Sara F L Kirk

Sara F L Kirk
Dalhousie University | Dal · School of Health and Human Performance

PhD

About

223
Publications
93,280
Reads
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5,388
Citations
Introduction
Applied Health Researcher using a socio-ecological approach to understand how we can create supportive environments for chronic disease prevention, an approach known as population health intervention research (PHIR). Follow me on Twitter @sflkirk.
Additional affiliations
September 2012 - June 2013
MRC Human Nutrition Research
Position
  • Senior Researcher
Description
  • Short term assignment (sabbatical)
August 2012 - present
Mount Saint Vincent University
Position
  • Professor (Associate)
January 2011 - present
University of Alberta
Position
  • Professor (Associate)

Publications

Publications (223)
Article
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The management of a child presenting with obesity in a primary care setting can be viewed as a multi-step behavioral process with many perceived and actual barriers for families and primary care providers. In order to achieve the goal of behavior change and, ultimately, clinically meaningful weight management outcomes in a child who is considered o...
Article
Issues related to program context are important components of population health interventions and particularly among complex, adaptive initiatives in schools. Health Promoting Schools (HPS) is a global approach to support early development of healthy behaviors among children and youth. The purpose of this study was to explicate the practical and co...
Article
Many Canadian school jurisdictions have developed nutrition policies to promote health and improve the nutritional status of children, but research is needed to clarify adherence, guide practice-related decisions, and move policy action forward. The purpose of this research was to evaluate policy adherence with a review of online lunch menus of ele...
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A Health at Every Size (HAES) approach has been proposed to address weight bias and stigma in individuals living with obesity, and more recently articulated as a promising public health approach beyond the prevailing focus on weight status as a health outcome. The purpose of this article is to examine our understanding of HAES within the context of...
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In this research, we examined the experiences of individuals living with obesity, the perceptions of health care providers, and the role of social, institutional, and political structures in the management of obesity. We used feminist poststructuralism as the guiding methodology because it questions everyday practices that many of us take for grant...
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Introduction School environments are an essential setting to shape and influence the health and well-being of students. Health promoting school (HPS) is a whole-school approach that strengthens and builds a safe and healthy school environment for students to learn and develop. A core component of HPS is the meaningful participation of youth. Despit...
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The ways gay men navigate socially constructed body tensions are explored through a post-structural lens. Nine self-identifying gay men in Canada use photovoice to create images that expressed their beliefs, values and practices about their bodies. Participants took part in semi-structured interviews to discuss the meanings of their images. Three d...
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Health Promoting Schools (HPS) is a whole-school approach that shapes the conditions necessary to support student health and well-being. Youth engagement is recognized as key to HPS implementation, yet research related to the involvement of youth voice in school health promotion initiatives is limited. The purpose of this study was to understand yo...
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Objectives: Public health restrictions varied by region during the COVID-19 pandemic and reduced opportunities for children to be physically active. The purpose of this study was to assess regional differences in movement behaviours of Canadian children and youth during the second wave of the COVID-19 pandemic. Methods: A national sample of Cana...
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Increasing rates of physical inactivity and sedentary behaviours among children and the youth are important determinants of chronic disease. Supporting children's participation in organised physical activities like sports has been promoted as a public health strategy to increase physical activity. Evidence shows that successful interventions are fa...
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The Play-Friendly Cities framework describes key municipal actions and indicators which support a community's playability and can positively influence children's health behaviors and quality of life. The purpose of this study was to conduct a content analysis of Nova Scotia physical activity (PA) and active transportation (AT) strategies by applyin...
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Development of fundamental movement skills in early childhood supports lifelong health. The potential for outdoor play with loose parts to enhance fundamental movement skills has not been investigated. A multi-methods randomized controlled design was used to determine the efficacy of integrating outdoor loose parts play into Nova Scotia childcare c...
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Food literacy is an evolving term fundamental to both health and education. The concept of food literacy typically has been informed by nutrition-focused thinking, with particular emphasis on food skills. Moving beyond this traditional focus is necessary to address the demands of consumers navigating today’s complex food environments. Although the...
