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Background: Breakfast skipping has previously been associated with worse diet quality among adolescents; the latter increases the risk of chronic disease. However, many studies do not consider diet quality as a function of calories, which is problematic as skippers tend to consume less energy than consumers. Additionally, due to the lack of one accepted definition of both breakfast skipping and diet quality, it is unclear how differences found may change when using varying definitions. Objectives: We aimed to compare the Healthy Eating Index-2015 (HEI-2015) scores and nutrient intakes of teen breakfast skippers and consumers in Southwestern Ontario, Canada. Methods: Cross-sectional, baseline data were used from SmartAPPetite, an ongoing nutrition intervention study. Singular 24-h dietary recalls and sociodemographic data from 512 adolescents aged 13-19 y were used to compare HEI-2015 scores and nutrient intakes via multivariable linear regression. Results: Previous day breakfast skippers had significantly lower HEI-2015 scores (-4.4; 95% CI: -8.4, -0.4) and significantly lower intakes of calories, saturated fat, and vitamin C, as well as significantly higher intake of sodium and total fat. Conclusions: Previous day breakfast consumers had significantly higher diet quality scores and better nutrient intakes than breakfast skippers, although, on average, both had poor diet quality. Consequently, it is unlikely that simply advising teens to consume breakfast will result in meaningful change in diet quality, and more effort should be placed on promoting nutritious breakfasts. [ABSTRACT FROM AUTHOR]

The aim of this study was to assess how children's personal exposure to fine particulate matter (PM 2.5) during the school commute is influenced by mode of travel and neighborhood environment in a mid-sized Canadian city. A total of 101 commutes to and from school were tracked using a GPS, and personal exposure to PM 2.5 along commute routes was assessed by spatially-referencing the monitored exposure levels with time-synchronized GPS data. Students who walked to and from school were exposed to lower PM 2.5 concentrations than those in cars or riding the school bus. There was also a significant difference in mean PM 2.5 concentrations by the built environment, with children who walked to school in suburban neighborhoods experiencing higher personal concentrations than children in urban neighborhoods. To reduce children's daily exposure to air pollutants, neighborhoods should be designed to maximize the number of children who are able to walk between home and school. [ABSTRACT FROM AUTHOR]

Various geospatial techniques have been employed to estimate children’s exposure to environmental cardiometabolic risk factors, including junk food. But many studies uncritically rely on exposure proxies which differ greatly from actual exposure. Misrepresentation of exposure by researchers could lead to poor decisions and ineffective policymaking. This study conducts a GIS-based analysis of GPS tracks—‘activity spaces’—and 21 proxies for activity spaces (e.g. buffers, container approaches) for a sample of 526 children (ages 9–14) in London, Ontario, Canada. These measures are combined with a validated food environment database (including fast food and convenience stores) to create a series of junk food exposure estimates and quantify the errors resulting from use of different proxy methods. Results indicate that exposure proxies consistently underestimate exposure to junk foods by as much as 68%. This underestimation is important to policy development because children are exposed to more junk food than estimated using typical methods. [ABSTRACT FROM AUTHOR]

Objective: To advance the knowledge of determinants of diet quality in pregnancy by focusing on both personal characteristics and the food environment. Design: Cross-sectional study in which participants from the Prenatal Health Project were linked to a geographic dataset by home address. Access to fast food, convenience stores, and grocery stores was measured using a geographic information system (ArcGIS9.3). Setting: Pregnant women (n = 2,282) were recruited between 2002 and 2005 in London, Ontario, Canada. Main Outcome Measure: Dietary quality was measured using a validated food frequency questionnaire and the Canadian Diet Quality Index for Pregnancy. Analysis: Univariate and multivariate linear regressions were calculated with the predictor variables on the Canadian Diet Quality Index for Pregnancy. Results: Pregnant women who were born in Canada, common-law, nulliparous, less physically active, smokers, more anxious, or lacking family support had lower diet quality on average. Presence of fast- food restaurants, convenience stores, and grocery stores within 500 m of participants' homes was not associated with diet quality after controlling for personal variables. Conclusions and Implications: The food environment does not seem to have a large influence on diet quality in pregnancy. Further research is needed to determine other potential reasons for low diet quality among pregnant women. [ABSTRACT FROM AUTHOR]

