National Sporting Organisation Policies: A health promotion opportunity?

The objective was to identify whether National Sporting Organisations (NSOs) have policy documentation on healthy behaviours (smokefree, sun-protection, healthy food/beverages, and alcohol) and, for organisations with such documentation, whether this is in-line with current scientific evidence of past best practice in cancer prevention.

METHODS

This cross-sectional policy analysis study was performed September - December 2018 in New Zealand. A content analysis was undertaken using NSO policy documents matched against a framework of key indicators for best practice within health behaviours of interest. Data analysis of the policy process was undertaken through key informant telephone interviews with NSO staff using semi-structured qualitative interviews.

RESULTS

Of 96 NSOs, nearly half (49%) mentioned smokefree at least once in one of their policy documents, and 47% had an alcohol policy, although in both instances the policies lacked comprehensiveness. Two NSOs had a reasonably comprehensive sun protection policy. Seventeen had at least one specific nutrition policy/guideline. The contents of the latter were primarily related to short-term athletic performance rather than non-communicable disease prevention, specifically promoting hydration during sports participation, and food and nutrition to support sporting performance. Two NSOs had policies relating to the promotion of health food/nutrition more widely. For some NSOs the lack of health-related policies was not a conscious choice but just not considered previously. Other NSOs reported they lacked resources or had other priorities.

CONCLUSIONS

Although this study clearly demonstrates that many NSOs lack adequate health-related policies, this is not necessarily a conscious choice, but the result of a lack of resources, other priorities, or just that they had not considered developing policies in these areas. A number expressed support for these types of policies although it was apparent that some, particularly smaller NSOs would require assistance in policy template development. It seems probable that the development of health-related policies will only occur if partner agencies become involved.

Changes in awareness of cancer risk factors among adult New Zealanders (CAANZ): 2001 to 2015

Behaviour change, specifically that which decreases cancer risk, is an essential element of cancer control. Little information is available about how awareness of risk factors may be changing over time. This study describes the awareness of cancer risk behaviours among adult New Zealanders in two cross-sectional studies conducted in 2001 and 2014/5.Telephone interviews were conducted in 2001 (n = 436) and 2014/5 (n = 1064). Participants were asked to recall things they can do to reduce their risk of cancer. They were then presented with a list of potential risk behaviours and asked if these could increase or decrease cancer risk.Most New Zealand adults could identify at least one action they could take to reduce their risk of cancer. However, when asked to provide specific examples, less than a third (in the 2014/5 sample) recalled key cancer risk reduction behaviours such as adequate sun protection, physical activity, healthy weight, limiting alcohol and a diet high in fruit. There had been some promising changes since the 2001 survey, however, with significant increases in awareness that adequate sun protection, avoiding sunbeds/solaria, healthy weight, limiting red meat and alcohol, and diets high in fruit and vegetables decrease the risk of developing cancer.

Sun protection practices in New Zealand secondary schools: a 2014 baseline study

Objective

Guided by the established primary school SunSmart programme, a survey of secondary schools' sun protection policies, planning, behavioural expectations, curriculum content and environment was undertaken in order to establish a baseline to inform advocacy and secondary level programme development.

Methods

All 448 principals of state or state integrated public secondary schools identified from the Ministry of Education database were mailed a hard copy questionnaire. School sun protection practices were assessed and a summative, non-weighted, 11-item Total Sun Protection Score (TSPS) was created. Associations between TSPS and socio-demographic factors, as well as school sun protection policy, were investigated using unadjusted and multiple linear regressions.

Results

Usable responses received from 211 of the 448 schools (47% participation) indicated reasonable representativeness of eligible schools, but under-representation of low socioeconomic decile institutions (p = 0.003) and those with the smallest roll size (p = 0.004). Only 50% of schools reported having a sun protection policy. The least attained TSPS components were outdoor event planning (17.1%), student breaks (16.6%), sun-protective clothing (8.5%) and shade provision (6.2%). The mean (SD) TSPS was 4.58 (2.06). In multivariable analysis, TSPS was statistically significantly positively associated with having a sun protection policy (p < 0.001) and the presence of primary level classes (p < 0.001) — the latter suggesting a possible influence of programme continuity, but negatively associated with integrated school status (p = 0.036).

Conclusion

A standard SunSmart programme could be promoted to all schools, irrespective of socioeconomic decile, overall roll size, gender status or regional population density. Low attainment of some TSPS components indicates targeting priorities.

