PHYSICAL ACTIVITY PROFILE FOR

Saskatoon Elementary Schools

Saskatchewan Population Health and Evaluation Research Unit Smart Cities, Healthy Kids smartcitieshealthykids.com Facebook.com/smartcitieshealthykids Twitter.com/SCHKsaskatoon

SASKATOON ELEMENTARY SCHOOL PROFILE

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 the Saskatchewan 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, and communities in general. We aim to provide information, ideas, and assistance to those who work with children to create innovative health intervention strategies. Videos about our research projects are found on YouTube by searching Smart Cities, Healthy Kids. We are grateful for the opportunity to collect data within the school systems and are happy to provide our results to those who have participated in this study. Throughout the report, you will find word bubbles titled In Their Own Words These quotations come directly from comments provided by students through the Smart Cities, Healthy Kids questionnaire. Participating schools: Alvin Buckwold, Bishop Filevich, Bishop Pocock, Bishop Roborecki, Brevoort Park, Cardinal Leger, Caswell, Dr. John Egnatoff, cole St. Paul, Fairhaven, Father Robinson, Forest Grove, Holliston, Howard Coad, King George, Lakeridge, Lawson Heights, Montgomery, North Park Wilson, Pleasant Hill, Pope John Paul II, Prince Philip, Princess Alexandra, River Heights, St. Anne, St. Dominic, St. George, St. Luke, St. Maria Goretti, St. Mark, St. Mary, St. Matthew, St. Michael, St. Volodymyr, Saskatoon French School, Sutherland, Victoria, Westmount, Wildwood, and W.P. Batein all 40 elementary schools.

Note: Please interpret some results with caution. If students from your school did not participate in
accelerometry data collection, your school will not be represented in the accelerometry data section. However, our sample size is large enough that reported trends are generally representative of Saskatoon. Accelerometry data analysis is on-going and we will share the forthcoming results from this portion of the study with participants as they become available. Smart Cities, Healthy Kids is pleased to provide this results profile for your school. Sharing information with the 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 Evaluation Research Unit KidSKAN (www.kidskan.ca) Saskatoon Health Region Canadian Institutes of Health Research Heart and Stroke Foundation of Canada Health Research Foundation

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

smartcitieshealthykids.com
or contact: Tracy Ridalls Research Manager, Smart Cities, Healthy Kids Saskatchewan Population Health and Evaluation Research Unit (306) 966-2237 tracy.ridalls@usask.ca

REPORT HIGHLIGHTS
The goal of the Smart Cities, Healthy Kids study is to understand how urban planning and design can be used to encourage children to be more physically active, thus slowing the rise in childhood obesity. Videos introducing this study and our sister study on the Food Environment in Saskatoon can be found on YouTube by searching Smart Cities, Healthy Kids. This report is the second in a series reporting to schools on study results to date. The first report covered our finding from the Smart Cities, Healthy Kids questionnaire that we administered with 1,610 children in the spring of 2010; this report was sent to schools in June 2011 and can also be found on our website, www.smartcitieshealthykids.com This report covers our findings from the Modifiable Activity Questionnaire for Adolescents (MAQ-A), administered to 1,610 grades 5-8 students in spring 2010, and a sub-group of 465 children who wore accelerometers for at least 10 hours a day for four days, including a weekend day, over a one week period. Children reported on the MAQ-A that they got more than twice the amount of physical activity from free play than from registered activities. Children also reported that more of their moderate to high intensity physical activity came from free play than from registered activities. Boys got more high intensity physical activity than girls, regardless of whether they were engaged in free play or registered activities. Children in the lowest income neighbourhoods in Saskatoon also reported the lowest intensity of physical activity. In the lowest income neighbourhoods, 24% of children reported low physical activity, compared to 14% in the middle income neighbourhoods, and 9% in the highest income neighbourhoods. In the lowest income neighbourhoods, 32% of children reported high intensity physical activity, compared to 40% in the middle income neighbourhoods, and 50% in highest income ones. The accelerometer data showed that 69% of boys and 57% of girls get 60 minutes of moderate to vigorous physical activity on 3-5 days of the week or more. It also showed children were much more active on weekdays than on weekends. Overall, boys had 77 minutes of moderate to vigorous activity on weekdays, and 48 minutes on weekends; girls had 67 minutes on weekdays, which dropped to 43 minutes on weekends. Sundays had the lowest levels of moderate to vigorous activity, while mid to late week (Wednesday, Thursday and Friday) appeared to have the highest levels. Our research corroborates what other researchers have found: that the promotion of moderate to vigorous physical activity on weekends may hold the greatest promise for increasing childrens overall total moderate to vigorous physical activity levels.

