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  1. Basa JE, Clemens R, Clemens SAC, Nicholson M
    Vaccine, 2024 Apr 02;42(9):2326-2336.
    PMID: 38448324 DOI: 10.1016/j.vaccine.2024.02.047
    This study examined the performance and structures of national immunization program in five middle-income Southeast Asian countries - Malaysia, Thailand, Philippines, Viet Nam, and Myanmar, and analyzed how the different structures relate to the difference in program performance to identify effective strategies in the study countries that facilitated good immunization performance. Data were derived from published literature, and WHO/UNICEF/Gavi databases, with 2010 as the baseline year. UMICs Malaysia and Thailand maintained ≥90 % coverage from 2010 to 2020 and even during the COVID-19 pandemic in 2021. LMICs Viet Nam and donor-supported Myanmar also achieved 80-90 % coverage for most routine vaccines in 2020. The Philippines have not reached ≥90 % coverage since 2010, with the maximum only 72 % (MCV1 and Polio3) in 2020. All study countries prioritize immunization and increased government financing since 2010 by minimum 91 % in Malaysia and 1897 % in Myanmar. However, Myanmar still largely depended on donor support with government financing only 32 % of immunization costs in 2021. The Philippines funds 100 % of immunization costs and ensures sustainable financing for the NIP through earmarked "sin tax" revenues from alcohol and tobacco. Donor support influenced new vaccine introductions among the study countries, with Gavi countries Myanmar and Viet Nam introducing more new vaccines, compared to Gavi-ineligible Malaysia and Thailand. The Philippines reported vaccine stock-outs every year amounting to 28 stock-outs events from 2010 to 2019, compared to only 1-4 stockouts in the other study countries. Donor support, innovative financing, and domestic vaccine manufacturing all play an important role in the efficient delivery of immunization services as demonstrated by the several new vaccine introductions and high immunization rates in Myanmar though Gavi and UNICEF support, additional annual $1.2 billion budget for health and immunization from "sin taxes" in the Philippines, and lack of stockouts for vaccines sourced at affordable prices from domestic manufacturers in Viet Nam.
  2. Donaldson A, Staley K, Cameron M, Dowling S, Randle E, O'Halloran P, et al.
    PMID: 34281130 DOI: 10.3390/ijerph18137193
    Interagency partnerships and collaborations underpin a settings-based approach to health promotion in all settings, including sport. This study used an online concept mapping approach to explore the challenges that Regional Sports Assemblies (RSAs) in Victoria, Australia experienced when working in partnerships to develop and deliver physical activity programs in a community sport context. Participants from nine RSAs brainstormed 46 unique partnership-related challenges that they then sorted into groups based on similarity of meaning and rated for importance and capacity to manage (6-point scale; 0 = least, 5 = most). A six cluster map (number of statements in cluster, mean cluster importance and capacity ratings)-Co-design for regional areas (4, 4.22, 2.51); Financial resources (3, 4.00, 2.32); Localised delivery challenges (4, 3.72, 2.33); Challenges implementing existing State Sporting Association (SSA) products (9, 3.58, 2.23); Working with clubs (8, 3.43, 2.99); and Partnership engagement (18, 3.23, 2.95)-was considered the most appropriate interpretation of the sorted data. The most important challenge was Lack of volunteer time (4.56). Partnerships to implement health promotion initiatives in sports settings involve multiple challenges, particularly for regional sport organisations working in partnership with community sport clubs with limited human and financial resources, to implement programs developed by national or state-based organisations.
  3. Trakman G, Staley K, Forsyth A, Devlin B, Skiadopoulos A, Pearce K, et al.
    PMID: 34639496 DOI: 10.3390/ijerph181910194
    (1) Background: Community sport settings present a range of conflicting health behaviours, including the tension between being physically active and consuming discretionary foods. Therefore, community sport settings are considered a promising location for health promotion. The aim of this project was to evaluate perceptions, knowledge and the impact (e.g., barriers and outcomes) of a healthy-canteen (cafeteria) display, based on traffic light labeling (TLL), which was set up at an Australian Basketball Association Managers' Convention and Trade Show. (2) Methods: We set up a healthy 'canteen display and surveyed Basketball managers on their perceptions of the display before (Survey 1) and after (Survey 2) visiting the display. Three months later they were surveyed (Survey 3) on changes made to their community sport canteens. (3) Results: Eighty-eight, 76 and 22 participants completed Surveys 1, 2 and 3, respectively. Participants believed stocking healthy foods and beverages was important (mean 8.5/10). Food waste, lack of consumer interest and price were identified barriers to stocking healthy foods. After visiting the display, 75% were inspired to make changes and 50% were surprised by the differences between their perceptions of the healthfulness of foods and the TLL ratings. Post-convention, 41% and 70% made or had planned healthy changes to their community sport canteen. (4) Conclusions: A healthy-canteen display is a low-cost, easy-to-implement strategy that may be able to direct self-driven improvement in the healthfulness of foods stocked at community canteens and lead to improved nutritional intakes at these venues.
  4. Seal E, Cardak BA, Nicholson M, Donaldson A, O'Halloran P, Randle E, et al.
    J Gambl Stud, 2022 Dec;38(4):1371-1403.
    PMID: 35106695 DOI: 10.1007/s10899-021-10101-7
    Survey responses from a sample of nearly 15,000 Australian sports fans were used to study the determinants of: (i) gambling behaviour, including if a person does gamble and the type of gambling engaged with; (ii) the number of sports and non-sports bets made over a 12-month period; and (iii) attitudes towards betting on sports. The probability of betting on sports decreased with increasing age and was lower for women and people with a university education. This gender difference varied with age, with the greatest difference found among the young. Similar effects were observed for the number of sports bets made, which declined with age. The gender difference in the number of sports bets also varied with age with the greatest difference found among the young arising from the high propensity of young men to bet on sports. Attitudes to sports betting were also analysed, with a key finding that, within friendship circles, the views that sports betting is perceived as harmless, common and very much a part of enjoying sports were stronger among young men. These permissive attitudes were stronger among people who bet on sports and those who bet on sports more frequently. The analysis of sports fans provides insights into the characteristics of the target market most likely to bet on sports, which can be used to inform public health initiatives and harm reduction campaigns.
  5. Wright A, De Livera A, Lee KH, Higgs C, Nicholson M, Gibbs L, et al.
    BMC Public Health, 2022 Dec 27;22(1):2434.
    PMID: 36575409 DOI: 10.1186/s12889-022-14836-9
    BACKGROUND: Population surveys across the world have examined the impact of the COVID-19 pandemic on mental health. However, few have simultaneously examined independent cross-sectional data with longitudinal data, each of which have different strengths and weaknesses and facilitate the investigation of distinct research questions. This study aimed to investigate psychological distress and life satisfaction during the first and second lockdowns in the state of Victoria, Australia, and the social factors that may be affected by lockdowns and could affect mental health.