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Sun-protection practices of 211 secondary schools were assessed.

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Event planning, breaks, clothing and shade criteria were least likely met.

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A summative, non-weighted Total Sun Protection (TSP) score was created.

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TSP score was associated with having a sun protection policy and primary classes.

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A standard SunSmart programme could be promoted irrespective of school demographics.

In multiple situational light settings, visual observation for skin colour assessment is comparable with colorimeter measurement

BACKGROUND

Finding inexpensive and reliable techniques for assessing skin colour is important, given that it is related to several adverse human health outcomes. Visual observation is considered a subjective approach assessment and, even when made by trained assessor, concern has been raised about the need for controlled lighting in the study venue. The aim of this study is to determine whether visual skin colour assessments correlate with objective skin colour measurements in study venues with different lighting types and configurations.

METHODS

Two trained investigators, with confirmed visual acuity, visually classified the inner, upper arm skin colour of 556 adults using Munsell(®) colour classifications converted to Individual Typology Angle (°ITA) values based on published data. Skin colour at the same anatomic site was also measured using a colorimeter. Each participant was assessed in one of 10 different buildings, each with a different study day. Munsell(®) -derived °ITA values were compared to colorimeter °ITA values for the full sample and by building/day.

RESULTS

We found a strong positive, monotonic correlation between Munsell(®) derived °ITA values and colorimeter °ITA values for all participants (Spearman ρ = 0.8585, P < 0.001). Similar relationships were found when Munsell(®) and colorimeter °ITA values were compared for participants assessed in the same building for all 10 buildings (Spearman ρ values ranged from 0.797 to 0.934, all correlations were statistically significant at P < 0.001).

CONCLUSION

It is possible to visually assess individual skin colour in multiple situational lighting settings and retrieve results that are comparable with objective measurements of skin colour. This was true for individuals of varying population groups and skin pigmentation.

Food for thought: edible gardens in New Zealand primary and secondary schools

ISSUE ADDRESSED

School gardens are a potentially important health promotion tool, allowing the growth and consumption of fruit and vegetables to be embedded within the students' educational experience. This study aimed to investigate the implementation of edible gardens in New Zealand (NZ) primary and secondary schools.

METHODS

A questionnaire mailed to principals from a randomly selected sample of 764 NZ schools included questions on whether or not the school had a garden and, if so, what produce was grown; how long the garden had been in place; how harvested crops were distributed; and curriculum integration.

RESULTS

Among 491 responding schools (64.3% response rate), 52.9% currently had an edible garden - with most gardens started in the previous two years. Vegetables, herbs and tree fruit were commonly grown. Gardens were integrated into curriculum subjects, cooking lessons, recipes and messages promoting increased fruit and vegetable consumption.

CONCLUSIONS

Edible gardens were common within NZ schools, though often relatively new, and were used for teaching in a variety of curriculum areas. SO WHAT?: Given the current popularity of school gardens, there are opportunities to deliver health promotion messages regarding consumption of fruit and vegetables, and for these to be reinforced by real life experience growing and preparing healthy food.

Edible gardens in early childhood education settings in Aotearoa, New Zealand

ISSUE ADDRESSED

This paper aims to explore the presence and role of edible gardens in Aotearoa/New Zealand Early Childhood Education Services (ECES).

METHODS

Participant ECES providers were identified from the Ministry of Education database of Early Childhood Education Services (March 2009). These include Education and Care and Casual Education and Care, Kindergarten, Home-based Education and Care services, Playcentres, Te Kōhanga Reo. A structured, self-administered questionnaire was sent to the Principal or Head Teacher of the service.

RESULTS

Of the 211 ECES that responded (55% response rate), 71% had edible gardens, incorporating vegetables, berry fruit, tree fruit, edible flowers and nut trees. Garden activities were linked with teaching across all strands of the New Zealand early childhood curriculum. In addition, 34% provided guidance on using garden produce and 30% linked the garden with messages on fruit and vegetable consumption. Most gardens were established recently (past 2 years) and relied on financial and non-financial support from parents, teachers and community organisations. Barriers included a lack of funding, space, time and staff support.

CONCLUSIONS/IMPLICATIONS

Study findings suggest that gardens are already being used as a versatile teaching tool in many ECES settings. Most gardens are new, with a need to support the sustainability and workforce development among teachers and parents in order to be able to maintain these resources for future generations. SO WHAT?: Given the inherent links between gardening and healthy food and exercise, there seem to be extensive opportunities for health promotion aligned with the edible garden movement.

