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Poulos A, Wilson K, Schulke M, Nam K, Ohri-Vachaspati P, Bai Y, Kulinna PH. A natural experiment to assess recess frequency on children's physical activity in Arizona (U.S.) elementary schools. BMC Public Health 2024; 24:225. [PMID: 38238751 PMCID: PMC10797942 DOI: 10.1186/s12889-023-17605-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Accepted: 12/28/2023] [Indexed: 01/22/2024] Open
Abstract
BACKGROUND In the United States, the number of state policies mandating recess in schools has rapidly increased over the past decade; however, few policies specify recess frequency. Informed by an ecological model of physical activity (PA) policy, this study examined and compared total amounts and intensity of PA expended during recess among children attending schools in compliance with Arizona recess policy ARS§ 15-118 mandating 2 + daily recess periods versus not. METHODS PA during recess was measured among grade three children (ages 8-10) in four randomly selected elementary schools (two complying averaging 30 daily recess minutes; two non-complying averaging 15 daily recess minutes) in Maricopa County, Arizona. Group-level PA was assessed by direct observation using the System for Observing Play and Leisure (137 observations). A subset of students (N = 134) from all schools wore ActiGraph GT3X + devices during recess to measure individual PA. General linear mixed effects models were used to analyze the impact of recess frequency on group and individual PA during recess. RESULTS Students attending complying schools spent significantly greater proportions of time in moderate-to-vigorous PA (MVPA) based on direct observation (5%) and accelerometry (15%) and less time being sedentary based on accelerometry (14%) during recess. Across the school day, this would equate to 5.1 more MVPA minutes based on systematic direct observation and 9.5 more MVPA minutes based on accelerometry, and 4.1 less minutes being sedentary based on accelerometry if students received two daily 15-minute recess periods compared to one. CONCLUSIONS Students attending elementary schools implementing 2 + recesses, in accordance with state policy, demonstrated greater MVPA and less sedentary time, providing preliminary evidence that recess frequency is associated with greater PA intensity among children during recess. Schools that adhere to state-level PA policies may provide a more supportive environment for PA, resulting in increased movement among students. Specifying recess frequency should be considered in statewide recess policy.
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Affiliation(s)
- Allison Poulos
- College of Health Solutions, Arizona State University, ABC 222 425 North 5th Street, Phoenix, AZ, 85004, USA.
| | - Kylie Wilson
- College of Health Solutions, Arizona State University, ABC 222 425 North 5th Street, Phoenix, AZ, 85004, USA
| | - Marissa Schulke
- College of Health Solutions, Arizona State University, ABC 222 425 North 5th Street, Phoenix, AZ, 85004, USA
| | - Kahyun Nam
- Mary Lou Fulton Teachers College, Arizona State University, Tempe, AZ, 85281, USA
| | - Punam Ohri-Vachaspati
- College of Health Solutions, Arizona State University, ABC 222 425 North 5th Street, Phoenix, AZ, 85004, USA
| | - Yang Bai
- Department of Health and Kinesiology, University of Utah, Salt Lake City, UT, 84112, USA
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Quail KR, Ward CL. Using Non-Violent Discipline Tools: Evidence Suggesting the Importance of Attunement. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:7187. [PMID: 38131738 PMCID: PMC10742770 DOI: 10.3390/ijerph20247187] [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: 09/23/2023] [Revised: 12/07/2023] [Accepted: 12/07/2023] [Indexed: 12/23/2023]
Abstract
Training in non-violent discipline is important to prevent violence against children and ensure that their caregivers remain a safe base for them. This paper aims to deepen understanding of non-violent discipline by exploring attunement as a mechanism in the effectiveness of non-violent discipline tools. Attunement describes the sensitive responsiveness of caregivers towards their children and has been found to be central to the formation of secure attachment bonds and development of self-regulation. It includes understanding or being "in tune with" the child's needs and signals, matching these with appropriate responses. The objective of this paper is to explore attunement in relation to non-violent discipline. Peer-reviewed systematic reviews previously included in a systematic overview of evidence on non-violent discipline options were screened for information relevant to attunement. All reviews were published in English between 1999 and 2018 and offered evidence on at least one non-violent discipline tool. Although no reviews explicitly addressed attunement, evidence was found suggesting its importance in the use and effectiveness of discipline methods. Research directly investigating attunement in discipline is needed.
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Affiliation(s)
- Karen R. Quail
- Department of Psychology, Faculty of Humanities, University of Cape Town, Cape Town 7700, South Africa;
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Nathan N, Hall A, Shoesmith A, Bauman AE, Peden B, Duggan B, Gardner C, Lane C, Lecathelinais C, Oldmeadow C, Duncan C, Groombridge D, Riley-Gibson E, Pollock E, Boyer J, Wiggers J, Gillham K, Pattinson M, Mattingly M, McCarthy N, Naylor PJ, Reeves P, Budgen P, Sutherland R, Jackson R, Croft T, Pascoe W, Wolfenden L. A cluster randomised controlled trial to assess the effectiveness of a multi-strategy sustainability intervention on teachers' sustained implementation of classroom physical activity breaks (energisers): study protocol. BMC Public Health 2023; 23:1942. [PMID: 37805480 PMCID: PMC10559446 DOI: 10.1186/s12889-023-16810-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 09/21/2023] [Indexed: 10/09/2023] Open
Abstract
BACKGROUND Governments internationally have invested hugely in the implementation and scale-up of school-based physical activity interventions, but have little evidence of how to best sustain these interventions once active implementation support ceases. This study will assess the effectiveness of a multi-strategy sustainability intervention on classroom teachers' sustainment of energisers (short 3-5 min physical activity breaks during class-time) scheduled across the school day from baseline to 12 and 24-month follow-up. METHODS A cluster randomised controlled trial will be conducted in 50 primary schools within the Hunter New England, Illawarra Shoalhaven, Murrumbidgee and Northern New South Wales (NSW) Local Health Districts of NSW Australia. Schools will be randomly allocated to receive either usual support or the multi-strategy sustainability intervention that includes: centralised technical assistance from a trained project officer; formal commitment and mandated change obtained from school principals; training in-school champions; reminders for teachers; educational materials provided to teachers; capturing and sharing local knowledge; and engagement of parents, carers and the wider school community. The primary trial outcome will be measured via a teacher logbook to determine the between-group difference in the change in mean minutes of energisers scheduled across the school day at 12 and 24-month follow-up compared to baseline. Analyses will be performed using an intention to treat framework. Linear mixed models will be used to assess intervention effects on the primary outcome at both follow-up periods. DISCUSSION This study will be one of the first randomised controlled trials to examine the impact of a multi-strategy sustainability intervention to support schools' sustainment of a physical activity intervention. The proposed research will generate new evidence needed for the partnering organisations to protect their considerable investments to date in physical activity promotion in this setting and will provide seminal evidence for the field globally. TRIAL REGISTRATION ACTRN12620000372987 version 1 registered 17th March 2020. Version 3 (current version) updated 4th August 2023.
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Affiliation(s)
- Nicole Nathan
- Hunter New England Population Health, Hunter New England Area Health Service, Newcastle, NSW Australia
- School of Medicine and Public Health, The University of Newcastle, Newcastle, NSW Australia
- National Centre of Implementation Science, Hunter New England Area Health Service, Newcastle, NSW Australia
- Hunter Medical Research Institute, New Lambton Heights, NSW Australia
| | - Alix Hall
- Hunter New England Population Health, Hunter New England Area Health Service, Newcastle, NSW Australia
- School of Medicine and Public Health, The University of Newcastle, Newcastle, NSW Australia
- National Centre of Implementation Science, Hunter New England Area Health Service, Newcastle, NSW Australia
- Hunter Medical Research Institute, New Lambton Heights, NSW Australia
| | - Adam Shoesmith
- Hunter New England Population Health, Hunter New England Area Health Service, Newcastle, NSW Australia
- School of Medicine and Public Health, The University of Newcastle, Newcastle, NSW Australia
- National Centre of Implementation Science, Hunter New England Area Health Service, Newcastle, NSW Australia
- Hunter Medical Research Institute, New Lambton Heights, NSW Australia
- Hunter New England Population Health, Hunter New England Local Health District, Locked Bag No. 10, Wallsend, NSW 2287 Australia
| | - Adrian E. Bauman
- Prevention Research Collaboration, Sydney School of Public Health, Sydney, Australia
- Charles Perkins Centre (D17), The University of Sydney, Sydney, NSW 2006 Australia
- Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW Australia
| | - Belinda Peden
- School of Medicine and Public Health, The University of Newcastle, Newcastle, NSW Australia
| | - Bernadette Duggan
- Catholic Schools Office Diocese of Maitland-Newcastle, Newcastle, NSW Australia
| | - Carly Gardner
- School of Medicine and Public Health, The University of Newcastle, Newcastle, NSW Australia
- National Centre of Implementation Science, Hunter New England Area Health Service, Newcastle, NSW Australia
| | - Cassandra Lane
- Hunter New England Population Health, Hunter New England Area Health Service, Newcastle, NSW Australia
- School of Medicine and Public Health, The University of Newcastle, Newcastle, NSW Australia
- National Centre of Implementation Science, Hunter New England Area Health Service, Newcastle, NSW Australia
- Hunter Medical Research Institute, New Lambton Heights, NSW Australia
| | - Christophe Lecathelinais
- Hunter New England Population Health, Hunter New England Area Health Service, Newcastle, NSW Australia
| | | | - Craig Duncan
- Catholic Schools Office Diocese of Maitland-Newcastle, Newcastle, NSW Australia
| | - Daniel Groombridge
- Hunter New England Population Health, Hunter New England Area Health Service, Newcastle, NSW Australia
| | - Edward Riley-Gibson
- Hunter New England Population Health, Hunter New England Area Health Service, Newcastle, NSW Australia
- School of Medicine and Public Health, The University of Newcastle, Newcastle, NSW Australia
- National Centre of Implementation Science, Hunter New England Area Health Service, Newcastle, NSW Australia
- Hunter Medical Research Institute, New Lambton Heights, NSW Australia
