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Youth health, long-term food sovereignty and the reclamation of traditional food-related knowledge are areas of concern within Indigenous communities in Canada. Learning Circles: Local Healthy Food to School (LC:LHF2S) built on an exemplar program in four predominantly Indigenous communities. In each, the initiative worked with interested community members to plan, implement and evaluate a range of activities aimed at enhancing access to local, healthy and traditional foods for schools and youth. This case study describes the context, process, outcomes and perceptions of implementation in one of the communities, Hazelton/Upper Skeena, located in northern British Columbia. Data were collected between 2016-2019 and included semi-directed interviews with community members and LCEF (n = 18), process reporting (e.g., LCEF reports, emails, conference calls and tracking data), photographs and video footage, and photovoice. Data were analyzed thematically. Hazelton/Upper Skeena has an active local and traditional food culture. Indigenous governance was supportive, and community members focused on partnership and leadership development, gardens, and food skills work. Findings point to strengths; traditional food, knowledge and practices are valued by youth and were prioritized. LC:LHF2S is a flexible initiative that aims to engage the broader community, and exemplifies some of the best practices recommended for community-based initiatives within Indigenous communities. Results indicate that a LC is a feasible venture in this community; one that can facilitate partnership-building and contribute to increased access to local and traditional food among school-aged youth. Recommendations based on community input may help the uptake of the model in similar communities across Canada, and globally.

Background: Recreation and sport facilities often have unhealthy food environments that may promote unhealthy dietary patterns among children. In response, some Canadian provinces have released voluntary nutrition guidelines for recreation and sport facilities, however implementation has been limited. Organizational capacity building may overcome barriers to implementing guidelines. Eat, Play, Live was a randomized controlled trial embedded within a natural experiment that tested the impact of an 18 month capacity building intervention (CBI) in enhancing implementation of provincial nutrition guidelines, and whether nutrition guidelines were associated with positive changes. Primary outcomes were facility capacity, policy development and food environment quality., Methods: Recreation and sport facilities in three guideline provinces were randomized into a guideline + CBI (GL + CBI; n = 17) or a guideline only comparison condition (GL-ONLY; n = 15). Facilities in a province without guidelines constituted a second comparison condition (NO-GL; n = 17). Facility capacity, policy development, and food environment quality (vending and concession) were measured and compared at baseline and follow-up across conditions using repeated measures ANOVA and Chi-square statistics. Healthfulness of vending and concession items was rated as Do Not Sell (least nutritious), Sell Sometimes or Sell Most (most nutritious)., Results: There were significant time by condition effects, with significant increases in facility capacity (mean ± SD: 30.8 ± 15.6% to 62.3 ± 22.0%; p <  0.01), nutrition policy development (17.6% developed new policies; p = 0.049), overall quality of the concession food environment (14.7 ± 8.4 to 17.5 ± 7.2; p <  0.001), and in the proportion of Sell Most (3.7 ± 4.4% to 11.0 ± 9.0%; p = 0.002) and Sell Sometimes vending snacks (22.4 ± 14.4% to 43.8 ± 15.8%; p <  0.001) in GL + CBI facilities, with a significant decline in Do Not Sell vending snacks (74.0 ± 16.6% to 45.2 ± 20.1%; p <  0.001)., Conclusions: Significant improvements in facility capacity, policy development and food environment quality occurred in recreation and sport facilities that were exposed to nutrition guidelines and participated in a CBI. Outcomes did not improve in facilities that were only passively or not at all exposed to guidelines. Ongoing capacity building may enhance implementation of voluntary nutrition guidelines, however food environments remained overwhelmingly unhealthy, suggesting additional scope to enhance implementation., Trials Registration: Clinical trials registration (retrospectively registered): ISRCTN14669997 Jul 3, 2018.

Objective: As part of a larger evaluation of school nutrition programmes (SNP), the present study examined programme coordinators' perceptions of strengths, weaknesses, opportunities and threats (SWOT) regarding their SNP and public health professionals' support., Design: Qualitative interviews were conducted with twenty-two of eighty-one programme coordinators who had completed a programme evaluation survey. Interviews followed a SWOT framework to evaluate programmes and assessed coordinators' perceptions regarding current and future partnerships with public health professionals., Setting: The study was conducted in a large, urban region within Ontario., Subjects: The twenty-two coordinators who participated represented a cross-section of elementary, secondary, Public and Catholic schools., Results: SNP varied enormously in foods/services offered, how they offered them and perceived needs. Major strengths included universality, the ability to reach needy students and the provision of social opportunities. Major weaknesses included challenges in forming funding partnerships, lack of volunteers, scheduling and timing issues, and coordinator workload. Common threats to effective SNP delivery included lack of sustainable funding, complexity in tracking programme use and food distribution, unreliable help from school staff, and conflicts with school administration. Opportunities for increased public health professionals' assistance included menu planning, nutrition education, expansion of programme food offerings, and help identifying community partners and sustainable funding., Conclusions: The present research identified opportunities for improving SNP and strategies for building on strengths. Since programmes were so diverse, tailored strategies are needed. Public health professionals can play a major role through supporting menu planning, food safety training, access to healthy foods, curriculum planning and by building community partnerships.

