A recess intervention to promote moderate-to-vigorous physical activity

The Effects of the LiiNK Intervention on Physical Activity and Obesity Rates among Children

BACKGROUND

Obesity and inactivity among children are at an all-time high and have been steadily increasing in prevalence over the last thirty years. The school environment provides the ideal setting for reaching a large number of children across diverse populations in order to reverse these trends. However, there are many inconsistent results yielded by school-based physical activity interventions due to implementation length, time for activities, and the use of structured physical activities. The LiiNK Project® is a whole-child intervention addressing these gaps by providing children 45-60 min of recess (unstructured, outdoor play) in their schools daily, while the control children are allowed to engage in recess for 30 min daily. The purpose of this study was to compare the physical activity intensity and obesity rates of third- and fourth-grade children participating in the LiiNK intervention, which provides 60 min of recess for third graders and 45 min for fourth graders, to those in a control group allowed 30 min of daily recess.

METHODS

The children were 8-10 years old (M = 9.2; 52% females and 48% males). The intervention children comprised 90 third graders and 100 fourth graders, and the control children comprised 101 third graders and 92 fourth graders. Physical activity levels were monitored using accelerometers to assess sedentary, light, and moderate-to-vigorous physical activity (MVPA). Obesity rates were evaluated using bio-electrical impedance analysis (BIA), in which body fat percentage is calculated based on normative values using age and sex in the equation.

RESULTS

The third-grade intervention children engaged in 13 more MVPA minutes and took 900 more steps daily than their control counterparts, and also presented a greater proportion of overweight children transitioning to a healthy weight status from the fall to the spring semester. Conversely, the fourth-grade control children increased their activity by 500 steps and 15 more MVPA minutes daily. Despite this, the intervention children overall demonstrated a reduction in body fat percentage, while the control children demonstrated an increase in body fat percentage.

CONCLUSIONS

Ultimately, 60 min of unstructured, outdoor play in schools provides children the best opportunity to engage in MVPA, which may positively impact body fat percentages, offering a potential strategy for combatting childhood obesity in school settings.

Influence of Body Mass Index, Physical Fitness, and Physical Activity on Energy Expenditure during Recess

This study aims to investigate the potential relationship between energy expenditure, physical fitness level, physical activity, and body mass index among children taking part in a 30 min school recess. A total of 259 participants from three schools were included in this study. Data on energy expenditure during recess, age, gender, anthropometric measurements, global physical fitness, and physical activity index were recorded. The evaluation sessions occurred twice a week on alternate days over two weeks. A significant gender difference was observed in energy expenditure during recess, favoring boys (p < 0.01). The participants classified as very active exhibited significantly higher scores compared to those categorized as sedentary and moderately active, respectively (p < 0.01), with a poor but significant correlation (rho: 0.208; p < 0.001). There were significant differences between energy expenditure and cardiorespiratory fitness and energy expenditure and global physical fitness (p < 0.01) with fair (rho: 0.289; p < 0.001) and poor (rho: 0.196, p = 0.001) correlation, respectively. In contrast, there were no significant differences by body mass index categories (p = 0.571). These results suggest that gender, physical activity index, and global physical fitness were found to influence energy expenditure during a 30 min recess. However, no significant relationships were found with the body mass index.

Influence of the Home Environment on Physical Activity Behaviors in African American Youth

Background: This study examined the relationships between components of the home environment and physical activity (PA) behaviors among African American adolescents. Methods: A community-based sample of 99 African American parent-child dyads (62% girls; 42% overweight/obese, 15.0 ± 0.2 years) were included in this analysis. The home environment (PA equipment, family support for PA, and internet access) was evaluated using the Health and Environment Survey. Child PA was measured objectively using accelerometry. Data collection occurred between 2014 and 2016. Results: Internet access was associated with 29 fewer minutes of light physical activity [p = 0.011, β = -29.25 ± 11.28 (95% confidence interval: -51.65 to -6.86)], 9 fewer minutes of moderate-to-vigorous physical activity [p = 0.045, β = -9.10 ± 4.48 (-17.98 to -0.21)], and 38 fewer minutes of total PA (TPA) [p = 0.006, β = -38.35 ± 13.38 (-65.62 to -11.08)]. Family support was associated with 2 minutes of TPA [p = 0.044, β = 2.25 ± 1.10 (-1.97 to 3.19)]. PA equipment was not significantly associated with greater PA (all p's > 0.05). Conclusions: These findings suggest that home internet access may hinder participation in PA among African American adolescents. Future research should continue to identify barriers in the home environment that contribute to physical inactivity among African American adolescents.

