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Carducci B, Dominguez G, Kidd E, Oh C, Jain R, Khan A, Bhutta ZA. Promoting healthy school food environments and nutrition in Canada: a systematic review of interventions, policies, and programs. Nutr Rev 2024:nuae030. [PMID: 38767979 DOI: 10.1093/nutrit/nuae030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/22/2024] Open
Abstract
CONTEXT The school food environment is a critical interface for child and adolescent nutrition, and there is a need to understand existing literature on Canadian school food environments to identify equity gaps and opportunities, and empower decision-makers to plan for future action. OBJECTIVE Literature on Canadian school food and nutrition interventions, policies, programs, and their effects on diets and nutritional status are synthesized and appraised in this systematic review. DATA SOURCES A search strategy was developed for each database used (Medline, Embase, PsycINFO, ERIC, Cochrane Collaboration, Canadian Electronic Library, BiblioMap), with a combination of free text and controlled vocabulary, for articles published from 1990 to 2021. Unpublished data and grey literature were also searched. DATA EXTRACTION Quantitative and qualitative studies with an observational or intervention study design, reviews, or program evaluations conducted in Canadian schools with participants aged 5-19.9 years were included. Key study characteristics and risk of bias were extracted independently by 2 investigators using a standardized tool. DATA ANALYSIS A total of 298 articles were included (n = 192 peer reviewed and 106 from the grey literature), which were mostly conducted in Ontario (n = 52), British Columbia (n = 43), and Nova Scotia (n = 28). Twenty-four interventions, 5 nonevaluated programs, and 1 policy involved Indigenous populations. Overall, 86 articles measured and reported on effectiveness outcomes, including dietary intake; anthropometry; knowledge, attitudes, and practices; and physical activity. The literature remains largely heterogenous and primarily focused on nutrition education programs that use subjective assessments to infer changes in nutrition. A key facilitator to implementation and sustainability was community engagement, whereas key barriers were staff capacity, access to resources and funding, and consistent leadership. CONCLUSIONS This review provides insight into Canadian school food and nutrition interventions, programs, and policies and uncovers important evidence gaps that require careful examination for future evaluations. Governments must create supportive environments that optimize nutrition for children and adolescents through equitable policies and programs. SYSTEMATIC REVIEW REGISTRATION PROSPERO registration no. CRD42022303255.
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Affiliation(s)
- Bianca Carducci
- Centre for Global Child Health, Hospital for Sick Children, Peter Gilgan Centre for Research, and Learning, Toronto, ON, Canada
- Department of Nutritional Sciences, University of Toronto, Faculty of Medicine, University of Toronto, Medical Sciences Building, Toronto, ON, Canada
| | - Georgia Dominguez
- Centre for Global Child Health, Hospital for Sick Children, Peter Gilgan Centre for Research, and Learning, Toronto, ON, Canada
| | - Emily Kidd
- Centre for Global Child Health, Hospital for Sick Children, Peter Gilgan Centre for Research, and Learning, Toronto, ON, Canada
| | - Christina Oh
- Western University, Schulich School of Medicine and Dentistry, London, ON, Canada
| | - Reena Jain
- Centre for Global Child Health, Hospital for Sick Children, Peter Gilgan Centre for Research, and Learning, Toronto, ON, Canada
| | - Amira Khan
- Centre for Global Child Health, Hospital for Sick Children, Peter Gilgan Centre for Research, and Learning, Toronto, ON, Canada
- Department of Nutritional Sciences, University of Toronto, Faculty of Medicine, University of Toronto, Medical Sciences Building, Toronto, ON, Canada
| | - Zulfiqar A Bhutta
- Centre for Global Child Health, Hospital for Sick Children, Peter Gilgan Centre for Research, and Learning, Toronto, ON, Canada
- Department of Nutritional Sciences, University of Toronto, Faculty of Medicine, University of Toronto, Medical Sciences Building, Toronto, ON, Canada
- Centre of Excellence in Women, and Child Health, Aga Khan University, Karachi, Pakistan
- Dalla Lana School of Public, Health University of Toronto Health Sciences Building, Toronto, ON, Canada
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McCormack GR, Koohsari MJ, Vena JE, Oka K, Nakaya T, Chapman J, Martinson R, Matsalla G. Associations between neighborhood walkability and walking following residential relocation: Findings from Alberta's Tomorrow Project. Front Public Health 2023; 10:1116691. [PMID: 36726629 PMCID: PMC9885132 DOI: 10.3389/fpubh.2022.1116691] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Accepted: 12/28/2022] [Indexed: 01/18/2023] Open
Abstract
Introduction Cross-sectional studies consistently find that the neighborhood built environment (e.g., walkability) is associated with walking. However, findings from the few existing longitudinal residential relocation studies that have estimated associations between changes in neighborhood built characteristics and walking are equivocal. The study objective was to estimate whether changes in neighborhood walkability resulting from residential relocation were associated with leisure, transportation, and total walking levels among adults. Methods This study included longitudinal data from the "Alberta's Tomorrow Project"-a province-wide cohort study (Alberta, Canada). The analysis included data collected at two time points (i.e., baseline and follow-up) from 5,977 urban adults. The International Physical Activity Questionnaire (IPAQ) captured self-reported walking. We estimated neighborhood walkability, an index capturing intersection, destination, and population counts for the 400 m Euclidean buffer around participants' homes. Using household postal codes reported at baseline and follow-up, we categorized participants into three groups reflecting residential relocation ("non-movers:" n = 5,679; "movers to less walkability:" n = 164, and; "movers to more walkability:" n = 134). We used Inverse-Probability-Weighted Regression Adjustment to estimate differences [i.e., average treatment effects in the treated (ATET)] in weekly minutes of leisure, transportation, and total walking at follow-up between residential relocation groups, adjusting for baseline walking, sociodemographic characteristics, and walkability. The median time between baseline and follow-up was 2-years. Results The three residential relocation groups mainly included women (61.6-67.2%) and had a mean age of between 52.2 and 55.7 years. Compared to "non-movers" (reference group), weekly minutes of transportation walking at follow-up was significantly lower among adults who moved to less walkable neighborhoods (ATET: -41.34, 95 CI: -68.30, -14.39; p < 0.01). We found no other statistically significant differences in walking between the groups. Discussion Our findings suggest that relocating to less walkable neighborhoods could have detrimental effects on transportation walking to the extent of adversely affecting health. Public health strategies that counteract the negative impacts of low walkable neighborhoods and leverage the supportiveness of high walkable neighborhoods might promote more walking.
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Affiliation(s)
- Gavin R. McCormack
- Cumming School of Medicine, University of Calgary, Calgary, AB, Canada,Faculty of Kinesiology, University of Calgary, Calgary, AB, Canada,School of Architecture, Planning and Landscape, University of Calgary, Calgary, AB, Canada,School of Knowledge Science, Japan Advanced Institute of Science and Technology, Nomi, Japan,*Correspondence: Gavin R. McCormack ✉
| | - Mohammad Javad Koohsari
- School of Knowledge Science, Japan Advanced Institute of Science and Technology, Nomi, Japan,Faculty of Sport Sciences, Waseda University, Tokorozawa, Japan
| | - Jennifer E. Vena
- Cumming School of Medicine, University of Calgary, Calgary, AB, Canada,Cancer Care Alberta, Alberta Health Services, Calgary, AB, Canada
| | - Koichiro Oka
- Faculty of Sport Sciences, Waseda University, Tokorozawa, Japan
| | - Tomoki Nakaya
- Graduate School of Environmental Studies, Tohoku University, Sendai, Japan
| | - Jonathan Chapman
- Public Space and Mobility Policy, Planning and Development Services Department, Calgary, AB, Canada
| | | | - Graham Matsalla
- Mental Health Promotion and Illness Prevention, Alberta Health Services, Calgary, AB, Canada
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Stotz SA, Fricke H, Perra C, Byker-Shanks C, Yaroch AL. Successful Community Nutrition Incentive Program Data Collection during the COVID-19 Pandemic: A Case Study. Curr Dev Nutr 2022; 6:nzac025. [PMID: 35368735 PMCID: PMC8903743 DOI: 10.1093/cdn/nzac025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 02/01/2022] [Accepted: 02/14/2022] [Indexed: 11/24/2022] Open
Abstract
Background The coronavirus 2019 (COVID-19) pandemic has complicated rigorous evaluation of public health nutrition programs. The USDA Gus Schumacher Nutrition Incentive Program (USDA GusNIP) funds nutrition incentive programs to improve fruit and vegetable purchasing and intake by incentivizing Supplemental Nutrition Assistance Program (SNAP) participants at the point of sale. GusNIP grantees are required to collect survey data (e.g., fruit and vegetable intake and food insecurity status) on a subset of participants. However, due to COVID-19, most GusNIP grantees faced formidable barriers to data collection. The Hunger Task Force Mobile Market (HTFMM), a Wisconsin-based 2019 GusNIP grantee, used particularly innovative methods to successfully collect these data (n > 500 surveys). Objectives The aim was to explore HTFMM's successful participant-level data-collection evaluation during COVID-19. Methods A single case study methodological approach framed this study. The case is the HTFMM in Milwaukee, WI, USA. Participants included HTFMM leadership (n = 3), evaluators (n = 2), staff (n = 3), volunteers (n = 3), and customers (n = 10). These teleconference interviews were recorded and transcribed verbatim. Transcripts were coded using thematic qualitative analysis methods with 2 independent coders. Results Four salient themes emerged: 1) there were multiple key players with unique roles and responsibilities who contributed to personalized, proactive, and time-intensive, telephone-based proctored survey collection methods; 2) the importance of resources dedicated to comprehensive evaluation; 3) longstanding relationships rooted in trust and community-based service are key to successful program delivery, engagement, and evaluation; and 4) the COVID-19 data-collection protocol also serves to mitigate nonpandemic challenges to in-person survey collection. Conclusions These findings provide guidance on how alternative methods for data collection during COVID-19 can be used and applied to other situations that may affect the ability to collect participant-level data. These findings contribute to a growing body of literature as to best practices and approaches to collecting participant-level data to evaluate public health nutrition programs.
