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Objective: Approximately 25 % of Canadian children aged 4-8 years fail to meet the recommended dietary allowance (RDA) of calcium (Ca). Young children's food choices are primarily determined by their parents. No interventions have directly targeted parents as a medium through which to increase children's Ca consumption. This study compared the effectiveness of a Ca-specific intervention targeted towards parents, with generic dietary advice on the Ca consumption of children aged 4-10 years.Design: A parallel two-arm randomised controlled trial was conducted.Setting: The study was conducted across Canada. Both conditions received information on the RDA of Ca and an index of intake requirements. Material sent to the intervention condition included behavioural strategies to increase dietary Ca consumption, information on the benefits of dietary Ca intake and messages addressing perceived barriers to the consumption of Ca-rich foods.Participants: A total of 239 parents (93 % mothers) of children aged 4-10 years who consumed less than the RDA of Ca were randomly assigned in a 1:1 allocation ratio.Results: There was a significant increase in total Ca intake and Ca from dairy for children at weeks 8, 34 and 52 (P ≤ 0·001) in both conditions. Parental Ca intake and amount spent on dairy products did not significantly increase following the intervention.Conclusions: Provision of daily Ca requirements with regular reminders could impact parents' delivery of Ca-rich foods to their children. This finding is important for public health messaging as it suggests that parents are a potent medium through which to promote Ca intake in children. [ABSTRACT FROM AUTHOR]

Purpose: The purposes of the current study were to (1) describe the restructuring and dissemination of a Canada-wide intervention curriculum designed to enhance health care professionals' prescription of physical activity to patients with physical disabilities, and (2) examine interventionists' social cognitions for, and their acceptance and adoption of, the new curriculum. Methods: A participatory curriculum development process was utilized, resulting in a theory- and evidence-based curriculum. Interventionists ( N = 28) were trained in curriculum delivery and most ( n = 22) completed measures of Theory of Planned Behavior (TPB) constructs assessing their cognitions for delivering the new curriculum at pre- and post-training and at 6-month follow-up. Interventionists also completed a Diffusion of Innovations (DOI) measure assessing their opinion of whether the new curriculum met characteristics that would facilitate its adoption and use. Results: Interventionists reported strong TPB cognitions for curriculum use before training. Significant increases emerged for some TPB constructs (ps ≤ 0.025) from pre- to post-training, and significant decreases were seen in some TPB constructs (ps ≤ 0.024) between post-training and 6-month follow-up. The interventionists rated the new curriculum as high on all the DOI characteristics. Conclusion: The theory-driven, participatory development process facilitated interventionists' social cognitions towards and adoption of the new curriculum. Positive increases in TPB cognitions from pre- to post-training were not maintained at follow-up. Further research is needed to determine if these changes in cognitions are indicative of a curriculum 'reinvention' process that facilitates long-term curriculum use. Understanding curriculum adoption and implementation is a crucial step to determining the potential population impact of the intervention. [ABSTRACT FROM AUTHOR]

Background The RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance) framework is a reliable tool for the translation of research to practice. This framework has been widely applied to assess the impact of individual interventions. However, RE-AIM has rarely been used to evaluate implementation interventions, especially from multi-sector partnerships. The primary purpose of this paper is to operationalize the RE-AIM approach to evaluate large, multi-sector partnerships. SCI Action Canada, a community-university partnership aimed to promote physical activity among adults with spinal cord injury, is used as an example. A secondary purpose is to provide initial data from SCI Action Canada by using this conceptualization of RE-AIM. Methods Each RE-AIM element is operationalized for multi-sector partnerships. Specific to SCI Action Canada, seven reach calculations, four adoption rates, four effectiveness outcomes, one implementation, one organizational maintenance, and two individual maintenance outcomes are defined. The specific numerators based on SCI Action Canada activities are also listed for each of these calculations. Results The results are derived from SCI Action Canada activities. SCI Action Canada's reach ranged from 3% (end-user direct national reach) to 37% (total regional reach). Adoption rates were 15% (provincial level adoption) to 76% (regional level adoption). Implementation and organizational maintenance rates were 92% and 100%, respectively. Conclusions We have operationalized the RE-AIM framework for larger multi-sectoral partnerships and demonstrated its applicability to such partnerships with SCI Action Canada. Future partnerships could use RE-AIM to assess their public health impact. [ABSTRACT FROM AUTHOR]

