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

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: Calls to action addressing the interconnections between physical (in)activity and the climate crisis are increasing. The current study aimed to investigate public support for policy actions that potentially have co-benefits for physical activity promotion and climate change mitigation. Methods: In 2023, a survey through the Angus Reid Forum was completed by 2507 adults living in Canada. Binary logistic regressions were conducted. Separate models were created to reflect support or opposition to the 8 included policy items. Several covariates were included in the models including age, gender, political orientation, physical activity levels, income, urbanicity climate anxiety, and attitudes surrounding physical activity and climate change. The data were weighted to reflect the gender, age, and regional composition of the country. Results: Most individuals living in Canada strongly or moderately supported all actions (ranging from 71% to 85%). Meeting the physical activity guidelines, higher self-reported income, and scoring high on personal experience of climate change were associated with higher odds of supporting the policy actions related to climate actions. Conclusions: Most adults living in Canada support policies that align with the recommended policy actions related to physical activity and climate change. National campaigns enhancing awareness and understanding of the bidirectional relationship between physical activity and climate change are warranted, and these should consider the consistent demographic differences (eg, gender, age, and political orientation) seen in public support for physical activity-related policies. [ABSTRACT FROM AUTHOR]

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]

Social-ecological models suggest that a strategy for increasing population physical activity participation is to reconstruct the "social climate" through changing social norms and beliefs about physical activity (PA). In this study, we assessed whether the PA social climate in Canada has changed over a five-year period after controlling for sociodemographic factors and PA levels. Replicating a survey administered in 2018, a sample of adults in Canada (n = 2,507) completed an online survey assessing social climate dimensions, including but not limited to descriptive and injunctive norms. Descriptive statistics were calculated, and binary logistic regressions were conducted to assess the associations of sociodemographic factors and year of the survey with social climate dimensions. Results suggest some social climate constructs are trending in a positive direction between 2018 and 2023. Physical inactivity was considered a serious public health concern by 49% of respondents, second to unhealthy diets (52%). Compared to those who participated in the 2018 survey, participants in 2023 were less likely to see others walking or wheeling in their neighbourhood (OR = 1.58, 95% CI: 1.41, 1.78), but more likely to see people exercising (OR = 0.82, 95% CI: 0.73, 0.92) and kids playing in their neighbourhood (OR = 0.75, 95% CI: 0.66, 0.85). No changes were reported between 2018 and 2023 in individuals' perceptions of whether physical inactivity is due to individual versus external factors (OR = 0.99, 95% CI: 0.87, 1.13). The findings of this work indicate a modest positive shift in some measured components of the social climate surrounding PA although attributing causes for these changes remain speculative. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Background We compared direct and daily cumulative energy expenditure (EE) differences associated with reallocating sedentary time to physical activity in adults for meaningful EE changes. Methods Peer-reviewed studies in PubMed, Medline, EMBASE, CINAHL, PsycINFO, Cochrane Central Register of Controlled Trials and Cochrane Database of Systematic Reviews were searched from inception to March 2017. Randomized and non-randomized interventions with sedentary time and EE outcomes in adults were included. Study quality was assessed by the National Heart Lung and Blood Institute tool, and summarized using random-effects meta-analysis and meta-regression. Results In total, 26 studies were reviewed, and 24 studies examined by meta-analysis. Reallocating 6–9 h of sedentary time to light-intensity physical activity (LIPA) (standardized mean difference [SMD], 2.501 [CI: 1.204–5.363]) had lower cumulative EE than 6–9 h of combined LIPA and moderate-vigorous intensity physical activity (LIPA and moderate-vigorous physical activity [MVPA]) (SMD, 5.218 [CI: 3.822–6.613]). Reallocating 1 h of MVPA resulted in greater cumulative EE than 3–5 h of LIPA and MVPA, but <6–9 h of LIPA and MVPA. Conclusions Comparable EE can be achieved by different strategies, and promoting MVPA might be effective for those individuals where a combination of MVPA and LIPA is challenging. [ABSTRACT FROM AUTHOR]