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Affiliation(s)
- Sarah A Stotz
- Centers for American Indian and Alaska Native Health, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | | | | | | | - Amy L Yaroch
- Gretchen Swanson Center for Nutrition, Omaha, NE, USA
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Reilly K, Bauman A, Reece L, Lecathelinais C, Sutherland R, Wolfenden L. Evaluation of a voucher scheme to increase child physical activity in participants of a school physical activity trial in the Hunter region of Australia. BMC Public Health 2021; 21:570. [PMID: 33757472 PMCID: PMC7986265 DOI: 10.1186/s12889-021-10588-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2020] [Accepted: 03/08/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Global population data suggest that physical activity levels in children remain unacceptably low. Improved participation in organised sport has been recommended by the WHO as one strategy to improve population levels of physical activity. In 2018, in the state of New South Wales, Australia, the government introduced the Active Kids scheme, to help families meet the cost of getting children into organized sport. The aim of this study is to describe the uptake of Active Kids and assess the impact of the scheme on organized sport participation and child physical activity in a region of New South Wales. METHODS A pragmatic longitudinal study was undertaken of parents/carers from primary school aged children (5-12 years) in the Hunter region of NSW, Australia. Baseline data were collected between Oct-Dec 2017, with follow-up 12 months later. A telephone survey occurred at both time points, asking questions regarding registration and redemption of an Active Kids voucher for their child, child participation in organised sports and child physical activity levels. RESULTS Of the 974 parents/carers who consented to participate, 511 (52.5%) completed the telephone surveys at both time points. A very large proportion of children (n = 454, 89.0%) were reported by their parents/carers at baseline as meeting the minimum physical activity guideline of 60 min per day. Of participating parents/carers in this study, 407 (96.0%) reported redeeming an Active Kids voucher. Children who redeemed a voucher had three times the odds to participate in organized team sports from baseline to follow-up (p = 0.009). Sub group analyses identified that females who redeemed a voucher had four times the odds to participate in organized team sports (p = 0.012). CONCLUSIONS Given the already active nature of this sample, no significant improvements in physical activity levels were noted, but the positive contribution community sport can have on health and wellbeing amongst children is reinforced. Whilst voucher schemes can address financial burdens across all socio-economic groups, more population targeting is needed to deliver voucher schemes to the most disadvantaged and inactive segments of the population in order to increase physical activity.
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Affiliation(s)
- Kathryn Reilly
- School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW, 2308, Australia.
- Hunter New England Population Health, Wallsend, NSW, 2287, Australia.
- Hunter Medical Research Institute, New Lambton, NSW, 2305, Australia.
| | - Adrian Bauman
- School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW, 2308, Australia
| | - Lindsey Reece
- SPRINTER research group, Prevention Research Collaboration, Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, 2006, Australia
| | | | - Rachel Sutherland
- School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW, 2308, Australia
- Hunter New England Population Health, Wallsend, NSW, 2287, Australia
- Hunter Medical Research Institute, New Lambton, NSW, 2305, Australia
| | - Luke Wolfenden
- School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW, 2308, Australia
- Hunter New England Population Health, Wallsend, NSW, 2287, Australia
- Hunter Medical Research Institute, New Lambton, NSW, 2305, Australia
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Laxer RE, Dubin JA, Brownson RC, Cooke M, Chaurasia A, Leatherdale ST. Noncomprehensive and Intermittent Obesity-Related School Programs and Policies May Not Work: Evidence from the COMPASS Study. THE JOURNAL OF SCHOOL HEALTH 2019; 89:818-828. [PMID: 31364181 DOI: 10.1111/josh.12820] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/04/2017] [Revised: 02/22/2018] [Accepted: 07/01/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND The school environment has the potential to influence student body mass index (BMI) through programs and policies. Our objective was to examine the effect of modifying obesity-related school policies and programs on youths' BMI trajectories. METHODS Obesity-related school policies and programs related to physical activity and healthy eating were collected from 41 schools across Ontario at baseline (2012-2013) and year 2 (2013-2014) of the COMPASS study. Self-reported height and weight were collected from the 4951 grades 9 and 10 students who attended those schools for 3 years. Linear mixed effects regression models examined the effect of modifying obesity-related school policies and programs on youths' BMI trajectories. RESULTS Between Y1 and Y2 , 26 of the 41 schools implemented distinct new obesity-related programs or policies related to physical activity or healthy eating. Five of the interventions were associated with BMI trajectories of students attending those schools compared to students attending a pooled sample of control schools, predicting a higher BMI trajectory. CONCLUSIONS Isolated programs and policies may not successfully improve youths' BMI trajectories. Further research is required to test the implementation of policies and programs that follow a comprehensive school health (CSH) approach, targeting BMI and associated behaviors.
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Affiliation(s)
- Rachel E Laxer
- 200 University Avenue W, University of Waterloo, Waterloo, ON N2L3G1
| | - Joel A Dubin
- 200 University Avenue W, University of Waterloo, Waterloo, ON N2L3G1
| | - Ross C Brownson
- Prevention Research Center, Brown School, Washington University, Campus Box 1196, One Brookings Drive, St. Louis, MO
| | - Martin Cooke
- 200 University Avenue W, University of Waterloo, Waterloo, ON N2L3G1
| | - Ashok Chaurasia
- 200 University Avenue W, University of Waterloo, Waterloo, ON N2L3G1
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Laska MN, Caspi CE, Lenk K, Moe SG, Pelletier JE, Harnack LJ, Erickson DJ. Evaluation of the first U.S. staple foods ordinance: impact on nutritional quality of food store offerings, customer purchases and home food environments. Int J Behav Nutr Phys Act 2019; 16:83. [PMID: 31533737 PMCID: PMC6751624 DOI: 10.1186/s12966-019-0818-1] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Accepted: 07/12/2019] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND Many lower-income and racially diverse communities in the U.S. have limited access to healthy foods, with few supermarkets and many small convenience stores, which tend to stock limited quantities and varieties of healthy foods. To address food access, in 2015 the Minneapolis Staple Foods Ordinance became the first policy requiring food stores to stock minimum quantities and varieties of 10 categories of healthy foods/beverages, including fruits, vegetables, whole grains and other staples, through licensing. This study examined whether: (a) stores complied, (b) overall healthfulness of store environments improved, (c) healthy customer purchases increased, and (d) healthfulness of home food environments improved among frequent small store shoppers. METHODS Data for this natural (or quasi) experiment were collected at four times: pre-policy (2014), implementation only (no enforcement, 2015), enforcement initiation (2016) and continued monitoring (2017). In-person store assessments were conducted to evaluate food availability, price, quality, marketing and placement in randomly sampled food retailers in Minneapolis (n = 84) and compared to those in a nearby control city, St. Paul, Minnesota (n = 71). Stores were excluded that were: supermarkets, authorized through WIC (Special Supplemental Nutrition Program for Women, Infants, and Children), and specialty stores (e.g., spice shops). Customer intercept interviews were conducted with 3,039 customers exiting stores. Home visits, including administration of home food inventories, were conducted with a sub-sample of frequent shoppers (n = 88). RESULTS Overall, findings indicated significant improvements in healthy food offerings by retailers over time in both Minneapolis and St. Paul, with no significant differences in change between the two cities. Compliance was low; in 2017 only 10% of Minneapolis retailers in the sample were fully compliant, and 51% of participating Minneapolis retailers met at least 8 of the 10 required standards. Few changes were observed in the healthfulness of customer purchases or the healthfulness of home food environments among frequent shoppers, and changes were not different between cities. CONCLUSIONS This study is the first evaluation a local staple foods ordinance in the U.S. and reflects the challenges and time required for implementing such policies. TRIAL REGISTRATION NCT02774330 .
