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Background: Given the significance of motor competence (MC) for healthy development and as a cornerstone for lifelong physical activity (PA), it is crucial to understand the manifold factors that are associated with MC. Thus, the aim of the present study was to investigate correlates of children's MC and their fundamental movement skills (FMS) within their daily life from a comprehensive biopsychosocial-ecological perspective. Methods: This is a cross-sectional sub-study of the 'Physical Literacy for Communities (PL4C)' WAVES cohort study conducted in the West Vancouver School District, Canada. Motor competence was assessed using the PLAYfun tool including overall MC score and five FMS category scores, namely, running, locomotor skills, upper and lower body control and balance skills. By means of structural equation modeling (SEM), direct associationswith MC and with the specific FMS categories addressing physical activity behavior, self-perceived physical literacy, parenting, and school ground design were investigated. Results: A total of 355 children with a mean age of 7.5 years and 111.1 min of MVPA per day participated. The group comprised 51% boys and 47% girls from 14 elementary schools. Most children were at an emerging MC-level (71%), while those at a competent MC-level exhibited significantly more daily minutes of MVPA (123 versus 109, p = 0.001). Additionally, they played outdoors more frequently and engaged in more instructor-led PA. The results revealed that logistical support from parents had not only a direct positive association with overall MC, both for girls and boys, but also with most of the FMS categories. However, the correlates of MC varied between genders and showed different patterns across the five FMS categories. While time spent in sports or coach-/instructor-led physical activities had a significant SEM generated direct effect only for boys' MC and for locomotor, upper body object control and balance, the aesthetic design of the school grounds was only associated with girls' MC and those same three FMS categories. Multivariate SEM could explain 26% of variance for girls' MC and 30% for boys'. Conclusions: This exploratory baseline assessment revealed parental logistical support as an important correlate of MC, irrespective of gender. There were distinct gender patterns across biopsychosocial-ecological correlates influencing MC and FMS. Despite the heterogeneity of the results, our findings indicate a potential role of school ground design in supporting the development of children's MC, especially for girls. Key Points: • The influence of biopsychosocial-ecological correlates on motor competence (MC) varied based on gender and the specific fundamental movement skill (FMS) categories. • While parental logistical support demonstrated a positive direct association with both genders' MC and most of the FMS categories, coach-led physical activities appeared to enhance only boys'. • The positive direct association of outdoor play on boys' MC and of school ground aesthetics on girls' MC might suggest the role of the physical environment in MC development. [ABSTRACT FROM AUTHOR]

Purpose: Considerable debate centered on the impact of school closures and shifts to virtual learning on adolescent mental health during the COVID-19 pandemic. We evaluated whether mental health changes differed by school learning modes during the pandemic response among Canadian adolescents and whether associations varied by gender and perceived home life. Methods: We used prospective survey data from 7270 adolescents attending 41 Canadian secondary schools. Conditional change linear mixed effects models were used to examine learning mode (virtual optional, virtual mandated, in-person, and blended) as a predictor of change in mental health scores (depression [Centre for Epidemiologic Studies – Depression], anxiety [Generalized Anxiety Disorder-7], and psychosocial well-being [Flourishing scale]), adjusting for baseline mental health and covariates. Gender and home life happiness were tested as moderators. Least square means were calculated across interaction groups. Results: Students learning in a blended learning mode had greater anxiety increases relative to their peers in other learning modes. Females learning fully in-person and males learning virtually when optional reported less of an increase in depression scores relative to their gender counterparts in other learning modes. Learning virtually when optional was associated with greater declines in psychosocial well-being in students without happy home lives relative to other learning modes. Conclusion: Findings demonstrate the importance of considering gender and home environments as determinants of mental health over the pandemic response and when considering alternative learning modes. Further research is advised before implementing virtual and blended learning modes. Potential risks and benefits must be weighed in the context of a pandemic. [ABSTRACT FROM AUTHOR]

