Exercise—Promoting healthy lifestyles in children and adolescents

Patterns of Physical Activity of Adolescents With ADHD in the School Context: A Cross-Sectional Study for Clinical Practice

OBJECTIVES

To describe the daily Physical Activity (PA) patterns of adolescents with Attention-deficit/hyperactivity disorder (ADHD), to analyze the differences in terms of PA patterns between adolescents with ADHD and those without ADHD, and to study the factors associated with achieving the daily PA recommendations.

METHODS

The sample was composed of 778 adolescents who provided complete information on their PA patterns through the Physical Activity Questionnaire for Adolescents (PAQ-A). Of these, 97 had ADHD according to DSM-5 criteria.

RESULTS

The results show that being a girl or being of foreign origin and having ADHD have an impact on the achievement of the recommended amount of daily PA.

CONCLUSIONS

When promoting PA in adolescents with ADHD within the school environment, it is necessary to consider different domains and specific contexts of a school day, paying special attention to girls and adolescents with ADHD of immigrant origin.

The Relation Between Adverse Childhood Experiences and Health Behaviors in Adult Women

PURPOSE

This study aims to identify whether adverse childhood experiences (ACEs) influence health lifestyles throughout adulthood and examine how ACEs influence dimensions of health lifestyles.

DESIGN

The data was collected cross-sectionally through an online questionnaire.

SETTING

Individuals were invited to participate in an online survey for a larger brain health study as a pre-screening measure.

SUBJECTS

Women in the Midwest between 18-25 and 65-85 who reported either no ACEs or 3 or more ACEs completed the survey, with 233 women answering all questionnaires.

MEASURES

Demographic indicators, the 10-item ACEs questionnaire, and the Health Promoting Lifestyle Profile (HPLP-II).

ANALYSIS

Independent sample t-tests revealed significantly lower scores for ACEs group on the HPLP-II and the 6 subcategories (heath responsibility, interpersonal relationships, nutrition, physical activity, spiritual growth, and stress management). A structural equation model using the 3 ACE categories (abuse, neglect, and household dysfunction) and 6 health domains showed substantial differences in the variance captured for each health behavior.

RESULTS

Findings indicate that abuse predicts physical activity, stress management, and spiritual growth (β = -.21, -.23, -.20); neglect predicts interpersonal relationships and spiritual growth (β = -.17, -.18); and household dysfunction predicts health responsibility, nutrition, stress management, and interpersonal relations (β = -.20, -.22, -.10, -.17).

CONCLUSION

The present investigation extends research in displaying that ACEs play a significant role in future health behaviors, with household dysfunction being the greatest predictor.

Association of Basic Psychological Need Fulfillment and School Happiness with Obesity Levels and Intensity of Physical Activity during Physical Education Classes in South Korean Adolescents

This study examined the relationship between basic psychological need fulfillment (BPNF) and school happiness in relation to the intensity of physical activity exhibited by adolescents during physical education (PE) classes and their obesity levels. We measured BPNF and school happiness using a questionnaire administered to 600 junior high school students. After exclusion, 532 questionnaires were analyzed. A 3D accelerometer (GT3X model) from Actigraph and the body mass index were used to measure physical activity intensity and obesity, respectively. The findings of this study indicate that BPNF and school happiness were significantly associated with physical activity intensity. Specifically, students who engaged in high-intensity physical activity exhibited higher levels of BPNF and school happiness. Additionally, BPNF and school happiness were not significantly related to obesity, whereas a significant relationship was observed between BPNF, school happiness, and the interaction between physical activity intensity and obesity level. This finding implies that adolescents with higher physical activity intensity and lower obesity reported higher levels of BPNF and school happiness. These findings suggest that physical activity intensity during PE classes significantly influences emotional development. Therefore, incorporating moderate-to-vigorous physical activity into PE may serve as a strategy for promoting emotional development in adolescents.