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Affiliation(s)
- Melissa N. Laska
- School of Public Health, Division of Epidemiology and Community Health, University of Minnesota, 1300 S. 2nd Street, Suite 300, Minneapolis, MN 55454 USA
| | - Caitlin E. Caspi
- Department of Family Medicine and Community Health, University of Minnesota, Minneapolis, USA
| | - Kathleen Lenk
- School of Public Health, Division of Epidemiology and Community Health, University of Minnesota, 1300 S. 2nd Street, Suite 300, Minneapolis, MN 55454 USA
| | - Stacey G. Moe
- School of Public Health, Division of Epidemiology and Community Health, University of Minnesota, 1300 S. 2nd Street, Suite 300, Minneapolis, MN 55454 USA
| | - Jennifer E. Pelletier
- School of Public Health, Division of Epidemiology and Community Health, University of Minnesota, 1300 S. 2nd Street, Suite 300, Minneapolis, MN 55454 USA
| | - Lisa J. Harnack
- School of Public Health, Division of Epidemiology and Community Health, University of Minnesota, 1300 S. 2nd Street, Suite 300, Minneapolis, MN 55454 USA
| | - Darin J. Erickson
- School of Public Health, Division of Epidemiology and Community Health, University of Minnesota, 1300 S. 2nd Street, Suite 300, Minneapolis, MN 55454 USA
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Ramanathan S, Faulkner G, Berry T, Deshpande S, Latimer-Cheung AE, Rhodes RE, Spence JC, Tremblay MS. Perceptions of organizational capacity to promote physical activity in Canada and ParticipACTION's influence five years after its relaunch: a qualitative study. HEALTH PROMOTION AND CHRONIC DISEASE PREVENTION IN CANADA-RESEARCH POLICY AND PRACTICE 2018; 38:170-178. [PMID: 29671966 DOI: 10.24095/hpcdp.38.4.03] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
INTRODUCTION ParticipACTION is a Canadian physical activity communications and social marketing organization relaunched in 2007. The purpose of this study was to qualitatively investigate organizational capacity for physical activity promotion among Canadian organizations, and the influence of ParticipACTION on capacity five years after relaunch. METHODS Using a purposive sampling strategy, semi-structured telephone interviews were conducted with 44 key informants representing national, provincial, and local organizations with a mandate to promote physical activity. Interview data were analyzed using a thematic analytic approach. RESULTS Organizational capacity in terms of partnerships and collaborations, and the general climate for physical activity promotion have improved since ParticipACTION's relaunch. Although financial resources reduced the ability of organizations to fulfil their mandates, internal factors such as skilled employees and sponsorships, and external factors such as technological improvements in communication and information sharing helped to offset this strain. There were mixed feelings on ParticipACTION's contribution to capacity. While ParticipACTION has brought more attention to inactivity, this was perceived as a complement to work already taking place. While some organizations perceived ParticipACTION's relaunch as competition to funding and access to popular media, others found it as an opportunity to co-brand social marketing campaigns, utilizing ParticipACTION's products and reputation. CONCLUSION According to participants, organizational capacity to promote physical activity in Canada has increased since 2007 in subtle but important ways because of a strong climate for physical activity promotion, skilled employees, and information sharing technology. Organizational capacity changes were minimally attributed to ParticipACTION.
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Affiliation(s)
- Subha Ramanathan
- School of Kinesiology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Guy Faulkner
- School of Kinesiology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Tanya Berry
- Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, Alberta, Canada
| | - Sameer Deshpande
- Faculty of Management, University of Lethbridge, Lethbridge, Alberta, Canada
| | - Amy E Latimer-Cheung
- School of Kinesiology and Health Studies, Queen's University, Kingston, Ontario, Canada
| | - Ryan E Rhodes
- School of Exercise Science, Physical and Health Education, University of Victoria, Victoria, British Columbia, Canada
| | - John C Spence
- Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, Alberta, Canada
| | - Mark S Tremblay
- Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada
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Faulkner G, Bassett-Gunter R, White L, Berry TR, Tremblay MS. Can The Moblees™ Move Canadian Children? Investigating the Impact of a Television Program on Children's Physical Activity. Front Public Health 2018; 6:206. [PMID: 30090806 PMCID: PMC6068359 DOI: 10.3389/fpubh.2018.00206] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2018] [Accepted: 07/04/2018] [Indexed: 11/13/2022] Open
Abstract
Background: The effects of messaging about physical activity and sedentary behavior purposefully integrated into children's TV programming on children's behavior is unknown. The Moblees is a Canadian childrens' show that explicitly promotes physical activity. Two studies were conducted to (1) examine whether children were more physically active when watching a Moblees episode, and (2) explore parental perceptions of the show. Methods: Study 1 was an experimental study with 21 families randomized to watch an episode of The Moblees vs. a control condition. Movement was assessed through accelerometry and observation. A Chi-square test was used to compare the direct observation proportions of children sitting between intervention and control conditions. Independent t-tests were performed to examine the differences in total vector magnitude counts between the experimental and control groups. Study 2 was an online cross-sectional study with 104 parent/child dyads that included viewing an episode of The Moblees. To identify correlates and predictors of parent-reported child PA during viewing The Moblees compared to other TV programs, Pearson's correlations and a linear regression were calculated, respectively. Results: In study 1 there was a significant association between condition and whether or not children remained sitting χ2 = 55.96, p < 0.001. There was a significant difference in counts between the two conditions, t(13, 61) = 2.29, p < 0.05. Children randomized to the experimental group (i.e., Moblees) moved more compared to control. In study 2 the majority (76%) of parents reported that their child engaged in some physical activity during viewing. Parent encouragement during viewing was the strongest predictor of child physical activity while viewing (β = 0.30, p < 0.01). Conclusion: Television content that includes messaging about physical activity and sedentary behavior, and positive portrayals of physical activity may influence the physical activity of young children. Although the benefits of such modest movement are not clear without further evidence of accumulation over time and/or transfer to other settings, television programming might provide a far reaching medium for knowledge translation.
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Affiliation(s)
- Guy Faulkner
- School of Kinesiology, University of British Columbia, Vancouver, BC, Canada
| | | | - Lauren White
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, ON, Canada
| | - Tanya R Berry
- Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, AB, Canada
| | - Mark S Tremblay
- Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada
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Taber JM, Dickerman BA, Okhovat JP, Geller AC, Dwyer LA, Hartman AM, Perna FM. Skin cancer interventions across the cancer control continuum: Review of technology, environment, and theory. Prev Med 2018; 111:451-458. [PMID: 29277407 PMCID: PMC5949070 DOI: 10.1016/j.ypmed.2017.12.019] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2017] [Revised: 11/11/2017] [Accepted: 12/19/2017] [Indexed: 12/12/2022]
Abstract
The National Cancer Institute's Skin Cancer Intervention across the Cancer Control Continuum model was developed to summarize research and identify gaps concerning skin cancer interventions. We conducted a mapping review to characterize whether behavioral interventions addressing skin cancer prevention and control from 2000 to 2015 included (1) technology, (2) environmental manipulations (policy and/or built environment), and (3) a theoretical basis. We included 86 studies with a randomized controlled or quasi-experimental design that targeted behavioral intervention in skin cancer for children and/or adults; seven of these were dissemination or implementation studies. Of the interventions described in the remaining 79 articles, 57 promoted only prevention behaviors (e.g., ultraviolet radiation protection), five promoted only detection (e.g., skin examinations), 10 promoted both prevention and detection, and seven focused on survivorship. Of the 79 non-dissemination studies, two-thirds used some type of technology (n=52; 65.8%). Technology specific to skin cancer was infrequently used: UVR photography was used in 15.2% of studies (n=12), reflectance spectroscopy was used in 12.7% (n=10), and dermatoscopes (n=1) and dosimeters (n=2) were each used in less than 3%. Ten studies (12.7%) targeted the built environment. Fifty-two (65.8%) of the studies included theory-based interventions. The most common theories were Social Cognitive Theory (n=20; 25.3%), Health Belief Model (n=17; 21.5%), and the Theory of Planned Behavior/Reasoned Action (n=12; 15.2%). Results suggest that skin cancer specific technology and environmental manipulations are underutilized in skin cancer behavioral interventions. We discuss implications of these results for researchers developing skin cancer behavioral interventions.
