Physical Activity Interventions For Youth Research Articles

A Comprehensive Planning Framework for Designing Effective Physical Activity Interventions in Youth.

Effective physical activity (PA) interventions are needed to counter the insufficient and declining levels of PA in youth. These require an updated, comprehensive planning framework that consolidates recent decades of progress in promoting PA in young children, children, and adolescents. Effective PA interventions require program planning and conceptual model development that target a coordinated and multilevel set of age-specific PA determinants. Accordingly, this paper presents a comprehensive planning framework that researchers can use to design intervention research to promote PA in youth. The first author conducted targeted searches through Google Scholar to compile PA models/frameworks/guides applicable to youth, a comprehensive set of PA determinants, and determinant-linked strategies to promote PA focusing on review articles. The information was summarized in tables, synthesized, and used to create a planning framework, all of which were reviewed by coauthors. The APPLE Framework for Planning PA Opportunities for Youth (APPLE = Age, PA focus, Place and time, Leverage relevant influences and strategies, and ensure Enjoyable PA opportunities) incorporated all core elements from targeted reviews to create a comprehensive planning framework. The APPLE Planning Framework has a set of questions/prompts that guide the intervention planning process and conceptual model templates to organize planning efforts for designing intervention research. The APPLE Framework for Planning PA Opportunities for Youth will enable researchers to develop comprehensive conceptual models to guide the design of PA interventions for youth. Future research should refine the model and its components to enable PA intervention research in youth to move forward.

The Rating of Perceived Exertion-Pediatric (RPE-P) Scale: Preliminary Validation.

Physical activity is critical to functional rehabilitation for youth with chronic pain, which may be especially true for those with co-occurring obesity. To facilitate the development of physical activity interventions for youth with chronic pain, the newly developed "Rating of Perceived Exertion-Pediatric" scale was modeled after the widely used pain numeric rating scale-11. This study is an initial evaluation of the scale in a sample of adolescents (n = 157, 13-17 years, 51% female) with four subgroups: (1) healthy controls (healthy weight/no pain); (2) chronic pain/healthy weight; (3) obese (no pain); (4) chronic pain/obese. Participants rated perceived exertion using the new scale and the Borg 6-20 Scale of Perceived Exertion while holding a three-minute yoga pose (Warrior II). In the whole sample, the Perceived Exertion-Pediatric scale showed good concurrent (p < 0.001), convergent (all ps < 0.05), discriminant (p = 0.431), and known-groups validity (all ps < 0.05). The chronic pain subgroup also showed good concurrent (p < 0.001), mixed convergent (ps < 0.001 to 0.315), and good discriminant validity (p = 0.607). Limitations include the restricted age range, lack of diversity, and lack of test-retest reliability. The RPE-P shows promise as an assessment tool for perceived exertion in adolescents with and without chronic pain.

Youth Perceptions of Sport-Confidence.

Zuk, EF, Maksymiw, K, Evanovich, J, McGarry, JE, Root, HJ, and Distefano, LJ. Youth perceptions in sport-confidence. J Strength Cond Res 35(11): 3232-3235, 2021-Sport-confidence is an important construct that is often missed during physical activity interventions in youth. Male and female children might display differences in sport-confidence that influences their activity levels. The purpose of this study is to assess any association between sport-confidence and gender in elementary school and middle-school children. All 286 children {(boys [ES: n = 71, age = 8±1 years; MS: n = 63, 11±1 years]; girls [ES: n = 67, 7±1 years; MS: n = 85, 11±1 years])} completed the Physical Literacy Assessment for Youth-Self Questionnaire. Separate chi-square tests of the association were used to evaluate the association between gender and sport-confidence among elementary (grades K-4) and middle-school (grades 5-8) children because of varying injury and participation rates for these groups, for each relevant question with a significance set at p ≤ 0.05. For elementary school children, there were no significant associations between genders and sport-confidence (p > 0.05). In middle-school children, there were significant associations detected for learning new skills (ϕ = 0.12; p = 0.031), perception of skill (ϕ = 0.12; p = 0.054), confidence in activity (ϕ = 0.17; p = 0.035), and being the best in the class (ϕ = 0.15; p = 0.048) between genders and sport-confidence. For all results, boys displayed more sport-confidence than girls. Education for key stakeholders about the importance of including sport-confidence in physical activity interventions is integral in promoting life-long activity, specifically in middle-school girls.

