Search

Abstract 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 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).

Even though regular engagement in physical activity (PA) among children can support their development and encourage the adoption of healthy lifelong habits, most do not achieve their recommended guidelines. Active travel (AT), or any form of human-powered travel (e.g., walking), can be a relatively accessible, manageable, and sustainable way to promote children’s PA. One common barrier to children’s engagement in AT, however, is a reported lack of education and training. To support children’s participation in AT, this paper presents the development of a comprehensive 4-module online road safety education intervention designed to improve children’s knowledge and confidence regarding AT. Using a qualitative integrated knowledge translation (iKT) approach undertaken with community collaborators (n = 50) containing expertise in health promotion, public safety, school administration, and transportation planning, our inductive thematic analysis generated fourth themes which constituted the foundation of the intervention modules: Active Travel Knowledge: Awareness of Benefits and Participation; Pedestrian Safety and Skills: Roles, Responsibilities, and Rules; Signs and Infrastructure: Identification, Literacy, and Behaviour; Wheeling Safety and Skills: Technical Training and Personal Maneuvers. Each theme/module was then linked to an explicit learning objective and connected to complementary knowledge activities, resources, and skill development exercises. Implications for research and practice are discussed.

BackgroundThe COVID-19 pandemic has prompted the deployment of digital technologies for public health surveillance globally. The rapid development and use of these technologies have curtailed opportunities to fully consider their potential impacts (eg, for human rights, civil liberties, privacy, and marginalization of vulnerable groups). ObjectiveWe conducted a scoping review of peer-reviewed and gray literature to identify the types and applications of digital technologies used for surveillance during the COVID-19 pandemic and the predicted and witnessed consequences of digital surveillance. MethodsOur methodology was informed by the 5-stage methodological framework to guide scoping reviews: identifying the research question; identifying relevant studies; study selection; charting the data; and collating, summarizing, and reporting the findings. We conducted a search of peer-reviewed and gray literature published between December 1, 2019, and December 31, 2020. We focused on the first year of the pandemic to provide a snapshot of the questions, concerns, findings, and discussions emerging from peer-reviewed and gray literature during this pivotal first year of the pandemic. Our review followed the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) reporting guidelines. ResultsWe reviewed a total of 147 peer-reviewed and 79 gray literature publications. Based on our analysis of these publications, we identified a total of 90 countries and regions where digital technologies were used for public health surveillance during the COVID-19 pandemic. Some of the most frequently used technologies included mobile phone apps, location-tracking technologies, drones, temperature-scanning technologies, and wearable devices. We also found that the literature raised concerns regarding the implications of digital surveillance in relation to data security and privacy, function creep and mission creep, private sector involvement in surveillance, human rights, civil liberties, and impacts on marginalized groups. Finally, we identified recommendations for ethical digital technology design and use, including proportionality, transparency, purpose limitation, protecting privacy and security, and accountability. ConclusionsA wide range of digital technologies was used worldwide to support public health surveillance during the COVID-19 pandemic. The findings of our analysis highlight the importance of considering short- and long-term consequences of digital surveillance not only during the COVID-19 pandemic but also for future public health crises. These findings also demonstrate the ways in which digital surveillance has rendered visible the shifting and blurred boundaries between public health surveillance and other forms of surveillance, particularly given the ubiquitous nature of digital surveillance. International Registered Report Identifier (IRRID)RR2-https://doi.org/10.1136/bmjopen-2021-053962

Abstract Background The COVID-19 a pandemic changed the world. Public health directives to socially distance with stay-at-home orders altered injury risk factor exposure, resulting injury patterns and conducting injury prevention (IP). The objective of this study was to determine the impact the COVID-19 pandemic on injury and IP at North American trauma centers (TC). Results Sixty-two responses were received from pediatric (44%), adult (11%), and combined (31%) TC, from 22 American states, 5 Canadian provinces and Australia. The majority (91%) of programs targeted age groups from birth to 15 years old. Nearly one-third reported IP to be less of an institutional priority with funding redistributed in 15% of centers [median (IQR) − 25% (− 43, 1)], and resultant staffing changes at 38% of centers. A decrease in IP efforts was reported at 64% of TC. Overall, the majority of respondents reviewed injury data, with the top reported increased mechanisms mainly intentional: Firearm-related (75%), assaults (72%), and abuse (71%). Leading increased unintentional injuries were injuries occurring in the home such as falls (70%), followed by ATV (62%), and cycling (57%). Sites pivoted by presenting (74%) or participating (73%) in IP education virtually, social media posts (61%) and the addition of technology (29%). Top barriers were redeployment of partners (45%) and staff (31%), as well as lack of technology (40%) in the target population. Facilitators were technology at TC (74%), support of trauma program (63%), and having IP funding maintained (55%). Conclusions Nearly two-thirds of TC decreased IP efforts during the pandemic due to staffing and funding reductions. The leading reported increased injuries were intentional, indicating that violence prevention is needed, along with support for mental health. While TC successfully pivoted by using technology, access issues in the target population was a barrier resulting in health inequities.

Abstract Background The implementation of community-based programs is key to effective, sustainable initiatives that can support population-level changes in children’s physical activity. The purpose of this scoping review was to explore the implementation models and frameworks used to develop (process models), explore (determinant frameworks), and/or evaluate (evaluation frameworks) community-based physical activity programs for children. Also, the foundational components of the implementation models and frameworks and practical application in real-world settings were described. Methods The methodological framework developed by Arksey and O’Malley (2005) and the updated recommendations from Levac, Colquhoun and O’Brien (2010) were used to search, identify, and summarize applicable studies. This review also met the requirements in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Scoping Reviews Checklist (PRISMA-ScR). A detailed search of six databases and three academic journals was conducted. Information about the article, the program, and the implementation model/framework were extracted and summarized. Results The search retrieved 42,202 articles, of which 27 met the inclusion criteria. Eleven process models, one determinant framework, and two evaluation frameworks were identified. Nineteen components were developed from the models and frameworks. Tailoring, situational analysis, and element identification were common components among the identified models and frameworks. Conclusions Since the execution of interventions is vital for creating successful health-promoting initiatives, researchers and program developers should consider using implementation models and frameworks to guide their community-based physical activity programs. Further research examining the application of new and existing implementation models and frameworks in developing, exploring, and evaluating community-level programs is warranted.

