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IntroductionThis qualitative study investigates children’s perceptions of the influences of a Centrally Procured School Food Program on their dietary behaviours and their recommendations on how to improve the program. MethodsThe observations of 208 students aged 9 to 14 years (Grades 5¬–8) at 21 elementary schools were collected through focus groups in 2017/18. The larger intervention consisted of a 10-week program offering daily snacks (i.e. fruit, vegetables, whole grains, dairy, meat alternatives) for elementary school children in southwestern Ontario, Canada. ResultsThe participants’ overall impressions of the program were positive. They noted reduced hunger, increased energy and improved nutrition. Many children felt that the program changed their dietary patterns at home as well as at school, particularly in terms of eating more fruit and vegetables. The snack program also enabled children to try healthy foods. ConclusionMost participants considered the program to be beneficial in promoting healthy eating. Participants recommended adding educational activities, expanding the variety of foods and increasing child involvement in selecting and preparing foods.

IntroductionCette étude qualitative s’intéresse à la perception qu’ont les enfants de l’influence d’un programme d’alimentation scolaire à approvisionnement centralisé sur leurs comportements alimentaires et à leurs recommandations sur la manière d’améliorer le programme. MéthodologieLes observations de 208 élèves de 9 à 14 ans (de la 5e à la 8e année) provenant de 21 écoles primaires ont été recueillies au moyen de groupes de discussion en 2017 et 2018. L’intervention la plus importante a consisté en un programme de dix semaines proposant des collations quotidiennes (fruits, légumes, aliments à grains entiers, produits laitiers, substituts de viande) à des élèves d’écoles primaires du Sud-Ouest de l’Ontario (Canada). RésultatsDans l’ensemble, les participants ont eu une perception positive du programme. Ils ont constaté un apaisement de leur faim, une augmentation de leur niveau d’énergie et une amélioration de leur alimentation. De nombreux enfants ont estimé que le programme avait modifié leurs habitudes alimentaires à la maison et pas simplement à l’école, car il les avait notamment amenés à accroître leur consommation de fruits et de légumes. De plus, le programme de collations a permis aux enfants d’essayer des aliments sains. ConclusionLa plupart des participants ont estimé que le programme s’avérait bénéfique pour favoriser une alimentation saine. Les participants ont recommandé d’ajouter des activités éducatives, de diversifier les aliments offerts et d’accroître la participation des enfants à la sélection et à la préparation des aliments.

Objective: To determine the prevalence of university students who have ever engaged in self-harm and to examine its correlates. Frequency of thinking about self-harm was explored as a secondary outcome. Participants: Students at Western University in London, Ontario, Canada. Methods: This cross-sectional study was completed via an online questionnaire. Logistic regressions assessed the influence of sociodemographic and behavioral factors associated with lifetime self-harm and thoughts about self-harm. Results: The sample consisted of 2626 university students. Almost 25% engaged in self-harm in their lifetime and close to 33% have thought about harming themselves. A non-straight sexual orientation, marijuana use, prescription drugs not prescribed, and mental health problems increased the risk of both outcomes. Females were over two times more likely to engage in self-harm than males. Conclusion: This study provides evidence that is needed for developing effective interventions to reduce the risk of self-harm by targeting university students who are most at-risk.

The COVID-19 pandemic and associated public health measures have interrupted the daily routines of parents and children. The purpose of this study was to explore parents' attitudes regarding their children's play/sport during COVID-19. A secondary objective was to explore the influence of parent demographics and parent-reported physical activity levels and risk tolerance on these attitudes. Ontario parents of children aged 12 and younger completed an online survey (August-December 2020) that assessed their attitudes (grouped by support, safety and socialization-related attitudes; n = 14 items) regarding their child(ren)'s play/sport, their physical activity levels (n = 2 items), and demographic details (n = 16 items). Two open-ended items were used to gather a deeper understanding of attitudes. Parents' tolerance for risk was measured via the validated Tolerance of Risk in Play Scale. Descriptive statistics were calculated to describe attitudes and risk tolerance. Least Absolute Shrinkage and Selection Operator regressions were conducted to examine factors influencing parents' attitudes. Multiple linear models were computed using the identified predictors for each attitude category. Deductive content analysis was undertaken on open-ended responses. Participants (n = 819) reported the highest scores for safety-related attitude items (M = 3.54, SD = 0.63) followed by socialization and support, which all influenced attitudes regarding children's play/sport (p < 0.05). Demographics and parents' physical activity levels were identified as important predictors of parents' attitudes. Qualitative data revealed that parents had mixed levels of comfort with respect to their children's return to play/sport. Findings from this study reveal that increased support is needed to guide future play/sport decision-making.

