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Background: Healthy Alberta Communities (HAC) was a 3-year community-based intervention to reduce lifestyle-related risk factors for chronic disease and obesity at a population-level. The current paper examines changes in blood pressure (BP) and anthropometric indicators within HAC communities compared to secular trends.Methods: Between 2006 and 2009, this community-academic partnership sought to create environments supportive of healthier dietary and physical activity behaviours within four diverse communities in Alberta, Canada. Height, weight, waist and hip circumference and BP were measured among 1554 and 1808 community residents at baseline (2006) and follow-up (2009), respectively. A comparison sample was drawn from a representative national survey. Samples were stratified by age and change between pre- and post-intervention was assessed using t-tests. Changes in parameters over time between groups were compared using meta-analysis. The net difference in change in outcomes (change in intervention communities minus change in comparison group) represented the effect of the intervention.Results: Adjusted systolic (SBP) and diastolic (DBP) BP declined within most age groups in HAC communities from pre- to post-intervention. The net decline in SBP was 1 mmHg in 20-39 year olds (p = 0.006) and 2 mmHg in 40-59 year olds (p = 0.001), while the net decline in DBP was 3 mmHg in 20-39 year olds (p < 0.001), 2 mmHg in 40-59 year olds (p < 0.001) and 3 mmHg in 60-79 year olds (p < 0.001). The net increase in the proportion of individuals with normal BP was 5.9 % (p < 0.001), while the net decline in the proportion of individuals with stage 1 hypertension was 4.5 % (p < 0.001). BMI and body weight were unchanged. There was a significant net increase in waist and hip circumference among 20-39 year olds within intervention communities.Conclusions: Findings suggest HAC succeeded in shifting the population distribution of BP in a leftward direction. By contrast, anthropometric parameters remained unchanged or worsened within intervention communities. Therefore, while improvements in some clinical risk factors can be achieved through relatively diffuse and shorter-term community-level environmental changes, improvements in others may require interventions of greater intensity and duration. Evaluating the success of community-based interventions based on their efficacy in changing individual-level clinical indicators may, however, underestimate their potential. [ABSTRACT FROM AUTHOR]

Young adult cancer survivors (YACS) face unique challenges from their disease and treatments that may influence their sport participation choices as well as their psychosocial response. Objectives: To examine the prevalence, correlates, and psychosocial outcomes of sport participation in YACS. Design: A provincial, population-based mailed survey of 588 YACS in Alberta, Canada, was completed in May 2008 and included measures of sport participation, psychosocial health (depression, self-esteem, and stress), quality of life (QoL), and medical and demographic variables. Results: One third (32.5%) of YACS reported participating in a sport in the past month with the most common being golf (40.8%) and ice hockey (8.3%). YACS participating in sport reported an average frequency of 1.7 (SD = 1.0) days/week and an average duration of 119 min/session (SD = 68) for a total of 189 (SD = 164) min/week. Independent t-tests showed that YACS who participated in sport reported better psychosocial health and QoL including physical QoL (p < 0.001), mental QoL (p < 0.001), self-esteem (p < 0.001), depression (p < 0.001), and stress (p < 0.001). In multivariate regression analysis, 8.5% (p < 0.001) of the variance in sport participation was explained by being male (β = 0.17, p < 0.001), Caucasian (β = 0.15, p = 0.001), in better general health (β = 0.15, p < 0.001), and having a normal body mass index (β = −0.10, p = 0.024). Discussion/conclusions: Sport participation is associated with better psychosocial health and QoL in YACS but only a third participated in the past month. Randomized controlled trials examining sport as an intervention strategy to increase physical activity and improve health outcomes in YACS are warranted. [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.)

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.)

Objectives: To examine the determinants of physical activity (PA) in young adult cancer survivors (YACS). Methods: A survey of 588 YACS in Alberta, Canada, assessed PA, medical and demographical factors, and theory of planned behavior variables. Results: Path analysis explained 38% (P<.001) of the variance in PA with significant contributions from intention, planning, affective attitude, education, and general health. In turn, 56% (P<.001) of the variance in intention was explained by perceived behavioral control, instrumental attitude, and affective attitude. Conclusion: PA interventions in YACS should focus on developing strong intentions by targeting perceived behavioral control, instrumental attitude, and affective attitude. [ABSTRACT FROM AUTHOR]

Background: Over half of kidney cancer survivors (KCS) are completely inactive and only a quarter are meeting physical activity (PA) guidelines. This highlights the need to identify and understand the determinants of PA in this understudied population. The purpose of this study is to determine the social cognitive correlates of PA intention and behavior in KCS using the Theory of Planned Behavior (TPB). Methods: All 1,985 KCS diagnosed between 1996 and 2010 in Alberta, Canada were mailed a self-report survey that consisted of the Godin Leisure Time Exercise Questionnaire and standard TPB items for intention, planning, perceived behavioral control (PBC), affective and instrumental attitudes, and descriptive and injunctive norms. Standard demographic and medical variables were also collected. Results: Completed surveys were received from 703 of 1,654 (43%) eligible KCS. The TPB was tested using structural equation modelling and demonstrated an adequate-to-good fit to the data [χ2² = 256.88, p < .001; TLI = 0.97; CFI = 0.98; RMSEA = 0.06, 90% CI = 0.05-0.06]. There were significant pathways to PA from PBC (β = 0.18, p = 0.02), planning (ß = 0.22, p < 0.01), and intention (β = 0.31, p < 0.01); and to planning from intention (β = 0.81, p < 0.01). In addition, there were significant model pathways to intention from instrumental attitude (β = 0.28, p = 0.03), descriptive norm (β = 0.09, p = 0.01), and PBC (β = 0.52, p < 0.01). Overall, the TPB accounted for 69%, 63%, and 42% of the variance in intention, planning and PA, respectively. Conclusion: The TPB appears to be a useful model for explaining PA in KCS. All TPB constructs except injunctive norm and affective attitude were useful for explaining intention with PBC emerging as the largest correlate. Developing PA interventions based on the TPB may be effective in promoting PA in KCS and may lead to important improvements in health. [ABSTRACT FROM AUTHOR]

Most of the population have positive intentions to engage in physical activity (PA) but fail to act; thus, the need to understand successful translation of intention into behavior is warranted in order to focus intervention efforts. The objective of the study is to examine constructs of the transtheoretical model, theory of planned behavior, and protection motivation theory as predictors of physical activity intention–behavior profiles across 6 months in a Canadian workplace sample. Employees from three large organizations in the province of Alberta ( n = 887) completed a baseline survey relating to their demographic and medical background, PA, and social–cognitive constructs. A total of 611 participants completed a second assessment 6 months later. Participants were grouped by five profiles: nonintenders, unsuccessful adopters, successful adopters, unsuccessful maintainers, and successful maintainers. Perceived importance and concern for PA (cognitive processes, instrumental attitude, perceived severity) distinguished nonintenders from the other four profiles, self-management and self-regulation of the behavior (behavioral processes, self-efficacy) distinguished successful adopters from unsuccessful adopters, while control over constraints (cons, perceived control, self-efficacy) were the key discriminators of successful maintainers from unsuccessful maintainers. The results provide useful information for intervention campaigns and demonstrate a need to consider adoption and maintenance profiles. [ABSTRACT FROM AUTHOR]

