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Canadian, municipally funded recreation/sport facilities typically have unhealthy food environments. Ontario, unlike some provinces, lacks a voluntary recreation facility nutrition policy. This study assessed the healthfulness of food environments and vending sales in 16 Ontario recreation/sport facilities and, secondarily, compared data from facilities within municipalities that banned versus permitted plastic bottled-water sales (water-ban, n = 8; water, n = 8) to test the nutritional effects of environmental policy. Concession and vending packaged food/beverage offerings and vending sales were audited twice, eighteen months apart. The products were categorized using nutrition guidelines as Sell Most (SM), Sell Sometimes (SS), and Do Not Sell (DNS). Both water and water-ban facilities offered predominantly (>87%) DNS packaged food items. However, proportions of DNS and SM concession and vending beverages differed (p< 0.01). DNS beverages averaged 74% and 88% of vending offerings in water and water-ban facilities, respectively, while SM beverages averaged 14% and 1%, respectively. Mirroring offerings, DNS beverages averaged 79% and 90% of vending sales in water versus water-ban facilities. Ontario recreation/sport facilities provided unhealthy food environments; most food/beverage offerings were energy-dense and nutrient-poor. Water bans were associated with increased facility-based exposure to DNS beverage options. A nutrition policy is recommended to make recreation facility food/beverage environments healthier and to mitigate unintended negative consequences of bottled-water bans.
Susan Caswell; Patti-Jean Naylor; Dana Olstad; Sara Kirk; Louise Mâsse; Kim Raine; Rhona Hanning. Recreation Facility Food and Beverage Environments in Ontario, Canada: An Appeal for Policy. International Journal of Environmental Research and Public Health 2021, 18, 8174 .
AMA StyleSusan Caswell, Patti-Jean Naylor, Dana Olstad, Sara Kirk, Louise Mâsse, Kim Raine, Rhona Hanning. Recreation Facility Food and Beverage Environments in Ontario, Canada: An Appeal for Policy. International Journal of Environmental Research and Public Health. 2021; 18 (15):8174.
Chicago/Turabian StyleSusan Caswell; Patti-Jean Naylor; Dana Olstad; Sara Kirk; Louise Mâsse; Kim Raine; Rhona Hanning. 2021. "Recreation Facility Food and Beverage Environments in Ontario, Canada: An Appeal for Policy." International Journal of Environmental Research and Public Health 18, no. 15: 8174.
In partnership with communities of the Williams Treaties First Nations in southern Ontario (Canada), we describe an approach to work with communities, and highlight perspectives of food security and sustainability, including priorities and opportunities to revitalize local food systems as a pathway to food security and food sovereignty. The objectives of our project were: (1) to build a shared understanding of food security and sustainability; and (2) to document community priorities, challenges and opportunities to enhance local food access. Utilizing an Indigenous methodology, the conversational method, within the framework of community-based participatory research, formative work undertaken helped to conceptualize food security and sustainability from a community perspective and solidify interests within the four participating communities to inform community-led action planning. Knowledge generated from our project will inform development of initiatives, programs or projects that promote sustainable food systems. The community-based actions identified support a path towards holistic wellbeing and, ultimately, Indigenous peoples’ right to food security and food sovereignty.
Ashleigh Domingo; Kerry-Ann Charles; Michael Jacobs; Deborah Brooker; Rhona Hanning. Indigenous Community Perspectives of Food Security, Sustainable Food Systems and Strategies to Enhance Access to Local and Traditional Healthy Food for Partnering Williams Treaties First Nations (Ontario, Canada). International Journal of Environmental Research and Public Health 2021, 18, 4404 .
AMA StyleAshleigh Domingo, Kerry-Ann Charles, Michael Jacobs, Deborah Brooker, Rhona Hanning. Indigenous Community Perspectives of Food Security, Sustainable Food Systems and Strategies to Enhance Access to Local and Traditional Healthy Food for Partnering Williams Treaties First Nations (Ontario, Canada). International Journal of Environmental Research and Public Health. 2021; 18 (9):4404.
Chicago/Turabian StyleAshleigh Domingo; Kerry-Ann Charles; Michael Jacobs; Deborah Brooker; Rhona Hanning. 2021. "Indigenous Community Perspectives of Food Security, Sustainable Food Systems and Strategies to Enhance Access to Local and Traditional Healthy Food for Partnering Williams Treaties First Nations (Ontario, Canada)." International Journal of Environmental Research and Public Health 18, no. 9: 4404.
The transition from elementary to secondary school is an emotionally and socially complex time when adverse behaviors appear, such as decreased levels of physical activity (PA). Behavioral and environmental factors that influence PA during this time are poorly understood. Therefore, we aimed to identify factors that influence PA as adolescents transition to secondary school. Qualitative interviews were conducted with a sample of 27 ethnically diverse child–parent dyads within the public-school system in British Columbia, Canada (50% boys, 68% mothers, 25% White). The interviews probed for environmental and behavioral factors in school, family, and social contexts that potentially initiated changes in PA, specifically related to the adolescents’ transitions. Interviews were recorded and transcribed verbatim. Thematic analyses identified factors at the individual, social, familial, and school levels that may trigger adolescents to change their participation in PA as they transition from elementary to secondary school. Twenty-two factors emerged from the qualitative analysis including school factors (8), household factors (3), social factors (4), and intrapersonal factors (7). These findings contribute to a better understanding of adolescents’ PA behaviors and highlight the influence of changing environments as they transition from elementary school to secondary school.
Tomoko McGaughey; Janae Vlaar; Patti-Jean Naylor; Rhona M. Hanning; Lucy Le Mare; Louise C. Mâsse. Individual and Environmental Factors Associated with Participation in Physical Activity as Adolescents Transition to Secondary School: A Qualitative Inquiry. International Journal of Environmental Research and Public Health 2020, 17, 7646 .
AMA StyleTomoko McGaughey, Janae Vlaar, Patti-Jean Naylor, Rhona M. Hanning, Lucy Le Mare, Louise C. Mâsse. Individual and Environmental Factors Associated with Participation in Physical Activity as Adolescents Transition to Secondary School: A Qualitative Inquiry. International Journal of Environmental Research and Public Health. 2020; 17 (20):7646.
Chicago/Turabian StyleTomoko McGaughey; Janae Vlaar; Patti-Jean Naylor; Rhona M. Hanning; Lucy Le Mare; Louise C. Mâsse. 2020. "Individual and Environmental Factors Associated with Participation in Physical Activity as Adolescents Transition to Secondary School: A Qualitative Inquiry." International Journal of Environmental Research and Public Health 17, no. 20: 7646.
