Promoting meal planning through mass media: awareness of a nutrition campaign among Canadian parents.

OBJECTIVE: To evaluate awareness of the Eat Well Campaign (EWC) among parents and assess perceptions about its effectiveness. DESIGN: Post-campaign evaluation study with a cross-section of parents recruited through random digit dialling. Participants completed an online survey about EWC awareness, its perceived effectiveness among parents and their meal planning practices (attitudes, behaviours and self-efficacy). SETTING: A federal mass-media campaign disseminated by Health Canada (2013-2014) to promote meal planning to Canadian parents. PARTICIPANTS: Parents (n 964) of children aged 2-12 years from all Provinces and Territories. RESULTS: Of respondents, 41 % (390/964) were aware of the campaign; Quebec City and rural Quebec had the highest rates of awareness, whereas Vancouver, Winnipeg and Toronto had the lowest. Awareness was greater among parents with lower income, basic education and French-speakers. Campaign intensity was significantly associated with greater odds of reporting positive attitudes towards the EWC and meal planning (P < 0·05). Campaign awareness was significantly associated with greater odds of believing that meal planning helps maintain a healthy diet (OR = 1·68, 95 % CI 1·03, 2·74) and planning meals (OR = 1·66, 95 % CI 1·03, 2·54), but not self-efficacy, in adjusted models. CONCLUSIONS: The present study is the first to evaluate an initiative that promoted meal planning with mass media. The EWC demonstrated evidence of success in terms of equitable access to a nutrition initiative by reaching lower-income and less-educated parents. Understanding behavioural factors among different segments of the population will be important to target appropriate audiences and develop tailored interventions that support healthy eating practices.

Full-Time Employment, Diet Quality, and Food Skills of Canadian Parents.

Purpose: To explore the associations between full-time employment status, food skills, and diet quality of Canadian parents. Methods: A sample of Canadian parents (n = 767) were invited to complete a web-based survey that included sociodemographic variables, questions about food skills, and a validated food frequency questionnaire. Results were analyzed with linear and logistic regression models, controlling for sociodemographic variables and multiple testing. Results: After controlling for covariates and multiple testing, there were no statistically significant differences in foods skills between parents' employment status. Time was the most reported barrier for meal preparation, regardless of work status, but was significantly greater for full-time compared with other employment status (P < 0.0001). Additionally, parents who worked full-time had lower odds of reporting food preferences or dietary restrictions (P = 0.0001) and health issues or allergies (P = 0.0003) as barriers to food preparation, compared with parents with other employment status. These results remained statistically significant even after controlling for covariates and multiple testing. Conclusions: Overall, food skills did not differ significantly between parents' employment status. Time, however, was an important barrier for most parents, especially those working full time. To promote home-based food preparation among parents, strategies to manage time scarcity are needed.

Facilitators and barriers experienced by federal cross-sector partners during the implementation of a healthy eating campaign.

OBJECTIVE: To identify facilitators and barriers that Health Canada's (HC) cross-sector partners experienced while implementing the Eat Well Campaign: Food Skills (EWC; 2013-2014) and describe how these experiences might differ according to distinct partner types. DESIGN: A qualitative study using hour-long semi-structured telephone interviews conducted with HC partners that were transcribed verbatim. Facilitators and barriers were identified inductively and analysed according partner types. SETTING: Implementation of a national mass-media health education campaign. SUBJECTS: Twenty-one of HC's cross-sector partners (food retailers, media and health organizations) engaged in the EWC. RESULTS: Facilitators and barriers were grouped into seven major themes: operational elements, intervention factors, resources, collaborator traits, developer traits, partnership factors and target population factors. Four of these themes had dual roles as both facilitators and barriers (intervention factors, resources, collaborator traits and developer traits). Sub-themes identified as both facilitators and barriers illustrate the extent to which a facilitator can easily become a barrier. Partnership factors were unique facilitators, while operational and target population factors were unique barriers. Time was a barrier that was common to almost all partners regardless of partnership type. There appeared to be a greater degree of uniformity among facilitators, whereas barriers were more diverse and unique to the realities of specific types of partner. CONCLUSIONS: Collaborative planning will help public health organizations anticipate barriers unique to the realities of specific types of organizations. It will also prevent facilitators from becoming barriers. Advanced planning will help organizations manage time constraints and integrate activities, facilitating implementation.

Factors influencing the adoption of a healthy eating campaign by federal cross-sector partners: a qualitative study.

