The Effectiveness of Physical Literacy Interventions: A Systematic Review with Meta-Analysis

Identifying moderators of physical literacy interventions using meta-regression

Physical literacy is a unifying concept that encompasses the physical competence, knowledge and understanding, motivation and confidence for engagement in life-long physical activity. In this study, we conducted a random-effects meta-analysis with meta-regression to examine (a) whether existing interventions were effective in enhancing individual's physical literacy and physical activity engagement, and (b) which factors moderated effectiveness of the interventions. The protocol of the meta-analysis was pre-registered in PROSPERO (Ref: CRD42020213898) on November 22, 2020. Specifically, a comprehensive literature search was conducted, and studies that evaluated any controlled intervention aimed to enhance physical literacy were included. Studies using either randomized or non-randomized designs were included. Intervention effects pertaining to each physical literacy component and activity engagement were pooled using a meta-analytical approach. Using meta-regressions, we investigated if study effects were moderated by characteristics of the interventions. Of the 29 studies included in the analyses, interventions successfully increased: physical competence (k = 18, g = 0.57), knowledge and understanding (k = 13, g = 0.55), motivation and confidence (k = 12, g = 0.44), global physical literacy (k = 27, g = 0.52), and engagement in physical activity (k = 13, g = 0.14). Intervention effects were weaker in school or university settings compared to non-educational settings and a positive bias for studies with smaller samples was found. While these findings were robust, long-term effectiveness of interventions should be further examined, as most included studies only evaluated short-term effects. Systematic approaches for the design and reporting of intervention components are also needed to help researchers design effective and scalable interventions in the future.

Physical literacy-based intervention for chronic disease management: a quasi-experimental study protocol

BACKGROUND

As chronic diseases proliferate globally, innovative interventions that promote sustainable physical activity are crucial. Physical literacy offers a holistic strategy for the promotion of lifelong health. This protocol describes a study investigating the effects of the integration of physical literacy principles in community-based physical activity group sessions in adults with chronic diseases. The primary outcome of this study is the physical literacy level (global physical literacy score and sub-scores) of participants.

METHODS

This quasi-experimental study will compare three groups: a control group, a group taking part in traditional physical activity (TPA) group sessions tailored for adults with chronic disease focusing on physical fitness general improvement, and a group taking part in TPA sessions that incorporates physical literacy goals and intervention content in line with 6 core dimensions of physical literacy (TPA + PL). Intervention groups will take part in 12 one-and-a-half-hour sessions organised weekly over a 3-month cycle. The study will assess the impact of these interventions using a mixed qualitative and quantitative physical literacy assessment tool at baseline (physical tests for the physical competence dimension; questionnaire for the 5 other core dimensions), three months (post-intervention), and six months (follow-up).

DISCUSSION

This studypresents an innovative intervention for chronic disease population through physical literacy, hypothesising that integrating physical literacy dimensions in tailored physical activity group sessions can significantly improve physical literacy to improve physical activity sustainability and health outcomes. Results from this study will provide insights into the efficacy of physical literacy interventions compared to traditional approaches, potentially guiding future public health initiatives and chronic disease management strategies.

TRIAL REGISTRATION

NCT06325306 (21/03/2024).

Physical Literacy, Physical Activity, and Health: A Citation Content Analysis and Narrative Review

Physical literacy has received increased research attention over the last decade focusing on the unification of the definition, measurement, and application, including in school and health-based contexts. In 2019, Cairney et al. released a model positioning physical literacy holistically as a primary determinant of health and disease, mediated by physical activity (PA), the physiological and psychological adaptations associated with PA, and the individual and social/environmental/contextual factors or conditions that impact PA-related behaviour, which had a significant impact on physical literacy-related literature. To assess the impact of the model on the extant literature, and better understand the relationship between physical literacy, PA and health as proposed by Cairney et al., we conducted a citation content analysis and narrative review. 956 citations were identified citing the model proposed by Cairney et al. Of these, 16 used the model to construct a theoretical framework and were included in the extended analysis. Thirteen studies were observational, and participants were all children or young people with a total age range 4-20 years. Results demonstrate that physical literacy is related to health-related fitness variables including aerobic fitness, body composition, flexibility, and muscular strength and power; total PA and MVPA; and health literacy, and wellbeing, supporting the model proposed by Cairney et al. However, gaps remain in understanding critical components of the model (e.g., the proposed mediation pathways), and in clarifying the nature of the relationships in a variety of populations (e.g., clinical populations) and across the lifespan. A pragmatic approach to addressing these gaps is recommended.

Global Insights and Key Trends in Physical Literacy Research: A Bibliometric Analysis and Literature Review from 2007 to 2024

Background

Extensive research has been carried out on physical literacy (PL) over the past decades. Nonetheless, no comprehensive bibliometric analysis of relevant publications has been performed. In this study, we conducted a comprehensive bibliometric review of studies on PL to track research trends and highlight current research hotspots.

Methods

The Web of Science Core Collection (WoSCC) database was selected to retrieve publications from inception to 2024 on PL. Articles and reviews written in English with PL as the main topic were included. VOSviewer and CiteSpace software were used to perform analysis and visualization of scientific productivity and emerging trends.

Results

A total of 710 publications were retrieved. Canada dominated this field with the most publications (188). The institution and author with the largest number of articles were The Chinese University of Hong Kong (46 publications) and Cairney John (35 publications), respectively. BMC Public Health was the most influential journal with 41 articles and 1214 citations. Publications were primarily distributed across journals in sports science, education, public health, and other allied disciplines. Five topics were identified by reference co-citation analysis and keyword analysis: the definition of PL, PL in education, the association of PL, the intervention of PL, and the measurement and assessment of PL. The measurement, assessment and intervention of PL may become the frontiers.

Conclusion

PL research has witnessed growing scholarly interest over the past 18 years. The concept of PL lacks consensus, and the necessity of establishing a unified conceptualization remains contentious. Most existing PL measurement tools lack comprehensiveness in capturing conceptual components, highlighting the need for established instruments aligned with its theoretical foundations. PL interventions vary in design and effectiveness, making it essential to identify effective strategies. Furthermore, multidisciplinary collaboration is imperative. This study could offer strategic guidance for identifying potential collaborators and prioritizing research priorities.

Fostering the Physical-Literacy Development of Individuals Experiencing Disability Through the Use of PLayTubs: A Pilot Study

Physical literacy (PL) is increasingly being implemented as a means for holistic development for children and youth. Despite this, children experiencing disabilities and their families continue to face barriers that impede participation in physical activities and subsequent PL development. To empower families to actively engage in their PL development, this study sought to provide an accessible, home- and play-based, parent-facilitated intervention, namely, PLayTubs. The purpose was to explore parents' subjective understanding, involvement, and attitudes toward facilitating physical activity opportunities contributing to PL development through this intervention. Four parents with a child (<12 years old) diagnosed with a developmental impairment participated in a 10-week PLayTub experience. Data were collected via semistructured interviews with parents and their children. Making use of an interpretive description methodology and an ecological-dynamics conceptual framework, this study resulted in three themes: (a) a catalyst for autonomy, (b) more than just movement, and (c) an accessible alternative. Parents found that PLayTubs fostered autonomous participation and individual agency, enhanced connections and togetherness, and allowed for the creation of meaningful experiences with physical activity. These positive insights demonstrate the benefit of home-based interventions for this population and highlight the need for larger studies in the future.

