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Jackson R, Jordan JT. Reliable change in developmental outcomes of Brain Balance ® participants stratified by baseline severity. Front Psychol 2023; 14:1171936. [PMID: 37674742 PMCID: PMC10478577 DOI: 10.3389/fpsyg.2023.1171936] [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: 03/10/2023] [Accepted: 08/04/2023] [Indexed: 09/08/2023] Open
Abstract
The effects of comprehensive multimodal programs on developmental outcomes have not been well-studied. Emerging evidence suggests a possible role for the Brain Balance® (BB) program, a multimodal training program, in serving as a nonpharmacologic approach to addressing cognitive, attentional, and emotional issues in youth. In this analysis, we examined the effects of 3 months of participation in the BB program on the outcomes of children and adolescents with developmental difficulties (N = 4,041; aged 4-18 years; 69.7% male). Parent-rated scores on the Brain Balance-Multidomain Developmental Survey (BB-MDS) were used to assess six areas at baseline and post-program: (1) negative emotionality; (2) reading/writing difficulties; (3) hyperactive/disruptive behavior; (4) academic disengagement; (5) motor/coordination problems; and (6) social communication problems. To estimate change from pre- to post-program, we calculated effect size (Cohen's d) and the Reliable Change Index (RCI) for groups stratified by baseline severity. There was a very large effect size for the moderate/high severity (d = 1.63) and extreme severity (d = 2.08) groups, and a large effect size for the mild severity group (d = 0.87). The average percentage of participants who observed reliable change over all BB-MDS domains was 60.1% (RCICTT) for extreme severity, 46.6% (RCICTT) for moderate/high severity, and 21.1% (RCICTT) for baseline mild severity. In additional assessments of primitive reflexes and sensory motor activity, students demonstrated significantly diminished primitive reflexes from pre- to post-participation and significant improvements in sensory motor skills including fine motor skills, gait and aerobic ability, proprioception, rhythm and timing, and eye-gaze stability. Overall, these results demonstrate improvements in primitive reflex integration and sensory motor skills, as well as statistically significant reliable change in emotionality, reading/writing, behavior, academic engagement, motor skills, and social communication in BB participants from pre- to post-program, with the probability and degree of change increasing as the participants' baseline severity increases. These results contribute to the growing literature on the need for evidence-based nonpharmacologic approaches to addressing developmental issues. Future research with well-controlled designs, longitudinal follow-up, implementation across settings, and participant groups in which diagnoses are known, will help to more fully characterize the effects of the BB program.
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Affiliation(s)
- Rebecca Jackson
- Brain Balance Achievement Centers, Naperville, IL, United States
| | - Joshua T. Jordan
- Department of Psychology, Dominican University of California, San Rafael, CA, United States
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Neshteruk C, Burkart S, Flanagan EW, Melnick E, Luecking C, Kracht CL. Policy, systems, and environmental interventions addressing physical activity in early childhood education settings: A systematic review. Prev Med 2023; 173:107606. [PMID: 37414226 PMCID: PMC10699121 DOI: 10.1016/j.ypmed.2023.107606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2023] [Revised: 05/30/2023] [Accepted: 07/02/2023] [Indexed: 07/08/2023]
Abstract
Policy, systems, and environmental (PSE) approaches can facilitate physical activity in priority populations (e.g., racial and ethnic minority, low wealth groups) within early childhood education (ECE) settings. The purpose of this review was to 1) characterize the inclusion of priority populations within ECE physical activity interventions containing PSE approaches and 2) identify and describe interventions within these populations. Seven databases were systematically searched (January 2000-Febrary 2022) for ECE-based interventions focusing on children (0-6 years) that utilized at least one PSE approach. Eligible studies included a child physical activity or physical activity environment outcome and child or center-level population characteristics. Forty-four studies, representing 42 interventions were identified. For Aim 1, half of interventions included one PSE approach (21/42), with only 11/42 including three or more approaches. Physical environment changes [e.g., adding play equipment, modifying space (25/42)] were the most used PSE approaches followed by system [e.g., integrating activity into routines, (21/42)] and policy [e.g., outdoor time (20/42)] approaches. Nearly half of interventions were conducted in predominantly priority populations (18/42). Studies were primarily rated as good (51%) or fair (38%) methodological quality using the Downs and Black checklist. In Aim 2, of the 12 interventions assessing child physical activity in priority populations, 9/12 reported at least one physical activity outcome in the expected direction. Of the 11 interventions assessing the physical activity environment, 9/11 reported an effect in the expected direction. Findings indicate clear opportunities exist to target priority populations by incorporating PSE approaches in ECE physical activity interventions.
