Australian sport and physical activity behaviours pre, during and post-COVID-19.

BACKGROUND: Globally, COVID-19 and associated restrictions impacted negatively on recreational physical activity (RPA). Participation in community sport was significantly impacted with cancelled training and competitions. Whilst team and club-based sport participation declined during COVID-19 restrictions, participation in some physical activities actually increased, particularly individual and online activities and outdoor activities not requiring facilities. AIM: The aim of this study is to investigate changes in the patterns of participation in club-based sport, informal sport and other RPA in Australia from pre, during and post-COVID-19 restrictions. Further, these participation patterns are broken down by gender, age and region of residence. METHODS: Two longitudinal waves of an online survey were conducted in mid-2020 and mid-2021. The first wave also captured retrospective pre-COVID19 (2019) data. Two sections of the survey dealt respectively with two 'settings' of RPA: organised club sport, and less structured sport and recreational physical activity (designated 'other RPA'). For each year 2019-2021 each individual was categorized as participating (Yes/No) in each of club sport and other RPA. For each setting, the proportions of each pattern of participation were tabulated, and the results for the demographic cohorts were compared. RESULTS: A total of 1,138 Australians aged 13 years and above completed both waves of the survey. Overall, there were considerable differences between the patterns of club sport and other RPA. Most individuals who participated in other RPA (69%) were able to and did participate continuously throughout the COVID-19 pandemic. However, and not surprisingly, the club-sport participants were forced to drop out in 2020 during COVID-19 restrictions, and less than half reported returning to play post-COVID-19 restrictions. Less than a quarter of sports club participants were able to continue to play throughout COVID-19 and beyond. Significantly more males returned to playing sport 51% than females 44%. CONCLUSION: Participation in community club-based sport has been significantly negatively impacted by COVID-19, more so than participation in some other recreational sport and physical activities. Further, fewer females than males returned to playing community sport, and priority and specific attention should be given to understanding why women and girls have not returned to playing community club-based sport.

Understanding volunteer motivations and concerns in coaching and officiating basketball: implications for sport policy.

Sport participation and volunteering can make important contributions to good health. Sporting organisations need volunteers to deliver their participation opportunities and for many years the sector has faced challenges to volunteer recruitment and retention, especially due to the increased bureaucratic and compliance demands in operating community sports clubs. As sporting organisations pivot to adapt to COVID-safe sport we can learn about their experiences to inform volunteer recruitment and retention policies and practices. This research examined volunteer intentions and motivations in coaching and officiating in basketball and explored factors influencing their decision to return to COVID-safe basketball. Data was collected via an online survey that drew on theoretical frameworks of volunteer motivations (i.e. modified Volunteer Functions Inventory VFI) in sport as well as sport policies related to COVID-safe guidelines for return to sport. Data was collected in Victoria Australia during July 2020 before basketball had the chance to return from the first Australian-wide COVID-19 lockdown. Volunteers had positive intentions to return to basketball following COVID-19 restrictions because it was fun, to help others, or because friends/family were involved. Volunteers were most concerned that others will not comply with COVID-safe policies particularly around isolating when feeling unwell (95%), but also reported concerns about the inconveniences of some COVID-safe policies introduced to return to organised sport (e.g. social distancing, density limits, and enforcing rule changes). Understanding these volunteer intentions, motivations and factors influencing the decision to return to COVID-safe basketball can help inform recruitment and retention strategies to support volunteers in sport. Practical implications for sport policy and practice are discussed.

The Impact of COVID-19 Restrictions on Perceived Health and Well-Being of Active Australian Older Adults.

The aim of this study was to determine the impact of COVID-19 restrictions on older adults' perceived health and well-being according to different types of participation in sport and physical activity by gender and region. A survey was implemented during the first COVID-19 lockdown in Australia (June 2020) and information collected on demographics, sport and physical activity patterns pre-COVID-19, and health and well-being outcomes during lockdown and compared to 1 year earlier. During COVID-19 lockdown, older adults who participated in both club sport and informal activities had significantly better general health, physical health, and resilience than those who participated solely in a single setting. Those participating in both team and individual activities reported better general well-being. Older adults who were active in a range of settings and modes had improved health and well-being. Social support is especially important for older adults to become and remain active.

