Understanding the challenges of injury in providing sport programmes for physically inactive women: concept mapping insights from programme deliverers.

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.

Attitudes and Opinions of Parents towards Water-Only Drink Policy at Junior Triathlon Events.

Rates of childhood obesity within Australia continue to rise, with consumption of sugar-sweetened beverages one contributing factor. Community sport provides an opportunity to implement policies promoting water as the beverage of choice. However, the attitudes of parents toward a water-only policy are not known. This cross-sectional study aimed to investigate parents' opinions towards beverage consumption and a water-only policy. Data were collected from participants (n = 159) using an investigator-designed questionnaire, administered using iPads, at a junior Triathlon Victoria event. Water was the most popular beverage provided before (75%), during (85%) and after (61%) sport. Parents were more likely to provide sports drinks to children older than 14 years (27%). Three-quarters (77%) of parents reported having received no information regarding hydration requirements. Parents rated the importance of hydration prior to, during and after a triathlon as high (9.08 ± 1.2, 8.76 ± 1.3 and 9.30 ± 0.4 out of 10, respectively). Parents were supportive of a water-only policy at all junior triathlon events and all junior sporting events (7.94 ± 1.3 and 7.86 ± 1.9, respectively). There was less support for a water-only policy for adult triathlons (6.40 ± 3.1). A water-only drink policy at junior sport is viewed positively by parents. This warrants further research and policy development to facilitate behaviour change.

Measuring change in adolescent physical activity: Responsiveness of a single item.

Self-report measures are frequently used to assess change in physical activity (PA) levels. Given the limited data from adolescent populations, the primary objective of this study was to examine the responsiveness of a single item measure (SIM) of PA for adolescents to detect change in moderate-to-vigorous physical activity (MVPA) using accelerometer data as the reference measure. A secondary objective was to provide further data on the validity of the measure at one point in time. The validity of the SIM to determine the number of days ≥60 minutes of MVPA was based on data from 200 participants (62% female; age: 14.0 ± 1.6 years) and analysis of change was based on data from 177 participants (65% female; age: 14.0 ± 1.6 years). Validity of change in days ≥60 minutes of MVPA was examined through agreement in classification of change between the SIM and accelerometry as the reference measurement and Spearman's correlation. Cohen's d and standardised response means were used to assess the responsiveness to change of the measure. The responsiveness of the SIM and accelerometer data were comparable and modest (0.27-0.38). The correlation for change in number of days ≥60 minutes MVPA between the SIM and accelerometery was low (r = 0.11) and the accuracy of the SIM for detecting change, using accelerometry as the reference, was only marginally above chance (53%). Therefore, the adolescent version of the SIM is adequate for assessing PA at a single time point but not recommended for assessing change.

The Gambling Behaviour and Attitudes to Sports Betting of Sports Fans.

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.

Staying safe while staying together: the COVID-19 paradox for participants returning to community-based sport in Victoria, Australia.

OBJECTIVE: To identify the challenges adult community sport participants anticipate when returning to sport in Victoria, Australia, post a COVID-19 shutdown. METHODS: Using online concept mapping, participants brainstormed challenges to returning to community sport, sorted them into groups and rated them for impact and ability/capacity to overcome. Analysis included multidimensional scaling and hierarchical cluster analysis. RESULTS: Forty-five community sport participants representing 24 sports identified 69 unique challenges to returning to sport. Eight clusters/questions participants need answered emerged from the sorting data (mean cluster impact and ability/capacity rating out of 5): Will we have enough participants? (3.32, 2.89); How do we stay safe? (3.31, 3.35); How will our sport change? (3.17, 2.85); How can we stay together? (3.15, 3.01); Will I be physically ready? (3.15, 3.05); What about the money? (2.86, 2.53); What about me? (2.65, 3.13); and What about the facilities? (2.49, 2.45). CONCLUSIONS: Participants perceived paradoxical challenges to returning to sport after COVID-19 shutdown, which revolved around staying safe, staying connected and accessing meaningful sport activities. Implications for public health: Sport organisations and public health practitioners should address the participant-centred challenges identified in this study to maximise the public health benefits of participants returning to community sport.

Interventions to reduce sugar-sweetened beverage consumption using a nudge approach in Victorian community sports settings.