[Health literacy and health behaviour-insights into a developing field of research and action for public health]

The research and action field of health literacy and health behaviour is increasingly differentiating. General health literacy is established and focuses on population-based studies. Specific health literacy for health behaviour offers topic-related starting points for interventions and public health strategies.There are various concepts, definitions and measurement instruments for general health literacy and specific health literacy in the areas of nutrition and physical activity. These differ in terms of the levels of action and areas of application of health literacy.Most studies show a positive association between health literacy and various health behaviours. Higher health literacy is more often associated with improved health-promoting behaviour. This applies to both general as well as specific health literacy regarding nutrition and exercise (physical activity). Some studies found no correlation for certain behaviours, while others only found correlations for certain groups, which may be due to the different measuring instruments and research contexts. This points to the importance of always considering the interaction between behaviour and circumstances in order to improve the fit between the individual and the everyday demands of dealing with health information.The behavioural and cultural insights (BCI) approach can provide insights into how to promote health literacy with regard to various health behaviours, individual barriers and facilitators that arise from life circumstances and conditions, and that take social practice into account. BCI and health literacy complement each other and have the potential to make strategies for improving health behaviour more effective and targeted.

Fostering early adolescent health and planetary well-being through nature: a Delphi study on nature-based literacy

Becoming nature 'literate' may promote nature engagement in early adolescence, supporting both health and well-being, while nurturing a sense of environmental stewardship. This study aimed to advance the formative research necessary for the development of a nature-based literacy framework including a set of indicators specific to its measurement during early adolescence. An e-Delphi study design was used with an expert panel comprised of international academics (n = 18) and practitioners (n = 8). After three rounds, experts agreed key components of nature-based literacy were knowledge, competence, confidence, motivation, experience, connection, and stewardship. The nature-based literacy framework comprehensively represents the intrapersonal factors and related indicators that influence nature engagement, particularly during early adolescence. This will support the development of interventions designed to enhance early adolescent health outcomes, strengthen their connection to nature, and inspire them to value and protect the natural world.

Relationships between perceived physical literacy and mental health in tertiary education students: a scoping review

BACKGROUND/OBJECTIVE

Physical literacy (PL) is "the motivation, confidence, physical competence, knowledge, and understanding to value and take responsibility for engagement in physical activities for life". Recent evidence has shown that PL was associated with mental wellbeing in different populations, yet a comprehensive review examining the association between PL and mental health among tertiary education students was lacking. The aims of this scoping review were to rapidly map relevant evidence on the relationships between perceived PL and mental health in higher education students and to determine the feasibility and value of conducting a full systematic review in this research area.

METHODS

All primary studies (observational and experimental) examining the associations between PL and mental health in college/university/undergraduate students were included. Seven electronic databases, namely PubMed, Academic Search Premier, CINAHL, ERIC, PsycINFO, Medline, and SPORTDiscus, were searched from their inceptions through 30 September 2024. A narrative approach was adopted to synthesize results relevant to the study aims categorized based on mental health outcomes.

RESULTS

Seven observational studies (n = 34,824) were included. Results showed that PL was positively correlated with better mental wellbeing, including greater quality of life, better subjective wellbeing, higher levels of life satisfaction, improved resilience, and greater compliance with sleep guideline, and negatively associated with psychological distress (depression, anxiety, and stress) among university students. During the COVID-19 pandemic, PL was also shown to buffer university students' psychological distress, declines in quality of life and life satisfaction, as well as impaired sleep in the population.

CONCLUSION

Despite emerging research efforts to decipher the relationships between perceived PL and mental health in tertiary institution settings, further high-quality experimental studies are imperatively needed to guarantee the relevance of rigorous systemic reviews in the realm of university students' mental health.

An Evaluation of the Sharing Dance Public School Program on Physical Literacy

Introduction: Physical literacy (PL) is a multidimensional concept that includes the domains of movement competence, positive affect, social participation, and the confidence, motivation, and knowledge and understanding necessary for regular engagement in physical activity. The Sharing Dance Public School Program was created by Canada's National Ballet School specifically designed to promote PL through dance. The objective of this study was to evaluate the effectiveness of the program to improve PL in grade 4 to 6 children over the course of a school year. Methods: Children were initially recruited from two schools including an intervention and a control school. However, due to the COVID-19 pandemic, data collection was prematurely terminated which resulted in baseline and mid-point data from the intervention group only. As such, participants included 57 children (n = 28 females, Mage = 10.34 ± 0.85 years) that engaged in the dance program once per week for 50 minutes. Assessments of PL included a direct measure of movement competence (PLAYfun) and a self-report measure (survey) to assess the other domains of PL. Results: Significant improvements were found in movement competence. However, significant decreases were found for fun and enjoyment, confidence, and social participation. No changes were observed for knowledge and understanding or overall PL. Conclusions: Findings from the present study are encouraging as they provide initial evidence for the support of community-based PL programs, such as the Sharing Dance Public School Program, to help children develop their movement competence. Future research is needed to further evaluate the effectiveness of the Sharing Dance Public School Program over a school year, and when compared to a control group, as was initially intended.

Feasibility and Effects of a Neuromuscular Warm-Up Based on the Physical Literacy Model for 8-12-Year-Old-Children

Background: Physical literacy and injury prevention strategies use similar movement-related constructs and can be connected to develop comprehensive interventions. We aimed to test the feasibility and effects of a neuromuscular warm-up based on physical literacy and injury prevention strategies for 8-12-year-old children. Methods: We conducted a cluster non-randomized controlled trial. We defined a priori feasibility criteria and studied the effects of the intervention on physical literacy constructs, movement competence, and neuromuscular performance. We used generalized linear mixed models controlling for covariates and clustering with a significance level of 0.001. Results: We recruited 18 groups (n = 363) and randomly allocated nine to intervention (n = 179; female = 63.7%, age = 9.8 ± 1 years) and nine to control (n = 184, female = 53.3%, age = 9.9 ± 0.9 years). We met four of seven feasibility criteria (i.e. recruitment, adherence, enjoyment, perceived exertion). The three feasibility criteria that were not met (i.e. compliance, fidelity, follow-up) were slightly below the predefined threshold (90%). Model-adjusted mean differences for physical literacy constructs, movement competence, vertical jump height, horizontal jump distance, 20-m sprint time, and dynamic balance favored the intervention (p < .001). Conclusion: The feasibility evidence indicates that the intervention should be slightly modified before implementing it in a larger study. The observed mean differences are promising and can be used in planning future interventions.

