Physical Activity Participation In Children Research Articles

Construction and Assessment of the Physical Activity and Physical Education Importance for Parents Scale.

A recent systematic review reported positive associations between parents and children's physical activity participation. Moreover, parents' perceptions of the importance and value of physical activity can influence their children's participation in it. Our aim in this study was to develop and validate an instrument to assess parents' perceptions of the importance of physical activity and physical education. After first creating the instrument, we conducted content and exploratory factorial validation and reliability analyses of it with 93 parents (M age = 44.76, SD = 6.05, range = 31-66years; 73 females, 20 males). The result was a 9-item instrument, with items assessed on a 5-point Likert scale and grouped into three factors: (a) importance of physical education; (b) importance of engaging in physical activity or sport; and (c) importance of joining your children in physical activity or sport. In a second confirmatory factor analysis with 224 parents (M age = 44.53, SD = 6.07; 174 or 77.7% females and 50 or 22.3% males) we confirmed the factor validity and reliability previously analyzed (χ2 = 42.77, df = 24, p = .011, GFI = 0.96, NFI = 0.98, NNFI = 0.99, CFI = 0.99, RMSEA = 0.06 (90% CI: 0,04, 0.08), SRMR = 0.04, ECVI = 0.04, CR = 0.70-0.87). Thus, the new Physical Activity and Physical Education Importance for Parents Scale (PAPEIPS) is a valid and reliable instrument for measuring parents' perceived importance of physical activity and physical education.

Associations of Chinese Mothers' Education with Children's Diet and Physical Activity

Objectives: Children's health has attracted much attention. The aim of this study was to examine the relationships between mothers' education duration and children's health behaviors in terms of diet and physical activity (PA) and the potential mechanisms. Methods: We used data, from 6610 mother-child pairs, from the 1993-2015 China Health and Nutrition Survey. We conducted a series of ordinary least squares regression analyses to explore the associations of mothers' education duration with children's health behaviors. We also conducted subgroup analyses and analyses of the underlying mechanisms. Results: We found that mothers' education duration was significantly and positively associated with all diet indicators (children's awareness of diet guidelines and healthy diet knowledge) and PA indicators (children's PA participation, PA duration on weekdays, and PA duration at weekends) assessed. These associations may be mediated by mothers' health opinions, health behaviors, and income. The associations differed by children's gender and age, with mothers' education duration having larger associations for girls than boys, and the associations with PA duration differing by age. Conclusion: Our research highlights the important associations of mothers' education with children's health behaviors. Policymakers in developing countries should pay attention to policies for promoting female education.

Reliability of Fitness Assessments in Children With Emotional and Behavioral Difficulties.

Examine the reliability of field-based fitness assessments in school-aged children with emotional or behavioral difficulties (EBD). Understanding the impact of fitness on physical activity participation for children with EBD is limited by our ability to reliably measure it. Fifteen children aged 7-12years with EBD completed 7 assessments-standing broad jump, overhead throw, grip strength, isometric plank hold, isometric wall squat, unilateral heel raise, and modified 6-minute walk test-in a random order on 2 separate occasions. Intraclass correlation coefficients (ICCs) were computed to evaluate reliability. ICCs ranged from .65 to .99 representing moderate to excellent reliability for all assessments. Shorter assessments requiring less attention and behavior regulation tended to demonstrate higher ICC values while assessments with greater attention or behavioral regulation demands tended to have lower ICC values. Results demonstrate varied reliability for fitness tests in children with EBD. Practitioners can use grip strength and standing broad jump assessments with confidence. Other assessments have good reliability but greater variability indicating they may be a challenge for some children with EBD.

