Promote Physical Activity Levels Research Articles

Teacher-Level Factors, Classroom Physical Activity Opportunities, and Children's Physical Activity Levels.

Classroom-based physical activity (CBPA) breaks are a cost-effective strategy to promote physical activity (PA) at school. Despite teachers' critical roles in sustained implementation of CBPA breaks, few studies examined the association of teacher-level factors with student PA levels, and none focused on rural schools. We monitored children's PA levels over 4 consecutive school days at 6 rural Oregon elementary schools with Walk4Life pedometers. During the same week, teachers recorded all student PA opportunities (recess, PE, and CBPA breaks) and answered a 26-item questionnaire about factors influencing their use of CBPA breaks. Mixed-effects models were used to associate teacher-level factors and PA opportunities with children's moderate to vigorous PA (MVPA; in minutes per day), controlling for child-level covariates. When teachers valued PA, students accumulated more MVPA (1.07min/d; P < .01) than students of teachers reporting low PA value. Students did more MVPA (1min/d; P < .001) when teachers agreed the school operating conditions posed barriers to providing PA than when teachers disagreed that barriers existed. PE classes contributed significantly to student's PA levels. Provision of PE, increasing teacher value for PA, and further investigation of how teacher-level factors relate to students' MVPA levels during CBPA breaks at rural elementary schools are warranted.

A kindergarten-based child health promotion program: the Adapted National Aeronautics and Space Administration (NASA) Mission X for improving physical fitness in South Korea.

Effective and sustainable intervention programs are needed to promote physical activity (PA) in children. To adapt the NASA Mission X: Train Like an Astronaut program for use with South Korean children, and to evaluate its feasibility and effectiveness for promoting children's physical fitness. Children 5 years old (n = 212) and their parents were recruited from three kindergartens in three cities to participate in a 6-week intervention program in fall 2014. We assessed the children's PA and related changes, and parental changes in attitude and beliefs, after participation in the intervention. Girls reported less PA than boys (40.7 vs. 59.0, p < 0.01). Children with a normal body mass index (BMI) were more likely to be active than underweight children (< 10 percentile) or overweight children (⩾ 85 percentile). After the intervention, about one-half of the children had increased their level of PA (49.4%), increased interest in PA (59.1%) and found psychological need satisfaction in exercise (52.6%). The majority of parents became aware of the necessity of childhood PA (94.2%), their child's PA capability (64.3%), and the relationship of PA with their children's self-esteem (79.9%). The adapted NASA Mission X program was feasible and effective in promoting PA in kindergarteners, and also improved their parents' attitude and beliefs about children's PA in South Korea. This study provided a model for promoting childhood health through child care and educational settings.

Community-wide physical activity intervention based on the Japanese physical activity guidelines for adults: A non-randomized controlled trial

Very few community intervention studies that promote physical activity (PA) using guidelines and its dissemination and implementation have been conducted. Consequently, we evaluated the effectiveness of a community-wide intervention (CWI) of PA with adults based on the Japanese guidelines for promoting PA.This was a non-randomized controlled trial, with four administrative districts in Fujisawa city assigned to the intervention group and nine to the control group. The CWI, conducted from 2013 to 2015, comprised information dissemination, education, and community support. The primary outcome was change in PA participation. Secondary outcomes were CWI awareness and PA guideline knowledge. Outcomes were assessed using questionnaires distributed to two independent, random samples of 3000 community-based adults (aged ≥20years).Two separate samples—1230 adults at baseline and 1393 at the two-year follow-up—responded to the survey. The median time spent in PA did not differ between intervention and control groups after adjusting for potential confounders (adjusted difference between groups=−0.02min/day [95% confidence interval (CI): −0.11, 0.10]). However, intervention group participants were more aware of the CWI (33.8%) than were control group participants (25.2%) at the two-year follow-up (odds ratio=1.44 [95% CI: 1.06, 1.95]). A significant difference was also observed in participants' PA guideline knowledge (adjusted difference between groups=0.82% [95% CI: 0.33, 1.31]).Although significant differences in awareness and knowledge were observed between groups, this CWI did not change PA levels over two years. Future studies should investigate the long-term effects of CWIs beyond two years.Trial registration number: UMIN-CTR UMIN000018389.

