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Saskatchewan Population Health and Evaluation Research Unit

Smart Cities, Healthy Kids

smartcitieshealthykids.com

PHYSICAL ACTIVITY PROFILE FOR

Forest Grove School


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YOUR SCHOOLS PROFILE Thank you, Forest Grove School, for participating in the Smart Cities, Healthy Kids project.

Smart Cities, Healthy Kids is a three-year project sponsored by the Canadian Institutes of Health Research,the Heart and Stroke Foundation of Canada, and the Health Research Foundation. We are centred in theSaskatchewan Population Health and Evaluation Research Unit (SPHERU) at the University of Saskatchewan.

Our goal is to conduct research that will be of direct benefit to our research participants, partners, andcommunities in general. We aim to provide information, ideas, and assistance to those who work withchildren to create innovative health intervention strategies. We are grateful for the opportunity to collectdata within the school systems and are happy to provide our results to those who have participated in thisstudy. This report focuses on the results from the Smart Cities, Healthy Kids questionnaire. We will continueto provide updated information from subsequent research phases, as it becomes available.

Smart Cities, Healthy Kids is pleased to provide this results profile for your school. Sharing information withthe community is made possible through the funding and support of the following organizations:

University of Saskatchewan

University of Regina

City of Saskatoon

Saskatchewan Population Health and EvaluationResearch Unit

Saskatoon Health Region

Canadian Institutes of Health Research

Heart and Stroke Foundation of CanadaHealth Research Foundation

Saskatchewan Health Research Foundation

The principal investigator for this project is Nazeem Muhajarine, PhD. For more information regarding thisprofile, the research project associated with it, or a complete list of contributing researchers, visit

smartcitieshealthykids.com or contact:

Tracy RidallsResearch Manager

Saskatchewan Population Health and Evaluation Research Unit(306) 966-2237

[email protected]

Note: Please interpret some results with caution. The data for this profile may or may not be representativeof your school due to small sample sizes. In particular, if your school has fewer than 20 participants in this study, your results may not be representative. However, you may still benefit from observing Saskatoontrends, which are reported in most areas for comparison.

Throughout the report, you will find word bubbles titled In Their Own Words These quotations comedirectly from comments provided by students through the Smart Cities, Healthy Kids questionnaire, andprovide unique insight into the student perspective.


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TABLE OF CONTENTSSmart Cities, Healthy Kids: The Project 1

Understanding the Issue: Childhood Obesity 2

Participants from Your School 3

Gender Distribution 3

Grade Distribution 3

Age Distribution 3

Aboriginal Participants 3

Home Neighbourhoods 4

The Home Environment 4

Student Personal Perceptions 5

Body Weight 5

Academic Performance 5Family and Peer Influences 6

Family Members 6

Friends and Peers 6

Reasons for Inactivity 7

Sedentary Behaviour 8

Screen Time 8

Sources of Physical Activity 9

Gym Class 9

Structured Activity 9

Unstructured Activity 9

The Neighbourhood Factor 10

Park Access 10

Neighbourhood Perceptions 10

Active Transportation 11

Food Consumption and Eating Habits 12

The Food Environment: Our Sister Study 13

References 14


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Page 1PHYSICAL ACTIVITY PROFILE FOREST GROVE SCHOOL 2011

SMART CITIES, HEALTHY KIDS:THE PROJECT The goal of Smart Cities, Healthy Kids is to understand how urban planning and design can be used to encouragechildren to be more physically active, thus slowing the rise in childhood obesity. Tackling the problem of childhoodobesity requires multiple approaches. Many people, from health professionals, funders, policy makers, andresearchers, to concerned parents, have identified environmental factors that can either help or hinder childrenand adults to live more active lifestyles. However, there has been little research into how aspects of the urbanbuilt environment in which we all live such as buildings, roadways, sidewalks, parks, and green spaces- canencourage children to be physically active. By learning about what is and isnt working in our currentneighbourhoods in Saskatoon, this study will help shape the design of future neighbourhoods, here and elsewherein Canada.

Research Question 1: How have the specific planning strategies that the City of Saskatoon hasused in its neighbourhoods contributed to the active living potential of these neighbourhoods?

