Search

Background: Population physical activity promotion (PPAP) is one of the most effective noncommunicable disease prevention strategies, yet coordination is lacking around the world. Whole-of-system approaches and complex systems methods are called for to advance PPAP. This paper reports on a project which (1) used an Attributes Framework with system mapping (group model building and causal loop diagramming of feedback loops) and (2) identified potential leverage points to address the challenge of effective coordination of multisectoral PPAP in British Columbia., Methods: Key findings from stakeholder interviews and workshops described the current system for PPAP in terms of attributes and dimensions in the framework. These were translated into variables and used in group model building. Participants prioritized the importance of variables to address the coordination challenge and then created causal loop diagrams in 3 small groups. One collective causal loop diagram was created, and top priority variables and associated feedback loops were highlighted to explore potential leverage points., Results: Leverage points included the relationships and feedback loops among priority variables: political leadership, visible policy support and governance, connectivity for knowledge translation, collaborative multisector grants, multisector collaboration, and integrating co-benefits. Leveraging and altering "vicious" cyclical patterns to increase coordinated multisector PPAP are key., Conclusions: The Attributes Framework, group model building and causal loop diagrams, and emergent feedback loops were useful to explore potential leverage points to address the challenge of multisectoral coordination of PPAP. Future research could apply the same methods in other jurisdictions and compare and contrast resultant frameworks, variables, feedback loops, and leverage points.

Background: UPnGO with ParticipACTION (UPnGO) was a commercialized 12-month workplace physical activity intervention, aimed at encouraging employees to sit less and move more at work. Its design took advantage of the ubiquitous nature of mobile fitness trackers and aimed to be implemented in any office-based workplace in Canada. The program was available at cost from June 2017 to April 2020. The objectives of this study are to evaluate the program and identify key lessons from the commercialization of UPnGO., Methods: Using a quasi-experimental design over 3 time points: baseline, 6 months, 12 months, five evaluation indicators were measured as guided by the RE-AIM framework. Reach was defined as the number and percentage of employees who registered for UPnGO and the number and percentage of sedentary participants registered. Effectiveness was assessed through average daily step count. Adoption was determined by workplace champion and senior leadership responses to the off-platform survey. Implementation was assessed as the percentage of participants who engaged with specific program elements at the 3-evaluation time points. Maintenance was assessed by the number of companies who renewed their contracts for UPnGO., Results: Reach across 17 organizations, 1980 employees participated in UPnGO, with 27% of participants identified as sedentary at baseline. Effectiveness Daily step count declined from 7,116 ± 3,558 steps at baseline to 6,969 ± 6,702 ( p = <0.001) at 12 months. Adoption Workplace champion and senior leadership engagement declined from 189 to 21 and 106 to 5 from baseline to 12 months, respectively. Maintenance Two companies renewed their contracts beyond the first year., Conclusions: The commercialization of UPnGO was an ambitious initiative that met with limited success; however, some key lessons can be generated from the attempt. The workplace remains an important environment for PA interventions but effective mHealth PA programs may be difficult to implement and sustain long-term., Competing Interests: KD and LY received funding through Mitacs Accelerate Awards in partnership with ParticipACTION. GF was a member of the ParticipACTION Research Advisory Group. The remaining author declares that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Di Sebastiano, Lau, Yun and Faulkner.)

Social marketing campaigns promoting moderate to vigorous physical activity (MVPA) may be more successful when associated with strong brands. Little is known regarding how brand constructs such as brand resonance may be related to MVPA and its antecedents (e.g., having a physical activity identity). A better knowledge of these constructs and their relationships can reveal how to strengthen brands to make them more useful for interventions. The purpose of this study was to test a model linking ParticipACTION (a Canadian social marketing organization) brand constructs (brand affective attitude, identification, resonance), MVPA antecedents (behavioral affective attitude, identity), and MVPA. This study used a cross-sectional online survey design with a representative Canadian adult sample of 1,475 people ( M age = 49.36; 49.1% female). Path analysis was conducted to test the model. Overall, the model fit the data well, demonstrating positive associations between brand affective attitude and identification, identification and resonance, resonance and both behavioral affective attitude and identity, behavioral affective attitude and both identity and MVPA, and identity and MVPA. The results suggest that building brand resonance is important for linking branding to MVPA variables. Brand management activities designed to target brand affective attitude may be crucial to helping people feel strong resonance with a brand in a way that supports behavior change.

Objective: Environmental interventions are more effective at changing nutrition behaviour than educational campaigns alone. As part of their health promotion efforts, the University of British Columbia (UBC) developed the Healthy Beverage Initiative (HBI) to ultimately reduce the consumption of sugar-sweetened beverages (SSB) on campus. We describe the development, implementation, preliminary evaluation and future of the HBI., Design: Naturalistic observation of environmental changes to induce behaviour change., Setting: Large urban research university campus., Participants: University community members and campus visitors., Results: Three main activities have been implemented since the initiation of the UBC HBI: renegotiation of the cold beverage agreement, a media campaign to promote tap water consumption and the removal of SSB from select retail locations on campus (residence dining hall). No significant loss of revenue was observed following the removal of SSB from a residence dining hall compared with similar locations. Compensatory purchasing behaviour of SSB was not observed at the closest retail locations where they were still available. After the removal of SSB, ~75% of survey respondents were not aware that the beverages had been removed., Conclusions: The implementation of the HBI has met little resistance from the UBC community. The removal of SSB from residence dining locations did not result in any significant revenue loss or compensatory purchasing behaviour. This suggests that environmental intervention initiatives appear to be a viable option that may reduce SSB consumption on post-secondary campuses.