Objectives: The COVID-19 pandemic has had a profound impact on the daily routines of parents and children. This study explored the influence of socioeconomic status (SES) and urbanicity on parents' attitudes toward their children's active play opportunities 6 months and 1.5 years into COVID-19. Methods: A sample of 239 Ontario parents of children aged 12 and younger completed two online surveys (August–December 2020; 2021) to assess parents' intentions, beliefs, and comforts concerning their child's eventual return to play, in addition to various sociodemographic and physical activity variables. Descriptive analyses were run as well as an exploratory factor analysis (EFA) was conducted to group the 14 attitude items into subscales for analysis, to ensure reliability and validity of attitude measures. Results: In general, parents in communities with more urban features (e.g., densely populated areas), single-parents, full-time employed parents, and parents with lower-incomes were more hesitant to return their children to active play during the pandemic. Conclusion: Findings from this work highlight SES and urbanicity disparities that continue to exist during COVID-19.

This study investigated the pandemic-related modifications to food hospitality businesses in Ontario, Canada and their effects on the health and wellbeing of workers. Semi-structured interviews were conducted with 22 food hospitality employees in Ontario between June 2020 and May 2021 as part of the Food Retail Environment Study for Health and Economic Resiliency (FRESHER). Transcripts were analyzed inductively using grounded theory as a means of allowing themes to be distilled organically from this relatively new area of research. Therapeutic landscapes emerged as a framework for the resultant themes. The three main themes in this analysis are compromised based on the physical, social, and symbolic spaces of a therapeutic landscape: physical aspects of food hospitality businesses as influencers of wellbeing, social relationships as sources of support and stress, and symbols of fear and safety within food hospitality workplaces. Results indicate that, for food hospitality employees, the workplace was an imperfect therapeutic landscape with a mix of benefits and threats to wellbeing. Further study is needed to understand how these spaces might be reconstructed to better promote wellbeing.

BackgroundUrinary stone disease (USD) historically has affected older men, but studies suggest recent increases in women, leading to a near identical sex incidence ratio. USD incidence has doubled every 10 years, with disproportionate increases amongst children, adolescent, and young adult (AYA) women. USD stone composition in women is frequently apatite (calcium phosphate), which forms in a higher urine pH, low urinary citrate, and an abundance of urinary uric acid, while men produce more calcium oxalate stones. The reasons for this epidemiological trend are unknown.MethodsThis perspective presents the extent of USD with data from a Canadian Province and a North American institution, explanations for these findings and offers potential solutions to decrease this trend. We describe the economic impact of USD.FindingsThere was a significant increase of 46% in overall surgical interventions for USD in Ontario. The incidence rose from 47.0/100,000 in 2002 to 68.7/100,000 population in 2016. In a single United States institution, the overall USD annual unique patient count rose from 10,612 to 17,706 from 2015 to 2019, and the proportion of women with USD was much higher than expected. In the 10–17-year-old patients, 50.1% were girls; with 57.5% in the 18–34 age group and 53.6% in the 35–44 age group. The roles of obesity, diet, hormones, environmental factors, infections, and antibiotics, as well as the economic impact, are discussed.InterpretationWe confirm the significant increase in USD among women. We offer potential explanations for this sex disparity, including microbiological and pathophysiological aspects. We also outline innovative solutions – that may require steps beyond typical preventive and treatment recommendations.

IntroductionThe COVID-19 pandemic prompted a surge in digital public health surveillance worldwide, with limited opportunities to consider the effectiveness or impact of digital surveillance. The news media shape public understanding of topics of importance, contributing to our perception of priority issues. This study investigated news media reports published during the first year of the pandemic to understand how the use and consequences of digital surveillance technologies were reported on.MethodsA media content analysis of 34 high- to low-income countries was completed. The terms “COVID-19,” “surveillance,” “technologies,” and “public health” were used to retrieve and inductively code media reports.ResultsOf the 1,001 reports, most were web-based or newspaper sources on the development and deployment of technologies directed at contact tracing, enforcing quarantine, predicting disease spread, and allocating resources. Technology types included mobile apps, wearable devices, “smart” thermometers, GPS/Bluetooth, facial recognition, and security cameras. Repurposed data from social media, travel cards/passports, and consumer purchases also provided surveillance insight. Media reports focused on factors impacting surveillance success (public participation and data validity) and the emerging consequences of digital surveillance on human rights, function creep, data security, and trust.DiscussionDiverse digital technologies were developed and used for public health surveillance during the first year of the COVID-19 pandemic. The use of these technologies and witnessed or anticipated consequences were reported by a variety of media sources worldwide. The news media are an important public health information resource, as media outlets contribute to directing public understanding and shaping priority public health surveillance issues. Our findings raise important questions around how journalists decide which aspects of public health crises to report on and how these issues are discussed.

Abstract Background COVID-19 has drastically changed the everyday lives of children, including limiting interactions with peers, loss of regularly organized activities, and closure of schools and recreational facilities. While COVID-19 protocols are in place to reduce viral transmission, they have affected children’s access to physical activity opportunities. The purpose of this study was to understand how COVID-19 has affected children’s engagement in physical activity and to identify strategies that can support children’s return to physical activity programming in public places. Methods Parents of past participants in the Grade 5 ACT-i-Pass Program in London, Ontario, Canada were invited to participate in a semi-structured interview online (in November and December 2020) via Microsoft Teams. The script was comprised of questions about their child’s physical activity levels (before, current, and anticipated following COVID-19), lifestyle changes due to COVID-19, and what service providers can do to assist children’s return to public programming. Interviews were transcribed in Microsoft Teams, reviewed by a member of the research team, and analyzed in NVivo 12 using thematic analysis. Results Twenty-seven parents participated in an interview. Four themes and two subthemes were identified during analysis: (1) modifications to everyday life (a. activity options available and b. altered social environment), (2) safety in public spaces, (3) accessibility of activities, and (4) utilizing outdoor spaces. Conclusions COVID-19 protocols have decreased children’s physical activity levels due to the loss of their regular activities, recreational spaces, and peer support. Implementing facility and activity-specific health protocols, providing outdoor activity options, and offering a variety of activity types, times, and locations are three strategies recommended by parents to help facilitate their children’s return to public recreational places. Due to the negative consequences of physical inactivity on children’s health and well-being, service providers need to implement programming and safety protocols that support children’s engagement in physical activity throughout the remainder of, and the years following, the COVID-19 pandemic.

