“And they’re OFF” Industry Health Promotion Investigation in … · 2020-02-17 · The...

“And they’re OFF”

Industry Health Promotion Investigation in Victorian

Thoroughbred Participants

September 2017

Prof. Jane Farmer Dr. Hilary Davis Dr. Ben Bullock

A/Prof. Christine Critchley

“And They’re Off” Industry Health Promotion in Victorian Thoroughbred Participants

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TABLE OF CONTENTS

ACKNOWLEDGEMENTS............................................................................................................................3

EXECUTIVESUMMARY.............................................................................................................................4

1. INTRODUCTION.................................................................................................................................5

2.BACKGROUND................................................................................................................................5

3.AIMS...............................................................................................................................................7

4.METHODOLOGY.................................................................................................................................74.1DATACOLLECTIONPHASE1–IPADANDPAPER-BASEDSURVEY...............................................................74.2THEPROCEDURE............................................................................................................................84.3PSYCHOLOGICALSUPPORT...............................................................................................................84.4DATACOLLECTIONPHASE2–TARGETEDEMAIL...................................................................................8

5.MEASURES........................................................................................................................................9

6.SAMPLE...........................................................................................................................................10

7.RESULTS..........................................................................................................................................117.1PSYCHOLOGICALDISTRESS.............................................................................................................127.2SLEEPQUALITY.............................................................................................................................15

8.HIGHERDEPRESSIONANDANXIETYAMONGSTTRAINERS..........................................................................17

9.CONCLUSIONS..............................................................................................................................19

10.REFERENCES..................................................................................................................................20

11.APPENDIXA-SURVEY.....................................................................................................................21


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ACKNOWLEDGEMENTS WethankKirraFitzgeraldofRacingVictoriaforheradviceduringtheexecutionofthisresearch.WethanktheInglisOaklandsPremierSaleforaccesstothisevent.WethankJarrodWalshe,LauraTirlea,andTracyDeCotta(allofSwinburneUniversityofTechnology)forspecialistsupportwithaspectsofsurveydesign,datacollectionanddataanalysis.WethanksurveyrespondentsfromthehorseracingindustryinVictoriawhoremainanonymous.WewishtoacknowledgethefinancialcontributionmadebytheVictorianGovernmenttowardsthisproject.


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EXECUTIVE SUMMARY TheSwinburneCentreforSocialImpactpartneredwithRacingVictoriatocollecthealth,psychologicalhealthandwell-beingdata,usinganonline,anonymoussurveymethod.Werecruitedmembersofthehorseracingindustryvisitinga“Well-beingLounge”duringtheannualyearlingsalesatOaklandJunction,Victoria,early2017;andbytargetedemailinmid-2017.Theaimofthisresearchwastogainevidenceaboutthementalhealthandwell-beingofpersonnelworkingintheVictorianhorseracingindustry.Theseincludeoccupationalgroupsofhorsetrainers,jockeys,horseowners,stablesupervisors,stablehandsandothers.

Thesurveyusedstandardisedquestionnairestoobtaindataondemographicdetails,sleephabits,mentalhealthandwell-being.Whilethesurveyidentifiedwell-beingissuesamongstthisgeneralcommunity,thisdatacannotbetracedbacktoindividualpeopleandisonlyusedinaggregateform.Theprojectrelieduponpeopleagreeingtoparticipate,itdidnotpre-identifypeoplewithhealthorwell-beingissues.TrainedpsychologistswereonhandattheYearlingsales,andsupportinformationavailable,incasethesurveytriggeredanyconcernsforparticipants.WeusedtheK10(ameasureofpsychologicaldistress)andPSQI(sleepbehaviour)standardisedsurveys,whichwereself-administeredbyparticipantsviaiPadsorpaperattheyearlingsales.AsecondroundofrecruitmentwasmadefromRacingVictoriahorsetraineremaillistsinmid-2017.Theresultsoftheresearchprovideevidenceofthementalhealthstatusandwell-beingofpeopleinthehorseracingcommunity,andofVictorianhorseracingtrainersspecifically.

Wesuggestafurtherroundofqualitativeinterviewstoexplorereasonsforidentifiedmentalhealthscoresofracingtrainers;evidencewhichcouldbeusedtoinformstrategiesformentalill-healthpreventionandsupportforthosewithwell-beingissues.ThiswouldassistRacingVictoriainitsgoalstooptimizewell-beingofthoseintheracingindustry.


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1. INTRODUCTION TheSwinburneCentreforSocialImpactpartneredwithRacingVictoriatocollecthealth,psychologicalhealthandwell-beingdata,usinganonline,anonymoussurveymethod.

Theaimofthisresearchwastogainevidenceaboutthementalhealthandwell-beingofpeopleworkinginthehorseracingindustry.Theseincludeoccupationalgroupssuchashorsetrainers,jockeys,horseowners,stablesupervisors,andstablehandswithracehorsetrainersbeingourprimaryfocus.

