Erin Hobin

The efficacy of sugar labeling formats: Implications for labeling policy

To examine knowledge of sugar recommendations and test the efficacy of formats for labeling total and added sugar on pre‐packaged foods.

Trajectories of Objectively Measured Physical Activity among Secondary Students in Canada in the Context of a Province-Wide Physical Education Policy: A Longitudinal Analysis

Lower levels of physical activity are associated with childhood obesity. School physical education (PE) policies have been identified as critical to improve child and adolescent physical activity levels but there has been little evaluation of such policies. In the province of Manitoba, Canada, the government implemented a mandatory PE policy in secondary schools designed to increase the daily physical activity levels of adolescents. The objective of this study was to examine the longitudinal changes in and the factors associated with the physical activity trajectories of adolescents in Manitoba during their tenure as secondary school students in the context of this school PE policy. The results found, despite the PE policy, a grade-related decline in the physical activity trajectories of adolescents; however, the decline in physical activity was attenuated among adolescents with low and moderate baseline physical activity compared to adolescents with high baseline physical activity and among adolescents who attended schools in neighbourhoods of low compared to high socioeconomic status. There are several possible explanations for these findings, including the influence of the PE policy on the PA patterns of adolescent subpopulations that tend to be at higher risk for inactivity in both childhood and adult life.

Lessons from Studies to Evaluate an Online 24-Hour Recall for Use with Children and Adults in Canada

With technological innovation, comprehensive dietary intake data can be collected in a wide range of studies and settings. The Automated Self-Administered 24-h (ASA24) Dietary Assessment Tool is a web-based system that guides respondents through 24-h recalls. The purpose of this paper is to describe lessons learned from five studies that assessed the feasibility and validity of ASA24 for capturing recall data among several population subgroups in Canada. These studies were conducted within a childcare setting (preschool children with reporting by parents), in public schools (children in grades 5–8; aged 10–13 years), and with community-based samples drawn from existing cohorts of adults and older adults. Themes emerged across studies regarding receptivity to completing ASA24, user experiences with the interface, and practical considerations for different populations. Overall, we found high acceptance of ASA24 among these diverse samples. However, the ASA24 interface was not intuitive for some participants, particularly young children and older adults. As well, technological challenges were encountered. These observations underscore the importance of piloting protocols using online tools, as well as consideration of the potential need for tailored resources to support study participants. Lessons gleaned can inform the effective use of technology-enabled dietary assessment tools in research.

The influence of menu labelling on food choices among children and adolescents: a systematic review of the literature

Introduction: Childhood obesity is a serious public health concern internationally, and population-level interventions are needed to support healthy food choices. Existing reviews of menu labelling have focused predominantly on adults. However, childhood and adolescence are distinct periods of development during which longer term eating behaviours and food preferences are established. Although some studies have examined the effect of menu labelling among children and adolescents, no reviews have synthesised this evidence. Objective: To assess whether menu labelling influences the amount of calories ordered by children and adolescents (or parents on behalf of youth) in food outlets including restaurants and cafeterias. Methods: Comprehensive literature searches were conducted in Medline, Scopus, PsycINFO, CINAHL, SocINDEX and Embase databases. Eleven relevant studies were identified from an initial search yielding 1,682 results. Studies were assessed using a validated quality assessment tool. Results: Examinations of hypothetical food purchases in artificial environments suggest that menu labelling may be efficacious in reducing calories purchased for or by children and adolescents. Real-world studies are less supportive, although school-based studies were generally positive. It is unclear whether contextual or interpretive menu-labelling formats are more effective compared to numeric calorie information alone. Conclusion: Evidence supporting the impact of menu labelling on lowering the energy content of restaurant and cafeteria food choices made for or by children or adolescents is limited. There remains a need for high-quality studies conducted in real-world settings.

Challenges to interdisciplinary training for junior space, place and health researchers

The complexity of research questions posed in space, place and health research has led some researchers to suggest that these questions cannot be addressed adequately through a single research discipline. The objective of this article is two-fold. First, we argue that junior researchers face distinct challenges in learning how to conduct interdisciplinary research. Second, we outline how a unique training experience, the Canadian Institutes of Health Research Space, Place and Health Summer Institute addressed some of the challenges to incorporating interdisciplinarity into this unique field. Interdisciplinary training can prepare the next generation of researchers in all health fields to work effectively with colleagues from various disciplines, ask novel questions and address complex issues in innovative ways.

