The PLUNGE randomized controlled trial: evaluation of a games-based physical activity professional learning program in primary school physical education

The Effect of Pedagogical Approach on Physical Activity of Girls During Physical Education

Purpose: Technical approaches (TAs) such as Direct Instruction are commonly utilized when teaching games in Physical Education (PE) classes, but game-based approaches (GBAs) such as Game Sense (GS) have gained greater interest over the past 30 years. However, little is known about which approach promotes more physical activity (PA). The aim of this study was to compare the PA of girls during single-gender PE classes in an invasion games unit utilizing either a GS approach or a TA. Methods: Two upper primary school PE classes were taught invasion games using a GS approach and two classes were taught using a TA. During each of the 7 lessons students wore a wearable GPS sensor (SPT2, Sport Performance Tracking, Australia) which measured total distance, distance in each speed zone, top speed and 3D load. Results: The GS group traveled a greater distance than the TA group (+203 m, p < .001). This result was explained mostly by a greater distance covered in zone 2 speeds (0.6-1.7 m/s). The 3D load was also significantly higher in the GS group, but there were no group differences in top speed. Conclusions: Findings suggested that a GS thematic invasion unit was more effective in promoting PA levels in all-girl primary PE classes than a traditional sport-based invasion unit.

Impact of Serious Games on Body Composition, Physical Activity, and Dietary Change in Children and Adolescents: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Over the past four decades, obesity in children of all ages has increased worldwide, which has intensified the search for innovative intervention strategies. Serious games, a youth-friendly form of intervention designed with educational or behavioral goals, are emerging as a potential solution to this health challenge. To analyze the effectiveness of serious games in improving body composition, physical activity, and dietary change, we performed a systematic review and meta-analysis of randomized controlled trials (RCTs) from PubMed, Web of Science, EMBASE, and Scopus databases. Pooled standardized mean differences (SMD) were calculated for 20 studies (n = 2238 the intervention group; n = 1983 in the control group) using random-effect models. The intervention group demonstrated a slightly better, although non-significant, body composition score, with a pooled SMD of -0.26 (95% CI: -0.61 to 0.09). The pooled effect tends to be stronger with longer duration of intervention (-0.40 [95% CI: -0.96, 0.16] for >3 months vs. -0.02 [95% CI: -0.33, 0.30] for ≤3 months), although the difference was not statistically significant (p-difference = 0.24). As for the specific pathways leading to better weight control, improvements in dietary habits due to serious game interventions were not significant, while a direct positive effect of serious games on increasing physical activity was observed (pooled SMD = 0.61 [95% CI: 0.04 to 1.19]). While the impact of serious game interventions on body composition and dietary changes is limited, their effectiveness in increasing physical activity is notable. Serious games show potential as tools for overweight/obesity control among children and adolescents but may require longer intervention to sustain its effect.

Systematic review and meta-analysis of physical activity interventions to increase elementary children's motor competence: a comprehensive school physical activity program perspective

BACKGROUND

Regular participation in physical activity (PA) benefits children's health and well-being and protects against the development of unhealthy body weight. A key factor in children's PA participation is their motor competence (MC). The comprehensive school physical activity program (CSPAP) framework offers a way to classify existing PA interventions that have included children's MC development and understand the potential avenues for supporting children's MC. However, there have been no systematic reviews or meta-analyses of PA interventions and their effects on the MC of elementary school children (aged 5-12 years) from a CSPAP perspective.

METHODS

This study was conducted in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) statement. We searched seven electronic databases (PubMed/Medline, Embase, ERIC, SPORTDiscus, CINAHL, Web of Science, and PsycINFO) for articles on 29 November 2021. The CSPAP framework was used to categorize the different intervention approaches. This review was registered with PROSPERO (CRD42020179866).

RESULTS

Twenty-seven studies were included in the review, and twenty-six studies were included in the meta-analysis. A wide range of PA intervention approaches (e.g., single component or multicomponent) within the context of the CSPAP framework appear to be promising pathways in enhancing children's MC. The results of the aggregate meta-analysis presented that effect sizes for the development of MC from pre-and post- intervention ranged from moderate to large (Hedges' g = 0.41-0.79). The analysis revealed that the predicted moderators, including study length, delivery agent, and study design, did not result in statistically significant moderate variations in MC outcomes. There was, however, considerable heterogeneity in study design, instruments, and study context, and studies were implemented in over 11 countries across diverse settings.

CONCLUSIONS

This study uniquely contributes to the literature through its primary focus on the effectiveness of PA interventions on elementary children's MC. This review emphasizes the importance of customizing CSPAP to fit the specific characteristics of each school setting, including its environmental, demographic, and resource attributes. The effectiveness of CSPAP, particularly its physical education (PE) component, is significantly enhanced when these programs are adapted to address the unique needs of each school. This adaptation can be effectively achieved through targeted professional teacher training, ensuring that PE programs are not only contextually relevant but also optimized for maximum impact in diverse educational environments. Researchers and practitioners should pursue how to effectively translate the evidence into practice to better conceptualize CSPAPs designed for children's MC development.

