Objective: To evaluate the SickKids Team Obesity Management Program (STOMP), an obesity management program for severely obese adolescents. Methods: Non-randomized study of 6 and 12 month outcomes in STOMP patients vs. a comparison group of obese adolescents. Results: At 6 months, STOMP patients stabilized their BMI (0.08±0.3 kg/m2;p=0.79) and reported improved psychological and health behaviour measures, whereas comparison participants increased their BMI (0.7±0.2 kg/m2;p=0.004) and had worsening of cardiometabolic outcomes. Between-group differences included improved cardiometabolic, psychological and health behaviour measures in STOMP patients. At 12 months, STOMP patients stabilized their BMI (0.8±0.5 kg/m2;p=0.07), had improvements in anthropometric and cardiometabolic outcomes and reported an increase in health behaviours, whereas comparison participants increased their BMI (1.2±0.4 kg/m2;p=0.001) and had worsening of cardiometabolic outcomes. Between-group differences included improved anthropometric, cardiometabolic and health behaviour outcomes in STOMP patients. Conclusions: Participation in STOMP improved anthropometric, cardiometabolic, psychological and health behaviour outcomes among severely obese adolescents.

The HIV and AIDS epidemic is having a devastating effect on the mental health of people living with HIV and AIDS (PL WHA), who join support groups to receive support and empowerment. However these support groups are often unstructured, sporadically attended and lacking in social cohesion. The purpose of this research was to design, implement and evaluate a psychological well-being intervention for PL WHA. The intervention was based on and measured with an objective psychological well-being scale, which included dimensions of autonomy, personal growth, environmental mastery, purpose in life, positive relations with others and self-acceptance. Following establishment of experimental and control groups, six-week interventions with weekly sessions were run during which participants took turns to lead group presentations on the improvement of a previously chosen component of psychological well-being. The six week interventions as well as individual sessions were pre and post-tested. Qualitative and quantitative evaluation revealed that participants generally found the psychological well-being intervention meaningful and valuable in its provision of knowledge, learning, understanding and empowerment. Further research with an extended intervention program, regular attendance, larger samples of participants, and comparative evaluations of physical, biological, social and environmental factors is needed in order to more clearly establish the effectiveness of psychological well-being interventions for PLWHA. / Thesis (M.A.) -- University of KwaZulu-Natal, 2004.

In the last two decades, school gardening programs including interdisciplinary curriculum have been on the rise across the United States and abroad. Many outcomes have been researched related to school gardening programs including children’s academic achievements, socialization through gardening activities, food preference and nutritional outcomes, and environmental impacts. Teachers often carry the greatest weight of responsibility in school gardening programs. While current literature evidences child outcomes by evaluating children, parents, teachers and principles, in this project, teachers specifically were able to identify barriers and concerns before and after teacher training workshops in a pilot program in Atlanta, Georgia and express their levels of experience as indicators of commitment and willingness to implement the program in their classrooms. This research provided an opportunity to assess how well the training addressed perceived barriers to outdoor teaching. Principles of self-­‐efficacy and social cognitive theory were used to guide the development of survey tools in this evaluation. A logic model was created to identify the inputs, activities, short, medium-­‐, and long-­‐term outcomes and overall impact of the Learning Gardens program to be used in program implementation and expansion and to keep goals in sight, providing measurable evaluation steps to monitor progress. Surveys were created to evaluate the efficacy of teacher training and how teachers perceived barriers and self-­‐efficacy during their first year participating in the school gardens program. Surveys were given online and in-­‐person before and after training and after the first year of program participation. Data was collected, analyzed and presented. Curriculum tool kits were prepared for use in the classroom. Results indicated that with training, barriers to teaching outdoors decreased; perceived self-­‐efficacy and thus the drive and motivation to continue forward movement in the Learning Gardens program increased. Once teachers became aware of their goals, and how they would be able to achieve them together, they gained understanding of how the program would be beneficial to their students. These results stress the importance of teacher training and the provision of tools and resources linked directly to standards-­‐based curriculum as critical components in the implementation of successful school garden programming.