Relationship Between Body Composition and Physical Literacy in Chilean Children (10 to 16 Years): An Assessment Using CAPL-2

Objectives: The aim of this study was to evaluate the levels of physical literacy (PL) in school children (10 to 16 years) in Santiago, Chile, and to explore the relationship between PL and body mass index (BMI). In addition, gender and age differences were analyzed in relation to PL levels in a context where childhood obesity remains a public health challenge. Methods: A total of 439 students in grades 5-8 were assessed using the Canadian Assessment of Physical Literacy-2 (CAPL-2) questionnaire. Demographic variables (sex, age, and BMI) were correlated with levels of motivation to engage in physical activity and physical activity knowledge. Chi-square and effect size were applied. Results: The results revealed a significant correlation between motivation for physical activity and gender, with boys showing higher levels of motivation than girls (χ² = 12.403, p < 0.006). In addition, an inverse relationship was observed between BMI and motivation (effect size = 0.198), suggesting that more motivated children tend to have a healthier BMI. Knowledge about physical activity increased with age (χ² = 60.460, p < 0.001) but did not have a significant influence on BMI. Conclusions: The findings highlight the need to design gender-specific interventions that enhance motivation as a key factor in promoting a healthy lifestyle and physical activity adherence. Public health strategies should include motivation-driven approaches to foster physical literacy and long-term engagement in physical activity, particularly for girls, to address pediatric health challenges in Chile. Public health policies should address these factors to improve pediatric health outcomes.

Technology-Supported Physical Activity and Its Potential as a Tool to Promote Young Women's Physical Activity and Physical Literacy: Systematic Review

BACKGROUND

Despite the known benefits of physical activity (PA), rates of engagement in PA remain low globally. Low engagement in PA among young women can impact their health. Technology-supported PA may increase PA and physical literacy (PL; skills that can support PA) among young women.

OBJECTIVE

This systematic review aims to investigate the (1) associations between technology-supported PA and PA levels, (2) associations between technology-supported PA and PL levels, and (3) types of technology-supported PA that are associated with higher levels of PA engagement among young women aged 13 to 24 years. This age range was chosen as it includes two transitional periods characterized by decreases in PA.

METHODS

We searched 6 databases: Applied Science and Technology Source, Education Source, Embase, MEDLINE Complete, Global Health, and SPORTDiscus. Eligible studies were original research published in English between January 1, 2010, and April 24, 2024; focused on young women; and involving either technology-supported PA interventions or research exploring the correlation between technology and PA and PL. The findings of the review were presented descriptively. Study quality was assessed using the JBI Critical Appraisal tools. There were no deviations from the registered protocol.

RESULTS

In total, 23 (0.1%) studies (10,233 participants) from 23,609 records were included: randomized controlled trials (n=9, 39%), nonrandomized or retrospective observational studies (n=9, 39%), and cross-sectional studies (n=5, 22%). Of the 23 studies, 12 (52%) focused on young adults (aged ≥19 y), 9 (39%) involved adolescents (aged <19 y), and 2 (9%) focused on both groups. Nine studies (39%) were theory based. Common types of technology-supported PA were interactive websites or social media platforms (10/23, 43%), wearable fitness trackers (4/23, 17%), and mobile apps (4/23, 17%). PA or PL were predominantly self-reported (18/23, 78%). A total of 53 PA outcomes were measured: 36% (19/53) reported a positive impact on PA from mobile apps (9/15; 60% of analyses), interactive websites or social media platforms (8/27; 30% of analyses) and wearable fitness trackers (2/11; 18% of analyses). The impact on PL was weak (2/7; 29% of analyses). Eight studies (35%) were rated high, 7 (30%) medium, and 8 (35%) low in quality.

CONCLUSIONS

There was limited evidence that technology-supported PA improved young women's PA or PL. The evidence was limited by poor study quality and a lack of theoretical frameworks. In addition, little information was provided on the designs of the technology used. Future interventions seeking to improve young women's PA and PL should focus on the development of mobile apps underpinned by behavior change theory and addressing whole domains of PL rather than specific elements. Given that technology continues to rapidly advance, further studies are needed to demonstrate the impact of technology-supported PA in improving PA and PL among young women.

Why don't women engage in muscle strength exercise? An integrative review

ISSUE ADDRESSED

Women are 'at-risk' population for failing to meet muscle strengthening guidelines. Health benefits specific to this exercise mode include maintenance of muscle mass, which is associated with reduced risk of chronic disease and falls. Of significance is the progressive decline in muscle strength exercise participation in women aged 35-54 in Australia. This period is critical for maintaining muscle strength as it establishes foundations for older women's engagement. This integrative review examined available evidence regarding factors influencing muscle strength exercise participation, specifically in women aged 35-54.

METHODS

Seven databases were searched. Study inclusion criteria were: (1) peer reviewed, (2) English language, (3) sample populations of healthy female adults or general adult sample population differentiating females from males, (4) mean age between 35 and 54 years, (5) focused on muscle strength exercise and measured as the primary outcome factors of participation in muscle strength exercise.

FINDINGS

Five of 1895 studies met inclusion criteria. Five key factors were associated with participation in muscle strength exercise of women aged 35-54 years: perceived time constraints; knowledge and education; modality and intensity; social support and behavioural strategies.

CONCLUSIONS

Focused education on strength exercise and guidelines, plus initiatives and strategies that suit the needs of this cohort, are necessary to achieve health and wellbeing benefits. Responsive approaches by health professionals to these women's circumstances can potentially address current low participation levels. SO WHAT?: Creating conditions where health professionals respect a woman's exercise preferences can positively impact these women's musculoskeletal health into older age.

Effects of Holistically Conceptualised School-Based Interventions on Children's Physical Literacy, Physical Activity, and Other Outcomes: A Systematic Review

BACKGROUND

Schools are a key setting for promoting children's physical literacy development. This review aimed to identify school-based interventions that adopted a holistic conceptualisation of physical literacy and examine the effects on children's physical literacy and any other outcomes, including physical activity (PA).

METHODS

Searches were conducted in seven databases (APA PsycINFO, EMBASE, ERIC, CINAHL, Global Health, MEDLINE Complete, SPORTDiscus with Full Text), and Google and Google Scholar, to identify articles published since 1/1/2017. Studies were included if they (i) adopted a holistic conception of physical literacy as represented by the Australian Physical Literacy Framework (APLF), (ii) were grounded in movement, (iii) assessed three or more domains of learning (either quantitatively or qualitatively), and (iv) included children aged 5-14 years. Quantitative research designs needed to provide pre-and post-intervention measures, whereas qualitative designs (e.g. post-intervention interviews) did not. Study selection, data extraction and quality assessment were conducted independently by teams of two authors. For intervention effects, quantitative and qualitative data were synthesised separately. For quantitative data, level of evidence for intervention effects was assessed by physical literacy domain and/or elements/items by examining the proportion of tests with a significant change in the expected direction. Qualitative data were synthesised using the framework synthesis method and mapped to a framework that included APLF domains/elements, PA, and additional outcomes.