Parents of children and youth with disabilities (CYD) have expressed unique physical activity (PA) information needs. Community-based organizations (CBOs) require assistance to meet these needs. Guided by the Appraisal of Guidelines, Research and Evaluation II, this project established evidence-informed recommendations for developing PA information targeting families of CYD. This process involved a systematic scoping review to inform draft recommendations (k = 23), which were revised via a consensus meeting with researchers, knowledge users from CBOs, and families of CYD. Broader consultation with CBO knowledge users informed the final recommendations (k = 5) that fit within the following categories: (a) language and definitions, (b) program information, (c) benefits of PA, (d) barriers to PA, and (e) PA ideas and self-regulation tools. CBOs are encouraged to consider these recommendations when developing PA information for families of CYD. Future research will focus on the development of knowledge products to disseminate the recommendations to CBOs and support implementation. [ABSTRACT FROM AUTHOR]

This report provides an expert appraisal of the Canadian Para Report Card on physical activity (PA) for children and adolescents with disabilities. Thirteen indicators were graded by a panel of researchers, representatives from disability and PA organizations, and parents of children and adolescents with disabilities using benchmarks of the Global Matrix 4.0 and previous Canadian PA Report Cards. Facilitated panel discussions were used to appraise the available evidence based on data gaps, opportunities, and recommendations. The available data sources included four nationally generalizable or representative data sets. Grades were assigned to 8/13 indicators and ranged from B+ to F. Data gaps in measurement and national surveillance systems were identified. Ableism was an issue identified within some of the reporting benchmarks. The absence of PA from existing accessibility legislation in Canada was a policy gap of concern. Recommendations related to research, surveillance, and policy are provided to enhance PA among children and adolescents with disabilities in Canada. [ABSTRACT FROM AUTHOR]

Background: Physical activity (PA) interventions in people with spinal cord injury (SCI) have been limited by a shortage of (1) evidence for sufficient increases in unsupervised PA to improve aerobic fitness and (2) stakeholder involvement in intervention design. Objectives: This study examined the effects of a theory-based PA intervention, developed in collaboration with nearly 300 stakeholders, on PA levels, aerobic fitness, and psychosocial predictors of PA among individuals with SCI. Methods: A randomized controlled trial (RCT) was conducted with 28 men and women with chronic SCI (age 45.0 ± 11.5 years, years post-injury 16.4 ± 12.4). Participants randomized to the intervention group (n = 14) received an introductory personal training session followed by eight weekly 15-min PA behavioral coaching sessions per week. PA was assessed using self-report and accelerometers. Aerobic fitness and psychosocial predictors of exercise were evaluated using an incremental exercise test and survey methods, respectively. Results: At post-intervention, controlling for baseline, the intervention group showed fivefold greater self-reported moderate to vigorous physical activity [mean difference 247.9 min/day; 95% confidence interval (CI) 92.8–403.1; p = 0.026, d = 1.04], 17% greater accelerometer-measured PA (mean difference 3.9 × 105 vector magnitude counts; 95% CI 1.1 × 104–7.7 × 105; p = 0.014, d = 0.31), and 19% higher peak oxygen uptake (VO2Peak; mean difference 0.23 L/min; 95% CI 0.12–0.33; p < 0.001, d = 0.54) compared with the control group. Mean values of psychosocial predictors of PA were also significantly improved in the intervention group compared with controls. Conclusion: To our knowledge, this co-created behavioral intervention produced the largest effect size to date for change in self-reported PA in an RCT involving people with physical disability. This is also the first RCT in people with SCI to demonstrate that a behavioral intervention can sufficiently increase unsupervised PA to improve aerobic fitness. Trial Registration: ClinicalTrials.gov, NCT03111030, 12 April 2017, https://clinicaltrials.gov/ct2/show/NCT03111030?term=NCT03111030&rank=1. [ABSTRACT FROM AUTHOR]

This paper provides a brief overview of the epidemiological data regarding Canadians with physical disabilities, with a particular emphasis on health status. A literature review is then presented, focusing on activity levels and the physiological and health-related quality of life benefits of activity for people with four different physical disabilities (arthritis, fibromyalgia, spinal cord injury, and multiple sclerosis). The unique physical activity barriers faced by people with physical disabilities are discussed. The paper concludes with recommendations for the development of a physical activity guide for Canadians with physical disabilities. [ABSTRACT FROM AUTHOR]