Background: There is an emerging knowledge base on the effectiveness of strategies to close the knowledge-practice gap. However, less is known about how attributes of an innovation and other contextual and situational factors facilitate and impede an innovation's adoption. The Healthy Heart Kit (HHK) is a risk management and patient education resource for the prevention of cardiovascular disease (CVD) and promotion of cardiovascular health. Although previous studies have demonstrated the HHK's content validity and practical utility, no published study has examined physicians' uptake of the HHK and factors that shape its adoption. Objectives: Conceptually informed by Rogers' Diffusion of Innovation theory, and Theory of Planned Behaviour, this study had two objectives: (1) to determine if specific attributes of the HHK as well as contextual and situational factors are associated with physicians' intention and actual usage of the HHK kit; and (2), to determine if any contextual and situational factors are associated with individual or environmental barriers that prevent the uptake of the HHK among those physicians who do not plan to use the kit. Methods: A sample of 153 physicians who responded to an invitation letter sent to all family physicians in the province of Alberta, Canada were recruited for the study. Participating physicians were sent a HHK, and two months later a study questionnaire assessed primary factors on the physicians' clinical practice, attributes of the HHK (relative advantage, compatibility, complexity, trialability, observability), confidence and control using the HHK, barriers to use, and individual attributes. All measures were used in path analysis, employing a causal model based on Rogers' Diffusion of Innovations Theory and Theory of Planned Behaviour. Results: 115 physicians (follow up rate of 75%) completed the questionnaire. Use of the HHK was associated with intention to use the HHK, relative advantage, and years of experience. Relative advantage and the observability of the HHK benefits were also significantly associated with physicians' intention to use the HHK. Physicians working in solo medical practices reported experiencing more individual and environmental barriers to using the HHK. Conclusion: The results of this study suggest that future information innovations must demonstrate an advantage over current resources and the research evidence supporting the innovation must be clearly visible. Findings also suggest that the innovation adoption process has a social element, and collegial interactions and discussions may facilitate that process. These results could be valuable for knowledge translation researchers and health promotion developers in future innovation adoption planning. [ABSTRACT FROM AUTHOR]

Climate change has received recent extensive media attention (e.g., Kyoto Protocol) and is currently on the international public health agenda. The purpose of this study was to survey knowledge, attitudes and behaviours related to climate change in the province of Alberta, Canada. A random sample of 600 Alberta households, using proportional quotas based on the Canada Census of the Alberta population, was surveyed on knowledge, attitudes and behaviours related to climate change using a computer-assisted telephone interviewing protocol. Albertans are highly concerned, particularly about health problems related to the environment and air pollution; yet are only moderately informed about a variety of environmental issues. While the great majority of Albertans appear to be engaged in environmental behaviours at home, fewer consider energy efficiency when purchasing consumer goods. An even smaller percentage makes environmentally conscious transportation decisions. To encourage the population to make recommended environmental behaviours, mass media approaches may do well to target the specific beliefs that were deemed salient (e.g., promote the association between environment issues and health). The public health sector has a major role in working with inter-sectoral groups to address this significant public health issue. [ABSTRACT FROM AUTHOR]

Purpose. To identify whether non-overweight students were different from their overweight or obese peers with respect to diet, suboptimal meal behaviours, and physical activity using a self-administered web-based survey. Methods. 4097 adolescents living in Alberta, Canada completed Web-SPAN (Web Survey of Physical Activity and Nutrition). Students were classified as overweight or obese, and differences were described in terms of nutrient intakes, physical activity, and meal behaviours. Results. Non-overweight students consumed significantly more carbohydrate and fibre, and significantly less fat and high calorie beverages, and had a higher frequency of consuming breakfast and snacks compared to overweight or obese students. Both non-overweight and overweight students were significantly more active than obese students. Conclusions. This research supports the need to target suboptimal behaviours such as high calorie beverage consumption, fat intake, breakfast skipping, and physical inactivity. School nutrition policies and mandatory physical education for all students may help to improve weight status in adolescents. [ABSTRACT FROM AUTHOR]

Background: Little is known about the intrapersonal and social factors associated with sufficient physical activity (PA) for cancer prevention, which is greater than for cardiovascular health., Methods: 1087 and 1684 randomly selected men and women, age 35-64, completed self-administered questionnaires on PA behavior and psycho-social characteristics. Using gender-stratified logistic regression, we investigated correlates of compliance with Canadian Society for Exercise Physiology PA guidelines for general health (150 min/wk), and the American Cancer Society (ACS; 225 min/wk) and World Cancer Research Fund/American Institute for Cancer Research (WCRF/AIRC; 420 min/wk) guidelines for cancer prevention., Results: Only 39% and 19% of men and women met ACS and WCRF/AICR guidelines, respectively. Self-efficacy, scheduling PA and friend social support were positively correlated with recommended PA for cancer prevention. In men, poor self-rated health and perceived negative outcomes were negatively correlated and hypertension was positively correlated with meeting cancer prevention guidelines. For women, not being married and having a companion for PA were positively correlated with meeting cancer prevention guidelines., Conclusions: Few adults participate in sufficient PA for cancer risk reduction. Multidimensional public health strategies that incorporate intrapersonal and social factors and are tailored for each gender are needed to promote PA for cancer prevention.

Objective: Unhealthy dietary and physical inactivity patterns inspired many initiatives promoting healthy youth and healthy schools in Alberta between 2005 and 2008. The purpose of this study was to examine differences in the prevalence of lifestyle risk factors for type 2 diabetes (T2D) between two province-wide samples of Alberta adolescents (2005 and 2008)., Methods: The dietary and physical activity (PA) patterns of Alberta youth were assessed in two cross-sectional studies of grade 7-10 students, one in 2005 (n=4936) and one in 2008 (n=5091), using a validated web-survey. For each diabetes risk factor, participants were classified as either at risk or not at risk, depending on their survey results relative to cut-off values. Chi-square tests and logistic regression models were used to determine differences in risk factor prevalence between 2005 and 2008., Results: Compared to 2005, mean BMI, energy intake, fat intake, glycemic index (GI) and glycemic load (GL) were lower in 2008 (p<0.05); and carbohydrate, protein, fibre and vegetable and fruit intakes were higher in 2008 (p<0.05). In 2008, a lower proportion of students were: overweight, obese, consuming high GI, high GL, high fat, low fibre, low veg/fruit intake (p<0.05). No differences existed in magnesium or PA levels between the two time points., Conclusions: Improvements were observed between 2005 and 2008 in terms of the proportion of adolescents having specific risk factors for T2D. The cause of these changes could not be determined. Continued monitoring of adolescent lifestyle habits and monitoring of exposure to health promotion programming is recommended.

Purpose: To examine the utility of the theory of planned behavior (TPB) for explaining physical activity (PA) intention and behavior among a large population sample of overweight and obese adolescents (Alberta, Canada), using a web-based survey. Secondary objectives were to examine the mediating effects of the TPB constructs and moderating effects of weight status., Methods: A subsample of 427 overweight and 133 obese participants (n = 560), completed a self-administered web-based questionnaire on health and PA behaviors, including assessment of attitude, subjective norm, perceived behavioral control (PBC), and intention to participate in regular PA. Structural equation models were examined using AMOS 17.0., Results: Overall, 62% of the variance in intention was accounted for by attitude, subjective norm, and PBC; whereas 44% of the variance in PA behavior was explained by PBC and intention. When examining the TPB separately in overweight and obese subsamples, 66% and 56% of the variance for PA intention was explained for overweight and obese subsamples, respectively; and 38% and 56% of the variance in PA behavior were accounted for in the overweight and obese subsamples. Overall, attitude was the strongest predictor of PA intention, whereas PBC was the strongest predictor for PA behavior. Intention was not predictive of PA behavior., Conclusions: These results provide partial support for the utility of TPB in explaining PA behavior in a sample of overweight and obese adolescents. In particular, strong associations regarding attitude and PBC were evident across each subsample. These findings have implications for tailoring PA programs in this population.

