Exploring Female University Students' Participation in Physical Activity in Saudi Arabia: A Mixed-Methods Study.

Background: The importance of physical activity in improving physical and mental health has been emphasized in many studies. Researchers in Saudi Arabia have reported an increase in physical inactivity among Saudis, especially among University female population. Current efforts in the field in Saudi Arabia have yet to explore barriers and facilitators that influence female University student's participation in physical activity. This study aims to provide an assessment of the situation regarding physical activity among female University students in Saudi Arabia. Methods: This mixed method study preceded a participatory action research initiative. The first part of the mixed method consisted of a cross-sectional survey of 375 female University students in Saudi Arabia who completed the short form of the International Physical Activity Questionnaire. The second part consisted of semi-structured, in-depth interviews with 14 female University students and 16 female exercise trainers. Results: Results showed that most participants (91%) spent more time in walking activity compared to moderate (66%) and vigorous activity (57%) for at least 10 min at a time over a period of 7 days. Results showed that 70% of participants did not meet the WHO recommendation of 150 min per week of moderate activity, while around 62% of participants did not meet the WHO recommendation of 75 min per week of vigorous activity. Barriers to participation included limited facilities for physical activities, academic workload, gender role, and the need to adhere to cultural standards. Facilitators included valuing positive results, general health concerns, and family support. Conclusion: Knowledge gained from this study might support organizations and public health authorities to develop physical activity interventions that better address Saudi women's perceived needs. These findings are an important contribution to current knowledge in light of recent advances in women's rights in Saudi Arabia.

Adopting healthier cooking oils: Findings from a qualitative study among independent food outlets in a rural district in Australia.

ISSUE ADDRESSED: This study explored key factors that motivated independent food outlets to voluntarily adopt healthier cooking oils following a health promotion intervention. METHODS: Sixteen food outlet managers from the Cessnock Local Government Area (LGA) participated in semi-structured interviews and a brief questionnaire which explored factors determining what cooking oils they use in preparing deep-fried foods. Interviews were analysed thematically and closed responses to survey questions using descriptive statistics. RESULTS: Four main reasons emerged around decisions relating to oil choice: fry life, cost, taste and general health. Health implications, Council advice, competitive price and maintaining a good relationship with the Council were the most frequently reported motivators for swapping to a healthier oil. CONCLUSION: Behaviour change among food outlet managers to switch cooking oils is influenced by a number of health-related and non-health-related factors. Council Environmental Health Officers (EHOs) can be a catalyst for food outlets to adopt healthier food preparation practices. SO WHAT?: This study highlights the factors which may motivate the switch to healthier oils by independent food outlets. EHOs are critical partners for health promotion initiatives that target the independent food service sector.

"We wouldn't of made friends if we didn't come to Football United": the impacts of a football program on young people's peer, prosocial and cross-cultural relationships.

BACKGROUND: Sport as a mechanism to build relationships across cultural boundaries and to build positive interactions among young people has often been promoted in the literature. However, robust evaluation of sport-for-development program impacts is limited. This study reports on an impact evaluation of a sport-for-development program in Australia, Football United(®). METHODS: A quasi-experimental mixed methods design was employed using treatment partitioning (different groups compared had different levels of exposure to Football United). A survey was undertaken with 142 young people (average age of 14.7 years with 22.5% of the sample comprising girls) in four Australian schools. These schools included two Football United and two Comparison schools where Football United was not operating. The survey instrument was composed of previously validated measures, including emotional symptoms, peer problems and relationships, prosocial behaviour, other-group orientation, feelings of social inclusion and belonging and resilience. Face to face interviews were undertaken with a purposeful sample (n = 79) of those who completed the survey. The participants in the interviews were selected to provide a diversity of age, gender and cultural backgrounds. RESULTS: Young people who participated in Football United showed significantly higher levels of other-group orientation than a Comparison Group (who did not participate in the program). The Football United boys had significantly lower scores on the peer problem scale and significantly higher scores on the prosocial scale than boys in the Comparison Group. Treatment partitioning analyses showed positive, linear associations between other-group orientation and total participation in the Football United program. A lower score on peer problems and higher scores on prosocial behaviour in the survey were associated with regularity of attendance at Football United. These quantitative results are supported by qualitative data analysed from interviews. CONCLUSIONS: The study provides evidence of the effects of Football United on key domains of peer and prosocial relationships for boys and other-group orientation for young people in the program sites studied. The effects on girls, and the impacts of the program on the broader school environment and at the community level, require further investigation.

Decision-makers, donors and data: factors influencing the development of mental health and psychosocial policy in the Solomon Islands.

Mental disorders and psychosocial problems are common, and present a significant public health burden globally. Increasingly, attention has been devoted to these issues in the aftermath of violent conflict. The Solomon Islands, a small Pacific island nation, has in recent years experienced periods of internal conflict. This article examines how policy decisions regarding mental health and wellbeing were incorporated into the national agenda in the years which followed. The study reveals the policy shifts, contextual influences and players responsible. The Solomon Islands' experience reflects incremental change, built upon longstanding but modest concern with mental health and social welfare issues, reinforced by advocacy from the small mental health team. Armed conflict and ethnic tensions from 1998 to 2003 promoted wider recognition of unmet mental health needs and psychosocial problems. Additional impetus was garnered through the positioning of key health leaders, some of whom were trained in public health. Working together, with an understanding of culture and politics, and drawing on external support, they drove the agenda. Contextual factors, notably further violence and the ongoing risk of instability, a growing youth population, and emerging international and local evidence, also played a part.

