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This study examined factors associated with children's and parents' recall of a communication campaign aimed at promoting children's physical activity. A cross-sectional population-based telephone survey was conducted among 1001 children and their parents. Respondents were recruited through a random digit dialing procedure. Respondents' recall of the campaign, beliefs, sociodemographics as well as levels of physical activity and sedentary behaviors were self-reported. Logistic regression analyses were conducted for tweens and their parents separately. Girls (odds ratio [OR] = 2.1; 95%confidence interval (CI): 1.3, 3.5) were more likely to have unaided recall when compared to boys. Tweens in primary school (OR = 1.9; 95%CI: 1.0, 3.4 and OR = 2.1; 95%CI: 1.4, 3.0) and those speaking French (OR = 3.3; 95%CI: 1.4, 8.1 and OR = 2.9; 95%CI: 1.8, 4.7) were more likely to have unaided and aided recall, respectively. Among parents, tweens' unaided (OR = 12.0; 95%CI: 5.2, 28.1) and aided (OR = 3.3; 95%CI: 1.5, 7.3) recall, obesity status (OR = 2.6; 95%CI: 1.3, 5.3), and low income (OR = 5.2; 95%CI: 1.9, 14.3) were positively associated with recall. Additional beliefs were associated with tweens' and parents' recall of the campaign. The association between sex, language, and recall is in line with the branding strategy adopted and no clear evidence for communication inequalities was observed.

Office workers are commonly targeted in interventions to modify their sitting behaviour, yet there is limited evidence of the correlates of breaks in sitting to inform intervention development. This study identifies the individual, workplace and spatial configuration correlates of the frequency of breaks in sitting (number/hour) in office workers (n = 5531) stratified by office type (private-enclosed, shared, open plan). All behaviours and potential correlates were measured via self-report using an online cross-sectional survey. Regression analyses revealed age was the only socio-demographic characteristic associated with frequency of breaks in sitting in all office types. Greater job autonomy and local connectivity were positively associated with frequency of breaks in sitting in shared and open-plan offices. In open-plan offices co-worker proximity was negatively associated with frequency of breaks in sitting. Co-worker visibility was positively associated with frequency of breaks in sitting in all offi...

The purpose of the study was to examine the association between the built environment and physical activity (PA) in prostate cancer survivors (PCS), as well as whether built environment factors (walkability, count of sports complexes) were effect modifiers of a PA intervention.Our study included 165 PCS residing in Edmonton, Alberta, from the PROMOTE trial. The PROMOTE trial was a randomized controlled trial of a behaviour change intervention to increase PA and quality of life in PCS. In the PROMOTE trial, 423 PCS were randomly assigned to a standard physical activity recommendation, self-administered implementation intention, or telephone-assisted implementation intention group. PA and quality of life outcomes were assessed at baseline, 1, and 3 months. To explore the role of the built environment, this study examined walkability and count of sport complexes.Linear regression analyses revealed that the self-administered intervention group had an increase in self-reported PA minutes/week (β = 133.4, 95% CI = -18.9 to 285.6); however, none of the built environment variables were found to be significantly associated with PA. The logistic regression showed that the self-administered intervention group had a significantly greater likelihood of meeting the PA guidelines (OR = 2.1, 95% CI = 0.9 to 4.9), though no built environment variables were associated with PA levels.Our findings suggest that the built environment was not associated with PA and was not an effect modifier in a PA behaviour change intervention for PCS. Further research is needed before clear conclusions can be generated ( ClinicalTrials.gov number NCT01410656).

OBJECTIVE: This study examines associations between area deprivation and perceived neighbourhood safety with active transport to school among preadolescents living in urban Quebec. METHODS: A sample of 809 preadolescents aged 9 to 13 years and one each of their parents living in urban Quebec were recruited by a polling firm for a telephone interview about the Opération WIXX multimedia communication campaign. Opération WIXX was launched in 2012 by Québec en forme to promote physical activity among preadolescents. Logistic regression models predicted active transportation to school (as reported by both the child and his or her parent) from area-level material and social deprivation and from parental and children’s perceptions of neighbourhood safety while controlling for socio-demographic variables. RESULTS: Child and parental reports of active commuting to school were highly concordant (Kendall’s tau=0.70, p

