Background Early detection of long-term, often asymptomatic, middle ear infection in young Aboriginal and Torres Strait Islander children is more likely to be achieved when ear health and hearing checks are routinely undertaken in primary healthcare. Evidence consistently demonstrates the adverse impacts of this condition on the development and wellbeing of children and their families. We aimed to develop feasible, evidence- and consensus-based primary healthcare recommendations addressing the components and timing of ear health and hearing checks for Aboriginal and Torres Strait Islander children aged under 6 years, not already known to have, nor being actively managed for, ear and hearing problems. Methods A 22-person working group comprising Aboriginal and Torres Strait Islander and non-Indigenous members from the primary healthcare, ear, hearing, and research sectors provided guidance of the project. A systematic scoping review addressed research questions relating to primary health ear health and hearing checks for Aboriginal and Torres Strait Islander and other populations at increased risk of persistent ear health problems. Twelve primary studies and eleven guidelines published between 1998 and 2020 were identified and reviewed. Quality and certainty of evidence and risk of bias ratings were completed for studies and guidelines. In the absence of certain and direct evidence, findings and draft recommendations were presented for consensus input to a 79-member expert panel using a modified e-Delphi process. Recommendations were finalised in consultation with working group members and presented to expert panel members for input on considerations relating to implementation. Results Overall, the quality, certainty, and directness of evidence in the studies and guidelines reviewed was low. However, the findings provided a basis and structure for the draft recommendations presented during the consensus-building process. After two e-Delphi rounds, seven goals and eight recommendations on the components and timing of Ear Health and Hearing Checks in primary healthcare for young Aboriginal and Torres Strait Islander children were developed. Conclusions The systematic scoping review and consensus-building process provided a pragmatic approach for producing strong recommendations within a reasonably short timeframe, despite the low quality and certainty of evidence, and paucity of studies pertaining to primary healthcare settings.

This consensus statement provides new recommendations for primary care assessment of ear health and hearing status of young Aboriginal and Torres Strait Islander children who are not known to have, or are not being actively managed for, ear health and hearing problems. Any child identified with otitis media should be actively managed. This national consensus statement extends existing treatment and management guidelines. Main recommendations: Undertake checks at least 6-monthly, commencing at 6 months until 4 years of age, then at 5 years. Undertake checks more frequently in high risk settings for children under 2 years, when acceptable to families, or in response to parent/carer concerns. Ask parents/carers about concerns, signs, and symptoms; check children's listening and communication skills; and assess middle ear appearance and mobility. Otoacoustic emissions testing is suggested when equipment is available, primary health practitioners have capability and confidence to use the equipment, and there is local preference for its use. Video otoscopy is suggested for health promotion purposes, and/ or for sharing images with other health practitioners. Audiometry should be done as per existing guidelines: when there are parent/carer concerns, signs of persistent/recurrent otitis media, or when listening and communication development is not yet on track. Changes in management as a result of this statement: Key practice changes include routine use of tympanometry, and listening and communication skills checklists. Implementation will require access to equipment and training; clear information on immediate, practical actions for families; timely pathways to referral services; and a change management process that shifts perception and tolerance of otitis media and its impacts and raises expectations that Aboriginal and Torres Strait Islander children can have healthy ears and hearing.

Health and well-being are holistic concepts that are perceived to be inseparable for Aboriginal and Torres Strait Islander peoples. We examined relationships between parent-reported ear symptoms for 787 Indigenous children at two time points (age 2–3 years, age 4–5 years) and two parent-reported speech and language outcomes one year later (age 5–6 years). Most parents (80.2%) reported no concern about their child’s expressive language and (93.8%) receptive language. Binary logistic regression models examined ear health as a predictor of children’s expressive and receptive speech and language adjusting for sociodemographic and health covariates. For children without parent-reported ear symptoms, there were lower odds of parental concern about expressive speech and language (aOR = 0.45; 95% CI 0.21–0.99) and receptive language (aOR = 0.24; 95% CI 0.09–0.62). Parents were less likely to have concerns about the child’s expressive speech and language if their child was female, lived in urban or regional areas, had excellent or very good global health, or had no disability when aged 2–5 years. Since parent-reported ear health and speech and language concerns were related, Aboriginal and Torres Strait Islander children could benefit from culturally safe, strength-based, and family-centered integrated speech, language, and ear health services.