TABLE OF CONTENTS
Smart Cities, Healthy Kids: The Project Understanding the Issue: Childhood Obesity Methodology: What and How Participants in the Study Gender Distribution Grade Distribution Age Distribution Home Neighbourhoods MAQ-A Questionnaire Registered vs. Free Play Intensity and Age Intensity and Gender The Neighbourhood Accelerometry Weekdays and Weekends Meeting the Guidelines The Food Environment: Our Sister Study References Appendix 1 3 4 6 6 6 6 7 8 8 9 10 11 12 12 13 14 16 18

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 encourage children to be more physically active, thus slowing the rise in childhood obesity. Tackling the problem of childhood obesity requires multiple approaches. Many people, from health professionals, funders, policy makers, and researchers, to concerned parents, have identified environmental factors that can either help or hinder children and adults to live more active lifestyles. However, there has been little research into how aspects of the urban built environment in which we all livesuch as buildings, roadways, sidewalks, parks, and green spacescan encourage children to be physically active. By learning about what is and isnt working in our current neighbourhoods in Saskatoon, this study will help shape the design of future neighbourhoods, here and elsewhere in Canada.

Research Question 1: How have the specific planning strategies that the City of Saskatoon has used 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 two research surveys: the 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 each neighbourhood. Activity friendliness measures how suited the neighbourhood is to human-powered activities such as walking, skateboarding, cycling, and wheelchair use. Safety measures physical and social characteristics of the neighbourhood. Density of destinations measures destinations within the neighbourhood that people can travel to, such as public parks, sports and recreational centres, bus stops, local events, and shops. Universal accessibility measures how easily people of all ages, abilities and circumstances can access destinations in their neighbourhood. IMI consists of 229 neighbourhood features that fall within five domains: attractiveness; diversity of destinations; pedestrian access; safety from crime; and safety from traffic. With these two surveys in hand, observers walked through all 60 of Saskatoons residential neighbourhoods and recorded what they encountered. Each neighbourhoods active living potential was then assessed based on the results. Reports summarizing the results for each neighbourhood in Saskatoon can be found at

Health Benefits from Physical Activity1

Improve health Do better in school Improve their fitness Grow stronger Have fun playing with friends Feel happier Maintain a healthy body weight Improve their self-confidence Learn new skills

The park should have more street lights to make it less scary

smartcitieshealthykids.com.

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SMART CITIES, HEALTHY KIDS: THE PROJECT

Research Question 2: What is the relationship between a neighbourhoods active living potential and the physical activity levels and active transportation of the children between 10 and 13 who live in that neighbourhood?

Quick Fact:
Food insecurity during the preschool years has been found to increase the likelihood of obesity later in childhood2

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 physical activity. The Modifiable Activity Questionnaire for Adolescents (MAQ-A) was used to gather data on the registered and unregistered physical activities in which the children participate. A sub-group of 465 children was also recruited to wear accelerometers for a week. Accelerometers are small, waist-mounted instruments that measure physical activity directly. This report includes physical activity information from the Smart Cities, Healthy Kids questionnaires.