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Affiliation(s)
- Jennifer M Taber
- Behavioral Research Program, National Cancer Institute, United States.
| | | | | | - Alan C Geller
- Harvard TH Chan School of Public Health, United States
| | | | - Anne M Hartman
- Behavioral Research Program, National Cancer Institute, United States
| | - Frank M Perna
- Behavioral Research Program, National Cancer Institute, United States
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Larouche R, Mammen G, Rowe DA, Faulkner G. Effectiveness of active school transport interventions: a systematic review and update. BMC Public Health 2018; 18:206. [PMID: 29390988 PMCID: PMC5796594 DOI: 10.1186/s12889-017-5005-1] [Citation(s) in RCA: 68] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2017] [Accepted: 12/20/2017] [Indexed: 12/04/2022] Open
Abstract
Background Active school transport (AST) is a promising strategy to increase children’s physical activity. A systematic review published in 2011 found large heterogeneity in the effectiveness of interventions in increasing AST and highlighted several limitations of previous research. We provide a comprehensive update of that review. Methods Replicating the search of the previous review, we screened the PubMed, Web of Science, Cochrane, Sport Discus and National Transportation Library databases for articles published between February 1, 2010 and October 15, 2016. To be eligible, studies had to focus on school-aged children and adolescents, include an intervention related to school travel, and report a measure of travel behaviors. We assessed quality of individual studies with the Effective Public Health Practice Project quality assessment tool, and overall quality of evidence with the Grades of Recommendation, Assessment, Development, and Evaluation (GRADE) approach. We calculated Cohen’s d as a measure of effect size. Results Out of 6318 potentially relevant articles, 27 articles reporting 30 interventions met our inclusion criteria. Thirteen interventions resulted in an increase in AST, 8 found no changes, 4 reported inconsistent results, and 5 did not report inferential statistics. Cohen’s d ranged from −0.61 to 0.75, with most studies reporting “trivial-to-small” positive effect sizes. Three studies reported greater increases in AST over longer follow-up periods and two Safe Routes to School studies noted that multi-level interventions were more effective. Study quality was rated as weak for 27/30 interventions (due notably to lack of blinding of outcome assessors, unknown psychometric properties of measurement tools, and limited control for confounders), and overall quality of evidence was rated as low. Evaluations of implementation suggested that interventions were limited by insufficient follow-up duration, incomplete implementation of planned interventions, and limited access to resources for low-income communities. Conclusions Interventions may increase AST among children; however, there was substantial heterogeneity across studies and quality of evidence remains low. Future studies should include longer follow-ups, use standardized outcome measures (to allow for meta-analyses), and examine potential moderators and mediators of travel behavior change to help refine current interventions. Trial registration Registered in PROSPERO: CRD42016033252 Electronic supplementary material The online version of this article (10.1186/s12889-017-5005-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Richard Larouche
- Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON K1H 8L1, Canada.,Faculty of Health Sciences University of Lethbridge, 4401 University Drive, office M3049 Lethbridge, Alberta, T1K 3M4, Canada
| | - George Mammen
- Centre for Addiction and Mental Health, Institute for Mental Health Policy Research, 1001 Queen St West, Toronto, ON M6J 1H4, Canada
| | - David A Rowe
- School of Psychological Sciences and Health, University of Strathclyde, 16 Richmond St, Glasgow G1 1XQ, Glasgow, UK
| | - Guy Faulkner
- School of Kinesiology, University of British Columbia, D H Copp Building 4606, 2146 Health Sciences Mall, Vancouver, BC, V6T 1Z3, Canada. .,Center for Hip Health and Mobility, Robert H.N. Ho Research Centre, 5th Floor, 2635 Laurel St, Vancouver, BC V5Z 1M9, Canada.
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Weatherson KA, McKay R, Gainforth HL, Jung ME. Barriers and facilitators to the implementation of a school-based physical activity policy in Canada: application of the theoretical domains framework. BMC Public Health 2017; 17:835. [PMID: 29061140 PMCID: PMC5654002 DOI: 10.1186/s12889-017-4846-y] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2017] [Accepted: 10/13/2017] [Indexed: 11/21/2022] Open
Abstract
Background In British Columbia Canada, a Daily Physical Activity (DPA) policy was mandated that requires elementary school teachers to provide students with opportunities to achieve 30 min of physical activity during the school day. However, the implementation of school-based physical activity policies is influenced by many factors. A theoretical examination of the factors that impede and enhance teachers’ implementation of physical activity policies is necessary in order to develop strategies to improve policy practice and achieve desired outcomes. This study used the Theoretical Domains Framework (TDF) to understand teachers’ barriers and facilitators to the implementation of the DPA policy in one school district. Additionally, barriers and facilitators were examined and compared according to how the teacher implemented the DPA policy during the instructional school day. Methods Interviews were conducted with thirteen teachers and transcribed verbatim. One researcher performed barrier and facilitator extraction, with double extraction occurring across a third of the interview transcripts by a second researcher. A deductive and inductive analytical approach in a two-stage process was employed whereby barriers and facilitators were deductively coded using TDF domains (content analysis) and analyzed for sub-themes within each domain. Two researchers performed coding. Results A total of 832 items were extracted from the interview transcripts. Some items were coded into multiple TDF domains, resulting in a total of 1422 observations. The most commonly coded TDF domains accounting for 75% of the total were Environmental context and resources (ECR; n = 250), Beliefs about consequences (n = 225), Social influences (n = 193), Knowledge (n = 100), and Intentions (n = 88). Teachers who implemented DPA during instructional time differed from those who relied on non-instructional time in relation to Goals, Behavioural regulation, Social/professional role and identity, Beliefs about Consequences. Forty-one qualitative sub-themes were identified across the fourteen domains and exemplary quotes were highlighted. Conclusions Teachers identified barriers and facilitators relating to all TDF domains, with ECR, Beliefs about consequences, Social influences, Knowledge and Intentions being the most often discussed influencers of DPA policy implementation. Use of the TDF to understand the implementation factors can assist with the systematic development of future interventions to improve implementation. Electronic supplementary material The online version of this article (10.1186/s12889-017-4846-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Katie A Weatherson
- School of Health and Exercise Sciences
- Faculty of Health and Social Development, The University of British Columbia Okanagan, ART 360- 1147 Research Road, Kelowna, BC, V1V 1V7, Canada
| | - Rhyann McKay
- School of Health and Exercise Sciences Faculty of Health and Social Development, The University of British Columbia Okanagan, ART 129- 1147 Research Road, Kelowna, BC, V1V 1V7, Canada
| | - Heather L Gainforth
- School of Health and Exercise Sciences Faculty of Health and Social Development, The University of British Columbia Okanagan, ART 129- 1147 Research Road, Kelowna, BC, V1V 1V7, Canada
| | - Mary E Jung
- School of Health and Exercise Sciences Faculty of Health and Social Development, The University of British Columbia Okanagan, RHS 119- 3333 University Way, Kelowna, BC, V1V 1V7, Canada.
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Rodrigues AMDS, Costa ABP, Campos DL, Silva MPS, Cândido AL, Santos LCD, Ferreira AVM. Low validity of predictive equations for calculating resting energy expenditure in overweight and obese women with polycystic ovary syndrome. J Hum Nutr Diet 2017; 31:266-275. [PMID: 28791776 DOI: 10.1111/jhn.12498] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND Predictive equations are the main clinical tools for determining resting energy expenditure (REE). However, their adequate use in overweight and obese individuals is unclear. Thus, we investigated the best predictive equations for estimating REE in overweight and obese women with polycystic ovary syndrome (PCOS). METHODS Eleven analyses were performed with prediction equations (pREE) based on anthropometric parameters in 30 overweight or obese women with PCOS without other chronic diseases. The measured REE (mREE) was calculated by indirect calorimetry. The validity of the equations was investigated by comparison, accuracy and agreement tests between pREE and mREE at both the individual and group level. RESULTS Four analyses were similar to those of mREE, and smallest mean differences were observed for the World Health Organization/Food and Agriculture Organization of the United Nations/United Nations University (WHO/FAO/UNU) considering weight (W) [0.07 (1.13) MJ (16 [270] kcal)]. Individual accuracy was greater than 50% for Harris and Benedict, Müller and Lazzer equations. The percentage of REE underestimation ranged between 16.7% and 73.3%, whereas higher rates of overestimation were observed in the De Luis (66.7%) and Ireton-Jones (43.3%) equations. Mean bias at the group level was lowest in the WHO/FAO/UNU W and WHO/FAO/UNU considering weight and height (WH), Müller and Lazzer equations (-2.8 to 0.5). The WHO/FAO/UNU W and WHO/FAO/UNU WH formulas were optimal in individual agreement (33.3%). CONCLUSIONS FAO/WHO/UNU W equations may estimate the REE in overweight and obese women with PCOS. However, the low individual accuracy and agreement in relation to mREE suggest caution regarding when to use the formula to perform an individual nutritional plan.