| | - Emma Pollock
- Hunter New England Population Health, Hunter New England Area Health Service, Newcastle, NSW Australia
- National Centre of Implementation Science, Hunter New England Area Health Service, Newcastle, NSW Australia
- Hunter Medical Research Institute, New Lambton Heights, NSW Australia
| | - James Boyer
- The NSW Department of Education, Sydney, NSW Australia
| | - John Wiggers
- Hunter New England Population Health, Hunter New England Area Health Service, Newcastle, NSW Australia
- School of Medicine and Public Health, The University of Newcastle, Newcastle, NSW Australia
- National Centre of Implementation Science, Hunter New England Area Health Service, Newcastle, NSW Australia
- Hunter Medical Research Institute, New Lambton Heights, NSW Australia
| | - Karen Gillham
- Hunter New England Population Health, Hunter New England Area Health Service, Newcastle, NSW Australia
- Hunter Medical Research Institute, New Lambton Heights, NSW Australia
| | - Martina Pattinson
- Health Promotion, Northern NSW Local Health District, Lismore, NSW Australia
| | - Megan Mattingly
- Health Promotion, Murrumbidgee Local Health District, Suite 1B/620 Macauley Street, Albury, NSW 2640 Australia
| | - Nicole McCarthy
- Hunter New England Population Health, Hunter New England Area Health Service, Newcastle, NSW Australia
- School of Medicine and Public Health, The University of Newcastle, Newcastle, NSW Australia
- National Centre of Implementation Science, Hunter New England Area Health Service, Newcastle, NSW Australia
- Hunter Medical Research Institute, New Lambton Heights, NSW Australia
| | - Patti-Jean Naylor
- School of Exercise Science, Physical and Health Education, University of Victoria, Victoria, BC Canada
| | - Penny Reeves
- School of Medicine and Public Health, The University of Newcastle, Newcastle, NSW Australia
- Hunter Medical Research Institute, New Lambton Heights, NSW Australia
| | - Philippa Budgen
- Health Promotion Service, Illawarra Shoalhaven Local Health District, NSW Health, Warrawong, NSW Australia
| | - Rachel Sutherland
- Hunter New England Population Health, Hunter New England Area Health Service, Newcastle, NSW Australia
- School of Medicine and Public Health, The University of Newcastle, Newcastle, NSW Australia
- National Centre of Implementation Science, Hunter New England Area Health Service, Newcastle, NSW Australia
- Hunter Medical Research Institute, New Lambton Heights, NSW Australia
| | - Rebecca Jackson
- Hunter New England Population Health, Hunter New England Area Health Service, Newcastle, NSW Australia
| | - Thomas Croft
- Aboriginal Health Unit, Hunter New England Local Health District, Wallsend, NSW Australia
| | - William Pascoe
- Hunter New England Population Health, Hunter New England Area Health Service, Newcastle, NSW Australia
- School of Medicine and Public Health, The University of Newcastle, Newcastle, NSW Australia
- National Centre of Implementation Science, Hunter New England Area Health Service, Newcastle, NSW Australia
- Hunter Medical Research Institute, New Lambton Heights, NSW Australia
| | - Luke Wolfenden
- Hunter New England Population Health, Hunter New England Area Health Service, Newcastle, NSW Australia
- School of Medicine and Public Health, The University of Newcastle, Newcastle, NSW Australia
- National Centre of Implementation Science, Hunter New England Area Health Service, Newcastle, NSW Australia
- Hunter Medical Research Institute, New Lambton Heights, NSW Australia
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Wendt J, Scheller DA, Flechtner-Mors M, Meshkovska B, Luszczynska A, Lien N, Forberger S, Banik A, Lobczowska K, Steinacker JM. Barriers and facilitators to the adoption of physical activity policies in elementary schools from the perspective of principals: An application of the consolidated framework for implementation research-A cross-sectional study. Front Public Health 2023; 11:935292. [PMID: 36908436 PMCID: PMC9992422 DOI: 10.3389/fpubh.2023.935292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Accepted: 01/24/2023] [Indexed: 02/24/2023] Open
Abstract
Background Studies have shown that policies to promote physical activity in schools can have a positive impact on children's physical activity behavior. However, a large research gap exists as to what determinants may influence the adoption of such policies. Applying the Consolidated Framework for Implementation Research (CFIR), we investigated barriers and facilitators to the adoption of physical activity policies in elementary schools in Baden-Wuerttemberg, Germany, from the perspective of school principals. Methods A cross-sectional study was conducted between May and June 2021. School principals from elementary and special needs schools (n = 2,838) were invited to participate in the study. The online questionnaire used was developed based on the CFIR and included questions on school characteristics and constructs of the CFIR domains inner setting, characteristics of individuals, and process. Logistic regression analyses were performed to examine associations between policy adoption and school characteristics as well as CFIR determinants. Results In total, 121 schools (4%) participated in the survey, of which 49 (40.5%) reported having adopted a policy to promote physical activity. Positive associations with policy adoption were found for general willingness among teaching staff [odds ratio (OR): 5.37, 95% confidence interval (CI): 1.92-15.05], available resources (OR: 2.15, 95% CI: 1.18-3.91), access to knowledge and information (OR: 2.11, 95% CI: 1.09-4.09), and stakeholder engagement (OR: 3.47, 95% CI: 1.24-9.75). Conclusions This study provides a first insight into potential barriers and facilitators at the organizational level of schools that may be relevant to the adoption of physical activity policies, from the perspective of school principals. However, due to a low response rate, the results must be interpreted with caution. A strength of this study includes theoretical foundation through the use of the CFIR. The CFIR could be well-adapted to the school setting and provided valuable support for developing the questionnaire and interpreting the study results.
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Affiliation(s)
- Janine Wendt
- Division of Sports and Rehabilitation Medicine, Department of Internal Medicine, University Hospital Ulm, Ulm, Germany
| | - Daniel A Scheller
- Division of Sports and Rehabilitation Medicine, Department of Internal Medicine, University Hospital Ulm, Ulm, Germany
| | - Marion Flechtner-Mors
- Division of Sports and Rehabilitation Medicine, Department of Internal Medicine, University Hospital Ulm, Ulm, Germany
| | - Biljana Meshkovska
- Department of Nutrition, Faculty of Medicine, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | - Aleksandra Luszczynska
- Department of Psychology, SWPS University of Social Sciences and Humanities, Wroclaw, Poland.,Melbourne School of Psychological Sciences, Melbourne Centre for Behavior Change, University of Melbourne, Melbourne, VIC, Australia
| | - Nanna Lien
- Department of Nutrition, Faculty of Medicine, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | - Sarah Forberger
- Department of Prevention and Evaluation, Leibniz Institute for Prevention Research and Epidemiology-BIPS, Bremen, Germany
| | - Anna Banik
- Department of Psychology, SWPS University of Social Sciences and Humanities, Wroclaw, Poland
| | - Karolina Lobczowska
- Department of Psychology, SWPS University of Social Sciences and Humanities, Wroclaw, Poland
| | - Jürgen M Steinacker
- Division of Sports and Rehabilitation Medicine, Department of Internal Medicine, University Hospital Ulm, Ulm, Germany
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How to Make Physical Activity Promotion Work in Thai Schools: Perspectives of Multiple Stakeholders. J Phys Act Health 2021; 19:63-70. [PMID: 34902839 DOI: 10.1123/jpah.2021-0504] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Revised: 10/17/2021] [Accepted: 10/19/2021] [Indexed: 11/18/2022]
Abstract
BACKGROUND This study aimed to determine current practice in physical activity (PA) promotion in Thai schools, explore barriers and facilitators to PA promotion within the school setting, and identify strategies to support schools' future practice. METHODS A qualitative study design was applied comprising document analysis, focus groups, in-depth interviews, and onsite observations. The focus groups and in-depth interviews were conducted with 144 informants, purposively recruited through 24 schools in 4 regions across Thailand. Inductive content analysis was used. RESULTS Most schools were promoting PA in the absence of written policies, and without an accurate understanding of PA. Nonalignment of school performance indicators and policies, concerns about children's academic performance, and lack of budget were raised as barriers to PA promotion, whereas strong partnerships with multiple local stakeholders facilitated school-based PA promotion. Mandated government PA policies and more information support were suggested as strategies to enhance schools' future practices. CONCLUSIONS For PA promotion to be successful in the school setting, significant challenges will need to be addressed. Results from this study help the government and concerned stakeholders to better understand the situation at the school level, and further strive for achieving the target PA levels specified in the National PA Plan.
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Stylianou M, Woodforde J, Duncombe S, Kolbe-Alexander T, Gomersall S. School physical activity policies and associations with physical activity practices and behaviours: A systematic review of the literature. Health Place 2021; 73:102705. [PMID: 34844131 DOI: 10.1016/j.healthplace.2021.102705] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Revised: 09/08/2021] [Accepted: 10/24/2021] [Indexed: 01/02/2023]
Abstract
The development and implementation of school policies is considered a key strategy for the promotion of physical activity (PA) in children and adolescents. This study aimed to systematically review and synthesise existing literature focusing on the associations between formal written school-based PA policies and (a) school PA practices and (b) PA behaviours of school-aged children and adolescents. Fifty-one papers reporting on 52 studies met the eligibility criteria. All but two studies were from high income countries, most used cross-sectional designs and demonstrated fair methodological quality, and just over a third examined language aspects of policies. Findings predominantly indicated a lack of or inconclusive associations between the various characteristics examined and PA outcomes. Inconclusive associations were identified between both PA practice and behaviour outcomes and state level policies, policies focusing on PE and school-day PA, and in studies examining language aspects of policies. Inconclusive associations with both types of outcomes were more likely to be identified compared to a lack of associations in studies using self-report measures and in studies not providing information about the quality of exposure and outcome measures used. Overall, findings highlight the need for further research that acknowledges the complex relationship between school policies and PA outcomes and employs robust methodological approaches to enhance our understanding of this area.
