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Poulos A, Wilson K, Schulke M, Nam K, Ohri-Vachaspati P, Bai Y, Kulinna PH. A natural experiment to assess recess frequency on children's physical activity in Arizona (U.S.) elementary schools. BMC Public Health 2024; 24:225. [PMID: 38238751 PMCID: PMC10797942 DOI: 10.1186/s12889-023-17605-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Accepted: 12/28/2023] [Indexed: 01/22/2024] Open
Abstract
BACKGROUND In the United States, the number of state policies mandating recess in schools has rapidly increased over the past decade; however, few policies specify recess frequency. Informed by an ecological model of physical activity (PA) policy, this study examined and compared total amounts and intensity of PA expended during recess among children attending schools in compliance with Arizona recess policy ARS§ 15-118 mandating 2 + daily recess periods versus not. METHODS PA during recess was measured among grade three children (ages 8-10) in four randomly selected elementary schools (two complying averaging 30 daily recess minutes; two non-complying averaging 15 daily recess minutes) in Maricopa County, Arizona. Group-level PA was assessed by direct observation using the System for Observing Play and Leisure (137 observations). A subset of students (N = 134) from all schools wore ActiGraph GT3X + devices during recess to measure individual PA. General linear mixed effects models were used to analyze the impact of recess frequency on group and individual PA during recess. RESULTS Students attending complying schools spent significantly greater proportions of time in moderate-to-vigorous PA (MVPA) based on direct observation (5%) and accelerometry (15%) and less time being sedentary based on accelerometry (14%) during recess. Across the school day, this would equate to 5.1 more MVPA minutes based on systematic direct observation and 9.5 more MVPA minutes based on accelerometry, and 4.1 less minutes being sedentary based on accelerometry if students received two daily 15-minute recess periods compared to one. CONCLUSIONS Students attending elementary schools implementing 2 + recesses, in accordance with state policy, demonstrated greater MVPA and less sedentary time, providing preliminary evidence that recess frequency is associated with greater PA intensity among children during recess. Schools that adhere to state-level PA policies may provide a more supportive environment for PA, resulting in increased movement among students. Specifying recess frequency should be considered in statewide recess policy.
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Affiliation(s)
- Allison Poulos
- College of Health Solutions, Arizona State University, ABC 222 425 North 5th Street, Phoenix, AZ, 85004, USA.
| | - Kylie Wilson
- College of Health Solutions, Arizona State University, ABC 222 425 North 5th Street, Phoenix, AZ, 85004, USA
| | - Marissa Schulke
- College of Health Solutions, Arizona State University, ABC 222 425 North 5th Street, Phoenix, AZ, 85004, USA
| | - Kahyun Nam
- Mary Lou Fulton Teachers College, Arizona State University, Tempe, AZ, 85281, USA
| | - Punam Ohri-Vachaspati
- College of Health Solutions, Arizona State University, ABC 222 425 North 5th Street, Phoenix, AZ, 85004, USA
| | - Yang Bai
- Department of Health and Kinesiology, University of Utah, Salt Lake City, UT, 84112, USA
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Souza LMS, Chaves SCL, Santana JM, Pereira M. Public policy interventions for preventing and treating obesity: scoping review. Nutr Rev 2023; 81:1653-1664. [PMID: 37080562 DOI: 10.1093/nutrit/nuad028] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/22/2023] Open
Abstract
CONTEXT Obesity is a multicausal social problem and a pandemic, and it presents a public health challenge in many countries. Hence, public health interventions have been used in an endeavour to prevent and/or control increased obesity among populations. OBJECTIVE This review study aimed to provide an overview of the academic literature and to analyze the strategies involved in the main public policies focused on preventing and controlling obesity in a number of countries. DATA SOURCES MEDLINE/PubMed, Web of Science, and LILACS databases were searched. DATA EXTRACTION Original studies were included for which the core objective was related to real-life public policy interventions for obesity. DATA ANALYSIS The studies were organized according to their characteristics, and the qualitative analysis was based on the categorization proposed by the author Poulain. The review included 41 studies and identified 15 types of interventions focused on obesity; the largest proportion of actions were developed in school and city environments and were geared toward behavioral change, supported by direct or indirect government action. It was observed that many strategies focused on environmental line through regulatory and legislative measures, and health promotion geared toward the individual was based on the dissemination of information as a means for behavioral change. A smaller focus was given to individual care and treatment, and participative actions in the community. CONCLUSION The design of public health strategies applicable to obesity as proposed by Poulain provides a valid model for evaluating interventions. The behavioral approach involving guidance through health education toward a healthy lifestyle prevails in public policies, indicating a movement toward accountability of individuals. However, it is necessary to deepen the debate on the social structures that determine obesity (and which limit possibilities of choice), aligned with cultural change regarding its occurrence, and to employ care strategies based on scientific evidence and which focus on the needs of the subjects.