The impact of COVID-19 restrictions on Australians' frequency and duration of participation in different types of sport and physical activity.

BACKGROUND: Sports management and public health physical activity stakeholders need to understand changing patterns of participation to inform the development of sport and physical activity opportunities and strategies. This study investigated changes in the frequency and duration of participation in sport and physical activity in Australia from pre-COVID-19 to during-COVID-19, broken down by the specific type of activity and by gender, age and region. METHODS: During the first pandemic restrictions and lockdowns in Australia in May-June 2020, 6140 survey respondents provided information about the types, frequency and duration of the sport and physical activity they participated in prior to and during COVID-19 restrictions. Differences between mean values were analyzed. RESULTS: The greatest decline in participation during COVID-19 was in team sports, and the decline was greater for men than for women. CONCLUSION: How will sport respond to getting these men back in the game, and women back from home-based yoga and Pilates?

Corrigendum: Five-Year Changes in Community-Level Sport Participation, and the Role of Gender Strategies.

[This corrects the article DOI: 10.3389/fspor.2021.710666.].

Five-Year Changes in Community-Level Sport Participation, and the Role of Gender Strategies.

Background: The rate of participation in community-based sport by boys and men has been double that of girls and women. Contributing to this is the fact that some sports have been traditionally male-only or at least very male-dominated. Aim: The aim of this study was to investigate changes in participation in sport by sex and age across 10 major sports in Australia over a 4-year period. In conjunction with the analysis of participation trends, the gender strategies that were developed and implemented during this time are reviewed. Methods: This study encompassed all sport participants registered with one of 10 State Sporting Associations in Victoria, Australia in 2015 and in 2019. Participation rates by region, age and sex were calculated. State sport and health policies relating to female participation in sport were reviewed. Results: There were 749,037 registrations in 2015 and 868,266 in 2019. A comparison between 2015 and 2019 shows increases in participation for women and girls across all age groups (4-84 years), and highest increases for those aged 4 (6.6%) and 5-9 (4.7%). For boys there was a considerable decrease in participation for those aged 5-9 years (-3.8%). Discussion: This study provides evidence that whilst participation in sport is still dominated by males, the gap might be gradually closing and this is in line with recent strategies and investments into sport and wider cultural developments in society. The implications of these findings are discussed.

Longitudinal Trends in Sport Participation and Retention of Women and Girls.

Measurement and analysis of sport participation data is vital to understand trends, and therefore to make informed decisions relating to sport policy and strategies to get more people active through sport. This study identified patterns of club sport participation, retention and drop-out of women and girls over a 7 year period in a popular team sport in Australia. The study included registered women and girls of all ages (4-96 years at baseline) in an almost exclusively female sport, with a particular focus on the ages 4-14 years where most participation occurs. All commencing participants in the base year (2010) were tracked over the 7 year period. Participants were classified in two ways: the total number of years they played and their overall pattern of participation. Differences between age groups were analyzed using Kruskall Wallis and Mann Whitney tests. Registration records of 29,225 participants were analyzed in the study. Overall, there were considerable differences in the years participating in the sport. Almost one third (30%) of commencing 4-9 year olds played continuously for the 7 years. This proportion diminished through ages at commencement from 10 to 19, reaching a low point of 4% for ages 15-19, then rebounded slightly, reaching 7% for ages 30+. The proportion who dropped out during the 7 year period and did not return varied with age in the converse manner, as did the proportion of single-year players. The optimal age of entry to sport for retention in participation was 6-9 years. Consideration needs to be given to the age appropriateness of sports programs for very young participants. Strategies specifically relating to retention of girls and young women during adolescence should be developed.

Demographic characteristics and type/frequency of physical activity participation in a large sample of 21,603 Australian people.