International audience; To examine the short-term impact of the WIXX multimedia communication campaign on children's physical activity (PA) beliefs and behaviors, 3 repeated cross-sectional telephone surveys were conducted before, 9 months after, and 21 months after the launch of the campaign. A random-digit dialing procedure was used to recruit children ages 9 to 13 years. Children's PA beliefs, behaviors, and recall of the WIXX ads were self-reported. Logistic regression models showed that girls exposed to the WIXX ads were more likely to believe that PA would help to make new friends (odds ratio [OR] = 1.4, 95% confidence interval [CI] [1.0, 1.9]) and that they can be active even if too busy (OR = 1.4, 95% CI [1.0, 1.8]) compared to girls not exposed. Boys exposed were more likely to believe that PA would help to spend time with friends (OR = 1.4, 95% CI [1.1, 1.9]). Boys (OR = 1.5, 95% CI [1.1, 2.0.]) and girls (OR = 1.4, 95% CI [1.1, 1.8]) exposed were more likely to report having tried new PAs. No significant impact of the campaign was observed on overall PA after we controlled for confounders. Recall of the WIXX ads was associated with a significant, albeit modest, impact on some PA beliefs and intermediate PA behaviors.

ObjectiveWe investigated the association between junk food consumption at lunchtime (JCL) and fast-food outlet access near school among secondary-school children in Quebec.DesignA geographic information system database was used to characterize the food environment around a sub-sample of 374 public schools in which 26 655 students were enrolled. The outcome variable was JCL during the previous week, dichotomized into low JCL (none or once)v. high JCL (twice or more). Access to fast-food outlets near school was assessed using an existing database of fast-food outlets in Quebec. Covariates included student (age, sex and self-rated perceived health), family (familial status and parental education) and school (urban/rural status and deprivation) variables. Hierarchical logistic regression models were employed for analyses using PROC GLIMMIX of SAS version 9.3.SettingProvince of Quebec, Canada.SubjectsWe used data from the Quebec Health Survey of High School Students (QHSHSS) 2010–11, a survey of secondary-school Quebec students.ResultsExposure to two or more fast-food outlets within a radius of 750 m around schools was associated with a higher likelihood of excess JCL (OR=1·50; 95 % CI 1·28, 1·75), controlling for the characteristics of the students, their families and their schools.ConclusionsThe food environment surrounding schools can constitute a target for interventions to improve food choices among secondary-school children living in the province of Quebec. Transforming environments around schools to promote healthy eating includes modifying zoning regulations that restrict access to fast-food outlets around schools.

International audience; BackgroundAsthma is the most common chronic illness among children. We aimed to better understand the association of neighbourhood context with asthma control and the moderating effect of obesity status on this association.MethodsData were from an asthma clinic cohort (n = 4621) of Montreal youths aged 2-18 years, recruited in 2000-2007 and followed for up to 6 years. Clinical data were linked with medical records on acute care visits and hospitalizations. Neighbourhoods were defined by the 750 m buffer around youths’ postal codes. Using spatial data, neighbourhood context was described by high or low deprivation (D) and walkability (W). Asthma control was based on a composite indicator of all adverse events. The outcome was described by the event rate, i.e. total number of composite events by duration of exposure (time in neighourhood). A Poisson model was fitted to predict asthma control rates by neighbourhood context, controlling for individual covariates and an air pollution index based on spatial exposure estimates. We used the Baron-Kenny framework to test for effect modification by obesity status.ResultsAsthma control was independently predicted by neighbourhood context. Youth living in low D, high W areas had better asthma control compared with those living in high D low W (IRR=0.83, 95%CI 0.69,0.99, p = 0.04) and those in high D high W (IRR=0.80, 95%CI 0.67,0.95, p = 0.01) areas. Within low D areas, higher W was associated with greater asthma control (IRR=0.88, 95%CI 0.76,1.01, p = 0.07). No other associations were found and obesity did not modify the association between neighbourhood context and asthma control.ConclusionsHigher deprivation is associated with lower rates of asthma control among youth; moreover, high walkability may have a protective effect in low deprivation areas. Efforts to reduce area deprivation may benefit youth suffering from poor asthma control; increasing walkability may be especially beneficial in the absence of area deprivation.

Objective:To undertake a 6-year longitudinal investigation of the relationship between the built environment (perceived and objectively measured) and change in body mass index (BMI). Specifically, this research examined whether change in BMI was predicted by objectively measured neighborhood walkability and socioeconomic status (SES), and perceived neighborhood characteristics (for example, crime, traffic and interesting things to look at) in addition to other factors such as age, gender, education, physical activity, fruit and vegetable consumption and smoking.Design:Longitudinal studySubjects:500 adults who provided complete data in 2002 and 2008 and who did not move over the course of the study (47.8% female; age in 2002: 18-90 years).Measurements:Telephone surveys in 2002 and 2008 measuring perceptions of their neighborhood environment and demographic factors. Objective measures of neighborhood characteristics were calculated using census data and geographical information systems in 2006.Results:Age, neighborhood SES and perceived traffic were significantly related to increased BMI over the 6 years. Younger participants and those in lower SES neighborhoods were more likely to have increased BMI. Agreement with the statement that traffic made it difficult to walk also predicted increased BMI.Conclusion:This study adds to the literature to show that BMI increased in low SES neighborhoods. Although more research is needed to fully understand how neighborhood SES contributes to obesity, it is without question that individuals in socially disadvantaged neighborhoods face more barriers to health than their wealthier counterparts. This study also calls into question the relationship between walkability and changes in BMI and emphasizes the necessity of longitudinal data rather than relying on cross-sectional research. Language: en