RESULTS

Twelve interventions with 1,427 participants from seven countries were identified: six physical education-based, three afterschool, one structured recess, and two multicomponent. All studies assessed the physical domain quantitatively, with strong positive evidence of intervention effects for the controlled designs (10 of 15 tests). For the affective and cognitive domains, evidence was mixed, and there was no evidence for interventions improving the social components of children's physical literacy (although this was understudied). Most studies assessed PA and one measured cognitive performance; however, there was no evidence for positive intervention effects (i.e. ≥35% of tests reporting an improvement) for either outcome. Five studies assessed intervention effects qualitatively, with positive results reported for all physical literacy domains, PA, and cognitive performance.

CONCLUSIONS

Holistic interventions in schools can improve the physical domain of children's physical literacy. For wider benefits, future interventions should aim to develop all facets of physical literacy, especially domains of learning less frequently targeted and examined.

TRIAL REGISTRATION

PROSPERO CRD42022351317.

Multistakeholder Perspectives on the Determinants of Family Fundamental Movement Skills Practice: A Qualitative Systematic Review

BACKGROUND

Childhood obesity is a significant public health crisis that is exposing children to associated morbidities and premature mortality. However, parents can positively influence physical activity trajectories and improve health outcomes by nurturing fundamental movement skills (FMS) in children. This is the first study to explore the determinants of family FMS practice via a systematic synthesis of qualitative evidence.

METHODS

Keyword searches were completed in SPORTDiscus, PubMed, Scopus, Web of Science, and Embase. Studies that offered perspectives relating to influences on the FMS of 2-6-year-old children in the family context via qualitative approaches, including visual methodologies that provided an important voice to children, were included. A thematic analysis was used to establish key themes.

RESULTS

The emergent themes included parent knowledge and beliefs, self-efficacy of parents to teach, and the home environment. Parents often undervalued FMS and lacked the self-efficacy to teach due to poor understanding, conflicting priorities, and multifaceted societal influences. Children preferred autonomous play and socialisation but were negatively influenced by technology and restrictive household rules.

CONCLUSIONS

Greater knowledge exchange between stakeholders is necessary to empower parents and enhance FMS application at home. More community initiatives could facilitate greater access to outdoor spaces, facilities, and equipment, which may improve family engagement with FMS.

Development of a Global Physical Literacy (GloPL) Action Framework: Study protocol for a consensus process

BACKGROUND

The holistic concept of physical literacy (PL) has gained growing attention in recent research, policy, and practice. Many important policy documents of the physical activity and educational fields (e.g., Global Action Plan on Physical Activity 2018-2030 by the World Health Organization, UNESCO's Quality Physical Education guidelines for policymakers) have specified PL. However, a clear framework for action is needed, as most initiatives across the world are fragmented, lack a prospective orientation, can benefit from conceptual clarification, and are not linked to effective translation into practice. Therefore, we aim to consensually develop a Global Physical Literacy (GloPL) Action Framework to define goals and principles (asking what is needed) as well as actions and ways (asking how these can be achieved) to move PL forward.

MATERIALS AND METHODS

We apply a three-stage group Delphi technique involving three representation groups: (a) geographical representatives to achieve global coverage of perspectives; (b) representatives of special thematic interest reflecting prominent gaps of current PL activities; and (c) representatives of societies from the broad field of physical activity and health to facilitate dissemination. The process will begin with an individual pre-Delphi exercise, in which experts generate initial ideas for the framework, followed by a four-eye document analysis to derive themes for the discussion. Subsequently, the experts will meet face-to-face in three online rounds to discuss and prioritize the themes. Interspersed formal voting with pre-defined agreement thresholds (via descriptive statistics) will inform the inclusion of themes within the final framework.

CONCLUSIONS

A global consensus on goals, principles, actions, and ways for the development of PL has the potential to provide a largely accepted roadmap for future activities in research, policy, and practice. The co-production approach will help disseminate the GloPL Action Framework and benefit work in relevant application fields of physical activity and health worldwide.

Healthy childhood development through outdoor risky play: Navigating the balance with injury prevention

Free play is essential for children's development and for their physical, mental, and social health. Opportunities to engage in outdoor free play-and risky play in particular-have declined significantly in recent years, in part because safety measures have sought to prevent all play-related injuries rather than focusing on serious and fatal injuries. Risky play is defined by thrilling and exciting forms of free play that involve uncertainty of outcome and a possibility of physical injury. Proponents of risky play differentiate "risk" from "hazard" and seek to reframe perceived risk as an opportunity for situational evaluation and personal development. This statement weighs the burden of play-related injuries alongside the evidence in favour of risky play, including its benefits, risks, and nuances, which can vary depending on a child's developmental stage, ability, and social and medical context. Approaches are offered to promote open, constructive discussions with families and organizations. Paediatricians are encouraged to think of outdoor risky play as one way to help prevent and manage common health problems such as obesity, anxiety, and behavioural issues.

Le développement sain de l'enfant par le jeu risqué extérieur : un équilibre à trouver avec la prévention des blessures

Le jeu libre est essentiel pour le développement de l'enfant, de même que pour sa santé physique, mentale et sociale. Les occasions de se livrer au jeu libre extérieur, et au jeu risqué en particulier, ont considérablement diminué ces dernières années, en partie parce que les mesures de sécurité ont visé à prévenir toutes les blessures liées aux jeux plutôt que seulement les blessures graves et fatales. Le jeu risqué désigne des formes passionnantes et stimulantes de jeu libre dont l'issue est incertaine et qui comportent une possibilité de blessure physique. Les promoteurs du jeu risqué distinguent le « risque » du « danger » et aspirent à recadrer la perception du risque pour qu'il devienne une occasion d'évaluer une situation et de favoriser le développement personnel. Dans le présent document de principes, les auteures soupèsent le fardeau des blessures liées au jeu par rapport aux données probantes en appui au jeu risqué, notamment les avantages, les risques et les nuances, qui peuvent varier en fonction de l'étape de développement de l'enfant, de ses aptitudes et du contexte social et médical. Elles proposent des approches pour promouvoir des échanges ouverts et constructifs avec les familles et les organisations. Les pédiatres sont invités à percevoir le jeu risqué extérieur comme un moyen de contribuer à prévenir et à gérer des problèmes de santé courants tels que l'obésité, l'anxiété et les problèmes de comportement.

