1
|
Pullyblank K, Rosen M, Wichman C, Rogers AE, Baron M, Dzewaltowski DA. Community-engaged Systems for Population Health Improvement: A Novel Approach to Improve Diabetes Outcomes in Rural Communities. J Community Health 2024; 49:798-808. [PMID: 38980510 PMCID: PMC11345328 DOI: 10.1007/s10900-024-01376-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/10/2024] [Indexed: 07/10/2024]
Abstract
BACKGROUND Approaches to prevent and manage diabetes at a community population level are hindered because current strategies are not aligned with the structure and function of a community system. We describe a community-driven process based on local data and rapid prototyping as an alternative approach to create diabetes prevention and care management solutions appropriate for each community. We report on the process and provide baseline data for a 3-year case study initiative to improve diabetes outcomes in two rural Nebraska communities. METHODS We developed an iterative design process based on the assumption that decentralized decision-making using local data feedback and monitoring will lead to the innovation of local sustainable solutions. Coalitions act as community innovation hubs and meet monthly to work through a facilitated design process. Six core diabetes measures will be tracked over the course of the project using the electronic health record from community clinics as a proxy for the entire community. RESULTS Baseline data indicate two-thirds of the population in both communities are at risk for prediabetes based on age and body mass index. However, only a fraction (35% and 12%) of those at risk have been screened. This information led both coalitions to focus on improving screening rates in their communities. DISCUSSION In order to move a complex system towards an optimal state (e.g., improved diabetes outcomes), stakeholders must have access to continuous feedback of accurate, pertinent information in order to make informed decisions. Conventional approaches of implementing evidence-based interventions do not facilitate this process.
Collapse
Affiliation(s)
- Kristin Pullyblank
- Bassett Research Institute, Center for Rural Community Health, Bassett Medical Center, Cooperstown, NY, USA.
| | - Marisa Rosen
- College of Public Health, Department of Health Promotion, University of Nebraska Medical Center, Omaha, NE, USA
| | - Christopher Wichman
- College of Public Health, Department of Biostatistics, University of Nebraska Medical Center, Omaha, NE, USA
| | - Ann E Rogers
- College of Public Health, Department of Health Promotion, University of Nebraska Medical Center, Omaha, NE, USA
| | - Melissa Baron
- College of Public Health, Department of Health Promotion, University of Nebraska Medical Center, Omaha, NE, USA
| | - David A Dzewaltowski
- College of Public Health, Department of Health Promotion, University of Nebraska Medical Center, Omaha, NE, USA
| |
Collapse
|
2
|
Ostermeier E, Gilliland J, Irwin JD, Seabrook JA, Tucker P. Developing community-based physical activity interventions and recreational programming for children in rural and smaller urban centres: a qualitative exploration of service provider and parent experiences. BMC Health Serv Res 2024; 24:1017. [PMID: 39227835 PMCID: PMC11373125 DOI: 10.1186/s12913-024-11418-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2024] [Accepted: 08/09/2024] [Indexed: 09/05/2024] Open
Abstract
BACKGROUND Children's physical inactivity is a persisting international public health concern. While there is a large body of literature examining physical activity interventions for children, the unique physical activity context of low-density communities in rural areas and smaller urban centres remains largely underexplored. With an influx of families migrating to rural communities and small towns, evaluations of health promotion efforts that support physical activity are needed to ensure they are meeting the needs of the growing populations in these settings. The aim of this community-based research was to explore service providers' and parents' perspectives on physical activity opportunities available in their community and recommendations toward the development and implementation of efficacious physical activity programming for children in rural communities and smaller urban centres. METHODS Three in-person community forums with recreation service providers (n = 37 participants) and 1 online community forum with the parents of school-aged children (n = 9 participants) were hosted. An online survey and Mentimeter activity were conducted prior to the community forums to gather participants' views on the barriers and facilitators to physical activities and suggestions for activity-promoting programs. The service provider and parent discussions were audio-recorded, transcribed verbatim, and analyzed following a deductive approach guided by Hseih and Shannon's (2005) procedure for direct content analysis. A code list developed from the responses to the pre-forum survey and Mentimeter activity was used to guide the analysis and category development. RESULTS Seven distinct categories related to the existing physical activity opportunities and recommendations for programs in rural communities and smaller urban centres were identified during the analysis: (1) Recovery from Pandemic-Related Measures, (2) Knowledge and Access to Programs, (3) Availability, (4) Personnel Support, (5) Quality of Programs and Facilities, (6) Expenses and Subsidies, and (7) Inclusivity and Preferences. CONCLUSION To improve the health and well-being of children who reside in low-density areas, the results of this study highlight service provider and parent recommendations when developing and implementing community-based physical activity programs and interventions in rural and smaller urban settings, including skill development programs, non-competitive activity options, maximizing existing spaces for activities, and financial support.
