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The impact of large-scale, 'mass' community-based sport, and physical activity (PA) events on population PA has yet to be established. The enhancement of organizational capacity to support health promotion initiatives is one mechanism through which such events may be helpful. Sports Day in Canada (SDIC) is an annual, nation-wide event celebrating the role of sport within communities and promoting sport participation. Beginning in 2010, thousands of Canadian sport and PA organizations have created SDIC events each year. The objective of this study was to examine the types of organizations who participate in SDIC and to determine if and how these organizations benefit from hosting an event. Online surveys of event organizers (2010 to 2013 SDIC) were conducted. Descriptive analyses identified organization and event characteristics, and one-way ANOVAs across time assessed event organizers' perceptions related to their overall satisfaction, benefits obtained, and challenges faced while participating in SDIC. Findings showed that organizations were mainly from the provinces of Ontario, British Columbia, and Quebec, worked with children and youth, and registered an event that was a tournament or school based. There was a significant increase in overall satisfaction [F(3, 996) = 27.26, p <.001] and benefits obtained [F(3, 1000) = 18.36, p <.001] across all four years of SDIC. One main benefit reported by organizations was an increased awareness and interest among community members in sport program(s) offered by their organization. Mass events like SDIC may help enhance organizational capacity to deliver health promotion initiatives including sport and PA programming. [ABSTRACT FROM AUTHOR]

Background Children's independent mobility (CIM) is critical to healthy development in childhood. The physical layout and social characteristics of neighbourhoods can impact opportunities for CIM. While global evidence is mounting on CIM, to the authors' knowledge, Canadian data on CIM and related health outcomes (i.e., physical activity (PA) behaviour) are missing. To examine if CIM is related to multiple characteristics of accelerometry-measured PA behaviour (total PA, light PA, moderate-to-vigorous PA, time spent sedentary) and whether associations between CIM and PA behaviour systematically vary by place of residence, stratifying by gender and type of day/period (weekdays, after-school, weekend). Methods Participants were recruited through Project BEAT (Built Environment and Active Transport; www.beat.utoronto.ca). Children (n = 856) were stratified into four neighbourhood classifications based on the period of neighbourhood development (urban built environment (BE) (old BE) versus inner-suburban BE (new BE)) and socioeconomic status (SES; low SES and high SES). Physical activity was measured via accelerometry (ActiGraph GT1M). CIM was assessed via parental report and two categories were created (low CIM, n = 332; high CIM, n = 524). A series of two-factor ANOVAs were used to determine gender-specific differences in PA for weekdays, weekend days and the after-school period, according to level of CIM, across four neighbourhood classifications. Results Children who were granted at least some independent mobility (high CIM) had more positive PA profiles across the school week, during the after-school period, and over the weekend; they were also less sedentary. The influence of CIM on PA behaviour was particularly salient during the after-school period. Associations of CIM with PA varied by gender, and also by neighbourhood classification. CIM seemed to matter more in urban neighbourhoods for boys and suburban neighbourhoods for girls. Conclusion Our findings highlight the importance of independent mobility to multiple characteristics of children's PA behaviour across the week. Furthermore, they emphasize that independent mobility-activity relationships need to be considered by gender and the type of neighbourhood independent mobility is offered in. Future work will focus on developing a predictive model of CIM that could be used to inform decision-making around alleviating barriers to CIM. [ABSTRACT FROM AUTHOR]

This qualitative study asked individuals with schizophrenia to identify environmental factors in a psychiatric facility that influence their diet, physical activity, and ultimately weight. Participants took photographs of environmental elements they perceived to be obesogenic within the hospital and then participated in a semi-structured interview during which they were asked about the identified environmental elements. The Analysis Grid for Environments Linked to Obesity (ANGELO) framework was used for the analysis of data. Participants recommended individual and environmental approaches to address obesity. The ANGELO framework is a useful tool for identifying obesogenic factors, a process that can inform environmental interventions in psychiatric settings. [ABSTRACT FROM AUTHOR]

