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BACKGROUND/AIM: Web 2.0 internet technology has great potential in promoting physical activity. This trial investigated the effectiveness of a Web 2.0-based intervention on physical activity behaviour, and the impact on website usage and engagement. METHODS: 504 (328 women, 126 men) insufficiently active adult participants were randomly allocated to one of two web-based interventions or a paper-based Logbook group. The Web 1.0 group participated in the existing 10 000 Steps programme, while the Web 2.0 group participated in a Web 2.0-enabled physical activity intervention including user-to-user interaction through social networking capabilities. ActiGraph GT3X activity monitors were used to assess physical activity at four points across the intervention (0, 3, 12 and 18 months), and usage and engagement were assessed continuously through website usage statistics. RESULTS: Treatment groups differed significantly in trajectories of minutes/day of physical activity (p=0.0198), through a greater change at 3 months for Web 2.0 than Web 1.0 (7.3 min/day, 95% CI 2.4 to 12.3). In the Web 2.0 group, physical activity increased at 3 (mean change 6.8 min/day, 95% CI 3.9 to 9.6) and 12 months (3.8 min/day, 95% CI 0.5 to 7.0), but not 18 months. The Logbook group also increased physical activity at 3 (4.8 min/day, 95% CI 1.8 to 7.7) and 12 months (4.9 min/day, 95% CI 0.7 to 9.1), but not 18 months. The Web 1.0 group increased physical activity at 12 months only (4.9 min/day, 95% CI 0.5 to 9.3). The Web 2.0 group demonstrated higher levels of website engagement (p=0.3964). CONCLUSIONS: In comparison to a Web 1.0 intervention, a more interactive Web 2.0 intervention, as well as the paper-based Logbook intervention, improved physical activity in the short term, but that effect reduced over time, despite higher levels of engagement of the Web 2.0 group. TRIAL REGISTRATION NUMBER: ACTRN12611000157976.

Sleep health is an important aspect of wellbeing and merits incorporation into workplace health promotion programs for employees. Men are a unique population with whom many traditional workplace health promotion programs have had limited success. This systematic review posed the question do workplace health promotion programs improve sleep among men, and what program design features contribute to improving sleep among working men? Databases searched were MEDLINE, EMBASE, the Cochrane Library, CINHAL, Academic Search Complete and Health Source: Nursing/Academic Edition and Google Scholar. Empirical research reporting non-pharmacological behavioral sleep programs and/or interventions for working men were eligible for review. 1049 articles were identified; 15 intervention studies were included: 13 interventions were delivered through workplaces, and two recruited workers to programs delivered outside of work. Interventions incorporated health education, stress reduction/relaxation, and/or physical activity components. Eleven studies reported positive findings for sleep health outcome(s) in men. A moderate level of evidence exists for sleep health programs with physical activity and stress management components. Evidence for the effectiveness of sleep health education programs was mixed. That only one study included a gender-sensitized intervention, where men's preferences shaped the content of a stress-reduction program which resulted in improved sleep quality, attests to the insufficient evidence and lack of gender-specific content and analyses. Next research steps should include considering cultural constructions of masculinity in program design in order to strengthen the appeal and engagement of men, and optimize health benefits for working men.

© 2019 Hughes et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Objective To assess the use of diet and the use of exercise for prostate cancer (and/or its treatments’ side effects) by long-term survivors and whether such use is associated with selected socio-demographic, clinical, health-related quality-of-life (HRQOL) and psychological factors. Design, setting and participants Population-based cohort study in New South Wales, Australia of prostate cancer survivors aged

Copyright © 2019 American College of Occupational and Environmental Medicine. Objective: This study examines the reach, effectiveness, adoption, implementation, and maintenance of the 10,000 Steps Pedometer Microgrant Scheme using the RE-AIM framework. Methods: The study used a mixed methods pre-post design. RE-AIM indicators were examined using employee surveys and workplace reports of microgrant implementation, adoption, and maintenance. Results: A total of 259 microgrants and 21,211 pedometers were awarded (reach). Significant increases in physical activity were observed (P

Men in high income countries have poorer dietary habits and higher rates of overweight and obesity than women. A major challenge with engaging men in health promotion is the perception that attention to one’s health runs counter to masculine identities. Contemporary health promotion programs are believed to hold little “manly” appeal and often fail to engage and retain men. The HAT TRICK program was designed to engage men with their health by delivering an intervention in collaboration with a semi-professional ice hockey team. The program included 12 weekly sessions promoting healthy eating, active living, and social connectedness among men. Gender-sensitized elements were reflected in the program design, setting, content, and delivery. Semistructured telephone interviews were conducted with 23 men to explore perspectives of their participation in the gender-sensitized intervention. Participants were white (100%) with a mean age of 53 years ( SD ± 9.9), Body Mass Index (BMI) of 37 kg/m2 ( SD ± 6.8), and waist circumference of 127 centimeters ( SD ± 14.5). Inductive thematic analysis revealed three overarching themes, including: (a) Harnessing nostalgia for past masculinities: “Closet athletes from 30 years ago,” (2) Offsetting resistance to change with sensible health advice: “Don’t give up drinking beer, just have less,” and (3) Gendered social spaces for doing health: “A night out with the guys,” The findings support the value of gender-sensitized approaches to men’s health promotion. Further research is needed to identify which gender-sensitized elements are critical to engaging men in healthy lifestyle changes.

© The Author(s) 2019. There is a need for tailored smoking cessation programs specifically for Indigenous fathers who want to quit smoking.The aim of this study was to engage Indigenous men and key informants in guiding cultural adaptations to the Dads in Gear (DIG) cessation program. In Phase 1 of this qualitative participatory study, Indigenous men were engaged in group sessions and key informants in semistructured interviews to gather advice related to cultural adaptations to the DIG program. These data were used to guide the development of program prototypes. In Phase 2, the prototypes were evaluated with Indigenous fathers who were using tobacco (smoking or chewing) or were ex-users. Data were analyzed inductively. Recommendations for programming included ways to incorporate cultural values and practices to advance men’s cultural knowledge and the need for a flexible program design to enhance feasibility and acceptability among diverse Indigenous groups. Men also emphasized the importance of positive message framing, building trust by providing “honest information,” and including activities that enabled discussions about their aspirations as fathers as well as cultural expectations of current-day Indigenous men. That the Indigenous men’s level of involvement with their children was diverse but generally less prescriptive than contemporary “involved fathering” discourse was also a key consideration in terms of program content. Strategies were afforded by these insights for meeting the men where they are in terms of their fathering—as well as their smoking and physical activity. This research provides a model for developing evidence-based, gender-specific health promotion programs with Indigenous men.