The Role of Physical Literacy in the Association Between Weather and Physical Activity: A Longitudinal Multilevel Analysis With 951 Children

BACKGROUND

Numerous studies showed an effect of weather on physical activity (PA) levels in children. However, no study has yet examined the relevance of personal factors in this relationship. Therefore, this study analyzes (1) whether there are systematic interindividual differences in the extent to which weather affects the PA behavior and (2) whether physical literacy (PL) moderates the weather-PA association in children.

METHODS

A total of 951 children in 12 Danish schools (age 9.76 [1.59] y; 54.3% girls) completed objective PA assessments via accelerometry (moderate to vigorous PA, light PA, and sedentary behavior). Local weather data (precipitation, wind speed, temperature, and sunshine duration) were provided by the Danish Meteorological Institute. Participants' PL was measured employing the Danish version of the Canadian Assessment of Physical Literacy-2. The 4116 accelerometer days underwent longitudinal multilevel analyses while considering their nesting into pupils and school classes (n = 51).

RESULTS

Fluctuations in all PA indicators were significantly explained by variations in weather conditions, especially precipitation (P ≤ .035). Significant interindividual differences were found for 9 of 12 analytical dimensions, suggesting that weather changes influence PA behavior differently across individuals (especially moderate to vigorous PA, χ2[4] ≥ 11.5, P ≤ .021). However, PL moderated the relationship between weather and PA in only 2 of the 48 analytical constellations.

CONCLUSIONS

Despite the varying impact of weather on PA across individuals, the present study favors a main effect model in which weather and PL exert independent effects on children's PA. The insufficient support for PL as a moderating factor calls for future studies to test alternative mechanisms in the weather-PA association.

Relationship between perceived physical literacy and obesity-related outcomes in adolescents: the EHDLA study

Purpose

The aim of the present study was to examine the relationship between perceived physical literacy and obesity-related outcomes among adolescents from Spain.

Methods

This is a secondary cross-sectional analysis including a total sample of 845 Spanish adolescents (55.3% girls) aged 12-17 years from the Valle de Ricote (Region of Murcia) from the Eating Healthy and Daily Life Activities (EHDLA) project. Physical literacy was evaluated using the Spanish Perceived Physical Literacy Instrument for adolescents (S-PPLI). Body mass index was computed by taking the participants' body weight in kilograms and dividing it by the square of their height in meters, and body mass index (z score) and overweight/obesity and obesity were computed by the World Health Organization age- and sex-specific thresholds. Waist circumference was measured using a constant tension tape. Moreover, the waist-to-height ratio was calculated, and therefore, abdominal obesity was determined. Skinfold measurements were taken at the triceps and medial calf using calibrated steel calipers.

Results

In general, the overall trend was downward (i.e., the higher the PPLI score the lower the obesity-related indicators), with the approximate significance of smooth terms being statistically significant for all models examined (p < 0.001). Adolescents with lower perceived physical literacy (PPL) showed the highest estimated marginal means of body mass index, body mass index z score, waist circumference, waist-to-height ratio, and skinfold (triceps and calf) and predictive probabilities of having excess weight, obesity, and abdominal obesity, while their counterparts with high PPL had the lowest. In addition, significant differences were observed for all the obesity-related indications between adolescents with low PPL and those with medium PPL (p-adjusted < 0.05 for all indicators), as well as with those with high PPL (p-adjusted < 0.05 for all indicators). Moreover, these significant differences were also shown for most indicators between adolescents with medium PPL and those with high PPL (except for obesity).

Conclusion

Physical literacy could play a crucial role in maintaining more desirable obesity-related outcomes in adolescents. Adolescents with high perceived physical literacy showed lower obesity-related indicators (i.e., body mass index, body mass index z score, waist circumference, waist-to-height ratio, skinfolds), as well as a lower probability of having excess weight, obesity, and abdominal obesity.

Unveiling the relationship of physical literacy with muscular fitness and muscle-strengthening activities in adolescents: the EHDLA study

Objective

This study evaluated the relationship between physical literacy (PL) and muscular fitness (MF) as well as muscle-strengthening activities (MSA) in adolescents.

Methods

A secondary cross-sectional study included 823 adolescents (45.1% boys) from the Eating Healthy and Daily Life Activities Study. The Spanish Perceived Physical Literacy Instrument for Adolescents (S-PPLI) assessed the participants' perceived PL. The evaluation of MF in the young population was conducted using the Assessing the Levels of Physical Activity and Fitness (ALPHA-FIT) test battery. MSA were assessed by the following question: 'In the past week, how many days did you exercise to strengthen or tone the muscle, such as through push-ups, sit-ups or lifting weights?' To examine the associations between S-PPLI scores and handgrip strength, standing long jump and MSA days in adolescents, we employed generalised additive models.

Results

Participants with high perceived physical literacty (PPL) had the highest handgrip strength (mean=25.1; PPL had the highest handgrip strength (mean=25.1; bias-corrected and accelerated (BCa) bootstrapped 95% CI 24.2 to 26.0) and standing long jump (mean=149.7; confidence interval (CI) 24.2 to 26.0) and standing long jump (mean=149.7; 24.2 to 26.0) and standing long jump (mean=149.7; BCa bootstrapped 95% CI 145.8 to 153.5). Conversely, those adolescents with low PPL had the lowest handgrip strength (mean=23.1; BCa bootstrapped 95% CI 22.3 to 23.8) and standing long jump (mean=137.3; BCa bootstrapped 95% CI 133.9 to 140.6). For MSA, adolescents with high PPL had the highest mean of MSA days (mean=3.0; BCa bootstrapped 95% CI 2.8 to 3.3), while the lowest mean was observed for those with low PPL (mean=2.0; BCa bootstrapped 95% CI 1.8 to 2.2).

Conclusion

A high level of PL was associated with higher levels of MF and MSA among Spanish adolescents.

School-based promotion of physical literacy: a scoping review

Introduction

The role of physical activity in children's healthy development is undisputed, with school-based interventions being seen as a priority. The promotion of physical literacy (PL) seems to be promising due to its holistic approach, combining physical, cognitive, and affective domains. To develop recommendations for possible measures, we compiled existing literature on existing school-based PL interventions.

Methods

Five databases (MEDLINE, Web of Science, SPORTDiscus, ERIC, and PsycInfo) were searched between July 6 and July 10, 2023, by combining the terms "physical literacy," "school," "program," "workshop," "intervention," and "curriculum" as well as a manual search. Records were screened in a two-stage process by two independent authors using a priori criteria. Eligible studies concerned PL interventions in the school context. The included records were sorted according to school type/population, structure, content, PL domains addressed, and evaluation.

Results

In total, 706 articles were found through the database search and an additional 28 articles through the manual search. After removing duplicates, 502 publications remained, which were screened by title and abstract, leaving 82 full texts. These were cut down to 37 articles describing 31 different programs (19 in primary schools, eight in secondary schools, one in both primary and secondary schools, and three unspecified). Most interventions were conducted during physical education classes (n = 12). All three PL domains were addressed by five interventions, while 11 interventions solely concerned the physical domain. In addition, 21 interventions evaluated their effects on PL. Most evaluations showed small to moderate but inconsistent effects on several PL-related constructs (e.g., self-efficacy, motivation, movement skills). Interventions incorporating all three domains reported positive effects on physical competence and enjoyment.

Discussion

Although there is a growing body of data related to school-based PL promotion, their effects and practical application remains relatively underdeveloped: study designs, study quality, PL assessments, and results are heterogeneous. Corresponding research adhering to the holistic approach of PL will be crucial in clarifying the potential lifelong role of PL in promoting physical activity, increasing health and well-being and to actually enable development of recommendations for action.

Cross-Sectional Association between Perceived Physical Literacy and Mediterranean Dietary Patterns in Adolescents: The EHDLA Study

PURPOSE

The objective of the current study was to analyze the relationship between perceived physical literacy (PPL) and adherence to the Mediterranean Diet (MedDiet) and its specific components in a sample of Spanish adolescents.

METHODS

In this cross-sectional study, we examined a sample of 845 adolescents (58.1% boys) aged 12-17 years from the Valle de Ricote (Region of Murcia, Spain). PPL was assessed by the Spanish Perceived Physical Literacy Instrument for adolescents (S-PPLI). To assess adherence to the MedDiet, the Mediterranean Diet Quality Index in children and adolescents (KIDMED) was applied.

RESULTS

In unadjusted analyses, adolescents with medium or high PPL were more likely to have optimal adherence to the MedDiet (medium PPL: OR = 1.69, 95% CI 1.20-2.40, p-adjusted = 0.003; high PPL: OR = 2.90, 95% CI 2.03-4.17, p-adjusted < 0.001). These findings remained significant after adjusting for sex, age, socioeconomic status, body mass index, energy intake, overall sleep duration, physical activity, and sedentary behavior (medium PPL: OR = 1.51, 95% CI 1.05-2.19, p-adjusted = 0.003; high PPL: OR = 2.27, 95% CI 1.53-3.39, p-adjusted < 0.001).

CONCLUSIONS

PPL could play a relevant role in the adoption of healthy eating habits among adolescents. Adolescents with low or medium PPL were less likely to report optimal adherence to the MedDiet. Adolescents with high PPL seem to consume more fruits, vegetables, fish, pulses, nuts, and dairies (for breakfast). Conversely, these adolescents tend to skip breakfast less, as well as to consume less commercially baked goods or pastries at this meal.

Effectiveness of Physical-Literacy-Based Online Education on Indices of Physical Fitness in High-School Adolescents: Intervention Study during the COVID-19 Pandemic Period

There is a global consensus that physical literacy (PL) is an important determinant of physical fitness (PF), but studies have rarely examined the effects of PL-based interventions on PF. The aim of this research was to evaluate the effectiveness of specific online video-based PL intervention on PF indices in high-school students from Croatia. Participants were 423 high-school adolescents (295 girls, 128 boys; 14-to-18 years of age), divided into an intervention group (n = 230) and a control group (n = 193). The intervention lasted 12 weeks. Educational video materials were disseminated to the intervention group by the closed social network during the pandemic period. Variables included height, mass, BMI, cardiorespiratory fitness (CRF), and power, strength, and flexibility indices. Pre- to post-testing design was applied, with two-way analysis of variance for repeated measurement (Time × Group). Applied intervention induced positive effects in CRF (the intervention group improved their capacities, while no changes occurred in the control group) and BMI (the intervention group retained their BMI levels at the pre-testing level, while BMI of the control group slightly increased over the course of the study), with better effectiveness in girls than in boys. No effects were evidenced for other variables. The positive effects of applied educational intervention on BMI and CRF are encouraging knowing that both indices are related to health status.

Development of the Perceived Physical Literacy Questionnaire (PPLQ) for the adult population

Background/objective

In physical literacy (PL) research, instruments for the adult population covering all relevant domians are currently lacking in German language. Therefore, the Perceived Physical Literacy Questionnaire (PPLQ) was developed as an assessment instrument of PL for the adult population. The purpose of this study is to describe the multistage development process leading to the aim to evaluate the psychometric properties of the PPLQ.

Methods

Based on established questionnaires (subscales) operationalizing the six defined PL domains (motivation, confidence, physical competence, knowledge, understanding, and physical activity behavior), we generated a large item pool. Exploratory analyses on survey data (n = 506), compelemented through an expert panel, served to identify the best fitting items. Cognitive interviews (n = 7) and a language certification process (level A2) helped to enhance the content validity of the items. Finally, we assessed the hypothesized factor structure of the PPLQ and its convergent validity with the Physical Activity-related Health Competence (PAHCO) questionnaire in a second independent sample.

Results

Valid data of 417 adults (66% women, 48 ± 16 years) entered the confirmatory factor analysis. We found empirical support for a theory-compatible 24-item version, after reducing complexity (i.e., domain subscales). Additionally, the six domains could be subsumed under an overall factor for PL (χ2247 = 450.70, χ2/df = 1.83, CFIRobust = 0.895, RMSEARobust = 0.074 [CI90 = 0.063-0.085], SRMR = 0.064). Factor loadings, composite reliability, and discriminant validity were sufficient, while acceptable convergent validity was achieved for the total PL score and three domains.

Conclusion

The 24-item version of the PPLQ is appropriate for assessing PL among adults. However, some items (especially in the knowledge domain) can benefit from refinement in further studies.

Parents, Teachers, and Community: A Team Approach to Developing Physical Competence in Children

Increasing children's physical activity engagement has short- and long-term health benefits. Developing physical competence is a key component of children's engagement in physical activity. The purpose of our study was to assess if a 12-week home, school, and community-based physical literacy intervention improved the physical competence of children in kindergarten and grade one. Four schools were either assigned to receive the intervention (n = 2 schools) or continue with their usual practice (control sites) (n = 2 schools). Physical competence was evaluated pre- and post-intervention in 103 intervention (41 female) and 83 usual practice (36 female) children using PLAY Fun. PLAY Parent and PLAY Coach tools measured parent and teacher perspectives of children's physical competence, respectively. The intervention effect was assessed with repeated measures MANOVA to evaluate change in physical competence, with alpha set at p < 0.05. Children in both groups improved their locomotor, object control, and overall physical competence (p < 0.05) over the 12-week intervention. There was a significant intervention effect for locomotor and overall physical competence (p < 0.05). Interestingly, parents did not perceive these changes in physical competence (p > 0.05). However, teachers perceived improved physical competence for children in the intervention. Our physical literacy intervention improved the physical competence of children in kindergarten and grade one.