Werecruitedmembersofthehorseracingindustryvisitinga“Well-beingLounge”attheannualyearlingsalesinearly2017.Participantswererecruitedoverfourdaysusingacombinationofpaper-basedandiPad-basedsurveys.Datacollectedincludeddemographicandwell-beinginformation,includingresponsestotheKesslerPsychologicalDistressScale(K10)-ameasureofpsychologicaldistress(K10;Kessleretal.,2002)andPittsburghSleepQualityIndex(PSQI)-ameasureofsleepbehaviour(PSQI;Buysseetal.,1988).K10andPSQIareestablished,widelyused,standardisedsurveys.Afteranalysisofresultingdata,afurtherroundofsurveyswasemailedoutbyRacingVictoria,toVictorianracehorsetrainersusingRacingVictoria’sexistingemaillist.Thiswastoincreasethenumberofrespondentsandthusensuresurveyfindingswereasreliableaspossible.

2. BACKGROUND InVictoria,therearearound937(2016-17season)thoroughbredhorsetrainers(includingrestrictedandpre-trainers).Ofthese,235arefemaletrainers(25%)and701aremaletrainers(75%).ThetotalnumberofparticipantsintheracingindustryinVictoriaisestimatedataround3,000includingarangeofstable-basedemployees(e.g.assistanttrainers,stablesupervisors,stablehandsandtrackriders).

Littleisknownabouttheoccupationalhealthoftheseemployees.ARacingVictoriasurveyofnearly10yearsagofoundthatof303horsetrainerssurveyed,72%weremale,withanaverageageof50years,andworkedanaverageof46hoursperweek(witharangeof4-110hours)(Speedetal,2008).Allhorsetrainersworkedatleastsixdaysperweekand98%workedsevendaysperweek.Thehorsetrainersreportedthattheyrarelytookannualleaveduetoaconcernaboutalackoftrustworthyreplacementstaff.Othercommonproblemsreportedwereissueswithdevelopingsocialnetworksoutsidetheindustry,physicalhealthissues(duetoongoingfatigue,lackofrespite,labourintensivework),mentalhealthissuescausedbyconstanthighmentalpressure,andfeelingunrecognisedintheirwork,unlesstheirhorseswin(Speed2008:24-26).


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The2008studyindicatedthat,whilethemajorityoftrainersfelthappyandsatisfiedwiththeirwork(70-75%),asignificantnumberfeltanxious(31%)ordepressed(22%),and9%feltunabletocope.Asmallnumberreportedpanicattacks(5%)andthoughtsofself-harmorsuicide(4%).Surveyauthorsconcludedthat:

“…intermsoftheactualnumbersofpeoplewhoexperiencethesefeelings,oroftheconsequencesofexperiencingthesefeelings,theimplicationsofthesestatisticsaresubstantial.Forexample,25trainersoften,veryoftenoralwaysfeelunabletocope,and10trainersoften,veryoftenoralwaysexperiencethoughtsofsuicideorself-harm,thatareinsomewayrelatedtotheirworkorbusinessesashorsetrainers.Remember,only24%oftrainersrespondedtothesurvey.Whenweprojectthesenumberstothe(trainer)populationatlarge(multiplythesenumbersby4.0),thenthesignificanceofthesefindingsbecomesalarming”.

Similarratesofmentalhealthwerereportedforstableemployees,bothmaleandfemale(ibid:138).

Comparedwiththegeneralpopulation,itispossiblethatparticipantsinthehorseracingindustrymayexperienceparticularstressesduetolongandunsociableworkinghours,pressurestosucceedinacompetitiveindustry,andfinancialpressures.Theremayalsobeenvironment-relatedstresses(suchasflood,fire,effectsofclimatechange)thatcouldimpactmentalhealth,ashasbeenreportedforfarmersinotherpartsofAustralia(Hartetal,2011).Someissuescouldbeassociatedwiththemale-dominatednatureoftheracingindustry.MenaretypicallyverylowusersofpreventativehealthservicesinAustralia.Theyhavepoorerhealthoutcomesthanwomen,andmeninregionalandruralcommunitiesaremorelikelytobesmokers,drinkalcoholinlargequantities,andbeoverweightorobese,andlessphysicallyactivethantheirmetropolitancounterparts.Inresponse,in2013theAustraliangovernmentlaunchedanationalmalehealthpolicyidentifyingprioritiesfortheimprovementofallaspectsofmalehealth(Lynch,W,2013).

