#LancerHealth: Using Twitter and Instagram as a tool in a campus wide health promotion initiative

The present study aimed to explore using popular technology that people already have/use as a health promotion tool, in a campus wide social media health promotion initiative, entitled #LancerHealth. During a two-week period the university community was asked to share photos on Twitter and Instagram of What does being healthy on campus look like to you?, while tagging the image with #LancerHealth. All publically tagged media was collected using the Netlytic software and analysed. Text analysis (N=234 records, Twitter; N=141 records, Instagram) revealed that the majority of the conversation was positive and focused on health and the university. Social network analysis, based on five network properties, showed a small network with little interaction. Lastly, photo coding analysis (N=71 unique image) indicated that the majority of the shared images were of physical activity (52%) and on campus (80%). Further research into this area is warranted

#orthorexia on Instagram: Exploring the online conversation and community using the Netlytic software

Background: Orthorexia nervosa is the pathological obsession for consuming only biologically pure food that may lead to the development of specific ritualistic attitudes towards food preparation and the restriction of specific food groups that can be harmful to one’s health (Zamora et al., 2005; Matera, 2012). Aim: Due to the rise in popularity with Instagram and online eating disorder communities, and the potential negative outcomes on psychosocial health, the purpose of this descriptive study was to investigate images tagged with #orthorexia on Instagram over 7 days. Methods: A mixed methods approach was utilized for this study. A text analysis was conducted using the Netlytic program (Gruzd, 2016) to explore for emerging themes of discussion specifically using word count frequency, and a network analysis using both a name network (i.e., who mentions whom) and a chain network (i.e., who replies to whom) was performed. Among a subsample of images, author/image information was manually obtained, and a coding scheme (adapted from Tiggemann and Zaccardo, 2016) was implemented for a subsample of images (results pending). Results: Among the 4,533 records downloaded, there were 48,780 unique words associated with the posts (in the description of the picture or in the comment section). Majority of most commonly used words were associated with eating disorder recovery (i.e., 425 instances of #edrecovery; 340 instances of #recovery; 297 instances of #eatingdisorderrecovery). The chain network/direct interactions analysis indicated a large online presence with 1,503 nodes (i.e., users) and 1,803 ties (i.e., direct replies between users). The coding of #orthorexia images is pending but will help us further understand the orthorexia online community. Conclusions: As the network analysis and text analysis suggested an eating disorder recovery theme, this suggests that Instagram may be being used as a supportive and interactive community for those who have/had symptoms of orthorexia

Family Meal Influence on Dietary Quality of Students in Grade Six, Seven, and Eight from Ontario and Nova Scotia

In 2004, Ontario’s Chief Medical Officer of Health Report, Healthy Weights, Healthy Lives (Ministry of Health and Long Term Care, 2004) identified the family (as well as the government, food industry, workplaces, schools, and individuals) for recommendations for action. As a means to promote, achieve, and maintain healthy body weights for both parents and children, Healthy Weights, Healthy Lives (2004) recommended enjoying family meals whenever possible. Very little evidence, however, exists to justify the promotion of family meals within Canada. Therefore, the purpose of this thesis was to describe family meal frequency and meal environments, and to examine the associations with diet quality (as assessed using a Canadian adaptation to the Health Eating Index (HEI-C; Glanville and McIntyre, 2006), and other commonly reported food behaviours and attitudes. The sample (males=1572 and females=1627) comprised students in grade six (n=1266), seven (n=1359), and eight (n=579) classrooms from Northern Ontario (Porcupine Region n=385), Southern Ontario (Peel Region n=1413, Region of Waterloo n=405, Toronto District n=216), and Nova Scotia (as part of the Physical Activity in Children and Youth (PACY) study n=804) participating in school surveillance-based studies. Data were collected using the web-based Food Behaviour Questionnaire, which included a 24 hour food recall, food frequency questionnaire, and specific questions relating to family meals. The majority of participants reported frequent family meals (70% on 6-7 days/week, 19% on 3-5 days/week, and 11% on 0-2 days/week). Family meal frequency decreased with increasing grade (X2=30.629 (df=4), p<0.001), and was significantly higher among participants from Porcupine, and lower among participants from Peel (X2=46.815 (df=8), p<0.001). The mean HEI-C score across all participants was 65.1 (SD 13.2) and the majority (73%) were rated in the needs improvement category. Family meal frequency, particularly between 0-2 and 6-7 days/week, was positively associated with diet quality scores (adjusted p=0.045) and ratings (p=0.049). When investigating the person(s) with whom meals were consumed, participants who ate breakfast with family members (versus alone, p=0.012) and/or lunch with friends (versus alone, p=0.007 or with family members, p<0.001) had a significantly greater likelihood of having a better diet quality. Participants who skipped breakfast (p<0.001) and/or lunch (p<0.001) had a greater likelihood of having a worse diet quality than those that consumed each meal. Cluster K-means procedures were used to classify observations about the four meal environment variables (where the meal was consumed, with whom the meal was consumed, who prepared the meal, and where the food was originally purchased) into groups. A total of 3, 8, and 6 clusters of meal environments were identified for breakfast, lunch, and dinner, respectively. Diet quality was negatively associated with consuming/purchasing meals outside of the home, and skipping breakfast and/or lunch. Meal skipping had a larger impact on overall diet quality than the environmental conditions under which the meal was consumed. Finally, associations among family meal frequency and other commonly reported food behaviours and attitudes were investigated. Higher family meal frequency was significantly associated with less pop consumption, consuming breakfast on the day of the survey, having higher self-efficacy for healthy eating when at home with family and during social times with friends. This research, in a large, geographically diverse sample of grade six, seven, and eight students from Ontario and Nova Scotia, found that family meal frequency and specific aspects of meal environments were positively associated with diet quality, and various healthy eating behaviours and attitudes. This research supports the growing body of literature in favour of family meals. Since the diet of most students in grade six, seven, and eight was suboptimal, strategies to promote healthy family meals should be widely encouraged

