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"Children are precious cargo; we don't let them take any risks!": Hearing from adults on safety and risk in children's active play in schools: a systematic review. Int J Behav Nutr Phys Act 2022; 19:111. [PMID: 36050699 PMCID: PMC9438168 DOI: 10.1186/s12966-022-01344-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Accepted: 08/01/2022] [Indexed: 11/25/2022] Open
Abstract
Background Understanding determinants of children’s outdoor play is important for improving low physical activity levels, and schools are a key setting for both. Safety concerns shape children’s opportunity to play actively outdoors, therefore, this qualitative evidence synthesis aimed to i) examine adult (e.g., parent, teacher, yard supervisor, principal) perspectives on safety and risk in children’s active play during recess in elementary and/or middle schools, and ii) identify how safety and risk influence playground supervision and decision making in this setting. Methods Six electronic databases were systematically searched in March 2021, with an updated search in June 2022. Records were screened against eligibility criteria using Covidence software, and data extraction and synthesis were performed using predesigned coding forms in Microsoft Excel and NVivo. Framework synthesis methodology was employed, guided by a conceptual framework structured on the socio-ecological model (SEM) and affordance theory. Results From 10,370 records, 25 studies were included that represented 608 adults across 89 schools from nine countries. The synthesis identified 10 constraining and four affording factors that influenced whether school staff were risk-averse or risk tolerant during recess, and, in turn, the degree to which children’s play was managed. Constraining factors stemmed from fears for children’s physical safety, and fear of blame and liability in the event of playground injury, which shaped parent, school staff and institutional responses to risk. Interrelated factors across SEM levels combined to drive risk-averse decision making and constraining supervision. Emerging evidence suggests children’s active play in schools can be promoted by fostering a risk tolerant and play friendly culture in schools through play facilitation training (e.g., risk-reframing, conflict resolution) and engaging stakeholders in the development of school policies and rules that balance benefits of play against potential risks. Conclusions Findings show several socio-cultural factors limited the ability of school staff to genuinely promote active play. Future work should seek to foster risk tolerance in schools, challenge the cultural norms that shape parent attitudes and institutional responses to risk in children’s play, and explore novel methods for overcoming policy barriers and fear of liability in schools. Trial registration PROSPERO registration: CRD42021238719. Supplementary Information The online version contains supplementary material available at 10.1186/s12966-022-01344-7.
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Peiris DLIHK, Duan Y, Vandelanotte C, Liang W, Yang M, Baker JS. Effects of In-Classroom Physical Activity Breaks on Children's Academic Performance, Cognition, Health Behaviours and Health Outcomes: A Systematic Review and Meta-Analysis of Randomised Controlled Trials. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19159479. [PMID: 35954831 PMCID: PMC9368257 DOI: 10.3390/ijerph19159479] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/28/2022] [Revised: 07/30/2022] [Accepted: 07/30/2022] [Indexed: 02/01/2023]
Abstract
In-Classroom physical activity breaks (IcPAB) are a promising way to promote children’s health behaviors, while contributing to the development of their academic and cognitive ability and health outcomes. Yet the effect of the activity breaks, which are exclusive to classroom settings, are still mixed and unclear. Hence, this review was conducted to identify the characteristics and the effects of IcPAB among primary school children. The review protocol was registered on PROSPERO (CRD42021234192). Following the Cochrane guidelines, PubMed, PsycINFO (ProQuest), MEDLINE (EBSCOhost), Embase/Ovid, SportDISCUS (EBSCOhost), Web of Science, Scopus and Academic Search Premier (EBSCOhost) databases were searched to collect data on randomised control trials without a time restriction. The final database search was conducted on the 8 November 2021. Random effects models were used to calculate the effect sizes. The systematic review identified ten eligible studies, nine of which were also included in the meta-analysis. Few studies used the theoretical frameworks and process evaluations. IcPAB showed mixed effectiveness on academic outcomes: i.e., IcPAB had effects on spelling performance (p < 0.05) and foreign language learning (p < 0.01) but not on mathematics and reading performance. Health behaviors such as moderate-to-vigorous physical activity levels were improved (p < 0.01), but IcPAB did not have an impact on cognition outcomes and health outcomes. Given these mixed results, further research is needed underpinned by strong methodological quality, theoretical underpinnings and reliable process evaluation methods.
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Affiliation(s)
- D. L. I. H. K. Peiris
- Department of Sport, Physical Education and Health, Faculty of Social Sciences, Hong Kong Baptist University, Hong Kong, China; (D.L.I.H.K.P.); (W.L.); (M.Y.); (J.S.B.)
| | - Yanping Duan
- Department of Sport, Physical Education and Health, Faculty of Social Sciences, Hong Kong Baptist University, Hong Kong, China; (D.L.I.H.K.P.); (W.L.); (M.Y.); (J.S.B.)
- Centre for Health and Exercise Science Research, Hong Kong Baptist University, Hong Kong, China
- Correspondence: (Y.D.); (C.V.)
| | - Corneel Vandelanotte
- Physical Activity Research Group, School of Health, Medical and Applied Sciences, Central Queensland University, Rockhampton 4701, Australia
- Correspondence: (Y.D.); (C.V.)
| | - Wei Liang
- Department of Sport, Physical Education and Health, Faculty of Social Sciences, Hong Kong Baptist University, Hong Kong, China; (D.L.I.H.K.P.); (W.L.); (M.Y.); (J.S.B.)