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

Quick Fact:
Along with physical activity, diet is the most well-studied behavioural factor influencing body weight and overweight and obesity risk2

The first two research questions examine the relationship between systematically measured aspects of neighbourhoods and childrens physical activity. Question three recognizes the importance of how children and their parents feel about their neighbourhoods. To find out, we conducted in-depth interviews with 24 families whose children had participated in earlier parts of the study. Each child was lent a digital camera with which to take photographs of places and things that they felt helped them to be active or, on the other hand, prevented them from being active. We discussed these photos in interviews with the children, and have included the photographs in presentations of the research findings. We also conducted indepth interviews with each parent about their perceptions of their neighbourhood environments.

It should be you dont have to be good at the sport to join

A second Smart Cities, Healthy Kids research project is currently being conducted that focuses on the impact of the food environment on childhood obesity. Data collection in the schools will commence in March of 2012. For more information please refer to page 14 of this report.

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UNDERSTANDING THE ISSUE: CHILDHOOD OBESITY

In recent years, child health researchers and health practitioners in Canada have been concerned about rising rates of obesity and physical inactivity among children. Evidence points to a greater percentage of children that are overweight or obese and experiencing associated health problems. These trends are a cause for concern and indicate a significant childhood obesity and physical inactivity crisis. In fact, if the current trends continue, we will have a generation of children growing up for the first time with poorer health status and lower life expectancy than that of their parents. Body mass index (BMI) is a measure used to determine childhood overweight and obesity. It is calculated using a childs weight and height.

Definitions of Childhood Obesity

Overweight: Body Mass Index (BMI) at or above the 85th percentile and lower than the 95th percentile for children of the same age and gender. Obesity: BMI at or above the 95th percentile for children of the same age and gender.

What's the Prevalence of Childhood Obesity in Canada?

In 2004, 26% of Canadian children and youth aged 2-17 years were overweight or obese, including 8% who were obese. Overweight and obesity among Canadian 2-5 year olds remained the same between 1979 and 2004 (21%), with obesity reported at 6.3% in 2004. Overweight and obesity doubled among Canadian 6-11 year olds between 1979 and 2004 and obesity tripled among Canadian adolescents aged 12-17 years.3

What's the Prevalence of Childhood Obesity in Saskatchewan?

In 2007/2008, one-quarter (25%) of youth in Saskatchewan were overweight or obese; this was a 16% increase over 2001. Notably, in the same year, more than half (57%) of youth in Saskatchewan were physically inactive, and the rate of inactivity has risen more than 17% since 2001.
I think physical activity is important for when we're younger so we can be fit and healthy when we're older.

Canadian Physical Activity Guidelines

For 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 (that will cause children to sweat and be out of breath) 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 such as improved self-confidence, stronger bones and maintenance of healthy weight.
4

Health and Social Problems associated with Childhood Obesity5

Being physically active makes you have a healthier mind/body and makes it easier to live. Without being fit the world would be an unhealthy place.

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

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

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METHODOLOGY: WHAT AND HOW

We used three different tools to explore physical activity trends among children in Saskatoon. The first was the Smart Cities, Healthy Kids (SCHK) questionnaire that we developed, the results of which we shared with you in the first round of reports distributed to the schools in June 2011. The results of the remaining two tools are included in this second report. We also administered a self-reported questionnaire (MAQ-A) to 1,610 children in grades 5-8. Students from 40 public and Catholic schools were chosen. We then asked a sub-group of 465 children to wear accelerometers to provide a direct measure of the childrens physical activity levels and patterns.

Quick Fact:
Research has suggested that indirect (MAQ-A questionnaire) and direct (accelerometry) measures may produce differing estimates of physical activity in children and youth2

Modifiable Activity Questionnaire for Adolescents (MAQ-A)

Questionnaires were administered from April to June of 2010. Keeping registered and non-registered activities separate, we asked children to list all of the activities they had participated in during the past month. We also asked them to record the number of participation minutes, the perceived intensity (light, medium, heavy) and the location of each type of activity (school, park, facility, home). Later, during data analysis, standard values (MET*) were assigned to the recorded activities according to their type and intensity. These were totaled to provided the number of minutes and levels of physical activity (low PA, moderate PA, high PA) achieved during each day. Self-reported questionnaires are a good way to understand childrens perceptions of physical activity. However, research has shown that children often have a difficult time recalling completed levels of physical activity, particularly as the time after completion increases. As a result, activity estimates may be somewhat exaggerated.5

