weight status and self-reported dietary intake. Setting: Twelve regional and rural Local Government Areas in North-East Victoria, Australia. Participants: Data were collected from 2456 grade 4 (approximately 9–10 years) and grade 6 (approximately 11–12 years) students. Results: The final sample included students living in regional centres (17·4 %), large rural towns (25·6 %), medium rural towns (15·1 %) and small rural towns (41·9 %). Weight status did not vary by remoteness. Compared to children in regional centres, those in small rural towns were more likely to meet fruit consumption guidelines (OR: 1·75, 95 % CI (1·24, 2·47)) and had higher odds of consuming fewer takeaway meals (OR: 1·37, 95 % CI (1·08, 1·74)) and unhealthy snacks (OR = 1·58, 95 % CI (1·15, 2·16)). Conclusions: Living further from regional centres was associated with some healthier self-reported dietary behaviours. This study improves understanding of how dietary behaviours may differ across remoteness levels and highlights that public health initiatives may need to take into account heterogeneity across communities. [ABSTRACT FROM AUTHOR]

The current study aims investigate the relationship between participants' neighbourhood perceptions and social capital and resident well-being using data from the Neighbourhood Renewal Project (NRP; n = 7855). Resident well-being was positively associated with the quality of the physical environment and safety of the neighbourhood, but negatively associated with government trustworthiness and community connections. Life satisfaction had a positive relationship with community connections, resident well-being, as well as quality of community services and safety. We conclude that free or low-cost opportunities to engage and connect with neighbours through participation in activities such as sporting groups, volunteer organizations, and leisure/hobby groups may increase life satisfaction of individuals in a neighbourhood, particularly for those living in low socioeconomic or stigmatized areas. (Contains 5 tables.)

Summary: Obesity, undernutrition, and climate change constitute a global syndemic that disproportionately affects vulnerable populations, including children. Double‐ and triple‐duty actions that simultaneously address these pandemics are needed to prevent further health, economic, and environmental consequences. Evidence describing the implementation and evaluation of such actions is lacking. This review summarized the literature on whole‐of‐population actions targeting children that were designed or adapted to be double or triple duty. Six academic databases were searched (January 2015–March 2021) using terms related to 'children', 'intervention', 'nutrition', 'physical activity', and 'climate change'. Data were extracted from 43/15,475 studies, including six randomized controlled trials. Most (58%) described triple‐duty actions targeting food systems in schools such as implementing guidelines for healthier and environmentally sustainable school meals programs, and 51% reported engaging community in the design, implementation, and/or evaluation of actions. Changes in dietary intake, diet composition, greenhouse gas emissions, and food waste were the most frequently reported outcomes and 21 studies (three randomized controlled trials) showed positive double‐ or triple‐duty effects. This review is the first to demonstrate that double‐ and triple‐duty actions for addressing the global syndemic in childhood have been implemented and can have a positive impact on obesity, undernutrition, and climate change. [ABSTRACT FROM AUTHOR]

Background: Community-based interventions have shown promise in reducing childhood overweight and obesity. However, they have been critiqued for using linear logic models. Participatory community-based systems approaches are posited as addressing the complexity of non-linear relationships in a local context. Community members are empowered to understand and describe obesity causation, identify and prioritise possible solutions. The application of such approaches to childhood obesity is in its infancy. Aim: To describe the first 12 months of a participatory whole-of-community systems approach to creating collective action to tackle childhood obesity, called GenR8 Change, in a local government area of Victoria, Australia. Methods: Three group model building (GMB) sessions focused on the development of a causal loop diagram (CLD), prioritised evidence-informed actions, and developed implementation strategies. The collective impact framework underpinned the approach, with a local backbone group supporting community members to implement prioritised actions. Results: The first two GMB sessions included 20 key community leaders where a CLD examining the factors contributing to childhood obesity in the community was constructed and refined (22 variables GMB1, 53 variables GMB2). In the third session, 171 members of the wider community further refined the CLD, identified priorities for childhood obesity prevention (72 variables in final CLD). One-hundred and thirteen individuals signed up across 13 working groups to plan and implement 53 prioritised actions. Agreed community actions included creating sugar free zones; developing healthy policies; increasing breastfeeding rates; improving drinking water access; and increasing physical activity options. Twelve months post-GMB3, 115 actions had been implemented. Conclusion: GenR8 Change is one of the first communities to apply systems thinking to childhood obesity prevention. Knowledge on how to collectively identify relevant leverage points to tackle childhood obesity can now be shared with other communities. [ABSTRACT FROM AUTHOR]