- Centre for Health and Exercise Science Research, Hong Kong Baptist University, Hong Kong, China
| | - Min Yang
- Department of Sport, Physical Education and Health, Faculty of Social Sciences, Hong Kong Baptist University, Hong Kong, China; (D.L.I.H.K.P.); (W.L.); (M.Y.); (J.S.B.)
| | - Julien Steven Baker
- Department of Sport, Physical Education and Health, Faculty of Social Sciences, Hong Kong Baptist University, Hong Kong, China; (D.L.I.H.K.P.); (W.L.); (M.Y.); (J.S.B.)
- Centre for Health and Exercise Science Research, Hong Kong Baptist University, Hong Kong, China
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Jerebine A, Fitton-Davies K, Lander N, Eyre ELJ, Duncan MJ, Barnett LM. "All the fun stuff, the teachers say, 'that's dangerous!'" Hearing from children on safety and risk in active play in schools: a systematic review. Int J Behav Nutr Phys Act 2022; 19:72. [PMID: 35752813 PMCID: PMC9233824 DOI: 10.1186/s12966-022-01305-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Accepted: 06/02/2022] [Indexed: 12/31/2022] Open
Abstract
Background Active play is vital for healthy child development, and schools are a valuable setting to promote this behaviour. Understanding the determinants of children’s physical activity behaviour during recess, particularly the role of risk-taking and the influence safety concerns have on active play, is required. This systematic review aimed to 1) synthesise qualitative research with children that explored their perceptions of safety and risk in active play during recess in elementary and/or middle school, and 2) develop a model from the findings to guide efforts in schools to optimise children’s active play opportunities during recess. Methods Six online databases were systematically searched for articles published between January 2000 and March 2021. Following PRISMA guidelines, records were screened against eligibility criteria using Covidence software, and data extraction and synthesis was conducted using customised forms in Excel and NVivo software. Framework synthesis methodology was employed, conceptually guided by Bronfenbrenner’s socio-ecological model and Gibson’s affordance theory. Results Of 9664 records, 31 studies met inclusion criteria, representing 1408 children across 140 schools from 11 countries. An emergent conceptual framework was developed encompassing 23 risk and safety themes and 10 risky play types that children desired in schools. Individual characteristics (age, gender, physical literacy) influenced children’s engagement with risk and how they kept themselves safe. Across outer SEM levels, factors interacted to constrain or afford children’s active play. Socio-cultural factors (supervision practices, rules, equipment restrictions) constrained active play, which children perceived were driven by adults’ concern with physical safety. These factors contributed to a cycle of risk-averse decision making and diminished play affordances, which could inadvertently exacerbate safety issues. A model for risk tolerance in children’s active play has been proposed. Conclusions The findings show a disparity between the active play children want in schools and what they are able to do. Future work should balance the concerns of adults against the active play children want, involve children in decisions about playground policy, and foster a risk-tolerant culture in schools. Supplementary Information The online version contains supplementary material available at 10.1186/s12966-022-01305-0.
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Affiliation(s)
- Alethea Jerebine
- School of Health and Social Development, Faculty of Health, Deakin University, VIC, Geelong, Australia. .,Centre for Sport, Exercise and Life Sciences, Coventry University, Coventry, UK.
| | - Katie Fitton-Davies
- Centre for Sport, Exercise and Life Sciences, Coventry University, Coventry, UK.,Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK
| | - Natalie Lander
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC, Australia
| | - Emma L J Eyre
- Centre for Sport, Exercise and Life Sciences, Coventry University, Coventry, UK
| | - Michael J Duncan
- Centre for Sport, Exercise and Life Sciences, Coventry University, Coventry, UK
| | - Lisa M Barnett
- School of Health and Social Development, Faculty of Health, Deakin University, VIC, Geelong, Australia.,Institute for Physical Activity and Nutrition, Deakin University, Geelong, VIC, Australia
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Design Process and Implementation of Teacher Training Modules in Movement Integration: What Have We Learnt? SUSTAINABILITY 2022. [DOI: 10.3390/su14095484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Substantial evidence shows that the current level of children’s physical activity (PA) is insufficient. Schools along with academic lessons can offer an effective avenue to increase children’s physical activity and decrease sedentary time. Teacher training in movement integration (MI) has been emphasized as an important strategy in facilitating less sedentary and more physically active lessons. The aim of this study was to explore the design process for developing a teacher training module for MI and its implementation within the comprehensive, school-based, physical activity program. Flexible co-creation methods with teachers were applied. Process evaluation was conducted through individual feedback surveys, observations in schools, evaluating the teacher’s MI mapping timetable, group feedback, and a follow-up study. The two-day module, a practical and flexible approach, ready-to-use resources, allocated time and autonomy for practice, communication with other teachers, and a whole school approach aligned with teachers’ needs are identified as key elements. A follow-up study after the training showed significant changes in teachers’ practices regarding the use of MI in the classroom. The study offers important insights into the design process and its successes and failures. The lessons learnt, a final model of designed seminars, and a toolbox of materials are presented.