BACKGROUND: Regular physical activity (PA) is imperative for good health and there are many different ways that people can be active. There are a range of health, PA and sport policies aiming to get more people active more often. Much research has been directed towards understanding the determinants of inactivity and PA. However, it is important to understand the differences not only between inactive and active people, but also between activity contexts (for example participation in sport compared to non-sport activities), in order to align policies and strategies to engage market segments who have different participation preferences and accessibility. The aim of this study was to investigate demographic correlates of the propensity to be physically inactive or active within different contexts, and at different levels of frequency of participation. METHODS: Data from the Australian Exercise, Recreation and Sport Survey was used for this analysis. This included information on the type, frequency and duration of leisure-time PA for Australians aged 15 years and over. Reported PA participation in the two-week period prior to the survey was used to allocate respondents into three categories: no PA, non-sport PA only, and sport. Subsequently, sport participants were further categorised according to frequency of participation. Potential demographic correlates included sex, age, education, employment, marital status, language spoken, having a condition that restricts life, children, and socio-economic status. RESULTS: The survey included 21,603 people. Bivariate chi-squared analysis showed that there were significant differences between the profiles of leisure-time PA participation across all demographic variables, except the variable languages spoken at home. Ordinal regression analysis showed that the same demographic variables were also correlated with the propensity to engage in more organised and competitive PA contexts, and to participate more frequently. CONCLUSIONS: People who were female, older, married or had a disability were less likely to participate in sport. Therefore when designing PA opportunities to engage those who are inactive, particularly those that are organised by a club or group, we need to ensure that appropriate strategies are developed, and tailored sport products offered, to ensure greater opportunities for increased diversity of participation in sport.

Girls' transition from participation in a modified sport program to club sport competition - a study of longitudinal patterns and correlates.

BACKGROUND: Participation in sport is very popular for young children. Many children participate in entry-level modified sports programs. These programs are modified to match the developmental capacity of children and are aimed at development of fundamental motor skills and sport-specific skills, rather than competition. There is limited research on the longitudinal tracking of children in these programs and into club-based competition. Research suggests that most children drop-out of the sport and do not transition into club-based competition. Furthermore, more females than males drop-out of sport. The aim of this study is to investigate longitudinally, the patterns and demographic predictors of children's transition from modified sport programs to club sport competition for females. METHODS: This study analysed sport participation for females in a popular Australian, predominantly female, sport. Players of the modified sports program were followed over 4 years to determine their pattern of transition: transition to junior player status, withdraw from the sport, or continue in the modified program. Pattern of transition was compared across age (4-10), geographical region (metropolitan/non-metropolitan) and socio-economic status (SES). Logistic regression was used to model the effect of the three factors on the likelihood of transition. RESULTS: A total of 13,760 female children (aged 4-10) participated in the modified sport in the first year. The majority (59%) transitioned from the modified sport program and into club competition. However the rate of transition varied with age, residential location and socio-economic status, and there was an interaction between region and SES, with SES having a significant influence on transition in the metropolitan region. The peak sport entry age with the highest rates of transition was 7-9 years. CONCLUSIONS: This study demonstrated that whilst the majority of female participants continued participantion and tranisitioned from the modified sport program and into club competition, the strongest correlate of transition was age of entry, with transition rate peaking among those who commenced at age 7-9 years. It is recommended that, in order to maximise continued participation, sport policy and strategic developments should consider the possibility that targeting the very young is not the optimum recruitment strategy for fostering continued sport participation.

Participant characteristics of users of holistic movement practices in Australia.

OBJECTIVES: The aim of this study was to compare the characteristics of users of holistic movement practices in Australia to people who were physically active but not using holistic movement practices. A second aim was to compare characteristics of users of specific holistic movement practices (yoga/Pilates and t'ai chi/qigong). DESIGN: We performed a secondary data analysis on pooled data of a nationally-representative physical activity survey conducted yearly 2001-2010 (n = 195,926). SETTING: Australia-wide Exercise, Recreation, and Sport Survey (ERASS). MAIN OUTCOME MEASURES: A range of socio-demographic and participation characteristics were documented and compared between users and non-users of holistic movement practices and between yoga/Pilates and t'ai chi/qigong users, employing descriptive statistics, chi square, and multiple logistic regression analyses. RESULTS: Users of holistic movement practices (n = 6826) were significantly more likely than non-users to be female, older, have fewer children at home, and have higher levels of education, socio-economic background, and physical activity involvement (p < 0.001). Yoga/Pilates (n = 5733) and t'ai chi/qigong (n = 947) users were also found to differ on a number of characteristics, including age, sex, socioeconomic background, and marital status. CONCLUSION: As a group, Australian users of holistic movement practices differ on a range of characteristics from those Australians active in other types of physical activities. However, differences between yoga/Pilates and t'ai chi/qigong users suggest these practices attract somewhat different sub-populations. To what extent these differences are due to characteristics inherent to the practices themselves or to differences in delivery-related parameters needs to be examined in future research.