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Affiliation(s)
- A M Dos S Rodrigues
- Department of Nutrition, Nursing School, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - A B P Costa
- Department of Nutrition, Nursing School, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - D L Campos
- Department of Nutrition, Nursing School, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - M P S Silva
- Department of Nutrition, Nursing School, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - A L Cândido
- Department of Medical Clinic, Medicine School, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - L C Dos Santos
- Department of Nutrition, Nursing School, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - A V M Ferreira
- Department of Nutrition, Nursing School, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
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Vine MM, Harrington DW, Butler A, Patte K, Godin K, Leatherdale ST. Compliance with school nutrition policies in Ontario and Alberta: An assessment of secondary school vending machine data from the COMPASS study. CANADIAN JOURNAL OF PUBLIC HEALTH = REVUE CANADIENNE DE SANTE PUBLIQUE 2017; 108:e43-e48. [PMID: 28425898 PMCID: PMC6972344 DOI: 10.17269/cjph.108.5701] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/26/2016] [Revised: 01/04/2017] [Accepted: 10/23/2016] [Indexed: 11/17/2022]
Abstract
OBJECTIVES We investigated the extent to which a sample of Ontario and Alberta secondary schools are being compliant with their respective provincial nutrition policies, in terms of the food and beverages sold in vending machines. METHODS This observational study used objective data on drinks and snacks from vending machines, collected over three years of the COMPASS study (2012/2013-2014/2015 school years). Drink (e.g., sugar-containing carbonated/non-carbonated soft drinks, sports drinks, etc.) and snack (e.g., chips, crackers, etc.) data were coded by number of units available, price, and location of vending machine(s) in the school. Univariate and bivariate analyses were undertaken using R version 3.2.3. In order to assess policy compliancy over time, nutritional information of products in vending machines was compared to nutrition standards set out in P/PM 150 in Ontario, and those set out in the Alberta Nutrition Guidelines for Children and Youth (2012) in Alberta. RESULTS Results reveal a decline over time in the proportion of schools selling sugar-containing carbonated soft drinks (9% in 2012/2013 vs. 3% in 2014/2015), crackers (26% vs. 17%) and cake products (12% vs. 5%) in vending machines, and inconsistent changes in the proportion selling chips (53%, 67% and 65% over the three school years). Conversely, results highlight increases in the proportion of vending machines selling chocolate bars (7% vs. 13%) and cookies (21% vs. 40%) between the 2012/2013 and 2014/2015 school years. CONCLUSION Nutritional standard policies were not adhered to in the majority of schools with respect to vending machines. There is a need for investment in formal monitoring and evaluation of school policies, and the provision of information and tools to support nutrition policy implementation.
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Affiliation(s)
- Michelle M Vine
- School of Public Health and Health Systems, University of Waterloo, Waterloo, ON.
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Allison KR, Irving HM, Adlaf EM, Faulkner GEJ, Boak A, Manson HE, Hamilton HA, Ng B. Ten-year trends in overweight/obesity among Ontario middle and high school students and their use in establishing baseline measures for government reduction targets. Canadian Journal of Public Health 2016; 106:e514-9. [PMID: 26986913 DOI: 10.17269/cjph.106.5175] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/18/2015] [Revised: 11/30/2015] [Accepted: 10/11/2015] [Indexed: 11/17/2022]
Abstract
OBJECTIVES Public health concern about increasing levels of child/youth overweight and obesity has resulted in initiatives to address this issue. In 2012, the Ontario Ministry of Health and Long-Term Care (MOHLTC) established a target to reduce childhood obesity by 20% within five years. In this paper, we examine trends and establish baseline levels of overweight/obesity to assess the impacts of population-level interventions. METHODS We analyzed 10 years (2003-2013) of data accumulated from six cycles of the Ontario Student Drug Use and Health Survey using logistic regression to assess trends in the prevalence of overweight/obesity among middle and high school students. The 2013 data are used to begin monitoring progress toward achieving the MOHLTC target. RESULTS From 2003 through 2013, the prevalence of overweight/obesity among middle school students in the province remained stable overall and among all subgroups except 7th-grade females, who showed a significant linear decline. Among high school students, the prevalence of overweight/obesity showed a significant linear increase and an increase among 11th graders, females, and 10th- and 11th-grade females specifically. The prevalence remained stable but elevated among 9th- and 12th-grade females as well as among males in all grades. In 2013 (baseline for the MOHLTC target), 25.1% of students in grades 7-12 were overweight or obese, implying a presumed 2018 target of 20.1%. CONCLUSION Ten-year trends in overweight/obesity indicate stability among males and significant linear increases in some female subgroups. Also, baseline data (2013) will facilitate the monitoring of future interventions aimed at achieving the 2018 MOHLTC target.
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Affiliation(s)
- Kenneth R Allison
- 1. Public Health Ontario 2. Dalla Lana School of Public Health, University of Toronto.
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15
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Horodyska K, Luszczynska A, Hayes CB, O'Shea MP, Langøien LJ, Roos G, van den Berg M, Hendriksen M, De Bourdeaudhuij I, Brug J. Implementation conditions for diet and physical activity interventions and policies: an umbrella review. BMC Public Health 2015; 15:1250. [PMID: 26678996 PMCID: PMC4683715 DOI: 10.1186/s12889-015-2585-5] [Citation(s) in RCA: 69] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2015] [Accepted: 12/08/2015] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND This umbrella review aimed at identifying evidence-based conditions important for successful implementation of interventions and policies promoting a healthy diet, physical activity (PA), and a reduction in sedentary behaviors (SB). In particular, we examined if the implementation conditions identified were intervention-specific or policy-specific. This study was undertaken as part of the DEterminants of DIet and Physical Activity (DEDIPAC) Knowledge Hub, a joint action as part of the European Joint Programming Initiative a Healthy Diet for a Healthy Life. METHODS A systematic review of reviews and stakeholder documents was conducted. Data from nine scientific literature databases were analyzed (95 documents met the inclusion criteria). Additionally, published documentation of eight major stakeholders (e.g., World Health Organization) were systematically searched (17 documents met the inclusion criteria). The RE-AIM framework was used to categorize elicited conditions. Across the implementation conditions 25 % were identified in at least four documents and were subsequently classified as having obtained sufficient support. RESULTS We identified 312 potential conditions relevant for successful implementation; 83 of these received sufficient support. Using the RE-AIM framework eight implementation conditions that obtained support referred to the reach in the target population; five addressed efficacy of implementation processes; 24 concerned adoption by the target staff, setting, or institutions; 43 referred to consistency, costs, and adaptations made in the implementation process; three addressed maintenance of effects over time. The vast majority of implementation conditions (87.9 %; 73 of 83) were supported by documents referring to both interventions and policies. There were seven policy-specific implementation conditions, which focused on increasing complexities of coexisting policies/legal instruments and their consequences for implementation, as well as politicians' collaboration in implementation. CONCLUSIONS The use of the proposed list of 83 conditions for successful implementation may enhance the implementation of interventions and policies which pursue identification of the most successful actions aimed at improving diet, PA and reducing SB.
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Affiliation(s)
- Karolina Horodyska
- Department of Psychology, SWPS University of Social Sciences and Humanities, 30b Ostrowskiego St, 53238, Wroclaw, Poland.
| | - Aleksandra Luszczynska
- Department of Psychology, SWPS University of Social Sciences and Humanities, 30b Ostrowskiego St, 53238, Wroclaw, Poland.
- Trauma, Health, & Hazards Center, University of Colorado, 1861 Austin Bluffs Pkwy, Colorado Springs, CO, 80933-7150, USA.
| | - Catherine B Hayes
- Department of Public Health and Primary Care, Trinity College Dublin, Centre for Health Sciences, Tallaght Hospital, Dublin 24, Ireland.
| | - Miriam P O'Shea
- Department of Public Health and Primary Care, Trinity College Dublin, Centre for Health Sciences, Tallaght Hospital, Dublin 24, Ireland.
| | - Lars J Langøien
- Department for Physical Education, Norwegian School of Sport Sciences, P.O. BOX 4014, Ullevål Stadion, N-0806, Oslo, Norway.
| | - Gun Roos
- SIFO - National Institute for Consumer Research, P.O. BOX 4682, Nydalen, N-0405, Oslo, Norway.
| | - Matthijs van den Berg
- National Institute for Public Health and the Environment, Antonie van Leeuwenhoeklaan 9, 3721, Bilthoven, The Netherlands.
| | - Marieke Hendriksen
- National Institute for Public Health and the Environment, Antonie van Leeuwenhoeklaan 9, 3721, Bilthoven, The Netherlands.
| | - Ilse De Bourdeaudhuij
- Department of Movement and Sport Sciences, Ghent University, Watersportlaan 2, 9000, Ghent, Belgium.
| | - Johannes Brug
- VU University Medical Center, Amsterdam, Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands.