Objectives: The value of workplace wellness programmes (WWPs) has been established in the literature. Such programmes, however, have an increased likelihood for success when both management and non-management employees’ perspectives and needs are incorporated into development and implementation. This study aimed to identify the perspectives of each of these two employee groups as a means of informing the future development and implementation of WWPs. Methods: Nine focus groups ( N = 56) were held in western Canada with participants employed at four diverse organisations consisting of >100 employees. Each participating organisation provided two separate groups, consisting of one management group and one non-management group. Participants were asked to share their perceptions, attitudes and beliefs concerning WWPs. Thematic inductive analysis was conducted to elicit emergent areas of focus. Results: Three areas of focus were identified: (1) role of the company in WWPs, (2) elements of successful WWPs and (3) mandatory participation in WWPs. Providing a clear indication of the roles and responsibilities of both employee groups, making these initiatives part of the organisational strategic plan, demonstrating a long term commitment to such programmes, and having employees play participatory roles in the design, implementation and decision making process, are components that need consideration. Conclusion: Both employee groups agreed that their organisation played a role in employee health. Similarities and discrepancies of the beliefs between groups are highlighted and key considerations are presented. Findings have implications for the future development and implementation of WWPs.

Objective To describe in detail the recruitment methods and enrollment rates, the screening methods, and the baseline characteristics of a sample of adults participating in the Walk 2.0 Study, an 18 month, 3-arm randomized controlled trial of a Web 2.0 based physical activity intervention. Methods A two-fold recruitment plan was developed and implemented, including a direct mail-out to an extract from the Australian Electoral Commission electoral roll, and other supplementary methods including email and telephone. Physical activity screening involved two steps: a validated single-item self-report instrument and the follow-up Active Australia Questionnaire. Readiness for physical activity participation was also based on a two-step process of administering the Physical Activity Readiness Questionnaire and, where needed, further clearance from a medical practitioner. Results Across all recruitment methods, a total of 1244 participants expressed interest in participating, of which 656 were deemed eligible. Of these, 504 were later enrolled in the Walk 2.0 trial (77% enrollment rate) and randomized to the Walk 1.0 group (n = 165), the Walk 2.0 group (n = 168), or the Logbook group (n = 171). Mean age of the total sample was 50.8 years, with 65.2% female and 79.1% born in Australia. Conclusion The results of this recruitment process demonstrate the successful use of multiple strategies to obtain a diverse sample of adults eligible to take part in a web-based physical activity promotion intervention. The use of dual screening processes ensured safe participation in the intervention. This approach to recruitment and physical activity screening can be used as a model for further trials in this area.

© 2019 The Author(s). Background: This study aimed to investigate the validity of the Active Australia Survey across different subgroups and its responsiveness to change, as few previous studies have examined this. Methods: The Active Australia Survey was validated against the ActiGraph as an objective measure of physical activity. Participants (n = 465) wore the ActiGraph for 7 days and subsequently completed the Active Australia Survey. Moderate activity, vigorous activity and total moderate and vigorous physical activity were compared using Spearman rank-order correlations. Changes in physical activity between baseline and 3-month assessments were correlated to examine responsiveness to change. The data were stratified to assess outcomes according to different subgroups (e.g., gender, age, weight, activity levels). Results: With regards to the validity, a significant correlation of ρ = 0.19 was found for moderate physical activity, ρ = 0.33 for vigorous physical activity and ρ = 0.23 for moderate and vigorous physical activity combined. For vigorous physical activity correlations were higher than 0.3 for most subgroups, whereas they were only higher than 0.3 in those with a healthy weight for the other activity outcomes. With regards to responsiveness to change, a correlation of ρ = 0.32 was found for moderate physical activity, ρ = 0.19 for vigorous physical activity and ρ = 0.35 for moderate and vigorous physical activity combined. For moderate and vigorous activity combined correlations were higher than 0.4 for several subgroups, but never for vigorous physical activity. Conclusions: Little evidence for the validity of Active Australia Survey was found, although the responsiveness to change was acceptable for several subgroups. Findings from studies using the Active Australia Survey should be interpreted with caution. Trial registration: World Health Organisation Universal Trial Number: U111-1119-1755. Australian New Zealand Clinical Trials Registry, ACTRN12611000157976. Registration date: 8 March 2011.

Despite the positive health benefits of physical activity, physical inactivity remains highly prevalent.1 To address this public health issue, population-based interventions that can effectively reach large numbers of people at low cost are needed.2 Numerous randomised controlled trials (RCT) have examined the effectiveness of web-based physical activity interventions, and overall, these intervention studies have found to increase participants’ physical activity levels.3 Few studies, however, have examined how well these interventions work in ‘real world’ or ecologically valid settings, where there are no repeated contacts with research staff, comprehensive assessments or incentives.4 A recent systematic review examined mobile health (mHealth) clinical trial study methodology for trials conducted in 2014 and 2015 and did not identify a single ecological trial, yet RCTs were dominant (80%, 51/71).5 To address this, we conducted two studies using the same web-based physical activity interventions: a RCT and a randomised ecological trial (RET).6 7 For the RCT, 504 inactive participants were randomised into either a control group or intervention group using the existing Australian 10000 Steps website or a new website with social network features that included annotation, messaging and group-publishing, as well as ‘status updates’, inviting ‘friends’ and personalised profile pages (WALK 2.0).7 Outcomes (accelerometer-based activity monitoring, Active Australia Survey questionnaire,8 website usage) were assessed at 0, 3, 12 and 18 months. For the RET, 1328 adults spontaneously signing up for the free 10000 Steps website were randomised into either the 10000 Steps website or the WALK 2.0 website. …

The workplace health promotion program, POWERPLAY, was developed, implemented, and comprehensively evaluated among men working in four male-dominated worksites in northern British Columbia, Canada. The purpose of this study was to explore the POWERPLAY program’s acceptability and gather recommendations for program refinement. The mixed-method study included end-of-program survey data collected from 103 male POWERPLAY program participants, interviews with workplace leads, and field notes recorded during program implementation. Data analyses involved descriptive statistics for quantitative data and inductive analysis of open-ended questions and qualitative data. Among participants, 70 (69%) reported being satisfied with the program, 51 (51%) perceived the program to be tailored for northern men, 56 (62%) believed the handouts provided useful information, and 75 (74%) would recommend this program to other men. The findings also highlight program implementation experiences with respect to employee engagement, feedback, and recommendations for future delivery. The POWERPLAY program provides an acceptable approach for health promotion that can serve as a model for advancing men’s health in other contexts.

