Representative Australian Sample Research Articles

Longitudinal gambling risk transitions: evidence from a nationally representative Australian sample

Aims Problem gambling has downstream consequences on individuals, families and the community. While a strong research base now exists on predictors and outcomes of problem gambling risk and severity, few studies have examined the transitions in gambling risk status over time, and factors associated with these transitions. Methods The current study addresses this knowledge gap by examining gambling transitions using two waves of longitudinal, population-representative Australian data (N = 12,364) collected in 2015 and 2018. Focal to our approach is the assessment of predictors of gambling risk status including demographics, and key psychosocial factors that might attenuate the risk of transition into more severe gambling. Results The results show significant stability in gambling risk over time, particularly among individuals who reported no or low gambling risk. Gambling risk transitions were more likely to occur toward less severe than more severe levels of gambling. Furthermore, gambling problems tended to persist in more severe levels of gambling risk. Financial hardship, younger age, male gender, experience of hardship, lower levels of educational attainment, chronic health conditions, risky levels of alcohol consumption, living in low SES areas, and low sense of mastery were associated with transitions from low to more severe gambling over the three-year period. There were no significant predictors of transitions to lower levels of gambling risk in the current data. Conclusions Our findings can help inform public health interventions by better targeting individuals at elevated risk for more severe gambling over time, and we outline a method for analyzing transitions in longitudinal datasets that can be applied in future studies in addiction.

Patient Preferences for Investigating Cancer-Related Symptoms in Australian General Practice: A Discrete Choice Experiment.

Striking the right balance between early cancer diagnosis and the risk of excessive testing for low-risk symptoms is of paramount importance. Patient-centred care must also consider patient preferences for testing. To investigate diagnostic testing preferences of the Australian public for symptoms associated with oesophagogastric (OG), bowel, or lung cancer. One of three discrete choice experiments (DCEs) related to either OG, bowel, or lung cancer were administered to a nationally representative sample of Australians aged 40 and above. Each DCE comprised three scenarios with symptom positive predictive values (PPVs) for undiagnosed cancer ranging from 1% to 3%. The numerical risk was concealed from participants. DCE attributes encompassed the testing strategy, GP familiarity, test and result waiting times, travel duration, and test cost. Preferences were estimated using conditional and mixed logit models. A total of 3013 individuals participated in one of three DCEs: OG (n=1004), Bowel (n=1006), and Lung (n=1003). Preferences were chiefly driven by waiting time, test cost followed by the test type. There was preference for more invasive tests. When confronted with symptoms carrying an extremely low risk (symptom PPV of 1% or less), participants were more inclined to abstain from testing. Access-related factors, particularly waiting times and testing costs, emerged as the most pivotal elements influencing preferences, underscoring the substantial impact of these systemic factors on patient choices regarding investigations.

Cognitive reappraisal moderates the protective effect of body satisfaction on mental health and wellbeing in adults: A prospective study during COVID-19 lockdown

BackgroundBody satisfaction is associated with mental health and well-being in adults. However, prospective studies are needed to better understand its protective effects, and in whom these are most beneficial. This study investigated body satisfaction as a predictor of depressive symptoms, generalised anxiety, and well-being in a representative Australian sample collected during the initial COVID-19 lockdown. Two emotion regulation strategies – cognitive reappraisal and expressive suppression – were also tested as moderating variables. MethodsThe sample comprised 684 adults aged 19 to 87 years who completed three primary waves of data spanning two months [Wave 3 (W3), W4 and W7] from the Australian National COVID-19 Mental Health, Behaviour and Risk Communication Survey. ResultsHierarchical multiple regression models controlling for demographic and COVID-19 risk factors, as well as W3 for each outcome variable, indicated that W3 body satisfaction predicted greater W7 well-being, and fewer W7 depressive symptoms and greater W7 well-being in participants reporting low levels of W4 cognitive reappraisal. No moderation for W4 expressive suppression was observed, nor predictive relationships between W3 body satisfaction and W7 anxiety. LimitationsThe two-month follow-up period precludes conclusions relating to the longer-term protective effects of body satisfaction within and beyond the pandemic context. Examination of focal relationships in clinical samples, and inclusion of broader indices of body image, emotion regulation and mental health, is needed in future studies. ConclusionsFindings suggest body satisfaction warrants attention in community well-being promotion in adults, and may be particularly beneficial for those lack adaptive emotion regulation strategies.

