The purpose of this study was to assess the effects of a water-based exercise and self-management program on balance, fear of falling, and quality of life in community-dwelling women 65 years of age or older with a diagnosis of osteopenia or osteoporosis. Fifty women with an average age of 73.3 years (range 65.5-82.4, SD 3.9) were randomised to intervention or control groups. The intervention group received a 10-week water-based exercise and self-management program compiled by Community Physiotherapy Services and conducted by a physiotherapist at an aquatic centre twice a week for one hour. The control group did not receive any instructions and were not encouraged to change their physical activity, activities of daily living or social habits during the study. Change in balance, measured using the step test, from baseline to follow-up differed between intervention and control groups, with mean (95% CI) between-group differences of 1.7 (0.9 to 2.6) and 2.1 (1.1 to 3.1) steps on the left and right sides respectively. Between-group differences in score changes were also significant in four of the eight domains of quality of life measured using the Short Form 36 questionnaire (SF36; physical function 8.6 (0.4 to 16.8), vitality 12.0 (2.3 to 21.8), social function, and 14.1 (0.6 to 27.7) mental health 10.2 (2.0 to 18.4)), but not fear of falling measured using the modified falls efficacy scale (0.25 (-0.3 to 0.81). It is concluded that a water-based exercise and self-management program produced significant changes in balance and quality of life, but not fear of falling, in this group of community-dwelling women 65 years of age or older with a diagnosis of osteopenia or osteoporosis.

Summary Obesity and diet-related health problems are complex, multi-factorial issues. Individual food choices are shaped by the wider context, and food environment level change is needed to support individual behaviour change. The food service sector can play an integral role, changing aspects of the food environment and contributing to improved consumer health. This systematic review aimed to analyse food service schemes that aimed to improve consumer health. Ten electronic databases were systematically searched to identify articles, supplemented with checking of reference lists from similar reviews and forward and backward searches to identify articles describing food service sector schemes. Sixteen schemes were identified, documented in 36 articles/reports. The schemes aimed to improve consumer health through one of three approaches—informing, enabling or engineering. In this order, these approaches involved increasing levels of effort from food services, corresponding with decreasing levels of effort for consumers. Half the schemes were informing, relying on an informed consumer to make a healthy choice. Most informing schemes had been evaluated to determine their impact on consumer choice and/or health, the evidence showed these schemes were generally ineffective. The effect of the enabling or engineering schemes on consumer choice and health had not been measured. Instead, evaluations focussed on process or business engagement rather than behavioural change assessments. This review indicates the food sector has the potential to contribute to consumer health through enabling and engineering; however, detailed outcome assessments are needed to draw definitive conclusions.

BACKGROUND: Health promotion programs and interventions are designed to encourage behavioral changes in children, encouraging them to make safe and healthy life choices. This systematic review seeks to examine how social impact is measured in primary school health promotion interventions. METHOD:A systematic search and review process was used to identify and examine primary school health promotion interventions. The PRISMA guidelines were followed to source articles from 6 electronic databases reporting school health promotion programs or interventions in Australia, Canada, New Zealand, or the United Kingdom. RESULTS:A total of 77 studies were located, representing 55 health promotion interventions delivered in primary school settings. Of these interventions, only 8 (15%) measured or attempted to measure social impact, whereas another 8 (15%) alluded to social impact. The predominant theories reported were social based theories (theories which examine the social influences on people, environments, and behaviors) (n = 17, 59%), with almost a third not informed by an overt health promotion framework or model (n = 34, 59%). A systematic rating system identified some level of stakeholder engagement (n = 30, 53%). CONCLUSIONS:This systematic review highlights the need for social impact measurement within health promotion to illuminate the role of school programs in delivering lasting change.