Active travel (AT) such as walking, cycling, or wheeling to/from places represents a relatively accessible form of transportation and source of physical activity for younger populations (ages 5–19). While youth AT is a topic of interest to geography, planning, and public health audiences, larger-scale qualitative reviews of specific topics like in-depth investigations of youth perceived barriers and facilitators of AT have been generally lacking. To offer an original qualitative review of this literature in service of supporting more precise intervention programming and policy recommendations, as well as to outline directions for future research, this paper pairs systematic review and qualitative meta-synthesis methods to document and thematically synthesize the existing qualitative literature regarding youth perceptions of AT barriers and facilitators. After vetting the results of our search, 53 papers met the parameters of the review inclusion criteria and were included in the final meta-synthesis. Using the National Institute for Health and Care Excellence’s tool, quality assessments of the 53 included articles suggested, generally, low- to moderate-quality research. Applying qualitative meta-analytical methods, the ensuing developed themes outlined youth perceived barriers as emphasizing social and physical threats, poor motivation and efficacy, and unsupportive local social and community capital. Perceived facilitator themes were characterized by positive individual assessments of AT skill and efficacy, social dynamics, and supportive local community environments. Collectively the generated themes related to perceived barriers and facilitators indicated that factors from across multiple levels (e.g., individual, community) of both social and built environments can be consequential in youth AT decision-making processes and eventual participation, suggesting that future AT interventions should consider multi-level approaches and designs in their programming efforts. Future research is encouraged to undertake sociogeographically comparative or targeted group analyses, explore the inclusion of youth perspectives of, or contributions to, local AT policy, and investigate crucial perceptual mechanisms more in-depth.

Throughout the COVID-19 pandemic, a variety of digital technologies have been leveraged for public health surveillance worldwide. However, concerns remain around the rapid development and deployment of digital technologies, how these technologies have been used, and their efficacy in supporting public health goals. Following the five-stage scoping review framework, we conducted a scoping review of the peer-reviewed and grey literature to identify the types and nature of digital technologies used for surveillance during the COVID-19 pandemic and the success of these measures. We conducted a search of the peer-reviewed and grey literature published between 1 December 2019 and 31 December 2020 to provide a snapshot of questions, concerns, discussions, and findings emerging at this pivotal time. A total of 147 peer-reviewed and 79 grey literature publications reporting on digital technology use for surveillance across 90 countries and regions were retained for analysis. The most frequently used technologies included mobile phone devices and applications, location tracking technologies, drones, temperature scanning technologies, and wearable devices. The utility of digital technologies for public health surveillance was impacted by factors including uptake of digital technologies across targeted populations, technological capacity and errors, scope, validity and accuracy of data, guiding legal frameworks, and infrastructure to support technology use. Our findings raise important questions around the value of digital surveillance for public health and how to ensure successful use of technologies while mitigating potential harms not only in the context of the COVID-19 pandemic, but also during other infectious disease outbreaks, epidemics, and pandemics.

Abstract Background Walkability is a popular term used to describe aspects of the built and social environment that have important population-level impacts on physical activity, energy balance, and health. Although the term is widely used by researchers, practitioners, and the general public, and multiple operational definitions and walkability measurement tools exist, there are is no agreed-upon conceptual definition of walkability. Method To address this gap, researchers from Memorial University of Newfoundland hosted “The Future of Walkability Measures Workshop” in association with researchers from the Canadian Urban Environmental Health Research Consortium (CANUE) in November 2017. During the workshop, trainees, researchers, and practitioners worked together in small groups to iteratively develop and reach consensus about a conceptual definition and name for walkability. The objective of this paper was to discuss and propose a conceptual definition of walkability and related concepts. Results In discussions during the workshop, it became clear that the term walkability leads to a narrow conception of the environmental features associated with health as it inherently focuses on walking. As a result, we suggest that the term Active Living Environments, as has been previously proposed in the literature, are more appropriate. We define Active Living Environments (ALEs) as the emergent natural, built, and social properties of neighbourhoods that promote physical activity and health and allow for equitable access to health-enhancing resources. Conclusions We believe that this broader conceptualization allows for a more comprehensive understanding of how built, natural, and social environments can contribute to improved health for all members of the population.

IntroductionChildren with disabilities may be unable engage playground spaces due to barriers exacerbating exclusion. Therefore, clarity on how to evaluate existing playgrounds for inclusivity of children with disabilities is required.MethodsA scoping review was undertaken to explore auditing tools.ResultsFourteen white and grey literature resources were identified. The term “inclusion” was operationalized differently across tools, primarily focusing on physical accessibility. Characteristics of the tools were synthesized into 13 inclusive design recommendations for playgrounds. Two tools showed promise, evaluating 12/13 recommendations.DiscussionThe results of this review provide guidance on existing tools for evaluating playgrounds for inclusion for community stakeholders and researchers.Systematic Review Registrationhttps://osf.io/rycmj.

Abstract Background The COVID-19 pandemic and associated public health measures have resulted in the closure of many physical activity-supporting facilities. This study examined Ontario parents’ and children’s perspectives of COVID-19’s impact on children’s physical activity behaviours, return to play/sport during COVID-19, as well as barriers/facilitators to getting active amid extended closures of physical activity venues. Methods Parents/guardians of children aged 12 years and under living in Ontario, Canada were invited to participate in an interview. 12 parent/guardian and 9 child interviews were conducted via Zoom between December 2020 – January 2021, were audio-recorded, and transcribed verbatim. Thematic content analysis was undertaken to identify pronounced themes. Results Themes for both parent and child interviews fell into one of three categories: 1) barriers and facilitators for getting children active amid COVID-19 closures of physical activity-supporting facilities; 2) changes in children’s activity levels; and, 3) perspectives on return to play/sport during and post-pandemic. Various subthemes were identified and varied between parents and children. The most common facilitator for dealing with children’s inactivity voiced by parents/guardians was getting active outdoors. Parents/guardians noted their willingness to have their children return to play/sport in the community once deemed safe by public health guidelines, and children’s willingness to return stemmed primarily from missing their friends and other important authority figures (e.g., coaches) and sporting events (e.g., tournaments). Conclusions Findings from this study could inform families of feasible and realistic strategies for increasing children’s physical activity during community closures, while also providing public health experts with information regarding what supports, or infrastructure might be needed during future lockdown periods and/or pandemics.