BackgroundEar and hearing care programs are critical to early detection and management of otitis media (or middle ear disease). Otitis media and associated hearing loss disproportionately impacts First Nations children. This affects speech and language development, social and cognitive development and, in turn, education and life outcomes. This scoping review aimed to better understand how ear and hearing care programs for First Nations children in high-income colonial-settler countries aimed to reduce the burden of otitis media and increase equitable access to care. Specifically, the review aimed to chart program strategies, map the focus of each program against 4 parts of a care pathway (prevention, detection, diagnosis/management, rehabilitation), and to identify the factors that indicated the longer-term sustainability and success of programs.MethodA database search was conducted in March 2021 using Medline, Embase, Global Health, APA PsycInfo, CINAHL, Web of Science Core Collection, Scopus, and Academic Search Premier. Programs were eligible or inclusion if they had either been developed or run at any time between January 2010 to March 2021. Search terms encompassed terms such as First Nations children, ear and hearing care, and health programs, initiatives, campaigns, and services.ResultsTwenty-seven articles met the criteria to be included in the review and described a total of twenty-one ear and hearing care programs. Programs employed strategies to: (i) connect patients to specialist services, (ii) improve cultural safety of services, and (iii) increase access to ear and hearing care services. However, program evaluation measures were limited to outputs or the evaluation of service-level outcome, rather than patient-based outcomes. Factors which contributed to program sustainability included funding and community involvement although these were limited in many cases.ConclusionThe result of this study highlighted that programs primarily operate at two points along the care pathway-detection and diagnosis/management, presumably where the greatest need lies. Targeted strategies were used to address these, some which were limited in their approach. The success of many programs are evaluated as outputs, and many programs rely on funding sources which can potentially limit longer-term sustainability. Finally, the involvement of First Nations people and communities typically only occurred during implementation rather than across the development of the program. Future programs should be embedded within a connected system of care and tied to existing policies and funding streams to ensure long term viability. Programs should be governed and evaluated by First Nations communities to further ensure programs are sustainable and are designed to meet community needs.

ISSUE ADDRESSED:Aboriginal and Torres Strait Islander child ear health is complex and multiple. We examined relationships between parent-reported sociodemographic, child health, health service access factors and ear symptoms among Aboriginal and Torres Strait Islander children aged 3 to 7 years.METHODS:The Longitudinal Study of Indigenous Children is a large child cohort study with annual parent-reported data collection. Generalised linear mixed model analyses examined Wave 1 (1309 children 0-5 years; 2008) predictors of being free of parent-reported ear symptoms in both Waves 2 and 3.RESULTS:A total of 1030 (78.7%) had no reported ear symptoms in either Wave 2 or 3. In the fully adjusted model, children who had been hospitalised in the past year (aOR = 2.16; 95% CI 1.19-3.93) and those with no ear symptoms (aOR = 2.94; 95% CI, 1.59-5.46) at Wave 1 had higher odds of no ear symptoms in both the subsequent waves. There were also relationships between parent main source of income-government pension or allowance as well as parents who reported no history of their own ear symptoms and higher odds of no ear symptoms in Waves 2 and 3 after partial adjustment for sociodemographic factors.CONCLUSION:These findings suggest relationships between different sociodemographic and health factors and parent-reported ear symptoms among Aboriginal and Torres Strait Islander children that warrant further investigation. So what? Children with parent-reported ear symptoms during the early years need holistic support to prevent future ear symptoms that impact health, social and educational life trajectories.

