Widening the gap? Unintended consequences of health promotion measures for young people during COVID-19 lockdown.

During the first wave of the COVID-19 pandemic, global measures preventing the spread of the new coronavirus required most of the population to lockdown at home. This sudden halt to collective life meant that non-essential services were closed and many health promoting activities (i.e. physical activity, school) were stopped in their tracks. To curb the negative health impacts of lockdown measures, activities adapting to this new reality were urgently developed. One form of activity promoted indoor physical activity to prevent the adverse physical and psychological effects of the lockdown. Another form of activity included the rapid development of online learning tools to keep children and youth engaged academically while not attending school. While these health promoting efforts were meant to benefit the general population, we argue that these interventions may have unintended consequences and inadvertently increase health inequalities affecting marginalized youth in particular, as they may not reap the same benefits, both social and physical, from the interventions promoting at-home physical activities or distance learning measures. We elaborate on several interventions and their possible unintended consequences for marginalized youth and suggest several strategies that may mitigate their impact.

Reflexivity in Health Promotion: A Typology for Training.

Reflexivity has emerged as a key concept in the field of health promotion (HP). Yet it remains unclear how diverse forms of reflexivity are specifically relevant to HP concerns, and how these "reflexivities" are interconnected. We argue that frameworks are needed to support more systematic integration of reflexivity in HP training and practice. In this article, we propose a typology of reflexivity in HP to facilitate the understanding of reflexivity in professional training. Drawing from key theories and models of reflexivity, this typology proposes three reflexive positions (ideal-types) with specific purposes for HP: reflexivity in, on, and underlying action. This article illustrates our typology's ideal-types with vignettes collected from HP actors working with reflexivity in North America and Europe. We suggest that our typology constitutes a conceptual device to organize and discuss a variety of experiences of engaging with reflexivity for HP. We propose the typology may support integrating reflexivity as a key feature in training a future cadre of health promoters and as a means for building a responsible HP practice.

Are inequalities produced through the differential access to play opportunities at school? A call to level the playing field.

Children's play is characterized as pleasurable, but it is also viewed as critical for child health and well-being. Yet over the past decade, play researchers and advocates from various disciplines have suggested that there are decreasing opportunities for children to play, particularly at school. One concern is that the changing play environment in schools is reducing children's active play options and is thereby contributing to increases in childhood obesity. Building on findings from the QUébec Adipose and Lifestyle InvesTigation in Youth (QUALITY), this commentary suggests that while opportunities to engage in physical activity may indeed be differentially shaped by school play environments, physical health may not be the only factor at stake in unequal play environments in schools. While this is not an altogether new concern, we argue that it is nevertheless important to highlight within physical activity research settings that children's overall well-being, including their experience of pleasure, creativity, imagination and sociability, is also shaped by a school's play environment. Addressing possible inequalities in children's experience of play in schools, we propose several questions and future research directions for addressing children's health and well-being in the school environment.

'You have to do 60 minutes of physical activity per day I saw it on TV': children's constructions of play in the context of Canadian public health discourse of playing for health.

Public health institutions in many industrialised countries have been launching calls to address childhood obesity. As part of these efforts, Canadian physical activity campaigns have recently introduced children's play as a critical component of obesity prevention strategies. We consider this approach problematic as it may reshape the meanings and affective experiences of play for children. Drawing on the analytical concept of biopedagogies, we place Canadian public health discourse on play in dialogue with children's constructions of play to examine first, how play is promoted within obesity prevention strategies and second, whether children take up this public health discourse. Our findings suggest that: (i) the public health discourse on active play is taken up and reproduced by some children. However, for other children sedentary play is important for their social and emotional wellbeing; (ii) while active play is deemed to be a solution to the risk of obesity, it also embodies contradictions over risk in play, which children have to negotiate. We argue that the active play discourse, which valorises some representations of play (that is, active) while obscuring others (that is, sedentary), is reshaping meanings of play for children, and that this may have unintended consequences for children's wellbeing.

Problematizing "play-for-health" discourses through children's photo-elicited narratives.

There are growing concerns in many industrialized Western societies about declining opportunities for children to play, and fears that this will have adverse health consequences for them. Informed by anti-obesity efforts, public health institutions have recently begun to advance active forms of play as a way of improving children's physical health; however, promoting play for physical health might reshape meanings of play for children. We conducted photography and interview sessions with 25 Canadian children aged 7 to 11 years to examine their representations of play. Our findings suggest that for children, (a) play is an end in itself, (b) play involves but is more than active play, (c) there is ambivalence about scheduled play, and (d) risk is considered a pleasurable component of play. These findings point to a dissonance between children's play promoted for physical health and the meaning of play for children as emotionally contingent, intrinsically motivated, and purposeless.

'Active play may be lots of fun, but it's certainly not frivolous': the emergence of active play as a health practice in Canadian public health.

In the context of what has been termed a childhood obesity epidemic, public health institutions have recently begun to promote active play as a means of addressing childhood obesity, thus advancing play for health. Drawing on Foucault, this article problematises the way that children's play is being taken up as a health practice and further considers some of the effects this may have for children. Six Canadian public health websites were examined, from which 150 documents addressing children's health, physical activity, obesity, leisure activities and play were selected and coded deductively (theoretical themes) and inductively (emerging themes). Bacchi's () question-posing approach to critical discourse analysis deepened our analysis of dominant narratives. Our findings suggest that several taken-for-granted assumptions and practices underlie this discourse: (i) play is viewed as a productive activity legitimises it as a health practice; (ii) tropes of 'fun' and 'pleasure' are drawn on to promote physical activity; (iii) children are encouraged to self-govern their leisure time to promote health. We underscore the need to recognise this discourse as contingent and as only one of many ways of conceptualising children's leisure activities and their health and social lives more generally.

Playing for health? Revisiting health promotion to examine the emerging public health position on children's play.

Concerns over dwindling play opportunities for children have recently become a preoccupation for health promotion in western industrialized countries. The emerging discussions of play seem to be shaped by the urgency to address the children's obesity epidemic and by societal concerns around risk. Accordingly, the promotion of play from within the field appears to have adopted the following principles: (i) particular forms of play are critical for increasing children's levels of physical activity; and (ii) play should be limited to activities that are not risky. In this article, we argue that these emerging principles may begin to re-shape children's play: play is predominantly instrumentalized as a means to promote children's physical health, which may result in a reduction of possibilities for children to play freely and a restriction of the kinds of play designated as appropriate for physical health. We argue that within this context some of the social and emotional elements of health and well-being that children gain through diverse forms of playing are neglected. This has implications for health promotion because it suggests a narrowing of the conception of health that was originally advocated for within the field. Additionally, this reveals a curious paradox; despite the urgency to promote physical activity through play, this position may limit the range of opportunities for children to freely engage in play, in effect reducing their activity levels. We propose an example that promotes play for children and better aligns with the conception of health as outlined in the Ottawa Charter.