Objective: To determine the association between physical activity (PA) intensities and cardiometabolic risk factors in youth., Design: Cross-sectional study using data from the 2008 Healthy Hearts Prospective Cohort Study of Physical Activity and Cardiometabolic Health in Youth., Setting: Rural and urban communities in Alberta, Canada., Participants: A convenience sample of 605 youth aged 9 to 17 years. Youth were on average aged 12.1 years, 248 were boys (41%), and 157 were overweight or obese (26%)., Main Exposure: Actical accelerometer-measured PA intensity., Main Outcomes Measures: The primary outcome was body mass index (calculated as weight in kilograms divided by height in meters squared) z score. Secondary outcome measures included waist circumference, systolic blood pressure, and cardiorespiratory fitness (maximal oxygen consumption [[Vdot]O2max])., Results: Body mass index z score, waist circumference, and systolic blood pressure decreased and [Vdot]O2max increased in a dose-response manner across tertiles of vigorous PA (adjusted P < .001). No significant differences in cardiometabolic risk factors were seen across tertiles of moderate or light PA in multivariable analyses. Achieving more than 7 minutes of vigorous PA daily was associated with a reduced adjusted odds ratio of overweight status (0.56; 95% CI, 0.33-0.95) and elevated systolic blood pressure (0.36; 95% CI, 0.16-0.79). The odds of overweight status and elevated blood pressure decreased with increasing time and intensity of PA., Conclusions: Only vigorous PA was consistently associated with lower levels of waist circumference, body mass index z score, systolic blood pressure, and increased cardiorespiratory fitness in youth. These findings underscore the importance of vigorous PA in guidelines for children and adolescents.

Purpose: Physical activity (PA) improves quality of life in kidney cancer survivors (KCS), but PA participation rates are low. Behavior change interventions to increase PA in KCS should take into account PA preferences. The purpose of this study was to identify the PA preferences of KCS and determine any associations with selected demographic and medical variables., Methods: All 1,985 KCS diagnosed between 1996 and 2010 identified through a Canadian provincial registry in Alberta, Canada were mailed a survey that consisted of the Godin Leisure-Time Exercise Questionnaire and various PA preference variables. Standard demographic and medical variables were also collected., Results: Completed surveys were received from 703 of 1,654 (43%) eligible KCS. Over 80% of KCS felt they were able or may be able to participate in a PA program designed for KCS and over 70% were interested or may be interested in doing so. The most common PA preferences were to receive PA information from a fitness expert at a cancer center (55.7%), receive information via print material (50.0%), start a PA program after treatment (36.5%), exercise with a spouse (39.6%), exercise at home (52.0%), do moderate-intensity PA (58.4%), and walk in both the summer (69.4%) and winter (48.2%). Chi-square analyses uncovered that age, sex, and current PA were the personal variables most consistently associated with PA preferences., Conclusion: The majority of KCS expressed an interest in doing a PA program and important preferences were identified. These preferences may be used to inform PA interventions to enhance motivation and adherence in KCS.

Objectives: Detailed assessments of the built environment often resist data reduction and summarization. This project sought to develop a method of reducing built environment data to an extent that they can be effectively communicated to researchers and community stakeholders. We aim to help in an understanding of how these data can be used to create neighbourhood groupings based on built environment characteristics and how the process of discussing these neighbourhoods with community stakeholders can result in the development of community-informed health promotion interventions., Methods: We used the Irvine Minnesota Inventory (IMI) to assess 296 segments of a semi-rural community in Alberta. Expert raters "created" neighbourhoods by examining the data. Then, a consensus grouping was developed using cluster analysis, and the number of IMI variables to characterize the neighbourhoods was reduced by multiple discriminant function analysis., Results: The 296 segments were reduced to a consensus set of 10 neighbourhoods, which could be separated from each other by 9 functions constructed from 24 IMI variables. Biplots of these functions were an effective means of summarizing and presenting the results of the community assessment, and stimulated community action., Conclusions: It is possible to use principled quantitative methods to reduce large amounts of information about the built environment into meaningful summaries. These summaries, or built environment neighbourhoods, were useful in catalyzing action with community stakeholders and led to the development of health-promoting built environment interventions.

Background: Few research studies have focused on physical activity in young-adult cancer survivors despite the potential long-term health consequences of inactivity in this population., Objective: Understanding the unique physical activity programming and counseling preferences of young-adult cancer survivors may inform future research as well as nursing practice., Methods: Participants were 588 young-adult cancer survivors (20-44 years old) who completed a mailed survey in the province of Alberta, Canada, that assessed physical activity preferences and standard demographic and medical variables., Results: Most young-adult cancer survivors indicated that they were interested (78%) and able (88%) to participate in an activity program. Young-adult cancer survivors also preferred receiving activity counseling from a fitness expert at the cancer center (49.6%), information by brochure (64%), starting activity after treatment (64%), walking (51%), doing activity with others (49%), and doing activity at a community fitness center (46%). The χ analyses indicated that younger cancer survivors (20-29 vs 30-39 vs 40-44 years) were less likely to prefer walking (P < .001), more interested in receiving information (P = .002), and more likely to prefer receiving information by e-mail (P = .044) or Internet (P = .006)., Conclusions: Young-adult cancer survivors show interest in receiving physical activity counseling. There were some consistent programming preferences, although other preferences varied by demographic and medical factors., Implications for Practice: Nurses may play a key role in promoting physical activity in young-adult cancer survivors. Understanding the physical activity preferences of young-adult cancer survivors may help nurses make practical recommendations and referrals.

The authors conducted a secondary analysis on 202 adults from the Physical Activity Workplace Study. The aim of this analysis was to examine demographic characteristics associated with reading Canada's Physical Activity Guide (CPAG), being motivated by the guide, and whether participants in the Physical Activity Workplace Study who read the CPAG increased their physical activity levels over 1 year. Results revealed that less than 50% of participants read the full version of CPAG, and less than 10% were motivated by it. The CPAG also appears to be more appealing to and effective for women than for men. Although the CPAG had some influence in increasing mild physical activity levels in a workplace sample, there was also a decrease in physical activity levels among some members of the group. Overall, the effectiveness of CPAG was not substantial, and the findings of this analysis could help guide future targeted intervention materials and programs.