Ensuring people affected by initiatives (including research, education and international development) are involved in shaping how they are done is essential to ensure that what is being done (including what is being researched) is aligned with the priorities of those affected. This includes ensuring that access to knowledge generated from the initiative is universal (open access), according to the UN Convention of Human Rights. Meanwhile, ‘citizen science’ and participatory action research are blurring the lines between concepts such as ‘researcher’, ‘public’, ‘patient’ and ‘citizen’. For example, those researching global air pollution are not limited to distinct disciplines such as ‘public health’, ‘environment’ or ‘education’, with everyone affected, including researchers. The importance of involving people in initiatives by sharing power is clear, but evidence-informed methods of doing this are lacking.Creating an evidence base to inform the most effective ways of sharing power when designing, doing and evaluating initiatives is essential in order to ensure efficient, effective and equitable ways of working for the benefit of all.Standardised Data on Initiatives (STARDIT) is designed to create a standard way to share information about who was involved in an initiative (who did which tasks), what was done, what was learned and any impacts which occurred. It is designed to be flexible, so it can be easily adapted to be useful across all disciplines, including health, environment, basic science, policy and international development. STARDIT reports will be shared open access (in the public domain), using machine readable linked-data.STARDIT is being co-created in a collaborative way, with anyone in the world invited to be a part of shaping the development. All information about it will be shared for free under a Creative Commons licence. The project is currently being hosted by the WikiJournals on Wikimedia Foundation servers. The co-creation process is being supported pro-bono by the charity ‘Science for All’.

Objectives The Child Dental Benefits Schedule (CDBS) is an Australian Government initiative providing basic dental care to children from low-income households. We sought to investigate levels of utilisation of the CDBS among Aboriginal and non-Aboriginal children to determine whether there is equal access to dental services provided through the schedule. Methods CDBS data were obtained for four financial (July-June) years (from 2013-14 to 2016-17). The data captured all claims made during this period. The data included estimates of usage by Aboriginal status, age group and Dental Benefits groups (administrative categories of related dental procedures). Results The utilisation of CDBS services was lower for Aboriginal children. However, in 2013-14, although the odds of using the schedule were higher for non-Aboriginal children (odds ratio (OR) 0.89; P<0.0001) this was reversed in 2015-16 and 2016-17 (OR 1.11 and 1.21 respectively; P<0.0001 in both years). The odds of Aboriginal children using preventive services was below that of non-Aboriginal children in 2013-14 (OR 0.82), 2014-15 (OR 0.76), 2015-16 (OR 0.83) and 2016-17 (OR 0.90; P<0.0001) in all years. Conclusions The data are encouraging with regard to equity because they show that for services overall, Australian Aboriginal and non-Aboriginal children have similar levels of utilisation. However, lower levels of the use of preventive services may indicate future inequalities in oral health among Aboriginal children. What is known about the topic? The CDBS is an Australian Government initiative aimed at improving access to dental care for children from low-income households, including for Aboriginal people. By facilitating greater access to dental care, the schedule has the potential to help address inequalities in oral health for both Aboriginal and non-Aboriginal children. What does this paper add? There are no analyses available comparing the utilisation of the CDBS by Aboriginal and non-Aboriginal children. This study compared levels of utilisation of the schedule overall and specifically for preventive services. What are the implications for practitioners? Greater efforts should be made to address inequalities in the utilisation of the CDBS between Aboriginal and non-Aboriginal children. Although there are some hopeful signs, inequalities remain that may affect the oral health of Aboriginal children. There is also potential to encourage utilisation of the CDBS for greater provision of preventive services, including targeted population oral health initiatives.

