Feasibility of implementing an outdoor walking break in Italian middle schools

School Children's Physical Activity and Preferred Activities during Outdoor Recess in Estonia: Using Accelerometers, Recess Observation, and Schoolyard Mapping

Studies about recess have found that children have higher physical activity (PA) during outdoor recess compared to indoor recess, and well-constructed schoolyards play an important role in stimulating PA in children. This study aimed at investigating the affordances of schoolyards and outdoor recess PA in two urban and two rural primary schools in Estonia. Schoolyards were described with the geographical mapping method, children's activities during outdoor recess were registered by using observations, and PA levels were measured with accelerometers. Students from grades two to six (8-13-year-olds) were included in the study. All observed schoolyards had different spaces including various ball game areas, climbing facilities, and slacklines. The natural environment dominated in the rural schools, and artificial surfaces dominated in the urban schools. Boys in the study tended to enjoy more sport-related activities, whereas girls preferred more social and less active activities. Students participating in outdoor recess spent about twice as much time (20.4%) on moderate-to-vigorous PA (MVPA) compared to indoor recess (9.5%), although boys were more active than girls (22.9% vs. 17.3%). All schoolyards afforded more MVPA during outdoor recess compared to indoor recess, whereas schoolyards with more space per child and natural environment elements generated more varied PA and higher MVPA. These findings confirm the importance of schoolyard design and quality for the variety and intensity of students' PA during outdoor recess.

The Most Active Child Is Not Always the Fittest: Physical Activity and Fitness Are Weakly Correlated

The present cross-sectional study aimed to evaluate the impact of physical activity level (PA) on physical fitness by controlling for individual characteristics in Italian children. A total of 329 children (girls n = 155, 42.6%; from five primary schools, 17 classes) aged 8-10 filled out the Physical Activity Questionnaire for Older Children (PAQ-C) to assess their PA level and performed anthropometric measurements (body mass, height, and BMI) and physical tests for measuring sprint (20 m sprint), cardiorespiratory fitness (shuttle-run test), balance (single-leg stance), handgrip strength (handgrip), lower-limb power (standing long-jump), peak force (countermovement jump), and low-back flexibility (sit-and-reach) skills. Linear mixed-effects models were applied to determine the relationship between physical fitness and PAQ-C score controlling for individual characteristics (i.e., gender, age, BMI). Results reported significant relationships between PAQ-C scores and sit-and-reach, shuttle-run, long-jump, and sprint tests. All considered physical tests were correlated with gender, age, and BMI, except for sit-and-reach from BMI. The variance in age, gender, BMI, and PAQ-C score accounted altogether for 30.0% of the variance in handgrip, 23.0% in single-leg stance, 26% in sit-and-reach, 36% in shuttle-run, 31% in long-jump, 34% in sprint, and 31% in countermovement jump. Therefore, the relationship between PA and fitness is not absolute and depends on the test and children's characteristics.

The Cut-Off Value for Classifying Active Italian Children Using the Corresponding National Version of the Physical Activity Questionnaire

The present study aimed to determine a cut-off value following the filling in of a questionnaire (PAQ-C-It) to identify active Italian children. One-hundred-twenty-nine primary school children (5 Piedmont schools; 47.3% female; mean age = 10 ± 1 years) wore an accelerometer (Actigraph wGT3X-BT) to objectively quantify individual moderate-to-vigorous physical activity during one week. Afterwards, the PAQ-C-It was filled in by participants. A ROC curve procedure was applied to obtain an active/non-active cut-off point. Spearman’s correlation coefficient was also applied to establish the relationship between the two parameters. According to the ROC analysis, the PAQ-C-It cut-off point value is identifiable at >2.75 to indicate active children (area under the curve = 0.62; standard error = 0.05; p = 0.025; coefficient intervals = 0.518−0.716; sensitivity = 0.592, specificity = 0.382), determining that 65 participants (55%) were non-active (mean PAQ-C-It value = 2.3 ± 0.4; active mean PAQ-C-It value = 3.3 ± 0.4). Spearman’s correlation coefficient results were significant but with a small effect size (rho = 0.214; p = 0.008). In conclusion, the present results suggest that the PAQ-C-It can be cautiously used as tool to practically classify active Italian children because of a non-solid relationship between respective accelerometer data and MVPA daily data.

