Early impact of a new food store intervention on health-related outcomes.

This study investigated the early impact of a community-based food intervention, the Good Food Junction (GFJ), a full-service grocery store (September 2012 - January 2016) in a former food desert in Saskatoon, Canada. The hypothesis tested was that frequent shopping at the GFJ improved food security and selected health-related outcomes among shoppers, and the impact was moderated by socioeconomic factors. Longitudinal data were collected from 156 GFJ shoppers, on three occasions: 12-, 18-, and 24-months post-opening. Participants were grouped into three categories based on the frequency of shopping at the GFJ: low, moderate, and high. A generalized estimating equations approach was used for model building; moderating effects were tested. Participants were predominantly female, Indigenous, low-income, and had high school or some post-secondary education. The GFJ use was associated with household food security (OR for high and moderate frequency shoppers reporting less than a high school education were 1.81 and 1.06, respectively), and mental health (OR for high and moderate frequency shoppers reporting high income were 2.82 and 0.87, respectively) exhibiting a dose-response relationship, and indicated that these outcomes were significantly moderated by participants' socioeconomic factors. Shopping at the GFJ had a positive effect on food security and mental health, but to varying levels for those with low incomes, with less than high school or high school or better levels of education.

"I Would Have My Children Participate IF ": Perceptions of Canadian Caregivers Towards School Food Programs.

Purpose: The Canadian federal government has expressed an intention to work with provinces and territories to develop a national school food program (SFP). This study aimed to explore caregivers' perception of attributes important to include in a future SFP.Methods: An online cross-sectional survey was conducted. Fifteen elementary schools from high, medium, or low median income neighbourhoods in Saskatoon were invited to participate. School principals sent a survey link to students' caregivers. The 37-item survey included an item with 15 statements asking caregivers to rate the importance of various components of a SFP. Descriptive statistics and exploratory factor analysis were conducted.Results: A total of 510 caregivers completed the survey (response rate of 52%). The factor analysis indicated four key components of a future SFP: (1) learning opportunities on growing and preparing food, (2) offering healthy food following Canada's Food Guide, (3) affordability of the meals offered, and (4) cultural adaptability of the meal program. Over 90% of caregivers thought providing healthy meals and ample time to eat meals to be very important.Conclusion: Our results indicate caregivers support multicomponent meal programs that, along with providing nutritious food, help children build healthy habits and sustainable food systems. These findings will help dietitians understand caregivers' perspectives to inform the design of a national SFP.

An examination of willingness to participate and willingness to pay for a universal school food program in the Canadian context.

OBJECTIVE: To examine parents'/caregivers' willingness to participate and willingness to pay (WTP) for a cost-shared school food program (SFP) and its associated factors. DESIGN: A quantitative survey design was used where WTP for a hypothetical SFP was elicited using a double-bounded dichotomous choice elicitation method. We used a double hurdle (logistic and truncated regression) model to examine WTP and positively or negatively associated factors. SETTING: Saskatoon Public School Division elementary schools situated in high-, mid- or low-median-income neighbourhoods. PARTICIPANTS: Parents or caregivers of children attending grades 1 to grade 8 in the Saskatoon Public School Division elementary schools. RESULTS: 94 % respondents were willing to participate in a SFP while less than two-thirds of participants were willing to pay for such a program. Over 90 % respondents from all the socio-economic groups were willing to participate. Multiple household income earners, higher household income, higher number of children, household food security status and higher academic attainment of parents'/caregivers predicted greater willingness to pay. Mean willingness to pay was $4·68 (CAN), and households reporting moderate or severe food insecurity were likely to be willing to pay significantly less for a SFP. CONCLUSION: A cost-shared program might be financially sustainable in Canada if community characteristics such as household food insecurity status, economic participation of women and average household size are kept in mind while determining the price of the program.

Factors contributing to school food program acceptance: a Review of Canadian literature.

Diet quality and food security are a concern in school-aged children in Canada. In 2019, the Canadian federal government announced the intention to work towards a national school food program. Understanding the factors that impact school food program acceptability can inform planning to ensure that students are willing to participate. A scoping review of school food programs in Canada completed in 2019 identified 17 peer-reviewed and 18 grey literature publications. Of these, five peer-reviewed and nine grey literature publications included a discussion of factors that impact the acceptance of school food programs. These factors were thematically analyzed into categories: stigmatization, communication, food choice and cultural considerations, administration, location and timing, and social considerations. Considering these factors while planning can help to maximize program acceptability.