Participation trends in holistic movement practices: a 10-year comparison of yoga/Pilates and t'ai chi/qigong use among a national sample of 195,926 Australians.

BACKGROUND: In recent decades, the evidence supporting the physical and mental health benefits of holistic movement practices such as yoga and t'ai chi have become increasingly established. Consequently, investigating the participation prevalence and patterns of these practices is a relevant pursuit in the public health field. Few studies have provided population-level assessment of participation rates, however, and even fewer have focused on patterns over time. The purpose of this study was to examine participation prevalence and trends in yoga/Pilates and t'ai chi/qigong over a ten-year period in a nationally representative sample of Australians aged 15 years and over, with particular attention to sex and age. A secondary purpose was to juxtapose these findings with participation trends in traditional fitness activities over the same period. METHODS: Data comprised modes and types of physical activity, age, and sex variables collected through the Exercise, Recreation and Sport Survey (ERASS), a series of independent cross-sectional Australia-wide surveys conducted yearly between 2001 and 2010. For each year, weighted population estimates were calculated for those participating in yoga/Pilates, t'ai chi/qigong, and fitness activities (e.g. aerobics, calisthenics). Linear regression and multiple logistic regression analyses were used to examine trends in prevalence rates over time and differences among sex and age (15-34; 35-54; 55+ years) groups, respectively. RESULTS: Average prevalence rates between 2001 and 2010 were 3.0% (95% CI 2.9-3.1) for yoga/Pilates, 0.6% (95% CI 0.5-0.6) for t'ai chi/qigong, and 19.2% (95% CI 18.9-19.4) for fitness activities. Across the decade, overall participation rates remained relatively stable for yoga/Pilates and t'ai chi/qigong, while increasing linearly for fitness activities. For both genders and in all three age groups, participation in fitness activities increased, whereas only in the 55+ age group was there a significant increase in yoga/Pilates participation; participation in t'ai chi/qigong declined significantly in the two younger age groups. CONCLUSIONS: Participation rates in yoga/Pilates and t'ai chi/qigong in Australia were low and relatively stable. As fitness activities increased in popularity across the decade, holistic movement practices did not. These findings point to the need to investigate activity-specific barriers and facilitators to participation, including intrapersonal, interpersonal, organisational, and environmental factors.

The relationship of sport participation to provision of sports facilities and socioeconomic status: a geographical analysis.

OBJECTIVE: Ecological models have been applied to investigate multiple domains influencing physical activity behaviour, including individual, social, organisational, community, environmental and policy factors. With regard to the built environment, research to date has been limited to small geographical areas and/or small samples of participants. This study examined the geographical association between provision of sport facilities and participation in sport across an entire Australian state, using objective total enumerations of both, for a group of sports, with adjustment for the effect of socioeconomic status (SES). METHODS: De-identified membership registration data were obtained from state sport governing bodies of four popular team sports. Associations between participation rate, facility provision rate and SES were investigated using correlation and regression methods. RESULTS: Participation rate was positively associated with provision of facilities, although this was complicated by SES and region effects. The non-metropolitan region generally had higher participation rates and better provision of facilities than the metropolitan region. CONCLUSIONS: Better provision of sports facilities is generally associated with increased sport participation, but SES and region are also contributing factors. Implications for public health: Community-level analysis of the population, sport participation and provision of facilities should be used to inform decisions of investments in sports facilities.

Who consults chiropractors in Victoria, Australia?: Reasons for attending, general health and lifestyle habits of chiropractic patients.