Availability, Location, and Format of Nutrition Information in Fast-food Chain Restaurants in Ontario, Canada

PURPOSE To assess the availability, location, and format of nutrition information in fast-food chain restaurants in Ontario. METHODS Nutrition information in restaurants was assessed using an adapted version of the Nutrition Environment Measures Study for Restaurants (NEMS-R). Two raters independently visited 50 restaurants, 5 outlets of each of the top-10 fast-food chain restaurants in Canada. The locations of the restaurants were randomly selected within the Waterloo, Wellington, and Peel regions in Ontario, Canada. Descriptive results are presented for the proportion of restaurants presenting nutrition information by location (e.g., brochure), format (e.g., use of symbols), and then by type of restaurant (e.g., quick take-away, full-service). RESULTS Overall, 96.0% (n = 48) of the restaurants had at least some nutrition information available in the restaurant. However, no restaurant listed calorie information for all items on menu boards or menus, and only 14.0% (n = 7) of the restaurants posted calorie information and 26.0% (n = 13) of restaurants posted other nutrients (e.g., total fat) for at least some items on menus boards or menus. CONCLUSIONS The majority of the fast-food chain restaurants included in our study provided at least some nutrition information in restaurants; however, very few restaurants made nutrition information readily available for consumers on menu boards and menus.

Is the Provision of Physical Education to Senior-Years Students Associated With Greater Physical Activity Levels? Insight Into a Province-Wide Policy.

OBJECTIVES The purpose of this study was to determine if participation in physical education (PE) was associated with increased moderate-to-vigorous physical activity (MVPA) levels in adolescents. METHODS This was a cross sectional study comparing MVPA levels in senior-years students-grade 11 and 12-enrolled in high school PE during the semester data were collected compared with those not enrolled in PE in that same semester. The primary outcome measure was daily MVPA measured by accelerometry. The primary exposure was participation in PE. RESULTS Among the 508 adolescents (16.9 ± 0.8 yrs, 49% female, n = 338 exposed to PE) studied, no differences in MVPA (47.0 ± 25.8 vs. 43.9 ± 25.0 mins/day, P = .25) or sedentary time (540.2 ± 94.7 vs. 550.2 ± 79.4 mins/day, P = .79) were noted between students enrolled in PE compared with students not enrolled in PE. Participation in PE was associated with a greater odds of achieving >60 minutes of MVPA daily (OR: 1.69; 95% CI: 1.04-2.75). This association was stronger among boys (OR: 2.4; 95% CI: 1.2-4.8) than girls (OR: 1.17; 95% CI: 0.5-2.7). CONCLUSION Enrollment in PE in grade 11 or 12 is associated with modestly higher levels of MVPA and an increased likelihood of meeting PA guidelines among students in grades 11 and 12, particularly among boys.

Editorial - Seeking a new ‘normal’ in the Canadian food environment

impressionable age group. Health care and other government-funded facilities serve as examples for the general public with regard to what foods they believe are acceptable to be served, as ostensibly these are the very institutions that have significant investment in population health and health care costs. The article summarizes consensus recommendations developed by thought leaders from across the country for procuring and providing healthy foods in public sector settings, and highlights the critical roles that multiple stakeholders are required to perform in successful implementation of healthy food procurement policies on a large scale.

School and classroom effects on Daily Physical Activity (DPA) policy implementation fidelity in Ontario classrooms: a multi-level analysis

BackgroundThis paper examines school and classroom effects on Daily Physical Activity (DPA) policy implementation in classrooms in Ontario, Canada. In 2005 the Ontario Ministry of Education mandated a policy requiring school boards to “ensure that all elementary students, including students with special needs, have a minimum of twenty minutes of sustained MVPA each school day during instructional time”. Based on an adaptation of Chaudoir’s conceptual framework, this paper contributes to understanding the extent to which school factors (as reported by administrators) and classroom factors (as reported by teachers) are associated with policy implementation fidelity at the classroom level.MethodsCross-sectional online surveys were conducted in 2014 with elementary school administrators and teachers, based on representative random samples of schools and classrooms. A measure assessing implementation fidelity was developed from the six required components of the policy and for this paper fidelity at the classroom level is treated as the outcome variable. Several school- and classroom-level measures were also included in the surveys and a number of these were selected for inclusion here. Data from the two surveys were merged and selected variables were included in the multi-level analysis. Two-level logistic regression models were conducted to account for nesting of classrooms within schools and a series of models were conducted to identify factors associated with implementation fidelity.ResultsThe analytic sample for this study included 170 school administrators and 307 classroom teachers from corresponding schools. Findings from the multi-level logistic regression analyses indicated that only classroom/teacher-level factors were significantly associated with implementation fidelity at the classroom level. None of the school/administrator predictors were significantly related to fidelity. The most parsimonious model included five significant classroom/teacher predictors: teachers’ perception of DPA as realistic and achievable; confidence (self-efficacy); scheduling DPA in timetables; lack of space; and lack of time.ConclusionsFindings from the study indicate the theoretical and practical importance of addressing classroom and teacher factors since they are most proximal to implementation fidelity to the policy. Several of these factors also reflect complex structural and organizational contexts, indicating that a systems approach to understanding and supporting DPA implementation fidelity is warranted.