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Background: Women face contradictions regarding their health: Pressure to be feminine, but also athletic; Criticism for being too sporty or muscular, but equally so for being perceived as lazy or overweight. These complexities are perpetuated through media and discourse. Purpose: Using a feminist post-structural approach and photovoice, this study...
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Background Stigmatization of persons living with obesity is an important public health issue. In 2015, Obesity Canada adopted person-first language in all internal documentation produced by the organization, and, from 2017, required all authors to use person-first language in abstract submissions to Obesity Canada hosted conferences. The impact of...
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Objectives: The COVID-19 pandemic led to school closures, cancellations of major events, and loss of in-person social interactions for children and youth. These restrictions undoubtedly impacted the lives of children and youth. This study describes the well-being of children and youth in Nova Scotia during the COVID-19 pandemic and their thoughts a...
Preprint
BACKGROUND Good nutrition affects children’s health, well-being, and learning, and schools offer an important setting to promote healthy behaviors that can last a lifetime. Once children reach school age, they spend more of their waking hours in school than in any other environment. Children’s eating habits may be easier to influence than those of...
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The construction of masculinities is an important component of the bodies and lives of gay men. The role of gay culture on body standards, body dissatisfaction, and the health of gay men was explored using poststructuralism and queer theory within an arts-based framework. Nine gay men were recruited within the city of Halifax, Nova Scotia, Canada....
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Objective: The purpose of this review is to describe how health service and delivery systems support health equity and to identify strategies and indicators being used to measure health equity. Introduction: It is widely acknowledged that a population health and equity approach is needed to improve the overall health of the population. The healt...
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Canadian, municipally funded recreation/sport facilities typically have unhealthy food environments. Ontario, unlike some provinces, lacks a voluntary recreation facility nutrition policy. This study assessed the healthfulness of food environments and vending sales in 16 Ontario recreation/sport facilities and, secondarily, compared data from facil...
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Purpose: To describe the energy (E), sodium, saturated fat, sugar, and fibre intakes of a sample of children attending regulated childcare (RCC) in Nova Scotia. Methods: Nutrient analyses from 79 food records were compiled and grouped by intakes in and outside of RCC, age, sex, location of the RCC (urban or rural), and nutrient intake data. Descrip...
Article
Our purpose in writing this Perspective in Practice is to create awareness about the role of compassion within dietetic practice, particularly the role of compassion for body image tensions. Nine self-identifying gay men were recruited to a photovoice research study that explored their beliefs, values, and practices relating to food and their bodie...
Preprint
UNSTRUCTURED Good nutrition impacts children’s health, wellbeing and learning, and schools offer an important setting to promote healthy behaviors that can last a lifetime. Once children reach school age, they spend more of their waking hours in school than in any other environment. Children’s eating habits may be easier to influence than those of...
Article
Background Good nutrition affects children’s health, well-being, and learning, and schools offer an important setting to promote healthy behaviors that can last a lifetime. Once children reach school age, they spend more of their waking hours in school than in any other environment. Children’s eating habits may be easier to influence than those of...
Article
Objective: The objective of this review is to chart the evidence relating to food security among African Canadian communities to inform future research and offer insight related to food security in African Canadian communities. Introduction: Achieving food security is of global importance in the attainment of the United Nations Sustainable Devel...
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Participation in physical education is often shaped by the gendered experiences of students. This study explored how the experiences of gendered bodies shaped participation in physical education (PE) among students in Nova Scotia, Canada. The study consisted of two phases: 1) focus groups with a total of 18 Grade 8 students (7 girls and 11 boys) at...
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The World Health Organization has identified the school community as a key setting for health promotion efforts, laying out its priorities in the Health-Promoting Schools (HPS) framework. This framework offers a comprehensive approach that has been adopted in countries around the globe, with defining characteristics focused around the school curric...
Article
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Free play is important in early childhood and offers physical and mental health benefits. Outdoor play offers opportunity for children to use natural elements and promotes physical activity, among other health benefits, including exploring their environment and taking risks. Risky outdoor play may involve challenges, heights, speed, and the potenti...
