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Watkins JM, Greeven SJ, Heeter KN, Brunnemer JE, Otile J, Solá PAF, Dutta S, Hobson JM, Evanovich JM, Coble CJ, Werner NE, Martinez Kercher VM, Kercher KA. Human-centered participatory co-design with children and adults for a prototype lifestyle intervention and implementation strategy in a rural middle school. BMC Public Health 2024; 24:845. [PMID: 38504193 PMCID: PMC10949632 DOI: 10.1186/s12889-024-18351-x] [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: 12/05/2023] [Accepted: 03/13/2024] [Indexed: 03/21/2024] Open
Abstract
PURPOSE The significance of regular physical activity (PA) in reducing cardiovascular disease (CVD) risk is widely acknowledged. However, children in rural areas encounter specific barriers to PA compared to their urban counterparts. This study employs human-centered participatory co-design, involving community stakeholders in developing a multi-level PA intervention named Hoosier Sport. The primary hypothesis is the co-design sessions leading to the development of a testable intervention protocol. METHODS Two co-design teams, each consisting of six children and six adults, were formed using human-centered participatory co-design facilitated by research faculty and graduate students. The process involved five co-design sessions addressing problem identification, solution generation, solution evaluation, operationalization, and prototype evaluation. Thematic analysis was employed to identify key themes and intervention components. RESULTS Child co-designers (n = 6) ranged from 6th to 8th grade, averaging 12.6 years (SD = 1.8), while adult co-designers (n = 6) averaged 43.3 years (SD = 8.08). Thematic analysis revealed children emphasizing autonomy, the freedom to choose physical and non-physical activities, and the importance of building peer relationships during PA. Adult interviews echoed the importance of autonomy and choice in activities, with a focus on relatedness through positive role modeling. CONCLUSION The prototype intervention and implementation strategies developed constitute a testable intervention aligned with Phase 1 of the ORBIT model. This testable prototype lays the groundwork for a collaborative campus-community partnership between the university and the local community, ensuring mutual benefits and sustainable impact.
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Affiliation(s)
- Janette M Watkins
- Department of Kinesiology, School of Public Health-Bloomington, Indiana University, Bloomington, IN, USA
- Program in Neuroscience, College of Arts and Sciences, Indiana University, Bloomington, IN, USA
| | - Sarah J Greeven
- Department of Kinesiology, School of Public Health-Bloomington, Indiana University, Bloomington, IN, USA
| | - Kathleen N Heeter
- Department of Applied Health Science, School of Public Health-Bloomington, Indiana University, Bloomington, IN, USA
| | - Julia E Brunnemer
- Department of Health & Wellness Design, School of Public Health-Bloomington, Indiana University, Bloomington, IN, USA
| | - Jacob Otile
- Department of Epidemiology & Biostatistics, School of Public Health-Bloomington, Indiana University, Bloomington, IN, USA
| | - Paola A Fernández Solá
- Department of Epidemiology & Biostatistics, School of Public Health-Bloomington, Indiana University, Bloomington, IN, USA
| | - Sandeep Dutta
- Neag School of Education, University of Connecticut, Storrs, CT, USA
| | | | | | - Cassandra J Coble
- Department of Kinesiology, School of Public Health-Bloomington, Indiana University, Bloomington, IN, USA
| | - Nicole E Werner
- Department of Health & Wellness Design, School of Public Health-Bloomington, Indiana University, Bloomington, IN, USA
| | - Vanessa M Martinez Kercher
- Department of Health & Wellness Design, School of Public Health-Bloomington, Indiana University, Bloomington, IN, USA
| | - Kyle A Kercher
- Department of Kinesiology, School of Public Health-Bloomington, Indiana University, Bloomington, IN, USA.