Background: The translation of Web-based physical activity intervention research into the real world is lacking and becoming increasingly important. Objective: To compare usage and effectiveness, in real-world settings, of a traditional Web 1.0 Web-based physical activity intervention, providing limited interactivity, to a Web 2.0 Web-based physical activity intervention that includes interactive features, such as social networking (ie, status updates, online “friends,” and personalized profile pages), blogs, and Google Maps mash-ups. Methods: Adults spontaneously signing up for the freely available 10,000 Steps website were randomized to the 10,000 Steps website (Web 1.0) or the newly developed WALK 2.0 website (Web 2.0). Physical activity (Active Australia Survey), quality of life (RAND 36), and body mass index (BMI) were assessed at baseline, 3 months, and 12 months. Website usage was measured continuously. Analyses of covariance were used to assess change over time in continuous outcome measures. Multiple imputation was used to deal with missing data. Results: A total of 1328 participants completed baseline assessments. Only 3-month outcomes (224 completers) were analyzed due to high attrition at 12 months (77 completers). Web 2.0 group participants increased physical activity by 92.8 minutes per week more than those in the Web 1.0 group (95% CI 28.8-156.8; P=.005); their BMI values also decreased more (–1.03 kg/m2, 95% CI –1.65 to -0.41; P=.001). For quality of life, only the physical functioning domain score significantly improved more in the Web 2.0 group (3.6, 95% CI 1.7-5.5; P

Background:Gender is a sociocultural factor known to impact the physical activity (PA) behaviors of South Asians. The purpose of this research was to examine gender-associated perceptions of barriers and motivators for PA in a South Asian population living Canada.Methods:A random sample (N = 204) of South Asian Punjabi adults (18yrs+) completed a computer assisted telephone interview concerning their perceptions to PA participation. Content analysis was used to identify relevant main themes and chi-square analysis was used to calculate gender differences.Results:Results indicated that women more often reported a lack of time due to work and family (χ2 = 7.284, df = 1, P = .007) and a lack of motivation (χ2 = 4.982, df = 1, P = .026), yet men more often reported climate (χ2 = 7.045, df = 1, P = .008) as a barrier. Regarding motivators, men more often reported prevention and reduction of disease (χ2 = 4.451, df = 1, P = .034) and watching others perform (χ2 = 10.827, df = 1, P = .001); however, reducing weight gain (χ2 = 4.806, df = 1, P = .028) and looking like others (χ2 = 4.730, df = 1, P = .029) were reported more often by women.Conclusions:Gender-associated differences concerning PA are present in this population and must be considered in the design and implementation of effective interventions.

Background: Interactive web-based physical activity interventions using Web 2.0 features (e.g., social networking) have the potential to improve engagement and effectiveness compared to static Web 1.0 interventions. However, older adults may engage with Web 2.0 interventions differently than younger adults. The aims of this study were to determine whether an interaction between intervention (Web 2.0 and Web 1.0) and age group (

IntroductionPhysical activity, healthy eating and maintaining a healthy weight are associated with reduced risk of cardiovascular disease, type 2 diabetes and cancer and with improved mental health. Despite these benefits, many men do not meet recommended physical activity guidelines and have poor eating behaviours. Many health promotion programmes hold little appeal to men and consequently fail to influence men’s health practices. HAT TRICK was designed as a 12-week face-to-face, gender-sensitised intervention for overweight and inactive men focusing on physical activity, healthy eating and social connectedness and was delivered in collaboration with a major junior Canadian ice hockey team (age range 16–20 years). The programme was implemented and evaluated to assess its feasibility. This article describes the intervention design and study protocol of HAT TRICK.Methods and analysisHAT TRICK participants (n=60) were men age 35 years, residing in the Okanagan Region of British Columbia, who accumulate 150 min of moderate to vigorous physical activity a week, with a body mass index of >25 kg/m2and a pant waist size of >38’. Each 90 min weekly session included targeted health education and theory-guided behavioural change techniques, as well as a progressive (ie, an increase in duration and intensity) group physical activity component. Outcome measures were collected at baseline, 12 weeks and 9 months and included the following: objectively measured anthropometrics, blood pressure, heart rate, physical activity and sedentary behaviour, as well as self-reported physical activity, sedentary behaviour, diet, smoking, alcohol consumption, sleep habits, risk of depression, health-related quality of life and social connectedness. Programme feasibility data (eg, recruitment, satisfaction, adherence, content delivery) were assessed at 12 weeks via interviews and self-report.Ethics and disseminationEthical approval was obtained from the University of British Columbia Okanagan Behavioural Research Ethics Board (reference no H1600736). Study findings will be disseminated through academic meetings, peer-reviewed publication, web-based podcasts, social media, plain language summaries and co-delivered community presentations.Trial registration numberISRCTN43361357,Pre results

While physical and mental health benefits of regular physical activity are well known, increasing evidence suggests that limiting sedentary behaviour is also important for health. Evidence shows associations of physical activity and sedentary behaviour with health-related quality of life (HRQoL), however, these findings are based predominantly on duration measures of physical activity and sedentary behaviour (e.g., minutes/week), with less attention on frequency measures (e.g., number of bouts). We examined the association of HRQoL with physical activity and sedentary behaviour, using both continuous duration (average daily minutes) and frequency (average daily bouts≥10 min) measures. Baseline data from the WALK 2.0 trial were analysed. WALK 2.0 is a randomised controlled trial investigating the effects of Web 2.0 applications on engagement, retention, and subsequent physical activity change. Daily physical activity and sedentary behaviour (duration = average minutes, frequency = average number of bouts ≥10 minutes) were measured (ActiGraph GT3X) across one week, and HRQoL was assessed with the 'general health' subscale of the RAND 36-Item Health Survey. Structural equation modelling was used to evaluate associations. Participants (N = 504) were 50.8±13.1 (mean±SD) years old with a BMI of 29.3±6.0. The 465 participants with valid accelerometer data engaged in an average of 24.0±18.3 minutes and 0.64±0.74 bouts of moderate-vigorous physical activity per day, 535.2±83.8 minutes and 17.0±3.4 bouts of sedentary behaviour per day, and reported moderate-high general HRQoL (64.5±20.0). After adjusting for covariates, the duration measures of physical activity (path correlation = 0.294, p

Background Evidence related to the effects of tobacco exposure in pregnancy and on infant and child health have focused on women's smoking cessation. Less often addressed is men's smoking, which when continued in fatherhood, reduces the chances of female partners' cessation and can negatively impact children's health as well as men's health. Dads in Gear (DIG) is an innovative program designed specifically for new fathers who want to reduce and quit smoking that includes three components: smoking cessation, fathering, and physical activity. The over-arching purpose of this study is to evaluate the feasibility of the DIG program and provide estimates of program efficacy. The purpose of this article is to describe the rationale and protocol for evaluating the DIG program's feasibility, acceptability and potential effectiveness. Methods Using a prospective, non-comparative design, the DIG program will be implemented and evaluated in six communities. The program will be offered by trained facilitators to fathers who currently smoke and want to quit. The RE-AIM framework will guide the evaluation. Open-ended questions in participant surveys, and semi-structured interviews and weekly telephone de-briefs with facilitators will provide data for a process evaluation. Estimates of effectiveness include smoking behavior, fathering and physical activity measures at baseline, end of program, and 3-month follow up. Conclusion The DIG program could support positive changes with respect to smoking cessation, physical activity and overall health for men. These effects could also promote family health. The program might also provide an effective model for engaging men in other health behavior change.

