Physical Activity Interventions For Children Research Articles

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)

A school-based physical activity intervention for children with developmental coordination disorder: A randomized controlled trial

BackgroundChildren with developmental coordination disorder (DCD) have lower physical activity (PA) than children with typical development (TD). PA and fundamental movement skills (FMS) are positively associated so interventions that promote FMS of children with DCD are recommended. AimTo examine the effects of a school-based FMS training program on motor functions, PA and other psychological outcomes. Methods and proceduresA total of 131 primary children were allocated to FMS training groups (DCD-FMS n = 35, TD-FMS n = 29), which received FMS training (eight weekly 40-min sessions), or to control groups (DCD-C n = 34, TD-C n = 33), which received conventional physical education lessons. Outcome measures, including accelerometer-assessed PA, motor functions, and self-perceived competence and enjoyment, were measured at baseline, 1-week (immediate effect), 3-months (short-term effect) and 12-months (longer-term effect) after the intervention. Outcomes and resultsFMS training resulted in improved FMS proficiency and increased PA and enjoyment of activity participation in children. In particular, the DCD-FMS group reported greater enjoyment over time. Some effects were also evident for both short- and longer-term. Conclusions and implicationsThe findings suggest that a school-based FMS training program has the potential to promote physical and psychological health in children with DCD in the long run.

Developing physical activity interventions for children with a visual impairment: Lessons from the First Steps initiative

Children with a visual impairment are less active than their sighted peers. Yet, they are born with the potential to match their sighted peers’ motor skill competency and levels of physical fitness. Environmental barriers are one of the main causes of inequities. This article provides insight on these issues, drawing upon a physical activity intervention called ‘First Steps’, a British Blind Sport initiative that aimed to get more children with a visual impairment more active. Physical activity packs were delivered to 53 children, aged 5–15 years, with a visual impairment. Of these participants, 62% had additional impairments or medical conditions. A mixed-methods approach was used to gather participants’ experiences of physical activity prior to receiving this pack and canvas opinion on how the pack changed their activity levels. The findings revealed inequitable experiences of physical activity. The First Steps pack made considerable progress in developing children’s physical activity levels. Participants’ motor skills, social interactions, and confidence improved. Organisations working with this population might look to adopt a similar concept. Recommendations for those wishing to do so are provided.

Are school-based physical activity interventions effective and equitable? A systematic review and meta-analysis of cluster randomised controlled trials

BackgroundChildhood obesity is increasing globally, with widening inequalities by socioeconomic status and sex. The aim of this study was to assess the efficacy of school-based physical activity interventions on children's daily moderate-to-vigorous physical activity (MVPA), and variations in efficacy by sex and socioeconomic status. MethodsWe systematically searched six electronic databases (ERIC, EMBASE, OVID Medline, PsycINFO, Scopus, SPORTDiscus) from inception to Feb 24, 2017. Search terms included “children”, “physical activity”, “cluster-randomized controlled trial”, and “accelerometer”. Inclusion was restricted to trials published in English of school-based physical activity interventions with accelerometer-assessed MVPA across the full day. After duplicate data extraction and quality assessment, lead authors were sent re-analysis requests. For each trial a mean change score from baseline to follow-up was calculated for daily minutes of accelerometer-assessed MVPA, for the main effect, by sex, and by socioeconomic status. Effects were pooled in random effects meta-analyses. Heterogeneity was explored with meta-regressions and subgroup meta-analyses. This study is registered with PROSPERO, CRD42017062565. Findings25 trials met the inclusion criteria; 17 trials (9044 participants) of predominantly multicomponent (88%), multisetting interventions (77%) provided relevant data and were included in meta-analyses. There was no effect of activity interventions on MVPA (standardised mean difference [SMD] 0·02, 95% CI −0·07 to 0·11). There was no evidence of differential efficacy by sex (SMD girls 0·07, 95% CI −0·07 to 0·21; boys 0·05, −0·09 to 0·19) or socioeconomic status (low −0·01, −0·12 to 0·11; middle −0·06, −0·17 to 0·05; high −0·01, −0·13 to 0·11). InterpretationThis review provides strong evidence that current school-based efforts do not increase young people's daily physical activity, with no difference in effect across sex and socioeconomic status. This is the first meta-analysis, to our knowledge, of children's physical activity interventions to pool accelerometer data with comparable outcome metrics. Our findings conflict with most previous syntheses, which have included substantial self-report data and reported positive effects. Further assessment, maximisation of implementation fidelity, and consideration of wider (including health) benefits is needed before these interventions can be concluded to have no contribution to make to children's health promotion. Until then we recommend that interventions are limited to research contexts. FundingMedical Research Council, British Heart Foundation, Cancer Research UK, Economic and Research Council, National Institute for Health Research, Wellcome Trust, Gates Cambridge.

