School-based Physical Activity Programs Research Articles

Effect of a 20-week physical activity intervention on selective attention and academic performance in children living in disadvantaged neighborhoods: A cluster randomized control trial.

ObjectivesTo evaluate the effect of a 20-week school-based physical activity intervention program on academic performance and selective attention among disadvantaged South African primary school children.DesignCluster randomized control trial.MethodsThe study cohort included 663 children from eight primary schools, aged 8–13 years. Data assessment took place between February 2015 and May 2016 following the implementation of a 20-week school-based physical activity program. The d2 test was employed to assess selective attention, while the averaged end-of-year school results (math, life skills, home language, and additional language) were used as an indicator of academic performance. Physical fitness was assessed using the 20-m shuttle run test (VO2 max) and grip strength tests. We controlled for cluster effects, baseline scores in selective attention or academic performance, and potential confounders, such as children’s age, gender, socioeconomic status, self-reported physical activity (as determined by a pre-tested questionnaire), body mass index, hemoglobin (as a proxy for anemia, as measured by blood sampling), and soil-transmitted helminth infections (as assessed by the Kato-Katz technique).ResultsOur multivariate analysis suggested that the physical activity intervention had a positive effect on academic performance (p = 0.032), while no effect was found on selective attention (concentration performance; p = 0.469; error percentage; p = 0.237). After controlling for potential confounders, the physical activity condition contributed to the maintenance of academic performance, whereas a decrease was observed in learners in the control condition. Furthermore, physically active and fit children tend to have better concentration performance (CP) than their less fit peers (self-reported activity; p<0.016, grip strength; p<0.009, VO2 max p>0.021).ConclusionA 20-week physical activity intervention contributes to the maintenance of academic performance among socioeconomically deprived school children in South Africa. School administrators should ensure that their school staff implements physical activity lessons, which are a compulsory component of the school by the curriculum.

School-Based Exercise Programs and Cardiometabolic Risk Factors: A Meta-analysis.

The effects of school-based physical activity (PA) programs on different cardiometabolic risk factors and the most appropriate features of PA programs to achieve maximum effectiveness are unclear. To provide a comprehensive synthesis of the effectiveness of school-based PA interventions on cardiometabolic risk factors in children. We identified studies from database inception to February 22, 2018. We selected studies that were focused on examining the effect of school-based PA interventions on cardiometabolic risk factors in children. Random-effects models were used to calculate the pooled effect size (ES) for the included cardiometabolic risk factors (waist circumference [WC], triglycerides, total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, systolic blood pressure and diastolic blood pressure (DBP), and fasting insulin and glucose). Nineteen randomized controlled trials (which included 11 988 children aged 3-12 years) were included in the meta-analysis. School-based PA programs were associated with a significant small improvement in WC (ES = -0.14; 95% confidence interval [CI]: -0.22 to -0.07; P < .001), DBP (ES = -0.21; 95% CI: -0.42 to -0.01; P = .040), and fasting insulin (ES = -0.12; 95% CI: -0.20 to -0.04; P = .003). Authors of few studies described the implementation conditions of their interventions in detail, and compliance rates were lacking in most studies. In addition, results by sex were provided in a small number of studies. School-based PA interventions improve some cardiometabolic risk factors in children, such as WC, DBP, and fasting insulin.

Effects of a School-Based Pedometer Intervention in Adolescents: 1-Year Follow-Up of a Cluster-Randomized Controlled Trial.

Physical activity (PA) is one of the most important health behaviors that may be modified by each individual. To foster PA in adolescents, a school-based intervention was evaluated. A cluster-randomized controlled trial with preassessment in 2014 and follow-up assessment in 2015 included 29 schools with 1020 students (47.6% girls, mean age = 13.69 years). Intervention students received pedometers and monitored their steps for 12 weeks. Classes with the most steps were awarded. Primary outcomes included moderate-to-vigorous PA, out-of-school sports activities, active transport assessed through questionnaires, as well as cardiorespiratory fitness measured using the 20-m shuttle-run test and anthropometric data (weight, height, body fat, and waist circumference) assessed by study staff. Significant interaction terms between group and time were found for all 3 indicators of PA; intervention students showed a higher increase of PA than control students. The same pattern was shown for cardiorespiratory fitness, but the effect missed significance. A more favorable development for the intervention students was shown for body fat and waist-to-height ratio, while there was no effect on body mass index percentile. An easy way to administer school-based PA program may enhance students' leisure-time PA even 1 year after the intervention has ended.