During the summers of 2009 and 2010, we assessed all 60 of Saskatoons residential neighbourhoods using tworesearch surveys: Neighbourhood Active Living Potential (NALP) and Irvine-Minnesota Inventory (IMI). NALP is a 22-item survey that examines the activity friendliness, safety, density of destinations and universal accessibility of eachneighbourhood. Activity friendliness measures how suited the neighbourhood is to human -powered activitiessuch as walking, skateboarding, cycling, and wheelchair use. Safety measures physical and social characteristicsof the neighbourhood. Density of destinations measures destinations within the neighbourhood that people cantravel to, such as public parks, sports and recreational centres, bus stops, local events, and shops. IMI consists of229 neighbourhood features that fall within five domains: attractiveness; diversity of destinations; pedestrianaccess; safety from crime; and safety from traffic. With these two surveys, observers walked through all 60 ofSaskatoons residential neighbourhoods and recorded what they encountered. Each neighbourhoods activeliving potential was then assessed based on the results. Reports summarizing the results for each neighbourhoodcan be found at smartcitieshealthykids.com .

Research Question 2: What is the relationship between a neighbourhoods active living potentialand the physical activity levels and active transportation of the children between 10 and 13 who

live in that neighbourhood?We recruited 1,610 children to complete two, detailed physical activity questionnaires. The Smart Cities, Healthy Kids questionnaire was used to determine demographic information and self-perceptions related to physicalactivity. The Modifiable Activity Questionnaire for Adolescents (MAQ-A) was used to gather data on the registeredand unregistered physical activities in which the children participate. A sub-group of 465 children was alsorecruited to wear accelerometers for a week. Accelerometers are small, waist-mounted instruments that measurephysical activity directly. This report includes exclusively descriptive information from the Smart Cities, Healthy Kids questionnaire.

Research Question 3: What do children and their parents think about the influence theirneighbourhood has on childrens activity levels?

The first two research questions examine the relationship between systematically measured aspects ofneighbourhoods and childrens physical activity. Question three recognizes the importance of how children andtheir parents feel about their neighbourhoods. To find out, we conducted in-depth interviews with 24 familieswhose children had participated in earlier parts of the study. Each child was lent a digital camera with which totake photographs of places and things that they feel help them to be active or prevent them from being active.These photos were discussed in the interviews with the children, and have been included in presentations of theresearch findings. In-depth interviews were also conducted with each parent about their perceptions of their neighbourhood environment.


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UNDERSTANDING THE ISSUE:CHILDHOOD OBESITY

Child health concerns in Canada have focused in recent years on rates ofobesity and physical inactivity among children. Evidence points to a risingpercentage of children that are overweight or obese and experiencingassociated health problems. These trends are a cause for concern andindicate a significant childhood obesity and physical inactivity crisis. Infact, if the current trends continue, we will have a generation of childrengrowing up for the first time with poorer health status and lower lifeexpectancy than that of their parents.

What's the Prevalence of Childhood Obesity in Canada?

In 2004, 26% of Canadian children and youth aged 2-17 years wereoverweight or obese, including 8% who were obese. Overweight andobesity among Canadian 2-5 year olds remained the same between 1979and 2004 (21%), with obesity reported at 6.3% in 2004. Overweight andobesity doubled among Canadian 6-11 year olds between 1979 and 2004and obesity tripled among Canadian adolescents aged 12-17 years. 1

What's the Prevalence of Childhood Obesity in Saskatchewan?

In 2007/2008, one-quarter (25%) of youth in Saskatchewan wereoverweight or obese; this was a 16% increase over 2001. Notably, in thesame year, more than half (57%) of youth in Saskatchewan were physicallyinactive, and the rate of inactivity rose more than 17% since 2001.

Canadian Physical Activity GuidelinesFor health benefits, children (age 5 to 11) and youth (age 12 to 17) should get at least 60

minutes of moderate to vigorous physical activity (MVPA) daily . This should include vigorous-

intensity activities (enough to raise your heart rate) at least 3 days per week and activities that

strengthen muscle and bone at least 3 days per week. More daily physical activity provides

greater health benefits. 2

Quick Fact:

Only 7% of Canadian

children and youth aremeeting the Canadian

Physical Activity

Guidelines. 4

I think physical activity is

important for when we'reyounger so we can be fitand healthy when we're

older .

Being physically activemakes you have a

healthier mind/body andmakes it easier to live.