Differences in Physical Activity Patterns among Korean Adolescents during and after COVID-19

Due to the COVID-19-induced social distancing restrictions, adolescents' physical activity declined and their level of health and fitness decreased. In March 2023, the Korean government established the beginning of the post-COVID-19 era by declaring that indoor masks were now "recommended" rather than "mandatory". Consequently, adolescents, whose physical activity decreased during COVID-19, began to participate in such activities again. This study aimed to verify the differences in adolescent physical activity during COVID-19 and after COVID-19. To achieve the study's purpose, an online survey was conducted twice, using the International Physical Activity Questionnaire, for 1143 Korean adolescents in 2022 and 2023. The following results were derived through frequency analysis, descriptive statistical analysis, and an independent variables t-test. First, moderate-to-vigorous physical activity was higher during the post-COVID-19 period than during COVID-19 (p = 0.018). Second, high-intensity (p = 0.018), moderate-intensity (p = 0.030), and low-intensity (p = 0.002) physical activities and total leisure-time physical activities (p = 0.003) were all higher during the post-COVID-19 period than during COVID-19. Third, high-intensity (p = 0.005), moderate-intensity (p = 0.003), low-intensity (p = 0.003) activities and total physical activities in school (p = 0.001) were all higher during the post-COVID-19 period than during COVID-19. Fourth, there was no difference in the commuting times for cycling (p = 0.515) and walking (p = 0.484) and the total physical activities during commuting (p = 0.375) during and after COVID-19. Based on these results, the methods to help adolescents form correct habits for leading a healthy life are discussed.

The Effect of Autonomy and Self-Control on Changes in Healthy Lifestyles of Inactive College Students through Regular Exercise

This study aimed to verify the influence of autonomy and self-control as psychological factors on the changes in lifestyles of inactive college students by participating in regular exercise. A total of 188 university students in Seoul, Korea, taking physical fitness classes for 5 weeks held three times a week participated in the surveys. Surveys were conducted in the first session (T1) and 15th session (T2) of the classes. Autonomy in exercise participation and self-control were measured at T1, and healthy lifestyle was measured at both T1 and T2. A paired t-test was used to measure the changes in healthy lifestyle between two time points, and hierarchical regression analysis was conducted to determine the effect of autonomy in exercise participation and self-control measured at T1 on the healthy lifestyle score at T2. According to the analysis, participants' healthy lifestyles were improved with a statistically significant difference between pre- and post-exercise. Furthermore, the levels of autonomy and self-control before the fitness classes positively influenced the participants' healthy lifestyle after the classes even when the influence of healthy lifestyle measured before the classes was controlled. Thus, it was confirmed that autonomy for participation and self-control are important to change one's healthy lifestyle through regular exercise participation.

Physical Activity, Medical Home, and Health Behavior Counseling Among Adolescents with Special Health Care Needs: NSCH 2016-2017

OBJECTIVES

Aim 1 was to establish updated prevalence estimates for meeting national physical activity (PA) guidelines among adolescents with and without special healthcare needs (SHCN), 12-17 years old. To identify at-risk subgroups, our sub-aim was to compare the distribution of prevalence estimates across PA levels by SHCN subtypes, and in reference to peers without SHCN. Aim 2 was to examine the association between meeting PA guidelines, having a medical home, and receiving positive health behavior counseling in this population.

METHODS

Weighted prevalence estimates for meeting the 2018 National PA Guidelines (inactive, insufficiently active, sufficiently active: guidelines met) were calculated from a secondary analysis of the National Survey of Children's Health 2016-2017 ( n = 16,171, 27% SHCN). Adjusted odds ratios and 95% CIs were estimated from logistic regression models to measure the association between PA, medical home, and postive health behavior counseling.

RESULTS

Of adolescents with SHCN, 15% were reported to be meeting PA guidelines compared to 19% of peers without SHCN peers. Among adolescents with a medical home, regardless of SHCN status, those receiving positive health behavior counseling had 1.70 times the adjusted odds of meeting PA guidelines compared to peers without counseling.

CONCLUSIONS FOR PRACTICE

Adolescents with and without SHCN were more likely to meet PA guidelines if they had a medical home and received positive health behavior counseling, highlighting the value of comprehensive healthcare practices for PA promotion.

Barriers and enablers to physical activity and aerobic fitness deficits among childhood cancer survivors

BACKGROUND

Physical activity and aerobic fitness are modifiable risk factors for cardiovascular disease (CVD) after childhood cancer. How survivors engage in physical activity remains unclear, potentially increasing CVD risk. We assessed survivors' physical activity levels, barriers and enablers, fitness, and identified predictors of fitness and physical activity stage of change.