I think its good to be physically active but its hard for people who are poor or for people who have no equipment

*Important Terms for

understanding the MAQ-A data MET = metabolic equivalent of task Low Physical Activity = light change from normal breathing Moderate Physical Activity = above normal breathing High Physical Activity = heavy breathing

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METHODOLOGY: WHAT AND HOW

Accelerometry
We gave accelerometers to a sub-group of children who had completed the MAQ-A questionnaire. We asked each child to wear the device for a one-week interval, at some point during the months of May and June. In order for the data to be usable, each child had to have worn the accelerometer for a minimum of 10 hours per day on at least 4 days of the week, including one weekend day. Accelerometers measure and record acceleration in all directions, providing an indication of activity intensity.6 They accurately measure stepbased activities (e.g. skateboarding, soccer, dance), while non-step-based activities, such as cycling, are not as reliably captured.7 Accelerometers do not measure water-based activities as they cannot be submerged in water. As a result of these restrictions, some childrens activity levels may be under-reported. Each childs activity levels were classified according to speed of movement (sedentary, light activity, moderate or vigorous activity), and thus total minutes of activity at each level was calculated over the course of a day and week.

Quick Fact:
Accelerometers measure movement in all direction providing data on trends in lifestyle choices7

Quick Fact:
Sedentary behaviours include screen time (watching TV or using the computer), reading, sitting during transit and sedentary hobbies2

Important Terms for understanding the accelerometry data

Show them the benefits of physical activity at a younger age and tell them how to do it on their own time. Also teaching them what different foods do to their body

SED = sedentary, no change in breathing Light = slight increase from normal breathing MVPA = moderate to vigorous physical activity

How can you help to increase childrens physical activity?

Encourage active forms of transportation Ask them to walk the dog with you Have them rake the leaves, shovel snow or carry groceries Encourage them to dance to their favourite music Replace computer and TV time with something active Build active opportunities into daily classroom routines Encourage children to join a school sports team Take kids to the playground or to the park to play PHYSICAL ACTIVITY PROFILE 2011 Page 5

PARTICIPANTS IN THE STUDY

Both the MAQ-A questionnaire and the accelerometry component were completed by voluntary participants from grades 5-8, during the spring of 2010. Schools were selected for participation based on previous phases of research, at which time target neighbourhoods were identified. Participation rates and demographic variables varied between schools. The following graphs describe the students who participated in this study.

Age Distribution
The graph below shows the age distribution of all participants in the study. Overall the number of participants in our study decreases with age. Studies show that physical activity habits form early on and can last a lifetime.8 It is therefore important to encourage physical activity during early childhood years.

Grade Distribution
The graph below shows the grade distribution of all participants. It indicates that as the grade increased the number of participants in our study decreased. Remember to keep in mind that within a single grade, more than one age group may be present.

Gender Distribution
The graph below shows the gender distribution of all participants in the study. More girls than boys participated in our study. National studies indicate that more boys than girls tend to participate in school sports.8 Also, girls tend to be more influenced by peer participation than boys.9

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PARTICIPANT HOME NEIGHBOURHOOD

The city of Saskatoon divides the city into Suburban Development Areas for planning purposes. The goal is to serve the commercial needs of several neighbourhoods through one central Suburban Centre. The map below identifies all nine of the SDAs Saskatoon. Blairmore, North Industrial, and East do not contain schools and are not included in the study. Refer to the Appendix on page 18 for a list of neighbourhoods in each SDA. The graph on the right shows the distribution of SDAs in which the participants live. The largest group of children participating in the study live in Confederation SDA. Studies shows that children living in lower income neighbourhoods have a higher likelihood of being overweight or obese than their counterparts living in higher income neighbourhoods. 10

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MAQ-A Registered vs. Free Play Activities

We asked participants to report on their past months activities from both registered and free play activities. They recorded the total number of active minutes as well as the level of perceived intensity for each type of activity. The graph at the bottom of the page shows the percentages of children who participated in low, moderate and high levels of physical activity during both registered and free play activities. The graph illustrates that children get more than twice the amount of physical activity from free play activities than from registered ones.