Background: Limited evidence exists on the determinants of quality of life (QoL) specific to adults with type 1 diabetes (T1D). Further, it appears no study has compared the determinants of QoL between T1D and type 2 diabetes (T2D) groups. The objectives of this study were to examine: (1) determinants of QoL in adults with T1D; and, (2) differences in QoL determinants between T1D and T2D groups., Methods: The Alberta Longitudinal Exercise and Diabetes Research Advancement (ALEXANDRA) study, a longitudinal study of adults with diabetes in Alberta, Canada. Adults (18 years and older) with T1D (N = 490) and T2D (N = 1,147) provided information on demographics (gender, marital status, education, and annual income), personality (activity trait), medical factors (diabetes duration, insulin use, number of comorbidities, and body mass index), lifestyle behaviors (smoking habits, physical activity, and diet), health-related quality of life (HRQL) and life satisfaction. Multiple regression models identified determinants of HRQL and life satisfaction in adults with T1D. These determinants were compared with determinants for T2D adults reported in a previous study from this population data set. Factors significantly associated with HRQL and life satisfaction in either T1D or T2D groups were further tested for interaction with diabetes type., Results: In adults with T1D, higher activity trait (personality) score (β = 0.28, p < 0.01), fewer comorbidities (β = -0.27, p < 0.01), lower body mass index (BMI)(β = -0.12, p < 0.01), being a non-smoker (β = -0.14, p < 0.01), and higher physical activity levels (β = 0.16, p < 0.01) were associated with higher HRQL. Having a partner (β = 0.11, p < 0.05), high annual income (β = 0.16, p < 0.01), and high activity trait (personality) score (β = 0.27, p < 0.01) were significantly associated with higher life satisfaction. There was a significant age × diabetes type interaction for HRQL. The T2D group had a stronger positive relationship between advancing age and HRQL compared to the T1D group. No interaction was significant for life satisfaction., Conclusions: Health services should target medical and lifestyle factors and provide support for T1D adults to increase their QoL. Additional social support for socioeconomically disadvantaged individuals living with this disease may be warranted. Health practitioners should also be aware that age has different effects on QoL between T1D and T2D adults.

This study explored facilitators and barriers to capacity building for chronic disease prevention (CDP) activities with participants in community-based workshops on environments related to CDP. Three phases of research were conducted. Worksheet analysis (Phase A) indicated that participants (n = 34) identified priority strategies related to the physical environment as a primary focus for CDP, followed by sociocultural, economic, and political environments. Questionnaire completion (Phase B; n = 17) indicated that individuals' capacity was inhibited by a lack of organizational infrastructure (particularly, resources and public and research support). Interviews (Phase C; n = 11) revealed five factors that limited participants' capacity: (a) organizations' lack of competing priorities, (b) priorities secondary to the organizational mandate, (c) disconnect between organizational and government or funder priorities, (d) limited resources, and (e) larger community issues. Implications for research and practice are discussed.

Purpose: To test the Theory of Planned Behavior (TPB) in a large population sample of adolescents from Alberta, Canada., Methods: 4,073 adolescents completed a self-administered web-based survey related to physical activity (PA)., Results: TPB explained 59% and 43% of the variance for intention and behavior, respectively. Moderating (by gender) and mediating tests were supported., Conclusions: TPB is useful for understanding PA in this population., (Copyright © 2011 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.)

Objective: The increasing prevalence of obesity among youth has elicited calls for schools to become more active in promoting healthy weight. The present study examined associations between various aspects of school food environments (specifically the availability of snack- and beverage-vending machines and the presence of snack and beverage logos) and students' weight status, as well as potential influences of indices of diet and food behaviours., Design: A cross-sectional, self-administered web-based survey. A series of multinomial logistic regressions with generalized estimating equations (GEE) were constructed to examine associations between school environment variables (i.e. the reported presence of beverage- and snack-vending machines and logos) and self-reported weight- and diet-related behaviours., Setting: Secondary schools in Alberta, Canada., Subjects: A total of 4936 students from grades 7 to 10., Results: The presence of beverage-vending machines in schools was associated with the weight status of students. The presence of snack-vending machines and logos was associated with students' frequency of consuming vended goods. The presence of snack-vending machines and logos was associated with the frequency of salty snack consumption., Conclusions: The reported presence of snack- and beverage-vending machines and logos in schools is related to some indices of weight status, diet and meal behaviours but not to others. The present study supported the general hypothesis that the presence of vending machines in schools may affect students' weight through increased consumption of vended goods, but notes that the frequency of 'junk' food consumption does not seem to be related to the presence of vending machines, perhaps reflecting the ubiquity of these foods in the daily lives of students.

Purpose: Determine the proportion of adults aware of Canada's Physical Activity Guide to Healthy Active Living (Guide) and its specific recommendations (objective 1); whether key demographic factors (objective 2a) and physical activity behavior (objective 2b) are associated with awareness and specific familiarity with the Guide; and if changes in awareness and specific recommendations with the Guide occurred over a 1-year period (objective 3a and 3b)., Design: Random selection with computer-assisted telephone interviewing., Setting: Edmonton, Alberta, Canada., Subjects: A total of 2803 adults 18 years or older completed interviews from 4831 telephone contacts (response rate, 58.0%), and after 1 year, 1423 individuals (55%) completed interviews., Measures: Demographic, physical activity, Guide awareness., Analysis: Chi-square, analysis of variance., Results: At baseline, 27.3% were aware of the Guide, and 15.6% were familiar with the Guide's specific recommendations. Younger individuals (p=.01), women (p<.001), and those with a higher education (p<.001) were more likely to be generally aware of the Guide, and women were also more specifically aware (p=.01). Physical activity levels were positively associated with the general (p<.001) and specific (p<.001) awareness of the Guide. Changes in general familiarity and specific recommendations over 1 year were observed., Conclusions: The majority of those surveyed were not familiar with the Guide. Men, individuals with a lower education, and older individuals may need to be specifically targeted., (Copyright © 2011 by American Journal of Health Promotion, Inc.)

Purpose: The primary objective of this study was to determine the physical activity (PA) preferences in a sample of individuals with prediabetes., Methods: Individuals with prediabetes (N = 232) residing in Northern Alberta, Canada completed a mailed questionnaire that assessed demographic and health variables, self-reported PA (Godin Leisure-Time Exercise Questionnaire), and PA preferences., Results: Respondents indicated they would like to be counseled about PA (75%), were physically able to participate (96%), were interested in a PA program for individuals with prediabetes (86%), and were most interested in walking (71%). Activity status, number of comorbidities, level of employment, marital status, body mass index, and time since diagnosis with prediabetes all demonstrated significant influence on different PA preference variables., Conclusions: There is a demand for PA-related programs for individuals with prediabetes. Incorporating identified PA preferences of those with prediabetes might aid in the development of relevant intervention tools, programs, and strategies to support PA.

The purposes of this research were to examine the characteristics of those who look for physical activity-related information, where they find it, and to examine what types of physical activity-related advertisements are recalled (i.e., publicly funded or commercial). These purposes were tested using secondary data analyses from two population health surveys. Results from the first survey (n=1211) showed gender, age, education, and activity-level differences in who is more likely to search for physical activity-related information. Adding the goal of being active into the model made age and activity level no longer significant but gender and education remained significant factors. The Internet was the most often cited source of physical activity information. The second survey (n=1600) showed that adults 55 years of age or older and participants with the least amount of education were more than twice as likely to name commercial advertisements than were participants aged 18-54 years or those with more education. These results help further our understanding of how publicly funded promotional campaigns fare against commercial advertising and also highlight the need to understand physical activity information-seeking behavior on the Internet and its implications for health promotion.

Objective: The objective of this study was to determine if differences existed in health-related quality of life (HRQoL) between individuals with prediabetes who are physically active (i.e., achieving >or=600METmin per week) compared to those who are inactive., Method: Individuals with prediabetes (N=232) residing in Northern Alberta, Canada completed a mailed questionnaire assessing self-reported PA, and health-related quality of life in August-September 2008., Results: Thirty-eight percent of individuals with prediabetes were meeting prediabetes PA guidelines. Covarying on age, gender, income, smoking and BMI, a significant multivariate analysis of covariance model [Wilks'lambda=0.967, F(2,224)=3.791, p<.05] indicated those achieving PA guidelines reported higher Physical Health (Mean diff=2.7, p<.05, ES=.27) and Mental Health (Mean diff=3.0, p<.05, ES=.31) compared to those not achieving PA guidelines., Conclusion: These findings demonstrate people with prediabetes who achieve prediabetes PA guidelines have higher levels of physical and mental HRQoL than people who are inactive. Further, these results support the rationale for developing strategically designed PA programs for individuals with prediabetes., (Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.)

