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Hatfield DP, Sharma S, Bailey CP, Bakun P, Hennessy E, Simon C, Economos CD. Implementation of nutrition and physical activity-related policies and practices on college campuses participating in the Healthier Campus initiative. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2024; 72:1192-1199. [PMID: 35549645 DOI: 10.1080/07448481.2022.2071617] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Revised: 04/05/2022] [Accepted: 04/25/2022] [Indexed: 06/15/2023]
Abstract
Objective: To evaluate implementation of nutrition/physical activity-related policies/practices at colleges participating in a healthy campus initiative and campus health leaders' perceptions of policies/practices' support for student health and ease of/barriers to implementation. Participants: Health leaders at colleges participating in the Healthier Campus Initiative (HCI), with completed or ongoing three-year HCI commitments. Methods: Surveys asked which of 41 guidelines were implemented and perceptions around support for student health and ease of/barriers to implementation. Qualitative interviews explored similar domains. Results: Campuses with completed HCI commitments (n = 17) averaged 27.6 guidelines implemented, versus 21.1 on campuses with commitments ongoing (n = 13; p = 0.003). Perceived support for student health and implementation ease varied by guideline. Common implementation barriers included financial costs and time. Interviews largely reinforced these findings. Conclusions: Completion of a campus environmental change initiative may be associated with more health-supporting practices. Campuses may benefit from implementing coordinated policy/practice changes supporting healthy eating and physical activity.
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Affiliation(s)
- Daniel P Hatfield
- ChildObesity180 and the Friedman School of Nutrition Science and Policy at Tufts University, Boston, Massachusetts, USA
| | - Shanti Sharma
- ChildObesity180 and the Friedman School of Nutrition Science and Policy at Tufts University, Boston, Massachusetts, USA
| | - Caitlin P Bailey
- ChildObesity180 and the Friedman School of Nutrition Science and Policy at Tufts University, Boston, Massachusetts, USA
| | - Peter Bakun
- ChildObesity180 and the Friedman School of Nutrition Science and Policy at Tufts University, Boston, Massachusetts, USA
| | - Erin Hennessy
- ChildObesity180 and the Friedman School of Nutrition Science and Policy at Tufts University, Boston, Massachusetts, USA
| | - Caitlin Simon
- The Partnership for a Healthier America, Washington, District of Columbia, USA
| | - Christina D Economos
- ChildObesity180 and the Friedman School of Nutrition Science and Policy at Tufts University, Boston, Massachusetts, USA
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Heerman WJ, Kenney E, Block JP, Fiechtner L, McMahon E, Kruse L, Sharifi M, Edmondson EK, Virudachalam S. A Narrative Review of Public Health Interventions for Childhood Obesity. Curr Obes Rep 2024; 13:87-97. [PMID: 38172483 DOI: 10.1007/s13679-023-00550-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/05/2023] [Indexed: 01/05/2024]
Abstract
PURPOSE OF REVIEW Public health interventions that intervene on macrolevel systems hold the promise of reducing childhood obesity at the population level through prevention. The purpose of this review is to highlight some of the recent and best scientific evidence related to public health interventions for the prevention of childhood obesity. We provide a narrative review of scientific evidence for six categories of public health interventions and their impact on childhood obesity: federal nutrition assistance programs, programs implemented in early care and education centers, interventions to support healthy nutrition and physical activity in schools, community-based programs and policies, labeling policies and marketing to children, and taxes on sugar sweetened beverages (SSB). RECENT FINDINGS Federal nutrition assistance programs have the strongest evidence to support reduction in childhood obesity and serve populations with the highest prevalence of childhood obesity. Other interventions including SSB taxes, community-wide interventions, and interventions at schools and early care and education centers also show significant improvements in child weight status. Overall public health interventions have strong evidence to support widespread implementation in service of reducing childhood obesity rates at the population level. To effectively address the recalcitrant childhood obesity epidemic, multi-pronged solutions are needed. The current evidence for public health obesity interventions is consistent with the paradigm that recognizes the importance of macrolevel systems influences on childhood obesity: interventions that are most effective intervene at macrolevels.
