Louise Masse
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- Understand how behaviour modification works to change lifestyles behaviours associated with obesity - Randomized control trial
- Understand how transitioning from elementary schools to secondary school influence student health behaviours associated with obesity
- Understand the influence of the Active Play standards influence licensed childcare centre as well as the opportunities for structured and unstructured physical activity. Determine whether the Active Play standard increase fundamental movement skills of 3 to 5 year old children.
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Dissertations completed in 2010 or later are listed below. Please note that there is a 6-12 month delay to add the latest dissertations.
This doctoral dissertation comprises four studies and an expert consensus meeting charged with identifying the most relevant areas of functioning for children and youth with cerebral palsy (CP) aged 0-18 years. The conceptual framework for this project was the International Classification of Functioning, Disability and Health for children and youth (ICF-CY). According to this model, functioning - “what a person can or cannot do every day” - results from the positive and negative interactions between factors within the child, the task, and the context, including personal and environmental factors. In these studies, functioning was described using the ICF-CY units of analysis: ICF-CY categories. This project’s design featured rigorous, evidence-based quantitative and qualitative techniques. Studies I-IV gathered evidence on critical aspects of functioning for children and youth with CP from various perspectives: the research community (Study I), the international experts (Study II), the children and youth with CP and their caregivers (Study III), and the clinicians (Study IV). Data from each study were linked to the ICF-CY using linking rules. Each study identified a unique list of ICF-CY categories representing every ICF-CY component. The most prevalent components included activities and participation and body functions. Specifically, topics related to d4-Mobility, d5-Self-care, d9-Communiy civil life, b7-Neuromusculoskeletal functions and b1-Learning and applying knowledge were described often in all the studies. The lists of ICF-CY categories generated from Studies I-IV were presented to an international group of experts in the field of childhood disability. The experts, by consensus, created the ICF Core Sets for children and youth with CP. Five Core Sets were developed: a Comprehensive Core Set to be used in interdisciplinary assessments of children aged 0–18 years, a Common Brief Core Set applicable to children aged 0-18 years, and three Age-Specific Core Sets (for children younger than 6 years, between 6-
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The research presented in this thesis explored relationships between healthful eating and food environments among overweight/obese adolescents. The three aims were to: 1) examine associations between parent and adolescent diets, 2) determine associations between a range of factors in the home food environment and adolescent diets, and 3) explore perceived factors that impede or facilitate healthful eating within home, school and community environments among adolescents. A secondary data analysis of baseline data collected from 176 parent-adolescent (11-16 years old) pairs who presented for an e-health intervention was conducted. Parent and adolescent intake of specific foods (vegetables and fruit (VF), total fat, sugar-sweetened beverages (SSB), desserts/treats, and snacks) was assessed from up to three 24-hour dietary recalls, while demographic and household factors were collected from questionnaires. Analyses examined associations between adolescent diets and the following parent and household factors: parent intake, parent modeling, parenting style, family meal practices, and home food and beverage availability. Upon completion of the intervention, a subset of 22 adolescents took part in a photovoice study to explore perceived barriers and facilitators to healthful eating within the home, school and community settings. Parent intake was positively associated with adolescent intake for all dietary components except for desserts/treats. Both parent modeling of healthful food choices and healthier family meal practices were associated with fewer high fat food items and soft drinks in the home, but neither were directly related to adolescent intake. The availability of less healthful foods at home was related to intake of fat, SSB, desserts/treats and snacks. These findings were further expanded by adolescents’ photographs depicting a struggle with an obesity-promoting environment. At home, themes that emerged included family meals, availability, parenting practices, modeling, celebrations, accessibility, and screen use. In the school and community, themes that emerged included availability, peers, convenience, price, school practices, marketing, and online influences.Targeting the home food environment through family-based obesity interventions and minimizing opportunities for less healthful eating in schools and communities may support dietary behaviour change among overweight/obese adolescents. Socio-ecological and systems-based approaches may help to conceptualize links between the multiple influences on dietary behaviour.
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Master's Student Supervision
Theses completed in 2010 or later are listed below. Please note that there is a 6-12 month delay to add the latest theses.
