BackgroundAn increasing number of patients bring Internet-based health information to medical consultations. However, little is known about how physicians experience, manage, and view these patients.Objective This study aimed to advance the understanding of the effects of incorporating Internet-based health information into routine medical consultations from physicians’ perspectives, using a qualitative approach.MethodsSix focus groups were conducted with 48 family physicians practising in Toronto. The data were analyzed using qualitative methods of content analysis and constant comparison, derived from grounded theory approach.ResultsThree overarching themes were identified: (1) perceived reactions of patients, (2) physician burden, and (3) physician interpretation and contextualization of information. Physicians in our study generally perceived Internet-based health information as problematic when introduced by patients during medical consultations. They believed that Internet information often generated patient misinformation, leading to confusion, distress, or an inclination towards detrimental self-diagnosis and/or self-treatment. Physicians felt these influences added a new interpretive role to their clinical responsibilities. Although most of the physicians felt obliged to carry out this new responsibility, the additional role was often unwelcome. Despite identifying various reactions of patients to Internet-based health information, physicians in our study were unprepared to handle these patients.ConclusionEffective initiatives at the level of the health care system are needed. The potential of Internet-based health information to lead to better physician-patient communication and patient outcomes could be facilitated by promoting physician acknowledgment of increasing use of the Internet among patients and by developing patient management guidelines and incentives for physicians.

Objectives: To determine the prevalence of smoking, low levels of physical activity, and missing breakfast among students (n=318) in grades 9 through 12 in three schools in southwestern Ontario; to see if these behaviours were associated; and, whether there were gender differences. Methods: A self-administered survey was conducted in grade 10 English classes. Results: The response rate was 87.1%. The prevalence of smoking was 36.2%; there was no gender difference. Only 42.8% of students ate breakfast daily; 48.8% of boys and 36.1% of girls (r 2 = 5.2; p<0.05). A higher proportion of boys (77.1%) were active for at least 30 minutes * 3 times/week compared to girls (66.0%) (r 2 = 4.8; p<0.05). Students who were active * 3 times/week were more likely to eat breakfast daily and, among boys, 60.4% of non-smokers ate breakfast daily compared to 31.9% of those currently smoking (r 2 = 13.3; p<0.001). There were no differences among girls. More girls (63.9%) were concerned about gaining weight compared to boys (36.1%) (r 2 = 37.7; p<0.001). Among girls, a higher proportion of those who were concerned about gaining weight were less likely to engage in physical activity or smoke, and more likely to skip breakfast compared to those who were not concerned. Discussion: Weight concern was not associated with frequency of physical activity, smoking, or breakfast consumption among boys. The high prevalence rates for these behaviours suggests that interventions in high schools should include daily physical activity, promotion of breakfast eating (either at home or in the school), and encouragement to quit smoking. La traduction du résumé se trouve à la fin de l'article.

Direct experience with PBL led to more favorable attitudes among the students and faculty. Recommendations are suggested for other schools and programs seeking to implement PBL curricula.

Background: More information is needed to document the prevalence of health risk factors in youth. The purpose of this study is to compare the prevalence of physical inactivity, smoking and overweight/obesity among youth in urban and rural schools. Methods: Data were obtained from a Student Physical Activity and Smoking Survey of 2,697 high school students in four urban schools in Ontario and four rural schools in Alberta. Prevalence of physical inactivity was assessed by examining compliance with Canada's Physical Activity Guide to Healthy Active Living, and with daily energy expenditure classification values. Prevalence of smoking was assessed by examining current smoking status. Overweight and obesity prevalences were examined by comparing BMI values to the BMI index for age and sex percentiles set by the Centers for Disease Control and Prevention. Results: Physical activity prevalence was found to be low in our study, with only 57.0% of youth achieving Canada's Physical Activity Guidelines, and with 26.0% classified as sedentary based on the daily energy expenditure classification values. A higher proportion of rural students reported "trying smoking" than urban school students (73.0% versus 64.4%, p<0.001). A significantly higher proportion of rural males were 'overweight' than urban males, and a significantly higher proportion of rural females were 'obese' in comparison to urban females. Conclusion: Our findings add further support for an urgent need to promote physical activity among Canadian youth. Additionally, our results suggest that it is especially important to target rural students, particularly girls, for smoking prevention programs. Future studies are required to examine such rural and urban differences within provinces. La traduction du résumé se trouve à la fin de l'article.

Although more similarities than discrepancies were found in the correlates of PA between the 2 geographical locations, findings from this study strengthen the policies that argue for a coordinated multisector approach to the promotion of PA in youth, which include the family, school, and community.