Therapeutic Substitution in Response to Patent Expiry? Statins in Australia*

This study aims to investigate the effects of generic entry on the market share of different statins. We use administrative records from a representative sample of Australians between 2003 and 2014 and analyse over 21 million prescriptions to quantify the change in the total market share of each statin after experiencing generic entry for the first time. With detailed information on patients' benefits and prices, we also estimate potential savings from increasing the use of statins where generics became available. Our results indicate that despite the price decrease, the market share of the molecule experiencing generic entry does not significantly increase, and there is some evidence of substitution away from statins with generic availability. For the most commonly used molecules, this association is stronger in patients receiving higher government subsidies. We calculate potential savings of A\$17 million if patients had initiated treatment with the most prescribed off‐patent statin rather than a patent‐protected statin. Generic entry after patent expiry presents an opportunity for a significant reduction in pharmaceutical expenditure if these are preferred. This study highlights the importance of improving prescription systems that help doctors recommend lower cost, clinically appropriate alternatives and enhance the effectiveness of policies promoting generic substitution.

High-speed internet access and energy poverty

We examine how access to high-speed internet affects the probability of being in energy poverty. To do so, we match data on Australia's National Broadband Network (NBN) high-speed internet rollout across postcodes with longitudinal data that contains information on household energy poverty for a nationally representative sample of Australians. Applying a difference-in-difference approach, we find that a 1% increase in the proportion of a postcode that gains access to the NBN causes an average increase of 2.2% in the probability of being in energy poverty. We find that social capital is a channel through which access to high-speed internet transmits to energy poverty. Specifically, the rollout of high-speed internet access has contributed to lower levels of social capital and lower levels of social capital have contributed to higher levels of household energy poverty.

Prospective Association Between the Dispensing of Antidepressants and of Medications to Treat Osteoporosis in Older Age

Osteoporosis is a common condition associated with fragility fractures, especially in older individuals and women. Antidepressants have emerged as a potential risk factor, but their association with bone fragility remains uncertain because the results of past studies are difficult to generalize. We aimed to investigate the association between antidepressant exposure and subsequent treatment for osteoporosis in a nationally representative sample of Australians. Cohort study using a 10% random sample of the Pharmaceutical Benefits Scheme (PBS) data for 2012, that included 566,707 individuals aged older than or equal to 50 years not dispensed osteoporosis medications. The effect of exposure to antidepressants during 2012 (prevalent or incident) or later (up to 2022) was examined using Cox regression models adjusted for age, sex, comorbidities and other psychotropic medications. Over 10 years, 73,360 (12.94%) received osteoporosis medications; 16,216 (22.10%) had been dispensed antidepressants in 2012. The hazard of osteoporosis medication dispensing was higher among those exposed to antidepressants (HR = 1.16, 99% CI = 1.14-1.18; average duration of follow up: 8.0 ± 3.1 years, range: 1-10 years). The hazard of osteoporosis medication diminished with increasing age, and the effect of antidepressants was 37%-76% more pronounced among men in the 50s and 60s. Different classes of antidepressants had a similar risk profile. The dispensing of antidepressants in older age is associated with higher hazard of subsequent dispensing of medications for osteoporosis, and this association is more marked for young older adults, particularly men. Clinicians should monitor the bone health of older individuals treated with antidepressants in order to decrease the morbidity associated with fragility fractures.