OneofthetacticsusedbyRacingVictoriatoaddresshealthissues,istodeploy“HealthPitStops”atkeyevents(inourresearchthiswasa“Well-beingLounge”attheannualyearlingsales.Originally,theconceptofaPitStopwasintendedtoappealtomen-drawinganalogiesbetweencarpartsandmen’shealthconcerns,encouragingmentochecktheirenginese.g.,oilpressure(bloodpressure),chassis(hiptowaistratio),fueladditive(alcoholconsumption),exhaust(smoking)andshockabsorbers(copingskills),amongstothers.(Chambers,D,2006).

HealthPitStopshavebeendeployedthroughoutAustraliaandoverseas,includingtotargetruralandremoteworkerssuchasfarmers(Kuhns,S2009,).TheyhavebeenusedbyRoyalFlyingDoctorService(Harveyetal,2006)andothers(Russell,etal2006).Inthisresearch,wecollectedsomesurveydataataHealthPitStop(Well-beingLounge)runbyRacingVictoria.


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Duetoageneralgapinresearchaboutracingindustrystaffhealth,trainerhealthinparticular,reasonsunderpinninganecdotalreportsofrelativelypoormentalhealthandwell-beingandalackofstrategiestoimprovehealth,thisstudywascommissionedbyRacingVictoria.Acontemporary,focusedandintensivedatasetonthementalhealthandwell-beingofpeoplelivingandworkingintheruralhorseracingcommunityinVictoria,wassought.Findingscouldbecomparedwithotherindustriesandwithracingindustrypersonnelofothergeographicallocations.Findingsmightinformfuturestudyandpilotworkaroundhealthandhealthimprovementstrategies.

3. AIMS Theaimsofthisresearchwereto:

•Obtainhealthandwell-beingdataaboutthoseworkingintheVictorianhorseracingsector,particularlytrainers,usinganonline,anonymoussurveymethod.

•ComparedatafoundwiththoseforthegeneralAustralianpopulation.

•Raiseawarenessofthepressures,stress,andmentalhealthissuesassociatedwiththehorseracingcommunitythroughthedisseminationofaggregateresultsandfindings.

•Usedatatoconsiderhowbesttosupportpeopleassociatedwiththehorseracingcommunity.

4. METHODOLOGY RacingVictoriacommissionedthisresearch.Theresearchisconcernedwithinvestigatingthementalhealthandwell-beingofpeopleworkingwithandtrainingthoroughbredracehorsesinVictoria.Permissionstoundertaketheresearchweresoughtfrom,andgrantedby,SwinburneUniversityofTechnologyEthicsCommittee(2016/320).

4.1 Data collection phase 1 – iPad and paper-based survey Asurveyformwasproducedthatincorporatedanintroduction,demographicandbriefstandardisedsurveyforms,theK10andPSQI(seelatersectionsandappendixforfurtherinformation).ThesurveywasuploadedandtestedoniPads.Thesurveywasfoundtobestraightforward,easytouse,andcouldbecompletedinaroundtenminutes.Thesurveywasdesignedtocollectdataaboutthementalhealthandwell-beingofpeopleattendingtheInglisMelbournePremierYearlingSale(OaklandJunction),potentiallyacrosssixconsecutivedaysinFebruary2017.

RacingVictoriahostedresearchersandparticipantsatadedicatedmarqueecentraltothesales.Themarqueeservedasahealth‘Well-beingLounge’forpeopleattendingtheyearlingsalestohavebasichealthchecks(e.g.skinchecks,weightanddiabetesriskchecksetc.)completedforthem,aswellasanopportunitytorestandcollectRacingVictoriamemorabilia.RacingVictoria


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supportedrecruitmenttothesurveyinwaysincludingprovidingincentives(e.g.water,rest,andfreemerchandise),advertisingtheeventonsocialmediaandontheRacingVictoriawebsite.

4.2 The procedure Researchersverballyintroducedthemselvestopeoplevisitingthemarquee,andinquiettimesopportunisticallyapproachedpeopleinotherspacesaroundtheyearlingsales(e.g.atcafé,ongrassareas)askingthemiftheywouldtakepart.Participantsself-completedtheanonymousonlinesurveyoniPads.ThesurveywasdeliveredthroughQualtricssoftware(see-https://www.qualtrics.com/au/)andsecurelyautomaticallyuploadedtotheSwinburneUniversityserver.Manysurveyswerecompletedbyhandonpaperafterthefirstday.Thiswasduetorespondentpreference,extremeheatattheeventthatcausediPadstooverheat(temperaturesreachedabove34degreesCelsius),andinternetconnectivityissues.Papercopieswereplacedinasealedbox,storedsecurely,andenteredintotheservermanuallybyresearchers.Thesurveywasanonymous-althoughresearchersmetrespondentsfacetoface,theywereunknowntothem,andnonamesoridentifyingdatawererecorded.

