Presentation 1: Development and Testing of a Model for Risk Factors for Eating Disorders and Higher Weight among Emerging Adults: A Study Protocol

Research has consistently demonstrated that eating disorders (ED) and higher weight have lifetime co-occurrence prompting the suggestion that EDs and higher weight may be best considered within a common etiological model. However, there is limited knowledge about the nature and extent of shared risk factors and no research has examined a model for these shared risk factors for ED and higher weight among emerging adults. The novel aspect of this research is that it presents a new model and methodology to evaluate the nature of these shared risk factors in adults. The proposed model, based on a review of the existing literature from both areas of scholarship, considers biological, sociocultural, psychological, and behavioral factors that may contribute to both outcomes. This model will be tested in a longitudinal study design with an initial sample of 600 emerging adults (aged 18-30) per country in nine different countries (total sample = 5000+ participants). Questionnaires will be completed online on two occasions, 12 months apart. Multi-group path analysis will be used to evaluate the proposed model for the sample overall as well as analyses within country and gender. The results of the study will identify the biopsychosocial predictors - both cross-sectionally and longitudinally - of both ED and higher weight and how these vary across countries and gender.

Presentation 2: Sweet tooth: A comparison of the consumption of sugary drinks and the associated risk factors for consumption across 9 countries.

Sugar consumption has been identified as a significant risk factor for obesity and a range of chronic illnesses worldwide. One common mode of consumption of sugar is through the ingestion of sugary drinks. However there is a need to better understand the cross-cultural comparisons of the frequency of the consumption of sugary drinks and the risk factors for consumption. As such, the recent findings on the consumption of sugary drinks from the International Academy of Body Image, Eating Problems and Heath’s international study will be presented. This study involved 600 emerging adults completing a battery of online questionnaires in each of 9 different countries. The presentation will compare the self-reported frequency of the consumption of sugary drinks across the participating countries (Australia, Belgium, Canada, China, Italy, Japan, Spain, United Kingdom, and the United States of America). In addition, the significant risk factors for the consumption of sugary drinks will be compared across these countries. These risk factors include demographics (age, gender, education, employment status, relationship status, and living status), biological variables (childhood weight, mother’s weight, and father’s weight), behavioural factors (frequency of eating breakfast, sleep quality) and psychological variables (depression, social anxiety, trauma, impulsivity, self-esteem). These findings will provide health psychologists with knowledge of important targets for interventions to reduce the frequency of the consumption of sugary drinks as part public health and clinical interventions for obesity and chronic disease.

Presentation 3: Emotional Eating around the world

Eating in response to emotional cues rather than hunger cues is a significant risk factor for weight gain and obesity in many countries across the world. However the relationship between emotional eating and weight gain varies from country to country indicating significant cultural factors in the frequency and risk for emotional eating. This presentation will present the findings from the International Academy of Body Image, Eating Problems and Heath’s international study with relation to emotional eating across 9 participating countries (Australia, Belgium, Canada, China, Italy, Japan, Spain, United Kingdom, and the United States of America). This study involved 600 participants from each of these 9 countries completing online questionnaires. The presentation will first compare the level of emotional eating (as measured by the Three Factor Eating Questionnaire) across the 9 countries. In addition, the possible risk factors for emotional eating will be compared across the countries. These risk factors include demographics (age, gender, education, employment status, relationship status, living status), biological variables (childhood weight, mother’s weight, father’s weight), behavioural factors (frequency of eating breakfast, frequency of drinking sugary drinks, sleep quality), and psychological variables (depression, social anxiety, trauma, impulsivity, and self-esteem). These findings may guide health psychologists in the development of effective health promotion and clinical interventions for unhealthy emotional eating behaviours.

Aim: To evaluate the effectiveness of attending Work It Out, a chronic disease self-management program, in improving indicators of psychological distress and wellness in urban First Australians with chronic disease.

Method: Participants who had attended the program for more than 4 weeks and had at least two occasions of assessment were included in this study (N= 386). The changes between baseline and review Kessler-5 (K5) scores were examined using one-way ANOVA. Qualitative comments from focus groups collected for program evaluation also serve to corroborate quantitative findings.