Social cynicism, greenwashing, and trust in green clothing brands

AbstractThis research develops a theoretical model of the effect of social cynicism as a personality trait on trust in green clothing brands. We conducted an online survey of a representative Australian sample to test the hypothesized relationships. Our findings confirmed that social cynicism affected green brand trust negatively and that this effect can be explained by an increase in perceived greenwashing. Conspicuous consumption moderates this indirect influence. This mediated influence decreased when conspicuous consumption was more salient. Findings provide important practical insights for brand managers intending to avoid a decrease in brand trust regarding garments marketed with sustainability claims.

Measures of socioeconomic advantage are not independent predictors of support for healthcare AI: subgroup analysis of a national Australian survey

Objectives: Applications of artificial intelligence (AI) have the potential to improve aspects of healthcare. However, studies have shown that healthcare AI algorithms also have the potential to perpetuate existing inequities...

There is (still) a global factor that underlies the PGSI: A reanalysis of Tseng, Flack, Caudwell, and Stevens (2023)

Tseng, Flack, Caudwell, and Stevens (2023) conducted confirmatory factor analyses (CFA) of the Problem Gambling Severity Index (PGSI)—a gold-standard measure of disordered gambling symptomatology that has traditionally been indexed using a total score—with data from a large representative sample of Australians residing in Northern Territory who gamble (N = 3,740). Based on their results, Tseng et al. argued that a two-factor model best fit the data and so the PGSI items could be separated into two subscales: Problem Behaviours and Consequences of Problem Behaviours. We reanalyzed their data using CFA and found that a hierarchical model provided the best fit to the data. The hierarchical model includes a global factor underlying all PGSI items and two sub factors that correspond to the PGSI items assessing behaviours and consequences. The global factor was empirically well-defined, but the behaviours and consequences sub factors were not. Also, the two sub factors did not reliably measure the more narrowly defined behaviours and consequences constructs independent of the global factor. Based on our reanalyses of Tseng et al.’s (2023) data, we encourage researchers in the field of gambling studies to continue using the PGSI total score as an index of disordered gambling symptomatology.

Norms and COVID‐19 health behaviours: A longitudinal investigation of group factors

AbstractMost studies on norms and COVID‐19 have ignored the group‐based and dynamic nature of normative influence where self‐relevant and salient groups might emerge and change along with their impact on health behaviours. The current research seeks to explore these issues using a three‐wave longitudinal design with a representative sample of Australians (Nwave 1 = 3024) where two group sources of potential normative influence (neighbourhood and national groups) and two COVID‐19 health behaviours (physical distancing and hand hygiene) were investigated in May, June/July and September/October 2020. Results indicated that especially from Wave 1 to Wave 2 neighbourhood descriptive norms (rather than national or injunctive norms) had the most impact on health behaviours while controlling for demographic and individual‐level health variables. This demonstrates that groups and associated norms that influence behaviours vary across time. It is concluded that research on norms needs to study which groups matter and when.

Relationships between hope, optimism, and conservation engagement.

The loss and degradation of nature can lead to hopelessness and despair, which may undermine engagement in conservation actions. Emerging movements, such as that behind the organization Conservation Optimism, aim to avert potential despair of those involved in conservation. Some argue that fostering positive states, such as hope or optimism, can motivate engagement and action; however, others question whether fostering hope or optimism may inadvertently undermine perceived gravity of conservation challenges. We examined this issue by quantifying dispositional hope and optimism with a representative sample of Australians (n=4285) and assessing their relationship with indicators of conservation engagement. We used the Great Barrier Reef (GBR) in Australia as a case study. We asked participants what they could do to help the GBR, then classified their responses into 2 outcome variables: identifying climate actions (i.e., actions that tackle the main threat to the reef) and identifying plastic actions (i.e., actions that are popular among community members). We also quantified likelihood of performing these actions and appraisals of both threats and actions. One dimension of hope, hope pathways (defined by Snyder's hope theory as knowing different ways to act), was associated with greater capacity to identify climate-related behaviors (odds ratio [OR]=1.44) and plastic reduction behaviors (OR=1.22) and greater likelihood of adopting climate-related actions (β=0.20). Optimism was associated with recognition of plastic reduction behaviors only (OR=1.22). Neither hope nor optimism undermined appraisal of conservation threats. The effects of optimism were mediated by reduced action futility, and effects of hope pathways were mediated by stronger perceptions of threats to the reef (threat appraisal) and confidence in performing useful actions (coping appraisal). Our findings suggest that dispositional hope can strengthen, rather than undermine, appraisal of conservation challenges and solutions and thereby increase conservation engagement.