BackgroundAlthough playgrounds are designed to promote outdoor play, children with disabilities may be unable to engage in these spaces due to intrinsic and extrinsic factors. Previous research has examined inclusive/accessible playground design when developing new playgrounds; however, it is unclear if there is a best-practice tool for evaluating the inclusivity of existing playground structures. ObjectiveA scoping review of both peer-reviewed and grey literature will be employed to explore evaluation tools for playground inclusivity, to enable the participation of children with disabilities. MethodsThe conduct of this study will adhere to the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) guidelines. A search for peer-reviewed research studies will be conducted in the following electronic databases: MEDLINE, Scopus, CINAHL, and Embase. Grey literature will be examined via a three-step process: (1) a search in the Canadian Health Research Collection Database; (2) a targeted Google search; and (3) reference list searching. Titles, abstracts, keywords, and full texts of identified studies will be independently screened for inclusion by two reviewers. A synthesis of included articles will describe the publication and auditing tool details. A summary of the findings will highlight the types of playgrounds measured, types of disability considered, measures of inclusion used, and psychometric properties. ResultsDatabase searches for peer-reviewed articles were completed in December 2021. A total of 1471 unique records were returned after the removal of 559 duplicate records. Full texts of 167 studies meeting eligibility criteria will be reviewed. The peer-reviewed research search will guide the grey literature search. The scoping review is planned for completion in 2022. ConclusionsA rigorous search of the literature will determine the availability of tools for evaluating existing playground structures for the inclusivity of children with disabilities. The results will inform recommendations on tool applications, and applicable knowledge translation activities. International Registered Report Identifier (IRRID)DERR1-10.2196/37312

Abstract Urban areas have complex thermal distribution. We examined the association between extreme temperature and mortality in urban Ontario, using two temperature data sources: high-resolution and weather station data. We used distributed lag non-linear Poisson models to examine census division-specific temperature–mortality associations between May and September 2005–2012. We used random-effect multivariate meta-analysis to pool results, adjusted for air pollution and temporal trends, and presented risks at the 99th percentile compared to minimum mortality temperature. As additional analyses, we varied knots, examined associations using different temperature metrics (humidex and minimum temperature), and explored relationships using different referent values (most frequent temperature, 75th percentile of temperature distribution). Weather stations yielded lower temperatures across study months. U-shaped associations between temperature and mortality were observed using both high-resolution and weather station data. Temperature–mortality relationships were not statistically significant; however, weather stations yielded estimates with wider confidence intervals. Similar findings were noted in additional analyses. In urban environmental health studies, high-resolution temperature data is ideal where station observations do not fully capture population exposure or where the magnitude of exposure at a local level is important. If focused upon temperature–mortality associations using time series, either source produces similar temperature–mortality relationships.

Background: Lifestyle genomics (LGx) is a science that explores interactions between genetic variation, lifestyle components such as physical activity (PA), and subsequent health- and performance-related outcomes. The objective of this study was to determine whether an LGx intervention could motivate enhanced engagement in PA to a greater extent than a population-based intervention. Methods: In this pragmatic randomized controlled trial, participants received either the standard, population-based Group Lifestyle BalanceTM (GLB) program intervention or the GLB program in addition to the provision of LGx information and advice (GLB + LGx). Participants (n = 140) completed a 7-day PA recall at baseline, 3, 6, and 12 months. Data from the PA recalls were used to calculate metabolic equivalents (METs), a measure of energy expenditure. Statistical analyses included split plot analyses of covariance and binary logistic regression (generalized linear models). Differences in leisure time PA weekly METs, weekly minutes of moderate + high-intensity PA, and adherence to PA guidelines were compared between groups (GLB and GLB + LGx) across the 4 time points. Results: Weekly METs were significantly higher in the GLB + LGx group (1,114.7 ± 141.9; 95% CI 831.5–1,397.8) compared to the standard GLB group (621.6 ± 141.9 MET/week; 95% CI 338.4–904.8) at the 6-month follow-up (p = 0.01). All other results were non-significant. Conclusions: The provision of an LGx intervention resulted in a greater weekly leisure time PA energy expenditure after the 6-month follow-up. Future research should determine how this could be sustained over the long-term. Clinical Trial Registration: NCT03015012.

Abstract Background Mental health (MH) problems are among the most important causes of morbidity and mortality for children and youth. Problems of lack of equity in child and youth MH services (CYMHS)—including, but not limited to, problems in inaccessibility and quality of services—are widespread. Characterizing the nature of equity in CYMHS is an ongoing challenge because the field lacks a consistent approach to conceptualizing equity. We will conduct a scoping review of how equity in MH services for children and youth has been defined, operationalized, and measured. Our objectives are to discover: (1) What conceptual definitions of equity are used by observational studies of CYMHS?; (2) What service characteristics of CYMHS care do indices of equity cover?; (3) What population dimensions have been used to operationalize equity?; (4) What statistical constructs have been used in indices that measure CYMHS equity?; and (5) What were the numerical values of those indices? Methods The following databases will be searched: Medline, Embase, PsycINFO, Cochrane Controlled Register of Trials, CINAHL, EconLit, and Sociological Abstracts. Searches will be conducted from the date of inception to the end of the last full calendar year (December 2019). Studies will be included if they include an evaluation of a mental health service for children or youth (defined as those under 19 years of age) and which quantify variation in some aspect of child or youth mental health services (e.g., accessibility, volume, duration, or quality) as a function of socio-demographic and/or geographic variables. Study selection will occur over two stages. Stage one will select articles based on title and abstract using the liberal-accelerated method. Stage two will review the full texts of selected titles. Two reviewers will work independently on full-text reviewing, with each study screened twice using pre-specified eligibility criteria. One reviewer will chart study characteristics and indices to be verified by a second reviewer. Reviewers will resolve full-text screening and data extraction disagreements through discussion. Synthesis of the collected data will focus on compiling and mapping the types and characteristics of the indices used to evaluate MH services equity. Discussion The planned, systematic scoping review will survey the literature regarding how equity in MH services for children and youth has been operationalized and help inform future studies of equity in CYMHS. Systematic review registration Open Science Foundation ID SYSR-D-19-00371, https://osf.io/58srv/ .