Investigating best practices of district-wide physical activity programmatic efforts in US schools\u2013 a mixed-methods approach

BackgroundThe majority of US children do not meet physical activity recommendations. Schools are an important environment for promoting physical activity in children, yet most school districts do not offer enough physical activity opportunities to meet recommendations. This study aimed to identify school districts across the country that demonstrated exemplary efforts to provide students with many physical activity opportunities and to understand the factors that facilitated their programmatic success.MethodsA total of 59 districts were identified as model districts by members of the Physical Activity and Health Innovation Collaborative, an ad hoc activity associated with the Roundtable on Obesity Solutions at the National Academies of Sciences, Engineering, and Medicine. Semi-structured interviews were conducted with consenting stakeholders from 23 school districts to understand physical education and activity efforts and elucidate factors that led to the success of these districts’ physical activity programming. Districts were geographically and socioeconomically diverse and varied in their administrative and funding structure.ResultsMost districts did not offer the recommended 150 or 225 min of physical activity a week through physical education alone; yet all districts offered a range of programs outside of physical education that provided additional opportunities for students to be physically active. The average number of school-based physical activity programs offered was 5.5, 3.5 and 2.1 for elementary, middle and high schools, respectively. Three overarching and broadly relevant themes were identified that were associated with successfully enhancing physical activity opportunities for students: soliciting and maintaining the support of champions, securing funding and/or tangible support, and fostering bi-directional partnerships between the district and community organizations and programs. Not only were these three themes critical for the development of physical activity opportunities, but they also remained important for the implementation, evaluation and sustainability of programs. These themes also did not differ substantially by the socioeconomic status of districts.ConclusionsThese findings demonstrate the success of school districts across the nation in providing ample opportunities for physical activity despite considerable variability in socioeconomic status and resources. These results can inform future research and provide actionable evidence for school districts to enhance physical activity opportunities to students.

Intervention effects and mediators of well-being in a school-based physical activity program for adolescents: The ‘Resistance Training for Teens’ cluster RCT

ObjectiveTo examine the impact of a school-based physical activity intervention on adolescents' self-esteem and subjective well-being, and to explore moderators and mediators of intervention effects. MethodsResistance Training for Teens was evaluated using a cluster RCT in 16 schools located in New South Wales, Australia. Adolescents (N = 508; 14.1 ± 0.5 years; 49.6% female) completed measures of global self-esteem, subjective well-being, and hypothesized mediators (i.e., perceived fitness, resistance training self-efficacy, and autonomous motivation) at baseline (April–June, 2015) and post-intervention (October–December). The school-based physical activity program was delivered by teachers over 10-weeks via Physical Education, co-curricular school sport, or an elective subject known as Physical Activity and Sport Studies, and involved once-weekly fitness sessions and additional lunch-time sessions. Intervention effects and moderator analyses were tested using multi-level linear regression analyses with interaction terms. Multi-level mediation analyses were used to explore potential mediators of changes in well-being outcomes. ResultsIntervention effects for self-esteem (β = 0.05, p = .194) and wellbeing (β = 0.03, p = .509) were not statistically significant. Moderator analyses showed effects for self-esteem were greater for the overweight/obese subgroup (p = .069 for interaction), and resistance training self-efficacy was a significant mediator of changes in self-esteem (product-of-coefficients [AB] = 0.021, SE = 0.010, 95% CIs = 0.002 to 0.040). No other significant indirect effects were observed. ConclusionOverall, Resistance Training for Teens did not improve adolescents' self-esteem or subjective well-being. However, our mediation findings lend support to resistance training self-efficacy as a mechanism explaining the positive effect of resistance training on self-esteem.