Objectives: Physical activity guidelines are evidence-based statements on recommended physical activity levels for good health. Guidelines, in isolation, are unlikely to increase population levels of physical activity; appropriate and effective communication is fundamental to maximising their impact. The aim of this paper is to provide a planning framework for physical activity guideline communication, including an overview of key audiences, aims and approaches., Methods: All authors considered and agreed on the three broad issues to address by consensus. We identified key sources of evidence through scoping of the literature and our knowledge of the research area., Results: Whether guidelines are global or national, communication of the physical activity guidelines should be informed by: (1) a situational analysis that considers the context in which the communication will take place and (2) a stakeholder analysis to determine the key target audiences for the communication and their values, needs and preferences. Audiences include policy-makers within and outside the health sector, other key stakeholders, the general public, specific population subgroups, health professionals and non-health professionals with a role in physical activity promotion. The aims and approach to communication will differ depending on the target audience., Conclusion: Communication to raise awareness and knowledge of the physical activity guidelines must be supported by policies, environments and opportunities for physical activity. Besides the intrinsic value of the physical activity guidelines, it is essential that substantial effort is put in to diligently planning, funding and implementing their communication from the outset., Competing Interests: Competing interests: KM and PK received financial reimbursement for some background work which informed parts of the manuscript. All other authors declare that they have no competing interests., (© Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Objective: The use of financial incentives to promote physical activity (PA) has grown in popularity due in part to technological advances that make it easier to track and reward PA. The purpose of this study was to update the evidence on the effects of incentives on PA in adults., Data Sources: Medline, PubMed, Embase, PsychINFO, CCTR, CINAHL and COCH., Eligibility Criteria: Randomised controlled trials (RCT) published between 2012 and May 2018 examining the impact of incentives on PA., Design: A simple count of studies with positive and null effects ('vote counting') was conducted. Random-effects meta-analyses were also undertaken for studies reporting steps per day for intervention and post-intervention periods., Results: 23 studies involving 6074 participants were included (64.42% female, mean age = 41.20 years). 20 out of 22 studies reported positive intervention effects and four out of 18 reported post-intervention (after incentives withdrawn) benefits. Among the 12 of 23 studies included in the meta-analysis, incentives were associated with increased mean daily step counts during the intervention period (pooled mean difference (MD), 607.1; 95% CI: 422.1 to 792.1). Among the nine of 12 studies with post-intervention daily step count data incentives were associated with increased mean daily step counts (pooled MD, 513.8; 95% CI:312.7 to 714.9)., Conclusion: Demonstrating rising interest in financial incentives, 23 RCTs were identified. Modest incentives ($1.40 US/day) increased PA for interventions of short and long durations and after incentives were removed, though post-intervention 'vote counting' and pooled results did not align. Nonetheless, and contrary to what has been previously reported, these findings suggest a short-term incentive 'dose' may promote sustained PA., Competing Interests: Competing interests: From 2015 to 2017 Marc Mitchell was the sole proprietor of a program evaluation company called Incentive Avenue Inc. Currently, he is the Principal Behavioural Insights Advisor for an incentive-based mHealth application company called Carrot Insights Inc. He reports consulting income from Carrot Insights Inc. in the past 36 months and company stock options as well. Furthermore, Stephanie Orstad worked as an independent contractor for Incentive Avenue Inc. in 2016. The other authors declare that no competing interests exist., (© Author(s) (or their employer(s)) 2020. No commercial re-use. See rights and permissions. Published by BMJ.)

Depression is the most common and prevalent mental disorder today, affecting an estimated 1 in 4 Canadians at some point in their lifetime. Physical activity is recommended as a primary treatment for mild to moderate depression and a secondary treatment for moderate to severe depression. Despite this, specific guidelines are still lacking on how to best promote physical activity in this population. Accordingly, this policy brief provides evidence-based recommendations for primary care providers and allied health professionals to promote lifelong physical activity in individuals with depression. Recommendations include asking for permission to discuss physical activity with the individual; framing physical activity as something that they have control over in order to feel better; clarifying that incorporating even a few more minutes of weekly physical activity is better than nothing and that mild forms are enough to achieve mental health benefits; and providing choices of activities to try and accompanying them on their first few sessions. Moreover, this article highlights the importance of promoting physical activity enjoyment for this population, which can be done by guiding the individual to slowly build up the frequency, duration and intensity of activity; encouraging them to be self-compassionate toward physical activity; suggesting they engage in outdoor activity, listen to music, and/or participate with a buddy or group; and incorporate self-monitoring or journalling to solidify the link between physical activity and improved mood. Practitioners are encouraged to use these evidence-informed recommendations-especially maximizing choices, enhancing physical activity enjoyment and emphasizing personal preferences-to help individuals with depression move, recover and flourish. These recommendations may also be used to tailor future interventions and inform policy guidelines to reduce depression rates in Canada., Competing Interests: The authors declare no conflicts of interest.

Background: The ParticipACTION Report Card on Physical Activity for Adults is a knowledge exchange tool representing a synthesis of the literature and data available at the national level. The purpose of this paper is to summarize the results of the inaugural 2019 edition., Methods: Thirteen physical activity indicators, grouped into 4 categories, were graded by a committee of experts using a process that was informed by the best available evidence. Sources included national surveys, peer-reviewed literature, and gray literature such as government and nongovernment reports and online content., Results: Grades were assigned to Daily Behaviors (overall physical activity: D; daily movement: C; moderate to vigorous physical activity: F; muscle and bone strength: INC; balance: INC; sedentary behavior: INC; sleep: B-), Individual Characteristics (intentions: B+), Settings and Sources of Influence (social support: INC; workplace: INC; community and environment: B-; health and primary care settings: C-), and Strategies and Investments (government: B-)., Conclusions: Generally, lower grades were given to behavior-related indicators (eg, overall physical activity) and better grades for indicators related to investments, community supports, and strategies and policies. Research gaps and future recommendations and directions are identified for each indicator to support future practice, policy, and research directions.

Compared with urban centers, rural, remote, and northern communities face substantial health inequities and increased rates of noncommunicable disease fuelled, in part, by decreased participation in physical activity. Understanding how the unique sociocultural and environmental factors in rural, remote, and northern communities contribute to implementation of physical activity interventions can help guide health promotion policy and practice. A scoping review was conducted to map literature describing the implementation of physical activity interventions in rural, remote, and/or northern communities. Databases MEDLINE, PsycINFO, EMBASE, CINAHL, and SPORTDiscus were searched using a predetermined search strategy. Outcomes of interest included community demographics, program characteristics, intervention results, measures of implementation, and facilitators or barriers to implementation. A total of 1672 articles were identified from a search of databases, and 8 from a targeted hand search. After screening based on inclusion and exclusion criteria, 12 articles were summarized in a narrative review. Prominent barriers to physical activity program implementation included transportation, lack of infrastructure, sociocultural factors, and weather. Facilitators of program success included flexibility and creativity on the part of the implementation team, leveraging community relationships, and shared resources. Few papers reported on traditional implementation outcomes such as fidelity, dose, and quality. There is a lack of rigorous implementation evaluations of physical activity interventions delivered in rural, remote, or northern communities. Positive aspects of rural life, such as social cohesion and willingness to share resources, appear to contribute to successful program implementation.

Issue Addressed: Public service announcements (PSA) targeting physical activity are not always effective at enacting behaviour change. One factor that may impact message effectiveness is whether the message matches its intent (ie, what norm is being portrayed and received). The current study explored the effects of two PSAs on parents' perceptions of outdoor play., Methods: Parents (N = 333) completed a pre/postexperimental online survey to examine the acute impact of a PSA on their perception of how often children play outdoors (ie, descriptive norms). Participants provided their descriptive norm perceptions and then were randomised to view one of two PSAs: (a) the Mr. Lonely PSA, which portrayed outdoor activity as not normative, and (b) a control message, which portrayed outdoor activity as the norm (VERB PSA). After viewing their PSA, descriptive norm perceptions were reported again., Results: A two-way mixed ANOVA indicated that participants who viewed the Mr. Lonely PSA (where outdoor play was not normative) perceived that children and youth played outdoors less frequently immediately after watching the PSA compared to before viewing it (P < 0.05). No significant change occurred in the control condition., Conclusions: PSAs can alter individuals' perceptions of whether they perceive outdoor play as normative among children and youth. SO WHAT?: As individuals align their behaviour with what is typical, PSA developers should be wary of what message is being conveyed. In terms of activity, portraying that outdoor play is not normative may not have the intended outcome., (© 2018 Australian Health Promotion Association.)

In the context of rising screen time, only a third of Canadian children are achieving adequate amounts of active play, an important source of physical activity. ParticipACTION, a national not-for-profit organization, created the "Make Room for Play" campaign targeting parents with television advertisements depicting how screen time takes away from active play. The advertisements featured children engaging in active play (e.g., jump rope) while a black screen progressively sequesters the room for them to play. This study's purpose was to evaluate the campaign using the hierarchy of effects model, a framework for conceptualizing the impact of mass media campaigns. It was hypothesized that recall would relate to intermediate (e.g., cognitions, self-efficacy) and distal (e.g., parental support) factors. Twenty-six percent of the general population and caregiver samples surveyed (N = 1576) recalled (unaided) the advertisement and 45.9% recalled when prompted. Parental support was significantly higher in those recalling the campaign, p = .009. Twenty-four percent of parents reporting unaided recall (versus 14.0% of those not) tried to engage in active play with their children and 21.2% (versus 12.0%) tried to create opportunities for children to engage in play. Strengths and limitations of mass media approaches targeting active play and screen time are discussed.

Objective In this study, we examine the effect of providing an incentive for engagement in self-regulatory behaviors (ie, action planning), in inactive, office-based university employees participating in an 11-week, Web-based walking intervention. Methods Participants were randomly assigned to either control (intervention only) or incentive (intervention plus incentive; CAD $5.00 e-gift card delivered weekly for completing action plans over 4 weeks) conditions. Cohen's d was used to estimate the effect of the incentive on action planning and a RM-ANOVA examined differences in average steps/day, between the 2 conditions, before, during, and after the 4-week incentive period. Results Sixty-nine participants were included in the analysis (incentive: N = 34; control: N = 35; 88% female; Mage = 40.46±10.6 years). A large effect size (d = 1.01) in action plan completion was observed, favoring the incentive condition, with the effect of condition remaining high after incentives were withdrawn (d = 1.0). Greater steps/day favored the incentive condition during the post-incentive period (small effect size; d = 0.28). Conclusions Incentives were effective in encouraging engagement in a self-regulatory strategy (action planning). Future research should examine the optimal incentive structure and timing for engagement.

Background: Given the high levels of sedentary time and treatment-related side effects in prostate cancer survivors (PCS), interventions targeting sedentary behavior (SED) may be more sustainable compared to physical activity (PA)., Purpose: To examine the feasibility of a web-based intervention (RiseTx) for reducing SED and increasing moderate-to-vigorous physical activity (MVPA) among PCS undergoing ADT. Secondary outcomes include changes in SED, MVPA, light intensity PA, and quality of life., Methods: Forty-six PCS were recruited from two cancer centres in Toronto, Ontario, Canada between July 2015-October 2016. PCS were given an activity tracker (Jawbone), access to the RiseTx website program, and provided with a goal of increasing walking by 3000 daily steps above baseline levels over a 12-week period. A range of support tools were progressively released to reduce SED time (e.g., self-monitoring of steps) during the five-phase program. Objective measures of SED, MVPA, and daily steps were compared across the 12-week intervention using linear mixed models., Results: Of the 46 PCS enrolled in the study, 42 completed the SED intervention, representing a 9% attrition rate. Measurement completion rates were 97 and 65% at immediately post-intervention and 12-week follow-up for all measures, respectively. Overall adherence was 64% for total number of logins (i.e., > 3 visits each week). Sample mean age was 73.2 ± 7.3 years, mean BMI was 28.0 ± 3.0 kg/m 2 , mean number of months since diagnosis was 93.6 ± 71.2, and 72% had ADT administered continuously. Significant reductions of 455.4 weekly minutes of SED time were observed at post-intervention (p = .005). Significant increases of + 44.1 for weekly minutes of MVPA was observed at immediately post-intervention (p = .010). There were significant increases in step counts of + 1535 steps from baseline to post-intervention (p < .001)., Conclusions: RiseTx was successful in reducing SED and increasing MVPA in PCS. PCS were satisfied with the intervention and its components. Additional strategies may be needed though for maintenance of behavior change. The next step for RiseTx is to replicate these findings in a larger, randomized controlled trial that will have the potential for reducing sedentary time among PCS., Trial Registration: NCT03321149 (ClinicalTrials.gov Identifier).

Introduction: ParticipACTION is a Canadian physical activity communications and social marketing organization relaunched in 2007. The purpose of this study was to qualitatively investigate organizational capacity for physical activity promotion among Canadian organizations, and the influence of ParticipACTION on capacity five years after relaunch., Methods: Using a purposive sampling strategy, semi-structured telephone interviews were conducted with 44 key informants representing national, provincial, and local organizations with a mandate to promote physical activity. Interview data were analyzed using a thematic analytic approach., Results: Organizational capacity in terms of partnerships and collaborations, and the general climate for physical activity promotion have improved since ParticipACTION's relaunch. Although financial resources reduced the ability of organizations to fulfil their mandates, internal factors such as skilled employees and sponsorships, and external factors such as technological improvements in communication and information sharing helped to offset this strain. There were mixed feelings on ParticipACTION's contribution to capacity. While ParticipACTION has brought more attention to inactivity, this was perceived as a complement to work already taking place. While some organizations perceived ParticipACTION's relaunch as competition to funding and access to popular media, others found it as an opportunity to co-brand social marketing campaigns, utilizing ParticipACTION's products and reputation., Conclusion: According to participants, organizational capacity to promote physical activity in Canada has increased since 2007 in subtle but important ways because of a strong climate for physical activity promotion, skilled employees, and information sharing technology. Organizational capacity changes were minimally attributed to ParticipACTION., Competing Interests: GF, TB, SD, AEL, RER, MST and JS serve on the ParticipACTION Research Advisory Group.