Synthesising physical literacy research for 'blank spots': A Systematic review of reviews

The holistic concept of physical literacy (PL) has gained considerable attention worldwide and integrates different determinants (e.g., physical, affective, and cognitive) of physical activity. The purpose of this systematic review (PROSPERO registration: CRD42022312764) was to broadly synthesise PL research and determine "blank spots". We performed standardized searches for PL reviews in 23 databases. Inclusion criteria were English language, any review with a systematized search, publication by June 2023 and PL relevance in an article's main body. The content and insights of the identified reviews were assigned to six literature-driven "problem fields": (i) theory/concept, (ii) measurement/levels/trends, (iii) determinants, (iv) outcomes, (v) interventions, and (vi) policy. We employed nine items for assessing the methodological quality of the reviews (including six items from AMSTAR-2). The screening resulted in an inclusion of 41 PL reviews of different methodology. Existing reviews most frequently analysed aspects of measurement (n = 20) as well as theory/definition (n = 19), followed by interventions (n = 17). In contrast, determinants (n = 6), outcomes (n = 5) and policy aspects (n = 4) were discussed less often. Accordingly, the major "blank spots" are: empirical studies on determinants and outcomes; PL levels and trends; pivotal moderators of interventions; and policy aspects. We recommend the scientific community to address these to move the field forward.

Development and evaluation of a school-based physical literacy intervention for children in Germany: protocol of the PLACE study

Introduction

Fueled by the COVID-19 pandemic, the physical activity behavior of children has reached a concerning level nowadays. By empowering individuals to be physically active throughout the life course, the concept of physical literacy has recently gained increasing attention and adopts a holistic-integrative perspective on PA promotion. Although the field has successively attempted to translate the conceptual ideas of physical literacy into interventions, the theoretical base is heterogeneous and is often lacking within interventions. Furthermore, several countries, including Germany, have not equally adopted the concept yet. Therefore, the goal of the present study protocol is to describe the development and evaluation approach of a PL intervention ("PLACE") for children in grades three and four within the German all-day schooling system.

Methods

The physical literacy intervention cultivates explicit theory-content links and comprises 12 heterogeneous sessions (each 60-90 min in length). The study contains three different phases with two initial pilot studies and a subsequent main study. The two pilot studies take a mixed-methods character by drawing on quantitative pre-post-designs as well as interviews with children (in groups). In the main study, we will longitudinally compare the course of PL values (five outcome domains: physical, affective, cognitive, social, behavioral) between two study arms: school classes of children are either assigned to an intervention condition (regular physical education and health care plus PL intervention) or to a control condition (regular physical education and health care only).

Discussion

The findings of this study will provide evidence on how to structure a multicomponent intervention in Germany based on the PL concept. In summary, the results will report on the effectiveness of the intervention and, therefore, decide whether to scale-up the intervention.

The Effectiveness of a Physical Literacy-Based Intervention for Increasing Physical Activity Levels and Improving Health Indicators in Overweight and Obese Adolescents (CAPACITES 64)

Recently, the concept of Physical Literacy (PL) has emerged as a key concept for promoting active behavior and improving health indicators in adolescents. Overweight and obese adolescents have a low level of Physical Activity (PA), low cardiorespiratory capacity, and high Body Fat percentage (%BF). However, the development of PL in the interest of health improvement has never been studied in overweight and obese adolescents. The objective of this study was to evaluate the impact of an intervention developing PL in overweight and obese adolescents in order to increase their (PA) and improve their health. The study was a prospective, single-arm, non-randomized interventional study. The intervention brings together different actions in PA and dietary education in different adolescent living environments. The study took place over a 9-month period with two data collection times (0; +9 months) and measured Body Mass Index (BMI) and BMI z score, %BF and Skeletal Muscle Mass (%SMM), Moderate-to-Vigorous intensity Physical Activity (MVPA) by accelerometry, CRF, as well as PL by the CAPL-2 tool. Thirteen adolescents (age 11.7 (±1.09) years old) improved their PL scores (+8.3 (±9.3) pts; p ≤ 0.01). BMI z score (-0.3 (±0.3), p ≤ 0.01), their %BF (-3.8 (±4.9); p ≤ 0.01), their CRF (+1.5 (±1.7) mL·min·kg-1; p ≤ 0.01), and their MVPA (+4.6 (±13.7) min/day; p = 0.36). Initiating multidimensional interventions to develop PL in overweight and obese adolescents may be a promising prospect to enable an increase in their MVPA and improve their long-term health. Longer-term randomized controlled interventional studies are needed to confirm these findings.

Promoting physical activity-related health competence to increase leisure-time physical activity and health-related quality of life in German private sector office workers

BACKGROUND

Office workers (OWs) are at risk of low levels of health-enhancing physical activity (HEPA) and impaired health-related quality of life (HRQOL). Interventions based on physical activity-related health competence (PAHCO) aim to facilitate long-term changes in HEPA and HRQOL. However, these assumptions rely on the changeability and temporal stability of PAHCO and have not been tested empirically. This study therefore aims to test the changeability and temporal stability of PAHCO in OWs within an interventional design and to examine the effect of PAHCO on leisure-time PA and HRQOL.

METHODS

Three hundred twenty-eight OWs (34% female, 50.4 ± 6.4 years) completed an in-person, three-week workplace health promotion program (WHPP) focusing on PAHCO and HEPA. The primary outcome of PAHCO as well as the secondary outcomes of leisure-time PA and HRQOL were examined at four measurement points over the course of 18 months in a pre-post design by employing linear mixed model regressions.

RESULTS

PAHCO displayed a substantial increase from the baseline to the time point after completion of the WHPP (β = 0.44, p < 0.001). Furthermore, there was no decrease in PAHCO at the first (p = 0.14) and the second follow-up measurement (p = 0.56) compared with the level at the end of the WHPP. In addition, the PAHCO subscale of PA-specific self-regulation (PASR) had a small to moderate, positive effect on leisure-time PA (β = 0.18, p < 0.001) and HRQOL (β = 0.26, p < 0.001). The subscale of control competence for physical training (CCPT) also had a positive small to moderate effect on HRQOL (β = 0.22, p < 0.001).

CONCLUSION

The results substantiate PAHCO's theoretical characteristics of changeability and temporal stability, and underline the theoretically postulated effects on leisure-time PA and HRQOL. These findings highlight the potential of PAHCO for intervention development, which can be assumed to foster long-term improvements in HEPA and HRQOL in OWs.

TRIAL REGISTRATION

The study was retrospectively registered in the German Clinical Trials Register, which is an approved Primary Register in the WHO network, at the 14/10/2022 (DRKS00030514).

Development, explanation, and presentation of the Physical Literacy Interventions Reporting Template (PLIRT)

BACKGROUND

The physical literacy (PL) concept integrates different personal (e.g., physical, cognitive, psychological/affective, social) determinants of physical activity and has received growing attention recently. Although practical efforts increasingly adopt PL as a guiding concept, latest evidence has shown that PL interventions often lack specification of important theoretical foundations and basic delivery information. Therefore, the goal of the present study was to develop an expert-based template that supports researchers and practitioners in planning and reporting PL interventions.