Collapse
Affiliation(s)
- Emma Ostermeier
- Health and Rehabilitation Sciences, Faculty of Health Sciences, Western University, London, ON, Canada
| | - Jason Gilliland
- Department of Geography and Environment, Western University, Social Science Centre, Rm 2333 - 1151 Richmond Street Western University, London, ON, Canada.
- Department of Epidemiology & Biostatistics, Western University, London, ON, Canada.
- Department of Paediatrics, Western University, London, ON, Canada.
- Children's Health Research Institute, London, ON, Canada.
- Lawson Health Research Institute, London, ON, Canada.
- School of Health Studies, Western University, London, ON, Canada.
| | - Jennifer D Irwin
- School of Health Studies, Western University, London, ON, Canada
| | - Jamie A Seabrook
- Department of Epidemiology & Biostatistics, Western University, London, ON, Canada
- Department of Paediatrics, Western University, London, ON, Canada
- Children's Health Research Institute, London, ON, Canada
- Lawson Health Research Institute, London, ON, Canada
- School of Food and Nutritional Sciences, Brescia University College, London, ON, Canada
| | - Patricia Tucker
- Children's Health Research Institute, London, ON, Canada
- Lawson Health Research Institute, London, ON, Canada
- School of Occupational Therapy, Faculty of Health Sciences, Western University, London, ON, Canada
| |
Collapse
|
3
|
Craig DW, Pfledderer CD, Heredia NI, Lanza K, Onadeko K, Pavlovic A, Injil J, DeFina LF, Walker TJ. Whole-of-School Physical Activity Promotion: Findings From Elementary Schools in the United States. Am J Prev Med 2024:S0749-3797(24)00268-X. [PMID: 39128591 DOI: 10.1016/j.amepre.2024.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2024] [Revised: 08/05/2024] [Accepted: 08/05/2024] [Indexed: 08/13/2024]
Abstract
INTRODUCTION Schools can support students' participation in physical activity by offering opportunities consistent with a Whole-of-School (WOS) approach; however, the extent to which physical activity opportunities are provided and how school-level characteristics associate with their use remains unclear. This study examined how elementary schools' use a WOS approach to promote physical activity, as well as associations between school-level characteristics and physical activity opportunities provided. METHODS Survey data was collected from 162 elementary schools participating in the NFL PLAY 60 FitnessGram Project during the 2022-2023 school year. A WOS index (ranging from 0 to 12) was created from responses by school staff on questions about 6 physical activity practices (physical education, recess, before- and after-school programs, classroom-based approaches, active transport). Multivariable regression models examined associations between school characteristics and WOS index scores. Analyses were completed in Spring 2024. RESULTS Fully adjusted models indicated a statistically significant difference between the percentage of economically disadvantaged students served and WOS index score. Schools serving between 20% and 39% (p<0.001), 40%-59% (p<0.01), 60%-79% (p<0.01) and ≥80% (p<0.001) economically disadvantaged students scored significantly lower on the WOS index compared to schools with 0%-19% economically disadvantaged students. CONCLUSIONS Studies are needed to examine disparities in physical activity practices consistent with a WOS approach to understand the implications on health, academic performance, and other key outcomes. This information can inform the development of strategies to address disparities and ensure youth have equitable access to school-based physical activity opportunities.
Collapse
Affiliation(s)
- Derek W Craig
- Department of Health Promotion and Behavioral Sciences, UTHealth Houston School of Public Health, Houston, Texas.
| | - Christopher D Pfledderer
- Department of Health Promotion and Behavioral Sciences, UTHealth Houston School of Public Health, Austin, Texas
| | - Natalia I Heredia
- Department of Health Promotion and Behavioral Sciences, UTHealth Houston School of Public Health, Houston, Texas
| | - Kevin Lanza
- Department of Environmental and Occupational Health Sciences, UTHealth Houston School of Public Health, Austin, Texas
| | - Kempson Onadeko
- Department of Health Promotion and Behavioral Sciences, UTHealth Houston School of Public Health, Houston, Texas
| | | | | | | | - Timothy J Walker
- Department of Health Promotion and Behavioral Sciences, UTHealth Houston School of Public Health, Houston, Texas
| |
Collapse
|
4
|
Sanz-Martín D, Ruiz-Tendero G, Alonso-Vargas JM, Melguizo-Ibáñez E. Physical Activity and Perceived Support among Adolescents According to Sex and Municipality. Healthcare (Basel) 2024; 12:1512. [PMID: 39120215 PMCID: PMC11311463 DOI: 10.3390/healthcare12151512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2024] [Revised: 07/26/2024] [Accepted: 07/28/2024] [Indexed: 08/10/2024] Open
Abstract
A cross-sectional study was conducted with three aims: (1) to determine the degree of compliance with physical activity recommendations among adolescents according to sex and place of residence, (2) to determine the perceived support of family and friends for physical activity among adolescents according to sex and place of residence, and (3) to analyse the influence of family and friends support on compliance with physical activity recommendations among adolescents according to sex and place of residence. A total of 694 adolescents from an inland area of Spain (14.06 ± 1.27 years) participated. Four one-day physical activity questionnaires were administered to assess physical activity and the Parental Support Scale and Peer Support to measure perceived support from family and friends regarding physical activity. Chi-square, Crammer's V and Student's tests were calculated to identify differences between variables according to sex and municipality of residence. Moreover, the initial binary logistic regression model was constructed to predict the physical activity compliance. Differences in adherence to physical activity recommendations were found according to the sex of the students (rural area: x2 = 4.192, p < 0.05; V = 0.106, p < 0.05; urban area: x2 = 8.999, p < 0.05; V = 0.167, p < 0.01). There were also sex differences in rural areas on items related to families providing transport (t = 3.878, p ≤ 0.001; d = 0.40) and doing physical activity together (t = 4.974, p ≤ 0.001; d = 0.50). It is concluded that most adolescents do not comply with physical activity recommendations. In addition, 30.4% of urban girls' compliance was predicted by the perception that their family members saw them doing physical activity and doing it with friends.