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 & 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. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Background: It is important to engage stakeholders and end users in the development of guidelines for knowledge translation purposes. The aim of this study was to examine stakeholders' (experts in pediatric and family medicine, physical activity knowledge translation, and research) and end users' (parents and early childhood educators) perceptions of the Canadian 24-Hour Movement Guidelines for the Early Years (0-4 years).Methods: Stakeholders (n = 10) engaged in telephone interviews and end users (n = 92) participated in focus groups (n = 14) to discuss perceived clarity and need for the guidelines, potential barriers to implementation, identification of credible messengers, and methods for dissemination of the guidelines. A thematic analysis was conducted.Results: The proposed guidelines were very well received by both stakeholders and end users. A clear need for such guidelines was identified, and most believed the guidelines were achievable. Stakeholders and end users identified several potential barriers to uptake, including low awareness of current guidelines; 'daily challenges' such as allure of screen time, lack of time, and competing priorities; and challenges in the context of shifting social norms. A range of methods and messengers of dissemination were identified. Medical and child care settings were the most frequently cited places for dissemination, and physicians and early childhood educators were the most common suggestions for messengers.Conclusions: There was consistent support for the Canadian 24-Hour Movement Guidelines for the Early Years (0-4 years) from both stakeholders and end users. Moving forward, it is important to dedicate appropriate support and funding toward dissemination efforts in order to reach end users, particularly parents and early childhood educators. [ABSTRACT FROM AUTHOR]

Background: The Canadian Society for Exercise Physiology convened representatives of national organizations, research experts, methodologists, stakeholders, and end-users who followed rigorous and transparent guideline development procedures to create the Canadian 24-Hour Movement Guidelines for the Early Years (0-4 years): An Integration of Physical Activity, Sedentary Behaviour, and Sleep. These novel guidelines for children of the early years embrace the natural and intuitive integration of movement behaviours across the whole day (24-h period).Methods: The development process was guided by the Appraisal of Guidelines for Research and Evaluation (AGREE) II instrument. Four systematic reviews (physical activity, sedentary behaviour, sleep, combined behaviours) examining the relationships within and among movement behaviours and several health indicators were completed and interpreted by a Guideline Development Panel. The systematic reviews that were conducted to inform the development of the guidelines, and the framework that was applied to develop the recommendations, followed the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) methodology. Complementary compositional analyses were performed using data from the Canadian Health Measures Survey to examine the relationships between movement behaviours and indicators of adiposity. A review of the evidence on the cost effectiveness and resource use associated with the implementation of the proposed guidelines was also undertaken. A stakeholder survey (n = 546), 10 key informant interviews, and 14 focus groups (n = 92 participants) were completed to gather feedback on draft guidelines and their dissemination.Results: The guidelines provide evidence-informed recommendations as to the combinations of light-, moderate- and vigorous-intensity physical activity, sedentary behaviours, and sleep that infants (<1 year), toddlers (1-2 years) and preschoolers (3-4 years) should achieve for a healthy day (24 h). Proactive dissemination, promotion, implementation, and evaluation plans were prepared to optimize uptake and activation of the new guidelines.Conclusions: These guidelines represent a sensible evolution of public health guidelines whereby optimal health is framed within the balance of movement behaviours across the whole day, while respecting preferences of end-users. Future research should consider the integrated relationships among movement behaviours, and similar integrated guidelines for other age groups should be developed. [ABSTRACT FROM AUTHOR]

