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McKay HA, Kennedy SG, Macdonald HM, Naylor PJ, Lubans DR. The Secret Sauce? Taking the Mystery Out of Scaling-Up School-Based Physical Activity Interventions. J Phys Act Health 2024; 21:731-740. [PMID: 38936808 DOI: 10.1123/jpah.2024-0274] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2024] [Accepted: 04/16/2024] [Indexed: 06/29/2024]
Abstract
Over the last 4 decades, physical activity researchers have invested heavily in determining "what works" to promote healthy behaviors in schools. Single and multicomponent school-based interventions that target physical education, active transportation, and/or classroom activity breaks effectively increased physical activity among children and youth. Yet, few of these interventions are ever scaled-up and implemented under real-world conditions and in diverse populations. To achieve population-level health benefits, there is a need to design school-based health-promoting interventions for scalability and to consider key aspects of the scale-up process. In this opinion piece, we aim to identify challenges and advance knowledge and action toward scaling-up school-based physical activity interventions. We highlight the key roles of planning for scale-up at the outset, scale-up pathways, trust among partners and program support, program adaptation, evaluation of scale-up, and barriers and facilitators to scaling-up. We draw upon our experience scaling-up effective school-based interventions and provide a solid foundation from which others can work toward bridging the implementation-to-scale-up gap.
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Affiliation(s)
- Heather A McKay
- Active Aging Research Team, University of British Columbia, Vancouver, BC, Canada
- Department of Family Practice, University of British Columbia, Vancouver, BC, Canada
| | - Sarah G Kennedy
- School of Health Sciences, Western Sydney University, Penrith, NSW, Australia
| | - Heather M Macdonald
- Active Aging Research Team, University of British Columbia, Vancouver, BC, Canada
- Department of Family Practice, University of British Columbia, Vancouver, BC, Canada
| | - Patti-Jean Naylor
- School of Exercise Science, Physical and Health Education, Faculty of Education, University of Victoria, Victoria, BC, Canada
| | - David R Lubans
- Centre for Active Living and Learning, College of Human and Social Futures, University of Newcastle, Callaghan, NSW, Australia
- Active Living Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
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2
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Treviño-Peña R, Romero Z, Fuentes JC, Cortez KE, Alanis E, Alvarenga JCL. A Coordinated School Health Program Effect on Cardiorespiratory Fitness of South Texas Preschool Children: A Cluster Randomized Trial. THE JOURNAL OF SCHOOL HEALTH 2024; 94:336-345. [PMID: 38252805 DOI: 10.1111/josh.13414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 11/22/2023] [Accepted: 11/27/2023] [Indexed: 01/24/2024]
Abstract
BACKGROUND The purpose of this study was to assess the effects of the Bienestar/NEEMA Coordinated School Health Program (BN CSHP) on cardiorespiratory fitness (CRF) of preschool children. METHODS A cluster randomized trial was conducted of preschools in South Texas. Of 48 eligible schools, 28 were randomly assigned (14 intervention, 14 control). Family demographics and household health characteristics were collected from parents and CRF from children. Generalized linear mixed model (GLMM) was used to analyze the data. RESULTS Family demographics, household health characteristics, and children's weight, obesity prevalence, and sedentary activity of the control group were similar to the intervention group at baseline. After adjusting for covariates, the number of laps ran by children in the control group increased by 23% (CI: -5% to 60%) per each data collection period compared with 53% (CI: 7% to 119%) in the intervention group. IMPLICATIONS FOR SCHOOL HEALTH POLICY, PRACTICE, AND EQUITY State mandates, parent engagement, and funding are key for designing effective health and Physical Education (PE) programs. CONCLUSION Children in the BN CSHP, compared to those in the control group, had a significantly higher increase in their CRF. This finding is important because of the health benefits of CRF in children. CLINICALTRIALS gov Identifier: NCT05501392.
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Affiliation(s)
| | - Zasha Romero
- University of Texas-Rio Grande Valley, Edinburgh, TX
| | | | | | | | - Juan C L Alvarenga
- Division of Population Health & Biostatistics, University of Texas-Rio Grande Valley, Edinburgh, TX
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3
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Huhtiniemi M, Sääkslahti A, Tolvanen A, Lubans DR, Jaakkola T. A scalable school-based intervention to increase early adolescents' motor competence and health-related fitness. Scand J Med Sci Sports 2023; 33:2046-2057. [PMID: 37231614 PMCID: PMC10946856 DOI: 10.1111/sms.14410] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Revised: 04/28/2023] [Accepted: 05/16/2023] [Indexed: 05/27/2023]
Abstract
Schools are key settings for the promotion of students' physical activity, fitness, and motor competence. The purpose of our study was to investigate the efficacy of a 5-month-long intervention program that aimed to increase students' motor competence and health-related fitness during school days. We conducted a quasi-experimental study with 325 Finnish Grade 5 (Mage = 11.26, SD = 0.33) students from five schools. Two schools were allocated to the intervention group and three schools to the control group. The intervention consisted of three components: (a) weekly 20 min session during regular PE lessons, (b) weekly 20 min session during recess, and (c) daily 5-minute-long classroom activity breaks. All activities were designed to systematically develop different elements of motor competence and fitness. The following assessments were conducted at baseline and 5-months: cardiorespiratory fitness levels were measured by 20-meter shuttle run test, muscular fitness by curl-up and push-up tests, and motor competence by 5-leaps and throwing-catching combination tests. We analyzed the data using a multi-group latent change score modeling. Results showed that students in the intervention group developed significantly better in 20-meter shuttle run test (β = 0.269, p = 0.000, 95% CI [0.141, 0.397]; +5.0 laps), push-up (β = 0.442, p = 0.000, 95% CI [0.267, 0.617]; +6.5 repetitions), curl-up (β = 0.353, p = 0.001, 95% CI [0.154, 0.552]; +7.8 repetitions), and throwing-catching combination tests (β = 0.195, p = 0.019, 95% CI [0.033, 0.356]; +1.1 repetitions) than students in the control group. The intervention program appeared to be feasible and effective in increasing students' cardiorespiratory fitness, muscular fitness, and object control skills. This indicates that guided school-based physical activity programs can be influential in promoting physical fitness and motor competence among early adolescent students.
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Affiliation(s)
- Mikko Huhtiniemi
- Faculty of Sport and Health SciencesUniversity of JyväskyläJyväskyläFinland
| | - Arja Sääkslahti
- Faculty of Sport and Health SciencesUniversity of JyväskyläJyväskyläFinland
| | - Asko Tolvanen
- Faculty of Education and PsychologyUniversity of JyväskyläJyväskyläFinland
| | - David R. Lubans
- Faculty of Sport and Health SciencesUniversity of JyväskyläJyväskyläFinland
- Centre for Active Living and Learning, School of EducationThe University of NewcastleCallaghanNew South WalesAustralia
| | - Timo Jaakkola
- Faculty of Sport and Health SciencesUniversity of JyväskyläJyväskyläFinland
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4
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Onyimadu O, Violato M, Astbury NM, Hüls H, Heath L, Shipley A, Taylor H, Wilkins LE, Abhari RE, Jebb SA, Petrou S. A systematic review of economic evaluations of interventions targeting childhood overweight and obesity. Obes Rev 2023; 24:e13597. [PMID: 37463862 DOI: 10.1111/obr.13597] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2022] [Revised: 05/03/2023] [Accepted: 05/29/2023] [Indexed: 07/20/2023]
Abstract
This systematic review critically appraised and synthesized evidence from economic evaluations of interventions targeting childhood excess weight. We conducted systematic searches in 11 databases from inception to April 19, 2023. Studies were eligible if they evaluated interventions targeting children up to 18 years and the study intervention(s) targeted childhood excess weight or sought to improve diet or physical activity, regardless of the type of economic evaluation or the underpinning study design. We synthesized evidence using narrative synthesis methods. One-hundred fifty-one studies met the eligibility criteria and were classified into three groups based on the intervention approach: prevention-only (13 studies), prevention and treatment (100 studies), and treatment-only (38 studies). The predominant setting and study design differed considerably between the three groups of studies. However, compared with usual care, most interventions were deemed cost-effective. The study participants' ages, sex, and socioeconomic status were crucial to intervention cost-effectiveness. Interventions whose effects were projected beyond childhood, such as bariatric surgery, lower protein infant formula, and home-based general practitioner consultations, tended to be cost-effective. However, cost-effectiveness was sensitive to the assumptions underlying the persistence and intensity of such effects. Our findings can inform future recommendations on the conduct of economic evaluations of interventions targeting childhood overweight and obesity, as well as practice and policy recommendations.