Objectives. School route measurement often involves estimating the shortest network path. We challenged the relatively uncritical adoption of this method in school travel research and tested the route discordance hypothesis that several types of difference exist between shortest network paths and reported school routes. Methods. We constructed the mapped and shortest path through network routes for a sample of 759 children aged 9 to 13 years in grades 5 and 6 (boys = 45%, girls = 54%, unreported gender = 1%), in Toronto, Ontario, Canada. We used Wilcoxon signed-rank tests to compare reported with shortest-path route measures including distance, route directness, intersection crossings, and route overlap. Measurement difference was explored by mode and location. Results. We found statistical evidence of route discordance for walkers and children who were driven and detected it more often for inner suburban cases. Evidence of route discordance varied by mode and school location. Conclusions. We found statistically significant differences for route structure and built environment variables measured along reported and geographic information systems-based shortest-path school routes. Uncertainty produced by the shortest-path approach challenges its conceptual and empirical validity in school travel research. [ABSTRACT FROM AUTHOR]

This paper describes a revised measure of self-efficacy to overcome barriers to moderate and vigorous physical activity in a sample of 484 high school students in Toronto, Ontario. The students had a mean age of 15.3 years. Principal axis factoring with oblique rotation yielded five factors: self-efficacy to overcome internal, harassment, physical environment, social mvironment, and responsibilities barriers. Two problematic items were removed, which resulted in a 22-item measure. Subsequent analyses were conducted on responses to this shortened measure. Confirmatory factor analysis supported the five-factor model and demonstrated age- and sexinvariance. The subscales had good internal consistency reliability. Structural regressions demonstrated a strong relationship between the resulting factors and a physical activity measure (energy expenditure), showing predictive validity. [ABSTRACT FROM AUTHOR]

Objective: To examine the prevalence and correlates of psychological distress in a school-based sample of Canadian adolescents. Method: Self-reported data of demographics, weight status, physical activity, screen-time, diet, substance use, and psychological distress were derived from a representative sample of 2935 students in grades 9 to 12 (Mage = 15.9 years) from the 2009 Ontario Student Drug Use and Health Survey. Results: Overall prevalence of psychological distress was 35.1%. Significant associations were shown between psychological distress and the following: being female, tobacco use, not meeting physical activity and screen-time recommendations, and inadequate consumption of breakfast and vegetables. Conclusions: These findings highlight the need for targeting greater physical health promotion for adolescents at risk of mental health problems. [ABSTRACT FROM AUTHOR]

Background: There is strong theoretical and empirical support for school connectedness as an important element of healthy youth development. The primary objective of this study was to replicate previous research identifying factors differentiating youth who do not feel connected to their schools in a sample of adolescents in Ontario, Canada. A secondary objective was to extend this work by assessing whether physical activity was an additional health behavior that differentiated youth who feel connected to their schools from those who do not. Methods: Data for this study were based on questionnaires from 2243 grade 7 to grade 12 students derived from the 2001 cycle of the Ontario Student Drug Use Survey. Logistic regression analysis was used to examine associations between physical activity, other health risk factors, and school disconnectedness. Results: The odds of feeling disconnected from their schools were substantially greater for female students who perceived their health or academic performance to be poor, engaged in no vigorous physical activity, reported 3 or more physician visits during the past year, and had low extracurricular involvement. None of the sociodemographic factors or substance use measures was significantly associated with school disconnectedness for any students. Conclusions: Our results highlight sex differences in how school disconnectedness is related to health-compromising behaviors such as physical inactivity. Further research is required to examine how boys and girls perceive, interpret, and internalize the school climate. Increasing school connectedness should be a consideration for academic administrators and health-promotion advocates. [ABSTRACT FROM AUTHOR]

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Abstract: Environmental measures that are designed to facilitate changes in opportunities for active school transport (AST) do not often account for individuals’ interpretations of the built environment (BE) in different urban contexts. The Built Environment and Active School Transport (BEAT) project was undertaken to explore the ways in which the transport-BE interface gives rise to the use of active or non-active travel modes as the primary travel mode for school trips. We wanted to know how children experienced and understood the transport-built environment relationship. We selected four Toronto elementary school sites in areas that differed with respect to socio-economic status and built environment. We conducted photovoice interviews with 41 children, 21 who walked to/from school, and 20 who were driven. Adopting a thematic analytic approach, this paper examines the similarities and differences in the visual narratives of children’s transport geographies and discusses some of the benefits of using photovoice with children in a study of the transport-built environment relationship. [Copyright &y& Elsevier]