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Heelan KA, Bartee RT, Nihiser A, Sherry B. Healthier School Environment Leads to Decreases in Childhood Obesity: The Kearney Nebraska Story. Child Obes 2015; 11:600-7. [PMID: 26440386 PMCID: PMC4739834 DOI: 10.1089/chi.2015.0005] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
BACKGROUND Schools play a role in addressing childhood obesity by implementing healthy eating and physical activity strategies. The primary aim of this case study was to describe prevalence of overweight and obesity among elementary school students in a rural Mid-western community between 2006 and 2012. The secondary aim was to use a novel approach called "population dose" to retrospectively evaluate the impact dose of each strategy implemented and its estimated potential population level impact on changes in overweight and obesity. METHODS Weight and height were directly measured annually beginning in January 2006 to assess weight status, using BMI (kg/m(2)), for all kindergarten to fifth-grade students (N ≈ 2400 per year). Multiple evidence-based strategies were implemented in nine schools to increase physical activity and healthy eating behaviors. BMI reporting and revised school meal programs were implemented districtwide. Comprehensive school physical activity programs, school food environment, and supportive/promotional strategies were implemented at individual schools. RESULTS The absolute change in prevalence of obesity (BMI ≥95th percentile) decreased from 16.4% to 13.9%, indicating a 15.2% relative change in prevalence of obesity in 6 years. There was an inverse relationship between the number of strategies implemented and prevalence of overweight and obesity over time. CONCLUSIONS District and school-level approaches have the potential to impact childhood obesity. Schools can successfully implement strategies to address overweight and obesity, but the extent of implementation between schools may vary. Population dose analysis can be used to estimate impact of clusters of strategies to address overweight/obesity.
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Affiliation(s)
- Kate A. Heelan
- Department of Kinesiology and Sport Sciences, University of Nebraska Kearney, 1410 W 26, Kearney, NE 68849
| | - R. Todd Bartee
- Department of Kinesiology and Sport Sciences, University of Nebraska Kearney, 1410 W 26, Kearney, NE 68849
| | - Allison Nihiser
- Division of Population Health, Centers for Disease Control and Prevention, 4770 Buford Hwy NE, MS F-78, Atlanta, GA 30341
| | - Bettylou Sherry
- Obesity Prevention and Control Branch, Division of Nutrition, Physical Activity, and Obesity, Centers for Disease Control and Prevention, MS F 22, 4770 Buford Highway, NE, Atlanta, GA 30341
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Abstract
Over the last decade, there has been a marked increase in studies about built environments and physical activity. As the number of publications is growing rapidly, literature reviews play an important role in identifying primary studies and in synthesizing their findings. However, many of the reviews of effectiveness in this field demonstrate methodological limitations that might lead to inaccurate portrayals of the evidence. Some literature reviews a priori excluded intervention studies even though they provide the strongest level of evidence. The label 'systematic review' has mostly been used inappropriately. One of the major criteria of a systematic review that is hardly ever met is that the quality of the primary studies needs to be assessed and this should be reflected in the synthesis, presentation and interpretation of results. With few exceptions, 'systematic' reviews about environments and physical activity did not refer to or follow the QUORUM or PRISMA statements. This commentary points out the usefulness of the PRISMA statement to standardize the reporting of methodology of reviews and provides additional guidance to limit sources of bias in them. The findings and recommendations from this article can help in moving forward the synthesis of evidence of effectiveness not only in built environments and physical activity, but also more broadly in exercise science and public health.
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Randall L, Robinson DB, Fletcher T. A Descriptive Profile of Physical Education Teachers and Programs in Atlantic Canada. ACTA ACUST UNITED AC 2014. [DOI: 10.7202/1025771ar] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The purpose of this research was to investigate the extent to which quality physical education is currently being taught in Atlantic Canada. We used survey methods to generate descriptive data indicating: (a) the backgrounds of those who teach physical education and (b) what is being taught in physical education. Our findings suggest physical education is taught by a group of mostly-white teachers with varying qualifications, interests, and experiences in teaching the subject. Further, sport experiences tend to dominate the subject matter that students engage with, at the expense of dance and gymnastics. Although some physical education programs could arguably be classified as being of a sound quality according to the national subject association, we contend that more needs to be done to present the subject as a diverse enterprise, both in terms of who teaches and what is taught in physical education.
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Silva CPD, Carmo ASD, Horta PM, Santos LCD. Intervenção nutricional pautada na estratégia de oficinas em um serviço de promoção da saúde de Belo Horizonte, Minas Gerais. REV NUTR 2013. [DOI: 10.1590/s1415-52732013000600004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
OBJETIVO: Avaliar as oficinas como uma estratégia de intervenção nutricional, com foco na aquisição de informações em nutrição e na percepção de mudanças de hábitos alimentares. MÉTODOS: Estudo de intervenção com usuários de uma Academia da Cidade de Belo Horizonte, Minas Gerais. Realizaram-se quatro oficinas, com frequência mensal e duração de trinta minutos cada uma, pautadas no "Guia Alimentar para a População Brasileira" e nos "Dez Passos para uma Alimentação Saudável". Aplicaram-se questionários para avaliar a aquisição de informações em nutrição antes e depois da execução das oficinas, investigar a percepção de mudanças de hábitos alimentares após três meses da intervenção e identificar as principais dificuldades verificadas nesse processo. Um observador apontou a viabilidade de execução das oficinas. RESULTADOS: O número de participantes das oficinas variou de 71 a 132. Houve maior ocorrência (80%) de mulheres, com média de 55,8 (±10,6) anos. Identificou-se incremento estatisticamente significante na média total de acertos das questões do questionário de avaliação da aquisição de informações em três dos quatro encontros. Ademais, 90,9% dos participantes referiram alguma mudança de hábito alimentar, destacando-se a redução no consumo de óleos, gorduras e frituras (29,5%) e o aumento na ingestão de frutas e hortaliças (22,5%). A redução no consumo de açúcares e doces foi apontada como a recomendação mais difícil de ser seguida (21,1%). A avaliação do observador denotou a necessidade de modificar o espaço utilizado para as atividades. CONCLUSÃO: A intervenção apresentou potencial para aquisição de informações em nutrição e mudança de hábitos alimentares, alterações que devem ser mais bem investigadas com a continuidade das ações.
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Kothari A, Gore D, MacDonald M, Bursey G, Allan D, Scarr J. Chronic disease prevention policy in British Columbia and Ontario in light of public health renewal: a comparative policy analysis. BMC Public Health 2013; 13:934. [PMID: 24099140 PMCID: PMC3852936 DOI: 10.1186/1471-2458-13-934] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2013] [Accepted: 09/30/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Public health strategies that focus on legislative and policy change involving chronic disease risk factors such as unhealthy diet and physical inactivity have the potential to prevent chronic diseases and improve quality of life as a whole. However, many public health policies introduced as part of public health reform have not yet been analyzed, such as in British Columbia and Ontario. The purpose of this paper is to present the results of a descriptive, comparative analysis of public health policies related to the Healthy Living Core Program in British Columbia and Chronic Disease Prevention Standard in Ontario that are intended to prevent a range of chronic diseases by promoting healthy eating and physical activity, among other things. METHODS Policy documents were found through Internet search engines and Ministry websites, at the guidance of policy experts. These included government documents as well as documents from non-governmental organizations that were implementing policies and programs at a provincial level. Documents (n = 31) were then analysed using thematic content analysis to classify, describe and compare policies in a systematic fashion, using the software NVivo. RESULTS Three main categories emerged from the analysis of documents: 1) goals for chronic disease prevention in British Columbia and Ontario, 2) components of chronic disease prevention policies, and 3) expected outputs of chronic disease prevention interventions. Although there were many similarities between the two provinces, they differed somewhat in terms of their approach to issues such as evidence, equity, and policy components. Some expected outputs were adoption of healthy behaviours, use of information, healthy environments and increased public awareness. CONCLUSIONS The two provincial policies present different approaches to support the implementation of related programs. Differences may be related to contextual factors such as program delivery structures and different philosophical approaches underlying the two frameworks. These differences and possible explanations for them are important to understand because they serve to contextualize the differences in health outcomes across the two provinces that might eventually be observed. This analysis informs future public health policy directions as the two provinces can learn from each other.