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Deng A, Zarrett N, Sweeney AM, Moon J. The influence of social support, social affiliation and intrinsic motivation for increasing underserved youth's physical activity: A social climate-based intervention study. J Sports Sci 2023; 41:502-511. [PMID: 37322573 PMCID: PMC10529264 DOI: 10.1080/02640414.2023.2225020] [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: 09/19/2022] [Accepted: 06/05/2023] [Indexed: 06/17/2023]
Abstract
The purpose of this study was to investigate the influences of intrinsic motivation, social affiliation orientations and reciprocal social support for physical activity (PA) on underserved youths' afterschool period moderate-to-vigorous (MVPA) changing trajectories across the 16-week Connect through PLAY intervention, a social-motivational climate intervention. A total of 113 youth (61.06% African American, 56.64% girls) provided full data. Youths' intrinsic motivation, social affiliation orientations and social support were measured by youth responses to a set of surveys at baseline and post-intervention. Youths' afterschool period MVPA was measured using data from 7-day ActiGraph accelerometer wear at baseline, midpoint and post-intervention. Hierarchical linear modelling analysis found that youth daily afterschool period (3pm-6pm) MVPA increased, on average, 37.94 min across the 16-week intervention. Increases in intrinsic motivation, social affiliation orientations and social support were positive predictors of youth afterschool MVPA changing trajectory. The findings clarify the contributions that a social-motivational climate intervention can have on youth afterschool period MVPA through increasing youth intrinsic motivation, social affiliation and reciprocal social support.
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Affiliation(s)
- Anqi Deng
- Department of Psychology, University of South Carolina, Columbia, SC, USA
| | - Nicole Zarrett
- Department of Psychology, University of South Carolina, Columbia, SC, USA
| | | | - Jongho Moon
- Department of Psychology, University of South Carolina, Columbia, SC, USA
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Zarrett N, Wilson DK, Sweeney A, Bell B, Fairchild A, Pinto B, Miller C, Thames T. An overview of the Connect through PLAY trial to increase physical activity in underserved adolescents. Contemp Clin Trials 2022; 114:106677. [DOI: 10.1016/j.cct.2022.106677] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Accepted: 01/05/2022] [Indexed: 11/29/2022]
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Zarrett N, Law LH, Wilson DK, Abraczinskas M, Taylor S, Cook BS, Roberts A. Connect through PLAY: a randomized-controlled trial in afterschool programs to increase adolescents' physical activity. J Behav Med 2021; 44:379-391. [PMID: 33677766 PMCID: PMC8131269 DOI: 10.1007/s10865-021-00206-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Accepted: 02/03/2021] [Indexed: 12/28/2022]
Abstract
The current study is a randomized controlled trial to test a novel 10-week climate-based intervention within pre-existing afterschool programs, designed to increase moderate-to-vigorous physical activity (MVPA) in underserved (low-income, minority status) middle school youth by addressing youth social developmental needs. Participants (n = 167; 56% female; 62% Black; 50% overweight/obese) enrolled in 6 middle schools were randomized to either the Connect through PLAY intervention or a wait-list control. Process evaluation measures (i.e., observations of external evaluators; staff surveys) indicated that essential elements were implemented with fidelity, and staff endorsed implementation ease/feasibility and acceptability. Regression analysis demonstrated that participation in the intervention (vs. control) was associated with an increase of 8.17 min of daily accelerometry-measured MVPA (56 min of additional weekly MVPA) at post-intervention controlling for baseline MVPA, school, gender, and weight status. The results provide support for social-motivational climate-based interventions for increasing MVPA in underserved youth that can inform future school-based health initiatives.Trial Registration: NCT03850821: https://clinicaltrials.gov/ct2/show/study/NCT03850821?term=NCT03850821&rank=1.
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Affiliation(s)
- Nicole Zarrett
- Department of Psychology, University of South Carolina, 1512 Pendleton Street, Columbia, SC, 29208, USA.
| | - Lauren H Law
- Department of Psychology, University of South Carolina, 1512 Pendleton Street, Columbia, SC, 29208, USA
| | - Dawn K Wilson
- Department of Psychology, University of South Carolina, 1512 Pendleton Street, Columbia, SC, 29208, USA
| | - Michelle Abraczinskas
- Department of Family, Youth, and Community Sciences, University of Florida, Gainesville, FL, USA
| | - Stephen Taylor
- Department of Psychology, University of South Carolina, 1512 Pendleton Street, Columbia, SC, 29208, USA
| | - Brittany S Cook
- Department of Psychology, University of South Carolina, 1512 Pendleton Street, Columbia, SC, 29208, USA
| | - Alex Roberts
- Department of Psychology, University of South Carolina, 1512 Pendleton Street, Columbia, SC, 29208, USA
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Zarrett N, Abraczinskas M, Cook BS, Wilson D, Roberts A. Formative Process Evaluation of the "Connect" Physical Activity Feasibility Trial for Adolescents. CLINICAL MEDICINE INSIGHTS-PEDIATRICS 2020; 14:1179556520918902. [PMID: 32547286 PMCID: PMC7271270 DOI: 10.1177/1179556520918902] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Accepted: 03/16/2020] [Indexed: 12/16/2022]
Abstract
Most interventions do not reach full implementation in real-world settings. Due
to this issue, formative process evaluation during pilot programs can be
especially useful to understand implementation strengths and areas for
improvement so that full implementation can be reached in future iterations.