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Song C, Ge S, Xue J, Yao W. Physical Exercise of Primary and Middle School Students From the Perspective of Educational Psychology and Parents' Entrepreneurship Education. Front Psychol 2022; 12:777069. [PMID: 35222149 PMCID: PMC8866457 DOI: 10.3389/fpsyg.2021.777069] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Accepted: 12/06/2021] [Indexed: 11/13/2022] Open
Abstract
The study aims to help primary and secondary school students develop a good habit of physical exercise by exploring the current situation of physical exercise of primary and secondary school students and analyzing the factors affecting their physical exercise. Then, intervention strategies are figured out for different groups of students and help them develop a good habit of physical exercise. From the perspective of educational psychology and parents' entrepreneurship education, the research on the physical exercise of primary and secondary school students is conducted by a questionnaire survey, mathematical statistics and literature review. A total of 280 students from five schools in Tianjin are selected as the research subjects, and the current situation of students' physical exercise in these five schools is investigated. The results show that 40.5% of boys and 39.4% of girls can take physical exercise more than three times a week; 48.9% of the students do physical exercise for more than 30 mins each time; the students who usually take regular exercise at school account for 82.1%. The physical exercise that students always do is running, badminton and table tennis, which rank the top three among the sports they do. The students usually play basketball, volleyball, and football, and they rarely do the sports like swimming, Wushu, and aerobics. This result is closely related to the characteristics and places of primary and middle school students. The survey shows that the physical exercise awareness of most primary and secondary school students is correct; most students can participate in physical exercise, but few students can do it regularly; parents' support, parents' habits of doing exercise, and family's spending on physical exercise have a significant impact on developing students' habits of doing physical exercise. Based on the above, it is concluded that the primary and secondary stage is very important for students. Physical education teachers should follow the principle of teaching different students with different methods, enrich teaching materials, and improve teaching quality. The study provides a reference for the reform of PE to guide primary and middle school students to participate in sports activities, improving students' physical quality.
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Affiliation(s)
- Chao Song
- College of Sports Science, Tianjin Normal University, Tianjin, China
| | - Sha Ge
- College of Sports Science, Tianjin Normal University, Tianjin, China
| | - Jingjing Xue
- School of Humanities, Beijing Dance Academy, Beijing, China
| | - Wanxiang Yao
- Department of Kinesiology, College for Health, Community and Policy, University of Texas at San Antonio, San Antonio, TX, United States
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Cumberland PM, Bountziouka V, Hammond CJ, Hysi PG, Rahi JS. Temporal trends in frequency, type and severity of myopia and associations with key environmental risk factors in the UK: Findings from the UK Biobank Study. PLoS One 2022; 17:e0260993. [PMID: 35045072 PMCID: PMC8769366 DOI: 10.1371/journal.pone.0260993] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Accepted: 11/20/2021] [Indexed: 01/13/2023] Open
Abstract
This study investigated temporal trends in the epidemiology of primary myopia and associations with key environmental risk factors in a UK population. Data were collected at recruitment (non-cycloplegic autorefraction, year of birth, sex, ethnicity, highest educational attainment, reason and age of first wearing glasses and history of eye disease) from 107,442 UK Biobank study participants aged 40 to 69 years, born between 1939 and 1970. Myopia was defined as mean spherical equivalent (MSE) ≤-1 dioptre (D). Temporal changes in myopia frequency by birth cohort (5-year bands using date of birth) and associations with environmental factors were analysed, distinguishing both type (childhood-onset, <18 years versus adult-onset) and severity (three categories: low -1.00 to -2.99D, moderate -3.00 to -5.99D or high ≥-6.00D). Overall myopia frequency increased from 20.0% in the oldest cohort (births 1939-1944) to 29.2% in the youngest (1965-1970), reflecting a relatively higher increase in frequency of adult-onset and low myopia. Childhood-onset myopia peaked in participants born in 1950-54, adult-onset myopia peaked in the cohort born a decade later. The distribution of MSE only shifted for childhood-onset myopia (median: -3.8 [IQR -2.4, -5.4] to -4.4 [IQR -3.0, -6.2]). The magnitude of the association between higher educational attainment (proxy for educational intensity) and myopia overall increased over time (adjusted Odds Ratio (OR) 2.7 [2.5, 2.9] in the oldest versus 4.2 [3.3, 5.2] in the youngest cohort), being substantially greater for childhood-onset myopia (OR 3.3 [2.8, 4.0] to 8.0 [4.2, 13]). Without delineating childhood-onset from adult-onset myopia, important temporal trends would have been obscured. The differential impact of educational experience/intensity on both childhood-onset and high myopia, amplified over time, suggests a cohort effect in gene-environment interaction with potential for increasing myopia frequency if increasing childhood educational intensity is unchecked. However, historical plateauing of myopia frequency does suggest some potential for effective intervention.
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Affiliation(s)
- Phillippa M. Cumberland
- Population, Policy and Practice Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, London, United Kingdom
- Ulverscroft Vision Research Group, Ulverscroft Foundation, Leicester, United Kingdom
| | - Vasiliki Bountziouka
- Population, Policy and Practice Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, London, United Kingdom
- Ulverscroft Vision Research Group, Ulverscroft Foundation, Leicester, United Kingdom
| | - Christopher J. Hammond
- Department of Ophthalmology, King’s College London, St Thomas’ Hospital Campus, London, United Kingdom
- Department of Twin Research and Genetic Epidemiology, King’s College London, St Thomas’ Hospital Campus, London, United Kingdom
| | - Pirro G. Hysi
- Department of Ophthalmology, King’s College London, St Thomas’ Hospital Campus, London, United Kingdom
| | - Jugnoo S. Rahi
- Population, Policy and Practice Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, London, United Kingdom
- Ulverscroft Vision Research Group, Ulverscroft Foundation, Leicester, United Kingdom
- National Institute for Health Research (NIHR) Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, United Kingdom
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Sami W, Mohamed E, Almhmd A, K Alenazy S, Alrashidi A, Aldhafeeri B, Binmuhareb A. The association between body mass index and lifestyle with academic performance of college of medicine students, Majmaah University, Saudi Arabia. ADVANCES IN HUMAN BIOLOGY 2022. [DOI: 10.4103/aihb.aihb_79_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Neill RD, Best P, Lloyd K, Williamson J, Allen J, Badham J, Tully MA. Engaging Teachers and School Leaders in Participatory Data Analysis for the Development of a School-Based Mental Health Intervention. SCHOOL MENTAL HEALTH 2021. [DOI: 10.1007/s12310-021-09418-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
AbstractThe success of school-based mental health interventions is often inconsistent, in part due to lack of input from teachers and students in the programme design. Therefore, the involvement and engagement of teachers in the co-production of an intervention, especially within data analysis, can create more innovative and effective solutions. This paper presents a teacher-led qualitative data analysis using a new approach within the field, participation theme elicitation. This approach will be used to gather information relevant to the initial development of a school-based mental health intervention. Teachers identified the following themes: (1) physical activity as a stress reliever, (2) programme facilitation, (3) exam pressure and (4) solutions to improve negative mental health. Results from the teacher-led analysis are broadly similar to previous research in the field. Our findings demonstrate that teachers can have a valuable input into research findings which should help address the development of a school-based mental health intervention. In summary, the findings suggest that the use of participatory theme elicitation is a valid and effective method to address the gaps and limitations of participatory qualitative data analysis.