A mixed-studies systematic review and meta-analysis of school-based interventions to promote physical activity and/or reduce sedentary time in children

PURPOSE

The aim of this mixed-studies systematic review was to ascertain the effectiveness of school-based interventions in increasing physical activity (PA) and/or reducing sedentary time (ST) in children aged 5-11 years, as well as to explore their effectiveness in relation to categories of the theory of expanded, extended, and enhanced opportunity (TEO).

METHODS

Adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, 5 databases were searched using predefined search terms. Following title and abstract screening of 1115 records, the removal of duplicates (n = 584) and articles that did not meet the inclusion criteria agreed to a priori (n = 419) resulted in 112 records that were full-text screened. Two independent reviewers subsequently used the mixed-methods appraisal tool to assess the methodological quality of 57 full-text studies that met the inclusion criteria after full-text screening. The interventions were summarised using the TIDierR checklist and TEO. The strength of evidence was determined using a 5-level rating system utilising a published decision tree.

RESULTS

Overall evidence ratings for interventions implemented within school settings were: no evidence of effects on moderate-to-vigorous physical activity (MVPA) and inconclusive evidence of effects on sedentary time. In relation to the TEO, expansion of PA appeared to be the most promising intervention type for MVPA, with moderate evidence of effect, whereas extension and enhancement of PA opportunity demonstrated no evidence of effect. A critical issue of possible compensatory behavior was identified by analysis of intervention effect in relation to PA measurement duration; when studies measured changes in PA during the actual intervention, there was moderate evidence of effect, whereas those that measured changes in PA during the school day presented inconclusive evidence of effect, and those that measured changes in PA over a whole day yielded no evidence of effect. Two meta-analyses of those studies using a whole-day accelerometer measure for MVPA or ST showed a significant but moderate effect for MVPA (effect size = 0.51; 95% confidence interval (CI): 0.02-0.99) and a large but nonsignificant effect for ST (effect size = 1.15; 95%CI: -1.03 to 3.33); both meta-analyses demonstrated low precision, considerable inconsistency, and high heterogeneity.

CONCLUSION

The findings have important implications for future intervention research in terms of intervention design, implementation, and evaluation.

Acceptability and Feasibility of Single-Component Primary School Physical Activity Interventions to Inform the AS:Sk Project

Multi-component school-based interventions provide physical activity (PA) opportunities for children but are often difficult for schools to execute and may not be implemented as intended. The primary aim of this study was to explore the acceptability and feasibility of three brief single-component primary school PA interventions targeting 9–10-year-old children. The secondary aim was to examine the effectiveness of the interventions on increasing PA levels and reducing sedentary time. The single-component interventions included active classroom breaks (AB; 3 schools; n = 119 children) Born to Move (BTM) exercise videos (2 schools; n = 50 children), and playground supervisory staff training (2 schools; n = 56 children). Qualitative data from participating children (n = 211), class teachers (n = 6), and playground supervisory staff (n = 8) explored the experiences, acceptability, and feasibility of each intervention component. Accelerometers were worn by 225 children during the last week of implementation. Teachers reported that they were able to implement ABs daily, but BTM videos were more difficult to implement daily because of accessing sufficient space. Playground staff reported difficulties in implementing activities due to children’s age and competing responsibilities on the staffs’ time. Children reported that the ABs and BTM videos were enjoyable. During half hour time windows, including the ABs and BTM videos, children engaged in 4.8 min and 8.6 min of moderate to vigorous PA (MVPA) on average, respectively. ABs and BTM videos positively affected MVPA. ABs were feasible to implement; however, teachers faced some barriers in implementing the BTM videos. Feasibility of playground interventions may be dependent on staff responsibilities and age of the children.

Effects of a strategy for the promotion of physical activity in students from Bogotá

OBJECTIVE

To examine the effect of the promotion of physical activity during recess on the levels of physical activity, sedentary behaviors, and adiposity of Colombian students.

