A social network analysis of interactions about physical activity and nutrition among APPLE schools staff.

Comprehensive school health (CSH) is a holistic approach to school-based health promotion that involves active participation and buy-in of school community members, including school staff (e.g., support staff, teachers, school health champions, principals). Implementation and sustainability of CSH builds on complex relationships within the school that support school-level health promoting changes and understanding the social relationships that exist in a school setting is critical. Thus, the purpose of this study was to conduct a social network analysis to examine adviceseeking networks of staff within three schools involved with a CSH program called APPLE Schools (A Project Promoting healthy Living for Everyone in Schools) project approach. The degree to which school staff were central in the network (i.e., gave or sought physical activity or nutrition advice, were connected or disconnected to others; indegree/outdegree centrality and betweenness centrality) and the overall structure of the networks were assessed (i.e., optimal levels of density and centralization). School health champions and several other individuals in the network were shown to be key sources of physical activity or nutrition advice and were identified as central players in the network. Whole networks across schools had low density and betweenness centralization, with optimal levels of out-centralization, and low to optimal levels of incentralization. This research allowed us to gain an understanding of network structures and relationship patterns in CSH schools, with specific attention to the coordinating role of school health champions, and other central players within the network. These findings increase our understanding of advice relationships that exist in a school setting and how these relationships may support CSH implementation and sustainability.

Implementing Comprehensive School Health in Alberta, Canada: the principal's role.

Comprehensive School Health (CSH) is an internationally recognized framework that moves beyond the individual to holistically address school health, leading to the development of health-enhancing behaviors while also improving educational outcomes. Previous research has suggested that principal support for CSH implementation is essential, but this role has yet to be explored. Therefore, the purpose of this research was to examine the role of the principal in the implementation of a CSH project aimed at creating a healthy school culture. This research was guided by the grounded ethnography method. Semi-structured interviews were conducted with APPLE School principals (n = 29) to qualitatively explore their role in creating a healthy school culture. A model consisting of five major themes emerged, suggesting that the principal played a fluid role throughout the CSH implementation process. Principals (i) primed the cultural change; (ii) communicated the project's importance to others; (iii) negotiated concerns and collaboratively planned; (iv) held others accountable to the change, while enabling them to take ownership and (v) played an underlying supportive role, providing positive recognition and establishing ongoing commitment. This research provides recommendations to help establish effective leadership practices in schools, conducive to creating a healthy school culture.

The effectiveness of workplace interventions to increase physical activity and decrease sedentary behaviour in adults: protocol for a systematic review.

BACKGROUND: A physically active lifestyle plays a preventative role in the development of various chronic diseases and mental health conditions. Unfortunately, few adults achieve the minimum amount of physical activity and spend excessive time sitting. Developing targeted interventions to increase active living among adults is an important endeavour for public health. One plausible context to reach adults is the workplace. This systematic review aims to review the effectiveness of workplace interventions on increasing physical activity and decreasing sedentary behaviour in the workplace. METHODS: An advisory group of practitioners will work in collaboration with the research team to inform the systematic review and knowledge mobilization. Fifteen electronic databases will be searched to identify studies examining the effectiveness of workplace interventions on physical activity and sedentary behaviour. All experimental designs and observational studies (non-experimental intervention studies) meeting the study criteria will be included. Studies examining generally healthy, employed, adult participants will be included for the review. Interventions will focus on increasing physical activity and/or decreasing sedentary behaviour from the individual to policy level. The primary outcome variables will be reported or observed physical activity and/or sedentary behaviour in the workplace. Secondary outcomes will include variables ranging from return on investment to quality of life. Study quality will be assessed for risk of bias following the protocol identified in the Cochrane Handbook for Systematic Reviews of Interventions and supplemented by the guidelines developed by the Cochrane Effective Practice and Organisation of Care group, using RevMan. The quality of the evidence will be assessed using the Grading of Recommendations, Assessment, Development and Evaluation approach. Meta-analyses, forest plots, and harvest plots will be used where appropriate to assess the direction, size, and consistency of the intervention effect across the studies using similar intervention strategies. Follow-up knowledge mobilization activities and products will be developed to support the use of this knowledge in practice. DISCUSSION: This protocol paper describes a systematic review assessing the effectiveness of various types of workplace interventions on increasing physical activity and decreasing sedentary behaviour at work. Collaborating with an advisory group of potential knowledge users throughout the process postulates a greater use and reach of the information gained from this systematic review by knowledge users. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42015019398.

Effects of Biggest Loser exercise depictions on exercise-related attitudes.

OBJECTIVES: To examine whether participants who watched an exercise-related segment of The Biggest Loser television program would have different explicit and implicit affective exercise-related attitudes than those of control participants. METHODS: University students (N=138) watched a clip of The Biggest Loser or American Idol, then completed a Go/No-go Association Task, a thought-listing task, and questionnaires measuring explicit attitudes, activity level, and mood. RESULTS: Participants who watched The Biggest Loser had significantly lower explicit, but not implicit, attitudes towards exercise than did control participants. CONCLUSIONS: There is a need to examine the influence of popular media depictions of exercise.

The relationship between implicit and explicit believability of exercise-related messages and intentions.

OBJECTIVE: This research explored whether implicit or explicit believability of exercise advertising predicted attitudes and intentions. It was hypothesized that implicit believability would be a stronger predictor of attitudes than explicit believability and that implicit believability would predict intentions. METHOD: Undergraduate student participants (N = 306) viewed health promotion or appearance-based exercise-related advertisements. They completed an implicit believability task followed by questionnaires of issue involvement, attention paid to the advertisements, explicit believability, exercise attitudes, and intentions to exercise. Participants listed 5 thoughts they had when viewing the advertisements. Health and appearance models were tested using structural equation modeling. Thoughts were coded and valence (negative statements subtracted from positive), believability, and motivation indices were created. Correlations between indices and model variables were calculated. RESULTS: Both models were good fits of the data. In the health condition, explicit believability did not predict attitudes or intentions but implicit believability predicted attitudes and explicit believability. In the appearance condition, implicit believability was negatively related to intentions, but was not related to explicit believability or attitudes. There were small positive correlations between attitudes and the thought-listing valence index in both conditions. CONCLUSIONS: The results indicate that exercise-related health promotion messages are believable and that the initial reaction to them coincides with reflective attitudes. However, if appearance messages are believed (even if not explicitly), the effects may be detrimental. It is important to include implicit measures in messaging research as they allow for a more complete understanding of how health messages may influence related cognitions.