The teenage pregnancy rate of 25% in Uganda is worrying though it may seem low compared to 28% in Sub-Saharan countries and West and Central Africa. Young mothers in Uganda risk poor maternal and child health, being isolated, attempting unsafe abortions, failure to continue with school, and poverty. This paper describes perceptions and recommendations of young mothers, family and community members on why the high rate of teenage pregnancies in Uganda and how these can be reduced. This qualitative research was conducted from March to May 2016 in six communities within Budondo sub-county (Jinja district), Eastern Uganda. In-depth oral interviews were conducted with 101 purposively sampled adolescent mothers, family members, and workers of government and non-government organizations. Thematic analysis framed around levels of influence within a social cognitive framework was conducted using Atlas-ti (version 7.5.4). Perceived determinants of teenage pregnancies include: lack of life and social survival skills, lack of knowledge on how to avoid pregnancy, low acceptance/use of contraceptives, neglect by parents, sexual abuse, pressure to contribute to family welfare through early marriage or sexual transactions, lack of community responsibility, media influence, peer pressure, cultural beliefs that promote early marriage/childbearing and lack of role models. Other contributing factors include drug use among boys, poverty, late work hours, long travel distances, e.g., to school, and unsupervised locations like sugarcane plantation thickets. Recommendations participants offered include: sensitization seminars and counselling for parents and girls, closing pornography outlets that accept entrance of minors, using the law to punish rapists, involvement of the President to campaign against early pregnancies, school dismissal before dark, locally accessible schools and job creation for parents to earn money to support the girls financially. Areas for capacity building are: training teachers and community members in transferring empowerment and vocational skills to girls, and construction of homes with separate rooms to support parents’ privacy. The factors associated with adolescent pregnancy in Uganda fall under individual, economic, social and physical environmental determinants. Recommendations spanning family, community and government involvement can ultimately empower girls, their families and community members, and support collective action to reduce teenage pregnancies.
Josephine Nabugoomu; Gloria K. Seruwagi; Rhona Hanning. What can be done to reduce the prevalence of teen pregnancy in rural Eastern Uganda?: multi-stakeholder perceptions. Reproductive Health 2020, 17, 1 -12.
AMA StyleJosephine Nabugoomu, Gloria K. Seruwagi, Rhona Hanning. What can be done to reduce the prevalence of teen pregnancy in rural Eastern Uganda?: multi-stakeholder perceptions. Reproductive Health. 2020; 17 (1):1-12.
Chicago/Turabian StyleJosephine Nabugoomu; Gloria K. Seruwagi; Rhona Hanning. 2020. "What can be done to reduce the prevalence of teen pregnancy in rural Eastern Uganda?: multi-stakeholder perceptions." Reproductive Health 17, no. 1: 1-12.
Canadian provincial governments have introduced voluntary nutrition guidelines for recreation and sport facilities to promote healthy dietary patterns in children. This paper presents baseline data from the Eat, Play, Live (EPL) randomized controlled trial to examine whether facilities in guideline provinces had greater capacity, more nutrition policies, and healthier food environments than facilities in a province without guidelines. Facility capacity, policy development, and food environment quality were measured and compared in guideline (GF; n = 32) and no guideline facilities (NoGF; n = 17) using ANOVA and Chi-square statistics. Healthfulness of vending and concession items were rated as Do Not Sell (least nutritious), Sell Sometimes or Sell Most (most nutritious). Facility capacity scores did not differ between GF and NoGF. A higher proportion of GF had facility-specific nutrition policies compared to NoGF. GF vending machines had healthier profiles than NoGF; including a lower proportion of Do Not Sell snacks and beverages, and a higher proportion of Sell Sometimes snacks and beverages and Sell Most beverages. GF concessions had healthier profiles than NoGF; with a lower proportion of Do Not Sell snacks and beverages, a higher proportion of Sell Sometimes snacks and Sell Most beverages, and higher food environment summary scores. Recreation and sport facilities in guideline provinces had more nutrition policies and healthier food environments than facilities in a province without guidelines. However, food environments were unhealthy regardless of guideline status which may promote correspondingly unhealthy dietary patterns among children. Clinical trials registration (retrospectively registered): ISRCTN14669997 Jul 3 2018.
Dana Lee Olstad; Rachel J.L. Prowse; Kim D. Raine; Dona Tomlin; Sara F. Kirk; Jessie-Lee D. McIsaac; Louise C. Mâsse; M. Susan Caswell; Rhona M. Hanning; Todd Milford; Patti-Jean Naylor. Baseline results from the Eat, Play, Live trial: A randomized controlled trial within a natural experiment examining the role of nutrition policy and capacity building in improving food environments in recreation and sport facilities. Food Policy 2020, 92, 101870 .
AMA StyleDana Lee Olstad, Rachel J.L. Prowse, Kim D. Raine, Dona Tomlin, Sara F. Kirk, Jessie-Lee D. McIsaac, Louise C. Mâsse, M. Susan Caswell, Rhona M. Hanning, Todd Milford, Patti-Jean Naylor. Baseline results from the Eat, Play, Live trial: A randomized controlled trial within a natural experiment examining the role of nutrition policy and capacity building in improving food environments in recreation and sport facilities. Food Policy. 2020; 92 ():101870.
Chicago/Turabian StyleDana Lee Olstad; Rachel J.L. Prowse; Kim D. Raine; Dona Tomlin; Sara F. Kirk; Jessie-Lee D. McIsaac; Louise C. Mâsse; M. Susan Caswell; Rhona M. Hanning; Todd Milford; Patti-Jean Naylor. 2020. "Baseline results from the Eat, Play, Live trial: A randomized controlled trial within a natural experiment examining the role of nutrition policy and capacity building in improving food environments in recreation and sport facilities." Food Policy 92, no. : 101870.