Diet quality and having sufficient food to eat are concerns in school-aged children in Canada. In 2019, the Canadian federal government announced the intention to work towards a national school food program. Providing food to children in schools can only address diet concerns if children participate. Understanding the factors that impact school food program acceptability can inform planning to contribute to program acceptance. Themes of factors contributing to school food program acceptance discussed in 14 publications were identified. Themes included stigmatization, communication, food choice and cultural considerations, administration, location and timing, and social considerations. Considering these factors while planning can help to maximize school food program acceptability.

Employing the equity lens to understand multisectoral partnerships: lessons learned from a mixed-method study in Canada.

BACKGROUND: Multisectoral approaches to health are collaborations between stakeholders across multiple sectors, usually formed to address issues that affect health but go beyond the purview of one particular sector. The significance of multisectoral partnerships to attain health equity has been widely acknowledged. However, the extent which equity can be attained depends upon the perceptions of various stakeholders. We examine how multisectoral partnerships promoting healthy eating and active living conceptualized and employed an equity lens in their work. METHOD: This study is part of a larger pan-Canadian mixed-method research and knowledge sharing program entitled MUSE (Multisectoral Urban Systems for health and Equity in Canadian cities). Data collected from both quantitative and qualitative sources for two sites of the MUSE project-Saskatoon and Toronto were analyzed. In the qualitative part, 30 semi-structured key informant interviews were conducted with key stakeholders from six different multisectoral partnerships based in Saskatoon and Toronto. Data were analyzed in an inductive way. In the quantitative part, a survey with 37 representatives of stakeholder organizations was carried out. Simple descriptive statistics (means and percentages) were used to observe the distribution of data and to complement the qualitative analysis. RESULTS: Equity was not a central component in program design although participants addressing equity, did so by discussing accessibility. How much consideration was given to equity varied as a function of the type of partnership. Most participants emphasized geographical accessibility but a few mentioned financial accessibility. Collaborative leadership style facilitated a participatory decision-making process, and thereby upholding equity in the partnership decision-making process. Communication, networking, and negotiation skills were found to be core competencies of a leader that contributed in upholding equity in partnership dynamics. The study also showed some challenges to embed equity in partnership works, such as the lack of comprehensive understanding of population health and its equity tenet. CONCLUSIONS: Findings indicate that multisectoral partnerships aimed at promoting healthy eating and physical activity experience several challenges to attain equity within the partnership as well as in the partnership-based works aimed at reducing health equity in populations. Factors identified can support decision makers commit to and work to attaining equity within their partnerships as well as in the partnership-based work in the community and beyond.

Effectiveness of the Healthy Start-Départ Santé approach on physical activity, healthy eating and fundamental movement skills of preschoolers attending childcare centres: a randomized controlled trial.

BACKGROUND: Since young children spend approximately 30 h per week in early childcare centres (ECC), this setting is ideal to foster healthy behaviours. This study aimed to assess the effectiveness of the Healthy Start-Départ Santé (HSDS) randomized controlled trial in increasing physical activity (PA) levels and improving healthy eating and fundamental movement skills in preschoolers attending ECC. METHODS: Sixty-one ECC were randomly selected and allocated to either the usual practice (n = 30; n = 433 children) or intervention group (n = 31; n = 464 children). The HSDS intervention group was provided a 3-h on-site training for childcare educators which aimed to increase their knowledge and self-efficacy in promoting healthy eating, PA and development of fundamental movement skills in preschoolers. PA was measured during childcare hours for five consecutive days using the Actical accelerometer. Preschoolers' fundamental movement skills were assessed using the standard TGMD-II protocol and POMP scores. Food intake was evaluated using digital photography-assisted weighted plate waste at lunch, over two consecutive days. All data were collected prior to the HSDS intervention and again 9 months later. Mixed-effect models were used to analyse the effectiveness of the HSDS intervention on all outcome measures. RESULTS: Total number of children who provided valid data at baseline and endpoint for PA, food intake and fundamental movement skills were 259, 670 and 492, respectively. Children in the HSDS intervention group had, on average, a 3.33 greater point increase in their locomotor motor skills scores than children in the control group (ß = 3.33, p = 0.009). No significant differences in effects were observed for object control, PA and food intake. However, results demonstrated a marginal increase in portions of fruits and vegetables served in the intervention group compared to control group (ß = 0.06, p = 0.05). CONCLUSION: Of the 12 outcome variables investigated in this study, 10 were not different between the study groups and two of them (locomotor skills and vegetables and fruits servings) showed a significant improvement. This suggests that HSDS is an effective intervention for the promotion of some healthy behaviours among preschoolers attending ECC. TRIAL REGISTRATION: Clinical Trials NCT02375490. Registered on February 24, 2015; 77 retrospectively registered.

