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Utility of Surveillance Research to Inform Physical Activity Policy: An Exemplar From Canada

Cora L. Craig, Christine A. Cameron, and Adrian Bauman

Background:

There are several well-known risk factor monitoring systems, but few examples of comprehensive surveillance systems designed specifically to inform physical activity (PA) policy. This paper examines the utility of Canada`s Physical Activity and Sport Monitoring System in guiding policy and practice.

Methods:

Indicators were determined in conjunction with government, nongovernmental associations and academics. Serial measures were collected from representative population (telephone interviews, n = 4000 to 11,000) and setting-based (postal surveys, n = 1425 to 4304) surveys.

Results:

Adult PA was higher in 2014 (47%) than 1998 (37%). The prevalence of knowledge about sufficient PA to meet national guidelines increased (31% to 57%). Most adults (66%) reported having many safe places to walk locally. Having policies to encourage walking and cycling when redeveloping communities increased by community size (5% to 37%). PA promotion was available in 10% to 15% of workplaces. Most parents (64%) provided transportation to support their child’s PA. The prevalence of policies mandating daily PE increased 2001 to 2011 (36% to 55%), as did having no policy to hire qualified PE teachers (25% to 34%).

Conclusions:

Canada’s surveillance system has provided information for guiding policy planning, resource allocation, setting and tracking national goals, assessing changes in PA determinants, and evaluating national campaigns, naturally occurring experiments, and innovative policies.

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Markers of Sedentarism: The Joint Canada/U.S. Survey of Health

Teresa L. Hart, Cora Lynn Craig, Joseph M. Griffiths, Christine Cameron, Ross E. Andersen, Adrian Bauman, and Catrine Tudor-Locke

Background:

The Joint Canada/United States Survey of Health (JCUSH) was a one-time collaborative survey undertaken by Statistics Canada and the National Center for Health Statistics.

Methods:

This analysis provides country-, sex-, and age-specific comparative markers of adult obesity and sedentarism, defined as independent and collective groupings of self-reported leisure-time inactivity (<1.5 MET-hours/day), usual occupational sitting, and no/low active transportation (<1 hour/week). Logistic regression assessed the likelihood of sedentarism in U.S. vs. Canada, with and without adjusting for BMI-defined obesity categories: healthy weight (18.5 ≤ BMI <25 kg/m2; n = 3542), overweight (25 ≤ BMI < 30 kg/m2; n = 2,651), and obesity (BMI ≥ 30 kg/m2; n = 1470).

Results:

Compared with Canadians, U.S. adults are 24% more likely to be overweight/ obese, 59% more likely to be inactive in leisure-time, 19% more likely to report no/low active transportation, and 39% more likely to collectively report all sedentarism markers, adjusting for sex and age. Focusing on obese individuals in both countries, obese U.S. residents were 90% more likely to be inactive during leisure-time, 41% more likely to report no/low active transportation, and 73% more likely to report all sedentarism markers.

Conclusions:

This ecological analysis sheds light on differential risks of obesity and sedentarism in these neighboring countries.

Open access

Results From Canada’s 2016 ParticipACTION Report Card on Physical Activity for Children and Youth

Joel D. Barnes, Christine Cameron, Valerie Carson, Jean-Philippe Chaput, Guy E.J. Faulkner, Katherine Janson, Ian Janssen, Roger Kramers, Allana G. LeBlanc, John C. Spence, and Mark S. Tremblay

Background:

The ParticipACTION Report Card on Physical Activity for Children and Youth is the most comprehensive assessment of child and youth physical activity in Canada and provides an update or “state of the nation” that assesses how Canada is doing at promoting and facilitating physical activity opportunities for children and youth. The purpose of this paper is to summarize the results of the 2016 ParticipACTION Report Card.

Methods:

Twelve physical activity indicators were graded by a committee of experts using a process that was informed by the best available evidence. Sources included national surveys, peer-reviewed literature, and gray literature such as government and nongovernment reports and online content.

