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Background: Childhood overweight and obesity is a major public health concern. Community-based interventions have the potential to reach caregivers and children. However, the overall health impact of these programs is rarely comprehensively assessed. This study evaluated a physical activity and healthy eating family program (Healthy Together; HT) using the RE-AIM framework., Methods: Ten sites implemented the 5-week program. Thirty-nine staff members and 277 program participants (126 caregivers [M age  = 35.6] and 151 children [M age  = 13]) participated in the evaluation. Each RE-AIM dimension was assessed independently using a mixed-methods approach. Sources of data included archival records, interviews and surveys. Effectiveness outcome variables were assessed at pre- and post-intervention and 6-month follow-up., Results: Reach: HT participants were almost entirely recruited from existing programs within sites. Effectiveness: Caregivers' nutrition related efficacy beliefs increased following HT (ps < .03). Participation in HT was not associated with significant changes in physical activity or nutrition behaviour or perceived social support (ps > .05). Knowledge surrounding healthy diets and physical activity increased in children and caregivers (ps < .05). Adoption: Thirty-five percent of sites approached to implement HT expressed interest. The 10 sites selected recruited existing staff members to implement HT., Implementation: Program objectives were met 72.8% of the time and 71 adaptations were made. HT was finance- and time-dependent. Maintenance: Two sites fully implemented HT in the follow-up year and 5 sites incorporated aspects of HT into other programs., Conclusions: Working alongside organizations that develop community programs to conduct comprehensive, arms-length evaluations can systematically highlight areas of success and challenges. Overall HT represents a feasible community-based intervention; however further support is required in order to ensure the program is effective at positively targeting the desired outcomes. As a result of this evaluation, modifications are currently being implemented to HT.

Background: Given the potential impact school-based daily physical activity (DPA) policies can have on the health outcomes of Canadian children, it is surprising that such little research has examined the implementation and student-level effectiveness of these policies, and that even less have used theory to understand the barriers and facilitators affecting uptake of this policy by teachers. This review descriptively summarizes the implementation status, approaches used to implement DPA, and the effectiveness of DPA at increasing the physical activity of children at school. In addition, the Theoretical Domains Framework (TDF) was used to explore the barriers and facilitators to DPA implementation., Methods: A scoping review of English articles using ERIC, CINAHL, and Google Scholar (2005 to 2016) was conducted. Only studies that evaluated the implementation and/or student-level effectiveness of DPA policies in Canadian elementary schools were included. Only articles that examined DPA implementation barriers and facilitators by teachers, principals, and/or administration were eligible for the TDF analysis. Data on study characteristics and major findings regarding implementation status, implementation approach used, and impact on student's physical activity were extracted and were summarized descriptively, including study quality indicators. Two coders extracted and categorized implementation barriers and facilitators into TDF domains., Results: The search resulted in 66 articles being retrieved and 38 being excluded for not meeting the eligibility criteria, leaving 15 eligible for review (10 of which examined barriers and facilitators to implementation from DPA deliverers' perspective). Eleven of 15 studies examined the Ontario DPA policy, and 2 studies were from both Alberta and British Columbia. Thirteen studies examined implementation, and only two examined effectiveness. DPA implementation status, approaches to delivery, and effectiveness on student's PA levels are inconsistent across the three provinces. A total of 203 barriers/facilitators were extracted across the ten implementation studies, most of which related to the environmental context and resources (ECR; n = 86; 37.4%), beliefs about consequences (n = 41; 17.8%), and social influences (n = 36; 15.7%) TDF domains., Conclusions: With the limited research examining the DPA policy in Canada, the current status and approaches used to implement DPA and the student-level effectiveness is not well understood; however, this review revealed that DPA deliverers often report many barriers to DPA implementation. Most importantly, in conducting a TDF-based analysis of the barriers/facilitators affecting implementation, this review provides a theoretical basis by which researchers and policy-makers can design interventions to better target these problems in the future., Registration: A protocol for this review was not registered.

Introduction ParticipACTION's 2011 "Think Again" campaign aimed to draw parents', and specifically mothers', attention to the amount of physical activity (PA) their children do relative to the national guidelines (physical activity guidelines [PAG]). Purpose To evaluate ParticipACTION's "Think Again" campaign in the context of the hierarchy of effects model. Methods Data were drawn from "Think Again" campaign evaluations conducted among two cohorts of parents with children ages 5 to 11 years (3 months postcampaign launch [T1], n = 702; 15 months postlaunch [T2], n = 670). Results At T2, campaign awareness was weakly associated with parents agreeing that their children were not active enough (p = .01, d = .18). Parents who were aware of the campaign showed greater knowledge of PAG (ps < .01, ϕs > .14), had higher outcome expectations about their children engaging in PA (p < .01, d = .16), had stronger intentions to help their child meet the guidelines (p < .01, d = .18), and engaged in more parental support behaviors (p < .001, d = .31) as compared with parents who were not aware. At T1, parents aware of the campaign had greater perceived behavioral control (PBC) to influence their child's PA participation (p < .01, d = .22), whereas parents not aware of the campaign had greater PBC to find practical ways to help their child be active (p < .01, d = .26). Parental awareness of the campaign was not associated with children meeting the PAG at either time point (ps > .05). Conclusions The campaign appeared marginally effective for increasing parental knowledge of PAG and for creating realistic awareness of children's PA levels. Additional intervention strategies are needed to produce larger effects and to change parental behavior., (© 2015 Society for Public Health Education.)