Children’s Physical Activity Behaviors During the COVID-19 Pandemic: A Mixed Methods Research

This study aimed to examine the impact of the COVID-19 pandemic on children’s physical activity behaviors. Furthermore, children's indoor and outdoor physical activity opportunities and daily habits including screen time and sleep patterns were investigated. A mixed methods approach was used in which survey methodology was combined with semi-structured interviews. The convenience sampling method was used. A sample of parents (n = 205, 165 mothers) of children (5-12 years) participated in the survey. Semi-structured interviews were used to assess changes in children’s physical activity behaviors and daily habits (screen time and sleep patterns) in detail. Descriptive statistics (frequencies, standard deviations, and means) and thematic analysis were used for data analysis. The results showed that the COVID-19 pandemic and related restrictions caused a decline in children’s physical activity participation, particularly a dramatic decrease in outdoor time. However, outdoor time was associated with better mental health, more active time, and less sedentary behaviors. The screen time also increased and parents had local and temporal solutions to control screen time. Although the sleep hours were sufficient for children, delays occurred in the sleep/wake schedule of children, and sleep-related problems were reported by parents. Based on the study results, professionals could help families to regulate children’s daily habits. These findings could also guide efforts to promote outdoor physical activity places to prevent the negative influence of long-term homestay periods for future extreme cases.

Perspectives of Swiss Paediatric Health Care Professionals on Factors Influencing Physical Activity Participation in Children with Disabilities

ABSTRACT Aim Investigation of the perspectives of paediatric health care professionals (PHCPs) in Switzerland regarding factors that influence participation in physical activity programs for children and adolescents with disabilities or chronic conditions (CADCCs). Evaluation of self-reported exercise counselling behavior of those professionals. Method A cross-sectional survey was used to collect the opinions of 171 PHCPs working with CADCCs using a structured questionnaire. The information obtained was evaluated by performing a combined quantitative and qualitative statistical analysis. Results PHCPs in Switzerland think that CADCC do not get enough physical activity and see the underlying reasons in lacking information/knowledge and organizational factors. We found that the level of knowledge about disability sports opportunities among PHCPs has a positive influence on their exercise counselling behaviour. Conclusions We propose three approaches to increase the level of physical activity in CADCC: Establishing personalized exercise counseling, intensifying information about disability sports programmes towards PHCPs, and improving inclusion and integration in PE lessons or regular sports clubs.

Physical Activity of Children and Adolescents in Croatia: A Global Matrix 4.0 Systematic Review of Its Prevalence and Associated Personal, Social, Environmental, and Policy Factors.

The previous review of physical activity (PA) among Croatian children and adolescents was conducted a decade ago. Therefore, the aim of this study was to summarize recent evidence on PA of Croatian children and adolescents and associated personal, social, environmental, and policy factors. Eighteen experts reviewed the available evidence and provided ratings (from the lowest grade "F" to the highest grade "A+") for the 10 Global Matrix indicators. A systematic search with 100 keywords was conducted in Hrčak, PubMed/MEDLINE, Scopus, SPORTDiscus, and Web of Science for documents published from January 01, 2012, to April 15, 2022. We also conducted internet searches and secondary analyses of data (relative frequencies) from 6 studies. After assessing 7562 references, we included 90 publications in the review and 18 studies (83.3% of medium-to-good quality) in evidence synthesis. We found a high prevalence of insufficient PA (especially among girls) and excessive screen time (especially among boys). PA participation of children and adolescents in Croatia has declined over time. The following grades were assigned to the indicators for Croatia: B- for overall PA, C- for organized sport and PA, C for active play, C- for active transportation, D+ for sedentary behavior, inconclusive for physical fitness, D+ for family and peers, B- for school, B- for community and environment, and D+ for government. Coordinated actions are needed across sectors to improve PA promotion, with a focus on increasing PA among girls, reducing sedentary screen time among boys, improving parental support for PA, and further development of national PA policies.

Factors associated with physical activity participation among children: a systematic review protocol