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Affiliation(s)
- William J Heerman
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, USA.
| | - Erica Kenney
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, USA
| | - Jason P Block
- Department of Population Medicine, Harvard Pilgrim Health Care Institute, Harvard Medical School, Boston, USA
| | - Lauren Fiechtner
- Division of Pediatric Gastroenterology and Nutrition, Mass General for Children, The Greater Boston Food Bank, Boston, USA
| | - Ellen McMahon
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, USA
| | - Lauren Kruse
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, USA
| | - Mona Sharifi
- Department of Pediatrics, Yale School of Medicine, New Haven, USA
| | - Emma K Edmondson
- Department of Pediatrics and Leonard Davis Institute of Health Economics at University of Pennsylvania Perelman School of Medicine, Division of General Pediatrics, PolicyLab, and Clinical Futures at Children's Hospital of Philadelphia, Philadelphia, USA
| | - Senbagam Virudachalam
- Department of Pediatrics and Leonard Davis Institute of Health Economics at University of Pennsylvania Perelman School of Medicine, Division of General Pediatrics, PolicyLab, and Clinical Futures at Children's Hospital of Philadelphia, Philadelphia, USA
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Kinder CJ, Nam K, Kulinna PH, Woods AM, McKenzie TL. System for Observing Play and Leisure Activity in Youth: A Systematic Review of US and Canadian Studies. THE JOURNAL OF SCHOOL HEALTH 2023; 93:934-963. [PMID: 37340586 DOI: 10.1111/josh.13345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 05/02/2023] [Accepted: 05/21/2023] [Indexed: 06/22/2023]
Abstract
BACKGROUND The System of Observing Play and Leisure Activity in Youth (SOPLAY) has assisted in providing valid and reliable data of youth physical activity and characteristics specific to environmental contexts. The review aimed to examine empirical research that employed the SOPLAY instrument to measure physical activity in leisure-based activity environments in North American countries. METHODS The review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. A systematic search was conducted with an exhaustive process using 10 electronic databases to locate peer-reviewed studies implementing SOPLAY that were published between 2000 and 2021. RESULTS A total of 60 studies were included in the review. Most studies (n = 35) reported physical activity findings related to contextual characteristics measured using SOPLAY. Interestingly, a few of the studies (n = 8) found the provision of equipment and supervision, particularly adult supervision, significantly increased child physical activity observed. CONCLUSIONS This review provides information relative to the group-level physical activity observed across multiple contexts (ie, playgrounds, parks, recreation centers) using a validated direct observation instrument.
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Affiliation(s)
- Christopher J Kinder
- University of Illinois at Urbana-Champaign, 906 South Goodwin Avenue, Urbana, IL, 61801
| | - Kahyun Nam
- Arizona State University, 200 E. Curry Road, Unit 146, Tempe, AZ, 85281
| | - Pamela H Kulinna
- Arizona State University, 200 E. Curry Road, Unit 146, Tempe, AZ, 85281
| | - Amelia M Woods
- University of Illinois at Urbana-Champaign, 906 South Goodwin Avenue, Urbana, IL, 61801
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Gosselin V, Robitaille N, Laberge S. An evaluation of the 'bottom-up' implementation of the Active at school! programme in Quebec, Canada. Health Promot Int 2022; 37:6697206. [PMID: 36102479 PMCID: PMC9472259 DOI: 10.1093/heapro/daac095] [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] [Indexed: 12/30/2022] Open
Abstract
The lack of physical activity (PA) amongst children is a public health concern in many industrialized countries. School-based daily physical activity (DPA) policies are a promising intervention for increasing PA levels amongst children. Informed by a logic model framework, this study examines the factors associated with meeting a 'top-down' DPA objective in the context of a 'bottom-up' implementation of a school-based DPA initiative in Quebec, Canada. An online survey assessing school-level inputs, outputs and outcomes was sent to all participating schools (415). Crude odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using logistic regression to evaluate potential associations between factors (inputs and outputs) and the school's adherence to providing at least 60 minutes of DPA (outcome). Adjusted ORs (AORs) and 95% CIs were calculated using a multivariate logistic regression to identify the best set of factors to predict adherence to the DPA objective. A total of 404 schools completed the questionnaire, amongst which 71% reported meeting the DPA target by implementing school-tailored activities. Three factors were identified as the best set of school inputs and outputs to predict meeting the objective: financial resources (per student) (AOR = 1.02; 95% CI 1.01-1.03), a shared vision amongst the school-team members that PA benefits learning outcomes (AOR = 1.94; 95% CI 1.04-3.19) and having conducted a detailed situational analysis (AOR = 1.89; 95% CI 1.00-3.58). Given that 'bottom-up' implementation might favour the development of policies that are more acceptable to stakeholders, our results should be considered by decision-makers and school administrators when implementing DPA initiatives.