METHODS

The development process was informed by Moher et al.'s guidance for the development of research reporting guidelines. We composed a group of ten distinguished experts on PL. In two face-to-face meetings, the group first discussed a literature-driven draft of reporting items. In the second stage, the experts anonymously voted and commented on the items in two rounds (each leading to revisions) until consensus was reached.

RESULTS

The panel recommended that stakeholders of PL initiatives should tightly interlock interventional aspects with PL theory while ensuring consistency throughout all stages of intervention development. The Physical Literacy Interventions Reporting Template (PLIRT) encompasses a total of 14 items (two additional items for mixed-methods studies) in six different sections: title (one item), background and definition (three items), assessment (one item each for quantitative and qualitative studies), design and content (five items), evaluation (one item plus one item each for quantitative and qualitative studies), discussion and conclusion (two items).

CONCLUSION

The PLIRT was designed to facilitate improved transparency and interpretability in reports on PL interventions. The template has the potential to close gaps between theory and practice, thereby contributing to more holistic interventions for the fields of physical education, sport, and health.

Physical literacy in Europe: The current state of implementation in research, practice, and policy

Background/objective

The holistic concept of physical literacy (PL) embraces different person-centered qualities (physical, cognitive, affective/psychological) necessary to lead physically active lifestyles. PL has recently gained increasing attention globally and Europe is no exception. However, scientific endeavors summarizing the current state of PL in Europe are lacking. Therefore, the goal of this study was to comprehensively assess and compare the implementation of PL in research, policy, and practice across the continent.

Methods

We assembled a panel of experts representing 25 European countries. Employing a complementary mixed-methods design, the experts first prepared reviews about the current state of PL in their countries (categories: research, practice/policy). The reviews underwent comparative document analysis, ensuring a transnational four-eyes principle. For re-validation purposes, the representatives completed a quantitative survey with questions reflecting the inductive themes from the document analysis.

Results

The document analysis resulted in ten disjunct themes (related to "concept", "research", "practice/policy", "future/prospect") and yielded a heterogenous PL situation in Europe. The implementation state was strongly linked to conceptual discussions (e.g., existence of competing approaches), linguistic issues (e.g., translations), and country-specific traditions. Despite growing scholarly attention, PL hesitantly permeates practice and policy in most countries. Nevertheless, the experts largely anticipate increasing popularity of PL for the future.

Conclusion

Despite the heterogeneous situation across Europe, the analysis has uncovered similarities among the countries, such as the presence of established yet not identical concepts. Research should intensify academic activities (conceptual-linguistic elaborations, empirical work) before PL may gain further access into practical and political spheres in the long term.

Development of a German Physical Literacy Assessment for Children in the Context of Health Promotion-An Explorative Approach

Addressing physical literacy (PL) has become increasingly relevant to counteract sedentary behaviour in children and youth. We developed an assessment tool to measure and evaluate the promotion of individual PL and its four subdomains: motivation and confidence (the affective dimension), physical competence (physical dimension), knowledge and understanding (cognitive dimension), and participation in physical activity. Within this cross-sectional study, we tested 567 children aged 6−12 years from four primary schools that differed in socioeconomic status (SES). A subsequent exploratory factor analysis conducted to examine the conformity revealed a five-factor structure. The five factors explained 39.8% of the total cumulative variance. Children with a low SES yielded lower scores in all subdomains except participation in physical activity. This effect was most pronounced in motor skills (p < 0.001, r = 0.28). Among the children with a low SES, 16.9% were overweight and 17.4% were obese, compared to 11.5% and 5.4%, respectively, for those with a high SES (p < 0.001). In conclusion, although the assessment tool was largely in line with the postulated structure, further adjustments are necessary in terms of participation and motivation. Nevertheless, this holistic view of PL, taking SES into account, should enable the focused promotion of health and health literacy.

Specificity of the Associations between Indices of Cardiovascular Health with Health Literacy and Physical Literacy; A Cross-Sectional Study in Older Adolescents

Background and Objectives: Cardiovascular health status (CVHS) is an important determinant of health, while it is theorized that health literacy (HL) and physical literacy (PL) could be directly related to CVHS. The aim of this study was to evaluate gender-specific associations between PL and HL and indices of CVHS in adolescence. Materials and Methods: The participants were 247 adolescents (177 females) from Split-Dalmatia county in Croatia who were tested on HL, PL, and CVHS (physical activity level (PAL) and lipid profile). The lipid profile included total cholesterol, triglycerides, high-density lipoproteins, non-high-density lipoprotein-cholesterol, and low-density lipoproteins. Gender-stratified multivariate cluster analysis (K-means clustering) was used to group participants into three homogenous groups on the basis of their HL and PL, while differences between clusters in CVHS were evidenced by analysis of the variance and consecutive post-hoc tests. Results: The lipid profile was better in girls with higher HL scores. Additionally, clusters consisting of participants with a better PL were characterized by higher PAL. We have found no evidence that HL is associated with PAL, while PL was not associated with the lipid profile. Conclusions: HL was specifically associated with direct indicators of health status (lipid profile) in girls, while PL was associated with PAL as a particular behavioral health indicator in both genders. The study highlights the necessity of including education of HL and PL in schools.

Cross-sectional associations between adolescents' physical literacy, sport and exercise participation, and wellbeing

Background

Adolescence is a significant period in one's development of positive emotional and social wellbeing. Physical literacy (PL) is considered a determinant of physical health and wellbeing and is thought to be the foundation for an individual's engagement in physical activities. Yet, limited evidence exists on PL's association with adolescents' health and physical activity behavior. This study aims to (1) explore the associations between Danish adolescents' PL and their emotional and social wellbeing, (2) examine whether these associations are mediated by sport and exercise participation (SEP), and (3) consider if the associations differ across sex.

Methods

Cross-sectional data from a national population survey were collected in 2020. The sample consisted of 1,518 Danish adolescents aged 13-15 years. PL was assessed with the validated MyPL questionnaire. The weekly time engaged in sports and exercise was self-reported. Self-esteem, life satisfaction, body satisfaction, and loneliness were measured with items from the standardized HBSC questionnaire, and a wellbeing composite score was calculated from these four measures. We constructed structural equation models with PL and sports and exercise participation as independent variables and the five aspects of wellbeing as dependent variables.

Results

Positive associations were observed between PL and SEP (β = 0.33, p < 0.001) and between PL and the five aspects of wellbeing with β-values between 0.19 and 0.30 (p < 0.001). These associations were greater among girls. The association between PL and four of the five wellbeing outcomes were partly mediated by SEP with indirect effects (β) between 0.03 and 0.05.

Conclusions

Results from this study support the hypotheses that PL is important for children and adolescents' wellbeing and physical activity behavior.