Copyright of Applied Physiology, Nutrition & Metabolism is the property of Canadian Science Publishing and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Engaging stakeholders in the development of guidelines and plans for implementation is vital. The purpose of this study was to examine stakeholders' (parents, teachers, exercise professionals, paediatricians, and youth) perceptions of the Canadian 24-Hour Movement Behaviour Guidelines for Children and Youth ("Movement Guidelines"). Stakeholders (n = 104) engaged in semi-structured focus groups or interviews to discuss the perceived acceptability of the guidelines, potential barriers to implementation, and preferred methods and messengers of dissemination. A thematic analysis was conducted. Overall, there was consistent support across all stakeholder groups, with the exception of youth participants, for the Movement Guidelines. Stakeholders identified a range of barriers to the uptake of the guidelines including concerns with accurately defining key terms such as "recreational" screen time; everyday challenges such as financial and time constraints; and the possibility of the Movement Guidelines becoming just another source of stress and guilt for already busy and overwhelmed parents. Participants identified a range of recommended methods and messengers for future dissemination. School and medical settings were the most commonly recommended settings through which dissemination efforts should be delivered. Overall, participants representing a range of stakeholder groups were receptive to the new Movement Guidelines and endorsed their value. In complementing the Movement Guidelines, messaging and resources will need to be developed that address common concerns participants had regarding their dissemination and implementation. [ABSTRACT FROM AUTHOR]

Copyright of Applied Physiology, Nutrition & Metabolism is the property of Canadian Science Publishing and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Although social marketing promotion efforts are typically evaluated online using either finished video or static images, limited evidence exists whether media type influences audience response. In a posttest-only experimental study with a nationally representative sample of 663 Canadian mothers of 5- to 11-year-old children, participants were randomly assigned to one of two media conditions consisting of Think Again physical-activity Public Service Announcements created by ParticipACTION. Mothers reported campaign recall, ad liking, motivation to respond to the ad (i.e., assist one’s child to get at least 60 min of physical activity every day), and their support behaviors. Data were analyzed using χ2 and independent samples t-tests. Those exposed to the video version of the ad in comparison to the static image reported higher message recall and liking, and motivation to respond. There were no differences in parental support behaviors. Social marketing promotion efforts should be evaluated using the same format as the media message originally used. The study concludes that media type influences findings when evaluating social marketing promotion campaigns. [ABSTRACT FROM AUTHOR]

Copyright of Applied Physiology, Nutrition & Metabolism is the property of Canadian Science Publishing and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: It is important to understand health-risk behaviours among young adults, as modifications in this can enhance and lessen the risk of chronic illness later in life. The purpose of the current study was to determine the prevalence of a broad range of health-risk behaviours among post-secondary students from across Canada, and to determine whether institutional variability exists in the prevalence of these behaviours. Methods: Data were collected from 8,182 undergraduate students enrolled in one of eight Canadian postsecondary institutions during the fall or spring of 2009, using the National College Health Assessment (NCHA). The NCHA consists of 60 questions, assessing student health status and engagement in various health behaviours. Results: Findings show relatively low prevalence in smoking (13.1%) marijuana (17.5%) or other illicit drug use (3.5%), and risky sexual behaviour (12%). Binge drinking, however, was much higher, with nearly 60% of students consuming more than 5 alcoholic drinks in a single occasion during the past 15 days. Similarly, prevalence rates for physical inactivity (72.2%), inadequate sleep (75.6%) and low fruit and vegetable intake (88.0%) were all high among the student population. Results also found that students in smaller institutions exhibited higher rates of inactivity, binge drinking, and marijuana and illicit drug use compared to institutions having a larger student body. Conclusion: Overall, findings point to the need for more concentrated health promotion campaigns, specifically targeting sleep, fruit and vegetables intake, and greater participation in physical activity. Given evidence of some institutional variability, future efforts are warranted in exploring how best to increase institutional commitment for collecting surveillance data on Canadian post-secondary students. [ABSTRACT FROM AUTHOR]