Identifying as a regular exerciser has been found to effectively alter stereotypes related to warmth and competence for adults with a physical disability; however, it remains unclear how sport participation can influence this trend. Therefore, this study aimed to examine warmth and competence perceptions of adults with a physical disability portrayed as elite and nonelite athletes relative to other athletic and nonathletic subgroups of adults with and without a physical disability in the context of the stereotype content model. Using survey data from able-bodied participants (N = 302), cluster analyses were applied to a behaviors from intergroup affect and stereotypes map for displaying the intersection of warmth and competence perceptions. The results demonstrated that adults with a physical disability who are described as elite athletes (i.e., Paralympians) are clustered with high warmth and high competence, similar to their able-bodied athletic counterparts (i.e., Olympians). The findings suggest that perceiving athletic and elite sport statuses for adults with a physical disability may counter the stereotypes commonly applied to this group. [ABSTRACT FROM AUTHOR]

Objective: The purpose of this study was to apply Ajzen's theory of planned behavior (TPB) and a measure of past physical activity behavior to predict first-year students' physical activity intentions and behavior. Participants and Methods: First-year university students (N = 212) completed measures of TPB variables and past physical activity at the start of the 2006 fall semester and a measure of physical activity 8 weeks later. Results: The TPB variables explained 37% of the variance in intentions, increasing to 39% with the addition of past behavior. Logistic regression showed that past behavior predicted whether students met Health Canada standards for being physically active (4 sessions of moderate/vigorous physical activity per week). Conclusions: Findings are consistent with other research showing that the TPB offers a good prediction of physical activity intentions but falls short of predicting behavior. [ABSTRACT FROM AUTHOR]

Background: The RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance) framework is a useful tool for evaluating the impact of programs in community settings. RE-AIM has been applied to evaluate individual programs but seldom used to evaluate the collective impact of community-based, public health programming developed and delivered by multiple autonomous organizations. The purposes of this paper were to (a) demonstrate how RE-AIM can be operationalized and applied to evaluate the collective impact of similar autonomous programs that promote health and well-being and (b) provide preliminary data on the collective impact of Canadian spinal cord injury (SCI) peer mentorship programs on the delivery of peer mentorship services.Methods: Criteria from all five RE-AIM dimensions were operationalized to evaluate multiple similar community-based programs. For this study, nine provincial organizations that serve people with SCI were recruited from across Canada. Organizations completed a structured self-report questionnaire and participated in a qualitative telephone interview to examine different elements of their peer mentorship program. Data were analyzed using summary statistics.Results: Having multiple indicators to assess RE-AIM dimensions provided a broad evaluation of the impact of Canadian SCI peer mentorship programs. Peer mentorship programs reached 1.63% of the estimated Canadian SCI population. The majority (67%) of organizations tracked the effectiveness of peer mentorship through testimonials and reports. Setting-level adoption rates were high with 100% of organizations offering peer mentorship in community and hospital settings. On average, organizations allocated 10.4% of their operating budget and 9.8% of their staff to implement peer mentorship and 89% had maintained their programming for over 10 years. Full interpretation of the collective impact of peer mentorship programs was limited as complete data were only collected for 52% of survey questions.Conclusions: The lack of available organizational data highlights a significant challenge when using RE-AIM to evaluate the collective impact of multiple programs that promote health and well-being. Although researchers are encouraged to use RE-AIM to evaluate the collective impact of programs delivered by different organizations, documenting limitations and providing recommendations should be done to further the understanding of how best to operationalize RE-AIM in these contexts. [ABSTRACT FROM AUTHOR]

Purpose: This study described how the Dutch and Canadian governments promote high performance sports, recreational sports, and physical activity (PA) among adults with disabilities on a national level. Methods: An internet-based study was conducted to identify and select relevant documents and websites containing information about the national approach to promote disability sports and physical activities in the Netherlands and Canada. Results: Both governments promote high performance sports in similar ways, but use different strategies to promote recreational sports and physical activities. The Dutch approach is characterized by using time-limited programs focusing on enhancement of sports infrastructure and inter-sector collaboration in which municipalities have key roles. The Canadian government promotes recreational sports in disabled populations by supporting programs via bilateral agreements with provinces and territories. Furthermore, the level of integration of disability sports into mainstream sports differs between countries. Conclusions: The findings of this study may inspire policy makers from different countries to learn from one another's policies in order to optimize national approaches to promote disability sports and PA on all levels. It is recommended for policy makers of national governments to develop and implement policy programs that promote sports and physical activities among people with disabilities because of its potential impact on functioning, participation, quality of life, and health. Insight into national approaches to promote sport and physical activities is relevant for rehabilitation practice to understand ongoing opportunities for people with disabilities to stay physically active after rehabilitation through participation in home and/or community-based sport and physical activities. It seems worthwhile to integrate activities to promote sport and physical activities in rehabilitation in such a way that it fits with the current governmental approach. It is recommended to set up international collaborations to develop and share knowledge about effective and sustainable national approaches to promote sports and physical activities among people with disabilities. [ABSTRACT FROM AUTHOR]