METHODS

Childhood cancer survivors (CCS; 8-18 years old) ≥1 year post-treatment were assessed for aerobic fitness (6-min walk test), used to extrapolate VO_2max , and body composition (InBody 570). Survivors self-reported physical activity to determine stage of change (Patient-Centered Assessment and Counselling for Exercise). Physical activity and fitness were compared with guidelines and CVD-risk cut-points (VO_2max  < 42 mL/kg/min: males; VO_2max  < 35 mL/kg/min: females). Multiple regression and mediator-moderator analysis were used to identify fitness predictors and stage of change.

RESULTS

One hundred two survivors (12.8 ± 3.3 years) participated (46% acute lymphoblastic leukaemia). Forty percent of males (VO_2max  = 43.3 ± 6.3 mL/kg/min) and 28% of females (VO_2max  = 36.5 ± 5.9 mL/kg/min) were in the CVD-risk category, while 25% met physical activity guidelines. Most prevalent physical activity barriers were fatigue (52%), preferring television instead of exercise (38%), and lacking time (34%). Predictive factors for reduced fitness included being older, female, higher waist-to-height ratio, higher screen time, and moderated by lower physical activity (r²  = 0.91, P < .001). Survivors with higher physical activity stage of change were male, lower body fat percentage, lower screen time, and lived with both parents (r = 0.42, P = .003).

CONCLUSION

Aerobic fitness and physical activity of CCS is low compared with population norms, potentially increasing CVD risk. Addressing physical activity barriers and enablers, including reducing screen time, could promote regular physical activity, reducing CVD risk.

Accelerometer-Assessed Physical Activity and School Absenteeism Due to Illness or Injury Among Children and Adolescents: NHANES 2003 to 2006

INTRODUCTION

To examine the association between objectively measured moderate to vigorous physical activity (MVPA) and total physical activity with school absenteeism due to illness or injury among children and adolescents.

DESIGN

Cross-sectional study.

SETTING

National Health and Nutrition Examination Survey 2003 to 2006.

PARTICIPANTS

A total of 1249 children (aged 6-11 years) and 1747 adolescents (aged 12-17 years).

MEASURES

School absenteeism was categorized as no/minimal school absenteeism (0-8 missed school days in the past 12 months), moderate absenteeism (9-17 missed days), or severe absenteeism (18+ missed days). Physical activity was objectively measured via accelerometry.

ANALYSIS

Multinomial logistic regression.

RESULTS

Children in the most active quartile had 89% reduced odds of severe absenteeism relative to the least active quartile (odds ratio [OR]: 0.11; 0.95% confidence interval [CI]: 0.02-0.48); results were similar for MVPA. For adolescents, those in the most active quartile for MVPA had a 41% reduced odds of having moderate (vs no/minimal) absenteeism (OR = 0.59; 95% CI: 0.35-0.99). For children, a multiplicative interaction effect of MVPA and poverty level on severe absenteeism was observed (OR = 0.98, P = .02).

CONCLUSION

Higher levels of physical activity were associated with lower odds of severe school absenteeism. Such an observation is important, as school absenteeism strongly contributes to academic performance. Particular attention for promoting physical activity and closely monitoring school absenteeism among youth below the poverty level may be warranted.

Specific Strategies for Promotion of Physical Activity in Kids-Which Ones Work? A Systematic Review of the Literature

The purpose of this systematic review was to summarize and evaluate the impact of physical activity (PA) interventions that were implemented in specific school settings on children's PA in those settings. Four research databases were searched to identify PA interventions. Of the 13 706 articles identified, 1352 abstracts were screened and 32 intervention studies were reviewed. Five intervention settings were identified (active travel, after school, classroom, physical education, and recess). Among these settings, a greater proportion of positive findings (ie, significant increase in PA) were found in the classroom (75%) and active travel (67%) settings. Additionally, a higher proportion of interventions implemented in these settings were of high methodological quality (active travel [33%] and classroom [33%]). These findings indicate that interventions in active travel and classrooms settings positively influence youth PA. Importantly, as evidenced in this review, evaluating intervention effects in the targeted setting may provide unique information for future researchers to consider when developing school-based multicomponent PA interventions.