BackgroundReduced physical activity (PA) is one of the significant health concerns in adults and children alike. Despite the proven benefits of PA, most children, globally, do not meet the weekly criteria of enough PA to maintain health. The proposed systematic review is the review of the factors and will provide information on the factors associated with PA participation in children.MethodsThe proposed systematic review will be conducted based on the methodology from the Cochrane Handbook for Systematic Reviews of Interventions. We will include observational studies (cross-sectional, case–control, and cohort studies), randomized controlled trials (RCTs), and non-randomized study designs for information on factors associated with PA participation among children. Studies with participants in the age range of 5–18 years, indulging in physical activity of 60 min per day for a minimum of 3 days a week, will be included. Studies including differently abled children, children under medical treatment, and those taking medications for illnesses such as neurological, cardiac, and mental health conditions will be excluded from the review. We will search MEDLINE (via PubMed and Web of Science), Scopus, EMBASE, CINAHL, Cochrane CENTRAL, and PEDro for English language publications published from the inception till October 2022. For additional studies, we will search websites such as the Australian Association for Adolescent Health International Association for Adolescent Health and a reference list of the included publications. Selection of studies, data extraction, and quality assessment of the included studies will be performed in duplicate. Quality assessment of the included studies will be performed using the Cochrane Risk of Bias tool (ROB-II) for RCTs, New-Castle Ottawa, for observational studies, and ROBINS-I (Risk of Bias for Non-Randomized studies of Interventions) for non-randomized study designs.DiscussionThe proposed systematic review and meta-analysis will present a summary of the available evidence on factors associated with PA participation in children. The findings of this review will provide new insights into how exercise providers can improve PA participation among children and can also help healthcare workers, clinicians, researchers, and policymakers to plan long-term interventions targeting child health.Systematic review registrationPROSPERO CRD42021270057.

Anxiety among pediatric asthma patients and their parents and quick-reliever medication use: The role of physical activity parenting behaviours

BackgroundClinical guidelines recommend the identification of asthma comorbidities, especially treatable problems such as parental behaviours and child and parent anxiety. PurposeWe aimed to (1) explore associations of asthma severity with child and parent state anxiety, trait anxiety, and asthma-related anxiety as well as with caregiver behaviours around physical activity and (2) explore if caregiver behaviours around physical activity were associated with use of inhaled β-Agonists when symptomatic, and with child and parent anxiety. Patients and methodsPatients ages 3–17 years with asthma (n = 72) and their parents were recruited from the Pulmonology-Allergology Pediatric clinic University Hospital Centre Split in Split, Croatia during 2021. During a clinical visit, the pharmacological regimen was assessed and spirometry was performed. Children completed the State-Trait Anxiety Inventory for Children (STAI-C) and the Youth Asthma-Related Anxiety Scale (YASS). Parents completed the State-Trait Anxiety Inventory (STAI), the Parent Asthma-Related Anxiety Scale (PASS), and the Physical Activity Parenting Practices – Short Form (PAPP). ResultsMost patients had mild asthma (69.4%). Children with moderate to severe asthma had increased asthma-related anxiety (mean = 11.94 ± 6.1) compared with children with mild asthma (mean = 5.97 ± 6.39, p = 0.003). Parents of children with mild asthma reported behaviours allowing unsupervised physical activity outside more often when compared to parents of children with moderate or severe asthma. Physical activity facilitation parenting behaviour reduced the odds of a child's need for quick-reliever medication when symptomatic (OR = 0.376,95% CI = −1.885 to −0.072; p = 0.034); more coercive parenting increased the odds of a child's additional use of such medications (OR = 2.602; 95% CI = 0.005 to 1.908; p = 0.049). Parents of children in the highest quartile of trait anxiety showed less non-directive support (1.97 ± 1.01 vs. 2.89 ± 1.19, p = 0.031) and less autonomy support (3.14 ± 1.32 vs. 4.11 ± 1.23, p = 0.037) of physical activity in their children than those with less trait anxiety. ConclusionAsthma-related anxiety was an important construct in this sample of children, associated with their disease severity as well as their parent's behaviours around the child's physical activities. Current research, conducted during the COVID-19 pandemic, recognised the tangible ways that parents support or avoid the asthmatic children's physical activity participation. Child anxiety and recognised parental physical activity behaviours are potentially important factors to assess and target for intervention.

Occupational therapists' understanding of supporting physical activity participation when working with children and adolescents: A national survey.