There is a pressing need for health promotion programs focused on increasing healthy eating and active living among “unreached” rural-based men. The purpose of the current study was to describe rural-based working men’s views about health to distil acceptable workplace approaches to promoting men’s healthy lifestyles. Two focus group interviews included 21 men who worked and lived in northern British Columbia, Canada. Interviews were approximately 2 hours in duration; data were analyzed using thematic analysis. Themes inductively derived included (a) food as quick filling fuels, (b) work strength and recreational exercise, and (c) (re)working masculine health norms. Participants positioned foods as quick filling fuels both at work and home as reflecting time constraints and the need to bolster energy levels. In the theme work strength and recreational exercise, men highlighted the physical labor demands pointing to the need to be resilient in overcoming the subarctic climate and/or work fatigue in order to fit in exercise. In the context of workplace health promotion programs for men, participants advised how clear messaging and linkages between health and work performance and productivity and cultivating friendly competition among male employees were central to reworking, as well as working, with established masculine health norms. Overall, the study findings indicate that the workplace can be an important means to reaching men in rural communities and promoting healthy eating and active living. That said, the development of workplace programs should be guided by strength-based masculine virtues and values that proactively embrace work and family life.

OBJECTIVES: To assess the effects of a 12-week pedometer-based intervention on the physical activity behavior, health-related quality of life (HRQOL), and psychological well-being of first-year university students. PARTICIPANTS: First-year university students (N = 184) were recruited during September 2012 and randomly assigned to an intervention or a control group. METHODS: Intervention participants were provided with a pedometer, monthly tracking logs, and follow-up e-mails. Control participants received no intervention. Physical activity, HRQOL, and psychological well-being were measured at baseline and post intervention. Data were analyzed using multivariate/univariate analysis of variance (MANOVA/ANOVA). RESULTS: All participants experienced an increase in mild physical activity (p < .01) from baseline to follow-up. The intervention failed to produce significant differences between groups for physical activity (p = .28), HRQOL (p = .80), or psychological well-being (p = .72). Psychological well-being (p < .001), vigorous physical activity (p = .04), and mental health status (p < .001) decreased across the duration of the study. CONCLUSIONS: More intensive interventions may be required to elicit physical activity behavior change.

Physical activity is an effective primary or adjunctive treatment to reduce depressive symptoms. Computer-tailored and interactive web-based physical activity interventions are potentially effective and accessible means for promoting physical activity, but little evidence exists regarding their efficacy in reducing depressive symptoms. We conducted a 2-arm randomised trial to compare the efficacy of these web-based interventions for increasing physical activity and reducing depressive symptoms. Participants (18 years or older and had no health condition limiting physical activity) were randomised to have access to a web-based physical activity intervention program with either computer-tailored advice (MyPAA) or interactive features (Walk 2.0). Only half of participants accessed the website at least once (MyPAA: allocated n = 252, accessed program n = 154, 61.1%; Walk 2.0: allocated n = 262, accessed program n = 120, 45.8%). Participants and the research team were blinded to group assignment. There were no significant between-group differences in change of self-reported physical activity or depressive symptoms. Physical activity significantly increased from baseline to one month (g = 0.21) and three months (g = 0.20), and depressive symptoms significantly decreased from baseline to one month (g = 0.36) and three months (g = 0.42). People who visited the website more and for longer had larger changes in physical activity and depressive symptoms than those who visited less. Web-based interventions with computer-tailoring and interactive features show promise as a method for increasing physical activity and reducing depressive symptoms, particularly for those who engage with the program. Trial registration Australian New Zealand Clinical Trials Registry ACTRN12613001215718.

Within a health context, men in Western societies are a hard-to-reach population who experience higher rates of chronic disease compared with women. Innovative technology-based interventions that specifically target men are needed; however, little is known about how these should be developed for this group. This study aimed to examine opinions and perceptions regarding the use of Internet and mobile phones to improve physical activity and nutrition behaviors for middle-aged men. The authors conducted 6 focus groups (n = 30) in Queensland, Australia. Their analyses identified 6 themes: (a) Internet experience, (b) website characteristics, (c) Web 2.0 applications, (d) website features, (e) self-monitoring, and (f) mobile phones as delivery method. The outcomes indicate that men support the use of the Internet to improve and self-monitor physical activity and dietary behaviors on the condition that the website-delivered interventions are quick and easy to use, because commitment levels to engage in online tasks are low. Participants also indicated that they were reluctant to use normal mobile phones to change health behaviors, although smartphones were perceived to be more acceptable. This pilot study suggests that there are viable avenues to engage middle-aged men in Internet- or in mobile-delivered health interventions. This study also suggests that to be successful, these interventions need to be tailor-made especially for men, with an emphasis on usability and convenience. A wider quantitative study would bring further support to these findings.

INTRODUCTION: Physical activity is a cost-effective and non-pharmaceutical strategy that can help mitigate the physical and psychological health challenges associated with breast cancer survivorship. However, up to 70% of women breast cancer survivors are not meeting minimum recommended physical activity guidelines. Project MOVE is an innovative approach to increase physical activity among breast cancer survivors through the use of Action Grants, a combination of microgrants (small amounts of money awarded to groups of individuals to support a physical activity initiative) and financial incentives. The purpose of this paper is to describe the rationale and protocol of Project MOVE. METHOD AND ANALYSIS: A quasi-experimental pre-post design will be used. Twelve groups of 8-12 adult women who are breast cancer survivors (N=132) were recruited for the study via face-to-face meetings with breast cancer-related stakeholders, local print and radio media, social media, and pamphlets and posters at community organisations and medical clinics. Each group submitted a microgrant application outlining their proposed physical activity initiative. Successful applicants were determined by a grant review panel and informed of a financial incentive on meeting their physical activity goals. An evaluation of feasibility will be guided by the reach, effectiveness, adoption, implementation, maintenance (RE-AIM) framework and assessed through focus groups, interviews and project-related reports. Physical activity will be assessed through accelerometry and by self-report. Quality of life, motivation to exercise and social connection will also be assessed through self-report. Assessments will occur at baseline, 6 months and 1 year. ETHICS AND DISSEMINATION: Ethical approval was obtained from the University of British Columbia's Behavioural Research Ethics Board (#H14-02502) and has been funded by the Canadian Cancer Society Research Institute (project number #702913). Study findings will be disseminated widely through peer-reviewed publications, academic conferences, local community-based presentations, as well as partner organisations, including the Canadian Cancer Society.

Translating evidence-based interventions into community practice is vital to health promotion. This study used the RE-AIM framework to evaluate the larger dissemination of the ManUp intervention, an intervention which utilized interactive web-based technologies to improve the physical activity and nutrition behaviors of residents in Central Queensland, Australia. Data were collected for each RE-AIM measure (Reach, Effectiveness, Adoption, Implementation, Maintenance) using (i) computer-assisted telephone interview survey (N = 312) with adults (18 years and over) from Central Queensland, (ii) interviews with key stakeholders from local organizations (n = 12) and (iii) examination of project-related statistics and findings. In terms of Reach, 47% of participants were aware of the intervention; Effectiveness, there were no significant differences between physical activity and healthy nutrition levels in those aware and unaware; Adoption, 73 participants registered for the intervention and 25% of organizations adopted some part of the intervention; Implementation, 26% of participants initially logged onto the website, 29 and 17% started the web-based physical activity and nutrition challenges, 33% of organizations implemented the intervention, 42% considered implementation and 25% reported difficulties; Maintenance, an average of 0.57 logins and 1.35 entries per week during the 12 week dissemination and 0.27 logins and 0.63 entries per week during the 9-month follow-up were achieved, 22 and 0% of participants completed the web-based physical activity and nutrition challenges and 33.3% of organizations intended to continue utilizing components of the intervention. While this intervention demonstrated good reach, effectiveness, adoption and implementation warrant further investigation.

