A Conceptual Model of Rural Household Food Insecurity: A Qualitative Systematic Review and Content Analysis

This systematic review explores experiences of household food insecurity in rural areas of developed countries. A search of 5 databases resulted in 32 peer-reviewed articles for inclusion. Data were analyzed using directed content analysis to broaden the understanding of rural household food insecurity. Elements of food security (ie, availability, accessibility, acceptability, adequacy, and agency) were exemplified across the literature. In addition, 4 key themes were found: exercising human capital, realizing social capital, coping with compounding stressors, and navigating complex systems. This review demonstrates the need for interventions that improve social connectedness, individual coping skills, and system navigation

Parents as Agents of Change in the Treatment of Childhood Obesity and the Promotion of Children\u27s Health Behaviours

The overarching purpose of this dissertation was to investigate the role of parents as agents of change in the treatment of childhood obesity and the promotion of children’s health behaviours. In order to achieve this purpose, four studies were conducted. The purpose of Study 1 was to explore parents’ perceptions of nutritional literacy, as well as their needs for nutritional literacy information, supports, and resources at familial and community levels. Next, Study 2 described the theoretical components and model used in the development and implementation of a parent-focused childhood overweight and obesity intervention (i.e., C.H.A.M.P. Families). The purpose of Study 3 was to investigate the impact of the C.H.A.M.P. Families program on: (a) children’s standardized body mass index (BMI-z); and (b) parental self-efficacy for promoting children’s health behaviours. Finally, the aim of Study 4 was to explore parents’ perspectives of their experiences in and the influence of C.H.A.M.P. Families, as well as their recommendations related to future paediatric overweight and obesity treatment interventions. The findings presented in Study 1 showed that parents perceived nutritional literacy as having an understanding of nutrition and healthy eating, as well as having the skills to translate such knowledge into practice. All participants agreed that nutritional literacy was important, and the majority believed that it could be improved within their families. With regard to the resources parents identified as needing to enhance nutritional literacy in their families, professional advice, practical skills, kid-friendly recipes, and environmental information were identified. Food regulation, accessible community programming, and school-based policies and curriculum were the needs identified at the community level. In Study 2, the “C.H.A.M.P. Families” intervention was described in detail. This 13-week parent-focused program involved eight group-based (parent-only) educations delivered to parents of children aged 6-14 years with overweight or obesity (i.e., body mass index equal to or greater than the 85th percentile for age and sex). The program also included eight home-based (family) activities and two group-based (family) follow-up support sessions. In addition to a description of the intervention and feasibility analyses, Study 2 detailed the use of the unique theoretical framework that integrated evidence-based group dynamics principles and motivational interviewing techniques within the broader context of Social Cognitive Theory. Several practical examples related to the application of specific theoretical constructs and evidence-based strategies within a parent-focused paediatric obesity interventions were presented. In Study 3, the results demonstrated that the C.H.A.M.P. Families intervention had a small, positive effect on both parental self-efficacy for promoting child health behaviours and child BMI-z, from baseline to post-intervention. However, the results also showed that these improvements were not maintained at the 6-month follow-up. Finally, findings from Study 4 showed that C.H.A.M.P. Families was well-received by parents. Parents highlighted several positive outcomes for children and families and underscored specifically the importance of the group environment, content and materials, and additional program components (e.g., home visits). Many participants also noted important socioenvironmental and personal barriers related to health behaviour changes for themselves and their child(ren), and recommended that future programs emphasize greater child involvement and additional information and strategies

Impact of awareness and concerns of climate change on children\u27s mental health: a scoping review protocol

OBJECTIVE: The purpose of this scoping review is to identify and describe the existing literature on the impact of the overarching awareness and concerns of climate change on children\u27s mental health and well-being. INTRODUCTION: Children are widely acknowledged as being disproportionately at risk to the effects of climate change, yet research overlooks the impact that climate change has on their mental health. Children\u27s overarching awareness of climate change, and its global effects, may influence their mental health and well-being. INCLUSION CRITERIA: This review will include all research that addresses school-aged children\u27s (aged 3-19) mental-health issues stemming from an awareness of climate change. It will not include research that examines direct impacts of climate change on children\u27s mental health, such as trauma from a specific climate-related event. METHODS: Searches will be conducted across eight research databases (Cochrane Database of Systematic Reviews, CINAHL, Embase, GreenFILE, PubMed, PsycINFO, Web of Science, and Scopus) and three unpublished/gray literature databases (ProQuest Dissertations and Theses, GreyLit.org, and OpenGrey). Data will be extracted for author(s), year of publication, country of origin, purpose, population, methodology, concepts of interest, outcomes, and key findings relating to the scoping review objectives. Findings will be presented as a narrative summary