Impact of primary care exercise referral schemes on the health of patients with obesity

Primary care exercise referral schemes (ERSs) are a potentially useful setting to promote physical activity (PA). It is not established, however, whether interventions to increase PA, such as ERSs, have differing health outcomes according to the participants’ body mass index (BMI). This paper summarizes evidence for the impact of primary care ERSs on the health of people with obesity and reports findings of a reanalysis of the EMPOWER study, providing the first data to report differential outcomes of ERSs by BMI category. Our literature review revealed a paucity of published data. A 2011 Health Technology Assessment review and 2015 update were identified, but normal-weight participants were neither excluded nor were results stratified by weight in the included studies. A study of the effect of exercise referral in overweight women reported a significantly greater increase in PA levels in the ERS group than the control group at 3 months. Reanalysis of the EMPOWER study data showed a significant improvement in PA at 3 months in both obese and overweight/normal BMI groups, with the effect size attenuated to 6 months. There was no significant difference from baseline to 6 months in blood pressure for either BMI category. At 6 months, there was a significant decrease in weight from baseline for the obese category. Comparison of crude mean differences between BMI groups revealed a significant mean difference in PA at 3 months favoring the overweight/normal BMI group, but not at 6 months. There were no further significant differences in unadjusted or adjusted mean differences for other outcomes at follow-up. We report some evidence of a differential impact of ERS on PA by BMI category. However, the effect of ERSs in primary care for patients with obesity remains unclear due to the small number of published studies that have reported outcomes by BMI category. Further research is needed.

Ownership and Use of Commercial Physical Activity Trackers Among Finnish Adolescents: Cross-Sectional Study.

BackgroundMobile phone apps for monitoring and promoting physical activity (PA) are extremely popular among adults. Devices, such as heart rate monitors or sports watches (HRMs/SWs) that work with these apps are at sufficiently low costs to be available through the commercial markets. Studies have reported an increase in PA levels among adults with devices; however, it is unknown whether the phenomena are similar during early adolescence. At a time when adolescents start to develop their own sense of independence and build friendship, the ease of smartphone availability in developed countries needs to be investigated in important health promoting behaviors such as PA.ObjectiveThe objective of this study was to investigate the ownership and usage of PA trackers (apps and HRM/SW) among adolescents in a national representative sample and to examine the association between use of devices and PA levels.MethodsThe Finnish school-aged physical activity (SPA) study consisted of 4575 adolescents, aged 11-, 13-, and 15-years, who took part in a web-based questionnaire during school time about PA behaviors between April and May 2016. Binary logistic regression analyses were used to test the associations between moderate to vigorous physical activity (MVPA) and devices, after controlling for gender, age, disability, and family affluence.ResultsPA tracking devices have been categorized into two types, which are accessible to adolescents: (1) apps and (2) HRM/SW. Half the adolescents (2351/4467; 52.63%) own apps for monitoring PA, yet 16.12% (720/4467) report using apps. Fewer adolescents (782/4413; 17.72%) own HRM/SW and 9.25% (408/4413) use HRM/SW. In this study, users of HRM/SW were 2.09 times (95% CI 1.64-2.67), whereas users of apps were 1.4 times (95% CI 1.15-1.74) more likely to meet PA recommendations of daily MVPA for at least 60 min compared with adolescents without HRM/SW or without apps.ConclusionsTo our knowledge, this is the first study that describes the situation in Finland with adolescents using PA trackers and its association with PA levels. Implications of the use of apps and HRM/SW by adolescents are discussed.