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Affiliation(s)
- Michalis Stylianou
- School of Human Movement and Nutrition Sciences, The University of Queensland, St. Lucia, Queensland, 4072, Australia.
| | - James Woodforde
- School of Human Movement and Nutrition Sciences, The University of Queensland, St. Lucia, Queensland, 4072, Australia
| | - Stephanie Duncombe
- School of Human Movement and Nutrition Sciences, The University of Queensland, St. Lucia, Queensland, 4072, Australia
| | - Tracy Kolbe-Alexander
- School of Health & Wellbeing, University of Southern Queensland, lpswich, Queensland, 4305, Australia
| | - Sjaan Gomersall
- School of Human Movement and Nutrition Sciences, The University of Queensland, St. Lucia, Queensland, 4072, Australia; School of Health and Rehabilitation Sciences, The University of Queensland, St. Lucia, Queensland, 4072, Australia
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Piekarz-Porter E, Lin W, Leider J, Turner L, Perna F, Chriqui JF. State laws matter when it comes to school provisions for structured PE and daily PE participation. Transl Behav Med 2021; 11:597-603. [PMID: 32115650 DOI: 10.1093/tbm/ibaa013] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
The physical and mental benefits children receive from physical activity have been well documented, and physical education is a key way to ensure that physical activity opportunities are available during the school day. This study evaluates whether state PE laws are associated with school-level practices of requiring structured PE classes and whether students take PE classes daily. State laws were obtained as part of the National Cancer Institute's Classification of Laws Associated with School Students (CLASS) and were compiled for all 50 states and District of Columbia using Boolean keyword searches in LexisAdvance and WestlawNext. PE time requirements and state daily PE requirements in the laws were subsequently linked to school-required structured PE classes and daily PE in the School Nutrition and Meal Cost Study (SNMCS) Principal Survey. Logistic regression analyses were conducted while controlling for grade level, district child poverty rate, district race/ethnicity, school urbanicity, and school size. The state daily PE analysis also controlled for region. Schools located in a state that required at least 90 min of PE per week at the elementary level or 150 min of PE per week at the middle or high school levels had almost seven times higher odds of requiring structured PE. Schools located in a state that required daily participation of PE had almost five times higher odds of at least some students taking PE daily. State policymakers can utilize these findings to promote laws that require time for PE every week, daily if possible.
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Affiliation(s)
- Elizabeth Piekarz-Porter
- Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, IL, USA.,Health Policy and Administration, School of Public Health, University of Illinois at Chicago, Chicago, IL, USA
| | - Wanting Lin
- Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, IL, USA
| | - Julien Leider
- Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, IL, USA
| | - Lindsey Turner
- College of Education, Boise State University, Boise, ID, USA
| | - Frank Perna
- Health Behaviors Research Branch, Behavioral Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD, USA
| | - Jamie F Chriqui
- Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, IL, USA.,Health Policy and Administration, School of Public Health, University of Illinois at Chicago, Chicago, IL, USA
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Campbell EJ, Lee Olstad D, Spence JC, Storey KE, Nykiforuk CIJ. Policy-influencer perspectives on the development, adoption, and implementation of provincial school-based daily physical activity policies across Canada: A national case study. SSM Popul Health 2020; 11:100612. [PMID: 32637553 PMCID: PMC7327280 DOI: 10.1016/j.ssmph.2020.100612] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2019] [Revised: 06/04/2020] [Accepted: 06/04/2020] [Indexed: 11/24/2022] Open
Abstract
Objectives School-based daily physical activity (DPA) policies represent a promising intervention for increasing physical activity levels among children. Between 2005 and 2010, five Canadian provinces adopted and implemented DPA policies. This national case study explored facilitators and challenges to developing, adopting and implementing DPA policies from the perspective of key stakeholders (‘policy-influencers’) in these five provinces. Methods Development, adoption and implementation of DPA policies at the provincial level was the phenomenon of interest, with each province constituting a distinct case. Semi-structured interviews were conducted with 15 purposively selected policy-influencers across the five case provinces. Cases were first analyzed separately, and then concurrently in a cross-case comparison. Qualitative content analysis was used to code interviews and develop themes. Results Four themes related to the development, adoption, and implementation of DPA policies emerged: existing resources and capacity for policy change; top-down policy development/adoption and bottom-up implementation; political will and windows of opportunity; and, ideology and policy change. Each of these themes encompassed facilitators and challenges related to policy processes surrounding development, adoption and implementation of DPA policies. Conclusion These findings can inform development of future health-related polices in schools. Stakeholders can, for instance, remain attuned to the opening of political windows and capitalize on them as an opportunity to advocate for policy change or create communities of practice to enhance coordination among policy stakeholders. Future studies that explore why other jurisdictions have failed to adopt DPA policies might yield novel insights regarding leverage points to support widespread diffusion of DPA policies. Between 2005 and 2010, five Canadian provinces adopted and implemented DPA policies. A national case study explored facilitators and challenges to adopting and implementing provincial DPA policies. Four key themes related to policy change: capacity, adoption and implementation, political will, and ideology. Recommendations can inform development and implementation of school-based physical activity and health promotion policy.
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Affiliation(s)
| | - Dana Lee Olstad
- School of Public Health, University of Alberta, Edmonton, Alberta, Canada.,Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - John C Spence
- Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, Alberta, Canada
| | - Kate E Storey
- School of Public Health, University of Alberta, Edmonton, Alberta, Canada
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Gelius P, Messing S, Goodwin L, Schow D, Abu-Omar K. What are effective policies for promoting physical activity? A systematic review of reviews. Prev Med Rep 2020; 18:101095. [PMID: 32346500 PMCID: PMC7182760 DOI: 10.1016/j.pmedr.2020.101095] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Revised: 01/14/2020] [Accepted: 04/04/2020] [Indexed: 11/25/2022] Open
Abstract
There is a growing need for evidence on the effectiveness of different policies to promote physical activity. We conducted a systematic literature review to collate the available evidence. We identified 57 reviews with evidence on 53 types of physical activity policies from 7 areas. There is a solid evidence base for the effectiveness of school-based and some infrastructural policies. The evidence for other (e.g. economic) policies remains insufficient.
The importance of policy for promoting physical activity (PA) is increasingly recognized by academics, and there is a push by national governments and international institutions for PA policy development and monitoring. However, our knowledge about which policies are actually effective to promote PA remains limited. This article summarizes the currently available evidence by reviewing existing reviews on the subject. Building on results from a previous scoping review on different types of PA-related evidence, we ran searches for combinations of the terms “physical activity”, “evidence”, “effect”, “review”, and “policy” in six different databases (PubMed, Scopus, SportDiscus, PsycInfo, ERIC, and IBSS). We used EPPI Reviewer 4 to further process the results and conduct an in-depth analysis. We identified 57 reviews providing evidence on 53 types of policies and seven broader groups of policies. Reviews fell into four main categories: 1) setting- and target group-specific; 2) urban design, environment and transport; 3) economic instruments; and 4) broad-range perspective. Results indicate that there is solid evidence for policy effectiveness in some areas (esp. school-based and infrastructural policies) but that the evidence in other areas is insufficient (esp. for economic policies). The available evidence provides some guidance for policy-makers regarding which policies can currently be recommended as effective. However, results also highlight some broader epistemological issues deriving from the current research. This includes the conflation of PA policies and PA interventions, the lack of appropriate tools for benchmarking individual policies, and the need to critically revisit research methodologies for collating evidence on policies.
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Affiliation(s)
- Peter Gelius
- Friedrich-Alexander University Erlangen-Nuremberg, Gebbertstraße 123b, 91058 Erlangen, Germany
| | - Sven Messing
- Friedrich-Alexander University Erlangen-Nuremberg, Gebbertstraße 123b, 91058 Erlangen, Germany
| | - Lee Goodwin
- Friedrich-Alexander University Erlangen-Nuremberg, Gebbertstraße 123b, 91058 Erlangen, Germany
| | - Diana Schow
- Friedrich-Alexander University Erlangen-Nuremberg, Gebbertstraße 123b, 91058 Erlangen, Germany
| | - Karim Abu-Omar
- Friedrich-Alexander University Erlangen-Nuremberg, Gebbertstraße 123b, 91058 Erlangen, Germany
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Killian CM, Kern BD, Ellison DW, Graber KC, Woods AM. State Lawmaker's Views on Childhood Obesity and Related School Wellness Legislation. THE JOURNAL OF SCHOOL HEALTH 2020; 90:257-263. [PMID: 31984511 DOI: 10.1111/josh.12871] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/19/2018] [Revised: 03/11/2019] [Accepted: 10/30/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND School wellness legislation has potential to impact the health of children and alter the obesity crisis in the United Sates. Little is known about how state lawmakers perceive child wellness legislation effectiveness relative to obesity prevention. Our purpose was to understand state lawmakers' perceptions of childhood obesity and school wellness policies relative to the Social Ecological Model (SEM). METHODS Twenty-one state representatives and nine state senators from one US state completed in-depth interviews. Member checks and peer debriefing occurred throughout data collection and analysis. Transcripts were coded and triangulated. A conventional content analysis generated consistent themes. RESULTS Five main themes developed: (1) child overweight and obesity is problematic; (2) current legislation is ineffective; (3) funding and enforcing child wellness legislation is difficult; (4) it is difficult to legislate personal behavior; and (5) efforts from other levels of the SEM are more effective at promoting wellness. CONCLUSIONS Lawmakers understand negative impacts of child obesity, but perceive immediate legislative issues like budgetary concerns inhibit robust policy-oriented action. Participants believe parents, guardians, and individuals should ultimately be responsible for child wellness. Community, school, and family efforts to address childhood obesity and support wellness may be more effective in achieving positive outcomes than state and federal policy.
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Affiliation(s)
- Chad M Killian
- Georgia State University, 125 Decatur Street, SE, Suite 137, Atlanta, GA 30303
| | - Ben D Kern
- University of Louisiana at Lafayette, 225 Cajundome Blvd., Lafayette, LA 70506
| | | | - Kim C Graber
- University of Illinois at Urbana-Champaign, 906 S. Goodwin Avenue, Urbana, IL 61801
| | - Amelia Mays Woods
- University of Illinois at Urbana-Champaign, 906 S. Goodwin Avenue, Urbana, IL 61801
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11
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Lin W, Leider J, Shang C, Hennessy E, Perna FM, Chriqui JF. The Association Between State Physical Education Laws and Student Physical Activity. Am J Prev Med 2020; 58:436-445. [PMID: 31870591 DOI: 10.1016/j.amepre.2019.09.018] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Revised: 09/16/2019] [Accepted: 09/17/2019] [Indexed: 12/28/2022]
Abstract
INTRODUCTION This study examined the association between state physical education time requirements and physical activity and physical education outcomes among high school students. METHODS State physical education time requirement laws for 2004-2016 from the Classification of Laws Associated with School Students database were linked with 2005-2017 national Youth Risk Behavior Survey data using state and year identifiers. Analyses were conducted between 2018 and 2019 to assess associations between physical education time requirement laws and physical activity or physical education outcomes using multinomial logistic regressions, while controlling for sociodemographic characteristics, year-fixed effects, and state confounders. RESULTS State laws requiring ≥90 minutes of physical education per week were associated with 3.1 percentage points lower probability of no days of physical activity ≥60 minutes (95% CI= -5.0, -1.1), 3.7 percentage points lower probability of no days of moderate exercise ≥30 minutes (95% CI= -6.2, -1.3), 4.2 percentage points lower probability of no days of vigorous exercise ≥20 minutes (95% CI= -5.2, -3.3), and 19.3 percentage points lower probability of not attending physical education class (95% CI= -34.4, -4.2). The laws were associated with a 2.4 percentage point higher probability of daily moderate exercise ≥30 minutes in male students (95% CI=0.6, 4.2) and a 3.4 percentage point higher probability in female students (95% CI=1.9, 4.9), with larger associations for female students (p<0.01). CONCLUSIONS Findings from this study help support the role that physical education state requirements can play in enhancing adolescents' ability to meet recommended amounts of daily physical activity and the related public health benefits.
