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This study describes the development and psychometric evaluation of four scales measuring leadership for health promotion at an organizational level in the baseline survey (n = 144) of the Alberta Heart Health Project. Content validity was established through a series of focus groups and expert opinion appraisals, pilot testing of a draft based on capacity assessment instruments developed by other provinces involved in the Canadian Heart Health Initiative, and the literature. Psychometric analyses provided empirical evidence of the construct validity and reliability of the organizational leadership scales. Principal component analysis verified the unidimensionality of the leadership scales of (a) Practices for Organizational Learning, (b) Wellness Planning, (c) Workplace Climate, and (d) Organization Member Development. Scale alpha coefficients ranged between 0.79 and 0.91 thus establishing good to high scale internal consistencies. These measures can be used by both researchers and practitioners for the assessment of organizational leadership for health promotion and heart health promotion. (Contains 1 figure and 2 tables.)

Objective: The purpose of this study was to validate measures of individual and organisational infrastructure for health promotion within Alberta's (Canada) 17 Regional Health Authorities (RHAs). Design: A series of phases were conducted to develop individual and organisational scales to measure health promotion infrastructure. Instruments were designed with focus groups and then pre-tested prior to the validation study. Setting: In 1993 all hospitals and Public Health Units in the province of Alberta were regionalised into 17 RHAs, with responsibility for public health, community health, and acute and long-term care. While regionalisation may offer more opportunity for community participation, reorganisation of the public health system may have fragmented and diluted resources and skills for heart health promotion in some RHAs. Infrastructure (for example, human and financial resources), amongst other items, is believed to contribute to the capacity to promote health. Method: All 17 RHAs participated in the study, yielding a total of 144 individuals (that is board members, senior/middle management, and front line staff). These representative employees completed a self-administered questionnaire on individual- and organisational-level infrastructure measures. Results: Psychometric analyses of survey data provided empirical evidence for the robustness of the measures. Principal component analyses verified the construct validity of the scales, with alpha coefficients ranging from 0.75 to 0.95. Conclusion: The scales can be used by health professionals and researchers to assess individual- and organisational-level infrastructure, and tailor interventions to increase infrastructure for health promotion in health organisations. (Contains 4 tables.)

This issue includes an illuminating paper entitled 'Variation across Canada in the economic burden attributable to excess weight, tobacco smoking, and physical inactivity'. (1) The research used innovative economic modeling [...]

OBJECTIVES: To assess what health promotion policies and practices were adopted by schools in Nova Scotia and the extent that these policies and practices affected the diet quality, physical activity (PA) and weight status of students. METHODS: We developed and administered a 'school practice assessment tool' to assess the presence of 72 different school-based health promotion policies and practices. Surveys were conducted in 2003 and 2011 to assess diet, PA and weight status in approximately 100 grade 5 students. We used multilevel regression methods to examine changes in these outcomes across schools with varying levels of health promotion policies and practices between the two time-points. RESULTS: Between 2003 and 2011 the diet quality of students improved, PA decreased and the prevalence of childhood obesity increased. Although we did not find consistent or significant favourable benefits resulting from higher implementation levels, we did observe fewer negative trends among schools at higher levels of implementation. CONCLUSION: Our results build on the current gap in knowledge on the impact of Health Promoting Schools (HPS) implementation through population health interventions, but there is a continued need for further evaluation and monitoring of school policies to understand how HPS practices are supporting healthier eating and PA for students. KEY WORDS: Public health; schools; health promotion; health behaviour; prevention Can J Public Health 2015; 106(2):e43-e51 doi: 10.17269/CJPH.106.4743 OBJECTIFS : Evaluer les politiques et les pratiques de promotion de la sante adoptees dans les ecoles de la Nouvelle-Ecosse et leur effet sur la qualite du regime, l'activite physique (AP) et le statut ponderal des eleves. METHODES : Nous avons elabore et administre un <> pour evaluer la presence de 72 politiques et pratiques distinctes de promotion de la sante a l'ecole. Des sondages ont ete menes en 2003 et en 2011 pour evaluer le regime, l'AP et le statut ponderal d'environ 10 000 eleves de 5e annee. Nous avons utilise des methodes de regression multiniveaux pour examiner les changements dans les resultats obtenus par les ecoles ayant adopte divers niveaux de politiques et de pratiques de promotion de la sante entre les deux dates. RESULTATS : Entre 2003 et 2011, la qualite du regime des eleves s'est amelioree, l'AP a diminue, et la prevalence de l'obesite juvenile a augmente. Nous n'avons pas trouve d'avantages systematiques ou significatifs resultant de niveaux de mise en reuvre superieurs, mais nous avons observe moins de tendances negatives dans les ecoles aux niveaux de mise en reuvre superieurs. CONCLUSION : Nos resultats comblent une partie des lacunes actuelles dans les connaissances sur l'effet de la mise en reuvre d'interventions en sante des populations dans les << ecoles faisant la promotion de la sante >> (EPS), mais il existe encore un besoin d'evaluer et de surveiller les politiques scolaires afin de comprendre comment les pratiques des EPS appuient l'alimentation saine et l'AP chez les eleves. MOTS CLES : sante publique; ecoles; promotion de la sante; comportement sanitaire; prevention, Establishing healthy eating and physical activity (PA) behaviours among children is important for prevention of chronic diseases later in life (1) and promotion of health and well-being throughout the lifespan. [...]

