Abstract Purpose This study examined whether body image self-discrepancy was a correlate of depressive symptoms among 556 early adolescents (45% girls; Mage = 11.65, SD = .94 years). Methods ...Participants completed self-report measures of their self-perceived actual and ideal body shapes and depressive symptoms. Sex-stratified polynomial regressions were used to examine the associations between depressive symptoms and (1) agreement (i.e., similar actual and ideal body shapes); (2) discrepancy (i.e., different actual and ideal body shapes); (3) direction of discrepancy (i.e., actual > ideal or actual < ideal); and (4) degree of discrepancy (i.e., how different actual and ideal body self-perceptions are). Results For both sexes, depressive symptoms were more frequent when the direction of the discrepancy was such that participants perceived their actual body was larger than their ideal body. Furthermore, depressive symptoms were more frequent when the degree of the discrepancy between actual and ideal body shape perceptions was larger. Conclusions Based on these findings, body image self-discrepancy may be a risk factor for depressive symptoms among early adolescents.
Children with unhealthy eating behaviours are more likely to experience poor physical and mental health. Few studies have investigated the importance of eating patterns for health-related quality of ...life (HRQoL) among children. This study aimed to identify common eating patterns, and their associations with HRQoL among Canadian children. Data were collected from 9150 grade five students (aged 10-11 years) in repeat cross-sectional population-based surveys in Alberta, Canada. Students' eating behaviours were analyzed using latent class analysis to identify the eating patterns. We applied multilevel multivariable logistic regression to examine the association of the eating patterns with HRQoL. We identified three groups of children with distinct eating patterns: eating healthy (52%), less healthy (31%) and unhealthy (17%). The first group had a higher proportion of students engaged in healthy eating behaviours. The unhealthy pattern group (third group) included a higher proportion of students with poor eating behaviours. Students' eating behaviours in the second group were healthier than the third group but less healthy than the first group. Children with unhealthy and less healthy patterns were more likely to experience lower HRQoL than children with the healthy pattern. Health promotion programs effective in improving healthy eating patterns may not only reduce the risk for chronic diseases in the long term, but also improve the HRQoL in the short term.
Objective
Excessive sugar consumption is an established risk factor for various chronic diseases (CDs). No earlier study has quantified its economic burden in terms of health care costs for treatment ...and management of CDs, and costs associated with lost productivity and premature mortality. This information, however, is essential to public health decision-makers when planning and prioritizing interventions. The present study aimed to estimate the economic burden of excessive free sugar consumption in Canada.
Methods
Free sugars refer to all monosaccharides and disaccharides added to foods plus sugars naturally present in honey, syrups, and fruit juice. Based on free sugar consumption reported in the 2015 Canadian Community Health Survey–Nutrition and established risk estimates for 16 main CDs, we calculated the avoidable direct health care costs and indirect costs.
Results
If Canadians were to comply with the free sugar recommendation (consumption below 10% of total energy intake (TEI)), an estimated $2.5 billion (95% CI: 1.5, 3.6) in direct health care and indirect costs could have been avoided in 2019. For the stricter recommendation (consumption below 5% of TEI), this was $5.0 billion (95% CI: 3.1, 6.9).
Conclusion
Excessive free sugar in our diet has an enormous economic burden that is larger than that of any food group and 3 to 6 times that of sugar-sweetened beverages (SSBs). Public health interventions to reduce sugar consumption should therefore consider going beyond taxation of SSBs to target a broader set of products, in order to more effectively reduce the public health and economic burden of CDs.
Unhealthy lifestyle behaviours are becoming increasingly common and might contribute to the growing burden of mental disorders in adolescence. We examined the associations between a comprehensive set ...of lifestyle behaviours and depression and anxiety in middle adolescents.
School-based survey responses were collected from 24,274 Canadian high school students at baseline and 1-year follow-up (average age 14.8 and 15.8 years, respectively). Using linear mixed-effects models, we examined prospective associations of adherence to recommendations for vegetables and fruit, grains, milk and alternatives, meat and alternatives, sugar-sweetened beverages SSB, physical activity, screen time, sleep, and no use of tobacco, e-cigarettes, cannabis, and binge drinking at baseline with the depressive and anxiety symptoms (measured by CESD-R-10 and GAD-7 scales, respectively) at follow-up.
Adherence to recommendations was low overall, particularly for vegetables and fruit (3.9%), grains (4.5%), and screen time (4.9%). Students adhering to individual recommendations, particularly for meat and alternatives, SSB, screen time, sleep, and no cannabis use, at baseline had lower CESD-R-10 and GAD-7 scores at follow-up. Adhering to every additional recommendation was associated with lower CESD-R-10 (β=-0.15, 95% CI -0.18, -0.11) and GAD-7 scores (β=-0.10, 95% CI -0.14, -0.07) at follow-up. Assuming cumulative impact, this might translate into 7.2- and 4.8-point lower CESD-R-10 and GAD-7 scores, respectively, among students adhering to 12 vs. 0 recommendations over four years of high school.
