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ABSTRACTThe impacts of the COVID-19 pandemic on youth mental health and stress levels warrants urgent attention. In Canada, as elsewhere in the world, public health measures in the early stages of the pandemic dramatically transformed the everyday geographies of young people. In the hyper-localisation of everyday life, surrounding neighbourhood features like parks and food-related stores may have provided the only outlets for physical activity, social interaction, and relaxation outside of the home. We examine how health-related behaviours, neighbourhood features, and demographic factors may relate to changes in youth mental health and stress levels during the first six months of the pandemic. A cross-sectional youth-informed online survey was conducted with youth, aged 13–19, in London, Ontario, Canada. Respondents were surveyed about their mental health and stress levels before and during the first six months of the COVID-19 pandemic. From 279 respondents, we identified how age, gender, ethnicity, dietary habits, physical activity levels, and availability of parks, fast food, convenience stores and grocery stores could correlate with mental health and stress levels. Given the role played by public spaces, our work underscores the importance of including youth perspectives in the planning of the public realm which contributes to healthy and thriving communities.

ABSTRACTAs most Canadian children are not attaining the recommended 60 minutes of daily physical activity, it is imperative that affordable and accessible programs are implemented to help children become more physically active. Specifically, community-based programs that are free and easy to access have shown to be advantageous for promoting beneficial health behaviours at a population level. The Grade 5 ACT-i-Pass (G5AP) is a community-based physical activity program in the mid-sized Canadian city of London, Ontario that offers free programming to all grade 5 children (ages 9–11 years) at various recreational facilities across the city. The data from 28 focus groups with past G5AP participants (n = 101) were analysed to understand the influence of the program on children’s perceived physical activity levels, and to investigate the enablers and/or barriers that children believe influenced their participation in, or access to, G5AP programming. Five distinct themes were identified during the analysis, including two themes describing participants’ perceived changes to their physical activity levels (i.e. additional physical activity opportunities, and well-being and self-efficacy), and three themes explaining enablers and/or barriers to G5AP programming (i.e. program structure and implementation, spatial accessibility of programming, and social supports and constraints). The findings from the focus groups were used to generate recommendations for current and future community-based physical activity programs as a means to improve the health and well-being of children.

ABSTRACTEngaging in human occupation is complex, often involving commonplace practices that cannot be readily articulated. Accordingly, a growing number of occupational science and occupational therapy scholars have called for expanded qualitative methodologies and methods to support enhanced understandings of occupation in context. In this paper we respond to these calls by discussing how the go-along method—a hybrid of participant observation and interviewing—can be layered with an occupational lens to enhance the in-depth study of occupation. We provide an overview of the use of interview and observational methods in occupational science and occupational therapy research, as well as an introduction to the go-along method. Next we draw upon two go-along interviews from a larger ethnographic study to illustrate the method’s contributions to the study of occupation and describe considerations when using this method. Ultimately, we assert that the go-along method is a useful tool for exploring the complex, situated, and experiential nature of occupation.

Intervention: Ontario’s Harmonized Heat Warning and Information System (HWIS) brings harmonized, regional heat warnings and standard heat-health messaging to provincial public health units prior to periods of extreme heat. Research question: Was implementation of the harmonized HWIS in May 2016 associated with a reduction in emergency department (ED) visits for heat-related illness in urban locations across Ontario, Canada? Methods: We conducted a population-based interrupted time series analysis from April 30 to September 30, 2012–2018, using administrative health and outdoor temperature data. We used autoregressive integrated moving average models to examine whether ED rates changed following implementation of the harmonized HWIS, adjusted for maximum daily temperature. We also examined whether effects differed in heat-vulnerable groups (≥65 years or <18 years, those with comorbidities, those with a recent history of homelessness), and by heat warning region. Results: Over the study period, heat alerts became more frequent in urban areas (6 events triggered between 2013 and 2015 and 14 events between 2016 and 2018 in Toronto, for example). The mean rate of ED visits was 47.5 per 100,000 Ontarians (range 39.7–60.1) per 2-week study interval, with peaks from June to July each year. ED rates were particularly high in those with a recent history of homelessness (mean rate 337.0 per 100,000). Although rates appeared to decline following implementation of HWIS in some subpopulations, the change was not statistically significant at a population level (rate 0.04, 95% CI: −0.03 to 0.1, p=0.278). Conclusion: In urban areas across Ontario, ED encounters for heat-related illness may have declined in some subpopulations following HWIS, but the change was not statistically significant. Efforts to continually improve HWIS processes are important given our changing Canadian climate.

To halve per capita global food waste by 2030, policies and programs that effectively reduce household food waste generation are needed. Building upon a previous randomized controlled trial, this study evaluated the long-term effectiveness of the “Reduce Food Waste, Save Money” household food waste reduction intervention by comparing direct measurements of household food waste generated by treatment (n= 47) and control households (n= 52) over three time periods. The results indicate that there has been a long-term, sustained 30% reduction of avoidable food waste sent to landfill by treatment households following the implementation of this intervention. Additionally, this study assessed the impact of pandemic circumstances on the quantity and composition of household food waste by comparing direct measurements of food waste generated by the same households before (October 2017) and during (June 2020) the COVID-19 pandemic. During the first wave of the pandemic in Ontario, Canada, study households (n= 99) sent 2.98 kg of food waste to landfill per week, of which 54% was classified as avoidable food waste, and the remaining 46% as unavoidable food waste. During the pandemic, the generation of unavoidable food waste significantly increased by 65% (p< 0.01). There were also significant changes to the composition of wasted food, including a 78% increase in avoidable fruit and vegetables (p< 0.01), a 228% increase in avoidable other food (p< 0.01), and an 84% increase in unavoidable other food (p= 0.02).