Background: Attitudes and beliefs of policy influencers and the general public toward physical activity policymay support or impede population-level action, requiring improved understanding of aggregate preferences toward policies that promote physical activity. Methods: In 2016, the Chronic Disease Prevention Survey was administered to a census sample of policy influencers (n = 302) and a stratified random sample of the public (n = 2400) in Alberta and Québec. Using net favorable percentages and the Nuffield Council on Bioethics' intervention ladder framework to guide analysis, the authors examined support for evidence-based healthy public policies to increase physical activity levels. Results: Less intrusive policy options (ie, policies that are not always the most impactful) tended to have higher levels of support than policies that eliminated choice. However, there was support for certain types of policies affecting influential determinants of physical activity such as the built environment (ie, provided they enabled rather than restricted choice) and school settings (ie, focusing on children and youth). Overall, the general public indicated stronger levels of support for more physical activity policy options than policy influencers. Conclusions: The authors' findings may be useful for health advocates in identifying support for evidence-based healthy public policies affecting more influential determinants of physical activity. [ABSTRACT FROM AUTHOR]

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 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. KEY WORDS: Type 2 Diabetes Mellitus; adolescents; prevalence; risk factors; diet; physical activity OBJECTIF: Les habitudes alimentaires malsaines et l'inactivite physique ont inspire de nombreuses initiatives de promotion de la sante des jeunes et des ecoles en Alberta entre 2005 et 2008. Nous avons cherche a examiner les differences dans la prevalence des facteurs de risque lies aux habitudes de vie pour le diabete de type 2 (DT2) entre deux echantillons provinciaux d'adolescents albertains (2005 et 2008). METHODE: Les habitudes d'alimentation et d'activite physique des jeunes de l'Alberta ont ete evaluees a la faveur de deux etudes transversales aupres d'eleves de la 7e a la 10e annee, l'une en 2005 (n=4 936) et l'autre en 2008 (n=5 091), a l'aide d'un sondage en ligne valide. Pour chaque facteur de risque du diabete, les participants ont ete classes comme etant a risque ou non a risque selon leurs reponses au sondage par rapport aux valeurs limites. Des tests du khi-carre et des modeles de regression logistique ont servi a determiner les differences dans la prevalence des facteurs de risque entre 2005 et 2008. RESULTATS: Comparativement a 2005, l'IMC moyen, l'apport energetique, l'apport en matieres grasses, l'indice glycemique (IG) et la charge glycemique (CG) etaient plus faibles en 2008 (p CONCLUSIONS: Des ameliorations ont ete observees entre 2005 et 2008 dans la proportion d'adolescents presentant les facteurs de risque propres au DT2. Nous n'avons pas pu determiner la cause de ces changements. Il est recommande de continuer a surveiller les habitudes de vie des adolescents et leur exposition aux programmes de promotion de la sante. MOTS CLES: diabete de type 2; adolescent; prevalence; facteurs de risque; regime alimentaire; exercice physique La traduction du resume se trouve a la fin de l'article., Unhealthy dietary and physical activity patterns are prevalent among Canadian youth (1,2) and are implicated in increasing rates of early onset type 2 diabetes that have been observed in Canada. [...]