METHODS

Three schools were randomly selected by an intervention group in Bogotá, Colombia, in 2013: Intervention (Active Module of Active Recess – MARA) + Text Messages (SMS) (MARA+SMS group), intervention (MARA group), control (control group). Intervention was implemented for ten weeks. The duration and intensity of physical activity and sedentary behaviors were measured objectively using accelerometers Actigraph-GT3X+. Adiposity was measured by body mass index and fat percentage. We measured at baseline (T0) and during the tenth week of intervention (T1). We evaluated the effect of the intervention using a difference-in-difference analysis (DID).

RESULTS

We included 120 students (57.5% girls; mean age = 10.5 years; standard deviation [SD] = 0.64). There was a significant increase in the mean daily minutes of moderate to vigorous physical activity in the MARA group (Difference T1-T0 = 6.1 minutes, standard error [SE] = 3.49, p = 0.005) in relation to the control group. There were no significant changes in the minutes of moderate to vigorous physical activity in the MARA+SMS group (Difference T1-T0 = -1.0 minute; SE = 3.06; p = 0.363). The minutes decreased in the control group (Difference T1-T0 = -7.7 minutes; SE = 3.15; p = 0.011). The minutes of sedentary behaviors decreased in the MARA and MARA+SMS groups and increased in the control group (MARA Difference T1-T0 = -15.8 minutes; SE = 10.05; p= 0.279; MARA+SMS Difference T1-T0 = -11.5 minutes; SE = 8.80; p= 0.869; Control Difference T1-T0 = 10.9 minutes; SE = 9.07; p = 0.407). There was a higher participation in the MARA group in relation to the MARA+SMS group (MARA group = 34.4%; MARA+SMS group = 12.1%). There were no significant changes in adiposity at 10 weeks according to difference-in-differences analysis (body mass index p: ΔMARA+SMS group versus Δcontrol group = 0.945, ΔMARA group versus Δcontrol group = 0.847, ΔMARA+SMS group versus ΔMARA group = 0.990; FP p ΔMARA+SMS group versus Δcontrol group = 0.788, ΔMARA group versus Δcontrol group = 0.915, ΔMARA+SMS group versus ΔMARA group = 0.975).

CONCLUSIONS

The Active Module of Active Recess is a promising strategy to increase physical activity levels and decrease sedentary behavior in students. The addition of Text Messages was not associated with increased moderate to vigorous physical activity or changes in adiposity.

Improvements in Physical Activity Opportunities: Results From a Community-Based Family Child Care Intervention

INTRODUCTION

Reaching preschool-aged children to establish healthy lifestyle habits, including physical activity, is an important component of obesity prevention efforts. However, few studies have examined family child care homes where nearly 1 million children receive care.

STUDY DESIGN

A pre- and post-intervention evaluation without a control group was conducted to evaluate what changes occurred in family child care homes that participated in the Healthy Eating and Active Living project, a multicomponent obesity prevention initiative, focused on community-driven policy and environmental change in neighborhoods within Kaiser Permanente service areas.

SETTING/PARTICIPANTS

From 2012 to 2014, a total of 17 family child care homes in Northern California participated in the intervention.

INTERVENTION

A physical activity workshop for child care staff and technical assistance to develop a policy to promote physical activity and other healthy behaviors.

MAIN OUTCOME MEASURES

Pre and post observations, questionnaires, and physical activity logs were completed to assess change in physical activity resources available in the family child care homes, the amount of child screen time offered, type and amount of physical activity offered to children, and implementation of physical activity best practices.

RESULTS

Between baseline and follow-up, providers significantly increased both the number of structured, adult-led activities (2.6 vs 3.2 activities per day) and the number of structured, adult-led minutes of activity in which children participated (49 vs 83 minutes per day). Providers also improved screen time practices and made improvements to the physical activity environment.

CONCLUSIONS

In this study, a community-based organization designed and implemented multicomponent strategies tailored for participating family child care homes. The successful implementation of the intervention likely contributed to implementation of practices that increased opportunities for physical activity for the young children attending these family child care homes.

SUPPLEMENT INFORMATION

This article is part of a supplement entitled Building Thriving Communities Through Comprehensive Community Health Initiatives, which is sponsored by Kaiser Permanente, Community Health.