The results highlight the preventive potential of population-based approaches promoting healthy lifestyle behaviours, particularly those with the lowest prevalence, as a strategy to improve mental health in adolescence.
Introduction
An association between socioeconomic status (SES) and smoke-free private spaces among smokers could be due to heavier smoking among low SES smokers. We assessed whether quantity smoked ...or SES are independently associated with smoke-free homes or cars in daily smokers.
Method
Data were drawn from a cross-sectional telephone survey (2011–2012) of 750 daily smokers age ≥18 years in Quebec, Canada (45% response). Multivariable logistic regression was used to model the independent association between (a) number of cigarettes smoked per day, and (b) each of educational attainment, annual household income, or active employment status and smoke-free homes or cars.
Results
Participants were 41.0 years old on average, 57% were female. Median (IQR) number of cigarettes smoked per day was 14 (10, 20). Forty-eight percent of participants reported smoke-free homes; 34% reported smoke-free cars. Quantity smoked was strongly associated with both smoke-free homes and cars. Income and education (but not actively employed) were associated with smoke-free homes. None of the SES indicators were associated with smoke-free cars.
Conclusions
Interventions targeting smokers to promote smoke-free homes and cars should incorporate components to help smokers reduce quantity smoked or preferably, to quit. Interventions targeting smoke-free homes will also need to address SES inequalities by education and income. Our data suggest that reduction in quantity smoked may help smokers reduce SHS exposure in cars, but that an inequality lens may not be relevant.
Abstract
We documented changes in depressive and anxiety symptoms from before to during the COVID-19 pandemic among young adults and investigated whether changes differed across participant ...characteristics. Data were available in an investigation of 1294 grade 7 students recruited in 1999–2000. For this analysis, we used data collected pre-pandemically in 2017–20 (mean (SD) age = 30.6 (1.0)) and during the pandemic in 2020–21 (mean (SD) age = 33.6 (0.6)). 673 participants with data in both cycles were retained for analysis. Symptoms were measured using the Major Depression Inventory (MDI) and the Generalized Anxiety Disorder-7 (GAD-7) scale. Standardized mean differences (SMD) of changes in MDI and GAD-7 values between cycles were calculated across participant characteristics. On average, MDI scores increased by 2.1 (95%CI 1.4, 2.8) points during the pandemic from mean 10.5; GAD-7 scores increased by 1.2 (0.8, 1.5) points from mean 4.7. The SMD was 0.24 (0.14, 0.33) for MDI, and 0.24 (0.13, 0.34) for GAD-7. No differences in MDI change scores were observed across participant characteristics. Differences in GAD-7 change scores were observed by mood/anxiety disorder (SMD − 0.31 (− 0.58, − 0.05)), household income (0.24 (0.02, 48)), living with young children (− 0.56 (− 1.23,− 0.05)), and adherence to public health recommendations 0.58 (0.19, 1.03)). Increases in depressive and anxiety symptoms were observed 10–16 months into the COVID-19 pandemic among adults age 32–36.
To inform strategies aimed at improving blood pressure (BP) control and reducing salt intake, we assessed educational inequalities in high blood pressure (HBP) awareness, treatment and control; ...physician's advice on salt reduction; and salt knowledge, perceptions and consumption behaviours in Eastern Europe and Central Asia.
Data were collected in cross-sectional, population-based nationally representative surveys, using a multi-stage clustered sampling design. Five HBP awareness, treatment and control categories were created from measured BP and hypertension medication use. Education and other variables were self-reported. Weighted multinomial mixed-effects regression models, adjusted for confounders, were used to assess differences across education categories.
Nine Eastern European and Central Asian countries (Armenia, Azerbaijan, Belarus, Georgia, Kyrgyzstan, Republic of Moldova, Tajikistan, Turkey and Uzbekistan).
Nationally representative samples of 30 455 adults aged 25-65 years.
HBP awareness, treatment and control varied substantially by education. The coverage of physician's advice on salt was less frequent among participants with lower education, and those with untreated HBP or unaware of their HBP. The education gradient was evident in salt knowledge and perceptions of salt intake but not in salt consumption behaviours. Improved salt knowledge and perceptions were more prevalent among participants who received physician's advice on salt reduction.
There is a strong education gradient in HBP awareness, treatment and control as well as salt knowledge and perceived intake. Enhancements in public and patient knowledge and awareness of HBP and its risk factors targeting socio-economically disadvantaged groups are urgently needed to alleviate the growing HBP burden in low- and middle-income countries.