The Role of Family Time Together in Meeting the Recommendation for Physical Activity among Primary School Children

Family time may have an influence on children’s physical activity (PA) participation or may contribute to increased sedentary behaviour. The aim of this paper was to examine whether spending family time is associated with the PA of children aged 10–11. Cross-sectional data on 158 primary school children (80 girls and 78 boys) with a mean age of 10.6 ± 0.49 years were collected. Weight and height were used to calculate body mass index. The level of moderate-to-vigorous physical activity (MVPA) was determined with a physical activity screening measure. Participants wore a Vivofit^® wrist band activity tracker to measure their daily number of steps. The Health Behaviour in School-Aged Children questionnaire was used to obtain information from children about the frequency of activities undertaken by the family. Analyses entailed descriptive statistics of the total sample and by gender, t-test, and the Mann–Whitney U-test to examine the gender differences and Spearman’s correlation coefficients. It was found that 32.3% of the children did not accomplish at least 60 min per day on ≥5 of the seven days and more than 75.9% of them did not accumulate at least 12,000 or more steps daily. More boys than girls tended to be sufficiently active and met the guideline of at least 60 min per day on ≥5 of the seven days (70.5% and 65.0%, respectively) or 12,000 steps per day (25.8% and 10.0%, respectively). The number of steps during the weekday was significantly and inversely associated both in girls and in boys with active family time (r = −0.27 and r = −0.25, respectively), and with total family time (r = −0.28) and non-active family time (r = −0.25) only in boys. Average MVPA was also inversely correlated with active family time (r = −0.31), non-active family time (r = −0.24), and total family time (r = −0.29) in boys. The correlation effect size values ranged between small to medium significant differences for these measures. The findings underscore the need for community-based PA programmes designed for whole families to meet the recommended PA of children and also to develop and promote active leisure activities among families.

The Daily Mile Is Able to Improve Cardiorespiratory Fitness When Practiced Three Times a Week

The Daily Mile is a promising initiative aimed at removing some of the barriers to physical activity in the school setting. This quasi-experimental study investigated the dose–effect of The Daily Mile on cardiorespiratory fitness, waist-to-height ratio, and body mass index (BMI) after a period of 3- and 6-months. A total of 279 students (mean age = 9 ± 1 years) participated in The Daily Mile while 269 students (mean age = 9 ± 1 years) did not (control group). A posteriori, the classes performing The Daily Mile on average two times per week were included in the 2_times subgroup, while those performing the activity on average three times per week in the 3_times subgroup. A significant difference was observed in favor of the experimental compared to the control group in the 6 Minute Run Test (F = 13.932, p = 0.008). Moreover, the improvement of the 6-minute run test was more pronounced for 3_times (effect size = 0.51) rather than for the 2_times subgroup (effect size = 0.29). No differences were observed in waist-to-height ratio and BMI scores. In conclusion, teachers are strongly recommended to implement The Daily Mile at least three times a week to see appreciable effects on cardiorespiratory fitness.

The Daily Mile: 15 Minutes Running Improves the Physical Fitness of Italian Primary School Children

The Daily Mile™ is an innovative school-based intervention that requires children to run or jog outside for 15 min at a self-selected pace during class time. Today, only one study has investigated the efficacy of The Daily Mile on physical fitness, which was conducted with Scottish children. Thus, we aimed to evaluate the feasibility and effectiveness of The Daily Mile in Italian primary schools. A total of 486 children participated in The Daily Mile for 3 months (experimental group), whereas 309 children continued their daily school routine (control group). The 6-min run test, standing long jump, body mass index, and waist-to-height ratio were assessed. Their teachers completed surveys for assessing the intervention acceptability. After correction for age and gender, significant group × time interactions were observed in the 6-min run test and standing long jump results. In the post-test period, the experimental group showed improvement in the 6-min run test and standing long jump results. Overall, the teachers were satisfied with the program and found it suitable for their school context and easy to implement. The Daily Mile was successfully implemented and smoothly accepted in the day routine of Italian primary schools.

The Daily Mile as a public health intervention: a rapid ethnographic assessment of uptake and implementation in South London, UK

Background

Existing evidence identifies health benefits for children of additional daily physical activity (PA) on a range of cardiovascular and metabolic outcomes. The Daily Mile (TDM) is a popular scheme designed to increase children’s PA within the school day. Emerging evidence indicates that participation in TDM can increase children’s PA, reduce sedentarism and reduce skinfold measures. However, little is known about the potential effects of TDM as a public health intervention, and the benefits and disbenefits that might flow from wider implementation in ‘real world’ settings.

Methods

We aimed to identify how TDM is being implemented in a naturalistic setting, and what implications this has for its potential impact on population health. We undertook a rapid ethnographic assessment of uptake and implementation in Lewisham, south London. Data included interviews (n = 22) and focus groups (n = 11) with stakeholders; observations of implementation in 12 classes; and analysis of routine data sources to identify school level factors associated with uptake.

Results

Of the 69 primary schools in one borough, 33 (48%) had adopted TDM by September 2018. There were no significant differences between adopters and non-adopters in mean school population size (means 377 vs 397, P = 0.70), mean percentage of children eligible for free school meals (16.2 vs 14.3%, P = 0.39), or mean percentage of children from Black and Minority Ethnic populations (76.3 vs 78.2%, P = 0.41). Addressing obesity was a key incentive for adoption, although a range of health and educational benefits were also hypothesised to accrue from participation. Mapping TDM to the TIDierR-PHP checklist to describe the intervention in practice identified that considerable adaption happened at the level of borough, school, class and pupil. Population health effects are likely to be influenced by the interaction of intervention and context at each of these levels.

