Dr. Nicholas L. Holt CASA research lab Faculty of Physical Education and Recreation University of Alberta Youth & Active Living Health Kids Alberta Presentation Funding Provided By:

Physical Activity Among Canadian Youth 49% of youth are active during their leisure time (equivalent of 1 hr walking per day). Only 21% of youth are active enough to meet international guidelines for optimal growth and development (CFLRI: 2004 Physical Activity Monitor) –63% of 5-17 year olds not active enough for optimal growth –90% adult & 70% child trips by car (2001 US Department of National Transportation Travel Survey). Approximately one in three Canadian children are overweight or obese (Tremblay & Willms, 2003). –In the past 15 years, the prevalence of obesity has tripled in Canadian children aged 7-13 (Tremblay and Willms, 2000) –Canada ranked as the fifth highest country for prevalence of overweight and obese school-aged youth following Malta, US, Wales, and Greenland (Janssen et al., 2005).

Developing Child Organized Activities (SPORT) Unorganized Activities (PLAY/PA) Compulsory Activities (SCHOOL) Opportunities for Physical Activity Family Neighborhood

Physical Activity Among Canadian Youth Decline in activity with age and gender (girls at yrs vs boys yrs) –Adolescents less active than children 2-12 years old (33% vs 43%) –Girls less active than boys: 30% vs 50% at 5-12 yrs vs 25% vs 40% at yrs –Girls - less intense physical activities Proportion of students in grades 6, 8, and 10 who exercise >1x/wk outside of school is declining ( ) –Proportion of students who watch TV >4 hrs/day is increasing –Proportion of students who play video games >4 hrs/wk is increasing (mostly males). Canadian children among highest in world –average Canadian child is sedentary for 3-5 hrs/day in front of TV alone (CMAJ, 1998)

Studies show that adults who live in low-density suburban areas are: –walk and bicycle less; –use cars more; –more overweight; –and have higher rates of obesity-related illnesses  (Cervero & Duncan, 2003; Ewing et al., 2003; Frank et al., 2004; Frank et al. 2005; Handy et al., 2006; Kelly-Schwartz et al., 2004; Lopez, 2004; Saelens et al., 2003; Sturm & Cohen, 2004). Neighbourhoods & Physical Activity

Neighbourhood and Developmental Influences on Play and PA More active transportation from children in grid-style neighborhood Benefits of cul-de-sacs for younger children Benefits of grid-style for older children

PA in Inner-City Locations I: So if you were going to talk to another kid from another school, what would you say is the best thing about living in this neighbourhood? S4: It’s close to the school and you don’t have to, in the wintertime you don’t like have to drive there and take the bus, you can just walk there and it’s pretty quick. I: Ok, how about, what would you say is the worst thing about living in this neighbourhood? S4: Sometimes there’s homeless people behind the house and stuff S3: It’s kinda bad because when my mom used to walk me to school when my brother was just in day care he would take a day care bus so she would walk me to school before we got the car, and she would always pick up needles along the way, and in the school yard and stuff.

Treatment Needs/Preferences of Overweight Children & Their Families Authoritative Parenting Skills Resistance to Changing Screen Time Help From Health Care Professionals Increase Social Support Network Provide Family-Centered Treatment Policy/Institutional Level Support

Sport and Youth Development Negative outcomes  Use of alcohol  Perf-enhancing drugs  Undesirable social norms  Injury ↓ Perspective taking ↓ Moral development Positive outcomes  Self-esteem  Skill development  Grade point averages  Attendance  Fruit consumption  Contraceptive use ↓ Use of illegal drugs ↓ School dropout Selected Sources: (Barber, Eccles, & Stone, 2001; Collis & Griffin, 1993; Eccles & Barber, 1999; Eder & Parker, 1987; Hansen, Larson, & Dworkin, 2003; Mahoney, 2000; Marsh & Kleitman, 2003; Martinek, McLaughlin, & Schilling, 1999; McNeal, 1995; Melnick, Miller, Sabo, Farrell, & Barnes, 2001; Novick & Glasgow, 1993; Pate et al., 2000; Pedersen & Seidman, 2004; Rainey, McKeown, Sargent, & Valois, 1996; Richman & Shaffer, 2000; Ryckman & Hamel, 1995; Sabo, Miller, Farrell, Melnick, & Barnes, 1999; Shields & Bredemeier, 1995)

Sport Participation Structure created by coach can promote responsibility and teamwork Authoritative parenting style associated with range of positive outcomes in sport

Developing Child Organized Activities (SPORT) Unorganized Activities (PLAY/PA) Compulsory Activities (SCHOOL) Opportunities for Physical Activity Family Neighborhood

7 Keys to Active Living for Children and Youth 1.Opportunity (Home, School, Community) 2.Daily Dose 3.Skill Development 4.Choice 5.Key Role Models 6.Appropriate Competition 7.Family Involvement (Adapted from, Active Start for Healthy Kids, Virgilio, 2006)

Dr. Nicholas L. Holt Child & Adolescent Sport & Activity research lab (780) (lab) (780) (office) Acknowledgements Contact

The Childhood Obesity Epidemic: How It Can Be Changed Suzanne Tough, PhD University of Calgary Alberta Centre for Child, Family & Community Research

A Synthesis of the Research Researchers used a systematic approach to find, select and critically appraise research literature on the prevention and treatment of childhood obesity Aimed to identify: –the common features of existing programs and the gaps –the best way to develop and implement existing programs –the features of existing programs that were most successful in achieving healthy weights Flynn, MA, McNeil DM, Tough SC, Maloff B, Ford C, Mutasingwa D, Wu M. Reducing obesity and related chronic disease risk in children and youth: a synthesis of evidence with best practice recommendations. Obesity Reviews 2006;7(Suppl 1):7-66.

What’s Missing in Existing Programs Very few programs for preschool children Very few programs in the home Lack of programs that change the environment Programs specifically for boys or girls were rare No program specifically targeted immigrants Most programs were short with little follow-up

Things that Worked Well in Program Development Community and stakeholder involvement Including program leaders and role models Keeping principles of population health, such as changing the environment and policies, central to program design

Things that Worked Well in Program Effectiveness Many programs had some success in reaching their goals Increased physical activity was successful most frequently Other successful strategies were: –behaviour modification –involvement of children’s families –psychological support –health education Although rarely used, changes to the environment were successful when used

What Action Should Be Taken? Develop community programs for immigrants, preschool children, and boys Encourage use of effective strategies, such as environmental change and physical activity Invest in long term programs and follow-up to enable monitoring and evaluation

Thank You! Alberta Centre for Child, Family and Community Research Website: