Dr Mark Babic

The aim of this study was to develop, implement and evaluate the novel one-day, school-based health education program Yantiin Kalabara that embedded Aboriginal and Torres Strait Islander culture and perspectives within a series of interactive learning stations. In consultation with local Aboriginal and Torres Strait Islander community members, the Yantiin Kalabara program was designed to encourage healthy lifestyle choices and promote strong, sustainable and mutually respectful relationships between Aboriginal and Torres Strait Islander peoples and non-Aboriginal Australians. The program involved five primary schools (March¿July 2021) within the Awabakal, Wonnarua, Darkinjung and Worimi Countries (Australia) in movement-based and culturally rich learning activities (primarily dance). The feasibility of the program for use in primary schools (mean age: 10.1±1.2yrs) and preliminary efficacy for affecting change in key health behaviours (physical activity, nutrition, screen-time) was assessed using student questionnaires. Yantiin Kalabara was delivered as intended by the Hunter Primary Care team and volunteers. Students (N = 293) reported that Yantiin Kalabara helped them improve their overall health (mean 3.6 out of 4), physical activity (mean 3.4/4), eating habits (mean 3.3/4) and screen-time patterns (mean 3.2/4). We have demonstrated that the Yantiin Kalabara program can be feasibly delivered in primary schools, and that the program was efficacious in affecting positive changes in key health behaviours of participating children. However, further evaluation of Yantiin Kalabara in larger and more diverse populations using a randomised controlled trial is warranted.

The aim of our systematic review and meta-analysis was to quantitatively synthesise the effects of school-based peer-led interventions on leaders' academic, psychosocial, behavioural, and physical outcomes. Eligible studies were those that: (i) evaluated a school-based peer-led intervention using an experimental or quasi-experimental study design, (ii) included an age-matched control or comparison group, and (iii) evaluated the impact of the intervention on one or more leader outcomes. Medline, Sportdiscus, Psychinfo, Embase, and Scopus online databases were searched on the 24th of October, 2022 which yielded 13,572 results, with 31 included in the narrative synthesis and 12 in the meta-analysis. We found large positive effects for leaders' attitudes toward bullying (d = 1.02), small-to-medium positive effects for leaders' literacy (d = 0.39), and small positive effects for leaders' self-esteem (d = 0.18). There were mixed findings for behavioural outcomes and null effects for physical outcomes. Notable limitations of this research are the inclusion of a relatively small number of studies, and high heterogeneity in those included. Our findings have the potential to inform educational practice, but also highlight the need for further research examining the mechanisms that might account for the observed effects. Our systematic review was prospectively registered with PROSPERO (CRD42021273129).

The purpose of this study was to assess the feasibility and preliminary efficacy of a high-intensity interval training (HIIT) intervention integrated into the workplace on physical and mental health outcomes in a sample of adults. The Work-HIIT intervention was evaluated at the University of Newcastle (March-July 2019). University employees (18+¿years) who self-identified as predominantly sedentary at work (n¿=¿47, 43.0¿±¿10.7¿years; 41 female) were recruited, screened, and randomized after baseline assessments into Work-HIIT (n¿=¿24) or wait-list control (n¿=¿23) conditions. Participants were asked to attend 2-3 researcher-facilitated HIIT sessions/week (weeks 1-8). Sessions included a 2-minute gross-motor warm-up, followed by various combinations of aerobic and muscular fitness exercises lasting 8¿minutes (using 30:30¿second work: rest intervals). Program feasibility was assessed using measures of satisfaction, compliance, adherence, fidelity, and retention. Physiological and psychological outcomes were measured at baseline and 9¿weeks. Feasibility data were investigated using descriptive statistics and efficacy outcomes determined using linear mixed models and Cohen's d effect sizes. Participant ratings showed high levels of satisfaction (4.6/5); 71% of participants attended =2 sessions/wk and averaged 85.9% HRmax across all sessions (including rest and work intervals). Small-to-medium positive effects resulted for cardiorespiratory fitness [+2.9 laps, 95% CI (-4.19-10.14); d¿=¿0.34] and work productivity [+0.26, d¿=¿0.47]. Large positive effects resulted for muscular fitness [push-ups +3.5, d¿=¿0.95; standing jump +10.1¿cm, d¿=¿1.12]; HIIT self-efficacy [+16.53, d¿=¿1.57]; sleep [weekday +0.76¿hours, d¿=¿1.05]; and autonomous motivation [+0.23, d¿=¿0.76]. This study supports the feasibility and preliminary efficacy of facilitator-led Work-HIIT as a time-efficient, enjoyable, and convenient workplace exercise option for adults.

