- Email: [email protected]
Wicked Problem Calls for Innovative Comprehensive Systems Thinking Evaluation
Abstracts / Can J Diabetes 37 (2013) S217eS289
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confirming, as self-characteristic, a negative stereotype about one’s group. Two studies examined weight stigma threat in a novel application using a menu-ordering paradigm. In Study 1 (N ¼ 174), overweight participants under stigma threat ordered menu items for dinner that were higher in calories than overweight participants not under threat and nonoverweight participants. When calorie information was presented on the menu, however, overweight participants under stigma threat ordered menu items containing fewer calories than overweight participants who ordered from a conventional menu (Study 2, N ¼ 100). Public health evidence of the overall effectiveness of menu-labeling has been mixed, and psychological processes may illuminate when, why, and how menu labeling influences food choices. This research suggests that weight stigma threat can lead to stereotype-disconfirming behavior when calorie information is used as a tool to assist self-regulation. At a time when obesity levels are high and weight bias is rampant, these findings have important implications for the obesity epidemic, weight loss efforts, and obesity intervention policies.
analysis of nutritional studies and review of underlying pathological metabolism has revealed a paradigm shift in our understanding of how foods affect our health. Reductions in fat consumption based on health messages over the last 40 years have led to unintended increase consumption of complex carbohydrates and simple sugars with associated rises in obesity and metabolic syndrome. Evidence suggests the dose of simple sugars has increased within range of being pharmacologically harmful as established by the associations of high sugar intake with significant adiposity, low grade inflammation, insulin resistance and dyslipidemia (metabolic syndrome) e conditions accompanying type 2 diabetes and cardiovascular disease. A greater understanding of lipid and lipoprotein metabolism does not support the belief that fats, with the exception of trans-fats, are unhealthy. Rather with the exception of trans-fats, most fats exhibit beneficial or neutral effects on lipid profiles and CVD risk. An overview of the literature will redirect our understanding that simple sugars and carbohydrates broken down into simple sugars not fats are significantly impacting the obesity epidemic and health of Canadians.
238
240
Wicked Problem Calls for Innovative Comprehensive Systems Thinking Evaluation JUDITH LAPIERRE, NATHALIE DUMAS, PHILIPPE DE WALS, MÉLANIE MICHAUD, MARIE-CLAUDE JEAN Centre de recherche Institut universitaire de cardiologie et de pneumologie de Québec, Université Laval, Québec, Québec, Canada
Weighing in From the North: Challenges and Opportunities in Developing a Health Authority Position on Health, Weight and Obesity FLO SHEPPARD, CHRISTINE GLENNIE-VISSER Northern Health, Terrace, British Columbia, Canada
Obesity rates are growing alarmingly in youths although some stabilisation is observed is certain age strata. One of Québec’s current political pillars, increased solidarity includes a policy on prevention and health promotion as core avenues with a vision that before 10 years, Québecers reached physical activity levels and health that are optimal worldwide and that, with a history of clear political agenda on prevention trough supportive environments and healthy behavior strategies is promising. Université Laval Evaluation Platform on Obesity Prevention (EPOP) aims at mobilising a research expertise on impact evaluation around obesity prevention of youths, 0-17 years old. Obesity is a complex societal public health problem requiring a multiple multilayers analytical lens. Current evidence indicates that such lens must magnify principles of systems science, socioecological perspective, multiple integrated intervention strategies, etc. among others. Policy coherence, health equity and healthy weights can be achieved with sustained coordinated efforts. The goal is to describe and compare comprehensive explanatory and evaluative concepts of available peer reviewed theoretical frameworks based on principles aforementioned, propose an evidenced-base evaluative conceptual mapping strategy and validate relevance and applicability to portray Québec’s current initiatives in healthy living and obesity prevention. A scoping review is proposed including a structural critical literature review and expert consultation process. 84 research published in journals were compiled. Frameworks were analysed based on a set of obesity related principles. Optimal peer reviewed and governmental frameworks are presented and compared. An emerging conceptual evaluative framework is proposed for the portrayal of Québec’s obesity prevention strategy.