Objective: 'Food deserts' and 'food swamps' are food retail environment typologies associated with unhealthy diet and obesity. The current study aimed to identify more complex food retail environment typologies and examine temporal trends. Design: Measures of food retail environment accessibility and relative healthy food availability were defined for small areas (SA2s) of Melbourne, Australia, from a census of food outlets operating in 2008, 2012, 2014 and 2016. SA2s were classified into typologies using a two-stage approach: (1) SA2s were sorted into twenty clusters according to accessibility and availability and (2) clusters were grouped using evidence-based thresholds. Setting: The current study was set in Melbourne, the capital city of the state of Victoria, Australia. Subjects: Food retail environments in 301 small areas (Statistical Area 2) located in Melbourne in 2008, 2012, 2014 and 2016. Results: Six typologies were identified based on access (low, moderate and high) and healthy food availability including one where zero food outlets were present. Over the study period, SA2s experienced an overall increase in accessibility and healthiness. Distribution of typologies varied by geographic location and area-level socio-economic position. Conclusion: Multiple typologies with contrasting access and healthiness measures exist within Melbourne and these continue to change over time, and the majority of SA2s were dominated by the presence of unhealthy relative to healthy outlets, with SA2s experiencing growth and disadvantage having the lowest access and to a greater proportion of unhealthy outlets. [ABSTRACT FROM AUTHOR]

Background: Approximately a quarter of Australian children are classified as overweight or obese. In high-income countries, childhood obesity follows a socio-economic gradient, with greater prevalence amongst the most socio-economically disadvantaged children. Community-based interventions (CBI), particularly those using a systems approach, have been shown to be effective on weight and weight-related behaviours. They are also thought to have an equitable impacts, however there is limited evidence of their effectiveness in achieving this goal.Methods: Secondary analysis was conducted on data collected from primary school children (aged 6-13 years) residing in ten communities (five intervention, five control) involved in the Whole of Systems Trial of Prevention Strategies for Childhood Obesity (WHO STOPS) cluster randomised trial in Victoria, Australia. Outcomes included Body Mass Index z-score (BMI-z) derived from measured height and weight, self-reported physical activity and dietary behaviours and health related quality of life (HRQoL). Repeat cross-sectional data from 2015 (n = 1790) and 2019 (n = 2137) were analysed, stratified by high or low socio-economic position (SEP). Multilevel linear models and generalised estimating equations were fitted to assess whether SEP modified the intervention effect on the outcomes.Results: There were no overall changes in BMI-z for either SEP strata. For behavioural outcomes, the intervention resulted in a 22.5% (95% CI 5.1, 39.9) point greater improvement in high-SEP compared to low-SEP intervention schools for meeting physical activity guidelines. There were also positive dietary intervention effects for high SEP students, reducing takeaway and packaged snack consumption, although there was no significant difference in effect between high and low SEP students. There were positive intervention effects for HRQoL, whereby scores declined in control communities with no change in intervention communities, and this did not differ by SEP.Conclusion: The WHO STOPS intervention had differential effects on several weight-related behaviours according to SEP, including physical activity. Similar impacts on HRQoL outcomes were found between high and low SEP groups. Importantly, the trial evaluation was not powered to detect subgroup differences. Future evaluations of CBIs should be designed with an equity lens, to understand if and how these types of interventions can benefit all community members, regardless of their social and economic resources. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to test the effectiveness of the Whole of Systems Trial of Prevention Strategies for Childhood Obesity (WHO STOPS Childhood Obesity) for behavioral, health-related quality of life (HRQoL), and BMI outcomes.Methods: This was a cluster randomized trial of 10 communities randomly allocated (1:1) to start intervention in 2015 (step 1) or in 2019 (after 4 years) in South West Victoria, Australia. Data were collected from participating primary schools in April to June of 2015 (73% school participation rate), 2017 (69%), and 2019 (63%). Student participation rates were 80% in 2015 (1,792/2,516 invited), 81% in 2017 (2,411/2,963), and 79% in 2019 (2,177/2,720). Repeat cross-sectional analyses of measured height and weight (grades two, four, and six [aged approximately 7 to 12 years]), self-reported behavior, and HRQoL (grades four and six) were conducted.Results: There was an intervention by time interaction in BMI z scores (P = 0.031) and obesity/overweight prevalence (P = 0.006). BMI z score and overweight/obesity prevalence decreased between 2015 and 2017 and increased between 2017 and 2019 in intervention communities. The intervention significantly reduced takeaway food consumption (P = 0.034) and improved physical (P = 0.019), psychosocial (P = 0.026), and global (P = 0.012) HRQoL. Water consumption increased among girls (P = 0.033) in the intervention communities, as did energy-dense, nutrient-poor snack consumption among boys (P = 0.006).Conclusions: WHO STOPS had a positive impact on takeaway food intake and HRQoL. [ABSTRACT FROM AUTHOR]