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Affiliation(s)
- Lana M S Souza
- Instituto de Saúde Coletiva, Universidade Federal da Bahia, Canela, Salvador, Brazil
| | - Sônia C L Chaves
- Faculdade de Odontologia, Universidade Federal da Bahia, Salvador, Brazil
| | - Jerusa M Santana
- Centro de Ciências da Saúde, Universidade Federal do Recôncavo da Bahia, Santo Antônio de Jesus, Brazil
| | - Marcos Pereira
- Instituto de Saúde Coletiva, Universidade Federal da Bahia, Salvador, Brazil
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Thompson HR, Madsen KA, Zamek M, McKenzie TL, Dzewaltowski DA. Implementation of elementary school physical education quantity and quality law through school district audit, feedback, and coaching. Int J Behav Nutr Phys Act 2023; 20:77. [PMID: 37386631 DOI: 10.1186/s12966-023-01479-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Accepted: 06/20/2023] [Indexed: 07/01/2023] Open
Abstract
BACKGROUND To address low state physical education (PE) quantity and quality law implementation in elementary schools, the New York City Department of Education (NYCDOE) delivered a multilevel intervention (PE Works; 2015-2019), which included a district-led audit of school PE-law implementation, feedback, and coaching with principals. Using the Reach, Effectiveness, Adoption, Implementation, Maintenance (RE-AIM) implementation science framework, we assessed the primary multilevel drivers of success for this approach in increasing adherence to PE quantity and quality law. METHODS We conducted in-depth, semi-structured interviews with district-level personnel (n=17), elementary school administrators (n=18), and PE teachers (n=6) in 2020-21. RESULTS Interview results suggested several key RE-AIM drivers of successful PE law implementation. Reach: Ensure higher-need schools receive the necessary initial support to improve PE and later focus on lower-need schools. EFFECTIVENESS Provide support tailored to school needs, not penalties, to improve PE. Adoption: Increase the priority of PE at both district and school levels (e.g., audit and feedback, themselves, appear to elevate PE's priority). Streamline data collection and feedback reports; collecting/reporting too much information is burdensome and leads to lack of focus. Involve qualified (i.e., skilled in both school administration and PE programming/pedagogy) district-level personnel to work collaboratively with schools. IMPLEMENTATION Build strong, trusting district-school relationships. Maintenance: Provide ongoing district-level support to schools and involve parents to advocate for quality PE. CONCLUSIONS PE audits, feedback, and coaching (PEAFC) can guide schools in establishing long-term plans for successfully implementing PE-related law. Future research should examine the impact of PEAFC elsewhere (e.g., secondary schools, other districts).
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Affiliation(s)
- Hannah R Thompson
- School of Public Health, Community Health Sciences, UC Berkeley, Berkeley, CA, USA.