Psychological distress and bowel cancer screening participation.

To better understand barriers to participation in mail-out bowel cancer screening programs, two survey studies tested the relationship between psychological distress and self-reported bowel cancer screening. First, a nationally representative sample of Australians N=5421 completed measures of bowel cancer screening and psychological distress (using the Kessler Psychological Distress Scale; K10). Second, N=479 completed a survey measuring participation in the National Bowel Cancer Screening Program (NBCSP) and psychological distress using the Depression, Anxiety and Stress Scale. In both studies, logistic regressions were conducted to test relationships between psychological distress and self-reported screening participation. Study one found that psychological distress had a significant quadratic effect on having ever screened for bowel cancer, where screening rates were similar for those with low, moderate, or high levels of distress, but were lower for those with very high levels of distress. In study two, depression scores had a negative linear relationship with NBCSP participation (higher depression levels were associated with lower screening participation), and anxiety had a quadratic effect whereby NBCSP participation rates were higher with increasing levels of anxiety except in the severe category, where participation was significantly lower. Findings indicate that psychological distress has a complex relationship with screening, and those with extreme levels of distress consistently show lower participation rates. Special efforts to encourage screening may be required for those experiencing extreme psychological distress and mental health disorders.

The Legitimation of Rewards to Education

Abstract Everywhere, education is well rewarded, roughly 5% to 15% for each additional year of university, hence a major source of income inequality. Why do ordinary people see income rewards to education as legitimate? Two key theories: (1) their moral views might align with classical equity arguments asserting a moral entitlement to rewards in proportion to contributions. (2) Alternatively, they might see rewards to education as fair returns on investment, a morally infused folk version of human capital. These share almost all their predictions, but they differ if an employer fully finances the education. Analysis of a large representative Australian sample reveals that the public’s ideal returns to education match equity justifications (~80%), not economists’ fair return on investments (~10%).

Autonomy versus support: self-reliance and help-seeking for mental health problems in young people

PurposeMany young people with mental ill-health do not seek support, and developmental growth in self-reliance may be a barrier to help-seeking. Increasing autonomy is a positive developmental task for youth and a key aspect of resilience. This study examined the influence of perceived social support and resilience on the previously unexamined relationship between self-reliance and intentions to seek help from informal, professional, and self-help sources for mental health problems.MethodsAn online survey was completed by a representative Australian community sample of 5,203 young people aged 12–25 years (half female), in May–June 2020.ResultsPath analysis showed the hypothesised conceptual model did not fit the data well, but a modified model was a good fit. Higher self-reliance was associated with lower intentions to seek informal and professional help, as expected, but not with greater intentions for self-help. The relationship between self-reliance and informal help-seeking intentions was fully mediated by perceived social support, whereas the relationship between self-reliance and professional help-seeking was also direct. Perceived social support fully mediated the relationship between self-reliance and resilience. Intentions to use self-help were not influenced by variables in the study, but higher self-help intentions were associated with higher professional help-seeking intentions. Associations were consistent across age and gender groups.ConclusionThe results show the critical role of social support for combating some of the unhelpful aspects of self-reliance for mental health help-seeking in young people. Future research should explore how self-reliance can hinder or be harnessed to facilitate accessing appropriate mental health.

