Childhood obesity has become an increasingly important public health concern in Canada. This paper provides an econometric analysis of the role of income and other explanatory factors on adolescent overweight and obese statuses within Canada using data from the 2009/2010 Canadian Community Health Survey. Results reveal the importance of low-income status on adolescent body weight. The effect of low income is particularly pronounced after accounting for household size. However, it does not account for much of the additional incidence of overweight and obesity in the Atlantic region of Canada.

Doctor of Philosophy / Department of Horticulture, Forestry, and Recreation Resources / Candice A. Shoemaker / Public health research shows that targeting behavior directly when promoting healthy behaviors is not as effective for sustainability. Instead the recommendation is to integrate a theoretical framework that identifies factors which affect the targeted behavior and develop the intervention aimed at those factors. The objectives of this dissertation were to measure the healthful benefits of gardening for youth. Strategies were developed for creating an after-school garden club curriculum to target healthy eating, physical activity, sedentary behavior, and gardening. Accelerometers were used to determine physical activity intensity during a garden club session following a curriculum developed to promote physical activity through gardening. In a separate experiment, a portable gas analyzer was used to measure energy expenditure of youth while gardening. The constructs of Social Cognitive Theory were used to provide a guide with strategies for developing a curriculum with a theoretical basis for an after-school garden club targeting overweight prevention. Strategies presented include activities for targeting the theoretical constructs as well as for implementing evaluations. Fourth and fifth grade students at four randomly selected elementary schools in Manhattan, Kansas were invited to join the garden club. Students with parental permission attended the club for ten weeks in the fall and twelve weeks in the spring. During the second year of implementation students with parental permission participated in the accelerometer study. For six days students wore an accelerometer and completed a daily activity log detailing their activities during that time. Students in the fourth and fifth grades from eight Manhattan, Kansas elementary schools were invited to participate in the energy expenditure study during the summer of 2010. Students who participated in this study (n=20) wore a portable gas analyzer and heart rate monitor while performing four gardening tasks. Data were used to calculate energy expenditure of youth while gardening. A theoretically-based after-school garden club curriculum was developed to target increasing youth healthy behaviors. Results from the accelerometer study showed that students were significantly more physically active at the moderate and vigorous intensity level and significantly less sedentary at garden club compared to not at garden club. For students who participated in the energy expenditure study, the gardening tasks (transplanting, weeding, cultivating, and raking) were moderate physical activity (3-5.99 METs). Gardening can be a valuable tool for promoting and increasing physical activity in youth.