Examining Elementary School Children’s Knowledge about Food and Nutrition in Southwestern Ontario, Canada

Purpose: Knowledge is fundamental to helping children make nutritional choices that support lifelong healthy behaviours. This study (i) investigates elementary school children’s knowledge about food and nutrition and (ii) identifies sociodemographic factors influencing children’s reported knowledge. Methods: In 2017–2019, a survey was administered to 2443 students (grades 5–8) at 60 schools across southwestern Ontario, Canada, and a parent survey was used to validate self-reported sociodemographics. Multiple regression was used to analyse children’s knowledge scores and related sociodemographic factors. A total knowledge score was calculated by summing correct responses derived from 46 individual questions in the student survey. Results: Mean total knowledge score was 29.2 out of a possible 46 points (63.5% correct). Students demonstrated some knowledge and awareness of strategies to encourage fruit and vegetable consumption, healthy food selection, nutrition, and food preparation skills, although knowledge of food guide recommendations and locally sourced produce were limited. Female sex, family income, and rurality were associated with higher knowledge scores. Conclusions: Results provide insight regarding strengths and gaps in elementary-school children’s food and nutrition knowledge. Poor performance of students on specific food guide-related questions suggests that the general guidance of the 2019 Canada’s Food Guide might be better understood by children and adolescents

Exploring the role of in-person components for online health behavior change interventions: Can a digital person-to-person component suffice?

© Sara Santarossa, Deborah Kane, Charlene Y Senn, Sarah J Woodruff. The growth of the digital environment provides tremendous opportunities to revolutionize health behavior change efforts. This paper explores the use of Web-based, mobile, and social media health behavior change interventions and determines whether there is a need for a face-to-face or an in-person component. It is further argued that that although in-person components can be beneficial for online interventions, a digital person-to-person component can foster similar results while dealing with challenges faced by traditional intervention approaches. Using a digital person-to-person component is rooted in social and behavioral theories such as the theory of reasoned action, and the social cognitive theory, and further justified by the human support constructs of the model of supportive accountability. Overall, face-to-face and online behavior change interventions have their respective advantages and disadvantages and functions, yet both serve important roles. It appears that it is in fact human support that is the most important component in the effectiveness and adherence of both face-to-face and online behavior change interventions, and thoughtfully introducing a digital person-to-person component, to replace face-to-face interactions, can provide the needed human support while diminishing the barriers of in-person meetings. The digital person-to-person component must create accountability, generate opportunities for tailored feedback, and create social support to successfully create health behavior change. As the popularity of the online world grows, and the interest in using the digital environment for health behavior change interventions continues to be embraced, further research into not only the use of online interventions, but the use of a digital person-to-person component, must be explored

Children’s perceptions of a centrally procured school food program in southwestern Ontario, Canada