This study explored the influence of healthy vending contracts (HVC) on the nutritional quality of vending machine products in 46 Canadian publicly funded recreation and sport facilities. A quasi-experimental comparison design was used to examine the difference in nutritional quality of snack and beverage vending machine products at baseline (December 2015–May 2016) and 18-month follow-up. Staff Surveys assessed facility contract type (HVC or conventional) and vending machine audits identified product nutritional quality. Products were categorized by provincial guidelines as Do Not Sell (DNS), Sell Sometimes (SS) or Sell Most (SM). ANOVA compared categories cross-sectionally (HVC vs conventional) and repeated measures ANOVA compared them longitudinally (HVC-HVC, vs conventional-conventional and conventional-HVC). Approximately one quarter of contracts (24% beverage and 28% snack) had health stipulations at baseline or follow-up. Cross-sectionally, facilities with HVC at any time period had significantly lower percentage DNS (beverage: 56% vs 73%, p = 0.001; snack: 55% vs 85%, p < 0.001), higher SS (beverage: 24% vs 14%, p = 0.003; snack: 35% vs 12%, p < 0.001) and higher SM Products (beverage: 21% vs 13%, p = 0.030; snack: 10% vs 3%, p < 0.003). Longitudinally, facilities with consistent HVC or that changed to HVC showed greater decreases in DNS products over time (p < 0.050). Although less healthy products were still highly prevalent, facilities with HVC or that changed to HVC had fewer unhealthy products available in their vending machines over time compared to those without HVCs. Healthy vending contracts appear to be an effective change strategy.
Cassandra Lane; Patti-Jean Naylor; Dona Tomlin; Sara Kirk; Rhona Hanning; Louise Masse; Dana Lee Olstad; Rachel Prowse; Susan Caswell; Sherry Jarvis; Todd Milford; Kim Raine. Healthy vending contracts: Do localized policy approaches improve the nutrition environment in publicly funded recreation and sport facilities? Preventive Medicine Reports 2019, 16, 100967 .
AMA StyleCassandra Lane, Patti-Jean Naylor, Dona Tomlin, Sara Kirk, Rhona Hanning, Louise Masse, Dana Lee Olstad, Rachel Prowse, Susan Caswell, Sherry Jarvis, Todd Milford, Kim Raine. Healthy vending contracts: Do localized policy approaches improve the nutrition environment in publicly funded recreation and sport facilities? Preventive Medicine Reports. 2019; 16 ():100967.
Chicago/Turabian StyleCassandra Lane; Patti-Jean Naylor; Dona Tomlin; Sara Kirk; Rhona Hanning; Louise Masse; Dana Lee Olstad; Rachel Prowse; Susan Caswell; Sherry Jarvis; Todd Milford; Kim Raine. 2019. "Healthy vending contracts: Do localized policy approaches improve the nutrition environment in publicly funded recreation and sport facilities?" Preventive Medicine Reports 16, no. : 100967.
Background: Canadian provincial policies, like Ontario’s School Food and Beverage Policy (P/PM 150), increasingly mandate standards for food and beverages offered for sale at school. Given concerns regarding students leaving school to purchase less healthy foods, we examined student behaviours and competitive food retail around schools in a large urban region of Southern Ontario. Methods: Using a geographic information system (GIS), we enumerated food outlets (convenience stores, fast-food restaurants, full-service restaurants) within 500, 1000 and 1500 m of all 389 regional schools spanning years of policy implementation. Consenting grade 6–10 students within 31 randomly selected schools completed a web-based 24-h diet recall (WEB-Q) and questionnaire. Results: Food outlet numbers increased over time (p < 0.01); post-policy, within 1000 m, they averaged 27.31 outlets, with a maximum of 65 fast-food restaurants around one school. Of WEB-Q respondents (n = 2075, mean age = 13.4 ± 1.6 years), those who ate lunch at a restaurant/take-out (n = 84, 4%) consumed significantly more energy (978 vs. 760 kcal), sodium (1556 vs. 1173 mg), and sugar (44.3 vs. 40.1 g). Of elementary and secondary school respondents, 22.1% and 52.4% reported ever eating at fast food outlets during school days. Conclusions: Students have easy access to food retail in school neighbourhoods. The higher energy, sodium and sugar of these options present a health risk.
Rhona M. Hanning; Henry Luan; Taryn A. Orava; Renata F. Valaitis; James K. H. Jung; Rashid Ahmed. Exploring Student Food Behaviour in Relation to Food Retail over the Time of Implementing Ontario’s School Food and Beverage Policy. International Journal of Environmental Research and Public Health 2019, 16, 2563 .
AMA StyleRhona M. Hanning, Henry Luan, Taryn A. Orava, Renata F. Valaitis, James K. H. Jung, Rashid Ahmed. Exploring Student Food Behaviour in Relation to Food Retail over the Time of Implementing Ontario’s School Food and Beverage Policy. International Journal of Environmental Research and Public Health. 2019; 16 (14):2563.
Chicago/Turabian StyleRhona M. Hanning; Henry Luan; Taryn A. Orava; Renata F. Valaitis; James K. H. Jung; Rashid Ahmed. 2019. "Exploring Student Food Behaviour in Relation to Food Retail over the Time of Implementing Ontario’s School Food and Beverage Policy." International Journal of Environmental Research and Public Health 16, no. 14: 2563.
Recreation and sport facilities often have unhealthy food environments that may promote unhealthy dietary patterns among children. In response, some Canadian provinces have released voluntary nutrition guidelines for recreation and sport facilities, however implementation has been limited. Organizational capacity building may overcome barriers to implementing guidelines. Eat, Play, Live was a randomized controlled trial embedded within a natural experiment that tested the impact of an 18 month capacity building intervention (CBI) in enhancing implementation of provincial nutrition guidelines, and whether nutrition guidelines were associated with positive changes. Primary outcomes were facility capacity, policy development and food environment quality. Recreation and sport facilities in three guideline provinces were randomized into a guideline + CBI (GL + CBI; n = 17) or a guideline only comparison condition (GL-ONLY; n = 15). Facilities in a province without guidelines constituted a second comparison condition (NO-GL; n = 17). Facility capacity, policy development, and food environment quality (vending and concession) were measured and compared at baseline and follow-up across conditions using repeated measures ANOVA and Chi-square statistics. Healthfulness of vending and concession items was rated as Do Not Sell (least nutritious), Sell Sometimes or Sell Most (most nutritious). There were significant time by condition effects, with significant increases in facility capacity (mean ± SD: 30.8 ± 15.6% to 62.3 ± 22.0%; p < 0.01), nutrition policy development (17.6% developed new policies; p = 0.049), overall quality of the concession food environment (14.7 ± 8.4 to 17.5 ± 7.2; p < 0.001), and in the proportion of Sell Most (3.7 ± 4.4% to 11.0 ± 9.0%; p = 0.002) and Sell Sometimes vending snacks (22.4 ± 14.4% to 43.8 ± 15.8%; p < 0.001) in GL + CBI facilities, with a significant decline in Do Not Sell vending snacks (74.0 ± 16.6% to 45.2 ± 20.1%; p < 0.001). Significant improvements in facility capacity, policy development and food environment quality occurred in recreation and sport facilities that were exposed to nutrition guidelines and participated in a CBI. Outcomes did not improve in facilities that were only passively or not at all exposed to guidelines. Ongoing capacity building may enhance implementation of voluntary nutrition guidelines, however food environments remained overwhelmingly unhealthy, suggesting additional scope to enhance implementation. Clinical trials registration (retrospectively registered): ISRCTN14669997 Jul 3, 2018.