Introduction: In this cross-sectional follow-up study, we explored Canadian's awareness of ParticipACTION and their levels of physical activity (PA) after seven years of campaigns., Methods: A population-based survey was conducted with 7282 adults over a period of 14 months from February 2014 to May 2015. The survey consisted of questions on the 2014-2015 Physical Activity Monitor relating to awareness and knowledge of ParticipACTION. Weighted logistic models were constructed to examine whether awareness was associated with PA-related beliefs, intentions, and leisure time physical activity (LTPA)., Results: Approximately 20% of Canadians reported unprompted awareness of ParticipACTION and 82% reported prompted awareness. Education, income, and having children were significant correlates of awareness among Canadians. The adjusted odds of people being aware of ParticipACTION (prompted and unprompted) were greater if they were more educated (OR = 1.57, 95% CI: 1.04-2.39; OR = 2.00, 95% CI: 1.24-3.24), reported higher income (OR = 3.92, 95% CI: 2.35-6.53; OR = 2.29, 95% CI: 1.44-3.62), and had children (OR = 1.93, 95% CI: 1.40-2.66; OR = 1.70, 95% CI: 1.26-2.30). Furthermore, awareness of ParticipACTION was positively associated with outcome expectations and self-efficacy, and negatively associated with LTPA status., Conclusion: Levels of unprompted awareness of ParticipACTION are higher than previously reported and, in comparison to active Canadians, inactive Canadians are more likely to be aware of the organization. Given that it had primarily targeted parents of inactive children over the past seven years, it appears the organization has been partially effective in achieving its communication goals., Competing Interests: JS, GF, TB, SD, AER, RER and MST serve on the ParticipACTION Research Advisory Group.

Introduction: ParticipACTION is a Canadian physical activity communications and social marketing organization relaunched in 2007. This study assesses the capacity of Canadian organizations to adopt, implement, and promote physical activity initiatives. The four objectives were to compare findings from baseline (2008) and follow-up (2013) with respect to: (1) awareness of ParticipACTION; (2) organizational capacity to adopt, implement and promote physical activity initiatives; (3) potential differences in capacity based on organizational size, sector, and mandate; and (4) assess perceptions of ParticipACTION five years after relaunch., Methods: In this cross-sectional study, representatives from local, provincial/territorial, and national organizations completed an online survey assessing capacity to adopt, implement, and promote physical activity. Descriptive statistics and one-way analyses of variance were conducted to examine the objectives., Results: Response rate for opening an email survey invitation and consenting to participate was 40.6% (685/1688) and 540 surveys were completed. Awareness of ParticipACTION increased from 54.6% at baseline to 93.9% at follow-up (Objective 1). Findings at both baseline and follow-up reflected good organizational capacity to adopt, implement and promote physical activity (Objective 2) although some varied by organizational sector and mandate (Objective 3). Most respondents reported that ParticipACTION provided positive leadership (65.3%), but there was less agreement regarding ParticipACTION's facilitation of infrastructure (44.0%) or organizational will/motivation (47.1%)(Objective 4)., Conclusion: Canadian organizations continue to report having good capacity to adopt, implement, and promote physical activity. There was no discernible change in capacity indicators five years after ParticipACTION's relaunch although its broader contribution to the physical activity sector was endorsed., Competing Interests: GF, TB, SD, AEL, RER, MST and JS serve on the ParticipACTION Research Advisory Group.

ParticipACTION is the Canadian physical activity communications and social marketing organization first launched in the fall of 1971 and then ceased operations in 2001. ParticipACTION was relaunched in 2007. Framed as a public health natural experiment, evidence was collected from a population-based survey of knowledge, awareness, understanding of physical activity, and physical activity levels among Canadians (individual level), and key informant surveys and interviews examining capacity, readiness and advocacy for physical activity promotion among physical activity organizations (organizational level). The purpose of this paper is to first provide an overview of some of the major initiatives undertaken by the 'new' ParticipACTION that may have contributed to any changes at these individual or organizational levels. Second, the paper sets the stage for the three empirical papers in this special series reporting follow-up results., Competing Interests: GF, MST and JCS serve on the ParticipACTION Research Advisory Group.

Youth physical activity levels remain low in Canada and worldwide. Lack of environmental resources (e.g., access to equipment and facilities, transportation options, and participation costs) is a key barrier for youth participation. Micro-grants are small budgets of money awarded via grant applications and may help community organizations facilitate youth physical activity participation by alleviating environmental resource barriers. ParticipACTION Teen Challenge was a national micro-grant scheme administered in Canada. Secondary analysis of survey data from Provincial and Territorial coordinators, registered community organizers, and successful grant applicants were used to evaluate the process and outcomes of Teen Challenge. Results showed that the financial subsidy of 500CAD was used mainly toward equipment, instruction, and transportation. Coordinators and community organizers indicated high levels of satisfaction and benefits for communities and teens. A key benefit for coordinators was leveraging the Teen Challenge network for physical activity promotion. Reported benefits for teenaged participants included leadership opportunities (e.g., helping create and implement programs) and increased physical activity participation. Findings highlight the value of micro-grants for supporting sport and physical activity opportunities for Canadian teens, and show that such schemes address barriers related to environmental resources. The sustainability of micro-grant schemes remains to be seen.

Background: Active school transport (AST) is a promising strategy to increase children's physical activity. A systematic review published in 2011 found large heterogeneity in the effectiveness of interventions in increasing AST and highlighted several limitations of previous research. We provide a comprehensive update of that review., Methods: Replicating the search of the previous review, we screened the PubMed, Web of Science, Cochrane, Sport Discus and National Transportation Library databases for articles published between February 1, 2010 and October 15, 2016. To be eligible, studies had to focus on school-aged children and adolescents, include an intervention related to school travel, and report a measure of travel behaviors. We assessed quality of individual studies with the Effective Public Health Practice Project quality assessment tool, and overall quality of evidence with the Grades of Recommendation, Assessment, Development, and Evaluation (GRADE) approach. We calculated Cohen's d as a measure of effect size., Results: Out of 6318 potentially relevant articles, 27 articles reporting 30 interventions met our inclusion criteria. Thirteen interventions resulted in an increase in AST, 8 found no changes, 4 reported inconsistent results, and 5 did not report inferential statistics. Cohen's d ranged from -0.61 to 0.75, with most studies reporting "trivial-to-small" positive effect sizes. Three studies reported greater increases in AST over longer follow-up periods and two Safe Routes to School studies noted that multi-level interventions were more effective. Study quality was rated as weak for 27/30 interventions (due notably to lack of blinding of outcome assessors, unknown psychometric properties of measurement tools, and limited control for confounders), and overall quality of evidence was rated as low. Evaluations of implementation suggested that interventions were limited by insufficient follow-up duration, incomplete implementation of planned interventions, and limited access to resources for low-income communities., Conclusions: Interventions may increase AST among children; however, there was substantial heterogeneity across studies and quality of evidence remains low. Future studies should include longer follow-ups, use standardized outcome measures (to allow for meta-analyses), and examine potential moderators and mediators of travel behavior change to help refine current interventions., Trial Registration: Registered in PROSPERO: CRD42016033252.