Baseline survey of sun protection policies and practices in primary school settings in New Zealand

The SunSmart Schools Accreditation Programme (SSAP) was launched as a national programme in October 2005 to help reduce the risk of excessive child exposure to ultraviolet radiation. As part of the need for evaluation, this paper reports the findings of a national survey of a randomly selected sample of approximately 12% of New Zealand primary schools prior to the national launch of the SSAP. Principals at 242 schools completed a mail survey (81% response rate) relating to school sun protection policies, practices, curriculum and environment. Survey responses were evaluated according to the 12 criteria of the SSAP, with schools assigned a score from 0 to 12. No school fully met all 12 accreditation criteria, although 2% of schools attained 11 criteria and another 2% attained 10. Nine per cent of schools attained three or fewer criteria. Overall, 7 was the most common score, achieved by 23%. School socio-economic decile rating and roll size were positively associated with higher scores (both P < 0.02). Continued support and resources are needed to encourage schools to address sun protection across the spectrum of curriculum, practices and environment and through commitment to written policy.

Patterns of real-time occupational ultraviolet radiation exposure among a sample of outdoor workers in New Zealand

OBJECTIVES

Exposure to solar ultraviolet radiation (UVR) is an occupational health and safety issue for outdoor workers since excessive exposure is associated with negative health outcomes, including eye conditions and skin cancers. The objective of this research was to describe the pattern of UVR exposure experienced by outdoor workers from selected occupations in New Zealand in order to identify the impact of behaviour and work conditions on exposure.

STUDY DESIGN

This paper reports on the occupational UVR exposure arm of a dual arm cross-sectional study that also examined workers' sun protection practices.

METHODS

For five consecutive working days in January-March 2007, electronic dosimeters were used to record the time-stamped UVR exposure of a sample of 77 outdoor workers from three occupations (building, horticulture and roading) in Central Otago, New Zealand.

RESULTS

The geometric mean total daily UVR exposure (between 1100 and 1600 h) was 5.32 standard erythemal doses (SED; 95% reference range 0.28-19.97 SED). The geometric mean total daily UVR exposure as a percentage of the total daily ambient UVR was 20.5% (95% confidence interval 1.4-83.0%). Personal UVR exposure dipped between 1200 h and 1300 h--the same time that ambient UVR peaked--indicating the effect of shade seeking over the lunch period. Personal UVR exposure peaked between 1400 h and 1500 h, alongside decreasing ambient UVR levels, suggesting the influence of behavioural rather than climatic factors. The difference in workers' exposure between 1200 h and 1300 h, and 1400 h and 1500 h was statistically significant for both measured personal exposure (P < 0.005) and exposure calculated as a percentage of concurrent available ambient UVR (P < 0.005).

CONCLUSIONS

All the workers in this study recorded mean daily UVR exposure in excess of the current recommended occupational exposure limits. Only a minority of workers sought shade during their lunch break; most remained in highly exposed conditions. There is no evidence that work tasks which involve substantial sun exposure are being scheduled outside the high UVR period.

Youth solar ultraviolet radiation exposure, concurrent activities and sun-protective practices: a review

To assist standardization of procedures, facilitate comparisons, and help guide research efforts to optimally inform development of appropriately targeted interventions, there is a need to review methods used to quantify child and adolescent solar ultraviolet radiation (UV) exposure, related outdoor activities and sun-protective practices. This holistic approach is essential for comprehensive research that will provide all-inclusive, informative and meaningful messages for preventive measures of harmful UV exposure. Two databases were searched and 29 studies were retrieved, and these studies report measurement or assessment techniques documenting UV exposure patterns and related outdoor activities. Polysulfone film badges were the main measurement instrument used in 10 studies, with questionnaire, survey data, observation, a model, electronic dosimeters, biological dosimeters, colorimeter and UV colouring labels used in the remaining studies. Methods used to record activities included self-report, parental report, a logbook and observation. Measurement duration and unit of UV exposure varied in most studies, but a method common to 15 studies was measured UV exposure as a percentage of ambient UV. The studies reviewed do not provide sufficient information for the development and evaluation of targeted youth sun protection programs. Studies are required which document precise UV exposure, concurrent activities and sun protection usage for children and adolescents.