This study demonstrated how a formative process evaluation of the Connect
through Positive Leisure Activities for Youth (Connect) pilot informed course
corrections for year 2 implementation. Connect is an intervention to promote a
positive social motivational climate for physical activity (PA) in pre-existing
after school programs. Connect ran 3 days a week for 8 weeks and had 2
components: a 30-minute “Get-to-Know-You” (GTKY) session and a 60-minute PA
session. Formative evaluation was assessed using an observational tool and staff
surveys. Changes in youth PA during program hours was assessed as a process
outcome using the System for Observing Children’s Activity and Relationships
during Play (SOCARP). All Connect essential elements were assessed with the
observational tool including (a) social goal-oriented support; (b)
collaborative, cooperative play; (c) equal treatment/access; and (d) an
inclusive and engaging climate. Adequate dose was achieved on all items in all
sessions. Although GTKY and PA sessions both reached high fidelity in promoting
equal treatment and access, success in reaching fidelity varied for the 3
remaining essential elements. Post-intervention staff surveys indicated
acceptability/adoptability of the Connect program and SOCARP observations
indicated significant increases in PA from baseline to post-intervention.
Changes for year 2 implementation based on the findings are discussed.
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Affiliation(s)
- Nicole Zarrett
- Department of Psychology, University of South Carolina, Columbia, SC, USA
| | | | - Brittany S Cook
- Department of Psychology, University of South Carolina, Columbia, SC, USA
| | - Dawn Wilson
- Department of Psychology, University of South Carolina, Columbia, SC, USA
| | - Alex Roberts
- Department of Psychology, University of South Carolina, Columbia, SC, USA
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Taylor SG, Zarrett N, Roberts AM. The Relation Between Early Adolescent Physical Activity and Internalizing Problems: Variations in Exercise Motivations as a Critical Moderator. THE JOURNAL OF EARLY ADOLESCENCE 2020; 40:662-688. [PMID: 32341617 PMCID: PMC7185262 DOI: 10.1177/0272431619870612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Inconsistencies exist regarding the relation between physical activity (PA) and internalizing symptomology in early adolescence, and there is need for investigation of potential moderators that may account for these discrepancies. The current study utilized a Self-Determination Theory Framework to investigate the main effects of five key motivations to exercise and their moderating effects between PA and internalizing problems in an underserved sample of adolescents (n = 167; mean age = 12.19 years; 73% African American). Analyses showed that intrinsic motivations were negatively related to internalizing problems and extrinsic motivations were positively related. PA was only protective against internalizing problems when intrinsic motivations were high and had iatrogenic effects when these were low. Exploratory analyses further delineated the unique effects of motivational orientations. Clinical implications and future research directions are discussed.
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Luesse HB, Contento IR. Context Considerations for Developing the In Defense of Food Nutrition Education Curriculum. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2019; 51:370-378. [PMID: 30527673 DOI: 10.1016/j.jneb.2018.10.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/05/2018] [Revised: 10/09/2018] [Accepted: 10/13/2018] [Indexed: 06/09/2023]
Abstract
OBJECTIVE To examine perceptions of teachers and afterschool program staff related to the positive aspects and challenges of afterschool education for youth to guide the development of the "In Defense of Food" nutrition education curriculum. METHODS Semi-structured in-depth interviews with a convenience sample of teachers and afterschool program staff experienced serving at-risk youth were conducted in New York, NY. They were audio-recorded, transcribed verbatim, and analyzed using inductive summative content analysis to identify, count, and compare themes. RESULTS Interviews (n = 12) generated 2 meta-themes (Pedagogical Elements for Successful Learning and Pragmatic Considerations for hosting health promotion programs in the afterschool context). Learner-centered and tailored approaches and building social connection were considered important for fostering learning in the afterschool context. CONCLUSIONS AND IMPLICATIONS This study emphasizes the importance of considering pedagogical elements related to delivery that minimizes didactic instruction and focuses on learner-centered approaches. Further research is needed to compare outcomes and process measures common approaches used in designing nutrition education curricula with those that have been described in this study.