    METHODS: The VicHealth Victorian Coronavirus Wellbeing Impact Study included two 20-min opt-in online panel surveys conducted in May and September 2020 in Victoria, each with a sample of 2000 adults aged 18 + . A two-part study design was used: a repeated cross-sectional study of respondents who participated in Survey One and Survey Two, followed by a longitudinal nested cohort study. The primary exposures were social solidarity, social connectedness and staying connected with family and friends. Using logistic regression modelling, we explored the associations between our exposures and primary outcomes of psychological distress and life satisfaction with and without adjustment for covariates, both cross-sectionally and longitudinally. The results from the multivariable models were summarised using adjusted Odds Ratios (aOR), 95% Confidence Intervals (CI).

    RESULTS: Cross-sectional results indicated that the percentage of participants with low life satisfaction was significantly higher in the second survey sample (53%) compared to the first (47%). The percentage of participants with high psychological distress was higher but not significantly different between the two survey samples (14% first survey vs 16% second survey). Longitudinal study results indicated that lower social connectedness was significantly associated with higher psychological distress (aOR:3.3; 95% CI: 1.3-8.4) and lower life satisfaction (aOR:0.2; 95% CI: 0.1-0.4). Younger adults had higher psychological distress compared to older adults (aOR:6.8; 95% CI:1.5-31.1). Unemployment at the time of the first survey was significantly associated with lower life satisfaction at the second survey (aOR:0.5; 95% CI: 0.3-0.9).

    CONCLUSION: This study supports the findings of other international studies. It also highlights the need to promote increased social connection and maintain it at times of isolation and separation, particularly amongst younger adults.

  6. Bauman A, McNeil N, Nicholson M, O'Halloran P, Seal E, Randle E, et al.
    BMC Public Health, 2023 Feb 15;23(1):333.
    PMID: 36793043 DOI: 10.1186/s12889-023-15091-2
    INTRODUCTION: Addressing gender inequalities in physical activity is an important public health goal. A major campaign, 'This Girl Can' (TGC) was conducted by Sport England from 2015, and TGC was licenced in 2018 by VicHealth in Australia for development and use in a 3-year mass media campaign. The campaign was adapted through formative testing to Australian conditions and implemented within the state of Victoria. The purpose of this evaluation was to assess the initial population impact of the first wave of the TGC-Victoria.

    METHODS: We assessed campaign impact using serial population surveys, with the target population being women living in Victoria who were not meeting the current physical activity guidelines. Two surveys were carried out before the campaign (October 2017 and March 2018), and the post-campaign survey immediately following the first wave of TGC-Victoria mass media (May 2018). Analyses were primarily on the cohort sample of 818 low-active women followed across all three surveys. We measured campaign effects using campaign awareness and recall, and self-report measures of physical activity behaviour and perceptions of being judged. Changes in perceptions of being judged and in reported physical activity were assessed in relation to campaign awareness over time.