To examine associations of physical activity (PA) and sedentary time (SED) with quality of life (QoL) in men on androgen deprivation therapy (ADT) for prostate cancer. A pooled analysis of 106 men on ADT was conducted. PA and SED were assessed using accelerometers. The Functional Assessment of Cancer Therapy (FACT) was used to assess self-reported QoL. Quantile regression examined the associations of QoL with PA and SED. Total time spent in SED was positively associated with FACT-General at the 50th (p = 0.010) and 75th percentile (p = 0.022). SED in ≥ 30-min bouts was inversely associated with FACT-General at the 50th (p = 0.025) and 75th percentile (p = 0.029). Breaks in SED were positively associated with physical well-being at the 75th percentile (p = 0.004). Light-intensity PA was positively associated with FACT-Prostate at the 25th percentile (p = 0.020). SED and PA were associated with QoL outcomes, but time in each varied across men reporting the poorest QoL compared to those in the highest QoL distributions. [ABSTRACT FROM AUTHOR]

The early years are critical for physical literacy (PL) and physical activity (PA). With increasing numbers of children attending early childhood education and care (ECEC), educators play a significant role in childhood development and may influence young children's PL journey. Educators receive minimal training in PL and PA, but receive increasing direction to integrate these concepts into ECEC learning. The purpose of this study was to assess educators' PL, then determine which components of their PL were associated with self-reported intentions and behaviours to promote PL and PA. Educator PL was moderate, while self-reported intentions and behaviours to provide PL and PA opportunities were high. Only one component of PL was associated with intentions and behaviours. The PL of educators may not inform their intentions and behaviours to provide PL and PA within ECEC frameworks. [ABSTRACT FROM AUTHOR]

Purpose: Guidelines for cancer survivors recommend both aerobic physical activity (PA) and strength training (ST). Few kidney cancer survivors (KCS) are meeting single-activity or combined guidelines; therefore, examining factors influencing PA participation is warranted. The purpose of this study is to examine demographic, medical, social-cognitive, and environmental correlates of meeting independent (i.e., aerobic-only, strength training (ST)-only) and combined guidelines (i.e., aerobic and ST) in KCS.Methods: KCS (N = 651) completed self-reported measures of PA and demographic, medical, social-cognitive, and perceived environmental factors. Built environment was assessed using the geographic information systems (GIS). Multinomial logistic regressions were conducted to determine the correlates of meeting the combined versus independent guidelines.Results: Compared with meeting neither guideline, meeting aerobic-only guidelines was associated with higher intentions (p < .01) and planning (p < .01); meeting ST-only guidelines was associated with higher intentions (p = .02) and planning (p < .01), lower perceived behavioral control (PBC) (p = .03), healthy weight (p = .01), and older age (p < .01); and meeting the combined guidelines were associated with higher intentions (p < .01), planning (p = .02), higher instrumental attitudes (p < .01), higher education (p = .04), better health (p < .01), and localized cancer (p = .05). Additionally, compared with neither guideline, meeting aerobic-only (p < .01) and combined (p < .01) guidelines was significantly associated with access to workout attire. Compared with neither guideline, meeting aerobic-only guidelines was associated with proximity to retail (p = .02).Conclusion: PA participation correlates may vary based on the modality of interest. Interventions may differ depending on the modality promoted and whether KCS are already meeting single-modality guidelines. [ABSTRACT FROM AUTHOR]

Purpose: Previous studies in cancer survivors have examined behavioral correlates of physical activity (PA), but no study to date has adopted a broader social-ecological framework in understanding PA. This study examined the associations among demographic, medical, social-cognitive, and environmental correlates of meeting PA guidelines among kidney cancer survivors (KCS).Methods: All 1985 KCS diagnosed between 1996 and 2010 identified through a Canadian provincial registry were mailed a survey that consisted of medical, demographic, and social-cognitive measures, as well as PA as measured by the Godin Leisure Time Exercise Questionnaire. Environmental constructs were also assessed for both self-report and objective measures using geographic information systems (GIS). A series of binary logistic regression analyses were conducted in this cross-sectional study.Results: Completed surveys with geographical information were received from 432 KCS with M age = 64.4 ± 11.1 years, 63.2 % male, and 82.2 % having localized kidney cancer. In the final multivariate model, meeting PA guidelines was associated with disease stage (OR = 0.25, p = .005), having drug therapy (OR = 3.98, p = .009), higher levels of instrumental attitudes (OR = 1.66, p = .053), higher levels of intention (OR = 1.72, p = .002), and the perceived presence of many retail shops in the neighborhood (OR = 1.37, p = .032).Conclusions: Meeting PA guidelines in KCS were associated with various aspects of the social-ecological model.Implications For Cancer Survivors: Understanding the social-ecological correlates for PA can provide insight into future interventions designed to increase PA in KCS. Prime targets for PA promotion should consider treatment-related factors, promote the benefits of PA, and enhance positive perceptions of the built environment. [ABSTRACT FROM AUTHOR]