Social cohesion through football: a quasi-experimental mixed methods design to evaluate a complex health promotion program.

UNLABELLED: Social isolation and disengagement fragments local communities. Evidence indicates that refugee families are highly vulnerable to social isolation in their countries of resettlement. Research to identify approaches to best address this is needed. Football United is a program that aims to foster social inclusion and cohesion in areas with high refugee settlement in New South Wales, Australia, through skills and leadership development, mentoring, and the creation of links with local community and corporate leaders and organisations. The Social Cohesion through Football study's broad goal is to examine the implementation of a complex health promotion program, and to analyse the processes involved in program implementation. The study will consider program impact on individual health and wellbeing, social inclusion and cohesion, as well as analyse how the program by necessity interacts and adapts to context during implementation, a concept we refer to as plasticity. The proposed study will be the first prospective cohort impact study to our knowledge to assess the impact of a comprehensive integrated program using football as a vehicle for fostering social inclusion and cohesion in communities with high refugee settlement. METHODS/DESIGN: A quasi-experimental cohort study design with treatment partitioning involving four study sites. The study employs a 'dose response' model, comparing those with no involvement in the Football United program with those with lower or higher levels of participation. A range of qualitative and quantitative measures will be used in the study. Study participants' emotional well being, resilience, ethnic identity and other group orientation, feelings of social inclusion and belonging will be measured using a survey instrument complemented by relevant data drawn from in-depth interviews, self reporting measures and participant observation. The views of key informants from the program and the wider community will also be solicited. DISCUSSION: The complexity of the Football United program poses challenges for measurement, and requires the study design to be responsive to the dynamic nature of the program and context. Assessment of change is needed at multiple levels, drawing on mixed methods and multidisciplinary approaches in implementation and evaluation. Attention to these challenges has underpinned the design and methods in the Social Cohesion through Football study, which will use a unique and innovative combination of measures that have not been applied together previously in social inclusion/cohesion and sport and social inclusion/cohesion program research.

Through the eyes of children: engaging primary school-aged children in creating supportive school environments for physical activity and nutrition.

ISSUES ADDRESSED: This paper presents a qualitative study of physical activity, eating and drinking experiences of children at Wellington Public School, NSW. The study was designed and implemented to inform school programs and policies with a goal of fostering a supportive and healthy environment at the school. METHODS: The study involved use of focus groups, drawings and photovoice with 37 students from Kindergarten to Year 6 to determine problems, underlying causes and possible student-led interventions to enhance the school physical activity and nutritional environment. RESULTS: Students considered play as related to fun games with friends. Sport was associated with structured, competitive types of physical activity. Infants class students preferred play, while primary students reported a preference for semi-structured and structured activities. Suggestions to improve school playing areas mirrored these preferences. The children suggested strategies for increasing fruit, vegetable and water consumption during the school day. CONCLUSION: The students were keen to explore ways to increase physical activity opportunities and develop a supportive nutritional environment at school. Simple, easy to implement suggestions were among the outcomes of the study, reinforcing the importance of including students' views in healthy school program and policy development.

Community perceptions of mental health needs: a qualitative study in the Solomon Islands.

BACKGROUND: Psychosocial and mental health needs in the aftermath of conflict and disaster have attracted substantial attention. In the Solomon Islands, the conceptualisation of mental health, for several decades regarded by policy makers as primarily a health issue, has broadened and been incorporated into the national development and social policy agendas, reflecting recognition of the impact of conflict and rapid social change on the psychosocial wellbeing of the community as a whole. We sought to understand how mental health and psychosocial wellbeing were seen at the community level, the extent to which these issues were identified as being associated with periods of 'tension', violence and instability, and the availability of traditional approaches and Ministry of Health services to address these problems. METHODS: This article reports the findings of qualitative research conducted in a rural district on the island of Guadalcanal in the Solomon Islands. Key informant interviews were conducted with community leaders, and focus groups were held with women, men and young people. Wellbeing was defined broadly. RESULTS: Problems of common concern included excessive alcohol and marijuana use, interpersonal violence and abuse, teenage pregnancy, and lack of respect and cooperation. Troubled individuals and their families sought help for mental problems from various sources including chiefs, church leaders and traditional healers and, less often, trauma support workers, health clinic staff and police. Substance-related problems presented special challenges, as there were no traditional solutions at the individual or community level. Severe mental illness was also a challenge, with few aware that a community mental health service existed. Contrary to our expectations, conflict-related trauma was not identified as a major problem by the community who were more concerned about the economic and social sequelae of the conflict. CONCLUSION: Communities identify and are responding to a wide range of mental health challenges; the health system generally can do more to learn about how this is being done, and build more comprehensive services and policy on this foundation. The findings underscore the need to promote awareness of those services which are available, to extend mental health care beyond urban centres to rural villages where the majority of the population live, and to promote community input to policy so as to ensure that it 'fits' the context.