This study examined the relationship between message variables and affective reactions with parents' attitudes after seeing a physical activity mass media public service announcement (PSA). It was hypothesized that there would be a positive relationship between message variables (i.e., personal relevance, novelty of information, and feelings toward sponsoring organization) and parents' attitudes toward their child/children's physical activity after viewing the PSA. Furthermore, we explored whether discrete affective reactions were related to attitudes, beyond the effect of message variables. A secondary data analysis was conducted with parental responses to an online campaign evaluation survey (n = 267). Hierarchical regression analyses showed an overall positive relationship between all three message variables and attitudes. Furthermore, two discrete affective reactions were positively related to attitudes. Parents who endorsed feeling motivated or guilty after viewing the advertisement had more positive attitudes toward their children's physical activity levels. This study represents an ecologically valid assessment of how message variables and affective reactions are related to attitudes within the context of a physical activity mass media campaign. The results provide guidance for the effective design of mass media physical activity campaigns.

Background: The ParticipACTION Report Card on Physical Activity for Children and Youth is the most comprehensive assessment of child and youth physical activity in Canada and provides an update or "state of the nation" that assesses how Canada is doing at promoting and facilitating physical activity opportunities for children and youth. The purpose of this paper is to summarize the results of the 2016 ParticipACTION Report Card., Methods: Twelve physical activity indicators were graded by a committee of experts using a process that was informed by the best available evidence. Sources included national surveys, peer-reviewed literature, and gray literature such as government and nongovernment reports and online content., Results: Grades were assigned to Daily Behaviors (Overall Physical Activity: D-; Organized Sport and Physical Activity Participation: B; Active Play: D+; Active Transportation: D; Physical Literacy: D+; Sleep: B; Sedentary Behaviors: F), Settings and Sources of Influence (Family and Peers: C+; School: B; Community and Environment: A-), and Strategies and Investments (Government: B-; Nongovernment: A-)., Conclusions: Similar to previous years of the Report Card, Canada generally received good grades for indicators relating to investment, infrastructure, strategies, policies, and programming, and poor grades for behavioral indicators (eg, Overall Physical Activity, Sedentary Behaviors).

Introduction ParticipACTION's 2011 "Think Again" campaign aimed to draw parents', and specifically mothers', attention to the amount of physical activity (PA) their children do relative to the national guidelines (physical activity guidelines [PAG]). Purpose To evaluate ParticipACTION's "Think Again" campaign in the context of the hierarchy of effects model. Methods Data were drawn from "Think Again" campaign evaluations conducted among two cohorts of parents with children ages 5 to 11 years (3 months postcampaign launch [T1], n = 702; 15 months postlaunch [T2], n = 670). Results At T2, campaign awareness was weakly associated with parents agreeing that their children were not active enough (p = .01, d = .18). Parents who were aware of the campaign showed greater knowledge of PAG (ps < .01, ϕs > .14), had higher outcome expectations about their children engaging in PA (p < .01, d = .16), had stronger intentions to help their child meet the guidelines (p < .01, d = .18), and engaged in more parental support behaviors (p < .001, d = .31) as compared with parents who were not aware. At T1, parents aware of the campaign had greater perceived behavioral control (PBC) to influence their child's PA participation (p < .01, d = .22), whereas parents not aware of the campaign had greater PBC to find practical ways to help their child be active (p < .01, d = .26). Parental awareness of the campaign was not associated with children meeting the PAG at either time point (ps > .05). Conclusions The campaign appeared marginally effective for increasing parental knowledge of PAG and for creating realistic awareness of children's PA levels. Additional intervention strategies are needed to produce larger effects and to change parental behavior., (© 2015 Society for Public Health Education.)

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.

Background: The Canadian Assessment of Physical Literacy (CAPL) was conceptualized as a tool to monitor children's physical literacy. The original model (fitness, activity behavior, knowledge, motor skill) required revision and relative weights for calculating/interpreting scores were required., Methods: Nineteen childhood physical activity/fitness experts completed a 3-round Delphi process. Round 1 was open-ended questions. Subsequent rounds rated statements using a 5-point Likert scale. Recommendations were sought regarding protocol inclusion, relative importance within composite scores and score interpretation., Results: Delphi participant consensus was achieved for 64% (47/73) of statement topics, including a revised conceptual model, specific assessment protocols, the importance of longitudinal tracking, and the relative importance of individual protocols and composite scores. Divergent opinions remained regarding the inclusion of sleep time, assessment/ scoring of the obstacle course assessment of motor skill, and the need for an overall physical literacy classification., Conclusions: The revised CAPL model (overlapping domains of physical competence, motivation, and knowledge, encompassed by daily behavior) is appropriate for monitoring the physical literacy of children aged 8 to 12 years. Objectively measured domains (daily behavior, physical competence) have higher relative importance. The interpretation of CAPL results should be reevaluated as more data become available.

Purpose: To examine the feasibility of conducting a randomized controlled trial investigating the effectiveness of financial incentives for exercise self-monitoring in cardiac rehabilitation (CR)., Methods: A 12-week, 2 parallel-arm, single-blind feasibility study design was employed. A volunteer sample of CR program graduates was randomly assigned to an exercise self-monitoring intervention only (control; n = 14; mean age ± SD, 62.7 ± 14.6 years), or an exercise self-monitoring plus incentives approach (incentive; n = 13; mean age ± SD, 63.6 ± 11.8 years). Control group participants received a "home-based" exercise self-monitoring program following CR program completion (exercise diaries could be submitted online or by mail). Incentive group participants received the "home-based" program, plus voucher-based incentives for exercise diary submissions ($2 per day). A range of feasibility outcomes is presented, including recruitment and retention rates, and intervention acceptability. Data for the proposed primary outcome of a definitive trial, aerobic fitness, are also reported., Results: Seventy-four CR graduates were potentially eligible to participate, 27 were enrolled (36.5% recruitment rate; twice the expected rate), and 5 were lost to followup (80% retention). Intervention acceptability was high with three-quarters of participants indicating that they would likely sign up for an incentive program at baseline. While group differences in exercise self-monitoring (the incentive "target") were not observed, modest but nonsignificant changes in aerobic fitness were noted with fitness increasing by 0.23 mL·kg-·min- among incentive participants and decreasing by 0.68 mL·kg-·min- among controls., Conclusion: This preliminary study demonstrates the feasibility of studying incentives in a CR context, and the potential for incentives to be readily accepted in the broader context of the Canadian health care system.