Background: Few breast cancer survivors (BCS) engage in sufficient physical activity (PA) to gain physical and mental health benefits. This may be due to a lack of appropriate PA information and support. While key messengers of PA information could be oncology clinicians, many do not consistently counsel their patients on PA.Purpose: To examine factors affecting PA counseling in clinicians and inform future strategies.Methods: Focus groups were conducted with clinicians (N = 27) at four cancer hospitals to better understand factors that affect PA counseling. Focus group discussions were transcribed verbatim and analyzed using inductive thematic analysis.Results: Clinicians perceived a lack of training and knowledge related to PA and BCS. Clinicians also discussed being unsure of when to integrate PA counseling into different phases of survivorship. Similarly, clinicians experienced barriers from hospital administration to maintain patient flow in-clinic, which decreased opportunities for PA counseling. Additionally, lack of awareness of community-based programs within large areas served by hospitals also decreased clinicians' self-efficacy for counseling. In order to facilitate PA counseling, clinicians wanted resources that promote patient-managed PA, available on multiple platforms (e.g., printed and online). Continued education, highlighting recent research and effective implementation of PA, was noted as an important facilitator.Conclusions: Researchers are encouraged to develop research agendas and test educational strategies that are integrated into current practice, empirically test barriers that developed from this study with a larger, representative sample to determine salient barriers and develop PA counseling strategies that are clinician-initiated but not dependent on clinicians. [ABSTRACT FROM AUTHOR]

Therapeutic recreation camps have been considered to be an effective context for improving the psychosocial functioning of children with congenital heart disease (CHD). However, there is limited research regarding their impact on parents. Nine parents participated in two semi-structured interviews before and after their children attended a camp for children with CHD. Parents described their perceptions of their children's camp experiences and identified the psychosocial utility of camp for themselves. Camp enabled parents to let their children grow and be independent, and helped reduce parents' restricting and overprotective behaviours. Camp also provided parents with respite care, which alleviated their need to be 'cardiac' parents. These findings strengthen the case for therapeutic recreation camps and underscore the importance of expanding camp access to more families affected by CHD. [ABSTRACT FROM AUTHOR]

Objective Excessive video gaming may represent a behavioural addiction among adolescents. The objective of this study was to identify and describe the taxonomy of problem gamers based on responses to the Problem Video Game Playing (PVP) scale. Methods Data based on 3338 Ontario high schoolers sampled from 103 schools (aged 11-20; male = 51 %) who completed self-administered questionnaires. Following latent class extraction, a regression assessed the association between the derived classes and the covariates sex and socioeconomic status. We also assessed self-rated physical and mental health as auxiliary variables in the model to evaluate the predictive validity of the extracted classes. Results A 4-class model provided the best statistical fit to the nine PVP symptoms. The Severe PVP, High PVP, Low PVP and Normative classes comprised 1.9 %, 12.2 %, 36.0 % and 50.0 % of the sample, respectively. The Severe PVP class was characterized by having the highest probabilities of endorsing the PVP items. The High PVP class was differentiated from the Severe PVP class by having lower probabilities of endorsing the disregard for consequences and the lies and deception items and moderate probabilities of endorsing withdrawal and escape items. Significantly poorer physical and mental health outcomes differentiated the Severe PVP class from the remaining classes. Conclusions Adolescent problem video gamers are not homogeneous. They experience differing patterns of symptoms requiring attention of prevention programmers and clinicians. [ABSTRACT FROM AUTHOR]