Review: The impact of climate change awareness on children\u27s mental well-being and negative emotions – a scoping review

Background: Climate change is a threat to children’s physical health, but there are also implications for mental well-being. Additionally, children may experience negative emotional responses stemming from an overarching awareness of the imminent threats to the planet due to climate change. Method: Using a scoping review, we examined the impact of climate change awareness on children’s mental well-being and negative emotions. Our aim was to identify and describe the existing literature and highlight priorities for future research. Three specific objectives guided the review: (1) to identify and provide an overview of research regarding the impact of climate change awareness on children’s mental well-being and negative emotions; (2) to summarize and clarify the terminology related to climate change awareness and children’s mental well-being and negative emotions; and (3) to make recommendations for areas of future research. Results: Thirty-three articles were included in a narrative synthesis. Many articles were reviews or editorials/commentaries. Of the empirical research, most were from Europe, North America, and Australia. The articles emphasized a large range of negative emotions that children felt about climate change, with anxiety and worry being the most researched and discussed. Conclusions: The research on the impact of awareness of climate change on children’s mental well-being and negative emotions is in its early phases. Efforts are needed to advance conceptual clarity and operationalize concepts. Additionally, there is a need for research into the impact of climate change awareness on children’s mental well-being and negative emotions among a greater diversity of people and places. Existing studies provide an encouraging basis from which to develop future research

Barriers to recruiting men into chronic disease prevention and management programs in rural areas: Perspectives of program delivery staff

Chronic disease is becoming increasingly prevalent in Canada. Many of these diseases could be prevented by adoption of healthy lifestyle habits including physical activity and healthy eating. Men, especially those in rural areas, are disproportionately affected by chronic disease. However, men are often underrepresented in community-based chronic disease prevention and management (CDPM) programs, including those that focus on physical activity and/or healthy eating. The purpose of this study was to explore the experiences and perceptions of program delivery staff regarding the challenges in recruitment and participation of men in physical activity and healthy eating programs in rural communities, and suggestions for improvement. Semistructured interviews were conducted by telephone with 10 CDPM program delivery staff from rural communities in Southwest Ontario, Canada. Time and travel constraints, relying on spouses, and lack of male program leaders were cited as barriers that contributed to low participation levels by men in CDPM programs. Hiring qualified male instructors and engaging spouses were offered as strategies to increase men’s participation. The results of this study highlight many of the current issues faced by rural health organizations when offering CDPM programming to men. Health care organizations and program delivery staff can use the recommendations in this report to improve male participation levels

Remembering Your Roots: The Role of Horticulture Therapy in People Living with Dementia

Introduction: Dementia is a debilitating disease affecting over 50 million people. Major challenges facing patients with dementia lie in the impact of the behavioral and psychological symptoms of dementia (BPSD). The American Geriatrics Society and Dementia Action Alliance recommend against the use of antipsychotics as first-line treatment. Antipsychotics often fail to treat BPSD whereas nonmedication practices such as horticulture therapy may lessen BPSD. Guideline evidence has provided a unique opportunity for public health officials to assist in filling this vital role in the approach to BPSD management.Methods: Several studies and meta-analyses were reviewed to determine the effectiveness of horticulture therapy in managing BPSD, and evidence supports horticulture therapy as an effective method of addressing BPSD.Results: The benefits of horticulture therapy extend beyond addressing only BPSD; through multisensory stimulation, patients have increased physical activity, reduced stress, and improved sleep. Horticulture therapy has been shown to decrease the sense of loss and reestablish the patient in a familiar nurturing role, providing the patient with a sense of purpose.Conclusion: Stakeholders within the public health sector are strategically positioned to implement evidence-based interventions that address the unmet needs for the care of dementia within the community

Physical activity and social connectedness interventions in outdoor spaces among children and youth: A rapid review