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Affiliation(s)
| | - Noémie Robitaille
- School of Kinesiology and Physical Activity Sciences, Université de Montréal, Station Downtown, Montréal, Québec H3C 3J7, Canada
| | - Suzanne Laberge
- School of Kinesiology and Physical Activity Sciences, Université de Montréal, Station Downtown, Montréal, Québec H3C 3J7, Canada
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Pfledderer CD, Burns RD, Byun W, Carson RL, Welk GJ, Brusseau TA. School-based physical activity interventions in rural and urban/suburban communities: A systematic review and meta-analysis. Obes Rev 2021; 22:e13265. [PMID: 33938109 DOI: 10.1111/obr.13265] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Revised: 04/08/2021] [Accepted: 04/09/2021] [Indexed: 12/20/2022]
Abstract
Disparities in physical activity and health outcomes exist between urban and rural youth. School settings can be utilized to promote physical activity in youth regardless of urban-rural status. This systematic review and meta-analysis aimed to assess and compare the effect of rural and urban/suburban school-based physical activity programs on total physical activity in youth. A search of five databases was conducted. A total of 33 studies remained after the exclusion process, 28 of which took place in urban/suburban schools and five of which took place in rural schools. The DerSimonian and Laird random effects model was employed with the estimates of heterogeneity taken from the inverse-variance fixed-effect model. For rural studies, the Hartung-Knapp-Sidak-Jonkman method was used to obtain error estimates. Results from the total sample indicated a significant but small pooled increase in daily physical activity (Hedge's g = 0.12, 95% confidence interval [CI]: 0.06-0.18), which held for interventions conducted in urban/suburban schools (Hedge's g = 0.12, 95% CI: 0.06-0.19). For rural school-based interventions, there was no significant pooled effect (Hedge's g = 0.06, 95% CI: -0.50 to 0.61). This meta-analysis provides evidence that school-based interventions can be marginally effective for increasing daily physical activity in children and adolescents; however, no effect was observed for interventions implemented in rural settings.
