Objective: Inequities can negatively impact the health outcomes of children. The aims of this study were to: i) ascertain the prevalence of food insecurity (FI) among regional and remote Western Australian (WA) children; and ii) determine which socio-demographic factors predicted child FI.
Methods: Caregiver-child dyads (n=219) completed cross-sectional surveys. Read More
Objective: Skipping breakfast has been linked with poor diet quality, higher BMI and adverse cardiometabolic outcomes. This study aimed to determine the prevalence and correlates of skipping breakfast among Australian children and adolescents.
Methods: A total of 1,592 2-17-year-olds completed two 24-hour recalls, collected via face-to-face and telephone interview, in the 2011-12 National Nutrition and Physical Activity Survey. Read More
Objective: Although the number of national measles cases has greatly decreased since 1980s, there has been resurgence in disease incidence in recent years. While parental knowledge and attitudes toward both disease and vaccinations are known to influence vaccine uptake, the contribution of these factors toward vaccination rates in NSW populations has not been studied. The aim of this study was to investigate the knowledge and opinions on measles and MMR vaccine in NSW Central and North Coast regions. Read More
Objective: To provide an overview of published research on the dietary intake of Aboriginal and Torres Strait Islander peoples.
Methods: Peer-reviewed literature from 1990 to October 2016 was searched to identify studies that measured the dietary intake of Australian Aboriginal and Torres Strait Islander populations. Study quality was assessed using a purposely devised quality appraisal tool. Read More
Objectives: Paediatric obesity predicts adult obesity, and alarming new data in New Zealand reveals that obesity among the young continues to rise. In this study, we used a novel solution-focused paradigm, or appreciative inquiry perspective, to explore the factors that influence not just obese but non-obese states (that is, healthy weight as well as obesity), in Pacific adolescents (aged 13-17) living in socioeconomically deprived neighbourhoods.
Methods: Sixty-eight parents and adolescents from 30 families were recruited and interviewed, resulting in 15 obese and 15 healthy weight adolescents participating in the study. Read More
Objective: In a sample of Pacific mothers living in New Zealand, we examined: 1) maternal reports about seven specific major housing problems (too small, difficult to get to from the street, in poor condition, damp, cold, presence of pests, too expensive); and 2) associations between these housing problems and maternal psychological distress, adjusting for some maternal sociodemographic characteristics.
Methods: The Pacific Islands Families longitudinal study follows a cohort of Pacific children born in Auckland, New Zealand, in 2000 and their parents. At the 14-year phase, mothers (n=844) were asked about housing conditions and psychological distress. Read More
Objective: To provide a direct estimate of the risk of admission to permanent residential aged care among older women while accounting for death, according to housing type and other variables.
Methods: A competing risk analysis from 8,867 Australian women born 1921-26, using linked data from the Australian Longitudinal Study on Women's Health (ALSWH), Residential Aged Care (RAC), and the Australian National Death Index.
Results: After accounting for deaths, around 35% of women will be admitted to RAC between ages 73 and 90. Read More
Objective: Although people of refugee background are likely to be under-immunised before and after resettlement, no study to date has evaluated refugee specific immunisation policies in Australia. We developed a framework to analyse immunisation policies across Australia to highlight the strengths and gaps so as to inform development of more effective refugee specific immunisation policies.
Methods: We sourced publicly available immunisation policy documents from state and territory government websites. Read More
Objectives: To assess current approaches to inclusion of equity in economic analysis of public health interventions and to recommend best approaches and future directions.
Methods: We conducted a systematic review of studies that have used socioeconomic position (SEP) in cost-effectiveness analyses. Studies were identified using MedLine, EconLit and HEED and were evaluated based on their SEP specific inputs and methods of quantification of the health and financial inequalities. Read More
Objective: To assess the impact of changing the Australian Goods and Services Tax (GST) on household food stress, which occurs when >25% of disposable income needs to be spent on food.
Methods: Weekly healthy meal plan costs for average-income (AI), low-income (LI) and welfare-dependent (WDI) families were calculated using the 2013 Western Australian (WA) Food Access and Costs Survey. Four GST scenarios were compared: 1) status quo; 2) increasing GST to 15%; 3) expanding base to include exempt foods at 10% GST; and 4) expanding base to include exempt foods and increasing the tax to 15%. Read More
Objectives: To determine whether specific demographic characteristics are associated with the presence or absence of household safety strategies.
Methods: This study was conducted within Growing Up in New Zealand, a contemporary longitudinal study of New Zealand (NZ) children. Multivariable analyses were used to examine the maternal (self-prioritised ethnicity, education, age, self-reported health) and household (area-level deprivation, tenure, crowding, residential mobility, dwelling type) determinants of household safety strategies being present in the homes of young children. Read More
Objectives: The number of people in the developed world who have dementia is predicted to rise markedly. This study presents a validated predictive model to assist decision-makers to determine this population's future resource requirements and target scarce health and welfare resources appropriately.