Long-term follow-up on biological risk factors, adiposity, and cardiorespiratory fitness development in a physical education intervention: a natural experiment (CHAMPS-study DK)

BackgroundSchools are a key setting for large-scale primordial non-communicable disease prevention in young people, but little data on sustainability of impacts on cardiometabolic risk markers is available.MethodsSix and a half year follow-up of a natural experiment. In 2008, six public schools in the municipality of Svendborg (Denmark) augmented their curricular physical education (intervention) and four matched schools served as controls. At long term follow up in 2015 n = 312 participants aged 5–11 years had complete data (33% of children providing necessary baseline data). The intervention, that consisted of a trebling of weekly physical education lessons and courses provided to physical education teachers, was provided at intervention schools up until 6th grade. Participants attended 6th to 10th grade at follow-up. Differences in the homeostasis model assessment of insulin resistance, blood pressure, triglycerides, cholesterol ratios, cardiorespiratory fitness, waist-circumference, and a composite score of these, between participants attending intervention and control schools were analysed by mixed linear regression models. Differences in physical activity at follow-up was analysed cross-sectionally (no baseline available) in n = 495.ResultsCompared to controls, children at intervention schools had a non-significant − 0.07 (− 0.32 to 0.18) standard deviations lower composite risk score 6.5 years after project initiation. Likewise, no statistically significant differences between intervention and control schools were found for any of the other outcomes (p-values ≥ 0.41). However, six of seven outcomes were in a direction favouring intervention schools. No statistically significant differences between intervention and control schools were observed for physical activity outcomes (p-values ≥ 0.13).ConclusionsAn augmented physical activity program including 270 min of weekly physical education provided for three to seven years did not materialize in statistically significant differences in established risk markers in children from intervention compared to control schools. As the intervention was discontinued after 6th grade, the post-intervention effect of augmented physical education throughout adolescence is unknown. School-based physical activity programs may benefit from incorporating instruments for behaviour translation to leisure time in their intervention models to increase the probability of achieving public health relevance.Trial registrationClinicalTrials.gov Identifier: NCT03510494.

Effect Of School-based Physical Activity Programs On Hamstring Flexibility

PURPOSE: Flexibility is an often neglected but very important physical fitness component that is gaining attention regarding its role in correct posture and the incidence of chronic injuries, especially among children and adolescents.The aim of the study was to examine the chronic effect of school-based physical activity (PA) programs on hamstring flexibility (HFlex) and to evaluate potential moderators of this effect using a meta-analytic approach. METHODS: A computerized literature search was conducted based on five databases: SPORTDiscus, Google Scholar, PubMed, Dialnet Plus, and MEDLINE. Studies needed to meet the following inclusion criteria to be included in the meta-analysis: 1) a randomized controlled trial design, 2) PA program took place in a school setting 3) published in English or Spanish, and 4) reported descriptive statistics that permitted effect size (ES) calculation. A random-effects model with a within-group design was used to calculate the ES. The moderator effects were analyzed either by one-way analysis of variance of independent groups or by Pearson product-moment correlation coefficients, depending on the variable considered. RESULTS: From 2006 articles, 13 studies representing 18 ES’s and totaling 792 participants (males and females, 10.3 ± 0.5 yo) were included in the analysis. The mean quality score for the studies was 3.4 ± 0.7 (on a scale from 1 to 5). A moderate overall ES of 0.38 (p ≤ 0.001; CI95% = 0.22 to 0.87; z=4.58; Q=13.38; I2=92.48%) was found suggesting a low-moderate effect of the school-based PA programs to enhance HFlex. Neither a) quality of the studies (r = -0.43, p = 0.87), b) number of intervention sessions (r = -0.16, p = 0.52), nor c) minutes per session (r = -0.03, p = 0.91) were significant moderators. Sex could not be included as a moderator because 78% of the studies did not report the effect on HFlex separately by sex. No bias was found according to Egger’s regression analysis (p=0.80). CONCLUSION: School-based PA programs have a significant positive overall effect on children and adolescents’ HFlex compared with their control peers. Reporting the effect differentiated by gender and including detailed group demographic data (i.e., experimental and control) is recommended for individual studies. KEYWORDS: hamstring flexibility, school-based physical activity

Effectiveness of the \u2018Girls Active\u2019 school-based physical activity programme: A cluster randomised controlled trial