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Chriqui JF, Leider J, Piekarz-Porter E, Lin W, Turner L, Michael SL, Brener N, Perna F. “Waiving” Goodbye to PE: State Law and School Exemption and Substitution Practices in the United States. TRANSLATIONAL JOURNAL OF THE AMERICAN COLLEGE OF SPORTS MEDICINE 2021. [DOI: 10.1249/tjx.0000000000000161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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10
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The Relationship between Physical Activity Levels, Cardiorespiratory Fitness and Academic Achievement School-Age Children from Southern Spain. SUSTAINABILITY 2020. [DOI: 10.3390/su12083459] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The relationship between physical activity (PA), cardiorespiratory fitness (CRF) and academic achievement in young people is unclear. The aim of this study was to analyze the relationship between PA, CRF and academic achievement in 152 children according to sex (average age of 8.6 ± 0.3 years) in southern Spain. A tri-axial accelerometer was used to measure PA; the 20-m Shuttle Run Test was performed to assess the CRF; and to know the academic achievement, the official school records were considered. The results showed a weak correlation between moderate PA and moderate-to-vigorous PA (MVPA) with CRF in boys (all, 0.2 > r < 0.4; p < 0.05), whereas the vigorous PA showed a moderate and weak correlation with CRF (all, p < 0.05), in both boys (r = 0.537) and girls (r = 0.382), respectively. In addition, a weak inverse correlation between moderate PA and MVPA with academic achievement showed in girls (all, 0.2 > r < 0.4; p < 0.05). Finally, the CRF weakly correlated with academic achievement only in boys (all, 0.2 > r < 0.4; p < 0.05). Our study showed a relationship between PA and CRF in both sexes. Nonetheless, the PA was inversely related to academic achievement in girls, whereas the CRF was related to academic achievement in boys.
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Erickson KI, Hillman C, Stillman CM, Ballard RM, Bloodgood B, Conroy DE, Macko R, Marquez DX, Petruzzello SJ, Powell KE. Physical Activity, Cognition, and Brain Outcomes: A Review of the 2018 Physical Activity Guidelines. Med Sci Sports Exerc 2019; 51:1242-1251. [PMID: 31095081 DOI: 10.1249/mss.0000000000001936] [Citation(s) in RCA: 501] [Impact Index Per Article: 100.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
PURPOSE Physical activity (PA) is known to improve cognitive and brain function, but debate continues regarding the consistency and magnitude of its effects, populations and cognitive domains most affected, and parameters necessary to achieve the greatest improvements (e.g., dose). METHODS In this umbrella review conducted in part for the 2018 Health and Human Services Physical Activity Guidelines for Americans Advisory Committee, we examined whether PA interventions enhance cognitive and brain outcomes across the life span, as well as in populations experiencing cognitive dysfunction (e.g., schizophrenia). Systematic reviews, meta-analyses, and pooled analyses were used. We further examined whether engaging in greater amounts of PA is associated with a reduced risk of developing cognitive impairment and dementia in late adulthood. RESULTS Moderate evidence from randomized controlled trials indicates an association between moderate- to vigorous-intensity PA and improvements in cognition, including performance on academic achievement and neuropsychological tests, such as those measuring processing speed, memory, and executive function. Strong evidence demonstrates that acute bouts of moderate- to vigorous-intensity PA have transient benefits for cognition during the postrecovery period after exercise. Strong evidence demonstrates that greater amounts of PA are associated with a reduced risk of developing cognitive impairment, including Alzheimer's disease. The strength of the findings varies across the life span and in individuals with medical conditions influencing cognition. CONCLUSIONS There is moderate-to-strong support that PA benefits cognitive functioning during early and late periods of the life span and in certain populations characterized by cognitive deficits.
