Abstract
BackgroundPhysical activity interventions targeting children and adolescents (≤18 years) often focus on complex intra- and inter-personal behavioral constructs, social-ecological frameworks, or some combination of both. Recently published meta-analytical reviews and large-scale randomized controlled trials have demonstrated that these intervention approaches have largely produced minimal or no improvements in young people’s physical activity levels.DiscussionIn this paper, we propose that the main reason for previous studies’ limited effects is that fundamental mechanisms that lead to change in youth physical activity have often been overlooked or misunderstood. Evidence from observational and experimental studies is presented to support the development of a new theory positing that the primary mechanisms of change in many youth physical activity interventions are approaches that fall into one of the following three categories: (a) the expansion of opportunities for youth to be active by the inclusion of a new occasion to be active, (b) the extension of an existing physical activity opportunity by increasing the amount of time allocated for that opportunity, and/or (c) the enhancement of existing physical activity opportunities through strategies designed to increase physical activity above routine practice. Their application and considerations for intervention design and interpretation are presented.SummaryThe utility of these mechanisms, referred to as the Theory of Expanded, Extended, and Enhanced Opportunities (TEO), is demonstrated in their parsimony, logical appeal, support with empirical evidence, and the direct and immediate application to numerous settings and contexts. The TEO offers a new way to understand youth physical activity behaviors and provides a common taxonomy by which interventionists can identify appropriate targets for interventions across different settings and contexts. We believe the formalization of the TEO concepts will propel them to the forefront in the design of future intervention studies and through their use, lead to a greater impact on youth activity behaviors than what has been demonstrated in previous studies.
Highlights
Physical activity interventions targeting children and adolescents (≤18 years) often focus on complex intra- and inter-personal behavioral constructs, social-ecological frameworks, or some combination of both
We believe the formalization of the Theory of expanded (TEO) concepts will propel them to the forefront in the design of future intervention studies and through their use, lead to a greater impact on youth activity behaviors than what has been demonstrated in previous studies
Some of the largest and most recently conducted interventions founded on complex intra- or inter-personal behavioral theories [17, 18] or ecological models [15, 19,20,21,22] have resulted in limited changes in youth physical activity or sedentary behaviors
Summary
Physical activity interventions targeting children and adolescents (≤18 years) often focus on complex intra- and inter-personal behavioral constructs, social-ecological frameworks, or some combination of both. A recent review indicates that youth physical activity interventions have produced a small effect of approximately 4 more minutes of moderate-to-vigorous physical activity (MVPA) per day [16]. Some of the largest and most recently conducted interventions founded on complex intra- or inter-personal behavioral theories [17, 18] or ecological models [15, 19,20,21,22] have resulted in limited changes in youth physical activity or sedentary behaviors. The effectiveness of existing theory-based intervention approaches has been marginal and, in some instances, such results were not altogether unexpected by those who designed the intervention [23]
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