Ben Smith

The University of Sydney · School of Public Health

Background Physical inactivity is a significant public health concern, with limited signs of improvement despite a global commitment to achieving the World Health Organization’s target of 15% reduction by 2030. A systems approach is required to tackle this issue, involving the creation of environments that are conducive to physical activity. Laws r...

Working from home (WfH) has public health implications including changes to physical activity (PA) and sedentary behavior (SB). We reviewed published and grey literature for interventions designed to support PA or reduce SB in WfH contexts. From 1355 published and grey literature documents since 2010, we screened 136 eligible documents and extracte...

Background Poor physical activity and excessive sedentary behaviour are well-established risk factors for morbidity and mortality. In the presence of emerging social problems, including loneliness and social isolation, these risks may be even greater. We aimed to investigate the joint effects of social health and movement behaviours on mortality an...

Introduction The past decade has increasingly seen systems approaches as a featured theme in public health studies and policy documents. This trend is evident in the area of physical activity, which is a significant global health risk factor that is addressed in WHO’s Global Action Plan on Physical Activity. We undertook a comprehensive scoping rev...

Citizen science is gaining attention as an approach to involving communities in gathering data and contributing to decision-making in public health. Stakeholders interested in citizen science have identified a need for support in applying these approaches and in obtaining evidence of their value. However, there have been few attempts to evaluate ci...

Aims To evaluate the immediate effect of text messages promoting healthy lifestyle and supporting parenting on physical activity amongst women with recent gestational diabetes (GDM). Methods Analysis of data from a pilot randomised controlled trial of a healthy lifestyle program for women with recent GDM. Intervention subjects received text messag...

Background Citizen science approaches, which involve members of the public as active collaborators in scientific research, are increasingly being recognized for their potential benefits in chronic disease prevention. However, understanding the potential applicability, feasibility and impacts of these approaches is necessary if they are to be more w...

Purpose: Loneliness and social isolation, experienced more long-term, has been shown to increase mortality and lead to poorer health outcomes in specific cohorts. However, it is unclear what the prevalence of chronic loneliness and social isolation is, and which demographic groups are most at risk of reporting more chronic forms. Methods: A psychom...

Background Physical activity and sport have numerous health benefits and participation is thought to be lower in disadvantaged children and adolescents. However, evidence for the disparity in physical activity is inconsistent, has not been reviewed recently, and for sport has never been synthesised. Our aim was to systematically review, and combine...

Background Loneliness and social isolation are increasingly recognised as global public health threats, meaning that reliable and valid measures are needed to monitor these conditions at a population level. We aimed to determine if robust and practical scales could be derived for conditions such as loneliness and social isolation using items from a...

Background and aims A better understanding of the relationship between cardiovascular disease risk factors and quality of life (QoL) in older age is needed to inform development of risk reduction strategies. This cross-sectional study investigated the association of QoL with health-related behaviours in older adults at risk of heart failure. Metho...

Objective The delivery of lifestyle advice concerning diet and physical activity has been found to be suboptimal in primary care settings, including for patients who require this for clinical management. This pilot study aimed to evaluate the acceptability and feasibility of integrating a mobile health intervention into primary care to support pati...

Background and aims Associations between overweight/obesity and television viewing have been identified in high-income countries, but little evidence is available from low- and middle-income countries. This study examined the trends and correlates of television viewing and overweight/obesity among Nepalese women between 2006 and 2016. Methods and...

The need to improve the practice and quality of evaluation in the health promotion and disease prevention field is widely recognized. In order to plan, implement and evaluate health promotion evaluation capacity building efforts, there is a need to better understand the practitioner, organisational and system-level determinants of evaluation capaci...

Background Type 2 diabetes mellitus (T2DM) is emerging as a major public health challenge in Nepal. Behavioural, social and economic changes are likely to play a part in the rise of this chronic disease, as they are in many developing countries. A better understanding of the relationship between physical activity (PA), social and economic factors a...

Recreational physical activity (PA) facilities have the potential to deliver health benefits for surrounding communities, however little is known about the impact of marketing strategies to encourage their use. This study aimed to assess the effectiveness of two low intensity interventions aimed at promoting usage of a new multipurpose recreation f...