Free Play Activity = Does not require

registration E.g. walking, biking or playing games with friends

Registered Activity = Requires sign up

E.g. school sports, community teams, dance or swim lessons, exercise classes

These results are similar to other research findings.11 Children, in particular, benefit from opportunities for unstructured, self-directed play that may assist in their physical, motor, creative and social development, and sense of independence.12 According to Health Canada, it is desirable for children to get half of their recommended daily physical activity from unstructured free play.13 Studies have reported that being involved in organized sports during childhood is positively related to frequency of leisure-time physical activity in early adulthood.14 Additionally it has been shown that youth involved in after school activity programs were more physically active than those who were not. 15 Although organized sports are beneficial both physically and socially, participation does not ensure that youth meet the daily physical activity recommendations on practice days. 16 This is because much of the practice time may be spent waiting for instructions or turns. According to an American study, 23% to 60% of school childrens daily moderate to high physical activity is obtained through youth sports, with the remainder coming from physical education, free play and activity during recess.16

School gym classes really need to be improved. They are kind of a free for all. Plus we need better equipment and programs. It should be more intense

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MAQ-A Intensity and Age

Age plays a large factor in the daily activity patterns of children. Studies consistently show that as children grow older they typically reduce their physical activity levels.17, 18 According to a U.S. study completed in 2010, the most dramatic age-related decline in physical activity occurs at the start of puberty.17 Youth who stay active as they grow older are more likely to be active adults than their counterparts who are not active.19 The graph at the bottom of the page shows the breakdown of registered and free play activities, based on age and intensity. Participants between the ages of 12-13 accumulated the most high intensity physical activity. It has been suggested that the benefits of participation in unstructured or free play activities/sports are greater than those from structured or registered play.20 As shown in the graph below, at each age, more of the moderate to high intensity physical activity comes from free play than from registered activities.

Understanding Intensity14
Low Intensity = will cause a slight change in breathing from normal e.g. Walking the dog Moderate Intensity = will cause children to sweat a little and breathe harder e.g. Bike riding and playground activities High Intensity = will cause children to sweat and be out of breath e.g. Running and swimming

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MAQ-A Intensity and Gender

On average, boys tend to be more physically active than girls, regardless of the type of activity they are doing. One study showed that children tend to be more active in locations where loose equipment (such as balls, skipping ropes, etc.) are available; however, this had a greater impact on boys activity levels than on girls.21 This is a concern as girls are at a greater risk for low physical activity levels and for obesity. Furthermore, in an Alberta study it was shown that boys had higher self-efficacy (belief in their own ability to carry out a task or behaviour) than girls, which in turn predicted higher physical activity levels. 22 The graph below is consistent with these studies and indicates that boys are getting a higher level of physical activity than girls.

Be more encouraging to kids that arent good at sports

A 2010 study, showed that boys had similar physical activity levels for both organized and free play activities; however, girls tended to be more active in free play activities than in organized activities. 21 The graph below shows the results from our study indicating that both boys and girls tended to accumulate greater amounts of high physical activity during free play activities than during registered activities. Overall, boys got more high intensity physical activity than girls regardless of whether they were engaged in free play or registered activities.

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MAQ-A The Neighbourhood

Researchers in the Smart Cities, Healthy Kids study are particularly interested in understanding how a childs neighbourhood impacts their physical activity. We examined differences in physical activity levels according to Suburban Development Areas and average neighbourhood incomes. The graph below shows that the Confederation and Core SDAs had the highest proportion of children reporting low physical activity levels. Lakewood SDA had the lowest proportion of children reporting low physical activity levels. In fact, Lakewood had the highest proportion of children reporting high physical activity levels.