Physical inactivity is a leading risk factor to disease and mortality. Despite the recognised benefits of physical activity, over half of the Australian population are not sufficiently active. For individuals with a disability, inactivity rates are further increased placing them at a higher risk of the negative effects of physical inactivity. Developing healthy lifestyle habits such as physical activity participation in early childhood has been found to be supportive of health behaviours being maintained into adulthood. Physical activity is an occupation said to involve the complex interaction between psychological, social, environmental, and physical factors placing it within the scope of occupation therapy. However, limited research is available exploring what this role looks like in practice. An online, anonymous survey was developed to better understand how Australian occupational therapists understood physical activity participation, as well as their current and potential role in facilitating regular physical activity participation with their clients. All registered Australian occupational therapists were eligible to participate in this survey, which consisted of both closed and open answered questions. A total of 43 occupational therapists registered to practice within Australia completed the survey. All participants viewed physical activity as an important occupation for maintaining the health and well-being of their clients. Participants described the holistic role occupational therapists could play supporting physical activity participation outside of motor skill development. Therapists identified several ways in which a family-centred, occupation-based approach could be used to support sustained engagement in physical activity. The findings from this study contribute to our understanding of the role occupational therapy can play supporting physical activity participation for children and adolescents. This sparsely researched area requires more evaluation to ensure intervention is delivered in a way that is most effective.

Facilitators and barriers of physical activity participation in children with a single ventricle physiology: a mixed-methods study.

The present study focuses on assessing the physical activity level of children with Fontan circulation for Hypoplastic Left Heart Syndrome and identifying potential barriers and facilitators toward their participation in physical activity. Seven children aged 5-16 years (mean (SD) 8.8 (3.7) years) with a Fontan procedure for hypoplastic left heart syndrome, their parents (n = 7), and siblings (n = 1) were recruited. Data were collected using a mixed-methods approach: (i) children wore an activity monitor for 7 days to record physical activity, with sedentary time and level of activity calculated from accelerometer data; (ii) children completed a bespoke questionnaire recording limitations in physical activity; (iii) parents completed a semi-structured interview discussing perceptions about their child's physical activity participation. Qualitative data were analysed using thematic analysis. Activity monitors data recorded highly active children with a mean (SD) of 153(36) minutes/day spent in moderate-to-vigorous physical activity. Time spent in sedentary behaviour was also high (57.5% of total accelerometer wearing-time). Four key themes relating to parental perceptions of physical activity were identified: (i) A new lease of life -post-Fontan; (ii) Setting limits - managing limitations; (iii) The wider world - how others set limits; and (iv) "I fear the future" - parental concerns. Following completion of the Fontan circulation, children engaged in higher levels of physical activity in comparison to the national average. However, more than half their time was spent in sedentary behaviour. Fears and anxiety from parents and teachers may act as a barrier toward physical activity participation.

Correlates of Physical Activity of Children and Adolescents with Autism Spectrum Disorder in Low- and Middle-Income Countries: A Systematic Review of Cross-Sectional Studies

Children and adolescents with autism spectrum disorder (ASD) are at a high risk for a lack of physical activity (PA). The aim of this study is to review the evidence on the correlates of PA in children and adolescents with ASD in low- and middle-income countries. We searched Psychology and Behavioral Sciences Collection (PBSC), Scopus, PsycINFO, Web of Science (WOS), MEDLINE, Education Resources Information Center (ERIC), Education Source (ES), and Academic Search Premier (ASP) databases for relevant studies until April 2022, inclusive, to examine the factors associated with the studies of PA in children and adolescents with ASD aged 5 to 17 years in low- and middle-income countries. A total of 15 articles are included in the present review. Three researchers assessed the methodological quality and extracted relevant data of the included reviews. The correlates were synthesized and further assessed semi-quantitatively. Results of this review show that gender (boys) and more PA opportunities were positively associated with the PA of children and adolescents with ASD, while age and body mass index (BMI) were negatively related to their PA levels in low- and middle-income countries. The day of week was found to be inconsistently associated with PA in children and adolescents with ASD. The findings suggest that research on the correlates of PA in adolescents with ASD in low- and middle-income countries is limited. However, there are clear correlates for which future interventions could be based (age, gender, BMI, and PA opportunity) to promote PA participation in children and adolescents with ASD in low- and middle-income countries.