Purpose: To understand the similarities and differences in the employment participation of people living with arthritis across the life course. Method: Focus groups and interviews were conducted with young (ages 18-34 years, n = 7), middle-aged (ages 35-54 years, n = 13) and older adults (>55 years, n = 25) with arthritis. Participants were asked about the impact of arthritis on employment, experiences with health-related changes, career progression and social role involvement. A modified grounded theory approach was used to inductively analyze the data. Results: Young adults indicated the school-to-work transition as being influential in their employment and described the need to direct their time and energy toward finding work that accommodated health and met career aspirations. Middle-aged adults described how the transition from good health to an arthritis diagnosis disrupted involvement in diverse social roles. However, they often downplayed the impact of arthritis on employment. Older adults described the work-to-retirement transition and their decline in physical functioning as contributing to changing involvement in the labor market. Conclusion: Transitions related to health, career progression and social role involvement shaped employment experiences, and represent opportunities for future research and practice that is tailored to life course issues. Implications for rehabilitation: Little is known about the work experiences of young- and middle-aged adults with arthritis and how they compare to their older counterparts. Life course theory offers an important framework for research and practice by providing a perspective to enhance our understanding of how employment participation differs across phases of life. Salient and diverse changes related to health, career and social role involvement were identified at each life phase and shaped employment. Rehabilitation practitioners should pay special attention to a client’s age, life phase and work history as a strategy to enhance the delivery of interventions that promote work participation. [ABSTRACT FROM AUTHOR]

Objective: Dairy products contain essential nutrients to ensure healthy growth and bone development in children. However, a significant proportion of children in developed countries fail to consume the daily recommended intake of dairy products. Parents are the gatekeepers of familial nutritional intake and represent a potential vehicle through which to increase dairy consumption in children. As such, formative research was conducted to gain insight into parents' perceived barriers to and benefits of purchasing and consuming dairy products and to develop innovative message content that could be utilized in future public health campaigns.Design: Seven in-depth group interviews were conducted in two phases between February and May 2015.Setting: Interviews were conducted in local recreational centres and libraries in British Columbia, Canada.Subjects: Mothers (n 21, mean age 38 (sd 5) years) and fathers (n 9, mean age 38 (sd 3) years) of children aged 4-10 years.Results: Parents perceived both positive and negative physical outcomes associated with consuming dairy. Lack of trustworthy information was a frequently discussed barrier theme to purchasing and consuming dairy products. Mothers were concerned about the cost of dairy products. Differences in purchasing and consumption strategies were reported between parents of children who consumed adequate dairy and those who did not. Parents believed the most appropriate communication channel was through print material.Conclusions: Messages targeting parents, as a means of increasing dairy consumption in children, should address barriers identified by parents. In addition, practical tips should be provided to promote purchasing and consumption of dairy products. [ABSTRACT FROM AUTHOR]

Purpose:Drawing from the tenets of transformational leadership theory, the purpose of this study was to examine the nature of effective peer mentoring of adults with a spinal cord injury (SCI) from the perspective of mentees. Methods:The study utilised a qualitative methodology (informed by a social constructionist approach), involving 15 adult mentees with a SCI (mean age = 47.2; mean time since injury = 14.5 years), in which data were obtained via semi-structured interviews. Results:The results revealed that effective mentoring, as used by mentors with SCIs, closely aligns with the core components of transformational leadership. Specifically, all four dimensions of transformational leadership (idealised influence, inspirational motivation, individualised consideration and intellectual stimulation) as displayed by mentors with a SCI were evident in their interactions with mentees. Participants who perceived their mentors to use transformational leadership behaviours reported increases in motivation, self-confidence, hope and overall well-being, relatedness with their mentor, greater comfort/acceptance of their situation, a redefined sense of their limitations, as well as greater engagement in various life pursuits. Conclusions:Displays of transformational leadership by peer mentors (i.e. transformational mentoring) were reported by mentees to be associated with a range of adaptive psychological and behavioural outcomes. The results have the potential to inform the development and dissemination of peer mentor-based interventions and initiatives.Implications for RehabilitationWithin the context of spinal cord injury (SCI) rehabilitation, positive peer mentorship is reflected in mentors’ use of transformational leadership behaviours (idealised influence, inspirational motivation, individualised consideration and intellectual stimulation).When SCI peer mentors use transformational leadership behaviours, mentees report a redefined sense of their limitations, and increased self-confidence, hope, motivation, acceptance, participation and overall well-being.The results of this study have the potential to inform future longitudinal and experimental research concerning the (causal) effects of peer mentoring on mentee outcomes. In particular, research should examine the effects of peer-mentorship training, informed by the tenets of transformational leadership theory, in relation to the mentee outcomes assessed in this qualitative study. [ABSTRACT FROM PUBLISHER]