Collapse
Affiliation(s)
- Daniel Sanz-Martín
- Faculty of Humanities and Social Sciences, Universidad Isabel I, 09003 Burgos, Spain
| | - Germán Ruiz-Tendero
- Department of Languages, Arts and Physical Education Teaching, Faculty of Education, Complutense University of Madrid, 28040 Madrid, Spain;
| | - José Manuel Alonso-Vargas
- Department of Didactics Musical, Plastic and Corporal Expression, Faculty of Education Science, University of Granada, 18071 Granada, Spain; (J.M.A.-V.); (E.M.-I.)
| | - Eduardo Melguizo-Ibáñez
- Department of Didactics Musical, Plastic and Corporal Expression, Faculty of Education Science, University of Granada, 18071 Granada, Spain; (J.M.A.-V.); (E.M.-I.)
| |
Collapse
|
5
|
Petre IM, Nobari H, Boscoianu M, Pelin B, Ionescu A, Prieto González P, Oliveira R, Oancea B. Differences in knee flexor and extensor force and kinematic variables in rural versus urban area female students in Romania. Front Physiol 2024; 15:1152119. [PMID: 38764860 PMCID: PMC11099611 DOI: 10.3389/fphys.2024.1152119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 04/10/2024] [Indexed: 05/21/2024] Open
Abstract
The study aimed to identify and explain the typical differences in low-intensity high-volume resistance training (LIHV-RT) performances for major muscle groups between rural versus urban young female students to establish the relevant set of quantitative and qualitative resistance training parameters. The study sample included 46 recreational active female students at the Transilvania University of Brașov, (mean ± SD age, 20 ± 1 year; body mass, 60 ± 3 kg; height, 160 ± 4 cm) grouped urban vs. rural. The study used modified resistance exercise machines for the hamstring- and quadricep-group muscles, equipped with a dynamometer and sensors for identifying developed forces and accelerations. A number of 368 tests were performed, representing two attempts for each subject, for knee flexion and knee extension exercises, with two different loads. For the performance analysis some variables were considered: the maximum number of repetition until failure, maximum force developed, maximum acceleration, the duration of the set and the mean time per repetition. The maximum number of repetition to failure shows a significant higher value for rural than urban in case of knee flexion (d = 0.98 [0.32, 1.54] for load 1(L1) and d = 0.65 [0.03, 1.21] for load 2(L2)) and in case of knee extension (d = 1.89 [1.11, 2.48] for L1 and d = 1.67 [0.92, 2.25] for L2). The total duration of the sets shows a significant higher value for rural than urban in case of knee flexion (d = 0.84 [0.19, 1.39] for L2) and in case of knee extension (d = 1.46 [0.74, 2.03] for L1 and d = 1.56 [0.98, 2.14] for L2). Additionally we found differences in the quality of the relevant repetitions execution and in the impulse developed during the LIHV- MNRF sets. The study's main finding was that there are differences in LIHV-RT performances knee flexion and knee extension antagonistic exercises, between rural and urban female students. We concluded that the obtained results allow teachers to understand the optimal design of RT programs for the different groups of participants, in order to adapt their teaching techniques so that their final objectives are achieved, insisting on particular aspects of the theoretical or practical contents.