The objective of the My ParticipACTION campaign was to inspire Canadian adults to increase their physical activity through messaging that was relevant, engaging, and designed to build self-efficacy to be more active. This research examined the communication effects of the campaign according to the a priori Hierarchy of Effects Model (saliency → cognitive engagement → self-efficacy to become more active → trial behavior) and investigated how these effects related to overall self-efficacy for physical activity, intention to be active, and current activity level. Participants (N = 1,110) were recruited from an existing panel of Canadian adults 18 years and older and completed a short online questionnaire about the potential communication effects. Logistic regression models were constructed to test the communication effects adjusting for age, gender, and education. The relations were consistent with those hypothesized in the model. In addition, some earlier outcomes in the sequence of effects were associated with other outcomes further down the progression. When intention to be active was included, the initial relation between ad-specific self-efficacy and current physical activity disappeared. This analysis suggested that the campaign was successful in increasing self-efficacy to be more active and that using the Hierarchy of Effects Model was useful in guiding the design of campaign messages and assessing communication effects. Given the limited amount of theoretical testing of the Hierarchy of Effects Model, future research employing longitudinal designs is required to further confirm the communication effects of such an intervention and further test the model.

Objective: MoveU is a social marketing initiative aimed at increasing moderate-to-vigorous physical activity (MVPA) among undergraduate students. Using the Hierarchy of Effects model (HOEM), this study identified awareness of MoveU and examined associations between awareness, outcome expectations, self-efficacy, intentions, and MVPA., Participants: Students (N = 2,784) from a Canadian university in March 2013., Methods: A secondary analysis of the National College Health Assessment-II survey and measures specific to the MoveU campaign. The main associations were examined in a path analysis., Results: MoveU awareness (36.4%) was lower than other well-established university health campaigns. Younger students, females, and individuals living on campus were more likely to be aware of MoveU. The HOEM was supported, and improvements in model fit were evident, with additional direct relationships between outcome expectancy and intention, and between self-efficacy and MVPA., Conclusions: The intended population was aware of the campaign. The HOEM was useful in the development and evaluation of the MoveU campaign. Longitudinal studies are needed to further test the efficacy of the HOEM in the social marketing of physical activity.

Objective: Active school travel (AST) may provide a significant source of physical activity for children although rates of AST are declining in many countries. The objective of this study was to evaluate the Canadian School Travel Planning (STP) intervention by examining changes in school travel mode and predictors of mode change., Methods: Schools (n=106) across Canada participated between January 2010 and March 2012. STP committees implemented school-specific strategies to increase active school transport (AST) which included educational strategies, activities and events, capital improvement projects and enforcement initiatives. Travel mode at each school was assessed by a hands-up survey and school travel plans were reviewed for content., Results: Complete data were available for 53 schools. There was no increase in AST at follow-up after one year. There was variation in mode change between schools. Only season of data collection predicted a decrease in AST in the morning (B=-5.36, p<.05)., Conclusion: This Canadian STP evaluation showed no change in AST after one year. There was evidence of some localized success at nearly half of the participating schools. More robust monitoring and evaluation are needed to examine STP effectiveness., (Copyright © 2013 Elsevier Inc. All rights reserved.)

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.

Financial health incentives, such as paying people to exercise, remain controversial despite widespread implementation. This focus group study explored the acceptability of incentives among a sample of Canadian cardiac rehabilitation (CR) patients (n = 15). Focus groups were conducted between March and April 2013 until further sampling ceased to produce new analytical concepts. A thematic analysis approach was adopted in analysing the data. Three broad themes emerged from the focus groups. First, ethical concerns were prominent. Half of participants disagreed with the incentive approach believing that it was unfair, unnecessary or a waste of limited resources. Second, ethical concerns were mitigated in considering a range of incentive features including type, size and source. Specifically, privately sponsored (not government funded) health-promoting voucher-based incentives (e.g., grocery or gym vouchers) were perceived to be highly acceptable. Third, if designed like this, then financial incentives were considered potentially effective in motivating behaviour change and in reducing economic barriers to exercise participation. Overall, the majority of participants welcomed incentives if ethical concerns were addressed through thoughtful incentive programme design. The results of this focus group study will inform the design of a financial health incentive feasibility RCT to promote post-CR programme exercise compliance in this population.

Context: Given its high prevalence and impact on quality of life, more research is needed in identifying factors that may prevent depression. This review examined whether physical activity (PA) is protective against the onset of depression., Evidence Acquisition: A comprehensive search was conducted up until December 2012 in the following databases: MEDLINE, Embase, PubMed, PsycINFO, SPORTDiscus, and Cochrane Database of Systematic Reviews. Data were analyzed between July 2012 and February 2013. Articles were chosen for the review if the study used a prospective-based, longitudinal design and examined relationships between PA and depression over at least two time intervals. A formal quality assessment for each study also was conducted independently by the two reviewers., Evidence Synthesis: The initial search yielded a total of 6363 citations. After a thorough selection process, 30 studies were included for analyses. Among these, 25 studies demonstrated that baseline PA was negatively associated with a risk of subsequent depression. The majority of these studies were of high methodologic quality, providing consistent evidence that PA may prevent future depression. There is promising evidence that any level of PA, including low levels (e.g., walking <150 minutes/weeks), can prevent future depression., Conclusions: From a population health perspective, promoting PA may serve as a valuable mental health promotion strategy in reducing the risk of developing depression., (Crown Copyright © 2013 Published by American Journal of Preventive Medicine All rights reserved.)

Objective: Given evidence of weekday-weekend variability in children's sleep and associations with obesity there is rationale for exploring sleep in relation to weekday and weekend physical activity (PA) and examining whether weekday-weekend variations in sleep impact physical activity., Methods: Children's (n=856) physical activity was measured using accelerometry (Toronto; 2010-2011). Sleep was assessed via parental report and collapsed into three categories (<9h; 9-10h; ≥ 10 h) and differences in anthropometric and physical activity characteristics were assessed. Data were compared to determine whether sleep increased, decreased or was maintained across the week and relationships with activity and overweight/obesity were explored (cross-sectional analysis) after controlling for confounders., Results: On weekdays, children who slept the least (<9h) were less active in terms of overall intensity than those attaining ≥ 10 h, and more were overweight/obese (p<0.05). On weekends, differences in light physical activity occurred at lower sleep levels. Weekday-weekend sleep regularity mattered; overall intensity was higher among those maintaining recommended sleep (>9h) compared to those engaging in weekend-catch-up-sleep., Conclusion: While sleep is associated with obesity and activity in children, relationships vary by day. Recommended weekday-weekend sleep (regularity) supports healthy activity and should be an important health-promoting strategy. Future studies using longitudinal designs (to establish causality) are recommended., (Copyright © 2012 Elsevier Inc. All rights reserved.)