Physical Activity Levels and Counseling Practices of Physicians &amp; Patients in a Chilean Sports Medicine Clinic

PURPOSE: Promoting physical activity (PA) among physicians and patients is one of the main pillars of Exercise is Medicine® (EIM). The purpose of this study was to evaluate the PA levels of physicians and their patients in a private sports medicine clinic in Santiago, Chile, in which a printed PA prescription and a small box recommending PA as a “medicine”, are delivered to all patients. METHODS: This study examined responses from 65 physicians (75% orthopedic surgeons) and 2,688 patients. Physicians answered the short IPAQ and questions regarding how often, and how, they recommend PA to their patients. Patients (59.5% men; 40.5% women; between 25-65 years of age) answered an online survey with questions regarding the frequency and duration of their weekly PA levels. RESULTS: A small percentage of patients (26.5%) reported practicing PA five or more days per week with 86.7% reporting 30-90 minutes per day. Results from the physicians showed that just 26.1 % reached the recommendation of at least 150 min/week of PA, and 55% reported not performing any resistance exercise. The median time sitting and attending patients was 6.1 hours per day. Median frequency of moderate and vigorous PA was 2 days/week for a duration of 45 minutes and 2 days/week and 30 minutes/day, respectively. In regards to their PA counseling attitudes and practices, 66% of the physicians considered it their responsibility to help their patients become physically active, 55% agreed that if they were physically active themselves they will have better capacity to counselling PA, and 40% of the physicians evaluating the PA levels of their patients and always recommending PA for them. Although 89% of the physicians in the clinic agreed to use PA prescription with their patients, just 50% delivered a written PA prescription. CONCLUSIONS: From this study, we conclude that physicians who are regularly involved with patients in a sports medicine clinic are aware of the importance of evaluating the PA levels of their patients, but that they need to improve their regular practice of prescribing PA to their patients.

A school-based motivational intervention to promote physical activity from a self-determination theory perspective

ABSTRACTThe authors analyzed the effects of a multidimensional intervention to promote physical activity (PA) in school, based on self-determination theory. The study involved 88 students, between 14 and 17 years old, who were divided into a control group (n = 59) and an experimental group (n = 29). In the experimental group, a 6-month intervention was conducted, applying a teaching unit of fitness and health in physical education (PE) classes, an extracurricular program of healthy PA, and meetings with families. Questionnaires were administered to measure different motivational variables and PA levels at four time points. Significant differences were found in favor of the experimental group in parental and peer autonomy support; integrated regulation in PE; autonomy, intrinsic, and identified regulation in leisure-time PA; moderate, hard, and very hard PA; and physical self-worth. Motivational effects were maintained over time but the effects on PA levels disappeared at 6 months.

MISSION POSSIBLE: USING UBIQUITOUS SOCIAL GOAL SHARING TECHNOLOGY TO PROMOTE PHYSICAL ACTIVITY IN CHILDREN

The present study investigated the acceptability of a novel ubiquitous socialgoal-sharing intervention aimed at promoting physical activity (PA) in schoolchildren. Methods: Thirty children (18 boys; 10.1±0.3 years; 1.39±0.06 m; 19.85±4.03 kg·m-2) were randomly assigned to ten groups and provided with Fitbit monitors. Video-clips describing mission-based activities were shown on iPads each week, for four consecutive weeks. An LED lighting-strip provided visual feedback on daily group PA levels. Three semistructured group interviews were conducted with 10 children (4 boys, 6 girls; n=2) and two teachers (n=1). Additionally, at baseline and post-intervention, seven-day accelerometry, cardiorespiratory fitness (CRF; 20m shuttle run test), anthropometrics and physical selfperceptions were assessed. Data were analysed using a mixed “between-within" analysis of variance (ANOVA). Results: Children stated that peers were positive role models and provided encouragement to accomplish the missions. Teachers felt that children’s fitness, teamwork and problem-solving skills considerably improved. Statistical analyses revealed no significant intervention effect (p&gt;0.05), though BMI and waist circumference, and CRF, decreased and increased, respectively. Conclusion: The integration of ubiquitous social goal-sharing technology in schools was well received by teachers and pupils. However, further studies integrating a larger sample size encompassing numerous schools, comparison groups and a longer intervention period with associated follow-up measurements, are warranted to ascertain the feasibility as a low-cost intervention to promote children’s PA levels.