Dana Lee Olstad; Kim D. Raine; Rachel J. L. Prowse; Dona Tomlin; Sara F. Kirk; Jessie-Lee D. McIsaac; Louise C. Mâsse; M. Susan Caswell; Rhona M. Hanning; Todd Milford; Patti-Jean Naylor. Eat, play, live: a randomized controlled trial within a natural experiment examining the role of nutrition policy and capacity building in improving food environments in recreation and sport facilities. International Journal of Behavioral Nutrition and Physical Activity 2019, 16, 1 -16.
AMA StyleDana Lee Olstad, Kim D. Raine, Rachel J. L. Prowse, Dona Tomlin, Sara F. Kirk, Jessie-Lee D. McIsaac, Louise C. Mâsse, M. Susan Caswell, Rhona M. Hanning, Todd Milford, Patti-Jean Naylor. Eat, play, live: a randomized controlled trial within a natural experiment examining the role of nutrition policy and capacity building in improving food environments in recreation and sport facilities. International Journal of Behavioral Nutrition and Physical Activity. 2019; 16 (1):1-16.
Chicago/Turabian StyleDana Lee Olstad; Kim D. Raine; Rachel J. L. Prowse; Dona Tomlin; Sara F. Kirk; Jessie-Lee D. McIsaac; Louise C. Mâsse; M. Susan Caswell; Rhona M. Hanning; Todd Milford; Patti-Jean Naylor. 2019. "Eat, play, live: a randomized controlled trial within a natural experiment examining the role of nutrition policy and capacity building in improving food environments in recreation and sport facilities." International Journal of Behavioral Nutrition and Physical Activity 16, no. 1: 1-16.
For adolescent mothers in rural Eastern Uganda, nutrition and health may be compromised by many factors. Identifying individual and environmental needs and barriers at local levels is important to inform community-based interventions. This qualitative study used interviews based on constructs from social cognitive theory. 101 adolescent mothers, family members, health-related personnel and community workers in Budondo sub-county (Jinja district), eastern Uganda were interviewed. Young mothers had needs, related to going back to school, home-based small businesses; social needs, care support and belonging to their families, employment, shelter, clothing, personal land and animals, medical care and delivery materials. Barriers to meeting their needs included: lack of skills in income generation and food preparation, harsh treatment, pregnancy and childcare costs, lack of academic qualifications, lack of adequate shelter and land, lack of foods to make complementary feeds for infants, insufficient access to medicines, tailored health care and appropriate communications. Using the social cognitive framework, this study identified myriad needs of young mothers and barriers to improving maternal/child nutrition and health. Adolescent-mother-and-child-friendly environments are needed at local levels while continuing to reduce broader socio-cultural and economic barriers to health equity. Findings may help direct future interventions for improved adolescent maternal/child nutrition and health.
Josephine Nabugoomu; Gloria K Seruwagi; Kitty Corbett; Edward Kanyesigye; Susan Horton; Rhona Hanning. Needs and Barriers of Teen Mothers in Rural Eastern Uganda: Stakeholders’ Perceptions Regarding Maternal/Child Nutrition and Health. International Journal of Environmental Research and Public Health 2018, 15, 2776 .
AMA StyleJosephine Nabugoomu, Gloria K Seruwagi, Kitty Corbett, Edward Kanyesigye, Susan Horton, Rhona Hanning. Needs and Barriers of Teen Mothers in Rural Eastern Uganda: Stakeholders’ Perceptions Regarding Maternal/Child Nutrition and Health. International Journal of Environmental Research and Public Health. 2018; 15 (12):2776.
Chicago/Turabian StyleJosephine Nabugoomu; Gloria K Seruwagi; Kitty Corbett; Edward Kanyesigye; Susan Horton; Rhona Hanning. 2018. "Needs and Barriers of Teen Mothers in Rural Eastern Uganda: Stakeholders’ Perceptions Regarding Maternal/Child Nutrition and Health." International Journal of Environmental Research and Public Health 15, no. 12: 2776.
Human biomonitoring represents an important tool for health risk assessment, supporting the characterization of contaminant exposure and nutrient status. In communities where country foods (locally harvested foods: land animals, fish, birds, plants) are integrated in the daily diet, as is the case in remote northern regions where food security is a challenge, such foods can potentially be a significant route of contaminant exposure. To assess this issue, a biomonitoring project was implemented among Dene/Métis communities of the Dehcho region of the Northwest Territories, Canada. Participants completed dietary surveys (i.e., a food frequency questionnaire and 24-h recall) to estimate food consumption patterns as well as a Health Messages Survey to evaluate the awareness and perception of contaminants and consumption notices. Biological sampling of hair, urine and blood was conducted. Toxic metals (e.g., mercury, lead, cadmium), essential metals (e.g., copper, nickel, zinc), fatty acids, and persistent organic pollutants (POPs) were measured in samples. The levels of contaminants in blood, hair and urine for the majority of participants were below the available guidance values for mercury, cadmium, lead and uranium. However, from the 279 participants, approximately 2% were invited to provide follow up samples, mainly for elevated mercury level. Also, at the population level, blood lead (GM: 11 μg/L) and blood cadmium (GM: 0.53 μg/L) were slightly above the Canadian Health Measures Survey data. Therefore, although country foods occasionally contain elevated levels of particular contaminants, human exposures to these metals remained similar to those seen in the Canadian general population. In addition, dietary data showed the importance and diversity of country foods across participating communities, with the consumption of an average of 5.1% of total calories from wild-harvested country foods. This project completed in the Mackenzie Valley of the Northwest Territories fills a data gap across other biomonitoring studies in Canada as it integrates community results, will support stakeholders in the development of public health strategies, and will inform environmental health issue prioritization.
Mylène Ratelle; Kelly Skinner; Matthew Laird; Shannon Majowicz; Danielle Brandow; Sara Packull-McCormick; Michèle Bouchard; Denis Dieme; Ken D. Stark; Juan Jose Aristizabal Henao; Rhona Hanning; Brian D. Laird. Implementation of human biomonitoring in the Dehcho region of the Northwest Territories, Canada (2016–2017). Archives of Public Health 2018, 76, 73 .