Results: Participation in the program was associated with lower K5 scores. This trend continued over time, indicating longer engagement with the program lead to continued improvements. The trend was present across a range demographic variables and health conditions. Qualitative comments indicated that participants reported improvements in social-emotional wellbeing and increased connectedness as a result of participating in the program.
Conclusion: This study demonstrates that the Work It Out program, which consists of physical exercises and health education in a group setting, is effective in decreasing psychological distress and improving wellness among First Australians with chronic disease. These findings have implications for the design of chronic disease self-management programs for First Australians.

Background: Motivational Interviewing administered by telephone has been shown to increase physical activity in individuals receiving physiotherapy for Low Back Pain, however it can be costly to implement. One solution is to teach allied health professionals to embed motivational interviewing in their usual treatment sessions. However, such approaches have not been efficacious for increasing physical activity, possibly due to the dose of motivational interviewing being too low. A newly designed smartphone app that enables people being treated for Low Back Pain to complete the bulk of motivational interviewing in between treatment sessions provides a potential alternative.

Aims/objectives: The aim is to describe a novel intervention that combines physiotherapists using motivational interviewing principles as part of their typical consultations with patients with a newly designed motivational interviewing smartphone application (app) for patient use between face-to-face treatment. A case study is utilised to describe how this intervention has operated in clinical practice across several large health care sites as part of a cluster randomized control trial examining its efficacy. This case study illustrates some of our experience of what can act as barriers and facilitators to implementation of this intervention in health care settings.

Implications: This described intervention and the experiences in implementation in health care sites has several potential implications for psychologists working with allied health professionals to facilitate behaviour change in rehabilitation settings. First, it describes a feasible model of how to enhance the efficiency with which evidence-based interventions, such as motivational interviewing can be applied to facilitate health behaviour change in large public acute health care settings. Second it is the first to describe an innovative interactive app we designed to complete significant proportion of motivational interviewing, without the need for direct therapist input.

Conclusion: A measure of treatment fidelity indicated that physiotherapists can be trained relatively quickly to be proficient in having conversations with patients in a way that is consistent with motivational interviewing. Several modifications to how we delivered the intervention, will be discussed for improving the delivery of similar interventions. These relate to the training of health practitioners and changes to the interface of the app.

Aim: Parents play a critical role in shaping body image development during early childhood. Confident Body, Confident Child (CBCC), is an intervention for parents of 2- to 6-year-old children, designed to promote body satisfaction, balanced eating and physical activity in early childhood. An RCT demonstrated that at 6-week post-intervention CBCC positively impacts parenting variables associated with childhood risk for body dissatisfaction and unhealthy eating. The current study aimed to examine whether CBCC has a direct, positive impact on children, by gathering child- and parent-report outcomes, at 18-month follow-up. It was expected that children of parents who received CBCC would show higher body satisfaction and lower unhealthy eating patterns than children of parents who received the control interventions.

Design: A four-arm randomized controlled trial was originally conducted with parents to assess parent-reported outcomes relating to known risk factors for eating disorders and body dissatisfaction. Group A received CBCC via a 2-hour in-person facilitated workshop plus printed materials, Group B received printed CBCC resources. Group C received a nutrition booklet (active control). Group D was the wait-list control. Online surveys were completed by parents at baseline, 6-weeks post-intervention, 6-months and 12-months follow-up.

Method: Promising results for parents drove a follow-up study at 18-months post-intervention, where children of parents in the trial were contacted for the first time and invited to complete a 30-min play-based interview. 92 children (67% Female, Mage=5.73 years) and 103 parents (98% Female, Mage=39.01 years) provided full data.

Results: ANCOVA analyses with planned orthogonal contrasts, controlling for child age and weight, revealed that children of parents who received CBCC, reported greater body satisfaction and lower external eating, compared to those receiving a nutrition-only control resource.

Conclusion: CBCC provides parents with effective guidance on how to positively impact on developing child body image. These findings need to be confirmed with further evaluation research collecting child data at baseline and with long-term follow-up. Nonetheless, this study serves as an important first step in establishing the positive child outcomes of the CBCC parenting program.