Background: Dietary behaviours are a modifiable risk factor contributing to adolescent obesity (13-to-17-year-olds). Interventions involving the home have shown promise in promoting healthy eating directly through parenting practices (i.e., structured, autonomy supportive and controlling parenting practices) and indirectly through adolescents’ commitment to healthy eating (i.e., cognitive factors including self-efficacy and motivation). However, it is currently unknown if boys and girls respond similarly to parenting practices or whether sex of parent matters. Objective: The aims of this thesis were to explore the associations between parenting practices (Aim 1) and cognitive factors (Aim 2) on adolescents’ dietary behaviours (i.e., fruit/vegetable (F&V) and sugar sweetened beverage (SSB) consumption) as well as the mediated associations of parenting practices through adolescents’ cognitive factors (Aim 3). Methods: Two samples were analyzed including the LiGHT project from Canada and the FLASHE study from the United States (US). The Canadian sample included 362 parent-adolescent dyads (65.5% mothers; 49.7% girls) and the US sample included 1633 parent-adolescent dyads (73.7% mothers; 50.4% girls). All measures were collected using self-reported questions. Using path analyses, direct associations between parenting practice (Aim 1) and adolescents’ cognitive factors (Aim 2), as well as indirect associations of parenting practices through adolescents’ cognitive factors on dietary behaviours (Aim 3) were explored. All models were stratified by sex of adolescent and controlled for known confounders. Sex of parent was explored as a moderator in aims 1 and 3. Results: Direct associations between controlling (β =-.24, p<.01 and="" autonomy="" supportive="" p="" parenting="" practices="" f="" intake="" emerged="" among="" boys="" only.="" direct="" associations="" between="" intrinsic="" motivation="" ssb="" consumption="" also="" for="" findings="" from="" the="" mediation="" analyses="" suggest="" that="" controlling="" have="" significant="" indirect="" on="" dietary="" behaviours="" through="" pathways="" but="" not="" girls.="" parent="" sex="" was="" found="" to="" act="" as="" a="" moderator.="" conclusion:="" girls="" do="" appear="" be="" affected="" in="" same="" way="" by="" practices.="" home-based="" interventions="" using="" broader="" range="" of="" may="" advantageous="" helping="" shape="" healthy="" eating="" more="" so="" than="">
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BACKGROUND: Adolescent obesity continues to be a major public health problem within Canada; therefore, effective solutions are required. E-health interventions can provide Canadian adolescents (13-17 years old) with personalized support to help them modify their obesogenic behaviours. However, predictors of app adoption and usage among adolescents have not been extensively examined. OBJECTIVE: This study aimed to examine user and household characteristics associated with adolescents’ adoption and usage of the Aim2Be© app; a health behaviour modification intervention delivered through a smartphone app. METHODS: 371 adolescent-parent dyads completed baseline assessment and were provided with access to the Aim2Be© app. Mean adolescent age was 14.9 years and 50.1% were male (n=186). Mean adult age was 44.1 years and 34.7% were male (n=129). Multivariable logistic and linear regressions, along with path analyses, were used to determine characteristics that were significantly associated with app adoption and usage, respectively. Additionally, analyses were stratified by parent’s sex. Univariable analyses were conducted in Stata (v.13.1), while path analyses were conducted in Mplus (v.8). All models were adjusted for adolescent’s age and sex, and a significance level of 5% was used. RESULTS: 79.2% of adolescents (n=294) adopted the Aim2Be© app. When examining user characteristics, adolescent engagement in healthy behaviours was directly associated with increased odds of app adoption (OR=1.08; 95%CI=1.01-1.14). Autonomous motivation was indirectly associated with app adoption (OR=1.02; 95%CI=1.00-1.04). When examining parenting practices, mediated through user characteristics, autonomy supportive practices were associated with increased app usage (β=0.21; 95%CI=0.07-0.36), while structure practices were indirectly associated with increased odds of app adoption (OR=1.02; 95%CI=1.00-1.04). When the analyses were stratified by parent’s sex, differences in the associations emerged. CONCLUSIONS: Both user characteristics and parenting practices were significantly associated with adolescents’ app adoption and/or usage. The findings of this study will help inform future e-health interventions increase user engagement by identifying the characteristics of individuals who are not accessing the intervention, as well as identifying factors of the household environment that support long-term intervention use. This information will fill an important gap within the literature, as high attrition rates are commonly reported among e-health interventions and can consequently jeopardize program effectiveness.
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Children’s independent mobility (IM), their freedom to move about their neighbourhood without supervision by adults, has been in steady decline in recent decades. Previous research has linked perceptions of the environment with various measures of IM, but recently concerns have been raised regarding inconsistency in measuring IM. This study used various measures of IM and aimed to address how parental perceptions of the neighbourhood environment are associated with children’s territorial range – their actual spatial mobility – as well as how this relationship is mediated by IM parenting practices. Territorial range was derived from GPS, accelerometer, and activity diary data and IM parenting practices measured by license for independent mobility (LIM), roaming allowance, and parental boundaries. Path analysis was used to investigate the direct and indirect effects of these relationships. Some parental perceptions of the neighbourhood environment were significantly associated with IM parenting practices (LIM and roaming allowance). IM parenting practices were significantly associated with children’s territorial range. Direct effects of parental perceptions of the neighbourhood environment on children’s territorial range were variable, and only roaming allowance was found to mediate this relationship. Results indicate that IM parenting practices directly affect children’s territorial range to varying degrees. Parental perceptions of the neighbourhood environment have mixed effects on IM parenting practices and children’s territorial range. These findings suggest that future interventions to increase children’s IM should focus primarily on behavior change among parents since they are setting restrictions or allowances for children’s IM.