MHealth Technologies to Influence Physical Activity and Sedentary Behaviors: Behavior Change Techniques, Systematic Review and Meta-Analysis of Randomized Controlled Trials.

mHealth programs offer potential for practical and cost-effective delivery of interventions capable of reaching many individuals. To (1) compare the effectiveness of mHealth interventions to promote physical activity (PA) and reduce sedentary behavior (SB) in free-living young people and adults with a comparator exposed to usual care/minimal intervention; (2) determine whether, and to what extent, such interventions affect PA and SB levels and (3) use the taxonomy of behavior change techniques (BCTs) to describe intervention characteristics. A systematic review and meta-analysis following PRISMA guidelines was undertaken to identify randomized controlled trials (RCTs) comparing mHealth interventions with usual or minimal care among individuals free from conditions that could limit PA. Total PA, moderate-to-vigorous intensity physical activity (MVPA), walking and SB outcomes were extracted. Intervention content was independently coded following the 93-item taxonomy of BCTs. Twenty-one RCTs (1701 participants-700 with objectively measured PA) met eligibility criteria. SB decreased more following mHealth interventions than after usual care (standardised mean difference (SMD) -0.26, 95% confidence interval (CI) -0.53 to -0.00). Summary effects across studies were small to moderate and non-significant for total PA (SMD 0.14, 95% CI -0.12 to 0.41); MVPA (SMD 0.37, 95% CI -0.03 to 0.77); and walking (SMD 0.14, 95% CI -0.01 to 0.29). BCTs were employed more frequently in intervention (mean=6.9, range 2 to 12) than in comparator conditions (mean=3.1, range 0 to 10). Of all BCTs, only 31 were employed in intervention conditions. Current mHealth interventions have small effects on PA/SB. Technological advancements will enable more comprehensive, interactive and responsive intervention delivery. Future mHealth PA studies should ensure that all the active ingredients of the intervention are reported in sufficient detail.

Teacher Fidelity to a Physical Education Curricular Model and Physical Activity Outcomes

Background:This study was informed by the bodies of literature emphasizing the role of physical education in promoting physical activity (PA) and addressing teacher fidelity to curricular models.Purpose:The purpose of this study was to compare student PA levels, lesson context, and teacher PA promotion behavior among classes where teachers were using the Dynamic Physical Education (DPE) curricular model with low, moderate, and high fidelity.Methods:Participants were 20 physical education teachers, and their 4th and 5th grade students. Each teacher was observed teaching three times during the study. Fidelity data were collected using a validated observation instrument. PA, lesson context, and teacher behavior data were collected using the System for Observing Fitness Instruction Time (SOFIT). Data analysis included descriptive statistics and group difference tests.Results:Significant differences among the three fidelity groups were identified in several items of the observation instrument. No significant moderate-to-vigorous PA or lesson context differences were found among the three groups. Students taught by teachers in the high fidelity group spent a significantly higher proportion of lesson time (7.5%) in vigorous PA than students taught by teachers in the low fidelity group. Teachers in the moderate and high fidelity groups spent a significantly higher proportion of lesson time promoting in-class PA than teachers in the low fidelity group.Discussion:Fidelity of implementation to the DPE model had little impact on student PA. The findings of this study can inform future researchers about the methodological importance of examining teacher fidelity to curricular models and associated outcomes.

Shared use agreements and leisure time physical activity in North Carolina public schools.