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Affiliation(s)
- Cody Neshteruk
- Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, United States of America.
| | - Sarah Burkart
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States of America
| | - Emily W Flanagan
- Pennington Biomedical Research Center, 6400 Perkins Road, Baton Rouge, LA 70808, United States of America
| | - Emily Melnick
- College of Health Solutions, Arizona State University, Phoenix, AZ, United States of America
| | - Courtney Luecking
- Department of Dietetics and Human Nutrition, College of Agriculture, Food and Environment, University of Kentucky, Lexington, KY, United States of America
| | - Chelsea L Kracht
- Pennington Biomedical Research Center, 6400 Perkins Road, Baton Rouge, LA 70808, United States of America
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Jakobovich R, Berry EM, Levita A, Levin-Zamir D. Developing Healthy Lifestyle Behaviors in Early Age-An Intervention Study in Kindergartens. Nutrients 2023; 15:nu15112615. [PMID: 37299578 DOI: 10.3390/nu15112615] [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: 01/30/2023] [Revised: 05/21/2023] [Accepted: 05/24/2023] [Indexed: 06/12/2023] Open
Abstract
Childhood obesity prevention is a leading public health challenge requiring the adoption of healthy lifestyles at an early age. We examined how the kindergarten environment can promote eating sensibly, drinking water and becoming physically active. The effects of an intervention program among 42 Israeli kindergartens (1048 children, aged 4-6) whose teachers participated in a health education training program were compared to 32 kindergartens (842 children) whose teachers did not undergo this training program. An eight-month intervention program focused on knowledge/mathematical/logical/critical thinking, self-regulation/control acquisition, and sensible decision-making abilities. We hypothesized that nutrition and physical-exercise-oriented intervention programs, combining knowledge/mathematical logical thinking, would positively impact the quality of children's mid-morning snack and water consumption, their ability to express feelings following physical exercise, and the adoption of healthy lifestyles at home. The quality of mid-morning snacks and water consumption were observed in both groups pre- and post-intervention. Qualitative interviews documented children's subjective feelings following physical exercise. A significant improvement (p < 0.001) was observed in the mid-morning snacks composition and in water drinking habits in the intervention group; 80% of children offered a physiological explanation regarding energy expenditure processes following intense physical exercise. In conclusion, kindergarten interventions implemented by trained teachers can promote adoption of health behaviors necessary for obesity prevention.