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Affiliation(s)
- Olu Onyimadu
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Mara Violato
- Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Nerys M Astbury
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Hannah Hüls
- The TUM School of Medicine, Technical University Munich, Munich, Germany
- The TUM School of Management, Technical University Munich, Munich, Germany
| | - Laura Heath
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Alexandra Shipley
- Level 3, John Radcliffe Hospital, Oxford University Medical School, Oxford, UK
| | - Harriet Taylor
- Level 3, John Radcliffe Hospital, Oxford University Medical School, Oxford, UK
| | | | - Roxanna E Abhari
- Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Susan A Jebb
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Stavros Petrou
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
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5
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Fasugba O, Dale S, McInnes E, Cadilhac DA, Noetel M, Coughlan K, McElduff B, Kim J, Langley T, Cheung NW, Hill K, Pollnow V, Page K, Sanjuan Menendez E, Neal E, Griffith S, Christie LJ, Slark J, Ranta A, Levi C, Grimshaw JM, Middleton S. Evaluating remote facilitation intensity for multi-national translation of nurse-initiated stroke protocols (QASC Australasia): a protocol for a cluster randomised controlled trial. Implement Sci 2023; 18:2. [PMID: 36703172 PMCID: PMC9879239 DOI: 10.1186/s13012-023-01260-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Accepted: 01/06/2023] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND Facilitated implementation of nurse-initiated protocols to manage fever, hyperglycaemia (sugar) and swallowing difficulties (FeSS Protocols) in 19 Australian stroke units resulted in reduced death and dependency for stroke patients. However, a significant gap remains in translating this evidence-based care bundle protocol into standard practice in Australia and New Zealand. Facilitation is a key component for increasing implementation. However, its contribution to evidence translation initiatives requires further investigation. We aim to evaluate two levels of intensity of external remote facilitation as part of a multifaceted intervention to improve FeSS Protocol uptake and quality of care for patients with stroke in Australian and New Zealand acute care hospitals. METHODS A three-arm cluster randomised controlled trial with a process evaluation and economic evaluation. Australian and New Zealand hospitals with a stroke unit or service will be recruited and randomised in blocks of five to one of the three study arms-high- or low-intensity external remote facilitation or a no facilitation control group-in a 2:2:1 ratio. The multicomponent implementation strategy will incorporate implementation science frameworks (Theoretical Domains Framework, Capability, Opportunity, Motivation - Behaviour Model and the Consolidated Framework for Implementation Research) and include an online education package, audit and feedback reports, local clinical champions, barrier and enabler assessments, action plans, reminders and external remote facilitation. The primary outcome is implementation effectiveness using a composite measure comprising six monitoring and treatment elements of the FeSS Protocols. Secondary outcome measures are as follows: composite outcome of adherence to each of the combined monitoring and treatment elements for (i) fever (n=5); (ii) hyperglycaemia (n=6); and (iii) swallowing protocols (n=7); adherence to the individual elements that make up each of these protocols; comparison for composite outcomes between (i) metropolitan and rural/remote hospitals; and (ii) stroke units and stroke services. A process evaluation will examine contextual factors influencing intervention uptake. An economic evaluation will describe cost differences relative to each intervention and study outcomes. DISCUSSION We will generate new evidence on the most effective facilitation intensity to support implementation of nurse-initiated stroke protocols nationwide, reducing geographical barriers for those in rural and remote areas. TRIAL REGISTRATION ACTRN12622000028707. Registered 14 January, 2022.
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Affiliation(s)
- O Fasugba
- Nursing Research Institute, St Vincent's Health Network Sydney & St Vincent's Hospital Melbourne & Australian Catholic University, Level 5, deLacy Building, St. Vincent's Hospital, 390 Victoria Street, Darlinghurst, NSW, 2010, Australia
- School of Nursing, Midwifery and Paramedicine, Australian Catholic University, Sydney, Australia
| | - S Dale
- Nursing Research Institute, St Vincent's Health Network Sydney & St Vincent's Hospital Melbourne & Australian Catholic University, Level 5, deLacy Building, St. Vincent's Hospital, 390 Victoria Street, Darlinghurst, NSW, 2010, Australia
- School of Nursing, Midwifery and Paramedicine, Australian Catholic University, Sydney, Australia
| | - E McInnes
- Nursing Research Institute, St Vincent's Health Network Sydney & St Vincent's Hospital Melbourne & Australian Catholic University, Level 5, deLacy Building, St. Vincent's Hospital, 390 Victoria Street, Darlinghurst, NSW, 2010, Australia
- School of Nursing, Midwifery and Paramedicine, Australian Catholic University, Sydney, Australia
| | - D A Cadilhac
- Stroke and Ageing Research, Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Melbourne, Victoria, Australia
| | - M Noetel
- School of Psychology, University of Queensland, Brisbane, Australia
| | - K Coughlan
- Nursing Research Institute, St Vincent's Health Network Sydney & St Vincent's Hospital Melbourne & Australian Catholic University, Level 5, deLacy Building, St. Vincent's Hospital, 390 Victoria Street, Darlinghurst, NSW, 2010, Australia
- School of Nursing, Midwifery and Paramedicine, Australian Catholic University, Sydney, Australia
| | - B McElduff
- Nursing Research Institute, St Vincent's Health Network Sydney & St Vincent's Hospital Melbourne & Australian Catholic University, Level 5, deLacy Building, St. Vincent's Hospital, 390 Victoria Street, Darlinghurst, NSW, 2010, Australia
- School of Nursing, Midwifery and Paramedicine, Australian Catholic University, Sydney, Australia
| | - J Kim
- Stroke and Ageing Research, Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Melbourne, Victoria, Australia
| | - T Langley
- St Vincent's Health Network Sydney, Sydney, New South Wales, Australia
| | - N W Cheung
- Centre for Diabetes and Endocrinology Research, Westmead Hospital and University of Sydney, Sydney, New South Wales, Australia
| | - K Hill
- Stroke Foundation, Sydney, New South Wales, Australia
| | - V Pollnow
- St Vincent's Health Network Sydney, Sydney, New South Wales, Australia
| | - K Page
- St Vincent's Health Network Sydney, Sydney, New South Wales, Australia
| | | | - E Neal
- Prince of Wales Hospital, Randwick, New South Wales, Australia
| | - S Griffith
- School of Psychology, University of Queensland, Brisbane, Australia
| | - L J Christie
- Allied Health Research Unit, St Vincent's Health Network, Sydney, Australia
- School of Allied Health, Faculty of Health Sciences, Australian Catholic University, Sydney, Australia
| | - J Slark
- School of Nursing, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - A Ranta
- Department of Medicine, University of Otago Wellington, Wellington, New Zealand
- Department of Neurology, Wellington Hospital, Wellington, New Zealand
| | - C Levi
- John Hunter Health and Innovation Precinct, New Lambton Heights, New South Wales, Australia
- Department of Medicine, University of Newcastle, Newcastle, New South Wales, Australia
| | - J M Grimshaw
- University of Ottawa, Ottawa, Ontario, Canada
- Ottawa Hospital Research Institute, Ottawa, Canada
| | - S Middleton
- Nursing Research Institute, St Vincent's Health Network Sydney & St Vincent's Hospital Melbourne & Australian Catholic University, Level 5, deLacy Building, St. Vincent's Hospital, 390 Victoria Street, Darlinghurst, NSW, 2010, Australia.
- School of Nursing, Midwifery and Paramedicine, Australian Catholic University, Sydney, Australia.