Abstract Background Evidence suggests that differences exist in physical activity (PA) participation among Culturally and Linguistically Diverse (CALD) children and adolescents. It is possible that these differences could be influenced by variations in measurement technique and instrument reliability. However, culturally sensitive instruments for examining PA behaviour among CALD populations are lacking. This study tested the reliability of the Child and Adolescent Physical Activity and Nutrition Survey (CAPANS-PA) recall questionnaire among a sample of Chinese-Australian youth. Methods The psychometric property of the CAPANS-PA questionnaire was examined among a sample of 77 Chinese-Australian youth (aged 11 - 14 y) who completed the questionnaire twice within 7 days. Test-retest reliability of individual items and scales within the CAPANS-PA questionnaire was determined using Kappa statistics for categorical variables and intraclass correlation coefficients (ICC) for continuous variables. Results The CAPANS-PA questionnaire demonstrated acceptable test-retest reliability for frequency and duration of time spent in weekly Moderate to Vigorous Physical Activity (MVPA) (ICC ≥ 0.70) for all participants. Test-retest reliability for time spent in weekly sedentary activities was acceptable for females (ICC = 0.82) and males (ICC = 0.72). Conclusions The results suggest the CAPANS-PA questionnaire provides reliable estimates for type, frequency and duration of MVPA participation among Chinese-Australian youth. Further investigation into the reliability of the sedentary items within the CAPANS-PA is required before these items can be used with confidence. This study is novel in that the reliability of instruments among CALD groups nationally and internationally remains sparse and this study contributes to the wider body of available psychometrically tested instruments. In addition, this study is the first to our knowledge to successfully engage and investigate the basic health enhancing behaviours of Chinese-Australian adolescents.

Objective: This study examined the prevalence and risk of overweight/obesity among expanded ethnicity categories within boys and girls in England and the differential influence of socioeconomic position using the 2015/2016 and the 2016/2017 cycles of the National Child Measurement Programme. Methods: This cross‐sectional and descriptive study examined surveillance data of weight status among primary school children in England. Data were pooled across data collection years, representing 1.25 million children in Reception (aged 4‐5 years) and 1.1 million children in Year 6 (aged 10‐11 years). Ethnicity was classified according to National Health Service definitions, and child residence was used to calculate quintiles of Income Deprivation Affecting Children Index. Measured weight status was classified using the International Obesity Task Force's definition. Logistic regression models were run for each sex and year group. Results: Within each sex, ethnicity‐ and socioeconomic‐specific differentials in overweight/obesity prevalence were evident. For example, among the five most populous ethnic groups in the most deprived quintile, 26.8% of White British girls in Reception had overweight/obesity compared with 20.7% of girls with Pakistani, 31.2% with Black African, 17.1% with Indian, and 22.2% with any Any Other White (e.g., White European) background. Conclusions: Ethnicity had an independent influence on overweight/obesity risk after adjustment for socioeconomic position. [ABSTRACT FROM AUTHOR]

Summary: The objectives were to systematically investigate the multiple dimensions of sleep and their association with overweight or obesity among primary school‐aged children. CINHAL, PsycINFO, SPORTDiscus, Medline, Cochrane, Embase, and PubMed databases were searched for papers reporting on an association between children's sleep and weight status. Studies on clinical populations, published in languages other than English, without objectively measured weight status, or where weight status was reported outside the outlined age bracket (5‐13 years) were excluded. A total of 34 248 citations were extracted from our systematic search protocol, of which 112 were included for detailed review. Compared with sleep duration, of which 86/103 articles found a significant inverse association between sleep duration and measured weight status, few studies examined other dimensions of sleep, such as quality, efficiency and bed/wake times, and relationship with weight status. Where studies existed, variation in defining and measurement of these dimensions restricted comparison and potentially influenced discrepancies across results. Overall, the findings of this review warrant the need for further research of the outlined dimensions of sleep. Future research would benefit from clarity on definitions across the different dimensions, along with the use of valid and reliable tools. [ABSTRACT FROM AUTHOR]