Collapse
Affiliation(s)
- Ioana Mădălina Petre
- Department of Industrial Engineering and Management, Transilvania University of Brasov, Brasov, Romania
| | - Hadi Nobari
- Department of Motric Performance, Transilvania University of Brasov, Brasov, Romania
- Faculty of Sport Sciences, University of Extremadura, Cáceres, Spain
| | - Mircea Boscoianu
- Department of Industrial Engineering and Management, Transilvania University of Brasov, Brasov, Romania
| | - Bogdan Pelin
- Department of Motric Performance, Transilvania University of Brasov, Brasov, Romania
| | - Anca Ionescu
- Department of Motric Performance, Transilvania University of Brasov, Brasov, Romania
| | - Pablo Prieto González
- Health and Physical Education Department, Prince Sultan University, Riyadh, Saudi Arabia
| | - Rafael Oliveira
- Sports Science School of Rio Maior–Polytechnic Institute of Santarém, Rio Maior, Portugal
- Research Center in Sport Sciences, Health Sciences and Human Development, Vila Real, Portugal
- Life Quality Research Centre, Rio Maior, Portugal
| | - Bogdan Oancea
- Department of Motric Performance, Transilvania University of Brasov, Brasov, Romania
| |
Collapse
|
6
|
Wu YP, Brady HL, Wankier AP, Tanguy WJ, Smith HJ, Brunsgaard EK, Chipman J, DeSantis S, Abildso C, Haaland B, Schlechter CR, Wetter DW, Tercyak KP. Preliminary effects of a rural skin cancer prevention intervention for youths. Health Psychol 2024; 43:339-351. [PMID: 38206847 PMCID: PMC11031317 DOI: 10.1037/hea0001355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2024]
Abstract
OBJECTIVES To pilot and assess the feasibility, acceptability, and preliminary effects of the Rural Adult and Youth Sun (RAYS) protection program, a multilevel skin cancer preventive intervention for young children living in rural U.S. communities, delivered through community-organized team sports. METHOD Three rural counties in Utah participated with two receiving the intervention and the third serving as a control. Youth sports leagues were recruited through recreation departments and the study took place from May through October 2021. Intervention leagues received sun protection supplies for players and coaches, educational materials for parents, and coaches were offered training on skin cancer and sun protection behaviors. RESULTS The RAYS program is both feasible to deliver and acceptable to coaches, parents, and players. The intervention also demonstrates beneficial preliminary effects on components of observed child sun-protective behaviors, coach sun protection behaviors, knowledge of skin cancer prevention recommendations, and self-efficacy in skin cancer prevention. CONCLUSIONS Multilevel interventions for skin cancer prevention among young children can be successfully delivered through community organizations and their settings. A priority moving forward is the identification of ways to optimize delivery of such programs to positively influence skin cancer preventive behaviors among children living in diverse rural areas. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
Collapse
Affiliation(s)
- Yelena P. Wu
- Department of Dermatology, University of Utah, Salt Lake City, Utah
- Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah
| | - Hannah L. Brady
- Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah
| | - Ali P. Wankier
- Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah
| | | | | | - Elise K. Brunsgaard
- Department of Dermatology, University of Utah, Salt Lake City, Utah
- Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah
| | - Jonathan Chipman
- Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah
- Department of Population Health Sciences, University of Utah, Salt Lake City, Utah
| | - Sarah DeSantis
- Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah
| | - Christiaan Abildso
- Department of Social and Behavioral Sciences, West Virginia University, Morgantown, West Virginia
| | - Benjamin Haaland
- Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah
- Department of Population Health Sciences, University of Utah, Salt Lake City, Utah
| | - Chelsey R. Schlechter
- Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah
- Department of Population Health Sciences, University of Utah, Salt Lake City, Utah
| | - David W. Wetter
- Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah
- Department of Population Health Sciences, University of Utah, Salt Lake City, Utah
| | - Kenneth P. Tercyak
- Georgetown University Lombardi Comprehensive Cancer Center, Washington, D.C
| |
Collapse
|
7
|
Von Seggern MJ, Rogers AE, Schenkelberg MA, Kellstedt DK, Welk GJ, High R, Dzewaltowski DA. Sociodemographic influences on youth sport participation and physical activity among children living within concentrated Hispanic/Latino rural communities. Front Public Health 2024; 12:1345635. [PMID: 38450148 PMCID: PMC10916700 DOI: 10.3389/fpubh.2024.1345635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Accepted: 02/06/2024] [Indexed: 03/08/2024] Open
Abstract
Introduction Lack of physical activity (PA) among children living in rural communities is a documented public health problem. Although studies have examined community conditions defined by a rural-urban dichotomy, few have investigated rural community conditions with a concentration of Hispanic/Latino people. This cross-sectional study examined sociodemographic characteristics associated with youth sport (YS) participation and daily PA among children living within concentrated Hispanic/Latino rural U.S. Midwest communities. Methods During spring 2022, 97% of 3rd-6th grade children (n = 281, aged approximately 8-12 years) attending school in rural Midwestern communities (n = 2) with >50% concentration of Hispanic students participated in the Wellscapes Project, a community randomized trial. Participants completed the Youth Activity Profile and supplemental National Survey of Children's Health questions assessing PA behaviors and YS participation. Caregivers of a subsample of children (n = 215; males, n = 93; females, n = 122) consented to pair their child's survey results with school enrollment records (e.g., free/reduced lunch status and race and ethnicity). Mixed models with community as a random effect examined main and interaction effects of grade, sex, ethnoracial status, and family income on YS participation and these sociodemographic characteristics and YS participation on daily moderate-to-vigorous PA (MVPA). Results Approximately half of children participated in YS. Non-Hispanic White children (n = 82) were over five times more likely to participate in YS than Hispanic peers (n = 133) (OR = 5.54, 95% CI = 2.64-11.61, p < 0.001). YS participants accumulated 8.3 ± 2.3 more minutes of daily MVPA than non-participants (p < 0.001). Sixth graders, females, and Hispanic children reported lower daily MVPA than comparison groups (p < 0.05). Significant interaction effects on daily MVPA between grade and ethnoracial status (F(3, 204) = 3.04, p = 0.030) were also found. Discussion Disparities in sport participation and PA outcomes based on sociodemographic characteristics exist among children living in ethnoracially diverse rural communities. Strategies to promote YS participation, including community structural changes, may help reduce PA disparities. The research provides valuable insights for policymakers, public health professionals, and community members to address YS participation barriers, not limited to cost, while considering other PA-promotion efforts to improve child population health.