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Affiliation(s)
| | - Ryan D Burns
- Department of Health, Kinesiology and Recreation, University of Utah, Salt Lake City, Utah, USA
| | - Wonwoo Byun
- Department of Health, Kinesiology and Recreation, University of Utah, Salt Lake City, Utah, USA
| | - Russell L Carson
- Research, Health and Wellness, PlayCore, Chattanooga, Tennessee, USA
| | - Gregory J Welk
- Department of Kinesiology, Iowa State University, Ames, Iowa, USA
| | - Timothy A Brusseau
- Department of Health, Kinesiology and Recreation, University of Utah, Salt Lake City, Utah, USA
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McLoughlin GM, Allen P, Walsh-Bailey C, Brownson RC. A systematic review of school health policy measurement tools: implementation determinants and outcomes. Implement Sci Commun 2021; 2:67. [PMID: 34174969 PMCID: PMC8235584 DOI: 10.1186/s43058-021-00169-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Accepted: 06/08/2021] [Indexed: 04/24/2023] Open
Abstract
BACKGROUND Governments in some countries or states/provinces mandate school-based policies intended to improve the health and well-being of primary and secondary students and in some cases the health of school staff. Examples include mandating a minimum time spent per week in programmed physical activity, mandating provision of healthy foods and limiting fat content of school meals, and banning tobacco products or use on school campuses. Although school health researchers have studied whether schools, districts, or states/provinces are meeting requirements, it is unclear to what extent implementation processes and determinants are assessed. The purposes of the present systematic review of quantitative measures of school policy implementation were to (1) identify quantitative school health policy measurement tools developed to measure implementation at the school, district, or state/provincial levels; (2) describe the policy implementation outcomes and determinants assessed and identify the trends in measurement; and (3) assess pragmatic and psychometric properties of identified implementation measures to understand their quality and suitability for broader application. METHODS Peer-reviewed journal articles published 1995-2020 were included if they (1) had multiple-item quantitative measures of school policy implementation and (2) addressed overall wellness, tobacco, physical activity, nutrition, obesity prevention, or mental health/bullying/social-emotional learning. The final sample comprised 86 measurement tools from 67 peer-review articles. We extracted study characteristics, such as psychometric and pragmatic measure properties, from included articles based on three frameworks: (1) Implementation Outcomes Framework, (2) Consolidated Framework for Implementation Research, and (3) Policy Implementation Determinants Framework. RESULTS Most implementation tools were developed to measure overall wellness policies which combined multiple policy topics (n = 35, 40%) and were in survey form (n = 75, 87%). Fidelity was the most frequently prevalent implementation outcome (n = 70, 81%), followed by adoption (n = 32, 81%). The implementation determinants most assessed were readiness for implementation, including resources (n = 43, 50%), leadership (n = 42, 49%), and policy communication (n = 41, 48%). Overall, measures were low-cost and had easy readability. However, lengthy tools and lack of reported validity/reliability data indicate low transferability. CONCLUSIONS Implementation science can contribute to more complete and rigorous assessment of school health policy implementation processes, which can improve implementation strategies and ultimately the intended health benefits. Several high-quality measures of implementation determinants and implementation outcomes can be applied to school health policy implementation assessment. Dissemination and implementation science researchers can also benefit from measurement experiences of school health researchers.
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Affiliation(s)
- Gabriella M McLoughlin
- Implementation Science Center for Cancer Control (WU-ISC3) and Prevention Research Center, Brown School, Washington University in St. Louis, Campus Box 1196, One Brookings Drive, St. Louis, MO, 63130, USA.
- Division of Public Health Sciences (Department of Surgery), Washington University School of Medicine, Washington University in St. Louis, St. Louis, 63110, USA.