Introduction: The rise in sedentary behaviour, coupled with the decline in overall mental health among Canadian children and youth in recent decades, demonstrates a clear need for applied research that focusses on developing and evaluating cross-disciplinary interventions. Outdoor spaces provide opportunities for physical activity and social connectedness, making them an ideal setting to address these critical health concerns among children and youth. Methods: We conducted a rapid review of peer-reviewed (n = 3096) and grey literature (n = 7) to identify physical activity and/or social connectedness outdoor space interventions targeted at children and youth (19 years and under) in Australia and New Zealand, Canada, Europe and the United States. We determined if interventions were effective by analyzing their research design, confidence intervals and reported limitations, and then conducted a narrative synthesis of the effective interventions. Results: We found 104 unique studies, of which 70 (67%) were determined to be effective. Overall, 55 interventions targeted physical activity outcomes, 10 targeted social connectedness outcomes and 5 targeted both. Play (n = 47) and contact with nature (n = 25) were dominant themes across interventions, with most taking place in a school or park. We report on the identifying features, limitations and implications of these interventions. Conclusion: The incorporation of natural and play-focussed elements into outdoor spaces may be effective ways to improve physical activity and social connectedness. There is a considerable need for more Canadian-specific research. Novel methods, such as incorporating smartphone technology into the design and evaluation of these interventions, warrant consideration.

Abstract Background Early experiences in physical activity (PA) are important to shape healthy movement behaviours long-term; as such, it is critical that PA is promoted from infancy, and that detrimental behaviours (e.g., prolonged sedentary time [ST]) are minimized. The purpose of this systematic review and meta-analysis was to examine infants’ and toddlers’ movement behaviours across daytime hours. Methods Seven online databases were searched for terms related to infants (

Introduction. La conjugaison d’une augmentation du comportement sédentaire et d’une baisse de la santé mentale globale chez les enfants et les jeunes canadiens dans les dernières décennies est le signe évident que l’on a besoin de recherche appliquée axée sur l’élaboration et l’évaluation d’interventions interdisciplinaires. Les espaces extérieurs offrent des possibilités d’activité physique et d’interactions sociales, ce qui en fait un cadre idéal pour répondre à ces préoccupations essentielles en matière de santé chez les enfants et les jeunes. Méthodologie. Nous avons procédé à une revue rapide de la littérature évaluée par les pairs (n = 3 096) et de la littérature grise (n = 7) afin de sélectionner les interventions en faveur de l’activité physique et de l’appartenance sociale portant sur les espaces extérieurs et visant les enfants et les jeunes (19 ans ou moins) en Australie et en Nouvelle­Zélande, au Canada, en Europe et aux États­Unis. Nous avons déterminé si les interventions étaient efficaces en analysant la conception de l’étude, les intervalles de confiance et les limites signalées, puis en réalisant une synthèse narrative des interventions efficaces. Résultats. Nous avons relevé 104 études, dont 70 (67 %) ont été jugées efficaces. Sur l’ensemble, 55 interventions visaient l’activité physique, 10 visaient l’appartenance sociale et 5 visaient les deux. Le jeu (n = 47) et le contact avec la nature (n = 25) étaient les thèmes dominants dans toutes les interventions, la plupart ayant lieu dans une école ou un parc. Nous rendons compte des caractéristiques, des limites et des conséquences de ces interventions. Conclusion. L’intégration d’éléments naturels et ludiques dans les espaces extérieurs peut être un moyen efficace d’améliorer l’activité physique et l’appartenance sociale. Il y a un besoin considérable de recherches plus spécifiques au Canada. De nouvelles stratégies, comme l’intégration de la technologie des téléphones intelligents dans la conception et l’évaluation de ces interventions, méritent d’être envisagées.

The COVID-19 pandemic resulted in closures of physical-activity-supporting environments, including playgrounds, outdoor recreation facilities (e.g., basketball courts), and community centers, which impacted children’s movement opportunities. This study evaluated changes in Ontario children’s physical activity levels during the COVID-19 pandemic and explored the impact of family sociodemographic markers on children’s activity. Parents (n = 243; Mage = 38.8 years) of children aged 12 and under (n = 408; Mage = 6.7 years) living in Ontario, Canada, completed two online surveys between August and December 2020 (survey 1) and August and December 2021 (survey 2). Generalized linear mixed-effects models were used to estimate changes in the proportion of children who accumulated 60 min of physical activity per day pre-lockdown, during lockdown, and post-lockdown in Ontario. Results revealed a significant non-linear trajectory whereby the proportion of children achieving 60 min of physical activity per day pre-lockdown (63%) declined during lockdown (21%) and then increased post-lockdown (54%). Changes in the proportion of children engaging in 60 min of daily physical activity were moderated by several demographic variables. Efforts are needed to provide parents of young children with a wider variety of resources to ensure children are obtaining sufficient levels of physical activity regardless of the presence of community lockdowns.

Introduction Infectious diseases pose a risk to public health, requiring efficient strategies for disease prevention. Digital health surveillance technologies provide new opportunities to enhance disease prevention, detection, tracking, reporting and analysis. However, in addition to concerns regarding the effectiveness of these technologies in meeting public health goals, there are also concerns regarding the ethics, legality, safety and sustainability of digital surveillance technologies. This scoping review examines the literature on digital surveillance for public health purposes during the COVID-19 pandemic to identify health-related applications of digital surveillance technologies, and to highlight discussions of the implications of these technologies.Methods and analysis The scoping review will be guided by the framework proposed by Arksey and O’Malley and the guidelines outlined by Colquhoun et al and Levac et al. We will search Medline (Ovid), PsycInfo, PubMed, Scopus, CINAHL (EBSCOhost), ACM Digital Library, Google Scholar and IEEE Explore for relevant studies published between December 2019 and December 2020. The review will also include grey literature. Data will be managed and analysed through an extraction table and thematic analysis.Ethics and dissemination Findings will be disseminated through traditional academic channels, as well as social media channels and research briefs and infographics. We will target our dissemination to provincial and federal public health organisations, as well as technology companies and community-based organisations managing the public response to the COVID-19 pandemic.

