{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,31]],"date-time":"2026-01-31T09:08:02Z","timestamp":1769850482636,"version":"3.49.0"},"reference-count":54,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2025,8,26]],"date-time":"2025-08-26T00:00:00Z","timestamp":1756166400000},"content-version":"vor","delay-in-days":56,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000024","name":"Canadian Institutes of Health Research","doi-asserted-by":"publisher","award":["179953"],"award-info":[{"award-number":["179953"]}],"id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100025588","name":"Murphy Family Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100025588","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Unity Health Toronto Chair in Homelessness, Housing and Health"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,7,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Unhealthy lifestyle behaviours and mental disorders disproportionately affect children living in deprived neighbourhoods. In Canada, schools are encouraged to adopt equity, diversity, inclusion, and accessibility (EDIA) practices to tackle these inequalities. We examined whether integrating EDIA school practices into curriculum and programming mitigates the impact of neighbourhood deprivation on children\u2019s lifestyle behaviours and mental health. In 2023\/2024, we surveyed 1970 students in grades 4\u20136 (aged 9\u201312) from 28 elementary schools in Alberta. Students self-reported diet, physical activity, screen time, and mental health and wellbeing. School principals reported on the extent (full vs. partial) of integrating EDIA school practices into curriculum and programming. The Canadian Index of Multiple Deprivation (i.e. residential instability, economic dependency, ethno-cultural composition, situational vulnerability) was used to capture neighbourhood deprivation. Over half (54%) of schools had fully integrated EDIA school practices into curriculum and programming, and were located primarily in areas with greater residential instability (50%), ethno-cultural diversity (57%), economic dependency and situational vulnerability (46%). In highly deprived neighbourhoods, students attending schools with fully integrated EDIA practices were less likely to have poor diets (0.9 vs. 1.6) and consume excessive intake of free sugar (1.3 vs. 1.8) and saturated fat (0.6 vs. 0.8). EDIA school practices did not appear to moderate the relationship of neighbourhood deprivation with physical activity, screen time, or mental health and wellbeing. These findings suggest that integrating EDIA school practices into curriculum and programming may help buffer some adverse effects of neighbourhood deprivation on children\u2019s health and diets in particular.<\/jats:p>","DOI":"10.1093\/heapro\/daaf142","type":"journal-article","created":{"date-parts":[[2025,8,26]],"date-time":"2025-08-26T04:13:55Z","timestamp":1756181635000},"source":"Crossref","is-referenced-by-count":1,"title":["Mitigating child health inequalities through equity, diversity, inclusion, and accessibility school practices in Canada"],"prefix":"10.1093","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9842-1927","authenticated-orcid":false,"given":"Katerina","family":"Maximova","sequence":"first","affiliation":[{"name":"MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael\u2019s Hospital , 209 Victoria St, Toronto, Ontario M5B 1T8 ,","place":["Canada"]},{"name":"Dalla Lana School of Public Health, University of Toronto , 155 College St Room 500, Toronto, Ontario M5T 3M7 ,","place":["Canada"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6989-0564","authenticated-orcid":false,"given":"Camila","family":"Honorato","sequence":"additional","affiliation":[{"name":"School of Public Health, University of Alberta , 3-50E University Terrace, 8303 112 Street NW, Edmonton, Alberta T6G 1K4 ,","place":["Canada"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0965-1048","authenticated-orcid":false,"given":"Flora I","family":"Matheson","sequence":"additional","affiliation":[{"name":"MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael\u2019s Hospital , 209 Victoria St, Toronto, Ontario M5B 1T8 ,","place":["Canada"]},{"name":"Dalla Lana School of Public Health, University of Toronto , 155 College St Room 500, Toronto, Ontario M5T 3M7 ,","place":["Canada"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4420-668X","authenticated-orcid":false,"given":"Julia","family":"Dabravolskaj","sequence":"additional","affiliation":[{"name":"MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael\u2019s Hospital , 209 Victoria St, Toronto, Ontario M5B 1T8 ,","place":["Canada"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8996-0822","authenticated-orcid":false,"given":"Paul J","family":"Veugelers","sequence":"additional","affiliation":[{"name":"School of Public Health, University of Alberta , 3-50E University Terrace, 8303 112 Street NW, Edmonton, Alberta T6G 1K4 ,","place":["Canada"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2025,8,26]]},"reference":[{"key":"2025082600135225400_daaf142-B1","doi-asserted-by":"publisher","first-page":"693","DOI":"10.1177\/00178969231180472","article-title":"School leadership that supports health promotion in schools: a systematic literature review","volume":"82","author":"Adams","year":"2023","journal-title":"Health Educ J"},{"key":"2025082600135225400_daaf142-B2","doi-asserted-by":"publisher","first-page":"1289","DOI":"10.1111\/obr.12585","article-title":"Influence of neighbourhood safety on childhood obesity: a systematic review and meta-analysis of longitudinal studies","volume":"18","author":"An","year":"2017","journal-title":"Obes Rev"},{"key":"2025082600135225400_daaf142-B3","doi-asserted-by":"publisher","first-page":"e0137987","DOI":"10.1371\/journal.pone.0137987","article-title":"Does school-based health promotion affect physical activity on weekends? And, does it reach those students most in need of health promotion?","volume":"10","author":"Bastian","year":"2015","journal-title":"PLoS One"},{"key":"2025082600135225400_daaf142-B4","doi-asserted-by":"publisher","first-page":"14829","DOI":"10.3390\/ijerph192214829","article-title":"The importance of school leaders\u2019 attitudes and health literacy to the implementation of a health-promoting schools approach","volume":"19","author":"Betschart","year":"2022","journal-title":"Int J Environ Res Public Health"},{"key":"2025082600135225400_daaf142-B5","doi-asserted-by":"publisher","first-page":"595","DOI":"10.1139\/apnm-2021-0415","article-title":"Development of the Healthy Eating Food Index (HEFI)-2019 measuring adherence to Canada\u2019s Food Guide 2019 recommendations on healthy food choices","volume":"47","author":"Brassard","year":"2022","journal-title":"Appl Physiol Nutr Metab"},{"key":"2025082600135225400_daaf142-B6","doi-asserted-by":"publisher","first-page":"25","DOI":"10.1016\/j.healthplace.2015.01.005","article-title":"The influence of the neighborhood physical environment on early child health and development: a review and call for research","volume":"33","author":"Christian","year":"2015","journal-title":"Health Place"},{"key":"2025082600135225400_daaf142-B7","doi-asserted-by":"publisher","first-page":"567","DOI":"10.1016\/j.healthplace.2010.01.001","article-title":"Neighborhood determinants of self-efficacy, physical activity, and body weights among Canadian children","volume":"16","author":"Davidson","year":"2010","journal-title":"Health Place"},{"key":"2025082600135225400_daaf142-B8","doi-asserted-by":"publisher","first-page":"460","DOI":"10.1136\/jech-2019-213159","article-title":"Deprivation matters: understanding associations between neighbourhood deprivation, unhealthy food outlets, unhealthy dietary behaviours and child body size using structural equation modelling","volume":"74","author":"Egli","year":"2020","journal-title":"J