Welcome to ARCH


Applied Research Collaborations for Health (ARCH) is the research group for Dr. Sara Kirk. Sara Kirk holds a Canada Research Chair in Health Services Research within the School of Health and Human Performance at Dalhousie University and a cross-appointment with the IWK Health Centre.

ARCH uses a social-ecological approach to understand lifestyle factors influencing health status and health services utilization, particularly in relation to excessive weight gain. In particular, ARCH is looking at how obesity is managed within the health setting, as well as in understanding the contribution of the "obesogenic" environment to population weight status.

Obesity News and ARCH Updates

Need to find more TIME for health?

July 17th, 2014

The TIME study is recruiting! TIME stands for Tools, Information, Motivation and Environment and is a study to evaluate a smartphone-based intervention to improve family nutrition habits. Previous research has found that parents and youth are often over-scheduled in ways that limit options for healthy meal preparation and that, ironically, healthy nutrition is often sacrificed due to the pressures of being involved in leisure-time physical activities. This suggests that changes in the food environment both in the family home and at recreational facilities where families go to be active may support healthier food choices.

We are currently recruiting families who have a child between the ages of 5-12 years who spend time at selected recreation facilities in the Halifax area to participate in the study. Participants must have access to an Android Smartphone to use the app. Participants will have their height, weight, and waist circumference measured, complete a survey, record a food diary and collect food receipts, wear small devices that measure physical activity and location, and optionally, take part in an interview. Some families will receive access to the smartphone app while others will not so that we can see if the app helps families to change their eating habits.

The TIME study is also featured in the Chronicle Herald Community News this week. Click here to read more.

If you are interested in finding out more about the study, please contact Becky Spencer on (902)494-4599 or TIME@dal.ca

Posted by Cindy

Community, Recruitment ,

Nova Scotia Schools: Leading the Way for a Healthier Tomorrow

May 20th, 2014

The CLASS II research team is holding a webinar on Wednesday, June 4th from 3-4pm (Atlantic time) to share recent results of the CLASS II project, developments from research in Alberta and to celebrate best practices in school health across NS through the launch of our video.

This webinar and video is a follow up to our release of preliminary research findings from the CLASS II project in May 2012. At this meeting, we heard that our partners wanted to learn more about successful school policies and practices and examples of success. We also learned that more knowledge was needed on factors that contributed to success and strategies to overcome potential obstacles moving forward.

Since our release, we have published our work in peer-review journals and received funding to support additional research on health promoting schools. We have also developed a video that will be launched at the webinar to capture stories of healthy school communities in NS. The video was funded by the Nova Scotia Health Research Foundation and provides real-life examples of how NS schools are creating active, healthy and happy places for their students.

Please RSVP to attend the webinar by emailing our research assistant Rianne McAleer at: rn325218@dal.ca by Friday, May 30th.

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Posted by jessielee

School health , ,

New CLASS II research published in Health Education Journal

May 20th, 2014

A recent study published in Health Education Journal describes how health promoting schools has been implemented in Nova Scotia using theoretical components identified in the literature. The results confirm that visioning and leadership across health and education sectors is needed to enable partnerships and support implementation across schools. Read more about results of the CLASS II research at our website.

Posted by jessielee

School health , ,

Event Announcement

April 25th, 2014

Food Fight Poster

Posted by arch


Blame, Shame, and Lack of Support: A Multilevel Study on Obesity Management

April 17th, 2014

A new publication, led by ARCH director Dr Sara Kirk, has been published in Qualitative Health Research. The paper explores how obesity is managed in the health care system across multiple perspectives.In this research, we examined the experiences of individuals living with obesity, the perceptions of health care
providers, and the role of social, institutional, and political structures in the management of obesity. We identified three key themes across the three participant groups: blame as a devastating relation of power, tensions in obesity management and prevention, and the prevailing medical management discourse. Our findings add to a
growing body of literature that challenges a number of widely held assumptions about obesity within a health care system that is currently unsupportive of individuals living with obesity. Our identification of these three themes is an important finding in obesity management given the diversity of perspectives across the three groups and the tensions arising among them. Click here to view the paper. Click here to view a summary of the article on Dr Arya Sharma’s blog.