Unlabelled: Community-based organizations (CBOs) and support personnel that serve marginalized members of society have the potential to be important partners in knowledge mobilization (KM). A CBO in partnership with researchers developed an event-based KM initiative to disseminate evidence-based physical activity guidelines for people with spinal cord injury., Purpose: The purpose of this case study is to demonstrate a) how a CBO can implement a KM initiative and b) the effectiveness of the initiative for disseminating the guidelines to support personnel., Method: The KM initiative consisted of 12 events about the new guidelines held within the CBO's regional areas. Evaluation of the events was guided by the RE-AIM (reach, efficacy or effectiveness, adoption, implementation, and maintenance) framework., Results: Adoption of the events was high, with 88% of regions hosting an event. Overall fidelity to the event protocol was high among researchers (100.00% ± .00), peers (65% ± 33.74), and staff (70.00% ± 34.96). The events reached 140 support personnel who attended the events. Significant increases in support personnel's self-efficacy and intentions to promote physical activity to people with spinal cord injury were seen at Time 2 but not maintained at Time 3., Conclusions: Event-based KM initiatives may be an effective strategy for CBOs to disseminate information to support personnel and ensure that KM initiatives are supported by staff and delivered as intended., (© 2014 Society for Public Health Education.)

Given the positive influence of action planning on physical activity, persuasive messages could be designed to promote action planning. The purpose of this paper was to test action planning messages in two studies. Participants were allocated to one of two message groups, reading either a physical activity only or physical activity plus action planning message (Study 1) and either a gain-framed or loss-framed action planning message (Study 2). The percent of individuals who created an action plan and the quality of the plans were evaluated. In Study 1, individuals in the physical activity plus action planning group created as many action plans as the physical activity only group, but their plans were higher quality. In Study 2, Week 2 differences between the gain- and loss-framed message groups were found for action planning. To our knowledge, these studies were the first to investigate message-induced action planning as a behavior. More research is needed to optimize these messages.

Background: Diffusion of innovations theory has been widely used to explain knowledge mobilization of research findings. This theory posits that individuals who are more interpersonally connected within an organization may be more likely to adopt an innovation (e.g., research evidence) than individuals who are less interconnected. Research examining this tenet of diffusion of innovations theory in the knowledge mobilization literature is limited. The purpose of the present study was to use network analysis to examine the role of interpersonal communication in the adoption and mobilization of the physical activity guidelines for people with spinal cord injury (SCI) among staff in a community-based organization (CBO)., Methods: The study used a cross-sectional, whole-network design. In total, 56 staff completed the network survey. Adoption of the guidelines was assessed using Rogers' innovation-decision process and interpersonal communication was assessed using an online network instrument., Results: The patterns of densities observed within the network were indicative of a core-periphery structure revealing that interpersonal communication was greater within the core than between the core and periphery and within the periphery. Membership in the core, as opposed to membership in the periphery, was associated with greater knowledge of the evidence-based physical activity resources available and engagement in physical activity promotion behaviours (ps < 0.05). Greater in-degree centrality was associated with adoption of evidence-based behaviours (p < 0.05)., Conclusions: Findings suggest that interpersonal communication is associated with knowledge mobilization and highlight how the network structure could be improved for further dissemination efforts., Keywords: diffusion of innovations; network analysis; community-based organization; knowledge mobilization; knowledge translation, interpersonal communication.

Background: Ensuring the physical activity (PA) guidelines for people with spinal cord injury (SCI) are effectively disseminated is important for promoting PA. Few studies have investigated knowledge mobilization (KM) initiatives that aim to disseminate PA guidelines. Diffusion research suggests that using interpersonal communication channels may increase the adoption of guidelines., Objective: The aim of the present study was to examine the reach and effectiveness of an event-based KM initiative that used interpersonal communication to disseminate the guidelines to people with SCI. The KM initiative consisted of 12 separate events attended by a total of 104 people with SCI (age = 53 ± 18.9 years; 31% female)., Methods: Questionnaires assessing attendees' adoption of the guidelines in accordance with Rogers' innovation-decision process were completed before (Time 1), directly after (Time 2) and 1 month following an event (Time 3)., Results: Findings indicate that in total the events reached 5% of SCI Ontario clients. RM-ANOVAs and Related-Samples McNemar Tests indicated that initial adoption of the guidelines was high but in general was not maintained. Specifically, at Time 2, attendees' knowledge of the guidelines, attitudes toward the guidelines, self-efficacy and intentions to meet the guidelines increased from Time 1 (ps < 0.05). At Time 3, the majority of these initial increases were not maintained and change in PA behavior was not observed. However, 67% of attendees tried the recommended exercises., Conclusions: An event-based KM initiative may be effective for initial dissemination of PA guidelines. Efforts are needed to foster long-term guideline adoption., (Copyright © 2013 Elsevier Inc. All rights reserved.)