Although increasing community access to public schools through shared use agreements (SUAs) has been a recommended strategy for promoting physical activity (PA) among national, state and local organizations, empirical evidence examining the efficacy of SUAs is limited. This study examined the degree of usage and production of PA among schools with shared use, and how variation in PA output is related to characteristics of the school, type of activity, facility type, and when activity occurs. Data were collected in 20 schools across North Carolina using System for Observing Play and Recreation in Communities (SOPARC) and Structured Physical Activity Surveys (SPAS) to assess PA in school athletic facilities during out of school time. Findings indicated that although schools had a policy of shared or open use, most facilities were empty during non-school hours. Hierarchal linear regression models also showed that formal programming was positively associated with both use and PA levels. Given the abundance of empty facilities, community groups in need of space to facilitate structured PA programs should pursue avenues of sharing facilities with public schools. Furthermore, to increase the efficacy of shared use, structured physical activity programs may be needed. Future studies are encouraged to further explore the effects of the specific types of shared use programs on PA production as well other aspects of the built environment surrounding schools.

Positioning Australia’s contemporary health and physical education curriculum to address poor physical activity participation rates by adolescent girls

Background: Given the wealth of research identifying how schools are in a strong position to promote physical activity (PA) among children, it would be reasonable to suggest that initial experiences of physical education and school sport are critical factors influencing whether a student will develop a healthy relationship to PA. However, research in Australia equally identifies how secondary school-aged young people are increasingly failing to meet national guidelines concerning PA levels and participation rates, with adolescent girls displaying the most disturbing trends. Purpose: This paper examines how the recent Australian Curriculum Assessment and Reporting Authority (ACARA) Health and Physical Education (HPE) structure aims to address such concerns as poor PA levels and participation rates by adolescent girls. Methods: A theoretical approach, consisting of document and literature analysis, was undertaken to develop insights into the current developments surrounding the ACARA HPE implementation, in an attempt to address identified socio-cultural issues within contemporary HPE practices. Such an approach is aimed at heightening effective pedagogy. Conclusion: This paper provides a vision for supporting future student inclusion in HPE, by acknowledging potential barriers to the adoption of PA by adolescent girls and identifying strategies that will collectively promote curriculum priorities and classroom practices accordingly.

Mobile and Wearable Device Features that Matter in Promoting Physical Activity

As wearable sensors/devices become increasingly popular to promote physical activity (PA), research is needed to examine how and which components of these devices people use to increase their PA levels. (1) To assess usability and level of engagement with the Fitbit One and daily SMS-based prompts in a 6-week PA intervention, and (2) to examine whether use/ level of engagement with specific intervention components were associated with PA change. Data were analyzed from a randomized controlled trial that compared (1) a wearable sensor/ device (Fitbit One) plus SMS-based PA prompts, and (2) Fitbit One only, among overweight/ obese adults (N = 67). We calculated average scores from Likert-type response items that assessed usability and level of engagement with device features (e.g., tracker, website, mobile app, and SMS-based prompts), and assessed whether such factors were associated with change in steps/day (using Actigraph GT3X+). Participants reported the Fitbit One was easy to use and the tracker helped to be more active. Those who used the Fitbit mobile app (36%) vs. those who did not (64%) had an increase in steps at 6-week follow-up, even after adjusting for previous web/app use: +545 steps/ day (SE = 265) vs. -28 steps/ day (SE = 242) (p = .04). Level of engagement with the Fitbit One, particularly the mobile app, was associated with increased steps. Mobile apps can instantly display summaries of PA performance and could optimize self-regulation to activate change. More research is needed to determine whether such modalities might be cost-effective in future intervention research and practice.