Background: Men continue to smoke cigarettes in greater numbers than women. There is growing evidence for the value of developing targeted, men-centered health promotion programs. However, few smoking cessation interventions have been designed for men. A gender-specific website, QuitNow Men, was developed based on focus group interview findings, stakeholder feedback, and evidence-based cessation strategies. The website was designed to incorporate a masculine look and feel through the use of images, direct language, and interactive content. Usability experts and end-users provided feedback on navigation and functionality of the website prior to pilot testing. Objectives: The objectives of the pilot study were to describe (1) men’s use and evaluations of the interactive resources and information on the QuitNow Men website, and (2) the potential of QuitNow Men to engage men in reducing and quitting smoking. Methods: A one-group, pretest-posttest study design was used. Men who were interested in quitting were recruited and invited to use the website over a 6-month period. Data were collected via online questionnaires at baseline, 3-month, and 6-month follow-up. A total of 117 men completed the baseline survey. Over half of those (67/117, 57.3%) completed both follow-up surveys. Results: At baseline, participants (N=117) had been smoking for an average of 24 years (SD 12.1) and smoked on average 15 cigarettes a day (SD 7.4). The majority had not previously used a quit smoking website (103/117, 88.0%) or websites focused on men’s health (105/117, 89.7%). At the 6-month follow-up, the majority of men used the QuitNow Men website at least once (64/67, 96%). Among the 64 users, 29 (43%) reported using the website more than 6 times. The men using QuitNow Men agreed or strongly agreed that the website was easy to use (51/64, 80%), the design and images were appealing (42/64, 66%), they intended to continue to use the website (42/64, 66%), and that they would recommend QuitNow Men to others who wanted to quit (46/64, 72%). Participants reported using an average of 8.76 (SD 4.08) of the 15 resources available on the website. At 6-month follow-up, 16 of the 67 participants (24%) had quit, 27 (40%) had reduced their smoking and 24 (36%) had not changed their smoking habits. Repeated measures general linear model showed a significant decrease in the number of cigarettes smoked between the 3-month and 6-month follow-up ( F 1,63 =6.41, P =.01, eta squared=0.09). Number of resources used on the website, quit confidence, nicotine dependence and age significantly predicted number of quit attempts by those still smoking at 6 months ( F 4,45 =2.73, P =.04), with number of resources used being the strongest predictor ( P =.02). Conclusions: The results of this research support efforts to integrate gender-sensitive approaches in smoking cessation interventions and indicate that this novel Web-based resource has potential in supporting men’s smoking cessation efforts. [J Med Internet Res 2016;18(4):e83]

Screening physical activity levels is common in trials to increase physical activity in inactive populations. Commonly applied single-item screening tools might not always be effective in identifying those who are inactive. We applied the more extensive Active Australia Survey to identify inactive people among those who had initially been misclassified as too active using a single-item measure. Those enrolled after the Active Australia Survey screening had significantly higher physical activity levels at subsequent baseline assessment. Thus, more extensive screening measures might result in the inclusion of participants who would otherwise be excluded, possibly introducing unwanted bias. Trial registration Australian New Zealand Clinical Trials Registry, ACTRN12611000157976.

Regular monitoring of population levels of physical activity is an effective way to assess change over time towards meeting public health recommendations. The objective of this study was to determine physical activity trends in Central Queensland over the period 2002 to 2008.Data was obtained from the Central Queensland Social Survey (CQSS) conducted annually from 2002 to 2008. A total sample of 8,936 adults aged 18 and over participated in seven cross-sectional surveys. Physical activity was measured using the Active Australia Questionnaire. Binary logistic regression was used to examine trends in sufficient physical activity.Averaged over all survey years 46.5% of study participants met national physical activity guidelines. A small significant upward trend was found for meeting physical activity recommendations across all years (OR=1.03; 95%CI=1.01-1.05), indicating that the odds of meeting the guidelines increased by an average of 3% per year from 2002 to 2008. Slightly more men than women met the activity guidelines (ns); however a significant positive trend in achieving sufficient activity levels was present in women only (4%).Although an increasing trend for sufficient physical activity was observed, overall physical activity levels in Central Queensland remain suboptimal and more efforts to increase physical activity are needed. The gender differences in physical activity trends indicate that men and women might need to be targeted differently in health promotion messages. The continuous monitoring of population levels of physical activity in Australia, which allow both state specific and international comparisons, is needed.

Objective: The RE-AIM framework has been recognized as a tool to evaluate the adoption, delivery, and sustainability of an intervention, and estimate its potential public health impact. In this study four dimensions of the RE-AIM framework (adoption, implementation, effectiveness, and maintenance) were used to evaluate the WellingTONNE Challenge Toolkit, a step-by-step resource explaining how to develop, implement and disseminate a healthy lifestyle community intervention. Design: Process evaluation. Methods: In association with the Commonwealth Department of Health and Ageing (DHA), a self-report questionnaire was distributed to individuals from health care organizations, local councils and community organizations throughout Australia who had received and/or requested the WellingTONNE Challenge Toolkit from the DHA. Results: The RE-AIM dimensions revealed a high adoption rate and confirmed that the toolkit was being implemented for what it was intended to be implemented for and was an effective resource for initiating, maintaining and encouraging a healthy lifestyle. Lastly, the evaluation highlighted that most participants would maintain use of the toolkit in future projects. Conclusion: The RE-AIM framework provided valuable information concerning the uptake, implementation and usability of the WellingTONNE Challenge Toolkit, however, future research should address the behavioural outcomes associated with using the toolkit in order to provide a clearer understanding of how research can be translated into public health practice.

This study examines how physical activity and perceptions of the built environment differ by degree of urbanisation in Queensland, Australia. A statewide sample of adults (n=1208) completed a CATI survey assessing physical activity and perceptions of the environment in July–August 2005. Results indicate that residents in metropolitan areas were more likely to report the presence of shops and services, footpaths, heavy traffic and physical activity facilities than non-metropolitan residents. Although geographic location was not associated with achievement of sufficient levels of physical activity or walking, a notable interaction in the associations between both physical activity measures and the presence of footpaths in metropolitan and non-metropolitan areas was observed. This finding suggests the presence of a differential mechanism in terms of the relationships between physical activity and environmental supports by geographical location. Such effects require future investigation in terms of replication and understanding.

The Women’s Active Living Kits (WALK) Community Grant Scheme was a key component of a federally funded Australian initiative aimed at increasing local capacity to promote and engage priority women’s groups in health-related physical activity. Under the program, community groups and organizations were provided with the opportunity to apply and receive small grants to support the development of women’s walking groups with the aim of increasing physical activity participation levels in women, supporting innovative community ideas for increasing women’s physical activity by improving social structures and environments, or both. This article describes the development and administration of the WALK Community Grant Scheme, outlines challenges and barriers encountered throughout the grant program process, and provides practical insights for replicating this initiative.