Does Dynamic Tailoring of A Narrative-Driven Exergame Result in Higher User Engagement among Adolescents? Results from A Cluster-Randomized Controlled Trial.

Physical activity interventions for youth are direly needed given low adherence to physical activity guidelines, but many interventions suffer from low user engagement. Exergames that require bodily movement while played may provide an engaging form of physical activity intervention but are not perceived as engaging to all. This study aimed to evaluate whether dynamic tailoring in a narrative-driven mobile exergame for adolescents played in leisure settings, can create higher user engagement compared to a non-tailored exergame. A cluster-randomized controlled trial assessed differences in user engagement between a dynamically tailored (based on an accelerometer sensor integrated in a T-shirt) and non-tailored condition. In total, 94 participants (M age = 14.61 ± 1.93; 35% female) participated and were assigned to one of the two conditions. User engagement was measured via a survey and game metric data. User engagement was low in both conditions. Narrative sensation was higher in the dynamically tailored condition, but the non-tailored condition showed longer play-time. User suggestions to create a more appealing game included simple and more colorful graphics, avoiding technical problems, more variety and shorter missions and multiplayer options. Less cumbersome or more attractive sensing options than the smart T-shirt may offer a more engaging solution, to be tested in future research.

Making a Strong Case for Prioritizing Muscular Fitness in Youth Physical Activity Guidelines

Although evidence indicates that muscular fitness is foundational for ongoing participation in active play, exercise and sport, current national and international youth physical activity guidelines underplay the critical importance of strength-building activities during this developmental phase of life. In view of troubling trends in muscular fitness in today's youth, specific recommendations to address neuromuscular deficiencies are required. An understanding of the multidimensional development of youth physical inactivity and the importance of muscular fitness are needed to have the most significant impact on youth physical activity at the population level. The mounting evidence of the detrimental effects of physical inactivity on youth warrant a review of existing physical activity recommendations and guidelines. The proposed pediatric activity pyramid recognizes the shared importance of strength, skill, and aerobic activities required for the successful implementation of sustainable youth physical activity interventions.

Implementation of a school-based Fitbit program for youth with Autism Spectrum Disorder: A feasibility study

BackgroundSchool settings may be optimal for physical activity interventions for youth with Autism Spectrum Disorder (ASD). Additionally, consumer-based fitness trackers may encourage youth with ASD to increase their physical activity levels, however, no studies have examined whether a fitness tracker program would be feasible in youth with ASD. ObjectiveTo examine the feasibility of a 12-week school-based Fitbit© program for youth with ASD. MethodsSix classroom teachers and their students (n = 45) were provided with Fitbit fitness trackers to wear over 12-weeks. Classroom teachers monitored student tracker use and completed open-ended surveys to describe both their experience and their students’ experience with the fitness trackers. ResultsOut of the 45 eligible students, 42 (94%) opted to participate in the study. All six teachers and 32 (76%) of the 42 students wore the fitness tracker daily over 12 weeks. Teachers reported that students were most interested in tracking their daily steps, and the short batter life, and account set-up were the biggest challenges to students. All six teachers felt that this program could have long-term sustainability, especially if tracker use could be incorporated into school curriculum and classroom activities. ConclusionsA school-based Fitbit program appears to be both feasible, and well-accepted by students with ASD. Future work should evaluate the preliminary efficacy of this type of program.