Studies of the role of the built environment in relation to obesity in young children have reported inconsistent results.We explored the association of objective measures of neighbourhood design (dwelling density, land use mix, intersection density, availability of facilities) with the bodyweight status of 501 preschool children (girls = 262; boys = 239) residing in Edmonton, Canada.Approximately 21% of the children were classified as overweight or at-risk of being overweight according to the Centers for Disease Control (CDC) growth charts, while 15% of the children were considered overweight or obese according to the International Obesity Task Force (IOTF) criteria. Controlling for measures of physical activity, junk food consumption and neighbourhood-level social class, significant interactions were found between sex of the child and walkability of the neighbourhood (composite index of dwelling density, land use mix, and intersection density) and sex of the child and intersection density regardless of the bodyweight status criteria. The odds of girls being overweight or obese were lower if they lived in walkable neighbourhoods (OR = 0.78, 95%CI, 0.66-0.91 CDC; OR = 0.73, 95%CI, 0.61-0.88 IOTF) with more intersections (OR = 0.57, 95%CI, 0.39-0.86 CDC; OR = 0.48, 95%CI, 0.30-0.76 IOTF). No significant associations were observed for boys.Thus, aspects of the built environment may differentially influence the bodyweight status of children depending upon sex.

This study examined regional and local tourism stakeholder perceptions of a sustainable tourism development strategy (STDS) in Protected Area Network (PAN) Park locations. An STDS overview from a cross‐cultural comparative analysis of a verified park (Sweden) versus a candidate site (Romania) is given. In‐depth interviews addressed stakeholder cooperation in sustainable tourism planning, perception of tourism in the region, development proposals, and their involvement in sustainable tourism planning. Findings were organized under three interlinkages of a sustainability framework: institutional referring to contribution to sustainable development; care involving management and product innovations; and democracy‐justice involving community rejuvenation via opportunities for small‐scale businesses having a voice in decision making. Regional authorities (in both countries) have other obligations than sustainable tourism development to fulfill while lack of infrastructure and access to parks is a barrier to ov...

Physical activity is associated with access to recreational facilities such as sports fields. Because it is not clear whether objectively- or subjectively-assessed access to facilities exerts a stronger influence on physical activity, we investigated the association between the objective and perceived accessibility of sport fields and the levels of self-reported physical activity among adults in Edmonton, Canada. A sample of 2879 respondents was surveyed regarding their socio-demographics, health status, self-efficacy, levels of physical activity, as well as their perceptions of built environment in relation to physical activity. Neighbourhood-level data were obtained for each respondent based on their residence. Accessibility to facilities was assessed using the enhanced Two-Step Floating Catchment Area method. Geographic Information Systems were employed. A logistic regression was performed to predict physical activity using individual- and neighbourhood-level variables. Women, older individuals, and individuals with higher educational attainment were less likely to be physically active. Also, individuals with higher self-efficacy and higher objectively-assessed access to facilities were more likely to be physically active. Interventions that integrate provision of relevant programs for various population groups and of improved recreational facilities may contribute to sport fields becoming catalysts for physical activity by generating movement both on the site and in the neighbourhood.

Resident perceptions of neighbourhood walkability, physical activity opportunities, food choice and factors influencing choice of neighbourhood were examined through focus group discussion in higher and lower walkability neighbourhoods. Almost all participants perceived their neighbourhoods as very or reasonably walkable with high food choice. Walking was described as primarily leisure or exercise focused and less frequenly as destination or task-oriented. Factors influencing walking and physical activity included connectivity, path quality, weather and traffic. The ability to drive easily was a key factor in neighbourhood choice. Our findings identified important environmental factors perceived by residents as either positively or negatively influencing behaviour related to physical activity and food choice. Future research should examine the relationship between perceived and actual walkability features as well as residential selection.

