Support for healthy eating at schools according to the comprehensive school health framework: evaluation during the early years of the Ontario School Food and Beverage Policy implementation.

Introduction: Provincial, national and international public health agencies recognize the importance of school nutrition policies that help create healthful environments aligned with healthy eating recommendations for youth. School-wide support for healthy living within the pillars of the comprehensive school health (CSH) framework (social and physical environments; teaching and learning; healthy school policy; and partnerships and services) has been positively associated with fostering improvements to student health behaviours. This study used the CSH framework to classify, compare and describe school support for healthy eating during the implementation of the Ontario School Food and Beverage Policy (P/PM 150).

Examining the impact of a province-wide physical education policy on secondary students' physical activity as a natural experiment.

Background: The purpose of this paper is to examine the impact of a province-wide physical education (PE) policy on secondary school students' moderate to vigorous physical activity (MVPA).

Methods: Policy: In fall 2008, Manitoba expanded a policy requiring a PE credit for students in grades 11 and 12 for the first time in Canada. The PE curriculum requires grades 11 and 12 students to complete a minimum of 55 h (50% of course hours) of MVPA (e.

Prevalence and correlates of electronic cigarette use among Canadian students: cross-sectional findings from the 2014/15 Canadian Student Tobacco, Alcohol and Drugs Survey.

Background: Over the past decade, youth tobacco use has declined, and electronic cigarettes (e-cigarettes) have entered the market. The aims of this study were to describe the prevalence of e-cigarette use among youth in Canada, by province, across sociodemographic variables and smoking-related correlates; and to examine associations among e-cigarette use, sociodemographic variables and smoking-related correlates, with adjustment for other factors.

Methods: The 2014/15 Canadian Student Tobacco, Alcohol and Drugs Survey, a biennial, school-based survey, was administered to students in grades 6-12 in all Canadian provinces.

Beverages and snacks available in vending machines from a subset of Ontario secondary schools: Do offerings align with provincial nutrition standards?

Objectives: As part of an evaluation of Ontario's School Food and Beverage Policy (P/PM 150) in a populous Ontario region, this research aimed to: 1) identify, describe and categorize beverages and snacks available for purchase in secondary school vending machines according to P/PM 150 standards; and 2) compare the number and percentage of beverages and snacks within P/PM 150 categories (Sell Most, Sell Less, Not Permitted) from Time I (2012/2013) to Time II (2014).

Methods: Representatives from consenting secondary schools assisted researchers in completing a Food Environmental Scan checklist in Times I and II. Sourced nutritional content information (calories, fats, sodium, sugars, ingredients and % daily values) was used to categorize products.

Evaluation of Daily Physical Activity (DPA) policy implementation in Ontario: surveys of elementary school administrators and teachers.

Background: School-based structured opportunities for physical activity can provide health-related benefits to children and youth, and contribute to international guidelines recommending 60 min of moderate-to-vigorous physical activity (MVPA) per day. In 2005, the Ministry of Education in Ontario, Canada, released the Daily Physical Activity (DPA) policy requiring school boards to "ensure that all elementary students, including students with special needs, have a minimum of twenty minutes of sustained MVPA each school day during instructional time". This paper reports on the first provincial study evaluating implementation fidelity to the DPA policy in Ontario elementary schools and classrooms.

Cigarette smoking susceptibility among youth alternate tobacco product users: implications of flavoured tobacco from a national cross-sectional Canadian sample (YSS 2012/2013).

Objectives: Declines in cigarette smoking have been accompanied by increases in alternative tobacco product (ATP) use, particularly among youth. This study examines smoking susceptibility and ATP use in a national sample of Canadian youth.

Methods: Data from grades 9-12 students who participated in the 2012/2013 Youth Smoking Survey, a nationally generalisable sample of Canadian students (n=27,404) were used to examine cigarette smoking susceptibility among never smokers (n=17,396).

Youth retail tobacco access in Canada: regional variation, perceptions, and predictors from YSS 2010/2011.

Purpose: Retail tobacco access is an important determinant of youth smoking prevalence. This study examines perceptions of ease in obtaining cigarettes and how prevalence of self-reported retail tobacco access among youth smokers varies by province in Canada. Additionally, relevant retail experiences, such as being asked for identification by a store clerk, are described.