Associations Between Perceived Social Support, Perceived Competence And Physical Activity In Hong Kong Children With Disabilities During The Covid-19 Pandemic

PURPOSE: The COVID-19 pandemic has caused adverse impacts on physical activity (PA) and psychosocial health in children with disabilities. The aim of this study was to examine the associations among their perceived social support, perceived competence, and participation in PA, and to determine the predicting effects of perceived social support and perceived competence towards PA during the lockdown of the COVID-19 pandemic. METHODS: Participants were 291 children with a physician diagnosis of physical disabilities (PD) and intellectual disabilities (ID) aged 6-17 years. They were asked to complete measures that assessed their perceptions of social support, perceived competence, and participation in PA. RESULTS: Significant differences were found in age, BMI and perceived competence between children with PD and ID (ID>PD). BMI was the most significant co-founding variable (p = 0.001) in the total sample of participants. After controlling for demographic variables, perceived competence explained more significance (an additional 17% variance) for PA participation (p < 0.05), rather than social support in the total sample. The total variance explained by the model was 24%, F (2, 240) = 12.42, p < 0.001. No significance was found for their interaction effect. CONCLUSIONS: Larger predictions were found for PA on perceived competence in children with PD and ID. Perceived social supports are essential, but needs to specify the role of significant others, such as mothers/fathers, siblings/peers during the COVID-19 outbreak. Future studies should target on these predictors to inform the intervention design to encourage PA participation in children with disabilities in Hong Kong.

A Clinical Practice Guide to Enhance Physical Activity Participation for Children with Developmental Coordination Disorder in Canada.

This clinical practice guide (CPG) aims to provide evidence-based recommendations for promoting and enhancing the participation and integration of children with developmental coordination disorder (DCD) into physical activities that take place in the home, school, community, or rehabilitation clinic contexts. A panel of key stakeholders relevant to these contexts (parents, instructors, rehabilitation professionals) developed evidence-based recommendations using a consensus methodology after reviewing results from a recent systematic review of relevant literature. The quality of the evidence on which the recommendations were based was evaluated (2011 Oxford Centre for Evidence-Based Medicine Levels of Evidence scale) as was the strength of the final CPG recommendations (American Society of Plastic Surgeons Grade Recommendation Scale). Recommendations (n = 50; 36% supported by robust, empirically derived evidence) for the different stakeholder groups fell into three categories: 1) Choose an appropriate activity for your child, 2) Harmonize the activity with the child's interests and abilities, and 3) Help the child learn new movements prior to the activity. This comprehensive CPG provides concrete recommendations, based on the currently available evidence, that can be used by stakeholders to address the physical activity participation and integration needs of children with DCD in a variety of contexts.

Physical Activity for Children and Youth with Physical Disabilities: A Case Study on Implementation in the Municipality Setting.

Children and youth with disabilities participate less in physical activity (PA) than their peers. This qualitative multiple-case study aimed to assess how municipal practices support PA implementation for these children and youth. A total of 23 interviews were conducted, which covered participants from different departments and professional positions in two municipalities. Local policy documents were included. A thematic analysis was performed, which was based on Winter’s integrated implementation model and Gittell’s theory on relational coordination. The study findings indicate how PA implementation for children and youth with disabilities is a complex challenge that involves several departments and agents. The study demonstrates that having an explicit policy that focuses on parasport can positively influence organisational and interorganisational behaviour, and that coordinating consultants seem to play an essential role in PA implementation. However, there is room for improvement at the municipal level in order to promote a better overall performance in terms of the support for PA participation of children and youth with disabilities.

Environmental and social determinants of leisure-time physical activity in children with autism spectrum disorder

BackgroundIt is increasingly recognized that children's physical activity behaviors are shaped by neighborhood environment factors and their parent's support. However, these factors have been scarcely studied among children with autism spectrum disorder (ASD), a population at risk of inactivity. ObjectiveThis cross-sectional survey study was designed to examine how neighborhood environmental factors and parental support are related to physical activity levels of children with ASD. Also, this study examined if the relationship between the environment and physical activity is modified by demographic factors and COVID-19 related concerns. MethodsAn online survey was completed by parents of children with ASD aged 10–17 years. The questionnaire included items related to environmental factors (i.e., distance to school, distance to park, existence of sidewalks, walkability), parent support for physical activity (i.e., encouraging, watching, and providing transportation), child's physical activity, and demographic characteristics. The instrument also queried parental concerns about COVID-19 and their child's physical activity participation. ResultsThe results indicate that proximity to a local park and to school is positively associated with physical activity. Parent's encouraging behavior correlated with and predicted children's physical activity levels. Also, higher levels of COVID-19 related concerns among parents were related to decreased physical activity supporting behaviors. ConclusionsThis study demonstrated that the neighborhood environment, in particular the distance between home and parks and schools, and parent support behavior are influential factors that may shape physical activity behaviors for children with ASD.