Pilot randomized controlled trial of a game-based intervention for teaching basketball in Chinese primary school physical education

This study aimed to examine the preliminary efficacy and feasibility of implementing a tailored version of the MASTER coach education programme in Chinese primary schools to support physical education (PE) teachers' basketball lesson design and delivery. A total of 20 primary schools in Beijing, China were recruited, with one PE teacher and their class (N = 715 students aged 10-13 yrs) from each school included in the study and randomly allocated to the MASTER intervention (n = 10) or control group (n = 10). Compared to the control group, a significant difference was observed in the MASTER group for the proportion of playing-form activities delivered during PE (27.65, 95% CI [20.27, 35.03]) and for teachers' perceptions of confidence (23.92, 95% CI [15.87, 31.92]) and competence (24.12, 95% CI [10.28, 24.71]) to teach. Significant differences between groups were observed for students' perceived athletic competence (3.56%; 95% CI [3.15, 3.96]), enjoyment (11.83%; 95% CI [10.98, 12.69]), well-being (8.51%; 95% CI [7.02, 10.00]), intrinsic motivation (+0.74%; 95% CI [0.30, 1.17]), introjected motivation (-2.24%; 95% CI [-2.77, -1.70]), and external motivation (-0.49%; 95% CI [-0.90, -0.08]). The MASTER programme was effective in improving teaching practices in Chinese primary schools, and in facilitating improvements in teacher and student outcomes.

The Effectiveness of Coaching the Australian Recommended Fundamental Overarm Throwing Skill Criteria for Less-Skilled Adolescents

Purpose: The aim of this study was to investigate the effects of coaching the Australian recommended fundamental overarm throwing skill criteria for less-skilled adolescents on movement competency using three-dimensional (3D) motion analysis. Methods: Less-skilled non-sports-active and skilled sports-active pupils were assigned to FMS Group (n = 97) and Sports Group (n = 129), respectively. Demographic, anthropometric, whole-body kinematic (discrete and time-series angular displacement and angular velocity data), motor coordination (segmental sequencing) and motor performance (maximum ball release speed) were analyzed. Baseline data were compared using independent T-tests and Chi-Square tests; interaction effects were assessed using repeated-measure ANOVAs. Changes in time-series kinematic data were analyzed by comparing the areas enclosed by the 95% confidence intervals. Results:There was merely a modest improvement in motor competency for the less-skilled pupils. The FMS group significantly acquired 13/75 discrete kinematic variables (p < .01) and four movement patterns but not motor coordination (p = .469) and motor performance (p = .756). Prior to the intervention, the pupils acquired 4/7 recommended skill criteria. The descriptions of another three criteria were not appropriate with no improvement in motor coordination and performance. Two new skills were identified and improved after the FMS intervention. Conclusions: The recommended skill criteria for children were not developmentally and age-appropriate for early adolescents. The use of quantitative 3D motion data provided a more precise and developmentally applicable fundamental overarm throwing criteria than content validated skill criteria. The recommended skill criteria should be modified to facilitate teachers and coaches for effective education.

The Effect of Primary School-Based Physical Education Programs: A Systematic Review of Randomized Controlled Trials

The present article aimed to systematically summarize primary school-based intervention programs and their effects evaluated through randomized-controlled trial design. A systematic review of relevant articles was carried out using 4 electronic databases. From a total of 193 studies initially found, 30 were included in the qualitative synthesis. Main results: (1) Intensive interval training or jump/strength exercises may positively influence physical fitness, promoting challenging task, psychological needs, and guided styles to a greater extent; (2) Games that demand more cognitive function seem more beneficial than those based on repetitive aerobic exertion to improve fundamental motor skills; (3) The jumping/strength exercises may cause benefits in bone area and bone mineral density, while flexibility and balance may reduce the risk of muscle injury; and (4) Programming a greater dose of moderate-to-vigorous physical activity seems to be related to positive effects in core executive function and academic performance. Additionally, providing information and involving the social environment may enhance the positive effects.

"I Felt I Was Actually Inside the Movie" An Exploratory Study into Children's Views of Staging a Physically Active Experience, with Implications for Future Interventions

Current levels of inactivity suggest novel approaches are needed to engage children in physical activity (PA), and enjoyment is a strong motivator for children's PA engagement. A physically active experience (PAE) was proposed as a way to use entertainment, education, (e)aesthetics and escapist methods to promote PA to children in a way that is immersive and enables them to actively partake whilst enjoying their experience. In this current mixed methods study, three physically active experiences based on popular children's movies were designed and staged, in order to explore children's views on staging a PAE and provide implications for future PA interventions. Seventeen children (boys n = nine, girls n = eight) between the ages of nine and ten years provided feedback on the experiences. The children watched a pre-recorded video presenting the physically active experiences and then completed a survey including affective forecasting responses, which was followed by participation in an online focus group where views on the experiences were explored further. For all three experiences, the mean anticipated affective response for valence was between "fairly good" and "good", and for arousal between "a bit awake" and "awake". Further, when asked, the children reported wanting to take part in the experiences (experience 1: 82.4%, experience 2: 76.5%, experience 3: 64.7%). The qualitative data revealed that children felt that they would enjoy the sessions, feel immersed in their environment, transported away from reality, and that they would be able to learn something new regarding PA. These results support the implementation of a PAE to engage children in enjoyable PA; future interventions should use these findings to engage children in a PAE, examining their actual responses to the activities.