Abstract: In spatial epidemiologic and public health research it is common to use spatially aggregated units such as centroids of postal/zip codes, census tracts, dissemination areas, blocks or block groups as proxies for sample unit locations. Few studies, however, address the potential problems associated with using these units as address proxies. The purpose of this study is to quantify the magnitude of distance errors and accessibility misclassification that result from using several commonly-used address proxies in public health research. The impact of these positional discrepancies for spatial epidemiology is illustrated by examining misclassification of accessibility to several health-related facilities, including hospitals, public recreation spaces, schools, grocery stores, and junk food retailers throughout the City of London and Middlesex County, Ontario, Canada. Positional errors are quantified by multiple neighborhood types, revealing that address proxies are most problematic when used to represent residential locations in small towns and rural areas compared to suburban and urban areas. Findings indicate that the shorter the threshold distance used to measure accessibility between subject population and health-related facility, the greater the proportion of misclassified addresses. Using address proxies based on large aggregated units such as centroids of census tracts or dissemination areas can result in very large positional discrepancies (median errors up to 343 and 2088m in urban and rural areas, respectively), and therefore should be avoided in spatial epidemiologic research. Even smaller, commonly-used, proxies for residential address such as postal code centroids can have large positional discrepancies (median errors up to 109 and 1363m in urban and rural areas, respectively), and are prone to misrepresenting accessibility in small towns and rural Canada; therefore, postal codes should only be used with caution in spatial epidemiologic research. [Copyright &y& Elsevier]

Abstract: Several studies have examined supermarket access for low-income residents, but few have explored how access to healthy food changes when a new food retailer such as a farmers’ market opens in a place previously known as a ‘food desert’. This paper uses a ‘before and after’ approach to examine the impact of the introduction of a farmers’ market on the price and availability of healthy food in an underserved urban neighbourhood. The farmers’ market had a major impact on grocery prices in the neighbourhood, which decreased by almost 12% in 3 years. [Copyright &y& Elsevier]

Adolescents are often exposed to food retailers selling unhealthy food items during their lunch breaks and school commutes. This systematic review examines the influence of school neighborhood food retail environments on adolescent food purchasing. A systematic search of 6 databases. Observational studies published from January 2012 to December 2022 that measured food availability, accessibility, or exposure, measured food purchasing, and focused on adolescents (aged 10–19 years) were eligible for inclusion. Twelve studies with 97 findings were included. Thirty-one findings indicated that a school neighborhood with a high density of unhealthy food retail, a school with unhealthy food retail nearby, or exposure to unhealthy food retail on the journey to/from school was associated with higher prevalence and frequency of unhealthy food purchases. Adolescents' food purchasing behaviors may be meaningfully affected by their school neighborhood food retail environment; however, the included studies have many methodological shortcomings. Results identify the need for new studies that measure food purchasing, use comprehensive definitions of food retail environments, and adopt more rigorous methods to approximate exposure to food retail. More robust evidence would strengthen the rationale for policy or program interventions and potentially indicate specific targets for intervention. [ABSTRACT FROM AUTHOR]

To examine the extent to which socioeconomic status, mental health, and substance use are associated with teenage pregnancies in Southwestern Ontario (SWO), and whether these pregnancies are at an elevated risk for adverse birth outcomes, after controlling for medical, behavioral, and socioeconomic status factors. Retrospective cohort study using perinatal and neonatal databases. Tertiary care hospital in SWO. Women residing in SWO who gave birth to singleton infants without congenital anomalies between 2009 and 2014. Teenage pregnancies (19 years of age or younger) were compared with pregnancies of women 20-34 years and 35 years or older. None. Low birth weight (LBW), very LBW, term LBW, preterm birth, very preterm birth, low and very low Apgar score, and fetal macrosomia. Of 25,263 pregnant women, 1080 (4.3%) were 19 years of age or younger. Approximately 18% of teenage mothers lived in socioeconomically disadvantaged neighborhoods, compared with 11% of mothers aged 20-34 and 9% of women 35 years of age or older (P <.001). Teenage mothers had higher rates of depression during pregnancy (9.8%) than mothers 20-34 years (5.8%) and those 35 years of age or older (6.8%; P <.001). Young mothers self-reported higher tobacco, marijuana, and alcohol use during pregnancy than adult mothers (P <.001). Teenage pregnancy increased the risk of a low Apgar score (adjusted odds ratio, 1.56; 95% confidence interval, 1.21-2.02), but was not associated with other birth outcomes after adjusting for covariates. Teenage pregnancy is associated with a higher risk of socioeconomic disadvantage, mental health problems, and substance use during pregnancy, but is largely unrelated to adverse birth outcomes in SWO. [ABSTRACT FROM AUTHOR]