4.3 Psychological support Twoqualifiedpsychologistswereavailableincaserespondentsexpressedmentalhealthconcerns.Whilesomepeoplechosetotalkaboutpersonalmatterswiththeresearchers,noneactivelysoughtprofessionalcounselling.SeveralrespondentsreportedthattheywerepleasedthatRacingVictoriahadcommissionedtheresearchwhichwasviewedasbeing‘muchneeded’andtimely.

4.4 Data collection phase 2 – targeted email

Theyearlingsalesyielded267fully-completedsurveyresponses(plus11thatwereexcludedfromanalysisduetoincompletedata).Twentyoftherespondentsattheyearlingsalesidentifiedastrainers.Manypeoplepresentattheyearlingsaleswereengagedinactivities(e.g.eating,caringforhorses,watchingsales,andbidding)andcouldnotbedisturbedtoaskthemtoparticipateinthesurvey.Datacollectionattheyearlingsaleswaslabour-intensiverequiringthreeresearcherstoattendduringfivedays.Therefore,inconsultationwithRacingVictoria,wesoughtafurthermethodforadditionalparticipantrecruitment,togainalargerpoolofrespondents.

ThesecondphaseinvolvedapproachviaatargetedemailsentbyRacingVictoriatotheRacingVictorialistofhorsetrainers.AnextensiontoethicalpermissionwassoughtfromSwinburneUniversityEthicsCommitteeandgrantedforthissecondphaseinlateApril2017.

AcoveringletterandstandaloneemailweregeneratedanddistributedbyRacingVictoriausingpre-existinglistsofVictorianhorsetrainers.Respondentswererequestednottocompletethe


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surveyiftheyhadalreadydonesoattheyearlingsales.Surveyresponseswerecompletedviaanembeddedlinkintheemailsent.DataweresecurelycapturedviaQualtrics,andheldonuniversityservers,thuspreservinganonymityandaseparationbetweenRacingVictoriaandsurveyrespondents.Areminderwassentattwoweeksaftertheoriginalemail.

Onehundredandtwo(102)surveyswerereturnedatRound2;ofthese,91werefullycompleted(62inresponsetotheoriginalemailtotrainers(pluseightnotcomplete)and29inresponsetothereminderemail(plusthreenotcomplete).OfthosewhocompletedtheRound2survey,71outof91(78%)identifiedastrainers.

Theoverallresponse–followingyearlingsalesdatacollectionandtheemailphase-was358respondentsafterdeductionofincompletesurveys,andthosethathadnottickedthe‘consent’box.Overall,91fullycompletedresponseswerefromtrainers.Itisestimatedthatthisfinalsamplerepresents9.7%ofallregisteredtrainersinVictoria,asrecordedonRacingVictoriaemaillists.

5. MEASURES Thedataarepresentedinaggregateform,presentingagroupcasestudyofpeopleworkingintheracingcommunityinVictoria,Australia.Theprimarygroupofinterestarethehorsetrainers,butothergroupsworkinginthisindustryarealsoconsidered.Thedataareanalysedintermsoftheprimarydemographiccategoriese.g.gender,agebands,occupationalgroups,householdincome(forcomparisonofsocio-economicgroups)andurban/rurallocation,asidentifiedbypostcode.AggregatedataarecomparedwithAustralianpublishednormsfortheinstrumentsused;andaverageAustraliandatareportedbytheAustralianBureauofStatisticsandtheAustralianInstituteofHealthandWelfare.

PsychologicaldistresswasmeasuredusingtheKesslerPsychologicalDistressScale10-itemchecklist(K10;Kessleretal.,2002).TheK10isawidelyusedcommunityscreeningmeasureofanxietyanddepression.Itisaself-reportquestionnairethatyieldsaglobalmeasureofdistressbasedonquestionsaboutsymptomsofanxietyanddepressionexperiencedinthemostrecent4-weekperiod.Subscalesofanxietyanddepressioncanbecalculatedaswellasanoveralldistressscore.TheK10cannotbeusedasanindicatorofanxietyanddepressivedisorderdiagnoses,andassuch,therearenodesignatedcut-offscores.InAustralia,scoresabove22(outof30)areconsidered‘hightoveryhigh’levelsofpsychologicaldistress(AustralianBureauofStatistics,2012).

SleepqualitywasmeasuredusingthePittsburghSleepQualityIndex(PSQI;Buysseetal.,1988).ThePSQIisawidely-used9-itemquestionnairethatmeasuresvariousaspectsofsleepoverthepreviousmonth,includingduration,timetofallasleep(latency),levelofsleepdisturbance,levelofdaytimedysfunctionduetosleepiness,sleepefficiency,sleepquality,anduseofmedicationstoaidsleep.Atotalscalescorecanbecalculatedfromtheseaspectsofsleepwithhigherscores


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indicatingworsesleep.Anempiricallyderivedcut-offscoreof>5distinguishespoorsleepersfromgoodsleepersandindicatesthatasubjectreportsseveredifficultiesinatleasttwoareas,ormoderatedifficultiesinmorethanthreeareas.Goodsleeperswilltypicallyscorebelow3andpeoplewithdiagnosableinsomniawilltypicallyscorehigherthan11.