Exploring Recommendations for Child and Adolescent Fundamental Movement Skills Development: A Narrative Review

Fundamental movement skills (FMS) are frequently referred to as the "building blocks" of movement for children and adolescents in their lifelong physical activity journey. It is critical, however, that FMS are developed within Physical Education learning environments and other sport-related settings, specifically as these building blocks of movement require appropriate teaching and practice opportunities. While FMS are well-established as an "important focus" for children and adolescents, to the authors' knowledge, there appears to be no standardized FMS development guidelines existent within the literature. This paper will examine whether the frequency, intensity, time, and type (FITT) principle could be transferable to interventions focusing on FMS development, and if so, whether sufficient consistency of findings exists to guide practitioners in their session design. Applying the FITT principle in this way may help to facilitate the comparison of FMS-related intervention studies, which may contribute to the future development of practical FMS-related guidelines for children and adolescents.

DEEP LEARNING ANALYSIS ON THE RESULTING IMPACTS OF WEEKLY LOAD TRAINING ON STUDENTS’ BIOLOGICAL SYSTEM

ABSTRACT Introduction The recent development of the deep learning algorithm as a new multilayer network machine learning algorithm has reduced the problem of traditional training algorithms easily falling into minimal places, becoming a recent direction in the learning field. Objective Design and validate an artificial intelligence model for deep learning of the resulting impacts of weekly load training on students’ biological system. Methods According to the physiological and biochemical indices of athletes in the training process, this paper analyzes the actual data of athletes’ training load in the annual preparation period. The characteristics of athletes’ training load in the preparation period were discussed. The value, significance, composition factors, arrangement principle and method of calculation, and determination of weekly load density using the deep learning algorithm are discussed. Results The results showed that the daily 24-hour random sampling load was moderate intensity, low and high-intensity training, and enhanced the physical-motor system and neural reactivity. Conclusion The research shows that there can be two activities of “teaching” and “training” in physical education and sports training. The sports biology monitoring research proves to be a growth point of sports training research with great potential for expansion for future research. Level of evidence II; Therapeutic studies - investigation of treatment outcomes.

Features of effective staff training programmes within school-based interventions targeting student activity behaviour: a systematic review and meta-analysis

BACKGROUND

Evaluations of school-based activity behaviour interventions suggest limited effectiveness on students' device-measured outcomes. Teacher-led implementation is common but the training provided is poorly understood and may affect implementation and student outcomes. We systematically reviewed staff training delivered within interventions and explored if specific features are associated with intervention fidelity and student activity behaviour outcomes.

METHODS

We searched seven databases (January 2015-May 2020) for randomised controlled trials of teacher-led school-based activity behaviour interventions reporting on teacher fidelity and/or students' device-measured activity behaviour. Pilot, feasibility and small-scale trials were excluded. Study authors were contacted if staff training was not described using all items from the Template for Intervention Description and Replication reporting guideline. Training programmes were coded using the Behaviour Change Technique (BCT) Taxonomy v1. The Effective Public Health Practice Project tool was used for quality assessment. Promise ratios were used to explore associations between BCTs and fidelity outcomes (e.g. % of intended sessions delivered). Differences between fidelity outcomes and other training features were explored using chi-square and Wilcoxon rank-sum tests. Random-effects meta-regressions were performed to explore associations between training features and changes in students' activity behaviour.

RESULTS

We identified 68 articles reporting on 53 eligible training programmes and found evidence that 37 unique teacher-targeted BCTs have been used (mean per programme = 5.1 BCTs; standard deviation = 3.2). The only frequently identified BCTs were 'Instruction on how to perform the behaviour' (identified in 98.1% of programmes) and 'Social support (unspecified)' (50.9%). We found moderate/high fidelity studies were significantly more likely to include shorter (≤6 months) and theory-informed programmes than low fidelity studies, and 19 BCTs were independently associated with moderate/high fidelity outcomes. Programmes that used more BCTs (estimated increase per additional BCT, d: 0.18; 95% CI: 0.05, 0.31) and BCTs 'Action planning' (1.40; 0.70, 2.10) and 'Feedback on the behaviour' (1.19; 0.36, 2.02) were independently associated with positive physical activity outcomes (N = 15). No training features associated with sedentary behaviour were identified (N = 11).

CONCLUSIONS

Few evidence-based BCTs have been used to promote sustained behaviour change amongst teachers in school-based activity behaviour interventions. Our findings provide insights into why interventions may be failing to effect student outcomes.

TRIAL REGISTRATION

PROSPERO registration number: CRD42020180624.

Physical activity promoting teaching practices and children’s physical activity within physical education lessons underpinned by motor learning theory (SAMPLE-PE)

Purpose

Movement competence is a key outcome for primary physical education (PE) curricula. As movement development in children emerges through physical activity (PA), it is important to determine the extent of PA promotion within movement competence focused teaching pedagogies. Therefore, this study aimed to assess children’s moderate-to-vigorous PA (MVPA) and related teaching practices in primary PE within Linear pedagogy and Nonlinear pedagogy and to compare this to current practice within PE delivery in primary schools.