Comparing Diet Quality of School Meals versus Food Brought from Home.

Purpose: Consuming nutritious food is essential to learning. The purpose of this research was to determine the diet quality of elementary school lunches, both those in meal programs and those bringing food from home, in urban and rural locations in Saskatchewan.Methods: Using a School Food Checklist and digital photography we compared food group servings and diet quality in 3 school types: urban schools with a meal program and urban and rural schools without a meal program. The total sample was 773 students.Results: Only 55% of students brought the minimum number of servings for grain products and meat and alternatives, with fewer bringing the minimum for vegetables and fruit (25.6%-34.9%), whole grains (24.1%), and milk and alternatives (14.1%). Students bringing food from home had significantly more calories in their lunches from minimally nutritious foods. Students in meal programs had the highest diet quality scores using the Healthy Eating Index adapted for school hours.Conclusions: The diet quality of elementary students' lunches needs improvement, although students in meal programs have healthier diets. Interventions targeting what children eat at school should focus on increasing the number of students meeting recommendations for healthy foods while decreasing minimally nutritious foods brought to school.

Facilitators and Barriers toward Food Security of Afghan Refugees Residing in Karachi, Pakistan.

The present study comparatively assesses how Afghan refugees in Pakistan understand both the factors and barriers affecting their food security status before and after refuge. Through qualitative in-depth interviews with 25 Afghan refugee families, we assess how quality of life, together with perceptions of a balanced meal, food environments both pre- and post-migration and push and pull factors of migration, impact food security and food choices for refugee families. Furthermore, our results reveal that regardless of the length of protracted status for Afghan refugees, food insecurity remains as a consistent condition for refugee families.

Health-related outcomes of new grocery store interventions: a systematic review.

OBJECTIVE: To assess the evidence of the impact of new food store (supermarket/grocery store) interventions on selected health-related outcomes. DESIGN: A systematic review following the Effective Public Health Practice Project guidelines. All quantitative studies were assessed for their methodological quality. Results were synthesized narratively. SETTING: Eight electronic databases - MEDLINE, EMBASE, CINAHL, ProQuest Public Health, Web of Science, Scopus, PsycINFO and Cochrane Library - were searched to identify relevant records. SUBJECTS: Peer-reviewed scholarly journal articles on new grocery store/supermarket interventions with adult study populations, published in the English language after 1995. RESULTS: Eleven records representing seven new grocery store interventions were identified. Six were assessed having 'weak' methodological quality, one as 'moderate' and two as 'strong'. All studies reported fruit and vegetable consumption but results were not consistent, some studies reporting significantly more and others no increase in consumption. BMI and self-rated health did not show significant improvements. Perceptions of food access, neighbourhood satisfaction and psychological health showed significant improvements. CONCLUSIONS: Improved food access through establishment of a full-service food retailer, by itself, does not show strong evidence towards enhancing health-related outcomes over short durations. Presently the field is developing and the complex linking pathways/mechanisms are yet to be elucidated. Further evidence, in the form of high-quality research in different communities with longer follow-up periods, is needed to inform policy decisions.

A multilevel intervention to increase physical activity and improve healthy eating and physical literacy among young children (ages 3-5) attending early childcare centres: the Healthy Start-Départ Santé cluster randomised controlled trial study protocol.