Posted by arch

Management, Publications , , , , ,

Weighing up the options for promoting health

March 5th, 2014


Sara Kirk, PhD, Canada Research Chair in Health Services Research, Research Associate with the Atlantic Health Promotion Research Centre and Full professor in the School of Health and Human Performance at Dal.

A new study on rising rates of obesity was published on March 3rd and has generated a lot of media interest. The trend analysis, by Laurie Twells and colleagues in Newfoundland, makes depressing reading – since 1981, the prevalence of obesity has increased by 200%, and rates in the Atlantic provinces are among the highest in the country. The health budget in Nova Scotia currently consumes more than 50% of the total budget, with much of this needed to address the burden of chronic disease in this province. Nova Scotians are among the least healthy in the country – with the highest rates of heart and lung diseases and the second-highest rates of diabetes and hypertension. We also have the highest proportion of individuals with multiple chronic conditions. Obese children have 21% higher physician and hospital costs than their normal weight peers (Kuhle et al, 2010), a cost differential that will only increase as these children age, threatening to overwhelm our health system unless we do something about these disturbing trends.

The reasons for the increasing rates of obesity and associated chronic diseases is complex. One key factor is that we live in an “obesogenic environment” – an environment that promotes the unhealthy choice as the default choice and in which healthy behaviour is the abnormal behaviour. Schools are one place where we can help our children to learn about healthy eating and active living, where we should be modelling the behaviours we want our children to adopt, yet these healthy messages are undermined by the constant barrage of unhealthy foods promoted by the food industry and a culture that equates junk food with “having fun”.  Junk food is everywhere and cheap to buy, but it is costing us dear in increasing rates of poor health. Time pressures mean that we have less time to prepare healthier, home-cooked meals or to sit down as a family to eat. Ironically, time pressures to engage in physical activity can limit our ability to eat family meals at home – a case of one healthy behavior threatening to displace another in our crazy world (Chircop et al, 2013).

There is a glimmer of hope and that rests with all of us. As a society, we need to look at the bigger picture and recognize the multitude of factors that influence our ability to eat a healthy diet and be physically active, such as income, availability, education and culture, to name a few. It will take time to reorient our physical and social environments to promote health rather than hinder it. But there are some quick wins – things that we can all do to improve our health. Evidence suggests that children who are involved in meal preparation and enjoy meals with their families also have healthier diets. With March being nutrition month, there is no better time to make plans to eat more healthily – “simply cook and enjoy”.

For information on Nutrition Month, visit http://www.dietitians.ca/Your-Health/Nutrition-Month/Nutrition-Month-2014.aspx


Chircop A, Shearer CL, Pitter R, Sim M, Rehman L, Flannery M, Kirk, SF. (2013). Privileging physical activity over healthy eating: “Time” to choose? Health Promotion International 2013; doi: 10.1093/heapro/dat056.

Kuhle S, Kirk S, Ohinmaa A, Yasui Y, Allen A, Veugelers P (2011). Use and cost of health services among overweight and obese Canadian children. International Journal of Pediatric Obesity April 2011, Vol. 6, No. 2: 142–148.

Twells LK, Gregory DM, Reddigan J, Midodzi WK (2014) Current and predicted prevalence of obesity in Canada. CMAJ opne, DOI: 10.9778/cmajo.20130016.

Posted by Cindy


Event Announcement

February 26th, 2014

CON-SNP Event Poster Final PDF

Posted by Cindy


How much physical activity do children and youth obtain through summer day camps?

February 4th, 2014


A summary of:

Zarrett et al.: Environmental and social-motivational contextual factors related to youth physical activity: systematic observations of summer day camps. International Journal of Behavioral Nutrition and Physical Activity 2013 10:63.

Guest post by Mike Arthur*

An approach to increasing physical activity (PA) among children and youth is to ensure that leaders in settings where they live, work and play maximize PA. One such setting is summer or seasonal day camps that are sponsored by municipal recreation departments and youth serving organizations. Can day camps claim that they contribute to the 60 minutes of moderate to vigorous PA that are required for health benefits? Researchers at The University of South Carolina tested this.