Purpose: To test the hypothesis among people with spinal cord injury (SCI) that greater fulfillment of peer support needs to be associated with greater participation and life satisfaction. A secondary objective was to identify characteristics of people in great need of SCI peer support.Method: The participants consisted of a population-based sample of 1549 adults with SCI. The participants completed a survey with questions on peer support, participation, life satisfaction and provided demographic and SCI-related information. A secondary analysis of cross-sectional survey data was conducted. A set of regression analyses tested the primary purpose and a partition analysis was conducted to examine the secondary objective.Results: In regression analyses, peer support need fulfillment was positively associated with autonomous-outdoors participation (p < 0.05), health participation (p < 0.05), and work/education participation (p < 0.05), as well as life satisfaction (p < 0.001) after controlling demographic and SCI-related variables. However, peer support need fulfillment was not related with overall participation or other subdomains of participation: autonomy indoors, social relationships and family role. The number of unmet SCI-related needs, injury characteristics and education were associated with fulfillment of SCI peer support needs.Conclusions: The results provide some evidence that SCI peer support plays an important role in promoting participation and life satisfaction. Individuals with many SCI-related unmet needs are most likely to report a need for peer support.Implications for RehabilitationThe receipt of peer support after a spinal cord injury (SCI) is positively related to aspects of social participation and life satisfaction.Provision of peer support can play an important role in the SCI rehabilitation process.Education, injury-related characteristics, and the number of other unmet needs are factors that rehabilitation professionals can use to identify those in particular need of peer support.Rehabilitation professionals should encourage patients who have sustained an SCI, to participate in peer support programs. [ABSTRACT FROM PUBLISHER]

Public health restrictions caused by the COVID-19 pandemic have dramatically impacted children and youth's ability to engage in the recommended amount of physical activity (PA), sedentary behaviour (SB), and sleep ('movement behaviours') for optimal health. There is heightened concern of the impact of this sudden 'time out' of active play for our most vulnerable children and youth including those living with disabilities who have a higher prevalence of multiple chronic conditions and less access to PA. PURPOSE: To assess the acute and longer-term impact of COVID-19 restrictions on the movement behaviours and guideline adherence in Canadian children and youth with disabilities. METHODS: Parents of school-aged children and youth with disabilities completed an online survey to assess their child's previous 7-day PA, SB, and sleep. Parents' perceived changes in their child's movement behaviours between pre-COVID-19 and (a) April-May 2020 (time 1; N = 151) and (b) April-November 2020 (time 2; N = 87) were also assessed. Descriptive statistics were used to analyze child behavioural patterns and guideline adherence. RESULTS: At time 1, 5.3%, 13.2%, and 66.2% of children and youth met the individual guidelines for PA, SB, and sleep, respectively. Only 1.3% of children and youth met all three movement guidelines. Similarly, at time 2, 7.2%, 20.7%, and 66.3% of children and youth met the individual guidelines for PA, SB and sleep, respectively; none met all three movement guidelines. Parents reported their child to spend less time in both outdoor (60% vs. 62.1%) and indoor (46% vs. 60.9%) PA, and more time in recreational screen time (83.5% vs. 77%) across time 1 and 2, respectively. The majority of parents reported their child's sleep quantity and quality to be the same as pre-pandemic levels for both time 1 (53.1% and 57.3%) and time 2 (77.6% and 64.4%). CONCLUSIONS: These results show very concerning PA and SB profiles of children and youth with disabilities over the early and subsequent periods of the COVID-19 pandemic compared to pre-COVID-19. Immediate action at the programmatic and policy levels is need for more accessible and inclusive strategies to increase PA and reduce SB in this vulnerable population of children and youth. Supported by Canadian Tire Jumpstart Charities [ABSTRACT FROM AUTHOR]

This article summarizes the main findings from the papers included in this journal supplement. It consolidates the evidence currently available to inform and advance the development of physical activity guidelines for Canadians, and it highlights the specific needs of various population subgroups. The challenges of translating guideline information into effective and persuasive physical activity messages, of campaigns to disseminate messages and of related evaluations are underlined. Recommendations on how to proceed are based on the evidence base provided by this series of papers; the immediate next steps mandated by this initiative are outlined and priorities for future research are indicated. [ABSTRACT FROM AUTHOR]