There is good evidence that fluoride varnish programs are effective in preventing dental caries in children. This study aims to provide a costing for the scale-up of a child fluoride varnish program in New South Wales (NSW), Australia. Most child fluoride varnish programs are school-based, and a number of studies have examined the acceptability and cost effectiveness of using non-dental providers to apply the fluoride varnish. This paper describes the number of primary schools in Australia that could be targeted using a standard population-based risk criteria based on published data. A costing method was developed for various scenarios of school enrolment and provider types, along with potential revenue from the Child Dental Benefits Schedule (CDBS). Most of the costs of a school-based fluoride varnish program can be covered by the CDBS with assumptions of 80% child consent and 75% CDBS eligibility. While the scale-up of child fluoride varnish programs to prevent dental caries has been recommended by numerous strategic plans and reports, particularly for Aboriginal and Torres Strait Islander children, limited progress has been made. This paper concludes that using a standardized criteria for targeting schools using a combination of ICSEA and Aboriginal enrolments, and aiming at four applications a year, is feasible, and that the main costs of the program could be covered by using the CDBS.

BACKGROUND:Promising health interventions tested in pilot studies will only achieve population-wide impact if they are implemented at scale across communities and health systems. Scaling up effective health interventions is vital as not doing so denies the community the most effective services and programmes. However, there remains a paucity of practical tools to assess the suitability of health interventions for scale-up. The Intervention Scalability Assessment Tool (ISAT) was developed to support policy-makers and practitioners to make systematic assessments of the suitability of health interventions for scale-up.METHODS:The ISAT was developed over three stages; the first stage involved a literature review to identify similar tools and frameworks that could be used to guide scalability assessments, and expert input to develop draft ISAT content. In the second stage, the draft ISAT tool was tested with end users. The third stage involved revising and re-testing the ISAT with end users to further refine the language and structure of the final ISAT.RESULTS:A variety of information and sources of evidence should be used to complete the ISAT. The ISAT consists of three parts. Part A: 'setting the scene' requires consideration of the context in which the intervention is being considered for scale-up and consists of five domains, as follows: (1) the problem; (2) the intervention; (3) strategic/political context; (4) evidence of effectiveness; and (5) intervention costs and benefits. Part B asks users to assess the potential implementation and scale-up requirements within five domains, namely (1) fidelity and adaptation; (2) reach and acceptability; (3) delivery setting and workforce; (4) implementation infrastructure; and (5) sustainability. Part C generates a graphical representation of the strengths and weaknesses of the readiness of the proposed intervention for scale-up. Users are also prompted for a recommendation as to whether the intervention (1) is recommended for scale-up, (2) is promising but needs further information before scaling up, or (3) does not yet merit scale-up.CONCLUSION:The ISAT fills an important gap in applied scalability assessment and can become a critical decision support tool for policy-makers and practitioners when selecting health interventions for scale-up. Although the ISAT is designed to be a health policy and practitioner tool, it can also be used by researchers in the design of research to fill important evidence gaps.

Background Lifestyle risk factors, in particular smoking, nutrition, alcohol consumption and physical inactivity (SNAP) are the main behavioural risk factors for chronic disease. Primary health care (PHC) has been shown to be an effective setting to address lifestyle risk factors at the individual level. However much of the focus of research to date has been in general practice. Relatively little attention has been paid to the role of nurses working in the PHC setting. Community health nurses are well placed to provide lifestyle intervention as they often see clients in their own homes over an extended period of time, providing the opportunity to offer intervention and enhance motivation through repeated contacts. The overall aim of this study is to evaluate the impact of a brief lifestyle intervention delivered by community nurses in routine practice on changes in clients' SNAP risk factors. Methods/Design The trial uses a quasi-experimental design involving four generalist community nursing services in NSW Australia. Services have been randomly allocated to an 'early intervention' group or 'late intervention' (comparison) group. 'Early intervention' sites are provided with training and support for nurses in identifying and offering brief lifestyle intervention for clients during routine consultations. 'Late intervention site' provide usual care and will be offered the study intervention following the final data collection point. A total of 720 generalist community nursing clients will be recruited at the time of referral from participating sites. Data collection consists of 1) telephone surveys with clients at baseline, three months and six months to examine change in SNAP risk factors and readiness to change 2) nurse survey at baseline, six and 12 months to examine changes in nurse confidence, attitudes and practices in the assessment and management of SNAP risk factors 3) semi-structured interviews/focus with nurses, managers and clients in 'early intervention' sites to explore the feasibility, acceptability and sustainability of the intervention. Discussion The study will provide evidence about the effectiveness and feasibility of brief lifestyle interventions delivered by generalist community nurses as part of routine practice. This will inform future community nursing practice and PHC policy. Trial Registration ACTRN12609001081202