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Affiliation(s)
- Ronit Jakobovich
- Department of Health Promotion, School of Public Health, Tel Aviv University, Tel Aviv 6209804, Israel
| | - Elliot M Berry
- Department of Human Nutrition and Metabolism, Braun School of Public Health, Hebrew University Hadassah Medical School, Jerusalem 9103102, Israel
| | - Asia Levita
- Faculty of Science and Technology Education, Technion, Haifa 3498838, Israel
| | - Diane Levin-Zamir
- School of Public Health, University of Haifa, Haifa 3498838, Israel
- Department of Health Education and Promotion, Clalit Health Services, School of Public Health, University of Haifa, Tel Aviv 6209804, Israel
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Wang G, Zeng D, Zhang S, Hao Y, Zhang D, Liu Y. The Effect of Different Physical Exercise Programs on Physical Fitness among Preschool Children: A Cluster-Randomized Controlled Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4254. [PMID: 36901266 PMCID: PMC10002293 DOI: 10.3390/ijerph20054254] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Revised: 02/24/2023] [Accepted: 02/24/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Preschool children are in a period of rapid physical and psychological development, and improving their level of physical fitness is important for their health. To better develop the physical fitness of preschool children, it is very important to understand the behavioral attributes that promote the physical fitness of preschool children. This study aimed to determine the effectiveness of and the differences between different physical exercise programs in improving preschool children's physical fitness. METHODS A total of 309 preschool children aged 4-5 years were recruited from 5 kindergartens to participate in the experiment. They were cluster-randomly allocated into five groups: basic movements (BM) group, rhythm activities (RA) group, ball games (BG) group, multiple activities (MA) group, and control (CG) group. The intervention groups received designed physical exercise programs with a duration of 30 min 3 times per week for 16 weeks. The CG group received unorganized physical activity (PA) with no interventions. The physical fitness of preschool children was measured using the PREFIT battery before and after the interventions. One-way analysis of variance, a nonparametric test; generalized linear models (GLM); and generalized linear mixed models (GLMM) were used to examine differences during the pre-experimental stage among groups and to assess the differential effects of the intervention conditions on all outcome indicators. The intervention condition models were adjusted for potential confounders (baseline test results, age, gender, height, weight, and body mass index) explaining the main outcome variance. RESULTS The final sample consisted of 253 participants (girls 46.3%) with an average age of 4.55 ± 0.28 years: the BG group (n = 55), the RA group (n = 52), the BM group (n = 45), the MA group (n = 44), and the CG group (n = 57). The results of the generalized linear mixed model and generalized linear model analyses indicated significant differences for all physical fitness tests between groups, except for the 20 m shuttle run test and the sit-and-reach test after the interventions. Grip strength was significantly higher in the BG and MA groups than in the BM group. The scores for standing long jump were significantly higher in the MA group than in the other groups. The scores for the 10 m shuttle run test were significantly lower in the BG and MA groups than in the CG, BM, and RA groups. The scores for skip jump were significantly lower in the BG and MA groups than in the RA group. The scores for balance beam were significantly lower in the BG and MA groups than in the RA group and significantly lower in the BG group than in the BM group. The scores for standing on one foot were significantly higher in the BG and MA groups than in the CG and RA groups and significantly higher in the BM group than in the CG group. CONCLUSIONS Physical exercise programs designed for preschool physical education have positive effects on the physical fitness of preschool children. Compared with the exercise programs with a single project and action form, the comprehensive exercise programs with multiple action forms can better improve the physical fitness of preschool children.
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Affiliation(s)
- Guangxu Wang
- School of Physical Education, Shanghai University of Sport, Shanghai 200438, China
- College of Physical Education, Henan Normal University, Xinxiang 453007, China
| | - Dan Zeng
- College of Physical Education, Henan Normal University, Xinxiang 453007, China
- National Institute of Sports Medicine, Beijing Sport University, Beijing 100084, China
| | - Shikun Zhang
- School of Physical Education, Shanghai University of Sport, Shanghai 200438, China
| | - Yingying Hao
- School of Exercise and Health, Shanghai University of Sport, Shanghai 200438, China
| | - Danqing Zhang
- School of Physical Education, Shanghai University of Sport, Shanghai 200438, China
| | - Yang Liu
- School of Physical Education, Shanghai University of Sport, Shanghai 200438, China
- Shanghai Research Center for Physical Fitness and Health of Children and Adolescents, Shanghai University of Sport, Shanghai 200438, China
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Basterfield L, Machaira T, Jones D, Rapley T, Araujo-Soares V, Cameron N, Azevedo LB. Early Years Physical Activity and Motor Skills Intervention-A Feasibility Study to Evaluate an Existing Training Programme for Early Years Educators. CHILDREN (BASEL, SWITZERLAND) 2023; 10:children10010145. [PMID: 36670695 PMCID: PMC9856565 DOI: 10.3390/children10010145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 12/21/2022] [Accepted: 01/05/2023] [Indexed: 01/15/2023]
Abstract
A lack of fundamental motor skills (FMS) in the early years can lead to lower engagement with physical activity (PA), and track into adulthood. This study aimed to test the feasibility of an existing intervention for Early Years Educators ("Educators") designed to increase knowledge, confidence and the ability to increase PA and FMS of children in a deprived area of England. Non-randomised design with wait-list control. Sixty-seven settings in Middlesbrough, North East England were invited. Recruitment target: 10 settings, 2 Educators per setting, four children per Educator. INTERVENTION one-day training course "Physical Literacy in the Early Years", an age-appropriate theoretical and practical training course to support the development of physical literacy. PRIMARY OUTCOMES recruitment, retention, acceptability of intervention and outcome measures. SECONDARY OUTCOMES change in Educators' knowledge, intentions and behaviour, and change in children's BMI z-score, PA and FMS. Eight settings were recruited; all Intervention Educators completed the training. Six settings participated at follow-up (four Intervention, two Control). The target for Educator recruitment was met (two per setting, total n = 16). Questionnaires were completed by 80% of Intervention Educators at baseline, 20% at follow-up. Control Educators completed zero questionnaires. No Educators took part in a process evaluation interview. Forty-eight children participated at baseline, 28 at follow-up. The intervention was deemed acceptable. The recruitment, retention and acceptability of measurements were insufficient to recommend proceeding. Additional qualitative work is needed to understand and surmount the challenges posed by the implementation of the trial.
