First Nations and Métis children living in Canada continue to experience disproportionately high levels of obesity and type 2 diabetes (T2D) compared to the general
Canadian child population (Young 2003; Oster and Toth 2009). Evidence supports the need to develop and implement culture-based physical activity and nutrition health programming in order to support the adoption of healthy lifestyles among First Nations and Métis school-aged children (Macaulay, Paradis et al. 1997; Potvin, Cargo et al. 2003; Ng, Young et al. 2010).
Culturally relevant health promoting interventions have been created in collaboration with First Nations communities; however, given that Métis populations have unique cultural characteristics that differ from First Nations groups, there is strong rationale for developing, implementing and evaluating culture-based health programs in collaboration with Métis communities that take a preventative approach with school-aged children. Therefore, the purpose of this research was to evaluate the impact of a Métis culture-based comprehensive school health program on the physical activity and nutrition knowledge, attitudes, beliefs and behaviours of Métis children, using participatory action research (PAR). Initially, relationships were built and nurtured with the participating community and collaborations commenced to develop and implement a Métis culture-based school health program. Métis community members’ input was sought to develop a series of 17 culturally relevant physical activity and nutrition health promoting lessons. The participating teacherdelivered these lessons to one split class of Grade 3 and 4 Métis students (age 8 and 9 years;
n=16) attending the local elementary school once per week over a 4-month timeframe. Overall,
children were taught about healthy eating and physical activity and how a healthy lifestyle can prevent obesity and diabetes.Physical activity and nutrition knowledge, attitudes, beliefs and behaviours among the Métis children were measured prior to and following the implementation of the health program. A group of 21 age-matched students attending separate Grade 3 and 4 classes acted as a comparison standard care group and did not receive health promotion programming. A variety of qualitative and quantitative methods were used including interviews (focus groups; individual with children and teachers), questionnaires (food frequency; knowledge, attitude and beliefs; physical activity questionnaire (PAQ-C)), accelerometry (using Actical accelerometers), and photovoice (using digital cameras). Physical activity data showed that participating students were more physically active than students who did not receive the intervention. Participating students spent significantly fewer minutes in sedentary activities compared to a comparison group post-intervention, 495 min/day compared to 527 min/day respectively. Moderate-to-vigorous physical activity (MVPA) levels did not significantly decrease in students participating in the intervention, while a comparison group experienced significant decreases in MVPA levels. This suggests that the intervention was successful in preventing a decline in MVPA levels that may normally be observed.Nutrition data revealed no statistically significant differences between the two groups. However, greater improvements were measured in the reported consumption of low nutrient dense foods such as cakes, cookies, pie, doughnuts and pop beverages. Fifty percent and 46% ofintervention participants improved their consumption of “pop drinking” and “cakes, cookies, pieand doughnuts”, respectively.
Student perceptions and awareness of healthy foods were positively impacted following the health programming.Although the primary purpose of the project was to evaluate the effectiveness of a school health program on physical activity and nutrition knowledge, attitudes, beliefs and behaviours, an important component of the research was also to evaluate the process of using PAR methods in collaboration with a Métis community. My reflections on using PAR methods integrated my personal observations, experiences, interactions and feedback received from the participating teacher and community research team members throughout the project. The successes and challenges of using PAR methods included the importance of (1) building rapport with the community; (2) maintaining flexibility regarding research timelines; (3) respecting reciprocity of exchanging knowledge and action between the community and myself; and (4) finding balanceto ensure that the community was actively participating. The overall results of this study indicate that a comprehensive school health program can improve physical activity levels and can influence awareness of healthy foods among Métis children. The active engagement of the community ensured the integration of Métis culture, enhanced the sustainability of the program in the community, and largely influenced my learning of engaging in collaborative, Métis community-based research that will be lasting for me as a researcher in the future Acknowledgements My Ph.D. journey could not have occurred without the involvement of many important people in my life, all of whom I am very grateful for and I feel honored to have them in my life.
I want to thank Brad. His unending support, encouragement, understanding and flexibility with my work demands made this journey possible; a journey that I feel we embarked on together. I thank my supervisors, Karen and Janet, for all of their guidance and the wisdom they shared with me throughout the Ph.D. process. I am very grateful for the time they both devoted to working with me and mentoring me ~ making me a better researcher. Thank you, as well, for creating a work environment that encouraged a balance with my role as a parent.I acknowledge and thank the members of my student advisory committee, Roland, Louise, Carol, Suzanne and Sylvia. Each one of these individuals brought their unique and important perspectives to this project all of which greatly enhanced the interdisciplinary nature of my work.I would also like to thank my colleagues, Kori, Lauren, Dale, Candace, and Leila for all of their understanding, advice and help they provided to me over the past several years. All of you have enhanced my life and my research and for that I am forever grateful ~ thank-you!I offer a very generous thank-you and acknowledgement to the community of Île-à-la-Crosse and all of the community members who made this project what it is. Thanks to Duane, Marie and Don for paving the road for this project; thank you to Ruby, Barb, Eddy and Wanda for their time and hard work devoted to this work. Thank you to all of the adults and students who participated. Finally, I would like to acknowledge the Physiotherapy Foundation of Canada and the Indigenous Peoples Health Research Centre (IPHRC) for their financial support in funding this research project. Furthermore, I am grateful to the CIHR Strategic Training Program in Public Health and the Agricultural Rural Ecosystem (PHARE) for the scholarship support I received.