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6
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Lang JJ, Zhang K, Agostinis-Sobrinho C, Andersen LB, Basterfield L, Berglind D, Blain DO, Cadenas-Sanchez C, Cameron C, Carson V, Colley RC, Csányi T, Faigenbaum AD, García-Hermoso A, Gomes TNQF, Gribbon A, Janssen I, Jurak G, Kaj M, Kidokoro T, Lane KN, Liu Y, Löf M, Lubans DR, Magnussen CG, Manyanga T, McGrath R, Mota J, Olds T, Onywera VO, Ortega FB, Oyeyemi AL, Prince SA, Ramírez-Vélez R, Roberts KC, Rubín L, Servais J, Silva DAS, Silva DR, Smith JJ, Song Y, Stratton G, Timmons BW, Tomkinson GR, Tremblay MS, Wong SHS, Fraser BJ. Top 10 International Priorities for Physical Fitness Research and Surveillance Among Children and Adolescents: A Twin-Panel Delphi Study. Sports Med 2023; 53:549-564. [PMID: 36001291 PMCID: PMC9399984 DOI: 10.1007/s40279-022-01752-6] [Citation(s) in RCA: 18] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/04/2022] [Indexed: 01/28/2023]
Abstract
BACKGROUND The measurement of physical fitness has a history that dates back nearly 200 years. Recently, there has been an increase in international research and surveillance on physical fitness creating a need for setting international priorities that could help guide future efforts. OBJECTIVE This study aimed to produce a list of the top 10 international priorities for research and surveillance on physical fitness among children and adolescents. METHODS Using a twin-panel Delphi method, two independent panels consisting of 46 international experts were identified (panel 1 = 28, panel 2 = 18). The panel participants were asked to list up to five priorities for research or surveillance (round 1), and then rated the items from their own panel on a 5-point Likert scale of importance (round 2). In round 3, experts were asked to rate the priorities identified by the other panel. RESULTS There was strong between-panel agreement (panel 1: rs = 0.76, p < 0.01; panel 2: rs = 0.77, p < 0.01) in the priorities identified. The list of the final top 10 priorities included (i) "conduct longitudinal studies to assess changes in fitness and associations with health". This was followed by (ii) "use fitness surveillance to inform decision making", and (iii) "implement regular and consistent international/national fitness surveys using common measures". CONCLUSIONS The priorities identified in this study provide guidance for future international collaborations and research efforts on the physical fitness of children and adolescents over the next decade and beyond.
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Affiliation(s)
- Justin J. Lang
- grid.415368.d0000 0001 0805 4386Centre for Surveillance and Applied Research, Public Health Agency of Canada, 785 Carling Ave, Ottawa, ON K9A 0K9 Canada ,grid.28046.380000 0001 2182 2255School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON Canada ,grid.414148.c0000 0000 9402 6172Healthy Active Living and Obesity Research Group, Children’s Hospital of Eastern Ontario Research Institute, Ottawa, ON Canada
| | - Kai Zhang
- grid.414148.c0000 0000 9402 6172Healthy Active Living and Obesity Research Group, Children’s Hospital of Eastern Ontario Research Institute, Ottawa, ON Canada ,grid.28046.380000 0001 2182 2255School of Human Kinetics, University of Ottawa, Ottawa, ON Canada
| | - César Agostinis-Sobrinho
- grid.14329.3d0000 0001 1011 2418Faculty of Health Sciences, Klaipeda University, Klaipeda, Lithuania
| | - Lars Bo Andersen
- grid.477239.c0000 0004 1754 9964Department of Sport, Food and Natural Sciences. Western, Norway University of Applied Science, Bergen, Norway
| | - Laura Basterfield
- grid.1006.70000 0001 0462 7212Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Daniel Berglind
- grid.4714.60000 0004 1937 0626Department of Global Public Health and Centre for Epidemiology and Community Medicine (CES), Karolinska Institutet, Stockholm, Sweden
| | - Dylan O. Blain
- grid.12362.340000 0000 9280 9077Institute of Management and Health, University of Wales Trinity Saint David, Wales, UK
| | - Cristina Cadenas-Sanchez
- grid.4489.10000000121678994PROFITH “PROmoting FITness and Health Through Physical Activity” Research Group, Sport and Health University Research Institute (iMUDS), Department of Physical and Sports Education, Faculty of Sport Sciences, University of Granada, Granada, Spain
| | - Christine Cameron
- grid.418590.10000 0001 2164 2780Canadian Fitness and Lifestyle Research Institute, Ottawa, ON Canada
| | - Valerie Carson
- grid.17089.370000 0001 2190 316XFaculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, AB Canada
| | - Rachel C. Colley
- grid.413850.b0000 0001 2097 5698Health Analysis Division, Statistics Canada, Ottawa, ON Canada
| | - Tamás Csányi
- Department of Physical Education Theory and Methodology, Hungarian University of Sports Science, Budapest, Hungary ,grid.5591.80000 0001 2294 6276Faculty of Primary and Pre-School Education, ELTE, Eötvös Loránd University, Budapest, Hungary
| | - Avery D. Faigenbaum
- grid.264500.50000 0004 0400 5239Kinesiology and Health Science, The College of New Jersey, Ewing, NJ USA
| | - Antonio García-Hermoso
- grid.410476.00000 0001 2174 6440Navarrabiomed, Hospital Universitario de Navarra (HUN), Navarra Institute for Health Research (IdiSNA), Universidad Pública de Navarra (UPNA), Pamplona, Navarra Spain
| | - Thayse Natacha Q. F. Gomes
- grid.411252.10000 0001 2285 6801Department of Physical Education, Federal University of Sergipe, São Cristóvão, SE Brazil
| | - Aidan Gribbon
- grid.413850.b0000 0001 2097 5698Centre for Population Health Data, Statistics Canada, Ottawa, ON Canada
| | - Ian Janssen
- grid.410356.50000 0004 1936 8331School of Kinesiology and Health Studies, Queen’s University, Kingston, ON Canada ,grid.410356.50000 0004 1936 8331Department of Public Health Sciences, Queen’s University, Kingston, ON Canada
| | - Gregor Jurak
- grid.8954.00000 0001 0721 6013Faculty of Sport, University of Ljubljana, Ljubljana, Slovenia
| | - Mónika Kaj
- grid.511942.aHungarian School Sport Federation, Budapest, Hungary
| | - Tetsuhiro Kidokoro
- grid.412200.50000 0001 2228 003XResearch Institute for Health and Sport Science, Nippon Sport Science University, Tokyo, Japan
| | - Kirstin N. Lane
- grid.143640.40000 0004 1936 9465School of Exercise Science, Physical and Health Education, University of Victoria, Victoria, BC Canada
| | - Yang Liu
- grid.412543.50000 0001 0033 4148School of Physical Education and Sport Training, Shanghai University of Sport, Shanghai, China ,grid.412543.50000 0001 0033 4148Shanghai Research Center for Physical Fitness and Health of Children and Adolescents, Shanghai University of Sport, Shanghai, China
| | - Marie Löf
- grid.4714.60000 0004 1937 0626Department of Biosciences and Nutrition, Karolinska Institutet, Stockholm, Sweden ,grid.5640.70000 0001 2162 9922Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - David R. Lubans
- grid.266842.c0000 0000 8831 109XCentre for Active Living and Learning, College of Human and Social Futures, The University of Newcastle, Callaghan, NSW Australia
| | - Costan G. Magnussen
- grid.1051.50000 0000 9760 5620Baker Heart and Diabetes Institute, Melbourne, VIC Australia ,grid.1374.10000 0001 2097 1371Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland ,grid.1374.10000 0001 2097 1371Centre for Population Health Research, Turku University Hospital, University of Turku, Turku, Finland ,grid.1009.80000 0004 1936 826XMenzies Institute for Medical Research, University of Tasmania, Hobart, TAS Australia