Epidemiol Community Health"},{"key":"2025082600135225400_daaf142-B9","doi-asserted-by":"publisher","first-page":"531","DOI":"10.1177\/1049731509335549","article-title":"Core implementation components","volume":"19","author":"Fixsen","year":"2009","journal-title":"Res Soc Work Pract"},{"key":"2025082600135225400_daaf142-B10","doi-asserted-by":"publisher","first-page":"27","DOI":"10.1186\/1479-5868-9-27","article-title":"From \u201cbest practice\u201d to \u201cnext practice\u201d: the effectiveness of school-based health promotion in improving healthy eating and physical activity and preventing childhood obesity","volume":"9","author":"Fung","year":"2012","journal-title":"Int J Behav Nutr Phys Act"},{"key":"2025082600135225400_daaf142-B11","doi-asserted-by":"publisher","first-page":"702922","DOI":"10.3389\/fspor.2021.702922","article-title":"Teaching for student and societal wellbeing in HPE: nine pedagogies for social justice","volume":"3","author":"Gerdin","year":"2021","journal-title":"Front Sports Act Living"},{"key":"2025082600135225400_daaf142-B12","author":"Government of Alberta"},{"key":"2025082600135225400_daaf142-B13","doi-asserted-by":"publisher","first-page":"172","DOI":"10.3148\/70.4.2009.172","article-title":"Web-based food behaviour questionnaire: validation with grades six to eight students","volume":"70","author":"Hanning","year":"2009","journal-title":"Can J Diet Pract Res"},{"key":"2025082600135225400_daaf142-B14","volume-title":"Manual for the Self-Perception Profile for Children.","author":"Harter","year":"1985"},{"key":"2025082600135225400_daaf142-B15","author":"Health Canada","year":"2019"},{"key":"2025082600135225400_daaf142-B16","author":"Health Canada","year":"2021"},{"key":"2025082600135225400_daaf142-B17","doi-asserted-by":"publisher","first-page":"21","DOI":"10.1177\/00333549131286S304","article-title":"School contexts as social determinants of child health: current practices and implications for future public health practice","volume":"128","author":"Huang","year":"2013","journal-title":"Public Health Reports"},{"key":"2025082600135225400_daaf142-B18","doi-asserted-by":"publisher","first-page":"447","DOI":"10.1136\/jech-2022-220242","article-title":"Long-term association between neighbourhood socioeconomic deprivation in early childhood and perceived stress in early adulthood: a multilevel cohort study","volume":"77","author":"Jakobsen","year":"2023","journal-title":"J Epidemiol Community Health"},{"key":"2025082600135225400_daaf142-B19","doi-asserted-by":"publisher","first-page":"501","DOI":"10.3934\/publichealth.2015.3.501","article-title":"Neighbourhood influences on children\u2019s weight-related behaviours and body mass index","volume":"2","author":"Jenkin","year":"2015","journal-title":"AIMS Public Health"},{"key":"2025082600135225400_daaf142-B20","doi-asserted-by":"publisher","first-page":"922","DOI":"10.1093\/eurpub\/ckz153","article-title":"The impact of life course exposures to neighbourhood deprivation on health and well-being: a review of the long-term neighbourhood effects literature","volume":"30","author":"Jivraj","year":"2020","journal-title":"Eur J Public Health"},{"key":"2025082600135225400_daaf142-B21","doi-asserted-by":"publisher","first-page":"659","DOI":"10.1111\/josh.13304","article-title":"Health-promoting school culture: how do we measure it and does it vary by school neighborhood deprivation?","volume":"93","author":"Kalubi","year":"2023","journal-title":"J Sch Health"},{"key":"2025082600135225400_daaf142-B22","first-page":"1","volume-title":"The Physical Activity Questionnaire for Older Children (PAQ-C) and Adolescents (PAQ-A) Manual","author":"Kowalski","year":"2004"},{"key":"2025082600135225400_daaf142-B23","doi-asserted-by":"publisher","first-page":"153","DOI":"10.1111\/j.1745-3984.1984.tb00227.x","article-title":"Self description questionnaire III: the construct validity of multidimensional self-concept ratings by late