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Affiliation(s)
- Anita Kothari
- Faculty of Health Sciences, University of Western Ontario, Ontario N6A 5B9, Canada
| | - Dana Gore
- Faculty of Health Sciences, University of Western Ontario, Ontario N6A 5B9, Canada
| | - Marjorie MacDonald
- School of Nursing, University of Victoria, British Columbia V8P 5C2, Canada
| | - Gayle Bursey
- Chronic Disease and Injury Prevention, Peel Public Health, Ontario L5M 2C1, Canada
| | - Diane Allan
- School of Nursing, University of Victoria, British Columbia V8P 5C2, Canada
| | - Jennifer Scarr
- Vancouver Coastal Health, British Columbia V5Z 4C2, Canada
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Williams AJ, Henley WE, Williams CA, Hurst AJ, Logan S, Wyatt KM. Systematic review and meta-analysis of the association between childhood overweight and obesity and primary school diet and physical activity policies. Int J Behav Nutr Phys Act 2013; 10:101. [PMID: 23965018 PMCID: PMC3844408 DOI: 10.1186/1479-5868-10-101] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2013] [Accepted: 08/16/2013] [Indexed: 11/10/2022] Open
Abstract
Obesity is a major public health concern and there are increasing calls for policy intervention. As obesity and the related health conditions develop during childhood, schools are being seen as important locations for obesity prevention, including multifaceted interventions incorporating policy elements. The objective of this systematic review was to evaluate the effects of policies related to diet and physical activity in schools, either alone, or as part of an intervention programme on the weight status of children aged 4 to 11 years. A comprehensive and systematic search of medical, education, exercise science, and social science databases identified 21 studies which met the inclusion criteria. There were no date, location or language restrictions. The identified studies evaluated a range of either, or both, diet and physical activity related policies, or intervention programmes including such policies, using a variety of observational and experimental designs. The policies were clustered into those which sought to affect diet, those which sought to affect physical activity and those which sought to affect both diet and physical activity to undertake random effects meta-analysis. Within the diet cluster, studies of the United States of America National School Lunch and School Breakfast Programs were analysed separately; however there was significant heterogeneity in the pooled results. The pooled effects of the physical activity, and other diet related policies on BMI-SDS were non-significant. The multifaceted interventions tended to include policy elements related to both diet and physical activity (combined cluster), and although these interventions were too varied to pool their results, significant reductions in weight-related outcomes were demonstrated. The evidence from this review suggests that, when implemented alone, school diet and physical activity related policies appear insufficient to prevent or treat overweight or obesity in children, however, they do appear to have an effect when developed and implemented as part of a more extensive intervention programme. Additional evidence is required before recommendations regarding the focus of policies can be made and therefore, increased effort should be made to evaluate the effect of policies and policy containing intervention programmes upon weight status.
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Affiliation(s)
- Andrew James Williams
- Institute of Health Services Research, University of Exeter Medical School (formerly Peninsula College of Medicine and Dentistry), Veysey Building, Salmon Pool Lane, EX2 4SG, Exeter, Devon, UK.
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Jain A, Langwith C. Collaborative school-based obesity interventions: lessons learned from 6 southern districts. THE JOURNAL OF SCHOOL HEALTH 2013; 83:213-222. [PMID: 23343322 DOI: 10.1111/josh.12017] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/28/2012] [Revised: 09/17/2012] [Accepted: 09/28/2012] [Indexed: 06/01/2023]
Abstract
BACKGROUND Although studies have shown that school-based obesity interventions can be effective, little is known about how to translate and implement programs into real-world school settings. METHODS Semistructured interviews were conducted in spring 2012 with 19 key informants who participated in a multifaceted childhood obesity intervention involving school nurses and wellness coordinators in 6 school districts and over 100 schools. RESULTS The intervention changed form according to the needs and interests of the school districts. Despite funding support, schools and nurses had little capacity to address childhood obesity without the help of the coordinator. Initiating programs at the beginning of the school year was particularly difficult for schools. Applying for grants from internal and external sources and assisting with planning and logistics for wellness activities were significant activities of the coordinator. Although some school personnel and families preferred a focus on wellness rather than obesity, those working with individual at-risk children and families found the experience especially gratifying. CONCLUSIONS In contrast to controlled studies, real-world implementation of obesity interventions in schools that are intended to create sustained change requires flexibility in intervention design, timing, and personnel. A single change agent focused on obesity-related activities was essential to success.
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Affiliation(s)
- Anjali Jain
- The Lewin Group, Fairview Park Drive, Suite 500, Falls Church, VA 22042, USA.
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Comte M, Hobin E, Majumdar SR, Plotnikoff RC, Ball GDC, McGavock J. Patterns of weekday and weekend physical activity in youth in 2 Canadian provinces. Appl Physiol Nutr Metab 2013; 38:115-9. [PMID: 23438220 DOI: 10.1139/apnm-2012-0100] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Few Canadian children are meeting physical activity (PA) guidelines for optimal growth and health. There is little information describing the patterns of PA among Canadian youth, so it is difficult to determine where the deficits occur. The purpose of this study was to identify subgroups of youth and windows of time characterized by low PA and high sedentary behaviour. We conducted a cross-sectional study of 626 youth (aged 10-15 years) in 2 Canadian provinces. The primary exposure variables included geographic setting (rural vs. urban), sex, and days of the week (weekend days vs. weekdays). The primary outcome measures were minutes of light PA, moderate to vigorous physical activity (MVPA), and sedentary behavior, assessed with accelerometry. Compared with weekdays, MVPA was ∼30% lower on weekend days (55.8 ± 23.0 min vs. 38.7 ± 26.7 min; p < 0.001), whereas light PA was ∼15% higher. Significantly more youth achieved an average of >60 min of MVPA on weekdays than on weekend days (46% vs. 22%; p < 0.001). Sex-specific differences in MVPA were more pronounced on weekdays than on weekend days (∼13 vs ∼8 min per day; p < 0.01). Youth in rural settings achieved ∼9 fewer minutes of MVPA daily than youth in urban settings (p < 0.001). In youth 10 to 15 years of age, daily MVPA is lower and light PA is higher on weekend days than on weekdays. Girls and students living in rural areas were particularly vulnerable to low levels of MVPA.
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Affiliation(s)
- Melisa Comte
- a Manitoba Institute of Child Health, Department of Paediatrics and Child Health, Faculty of Medicine, University of Manitoba, Winnipeg, MB R3E 3P4, Canada
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Robertson-Wilson JE, Dargavel MD, Bryden PJ, Giles-Corti B. Physical activity policies and legislation in schools: a systematic review. Am J Prev Med 2012; 43:643-9. [PMID: 23159260 DOI: 10.1016/j.amepre.2012.08.022] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2012] [Revised: 05/25/2012] [Accepted: 08/14/2012] [Indexed: 11/17/2022]
Abstract
CONTEXT Current physical activity levels of youth are alarmingly low. One way to promote higher levels of physical activity to youth is through school-based government policies. The current review examines evaluation of school-based physical activity policies for youth over the past 10 years. EVIDENCE ACQUISITION Articles included met the following criteria: was an original research study published in an academic journal in English; examined or was related to physical activity behavior; applied to a youth population in a school setting; highlighted a law, bill, or policy reflective of physical activity based on government initiatives; and involved an evaluation. After searching five databases in January 2011, a total of 13 articles were selected for inclusion. EVIDENCE SYNTHESIS All policies came from the U.S.; seven studies highlighted the federal Child Nutrition and Women, Infants, and Children Reauthorization Act of 2004 whereas the other six studies highlighted state-level policies dealing with safe routes to schools, physical activity-only initiatives, or physical activity as well as other initiatives. Eight articles evaluated policy implementation, three examined policy implementation and impact, and two articles considered only policy impact. CONCLUSIONS This evaluation of the impact of policies on school-based physical activity indicates that such policies can affect health outcomes, specifically by increasing levels of physical activity. This study highlights the value of policy reform and calls attention to the need for independent evaluation of such policies.
