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Purpose The purpose of the study was to explore Hispanic adults’ experiences participating in the Building a Healthy Temple diabetes self-management education and support (DSMES) cluster randomized trial and collect their insights on intervention approach, delivery, content, impact, and suggested improvements for future DSMES programs delivered at church.Methods Focus groups were conducted with participants from both intervention arms, that is, faith-based (FB) group and faith-placed group. Participating churches were predominantly Hispanic and located in San Antonio, Texas. Focus groups were audiotaped and transcribed verbatim. Inductive content analysis was performed with the assistance of NVivo software to code and categorize emerging themes.Results A total of 138 adult participants took part in the current study. Participants in both groups highly valued the church setting for its convenient location and support system and reported positive changes in diabetes-related beliefs, knowledge, skills, behaviors, and health outcomes. FB participants appreciated the incorporation of spiritual teachings and facilitation by lay leaders, which created a sense of empowerment and improved outlook on living with diabetes.Conclusions Church holds promise as a setting for DSMES program delivery in Hispanic communities. Church-based DSMES programs using a FB approach may further facilitate program adoption and sustainability.

AbstractThis study assessed possible dietary supplement–medication interactions of 62 older adults recruited from 8 senior congregate sites in Bexar County, Texas. Dietary supplement and medication use were collected by paper questionnaire and potential supplement–medication interactions were assessed using online databases. The majority of participants reported dietary supplements (77%), non-prescription medication (50%), and prescription medication (73%) use. Fifty percent of participants who reported dietary supplement and medication use were at-risk for a potential supplement–medication interaction, ranging from one to eight potential interactions. Calcium and multivitamin-mineral supplements were the most common dietary supplements with potential medication interactions. Surveyed older adults reported dietary supplements should be reported to a physician (97%), but over 20% believe herbal products are pure (38%) and dietary supplements are risk free (34%) and will not cause harm (22%). In conclusion, regular education and screening of dietary supplement and medication use among older adults is recommended.

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.

Background:Obesity prevention research is sparse in young children at risk for obesity. This study tested the effectiveness of a culturally tailored, multicomponent prevention intervention to promote healthy weight gain and gross motor development in lowincome preschool age children.Methods:Study participants were predominantly Mexican-American children (n 423; mean age 4.1; 62% in normal weight range) enrolled in Head Start. The study was conducted using a quasi-experimental pretest/posttest design with two treatment groups and a comparison group. A center-based intervention included an age-appropriate gross motor program with structured outdoor play, supplemental classroom activities, and staff development. A combined center- and home-based intervention added peer-led parent education to create a broad supportive environment in the center and at home. Primary outcomes were weight-based z-scores and raw scores of gross motor skills of the Learning Achievement Profile Version 3.Results:Favorable changes occurred in z-scores for weight (one-tailed p< 0.04) for age and gender among children in the combined center- and home-based intervention compared to comparison children at posttest. Higher gains of gross motor skills were found in children in the combined center- and home-based (p< 0.001) and the center-based intervention (p< 0.01). Children in both intervention groups showed increases in outdoor physical activity and consumption of healthy food. Process evaluation data showed high levels of protocol implementation fidelity and program participation of children, Head Start staff, and parents.Conclusion:The study demonstrated great promise in creating a health-conducive environment that positively impacts weight and gross motor skill development in children at risk for obesity. Program efficacy should be tested in a randomized trial.

Obesity and overweight in children are an escalating problem in Canada and worldwide. Currently, little is known about the manner in which primary health care providers are responding to Canada's obesity epidemic.

Purpose. To explore the factors that contribute to children's screen-related sedentary (S-RS) behaviors.Settings. Elementary schools.Subjects. A random sample of children in grades five and six and their parents.Measures. The outcome measure was children's S-RS activity level measured by a self-administered questionnaire. A full spectrum of potential contributing factors for children's S-RS behaviors was obtained through surveys. Multilevel linear regression methods were used to determine the associations between these factors and children's screen time (hours per day) and results were expressed as regression coefficients (g).Results. Of 955 child-parent pairs in 14 participating schools, 508 pairs (53%) completed the surveys. At an intrapersonal level, protective factors included being a girl (g = − .71); belonging to a sports team inside (g = −.56) or outside (g = −.49) of school; having a negative attitude toward S-RS activities (g = −.13); and having a positive attitude toward physical activity (g = −.48). At the interpersonal and social levels, parental leisure S-RS behaviors (g = .32) were positively associated, whereas strict parental rules on computer use (g = −.27) and family income (g = −.32) were inversely correlated with S-RS behavior. At the environmental level, the presence of TVs in children's bedrooms (g = .44) and owning videogame devices (g = .58) increased the risk of S-RS behaviors, whereas after school programs (g = −.86) and schools' participation in the Turn Off the Screen Week campaign (g = −.91) decreased the risk.Conclusions. Public health interventions should target multilevel factors, including increasing children's awareness, promoting parental involvement in healthy lifestyle pursuits, and creating less screenogenic environments.