BackgroundGood nutrition affects children’s health, well-being, and learning, and schools offer an important setting to promote healthy behaviors that can last a lifetime. Once children reach school age, they spend more of their waking hours in school than in any other environment. Children’s eating habits may be easier to influence than those of adults. In Canada, households with children are more likely to experience food insecurity, and school food programs that are universally available to all children can support the development of healthy eating patterns across groups of varying socioeconomic status. There is a significant gap in the rigorous community-engaged academic research on the impact of school meal programs, especially universal ones. ObjectiveThe aim of this population health intervention research is to study the impact of a 2-year universal, curriculum-integrated healthy school lunch program in elementary schools in Saskatoon, Saskatchewan, Canada, on food consumption, dietary quality and food and nutrition-related knowledge, attitudes, and practices. MethodsThis population health intervention study will be conducted in 2 intervention elementary schools matched with 2 control schools. We will collect preintervention data, including objective measurements of food eaten at school and food-related knowledge, attitudes, and behaviors. This will be followed by the intervention itself, along with qualitative case studies of the intervention process in the 2 intervention schools. Then, we will collect postintervention data similar to the preintervention data. Finally, we will finish the data analysis and complete the ongoing sharing of learning from the project. ResultsThis study was funded in April 2020 but because of the COVID-19 pandemic, data collection did not begin until May 2021. The intervention will begin in September 2021 and end in June 2023, with end point data collection occurring in May and June 2023. The case study research will begin in September 2021 and will be ongoing for the duration of the intervention. ConclusionsThe opportunity we have to systematically and comprehensively study a curriculum-integrated school lunch program, as well as the promising practices for school food programs across Canada, is without precedent. International Registered Report Identifier (IRRID)DERR1-10.2196/30899

Abstract Background The nutrigenomics, overweight/obesity and weight management trial (NOW Trial) is a pragmatic randomized controlled trial of community-dwelling adults recruited from the Group Lifestyle Balance™ (GLB™) Program. The GLB™ Program (formerly referred to as the Diabetes Prevention Program) is an evidence-based, intensive weight management program, which was offered to overweight/obese patients (BMI ≥ 25.0 kg/m2) in a rural Ontario community. Methods Patients enrolled in the GLB™ Program were invited to participate in this study. GLB™ groups were randomized 1:1 to receive either the standard GLB™ program + population-based lifestyle advice for weight management, or a modified GLB™ program + personalized, genetic-based lifestyle advice for weight management. The purpose of this study is to determine if the provision of genetic-based lifestyle guidelines is superior to the provision of population-based guidelines in a pragmatic clinical setting to promote changes in: body composition, weight, body mass index, dietary and physical activity habits, as well as attitudes, subjective norms, and behavioural control. The 12-month intervention protocol consists of 23 group-based sessions and 4 one-on-one sessions. Data collection time points include baseline in addition to 3, 6, and 12-month follow up. The comprehensive study design is described in the present manuscript, using both the extended CONSORT checklist for reporting pragmatic trials and the SPIRIT checklist as guidance during manuscript development. Discussion Overall, this study seeks to pragmatically determine if the provision of DNA-based lifestyle advice leads to improved health and lifestyle outcomes compared to the provision of standard, population-based lifestyle advice. The results of this trial can be used to inform clinical and community nutrition practice guidelines. Trial registration This study was registered with clinicaltrials.gov: NCT03015012 on January 9, 2017.

Physical inactivity among children is a public health concern. Children's ability to travel independently is associated with increased physical activity and social connectedness. Consequently, it is concerning that children's independent mobility has decreased in recent years. Studies have highlighted that rates of independent mobility vary by gender; this study analyzed how correlates of independent mobility vary between boys (n = 476) and girls (n = 618) attending 32 elementary schools in Southwestern Ontario. Hierarchical logistic regression modeling methods were used. All analyzes were stratified by gender. For boys, age was negatively associated with travel with peers. Having one or more siblings of any age was associated with increased travel with peers and having one or more older/same siblings decreased the likelihood of travel alone. Parents’ perceptions of the journey being too far/taking too much time was negatively associated with boys’ traveling alone. In comparison, age was positively associated with traveling alone for girls. Having one or more younger or older/same siblings were associated with decreased traveling alone, while older/same age siblings were positively associated with traveling with peers. Distance was negatively associated with both traveling with peers and alone. For girls, parents’ perceptions of the journey between home and school being easier to drive and having enough walking trails in the neighbourhood were negatively associated with travel alone and with peers, respectively. The findings of this study can aid in informing future interventions targeting children's school travel and help address inequities in independent mobility between boys and girls.

Introduction: Low levels of physical activity among children are a significant public health concern in several industrialized nations. The current research body has failed to gather adequate information on various geographic regions. Understanding barriers and facilitators in different rural regions is imperative for creating successful physical activity interventions for children in rural areas. The purpose of this study is to explore rural children's perspectives on physical activity and to discuss barriers or facilitators to physical activity participation in rural Northwestern Ontario, Canada. Methods: Children (n=84) in Grades 4-8 (ages 8-14 years) in rural Northwestern Ontario participated in focus groups to discuss barriers and facilitators to physical activity. Twenty focus groups were conducted in schools. The focus groups were audio-recorded and transcribed verbatim. Transcripts were analyzed using thematic analysis. Subthemes were created based on the explicit content of the data and grouped to form broader themes. Results: Three key themes were identified: environment, social environment, and perceptions of safety. Environmental features include weather and the built environment. Social environment includes the role of friends and adults to either facilitate or restrict children's play. The fear of wildlife was pervasive across all focus groups and resulted in restricted independent mobility and physical activity. Conclusion: Rural children are typically under-represented in physical activity research. The findings of this study reveal that rural children experience some barriers to physical activity that are distinct from those of urban children. The findings suggest that researchers need to understand contextual nuances of the rural environment. Specific to the setting of Northwestern Ontario, these rural children could benefit from the addition of a skate park, indoor places to play, and more wildlife education.