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Inspired by Fiset-Laniel et al.’s (2020) article entitled “Public health investments: neglect or wilful omission? Historical trends in Quebec and implications for Canada”, we assessed public health investments since the establishment of the Nova Scotia provincial health authority in 2015. We analyzed Nova Scotia Department of Health and Wellness bu...
Article
As providers of community-based physical activity programs, recreation and sports facilities serve as an important resource for health promotion. Unfortunately, the food environments within these settings often do not reflect healthy eating guidelines. This study sought to describe facilitators and barriers to implementing provincial nutrition guid...
Article
Objective: The objectives of this review are to identify, appraise, and synthesize the qualitative evidence on the breastfeeding experiences of mothers living with food insecurity in high-resource, Western countries. Introduction: Breastfeeding and food insecurity are inter-related health issues. Globally, breastfeeding augments food security at...
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Obesity is a prevalent, complex, progressive and relapsing chronic disease, characterized by abnormal or excessive body fat (adiposity), that impairs health. People living with obesity face substantial bias and stigma, which contribute to increased morbidity and mortality independent of weight or body mass index. This guideline update reflects su...
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KEY POINTS • Obesity is a prevalent, complex, progressive and relapsing chronic disease, characterized by abnormal or excessive body fat (adiposity), that impairs health. • People living with obesity face substantial bias and stigma, which contribute to increased morbidity and mortality independent of weight or body mass index. • This guideline upd...
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Providing the best start for our youngest generation is a growing priority internationally. Integrated Service Delivery (ISD) offers an approach to address complex system challenges and improve access to early childhood public services for young children and their families. The purpose of this paper is to use the Integrative Framework for Collabora...
Article
Breastfeeding is represented to support healthy body weight and food security. However, breastfeeding may be negatively impacted by high maternal body weight and income-related food insecurity. Guided by feminist poststructural methodology, this study explored breastfeeding beliefs and practices among women from Nova Scotia, Canada, identifying as...
Article
Objective To explore the impact of a capacity-building intervention (CBI) to support implementing provincial nutrition guidelines on food marketing in recreation facilities (RFs). Design Randomized controlled trial within a natural experiment: food marketing in RFs from 3 guideline provinces randomly assigned to intervention (GL+CBI) or comparison...
Article
Canadian provincial governments have introduced voluntary nutrition guidelines for recreation and sport facilities to promote healthy dietary patterns in children. This paper presents baseline data from the Eat, Play, Live (EPL) randomized controlled trial to examine whether facilities in guideline provinces had greater capacity, more nutrition pol...
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It is important to consider physical activity and movement in early life to ensure children establish and maintain healthy physical activity patterns. Recent evidence has highlighted the importance of outdoor play and the childcare environment. Active outdoor play, especially free play, supports independence, self-regulation and allows children to...
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Engaged scholarship offers a collaborative approach to bridge the gap between theory and practice by integrating research and practical knowledge. This study used a case–study approach to evaluate the facilitative and obstructive factors influencing engaged scholarship to support health promotion practice within the education system. Individuals wh...
Article
Purpose: The vegetable/fruit intakes of a sample of children attending regulated childcare in Nova Scotia was assessed and compared by age groups (3 and 4-5 year olds) and by home and childcare environments. Methods: Seventy-nine children had 3-4-day food records and 58 had records from both environments. The data were coded by the 2007 Canada's Fo...
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This study explored the influence of healthy vending contracts (HVC) on the nutritional quality of vending machine products in 46 Canadian publicly funded recreation and sport facilities. A quasi-experimental comparison design was used to examine the difference in nutritional quality of snack and beverage vending machine products at baseline (Decem...
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Background: Recreation and sport facilities often have unhealthy food environments that may promote unhealthy dietary patterns among children. In response, some Canadian provinces have released voluntary nutrition guidelines for recreation and sport facilities, however implementation has been limited. Organizational capacity building may overcome...
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Supporting the implementation of school food and nutrition policies is an international priority to encourage healthier eating among children and youth. Schools are an important intervention setting to promote childhood nutrition, and many jurisdictions have adopted policies, guidelines, and programs to modify the school nutrition environment and p...