239 Paradigm Shift: The Importance of Reducing Carbohydrate Consumption to Reverse the Obesity Epidemic ALEXANDER FRAME, RICHARD MATHIAS University of British Columbia, Vancouver, British Columbia, Canada The physiological and pathological processes underlying obesity are significantly more complicated than initially perceived. A meta-
Northern and rural populations demonstrate higher rates of health status concern around weight status and contributing modifiable risk factors. In Northern Health, nearly two in every three adult men and more than one in every two adult women are classified as overweight or obese. While similar to other comparable regions, these rates are much higher than more urban counterparts. As a way to address upstream risk factors collectively, Northern Health has developed position statements to address prevention, management and treatment of many of those factors that place the population at health risk. Northern Health’s Position on Health, Weight and Obesity draws on current evidence and identified best practices to inform policy regarding a population health approach to weight and obesity. This presentation highlights Northern Health’s experience in translating field and research evidence so that the policy-informing work is applicable to Northern, rural and remote regional populations and circumstances. The presentation explores the challenges of adherence to a position which challenges many common organizational practices with respect to obesity. The presentation also explores the opportunities and strength of working within a health authority with an endorsed approach to weight.
241 Making Healthy Choices the Easy Choices: A Follow-up Study of Health Basics Program Alumni LORNA MILKOVICH, BEV WHITMORE, DONNA THOMPSON, NELLY OELKE Red Deer Primary Care Network, Red Deer, Alberta, Canada This session will share the journey and early results of a longitudinal study being conducted by the Red Deer Primary Care Network (RDPCN) for the Health Basics CHOICES program. This study has received a one year funding grant through the Alberta Health Services Obesity Strategy. Participants will learn how a weight management program responsive to health data and physician need was designed utilizing a health promotion and value-based approach to engage and empower physician-referred patients. This program consists of a no-cost eight week interactive series of classes which are preceded by a mandatory introductory class and followed by optional monthly follow-up classes for alumni. Program foci are active living, healthy eating and life
S277
confirming, as self-characteristic, a negative stereotype about one’s group. Two studies examined weight stigma threat in a novel application using a menu-ordering paradigm. In Study 1 (N ¼ 174), overweight participants under stigma threat ordered menu items for dinner that were higher in calories than overweight participants not under threat and nonoverweight participants. When calorie information was presented on the menu, however, overweight participants under stigma threat ordered menu items containing fewer calories than overweight participants who ordered from a conventional menu (Study 2, N ¼ 100). Public health evidence of the overall effectiveness of menu-labeling has been mixed, and psychological processes may illuminate when, why, and how menu labeling influences food choices. This research suggests that weight stigma threat can lead to stereotype-disconfirming behavior when calorie information is used as a tool to assist self-regulation. At a time when obesity levels are high and weight bias is rampant, these findings have important implications for the obesity epidemic, weight loss efforts, and obesity intervention policies.
analysis of nutritional studies and review of underlying pathological metabolism has revealed a paradigm shift in our understanding of how foods affect our health. Reductions in fat consumption based on health messages over the last 40 years have led to unintended increase consumption of complex carbohydrates and simple sugars with associated rises in obesity and metabolic syndrome. Evidence suggests the dose of simple sugars has increased within range of being pharmacologically harmful as established by the associations of high sugar intake with significant adiposity, low grade inflammation, insulin resistance and dyslipidemia (metabolic syndrome) e conditions accompanying type 2 diabetes and cardiovascular disease. A greater understanding of lipid and lipoprotein metabolism does not support the belief that fats, with the exception of trans-fats, are unhealthy. Rather with the exception of trans-fats, most fats exhibit beneficial or neutral effects on lipid profiles and CVD risk. An overview of the literature will redirect our understanding that simple sugars and carbohydrates broken down into simple sugars not fats are significantly impacting the obesity epidemic and health of Canadians.