Methods

Participants (n = 162, 53% females, 5-6y) were recruited from 9 primary schools within the SAMPLE-PE cluster randomised controlled trial. Schools were randomly-allocated to one of three conditions: Linear pedagogy, Nonlinear pedagogy, or control. Nonlinear and Linear pedagogy intervention schools received a PE curriculum delivered by trained deliverers over 15 weeks, while control schools followed usual practice. Children’s MVPA was measured during 3 PE lessons (44 PE lessons in total) using an ActiGraph GT9X accelerometer worn on their non-dominant wrist. Differences between conditions for children’s MVPA were analysed using multilevel model analysis. Negative binomial models were used to analyse teaching practices data.

Results

No differences were found between Linear pedagogy, Nonlinear pedagogy and the control group for children’s MVPA levels during PE. Linear and Nonlinear interventions generally included higher percentages of MVPA promoting teaching practices (e.g., Motor Content) and lower MVPA reducing teaching practices (e.g., Management), compared to the control group. Teaching practices observed in Linear and Nonlinear interventions were in line with the respective pedagogical principles.

Conclusions

Linear and Nonlinear pedagogical approaches in PE do not negatively impact MVPA compared to usual practice. Nevertheless, practitioners may need to refine these pedagogical approaches to improve MVPA alongside movement competence.

Does Learning Through Movement Improve Academic Performance in Primary Schoolchildren? A Systematic Review

Physically active children have greater motor competence and a faster maturation compared with their sedentary peers. Recent research also suggests that physical activity during childhood may also promote cognitive development and therefore improve academic performance. The aim of this study was to understand if physically active academic lessons may improve academic achievement in primary schoolchildren. A systematic review following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines was conducted. The search was performed on the following database: PubMed, Web of Science, Scopus, Education Resources Information Center (ERIC), and PsycINFO (APA). Studies evaluating schoolchildren aged between 3 and 11 years taking part in educational contexts that include physical activity and natural environments evaluating physical fitness and/or educational outcomes were included. A total of 54 studies (for a total sample of 29,460 schoolchildren) were considered eligible and included in the qualitative synthesis. The Effective Public Health Practice Project risk-of-bias assessment revealed a moderate quality of the included studies with only two considered weeks. Despite differences in the retrieved protocols, physically active academic lessons improve the total time engaged in physical activity, motor skills, and/or academic performance. The results of this review suggest that learning through movement is an effective, low-cost, and enjoyable strategy for elementary schoolchildren.

School-based physical activity programs for promoting physical activity and fitness in children and adolescents aged 6 to 18

BACKGROUND

Physical activity among children and adolescents is associated with lower adiposity, improved cardio-metabolic health, and improved fitness. Worldwide, fewer than 30% of children and adolescents meet global physical activity recommendations of at least 60 minutes of moderate to vigorous physical activity per day. Schools may be ideal sites for interventions given that children and adolescents in most parts of the world spend a substantial amount of time in transit to and from school or attending school.

OBJECTIVES

The purpose of this review update is to summarise the evidence on effectiveness of school-based interventions in increasing moderate to vigorous physical activity and improving fitness among children and adolescents 6 to 18 years of age. Specific objectives are: • to evaluate the effects of school-based interventions on increasing physical activity and improving fitness among children and adolescents; • to evaluate the effects of school-based interventions on improving body composition; and • to determine whether certain combinations or components (or both) of school-based interventions are more effective than others in promoting physical activity and fitness in this target population.

SEARCH METHODS

We searched CENTRAL, MEDLINE, Embase, CINAHL, PsycINFO, BIOSIS, SPORTDiscus, and Sociological Abstracts to 1 June 2020, without language restrictions. We screened reference lists of included articles and relevant systematic reviews. We contacted primary authors of studies to ask for additional information.

SELECTION CRITERIA

Eligible interventions were relevant to public health practice (i.e. were not delivered by a clinician), were implemented in the school setting, and aimed to increase physical activity among all school-attending children and adolescents (aged 6 to 18) for at least 12 weeks. The review was limited to randomised controlled trials. For this update, we have added two new criteria: the primary aim of the study was to increase physical activity or fitness, and the study used an objective measure of physical activity or fitness. Primary outcomes included proportion of participants meeting physical activity guidelines and duration of moderate to vigorous physical activity and sedentary time (new to this update). Secondary outcomes included measured body mass index (BMI), physical fitness, health-related quality of life (new to this update), and adverse events (new to this update). Television viewing time, blood cholesterol, and blood pressure have been removed from this update.  DATA COLLECTION AND ANALYSIS: Two independent review authors used standardised forms to assess each study for relevance, to extract data, and to assess risk of bias. When discrepancies existed, discussion occurred until consensus was reached. Certainty of evidence was assessed according to GRADE. A random-effects meta-analysis based on the inverse variance method was conducted with participants stratified by age (children versus adolescents) when sufficient data were reported. Subgroup analyses explored effects by intervention type.

