Why children’s fundamental movement skill development is important, how Aussie kids are doing and how allied health practitioners can help.

A/Prof LM Barnett

Deakin University

A/Prof Barnett will firstly provide an overview of the Australian context of sport and physical activity for children, including the notion of physical literacy. Many Australian children do not meet physical activity guidelines, are not cardio-vascularly fit and are overweight or obese. Then she will give data on Australian children’s fundamental movement skills. Around half of Australian children are not competent in basic movement skills; e.g. the ability to catch, run and jump. Even in adolescence, when we would expect these skills to be mastered, movement skill competency is low. She will then use a lifespan approach to discuss the importance of children’s movement skill competence to future health. A/Prof Barnett will present a range of her studies covering the age period from pre-school to upper high school, and the key work of others in the field, to demonstrate the current state of evidence in this area and the remaining research questions to be answered. Importantly, there is now compelling evidence demonstrating that poor childhood movement skill competence and poor perceptions of movement competence, links to subsequent reduced physical activity and health-related physical fitness, and a higher chance of becoming overweight/obese. Finally she will discuss which children are most at risk of poor skill.

 Key Practice Points

Allied health practitioners have a crucial role to play. For example, paediatric physiotherapists and podiatrists have the opportunity to screen and promote movement skill competency in children and youth. This presentation will give practitioners a fresh perspective on the importance of movement skill development for all children.

Biography:

A/Prof Barnett had over 10 years in Health Promotion before entering academia. She completed a Bachelor in Social Science (Edith Cowan University), a Master’s in Public Health (University of New South Wales) and her PhD (2006-08, University of Sydney). She was then successful with prestigious research fellowships to engage in research full time: a NHMRC Early Career Fellowship from 2011-14, and an Alfred Deakin Research Fellowship from 2015-2016. Currently she is Course Leader of Honours in Health Promotion, Public Health and Health Science, Deputy Leader of the Health Undergraduate Team and a Member of the Institute for Physical Activity and Nutrition Research at Deakin University. She is President Elect of the International Motor Development Research Consortium, and a Sports Medicine Australia Fellow. She is internationally recognized in the assessment of children’s actual and perceived movement skill competency and the relationship between these skills and health behaviours. She has a career total > 125 publications. She has been awarded close to 4 million dollars of research funding, including competitive, international and government. Recently she was one of the three lead investigators to develop the Australian Physical Literacy plan.

Communicating Health – Understanding the Aspects of an Engaging Social Media Post

Ms Emma Herron1, Ms Annika Molenaar1, Mr Jamie Choong1, Dr Karen Klassen1, Dr Megan Lim2, Prof Linda Brennan3, Prof Mike Reid4, Prof Helen Truby1, Dr Tracy McCaffrey1

1Department of Nutrition, Dietetics & Food, Monash University, Notting Hill, Australia, 2Behaviours and Health Risks, Burnet Institute, Melbourne, Australia, 3School of Media & Communication, RMIT University , Melbourne, Australia, 4School of Economics, Finance & Marketing, RMIT University, Melbourne, Australia

Abstract:

Aim:
People are increasingly using social media (SM) to seek health and nutrition information, with some content increasing audience engagement (likes, comments, share etc). We aimed to identify strategies used on SM associated with higher engagement, across popular profiles in Australia, from food industry (n=10); lifestyle personalities (n=10); health organisations (n=7); and nutrition professionals (n=10).

Method:
An exploratory content analysis, using a coding framework was conducted on SM content (n=524 SM posts) across Instagram, Facebook and Twitter for 4 weeks (February to March) in 2018. The association between content strategies and engagement metrics was explored using multivariate linear regression.

Results:
Engagement was higher for lifestyle personalities on all platforms. Strategies most associated with higher engagement were content “Showing People” on Instagram (β 0.233, 95% CI (0.298 to 1.041), p<0.001) and a “Positive Tone” on Twitter (β 0.218, 95% Cl (0.037 to 0.246), p<0.009). Other strategies associated with increased engagement included “Fast-Paced” videos (e.g. recipes) on Facebook, “Body Image” related content on Instagram and “Visually Appealing” content on Twitter. Strategies associated with lower engagement were posts of “Health Success” on both Facebook (β= -0.208, 95% CI (-0.274 to -0.065), p <0.002) and Instagram (β= -0.228, 95% CI (-1.017 to -0.265), p<0.001) and Twitter content with “Links to Health Information” (β= -0.251, 95% CI (-0.265 to -0.067), p<0.001).