Background Lifestyle risk factors like smoking, nutrition, alcohol consumption, and physical inactivity (SNAP) are the main behavioural risk factors for chronic disease. Primary health care is an appropriate setting to address these risk factors in individuals. Generalist community health nurses (GCHNs) are uniquely placed to provide lifestyle interventions as they see clients in their homes over a period of time. The aim of the paper is to examine the impact of a service-level intervention on the risk factor management practices of GCHNs. Methods The trial used a quasi-experimental design involving four generalist community nursing services in NSW, Australia. The services were randomly allocated to either an intervention group or control group. Nurses in the intervention group were provided with training and support in the provision of brief lifestyle assessments and interventions. The control group provided usual care. A sample of 129 GCHNs completed surveys at baseline, 6 and 12 months to examine changes in their practices and levels of confidence related to the management of SNAP risk factors. Six semi-structured interviews and four focus groups were conducted among the intervention group to explore the feasibility of incorporating the intervention into everyday practice. Results Nurses in the intervention group became more confident in assessment and intervention over the three time points compared to their control group peers. Nurses in the intervention group reported assessing physical activity, weight and nutrition more frequently, as well as providing more brief interventions for physical activity, weight management and smoking cessation. There was little change in referral rates except for an improvement in weight management related referrals. Nurses’ perception of the importance of ‘ client and system-related ’ barriers to risk factor management diminished over time. Conclusions This study shows that the intervention was associated with positive changes in self-reported lifestyle risk factor management practices of GCHNs. Barriers to referral remained. The service model needs to be adapted to sustain these changes and enhance referral. Trial registration ACTRN12609001081202

Background: Social marketing integrates communication campaigns with behavioural and environmental change strategies. Childhood obesity programs could benefit significantly from social marketing but communication campaigns on this issue tend to be stand-alone.Methods: A large-scale multi-setting child obesity prevention program was implemented in the Hunter New England (HNE) region of New South Wales (NSW), Australia from 2005-2010. The program included a series of communication campaigns promoting the program and its key messages: drinking water; getting physically active and; eating more vegetables and fruit. Pre-post telephone surveys (n = 9) were undertaken to evaluate awareness of the campaigns among parents of children aged 2-15 years using repeat cross-sections of randomly selected cohorts. A total of 1,367 parents (HNE = 748, NSW = 619) participated.Results: At each survey post baseline, HNE parents were significantly more likely to have seen, read or heard about the program and its messages in the media than parents in the remainder of the state (p < 0.001). Further, there was a significant increase in awareness of the program and each of its messages over time in HNE compared to no change over time in NSW (p < 0.001). Awareness was significantly higher (p < 0.05) in HNE compared to NSW after each specific campaign (except the vegetable one) and significantly higher awareness levels were sustained for each campaign until the end of the program. At the end of the program participants without a tertiary education were significantly more likely (p = 0.04) to be aware of the brand campaign (31%) than those with (20%) but there were no other statistically significant socio-demographic differences in awareness.Conclusions: The Good for Kids communication campaigns increased and maintained awareness of childhood obesity prevention messages. Moreover, messages were delivered equitably to diverse socio-demographic groups within the region.