MAIN RESULTS

Based on the three new inclusion criteria, we excluded 16 of the 44 studies included in the previous version of this review. We screened an additional 9968 titles (search October 2011 to June 2020), of which 978 unique studies were potentially relevant and 61 met all criteria for this update. We included a total of 89 studies representing complete data for 66,752 study participants. Most studies included children only (n = 56), followed by adolescents only (n = 22), and both (n = 10); one study did not report student age. Multi-component interventions were most common (n = 40), followed by schooltime physical activity (n = 19), enhanced physical education (n = 15), and before and after school programmes (n = 14); one study explored both enhanced physical education and an after school programme. Lack of blinding of participants, personnel, and outcome assessors and loss to follow-up were the most common sources of bias.  Results show that school-based physical activity interventions probably result in little to no increase in time engaged in moderate to vigorous physical activity (mean difference (MD) 0.73 minutes/d, 95% confidence interval (CI) 0.16 to 1.30; 33 studies; moderate-certainty evidence) and may lead to little to no decrease in sedentary time (MD -3.78 minutes/d, 95% CI -7.80 to 0.24; 16 studies; low-certainty evidence). School-based physical activity interventions may improve physical fitness reported as maximal oxygen uptake (VO₂max) (MD 1.19 mL/kg/min, 95% CI 0.57 to 1.82; 13 studies; low-certainty evidence). School-based physical activity interventions may result in a very small decrease in BMI z-scores (MD -0.06, 95% CI -0.09 to -0.02; 21 studies; low-certainty evidence) and may not impact BMI expressed as kg/m² (MD -0.07, 95% CI -0.15 to 0.01; 50 studies; low-certainty evidence). We are very uncertain whether school-based physical activity interventions impact health-related quality of life or adverse events.

AUTHORS' CONCLUSIONS

Given the variability of results and the overall small effects, school staff and public health professionals must give the matter considerable thought before implementing school-based physical activity interventions. Given the heterogeneity of effects, the risk of bias, and findings that the magnitude of effect is generally small, results should be interpreted cautiously.

Through the Looking Glass: A Systematic Review of Longitudinal Evidence, Providing New Insight for Motor Competence and Health

Introduction

In 2008, a conceptual model explaining the role of motor competence (MC) in children’s physical activity (PA), weight status, perceived MC and health-related fitness was published.

Objective

The purpose of the current review was to systematically compile mediation, longitudinal and experimental evidence in support of this conceptual model.

Methods

This systematic review (registered with PROSPERO on 28 April 2020) was conducted in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) statement. Separate searches were undertaken for each pathway of interest (final search 8 November 2019) using CINAHL Complete, ERIC, Medline (OVID), PsycINFO, Web of Science Core Collection, Scopus and SportDiscus. Potential articles were initially identified through abstract and title checking (N = 585) then screened further and combined into one review (n = 152), with 43 articles identified for extraction. Studies needed to be original and peer reviewed, include typically developing children and adolescents first assessed between 2 and 18 years and objective assessment of gross MC and at least one other variable (i.e., PA, weight status, perceived MC, health-related fitness). PA included sport participation, but sport-specific samples were excluded. Longitudinal or experimental designs and cross-sectional mediated models were sought. Strength of evidence was calculated for each pathway in both directions for each domain (i.e., skill composite, object control and locomotor/coordination/stability) by dividing the proportion of studies indicating a significantly positive pathway in the hypothesised direction by the total associations examined for that pathway. Classifications were no association (0–33%), indeterminate/inconsistent (34–59%), or a positive ‘+’ or negative ‘ − ’ association (≥ 60%). The latter category was classified as strong evidence (i.e., ++or −−) when four or more studies found an association. If the total number of studies in a domain of interest was three or fewer, this was considered insufficient evidence to make a determination.

Results

There was strong evidence in both directions for a negative association between MC and weight status. There was strong positive evidence for a pathway from MC to fitness and indeterminate evidence for the reverse. There was indeterminate evidence for a pathway from MC to PA and no evidence for the reverse pathway. There was insufficient evidence for the MC to perceived MC pathway. There was strong positive evidence for the fitness-mediated MC/PA pathway in both directions. There was indeterminate evidence for the perceived MC-mediated pathway from PA to MC and no evidence for the reverse.

Conclusion

Bidirectional longitudinal associations of MC with weight status are consistent with the model authored by Stodden et al. (Quest 2008;60(2):290–306, 2008). However, to test the whole model, the field needs robust longitudinal studies across childhood and adolescence that include all variables in the model, have multiple time points and account for potential confounding factors. Furthermore, experimental studies that examine change in MC relative to change in the other constructs are needed.

Trial Registrations

PROSPERO ID# CRD42020155799.

Supplementary Information

The online version contains supplementary material available at 10.1007/s40279-021-01516-8.

It's Not Just What You Do but the Way You Do It: A Systematic Review of Process Evaluation of Interventions to Improve Gross Motor Competence

BACKGROUND

Motor competence is an important predictor of health behaviours. However, levels of motor competence are low in children and adolescents. Many interventions have improved motor competence, yet intervention effects were highly variable. Potential causes of such variations are not fully understood. Process evaluation can assist with the understanding of why an intervention worked or not, but its application and reporting in motor competence interventions has received little attention.

OBJECTIVES

The primary aim of this review was to investigate whether process evaluations have been reported in interventions to improve motor competence and, if reported, which process evaluation measures have been used. A secondary aim was to explore the association of intervention characteristics and process evaluation findings (outcomes of process evaluation measures) with intervention outcomes, in a search for what process evaluation measures may impact on intervention functioning and outcomes.