The graph below indicates that children in lower income neighbourhoods had lower levels of physical activity than those in higher income neighbourhoods. In an eight-year Canadian study, a link was identified between neighbourhood disadvantage and increased rates of obesity among children. 10,23 Furthermore, children in lower income families have less access to after-school programming and as a result are less able to participate in organized sport and physical activities after school.8

Stop making gym class the class to miss if something comes up

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Accelerometry Weekdays and Weekends

A sub-group of 465 children was asked to wear accelerometers in Quick Fact: order to directly measure their daily levels of physical activity. Both The promotion of moderate weekday and weekend days were recorded. The graph at the bottom of the page shows the number of weekend and weekday minutes to vigorous physical activity spent participating in moderate to vigorous activity. On average the (MVPA) during the weekend majority of children are meeting the 60-minute daily recommendation may hold the greatest for physical activity during the week, with the exception of 14-year-old promise for increasing total girls who fall just shy of the mark. The graph shows that children are MVPA25 much more active on weekdays than on weekends. This is consistent with other research findings.24 According to the graph below, 12-yearold boys had the highest levels of MVPA (moderate to vigorous physical activity) both during weekdays and weekends, while 14-year-old girls had the lowest levels of MVPA. In order to successfully influence childrens physical activity patterns it is imperative to understand why they are not meeting the daily recommendations, particularly on weekends. Parents can, both directly and indirectly, influence childrens activity levels through a variety of behaviours, such as, by acting as role models for engaging in consistent and vigorous levels of physical activity, by providing verbal encouragement, or by engaging in the activity with their child.26 A 2007 study on parents support for childrens physical activity, found that boys tended to engage in more physical activity on the weekend when their fathers directly participated in the activity with them, while girls tended to be influenced by their mothers planning of activities during the week.27

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Accelerometry Meeting the Guidelines

According to Active Healthy Kids Canada, results suggest that Canadian children are at least part way to meeting the daily recommended guidelines for physical activity (see page 3). Roughly 44% of children get 60 minutes of daily MVPA (moderate to vigorous physical activity) on at least 3 days per week, while 83% of boys and 73% of girls are getting 30 minutes of MVPA on at least 3 days of the week. 19 Looking at the graph below, results from our study reflect similar findings: 69% of boys and 57% of girls are meeting the guidelines (60 min) on 3-5 days of the week or better.

Dont force us into desks all day Designate some time everyday to physical activity

The graph below shows the average amount of time (in minutes and hours) that children spent in sedentary, light, or moderate to vigorous physical activity each day of the week. During weekend days children accumulated less time in MVPA than during the weekdays, with Sundays having the lowest total number of accumulated minutes at every activity level including sedentary. Mid to late week (Wednesday, Thursday and Friday) appears to be the days with the most time in MVPA.

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THE FOOD ENVIRONMENT: OUR SISTER STUDY

Please consider Participating our research again when we return to schools in the spring of 2012.
Smart Cities, Healthy Kids has received additional funding from the Canadian Institutes of Health Research and the Saskatchewan Health Research Foundation for a sister study evaluating the impact of the food environment on childhood 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, and how nutritious the foods are that they carry. By incorporating data on childrens body weight, we ultimately hope to support the development of improvements to health policy and practice in Saskatoon, and also provide children and their families with information on their neighbourhood food environments.

Question 1a: What is the geographical distribution of food stores and fast food restaurants in Saskatoon, and how is this distribution related to neighbourhood demographic and socioeconomic profiles?
During the first four months of the study (September-December 2010), Geographic Information Systems (GIS) tools were used to create maps of fast food restaurants, grocery, convenience, specialty, and all other food stores in all Saskatoon neighbourhoods. Public Health Services (Saskatoon Health Region) has already begun mapping the location of food stores in Saskatoon. Parts of the city where food access is limited have been identified and can be related back to demographic and socio-economic profiles. The map below represents a sample of the maps created through GIS and illustrates the walking distance to large and small supermarkets and convenience stores. It also shows that in some areas of Saskatoon it would not be possible to walk to a supermarket.