BACKGROUND: Childhood obesity is a growing concern for public health. Given a majority of children in many countries spend approximately 30 h per week in early childcare centers, this environment represents a promising setting for implementing strategies to foster healthy behaviours for preventing and controlling childhood obesity. Healthy Start-Départ Santé was designed to promote physical activity, physical literacy, and healthy eating among preschoolers. The objectives of this study are to assess the effectiveness of the Healthy Start-Départ Santé intervention in improving physical activity levels, physical literacy, and healthy eating among preschoolers attending early childcare centers. METHODS/DESIGN: This study follows a cluster randomized controlled trial design in which the childcare centers are randomly assigned to receive the intervention or serve as usual care controls. The Healthy Start-Départ Santé intervention is comprised of interlinked components aiming to enable families and educators to integrate physical activity and healthy eating in the daily lives of young children by influencing factors at the intrapersonal, interpersonal, organizational, community, physical environment and policy levels. The intervention period, spanning 6-8 months, is preceded and followed by data collections. Participants are recruited from 61 childcare centers in two Canadian provinces, New Brunswick and Saskatchewan. Centers eligible for this study have to prepare and provide meals for lunch and have at least 20 children between the ages of 3 and 5. Centers are excluded if they have previously received a physical activity or nutrition promoting intervention. Eligible centers are stratified by province, geographical location (urban or rural) and language (English or French), then recruited and randomized using a one to one protocol for each stratum. Data collection is ongoing. The primary study outcomes are assessed using accelerometers (physical activity levels), the Test of Gross Motor Development-II (physical literacy), and digital photography-assisted weighted plate waste (food intake). DISCUSSION: The multifaceted approach of Healthy Start-Départ Santé positions it well to improve the physical literacy and both dietary and physical activity behaviors of children attending early childcare centers. The results of this study will be of relevance given the overwhelming prevalence of overweight and obesity in children worldwide. TRIAL REGISTRATION: NCT02375490 (ClinicalTrials.gov registry).

Assessing the Consumer Food Environment in Restaurants by Neighbourhood Distress Level across Saskatoon, Saskatchewan.

PURPOSE: To assess the consumer food environment in restaurants in Saskatoon, using the Nutrition Environment Measures Survey for Restaurants (NEMS-R), to examine differences by neighbourhood distress level and to reflect on the need for further refinement of the assessment of restaurant consumer food environments. METHODS: Neighbourhoods were classified as low, middle, or high distress level based on the socioeconomic indicators (income, employment, and education) in the Material Deprivation Index. Differences in restaurant consumer food environments, indicated by mean NEMS-R total and sub-scores, were examined by various restaurant categories and by varying neighbourhood distress levels. RESULTS: Chain coffee shops and pita and sandwich restaurants had higher NEMS-R totals and "Healthy Entrées" sub-scores; however, burger and chicken restaurants and pizza restaurants had more barriers to healthful eating. Although restaurants in lower distress level neighbourhoods generally rated healthier (higher NEMS-R scores), only a few measures (such as "Facilitators" and "Barriers") significantly differed by neighbourhood distress level. CONCLUSIONS: The findings highlight the importance of developing interventions to improve restaurant consumer food environments, especially in neighbourhoods with higher distress levels. The results suggest that reliable measures of the consumer food environment could be developed beginning with what can be measured by NEMS-R.

The community and consumer food environment and children's diet: a systematic review.

BACKGROUND: While there is a growing body of research on food environments for children, there has not been a published comprehensive review to date evaluating food environments outside the home and school and their relationship with diet in children. The purpose of this paper is to review evidence on the influence of the community and consumer nutrition environments on the diet of children under the age of 18 years. METHODS: Our search strategy included a combination of both subject heading searching as well as natural language, free-text searching. We searched nine databases (MEDLINE, Web of Science, CINAHL, Embase, Scopus, ProQuest Public Health, PsycINFO, Sociological Abstracts, and GEOBASE) for papers published between 1995 and July 2013. Study designs were included if they were empirically-based, published scholarly research articles, were focused on children as the population of interest, fit within the previously mentioned date range, included at least one diet outcome, and exposures within the community nutrition environment (e.g., location and accessibility of food outlets), and consumer nutrition environment (e.g., price, promotion, and placement of food choices). RESULTS: After applying exclusion and inclusion criteria, a total of 26 articles were included in our review. The vast majority of the studies were cross-sectional in design, except for two articles reporting on longitudinal studies. The food environment exposure(s) included aspects of the community nutrition environments, except for three that focused on the consumer nutrition environment. The community nutrition environment characterization most often used Geographic Information Systems to geolocate participants' homes (and/or schools) and then one or more types of food outlets in relation to these. The children included were all of school age. Twenty-two out of 26 studies showed at least one positive association between the food environment exposure and diet outcome. Four studies reported only null associations. CONCLUSIONS: This review found moderate evidence of the relationship between the community and consumer nutrition environments and dietary intake in children up to 18 years of age. There is wide variation in measures used to characterize both the community and consumer nutrition environments and diet, and future research should work to decrease this heterogeneity.