OBJECTIVE: To assess the effectiveness of interventions using a nudge approach to reduce sugar-sweetened beverage purchases in community sports settings. METHODS: A total of 155 community sporting organisations participating in VicHealth funded programs were invited to nominate a nudge based on a traffic light approach to drinks classification. These included limit red drinks, red drinks off display, water the cheapest option, and meal deals. Sales data was collected for a predetermined period prior to and following the introduction of the nudge. Nudges were classified initially on whether they were implemented to VicHealth standards. Appropriately implemented nudges were classified as successful if they achieved a relative decrease in sales from drinks classified as red. RESULTS: In all, 148 organisations trialled 195 nudges; 15 (7.7%) were successful and 20 (10.3%) were appropriately implemented but unsuccessful. Limit red drinks was the most frequently attempted nudge (30.8%). Red drinks off display had the greatest rate of success (20.0%). CONCLUSIONS: Red drinks off display was the simplest and most successful nudge. Implications for public health: Guidelines limiting the display of sugar-sweetened beverages may be an effective means of altering consumer behaviour.

Healthy-Canteen Displays: A Tactic to Encourage Community Sport Canteens to Provide Healthier Food and Beverage Options.

(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.

The Challenges of Partnering to Promote Health through Sport.

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.

Deep Learning to Predict Energy Expenditure and Activity Intensity in Free Living Conditions using Wrist-specific Accelerometry.

Wrist-worn accelerometers are more comfortable and yield greater compliance than hip-worn devices, making them attractive for free-living activity assessments. However, intricate wrist movements may require more complex predictive models than those applied to hip-worn devices. This study developed a novel deep learning method that predicts energy expenditure and physical activity intensity of adults using wrist-specific accelerometry. Triaxial accelerometers were worn by 119 participants on their wrist and hip for two weeks during waking hours. A deep learning model was developed from week 1 data of 60 participants and tested using week 2 data for: (i) the remaining 59 participants (Group UT), and (ii) participants used for training (Group TR). Estimates of physical activity were compared to a reference hip-specific method. Moderate-to-vigorous physical activity predicted by the wrist-model was not different to the reference method for participants in Group UT (5.9±3.1vs. 6.3±3.3 hour/week) and Group TR (6.9±3.7 vs. 7.2±4.2 hour/week). At 60-s epoch level, energy expenditure predicted by the wrist-model on Group UT was strongly correlated with the reference method (r=0.86, 95%CI: 0.84-0.87) and closely predicted activity intensity (83.7%, 95%CI: 80.9-86.5%). The deep learning method has application for wrist-worn accelerometry in free-living adults.

Responsiveness of the single item measure to detect change in physical activity.

OBJECTIVE: The objective of this study was to evaluate the responsiveness of the single item measure (SIM) to detect change in PA when compared to hip-worn accelerometry. A secondary aim was to provide further data on validity of the measure at a single time point. METHODS: Validity of the SIM to determine the number of days of ≥30 minutes of accelerometer-derived moderate-to-vigorous physical activity (MVPA) was assessed in 120 participants (78% female, 19% male, 3% other; age: 46 ± 11 years). Analysis of change was based on change in the number of days that participants completed ≥30 minutes of MVPA determined by the SIM and accelerometry over two 7-day periods in 90 participants (age: 47±11 years). Accelerometer data were analysed as total minutes of MVPA per day (MVPA-total) and as sustained bouts of 10 minutes or more of MVPA (MVPA-bouts). Validity of the SIM to detect change in MVPA, using accelerometer data as the reference measurement, was examined through Spearman's correlation and agreement in classification of change between SIM and accelerometry. Responsiveness to change was assessed by standardised response means and Cohen's d. RESULTS: Standardised response means for PA change were moderate for the SIM (0.77), MVPA-total (0.57) and MVPA-bouts (0.79). The correlation for change in number of days ≥30 minutes MVPA between the SIM and accelerometry were small to moderate (MVPA-total: r = 0.36 and MVP-bouts: r = 0.40). The SIM displayed moderate accuracy (60%-63%), using accelerometer data as the reference measurement, in detecting increases in days ≥30 minutes of MVPA. CONCLUSION: The SIM is a potentially useful assessment tool for evaluating change in MVPA, particularly when device-based measures or longer self-report measures are not feasible.

Challenges for sport organisations developing and delivering non-traditional social sport products for insufficiently active populations.

OBJECTIVES: To explore the challenges that Victorian sporting organisations experience when developing, delivering or scaling non-traditional social sport products to engage insufficiently active people. METHODS: Online Concept Mapping was used to gather qualitative data and analyse it quantitatively. RESULTS: A total of 68 participants (27 organisations) brainstormed 158 challenges. The research team synthesised these to 71 unique challenges for participants to sort into groups and rate for importance (0-5) and ease of overcoming (0-5). A nine-cluster solution - Deliverers; Capacity to drive the product; Facilities and partnerships; Product development; Sustainable business model; Marketing to insufficiently active; Attracting the insufficiently active; Clubs and volunteers; and Shifting traditional sport culture - was considered most appropriate. Participants rated the Deliverers challenges as the most important (mean=3.52), and the Marketing to insufficiently active challenges as the easiest to overcome (2.72). CONCLUSIONS: Key ingredients to successfully developing and delivering non-traditional sport opportunities for insufficiently active populations are: recruiting appropriate product deliverers; building the capacity of delivery organisations and systems; and developing products relevant to the delivery context that align with the needs and characteristics of the target population. Implications for public health: A system-wide response is required to address the challenges associated with sport organisations developing, scaling and delivering innovative social sport products for insufficiently active populations.