6. SAMPLE Atotalsampleof358peoplecompletedthesurvey,with91(25.4%)identifyingthemselvesashorsetrainers.Sixty-fourpercentofthetrainersweremen,slightlybelowtheindustrynumbersprovidedbyRacingVictoria(75%).Theaverageageofthetrainersinthesamplewas51years,whichisagainconsistentwithindustrystatisticsthatshowtheaverageageofallVictorianhorsetrainersis55years.Incomparisontoothers(“non-trainers”)inthesample,horsetrainersweresignificantlyolder(M=51years,SD=13yearsvs.M=46years,SD=15years),p<.05.Theproportionofmeninthetrainersample(63.7%)wasgreaterthantheproportionofmeninthenon-trainersample(53.6%),howeverthisdifferencewasnotstatisticallysignificant(p=.11).


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7. RESULTS Participantsinthesurveywereasked“Givenyourcurrentneedsandfinancialresponsibilities,wouldyousaythatyouandyourfamilyare:Prosperous,VeryComfortable,ReasonablyComfortable,JustGettingAlong,Poor,VeryPoor”inordertoassessfinancialwell-being.1AsshowninFigure1,asignificantlylowerpercentageoftrainersratedthemselvesasatleast“Reasonablycomfortable”andabovecomparedtonon-trainers(48%vs.76%,respectively).

Figure1.Proportionoftrainersandnon-trainersselectingeachcategoryoffinancialwell-being

Theregionaldistributionoftrainersandnon-trainerswasassessedusingtheAccessibility/RemotenessIndexofAustraliaandiscalculatedusingparticipants’self-reportedpostcode.2Ahigherpercentageoftrainers(57.8%)thannon-trainers(30.2%)liveinInnerRegionalareas(seeFigure2).

1CategoriesoffinancialprosperitywerebasedonthoseusedintheGovernment-runHILDA(Household,IncomeandLabourDynamicsinAustralia)Survey.2Bywayofexample,GeelongisconsideredaMajorCity,ColacisconsideredInnerRegional,andHorshamisconsideredOuterRegional.


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Figure2.Regionaldistributionoftrainersandnon-trainersinthesample

7.1 Psychological Distress Figure3showsthattrainersreportedsignificantlyhigherpsychologicaldistressscoresontheK10comparedtonon-trainers(p<.001).Thepatternofdifferenceswasthesameforbothmenandwomen.Womenreportedslightlyhigherpsychologicaldistressthanmen,butthedifferenceswerenotstatisticallysignificant.


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Figure3.Comparisonbetweentrainersandnon-trainersontotalK10scores

ApplyingthecategoriesrecommendedbytheAustralianBureauofStatistics,wecanseeinFigure4thatthereisasignificantlyhigherpercentageoftrainersthannon-trainersinallcategoriesofdistressexceptLowdistress.Therewerenostatisticallysignificantdifferencesbetweentrainersinthesampleandpopulationpercentages.ItisworthnotingthatpopulationscoresdisplayedinFigure4werebasedondataderivedfromtheSwinburneWell-beingMonitor(2014),N=900.PopulationscoresontheK10fromtheSwinburneWell-beingMonitorareknowntobehigherthanpreviouspopulationsurveysthathaveusedtheK10.Forexample,intheNationalHealthSurvey2014-15runbytheAustralianBureauofStatistics,thepercentageoftheadultpopulationexperiencingLowdistresswas68%,apercentagemorecloselyalignedtowhatisshowninFigure4forthenon-trainersample,andmuchhigherthanthe40%foundintheSwinburneWell-beingMonitorsample.Thereasonsforthesehigherscoresinthelattersamplearecurrentlyunderinvestigation,butforcurrentpurposesitissuggestedthatdifferencesinlevelsofpsychologicaldistressbetweenthetrainersandthepopulationmaybemorepronouncedthanwhatisshowninFigure4.


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Figure4.Comparisonbetweentrainersandnon-trainersonK10categories

TotalK10scorescanalsobebrokendownintosubscalesofanxiety(6items)anddepression(4items).Figure5showsthattrainersreportedsignificantlyhigherlevelsofanxiety(p<.01)anddepression(p<.001)thannon-trainers.ItisworthnotingthathigheranxietyscoresthandepressionscoresareduetothefactthatmoreK10itemscontributetotheanxietysubscalescore(6)thanthedepressionsubscalescore(4).Thehighestpossiblescorefortheanxietysubscaleis30,whereasthehighestpossiblescoreforthedepressionsubscaleis20.Thehigherscoresforanxietydonotthereforemeanthatitismoreofaprobleminthissamplethandepression,theycontributeequallytooverallpsychologicaldistress.