ABSTRACTThe public realm is a well-recognized contributor to positive health and wellbeing. Public parks and recreational spaces are now some of the main outlets for people to get outdoors, however COVID-19 has created challenges in these spaces. We classify local government responses around maintaining physical distancing in the public realm using a preliminary conceptual map of theories and actions to identify variations in these approaches around the globe. This pilot classification approach provides a useful lens to examine pandemic responses, with future work building upon this map to potentially inform how cities may react to other complex planetary health issues.

Objectives: On January 1, 2020, the Government of Ontario passed a regulation banning vaping advertisements by retailers, apart from specialty shops. A motivation for this ban was to limit youth exposure to vaping advertisements. The primary goal of this research was to evaluate the impact of this ban on the number and density of vaping advertisements surrounding secondary schools. Additionally, we examined whether the number of vaping advertisements varied by school socio-demographic characteristics. Methods: This study used a pre-post design. Audits were conducted December 2019 (pre-ban) and again January to February 2020 (post-ban), to identify vaping advertisements within 800 m surrounding secondary schools (n= 18) in London, Ontario. Results: Prior to the ban, there were 266 vaping advertisements within 800 m of secondary schools. After the ban, this was reduced to 58, a 78.2% reduction. The mean number of vaping advertisements surrounding schools significantly decreased from 18.1 before the ban to 3.6 after the ban (p&lt; 0.001). A significant positive correlation was found, prior to the ban, between the number of vaping advertisements surrounding schools and school-level residential instability (r= 0.42, p= 0.02). After the ban, no significant correlations were found between the number of vaping advertisements and school socio-demographic characteristics. Conclusion: The provincial ban of vaping advertisements in select retail settings significantly reduced the number of vaping advertisements in the areas surrounding secondary schools in London, Ontario. The ban also reduced socio-demographic inequities in youths’ potential exposure to marketing of vaping products. Continued monitoring of the geographic accessibility and promotion of vaping products is warranted.

The coronavirus disease 2019 (COVID-19) pandemic has taken the lives of millions and disrupted countless more worldwide. Simply living through the pandemic has had drastic effects on the health of citizens. Diet, an important aspect of health, has been uniquely affected by the pandemic, although these changes have not been sufficiently studied among youth.

Objective: The objective was to examine the influence of weather on moderate-to-vigorous physical activity (MVPA) and light physical activity (LPA) levels of children aged 8–14 years from rural communities, an understudied Canadian population. Methods: Children (n?=?90) from four communities in rural Northwestern Ontario participated in this study between September and December 2016. Children’s MVPA and LPA were measured using an Actical accelerometer and demographic data were gathered from surveys of children and their parents. Weather data were collected from the closest weather station. Cross-classified regression models were used to assess the relationship between weather and children’s MVPA and LPA. Results: Boys accumulated more MVPA than girls (b?=?26.38, p?&lt;?0.01), children were more active on weekdays as compared with weekends (b?=?-?16.23, p?&lt;?0.01), children were less active on days with precipitation (b?=?-?22.88, p?&lt;?0.01), and higher temperature led to a significant increase in MVPA (b?=?1.33, p??&lt;?0.01). As children aged, they accumulated less LPA (b?=?-?9.36, p?&lt;?0.01) and children who perceived they had higher levels of physical functioning got more LPA (b?=?25.18, p?=0.02). Similar to MVPA, children had higher levels of LPA on weekdays (b?=?-?37.24, p?&lt;?0.01) as compared to weekend days and children accumulated less LPA (b?=?-50.01, p?&lt;?0.01) on days with rain. Conclusion: The study findings indicate that weather influences rural children’s MVPA and LPA. Future research is necessary to incorporate these findings into interventions to increase rural children’s overall PA levels and improve their overall health.

Supplemental Digital Content is Available in the Text.This systematic review explores experiences of household food insecurity in rural areas of developed countries. A search of 5 databases resulted in 32 peer-reviewed articles for inclusion. Data were analyzed using directed content analysis to broaden the understanding of rural household food insecurity. Elements of food security (ie, availability, accessibility, acceptability, adequacy, and agency) were exemplified across the literature. In addition, 4 key themes were found: exercising human capital, realizing social capital, coping with compounding stressors, and navigating complex systems. This review demonstrates the need for interventions that improve social connectedness, individual coping skills, and system navigation.

Background: The use of nutrigenomics and lifestyle genomics in clinical practice has the potential to optimize weight-related outcomes for patients.Aim: A scoping review was conducted to summarize and evaluate the current body of knowledge related to the effectiveness of providing DNA-based lifestyle advice on weight-related outcomes, with the aim of providing direction for future research.Method: Primary studies were included if they were written in English, evaluated weight-related and/or body mass index and/or body composition outcomes, and provided participants with an actionable genetic-based lifestyle intervention; interventions that only provided information on genetic risk for diseases/conditions were excluded. Data was extracted from each article meeting inclusion criteria (N=3) and the studies were critically appraised for methodological limitations.Results: Research in this area is promising, but limited. Specific limitations relate to study designs, the nature of the recommendations provided to participants, small (underpowered) sample sizes, the use of self-reported weight/BMI data and lack of consideration of important confounding factors.Conclusions: Therefore, the effectiveness of nutrigenomics and lifestyle genomics interventions for weight management in clinical practice cannot yet be conclusively determined. Recommendations for future research are detailed in the present manuscript.