Without being fit the worldwould be an unhealthy

place.

Type 2 diabetes Hypertension Sleep apnea Impaired balance Orthopedic problems Glucose intolerance andinsulin resistance

Low self-esteem Negative body image Depression Negative stereotyping Teasing and bullying Social marginalization

Health and Social Problems associated with Childhood Obesity 3


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PARTICIPANTS FROM YOUR SCHOOL The Smart Cities, Healthy Kids Physical Activity Questionnaire was completed by voluntary participants from grades5-8 students during spring 2010. Participation rates and demographics varied between schools. There were 1584total participants that completed the questionnaire. From your school, 28 students participated. The followinggraphs describe the participants from your school and how they compare to the participants from all schools.

Gender Distribution Grade Distribution

Age Distribution Aboriginal Participants

The graph below shows the gender distribution of theparticipants from your school compared to theparticipants from all schools. Your school had a higher percentage of boys participate in the study. Nationalstudies show that more boys than girls tend toparticipate in school sports. 5 Also, girls tend to be moreinfluenced by peer participation than boys. 6

The graph below shows the grade distribution of theparticipants from your school compared to theparticipants from all schools. Your school had a lower percentage of grade 5 students and a higher percentage of grade 8 students than other participating schools.

The above graph shows the age distribution of theparticipants from your school compared to theparticipants from all schools. Participants from your school tended to be older than those from other schools who participated.

The above graph shows the concentration ofAboriginal participants from your school compared toall schools. It is important to acknowledge that theAboriginal population is more vulnerable, facesadditional barriers to physical activity and sportparticipation than the general population, and is inneed of tailored support and engagement strategies. 7


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Home Neighbourhoods

The Home Environment

The graph to the right shows the distribution of homeneighbourhoods for the student participants. With theopen school district, most schools had a wide rangeof home neighbourhoods represented in the studentparticipant sample. This is important to recognizebecause it provides insight when analyzing topicssuch as active transportation, distance to park space,and participation in school activities.

The graphs below show the parent-child living arrangements and number of siblings living in the same householdfor students from your school compared to students from all schools. The household context has been recognizedas an important factor in sport participation rates in adolescents: the parent/guardian arrangement, familyincome, and other family members sports participation levels can all have an impact. 8 This impact can beunderstood in a number of ways. A childs home environment can determine, for example, the type of adultmodeling behaviour children could emulate, the number of other individuals with whom to engage in physicalactivity, the level of access to different types of activity (in terms of money, time, or transportation), and the levelof support and encouragement provided.


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STUDENT PERSONALPERCEPTIONS

Body Weight

Although external influences can have a strong impact on physical activitylevels in children, so too can internal self-perceptions and self-esteem.Indeed, confidence levels can be important for children when engaging inactivities that expose their vulnerability. The physical activity questionnaireincluded some questions about body weight and academic performance.

We asked students to indicate how they felt abouttheir own body weight. The graph to the right showsthe percentage of students who felt they were over/underweight by 5 pounds or more and those whofelt their weight was okay.

A US study found that lower body satisfaction isassociated with lower levels of physical activity in

adolescents and higher levels of sedentary activity.9

Another Canadian study found similar results in thatself-perceptions of body composition and condition,as well as sport skills, were significant determinants ofphysical activity levels. 10 Therefore, efforts aimed atencouraging active participation should stay awayfrom approaches that could also contribute todecreased body satisfaction.

Student Perception of Academic StandingGrade Range (%) Forest Grove All Schools80 and above 51% 74%70 to 79 30% 14%60 to 69 15% 6%59 and below 4% 6%

Academic Performance

The graph and chart to the left show how students at

your school compare to how students at all schoolsperceive their academic performance and standing.Academic performance can be connected tophysical activity. On one hand, school marks andstudent perceptions of academic performance havean effect on confidence levels, self-esteem, andperceptions of control over personal outcomes. 11 Eachof these can be a factor in student physical activityparticipation levels. On the other hand, physicalactivity is shown to have benefits for mental activity inchildren and youth 12 and is positively linked toattention, memory, and executive functions (such asabstract thinking). 13 Therefore, physical activity andacademic performance can be self-reinforcing:greater physical activity levels can lead to better academic performance and vice versa. However,poor performance in either area could also have anegative impact on the other.