Background: COVID-19 caused closures of movement supporting environments such as gyms and schools in Canada. This study evaluated the association between Ontario parents' and children's physical activity levels across time during COVID-19, controlling for variables that were identified as significant predictors of children's and parents' physical activity (e.g., children's age, parents' employment status). Methods: Parents (n = 243; mean age = 38.8 y) of children aged 12 and under (n = 408; mean age = 6.3 y) living in Ontario, Canada completed 2 online surveys, the first between August and December 2020 and the second between August and December 2021. At baseline, parents were asked to recall prepandemic physical activity levels. To determine the association between parent and child physical activity during COVID-19, a cross-lagged model was estimated to determine the cross-sectional and longitudinal associations between parents' and children's physical activity across time. Results: Bivariate associations revealed that parents' and children's physical activity levels were significantly related during lockdown and postlockdown but not prelockdown. The autoregressive paths from prelockdown to during lockdown were significant for children (β = 0.53, P <.001) and parents (β = 1.058, P <.001) as were the autoregressive paths from during lockdown to postlockdown for children (β = 0.61, P <.001) and parents (β = 0.48, P <.001). In fully adjusted models, the cross-lagged association between parents' physical activity prelockdowns was significantly positively associated with their children's physical activity during lockdowns (β = 0.19, P =.013). Conclusions: Resources are needed to ensure that children and parents are obtaining sufficient levels of physical activity, particularly during a pandemic. [ABSTRACT FROM AUTHOR]

Background: Children's physical inactivity is a persisting international public health concern. While there is a large body of literature examining physical activity interventions for children, the unique physical activity context of low-density communities in rural areas and smaller urban centres remains largely underexplored. With an influx of families migrating to rural communities and small towns, evaluations of health promotion efforts that support physical activity are needed to ensure they are meeting the needs of the growing populations in these settings. The aim of this community-based research was to explore service providers' and parents' perspectives on physical activity opportunities available in their community and recommendations toward the development and implementation of efficacious physical activity programming for children in rural communities and smaller urban centres. Methods: Three in-person community forums with recreation service providers (n = 37 participants) and 1 online community forum with the parents of school-aged children (n = 9 participants) were hosted. An online survey and Mentimeter activity were conducted prior to the community forums to gather participants' views on the barriers and facilitators to physical activities and suggestions for activity-promoting programs. The service provider and parent discussions were audio-recorded, transcribed verbatim, and analyzed following a deductive approach guided by Hseih and Shannon's (2005) procedure for direct content analysis. A code list developed from the responses to the pre-forum survey and Mentimeter activity was used to guide the analysis and category development. Results: Seven distinct categories related to the existing physical activity opportunities and recommendations for programs in rural communities and smaller urban centres were identified during the analysis: (1) Recovery from Pandemic-Related Measures, (2) Knowledge and Access to Programs, (3) Availability, (4) Personnel Support, (5) Quality of Programs and Facilities, (6) Expenses and Subsidies, and (7) Inclusivity and Preferences. Conclusion: To improve the health and well-being of children who reside in low-density areas, the results of this study highlight service provider and parent recommendations when developing and implementing community-based physical activity programs and interventions in rural and smaller urban settings, including skill development programs, non-competitive activity options, maximizing existing spaces for activities, and financial support. [ABSTRACT FROM AUTHOR]

Food retail businesses experienced a pronounced increase in sales when food hospitality outlets closed in the early stages of the COVID-19 pandemic in Canada. This study investigates how pandemic-related modifications to food retail businesses in Ontario, Canada affected the well-being of workers. Semi-structured interviews were conducted with 17 food retail employees between June 2020 and May 2021 as part of the Food Retail Environment Study for Health and Economic Resiliency (FRESHER). Transcripts were analyzed inductively, and themes were refined using the Effort Reward Imbalance Model. Themes were connected to the main components of this model: extrinsic effort, intrinsic effort, money, esteem, status control, and burnout. Results indicate that, for food retail employees, the presence of an imbalance between efforts and rewards threatens well-being via symptoms of burnout. Further study is needed to examine how this inequality and burnout among this population might be measured and addressed. [ABSTRACT FROM AUTHOR]

Background: Reports of children's engagement in active transportation outline low participation rates in many countries despite many associated mental, physical, and social health benefits. One of the main contributors to this phenomenon is a cited lack of education and knowledge among children regarding active travel (AT), specifically road safety. To address this issue, the aim of this study was to evaluate the feasibility and effectiveness of an online road safety education intervention to promote AT among children and their parents. Methods: Applying the Multiphase Optimization Strategy (MOST) for intervention development, implementation, and evaluation, we designed and assessed a four-module online road safety education intervention with a sample of 57 parent-child dyads using a 23 factorial design featuring both qualitative and quantitative analyses. Results: Main intervention feasibility findings include positive and critical feedback on the program's content and design, and moderate participant engagement as reflected by program retention and completion rates. With respect to the preliminary intervention effectiveness on children, a significant improvement in road safety knowledge scores was observed for groups that feature the "wheeling safety and skills" module. Slight improvements in AT knowledge scores across all the intervention groups were observed, but were not of significance. Preliminary intervention effectiveness on select parental AT practices and perceptions saw significant improvements in some groups. Groups that featured the 'wheeling safety and skills' module exhibited significantly higher guided choice scores upon completion of the program than those who did not receive this component. Conclusion: The MOST framework allowed us to design and evaluate the feasibility and preliminary effectiveness of an online road safety education intervention. The developed intervention has demonstrated that it has the potential to improve children's road safety knowledge and some areas of parental AT practices and perceptions, to which improvements may be attributed to the inclusion of the "wheeling safety and skills" module, suggesting that the targeted focus on cycling skills is a prioritized area. AT programming and practice implications are discussed. Future research is encouraged to refine modules to better reflect the priorities of children and parents and to test these refined components among larger samples. Word count: 9,391 (excludes abstract, tables, figures, abbreviations, and references). [ABSTRACT FROM AUTHOR]