“I’m not in this alone” the perspective of parents mediating a physical activity intervention for their children with autism spectrum disorder

Background and aimsWeb-based, parent-mediated interventions have shown to be beneficial for children with autism spectrum disorder (ASD) in a variety of domains. We aimed to examine how parents of children with ASD perceive mediating a physical activity intervention delivered via a private Facebook group. MethodsThirteen families participated in a four-week trial of Project CHASE. Inductive thematic analysis of semi-structured interviews and interactions within the Facebook group were conducted to elicit the perspective of the parents. Outcomes and resultsThematic analysis resulted in three themes emerging: (1) ‘Remembering to Act’ encompassed the participants’ perspectives of Project CHASE as being an intervention that reminded them of the importance of physical activity, and served as a prompt for them to take action; (2) ‘A sharing community’ included the subthemes of ‘sharing success and struggles’ and ‘sharing ideas’; and, (3) ‘Taking control: possibilities and problems’ encapsulates the dichotomy between participants who spoke of embracing and rising to the challenge of taking control, with the parents who spoke of the need for more support, direction, and guidance. Conclusion and implicationThe current study suggests parent-mediated, web-based interventions may have the potential for improving the effectiveness of physical activity interventions for children with ASD.

Preliminary Feasibility and Acceptability of the Remote Food Photography Method for Assessing Nutrition in Young Children with Type 1 Diabetes.

Nutrition is a critical component of diabetes and other chronic diseases for young children. However, nutritional intake is burdensome to measure accurately and easily, making it difficult to evaluate in research or clinical contexts. This pilot study examined the feasibility and acceptability of having parents of young children with T1D use the Remote Food Photography Method (RFPM) to measure breakfast nutrition. Participants were 9 mothers of children ages 2-5 years (Mage=4.2), with a T1D duration of at least 1 year (Mage=2.4 years at diagnosis), representing diverse backgrounds (55.6% Caucasian; 44.4% African American; 55.6% married). During baseline and follow-up of a healthy eating and physical activity intervention for children with T1D, parents used the RFPM to capture before and after images of their children's breakfast. Feasibility and acceptability were assessed by adherence to taking photos, percent of usable photos, and participant satisfaction. The RFPM was feasible across participants with high adherence rates (100% at baseline and 87% at follow-up) for sending usable photographs. Most participants reported satisfaction with the method. Using the RFPM to assess nutrition in a small sample of young children with T1D was feasible and acceptable. Given the importance of assessing nutrition in young children with T1D as well as other chronic illnesses (e.g., cystic fibrosis, obesity), the RFPM may be a useful tool for both research and clinical data collection in lieu of other methods. More research is needed to evaluate reliability and validity of RFPM in pediatric populations.

Variability in school children's activity occurs in the recess and before-school periods.