Abstract: Interest in utilitarian sources of physical activity, such as walking to school, has emerged in response to the increased prevalence of sedentary behavior in children and youth. Public health practitioners and urban planners need to be able to survey and monitor walking practices in space and time, with a view to developing appropriate interventions. This study explored the prevalence of walking to and from school of 11–13 year olds in the Greater Toronto Area (GTA), Canada. The Getis–Ord (G i *) local spatial statistic, Markov transition matrices, and logistic regressions were used to examine the spatial clustering of walking trips in the study area, and to document any temporal drift of places in and out of walking clusters. Findings demonstrate that walking tends to cluster within the urban and inner-suburban GTA, and in areas with low household income. Temporally persistent cluster membership was less likely within inner-suburban and outer-suburban places. The evidence suggests that interventions to increase active school transportation need to acknowledge spatial and temporal differences in walking behavior. [Copyright &y& Elsevier]

Background: To date, no longitudinal population-based studies of school start times have been conducted within Canada. School schedule changes provided an opportunity to examine start times in association with youth sleep, physical activity, and screen use over time.Methods: This longitudinal study included grade 9-12 students attending 49 Ontario secondary schools that participated in at least two consecutive years of the COMPASS study (2012-2017). Fixed effects models tested whether differences in within-student change in self-reported sleep duration, moderate-to-vigorous physical activity, and screen time were associated with school start time changes, adjusting for student- (grade, sex, ethnicity, spending money) and school-level covariates (median income, urbanicity, geographical area).Results: Thirteen start time changes of 5-10 min were reported. Ten-minute advances at earlier clock times (8:30 AM-8:20 AM; 8:40 AM-8:30 AM) were associated with steeper sleep duration declines than schools with consistent start times but had no effect at later times (9:00 AM-8:50 AM). While sleep change did not differ with 5-min delays, 10-min delays (8:50 AM-9:00 AM) were associated with additional sleep (23.7 min). Apart from one school that shifted from 8:30 AM to 8:35 AM, in which screen time and physical activity decreased more steeply, no effect was found for screen time, and 5-min delays were associated with more physical activity (10.9 min) and advances with less activity (-8.0 min).Conclusions: Results support start time delays as a valuable strategy to help ameliorate sleep debt among youth. Interference with physical activity or increased screen time appear unlikely with modest schedule changes. Potential adverse impacts on sleep require consideration with 10-min advances. [ABSTRACT FROM AUTHOR]

This study examines whether access to alcohol and tobacco around the school relates to higher or lower odds of cigarette smoking and binge-drinking among Ontario high school students. The 2013 Ontario Student Drug Use and Health Survey provides data on self-reported smoking and drinking, individual covariates and subjective socio-economic status for 6142 students (grades 9-12) in Ontario, Canada. Locations of schools were geocoded and 1.6km network buffers defined the school neighbourhoods. Multi-level logistic regression examines individual and school neighbourhood factors with smoking and binge drinking as the dependent variable. Higher density of retail outlets increased the odds of smoking, but not the odds of binge-drinking. Older age, lower SES and being male increased the odds of smoking; while older age and being male also increased the odds of binge-drinking. Lower SES and higher population density decreased the odds of binge-drinking. Proximity to tobacco and alcohol outlets was not significant. Findings showed that a greater number of outlets in the school neighbourhood is significantly associated with higher odds of smoking, but not binge-drinking. School neighbourhood access to tobacco outlets should be considered when formulating policy interventions to reduce smoking for adolescents. [ABSTRACT FROM AUTHOR]

Purpose/Objectives: To describe and understand the perceptions of sedentary behavior (SED) and the interests and preferences for a SED intervention of men on androgendeprivation therapy (ADT) within a two-phase (formative and intervention research) feasibility study. Research Approach: Qualitative, descriptive. Setting: Princess Margaret Cancer Centre and Odette Cancer Centre, both in Toronto, Ontario, Canada. Participants: 27 men on ADT. Methodologie Approach: Men were recruited from prostate cancer clinics. Nine focus groups were conducted from November 2013 to April 2014 until data saturation was reached. Probe questions assessed perceptions regarding SED and preferences for a mobile SED intervention. Data were transcribed verbatim, and a thematic analysis was conducted. Findings: Twenty-seven men with a mean age of 73.5 years (SD = 8.1 years) volunteered for the study. Most men were aware of the health risks associated with SED, but most discussed SED in terms of increasing physical activity (PA). Many men were interested in a mobile application to reduce SED and expressed that the design should be easy to use, have an alerting function to interrupt sitting, have the ability to track and monitor PA levels, be tailored to the individual, and involve social support. Conclusions: These findings will inform the development and evaluation of a novel SED intervention to improve health outcomes in this population. Interpretation: Oncology nurses may serve as a motivational factor in encouraging men on ADT to reduce SED. [ABSTRACT FROM AUTHOR]