| | - Taru Manyanga
- grid.266876.b0000 0001 2156 9982Division of Medical Sciences, University of Northern British Columbia, Prince George, BC Canada
| | - Ryan McGrath
- grid.261055.50000 0001 2293 4611Department of Health, Nutrition, and Exercise Sciences, North Dakota State University, Fargo, ND USA ,grid.509356.c0000 0004 0420 0122Fargo VA Healthcare System, Fargo, ND USA
| | - Jorge Mota
- grid.5808.50000 0001 1503 7226Laboratory for Integrative and Translational Research in Population Health (ITR), Research Center in Physical Activity, Health and Leisure (CIAFEL), Faculty of Sports, University of Porto (FADEUP), Porto, Portugal
| | - Tim Olds
- grid.1026.50000 0000 8994 5086Alliance for Research in Exercise, Nutrition and Activity (ARENA), University of South Australia, Adelaide, SA Australia ,grid.1008.90000 0001 2179 088XMurdoch Children’s Research Institute, University of Melbourne, Parkville, Melbourne, VIC Australia
| | - Vincent O. Onywera
- grid.9762.a0000 0000 8732 4964Department of Physical Education, Exercise and Sports Science, Kenyatta University, Nairobi, Kenya
| | - Francisco B. Ortega
- grid.4489.10000000121678994PROFITH “PROmoting FITness and Health Through Physical Activity” Research Group, Sport and Health University Research Institute (iMUDS), Department of Physical and Sports Education, Faculty of Sport Sciences, University of Granada, Granada, Spain ,grid.9681.60000 0001 1013 7965Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Adewale L. Oyeyemi
- grid.413017.00000 0000 9001 9645Department of Physiotherapy, University of Maiduguri, Maiduguri, Nigeria
| | - Stephanie A. Prince
- grid.415368.d0000 0001 0805 4386Centre for Surveillance and Applied Research, Public Health Agency of Canada, 785 Carling Ave, Ottawa, ON K9A 0K9 Canada ,grid.28046.380000 0001 2182 2255School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON Canada
| | - Robinson Ramírez-Vélez
- grid.410476.00000 0001 2174 6440Navarrabiomed, Hospital Universitario de Navarra (HUN), Navarra Institute for Health Research (IdiSNA), Universidad Pública de Navarra (UPNA), Pamplona, Navarra Spain ,grid.442065.10000 0004 0486 4893Facultad de Ciencias de la Educación, Unidad Central del Valle del Cauca (UCEVA), Túlua, Colombia ,grid.413448.e0000 0000 9314 1427CIBER of Frailty and Healthy Aging (CIBERFES), Instituto de Salud Carlos III, Madrid, Spain
| | - Karen C. Roberts
- grid.415368.d0000 0001 0805 4386Centre for Surveillance and Applied Research, Public Health Agency of Canada, 785 Carling Ave, Ottawa, ON K9A 0K9 Canada
| | - Lukáš Rubín
- grid.6912.c0000000110151740Department of Physical Education and Sport, Technical University of Liberec, Liberec, Czech Republic ,grid.10979.360000 0001 1245 3953Institute of Active Lifestyle, Palacký University Olomouc, Olomouc, Czech Republic
| | - Jennifer Servais
- grid.413850.b0000 0001 2097 5698Centre for Population Health Data, Statistics Canada, Ottawa, ON Canada
| | - Diego Augusto Santos Silva
- grid.411237.20000 0001 2188 7235Sports Center, Federal University of Santa Catarina, Florianópolis, SC Brazil
| | - Danilo R. Silva
- grid.411252.10000 0001 2285 6801Department of Physical Education, Federal University of Sergipe, São Cristóvão, SE Brazil ,grid.441837.d0000 0001 0765 9762Faculty of Health Science, Universidad Autónoma de Chile, Santiago, Chile
| | - Jordan J. Smith
- grid.266842.c0000 0000 8831 109XCentre for Active Living and Learning, College of Human and Social Futures, The University of Newcastle, Callaghan, NSW Australia
| | - Yi Song
- grid.11135.370000 0001 2256 9319Institute of Child and Adolescent Health, School of Public Health, National Health Commission Key Laboratory of Reproductive Health, Peking University, Beijing, China
| | - Gareth Stratton
- grid.4827.90000 0001 0658 8800Applied Sport Technology Exercise and Medicine Research Centre, Faculty Science and Engineering, Swansea University, Wales, UK
| | - Brian W. Timmons
- grid.414148.c0000 0000 9402 6172Healthy Active Living and Obesity Research Group, Children’s Hospital of Eastern Ontario Research Institute, Ottawa, ON Canada ,grid.25073.330000 0004 1936 8227Child Health and Exercise Medicine Program, McMaster University, Hamilton, ON Canada
| | - Grant R. Tomkinson
- grid.1026.50000 0000 8994 5086Alliance for Research in Exercise, Nutrition and Activity (ARENA), University of South Australia, Adelaide, SA Australia ,grid.266862.e0000 0004 1936 8163Department of Education, Health and Behavior Studies, University of North Dakota, Grand Forks, ND USA
| | - Mark S. Tremblay
- grid.414148.c0000 0000 9402 6172Healthy Active Living and Obesity Research Group, Children’s Hospital of Eastern Ontario Research Institute, Ottawa, ON Canada ,grid.28046.380000 0001 2182 2255Department of Pediatrics, University of Ottawa, Ottawa, ON Canada ,grid.34428.390000 0004 1936 893XDepartment of Health Sciences, Carleton University, Ottawa, ON Canada
| | - Stephen H. S. Wong
- grid.10784.3a0000 0004 1937 0482Department of Sports Science and Physical Education, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Brooklyn J. Fraser
- grid.1009.80000 0004 1936 826XMenzies Institute for Medical Research, University of Tasmania, Hobart, TAS Australia
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Jago R, Salway R, House D, Beets M, Lubans DR, Woods C, de Vocht F. Rethinking children's physical activity interventions at school: A new context-specific approach. Front Public Health 2023; 11:1149883. [PMID: 37124783 PMCID: PMC10133698 DOI: 10.3389/fpubh.2023.1149883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 03/21/2023] [Indexed: 05/02/2023] Open
Abstract
Physical activity is important for children's health. However, evidence suggests that many children and adults do not meet international physical activity recommendations. Current school-based interventions have had limited effect on physical activity and alternative approaches are needed. Context, which includes school setting, ethos, staff, and sociodemographic factors, is a key and largely ignored contributing factor to school-based physical activity intervention effectiveness, impacting in several interacting ways. Conceptualization Current programs focus on tightly-constructed content that ignores the context in which the program will be delivered, thereby limiting effectiveness. We propose a move away from uniform interventions that maximize internal validity toward a flexible approach that enables schools to tailor content to their specific context. Evaluation designs Evaluation of context-specific interventions should explicitly consider context. This is challenging in cluster randomized controlled trial designs. Thus, alternative designs such as natural experiment and stepped-wedge designs warrant further consideration. Primary outcome A collective focus on average minutes of moderate-to-vigorous intensity physical activity may not always be the most appropriate choice. A wider range of outcomes may improve children's physical activity and health in the long-term. In this paper, we argue that greater consideration of school context is key in the design and analysis of school-based physical activity interventions and may help overcome existing limitations in the design of effective interventions and thus progress the field. While this focus on context-specific interventions and evaluation is untested, we hope to stimulate debate of the key issues to improve future physical activity intervention development and implementation.
