Provision Of Physical Activity Research Articles

School-level intra-cluster correlation coefficients and autocorrelations for children’s accelerometer-measured physical activity in England by age and gender

BackgroundRandomised, cluster-based study designs in schools are commonly used to evaluate children’s physical activity interventions. Sample size estimation relies on accurate estimation of the intra-cluster correlation coefficient (ICC), but published estimates, especially using accelerometry-measured physical activity, are few and vary depending on physical activity outcome and participant age. Less commonly-used cluster-based designs, such as stepped wedge designs, also need to account for correlations over time, e.g. cluster autocorrelation (CAC) and individual autocorrelation (IAC), but no estimates are currently available. This paper estimates the school-level ICC, CAC and IAC for England children’s accelerometer-measured physical activity outcomes by age group and gender, to inform the design of future school-based cluster trials.MethodsData were pooled from seven large English datasets of accelerometer-measured physical activity data between 2002–18 (> 13,500 pupils, 540 primary and secondary schools). Linear mixed effect models estimated ICCs for weekday and whole week for minutes spent in moderate-to-vigorous physical activity (MVPA) and being sedentary for different age groups, stratified by gender. The CAC (1,252 schools) and IAC (34,923 pupils) were estimated by length of follow-up from pooled longitudinal data.ResultsSchool-level ICCs for weekday MVPA were higher in primary schools (from 0.07 (95% CI: 0.05, 0.10) to 0.08 (95% CI: 0.06, 0.11)) compared to secondary (from 0.04 (95% CI: 0.03, 0.07) to (95% CI: 0.04, 0.10)). Girls’ ICCs were similar for primary and secondary schools, but boys’ were lower in secondary. For all ages, combined the CAC was 0.60 (95% CI: 0.44–0.72), and the IAC was 0.46 (95% CI: 0.42–0.49), irrespective of follow-up time. Estimates were higher for MVPA vs sedentary time, and for weekdays vs the whole week.ConclusionsAdequately powered studies are important to evidence effective physical activity strategies. Our estimates of the ICC, CAC and IAC may be used to plan future school-based physical activity evaluations and were fairly consistent across a range of ages and settings, suggesting that results may be applied to other high income countries with similar school physical activity provision. It is important to use estimates appropriate to the study design, and that match the intended study population as closely as possible.

Physical Activity-Related Practices and Psychosocial Factors of Childcare Educators: A Latent Profile Analysis.

Limited research investigates early childhood education and care (ECEC) educators' involvement in promoting physical activity. The aim was to identify distinct profiles based on physical activity-related practices and psychosocial factors in ECEC educators and examine how they relate to the amount of time allocated to children's physical activity. A secondary analysis of educator-reported survey data from the Play Active study was undertaken. Educators (n = 532) reported on four practices and four psychosocial subscales adapted from the Environment and Policy Evaluation and Observation relating to the provision of physical activity in childcare. Latent profile analysis was used to identify distinct groups of educators based on their practices and psychosocial factors. Logistic regression analysed associations between latent profiles and educator-reported time provided for children's physical activity. Five profiles of educators' physical activity-related practices and psychosocial factors were identified. Profiles with higher practice scores also had higher psychosocial scores. Educators in profiles characterised by higher scores had greater odds of meeting the best practice guidelines for daily time allocated to children for total physical activity and energetic play. This study highlights interventions which address multiple educator behaviour change determinants to improve children's physical activity in childcare.

Preservice Classroom Teachers’ Self-Efficacy Toward Providing Physical Activity in the Classroom

Purpose: The purpose of this study was to understand preservice classroom teachers’ perceptions of and efficacy toward providing physical activity (PA) during the school day. Method: One hundred and seventy-one participants (89% women; 12 universities; 25% secondary) participated in this exploratory sequential mixed-methods study. Teachers participated in a survey that included validated scales, and 20 teachers participated in follow-up interviews. Results: A series of analyses of variance showed significant differences between level of certification sought and teacher efficacy toward providing PA, specifically in areas of institutional and general self-efficacy. Regressions revealed that PA enjoyment was the only significant predictor of teacher efficacy (general, psychological, institutional, and educational efficacy) toward providing PA. Qualitative themes included: (a) perceived benefits of PA, (b) the need for meaningful preparation, and (c) motivation and enjoyment. Conclusion: Increasing PA enjoyment and providing professional development could help preservice classroom teachers be more efficacious toward providing PA in the classroom.