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BACKGROUND: The familial environment can influence an adolescent’s risk for obesity. However, we do not fully understand the mechanisms through which parents can influence obesity-related adolescent health behaviours, specifically whether parenting practices (e.g., rules or routines) and/or their own health behaviours are associated with their adolescent’s behaviours.OBJECTIVES: This study examined, in a sample of overweight/obese adolescents, whether parenting practices and/or parental modeling of health behaviours are associated with adolescents’ health behaviours (physical activity (PA), dietary, sedentary and screen behaviours) while considering the moderating effects of parenting styles and family functioning.METHODS: Baseline data from 172 overweight/obese adolescents and one of their parents who enrolled in a lifestyle modification intervention were analyzed [Mean age=13.1 (1.8); Mean BMI z-score=2.70 (0.83)]. Parent-adolescent dyads completed questionnaires about their PA and screen time, wore an accelerometer for 8 days to objectively measure PA and sedentary time, and completed three 24-hr dietary recalls online. Parents completed questionnaires about their family functioning, parenting practices, and styles (authoritative and permissive). Path analysis was used to model interrelationships among the variables.RESULTS: Both parenting practices and modeling of health behaviours were significantly associated with all adolescent obesity-related health behaviours. However, in many instances, these associations were significantly moderated by parenting styles or family functioning. When both parenting practices and modeling of health behaviours were entered in the analyses, both modeling and parenting practices remained significant for objective PA and sedentary time; however parenting practices and modeling were moderated by parenting style for sedentary time (permissive style; p<.05 for="" accelerometer="" pa="" styles="" moderated="" parenting="" practices="" style="" p="" finally="" dietary="" quality="" parental="" modeling="" the="" interactions="" however="" only="" partially="" supported="" study="" hypotheses.conclusions:="" this="" work="" suggests="" that="" and="" are="" important="" it="" is="" necessary="" to="" consider="" broader="" emotional="" context="" into="" which="" these="" expressed="" since="" effects.="" provides="" insight="" how="" may="" alter="" effectiveness="" of="" highlights="" need="" account="" improve="" efficacy="" current="" family-based="" interventions.="">
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PURPOSE: The purpose of this study was to: 1) investigate whether adherence to components of a web-based weight management intervention have an effect on health behaviours (moderate-to-vigorous physical activity (MVPA), sedentary behaviour, and dietary quality) and change in body mass index (BMI) z-score of adolescents; and 2) to examine how health behaviours mediate the relationship between adherence to components of the intervention and change in BMI-z-score. METHOD: A total of 158 overweight/obese adolescents and their parents participated in an 8-month web-based weight management intervention. Path analysis was used to examine the effect of adherence to intervention components on health behaviours associated with obesity (MVPA, sedentary behaviour, and dietary quality) and change in BMI z-score at 4 and 8 months and to test for mediation effects. Adherence assessed the percentage of content viewed and number of weeks of self-monitoring of physical activity (steps), sedentary time, and dietary intake. MVPA and sedentary behaviour were assessed with accelerometers and self-reported questionnaires. Three self-administered 24-hour dietary recalls were used to compute a dietary quality index. RESULTS: Adolescents viewed 49% and 39% of the web content at 4 and 8 months, respectively. They self-monitored their steps, sedentary time, and dietary intake for 7.5, 2.0, and 3.9 weeks during the first four months and 10.9, 2.7, and 5.6 weeks for the duration of the intervention period (8 months), respectively. The amount of content adolescents’ viewed had a significant direct effect on their dietary quality at both 4 and 8 months (Standardized Coefficient (SC)=0.19, p=0.09 and SC=0.24, p=0.01, respectively) and a significant direct effect on change in BMI z-score at 8 months (SC=0.26, p=0.01). None of the health behaviours mediated the effect of adherence to intervention on change in BMI z-score. CONCLUSION: The study highlights that viewing more content was associated with improved dietary quality and greater reduction in BMI z-score but use of the self-monitoring tools did not explain these changes. Health behaviours could not explain the underlying process of the intervention. Finding ways to maintain adolescents engaged with the intervention is necessary given its effects on health outcomes.
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BACKROUND: As very few Canadian children are meeting the recommended physical activity (PA) levels suggested for maximal health benefits, gaining an understanding of the role of the school-environment in PA promotion is critical. While physical education (PE) classes have the potential for increasing PA levels of students both inside and outside school, little is known about why some schools are providing more PE than others. PURPOSE: The purpose of this exploratory study was to 1) determine what school-level factors were associated with the number of PE classes provided to elementary school students and 2) determine how these school factors, including PE amount, were associated with the PA levels of students. METHODS: Multi-level regression techniques were used to explore which school-level and student-level variables were associated with the PE amount provided to students and their PA levels. Administrator (n=30) and student (n=2,447) responses from two separate surveys from the PLAY-ON study were used to answer the study questions. RESULTS: After adjusting for important demographic characteristics, the number of PE classes reported per week was higher in schools that had two PA facilities in addition to a gymnasium (β=1.13, p =0.048) and in schools with greater levels of parental involvement in school-based PA decisions and programs (β=2.06, p =0.001). In contrast, students in schools that provided intramural programs reported fewer PE classes than those in schools without (β=-1.97, p
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