BACKGROUND: COAST (Chiropractic Observational and Analysis STudy) reported the clinical practices of chiropractors. The aims of this study were to: 1) describe the chiropractic patient demographic and health characteristics; 2) describe patient-stated reasons for visiting a chiropractor; 3) describe chiropractic patient lifestyle characteristics; 4) compare, where possible, chiropractic patient characteristics to the general Australian population. METHODS: Fifty-two chiropractors in Victoria, Australia, provided information for up to 100 consecutive encounters. If patients attended more than once during the 100 encounters, only data from their first encounter were included in this study. Where possible patient characteristics were compared with the general Australian population. RESULTS: Data were collected from December 2010 to September 2012. Data were provided for 4464 encounters, representing 3287 unique individuals. The majority of chiropractic encounters were for musculoskeletal conditions or for wellness/maintenance. The majority of patient comorbidities were musculoskeletal, circulatory or endocrine/metabolic in nature. Eight hundred chiropractic patients (57 %, 95 % CI: 53-61) described their self-reported health as excellent or very good and 138 patients (10 %, 95 % CI: 8-12) as fair or poor. Seventy-one percent of adult male patients (18 years and older), and 53 % of adult female patients, were overweight or obese. Fourteen percent (n = 188, 95 % CI: 12-16) were current smokers and 27 % (n = 359, 95 % CI: 24-31) did not meet Australian alcohol consumption guidelines. Less than half of the chiropractic patients participated in vigorous exercise at least twice per week. Approximately 20 % ate one serving of vegetables or less each day, and approximately 50 % ate one serve of fruit or less each day. Compared to the general Australian population, chiropractic patients were less likely to smoke, less likely to be obese and more likely to describe their health in positive terms. However, many patients were less likely to meet alcohol consumption guidelines, drinking more than is recommended. CONCLUSIONS: In general, chiropractic patients had more positive health and lifestyle characteristics than the Australian population. However, there were a significant proportion of chiropractic patients who did not meet guideline recommendations about lifestyle habits and there is an opportunity for chiropractors to reinforce public health messages with their patients.

Pumping Iron in Australia: Prevalence, Trends and Sociodemographic Correlates of Muscle Strengthening Activity Participation from a National Sample of 195,926 Adults.

OBJECTIVE: The current Australian Physical Activity Guidelines recommend that adults engage in regular muscle-strengthening activity (e.g. strength or resistance training). However, public health surveillance studies describing the patterns and trends of population-level muscle-strengthening activity participation are sparse. The aim of this study is to examine the prevalence, trends and sociodemographic correlates of muscle-strengthening activity participation in a national-representative sample of Australians aged 15 years and over. METHODS: Between 2001 and 2010, quarterly cross-sectional national telephone surveys were conducted as part of the Australian Sports Commission's 'Exercise, Recreation and Sport Survey'. Pooled population-weighted proportions were calculated for reporting: [i] no muscle-strengthening activity; [ii] insufficient muscle-strengthening activity, and [iii] sufficient muscle-strengthening activity. Associations with sociodemographic variables were assessed using multiple logistic regression analyses. RESULTS: Out of 195,926 participants, aged 15-98 years, only 10.4% (95% CI: 10.1-10.7) and 9.3% (95% CI: 9.1-9.5) met the muscle-strengthening activity recommendations in the past two weeks and in the past year, respectively. Older adults (50+ years), and those living in socioeconomically disadvantaged, outer regional/remote areas and with lower education were less likely to report sufficient muscle-strengthening activity (p<0.001). Over the 10-year monitoring period, there was a significant increase in the prevalence of sufficient muscle-strengthening activity (6.4% to 12.0%, p-value for linear trend <0.001). CONCLUSIONS: A vast majority of Australian adults did not engage in sufficient muscle-strengthening activity. There is a need for public health strategies to support participation in muscle-strengthening activity in this population. Such strategies should target older and lower educated adults, and those living in socioeconomically disadvantaged, outer regional/remote and areas.

Age profiles of sport participants.