The workshops will be targeted at the intermediate level. The goal will be to provide participants with some strategies, based on motivational interviewing, for working with challenging situations and clients in behaviour change settings. A combination of presenter material, facilitator led discussions, video clips from sessions, and small group role plays will be utilised to facilitate learning. Some specific strategies that will be introduced in the workshop to deal with clients that are resistant include: exploring client resistance with curiosity, ensuring the shared focus has been negotiated and is clear, eliciting client strengths and providing information and suggestions in an MI consistent way. This is relevant as client resistance can be a core barrier to behaviour change in allied health settings.

Aim: The purpose of this study was to determine whether children experiencing stress and depressive symptoms were at greater risk for current and future impairment in glucose homeostasis and increased adiposity, both risk factors for Type 2 diabetes.

Design: Longitudinal cohort study.

Methods: Participants were 791 healthy, initially grade 2 children (7-8 years; 394 girls), selected from the general community. Psychosocial stress was assessed using the Children’s Stress Questionnaire, whilst depressive symptoms were assessed using the Children’s Depression Inventory. Fasting blood samples for serum insulin and plasma glucose were collected to calculate the homeostasis model assessment-insulin resistance (HOMA-IR). Other measurements were height, weight, percent body fat (dual energy x-ray absorptiometry), physical activity (pedometers), and pubertal maturation (Tanner score).

Results: Boys who reported more symptoms of depression had higher insulin resistance, irrespective of adiposity (p = .016); and longitudinally, we found a trend for boys who developed more depressive symptoms to develop higher insulin resistance (p = .073). These findings did not extend to girls. Furthermore, boys and girls with higher depressive symptoms had higher percent body fat (p = .011, .020 respectively); and longitudinally, boys whose depressive symptoms increased became fatter (p = .046).

Conclusions: Our data provide evidence that early symptoms of depression increase insulin resistance, independent of adiposity. Our evidence that early symptoms of depression may lead to overweight and obesity provides further reason to suggest that early attention to children with depression, even in pre-clinical stages, may reduce risk of chronic disease in later life.

Background: Communication between parent and adolescent is crucial, as the responsibility for diabetes self-management typically shifts from parent to adolescent during this stage of development. An earlier systematic literature review (Dashiff et al., 2007) found parent-adolescent communication to be characterized by maternal support, conflict, control, involvement, and emotional expression. Since then, emerging technologies such as online health interventions, mobile communication, and insulin pump technologies are likely to further influence parent-adolescent communication.

Aims/objectives: To present a synthesis of findings from empirical studies over the past 12 years regarding communication and interactions between parents and their adolescents’ self-management of type 1 diabetes.

Method: The review followed PRIMSA guidelines. The search included databases Pubmed, CINAHL, PsychINFO and Health source: Nursing/Academic edition covering articles between 1 January 2006 and 28 May 2018. A search of reference lists and citations of eligible articles was also complete. Inclusion criteria stipulated studies had to be peer-reviewed, in English, reporting data that featured any aspect of communication or interaction between parents and adolescents with type 1 diabetes. Studies previously reviewed (Dashiff et al., 2007) were excluded.

Results: The search retrieved 212 articles, from which eighty were selected based on title and abstract. Forty-one articles met the eligibility criteria for inclusion, comprising thirty-five quantitative, three qualitative, two interventions, and one mixed methods studies. Self-management outcomes measured adherence, glyacemic control, diabetes self-efficacy, and self-care. No studies reported outcomes related to diet or exercise. Studies were grouped into four main categories. Warmth and conflict yielded the most findings, followed by support, then control. Evidence related to warmth and support was associated with adaptive self-management outcomes, conflict was associated with maladaptive outcomes, and control was associated with both. Findings were discussed in relation to adapted version of Structural Analysis of Social Behavior (SASB, 1996) specifically for parent-adolescent communication and diabetes self-management.

Conclusion: Overall, a better understanding about the complexities of parent-adolescent communication may inform the development of effective interventions to improve diabetes self-care and glycaemic control among adolescents with type 1 diabetes.