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BackgroundParents are an important influence on children's dietary intake and eating behaviors. However, the lack of a conceptual framework and inconsistent assessment of food parenting practices limits our understanding of which food parenting practices are most influential on children. The aim of this study was to develop a food parenting practice conceptual framework using systematic approaches of literature reviews and expert input.MethodA previously completed systematic review of food parenting practice instruments and a qualitative study of parents informed the development of a food parenting practice item bank consisting of 3632 food parenting practice items. The original item bank was further reduced to 110 key food parenting concepts using binning and winnowing techniques. A panel of 32 experts in parenting and nutrition were invited to sort the food parenting practice concepts into categories that reflected their perceptions of a food parenting practice conceptual framework. Multi-dimensional scaling produced a point map of the sorted concepts and hierarchical cluster analysis identified potential solutions. Subjective modifications were used to identify two potential solutions, with additional feedback from the expert panel requested.ResultsThe experts came from 8 countries and 25 participated in the sorting and 23 provided additional feedback. A parsimonious and a comprehensive concept map were developed based on the clustering of the food parenting practice constructs. The parsimonious concept map contained 7 constructs, while the comprehensive concept map contained 17 constructs and was informed by a previously published content map for food parenting practices. Most of the experts (52%) preferred the comprehensive concept map, while 35% preferred to present both solutions.ConclusionThe comprehensive food parenting practice conceptual map will provide the basis for developing a calibrated Item Response Modeling (IRM) item bank that can be used with computerized adaptive testing. Such an item bank will allow for more consistency in measuring food parenting practices across studies to better assess the impact of food parenting practices on child outcomes and the effect of interventions that target parents as agents of change.

BackgroundParents are an important influence on children's dietary intake and eating behaviors. However, the lack of a conceptual framework and inconsistent assessment of food parenting practices limits our understanding of which food parenting practices are most influential on children. The aim of this study was to develop a food parenting practice conceptual framework using systematic approaches of literature reviews and expert input.MethodA previously completed systematic review of food parenting practice instruments and a qualitative study of parents informed the development of a food parenting practice item bank consisting of 3632 food parenting practice items. The original item bank was further reduced to 110 key food parenting concepts using binning and winnowing techniques. A panel of 32 experts in parenting and nutrition were invited to sort the food parenting practice concepts into categories that reflected their perceptions of a food parenting practice conceptual framework. Multi-dimensional scaling produced a point map of the sorted concepts and hierarchical cluster analysis identified potential solutions. Subjective modifications were used to identify two potential solutions, with additional feedback from the expert panel requested.ResultsThe experts came from 8 countries and 25 participated in the sorting and 23 provided additional feedback. A parsimonious and a comprehensive concept map were developed based on the clustering of the food parenting practice constructs. The parsimonious concept map contained 7 constructs, while the comprehensive concept map contained 17 constructs and was informed by a previously published content map for food parenting practices. Most of the experts (52%) preferred the comprehensive concept map, while 35% preferred to present both solutions.ConclusionThe comprehensive food parenting practice conceptual map will provide the basis for developing a calibrated Item Response Modeling (IRM) item bank that can be used with computerized adaptive testing. Such an item bank will allow for more consistency in measuring food parenting practices across studies to better assess the impact of food parenting practices on child outcomes and the effect of interventions that target parents as agents of change.