Objectives:
Children’s mental health and wellbeing declined during the first COVID-19 lockdown (Spring 2020), particularly among those from disadvantaged settings. We compared mental health and ...wellbeing of school-aged children observed pre-pandemic in 2018 and after the first lockdown was lifted and schools reopened in Fall 2020.
Methods:
In 2018, we surveyed 476 grade 4–6 students (9–12 years old) from 11 schools in socioeconomically disadvantaged communities in Northern Canada that participate in a school-based health promotion program targeting healthy lifestyle behaviours and mental wellbeing. In November-December 2020, we surveyed 467 grade 4–6 students in the same schools. The 12 questions in the mental health and wellbeing domain were grouped based on correlation and examined using multivariable logistic regression.
Results:
There were no notable changes pre-pandemic vs. post-lockdown in responses to each of the 12 questions or any of the sub-groupings.
Conclusion:
Supporting schools to implement health promotion programs may help mitigate the impact of the pandemic on children’s mental health and wellbeing. The findings align with recent calls for schools to remain open as long as possible during the pandemic response.
Introduction L’offre à long terme d’interventions de promotion de la santé (IPS) en milieu scolaire peut se révéler bénéfique pour la santé des enfants. Toutefois, on en sait peu sur les facteurs ...associés à cette institutionnalisation dans les écoles. Dans cette étude, nous avons dégagé les corrélats de l’institutionnalisation des IPS offertes dans les écoles primaires du Québec (Canada). Méthodologie Dans le cadre d’entrevues téléphoniques structurées en deux parties réalisées sur trois années scolaires (2016-2019), des directeurs et directrices d’écoles primaires (ou leurs représentants désignés) du Québec devaient choisir une IPS de référence ayant été offerte au moins une fois dans leur école dans les trois années précédentes. Ils devaient ensuite indiquer si l’IPS avait été institutionnalisée (c.-à-d. si elle figurait explicitement dans le projet éducatif de l’école, par exemple sous la forme d’objectifs éducatifs accompagnés des mesures permettant leur atteinte). Nous avons analysé les associations entre, d’une part, l’institutionnalisation des IPS et, d’autre part, dix caractéristiques liées aux écoles et seize caractéristiques liées aux IPS à l’aide d’analyses de régression logistique univariées et multivariées. Résultats Les informateurs clés des écoles (n = 163) ont fait état de 147 IPS différentes ayant été offertes dans leur école dans les trois années précédentes et 56 % de ces IPS avaient été institutionnalisées. Trois dimensions de la culture de l’école – soit 1) la participation des parents et de la collectivité à la vie scolaire, 2) l’engagement de l’école et du personnel enseignant à l’égard de la santé des élèves et 3) l’environnement physique de l’école – étaient associées positivement à l’institutionnalisation des IPS. En ce qui a trait aux caractéristiques liées aux IPS, ce sont le nombre de compétences visées par celles-ci, le nombre de stratégies d’enseignement utilisées, les modifications apportées à l’IPS avant ou pendant sa mise en oeuvre et le succès perçu de l’IPS qui ont présenté une association positive avec l’institutionnalisation des IPS. Le fait d’inviter les familles ou les groupes communautaires à participer à l’IPS était inversement associé à l’institutionnalisation. Conclusion Une meilleure compréhension des facteurs liés à l’institutionnalisation des IPS pourrait éclairer l’élaboration d’IPS présentant un potentiel de durabilité en milieu scolaire.
Purpose:
To explore the selection, use, and reporting of theories, models, and frameworks (TMFs) in implementation studies that promoted healthy eating in center-based childcare.
Data Source:
We ...searched 11 databases for articles published between January 1990 and October 2018. We also conducted a hand search of studies and consulted subject matter experts.
Study Inclusion and Exclusion Criteria:
We included studies in center-based settings for preschoolers that addressed the development, delivery, or evaluation of interventions or implementation strategies related to healthy eating and related subjects and that explicitly used TMF. Exclusion criteria include not peer reviewed or abstracts and not in English, French, German, and Korean.
Data Extraction:
The first author extracted the data using extraction forms. A second reviewer verified data extraction.
Data Synthesis:
Direct content analysis and narrative synthesis.
Results:
We identified 8222 references. We retained 38 studies. Study designs included quasi-experimental, randomized controlled trials, surveys, case studies, and others. The criteria used most often for selecting TMFs were description of a change process (n = 12; 23%) or process guidance (n = 8; 15%). Theories, models, and frameworks used targeted different socioecological levels and purposes. The application of TMF constructs (e.g., factors, steps, outcomes) was reported 69% (n = 34) of times.
Conclusion:
Reliance on TMFs focused on individual-level, poor TMF selection, and application and reporting for the development of implementation strategies could limit TMF utility.
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