Conclusions

Examining TDM in ‘real world’ settings surfaces adaptions and variations in implementation. This has implications for the likely effects of TDM, and points more broadly to an urgent need for more appropriate methods for evaluating public health impact and implementation in complex contexts.

Electronic supplementary material

The online version of this article (10.1186/s12889-019-7511-9) contains supplementary material, which is available to authorized users.

Using the School Environment to Promote Walking amongst Adolescent Females: A Mixed-Method Study

Schools have the potential to promote physical activity (PA) in adolescents through physical education (PE) and extra-curricular PA. The aims of this study were to firstly understand the experiences of adolescent females who participated in a school-based walking programme (the Walking In ScHools (WISH) study) and secondly, to assess the potential for schools to further promote PA outside of structured PE. A sample of female participants (n = 45, mean age 13.1 years) who participated in the WISH study were randomly selected to participate in focus group discussions, to explore their experiences of the intervention. In addition, an online survey was distributed to all post-primary schools (n = 208) in Northern Ireland to assess the provision of extra-curricular PA and further evaluate the feasibility of the WISH study. In total, six focus groups were conducted. Walking during the school day was viewed as an acceptable form of PA by adolescent females, providing an opportunity to be active with friends, and helped participants overcome barriers previously associated with being active at school. Responding schools (n = 59) identified adolescent females and non-sporty pupils as sub-groups who would benefit most from participation in a school-based walking programme. This study has highlighted that the delivery of a walking programme within the school setting is acceptable, warranted and practically feasible from the point of view of adolescent females and key stakeholders within the school setting.

The Daily Mile: teachers' perspectives of the barriers and facilitators to the delivery of a school-based physical activity intervention

OBJECTIVES

Children spend a significant amount of their time in a school environment, often engaged in sedentary activities. The Daily Mile is a physical activity intervention which aims to increase physical activity and fitness in children through the completion of an outdoor teacher-led walk or run during the school day. This study aimed to explore the barriers, facilitators and perceived benefits of the Daily Mile from the perspectives of teachers through the use of qualitative semi-structured interviews. It also aimed to identify important context-specific factors, which might require consideration for those who intend to adopt the Daily Mile.

SETTING

Eight Local Authority primary schools in the City of Edinburgh and East Lothian, UK.

PARTICIPANTS

Thirteen teachers (eleven women) who teach children in primaries one to seven in a school which delivered the Daily Mile.

RESULTS

Data were analysed using an interpretative thematic analysis. Teachers were positive and enthusiastic about the Daily Mile and perceived it to be beneficial to children's health and fitness. A number of barriers to participation were identified including inadequate all-weather running surfaces and time constraints in an already full school curriculum. The perceived impact on learning time was identified as a concern for teachers, while other benefits were also identified including increased teacher-child rapport and perceived enhanced classroom concentration levels.

CONCLUSION

The Daily Mile appears to be a valuable addition to the school day, however important context-specific barriers to delivery of the Daily Mile exist, which should be considered when implementing the Daily Mile in schools.

Participation in a school-based walking intervention changes the motivation to undertake physical activity in middle-school students

The motivation to perform physical activity is a crucial factor in achieving a persistent active lifestyle. However, motivation decreases with increasing age from childhood to adolescence. The promotion of physical activity in educational settings might be an important tool to increase motivation and, consequently, to decrease sedentary behavior. The aim of this study was to explore the effect of a 4-month school-based walking intervention on motivation to participate in physical activity among Italian middle-school students. This study included 276 students (mean age 13 ± 1 years, 41.3% female). A total of 138 students (intervention group) participated in a brief walking intervention that was added to their routine daily school activity, while a convenience sample of 138 students performed the routine daily school activity. The activity consisted of walking one kilometer outside of school buildings during the morning break. Motivation data were collected before and after the walking breaks using the Participation Motivation Questionnaire (PMQ). Controlling for age, significant interactions between group and time were observed in the "Social Status" [F(1,273) = 4.851; p = 0.028], "Team" [F(1,273) = 6.015; p = 0.015] and "Energy Release" components [F(1,273) = 8.527; p = 0.038]. Specifically, a significant decrease in the "Social Status" components of the PMQ and an increase in the "Team" and "Energy Release" components were observed in the intervention group. On the contrary. control group showed an increase in "Social Status" and a decrease in the "Team" and "Energy Release" components. Within this developmental context, incorporation of the walking activity helped to modify the motivational orientation towards physical activity to include more intrinsic factors, which were related to the possibility of remaining with classmates and peer groups and releasing a surplus of energy.