Developing Empirical Decision Points to Improve the Timing of Adaptive Digital Health Physical Activity Interventions in Youth: Survival Analysis.

BackgroundCurrent digital health interventions primarily use interventionist-defined rules to guide the timing of intervention delivery. As new temporally dense data sets become available, it is possible to make decisions about the intervention timing empirically.ObjectiveThis study aimed to explore the timing of physical activity among youth to inform decision points (eg, timing of support) for future digital physical activity interventions.MethodsThis study comprised 113 adolescents aged between 13 and 18 years (mean age 14.64, SD 1.48 years) who wore an accelerometer for 20 days. Multilevel survival analyses were used to estimate the most likely time of day (via odds ratios and hazard probabilities) when adolescents accumulated their average physical activity. The interacting effects of physical activity timing and moderating variables were calculated by entering predictors, such as gender, sports participation, and school day, into the model as main effects and tested for interactions with the time of day to determine conditional main effects of these predictors.ResultsOn average, the likelihood that a participant would accumulate a typical amount of moderate-to-vigorous physical activity increased and peaked between 6 PM and 8 PM before decreasing sharply after 9 PM. Hazard and survival probabilities suggest that optimal decision points for digital physical activity programs could occur between 5 PM and 8 PM.ConclusionsOverall, the findings of this study support the idea that the timing of physical activity can be empirically identified and that these markers may be useful as intervention triggers.

The Feasibility of Project CHASE: A Facebook-Delivered, Parent-Mediated Physical Activity Intervention for Children with Autism

ABSTRACTTo effectively combat high levels of inactivity among children with autism spectrum disorder (ASD), scalable and sustainable methods of intervention are required. The purpose of this study was to examine the feasibility of a web-based, parent-mediated physical activity intervention for thirteen children with ASD. The intervention, Project CHASE, involved parents joining a private Facebook group where they were exposed to five intervention components, based on the social cognitive theory. The primary outcome of interest was the feasibility and perceived effectiveness of, and engagement with, the intervention, as measured by a parent-completed questionnaire and activity within the Facebook group. The analysis focused on descriptive statistics, rather than inferential statistics. Participants reported Project CHASE to be a feasible means of supporting their child’s physical activity, with all participants reporting being satisfied or very satisfied with their ‘overall experience’, and finding the content interesting and useful. Over 75% of the sample reported the weekly goals, physical activity reporting, information on physical activity opportunities and ideas, and posting/viewing pictures of children being active to be effective or very effective components. Suggestions are provided for the refinement of Project CHASE, and how the results can inform future web-based physical activity interventions for youth with ASD.Abbreviations: Autism spectrum disorder (ASD); Typical development (TD); Social Cognitive Theory (SCT); Self-efficacy (SE)

Group-based physical activity trajectories in children transitioning from elementary to high school

BackgroundPhysical activity has been observed repeatedly to decline as children transition into adolescence; however, few studies have explored the possibility that sub-groups of children experience unique patterns of change during this transition. The purpose of this longitudinal study was to examine the physical activity trajectories in clusters of youth transitioning from 5th to 11th grade.MethodsParticipants (n = 652) were recruited as 5th graders (ages 10–12 years) from elementary schools (n = 21) in two school districts. Demographic, anthropometric, and physical activity data were collected once per year when children were in 5th, 6th, 7th, 9th, and 11th grades. Children wore accelerometers for 7 consecutive days. Group-based trajectory modeling statistical techniques were applied to identify patterns of physical activity trajectories. Posterior probabilities confirmed participants’ membership in their respective group.ResultsThree distinct physical activity trajectories were identified. Group 1 (n = 27) remained highly active over time, and physical activity increased from ages 14 to 16 years. Group 2 (n = 365) was active at baseline, but activity declined and remained low as group members aged. Group 3 (n = 260) had the lowest levels of physical activity at all ages, and activity declined from ages 10 to 16 years.ConclusionsWhile most children experienced a decline in physical activity as they transitioned into high school, some remained highly active and increased their level of physical activity. Future studies should test physical activity interventions for youth that are tailored for age-related trajectory groups.