Methods: A novel individual patient discrete event simulation was developed to estimate the future prevalence of dementia and related health and welfare resource use in Australia. Read More
Objective: Aboriginal leaders concerned about high rates of Fetal Alcohol Spectrum Disorder (FASD) in the Fitzroy Valley, remote north-western Australia, introduced restrictions on access to take-away full-strength alcohol. Following this, Aboriginal leaders engaged strategic partners in a broader strategy to address FASD in the region. The aim of this study was to develop and implement a community-led, researcher-supported, FASD strategy. Read More
Objective: To support a national initiative to remove sugary drinks from schools and limit drinks to water or unflavoured milk ('water-only').
Methods: We emailed all 201 schools with primary school aged children in the Greater Wellington region with a survey on (1) current status of, (2) support needs for, and (3) barriers to or lessons learned from, a 'water-only' school policy.
Results: Only 78 (39%) of schools responded. Read More
Objective: Understanding which population groups intentionally poison themselves by overdose and which substances are used are key to developing prevention efforts for such injuries. This paper uses Ministry of Health (MOH) data to explore the demographic characteristics of those who intentionally self-poison and the substances used, identifies limitations of existing data collections and makes recommendations for the future.
Methods: MOH mortality data from 2000 to 2012, and public hospital presentation data from 2000-2014 of cases of intentional self-poisoning (ISP), and poisoning of undetermined intent (UDP), were examined. Read More
Objective: This study examines the extent to which young people are acting as 'agents of change' in discouraging smoking among their peers.
Methods: This study used data from a survey of 2,919 New Zealand secondary school students who participated in the 2014 national Youth In-depth Survey. Relevant questions were used to assess the extent to which students engaged in behaviours to discourage or promote smoking among their peers. Read More
Objective: To explore Australian experts' views regarding strengths and gaps in school-leavers' knowledge of nutrition and food systems ( N&FS) and factors that influence that knowledge.
Method: Semi-structured interviews were conducted with 21 highly experienced food-related experts in Australia. Qualitative data were analysed thematically using Attride-Stirling's thematic network framework. Read More
Background: Disparities in health perspectives between Indigenous and non-Indigenous populations are major concerns in many of the world's well-developed nations. Indigenous populations are largely less healthy, more prone to chronic diseases, and have an earlier overall mortality than non-Indigenous populations. Low levels of physical activity (PA) contribute to the high levels of disease in Indigenous Australians. Read More
Objective: The Australian Capital Territory 'It's Your Move!' (ACT-IYM) was a three-year (2012-2014) systems intervention to prevent obesity among adolescents.
Methods: The ACT-IYM project involved three intervention schools and three comparison schools and targeted secondary students aged 12-16 years. The intervention consisted of multiple initiatives at individual, community, and school policy level to support healthier nutrition and physical activity. Read More
Objective: To examine trends in leisure time physical activity and inactivity in Australians aged 15 years or older from 1989 to 2011.
Method: We used data from six Australian National Health Surveys conducted from 1989/90 to 2011/12 in which physical activity was assessed using comparable questions. Analyses examined trends in the prevalence of sufficient physical activity (≥150 minutes/week moderate-to-vigorous physical activity) and of inactivity (<30 minutes/week moderate-to-vigorous physical activity). Read More
Objective: To measure changes in undiagnosed HIV among gay and bisexual men (GBM) in Melbourne.
Methods: Undiagnosed HIV was compared between GBM recruited anonymously in 2008 in gay venues only and GBM anonymously or confidentially (results delivery) recruited in 2014 at gay venues and a community festival. Surveys were completed and oral fluid specimens collected for HIV testing; positive tests among GBM reporting being HIV-negative or unknown/untested were classified as undiagnosed. Read More
Objective: Indigenous Australians experience a disproportionately higher burden of disease compared to non-Indigenous Australians. High-quality evaluation of Indigenous health programs is required to inform health and health services improvement. We aimed to quantify methodological and other characteristics of Australian Indigenous health program evaluations published in the peer-reviewed literature. Read More
Objective: To describe Aboriginal community members' perspectives on the outcomes and origins of resilience among Aboriginal children.
Methods: Face-to-face interviews were conducted with 36 Aboriginal adults (15 health service professionals, 8 youth workers and 13 community members) at two urban and one regional Aboriginal Community Controlled Health Service in New South Wales. Interviews were transcribed and analysed thematically. Read More
Objective: This study compares the patterns of quad-related fatal injuries between Australia and New Zealand (NZ).
Method: Fatal injuries from July 2007 to June 2012 involving a quad (quad bike or all-terrain vehicle) were identified from coronial files. Data described the socio-demographic, injury, vehicle and environment factors associated with incidents. Read More
Objective: To estimate the incidence of dog bite-related injuries requiring public sector hospitalisation in Australia during the period 2001-13.
Methods: Summary data on public sector hospitalisations due to dog bite-related injuries with an ICD 10-AM W54.0 coding were sourced from the Australian Institute of Health and Welfare for the study period 2001-2013. Read More
Objective: To synthesise client perceptions of the unique characteristics and value of care provided in Aboriginal Community Controlled Health Organisations (ACCHOs) compared to mainstream/general practitioner services, and implications for improving access to quality, appropriate primary health care for Indigenous Australians.