Context The mental health benefits of physical activity are well established. However, less is known about whether the relationship between physical activity and mental health is consistent across different life domains. It is important to understand how context may influence the relationship between physical activity and mental health so that interventions and policy guidelines can be tailored to maximize positive effects. Evidence acquisition In 2015, systematic searches of four databases identified 13,435 records, of which 98 studies met the inclusion criteria. Evidence synthesis Included studies were published between 1988 and 2015 and had a combined sample size of 648,726. Of the 98 included studies, 93 examined leisure-time physical activity, 14 examined work-related physical activity, 15 examined transport physical activity, 16 examined household physical activity, three examined school sport, and three examined physical education. Multi-level meta-analyses showed that leisure-time physical activity (r =0.13) and transport physical activity (r =0.13) both had a positive association with mental health. Leisure-time physical activity (r = ¿0.11) and school sport (r = ¿0.09) both had an inverse association with mental ill-health. However, physical activity was not consistently associated with lower mental ill-health across domains, as work-related physical activity was positively associated with mental ill-health (r =0.09). Household physical activity and participation in physical education had no relationship with mental health or mental ill-health. Conclusions The domain in which physical activity occurs influences the relationship between physical activity and mental health and should, therefore, be considered when developing interventions, treatment programs, and policy guidelines.

Introduction The primary aim was to examine longitudinal associations between changes in screen-time and mental health outcomes among adolescents. Methods Adolescents (N¿=¿322, 65.5% females, mean age¿=¿14.4¿±¿0.6 years) reported screen-time and mental health at two time points over a school year. Multi-level linear regression analyses were conducted after adjusting for covariates. Results Changes in total recreational screen-time (ß¿=¿-0.09 p¿=¿0.048) and tablet/mobile phone use (ß¿=¿-0.18, p¿<¿0.001) were negatively associated with physical self-concept. Changes in total recreational screen-time (ß¿=¿-0.20, p¿=¿0.001) and computer use (ß¿=¿-0.23, p¿=¿0.003) were negatively associated with psychological well-being. A positive association was found with television/DVD use and psychological difficulties (ß¿=¿0.16, p¿=¿0.015). No associations were found for non-recreational screen-time. Conclusion Changes in recreational screen-time were associated with changes in a range of mental health outcomes.

Introduction The primary objective was to evaluate the impact of the 'Switch-off 4 Healthy Minds' (S4HM) intervention on recreational screen-time in adolescents. Methods Cluster randomized controlled trial with study measures at baseline and 6-months (post-intervention). Eligible participants reported exceeding recreational screen-time recommendations (i.e., >¿2¿h/day). In total, 322 adolescents (mean age¿=¿14.4¿±¿0.6¿years) from eight secondary schools in New South Wales, Australia were recruited. The S4HM intervention was guided by Self-Determination Theory and included: an interactive seminar, eHealth messaging, a behavioral contract and parental newsletters. The primary outcome was recreational screen-time. Secondary outcomes included mental health (i.e., well-being, psychological distress, self-perceptions), objectively measured physical activity, and body mass index (BMI). Outcome analyses were conducted using linear mixed models and mediation was examined using a product-of-coefficients test. Results At post-intervention, significant reductions in screen-time were observed in both groups, with a greater reduction observed in the intervention group (-¿50¿min/day versus -¿29¿min, p¿<¿0.05 for both). However, the adjusted difference in change between groups was not statistically significant (mean¿=¿-¿21.3¿min/day, p¿=¿0.255). There were no significant intervention effects for mental health outcomes, physical activity or BMI. Significant mediation effects for autonomous motivation were found. Conclusions Participants in both the S4HM intervention and control groups significantly reduced their screen-time, with no group-by-time effects. Enhancing autonomous motivation might be a useful intervention target for trials aimed at reducing adolescents' recreational screen-time. Trial registration ACTRN12614000163606.

Introduction: Excessive recreational screen time (i.e., screen use for entertainment) is a global public health issue associated with adverse mental and physical health outcomes. Considering the growing popularity of screen-based recreation in adolescents, there is a need to identify effective strategies for reducing screen time among adolescents. The aim of this paper is to report the rationale and study protocol for the 'Switch-off 4 Healthy Minds' (S4HM) study, an intervention designed to reduce recreational screen time among adolescents. Methods: The S4HM intervention will be evaluated using a cluster randomized controlled trial in eight secondary schools (. N=. 322 students) in New South Wales, Australia. The 6-month multi-component intervention will encourage adolescents to manage their recreational screen time using a range of evidence-based strategies. The intervention is grounded in Self-Determination Theory (SDT) and includes the following components: an interactive seminar for students, eHealth messaging, behavioral contract and parental newsletters. All outcomes will be assessed at baseline and at 6-months (i.e., immediate post-test). The primary outcome is recreational screen time measured by the Adolescent Sedentary Activity Questionnaire (ASAQ). Secondary outcomes include: self-reported psychological well-being, psychological distress, global physical self-concept, resilience, pathological video gaming and aggression, and objectively measured physical activity (accelerometry) and body mass index (BMI). Hypothesized mediators of behavior change will also be explored. Discussion: The S4HM study will involve the evaluation of an innovative, theory-driven, multi-component intervention that targets students and their parents and is designed to reduce recreational screen time in adolescents. The intervention has been designed for scalability and dissemination across Australian secondary schools.