adolescents","volume":"21","author":"Marsh","year":"1984","journal-title":"J Educ Meas"},{"key":"2025082600135225400_daaf142-B24","doi-asserted-by":"publisher","first-page":"S12","DOI":"10.1007\/BF03403823","article-title":"Development of the Canadian Marginalization Index: a new tool for the study of inequality","volume":"103","author":"Matheson","year":"2012","journal-title":"Can J Public Health"},{"key":"2025082600135225400_daaf142-B25","doi-asserted-by":"publisher","first-page":"101454","DOI":"10.1016\/j.ssmph.2023.101454","article-title":"The impact of the COVID-19 pandemic on inequalities in lifestyle behaviours and mental health and wellbeing of elementary school children in northern Canada","volume":"23","author":"Maximova","year":"2023","journal-title":"SSM Popul Health"},{"key":"2025082600135225400_daaf142-B26","doi-asserted-by":"publisher","first-page":"155","DOI":"10.1016\/j.healthplace.2017.04.012","article-title":"A review of neighborhood effects and early child development: how, where, and for whom, do neighborhoods matter?","volume":"46","author":"Minh","year":"2017","journal-title":"Health Place"},{"key":"2025082600135225400_daaf142-B27","doi-asserted-by":"publisher","first-page":"311","DOI":"10.1177\/08404704211038232","article-title":"Inclusion, diversity, equity, and accessibility: from organizational responsibility to leadership competency","volume":"34","author":"Mullin","year":"2021","journal-title":"Healthc Manage Forum"},{"key":"2025082600135225400_daaf142-B28","doi-asserted-by":"publisher","first-page":"e008693","DOI":"10.1136\/bmjopen-2015-008693","article-title":"Cross-sectional associations between high-deprivation home and neighbourhood environments, and health-related variables among Liverpool children","volume":"6","author":"Noonan","year":"2016","journal-title":"BMJ Open"},{"key":"2025082600135225400_daaf142-B29","author":"OECD","year":"2023"},{"key":"2025082600135225400_daaf142-B30","doi-asserted-by":"publisher","first-page":"1582","DOI":"10.2105\/AJPH.2004.047399","article-title":"Promoting social inclusion in schools: a group-randomized trial of effects on student health risk behavior and well-being","volume":"96","author":"Patton","year":"2006","journal-title":"Am J Public Health"},{"key":"2025082600135225400_daaf142-B31","doi-asserted-by":"crossref","first-page":"326","DOI":"10.1515\/9781400876136","volume-title":"Society and the Adolescent Self-Image","author":"Rosenberg","year":"1965"},{"key":"2025082600135225400_daaf142-B32","doi-asserted-by":"publisher","first-page":"e008189","DOI":"10.1136\/bmjgh-2021-008189","article-title":"Immigrant child health in Canada: a scoping review","volume":"7","author":"Salami","year":"2022","journal-title":"BMJ Glob Health"},{"key":"2025082600135225400_daaf142-B33","doi-asserted-by":"publisher","first-page":"333","DOI":"10.19191\/EP22.5-6.A542.089","article-title":"School closures and mental health, wellbeing and health behaviours among children and adolescents during the second COVID-19 wave: a systematic review of the literature","volume":"46","author":"Saulle","year":"2022","journal-title":"Epidemiol Prev"},{"key":"2025082600135225400_daaf142-B34","doi-asserted-by":"publisher","first-page":"S55","DOI":"10.1007\/BF03403836","article-title":"Physical activity and nutrition among youth in rural, suburban and urban neighbourhood types","volume":"103","author":"Shearer","year":"2012","journal-title":"Can J Public Health"},{"key":"2025082600135225400_daaf142-B35","author":"StataCorp"},{"key":"2025082600135225400_daaf142-B36","author":"Statistics Canada","year":"1995"},{"key":"2025082600135225400_daaf142-B37","author":"Statistics Canada","year":"2021"},{"key":"2025082600135225400_daaf142-B38","author":"Statistics Canada","year":"2021"},{"key":"2025082600135225400_daaf142-B39","author":"Statistics Canada","year":"2022"},{"key":"2025082600135225400_daaf142-B40","author":"Statistics Canada"},{"key":"2025082600135225400_daaf142-B41","author":"Statistics