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

Want to learn about weight bias?

April 7th, 2015

In partnership with Dalhousie’s Faculty of Health Professions, ARCH is running a Massive, Open, Online Course (MOOC)! A MOOC is a free, open access course that is offered fully online, providing participants with the opportunity to learn about current research and practices in a broad range of topics. This  MOOC, called “Behind the Scenes: Addressing Weight Bias and Stigma in Obesity“, will be starting on April 20th 2015 and will explore some of the personal and professional biases that surround weight management and that impact patient care and experience. Participants will gain an appreciation of the causes and consequences of obesity and better insight into how weight bias and stigma impact health and society.

Participants who complete the course requirements can apply for a citation of completion (for a $50 fee). The course is equivelent to 15 credit hours (around 3 hours per week). For more information, please visit the course listing and registration page: https://www.canvas.net/browse/canvasnet/dalhousieu/courses/weight-bias-stigma-in-obesity

Follow the course on twitter #weightbiasaware

Posted by sara

Community , , ,

NS principals – please complete School Food Environment Survey

January 26th, 2015

NS school principals have the opportunity to share feedback on the Food and Nutrition Policy in Nova Scotia by completing a  School Food Environment Survey. The provincial results will help to inform the release of the revised Food and Nutrition policy and the resources that are available to schools.

Emails with the survey link have been sent directly to school principals. The survey ask questions about food service in schools (serving, selling), the promotion of healthy eating to students, staff and parents and the overall experiences with implementing the policy.

We thank all schools in advance for your support of this work that will help to create healthier school environments for Nova Scotian students.

Please contact Jessie-Lee McIsaac (Jessie-Lee.McIsaac@dal.ca) or Sara Kirk (Sara.Kirk@dal.ca) if you have any questions or concerns about this research.

Posted by jessielee

Policy, Recruitment, School health , ,

Student response to re-classification of Health Promotion jobs

December 8th, 2014

The most recent List of Classifications and Redistribution http://www.nsgeu.ca/filemanager/pdf/HANSClassificationList.pdf have moved all Health Promotion classifications to clerical. Below is the letter that students/trainees at ARCH have submitted to the Health Association Nova Scotia.

To Whom It May Concern:

We are writing on behalf of students/trainees of the Applied Research Collaborations for Health (School of Health and Human Performance, Dalhousie University) to express deep concern and distress over the proposed re-classification of Health Promotion jobs from Healthcare to Clerical in the List of Classifications by DHA and Union with Proposed Redistribution. All previous versions of the List of Classifications maintained health promotion as a part of Healthcare positions.

As trainees in the field of Health Promotion, we believe that this redistribution undermines our discipline and represents a serious setback for health care reform in Nova Scotia. An abundance of evidence-based research has illustrated the critical need to step away from the individual and place focus on the social determinants of health and primary prevention strategies. Health Promotion is defined by the World Health Organization (WHO) in the Ottawa Charter for Health Promotion as “a process of enabling people to increase control over, and to improve, their health” and plays a vital role in changes needed in the health system. The field of Health Promotion moves beyond a focus on individual behaviour towards a wide range of social and environmental interventions.

Health Canada states that a key feature of primary care health reform is to place “greater emphasis on health promotion and illness/injury prevention.” Health promoters play a critical role in primary prevention, disease prevention, and the reduction of health inequities. Our training is rooted in evidence-based practice that enables us to produce long-term solutions, rather than short-term gains. Health promoters are interdisciplinary health professionals that are able to bring a comprehensive perspective to health and work at all levels of the health system, including but not limited to health care. Health Promoters build connections with other health professionals and use an upstream approach to enable realistic, broad change rather than focusing solely on individuals and illnesses. We work across communities, with policy makers and researchers to help strengthen the knowledge needed for better health of the population and to reduce health disparities. We take a population health approach by addressing an array of complex health issues that impact our behaviours, the environments in which we live, the health care system, and the economy.