Abstract 018: New York City Youth Cardiovascular Fitness and Subsequent School Absenteeism Have an Inverse, Dose-Response Relationship, Regardless of How Poverty is Measured

Introduction: Recent research demonstrates that cardiovascular fitness improvements are associated with lower absenteeism, particularly for girls attending schools located in high poverty neighborhoods. Poverty at the student, school, and neighborhood levels may each have unique effects on both cardiovascular fitness and school absenteeism. There is a need to simultaneously explore the effects of poverty measures collected at different levels of observation on the longitudinal fitness-absenteeism relationship and across gender in order to inform policy targeting reduced school absenteeism. Hypothesis: It was hypothesized that poverty measured at the neighborhood level would have the strongest magnitude of effects on the cardiovascular fitness-absenteeism relationship compared with poverty measured at the school and student levels. Methods: Data for this study were drawn from the New York City Fitnessgram dataset. Inclusion criteria were enrollment in a New York City public school for at least 2 consecutive years in grades 6-8 (2006-2013) while attending a school that collected Fitnessgram measurements. Negative binomial longitudinal mixed models with random-intercepts were run to test the association between the exposure, child-specific change in cardiovascular fitness from the year prior, and the outcome, days absent the subsequent year. Separate crude and adjusted models were run stratified by student (individual household), school (percent of students living in poverty or qualifying for free/reduced price school meals) and neighborhood (home- and school-area) poverty measures, and also by gender. Models were adjusted for individual- and group-level confounders (time, grade, race/ethnicity, place of birth, change in obesity status, and school size), and clustering by individual student and school. Results: The sample included 360,743 students (67% black or Hispanic, 51% male, 69% qualifying for free/reduced price school meals). Adjusted estimates showed an inverse-dose response fitness-absenteeism relationship across all poverty measures, with the highest magnitude of effects for youth attending schools in high poverty neighborhoods (IRR= -0.12, 95%CI: -0.20, -0.04 in girls; IRR= -.13, 95%CI: -.29, .03 in boys), and in girls attending schools with a high proportion of students qualifying for free/reduced school meals (IRR= -.11, 95%CI: -.23, -.01). Conclusions: In conclusion, there is an inverse, dose-response trend between cardiovascular fitness and subsequent absenteeism in high poverty youth, regardless of how poverty is measured, and particularly among girls. Future research should examine the potential for distinct youth physical activity interventions tailored to the individual, school and neighborhood levels to reduce school absenteeism associated with poverty.

Associations Between Parent-Perceived Neighborhood Safety and Encouragement and Child Outdoor Physical Activity Among Low-Income Children.

A growing body of research has examined the relationship between perceived neighborhood safety and parental encouragement for child physical activity (PA), yet these potential predictors have not been studied together to predict child outdoor PA. The purpose of this study is to examine these predictors and parent- and child-reported child outdoor PA. The Texas Childhood Obesity Research Demonstration study collected data from fifth-grade students attending 31 elementary schools across Austin and Houston and their parents (N = 748 parent-child dyads). Mixed-effects linear and logistic regressions stratified by gender and adjusted for sociodemographic covariates assessed associations among parental-perceived neighborhood safety, parental encouragement for child's outdoor PA, and parent- and child-reported child's outdoor PA. Parental-perceived neighborhood safety was significantly associated with encouraging outdoor PA (P = .01) and child-reported child's outdoor PA in boys, but not in girls. Significant associations were found between parental encouragement and child-reported outdoor PA for girls (P < .05) and parent-reported outdoor PA (P < .01) for boys and girls. Parent encouragement of PA and neighborhood safety are potential predictors of child outdoor PA and could be targeted in youth PA interventions.

Trends in Active Commuting to School among Czech Schoolchildren from 2006 to 2014.