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Affiliation(s)
- Russell Jago
- Centre for Exercise, Nutrition and Health Sciences, School for Policy Studies, University of Bristol, Bristol, United Kingdom
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
- The National Institute for Health Research, Applied Research Collaboration West (NIHR ARC West), University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, United Kingdom
- NIHR Bristol Biomedical Research Centre, University Hospitals Bristol and Weston NHS Foundation Trust and University of Bristol, Bristol, United Kingdom
- *Correspondence: Russell Jago,
| | - Ruth Salway
- Centre for Exercise, Nutrition and Health Sciences, School for Policy Studies, University of Bristol, Bristol, United Kingdom
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Danielle House
- Centre for Exercise, Nutrition and Health Sciences, School for Policy Studies, University of Bristol, Bristol, United Kingdom
| | - Michael Beets
- Arnold School of Public Health, University of South Carolina, Columbia, SC, United States
| | - David Revalds Lubans
- Centre for Active Living and Learning, College of Human and Social Futures, University of Newcastle, Callaghan, NSW, Australia
- Hunter Medical Research Institute, Newcastle, NSW, Australia
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Catherine Woods
- Physical Activity for Health Research Centre, Health Research Institute, University of Limerick, Limerick, Ireland
| | - Frank de Vocht
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
- The National Institute for Health Research, Applied Research Collaboration West (NIHR ARC West), University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, United Kingdom
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Lubans DR, Sanders T, Noetel M, Parker P, McKay H, Morgan PJ, Salmon J, Kirwan M, Bennie A, Peralta L, Cinelli R, Moodie M, Hartwig T, Boyer J, Kennedy SG, Plotnikoff RC, Hansen V, Vasconcellos D, Lee J, Antczak D, Lonsdale C. Scale-up of the Internet-based Professional Learning to help teachers promote Activity in Youth (iPLAY) intervention: a hybrid type 3 implementation-effectiveness trial. Int J Behav Nutr Phys Act 2022; 19:141. [PMID: 36451168 PMCID: PMC9713961 DOI: 10.1186/s12966-022-01371-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Accepted: 10/06/2022] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Whole-of-school programs have demonstrated success in improving student physical activity levels, but few have progressed beyond efficacy testing to implementation at-scale. The purpose of our study was to evaluate the scale-up of the 'Internet-based Professional Learning to help teachers promote Activity in Youth' (iPLAY) intervention in primary schools using the RE-AIM framework. METHODS We conducted a type 3 hybrid implementation-effectiveness study and collected data between April 2016 and June 2021, in New South Wales (NSW), Australia. RE-AIM was operationalised as: (i) Reach: Number and representativeness of students exposed to iPLAY; (ii) Effectiveness: Impact of iPLAY in a sub-sample of students (n = 5,959); (iii) Adoption: Number and representativeness of schools that received iPLAY; (iv) Implementation: Extent to which the three curricular and three non-curricular components of iPLAY were delivered as intended; (v) Maintenance: Extent to which iPLAY was sustained in schools. We conducted 43 semi-structured interviews with teachers (n = 14), leaders (n = 19), and principals (n = 10) from 18 schools (11 from urban and 7 from rural locations) to determine program maintenance. RESULTS Reach: iPLAY reached ~ 31,000 students from a variety of socio-economic strata (35% of students were in the bottom quartile, almost half in the middle two quartiles, and 20% in the top quartile). EFFECTIVENESS We observed small positive intervention effects for enjoyment of PE/sport (0.12 units, 95% CI: 0.05 to 0.20, d = 0.17), perceptions of need support from teachers (0.26 units, 95% CI: 0.16 to 0.53, d = 0.40), physical activity participation (0.28 units, 95% CI: 0.10 to 0.47, d = 0.14), and subjective well-being (0.82 units, 95% CI: 0.32 to 1.32, d = 0.12) at 24-months. Adoption: 115 schools received iPLAY. IMPLEMENTATION Most schools implemented the curricular (59%) and non-curricular (55%) strategies as intended. Maintenance: Based on our qualitative data, changes in teacher practices and school culture resulting from iPLAY were sustained. CONCLUSIONS iPLAY had extensive reach and adoption in NSW primary schools. Most of the schools implemented iPLAY as intended and effectiveness data suggest the positive effects observed in our cluster RCT were sustained when the intervention was delivered at-scale. TRIAL REGISTRATION ACTRN12621001132831.
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Affiliation(s)
- D R Lubans
- grid.266842.c0000 0000 8831 109XCentre for Active Living and Learning, College of Human and Social Futures, University of Newcastle, Callaghan, NSW Australia ,grid.413648.cHunter Medical Research Institute, New Lambton Heights, NSW Australia ,grid.9681.60000 0001 1013 7965Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - T Sanders
- grid.411958.00000 0001 2194 1270Institute for Positive Psychology and Education, Australian Catholic University, North Sydney, NSW Australia
| | - M Noetel
- grid.1003.20000 0000 9320 7537School of Psychology, University of Queensland, Brisbane, QLD Australia
| | - P Parker
- grid.411958.00000 0001 2194 1270Institute for Positive Psychology and Education, Australian Catholic University, North Sydney, NSW Australia
| | - H McKay
- grid.17091.3e0000 0001 2288 9830Centre for Hip Health and Mobility, University of British Columbia, Vancouver, BC Canada
| | - PJ Morgan
- grid.266842.c0000 0000 8831 109XCentre for Active Living and Learning, College of Human and Social Futures, University of Newcastle, Callaghan, NSW Australia ,grid.413648.cHunter Medical Research Institute, New Lambton Heights, NSW Australia
| | - J Salmon
- grid.1021.20000 0001 0526 7079Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC Australia
| | - M Kirwan
- grid.1004.50000 0001 2158 5405Faculty of Medicine, Health and Human Sciences, Macquarie University, Macquarie Park, NSW Australia
| | - A Bennie
- grid.1029.a0000 0000 9939 5719School of Health Sciences, Western Sydney University, Penrith, NSW Australia
| | - L Peralta
- grid.1013.30000 0004 1936 834XSchool of Education and Social Work, University of Sydney, Camperdown, NSW Australia
| | - R Cinelli
- grid.411958.00000 0001 2194 1270School of Education, Australian Catholic University, Strathfield, NSW Australia
| | - M Moodie
- grid.1021.20000 0001 0526 7079Deakin Health Economics Deakin University, Burwood, VIC Australia
| | - T Hartwig
- grid.411958.00000 0001 2194 1270School of Behavioural and Health Sciences, Australian Catholic University, Strathfield, NSW Australia
| | - J Boyer
- grid.461941.f0000 0001 0703 8464NSW Department of Education, Turrella, NSW Australia
| | - S G Kennedy
- grid.1029.a0000 0000 9939 5719School of Health Sciences, Western Sydney University, Penrith, NSW Australia
| | - R C Plotnikoff
- grid.266842.c0000 0000 8831 109XCentre for Active Living and Learning, College of Human and Social Futures, University of Newcastle, Callaghan, NSW Australia ,grid.413648.cHunter Medical Research Institute, New Lambton Heights, NSW Australia
| | - V Hansen
- grid.1031.30000000121532610Southern Cross University, East Lismore, NSW Australia
| | | | - J Lee
- Global Centre for Modern Ageing, Tonsley, South Australia Australia
| | - D Antczak
- grid.411958.00000 0001 2194 1270Institute for Positive Psychology and Education, Australian Catholic University, North Sydney, NSW Australia
| | - C Lonsdale
- grid.411958.00000 0001 2194 1270Institute for Positive Psychology and Education, Australian Catholic University, North Sydney, NSW Australia
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Koorts H, Bauman A, Edwards N, Bellew W, Brown WJ, Duncan MJ, Lubans DR, Milat AJ, Morgan PJ, Nathan N, Searles A, Lee K, Plotnikoff RC. Tensions and Paradoxes of Scaling Up: A Critical Reflection on Physical Activity Promotion. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph192114284. [PMID: 36361159 PMCID: PMC9657872 DOI: 10.3390/ijerph192114284] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Revised: 10/20/2022] [Accepted: 10/27/2022] [Indexed: 05/21/2023]
Abstract
Achieving system-level, sustainable 'scale-up' of interventions is the epitome of successful translation of evidence-based approaches in population health. In physical activity promotion, few evidence-based interventions reach implementation at scale or become embedded within systems for sustainable health impact. This is despite the vast published literature describing efficacy studies of small-scale physical activity interventions. Research into physical activity scale-up (through case-study analysis; evaluations of scale-up processes in implementation trials; and mapping the processes, strategies, and principles for scale-up) has identified barriers and facilitators to intervention expansion. Many interventions are implemented at scale by governments but have not been evaluated or have unpublished evaluation information. Further, few public health interventions have evaluations that reveal the costs and benefits of scaled-up implementation. This lack of economic information introduces an additional element of risk for decision makers when deciding which physical activity interventions should be supported with scarce funding resources. Decision-makers face many other challenges when scaling interventions which do not relate to formal research trials of scale-up; Methods: To explore these issues, a multidisciplinary two-day workshop involving experts in physical activity scale-up was convened by the University of Newcastle, Australia, and the University of Ottawa, Canada (February 2019); Results: In this paper we discuss some of the scale-up tensions (challenges and conflicts) and paradoxes (things that are contrary to expectations) that emerged from this workshop in the context of the current literature and our own experiences in this field. We frame scale-up tensions according to epistemology, methodology, time, and partnerships; and paradoxes as 'reach without scale', 'planned serendipity' and 'simple complexity'. We reflect on the implications of these scale-up tensions and paradoxes, providing considerations for future scale-up research and practice moving forward; Conclusions: In this paper, we delve deeper into stakeholders' assumptions, processes and expectations of scaling up, and challenge in what ways as stakeholders, we all contribute to desired or undesired outcomes. Through a lens of 'tensions' and 'paradoxes', we make an original contribution to the scale-up literature that might influence current perspectives of scaling-up, provide future approaches for physical activity promotion, and contribute to understanding of dynamic of research-practice partnerships.