Wrist-specific accelerometry methods for estimating free-living physical activity.

OBJECTIVES: To compare accelerometry-derived estimates of physical activity from 9 wrist-specific predictive models and a reference hip-specific method. DESIGN: Prospective cohort repeated measures study. METHODS: 110 participants wore an accelerometer at wrist and hip locations for 1 week of free-living. Accelerometer data from three axes were used to calculate physical activity estimates using existing wrist-specific models (3 linear and 6 artificial neural network models) and a reference hip-specific method. Estimates of physical activity were compared to reference values at both epoch (≤60-s) and weekly levels. RESULTS: 9044h were analysed. Physical activity ranged from 7 to 96min per day of moderate-to-vigorous physical activity (MVPA). Method of analysis influenced determination of sedentary behaviour (<1.5 METs), light physical activity (1.5 to <3 METs) and MVPA (>3 METs) (p<0.001, respectively). All wrist-specific models produced total weekly MVPA values that were different to the reference method. At the epoch level, Hildebrand et al. (2014) produced the strongest correlation (r=0.69, 95%CI: 0.67-0.71) with tightest ratio limits of agreement (95%CI: 0.53-1.30) for MVPA, and highest agreement to predict MVPA (94.1%, 95%CI: 94.0-94.1%) with sensitivity of 63.1% (95%CI: 62.6-63.7%) and specificity of 96.0% (95%CI: 95.9-96.0%). CONCLUSIONS: Caution is required when comparing results from studies that use inconsistent analysis methods. Although a wrist-specific linear model produced results that were most similar to the hip-specific reference method when estimating total weekly MVPA, modest absolute and relative agreement at the epoch level suggest that additional analysis methods are required to improve estimates of physical activity derived from wrist-worn accelerometers.

Brief Education Intervention Increases Nutrition Knowledge and Confidence of Coaches of Junior Australian Football Teams.

This study evaluated the impact of a brief (20-min) nutrition education intervention embedded in an existing mandatory coach education course for coaches of junior (8-12 years old) Australian football teams. A total of 284 coaches (68% of 415 coaching course participants) completed a presession questionnaire, and 110 coaches (27% of coaching course participants) completed an identical postsession questionnaire. The responses to the pre- and postsession surveys were matched for 78 coaches. Coaches' ratings of their own understanding of the nutritional needs of young athletes (6.81, 8.95; p < .001), the importance of young athletes adhering to a healthy diet (9.09, 9.67; p = .001), their confidence in their own nutrition knowledge (7.24, 8.64; p < .001), and their confidence in advising young athletes on nutrition and hydration practices (6.85, 8.62; p < .001), all significantly improved following the education session. Nearly all coaches (>95%) provided a correct response to six of the 15 nutrition and hydration knowledge questions included in the presession questionnaire. Even with this high level of presession knowledge, there was a significant improvement in the coaches' nutrition and hydration knowledge after the education session across five of the 15 items, compared with before the education session. The results of this study suggest that a simple, short nutrition education intervention, embedded in an existing coach education course, can positively influence the nutrition knowledge and self-efficacy of community-level, volunteer coaches of junior sports participants.

The impact of coaches providing healthy snacks at junior sport training.

OBJECTIVE: Sports clubs provide an opportunity to tackle childhood obesity rates through targeted interventions. Our study aimed to investigate if coaches providing healthy snacks to participants before junior netball sessions at five clubs in Melbourne, Australia, increased consumption of healthy foods and influenced coach perceptions of participants' attention/participation levels. METHODS: Coaches provided healthy snacks to participants before each netball session for one school term. Children's food consumption was observed at one session before, during and after the intervention. Parents attending the observed session completed pre- and post-intervention questionnaires. Coaches rated participants' attention/participation at the observed sessions before and during the intervention, and completed a questionnaire post-intervention. RESULTS: Baseline: Ice cream and cake were the most frequently consumed snacks. During intervention: Fruit, cheese and crackers and vegetables were the most frequently consumed snacks. Coaches ratings of participants' attention/participation increased significantly (baseline: 6.4 ± 0.17, intervention: 7.5 ± 0.36; p=0.02) where the same coach undertook ratings at both time points. CONCLUSIONS: Coaches providing healthy snacks before sessions at sports clubs increased consumption of nutrient-dense foods at the session, and may have positively affected participants' attention/participation. Implications for public health: This study highlights how a simple intervention could improve the diet of Australian children.