BACKGROUND: The Eat Well Campaign (EWC) was a social marketing campaign developed by Health Canada and disseminated to the public with the help of cross-sector partners. The purpose of this study was to describe factors that influenced cross-sector partners' decision to adopt the EWC. METHODS: Thematic content analysis, based primarily on an a priori codebook of constructs from Roger's diffusion of innovations decision process model, was conducted on hour-long semi-structured telephone interviews with Health Canada's cross-sector partners (n = 18). RESULTS: Dominant themes influencing cross-sector partners' decision to adopt the EWC were: high compatibility with the organization's values; being associated with Health Canada; and low perceived complexity of activities. Several adopters indicated that social norms (e.g., knowing that other organizations in their network were involved in the collaboration) played a strong role in their decision to participate, particularly for food retailers and small organizations. The opportunity itself to work in partnership with Health Canada and other organizations was seen as a prominent relative advantage by many organizations. Adopters were characterized as having high social participation and positive attitudes towards health, new ideas and Health Canada. The lack of exposure to the mass media channels used to diffuse the campaign and reserved attitudes towards Health Canada were prominent obstacles identified by a minority of health organizations, which challenged the decision to adopt the EWC. Most other barriers were considered as minor challenges and did not appear to impede the adoption process. CONCLUSIONS: Understanding factors that influence cross-sector adoption of nutrition initiatives can help decision makers target the most appropriate partners to advance public health objectives. Government health agencies are likely to find strong partners in organizations that share the same values as the initiative, have positive attitudes towards health, are extremely implicated in social causes and value the notion of partnership.

Perception de l'avenir de la profession de diététiste par les étudiants finissants en nutrition du Québec.

PURPOSE: The main objective is to examine the perception Quebec nutrition students have of the future of the profession based on critical incidents they have reported. METHODS: An electronic questionnaire was sent to the 158 nutrition students graduating from the three Quebec universities offering a nutrition program. The critical incident technique was chosen as the qualitative method. A theme and subtheme table was devised from the analysis of the incidents and entered into Excel to synthesize the data. Results: Positive incidents were associated with the recognition of other professionals and clients, an understanding of the scope of the profession and related opportunities, and the impact of nutrition interventions. Negative incidents mainly pertained to lack of recognition, competition, the realization that employment opportunities are limited, work conditions, and the ability to assert their roles as dietitians. Most of the incidents reported occurred during practicums. CONCLUSIONS: Leadership competencies should be developed to help dietitians take their place on care teams and create a space for themselves in the public sphere. Furthermore, practicum experiences are fundamental in the development of the image students have of the profession.

Portrait des étudiants universitaires en nutrition du Québec : motivations, aspirations et satisfaction concernant leurs études.

PURPOSE: To describe the motivations, study and career objectives, and satisfaction of future nutrition professionals in Quebec. METHODS: An electronic questionnaire was sent to the 158 nutrition students graduating from the three Quebec universities offering a nutrition program. Data were analyzed with SPSS software. Descriptive statistics and McNemar's and χ2 tests were used. RESULTS: A total of 72 students filled out the questionnaire. Nutrition was the first program choice for 60% of the respondents. An interest in nutrition, health and food, and a desire to help people were the main motivations to undertake nutrition studies. Clinical nutrition is the field most favoured by the students to obtain employment, followed by public nutrition and private practice. Fifty-five percent of the students plan to pursue graduate studies in nutrition and 28% in a related field. The nutrition program met the expectations of 70% of the students. CONCLUSION: Results show practical training is required to meet the needs of the varied environments, including that of public nutrition, which is a promising field. More information on work contexts should be integrated into the study program.

Nutrition information-seeking behaviour of low-income pregnant Maghrebian women.

PURPOSE: Nutrition information-seeking behaviour was explored among low-income pregnant Maghrebian women living in Montreal. Environmental factors likely to influence nutrition information-seeking behaviour during pregnancy are discussed. METHODS: Data were collected in face-to-face interviews with 14 primigravid pregnant women recruited via the Montreal Diet Dispensary, a nonprofit agency with the mission of promoting health among low-income pregnant women. Data collection was part of a larger project on pregnant women's nutrition decision-making. RESULTS: Environmental factors likely to influence information-seeking behaviour were identified. They were grouped within two major themes: culture and interactions with individuals from the social environment. The culture theme was divided into three minor themes: eating habits, food beliefs, and religious beliefs. The interactions with individuals from the social environment theme was divided into two minor themes: interactions with health care providers and interactions with family members. CONCLUSIONS: Understanding the influence of these environmental factors should help registered dietitians tailor communication strategies to pregnant immigrant women's specific information needs.

