Leveraging the construct of physical literacy to promote physical activity for youth with obesity - A qualitative analysis of physical therapists' perceptions

Physical literacy and health of Chinese medical students: the chain mediating role of physical activity and subjective well-being

Background/objective

While Physical Literacy has been highlighted as a determinant in health in recent study, there is a dearth of studies examining its effect on physical health, and there is a little in the way of empirical data linking Physical Literacy to health outcomes. Accordingly, further empirical research is needed to clarify the mechanisms by which Physical Literacy affects physical health. The purpose of this study was to verify the role of medical students' Physical Literacy on Health-related quality of life as well as to explore the chain mediating role of Physical Activity and Subjective Well-being in it.

Methods

This study utilized a cross-sectional study design. The Physical Literacy, Health-related Quality of Life, Physical Activity ratings, and Subjective Well-being of students at Shanxi Medical University were all measured using an online survey administered in September 2023. A total of 1968 valid questionnaires were returned. First, descriptive statistics and correlation analysis were performed using SPSS software. Second, PROCESS was used to test the mediating role. Finally, we used structural equation modeling (Amos) to test the model fit.

Results

There is a significant correlation between all variables. After mediation effects analysis, we found that there were three indirect pathways of physical literacy on health-related quality of life: a single mediating effect of physical activity, a single mediating effect of subjective well-being, and a chained mediating effect of physical activity-subjective well-being.

Conclusion

The mediating role of physical activity and subjective well-being on the relationship between physical literacy and health-related quality of life has been confirmed. Our research results support the integration of physical literacy into physical education teaching and the modification of curriculum content by physical education teachers as part of efforts to enhance students' physical activity levels, subjective well-being levels, and overall health. This study provides a new perspective for intervention in improving the health of medical students.

Relationship between perceived physical literacy and obesity-related outcomes in adolescents: the EHDLA study

Purpose

The aim of the present study was to examine the relationship between perceived physical literacy and obesity-related outcomes among adolescents from Spain.

Methods

This is a secondary cross-sectional analysis including a total sample of 845 Spanish adolescents (55.3% girls) aged 12-17 years from the Valle de Ricote (Region of Murcia) from the Eating Healthy and Daily Life Activities (EHDLA) project. Physical literacy was evaluated using the Spanish Perceived Physical Literacy Instrument for adolescents (S-PPLI). Body mass index was computed by taking the participants' body weight in kilograms and dividing it by the square of their height in meters, and body mass index (z score) and overweight/obesity and obesity were computed by the World Health Organization age- and sex-specific thresholds. Waist circumference was measured using a constant tension tape. Moreover, the waist-to-height ratio was calculated, and therefore, abdominal obesity was determined. Skinfold measurements were taken at the triceps and medial calf using calibrated steel calipers.

Results

In general, the overall trend was downward (i.e., the higher the PPLI score the lower the obesity-related indicators), with the approximate significance of smooth terms being statistically significant for all models examined (p < 0.001). Adolescents with lower perceived physical literacy (PPL) showed the highest estimated marginal means of body mass index, body mass index z score, waist circumference, waist-to-height ratio, and skinfold (triceps and calf) and predictive probabilities of having excess weight, obesity, and abdominal obesity, while their counterparts with high PPL had the lowest. In addition, significant differences were observed for all the obesity-related indications between adolescents with low PPL and those with medium PPL (p-adjusted < 0.05 for all indicators), as well as with those with high PPL (p-adjusted < 0.05 for all indicators). Moreover, these significant differences were also shown for most indicators between adolescents with medium PPL and those with high PPL (except for obesity).

Conclusion

Physical literacy could play a crucial role in maintaining more desirable obesity-related outcomes in adolescents. Adolescents with high perceived physical literacy showed lower obesity-related indicators (i.e., body mass index, body mass index z score, waist circumference, waist-to-height ratio, skinfolds), as well as a lower probability of having excess weight, obesity, and abdominal obesity.

Pivot from Pain to Productive: Conversations about Weight Management in Youth with Obesity

ABSTRACT

The prevalence of childhood obesity is almost 20% and affects 14.7 million youth. It is not a matter of if but when and how often sports medicine clinicians will care for patients with obesity. Considering the social, emotional, medical, and physical impact of obesity, we need a nuanced approach to communicate with patients and develop effective treatment plans to maintain or encourage physical activity. Neuromusculoskeletal impairments, physical complications, pain, biomechanical differences, and physical deconditioning act as potential barriers to treatment. This article introduces ways to pivot the conversation from musculoskeletal pain to a productive, well-received conversation about a holistic approach to weight management that also promotes physical activity and overall wellness in youth with obesity. Special attention is given to equipping clinicians with recommendations that incorporate the use of inclusive language, health behavior theories, and tenets of motivational interviewing to deliver equitable treatment regardless of body habitus.