A need for multi-sector and multi-pronged solutions to address the many barriers inhibiting change from unhealthy food environments in publicly funded recreation facilities: a mixed-method study.

Public recreation facilities are preferred gathering places for families to participate in physical, social, intellectual, and creative pursuits, and the importance of food environments in these facilities is gaining recognition. Evidence from other Canadian jurisdictions describes such food environments as unsupportive of health, which contradicts national recreation priorities to have healthy choices as the easy choices. This study aimed to characterize food environments in a convenient sample of Saskatchewan public recreation facilities. A convergent/parallel mixed methods study design used quantitative methods to determine the healthfulness of concession stands and vending machines and qualitative methods to examine barriers and facilitators to healthy eating in facilities. The results found that 5% of concession main dishes were defined as healthy and packaged foods/beverages in concession stands and vending machines were defined as Offer Most Often 6% and 8% of the time, respectively, according to Saskatchewan Nutrition Standards. Reported barriers to healthy eating were more than twice as prevalent as facilitators. To align with population health recommendations in Saskatchewan, food environments in public recreation facilities require immediate attention. The results and recommendations can be used to build collective action to address the problem and as a benchmark to measure change. Novelty: Only 5% of concession main dishes were defined as healthy. Only 6% of packaged foods and beverages in concessions, and 8% in vending, were defined as Offer Most Often. Reported barriers to healthy eating were more than twice as prevalent as facilitators, resulting in a current state that is difficult to change.

Food Security of Temporary Foreign Farm Workers under the Seasonal Agricultural Worker Program in Canada and the United States: A Scoping Review.

Temporary foreign farm workers (TFWs) are among the most vulnerable and exploitable groups. Recent research shows alarming rates of food insecurity among them. This review explores research focussing on food security of TFWs in Canada and the United States, summarizes findings, and identifies research gaps. Online databases, including MEDLINE, Web of Science, Scopus, Google Scholar, and government and nongovernment websites, and websites of migrant worker-supporting organizations were searched for peer-reviewed and non-peer-reviewed papers and reports published between 1966 and 2020 regarding food security of TFWs. Articles reviewed were analyzed to determine publication type, country, year, target population, and main findings. Content analysis was performed to identify major themes. Of 291 sources identified, 11 met the inclusion criteria. Most articles (n = 10) were based on studies conducted in the United States. The prevalence of food insecurity among TFWs ranged between 28% and 87%. From the content analysis, we formulated 9 themes, representing a diversity of perspectives, including access to resources, income, housing and related facilities, food access, dietary pattern and healthy food choices, and migrant's legal status. Instruments reported for the measurement of food security include USDA Household Food Security Survey Module (HFSSM; n = 8, 72.7%), the modified version of the USDA HFSSM (n = 1, 9%), hunger measure (n = 1, 9%), the modified CDC's NHANES (n = 1, 9%), and 24-h recall, diet history, and/or food-frequency questionnaire (n = 3, 27.3%). Factors impacting food security of TFWs working under the Seasonal Agricultural Worker Programs (SAWPs) in North America are understudied. There is a need to advance research looking particularly at policies and regulatory and administrative aspects of the SAWPs to improve the food security of this cohort. There is also a need for qualitative studies that explore lived experiences and perspectives of TFWs and key informants. Longitudinal studies may be useful to examine various factors, including policy-related, contributing to food insecurity of TFWs over time.

Food selection and preparation practices in a group of young low-income women in Montreal.

This paper presents results from an interview and focus group study of cooking practices in a group of young, low-income women in Montreal. Overall, food choices appeared to be high in refined carbohydrates and relatively low in fresh vegetables and fruit. Participants prepared packaged noodle and sauce dishes often, as well as other packaged sauces, in part because of concern for food waste. Participants felt that the cost of spices was prohibitive. Results illustrate how individuals manage their resources under conditions of financial challenge, given other life circumstances.