[Relations between maternal food practices and diet of preschool age Quebec children]. / Relations entre les pratiques alimentaires maternelles et l'alimentation d'enfants québécois d'âge préscolaire.

PURPOSE: The goal of this study is to examine the relationships between mothers' food practices and the diets of their preschool children. METHODS: Daycare facilities on the Island of Montréal recruited 122 mothers to complete a self-administered questionnaire that addressed the impact of parents' food practices on their children's diets, particularly the frequency of intake and food preferences. RESULTS: Correlations were observed between three maternal food practices--restrictions, pressure to eat and food reward--and children's eating behaviour. These three practices correlated with less desirable eating behaviours in children. CONCLUSIONS: This study suggests that in Quebec, mothers' food practices have a direct impact on the food practices of their children. Mothers must therefore be informed about the counterproductive nature of some food practices and given tools to develop healthier food strategies by focusing on children's appetites and emphasizing the pleasure of eating.

Toward Food Sovereignty for Coastal Communities of Eastern Québec: Co-designing A Website to Support Consumption of Edible Resources from the St. Lawrence River, Estuary, and Gulf.

Background. Despite the abundance and proximity of edible marine resources, coastal communities along the St. Lawrence in Eastern Québec rarely consume these resources. Within a community-based food sovereignty project, Manger notre Saint-Laurent ("Sustenance from our St. Lawrence"), members of participating communities (3 non-Indigenous, 1 Indigenous) identified a need for a web-based decision tool to help make informed consumption choices. Methods. We thus aimed to co-design a prototype website that facilitates informed choices about consuming local edible marine resources based on seasonal and regional availability, food safety, nutrition, and sustainability, with community members, regional stakeholders, and experts in user experience design and web development. We conducted 48 interviews with a variety of people over 3 iterative cycles, assessing the prototype's ease of use with a validated measure, the System Usability Scale. Results. Community members, regional stakeholders, and other experts identified problematic elements in initial versions of the website (e.g., confusing symbols). We resolved issues and added features people identified as useful. Usability scores reached "best imaginable" for both the second and the third versions and did not differ significantly between sociodemographic groups. The final prototype includes a tool to explore each species and index cards to regroup accurate evidence relevant to each species. Conclusions. Engaging co-designers with different sociodemographic characteristics brought together a variety of perspectives. Several components would not have been included without co-designers' input; other components were greatly improved thanks to their feedback. Co-design approaches in research and intervention development are preferable to foster the inclusion of a variety of people. Once the prototype is programmed and available online, we hope to evaluate the website to determine its effects on food choices.

[Attitudes and habits of Canadians in relation to planning and preparing meals at home]. / Attitudes et habitudes de Canadiens relativement à la planification des repas et à la cuisine maison.

PURPOSE: To describe the attitudes and habits of Canadians in relation to planning and preparing meals at home, in order to identify motivations that can be used to promote home cooking. METHODS: An electronic survey consisting of 39 multiple-choice questions was posted on the Dietitians of Canada website between November 16 and December 22, 2006. The statements analyzed have to do with perceived benefits associated with home cooking, obstacles preventing people from cooking, preparation time and meal planning, learning to cook, and sources of recipe ideas. RESULTS: A total of 4,080 people filled out the questionnaire. Although they believe that home cooking can improve diet quality and eating behaviours, respondents experience several obstacles relating to day-to-day food preparation. Among these are lack of time, energy, ideas, and planning. CONCLUSIONS: This study underlines the relevance of creating strategies not only for educating consumers about the benefits of home cooking, but also for providing practical information to help them overcome obstacles limiting the day-to-day preparation of food.

[Development of a tool to analyze the menus provided in early childhood daycare centres]. / Développement d'une grille d'analyse des menus en services de garde à la petite enfance.

A review of the literature reveals that there are currently no tools available to analyze the quality of the menus provided in daycare centres. An analysis grid has been developed for this purpose, specifically targeting the food served to preschool children aged 18 months and over. The tool was produced on the basis of findings from recent scientific research. The final version of the grid features 25 statements that cover types of menus, the food groups and recommendations of Canada's Food Guide, sources of protein, the supply of beverages,processed foods, cariogenic products, nutritional variety,allergens and sensory properties of foods. The data gathered using this grid will help establish recommendations for daycare administrators and kitchen managers with respect to various considerations that are key to promoting healthy eating habits in early childhood. The limitations to its use stem from the need to complement these recommendations by conducting an analysis of the recipes and ingredients used, the beverages served and the portion sizes offered.