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Affiliation(s)
- Hiershenee B Luesse
- Teachers College, Columbia University, New York, NY; 8RES, LLC, New York, NY.
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Watson DP, Adams EL, Shue S, Coates H, McGuire A, Chesher J, Jackson J, Omenka OI. Defining the external implementation context: an integrative systematic literature review. BMC Health Serv Res 2018; 18:209. [PMID: 29580251 PMCID: PMC5870506 DOI: 10.1186/s12913-018-3046-5] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2017] [Accepted: 03/20/2018] [Indexed: 11/27/2022] Open
Abstract
Background Proper implementation of evidence-based interventions is necessary for their full impact to be realized. However, the majority of research to date has overlooked facilitators and barriers existing outside the boundaries of the implementing organization(s). Better understanding and measurement of the external implementation context would be particularly beneficial in light of complex health interventions that extend into and interact with the larger environment they are embedded within. We conducted a integrative systematic literature review to identify external context constructs likely to impact implementation of complex evidence-based interventions. Methods The review process was iterative due to our goal to inductively develop the identified constructs. Data collection occurred in four primary stages: (1) an initial set of key literature across disciplines was identified and used to inform (2) journal and (3) author searches that, in turn, informed the design of the final (4) database search. Additionally, (5) we conducted citation searches of relevant literature reviews identified in each stage. We carried out an inductive thematic content analysis with the goal of developing homogenous, well-defined, and mutually exclusive categories. Results We identified eight external context constructs: (1) professional influences, (2) political support, (3) social climate, (4) local infrastructure, (5) policy and legal climate, (6) relational climate, (7) target population, and (8) funding and economic climate. Conclusions This is the first study to our knowledge to use a systematic review process to identify empirically observed external context factors documented to impact implementation. Comparison with four widely-utilized implementation frameworks supports the exhaustiveness of our review process. Future work should focus on the development of more stringent operationalization and measurement of these external constructs. Electronic supplementary material The online version of this article (10.1186/s12913-018-3046-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Dennis P Watson
- Department of Social and Behavioral Sciences, Indiana University Richard M. Fairbanks School of Public Health, 1050 Wishard Blvd, Indianapolis, IN, 46202, USA.
| | - Erin L Adams
- Department of Psychology, Indiana University Purdue University-Indianapolis, 420 N Blackford St, Indianapolis, IN, 46202, USA
| | - Sarah Shue
- Indiana University-Purdue University Indianapolis, School of Health and Rehabilitation Sciences, 1050 Wishard Blvd, Indianapolis, IN, 46202, USA
| | - Heather Coates
- Indiana University-Purdue University Indianapolis, University Library, Center for Digital Scholarship, 755 W. Michigan St, Indianapolis, IN, 46202, USA
| | - Alan McGuire
- Richard L. Roudebush VA, 1481 W. 10th St, Indianapolis, IN, 46202, USA
| | - Jeremy Chesher
- Department of Environmental Health Sciences, Indiana University Richard M. Fairbanks School of Public Health, 1050 Wishard Blvd, Indianapolis, IN, 46202, USA
| | - Joanna Jackson
- Department of Health Policy and Management, Indiana University Richard M. Fairbanks School of Public Health, 1050 Wishard Blvd, Indianapolis, IN, 46202, USA
| | - Ogbonnaya I Omenka
- Department of Health Policy and Management, Indiana University Richard M. Fairbanks School of Public Health, 1050 Wishard Blvd, Indianapolis, IN, 46202, USA
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Promoting Social Nurturance and Positive Social Environments to Reduce Obesity in High-Risk Youth. Clin Child Fam Psychol Rev 2018; 20:64-77. [PMID: 28229248 DOI: 10.1007/s10567-017-0230-9] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Nurturing environments within the context of families, schools, and communities all play an important role in enhancing youth's behavioral choices and health outcomes. The increasing prevalence rates of obesity among youth, especially among low income and ethnic minorities, highlight the need to develop effective and innovative intervention approaches that promote positive supportive environments across different contexts for at-risk youth. We propose that the integration of Social Cognitive Theory, Family Systems Theory, and Self-Determination Theory offers a useful framework for understanding how individual, family, and social-environmental-level factors contribute to the development of nurturing environments. In this paper, we summarize evidence-based randomized controlled trials that integrate positive parenting, motivational, and behavioral skills strategies in different contexts, including primary care, home, community, and school-based settings. Taken together, these studies suggest that youth and parents are most likely to benefit when youth receive individual-level behavioral skills, family-level support and communication, and autonomous motivational support from the broader social environment. Future investigators and healthcare providers should consider integrating these evidence-based approaches that support the effects of positive social climate-based interventions on promoting healthy eating, physical activity, and weight management in youth.