METHODS

The process of conducting and reporting this review adhered to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The review protocol was registered with PROSPERO (CRD42019124412). A systematic search of seven electronic databases (i.e. MEDLINE [via EBSCOhost], Cochrane Central Register of Controlled Trials [CENTRAL], CINAHL, Academic Search Complete, Education Database, SPORTDiscus and Scopus) was conducted with no date restrictions. Eligibility criteria included the following: (1) a study sample of typically developing children and adolescents aged 5-18 years, (2) an intervention aimed to improve motor competence, (3) an intervention included a control group, (4) a report of motor competence outcome at both pre- and post-intervention. Only original articles published in English in peer-reviewed journals were considered. Process evaluation measures and findings were extracted using the UK Medical Research Council's process evaluation framework in order to provide overarching descriptions on the implementation, mechanism of change and context of interventions. Univariable meta-regressions were performed to ascertain whether selected study-level covariates moderated the improvement in motor competence outcomes in interventions.

RESULTS

The search identified 60 intervention studies. Only 30 studies (50%) reported process evaluation measures. No studies reported (or employed) theoretical frameworks to guide process evaluation. Process evaluation measures relating to implementation were most commonly reported, with the most prevalent aspect being fidelity. This was followed by reporting on measures relating to mechanism of change and context of the intervention. Meta-analysis results suggested intervention duration, dose, inclusion of process evaluation aim, provision of lesson plans, sample size and sex as potential moderators.

CONCLUSIONS

Reporting of process evaluation measures may help build our understanding of the optimal characteristics of motor competence interventions. However, process evaluation is under-used and/or under-reported. This review serves as a call for more process evaluations and better reporting in motor competence interventions.

Rationale and study protocol for the Movement Oriented Games Based Assessment (MOGBA) cluster randomized controlled trial: A complex movement skill intervention for 8-12 year old children within 'Made to Play'

There is a positive relationship between children's movement competence and physical activity, with a further relationship established between physical activity and childhood obesity. The Movement Oriented Games Based Assessment (MOGBA) is a delivery and assessment intervention designed to improve children's complex movement skills, based on principles of motor development and assessment theories. MOGBA aims to improve children's movement competence, physical fitness and self-perceptions (physical and game) and increase children's moderate-to-vigorous physical activity (MVPA). MOGBA is to be used in the 'Made to Play' initiative, involving 105 sports and activity programs across 21 countries, involving over 25 million children. A multi-site cluster randomized controlled trial will take place across three global sites (UK, Ireland and Australia). Each site will recruit eight primary schools (four experiment, four control) with each school providing two separate classes of children from age ranges 8-12 years (Site n = ~300, total n = 904). After baseline assessments, schools will be randomly allocated to an experimental or wait-list control group. Following two half-day workshops, trained facilitators will deliver the MOGBA intervention for 9 weeks. The main intervention components include delivery of 14 games-based activities with associated assessments of children's movement and differentiation to meet children's needs by manipulating space, effort and relationships. The primary outcome of the trial is to improve children's' movement competence (The Dragon Challenge), with secondary outcomes of improving children's' in-activity and leisure-time MVPA (5-day accelerometer), physical fitness (standing long jump and push ups) and self-perceptions (physical and game). Data will be analysed using multilevel modelling approaches. The MOGBA intervention has been designed to improve children's movement competence and scalable interventions based on MOGBA could be applied across programs within the Made to Play initiative, globally. The trial is registered at the Australia New Zealand Clinical Trial Registry (ACTRN12619001320145p, 27 Sep 2019).

Global levels of fundamental motor skills in children: A systematic review

Competence in fundamental motor skills (FMS) facilitates physical activity participation and is important for children's holistic development. This study aimed to systematically review the FMS levels of children worldwide, using the Test of Gross Motor Development-2 (TGMD-2). In accordance with PRISMA guidelines, studies were identified from searches across 7 databases. Studies were required to: (i) include typically developing children (3-10 years), (ii) be published in English, (iii) have been published between 2004 and 2019 and, (iv) report ≥1 TGMD-2 outcome scores. Extracted data were evaluated based on importance of determinants, strength of evidence, and methodological quality. Data from 64 articles were included. Weighted mean (and standard deviation) scores were calculated for each FMS outcome score. Analyses revealed FMS competence increases across age during childhood, with greater proficiency in locomotor skills than object control skills. Additionally, boys exhibit higher object control skill proficiency than girls. Compared to TGMD-2 normative data, children demonstrate "below average" to "average" FMS levels. This review highlights the scope for FMS development among children worldwide. These findings reinforce the necessity for FMS interventions in early educational settings, as FMS competence is positively associated with physical activity and other health outcomes.

Effects of 6 Weeks Direct Instruction and Teaching Games for Understanding Programs on Physical Activity and Tactical Behaviour in U-12 Soccer Players

The purpose of this study was to compare the effects of 6 weeks direct instruction and teaching games for understanding (TGfU) programs on the decision-making and execution (post-interventions), as well, as on the physical activity (PA) levels during sessions. Thirty under-12 football players participated in this study (age: 10.3 ± 0.45 years) and were randomly assigned to TGfU (n = 15) or direct instruction (n = 15) group. Two sessions/week were implemented. Results revealed that TGfU promoted higher levels (p = 0.043; d = 2.99) of light PA (28.96%) compared with direct instruction (27.55%). Non-significant higher sedentary PA levels (p = 0.073; d = 2.62) were found in the control group (35.48%). In terms of tactical principles, conservation of the ball increased the percentage of moderate to vigorous physical activity in TGfU (43.60%) compared with direct instruction (38.05%). According to the Game Performance Evaluation Tool (GPET), significant improvements (p = 0.018, d = 3.78) of the attacking player with the ball in the percentage of change between groups in the unsuccessful execution in TGfU (% = −62.2) were observed compared with direct instruction (% = 14.2). TGfU seems to be more appropriate than direct instruction to increase the light PA levels during sessions while no significant differences were found between programs in moderate and vigorous intensities. Regarding the effects of programs in decisions, greater improvements in decisions with the ball were found in TGFU compared to DI.