Exploring adolescents' awareness of diabetes using the free association technique.

PURPOSE: Healthy adolescents' awareness of diabetes was explored, and gender and grade-level differences in understanding were determined. METHODS: Adolescents without diabetes in grades five, eight, and 10 (n=128) at four New Brunswick schools wrote down all words/expressions that came to mind when they heard the word "diabetes" (i.e., they used the free association technique). Answers were classified into categories using content analysis. RESULTS: Eighty-eight girls and 40 boys completed the activity (n=44, 52, and 32 in grades five, eight, and 10, respectively). Nine principal categories were identified: 66% of the adolescents cited sugar (e.g., eating too much sugar, not enough sugar), 48% treatment (e.g., needles, injections), 45% the nature of diabetes (e.g., a disease, types of diabetes, heredity), 41% nutrition (e.g., diet, sugar-containing foods, other foods), 38% blood (e.g., too much/not enough sugar in blood), 18% complications (e.g., death), 11% physiological manifestations/symptoms (e.g., fainting), 6% obesity, and 6% physical activity. No differences were found in category citation frequency between boys and girls and grade levels, except that grade 10 students more frequently cited the categories of treatment, blood, and obesity (p=0.05). CONCLUSIONS: Students thought of diabetes in terms of sugar and injections. Words related to obesity, prevention, and complications were cited infrequently.

Healthy adolescents' social representations of diabetes.

OBJECTIVE: This study explores healthy adolescents' social representations of diabetes in terms of its definition, origins and prevention. METHODS: Focus groups were conducted with students in Grades 5, 8 and 10 from 4 francophone schools in New Brunswick, Canada. Audiotaped discussions were transcribed and categorized using qualitative content analysis (Atlas.ti software). Chi-square and Fisher's exact tests were used to determine sex and grade-level differences in frequency of category citations. RESULTS: Nineteen focus groups involved 130 adolescents. Students defined diabetes as a disease (13 groups) related to sugar (15 groups) and blood (13 groups), but only a few mentioned the role of insulin/pancreas, types of diabetes and/or complications. Symptoms/physiological manifestations (11 groups), monitoring blood sugar (10 groups) and insulin injections (5 groups) were discussed primarily in terms of behaviours observed among family and friends with diabetes, demonstrating the importance of social environment in their representations. Half of the groups identified heredity, age, obesity, physical activity and poor diet as playing a role in developing diabetes. Students had a general idea about the importance of good eating habits and physical activity in terms of managing and preventing diabetes. Eleven groups had the misconception that sugar causes diabetes. Although each focus group had at least 1 adolescent with a family member affected by the disease, only half of the groups cited feeling at risk of diabetes - girls more likely than boys (p≤0.05). CONCLUSION: Healthy adolescents in Moncton, New Brunswick, have a limited comprehension of diabetes, which could make it difficult for them to take preventive action to contain this epidemic disease.

Short-term effects of adhesion peptides on the responses of preosteoblasts to pBMP-9.

Adhesion peptides are currently used to enhance the interactions of osteoblasts with biomaterials. However, little is known about the effects of adhesion peptides on cell responses to growth factors, especially the bone morphogenetic proteins (BMPs). We used adhesion peptides Ac-CGGNGERPRGDTYRAY-NH(2) (pRGD), derived from bone sialoprotein, and Ac-CGGDGEA-NH(2) (pDGEA), derived from collagen, which interact with alpha(v)beta(3) and alpha(2)beta(1) integrins, respectively. We analyzed the effects of pRGD- and pDGEA-coated polystyrene (PS) on the responses of murine MC3T3-E1 preosteoblasts to a peptide derived from human BMP-9 (pBMP-9) in serum-free medium. After 1h, pRGD favoured interactions with alpha(v) while pDGEA bound beta(1) integrin subunits. Adding pBMP-9 (400 ng/mL) increased the amount of alpha(v) integrin subunits in cell membranes on pRGD-coated PS, but had no effect on beta(1) integrin subunits. Only on this substratum, collagen type I mRNA was enhanced and the addition of pBMP-9 promoted the early cell differentiation, increasing their alkaline phosphatase (ALP) activity within 24 h. These cells also organized beta(1) integrin subunits at their focal adhesion points. Inhibiting alpha(2)beta(1) integrins by pDGEA pre-treatment decreased this ALP activity. It is therefore important to understand the impact of adhesion peptides on the early cell responses to growth factors in order to improve biomimetic materials.

