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The mechanisms of behavior change in youth screen-time interventions are poorly understood. Participants were 361 adolescent boys (12-14 years) participating in the ATLAS obesity prevention trial, evaluated in 14 schools in low-income areas of New South Wales, Australia. Recreational screen-time was assessed at baseline, 8- and 18-months, whereas potential mediators (i.e., motivation to limit screen-time and parental rules) were assessed at baseline, 4- and 18-months. Multi-level mediation analyses followed the intention-to-treat principle and were conducted using a product-of-coefficients test. The intervention had a significant impact on screen-time at both time-points, and on autonomous motivation at 18-months. Changes in autonomous motivation partially mediated the effect on screen-time at 18-months in single and multi-mediator models [AB (95% CI) = -5.49 (-12.13, -.70)]. Enhancing autonomous motivation may be effective for limiting screen-time among adolescent males. Trial registration: Australian New Zealand Clinical Trials Registry No: ACTRN12612000978864., Author(s): Jordan J. Smith [sup.1] , Philip J. Morgan [sup.1] , Chris Lonsdale [sup.2] , Kerry Dally [sup.1] , Ronald C. Plotnikoff [sup.1] , David R. Lubans [sup.1] Author Affiliations: [...]

Background: Despite the benefits of physical activity (PA), a significant proportion of youth remains inactive. Studies assessing differences in the correlates of PA among urban and rural youth are scarce, and such investigations can help identify subgroups of the population that may need to be targeted for special intervention programs. The purpose of this study was to assess differences in the correlates of PA between Canadian urban and rural youth. Methods: The sample consisted of 1398 adolescents from 4 urban schools and 1290 adolescents from 4 rural schools. Mean age of the participants was 15.6 plus or minus 1.3 years. Hierarchical regression analyses were used to examine the association between self-reported PA and a number of demographic, psychological, behavioral, and social correlates. Results: Common correlates between the 2 locations included gender (with girls being less active than boys) perceptions of athletic/physical ability, self-efficacy, interest in organized group activities, use of recreation time, and friends' and siblings' frequency of participation in PA. Active commuting to school and taking a physical education class were unique correlates of PA at the multivariate level in urban and rural students, respectively. Variance explained in PA ranged from 43% for urban school students to 38% for rural school students. Conclusions: Although more similarities than discrepancies were found in the correlates of PA between the 2 geographical locations, findings from this study strengthen the policies that argue for a coordinated multisector approach to the promotion of PA in youth, which include the family, school, and community.

The purpose of this study was to test a conceptual model based on theoretical and empirically supported relationships related to the influences of weight perceptions, weight concerns, desires to change weight, friends, age and location in relation to physical activity (PA) and smoking in adolescents. A total of 1242 males and 1446 females (mean age = 15.6 [plus or minus] 1.3) were recruited from rural and urban Canadian schools. Study respondents provided self-reports of PA, "smoking", "perceived body weight", "desire to change weight", "concern about weight gain" and "friends' smoking and PA behaviors". Results revealed an acceptable fitting model [chi][squared] (40) = 155.63, P less than 0.05, root mean square error of approximation = 0.047 and comparative fit index = 0.98. Large effect sizes for both genders were observed between friends' and adolescents' smoking behavior, and between perceived body weight and desire to change weight. Further, significant differences were identified between the male and female models [[chi][squared] difference (24) = 65.28, P less than 0.05]. Several findings of this study point to the need to design programs to motivate adolescent females to adopt healthy weight-control practices and to target young peoples' social networks to promote health behaviors, especially with regard to smoking. (Contains 2 figures and 2 tables.)