Collapse
Affiliation(s)
- Mary J. Von Seggern
- Department of Health Promotion, College of Public Health, University of Nebraska Medical Center, Omaha, NE, United States
| | - Ann E. Rogers
- Department of Health Promotion, College of Public Health, University of Nebraska Medical Center, Omaha, NE, United States
| | - Michaela A. Schenkelberg
- School of Health and Kinesiology, College of Education, Health, and Human Sciences, University of Nebraska at Omaha, Omaha, NE, United States
| | - Debra K. Kellstedt
- Texas A&M AgriLife Extension, Family and Community Health, Texas A&M University, College Station, TX, United States
| | - Gregory J. Welk
- Department of Kinesiology, College of Human Sciences, Iowa State University, Ames, IA, United States
| | - Robin High
- Department of Biostatistics, College of Public Health, University of Nebraska Medical Center, Omaha, NE, United States
| | - David A. Dzewaltowski
- Department of Health Promotion, College of Public Health, University of Nebraska Medical Center, Omaha, NE, United States
| |
Collapse
|
8
|
Kliethermes SA, Asif IM, Blauwet C, Christensen L, Coleman N, Lavallee ME, Moeller JL, Phillips SF, Rao A, Rizzone KH, Sund S, Tanji JL, Tuakli-Wosornu YA, Stafford CD. Focus areas and methodological characteristics of North American-based health disparity research in sports medicine: a scoping review. Br J Sports Med 2024; 58:164-171. [PMID: 38216322 PMCID: PMC10961938 DOI: 10.1136/bjsports-2023-107607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/22/2023] [Indexed: 01/14/2024]
Abstract
OBJECTIVE Health disparities are widely prevalent; however, little has been done to examine and address their causes and effects in sports and exercise medicine (SEM). We aimed to summarise the focus areas and methodology used for existing North American health disparity research in SEM and to identify gaps in the evidence base. DESIGN Scoping review. DATA SOURCES Systematic literature search of PubMed, Scopus, SPORTDiscus, CINAHL Plus with Full Text, Web of Science Core Collection and Cochrane Central Register of Controlled Trials. ELIGIBILITY CRITERIA Full-text, peer-reviewed manuscripts of primary research, conducted in North America; published in the year 2000 or after, in English; and focusing on organised sports were included. RESULTS 103 articles met inclusion criteria. Articles were classified into five focus areas: access to and participation in sports (n=45), access to SEM care (n=28), health-related outcomes in SEM (n=24), provider representation in SEM (n=5) and methodology (n=1). Race/ethnicity (n=39), socioeconomic status (n=28) and sex (n=27) were the most studied potential causes of health disparities, whereas sexual orientation (n=5), location (rural/urban/suburban, n=5), education level (n=5), body composition (n=5), gender identity (n=4) and language (n=2) were the least studied. Most articles (n=74) were cross-sectional, conducted on youth (n=55) and originated in the USA (n=90). CONCLUSION Health disparity research relevant to SEM in North America is limited. The overall volume and breadth of research required to identify patterns in a heterogeneous sports landscape, which can then be used to inform positive change, need expansion. Intentional research focused on assessing the intersectionality, causes and consequences of health disparities in SEM is necessary.