Sponsorship and fund-raising in New Zealand schools: implications for health

OBJECTIVE

To examine school participation in sponsorship, incentive and fundraising initiatives and to describe feedback about potential health implications and possible solutions from key stakeholders in the health and education sectors.

METHODS

All secondary/area schools and 15% of primary/intermediate schools were randomly selected from six geographical regions of New Zealand. School principals completed a self-report questionnaire. Survey findings were summarised in a discussion document and forwarded to 53 key stakeholders for comment.

RESULTS

Most schools reported participation in sponsorship, incentive and fundraising initiatives (83% of primary/intermediate and 85% of secondary/area schools). Some partnerships delivered positive health messages to students, but others were linked with products or activities potentially deleterious to health. Examples of the latter included provision of foods high in fat and sugar to students and funding from organisations whose profits were generated from gambling and alcohol sales. Key stakeholder concerns included the undermining of classroom health education and perceptions that schools were endorsing product consumption. Suggestions to address these concerns included increasing co-ordination and awareness, alternative sources of funding, and policy guidelines or legislation.

CONCLUSIONS

Most schools were involved in some sort of sponsorship, incentive and fundraising initiatives, some of which had the potential to have a negative impact on the health of students.

IMPLICATIONS

There is an urgent need for co-operation between the health and education sectors to ensure that these funding partnerships do not compromise student health.

Fine forecasts: encouraging the media to include ultraviolet radiation information in summertime weather forecasts

Melanoma and skin cancer are largely attributable to over-exposure to solar ultraviolet radiation (UVR). Reports of UVR levels within media weather forecasts appear to be well received by the public and have good potential to communicate the need for appropriate sun protection to a broad audience. This study describes provision of UVR messages by New Zealand newspapers, radio and TV stations over a 4-year period, and examines the impact of an intervention which aimed to address media concerns about the financial costs of accessing UVR information for broadcast. Newspaper and radio presentation of UVR information increased immediately after these costs were removed; however, among radio stations it dropped in subsequent years. Among those media that were presenting UVR, this information was broadcast throughout the summer period and repeated throughout the day. Furthermore, most reports included concomitant, behavioral sun protection messages. At the final assessment (summer 2001/02), 66% of radio stations, both TV channels and 48% of newspapers reported UVR information in summertime weather reports. Efforts to further increase UVR presentation will need to address media concerns about time constraints on weather forecasts and media perceptions of poor audience demand or understanding of some UVR messages.

Nicotine dependence and attempts to quit or cut down among young adult smokers

AIMS

To describe tobacco smoking behaviours, attempts to cut down or quit, and estimate the prevalence of DSM-IV nicotine dependence among young adult smokers. To relate these findings to population demand for national Quitline services.

METHODS

Confidential interviews were conducted during the assessment of the Dunedin Multidisciplinary Health and Development Study birth cohort at age 26 years. Current smokers who had smoked daily for at least one month during the twelve months before interview were asked questions to identify nicotine dependence, based on DSM-IV criteria.

RESULTS

Overall, 40% (n = 386) of the cohort followed up were current smokers who met the twelve month daily smoking criterion, one third of whom fulfilled DSM-IV criteria for nicotine dependence. The mean number of attempts to quit or cut down in the past year was 1.2. Assuming that each attempt represents a potential call to the Quitline, more than 5500 calls per month might be anticipated from the 25-29 year age group and in excess of 40 000 from the total New Zealand population, eighteen years and older.

CONCLUSIONS

Results indicate that many young adult smokers are potential users of smoking cessation services and many are nicotine dependent. In order to satisfy this reservoir of need and reduce the population burden of ill-health and premature death due to tobacco smoking, resources should continue to be provided to support and enhance tobacco control programmes with proven effectiveness in helping smokers to quit.

An evaluation of the general effect of the New Zealand graduated driver licensing system on motorcycle traffic crash hospitalisations

In 1987, New Zealand introduced a comprehensive Graduated Driver Licensing System (GDLS) which was designed to allow new drivers to gain driving experience while being excluded from high risk situations. This study sought to evaluate the impact of the GDLS on motorcycle traffic crashes that resulted in serious injury. Injury crash data were obtained from the New Zealand Health Information Services national public hospital inpatient data files for the years 1978-1994, inclusive. Cases were disaggregated into three age groups, 15-19 years, 20-24 years, and 25 years or older, for which injury trends were obtained. In order to determine whether trends in motorcycle traffic crashes simply followed national trends in other injury events, two non-traffic comparison groups for the main target group (15-19 years) were included. Using time series analyses, the introduction of the GDLS was found to be closely followed by a significant reduction (22%) in motorcycle traffic crash hospitalizations for the 15-19 year age group. An examination of vehicle registration and driver licensure data suggests that the reduction in injury crashes may, largely, be attributable to an overall reduction in exposure to motorcycle riding.