Background The purpose of this study was to examine the relationship between body mass index and neighborhood walkability, socioeconomic status (SES), reasons for choosing neighborhoods, physical activity, fruit and vegetable intake, and demographic variables. Methods Two studies, one longitudinal and one cross-sectional, were conducted. Participants included adults (n = 572) who provided complete data in 2002 and 2008 and a concurrent sample from 2008 (n = 1164). Data were collected with longitudinal and cross-sectional telephone surveys. Objective measures of neighborhood characteristics (walkability and SES) were calculated using census data and geographic information. Results In the longitudinal study, neighborhood choice for ease of walking and proximity to outdoor recreation interacted with whether participants had moved during the course of study to predict change in BMI over 6 years. Age, change in activity status, and neighborhood SES were also significant predictors of BMI change. Cross-sectionally, neighborhood SES and neighborhood choice for ease of walking were significantly related to BMI as were gender, age, activity level and fruit and vegetable intake. Conclusions Results demonstrate that placing importance on choosing neighborhoods that are considered to be easily walkable is an important contributor to body weight. Findings that objectively measured neighbourhood SES and neighborhood choice variables contributed to BMI suggest that future research consider the role of neighborhood choice in examining the relationships between the built environment and body weight.

Background Outside of the United States, evidence for associations between exposure to fast-food establishments and risk for obesity among adults is limited and equivocal. The purposes of this study were to investigate whether the relative availability of different types of food retailers around people's homes was associated with obesity among adults in Edmonton, Canada, and if this association varied as a function of distance between food locations and people's homes. Methods Data from a population health survey of 2900 adults (18 years or older) conducted in 2002 was linked with geographic measures of access to food retailers. Based upon a ratio of the number of fast-food restaurants and convenience stores to supermarkets and specialty food stores, a Retail Food Environment Index (RFEI) was calculated for 800 m and 1600 m buffers around people's homes. In a series of logistic regressions, associations between the RFEI and the level of obesity among adults were examined. Results The median RFEI for adults in Edmonton was 4.00 within an 800 m buffer around their residence and 6.46 within a 1600 m buffer around their residence. Approximately 14% of the respondents were classified as being obese. The odds of a resident being obese were significantly lower (OR = 0.75, 95%CI 0.59 – 0.95) if they lived in an area with the lowest RFEI (below 3.0) in comparison to the highest RFEI (5.0 and above). These associations existed regardless of the covariates included in the model. No significant associations were observed between RFEI within a 1600 m buffer of the home and obesity. Conclusion The lower the ratio of fast-food restaurants and convenience stores to grocery stores and produce vendors near people's homes, the lower the odds of being obese. Thus the proximity of the obesogenic environment to individuals appears to be an important factor in their risk for obesity.

This study examines whether exposure to supermarkets and fast food outlets varies with neighborhood-level socioeconomic status in Edmonton, Canada. Only market area and fast food proximity predicted supermarket exposure. For fast food outlets, the odds of exposure were greater in areas with more Aboriginals, renters, lone parents, low-income households, and public transportation commuters; and lower in those with higher median income and dwelling value. Low wealth, renter-occupied, and lone parent neighborhoods had greater exposure to fast food outlets, which was not offset by better supermarket access. The implications are troubling for fast food consumption among lone parent families in light of growing obesity rates among children.

The purposes of this study were to examine perceptions of places to play and be physically active among children from two different urban neighborhoods, and evaluate these perceptions for age-related developmental differences. One hundred and sixty-eight children from grades K-6 (aged 6-12 years old) completed mental maps depicting places where they could play and be physically active. The children were recruited from schools in two neighborhoods-one a high-walkability (H-W) grid-style neighborhood, the other a low-walkability (L-W) lollipop-style (i.e., cul-de-sacs) neighborhood. Analysis revealed that children in the H-W neighborhood depicted more active transportation and less non-active transportation than children in the L-W neighborhood. Children in the lowest grades (K-2) in the L-W neighborhood depicted more play in the home/yard environment than the oldest children, more good weather image events than children in Grades 3-6, and less play outside the home/yard environment than children in Grades 3 and 4. In the H-W neighborhood, the youngest children (K-2) depicted significantly less play in the home/yard environment and less play outside the home/yard environment than older children (Grades 3-6). Thus, both the type of urban neighborhood and children's age moderated perceptions of places to play and be physically active.