Exploring the Influence of News Consumption on Non-Muslim Australians’ Attitudes towards Muslims

Research into news media representations of Muslims and their faith has focused mainly on how Muslims are portrayed in various types of news media and how stories about or involving them are framed. However, there has been very little attention paid to the effects of news consumption on attitudes towards Muslims. Accordingly, we wanted to explore a range of issues associated with news consumption levels and attitudes towards Muslims in Australia. The three objectives of this article are to: explore whether the amount of news consumed by respondents to an Australian survey influences the level of animosity they hold towards Muslims; determine how political viewpoint and religiosity influence the relationship between news consumption and animosity towards Muslims; and see whether engagement with Muslims influences the relationship between news consumption and animosity towards Muslims. Through a 2018 nationally representative sample of Australians, we target these objectives by investigating whether the amount of news that non-Muslim survey participants consume in a week influences the levels of anger they feel towards Muslims and how their self-defined religiosity, political viewpoint, and engagement with Muslims affect that relationship, while controlling for known drivers of anti-Muslim sentiment, such as demographic characteristics and knowledge about Muslims. We set our study in the contemporary context of mostly lab-based research that helps us understand how news media consumption affects particular types of people and whether there are commonalities in like-groups’ responses to different types of news consumption; in this case, stories about Muslims and their faith. The findings of our research will be of interest to news media organizations and journalists wanting to know about the effects of their coverage of stories about Muslims and their faith and those wanting to improve that reportage. The results will also interest groups working on social cohesion efforts, those trying to improve inter-faith and inter-cultural relations, and academics investigating news media coverage of Muslims and Islam. Significantly, we find quantity of news consumption to lack effect on anger levels.

Temporal Associations between Religiosity and Subjective Well-Being in a Nationally Representative Australian Sample

ABSTRACT This study examined the between-person and within-person associations between 4 components of subjective well-being (i.e., general life satisfaction, satisfaction with life domains, positive affect, and negative affect) and 2 components of religiosity (i.e., religious salience and religious participation). Data were drawn from the Household, Income, and Labor Dynamics in Australia (HILDA) Survey, collected 5 times between 2004 and 2018. The Random-Intercept Cross-Lagged Panel Model was used to analyze the data. Results showed weak between-person associations between the components of religiosity and subjective well-being. At the within-person level, the cross-lagged associations between religiosity and subjective well-being variables were trivial and nonsignificant. This indicates a lack of robust temporal associations between religiosity and subjective well-being when measured at intervals of a few years.

Risk tolerance and changes in coronavirus disease (COVID) related health behaviors: A longitudinal study.

The present study examined behavioral responses during the coronavirus disease 2019 (COVID-19) pandemic and the role of dispositional risk tolerance in the Australian context. The study involved a six-wave longitudinal investigation with a nationally representative sample of Australians (N = 1,296). Dispositional risk tolerance was measured at Wave 1 and participants' anxiety level and self-report implementation of 10 COVID actions was assessed in each wave. Autoregressive multinomial regression models were estimated to assess the unique contribution of risk tolerance to the longitudinal change of participants' implementation of COVID actions. The results revealed a high implementation rate for protective actions when Australia had a peak in the severity of the COVID-19 pandemic and subsequently declined with the easing threat of the pandemic. Individuals' dispositional risk tolerance significantly predicted transition to, and endorsement of, protective actions. Participants who had low risk tolerance were more likely to remain at the state of implementing COVID-19 measures than being in, or transitioning to, other states. The findings suggest that when encouraging protective actions, governments and public authorities should acknowledge variability in the community in responding to risk and consider measures in addition to risk messaging to encourage protective actions among individuals with a high level of risk tolerance. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Terrorism concern and persistence of negative attitudes towards Islam and Muslims

AbstractThis study suggests that terrorism concerns can hinder the effect of prejudice reduction interventions based on education and outgroup knowledge. There is accordance in the literature that individuals who possess more knowledge about Muslim people and Islam are less likely to have anti‐Muslim prejudice. We conducted secondary analyses of data from a representative sample of Australians (N = 1,267), and we found that terrorism concerns moderate the relationship between anti‐Muslim prejudice and knowledge of Islam, wherein individuals with higher levels of terrorism concern have high anti‐Muslim attitudes regardless of their levels of knowledge. In an experimental study manipulating terrorism concerns, a national sample of 502 Australians was randomly allocated to watch a news video about ISIS or a video portraying Muslims positively. Individuals who watched the ISIS video had significantly higher anti‐Muslim attitudes and were significantly more likely to retain negatively framed information about Muslims than those who watched the positive video. Please refer to the Supplementary Material section to find this article's Community and Social Impact Statement.