• Household food waste may be underestimated if self-reported. • An objective method to collect household food waste samples was tested. • Households self-reported 6.63 portions/week and disposed 2,783 g/week of food waste. • How food waste data is collected impacts relationships with behavioural determinants. • A poor understanding of food waste disposal can impair intervention development. A survey, based on an expanded Theory of Planned Behavior (TPB), was used to indirectly measure self-reported food wasting and its behavioral determinants. This was complemented with directly and objectively measured food waste in curbside garbage samples. Households (n = 189) reported throwing out avoidable food waste a mean of 5.48 times (SD = 5.58) and 6.63 portions (SD = 6.61) the week prior to completing the survey. These same households threw out a mean of 2,783 g/week of food waste (SD = 2,664) in a curbside garbage sample, with 63.27% of this consisting of avoidable food waste. There were weak to fair correlations between self-reported and curbside food waste samples. The direction and level of significance of all correlations of TPB behavioral determinants with self-reported and curbside food waste samples were similar, although the correlation coefficients were higher for self-reported food wasting. A linear regression (R2 = 0.34, p < 0.001) on self-reported avoidable food waste frequency demonstrated that it was significantly (p < 0.05) associated with perceived behavioral control, personal attitude, number of people per household, gender and employment status. This was contrasted with a linear regression (R2 = 0.19, p < 0.001) on curbside avoidable food waste which was also significantly (p < 0.05) associated with perceived behavioral control and number of people per household, but also housing tenure type (owner-occupancy vs tenancy) and the good provider identity. In general, self-reported results should be used with caution as they may underestimate food waste disposal and consideration should be given to supplement, if not replace, them with direct measurement of food waste disposal. [ABSTRACT FROM AUTHOR]

Children's perceptions of their environment have been associated with their physical activity (PA) levels, however a better understanding of the formation of perceptions within different contexts is needed. This will help to inform decision making related to physical inactivity trends in Canadian children. We examined socio-ecological factors influencing children's perceptions of barriers to PA in Ontario, Canada. Binary logistic regression models measured the relationship between perceptions of barriers and PA for 892 children in Ontario. At the intrapersonal level, girls reported the most barriers to PA. Interpersonally, children whose mother was employed reported the most barriers. At the physical environment level, children in urban and suburban neighbourhoods of large cities, and rural areas reported the most barriers, differing relative to population size. The major contribution of this paper is a new perspective of environmental influences on children's perceptions of PA, using an urbanicity spectrum, and highlighting place specific needs of Canadian children. [ABSTRACT FROM AUTHOR]

