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- Purpose: To explore knowledge, attitudes, and behaviour related to physical activity (PA) and sedentariness among registered dietitians (RDs) in family health teams in Ontario.Methods: This cross-sectional, descriptive study utilized a semi-structured interview guide to conduct qualitative interviews with 20 RDs. Self-administered questionnaires were used to assess personal PA (short version of the International Physical Activity Questionnaire) and sedentary behaviour (Sedentary Behavior Questionnaire).Results: Thematic analysis indicated that, in general, participants had good knowledge of PA and sedentariness. They were knowledgeable about the PA guidelines. They had positive attitudes toward PA and nonsedentariness, stating that both are important in the prevention and treatment of chronic conditions. Quantitative analysis indicated they had moderate-to-high PA levels and were fairly sedentary.Conclusions: This study supports the position that RDs can serve as excellent role models for PA. Though participants had basic knowledge, RDs may benefit from additional education regarding PA and sedentariness when counselling.
- Dawna Royall MSc, RD,
- Paula Brauer PhD, RD,
- Edwoba Atta-Konadu MSc,
- John J.M. Dwyer PhD,
- A. Michelle Edwards PhD, MLIS,
- Tracy Hussey MSc, RD, and
- Nick Kates MB, BS, FRCP(C)
Purpose: Both providers and patients may have important insights to inform the development of obesity prevention and management services in Canadian primary care settings. In this formative study, insights for new obesity management services were sought from both providers and patients in 1 progressive citywide organization (150 physicians, team services, separate offices).Methods: Seven focus groups with interprofessional health providers (n = 56) and 4 focus groups with patients (n = 34) were conducted. Two clinical vignettes (adult, child) were used to focus discussion. Four analysts coded for descriptive content and interpretative themes on possible tools and care processes using NVivo.Results: Participants identified numerous strategies for care processes, most of which could be categorized into 1 or more of 11 themes: 6 directed at clinical care of patients (raising awareness, screening, clinical care, skill building, ongoing support, and social/peer support) and 5 directed at the organization (coordination/collaboration, creating awareness among health professionals, adding new expertise to the team, marketing, and lobbying/advocacy).Conclusions: The approach was successful in generating an extensive list of diverse activities to be considered for implementation studies. Both patients and providers identified that multiple strategies and systems approaches will be needed to address obesity management in primary care.- Purpose: This qualitative study, guided by a phenomenological approach, explored senior-level undergraduate, nutrition students’ perceptions of how obesity and weight bias were addressed in the undergraduate curricula and how the curricula influenced their attitudes toward individuals with obesity.Methods: Twenty senior-level undergraduate, nutrition students from the University of Guelph participated in interviews. Interviews were audio-recorded and transcribed verbatim. Thematic analysis entailed open, axial, and selective coding.Results: Participants’ sources of information about obesity in the curricula included nutrition courses, case studies, and non-nutrition courses. Regarding sources of information about weight bias in the curricula, they discussed nutrition courses, non-nutrition courses, and limited coverage of weight bias. Themes for curricular influence on attitudes toward people with obesity were increased knowledge of obesity, understanding the complexity of obesity, increased empathy toward individuals with obesity, and better ability to avoid stereotypes toward people with obesity.Conclusions: The perceptions among nutrition students varied regarding the amount and type of obesity and weight-bias information in the curricula, as well as the influence of the curricula on attitudes toward individuals with obesity, suggesting that obesity and weight bias warrant more coordinated coverage in the nutrition curricula.
- Purpose: The clustering of specific health-related behaviours was examined among adolescents. Methods: In 2005, cluster analysis was conducted to identify homogeneous groups of Toronto, Ontario, 14- to 17-year-old adolescents (n=445) with similar behaviour patterns according to self-reported measures of moderate to vigorous physical activity (metabolic equivalent [MET] hours a week of MVPA), sedentary behaviours (viewing television or videos, using a computer/the internet, doing homework, and talking with friends), fruit and vegetable consumption, and alcohol consumption. Results: Three clusters of adolescents were identified: “active, high screen-time users,” “active, low screen-time users,” and “less active, least frequent drinkers.” Conclusions: Identifying clusters of adolescents with similar health-related behaviour patterns suggests that researchers and practitioners should develop and implement interventions tailored to specific clusters.