Patterns and predictors of alcohol use during the early stages of the COVID‐19 pandemic in Australia: Longitudinal cohort study

BackgroundThe COVID‐19 pandemic has resulted in disruptions across many life domains. The distress associated with the pandemic itself, and with public health efforts to manage the outbreak, could result in increased alcohol use. This study aimed to quantify changes in alcohol use during the early stages of the pandemic and factors associated with different patterns of use.MethodsData were obtained from a longitudinal survey of a representative Australian adult sample (N = 1296, 50% female, M age = 46.0) conducted from March to June 2020, during the first wave of the COVID‐19 outbreak in Australia. Change in alcohol consumption was examined using Alcohol Use Disorders Identification Test‐Consumption (AUDIT‐C) scores from waves one, three, five, and seven of the study, each 4 weeks apart. Factors associated with alcohol consumption were examined, including depression (PHQ‐9) and anxiety (GAD‐7) symptoms, health risk tolerance, stress and coping, work and social impairment (WSAS), COVID impacts, and sociodemographic variables. We tested changes in alcohol use across the full sample using a mixed effects repeated measure ANOVA model and a multinomial logistic regression to identify factors assessed at wave 1 that were independently associated with alcohol use.ResultsThere was no significant change in AUDIT‐C scores across the study. For most participants, alcohol use did not increase during the early phase of the COVID‐19 pandemic in Australia. COVID‐19 exposure, higher perceived coping, depression symptoms, and male gender were associated with greater odds of increasing or elevated levels of alcohol use. Social changes, which included working from home, had mixed effects on alcohol consumption.ConclusionsAlthough no evidence was found for increased alcohol use overall during the early months of the pandemic, several factors were associated with alcohol consumption at risky levels. Greater understanding of motivations for drinking across public and private contexts, along with targeted support for high‐risk groups, could assist in reducing harm associated with alcohol consumption.

To “tell or not to tell”—Exploring disclosure about medicine use by people living with sleep disorders

ObjectiveTo explore the difference in rates and reasons for disclosure of either conventional or complementary medicine (CM) to healthcare practitioners between people living with sleep disorders (SDs) and those without SDs. MethodsA cross-sectional survey (N = 2019 adults) that measured sociodemographic characteristics, health status, health service utilisation, health literacy and health communication (medicine disclosure) of a representative sample of Australians was conducted. Data from participants reporting an SD (n = 265) were compared to those not reporting an SD to assess measures of health communication and disclosure about medicine use. ResultsOverall, rates of medicine disclosure to both conventional and CM practitioners were high, in respondents with (70%) and without an SD (57%). Those reporting an SD had higher expectations of their conventional health practitioner’s knowledge of CM, associated clinical decision-making skills, and approval of CM use, and held a higher degree of concern about drug interactions (P < 0.05). The main reasons cited for disclosing CM use to conventional health practitioners and conventional medicine use to CM practitioners were “I want them to fully understand my health status” and “I was concerned about drug interactions with the CMs used.” ConclusionThe high rate of medicine use disclosure by people with SDs is driven by an intention to inform their healthcare practitioner about their health status and concerns about potential medicine interactions. Therefore, research about the expectations that people with an SD have of their conventional healthcare practitioners’ knowledge of CM and CM-drug interactions requires further examination. Likewise, further examination of CM practitioner’s conventional medicine knowledge is encouraged.