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Affiliation(s)
- Harriet Koorts
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC 3220, Australia
| | - Adrian Bauman
- Prevention Research Collaboration, Sydney School of Public Health, The University of Sydney, Sydney, NSW 2006, Australia
- The Australian Prevention Partnership Centre, Sax Institute, Sydney, NSW 2037, Australia
| | - Nancy Edwards
- School of Nursing, University of Ottawa, Ottawa, ON K1H 8M5, Canada
| | - William Bellew
- Sydney Medical School & Sydney School of Public Health, The University of Sydney, Sydney, NSW 2006, Australia
| | - Wendy J. Brown
- School of Human Movement and Nutrition Sciences, University of Queensland, St Lucia, QLD 4072, Australia
| | - Mitch J. Duncan
- School of Public Health, University of Newcastle, Callaghan, NSW 2308, Australia
| | - David R. Lubans
- Centre for Active Living and Learning, College of Human and Social Futures, University of Newcastle, Callaghan, NSW 2308, Australia
- Hunter Medical Research Institute, New Lambton Heights, NSW 2305, Australia
- Faculty of Sport and Health Sciences, University of Jyväskylä, 40014 Jyvaskyla, Finland
| | - Andrew J. Milat
- Prevention Research Collaboration, Sydney School of Public Health, The University of Sydney, Sydney, NSW 2006, Australia
- Centre for Epidemiology and Evidence, NSW Ministry of Health, 1 Reserve Rd., St Leonards, NSW 2065, Australia
| | - Philip J. Morgan
- Centre for Active Living and Learning, College of Human and Social Futures, University of Newcastle, Callaghan, NSW 2308, Australia
- Hunter Medical Research Institute, New Lambton Heights, NSW 2305, Australia
| | - Nicole Nathan
- Hunter Medical Research Institute, New Lambton Heights, NSW 2305, Australia
- School of Medicine and Public Health, The University of Newcastle, Newcastle, NSW 2308, Australia
- Hunter New England Population Health, Hunter New England Area Health Service, Newcastle, NSW 2287, Australia
| | - Andrew Searles
- Hunter Medical Research Institute, New Lambton Heights, NSW 2305, Australia
| | - Karen Lee
- Prevention Research Collaboration, Sydney School of Public Health, The University of Sydney, Sydney, NSW 2006, Australia
- The Australian Prevention Partnership Centre, Sax Institute, Sydney, NSW 2037, Australia
| | - Ronald C. Plotnikoff
- Centre for Active Living and Learning, College of Human and Social Futures, University of Newcastle, Callaghan, NSW 2308, Australia
- Hunter Medical Research Institute, New Lambton Heights, NSW 2305, Australia
- Correspondence: ; Tel.: +61-(02)-49854465
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Bonnema J, Coetzee D, Lennox A. Effect of a Three-Month HOPSports Brain Breaks ® Intervention Program on the Physical Fitness Levels of Grade 6-Learners in South Africa. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11236. [PMID: 36141508 PMCID: PMC9517318 DOI: 10.3390/ijerph191811236] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 09/02/2022] [Accepted: 09/04/2022] [Indexed: 06/16/2023]
Abstract
Despite the numerous health benefits of being physically active, children are not active enough. Various researchers have indicated that intervention programs improve physical fitness levels. Still, only a few have focused on improving physical fitness levels by incorporating technology. HOPSports Brain Breaks® are designed and presented as physical activity solutions with online videos requiring the participants to imitate the movements. These videos are 2-5-min classroom activity breaks. This study determined the effect of a three-month HOPSports Brain Breaks® intervention program on the physical fitness levels of Grade 6-learners. Physical fitness was measured with the EUROFIT test battery. The experimental group consisted of 79 children (26 boys and 47 girls) and the control group of 47 children (16 boys and 33 girls). The mean age for the entire group was 11.92 (±0.36) years. The results indicated that there was a statistically (p ≤ 0.05) and practically (d ≥ 0.20) significant difference between the experimental and control group for percentage body fat; stork balance; plate tapping; sit-and-reach; standing jump; sit-ups; and 10 × 5 m shuttle run and 20 m shuttle run between the pre-and post-test. Therefore, considering the results mentioned above, the HOPSports Brain Breaks® intervention program can indeed contribute to the improvement of physical fitness, and motor skills of children. Therefore, future studies should be conducted to determine the effect of HOPSports Brain Breaks® between genders as well as what impact it will have on academic performance.
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Affiliation(s)
- Jacqueline Bonnema
- Physical Activity, Sport and Recreation, (PhASRec) Focus Area, Faculty of Health Science, North-West University, Potchefstroom Campus, Private Bag X 6001, Potchefstroom 2531, South Africa
| | - Dané Coetzee
- Physical Activity, Sport and Recreation, (PhASRec) Focus Area, Faculty of Health Science, North-West University, Potchefstroom Campus, Private Bag X 6001, Potchefstroom 2531, South Africa
| | - Anita Lennox
- School of Management Sciences, North-West University (Vaal Triangle Campus), Vanderbijlpark 1900, South Africa
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Gao L, Tan E, Kim J, Bladin CF, Dewey HM, Bagot KL, Cadilhac DA, Moodie M. Telemedicine for Stroke: Quantifying the Long-Term National Costs and Health Benefits. Front Neurol 2022; 12:804355. [PMID: 35813183 PMCID: PMC9265143 DOI: 10.3389/fneur.2021.804355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Accepted: 12/22/2021] [Indexed: 11/13/2022] Open
Abstract
ObjectiveFew countries have established national programs to maximize access and reduce operational overheads. We aimed to use patient-level data up to 12 months to model the potential long-term costs and health benefits attributable to implementing such a program for Australia.MethodsA Markov model was created for Australia with an inception population of 10,000 people with stroke presenting to non–urban or suburban hospitals without stroke medical specialists that could receive stroke telemedicine under a national program. Seven Markov states represented the seven modified Rankin Scale (mRS) scores (0 no disability to 6 dead) plus an absorbing state for all other causes of death. The literature informed inputs for the model; for the telemedicine program (including program costs and effectiveness) and patients, these were extrapolated from the Victorian Stroke Telemedicine (VST) program with the initial status of patients being their health state at day 365 as determined by their mRS score. Costs (2018 Australian dollars, healthcare, non–medical, and nursing home) and benefits were reported for both the societal and healthcare perspectives for up to a 25 years (lifetime) time horizon.ResultsWe assumed 4,997 to 12,578 ischemic strokes would arrive within 4.5 h of symptom onset at regional hospitals in 2018. The average per person lifetime costs were $126,461 and $127,987 from a societal perspective or $76,680 and $75,901 from a healthcare system perspective and benefits were 4.43 quality-adjusted life years (QALYs) and 3.98 QALYs gained, respectively, for the stroke telemedicine program and practice without such program. The stroke telemedicine program was associated with a cost saving of $1,526 (from the societal perspective) or an additional $779 (from the healthcare system perspective) and an additional 0.45 QALY gained per patient over the lifetime. The incremental costs of the stroke telemedicine program ($2,959) and management poststroke ($813) were offset by cost savings from rehospitalization (–$552), nursing home care (–$2178), and non–medical resource use (–$128).ConclusionThe findings from this long-term model provide evidence to support ongoing funding for stroke telemedicine services in Australia. Our estimates are conservative since other benefits of the service outside the use of intravenous thrombolysis were not included.