Exploring Mental Health Professionals’ Perceptions of Physical Activity Provision for Mental Health Service Users

Exploring Mental Health Professionals’ Perceptions of Physical Activity Provision for Mental Health Service Users

Towards the standardization of physical activity programs for severe mental ill health: A survey of current practice across 54 mental health trusts in England

AimsWhile physical activity (PA) is recommended in the treatment of severe mental illness (SMI), there are no standardized processes for implementing PA in mental healthcare, and the extent to which PA programs have been implemented is unknown. Therefore, we sought to describe usual care in terms of the provision of PA in the National Health Service (NHS) mental health trusts in England for people with SMI. MethodsWe invited all NHS Mental Health Trusts across England to participate in a bespoke survey. ResultsFifty-two mental health trusts (96.2%) responded, of which 47 (87%) offered some form of physical activity provision. The provision across these 47 trusts comprised 93 different types of PA programs. The programs that were identified showed vast differences in the types of physical activity offered, the settings in which they were provided, and the providers. ConclusionsAlthough existing mental healthcare services are demonstrating good practice in some areas, the findings of this survey underline the pressing need for more standardization of PA programs that are delivered to people with SMI, better allocation of resources, staff training, improved monitoring of the delivery of these programs, and better PA support for patients as they transition to community care.

Making the Case for Standardized Outcome Measures in Exercise and Physical Activity Research in Chronic Kidney Disease

Physical activity and exercise are core components of lifestyle modification strategies for the management of chronic kidney disease (CKD). Yet, physical activity levels have consistently remained poor across all stages of CKD. Exercise interventions, including aerobic and resistance training, and lifestyle interventions promoting physical activity, have been shown to improve a multitude of clinical endpoints and factors important to patients; however, despite the evidence, the provision of physical activity in clinical practice is still inadequate. The usefulness of any study hinges on the adequacy and clinical relevance of the outcomes and outcome measures used. Inconsistent reporting and wide disparities in outcome use across studies limit evidence synthesis to help guide clinical practice. The kidney exercise and physical activity field has been particularly prone to inconsistent outcome reporting. To ensure research is relevant and able to influence clinical practice and future research, we need to ensure the use (and reporting) of standardized, relevant outcome measures. Core outcome sets (COS) have been widely developed across many chronic conditions, yet these COS have not been tailored to physical activity and exercise in CKD. Outcomes in clinical research need to be relevant to the intervention being employed. From this perspective, we summarize the importance that standardizing outcomes and outcome measures may have in relation to physical activity and exercise interventions for people living with kidney disease.

Factors associated with provision of physical activity in primary schools in Makindye Division in Kampala, Uganda: a cross-sectional study

BackgroundGlobally, school-going children spend most of their days at school, sitting in lessons and unable to achieve the daily WHO recommendations for Physical Activity (PA) of at least 60 minutes per day. Limited studies have assessed the opportunities schools provide for PA to help the children achieve their daily recommended PA. We determined the level of and the factors associated with PA offered in primary schools in Makindye Division in Kampala during the school term.MethodsThis cross-sectional study was conducted in 36 selected government and private primary schools in Makindye Division, Kampala. PA was defined as the amount of time in minutes available for PA as per WHO recommendations – sufficient (60 minutes or more of PA) or insufficient (less than 60 minutes of PA) and assessed for any factors associated with provision of time for PA in schools. Data were collected by interview administered questionnaires and analysed descriptively. Factors associated with PA were assessed using a logistic regression model.ResultsOf the 36 schools, 3 were government and 33 were private schools. The proportion of schools offering sufficient time for PA among Primary schools in the Makindye Division was (8/36) 22%. The average time for PA for all schools per week was 197 minutes (SD 70.7). Sufficient PA was associated with the provision of PE lessons after a break or after lunch (p-value 0.038). Sufficient PA was more likely in schools that offered volleyball (OR 8.69), had space in the school for PA (OR 13.27), provided athletics (OR 2.26) and whose fees were Ushs 700,000 (USD 187) or more (OR 1.30).ConclusionsOnly 22% of sampled schools offered sufficient time for PA among Primary schools in Kampala per WHO guidelines. Provision of sufficient time for PA was associated with PE scheduled either after break or lunch. Sufficient PA was more likely with schools that had space for PA, schools which offered volleyball and athletics, and whose fees were 700,000/= or more.Schools should consider scheduling PE lessons after break or after lunch to increase the likelihood of meeting the targeted time for PA. Primary schools need to be supported to establish facilities and to increase diversity in available activities to ensure children achieve their recommended PA.