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THE FOOD ENVIRONMENT: OUR SISTER STUDY

Question 1b: What are the differences in food environments, such as location of different types of food stores and food quality, between higher and lower socioeconomic status neighbourhoods in Saskatoon?
We measured the consumer nutrition environments of chain supermarkets, smaller grocery stores, convenience stores and restaurants 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). We will calculate scores for each store using availability, quality, and price, and for each restaurant using availability, nutrition information, and price. Using these scores, we will then develop a series of maps showing the distribution of the quality of the food environment within all residential 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, as measured by (NEMS-S) and (NEMS-R), in Saskatoon neighbourhoods, and the dietary intake and body weights 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 least positive food environment characteristics based on the previous study data collection (GIS and NEMS). Children will participate in a food frequency questionnaire (FFQ) for dietary assessment that will be self-administered in class. A research assistant will also measure heights and weights in order to calculate body mass index (BMI) and determine body weight status. The questionnaire includes questions on socio-demographic characteristics, and our analysis will account 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 change that will improve food environments for Saskatoon, and then in other cities in other regions of the country?
We will conduct interviews with various governmental, health region, and community-based officials to share preliminary results, ask for feedback, and discuss policy change options to improve the food environment in Saskatoon. We will compile the results into a document that will be disseminated widely.

Quick Fact:
Children who eat fruit and veggies at least 5 times per day are substantially less likely to be overweight.1 PHYSICAL ACTIVITY PROFILE

For further information regarding either of our Smart Cities, Healthy Kids projects please visit our website smartcitieshealthykids.com.

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REFERENCES
1. The Canadian Society for Exercise Physiology. Canadian Physical Activity Guidelines. 2011 Available online: www.csep.ca/guidelines. 2. Obesity in Canada: A joint report from the Public Health Agency of Canada and the Canadian Institute for health Information. 2011. Available online: https://secure.cihi.ca/estore/productFamily.htm?locale=en&pf=PFC1636. 3. Shields, M. Measured Obesity: Overweight Canadian Children and Adolescents. Nutrition: Findings from the Canadian Community Health Survey: Issue no. 1. Statistics Canada, 2005. 4. Tremblay MS, Warburton DER, Janssen I, Paterson DH, Latimer AE, Rhodes RE, et al. New Canadian physical activity guidelines. Appl Physiol Nutrition Metab. 2011; 36:36-46. 5. Sallis, JF, Stirkmiller PK, Harsha DW, Feldman HA, Ehlinger S, Stone EJ, Williston J, Woods S. Validation of interviewer and selfadministered physical activity checklists for fifth grade students. Med & Sc in Sport & Exercise. 1996; 28(7):840-851. 6. Colley R, Gorber SC, Tremblay MS. Quality control and data reduction procedures for accelerometry-derived measures of physical activity. Health Reports. 2010; 21(1). 7. Colley RC, Garriguet D, Janssen I, Craig CL, Clarke J, Tremblay MS. Physical activity of Canadian children and youth: Accelerometer results from the 2007 to 2009 Canadian Health Measures Survey. Health Reports. 2011;22(1). 8. Active Healthy Kids Canada. Dont Let This Be The Most Physical Activity Our Kids Get After School. The Active Healthy Kids Canada 2011 Report Card on Physical Activity for Children and Youth. 2011. Available online: www.activehealthykids.ca. 9. Pfaeffli L. In Her Voice: An exploration of young womens sport and physical activity experiences. Focus group report and recommendations. Ottawa, ON: Canadian Association for the Advancement of Women and Sport and Physical Activity (CAAWS); 2009. 10. Oliver LN, Hayes MV. Effects of Neighbourhood Income on Reported Body Mass-Index: An eight-year longitudinal study of Canadian children. BMC Public Health. 2008;8:16. 11. Trost S.G., Rosenkrantz R.R., Dzewaltowski D. Physical Activity Levels among Children Attending After School Programs. Med Sci Sports & Exerc. 2008;40(4):622-629. 12. Hewes J. Let the children play: Natures answer to early learning. Canadian Council on Learnings Early Childhood Learning Knowledge Centre. 2008. 13. Pate R, Pfeiffer K, Trost S, Ziegler P, Dowda M. Physical activity among children attending preschools. Pediatrics. 2004;114:1258-1263. 14. The Canadian Society for Exercise Physiology. Canadian Physical Activity Guidelines. 2011 Available online: www.csep/ca/guidelines. 15. Flohr JA, Todd MK. Pedometer counts among young adolescents: A comparison between after school activity program participants and non-participants. Medicine & Science in Sport & Exercise. 2003;35(5):342. 16. Leek D, Carlson J, Cain K, Henrichon S, Rosinberg D, Patrick K, Sallis J. Physical Activity during Youth Sports Practices. Arch Pediatr Adolesc Med. 2011;165(4):294-299. 17. Belcher B, Berrigan D, Dodd K, Emken B, Chou C, Spruijt-Metz D. Physical Activity in US Youth: Effect of Race/Ethnicity. Age, Gender and Weight Status. Med Sci Sports & Exerc. 2010. 18. Physical Activity Guidelines for Americans. 2008. Available online: www.hhs.gov. 19. Active Healthy Kids Canada. The Active Healthy Kids Canada Report Card on Physical Activity for Children and Youth Saskatchewan Supplement. 2009. Available online: www.activehealthykids.ca. 20. Tremblay MS, and JD Willms. Is the Canadian Childhood Obesity Epidemic Related to Physical Inactivity? International Journal of Obesity 2003 27: 1100-1105. 21. McKenzie T, Crespo N, Banquero B, Elder J. Leisure Time Physical Activity in Elementary Schools: Analysis of Contextual Conditions. J of School Health 2010;80(10):470-477. 22. Spence J.C., Blanchard C.M., Clarke M, Plotnikoff R.C., Storey K.E., McCargar L. The role in self-efficacy in explaining gender differences in physical activity among adolescents: A multilevel analysis. Journal of PA & Health. 2010;7:176-183. 23. McDonald NC, Deakin E, Aalborg AE. Influences of the Social Environment on Childrens School Travel. Preventative Medicine. 2010;50 (1):565-568. 24. Soric M, Misigoj-Durakovic M. Acta. Physical activity levels and estimated energy expenditure in overweight and normal-weight 11year-old children, Paediatric. 2010;99:244-250.