Four camps sponsored by municipalities, YMCA, 4H, and Boys and Girls Clubs participated. Each camp was full day (8 – 4pm); all summer, had a PA component, optional arts and crafts, and field trips. They served 47, 54, 120 and 263 campers for a total of 483. Two camps served a low SES population. Trained observers used a tool called the System for Observing Play and Leisure Activity measured PA ( SOPlay). Campers were observed and coded every 15 minutes for 4 days over 2 weeks. Observed PA was classified as sedentary, walking/moderate or vigorous. Leader behaviors, availability of equipment and space, and motivational climate were also measured.

What did these researchers find?
• Youth were sedentary for 72% of the observations; moderately active 13.8%, and vigorously active 13.8%. Observations were not translated into minutes of PA.
• Males were slightly more active than females
• Higher resourced camps had more PA for males but not females.
• There was little physical activity promotion by camp staff. Staff observed campers but did not encourage, praise, or demonstrate PA.
• Camps with highly organized activities with rules did not promote PA. It may be that structured activities spent too much time on explaining rules, team selection; and turn taking.

What can practitioners learn from this research?
Day camp planners and managers should make PA an explicit goal for day camps by:
• Ensuring that staff are aware of the need for kids to meet PA guidelines (i.e., daily 60 minutes of mod to vigorous activity) and educated on how to promote PA through encouragement, praise, modeling, and minimizing rules and structure.
• Engaging staff and youth in discussions about other ways to increase PA in day camps.
• Developing and using simple tools to observe activity levels of camper and staff, in order to monitor and evaluate whether desired activity levels are being met.

*  Mike Arthur is a recently retired ( 2013 ) Manager, Physical Activity with the Government of Nova Scotia. His primary interests have been working with governments, non government organizations and researchers to ” make the case ” for physical activity as a public health priority. He strongly believes that an evidence base combined with local knowledge and experience is an ideal combination to produce effective comprehensive physical activity strategies and initiatives.

Posted by arch


The blame game

January 15th, 2014

An article published yesterday in CBC news puts all the blame on parents for “enabling kids’ candy addiction”. The article makes important points about the overabundance of candy in children’s daily lives and the role of parents in setting rules and limits related to food. But it fails to ask why we all accept this role of candy/junk food and what we can do to make bigger changes in our environment and culture. Oh yes – and pointing blame at the low-income, single mother for sending their child to school with candy will only reinforce the stigma that she is facing every day to provide her family with nutritious food. Let’s get away from the blame game and work toward more comprehensive, sustainable solutions than “just say no” to kids. (See Dr. Yoni Freedhoff’s Weighty Matters blog for much more discussion on the “parental no.”)

Posted by jessielee


ARCH research featured on Dal News

January 14th, 2014

‘Balancing the Scales: Promoting Healthy Weight Management without Blame or Shame’ is a recently completed research project, led by ARCH Director Dr Sara Kirk. The project explored multiple perspectives on how weight issues are managed in the Nova Scotia health care system through interviews with individuals seeking support for weight management, health care professionals and policy-makers. We observed how the management of weight within the health care system is rife with weight bias, stigma and blame, across all three groups. These issues hindered the relationship between health care providers and the individuals they worked with, and prevented weight issues from being managed in a way that was supportive and sensitive to issues of weight bias. The rich narratives that we obtained from our participants have subsequently been developed into a dramatic presentation that depicts the relationship between a health professional and an individual seeking support for managing their weight. The setting is the office of a family doctor. Internal dialogue (directed at the audience) and external dialogue (directed at each other) highlight the spoken and unspoken tensions around weight management that were so powerfully described by our participants. Our findings clearly highlight some of the barriers in weight management within a system that is not designed to support individuals who are seeking support for weight management. These findings are being used to stimulate debate about how weight issues are managed, and as an interprofessional education tool with a variety of health professional students as a way to support a more open, non-judgmental and collaborative dialogue around managing weight issues with clients. The drama has subsequently been developed into a three hour inter professional workshop called ‘Behind the Scenes’. An article about our recent workshop at Dalhousie University (held in November 2013) is featured in the Dal News this week.

BTS Team: Sara Kirk, Megan Aston,  Sheri Price, Renee Lyons, Laurene Rehman, Michael Vallis, Janet Curran. Original project funded by the Nova Scotia Health Research Foundation, interprofessional workshops funded by the Canadian Institutes of Health Research

Posted by Cindy

Health care, Management, Treatment , , ,