Significance of the findings to allied health:
Nutrition professionals and health organisations could learn from successful engagement strategies of online personalities as to how to increase reach and interactions with social media content.

Biography:

Dr Tracy McCaffrey is a Senior Lecturer in the Department of Nutrition, Dietetics and Food at Monash University. She is a Registered Nutritionist (UK) with a research focus in Public Health Nutrition. At Monash, she leads the research stream on Dietary Assessment Methodologies to provide specialist analysis and advice on suitable methods to assess dietary intake. She has advised government departments in Australia, New Zealand, UK and Ireland on the assessment of dietary intakes and consumer understanding of portion size. Dr McCaffrey is currently chair of the Melbourne group for the Nutrition Society of Australia and Trustee of the Australian Nutrition Trust Fund. She is co-investigator and project co-ordinator on Communicating Health.

Can I eat that? – Nutrition knowledge and behaviours or practices of pregnant women and clinicians

Dr Amelia Lee1, Dr Jessica Radcliffe2, Dr Michelle Newton2, Dr Regina Belski2

1Royal Women’s Hospital, Parkville, Australia, 2La Trobe University, Bundoora, Australia

Abstract:

Aim:
To measure pregnancy nutrition recommendation knowledge in pregnant women and clinicians and to explore how nutrition information influences food choice or nutrition counselling practices.

Method:
Participants self-administered a nutrition knowledge questionnaire asking about nutrition recommendations and source of nutrition information.  Interviews were then conducted to explore dietary behaviour and/or practices.

Results:
Clinicians nutrition knowledge score was higher than for women.  Gaps in knowledge included food group recommendations, weight gain recommendations and identifying high risk foods.  Clinicians procure their information from dietitians and print materials whereas women obtain their information from clinicians and the internet.  Interviews revealed that clinicians reported providing nutrition advice; however, few women reported receiving it.  When women did receive nutrition advice, it was brief, in general terms and at times conflicting.  Women want to know about the nutrition recommendations and the reasons for them.  Lack of nutrition knowledge, inadequate nutrition training and time constraints were associated with clinician’s ability to provide adequate and accurate nutrition advice.

Significance of the findings to allied health:
Enhancing nutrition knowledge is a cost-effective approach to optimising maternal and infant health outcomes.  Until knowledge deficits are addressed, opportunities for nutrition education, and the prevention of adverse health outcomes, will be limited.  Findings of this study highlight the need to develop accurate and comprehensive pregnancy nutrition education programs suitable for both women and clinicians.

Biography:

Move Baby Move: Physical activity ‘messaging’ needs of women with gestational diabetes mellitus: a qualitative study

Ms Anne Harrison1,2, Professor Nicholas Taylor2,3, Associate Professor Helena Frawley4,5, Professor Nora Shields2

1Werribee Mercy Hospital, Werribee, Australia, 2La Trobe University, Melbourne, Australia, 3Eastern Health, Box Hill, Australia, 4Monash University, Frankston, Australia, 5Cabrini Health, Malvern, Australia

Abstract:

Aim:
To identify the perceptions of women diagnosed with gestational diabetes mellitus (GDM) to physical activity during pregnancy?

Design:
A qualitative study with phenomenology and interpretative description as theoretical frameworks.

Method:
Pregnant women, with GDM, aged 18 to 40 years were purposively recruited. Recruitment continued until data saturation. Semi-structured interviews were recorded, transcribed verbatim and returned to participants for checking. Qualitative data were analysed thematically by three researchers independently. Data were coded, compared and themes developed, discussed and defined. Emergent themes were sent to participants and peer-reviewed for confirmation.

Results:
Twenty-seven women participated who were of mean age 32 years (SD 3), mean gestation 30 weeks (SD 5), mean pre-pregnancy body mass index 26 kg/m2 (SD 5) and born in 10 different countries. The process of communicating information about physical activity (messaging) was the main theme to emerge. Sub-themes included receiving information about physical activity from credible sources (‘who’), knowing what type and how much physical activity was safe for their pregnancy (‘what’), receiving information at GDM diagnosis as this triggered women’s desire to be more physically active (‘when’), understanding the positive effects of physical activity on pregnancy outcome (‘why’), and identifying flexible, individually-tailored physical activity options (‘how’).