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Webster CA, Zarrett N, Cook BS, Egan C, Nesbitt D, Weaver RG. Movement integration in elementary classrooms: Teacher perceptions and implications for program planning. EVALUATION AND PROGRAM PLANNING 2017; 61:134-143. [PMID: 28068554 DOI: 10.1016/j.evalprogplan.2016.12.011] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/16/2016] [Revised: 12/06/2016] [Accepted: 12/23/2016] [Indexed: 06/06/2023]
Abstract
Movement integration (MI), which involves infusing physical activity (PA) into regular classroom time in schools, is widely recommended to help children meet the national guideline of 60min of PA each day. Understanding the perspective of elementary classroom teachers (ECTs) toward MI is critical to program planning for interventions/professional development. This study examined the MI perceptions of ECTs in order to inform the design and implementation of a school-based pilot program that focused in part on increasing children's PA through MI. Twelve ECTs (Grades 1-3) from four schools were selected to participate based on their responses to a survey about their use of MI. Based on the idea that MI programming should be designed with particular attention to teachers who integrate relatively few movement opportunities in their classrooms, the intent was to select the teacher who reported integrating movement the least at her/his respective grade level at each school. However, not all of these teachers agreed to participate in the study. The final sample included two groups of ECTs, including eight lowest integrating teachers and four additional teachers. Each ECT participated in an interview during the semester before the pilot program was implemented. Through qualitative analysis of the interview transcripts, four themes emerged: (a) challenges and barriers (e.g., lack of time), (b) current and ideal resources (e.g., school support), (c) current implementation processes (e.g., scheduling MI into daily routines), and (e) teachers' ideas and tips for MI (e.g., stick with it and learn as you go). The themes were supported by data from both groups of teachers. This study's findings can inform future efforts to increase movement opportunities for children during regular classroom time.
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Affiliation(s)
| | | | | | - Cate Egan
- University of South Carolina, United States
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Jiménez-Herranz B, Manrique-Arribas JC, López-Pastor VM, García-Bengoechea E. Transforming a municipal school sports programme through a critical communicative methodology: The role of the of advisory committee. EVALUATION AND PROGRAM PLANNING 2016; 58:106-115. [PMID: 27362584 DOI: 10.1016/j.evalprogplan.2016.06.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/22/2015] [Revised: 05/24/2016] [Accepted: 06/01/2016] [Indexed: 06/06/2023]
Abstract
This research applies a communicative methodology (CM) to the transformation and improvement of the Municipal Comprehensive School Sports Programme in Segovia, Spain (MCSSP), using egalitarian dialogue, based on validity rather than power claims to achieve intersubjectivity and arrive at consensus between all of the Programme's stakeholders through the intervention of an advisory committee (AC). The AC is a body comprising representatives of all stakeholder groups involved in the programme. During the 2013-2014 academic year the programme's AC met four times, operating as a communicative focus group (CFG). The meetings focused on: (1) excluding dimensions (barriers preventing transformation) and transforming dimensions (ways of overcoming barriers), (2) the programme's strengths, (3) the programme's weaknesses and specific actions to remedy them, and (4) the resulting conclusions which were then incorporated into the subsequent programme contract signed between the University and the Segovia Local Authority for 2014-2018. The key conclusions were: (1) the recommendations of the AC widen the range of perspectives and help the research team to make key decisions and (2) the use of CM to fully evaluate the programme and to reach a consensus on how to improve it proved very valuable.