Hookah use prevalence, predictors, and perceptions among Canadian youth: findings from the 2012/2013 Youth Smoking Survey.

Purpose: Few national surveys currently assess hookah smoking among youth. This study describes the prevalence, patterns of use, and perceptions about hookah in a nationally representative survey of Canadian grades 9-12 students.

Methods: The Youth Smoking Survey 2012/2013 was administered to 27,404 Canadian grades 9-12 students attending schools in nine Canadian provinces representing 96 % of Canadian population.

Is the Provision of Physical Education to Senior-Years Students Associated With Greater Physical Activity Levels? Insight Into a Province-Wide Policy.

Objectives: The purpose of this study was to determine if participation in physical education (PE) was associated with increased moderate-to-vigorous physical activity (MVPA) levels in adolescents.

Methods: This was a cross sectional study comparing MVPA levels in senior-years students-grade 11 and 12-enrolled in high school PE during the semester data were collected compared with those not enrolled in PE in that same semester. The primary outcome measure was daily MVPA measured by accelerometry.

The relationship between school physical activity policy and objectively measured physical activity of elementary school students: a multilevel model analysis.

Background: There is evidence of school level variability in the physical activity of children and youth. Less is known about factors that may contribute to this variation. The purpose of this study was to examine if the school health environment (Healthy Physical Environment, Instruction and Programs, Supportive Social Environment, and Community Partnerships) is associated with objectively measured time spent in light to vigorous physical activity among a sample of Toronto children.

Flavored tobacco use among Canadian students in grades 9 through 12: prevalence and patterns from the 2010-2011 youth smoking survey.

Introduction: This study examined patterns of use of flavored tobacco products in a nationally generalizable sample of Canadian students in grades 9 through 12 after the implementation of a national ban on certain flavored tobacco products.

Methods: Data from the 2010-2011 Youth Smoking Survey, a nationally generalizable sample of Canadian students in grades 9 through 12 (n = 31,396), were used to examine tobacco product use. Logistic regression models were used to examine differences in use of flavored tobacco products (cigarettes, pipes, little cigars or cigarillos, cigars, roll-your-own cigarettes, bidis, smokeless tobacco, water pipes, and blunt wraps) by sociodemographic and regional characteristics.

Smoking intensity and intent to continue smoking among menthol and non-menthol adolescent smokers in Canada.

Purpose: Research suggests that menthol cigarette use is associated with nicotine dependence. However, findings on the relationship between menthol smoking status and quantity of cigarettes smoked are less clear. The objective of this paper was to examine whether menthol cigarette smoking is associated with higher smoking intensity and intention to continue smoking among adolescents.

The COMPASS study: a longitudinal hierarchical research platform for evaluating natural experiments related to changes in school-level programs, policies and built environment resources.

Background: Few researchers have the data required to adequately understand how the school environment impacts youth health behaviour development over time.

Methods/design: COMPASS is a prospective cohort study designed to annually collect hierarchical longitudinal data from a sample of 90 secondary schools and the 50,000+ grade 9 to 12 students attending those schools. COMPASS uses a rigorous quasi-experimental design to evaluate how changes in school programs, policies, and/or built environment (BE) characteristics are related to changes in multiple youth health behaviours and outcomes over time.

The prevalence of eating behaviors among Canadian youth using cross-sectional school-based surveys.

Background: Obesity is a growing public health concern in Canada. Excess weight is particularly a concern among youth given that obesity in youth predicts obesity in adulthood. Eating behaviors, both inside and outside the home have been associated with increased risk of obesity; however, there is little data among Canadian youth to monitor trends.

Trajectories of objectively measured physical activity among secondary students in Canada in the context of a province-wide physical education policy: a longitudinal analysis.

Lower levels of physical activity are associated with childhood obesity. School physical education (PE) policies have been identified as critical to improve child and adolescent physical activity levels but there has been little evaluation of such policies. In the province of Manitoba, Canada, the government implemented a mandatory PE policy in secondary schools designed to increase the daily physical activity levels of adolescents.

Sugar-sweetened beverage consumption among a subset of Canadian youth.

Background: Sugar-sweetened beverages (SSBs) may play a role in increased rates of obesity. This study examined patterns and frequencies of beverage consumption among youth in 3 distinct regions in Canada, and examined associations between beverage consumption and age, sex, body mass index (BMI), physical activity and dieting behavior, as well as beverage displacement.