Elementary physical education: A focus on fitness activities and smaller class sizes are associated with higher levels of physical activity

Optimizing physical activity during physical education is necessary for children to achieve daily physical activity recommendations. The purpose of this study was to examine the relationship among various contextual factors with accelerometer measured physical activity during elementary physical education. Data were collected during 2015–2016 from 281 students (1st–5th grade, 137 males, 144 females) from a private school located in a metropolitan area of Utah in the U.S. Students wore accelerometers for 12 consecutive weeks at an accelerometer wear frequency of 3 days per week during physical education. A multi-level general linear mixed effects model was employed to examine the relationship among various physical education contextual factors and percent of wear time in moderate-to-vigorous physical activity (%MVPA), accounting for clustering of observations within students and the clustering of students within classrooms. Explored contextual factors included grade level, lesson context, sex, and class size. Main effects and interactions among the factors were explored in the multi-level models. A two-way interaction of lesson context and class size on %MVPA was shown to be statistically significant. The greatest differences were found to be between fitness lessons using small class sizes compared to motor skill lessons using larger class sizes (β = 14.8%, 95% C.I. 5.7%–23.9% p < 0.001). Lessons that included a focus on fitness activities with class sizes that were < 25 students associated with significantly higher %MVPA during elementary physical education.

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Small class sizes relate to increased physical activity during physical education.

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Fitness lessons yielded higher physical activity compared to motor skills/games.

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Small classes and fitness lessons are additive for increasing physical activity.

Effectiveness of a Playground Intervention for Antisocial, Prosocial, and Physical Activity Behaviors

BACKGROUND

We examined the effectiveness of Peaceful Playgrounds™ (P2) to decrease antisocial behaviors (ASB) while increasing physical activity (PA) and prosocial behaviors (PSB) in elementary school children.

METHODS

A longitudinal, cluster-randomized design was employed in 4 elementary school playgrounds where students (third to fifth) from 2 intervention and 2 control schools were observed during recess periods. The intervention included environmental changes (eg, marked surfaces) and student education. Data were collected using systematic observations of youth behavior and semistructured interviews conducted with key informants. Mixed-effects regression models controlling for scans nested within days nested within schools estimated the interaction of measurement period and treatment condition on children's PA, PSB, and ASB. It was hypothesized that children in intervention, but not control schools, would demonstrate increased PA/PSB and decreased ASB.

RESULTS

Contrary to the hypotheses, intervention and control schools showed favorable changes for all dependent variables except for PSB, but 1 intervention and 1 control school drove these effects. Follow-up interviews indicated variability in implementation and lack of adherence to the control condition.

CONCLUSIONS

P2 may promote increased PA during recess, but these results demonstrate the complexity of intervention implementation and the need for rigor when measuring intervention fidelity in real-world settings.

Are inequalities produced through the differential access to play opportunities at school? A call to level the playing field

Children's play is characterized as pleasurable, but it is also viewed as critical for child health and well-being. Yet over the past decade, play researchers and advocates from various disciplines have suggested that there are decreasing opportunities for children to play, particularly at school. One concern is that the changing play environment in schools is reducing children's active play options and is thereby contributing to increases in childhood obesity. Building on findings from the QUébec Adipose and Lifestyle InvesTigation in Youth (QUALITY), this commentary suggests that while opportunities to engage in physical activity may indeed be differentially shaped by school play environments, physical health may not be the only factor at stake in unequal play environments in schools. While this is not an altogether new concern, we argue that it is nevertheless important to highlight within physical activity research settings that children's overall well-being, including their experience of pleasure, creativity, imagination and sociability, is also shaped by a school's play environment. Addressing possible inequalities in children's experience of play in schools, we propose several questions and future research directions for addressing children's health and well-being in the school environment.

School's out … now what? Objective estimates of afterschool sedentary time and physical activity from childhood to adolescence

OBJECTIVES

To describe the change in afterschool levels of sedentary time and physical activity from childhood to adolescence.

DESIGN

Longitudinal.

METHODS

375 youth (50% boys) from the Study of Early Child Care and Youth Development (United States) provided accelerometer data at 9 (2000/01) and 15 yrs (2006/07). Average time spent in sedentary, light, moderate, vigorous, and moderate-to-vigorous physical activity (MVPA; minh(-1)) was reported across the afterschool period (15:00-22:00) and separately across whole days. Mean comparisons were conducted to report between- and within-group differences in afterschool data. Analysis of covariance was used to determine the effect of sex, ethnicity, and baseline body mass index (BMI) on the 6-yr change in afterschool sedentary time and MVPA before and after adjusting for covariates (baseline afterschool sedentary/MVPA time, change in non-afterschool sedentary/MVPA time, difference in afterschool wear time, and socioeconomic status).