The purpose of this study was to provide some preliminary description of the Latin-Canadian community by reporting the socioeconomic status, physical activity, and weight status (i.e., healthy weight, overweight, or obese status) of Colombians newly immigrated to London, Ontario Canada. Face-to-face interviews were conducted on a convenience sample of 77 adult Colombian immigrant food bank users (46.8% men; mean age 39.9 yr., SD= 11.8). Physical activity was gauged using the International Physical Activity Questionnaire and self-report Body Mass Index, and sociodemographic data were collected. Of respondents, 47% had a university education, and 97% received social support. 61% met recommended levels of physical activity. Men were more active, being involved in about 130 min. more of exercise per week, and more men were overweight than women (63.9% versus 39.0%, respectively). Of respondents, 73% reported being less active than before coming to Canada. This pilot study indicates that Latin-Canadian immigrants are a vulnerable group in need of acculturational support. Further study is warranted.

Concerns about adequate food supply is a mounting problem in Canada, making food bank visits a necessity for over 820,000 Canadians.1Given this reliance, the purpose of this study was to compare contents of food hampers with Canadian guidelines, at a large urban food bank in Southwestern Ontario that intends to provide 3 days worth of food per person. Thirty hampers of each available size (for 1–6 people) were sampled (N = 180). Food items were recorded and analyzed for caloric value, food group, and macro- and micro-nutrient values. Results were compared to Dietary Reference Intakes (DRI) and Canada’s Food Guide to Healthy Eating. 99% of hampers did not provide 3 days worth of nutrients. Grains and cereals met the lower range of Canada’s Food Guide recommendations, and fruits and vegetables, meats and alternatives, and dairy products were below recommended levels, as were numerous vitamins and minerals, including vitamins A, D, B12, C, riboflavin, niacin, calcium, magnesium and zinc. Carbohydrates were slightly above recommended DRI, and energy from fat and protein scarcely met the minimums recommended. Hampers contained 1.6 days worth of energy per person. The energy available per person was below recommendations for most Canadians. Nutrients missing from the hampers can come from fresh fruits, vegetables, dairy products, and meats and alternatives. However, many low-income families have limited finances to purchase these foods which are relatively more expensive than processed foods. Encouraging more perishable food donations and storage facilities to maximize the nutritional intake for clients is imperative. Les problèmes de disponibilité alimentaire sont de plus en plus préoccupants au Canada, et la fréquentation des banques d’alimentation est devenue une nécessité pour plus de 820 000 Canadiens1. Comme ces banques jouent un rôle essentiel, nous avons voulu comparer aux directives canadiennes le contenu des paniers alimentaires distribués dans une grande banque d’alimentation d’une ville du sud-ouest de l’Ontario, censés nourrir une personne pendant trois jours. Nous avons étudié un échantillon de 30 paniers de chaque taille disponible (pour 1 à 6 personnes) (n=180). Les articles alimentaires ont été notés, et nous en avons analysé le nombre de calories, le groupe d’aliments et la valeur en macro- et en micronutriments. Les résultats ont été comparés aux Apports nutritionnels de référence (ANREF) et au Guide alimentaire canadien pour manger sainement. 99 % des paniers ne contenaient pas l’équivalent de trois jours d’éléments nutritifs. Les produits céréaliers correspondaient au nombre minimum de portions recommandées dans le Guide alimentaire canadien, et les légumes et fruits, les viandes et substituts et les produits laitiers étaient en deçà des niveaux recommandés, tout comme bon nombre de vitamines et de minéraux, dont les vitamines A, D, B12 et C, la riboflavine, la niacine, le calcium, le magnésium et le zinc. Les glucides étaient légèrement au-dessus des ANREF recommandés, et les apports énergétiques provenant des matières grasses et des protéines atteignaient à peine les minimums recommandés. Les paniers contenaient un apport énergétique de 1,6 jour par personne. L’apport énergétique disponible par personne était inférieur aux recommandations qui valent pour la plupart des Canadiens. Les nutriments manquants dans les paniers se trouvent dans les fruits frais, les légumes, les produits laitiers et les viandes et substituts. Cependant, beaucoup de familles à faible revenu n’ont pas les moyens d’acheter ces aliments, qui sont relativement plus chers que les aliments transformés. Il faut absolument encourager davantage les dons d’aliments périssables et les installations de stockage connexes, afin de maximiser les apports nutritionnels des clients des banques alimentaires.