BACKGROUND: Participation in sport has many health benefits, and is popular amongst children. However participation decreases with age. While the membership records of peak sports organisations have improved markedly in recent years, there has been little research into sport participation trends across the lifespan. This study investigates age profiles of participation in sport and compares these trends between genders and residential locations. METHODS: De-identified 2011 participant registration data for seven popular Australian sports (Australian Football, Basketball, Cricket, Hockey, Lawn Bowls, Netball and Tennis) were obtained and analysed according to age, gender and geographical location (metropolitan v non-metropolitan) within the state of Victoria, Australia. All data were integrated and sports were analysed collectively to produce broadly based participation profiles while maintaining confidentiality of membership data for individual sports. RESULTS: The total number of registered participants included in the data set for 2011 was 520,102. Most participants (64.1 %) were aged less than 20 years. Nearly one third (27.6 %) of all participants were aged 10-14 years, followed by the 5-9 year age group (19.9 %). Participation declined rapidly during adolescence. A higher proportion of males than female participants were young children (4-7 years) or young adults 18-29 years; this pattern was reversed among 8-17 year-olds. A higher proportion of metropolitan participants were engaged between the ages of 4-13 and 19-29, whereas a higher proportion of non-metropolitan participants played during adolescence (14-18 years) and throughout mature adulthood (30+ years). CONCLUSIONS: Increasing participation in sport is an objective for both government and sporting organisations. In order to have both mass population-based participation, from a health policy and elite performance perspective, we need to further explore the findings arising from the analysis of this extensive data set. Such an examination will lead to better understand of the reasons for attrition during adolescence to inform program and policy developments to retain people participating in sport, for a healthy and sport performing nation.

Providing services for acute low-back pain: A survey of Australian physiotherapists.

OBJECTIVE: To determine whether physiotherapists avoid lumbar X-rays for acute non-specific low back pain and advise people to stay active. METHODS: We conducted a cross sectional survey of Australian physiotherapists. 880 physiotherapists were randomly sampled from Victoria (495), South Australia (158), and Western Australia (227). Physiotherapists were asked which investigations they would order and interventions they would provide for five acute low back pain (LBP) presentations described in vignettes. Four of the five vignettes represented people who would not require a plain lumbar X-ray and would benefit from advice to stay active; one described a patient with a suspected vertebral fracture and would require a plain X-ray. Participants selected from a list of response options or provided free text responses. RESULTS: Questionnaires were completed by 203 of 567 potentially eligible physiotherapists (response rate 36%). Across the four vignettes where an X-ray was not indicated, 75% (95%CI 71-78%) of physiotherapists reported they would practice concordant with the guidelines and not order an X-ray, and 62% (95%CI 57-66%) provided advice to stay active. CONCLUSIONS: Most physiotherapists report intended compliance with recommendations in Australian clinical practice guidelines (CPGs) regarding avoiding the use of X-rays and providing advice to stay active for people with simple acute low back pain, given a vignette based scenario. The majority of respondents reported that they would not advise bed rest. Possible opportunities to further enhance compliance need to be developed and tested to reinforce the role of CPGs in informing physiotherapy practice.

Participation in modified sports programs: a longitudinal study of children's transition to club sport competition.

BACKGROUND: Many children are not physically active enough for a health benefit. One avenue of physical activity is modified sport programs, designed as an introduction to sport for young children. This longitudinal study identified trends in participation among children aged 4-12 years. Outcomes included continuation in the modified sports program, withdrawal from the program or transition to club sport competition. METHODS: De-identified data on participant membership registrations in three popular sports in the Australian state of Victoria were obtained from each sport's state governing body over a 4-year period (2009-2012 for Sport A and 2010-2013 for Sports B and C). From the membership registrations, those who were enrolled in a modified sports program in the first year were tracked over the subsequent three years and classified as one of: transition (member transitioned from a modified sport program to a club competition); continue (member continued participation in a modified sport program; or withdraw (member discontinued a modified program and did not transition to club competition). RESULTS: Many modified sports participants were very young, especially males aged 4-6 years. More children withdrew from their modified sport program rather than transitioning. There were age differences between when boys and girls started, withdrew and transitioned from the modified sports programs. CONCLUSIONS: If we can retain children in sport it is likely to be beneficial for their health. This study highlights considerations for the development and implementation of sport policies and programming to ensure lifelong participation is encouraged for both males and females.

Participation in sport and physical activity: associations with socio-economic status and geographical remoteness.