OBJECTIVE: Unhealthy dietary and physical inactivity patterns inspired many initiatives promoting healthy youth and healthy schools in Alberta between 2005 and 2008. The purpose of this study was to examine differences in the prevalence of lifestyle risk factors for type 2 diabetes (T2D) between two province-wide samples of Alberta adolescents (2005 and 2008). METHODS: The dietary and physical activity (PA) patterns of Alberta youth were assessed in two cross-sectional studies of grade 7-10 students, one in 2005 (n=4936) and one in 2008 (n=5091), using a validated web-survey. For each diabetes risk factor, participants were classified as either at risk or not at risk, depending on their survey results relative to cut-off values. Chi-square tests and logistic regression models were used to determine differences in risk factor prevalence between 2005 and 2008. RESULTS: Compared to 2005, mean BMI, energy intake, fat intake, glycemic index (GI) and glycemic load (GL) were lower in 2008 (p CONCLUSIONS: Improvements were observed between 2005 and 2008 in terms of the proportion of adolescents having specific risk factors for T2D. The cause of these changes could not be determined. Continued monitoring of adolescent lifestyle habits and monitoring of exposure to health promotion programming is recommended. KEY WORDS: Type 2 Diabetes Mellitus; adolescents; prevalence; risk factors; diet; physical activity OBJECTIF: Les habitudes alimentaires malsaines et l'inactivite physique ont inspire de nombreuses initiatives de promotion de la sante des jeunes et des ecoles en Alberta entre 2005 et 2008. Nous avons cherche a examiner les differences dans la prevalence des facteurs de risque lies aux habitudes de vie pour le diabete de type 2 (DT2) entre deux echantillons provinciaux d'adolescents albertains (2005 et 2008). METHODE: Les habitudes d'alimentation et d'activite physique des jeunes de l'Alberta ont ete evaluees a la faveur de deux etudes transversales aupres d'eleves de la 7e a la 10e annee, l'une en 2005 (n=4 936) et l'autre en 2008 (n=5 091), a l'aide d'un sondage en ligne valide. Pour chaque facteur de risque du diabete, les participants ont ete classes comme etant a risque ou non a risque selon leurs reponses au sondage par rapport aux valeurs limites. Des tests du khi-carre et des modeles de regression logistique ont servi a determiner les differences dans la prevalence des facteurs de risque entre 2005 et 2008. RESULTATS: Comparativement a 2005, l'IMC moyen, l'apport energetique, l'apport en matieres grasses, l'indice glycemique (IG) et la charge glycemique (CG) etaient plus faibles en 2008 (p CONCLUSIONS: Des ameliorations ont ete observees entre 2005 et 2008 dans la proportion d'adolescents presentant les facteurs de risque propres au DT2. Nous n'avons pas pu determiner la cause de ces changements. Il est recommande de continuer a surveiller les habitudes de vie des adolescents et leur exposition aux programmes de promotion de la sante. MOTS CLES: diabete de type 2; adolescent; prevalence; facteurs de risque; regime alimentaire; exercice physique La traduction du resume se trouve a la fin de l'article., Unhealthy dietary and physical activity patterns are prevalent among Canadian youth (1,2) and are implicated in increasing rates of early onset type 2 diabetes that have been observed in Canada. [...]

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

Objective: The Healthy Heart Kit (HHK) is a risk management and patient education kit for the prevention of cardiovascular disease (CVD) and the promotion of CV health. There are currently no published data examining predictors of HHK use by physicians. The main objective of this study was to examine the association between physicians&apos; characteristics (socio-demographic, cognitive, and behavioural) and the use of the HHK. Methods: All registered family physicians in Alberta (n=3068) were invited to participate in the "Healthy Heart Kit" Study. Consenting physicians (n=153) received the Kit and were requested to use it for two months. At the end of this period, a questionnaire collected data on the frequency of Kit use by physicians, as well as socio-demographic, cognitive, and behavioural variables pertaining to the physicians. Results: The questionnaire was returned by 115 physicians (follow-up rate = 75%). On a scale ranging from 0 to 100, the mean score of Kit use was 61 [SD=26]. A multiple linear regression showed that "agreement with the Kit" and the degree of "confidence in using the Kit" was strongly associated with Kit use, explaining 46% of the variability for Kit use. Time since graduation was inversely associated with Kit use, and a trend was observed for smaller practices to be associated with lower use. Conclusion: Given these findings, future research and practice should explore innovative strategies to gain initial agreement among physicians to employ such clinical tools. Participation of older physicians and solo-practitioners in this process should be emphasized. Key words: Cardiovascular medicine; clinical practice guidelines; evidence based medicine; family medicine; primary care Objectif: La trousse Coeur en sante est une trousse de gestion des risques et d&apos;education des patients pour la prevention des maladies cardiovasculaires et la promotion de la sante cardiovasculaire. Actuellement, il n&apos;existe aucune donnee publiee examinant les indicateurs previsionnels pour l&apos;utilisation de la trousse Coeur en sante par les medecins. Le principal objectif de cette etude est d&apos;examiner l&apos;association entre les caracteristiques des medecins (sociodemographiques, cognitives et comportementales) et l&apos;utilisation de la trousse. Methode: Tous les medecins de famille de l&apos;Alberta (n=3068) ont ete invites a participer a l&apos;etude sur la << trousse Coeur en sante >>. Les medecins consentants (n=153) ont recu la trousse et on leur a demande de l&apos;utiliser pendant deux mois. A la fin de cette periode, un questionnaire a permis de recueillir les donnees sur la frequence de l&apos;utilisation de la trousse par les medecins, ainsi que les variables sociodemographiques, cognitives et comportementales relatives aux medecins. Resultats: Le questionnaire a ete retourne par 115 medecins (taux de suivi = 75 %). Sur une echelle allant de 0 a 100, la note moyenne pour l&apos;utilisation de la trousse etait de 61 [ecart type=26]. Une regression lineaire multiple a demontre que << le consentement a utiliser la trousse >> et le degre de << confiance dans l&apos;utilisation de la trousse >> etaient fortement associes a l&apos;utilisation de la trousse, ce qui explique 46 % de la variabilite de l&apos;utilisation de la trousse. Le temps ecoule depuis l&apos;obtention du diplome etait inversement associe a l&apos;utilisation de la trousse, et on a observe une tendance pour les plus petits cabinets associes a une utilisation moins frequente. Conclusion: Etant donne ces resultats, les prochaines recherches et les prochains exercices devraient examiner des strategies innovatrices pour obtenir l&apos;accord initial parmi les medecins d&apos;employer de tels outils cliniques. La participation des medecins plus ages et des medecins exercant seuls a ce processus devrait etre mise en evidence. Mots cles: medecine cardiovasculaire; lignes directrices sur les pratiques cliniques; medecine fondee sur des preuves; medecine de famille; soins primaires, Cardiovascular disease (CVD) is Canada's leading cause of mortality and morbidity, with estimated direct and indirect costs of $7.2 and $12.4 billion respectively. (1) Further, physicians report difficulty in meeting [...]