To understand parents’ perspectives of their preschoolers’ physical activity behaviours. A maximum variation sample of 71 parents explored their preschoolers’ physical activity behaviours through 10 semi-structured focus group discussions. Parents perceived Canada’s Physical Activity Guidelines for Children as inadequate; that their preschoolers get and need more than 30–90 minutes of activity daily; and that physical activity habits must be established during the preschool years. Nine barriers against and facilitators toward adequate physical activity were proposed: child’s age, weather, daycare, siblings, finances, time, society and safety, parents’ impact, and child’s activity preferences. The need for education and interventions that address current barriers are essential for establishing physical activity as a lifestyle behaviour during early childhood and, consequently, helping to prevent both childhood and adulthood obesity. Comprendre le point de vue des parents sur les habitudes d’activité physique de leurs enfants d’âge préscolaire. Soixante-et-onze parents composant un échantillon le plus variable possible ont analysé les habitudes d’activité physique de leurs enfants d’âge préscolaire au sein de 10 groupes d’entretien en profondeur semi-structurés. Selon les parents, le Guide d’activité physique canadien pour les jeunes et les enfants est insuffisant. Les parents ont par ailleurs indiqué que leurs enfants d’âge préscolaire faisaient plus de 30 à 90 minutes d’activité par jour, qu’ils avaient besoin de ce niveau d’activité, et que c’est à l’âge préscolaire que s’acquièrent les bonnes habitudes d’activité physique. Ils ont cerné neuf facteurs qui facilitent ou font obstacle à une activité physique adéquate: l’âge de l’enfant, les conditions météorologiques, la garderie, les frères et sours, les moyens financiers, le temps, la sécurité du milieu de vie, l’influence des parents et les activités préférées de l’enfant. La sensibilisation et les interventions qui tiennent compte des obstacles courants sont deux éléments indispensables à l’acquisition de bonnes habitudes d’activité physique dès la petite enfance. Ces deux éléments peuvent donc aussi aider à prévenir l’obésité, depuis l’enfance jusqu’à l’âge adulte.

Childhood obesity is a public health concern in Canada. Few anthropometrical data are available to monitor the obesity trend in young Canadian children. This study explored the feasibility of using routine growth monitoring data from physicians’ offices for tracking the prevalence of obesity in children from two to six years of age in County of Middlesex and the City of London, Ontario. Data on body weight and height were retrieved from the growth chart at each immunization visit and routine checkup in five medical centres in the Middlesex-London area. Postal code data were also collected as a proxy measure for socio-economic status. The BMI-for-age references by the Centers for Disease Control and Prevention (CDC) of the United States were used to classify the weight status of the children. In total, 1,370 growth charts of children from two to six years of age were reviewed. Approximately 30% of young children were either at risk of being overweight or were overweight, with an onset as early as age two. Overweight is prevalent in young children. Data from routine growth monitoring in primary health care settings have great potential to be used as a population-based data source to track the prevalence of obesity in young children. L’obésité de l’enfance est un problème de santé publique au Canada, mais on a peu de données anthropométriques pour en surveiller la progression chez les jeunes enfants. Nous avons cherché à déterminer s’il était possible d’utiliser les données de surveillance de la croissance couramment recueillies dans les cabinets de médecins pour suivre la prévalence de l’obésité chez les enfants de deux à six ans du comté de Middlesex et de la ville de London, en Ontario. Nos données sur le poids et la taille des enfants provenaient de leur fiche de croissance à chaque vaccination et à chaque examen médical complet dans cinq centres médicaux de la région de Middlesex-London. Nous avons aussi recueilli des données sur le code postal comme variables substitutives pour mesurer le statut socio-économique. Les données de référence concernant l’indice de masse corporelle selon l’âge, élaborées par les Centers for Disease Control and Prevention (CDC) des États-Unis, ont servi à classer le statut pondéral des enfants. Nous avons examiné en tout 1 370 fiches de croissance d’enfants de deux à six ans. Environ 30 % des jeunes enfants étaient à risque de surcharge pondérale ou satisfaisaient déjà au critère de surcharge pondérale, parfois dès l’âge de deux ans. L’embonpoint est courant chez les jeunes enfants. Les données extraites de la surveillance régulière de la croissance en milieu de soins de santé primaires pourraient être des outils représentatifs très intéressants pour suivre la prévalence de l’obésité chez les jeunes enfants.

For Abstract see ChemInform Abstract in Full Text.