BackgroundGlobally, adolescent girls’ physical activity (PA) levels are low. The ‘Girls Active’ secondary school-based programme, developed by the Youth Sport Trust, aims to increase PA in adolescent girls. This paper explores the effectiveness of the ‘Girls Active’ school-based PA programme.MethodsA random sample of girls aged 11–14 from 20 secondary schools (Midlands, UK) participated in a two-arm cluster randomised controlled trial. Ten schools received Girls Active and 10 continued with usual practice. Measurements were taken at baseline, seven- and 14-month follow-up. Primary outcome: wrist-worn accelerometer measured moderate- to vigorous-intensity PA (MVPA). Secondary outcomes: overall PA, light PA, sedentary time, body composition, and psychosocial outcomes. Generalised estimating equations, adjusted for school cluster and potential confounders, were used and A priori subgroup analysis was undertaken. Micro-costing and cost-consequence analyses were conducted using bespoke collection methods on programme delivery information. Outcomes for the cost-consequence analysis were health related quality of life measured by the Child Health Utility-9D and service use.ResultsOverall, 1752 pupils participated, 1211 (69.1%) provided valid 14-month accelerometer data. No difference in MVPA (mins/day; 95% confidence intervals) was found at 14 months (1.7; -0.8 to 4.3), there was at seven months (2.4; 0.1 to 4.7). Subgroup analyses showed significant intervention effects on 14-month in larger schools (3.9; 1.39 to 6.09) and in White Europeans (3.1; 0.60 to 6.02) and in early maturers (5.1; 1.69 to 8.48) at seven months. The control group did better in smaller schools at 14-months (-4.38; -7.34 to -1.41). Significant group differences were found in 14-month identified motivation (-0.09; -0.18 to -0.01) and at seven months in: overall PA (1.39 mg/day; 0.1 to 2.2), after-school sedentary time (-4.7; -8.9 to -0.6), whole day (5.7; 1.0 to 10.5) and school day (4.5; 0.25 to 8.75) light PA, self-esteem. Small, statistically significant, differences in some psychosocial variables favoured control schools. Micro-costing demonstrated that delivering the programme resulted in a range of time and financial costs at each school. Cost-consequence analysis demonstrated no effect of the programme for health related quality of life or service use.ConclusionsCompared with usual practice, ‘Girls Active’ did not affect 14-month MVPA.Trial registrationISRCTN10688342

Abstract MP36: Poverty Modifies the Association of Health-Related Fitness and School Absenteeism in New York City Middle School Girls

Introduction: One-fifth to one-third of students in high-poverty, urban school districts do not attend school regularly (missing ≥6 days per year). Health related fitness is shown to be associated with absenteeism, although this relationship may differ across poverty and gender subgroups. Hypothesis: We hypothesized that area poverty would be a stronger effect modifier on the association of fitness (cardiorespiratory, muscular endurance, and muscular strength fitness composite percentile scores) and subsequent absenteeism (one-year lagged days absent) in girls compared with boys. Methods: Six cohorts of New York City public school students were followed from grades 5-8 during 2006/7-2012/13 (n=349,381). Stratified three-level longitudinal generalized linear mixed models were used to test the modification of poverty on the association of fitness changes and one-year lagged child-specific days absent across gender. Results: The fitness-absenteeism association was not significant in boys attending schools in high/very high (p=0.075) or low/mid poverty (p=0.454) areas. In girls attending schools in high/very high poverty areas, greater improvements in fitness the prior year were associated with greater improvements in attendance (p=0.034). Relative to the reference group (&gt;20% decrease in fitness composite percentile scores from the prior year), girls with a large increase in fitness (&gt;20%) demonstrated 10.3% fewer days absent (IRR 95% CI: 0.834, 0.964), followed by those who had a 10-20% increase in fitness (9.2%, IRR 95% CI: 0.835, 0.987), no change (5.4%, IRR 95% CI: 0.887, 1.007) and a 10-20% decrease in fitness (3.8%, IRR 95% CI: 0.885, 1.045). In girls attending schools in low/mid poverty areas, the fitness-attendance relationship was also positive, but no clear trend emerged. Conclusions: Fitness improvements may be more important to attendance improvements in high/very high poverty girls compared with low/mid poverty girls, and both high/very high and low/mid poverty boys. In conclusion, expanding school-based physical activity programs for girls in high-poverty neighborhoods may increase student attendance.