Objective: The goal of this study was to examine use of weight control strategies in Canadian adults and the role of income as a barrier to using these strategies. Methods: Data from the Canadian Community Health Survey cycle 4.1 on health behaviour change was used for this study. Analysis was restricted to adults (18+ years) residing in the 10 provinces of Canada. Respondents were categorized as having used weight control strategies in their lifestyle if they responded that they increased exercise, improved/modified their eating habits, or lost weight in the previous 12 months, as the primary means of health improvement. An adjusted household income ratio divided into deciles was used as a measure of income. Multivariable logistic regression was used to examine the relationship between income and weight control strategies adjusting for known confounders. Results: Of the 103,990 respondents analyzed, 60% were overweight or obese and 45% reported using weight control strategies in the previous 12 months. Age, sex, ethnicity, having a regular doctor, education, and income were all significantly associated with using weight control strategies in the multivariable model. Results that included all two- and three-way interactions between sex, weight category, and income found that lower income was significantly associated with using fewer weight control strategies - more so for obese men and normal weight women. Conclusion: Efforts must be made to create equal access to services and food products that promote weight reduction or control strategies given the rising prevalence of adult obesity in Canada. Key words: Income; weight control; barrier; Canada; adults; survey Objectif : Examiner l'utilisation des strategies de controle du poids chez les adultes canadiens et le role du revenu comme obstacle a l'utilisation de ces strategies. Methode : Pour cette etude nous avons utilise les donnees sur le changement des habitudes de sante du cycle 4.1 de l'Enquete sur la sante dans les collectivites canadiennes. Notre analyse s'est limitee aux adultes (18 ans et plus) residant dans les 10 provinces du Canada. Les repondants ont ete categorises comme ayant utilise des strategies de controle du poids dans leur mode de vie s'ils disaient avoir augmente leur niveau d'activite physique, ameliore ou modifie leurs habitudes alimentaires ou perdu du poids au cours des 12 mois precedents comme principal moyen d'ameliorer leur sante. Nous avons choisi comme indicateur du revenu un ratio de revenu du menage ajuste divise en deciles. Par regression logistique multivariee, nous avons examine la relation entre le revenu et les strategies de controle du poids en tenant compte des facteurs confusionnels connus. Resultats : Sur les 103 990 repondants analyses, 60 % etaient en surpoids ou obeses et 45 % ont declare avoir utilise des strategies de controle du poids au cours des 12 mois precedents. L'age, le sexe, l'ethnicite, le fait d'avoir un medecin regulier, la scolarite et le revenu presentaient tous une correlation significative avec l'utilisation de strategies de controle du poids dans le modele multivarie. Selon les resultats incluant toutes les interactions possibles entre le sexe, la categorie de poids et le revenu, un revenu inferieur presentait une correlation significative avec l'utilisation d'un moins grand nombre de strategies de controle du poids - davantage encore chez les hommes obeses et les femmes de poids normal. Conclusion : Etant donne la prevalence croissante de l'obesite a l'age adulte au Canada, il faut s'efforcer d'assurer un acces egal aux services et aux produits alimentaires qui favorisent les strategies de reduction ou de controle du poids. Mots cles : revenu; controle du poids; obstacle; Canada; adulte; Enquete, Globally, there has been a rise in the prevalence of obesity since the early 1980s. (1,2) In Canada, the percentage of obese adults increased from 14% in 1979 to 23% [...]

Introduction: British Columbia (BC) declared an overdose public health emergency in 2016. Since then, BC has consistently reported the highest overdose death rates of any province in Canada. In the context of the COVID‐19 pandemic, overdose deaths in BC reached a record high in 2020. This analysis reports on changes in the profile of people who have died of overdose since BC's declaration of COVID‐19 as a public health emergency on 17 March 2020. Methods: Using BC Coroners Service data, Chi‐square tests and multivariable logistic regression were conducted to compare demographic, geographic and post‐mortem toxicology data between people who died of overdose before (17 March–31 December 2019) and after (17 March–31 December 2020) BC's declaration of COVID‐19 as a public health emergency. Results: Overdose deaths observed since 17 March 2020 (n = 1516) more than doubled those observed in the same period in 2019 (n = 744). In the adjusted logistic regression model, odds of death in the post compared to pre‐COVID‐19 period was significantly higher among males compared to females, among all older age groups compared to people aged 30–39, and was lower in public buildings compared to private residences. Discussion and Conclusions: Alongside a significant increase in overdose deaths since BC's declaration of COVID‐19 as a public health emergency, the demographic profile of people who have died of overdose has changed. Ongoing overdose prevention efforts in BC must seek to reach people who remain most isolated, including older adults, who during dual public health emergencies are facing compounded risk of preventable mortality. [ABSTRACT FROM AUTHOR]