238
240
Wicked Problem Calls for Innovative Comprehensive Systems Thinking Evaluation JUDITH LAPIERRE, NATHALIE DUMAS, PHILIPPE DE WALS, MÉLANIE MICHAUD, MARIE-CLAUDE JEAN Centre de recherche Institut universitaire de cardiologie et de pneumologie de Québec, Université Laval, Québec, Québec, Canada
Weighing in From the North: Challenges and Opportunities in Developing a Health Authority Position on Health, Weight and Obesity FLO SHEPPARD, CHRISTINE GLENNIE-VISSER Northern Health, Terrace, British Columbia, Canada
Obesity rates are growing alarmingly in youths although some stabilisation is observed is certain age strata. One of Québec’s current political pillars, increased solidarity includes a policy on prevention and health promotion as core avenues with a vision that before 10 years, Québecers reached physical activity levels and health that are optimal worldwide and that, with a history of clear political agenda on prevention trough supportive environments and healthy behavior strategies is promising. Université Laval Evaluation Platform on Obesity Prevention (EPOP) aims at mobilising a research expertise on impact evaluation around obesity prevention of youths, 0-17 years old. Obesity is a complex societal public health problem requiring a multiple multilayers analytical lens. Current evidence indicates that such lens must magnify principles of systems science, socioecological perspective, multiple integrated intervention strategies, etc. among others. Policy coherence, health equity and healthy weights can be achieved with sustained coordinated efforts. The goal is to describe and compare comprehensive explanatory and evaluative concepts of available peer reviewed theoretical frameworks based on principles aforementioned, propose an evidenced-base evaluative conceptual mapping strategy and validate relevance and applicability to portray Québec’s current initiatives in healthy living and obesity prevention. A scoping review is proposed including a structural critical literature review and expert consultation process. 84 research published in journals were compiled. Frameworks were analysed based on a set of obesity related principles. Optimal peer reviewed and governmental frameworks are presented and compared. An emerging conceptual evaluative framework is proposed for the portrayal of Québec’s obesity prevention strategy.
239 Paradigm Shift: The Importance of Reducing Carbohydrate Consumption to Reverse the Obesity Epidemic ALEXANDER FRAME, RICHARD MATHIAS University of British Columbia, Vancouver, British Columbia, Canada The physiological and pathological processes underlying obesity are significantly more complicated than initially perceived. A meta-
Northern and rural populations demonstrate higher rates of health status concern around weight status and contributing modifiable risk factors. In Northern Health, nearly two in every three adult men and more than one in every two adult women are classified as overweight or obese. While similar to other comparable regions, these rates are much higher than more urban counterparts. As a way to address upstream risk factors collectively, Northern Health has developed position statements to address prevention, management and treatment of many of those factors that place the population at health risk. Northern Health’s Position on Health, Weight and Obesity draws on current evidence and identified best practices to inform policy regarding a population health approach to weight and obesity. This presentation highlights Northern Health’s experience in translating field and research evidence so that the policy-informing work is applicable to Northern, rural and remote regional populations and circumstances. The presentation explores the challenges of adherence to a position which challenges many common organizational practices with respect to obesity. The presentation also explores the opportunities and strength of working within a health authority with an endorsed approach to weight.
241 Making Healthy Choices the Easy Choices: A Follow-up Study of Health Basics Program Alumni LORNA MILKOVICH, BEV WHITMORE, DONNA THOMPSON, NELLY OELKE Red Deer Primary Care Network, Red Deer, Alberta, Canada This session will share the journey and early results of a longitudinal study being conducted by the Red Deer Primary Care Network (RDPCN) for the Health Basics CHOICES program. This study has received a one year funding grant through the Alberta Health Services Obesity Strategy. Participants will learn how a weight management program responsive to health data and physician need was designed utilizing a health promotion and value-based approach to engage and empower physician-referred patients. This program consists of a no-cost eight week interactive series of classes which are preceded by a mandatory introductory class and followed by optional monthly follow-up classes for alumni. Program foci are active living, healthy eating and life