A close examination of epidemiological data reveals burdens of disease particular to culturally and linguistically diverse (CALD) migrants, as these individuals adjust to both culture and modernization gaps. Despite the increased risk of hypertension, diabetes mellitus, overweight/obesity and cardiovascular disease, individuals from CALD groups are less likely to be proactive in accessing healthcare or undertaking preventative measures to ensure optimal health outcomes. The purpose of this paper is to review literature that outlines the barriers, challenges and enablers of physical activity in CALD groups who have recently migrated to Western society, and to identify key strategies to increase physical activity participation for these individuals. Electronic and manual literature searches were used to identify 57 publications that met the inclusion criteria. Findings from the review indicate that migration to Western societies has a detrimental effect on the health status and health behaviours of CALD groups as they assimilate to their new surroundings, explore different cultures and customs, and embrace a new way of life. In particular, there is evidence that physical inactivity is common in migrant CALD groups, and is a key contributing risk factor to chronic disease for these individuals. Challenges and barriers that limit physical activity participation in CALD groups include: cultural and religious beliefs, issues with social relationships, socioeconomic challenges, environmental barriers, and perceptions of health and injury. Strategies that may assist with overcoming these challenges and barriers consist of the need for cultural sensitivity, the provision of education sessions addressing health behaviours, encouraging participation of individuals from the same culture, exploration of employment situational variables, and the implementation of 'Health Action Zones' in CALD communities. This information will inform and support the development of culturally appropriate programmes designed to positively influence the physical activity behaviours of individuals from CALD populations.

Many health promotion programs hold little “manly” appeal and as a consequence fail to influence men's self-health practices. That said, the workplace can provide an important delivery point for targeted health promotion programs by supporting positive aspects of masculinity. The purpose of this article is to, a) describe the intervention design and study protocol examining the feasibility of a gender-sensitive workplace health promotion intervention focusing on physical activity and healthy eating in male-dominated rural and remote worksites, and b) report baseline findings. This study is a non-randomized quasi-experimental intervention trial examining feasibility and acceptability, and estimated intervention effectiveness. The POWERPLAY program was developed through consultations with men and key workplace personnel, and by drawing on a growing body of men's health promotion research. The program includes masculine print-based messaging, face-to-face education sessions, friendly competition, and self-monitoring concerning physical activity and healthy eating. Male participants (N=139) were recruited from four worksites in northern British Columbia, Canada. Baseline data were collected via computer assisted telephone interview (CATI) survey which assessed physical activity, dietary behavior and workplace environment. This protocol will also be used to collect follow-up data at 6months. A process evaluation, using semi-structured interviews, will be undertaken to assess feasibility and acceptability among participants and worksites. Study outcomes will guide intervention refinement and further testing in a sufficiently powered randomized control trial.

The marked disparity in life expectancy between men and women suggests men are a vulnerable group requiring targeted health promotion programs. As such, there is an increasing need for health promotion strategies that effectively engage men with their health and/or illness management. Programs that promote physical activity could significantly improve the health of men. Although George et al. (Sports Med 42(3):281, 30) reviewed physical activity programs involving adult males published between 1990 and 2010, developments in men’s health have prompted the emergence of new sex- and gender-specific approaches targeting men. The purpose of this review was to: (1) extend and update the review undertaken by George et al. (Sports Med 42(3):281, 30) concerning the effectiveness of physical activity programs in males, and (2) evaluate the integration of gender-specific influences in the content, design, and delivery of men’s health promotion programs. A search of MEDLINE, CINAHL, ScienceDirect, Web of Science, PsycINFO, the Cochrane Library, and the SPORTDiscus databases for articles published between January 2010 and August 2014 was conducted. In total, 35 studies, involving evaluations of 31 programs, were identified. Findings revealed that a variety of techniques and modes of delivery could effectively promote physical activity among men. Though the majority of programs were offered exclusively to men, 12 programs explicitly integrated gender-related influences in male-specific programs in ways that recognized men’s interests and preferences. Innovations in male-only programs that focus on masculine ideals and gender influences to engage men in increasing their physical activity hold potential for informing strategies to promote other areas of men’s health.

This study contrasted the effects of an enhanced group intervention program against a standard group intervention, with specific reference to the influences of group cohesion on changes in health-related physical activity of older adults. Older adults (N = 122) took part in a 12-week intervention with repeated post-intervention follow-up (6 & 12 months) assessing physical activity behaviour and perceptions of group cohesion. Results indicated significant positive change (p< 0.05) across time, but a non-significant difference between groups, for physical activity behaviour. For group cohesion, results indicated a significant negative (p< 0.05) change across time and similar to physical activity behaviour, a nonsignificant difference between the intervention groups. Further research is needed to understand the mechanism that fosters group cohesion in order to develop future interventions aimed at increasing physical activity behaviour and adherence in older adults.

Loneliness can be defined as perceived social isolation and appears to be a relatively common experience in adults. It carries a significant health risk and has been associated with heart disease, depression and poor recovery after coronary heart surgery. The mechanisms that link loneliness and morbidity are unclear but one of the mechanisms may be through poor health beliefs and behaviours. The aims of this cross-sectional survey of 1289 adults were to investigate differences in health behaviours (smoking, overweight, BMI, sedentary, attitudes towards physical activity) in lonely and non-lonely groups. Lonely individuals were more likely to be smokers and more likely to be overweight - obese. The lonely group had higher body mass index scores controlling for age, annual income, gender, employment and marital status. Logistic regression revealed no differences in sedentary lifestyles. Lonely individuals were significantly less likely to believe it was desirable for them to lose weight by walking for recreation, leisure or transportation. The findings provide support for an association between health behaviours, loneliness and excess morbidity reported in previous studies.

IntroductionLow levels of health-enhancing physical activity require novel approaches that have the potential to reach broad populations. Web-based interventions are a popular approach for behaviour change given their wide reach and accessibility. However, challenges with participant engagement and retention reduce the long-term maintenance of behaviour change. Web 2.0 features present a new and innovative online environment supporting greater interactivity, with the potential to increase engagement and retention. In order to understand the applicability of these innovative interventions for the broader population, ‘real-world’ interventions implemented under ‘everyday conditions’ are required. The aim of this study is to investigate the difference in physical activity behaviour between individuals using a traditional Web 1.0 website with those using a novel Web 2.0 website.Methods and analysisIn this study we will aim to recruit 2894 participants. Participants will be recruited from individuals who register with a pre-existing health promotion website that currently provides Web 1.0 features (http://www.10000steps.org.au). Eligible participants who provide informed consent will be randomly assigned to one of the two trial conditions: the pre-existing 10 000 Steps website (with Web 1.0 features) or the newly developed WALK 2.0 website (with Web 2.0 features). Primary and secondary outcome measures will be assessed by self-report at baseline, 3 months and 12 months, and include: physical activity behaviour, height and weight, Internet self-efficacy, website usability, website usage and quality of life.Ethics and disseminationThis study has received ethics approval from the University of Western Sydney Human Research Ethics Committee (Reference Number H8767) and has been funded by the National Health and Medical Research Council (Reference Number 589903). Study findings will be disseminated widely through peer-reviewed publications, academic conferences and local community-based presentations.Trial registration numberAustralian New Zealand Clinical Trials Registry Number: ACTRN12611000253909, WHO Universal Trial Number: U111-1119-1755