Lowdistress Moderatedistress Highdistress Veryhigh

distress

Trainers 38.6 28.9 20.5 12

Non-trainers 62.6 21 11.8 4.6

Populaqon 42.6 31.5 18.4 7.6

0

10

20

30

40

50

60

70

Percen

tage

Trainers Non-trainers Populaqon


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Figure5.Comparisonbetweentrainersandnon-trainersontotalK10anxietyanddepressionsubscalescores

7.2 Sleep quality Figure6showsastatisticallysignificantdifferenceinPSQItotalscorebetweentrainersandnon-trainers(p<.01)andbetweentrainersandpopulation(p<.01).3Acut-offscoreof>5distinguishespoorsleepersfromgoodsleepers.Almosttwo-thirdsoftrainers(62.64%)scoredabovethiscut-offcomparedto45.15%ofnon-trainers.

3PopulationscoreforcomparisonbasedonMagee,Caputi,Iverson,andHuang(2008),N=364,Australiansample,agerange18-59years


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Figure6.Comparisonbetweentrainersandnon-trainersontotalPSQIscores

InvestigatingscoresonthesubscalesofthePSQIrevealsthemainreasonsforworsescoresamongtrainers,withastatisticallysignificantdifferencebetweentrainersandnon-trainersonsleepdurationanddaytimedysfunction,bothp<.01(seeFigure7).Worsesleepdurationisperhapsnotsurprisinginthissamplegiventhenormalworkinghoursofhorsetrainers.4Thehigherlevelofdaytimedysfunctionreportedbytrainerscomparedtonon-trainersismoreconcerning.ScoresforthedaytimedysfunctionsubscalearecalculatedonthebasisofresponsestotwoitemsinthePSQIthatrefertoa)“havingtroublestayingawakewhiledriving,eatingmeals,orengaginginsocialactivity”andb)“havingproblemskeepingupenoughenthusiasmtogetthingsdone”.Trainersarereportingdifficultiesinthesetwoareas.

4RecallthathigherscoresonthePSQIscaleandsubscalesindicateworsesleep


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Figure7.Comparisonbetweentrainersandnon-trainersonPSQIsubscales

8. HIGHER DEPRESSION AND ANXIETY AMONGST TRAINERS Thedirectarrows(calleddirecteffects)betweentrainersandthetwosleepbehaviourvariablesinFigure8suggestthattrainerstendtoexperiencesignificantlymoresleepdisturbanceanddaytimesleepdysfunctionthanallothersinthesample.Theyarealsomorelikelytodirectlyreporthigherdepression.Onaverage,sleepdisturbanceis.32ofapointhigheranddaytimesleepdysfunctionis.55ofapointhigheramongsttrainers.Sincethesedirecteffectresultsaretakingintoaccountthegender,socioeconomicstatusandageoftrainerswecanbeconfidentthatthesedifferencesinsleepbehavioursanddepressionareduetobeingatrainerratherthantheirdemographiccharacteristics.Inotherwordstrainershavepoorersleepbehavioursandincreaseddepressionregardlessoftheirgender,socioeconomicstatusorage.Theresultsalsoshowthatregardlessofwhetheroneisatrainerornot,thosefromlowersocioeconomicbackgroundsandyoungerpeoplealsoexperiencesignificantlymoredaytimesleepdysfunction(butnotsleepdisturbance).Interestingly,onceallotherbackgroundvariablesaretakenintoconsideration,therewerenodifferencesinsleepbehaviours,depressionoranxietyacrossgender.

Whilethedirecteffectsbetweensleepdisturbanceanddepressionandanxietywerenotsignificant,theywerefordaytimedysfunction.Thissuggeststhatitisincreaseddaytime


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dysfunctionratherthansleepamount,thatleadtoincreaseddepressionandanxiety.Themodelalsotestsfortheindirecteffectsofbeingatrainerondepressionandanxietythroughsleepbehaviours.Botheffectsviadaytimedysfunctionweresignificant(atp<.05)implyingthattrainershaveincreaseddepressionandanxietybecausetheyalsotendtoexperiencegreaterdaytimedysfunctionduetotheirsleep.Becausesleepdisturbancedidnotsignificantlypredictdepressionandanxiety,wecanconcludethattrainersarenotatriskforincreaseddepressionandanxietybecauseoftheirgreatertendencytohavemoredisturbedsleep.Itisthereforemoreabouthowtheirsleepdisturbstheirdaytodayfunctioning.Thedirectarrowfromtrainerstodepressionsuggestshowever,thattrainersarealsomoredepressedforreasonsapartfromdaytimedysfunction.Thustrainersaremoredepressedbecausetheirsleepismorelikelytoresultindaytimedysfunction(asindicatedbytheindirecteffect)andforotherreasonsthatarenotassessedinthismodel.Wesuggestaneedforfurtherresearchtoexploreotherpossiblereasonsastowhytrainersreportsignificantlymoredepressionthanothermembersofthehorseracingindustry.