An accurate description of physical activity (PA) at school is required for appropriate health interventions. We examined PA patterns in children, and identified the time periods that influenced them. Forty students in five Japanese primary schools were asked to wear triaxial accelerometers for ≥7days. We obtained coefficients of variance (CV) at 15min intervals, and conducted factor analysis of the school periods. A questionnaire was used to investigate where students spent time before school, and during recess. The amount of PA, and its CV were higher around 8a.m. (before-school period), 10a.m. (morning recess), 1p.m. (lunch recess), and 4p.m. (commuting home from school). Moderate-vigorous PA (MVPA; ≥3.0 metabolic equivalent units [MET]) was highest during lunch recess and the after-school period (12.9 ± 7.4min and 12.6 ± 6.2min, respectively). The percentage of MVPA time was high (>15%) in the before-school period and morning and lunch recesses, but low (10%) in the after-school period. On factor analysis there were differences in PA patterns between the school period and the after-school period. The students who spent their time in the playground logged more MVPA time and less sedentary time (≤1.5 MET) than those who did not spend their time in the playground. Activities before school, and in the morning and lunch recesses influenced daily PA, and were different from after-school PA. Close attention to these periods may help in defining PA parameters during free time at school for PA interventions in children.

Enabling physical activity participation for children and youth with disabilities following a goal-directed, family-centred intervention

BackgroundThere is a paucity of research demonstrating the optimisation and maintenance of participation outcomes following physical activity interventions for children and youth with disabilities. AimTo evaluate changes in physical activity participation in children with disabilities following a goal-directed, family-centred intervention at a healthsports centre, and to identify factors influencing participation following the intervention. Methods and proceduresA mixed methods pre-test post-test cohort design was applied. Recruitment occurred over a 12 month period during standard clinical service provision. The Canadian Occupational Performance Measure (COPM) was administered to children and parents pre (T1) and post-intervention (T2), and at 12 weeks follow-up (T3). Goal Attainment Scaling (GAS) was applied to assess outcomes at 12 weeks follow-up (T2–T3). Qualitative inquiry described barriers to goal attainment at T3. Outcomes and resultsNinety two children with a range of disabilities (mean age 11.1yr; 49 males) were included in the study. Statistically significant and clinically meaningful improvements in parent ratings of COPM performance and satisfaction of participation goals were observed following intervention. Ratings at 12 weeks follow-up remained significantly higher than baseline, and 32% of children attained their COPM-derived GAS goal. Environmental factors were the most frequent barrier to goal attainment following intervention. Conclusion and implicationsThese results provide preliminary evidence for goal-directed, family-centred interventions to optimise physical activity participation outcomes for children with disabilities.

A physical activity intervention for children with type 1 diabetes- steps to active kids with diabetes (STAK-D): a feasibility study

BackgroundThis study describes the development and feasibility evaluation of a physical activity intervention for children with type 1 diabetes called ‘Steps to Active Kids with Diabetes’ (STAK-D). It aims to explore the feasibility and acceptability of the intervention and study design.MethodsThirteen children aged 9–11 years and their parents were recruited from one paediatric diabetes clinic. A process evaluation was conducted alongside a two-arm randomised feasibility trial, including assessment of rate of recruitment, adherence, retention, data completion and burden, implementation fidelity and adverse events. Qualitative interviews with children (n = 9), parents (n = 8), healthcare professionals (n = 3) and STAK-D volunteers (n = 8) explored intervention acceptability. Interviews were analysed thematically.ResultsRate of recruitment was 25%, with 77% retention at 3-month follow-up. Study burden was low, data completion was high and the intervention was delivered as per protocol. No serious adverse event was reported. Engagement with intervention materials was generally good, but attendance at group activity sessions was low due to logistical barriers. Interview analysis identified preferred methods of recruitment, motivations for recruitment, barriers and facilitators to adherence, the experience of data collection, experience of the STAK-D programme and its perceived benefits.ConclusionsSTAK-D was feasible and acceptable to children, their parents and healthcare professionals, but group sessions may present logistical issues. Recruitment and retention may be improved with a clinic-wide approach to recruitment.Trial registrationThis trial was registered on ClinicalTrials.gov: NCT02144337 (16/01/2014).

Physical activity interventions for children and young people with cerebral palsy.