RESULTS

From 9 to 15 yrs, sedentary time increased and activity decreased during the afterschool period. After covariate adjustment, the decline in afterschool MVPA was significantly greater among girls, compared to boys (B coefficient (95%CI)=-0.94 (-1.47, -0.40)), and among overweight/obese youth, compared to youth with normal BMI values (B coefficient (95%CI)=-0.65 (-1.22, -0.08)).

CONCLUSIONS

During the transition from childhood to adolescence, afterschool activity (minh(-1)) decreases while sedentary time increases. Programs are needed throughout this period that promote the maintenance of activity or encourage additional activity with age.

Combinations of obesity prevention strategies in US elementary schools: a critical review

The prevalence of obesity among children has roughly tripled in the past 30 years. Given the numerous health risks associated with obesity, elementary schools have implemented a variety of prevention programs targeting this problem. This review examines recent studies of combinations of obesity prevention programs in US elementary schools and offers recommendations about effective strategies. We found 12 studies that met selection criteria and reviewed their findings related to obesity-related outcomes. Among the single intervention strategies, neither physical activity nor education alone demonstrated efficacy in reducing objective measures of obesity. Most studies of programs with two or three components (i.e., physical activity plus nutrition, physical activity plus both education and nutrition) reported statistically significant improvements in objective obesity-related outcomes. Studies evaluating programs with community and parental involvement suggest that these components may increase effectiveness. However, studies assessing outcomes following the cessation of the program showed a reversal of positive effects, suggesting that long-term implementation of programs is important for sustained gains. Results suggest that combinations of obesity prevention programs sustained over time are most likely to be effective.

Community-identified strategies to increase physical activity during elementary school recess on an American Indian reservation: A pilot study

The aim of this study was to determine the effect of an 8-week recess intervention on physical activity levels in children attending elementary school on an American Indian reservation during fall 2013. Physical activity was measured with direct observation in three zones on the playground. Lines were painted on existing pavement in zone 1. Zone 2 had permanent playground equipment and was unchanged. Zone 3 contained fields where bi-weekly facilitators led activities and provided equipment. Pre- to post-changes during recess in sedentary, moderate physical activity, moderate-to-vigorous, and vigorous physical activities were compared within zones. Females physical activity increased in Zone 1 (moderate: 100% increase; moderate-to-vigorous: 83%; vigorous: 74%, p < 0.01 for all) and Zone 3 (moderate: 54% increase, p < 0.01; moderate-to-vigorous: 48%, p < 0.01; vigorous: 40%, p < 0.05). Male sedentary activity decreased in Zone 2 (161%, p < 0.01). Physical activity changes in Zone 3 were not dependent upon the presence of a facilitator. Simple and low-cost strategies were effective at increasing recess physical activity in females. The findings also suggest that providing children games that are led by a facilitator is not necessary to increase physical activity as long as proper equipment is provided.

The effectiveness of a high-intensity games intervention on improving indices of health in young children

This study assessed the effectiveness of a 6-week, high-intensity, games-based intervention on physiological and anthropometric indices of health, in normal weight (n = 26; 32.5 ± 8.9 kg) and obese (n = 29; 49.3 ± 8.9 kg) children (n = 32 boys, 23 girls), aged 8-10 years. Children were randomised into an exercise or control group. The exercise group participated in a twice-weekly, 40 min active games intervention, alongside their usual school physical education classes. The control group did not take part in the intervention. Before and after the intervention, participants completed both a maximal and submaximal graded exercise test. The submaximal exercise test comprised of a 6 min, moderate- and 6 min heavy-intensity bout, interspersed with a 5 min recovery. The exercise group demonstrated improvements in maximal oxygen uptake (51.4 ± 8.5 vs 54.3 ± 9.6 ml · kg(-1) · min(-1)) and peak running speed (11.3 ± 1.6 vs 11.9 ± 1.6 km · h(-1)), and a reduction in the oxygen cost of submaximal exercise between assessments (P < .05). A decrease in waist circumference and increase in muscle mass were observed between assessments for the obese participants randomised to the intervention (both P < .05). This study demonstrates that a short-term, high-intensity games intervention may elicit positive changes in physiological and anthropometric indices of health in normal weight and obese children.