DedicationI dedicate this thesis to my partner, Brad. Throughout this Ph.D. journey, you werealways there to listen and offer support and valuable insight into my work, and to take on the added tasks that accompany single parenting when I was up north or away at conferences. You always kept me motivated and uplifted at difficult times and celebrated the successful and positive times. Thank you.I also want to dedicate this thesis to my parents, Joan and Farook, and my parents-in-law, Cathy and Trent. I want to thank and acknowledge you for everything you have done for my family and myself. You have provided me with tremendous support over the past several years, always lending an ear, never doubting the path I have chosen, and importantly for providing such an amazing care environment for Olive and Hamish at times when we needed extra childcare. I am forever grateful to you for all of this and more. Finally and importantly, I dedicate this thesis to my children, Olive and Hamish. I thank you for your love of life, your energy and for always keeping me in the moment and allowing me to see the world through your young eyes. I dedicate this work to your current and future health.
First Nations and Métis children living in Canada continue to experience disproportionately high levels of obesity and type 2 diabetes (T2D) compared to the general
Canadian child population (Young 2003; Oster and Toth 2009). Evidence supports the need to develop and implement culture-based physical activity and nutrition health programming in order to support the adoption of healthy lifestyles among First Nations and Métis school-aged children (Macaulay, Paradis et al. 1997; Potvin, Cargo et al. 2003; Ng, Young et al. 2010).
Culturally relevant health promoting interventions have been created in collaboration with First Nations communities; however, given that Métis populations have unique cultural characteristics that differ from First Nations groups, there is strong rationale for developing, implementing and evaluating culture-based health programs in collaboration with Métis communities that take a preventative approach with school-aged children. Therefore, the purpose of this research was to evaluate the impact of a Métis culture-based comprehensive school health program on the physical activity and nutrition knowledge, attitudes, beliefs and behaviours of Métis children, using participatory action research (PAR). Initially, relationships were built and nurtured with the participating community and collaborations commenced to develop and implement a Métis culture-based school health program. Métis community members’ input was sought to develop a series of 17 culturally relevant physical activity and nutrition health promoting lessons. The participating teacherdelivered these lessons to one split class of Grade
First Nations and Métis children living in Canada continue to experience disproportionately high levels of obesity and type 2 diabetes (T2D) compared to the general
Canadian child population (Young 2003; Oster and Toth 2009). Evidence supports the need to develop and implement culture-based physical activity and nutrition health programming in order to support the adoption of healthy lifestyles among First Nations and Métis school-aged children (Macaulay, Paradis et al. 1997; Potvin, Cargo et al. 2003; Ng, Young et al. 2010).
Culturally relevant health promoting interventions have been created in collaboration with First Nations communities; however, given that Métis populations have unique cultural characteristics that differ from First Nations groups, there is strong rationale for developing, implementing and evaluating culture-based health programs in collaboration with Métis communities that take a preventative approach with school-aged children. Therefore, the purpose of this research was to evaluate the impact of a Métis culture-based comprehensive school health program on the physical activity and nutrition knowledge, attitudes, beliefs and behaviours of Métis children, using participatory action research (PAR). Initially, relationships were built and nurtured with the participating community and collaborations commenced to develop and implement a Métis culture-based school health program. Métis community members’ input was sought to develop a series of 17 culturally relevant physical activity and nutrition health promoting lessons. The participating teacherdelivered these lessons to one split class of Grade 3 and 4 Métis students (age 8 and 9 years;
n=16) attending the local elementary school once per week over a 4-month timeframe. Overall,
children were taught about healthy eating and physical activity and how a healthy lifestyle can prevent obesity and diabetes.Physical activity and nutrition knowledge, attitudes, beliefs and behaviours among the Métis children were measured prior to and following the implementation of the health program. A group of 21 age-matched students attending separate Grade 3 and 4 classes acted as a comparison standard care group and did not receive health promotion programming. A variety of qualitative and quantitative methods were used including interviews (focus groups; individual with children and teachers), questionnaires (food frequency; knowledge, attitude and beliefs; physical activity questionnaire (PAQ-C)), accelerometry (using Actical accelerometers), and photovoice (using digital cameras). Physical activity data showed that participating students were more physically active than students who did not receive the intervention. Participating students spent significantly fewer minutes in sedentary activities compared to a comparison group post-intervention, 495 min/day compared to 527 min/day respectively. Moderate-to-vigorous physical activity (MVPA) levels did not significantly decrease in students participating in the intervention, while a comparison group experienced significant decreases in MVPA levels. This suggests that the intervention was successful in preventing a decline in MVPA levels that may normally be observed.Nutrition data revealed no statistically significant differences between the two groups. However, greater improvements were measured in the reported consumption of low nutrient dense foods such as cakes, cookies, pie, doughnuts and pop beverages. Fifty percent and 46% ofintervention participants improved their consumption of “pop drinking” and “cakes, cookies, pieand doughnuts”, respectively.