Collapse
Affiliation(s)
- Stephanie A Kliethermes
- Department of Orthopedics and Rehabilitation, University of Wisconsin-Madison, Madison, Wisconsin, USA
- The American Medical Society For Sports Medicine, Leawood, Kansas, USA
| | - Irfan M Asif
- Family and Community Medicine, The University of Alabama at Birmingham Heersink School of Medicine, Birmingham, Alabama, USA
| | - Cheri Blauwet
- Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation; Spaulding Hospital/Brigham and Women's Hospital, Harvard Medical School, Charlestown, Massachusetts, USA
- Kelley Adaptive Sports Research Institute, Boston, Massachusetts, USA
| | - Leslie Christensen
- Department of Library Science, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Nailah Coleman
- Pediatric Primary Care, Children's National Hospital, Washington, District of Columbia, USA
| | - Mark E Lavallee
- Department of Orthopedics, UPMC, Harrisburg, Pennsylvania, USA
| | - James L Moeller
- Orthopaedic Surgery, West Virginia University, Morgantown, West Virginia, USA
| | - Shawn F Phillips
- Department of Family and Community Medicine, Penn State Health, Mount Joy, Pennsylvania, USA
| | - Ashwin Rao
- Family Medicine, University of Washington, Seattle, Washington, USA
| | - Katherine H Rizzone
- Orthopaedics, University of Rochester Medical Center, Rochester, New York, USA
| | - Sarah Sund
- The American Medical Society For Sports Medicine, Leawood, Kansas, USA
| | - Jeffrey L Tanji
- Orthopedics, UC Davis Sports Medicine, Sacramento, California, USA
| | - Yetsa A Tuakli-Wosornu
- Chronic Disease Epidemiology, Yale University School of Public Health, New Haven, Connecticut, USA
| | - Cleo D Stafford
- Department of Orthopaedics and Rehabilitations Medicine, Emory University School of Medicine, Atlanta, Georgia, USA
| |
Collapse
|
9
|
Johnson AM, Bocarro JN, Saelens BE. Youth Sport Participation by Metropolitan Status: 2018-2019 National Survey of Children's Health (NSCH). RESEARCH QUARTERLY FOR EXERCISE AND SPORT 2023; 94:895-904. [PMID: 35580038 DOI: 10.1080/02701367.2022.2069662] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Accepted: 04/18/2022] [Indexed: 06/15/2023]
Abstract
Purpose: This cross-sectional study used data from the 2018-2019 National Survey of Children's Health to examine the association between metropolitan statistical area (MSA) status and sports participation among American youth ages 6-17. Methods: Weighted prevalence statistics were computed for sports participation by MSA status (non-MSA, MSA), overall and by child sex and age. Modified Poisson regression was used to estimate prevalence ratios (PR) for non-MSA versus MSA youth, before and after adjusting for special health-care needs, race/ethnicity, household income, parent education, and family structure. Results: The final sample included 30,029 youth [Mage = 11.6 years (SD = 0.4), 51.4% female, 49.0% White]. About 56% participated in sports in the past year. Sports participation was significantly higher among females versus males [59.1% (95% CI: 57.4%-60.7%) versus 52.1% (95% CI: 50.4%-53.8%), p < .001]. Among ages 6-11, those in non-MSAs (versus MSAs) were less likely to participate in sports [PR 0.92 (95% CI: 0.86-0.99), p = .033], which was non-significant after adjustment. In adjusted models, youth ages 12-17 in non-MSAs (versus in MSAs) were more likely to participate in sports overall [aPR 1.07 (95% CI: 1.00-1.15), p = .042] and among males [aPR 1.12 (95% CI: 1.01-1.23), p = .026]. Conclusion: The relationship between MSA status and sports participation may be largely driven by factors that affect youth's ability to participate in sports. Sports participation was higher among females versus males overall. In the models adjusted for demographics, non-MSA youth ages 12-17 were more likely to participate, particularly males. Efforts promoting youth sports should consider differences in socio-demographic factors between MSA versus non-MSA areas to help increase participation.
Collapse
Affiliation(s)
| | | | - Brian E Saelens
- Seattle Children's Research Institute
- University of Washington
| |
Collapse
|
10
|
Johnson AM, Knell G, Walker TJ, Kroshus E. Differences in American adolescent sport participation during the COVID-19 pandemic by learning mode: A national survey. Prev Med Rep 2023; 32:102151. [PMID: 36820265 PMCID: PMC9933460 DOI: 10.1016/j.pmedr.2023.102151] [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: 08/22/2022] [Revised: 01/19/2023] [Accepted: 02/14/2023] [Indexed: 02/18/2023] Open
Abstract
This study aimed to examine the relation between learning mode with sport participation and compare participation prevalence in different settings by learning mode among United States adolescents during the COVID-19 pandemic. A cross-sectional, national survey was conducted by a market research company (December 2021-January 2022) among parents whose child participated in sports pre-pandemic. Parents were asked about their child's learning mode (in-person, online, hybrid); sports participation (yes/no) during the pandemic; and participation setting (school, community, club/elite). Weighted logistic regression models examined the relation between learning mode with sport participation. Weighted prevalence estimates of participation setting were compared by learning mode. Among youth included in the analysis (n = 500; Meanage = 14.0 years), 71.0% played sports during the pandemic. Learning mode was significantly associated with participating (versus not participating) among adolescents attending school online (aOR = 0.09; 95% CI: 0.04-0.18) and in a hybrid modality (aOR = 0.30; 95% CI: 0.15-0.58) versus those attending in-person. Those attending school online (versus in-person or hybrid) had significantly lower participation prevalence in community, school, and club/elite sports. Findings may reflect parents opting out of in-person activities or schools canceling organized sport opportunities. To inform engagement strategies, research is needed to understand reasons for declined participation and extent to which participation resumed.
Collapse
Affiliation(s)
- Ashleigh M. Johnson
- Work conducted while at the Center for Child Health, Behavior, and Development, Seattle Children’s Research Institute, Seattle, WA, USA,Corresponding author at: 5499 Aztec Bowl, San Diego, CA 92182, USA.
| | - Gregory Knell
- Department of Epidemiology, Human Genetics, and Environmental Sciences, The University of Texas Health Science Center at Houston School of Public Health, Dallas, TX, USA,Center for Pediatric Population Health, The University of Texas Health Science Center at Houston, Dallas, TX, USA,Children’s Health Andrews Institute for Orthopaedics and Sports Medicine, Plano, TX, USA
| | - Timothy J. Walker
- Department of Health Promotion & Behavioral Sciences, Center for Health Promotion and Prevention Research, The University of Texas Health Science Center at Houston School of Public Health, Houston, TX, USA
| | - Emily Kroshus
- Work conducted while at the Center for Child Health, Behavior, and Development, Seattle Children’s Research Institute, Seattle, WA, USA,Department of Pediatrics, University of Washington, Seattle, WA, USA
| |
Collapse
|
11
|
Stoepker P, Biber D, Davis A, Welk GJ, Meyer A. Contextualizing Adolescent Female Physical Activity Behavior: A Descriptive Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3125. [PMID: 36833821 PMCID: PMC9960919 DOI: 10.3390/ijerph20043125] [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: 01/04/2023] [Revised: 02/07/2023] [Accepted: 02/08/2023] [Indexed: 06/18/2023]
Abstract
Physical activity (PA) behavior tends to decline as youth get older, especially in female adolescents. The purpose of this study was to develop an understanding of female adolescent moderate-to-vigorous physical activity (MVPA) behavior. Baseline MVPA data was collected during year one of a female-specific PA related program. The Youth Activity Profile was administered to contextualize current middle school female PA levels. Data were collected on over 600 6th-8th grade youths with even distributions by grade. No significant differences between grade, race/ethnicity, and MVPA minutes were found. The average estimated value for daily MVPA across all grades was 43.93 (+/-12.97) min, which is considerably lower than the public health recommendation of 60 min per days. Similar amounts were observed for weekend days 45.03 (+/-19.98) and weekdays 45.50 (+/-13.14); however, allocations were smaller during school (9.45 +/- 5.13 min) than at home (34.04 +/- 11.15). The findings from this study highlight the need for further investigation in developing sustainable and innovative PA interventions that target adolescent females.
Collapse
Affiliation(s)
- Peter Stoepker
- Department of Kinesiology, Kansas State University, Manhattan, KS 66506, USA
| | - Duke Biber
- Department of Health Promotion & Physical Education, Kennesaw State University, Kennesaw, GA 30144, USA
| | - Ashlee Davis
- Department of Sport Management, Wellness, & Physical Education, University of West Georgia, Carrollton, GA 75006, USA
| | - Gregory J. Welk
- Department of Kinesiology, Iowa State University, Ames, IA 50011, USA
| | | |
Collapse
|
12
|
Vieira D, Gomes EC, Negrão ÂS, Thuany M, Gomes TN. Movement Behaviour and Health Outcomes in Rural Children: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2514. [PMID: 36767880 PMCID: PMC9915981 DOI: 10.3390/ijerph20032514] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/11/2022] [Revised: 01/27/2023] [Accepted: 01/28/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Studies with rural children are limited, and results are divergent regarding the information on movement behaviours. PURPOSE to (i) describe the physical activity and sedentary behaviour in children; (ii) synthetize the year and place of publication, methodological quality, and instruments used to measure physical activity and sedentary behaviour; and (iii) to analyse the relationship between physical activity, sedentary behaviour, and health outcomes in these children. METHODS We use the databases PubMed, Web of Science, SPORTDiscus, Scopus, Virtual Health Library, and SciELO, considering papers published until October 2021. A total of 12,196 studies were identified, and after the exclusion of duplicate, title and abstract screening, and the full-text assessment, a total of 68 were included in the study. RESULTS A cross-sectional design was dominant among the studies, with sample sizes ranging from 23 to 44,631 children of both sexes. One-third of the studies were conducted in North America and Europe, and most of them used device-based measurements. Inequalities were observed regarding sex, age, economic level, race, and physical activity domains within and between the places of residence. Sociodemographic characteristics were also related to health outcomes for children living in rural and urban areas. CONCLUSION It is necessary to increase the evidence on movement behaviours among children living in the countries of South America and Oceania, as well as to increase the level of evidence on the role of school for physical activity in children in rural areas, given the inconsistent findings.
