Welcome to ARCH

statement

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

Nova Scotia Education Review recognises the relationship between health and learning

October 30th, 2014

Earlier this year, Nova Scotians had the opportunity to provide input into a review of the public education system in the province. Today, the report of the consultation was released. The report contains seven themes that represent what over 19,000 Nova Scotians said are the most important issues to improve the education system. The relationship between health and learning appears throughout the report, and also forms one of the seven recommendations – collaborate for improved student health and wellbeing.

Physical and mental health are undoubtedly concerns in this province, which has among the highest rates of obesity and associated chronic diseases. 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 live and learn about healthy eating, active living and positive mental health. Schools are also a place where we should be modelling the behaviours we want our children to adopt.  Yet healthy messages are often undermined by the constant barrage of unhealthy foods promoted by the food industry, an environment that is built for cars rather than walking or wheeling and a culture that does not support healthy behaviours as the norm.

The need to change these unsupportive environments is grounded in evidence. For example, the provincial food and nutrition policy was developed partly in response to research from Nova Scotia that highlighted that children attending schools with a comprehensive health promoting schools program had better diets, were more physically active, had less screen time, were 50% less likely to be overweight and 72% less likely to be obese. Further, grade 5 students with the best diet quality were 30% less likely to fail their Elementary Literacy Assessment (after adjusting for things that we know might influence this finding such as socio-economic status). These local results highlight the importance of integrating comprehensive strategies that support nutrition and mental health, as well as physical activity, as part of upcoming changes to the public education system that relates to overall student health and well-being.

We applaud the government for connecting the dots and recognising that healthy children learn better and that promoting healthy behaviours could actually save money as well as lives. Investing in our children’s health should go hand-in-hand with investment in their education. It is now up to us all to work together to make the healthy choice the easy choice for the future of our children.

Posted by sara

School health , , , ,

Are you ready for the Fed Up Challenge?

September 30th, 2014

Could you go 10 days without added sugar or artificial sweeteners? Katie Couric, American television journalist and co-executive producer and narrator of Fed Up highlighted the invasive nature of sugar in the modern American diet in the recently released documentary, announcing her challenge to all viewers at the end of the film to go without added or artificial sugar for 10 days and see what happens. With even minimal attention paid to the previous 92 minutes of content, viewers should know what to expect if they choose to accept this challenge. Fed-Up offers an eye-opening look at how sugar impacts our brain, our waistlines, and most significantly, our children’s waistlines.

Fed Up explains that the “drug addiction-like” biological response people have to sugar is one of many challenges to regulating sugar intake, considering the added influence of junk food companies’ deceptive marketing tactics, government subsidies for the sugar industry, and undue privileging of physical activity over healthy eating in the fight against obesity. The film especially highlights Michelle Obama’s Let’s Move campaign, describing it as a misguided intervention to increase childhood physical activity in an effort to fight obesity. Let’s Move is criticized for disregarding the harm in perpetuating the idea that physical activity can resolve the obesity epidemic, without consideration for the arguably more significant influence of diet (see also Kirk, Penney, & Freedhoff, 2010).

Popular film review website, Rotten Tomatoes, describes Fed Up as “compelling and troubling in equal measure”, adding that “Fed Up is an advocacy documentary that earns its outrage”. My impression is that such outrage is derived from witnessing government putting profit ahead of public health. This message is expressed so decidedly by in-film statements about government subsidizing the obesity epidemic, which allude to the USDA having an inherent conflict of interest when it comes to promoting the agriculture industry and setting public dietary guidelines. Conflict between promoters of public health and the food industry is more directly addressed by those in the film who liken the tactics of food companies to tobacco companies in the era before it became undeniable that smoking was dangerous to public health (see Brownell & Warner, 2009). Failure to address the responsibility of the food industry for the obesity epidemic is framed as being more vital to preserving public health than reducing tobacco use, because, unlike smoking, everyone must eat.

Amid the daunting list of pervasive environmental barriers to consuming a diet that supports healthy weight maintenance, Fed Up offers some consolation to viewers who fail to find the individual willpower to make the healthy dietary choices they might aspire to. Instead of blaming individuals within an environment where healthy behaviour is unusual, Fed Up sends the message that broad societal change, especially that fueled by public policy is necessary to create an environment that facilitates healthy dietary choices. In sum, Fed Up promotes the notion that the alarming consequences of American feeding habits are all preventable. Couric encourages a movement toward eating whole, non-processed foods, with an emphasis on consuming less sugar from unnatural sources. Whether or not Couric’s call for action will have impact remains to be seen; however, I think the film at least succeeds as an initiative to raise consciousness regarding this public health issue among viewers. If nothing else, I appreciate Fed Up relinquishing the blame so often placed on individuals for being “fat.”