The inter-connections between educational, family and social spheres of life are integral to the experiences and outcomes of mature student participation in education. This relationship highlights the need to understand the educational experience in the context of the life of the mature student. Mature nursing students have been shown to experience many difficulties during their course. These problems include childcare, relationship and financial difficulties. What is not well documented are the problems and coping strategies of future nursing students who are undertaking Access to Nursing courses and whether these mirror those found in mature nursing students. This small scale exploratory study investigated the course-related problems and coping strategies of mature students undertaking an access to nursing in a Further Education College. This study is one part of a larger programme of research investigating mature students in nursing. In-depth interviews were conducted on mature students and data were analysed using content analysis methods. Content analysis revealed particular concerns regarding the obstacles faced by mature nursing students. In particular the findings suggested that financial difficulties and re-entry into tertiary education were the prominent concerns for these individuals. The coping mechanisms identified to overcome these problems included; support networks, prioritizing and organising, and positive expectations and attitudes for the future. Understanding how students cope with their difficulties will provide the building block for future intervention strategies designed to minimise problems and increase retention rates. Further longitudinal research is required on the long term and cumulative nature of stress and coping in this group from access to post-qualification.

Objective: The purpose of this study was to examine the dose-response relationship between physical activity and mental health, comparing two recommended levels of physical activity involvement. The two current physical activity recommendations used to study the dose-response relationships in a sample of older adults were 150 minutes per week and 420 minutes per week. Method: Data were collected on a sample (n=337) of independent living older adults ranging from 55 to 89 years of age (mean age 65.2 years) using a computer-assisted telephone interview (CATI) survey. Activity status was assessed using the Active Australia questionnaire, whereas health status was assessed using the SF-12 health survey questionnaire. Results: Participants classed as moderately active (150–420 minutes per week) and highly active (>420 minutes per week) displayed significantly higher mental health status than those who were classified as inactive (>150 minutes per week) when controlling for physical health status. Further analysis failed to reveal any significant difference in mental health status between moderately and highly active participants. Conclusion: When controlling for the variability in mental health status relating to physical health, individuals meeting current guidelines of 150 minutes of physical activity per week displayed higher mental health than those who did not. Increased levels of activity showed no reliable increase in health status. Implications: The benefits of moderate levels of physical activity were supported for older adults. In terms of mental health, recent recommendations for increased amounts of daily activity were not supported.

This paper presents a new visual analytics framework for analyzing health-related physical activity data. Existing techniques mostly rely on node-links visualizations to represent the usage patterns as social networks. This work takes a different approach that provides interactive scatter-plot visualizations on classified and time-based data. By providing a flexible visualization that can provide different angles on the multidimensional and classified data, the analyst could have better understanding and insight on web user behavior compared to the traditional social network methods. The effectiveness of our method has been demonstrated with a case study on an online portal system for tracking passive physical activity, called Walk 2.0.

Background Males experience a shorter life expectancy and higher rates of chronic diseases compared to their female counterparts. To improve health outcomes among males, interventions specifically developed for males that target their health behaviors are needed. Information technology (IT)-based interventions may be a promising intervention approach in this population group, however, little is known about how to maximize engagement and retention in Web-based programs. Objective The current study sought to explore attributes hypothesized to influence user engagement among a subsample of participants from the ManUp study, a randomized controlled trial testing the efficacy of an interactive Web-based intervention for promoting physical activity and nutrition among middle-aged males. Methods Semistructured interviews were conducted and audiotaped with 20 of the ManUp participants. Interview questions were based on a conceptual model of engagement and centered on why participants took part in the study, what they liked and did not like about the intervention they received, and how they think the intervention could be improved. Interview recordings were transcribed and coded into themes. Results There were five themes that were identified in the study. These themes were: (1) users’ motives, (2) users’ desired outcomes, (3) users’ positive experiences, (4) users’ negative emotions, and (5) attributes desired by user. Conclusions There is little research in the field that has explored user experiences in human-computer interactions and how such experiences may relate to engagement, especially among males. Although not conclusive, the current study provides some insight into what personal attributes of middle-aged males (such as their key motives and goals for participating) and attributes of the intervention materials (such as usability, control, and interactivity) may impact on user engagement in this group. These findings will be helpful for informing the design and implementation of future health behavior interventions for males. Trial Registration Australian New Zealand Clinical Trials Registry: ACTRN12611000081910; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?ACTRN=12611000081910 (Archived by WebCite at http://www.webcitation.org/6M4lBlvCA).

Part I: The Connection Between Nutrition and Health Chapter 1: Nutrigenetics and Metabolic Disease: Current Status and Implications for Personalised Nutrition Catherine M. Phillips Chapter 2: A Review of the Nature and Effectiveness of Nutrition Interventions in Adult Males: A Guide for Intervention Strategies Pennie J. Taylor, Gregory S. Kolt, Corneel Vandelanotte, Cristina M. Caperchione, W. Kerry Mummery, Emma S. George, Mohanraj Karunanithi, and Manny J. Noakes Chapter 3: Nutrient Timing Revisited: Is There a Post-Exercise Anabolic Window? Alan Albert Aragon and Brad Jon Schoenfeld Chapter 4: Nutritional Therapies for Mental Disorders Shaheen E. Lakhan and Karen F. Vieira Chapter 5: Fructose Metabolism in Humans: What Isotopic Tracer Studies Tell Us Sam Z. Sun and Mark W. Empie Chapter 6: Vitamin C in Human Health and Disease is Still a Mystery? An Overview K. Akhilender Naidu Chapter 7: Daily Egg Consumption in Hyperlipidemic Adults: Effects on Endothelial Function and Cardiovascular Risk Valentine Njike, Zubaida Faridi, Suparna Dutta, Anjelica L. Gonzalez-Simon and David L. Katz Chapter 8: Protein-Enriched Meal Replacements do not Adversely Affect Liver, Kidney or Bone Density: An Outpatient Randomized Controlled Trial Zhaoping Li, Leo Treyzon, Steve Chen, Eric Yan, Gail Thames, and Catherine L. Carpenter Chapter 9: Functional Food and Organic Food are Competing Rather than Supporting Concepts in Europe Johannes Kahl, Aneta Zalecka, Angelika Ploeger, Susanne Bugel, and Machteld Huber Part II: Functional Foods: The Connection Between Health and Food Science Chapter 10: Exercise and Functional Foods Wataru Aoi, Yuji Naito, and Toshikazu Yoshikawa Chapter 11: Effects of Micronutrient Fortified Milk and Cereal Food for Infants and Children: A Systematic Review Klaus Eichler, Simon Wieser, Isabelle Ruthemann, and Urs Brugger Chapter 12: Effect of Mineral-Enriched Diet and Medicinal Herbs on Fe, Mn, Zn, And Cu Uptake in Chicken Ducu Sandu Stef and Iosif Gergen Chapter 13: Consuming Iodine Enriched Eggs to Solve the Iodine Deficiency Endemic for Remote Areas in Thailand Wiyada Charoensiriwatana, Pongsant Srijantr, Punthip Teeyapant, and Jintana Wongvilairattana Chapter 14: Cinnamon Extract Inhibits alpha-Glucosidase Activity and Dampens Postprandial Glucose Excursion in Diabetic Rats H. Mohamed Sham Shihabudeen, D. Hansi Priscilla, and Kavitha Thirumurugan Chapter 15: Garlic Improves Insulin Sensitivity and Associated Metabolic Syndromes in Fructose Fed Rats Raju Padiya, Tarak N. Khatua, Pankaj K. Bagul, Madhusudana Kuncha, and Sanjay K. Banerjee Chapter 16: A Bilberry Drink with Fermented Oatmeal Decreases Postprandial Insulin Demand in Young Healthy Adults Yvonne E. Granfeldt and Inger M.E. Bjorck Chapter 17: Brazil Nuts Intake Improves Lipid Profile, Oxidative Stress, and Microvascular Function in Obese Adolescents: A Randomized Controlled Trial Priscila A. Maranhao, Luiz G. Kraemer-Aguiar, Cecilia L. de Oliveira, Maria C.C. Kuschnir, Yasmine R. Vieira, Maria G.C. Souza, Josely C. Koury, and Eliete Bouskela