Tobacco smoking among fourth form school students in Wellington, New Zealand, 1991-97

OBJECTIVE

To investigate trends in smoking and associated demographic factors among fourth form (14-15 years) school students.

METHOD

In 1991, all 35 secondary schools in Wellington, New Zealand, were invited to participate; 15 took part. Smoking behaviours were assessed biennially by self-report. Trends were examined among 5,834 students, using multilevel regression.

RESULTS

When adjusted for sex, ethnicity and their interaction, the baseline (1991) prevalence of smoking within the past month was 18% (95% CI 10-29) rising to 28% (95% CI 15-46) in 1997. The comparable baseline prevalence of daily smoking was 8% (95% CI 3-21) rising to 15% (95% CI 4-40) in 1997. Smoking was more common among girls than boys and most common among Maori girls, for whom the adjusted odds of current and daily smoking were, respectively, 3.40 times (95% CI 2.56-4.52) and 5.00 times (95% CI 3.64-6.87) those of Europeans. School socio-economic status and sex composition added to the explanatory power of the model for daily smoking, but had negligible effect on the odds ratios for sex and ethnic group.

CONCLUSIONS AND IMPLICATIONS

The suggested rise in the prevalence of smoking has implications for future adult smoking rates and health costs. Under-representation of socio-economically disadvantaged schools may have produced conservative estimates. The increased odds of smoking among girls and Maori confirm the need to develop interventions appropriate for these groups.

Continuity and change in sporting and leisure time physical activities during adolescence

OBJECTIVES

To map the pattern of involvement in physical activities by adolescents at ages 15 and 18 years.

METHODS

Data from a longitudinal cohort study were used. Participants in the Dunedin Multidisciplinary Health and Development Study provided information about their sporting and similar physical activities during the 12 months before study assessments at ages 15 and 18 years.

RESULTS

Total participation time at age 18 was 63% of that reported at age 15. Mean participation time for girls decreased from 7.5 hours a week to 4.3 hours a week (p<0.001) whereas for boys it decreased from 11.7 hours a week to 7.8 hours a week (p<0.001). At both ages, boys spent significantly more time in physical activity than girls. More time in physical activity at age 18 was reported by participants who judged their fitness higher than their peers (odds ratio (OR) 1.7: 1.2, 2.5), those who played sport for their school (OR 1.8: 1.3, 2.4), and those reporting very good self assessed health (OR 1.4: 1.0, 1.8) at age 15. The overall median number of activities decreased from seven at age 15 to three at 18. Boys were involved in more activities at age 15 but there was no sex difference at age 18 in the number of different activities reported.

CONCLUSION

Although involvement in school sporting activities and high levels of fitness in mid-adolescence may protect against marked reductions in physical activity in late adolescence, social and organisational factors are also likely to be important. There is a need for innovative approaches to health promotion which will encourage adolescents to maintain higher levels of physical activity after they leave school.

Psychological and social predictors of motorcycle use by young adult males in New Zealand

Motorcycle riding is a significant cause of serious injuries to young males. Little is known about the psychological and social characteristics of these riders, despite such knowledge being potentially important for the targeting of appropriate injury prevention interventions. Using problem-behaviour theory to broadly guide and structure the research, the present study focused on identifying predictors of motorcycle riding. Previous research investigating differences between riders and non-riders has tended to be inconclusive, methodologically limited, and lacking in explicit theoretical foundations. The present research was based on the birth cohort enrolled in the Dunedin Multidisciplinary Health and Development Study (DMHDS), a comprehensive New Zealand longitudinal study of health, development, attitudes, and behaviours. Logistic regression models were built using prior measures of health risk behaviour, other psychological and social factors, and motorcycle riding history as potential predictors of any motorcycle use at the age of 18 years. The strongest predictors were early motorcycle riding, including illegal on-road driving at age 13 (OR 4.0; 95% CI 1.7, 9.1), below average reading skills (OR 2.4; 95% CI 1.3, 4.6) and fighting in a public place at age 15 (OR 2.9; 95% CI 1.2, 6.9). It was of particular interest that this profile tended to fit less well those subgroups of riders with greatest exposure to on-road motorcycle driving. Although based on small numbers, this finding was consistent with earlier cross-sectional research that linked casual and unlicensed driving with less protective motorcycling opinions and behaviours. Some implications for injury prevention and public policies regarding motorcycling are discussed. In particular, stricter enforcement of present licensing regulations and stronger penalties for their violation could help to reduce the number of less responsible riders.