Background: ParticipACTION's Think Again campaign targeted mothers who think their children are sufficiently active, yet whose children do not achieve recommended amounts of physical activity. Purpose: This research examined the relationship of mothers' intentions to support children's physical activity with explicit believability and implicit agreement with the Think Again campaign message, attention paid to the advertisement, involvement with the issue, concern regarding children's inactivity, and attitudes. Method: Participants were mothers from Edmonton, Canada ( N = 102) who viewed one Think Again advertisement then completed a measure of implicit agreement with the campaign message and questionnaires. Results: The mothers who paid attention to the message and were concerned for their own children were more likely to intend to act on campaign messages. The majority of participants implicitly agreed that children's physical inactivity was a problem, but there was less agreement that physical inactivity was a problem for their own children. Conclusion: Participants automatically tended to agree with campaign messages when the focus was on children in general, but there was greater disagreement when asked about participant's own children. Why most mothers were not in agreement with the reality of how much physical activity their children needs remains to be determined. [ABSTRACT FROM AUTHOR]

This randomized trial compared physical activity enhancing exercise prescription and education programs in 61 children (36 male) with single-ventricle physiology after Fontan. After Fontan, children are less active than recommended for optimal health. They are often geographically dispersed and unable to attend weekday programs. Participants, 5.9-11.7 years of age who were status 5.3 years post-Fontan, received 12-month, parent-delivered home programs to enhance physical activity, motor skill, fitness, and activity attitudes. Daily moderate-to-vigorous physical activity (MVPA) was measured at baseline and again at 6, 12, and 24 months. Secondary outcomes were gross motor skill, fitness, and activity attitudes. Gross motor skill ( p = .01) was significantly greater at the end of the 2-year study period for both intervention groups combined. MVPA at 2 years was significantly greater ( p = .03) than the predicted decrease with age. Spring season (85 ± 25 min), male sex (69 ± 21 min), greater baseline activity (0.3 ± 0.1 min/baseline minute), and better gross motor skill (1.1 ± 0.4 min/percentile) increased weekly MVPA in a multivariable repeated-measures regression model adjusted for intervention, maturation during the 2-year study, sex, season, and baseline activity. Benefits were not influenced by type of rehabilitation, compliance, or rural/urban location. Home-based, pediatric physical activity rehabilitation enhances physical activity, gross motor skill, exercise capacity, and physical fitness among preadolescent children after Fontan regardless of rural/urban location. Prescribed education and exercise programs are similarly effective for providing the important health benefits of daily physical activity. Enhanced gross motor skill is associated with increased MVPA despite exercise capacity limitations after Fontan. Rehabilitation attenuates the expected decrease in MVPA with age. [ABSTRACT FROM AUTHOR]

Many policy-related reviews of the potential social value of sport and physical activity list the prevention of juvenile delinquency. We examined the relationships among vigorous physical activity, self-esteem, and delinquent behavior among adolescents in a large cross-sectional survey of Ontario adolescents. Data are based on questionnaires from 3,796 students (range 11–20 years) derived from the 2005 Ontario Student Drug Use Survey. Negative binominal regression methods were used to estimate both additive and interactive models predicting delinquent behavior. Vigorous physical activity was positively associated with delinquent behavior; however, this pattern of association was observed only among male adolescents. There was no evidence of a mediating role for self-esteem. Our findings suggest that physical activity is not the solution for reducing juvenile delinquency. [ABSTRACT FROM AUTHOR]

An emerging threat to public health is seen in the dramatic rise in obesity status of Canadians, especially among young people. In addressing the possible factors responsible for these dramatic increases, this paper outlines the importance of understanding sedentariness as an important health behaviour, distinct from physical activity, and identifying the modifiable determinants of sedentary behaviours. [ABSTRACT FROM AUTHOR]

Background: Research evaluating mediated physical activity campaigns uses an unsophisticated conceptualization of the media and would benefit from the application of a media studies approach. The purpose of this article is to report on the application of this type of analysis to the Canada on the Move media campaign.Methods: Through interviews and document analysis, the press release surrounding Canada on the Move was examined at four levels: inception, production, transmission and reception. Analytic strategies of thematic and textual analysis were conducted.Results and Conclusion: The press release was well received by journalists and editors and was successfully transmitted as inferred from national and local television coverage, although there was no national print pickup. Canada on the Move was perceived by sampled audience members as a useful and interesting strategy to encourage walking. A holistic approach to media analysis reveals the complex and frequently messy process of this mediated communication process. Implications for future media disseminations of Canada on the Move are discussed. [ABSTRACT FROM AUTHOR]