The purpose of this doctoral thesis was to develop, implement and evaluate the PULSE program, a community-based physical activity and life skills program for at-risk youth. The thesis is composed of four articles. The first paper describes the rationale and development of the PULSE program which was designed to help youth develop the skills to self-regulate and successfully perform physical activity. The second article presents a process evaluation of the PULSE program. This article examines how the youth progressed through the program with regards to the five levels of the Teaching and Social Responsibility (TPSR) model, one of the frameworks on which the PULSE program is based. A second purpose of this study was to understand the youths’ perceptions of the impact of the program on these five levels. The results indicated that the program led to slight increases in the five levels of the TPSR model and the youth reported transferring the skills they learned related to the levels in their lives outside of the program. The third paper represents an outcome evaluation of the PULSE program. Results showed that youth who participated in PULSE increased their fitness, physical activity levels as well as a number of positive youth development outcomes. Finally, the fourth paper examined how the PULSE program helps support the tenets of Basic Needs Theory. The results indicated that the program successfully nurtured the three basic needs of autonomy, competence and relatedness. The overall findings suggest that the PULSE program is a practical, evidence-informed program that may help youth understand and apply life skills to be physically active as they approach adulthood, and also more generally in their lives. The current findings show promise for both Physical Activity (PA) and Positive Youth Development (PYD) outcomes but further research is needed to make causal links.

The College of Family Physicians of Canada, responsible for accreditation of residency programs, prescribe ‘The Four Principles of Family Medicine’ and the 27 competencies derived from them, as the curricular framework for Canadian family medicine residencies. The literature reveals little about the development of the Four Principles of Family Medicine. This study was conducted to determine the degree to which each competency was considered relevant to clinical practice and learned by recent graduates of the University of Manitoba Family Medicine program. For the 27 competencies, the ratings of graduates were similar to those of family medicine experts as the competencies were generally viewed as moderately important and frequently used. Graduates reported being well prepared in most of the competencies. This supports the use of the Four Principles of Family Medicine as a curricular framework for family physician trainees in Canada.

Community sport organizations (CSO) are the most predominant type of nonprofit and voluntary organization in Canada (Gumulka, Barr, Lasby, & Brown-lee, 2005), and, it is vital that researchers recognize the critical, and often contradictory, social roles that these organizations are expected to perform. Community sport is both lauded as a progressive force of individual and community development (Sport for Development and Peace, International Working Group [SDP IWG], 2006) and criticized for reproducing race and class-based stereotypes that marginalize Aboriginal peoples (Canadian Heritage, 2005). Added to these challenges is the fact that sport leaders are expected to negotiate conflicting interests and unequal power relations (see Forester, 1989) while relying on a very limited body of research in which to guide their work in designing, delivering and facilitating culturally relevant sport programs for Aboriginal youth (see Forsyth, Heine & Halas, 2007; Maskawachees Declaration, 2000). Positioned within a transdisciplinary theoretical framework and guided by principles of indigenous research (Schnarch, 2004; Wilson, 2008), I conducted a multi-layered community-based study with sport leaders and youth participants at the Winnipeg Aboriginal Sport Achievement Center (WASAC), a successful urban Aboriginal sport organization in Manitoba, Canada. Building on similar research in the area of culturally relevant physical activity and education (e.g., Carpenter, 2009; Forsyth et al., 2007), the purpose of my research was to examine the politics and praxis of culturally relevant sport education (CRSE) – specifically, program planning and leadership practices - as an alternative to deficit-based and culturally inappropriate sport programs for urban Aboriginal youth. Findings reveal that WASAC leaders utilize a complex set of explicit and tacit cultural teachings rooted within a context- and relationship-based approach to program planning and facilitation. Findings also indicate that culturally relevant sport leadership practices are strongly related to the personal, experiential and cultural background and knowledge of sport leaders. The study concludes by suggesting that sport leaders who understand the cultural landscape of urban Aboriginal youth and utilize critical self-reflexive practices are more likely to recognize and build upon the resilience of urban Aboriginal youth while proactively responding to the complex challenges that shape the lives of youth.

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Thesis (M.A. (Population and Reproductive Health Research))--Mahidol University, 2008. / LICL has E-Thesis 0043 ; please contact computer services.

Thesis (M.P.H.)--University of Michigan, 1945.