BACKGROUND: Many factors influence participation in sport and Physical Activity (PA). It is well established that socio-economic status (SES) is a critical factor. There is also growing evidence that there are differences in participation patterns according to residential location. However, little is known more specifically about the relationship of PA participation and frequency of participation in particular contexts, to SES and residential location. This study investigated the relationship of participation, and frequency and context of participation, to SES and location. METHODS: Three aspects of participation were investigated from data collected in the Exercise, Recreation and Sport Survey (ERASS) 2010 of persons aged 15+ years: any participation (yes, no), regular participation (<12 times per year, ≥ 12 times per year) and level of organisation of participation setting (non-organised, organised non-club setting, club setting). RESULTS: The rates of both any and regular PA participation increased as SES increased and decreased as remoteness increased. However, participation in PA was SES- or remoteness-prohibitive for only a few types of PA. As remoteness increased and SES decreased, participation in many team sports actually increased. For both SES and remoteness, there were more significant associations with overall participation, than with regular participation or participation in more organised contexts. CONCLUSIONS: This study demonstrates the complexity of the associations between SES and location across different contexts of participation. Nevertheless, it seems that once initial engagement in PA is established, SES and remoteness are not critical determinants of the depth of engagement.

Who uses Australian chiropractic services?

BACKGROUND: The use of chiropractic services is widespread, however, little is known about the characteristics of people who seek chiropractic care in Australia. This study compared the characteristics of users and non-users of chiropractic services from a cohort of patients sourced from general medical practice in Victoria, Australia. METHODS: This is a secondary analysis of baseline screening data from a prospective adult cohort study beginning in 2005. Thirty randomly selected Australian general medical practices mailed out surveys to 17,780 of their patients. Differences were examined between chiropractic users and others, and between chiropractic users who reported a back problem to those who did not. RESULTS: Of 7,519 respondents, 15% indicated they had visited a chiropractor in the last 12 months. Chiropractic users were more likely to have their GP located in a rural location and to be born in Australia; they were less likely to be in the older age group (55-76), to be unemployed or to have a pension/benefit as their main source of income. Chiropractic users were more likely to: have a back problem; use complementary or alternative medication; visit another type of complementary health practitioner or a physiotherapist. They were less likely to take medication for certain health problems (e.g. for high blood pressure, high cholesterol or asthma). No important differences were seen between chiropractic users and non-users for other health problems. People who visited a chiropractor and reported a back problem were more likely to: be a current smoker; have a number of other chronic conditions, including arthritis, hypertension, chronic sinusitis, asthma, dermatitis, depression and anxiety; report taking medications, including antidepressants, analgesics (painkillers and arthritis medication) and complementary or alternative medications. CONCLUSIONS: This large cross-sectional study of general medical practice attendees suggests that chiropractors are the most commonly consulted complementary health profession. Chiropractors should ensure they are aware of their patients' health conditions other than musculoskeletal problems and should ensure they are appropriately managed.

A systematic review of the psychological and social benefits of participation in sport for adults: informing development of a conceptual model of health through sport.

BACKGROUND: The definition of health incorporates the physical, social and mental domains, however the Physical Activity (PA) guidelines do not address social health. Furthermore, there is insufficient evidence about the levels or types of PA associated specifically with psychological health. This paper first presents the results of a systematic review of the psychological and social health benefits of participation in sport by adults. Secondly, the information arising from the systematic review has been used to develop a conceptual model of Health through Sport. METHODS: A systematic review of 14 electronic databases was conducted in June 2012, and studies published since 1990 were considered for inclusion. Studies that addressed mental and/or social health benefits from participation in sport were included. RESULTS: A total of 3668 publications were initially identified, of which 11 met the selection criteria. There were many different psychological and social health benefits reported, with the most commonly being wellbeing and reduced distress and stress. Sport may be associated with improved psychosocial health in addition to improvements attributable to participation in PA. Specifically, club-based or team-based sport seems to be associated with improved health outcomes compared to individual activities, due to the social nature of the participation. Notwithstanding this, individuals who prefer to participate in sport by themselves can still derive mental health benefits which can enhance the development of true-self-awareness and personal growth which is essential for social health. A conceptual model, Health through Sport, is proposed. The model depicts the relationship between psychological, psychosocial and social health domains, and their positive associations with sport participation, as reported in the literature. However, it is acknowledged that the capacity to determine the existence and direction of causal links between participation and health is limited by the cross-sectional nature of studies to date. CONCLUSION: It is recommended that participation in sport is advocated as a form of leisure-time PA for adults which can produce a range of health benefits. It is also recommended that the causal link between participation in sport and psycho-social health be further investigated and the conceptual model of Health through Sport tested.