Elyse Quann, BSc Health Promotion Student and Research Assistant for ARCH


Posted by jessielee

Community, Environment, Nutrition , , ,

Need to find more TIME for Health?

August 7th, 2014

Is your family always on the run?

Does your family’s busy schedule get in the way of eating healthy?

TIME

We are looking for families who…

  • Have at least one child between the ages of 5-12 years who is registered in a physical activity program at selected recreation facilities in HRM or attends the recreation facility at least once per week (or more often) for recreation activities.
  • Are willing and able to interact with an Android application for a 6-week period (if selected).
  • Speak fluent English.
  • Are willing to participate in all aspects of data collection for the project (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).

Are there incentives for participating?

Yes! All participants will receive up to $50 in grocery or gas gift cards. Those participating in the family interviews will also be entered into a draw for one of two $50 gift certificates.

How can I get involved?

For more information or to participate in the project, please contact the TIME for Health Project Coordinator at 902-494-4599 or e-mail TIME@dal.ca. You can also visit the project website at www.timeforhealth.ca

Posted by sara

Recruitment

A student’s experience at the Health Promotion Nova Scotia Annual General Meeting

July 25th, 2014

Research assistants Elyse Quann, Rianne McAleer, Kyra Phillips & I (Julia Kontak) had the pleasure of representing ARCH at the Health Promotion Clearinghouse AGM which has recently changed their name to Health Promotion Nova Scotia (HPNS)! HPNS is an association that acts as a resource system for health promotion and population health.

The AGM was split into two parts; the Annual Update and the Panel Discussion on Behavior Change. The AGM was kicked off with a bang that involved a fabulous buffet, as well as a heated debate over the selection of unhealthy desserts. A popular mission for health promoters is to try to make “the healthy choice, the easy choice” but the food selection for us highlighted how the “social norm” of offering both treats and healthy alternatives at a social gathering can easily influence a healthy work environment and impact our own food choices.

Once all the health promoters’ taste buds were satisfied, the annual update of HPNS was presented. As a new face in the world of health promotion, the annual update was able to showcase the past, present and future objectives of HPNS. In my eyes, the association seemed to have made great leaps by creating an image in social media and nominating a new Slate of Directors.

The highly anticipated panel discussion took place following the annual update, including Lynn Langille (Coordinator, Health Disparities, N.S. Dept. of Health & Wellness), Martin Delaney (Partner, VP Planning, Extreme Group) & Dr. Michael Vallis (Health Psychologist, Dalhousie University). The guest-speakers were complementary, but also highlighted a large gap in health promotion. For me, it seemed that due to the complexity of health research and practice, it is difficult to create a set direction of goals that all health promoters agree upon. A concern that was voiced by many attendees was that our knowledge and ideas are not being put into practice. However, as an observer of the discussion, I found each guest-speaker provided evidence of putting their actions into practice, such as the Behavioral Change Institute that is led by Dr. Vallis, but it was the bridge between the speakers work that was missing.  For instance, Delaney explained various benefits of technology based health tools, but Vallis’ website for the Behavioral Change Institute only has PDF formatted health tools available.

The main message I took away from the AGM is that though there may be great work being done in each health discipline, there is lack of collaboration across the field that may be a strong barrier for behavioral change.  The discussion was able to demonstrate how health promoters from various viewpoints can feed off each other’s expertise and create a discussion that is interactive. An open-view approach needs to be taken to heath promotion where health promoters listen to other professional’s views, and understand the benefits of integration.

Langille used a metaphor titled the “upstream approach” to discuss the importance of looking at the larger picture.  As Langille voiced, we need to remember that like a stream, everything in the health environment is connected and flowing. I believe that if the health concerns we are trying to solve are connected, we as health promoters need to work as a collaborative group rather than independently to ultimately make a difference in the health of our society.

I am looking forward to the future of HPNS and the progress it will make over the 2014-2015 year!ResearchAssistantsHPNS

Julia Kontak (second from left in photo)


Posted by jessielee

Community, Environment, Uncategorized , , ,

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 ,

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 , ,

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 , ,

Event Announcement

April 25th, 2014

Food Fight Poster

Posted by arch

Uncategorized

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

4-6healthyeating476x290

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

References

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

Uncategorized