Objectives: Public health restrictions varied by region during the COVID-19 pandemic and reduced opportunities for children to be physically active. The purpose of this study was to assess regional differences in movement behaviours of Canadian children and youth during the second wave of the COVID-19 pandemic., Methods: A national sample of Canadian parents (n=1568; 58% women) of children and youth (5-17 years of age) completed an online survey. Participants were classified based on region of residence (British Columbia, Prairies, Ontario, Quebec, or Atlantic Canada). Differences in movement and play behaviours (physical activity, outdoor play, sleep, screen time) between children and youth living in different regions were examined., Results: Compared to children and youth in Quebec (the region with the highest COVID-19 prevalence), children and youth in the Prairies (F (1,1563) =9.0, p=0.01) and Atlantic Canada (F (1,1563) =17.1, p<0.001) participated in more moderate-to-vigorous physical activity (MVPA). Compared to Quebec, living in Atlantic Canada increased the odds of meeting the MVPA guideline (odds ratio (OR)=2.1, p=0.02), living in Ontario decreased the odds of meeting the sleep guideline (OR=0.6, p=0.01), and living in Ontario (OR=0.7, p=0.04) or Atlantic Canada (OR=0.6, p=0.049) decreased the odds of meeting the screen time guideline. Children and youth in Atlantic Canada demonstrated smaller declines in outdoor play than their counterparts in Quebec., Conclusion: Movement and play behaviours varied between regions of Canada where the highest COVID-19 prevalence corresponded to lower odds of meeting the physical activity guidelines. Low compliance with 24-hour movement guidelines suggests that regional pandemic recovery plans need to prioritize opportunities for healthy movement., (© 2022. The Author(s) under exclusive license to The Canadian Public Health Association.)

To reduce the spread of COVID-19, public health authorities across the country have recommended that Canadians keep their distance, wash their hands, and stay home. To enforce these measures, restrictions on outdoor behaviour have been implemented, limiting access to parks and recreational outdoor spaces. New evidence shows that COVID-19 restrictions are associated with an overall lower amount of time spent in outdoor play among Canadian children and youth. This is concerning, as outdoor play is important for children's physical and mental health and helps provide them with a sense of control during times of uncertainty and stress. As policies on access to the outdoors during the COVID-19 outbreak vary by province, it is possible that policy differences have led to regional differences in changes in outdoor play among children and youth. In this commentary, we examine regional differences in outdoor play among children and youth across Canada, and the association between provincial policies related to COVID-19 and outdoor play. We argue that through the recovery process, in the event of a second wave of infections, and in preparing for future public health challenges, policy decisions should consider ways to preserve outdoor play for Canadian children and youth.

The article "Why public health matters today and tomorrow: the role of applied public health research," written by Lindsay McLaren et al., was originally published Online First without Open Access.

Objectives: Female sport participation is a prioritized action area in the 2018 Canadian federal budget for improving health and well-being. This study examined team sport participation prevalence and longitudinal associations with health-related behaviours among Canadian adolescent girls., Methods: We analyzed data from the COMPASS study. Participants included 1978 female secondary-school students who self-reported the following information at all measurement time-points (grades 9, 10, 11, and 12): socio-demographic, team sport participation status (consistent, intermittent and non-participator), moderate-to-vigorous physical activity (MVPA), dietary behaviours, smoking, cannabis use and binge drinking. Linear mixed models and generalized estimating equation models were used to examine team sport participation status in association with changes in health-related behaviours across grades., Results: The prevalence of team sport participation declined by an average of 38.4% between grades 9 and 12. Proportions of participants being categorized as consistent, intermittent and non-participators were 25.7%, 36.4% and 37.9%, respectively. Compared to non-participators, consistent participators reported significantly greater decline in MVPA (β = - 2.77, 95% CI - 5.36, - 0.18), and the increase in odds of becoming more frequent cannabis users (OR 1.11, 95% CI 1.00, 1.26) and binge drinkers (OR 1.13, 95% CI 1.04, 1.23) was significantly greater. Girls' team sport participation had no significant longitudinal association with dietary behaviours and smoking status., Conclusion: Team sport participation outside of school settings is risky for prospective health-related behaviours in adolescent girls. Our findings highlight the need for investing in tailored participation initiatives that also consider how to prevent harmful substance use.