The association of fitness and school absenteeism across gender and poverty: a prospective multilevel analysis in New York City middle schools

PurposeOne-fifth to one-third of students in high poverty, urban school districts do not attend school regularly (missing ≥6 days/year). Fitness is shown to be associated with absenteeism, although this relationship may differ across poverty and gender subgroups. MethodsSix cohorts of New York City public school students were followed up from grades 5 to 8 during 2006/2007–2012/2013 (n = 349,381). Stratified three-level longitudinal generalized linear mixed models were used to test the association between changes in fitness and 1-year lagged child-specific days absent across gender and poverty. ResultsIn girls attending schools in high/very high poverty areas, greater improvements in fitness the prior year were associated with greater reductions in absenteeism (P = .034). Relative to the reference group (>20% decrease in fitness composite percentile scores from the prior year), girls with a large increase in fitness (>20%) demonstrated 10.3% fewer days absent (incidence rate ratio [IRR] 95% confidence interval [CI]: 0.834, 0.964), followed by those who had a 10%–20% increase in fitness (9.2%; IRR 95% CI: 0.835, 0.987), no change (5.4%; IRR 95% CI: 0.887, 1.007), and a 10%–20% decrease in fitness (3.8%; IRR 95% CI: 0.885, 1.045). In girls attending schools in low/mid poverty areas, fitness and absenteeism also had an inverse relationship, but no clear trend emerged. In boys, fitness and absenteeism had an inverse relationship but was not significant in either poverty group. ConclusionsFitness improvements may be more important to reducing absenteeism in high/very high poverty girls compared with low/mid poverty girls and both high/very high and low/mid poverty boys. Expanding school-based physical activity programs for youth particularly in high poverty neighborhoods may increase student attendance.

Improved cognitive performance in preadolescent Danish children after the school-based physical activity programme “FIFA 11 for Health” for Europe – A cluster-randomised controlled trial

Objective: Recent studies have shown promising effects of physical activity on cognitive function, but there is a need to investigate this link in real-life settings such as schools. Hence, the objective of the present pilot study was to investigate whether the school-based physical activity programme “FIFA 11 for Health” for Europe could improve cognitive performance in preadolescent Danish children. Methods: The pilot study used an 11-week cluster-randomised intervention study design. School classes were randomly assigned to either a control group (CG) (n = 93 children, age = 11.8, s = 0.2 years), which performed the obligatory daily school-based physical activity (5 × 45 minutes per week); or an intervention group (IG) (n = 838 children, age = 11.9, s = 0.4 years), which substituted 2 × 45 minutes per week of the daily school physical activity with the “FIFA 11 for Health” for Europe programme. The programme combines small-sided football games, drills and health education. Cognitive performance was evaluated at baseline and follow-up. Results: The IG improved their cognitive performance compared to the CG for psychomotor function (56, sx– = 22 ms, p < .001), attention (39, sx– = 17 ms, p = .012) and working memory (79, sx– = 35 ms, p = .020). Conclusion: This pilot study provides evidence that the school-based physical activity programme “FIFA 11 for Health” for Europe can improve cognitive performance in preadolescent Danish schoolchildren. Future studies should attempt to disentangle the effects of “FIFA 11 for Health” for Europe on cognitive performance by investigating the characteristics of the programme’s physical activity.

Bridging Public Health and Education: Results of a School-Based Physical Activity Program to Increase Student Fitness

Power Up for 30 (PU30) is a schoolwide intervention that encourages schools to provide an additional 30 minutes of physical activity during the school day, beyond physical education. The objective of this study was to evaluate the impact of PU30 on Georgia public elementary schools and their students. A total of 719 of 1320 public elementary schools in Georgia that were sent a baseline survey about school physical activity during October 2013 to September 2014 completed the survey, 160 of which were asked to complete a second survey. In the interim (March to June 2015), half (80) of these schools implemented the PU30 program. The interim surveys, which were completed during March to June 2015, assessed opportunities for student physical activity and staff member professional development focused on student physical activity. Compared with schools that had not implemented the program, more schools using the PU30 program reported offering before- and after-school physical activity programs. Forty-four of 78 (57%) PU30 schools compared with 20 of 53 (38%) non-PU30 schools offered before-school physical activity programs. Likewise, more PU30 schools than non-PU30 schools offered after-school physical activity programs (35% vs 16%), and a greater proportion of students at PU30 schools compared with non-PU30 schools met fitness benchmarks: recess 5 days per week (91% [288 of 323] vs 80% [273 of 341]), offering ≥11 minutes per day of classroom-based physical activity (39% [53 of 136] vs 25% [47 of 189] for kindergarten through second grade; 20% [37 of 187] vs 6% [9 of 152] for grades 3 through 5), and receiving physical activity-related professional development time (42% [136 of 323] vs 14% [48 of 341]). The surveys provided a statewide picture of the physical activity opportunities offered to students and staff members in Georgia elementary schools and demonstrated the effective use of a comprehensive, multicomponent program to offer more school-based physical activity opportunities and to improve student fitness.