Introduction Gestational diabetes (GDM) contributes substantially to the population burden of type 2 diabetes (T2DM), with a high long-term risk of developing T2DM. This study will assess whether a structured lifestyle modification programme for women immediately after a GDM pregnancy, delivered via customised text messages and further individualis...

The World Health Assembly has adopted the World Health Organization's (WHO) recommended target of achieving a 15% reduction in physical inactivity by 2030. The WHO Global Action Plan on Physical Activity provides a framework for countries to achieve this, using a systems-based approach to address the social and environmental determinants of physica...

Objective To determine the prevalence and sociodemographic factors associated with active commuting and leisure-time physical activity (LTPA) among adults in western Nepal. Design Cross-sectional study. Setting Adults from semiurban areas in western Nepal. Participants 2815 adults aged 25–65 years who participated in the ‘Community-Based Managem...

Substantial cross-sectional evidence and limited longitudinal research indicates that the availability of recreational facilities (e.g., parks, fitness centres) is associated with physical activity participation. However, few intervention trials have investigated how recreational infrastructure can be used to reduce inactivity levels in communities...

Background With economic and social changes, participation in occupational and transport-related physical activity is declining among Nepalese adults, highlighting the growing importance of leisure-time physical activity. However, limited information is available to guide public health policies and interventions to promote leisure-time physical act...

Background: The number of people living with dementia is rising globally due to population aging. Mass media campaigns which aim to reduce the risk of people developing dementia have been conducted across many countries, but few have reported evaluation findings. Objective: The present study investigated the impact of the Your Brain Matters deme...

Background: The International Society for Physical Activity and Health (ISPAH) is a leading global organization working to advance research, policy, and practice to promote physical activity. Given the expanding evidence base on interventions to promote physical activity, it was timely to review and update a major ISPAH advocacy document-Investmen...

Abstract: Meaningful public engagement is essential to enable effective action in chronic disease prevention. Citizen science shows considerable promise as an approach to purposefully engage the public in research and decision making. However, it is unknown whether or how citizen science approaches are used to complement the work of policy and prac...

Objective: Mis-reporting is common in dietary assessment leading to misinterpretation of disease risk and could be important in older adults with increased chronic disease risk. The study investigated the prevalence and characteristics of mis-reporting among older adults and its association with health outcomes including quality of life (QoL). Meth...

The objective of this systematic review was to determine the effectiveness of lifestyle interventions to improve the management of type 2 diabetes mellitus (T2DM) among migrants and ethnic minorities. Major searched databases included MEDLINE (via PubMed), EMBASE (via Ovid) and CINAHL. The selection of studies and data extraction followed the Prefe...

Previous research suggests that a range of factors influence an individual’s physical activity (PA) participation, but studies among Nepalese adults are limited. In this qualitative study, we aimed to explore the multilevel influences upon PA participation among community-dwelling adults aged 40 years and above living in an urban setting in Kathman...

Cash transfers (CTs) are increasingly high on the agenda of most governments and development partners in low-and middle-income countries. Even though burgeoning evidence points to CTs’ impact on the social determinants of health (SDoH), there is little evidence about how and why CTs work to influence the SDoH. This paper reports on a realist evalua...

Background Type 2 diabetes mellitus (T2DM) is emerging as a significant public health challenge in Nepal. Behavioural, social and economic changes are likely to play a part in the rise of this chronic disease, as they are in many developing countries. A better understanding of the relationship between physical activity (PA), socioeconomic factors a...

Method: Using MeSH keywords, we searched major electronic databases including Medline, EMBASE, CINAHL, and PsycINFO in order to identify relevant publications published between January 2000 and October 2018. We included 19 qualitative studies which met inclusion criteria and were focused on physical activity determinants among adults. Results: D...

1. The case for physical activity 1.1 Co-benefits of physical activity – health, social, economic, environmental and other societal gains from building a more active nation 1.2 Are Australians active? Prevalence, trends and correlates of meeting physical activity guidelines 2. Whole-of-systems approaches 2.1 Whole-of-systems approaches to physi...

Aim: To analyze the data from the World Health Organization Nepal STEPS survey 2013 to determine the prevalence of total and domain-specific physical activity (PA) and associated factors among Nepalese adults. Methods: A multistage cluster sampling technique was used to proportionately select participants from the 3 ecological zones (Mountain, H...