Intervention: This study examines the impact of London’s Healthy Kids Community Challenge (HKCC) ‘Water Does Wonders’ interventions, which combined water infrastructure and education programs. Research question: How effective were the HKCC interventions at increasing water and decreasing sugar-sweetened beverage (SSB) consumption among grade 4–8 children in London, Ontario? Methods: Non-randomized controlled trial. Children’s knowledge and beverage intake were measured before and after the interventions were implemented during the 2016–2017 school year. Children at intervention schools (n= 521) received education programs (Growing Chefs or UTRCA [Upper Thames River Conservation Authority]) and water bottle filling stations. Children at control schools (n= 410) received filling stations only. Multivariable linear mixed-model ANCOVAs were used to compare water and SSB consumption and knowledge across intervention groups, accounting for school-level clustering. Results: Children who received an education intervention and filling station compared with only a filling station consumed more water (β= 2.18 (95% CI − 1.87, 6.22) for Growing Chefs and β= 2.90 (95% CI − 0.23, 6.03) for UTRCA) and fewer SSBs (β= − 1.17 (95% CI − 3.83, 1.49) for Growing Chefs and β= − 2.56 (95% CI − 5.12, 0.001) for UTRCA) post-intervention, and had higher nutrition knowledge (β= 1.57 (95% CI − 1.68, 4.83) for Growing Chefs and β= 2.02 (95% CI − 0.35, 4.39) for UTRCA). These findings were not statistically significant. Conclusions: An intervention intended to promote healthy beverage consumption yielded effects in the expected direction; however, they were small and not statistically significant. This is likely because the educational interventions were not fully aligned with the goals of the ‘Water Does Wonders’ program, preventing them from evoking meaningful changes in dietary behaviours.

ABSTRACTPhysical activity in Canada mirrors the gender gap observed globally, with boys more likely than girls to meet recommended guidelines. While a growing body of research has examined the relationships between environmental factors and children’s physical activity levels, much less is known about how environments play a role in gendering physical activity. In this paper, using a material feminist approach to environmental affordances, we explore girls’ perspectives on the features of their everyday environments that support or inhibit their uptake of physical activities in Southwestern Ontario, Canada. As part of the larger multi-method Spatial Temporal Environment and Activity Monitoring (STEAM) project, we held six focus groups with girls ages 10–12 years from rural, suburban, and urban schools. Through inductive thematic analysis, we identified two themes: (1) Outdoor matter matters for physical activity, and (2) Social levers and liabilities shape physical activity affordances. Our results indicate that some girls may be better afforded physical activity opportunities by providing proximate outdoor play in spaces with natural elements and diverse infrastructure, coupled with efforts to alleviate social liabilities (e.g., care responsibilities) and leverage social supports (e.g., peers). Based on our findings, we put forward naturalised schoolyards as a potentially gender-sensitive physical activity intervention. This study contributes to identifying the gendered ways in which environments may differentially ‘afford’ children opportunities for physical activity, thereby opening the way for developing more gender-equitable interventions.

The COVID-19 pandemic has had a profound impact on the daily routines of parents and children. This study explored the influence of socioeconomic status (SES) and urbanicity on parents' attitudes toward their children's active play opportunities 6 months and 1.5 years into COVID-19.

Active school travel (AST) can be a viable way to increase children's low levels of daily physical activity by promoting opportunities to walk and wheel. To promote AST in Canada, School Travel Plan (STP) programs have been implemented throughout the country. The STP program is a comprehensive 2-year intervention that is facilitated by a committee of community and school partners who implement education, encouragement, enforcement, and engineering initiatives at their school to support AST.

In this article, we undertake a methodological and creative exploration of poetic representation in children’s geographies. Drawing on qualitative approaches to poetry as a method, we consider how poetic techniques have the potential to bring us into children’s experiences in different ways and inspire more playful engagement with our research data more broadly. We present an illustrated series of research poems derived from our project on children’s perspectives on nature and adventurous nature play in New Zealand. We invite readers and viewers to engage with these works and consider what disrupting traditional prose representations of research can add to critical children’s geographies and beyond.