Background Simultaneously advocating for sustainable development and promoting population health seems synergistic but few integrated interventions have been studied. We developed a logic model for the Montreal Quartiers 21 Program and assessed awareness of the Program among Montreal residents. Methods We developed a logic model of the Montreal Quartiers 21 Program, which is part of Montreal's Strategic Action Plan towards Sustainable Development and allocates money to community groups to support grassroots health projects for sustainable development. We also did a 20 min online survey of Montreal residents aged 18 years or older to assess their awareness of the Program. Survey participants were randomly selected from a panel recruited by a polling firm. We estimated weighted prevalence of awareness and used logistic regression to identify variables associated with awareness. Findings The two iterations of the Program (in 2005–09, and 2010–13) funded 28 projects for revitalisation of commercial streets, active and public transportation, creating green public and outdoor private spaces, making public spaces safer, calming traffic, promoting urban agriculture, collecting recyclable materials, and increasing quality of rainfall runoff. Of the 1793 respondents with complete data, 6·0% (95% CI 4·5–7·9) could spontaneously recognise the Program and 25·7% (22·8–28·8) could after prompting. Interpretation Interventions, such as the Montreal Quartiers 21 Program can provide feasible projects consistent with principles of sustainable development and public health. However, public awareness of projects is modest. Funding Canadian Institutes of Health Research.

157 schools. Rural schools had less favourable built environments than urban schools. conclusions: Canadian children, particularly those from rural areas and those attending secondary

BackgroundSedentary behavior is considered a separate construct from physical activity and engaging in sedentary behaviors results in health effects independent of physical activity levels. A major source of sedentary behavior in children is time spent viewing TV or movies, playing video games, and using computers. To date no study has examined the impact of neighborhood socioeconomic status (SES) on pre-school children's screen time behavior.MethodsProxy reports of weekday and weekend screen time (TV/movies, video games, and computer use) were completed by 1633 parents on their 4-5 year-old children in Edmonton, Alberta between November, 2005 and August, 2007. Postal codes were used to classified neighborhoods into low, medium or high SES. Multiple linear and logistic regression models were conducted to examine relationships between screen time and neighborhood SES.ResultsGirls living in low SES neighborhoods engaged in significantly more weekly overall screen time and TV/movie minutes compared to girls living in high SES neighborhoods. The same relationship was not observed in boys. Children living in low SES neighborhoods were significantly more likely to be video game users and less likely to be computer users compared to children living in high SES neighborhoods. Also, children living in medium SES neighborhoods were significantly less likely to be computer users compared to children living in high SES neighborhoods.ConclusionsSome consideration should be given to providing alternative activity opportunities for children, especially girls who live in lower SES neighborhoods. Also, future research should continue to investigate the independent effects of neighborhood SES on screen time as well as the potential mediating variables for this relationship.

Little research has examined seasonal differences in physical activity (PA) levels among children. Proxy reports of PA were completed by 1,715 parents on their children in Edmonton, Alberta, Canada. Total PA (TPA) minutes were calculated, and each participant was classified as active, somewhat active, or inactive. Logistic regression models were conducted to examine associations between PA status and seasons. Significant seasonal differences were observed for TPA, weekday PA, weekend PA, and active play. Children were significantly more likely to be physically active in the summer and spring and somewhat physically active in the summer and fall, relative to winter. Children living in cold climates are less likely to be physically active in the winter

Background Spatial configurations of office environments assessed by Space Syntax methodologies are related to employee movement patterns. These methods require analysis of floors plans which are not readily available in large population-based studies or otherwise unavailable. Therefore a self-report instrument to assess spatial configurations of office environments using four scales was developed. Methods The scales are: local connectivity (16 items), overall connectivity (11 items), visibility of co-workers (10 items), and proximity of co-workers (5 items). A panel cohort (N = 1154) completed an online survey, only data from individuals employed in office-based occupations (n = 307) were used to assess scale measurement properties. To assess test-retest reliability a separate sample of 37 office-based workers completed the survey on two occasions 7.7 (±3.2) days apart. Redundant scale items were eliminated using factor analysis; Chronbach’s α was used to evaluate internal consistency and test re-test reliability (retest-ICC). ANOVA was employed to examine differences between office types (Private, Shared, Open) as a measure of construct validity. Generalized Linear Models were used to examine relationships between spatial configuration scales and the duration of and frequency of breaks in occupational sitting. Results The number of items on all scales were reduced, Chronbach’s α and ICCs indicated good scale internal consistency and test re-test reliability: local connectivity (5 items; α = 0.70; retest-ICC = 0.84), overall connectivity (6 items; α = 0.86; retest-ICC = 0.87), visibility of co-workers (4 items; α = 0.78; retest-ICC = 0.86), and proximity of co-workers (3 items; α = 0.85; retest-ICC = 0.70). Significant (p ≤ 0.001) differences, in theoretically expected directions, were observed for all scales between office types, except overall connectivity. Significant associations were observed between all scales and occupational sitting behaviour (p ≤ 0.05). Conclusion All scales have good measurement properties indicating the instrument may be a useful alternative to Space Syntax to examine environmental correlates of occupational sitting in population surveys.