Postsecondary students report a low intake of fruits and vegetables and high intake of fast food. As inadequate food knowledge is associated with postsecondary students' inability to consume a healthy diet, food literacy interventions may improve their dietary behaviors. Qualitative inquiry into participants' perspectives of an intervention can provide insight on an intervention's impact on dietary behaviors and why it may or may not have been effective. Explore postsecondary students' perceptions of the impact of a smartphone-based food literacy intervention on their dietary behaviors; and explore participants' views on why the intervention was or was not effective at influencing their dietary behavior. Intervention participants (17-25 years old) from a smartphone-based food literacy intervention in postsecondary institutions across Southwestern Ontario, Canada, were asked to participate in virtual focus groups to share their perspectives on the intervention's impact on their dietary behaviors at the end of the 10-week intervention period. Focus group data was coded via consensus coding by two researchers. After coding was complete, inductive thematic analysis was used to analyze the data for both research objectives. In total, 10 focus groups were conducted (N=30 participants). Themes regarding impact on dietary behavior included increased dietary consciousness, a reduction of perceived "unhealthy foods," an increase of perceived "healthy foods," choosing healthier dietary choices, and "Hawthorne Effect." Themes for why the intervention was or was not effective centered on barriers and facilitators to engagement with the intervention and participants' ability to implement the intervention into their dietary behaviors. Facilitators included the intervention's suitability and app functionality, whereas barriers included technology concerns, a lack of time, food accessibility, food affordability, and intervention suitability. This study provides insight into the impact and the facilitators and barriers of a mHealth food literacy intervention on postsecondary students' dietary behaviors. Researchers should consider these barriers and how to mitigate them to improve the effectiveness of future food literacy and mHealth interventions. Canadian Institutes of Health Research (CIHR) and Children's Health Research Institute (CHRI) [ABSTRACT FROM AUTHOR]

Physical inactivity among children is a significant public health concern. Active school travel (AST) methods, such as walking and wheeling to school, can be a valuable way to increase children's levels of daily physical activity. In Canada, Active and Safe Routes to School (ASRTS), a national health promotion initiative, has led the campaign for AST through its flagship school travel plan (STP) program. At present little is known about the on-the-ground implementation processes that impede or facilitate the success of STPs. Through a thematic analysis of 18 interviews with STP facilitators and 4 focus groups with the larger STP committees, our study evaluates the factors shaping the functioning of STP interventions at ten elementary schools participating in a regional ASRTS program in Southwestern Ontario. Our analysis yielded six themes that have implications for STP implementation and sustainability: 1) accounting for school context; 2) establishing committee capacity and leadership; 3) supporting STP action; 4) responsiveness to external and internal barriers; 5) engaging schools at the grassroots level; and 6) building future champions. We draw from Lewin's Field Theory and discuss the forces affecting STP committees to frame our findings in a way that can be discussed to support the building of efficient, effective, and viable AST intervention environments. [ABSTRACT FROM AUTHOR]

E-cigarettes are a popular mode of delivery for nicotine, tobacco and cannabis. The prevalence of vaping among youth is increasing and this review aims to identify features of the neighbourhood environment, e.g., retailers, advertisements, and policies, that are associated with youth vaping. We included 48 studies. Of these, approximately 40% and 60% reported that presence of e-cigarette retailers, and advertisements, was associated with statistically higher odds of e-cigarette use in youth, respectively. Approximately 30% of studies reported that policies affecting e-cigarette availability were associated with statistically lower odds of vaping. Identifying these influential features of the neighbourhood environment will help formulate appropriate policies to reduce e-cigarette use among youth. • E-cigarettes are a popular mode of delivery for nicotine, tobacco and cannabis and prevalence of vaping among youth is increasing. • This review identifies features of the neighbourhood environment, e.g., retailers, advertisements, and policies, that are associated with vaping among youth. • Approximately 40% of included studies reported that interaction with e-cigarette retailers, was associated with statistically higher odds of e-cigarette use in youth. • Approximately 60% of included studies reported that interaction with e-cigarette advertisements was associated with statistically higher odds of e-cigarette use in youth,. • Approximately 30% of studies reported that policies affecting e-cigarette availability were associated with statistically lower odds of vaping. • More research with objective measures is needed, and identifying influential elements of the neighbourhood environment will help formulate appropriate policies to reduce e-cigarette use among youth. [ABSTRACT FROM AUTHOR]