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Affiliation(s)
- Wanting Lin
- Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, Illinois
| | - Julien Leider
- Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, Illinois
| | - Ce Shang
- Department of Pediatrics, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
| | - Erin Hennessy
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts
| | - Frank M Perna
- Health Behaviors Research Branch, Behavioral Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, Maryland
| | - Jamie F Chriqui
- Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, Illinois; Division of Health Policy and Administration, School of Public Health, University of Illinois at Chicago, Chicago, Illinois.
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12
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Comprehensive Policies to Support Comprehensive Practices: Physical Activity in Elementary Schools. J Phys Act Health 2020; 17:313-322. [PMID: 32023534 DOI: 10.1123/jpah.2019-0402] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Revised: 10/27/2019] [Accepted: 12/20/2019] [Indexed: 11/18/2022]
Abstract
BACKGROUND Schools are a setting in which students learn about the importance of lifelong physical activity (PA). Best practice guidelines indicate that schools should provide students with adequate physical education (PE) minutes and opportunities to engage in PA throughout the school day. METHODS Data from the nationally representative School Nutrition and Meal Cost Study in 2014-2015 were utilized to assess PA practices (including PE) at 412 public elementary schools. These data were linked to state- and district-level policy data from the National Wellness Policy Study to examine the relationships between state law and school district policies and school practices. RESULTS Just over half of the schools were in a state with a policy regarding PE minutes. The comprehensiveness and strength of PA policies were higher at the district level than the state level, but were still low overall. Comprehensiveness of PA policies at the state level, but not at the district level, was related to schools within those states that provide more PA practices. CONCLUSIONS Existence of PE and PA policies at the state level appears to be an important predictor of school PA practices. Having more comprehensive policies at the state level may be an important facilitator of school implementation of comprehensive PA practices.
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13
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Peralta LR, Mihrshahi S, Bellew B, Reece LJ, Hardy LL. Influence of School-Level Socioeconomic Status on Children's Physical Activity, Fitness, and Fundamental Movement Skill Levels. THE JOURNAL OF SCHOOL HEALTH 2019; 89:460-467. [PMID: 30945311 DOI: 10.1111/josh.12761] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Revised: 02/13/2019] [Accepted: 02/18/2019] [Indexed: 06/09/2023]
Abstract
BACKGROUND Authorities recommend that youth undertake at least 60 minutes of daily moderate-to-vigorous physical activity (MVPA), with young people having the opportunity to undertake at least half of this MVPA during school hours. METHODS In this study, we examined the influence of school-level socioeconomic status (SES) on children's PA, fitness and fundamental movement skill (FMS) levels, and the barriers and enablers of children's PA in 86 Australian schools (41 primary, 45 secondary). School-level SES was based on an Index of Community Socio-Educational Advantage (ICSEA). School representatives reported potential barriers and enablers for children's PA. We used subjective and objectives measures of PA, fitness, and FMS levels. Multiple logistic regression examined the associations of ICSEA category (low or high) with barriers and enablers, and PA outcomes, adjusting for children's language background and residence. RESULTS Children from high SES schools were more likely to achieve the healthy fitness zone for cardiorespiratory fitness; those from low SES schools consistently reported more barriers and fewer enablers than their high SES counterparts. CONCLUSIONS Extra efforts may be required to address school-level barriers and enablers to enhance PA, fitness, and FMS levels for schools in disadvantaged areas.
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Affiliation(s)
- Louisa R Peralta
- Sydney School of Education and Social Work, The University of Sydney, Sydney, NSW 2006, Australia
| | - Seema Mihrshahi
- Prevention Research Collaboration, Sydney School of Public Health, The University of Sydney, Sydney, NSW 2006, Australia
| | - Bill Bellew
- Prevention Research Collaboration, Sydney School of Public Health, The University of Sydney, Sydney, NSW 2006, Australia
| | - Lindsey J Reece
- Prevention Research Collaboration, Sydney School of Public Health, The University of Sydney, Sydney, NSW 2006, Australia
| | - Louise L Hardy
- Prevention Research Collaboration, Sydney School of Public Health, The University of Sydney, Sydney, NSW 2006, Australia
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14
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Kim MS, Cardinal BJ. Differences in university students' motivation between a required and an elective physical activity education policy. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2019; 67:207-214. [PMID: 29952738 DOI: 10.1080/07448481.2018.1469501] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/04/2017] [Revised: 04/09/2018] [Accepted: 04/23/2018] [Indexed: 06/08/2023]
Abstract
OBJECTIVE The aim of this study was to examine differences in students' physical activity motivation, competence, and weekly exercise metabolic equivalent units (METs) between universities with different physical activity education (PAE) policy arrangements (ie, a required PAE vs. an elective PAE). PARTICIPANTS Participants (N = 953) were purposefully recruited from two universities with different PAE policies 1 week before the start of fall term 2015. METHODS Participants completed questionnaires assessing their physical activity motivation, competence, and weekly exercise METs. RESULTS The results of this study suggest that having a required PAE policy allows for more students with lower self-determined forms of motivation (ie, amotivation) to be reached in comparison to the elective PAE policy. CONCLUSIONS This finding highlights that a primary value of having a required PAE policy is its ability to reach less motivated students.
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Affiliation(s)
- Moo Song Kim
- a Department of Health and Kinesiology, College of Education , Northeastern State University , Tahlequah , Oklahoma , USA
| | - Bradley J Cardinal
- b Kinesiology Program, School of Biological and Population Health Sciences, College of Public Health and Human Sciences , Oregon State University , Corvallis , Oregon , USA
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15
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Pedersen NH, Koch S, Larsen KT, Kristensen PL, Troelsen J, Møller NC, Brønd JC, Hjelmborg JVB, Brage S, Grøntved A. Protocol for evaluating the impact of a national school policy on physical activity levels in Danish children and adolescents: the PHASAR study - a natural experiment. BMC Public Health 2018; 18:1245. [PMID: 30409171 PMCID: PMC6225578 DOI: 10.1186/s12889-018-6144-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2018] [Accepted: 10/23/2018] [Indexed: 12/17/2022] Open
Abstract
Background In 2014 the Danish Government introduced a wide-ranging school reform that applies to all public schools in Denmark. The reform involves changes in several aspects of the school structure and content. In a physical activity promotion perspective, a distinctive feature of the school reform is that it has become mandatory to integrate an average of 45 min of daily physical activity in the regular school day. The overarching objective of the PHASAR study is to evaluate the implementation and effect of this ambitious policy-driven physical activity promotion initiative on physical activity and overweight. This paper describes in detail the study protocol. Methods The evaluation is divided into a quantitative effect evaluation and a combined quantitative and qualitative process evaluation. A total of 31 schools are enrolled in the PHASAR study including more than 2,000 school-aged children. Objectively measured physical activity data are obtained in the PHASAR study in 2017/18 and compared to repeated cross sectional data collected in four historical school-based studies from 1998 to 2012. Body mass index data from 2012 to 2018 will be collected from The Child Database, which includes repeated cross-sectional assessments on approximately 100,000 children annually. In the absence of a control group, interrupted time-series analysis will be used to evaluate pre- and post-reform physical activity and body mass index levels and trends. A characterization of the school environment for physical activity promotion on a political, environmental, organizational and individual level and school implementation processes will be conducted to evaluate the implementation process. Data will be collected using interviews, surveys, document analyses and observations. Discussion The PHASAR study is a rare opportunity to evaluate the effectiveness of a nation-wide policy-driven school-based physical activity promotion initiative. The use of objectively measured pre- and post-reform physical activity and body mass index data combined with a characterization of the school implementation processes for physical activity promotion will provide a comprehensive source to evaluate the school reform. The study findings have the potential to influence national and international policy makers, health professionals and school staff.