AMA StyleMylène Ratelle, Kelly Skinner, Matthew Laird, Shannon Majowicz, Danielle Brandow, Sara Packull-McCormick, Michèle Bouchard, Denis Dieme, Ken D. Stark, Juan Jose Aristizabal Henao, Rhona Hanning, Brian D. Laird. Implementation of human biomonitoring in the Dehcho region of the Northwest Territories, Canada (2016–2017). Archives of Public Health. 2018; 76 (1):73.
Chicago/Turabian StyleMylène Ratelle; Kelly Skinner; Matthew Laird; Shannon Majowicz; Danielle Brandow; Sara Packull-McCormick; Michèle Bouchard; Denis Dieme; Ken D. Stark; Juan Jose Aristizabal Henao; Rhona Hanning; Brian D. Laird. 2018. "Implementation of human biomonitoring in the Dehcho region of the Northwest Territories, Canada (2016–2017)." Archives of Public Health 76, no. 1: 73.
Purpose: To conduct a qualitative evaluation of adjunct supports (brief motivational messaging regarding goals delivered by email/website, contact centre dietitian assistance) offered by EatRight Ontario (ERO) for users of a website-based nutrition/activity goal setting/tracking feature (eaTracker “My Goals”). Methods: One-on-one semi-structured interviews were conducted with My Goals users in Ontario (n = 18) and Alberta (n = 5) recruited via the eaTracker website and ERO contact centre dietitians (n = 5). Interview transcripts were analyzed using content analysis. Results: Participants had mixed experiences and perspectives with ERO motivational messaging. Messages targeted towards specific goals (e.g., tips, recipes) were generally well-liked, and generic messages (e.g., eaTracker login reminders) were less useful. No interviewed users had contacted ERO dietitians regarding goals, and dietitians reported encountering few callers asking for assistance while using My Goals. Limited user knowledge was one explanation for this finding. Participants provided suggestions to enhance these supports. Conclusion: Electronic motivational messaging and contact centre dietitian assistance have the potential to support achievement of goals set with website-based features. When considering using electronic messaging, researchers and practitioners should consider message content and delivery tailoring. Marketing that focuses on how contact centre dietitians can assist website users with their goals is needed when services are used in naturalistic settings.
Jessica R.L. Lieffers; Helen Haresign; Christine Mehling; José F. Arocha; Rhona M. Hanning. A Qualitative Evaluation of Contact Centre Dietitian Support and Electronic Motivational Messaging for eaTracker My Goals Users. Canadian Journal of Dietetic Practice and Research 2018, 79, 67 -73.
AMA StyleJessica R.L. Lieffers, Helen Haresign, Christine Mehling, José F. Arocha, Rhona M. Hanning. A Qualitative Evaluation of Contact Centre Dietitian Support and Electronic Motivational Messaging for eaTracker My Goals Users. Canadian Journal of Dietetic Practice and Research. 2018; 79 (2):67-73.
Chicago/Turabian StyleJessica R.L. Lieffers; Helen Haresign; Christine Mehling; José F. Arocha; Rhona M. Hanning. 2018. "A Qualitative Evaluation of Contact Centre Dietitian Support and Electronic Motivational Messaging for eaTracker My Goals Users." Canadian Journal of Dietetic Practice and Research 79, no. 2: 67-73.
The home food environment may be an important target for addressing adolescent obesity. The aim of this study was to investigate associations between aspects of the home food environment and the diets of adolescents who present for obesity treatment. Cross-sectional baseline data were collected from 167 overweight/obese adolescent-parent pairs participating in an e-health lifestyle modification intervention. Adolescent intake of specific foods (fruit and vegetables, total fat, sugar-sweetened beverages, desserts/treats, and snacking occasions) was assessed by three 24-h dietary recalls, while household factors were collected from adolescent and parent questionnaires. Structural Equation Modeling, controlling for relevant covariates, was used to examine the relationship between adolescent diet and the following household factors: parent modeling, parenting style, family meal practices, and home food/beverage availability. Findings reveal that few characteristics of the home food environment were associated with adolescent dietary intake. Greater home availability of high-fat foods was moderately associated with adolescent snack intake (β = 0.27, p < .001). Associations with fruit/vegetables and fat intake were small and some were in unexpected directions. Parent modeling of healthful food choices and healthier family meal practices were associated with lower availability of high-fat foods and treats in the home, but were not directly associated with adolescent diets. Parent modeling of healthy foods and positive mealtime routines might contribute to the healthfulness of foods offered in the homes of adolescents who are overweight/obese. Additional research is needed to better characterize the complex aspects of the household environment that influence adolescent diet.
Allison W. Watts; Susan I. Barr; Rhona M. Hanning; Chris Y. Lovato; Louise C. Mâsse. The home food environment and associations with dietary intake among adolescents presenting for a lifestyle modification intervention. BMC Nutrition 2018, 4, 1 -9.
AMA StyleAllison W. Watts, Susan I. Barr, Rhona M. Hanning, Chris Y. Lovato, Louise C. Mâsse. The home food environment and associations with dietary intake among adolescents presenting for a lifestyle modification intervention. BMC Nutrition. 2018; 4 (1):1-9.
Chicago/Turabian StyleAllison W. Watts; Susan I. Barr; Rhona M. Hanning; Chris Y. Lovato; Louise C. Mâsse. 2018. "The home food environment and associations with dietary intake among adolescents presenting for a lifestyle modification intervention." BMC Nutrition 4, no. 1: 1-9.
L’insécurité alimentaire et les maladies d’origine alimentaire constituent des enjeux importants au Canada, et on peut considérer les mesures de santé publique prises pour les résoudre comme des facteurs qui façonnent l’environnement alimentaire. De nouvelles données probantes allant dans le sens d'une interrelation entre ces deux domaines, l’objectif de cette étude était d'explorer comment, en Colombie-Britannique (Canada), les efforts en matière de sécurité alimentaire des collectivités et les pratiques de salubrité des aliments (ainsi que les problèmes de santé de la population associés) peuvent se recouper, puis d’interpréter ces résultats pour concevoir et construire un environnement alimentaire plus sain.
Kelsey A. Speed; Samantha B. Meyer; Rhona M. Hanning; Shannon E. Majowicz. « Très transformés, très emballés et très mauvais pour la santé... mais à faible risque » : exploration des liens entre sécurité des aliments et salubrité des aliments dans les collectivités. Promotion de la santé et prévention des maladies chroniques au Canada 2017, 37, 361 -372.