Abstract: Purpose: The aim of this study was to compare patterns of PA and its potential correlates in individuals with BD to the general population using a representative sample of Canadians. Methods: We used data from the 2002 Canadian Community Health Survey 1.2, a national, cross-sectional survey focusing on mental health and addiction (n = 36,984). We compared PA levels among individuals with BD (n = 831) to those diagnosed with major depression (n = 4713) and those with no identified mood disorder (n = 31,834). Using multivariable logistic regression, we then compared independent effects of sociodemographic and clinical factors in active and inactive BD individuals stratified by relative weight status. Results: There were no differences in the proportion of individuals characterized as active, moderately active or inactive among individuals with BD, major depressive disorder or the general population. No sociodemographic or clinical variables were related to PA in individuals with BD, and the relationships between these variables and PA level were not different than those observed in the general population. BD status was independently associated with being overweight (OR = 1.26, p = 0.03). An interaction between BD status and PA was also observed (OR = 1.12, p = 0.005), suggesting a reduced role for PA in reducing the risk of being overweight in person with BD. Conclusions: The results suggest that levels of self-reported PA are not lower among people with BD living in the community than in the general population. Future research should assess levels of PA using objective measures and determine whether PA improves psychosocial outcomes in this population. [Copyright &y& Elsevier]

The Ontario (Canada) government has instituted a policy requiring elementary schools to offer at least 20 mm of daily physical activity for students in Grades 1-8 and replace non-nutritious vending machine foods with healthier choices. These policy interventions represent 'natural experiments' offering unique opportunities for conducting research and evaluation. The use of natural experiments to contribute evidence on the effectiveness of policy interventions is identified as an underused tool for public health [Tudor-Locke, C., Ainsworth, B. E. and Popkin, B. M. (2001) Active commuting to school: an overlooked source of children's physical activity? Sports Medicine, 31, 309-313; Petticrew, M., Cummins, S., Ferrell, C., Findlay, A., Higgins, C., Hoy, C. et al. (2005) Natural experiments: an underused tool for public health? Public Health, 119, 751-757]. To date, some Canadian school- based food and nutrition policies are being monitored, but their impact on child and youth obesity is unknown [Canadian Institute for Health Information. (2006) Improving the Health of Canadians: Promoting Healthy Weights, Ottawa, ON]. There are a number of challenges to the evaluation of policy interventions as natural experiments. Often, there are little or no baseline data available to use as the basis for assessing change. Government policies that result in the adoption of particular approaches across large jurisdictions, such as provinces, may result in wide variation in the design and implementation of interventions. Thus, in some cases, natural experiments may be at risk of having low potential to be adequately evaluated on key outcomes. In this paper, we discuss the context of these challenges in relation to the Ontario government school physical activity and nutrition policies. [ABSTRACT FROM AUTHOR]

Examines the impact of physical activity on the mental and physical health of individuals with serious mental illness. Relationship of physical activity and mental health; Effect of lifestyle modification, including diet and exercise on chronic disease; Important benefit of physical activity for people with serious mental illness in the population; Improvement of regular physical activity on mental health among people with serious mental illness.

Introduction: While the benefits of complying with health recommendations is well documented, a considerable proportion of Canadians engage in multiple modifiable risk behaviors. The purpose of this multi-wave longitudinal study was to identify the individual period prevalence and co-occurrence of multiple modifiable risk behaviors, particularly excessive alcohol consumption, physical inactivity, and tobacco use, within a nationally representative sample of Canadians.Methods: Secondary data analysis was conducted on the first seven cycles of the National Population Health Survey. This longitudinal sample included 15,167 Canadians aged 12years of age or older. Gender-specific criteria were employed to define excessive alcohol consumption. Individuals expending <3.0kcal/kg/day during their leisure-time and smoking cigarettes (daily or occasionally) met the criteria for physical inactivity and tobacco use, respectively.Results: The period prevalence of the Canadian general population that participated in multiple risk behaviors was 21.5% in cycle 7. The most common pairwise combination of co-occurring risk behaviors was physical inactivity and smoking. The proportion of Canadians reporting the co-occurrence of all three risk behaviors in cycle 7 was 2.6%.Conclusions: Understanding patterns of modifiable risk behaviors is an initial step in developing and implementing public health interventions. The co-occurrence of these three risk behaviors is a viable concern for one in five Canadians. For these individuals, the likelihood of encountering premature morbidity and mortality is escalated. As the majority of Canadians reported being physically inactive, allocating limited resources towards enhancing leisure-time physical activity levels could have significant population-level implications for improving the health of Canadians. [ABSTRACT FROM AUTHOR]