Objectives: Detailed assessments of the built environment often resist data reduction and summarization. This project sought to develop a method of reducing built environment data to an extent that they can be effectively communicated to researchers and community stakeholders. We aim to help in an understanding of how these data can be used to create neighbourhood groupings based on built environment characteristics and how the process of discussing these neighbourhoods with community stakeholders can result in the development of community-informed health promotion interventions. Methods: We used the Irvine Minnesota Inventory (IMI) to assess 296 segments of a semi-rural community in Alberta. Expert raters 'created' neighbourhoods by examining the data. Then, a consensus grouping was developed using cluster analysis, and the number of IMI variables to characterize the neighbourhoods was reduced by multiple discriminant function analysis. Results: The 296 segments were reduced to a consensus set of 10 neighbourhoods, which could be separated from each other by 9 functions constructed from 24 IMI variables. Biplots of these functions were an effective means of summarizing and presenting the results of the community assessment, and stimulated community action. Conclusions: It is possible to use principled quantitative methods to reduce large amounts of information about the built environment into meaningful summaries. These summaries, or built environment neighbourhoods, were useful in catalyzing action with community stakeholders and led to the development of health-promoting built environment interventions. Key words: Built environment; quantitative methods; health promotion; knowledge exchange; obesity reduction Objectifs: Les evaluations approfondies du milieu bati resistent souvent aux tentatives de reduction et de synthese des donnees. Nous avons cherche a elaborer une methode de reduction des donnees sur le milieu bati qui permette de communiquer efficacement ces donnees aux chercheurs et aux acteurs locaux. Notre objectif est de faire comprendre comment on peut utiliser ces donnees pour creer des regroupements de quartiers fondes sur les caracteristiques du milieu bati, et que le processus de discussion des quartiers avec les acteurs locaux peut entrainer la mise au point d'interventions de promotion de la sante renforcees par un apport communautaire. Methode: A l'aide de la liste de criteres Irvine-Minnesota Inventory (IMI), nous avons evalue 296 segments d'une communaute semi-rurale de l'Alberta. Des evaluateurs experts ont << cree >> des quartiers en examinant les donnees. Ensuite, nous avons elabore un regroupement consensuel au moyen d'une analyse en grappes, et reduit le nombre de variables IMI caracterisant les quartiers au moyen d'une analyse discriminante multiple. Resultats: Les 296 segments ont ete reduits par consensus a un ensemble de 10 quartiers, lesquels se distinguent les uns des autres selon 9 fonctions construites a partir de 24 variables IMI. Des biplots de ces fonctions ont ete un moyen efficace de resumer et de presenter les resultats de l'evaluation communautaire, et ont stimule l'action communautaire. Conclusions: Il est possible d'utiliser des methodes quantitatives raisonnees pour reduire de grandes quantites d'information sur le milieu bati en resumes signifiants. Ces resumes, ou << quartiers selon le milieu bati >>, ont ete utiles pour catalyser des actions avec les acteurs locaux et ont mene a l'elaboration d'interventions sur le milieu bati favorisant la sante. Mots cles: milieu bati; methodes quantitatives; promotion de la sante; echange des connaissances; reduction de l'obesite, In Canada, chronic diseases as leading causes of death are linked by common preventable risk factors related to lifestyle: tobacco use, unhealthy diet and physical inactivity. (1) Recent research suggests [...]