The purpose of this study was to explore individual-level socio-demographic factors and interpersonal-level factors related to social support, as well as the potential role of neighborhood and school environments that may influence the physical activity (PA) levels of children (ages 9–11). Child and parent questionnaires included individual and interpersonal factors, and PA behaviour. Home postal codes were used to determine the neighbourhood the child resides within, as well as their geographic accessibility to recreation opportunities. The models were assessed using a series of cross-classified random-intercept multi-level regression models as children’s PA may be affected by both the school they attend and the neighbourhood in which they live. In the unadjusted model, PA varied significantly across school environments (γ = 0.023; CI: 0.003–0.043), but not across neighbourhoods (γ = 0.007; CI: -0.008 to 0.021). Boys were found to be more active compared to girls (b = 0.183; CI: 0.092–0.275), while the level of PA was lower for children whose fathers achieved post-secondary education (b = - 0.197; CI: -0.376 to 0.018) than for those whose parents completed only high school. The addition of the individual-level correlates did not have a substantial effect on level 2 variances and the level 2 variance associated with school environment remained statistically significant. At the interpersonal level, children’s perception of parental support (b = 0.117; CI: 0.091–0.143) and peer support (b = 0.111; CI: 0.079–0.142) were positively related to PA. The level 2 variance for the school environment became statistically non-significant when the interpersonal factors were added to the model. At the environmental level, geographic accessibility did not have a significant association with PA and they did not significantly affect level 1 or 2 variance. As many children do not accrue sufficient levels of PA, identifying modifiable determinants is necessary to develop effective strategies to increase PA.

Purpose: To evaluate the uptake of ACT-i-Pass (G5AP), a physical activity (PA) intervention that provides free access to PA opportunities, and to understand the extent to which the intervention provides equitable access to children.Design: This study evaluates the differences in uptake (ie, enrollment) by comparing postal codes of registrants with the postal codes of all eligible children.Setting: Children were provided the opportunity to register for the G5AP during the 2014 to 2015 school year in London, Canada.Participants: The population of grade 5 students in London who registered for the G5AP (n = 1484) and did not register (n = 1589).Intervention: The G5AP offered grade 5 students free access to select PA facilities/programs during 2014 to 2015 school year.Measures: Measures included G5AP registration status, method of recruitment, distance between home and the nearest facility, and neighborhood socioeconomic status.Analysis: Getis-Ord Gi* and multilevel logistic regression were used to analyze these data.Results: There were significant differences in the uptake of the G5AP: residing in neighborhoods of high income (odds ratio [OR] = 1.062, P= .029) and high proportion of recent immigrants (OR = 1.036, P= .001) increased the likelihood of G5AP registration. Children who were recruited actively were significantly more likely to register for the G5AP (OR = 2.444, P< .001).Conclusion: To increase the uptake of a PA intervention, children need to be actively recruited. Interactive presentations provide children with increased access to information about both the program and its nuances that cannot be communicated as effectively through passive methods.

BackgroundIt is commonly believed that nature has positive impacts on children’s health, including physical, mental and social dimensions. This review focuses on how accessibility to, exposure to and engagement with nature affects the mental health of children and teenagers.MethodsTen academic databases were used to systematically search and identify primary research papers in English or French from 1990 to 1 March 2017. Papers were included for review based on their incorporation of nature, children and teenagers (0–18 years), quantitative results and focus on mental health.ResultsOf the 35 papers included in the review, the majority focused on emotional well-being and attention deficit disorder/hyperactivity disorder. Other outcome measures included overall mental health, self-esteem, stress, resilience, depression and health-related quality of life. About half of all reported findings revealed statistically significant positive relationships between nature and mental health outcomes and almost half reported no statistical significance.ConclusionsFindings support the contention that nature positively influences mental health; however, in most cases, additional research with more rigorous study designs and objective measures of both nature and mental health outcomes are needed to confirm statistically significant relationships. Existing evidence is limited by the cross-sectional nature of most papers.

ABSTRACTIn response to neoliberal policies and globalization pressures over the past three decades, urban governments in advanced economies have, with near-unanimity, adopted place branding as an approach to foster local economic growth. Framed as an outcome of multilevel neoliberal policymaking and local entrepreneurial governance, place branding has been adopted by urban places at all scales and geographic contexts with little regard for its efficacy. It is unclear, however, whether place branding represents a substantive approach, or is merely an emerging example of a neoliberal scripting. In many regards, the debate surrounding place branding is similar to the discourse on the Creative Class a decade ago. Consequently, uncertainty exists regarding whether place branding reflects practical and responsible urban governance or a superficial, fast policy with limited potential to foster local development. To date, little is known about how practitioners perceive place branding as a policy tool in the context of economic development. This study examines the perceptions of economic development practitioners regarding how place branding is being developed and implemented as a policy tool. The analysis is based on in-depth interviews with economic development practitioners (n = 25) from a wide range of municipalities in Ontario. Findings of this study indicate that while opportunity exists for place branding to represent in-depth and extensive local development policy, it is more generally an urban development script for creating a sense of place and fostering local economic development. Additionally, the majority of place branding policy represents superficial policy, emphasizing hegemonic approaches. Place branding can therefore be explained as an example of fast policy.

Sleep health inequities likely contribute to disparities in health outcomes. Our objective was to identify social determinants of sleep health among middle-aged/older adults in Canada, where prior evidence is limited.