ISSUE ADDRESSEDThe consumption of soft and other sweetened drinks is an emerging nutrition issue in Australia. In 2005-6, 63% of NSW children aged between 2 and 15 years consumed sweetened drinks (soft drinks, cordials or sports drinks) weekly, 33% of which consumed at least 6 cups per week. In 2008 NSW Health implemented the 'Water Campaign' to increase the proportion of NSW children up to 15 years of age who consume water in place of sweetened drinks.METHODSA pre-post survey study design was used to evaluate the Campaign. Two telephone surveys of stratified random samples of 500 respondents each from the primary target audience (parents and carers of children up to 15 years of age) were conducted across NSW.RESULTSFifty-three per cent of respondents in the post-survey said that they recalled the mass media Campaign when it was described to them compared to 19% in the pre-survey. There was an increase in parents' knowledge of the high sugar content of sweetened drinks and a decline in the reported consumption of sweetened drinks by boys.CONCLUSIONSThough modest in size and duration, the campaign was successful in achieving a number of campaign objectives, particularly changes in parent's and carer's knowledge and awareness of water related nutrition and reduced reported consumption of sweetened drinks among boys.

PURPOSE:To explore childhood obesity through mothers' perceptions, attitudes, beliefs, and behaviors.STUDY DESIGN AND METHODS:Descriptive qualitative study using in-depth interviews. Sixteen in-depth interviews were conducted with primiparous mothers of children aged 0-2 years. The questions focused on nutrition, the context of eating in the family, physical activity, television viewing, and the responsibility of parents as role models. Thematic analysis was used to identify regular patterns of meaning regarding the major issues pertaining to childhood obesity, nutrition, and physical activity.RESULTS:Five themes were identified: (1) developing eating habits, (2) developing active and sedentary habits, (3) differences between age groups, (4) sources of information, and (5) response to information. Although awareness about the need to provide a nutritious diet and opportunities for children to be active was high among the mothers, this was not always reflected in their behaviors. For many mothers, obesity became a concern only if excessive weight gain occurred. Prevention through establishing good habits early, although considered, was not always actively pursued.CLINICAL IMPLICATIONS:Interventions to prevent overweight and obesity need to focus on equipping parents with the skills to translate their knowledge into behavior and lay the foundations early for their children to develop healthy habits.

Closed-circuit television has the potential to promote health in hospitals, as a significant number of patients watch large amounts of television (TV) during their stays. This project sought to investigate the potential of a dedicated hospital TV channel to communicate health messages in an entertaining way by assessing the reach and appeal of a closed-circuit hospital TV channel - RPAtv. A cross-sectional survey of 162 inpatients and visitors at the Royal Prince Alfred Hospital was conducted. Sixty-four percent of participants were aware of RPAtv, with patients (72%) significantly more likely (P < 0.001) to be aware of RPAtv than visitors (41%). Almost 60% of those who were aware of the channel had viewed it. Of those who had viewed RPAtv, 73.3% rated the programming as "good" or "very good". When asked about programming preferences, 34% suggested that the channel should include health and hospital information. However, 66% said that they would rather watch programming that was entertaining, light-hearted and escapist. The high approval rating of programming by viewers suggests that the channel is improving the experience of patients and visitors during their time in hospital. However, its effectiveness as a vehicle for health promotion could be somewhat limited. Any health education-focused objectives of similar channels need to be realistic about the extent of likely increases in health knowledge.

This paper explores access to and acceptability of home visiting for early childhood health and wellbeing among the New South Wales population. The study examined demographic and social characteristics of children and their families to identify the factors that predicted home visiting by a community health nurse or volunteer, as well as the level of acceptability of home visiting as a strategy for improving child health. The data were extracted from the 2001 NSW Child Health Survey and a total of 3570 respondents who reported having a child aged 4 years or under were included in the study. The results show that culturally and linguistically diverse populations were less likely to be visited by a nurse or volunteer (adjusted odds ratio (OR), 0.78; 95% CI, 0.64-0.97), and when they were visited were more likely to find the visit "uncomfortable" or "very uncomfortable" (adjusted OR, 1.54; 95% CI, 1.19-1.99). Other factors associated with acceptability included the age of both children and mothers, education levels of parents and home smoking status. For home visiting to be effective in promoting child health, these factors must be considered.