Prevalence of School-Based Extracurricular Sport and Physical Activity Participation among Children with Disabilities

ABSTRACT This study aimed to examine the prevalence and types of school-based extracurricular sports and physical activity participation among children with disabilities. This study utilised the 2013–2016 National Health and Examination Surveys (N = 4416). A total of 509 children who received special education services were identified as children with disabilities in this study. Descriptive statistics, Rao-Scott chi-square tests, binary logistic regression, and multivariate logistic regression model were used to answer the research questions. The results suggested a discrepancy in school-based extracurricular sport and physical activity participation between children with and without disabilities. Furthermore, there were significant disparities in participation in school-based extracurricular sports and physical activities among girls with disabilities. It is recommended that sufficient resources and training opportunities be provided for policy implementation to promote school-based extracurricular sport and physical activity participation of children with disabilities. Offering more favourable and suitable extracurricular sport and physical activity programs can also ensure children with disabilities have an equal opportunity to participate in sport and physical activity after school hours.

Development of Physical Activity Models Based on Motor Perception for Kindergarten Children

The phenomenon that occurs in today's children is the decreasing number of play activities that involve children's physical activity. This study aims to produce five models of motor perception activity to improve executive function in kindergarten students. This research was pursued by using the research & development method. The research procedure consisted of four stages; Stage 1. Preliminary study (N=50); Stage 2. Development of 5 models of motor perception activity; Stage 3. Expert validation consists of lecturers (N=7) and teachers (N=3); and Stage 4. Trial of motor perception activity model (N=50). The data collection technique used was in the form of filling out observation sheets for 50 parents. Data analysis was summarized in the form of quantitative descriptive analysis and qualitative analysis. The results showed that children's motoric elements were low, including 15% student activity, 40% balance, 23% motor skills, 27% interest, and 57% attention. The availability of learning equipment to support motor perception activities is indicated by the percentage of 49% or very low. This motor perception activity model is created in 5 activities, namely: (1) walking on a balance beam, (2) jumping in a half circle of hola hops, (3) running, jumping, jumping & tiptoeing, (4) crawling while dribbling, and (5) throwing balloons while sitting. Based on the results of the calculation of quantitative data from the teacher's assessment as the model user, it is known that the level of implementation of the motor perception activity model for kindergarten students is very high at 96.15% and the quality of the model is very high at 94.85%. Through quantitative and qualitative analysis, it is known that the motor perception activity learning model is suitable for use in learning physical activity for kindergarten students while at the same time giving an impact on children's physical activity participation.

Descriptive contents analysis of ParticiPAte CP: a participation-focused intervention to promote physical activity participation in children with cerebral palsy