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Affiliation(s)
| | | | | | - Enrique García-Bengoechea
- Participatory Research at McGill (PRAM), Department of Family Medicine, McGill University, Montreal, Canada
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Zarrett N, Abraczinskas M, Cook BS, Wilson DK, Ragaban F. Promoting physical activity within under-resourced afterschool programs: A qualitative investigation of staff experiences and motivational strategies for engaging youth. APPLIED DEVELOPMENTAL SCIENCE 2016; 22:58-73. [PMID: 30147291 PMCID: PMC6107084 DOI: 10.1080/10888691.2016.1211482] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Afterschool programs (ASPs) have become increasingly recognized as a key context to support youth daily physical activity (PA) accrual. Using Self-Determination Theory (SDT) as a framework, this study examined staff perspectives on the strengths and barriers within under-resourced ASPs for establishing a social-motivational climate for encouraging and supporting youth PA. Analysis of semi-structured staff interviews (28 staff; 7 ASPs) indicated that staff had knowledge and value for establishing a PA-supportive motivational climate. However, the feasibility of implementing PA curricula was identified as challenging across programs. Findings suggest increased need for staff training and supports to provide a PA climate that meets the developmental needs/interests of all youth, with particular attention toward increasing the PA of girls and older program youth. Furthermore, striking an appropriate balance between PA and other competing program demands (e.g., academics) will be required to optimize on the effectiveness of PA program components.
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Weaver RG, Beets MW, Beighle A, Webster C, Huberty J, Moore JB. Strategies to Increase After-School Program Staff Skills to Promote Healthy Eating and Physical Activity. Health Promot Pract 2016; 17:88-97. [PMID: 26055462 PMCID: PMC7244216 DOI: 10.1177/1524839915589732] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Standards targeting children's healthy eating and physical activity (HEPA) in after-school programs call for staff to display or refrain from HEPA-promoting or -discouraging behaviors that are linked to children's HEPA. This study evaluated strategies to align staff behaviors with HEPA Standards. Staff at four after-school programs serving approximately 500 children participated in professional development training from January 2012 to May 2013. Site leaders also attended workshops and received technical support during the same time frame. Changes in staff behaviors were evaluated using the System for Observing Staff Promotion of Activity and Nutrition in a pre- (fall 2011) multiple-post (spring 2012, fall 2012, and spring 2013), no-control group study design. A total of 8,949 scans were completed across the four measurement periods. Of the 19 behaviors measured, 14 changed in the appropriate direction. For example, staff engaging in physical activity with children increased from 27% to 40% of scans and staff eating unhealthy foods decreased from 56% to 14% of days. Ongoing training and technical assistance can have a measureable impact on staff behaviors linked to child-level HEPA outcomes. Future research should explore the feasibility of disseminating ongoing trainings to after-school program staff on a large scale.
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Wilson DK. Behavior matters: the relevance, impact, and reach of behavioral medicine. Ann Behav Med 2015; 49:40-8. [PMID: 25559044 DOI: 10.1007/s12160-014-9672-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND/PURPOSE Growing evidence suggests behavioral interventions that target a few key behaviors may be effective at improving population-level health outcomes; health status indicators; social, economic, and physical environments; personal capacity; and biological outcomes. A theoretical framework that targets both social and cognitive mechanisms of behavioral interventions is outlined as critical for understanding "ripple effects" of behavioral interventions on influencing a broad range of outcomes associated with improved health and well-being. METHODS/RESULTS Evidence from randomized controlled trials is reviewed and demonstrates support for ripple effects-the effects that behavioral interventions have on multiple outcomes beyond the intended primary target of the interventions. These outcomes include physical, psychological, and social health domains across the lifespan. CONCLUSIONS Cascading effects of behavioral interventions have important implications for policy that argue for a broader conceptualization of health that integrates physical, mental, and social well-being outcomes into future research to show the greater return on investment.