A comprehensive, multi-level approach to curb chronic disease-related costs in Canada is needed. One target for intervention is the economic domain. The emergence of user financial incentives (UFI) in public health policy as well as their broad implementation in corporate settings has stimulated a growing but limited body of research in this area. The authors'position is that the jury is still out on the question of their effectiveness in sustaining long-term health behaviour change, given the nature of the UFI that have been designed and delivered to date--that is, UFI with limited theoretical and contextual consideration. It is their contention that manipulating UFI design features (there are seven core features with a range of attributes) to exploit contextual (e.g., personal income) and theoretical (e.g., self-efficacy) factors may optimize UFI effectiveness over the long term. Although UFI are not the solution, they might very well be apart.

Background: Active school transport (AST), school travel using an active mode like walking, may be important to children's overall physical activity. A "school travel plan" (STP) documents a school's transport characteristics and provides an action plan to address school and neighborhood barriers to AST., Methods: We conducted a pilot STP intervention at 12 schools in 4 Canadian provinces. Facilitators and school personnel created and implemented AST action plans. Parent's self-reports (N = 1489) were the basis for evaluating the intervention. A content analysis identified type, frequency, and perceived success of initiatives., Results: School travel plans emphasized education and promotion, and AST activities and events. Capital improvement projects were more common at schools in older suburban neighborhoods, whereas enforcement was more common at schools in newer suburban neighborhoods. Rates of active transportation increased from 43.8% to 45.9%. At follow-up, 13.3% of households reported less driving. Parents/caregivers cited weather, convenience, and trip chaining as primary reasons for continued driving., Conclusion: The STP process may facilitate changes to patterns of school travel. An STP can expand a school's capacity to address transportation issues through mobilization of diverse community resources. Future STP initiatives may benefit from addressing convenience, safety through enforcement, and by examining how schools can be supported in implementing infrastructure improvements., (© 2011, American School Health Association.)

ParticipACTION is a Canadian physical activity communications and social marketing organization that has been relaunched in 2007 after a 6-year hiatus. The purpose of this study is to qualitatively identify and describe the expectations and challenges the relaunch of the new ParticipACTION may present for existing physical activity organizations. Using a purposeful sampling strategy, the authors conduct semistructured telephone interviews with 49 key informants representing a range of national, provincial, and local organizations with a mandate to promote physical activity. Overall, there is strong support in seeing ParticipACTION relaunched. However, organizational expectations and/or their ideal vision for it are mixed. Organizations envision and support its performing an overarching social marketing and advocacy role, and in providing tools and resources that supplement existing organizational activities. Four major organizational challenges are identified concerning overlapping mandates, partnership and leadership concerns, competition for funding, and capacity concerns. Social marketing initiatives, such as ParticipACTION, may not be able to maximize their impact unless they address the expectations and concerns of competing organizations with a mandate to promote physical activity.

Media interventions are one strategy used to promote physical activity, but little is known about their effectiveness with children. As part of a larger evaluation, the purpose of this study was to assess the short-term effect of a private industry sponsored media literacy campaign, Long Live Kids, aimed at children in Canada. Specifically, we investigated children's awareness of the campaign and its correlates. Using a cohort design, a national sample (N = 331, male = 171; mean age = 10.81, SD = 0.99) completed a telephone survey two weeks prior to the campaign release, and again 1 year later. Only 3% of the children were able to recall the Long Live Kids campaign unprompted and 57% had prompted recall. Logistic regression found family income (Wald χ(2) = 11.06, p < .05), and free-time physical activity (Wald χ(2) = 5.67, p < .01) significantly predicted campaign awareness. Active children (≥3 days/week) were twice as likely to have recalled the campaign compared with inactive children (<3 days/week), whereas children living in high-income households (>$60,000/yr) were between 3.5 to 5 times more likely to have campaign recall compared with children living in a low-income households (<$20,000/yr). These findings suggest that media campaigns developed by industry may have a role in promoting physical activity to children although our findings identified a knowledge gap between children living in high- and low-income households. Future research needs to examine how children become aware of such media campaigns and how this mediated information is being used by children.

Objective: This study assessed the environmental characteristics of ten universities, comparing the extent to which physical infra-structures are able to support a route-based walking intervention., Method: Following protocol standardization between and within sites, major pedestrian routes at main suburban campuses in seven countries (Australia, Canada, England, Northern Ireland, Scotland, Spain and the United States) were audited by researchers using an established inventory (March-June 2008). The inventory assessed key characteristics (e.g. size and employee number) and nine specific items (pedestrian facilities, vehicle conflicts, crossings, route-maintenance, walkway width, roadway buffer, universal accessibility, aesthetics and cover), scored on a five-point scale (1=very poor; 5=excellent). Item scores for each route, were combined and weighted, to provide indicators of low (score of 20-39), fair (score of 40-69), or good (score of 70-100) physical infra-structure support., Results: Sites varied in area (range of 7-1000 acres) and employee numbers (range of 700-7500 employees). Audits reported good support for route-based walking at seven sites (overall route score range=72.5+/-13.9-82.2+/-17.4), fair support at two sites (overall route score of 69.1+/-11.7 and 61.7+/-14.6), and low support at one site (overall route score of 22.1+/-7.3)., Conclusions: Study methods highlight a valuable audit process, while findings identify the need to improve aspects of physical infra-structure at sites where the built environment may be less conducive for route-based walking.

Explored the hypothesis that framing health information as safer smoking tips might motivate change in cigarette smokers. Daily smokers were randomly assigned to a control condition or to an intervention condition in which respondents were asked if they knew about a range of different safer smoking tips. Respondents (43 daily smokers, 18 years or older, 58% male) who received safer smoking tips reported a small reduction in the number of cigarettes smoked (p=.05) by the 3-month follow-up as compared to respondents in the control condition. This pilot result is encouraging but requires replication before considering the value of including safer smoking tips in health messages for smokers in the general population.

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.

