BackgroundDespite declining smoking rates among the general Australian population, rates among Indigenous Australians remain high, with 47% of the Indigenous population reporting daily smoking - twice that of other Australians. Among women, smoking rates are highest in younger age groups, with more than half of Aboriginal women smoking during pregnancy. A lack of research focused on understanding the social context of smoking by Aboriginal women in rural Australia limits our ability to reduce these rates. This study aimed to explore the factors contributing to smoking initiation among rural Aboriginal women and girls and the social context within which smoking behaviour occurs.MethodsWe conducted three focus groups with 14 Aboriginal women and service providers and 22 individual interviews with Aboriginal women from four rural communities to explore their perceptions of the factors contributing to smoking initiation among Aboriginal girls.ResultsFour inter-related factors were considered important to understanding the social context in which girls start smoking: colonisation and the introduction of tobacco; normalization of smoking within separate Aboriginal social networks; disadvantage and stressful lives; and the importance of maintaining relationships within extended family and community networks. Within this context, young girls use smoking to attain status and as a way of asserting Aboriginal identity and group membership, a way of belonging, not of rebelling. Family and social structures were seen as providing strong support, but limited the capacity of parents to influence children not to smoke. Marginalization was perceived to contribute to limited aspirations and opportunities, leading to pleasure-seeking in the present rather than having goals for the future.ConclusionsThe results support the importance of addressing contextual factors in any strategies aimed at preventing smoking initiation or supporting cessation among Aboriginal girls and women. It is critical to acknowledge Aboriginal identity and culture as a source of empowerment; and to recognise the role of persistent marginalization in contributing to the high prevalence and initiation of smoking.

IntroductionInterrupting sedentary time during the day reduces postprandial glycemia (a risk factor for cardiometabolic disease). However, it is not known if benefits exist for postprandial glucose, insulin and triglyceride responses in the evening, and if these benefits differ by body mass index (BMI) category.MethodsIn a randomized crossover study, 30 participants (25.4 ± 5.4 yr old; BMI 18.5–24.9: n = 10, BMI 25–29.9: n = 10, BMI ≥30: n = 10) completed two intervention arms, beginning at ~1700 h: prolonged sitting for 4 h, and sitting with regular activity breaks of 3 min of resistance exercises every 30 min. Plasma glucose, insulin, and triglyceride concentrations were measured in response to two meals fed at baseline and 120 min. Four-hour incremental area under the curve was compared between interventions. Moderation by BMI status was explored.ResultsOverall, when compared with prolonged sitting, regular activity breaks lowered plasma glucose and insulin incremental area under the curve by 31.5% (95% confidence interval = −49.3% to −13.8%) and 26.6% (−39.6% to −9.9%), respectively. No significant differences were found for plasma triglyceride area under the curve. Interactions between BMI status and intervention was not statistically significant.ConclusionsInterventions that interrupt sedentary time in the evening may improve cardiometabolic health by some magnitude in all participants regardless of bodyweight.

Background: The majority of adolescents do less physical activity than is recommended by the World Health Organization. Active commuting and participation in organised sport and/or physical education individually have been shown to increase physical activity in adolescents. However, how these domains impact physical activity both individually and in combination has yet to be investigated in a sample of New Zealand female adolescents from around the country. Methods: Adolescent females aged 15–18 y (n = 111) were recruited from 13 schools across eight locations throughout New Zealand to participate in this cross-sectional study. Participants completed questions about active commuting, and participation in organised sport and physical education, before wearing an Actigraph GT3X (Actigraph, Pensacola, FL, USA) +24 h a day for seven consecutive days to determine time spent in total, MVPA and light physical activity. Results: Active commuters accumulated 17 min/d (95% CI 8 to 26 min/d) more MVPA compared to those who did not. Those who participated in sport accumulated 45 min/d (95% CI 20 to 71 min/d) more light physical activity and 14 min/d (95% CI 5 to 23 min/d) more MVPA compared to those who did not. Participation in physical education did not seem to have a large impact on any component of physical activity. Participation in multiple domains of activity, e.g., active commuting and organised sport, was associated with higher accumulation of MVPA but not light activity. Conclusion Active commuting and sport both contribute a meaningful amount of daily MVPA. Sport participation has the potential to increase overall activity and displace sedentary behaviour. A combination of physical activity domains may be an important consideration when targeting ways to increase physical activity in adolescent females.

INTRODUCTIONPractice nurses in general practice are ideally placed to deliver weight management treatments. Teaching people to eat according to their appetite, based on measurements of blood glucose (‘hunger training’), is known to lead to weight loss and improved eating behaviour. To effectively translate this research to primary care requires understanding of key stakeholder perspectives. AIMThe aim of this study was to explore the perspectives of practice nurses on the suitability of using hunger training as a weight management intervention in general practice. METHODSTen nurses trialled hunger training for 1 week, followed by a semi-structured interview where they were asked about their experience; perceived patient interest; enablers and barriers; and suggested changes to hunger training. RESULTSAll nurses were positive about hunger training and wanted to use it with their patients. They thought it was a useful method for teaching patients about eating according to their appetite, and the impact of food choices on glucose. Motivation was seen to be both an important potential barrier and enabler for patients. Other anticipated patient enablers included the educational value of hunger training and ease of the programme. Other barriers included lack of time and cost of equipment and appointments. For most nurses, 1 week of following hunger training was sufficient training to deliver the intervention. Suggested refinements included adding nutrition advice to the booklet, incorporating other health goals and enabling social support. DISCUSSIONThese findings suggest that hunger training could be translated to primary care with minor modifications.