Objectives: Public health restrictions varied by region during the COVID-19 pandemic and reduced opportunities for children to be physically active. The purpose of this study was to assess regional differences in movement behaviours of Canadian children and youth during the second wave of the COVID-19 pandemic., Methods: A national sample of Canadian parents (n=1568; 58% women) of children and youth (5-17 years of age) completed an online survey. Participants were classified based on region of residence (British Columbia, Prairies, Ontario, Quebec, or Atlantic Canada). Differences in movement and play behaviours (physical activity, outdoor play, sleep, screen time) between children and youth living in different regions were examined., Results: Compared to children and youth in Quebec (the region with the highest COVID-19 prevalence), children and youth in the Prairies (F (1,1563) =9.0, p=0.01) and Atlantic Canada (F (1,1563) =17.1, p<0.001) participated in more moderate-to-vigorous physical activity (MVPA). Compared to Quebec, living in Atlantic Canada increased the odds of meeting the MVPA guideline (odds ratio (OR)=2.1, p=0.02), living in Ontario decreased the odds of meeting the sleep guideline (OR=0.6, p=0.01), and living in Ontario (OR=0.7, p=0.04) or Atlantic Canada (OR=0.6, p=0.049) decreased the odds of meeting the screen time guideline. Children and youth in Atlantic Canada demonstrated smaller declines in outdoor play than their counterparts in Quebec., Conclusion: Movement and play behaviours varied between regions of Canada where the highest COVID-19 prevalence corresponded to lower odds of meeting the physical activity guidelines. Low compliance with 24-hour movement guidelines suggests that regional pandemic recovery plans need to prioritize opportunities for healthy movement., (© 2022. The Author(s) under exclusive license to The Canadian Public Health Association.)

Physical activity questionnaires exist, but effective implementation in primary care remains an issue. We sought to develop a physical activity screen (PAS) for electronic medical record (EMR) integration by 1) identifying healthcare professionals' (HCPs), patients' and stakeholders' barriers to and preferences for physical activity counselling in primary care; and 2) using the information to co-create the PAS. We conducted semi-structured interviews with primary care HCPs, patients and stakeholders, and used content and thematic analyses to inform iterative co-design of the PAS. Interviews with 38 participants (mean age 41 years) resulted in 2 themes: 1) HCPs are willing to conduct physical activity screening, but acknowledge they don't do it well; and 2) HCPs have limited opportunity and capacity to discuss physical activity, and need a streamlined process for EMR that goes beyond quantifying physical activity. HCPs, patients and stakeholders co-designed a physical activity screen for integration into the EMR that can be tested for feasibility and effects on HCP behaviour and patients' physical activity levels. Novelty: EMR-integration of physical activity screening needs to go beyond just asking about physical activity minutes. Primary care professionals have variable knowledge and time, and need physical activity counselling prompts and resources. We co-developed a physical activity EMR tool with patients and primary care providers.

(1) Background: The Healthy Kids Community Challenge (HKCC) was a community-based obesity prevention intervention funded by the Government of Ontario (Canada). (2) Methods: A quasi-experimental design was used to examine the impact of the HKCC on physical activity (PA) outcomes using both repeat cross-sectional (T1 2014-2015, n = 31,548; T2 2015-2016, n = 31,457; and T3 2016-2017, n = 30,454) and longitudinal data (n = 3906) from the COMPASS study. Grade 9-12 students in HKCC communities were placed into one of three intervention groups [T2 data collection post-HKCC finishing (IG1), T2 data collection during HKCC (IG2), and T2 data collection pre-HKCC starting (IG3)], Ontario students in non-HKCC communities were Control Group 1 (CG1) and Alberta students were Control Group 2 (CG2). (3) Results: Repeat cross-sectional results show over time the HKCC had no significant impact on PA outcomes in any of the intervention groups. Longitudinal results show a significant decrease in time spent in moderate-to-vigorous PA (IG2: -3.15 min/day) between T1 and T3 in IG2. (4) Conclusions: These results suggest the HKCC did not have an impact on improving PA outcomes among older youth in HKCC communities. Moving forward, there is a need to provide effective and sustainable interventions to promote PA among older youth.