Figure8.Pathmodelexplainingthereasonsforhigherdepressionandanxietyamongsttrainers.

Note:Estimatesareun-standardisedregressionweights.Onlysignificantpathsareshown.*=p<.01,allotherpathsp<.001.ForSocioeconomicstatus(SES)lowerscores=higherSES.Trainers=1,Others=0.Trainersmorelikelytobemale,olderandlowerSES.


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9. CONCLUSIONS Thisreporthaspresentedimportant,relevantandtimelyinformationabouttherelationshipbetweentrainersintheVictorianhorseracingindustry-andtheirsleep,anxietyandratesofdepression.WehavefoundthatVictorianhorsetrainersthatrespondedtothesurveyaremoredepressedthanotherpopulations,evenwhenwetakeintoaccounttheirparticularsleepingpatternswhichreflectindustrynorms.Onthebasisofthedatapresentedinthisreport,andwithoutanyfurtherinvestigation,weareunabletomakeanyrecommendationsforspecificinterventionswhichmighthelp.Howeverthereiscertainlyscopeforfurtherqualitativeinvestigation(e.g.in-depthinterviews,focusgroups)toexaminetheserelationshipsinmoredetail,andtodeterminewhytrainersaremoredepressedthanotherpopulations.Inaddition,thereisscopetoinvestigateinterventionswhichmighthelpsupporttrainers,andbyextensiontheirfamilies,colleaguesandthehorseracingindustrymorewidely.Asleephygienepsycho-educationalprogramtailoredspecificallytotheuniqueworkplaceconditionsoftrainerswouldappeartobeaninterventionworthyofinvestigationinthispopulation.


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10. REFERENCES

AustralianBureauofStatistics(2012).InformationPaper:UseoftheKesslerPsychologicalDistressScaleinABSHealthSurveys,Australia,2007-08(ABSPublicationNo.4817.0.55.001).Retrievedfrom:http://www.abs.gov.au/ausstats/[email protected]/Lookup/4817.0.55.001Chapter92007-08

Buysse,Detal(1988)ThePittsburghSleepQualityIndex:ANewInstrumentforPsychiatricPracticeandResearch.PsychiatryResearch,28,193-213.

ChambersD.'Apartfromtakingitdownthepubhere,it'saboutasmasculineasyoucanget"-AnevaluationofthePitStopmen'shealthprograminruralandremoteWesternAustralia.Proceedingsofthe16thNationalHealthPromotionConference;2006April23-26;AliceSpringsConventionCentre,AliceSprings,NorthernTerritory,Australia.

Hart,C.R.,Berry,H.L.,andTonna,A.N.(2011)ImprovingthementalhealthofruralNewSouthWalescommunitiesfacingdroughtandotheradversities,AustralianJournalofruralHealth,19,231-238.

Harvey,DJandHill,W.K.(2006)AflyingstarttohealthpromotioninremoteNorthQueensland,Australia:thedevelopmentofRoyalFlyingDoctorServicefielddays.RuralandRemoteHealth:6:485

Kessler,R.C.,Andrews,G.,Colpe,.etal(2002)Shortscreeningscalestomonitorpopulationprevalencesandtrendsinnon-specificpsychologicaldistress.PsychologicalMedicine,32,959-956.

Kuhns,S(2009)Men’sHealthPitStop.Anursecoordinatedprogramtobringhealthscreeningtoruralfarmers.AJN,Vol109,No7.58-60.

Lynch,W(2013)Men’shealthinAustralia.TrendsinUrologyandMen’sHealth,January/February.6thScientificForumonRuralandRemoteMedicine,Hobart,Tasmania,22-24October2010.

Russell,N.,Harding,C.,Chamberlain,C.,andJohnston,L(2006).Implementinga‘Men’sHealthPitStop’intheRiverina,South-westNewSouthWales.AustralianJournalofRuralHealth,14,129-131.

Speed,HandAnderson,M(2008)Thehealthandwelfareofthoroughbredhorsetrainersandstableemployees.CentreforAgeing,rehabilitation,ExerciseandSport,VictoriaUniversity,Melbourne,Australia.