The relationship among playground areas and physical activity levels in children

INTRODUCTION

Almost 20% of American children aged 6 to 11 years are obese. A decrease in physical activity has been associated with an increase in obesity. The school environment is one place where many children can be reached. This cross-sectional study determined which types of playground areas attract children and promote moderate to vigorous physical activity (MVPA) or sedentarism.

METHOD

Children on two urban elementary school playgrounds (one of which offered a jogging program called Jog and Walk Stars [JAWS]) were observed before school with use of the System for Observing Play and Leisure Activity in Youth and System for Observing Play and Recreation in Communities observational tools. Descriptive statistics, paired-samples t tests, and independent-samples t tests were used to analyze the data.

RESULTS

The highest populated areas for schools K and B on non-JAWS days were the general blacktop areas; however, approximately 50% of the children in these areas were sedentary. At school B on days when the JAWS program was offered, the highest populated area was the JAWS track, and 99% of those children participated in MVPA. There was a significant difference in counts for average total sedentary children per square foot between school K (M = 216.70) and school B on JAWS days: M = 80.38, t (22.02) = 2.24, p < .5, two-tailed.

DISCUSSION

A playground environment assessment to identify areas that promote MVPA, such as offering a JAWS program, may be one avenue to address the need for increasing MVPA levels in children in general, in addition to physical education class, and help them obtain the recommended 60 minutes of daily MVPA.

Does a higher incidence of break times in primary schools result in children being more physically active?

BACKGROUND

Regular physical activity (PA) has multiple benefits to health; however, the majority of schoolchildren do not reach PA guidelines of 60 minutes of moderate to vigorous PA (MVPA) daily. During the school day, break times are often the only opportunity for children to be physically active. This study investigated PA levels during school breaks in German primary school children.

METHODS

PA of 294 children (7.1 ± 0.7 years; 48% boys) was assessed. On the basis of timetables, individual activity times and intensities for daily breaks were determined. Children's weight status was determined on site.

RESULTS

Breaks lasted 30.7 (± 13.8) minutes; length varied significantly between 1 and 2 breaks (21.7 ± 4.1 versus 36.2 ± 14.8 minutes; p ≤ .01). Children spent 25.3% of their breaks in MVPA, boys being significantly more active (30.8% versus 20.4%; p ≤ .01). Time spent in MVPA differed significantly between normal weight and overweight/obese children (26.1% versus 18.4%; p ≤ .05). Children having 2 breaks engaged in significantly more MVPA than those with only 1 (7.4 ± 6.1 versus 5.6 ± 4.7 minutes; p ≤ .02).

CONCLUSIONS

Children spent 25% of their break in MVPA; having 2 breaks increased time in MVPA significantly, although this is also influenced by weight status. Consequently, more activity breaks should be scheduled during school hours.

An Examination of Four Traditional School Physical Activity Models on Children's Step Counts and MVPA

Schools have been identified as primary societal institutions for promoting children's physical activity (PA); however, limited evidence exists demonstrating which traditional school-based PA models maximize children's PA.

PURPOSE

The purpose of this study was to compare step counts and moderate-to-vigorous physical activity (MVPA) across 4 traditional school PA modules.

METHOD

Step count and MVPA data were collected on 5 consecutive school days from 298 children (Mage = 10.0 ± 0.6 years; 55% female) in Grade 5. PA was measured using the NL-1000 piezoelectric pedometer. The 4 models included (a) recess only, (b) multiple recesses, (c) recess and physical education (PE), and (d) multiple recesses and PE.

RESULTS

Children accumulated the greatest PA on days that they had PE and multiple recess opportunities (5,242 ± 1,690 steps; 15.3 ± 8.8 min of MVPA). Children accumulated the least amount of PA on days with only 1 recess opportunity (3,312 ± 445 steps; 7.1 ± 2.3 min of MVPA). Across all models, children accumulated an additional 1,140 steps and 4.1 min of MVPA on PE days.

CONCLUSIONS

It appears that PE is the most important school PA opportunity for maximizing children's PA. However, on days without PE, a 2nd recess can increase school PA by 20% (Δ = 850 steps; 3.8 min of MVPA).

School influences on the physical activity of African American, Latino, and White girls

BACKGROUND

The purpose of this research was to examine the impact of school-related variables on the physical activity (PA) levels of early adolescent African American, Latino, and White girls.