Background: There remains a need for prospective research examining movement behaviours in the prevention and management of mental illness. This study examined whether changes in adherence to the 24-h Movement Guidelines (moderate-to-vigorous physical activity [MVPA], sleep duration, screen time) were associated with depression symptoms among youth., Methods: Conditional change models were used to analyze two waves of longitudinal questionnaire data (2016/17, 2017/18) from students in grades 9-12 (N = 2292) attending 12 schools in Ontario and British Columbia, Canada, as part of the COMPASS study. One-year change in adherence to the MVPA, screen time, and sleep duration guidelines were modeled as predictors of depressive symptoms, adjusting for covariates and prior year depressive symptoms. Models were stratified by sex., Results: Continued adherence to sleep guidelines and transitioning from inadequate to sufficient sleep were associated with lower depressive symptoms than continued nonadherence, and continued adherence was associated with lower depression than transitioning from sufficient to short sleep. For screen time, transitioning from exceeding guidelines to guideline adherence was associated with lower depressive symptoms than continued nonadherence. MVPA guideline adherence was not associated with depression scores, when controlling for sleep and screen time guideline adherence change and covariates. When combined, meeting additional guidelines than the year prior was associated with lower depressive symptoms among females only., Conclusions: Adherence to the sleep guidelines emerged as the most consistent predictor of depression symptoms. Promoting adherence to the Movement Guidelines, particularly sleep, should be considered priorities for youth mental health at a population level.

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

Objectives: The purpose of this paper is to examine whether high school students in Ontario with asthma smoke cigarettes, waterpipes, marijuana or e-cigarettes more or less than those without asthma., Methods: The 2013 Ontario Student Drug Use and Health Survey provides self-report data on tobacco cigarettes, waterpipes, marijuana and e-cigarette smoking and asthma rates from 109 high schools in Ontario, Canada. Individual and social characteristics were also collected. Multiple binary logistic regression models measures the association with the various types of smoking in relation to asthma., Results: Adolescents with asthma have higher odds of smoking e-cigarettes or smoking any type including either cigarettes, waterpipes, marijuana or e-cigarettes. Respondents of lower socio-economic status had a higher odds of smoking marijuana or any type. Boys were more likely to smoke waterpipes, e-cigarettes or any type, while students in higher grades had a higher odds of smoking cigarettes, waterpipes, marijuana or any type., Conclusions: Results from this study suggest that adolescents with asthma have a higher odds of smoking e-cigarettes than those without asthma, but no relationship was found for cigarettes, waterpipes or marijuana. Findings present some new challenges as technology changes how adolescents can smoke. Public health campaigns should target adolescents, especially those with asthma, to raise their awareness of the risks of all types of smoking including e-cigarettes., (Copyright © 2016 Elsevier Ltd. All rights reserved.)

Objectives: Public health concern about increasing levels of child/youth overweight and obesity has resulted in initiatives to address this issue. In 2012, the Ontario Ministry of Health and Long-Term Care (MOHLTC) established a target to reduce childhood obesity by 20% within five years. In this paper, we examine trends and establish baseline levels of overweight/obesity to assess the impacts of population-level interventions., Methods: We analyzed 10 years (2003-2013) of data accumulated from six cycles of the Ontario Student Drug Use and Health Survey using logistic regression to assess trends in the prevalence of overweight/obesity among middle and high school students. The 2013 data are used to begin monitoring progress toward achieving the MOHLTC target., Results: From 2003 through 2013, the prevalence of overweight/obesity among middle school students in the province remained stable overall and among all subgroups except 7th-grade females, who showed a significant linear decline. Among high school students, the prevalence of overweight/obesity showed a significant linear increase and an increase among 11th graders, females, and 10th- and 11th-grade females specifically. The prevalence remained stable but elevated among 9th- and 12th-grade females as well as among males in all grades. In 2013 (baseline for the MOHLTC target), 25.1% of students in grades 7-12 were overweight or obese, implying a presumed 2018 target of 20.1%., Conclusion: Ten-year trends in overweight/obesity indicate stability among males and significant linear increases in some female subgroups. Also, baseline data (2013) will facilitate the monitoring of future interventions aimed at achieving the 2018 MOHLTC target.