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Objective As part of a study exploring school food environments, this study aimed to understand youth perspectives of school food. Design Photovoice, a qualitative visual methodology, was used to engage participants through photo-taking, with goals of enabling reflection, promoting dialogue, and facilitating change. Setting Participants were recr...
Article
This study examines the shifting patterns in meal consumption practices among Canadians and the sources of disruption of meal habits. It analyses the notion of breakfast, lunch, dinner, out-of-household consumption of food, cooking, and snacking which could be considered as disrupting eating habits. Meal skipping, primarily breakfast and lunch was...
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Background: The Physical Literacy in the Early Years (PLEY) intervention is a randomized mixed-methods controlled trial focused on embedding loose parts materials into the outdoor play spaces of regulated child care centres across Nova Scotia. The aim is to evaluate the efficacy of the PLEY intervention versus standard regulated childcare practice...
Article
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Supporting the implementation of school food and nutrition policies (SFNPs) is an international priority to encourage healthier eating among children and youth. Such policies can improve equitable access, resources, and supports for healthy eating. However, despite the potential impact of SFNPs, several implementation barriers have been reported. T...
Article
Objective Bullying and its potential consequence for poor mental health constitutes a public health concern, yet there is a dearth of longitudinal studies examining the topic. This study examines the temporal relationship between childhood bullying behaviours (being a victim, being a bully, or being a bully and a victim) and physician-diagnosed int...
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The objective of this study was to describe the levels and bouts of physical activity (PA) and sedentary behaviour (SB) among preschoolers in Nova Scotia, Canada, and the proportion meeting PA and step guidelines. Children (75 boys, 49 girls; mean age = 4.2 (range = 3-5 years)) participating in the Physical Literacy in the Early Years (PLEY) study...
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Interventions to support healthy eating among populations are needed to address diet-related chronic disease. Recreation and sport settings are increasingly identified as ideal settings for promoting overall health, particularly for children, through creation of environments that support positive health behaviours. These publicly funded settings ty...
Article
Purpose: Internationally, there is debate on whether a nutrient or a food-based approach to policy is more effective. This study describes the food/beverage availability in schools in Nova Scotia through a comparison of a traditional nutrient classification ("Maximum/Moderate/Minimum"), currently used in the provincial school policy and a simplifi...
Article
Purpose: Internationally, there is debate on whether a nutrient or a food-based approach to policy is more effective. This study describes the food/beverage availability in schools in Nova Scotia through a comparison of a traditional nutrient classification ("Maximum/Moderate/ Minimum"), currently used in the provincial school policy and a simplifi...
Article
Full-text available
Canada is one of the only member countries of the Organization for Economic Cooperation and Development (OECD) without a national school food program. Good nutrition impacts children’s health, wellbeing, and learning; and school food environments offer an important setting to promote health and other food system sustainability behaviours that can l...
Article
Background: Although school nutrition policies (SNPs) have been highlighted as an important intervention to support childhood nutrition, their implementation and maintenance within real-word settings is complex. There is a need to understand the factors that influence implementation by consolidating existing research and identifying commonalities...
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Background: Integrated knowledge translation (IKT) is encouraged in population health intervention research (PHIR) to ensure the co-production of policy-relevant research, yet there is little published literature that reports its implementation and outcomes. The purpose of this study was to describe and evaluate the IKT approach used in a school-b...
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Purpose: School food and nutrition policies have the potential to encourage healthier eating among children and youth to address rising concerns of poor diet quality. Despite their widespread implementation, there is little reported monitoring of policy adherence. This short report describes adherence to the provincial school food and nutrition po...
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Background: Children's recreational sport settings typically sell energy dense, low nutrient products; however, it is unknown whether the same types of food and beverages are also marketed in these settings. Understanding food marketing in sports settings is important because the food industry often uses the promotion of physical activity to justi...
Article
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Background: Current methods for evaluating food marketing to children often study a single marketing channel or approach. As the World Health Organization urges the removal of unhealthy food marketing in children's settings, methods that comprehensively explore the exposure and power of food marketing within a setting from multiple marketing chann...