Nursing is acknowledged as a stressful occupation, and the negative impact of high stress levels have been widely researched. Less attention has been paid to methods for coping with stress. The researchers conducted a study to explore and identify how nurses cope with work-related stress away from their work environments. Six focus groups were conducted with 38 nurses, including nursing directors, nurse unit managers, and ward nurses from a wide range of clinical areas. From the interview material, 11 coping strategies were identified: drinking alcohol, smoking, using the staff social club, using social networking websites, exercising, family activities, home-based activities, outdoor activities, avoiding people, displacement, and sleep. Although several adaptive strategies appear in this list (e.g., exercising, home-based activities), some nurses were using unhealthy behaviours to cope with work-related stress (e.g., drinking alcohol, smoking, displacement). This study clearly demonstrates the value of using qualitative approaches to understanding how nurses cope with stress. Knowledge produced locally, such as that generated for the hospital in this study, should serve as the foundation for organisational strategies to enhance the health of nurses.

Background Physical inactivity is one of the leading modifiable causes of death and disease in Australia. National surveys indicate less than half of the Australian adult population are sufficiently active to obtain health benefits. The Internet is a potentially important medium for successfully communicating health messages to the general population and enabling individual behaviour change. Internet-based interventions have proven efficacy; however, intervention studies describing website usage objectively have reported a strong decline in usage, and high attrition rate, over the course of the interventions. Web 2.0 applications give users control over web content generated and present innovative possibilities to improve user engagement. There is, however, a need to assess the effectiveness of these applications in the general population. The Walk 2.0 project is a 3-arm randomised controlled trial investigating the effects of “next generation” web-based applications on engagement, retention, and subsequent physical activity behaviour change. Methods/design 504 individuals will be recruited from two sites in Australia, randomly allocated to one of two web-based interventions (Web 1.0 or Web 2.0) or a control group, and provided with a pedometer to monitor physical activity. The Web 1.0 intervention will provide participants with access to an existing physical activity website with limited interactivity. The Web 2.0 intervention will provide access to a website featuring Web 2.0 content, including social networking, blogs, and virtual walking groups. Control participants will receive a logbook to record their steps. All groups will receive similar educational material on setting goals and increasing physical activity. The primary outcomes are objectively measured physical activity and website engagement and retention. Other outcomes measured include quality of life, psychosocial correlates, and anthropometric measurements. Outcomes will be measured at baseline, 3, 12 and 18 months. Discussion The findings of this study will provide increased understanding of the benefit of new web-based technologies and applications in engaging and retaining participants on web-based intervention sites, with the aim of improved health behaviour change outcomes. Trial registration Australian New Zealand Clinical Trials Registry, ACTRN12611000157976

Strong evidence exists for the role of physical activity in preventing and managing a range of chronic health conditions. A particular challenge in promoting physical activity as a health strategy exists in culturally and linguistically diverse (CALD) groups, as such groups demonstrate high risk for a range of non-communicable diseases. The aim of this research was to examine the perspective of multicultural health service providers for CALD groups with respect to the physical activity services/initiatives on offer, access barriers to these services, and ideas for future service delivery in this area. Semi-structured interviews were conducted with 15 multicultural health service providers across the capital cities of the three most populous states in Australia (New South Wales, Queensland, and Victoria), and thematic content analysis was used to examine the data. Findings indicated that the majority of physical activity initiatives were associated with organizations offering other social services for CALD communities but were greatly restrained by resources. As well, it was found that most services were not designed by taking into account specific cultural requirements for CALD communities or their cultural expectations. Common barriers identified to service uptake were classified as socio-cultural (e.g., gender, language, context of health) and environmental (e.g., transportation) in nature. These findings should be utilized when planning future physical activity and health promotion initiatives for increasing CALD participation. In particular, programs need to be culturally tailored to the specific expectations of CALD groups, addressing cultural safety and sensitivity, and should be in partnership with other organizations to extend the reach and capacity.

The purpose of this study was to examine the leisure-time physical activity of South Asians living in Canada using a four-mode, bidimensional acculturation framework.Cross-sectional, descriptive study.A random sample (N=204) of South Asian adults living in Calgary, Canada completed a telephone interview that assessed their leisure-time physical activity and acculturation. Interviews were conducted in either English or Punjabi, depending on participant preference.Cluster analysis identified four acculturation clusters: Low-Separated and High-Separated (with separation signifying different preference levels for maintaining one's heritage culture while distancing oneself from the mainstream culture); and Integrated-Heritage and Integrated-Mainstream (with integration indicating a preference for maintaining one's heritage culture and being involved in the mainstream culture-albeit with the former cluster emphasizing heritage more whereas the latter cluster emphasized the mainstream more). A MANOVA performed on light, moderate, and vigorous leisure-time physical activity using the four clusters was significant (p.05). Moderate leisure-time physical activity was greater for the two separated clusters than the two integrated clusters (p.05), with the Separated-Low cluster being greater than both the Integrated-Mainstream (p.05) and the Integrated-Heritage (p.01) clusters. Vigorous leisure-time physical activity was greater for the two integrated clusters than the two separated clusters (p.01), with the Integrated-Mainstream cluster being greater than both the Separated-Low (p.05) and Separated-High (p.01) clusters.An integrative, four-mode bidimensional approach should be employed when developing messages and designing programs to promote and encourage leisure-time physical activity in South Asian communities.