Background: Some Canadian schools have modified their daily schedules from the traditional school day (TSD) schedule (two 15-minute breaks and one 60-minute break) to a balanced school day (BSD) schedule (two 40-minute breaks). While this change increases daily planning and instructional time, it also changes the amount of time available for moderate-vigorous physical activity (MVPA). Methods: This study uses a case-control design to examine differences in objectively measured MVPA between children in 3 schools using a BSD schedule and 3 schools using a TSD schedule. Study participants (aged 10-12 years) were recruited from schools in Ontario, Canada. Results: Regardless of schedule type, girls had lower MVPA than boys, and as both boys and girls got older their MVPA significantly decreased. The findings indicate there was no statistically significant difference in the total minutes of in-school MVPA between children from BSD schools and children from TSD schools. MVPA was significantly higher for older girls attending BSD schools than older girls attending TSD schools, suggesting that implementing a BSD may help curb declining MVPA as girls enter adolescence. Conclusion: Despite encouraging findings, more rigorous studies (ie, pre-post experiments with control) are needed to better understand how changing schedules impacts children's health.

Transportation research has shown that socio‐demographic factors impact people's mobility patterns. During the COVID‐19 pandemic, some of these effects have changed in accordance with changing mobility needs adapting to the pandemic, including restrictions on in‐person gatherings, closure of in‐person businesses, and working from home. We investigate two gaps in current knowledge in this area of transportation research: to what extent the associations between socio‐demographic factors and mobility metrics have changed, and how these associations vary across geographic space. We used aggregate deidentified cell tower location data to measure two mobility metrics—movement time and radius of gyration—and socio‐demographic data from the 2016 Canadian Census to model these associations across Ontario, Canada in 2020 using a linear model and a geographically weighted regression model. We find that certain associations between socio‐demographics and mobility have changed from what we previously observed before the pandemic, and we can see the variation of these associations across space. These findings will improve our understanding of how socio‐demographic factors affect mobility patterns in different communities and demonstrate the importance of measuring these associations at a more fine‐grained level using models that consider spatial variation to best reflect the nature of these associations. Key messages: Geographically weighted regression was used to study associations between mobility and five socio‐demographic factors in Ontario, Canada during the COVID‐19 pandemic.All five variables exhibited positive and negative associations with mobility change for at least one period of analysis, highlighting the complexity of these relationships.Our results provide new information on the geographical relationships between mobility change during COVID‐19 and neighbourhood‐level socio‐demographic variables. [ABSTRACT FROM AUTHOR]

Context Adolescence is a critical stage for improving nutrition. The popularity of smartphones makes them an ideal platform for administering interventions to adolescents. A systematic review has yet to assess the impact of smartphone app–based interventions exclusively on adolescents' dietary intake. Furthermore, despite the impact of equity factors on dietary intake and the claim for mobile health of increased accessibility, there is minimal research on the reporting of equity factors in the evaluation of smartphone app–based nutrition-intervention research. Objectives This systematic review examines the effectiveness of smartphone app–based interventions on adolescents' dietary intake and the frequency with which equity factors and statistical analyses specific to equity factors are reported in these intervention studies. Data Sources Databases (ie, Scopus, CINAHL, EMBASE, MEDLINE, PsycINFO, ERIC, and Cochrane Central Register for Randomized Control Trials) were searched for studies published from January 2008 to October 2022. Smartphone app–based intervention studies that were nutrition focused, evaluated at least 1 dietary intake variable, and included participants with a mean age between 10 and 19 years were included. All geographic locations were included. Data Extraction and Analysis Study characteristics, intervention results, and reported equity factors were extracted. Because of the heterogeneity of dietary outcomes, findings were reported as a narrative synthesis. Conclusion In total, 3087 studies were retrieved, 14 of which met the inclusion criteria. Eleven studies reported a statistically significant improvement in at least 1 dietary outcome because of the intervention. Reporting of at least 1 equity factor across articles' Introduction, Methods, Results, and Discussion sections was minimal (n = 5), and statistical analyses specific to equity factors were rare, occurring in only 4 of the 14 included studies. Future interventions should include a measurement of intervention adherence and report the impact of equity factors on the effectiveness and applicability of interventions for equity-deserving groups. [ABSTRACT FROM AUTHOR]