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Affiliation(s)
- Lan Gao
- Deakin Health Economics, Institute for Health Transformation, Deakin University, Geelong, VIC, Australia
| | - Elise Tan
- Deakin Health Economics, Institute for Health Transformation, Deakin University, Geelong, VIC, Australia
| | - Joosup Kim
- Stroke and Ageing Research, School of Clinical Sciences at Monash Health, Monash University, Melbourne, VIC, Australia
- Stroke Division, Florey Institute of Neuroscience and Mental Health, Parkville, VIC, Australia
| | - Christopher F. Bladin
- Stroke Division, Florey Institute of Neuroscience and Mental Health, Parkville, VIC, Australia
- Ambulance Victoria, Doncaster, VIC, Australia
| | - Helen M. Dewey
- Eastern Health and Eastern Health Clinical School, Monash University, Melbourne, VIC, Australia
| | - Kathleen L. Bagot
- Stroke and Ageing Research, School of Clinical Sciences at Monash Health, Monash University, Melbourne, VIC, Australia
- Stroke Division, Florey Institute of Neuroscience and Mental Health, Parkville, VIC, Australia
| | - Dominique A. Cadilhac
- Stroke and Ageing Research, School of Clinical Sciences at Monash Health, Monash University, Melbourne, VIC, Australia
- Stroke Division, Florey Institute of Neuroscience and Mental Health, Parkville, VIC, Australia
- *Correspondence: Dominique A. Cadilhac
| | - Marj Moodie
- Deakin Health Economics, Institute for Health Transformation, Deakin University, Geelong, VIC, Australia
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Goswami N, Hansen D, Gumze G, Brix B, Schmid-Zalaudek K, Fredriksen PM. Health and Academic Performance With Happy Children: A Controlled Longitudinal Study Based on the HOPP Project. Front Cardiovasc Med 2022; 9:820827. [PMID: 35722126 PMCID: PMC9203822 DOI: 10.3389/fcvm.2022.820827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Accepted: 04/29/2022] [Indexed: 11/29/2022] Open
Abstract
Background Overweight/obesity in children and adolescents, largely arising due to increased food intake and reduced physical activity, is a major health concern. Physical activity (PA) integrated into learning has been shown to not only lead to improved health outcomes and wellbeing but also positively affect academic performance. The Health and Academic Performance with Happy Children (HAPHC) project aims at enhancing health and academic performance in elementary school children via implementation of a daily unit of Physical Activity Across the Curriculum (PAAC), which is carried out within the school setting. In this project, PA as an integrated part of learning will be evaluated and the learning material adapted for a large scale implementation across several European countries. Methods In three European countries (Austria, Slovenia, and Belgium), 12 primary schools in total will be recruited to act as either intervention or control school in a large intervention study, which applies the PAAC pedagogy during lectures. It is estimated that, at least 3,000+ children across the three countries will be recruited in this study. All teachers of intervention schools will receive training and materials/teaching equipment that will allow them to integrate a daily PA unit of 45 min over 3 years across the curriculum. In response to the daily PA intervention, the following primary outcomes will be assessed: changes in health related physiological factors, academic achievement, psycho-social aspects and wellbeing. Impact of Project The HAPHC project aims at promoting public health by increasing PA at an early age within the school setting and therewith preventing the increasing risk of non-communicable diseases across Europe. HAPHC project aims to develop knowledge and materials, which will ensure that the PAAC can be scalable to other European countries. Trial Registration Number ClinicalTrials.gov, identifier: NCT04956003.
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Affiliation(s)
- Nandu Goswami
- Physiology Division, Otto Loewi Research Center, Medical University of Graz, Graz, Austria
- Health Sciences, Alma Mater Europaea, Maribor, Slovenia
- Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai Healthcare City, Dubai, United Arab Emirates
| | - Dominique Hansen
- REVAL/BIOMED, Faculty of Rehabilitation Sciences, Hasselt/Heart Centre Hasselt, Jessa Hospital, Hasselt University, Hasselt, Belgium
- *Correspondence: Dominique Hansen
| | - Goran Gumze
- Health Sciences, Alma Mater Europaea ECM, Maribor, Slovenia
| | - Bianca Brix
- Physiology Division, Otto Loewi Research Center, Medical University of Graz, Graz, Austria
| | - Karin Schmid-Zalaudek
- Physiology Division, Otto Loewi Research Center, Medical University of Graz, Graz, Austria
| | - Per Morten Fredriksen
- Faculty of Health and Social Science, Inland Norway University of Applied Sciences, Hamar, Norway
- School of Health Sciences, Kristiania University College, Oslo, Norway
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13
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Cheung AT, Li WHC, Ho LLK, Chan GCF, Lam HS, Chung JOK. Efficacy of Mobile Instant Messaging-Delivered Brief Motivational Interviewing for Parents to Promote Physical Activity in Pediatric Cancer Survivors: A Randomized Clinical Trial. JAMA Netw Open 2022; 5:e2214600. [PMID: 35699959 PMCID: PMC9198728 DOI: 10.1001/jamanetworkopen.2022.14600] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Accepted: 04/12/2022] [Indexed: 01/10/2023] Open
Abstract
Importance Physical activity has beneficial effects that mitigate cancer- and treatment-related late effects. However, children who survive cancer are often physically inactive. Brief motivational interviewing may be an effective approach for increasing children's physical activity levels. Objective To examine the effects of mobile instant messaging-delivered brief motivational interviewing for parents in promoting regular physical activity in children who have survived cancer. Design, Setting, and Participants An assessor-blinded randomized clinical trial was conducted at 2 Hong Kong pediatric oncology outpatient clinics from March 1, 2019, to January 29, 2021. A total of 161 children who had survived cancer, aged 9 to 16 years, and their parents were randomized (1:1) to an intervention or control group. Interventions The intervention group received a 6-month mobile instant messaging-delivered brief motivational interviewing using a strategy menu. Parent-child dyads in both groups received a health advice session and were directed to a physical activity website at baseline. Main Outcomes and Measures The primary outcome was the children's physical activity levels at 12-month follow-up, measured by the Chinese University of Hong Kong: Physical Activity Rating for Children and Youth (total sores: 0-10, higher scores indicate greater physical activity levels). Secondary outcomes were cancer-related fatigue levels, handgrip strength, peak expiratory flow rate, and quality of life. Intention-to-treat analysis was performed. Results Of the 161 children included in the study, 93 were boys (57.8%), and the mean (SD) age was 12.4 (2.4) years. Generalized estimating equation analyses showed a significant improvement in outcomes in the intervention group compared with the control group: physical activity levels (group-by-time interaction, 6 months: β = 3.09; 95% CI, 2.65-3.53; P < .001; 12 months: β = 3.91; 95% CI, 3.45-4.36; P < .001), cancer-related fatigue (6 months: β = -5.69; 95% CI, -8.03 to -3.35; P < .001; 12 months: β = -9.16; 95% CI, -11.31 to -7.00; P < .001), left handgrip strength (6 months: β = 2.69; 95% CI, 0.96-4.43; P = .002; 12 months: β = 5.52; 95% CI, 3.70-7.33; P < .001), right handgrip strength (6 months: β = 2.75; 95% CI, 1.01-4.50; P = .002; 12 months: β = 5.45; 95% CI, 3.62-7.27; P < .001), peak expiratory flow rate (12 months: β = 28.51; 95% CI, 16.10-40.92; P < .001), and quality of life (6 months: β = 5.01; 95% CI, 1.19-8.82; P = .01); 12 months: β = 14.19; 95% CI, 10.84-17.54; P < .001). Conclusions and Relevance In this randomized clinical trial, mobile instant messaging-delivered brief motivational interviewing was effective in promoting the adoption and maintenance of regular physical activity and ameliorating cancer- or treatment-related adverse effects in children who survived cancer. Trial Registration ClinicalTrials.gov Identifier: NCT03859271.