Inattentive and hyperactive behaviors and driving offenses in adolescence

OBJECTIVE

The associations between symptoms of attention-deficit hyperactivity disorder (ADHD), conduct disorder, anxiety, or depression and no disorder in relation to driving offenses were examined in 916 adolescents.

METHOD

Self-report and parent report were used to assess a birth cohort of New Zealand adolescents' mental health status at age 15 years. Adolescents who scored 1.5 SD above the mean on the DSM-III total ADHD symptom scale were identified as reporting significant ADHD symptomatology. Self-report data and official traffic conviction records were used to identify adolescents who had committed driving offenses between ages 15 and 18 years.

RESULTS

ADHD symptomatology and conduct disorder were strongly associated with driving offenses. ADHD symptomatology in females was significantly associated with driving offenses and more traffic crashes compared with other disorder or no disorder.

CONCLUSIONS

Adolescents with a history of ADHD and conduct problems are significantly more likely than their peers to commit traffic offenses. Research in ADHD and risky driving should include female adolescents, as those with attentional difficulties are at a high risk for being involved in traffic crashes than females who do not experience attentional difficulties.

Rider training, reasons for riding, and the social context of riding among young on-road motorcyclists in New Zealand

Serious injuries to young motorcyclists represent an important public health problem. Little is known about the opinions and behaviours of the young riders at risk. We document the training experiences of young motorcyclists, and their reasons for riding or discontinuing riding, and identify the role models and sources of disapproval of motorcycling. The research was part of a longitudinal study of health, development, attitudes and behaviours of a birth cohort. At age 18 years, cohort members who had ridden a motorcycle during the past year completed a comprehensive questionnaire. Initial riding instruction was rarely received from a qualified instructor but was usually informal, from a male friend or father, and occurred off the road, usually on a farm. The most commonly given reasons for riding were excitement and economy. Most motorcyclists who had ceased riding attributed this to the lack of access to a motorcycle, and few mentioned safety. Mothers were the main source of disapproval. The young riders were not a homogeneous group. More licensed than unlicensed riders said manoeuvrability in traffic and ease of parking were reasons for riding. Licensed motorcyclists had more friends who rode and were more likely than unlicensed riders to have received paternal instruction. Early informal training off the road may establish attitudes and behaviours inappropriate in a traffic context. The main reasons for motorcycling (excitement, economical and manoeuvrable transport, freedom from supervision) and for discontinuing riding (lack of access) indicate motivations that should be considered before implementation of injury prevention interventions.

The risky and protective motorcycling opinions and behaviours of young on-road motorcyclists in New Zealand

This research documented the frequency of protective and risky motorcycling opinions and behaviours and investigated whether these opinions and behaviours were more frequently expressed by licensed than unlicensed riders and by riders with high rather than low exposure to motorcycling. Areas where there was scope for improvement were identified to help guide the promotion of protective strategies. As part of a broader study of a birth cohort, 217 18 year old motorcyclists were administered a motorcycling computer questionnaire. Evidence of positive protective opinions was found, but there was considerable scope for behavioural improvements. While 92% had worn a helmet, optimal protection was reported less frequently for other body areas: most often for the feet (54%), hands (47%) and upper body (35%) and least often for the legs (8%). Most (87%) riders considered conspicuity increased safety, 68% favoured mandatory day-time headlight use, and 66% used dipped headlights in day-time. While 55% favoured mandatory wearing of high-visibility clothing, only 15% of day-time and 20% of night-time riders reported doing this. During the past month, 16% had driven within two hours of drinking alcohol and 6% when too tired to be fully in control. Overall, 22% had been penalized for a motorcycle driving offence, most often speeding. While 46% said they agreed with the Graduated Driver Licensing System (GDLS), most licensed under that system reported breaking licence conditions and most were not apprehended. Licensed motorcyclists were significantly more likely than the unlicensed to favour mandatory day-time headlight usage, report using dipped headlights in day-time, and wear better protection for the head, upper body and hands, but were also more likely to report drinking and driving and traffic convictions--probably because of their greater exposure. Other, non-significant, results were in the same direction, except that fewer licensed than unlicensed riders were in favour of mandatory high visibility clothing or the GDLS. A similar pattern of more protective attitudes and behaviours was found for high rather than low exposure riders, though it was generally weaker, and high exposure was associated with drinking and driving, driving while tired and traffic convictions. The issues of representativeness and reliability are discussed and some implications for public policies towards motorcycling by young people are considered. Further research is recommended in order to determine which are the best predictors of motorcycling opinions and behaviours: personal characteristics, the formal training associated with licensure, or exposure to motorcycling.