Significance of findings for Allied Health:
Women with GDM wanted clear, simple and GDM-specific messages from credible sources to feel confident and safe being physically active. Health professionals can support women with a GDM pregnancy with targeted physical activity messages.

Biography:

Anne Harrison is a physiotherapist with over 30 year’s clinical experience including 20 years of health management experience. She is currently manager of physiotherapy services at Werribee Mercy Hospital in Melbourne. She has interests in women’s health and translating research into practice as well as health service planning. Anne’s present research is investigating physical activity participation for women diagnosed with GDM and has several publications in this area. Her qualifications include a Bachelor of Applied Science in Physiotherapy, a Master of Health Administration and she is currently a Professional Doctoral candidate.

 

Adherence rates to home exercise programs in older adults following hip fracture: A systematic review and meta-analysis

Ms Lucinda  Yau1, Mr  Brendon  Cook2, Mr  Tony  Nguyen2, Dr Sze-Ee Soh2

1Alfred Health , Caulfield , Australia, 2Monash University , Frankston , Australia

Abstract:

Aim:
To determine the adherence rates to prescribed home exercise programs in older adults following a hip fracture.

Method:
A PRISMA structured literature search was conducted in three databases. Randomised controlled trials were included, and study quality was assessed using the PEDro scale. Random-effects meta-analysis of participant adherence rates was performed using Stata.

Results:
Six studies met the predetermined inclusion criteria. Pooled adherence rates across all included studies was 61% (95% CI 0.53-0.68). In studies where the exercise programs was less than 6 months in duration, adherence rates was 71% (95% CI 0.63-0.79), while studies with exercise programs longer than 6 months had a pooled adherence rate of 55% (95% CI 0.48-0.63).

Significance of the findings to allied health:
The results of this systematic review and meta-analysis indicate that adherence rates to home exercise programs following hip fracture may be lower in programs that last for more than 6 months. This highlights the need for clinicians to consider the length of their interventions and service provision for older adults following a hip fracture, and how this may impact on their ability to make significant functional improvements.

Biography:

Bachelor Health Science and Masters of Physiotherapy Practice 2012

Post Graduate Certificate of Musculoskeletal Physiotherapy 2018

Senior Musculoskeletal/Spinal Cord Injuries/Amputee/ Physiotherapist

Caulfield Hospital Alfred Health

Strictly Come Dancing with Parkinson’s: a regional health service – community research initiative translating evidence into practice

Dr Anna Moran1, Ms Georgina Howard2, Ms Alys Cummings2

1Albury Wodonga Health – University Of Melbourne, Albury, Australia, 2Albury Wodonga Health, WODONGA, Australia

Abstract:

Aim:
o examine the impact of translating evidence-based dance classes for persons with Parkinson’s Disease (PD) into a regional Victorian dance school.

Method:
Pragmatic, multi-methods design. Persons with PD and their carers were invited to participate in a jointly-led rehabilitation staff, dance school initiative in regional Victoria to implement a 6 month evidence-based dance programme for persons with PD. Mirroring Shanahan & Morris’s work: capacity to participate safely in the classes was assessed, dance teachers were trained and baseline and follow-up measures were taken. Focus group interviews were undertaken with participants and dance staff. Data were analysed descriptively and thematically.

Results:
12 people with PD, 4 carers, 4 dance teachers and 2 rehabilitation staff participated in the initiative. The group were extremely varied in their PD presentation (n=11, Hoehn and Yahr range 1-5, median 2). Follow-up outcome measures demonstrated little functional change. The initiative engaged participants who were not currently accessing other rehabilitation services offered. The success of the intervention was perceived as: providing an opportunity for “connectedness” and “enjoyable movement”. This was achieved through a small funding grant and support from rehabilitation professionals alongside the skill of dance staff who used “happy music”, mirroring, repetition and the use of storey lines that were progressively built upon over the 6 month period. The programme has continued beyond the life of the project.