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Affiliation(s)
- Laura Basterfield
- Human Nutrition and Exercise Research Centre, and Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne NE2 4HH, UK
- Correspondence:
| | | | - Dan Jones
- SHLS Nursing & Midwifery, Teesside University, Middlesbrough TS1 3BX, UK
| | - Tim Rapley
- Department of Social Work, Education and Community Wellbeing, Northumbria University, Newcastle upon Tyne NE7 7XA, UK
| | - Vera Araujo-Soares
- Center for Preventive Medicine and Digital Health, Medical Faculty Mannheim, Heidelberg University, D-68167 Mannheim, Germany
| | - Neil Cameron
- SportWorks (North East) Ltd., North Shields NE29 6DE, UK
| | - Liane B. Azevedo
- School of Human and Health Sciences, University of Huddersfield, Huddersfield HD1 3DH, UK
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Specht IO, Larsen SC, Rohde JF, Østergaard JN, Heitmann BL. Comparison of Motor Difficulties Measured in the First Year of School among Children Who Attended Rural Outdoor or Urban Conventional Kindergartens. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14158. [PMID: 36361035 PMCID: PMC9653742 DOI: 10.3390/ijerph192114158] [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: 09/29/2022] [Revised: 10/26/2022] [Accepted: 10/26/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Kindergartens can potentially contribute substantially to the daily level of physical activity and development of motor skills and might be an ideal setting for improving these as a public health initiative. We aimed to examine whether children from rural outdoor kindergartens had a lower risk of motor difficulties than children from urban conventional kindergartens. METHODS Motor test results were measured during the first school year by school health nurses using a six-item test of gross- and fine motor skills (jumping, handle a writing tool, cutting with a scissor following a line, one-leg stand on each leg, throwing and grabbing). Register-based information was available on potential confounding factors. RESULTS We included 901 children from outdoor kindergartens and 993 from conventional kindergartens with a mean (SD) age of 6.5 years (0.4). The children from the two types of kindergarten differed according to demographic information, with outdoor kindergarten children more often being from more affluent families (long maternal education level: 47.5% vs. 31.0%, p < 0.0001) and fewer girls attending the outdoor kindergartens (42.7% vs. 49.5%, p = 0.003). In the adjusted models, we found no evidence of differences in the risk of motor difficulties between children attending either type of kindergarten (OR: 0.95, 95%CI: 0.71; 1.27, p = 0.72). CONCLUSION Our results do not support outdoor kindergartens as a potential intervention to improve motor abilities among children. Randomized controlled trials are needed to confirm these findings.