OBJECTIVES:This study examines the influence of adolescents’ exposure to unhealthy food outlets on junk food purchasing during trips between home and school, with particular attention to how exposure and purchasing differ according to child’s biological sex, mode of transportation, and direction to or from school. METHODS:Between 2010 and 2013, students (n = 654) aged 9-13 years from 25 schools in London and Middlesex County, ON, completed a socio-demographic survey and an activity diary (to identify food purchases), and were observed via a global positioning system for 2 weeks (to track routes for trips to/from school). Spatial data on routes and purchase data were integrated with a validated food outlet database in a geographic information system, and exposure was measured as the minutes a child spent within 50 m of an unhealthy food outlet (i.e., fast food restaurants, variety stores). For trips involving junk food exposure (n = 4588), multilevel logistic regression was used to assess the relationship between exposure and purchasing. RESULTS:Multilevel analyses indicated that adolescents’ duration of exposure to unhealthy food outlets between home and school had a significant effect on the likelihood of junk food purchasing. This relationship remained significant when the data were stratified by sex (female/male), trip direction (to/from school) and travel mode (active/car), with the exception of adolescents who travelled by bus. CONCLUSION:Policies and programs that mitigate the concentration of unhealthy food outlets close to schools are critical for encouraging healthy eating behaviours among children and reducing diet-related health issues such as obesity. OBJECTIFS :Examiner l’influence de l’exposition des adolescents aux points de vente d’aliments malsains sur leurs achats d’aliments vides durant le trajet entre l’école et la maison, et en particulier à la façon dont l’exposition et les achats diffèrent selon le sexe biologique de l’enfant, le moyen de transport et le sens du trajet. MÉTHODE :Entre 2010 et 2013, des élèves (n= 654) de 9–13 ans fréquentant 25 écoles du comté de London-Middlesex, ON, ont rempli un questionnaire sociodémographique et un journal de leurs activités (pour repérer leurs achats d’aliments), et ont été observés pendant deux semaines par un système mondial de localisation (pour suivre leurs trajets entre l’école et la maison). Les données spatiales sur les itinéraires et les données d’achat ont été intégrées à une base de données validée de points de vente d’aliments dans un système d’information géographique; l’exposition a été mesurée selon le nombre de minutes qu’un enfant passait à moins de 50 m d’un point de vente d’aliments malsains (p. ex., restaurants rapides, magasins à prix uniques). Pour les trajets où les enfants étaient exposés à des aliments vides (n = 4588), nous avons procédé par régression logistique multiniveau pour évaluer la relation entre l’exposition et l’achat. RÉSULTATS :Les analyses multiniveaux ont montré que la durée d’exposition des adolescents aux points de vente d’aliments malsains sur le chemin de l’école avait un effet significatif sur leur probabilité d’achat d’aliments vides. Cette relation est demeurée significative lorsque les données ont été stratifiées selon le sexe (fille/garçon), le sens du trajet (vers l’école/vers la maison) et le moyen de transport (transport actif/automobile), sauf pour les adolescents se déplaçant en autobus. CONCLUSION :Les politiques et les programmes qui atténuent la concentration des points de vente d’aliments malsains près des écoles sont essentiels pour encourager les comportements alimentaires sains chez les enfants et pour réduire les problèmes de santé liés à l’alimentation, comme l’obésité.

Objective:Frequent fast-food consumption is a well-known risk factor for obesity. This study sought to determine whether the availability of fast-food restaurants has an influence on body mass index (BMI). METHODS:BMI and individual-level confounding variables were obtained from the 2007-08 Canadian Community Health Survey. Neighbourhood socio-demographic variables were acquired from the 2006 Canadian Census. The geographic locations of all restaurants in Canada were assembled from a validated business registry database. The density of fast-food, full-service and non-chain restaurants per 10,000 individuals was calculated for respondents’ forward sortation area. Multivariable regression analyses were conducted to analyze the association between restaurant density and BMI. RESULTS:Fast-food, full-service and non-chain restaurant density variables were statistically significantly associated with BMI. Fast-food density had a positive association whereas full-service and non-chain restaurant density had a negative association with BMI (additional 10 fast-food restaurants per capita corresponded to a weight increase of 1 kilogram; p<0.001). These associations were primarily found in Canada’s major urban jurisdictions. CONCLUSIONS:This research was the first to investigate the influence of fast-food and full-service restaurant density on BMI using individual-level data from a nationally representative Canadian survey. The finding of a positive association between fast-food restaurant density and BMI suggests that interventions aiming to restrict the availability of fast-food restaurants in local neighbourhoods may be a useful obesity prevention strategy. OBJECTIF:La consommation fréquente d’aliments de restauration rapide est un facteur de risque d’obésité bien connu. Nous avons cherché à déterminer si la présence de restaurants rapides a une influence sur l’indice de masse corporelle (IMC). MÉTHODE:L’IMC et les variables de confusion individuelles ont été puisés dans l’Enquête sur la santé dans les collectivités canadiennes de 2007-2008. Les variables sociodémographiques par quartier ont été obtenues dans le Recensement du Canada de 2006. Nous avons déterminé l’emplacement géographique de tous les restaurants au Canada à partir d’un registre des entreprises validé. Nous avons calculé la densité pout 10 000 habitants des restaurants rapides, plein service et n’appartenant pas à une chaîne, selon la région de tri d’acheminement des répondants. Nous avons effectué des analyses de régression multivariées pour étudier l’association entre la densité des restaurants et l’IMC. RÉSULTATS:Les variables de densité des restaurants rapides, plein service et n’appartenant pas à une chaîne présentaient une corrélation significative avec l’IMC. Pour la densité des restaurants rapides, cette association était positive, tandis que pour les restaurants plein service et n’appartenant pas à une chaîne, la densité était négativement associée à l’IMC (chaque tranche supplémentaire de 10 restaurants rapides par habitant correspondait à une hausse pondérale d’1 kilogramme; p<0,001). Ces associations étaient principalement observées dans les grands centres urbains du Canada. CONCLUSIONS:Notre étude est la première à analyser l’influence de la densité des restaurants rapides et plein service sur l’IMC à l’aide de données individuelles provenant d’une enquête nationale représentative menée au Canada. La découverte d’une association positive entre la densité des restaurants rapides et l’IMC donne à penser que les interventions visant à limiter la présence des restaurants rapides à l’échelle des quartiers pourraient être des stratégies utiles pour prévenir l’obésité.