Objective: Framing a message in terms of the benefits of engaging in the behavior (gain frame), the costs of failing to engage in the behavior (loss frame), or both the benefits and the costs (mixed frame) can impact parents' decisions about their childrens' and adolescents' health. This study, investigated the effect of framed messages on parents' intentions to have their children vaccinated against human papillomavirus (HPV)., Design and Sample: The study employed a 2 (gender of the parent) × 2 (gender of the child) × 3 (message frame) between-groups, quasi-experimental design. A convenience sample of 367 parents with children in Grade 5, 6, or 7 who had at least one child who had not been vaccinated against HPV., Measures: Social-cognitive variables relating to intentions to vaccinate a child were assessed., Intervention: Participants were randomly assigned to read one of three framed messages about the HPV vaccine (gain, loss, or mixed)., Results: Gain-framed messages seemed to persuade mothers of sons to speak to a doctor about the vaccine (p < .05). Framing effects were not significant for other outcomes., Conclusions: Findings provide preliminary evidence that certain vaccination messages may be more effective for different parent-child dyads., (© 2012 Wiley Periodicals, Inc.)

To explore sexuality after spinal cord injury (SCI) from the perspectives of individuals with SCI and their romantic partners. A sample of 8 Canadian adults with SCI (6 men, 2 women) and their partners participated in this study (N = 16). Semi-structured dyadic and individual interviews were conducted, discussions surrounding sexuality and intimacy were extracted, and a qualitative description of the interview data was performed using thematic analysis. Three major themes were identified: the changing definition of sex; emotions; and practical support. Couples' conversations around the changing definition of sex after SCI addressed the taboo topic of sexuality and the importance of communication between couples, peers, and healthcare providers. Emotions included fears of losing intimacy, embarrassment in managing bladder and bowel interference, and acceptance in balancing being a romantic partner and a caregiver. Finally, couples reported challenges accessing practical support including medical interventions and sexual health nurses, but saw value in peer mentorship programs. Couples explored a changing definition of sex following SCI that was complicated by the taboo nature of discussing sexuality, experienced a range of emotions throughout the recovery process, and had difficulties navigating the healthcare system for appropriate support. Healthcare professionals should promote discussion and provide support for sexuality following SCI, but during initial rehabilitation may be too early. Healthcare providers should prepare people with SCI and their partners for the inevitable trial-and-error process involved in sexual rehabilitation. Rehabilitation professionals could direct couples to SCI peer mentorship programs to help normalize the experiences and emotions of sexual rehabilitation. [ABSTRACT FROM AUTHOR]

Background: Few validated guidelines exist for developing messages in health promotion practice. In clinical practice, the Appraisal of Guidelines, Research, and Evaluation II (AGREE II) Instrument is the international gold standard for guideline assessment, development, and reporting. In a case study format, this paper describes the application of the AGREE II principles to guide the development of health promotion guidelines for constructing messages to supplement the new Canadian Physical Activity Guidelines (CPAG) released in 2011. Methods: The AGREE II items were modified to suit the objectives of developing messages that (1) clarify key components of the new CPAG and (2) motivate Canadians to meet the CPAG. The adapted AGREE II Instrument was used as a systematic guide for the recommendation development process. Over a two-day meeting, five workgroups (one for each CPAG - child, youth, adult, older adult - and one overarching group) of five to six experts (including behavior change, messaging, and exercise physiology researchers, key stakeholders, and end users) reviewed and discussed evidence for creating and targeting messages to supplement the new CPAG. Recommendations were summarized and reviewed by workgroup experts. The recommendations were pilot tested among end users and then finalized by the workgroup. Results: The AGREE II was a useful tool in guiding the development of evidence-based specific recommendations for constructing and disseminating messages that supplement and increase awareness of the new CPAG (child, youth, adults, and older adults). The process also led to the development of sample messages and provision of a rationale alongside the recommendations. Conclusions: To our knowledge, these are the first set of evidence-informed recommendations for constructing and disseminating messages supplementing physical activity guidelines. This project also represents the first application of international standards for guideline development (i.e., AGREE II) to the creation of practical recommendations specifically aimed to inform health promotion and public health practice. The messaging recommendations have the potential to increase the public health impact of evidence-based guidelines. [ABSTRACT FROM AUTHOR]

The effect of response cost information, message framing and past behaviour on women’s coping appraisal and motivation to be vaccinated against the Human Papillomavirus (HPV) were investigated using a 2 Frame × 2 Response Cost × 2 Pap Status design. Women (N = 286) read one of four messages about the vaccine. Women who received high-risk information perceived the vaccine as having higher response cost and were less motivated to be vaccinated compared to women who received low-risk information. The deleterious effects of risk information on specific aspects of women’s coping appraisal may be mitigated by appropriately framed messages. [ABSTRACT FROM PUBLISHER]