| | - Kristine A Madsen
- School of Public Health, Community Health Sciences, UC Berkeley, Berkeley, CA, USA
| | - Maya Zamek
- School of Public Health, Community Health Sciences, UC Berkeley, Berkeley, CA, USA
| | - Thomas L McKenzie
- School of Exercise and Nutritional Sciences, San Diego State University, San Diego, CA, USA
| | - David A Dzewaltowski
- Department of Health Promotion, College of Public Health, University of Nebraska Medical Center, Omaha, NE, USA
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Hoelscher DM, Ganzar LA, Salvo D, Kohl HW, Pérez A, Brown HS, Bentley SS, Dooley EE, Emamian A, Durand CP. Effects of Large-Scale Municipal Safe Routes to School Infrastructure on Student Active Travel and Physical Activity: Design, Methods, and Baseline Data of the Safe Travel Environment Evaluation in Texas Schools (STREETS) Natural Experiment. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031810. [PMID: 35162829 PMCID: PMC8834930 DOI: 10.3390/ijerph19031810] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 01/31/2022] [Accepted: 02/02/2022] [Indexed: 11/16/2022]
Abstract
Past evaluations of Safe Routes to School (SRTS) programs have been relatively small in scope and have lacked objective measurements of physical activity. A 2016 Mobility Bond in Austin, Texas, USA, allocated USD 27.5 million for infrastructure changes to facilitate active commuting to schools (ACS). The Safe TRavel Environment Evaluation in Texas Schools (STREETS) study aims to determine the health effects of these infrastructure changes. The purpose of this paper is to describe the STREETS study design, methods, and selected baseline results. The STREETS study is comprised of two designs: (1) a serial cross-sectional design to assess changes in ACS prevalence, and (2) a quasi-experimental, prospective cohort to examine changes in physical activity. Differences between study arms (Austin SRTS and comparison) were assessed for school demographics, ACS, and school programs. At baseline, 14.3% of school trips were made by ACS, with non-significant differences between study arms. Only 26% of schools implemented ACS-related programs. Some significant differences across SRTS and comparison schools were identified for several school- and neighborhood-level characteristics. Substantial changes are needed across area schools and neighborhoods to promote optimum ACS. STREETS study longitudinal findings will be critical for informing optimal future implementations of SRTS programs.
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Affiliation(s)
- Deanna M. Hoelscher
- Michael and Susan Dell Center for Healthy Living, School of Public Health in Austin, The University of Texas Health Science Center at Houston (UTHealth), Austin, TX 78701, USA; (L.A.G.); (H.W.K.III); (A.P.); (H.S.B.); (S.S.B.)
- Correspondence:
| | - Leigh Ann Ganzar
- Michael and Susan Dell Center for Healthy Living, School of Public Health in Austin, The University of Texas Health Science Center at Houston (UTHealth), Austin, TX 78701, USA; (L.A.G.); (H.W.K.III); (A.P.); (H.S.B.); (S.S.B.)
| | - Deborah Salvo
- Prevention Research Center in St. Louis, Brown School, Washington University, St. Louis, MO 63130, USA;
| | - Harold W. Kohl
- Michael and Susan Dell Center for Healthy Living, School of Public Health in Austin, The University of Texas Health Science Center at Houston (UTHealth), Austin, TX 78701, USA; (L.A.G.); (H.W.K.III); (A.P.); (H.S.B.); (S.S.B.)
- Department of Kinesiology and Health Education, The University of Texas at Austin, Austin, TX 78712, USA
| | - Adriana Pérez
- Michael and Susan Dell Center for Healthy Living, School of Public Health in Austin, The University of Texas Health Science Center at Houston (UTHealth), Austin, TX 78701, USA; (L.A.G.); (H.W.K.III); (A.P.); (H.S.B.); (S.S.B.)
| | - Henry Shelton Brown
- Michael and Susan Dell Center for Healthy Living, School of Public Health in Austin, The University of Texas Health Science Center at Houston (UTHealth), Austin, TX 78701, USA; (L.A.G.); (H.W.K.III); (A.P.); (H.S.B.); (S.S.B.)
| | - Sarah S. Bentley
- Michael and Susan Dell Center for Healthy Living, School of Public Health in Austin, The University of Texas Health Science Center at Houston (UTHealth), Austin, TX 78701, USA; (L.A.G.); (H.W.K.III); (A.P.); (H.S.B.); (S.S.B.)
