A Coaching and/or Education Intervention Targeting Physical Activity and Nutrition Behaviours in Parents with Overweight/obesity and their Children

The purpose of this dissertation is to provide a detailed overview of, findings from, and experiences participating in a 3-month randomized controlled trial (RCT) targeting obesity-related behaviours in parents with overweight/obesity (body mass index [BMI] ≥ 25 kg/m2) and their children (2.5-10 years old, any weight; N = 50 dyads). A concurrent mixed methods study comprised of an RCT and descriptive qualitative design was utilized. Parent-participants received Co-Active Life Coaching (CALC) and webinar-based health education (intervention) or education only (control). To address the dissertation’s purpose, Chapter II provides a detailed methodological account of the program, including rationale and a description of utilized measures. Chapter III depicts a study exploring the impact of the program on the primary outcomes of physical activity (PA) and dietary intake of parents and children, parental motivation to engage in healthy behaviours, and parental perceptions of program improvements. To determine anthropometric impacts, parental BMI and waist circumference were included. Quantitative results were not statistically significant; however, decrease in sodium intake in intervention group parents showed a trend toward significance (p = 0.04) from baseline to 6-month follow-up. Qualitatively, parents in both groups reported increased awareness of health behaviours, diet and PA improvements, and positive program experiences. Some parents felt the webinars were reminders about healthy habits, whereas others felt the information was new and important. Finally, to understand both client and coach perspectives, and what might be needed to maximize this behaviour change approach, Chapter IV presents a qualitative exploration of the experiences of parents and coaches in the intervention group. Parents reported increased accountability for their behaviours, learning how to effectively set goals, working through root causes of their behaviours, and changing their perspectives. Coaches provided information on tools/techniques they most commonly used, insights into working with this population, and advice for future coaches. The findings from this study will allow researchers, coaches, and participants to better understand the foundations for a strong coaching partnership in the context of obesity-related health behaviour changes. Together, these chapters represent the first (to the researchers’ knowledge) CALC and/or health education intervention for parents with overweight/obesity and their children

Coaching and/or education intervention for parents with overweight/obesity and their children: Study protocol of a single-centre randomized controlled trial

Background: In Canada, a majority of children and adults are insufficiently active for health gains, and about one in seven children and over 20% of adults are overweight or obese. Overweight and obesity are risk factors for many chronic diseases in both adults and children and can result in lower quality and quantity of life. Children whose parents are overweight or obese are more likely to become overweight themselves. Thus, parent/child interventions are important for reducing obesity and promoting long-term healthy weights among members of the family unit. Programs using Co-Active coaching have resulted in positive behaviour changes among adults with overweight/obesity; however, little research has explored the effects of Co-Active coaching on parents, and the consequent impact on the family unit (i.e. all parents and children in the same household). This protocol paper provides a detailed methodological account of a coaching-based program targeting parent and child dyads, in hopes of enhancing health behaviours within the family unit. Methods: Using a randomized controlled trial design, the researchers aim to identify the impact of coaching plus education (intervention) compared to education only (control) on parents with overweight/obesity and their children (ages 2.5-10, of any weight). A total of 50 dyads are being recruited and randomly assigned using a 1:1 ratio into the control or intervention group. The control group receive 6 webinar-based education sessions focused on physical activity and nutrition. The intervention group receive the same education sessions and nine, 20-min telephone-based sessions with a certified coach. Coaching and health education sessions are conducted with the parent/guardian of the dyad. This paper provides a detailed methodological account of this program. Discussion: The expected findings from this research will advance coaching literature, research, and practice on this topic by determining whether coaching and education are more effective than education alone at producing behaviour changes among a family unit. If proven effective, this approach may be applied more broadly through public health interventionists to parent and child populations in hopes of affecting change with both individuals and their families. Trial registration: ISRCTN ISRCTN69091372. Retrospectively registered 24 September 2018

Perspectives and impact of a parent-child intervention on dietary intake and physical activity behaviours, parental motivation, and parental body composition: A randomized controlled trial

Adults and children in Canada are not meeting physical activity guidelines nor consuming sufficient nutrient-rich foods. High engagement in these unhealthy behaviours can lead to obesity and its associated diseases. Parent-child interventions aimed at obesity prevention/treatment have assisted families with making positive changes to their nutrition and physical activity behaviours. Given that the home environment shapes early health behaviours, it is important to target both parents and children when addressing diet and physical activity. One method that has been shown to improve health outcomes is co-active coaching. The current study explored the impact of a threemonth co-active coaching and/or health education intervention on the dietary intake and physical activity behaviours of parents with overweight/obesity and their children (ages 2.5–10; of any weight). Body composition (i.e., body mass index [BMI] and waist circumference), changes in parental motivation with respect to physical activity and dietary behaviours, and parental perceptions of program improvements were collected. A concurrent mixed methods study comprised of a randomized controlled trial and a descriptive qualitative design was utilized. Fifty parent-child dyads were recruited and randomly assigned to the control (n = 25) or intervention (n = 25) group. Assessments were completed at baseline, mid-intervention (six weeks), postintervention (three months), and six-month follow-up. A linear mixed effects model was utilized for quantitative analysis. Inductive content analysis was used to extract themes from parent interviews. No significant results were observed over time for the dependent measures. Parents in both control and intervention groups reported varied program experiences, including developing changes in perspective, increased awareness of habits, and heightened accountability for making positive changes in themselves, and consequently, their families. Parents also shared barriers they faced when implementing changes (e.g., time, weather, stress). Qualitatively, both groups reported benefitting from this program, with the intervention group describing salient benefits from engaging in coaching. This research expands on the utility of coaching as a method for behaviour change, when compared to education only, in parents with overweight/obesity and their children