In spite of the consistent evidence of cash transfers’ (CTs) impact on the social determinants of health (SDoH) in low-and middle-income countries, and their potential for achieving health sector objectives, there is a growing concern that the health sector has not been actively involved in these programs. This study used a critical realist approac...

Cash transfers (CTs) can play a significant role in tackling the social determinants of health (SDoH), but to date there is a lack of conceptual framework for understanding CTs linkages to the SDoH. This article proposes a framework that identifies the linkages between CTs and SDoH, discusses its implications, and argues for active involvement of h...

Background: The literature on whole of system approaches (WSAs) has been largely theoretical in focus. The Australian Systems Approaches to Physical Activity is a national project designed to contribute a practical implementation focus to such approaches at the population level. Methods: National meetings were convened with federal and state gov...

Group-based physical activity (PA) in community-based settings represents a promising avenue for promoting healthy ageing, however, lower levels of adherence have been found to be associated with aspects of social disadvantage. Providers are in a key position to provide important insights about strategies to improve adherence, however, few studies...

Background: The value of a systems thinking approach to tackling population physical inactivity is increasingly recognized. This study used conceptual systems thinking to develop a cognitive map for physical activity (PA) influences and intervention points, which informed a standardized approach to the coding and notation of PA-related policies in...

Issue addressed: This study aimed to examine evaluation methods and quality in Australian health promotion agencies, and the factors associated with this. The evidence base for prevention strategies is limited, with the evidence generated through program evaluation by health promotion and disease prevention agencies lacking rigour. Despite the nee...

Background: The built environment is reported to influence physical activity in populations, but longitudinal evidence about the impact of building new physical activity infrastructure is limited. This study aimed to prospectively investigate the uptake and usage of the newly established Peninsula Aquatic and Recreation Centre (PARC), a large mult...

South Asia specific reviews on the role of physical activity (PA) domains on chronic disease prevention are lacking. This study aimed to systematically review published literature to identify the association between PA domains and chronic diseases and to provide summary estimates of the strength of association. Nine electronic databases were search...

Background: Considering that building a sports facility is a major investment to promote population health, it is important to understand whether it is effective in increasing the level of physical activity (PA) in the community. This study examined the impact of building a new multipurpose exercise facility on community-level PA in Japan. Method...

The demand for improved quality of health promotion evaluation and greater capacity to undertake evaluation is growing, yet evidence of the challenges and facilitators to evaluation practice within the health promotion field is lacking. A limited number of evaluation capacity measurement instruments have been validated in government or non-governme...

Gestational diabetes (GDM) is a highly prevalent disorder of pregnancy which portends a high risk for future type 2 diabetes. Limited evidence indicates lifestyle intervention prevents the development of diabetes, but most previously studied interventions are resource-intensive. Intervention programs that utilise newer technologies may be scalable...

Evaluation of primary prevention and health promotion programs contributes necessary information to the evidence base for prevention programs. There is increasing demand for high-quality evaluation of program impact and effectiveness for use in public health decision making. Despite the demand for evidence and known benefits, evaluation of preventi...

Background and objectives: Participation in physical activity (PA) is low among older adults in developed nations and even lower among several socially disadvantaged groups. This study aimed to identify the actions that can be taken in the promotion, design, and implementation of organized PA programs to improve engagement with socially disadvanta...

This study investigated the prevalence of physical activity prescriptions in the management of high blood pressure (BP), the characteristics of people given these, and whether prescriptions were associated with the physical activity beliefs and practices of patients. A retrospective cohort study was undertaken, involving 365 general practitioners (...

The popular reality television show The Biggest Loser Australia (TBL) is a significant source of media content about physical activity. This study examined audience responses to and interpretations of physical activity in TBL. A qualitative study using in-depth interviews was conducted in New South Wales, Australia. A sample of 46 viewers of TBL wa...

Cash transfers are a widely adopted social policy initiative for addressing poverty and vulnerability. Cash transfers’ exponential growth in low- and middle-income countries provides a unique opportunity to advance our understanding of how they work to impact the social determinants of health. This article reports on a realist qualitative approach...