Objective: Unhealthy dietary and physical inactivity patterns inspired many initiatives promoting healthy youth and healthy schools in Alberta between 2005 and 2008. The purpose of this study was to examine differences in the prevalence of lifestyle risk factors for type 2 diabetes (T2D) between two province-wide samples of Alberta adolescents (2005 and 2008)., Methods: The dietary and physical activity (PA) patterns of Alberta youth were assessed in two cross-sectional studies of grade 7-10 students, one in 2005 (n=4936) and one in 2008 (n=5091), using a validated web-survey. For each diabetes risk factor, participants were classified as either at risk or not at risk, depending on their survey results relative to cut-off values. Chi-square tests and logistic regression models were used to determine differences in risk factor prevalence between 2005 and 2008., Results: Compared to 2005, mean BMI, energy intake, fat intake, glycemic index (GI) and glycemic load (GL) were lower in 2008 (p<0.05); and carbohydrate, protein, fibre and vegetable and fruit intakes were higher in 2008 (p<0.05). In 2008, a lower proportion of students were: overweight, obese, consuming high GI, high GL, high fat, low fibre, low veg/fruit intake (p<0.05). No differences existed in magnesium or PA levels between the two time points., Conclusions: Improvements were observed between 2005 and 2008 in terms of the proportion of adolescents having specific risk factors for T2D. The cause of these changes could not be determined. Continued monitoring of adolescent lifestyle habits and monitoring of exposure to health promotion programming is recommended.

Objective: To evaluate the impact of a pilot comprehensive school nutrition program modeled on Social Cognitive Theory on knowledge, intentions, self-efficacy, and intake of milk and milk alternatives (MMA) in First Nations youth., Methods: A pilot school nutrition program was implemented at Peetabeck Academy in Fort Albany, Ontario in May, 2010. The Knowledge, Self-Efficacy, and Intentions Questionnaire (KSIQ) and Waterloo Web-based Eating Behavior Questionnaire (WEB-Q) were used to assess change in attitudes and behavior from pre- to postprogram., Results: The KSIQ preprogram (n = 26), postprogram (n = 19); WEB-Q preprogram (n = 30), postprogram (n = 10). Improved knowledge (6.0 ± 1.5 vs. 6.9 ± 1.5, P = .05) and intention scores (9.6 ± 4.4 vs. 11.3 ± 4.1, P = .01) were observed., Conclusions and Implications: A comprehensive school nutrition program can improve knowledge and intentions for intake of MMA in First Nations youth. Environmental constraints beyond the school environment need to be addressed., (Copyright © 2013 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.)

Government actors have an important role to play in creating healthy public policies and supportive environments to facilitate access to safe, affordable, nutritious food. The purpose of this research was to examine Waterloo Region (Ontario, Canada) as a case study for "what works" with respect to facilitating access to healthy, local food through regional food system policy making. Policy and planning approaches were explored through multi-sectoral perspectives of: (a) the development and adoption of food policies as part of the comprehensive planning process; (b) barriers to food system planning; and (c) the role and motivation of the Region's public health and planning departments in food system policy making. Forty-seven in-depth interviews with decision makers, experts in public health and planning, and local food system stakeholders provided rich insight into strategic government actions, as well as the local and historical context within which food system policies were developed. Grounded theory methods were used to identify key overarching themes including: "strategic positioning", "partnerships" and "knowledge transfer" and related sub-themes ("aligned agendas", "issue framing", "visioning" and "legitimacy"). A conceptual framework to illustrate the process and features of food system policy making is presented and can be used as a starting point to  engage multi-sectoral stakeholders in plans and actions to facilitate access to healthy food.

Purpose: To plan community-driven health promotion strategies based on a strengths, weaknesses, opportunities, and threats (SWOT) analysis of the healthy eating and physical activity patterns of First Nation (FN) youth.Design: Cross-sectional qualitative and quantitative data used to develop SWOT themes and strategies.Setting: Remote, subarctic FN community of Fort Albany, Ontario, Canada.Subjects: Adult (n  =  25) and youth (n  =  66, grades 6-11) community members.Measures: Qualitative data were collected using five focus groups with adults (two focus groups) and youth (three focus groups), seven individual interviews with adults, and an environmental scan of 13 direct observations of events/locations (e.g., the grocery store). Quantitative data on food/physical activity behaviors were collected using a validated Web-based survey with youth.Analysis: Themes were identified from qualitative and quantitative data and were analyzed and interpreted within a SWOT matrix.Results: Thirty-two SWOT themes were identified (e.g., accessibility of existing facilities, such as the gymnasium). The SWOT analysis showed how these themes could be combined and transformed into 12 strategies (e.g., expanding and enhancing the school snack/breakfast program) while integrating suggestions from the community.Conclusion: SWOT analysis was a beneficial tool that facilitated the combination of local data and community ideas in the development of targeted health promotion strategies for the FN community of Fort Albany. [ABSTRACT FROM AUTHOR]