The objective of this study was to describe the epidemiology of concussions presenting to the emergency department (ED).

This study was initiated was initiated to describe pediatric rear-occupant motor vehicle collision (MVC) injuries, including injury patterns and outcomes as well as characteristics associated with severe injury to the head and abdomen.

This study examines environmental factors associated with BMI (body mass index) levels among adolescents with the aim of identifying potential interventions for reducing childhood obesity. Students (n=1,048) aged 10–14 years at 28 schools in London, ON, completed a survey providing information on age, sex, height, weight, home address, etc., which was used to construct age-sex adjusted BMI z-scores. The presence of recreation opportunities, fast-food outlets and convenience stores was assessed using four areal units around each participant’s home and school neighbourhood: “circular buffers” encompassing territory within a straight-line distance of 500 m and 1000 m; and “network buffers” of 500 m and 1000 m measured along the street network. School neighbourhoods were also assessed using school-specific “walksheds”. Multilevel structural equation modeling techniques were employed to simultaneously test the effects of school-environment (Level 2) and home-environment (Level 1) predictors on BMI z-scores. Most participants (71%) had a normal BMI, 16.9% were overweight, 7.6% were obese, and 4.6% were considered underweight. Multilevel analyses indicated that built environment characteristics around children’s homes and schools had a modest but significant effect on their BMI. The presence of public recreation opportunities within a 500 m network distance of home was associated with lower BMI z-scores (p<0.05), and fast-food outlets within the school walkshed was associated with higher BMI z-scores (p<0.05). Interventions and policies that improve children’s access to publicly provided recreation opportunities near home and that mitigate the concentration of fast-food outlets close to schools may be key to promoting healthy lifestyles and reducing childhood obesity. Notre étude porte sur les facteurs environnementaux associés à l’IMC (indice de masse corporelle) d’adolescents en vue de cerner des interventions possibles pour réduire l’obésité infantile. Des élèves (n=1 048) de 10 à 14 ans fréquentant 28 écoles de London, en Ontario, ont rempli un questionnaire sur leur âge, leur sexe, leur taille, leur poids, leur adresse personnelle, etc., lequel a servi à construire des écarts Z ajustés selon l’âge et le sexe pour l’IMC. La présence de possibilités de loisir, d’établissements de restauration rapide et de dépanneurs a été évaluée à l’aide de quatre unités de surface autour du domicile et du quartier scolaire de chaque participant: des «zones tampons circulaires» englobant le territoire sur une distance entre 500 et 1000 m en ligne droite; et des «zones tampon de réseau» de 500 à 1000 m mesurées le long du réseau des rues. Les quartiers scolaires ont aussi été évalués à l’aide des «bassins de marche» propres à l’école. Une modélisation multiniveaux par équations structurelles a servi à évaluer simultanément les effets de prédicteurs des écarts Z de l’IMC liés à l’environnement scolaire (niveau 2) et au milieu de vie (niveau 1). La plupart des participants (71 %) avaient un IMC normal, 16,9 % étaient en surpoids, 7,6 % étaient obèses, et 4,6 % étaient considérés comme étant de poids insuffisant. Des analyses multiniveaux ont montré que les caractéristiques du milieu bâti autour du domicile et de l’école des enfants avaient un effet mineur mais significatif sur leur IMC. La présence d’installations de loisir publiques dans un réseau de 500 m du domicile était associée à des écarts Z d’IMC inférieurs (p<0,05), et la présence d’établissements de restauration rapide dans le bassin de marche de l’école était associée à des écarts Z d’IMC supérieurs (p<0,05). Les interventions et les politiques qui améliorent l’accès des enfants à des installations de loisir publiques près de chez eux et qui atténuent la concentration des établissements de restauration rapide près des écoles pourraient être la clé du succès pour promouvoir les modes de vie sains et réduire l’obésité infantile.

Inflicted traumatic brain injury associated with Shaken Baby Syndrome (SBS) is a leading cause of injury mortality and morbidity in infants. A triple-dose SBS prevention program was implemented with the aim to reduce the incidence of SBS. The objectives of this study were to describe the epidemiology of SBS, the triple-dose prevention program, and its evaluation.

Southwestern Ontario largely comprises rural farming districts and is home to numerous Old-Order Anabaptist settlements. Our objective was to describe the injuries sustained by rural children, both Old-Order Anabaptist and non-Anabaptist, to better target injury prevention programs.

This article maps and measures several dimensions of residential segregation in Montreal in 1881, thereby adding to our understanding of the social structure of the industrial city. Taking advantage of an unusual historical database—a historical geographic information system (H-GIS)—we locate 17,000 individual households with precision, and evaluate the "dissimilarity" of neighborhoods along several social dimensions and at various levels of spatial aggregation. The empirical findings suggest that Montreal was highly segregated along lines of ethnic identity as well as socioeconomic status; segregation values increased inversely with size of the spatial unit, but precision of unit boundaries have negligible effect. Coupling the highprecision GIS with a statistical model such as the classic index of dissimilarity lends new power to grasp the scale of phenomena, to inquire into behavioral choices of 19th-century households, and even to challenge our assumptions about the meaning of "segregation" or "integration."