Made available in DSpace on 2014-12-17T14:47:03Z (GMT). No. of bitstreams: 1 CarolineENKV_DISSERT.pdf: 3807500 bytes, checksum: a47dd134372904c5d622a5ed69238b91 (MD5) Previous issue date: 2013-11-29 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior / One of the Primary Health Care strategies for adolescent health is the growth and development follow-up and the early detection of overweight adolescents. Even though the School Health Program in Brazil proposes to evaluate the nutritional state of the school population in the corresponding community health units, not all cities have adhered to the Program and many nurses do not recognize overweight as a problem in their territory. The objective of the study was to identify the nurse?s participation in the screening of overweight adolescent students in their work territory. Cross sectional study conducted in eight state supported schools of the municipality of Natal/RN and in four Primary Health Units. The total student population was 27.277. A stratified sample was statistically calculated based on the student population of the four city geographical zones: 112 North , 74 West; 108 East; and 78 South, totalizing 372 adolescents. The students were selected by a probability process where eight schools were first selected, two per district, until the number per subsample in each district was reached. Four primary health nurses, responsible for the health units were included. Two instruments were used for data collection, a screening questionnaire and a semi-structured interview form for questioning of the nurses. The content of both instruments was validated. Anthropometric and health data were collected from the students and analyzed with descriptive and analytical statistics. Interview data were transcribed and submitted to content analysis. The nursing diagnosis of overweight was identified in 50 (13,5%) of the adolescents and its association with consumption of foods that have cardiovascular risk (canned foods, pasta and fried food). An association of the nursing diagnosis was identified with family history (diabetes, hypertension, obesity, and kidney disease). The nurses judged that care of overweight adolescents was important but noted difficulties because of the absence of this population in the health units, because of their work overload, and the lack of school articulation. The nurses do not have impacting actions with this population and delegate the responsibility to other professionals. It is concluded that overweight is a nutritional problem relevant to the adolescent school population in Natal/RN, with a 13,5% prevalence and that it is related to food consumption with cardiovascular risk and family health history. The nurses consider overweight as an important public health problem but do not envision ways to maintain linkage with adolescents and with the school to promote the needed care / Uma das principais estrat?gias da enfermagem na Aten??o prim?ria em Sa?de (APS) ? o acompanhamento do crescimento e identifica??o precoce do excesso de peso em adolescentes. Apesar dos incentivos do Programa Sa?de na Escola (PSE) no Brasil, que prop?s avaliar o estado nutricional dos escolares pelas Unidades B?sicas de Sa?de (UBS), ainda n?o h? ades?o de todos os munic?pios e muitos enfermeiros n?o reconhecem o excesso de peso como um problema. O objetivo desse estudo foi identificar a participa??o do enfermeiro da APS no screening de adolescentes escolares com excesso de peso na sua ?rea de atua??o. Estudo transversal, realizado em oito escolas estaduais de Natal-RN e em quatro UBS. A popula??o de alunos das escolas estaduais foi 27.377. Com base em procedimento estat?stico, definiu-se uma amostra estratificada pelas quatro zonas municipais: 112 na Norte, 74 na Oeste, 108 na Leste e 78 na Sul, o que totalizou 372 adolescentes. Na sele??o de alunos, sortearam-se aleatoriamente as escolas e as turmas participantes, at? totalizar o tamanho das subamostras por zona. Participaram quatro enfermeiras respons?veis pelas UBS inclu?das. Dois instrumentos de coleta de dados foram utilizados, um formul?rio para o screening e um roteiro de entrevista semi-estruturada para questionar os enfermeiros. O conte?do dos instrumentos foi validado por especialistas. A coleta de dados com os adolescentes compreendeu a verifica??o de peso, altura e condi??es de sa?de e analisados por meio estat?stica descritiva e anal?tica. Os ?udios das entrevistas foram gravados, transcritos e analisadas quanto ao conte?do. Dentre os adolescentes, 50 (13,5%) foram identificados com o Diagn?stico de Enfermagem (DE) excesso de peso, com associa??o ao consumo de alimentos de risco cardiovascular (embutidos, macarr?o e fritura). Identificou-se associa??o entre o DE e a hist?ria familiar de doen?as (diabetes, hipertens?o, obesidade e doen?a nos rins). As enfermeiras julgaram fundamental a assist?ncia aos adolescentes com excesso de peso, mas apontaram dificuldades devido a pouca procura dessa clientela pelos servi?os de sa?de, pelo excesso de tarefas que realizam nas UBS e pela baixa articula??o com as escolas. Elas se isentaram de condutas de maior impacto e atribu?ram a outros profissionais a responsabilidade maior. Conclui-se que o excesso de peso ? um desvio nutricional relevante na popula??o de adolescentes de escolas estaduais de Natal/RN, com frequ?ncia de 13,5% e que o problema est? relacionado ao consumo de alimentos de risco cardiovascular e ? hist?ria familiar de doen?as. Os enfermeiros consideram o excesso de peso como importante problema de sa?de p?blica, que necessita de assist?ncia de enfermagem, mas n?o vislumbram estrat?gias para manter o v?nculo com o adolescente e com a escola para promover a assist?ncia resolutiva diante esse DE

Youth obesity prevalence rates in the United States are trending down; however, for Hispanic youth, rates are increasing despite efforts toward a reduction. The purpose of this study was to evaluate the impact of a culturally focused intervention program on weight reduction of Hispanic youth age 2 to 19 through examination of body mass index (BMI) percentile outcomes comparing age, gender, distance to program, time in program, and season of enrollment. Review of literature supports ecological and cultural approaches requiring behavior modification tailored to family and community as successful in decreasing youth obesity. However, researchers have yet to establish how various variables impact intervention outcomes making it difficult to determine what aspects of the cultural approach is effective. The epidemiology triangle and the social cognitive theory approach were used to relate to findings. Use of retrospective clinical archival participant data dating from November 7, 2008 to February 23, 2015 was analyzed through the use of various statistical applications. The analyses of this study indicated that only one age variable had significant results. The category for age 8 to12 had a significantly higher change in BMI than the other groups (p <.05) . This research has the potential to contribute to social change since it reveals that interventions tailored for the 8-12 age group may significantly improve the effectiveness of the program in reducing BMI percentile, thus decreasing obesity rates and associated disease along with morbidity and mortality. This knowledge can benefit educators, community collaborative efforts, practitioners, and other researchers.