AMA StyleKelsey A. Speed, Samantha B. Meyer, Rhona M. Hanning, Shannon E. Majowicz. « Très transformés, très emballés et très mauvais pour la santé... mais à faible risque » : exploration des liens entre sécurité des aliments et salubrité des aliments dans les collectivités. Promotion de la santé et prévention des maladies chroniques au Canada. 2017; 37 (10):361-372.
Chicago/Turabian StyleKelsey A. Speed; Samantha B. Meyer; Rhona M. Hanning; Shannon E. Majowicz. 2017. "« Très transformés, très emballés et très mauvais pour la santé... mais à faible risque » : exploration des liens entre sécurité des aliments et salubrité des aliments dans les collectivités." Promotion de la santé et prévention des maladies chroniques au Canada 37, no. 10: 361-372.
Introduction Les agences provinciales, nationales et internationales de santé publique reconnaissent l’importance des politiques en matière de nutrition en milieu scolaire, qui contribuent à instaurer des environnements sains respectant les recommandations en matière d’alimentation saine à l’intention des jeunes. Le soutien à l’échelle de l’école d’un mode de vie sain reposant sur les piliers de l’approche globale de la santé en milieu scolaire (milieux social et physique; enseignement et apprentissage; politique de santé en milieu scolaire; partenariats et services) a été positivement associé à des améliorations encourageantes des comportements des élèves en matière de santé. Notre étude a utilisé l’approche globale de la santé en milieu scolaire pour classifier, comparer et décrire le soutien à une alimentation saine lors de la mise en oeuvre de la Politique de l’Ontario concernant les aliments et les boissons dans les écoles (N P/P 150). Méthodologie Nous avons recueilli des données provenant d’écoles élémentaires et secondaires consentantes d’une zone peuplée de l’Ontario à deux reprises, en 2012-2013 (période I) et en 2014 (période II). Des représentants des écoles ont rempli l’enquête Planificateur des écoles en santé ainsi qu’un document d’analyse environnementale de l’alimentation, qui ont fait l’objet d’une attribution de scores et d’analyses de contenu. Le soutien de chaque école en faveur d’une alimentation saine a été classé comme relevant de la phase « lancement », « prise de mesures » ou « maintenance » du continuum des écoles en santé pour les deux périodes, et comme étant « élevé/en hausse », « modéré », « faible/en baisse » entre la période I et la période II par rapport aux piliers de l’approche globale de la santé en milieu scolaire. Résultats Ont pris part à l’enquête 25 représentants scolaires (8 écoles élémentaires et 17 écoles secondaires). La plupart des écoles sont demeurées dans la catégorie « prise de mesures » (n = 20) au cours des deux périodes, avec des niveaux divers de soutien aux piliers de la santé en milieu scolaire. Le milieu physique a fait l’objet du soutien le plus élevé (100% de soutien « élevé/en hausse »), le milieu social a fait l’objet du soutien le plus faible (68 % de soutien « faible/en baisse »). Seules deux écoles ont atteint la plus haute note (maintenance) au cours de la période II. Les soutiens respectant la N P/P 150 semblent avoir été influencés par l’adhésion de l’administration, le soutien des intervenants et la pertinence du contexte local. Conclusion Une aide supplémentaire est nécessaire pour maintenir une alimentation saine dans les environnements alimentaires des écoles ontariennes.
Taryn Orava; Steve Manske; Rhona Hanning. Soutien en faveur de l’alimentation saine dans les écoles conformément à l’approche globale de la santé en milieu scolaire : évaluation au cours des premières années de la mise en oeuvre de la Politique de l’Ontario concernant les aliments et les boissons dans les écoles. Promotion de la santé et prévention des maladies chroniques au Canada 2017, 37, 338 -348.
AMA StyleTaryn Orava, Steve Manske, Rhona Hanning. Soutien en faveur de l’alimentation saine dans les écoles conformément à l’approche globale de la santé en milieu scolaire : évaluation au cours des premières années de la mise en oeuvre de la Politique de l’Ontario concernant les aliments et les boissons dans les écoles. Promotion de la santé et prévention des maladies chroniques au Canada. 2017; 37 (9):338-348.
Chicago/Turabian StyleTaryn Orava; Steve Manske; Rhona Hanning. 2017. "Soutien en faveur de l’alimentation saine dans les écoles conformément à l’approche globale de la santé en milieu scolaire : évaluation au cours des premières années de la mise en oeuvre de la Politique de l’Ontario concernant les aliments et les boissons dans les écoles." Promotion de la santé et prévention des maladies chroniques au Canada 37, no. 9: 338-348.
Nutrition mobile apps have become accessible and popular weight-management tools available to the general public. To date, much of the research has focused on quantitative outcomes with these tools (eg, weight loss); little is known about user experiences and perceptions of these tools when used outside of a research trial environment. Our aim was to understand the experiences and perceptions of adult volunteers who have used publicly available mobile apps to support nutrition behavior change for weight management. We conducted one-on-one semi-structured interviews with individuals who reported using nutrition mobile apps for weight management outside of a research setting. Twenty-four healthy adults (n=19 females, n=5 males) who had used publicly available nutrition mobile apps for weight management for ≥1 week within the past 3 to 4 months were recruited from the community in southern Ontario and Edmonton, Canada, using different methods (eg, social media, posters, and word of mouth). Interviews were audiorecorded, transcribed verbatim, and transcripts were verified against recordings. Data were coded inductively and organized into categories using NVivo, version 10 (QSR International). Participants used nutrition apps for various amounts of time (mean=approximately 14 months). Varied nutrition apps were used; however, MyFitnessPal was the most common. In the interviews, the following four categories of experiences with nutrition apps became apparent: food data entry (database, data entry methods, portion size, and complex foods); accountability, feedback, and progress (goal setting, accountability, monitoring, and feedback); technical and app-related factors; and personal factors (self-motivation, privacy, knowledge, and obsession). Most participants used apps without professional or dietitian support. This work reveals that numerous factors affect use and ongoing adherence to use of nutrition mobile apps. These data are relevant to professionals looking to better assist individuals using these tools, as well as developers looking to develop new and improved apps.
Jessica R.L. Lieffers; Jose F. Arocha; Kelly Grindrod; Rhona M. Hanning. Experiences and Perceptions of Adults Accessing Publicly Available Nutrition Behavior-Change Mobile Apps for Weight Management. Journal of the Academy of Nutrition and Dietetics 2017, 118, 229 -239.e3.