Public health is critical to a healthy, fair, and sustainable society. Realizing this vision requires imagining a public health community that can maintain its foundational core while adapting and responding to contemporary imperatives such as entrenched inequities and ecological degradation. In this commentary, we reflect on what tomorrow's public health might look like, from the point of view of our collective experiences as researchers in Canada who are part of an Applied Public Health Chairs program designed to support "innovative population health research that improves health equity for citizens in Canada and around the world." We view applied public health research as sitting at the intersection of core principles for population and public health: namely sustainability, equity, and effectiveness. We further identify three attributes of a robust applied public health research community that we argue are necessary to permit contribution to those principles: researcher autonomy, sustained intersectoral research capacity, and a critical perspective on the research-practice-policy interface. Our intention is to catalyze further discussion and debate about why and how public health matters today and tomorrow, and the role of applied public health research therein.

Intervention: UPnGO with ParticipACTION (UPnGO) is a 6-week workplace physical activity (PA) initiative aiming to increase habitual PA (steps) during the workday. Core intervention components included (1) self-monitoring of steps and action planning behaviours using a Web/mobile app with incentives and (2) organizational support, which included senior management's role modeling and endorsement of the program., Research Question: What is the effectiveness and levels of implementation of the UPnGO intervention? What is the relationship between effectiveness and levels of implementation?, Methods: A single-arm, pre-/post-test study design was used. Participants were 660 employees from nine organizations who had valid step data and complete socio-demographic information at baseline. The primary outcome (mean daily steps) was assessed by Garmin VivoFit. Using the usage data from the UPnGO web-based system, a composite score for levels of implementation was calculated based on participant's compliance with the self-monitoring component and senior management's role modeling. Associations of interest were analyzed using linear mixed-effects models., Results: Levels of implementation were highly variable across organizations (mean = 68.22% ± 18.75, range = 19.8 to 100%). A significant Time × Implementation (IM) status interaction effect was observed. When stratified by IM status, a significant increase in mean daily steps at week 6 was found among participants in the high (β = 540.01 ± 202.69, p = 0.011) but not low (β = - 81.54 ± 291.96, p = 0.78) implementation group., Conclusion: Findings suggest significant intervention effects in increasing average daily steps among participants who were exposed to optimal levels of implementation (~ 70%). UPnGO may be a scalable workplace PA intervention at a national level, although this needs further verification with more rigorous study designs.

Objective: Municipal policies may have a significant impact on the development of environments that provide sustainable opportunities for individuals to engage in healthy, active lifestyles. Little is known about how explicitly community planning in Canada integrates strategies to promote physical activity. In the context of Active Saskatchewan 2020 (AS2020), the strategic plan of Saskatchewan in motion, such an analysis would create a basis for identifying policy gaps and ongoing monitoring. The objective of this study was to review the official community plan (OCP) of each city in the province of Saskatchewan, Canada and identify policies supportive of physical activity., Methods: A conventional content analysis was completed of the OCPs of the 17 cities in Saskatchewan. Each OCP was reviewed and text extracted that related to supporting physical activity. Extracted text was thematically organized within and across cities, creating a set of indicators for ongoing monitoring., Results: Overall, 17 indicators were identified. The frequency of inclusion of these indicators within the 17 OCPs varied from 17.6% to 82.4%. The mean frequency of indicators identified per OCP was 7.4. The most commonly included indicators included residential neighbourhood plans associated with active living, downtown cycling and pedestrian plans, and joint-use agreements between communities and schools., Conclusions: Most Saskatchewan OCPs make little direct reference to policies supportive of physical activity. Impacting community-level policy is an expected outcome of AS2020/Saskatchewan in motion. This study identifies a range of indicators for monitoring this process and highlights potential areas for policy development within OCPs.

Objectives: To examine school- and student-level correlates of physical activity., Methods: Cross-sectional Year 2 data collected from 45 298 grade 9-12 students attending 89 secondary schools in the COMPASS study were examined using multi-level modelling to predict the likelihood of students a) achieving 60 minutes of moderate to vigorous physical activity (MVPA) daily; and b) achieving the Canadian Society for Exercise Physiology (CSEP) activity guideline for youth (60 minutes/MVPA daily, vigorous physical activity at least three days in a week, and resistance training at least three days in a week)., Results: The prevalence of students achieving 60 minutes of MVPA daily and meeting the CSEP guideline was 49.3% and 31.0% respectively. Modest between-school variability was identified (1.1% for 60 minutes MVPA and 0.8% for CSEP guideline). School-level characteristics significantly associated with the outcome measures included location, school size, quality of facilities, and accessibility of facilities. Significant student-level correlates included sex, grade, weekly income, binge drinking, fruit and vegetable consumption, and body mass index., Conclusions: Most youth in this large study reported inadequate physical activity levels. Students were more likely to achieve 60 minutes of MVPA if they attended a larger school or a school in an urban location, whereas students were less likely to meet the CSEP guideline if they attended a school in a small urban location. However, student-level factors, such as binge drinking and inadequate fruit and vegetable consumption, were more strongly associated with the outcomes examined.

