education plus low (30% heart rate reserve (HRR); N=20) or moderate (70% HRR; N=20) intensity exercise intervention group. The program consisted of supervised walking for 45 minutes, three to four times per week for 16 weeks. All women were screened for CD at the beginning (seven to eight weeks postpartum) and end (23-25 weeks postpartum) of the study. A historical control group of 20 sedentary postpartum women were matched by body mass index, age, and parity. results: The low- and moderate-intensity groups lost more body mass (-4.2 ± 4.0kg and -5.0 ± 2.9kg, respectively) compared to the control group (-0.1 ± 3.3kg, p<0.01). Plasma low density lipoprotein was reduced for the low- and moderate-intensity groups (-0.29±0.21 mmol/L and -0.28±0.17 mmol/L) compared to the control group (0.03±0.18 mmol/L, p=0.015). In addition, glucose concentrations were reduced; and adiponectin concentrations increased (p=0.037), regardless of exercise intensity, while the sedentary controls remained unchanged or at increased risk for CD. conclusions: Women receiving an exercise and nutrition postpartum intervention targeting healthy weight loss, regardless of exercise intensity, improved CD risk factors. This study was supported by CIHR and Rx&D Health Research Foundation.

105

Process evaluation of international knowledge translation targeting obesity researcher trainees in Mexico

M. Héroux1, L. Lévesque1, J. Lopez Taylor2, E. Jáuregui Ulloa2, and I. Janssen1 1Queen’s University, Kingston, Ontario, Canada; 2University of Guadalajara, Guadalajara, Jalisco, Mexico

Introduction: Research capacity to deal with increasing obesity in Mexico is underdeveloped. CAMBIO (Canada - Mexico Battling Childhood Obesity), established in 2007 to increase obesity-related research capacity within Mexico, delivers an annual course aimed at improving research skills among emerging Mexican obesity researchers using a knowledge translation approach. The objective of this study was to conduct a process evaluation of the CAMBIO course. Methods: Sixteen Mexican graduate students and new professionals (10 women) between 22 and 54 years (mean = 33, SD = 8.6) participated in a 10-day course taught by Canadian, American, and Mexican faculty members. The course guided participants through the research process from developing research questions to writing manuscripts. Theoretical (i.e., lectures, web-tutorials) and practical (i.e., labs, field work) teaching approaches were used. Qualitative and quantitative process evaluation data were collected prior to, during, and after the course. Process evaluation examined reach, dose delivered, and dose received. results: Student attendance and feedback demonstrated excellent reach. Dose delivered was high with all 21 course sections taught as planned. Furthermore, >80% of students rated the information in all 21 sessions as being very credible. Students reported a significant increase (p<0.05) from pre to post course in their perceived ability to write and publish scientific papers, suggesting that dose received was also high. The qualitative component of the evaluation identified several areas that hindered course delivery, including language barriers between faculty and students, which affected the overall dose received. conclusion: International knowledge translation can be achieved through research courses targeted to small groups of students.

106

stacking the deck: Developing a clinical tool to improve interactions between clinicians and parents of overweight boys and girls

B.C. Farnesi1, A.S. Newton1, K. Ambler2, N. Holt2, J. Geller3, C. Matteson4, D. Finegood4, S. Johnson5, S. Colberg2, P. Mayer6, and G.D.C. Ball1 1Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada; 2University of Alberta, Edmonton, Alberta, Canada; 3University of British Colombia, Vancouver, British Columbia, Canada; 4Simon Fraser

University, Burnaby, British Columbia, Canada; 5Athabasca University, Athabasca, Alberta, Canada; 6Consultant

Introduction: There is a great need to develop effective weight-management strategies to help overweight children and their families. The purpose of this research was to develop a set of “Agenda Cards” to facilitate communication and collaboration between clinicians and parents of overweight children. Methods: In Phase 1, clinicians (n=13) and parents (n=16) were recruited through the Pediatric Centre for Weight and Health (Edmonton, Alberta, Canada) to participate in semi-structured focus groups or individual interviews. Sessions were audio-recorded and transcribed; a modified thematic analysis was used to identify key elements of collaboration. Based on these elements, sample statements for the Agenda Cards were generated (Phase 2), which were reviewed for content, language, and clarity. A two-step e-Delphi procedure will be completed (Fall, 2010) to prioritize and condense the number of statements with previous and new participants. results: Our analyses revealed that partnerships between clinicians and parents were established through a collaborative process that included: (1) positive therapeutic relationship, (2) agenda setting, and (3) monitoring and evaluation. These elements informed the generation of 130 statements, which were subsequently reduced to 100 through consolidation and refinement. The e-Delphi procedure will result in a deck of Agenda Cards that will be useable clinically (i.e., 40 to 60 cards). conclusion: Agenda Cards may serve as a clinical tool to identify barriers and opportunities for effective weight management. Future research directions include pilot testing the cards in real-world clinical settings to assess elements of feasibility, acceptability, and satisfaction with care.

107

the association between sleep disturbances and obesity in adolescents may be mediated by increased consumption of caffeinated beverages

J. Davies1, C. Manlhiot1, H. Wong1, D. Gibson2, N. Chahal1, K. Stearne2, A. Fisher2, O. Makerewich2, S.W. Dobbin2, I. Narang1, and B.W. McCrindle1 1Division of Cardiology, Labatt Family Heart Centre, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada; 2Heart Niagara, Niagara Falls, Ontario, Canada

Introduction: Emerging data reveal associations between increased adiposity in adolescents and poor sleep quality and reduced sleep duration. The degree to which these associations may be mediated by nutritional factors is poorly understood. Methods: A population-based cross-sectional study of all grade 9 students evaluated cardiovascular risk through the Healthy Heart Schools’ Program provided by Heart Niagara. Participants completed a questionnaire reporting on nutritional habits, amount and quality of sleep, frequency of sleep disturbances, use of sleep medication, and self health assessment. Clinical staff recorded anthropometry, blood pressure, and non-fasting lipid assessment. results: A total of 4,104 adolescents (51% males) were enrolled. Students with body mass index >85th percentile and waist circumference >90th (overweight) had a higher sleep disturbance index (SDI) score (average SDI 7.5 vs. 6.5, p=0.006) and lower average number of hours of sleep per night (8.2±1.0 vs. 8.4±1.0, p=0.001). Lower sleep quality and reduced sleep time were both associated with increased caffeine intake (average SDI 4.8 if no caffeine, 6.7 if ≤1 cup/day and 8.1 if >1 cup/day, p<0.001; average hours sleep/night 8.6 if no caffeine, 8.4 if 1 cup/day and 8.1 if >1 cup/day, p<0.001). Overweight teens had a higher prevalence of caffeine consumption (94% >0cup/day vs. 88% >0cup/day, p=0.04). Higher caffeine intake was associated with increased consumption of red meat, cheese, chips, fried food, cake, snacks, and lower fruit and vegetable intake, all of which were also associated with adiposity.

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