AMA StyleJessica R.L. Lieffers, Jose F. Arocha, Kelly Grindrod, Rhona M. Hanning. Experiences and Perceptions of Adults Accessing Publicly Available Nutrition Behavior-Change Mobile Apps for Weight Management. Journal of the Academy of Nutrition and Dietetics. 2017; 118 (2):229-239.e3.
Chicago/Turabian StyleJessica R.L. Lieffers; Jose F. Arocha; Kelly Grindrod; Rhona M. Hanning. 2017. "Experiences and Perceptions of Adults Accessing Publicly Available Nutrition Behavior-Change Mobile Apps for Weight Management." Journal of the Academy of Nutrition and Dietetics 118, no. 2: 229-239.e3.
Purpose: This study investigated relationships between psychosocial and treatment-related factors, diet, and weight change in women treated with chemotherapy for early-stage breast cancer. Methods: Comprehensive qualitative interviews were conducted with 28 women who were within 12 months of completing chemotherapy treatment. Results: Changes in food intake and eating patterns were universal over the course of chemotherapy, with broad variability in treatment effects and associated dietary responses linked to weight change. Increased appetite, food cravings, and intake of energy-dense comfort foods were more common among women who gained weight during treatment (n = 11). Changes in taste, nausea, and emotional distress were central in promoting these dietary responses. Women who lost weight during treatment (n = 6) tended to report more severe and persistent side effects of treatment leading to poor appetite and lower food intake, and they were more likely to live alone. Conclusions: While the etiology of weight change in this population is complex, this study suggests that changes in food intake related to treatment and psychosocial challenges may play an important role for some women. These findings may help to identify women who are most at risk of weight change during treatment and may inform the development of tailored dietary interventions.
Vivienne Vance; Sharon Campbell; Linda McCargar; Marina Mourtzakis; Rhona Hanning. The Voice of Experience: Diet and Weight Change in Women with Breast Cancer Associate with Psychosocial and Treatment-Related Challenges. Canadian Journal of Dietetic Practice and Research 2017, 78, 74 -80.
AMA StyleVivienne Vance, Sharon Campbell, Linda McCargar, Marina Mourtzakis, Rhona Hanning. The Voice of Experience: Diet and Weight Change in Women with Breast Cancer Associate with Psychosocial and Treatment-Related Challenges. Canadian Journal of Dietetic Practice and Research. 2017; 78 (2):74-80.
Chicago/Turabian StyleVivienne Vance; Sharon Campbell; Linda McCargar; Marina Mourtzakis; Rhona Hanning. 2017. "The Voice of Experience: Diet and Weight Change in Women with Breast Cancer Associate with Psychosocial and Treatment-Related Challenges." Canadian Journal of Dietetic Practice and Research 78, no. 2: 74-80.
Background: Dietitians are engaging with mobile health (mHealth) technologies, particularly with diet and nutrition apps in their patient care. Despite the plethora of apps available, the majority are not designed with a dietitian’s input. Objective: The aim of this study was to identify the user preferences of dietitians in relation to tools, resources, and design features for smartphone health apps that would support their dietetic professional practice and their patients. Methods: As part of a larger international Web-based survey of health-app use among dietitians, three open-ended responses were included for specific exploration of app design features and additional resources or tools that could guide the development of apps for use in dietetic practice and patient care. Inductive thematic analysis of responses was conducted using the qualitative data analysis program, NVivo version 11 (QSR International Pty Ltd), to understand the design preferences and features valued by dietitians. Results: The responses from 381 dietitian respondents were analyzed. Five key themes were identified. Dietitians wanted access to credible apps, suggesting that dietetic associations should have greater involvement in reviewing and endorsing evidence-based apps for use in dietary counseling. Improvements to the usability of apps, relating to their ease of use and design, were also raised, as self-monitoring of dietary behaviors using existing nutrition apps was deemed to be burdensome. Furthermore, apps providing dietitian-oriented support were favored, for example, those with the ability to streamline the dietary assessment process, so that dietitians could spend more time on dietary counseling and negotiating patient goals for dietary and lifestyle behavior change. Provision of patient-oriented support, such as functionality to tailor apps to patient-specific needs, was also considered important. Finally, respondents valued apps that could integrate into their work systems to enhance the quality of the dietitian-patient relationship. Conclusions: App developers should draw upon the features and characteristics valued by dietitians to guide their development of apps that support dietetic practice and enhance patient care. Moreover, to achieve better dietitian and patient-centered app design, it is imperative that app developers take a collaborative approach with dietitians, their professional associations, and their patients. [JMIR Mhealth Uhealth 2017;5(3):e40]
Juliana Chen; Jessica Lieffers; Adrian Bauman; Rhona Hanning; Margaret Allman-Farinelli. Designing Health Apps to Support Dietetic Professional Practice and Their Patients: Qualitative Results From an International Survey. JMIR mHealth and uHealth 2017, 5, e40 .
AMA StyleJuliana Chen, Jessica Lieffers, Adrian Bauman, Rhona Hanning, Margaret Allman-Farinelli. Designing Health Apps to Support Dietetic Professional Practice and Their Patients: Qualitative Results From an International Survey. JMIR mHealth and uHealth. 2017; 5 (3):e40.
Chicago/Turabian StyleJuliana Chen; Jessica Lieffers; Adrian Bauman; Rhona Hanning; Margaret Allman-Farinelli. 2017. "Designing Health Apps to Support Dietetic Professional Practice and Their Patients: Qualitative Results From an International Survey." JMIR mHealth and uHealth 5, no. 3: e40.
ObjectiveIn 2011, Dietitians of Canada added ‘My Goals’ to its website-based nutrition/activity tracking program (eaTracker®,http://www.eaTracker.ca/); this feature allows users to choose ‘ready-made’ or ‘write-your-own’ goals and to self-report progress. The purpose of the present study was to document experiences and perceptions of goal setting and My Goals, and report users’ feedback on what is needed in future website-based goal setting/tracking tools.DesignOne-on-one semi-structured interviews were conducted with (i) My Goals users and (ii) dietitians providing a public information support service, EatRight Ontario (ERO).SettingMy Goals users from Ontario and Alberta, Canada were recruited via an eaTracker website pop-up box; ERO dietitians working in Ontario, Canada were recruited via ERO.SubjectsMy Goals users (n23; age 19–70 years; 91 % female;n5 from Alberta/n18 from Ontario) and ERO dietitians (n5).ResultsDietitians and users felt goal setting for nutrition (and activity) behaviour change was both a beneficial and a challenging process. Dietitians were concerned about users setting poor-quality goals and users felt it was difficult to stick to their goals. Both users and dietitians were enthusiastic about the My Goals concept, but felt the current feature had limitations that affected use. Dietitians and users provided suggestions to improve My Goals (e.g. more prominent presence of My Goals in eaTracker; assistance with goal setting; automated personalized feedback).ConclusionsDietitians and users shared similar perspectives on the My Goals feature and both felt goal use was challenging. Several suggestions were provided to enhance My Goals that are relevant to website-based goal setting/tracking tool design in general.