Background: The purpose of this study was to compare the physical activity parenting practices (PAPPs) parents report using with the PAPPs incorporated in the published literature. Methods: PAPPs in the literature were identified by reviewing the content of 74 published PAPP measures obtained from current systematic reviews supplemented with a literature search. The types of PAPPs used by parents were identified by surveying a stratified sample of 134 Canadian and US parents of 5- to 12 year-old children. Items from the literature and parent responses were coded using the same coding scheme. Differences between the PAPPs emphasized by the parents and the literature were examined. Results: Parents significantly emphasized different issues than what is measured in the literature (P < .001). Parents emphasized more control (13.6% vs. 6.9%), modeling and teaching (13.2% vs. 9.2%), and structural strategies (32.2% vs. 28.6%) and less autonomy support (11.8% vs. 14.0%), logistical support (9.9% vs. 12.8%), and responsiveness strategies (19.3% vs. 28.5%). Conclusions: Physical activity practices most often employed by parents are not the ones emphasized in current measures. The extent to which putting more emphasis on the areas identified by parents will increase the predictive validity of the measures warrants further examination. [ABSTRACT FROM AUTHOR]

Background: The purpose of this study was to examine the association between parent and adolescent levels of physical activity, sedentary behaviors, and sleep among a group of overweight and obese adolescents. Methods: Baseline data of parent-adolescent pairs who enrolled in a lifestyle modification intervention were analyzed for this study (n = 176). Participants completed questionnaires about their screen time (TV, video game, and computer time), wore an accelerometer for 8 days, and completed a sleep diary for 1 week. In total, 98 parent-adolescent dyads provided valid data for the analyses. Multivariable regression analyses were conducted to assess the relationship between parent and adolescent's moderate-to-vigorous activity (MVPA), step counts, sedentary behaviors, and sleep duration. Analyses were split by weekday, weekday evening and weekend. Results: Parent-adolescent MVPA was significantly associated on weekdays (b = 0.18; SE = 0.08; β = 0.26), weekday evenings (b = 0.21; SE = 0.08; β = 0.28), and weekends (b = 0.29; SE = 0.12; β = 0.27). This study found associations between parent-child video game time on weekends (b = 1.10; SE = 0.49; β = 0.24) and computer time on weekdays (b = 0.42; SE = 0.19; β = 0.23). Adolescent sleep was associated with parental sleep on weekdays only (b = 0.38; SE = 0.09; β = 0.46). Conclusion: The findings warrant further investigation into the direction and mechanism of the relationship between parent and adolescent weight related behaviors. [ABSTRACT FROM AUTHOR]

Abstract Background Illicit drug overdose deaths (IDD) relate to individual drug dose and context of use, including use with other drugs and alcohol. IDD peaked in British Columbia (BC) in 1998 with 417 deaths, and continues to be a public health problem. The objective of this study was to examine IDD in 2006 in BC by place of residence, injury and death, decedents' age and sex and substances identified. Methods IDD data was obtained through the BC Coroners Office and entered into SPSS (version 14). Fisher's exact and Pearson's χ2 were used for categorical data; Mann-Whitney U-test for continuous variables. Rates were calculated using 2006 population estimates. Results We identified 223 IDD in BC; 54 (24%) occurred in Vancouver. Vancouver decedents (compared to those occurring outside Vancouver) were older (mean age 43.9 vs. 39.2 years; p < 0.01) and more likely to be male (90.7% vs. 77.5%; p = 0.03). Provincially Aboriginal ethnicity was reported for 19 deaths; 13 (30.2%) of 43 females and 6 (3.3%) of 180 males (p = < 0.001). Cocaine was identified in 80.3%, opiates 59.6%, methadone 13.9%, methamphetamine/amphetamine 6.3%, and alcohol in 22.9% of deaths. Poly-substance use was common, 2 substances were identified in 43.8% and 3 or more in 34.5% of deaths. Opiates were more frequently identified in Vancouver compared to outside Vancouver (74.1% vs. 55.0%) p = 0.015. Conclusion Collaboration with the Coroner's office allowed us to analyze IDD in detail including place of death; cocaine, opiates and poly-substance use were commonly identified. Poly-substance use should be explored further to inform public health interventions.