Active commuting (AC) is an important factor in increasing the total daily physical activity (PA) in children, which is significant for their health and positive physical behaviour in adulthood. The objective of the study was to describe trends in active commuting to school among Czech girls and boys aged 11-15 years from 2006 to 2014, using data from the Health Behaviour in School-aged Children (HBSC) study. To investigate trends in AC among Czech children of school age data obtained from the HBSC surveys carried out in 2006, 2010, and 2014 was used. The study sample comprised 12,273 respondents, out of whom 5,992 (48.8%) were boys and 6,281 (51.2%) girls. The overall trends in AC were evaluated using logistic regression analysis. Compared with 2006, there was an overall decrease in AC among the 13-year-old boys and 13-year-old girls (boys - 1.8% in 2006 to 50.1% in 2014, girls - 69.3% in 2006 to 46.3% in 2014). The proportion of children AC (walking and cycling) to school significantly decreased from 74.3% in 2006 to 53.4% in 2014. This study demonstrated that AC to school decreased sharply among Czech children of school age from 2006 to 2014. However, walking was the most frequently used mode of travel. The boys were significantly more likely to cycle to school compared to the girls. PA interventions for youth should encourage participation in AC to school in the Czech Republic.

The theory of expanded, extended, and enhanced opportunities for youth physical activity promotion.

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.

Factors Influencing Implementation of Youth Physical Activity Interventions: An Expert Perspective

ABSTRACT Little is known about the factors that influence implementation of physical activity interventions undertaken in youth-serving settings, and this lack of information impedes the development of effective implementation strategies. This study convened a panel of experts to identify factors that are most important in achieving successful implementation of physical activity interventions in youth-serving organizations. Five recognized experts participated in a four-round, modified Delphi consensus process. The panelists were asked to achieve consensus on a list of potential factors that are most important in predicting successful implementation and on the descriptions of these factors. They also provided estimates regarding the individual contributions each of the identified factors make in predicting a successful implementation. These estimates were then translated into Bayesian predictive models for factor selection. The expert panel achieved consensus on 23 factors. Results from the factor selection procedures indicated that a final model containing 15 factors yielded the greatest contributions in predicting successful implementation of youth physical activity interventions. In this final model, five factors were classified as organizational characteristics, six factors as implementation processes, two factors as provider characteristics, and two factors as program characteristics and community-level factors, respectively. In conclusion, this is the first study to identify factors that are important in achieving a successful implementation of youth physical activity interventions through systemically gathering information from a panel of experts. The 15 factors identified in this study provide important information to inform implementation planning and evaluation of future interventions.

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F-67 Thematic Poster - Physical Activity Interventions in Youth: Novel Strategies Friday, May 29, 2015, 3: 15 PM - 5: 15 PM Room: 28E: PDF Only

B-41 Free Communication/Poster - Physical Activity Interventions in Youth

The long-term effects of concussion have been widely debated. Evidence suggests there are persistent changes in cognitive function and but balance and gait performance alterations have also been observed to a lesser degree. It is unclear if motor alterations are limited to gait and balance. PURPOSE: To assess the long-term effects of concussion on visuomotor performance of the hand and foot in those with and without a history of concussion. METHODS: Twenty-seven college-aged participants were divided into a control (n = 13) and previously concussed (n = 14) groups based on medical self-report. Each participant signed an Institutional Review Board approved consent form. Using the hand or foot to squeeze an air-filled, rubber bladder, each participant applied pressure that matched the movement pattern of a visual stimulus during a continuous tracking task. Each participant completed three blocks of tracking for both the hand and foot. Each block consisted of three 30 second trials. RESULTS: Independent samples t-Tests and Cohen’s D effect sizes were calculated to compare root mean squared errors between groups. For the hand, baseline performance (Block 1) was not different between the control and concussed groups (6.98 ± .98 vs 7.03 ± .93; p = .44; Cohen’s d = .17). However, for Blocks 2 the control group demonstrated less tracking error that the concussed group (5.92 ± .74 vs 6.51 ± 1.10; p = .06; Cohen’s d = .83). This difference was persistent but reduced for Block 3 (6.02 ± .89 vs 6.32 ± .90; p = .21; Cohen’s d = .43). There were no differences between groups when using the foot to perform the tracking task. CONCLUSION: These preliminary data suggest that young adults without a concussion history demonstrate greater performance improvements quicker than individuals with a history of concussion. The previously concussed group may be applying a compensatory mechanism that prolongs the rate of performance improvement. How this observed trend affects daily living is still unknown, further research is needed.