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Affiliation(s)
- Kirk I Erickson
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA
| | - Charles Hillman
- Department of Psychology and Department of Physical Therapy, Movement, and Rehabilitation Sciences, Northeastern University, Boston, MA
| | | | - Rachel M Ballard
- Office of Disease Prevention, Office of the Director, National Institutes of Health, Bethesda, MD
| | | | - David E Conroy
- Department of Kinesiology, The Pennsylvania State University, University Park, PA
| | - Richard Macko
- Department of Neurology, University of Maryland School of Medicine, Baltimore, MD
| | - David X Marquez
- Department of Kinesiology and Nutrition, Center for Research on Health and Aging, University of Illinois at Chicago, Chicago, IL
| | - Steven J Petruzzello
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Urbana, IL
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Khan M, Bell R. Effects of a School Based Intervention on Children's Physical Activity and Healthy Eating: A Mixed-Methods Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E4320. [PMID: 31698796 PMCID: PMC6888275 DOI: 10.3390/ijerph16224320] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Revised: 10/26/2019] [Accepted: 10/30/2019] [Indexed: 01/04/2023]
Abstract
Combined diet and physical activity school-based interventions (rather than only diet or physical activity interventions) are more likely to help prevent children from becoming overweight in the long term. However, such interventions are less prevalent, and therefore, this pilot study aimed to assess the feasibility of a gardening intervention coupled with awareness about plant-based meals among 9-10 year old children in a London primary school. We recruited 60 children from two Year 5 classes, one class participated as an intervention group, and results were compared against another class who acted as the control group. Children's physical activity (PA) was measured using GENEActiv wrist-worn accelerometers. Their fruit and vegetable intake and attitudes to and preferences in eating fruits and vegetables were measured using a self-report questionnaire. Furthermore, three focus groups were held with children in the intervention group to understand the reasons behind any change as a result of the intervention. Results are inconclusive; however, they indicate some impact on reduction of sedentary behaviour, increase of moderate to vigorous PA, knowledge of nutrition and some level of acceptance in trying new vegetables. School-based interventions involving gardening show some promise to increase children's PA and improve their attitudes to eating fruits and vegetables.
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Affiliation(s)
- Matluba Khan
- Institute of Health Equity, University College London, London, WC1E 6BT, UK;
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Jones RA, Blackburn NE, Woods C, Byrne M, van Nassau F, Tully MA. Interventions promoting active transport to school in children: A systematic review and meta-analysis. Prev Med 2019; 123:232-241. [PMID: 30904600 DOI: 10.1016/j.ypmed.2019.03.030] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Revised: 02/04/2019] [Accepted: 03/16/2019] [Indexed: 11/17/2022]
Abstract
The systematic review investigated the effectiveness of active travel (AT) interventions on physical activity and fitness in primary school children. The review assessed intervention effectiveness, design, complexity, and study quality. Searches were conducted in five databases on 30/08/2018. Studies with an AT intervention compared to an inactive control, in 4 to 11 year olds, measuring AT or fitness outcomes were included. Two-stage screening identified relevant studies. Relevant data were extracted using Cochrane Extraction Form, Quality Assessment Tool for Quantitative Studies, Active Living by Design model, and intervention Complexity Assessment Tool for Systematic Reviews. Meta-analysis and Cohen's D effect size assessed effectiveness. Seventeen eligible studies were included. Effectiveness assessment found a statistically significant standardised mean difference (SMD) in AT outcomes in favour of the intervention (continuous AT - SMD 0.78 (CI 0.11-1.46); frequency AT - SMD 1.87 (CI 0.88-2.86)). Cohen's D calculation concurred with this finding. Fifteen studies had SMD favouring the intervention - two studies had SMD favouring the control. Sixteen studies received a weak quality rating - one study rated moderate. Active travel shows promise in increasing physical activity in primary school children. The review found walking school buses and educational strategies most effective for increasing relevant outcomes, although overall study quality was weak. Effect size did not associate with the complexity of an intervention, therefore supporting efforts to promote active travel through interventions may be easier to scale. Further intervention studies of greater methodological quality are necessary to confirm these findings due to the limited evidence available.
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Affiliation(s)
- Rebecca A Jones
- Centre for Public Health, Queen's University Belfast, Institute of Clinical Sciences, Block B, Royal Victoria Hospital, Belfast BT12 6BA, United Kingdom.
| | - Nicole E Blackburn
- Centre for Public Health, Queen's University Belfast, Institute of Clinical Sciences, Block B, Royal Victoria Hospital, Belfast BT12 6BA, United Kingdom.
| | | | - Molly Byrne
- Health Behaviour Change Research Group, National University of Ireland Galway, University Road, Galway, Ireland.
| | - Femke van Nassau
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Public and Occupational Health, Amsterdam Public Health research institute, Van der Boechorststraat 7, NL-1081 BT Amsterdam, the Netherlands.
| | - Mark A Tully
- Centre for Public Health, Queen's University Belfast, Institute of Clinical Sciences, Block B, Royal Victoria Hospital, Belfast BT12 6BA, United Kingdom; UK Clinical Research Collaboration Centre of Excellence for Public Health, Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, United Kingdom; Institute of Mental Health Sciences, School of Health Sciences, Ulster University, Shore Road, Newtownabbey, Co Antrim BT37 0QB, United Kingdom.
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Wassenaar TM, Wheatley CM, Beale N, Salvan P, Meaney A, Possee JB, Atherton KE, Duda JL, Dawes H, Johansen-Berg H. Effects of a programme of vigorous physical activity during secondary school physical education on academic performance, fitness, cognition, mental health and the brain of adolescents (Fit to Study): study protocol for a cluster-randomised trial. Trials 2019; 20:189. [PMID: 30940164 PMCID: PMC6444886 DOI: 10.1186/s13063-019-3279-6] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Accepted: 03/04/2019] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Early adolescence is a period of dynamic neurobiological change. Converging lines of research suggest that regular physical activity (PA) and improved aerobic fitness have the potential to stimulate positive brain changes, improve cognitive function and boost academic attainment in this age group, but high-quality studies are needed to substantiate these findings. The primary aim of the Fit to Study trial is to investigate whether short infusions of vigorous PA (VPA) delivered during secondary school physical education (PE) can improve attainment in maths, as described in a protocol published by NatCen Social Research. The present protocol concerns the trial's secondary outcome measures, which are variables thought to moderate or mediate the relationship between PA and attainment, including the effect of the intervention on cardiorespiratory fitness, cognitive performance, mental health and brain structure and function. METHOD The Fit to Study project is a cluster-randomised controlled trial that includes Year 8 pupils (aged 12-13) from secondary state schools in South/Mid-England. Schools were randomised into an intervention condition in which PE teachers delivered an additional 10 min of VPA per PE lesson for one academic year, or a 'PE as usual' control condition. Intervention and control groups were stratified according to whether schools were single-sex or co-educational. Assessments take place at baseline (end of Year 7, aged 11-12) and after 12 months (Year 8). Secondary outcomes are cardiorespiratory fitness, objective PA during PE, cognitive performance and mental health. The study also includes exploratory measures of daytime sleepiness, attitudes towards daily PA and PE enjoyment. A sub-set of pupils from a sub-set of schools will also take part in a brain imaging sub-study, which is embedded in the trial. DISCUSSION The Fit to Study trial could advance our understanding of the complex relationships between PA and aerobic fitness, the brain, cognitive performance, mental health and academic attainment during adolescence. Further, it will add to our understanding of whether school PE is an effective setting to increase VPA and fitness, which could inform future PA interventions and education policy. TRIAL REGISTRATION ClinicalTrials.gov, NCT03286725 . Retrospectively registered on 18 September 2017. ClinicalTrials.gov, NCT03593863 . Retrospectively registered on 19 July 2018.