Since the effects of tobacco smoke are so detrimental to health, growing consideration has been given to the development of harm reduction strategies for those smokers who are unable or unwilling to stop using tobacco. The term harm reduction refers to a policy, strategy, or particular intervention that assumes continued use of an undesired behavior and aspires to lower the risk of adverse consequences associated with the continuation of this addictive behavior. Up to this point, tobacco harm reduction interventions have focused on reducing tobacco-related harm through the utilization of innovative tobacco products, reduced tobacco consumption, and pharmaceutical medications. With the possible exception of medicinal nicotine products, these strategies remain unproven and thus far no scientific or medical literature exists to suggest these harm reduction strategies reduce tobacco-related exposure, morbidity, or mortality. Consequently, a need exists for broadening the range of potentially effective harm reduction strategies. This preliminary review suggests that physical activity has the potential to become one such strategy. Of the eight principles that characterize a harm reduction strategy, all are at least partially satisfied by physical activity. Further, emerging evidence indicates that physical activity may delay the occurrence of disease and premature death initiated by tobacco consumption. Significant concerns remain regarding the practicality of physical activity as a harm reduction strategy and the extent to which participation in physical activity may be used to justify continued smoking.

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.

Background: Evaluations of physical activity and health media campaigns have been limited and ignore the complex process of communication and the socially constructed nature of news messages., Methods: A systematic search strategy was conducted of the literature which was then assessed from two perspectives. First, studies since 1998 were reviewed for their success in impacting message recall and behavior change. Second, employing a critical media studies perspective the papers were assessed for the presence of a more sophisticated understanding of the media processes of inception, transmission and reception., Results: Overall, recent studies support mass media interventions in influencing short-term physical activity message recall and to a lesser extent associated changes in physical activity knowledge. However, the majority of the papers were found to follow a social marketing or media advocacy theory of media promotion with little in-depth consideration of the comprehensive media processes involved in creating media messages and meaning., Conclusions: Simplistic understandings of media transmission dominate in assessing physical activity and health media campaigns. Fuller understandings of the success of media campaigns, the recall of media messages or associated behaviour change can only truly be understood through the application of a more sophisticated form of media analysis.

Objective: MoveU is a social marketing initiative aimed at increasing moderate-to-vigorous physical activity (MVPA) among undergraduate students. Using the Hierarchy of Effects model (HOEM), this study identified awareness of MoveU and examined associations between awareness, outcome expectations, self-efficacy, intentions, and MVPA. Participants: Students (N = 2,784) from a Canadian university in March 2013. Methods: A secondary analysis of the National College Health Assessment-II survey and measures specific to the MoveU campaign. The main associations were examined in a path analysis. Results: MoveU awareness (36.4%) was lower than other well-established university health campaigns. Younger students, females, and individuals living on campus were more likely to be aware of MoveU. The HOEM was supported, and improvements in model fit were evident, with additional direct relationships between outcome expectancy and intention, and between self-efficacy and MVPA. Conclusions: The intended population was aware of the campaign. The HOEM was useful in the development and evaluation of the MoveU campaign. Longitudinal studies are needed to further test the efficacy of the HOEM in the social marketing of physical activity.

Background: Active school transport (AST), school travel using an active mode like walking, may be important to children's overall physical activity. A "school travel plan" (STP) documents a school's transport characteristics and provides an action plan to address school and neighborhood barriers to AST. Methods: We conducted a pilot STP intervention at 12 schools in 4 Canadian provinces. Facilitators and school personnel created and implemented AST action plans. Parent's self-reports (N = 1489) were the basis for evaluating the intervention. A content analysis identified type, frequency, and perceived success of initiatives. Results: School travel plans emphasized education and promotion, and AST activities and events. Capital improvement projects were more common at schools in older suburban neighborhoods, whereas enforcement was more common at schools in newer suburban neighborhoods. Rates of active transportation increased from 43.8% to 45.9%. At follow-up, 13.3% of households reported less driving. Parents/caregivers cited weather, convenience, and trip chaining as primary reasons for continued driving. Conclusion: The STP process may facilitate changes to patterns of school travel. An STP can expand a school's capacity to address transportation issues through mobilization of diverse community resources. Future STP initiatives may benefit from addressing convenience, safety through enforcement, and by examining how schools can be supported in implementing infrastructure improvements. (Contains 1 table and 2 figures.)

Objective: The purpose of this study was to identify the health topics students received information about, how students obtained health-related information, and perceived believability of those sources. Participants and Methods: Students (N = 1202) were surveyed using the National College Health Assessment (NCHA) of the American College Health Association. Results: Nearly half (46%) of the sample reported not receiving any information, whereas only 0.5% received information on all health topics. The Internet was the most common source of health-related information, but, conversely, was perceived as the least believable source. Health center medical staff and university health educators were perceived to be the most believable sources. Conclusions: Future practice at the university setting should focus on delivering health information through believable messengers utilizing the most commonly reported sources of information. This may have implications towards how students shape their health-related social cognitions and subsequent behaviors. (Contains 4 tables.)

Tested the theory of planned behavior's (TPB) ability to predict stage of change for physical activity promotion among health professionals. Researchers measured attitudes, subjective norms, intentions, perceived behavioral control, and stage of change, then later reassessed stage of change. TPB variables of attitude, subjective norms, perceived behavior control, and intention predicted stage of change for physical activity promotion. (Contains references.) (SM)

Awareness and knowledge of national movement behaviour guidelines are needed to influence individual behaviour and public health policies. This study assessed the awareness and knowledge of the Canadian 24-Hour Movement Guidelines for Adults Aged 18–64 Years and Adults Aged 65 Years or Older (24HMG) recommendations among adults living in Canada across three timepoints. Online surveys were distributed to representative samples of adults living in Canada over a 6-month period. Findings suggest that short-term dissemination efforts were successful in increasing awareness of the 24HMG following guideline release. However, other strategies, such as education, may be needed to influence knowledge of guideline recommendations. [ABSTRACT FROM AUTHOR]

The cost of physical inactivity is alarming, and calls for whole-of-system approaches to population physical activity promotion (PPAP) are increasing. One innovative approach to PPAP is to use a framework of interdependent attributes and associated dimensions of effective systems for chronic disease prevention. Describing system boundaries can be an elusive task, and this article reports on using an attribute framework as a first step in describing and then assessing and strengthening a provincial system for PPAP in British Columbia, Canada. Interviews were conducted with provincial stakeholders to gather perspectives regarding attributes of the system. Following this, two workshops were facilitated to document important stories about the current system for PPAP and link story themes with attributes. Results from interviews and workshops were summarized into key findings and a set of descriptive statements. One hundred and twenty-one statements provide depth, breadth and scope to descriptions of the system through the lens of an adapted framework including four attributes: (i) implementation of desired actions, (ii) resources, (iii) leadership and (iv) collaborative capacity. The attribute framework was a useful tool to guide a whole-of-system approach and turn elusive boundaries into rich descriptors of a provincial system for PPAP. Immediate implications for our research are to translate descriptive statements into variables, then assess the system through group model building and identify leverage points from a causal loop diagram to strengthen the system. Future application of this approach in other contexts, settings and health promotion and disease prevention topics is recommended. [ABSTRACT FROM AUTHOR]