Background Evidence suggests that physical self-concept is associated with physical activity in children and adolescents, but no systematic review of this literature has been conducted. Objective The primary aim of this systematic review and meta-analysis was to determine the strength of associations between physical activity and physical self-concept (general and sub-domains) in children and adolescents. The secondary aim was to examine potential moderators of the association between physical activity and physical self-concept. Methods A systematic search of six electronic databases (MEDLINE, CINAHL, SPORTDiscus, ERIC, Web of Science and Scopus) with no date restrictions was conducted. Random effects meta-analyses with correction for measurement were employed. The associations between physical activity and general physical self-concept and sub-domains were explored. A risk of bias assessment was conducted by two reviewers. Results The search identified 64 studies to be included in the meta-analysis. Thirty-three studies addressed multiple outcomes of general physical self-concept: 28 studies examined general physical self-concept, 59 examined perceived competence, 25 examined perceived fitness, and 55 examined perceived appearance. Perceived competence was most strongly associated with physical activity (r = 0.30, 95 % CI 0.24-0.35, p < 0.001), followed by perceived fitness (r = 0.26, 95 % CI 0.20-0.32, p < 0.001), general physical self-concept (r = 0.25, 95 % CI 0.16-0.34, p < 0.001) and perceived physical appearance (r = 0.12, 95 % CI 0.08-0.16, p < 0.001). Sex was a significant moderator for general physical self-concept (p < 0.05), and age was a significant moderator for perceived appearance (p = 0.01) and perceived competence (p < 0.05). No significant moderators were found for perceived fitness. Conclusion Overall, a significant association has been consistently demonstrated between physical activity and physical self-concept and its various sub-domains in children and adolescents. Age and sex are key moderators of the association between physical activity and physical self-concept. © 2014 Springer International Publishing Switzerland.

The primary aim of this study was to examine the association between the types of video games played by adolescent boys and their participation in physical activity and recreational screen-time. Participants were 320 boys (mean age=12.7, ±0.5 years) from 14 secondary schools located in low-income areas of New South Wales, Australia. Outcomes included height, weight, physical activity (accelerometers), total screen-time, and video game genre preference. Significant differences in both weekday and weekend screen-time were found between video game genre groups. In addition, significant differences in overall activity and moderate-to-vigorous physical activity were found between genre groups on weekdays. Between-group differences in physical activity on weekends were not statistically significant. This cross-sectional study has demonstrated that video game genre preference is associated with physical activity and screen-time in adolescent boys from low-income communities.

Introduction: The negative consequences of unhealthy weight gain and the high likelihood of pediatric obesity tracking into adulthood highlight the importance of targeting youth who are 'at risk' of obesity. The aim of this paper is to report the rationale and study protocol for the 'Active Teen Leaders Avoiding Screen-time' (ATLAS) obesity prevention intervention for adolescent boys living in low-income communities. Methods/design: The ATLAS intervention will be evaluated using a cluster randomized controlled trial in 14 secondary schools in the state of New South Wales (NSW), Australia (2012 to 2014). ATLAS is an 8-month multi-component, school-based program informed by self-determination theory and social cognitive theory. The intervention consists of teacher professional development, enhanced school-sport sessions, researcher-led seminars, lunch-time physical activity mentoring sessions, pedometers for self-monitoring, provision of equipment to schools, parental newsletters, and a smartphone application and website. Assessments were conducted at baseline and will be completed again at 9- and 18-months from baseline. Primary outcomes are body mass index (BMI) and waist circumference. Secondary outcomes include BMI z-scores, body fat (bioelectrical impedance analysis), physical activity (accelerometers), muscular fitness (grip strength and push-ups), screen-time, sugar-sweetened beverage consumption, resistance training skill competency, daytime sleepiness, subjective well-being, physical self-perception, pathological video gaming, and aggression. Hypothesized mediators of behavior change will also be explored. Discussion: ATLAS is an innovative school-based intervention designed to improve the health behaviors and related outcomes of adolescent males in low-income communities. © 2013 Elsevier Inc.