Objectives: To investigate the utility of the protection motivation theory (PMT) for explaining physical activity (PA) in an adult population with type 1 diabetes (T1D) and type 2 diabetes (T2D)., Design: Cross-sectional and 6-month longitudinal analysis using PMT., Methods: Two thousand three hundred and eleven individuals with T1D (N=697) and T2D (N=1,614) completed self-report PMT constructs of vulnerability, severity, response efficacy, self-efficacy, and intention, and PA behaviour at baseline and 6-month follow-up. Multi-group structural equation modelling was conducted to: (1) test the fit of the PMT structure; (2) determine the similarities and differences in the PMT structure between the two types of diabetes; and (3) examine the explained variance and compare the strength of association of the PMT constructs in predicting PA intention and behaviour., Results: The findings provide evidence for the utility of the PMT in both diabetes samples (chi(2)/df=1.27-4.08, RMSEA=.02-.05). Self-efficacy was a stronger predictor of intention (beta=0.64-0.68) than response efficacy (beta=0.14-0.16) in individuals with T1D or T2D. Severity was significantly related to intention (beta=0.06) in T2D individuals only, whereas vulnerability was not significantly related to intention or PA behaviour. Self-efficacy (beta's=0.20-0.28) and intention (beta's=0.12-0.30) were significantly associated with PA behaviour., Conclusions: Promotion of PA behaviour should primarily target self-efficacy to form intentions and to change behaviour. In addition, for individuals with T2D, severity information should be incorporated into PA intervention materials in this population.

This article explores facilitators and barriers to individual and organizational capacity to address priority strategies for community-level chronic disease prevention. Interviews were conducted with a group of participants who previously participated in a community priority-setting workshop held in two Alberta communities. The goal of the workshop was to bring together key community stakeholders to collaboratively identify action strategies for preventing chronic diseases in their communities. While capacity building was not the specific aim of the workshop, it could be considered an unintended byproduct of bringing together community representatives around a specific issue. One purpose of this study was to examine the participants' capacity to take action on the priority strategies identified at the workshop. Eleven one-on-one semi-structured interviews were conducted with workshop participants to examine facilitators and barriers to individual and organizational level capacity building. Findings suggest that there were several barriers identified by participants that limited their capacity to take action on the workshop strategies, specifically: (i) organizations' lack of priorities or competing priorities; (ii) priorities secondary to the organizational mandate; (iii) disconnect between organizational and community priorities; (iv) disconnect between community organization priorities; (v) disconnect between organizations and government/funder priorities; (vi) limited resources (i.e. time, money and personnel); and, (vii) bigger community issues. The primary facilitator of individual capacity to take action or priority strategies was supportive organizations. Recognition of these elements will allow practitioners, organizations, governments/funders, and communities to focus on seeking ways to improve capacity for chronic disease prevention.

Purpose: To evaluate the effects of a 12-week e-mail intervention promoting physical activity and nutrition, and to describe participant use and satisfaction feedback., Design: A longitudinal, randomized trial., Setting: Five large workplaces in Alberta, Canada., Participants: One thousand forty-three participants completed all three assessments, and 1263 participants in the experimental group provided use and satisfaction feedback after receiving the 12-week intervention., Intervention: Paired physical activity and nutrition messages were e-mailed weekly to the experimental group. The control group received all messages in bulk (i.e., within a single e-mail message) at the conclusion of the intervention., Measures: Self-report measures of knowledge, cognitions, and behaviors related to physical activity and nutrition were used. Satisfaction with e-mail messages was assessed at Time 2., Analysis: Planned contrasts compared the experimental group measures at Time 3 with those reported at Time 2 and with control group measures reported at Time 3. Control group measures at Time 3 were also compared with control group measures at Time 2., Results: The small intervention effects previously reported between Time 1 and Time 2 were maintained at Time 3. Providing the e-mail messages in bulk also had a significant positive effect on many of the physical activity and nutrition variables., Conclusions: E-mail offers a promising medium for promoting health-enhancing knowledge, attitudes, and behaviors. Additional research is needed to determine optimal message dose and content.

Background: The purposes of this study were to determine if a) gender moderated the relationship between self-efficacy and physical activity (PA) among youth in Alberta, Canada, and, alternatively b) if self-efficacy mediated the relationship between gender and PA., Methods: A novel web-based tool was used to survey a regionally diverse sample of 4779 students (boys = 2222, girls = 2557) from 117 schools in grades 7 to 10 (mean age = 13.64 yrs.). Among other variables, students were asked about their PA and self-efficacy for participating in PA., Results: Based upon a series of multilevel analyses, self-efficacy was found to be a significantly stronger correlate of PA for girls. But, boys had significantly higher self-efficacy compared with girls, which resulted in significantly more PA., Conclusions: Findings suggest self-efficacy is an important correlate of PA among adolescent girls but that boys are more physically active because they have more self-efficacy for PA.

Background: The primary aim of this study was to compare the efficacy of three physical activity (PA) behavioural intervention strategies in a sample of adults with type 2 diabetes., Method/design: Participants (N = 287) were randomly assigned to one of three groups consisting of the following intervention strategies: (1) standard printed PA educational materials provided by the Canadian Diabetes Association [i.e., Group 1/control group)]; (2) standard printed PA educational materials as in Group 1, pedometers, a log book and printed PA information matched to individuals' PA stage of readiness provided every 3 months (i.e., Group 2); and (3) PA telephone counseling protocol matched to PA stage of readiness and tailored to personal characteristics, in addition to the materials provided in Groups 1 and 2 (i.e., Group 3). PA behaviour measured by the Godin Leisure Time Exercise Questionnaire and related social-cognitive measures were assessed at baseline, 3, 6, 9, 12 and 18-months (i.e., 6-month follow-up). Clinical (biomarkers) and health-related quality of life assessments were conducted at baseline, 12-months, and 18-months. Linear Mixed Model (LMM) analyses will be used to examine time-dependent changes from baseline across study time points for Groups 2 and 3 relative to Group 1., Discussion: ADAPT will determine whether tailored but low-cost interventions can lead to sustainable increases in PA behaviours. The results may have implications for practitioners in designing and implementing theory-based physical activity promotion programs for this population., Clinical Trials Registration: ClinicalTrials.gov identifier: NCT00221234.

Despite strong evidence supporting the benefits of physical activity in managing and preventing diabetes, the majority of Canadians living with or without diabetes are insufficiently active to achieve health benefits. The purpose of this study was to examine the difference in key physical activity-related, psychosocial constructs from major social-cognitive theories/models for individuals with type 1 diabetes (n = 695), type 2 diabetes (n = 1540) and those without diabetes (n = 829). The relatively similar scores reported for the social-cognitive constructs between the groups suggest that theoretically driven, generic population-based strategies operationalizing key socio-cognitive constructs for promoting physical activity may have utility for the general and diabetes specific populations. However, both diabetes groups reported significantly lower (p < 0.001) response efficacy (benefits of physical activity) scores, and higher scores for cons of performing physical activity than the non-diabetes group (p < 0.001). Further, the type 1 diabetes group had significantly higher (p < 0.05) physical activity cons scores than the other two study groups. The findings of this study may guide practitioners in designing population-based, physical activity programs that capitalize on generic strategies for the general and diabetes populations, and identify efforts as to where specific tailoring (e.g. emphasizing physical activity benefits) is needed for those living with diabetes.