Complexity of food preparation and food security status in low-income young women.

PURPOSE: This study was conducted to explore whether preparing more complex meals was associated with higher food security status. METHODS: This mixed-methods, community-based study involved the use of semistructured interviews to examine the cooking practices of a group of young, low-income women in Montreal. Fifty participants aged 18 to 35 were recruited at 10 locations in five low-income neighbourhoods. Food security status was the main outcome measure and the main exposure variable, "complex food preparation," combined the preparation of three specific food types (soups, sauces, and baked goods) using basic ingredients. RESULTS: Low-income women preparing a variety of meals using basic ingredients at least three times a week were more than twice as likely to be food secure as were women preparing more complex meals less frequently. CONCLUSIONS: Women who prepared more complex meals more frequently had higher food security. Whether this means that preparing more complex foods results in greater food security remains unclear, as this was an exploratory study.

Evaluation of the impact of the Healthy Start/Départ Santé intervention on improving menu planning practices and improving the congruence between planned menus and actual food served in Saskatchewan childcare centres.

The objective of this study was to evaluate the impact of the Healthy Start/Départ Santé (HS/DS) intervention program on improving menu planning practices and improving the congruence between planned menus and actual food served in licensed childcare centres in Saskatchewan. Overall, 39 licensed childcare centres in the province of Saskatchewan, Canada, were selected through a cluster randomized control trial to evaluate the impact of the HS/DS intervention. The pre and post intervention food menus of these centres were analyzed and compared to the Saskatchewan Childcare Nutrition Guidelines (SCNG). The food and beverages served at lunch were observed and digitally recorded using digital plate-waste measures. The congruence between the planned menus and the actual food served was assessed. Descriptive analyses and non-parametric tests were performed to determine the impact of the intervention. The results of this study indicated that there was no significant difference between the groups regarding the distribution and proportion of centres that adhered to the SCNG. The centres that received the intervention demonstrated significant improvements in adherence to their written menus, with the proportions of match between the items that served and listed (p-value = 0.029), and additional items served (p-value = 0.014). Within each group, intervention and usual practice, there were significant differences in centres that met the foods to limit guideline among the usual practice centres (p-value = 0.035). Findings from this study indicated that the HS/DS intervention had a positive impact on improving the adherence of the participating centres to the centres' planned menus. HS/DS trial registration number: NCT02375490.

Improving health through multisectoral collaboration: enablers and barriers.

OBJECTIVE: Multisectoral partnerships (MPs) are increasingly viewed as an excellent strategy for promoting population health, although the Canadian evidence on MPs remains scant. The objective of this research was to identify enablers and barriers to multisectoral collaboration across three MPs (focused on food systems, urban development, and active transportation) in a Canadian urban centre. METHODS: This study is part of a pan-Canadian research program-MUSE (Multisectoral Urban Systems for health and Equity in Canadian cities). A qualitative case study methodology was used to explore enablers and barriers to collaboration among three MPs in a mid-sized Canadian city. Key strategy documents of the MPs and 13 in-depth, semi-structured interviews were conducted with stakeholders from each MP. Interview data were transcribed and subjected to thematic analysis using NVivo 12 software, with rigour ensured through member checking. RESULTS: Enablers to collaboration included agenda and goal alignment among partners, quality of relationships in MPs, and external enabling factors. Barriers to multisectoral collaboration included agenda and priority differences, factors related to partnership structure, constitution and processes, and external barriers. Based on these factors, we developed a multisectoral collaboration matrix that dichotomizes enablers and barriers into intrinsic/internal and extrinsic/external to increase understanding of health-promoting MPs in Canada. CONCLUSION: Various enablers and barriers promote or inhibit multisectoral partnerships. By casting these factors into a matrix, members of ongoing or emerging MPs could take advantage of the factors that promote their work and are in their control (intrinsic enablers) or outside their control (extrinsic enablers) while working to overcome challenges presented by collaboration barriers.