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Affiliation(s)
- Natascha Holbæk Pedersen
- Centre of Research in Childhood Health, Research Unit for Exercise Epidemiology, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, 5230, Odense M, Denmark.
| | - Sofie Koch
- Research unit for Active Living, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, 5230, Odense M, Denmark
| | - Kristian Traberg Larsen
- Centre of Research in Childhood Health, Research Unit for Exercise Epidemiology, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, 5230, Odense M, Denmark
| | - Peter Lund Kristensen
- Centre of Research in Childhood Health, Research Unit for Exercise Epidemiology, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, 5230, Odense M, Denmark
| | - Jens Troelsen
- Research unit for Active Living, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, 5230, Odense M, Denmark
| | - Niels Christian Møller
- Centre of Research in Childhood Health, Research Unit for Exercise Epidemiology, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, 5230, Odense M, Denmark
| | - Jan Christian Brønd
- Centre of Research in Childhood Health, Research Unit for Exercise Epidemiology, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, 5230, Odense M, Denmark
| | - Jacob von Bornemann Hjelmborg
- The Danish Twin Registry, Epidemiology, Biostatistics and Biodemography, SDU eScience Centre, J. B. Winsløws Vej 9, 5000, Odense C, Denmark
| | - Søren Brage
- Centre of Research in Childhood Health, Research Unit for Exercise Epidemiology, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, 5230, Odense M, Denmark.,MRC Epidemiology Unit, Cambridge School of Clinical Medicine, Institute of Metabolic Science, University of Cambridge, Box 285, Cambridge Biomedical Campus, Cambridge, CB2 0QQ, UK
| | - Anders Grøntved
- Centre of Research in Childhood Health, Research Unit for Exercise Epidemiology, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, 5230, Odense M, Denmark
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16
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Mann M, Silver EJ, Stein REK. Active Commuting to School, Physical Activity, and Behavior Problems Among Third-Grade Children. THE JOURNAL OF SCHOOL HEALTH 2018; 88:734-743. [PMID: 30203477 DOI: 10.1111/josh.12677] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/31/2017] [Revised: 11/10/2017] [Accepted: 01/14/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND We examined factors associated with active commuting to school and the relationships of active commuting and physical activity to child- and teacher-reported internalizing and externalizing behavior problems in a sample of third graders. METHODS The study sample consisted of 13,166 third graders enrolled in the Early Childhood Longitudinal Study Kindergarten Class of 1998-1999. "Active" commuters were children who walked to school and "passive" commuters were those who took the bus or were driven. Linear analyses evaluated differences in behavior problems by school commute, physical activity, and sports team participation after adjusting for sociodemographic, regional, and neighborhood factors. RESULTS Overall, 11% of children actively commuted. Type of commute differed by sociodemographics, region, urbanicity, school type, and neighborhood safety. Active commuters had less general physical activity participation and sports team participation. Commuting type and general physical activity were not associated with behavior problems, but sports team participation was associated with fewer child-reported internalizing and externalizing behaviors as well as fewer teacher-reported internalizing behaviors. CONCLUSIONS Our findings demonstrate the ongoing need for creating and maintaining physical activity programs (such as sports teams) among school-aged children to optimize children's overall health and well-being.
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Affiliation(s)
- Mana Mann
- Developmental-Behavioral Pediatrics, Albert Einstein College of Medicine/Children's Hospital at Montefiore, 1225 Morris Park Ave., Bronx, NY 10461
| | - Ellen J Silver
- Albert Einstein College of Medicine/Children's Hospital at Montefiore, 1225 Morris Park Ave., Bronx, NY 10461
| | - Ruth E K Stein
- Albert Einstein College of Medicine/Children's Hospital at Montefiore, 1225 Morris Park Ave., Bronx, NY 10461
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17
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Stylianou M, Walker JL. An assessment of Australian school physical activity and nutrition policies. Aust N Z J Public Health 2017; 42:16-21. [PMID: 29235711 DOI: 10.1111/1753-6405.12751] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2017] [Revised: 08/01/2017] [Accepted: 10/01/2017] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVE This study's objective was to identify and assess existing physical activity and nutrition policies for Australian schools. METHODS Policies were identified through a search of the websites of national and state/territory education departments and school associations, and were subsequently assessed against specific criteria. RESULTS Policies were identified for government schools, but only for one non-government school association. Physical activity policies were identified at the national level and for six of eight state/territories. The national policy was mandated, and most state/territory physical activity policies were mandated and consistent with the national policy. Several physical activity policies did not meet expert recommendations for time and instructor qualifications. Nutrition policies were identified at the national level and all eight states/territories. The national policy was not mandated, but all state/territory nutrition policies were mandated and consistent with the national policy and relevant guidelines. Most physical activity and nutrition policies lacked information about implementation monitoring. CONCLUSIONS To improve school practices, policies are needed that are mandated and consistent with expert recommendations, use clear language, and specify monitoring and accountability mechanisms. Implications for public health: Improvements in school policies can promote physical activity and healthy eating behaviours to positively influence student outcomes across Australia.
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Affiliation(s)
- Michalis Stylianou
- School of Human Movement and Nutrition Sciences, The University of Queensland
| | - Jacqueline L Walker
- School of Human Movement and Nutrition Sciences, The University of Queensland
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18
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Hanneke R, Young SK. Information sources for obesity prevention policy research: a review of systematic reviews. Syst Rev 2017; 6:156. [PMID: 28789703 PMCID: PMC5549286 DOI: 10.1186/s13643-017-0543-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2016] [Accepted: 07/12/2017] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Systematic identification of evidence in health policy can be time-consuming and challenging. This study examines three questions pertaining to systematic reviews on obesity prevention policy, in order to identify the most efficient search methods: (1) What percentage of the primary studies selected for inclusion in the reviews originated in scholarly as opposed to gray literature? (2) How much of the primary scholarly literature in this topic area is indexed in PubMed/MEDLINE? (3) Which databases index the greatest number of primary studies not indexed in PubMed, and are these databases searched consistently across systematic reviews? METHODS We identified systematic reviews on obesity prevention policy and explored their search methods and citations. We determined the percentage of scholarly vs. gray literature cited, the most frequently cited journals, and whether each primary study was indexed in PubMed. We searched 21 databases for all primary study articles not indexed in PubMed to determine which database(s) indexed the highest number of these relevant articles. RESULTS In total, 21 systematic reviews were identified. Ten of the 21 systematic reviews reported searching gray literature, and 12 reviews ultimately included gray literature in their analyses. Scholarly articles accounted for 577 of the 649 total primary study papers. Of these, 495 (76%) were indexed in PubMed. Google Scholar retrieved the highest number of the remaining 82 non-PubMed scholarly articles, followed by Scopus and EconLit. The Journal of the American Dietetic Association was the most-cited journal. CONCLUSIONS Researchers can maximize search efficiency by searching a small yet targeted selection of both scholarly and gray literature resources. A highly sensitive search of PubMed and those databases that index the greatest number of relevant articles not indexed in PubMed, namely multidisciplinary and economics databases, could save considerable time and effort. When combined with a gray literature search and additional search methods, including cited reference searching and consulting with experts, this approach could help maintain broad retrieval of relevant studies while improving search efficiency. Findings also have implications for designing specialized databases for public health research.
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Affiliation(s)
- Rosie Hanneke
- Library of the Health Sciences-Chicago, University of Illinois at Chicago, 1750 W. Polk St, Chicago, IL, 60612, USA.
| | - Sabrina K Young
- Health Policy and Administration, School of Public Health, University of Illinois at Chicago, 1603 W. Taylor St, Chicago, IL, 60612, USA.,The Cancer Education and Cancer Development Program, Institute for Health Research and Policy, 1747 W. Taylor St, Chicago, IL, 60608, USA
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19
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Hobin E, Erickson T, Comte M, Zuo F, Pasha S, Murnaghan D, Manske S, Casey C, Griffith J, McGavock J. Examining the impact of a province-wide physical education policy on secondary students' physical activity as a natural experiment. Int J Behav Nutr Phys Act 2017; 14:98. [PMID: 28724390 PMCID: PMC5518116 DOI: 10.1186/s12966-017-0550-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2016] [Accepted: 07/07/2017] [Indexed: 11/18/2022] Open
Abstract
Background The purpose of this paper is to examine the impact of a province-wide physical education (PE) policy on secondary school students’ moderate to vigorous physical activity (MVPA). Methods Policy: In fall 2008, Manitoba expanded a policy requiring a PE credit for students in grades 11 and 12 for the first time in Canada. The PE curriculum requires grades 11 and 12 students to complete a minimum of 55 h (50% of course hours) of MVPA (e.g., ≥30 min/day of MVPA on ≥5 days a week) during a 5-month semester to achieve the course credit. Study Designs: A natural experimental study was designed using two sub-studies: 1) quasi-experimental controlled pre-post analysis of self-reported MVPA data obtained from census data in intervention and comparison [Prince Edward Island (PEI)] provinces in 2008 (n = 33,619 in Manitoba and n = 2258 in PEI) and 2012 (n = 41,169 in Manitoba and n = 4942 in PEI); and, 2) annual objectively measured MVPA in cohorts of secondary students in intervention (n = 447) and comparison (Alberta; n = 224) provinces over 4 years (2008 to 2012). Analysis: In Study 1, two logistic regressions were conducted to model the odds that students accumulated: i) ≥30 min/day of MVPA, and ii) met Canada's national recommendation of ≥60 min/day of MVPA, in Manitoba versus PEI after adjusting for grade, sex, and BMI. In Study 2, a mixed effects model was used to assess students’ minutes of MVPA per day per semester in Manitoba and Alberta, adjusting for age, sex, BMI, school location and school SES. Results In Study 1, no significant differences were observed in students achieving ≥30 (OR:1.13, 95% CI:0.92, 1.39) or ≥60 min/day of MVPA (OR:0.92, 95% CI: 0.78, 1.07) from baseline to follow-up between Manitoba and PEI. In Study 2, no significant policy effect on students’ MVPA trajectories from baseline to last follow-up were observed between Manitoba and Alberta overall (−1.52, 95% CI:-3.47, 0.42), or by covariates. Conclusions The Manitoba policy mandating PE in grades 11 and 12 had no effect on student MVPA overall or by key student or school characteristics. However, the effect of the PE policy may be underestimated due to the use of a nonrandomized research design and lack of data assessing the extent of policy implementation across schools. Nevertheless, findings can provide evidence about policy features that may improve the PE policy in Manitoba and inform future PE policies in other jurisdictions.
