Moderating Effects of Physical Activity on the Relationship between Adverse Childhood Experiences and Health-Related Quality of Life

Move & Thrive: Development of a Web-Based Training for Schools About Trauma-Informed Physical Activity

BACKGROUND

Youth who have experienced trauma or other adverse childhood events have the potential to uniquely benefit from physical activity (PA). However, how PA is administered in schools can be re-traumatizing and fail to create positive experiences through movement. We sought to develop role-specific training to help increase the implementation of trauma-informed PA.

METHODS

Guided by intervention mapping methodology, we developed "Move & Thrive"-a brief web-based training about trauma-informed PA. We then conducted a pilot evaluation of this training using a pre-posttest design with no control group in a sample of youth sport coaches, parents of school-aged children, and teachers (n = 150) recruited from an online opt-in non-probability panel.

RESULTS

Mixed methods feedback found that "Move & Thrive" was highly acceptable. Across all roles (coaches, teachers, and parents/guardians) there were statistically significant increases in all targeted implementation determinants (knowledge, attitudes, self-efficacy, and perceived resources/support), with moderate to large effect sizes.

CONCLUSIONS

These results provide the foundation for a larger, adequately powered trial with randomization and follow-up to assess the implementation of trauma-informed PA.

Associations Between Adverse Childhood Experiences and Early Adolescent Physical Activity in the United States

OBJECTIVE

To determine the associations between the number of adverse childhood experiences (ACEs) and objectively-measured physical activity (PA) in a population-based, demographically diverse cohort of 9-14-year-olds and to determine which subtypes of ACEs were associated with physical activity levels.

METHODS

We analyzed data (n = 7046) from the Adolescent Brain Cognitive Development (ABCD) Study 4.0 release at baseline and year 2 follow-up. ACE (cumulative score and subtypes) and physical activity (average Fitbit daily steps assessed at Year 2) were analyzed using linear regression analyses. Covariates included race and ethnicity, sex, household income, parent education, body mass index, study site, twins/siblings, and data collection period.

RESULTS

Adjusted models suggest an inverse association between number of ACEs and Fitbit daily steps, with ≥4 (compared to 0) ACEs associated with 567 fewer daily steps (95% CI -902.2, -232.2). Of the ACEs subtypes, emotional abuse (B = -719.3, 95% CI -1430.8, -7.9), physical neglect (B = -423.7, 95% CI -752.8, -94.6), household mental illness (B = -317.1, 95% CI -488.3, -145.9), and household divorce or separation (B = -275.4, 95% CI -521.5, -29.2) were inversely and statistically significant associated with Fitbit daily steps after adjusting for confounders.

CONCLUSIONS

Our results suggest that there is an inverse, dose-dependent relationship between cumulative number of ACEs and physical activity as measured by daily steps. This work highlights the importance of screening for ACEs among young people at an early age to help identify those who could benefit from interventions or community programs that support increased physical activity.

The Moderating Effects of Physical Activity on the Relationships between Child Maltreatment and Health Outcomes among Korean Adolescents: A Secondary Analysis of the 2020 Korean Children and Youth Rights Survey

Adverse childhood events (ACEs) are associated with poor health outcomes and behaviors. Research has shown that physical activity (PA) can have a protective effect on the relationship between ACEs and health outcomes. This study aimed to explore the moderating effects of PA on the relationships between ACEs (physical and emotional abuse) and physical and psychological health (depression and self-esteem) among South Korean middle school students. The data used in this study were from the 2020 Korean Children and Youth Rights Survey (KCYRS), which had 2640 participants. The results indicated that PA could lessen the negative effects of emotional abuse on physical health and self-esteem. However, there was no significant moderating effect of PA in the relationship between physical abuse and health outcomes. The findings suggest that, while PA might be a protective factor for individuals exposed to emotional abuse, the effects of abuse on engaging in PA and the benefits of PA can be complex. Further research is needed to understand how different types of ACEs affect individuals and how PA can mitigate negative impacts. Health professionals, educators, and stakeholders should provide more opportunities for PA to support healthy behaviors and prevent negative health outcomes in adulthood for youth exposed to ACEs.

The Associations Between Adverse Childhood Experiences, Physical and Mental Health, and Physical Activity: A Scoping Review

BACKGROUND

Adverse childhood experiences (ACEs) may be associated with worse physical and mental health in adulthood, and low physical activity engagement, but the relationships are not fully understood.

OBJECTIVES

To establish the scope of the literature exploring associations between ACEs, physical activity, and physical and mental health.

METHODS

We conducted this scoping review according to PRISMA-ScR guidelines. We searched MEDLINE, Scopus, SPORTDiscus, and PsycInfo for relevant articles.

RESULTS

Eighteen studies were included, 17 observational and 1 randomized controlled trial. The majority of studies were cross-sectional and employed self-reported physical activity and ACE measures. Six studies explored physical health, 9 explored mental health, and 3 explored both. Associations between ACEs and poor physical health outcomes (poor self-reported physical health, inflammation, high resting heart rate, and obesity) were consistently weaker or attenuated among those who were physically active. Physical activity may also moderate the associations between ACEs and depressive symptoms, psychological functioning, and health-related quality of life.

CONCLUSION

Associations between ACEs and poor physical and mental health were observed in those with less frequent physical activity engagement, though the majority of evidence relies on cross-sectional observational designs with self-report instruments. Further research is required to determine whether physical activity can prevent or treat poor physical and mental health in the presence of ACEs.