Sometimes I feel

embarrassed about

doing something wrong

in a sport.


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Page 6 PHYSICAL ACTIVITY PROFILE FOREST GROVE SCHOOL 2011

FAMILY AND PEERINFLUENCESChildrens behaviour can be influenced by the behaviours they observe in people around them. It is important totake into account the type and sources of behaviour modelling to which children are exposed.

Family Members

Friends and Peers

The physical activity questionnaire asked the students

how often they saw any of their family membersparticipate in sports or exercise activities over theprevious 30 day period. The graph to the right showsthe results from students from your school comparedto students from all schools. It is important to note thatseveral students never or rarely observe familymembers in exercise. National data suggests that fewCanadian adults are meeting the Canadian PhysicalActivity Guidelines for Adults, 4 which indicates that fewparents are modelling appropriate physical activitylevels for their children.

Friends can also have a significant influence onchildrens participation in physical activity. 8 Thephysical activity questionnaire asked students howmany of their closest friends exercise regularly andhow often they had seen any of their friendsparticipate in physical activity. The graphs to the rightand below show results from your school compared toall schools. An Ontario study found that children aremore likely to be active if 3 or more of their closefriends are also physically active. 14 Further, childrenreport that participating in physical activity withfriends increases their enjoyment of the activity. 15 However, it is important to note that peer influencecan both encourage or discourage participation.

I could bike to thepark with my brother

and sister cause theylove going to the park,so it would make me

and them more activeand healthier.


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REASONS FOR INACTIVITYIf physical activity intervention and obesity prevention strategies for children are to be successful, it is important to understand why children arenot meeting recommended physical activity guidelines. The Smart Cities,Healthy Kids questionnaire asked kids what kinds of things most often keptthem from being active. The graph below highlights the reasons that

students from all schools most identified with.

I wish I had more timeand got around to

doing physical activityevery day!

Bad weather

I felt lazy

Too much

homework

Familyresponsibilities

Not enough

time

Couldnt get

a ride

Area was

not safe


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SEDENTARY BEHAVIOURThere has been a lot of focus recently in health intervention researchon the role of sedentariness in childhood obesity. Children who aresedentary for several hours a day are less likely to meet the physicalactivity guidelines. 16 Sedentary behaviour is associated withunfavourable body composition, decreased physical fitness,

increased risk for metabolic syndrome and cardiovascular disease,decreased self-esteem, behavioural problems and decreasedacademic achievement. 17 Further, it has been found that health risksassociated with sedentary behaviour increase as sedentary timeincreases.

Canadian Sedentary Behaviour Guidelines for School-Aged Children 18

For health benefits, children (age 5 to 11) and youth (age 12 to 17) should minimize the timethey spend being sedentary each day. This may be achieved by:

1. Limiting recreational screen time to no more than 2 hours per day; lower levels are associatedwith additional health benefits.

2. Limiting sedentary (motorized) transport, extended sitting, and time spent indoors throughoutthe day.

Sedentary behaviour is timewhen teens are doing very littlephysical movement. Someexamples are:

Sitting for long periods Using motorized transportation

(such as a bus or a car) Watching television Playing passive video games Playing on the computer

Screen Time

Sedentary behaviour is often associated with some form of screentime. The graph below displays how many hours per day studentsreported engaging in various forms of screen time, including

watching TV or videos/DVDs, playing video games, or using thecomputer. Research shows that every hour of screen time childrenand youth accumulate translates into 1/3 of an hour less beingphysically active. 5

It would be good ifparents gave a timingor a limit a day on the

computer or on anyelectronics.


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SOURCES OF PHYSICAL ACTIVITYGym ClassThe graph to the left shows how many daysper week students report attending gymclass. Classroom time devoted to physicaland health education curricula is importantfor the health of children and youth. Theimportance of this time is two-fold: it canboth increase the time children spendbeing active, and provide them with healthliteracy that they can apply in their dailylives outside of the classroom. 19 A study onthe predictors of obesity found that eachadditional weekday that adolescentsparticipated in physical educationdecreased their odds of being overweightas an adult by 5%. 20

Structured Activity

Unstructured Activity

Children involved in organized sports andphysical activity programs have higher overall levels of physical activity 21 and aremore likely to meet the physical activityguidelines. 16 The graph to the right showshow often students engaged in physicalactivities with a coach over a 30 dayperiod.