Significance to AH:
This initiative demonstrates the importance of translating low-cost, high impact evidence-based interventions into practice in settings outside traditional rehabilitation environments.

Biography:

Georgie Howard is a Physiotherapist currently working within the Transition Care Program and has a special interest in stroke recovery and Parkinson’s disease. Georgie has extensive clinical experience in geriatric rehabilitation and enjoys supporting patients to bridge the gap between hospital and home after a major health event.

Alys Cummings is a speech pathologist who works within the Rural Allied Health Team and the Transition Care Program. Alys supports the Albury Wodonga, Beechworth and Corryong Parkinson’s peer support groups. She has a clinical interest in improving the quality of life of adults living with disability.

Associations of dietetic intervention and maternal and neonatal outcomes in women with gestational diabetes

Ms Julia Zinga1, Dr Paige  van der Pligt2, Dr Claire Margerison2, Ms Gina Absalom2

1Royal Women’s Hospital, St Helena, Australia, 2School of Exercise and Nutrition Science, Deakin University, Burwood, Australia

Abstract:

Aims:
Dietitians play a pivotal role in gestational diabetes (GDM) management, yet, limited literature has assessed the impact of dietetic intervention in women with GDM. This study aimed to assess the associations between dietetic intervention and aspects of care in women with GDM, and a range of maternal and neonatal outcomes.

Methods:
This was a retrospective cohort study, of 1233 adult women diagnosed with GDM in a singleton pregnancy, who delivered at the Royal Women’s Hospital (RWH) between 2015 and 2017. A medical records audit determined the number of dietetic consultations per patient, and aspects of care: medical nutrition therapy vs added pharmacotherapy; specialist diabetes clinic care vs routine antenatal clinic; and a range of maternal and neonatal outcomes. Adjusted linear and logistic regression was used to analyse associations.

Results:
Women requiring pharmacotherapy had a greater number of dietetic consultations compared to women managed solely with medical nutrition therapy (β-coef (95%CI) =0.28(0.17-0.39)), (p<0.001). Women who received 1 or more dietetic consultations had a decreased likelihood of infant admission to the neonatal intensive care unit (NICU) or special care nursery (SCN) ([OR] 0.41, 95% CI 0.22-0.75; P=0.004), compared to women who didn’t receive dietetic intervention. No associations were noted between number of dietetic consultations and maternal outcomes or other neonatal health outcomes.

Significance:
Dietetic intervention in GDM, within a comprehensive healthcare package, is associated with fewer infant admissions to NICU or SCN. Further research should assess the impact of dietetic intervention on optimising maternal and neonatal health in women with GDM.

Biography:

Julia Zinga is a Diabetes Dietitian and holds a Bachelor of Health Science (Nutrition & Dietetics) from The University of Newcastle. The majority of Julia’s dietetic career has been in the field of diabetes, providing dietary counselling to people of all ages with diabetes. Since 2014, Julia has worked as Diabetes Dietitian at Royal Women’s Hospital, Melbourne, working in the multidisciplinary diabetes unit to support women with Type 1 or Type 2 diabetes who are pregnant or planning pregnancy, and women with gestational diabetes.

A cost effective approach to combating the diabesity epidemic with an integrated diet and lifestyle approach

Professor Catherine Itsiopoulos, BSc(Hons) Grad Dip Diet MPH PhD APD1

1 Head of School of Allied Health, Professor of Dietetics and Human Nutrition, La Trobe University

Cardiovascular Disease is a major cause of disease burden and death in the Australian population, accounting for 29% of all deaths. Furthermore, with the increasing prevalence of obesity and type 2 diabetes, premature CVD as a complication of type 2 diabetes is also rising. Because of this increasing prevalence, CVD-related health-care expenditure has been estimated at $8 billion, higher than for any other disease. Although there are long-standing public health strategies targeting primary prevention of CVD, the dominant treatment for people with established CVD is pharmacotherapy, with $3 billion spent on non-hospital prescription CVD medications alone in 2009-10. Dietary interventions have demonstrated benefits in both primary and secondary prevention of CVD. For example, the INTERHEART case-control study identified diet as one of nine modifiable risk factors that account for more than 90% of the population attributable risk for acute myocardial ischemia worldwide.