Less sitting, more physical activity and higher cardiorespiratory fitness: associations with weight status among a national sample of children

Background: Very few studies have evaluated the independent and combined associations of sedentary behavior (SB), moderate-to-vigorous physical activity (MVPA) and cardiorespiratory fitness (CRF) on obesity. Our recent work has evaluated this paradigm in the adult population,but no study has evaluated this paradigm in the child population, which was the purpose of this study. Methods: A national sample of children (N=680, 6-11 years) were evaluated via the National Youth Fitness Survey; this study was conducted in 2012, employing a nationally representative sample, occurring across 15 different geographic regions in the United States. SB and MVPA were assessed via parental recall, with CRF objectively measured via a treadmill-based aerobic test. Obesity was determined for measured body mass index. A PACS (Physical Activity Cardiorespiratory Sedentary) score was created ranging from 0-3, indicating each child's number of positive characteristics (PA, CRF, SB). Results: Meeting MVPA guidelines (OR _adjusted=0.47; 95% CI: 0.29-0.77) and above-median CRF (OR _adjusted=0.12; 95% CI: 0.07-0.21), but not SB (OR _adjusted=0.62; 95% CI: 0.35-1.10),were associated with reduced odds of obesity. Compared to those with a PACS score of 0, the odds of obesity for PACS scores of 1-3, respectively, were: 0.31 (0.18-0.53), 0.12 (0.04-0.34), and 0.05 (0.02-0.10). Conclusion: These findings highlight the need for public health strategies to promote child MVPA and CRF, and to reduce SB.

Evaluating the effects of the Lunchtime Enjoyment Activity and Play (LEAP) school playground intervention on children's quality of life, enjoyment and participation in physical activity

BACKGROUND

An emerging public health strategy is to enhance children's opportunities to be physically active during school break periods. The aim of this study was to evaluate the effects of the Lunchtime Enjoyment Activity and Play (LEAP) school playground intervention on primary school children's quality of life (QOL), enjoyment and participation in physical activity (PA).

METHODS

This study consisted of a movable/recycled materials intervention that included baseline, a 7-week post-test and an 8-month follow-up data collection phase. Children within an intervention school (n = 123) and a matched control school (n = 152) aged 5-to-12-years-old were recruited for the study. Children's PA was measured using a combination of pedometers and direct observation (SOPLAY). Quality of life, enjoyment of PA and enjoyment of lunchtime activities were assessed in the 8-12 year children. A multi-level mixed effect linear regression model was applied in STATA (version 12.0) using the xtmixed command to fit linear mixed models to each of the variables to examine whether there was a significant difference (p < 0.05) between the intervention and control school at the three time points (pre, post and follow-up).

RESULTS

Significant overall interaction effects (group × time) were identified for children's mean steps and distance (pedometers) in the intervention school compared to the control school. Intervention school children also spent significantly higher proportions within specified target areas engaged in higher PA intensities in comparison to the control school at both the 7-week post-test and 8-month follow-up. A short-term treatment effect was revealed after 7-weeks for children's physical health scale QOL, enjoyment of PA and enjoyment of intra-personal play activities.

CONCLUSIONS

Examining the effects of this school playground intervention over a school year suggested that the introduction of movable/recycled materials can have a significant, positive long-term intervention effect on children's PA. The implications from this simple, low-cost intervention provide impetus for schools to consider introducing the concept of a movable/recycled materials intervention on a wider scale within primary school settings.

TRIAL REGISTRATION

Australian and New Zealand Clinical Trials Registration Number: ACTRN12613001155785.

Gross motor development and physical activity in kindergarten age children

Physical activity in kindergarten is a fundamental part of the child's educational process. Body experience and physical activity contribute to the development of self-awareness and the learning of different modes of expression, as well as encouraging the acquisition of physically active lifestyles. Recent scientific evidence has confirmed the role of physical activity in disease prevention and quality of life improvement, and stressed the importance of integrated educational programmes promoting physical activity and healthy eating habits. A key priority of scientific research is to identify the opportunities and methods of motor learning and to increase the daily physical activity levels of children by reducing sedentary time and promoting active play and transport (i.e. walking, cycling). Family, school and community involvement are all needed to assure adherence to the official guidelines on how much physical activity children need to boost their health and stave off obesity.