Collapse
Affiliation(s)
- Douglas Vieira
- Post-Graduation Program of Physical Education, Department of Physical Education, Federal University of Sergipe, São Cristóvão 49100-000, Brazil
| | - Elenir Campelo Gomes
- Post-Graduation Program of Human Movement Sciences, Federal University of Pará, Belém 66075-110, Brazil
| | - Ângelo Solano Negrão
- Post-Graduation Program of Anthropic Studies in the Amazon, Federal University of Pará, Belém 66075-110, Brazil
| | - Mabliny Thuany
- Centre of Research, Education, Innovation and Intervention in Sport (CIFI2D), Faculty of Sport, University of Porto, 4200-450 Porto, Portugal
| | - Thayse Natacha Gomes
- Post-Graduation Program of Physical Education, Department of Physical Education, Federal University of Sergipe, São Cristóvão 49100-000, Brazil
- Department of Physical Education and Sports Science, University of Limerick, V94 T9PX Limerick, Ireland
- Physical Activity for Health Cluster, Health Research Institute, University of Limerick, V94 T9PX Limerick, Ireland
| |
Collapse
|
13
|
Song Y, Shi C. Association between sports participation and overall health in children and adolescents. Complement Ther Clin Pract 2022; 51:101718. [PMID: 36801646 DOI: 10.1016/j.ctcp.2022.101718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 12/12/2022] [Accepted: 12/15/2022] [Indexed: 12/23/2022]
Abstract
Emerging evidence revealed that participating in sports may have benefits for health, but the association between sports participation and self-rated overall health has not been clearly established in children and adolescents. The present study aimed to examine the cross-sectional relationships between sports participation and self-rated overall health. A national sample of 42,777 (mean age = 9.4 ± 5.2, 48.3% girls) United States children and adolescents completed self-administered questionnaires and were included in the final analysis. The crude and adjusted odds ratio (ORs) and 95% CI were used to analyze the association between sports participation and self-rated overall health. Results indicated that children and adolescents participated in sports were more likely to report better overall health (OR = 1.92, 95%CI: 1.83, 2.02) compared to those not participating in sports. This study found that sport participation was positively associated with self-rated overall health in children and adolescents. This study offers evidence concerning adolescents' health literacy promotion.
Collapse
Affiliation(s)
- Yagang Song
- Department of Physical Education Teaching, Shanghai Sanda University, 201209, Shanghai, China
| | - Chongyan Shi
- School of Physical Education and Humanity, Nanjing Sport Institute, 210014, Nan Jing, China.
| |
Collapse
|
14
|
Lin L, Liu Q, Xiao X, Luo Q. Perceived Constraints on Active Recreational Sport Participation among Residents in Urban China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14884. [PMID: 36429601 PMCID: PMC9690259 DOI: 10.3390/ijerph192214884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Revised: 11/02/2022] [Accepted: 11/10/2022] [Indexed: 06/16/2023]
Abstract
Recreational sport participation is an important pathway to improving the quality of life. While facilities for recreational sports are provided in many urban areas in China, how urban residents might be aware of or use these facilities for recreational sport participation is still a vague notion in the literature. This study explored the linkages between perceived leisure constraints and active participation in recreational sports among urban residents. We collected data samples from 2901 urban residents in China to identify their perceived constraints and the effects of the perceived constraints on active recreational sport participation by structural equation models. Five perceived constraints of active recreational sport participation were identified: intrapersonal, interpersonal, environmental condition, facility-service management, and leisure opportunity constraints. More specifically, leisure opportunity, intrapersonal, facility-service management, and interpersonal constraints were the four most important constraints limiting active recreational sport participation of urban residents. Theoretical and practical implications to facilitate the active recreational sport participation of Chinese urban residents were discussed.
Collapse
Affiliation(s)
- Lan Lin
- School of Geographical Sciences, Institute of Tourism, Fujian Normal University, Fuzhou 350117, China
| | - Qun Liu
- School of Geographical Sciences, Institute of Tourism, Fujian Normal University, Fuzhou 350117, China
| | - Xiao Xiao
- School of Community Resources and Development, Arizona State University, Phoenix, AZ 85004, USA
| | - Qin Luo
- School of Geographical Sciences, Institute of Tourism, Fujian Normal University, Fuzhou 350117, China
| |
Collapse
|