An RCT to Facilitate Implementation of School Practices Known to Increase Physical Activity

Although comprehensive school-based physical activity interventions are efficacious when tested under research conditions, they often require adaptation in order for implementation at scale. This paper reports the effectiveness of an adapted efficacious school-based intervention in improving children's moderate to vigorous physical activity. The impact of strategies to support program implementation was also assessed. A cluster RCT of low socioeconomic elementary schools in New South Wales, Australia. Consenting schools were randomized (25 intervention, 21 control) using a computerized random number function. Follow-up measures were taken at 6 months post-randomization (May-August 2015) by blinded research assistants. The multicomponent school-based intervention, based on an efficacious school-based physical activity program (Supporting Children's Outcomes using Rewards, Exercise and Skills), consisted of four physical activity strategies and seven implementation support strategies. The intervention was adapted for scalability and delivery by a local health service over 6 months. The primary outcome was accelerometer assessed, student mean daily minutes spent in moderate to vigorous physical activity. Physical education lesson quality and other school physical activity practices were also assessed. Participants (n=1,139, 49% male) were third- through sixth-grade students at follow-up (May-August 2015). Valid wear time and analysis of data were provided for 989 (86%) participants (571 intervention, 568 control). At 6-month follow-up, there were no significant effects in overall daily minutes of moderate to vigorous physical activity between groups (1.96 minutes, 95% CI= -3.49, 7.41, p=0.48). However, adjusted difference in mean minutes of overall vigorous physical activity (2.19, 95% CI=0.06, 4.32, p=0.04); mean minutes of school day moderate to vigorous physical activity (2.90, 95% CI=0.06, 5.85, p=0.05); and mean minutes of school day vigorous physical activity (1.81, 95% CI=0.78, 2.83, p≤0.01) were significantly different in favor of the intervention group. Physical education lesson quality and school physical activity practices were significantly different favoring the intervention group (analyzed October 2015-January 2016). The modified intervention was not effective in increasing children's overall daily minutes of moderate to vigorous physical activity, when adapted for implementation at scale. However, the intervention did improve daily minutes of vigorous physical activity and school day moderate to vigorous physical activity, lesson quality, and school physical activity practices. Australian New Zealand Clinical Trials Registry: ACTRN12615000437561.

“It’s a Battle… You Want to Do It, but How Will You Get It Done?”: Teachers’ and Principals’ Perceptions of Implementing Additional Physical activity in School for Academic Performance

School is an ideal setting to promote and increase physical activity (PA) in children. However, implementation of school-based PA programmes seems difficult, in particular due to schools’ focus on academic performance and a lack of involvement of school staff in program development. The potential cognitive and academic benefits of PA might increase chances of successful implementation. Therefore, the aim of this qualitative study was: (1) to explore the perceptions of teachers and principals with regard to implementation of additional PA aimed at improving cognitive and academic performance, and (2) to identify characteristics of PA programmes that according to them are feasible in daily school practice. Twenty-six face-to-face semi-structured interviews were conducted with primary school teachers (grades 5 and 6) and principals in The Netherlands, and analysed using inductive content analysis. Teachers and principals expressed their willingness to implement additional PA if it benefits learning. Time constraints appeared to be a major barrier, and strongly influenced participants’ perceptions of feasible PA programmes. Teachers and principals emphasised that additional PA needs to be short, executed in the classroom, and provided in “ready-to-use” materials, i.e., that require no or little preparation time (e.g., a movie clip). Future research is needed to strengthen the evidence on the effects of PA for academic purposes, and should examine the forms of PA that are both effective as well as feasible in the school setting.