Experiences of physical activity for adolescents in secure psychiatric care: Staff and patient perspectives

This study presents a novel contribution to understanding physical activity provision in secure psychiatric care. This is the first study to directly explore adolescent experiences, and triangulate these perspectives with two staff groups, a multidisciplinary team and physical health practitioners. This study included semi-structured with nine physical health practitioners, thirteen members of a multidisciplinary team (MDT), and five adolescent patients. Through an inductive reflexive thematic analysis, we constructed three overarching themes i) institutional barriers to PA, ii) the rehabilitative benefits of PA and iii) the need for collaborative working. Many of the barriers to PA were a function of the secure environment, which was associated with restrictions on movement, perpetuated by limited staff availability to escort to PA sessions. However, there was a widespread agreement that PA was multi-beneficial for patient's rehabilitation, incorporating mood improvement, increased engagement and increase in pro-social behaviours. For PA promotion and physical health support to become embedded within the service provision, collaboration and support is needed from a wider network of staff members. This suggests that future intervention work should target change at an institutional level, which involves targeting organisational policy. Such work could support staff to promote PA and motivate adolescent patients to engage in PA, whilst also supporting patient physical health within their job role.

Assessing the Impacts of Creating Active Schools on Organisational Culture for Physical Activity.

National and international guidance recommends whole-school approaches to physical activity, but there are few studies assessing their effectiveness, especially at an organisational level. This study assesses the impact of the Creating Active School's (CAS) programme on organisational changes to physical activity provision. In-school CAS leads completed a 77-item questionnaire assessing school-level organisational change. The questionnaire comprised 19 domains aligned with the CAS framework and COM-B model of behaviour change. Wilcoxon Signed Rank Tests assessed the pre-to-nine-month change. >70% of schools (n = 53) pre-CAS had inadequate whole-school physical activity provision. After nine months (n = 32), CAS had a significant positive effect on organisational physical activity. The positive change was observed for: whole-school culture and ethos, teachers and wider school staff, academic lessons, physical education (PE) lessons, commute to/from school and stakeholder behaviour. This study provides preliminary evidence that CAS is a viable model to facilitate system-level change for physical activity in schools located within deprived areas of a multi-ethnic city. To confirm the results, future studies are required which adopt controlled designs combined with a holistic understanding of implementation determinants and underlying mechanisms.

Realising curriculum possibilities in Wales: teachers’ initial experiences of re-imagining secondary physical education

ABSTRACT This paper provides insight into secondary Physical Education (PE) teachers’ experiences of beginning to re-imagine secondary physical education provision in light of the new Curriculum for Wales, 2022 (CfW). Data were generated through analysis of semi-structured interviews (n = 5) with secondary PE teachers who participated in three workshops which uses a design-thinking methodology. Informed by Ball and colleagues’ conceptualisation of policy work, findings draw attention towards how engagement in the workshops provided a foundation for the participants to begin interpretation and translation of the new CfW and consider re-imagining existing PE provision within the school context. Participants’ interpretations of the new CfW centred around health and physical activity provision which were shaped by a connection with a range of health and physical activity stakeholders. This enabled participants to translate their ideas from the workshops into pedagogical practices within the school context. The paper concludes by suggesting secondary PE teacher’s realisation of the new CfW would be enhanced through opportunities to further integrate disciplinary ideas from health, sport, physical activity, and education across national and global contexts.

'Community reporting': an insight-generating approach for local authority physical activity provision.

'Community reporting': an insight-generating approach for local authority physical activity provision.

Accelerometer-measured physical activity and sedentary time among children and their parents in the UK before and after COVID-19 lockdowns: a natural experiment

BackgroundRestrictions due to the coronavirus disease 2019 (COVID-19) pandemic reduced physical activity provision for both children and their parents. Recent studies have reported decreases in physical activity levels during lockdown restrictions, but these were largely reliant on self-report methods, with data collected via unrepresentative self-report surveys. The post-pandemic impacts on children’s activity levels remain unknown. A key question is how active children become once lockdown restrictions are lifted.MethodsActive-6 is a repeated cross-sectional natural experiment. Accelerometer data from 1296 children aged 10–11 and their parents were collected in 50 schools in the Greater Bristol area, UK in March 2017-May 2018 (pre-COVID-19 comparator group), and compared to 393 children aged 10–11 and parents in 23 of the same schools, collected in May-December 2021. Mean minutes of accelerometer-measured moderate-to-vigorous physical activity (MVPA) were derived for weekdays and weekend and compared pre- and post-lockdown via linear multilevel models.ResultsAfter adjusting for seasonality, accelerometer wear time and child/parent demographics, children’s mean weekday and weekend MVPA were 7.7 min (95% CI: 3.5 to 11.9) and 6.9 min (95% CI: 0.9 to 12.9) lower in 2021 than in 2018, respectively, while sedentary time was higher by 25.4 min (95% CI: 15.8 to 35.0) and 14.0 min (95% CI: 1.5 to 26.5). There was no evidence that differences varied by child gender or household education. There was no significant difference in parents’ MVPA or sedentary time, either on weekdays or weekends.ConclusionsChildren’s MVPA was lower by 7–8 min/day in 2021 once restrictions were lifted than before the pandemic for all groups, on both weekdays and weekends. Previous research has shown that there is an undesirable age-related decline in children’s physical activity. The 8-min difference reported here would be broadly comparable to the decline that would have previously been expected to occur over a three-year period. Parents’ physical activity was similar to pre-pandemic levels. Our results suggest that despite easing of restrictions, children’s activity levels have not returned to pre-pandemic levels. There is an urgent need to understand why these changes have occurred and how long they are maintained.