Background Chronic diseases contribute to about half of the adult disease burden in the South Asian region. Meanwhile, physical activity levels are declining despite the global evidence of its role in the prevention of chronic diseases. While there are a plethora of systematic reviews on the effects of physical activity on chronic diseases, there h...

Despite the availability of numerous obesity prevention initiatives in developed countries including Australia, rising childhood obesity levels have been found among migrant communities which contribute to widening obesity-related disparities in these countries. We sought to understand the factors influencing the participation of migrant communitie...

Program evaluation is essential to inform decision making, contribute to the evidence base for strategies, and facilitate learning in health promotion and disease prevention organizations. Theoretical frameworks of organizational learning, and studies of evaluation capacity building describe the organization as central to evaluation capacity. Austr...

Cash transfers (CTs) are now high on the agenda of most governments in low- and middle-income countries. Within the field of health promotion, CTs constitute a healthy public policy initiative as they have the potential to address the social determinants of health (SDoH) and health inequalities. A systematic review was conducted to synthesise the e...

A systematic review was undertaken to identify lifestyle intervention studies in South Asian migrant populations to determine the effect on the components of the metabolic syndrome. A total of seven studies were identified, of which six focused on educational advice and the seventh on intensive exercise intervention. Four studies were Randomised Co...

Aim: This review examines program features that influence attendance and adherence to group-based physical activity (PA) by older adults. Methods: Medline, PubMed, CINAHL plus, PsycINFO, and the Cochrane Library were searched for studies published from 1995-2016. Quantitative and qualitative studies investigating factors related to PA group atte...

Aim: To investigate how a behavioural lifestyle intervention influences psychosocial determinants of physical activity and dietary behaviours in a population at risk of type 2 diabetes (T2DM). Methods: 59 women with a body mass index of ≥25 kg/m(2) and a history of gestational diabetes mellitus (GDM) participated in a randomized controlled study...

Aim: Assisting women with a history of gestational diabetes mellitus (GDM) to adopt healthy lifestyles is a priority for diabetes prevention. The aim of this study was to develop and evaluate measures that can be used to assess the efficacy of behavior change interventions in this group. Method: Measures of psychosocial influences on physical ac...

Only 37% of Australians perform exercise at a level sufficient to achieve benefits to their health (Australian Institute of Health and Welfare, 2010). As a result, a substantial proportion of the Australian population is at increased risk of developing a range of physical ailments associated with low levels of exercise, including cardiovascular dis...

Issue addressed: Christian churches have historically undertaken welfare and community service activities to practise faith and increase their relevance to communities. However, the church in Australia has received little attention from health promotion practitioners and researchers. The objective of this qualitative study was to explore the barrie...

Background: There is increasing pressure to address the social determinants of health (SDoH) and health inequities through the implementation of culturally acceptable interventions particularly in Sub-Saharan Africa (SSA) where health outcomes are generally poor. Available evaluation research on cash transfers (CTs) suggests that the programs may...

Objective: To examine 25(OH)D testing patterns and frequency among General Practitioners in a major community health service. Method: Clinical audit of patient records at a community health centre in Melbourne was undertaken. Patients aged 18 years and above were included in the study. Univariate and multivariate logistic regression was used to exa...

Background Although community engagement (CE) is widely used in health promotion, components of CE models associated with improved health are poorly understood. This study aimed to examine the magnitude of the impact of CE on health and health inequalities among disadvantaged populations, which methodological approaches maximise the effectiveness o...

Exploring the role of community engagement in improving the health of disadvantaged populations: a systematic review

Issue addressed: Alzheimer's disease and dementia are recognised as critical public health priorities. This study investigated intentions and behaviours concerning brain health and dementia risk reduction among Australians. Methods: A cross-sectional survey of 1000 persons aged 20-75 years measured knowledge, beliefs, intentions and behaviours c...

Church-based health promotion has increasingly gained attention in strategies to address health disparities. In Australia, we have limited understanding of the role of local churches in health promotion and without this, how they might be involved in meaningful partnerships to tackle public health challenges. The objective of this qualitative study...

Organized physical activity through sport and recreational activities is beneficial for physical and psychosocial well-being and community connectedness. However, many who could gain significantly from this have lower participation, especially the socioeconomically disadvantaged, Indigenous people, culturally diverse communities and people with a d...