Physical activity doesnt have to beorganized and scheduled. Indeed,unstructured forms of active play can helpchildren increase their physical activitywhile also contributing to social,emotional, and cognitive development. 19

The graph to the right shows how oftenstudents engaged in physical activitieswithout a coach over a 30 day period.

It should be youdont have to be

good at the sport to join.


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THE NEIGHBOURHOODFACTOR

Park AccessChildren with access to playgrounds, parks, andrecreational facilities in their neighbourhoods aremore likely to be physically active and less likely to beoverweight. 22 The graph to the right shows that mostchildren in Saskatoon have adequate access toneighbourhood facilities, which is in line with other Canadian cities. 19 However, several studies suggestthat park access alone is not a strong determinant ofpark usage; other factors that influence park use arelook of the park (upkeep and condition), presence ofamenities (footpaths, wading pools, picnic tables),and safety. 23

Neighbourhood PerceptionsChildren are more likely to be active outside of school if they perceive their neighbourhood as safe. 24 We askedthe participants questions about their perception of safety in their home neighbourhood. The graph below showsthe percentage of students who responded feeling safe, pretty safe, or very safe. It is important to note thatvery few children in Saskatoon felt unsafe in their neighbourhood.

However, perhaps more importantly, parents need to perceive that their neighbourhood is safe if they are to allowtheir children the freedom to engage in independent play and mobility outside. A national survey suggests that18% of parents agree or strongly agree that safety concerns are an issue in their neighbourhood. 25 Neighbourhoodsafety concerns commonly cited by parents are harm from strangers, road safety, personal injury, and bullying. 26

Indeed, parental perceptions of neighbourhood safety can have a strong impact on childrens physical activitylevels. Research shows that independent mobility in children has drastically reduced over time: in an effort tominimize safety risks to their children, parents have restricted their childrens free time away from adultsupervision. 27-31 Having to coordinate active outdoor play with parents schedules and willingness to supervise maybe a hindrance to the amount of unstructured activity children ultimately engage in, which may prove to bemore harmful to their wellbeing in the end.

The park shouldhave more street

lights to make it lessscary.

This Smart Cities, Healthy Kids study has a particular interest in understandinghow a childs neighbourhood impacts their physical activity. Accordingly, theSmart Cities, Healthy Kids questionnaire asked the students some questionsabout park space and how safe they feel in their home neighbourhood.


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Quick Fact:

On a national level, themost commonly

reported barrier toactive transportation isthe distance between

home and school.

ACTIVETRANSPORTATION

Some National Figures: 34

24% of parents say their children useonly active modes of transportation intrips to and from school. (20% walk, 4%bike)

62% of parents say their children rely ononly inactive modes of transportation intrips to and from school. (24% by car,34% by bus/train, 4% mixed modes)

14% of parents say their children use acombination of active and inactivemodes of transportation to and fromschool.

With parent and school support, active transportation can be a safeand inexpensive way to increase physical activity levels. Someschools have explored ideas such as walking school buses, or policies requiring students be dropped off a safe walking distancefrom school or discouraging parents who live close by from drivingtheir children to school. 19 Research has shown that activetransportation is most likely to be adopted if the built environment hasstrong street connectivity and pedestrian infrastructure, parentsperceive the route to school to be safe, and families have strongsocial ties with neighbours and emotional satisfaction with their neighbourhood. 32-33

The graph below shows how often students from your school reportedwalking or biking to school compared with students from all schools.

The two graphs below show the reasons for not walking or biking to school reported by students from your schoolcompared to students from all schools. For comparison, a 2008-2009 National Family Intervention Survey reportedreasons given by parents for motorized transportation included inclement weather (21%), convenience and timepressures (18%), driving somewhere else anyway (17%), distance to school is too far (16%), traffic danger (11%) andpersonal safety issues (11%). 35


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FOOD CONSUMPTION AND EATING HABITSPhysical activity alone is not sufficient to mitigate against obesity: proper nutrition must also be considered. Thereis a direct link between food consumption, nutrition, and overall health outcomes, including obesity. The Smart Cities, Healthy Kids questionnaire included some questions about each students food consumption patterns andeating habits. The results from this portion of the questionnaire provide a general impression of childrens foodand nutrition health in Saskatoon. Smart Cities, Healthy Kids has launched a sister study to further investigate therole of the food environment on childrens health. (The details of the study can be found on the following page.)