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Affiliation(s)
- T. M. Wassenaar
- Wellcome Centre for Integrative Neuroimaging, FMRIB Centre, Nuffield Department of Clinical Neurosciences, University of Oxford, John Radcliffe Hospital, Headley Way, Oxford, OX3 9DU UK
| | - C. M. Wheatley
- Wellcome Centre for Integrative Neuroimaging, FMRIB Centre, Nuffield Department of Clinical Neurosciences, University of Oxford, John Radcliffe Hospital, Headley Way, Oxford, OX3 9DU UK
| | - N. Beale
- Centre for Movement, Occupational and Rehabilitation Sciences (MOReS), Oxford Brookes University, Headington Campus, Oxford, OX3 0BP UK
| | - P. Salvan
- Wellcome Centre for Integrative Neuroimaging, FMRIB Centre, Nuffield Department of Clinical Neurosciences, University of Oxford, John Radcliffe Hospital, Headley Way, Oxford, OX3 9DU UK
| | - A. Meaney
- Centre for Movement, Occupational and Rehabilitation Sciences (MOReS), Oxford Brookes University, Headington Campus, Oxford, OX3 0BP UK
| | - J. B. Possee
- Centre for Movement, Occupational and Rehabilitation Sciences (MOReS), Oxford Brookes University, Headington Campus, Oxford, OX3 0BP UK
| | - K. E. Atherton
- Wellcome Centre for Integrative Neuroimaging, FMRIB Centre, Nuffield Department of Clinical Neurosciences, University of Oxford, John Radcliffe Hospital, Headley Way, Oxford, OX3 9DU UK
| | - J. L. Duda
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, B15 2TT UK
| | - H. Dawes
- Centre for Movement, Occupational and Rehabilitation Sciences (MOReS), Oxford Brookes University, Headington Campus, Oxford, OX3 0BP UK
| | - H. Johansen-Berg
- Wellcome Centre for Integrative Neuroimaging, FMRIB Centre, Nuffield Department of Clinical Neurosciences, University of Oxford, John Radcliffe Hospital, Headley Way, Oxford, OX3 9DU UK
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Mezcua-Hidalgo A, Ruiz-Ariza A, Suárez-Manzano S, Martínez-López EJ. 48-Hour Effects of Monitored Cooperative High-Intensity Interval Training on Adolescent Cognitive Functioning. Percept Mot Skills 2019; 126:202-222. [PMID: 30665339 DOI: 10.1177/0031512518825197] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Physical activity has been positively related to better cognitive performance though the effects of varied exercise type and intensity and the duration of cognitive benefits are unclear. This study analyzed the effect of 16 minutes of monitored cooperative high-intensity interval training (monitored C-HIIT) at the start of the school day, on various cognitive variables over the next 24-48 hours. We randomly assigned 158 participants either to a control group ( n = 81) that engaged only in static stretching or to an experimental group ( n = 77) that performed monitored C-HIIT. We assessed cognitive functioning before the exercise, immediately afterward, and for five follow-up time points over the next two days (i.e., at 2, 3, 4, 24, and 48 hours). We analyzed age, sex, body mass index, and moderate-to-vigorous physical activity as potential confounder variables. Adolescents in the monitored C-HIIT group increased selective attention by 17.39% during the next hour ( p = .015) and increased concentration by 20.31% and 15.26% during the first ( p = .022) and second ( p = .059) subsequent hours, respectively. This positive short-term benefit of monitored C-HIIT during immediate subsequent hours is an important finding with implications for the school curricula and schedule.