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Affiliation(s)
- Dawn K Wilson
- Department of Psychology, University of South Carolina, Columbia, SC, 29208, USA,
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A comprehensive professional development training's effect on afterschool program staff behaviors to promote healthy eating and physical activity. JOURNAL OF PUBLIC HEALTH MANAGEMENT AND PRACTICE 2015; 20:E6-E14. [PMID: 24858323 DOI: 10.1097/phh.0b013e3182a1fb5d] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Evaluate a comprehensive intervention designed to support staff and program leaders in the implementation of the YMCA of USA healthy eating and physical activity (HEPA) standards for their afterschool programs (3-6 pm). DESIGN Pre- (fall 2011) and postassessment (spring 2012) no-control group. SETTING/PARTICIPANTS Four large-scale YMCA afterschool programs serving approximately 500 children. INTERVENTION Professional development training founded on the 5Ms (ie, Mission, Model, Manage, Monitor, and Maximize) and LET US Play principles (ie, Lines, Elimination, Team size, Uninvolved staff/kids, and Space, equipment, and rules), on-site booster training sessions, workshops, and ongoing technical support for staff and program leaders from January to May 2012. MAIN OUTCOME MEASURES System for Observing Staff Promotion of Activity and Nutrition. ANALYSIS Multilevel mixed-effects linear (ie, staff behaviors expressed as a percentage of the number of scans observed) and logistic regression. RESULTS A total of 5328 System for Observing Staff Promotion of Activity and Nutrition scans were completed over the 2 measurement periods. Of the 20 staff behaviors identified in HEPA standards and measured in this study, 17 increased or decreased in the appropriate direction. For example, the proportion staff engaged in physical activity with children increased from 26.6% to 37% and the proportion of staff eating unhealthy foods decreased from 42.1% to 4.5%. CONCLUSIONS Comprehensive professional development training, founded on the 5Ms and LET US Play principles, and ongoing technical assistance can have a sizable impact on key staff behaviors identified by HEPA standards for afterschool programs.
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Zarrett N, Sorensen C, Skiles B. Environmental and social-motivational contextual factors related to youth physical activity: systematic observations of summer day camps. Int J Behav Nutr Phys Act 2013; 10:63. [PMID: 23688205 PMCID: PMC3665664 DOI: 10.1186/1479-5868-10-63] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2012] [Accepted: 05/10/2013] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Youth risk of obesity is high during the summer months. Summer day camps can be ideal settings for preventing obesity through reducing youth summer sedentary behaviors. However, with limited research on camp settings, the mechanisms by which these programs promote children's physical activity (PA) remains largely unknown. The current study was designed to take a first step in addressing this gap in research through systematic observations of 4 summer day camps. METHODS Systematic observations of 4 summer day camps was conducted using the System for Observing Play and Leisure Activity in Youth (SOPLAY) and a social-motivational climate supplemental observation tool founded on Self-Determination Theory and previous research developed by the authors. Teams of two coders observed daily activities for four days across two-week periods at each camp. On 15 minute intervals throughout each day, camps were assessed on level of youth PA (e.g., sedentary, moderate, vigorous), five physical features (e.g., equipment), eight staff interactions (e.g., encourage PA), and six social climate components (e.g., inclusive game). RESULTS Across the sample, highly engaging games [F(1,329) = 17.68, p < .001], positive peer interactions [F(1,329) = 8.43, p < .01], and bullying [F(1,329) = 9.39, p < .01] were significantly related to higher PA participation rates, and clarity of rules [F(1,329) = 11.12, p < .001] was related to fewer youth participating in PA. Separate analyses for males and females indicated some sex differences with highly engaging games [F(1,329) = 23.10, p < .001] and bullying [F(1,329) = 10.00, p < .01] related to males' but not females' PA, and positive peer interactions related to only females' PA [F(1,329) = 9.58, p < .01]. Small, yet significant physical-environmental effects of temperature [F(1,328) = 1.54, p < .05] and equipment [F(1,328) = 4.34, p = .05] for girls also suggests that activities offered indoors (which was most common during high temperatures), and provision of equipment may also be important considerations for promoting girls' PA. Staff behaviors were minimally predictive of youth PA. CONCLUSIONS This is the first study to conduct systematic observations of the physical and social resources of summer day camps and contributes to our understanding of the strengths and needs of camps to effectively promote PA in both boys and girls during the summer months when risks for obesity are high.
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Affiliation(s)
- Nicole Zarrett
- Department of Psychology, University of South Carolina, 1512 Pendleton Street, Columbia, SC, 29208, USA
| | - Carl Sorensen
- Department of Psychology, University of South Carolina, 1512 Pendleton Street, Columbia, SC, 29208, USA
| | - Brittany Skiles
- Department of Psychology, University of South Carolina, 1512 Pendleton Street, Columbia, SC, 29208, USA
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