Proper nutrition and food consumption habits contribute to better overall health, increase energy, providestronger muscles and bones, and lower the risk of chronic health problems. 36 Canadas Food Guide suggestschildren between ages 9-13 should consume 6 daily servings of fruits and vegetables, 3-4 daily servings of milk or milk alternatives, 6 daily servings of grain products, 1-2 daily servings of meat and meat alternatives, and shouldlimit unsaturated fats. 36 Consumption of saturated and trans-fats and sugar-sweetened drinks, along with missingbreakfast, are all contributing risk factors associated with childhood obesity. 37-38 The charts below show your students self -reported food consumption patterns.

drink pop,fruit drinks, or

energy drinks?

eat fast food?

eat fruit?

eat vegetables?

drink milk?


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THE FOOD ENVIRONMENT:OUR SISTER STUDY

Smart Cities, Healthy Kids has received additional funding from the Canadian Institutes of Health Research and theSaskatchewan Health Research Foundation for a sister study evaluating the impact of the food environment onchildhood obesity. The food environment refers to how easily we, and our children, can access nutritious food in the

neighbourhoods in which we live. We are interested in where food stores and restaurants are located in Saskatoon andhow nutritious the foods they carry are. By incorporating data on body weight of children, we ultimately hope to supportthe development of improvements to health policy and practice in Saskatoon, and also provide information that wouldbenefit the nutrition and health of children and families.

Question 1a: What is the geographical distribution of food stores and fast food restaurants in Saskatoon andhow is this distribution related to neighbourhood demographic and socio-economic profiles?

During the first four months of the study (September-December 2010), Geographic Information Systems (GIS) tools wereused to complete maps of fast food restaurants, grocery, convenience, specialty, and all other food stores in allSaskatoon neighbourhoods. This process has already been initiated by Public Health Services (Saskatoon Health Region);parts of the city where food access is limited have already been identified and can be related back to demographic

and socio-economic profiles.

Question 1b: What are the differences in food environments, such as location of different types of foodstores and food quality, between higher and lower socioeconomic status neighbourhoods inSaskatoon?

The consumer nutrition environments of chain supermarkets, smaller grocery stores, convenience stores and restaurantshave been measured using a Canadian adaptation of the Nutrition Environment Measures Survey for Stores (NEMS-S)and the original Nutrition Environment Measures Survey for Restaurants (NEMS-R). Scores will be calculated for each storeusing availability, quality, and price, and for each restaurant using availability, nutrition information, and price. Using thesescores, we will then develop a series of maps showing the distribution of the quality of the food environment within allresidential neighbourhoods in Saskatoon. We will also add selected demographic and socio-economic variables to

assess the relationship between the food environment and neighbourhood income levels.

Question 2: What is the relationship between the quality of the food environment available, asmeasured by (NEMS-S) and (NEMS-R), in Saskatoon neighbourhoods, and the dietary intake and bodyweights of children aged 10-13 years living in those neighbourhoods?

We will recruit approximately 100 children from each of the 20 neighbourhoods that show the most and the leastpositive food environment characteristics based on the previous study data collection (GIS and NEMS). Children willparticipate in a food frequency questionnaire (FFQ) for dietary assessment that will be self-administered in class. Aresearch assistant will also measure heights and weights in order to calculate body mass index (BMI) and determinebody weight status. The questionnaire includes questions on socio-demographic characteristics, and our analysis willaccount for things like parental educational level, parental income, proportion of families with no vehicles, and

proportion of lone parent families.

Question 3: How should the information collected in this study be shared in order to facilitate changethat will improve food environments for Saskatoon, and then in other cities in other regions of thecountry?

Interviews will be conducted with various governmental, health region, and community-based officials to sharepreliminary results, ask for feedback, and discuss policy change options to improve the food environment in Saskatoon.The results will be compiled into a document that will be disseminated widely.


PLEASE CONSIDER ASSISTING OUR RESEARCH AGAIN WHEN WE RETURN TO SCHOOLS IN THE SPRING OF 2012.


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