Introduction: This qualitative study investigates children’s perceptions of the influences of a Centrally Procured School Food Program on their dietary behaviours and their recommendations on how to improve the program. Methods: The observations of 208 students aged 9 to 14 years (Grades 5–8) at 21 elementary schools were collected through focus groups in 2017/18. The larger intervention consisted of a 10-week program offering daily snacks (i.e. fruit, vegetables, whole grains, dairy, meat alternatives) for elementary school children in southwestern Ontario, Canada. Results: The participants’ overall impressions of the program were positive. They noted reduced hunger, increased energy and improved nutrition. Many children felt that the program changed their dietary patterns at home as well as at school, particularly in terms of eating more fruit and vegetables. The snack program also enabled children to try healthy foods. Conclusion: Most participants considered the program to be beneficial in promoting healthy eating. Participants recommended adding educational activities, expanding the variety of foods and increasing child involvement in selecting and preparing foods

Children’s perceptions of a centrally procured school food program in southwestern Ontario, Canada

Introduction: This qualitative study investigates children’s perceptions of the influences of a Centrally Procured School Food Program on their dietary behaviours and their recommendations on how to improve the program. Methods: The observations of 208 students aged 9 to 14 years (Grades 5–8) at 21 elementary schools were collected through focus groups in 2017/18. The larger intervention consisted of a 10-week program offering daily snacks (i.e. fruit, vegetables, whole grains, dairy, meat alternatives) for elementary school children in southwestern Ontario, Canada. Results: The participants’ overall impressions of the program were positive. They noted reduced hunger, increased energy and improved nutrition. Many children felt that the program changed their dietary patterns at home as well as at school, particularly in terms of eating more fruit and vegetables. The snack program also enabled children to try healthy foods. Conclusion: Most participants considered the program to be beneficial in promoting healthy eating. Participants recommended adding educational activities, expanding the variety of foods and increasing child involvement in selecting and preparing foods

Differential Immunotoxicity Induced by Two Different Windows of Developmental Trichloroethylene Exposure

Developmental exposure to environmental toxicants may induce immune system alterations that contribute to adult stage autoimmune disease. We have shown that continuous exposure of MRL+/+ mice to trichloroethylene (TCE) from gestational day (GD) 0 to postnatal day (PND) 49 alters several aspects of CD4 + T cell function. This window of exposure corresponds to conception-adolescence/young adulthood in humans. More narrowly defining the window of TCE developmental exposure causes immunotoxicity that would establish the stage at which avoidance and/or intervention would be most effective. The current study divided continuous TCE exposure into two separate windows, namely, gestation only (GD0 to birth (PND0)) and early-life only (PND0-PND49). The mice were examined for specific alterations in CD4 + T cell function at PND49. One potentially longlasting effect of developmental exposure, alterations in retrotransposon expression indicative of epigenetic alterations, was found in peripheral CD4 + T cells from both sets of developmentally exposed mice. Interestingly, certain other effects, such as alterations in thymus cellularity, were only found in mice exposed to TCE during gestation. In contrast, expansion of memory/activation cell subset of peripheral CD4 + T cells were only found in mice exposed to TCE during early life. Different windows of developmental TCE exposure can have different functional consequences

Topological organization of whole-brain white matter in HIV infection

Infection with human immunodeficiency virus (HIV) is associated with neuroimaging alterations. However, little is known about the topological organization of whole-brain networks and the corresponding association with cognition. As such, we examined structural whole-brain white matter connectivity patterns and cognitive performance in 29 HIV+ young adults (mean age = 25.9) with limited or no HIV treatment history. HIV+ participants and demographically similar HIV− controls (n = 16) residing in South Africa underwent magnetic resonance imaging (MRI) and neuropsychological testing. Structural network models were constructed using diffusion MRI-based multifiber tractography and T(1)-weighted MRI-based regional gray matter segmentation. Global network measures included whole-brain structural integration, connection strength, and structural segregation. Cognition was measured using a neuropsychological global deficit score (GDS) as well as individual cognitive domains. Results revealed that HIV+ participants exhibited significant disruptions to whole-brain networks, characterized by weaker structural integration (characteristic path length and efficiency), connection strength, and structural segregation (clustering coefficient) than HIV− controls (p < 0.05). GDSs and performance on learning/recall tasks were negatively correlated with the clustering coefficient (p < 0.05) in HIV+ participants. Results from this study indicate disruption to brain network integrity in treatment-limited HIV+ young adults with corresponding abnormalities in cognitive performance