METHODS

Data were collected from 353 African American (N = 123), Latino (N = 118), and White (N = 112) girls. Physical activity levels included a PA latent factor and minutes per day of moderate-to-vigorous physical activity (MVPA). School variables included hours of physical education (PE), PE enjoyment, school physical environment, recess activity, and active transport to/from school. Multiple-group structural equation modeling examined relations between school variables and PA across ethnic groups.

RESULTS

Hours of PE were positively related to higher PA factor scores. Active transport was related to higher PA factor scores for White girls only, and to greater MVPA for African American girls only. Hours of PE were related to PE enjoyment and the school physical environment for some ethnic groups. Physical education enjoyment was related to more recess activity among African American and Latino girls, and PE enjoyment was associated with more active transport to school for all girls.

CONCLUSIONS

Physical education participation and active transport significantly contribute to girls' levels of PA, with differences across ethnic groups.

A systematic review of interventions to promote physical activity in the preschool setting

PURPOSE

Conduct a systematic review of school-based interventions to promote physical activity in preschoolers.

DESIGN AND METHODS

A systematic search of literature between 2002 and 2014 in nine electronic databases and reference lists was conducted using the terms physical activity combined with environment, children, or interventions.

RESULTS

Fourteen articles were identified. Interventions were environmental, cognitive/behavioral, or a combination. Positive interventions involving preschool children included manipulation of the playground with the number of children playing at one time, markings, or equipment, and goal setting and reinforcement.

PRACTICE IMPLICATIONS

More research is needed to determine interventions to promote physical activity in preschool children.

A repeated measures experiment of school playing environment to increase physical activity and enhance self-esteem in UK school children

School playtime provides daily opportunities for children to be active outdoors, but only makes small contributions to physical activity (PA) requirements. Natural environments facilitate unstructured PA and children report a preference for play in nature. Thus, play on the school field might encourage children to be more active during playtime. The primary aim of this study was to examine the impact of the school playing environment on children's PA. Descriptive data and fitness were assessed in 25 children aged 8–9 years from a single primary school. Over two consecutive weeks participants were allocated to either play on the school field or playground during playtime. The order of play in the two areas was randomised and counterbalanced. Moderate to vigorous PA (MVPA) was assessed during playtime on the last two days of each week using accelerometers. There was a significant interaction of environment and sex on MVPA during morning play (F(1,22) = 6.27; P<0.05; n_p² = 0.222), but not during lunch (P>0.05; n_p² = 0.060) or all of playtime combined (P>0.05; n_p² = 0.140). During morning play boys were significantly more active than girls on the playground (t(23) = 1.32; P<0.01; n² = 0.291), but not on the field (P>0.05; n² = 0.071). For lunch (F(1,22) = 24,11; P<0.001; n_p² = 0.523) and all of playtime combined (F(1,22) = 33.67; P<0.001; n_p² = 0.616) there was a significant effect of environment. There was also a significant main effect of sex during lunch (F(1,22) = 11.56; P<0.01; n_p² = 0.344) and all of playtime combined (F(1,22) = 12.37; P<0.01; n_p² = 0.371). MVPA was higher on the field and boys were more active than girls. Play on the field leads to increases in MVPA, particularly in girls. The promising trend for the effect of the natural environment on MVPA indicates that interventions aimed at increasing MVPA should use the natural environment and that schools should encourage greater use of their natural areas to increase PA.

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.

Playground designs to increase physical activity levels during school recess: a systematic review

School recess provides a major opportunity to increase children's physical activity levels. Various studies have described strategies to increase levels of physical activity. The purpose of this systematic review is therefore to examine the interventions proposed as forms of increasing children's physical activity levels during recess. A systematic search of seven databases was made from the July 1 to July 5, 2012, leading to a final set of eight studies (a total of 2,383 subjects-599 "preschoolers" and 1,784 "schoolchildren") meeting the inclusion criteria. These studies were classified according to the intervention used: playground markings, game equipment, playground markings plus physical structures, and playground markings plus game equipment. The results of these studies indicate that the strategies analyzed do have the potential to increase physical activity levels during recess. The cumulative evidence was (a) that interventions based on playground markings, game equipment, or a combination of the two, do not seem to increase the physical activity of preschoolers and schoolchildren during recess and (ii) that interventions based on playground markings plus physical structures do increase the physical activity of schoolchildren during recess in the short to medium term.