Background Adherence to nutritional guidelines for chronic disease prevention and management remains a challenge in clinical practice. Innovative strategies are needed to help optimise dietary behaviour change.Objective The objective of this study was to determine if a nutrigenomics-guided lifestyle intervention programme could be used to motivate greater dietary adherence and change in dietary intake short-term, moderate-term and long-term compared to the gold-standard population-based weight management intervention (Group Lifestyle Balance (GLB)/Diabetes Prevention Programme (DPP)).Design The Nutrigenomics, Overweight/Obesity, and Weight Management (NOW) randomised controlled trial is a pragmatic, parallel-group, superiority clinical trial (n=140), which was conducted at the East Elgin Family Health Team (EEFHT). GLB weight management groups were prerandomised 1:1 to receive either the standard GLB programme or a modified GLB+nutrigenomics (GLB+NGx) programme. Three 24-hour recalls were collected at baseline, 3, 6 and 12 months using the validated multiple pass method. Research assistants collecting the three 24-hour recalls were blinded to the participants’ group assignments. Statistical analyses included split plot analyses of variance (ANOVAs), two-way ANOVAs, binary logistic regression, χ2 and Fisher’s exact tests. Using the Theory of Planned Behaviour as guidance, key confounding factors of behaviour change were considered in the analyses. This study was registered with clinicaltrials.gov (NCT03015012).Results Only the GLB+NGx group significantly reduced their total fat intake from baseline to 12-month follow-up (from 36.0%±4.8% kcal to 30.2%±8.7% kcal, p=0.02). Long-term dietary adherence to total fat and saturated fat guidelines was also significantly (p

Objective The objective of this study is to examine the magnitude and pattern of small-area geographic variation in rates of preventable hospitalisations for ambulatory care-sensitive conditions (ACSC) across Canada (excluding Québec).Design and setting A cross-sectional study conducted in Canada (excluding Québec) using data from the 2006 Canadian Census Health and Environment Cohort (CanCHEC) linked prospectively to hospitalisation records from the Discharge Abstract Database (DAD) for the three fiscal years: 2006–2007, 2007–2008 and 2008–2009.Primary outcome measure Preventable hospitalisations (ACSC).Participants The 2006 CanCHEC represents a population of 22 562 120 individuals in Canada (excluding Québec). Of this number, 2 940 150 (13.03%) individuals were estimated to be hospitalised at least once during the 2006–2009 fiscal years.Methods Age-standardised annualised ACSC hospitalisation rates per 100 000 population were computed for each of the 190 Census Divisions. To assess the magnitude of Census Division-level geographic variation in rates of preventable hospitalisations, the global Moran’s I statistic was computed. ‘Hot spot’ analysis was used to identify the pattern of geographic variation.Results Of all the hospitalisation events reported in Canada during the 2006–2009 fiscal years, 337 995 (7.10%) events were ACSC-related hospitalisations. The Moran’s I statistic (Moran’s I=0.355) suggests non-randomness in the spatial distribution of preventable hospitalisations. The findings from the ‘hot spot’ analysis indicate a cluster of Census Divisions located in predominantly rural and remote parts of Ontario, Manitoba and Saskatchewan and in eastern and northern parts of Nunavut with significantly higher than average rates of preventable hospitalisation.Conclusion The knowledge generated on the small-area geographic variation in preventable hospitalisations can inform regional, provincial and national decision makers on planning, allocation of resources and monitoring performance of health service providers.

Introduction: The lack of policy, practice and research action on physical activity and features of the physical (built and natural) environments in rural, remote and northern settings is a significant threat to population health equity in Canada. This paper presents a synthesis of current evidence on the promotion of physical activity in non-urban settings, outcomes from a national priority-setting meeting, and a preliminary call to action to support the implementation and success of population-level initiatives targeting physical activity in non-urban settings. Methods: We conducted a “synopses of syntheses” scoping review to explore current evidence on physical activity promotion in rural, remote, northern and natural settings. Next, we facilitated a collaborative priority-setting conference with 28 Canadian experts from policy, research and practice arenas to develop a set of priorities on physical activity in rural, remote and northern communities. These priorities informed the development of a preliminary Canadian call to action. Results: We identified a limited number of reviews that focused on physical activity and the built environment in rural, remote and northern communities. At the prioritysetting conference, participants representing rural, remote and northern settings identified top priorities for policy, practice and research action to begin to address the gaps and issues noted in the literature. These priorities include self-identifying priorities at the community level; compiling experiences; establishing consistency in research definitions and methods; and developing mentorship opportunities. Conclusion: Coordinated action across policy, practice and research domains will be essential to the success of the recommendations presented in this call to action.

Abstract Background Alzheimer’s disease (AD) is a chronic neurodegenerative disease with pathological hallmarks including the formation of extracellular aggregates of amyloid-beta (Aβ) known as plaques and intracellular tau tangles. Coincident with the formation of Aβ plaques is recruitment and activation of glial cells to the plaque forming a plaque niche. In addition to histological data showing the formation of the niche, AD genetic studies have added to the growing appreciation of how dysfunctional glia pathways drive neuropathology, with emphasis on microglia pathways. Genomic approaches enable comparisons of human disease profiles between different mouse models informing on their utility to evaluate secondary changes to triggers such as Aβ deposition. Methods In this study, we utilized two animal models of AD to examine and characterize the AD-associated pathology: the Tg2576 Swedish APP (KM670/671NL) and TgCRND8 Swedish plus Indiana APP (KM670/671NL + V717F) lines. We used laser capture microscopy (LCM) to isolate samples surrounding Thio-S positive plaques from distal non-plaque tissue. These samples were then analyzed using RNA sequencing. Results We determined age-associated transcriptomic differences between two similar yet distinct APP transgenic mouse models, known to differ in proportional amyloidogenic species and plaque deposition rates. In Tg2576, human AD gene signatures were not observed despite profiling mice out to 15 months of age. TgCRND8 mice however showed progressive and robust induction of lysomal, neuroimmune, and ITIM/ITAM-associated gene signatures overlapping with prior human AD brain transcriptomic studies. Notably, RNAseq analyses highlighted the vast majority of transcriptional changes observed in aging TgCRND8 cortical brain homogenates were in fact specifically enriched within the plaque niche samples. Data uncovered plaque-associated enrichment of microglia-related genes such as ITIM/ITAM-associated genes and pathway markers of phagocytosis. Conclusion This work may help guide improved translational value of APP mouse models of AD, particularly for strategies aimed at targeting neuroimmune and neurodegenerative pathways, by demonstrating that TgCRND8 more closely recapitulates specific human AD-associated transcriptional responses.