Effectiveness of a Parent-led Physical Activity Intervention in Youth with Obesity

PURPOSE

Prader-Willi syndrome (PWS) is a complex, rare neurobehavioral syndrome characterized by excessive fat, hypotonia, poor motor skills, and behavioral and cognitive disabilities. We tested the effectiveness of a home-based physical activity (PA) intervention led by parents in youth with obesity with and without PWS to increase moderate-to-vigorous PA (MVPA) and gross motor proficiency.

METHODS

Participants were 111 youth age 8 to 16 yr (45 with PWS and 66 without PWS, but categorized as obese). A parallel design was used with the control group (C) receiving the intervention after serving as control. Intervention participants (I) completed a PA curriculum 4 d·wk for 24 wk including warm-up exercises, strengthening exercises, and playground games 2 d·wk and interactive console games 2 d·wk guided by their parents. Pre-post outcomes (baseline to 24 wk) included MVPA (7-d accelerometry) and motor proficiency including upper limb coordination, bilateral coordination, balance, running speed and agility, and muscle strength (Bruininks-Oseretsky Test of Motor Proficiency).

RESULTS

The intervention led to no change in MVPA (I group, 39.6 vs 38.9 min·d; C group, 40.6 vs 38.3 min·d). The intervention led to improvements in body coordination (22.3%; P < 0.05), as well as strength and agility (13.7%; P < 0.05). Specifically, the I group showed increases in upper limb coordination (19.1%), bilateral coordination (27.8%), and muscle strength (12.9%; P < 0.05 for all) not observed in the C group: -0.2%, 2.5%, and -3.2%, respectively.

CONCLUSIONS

This parent-guided PA intervention did not increase PA. However, the intervention led to improvements in gross motor skill competency. Providing families with tools and support can lead to implementation of PA routines that contribute to motor skill proficiency in youth with and without PWS.

Pedagogical Approaches to and Effects of Fundamental Movement Skill Interventions on Health Outcomes: A Systematic Review

BACKGROUND

Fundamental movement skills (FMS) are assumed to be the basic prerequisite motor movements underpinning coordination of more integrated and advanced movement capabilities. FMS development and interventions have been associated with several beneficial health outcomes in individual studies.

OBJECTIVE

The primary aim of this review was to identify FMS intervention characteristics that could be optimised to attain beneficial outcomes in children and adolescents, while the secondary aim was to update the evidence as to the efficacy of FMS interventions on physiological, psychological and behavioural health outcomes.

METHODS

A systematic search [adhering to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines] was conducted in seven databases. Studies were included if they conducted an FMS intervention and targeted at least one physiological, behavioural or psychological outcome in school-aged children (5-18 years).

RESULTS

Twenty-nine studies examining the effect of FMS interventions relative to controls were identified. Specialist-led interventions, taught in conjunction with at-home practice and parent involvement, appeared more efficacious in enhancing FMS proficiency than school physical education alone. Intervention environments encouraging psychological autonomy were likely to enhance perceived and actual competence in FMS alongside physical activity. FMS interventions had little influence on overweight/obesity reduction, strength or flexibility. In 93% of studies, evidence indicated interventions improved FMS motor proficiency. Favourable specific physiological, psychological and behavioural outcomes were also identified across a variety of interventions.

CONCLUSION

With reference to clinical and normative school-age populations, future studies should be directed toward determining validated standard FMS assessments to enable accurate effect estimates, permit intervention comparisons and improve the efficacy of FMS development.

Perceived and Actual Movement Skill Competence: The Association Among Primary School Children in Hong Kong

The purpose of this study was to examine the association between perceived and actual movement skill competence among primary school children in Hong Kong. Participants were 568 primary (P) school children (229 boys, 339 girls; Mage = 9.3 years, SD = 1.7). Children’s perceived skill competence was assessed using an identical format to that of Harter’s Self-Perception Profile for Children in the same 12 fundamental movement skills (FMS) objectively measured. The actual locomotor and object control skills were assessed using the Test of Gross Motor Development (2nd edition). Pearson’s correlation coefficients were calculated to examine the association between children’s perceived and actual movement skill competence separately for lower (P1–P3) and upper (P4–P6) grades. There was no association between students’ perceptions and actual FMS scores. MANCOVA results indicated that children in upper grades had significantly lower skill perceptions than their younger counterparts. Overall, boys had higher perceptions of object control skill than girls did. The findings indicate that many primary school children have inaccurate perceptions of their FMS competence. These misperceptions may lead to low self-confidence and to gradually opting out of sport and physical activity.