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Affiliation(s)
| | - Alberto Ruiz-Ariza
- 1 Faculty of Humanities and Educational Sciences, University of Jaén, Spain
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16
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Taylor SL, Noonan RJ, Knowles ZR, Owen MB, Fairclough SJ. Process evaluation of a pilot multi-component physical activity intervention - active schools: Skelmersdale. BMC Public Health 2018; 18:1383. [PMID: 30563488 PMCID: PMC6299621 DOI: 10.1186/s12889-018-6272-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2018] [Accepted: 11/27/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Schools have been identified as key environments to promote child physical activity (PA). Implementation of multi-component PA interventions within schools is advocated but research has showed that they may not always be effective at increasing child PA. Results of the Active Schools: Skelmersdale (AS:Sk) multi-component pilot intervention indicated no significant positive change to child PA levels. Process evaluations can provide information on which aspects of an intervention were delivered and how. Therefore, the purpose of this study was to use a combination of methods to elicit child and teacher perceptions regarding the feasibility and acceptability of the AS:Sk intervention, alongside systematic researcher observations. The overarching study aim was to understand how schools implemented the AS:Sk intervention, with a specific focus on the frequency of intervention component implementation, and how the components were incorporated into the school day. METHODS The study generated five data sets. Data elicited from 18 participating children via a write draw, show and tell task included, frequency counts of most enjoyable intervention components, drawings, and verbatim data. Teacher verbatim data was collected from 3 interviews, and 18 researcher observations were recorded using field notes. The data sources were pooled to produce the themes presented in the results section. RESULTS The combination of data sources revealed four themes and 16 sub-themes. Implementation methods: how and when the components were implemented in schools. Child engagement: enjoyment and positive behaviour. Facilitators: peer influence, teacher influence, staggered implementation, incentives, rewards, challenges and competition, flexibility and adaptability, child ownership, routine. Barriers: time within an intense curriculum, space, sustaining child interest, parental support, school policies. CONCLUSIONS This study revealed that teachers believed classroom based activities were most feasible and acceptable due to the reduced implementation barriers of sufficient time and space. In contrast, children reported that the activities outside of the classroom were preferred. Future school-based PA interventions should aim to achieve a balance between routine PA at a set time and PA that is flexible and adaptable. Further process evaluations of multi-component school-based PA interventions are warranted to develop the limited evidence base.
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Affiliation(s)
- Sarah L Taylor
- Physical Activity and Health Research Group, Department of Sport and Physical Activity, Edge Hill University, St. Helens Road, Ormskirk, Lancashire, L39 4QP, UK.
| | - Robert J Noonan
- Physical Activity and Health Research Group, Department of Sport and Physical Activity, Edge Hill University, St. Helens Road, Ormskirk, Lancashire, L39 4QP, UK
| | - Zoe R Knowles
- Physical Activity Exchange, Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, L3 2AT, UK
| | - Michael B Owen
- Physical Activity and Health Research Group, Department of Sport and Physical Activity, Edge Hill University, St. Helens Road, Ormskirk, Lancashire, L39 4QP, UK
| | - Stuart J Fairclough
- Physical Activity and Health Research Group, Department of Sport and Physical Activity, Edge Hill University, St. Helens Road, Ormskirk, Lancashire, L39 4QP, UK.,Department of Physical Education and Sports Science, University of Limerick, Limerick, Ireland
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17
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Brustio PR, Moisè P, Marasso D, Miglio F, Rainoldi A, Boccia G. Feasibility of implementing an outdoor walking break in Italian middle schools. PLoS One 2018; 13:e0202091. [PMID: 30092012 PMCID: PMC6084989 DOI: 10.1371/journal.pone.0202091] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2017] [Accepted: 07/30/2018] [Indexed: 11/20/2022] Open
Abstract
Brief bouts of physical activity during the school day are an innovative method for increasing physical activity in the school setting. The purpose of the study was to investigate if the introduction of an outdoor active break, based on walking and running, in a middle school in Italy is feasible in terms of implementation (i.e., adherence, costs, safety) and acceptability (i.e., satisfaction, intent to continue use, perceived appropriateness). One hundred and forty students (aged 12 ± 1 years) and 20 teachers (aged 50 ± 8 years) participated in the activity for four months. The activity consisted of walking (or running) one kilometer outside the school buildings during the mid-morning. Data from questionnaires regarding the satisfaction with and the acceptability of the activity were collected. The activity was safely performed three to four days a week, without any costs to the school or to students’ parents. Students and teachers were satisfied with the activity (positive answers from 95% and 89% of each group, respectively). Moreover, the teachers reported that the program was easy to organize and did not negatively influence their teaching activities. The intervention was easily and safely implemented, and it was considered suitable for the daily routine of an Italian middle school. Further studies are needed to examine its impact on physical activity levels and academic achievement.
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Affiliation(s)
- Paolo Riccardo Brustio
- NeuroMuscularFunction Research Group, School of Exercise and Sport Sciences, Department of Medical Sciences, University of Turin, Turin, Italy
| | - Paolo Moisè
- School of Exercise & Sport Sciences, SUISM, University of Turin, Torino, Italy
- Istituto Comprensivo Statale Buttigliera Alta-Rosta, Scuola Secondaria di primo grado “G. Jaquerio”—Buttigliera Alta, Torino, Italy
| | - Danilo Marasso
- School of Exercise & Sport Sciences, SUISM, University of Turin, Torino, Italy
| | - Franco Miglio
- Istituto Comprensivo Statale Buttigliera Alta-Rosta, Scuola Secondaria di primo grado “G. Jaquerio”—Buttigliera Alta, Torino, Italy
| | - Alberto Rainoldi
- NeuroMuscularFunction Research Group, School of Exercise and Sport Sciences, Department of Medical Sciences, University of Turin, Turin, Italy
- * E-mail:
| | - Gennaro Boccia
- NeuroMuscularFunction Research Group, School of Exercise and Sport Sciences, Department of Medical Sciences, University of Turin, Turin, Italy
- CeRiSM Research Center for Sport, Mountain, and Health, University of Verona, Rovereto (TN), Italy
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Asigbee FM, Whitney SD, Peterson CE. The Link Between Nutrition and Physical Activity in Increasing Academic Achievement. THE JOURNAL OF SCHOOL HEALTH 2018; 88:407-415. [PMID: 29748999 DOI: 10.1111/josh.12625] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/03/2017] [Revised: 06/17/2017] [Accepted: 03/02/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND Research demonstrates a link between decreased cognitive function in overweight school-aged children and improved cognitive function among students with high fitness levels and children engaging in regular physical activity (PA). The purpose of this study was to examine whether regular PA and proper nutrition together had a significant effect on academic achievement. METHODS Using the seventh wave of the Early Childhood Longitudinal Study, Kindergarten Class 1998-99 (ECLS-K) dataset, linear regression analysis with a Jackknife resampling correction was conducted to analyze the relationship among nutrition, PA, and academic achievement, while controlling for socioeconomic status, age, and sex. A nonactive, unhealthy nutrition group and a physically active, healthy nutrition group were compared on standardized tests of academic achievement. RESULTS Findings indicated that PA levels and proper nutrition significantly predicted achievement scores. Thus, the active, healthy nutrition group scored higher on reading, math, and science standardized achievement tests scores. CONCLUSIONS There is a strong connection between healthy nutrition and adequate PA, and the average performance within the population. Thus, results from this study suggest a supporting relationship between students' health and academic achievement. Findings also provide implications for school and district policy changes.