Abstract Background Pediatrician and pediatric subspecialist density varies substantially among the various Canadian provinces, as well as among various states in the US. It is unknown whether this variability impacts health outcomes. To study this knowledge gap, we evaluated pediatric asthma admission rates within the 2 Canadian provinces of Manitoba and Saskatchewan, which have similarly sized pediatric populations and substantially different physician densities. Methods This was a retrospective cross-sectional cohort study. Health regions defined by the provincial governments, have, in turn, been classified into “peer groups” by Statistics Canada, on the basis of common socio-economic characteristics and socio-demographic determinants of health. To study the relationship between the distribution of the pediatric workforce and health outcomes in Canadian children, asthma admission rates within comparable peer group regions in both provinces were examined by combining multiple national and provincial health databases. We generated physician density maps for general practitioners, and general pediatricians practicing in Manitoba and Saskatchewan in 2011. Results At the provincial level, Manitoba had 48.6 pediatricians/100,000 child population, compared to 23.5/100,000 in Saskatchewan. There were 3.1 pediatric asthma specialists/100,000 child population in Manitoba and 1.4/100,000 in Saskatchewan. Among peer-group A, the differences were even more striking. A significantly higher number of patients were admitted in Saskatchewan (590.3/100,000 children) compared to Manitoba (309.3/100,000, p

Introduction. L’absence d’interventions en matière de recherche, de pratiques et de politiques relativement à l’activité physique et les particularités de l’environnement physique (bâti et naturel) en milieu rural ou éloigné et dans les régions du Nord constituent des freins importants à l’équité en santé de la population au Canada. Cet article présente une synthèse des données probantes pertinentes sur l’activité physique en milieu non urbain, les résultats d’une rencontre sur l’établissement de priorités nationales ainsi qu’un appel préliminaire à l’action en vue de favoriser la mise en place et la réussite, à l’échelle de la population, d’initiatives axées sur l’activité physique en milieu non urbain. Méthodologie. Nous avons d’abord réalisé un examen de la portée des synopsis de synthèses pour étudier les données probantes pertinentes en lien avec la promotion de l’activité physique en milieu rural, éloigné ou naturel et dans les régions du Nord. Nous avons ensuite organisé une conférence à laquelle ont pris part 28 experts canadiens spécialisés en politiques, en recherche et en pratiques, afin de concevoir de manière concertée un ensemble de priorités sur l’activité physique en milieu rural ou éloigné et dans les régions du Nord. À la suite de cette rencontre, nous avons rédigé un appel à l’action préliminaire pour tout le Canada. Résultats. Nous avons relevé relativement peu de travaux axés sur l’activité physique et l’environnement bâti en milieu rural ou éloigné et dans les régions du Nord. Lors de la conférence sur l’établissement de priorités, des participants représentant des milieux ruraux ou éloignés et des collectivités du Nord ont formulé les grandes priorités d’action en matière de politiques, de pratiques et de recherche pour commencer à réduire les écarts et résoudre les problèmes soulevés dans la littérature : le besoin d’identification au niveau communautaire; la compilation d’expériences; l’assurance d’une cohésion dans les définitions et les méthodes de recherche et enfin la création de possibilités de mentorat. Conclusion. Une action concertée entre les domaines des politiques, des pratiques et de la recherche est essentielle au succès des recommandations formulées dans cet appel à l’action.

Place branding has become an increasingly integral part of local and regional economic development strategies in the global competition for business investment. Professional and academic understanding remains limited, however, regarding whether place branding can be classified as a ‘high-road’ policy with substantive and effective merits or a ‘low-road’ policy that is generally inefficient and ineffective at fostering sustainable economic growth. Through the context of business attraction, this study examines whether place branding represents ‘high-road’ policy by comparing what economic development practitioners are doing to create and support their brands against the needs and desires of businesses considering relocation. The research goal is achieved through a series of in-depth interviews with economic development practitioners (n = 25) and private-sector site selectors (n = 10) in the province of Ontario, Canada. Gaps between policy and practicality are identified by comparing the responses of the two groups. Results demonstrate that place branding has the potential to be ‘high-road’ policy given its utility in business attraction. In its current implementation, however, place branding remains better described as a ‘low-road’ policy, as it is not being used efficiently. Several gaps in place-branding policy are identified, including an overreliance on visual identities and narratives, poor communication of the brand information, and overemphasis on presenting quality of life and affordability. These gaps present possible areas of ineffectiveness that can limit the ability of a place brand to attract investment, but provide areas of future policy improvements, thus enabling place branding to shift from ‘low road’ to ‘high road’.

In the original publication of this article [1], the institutional author’s name needs to be revised from The Paediatric Chairs of Canada Mark Bernstein to The Paediatric Chairs of Canada.

Urban cyclists are exposed to many traffic-related air pollutants including particulate matter (PM) that may increase vulnerability to health effects. This study investigates second-by-second personal exposure to PM2.5 (fine particulate matter that is 2.5 microns in diameter and less) along bicycle commuting paths, and assesses elements of the natural and built environment for the relative importance of these factors in understanding the variability in PM2.5 personal exposure. Urban cyclists were carrying high resolution PM2.5 monitors (placed in a backpack) in combination with portable GPS trackers to provide a spatial identity to each one-second pollutant measurement. The results of this study indicate that daily averages of PM2.5 concentrations from all bicycle routes were weakly correlated with meteorological variables, however, a strong influence of regional levels of PM2.5 was observed. Geospatial analysis of PM2.5 personal exposure concentrations showed a considerable variation within routes, correlated with land use (with lower concentrations in parks and higher in industrial areas) and clustered at four areas: busiest bridge, heavily trafficked road segments, the downtown urban core, and two construction sites. This study has found many incidences of personal exposure to PM2.5 exceeding the provincial guidelines for healthy activity (e.g., very poor (PM2.5 > 91 μg/m3) pollution concentrations are clustered in three regions: approaching the bridge in the west part of the city; the downtown urban core; and two under construction spots), which suggests behavioural and infrastructure modifications in balancing the health benefits of cycling with the environmental exposure to air pollutants.

None