Methods: The study included data from 10,188 youth (ages 13-18) from Hamilton and Thunder Bay, Ontario, and Prince Edward Island (PEI) in 2009 to 2010.

The Happy Meal® Effect: the impact of toy premiums on healthy eating among children in Ontario, Canada.

Objectives: "Toy premiums", offered with McDonald's Happy Meals®, are a prominent form of food marketing directed at children. Two California jurisdictions recently implemented policies that only permit offering fast-food toy premiums with meals that meet certain nutritional criteria. The primary objective of the current study was to examine elements of this policy in a Canadian context and determine if children select healthier food products if toy premiums are only offered with healthier food options.

Are environmental influences on physical activity distinct for urban, suburban, and rural schools? A multilevel study among secondary school students in Ontario, Canada.

Background: This study examined differences in students' time spent in physical activity (PA) across secondary schools in rural, suburban, and urban environments and identified the environment-level factors associated with these between school differences in students' PA.

Methods: Multilevel linear regression analyses were used to examine the environment- and student-level characteristics associated with time spent in PA among grades 9 to 12 students attending 76 secondary schools in Ontario, Canada, as part of the SHAPES-Ontario study. This approach was first conducted with the full data set testing for interactions between environment-level factors and school location.

Young adult smoking cessation: predictors of quit attempts and abstinence.

We examined young adult smoking cessation behaviors, coding cessation behavior as no attempt, quit attempt (< 30 days), or abstinence (≥ 30 days) during follow-up from July 2005 through December 2008, observed in 592 young adult smokers from the Ontario Tobacco Survey. One in 4 young adults made an attempt; 14% obtained 30-day abstinence. Cessation resources, prior attempts, and intention predicted quit attempts, whereas high self-efficacy, using resources, having support, and low addiction predicted abstinence, indicating that young adult smokers require effective and appropriate cessation resources.

School and community predictors of smoking: a longitudinal study of Canadian high schools.

Objectives: We identified the most effective mix of school-based policies, programs, and regional environments associated with low school smoking rates in a cohort of Canadian high schools over time.

Methods: We collected a comprehensive set of student, school, and community data from a national cohort of 51 high schools in 2004 and 2007. Hierarchical linear modeling was used to predict school and community characteristics associated with school smoking prevalence.

A multilevel examination of factors of the school environment and time spent in moderate to vigorous physical activity among a sample of secondary school students in grades 9-12 in Ontario, Canada.

Objective: To examine associations between students' time spent in moderate to vigorous physical activity (MVPA) and the school built environment while also considering features of the schools' social environment and student-level characteristics.

Methods: Using surveys and GIS measures, multilevel linear regression analysis was applied to examine the environment- and student-level characteristics associated with time spent in MVPA among grade 9-12 students (n = 22,117) attending 76 secondary schools in Ontario, Canada as part of the SHAPES-Ontario study.

Results: Statistically significant between-school random variation in student MVPA was identified [[Formula: see text] = 9,065.

A multilevel examination of gender differences in the association between features of the school environment and physical activity among a sample of grades 9 to 12 students in Ontario, Canada.

Background: Creating school environments that support student physical activity (PA) is a key recommendation of policy-makers to increase youth PA. Given males are more active than females at all ages, it has been suggested that investigating gender differences in the features of the environment that associate with PA may help to inform gender-focused PA interventions and reduce the gender disparity in PA. The purpose of this cross-sectional study was to explore gender differences in the association between factors of the school environment and students' time spent in PA.

Youth Excel: towards a pan-Canadian platform linking evidence and action for prevention.

Population-level intervention is required to prevent cancer and other chronic diseases. It also promotes health for those living with established risk factors and illness. In this article, the authors describe a vision and approach for continuously improving population-level programs and policies within and beyond the health sector.

A multilevel examination of school and student characteristics associated with moderate and high levels of physical activity among elementary school students (Ontario, Canada).

Objectives: Schools represent an important environment for physical activity (PA) promotion among youth. Schools can promote PA through policies and programs but our understanding of how these school characteristics associate with student PA levels is largely unknown. Developing this understanding is critical for implementing new prevention interventions.