This commentary is on the systematic reviews by Bloemen et al. and Reedman et al. on pages 1004–1010 and 1011–1018 of this issue.

Examining How Neighborhood Socioeconomic Status, Geographic Accessibility, and Informational Accessibility Influence the Uptake of a Free Population-Level Physical Activity Intervention for Children.

To evaluate the uptake of ACT-i-Pass (G5AP), a physical activity (PA) intervention that provides free access to PA opportunities, and to understand the extent to which the intervention provides equitable access to children. This study evaluates the differences in uptake (ie, enrollment) by comparing postal codes of registrants with the postal codes of all eligible children. Children were provided the opportunity to register for the G5AP during the 2014 to 2015 school year in London, Canada. The population of grade 5 students in London who registered for the G5AP (n = 1484) and did not register (n = 1589). The G5AP offered grade 5 students free access to select PA facilities/programs during 2014 to 2015 school year. Measures included G5AP registration status, method of recruitment, distance between home and the nearest facility, and neighborhood socioeconomic status. Getis-Ord Gi* and multilevel logistic regression were used to analyze these data. There were significant differences in the uptake of the G5AP: residing in neighborhoods of high income (odds ratio [OR] = 1.062, P = .029) and high proportion of recent immigrants (OR = 1.036, P = .001) increased the likelihood of G5AP registration. Children who were recruited actively were significantly more likely to register for the G5AP (OR = 2.444, P < .001). To increase the uptake of a PA intervention, children need to be actively recruited. Interactive presentations provide children with increased access to information about both the program and its nuances that cannot be communicated as effectively through passive methods.

Physical Activity Interventions for Children with Social, Emotional, and Behavioral Disabilities-A Systematic Review.

Perform a systematic review of the available literature regarding the effectiveness of exercise interventions on children with any type of social, emotional, or behavioral disability (SEBD), with attention to a range of physiological, behavioral, and mood outcomes. Six databases were searched using a systematic methodology. References of included studies, as well as relevant reviews, were also examined. The review was limited to studies published since 2000 reporting a quantitative analysis of the effects of a physical activity (PA) intervention on at least 1 behavioral, psychological, or cognitive outcome in children aged 21 and under, diagnosed with a SEBD. Only studies with a control group were included. We identified 24 eligible studies. Studies varied in design, participant characteristics, and intervention characteristics (single-bout vs repeated exposure, duration, intensity level, mode of exercise). Of the 20 behavioral outcome assessments, there was 1 negative finding, 12 null findings, 5 positive findings, and 2 mixed findings. For the 25 executive functioning outcome assessments, there were 5 null findings, 18 positive findings, and 2 mixed findings. For the remaining outcome domains, 1 of 2 studies looking at academic performance, 3 of 6 studies looking at objective neurological measures, and 1 of 3 studies looking at affect outcomes found positive results. All other results were null or mixed. Although additional research is warranted to further understand the mechanisms by which PA affects behavioral and cognitive outcome measures in children with SEBDs, PA offers a safe and alternative form of treatment for this population.

School-based physical activity interventions for children and youth: Keys for success

Given the rising trend in obesity in children and youth and age-related decline in moderate-to- vigorous-intensity physical activity (MVPA) in several Western, African, and Asian-Pacific countries1 and strong evidence that past physical activity (PA) interventions have had only a small effect on children's and youth's overall activity levels,2 it is important to clarify whether school-based PA interventions warrant resource allocation. Schools represent an accessible and cost-effective setting from which to stimulate engagement in PA because an underlying link already exists within that curriculum domain, and there is the potential to directly reach all cohorts of children and youth.3 School-based PA interventions fall into 5 broad categories: physical education (PE) curriculum, classroom activity breaks, active commuting to school, modified playgrounds, and comprehensive approaches that combine these approaches.4 Previous reviews of PA1 and school-based interventions4 for children and youth highlight the following key points in order to increase the effectiveness of future efforts to promote PA behavior in the school context.