Summary: Physical inactivity is a major contributing factor to obesity, and both follow a socio‐economic gradient. This systematic review aims to identify whether the physical activity environment varies by socio‐economic position (SEP), which may contribute to socio‐economic patterning of physical activity behaviours, and in turn, obesity levels. Six databases were searched. Studies were included if they compared an objectively measured aspect of the physical activity environment between areas of differing SEP in a high‐income country. Two independent reviewers screened all papers. Results were classified according to the physical activity environment analysed: walkability/bikeability, green space, and recreational facilities. Fifty‐nine studies met the inclusion criteria. A greater number of positive compared with negative associations were found between SEP and green space, whereas there were marginally more negative than positive associations between SEP and walkability/bikeability and recreational facilities. A high number of mixed and null results were found across all categories. With a high number of mixed and null results, clear socio‐economic patterning in the presence of physical activity environments in high‐income countries was not evident in this systematic review. Heterogeneity across studies in the measures used for both SEP and physical activity environments may have contributed to this result. [ABSTRACT FROM AUTHOR]

Children's fundamental movement skill levels (FMS) predict moderate-to-vigorous physical activity (MVPA). Asian children have been reported as less active than English-Europeans, possibly due to poorer skills. This study compared the FMS of children from Culturally and Linguistically Diverse (CALD) backgrounds and examined FMS correlates. A total of 261 children (122 males) aged 9-to-11 years were divided based on language spoken at home: English-European (n = 105) and Asian (n = 156). Height, mass, FMS (Test of Gross Motor Development-2), MVPA (accelerometer) and cardio-respiratory fitness (20m multistage shuttle run) were directly measured. Sex, age, language and perceived sport competence (CY-PSPP) were self-reported. Independent sample t-tests assessed age, BMI, FMS and perception by CALD group. Linear mixed models examined FMS correlates. Asian-speaking children had lower object control skill (35.5 v 37.2; CI [0.17, 3.18]; p < 0.03) compared to English-European- children, but no between-group differences in locomotor skills were observed. Fitness, physical activity and sport competence perception were positively associated with object control, yet adjusting for these variables (and age and BMI) did not remove the CALD effect (B = −2.02, SE = 0.69, p = 0.004). Cultural factors may affect object control competence in Asian-Australian children. [ABSTRACT FROM AUTHOR]

Introduction. Few studies have quantified children's adherence to sustainable healthy diets, and none have explored whether adherence varies with child or maternal characteristics. Objectives. To describe adherence to sustainable healthy among a sample of 958 Chilean preschoolers (3-6 years) from the Food Environment Chilean Cohort (FECHiC) and explore associations between adherence and child and maternal sociodemographic and anthropometric characteristics. Methods. A single 24-hour multi-pass dietary recall, collected by trained dietitians in 2016, was used to describe FECHiC participants' adherence to the Planetary Health Diet Index for Children and Adolescents (PHDI-C). Adjusted linear models were fitted to explore associations in total and individual component scores with child and maternal characteristics. Results. This sample of Chilean children obtained low PHDI-C total scores (median 50.0 [IQR 39.5-59.8] out of 150 points). This was due to low reported consumption of nuts & peanuts, legumes, vegetables, whole cereals, and vegetable oils; a lack of balance between dark green and red & orange vegetables, inadequate (either low or excess) consumption of tubers & potatoes and eggs & white meats, and excess consumption of dairy products, palm oil, red meats, and added sugars. Mean PHDI-C total score was significantly higher (50.63 [95%CI 49.60, 51.66] vs 47.26 [95%CI 44.97, 49.54]) among children whose mothers were =25 years compared to those with younger mothers. We observed positive associations between scores for fruits and maternal education, vegetables, and maternal age, and added sugars and child weight status, and negative associations between scores for fruits and child age, and vegetable oils and maternal education. Scores for dairy products were lower among girls. Conclusions. Our findings support the need for strategies targeting the low consumption of nuts & peanuts, legumes, vegetables (particularly dark green vegetables), and whole cereals, and high consumption of dairy products, palm oil, red meats, and added sugars, particularly among children with younger mothers and mother with low levels of education. Tripleduty actions aimed at increasing access to and affordability of minimally processed foods and decreasing the availability of animal-source foods and ultra-processed products might contribute to achieving sustainable healthy diets among children. [ABSTRACT FROM AUTHOR]