Getting the Message Across : The Role of Technology-Enabled Knowledge Translation in Sports Medicine Research

An editorial message on the role of technology-enabled knowledge translation in sports medicine research.Medicine, Faculty ofPediatrics, Department ofReviewedFacult

Perspective From a Varsity Athlete Seeking Concussion Information to Help Recovery

The purpose of this paper is to share my experience, as a varsity rugby player, in seeking guidance and accurate and accessible concussion education and information through online web-based platforms after suffering multiple concussions. My experience is not unique; I am one of countless young adults who search the web for knowledge and information through online search engines for health-related advice. Young adults utilize the Internet for accurate and relevant health information, as the digital age has reshaped how one obtains relevant information to change their knowledge and behaviour. When my sports medicine physician informed me that I could not participate in rugby-related contact practices for six-months, I felt I needed more information on my brain’s recovery time following multiple concussions, and an explanation as to why I had to take so much time off to heal when physically I felt fine. Knowing that I would be missing provincial rugby tournaments and a tour to Ireland, I wanted to find answers beyond those provided by my healthcare provider. Throughout my search for information, I discovered a lot of information on concussions but I had troubles finding all the answers from one trusted and reputable source. In this commentary, I discuss my experience with concussions, how I used the internet to obtain credible information and what I found, how social media provided me with support, and why finding accurate concussion information is important for recovery.Medicine, Faculty ofPediatrics, Department ofArts, Faculty ofReviewedFacultyResearcherUndergraduat

Parents’ A priori Expectations of an Obesity Focused Intervention and What They Found Valuable from its Health Education Webinars

ABSTRACT Purpose: Explore parents with obesity’s: (1) a priori expectations of what they wanted to gain from participating in an obesity-focused intervention compared to (2) post-participation views of what was valuable from the webinar-based health education sessions. Design: A before and after descriptive study, baseline interviews gleaned parents’ motivations for program participation. Following 6 webinar-based health education sessions focused on physical activity (PA) and nutrition in the family unit, parents’ perceptions of what was valuable were collected. Setting: Community-dwelling members in southwestern Ontario. Participants: “Parents” (N=50) were adults with a body mass index of 25+ kg/m2 and had a child of any body composition, aged 2.5 – 10. Methods:  Inductive content analyses were employed on semi-structured qualitative interview transcripts and written responses to open-ended questions. Results: Wanting to provide a healthier life for their children was a prominent finding from parents’ baseline interviews. From the webinars, information on local PA resources and on creating positive food environments were especially valuable. In total, there were 7 themes and 4 sub-themes from the baseline interviews; 7 themes and 7 sub-themes from the PA webinars; and 7 themes and 11 sub-themes from the nutrition webinars. Conclusions: Parents found the webinars addressed various concepts they hoped to gain from their participation in the intervention. Results from these webinars can inform other parent-focused family interventions on important components when crafting future webinars. Keywords: parents, health education, obesity, overweigh

Concussion Awareness Training CATT for Health Practitioners : CATT Pilot Study & Evaluation

To pilot, evaluate, and disseminate the on-line Concussion Awareness Training Toolkit (CATT) for Health Practitioners to health care providers in British Columbia and beyond in order to establish standardized practice for the recognition, diagnosis, treatment and management of concussions at the provincial level.Medicine, Faculty ofPediatrics, Department ofOther UBCUnreviewedFacultyResearche

Outlining the Invisible: Experiences and Perspectives Regarding Concussion Recovery, Return-to-Work, and Resource Gaps

Appropriate supports and accommodations are necessary to ensure full concussion recovery and return-to-work (RTW). This research investigated barriers and facilitators to concussion recovery and RTW, and resource gaps reported by adults with concussion (‘workers’) and workplace and healthcare professionals (‘workplaces’). Semi-structured interviews and focus groups were conducted with workers (n = 31) and workplaces (n = 16) across British Columbia. Data were analyzed using inductive content analysis. Facilitators to workers’ concussion recovery and RTW included treatment, social support, and workplace and lifestyle modifications. To address barriers, both groups recommended: (a) widespread concussion and RTW education and training (b) standardized concussion recovery guidelines; (c) changing attitudes toward concussion; (d) mental health supports; and (e) increasing awareness that every concussion is unique. Findings can inform best practice for concussion recovery and RTW among professionals in workplaces, healthcare, occupational health and safety, and workers’ compensation boards.Medicine, Faculty ofNon UBCPediatrics, Department ofPopulation and Public Health (SPPH), School ofReviewedFacultyResearche