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Affiliation(s)
- Fiona M Asigbee
- Department of Nutritional Sciences, The University of Texas at Austin, 103 West 24th Street, A2703, T.S. Painter Hall, Room 3.24, Austin, TX 78712
| | - Stephen D Whitney
- Educational, School & Counseling Department, University of Missouri-Columbia, 5B Hill Hall, Columbia, MO 65211
| | - Catherine E Peterson
- Educational, School & Counseling Department, University of Missouri-Columbia, 16B Hill Hall, Columbia, MO 65211
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19
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Cross-sectional and longitudinal associations of screen time and physical activity with school performance at different types of secondary school. BMC Public Health 2018; 18:563. [PMID: 29703168 PMCID: PMC5924472 DOI: 10.1186/s12889-018-5489-3] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2017] [Accepted: 04/20/2018] [Indexed: 01/09/2023] Open
Abstract
Background Previous studies have already reported associations of media consumption and/or physical activity with school achievement. However, longitudinal studies investigating independent effects of physical activity and media consumption on school performance are sparse. The present study fills this research gap and, furthermore, assesses relationships of the type of secondary school with media consumption and physical activity. Methods The consumption of screen-based media (TV/video, game console, PC/internet, and mobile phone) and leisure physical activity (organized and non-organized) of 10 – to 17-year old adolescents participating in the LIFE Child study in Germany were related to their school grades in two major school subjects (Mathematics and German) and in Physical Education. In addition to a cross-sectional analysis at baseline (N = 850), a longitudinal analysis (N = 512) investigated the independent effects of these activities on the school grades achieved 12 months later. All associations were adjusted for age, gender, socio-economic status, year of data assessment, body-mass-index, and school grades at baseline. A further analysis investigated differences in the consumption of screen-based media and physical activity as a function of the type of secondary school (highest vs. lower secondary school). Results Adolescents of lower secondary schools reported a significantly higher consumption of TV/video and game consoles than adolescents attending the highest secondary school. Independently of the type of school, a better school performance in Mathematics was predicted by a lower consumption of computers/internet, and a better performance in Physical Education was predicted by a lower consumption of TV/video and a higher frequency of non-organized physical activity. However, the association between non-organized physical activity and subsequent grades in Physical Education was significant in girls only. Conclusion The present results suggest that media consumption has a negative effect on school achievement, whereas physical activity has a positive effect, which, however, is restricted to the subject Physical Education. Future studies might explore the relationship between media consumption and school career, for example, the choice or change of the secondary school type, in more detail. Trial registration LIFE Child study: ClinicalTrials.gov, clinical trial number NCT02550236
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Saunders RP, Dowda M, Mciver K, McDonald SM, Pate RR. Physical and Social Contexts of Physical Activity Behaviors of Fifth and Seventh Grade Youth. THE JOURNAL OF SCHOOL HEALTH 2018; 88:122-131. [PMID: 29333648 PMCID: PMC6599639 DOI: 10.1111/josh.12587] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/09/2017] [Revised: 05/12/2017] [Accepted: 07/25/2017] [Indexed: 05/06/2023]
Abstract
BACKGROUND The purpose of this study was to characterize the temporal, social, and physical contexts for physical activities commonly reported in a diverse cohort of 753 boys and girls from fifth to seventh grade. METHODS Data were obtained from a multilevel longitudinal study, the Transitions and Activity Changes in Kids. The Physical Activity Choices instrument assessed previous 5-day participation in specific physical activities and their temporal, social, and physical contexts. Mixed model repeated measure analyses of variance and multinomial analyses examined sex differences and change over time. RESULTS Fifth grade boys and girls reported participation in similar activities at similar frequencies, which declined significantly by seventh grade. One temporal pattern, playing with younger children, changed over time from "both inside/outside" to "outside" school. Boys and females reported more activities performed in class/team groups over time. Most activities took place primarily at home for all participants in both grades. CONCLUSIONS Boys and girls reported declines in the variety and frequency of activities from fifth to seventh grade. There were sex-specific patterns in physical activities and groups; however, all participants reported home as the primary location and a shift to class/team groups over time. Schools are well-positioned to provide additional physical activity opportunities.
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Affiliation(s)
- Ruth P Saunders
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, 921 Assembly Street, Columbia, SC 29208
| | - Marsha Dowda
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, 921 Assembly Street, Columbia, SC 29208
| | - Kerry Mciver
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, 921 Assembly Street, Columbia, SC 29208
| | - Samantha M McDonald
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, 921 Assembly Street, Columbia, SC 29208
| | - Russell R Pate
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, 921 Assembly Street, Columbia, SC 29208
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