Objective: The objective of this study is to assess the prevalence of overweight among 10-12-year-old South Asian children in comparison to non-South Asian children., Methods: This cross-sectional study obtained data from 16 schools in Toronto, Ontario. The analysis included 734 children (260 South Asian and 475 non-South Asian) aged 10-12 years. Height and weight were measured, and body mass index (BMI; kg/m(2)) was calculated according to age- and sex-specific cut points established by the International Obesity Task Force (IOTF)., Results: The prevalence of overweight was significantly higher among South Asian children when compared to non-South Asian children (36.9 vs. 23.0 %; p < 0.001). Unadjusted, South Asian children exhibited increased odds for being overweight (OR = 1.96; CI = 1.41-2.73; p < 0.001) compared to non-South Asian children and persisted after the adjustment for socio-demographic covariates but did not remain significant after the inclusion of physical activity and sedentary behaviour variables. The adjusted odds for being overweight was significantly higher among South Asian boys (but not girls) compared to their non-South Asian counterparts (OR = 2.45; CI = 1.32-4.55; p < 0.0001)., Conclusions: The prevalence of overweight differs by ethnic group and gender. South Asian boys have increased odds of being overweight compared to non-South Asian boys. Children of South Asian origin should receive focused attention in public health initiatives to reduce the risk of becoming overweight and the associated metabolic consequences.

Background: Walking to school is associated with higher levels of physical activity. The purpose of this study was to examine the relationship between school travel mode and physical activity using a sampling frame that purposefully locates schools in varying neighbourhoods., Methods: Cross-sectional survey of 785 children (10.57 ± 0.7 years) in Toronto, Canada. Physical activity was measured by accelerometry and travel mode was self-reported by parents. Linear regression models accounting for school clustering effects examined the associations between mode choice, BMI, and physical activity and were estimated adjusting for age, types of neighbourhoods and travel distance to school., Results: Significant associations between walking to school and moderate activity during weekdays were found. Interactions between walking to school and travel distance to school were found only in boys with significant associations between walking to school and higher physical activity levels in those living within 1000-1600 meters from school. Boys walking to school and living in this range accumulated 7.6 more minutes of daily MVPA than boys who were driven., Conclusions: Walking to school can make a modest but significant contribution to overall physical activity. This contribution was modified by travel distance and not school neighbourhood socioeconomic status or the built environment.

Objective: In 2005, the Ontario Ministry of Education announced a policy requiring that all elementary students be provided with opportunities to participate in a minimum of 20 minutes of sustained moderate-to-vigorous physical activity (MVPA) each school day during instructional time. To the authors' knowledge, this policy has never been formally evaluated. In a form of natural experiment with Project BEAT, we explored within 16 Toronto District School Board schools the proportion of children who participate in DPA, and the proportion who achieve sustained MVPA within these sessions; these are the objectives of this article., Methods: Consent was given by 1027 parents/guardians for their children to participate (boys, n=478; girls, n=549). Physical activity (PA) was measured using accelerometry and classroom schedules collected to identify sessions of DPA. The frequency of DPA and number and duration of sustained bouts of MVPA (> or =5 min) were computed and explored relative to PA levels and health outcomes., Results: Fewer than half of the participating children were provided with DPA every day and not a single child engaged in sustained MVPA for > or =20 minutes. On the more positive side, children who engaged in DPA every day were significantly more active than their peers. Those accumulating at least 1 bout of MVPA were more active and likely to meet PA guidelines, and fewer of these children were overweight., Conclusion: The majority of schools are not meeting the DPA policy. However, as the frequency and intensity of DPA increases, so do positive health outcomes. This paper provides supporting evidence that when this policy is implemented, the intended health benefits are achievable.

Background: Studies examining the correlates of school transport commonly fail to make the distinction between morning and afternoon school trips. The purpose of this study was to examine the prevalence and correlates of mode shift from passive in the morning to active in the afternoon among elementary and secondary school students in Ontario, Canada., Methods: Data were derived from the 2009 cycle of the Ontario Student Drug Use and Health Survey (OSDUHS). 3,633 students in grades 7 through 12 completed self-administered questionnaires. Socio-demographic, behavioural, psychological, and environmental predictors of active school transport (AST) were assessed using logistic regression., Results: Overall, 47% and 38% of elementary school students reported AST to and from school, respectively. The corresponding figures were 23% and 32% for secondary school students. The prevalence of AST varied temporarily and spatially. There was a higher prevalence of walking/biking found for elementary school students than for secondary school students, and there was an approximate 10% increase in AST in the afternoon. Different correlates of active school transport were also found across elementary and secondary school students. For all ages, students living in urban areas, with a shorter travel time between home and school, and having some input to the decision making process, were more likely to walk to and from school., Conclusions: Future research examining AST should continue to make the analytic distinction between the morning and afternoon trip, and control for the moderating effect of age and geography in predicting mode choice. In terms of practice, these variations highlight the need for school-specific travel plans rather than 'one size fits all' interventions in promoting active school transport.