Parental perception on the efficacy of a physical activity program for preschoolers

Childhood obesity is among the leading health concerns in the United States. The relationship between unmet physical activity needs in young children is of particular interest as the trend in childhood obesity continues to rise and unmet physical activity needs are identified. The preschool years are an influential time in promoting healthful lifestyle habits and early childhood interventions may help establish lifelong healthful behaviors which could help prevent obesity later in life. The Food Friends®: Get Movin' with Mighty Moves® is a preschool physical activity program which aims to improve children's gross motor skills and physical activity levels. The home environment and parental modeling are critical factors related to child physical activity in this population. The parent component, Mighty Moves®: Fun Ways to Keep Families Active and Healthy, was designed to address barriers in the home environment that lead to unmet physical activity needs in preschoolers and their families. The program and materials were designed based on Social Marketing tenets and Social Learning Theory principles. Four Colorado Head Start centers were assigned to an experimental group as part of the Mighty Moves® group randomized trial. Quantitative and qualitative evaluation methods were used to determine what messages and materials reached and motivated the target audience to increase physical activity levels. Results of the study indicated the program's materials helped families and children to be more physically active. Additionally, materials and material dissemination were revised to enhance program goals.

Parental perception on the efficacy of a physical activity program for preschoolers

Childhood obesity is among the leading health concerns in the United States. The relationship between unmet physical activity needs in young children is of particular interest as the trend in childhood obesity continues to rise and unmet physical activity needs are identified. The preschool years are an influential time in promoting healthful lifestyle habits and early childhood interventions may help establish lifelong healthful behaviors which could help prevent obesity later in life. The Food Friends®: Get Movin' with Mighty Moves® is a preschool physical activity program which aims to improve children's gross motor skills and physical activity levels. The home environment and parental modeling are critical factors related to child physical activity in this population. The parent component, Mighty Moves®: Fun Ways to Keep Families Active and Healthy, was designed to address barriers in the home environment that lead to unmet physical activity needs in preschoolers and their families. The program and materials were designed based on Social Marketing tenets and Social Learning Theory principles. Four Colorado Head Start centers were assigned to an experimental group as part of the Mighty Moves® group randomized trial. Quantitative and qualitative evaluation methods were used to determine what messages and materials reached and motivated the target audience to increase physical activity levels. Results of the study indicated the program's materials helped families and children to be more physically active. Additionally, materials and material dissemination were revised to enhance program goals.

ParticipACTION: Baseline assessment of the 'new ParticipACTION': A quantitative survey of Canadian organizational awareness and capacity

BACKGROUND

ParticipACTION is a Canadian physical activity (PA) communications and social marketing organization that was relaunched in 2007 after a six-year hiatus. This study assesses the baseline awareness and capacity of Canadian organizations that promote physical activity, to adopt, implement and promote ParticipACTION's physical activity campaign. The three objectives were: (1) to determine organizational awareness of both the 'original' and 'new' ParticipACTION; (2) to report baseline levels of three organizational capacity domains (i.e., to adopt, implement and externally promote physical activity initiatives); and, (3) to explore potential differences in those domains based on organizational size, sector and primary mandate.

METHODS

Organizations at local, provincial/territorial, and national levels were sent an invitation via email prior to the official launch of ParticipACTION to complete an on-line survey. The survey assessed their organization's capacity to adopt, implement and externally promote a new physical activity campaign within their organizational mandates. Descriptive statistics were employed to address the first two study objectives. A series of one-way analysis of variance were conducted to examine the third objective.

RESULTS

The response rate was 29.7% (268/902). The majority of responding organizations had over 40 employees and had operated for over 10 years. Education was the most common primary mandate, followed by sport and recreation. Organizations were evenly distributed between government and not-for-profits. Approximately 96% of respondents had heard of the 'original' ParticipACTION while 54.6% had heard of the 'new' ParticipACTION (Objective 1). Findings indicate good organizational capacity in Canada to promote physical activity (Objective 2) based on reported means of approximately 4.0 (on 5-point scales) for capacity to adopt, implement, and externally promote new physical activity campaigns. Capacity to adopt new physical activity campaigns differed by organizational sector and mandate, and capacity to implement differed by organizational mandate (Objective 3).