Introduction: The rise in sedentary behaviour, coupled with the decline in overall mental health among Canadian children and youth in recent decades, demonstrates a clear need for applied research that focusses on developing and evaluating cross-disciplinary interventions. Outdoor spaces provide opportunities for physical activity and social connectedness, making them an ideal setting to address these critical health concerns among children and youth. Methods: We conducted a rapid review of peer-reviewed (n = 3096) and grey literature (n = 7) to identify physical activity and/or social connectedness outdoor space interventions targeted at children and youth (19 years and under) in Australia and New Zealand, Canada, Europe and the United States. We determined if interventions were effective by analyzing their research design, confidence intervals and reported limitations, and then conducted a narrative synthesis of the effective interventions. Results: We found 104 unique studies, of which 70 (67%) were determined to be effective. Overall, 55 interventions targeted physical activity outcomes, 10 targeted social connectedness outcomes and 5 targeted both. Play (n = 47) and contact with nature (n = 25) were dominant themes across interventions, with most taking place in a school or park. We report on the identifying features, limitations and implications of these interventions. Conclusion: The incorporation of natural and play-focussed elements into outdoor spaces may be effective ways to improve physical activity and social connectedness. There is a considerable need for more Canadian-specific research. Novel methods, such as incorporating smartphone technology into the design and evaluation of these interventions, warrant consideration

Participants’ perceptions of “C.H.A.M.P. families”: A parent-focused intervention targeting paediatric overweight and obesity

Background: Recently, our team implemented a 13-week group-based intervention for parents of children with obesity (“C.H.A.M.P. Families”). The primary objective of this study was to explore, qualitatively, parents’ perspectives of their experiences in and influence of C.H.A.M.P. Families, as well as their recommendations for future paediatric obesity treatment interventions. Methods: Twelve parents (seven mothers, five fathers/step-fathers) representing seven children (four girls, three boys) with obesity participated in one of two focus groups following the intervention. Focus groups were audio recorded and transcribed verbatim and data were analyzed using inductive thematic analysis. Results: Findings showed that parents perceived their participation in C.H.A.M.P. Families to be a positive experience. Participants highlighted several positive health-related outcomes for children, families, and parents. Parents also underscored the importance and positive impact of the group environment, specific educational content, and additional program components such as free child-minding. Recommendations for future interventions were also provided, including greater child involvement and more practical strategies. Finally, parents identified several barriers including socioenvironmental issues, time constraints, and parenting challenges. Conclusions: Researchers developing family-based childhood obesity interventions should consider the balance of parent and child involvement, as well as emphasize group dynamics strategies and positive family communication

C.H.A.M.P. Families : Description and Theoretical Foundations of a Paediatric Overweight and Obesity Intervention Targeting Parents-A Single-Centre Non-Randomised Feasibility Study.

Childhood obesity represents a significant global health challenge, and treatment interventions are needed. The purpose of this paper is to describe the components and theoretical model that was used in the development and implementation of a unique parent-focussed paediatric overweight/obesity intervention. C.H.A.M.P. Families was a single-centre, prospective intervention offered to parents of children aged between 6⁻14 years with a body mass index (BMI) ≥85th percentile for age and sex. The intervention included: (1) eight group-based (parent-only) education sessions over 13-weeks; (2) eight home-based activities; and (3) two group-based (family) follow-up support sessions. The first section of the manuscript contains a detailed description of each intervention component, as well as an overview of ongoing feasibility analyses. The theoretical portion details the use of evidence-based group dynamics principles and motivational interviewing techniques within the context of a broader social cognitive theory foundation. This paper provides researchers with practical examples of how theoretical constructs and evidence-based strategies can be applied in the development and implementation of parent-focussed paediatric obesity interventions. Given the need for transparent reporting of intervention designs and theoretical foundations, this paper also adds to the areas of implementation science and knowledge translation research

Social media for research discourse, dissemination, and collaboration in rheumatology

Social media has become an important venue for rheumatologists, patients, organizations, and other stakeholders to discuss recent research advances in diagnosis and management of rheumatic disorders. In this article, we describe the current state of how social media may enhance dissemination, discourse, and collaboration in rheumatology research. Social media may refer to social platforms like Twitter and Instagram or digital media like podcasts and other websites that are operated for providing as free, open-access medical education (FOAM). Twitter has been one of the most active social media venues and continues to host a vibrant rheumatology community. Examples of research discussions on Twitter include organic user tweets, educational threads ( tweetorials ), live-tweeting academic conferences, and journals posting recently-accepted articles. Some research collaborations have been initiated through social media interactions. Social media may also directly contribute to research by facilitating the recruitment of study participants and the collection of survey-based data. Thus, social media is an evolving and important tool to enhance research discourse, dissemination, and collaboration in rheumatology