Designing a physical activity intervention for children with asthma: a qualitative study of the views of healthcare professionals, parents and children with asthma

ObjectivesQualitative methods were used to examine: (1) the attitudes of health professionals to promoting physical activity for children with asthma; (2) reasons why children with asthma are less active and...

An intervention to promote physical activity in Mexican elementary school students: building public policy to prevent noncommunicable diseases.

Physical activity is an important component of strategies for health promotion and prevention of noncommunicable diseases. It is also associated with decreased risk for cardiovascular disease in overweight and obese adults and children. This article addresses the initial description of a physical activity intervention for children attending public elementary schools in Mexico. The objective was to develop a replicable model based on a strategic public, private, academic, and social partnership that would have a short-term impact on the metabolic health of children and be useful for building effective public policy. Forty-nine schools (20000 students) participated, and 5 schools were selected for evaluation. The intervention included a 30-minute supervised middle-effort interchangeable routine, 5 days a week for a complete school year, adapted for different school conditions and students of different ages. Evaluation included anthropometric measurements and biochemical markers. Actual prevalence of combined overweight and obesity in these children was 31.9%. The intervention was successfully implemented in all schools. No change in body mass index, waist circumference, or other anthropometric indicators was found. However, changes in biochemical markers showed a significant decrease in blood glucose, total cholesterol, and cholesterol-low-density lipoproteins, reflecting a positive effect on cardiovascular health indicators.

The Influence of Neighborhood Crime on Increases in Physical Activity during a Pilot Physical Activity Intervention in Children.

The purpose of this study was to examine whether neighborhood crime moderated the response (increases in steps) to a pilot intervention to increase physical activity in children. Twenty-seven insufficiently active children aged 6-10 years (mean age = 8.7 years; 56 % female; 59 % African American) were randomly assigned to an intensive intervention group (IIG) or minimal intervention group (MIG). Change in average daily number of steps from baseline was regressed against an index of neighborhood crime in a multilevel repeated-measures model that included a propensity score to reduce confounding. Safer neighborhoods were associated with higher increases in steps during the pilot intervention (interaction p = 0.008). Children in the IIG living in low-crime neighborhoods significantly increased their physical activity (5275 ± 1040 steps/day) while those living in high-crime neighborhoods did not (1118 ± 1007) (p for difference = 0.046). In the IIG, the increase in daily steps was highly correlated with neighborhood crime (r = 0.58, p = 0.04). These findings suggest the need for physical activity interventions to account for participants' environments in their design and/or delivery. To promote healthy behaviors in less-supportive environments, future studies should seek to understand how environments modify intervention response and to identify mediators of the relationship between environment and intervention.

A systematic review and meta-analysis of energy and macronutrient intake responses to physical activity interventions in children and adolescents with obesity.

The effects of regular physical activity on energy intake in obese adolescents are unknown. The objective is to determine how physical activity interventions affect energy and macronutrient intake in overweight/obese youth. Databases were searched from December 2014 to December 2015 for studies that measured energy and/or macronutrient consumption in response to physical activity intervention in overweight/obese youth. The review comprises primary source articles published in English in peer-reviewed journals. Articles that presented data on energy and/or macronutrient intake before and after a physical activity intervention (without dietary restriction) in overweight or obese children and teenagers (up to 18 years old) were included. Of the initial 307 references found, nine were included. The nine included studies analysed the effect of 15 different physical activity interventions. Nine showed a decrease and six unchanged energy intakes. The effect size for total energy intake ranged from -2.108 to -0.207 (n = 14). Results of the meta-analysis revealed a mean effect of physical intervention to reduce intake of -1.003 (95% confidence interval = -1.261 to -0.745, p < 0.001). Results for heterogeneity among these studies were I2 = 67.421; Q = 39.903; df = 13, p < 0.001. The mean energy intake reduction was -323 ± 286 kcal. Macronutrient intake was assessed in 11 interventions. Protein intake was found decreased in five (reduction of -26.8 ± 19.2 g), seven reported fat decrease (reduction of -26.4 ± 17.8 g) and five a decrease in CHO (reduction of -72.5 ± 22.8 g). The meta-analysis revealed significant decreases of each macronutrient (p < 0.001). Structured physical activity interventions favour decreased daily energy intake in obese adolescents.