This study examined the prevalence, clustering, age trends, and gender differences of chronic-disease related risk factors among a large sample of adolescents (N = 4932) in Alberta, Canada. Approximately 43% of boys and 53% of girls displayed two or more risk factors. Age trends and gender differences were also observed.

Objective: The Healthy Heart Kit (HHK) is a risk management and patient education kit for the prevention of cardiovascular disease (CVD) and the promotion of CV health. There are currently no published data examining predictors of HHK use by physicians. The main objective of this study was to examine the association between physicians' characteristics (socio-demographic, cognitive, and behavioural) and the use of the HHK., Methods: All registered family physicians in Alberta (n=3068) were invited to participate in the "Healthy Heart Kit" Study. Consenting physicians (n=153) received the Kit and were requested to use it for two months. At the end of this period, a questionnaire collected data on the frequency of Kit use by physicians, as well as socio-demographic, cognitive, and behavioural variables pertaining to the physicians., Results: The questionnaire was returned by 115 physicians (follow-up rate = 75%). On a scale ranging from 0 to 100, the mean score of Kit use was 61 [SD=26]. A multiple linear regression showed that "agreement with the Kit" and the degree of "confidence in using the Kit" was strongly associated with Kit use, explaining 46% of the variability for Kit use. Time since graduation was inversely associated with Kit use, and a trend was observed for smaller practices to be associated with lower use., Conclusion: Given these findings, future research and practice should explore innovative strategies to gain initial agreement among physicians to employ such clinical tools. Participation of older physicians and solo-practitioners in this process should be emphasized.

Chronic disease interventions for women have been understudied in the workplace domain. Understanding the role of cognitions in individual behaviour can help motivate change and suggest directions for achieving improvements in health. The purpose of this study was to identify psychosocial constructs and social-cognitive theories [e.g. Transtheoretical model (TTM), Theory of Planned Behaviour (TPB), Protection Motivation Theory (PMT) and Social Cognitive Theory (SCT)] that are most salient for explaining physical activity behaviour among employed women (n = 1183). Demographic information, and social-cognitive measures related to physical activity, intention and behaviours (e.g. stage of change, energy expenditure) were assessed. A series of multiple regression analyses predicting intention, energy expenditure and stage of change were conducted separately for: (1) women with young children (n = 302), and (2) women without young children (n = 881) for each of the respective social-cognitive theories. Although taken as a whole the results were relatively similar between the two sub-groups of women for each of the socio-cognitive theories examined in this study, differences were observed in the relative contributions of the theoretical constructs between the two sub-groups. Results also indicate that self-efficacy and intention were the strongest predictors of behaviour among both women with and without young children. The explained variances (R(2)) for the theories examined in this study for different sub-groups ranged from 16 to 60%, generally reflecting what has been reported in other studies within the physical activity domain. The results of this study could be useful in guiding future research and in designing physical activity intervention programs for these specific population groups. Integrating approaches of individual lifestyle change while addressing issues related to creating supportive environments for women in various life stages is a suggested strategy for future work in this area.

Goals of Work: Although exercise has gained recognition as an effective supportive care intervention for cancer survivors, exercise participation rates are low. The present study examined the determinants of exercise in bladder cancer survivors using the Theory of Planned Behavior (TPB)., Patients and Methods: Bladder cancer survivors (N = 397) residing in Alberta, Canada completed a mailed questionnaire at baseline that assessed demographic, medical, behavioral, and social cognitive variables and a second questionnaire 3 months later that assessed exercise. Multiple regression was the primary analysis., Main Results: Adjuvant therapy (r = -0.10, p = 0.021), cancer invasiveness (r = -0.10, p = 0.051), and age (r = -0.11, p = 0.037) were all negatively associated with exercise. Intention (beta = 0.25, p < 0.001), perceived behavioral control (beta = 0.18, p = 0.001), and planning (beta = 0.12, p = 0.018) explained 20.9% of the variance in exercise over a 3-month period. Perceived behavioral control (beta = 0.32, p < 0.001), affective attitude (beta = 0.18, p = 0.002), instrumental attitude (beta = 0.15, p = 0.025) and descriptive norm (beta = 0.10, p = 0.032) explained 39.1% of the variability in exercise intention. Constructs from the TPB mediated the associations between adjuvant therapy, cancer invasiveness, age, and exercise. Age and adjuvant therapy also moderated some of the associations within the TPB., Conclusions: Some medical and demographic variables predict exercise behavior in bladder cancer survivors, but these associations are mediated by the TPB. Interventions based on the TPB may be effective for promoting exercise in this cancer survivor population.

Many interventions promoting physical activity (PA) are effective in preventing disease onset, and although studies have found a positive relationship between health-related quality of life (HRQL) and PA, most of these studies have focused on older adults and those with chronic conditions. Less is known regarding the association between PA level and HRQL among healthy adults. Our objective was to analyse the relationship between PA level and HRQL among a sample of 573 employees aged 20-68 taking part in a workplace intervention to promote PA. Measures included HRQL (using a single item) and PA (i.e. Godin Leisure-Time Questionnaire). The Modified Canadian Aerobic Fitness Test (MCAFT) was also completed by 10% of the employees. MET-minute scores (assessing energy expenditure over one week) were compared across HRQL categories using ANOVA. A multiple linear regression analysis was conducted to further examine the relationship between HRQL and PA, controlling for potential covariates. Participants in the higher health status categories were found to report higher levels of energy expenditure (one-way ANOVA, p < 0.001). In the multiple linear regression model, each unit increase in health status level translated in a mean increase of 356 MET-minutes in energy expenditure (p < 0.001). This single-item assessment of health status explained six percent of the variance in energy expenditure. The study concludes that higher energy expenditure through PA among an adult workplace population is positively associated with increased health status, and it also suggests that a single-item HRQL measure is suitable for community- and population-based studies, reducing response burden and research costs.

Objectives: Public policies impact the amount of physical activity (PA) that children receive at school. These policies are of interest because overweight and obesity among Canadian children have grown at significant rates, and increasing PA among children is one way to reverse this trend. This research investigates the public policy processes that have resulted in Alberta's education system adopting in-school daily physical activity (DPA) and not supporting walk-to-school (WTS) initiatives., Methods: Using the policy process described by Kingdon and others as a conceptual framework, this research reviews literature and documents on public policy relating to PA in schools and interviews key individuals (N = 20) to identify the policy-related facilitators and barriers in Alberta, Canada to increasing PA in school-aged children., Results: DPA was mandated because Kingdon's three policy streams (problem, solution and politics) became joined or linked. DPA was the most viable solution because literature supports and teachers believe in the educational benefits of PA. As well, a physician with personal beliefs about the benefits of PA became the minister of education and coupled the solution with the political stream through his ministerial power. Reasons that WTS programs have not become school or health policy include advocacy led by politically weak organizations, lack of a supportive policy entrepreneur and poor saliency among educators., Conclusions: This research illuminates the inner workings of the policy process shaping PA in schools, identifying the unseen forces of the policy process that move issues forward. The findings provide valuable insight for building other healthy public policies.