Illicit drug toxicity (i.e. overdose) is the leading cause of unnatural death in British Columbia, with 2021 recording a 26% increase since 2020, and more deaths than recorded in any prior year. This rise has been largely driven by the increased toxicity of the illicit drug supply. While harm reduction and treatment interventions have reduced deaths, these services alone are insufficient to stop the illicit drug toxicity crisis. Calls are mounting to provide access to a "safe supply" of drugs. One size does not fit all, and a diverse range of substances must be made widely available to separate British Columbians from the illicit drug supply. [ABSTRACT FROM AUTHOR]

Introduction: British Columbia (BC) declared a public health emergency in April 2016 in response to a rapid rise in overdose deaths. Further understanding of health care utilization is needed to inform prevention strategies for individuals who overdose from illegal drugs. Methods: The Provincial Overdose Cohort includes linked administrative data on health care utilization by individuals who experienced an illegal drug overdose event in BC between 1 January 2015 and 30 November 2016. Overdose cases were identified using data from ambulance services, coroners' investigations, poison control centre calls and hospital, emergency department and physician administrative records. In total, 10 455 overdose cases were identified and compared with 52 275 controls matched on age, sex and area of residence for a descriptive analysis of health care utilization. Results: Two-thirds (66%) of overdose cases were male and about half (49%) were 20-39 years old. Over half of the cases (54%) visited the emergency department and about one-quarter (26%) were admitted to hospital in the year before the overdose event, compared with 17% and 9% of controls, respectively. Nevertheless, nearly onefifth (19%) of cases were recorded leaving the emergency department without being seen or against medical advice. High proportions of both cases (75%) and controls (72%) visited community-based physicians. Substance use and mental health-related concerns were the most common diagnoses among people who went on to overdose. Conclusion: People who overdosed frequently accessed the health care system in the year before the overdose event. In light of the high rates of health care use, there may be opportunities to identify at-risk individuals before they overdose and connect them with targeted programs and evidence-based interventions. Further work using the BC Provincial Overdose Cohort will focus on identifying risk factors for overdose events and death by overdose. [ABSTRACT FROM AUTHOR]

Background: Parents are widely recognized as playing a central role in the development of child behaviors such as physical activity. As there is little agreement as to the dimensions of physical activity-related parenting practices that should be measured or how they should be operationalized, this study engaged experts to develop an integrated conceptual framework for assessing parenting practices that influence multiple aspects of 5 to 12 year old children's participation in physical activity. The ultimate goal of this study is to inform the development of an item bank (repository of calibrated items) aimed at measuring physical activity parenting practices.Methods: Twenty four experts from 6 countries (Australia, Canada, England, Scotland, the Netherlands, & United States (US)) sorted 77 physical activity parenting practice concepts identified from our previously published synthesis of the literature (74 measures) and survey of Canadian and US parents. Concept Mapping software was used to conduct the multi-dimensional scaling (MDS) analysis and a cluster analysis of the MDS solution of the Expert's sorting which was qualitatively reviewed and commented on by the Experts.Results: The conceptual framework includes 12 constructs which are presented using three main domains of parenting practices (neglect/control, autonomy support, and structure). The neglect/control domain includes two constructs: permissive and pressuring parenting practices. The autonomy supportive domain includes four constructs: encouragement, guided choice, involvement in child physical activities, and praises/rewards for their child's physical activity. Finally, the structure domain includes six constructs: co-participation, expectations, facilitation, modeling, monitoring, and restricting physical activity for safety or academic concerns.Conclusion: The concept mapping analysis provided a useful process to engage experts in re-conceptualizing physical activity parenting practices and identified key constructs to include in measures of physical activity parenting. While the constructs identified ought to be included in measures of physical activity parenting practices, it will be important to collect data among parents to further validate the content of these constructs. In conclusion, the method provided a roadmap for developing an item bank that captures key facets of physical activity parenting and ultimately serves to standardize how we operationalize measures of physical activity parenting. [ABSTRACT FROM AUTHOR]