The New Zealand graduated driver licensing system: teenagers' attitudes towards and experiences with this car driver licensing system

OBJECTIVES

This study examined the attitudes of teenagers towards the New Zealand graduated driver licensing system (GDLS), and the extent to which it affected them.

METHOD

Teenagers, who are members of a longitudinal study of a birth cohort, were interviewed at 15 years of age when the GDLS was first introduced and before they had begun licensure, and again at 18 years of age after they had experience with this licensing system.

RESULTS

At both ages the majority (over 70%) agreed with the driving restrictions imposed by this system. After experience with the restrictions, however, significantly more reported being affected a lot by them, than had expected to be at age 15. This was especially true of the restrictions on the carrying of passengers and the night time curfew (10 pm - 5 am). However, few reported that they were affected by the alcohol restriction. Sixty eight per cent of those with a graduated licence reported breaking at least one of the conditions, most frequently carrying passengers. Very few were penalised by the police for this.

CONCLUSIONS

Generally these young drivers were positively disposed towards the driving restrictions, but noncompliance was common. A full evaluation of all aspects of this licensing system is recommended.

Young on-road motorcyclists in New Zealand: age of licensure, unlicensed riding, and motorcycle borrowing

OBJECTIVES

The study aimed to determine the prevalence of unlicensed riding and motorcycle borrowing among young motorcyclists, and to document their perceptions of how they would be affected if the minimum age of licensure were raised.

METHODS

Motorcycling was investigated as part of the Dunedin Multidisciplinary Health and Development Study, a broad longitudinal study of the health, development, attitudes, and behaviours of a birth cohort. Young motorcyclists, who had ridden on-road during the year before their interview at age 18 years, completed a computer administered questionnaire containing questions about licensure, riding frequency, and motorcycle borrowing.

RESULTS

Of the 217 motorcyclists identified, 36% were licensed, 54% had ridden once a month or less frequently, and 72% had usually ridden a borrowed motorcycle during the one year recall period. Significantly more licensed than unlicensed riders and owners than borrowers reported higher exposure and significantly more licensed than unlicensed riders were owners. Most licensed riders (86%) had ridden on public roads before licensure, and many (54%) thought that they would have been much affected by a higher minimum age of licensure.

CONCLUSIONS

More stringent enforcement of existing licensing regulations, tougher penalties for breaching graduated driver licensing restrictions, raising the minimum age for motorcycle licensure, and prohibiting the sale or lending of motorcycles to unlicensed riders are possible injury prevention strategies.

Motorcycle crashes resulting in death and hospitalisation. II: Traffic crashes

This is the second paper in a series of three that describe the epidemiology of motorcycle crashes in New Zealand that result in death and hospitalisation. The first paper presented an overview of all motorcycle crashes. This paper focuses on traffic crashes. The source of the fatality data was national mortality data files for the years 1978 to 1987 inclusive. The source of the hospitalisation data was the 1988 national morbidity file which records all public hospital discharges in New Zealand. For the period 1978 to 1987, 1,175 fatalities were identified resulting in a mortality rate of 3.5 per 100,000 persons per year. Males aged 15-19 and 20-24 had very high rates (25.2 and 26.4, respectively), especially labourers (40.0) and forestry workers (32). Maori and non-Maori had similar rates. The majority (63%) of the deaths were attributable to a collision with another motor vehicle. During 1988 2,222 motorcyclists were hospitalised giving an incidence rate of 68.1 per 100,000 persons per year. Males aged 15-19 and 20-24 had very high rates (409 and 416, respectively), especially labourers (355). Maori had a higher morbidity rate than non-Maori (99 versus 61). The most common (40%) crash was a collision with another motor vehicle. The most common sites of injury were the lower limb (43%) and head (23%). Collision crashes were more likely to result in lower limb injury, be more severe, and result in longer stays in hospital.