The curriculum took a back seat to huff and puff: Teaching high school health and physical education during Covid-19.

This study examined secondary (high) school teachers’ experiences of online delivery of health and physical education (HPE) during Covid-19 suppression measures in one Australian state in 2020. Research has noted the use of blended learning and flipped classrooms in HPE, yet little is known about the delivery of fully online school HPE. Semi-structured interviews occurred with eight high school HPE specialist teachers, providing qualitative data for analysis. The analysis of teachers’ experiences indicated that in most cases HPE did not happen; rather, physical activity provision was initiated, or HPE was marginalised to a movement break between subjects with perceived higher status and priority. Additionally, teachers found that providing HPE online was challenging, and struggled to connect with, engage and provide equitable opportunities for their students online. The results showed that the move to online provision of HPE resulted in diminished educative purpose.

Sport policy formation and enactment in post-devolution Wales: 1999–2020

ABSTRACT Sport Wales (previously the Sports Council for Wales) is the lead non-government organisation for the delivery and management of sport policy in Wales and receives an annual grant from the Welsh Government, which is supplemented by additional money from the National Lottery. There are also 22 unitary authorities that are responsible for school and community-level sport and physical activity provision. The purpose of this article is to undertake a policy critique of sport in Wales since devolution. The provided commentary charts the development of Welsh sport policy since 1999 as part of an overall governmental emphasis on physical health and wellbeing. It is divided into the three organising themes that reflect three domains of sport and physical activity participation – school, community and elite. The analysis is predicated on a review of outcomes and impact on different sectors and draws upon (some) comparisons with the English context. The principal conclusion is that even though the Welsh Government has been led by the Labour Party since devolution, the adoption of neo-liberal principles has (at least implicitly) impacted negatively on policy formation and enactment. This article offers new insight into sports policy development and enactment in Wales since 1999 and draws attention, in particular, to the importance of sport and physical activity at a time of global pandemic as well as the neglect of black, Asian and minority ethnic groups in policy discourses.

Physical activity and its relationship with COVID-19 cases and deaths: Analysis of U.S. counties

PurposeThe study was to examine county-level associations of physical activity with coronavirus disease 2019 (COVID-19) cases and deaths, per 100,000 county residents. MethodsData were collected from publicly available data sources for 3142 counties and equivalents, including the District of Columbia. Subjective health ratings, percentage uninsured, percentage unemployed, median household income, percentage female residents, percentage White residents, percentage of residents 65 years of age or older, and rural designation served as controls. ResultsThe two-level random intercept regression showed that physical activity rates at the county level were statistically and negatively associated with COVID-19 cases and deaths. Additional analyses showed that physical activity rates moderated the relationship between cases and deaths, such that the relationship was strongest when physical activity rates were low. ConclusionThe results presented here offer empirical evidence of the benefits of county-level physical activity during a pandemic. Implications for public health and physical activity provision are discussed.

Experience of Using an Online Pre-Ordering System for A Workplace Canteen That Offers Lower-Energy Swaps: A Think-Aloud Study.