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The implementation and effectiveness of school-based nutrition promotion programmes using a health-promoting schools approach: a systematic review. Public Health Nutr 2012; 16:1082-100. [DOI: 10.1017/s1368980012003497] [Citation(s) in RCA: 108] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
AbstractObjectiveTo evaluate implementation and effectiveness of nutrition promotion programmes using the health-promoting schools (HPS) approach, to indicate areas where further research is needed and to make recommendations for practice in this field.DesignThe searched electronic databases included: CINAHL, Cochrane Library, Health Reference Center, Informit Search, MEDLINE, ProQuest, PsycINFO, PubMed, ScienceDirect, Scopus, Social Services Abstracts and Web of Science. Inclusion criteria were: (i) controlled or before-and-after studies evaluating a nutrition intervention and involving the HPS approach, either fully or in part; (ii) provision of information about components and delivery of the intervention; and (iii) report on all evaluated outcomes.SettingSchools.SubjectsStudents, parents and school staff.ResultsAll included studies described intervention delivery and six reported on process evaluation. In intervention schools school environment and ethos were more supportive, appropriate curriculum was delivered and parents and/or the community were more engaged and involved. Students participated in interventions at differing levels, but the majority was satisfied with the intervention. The evidence indicates that nutrition promotion programmes using the HPS approach can increase participants’ consumption of high-fibre foods, healthier snacks, water, milk, fruit and vegetables. It can also reduce participants’ ‘breakfast skipping’, as well as reduce intakes of red food, low-nutrient dense foods, fatty and cream foods, sweet drinks consumption and eating disorders. It can help to develop hygienic habits and improved food safety behaviours.ConclusionsMore professional training for teachers in the HPS approach, further qualitative studies, longer intervention periods, improved follow-up evaluations and adequate funding are required for future school-based nutrition promotion programmes.
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Geography influences dietary intake, physical activity and weight status of adolescents. J Nutr Metab 2012; 2012:816834. [PMID: 22685637 PMCID: PMC3366226 DOI: 10.1155/2012/816834] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2011] [Revised: 02/16/2012] [Accepted: 02/19/2012] [Indexed: 11/17/2022] Open
Abstract
Purpose. The purpose of this study was to assess rural and urban differences in the dietary intakes, physical activity levels and weight status of a large sample of Canadian youth in both 2005 and 2008. Materials and Methods. A cross-sectional study of rural and urban adolescents (n = 10, 023) in Alberta was conducted in both 2005 and 2008 using a web-based survey. Results. There was an overall positive change in nutrient intakes between 2005 and 2008; however, rural residents generally had a poorer nutrient profile than urban residents (P < .001). They consumed less fibre and a greater percent energy from saturated fat. The mean physical activity scores increased among rural youth between 2005 and 2008 (P < .001), while remaining unchanged among urban youth. Residence was significantly related to weight status in 2005 (P = .017), but not in 2008. Conclusion. Although there were small improvements in nutrient intakes from 2005 to 2008, several differences in the lifestyle behaviours of adolescents living in rural and urban areas were found. The results of this study emphasize the importance of making policy and program recommendations to support healthy lifestyle behaviours within the context of the environments in which adolescents live.
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Taylor JP, McKenna ML, Butler GP. Monitoring and evaluating school nutrition and physical activity policies. Canadian Journal of Public Health 2011. [PMID: 21133199 DOI: 10.1007/bf03405622] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Given the increase in the number of Canadian jurisdictions with school nutrition and/or physical activity policies, there is a need to assess the effectiveness of such policies. The objectives of this paper are to 1) provide an overview of key issues in monitoring and evaluating school nutrition and physical activity policies in Canada and 2) identify areas for further research needed to strengthen the evidence base and inform the development of effective approaches to monitoring and evaluation. Evaluation indicators, data sources and existing tools for evaluating nutrition and physical activity are reviewed. This paper has underscored the importance of identifying common indicators and approaches, using a comprehensive approach based on the WHO framework and ensuring that research capacity and funding is in place to facilitate high-quality evaluation efforts in the future.
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Affiliation(s)
- Jennifer P Taylor
- Department of Family and Nutritional Sciences, University of Prince Edward Island, Charlottetown, PEI.
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Abstract
The Canadian education system is among the best in the world academically. In contrast, students' (children and youth) eating and activity levels are so poor that they have led to prevalence rates of overweight that are among the highest in the world. Given the enormous public health burden associated with poor nutrition and physical inactivity, Canada needs to address this health risk. Comprehensive school health (CSH) is a promising approach to promoting healthy eating and active living (HEAL). This article provides a review of CSH and discusses its four essential elements: 1) teaching and learning; 2) social and physical environments; 3) healthy school policy; and 4) partnerships and services. It also provides a common understanding of the implementation and broader benefits of CSH, which, in addition to health, include student learning and self-esteem. The article further discusses some complexities of a rigorous evaluation of CSH, which comprises proof of implementation, impact and positive outcome. Though such an evaluation has yet to be conducted, some studies did confirm successful implementation, and another study observed positive outcomes. Rigorous evaluation is urgently needed to provide a stronger evidence base of the benefits of CSH for learning, self-esteem and disease prevention. This evidence is essential to justify devoting more school time to promote HEAL and more resources to implement and support CSH to the benefit of both learning and health.
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Cohn T, Grant S, Faulkner GE. Schizophrenia and obesity: addressing obesogenic environments in mental health settings. Schizophr Res 2010; 121:277-8. [PMID: 20542411 DOI: 10.1016/j.schres.2010.05.024] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2010] [Revised: 05/18/2010] [Accepted: 05/20/2010] [Indexed: 10/19/2022]
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Robertson-Wilson JE, Lévesque L. Ontario's daily physical activity policy for elementary schools: is everything in place for success? Canadian Journal of Public Health 2009. [PMID: 19839289 DOI: 10.1007/bf03405521] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVES The development, implementation, and evaluation of policies may play an important role in promoting health behaviours such as physical activity. The Ontario Ministry of Education (OME) recently mandated Memorandum No. 138 requiring daily physical activity (DPA) for Ontario elementary students in grades one through eight. The purpose of this paper is to examine implementation strategies. METHODS Hogwood and Gunn's 10 preconditions for "perfect implementation" are used to examine publicly available Ministry DPA policy documents to assess whether these implementation strategies have been considered in the policy documents. RESULTS Several preconditions (e.g., allocation of resources, task specification) appear to have been considered, however a number of preconditions (e.g., the sustainability of resources, extent to which the policy is valued, and evaluation plans) thought to be important require additional attention to ensure optimal DPA implementation. CONCLUSIONS Additional reflection upon Hogwood and Gunn's implementation preconditions would, in our opinion, assist in facilitating optimal DPA implementation as per Memorandum No. 138.
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Barroso CS, Kelder SH, Springer AE, Smith CL, Ranjit N, Ledingham C, Hoelscher DM. Senate Bill 42: implementation and impact on physical activity in middle schools. J Adolesc Health 2009; 45:S82-90. [PMID: 19699442 PMCID: PMC2903960 DOI: 10.1016/j.jadohealth.2009.06.017] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2009] [Revised: 06/16/2009] [Accepted: 06/18/2009] [Indexed: 10/20/2022]
Abstract
PURPOSE In 2005, the Texas State Legislature passed Senate Bill 42 (SB42), which required public middle school students (grades 6-8) to participate in 30 minutes of daily structured physical activity. The purpose of this study was to assess awareness of and adherence to SB42 in Texas middle schools, and to assess the impact of SB42 on the frequency and quality of structured physical activity. METHODS Key informant (school principals, physical education [PE] instructors, nurses, or designated personnel) telephone interviews on the implementation of SB42 were conducted from a statewide representative sample of public middle schools (n=112). Direct observation, key informant, and student report of physical activity in PE classes at 17 Texas-Mexico border middle schools assessed the frequency and quality of structured physical activity. RESULTS State level (94% +/- 4.5%) and border district (94% +/- 13.5%) key informants reported a high level of overall awareness of SB42. Postimplementation of SB42 border districts reported a minimum of 4 days per week of PE instruction and more than 58 minutes per PE class, exceeding the 30-minute minimum of structured physical activity per day or 135 minutes per week as required by SB42 (range: 58.2-61.4 minutes). A significant increase in the number of days of PE class was observed in the border sample between 2004 and 2005 and 2006 and 2008, with eighth grade students reporting an average of 2.0 days and 3.7 days of PE per week, respectively (p < .001). Additionally, border districts met the Healthy People 2010 objective of 50% time in moderate-to-vigorous physical activity (mean 54.9% +/- 5.1%) during PE class. CONCLUSIONS Implementation of SB42 appears to have impacted the frequency of school PE in Texas and the prevalence of child self-reported physical activity behaviors along the Texas-Mexico border. General awareness of and adherence to SB42 was high in both statewide and among the border districts. Our mixed findings on adherence to specific components of the legislation suggest the need for further investigation of the factors that both facilitate and inhibit local leadership around school policy and the mechanisms to ensure the school policy is being implemented.
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Affiliation(s)
- Cristina S Barroso
- Hispanic Health Research Center, Michael & Susan Dell Center for Advancement of Healthy Living, University of Texas School of Public Health, Brownsville Regional Campus, Brownsville, Texas 78520, USA.
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Colabianchi N. Does the built environment matter for physical activity? CURRENT CARDIOVASCULAR RISK REPORTS 2009. [DOI: 10.1007/s12170-009-0046-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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