Results:

Grades were assigned to Daily Behaviors (Overall Physical Activity: D-; Organized Sport and Physical Activity Participation: B; Active Play: D+; Active Transportation: D; Physical Literacy: D+; Sleep: B; Sedentary Behaviors: F), Settings and Sources of Influence (Family and Peers: C+; School: B; Community and Environment: A-), and Strategies and Investments (Government: B-; Nongovernment: A-).

Conclusions:

Similar to previous years of the Report Card, Canada generally received good grades for indicators relating to investment, infrastructure, strategies, policies, and programming, and poor grades for behavioral indicators (eg, Overall Physical Activity, Sedentary Behaviors).

Free access

Expert Appraisal of the 2022 Canadian Para Report Card on Physical Activity for Children and Adolescents With Disabilities

Kelly P. Arbour-Nicitopoulos, Nicholas Kuzik, Leigh M. Vanderloo, Kathleen A. Martin Ginis, Maeghan E. James, Rebecca L. Bassett-Gunter, Daniela Ruttle, Pinder DaSilva, Katerina Disimino, Christine Cameron, Mike Arthur, Keiko Shikako, and Amy E. Latimer-Cheung

This report provides an expert appraisal of the Canadian Para Report Card on physical activity (PA) for children and adolescents with disabilities. Thirteen indicators were graded by a panel of researchers, representatives from disability and PA organizations, and parents of children and adolescents with disabilities using benchmarks of the Global Matrix 4.0 and previous Canadian PA Report Cards. Facilitated panel discussions were used to appraise the available evidence based on data gaps, opportunities, and recommendations. The available data sources included four nationally generalizable or representative data sets. Grades were assigned to 8/13 indicators and ranged from B+ to F. Data gaps in measurement and national surveillance systems were identified. Ableism was an issue identified within some of the reporting benchmarks. The absence of PA from existing accessibility legislation in Canada was a policy gap of concern. Recommendations related to research, surveillance, and policy are provided to enhance PA among children and adolescents with disabilities in Canada.

Open access

Results from Canada’s 2018 Report Card on Physical Activity for Children and Youth

Joel D. Barnes, Christine Cameron, Valerie Carson, Jean-Philippe Chaput, Rachel C. Colley, Guy E.J. Faulkner, Ian Janssen, Roger Kramers, Travis J. Saunders, John C. Spence, Patricia Tucker, Leigh M. Vanderloo, and Mark S. Tremblay

Open access

Results From the 2019 ParticipACTION Report Card on Physical Activity for Adults

Soultana Macridis, Christine Cameron, Jean-Philippe Chaput, Tala Chulak-Bozzer, Patricia Clark, Margie H. Davenport, Guy Faulkner, Jonathon Fowles, Lucie Lévesque, Michelle M. Porter, Ryan E. Rhodes, Robert Ross, Elaine Shelton, John C. Spence, Leigh M. Vanderloo, and Nora Johnston

Background: The ParticipACTION Report Card on Physical Activity for Adults is a knowledge exchange tool representing a synthesis of the literature and data available at the national level. The purpose of this paper is to summarize the results of the inaugural 2019 edition. Methods: Thirteen physical activity indicators, grouped into 4 categories, were graded by a committee of experts using a process that was informed by the best available evidence. Sources included national surveys, peer-reviewed literature, and gray literature such as government and nongovernment reports and online content. Results: Grades were assigned to Daily Behaviors (overall physical activity: D; daily movement: C; moderate to vigorous physical activity: F; muscle and bone strength: INC; balance: INC; sedentary behavior: INC; sleep: B−), Individual Characteristics (intentions: B+), Settings and Sources of Influence (social support: INC; workplace: INC; community and environment: B−; health and primary care settings: C−), and Strategies and Investments (government: B−). Conclusions: Generally, lower grades were given to behavior-related indicators (eg, overall physical activity) and better grades for indicators related to investments, community supports, and strategies and policies. Research gaps and future recommendations and directions are identified for each indicator to support future practice, policy, and research directions.