Online systems that allow employees to pre-order their lunch may help reduce energy intake. We investigated the acceptability of a pre-ordering website for a workplace canteen that prompts customers to swap to lower-energy swaps and the factors influencing swap acceptance. Employees (n = 30) placed a hypothetical lunch order through a pre-ordering website designed for their canteen while thinking aloud. Semi-structured interview questions supported data collection. Data were analysed using thematic analysis. Acceptability was generally high, but potentially context dependent. Practical considerations, such as reminders to pre-order, user-friendliness, provision of images of menu items and energy information while browsing, an ability to reserve pre-ordered meals, and a swift collection service facilitated acceptability. The restrictive timeframe within which orders could be placed, a lack of opportunity to see foods before ordering, and prompts to swap being perceived as threatening autonomy were barriers to acceptability. Swap acceptance was facilitated by the provision of physical activity calorie equivalents (PACE) information, and swap similarity in terms of taste, texture, and expected satiety as well as the perception that alternatives provided meaningful energy savings. Online canteen pre-ordering systems that prompt lower-energy swaps may be an acceptable approach to help reduce energy intake in the workplace.

Physical Activity Programming and Physical Function of Older Adults in Adult Day Centers: A Mixed-Methods Approach

With increased prevalence of Alzheimer’s disease, there is a need for long-term care services (e.g., Adult Day Centers (ADCs)) to provide physical activity (PA) programs to maintain physical function of older adults. ADCs report offering PA programs; however, information on PA programs and physical function of participants attending ADCs is limited. The study aims to a) explore perspectives of ADC directors on PA programming; b) examine physical function in older adults attending ADCs. A cross-sectional mixed-methods study was conducted among ADC directors and attending participants. Interviews were conducted with ADC directors to assess barriers and facilitators of PA programming. Physical function was assessed among ADC participants via the Short Physical Performance Battery (SPPB) and Timed Up and Go (TUG). Five director interviews were conducted and three major themes emerged; 1) current PA programming limited by fear of falls, 2) staff training and retention, and 3) diversifying PA programming. Twenty-nine ADC participants enrolled in the study, Mage= 74.5±8.2 years; BMI= 29.2 ±7.4 kg/m2; MMSE= 25.6 ±3.3; 51.7% (n=15) African American; 79.3% (n=23) males. ADC participants scored 6.7±3.1 on the SPPB and 15.4±5.3 seconds on the TUG. Directors expressed the importance of PA; however, mentioned current programming was limited due to risk of falls and untrained staff in PA. Findings indicate that older adults attending ADCs have physical function scores indicative of high fall risk. Future PA programming may consider including alternative forms of PA while embedding falls prevention strategies to reduce risk of falls and improve physical function among ADC participants.

Physical Activity Among Low-Income Food Pantry Patrons: Improving the Role of a Rural Food Pantry

Obesity and obesity-related health problems are of growing concern in the United States, particularly among low-income and minority groups. Food pantries have been utilized to reduce barriers to healthy eating; however, challenges still exist with providing physical activity (PA) services. A needs assessment was conducted among rural food-pantry patrons to determine PA behaviors, knowledge, self-efficacy, and perceived barriers to PA. Data were used to infer the health education needs and services of food pantry patrons. Fifty percent of participants indicated that providing fitness classes and PA education materials could help them overcome barriers such as time, money, and childcare.

Move It or Lose It: Summarizing Peer-reviewed Evidence for Practicing What You Preach.

Physically active health care providers are more likely to provide physical activity (PA) counseling to their patients, but barriers in PA counseling exist. Common barriers include knowledge, time constraints, lack of reimbursement, as well as lack of personal habits. This article will summarize evidence-based knowledge regarding provider PA habits as a means of improving rapport, compliance, and empathy for patients when prescribing PA. Clinical pearls for successful PA counseling scenarios also will be discussed.

Practical implications for providing physical activity counseling for the older adult: An integrative review.

Physical inactivity in the older adult is associated with functional decline, increased fall risk, and threatens the ability of the older adult to live independently. Nurse practitioners, with their expertise in health promotion and chronic disease management, are well positioned to provide physical activity (PA) counseling. However, there is a gap in the literature describing a practical formula for providing PA counseling and PA prescriptions for clinical practice. The objective of this integrative review was to synthesize the literature related to counseling interventions designed to increase PA among older adults and provide practical recommendations for incorporating recommendations into practice. Five different databases were searched along with ancestry searching of relevant articles. Eligible studies tested methods of recommending PA for adults age ≥65 years, including in-person counseling, phone calls, written information, and exercise prescriptions. Health care providers are able to motivate older adults to increase PA in the short term. Diverse health care disciplines are efficacious at motivating older adults to increase PA. Various counseling interventions can be used with varying amounts of time investment. Physical activity counseling is an underused but effective intervention for increasing PA in older adults. Older adults respond well to advice to increase their PA especially with the addition of a written exercise prescription. Basing PA counseling interventions on a theoretical construct such as social cognitive theory or transtheoretical stages of change theory improves the efficacy of the interventions.