title: Large and forgotten in rural Australia: assessment, attitudes and possible approaches to losing weight in young adult males.
abstract: BACKGROUND
  Young Adult Males (YAMs) in rural Australia are poorly studied with respect to overweight and obesity. Firstly, we explored the feasibility of recruiting 17-25 year old YAMs to obtain baseline data on overweight and obesity rates, socio-demographics, nutrition, exercise and mobile phone usage. Secondly, we explored the views of YAMs with a waist measurement over 94 cm about using mobile phone text messages to promote weight loss and incentives to promote healthy lifestyles.
  
  
  METHODS
  A two-staged, mixed-methods approach was used to study obesity and overweight issues in Dubbo, a regional city in New South Wales, Australia. In Phase I, socio-demographic, health behaviour and mobile phone usage data were collected using a questionnaire and anthropometric data collected by direct measurement. In Phase II, YAMs' views were explored by focus group discussion using a semi-structured questionnaire.
  
  
  RESULTS
  Phase I (145 participants): mean Body Mass Index (BMI) 25.06±5.01; mean waist circumference 87.4±15.4 cm. In total, 39.3% were obese (12.4%) or overweight (26.9%) and 24.1% had an increased risk of metabolic complications associated with obesity. 135 (93.1%) owned a mobile phone and sent on average 17±25 text messages per day and received 18±24. Phase II (30 participants): YAMs acknowledged that overweight and obesity was a growing societal concern with many health related implications, but didn't feel this was something that affected them personally at this stage of their lives. Motivation was therefore an issue. YAMs admitted that they would only be concerned about losing weight if something drastic occurred in their lives. Text messages would encourage and motivate them to adopt a healthy lifestyle if they were individually tailored. Gym memberships, not cash payments, seem to be the most favoured incentive.
  
  
  CONCLUSIONS
  There is a clear need for an effective health promotion strategy for the almost 40% overweight or obese Dubbo YAMs. The high rate of text message usage makes it feasible to recruit YAMs for a prospective study in which personalized text messages are used to promote healthy behaviours. It may be important to target motivation specifically in any weight-related intervention in this group with incentives such as gym membership vouchers.
authors.affiliation: School of Rural Health, University of Sydney, Dubbo, Australia. k.mendis@uws.edu.au.
authors.forename: Kumara
authors.initials: K
authors.lastname: Mendis
authors.forename: Tanya
authors.initials: T
authors.lastname: Forster
authors.forename: Karen
authors.initials: K
authors.lastname: Paxton
authors.forename: Karen
authors.initials: K
authors.lastname: Hyland
authors.forename: Jason
authors.initials: J
authors.lastname: Yelverton
authors.forename: Rick
authors.initials: R
authors.lastname: McLean
authors.forename: Joseph
authors.initials: J
authors.lastname: Canalese
authors.forename: Anthony
authors.initials: A
authors.lastname: Brown
authors.forename: Katharine
authors.initials: K
authors.lastname: Steinbeck
mesh_terms: D000328:Adult; D017144:Focus Groups; D007722:Health Knowledge, Attitudes, Practice; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D008297:Male; D009042:Motivation; D009517:New South Wales; D009765:Obesity / Q000628:therapy*; D011446:Prospective Studies; D036301:Qualitative Research; D012424:Rural Population; D011795:Surveys and Questionnaires; D060145:Text Messaging; D015431:Weight Loss; D055815:Young Adult