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Letters to the Editor and Comings and Goings, November 2005

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I Introduction

This week, we have some Comings and Goings from Ontario health
promotion and a Letters to the Editor column, covering the past few
months. Our regular feature articles will resume next week.  

Remember, you can send us your news or comments at any time. We welcome
your feedback on our feature articles, news about old colleagues and
new colleagues, and comments on our newsletter and searchable database
of health promotion information. Read our complete submission
guidelines at and write to

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II Letters to the Editor

A. Responses to OHPE 423, "From ‘Fat Nation' to Healthy Active Cultures," July 29, 2005,

1. Letter from Elizabeth Lowenger

I think you missed the mark on these resources. If you look at the
article on the subject, the obesity crisis is hype and not a scientific
fact. It is also creating generations of people fixated on body image
and eating disorders.

The resources should relate to organizations that provide support for
those who have to deal with these issues or have chosen to live their
lives in a healthy way while being overweight or obese ... this
includes me.

I am a member of ISAA Canada, you might want to check this organization out.

[in second message she writes...]

[T]here is an article I would like you to read regarding the link
between social isolation and heart disease, which turns out to be a
much larger indicator than body weight. Funny how this is largely

Also, have you considered looking at who FUNDS most of the research
related to health risk and obesity? As a trained scientist I know to
question results even if they are published.

Enjoy the attached.

Elizabeth Lowenger Msc

[[Ed: the attached article was Raphael, D. (2002). Social Justice is
Good for Our Hearts: Why Societal Factors—Not Lifestyles—are Major
Causes of Heart Disease in Canada and Elsewhere. Toronto: CSJ
Foundation for Research and Education.].

[Our reply]

Regarding your comments on the resources message,  due to space
and time limitations we focus bulletin content on practitioners rather
than the general public. In that way, we draw on article bibiographies
and the programs or organizations mentioned, in order to provide a
starting point for health promoters to read further on the topic
discussed. We regret that we cannot provide resources for, for example,
someone struggling with body image or  weight issues, but in the
past when the public has contacted us for information we are pleased to
direct them to organizations that have that support focus and capacity.
Regarding the omission of the connection between heart disease and the
broader determinants of health in Dr. MacNeill's article, the lack of
an explicit mention of these issues or a critique of the research is,
again, a function of the space limitations we have as a weekly email
In interim, you may enjoy searching or browsing the OHPE database at
We have had a number of articles in the past focusing on the
determinants of health—including poverty and inclusion—with the
attendant resource lists.
2. Letter from Paula Robeson

Thank you for your production and dissemination of the OHPE bulletin. I look forward to receiving it in my email on Fridays.

I would like to comment on the promotion of documents and resources in
this current issue. When promoting a practice, intervention, program,
or other resource, I believe it is important and our responsibility to
ensure that we, as health professionals, promote evidence-based
approaches. To that end, when promoting such resources, it would be
important to include information on the
* Theoretical basis for the program
* Program goals and objectives
* Evidence used to support the development of that program with its
particular components. That is, what evidence is there from quality
research studies that indicated that the approaches taken in or
advocated through a particular program or resource have been shown to
be effective with the target population?
* The results of any evaluations that have been conducted or are
planned and whether these evaluations were/are process or
outcome-based. If no evaluation has been conducted, readers should be
told. If outcome-based evaluations have not been conducted that should
factor into the readers trust in the resource or program. These outcome
interventions, as you have stated, should be based on behavioural
change outcomes and not simply on knowledge acquisition or attitude
change. Additionally, the methodology through which the evaluations
were conducted should be described or readily available. That way the
reader can critically appraise that program and determine the quality
of the results or potential results.

I am not aware of whether an evaluation has been conducted on the
Living Schools initiative. If one has been conducted, was it is focused
on outcomes, process, or both? This is information that, as a reader
interested in making decisions that are informed by the best available
research evidence, I would like to know. I am disappointed that this
information was not included.

The OPHE bulletin is a wonderful venue for the dissemination of high
quality information that can provide decision makers at the front line
and various management levels with the evidence needed to make sound
evidence-based decisions with local relevance and the desired health
outcome. When promoting programs in your bulletin, please consider the
importance of providing the important details mentioned above.

Other resources to which you may wish to direct your readers include
sources of effectiveness evidence related to public health, health
promotion, and population health interventions. These resources include (
free searchable online registry of systematic reviews on the
effectiveness of public health, health promotion, and population health
interventions. These reviews have been quality rated so users can judge
for themselves whether and how to use the evidence from them in their
program and policy development.    The registry will be
one component of a comprehensive knowledge translation site that will
support users in accessing and interpreting research evidence. The
strategy will also work toward connecting users across Canada (and
internationally), who work in similar areas, or have similar interests.

