Congratulations to our 2021 DPRG Honours Students!

Last Friday, our three DRPG honours students successfully defended their honours theses! A huge congratulations to Jenna Sim, Alexa Durand, and Blessing Adeagbo for their hard work with the DPRG team. It has been an honour to have all three students with us this year, and we cannot wait to see what’s next for them all.

Learn more about the research projects that Jenna, Alexa, and Blessing have been involved with this year below.

Jenna Sim

Saying goodbye to biases: Examining whether a 20-minute online module can reduce Human Kinetic students’ explicit biases on weight and race

Objective: Many healthcare practitioners hold explicit biases. Two common types of explicit bias seen in healthcare are weight and
racial bias. The bias a practitioner holds can have negative effects on the quality of care provided to their patients. Small Steps for Big Changes (SSBC) is a diabetes prevention program designed to empower individuals at risk of developing type 2 diabetes to make diet and exercise changes in their life. It is important to train SSBC coaches on cultural safety and inclusivity (CSI) to try to reduce the explicit biases they may hold towards future SSBC clients. The goal of this study was to examine whether existing weight and racial bias in undergraduate Human Kinetics students (a population representative of SSBC coaches) could be feasibly reduced. A brief cultural safety training module was developed for SSBC coaches. It was hypothesized that, compared to students who did not read the CSI module, students who read the CSI module would report less explicit weight and racial bias.

Methods: 22 UBC Okanagan Human Kinetics undergraduate students (82% women) were recruited through classroom visits and online postings. Participants were randomly divided into four groups: CSI Indigenous vignette, non-CSI Indigenous vignette, CSI overweight vignette, and non-CSI overweight vignette. The two CSI groups read the module, and the non-CSI groups watched an irrelevant neutral video matched for length of time to the CSI material. Participants then read a written vignette describing a mock SSBC client who was identified as either Indigenous or overweight. Explicit bias was measured by asking participants to rate the mock SSBC client on their competence, compliance, reliability and motivation.

Results: There was no significant difference (p=0.41) in explicit bias between the CSI Indigenous group (mean=4.50;SD=1.19) and the non-CSI Indigenous group (mean=5.03;SD=0.91). Similarly, there was no significant difference (p=0.31) in explicit bias between the CSI overweight group (mean=5.04;SD=0.76) and the non-CSI overweight group (mean=4.25;SD=1.55).

Conclusion: These findings suggest that there was no difference in weight or racial explicit bias between those who read the brief CSI module and those who did not read it. On average, both the students who read the module and those who were in the non-CSI groups rated the mock clients as competent, compliant, reliable and motivaated. Human Kinetics students may not hold negative explicit biases about potential behaviour change clients based on weight and ethnicity, although caution should be made with interpretations as this analysis
is being conducted on a portion of the full sample size anticipated. Further research needs to be conducted to examine the effectiveness of watching this module on SSBC coaches’ explicit biases, as well as to examine whether these coaches have implicit racial and weight biases that may lead to negative client healthcare experiences.

Link to thesis presentation

Alexa Durand

Digital Diabetes Prevention Programs: A Scoping Review

Objective: Type 2 diabetes (T2D) is a major cause of heart failure, kidney disease and amputations that places a large economic burden on the Canadian health care system. Fortunately, in the majority of cases, incidence of T2D can be prevented or delayed through modifiable lifestyle factors such as diet and or exercise. The increasing reliance on technology in everyday lives can be leveraged to improve reach of DPPs. The goal of this review is to summarize results and what specific intervention characteristics are used in digital diet and exercise interventions targeting diabetes risk and provide a single location where future researchers can find a compilation of current digital diabetes prevention programs.

Methods: In this scoping review, multiple electronic databases were searched for general key terms related to prediabetes or diabetes prevention combined with interventions or programs. Specific eligibility criteria were created to ensure consistent screening guidelines between the reviewers. Each title and abstract, then full text were screened by 2 independent reviewers. All eligible studies were screened to identify digital diabetes prevention programs. The TIDieR checklist was used to extract the relevant information from each study.