- Catherine Shea MAN, RD,
- John J. M. Dwyer PhD,
- Elizabeth Shaver Heeney MSc, RD,
- Richard Goy MA, and
- Janis Randall Simpson PhD, RD
Purpose: In this cross-sectional descriptive study, we explored the relationship of parental feeding practices and child physical activity levels with measured body mass index (BMI) in a sample of 97 Ontario preschoolers. Methods: Child weight and height were measured; physical activity and sedentary behaviours were assessed by questionnaire. Preschoolers’ parents used the Child Feeding Questionnaire to report their attitudes, concerns, and practices in relation to child feeding. Hierarchical multiple linear regression was used to determine relationships among variables. Results: Up to 25% of the preschoolers were overweight and/or obese. The regression model accounted for 53% of the variance in child BMI. Child BMI was predicted to be higher when parents had concerns about and perceived their children to be overweight, and when they felt responsible for what their children ate. Children's BMIs were predicted to be lower for those whose parents pressured them to eat and also for those who engaged in organized sports or activities. Conclusions: This study suggests an association between BMI and parental perceptions, concerns, and practices related to child feeding and organized sports or activities. Public health initiatives related to healthy eating and/or obesity prevention should include a focus on parents of preschool-aged children with the home environment as a potential setting.- Lesley A. Macaskill MHSc, RD,
- John J.M. Dwyer PhD,
- Connie L. Uetrecht MS, RD, and
- Carol Dombrow BSc, RD
Eat Smart! Ontario's Healthy Restaurant Program is a standard provincial health promotion program. Public health units grant an award of excellence to restaurants that meet designated standards in nutrition, food safety, and non-smoking seating. The purpose of this study was to assess whether program objectives for participating restaurant operators were achieved during the first year of program implementation, and to obtain operators’ recommendations for improving the program. Dillman's tailored design method was used to design a mail survey and implement it among participating operators (n = 434). The design method, which consisted of four mail-outs, yielded a 74% response rate. Fifty percent of respondents operated family-style or quick-service restaurants, and 82% of respondents learned about the program from public health inspectors. Almost all respondents (98%) participated in the program mainly to have their establishments known as clean and healthy restaurants, 65% received and used either point-of-purchase table stands or postcards to promote the program, and 98% planned to continue participating. The respondents’ suggestions for improving the program were related to the award ceremony and program materials, media promotion, communication, education, and program standards. Program staff can use the findings to enhance the program.- John J.M. Dwyer PhD,
- Lesley A. Macaskill MHSc, RD,
- Connie L. Uetrecht MS, RD, and
- Carol Dombrow BSc, RD
Eat Smart! Ontario’s Healthy Restaurant Program is a standard provincial health promotion program. Public health units give an award of excellence to restaurants that meet nutrition, food safety, and non-smoking seating standards. The purpose of this study was to determine why some restaurant operators have not applied to participate in the program, and how to get them to apply. Four focus group interviews were conducted with 35 operators who didn’t apply to participate. The analysis of responses yielded various themes. The participants’ perceived barriers to participation were misunderstandings about how to qualify for the program, lack of time, concern about different non-smoking bylaw requirements, and potential loss of revenue. Their perceived facilitators to participation were convenience of applying to participate, franchise executives’ approval to participate, a 100% non-smoking bylaw, flexibility in the assessment of restaurants, the opportunity for positive advertising, alternative payment for food handler training, and customer demand. Program staff can use the findings to develop and use strategies to encourage participation.- Purpose: The nutrition component of the Eat Smart! Workplace Cafeteria Program (ESWCP) in a hospital was evaluated. We assessed staff’s frequency of visits to and purchases in the hospital cafeteria, attitudes about the program, short-term eating behaviour change, and suggestions to improve the ESWCP. Methods: Questionnaires were sent to hospital staff members who were not on leave (n=504). Dillman’s Tailored Design Method was used to design and implement the survey. Four mail-outs were used and yielded a 51% response rate. Results: Eighty-seven percent of respondents visited the hospital cafeteria at least once a week in an average seven-day week, and 69% purchased one to five meals or snacks there each week. Eighty-six percent of respondents said that they were aware of the hospital’s program. Notices on cafeteria tables were the primary method of learning about the program (67%). Reported program benefits included increased knowledge about healthy eating, convenience of having healthy foods in the cafeteria, and increased energy. Conclusion: Many respondents were aware of the program, provided positive comments about it, and reported positive changes in eating habits. However, future observational research is warranted to note foods served and sold before and after program implementation, as well as to examine whether results can be generalized to other settings.