However, while there has been significant attention to the primary prevention of CVD, there has been less attention given to improving secondary or tertiary prevention, where the risks of an imminent CVD event are considerably higher and where benefits from a reduction in risk are considerably greater and will accrue almost immediately. The traditional Mediterranean diet and lifestyle has been established as cardioprotective and cost effective in European trials however there are knowledge gaps that prevent the clear translation of those recommendations into the Australian healthcare setting. The AUSMED Heart Trial aims to address these knowledge gaps.

The risk and opportunity of employing part time clinical staff in allied health

Ms Deb Mitchell1, Ms Samantha  Sevenhuysen1, Mr Ben Smith1

1Monash Health , Clayton , Australia

 

Aim: A perceived increase in the proportion of part time clinical staff providing allied health services to inpatient areas was identified as a risk to the program.  Drivers were identified as the proportion of female worker returning to part time work after maternity leave.

Method:  A mixed methods approach was used.  Quantitative measures included the change in proportion of part time staff over time.  Interviews were undertaken with managers and part time staff in flexible return to work arrangements.

Results:

Analysis of human resources data showed that the proportion of casual employees was increasing, full time decreasing and part time staying stable.

Qualitative data collected suggested that part time staff can be an asset to an Allied Health department, retaining high quality, experienced and motivated staff.  Flexible return to work will continue to be a challenge for managers, particularly in negotiating appropriate roles and providing and tracking back fill.  Part time roles are also challenging for managers in ensuring junior staff and students have the supervision and support they need and in managing large numbers of individual staff.

The Monash Health Allied Health staff interviewed who work in part time roles reported high levels of engagement and satisfaction with their work overall, particularly those who were past the early stages returning to work after maternity leave.

Significance of finding to allied health:

Whilst offering part time work may result in some challenges for manager, it is one strategy that Allied Health could consider to attract and retain high quality, experienced staff.

The feasibility of moderate-intensity cardiovascular fitness training to improve peak oxygen uptake, function, mood and quality of life following stroke. A pilot randomised controlled trial

Ms Hanna Reynolds1, Ms Sarah Steinfort1, A/Prof Alan Hayes2,3,4, Ms  Sarah  Ellis1, Ms Jane Tillyard1, A/Prof Tissa Wijeratne1, Dr Elizabeth Skinner1,2,3,5,6

1Western Health, Melbourne, Australia, 2Australian Institute of Musculoskeletal Science, Melbourne, Australia, 3Western Centre for Health Research and Education, Melbourne, Australia, 4Victoria University, Melbourne, Australia, 5University of Melbourne, Melbourne, Australia, 6Monash University, Melbourne, Australia

Aim: Cardiovascular fitness levels are significantly lower in stroke survivors compared to the general population, which limits participation in everyday activities. Meta-analysis favours the efficacy of aerobic exercise on fitness (VO₂ peak) following stroke, whilst the effect on mood and quality of life (QOL) is not yet known.  The optimal dosage and intensity of cardiovascular fitness training following stroke is unclear. The primary hypothesis was that the addition of moderate-intensity fitness training to ‘usual’ rehabilitation following stroke is feasible and safe to conduct. Secondary hypotheses were that this training will improve fitness (VO₂ peak), walking capacity and speed, depression and QOL, when compared to a low-intensity control exercise.

Method: This study was a pilot, prospective, patient- and assessor-blinded parallel group randomised controlled trial of 20 participants, conducted in the Community Based Rehabilitation centre of a tertiary, metropolitan hospital.  Eligibility criteria included ambulant stroke survivors (>100m) who were at least 6 weeks post stroke and medically stable. Participants were randomly allocated to moderate-intensity fitness training or ‘low-intensity’ control exercise; attended 2 sessions for 12 weeks; and completed a home exercise program. The primary outcome measure was VO₂ peak; secondary outcomes were functional independence (6 minute walk test, 10m walk test), QOL (SF-36) and depression (PHQ-9). Patient demographics, attendance, adherence to training parameters and home exercise compliance were recorded.

Results: 20 participants were recruited.  Statistical analyses will be available to present including safety, feasibility, the effect size for power analysis, between-group and within- group differences. Participant capacity to adhere to training parameters will be examined

Significance of the findings to allied health: This study will contribute to optimising outcomes in post stroke rehabilitation and functional participation.

12