Motorcycle crashes in New Zealand resulting in death and hospitalisation. I: Introduction methods and overview

Relative to car crashes motorcycle crashes have received relatively little attention by the research community. This is the first in a series of three papers describing the epidemiology of motorcycle crashes resulting in death and hospitalisation in New Zealand. This paper describes the methods used for the study, provides an overview of all crashes, and, in particular, compares traffic crashes with nontraffic crashes. The source of the fatality data was national mortality data files for the years 1978 to 1987 inclusive. The source of the hospitalisation data was a national morbidity file, which records all public hospital discharges in New Zealand. A total of 1,175 motorcyclist fatalities were identified for the period 1978-1987, resulting in a mortality rate of 3.6 per 100,000 persons per year. A total of 2,623 motorcycle crash victims were hospitalised in 1988 resulting in a hospitalisation rate of 80.4 per 100,000 persons per year. Males, especially those 15-24 years of age had very high mortality (26-27) and morbidity rates (464-462). Motor vehicle traffic crashes represented 96% of the fatalities and 85% of the hospitalisations. Drivers were the victims in 88% of fatalities and 86% of hospitalisations. For hospitalised victims the leading injuries were to the lower limb (43%) and head (24%). Whereas 29% of the traffic crashes were AIS-3 or higher the comparable figure for nontraffic crashes was 19%. There has been a significant linear increase in the fatality rate between 1978 and 1988 but no comparable trend in hospitalisations.(ABSTRACT TRUNCATED AT 250 WORDS)

Motorcycling attitudes and behaviours. II. 14 and 15 year old adolescents

Of 846 adolescents interviewed near their 15th birthday, 51% could drive a motorcycle. A further 13% intended to learn. Drivers reported friends (mean age 16.5 years) as the most common source of instruction. Forty-four per cent of drivers and 69% of intending learners planned to apply for licences. Thirty-five per cent of the sample had driven or ridden as passengers on a motorcycle on-road in the past year and 85% of these had worn a helmet on the last occasion. The commonest cause of injuries to motorcyclists resulting in hospitalization (lower limb injury) was correctly identified by 52% of the sample. Fear of injury was the reason given for not learning to ride by 55% of confirmed non-drivers. Fifteen medically treated motorcycling injuries were reported for a 2-year recall period. Females reported significantly less exposure and less use of protective clothing than males. The issues of initiation, training, constraints on use and preventive strategies are discussed.

Motorcycling attitudes and behaviours. I. 12 and 13 year old adolescents

The death and serious injury of adolescent motorcyclists is a major public health problem. Effective preventive strategies depend on knowledge about target populations. The attitudes and patterns of exposure to motorcycling of 730 13 year old New Zealand adolescents are described. Fifty-two per cent could ride a motorcycle, a further 13% intended to learn, 22% had driven on-road, and 60% had ridden as pillion passengers on-road. Significantly more males than females were riders (P less than 0.001) and had ridden as pillion passengers (P less than 0.05). More male than female non-riders intended to learn (P less than 0.001). Eighty per cent of the sample recognized road 'accidents' as the main cause of death for their peers, and 31% had known a motorcyclist killed or injured. Seventeen per cent of on-road riders had not worn a helmet when last riding. Few statistically significant differences in risk perception were obtained between males and females or riders and non-riders. Preventive options are discussed.

Adolescents' sporting and leisure time physical activities during their 15th year

Participation in physical activity may influence health outcomes, so its quantification is important. There is little data on adolescent physical activities. Recall of physical activity in the preceding year was obtained from a birth cohort of 799 fifteen-year-old adolescents in New Zealand using a modified version of the Minnesota Leisure Time Activities Questionnaire. Mean total participation times were relatively high, with 612 hrs/year (1.68 hrs/day) for males and 401 hrs/year (1.1 hrs/day) for females. Individual total participation ranged from less than a minute to 6.5 hrs/day. Over 10% more females than males reported netball, equestrian activities, and dancing, and at least 10% more males reported cricket, rugby, fishing, soccer, squash, golf, and surfing. Ranked by mean participation time, equestrian activity was highest for females and walking was highest for males. Cycling and swimming represented the largest proportion of total group participation time. The sample will be followed up at age 18 years.