Suchergebnisse

IntroductionEarly-life prevention of chronic diseases is crucial to a healthy adulthood. However, evidence is often lacking to assess the effectiveness of early intervention programs, partly because of failure to make use of existing data. This project aims to capitalize on existing administrative data in two provinces to address this gap.
Objectives and ApproachTo identify and evaluate selected administrative databases (AD) from NB and PEI to create an intra-provincial Child Health Profile (CHP) and establish the foundation for a population-based birth cohort database in each province using existing administrative data. Integrated knowledge translation (iKT) was implemented to facilitate the continuous involvement of knowledge users and stakeholders, including provincial government managers/decision-makers, data custodians, health practitioners, parents and community organizations. Consultations were held to identify the AD of interest and develop a roadmap for the CHP. For each dataset, a list and description of data and analytical variables was produced and data access requested.
ResultsNot all AD identified are equally complete and accessible to researchers. Data access, preparation and linkage are challenging but feasible. This process was facilitated by iKT, which also contributes to capacity building. Several AD, mainly healthcare AD, including the Healthy Toddler Assessment and NutriSTEP, are currently accessible. An analytic framework was developed for pulling the data together and planning their analyses to produce the CHP. Based on the data currently accessible, the first CHP will focus on data at birth and at 18 months. Other databases (e.g., preschooler assessments) may be included subsequently. Work is underway to create workable datasets from which the CHP and roadmap for the birth cohort are being developed. This approach is scalable and can be extended to other jurisdictions.
Conclusion/ImplicationsSelect AD in NB and PEI are rich resources for establishing a comprehensive CHP and population-based birth cohort database in each province. These new tools will enable various stakeholders to monitor and report on child health over the long term, and to evaluate current practices and future health interventions.

Despite their prevalence, the longitudinal impacts of relative age effects (RAEs) on sport and other forms of physical activity (PA) are understudied. This study examined longitudinal participation patterns in organized sport (team and individual), unorganized PA, and non-participation with respect to RAEs in a prospective cohort of adolescents. Data from the first 24 cycles of the MATCH study were used for analyses. Elementary students (n = 929) were recruited from 17 schools in Atlantic Canada. Respondents self-reported PA three times/year. Mixed multilevel logistic models compared the likelihood of participating in each context across birth quarter. Chronological age and gender were considered, along with the interaction between chronological and relative age. Individuals born in Quarter 1/Quarter 2 were more likely to report participation in organized team sport but not individual sports. Relatively older participants born in Quarter 2 were more likely to report participation in unorganized PA. Increasing chronological age was associated with decreased participation in organized sport (particularly team-based) and increased non-participation. Gender was not associated with organized sport participation, but girls were under-represented in unorganized PA and more likely to report non-participation. The interaction parameters suggested that RAEs were consistent throughout adolescence in each context. Longitudinal analyses suggest RAEs are context dependent.

IntroductionAdministrative health data (AHD) are typically not analyzed to produce evidence on the effectiveness and limitations of primary prevention programs and strategies. The value of AHD for answering research questions is generally recognized, but the challenges in accessing and using these data for research are not always know and documented.
Objectives and ApproachTo identify and advise on the facilitating factors and challenges of accessing select AHD in New Brunswick (NB) and Prince Edward Island (PEI) for the purpose of creating an intra-provincial Child Health Profile (CHP) and population-based birth cohort database, using existing AHD not been previously linked. This research is a cross-jurisdictional collaboration between NB and PEI with an integrated knowledge translation (iKT) approach that adheres to each province's unique data policies, data procedures, and data governance. The collaboration involves people in various roles: provincial government managers, policy-makers, data custodians, health practitioners, citizens, community organizations, in addition to academic researchers.
ResultsAccess to select AHD required considerable preparation, cross province coordination, and ongoing discussions over many months. Key facilitators were the NB Institute for Research, Data and Training, a newly established data repository that holds provincial AHD in NB, and the provincial health authority in PEI. In NB, the existence of well-documented protocols and support from designated personnel (including trained data analysts) were assets facilitating data access through the data repository. In PEI, REB approval was obtained more rapidly but challenges occurred in subsequent stages of data access directly through the health authority. This research supports the empowerment of stakeholders such as Public Health and researchers who are trying to leverage 'big data' resources to address research and practice questions regarding children's health.
Conclusion/ImplicationsAccessing AHD for the project was facilitated by the existence of well-documented protocols and other specialized resources that help streamline the process of data sharing while ensuring data privacy and security. Continued relationship-building among stakeholders is needed to facilitate and maximize the use of existing AHD in NB and PEI.

Purpose: To assess how nutrition knowledge is associated with global diet quality and to investigate whether sociodemographic characteristics (ie, sex, age, education, income, marital status, and living with children or not) moderate this association. Design: Cross-sectional web-based study. Participants: The PREDISE study aims at identifying correlates of adherence to healthy eating guidelines in French-speaking adults from the Province of Quebec, Canada. Subjects: A probability sample of 1092 participants (50% female). Measures: The Nutrition Knowledge Questionnaire and 24-hour food recalls from which the Canadian Healthy Eating Index (C-HEI) was calculated. Analysis: Multiple linear regressions performed to assess how nutrition knowledge is associated with the C-HEI. Interaction terms tested to evaluate whether sociodemographic characteristics moderate the association between nutrition knowledge and the C-HEI. Results: Nutrition knowledge (B = 0.141 [95% CI: 0.075-0.208], P < .0001) was identified as a significant correlate of the C-HEI. Education significantly moderated the association between nutrition knowledge and the C-HEI ( P interaction = .0038), with a significative association among participants with a lower education level (B = 0.295 [95% CI: 0.170-0.421], P < .0001) but not among participants with a higher education level (B = 0.077 [95% CI: −0.004 to 0.157], P = .06). Whether participants lived with or without children also significantly moderated the association ( P interaction = 0.0043); nutrition knowledge was associated with the C-HEI only in participants who were not living with children (B = 0.261 [95% CI: 0.167 to 0.355], P < .0001). Conclusion: This study suggests that the association between nutrition knowledge and adherence to healthy eating guidelines is not the same in different subgroups of the population. Interventions aiming at increasing nutrition knowledge may be a promising approach to improve diet quality, especially among individuals with a lower education.