Method: Standardised systematic review methods with modification informed by ethical and methodological considerations in research involving Indigenous Australians.
Results: Perceived unique valued characteristics of ACCHOs were: 1) accessibility, facilitated by ACCHOs welcoming social spaces and additional services; 2) culturally safe care; and 3) appropriate care, responsive to holistic needs. Read More
Objective: To measure progress towards Australia's National Hepatitis B Strategy 2014-17 targets, and assess geographic variation in disease burden and access to care for those living with chronic hepatitis B (CHB).
Methods: Data were generated from routinely collected sources, including risk-group prevalence and population data, infectious diseases notifications, Medicare records, and immunisation registry data, and assessed nationally and according to geographic area for 2013-15.
Results: CHB prevalence in 2015 was 239,167 (1. Read More
Objective: Sexual violence (SV) against adult women is prevalent and associated with a range of mental health issues. General practitioners could potentially have a role in responding, however, there is little information to help guide them. Data around prevalence of all forms of adult SV (not just rape) is inconsistent, particularly in clinical samples, and the links between other forms of SV and mental health issues are not well supported. Read More
Objective: Describe program theories of substance misuse interventions with Aboriginal and Torres Strait Islander (Indigenous) Australians funded by the National Health and Medical Research Council (NHMRC) since the 'Roadmap' for Indigenous health.
Methods: Projects funded 2003-2013 were categorised by intervention strategies. Realist concepts informed the program theory: intended resources and responses; influence of context on outcomes; explicit and implicit program assumptions. Read More
Objective: To examine gender differences in the characteristics, treatment costs and health outcomes of farm injuries resulting in hospitalisation of New South Wales (NSW) residents.
Method: A population-based study of individuals injured on a farm and admitted to hospital using linked hospital admission and mortality records from 1 January 2010 to 30 June 2014 in NSW. Health outcomes, including injury severity, hospital length of stay (LOS), 28-day readmission and 30-day mortality were examined by gender. Read More
Objective: To find appropriate regression model specifications for counts of the daily hospital admissions of a Sydney cohort and determine which human heat stress indices best improve the models' fit.
Methods: We built parent models of eight daily counts of admission records using weather station observations, census population estimates and public holiday data. We added heat stress indices; models with lower Akaike Information Criterion scores were judged a better fit. Read More
Objective: To compare the cost of a basket of staple foods, together with the availability and quality of fresh fruit and vegetables, by supermarket store type in high and low socioeconomic suburbs of Sydney.
Methods: A food basket survey was undertaken in 100 supermarkets in the 20 highest and 20 lowest socioeconomic suburbs of Sydney. We assessed the cost of 46 foods, the range of 30 fresh fruit and vegetables and the quality of ten fresh fruit and vegetables. Read More
Objective: While governments draft law and policy to promote public health, it is through cases put before the judiciary that the implementation of law can be challenged and where its practical implications are typically determined. In this paper, we examine the role of court judgements on efforts in Australia to regulate the harmful use of alcohol.
Methods: Australian case law (2010 to June 2015) involving the judicial review of administrative decisions relating to development applications or liquor licences for retail liquor outlets (bottle shops), hotels, pubs and clubs was identified using a case law database (WestLaw AU). Read More
Objectives: While skin cancer is still the most common cancer in Australia, important information gaps remain. This paper addresses two gaps: i) the cost impact on public hospitals; and ii) an up-to-date assessment of economic credentials for prevention.
Methods: A prevalence-based cost approach was undertaken in public hospitals in Victoria. Read More
Objective: To investigate the barriers that prevent or delay people seeking a sexually transmitted infection (STI) test.
Methods: Qualitative in-depth interviews were conducted with 24 university students, who are a group prone to behaviours putting them at risk of STIs, to understand the factors that had prevented or delayed them from going for an STI test in the past. Resulting data were thematically analysed employing a qualitative content analysis method, and a final set of themes identified. Read More
Objectives: To develop a scale to assess the perceived readiness of general practitioners (GPs) to identify and respond to intimate partner abuse (IPA) and to examine its psychometric properties.
Methods: A qualitative study of GPs' perceived readiness and a literature review were used to generate items for the General Practitioners' Perceived Readiness to identify and respond to Intimate Partner Abuse Scale (GRIPS). Responses of 287 Australian GPs and GP registrars were analysed to provide psychometric evaluation of the GRIPS. Read More
Objectives: Skin cancer represents a major health issue for Australia. Childhood sun exposure is an important risk factor and evidence suggests the use of sun protection measures by Australian school children could be improved. This study examines how the SunSmart Program, a school-based skin cancer prevention resource, can be supported to further increase sun protection behaviours to assist in lowering skin cancer incidence. Read More
Objective: DrinkWise Australia is an alcohol industry Social Aspects/Public Relations Organisation (SAPRO). We assessed the Australian public's awareness of DrinkWise, beliefs about its funding source, and associations between funding beliefs and perceptions of DrinkWise.
Methods: A total of 467 adult weekly drinkers completed an online cross-sectional survey in February 2016. Read More