Full access

Results from Canada’s 2014 Report Card on Physical Activity for Children and Youth

Casey E. Gray, Joel D. Barnes, Jennifer Cowie Bonne, Christine Cameron, Jean-Philippe Chaput, Guy Faulkner, Ian Janssen, Peter T. Katzmarzyk, Angela M. Kolen, Stephen R. Manske, Art Salmon, John C. Spence, Brian W. Timmons, and Mark S. Tremblay

Background:

The Active Healthy Kids Canada (AHKC) Report Card consolidates and translates research and assesses how Canada is being responsible in providing physical activity opportunities for children (3- to 11-years-old) and youth (12- to 17-years-old). The primary aim of this article is to summarize the results of the 2014 AHKC 10th Anniversary Report Card.

Methods:

Ten physical activity indicators were graded using the AHKC Report Card development process, which includes a synthesis of the best available research, surveillance, policy and practice findings, and expert consensus.

Results:

Grades assigned were for: ‘Behaviors that Contribute to Overall Physical Activity Levels’ (Overall Physical Activity Levels, D-; Organized Sport Participation, C+; Active Play, INCOMPLETE; Active Transportation, D; Sedentary Behaviors, F), ‘Settings and Sources of Influence’ (Family and Peers, C; School, C+; and Community and the Built Environment, B+), and ‘Strategies and Investments’ (Government Strategies and Investments, C; and Non-Government Strategies and Investments, A-).

Conclusions:

Despite good availability of policies, programs, and infrastructure, the overall physical activity levels of Canadian children and youth remain low while sedentary behavior levels remain high. As with many nations, there is room for improvement in most physical activity behaviors and some sources of influence.

Open access

Status and Trends of Physical Activity Surveillance, Policy, and Research in 164 Countries: Findings From the Global Observatory for Physical Activity—GoPA! 2015 and 2020 Surveys

