Supporting nutrition and physical activity in adolescent girls - A systems analysis

There is a current public health focus on childhood obesity, with nutrition and physical activity (PA) as associated behaviours. Canadian youth do not meet nutritional guides, and are insufficiently active, a problem especially evident in girls, who tend to become less active with age. While comprehensive interventions are known to be most effective, it is common for initiatives to target only one behaviour, such as PA, rather than both PA and nutrition. As Nova Scotia currently has a comprehensive provincial strategy to support obesity prevention, there appears to be a disconnect between policy and practice. This study will explore this disconnect, to determine what is being or could be done to support comprehensive interventions for adolescent girls' health. The study will focus on both PA and nutrition in older girls (aged 16-19 years), using the social ecological model (SEM), which recognizes that environmental influences across multiple levels may help or hinder the ability of individuals to engage in healthy behaviours. Institutional ethnography, an approach that examines experiences of social relations and institutional processes will be used to examine processes influencing girls' PA and nutrition. The purpose of the study will be to explore the processes influencing implementation of interventions to support girls' PA and nutrition, and how those processes are influenced by institutional, social, and political relations. Data collection will involve observation of existing interventions in local schools and communities, document review of policies and procedures, and interviews with participants and key stakeholders. Outcomes will demonstrate the processes that contribute to the health of adolescent girls through nutrition and PA interventions. This systems level analysis will indicate where, how, and what is being done, and make recommendations for multi-level changes to support the health of young girls in research, policy, and practice.