| | - Peg Allen
- Implementation Science Center for Cancer Control (WU-ISC3) and Prevention Research Center, Brown School, Washington University in St. Louis, Campus Box 1196, One Brookings Drive, St. Louis, MO, 63130, USA
| | - Callie Walsh-Bailey
- Implementation Science Center for Cancer Control (WU-ISC3) and Prevention Research Center, Brown School, Washington University in St. Louis, Campus Box 1196, One Brookings Drive, St. Louis, MO, 63130, USA
| | - Ross C Brownson
- Implementation Science Center for Cancer Control (WU-ISC3) and Prevention Research Center, Brown School, Washington University in St. Louis, Campus Box 1196, One Brookings Drive, St. Louis, MO, 63130, USA
- Division of Public Health Sciences (Department of Surgery), Washington University School of Medicine, Washington University in St. Louis, St. Louis, 63110, USA
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Reynolds KD, Buller DB, Berteletti J, Massie K, Ashley J, Buller MK, Meenan RT, Liu X. School-Level Factors Associated with Sun Protection Practices in California Elementary Schools. THE JOURNAL OF SCHOOL HEALTH 2020; 90:386-394. [PMID: 32141621 PMCID: PMC7127930 DOI: 10.1111/josh.12884] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Revised: 03/15/2019] [Accepted: 05/04/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND This study examined implementation of district sun safety policy in schools and tested correlates of implementation in California public school districts. METHODS Principals (N = 118) and teachers (N = 113) in California public elementary schools (N = 118) were recruited and completed a survey on sun protection policies and practices. The sample contained schools whose districts subscribed to the California School Boards Association and adopted Board Policy 5141.7 for sun safety. Principals and teachers reported on implementation of 10 school practices related to BP 5141.7 indicating which practices were implemented in the school. RESULTS Years in public education (Exponentiated Score (ES) = 0.51, p < .001), years worked in the current district (ES = 0.49, p < .001), perception that parents should take action to protect children from the sun (ES = 0.43, p < .01), and personal skin phenotype (Low Risk ES = 0.55; High Risk ES = 0.09, p < .05) were associated with number of practices implemented in the school using multiple Poisson regression. CONCLUSIONS Policy implementation is more likely among schools with experienced faculty, when parents are seen as important partners in student skin cancer prevention, and when school principals and teachers have a lower personal risk phenotype.
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Affiliation(s)
- Kim D. Reynolds
- Professor, School of Community & Global Health, Claremont Graduate University. 675 W. Foothill Blvd., Ste. 310, Claremont, CA 91711, USA
| | - David B. Buller
- Director of Research and Senior Scientist, Klein Buendel, Inc. 1667 Cole Boulevard, Suite 225, Golden, CO 80401, USA
| | - Julia Berteletti
- Research Program Manager, Klein Buendel, Inc. 1667 Cole Boulevard, Suite 225, Golden, CO 80401, USA
| | - Kim Massie
- Project Manager, School of Community & Global Health, Claremont Graduate University. 675 W. Foothill Blvd., Ste. 310, Claremont, CA 91711, USA
| | - Jeff Ashley
- President, Sun Safety for Kids. 2625 W. Alameda Ave., Suite 517, Burbank, CA 91505, USA
| | - Mary Klein Buller
- President, Klein Buendel, Inc. 1667 Cole Boulevard, Suite 225, Golden, CO 80401, USA
| | - Richard T. Meenan
- Senior Investigator, Kaiser Permanente Center for Health Research. 3800 N. Interstate Ave, Portland, OR 97227, USA
| | - Xia Liu
- Biostatistical Manager, Klein Buendel, Inc. 1667 Cole Boulevard, Suite 225, Golden, CO 80401, USA
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LaJeunesse S, Thompson S, Pullen-Seufert N, Kolbe MB, Heiny S, Thomas C, Johnson ER. Diverse school community engagement with the North Carolina active routes to school project: a diffusion study. Int J Behav Nutr Phys Act 2019; 16:118. [PMID: 31783871 PMCID: PMC6884761 DOI: 10.1186/s12966-019-0889-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Accepted: 11/20/2019] [Indexed: 12/02/2022] Open
Abstract
Background Schools located in rural parts of the United States and North Carolina have benefited proportionally less from the federal Safe Routes to School (SRTS) program than their more urban counterparts. We investigated whether and how diverse elementary and middle school communities throughout North Carolina have engaged in a SRTS-inspired, multi-sectoral initiative called the Active Routes to School (ARTS) project over the course of 5 years (2013 through 2017). Methods Analyses included a study sample of 2602 elementary and middle schools in North Carolina, 853 that participated in the ARTS project over the five-year study period and 1749 that had not. Statistical models controlling for county- and school-level confounders predicted schools’ involvement in walking and bicycling-promotive events, programs, and policies over time. Results Schools’ engagement with ARTS Project programming increased significantly over the study period, with 33% of eligible schools participating with the project by the end of 2017. Participation was most common in promotional events. Such event participation predicted engagement with regularly recurring programming and school- and district-level establishment of biking- and walking-facilitative policies. Lower income schools were more likely to establish recurring bike and walk programs than wealthier schools, whereas rural schools were less likely than city schools to participate in promotional events, yet equally as likely as other schools to participate in recurring bike and walk programs. Conclusions Schools’ engagement with the North Carolina ARTS Project diffused despite many schools’ rural geographies and lower socioeconomic status. Further, participation in one-time promotional events can portend schools’ establishment of recurring walking and biking programs and supportive policies.