In April 2011, a conference with invited experts from research, policy and practice was held to build consensus around policy levers to address environmental determinants of obesity. The gap between existing policy tools and what can promote health through community design is a major policy opportunity. This commentary represents a consensus of next actions towards creating built environments that support healthy active living. The policy environment and Canadian evidence are reviewed. Issues and challenges to policy change are discussed. Recommendations to create supportive built environments that encourage healthy active living in communities include the following: 1) empower planning authorities to change bylaws that impede healthy active living, protect and increase access to green space, introduce zoning to increase high density, mixed land use, and influence the location and distribution of food stores; 2) establish stable funding for infrastructure promoting active transportation and opportunities for recreation; 3) evaluate the effectiveness of programs to improve the built environment so that successful interventions can be identified and disseminated; 4) mandate health impact assessment of planning, development and transportation policies to ensure that legislative changes promote health and safety; 5) frame issues to dispel myths and to promote protection from obesity risk factors. Key words: Child; adolescent; health status; obesity; health policy; environment design En avril 2011, une conference d'experts invites du monde de la recherche, des politiques et de la pratique a cherche a construire des consensus autour de leviers politiques pour aborder les determinants environnementaux de l'obesite. Le fosse entre les outils strategiques existants et ceux qui pourraient favoriser la sante par le design communautaire presente une importante occasion strategique a saisir. Ce commentaire expose le consensus des experts sur les prochaines etapes en vue de la creation de milieux batis favorisant une vie active saine. Nous passons en revue l'environnement politique et les donnees probantes canadiennes. Les enjeux et les difficultes des changements d'orientation sont abordes. Les recommandations en vue de creer des milieux batis qui encouragent une vie active saine dans les communautes sont les suivantes : 1) habiliter les responsables de la planification a changer les reglements qui nuisent a une vie active saine, a proteger et elargir l'acces aux espaces verts, et a introduire un zonage qui accroit la densite et l'utilisation mixte des sols et qui influence l'emplacement et la repartition des magasins d'alimentation; 2) etablir des budgets de financement stables pour les infrastructures qui favorisent le transport actif et les possibilites de loisir; 3) evaluer l'efficacite des programmes d'amelioration du milieu bati pour que les interventions fructueuses puissent etre identifiees et disseminees; 4) ordonner l'evaluation des incidences sur la sante pour toutes les initiatives de planification et les politiques de developpement et de transport, afin que les modifications legislatives favorisent la sante et la securite; 5) presenter les enjeux de maniere a deboulonner les mythes et a promouvoir la protection contre les facteurs de risque de l'obesite. Mots cles : enfant; adolescent; etat sanitaire; obesite; politique sanitaire; conception de l'environnement La traduction du resume se trouve a la fin de l'article. Can J Public Health 2012;103(Suppl. 3):S5-S8., In April 2011, a consensus conference was held with invited experts from research, policy and practice fields. The conference aimed to build consensus around policy levers to address environmental determinants [...]

Objectives. We compared television food advertising to children in several countries. Methods. We undertook a collaboration among 13 research groups in Australia, Asia, Western Europe, and North and South America. Each group recorded programming for 2 weekdays and 2 weekend days between 6:00 and 22:00, for the 3 channels most watched by children, between October 2007 and March 2008. We classified food advertisements as core (nutrient dense, low in energy), noncore (high in undesirable nutrients or energy, as defined by dietary standards), or miscellaneous. We also categorized thematic content (promotional characters and premiums). Results. Food advertisements composed 11% to 29% of advertisements. Noncore foods were featured in 53% to 87% of food advertisements, and the rate of noncore food advertising was higher during children's peak viewing times. Most food advertisements containing persuasive marketing were for noncore products. Conclusions. Across all sampled countries, children were exposed to high volumes of television advertising for unhealthy foods, featuring child-oriented persuasive techniques. Because of the proven connections between food advertising, preferences, and consumption, our findings lend support to calls for regulation of food advertising during children's peak viewing times. (Am J Public Health. 2010;100:1730-1736. doi: 10.2105/AJPH.2009.179267)

Migration to a new country often results in a variety of social and economic challenges, often reflected in foodways. Food is of central importance in maintaining connections to home, and signifying ethnic identity among diasporic community members. Alternatively, new opportunities may be represented by the incorporation of new food elements into consumption patterns. Focus group interviews conducted with Arabic and South Asian immigrant women residing in a smaller Canadian city reveal the meanings women imparted to their own and their families' food choices and dietary habits. Women shared their struggles of maintaining ethnic cuisine as a marker of community affiliation while to varying degrees, integrating new foods, usually at their children's request. Experiences were not uniform, yet comparisons within and across these two communities suggest the importance of local social factors and politico-economic context in shaping commonly shared food and migration experiences and such shared realities highlight areas for advocacy. Keywords: gender, migration, family food practices, culinary heritage, identity, Introduction Migration to Canada frequently entails adapting to new lifeways, and part of this process may include adjusting conceptualizations of self and performance of identities. Experiences of this process of [...]