Sex and cultural differences in the acceptance of functional foods: a comparison of American, Canadian, and French college students.

OBJECTIVE: Functional foods (FF)--foods containing nutritional supplements in addition to natural nutrients--have an increasing presence in the marketplace. Expanding on previous research, the authors investigated college students' acceptance of FF. PARTICIPANTS: In September--March 2004, 811 undergraduates in Canada, the United States, and France participated in the study. METHODS: A self-administered questionnaire measured students' general food attitudes and beliefs as well as FF-related knowledge, attitudes, beliefs, and purchase intention. RESULTS: Overall, participants slightly favored FF over traditional foods. However, although most respondents associated FF with positive health benefits, many remained dubious of currently available FF information. In terms of culture and sex, the authors found small but significant divergences in FF knowledge, attitudes, and behaviors. CONCLUSIONS: Stronger labeling and education efforts may increase cross-cultural acceptance of FF by college students.

Research- and Practice-Based Nutrition Education and Cooking Workshops in Pediatric Oncology: Protocol for Implementation and Development of Curriculum.

BACKGROUND: Progresses in childhood cancer treatment, diagnosis, and management have resulted in childhood cancer survival rates of over 80%. However, this therapeutic success comes with a heavy price: two-thirds of childhood cancer survivors will be affected by further complications, including cardiovascular and metabolic diseases. Adequate nutrition during cancer treatment is essential to ensure the child's optimal development, improve tolerance to treatments, and can contribute to lower the risk of developing cardiometabolic diseases. Side effects of cancer treatments can negatively impact children's nutritional intake and eating behaviors. Involving the families of childhood cancer patients in educational workshops could be a promising avenue to promote healthy eating during and after cancer treatment. OBJECTIVE: The objectives of this study were to develop, validate, and implement a family-based nutrition education and cooking workshop curriculum in a pediatric oncology setting that addresses the nutritional issues encountered during treatments while promoting the adoption of healthy eating habits for the prevention of long-term cardiometabolic effects. METHODS: The workshops were developed and validated following an 8-step iterative process, including a review of the literature and consultations with a steering committee. An evaluation tool was also developed. A nonrandomized study protocol was elaborated to implement the workshops and measure their impact. The themes of the 6 research- and practice-based lessons are as follows: meal fortification during cancer treatment, changes in taste during cancer therapy and their impact on children, adapting diet to eating-related side effects of treatments, nutritional support during cancer treatment, Mediterranean diet and health, and planning quick and economic meals. The validation process included consultations with the institution's clinical nutrition professionals. Self-administered post questionnaires were developed according to the content of each workshop to measure short-term outcomes, namely, participants' perception of knowledge acquisition, behavioral intention, and satisfaction. Medium-term outcomes that will be evaluated are participants' anthropometric profile, quality of the diet, and circulating biomarkers of metabolic health. RESULTS: The project was funded in 2016 and enrollment will be completed in 2021. Data analysis is currently under way and the first results are expected to be submitted for publication in 2019. CONCLUSIONS: This research- and practice-based nutrition education and cooking demonstration curriculum could be a valuable complement to a multidisciplinary lifestyle intervention for the prevention of long-term cardiometabolic complications in childhood cancer.

[Food choice and place of eating for Quebec children]. / Choix et comportements alimentaires d'enfants québécois.

PURPOSE: The relationships are explored between food choices of school-aged children and eating in the bedroom, while watching television, or in front of the computer. METHODS: Data were collected using a self-administered questionnaire that 534 subjects completed in class. Participants were ten- to 12-year-old children from Québec. RESULTS: Significant positive correlations were found between the act of eating in the bedroom and eating in front of the television or the computer (p<0.05). Significant positive correlations were also found between eating in the bedroom, or eating in front of the television or the computer, and the consumption of low-density food, foods high in sugar and fat, and foods low in fibre (p<0.05). Data also revealed more negative food habits for boys than for girls (p<0.05). CONCLUSIONS: Because of the prevalence of childhood obesity, these findings support the need to document children's food consumption patterns and gender differences.