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Affiliation(s)
- Seth LaJeunesse
- Highway Safety Research Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
| | - Sam Thompson
- Division of Public Health, North Carolina Department of Health and Human Services, Raleigh, NC, USA
| | - Nancy Pullen-Seufert
- Highway Safety Research Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Mary Bea Kolbe
- Division of Public Health, North Carolina Department of Health and Human Services, Raleigh, NC, USA
| | - Stephen Heiny
- Highway Safety Research Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Cathy Thomas
- Division of Public Health, North Carolina Department of Health and Human Services, Raleigh, NC, USA
| | - Edward R Johnson
- Division of Bicycle and Pedestrian Transportation, North Carolina Department of Transportation, Raleigh, NC, USA
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Chen BH, Michael S, Borgogna B, Holmes K, Hughes K, Jew L, Juergens M. Integrate Classroom Physical Activity in Schools. JOURNAL OF PHYSICAL EDUCATION, RECREATION & DANCE 2019; 90:10-19. [PMID: 37204989 PMCID: PMC10189950 DOI: 10.1080/07303084.2019.1649577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Affiliation(s)
| | - Shannon Michael
- Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, in Atlanta, GA
| | - Bridget Borgogna
- Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, in Atlanta, GA
| | - Kate Holmes
- National Network of Public Health Institutes in New Orleans, LA
| | - Kelly Hughes
- National Network of Public Health Institutes in New Orleans, LA
| | - Lina Jew
- Health Resources in Action in Boston, MA
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Escaron AL, Vega-Herrera C, Steers N, Chung J, Martinez C, Hochman M, Lara M. Factors Associated With Leisure Time Physical Activity Among Schoolchildren in a Predominantly Latino Community. THE JOURNAL OF SCHOOL HEALTH 2019; 89:444-451. [PMID: 30906999 DOI: 10.1111/josh.12755] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/24/2017] [Revised: 05/21/2018] [Accepted: 12/09/2018] [Indexed: 06/09/2023]
Abstract
BACKGROUND School initiatives aimed at increasing physical activity (PA) may improve the health of children in low-income communities. METHODS Assessors completed 5909 observations of students' PA during leisure periods using a validated instrument in 19 schools in low-income Latino communities. We examined relationships between school environment factors (eg, presence of playground equipment) and levels of moderate-to-vigorous physical activity (MVPA). RESULTS Overall, 16.4% of students were engaged in vigorous activity, lower than reported in prior analyses. Consistent with earlier reports, boys were more engaged in vigorous PA than girls (18.6% vs 13.2%). Playground equipment, such as balls and jump ropes, were present in 27.5% of activity areas. Supervision was present in 83.1% of observations; however, staff members were only observed leading organized activity in 1.7%. Playground equipment was associated with higher rates of MVPA, particularly among elementary boys (p < .0001). Staff supervision was not associated with MVPA, possibly because staff members rarely led organized activity. CONCLUSIONS We found low rates of leisure time PA among students in this low-income Latino community. The presence of playground equipment was favorably associated with activity levels. Increasing the availability of playground equipment might promote activity among children in similar populations.