Abstract: This study assessed the amount of physical activity engaged in by youth aged 11–13, in relation to: (1) the presence of neighborhood recreational opportunities, objectively measured within a geographic information system; and (2) parents’ perceptions of recreation opportunities in their neighborhoods. Students in grade 7 and 8 (n=811) in 21 elementary schools throughout London, Ontario completed the adapted Previous Day Physical Activity Recall and a questionnaire assessing environmental influences in the home and school neighborhoods. Parents/guardians of participants also completed a questionnaire eliciting demographic information and perceptions of the neighborhood environment. On average, students engaged in 159.9min/day of physical activity. Both subjective and objective measures of recreational opportunities were associated positively with physical activity (p<0.05). Greater access to recreational opportunities seem essential to facilitate youths’ healthy levels of physical activity. [Copyright &y& Elsevier]

• Residents living in a green bin regime support green bin more than those who are not. • Convenience (time and space to sort waste) is highly predictive of green bin support. • Concern about the environment is highly predictive of green bin support. • The notion that green bin causes people to discard more food does not predict support. • Residents in a proposed green bin waste regime disagree on the most issues. Food waste remains a high priority greenhouse gas (GHG) emission problem and household curbside collection – green bin 1 1 This literature has not yet settled on common terminology. Wu et al., (2019) use the term "curbside composting carts", while (Geislar 2017) uses the term "organics collection programs" OCP. The scope of our study is bins used to collect food waste at individual households. - with mass treatment is often adopted as a viable solution for GHG reduction. The aim of this study is to explore attitudinal and situational predictors of support for residential curbside green bin programs. Using responses to 517 household surveys from the mid-sized Canadian cities of London, Ontario (proposed green bin program) and Kitchener-Waterloo (KW), Ontario (operating green bin program for 10+ years) comparison of means t-tests, correlations and linear regression are used to test five hypotheses derived from the food waste and waste diversion literatures that predict green bin support: situational factors, current food wasting, theory of planned behaviour attitudes, concern that green bin encourages food wasting, and concern that food waste ends up in the garbage regardless of green bin. There is some support for all five hypotheses. Residents in Kitchener-Waterloo were significantly more supportive (83%) than those in London (65%). While residents in both communities are supportive because of the perceived convenience and environmental benefits of the green bin, the number of regression model predictors is greater in London (16 compared to 9 for Kitchener-Waterloo). The findings overall suggest sustained municipal education at the implementation stage may lead to positive resident habituation to green bin and thus, durable public buy-in. [ABSTRACT FROM AUTHOR]

The aim of this study is to evaluate how retail food environments for children in the City of London and Middlesex County, Ontario, Canada, vary according to level of urbanicity and level of socioeconomic distress. Urbanicity in this study is defined as a neighbourhood's designation as urban, suburban, or rural. We assessed community food environments (e.g., the type, location, and accessibility of food outlets) using 800m and 1600m network buffers (school zones) around all public and private elementary schools, and we calculated and compared density of junk food opportunities (JFO) (e.g., fast food and full-service restaurants, grocery stores, and convenience stores) within each school zone in urban, suburban and rural settings. The study also assessed consumer food environments (e.g., the price, promotion, placement, and availability of healthy options and nutrition information) through restaurant children's menu audits using the Children's Menu Assessment tool. Results suggest JFO density is greater around elementary schools in areas with higher levels of socioeconomic distress and urbanicity, while urbanicity is also associated with greater use of branded marketing and inclusion of an unhealthy dessert on children's menus. [ABSTRACT FROM AUTHOR]

Context: As children's lifestyles have become increasingly sedentary, active school travel can be a relatively accessible way to increase their daily physical activity. In recent years, several different models of interventions have been utilized to promote children participating in active school travel. This review documents and analyzes the different active school travel intervention methodologies that have been used in North America (Canada or U.S.) by collecting, organizing, and evaluating data relating to all phases of active school travel interventions.Evidence Acquisition: This systematic review developed a key word search and applied it in six databases (BIOSIS Previews, GeoBase, PubMed, SCOPUS, SPORTDiscus, Web of Science) to gather scholarly literature. A total of 22 studies evaluating children's active school travel interventions in a North American setting (four Canada, 18 U.S.) were identified for the period between January 2010 and March 2017.Evidence Synthesis: Applying the Safe Routes to School Education, Encouragement, Enforcement, Engineering, Equity, and Evaluation ("6 E's") framework, interventions were thematically assessed for their structure and organization, approaches and methods, and outcomes and discussions. Encouragement and education were the most commonly observed themes within the different methodologies of the studies reviewed. Details relating to intervention approaches and methods were common; whereas data relating to intervention structure and organization received much less attention.Conclusions: Kingdon's multiple streams approach was applied to frame the findings for program facilitators and evaluators. Within the multiple streams approach, several considerations are offered to address and potentially improve active school travel intervention conceptualization, partnerships, organization, and evaluation. [ABSTRACT FROM AUTHOR]