E-29 Free Communication/Poster - Physical Activity Interventions in Youth

E-29 Free Communication/Poster - Physical Activity Interventions in Youth

Physical Activity Interventions for Adolescents: An Ecological Perspective

Many factors contribute to the decline in physical activity (PA) observed during adolescence. We used an ecological framework to review 30 publications of PA interventions published between 1977 and 2009 targeting youth aged 12-18 years (19 PA interventions). We included studies that measured a primary outcome of PA and also examined intervening variables. Most studies targeted the intrapersonal and environmental domains. The body of literature on PA interventions in youth suggests the importance of targeting ecological domains beyond the individual level. Future investigations should be theory-based and include analysis of mediators across ecological domains in order to identify the most effective combination of factors to promote PA in youth.

Developing physical activity interventions for youth with cystic fibrosis and congenital heart disease: Learning from their parents

Despite the benefits of physical activity for youth with cystic fibrosis (CF) and congenital heart disease (CHD), most are insufficiently active. More information is required on how to facilitate physical activity in these populations. Although there are no studies that provide information about participation in CF and CHD youth from the perspective of parents, the involvement of caregivers may be an important facilitator to physical activity in youth with chronic diseases. Objective This qualitative study explored how the parents of youth with CF and CHD experience physical activity, and parents commented on both their own and their child’s physical activity. Methods Twenty-nine parents from a CHD and CF clinic participated in a semi-structured interview, and a thematic analysis of the transcribed data was undertaken. Results Parents discussed the numerous benefits and barriers associated with physical activity for both child and self. Role modeling was a critical social process to overcoming barriers. Parents experiences were situated within the broader family context characterized by a prevailing sense of stress and complexity. Conclusion By illustrating how the parents of youth with CF and CHD understand the role of physical activity in their and their child’s life, this study provides valuable information regarding the development of interventions to increase physical activity among children with CF and CHD.

Physical activity from early childhood to adolescence: a literature review of issues and interventions in disadvantaged populations

Background: This paper is based on a report commissioned by the South Australian Health Department to undertake a literature review identifying key physical activity interventions in ‘different’ populations. This paper presents the findings from the literature surrounding youth from early childhood through to adolescence only.&#x0D; Methods: We conducted a comprehensive literature search using the following online academic databases: Proquest, Informit, Blackwell Synergy, Sage Publications, CINAHL and Cochrane. The search targeted peerreviewed articles, systematic reviews and evaluations. Each search used the term ‘physical activity and’, using the Boolean ‘or’ exercise. Using the Boolean ‘and’ combinations of the following words were added: low socioeconomic position ‘or’ low socioeconomic status, culture, intervention, health promotion, evaluation, strategies, South Australia, Australia. We also reviewed Australian government websites.&#x0D; Results: There are myriad reasons for the success or failure of physical activity interventions for youth ranging from parental influences, gender and age, culture, socioeconomic status, and social and physical environments.&#x0D; Conclusions: Multi-faceted approaches to interventions are required to achieve optimal outcomes for youth from early childhood through to adolescence. School provides an ideal site to engage students in physical activity. However ‘curriculum-only’ strategies do not work. Engaging parents&#x0D; in the interventions will heighten the probability of success.