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Affiliation(s)
- Anne L Escaron
- Research and Evaluation Manager, Health Education & Wellness Department, AltaMed Health Services Corporation, Los Angeles, CA 90040
| | - Celia Vega-Herrera
- Analyst, Office of the Chief Medical Officer, AltaMed Health Services Corporation, Los Angeles, CA 90040
| | - Neil Steers
- Adjunct Assistant Professor, David Geffen School of Medicine, UCLA Division of General Internal Medicine and Health Services Research, Los Angeles, CA 90095
| | - Jane Chung
- Director, Innovation and Research Implementation, AltaMed Institute for Health Equity, AltaMed Health Services Corporation, Los Angeles, CA 90040
| | - Corina Martinez
- Program Manager, Health Education & Wellness Department, AltaMed Health Services Corporation, Los Angeles, CA 90040
| | - Michael Hochman
- Director, Gehr Family Center for Health Systems Science, Keck Medicine of University of Southern California, Los Angeles, CA 90033
| | - Marielena Lara
- Professor of Pediatrics, Keck Medicine of University of Southern California, and Children's Hospital Los Angeles, Affiliated Senior Scientist, RAND Corporation, Los Angeles, CA 90027
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Association of School Physical Activity Policies With Student Physical Activity Behavior. J Phys Act Health 2019; 16:340-347. [PMID: 30925846 DOI: 10.1123/jpah.2018-0057] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Background: Few studies have examined school physical activity policies to assess dose-response on student outcomes. The purpose of this study was to evaluate the association between health-promoting physical activity policies in elementary schools and physical activity behavior. Methods: In this cross-sectional study, physical activity was assessed using self-report measures in fourth-grade students in Texas (N = 1958, x = 9.66 y) from the School Physical Activity and Nutrition (SPAN) survey. School policies were assessed using the number of health-promoting policies in place taken from the SPAN School Health Survey with principals and their proxies. Multiple linear regressions adjusted for student- and school-level confounders and school clustering were performed. Results: School physical activity policies were significantly associated with student-level physical activity behavior (P < .05), even after controlling for the student- and school-level confounding variables. The interactions between physical activity policy-by-economic disadvantage (P < .01) and between physical activity policy-by-geographic strata (P < .01) were both significant, with stronger direct effects of policies on student physical activity for economically disadvantaged schools and major urban schools. Conclusion: Results from this study provide evidence for the importance of school-based health policies and practices in potentially reducing health disparities, especially in low-income and urban schools.
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Lachance L, Quinn M, Kowalski-Dobson T. The Food & Fitness Community Partnerships: Results From 9 Years of Local Systems and Policy Changes to Increase Equitable Opportunities for Health. Health Promot Pract 2018; 19:92S-114S. [PMID: 30176779 DOI: 10.1177/1524839918789400] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The Food & Fitness (F&F) community partnerships, funded by the W.K. Kellogg Foundation from 2007 to 2016, were established to create community-determined change in the conditions that affect health and health equity in neighborhoods. The focus of the work has been to increase access to locally grown good food (food that is healthy, sustainable, fair, and affordable), and safe places for physical activity for children and families in communities with inequities across the United States through changes in policies, community infrastructure, and systems at the local level. This article describes the outcomes related to systems and policy change over 9 years of community change efforts in the F&F partnerships. Characteristics of the F&F communities where the work took place; the change model that emerged from the work; efforts and changes achieved related to community food, school food, and active living/built environment; overall factors in the community that helped or hindered the work of the partnerships; and a depiction of the community-determined process for change employed by the partnerships are described. Local systems and policy change is a long-term process. Community-determined efforts that build capacity for systems change, commitment to long-term funding, and provision of technical assistance tailored to community needs were elements that contributed to success in the F&F work. Achieving intermediate outcomes on the road to policy and systems change created a way to monitor success and make midcourse corrections when needed.
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Affiliation(s)
- Laurie Lachance
- 1 University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Martha Quinn
- 1 University of Michigan School of Public Health, Ann Arbor, MI, USA
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