Perspectives in Public Health最新文献

Aims: Active transport to and from school provides an opportunity for adolescents to engage in physical activity, but travelling through an obesogenic environment may have unintended consequences on their snacking behaviour. This study aimed to: (1) identify whether adolescents' unhealthy snacking behaviour was associated with school transport modes and food outlets on their estimated school route and (2) explore whether food outlet density on the school route differed between school transport modes.

Methods: Adolescents (n = 406; aged 15.1 ± 1.4 years; 50.7% boys; 63.5% New Zealand European) from all 12 secondary schools in Dunedin city, Aotearoa New Zealand, completed an online survey. School transport modes (active, motorised or mixed) and unhealthy snacking data were collected. Food outlet data were collected using Google Places Application Programming Interface (API). Home-to-school route and distance were estimated using geographical information system (GIS) analysis based on a walkable road network. Data were analysed using the chi-square test and logistic regression.

Results: Overall, 26.4% of adolescents reported purchasing and consuming unhealthy snacks or soft drinks on the way to school and 41.4% from school. The odds of unhealthy snacking during the school journey was higher among mixed transport users than active transport users on the way to (odds ratio (OR) = 2.73, 95% confidence interval (CI) = 1.39-5.36) and from school (OR = 2.68, 95% CI = 1.40-5.13). No differences were observed by food outlet type. There were no food outlets on the estimated school route for 44.8% of adolescents. The presence of more than one food outlet per kilometre of the estimated school route differed between active (38.7%), motorised (42.6%) and mixed transport users (46.4%; p = 0.006).

Conclusion: School transport modes were significantly associated with adolescents' unhealthy snacking behaviour and food outlets on their school journey. Policy measures which minimise exposure to unhealthy food outlets may reduce unhealthy snacking among adolescents.

Aims: Physical activity (PA) and nutrition are important determinants of health in late adulthood. However, low levels of PA and poor nutrition are common in older adults and have become more prevalent during the COVID-19 pandemic. We hypothesised that Healthy Conversation Skills could be used to support health behaviour changes beneficial for health in older adults and thus conducted a study nested within the UK Hertfordshire Cohort Study.

Methods: Between November 2019 and March 2020, 176 participants were visited at home. A trained researcher administered a questionnaire and undertook anthropometric and physical performance tests. A total of 89 participants were randomised to the control group and received a healthy living leaflet; 87 participants in the intervention group were interviewed using Healthy Conversation Skills at the initial visit with follow-up telephone calls at 1, 3, 6 and 9 months. Follow-up at 1 year by postal questionnaire assessed change in PA and diet. In total, 155 participants (79 control and 76 intervention) completed the baseline and 1-year follow-up.

Results: At baseline, median (lower quartile, upper quartile) age (years) was 83.1 (81.5, 85.5) and median PA time (min/day) from walking, cycling and sports was 30.0 (15.0, 60.0). In total, 95% of participants completed the intervention; the total response rate for postal questionnaires was 94%. There were no statistically significant differences in outcomes between the trial arms. In women, there was a tendency for greater increases in diet quality in the intervention group compared to the control group (p = 0.075), while among men, there was a tendency for reduced decline in self-reported physical function in the intervention group compared to the control group (p = 0.081).

Conclusion: We have shown that it is viable to utilise Healthy Conversation Skills via telephone to promote healthier lifestyles in older adults. Larger appropriately powered studies to determine the efficacy of such an intervention are now warranted.

Aim: Public health lifestyle databases at local authority level are currently poorly aligned across the UK. The integration of lifestyle databases at a regional level could provide a rich resource to support research and help inform public health leads and service commissioners in improving service delivery, facilitating decision-making and developing key public health policies. Prior to its implementation, the acceptability of an integrated lifestyle database should be explored. The aim of this study was to consult with public health stakeholders to explore the acceptability of developing and implementing a regional integrated lifestyle database across four key areas of public health: smoking cessation, diet, physical activity and alcohol consumption.

Method: Qualitative interviews were conducted with public health stakeholders recruited from across the East Midlands region of England. All interviews were conducted using video conferencing software and recorded, transcribed, and analysed using the Framework approach. Sixteen public health stakeholders were purposively identified and invited to participate in interviews.

Results: Stakeholders viewed the integrated database as having potential to support research, service development and commissioning decisions. Barriers such as providers' reluctance to reveal their business strategies to rival organisations, cost of setting up and running the proposed database, complex information-sharing and governance were identified.

Conclusion: An integrated lifestyle database has the potential to support research and service commissioning regionally. However, several barriers were identified that must be addressed prior to the development and implementation of an integrated database.

Aims: Previous evidence suggests that engagement with heritage such as visiting heritage sites provides benefits for people's mental and social wellbeing, and helps to establish social capital. However, far less is known about whether living in areas of historic built environment also helps build social capital. Furthermore, it remains unclear how the association between historic built environment and social capital may vary across heritage engagement frequency and areas of deprivation levels. This study was therefore designed to explore the cross-sectional relationship between historic built environment and social capital.

Methods: Analysis was based on three datasets: Understanding Society: The UK Household Longitudinal Study Waves 5 (2013/2015) and 6 (2014/2016), 2019 National Heritage List for England, and 2015 English Index of Multiple Deprivation (IMD). Ordinary least squares (OLS) regressions were applied to estimate the relationships between historic built environment (listed buildings, scheduled monuments, and registered parks and gardens) and social capital (personal relationships, social network support, civic engagement, and trust and cooperative norms).

Results: We found that people living in places with greater historic built environment experienced higher levels of personal relationships, social network support, and civic engagement. However, these associations were attenuated once rurality was adjusted. Individuals living in areas of greater levels of historic built environment displayed higher levels of trust and cooperative norms, even after adjusting for all relevant covariates. Heritage engagement frequency was found to moderate the association between historic built environment and personal relationships. Similarly, IMD was also found to moderate the association between historic built environment and trust and cooperative norms.

Conclusion: These findings highlight the importance of neighbourhood environment in building social capital in communities. Particularly, areas with heritage assets may provide both socially inviting and aesthetically pleasing environments that could help strengthen community and restore pride in place.