Physical activity is a modifiable behaviour that can help curtail the increasing worldwide problem of childhood obesity. Appropriate recreational opportunities, including neighbourhood parks, are particularly important for promoting physical activity among children. Because children’s use of parks is mainly under the influence of their parents, understanding parents’ preferences is essential for creating the most inviting and usable park space to facilitate children’s physical activity. Eighty-two intercept interviews were conducted with a heterogeneous sample of parents/guardians watching their children at neighbourhood parks in London, Ontario. Parents/guardians were asked questions about how often they frequent the park, whether it is the closest to their residence, and their likes/dislikes for the park. Strategies to ensure trustworthiness of the data were employed. Interviewees attended their park of choice between 1–7 times per week with the average being 2.5 times per week. Only 49% of respondents frequented the park closest to their starting destination (home or daycare facility), and the majority travelled more than 4 km to get to the park. For those who chose to travel a significant distance to attend their park of choice, park location was not as important as the amenities they desired. Parents’ main reasons for choosing parks were: water attractions, shade, swings, and cleanliness. The current study provides useful insights on park use with potentially important implications for increasing physical activity among children. Incorporating parents’ preferences into strategies for creating or modifying city parks will help to ensure that limited public resources are being targeted most effectively in support of children’s physical activity. L’activité physique est un comportement modifiable qui pourrait mettre un frein au problème mondial de l’obésité de l’enfance. Des installations de loisirs appropriées, y compris des parcs de quartier, sont particulièrement importantes pour promouvoir l’activité physique chez les enfants. Comme ce sont surtout les parents qui déterminent la fréquentation des parcs par les enfants, il est essentiel de comprendre les préférences des parents afin de créer les parcs les plus invitants et les plus accueillants possibles et faciliter ainsi l’activité physique des enfants. Quatre-vingt deux entretiens sur place ont été menés auprès d’un échantillon hétérogène de parents et autres responsables qui surveillaient leurs enfants dans des parcs de quartier de London, en Ontario. Les parents et responsables ont répondu à des questions sur la fréquence de leurs visites au parc, la distance entre le parc et leur domicile, et ce qu’ils aimaient ou n’aiment pas dans le parc. Nous avons ensuite appliqué des méthodes de vérification de la fiabilité des données. Les répondants fréquentaient leur parc préféré entre 1 et 7 fois par semaine; la moyenne était de 2,5 fois par semaine. Seulement 49 % des répondants fréquentaient le parc le plus proche de leur point de départ (domicile ou garderie); la majorité faisaient un trajet de plus de 4 km pour s’y rendre. Pour ceux et celles qui faisaient un long trajet, l’emplacement du parc était moins important que la présence de certains équipements. Les principales raisons pour lesquelles les parents choisissaient certains parcs étaient: les jeux d’eau, l’ombre, les balançoires et la propreté des lieux. Cette étude donne des aperçus précieux sur la fréquentation des parcs qui pourraient avoir des conséquences importantes pour l’augmentation de l’activité physique des enfants. En tenant compte des préférences des parents dans les stratégies de création ou de réaménagement des parcs locaux, on peut affecter les ressources publiques limitées en maximisant leur impact sur l’activité physique des enfants.