Jessica Rl Lieffers; Helen Haresign; Christine Mehling; Jose F Arocha; Rhona M Hanning. The website-based eaTracker®‘My Goals’ feature: a qualitative evaluation. Public Health Nutrition 2016, 20, 859 -869.
AMA StyleJessica Rl Lieffers, Helen Haresign, Christine Mehling, Jose F Arocha, Rhona M Hanning. The website-based eaTracker®‘My Goals’ feature: a qualitative evaluation. Public Health Nutrition. 2016; 20 (5):859-869.
Chicago/Turabian StyleJessica Rl Lieffers; Helen Haresign; Christine Mehling; Jose F Arocha; Rhona M Hanning. 2016. "The website-based eaTracker®‘My Goals’ feature: a qualitative evaluation." Public Health Nutrition 20, no. 5: 859-869.
Little is known about use of goal setting and tracking tools within online programs to support nutrition and physical activity behaviour change. In 2011, Dietitians of Canada added "My Goals," a nutrition and physical activity behaviour goal setting and tracking tool to their free publicly available self-monitoring website (eaTracker® ( http://www.eaTracker.ca/ )). My Goals allows users to: a) set "ready-made" SMART (Specific, Measurable, Attainable, Realistic, Time-related) goals (choice of n = 87 goals from n = 13 categories) or "write your own" goals, and b) track progress using the "My Goals Tracker." The purpose of this study was to characterize: a) My Goals user demographics, b) types of goals set, and c) My Goals Tracker use. Anonymous data on all goals set using the My Goals feature from December 6/2012-April 28/2014 by users ≥19y from Ontario and Alberta, Canada were obtained. This dataset contained: anonymous self-reported user demographic data, user set goals, and My Goals Tracker use data. Write your own goals were categorized by topic and specificity. Data were summarized using descriptive statistics. Multivariate binary logistic regression was used to determine associations between user demographics and a) goal topic areas and b) My Goals Tracker use. Overall, n = 16,511 goal statements (75.4 % ready-made; 24.6 % write your own) set by n = 8,067 adult users 19-85y (83.3 % female; mean age 41.1 ± 15.0y, mean BMI 28.8 ± 7.6kg/m(2)) were included for analysis. Overall, 33.1 % of ready-made goals were from the "Managing your Weight" category. Of write your own goal entries, 42.3 % were solely distal goals (most related to weight management); 38.6 % addressed nutrition behaviour change (16.6 % had unspecific general eating goals); 18.1 % addressed physical activity behaviour change (47.3 % had goals without information on exercise amount and type). Many write your own goals were poor quality (e.g., non-specific (e.g., missing amounts)), and possibly unrealistic (e.g., no sugar). Few goals were tracked (<10 %). Demographic variables had statistically significant relations with goal topic areas and My Goals Tracker use. eaTracker® users had high interest in goal setting and the My Goals feature, however, self-written goals were often poor quality and goal tracking was rare. Further research is needed to better support users.
Jessica R. L. Lieffers; Helen Haresign; Christine Mehling; Rhona M. Hanning. A retrospective analysis of real-world use of the eaTracker® My Goals website by adults from Ontario and Alberta, Canada. BMC Public Health 2016, 16, 978 .
AMA StyleJessica R. L. Lieffers, Helen Haresign, Christine Mehling, Rhona M. Hanning. A retrospective analysis of real-world use of the eaTracker® My Goals website by adults from Ontario and Alberta, Canada. BMC Public Health. 2016; 16 (1):978.
Chicago/Turabian StyleJessica R. L. Lieffers; Helen Haresign; Christine Mehling; Rhona M. Hanning. 2016. "A retrospective analysis of real-world use of the eaTracker® My Goals website by adults from Ontario and Alberta, Canada." BMC Public Health 16, no. 1: 978.
OBJECTIVES: As part of an evaluation of Ontario’s School Food and Beverage Policy (P/PM 150) in a populous Ontario region, this research aimed to: 1) identify, describe and categorize beverages and snacks available for purchase in secondary school vending machines according to P/PM 150 standards; and 2) compare the number and percentage of beverages and snacks within P/PM 150 categories (Sell Most, Sell Less, Not Permitted) from Time I (2012/2013) to Time II (2014).METHODS: Representatives from consenting secondary schools assisted researchers in completing a Food Environmental Scan checklist in Times I and II. Sourced nutritional content information (calories, fats, sodium, sugars, ingredients and % daily values) was used to categorize products. The number and percentage of products in P/PM 150 categories were compared between Times by paired t-tests.RESULTS: Of 26 secondary schools participating in total, 19 participated in both Time periods and were included in the study. There were 75 beverages identified (59 Time I, 45 Time II), mostly water, juices and milk-based beverages; and 132 types of snacks (87 Time I, 103 Time II), mostly grain-based snacks, vegetable/fruit chips, and baked goods. A majority of schools offered one or more Not Permitted beverages (47% Time I, 58% Time II) or snacks (74% Time I, 53% Time II). Significantly more schools met P/PM 150 standards for snacks (p = 0.02) but not beverages in Time II.CONCLUSION: Full P/PM 150 compliance was achieved by few schools, indicating that schools, school boards, public health, and food services need to continue to collaborate to ensure nutrient-poor products are not sold to students in school settings.
Taryn Orava; Steve Manske; Rhona Hanning. Beverages and snacks available in vending machines from a subset of Ontario secondary schools: Do offerings align with provincial nutrition standards? Canadian Journal of Public Health 2016, 107, e417 -e423.
AMA StyleTaryn Orava, Steve Manske, Rhona Hanning. Beverages and snacks available in vending machines from a subset of Ontario secondary schools: Do offerings align with provincial nutrition standards? Canadian Journal of Public Health. 2016; 107 (4-5):e417-e423.
Chicago/Turabian StyleTaryn Orava; Steve Manske; Rhona Hanning. 2016. "Beverages and snacks available in vending machines from a subset of Ontario secondary schools: Do offerings align with provincial nutrition standards?" Canadian Journal of Public Health 107, no. 4-5: e417-e423.