Effective Public Health Practice Project (EPHPP)
key initiative of Ontario's Public Health Research, Education and
Development (PHRED) Program. EPHPP produces systematic reviews on the
effectiveness of public health interventions. Reviews included in this
database focus on interventions that are addressed in the Ontario
MOHLTC Mandatory Health Program and Services Guidelines and summarize
recent, high quality reviews produced by others. This site provides
Final Systematic Reviews Summaries for Practitioners &
Managers/Highlights for Policy Development free of charge

In the case of obesity prevention among children and youth, there are
several high quality systematic reviews of effectiveness evidence that
have not been mentioned. I have attached a list [follows this letter]
of 7 such reviews. The references for these reviews (among others) and
their summary statements can be found at


Paula Robeson RN, MScN
Knowledge Broker
Evaluating the Evidence on Knowledge Brokers
c/o City of Hamilton

Thomas, H., Ciliska, D., Micucci, S., Wilson-Abra, J. & Dobbins, M.
(2004). Effectiveness of physical activity enhancement and obesity
prevention programs in children and youth. Hamilton, Ontario: Public
Health Research Education and Development Program. Effective Public
Health Practice Project.

Ciliska, D., Miles, E., O'Brien, M.A., Turl, C., Tomasik, H.H.,
Donovan, U., et al. (2000) Effectiveness of community-based
interventions to increase fruit and vegetable consumption. Journal of
Nutrition Education and Behaviour, 32(6), 341-352.

Kahn, E.B., Ramsey, L.T., Brownson, R.C., Heath, G.W., Howze, E.H.
Powell, K.E., et al. (2002). The effectiveness of interventions to
increase physical activity: A systematic review. The American Journal
of Preventive Medicine, 22(4S), 73-107.

Campbell, K., Waters, E., O'Meara, S., Kelly, S., & Summerbell, C.
(2002). Interventions for preventing obesity in children. The Cochrane
Database of Systematic Reviews 2002, Issue 2.

Pratt B.M. & Woolfenden, S.R. (2002). Interventions for preventing
eating disorders in children and adolescents. The Cochrane Database of
Systematic Reviews 2002, Issue 2.

Hardeman, W., Griffin, S., Johnston, M., Kinmonth, A.L., & Wareham,
N.J. (2000). Interventions to prevent weight gain: A systematic review
of psychological models and behaviour change methods. International
Journal of Obesity, 24(2), 131-143.

Dishman, R.K., & Buckworth, J. (1996). Increasing physical
activity: A quantitative synthesis. Medicine & Science in Sports
and Exercise, 28(6), 706-719.

[our reply]

It would be wonderful if every article covering a program could include
the level of detail you request. However, due to space, time and budget
limitations, we are unable to provide that much detail in the article
itself nor can every article be a full and comprehensive review of any
given issue. As well, in order to fulfill our goal of informing health
promoters of current work in different areas of the profession, we do
cover programs in various stages—including ones just begun, ones in
process, and ones ended and fully evaluated.

Coverage in the OHPE is not intended as promotion, per se. As our
footer notes, "Content of the OHPE Bulletin is provided as an
information-sharing service and inclusion does not represent
endorsement by OPC, THCU or their funder."

The resources message, along with the article references, is intended
to give health promoters a place to start if they are interested in
tracking down the detailed information you list. We do our best to
include full contact information for the organizations involved.

For example, with Dr. MacNeill's article, her references list the
following: Shain, M. (April 7, 2005). The Living School evaluation,
research presentation given to the Living School Forum, Toronto. 
The Living School's website provided in 423.1 indicates that the
evaluation report on their original pilot sites will be available in
September 2005 and contact information for Ophea and this specific
project are both included.

B. Reponse to OHPE 431, "Kids Have Stress Too!" September 23, 2005

1. Letter from Krista Saleh

[J]ust wanted to comment that we have included this program in our
Resources section at the back of our "When Something's Wrong: Ideas for
Families" handbook which is a companion handbook to our "When
Something's Wrong: Ideas for Teachers" handbook. Both handbooks help
parents/caregivers and teachers deal with children and youth who suffer
from mood, behavioural or thinking difficulties related to mental
disorders (e.g. anxiety disorders, impulse control disorders like
AD/HD, schizophrenia, mood disorders like depression and bipolar
disorder, and many more). Please feel free to mention this in the OHPE
and that the handbooks can be ordered on our Web site at Further information can be obtained on the handbooks by visiting
It is so important that we partner together to reach kids who are
suffering and get them the help that they need to live full, happy and
productive lives.