BackgroundIn randomized controlled trials, participants cannot choose their preferred intervention delivery mode and thus might refuse to participate or not engage fully if assigned to a nonpreferred group. This might underestimate the true effectiveness of behavior-change interventions. ObjectiveTo examine whether receiving interventions either matched or mismatched with participants’ preferred delivery mode would influence effectiveness of a Web-based physical activity intervention. MethodsAdults (n = 863), recruited via email, were randomly assigned to one of three intervention delivery modes (text based, video based, or combined) and received fully automated, Internet-delivered personal advice about physical activity. Personalized intervention content, based on the theory of planned behavior and stages of change concept, was identical across groups. Online, self-assessed questionnaires measuring physical activity were completed at baseline, 1 week, and 1 month. Physical activity advice acceptability and website usability were assessed at 1 week. Before randomization, participants were asked which delivery mode they preferred, to categorize them as matched or mismatched. Time spent on the website was measured throughout the intervention. We applied intention-to-treat, repeated-measures analyses of covariance to assess group differences. ResultsAttrition was high (575/863, 66.6%), though equal between groups (t863 =1.31, P =.19). At 1-month follow-up, 93 participants were categorized as matched and 195 as mismatched. They preferred text mode (493/803, 61.4%) over combined (216/803, 26.9%) and video modes (94/803, 11.7%). After the intervention, 20% (26/132) of matched-group participants and 34% (96/282) in the mismatched group changed their delivery mode preference. Time effects were significant for all physical activity outcomes (total physical activity: F2,801 = 5.07, P = .009; number of activity sessions: F2,801 = 7.52, P < .001; walking: F2,801 = 8.32, P < .001; moderate physical activity: F2,801 = 9.53, P < .001; and vigorous physical activity: F2,801 = 6.04, P = .002), indicating that physical activity increased over time for both matched and mismatched groups. Matched-group participants improved physical activity outcomes slightly more than those in the mismatched group, but interaction effects were not significant. Physical activity advice acceptability (content scale: t368 = .10, P = .92; layout scale: t368 = 1.53, P = .12) and website usability (layout scale: t426 = .05, P = .96; ease of use scale: t426 = .21, P = .83) were generally high and did not differ between the matched and mismatched groups. The only significant difference (t621 = 2.16, P = .03) was in relation to total time spent on the website: the mismatched group spent significantly more time on the website (14.4 minutes) than the matched group (12.1 minutes). ConclusionParticipants’ preference regarding delivery mode may not significantly influence intervention outcomes. Consequently, allowing participants to choose their preferred delivery mode may not increase effectiveness of Web-based interventions.

BACKGROUND: Despite the benefits of physical activity (PA), a significant proportion of youth remains inactive. Studies assessing differences in the correlates of PA among urban and rural youth are scarce, and such investigations can help identify subgroups of the population that may need to be targeted for special intervention programs. The purpose of this study was to assess differences in the correlates of PA between Canadian urban and rural youth. METHODS: The sample consisted of 1398 adolescents from 4 urban schools and 1290 adolescents from 4 rural schools. Mean age of the participants was 15.6 ± 1.3 years. Hierarchical regression analyses were used to examine the association between self-reported PA and a number of demographic, psychological, behavioral, and social correlates. RESULTS: Common correlates between the 2 locations included gender (with girls being less active than boys) perceptions of athletic/physical ability, self-efficacy, interest in organized group activities, use of recreation time, and friends' and siblings' frequency of participation in PA. Active commuting to school and taking a physical education class were unique correlates of PA at the multivariate level in urban and rural students, respectively. Variance explained in PA ranged from 43% for urban school students to 38% for rural school students. CONCLUSIONS: Although more similarities than discrepancies were found in the correlates of PA between the 2 geographical locations, findings from this study strengthen the policies that argue for a coordinated multisector approach to the promotion of PA in youth, which include the family, school, and community. Keywords: physical activity; exercise; adolescents; urban-rural. Citation: Loucaides CA, Plotnikoff RC, Bercovitz K. Differences in the correlates of physical activity between urban and rural Canadian youth. J Sch Health. 2007; 77: 164-170., Health benefits of physical activity (PA) in young people include decreased overweight and obesity, increased psychological well-being, improved health in adulthood, and a carryover of PA behavior to adulthood. (1-3) [...]