Associations of object control motor skill proficiency, game play competence, physical activity and cardiorespiratory fitness among primary school children

This study investigated if object control relates to children's game play competence, and examined these competencies as correlates of physical activity and cardiorespiratory fitness. Game play (Game Performance Assessment Instrument), object control (The Test Gross Motor Development-3), moderate-to-vigorous physical activity (Accelerometry), and cardiorespiratory fitness (20-metre shuttle) assessments were completed for 107 children (57% Female, 43% Male) aged 9-12 years (M 10.53, SD 0.65). Two-level regression of object control on game play competence, and object control and game play competence on physical activity and cardiorespiratory fitness assessed associations. Object control competence was positively associated with game play competence (Std. B = 0.25, t (104.77) = 2.38, p = 0.001). Game play competence (Std. B = 0.33, t (99.81) = 5.21, p < 0.000) was more strongly associated with moderate-to-vigorous physical activity than object control competence (Std. B = 0.20, t (106.93) = 2.96, p = 0.003). Likewise, game competence (Std. B = 0.39, t (104.41) = 4.36, p < 0.000) was more strongly associated with cardiorespiratory fitness than object control competence (Std. B = 0.22, t (106.69) = 2.63, p = 0.002). Object control and game competence are both important as correlates of physical activity and cardiorespiratory fitness in children.

Children's physical activity levels during organised sports practices

OBJECTIVES

This study measured the physical activity levels of children during practice sessions of four popular organised sports in Australia.

DESIGN

Cross-sectional observational design.

METHODS

Participants comprised children from four local organised sports clubs in suburban Adelaide, South Australia. The sports examined were Australian Rules Football (AFL), girls' netball, boys' soccer and girls' soccer. Each participant wore a waist-mounted GT3X or GT3X+Actigraph accelerometer in either one or two of the practice sessions.

RESULTS

Participants typically spent 40-50% of each sport practice session in moderate to vigorous physical activity (MVPA). Participants in the boys' soccer teams spent significantly greater time in MVPA (mean=47% of practice time, 95% CI=37%, 57%) than participants in the girls' netball teams (mean=40%, 95% CI=30%, 50%), participants in the girls' soccer teams (mean=38%, 95% CI=28%, 48%) and participants in the boys' AFL teams (mean=40%, 95% CI=36%, 44%). The practice sessions contributed approximately half of the 60min of MVPA per day recommended by physical activity guidelines for children and young people.

CONCLUSIONS

The results suggested that organised sports provide a supportive environment for physical activity accrual; however, one practice session is insufficient for children to reach the amount of MVPA recommended in daily physical activity guidelines.

Improving fundamental movement skills in Hong Kong students through an assessment for learning intervention that emphasizes fun, mastery, and support: the A + FMS randomized controlled trial study protocol

BACKGROUND

Assessment for learning has been identified as an effective strategy to help children learn more effectively. Developing children to master basic movement skills in primary school requires formative assessments to inform instruction and learning. This study reports the rationale and methods for an assessment-based intervention that emphasizes fun, mastery and support (A + FMS) designed to improve fundamental movement skill (FMS) proficiency of primary schoolchildren.

METHODS/DESIGN

Utilizing a cluster randomized controlled trial, the A + FMS intervention was designed to improve FMS proficiency of Hong Kong Chinese schoolchildren. A target sample of 282 students or more from 10 Grade 3 classes (from five schools) will be recruited and randomly assigned into an experimental group or a wait-list control group. Competence motivation theory provided a framework for the intervention that emphasizes fun activities to develop basic fundamentals, improving mastery of movement, and providing support for teaching and learning skills. Primary outcome measures are the raw scores of six objectively measured FMS (i.e., jump, hop, skip, dribble, catch, and overhand throw). Secondary outcomes include self-reported measures: enjoyment in physical education, perceived physical competence, perceived skill competence, and perceived social support. Teachers in the experimental group are required to attend a six-h training workshop and integrate 550 min of assessment for learning strategies into their physical education lessons. Resources such as videos, skills checklists, and equipment will also be provided to support children to accumulate extra learning and practice time after school. The rate of changes in primary and secondary outcomes across the experimental and control groups will be compared to determine the effectiveness of the program.

DISCUSSION

The A + FMS is an innovative school-based intervention targeting improvements in movement mastery by supporting physical education teachers in FMS instruction and assessment practices. The findings from the study may be used to guide pre-service teacher education and continuous professional development in FMS teaching and assessment. Trial registration CUHK_CCRB00479.

Fundamental Movement Skills and Health-Related Outcomes: A Narrative Review of Longitudinal and Intervention Studies Targeting Typically Developing Children

Many children with typical development are highly sedentary, overweight/obese, and are deemed not ready for school at kindergarten entry. All of these concerns can be related to a lack of movement skill proficiency in this population. The purpose of this narrative review was to synthesize the literature examining the impact of movement skills on 5 areas of overall health: physical activity, physical fitness, body composition, self-beliefs, and executive functioning. To gain an understanding of these relationships, only studies employing an experimental or observational longitudinal design were reviewed. Although the results were limited in the number of studies available, there is evidence that movement skill may have a positive influence on these broad domains of health both naturally over the course of development and through intervention. We recommend that a universal approach to movement skill development is warranted, given the range of benefits that stem from developing proficiency in these skills.