Background: We previously reported that a physical activity (PA) behavior change intervention based on the theory of planned behavior (TPB) increased PA and quality of life in breast cancer survivors., Purpose: To examine the effects of our interventions on TPB variables and to determine if PA at 12 weeks follow-up was mediated by TPB variables at 4 weeks., Methods: Breast cancer survivors (N = 377) were randomly assigned to receive either a standard public health recommendation for PA (SR group), a step pedometer alone, or one of two TPB-based behavior change interventions consisting of print materials (alone or combined with a step pedometer). For the purpose of this study, we compared the two TPB-based intervention groups (INT group) to the SR group., Results: Compared to the SR group, the INT group reported more favorable changes in instrumental attitude (mean difference = 0.13; 95% CI = -0.01 to 0.23; d = 0.19; p = 0.077), intention (mean difference = 0.33; 95% CI = 0.10 to 0.56; d = 0.33; p = 0.006), and planning (mean difference = 0.39; 95% CI = 0.04 to 0.73; d = 0.26; p = 0.027). Mediation analyses indicated that both planning and intention partially mediated the effects of the intervention on PA at 12 weeks., Conclusions: Our TPB-based behavior change intervention resulted in small improvements in the TPB constructs that partially mediated the effects of our intervention on PA behavior. Additional research with the TPB is warranted.

Background: No studies have yet examined the associations of physical environmental attributes specifically with walking in adults with type 2 diabetes., Purpose: The purpose of this study was to examine associations of perceived community physical environmental attributes with walking for transport and for recreation among adults living with type 2 diabetes., Methods: Participants were 771 adults with type 2 diabetes who completed a self-administered survey on perceived community physical environmental attributes and walking behaviors., Results: Based on a criterion of a minimum of 120-min/week, some 29% were sufficiently active through walking for transport and 33% through walking for recreation. Significantly higher proportions of those actively walking for transport and for recreation had shops or places to buy things close by (67.8% and 60.9%); lived within a 15-min walk to a transit stop (70.6% and 71.0%); did not have dead-end streets close by (77.7% and 79.8%); reported interesting things to look at (84.8% and 84.4%); and lived close to low-cost recreation facilities (81.3% and 78.8%). In addition, those actively walking for transport reported living in a community with intersections close to each other (75.6%) and with sidewalks on their streets (88.1%). When these variables were entered simultaneously into logistic regression models, living close by to shops was positively related to walking for transport (OR = 1.92, 99% CI = 1.11-3.32)., Conclusions: Consistent with findings from studies of healthy adult populations, positive perceptions of community environmental attributes are associated with walking for transport among adults with type 2 diabetes. The now-strong public health case for environmental innovations to promote more walking for transport is further reinforced by the potential to benefit those living with diabetes.

This study sets out to determine the main issues employed women with and without young children voice as influencing their physical activity behaviors, and to identify the environmental dimensions (e.g., physical, social, cultural, organizational, policy) within and outside of the workplace surrounding physical activity promotion that are most pertinent to employed women in Canada. Thirty employed women participated in focus groups, and four senior personnel were interviewed. Worksite observations were carried out and a Workplace Physical Activity Audit Tool was administered. Results indicate that time constraints and demands of personal and work life are barriers to achieving more activity. The issues surrounding family obligations and pressures for women with young children illustrate the main differences between groups. Key environmental factors are addressed and considered for future workplace physical activity programming goals.

Purpose: The purpose of this study was to examine the longer-term effects of pedometers and print materials on changes in physical activity (PA) and health-related quality of life (HRQoL) in breast cancer survivors who participated in a 3-month behavior change intervention., Methods: Breast cancer survivors (N = 377) were randomly assigned to receive either (a) a standard public health recommendation for PA (SR), (b) previously developed breast cancer-specific PA print materials (PM), (c) a step pedometer (PED), or (d) a combination of the two (COM). The primary endpoint was self-reported moderate/vigorous PA minutes per week at 6-month follow-up after the initial 3-month intervention period., Results: Seventy-one percent (266/377) of participants completed the 6-month follow-up assessment. According to intention-to-treat linear mixed-model analyses, self-reported moderate to vigorous PA increased by 9 min x wk(-1) in the SR group compared with 39 min x wk(-1) in the PM group (mean difference = 30 min x wk(-1); 95% CI = -44 to 104; P = 0.425), 69 min x wk(-1) in the PED group (mean difference = 60 min x wk(-1); 95% CI = -13 to 132; P = 0.107), and 56 min x wk(-1) in the COM group (mean difference = 47 min x wk(-1); 95% CI = -26 to 119; P = 0.210). The same pattern was observed for self-reported, brisk walking. No differences were found for HRQoL or fatigue., Conclusion(s): Breast cancer-specific PM and PED did not maintain significantly higher PA or HRQoL at 6-month follow-up in breast cancer survivors, but the magnitude of the effect on PA (30-60 min x wk(-1)) was consistent with the immediate postintervention effect observed at the 3-month postintervention time point. Issues of power resulting from additional loss to follow-up may account for the failure to achieve statistical significance. Additional research with larger sample sizes and more complete follow-up is warranted.

Background: Canadian political discourse supports the importance of health promotion and advocates the allocation of health resources to health promotion. Furthermore, the current literature frequently identifies financial and human resources as important elements of organizational capacity for health promotion. In the Alberta Heart Health Project (AHHP), we sought to learn if the allocation of health resources in a regionalized health system was congruent with the espoused support for health promotion in Alberta, Canada., Methods: The AHHP used a mixed method approach in a time series design. Participants were drawn from multiple organizational levels (i.e., service providers, managers, board members) across all Regional Health Authorities (RHAs). Data were triangulated through multiple collection methods, primarily an organizational capacity survey, analysis of organizational documents, focus groups, and personal interviews. Analysis techniques were drawn from quantitative (i.e., frequency distributions, ANOVAs) and qualitative (i.e., content and thematic analysis) approaches., Results: In most cases, small amounts (<5%) of financial resources were allocated to health promotion in RHAs' core budgets. Respondents reported seeking multiple sources of public health financing to support their health promotion initiatives. Human resources for health promotion were characterized by fragmented responsibilities and short-term work. Furthermore, valuable human resources were consumed in ongoing searches for funding that typically covered short time periods., Conclusions: Resource allocations to health promotion in Alberta RHAs are inconsistent with the current emphasis on health promotion as an organizational priority. Inadequate and unstable funding erodes the RHAs' capacity for health promotion. Sustainable health promotion calls for the assured allocation of adequate, sustainable financial resources.

Purpose: The purpose of this paper is to examine organizational leadership and its relationship to regional health authority actions to promote health., Design/methodology/approach: Through use of four previously developed measures of Perceived Organizational Leadership for Health Promotion, this paper focused on leadership as a distributed entity within regional health authority (RHA) jurisdictions mandated to address the health of the population in the province of Alberta, Canada., Findings: First, examination of differentials between organizational levels (i.e. board members, n = 30; middle/senior management, n = 58; and service providers, n = 56) on ratings of the four leadership measures revealed significant differences. That is, board members tended to rate leadership components significantly higher than service providers and middle/senior managers: from across all 17 RHAs; and in low health promotion capacity and high health promotion capacity RHAs. Second, regression analyses identified that the leadership measures "Practices for Organizational Learning" and "Wellness Planning" were positively associated with health authority actions on improving population heart health (heart health promotion). The presence of a "Champion for Heart Health Promotion" and the leadership measures "Workplace Milieu" and "Organization Member Development" were also positively associated with health authority actions for health promotion. A subsidiary aim revealed low to moderate positive relationships of the dimensions of Leadership, Infrastructure and Will to Act with one another, as proposed by the Alberta Model on "Organizational Capacity Building for Health Promotion.", Originality/value: This paper, conducted on the baseline dataset (n = 144) of the "Alberta Heart Health Project's Dissemination Phase", represents a rare effort to examine leadership at a collective organizational level.