Results: 18,795 titles and abstracts were screened resulting in 788 eligible full-text studies to be reviewed. After full-text screening there were 200 programs eligible for data extraction and of those, 31 programs were digital diabetes prevention programs. Data extraction using the TIDieR has been completed for 14 studies and is ongoing for the remaining 17. Mode of delivery included mobile phone applications (n=6), websites (n=7) and texting (n=1). Majority of these DPPs were conducted in America (n=7), with participants identifying most commonly as white (49%). The majority of the studies had contact with the participants about twice a week, however this ranged from daily messages to monthly phone calls. The majority of the studies had the participants working with a health coach or trainer to help guide and support the participants to reach their diet and/or exercise goals. Digital DPPs consistently underreport use of theory (only 1 discussed theory use) and demographic data (only 4 of the 14 analyzed thus far provided demographic information, and of those, none reported on both sex and gender).Majority of the completed studies showed positive results such as, improved weight loss (n = 6), decreased values of HbA1c (n = 3) and a general acceptance of the use of digital platforms for diabetes prevention programs (n = 3). Ongoing analysis for the remaining 17 studies will add to these findings.

Conclusion: While Digital DPPs are consistently shown to positively impact diabetes risk and are well accepted, future research is needed to know which mode of digital delivery is best and how these digital programs may differentially influence and can be tailored for different population groups. These components are important because the use of a digital format for diabetes prevention programs can help to provide resources to individuals who aren’t able to or have trouble accessing in-person DPPs.

Link to thesis presentation

Blessing Adeagbo

Receptiveness to Workplace Exercise

Introduction: The majority of Canadians are not currently active enough to meet physical activity guidelines. In addition to being
inactive, most Canadian adults are spending long periods of time engaging in sedentary behaviours. A large proportion of this
sedentary time is spent in the workplace – whether that work is conducted at home or on-site. The work environment may be one
viable target for physical activity interventions. “Exercise snacks” – short bouts of high-intensity exercise with 1-4 hours of rest in-between – is one possible mode of delivering physical activity throughout a work shift as it does not require long breaks, change of attire, and could break up long periods of sitting. Understanding perceived barriers and receptivity to workplace physical activity interventions is critical information needed to inform the design of future interventions. The purpose of this study was to 1) investigate determinants of workplace
exercise participation, 2) assess whether motivating factors and receptivity to workplace exercise interventions differ based on workplace location, and 3) explore receptivity of exercise snacks as a modality of workplace physical activity.

Methods: Thirty-eight full time employees (23 women; Mage = 37.5 ± 12.8 years) who reported 6+ hours per workday of sitting and/or standing still participated in this study. Participants completed an online survey with questions related to determinants of participation in
workplace exercise – using the Determinants of Physical Activity Questionnaire (DPAQ) – and receptivity to exercise snacks in the workplace (1-7 point scale). Participants were dichotomized into two groups dependent on where they spent a majority (i.e., 3+ days/ week) of their weekdays working: at home or on-site.

Results: Scores of ≤ 5 on the DPAQ indicate likely barriers to physical activity participation. In this sample, motivation and goals (M = 4.9), action planning (M = 4.6), coping planning (M = 3.5), and goal conflict (M = 4.4) were lowest out of the 11 DPAQ areas. For the determinant of motivation and goals, on-site participants had significantly lower mean scores (M = 4.2; n = 10) than at-home participants (M = 5.2; p = 0.04; n = 28). No significant differences were found between at-home versus on-site participants for any other determinant areas. Anticipated enjoyment of engaging in exercise snacks was relatively high for exercise snacks (M = 5.3), and factors that may encourage participation included an exercise-friendly workplace (M = 5.9), performing exercise snacks with co-workers (M = 5.1), and having
informational (M = 5.0) or instructional guidance (M = 5.1). Factors that may discourage participation in exercise snacks included perceived belief that a change of clothes was needed (M = 3.4) and that they would break a sweat (M = 3.7).

Conclusion: These preliminary findings suggest workplace physical activity interventions should target individuals’ motivation and ability to plan exercise sessions, as well as teaching strategies to self-regulate and preplan for exercise sessions. Work location does not appear
to impact which determinants of exercise should be targeted for workplace physical activity interventions. The findings also suggest exercise snacks may present a plausible workplace exercise modality.

Link to thesis presentation

Congratulations, Jenna, Alexa, and Blessing!