Trajectories of objectively measured sedentary time among secondary students in Manitoba, Canada in the context of a province-wide physical education policy: A longitudinal analysis.

OBJECTIVES: Canadian adolescents’ sedentary behaviour (SB) is poorly understood and greatly understudied compared to physical activity (PA). Accumulating evidence suggests that SB poses long-term health risks regardless of PA levels. To design effective interventions that target SB, it is critical to first understand adolescents’ sedentary time (ST) trajectories in a Canadian context. Therefore, we examined longitudinal trajectories of Manitoba students’ ST from 2008 to 2011 and identified associated factors in the context of a province-wide physical education (PE) policy.METHODS: Secondary schools offering grades 9 through 12 were randomly selected in blocks to represent the urban and rural geography of Manitoba. In each selected school (n = 31), a convenience sample of grade 9 or 10 PE classes was recruited, leading to a final sample of 447 students. To assess ST, participants wore accelerometers on 7 consecutive days at baseline (2008) and during at least one follow-up period (2009, 2010 and 2011).RESULTS: At baseline, students accumulated an average of 540 minutes/day of ST. Over the course of secondary school, students’ ST trajectories remained stable. Females compared to males had a slightly higher rate of decline in ST (p = 0.035), adjusting for socio-demographic variables. ST trajectories were not associated with baseline PA, body mass index and school neighbourhood socio-economic status.CONCLUSION: Adolescent ST remained high throughout secondary school. SB may be well established by early adolescence and track through late adolescence. Our findings suggest the potential need for additional interventions to reduce SB before and over the course of secondary school.RésuméOBJECTIFS: Le comportement sédentaire (CS) des adolescents canadiens est mal compris et beaucoup moins étudié que leur activité physique (AP). Les données qui s’accumulent laissent croire que le CS pose des risques à long terme pour la santé, indépendamment des niveaux d’AP. Pour concevoir des interventions efficaces qui ciblent le CS, il est indispensable de comprendre d’abord les trajectoires du temps de sédentarité (TS) des adolescents dans un contexte canadien. C’est pourquoi nous avons examiné les trajectoires longitudinales du TS d’élèves du Manitoba de 2008 à 2011 et répertorié les facteurs associés dans le contexte d’une politique d’éducation physique (ÉP) provinciale.MÉTHODE: Des écoles secondaires offrant des classes de la 9e à la 12e année ont été sélectionnées au hasard en blocs pour représenter la géographie urbaine et rurale du Manitoba. Dans chaque école sélectionnée (n = 31), nous avons recruté un échantillon de commodité de classes d’ÉP de 9e ou de 10e année, ce qui a donné un échantillon final de 447 élèves. Pour l’évaluation du TS, les participants ont porté des accéléromètres pendant 7 jours consécutifs au départ (2008) et durant au moins une période de suivi (2009, 2010 et 2011).RÉSULTATS: Au départ, les élèves ont accumulé 480 minutes/jour de TS. Durant leurs études secondaires, les trajectoires du TS des élèves sont restées stables. Comparativement aux garçons, les filles ont affiché un taux de diminution du TS légèrement supérieur (p = 0,035), compte tenu des variables sociodémographiques. Les trajectoires du TS n’étaient pas associées à l’AP de départ, à l’indice de masse corporelle, ni au statut socioéconomique du quartier de l’école.CONCLUSION: Le TS des adolescents est resté élevé durant toutes leurs études secondaires. Le CS pourrait être bien ancré dès le début de l’adolescence et se poursuivre jusqu’à la fin de l’adolescence. Nos constatations indiquent que des interventions supplémentaires pourraient être nécessaires pour réduire le CS avant et durant les études secondaires.