ABSTRACT
OBJECTIVE: Physical inactivity is an important modifiable cause of the excess burden of disease among Indigenous Australians. We describe physical activity patterns and influencing factors, comparing Indigenous and non-Indigenous adolescents. METHODS: Indigenous (n=359) and non-Indigenous (n=637) adolescents aged 13-17 years from disadvantaged New South Wales regions completed a health and lifestyle survey. Socio-demographic, social, psychosocial and health correlates of out of school physical activity (high vs. low) among the whole sample, and stratified by Indigenous status were examined. RESULTS: Only 21% of Indigenous and 28% of non-Indigenous adolescents achieved higher levels of physical activity. Overall, higher levels were associated with being male; sports team membership; lower levels of TV viewing time and having an employed mother. Indigenous girls were less active than boys (OR=0.36; 85%CI=0.24-0.54), as were those whose mothers were unemployed (OR=0.66; 95%CI=0.40-1.09). Among non-Indigenous adolescents, high levels of physical activity were associated with sports team membership (OR=2.28; 95%CI=1.39-3.74) and community involvement (OR=1.46; 95%CI=1.04-2.06). CONCLUSIONS: Physical activity levels were similarly low among disadvantaged Indigenous and non-Indigenous adolescents. Some influencing factors existed across the whole sample; others in stratification by Indigenous status. Implications for public health: Early and targeted, supportive approaches are necessary. Some apply to disadvantaged adolescents broadly; others are Indigenous or non-Indigenous specific.
Subject(s)
Adolescent Behavior , Exercise , Native Hawaiian or Other Pacific Islander/statistics & numerical data , Residence Characteristics , Adolescent , Australia , Cross-Sectional Studies , Female , Health Surveys , Humans , Male , New South Wales , Sedentary Behavior , Social Support , Socioeconomic Factors , Sports , Surveys and QuestionnairesABSTRACT
ISSUE ADDRESSED: The prevalence of smoking among the adult Aboriginal population is almost double that of the non-Aboriginal population. Research shows smoking cessation brief interventions have a positive impact on quit attempts. However, examples of statewide, Aboriginal-led initiatives that ensure health service delivery of brief intervention to all Aboriginal clients are limited. METHODS: Guidance from an Aboriginal chief investigator and key health stakeholders supported the development of the NSW SmokeCheck Program. One component of the program was the establishment of a state-wide network of Aboriginal Health Workers (AHWs) and other health professional participants. Another was a culturally specific training program to strengthen the knowledge, skills, and confidence of participants to provide an evidence-based brief smoking-cessation intervention to Aboriginal clients. The brief intervention was based on the transtheoretical model of behaviour change, adapted for use in Aboriginal communities. RESULTS: SmokeCheck training reached 35.5% of the total NSW AHW workforce over a 15-month period. More than 90% of participants surveyed indicated satisfaction with the curriculum content, workshop structure and training delivery, agreeing that they found it relevant, easy to understand and applicable to practice. CONCLUSIONS: An evidence-based approach to designing and delivering an Aboriginal-specific health promotion intervention appears to have facilitated the development of a state-wide network of Aboriginal and non-Aboriginal health professionals and strengthened their capacity to deliver a brief smoking cessation intervention with Aboriginal clients.
Subject(s)
Health Promotion/organization & administration , Health Services, Indigenous/organization & administration , Native Hawaiian or Other Pacific Islander , Smoking Cessation/ethnology , Smoking Cessation/methods , Community Health Workers/organization & administration , Cultural Competency , Health Plan Implementation , Health Promotion/methods , Humans , New South Wales/epidemiology , Patient Satisfaction , Smoking/ethnology , Social PlanningABSTRACT
ISSUE ADDRESSED: This paper reports on the evaluation of a culturally specific smoking cessation training program (SmokeCheck) for health professionals working in Aboriginal health in NSW. Training aimed to increase professionals' knowledge, skills and confidence to offer an evidence-based quit smoking brief intervention to Aboriginal clients. METHODS: Using a quasi-experimental pre-post with 165 matched intervention participants, surveys were completed immediately before (baseline) and 6-months post training. The control group were on a waiting list for 6 months before receiving the intervention, and completed surveys at baseline, immediately before training and 3-6 months following training. Surveys assessed knowledge, skills and confidence to deliver the intervention, availability of resources, and smoke-free status of homes. RESULTS: Post training, a higher proportion of intervention group participants were more confident talking about health effects (22%, p=0.001), offering quit advice (27%, p=0.001), assessing readiness to quit (31%, p=0.001) and initiating a conversation about smoking (24%, p=0.001). After training, more participants reported providing advice about NRT (15%, p=0.001), ETS (12%, p=0.006), and reducing tobacco use (10%, p=0.034), but no changes were reported in smoking or intention to quit. Conversely, the control group showed no significant changes. CONCLUSIONS: SmokeCheck training strengthened participants' knowledge, skills and confidence to deliver a smoking cessation intervention to Aboriginal clients.'