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11. APPENDIX A - SURVEY Survey

DemographicQuestions

Age:_____

Gender:_____

Occupation: ! Trainer

! Owner

! HorseBreeder

! Jockey

! StableForeman

! Salesvendors

! Stablehand

! Racingenthusiast

! Other,pleasespecify:__________

! Pleasetickthisboxifyouareafamilymemberofatrainer

Pleaseenteryourpostcode:__________

Givenyourcurrentneedsandfinancialresponsibilities,wouldyousaythatyouandyourfamilyare…(chooseone)

! Prosperous

! Verycomfortable

! Reasonablycomfortable


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! Justgettingalong

! Poor

! Verypoor

Inthelast12monthsdidanyofthefollowinghappentoyoubecauseofashortageofmoney?(Crossoneboxforeachline)

YES NO

ACouldnotpayelectricity,gasortelephonebillsontime ! !

BCouldnotpaythemortgageorrentontime ! !

CPawnedorsoldsomething ! !

DWentwithoutmeals ! !

EWasunabletoheat(orcool)home ! !

FAskedforfinancialhelpfromfriendsorfamily ! !

GAskedforhelpfromwelfare/communityorganisations ! !

Thefollowingquestionsrelatetoyourusualsleephabitsduringthepastmonthonly.Youranswersshouldindicatethemostaccuratereplyforthemajorityofdaysandnightsinthepastmonth.Pleaseanswerallquestions.

1.Duringthepastmonth,whattimehaveyouusuallygonetobedatnight?

BEDTIME___________

2.Duringthepastmonth,howlong(inminutes)hasitusuallytakenyoutofallasleepeachnight?

NUMBEROFMINUTES___________

3.Duringthepastmonth,whattimehaveyouusuallygottenupinthemorning?


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GETTINGUPTIME___________

4.Duringthepastmonth,howmanyhoursofactualsleepdidyougetatnight?(Thismaybedifferentthanthenumberofhoursyouspentinbed.)

HOURSOFSLEEPPERNIGHT___________

Foreachoftheremainingquestions,checktheonebestresponse.Pleaseanswerallquestions.

5.Duringthepastmonth,howoftenhaveyouhadtroublesleepingbecauseyou...

a)Cannotgettosleepwithin30minutes

NotduringthepastmonthLessthanonceaweekOnceortwiceaweekThreeormoretimesaweek

b)Wakeupinthemiddleofthenightorearlymorning


c)Havetogetuptousethebathroom


d)Cannotbreathecomfortably



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e)Coughorsnoreloudly


f)Feeltoocold


g)Feeltoohot


h)hadbaddreams


i)Havepain


j)Otherreasons(s)pleasedescribe________________________________________________________________________________________________________________________________________________


25

Howoftenduringthepastmonthhaveyouhadtroublesleepingbecauseofthis?


6.Duringthepastmonth,howwouldyourateyoursleepqualityoverall?Verygood___________Fairlygood___________Fairlybad___________Verybad___________

7.Duringthepastmonth,howoftenhaveyoutakenmedicinetohelpyousleep(prescribedor"overthecounter")?


8.Duringthepastmonth,howoftenhaveyouhadtroublestayingawakewhiledriving,eatingmeals,orengaginginsocialactivity?


9.Duringthepastmonth,howmuchofaproblemhasitbeenforyoutokeepupenoughenthusiasmtogetthingsdone?

NoproblematallOnlyaveryslightproblem


26

SomewhatofaproblemAverybigproblem

Thesequestionsconcernhowyouhavebeenfeelingoverthepast30days.Tickaboxbeloweachquestionthatbestrepresentshowyouhavebeen.

1.Duringthelast30days,abouthowoftendidyoufeeltiredoutfornogoodreason?

1. Noneofthetime2. Alittleofthetime3. Someofthetime4. Mostofthetime5. Allofthetime

2.Duringthelast30days,abouthowoftendidyoufeelnervous?


3.Duringthelast30days,abouthowoftendidyoufeelsonervousthatnothingcouldcalmyoudown?


4.Duringthelast30days,abouthowoftendidyoufeelhopeless?

1. Noneofthetime2. Alittleofthetime3. Someofthetime


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4. Mostofthetime5. Allofthetime

5.Duringthelast30days,abouthowoftendidyoufeelrestlessorfidgety?1. Noneofthetime2. Alittleofthetime3. Someofthetime4. Mostofthetime5. Allofthetime

6.Duringthelast30days,abouthowoftendidyoufeelsorestlessyoucouldnotsitstill?


7.Duringthelast30days,abouthowoftendidyoufeeldepressed?


8.Duringthelast30days,abouthowoftendidyoufeelthateverythingwasaneffort?


9.Duringthelast30days,abouthowoftendidyoufeelsosadthatnothingcouldcheeryouup?

1. Noneofthetime


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2. Alittleofthetime3. Someofthetime4. Mostofthetime5. Allofthetime

10.Duringthelast30days,abouthowoftendidyoufeelworthless?


Thankyouforcompletingthissurvey.

Date post:	22-Jun-2020
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