    RESULTS: Overall, TGC-Victoria campaign recall increased from 11.2% pre-campaign to 31.9% post-campaign, with campaign awareness more likely among younger and more educated women. There was a slight increase of 0.19 days in weekly physical activity following the campaign. Feeling that being judged was a barrier to physical activity declined at follow up, as did the single item perceptions of feeling judged (P 

  7. Staley K, Donaldson A, Mosler AB, O'Halloran P, Seal E, Forsyth A, et al.
    Inj Prev, 2024 Feb 02.
    PMID: 38307715 DOI: 10.1136/ip-2023-045028
    OBJECTIVES: Injury/poor health is an important barrier to women's participation in sport and physical activity. This study aimed to identify perceived challenges sport programme deliverers face when supporting physically inactive women to prevent/manage injury.

    METHODS: Sport programme deliverers, targeting physically inactive women in Victoria, participated in concept mapping to brainstorm, sort and rate (impact on their ability to prevent/manage injury, frequency of and difficulty to overcome the challenge on a 1 (low)-5 (high) scale) the challenges faced. Analysis included multidimensional scaling, hierarchical cluster analysis and descriptive statistics (eg, mean ratings).

    RESULTS: Twenty-five deliverers brainstormed 82 injury prevention/management-related challenges. An eight cluster map was considered the most appropriate representation of the participants' sorting data (mean cluster impact, frequency and difficulty to overcome rating (1-5)): time constraints (3.42, 3.69, 3.12); perceived competence in injury prevention/management (3.36, 3.50, 3.27); navigating participant perceptions and knowledge (3.35, 3.74, 3.49); information and responsibility (3.32, 3.50, 3.26); session planning and structure (3.25, 3.45, 3.07); participant engagement (3.13, 3.47, 3.08); responding to individual needs (3.07, 3.42, 2.92) and access to injury management resources (2.87, 3.25, 3.17).

    CONCLUSION: Limited time created injury prevention/management challenges for programme deliverers when planning and modifying sport programmes for physically inactive women. Injury prevention/management should be integrated into programme design and delivery principles. Programme deliverers need education/training and access to injury prevention/management resources (eg, activity modification) and engagement/communication strategies tailored for physically inactive women. Public health funders, coaching course accreditors, programme designers and deliverers can use these insights to develop strategies to minimise injury risk and effect systemic change in sport programme delivery.

  8. Pennay A, van Egmond K, Anderson-Luxford D, Wright CJC, Caluzzi G, Livingston M, et al.
    Drug Alcohol Rev, 2023 Sep;42(6):1349-1357.
    PMID: 37399138 DOI: 10.1111/dar.13706
    INTRODUCTION: The aim of this study was to: (i) determine the feasibility of using ecological momentary assessment to collect data from Australian Football League (AFL) fans; (ii) explore pre-game, during-game and post-game consumption patterns of AFL fans; and (iii) explore the social and setting-related factors associated with risky single occasion drinking (5+ drinks) among AFL fans.

    METHODS: Thirty-four participants completed up to 10 ecological momentary assessment surveys before, during and after 63 AFL games (n = 437 completed surveys). Surveys collected data about their drinking, and their social and environmental milieu (e.g., location, company). Binary logistic regression analyses clustered by participant identified which game-day characteristics were associated with higher odds of risky single occasion drinking. Significant differences between pre-game, during-game and post-game drinking on social and environmental factors were explored using pairwise comparisons.

    RESULTS: Risky single occasion drinking was more likely when games began in the early-afternoon (1-3 pm) than late-afternoon (3-6 pm), when participants watched the game at a stadium or pub compared to home, and when participants watched the game with friends compared to family. Pre-drinking was more likely before night games and post-drinking was more likely after day games. Drinking during the game was heavier when watching the game at a pub and when watching with a combined group of friends and family.

    DISCUSSION AND CONCLUSIONS: Preliminary findings suggest that social and contextual factors matter in the way alcohol is consumed while watching AFL games. These findings require further investigation in larger samples.

  9. Kpokiri EE, Wu D, Srinivas ML, Anderson J, Say L, Kontula O, et al.
    Sex Transm Infect, 2022 02;98(1):38-43.
    PMID: 33846277 DOI: 10.1136/sextrans-2020-054822
    Population health surveys are rarely comprehensive in addressing sexual health, and population-representative surveys often lack standardised measures for collecting comparable data across countries. We present a sexual health survey instrument and implementation considerations for population-level sexual health research. The brief, comprehensive sexual health survey and consensus statement was developed via a multi-step process (an open call, a hackathon, and a modified Delphi process). The survey items, domains, entire instruments, and implementation considerations to develop a sexual health survey were solicited via a global crowdsourcing open call. The open call received 175 contributions from 49 countries. Following review of submissions from the open call, 18 finalists and eight facilitators with expertise in sexual health research, especially in low- and middle-income countries (LMICs), were invited to a 3-day hackathon to harmonise a survey instrument. Consensus was achieved through an iterative, modified Delphi process that included three rounds of online surveys. The entire process resulted in a 19-item consensus statement and a brief sexual health survey instrument. This is the first global consensus on a sexual and reproductive health survey instrument that can be used to generate cross-national comparative data in both high-income and LMICs. The inclusive process identified priority domains for improvement and can inform the design of sexual and reproductive health programs and contextually relevant data for comparable research across countries.
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