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Affiliation(s)
- Erin Hobin
- Public Health Ontario, 480 University Ave, Suite 300, Toronto, ON, M5R 1V2, Canada. .,University of Toronto, 27 King's College Circle, Toronto, ON, M5S 1A2, Canada.
| | - Tannis Erickson
- Children's Hospital Research Institute of Manitoba, 513-715 McDermot Ave, Winnipeg, MB, R3E 3P4, Canada
| | - Melisa Comte
- Children's Hospital Research Institute of Manitoba, 513-715 McDermot Ave, Winnipeg, MB, R3E 3P4, Canada.,University of Manitoba, 66 Chancellors Circle, Winnipeg, MB, R3T 2N2, Canada
| | - Fei Zuo
- Public Health Ontario, 480 University Ave, Suite 300, Toronto, ON, M5R 1V2, Canada
| | - Saamir Pasha
- Peel Public Health Unit, 150 Central Park Dr, Brampton, ON, L6T 2T9, Canada
| | - Donna Murnaghan
- Thompson Rivers University, 900 McGill Rd, Kamloops, BC, V2C 0C8, Canada
| | - Steve Manske
- University of Waterloo, 200 University Ave W, Waterloo, ON, N2L 3G1, Canada.,Propel Centre for Population Health Impact, 200 University Ave W, Waterloo, ON, N2L 3G1, Canada
| | - Catherine Casey
- University of Manitoba, 66 Chancellors Circle, Winnipeg, MB, R3T 2N2, Canada
| | - Jane Griffith
- Cancer Care Manitoba, 675 McDermot Ave, Winnipeg, MB, R3E 0V9, Canada
| | - Jonathan McGavock
- Children's Hospital Research Institute of Manitoba, 513-715 McDermot Ave, Winnipeg, MB, R3E 3P4, Canada.,University of Manitoba, 66 Chancellors Circle, Winnipeg, MB, R3T 2N2, Canada
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Shuval K, Leonard T, Drope J, Katz DL, Patel AV, Maitin-Shepard M, Amir O, Grinstein A. Physical activity counseling in primary care: Insights from public health and behavioral economics. CA Cancer J Clin 2017; 67:233-244. [PMID: 28198998 DOI: 10.3322/caac.21394] [Citation(s) in RCA: 52] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
Physical inactivity has reached epidemic proportions in modern society. Abundant evidence points to a causal link between physical inactivity and increased risk for numerous noncommunicable diseases, such as some types of cancer and heart disease, as well as premature mortality. Yet, despite this overwhelming evidence, many individuals do not meet the recommended amount of physical activity required to achieve maximum health benefits. Because primary care physicians' advice is highly regarded, clinicians have the unique opportunity to play an important role in enabling patients to modify their behavior at the point of care with the goal of guiding patients to adopt and maintain an active lifestyle. In the current study, the authors evaluate pertinent literature from the fields of medicine/public health and economics/psychology to suggest a comprehensive approach to physical activity counseling at the primary care level. They first examine the public health approach to physical activity counseling, and then proceed to offer insights from behavioral economics, an emerging field that combines principles from psychology and economics. The application of key behavioral economics tools (eg, precommitment contracts, framing) to physical activity counseling in primary care is elaborated. CA Cancer J Clin 2017;67:233-244. © 2017 American Cancer Society.
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Affiliation(s)
- Kerem Shuval
- Director, Physical Activity and Nutrition Research, Economic & Health Policy Research Program, American Cancer Society, Atlanta, GA
| | - Tammy Leonard
- Associate Professor, Department of Economics, University of Dallas, Irving, TX
| | - Jeffrey Drope
- Vice President, Economic & Health Policy Research Program, American Cancer Society, Atlanta, GA
| | - David L Katz
- Director, Yale University Prevention Research Center, Griffin Hospital, Derby, CT
| | - Alpa V Patel
- Strategic Director, Cancer Prevention Study-3, Epidemiology Research Program, American Cancer Society, Atlanta, GA
| | | | - On Amir
- Associate Professor, Rady School of Management, University of California-San Diego, La Jolla, CA
| | - Amir Grinstein
- Associate Professor of Marketing, D'Amore-McKim School of Business, Northeastern University, Boston, MA
- Associate Professor of Marketing, Faculty of Economics and Business Administration, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
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21
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Weatherson KA, Gainforth HL, Jung ME. A theoretical analysis of the barriers and facilitators to the implementation of school-based physical activity policies in Canada: a mixed methods scoping review. Implement Sci 2017; 12:41. [PMID: 28347322 PMCID: PMC5369225 DOI: 10.1186/s13012-017-0570-3] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2016] [Accepted: 03/13/2017] [Indexed: 11/10/2022] Open
Abstract
Background Given the potential impact school-based daily physical activity (DPA) policies can have on the health outcomes of Canadian children, it is surprising that such little research has examined the implementation and student-level effectiveness of these policies, and that even less have used theory to understand the barriers and facilitators affecting uptake of this policy by teachers. This review descriptively summarizes the implementation status, approaches used to implement DPA, and the effectiveness of DPA at increasing the physical activity of children at school. In addition, the Theoretical Domains Framework (TDF) was used to explore the barriers and facilitators to DPA implementation. Methods A scoping review of English articles using ERIC, CINAHL, and Google Scholar (2005 to 2016) was conducted. Only studies that evaluated the implementation and/or student-level effectiveness of DPA policies in Canadian elementary schools were included. Only articles that examined DPA implementation barriers and facilitators by teachers, principals, and/or administration were eligible for the TDF analysis. Data on study characteristics and major findings regarding implementation status, implementation approach used, and impact on student’s physical activity were extracted and were summarized descriptively, including study quality indicators. Two coders extracted and categorized implementation barriers and facilitators into TDF domains. Results The search resulted in 66 articles being retrieved and 38 being excluded for not meeting the eligibility criteria, leaving 15 eligible for review (10 of which examined barriers and facilitators to implementation from DPA deliverers’ perspective). Eleven of 15 studies examined the Ontario DPA policy, and 2 studies were from both Alberta and British Columbia. Thirteen studies examined implementation, and only two examined effectiveness. DPA implementation status, approaches to delivery, and effectiveness on student’s PA levels are inconsistent across the three provinces. A total of 203 barriers/facilitators were extracted across the ten implementation studies, most of which related to the environmental context and resources (ECR; n = 86; 37.4%), beliefs about consequences (n = 41; 17.8%), and social influences (n = 36; 15.7%) TDF domains. Conclusions With the limited research examining the DPA policy in Canada, the current status and approaches used to implement DPA and the student-level effectiveness is not well understood; however, this review revealed that DPA deliverers often report many barriers to DPA implementation. Most importantly, in conducting a TDF-based analysis of the barriers/facilitators affecting implementation, this review provides a theoretical basis by which researchers and policy-makers can design interventions to better target these problems in the future. Registration A protocol for this review was not registered. Electronic supplementary material The online version of this article (doi:10.1186/s13012-017-0570-3) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Katie A Weatherson
- School of Health and Exercise Sciences, Faculty of Health and Social Development, University of British Columbia, Okanagan, ART 360-1147 Research Road, Kelowna, BC, V1V 1V7, Canada
| | - Heather L Gainforth
- School of Health and Exercise Sciences, Faculty of Health and Social Development, University of British Columbia, Okanagan, ART 129-1147 Research Road, Kelowna, BC, V1V 1V7, Canada
| | - Mary E Jung
- School of Health and Exercise Sciences, Faculty of Health and Social Development, The University of British Columbia, Okanagan, RHS 119-3333 University Way, Kelowna, BC, V1V 1V7, Canada.
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Hager ER, Rubio DS, Eidel GS, Penniston ES, Lopes M, Saksvig BI, Fox RE, Black MM. Implementation of Local Wellness Policies in Schools: Role of School Systems, School Health Councils, and Health Disparities. THE JOURNAL OF SCHOOL HEALTH 2016; 86:742-750. [PMID: 27619765 DOI: 10.1111/josh.12430] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/06/2015] [Revised: 02/19/2016] [Accepted: 02/22/2016] [Indexed: 06/06/2023]
Abstract
BACKGROUND Written local wellness policies (LWPs) are mandated in school systems to enhance opportunities for healthy eating/activity. LWP effectiveness relies on school-level implementation. We examined factors associated with school-level LWP implementation. Hypothesized associations included system support for school-level implementation and having a school-level wellness team/school health council (SHC), with stronger associations among schools without disparity enrollment (majority African-American/Hispanic or low-income students). METHODS Online surveys were administered: 24 systems (support), 1349 schools (LWP implementation, perceived system support, SHC). The state provided school demographics. Analyses included multilevel multinomial logistic regression. RESULTS Response rates were 100% (systems)/55.2% (schools). Among schools, 44.0% had SHCs, 22.6% majority (≥75%) African-American/Hispanic students, and 25.5% majority (≥75%) low-income (receiving free/reduced-price meals). LWP implementation (17-items) categorized as none = 36.3%, low (1-5 items) = 36.3%, high (6+ items) = 27.4%. In adjusted models, greater likelihood of LWP implementation was observed among schools with perceived system support (high versus none relative risk ratio, RRR = 1.63, CI: 1.49, 1.78; low versus none RRR = 1.26, CI: 1.18, 1.36) and SHCs (high versus none RRR = 6.8, CI: 4.07, 11.37; low versus none RRR = 2.24, CI: 1.48, 3.39). Disparity enrollment did not moderate associations (p > .05). CONCLUSIONS Schools with perceived system support and SHCs had greater likelihood of LWP implementation, with no moderating effect of disparity enrollment. SHCs/support may overcome LWP implementation obstacles related to disparities.
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Affiliation(s)
- Erin R Hager
- Department of Epidemiology and Public Health, University of Maryland School of Medicine, Department of Pediatrics, Growth and Nutrition Division, 737 West Lombard Street, Room 163, Baltimore, MD 21201.
| | - Diana S Rubio
- Department of Pediatrics, Growth and Nutrition Division, University of Maryland School of Medicine, 737 West Lombard Street, Room 163, Baltimore, MD 21201.
| | - G Stewart Eidel
- Professional Development and Technical Assistance, Maryland State Department of Education, Office of School & Community Nutrition Programs, Baltimore, MD 21201.
| | - Erin S Penniston
- Maryland Department of Health and Mental Hygiene, 201 West Preston Street, Baltimore, MD 21201.
| | - Megan Lopes
- Maryland State Department of Education, Professional Development and Technical Assistance Section, Office of School and Community Nutrition Programs/Office for School Effectiveness, Baltimore, MD 21201.
| | - Brit I Saksvig
- Department of Epidemiology and Biostatistics, University of Maryland School of Public Health, College Park, MD 20742.
| | - Renee E Fox
- Division of Quality & Health Outcomes (DQHO), Center for Medicare and Medicaid Services, CMCS/CAHPG, 7500 Security Blvd, Baltimore, MD 21244.
| | - Maureen M Black
- Division of Growth and Nutrition, Department of Epidemiology and Public Health, University of Maryland School of Medicine, 737 West Lombard Street, Room 161, Baltimore, MD 21201.