Physical inactivity is a pressing public health concern. In this commentary we argue that Canada's approach to increasing physical activity (PA) has been fragmented and has lacked coordination, funding and a strategic approach. We then describe a potential solution in Active Canada 20/20 (AC 20/20), which provides both a national plan and a commitment to action from non-government and public sectors with a view to engaging corporate Canada and the general public. It outlines a road map for initiating, coordinating and implementing proactive initiatives to address this prominent health risk factor. The identified actions are based on the best available evidence and have been endorsed by the majority of representatives in the relevant sectors. The next crucial steps are to engage all those involved in public health promotion, service provision and advocacy at the municipal, provincial and national levels in order to incorporate AC 20/20 principles into practice and planning and thus increase the PA level of every person in Canada. Further, governments, as well as the private, not-for-profit and philanthropic sectors, should demonstrate leadership and continue their efforts toward providing the substantial and sustained resources needed to recalibrate Canadians' habitual PA patterns; this will ultimately improve the overall health of our citizens.

Objectives: Public health concern about increasing levels of child/youth overweight and obesity has resulted in initiatives to address this issue. In 2012, the Ontario Ministry of Health and Long-Term Care (MOHLTC) established a target to reduce childhood obesity by 20% within five years. In this paper, we examine trends and establish baseline levels of overweight/obesity to assess the impacts of population-level interventions., Methods: We analyzed 10 years (2003-2013) of data accumulated from six cycles of the Ontario Student Drug Use and Health Survey using logistic regression to assess trends in the prevalence of overweight/obesity among middle and high school students. The 2013 data are used to begin monitoring progress toward achieving the MOHLTC target., Results: From 2003 through 2013, the prevalence of overweight/obesity among middle school students in the province remained stable overall and among all subgroups except 7th-grade females, who showed a significant linear decline. Among high school students, the prevalence of overweight/obesity showed a significant linear increase and an increase among 11th graders, females, and 10th- and 11th-grade females specifically. The prevalence remained stable but elevated among 9th- and 12th-grade females as well as among males in all grades. In 2013 (baseline for the MOHLTC target), 25.1% of students in grades 7-12 were overweight or obese, implying a presumed 2018 target of 20.1%., Conclusion: Ten-year trends in overweight/obesity indicate stability among males and significant linear increases in some female subgroups. Also, baseline data (2013) will facilitate the monitoring of future interventions aimed at achieving the 2018 MOHLTC target.

Objective: To examine the prevalence of students meeting physical activity, diet and smoking health recommendations and to examine the correlates of meeting these guidelines., Methods: Randomly selected students at the University of Toronto (N = 2,812; female = 71.60%, mean age = 22.11 ± 5.24 years, mean body mass index = 22.80 kg/m2) completed the National College Health Assessment-II survey in spring of 2013., Results: Only 0.1% of the sample reported meeting physical activity, diet and non-smoking guidelines. Males were more likely than females to meet physical activity and both physical activity and fruit and vegetable guidelines (X2 [1, 2812] = 7.33, p &lt; 0.05). Women were more likely than men to be nonsmokers (X2 [1, 2812] = 7.80, p &lt; 0.05). Being overweight was associated with meeting physical activity guidelines. Being a healthy weight was associated with meeting both physical activity and fruit and vegetable guidelines (X2 [1, 2812] = 6.29, p &lt; 0.05). Underweight participants were more likely to be nonsmokers (X2 [2, 2812] = 6.36, p &lt; 0.05). In the logistic regression, being Caucasian and male and trying to change weight were correlated with meeting moderate-to-vigorous physical activity and strength training guidelines. Being older, Caucasian and trying to change weight were correlates of consuming greater than five fruits and vegetables per day. Beings Caucasian, female, and trying to change weight were correlates of being a non-smoker., Conclusion: University health promotion programs should be targeted to specific age, ethnicity and weight status groups, as there are distinct differences among those not meeting physical activity, diet and non-smoking guidelines.