Classifying health promotion employees to clerical positions rather than healthcare workers is a huge step backward in reforming the health care system and could have tremendous impacts on the future health system in Nova Scotia. Health promoters are highly trained individuals who have had rigorous training and education in health promotion or a specific health-related domain (i.e. public health). Many current positions in the health promotion field require highly qualified healthcare professionals through Master’s level training or higher. As health promotion students and trainees, we are concerned that our current training is being devalued and that our potential for future impact on the health system will be restricted due to the shift in classification.

The Ivany Report calls for “new vision, innovative approaches, greater collaboration and a greater willingness to take on the risks associated with economic change and progress” to support the prosperity of our province. Classifying health promotion as clerical work is disparaging to our field and we feel it will have a negative impact on the health system and the health of Nova Scotia as a whole. We strongly advocate that the classification of Health Promotion jobs remain in the Healthcare grouping instead of being classified as Clerical work.

Thank you for your time and attention to the matter.

This letter is endorsed by the following students/trainees of the Applied Research Collaboration for Health, School of Health and Human Performance, Dalhousie University: Julia Kontak (MA Health Promotion Student), Dr. Jessie-Lee McIsaac (Postdoctoral Fellow), Rebecca Spencer (Interdisciplinary PhD Student), Logan Lawerence (MSc Kinesiology Student), Jessie MacKay (BSc Health Promotion Student), Elyse Quann (BSc Health Promotion Student), Melissa Stewart (BSc Health Promotion Student), Isabelle Ouellette (BSc Health Promotion Student), Sherry Jarvis (BSc Health Promotion Graduate), Kate MacLeod (BSc Health Promotion Graduate)

Posted by jessielee

Health care, Policy , , , ,

Launch of School Food Environment Online Survey

November 26th, 2014

As mentioned in our earlier post, all principals in the Cape Breton Victoria Regional School Board, Halifax Regional School Board, Annapolis Valley Regional School Board and South Shore Regional School Board are invited to complete the School Food Environment Online Survey. The survey ask questions about food service in your school (serving, selling), the promotion of healthy eating to students, staff and parents and the experiences you have had with implementing the food and nutrition policy over the last eight years. Data collection in other school boards will begin in January 2015.

Please contact Jessie-Lee McIsaac (Jessie-Lee.McIsaac@dal.ca) or Sara Kirk (Sara.Kirk@dal.ca) if you have any questions or concerns about this research.

Posted by jessielee

Nutrition, Policy, Recruitment, School health , ,

What is the current state of school food environments in Nova Scotia?

November 19th, 2014

The provincial government has embarked on a review and update of the 2006 Food and Nutrition Policy, with a revised policy document due to be released in the winter of 2015. To understand how to best support schools to implement the revised policy, ARCH is conducting a “current state” scan of the school food environment. This research aims to build knowledge on nutrition policy implementation across schools in Nova Scotia.

All principals in public schools across Nova Scotia will be invited to take part in an online survey as part of the research. Schools in different boards will also be selected to participate as a case study for additional research that will include a scan of the school food environment.

Participating in this study is voluntary. Principals will receive an email directly from the research team and/or their school board with more information. In November 2014, we are inviting principals in the Cape Breton Victoria Regional School Board, Halifax Regional School Board, Annapolis Valley Regional School Board and South Shore Regional School Board to complete the survey. Data collection in other school boards will begin in January 2015.

The results of this research will help to inform the dissemination of the revised Food and Nutrition policy and the support that will be available to schools. We thank all schools in advance for your support of this work that will help to create healthier school environments for Nova Scotian students.

Please contact Jessie-Lee McIsaac (Jessie-Lee.McIsaac@dal.ca) or Sara Kirk (Sara.Kirk@dal.ca) if you have any questions or concerns about this research.

Posted by jessielee

Nutrition, Policy, School health , ,

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?


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


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 arch

Community, Recruitment ,