The roles of physical activity and sedentary behavior on Hispanic children’s mental health: a motor skill perspective

Motor competence (MC) has been recognized as the foundation for life-time moderate-to-vigorous physical activity (MVPA) as well as an influential factor in reducing sedentary behavior during childhood. Guided by Blair et al.'s health model, the purpose of this study was to examine the behavioral mechanism of mental health including physical, psychosocial, and cognitive health among Hispanic children related to MC and MVPA. A prospective research design was used with two-wave assessments across one academic year. A total of 141 Hispanic kindergarteners (Meanage=5.37, SD=0.48) were recruited in Texas. Nearly all (94.3%) of the participants were from low-income families based on the Income Eligibility Guidelines. The study was approved by the University Research Review Board, and informed consent was obtained from parents/guardians prior to starting the study. Multiple regressions indicated that manipulative skill was a significant predictor of physical and psychosocial health (β=0.21, β=0.26, p<0.05, respectively) and locomotor skill served as a significant predictor for cognitive health (β=0.22, p<0.01), after controlling for BMI. Bootstrapping analyses supported the statistical significance of indirect effects of MC on mental health outcomes through MVPA (95% CI [0.031, 0.119]) and sedentary behavior (95% CI [0.054, 0.235]), respectively. The results suggest that skill-based activities/games, with instructions, should be encouraged during school-based physical activity and health promotion programs in childhood education. Better understanding of the early effects of MC may contribute to designing strategies to promote Hispanic children's well-being.

Study Protocol of MINI SALTEN: a technology-based multi-component intervention in the school environment targeting healthy habits of first grade children and their parents

BackgroundMINI SALTEN is a program developed to increase moderate to vigorous physical activity (PA) and improve eating habits at home and school in first grade children. It aims to assess the effects of a technology family-based and PA school-based intervention. The purpose of this manuscript is to describe the protocol design and the MINISALTEN intervention.MethodsThis is cluster-randomized controlled trial designed to run from July 2015 to November 2016 in 12 public schools of the city of Buenos Aires, matched for socio-demographic characteristics. The intervention is based on two main components: (a) “active breaks” (AB): implemented during school breaks by a PA instructor; (b) “virtual” (V): web-based contents delivered to the families via a multiplatform application. Using a computer generated random sequence participants are allocated to one of four intervention conditions: (AB), (V), (AB + V), and control (C). Outcomes are measured at baseline and 12 months post intervention, and will include data collected from the child and her/his mother/father or guardian. Primary outcome measures are: PA and sedentary behaviour (measured with accelerometers). Secondary outcome measures related are: percentage of kilocalories (kcal) from added sugars, and from total and saturated fats; grams of fruits and vegetables; and number of snacks and kcal coming from their added sugars and total and saturated fats. Family socio-economic level, home environment, and school environment will also be assessed. Statistical analysis is on an intention-to-treat principle. Baseline characteristics are described using summary measures and mixed models (with school as random effect). The effect of the two interventions will be estimated using a generalized mixed linear model with link and distribution selected according to the type of outcome. Included random effects are: child (or mother/father or guardian) accounting for repeated measures; school accounting for cluster induced by school. The most parsimonious model for each outcome will be reported. The False Discovery Rate criterion will be used to correct for multiple testing in non-planned analyses.DiscussionIt is a pioneer assessment of the impact of a technology-based virtual intervention and a school-based PA program, designed to prevent obesity, and involving the parents at public schools of Buenos Aires.Trial registrationCurrent Controlled Trials ISRCTN58093412. Registered March 14th, 2016 (retrospectively registered).

The Impact of a Recess-Based Leadership Program on Urban Elementary School Students

The purpose of this study was to examine the impact of a peer-leadership training program on youth from a low-income urban school district. The methodological approach was grounded in community-based participatory research, in which a multicomponent school-based recess and physical activity program was examined. Data included 15 focus groups conducted with 77 fourth- and fifth-grade participants and semistructured interviews with 13 adult leaders. Results of a thematic content analysis suggest that decisions to join the program, role expectations, and training received impacted leadership development, personal development, and transfer of skills to other domains.