Australian and New Zealand Journal of Public HealthVolume 30, Issue 5 p. 487-489 Free to Read Sampling from childcare centres and pre-schools: how representative are they? Li Ming Wen, Corresponding Author Li Ming Wen Health Promotion Service, Sydney South West Area Health Service, New South Wales Health Promotion Service, Sydney South West Area Health Service, Level 9, King George V Building, Missenden Road, Camperdown, New South Wales 2050. Fax: (02) 9515 9056; e-mail: lmwen@email.cs.nsw.gov.auSearch for more papers by this authorNeil Orr, Neil Orr Health Promotion Service, Sydney South West Area Health Service, New South WalesSearch for more papers by this authorSallie Bacon, Sallie Bacon Health Promotion Service, Sydney South West Area Health Service, New South WalesSearch for more papers by this authorChris Rissel, Chris Rissel Health Promotion Service, Sydney South West Area Health Service, New South WalesSearch for more papers by this author Li Ming Wen, Corresponding Author Li Ming Wen Health Promotion Service, Sydney South West Area Health Service, New South Wales Health Promotion Service, Sydney South West Area Health Service, Level 9, King George V Building, Missenden Road, Camperdown, New South Wales 2050. Fax: (02) 9515 9056; e-mail: lmwen@email.cs.nsw.gov.auSearch for more papers by this authorNeil Orr, Neil Orr Health Promotion Service, Sydney South West Area Health Service, New South WalesSearch for more papers by this authorSallie Bacon, Sallie Bacon Health Promotion Service, Sydney South West Area Health Service, New South WalesSearch for more papers by this authorChris Rissel, Chris Rissel Health Promotion Service, Sydney South West Area Health Service, New South WalesSearch for more papers by this author First published: 25 September 2007 https://doi.org/10.1111/j.1467-842X.2006.tb00473.xAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat No abstract is available for this article. Volume30, Issue5October 2006Pages 487-489 RelatedInformation

The increase in the proportion of children being driven to and from school has been well documented. Driving children to school reduces their opportunities for physical activity and leads to increased traffic congestion. Greater traffic congestion is of immediate concern for child safety. Schools often make significant efforts to discourage parents from driving to school, adding to congestion and breaking traffic rules such as restricting parking to shift traffic away from areas with high pedestrian traffic. However, during peak times such at the start and end of school, where the convergence of parents and children increases the competition for space, some parents illegally park or stop. This can significantly increase the danger to children on neighbouring roads, footpaths and school crossings. In recognition of this, and following discussions with schools in Metropolitan Sydney, the authors conducted a study to test the effectiveness of a localised intervention to reduce traffic congestion around two inner-city schools. (a)

Women are less likely than men to reach recommended levels of physical activity and have unequal access to active leisure time. Studies in Australia have consistently found that women are only half as likely as men to be adequately active. A community-based multi-strategic health promotion intervention, 'Concord, A Great Place to be Active', was implemented from 1997 to 1999. It aimed to increase the physical activity levels of women aged 20-50 years living in the Concord Local Government Area (LGA), an inner-western region of Sydney, Australia. A key feature of this intervention was a partnership between Concord Council (the local government) and the Central Sydney Health Promotion Unit (CSHPU). The project was evaluated using qualitative and quantitative methods. Key informant interviews and focus groups were conducted to inform the development of the intervention and to assess the impact of the project on Concord Council. Pre- and post-intervention telephone surveys of the target group were also conducted. Following the intervention, there was a statistically significant (6.4%) reduction in the proportion of sedentary women. Further, there were a number of positive enhancements in the Council's capacity to promote physical activity in the community. These findings demonstrate that a community-based intervention targeting a specific population can achieve positive changes in physical activity and that a local government has the capacity to be involved in and sustain physical activity interventions.