Exposure assessment in the context of mobility-oriented health research often is challenged by the type of spatial measurement technique used to estimate exposures to environmental features. The purpose of this study is to compare smartphone global positioning system (GPS), shortest network path mobility, and buffer-based approaches in estimating exposure to outdoor food and beverage advertising among a sample of 154 teenagers involved in the SmartAPPetite study during 2018 in London, Ontario, Canada. Participants were asked to report their home postal code, age, gender identity, ethnicity, and number of purchases they had made at a retail food outlet in the past month. During the same time period, a mobile phone application was used to log their mobility and specifically record when a participant was in close proximity to outdoor advertising. The results of negative binomial regression modelling reveal significant differences in estimates of advertising exposure, and the relationship to self-reported purchasing. Spatial exposure estimation methods showed differences across regression models, with the buffer and observed GPS approaches delivering the best fitting models, depending on the type of retail food outlet. There is a clear need for more robust research of spatial exposure measurement techniques in the context of mobility and food (information) environment research. • Exposure to outdoor food and beverage advertising has little association with purchasing among adolescents. • Comparison of GPS, network paths, and residential buffers in measuring exposure to outdoor food and beverage advertising. • Residential buffers and GPS delivered the best-fitting models, dependent on the type of retail food outlet under study. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic may have amplified the environmental, social, and economic implications of household food waste. A better understanding of household food wasting during the pandemic is needed to improve the management of waste and develop best practices for municipal waste management programs under crisis circumstances. A waste composition study was undertaken with 100 single-family households across the city of London, Ontario, Canada to determine the quantity and composition of household food waste disposed in June 2020, during the first wave of the COVID-19 pandemic. This study examines how household demographic, socioeconomic, and neighbourhood food environment characteristics influence household food wasting. On average, each household sent 2.81 kg of food waste to landfill per week, of which 52% was classified as avoidable food waste and 48% as unavoidable food waste. The quantity and composition of household food waste was found to be strongly influenced by the number of people and children in a household, and somewhat influenced by socioeconomic factors and neighbourhood food environment characteristics, including the availability, density, and proximity of retail food outlets. • This is one of the only direct measurement studies of food waste during COVID-19. • During COVID-19, sample households sent 2.81 kg of food waste to landfill per week. • 52% of household food waste was classified as avoidable and 48% as unavoidable. • Food waste was influenced by the number of people and children in a household. • Proximity to and density of some food outlet types influenced unavoidable food waste. [ABSTRACT FROM AUTHOR]

There is a dearth of studies examining associations between active school travel and children's health-related quality of life. Additionally, studies have not examined how perceived neighbourhood characteristics may moderate these associations. This study aims to examine the relationship between regular active school travel, children's physical and psychosocial health-related quality of life, and the potential moderating effects of their perceived neighbourhood safety (interpersonal and traffic). This cross-sectional study used data from Ontario schoolchildren (aged 8-14) as part of the Spatial Temporal Environment and Activity Monitoring (STEAM) Project. Results showed no significant direct relationship between regular active school travel and children's physical or psychosocial functioning; but the relationships were moderated by perceived neighbourhood safety. Regular active school travelers with high levels of perceived neighbourhood interpersonal safety, had higher physical and psychosocial functioning than regular active school travelers with low levels of perceived neighbourhood interpersonal safety. Additionally, at higher levels of perceived neighbourhood traffic safety, regular active school travelers had higher psychosocial functioning than regular active school travelers with lower perceived neighbourhood traffic safety. Interventions promoting active school travel should consider the environments through which children will be traveling. [ABSTRACT FROM AUTHOR]