The study aims were to examine (i) adolescents' attitudes towards family members who use a wheelchair in relation to other health problems and conditions, and (ii) the association between perceived wheelchair stigma and socio-demographic factors. Data were based on surveys from 2790 seventh to 12th grade students derived from the 2007 cycle of the Ontario Student Drug Use and Health Survey. Stigmatized attitudes towards a family member who required the use of a wheelchair (5.5%) were lower than those attitudes towards a family member who was addicted to drugs (68.3%), alcohol (54.9%), or gambling (53.7%), or who had mental illness (25.9%), and similar to those attitudes for a family member with asthma (2.2%). Grade level was the only significant negative correlate of the perceived wheelchair stigma. The perceived wheelchair stigma among the adolescents may not be a significant barrier towards community integration for wheelchair users.

Objective: This study describes temporal and spatial trends in active transportation for school trips in the Greater Toronto Area, Canada's largest city-region., Methods: Proportions of trips by travel mode to and from school were estimated and compared for children (11-13 years) and youth (14-15 years). Data were drawn from the 1986, 1996, 2001, and 2006 versions of the Transportation Tomorrow Survey (TTS)., Results: Between 1986 and 2006, walking mode share for trips to school declined (53.0%-42.5% for 11-13 year olds, 38.6%-30.7% for 14-15 year olds). Although there has also been a decline in walking home from school, walking rates were higher in the afternoon. In 2006, younger children in the suburbs walked less to school (36.1%-42.3% of trips) than 11-13 year olds in Toronto (48.1%) and Toronto's 14-15 year olds walked less (38.3% of trips) but used transit more (44.8% of trips) than students in the suburbs., Conclusion: The findings indicate a period of decline (1986-2006) in the use of active modes for journeys to and from school for both age groups. Policies and programs to increase active transportation should acknowledge the spatial, temporal, and demographic heterogeneity of school travel decisions and outcomes.

Many policy-related reviews of the potential social value of sport and physical activity list the prevention of juvenile delinquency. We examined the relationships among vigorous physical activity, self-esteem, and delinquent behavior among adolescents in a large cross-sectional survey of Ontario adolescents. Data are based on questionnaires from 3,796 students (range 11-20 years) derived from the 2005 Ontario Student Drug Use Survey. Negative binominal regression methods were used to estimate both additive and interactive models predicting delinquent behavior. Vigorous physical activity was positively associated with delinquent behavior; however, this pattern of association was observed only among male adolescents. There was no evidence of a mediating role for self-esteem. Our findings suggest that physical activity is not the solution for reducing juvenile delinquency.

Purpose: Adolescents spend considerable time at school and thus it is important to understand their opportunities for school-based physical activity. This study surveyed Ontario secondary schools to identify the range of structured opportunities and their engagement by students., Methods: A questionnaire was mailed to key informants in 600 randomly selected secondary schools in Ontario, for which 474 respondents (79%) returned completed questionnaires., Results: Curriculum-based physical education (PE) classes in grade nine were reported to be offered in all schools and these classes in grades 10, 11 and 12 were offered in almost all schools. Student enrollment in PE decreased from grades 9 to 12 (97.9%, 49.6%, 43.3% and 35.9%, respectively). Respondents reported that funding, timetable, facilities and resources made it somewhat difficult to implement the health and physical education curriculum in their schools. About two-thirds (65.5%) of the schools had an intramural program and 15.0% of students participated in it, whereas 97.2% of the schools had an inter-school sports program and 25.0% of students participated in it. Supervision issues made it difficult to provide intramural programs and funding made it difficult to provide inter-school sports programs., Conclusions: Although provision of physical activity opportunities in Ontario appears satisfactory, actual engagement by students is low. The results suggest that strategies to increase student participation in PE, intramural programs, and inter-school sports programs need further consideration.