The Fueling Learning Through Exercise (FLEX) Study

PURPOSE: Throughout the elementary school years school-time moderate-to-vigorous physical activity (MVPA) tends to decrease while sedentary time (SED) increases, contributing independent effects on health outcomes. There is insufficient research on how physical activity (PA) programming may impact SED in children. Our objective was to determine whether two innovative school-based PA programs impact school SED in children and if program reach differed by sex, race/ethnicity, and weight status. METHODS: Eighteen schools from lower-income Massachusetts school districts were enrolled in the Fueling Learning through Exercise Study (FLEX) and randomized to 100 Mile Club (100MC; walking/running program), Just Move (JM; active classroom breaks), or a Control group. Third- and fourth-grade children (n=883) were recruited and measured at baseline (Fall 2015) and short-term follow-up (Spring 2016) for height/weight and 7-day accelerometry (ActigraphGT3x). Demographic information was obtained by parent questionnaire. PA program effects on SED were examined using mixed-effects models adjusting for child sex, race/ethnicity, free or reduced-price lunch (FRPL) eligibility, weight status, accelerometer wear time, average daily temperature, and controlling for school-level clustering. RESULTS: 793 children (8.7 ± 0.7 years, 44% male, 65% non-white, 53% FRPL, 41% overweight/obese) had valid accelerometer wear-time (33 days, 310hrs/day) at both study visits. At baseline, few children achieved the recommended 30 minutes of school-time MVPA (9%; 18.1 ± 7.9 min) and children were sedentary for 59.7% (233 ± 43 min) of their school day. There was a significant effect of program on SED (p=0.041) with Control and JM increasing in SED (6.2 [95%CI: 2.7, 9.5], p<0.001 and 4.3 [95%CI: 0.9, 7.7] mins/day, p=0.012 respectively) while 100MC did not change (p=0.88). There were no differences in program effects by sex (p=0.58), race/ethnicity (p=0.08), or weight status (p=0.19). CONCLUSIONS: Short-term follow-up of program implementation during a two-year PA intervention demonstrates a potential effect of 100MC on mitigating an increase in SED that may occur over the elementary school years. Longer-term findings will demonstrate whether the effects of PA programming on SED are sustained.

Impact of enjoyment on physical activity and health among children with disabilities in schools

BackgroundEnjoyment in school-based physical activity (PA) programs, such as recess or physical education may be important for promoting children's health, but there is a lack of evidence explaining how enjoyment affects health in children with disabilities. HypothesesEnjoyment in school-based PA programs will positively influence general health through participating in more daily PA, and this relationship will vary between younger and older children with disabilities. MethodsWe conducted secondary analysis of data from the 2012 National Youth Fitness Survey. The sample included 241 children with disabilities (age 5–15 years; 129 boys and 112 girls) identified using three criteria: (a) having an impairment, health problem and mobility limitations; (b) needing special equipment; or (c) receiving special education services. Variables extracted were the number of days per week participating for at least 60 min in PA a day; general perceived health; enjoyment in school recess (for ages 5–11 y) or physical education (for ages 12–15 y). Mediation analysis was conducted to test the research hypotheses. ResultsDaily PA participation significantly mediated the relationship between enjoyment in physical education/recess and general health. Children who enjoyed physical education or recess more participated in PA, and those who spent more days being physical active were healthier than their counterparts. However, this mediating relationship, when divided by age groups, was shown for only older group (ages 12–15 y) that received physical education. ConclusionsPhysical educators should provide enjoyable PA opportunities during physical education classes for students with disabilities for promoting their health.

Effects of School-Based Physical Activity Program on Students' Moderate-to-Vigorous Physical Activity and Perceptions of Physical Competence.

The study examined the effects of school-based program on students' self-reported moderate to vigorous physical activity and physical competence, and associated links to gender, grade, body mass index, and physical education assessments. Participants were 240 middle school students (143 intervention, 97 control) from 3 small cities in North-East Finland. The intervention group received task-involving climate support in physical education classes and additional physical activities during school days across 1 year. The intervention group's physical competence increased, whereas the control group's competence remained stable across the period. However, physical activity levels were stable in both groups. The findings also showed that body mass index was negatively associated with physical competence and activity in the intervention group at the follow-up measure. Physical education assessments were positively related with only the baseline scores of physical competence in the intervention group. In contrast, the assessments had positive relationships with physical competence and activity of control group students. The present program was an effective protocol to increase student's perceptions of physical competence. Since the quantity of school physical education including recess activities cannot be dramatically increased, positive learning experiences should be provided, and thus, support perceptions of physical competence.