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25. Steele RM, Slujis E, Sharp S, Landsbaugh J, Ekelund U, Griffin S. An investigation of patterns of childrens sedentary and vigorous physical activty throughout the week. Int. Journal Beh.Nutr. And PA. 2010;7-88. 26. Trost S, Sallis J, Pate R, Freedson P, Taylor W, Dowda M. Evaluating a model of parental influence on youth physical activity. Am. Journal of Prev. Med. 2003;25(4):277-282. 27. Beets M, Vogel R, Chapman S, Pitetti K, Cardinal B. Parents Social Support for Childrens Outdoor Physical Activity: Do Weekdays and Weekends Matter? Sex Roles 2007; 56:125-131.

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APPENDIX: SUBURBAN DEVELOPMENT AREAS

Confederation SDA: Confederation Park Confederation Suburban Centre Dundonald Fairhaven Hampton Village Holiday Park Hudson Bay Park Massey Place Meadowgreen Montgomery Place Mount Royal Pacific Heights Parkridge Westview Lawson SDA: Kelsey-Woodlawn Lawson Heights Lawson Heights Suburban Centre Mayfair North Park Richmond Heights University Heights SDA: River Heights Arbor Creek Silverwood Heights Erindale Evergreen Forest Grove Silverspring Nutana SDA: Sutherland Adelaide/Churchill University Heights Suburban Centre Avalon Willowgrove Brevoort Park Buena Vista Eastview Exhibition Greystone Heights Grosvenor Park Haultain Holliston Nutana Park Nutana Suburban Centre Queen Elizabeth Stonebridge The Willows

Core: Caswell Hill Central Business District City Park King George Nutana Pleasant Hill Varsity View Riversdale Westmount

Lakewood SDA: Briarwood College Park College Park East Lakeridge Lakeview Lakewood Suburban Centre Rosewood Wildwood

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