Synthesising physical literacy research for 'blank spots': A Systematic review of reviews

The holistic concept of physical literacy (PL) has gained considerable attention worldwide and integrates different determinants (e.g., physical, affective, and cognitive) of physical activity. The purpose of this systematic review (PROSPERO registration: CRD42022312764) was to broadly synthesise PL research and determine "blank spots". We performed standardized searches for PL reviews in 23 databases. Inclusion criteria were English language, any review with a systematized search, publication by June 2023 and PL relevance in an article's main body. The content and insights of the identified reviews were assigned to six literature-driven "problem fields": (i) theory/concept, (ii) measurement/levels/trends, (iii) determinants, (iv) outcomes, (v) interventions, and (vi) policy. We employed nine items for assessing the methodological quality of the reviews (including six items from AMSTAR-2). The screening resulted in an inclusion of 41 PL reviews of different methodology. Existing reviews most frequently analysed aspects of measurement (n = 20) as well as theory/definition (n = 19), followed by interventions (n = 17). In contrast, determinants (n = 6), outcomes (n = 5) and policy aspects (n = 4) were discussed less often. Accordingly, the major "blank spots" are: empirical studies on determinants and outcomes; PL levels and trends; pivotal moderators of interventions; and policy aspects. We recommend the scientific community to address these to move the field forward.

The Effectiveness of a Physical Literacy-Based Intervention for Increasing Physical Activity Levels and Improving Health Indicators in Overweight and Obese Adolescents (CAPACITES 64)

Recently, the concept of Physical Literacy (PL) has emerged as a key concept for promoting active behavior and improving health indicators in adolescents. Overweight and obese adolescents have a low level of Physical Activity (PA), low cardiorespiratory capacity, and high Body Fat percentage (%BF). However, the development of PL in the interest of health improvement has never been studied in overweight and obese adolescents. The objective of this study was to evaluate the impact of an intervention developing PL in overweight and obese adolescents in order to increase their (PA) and improve their health. The study was a prospective, single-arm, non-randomized interventional study. The intervention brings together different actions in PA and dietary education in different adolescent living environments. The study took place over a 9-month period with two data collection times (0; +9 months) and measured Body Mass Index (BMI) and BMI z score, %BF and Skeletal Muscle Mass (%SMM), Moderate-to-Vigorous intensity Physical Activity (MVPA) by accelerometry, CRF, as well as PL by the CAPL-2 tool. Thirteen adolescents (age 11.7 (±1.09) years old) improved their PL scores (+8.3 (±9.3) pts; p ≤ 0.01). BMI z score (-0.3 (±0.3), p ≤ 0.01), their %BF (-3.8 (±4.9); p ≤ 0.01), their CRF (+1.5 (±1.7) mL·min·kg^-1; p ≤ 0.01), and their MVPA (+4.6 (±13.7) min/day; p = 0.36). Initiating multidimensional interventions to develop PL in overweight and obese adolescents may be a promising prospect to enable an increase in their MVPA and improve their long-term health. Longer-term randomized controlled interventional studies are needed to confirm these findings.

Assessment of the Relationship between Body Weight Status and Physical Literacy in 8 to 12 Year Old Pakistani School Children: The PAK-IPPL Cross-Sectional Study

(1) Background: Physical literacy (PL) is a multidimensional concept, since it fosters lifetime engagement in physical activities and reduces obesity; however, empirical evidence is lacking to support this association. This study first aimed to establish PL levels stratified by normal weight children and children with overweight and obesity. Furthermore, this study determined a correlation between PL domains and BMI by weight status among South Punjab school children. (2) Methods: This cross-sectional study involved 1360 (Boys: 675 and Girls: 685) children aged 8 to 12, and was conducted using CAPL-2. T-tests and chi-square were used to determine the difference between categorical variables, with MANOVA used to compare weight statuses. Spearman correlation was employed to determine the correlation between variables; p < 0.05 was considered significant. (3) Results: Normal weight children had significantly higher PL and domain scores, except for the knowledge domain. Most children with normal weights were at the achieving and excelling levels, while children with overweight and obesity were at the beginning and progressing levels. The correlation among PL domains in normal and overweight and obese children ranged from weak to strong (r = 0.001 to 0.737), and the knowledge domain was inversely correlated with the motivation domain (r = -0.023). PL and domain scores were inversely correlated to BMI, except for the knowledge domain. (4) Conclusions: Children with normal weight tend to have higher PL and domain scores, while those with overweight or obesity tend to have lower scores. There was a positive relationship between normal weight and higher PL and domain scores, and an inverse relationship was observed between BMI and higher PL scores.

Physical literacy as a determinant of physical activity level among late adolescents

BACKGROUND/OBJECTIVES

This study aimed to investigate the level of physical literacy among late adolescents according to the current physical activity level and to examine the relationship between current physical activity, barriers to engaging in physical activity, and enjoyment of physical activity and physical literacy.

METHODS

A total of 568 university students (405 women) aged from 18 to 20 were involved in this study. The physical literacy, physical activity level, enjoyment from activity, and barriers to physical activity were assessed with the Perceived Physical Literacy Instrument (PPLI), the International Physical Activity Questionnaire-Short Form (IPAQ-SF), Physical Activity Enjoyment Scale (PACES), and the Physical Activity Barriers Questionnaire (PABQ), respectively. Multinomial and binary logistic regression analyses were employed to explore the association between physical literacy and physical activity level.

RESULTS

Highly physically active adolescents had better scores on the PPLI, PACES, and PABQ than moderately active and inactive participants. The PPLI total score was significantly moderately correlated with PACES total, positive, and negative scores and the PABQ score. There were significant poor correlations between the IPAQ-MET value and the PPLI scores. Adjusted logistic regression analysis revealed the PPLI total score and the PACES positive sub-scale scores, and gender (men) were associated with being highly active relative to moderately active.

CONCLUSIONS

The findings highlight the evidence that physical literacy, gender, and enjoyment from activity can be determinants of high or moderate physical activity levels. Therefore, improving physical literacy among late adolescence may be key to achieving increased physical activity level.