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Obstacles and Enablers on the Way towards Integrated Physical Activity Policies for Childhood Obesity Prevention: An Exploration of Local Policy Officials' Views. BIOMED RESEARCH INTERNATIONAL 2016; 2016:5739025. [PMID: 27668255 PMCID: PMC5030399 DOI: 10.1155/2016/5739025] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/28/2016] [Accepted: 07/19/2016] [Indexed: 01/17/2023]
Abstract
Background. Limited physical activity (PA) is a risk factor for childhood obesity. In Netherlands, as in many other countries worldwide, local policy officials bear responsibility for integrated PA policies, involving both health and nonhealth domains. In practice, its development seems hampered. We explore which obstacles local policy officials perceive in their effort. Methods. Fifteen semistructured interviews were held with policy officials from health and nonhealth policy domains, working at strategic, tactic, and operational level, in three relatively large municipalities. Questions focused on exploring perceived barriers for integrated PA policies. The interviews were deductively coded by applying the Behavior Change Ball framework. Findings. Childhood obesity prevention appeared on the governmental agenda and all officials understood the multicausal nature. However, operational officials had not yet developed a tradition to develop integrated PA policies due to insufficient boundary-spanning skills and structural and cultural differences between the domains. Tactical level officials did not sufficiently support intersectoral collaboration and strategic level officials mainly focused on public-private partnerships. Conclusion. Developing integrated PA policies is a bottom-up innovation process that needs to be supported by governmental leaders through better guiding organizational processes leading to such policies. Operational level officials can assist in this by making progress in intersectoral collaboration visible.
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Morton KL, Atkin AJ, Corder K, Suhrcke M, van Sluijs EMF. The school environment and adolescent physical activity and sedentary behaviour: a mixed-studies systematic review. Obes Rev 2016; 17:142-58. [PMID: 26680609 PMCID: PMC4914929 DOI: 10.1111/obr.12352] [Citation(s) in RCA: 146] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2015] [Revised: 09/04/2015] [Accepted: 10/07/2015] [Indexed: 12/21/2022]
Abstract
There is increasing academic and policy interest in interventions aiming to promote young people's health by ensuring that the school environment supports healthy behaviours. The purpose of this review was to summarize the current evidence on school-based policy, physical and social-environmental influences on adolescent physical activity and sedentary behaviour. Electronic databases were searched to identify studies that (1) involved healthy adolescents (11-18 years old), (2) investigated school-environmental influences and (3) reported a physical activity and/or sedentary behaviour outcome or theme. Findings were synthesized using a non-quantitative synthesis and thematic analysis. Ninety-three papers of mixed methodological quality were included. A range of school-based policy (e.g. break time length), physical (e.g. facilities) and social-environmental (e.g. teacher behaviours) factors were associated with adolescent physical activity, with limited research on sedentary behaviour. The mixed-studies synthesis revealed the importance of specific activity settings (type and location) and intramural sport opportunities for all students. Important physical education-related factors were a mastery-oriented motivational climate and autonomy supportive teaching behaviours. Qualitative evidence highlighted the influence of the wider school climate and shed light on complexities of the associations observed in the quantitative literature. This review identifies future research needs and discusses potential intervention approaches to be considered.
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Affiliation(s)
- K L Morton
- UKCRC Centre for Diet and Activity Research (CEDAR), MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - A J Atkin
- UKCRC Centre for Diet and Activity Research (CEDAR), MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - K Corder
- UKCRC Centre for Diet and Activity Research (CEDAR), MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - M Suhrcke
- Centre for Health Economics, University of York, York, UK
| | - E M F van Sluijs
- UKCRC Centre for Diet and Activity Research (CEDAR), MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
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Horodyska K, Luszczynska A, Hayes CB, O'Shea MP, Langøien LJ, Roos G, van den Berg M, Hendriksen M, De Bourdeaudhuij I, Brug J. Implementation conditions for diet and physical activity interventions and policies: an umbrella review. BMC Public Health 2015; 15:1250. [PMID: 26678996 PMCID: PMC4683715 DOI: 10.1186/s12889-015-2585-5] [Citation(s) in RCA: 69] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2015] [Accepted: 12/08/2015] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND This umbrella review aimed at identifying evidence-based conditions important for successful implementation of interventions and policies promoting a healthy diet, physical activity (PA), and a reduction in sedentary behaviors (SB). In particular, we examined if the implementation conditions identified were intervention-specific or policy-specific. This study was undertaken as part of the DEterminants of DIet and Physical Activity (DEDIPAC) Knowledge Hub, a joint action as part of the European Joint Programming Initiative a Healthy Diet for a Healthy Life. METHODS A systematic review of reviews and stakeholder documents was conducted. Data from nine scientific literature databases were analyzed (95 documents met the inclusion criteria). Additionally, published documentation of eight major stakeholders (e.g., World Health Organization) were systematically searched (17 documents met the inclusion criteria). The RE-AIM framework was used to categorize elicited conditions. Across the implementation conditions 25 % were identified in at least four documents and were subsequently classified as having obtained sufficient support. RESULTS We identified 312 potential conditions relevant for successful implementation; 83 of these received sufficient support. Using the RE-AIM framework eight implementation conditions that obtained support referred to the reach in the target population; five addressed efficacy of implementation processes; 24 concerned adoption by the target staff, setting, or institutions; 43 referred to consistency, costs, and adaptations made in the implementation process; three addressed maintenance of effects over time. The vast majority of implementation conditions (87.9 %; 73 of 83) were supported by documents referring to both interventions and policies. There were seven policy-specific implementation conditions, which focused on increasing complexities of coexisting policies/legal instruments and their consequences for implementation, as well as politicians' collaboration in implementation. CONCLUSIONS The use of the proposed list of 83 conditions for successful implementation may enhance the implementation of interventions and policies which pursue identification of the most successful actions aimed at improving diet, PA and reducing SB.
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Affiliation(s)
- Karolina Horodyska
- Department of Psychology, SWPS University of Social Sciences and Humanities, 30b Ostrowskiego St, 53238, Wroclaw, Poland.
| | - Aleksandra Luszczynska
- Department of Psychology, SWPS University of Social Sciences and Humanities, 30b Ostrowskiego St, 53238, Wroclaw, Poland.
- Trauma, Health, & Hazards Center, University of Colorado, 1861 Austin Bluffs Pkwy, Colorado Springs, CO, 80933-7150, USA.
| | - Catherine B Hayes
- Department of Public Health and Primary Care, Trinity College Dublin, Centre for Health Sciences, Tallaght Hospital, Dublin 24, Ireland.
| | - Miriam P O'Shea
- Department of Public Health and Primary Care, Trinity College Dublin, Centre for Health Sciences, Tallaght Hospital, Dublin 24, Ireland.
| | - Lars J Langøien
- Department for Physical Education, Norwegian School of Sport Sciences, P.O. BOX 4014, Ullevål Stadion, N-0806, Oslo, Norway.
| | - Gun Roos
- SIFO - National Institute for Consumer Research, P.O. BOX 4682, Nydalen, N-0405, Oslo, Norway.
| | - Matthijs van den Berg
- National Institute for Public Health and the Environment, Antonie van Leeuwenhoeklaan 9, 3721, Bilthoven, The Netherlands.
| | - Marieke Hendriksen
- National Institute for Public Health and the Environment, Antonie van Leeuwenhoeklaan 9, 3721, Bilthoven, The Netherlands.
| | - Ilse De Bourdeaudhuij
- Department of Movement and Sport Sciences, Ghent University, Watersportlaan 2, 9000, Ghent, Belgium.
| | - Johannes Brug
- VU University Medical Center, Amsterdam, Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands.
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Bunketorp Käll L, Malmgren H, Olsson E, Lindén T, Nilsson M. Effects of a Curricular Physical Activity Intervention on Children's School Performance, Wellness, and Brain Development. THE JOURNAL OF SCHOOL HEALTH 2015; 85:704-713. [PMID: 26331753 DOI: 10.1111/josh.12303] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/04/2014] [Revised: 02/27/2015] [Accepted: 04/23/2015] [Indexed: 06/05/2023]
Abstract
BACKGROUND Physical activity and structural differences in the hippocampus have been linked to educational outcome. We investigated whether a curriculum-based physical activity intervention correlates positively with children's academic achievement, psychological well-being, health-related quality of life (HRQoL), fitness, and structural development of the brain. METHODS The study had a quasi-experimental design and a control group. National test results were gathered from 545 students, 122 in the intervention school, and 423 in 3 control schools. HRQoL and socioemotional data were collected with child and proxy versions of KIDSCREEN and the Strength and Difficulties Questionnaire. Overall, 79 students in grades 5 and 6 were recruited for an in-depth study, consisting of a submaximal oxygen consumption test and magnetic resonance imaging of the brain. HRQoL and socioemotional data were collected from 349 students (65%), 182 (52%) in the intervention school, and 167 (48%) in one of the control schools. RESULTS Girls attending the intervention school were more likely to pass national tests in Swedish (odds ratio 5.7) and Mathematics (odds ratio 3.2). The fourth to sixth graders in the intervention school reported lower levels of conduct problems (p < .05), and the girls were also less likely to report hyperactivity (p < .05). Girls reported higher levels of emotional problems (p < .05) than boys. Boys in the intervention group had significantly higher levels of estimated maximal oxygen uptake (p < .05) than controls. No difference in hippocampal structure was seen. CONCLUSIONS Curriculum-based physical activity in school may improve the academic achievement and psychological health of children, particularly for girls.
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Affiliation(s)
- Lina Bunketorp Käll
- Advanced Reconstruction of Extremities, Sahlgrenska University Hospital, House U1, 6th Floor, 43180 Mölndal, Sweden; Center for Brain Repair and Rehabilitation, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, 40530 Gothenburg, Sweden.
| | - Helge Malmgren
- Department of Philosophy, Linguistics and Theory of Science, University of Gothenburg, Box 200, 40530 Gothenburg, Sweden.
| | - Erik Olsson
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, 40530 Gothenburg, Sweden.
| | - Thomas Lindén
- Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, 40530 Gothenburg, Sweden.
- Hunter Medical Research Institute/University of Newcastle, New Lambton, NSW 2305, Australia.
- Florey Institute of Neuroscience and Mental Health, 245 Burgundy Street, Heidelberg, VIC 3084, Australia.
| | - Michael Nilsson
- Hunter Medical Research Institute/University of Newcastle, New Lambton, NSW 2305, Australia.
- Centre for Brain Repair and Rehabilitation, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, 40530 Gothenburg, Sweden.