Andrea Ramírez Varela, Pedro C. Hallal, Juliana Mejía Grueso, Željko Pedišić, Deborah Salvo, Anita Nguyen, Bojana Klepac, Adrian Bauman, Katja Siefken, Erica Hinckson, Adewale L. Oyeyemi, Justin Richards, Elena Daniela Salih Khidir, Shigeru Inoue, Shiho Amagasa, Alejandra Jauregui, Marcelo Cozzensa da Silva, I-Min Lee, Melody Ding, Harold W. Kohl III, Ulf Ekelund, Gregory W. Heath, Kenneth E. Powell, Charlie Foster, Aamir Raoof Memon, Abdoulaye Doumbia, Abdul Roof Rather, Abdur Razzaque, Adama Diouf, Adriano Akira Hino, Albertino Damasceno, Alem Deksisa Abebe, Alex Antonio Florindo, Alice Mannocci, Altyn Aringazina, Andrea Backović Juričan, Andrea Poffet, Andrew Decelis, Angela Carlin, Angelica Enescu, Angélica María Ochoa Avilés, Anna Kontsevaya, Annamaria Somhegyi, Anne Vuillemin, Asmaa El Hamdouchi, Asse Amangoua Théodore, Bojan Masanovic, Brigid M. Lynch, Catalina Medina, Cecilia del Campo, Chalchisa Abdeta, Changa Moreways, Chathuranga Ranasinghe, Christina Howitt, Christine Cameron, Danijel Jurakić, David Martinez-Gomez, Dawn Tladi, Debrework Tesfaye Diro, Deepti Adlakha, Dušan Mitić, Duško Bjelica, Elżbieta Biernat, Enock M. Chisati, Estelle Victoria Lambert, Ester Cerin, Eun-Young Lee, Eva-Maria Riso, Felicia Cañete Villalba, Felix Assah, Franjo Lovrić, Gerardo A. Araya-Vargas, Giuseppe La Torre, Gloria Isabel Niño Cruz, Gul Baltaci, Haleama Al Sabbah, Hanna Nalecz, Hilde Liisa Nashandi, Hyuntae Park, Inés Revuelta-Sánchez, Jackline Jema Nusurupia, Jaime Leppe Zamora, Jaroslava Kopcakova, Javier Brazo-Sayavera, Jean-Michel Oppert, Jinlei Nie, John C. Spence, John Stewart Bradley, Jorge Mota, Josef Mitáš, Junshi Chen, Kamilah S Hylton, Karel Fromel, Karen Milton, Katja Borodulin, Keita Amadou Moustapha, Kevin Martinez-Folgar, Lara Nasreddine, Lars Breum Christiansen, Laurent Malisoux, Leapetswe Malete, Lorelie C. Grepo-Jalao, Luciana Zaranza Monteiro, Lyutha K. Al Subhi, Maja Dakskobler, Majed Alnaji, Margarita Claramunt Garro, Maria Hagströmer, Marie H. Murphy, Matthew  Mclaughlin, Mercedes Rivera-Morales, Mickey Scheinowitz, Mimoza Shkodra, Monika Piątkowska, Moushumi Chaudhury, Naif Ziyad Alrashdi, Nanette Mutrie, Niamh Murphy, Norhayati Haji Ahmad, Nour A. Obeidat, Nubia Yaneth Ruiz Gómez, Nucharapon Liangruenrom, Oscar Díaz Arnesto, Oscar Flores-Flores, Oscar Incarbone, Oyun Chimeddamba, Pascal Bovet, Pedro Magalhães, Pekka Jousilahti, Piyawat Katewongsa, Rafael Alexander Leandro Gómez, Rawan Awni Shihab, Reginald Ocansey, Réka Veress, Richard Marine, Rolando Carrizales-Ramos, Saad Younis Saeed, Said El-Ashker, Samuel Green, Sandra Kasoma, Santiago Beretervide, Se-Sergio Baldew, Selby Nichols, Selina Khoo, Seyed Ali Hosseini, Shifalika Goenka, Shima Gholamalishahi, Soewarta Kosen, Sofie Compernolle, Stefan Paul Enescu, Stevo Popovic, Susan Paudel, Susana Andrade, Sylvia Titze, Tamu Davidson, Theogene Dusingizimana, Thomas E. Dorner, Tracy L. Kolbe-Alexander, Tran Thanh Huong, Vanphanom Sychareun, Vera Jarevska-Simovska, Viliami Kulikefu Puloka, Vincent Onywera, Wanda Wendel-Vos, Yannis Dionyssiotis, and Michael Pratt

Background: Physical activity (PA) surveillance, policy, and research efforts need to be periodically appraised to gain insight into national and global capacities for PA promotion. The aim of this paper was to assess the status and trends in PA surveillance, policy, and research in 164 countries. Methods: We used data from the Global Observatory for Physical Activity (GoPA!) 2015 and 2020 surveys. Comprehensive searches were performed for each country to determine the level of development of their PA surveillance, policy, and research, and the findings were verified by the GoPA! Country Contacts. Trends were analyzed based on the data available for both survey years. Results: The global 5-year progress in all 3 indicators was modest, with most countries either improving or staying at the same level. PA surveillance, policy, and research improved or remained at a high level in 48.1%, 40.6%, and 42.1% of the countries, respectively. PA surveillance, policy, and research scores decreased or remained at a low level in 8.3%, 15.8%, and 28.6% of the countries, respectively. The highest capacity for PA promotion was found in Europe, the lowest in Africa and low- and lower-middle-income countries. Although a large percentage of the world’s population benefit from at least some PA policy, surveillance, and research efforts in their countries, 49.6 million people are without PA surveillance, 629.4 million people are without PA policy, and 108.7 million live in countries without any PA research output. A total of 6.3 billion people or 88.2% of the world’s population live in countries where PA promotion capacity should be significantly improved. Conclusion: Despite PA is essential for health, there are large inequalities between countries and world regions in their capacity to promote PA. Coordinated efforts are needed to reduce the inequalities and improve the global capacity for PA promotion.