Section 1: Our health our future – A national dialogue on healthy weights dialogue report – Introduction
Rates of overweight and obese children and youth have risen steadily in recent decades. Today, more than one in four children in Canada is overweight or obese. Acknowledging that childhood obesity can lead to a number of long-term health issues, and recognizing the important role that collaboration plays in promoting healthy weights for children, the federal, provincial and territorial (FPT) Ministers of Health and/or Health Promotion/Healthy Living moved into action. In September 2010, they endorsed Curbing Childhood Obesity: A Federal, Provincial and Territorial Framework for Action to Promote Healthy Weights, which outlines a vision, strategies and priority areas for collaboration to address this issue.
As an important first step, Our Health Our Future – A National Dialogue on Healthy Weights was launched in March 2011 to reach out to and engage children, their parents, and communities. The initiative set out to inform Canadians on the real impact of childhood overweight and obesity, help people understand and recognize the contributing factors to unhealthy weights, start a conversation on moving towards healthy weights, and secure commitment to action from across the country. Through a series of events across the country, and the use of online and social media tools, more than 1,000 Canadians shared their ideas, suggestions and views on how to address childhood obesity. This report summarizes their contributions and key findings, which will be provided to the FPT Ministers of Health to inform their actions on the issue.
To guide and inform the process of speaking to citizens, the FPT Ministers of Health contracted the services of Ascentum, a leading North American public engagement firm, to create and execute an engagement strategy using a combination of in-person, online and social media tools. On March 7, 2011, the Ministers of Health officially launched Our Health Our Future, a broad-reaching engagement process, which set out to:
The initiative had four key objectives.
- Raise awareness of the impact childhood overweight and obesity has on physical, emotional and social health;
- Help people understand and recognize factors that can contribute to childhood overweight and obesity;
- Start a conversation on moving toward healthy weights for children and youth; and,
- Facilitate commitment to action to support healthy weights for children and youth from individuals, communities, industry, Aboriginal organizations and non-government organizations.
The initiative will culminate in a National Summit, where stakeholders from across the country will showcase best practices in addressing childhood obesity and determine concrete actions for the future. The key findings from the engagement process will be provided to the FPT Ministers of Health.
Reducing overweight and obesity levels and promoting healthy weights among children are important measures to prevent long-term illness and poor health. An increasing number of children are being affected by health problems that were previously seen only in adults, such as high blood pressure and Type 2 diabetes. If action is not taken now to promote healthy weights in children, Canadian youth will be forced to deal with serious health issues later in life.
Many Canadians have heard the message that healthy living means eating well and being active. But the ability to make these healthy choices is influenced by a range of complex and interacting factors –biological, behavioural, social, psychological, technological, environmental, economic and cultural –operating at all levels from the individual to the family to society as a whole. If the causes of overweight and obesity are to be addressed, close attention needs to be paid to Canadians' everyday environments.
In 2005, all of the FPT Ministers of Health came together to support the Pan-Canadian Healthy Living Strategy (PCHLS). The PCHLS's vision is a healthy nation in which all Canadians experience the conditions that support the attainment of good health. The PCHLS aims to promote good health, prevent chronic diseases, and reduce health inequalities among Canadians by coordinating efforts across the country to address common risk factors, such as physical inactivity and unhealthy eating.
In 2010, the PCHLS was revised to better address these common risk factors and conditions, and to identify new areas for opportunity, including overweight and obesity prevention, mental health promotion and injury prevention. To support the new PCHLS, the FPT Ministers of HealthFootnote  endorsed two documents in September 2010:
- The Declaration of Prevention and Promotion: Outlines the vision shared by the FPT Ministers of Health to work together and make disease, disability and injury prevention, as well as health promotion, priorities.
- Curbing Childhood Obesity - A Federal, Provincial and Territorial Framework for Action to Promote Healthy Weights: Focuses on reducing childhood overweight and obesity levels in Canada. It also outlines the strategies and priorities for FPT governments in working together to address this issue. It also served as the foundation for the Our Health Our Future engagement.
-  All provinces and territories except Quebec. It should be noted that although Quebec shares the general goals of this Framework, it was not involved in developing it and does not subscribe to a Canada-wide strategy in this area. Quebec intends to remain solely responsible for developing and implementing programs for promoting healthy living within its territory. However, Quebec does intend to continue exchanging information and expertise with other governments in Canada.
This report is divided into five chapters. Following an introduction, chapter two provides an overview of the integrated online and in-person engagement approach and chapter three describes the breadth and scope of participation from across the country. The key findings of the engagement process are presented in chapter four, under the four FPT Framework for Action priority areas: (i) Making nutritious food more accessible and available to all; (ii) Reducing the marketing of foods and beverages high in fat, sugar and/or sodium to children; (iii) Making the places where children live, learn and play more supportive of physical activity and healthy eating;and (iv) Developing tools for parents and health practitioners to help identify overweight and obesity and address it early on. The final chapter offers closing remarks and a summary of participant evaluations.
Through its three engagement channels – in-person events, online engagement, and social media – Our Health Our Future gathered significant volumes of data in the form of participant ideas, comments, submissions, messages, and posts. The research team analyzed all of the contributions received during the Our Health Our Future engagement.
Contributions from in-person events, online and social media posts were documented and carefully analyzed to identify key shared themes in what was heard. This qualitative analysis was performed using NVivo, a specialized qualitative software tool for coding data findings. It supports the identification of common ground points and divergent views. A coding tree was developed to categorize and group similar themes and findings, then individual branches were created.
Analysis and synthesis of the data reveals both common and divergent perspectives associated with the identified themes and ideas associated with the four policy topics. In chapter three, the key findings are accompanied by a table that indicates the number of times a theme or idea was discussed by participants in small groups and/or plenary discussion. Analysis shows the context within which the themes and ideas emerged and where there is convergence and divergence of views. The actual number of references is less important than the content of their conversations. The Nvivo software used to help identify the themes is a qualitative not a quantitative analysis tool.
Figure 1. An illustration of the NVivo coding tree and selected branches for Topic 2:
Text equivalent - Topic 2: Taking Early Action
An illustration of a branch with leaves. There is a central branch labelled “Topic 2: Taking Early Action”. There are 4 leaves sprouting from the left side of the branch; 1 leaf is labelled “Theme: Engage Parents and Families”. There is 1 leaf sprouting from the end of the branch labelled “Theme: Pre and Post Natal Services”. There are 4 leaves sprouting from the right side of the branch; 1 leaf is labelled “Theme: Breastfeeding Initiative”, 1 leaf is labelled “Theme: Support Practitioners”, and 1 leaf is labelled “Theme: Assess Health Needs and Risk Factors”.
Our Health Our Future gathered a high volume of qualitative data in the form of online ideas, submissions, social media comments and in-person event worksheets and plenary notes. In total, the engagement project generated 184,117 words, about the length of several standard length novels. The table below provides detail on the word count per engagement channel.
|Data Source||Word count|
|Facebook and Twitter comments||2,606|
|Small group idea worksheets and plenary notes||50,120|
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