Interdisciplinary, child-centred collaboration could increase the success of potentially successful Internet-based physical activity interventions.

Physical activity promotes health in children and adolescents, but activity levels are low. The Internet offers opportunities for physical activity interventions because children and adolescents are widely exposed to the web and enjoy being online. This review investigated the success of Internet-based interventions designed to increase physical activity in children and adolescents. Of the 13 studies we included, five reported that Internet-based interventions had significant effects on most physical activities. Internet-based physical activity interventions in children and adolescents are potentially successful, but interdisciplinary, child-centred collaboration is needed to design interventions that align with their Internet experiences and preferences.

Parental views of children's physical activity: a qualitative study with parents from multi-ethnic backgrounds living in England.

BackgroundGuidelines recommend children and young people participate in at least 60 min of physical activity (PA) every day, however, findings from UK studies show PA levels of children vary across ethnic groups. Since parents play an instrumental role in determining children’s PA levels, this article aims to explore parental views of children’s PA in a multi-ethnic sample living in a large city in the North-West of England.MethodsSix single-ethnic focus groups were conducted with 36 parents of school-aged children (4 to 16 years) with a predominantly low socio-economic status (SES). Parents self-identified their ethnic background as Asian Bangladeshi (n = 5), Black African (n = 4), Black Somali (n = 7), Chinese (n = 6), White British (n = 8) and Yemeni (n = 6). Focus group topics included understanding of PA, awareness of PA guidelines, knowledge of benefits associated with PA and perceived influences on PA in childhood. Data were analysed thematically using QSR NVivo 9.0.ResultsParents from all ethnic groups valued PA and were aware of its benefits, however they lacked awareness of PA recommendations, perceived school to be the main provider for children’s PA, and reported challenges in motivating children to be active. At the environmental level, barriers to PA included safety concerns, adverse weather, lack of resources and lack of access. Additional barriers were noted for ethnic groups from cultures that prioritised educational attainment over PA (Asian Bangladeshi, Chinese, Yemeni) and with a Muslim faith (Asian Bangladeshi, Black Somali, Yemeni), who reported a lack of culturally appropriate PA opportunities for girls.ConclusionParents from multi-ethnic groups lacked awareness of children’s PA recommendations and faced barriers to promoting children’s PA out of school, with certain ethnic groups facing additional barriers due to cultural and religious factors. It is recommended children’s PA interventions address influences at all socio-ecological levels, and account for differences between ethnic groups.

Results of a 3-year, nutrition and physical activity intervention for children in rural, low-socioeconomic status elementary schools.

Improving children's nutrition and physical activity have become priorities in the United States. This quasi-experimental study evaluated the longitudinal effects of a 3-year, school-based, health promotion intervention (i.e. nutrition and physical education, classroom physical activity, professional development and health promotion for teachers and families, and strengthening wellness policies and family/community partnerships) on children's health behaviors in four, rural, low-socioeconomic status elementary schools. A total of 999 kindergarten to third-grade children participated in data collection consisting of 4-day pedometer tracking and previous-day fruits and vegetables consumption recall from baseline in January, 2011 through 12 follow-up assessments ending May, 2013. The mixed-effects regression models showed that children's nutrition and physical activity behaviors significantly improved over the 3-year intervention. The percentages of children who met the nutrition recommendation increased from 11 to 23% for girls and 12 to 23% for boys, while the percent who met the physical activity recommendation increased from 1 to 16% for girls and 3 to 7% for boys. Further, children's age and their school impacted certain intervention effects. This school-based intervention could be disseminated to promote healthy behaviors among rural disadvantaged children. Engaging parents and community partnerships is recommended to expand the traditional, children-focused education interventions.