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Affiliation(s)
- Ankie Tan Cheung
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Sha Tin, Hong Kong
| | - William Ho Cheung Li
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Sha Tin, Hong Kong
| | - Laurie Long Kwan Ho
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Sha Tin, Hong Kong
| | - Godfrey Chi-Fung Chan
- Department of Paediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
- Department of Paediatrics and Adolescent Medicine, Hong Kong Children's Hospital, Hong Kong Children’s Hospital, Hong Kong
| | - Huen Sum Lam
- Hong Kong Council for Accreditation of Academic and Vocational Qualifications, Hong Kong
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14
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Duncombe SL, Barker AR, Bond B, Earle R, Varley-Campbell J, Vlachopoulos D, Walker JL, Weston KL, Stylianou M. School-based high-intensity interval training programs in children and adolescents: A systematic review and meta-analysis. PLoS One 2022; 17:e0266427. [PMID: 35507539 PMCID: PMC9067698 DOI: 10.1371/journal.pone.0266427] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Accepted: 03/18/2022] [Indexed: 01/27/2023] Open
Abstract
PURPOSE 1) To investigate the effectiveness of school-based high-intensity interval training (HIIT) interventions in promoting health outcomes of children and adolescents compared with either a control group or other exercise modality; and 2) to explore the intervention characteristics and process outcomes of published school-based HIIT interventions. METHODS We searched Medline, Embase, CINAHL, SPORTDiscus, and Web of Science from inception until 31 March 2021. Studies were eligible if 1) participants aged 5-17 years old; 2) a HIIT intervention within a school setting ≥ 2 weeks duration; 3) a control or comparative exercise group; 4) health-related, cognitive, physical activity, nutrition, or program evaluation outcomes; and 5) original research published in English. We conducted meta-analyses between HIIT and control groups for all outcomes with ≥ 4 studies and meta-regressions for all outcomes with ≥ 10 studies. We narratively synthesised results between HIIT and comparative exercise groups. RESULTS Fifty-four papers met eligibility criteria, encompassing 42 unique studies (35 randomised controlled trials; 36 with a high risk of bias). Meta-analyses indicated significant improvements in waist circumference (mean difference (MD) = -2.5cm), body fat percentage (MD = -1.7%), body mass index (standardised mean difference (SMD) = -1.0), cardiorespiratory fitness (SMD = +1.0), resting heart rate (MD = -5bpm), homeostatic model assessment-insulin resistance (MD = -0.7), and low-density lipoprotein cholesterol (SMD = -0.9) for HIIT compared to the control group. Our narrative synthesis indicated mixed findings between HIIT and other comparative exercise groups. CONCLUSION School-based HIIT is effective for improving several health outcomes. Future research should address the paucity of information on physical activity and nutrition outcomes and focus on the integration and long-term effectiveness of HIIT interventions within school settings. TRIAL REGISTRATION NUMBER PROSPERO CRD42018117567.
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Affiliation(s)
- Stephanie L. Duncombe
- School of Human Movement and Nutrition Sciences, University of Queensland, Saint Lucia, Queensland, Australia
- Children’s Health and Exercise Research Centre, Sport and Health Sciences, College of Life and Environmental Sciences, University of Exeter, Exeter, United Kingdom
| | - Alan R. Barker
- Children’s Health and Exercise Research Centre, Sport and Health Sciences, College of Life and Environmental Sciences, University of Exeter, Exeter, United Kingdom
| | - Bert Bond
- Children’s Health and Exercise Research Centre, Sport and Health Sciences, College of Life and Environmental Sciences, University of Exeter, Exeter, United Kingdom
| | - Renae Earle
- School of Human Movement and Nutrition Sciences, University of Queensland, Saint Lucia, Queensland, Australia
| | - Jo Varley-Campbell
- Department of Clinical, Educational and Health Psychology, University College London, London, United Kingdom
| | - Dimitris Vlachopoulos
- Children’s Health and Exercise Research Centre, Sport and Health Sciences, College of Life and Environmental Sciences, University of Exeter, Exeter, United Kingdom
| | - Jacqueline L. Walker
- School of Human Movement and Nutrition Sciences, University of Queensland, Saint Lucia, Queensland, Australia
| | - Kathryn L. Weston
- School of Applied Sciences, Edinburgh Napier University, Edinburgh, United Kingdom
| | - Michalis Stylianou
- School of Human Movement and Nutrition Sciences, University of Queensland, Saint Lucia, Queensland, Australia
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15
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Ma J, Hogan MJ, Eyre ELJ, Lander N, Barnett LM, Duncan MJ. Enhancing the implementation and sustainability of fundamental movement skill interventions in the UK and Ireland: lessons from collective intelligence engagement with stakeholders. Int J Behav Nutr Phys Act 2021; 18:144. [PMID: 34732223 PMCID: PMC8565647 DOI: 10.1186/s12966-021-01214-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2021] [Accepted: 10/14/2021] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND To have population-level impact, physical activity (PA) interventions must be effectively implemented and sustained under real-world conditions. Adequate Fundamental Movement Skills (FMS) is integral to children being able to actively participate in play, games, and sports. Yet, few FMS interventions have been implemented at scale, nor sustained in routine practice, and thus it is important to understand the influences on sustained implementation. The study's aim was to use Collective Intelligence (CI)-an applied systems science approach-with stakeholder groups to understand barriers to the implementation of FMS interventions, interdependencies between these barriers, and options to overcome the system of barriers identified. METHODS Three CI sessions were conducted with three separate groups of experienced FMS intervention researchers/practitioners (N = 22) in the United Kingdom and Ireland. Participants generated and ranked barriers they perceive most critical in implementing FMS interventions. Each group developed a structural model describing how highly ranked barriers are interrelated in a system. Participants then conducted action mapping to solve the problem based on the logical relations between barriers reflected in the model. RESULTS The top ranked barriers (of 76) are those related to policy, physical education curriculum, and stakeholders' knowledge and appreciation. As reflected in the structural model, these barriers have influences over stakeholders' efficacy in delivering and evaluating interventions. According to this logical structure, 38 solutions were created as a roadmap to inform policy, practice, and research. Collectively, solutions suggest that efforts in implementation and sustainability need to be coordinated (i.e., building interrelationship with multiple stakeholders), and a policy or local infrastructure that supports these efforts is needed. CONCLUSIONS The current study is the first to describe the complexity of barriers to implementing and sustaining FMS interventions and provide a roadmap of actions that help navigate through the complexity. By directing attention to the ecological context of FMS intervention research and participation, the study provides researchers, policy makers, and practitioners with a framework of critical components and players that need to be considered when designing and operationalising future projects in more systemic and relational terms.
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Affiliation(s)
- Jiani Ma
- Centre for Sport, Exercise and Life Sciences, Faculty of Health and Life Sciences, Coventry University, Coventry, UK.
- School of Health and Social Development, Institute for Physical Activity and Nutrition, Deakin University, Melbourne, Australia.
| | - Michael J Hogan
- School of Psychology, National University of Ireland, Galway, Ireland
| | - Emma L J Eyre
- Centre for Sport, Exercise and Life Sciences, Faculty of Health and Life Sciences, Coventry University, Coventry, UK
| | - Natalie Lander
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Melbourne, Australia
| | - Lisa M Barnett
- School of Health and Social Development, Institute for Physical Activity and Nutrition, Deakin University, Melbourne, Australia
| | - Michael J Duncan
- Centre for Sport, Exercise and Life Sciences, Faculty of Health and Life Sciences, Coventry University, Coventry, UK
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16
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The Relation between Physical Education Teachers' (De-)Motivating Style, Students' Motivation, and Students' Physical Activity: A Multilevel Approach. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18147457. [PMID: 34299907 PMCID: PMC8307004 DOI: 10.3390/ijerph18147457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 07/09/2021] [Accepted: 07/11/2021] [Indexed: 11/16/2022]
Abstract
Research suggests that physical education (PE) teachers can play a crucial role in the promotion of students’ physical activity. Grounded in Self-Determination Theory, this study investigated how students’ perceptions of PE teachers (de-)motivating style relate to students’ device-based physical activity levels during PE. Moreover, it was examined whether students’ motivation plays an intervening role in this relation and whether students’ physical activity differs according to their gender and lesson topic. A sample of 302 secondary school students aged between 11 and 16 years (M = 13.05, SD = 1.04) completed a questionnaire assessing their perceptions of teachers’ (de-)motivating style and their personal motivation toward PE. Students also wore ActiGraph GT3X accelerometers during the PE lesson. Multilevel structural equation modeling revealed that the teachers’ motivating style had a significant positive relation with students’ autonomous motivation, both at the student level and the class level, and teachers’ controlling style had a significant positive relation with students’ controlled motivation and amotivation at both levels. However, in terms of students’ physical activity levels, students’ gender, the lesson topic, and teachers’ controlling style seemed to be more decisive than students’ motivation and teachers’ motivating style.
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