Physical Activity Prevalence and Awareness after an Exercise is Medicine on Campus Campaign, 2011-2013

Exercise Is Medicine (EIM) is a global health initiative to establish physical activity. Exercise Is Medicine with Altitude (EIMA) was a campaign implemented to promote physical activity (PA) on a university campus. Objective: To evaluate awareness of the EIMA campaign and PA of students. Participants: Individuals enrolled in a regional comprehensive university. Methods: An online questionnaire was administered over three years (2011-2013). Respondents were queried on awareness of the EIMA campaign and modified BRFSS PA questions. Results: Questionnaire responses were as follows: Y1 (n = 1411), Y2 (n = 622), and Y3 (n = 888). There was a significant difference across all years for awareness of the EIMA campaign by PA level (p <.05). Awareness and PA increased during each year. During Y3 awareness increased the likelihood of being PA by 1.76. Conclusion: Results suggest that more aggressive awareness techniques should be examined in an effort to promote PA in

Differences in Spatial Physical Activity Patterns between Weekdays and Weekends in Primary School Children: A Cross-Sectional Study Using Accelerometry and Global Positioning System.

Targeting the weekend to promote physical activity (PA) in children seems to be promising given that they tend to be less physically active and, particularly, as the age-related decline in PA is more marked during weekends. Considering the ambiguity of why children are not able to maintain their PA level on weekends, the aim of the present study was to objectively investigate differences in children’s spatial PA patterns between week and weekend days using the combination of Global Positioning System (GPS) and accelerometry. Seventy-four second graders (aged 7–9 years) and 98 sixth graders (aged 11–14 years) wore an accelerometer and GPS sensor for seven consecutive days to determine where children spend time and engage in PA. Time-matched accelerometer and GPS data was mapped with a geographic information system and multilevel analyses accounting for the hierarchical structure of the data were conducted. Differences between weekdays and weekends regarding the total time spent and the absolute and relative level of PA in various settings were found in both age groups. The findings support previous research pointing to the importance of targeting weekend PA, especially when children grow older. Future interventions should encourage children to use outdoor spaces more frequently on weekends, rather than stay at home, and to commute actively to destinations other than school.

Physical activity and health-related quality of life in pediatric cancer patients following a 4-week inpatient rehabilitation program

Chronic health conditions and impaired quality of life are commonly experienced in childhood cancer survivors. While rehabilitation clinics support patients in coping with the disease, studies evaluating an inpatient rehabilitation program on promoting physical activity (PA) and health-related quality of life (HRQoL) are missing. A 4-week inpatient rehabilitation program was prospectively evaluated. One hundred fifty patients with leukemia or lymphoma (N=86), brain tumors (N=38), and sarcomas (N=26) were enrolled on average 17months after cessation of acute medical treatment. PA amount and cadence (indicating the intensity of walking activity) using the StepWatch™ 3 Activity Monitor and HRQoL global and physical well-being scores using the KINDL(®) questionnaire were assessed before, immediately after, and 6 and 12months following the program and analyzed using multiple linear mixed models. Significant effects on PA were only found at 12-month follow-up for amount and cadence variables (all p<0.05). While leukemia and lymphoma patients revealed the highest PA level throughout the study, rehabilitation effects were more pronounced for cadence variables in brain tumor and sarcoma patients. The rehabilitation program had immediate (t=4.56, p<0.001) and sustainable effects on HRQoL global scores (6-month follow-up, t=4.08, p<0.001; 12-month follow-up, t=3.13, p<0.006). Immediate and sustainable increases in HRQoL indicate that a 4-week rehabilitation program is beneficial for improving psychosocial well-being, while the significant increase in PA levels could be related to general recovery as well. The lack of a control group hampers the evaluation of the rehabilitation program on promoting PA levels in pediatric cancer patients.

Body, Person and Environment: Why Promoting Physical Activity (PA) with Stroke Survivors Requires Holistic Thinking

The role of physical activity (PA) after stroke is increasingly recognised as important for function, fitness and wellbeing. Current evidence shows that targeted PA after stroke improves cardiovascular fitness, walking ability and muscle strength and may ameliorate depression and improve quality of life. Secondary stroke prevention and management of cardiovascular risk factors are further health benefits. Despite increasing emphasis on organised exercise classes for stroke, PA levels remain low and effects of organised exercise interventions are not maintained once programmes have finished. Barriers to PA after stroke are complex and innovative approaches to maintaining and promoting long-term engagement in activity are required. This commentary proposes that using the International Classification of Disability and Functioning (ICF) to guide thinking about PA after stroke may help us develop and apply comprehensive solutions that increase PA levels. This approach considers stroke survivors’ PA engagement in terms of Body – the physical impairments imposed by stroke; Person – the role of identity, and psychological factors on PA; and Environment – the physical and social environments that influence PA engagement. The commentary discusses how innovative solutions addressing these issues may enable stroke survivors to be better supported to lead active lifestyles.