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Affiliation(s)
- Ina Olmer Specht
- Research Unit for Dietary Studies, The Parker Institute, Bispebjerg and Frederiksberg Hospital, The Capital Region, 2000 Frederiksberg, Denmark
| | - Sofus Christian Larsen
- Research Unit for Dietary Studies, The Parker Institute, Bispebjerg and Frederiksberg Hospital, The Capital Region, 2000 Frederiksberg, Denmark
| | - Jeanett Friis Rohde
- Research Unit for Dietary Studies, The Parker Institute, Bispebjerg and Frederiksberg Hospital, The Capital Region, 2000 Frederiksberg, Denmark
| | - Jane Nautrup Østergaard
- Steno Diabetes Center Aarhus, Aarhus University Hospital, Central Denmark Region, 8200 Aarhus, Denmark
| | - Berit Lilienthal Heitmann
- Research Unit for Dietary Studies, The Parker Institute, Bispebjerg and Frederiksberg Hospital, The Capital Region, 2000 Frederiksberg, Denmark
- The Boden Group, Faculty of Medicine and Health, Sydney University, Sydney, NSW 2006, Australia
- Section for General Practice, Department of Public Health, University of Copenhagen, 1165 Copenhagen, Denmark
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Faßbender DM, Kreffter K, Götz S, Hagemeister M, Lisak-Wahl S, Nguyen TH, Stemper T, Weyers S. Is the Level of Motor Development at School Entry Related to the Use of Municipal Exercise Programs? A Social-Differential Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:3047. [PMID: 35270739 PMCID: PMC8910425 DOI: 10.3390/ijerph19053047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 02/23/2022] [Accepted: 03/03/2022] [Indexed: 01/25/2023]
Abstract
Children's motor development is socially unevenly distributed despite many municipal exercise programs (EXP). It has not been sufficiently investigated whether and how they appeal to children from different social backgrounds. This study investigates the use of municipal EXP in preschool age and the association between participation and motor development considering social circumstances. In school entry health examinations, parents were asked about participating in various EXP (response = 65.5%; n = 6480). Motor development, i.e., body coordination and visual-motor coordination, were assessed by a social pediatric development screening, and social circumstances by migration background (MB) and parental education (PE). Poisson regression estimated adjusted Incidence Rate Ratios (IRR; 95% confidence interval, 95%-CI) for relationships between social circumstances and participation in programs and participation and body coordination/visual-motor coordination. Children with MB (IRR 0.73; 95%-CI 0.71-0.75) and low PE (IRR 0.45; 95%-CI 0.40-0.50) used EXP less often. Children participating less often have a finding in body- (IRR 0.76; 95%-CI 0.63-0.90) and visual-motor coordination (IRR 0.47; 95%-CI 0.35-0.62). Significant effects were found for children with and without MB and higher PE. Municipalities should make EXP more attractive for families with MB and low PE.
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Affiliation(s)
- Daniel M. Faßbender
- Faculty of Medicine, University Hospital Duesseldorf, Centre for Health and Society, Institute of Medical Sociology, Moorenstrasse 5, 40225 Duesseldorf, Germany; (S.G.); (M.H.); (S.W.)
| | - Katharina Kreffter
- Hamm-Lippstadt, University of Applied Sciences, Marker Allee 76-78, 59063 Hamm, Germany;
| | - Simon Götz
- Faculty of Medicine, University Hospital Duesseldorf, Centre for Health and Society, Institute of Medical Sociology, Moorenstrasse 5, 40225 Duesseldorf, Germany; (S.G.); (M.H.); (S.W.)
| | - Maurus Hagemeister
- Faculty of Medicine, University Hospital Duesseldorf, Centre for Health and Society, Institute of Medical Sociology, Moorenstrasse 5, 40225 Duesseldorf, Germany; (S.G.); (M.H.); (S.W.)
| | - Stefanie Lisak-Wahl
- Academy of Public Health Services, Kanzlerstrasse 4, 40472 Duesseldorf, Germany;
| | - Thuy Ha Nguyen
- IGES Institute, Friedrichstrasse 180, 10117 Berlin, Germany;
| | - Theodor Stemper
- School of Human and Social Sciences, University of Wuppertal, Sport Science, 42119 Wuppertal, Germany;
| | - Simone Weyers
- Faculty of Medicine, University Hospital Duesseldorf, Centre for Health and Society, Institute of Medical Sociology, Moorenstrasse 5, 40225 Duesseldorf, Germany; (S.G.); (M.H.); (S.W.)
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