Community-based obesity prevention efforts are dependent on the strength and function of collaborative networks across multiple community members and organizations. There is little empirical work on understanding how community network structure influences obesity prevention capacity. We describe network structures within 19 local government communities prior to a large-scale community-based obesity prevention intervention, Healthy Together Victoria, Australia (2012-2015). Participants were from a large, multi-site, cluster randomized trial (cRCT) of a whole-of-systems chronic disease prevention initiative. Community leaders from 12 intervention and seven comparison (non-intervention) regions identified and described their professional networks in relation to dietary, physical activity, and weight status among young children (<5 years of age). Social network measures of density, modularity, clustering, and centrality were calculated for each community. Comparison of means and tests of association were conducted for each network relationship. One-hundred and seven respondents (78 intervention; 29 comparison) reported on 996 professional network relationships (respondent average per region: 10 intervention; 8 comparison). Networks were typically sparse and highly modular. Networks were heterogeneous in size and relationship composition. Frequency of interaction, close and influential relationships were inversely associated with network density. At baseline in this cRCT there were no significant differences between community network structures of key actors with influence over environments affecting children's diet and physical activity. Tracking heterogeneity in both networks and measured outcomes over time may help explain the interaction between professional networks and intervention effectiveness of community-based obesity prevention. [ABSTRACT FROM AUTHOR]

Objective: Depression affects many Australian adolescents. Research points to the potential of lifestyle improvement for the population-level prevention of mental disorders. However, most studies examine single relationships without considering the combined contribution of lifestyle factors to variance in depression. This study examined associations between adolescent diet, physical activity and screen time behaviours and depressive symptomatology. Methods: A cross-sectional sample of year 8 and 10 students was recruited from 23 participating schools in 18 Victorian communities. Students were recruited using opt-out consent, resulting in 3295 participants from 4680 registered school enrolments (Participation Rate: 70.4%). Participants completed a supervised self-report questionnaire comprising Moods and Feelings Questionnaire–Short Form, an assessment of physical activity and sedentary behaviours during and outside school, and weekly food intake. Surveyed covariates included hours of sleep per night, age, socio-economic status and measured anthropometry. A hierarchical regression stratified by gender was conducted, with dichotomised Moods and Feelings Questionnaire–Short Form score as the outcome, and screen time, physical activity and dietary patterns as predictors. Nested regression analyses were then conducted to ascertain the variance in Moods and Feelings Questionnaire–Short Form score attributable to each significant predictor from the initial regression. Results: Increased scores on an unhealthy dietary pattern (odds ratio = 1.18; 95% confidence interval = [1.07, 1.32]) and physical activity guideline attainment (0.91; [0.85, 0.97]) were associated with depressive symptomatology in males, while screen time guideline attainment (0.95; [0.91, 0.98]) was associated with depression in females. No association was observed between healthy diet pattern and Moods and Feelings Questionnaire–Short Form. Overall, effect sizes were generally small, and the regression model accounted for 5.22% of Moods and Feelings Questionnaire–Short Form variance. Conclusion: Gender-specific associations were observed between physical activity and both sedentary and dietary behaviours and depressive symptomatology among adolescents, although reverse causality cannot be refuted at this stage. Lifestyle behaviours may represent a modifiable target for the prevention of depressive symptomatology in adolescents. [ABSTRACT FROM AUTHOR]