Student perceptions and awareness of healthy foods were positively impacted following the health programming.Although the primary purpose of the project was to evaluate the effectiveness of a school health program on physical activity and nutrition knowledge, attitudes, beliefs and behaviours, an important component of the research was also to evaluate the process of using PAR methods in collaboration with a Métis community. My reflections on using PAR methods integrated my personal observations, experiences, interactions and feedback received from the participating teacher and community research team members throughout the project. The successes and challenges of using PAR methods included the importance of (1) building rapport with the community; (2) maintaining flexibility regarding research timelines; (3) respecting reciprocity of exchanging knowledge and action between the community and myself; and (4) finding balanceto ensure that the community was actively participating. The overall results of this study indicate that a comprehensive school health program can improve physical activity levels and can influence awareness of healthy foods among Métis children. The active engagement of the community ensured the integration of Métis culture, enhanced the sustainability of the program in the community, and largely influenced my learning of engaging in collaborative, Métis community-based research that will be lasting for me as a researcher in the future Acknowledgements My Ph.D. journey could not have occurred without the involvement of many important people in my life, all of whom I am very grateful for and I feel honored to have them in my life.
I want to thank Brad. His unending support, encouragement, understanding and flexibility with my work demands made this journey possible; a journey that I feel we embarked on together. I thank my supervisors, Karen and Janet, for all of their guidance and the wisdom they shared with me throughout the Ph.D. process. I am very grateful for the time they both devoted to working with me and mentoring me ~ making me a better researcher. Thank you, as well, for creating a work environment that encouraged a balance with my role as a parent.I acknowledge and thank the members of my student advisory committee, Roland, Louise, Carol, Suzanne and Sylvia. Each one of these individuals brought their unique and important perspectives to this project all of which greatly enhanced the interdisciplinary nature of my work.I would also like to thank my colleagues, Kori, Lauren, Dale, Candace, and Leila for all of their understanding, advice and help they provided to me over the past several years. All of you have enhanced my life and my research and for that I am forever grateful ~ thank-you!I offer a very generous thank-you and acknowledgement to the community of Île-à-la-Crosse and all of the community members who made this project what it is. Thanks to Duane, Marie and Don for paving the road for this project; thank you to Ruby, Barb, Eddy and Wanda for their time and hard work devoted to this work. Thank you to all of the adults and students who participated. Finally, I would like to acknowledge the Physiotherapy Foundation of Canada and the Indigenous Peoples Health Research Centre (IPHRC) for their financial support in funding this research project. Furthermore, I am grateful to the CIHR Strategic Training Program in Public Health and the Agricultural Rural Ecosystem (PHARE) for the scholarship support I received.
DedicationI dedicate this thesis to my partner, Brad. Throughout this Ph.D. journey, you werealways there to listen and offer support and valuable insight into my work, and to take on the added tasks that accompany single parenting when I was up north or away at conferences. You always kept me motivated and uplifted at difficult times and celebrated the successful and positive times. Thank you.I also want to dedicate this thesis to my parents, Joan and Farook, and my parents-in-law, Cathy and Trent. I want to thank and acknowledge you for everything you have done for my family and myself. You have provided me with tremendous support over the past several years, always lending an ear, never doubting the path I have chosen, and importantly for providing such an amazing care environment for Olive and Hamish at times when we needed extra childcare. I am forever grateful to you for all of this and more. Finally and importantly, I dedicate this thesis to my children, Olive and Hamish. I thank you for your love of life, your energy and for always keeping me in the moment and allowing me to see the world through your young eyes. I dedicate this work to your current and future health.
First Nations and Métis children living in Canada continue to experience disproportionately high levels of obesity and type 2 diabetes (T2D) compared to the general
Canadian child population (Young 2003; Oster and Toth 2009). Evidence supports the need to develop and implement culture-based physical activity and nutrition health programming in order to support the adoption of healthy lifestyles among First Nations and Métis school-aged children (Macaulay, Paradis et al. 1997; Potvin, Cargo et al. 2003; Ng, Young et al. 2010).
Culturally relevant health promoting interventions have been created in collaboration with First Nations communities; however, given that Métis populations have unique cultural characteristics that differ from First Nations groups, there is strong rationale for developing, implementing and evaluating culture-based health programs in collaboration with Métis communities that take a preventative approach with school-aged children. Therefore, the purpose of this research was to evaluate the impact of a Métis culture-based comprehensive school health program on the physical activity and nutrition knowledge, attitudes, beliefs and behaviours of Métis children, using participatory action research (PAR). Initially, relationships were built and nurtured with the participating community and collaborations commenced to develop and implement a Métis culture-based school health program. Métis community members’ input was sought to develop a series of 17 culturally relevant physical activity and nutrition health promoting lessons. The participating teacherdelivered these lessons to one split class of Grade
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