Background Evaluating the interrelationship of health behaviors could assist in the development of effective public health interventions. Furthermore, the ability to identify cognitive mediators that may influence multiple behavioral changes requires evaluation. Purpose To evaluate covariation among health behaviors, specifically alcohol consumption, leisure-time physical activity, and smoking, and examine whether mastery acts as a mediating social-cognitive mechanism that facilitates multiple health behavior change in a longitudinal analysis. Methods In 2010, secondary data analysis was conducted on the first seven cycles of the Canadian National Population Health Survey. Data collection began in 1994-1995 and has continued biennially. At the time of this analysis, only seven cycles of data (2006-2007) were available. Parallel process growth curve models were used to analyze covariation between health behaviors and the potential mediating effects of perceived mastery. Results Increases in leisure-time physical activity were associated with reductions in tobacco use, whereas declines in alcohol consumption were associated with decreases in tobacco use. Covariation between alcohol consumption and leisure-time physical activity did not reach statistical significance. For the most part, mastery was unsuccessful in mediating the interrelationship of multiple behavioral changes. Conclusions Health behaviors are not independent but rather interrelated. In order to optimize limited prevention resources, these results suggest that population-level intervention efforts targeting multiple modifiable behavioral risk factors may not need to occur simultaneously. [ABSTRACT FROM AUTHOR]

This paper examines the influence of an initial face-to face meeting in an e-mail delivered physical activity intervention. RMANCOVA was conducted to examine differences between e-mail and face-to-face arms in mean weekly steps adjusted for baseline steps, sex, and body mass index (BMI). Overall, 68 participants were analyzed (face-to-face: (n=35); e-mail: (n=33). Participants in the face-to-face arm walked a greater number of steps each week; however, differences between arms pre- and post-intervention were not statistically significant (F (1, 60) = 0.31, p = .5796). These findings suggest that a physical activity intervention where initial instructions are delivered via e-mail is not statistically significantly different from a face-to-face approach. [ABSTRACT FROM AUTHOR]

Context: Less than 5% of U.S. adults accumulate the required dose of exercise to maintain health. Behavioral economics has stimulated renewed interest in economic-based, population-level health interventions to address this issue. Despite widespread implementation of financial incentive-based public health and workplace wellness policies, the effects of financial incentives on exercise initiation and maintenance in adults remain unclear. Evidence acquisition: A systematic search of 15 electronic databases for RCTs reporting the impact of financial incentives on exercise-related behaviors and outcomes was conducted in June 2012. A meta-analysis of exercise session attendance among included studies was conducted in April 2013. A qualitative analysis was conducted in February 2013 and structured along eight features of financial incentive design. Evidence synthesis: Eleven studies were included (N=1453; ages 18–85 years and 50% female). Pooled results favored the incentive condition (z=3.81, p<0.0001). Incentives also exhibited significant, positive effects on exercise in eight of the 11 included studies. One study determined that incentives can sustain exercise for longer periods (>1 year), and two studies found exercise adherence persisted after the incentive was withdrawn. Promising incentive design feature attributes were noted. Assured, or “sure thing,” incentives and objective behavioral assessment in particular appear to moderate incentive effectiveness. Previously sedentary adults responded favorably to incentives 100% of the time (n=4). Conclusions: The effect estimate from the meta-analysis suggests that financial incentives increase exercise session attendance for interventions up to 6 months in duration. Similarly, a simple count of positive (n=8) and null (n=3) effect studies suggests that financial incentives can increase exercise adherence in adults in the short term (<6 months). [Copyright &y& Elsevier]