Krista L. Saleh
Project Director
Canadian Psychiatric Research Foundation (CPRF)

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III Comings and Goings

A. New ARAPO Program Coordinator (July)

At the same time as the Alcohol Policy Network receives a facelift with
a brand new website, you will also notice a new face around APOLNET.
The new ARAPO Program Coordinator, Rebecca Fortin, has begun filling
this role and has joined the efforts to reduce the impact of alcohol
advertising among youth. Rebecca is a recent Honours Bachelor of
Science graduate in Health Studies from the University of Waterloo.
Though this program, she has gained a solid foundation in areas of
program evaluation, health promotion, health behaviour change and
epidemiology and is thrilled to finally apply to these learnings to the
real world.

B. New Director, Marketing and Communications, CATIE (August)

The Canadian AIDS Treatment Information Exchange (CATIE) is pleased to
announce the appointment of Matthew Church to the position of Director,
Marketing and Communications, effective immediately.  Matthew
joins CATIE after a long and distinguished career in magazine
journalism where he served as editor-in-chief of Saturday Night
magazine, enRoute magazine as well as several other titles.  As
Director, Marketing and Communications, Matthew's primary role will be
to help inform CATIE's diverse national constituencies about the wide
range of authoritative and supportive material and services the
organization offers and to help these groups get the greatest benefit
from CATIE's services. His priorities will include fostering and
facilitating innovative partnerships with community-based organizations
and health care providers, raising awareness and use among end-users
and further developing essential relationships with Canadian media

[See the complete press release at]

C. People on the Move from CharityVillage

* Election of Dr. Ruth Collins-Nakai to the position of president of the Canadian Medical Association
* appointment of Edward Sonshine, QC, as chair of the board of the Mount Sinai Hospital Foundation

[To see more people on the move in the not-for-profit sector, visit]

D. Award for John Garcia (October)

[The Non-Smoker's Rights Association] had the pleasure of awarding John
Garcia its Non-Smoker of the Year Award.  When we looked across
Canada, we determined that for the period covered by the award, we
could find nobody more deserving.  By the way, we do not give the
award to sitting politicians, to government officials, or to anyone
connected to this Association.

John received the award for several reasons:
1. his total life commitment to the tobacco control issue,
2. as a director in the Ministry of Health of the Rae government, he
pressed to secure passage of the Ontario Tobacco Control Act. 
Having been close to the action, the NSRA's assessment is that this
legislation may not have passed in the absence of his leadership;
3. when it became obvious last year in Ontario that major funding and
legislation would roll out in late 2004 or 2005, at some risk, John
returned to the Ministry of Health.  By working long hours and
weekends with a level of commitment seldom seen, John tried to build a
department virtually from scratch;
4. it was the assessment of the NSRA, that John's contribution to the
passage of Ontario's Smoke-Free Ontario Act  was significant and
that Ontario's ambitious tobacco control programme may not have been
realized in his absence;

This is not to suggest that other players did not play a major role in
recent achievements in Central Canada.  Rather, when major tobacco
control objectives are achieved, it is often by a hair, the result of a
magical combination of inputs.  Had any of these inputs not been
present, the health objective would have been lost.  The NSRA
believes that John Garcia has consistently provided the qualities of
leadership, dedication, commitment and principled decision-taking in
Ontario that have led to major public health achievements.

Garfield Mahood
Executive Director
Non-Smokers' Rights Association
E. People News from Health Canada (October and November)

* Minister of State Carolyn Bennett Receives National Award of
Excellence for her Work in Injury Prevention and Safety Promotion [read
more at]
* New Appointments to the National Advisory Council On Aging-Gilbert
Barrette and Robert Dobie from Quebec, Roberta Morgan from the Yukon,
Bhupinder Kaur Dhillon from British Columbia, Verdon Mercer from
Newfoundland and Labrador, and Mike Sommerville from Ontario. The
Minister also announced the reappointment of two members of the
Council—Mohindar Singh from Manitoba and Lloyd Brunes from the
Northwest Territories. This brings the total membership of the Council
to 10. [read more at]
F. People News from the Heart Health Resource Centre (October)
Alicia Tyson will be joining our team as a part-time Program
Coordinator.  Alicia will be working off site, managing primarily
the Coaching and Consultation Service. We are also joined by Eleanor
Sam, who will be full-time and primarily responsible for the training
and resource development aspects of our service.

Welcome Alicia and Eleanor!

Karima Kassam, MHSc
Program Coordinator
Heart Health Resouce Centre