Background: Gambling is a risky behaviour that involves uncertain financial outcomes, can be addictive, and has been associated with strongly adverse social and public health outcomes. We wanted to assess whether socio-economic and gambling-related-opportunity environments of neighbourhoods affected the uptake of video lottery terminal (VLT) gambling among Montréal youth. Methods: Spatial and statistical analyses were conducted to examine geographical patterns of neighbourhood socio-economic conditions, VLT sites (n=407), and high school locations (n=305) within the Montréal Census Metropolitan Area (CMA). VLT concentration within high school neighbourhoods was measured to examine how the number of VLT opportunities varies according to socio-economic status of the school neighbourhood. A student survey was analyzed using logistic regression analysis to explore the role of individual (student) characteristics and environmental (neighbourhood) characteristics in predicting the VLT gambling behaviours reported among a sample (n=1206) of high school students. Results: Video lottery gambling opportunities are more prevalent near schools located in socio-economically deprived neighbourhoods compared with schools located in more affluent neighbourhoods. The principal individual risk factors for VLT gambling were shown to be male sex, peer VLT-use, substance use, as well as the after-school routines of youth. Interpretation: The spatial distribution of VLTs reflects local geographies of socio-economic disadvantage and may have a pronounced impact on students attending schools in lower income neighbourhoods, especially those with individual risk factors. Efforts to reduce gambling-related public health costs may want to take into account the socio-spatial distribution of gambling opportunities, particularly in the local environments that youth frequent. Contexte: Le jeu est un comportement très risqué dont les résultats financiers sont incertains, qui peut être accrocheur et qu’on a associé avec des résultats fortement indésirables pour la santé sociale et publique. Nous voulions déterminer si le contexte socioéconomique et l’environnement qui offre des possibilités reliées aux jeux de hasard dans les quartiers avaient un effet sur l’utilisation des appareils de loterie vidéo (ALV) chez les adolescents de Montréal. Méthodologie: Nous avons procédé à des analyses spatiales et statistiques pour déterminer les tendances géographiques de la conjoncture socioéconomique des quartiers, les sites d’ALV (n=407) et l’emplacement des écoles secondaires (n=305) dans la région métropolitaine de recensement (RMR) de Montréal. Nous avons mesuré la concentration d’ALV dans les quartiers des écoles secondaires afin de déterminer comment le nombre de possibilités offertes par les ALV varie en fonction de la situation socioéconomique du quartier où se trouve l’école. Nous avons analysé les résultats d’un sondage mené auprès des élèves en procédant à une analyse de régression logistique afin d’étudier le rôle des caractéristiques individuelles (étudiant) et environnementales dans la prédiction des comportements de jeu aux ALV déclarés dans un échantillon (n=1 206) d’élèves du secondaire. Résultats: Les possibilités de jeu par appareils de loterie vidéo sont plus prévalentes à proximité des écoles situées dans des quartiers démunis sur le plan socioéconomique comparativement à celles qui se trouvent dans des quartiers plus riches. On a démontré que les principaux facteurs de risque individuels de jeu aux ALV étaient le sexe masculin, l’utilisation d’ALV par des pairs, la consommation de substances, ainsi que les habitudes des adolescents après les heures de cours. Interprétation: La répartition spatiale des ALV reflète les caractéristiques géographiques locales du désavantage socioéconomique et peuvent avoir un effet prononcé sur les élèves qui fréquentent des écoles de quartiers à revenu plus faible, et en particulier sur ceux qui présentent des facteurs de risque individuels. Les efforts visant à réduire les coûts de la santé publique reliés aux jeux de hasard peuvent tenir compte de la répartition sociospatiale des possibilités de jeu de hasard, et en particulier de l’environnement local fréquenté par les adolescents.

In the province of Québec, video lottery terminal (VLT) gambling has proliferated under government control since 1993. The aims of this study were to describe the spatial distribution of video lottery terminals (VLTs) in the municipalities of Montréal and Laval and to identify neighbourhood socio-economic conditions associated with their distribution. Locations of all establishments holding VLT licences in Montréal and Laval (n=834) were geocoded by their street address. Boroughs (n=49) were characterized by socio-economic indicators (unemployment, educational attainment, lone parenthood), a neighbourhood distress index, and measures of VLT prevalence, VLT adoption and VLT density. VLT prevalence, adoption and density were strongly correlated (p<0.01) with lower borough socio-economic conditions. Although liquor establishments were also more likely to be located in poorer neighbourhoods, the adoption rate of VLT licences by bars in poorer neighbourhoods was systematically higher than in more affluent ones. The spatial distribution of VLTs in Montréal and Laval closely reflects local geographies of socio-economic disadvantage. Any public health effort to reduce the burden of gambling-related health and social problems must recognize the spatial distortion of gambling opportunities in the urban environment. Au Québec, les appareils de loterie vidéo (ALV) prolifèrent sous le contrôle de l’état depuis 1993. Notre étude décrit la répartition spatiale de ces appareils dans les municipalités de Montréal et de Laval et les conditions socio-économiques dans les quartiers où trouve les ALV. Les emplacements de tous les établissements titulaires de licences d’ALV à Montréal et à Laval (n = 834) ont été codés selon leur adresse de voirie. Les bourgs (n = 49) ont été caractérisés selon des indicateurs socio-économiques (chômage, niveau d’instruction, monoparentalité), l’indice de détresse du quartier et des mesures de la prévalence, de l’adoption et de la densité des ALV. La prévalence, l’adoption et la densité des ALV présentaient une forte corrélation (p<0,01) avec les bourgs où les conditions socio-économiques étaient inférieures. Les débits de boissons étaient aussi plus susceptibles de se trouver dans les quartiers pauvres, mais néanmoins, le taux d’adoption des licences d’ALV dans les bars des quartiers pauvres était systématiquement plus élevé que dans les quartiers mieux nantis. La répartition spatiale des ALV à Montréal et à Laval correspond étroitement à la géographie locale des milieux socio-économiques défavorisés. Tout effort déployé par les autorités de santé publique pour réduire le fardeau des problèmes sanitaires et sociaux liés au jeu devrait donc tenir compte de la distorsion spatiale des possibilités de jeu en milieu urbain.

In recent years, many jurisdictions have legalized medicinal and/or recreational cannabis. Yet, limited information is available on the effects of cannabis commercialization (provision of legal supply of cannabis to adults through licensed retail outlets) on adverse outcomes, such as traffic fatalities. The purpose of this study was to systematically review the literature on the effects of cannabis retail outlets on traffic collisions, fatalities and other traffic-related outcomes.

Trends over the last half century have shown that fewer children today are engaging in active modes of travel to and from school than in previous generations. Interventions promoting active school travel (AST) can be effective at reversing these trends and increasing rates of AST among children. This paper aims to explore (1) how studies of AST interventions have considered or framed multiple equity factors, namely those related to gender, socioeconomic status (SES), and ethnic background, in the design and evaluation of AST interventions, and (2) to what extent studies of AST interventions report these equity considerations in their analyses, outcomes, programming, and discussions.