Preventing dementia by promoting physical activity and the long-term impact on health and social care expenditures

BackgroundPreventing dementia has been proposed to increase population health as well as reduce the demand for health and social care. Our aim was to evaluate whether preventing dementia by promoting physical activity (PA) a) improves population health or b) reduces expenditure for both health and social care if one takes into account the additional demand in health and social care caused by increased life expectancy. MethodsA simulation model was developed that models the relation between PA, dementia, mortality, and the use of health care and social care in England. With this model, scenarios were evaluated in which different assumptions were made about the increase in PA level in (part of) the population. ResultsLifetime spending on health and social care related to dementia was highest for the physically inactive (£28,100/£28,900 for 40-year-old males/females), but spending on other diseases was highest for those that meet PA recommendations (£55,200/£43,300 for 40-year-old males/females) due to their longer life expectancies. If the English population aged 40–65 were to increase their PA by one level, life expectancy would increase by 0.23years and health and social care expenditures would decrease by £400 per person. ConclusionsPreventing dementia by increasing PA increases life expectancy and can result in decreased spending overall on health and social care, even after additional spending during life years gained has been taken into account. If prevention is targeted at the physically inactive, savings in dementia-related costs outweigh the additional spending in life years gained.

Let's Wiggle with 5-2-1-0: Curriculum Development for Training Childcare Providers to Promote Activity in Childcare Settings.

Overweight and obesity are increasing in preschool children in the US. Policy, systems, and environmental change interventions in childcare settings can improve obesity-related behaviors. The aim of this study was to develop and pilot an intervention to train childcare providers to promote physical activity (PA) in childcare classrooms. An evidence scan, key informant (n = 34) and focus group (n = 20) interviews with childcare directors and staff, and environmental self-assessment of childcare facilities (n = 22) informed the design of the training curriculum. Feedback from the interviews indicated that childcare providers believed in the importance of teaching children about PA and were supportive of training teachers to incorporate PA into classroom settings. The Promoting Physical Activity in Childcare Setting Curriculum was developed and training was implemented with 16 teachers. Participants reported a positive experience with the hands-on training and reported acquiring new knowledge that they intended to implement in their childcare settings. Our findings highlight the feasibility of working with childcare staff to develop PA training and curriculum. Next steps include evaluating the curriculum in additional childcare settings and childcare staff implementation of the curriculum to understand the effectiveness of the training on PA levels of children.

Promoting physical activity at the school playground: a quasi-experimental intervention study

In looking for new strategies to promote physical activity (PA), the purpose of this study was to determine whether providing equipment, playground markings, and a physical education (PE)-based intervention effectively increases PA levels during school recess. A total of 223 children (mean age = 7.10 years ± 0.6; 45.3% female) from three schools participated in this study in 2012. In the first intervention school (G1; n = 75) six previous PE classes teaching games for recess were performed and playground markings and game equipment were provided. In the second intervention school (G2; n = 68) only playground markings and game equipment were provided. The third school served as the control group (GC; n = 80). PA was assessed with pedometers. The increase in mean steps after intervention in G2 was higher than the G1 and GC ( P < 0.001). No differences between G1 and GC were observed at post-intervention ( P = 0.05). The effects did not vary by gender or BMI. Providing game equipment and playground marks may increase children PA in recess. Nevertheless, additional PE-based intervention did not imply an improvement, and was not effective in increasing PA. Normal 0 21 false false false ES X-NONE X-NONE