Canada","year":"2022"},{"key":"2025082600135225400_daaf142-B42","author":"Statistics Canada","year":"2024"},{"key":"2025082600135225400_daaf142-B43","author":"Statistics Canada","year":"2024"},{"key":"2025082600135225400_daaf142-B44","doi-asserted-by":"publisher","first-page":"771","DOI":"10.1007\/s12187-015-9339-x","article-title":"Psychometric validation of the revised family affluence scale: a latent variable approach","volume":"9","author":"Torsheim","year":"2016","journal-title":"Child Indic Res"},{"key":"2025082600135225400_daaf142-B45","doi-asserted-by":"publisher","first-page":"125","DOI":"10.1017\/S0047279400020341","article-title":"Deprivation","volume":"16","author":"Townsend","year":"1987","journal-title":"J Soc Policy"},{"key":"2025082600135225400_daaf142-B46","doi-asserted-by":"publisher","first-page":"S311","DOI":"10.1139\/apnm-2016-0151","article-title":"Canadian 24-hour movement guidelines for children and youth: an integration of physical activity, sedentary behaviour, and sleep","volume":"41","author":"Tremblay","year":"2016","journal-title":"Appl Physiol Nutr Metab"},{"key":"2025082600135225400_daaf142-B47","author":"UNESCO","year":"2023"},{"key":"2025082600135225400_daaf142-B48","doi-asserted-by":"publisher","first-page":"80","DOI":"10.1016\/j.socscimed.2014.04.032","article-title":"Do school-based physical activity interventions increase or reduce inequalities in health?","volume":"112","author":"Vander Ploeg","year":"2014","journal-title":"Soc Sci Med"},{"key":"2025082600135225400_daaf142-B49","doi-asserted-by":"publisher","first-page":"34","DOI":"10.1016\/j.healthplace.2014.05.010","article-title":"Neighborhood socioeconomic deprivation characteristics in child (0\u201318 years) health studies: a review","volume":"29","author":"van Vuuren","year":"2014","journal-title":"Health Place"},{"key":"2025082600135225400_daaf142-B50","volume-title":"Canadian Standards and Indicators for Health Promoting Schools","author":"Veugelers","year":"2023"},{"key":"2025082600135225400_daaf142-B51","doi-asserted-by":"publisher","first-page":"152","DOI":"10.1080\/17477160801970278","article-title":"Neighborhood characteristics in relation to diet, physical activity and overweight of Canadian children","volume":"3","author":"Veugelers","year":"2008","journal-title":"Int J Pediatr Obes"},{"key":"2025082600135225400_daaf142-B52","doi-asserted-by":"publisher","first-page":"113542","DOI":"10.1016\/j.socscimed.2020.113542","article-title":"Neighbourhood deprivation effects on young people\u2019s mental health and well-being: a systematic review of the literature","volume":"270","author":"Visser","year":"2021","journal-title":"Soc Sci Med"},{"key":"2025082600135225400_daaf142-B53","doi-asserted-by":"crossref","DOI":"10.1093\/acprof:oso\/9780199754038.001.0001","volume-title":"Nutritional Epidemiology","author":"Willett","year":"2012","edition":"3rd edn"},{"key":"2025082600135225400_daaf142-B54","author":"World Health Organization","year":"2021"}],"container-title":["Health Promotion International"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/heapro\/article-pdf\/40\/4\/daaf142\/64128991\/daaf142.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/heapro\/article-pdf\/40\/4\/daaf142\/64128991\/daaf142.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,26]],"date-time":"2025-08-26T04:13:57Z","timestamp":1756181637000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/heapro\/article\/doi\/10.1093\/heapro\/daaf142\/8241014"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7,1]]},"references-count":54,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2025,7,1]]}},"URL":"https:\/\/doi.org\/10.1093\/heapro\/daaf142","relation":{},"ISSN":["0957-4824","1460-2245"],"issn-type":[{"value":"0957-4824","type":"print"},{"value":"1460-2245","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2025,8]]},"published":{"date-parts":[[2025,7,1]]},"article-number":"daaf142"}}