CONCLUSION

At baseline, and without specific details of the campaign, respondents believe they have good capacity to work with ParticipACTION. ParticipACTION may do well to capitalize on the existing strong organizational capacity components of leadership, infrastructure and 'will' of national organizations to facilitate the success of its future campaigns.

ParticipACTION: Baseline assessment of the 'new ParticipACTION': A quantitative survey of Canadian organizational awareness and capacity

Background

ParticipACTION is a Canadian physical activity (PA) communications and social marketing organization that was relaunched in 2007 after a six-year hiatus. This study assesses the baseline awareness and capacity of Canadian organizations that promote physical activity, to adopt, implement and promote ParticipACTION's physical activity campaign. The three objectives were: (1) to determine organizational awareness of both the 'original' and 'new' ParticipACTION; (2) to report baseline levels of three organizational capacity domains (i.e., to adopt, implement and externally promote physical activity initiatives); and, (3) to explore potential differences in those domains based on organizational size, sector and primary mandate.

Methods

Organizations at local, provincial/territorial, and national levels were sent an invitation via email prior to the official launch of ParticipACTION to complete an on-line survey. The survey assessed their organization's capacity to adopt, implement and externally promote a new physical activity campaign within their organizational mandates. Descriptive statistics were employed to address the first two study objectives. A series of one-way analysis of variance were conducted to examine the third objective.

Results

The response rate was 29.7% (268/902). The majority of responding organizations had over 40 employees and had operated for over 10 years. Education was the most common primary mandate, followed by sport and recreation. Organizations were evenly distributed between government and not-for-profits. Approximately 96% of respondents had heard of the 'original' ParticipACTION while 54.6% had heard of the 'new' ParticipACTION (Objective 1). Findings indicate good organizational capacity in Canada to promote physical activity (Objective 2) based on reported means of approximately 4.0 (on 5-point scales) for capacity to adopt, implement, and externally promote new physical activity campaigns. Capacity to adopt new physical activity campaigns differed by organizational sector and mandate, and capacity to implement differed by organizational mandate (Objective 3).

Conclusion

At baseline, and without specific details of the campaign, respondents believe they have good capacity to work with ParticipACTION. ParticipACTION may do well to capitalize on the existing strong organizational capacity components of leadership, infrastructure and 'will' of national organizations to facilitate the success of its future campaigns.

Changes in psychosocial factors and physical activity frequency among third- to eighth-grade girls who participated in a developmentally focused youth sport program: a preliminary study

BACKGROUND

Despite the numerous physiological, psychological, and academic benefits of physical activity (PA), declines in PA levels among girls have been observed over the last decade. The purpose of this preliminary study was to assess the short-term changes pertaining to Girls on the Run and Girls on Track developmentally focused youth sport programs (DYS) on global self-esteem, body image, commitment to PA, and PA frequency.

METHODS

This preliminary study employed a nonexperimental, one-group, pre- and postintervention study design using a 29-item paper-and-pencil assessment tool (n = 1034).

RESULTS

Paired sample t-tests from pre- to postintervention revealed statistically significant differences in self-esteem (p < .001), body size satisfaction (p < .001), and vigorous PA frequency (p < .001). Stratification by the number of times participating in the intervention revealed the greatest changes at first participation followed with continued improvements in self-esteem (p = .013) and body size satisfaction (p < .001) for those participating in a second time. Age differences were also observed between participants </=10 years old and 11-15 years; in that significant improvements in commitment to PA (p = .003) were observed for the older girls.

CONCLUSIONS

Findings suggest DYS programs Girls on the Run and Girls on Track may produce beneficial changes in self-esteem, body size satisfaction, PA commitment, and PA frequency. Although the findings from the current report are preliminary, they suggest that DYS programs designed exclusively for girls may provide the necessary framework to promote PA to achieve the numerous associated benefits.