Purpose ParticiPAte CP is a participation-focused therapy intervention that is effective to increase perceived performance of physical activity (PA) participation goals in children with cerebral palsy (CP). We aimed to characterise the contents of ParticiPAte CP using validated behaviour change frameworks. Materials and methods Data came from physiotherapist treatment notes and were used to specify: (1) physiotherapist-perceived barriers to behaviour change (using the International Classification of Functioning, Disability and Health Framework [ICF] and Theoretical Domains Framework), intervention content (Behaviour Change Technique Taxonomy v1), intervention functions (Behaviour Change Wheel) and mechanisms of action (Capability, Opportunity, Motivation – Behaviour model). Results Physiotherapist-perceived barriers to participation were identified in all ICF and Theoretical Domains Framework domains. ParticiPAte CP consisted of 32 behaviour change techniques, delivered via six intervention functions of the Behaviour Change Wheel, especially enablement. All six possible mechanisms of action were identified according to the Capability, Opportunity, Motivation – Behaviour model. These were targeted most frequently through Theoretical Domains Framework domains social influences, environmental context and resources, intentions, skills, knowledge, and beliefs about capabilities. Conclusions The content of a PA intervention for children with CP can be specified according to behaviour change frameworks. ParticiPAte CP was complex, with multiple targets, constituent behaviour change techniques and mechanisms of action. Trial Registration: Australian New Zealand Clinical Trials Registry ACTRN12615001064594. Implications for rehabilitation Providing social support to families through practical actions such as motivating conversation, providing information, linking families to community services and participating in activities with children to support their self-efficacy may be a defining feature of effective participation-focused therapies. If children with cerebral palsy (CP) and their families nominate goals for increased frequency of attendance or improved involvement in physical activities (PAs), therapists must identify all important barriers to participation, including behavioural barriers that may be thought of less often (e.g. emotions, beliefs, optimism etc.). Promoting PA participation in children with CP may require a complex or multi-faceted therapy intervention that supports not only physical capability, but also enhances the social and physical opportunity for participation to take place and promotes the psychological capability and motivation for PA of children and families. Therapists or researchers may consider using the Behaviour Change Wheel to prospectively design their own health behaviour intervention for children with CP.

Development of a School-Based Intervention to Increase Physical Activity Levels Among Chinese Children: A Systematic Iterative Process Based on Behavior Change Wheel and Theoretical Domains Framework.

Regular physical activity has a range of benefits for children's health, academic achievement, and behavioral development, yet they face barriers to participation. The aim of the study was to systematically develop an intervention for improving Chinese children's physical activity participation, using the Behavior Change Wheel (BCW) and Theoretical Domains Framework (TDF). The BCW and TDF were used to (i) understand the behavior (through literature review), (ii) identify intervention options (through the TDF-intervention function mapping table), (iii) select content and implementation options [through behavior change technique (BCT) taxonomy and literature review], and (iv) finalize the intervention content (through expert consultation, patient and public involvement and engagement, and piloting). A systematic iterative process was followed to design the intervention by following the steps recommended by the BCW. This systematic process identified 10 relevant TDF domains to encourage engagement in physical activity among Chinese children: knowledge, memory, attention and decision processes, social influences, environmental context and resources, beliefs about capabilities, beliefs about consequences, social/professional role and identity, emotions, and physical skills. It resulted in the selection of seven intervention functions (education, persuasion, environmental restricting, modeling, enablement, training, and incentivization) and 21 BCTs in the program, delivered over a period of 16 weeks. The BCW and TDF allowed an in-depth consideration of the physical activity behavior among Chinese children and provided a systematic framework for developing the intervention. A feasibility study is now being undertaken to determine its acceptability and utility.

Factors That Influence Participation in Physical Activity in School-Aged Children and Adolescents: A Systematic Review from the Social Ecological Model Perspective.

High prevalence of physical inactivity and obesity in children and adolescents has become a global problem. This systematic review aimed to examine the existing literature regarding the factors that influence participation in physical activity (PA) in children and adolescents with reference to the social ecological model (SEM) proposed by McLeroy et al. (1988). The SEM provides a framework under which the influencing factors are categorized into five levels: intrapersonal, interpersonal, organizational, community, and public policy. A systematic search of relevant literature published before July 2020 was conducted through Ebsco, ProQuest, PubMed Central, Scopus, and Web of Science. A total of fourteen studies met the inclusion criteria. The selected articles were all of high quality as assessed using the Mixed Methods Appraisal Tool (2018). The results indicated that gender, age, ethnicity, and self-concept were the most common influencing factors at the intrapersonal level. At the interpersonal and organization levels, supports from friends, parents, and teachers were positive predictors of students’ PA participation. Accessibility of facilities and safe neighborhoods was a crucial factor that influenced children and adolescents’ participation in PA at the community level. Future studies on the effective types of policies or practices that could successfully promote facilities’ accessibility and improve neighborhood safety are required. The outcomes of this systematic review are expected to inform practice and support the development and implementation of sound policies for the promotion of PA participation in children or adolescents from a comprehensive social ecological viewpoint.