Objective: A child's opportunity for physical activity and the safety of engaging in activity are influenced by built environment (BE) elements. This study examined the relationship of neighbourhood type and socio-economic status (SES) with activity using a sampling frame that purposely located schools in varying neighbourhoods to ensure that there was variability in BE characteristics and SES., Methods: Participants (1,027 Grade 5 & 6 students, Toronto, ON) were drawn from 16 schools that varied by neighbourhood type (pre-1946 "old/urban BE" with grid-based street layout versus post-1946 "new/inner-suburban BE" with looping street layout) and socio-economic status (low and high SES). Physical activity was recorded by accelerometry for seven days. Only children living within 1.6 km of school were included in the analyses (n=713; boys=339, girls=374). Generalized linear mixed models examined sex-specific differences in physical activity across four geographic stratifications: old BE, low-SES (OL); old BE, high-SES (OH); new BE, low-SES (NL); and new BE, high-SES (NH)., Results: Children who attended schools in more affluent neighbourhoods (urban and inner-suburban) had more positive physical activity profiles. Across school days, boys were more active in inner-suburban neighbourhoods whereas urban and inner-suburban girls' activity levels were similar. On the weekend, the influence of the neighbourhood environment was stronger, especially for girls and also for boys with respect to total activity and the accumulation of moderate-to-vigorous physical activity., Conclusion: These findings focus attention on the need to consider the broader social and temporal contexts of specific geographic locations when planning and implementing built environment interventions to increase physical activity among children.

Objective: Climatic conditions may enable or deter active school transportation in many North American cities, but the topic remains largely overlooked in the existing literature. This study explores the effect of seasonal climate (i.e., fall versus winter) and weekly weather conditions (i.e., temperature, precipitation) on active travelling to school across different built and policy environments., Methods: Home-to-school trips by 11-12-year-old children in the City of Toronto were examined using data from the 2006 Transportation Tomorrow Survey. Binomial logistic regressions were estimated to explore the correlates of the choice of active (i.e., walking) versus non-active (i.e., private automobile, transit and school bus) mode for school trips., Results: Climate and weather-related variables were not associated with choice of school travel mode. Children living within the sidewalk snow-plough zone (i.e., in the inner-suburban neighbourhoods) were less likely to walk to school than children living outside of the zone (i.e., in the inner-city neighbourhoods)., Conclusion: Given that seasonality and short-term weather conditions appear not to limit active school transportation in general, built environment interventions designed to facilitate active travel could have benefits that spill over across the entire year rather than being limited to a particular season. Educational campaigns with strategies for making the trip fun and ensuring that the appropriate clothing choices are made are also warranted in complementing built environment modifications.

Objective: In 2005, the Ontario Ministry of Education announced a policy requiring that all elementary students be provided with opportunities to participate in a minimum of 20 minutes of sustained moderate-to-vigorous physical activity (MVPA) each school day during instructional time. To the authors' knowledge, this policy has never been formally evaluated. In a form of natural experiment with Project BEAT, we explored within 16 Toronto District School Board schools the proportion of children who participate in DPA, and the proportion who achieve sustained MVPA within these sessions; these are the objectives of this article., Methods: Consent was given by 1027 parents/guardians for their children to participate (boys, n=478; girls, n=549). Physical activity (PA) was measured using accelerometry and classroom schedules collected to identify sessions of DPA. The frequency of DPA and number and duration of sustained bouts of MVPA (> or =5 min) were computed and explored relative to PA levels and health outcomes., Results: Fewer than half of the participating children were provided with DPA every day and not a single child engaged in sustained MVPA for > or =20 minutes. On the more positive side, children who engaged in DPA every day were significantly more active than their peers. Those accumulating at least 1 bout of MVPA were more active and likely to meet PA guidelines, and fewer of these children were overweight., Conclusion: The majority of schools are not meeting the DPA policy. However, as the frequency and intensity of DPA increases, so do positive health outcomes. This paper provides supporting evidence that when this policy is implemented, the intended health benefits are achievable.