RéSUMé: OBJECTIF: L'établissement de partenariats multisectoriels (PM) est de plus en plus reconnu comme une excellente stratégie pour promouvoir la santé des populations bien que les données probantes canadiennes soient disponibles en quantités limitées. L'objectif de cette étude est d'identifier les leviers et les obstacles à la collaboration multisectorielle dans trois PM (visant respectivement le système alimentaire, le développement urbain et le transport actif) œuvrant dans un centre urbain canadien. MéTHODES: Cette étude fait partie d'un programme de recherche pancanadien ­ MUSE (Multisectorielles et urbaines : santé et équité dans les villes canadiennes). Une étude de cas méthodologie qualitative a été utilisée pour explorer les leviers et les obstacles à la collaboration dans trois PM dans une ville canadienne de taille moyenne. Les documents décrivant les orientations stratégiques de chacun des PM ont été examinés et 13 entrevues approfondies et semi-dirigées ont été menées avec les parties-prenantes de chacun des PM. Les verbatim d'entrevues ont été transcrits et soumis à une analyse thématique en utilisant le logiciel NVivo 12. La rigueur a été assurée via des vérifications entre codeurs. RéSULTATS: Les leviers à la collaboration incluent une bonne adéquation entre les agendas et les objectifs des différents membres d'un PM, la qualité des relations interpersonnelles entre membres des PM et des facteurs facilitants externes. Les obstacles à la collaboration multisectorielle incluent des agendas et priorités divergents, des facteurs reliés à la structure du partenariat, la composition et les processus de fonctionnement du PM, et les barrières externes. Les leviers et obstacles ainsi identifiés ont été catégorisés comme étant intrinsèques/internes ou extrinsèques/externes menant à la création d'une matrice de collaboration multisectorielle qui permet de mieux comprendre les enjeux vécus dans les PM qui font la promotion de la santé au Canada. CONCLUSION: Différents leviers et obstacles soutiennent ou entravent les partenariats multisectoriels. En illustrant ces facteurs dans une matrice, les membres de PM existants ou émergeants peuvent prendre acte des facteurs qui soutiennent leurs travaux ­ qu'ils soient maniables (leviers intrinsèques) ou non (leviers extrinsèques) ­ tout en surmontant les défis occasionnés par les obstacles à la collaboration.

Correction: The Good Food for Learning Universal Curriculum-Integrated Healthy School Lunch Intervention: Protocol for a Two-Year Matched Control Pre-Post and Case Study.

[This corrects the article DOI: 10.2196/30899.].

The Good Food for Learning Universal Curriculum-Integrated Healthy School Lunch Intervention: Protocol for a Two-Year Matched Control Pre-Post and Case Study.

BACKGROUND: Good nutrition affects children's health, well-being, and learning, and schools offer an important setting to promote healthy behaviors that can last a lifetime. Once children reach school age, they spend more of their waking hours in school than in any other environment. Children's eating habits may be easier to influence than those of adults. In Canada, households with children are more likely to experience food insecurity, and school food programs that are universally available to all children can support the development of healthy eating patterns across groups of varying socioeconomic status. There is a significant gap in the rigorous community-engaged academic research on the impact of school meal programs, especially universal ones. OBJECTIVE: The aim of this population health intervention research is to study the impact of a 2-year universal, curriculum-integrated healthy school lunch program in elementary schools in Saskatoon, Saskatchewan, Canada, on food consumption, dietary quality and food and nutrition-related knowledge, attitudes, and practices. METHODS: This population health intervention study will be conducted in 2 intervention elementary schools matched with 2 control schools. We will collect preintervention data, including objective measurements of food eaten at school and food-related knowledge, attitudes, and behaviors. This will be followed by the intervention itself, along with qualitative case studies of the intervention process in the 2 intervention schools. Then, we will collect postintervention data similar to the preintervention data. Finally, we will finish the data analysis and complete the ongoing sharing of learning from the project. RESULTS: This study was funded in April 2020 but because of the COVID-19 pandemic, data collection did not begin until May 2021. The intervention will begin in September 2021 and end in June 2023, with end point data collection occurring in May and June 2023. The case study research will begin in September 2021 and will be ongoing for the duration of the intervention. CONCLUSIONS: The opportunity we have to systematically and comprehensively study a curriculum-integrated school lunch program, as well as the promising practices for school food programs across Canada, is without precedent. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/30899.