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Abstract
OBJECTIVE To compare the strength of district wellness policies with corresponding school-level practices reported by principals and teachers. DESIGN District-level wellness policy data were collected from school district websites and, if not available online, by requests made to district administrators in the autumn of 2013. The strength of district policies was scored using the Wellness School Assessment Tool. School-level data were drawn from the 2012 Minnesota School Health Profiles principal and teacher surveys and the National Center for Education Statistics Common Core Data. Generalized estimating equations which accounted for school-level demographics and the nesting of up to two schools within some districts were used to examine ten district policy items and fourteen school-level practices of relevance to nutrition standards, nutrition education and wellness promotion, and physical activity promotion. SETTING State-wide sample of 180 districts and 212 public schools in Minnesota, USA. RESULTS The mean number of energy-dense, nutrient-poor snack foods and beverages available for students to purchase at school was inversely related to the strength of district wellness policies regulating vending machines and school stores (P=0·01). The proportion of schools having a joint use agreement for shared use of physical activity facilities was inversely related to the strength of district policies addressing community use of school facilities (P=0·03). No associations were found between the strength of other district policies and school-level practices. CONCLUSIONS Nutrition educators and other health professionals should assist schools in periodically assessing their wellness practices to ensure compliance with district wellness policies and environments supportive of healthy behaviours.
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Olstad DL, Campbell EJ, Raine KD, Nykiforuk CIJ. A multiple case history and systematic review of adoption, diffusion, implementation and impact of provincial daily physical activity policies in Canadian schools. BMC Public Health 2015; 15:385. [PMID: 25885026 PMCID: PMC4436021 DOI: 10.1186/s12889-015-1669-6] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2014] [Accepted: 03/19/2015] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Few children meet physical activity (PA) recommendations, and are therefore at increased risk for overweight/obesity and adverse health outcomes. To increase children's opportunities for PA, several Canadian provinces have adopted school-based daily PA (DPA) policies. It is not clear why some jurisdictions have adopted DPA policies, and others have not, nor whether these policies have been implemented and have achieved their intended outcomes. The purpose of this study was to understand the processes underlying adoption and diffusion of Canadian DPA policies, and to review evidence regarding their implementation and impact. METHODS We adopted a multiple case history methodology in which we traced the chronological trajectory of DPA policies among Canadian provinces by compiling timelines detailing key historical events that preceded policy adoption. Publicly available documents posted on the internet were reviewed to characterize adopter innovativeness, describe the content of their DPA policies, and explore the context surrounding policy adoption. Diffusion of Innovations theory provided a conceptual framework for the analyses. A systematic literature search identified studies that had investigated adoption, diffusion, implementation or impact of Canadian DPA policies. RESULTS Five of Canada's 13 provinces and territories (38.5%) have DPA policies. Although the underlying objectives of the policies are similar, there are clear differences among them and in their various policy trajectories. Adoption and diffusion of DPA policies were structured by the characteristics and capacities of adopters, the nature of their policies, and contextual factors. Limited data suggests implementation of DPA policies was moderate but inconsistent and that Canadian DPA policies have had little to no impact on school-aged children's PA levels or BMI. CONCLUSIONS This study detailed the history and current status of Canadian DPA policies, highlighting the conditional nature of policy adoption and diffusion, and describing policy and adopter characteristics and political contexts that shaped policy trajectories. An understanding of the conditions associated with successful policy adoption and diffusion can help identify receptive contexts in which to pioneer novel legislative initiatives to increase PA among children. By reviewing evidence regarding policy implementation and impact, this study can also inform amendments to existing, and development of future PA policies.
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Affiliation(s)
- Dana Lee Olstad
- Centre for Physical Activity and Nutrition Research, School of Exercise and Nutrition Sciences, Deakin University, 221 Burwood Highway, Burwood, VIC, 3125, Australia.
| | - Elizabeth J Campbell
- School of Public Health, 3-300 Edmonton Clinic Health Academy, University of Alberta, 11405 87 Avenue, Edmonton, AB, T6G 1C9, Canada.
| | - Kim D Raine
- School of Public Health, 3-300 Edmonton Clinic Health Academy, University of Alberta, 11405 87 Avenue, Edmonton, AB, T6G 1C9, Canada.
| | - Candace I J Nykiforuk
- School of Public Health, 3-300 Edmonton Clinic Health Academy, University of Alberta, 11405 87 Avenue, Edmonton, AB, T6G 1C9, Canada.
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Pavelka J, Sigmund E, Hamřík Z, Kalman M. Analysis of foreign physical activity recommendations and guidelines for schools. ACTA GYMNICA 2014. [DOI: 10.5507/ag.2014.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Gallego P, Galán I, José Medrano M, Ramos P, Rivera F, Moreno C. Recent changes in school-based policies on physical activity and nutrition in Spain. Eur J Public Health 2014; 24:899-904. [PMID: 24614650 DOI: 10.1093/eurpub/cku022] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND This study evaluates the changes in Spain between 2006 and 2012, of school-based policies encouraging healthy eating and the undertaking of physical activity (PA). METHODS A longitudinal study was undertaken comprising 277 representative schools from all the regions of Spain. The questionnaires were completed by the school management board. An indicator for school policies on PA was constructed (score 0-4) from the following indicators: (i) participation in PA programmes, (ii) existence of written PA guidelines, (iii) training of teachers about PA and (iv) organization of extracurricular PA activities. For nutrition, indicators similar to the first three for PA were evaluated, together with access to healthy foods (score 0-4). In addition to comparing the scores for 2006 and 2012, multivariate linear regression was used to study the association between the characteristics of the schools and the changes in the scores. RESULTS The indicators for school-based policies on nutrition and PA improved between 2006 and 2012: the average score for PA increased from 1.33 to 1.79 (P < 0.001) and that for nutrition from 1.28 to 1.92 (P < 0.001). The greatest changes were seen regarding the written guidelines for action and participation in PA and nutrition programmes as well as the training of teachers about nutrition. The schools with the least number of students had the highest changes in scores for policies on nutrition (P < 0.05). CONCLUSIONS There has been an increase of school-based policies on PA and nutrition, although there is still room for improvement.
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Affiliation(s)
- Pilar Gallego
- 1 Centro Nacional de Epidemiología. Instituto de Salud Carlos III [National Centre for Epidemiology, Carlos III Institute of Health], Madrid, Spain
| | - Iñaki Galán
- 1 Centro Nacional de Epidemiología. Instituto de Salud Carlos III [National Centre for Epidemiology, Carlos III Institute of Health], Madrid, Spain 2 Departamento de Medicina Preventiva y Salud Pública. Facultad de Medicina. Universidad Autónoma de Madrid [Department of Preventive Medicine and Public Health, Faculty of Medicine, Autonomous University of Madrid], Madrid, Spain
| | - María José Medrano
- 1 Centro Nacional de Epidemiología. Instituto de Salud Carlos III [National Centre for Epidemiology, Carlos III Institute of Health], Madrid, Spain
| | - Pilar Ramos
- 3 Departamento de Psicología Evolutiva y de la Educación. Facultad de Psicología. Universidad de Sevilla [Department of Developmental and Educational Psychology, Faculty of Psychology, University of Seville], Seville, Spain
| | - Francisco Rivera
- 4 Departamento de Psicología Clínica, Social y Experimental. Facultad de Psicología. Universidad de Huelva [Department of Clinical, Social and Experimental Psychology, Faculty of Psychology, University of Huelva], Huelva, Spain
| | - Carmen Moreno
- 3 Departamento de Psicología Evolutiva y de la Educación. Facultad de Psicología. Universidad de Sevilla [Department of Developmental and Educational Psychology, Faculty of Psychology, University of Seville], Seville, Spain
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Abstract
Obesity is a complex problem requiring large-scale, population-based solutions. Public policy strategies have been identified as critical tools in obesity prevention efforts as they can benefit all who are exposed rather than simply changing individual behaviors one at a time. This paper reviews the peer-reviewed scientific U.S.-based literature published between January 2012 and March 2013 to examine the influence of state laws and local policies on changes to school and other environments, individual activity and nutrition-related behaviors, and obesity and weight outcomes. Virtually all recent studies have focused on policies directed at the school environment and, across-the board, the evidence was mixed. Most studies were cross-sectional, focused on policy implementation in schools and other settings rather than impacts on individual behaviors or obesity. Opportunities exist for impact studies focusing on a broader spectrum of policies as well as for continued policy actions at all levels of government.
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Affiliation(s)
- Jamie F Chriqui
- Institute for Health Research and Policy, University of Illinois at Chicago, 1747 W. Roosevelt Road, M/C 275, Chicago, IL 60608; tel. 312-996-6410; fax 312-355-2801;
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Long MW, Sobol AM, Cradock AL, Subramanian SV, Blendon RJ, Gortmaker SL. School-day and overall physical activity among youth. Am J Prev Med 2013; 45:150-7. [PMID: 23867021 DOI: 10.1016/j.amepre.2013.03.011] [Citation(s) in RCA: 72] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2012] [Revised: 02/15/2013] [Accepted: 03/22/2013] [Indexed: 10/26/2022]
Abstract
BACKGROUND Increasing school-day physical activity through policy and programs is commonly suggested to prevent obesity and improve overall child health. However, strategies that focus on school-day physical activity may not increase total physical activity if youth compensate by reducing physical activity outside of school. PURPOSE Objectively measured, nationally representative physical activity data were used to test the hypothesis that higher school-day physical activity is associated with higher overall daily physical activity in youth. METHODS Accelerometer data from 2003-2004/2005-2006 National Health and Nutrition Examination Surveys were analyzed in 2012 to estimate physical activity levels during the school day (8AM-3PM) among youth aged 6-19 years (n=2548). Fixed-effects regressions were used to estimate the impact of changes in school-day minutes of moderate-to-vigorous physical activity (MVPA) on changes in total daily MVPA. RESULTS Each additional minute of school-day MVPA was associated with an additional 1.14 minutes (95% CI=1.04, 1.24; p<0.001) of total daily MVPA, or 0.14 additional minutes (95% CI=0.04, 0.24; p=0.008) outside the school day, controlling for total daily accelerometer wear time and age, gender, race/ethnicity, and other non-time varying covariates. There were no differences in the effect of school-day MVPA on total MVPA by age group, gender, race/ethnicity, poverty status, or degree of change in MVPA. CONCLUSIONS Higher school-day MVPA was associated with higher daily MVPA among U.S. youth with no evidence for same-day "compensation." Increasing school-based physical activity is a promising approach that can improve total daily physical activity levels of youth.
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Affiliation(s)
- Michael W Long
- Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston, MA, USA.
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