Background: Insufficient sleep is potentially an important modifiable risk factor for obesity and poor physical activity and sedentary behaviours among children. However, inconsistencies across studies highlight the need for more objective measures. This paper examines the relationship between sleep duration and objectively measured physical activity, sedentary time and weight status, among a sample of Victorian Primary School children.Methods: A sub-sample of 298 grades four (n = 157) and six (n = 132) Victorian primary school children (aged 9.2-13.2 years) with complete accelerometry and anthropometry data, from 39 schools, were taken from a pilot study of a larger state based cluster randomized control trial in 2013. Data comprised: researcher measured height and weight; accelerometry derived physical activity and sedentary time; and self-reported sleep duration and hypothesised confounding factors (e.g. age, gender and environmental factors).Results: Compared with sufficient sleepers (67 %), those with insufficient sleep (<10 hrs/day) were significantly more likely to be overweight (OR 1.97, 95 % CI:1.11-3.48) or obese (OR 2.43, 95 % CI:1.26-4.71). No association between sleep and objectively measured physical activity levels or sedentary time was found.Conclusion: The strong positive relationship between weight status and sleep deprivation merits further research though PA and sedentary time do not seem to be involved in the relationship. Strategies to improve sleep duration may help obesity prevention initiatives in the future. [ABSTRACT FROM AUTHOR]

Background: There is little empirical evidence of the impact of transition from primary to secondary school on obesity-related risk behaviour. The purpose of this study was to examine the effect of a change of school system on physical activity (PA) and sedentary behaviour in pre-early adolescents. Methods: Fifteen schools in Victoria, Australia were recruited at random from the bottom two strata of a five level socio-economic scale. In nine schools, students in year 6 primary school transitioned to a different school for year 7 secondary school, while in six schools (combined primary-secondary), students remained in the same school environment from year 6 to year 7. Time 1 (T1) measures were collected from students (N=245) in year 6 (age 11-13). Time 2 (T2) data were collected from 243 (99%) of the original student cohort when in year 7. PA and sedentary behaviour data were collected objectively (via ActiGraph accelerometer) and subjectively (via child self-report recall questionnaire). School environment data were collected via school staff survey. Change of behaviour analyses were conducted longitudinally i) for all students and ii) by change/no change of school. Mixed model regression analysis tested for behavioural interaction effects of changing/not changing school. Results: Sixty-three percent (N=152) changed schools from T1 to T2. Across all students we observed declines in average daily moderate to vigorous physical activity (MVPA) (-4 min) and light PA (-23 min), and increases in average daily sedentary behaviour (16 min), weekday leisure screen time (17 min) and weekday homework screen time (25 min), all P<0.05. Compared to students who remained in the same school environment, students who changed school reported a greater reduction in PA intensity at recess and lunch, less likelihood to cycle to/from school, greater increase in weekday (41 mins) and weekend (45 mins) leisure screen time (P<0.05) and greater encouragement to participate in sport. School staff surveys identified that sport participation encouragement was greater in primary and combined primary-secondary than secondary schools (P<0.05). Conclusion: Transitioning from primary to secondary school negatively impacts on children's PA and sedentary behaviour, and has further compounding effects on behaviour type by changing school environments. [ABSTRACT FROM AUTHOR]

Background To date, few questionnaires examining psychosocial influences of physical activity (PA) participation have been psychometrically tested among Culturally and Linguistically Diverse (CALD) youth. An understanding of these influences may help explain the observed differences in PA among CALD youth. Therefore, this study examined the reliability and predictive validity of a brief self-report questionnaire examining potential psychological and social correlates of physical activity among a sample of Chinese-Australian youth. Methods Two Chinese-weekend cultural schools from eastern metropolitan Melbourne consented to participate in this study. In total, 505 students aged 11to 16 years were eligible for inclusion in the present study, and of these, 106 students agreed to participate (21% response rate). Participants completed at 37-item self-report questionnaire examining perceived psychological and social influences on physical activity participation twice, with a test–retest interval of 7 days. Predictive validity, internal consistency and test–retest reliability were evaluated using exploratory factor analyses, Cronbach's α coefficient, and the intraclass correlation coefficient (ICC) respectively. Predictive validity was assessed by correlating responses against duration spent in self-reported moderate-to-vigorous physical activity (MVPA). Results The exploratory factor analysis revealed a nine factor structure, with the majority of factors exhibiting high internal consistency (α ≥ 0.6). In addition, four of the nine factors had an ICC ≥ 0.6. Spearman rank-order correlations coefficients between the nine factors and selfreported minutes spent in MVPA ranged from −0.5 to 0.3 for all participants. Conclusion This is the first study to examine the psychometric properties of a potential psychological and social correlates questionnaire among Chinese-Australian youth. The questionnaire was found to provide reliable estimates on a range of psychological and social influences on physical activity and evidence of predictive validity on a limited number of factors. More research is required to improve the reliability and validity of the questionnaire. [ABSTRACT FROM AUTHOR]