Purpose: The purpose of this study was to explore (1) patterns in physical activity behaviors and (2) the meaning and personal significance of social cognitive theory (SCT) constructs on physical activity, across gender and income groups among people with type 2 diabetes (T2DM)., Methods: Albertans, 18 years and older (x- = 63, SD = 12.08) with T2DM (N = 1614) completed self-report measures of demographic characteristics and physical activity. Two-way, between-groups analyses of variance (ANOVAs) assessed main and interaction effects of gender and income on leisure time physical activity (LTPA). A subsample of these participants (n = 20) subsequently completed qualitative telephone interviews to provide contextual understanding of the quantitative data and to explore salient SCT influences on physical activity., Results: Significant findings indicated that men participate in more LTPA than women do, and those from the highest income group participate in more LTPA than low- or middle-income groups (P < .01). Interview results suggested that walking is the most popular form of physical activity; however, gender and income groups differ in other leisure and nonleisure physical activities. Furthermore, patterns for SCT constructs related to physical activity were apparent across gender and income, most noticeably for self-efficacy and environmental and situational influences. Specifically among men, noteworthy differences existed between income groups for self-control and reinforcement strategies., Conclusions: The study highlights the need for more sensitive self-report measures and objective measures of physical activity to help distinguish whether true differences exist between certain demographic groups. Moreover, interventions that promote walking may be beneficial for people with T2DM, provided that appropriate environmental and policy changes occur to accommodate walking and other physical activity behaviors.

Introduction: The purpose of this study was to identify key demographic and health factors associated with physical activity (PA) participation in adults with type 1 or type 2 diabetes., Methods: Participants were adults > or = 18 yr of age living in the province of Alberta, Canada who were previously diagnosed with type 1 (N = 697) or type 2 (N = 1614) diabetes. Individuals were recruited from the Canadian Diabetes Association (Alberta) registry and through a random digit-dialing protocol. Multiple and logistic regression models were employed to identify demographic and health factors related to PA levels, of which many to date have not been examined in this population. Analyses were conducted separately for type 1 and type 2 groups., Results: Of those with type 1 and type 2 diabetes, 63.7 and 71.9%, respectively, were not achieving recommended PA levels. For those with type 1, higher PA levels were associated with a younger age, being single, higher income, lower level of perceived disability, and not smoking. For the type 2 group, a younger age, male gender, higher education, higher income, lower body mass index, and lower level of perceived disability were associated with higher PA levels., Conclusions: Many of our results for both diabetes types are consistent with findings from other limited research in this domain. Contrary to previous research, however, a significant negative relationship was reported between body mass index and PA for the type 2 group. In addition, perceived disability was negatively associated with PA, which, to date, has not been reported in the literature with type 2 individuals. Research and practice related to physical activity promotion for this population should take into account specific demographic and health factors associated with PA.

Background: Recognition of the common risk factors for leading chronic diseases in Canada has contributed to the development of integrated chronic disease prevention and health promotion approaches. The Alberta Heart Health Project studied the capacity of health organizations in Alberta, Canada, to engage in heart health promotion. This article describes how the Alberta Heart Health Project acted on emerging research findings describing the preliminary stages of integrated chronic disease prevention in Alberta to provide leadership to encourage provincial chronic disease prevention efforts., Context: Political support for integrated chronic disease prevention was evident at the provincial and federal levels in Canada. As a result of organizational restructuring, loss of key health promotion champions, and decreased funding allocations, Alberta's regional health authorities sought increased efficiency in their chronic disease prevention efforts., Methods: Descriptive data were derived from a brief questionnaire on regional health authorities' chronic disease prevention priorities and activities, an inventory of regional health authority health promotion programs and services, content analysis of key regional health authority documents, and focus groups with regional health authority staff, management, and policymakers., Consequences: In 2002, the Alberta Heart Health Project data revealed that many regional health authorities were beginning to engage in integrated chronic disease prevention. However, little collaboration occurred across the health organizations; provincial leadership to facilitate collaboration and networking for integrated chronic disease prevention was needed., Interpretation: Results supported the growing momentum for provincial leadership to enhance collaboration for integrated chronic disease prevention, which contributed to the development of the Alberta Healthy Living Network. The government's assistance is also needed to support the intersectoral collaborations essential for integrated chronic disease prevention.

This project was undertaken to develop a Workplace Physical Activity Assessment Tool to evaluate workplace physical activity programs based on a standard of best practices indicated in the literature and by key stakeholders. The development of the Assessment Tool was structured on an ecological model for health and physical activity promotion and an occupational health and safety audit instrument. The project included a review and synthesis of pertinent literature, expert and stakeholder reviews, interrater reliability appraisals, and workplace consultations over three distinct study phases. The Assessment Tool was received positively by the expert reviewers (i.e., academics, policy makers, and practitioners) and revealed generally high interrater reliability. The Workplace Physical Activity Assessment Tool can be used to plan, implement, and evaluate physical activity programs in the workplace. Recommendations for future research are identified.

Purpose: The purpose of this study was to evaluate a 12-week workplace e-mail intervention designed to promote physical activity and nutrition behavior., Design: A pre- and post-test design was conducted to compare the effects of e-mail messages between intervention and control groups., Setting: Five large workplaces in Alberta, Canada., Subjects: Employees with access to a personal e-mail address (N = 2121) were randomly assigned to an intervention (n = 1566) or a control group (n = 555)., Intervention: Physical activity and nutrition messages were based on social-cognitive theories. The intervention group received one physical activity and one parallel nutrition message per week for 12 weeks. The control group received no weekly messages., Measures: Each participant completed self-report measures of physical activity and nutrition related to knowledge, attitudes, and behaviors 1 week before (time 1) and 1 week after (time 2) the intervention., Results: The intervention group was more efficacious at time 2 on measures of self-efficacy, pros, cons, intentions, and behavior related to physical activity. This group also reported more favorable changes in practicing healthy eating, balancing food intake with activity level, cooking meals with techniques to reduce fat, and avoiding eating high-fat foods. Effect sizes for all significant differences were small., Conclusion: E-mail is a promising mode of delivery for promoting physical activity and nutrition in the workplace. Further theoretically driven studies are needed.

This study describes the development and psychometric evaluation of four scales measuring leadership for health promotion at an organizational level in the baseline survey (n=144) of the Alberta Heart Health Project. Content validity was established through a series of focus groups and expert opinion appraisals, pilot testing of a draft based on capacity assessment instruments developed by other provinces involved in the Canadian Heart Health Initiative, and the literature. Psychometric analyses provided empirical evidence of the construct validity and reliability of the organizational leadership scales. Principal component analysis verified the unidimensionality of the leadership scales of (a) Practices for Organizational Learning, (b) Wellness Planning, (c) Workplace Climate, and (d) Organization Member Development. Scale alpha coefficients ranged between .79 and .91 thus establishing good to high scale internal consistencies. These measures can be used by both researchers and practitioners for the assessment of organizational leadership for health promotion and heart health promotion.