| | - Erin E. Dooley
- Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, AL 35233, USA;
| | - Amir Emamian
- Public Works Department, City of Austin, Austin, TX 78704, USA;
| | - Casey P. Durand
- Michael and Susan Dell Center for Healthy Living, Department of Health Promotion & Behavioral Sciences, School of Public Health in Houston, The University of Texas Health Science Center at Houston, Houston, TX 77030, USA;
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Stylianou M, Woodforde J, Duncombe S, Kolbe-Alexander T, Gomersall S. School physical activity policies and associations with physical activity practices and behaviours: A systematic review of the literature. Health Place 2021; 73:102705. [PMID: 34844131 DOI: 10.1016/j.healthplace.2021.102705] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Revised: 09/08/2021] [Accepted: 10/24/2021] [Indexed: 01/02/2023]
Abstract
The development and implementation of school policies is considered a key strategy for the promotion of physical activity (PA) in children and adolescents. This study aimed to systematically review and synthesise existing literature focusing on the associations between formal written school-based PA policies and (a) school PA practices and (b) PA behaviours of school-aged children and adolescents. Fifty-one papers reporting on 52 studies met the eligibility criteria. All but two studies were from high income countries, most used cross-sectional designs and demonstrated fair methodological quality, and just over a third examined language aspects of policies. Findings predominantly indicated a lack of or inconclusive associations between the various characteristics examined and PA outcomes. Inconclusive associations were identified between both PA practice and behaviour outcomes and state level policies, policies focusing on PE and school-day PA, and in studies examining language aspects of policies. Inconclusive associations with both types of outcomes were more likely to be identified compared to a lack of associations in studies using self-report measures and in studies not providing information about the quality of exposure and outcome measures used. Overall, findings highlight the need for further research that acknowledges the complex relationship between school policies and PA outcomes and employs robust methodological approaches to enhance our understanding of this area.
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Affiliation(s)
- Michalis Stylianou
- School of Human Movement and Nutrition Sciences, The University of Queensland, St. Lucia, Queensland, 4072, Australia.
| | - James Woodforde
- School of Human Movement and Nutrition Sciences, The University of Queensland, St. Lucia, Queensland, 4072, Australia
| | - Stephanie Duncombe
- School of Human Movement and Nutrition Sciences, The University of Queensland, St. Lucia, Queensland, 4072, Australia
| | - Tracy Kolbe-Alexander
- School of Health & Wellbeing, University of Southern Queensland, lpswich, Queensland, 4305, Australia
| | - Sjaan Gomersall
- School of Human Movement and Nutrition Sciences, The University of Queensland, St. Lucia, Queensland, 4072, Australia; School of Health and Rehabilitation Sciences, The University of Queensland, St. Lucia, Queensland, 4072, Australia
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Burson SL, Mulhearn SC, Castelli DM, van der Mars H. Essential Components of Physical Education: Policy and Environment. RESEARCH QUARTERLY FOR EXERCISE AND SPORT 2021; 92:209-221. [PMID: 34009092 DOI: 10.1080/02701367.2021.1884178] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/05/2020] [Accepted: 01/27/2021] [Indexed: 06/12/2023]
Abstract
Purpose: Physical education policies provide guidance and accountability to develop quality programs that increase physical literacy. The purpose of this study was to conduct a systematic review of physical education policy research to explore its effects on the school environment and programming as an essential component of physical education. Methods: Using the PRISMA guidelines of identify, screen, determine eligibility, and include, studies were extracted from four different databases, using search terms related to the essential physical education component of policy and environment. Of the 225 publications identified, 42 studies met the inclusion criteria for this investigation. Each paper was coded, and emergent themes were identified. Results: The policy research was predominantly descriptive and focused on: (a) minutes in physical education (83%), (b) moderate to vigorous physical activity (MVPA; 31%), (c) certified/qualified teachers (24%), (d) exemptions (17%), and (e) student-teacher ratio (12%). Emergent themes of adherence, policy strength, and implementation accountability were identified as influential physical education policy aspects. Conclusions: Policy research over the last 20 years was focused on the regulatory mandate of time. Policy research did not directly address disciplinary process variables of learning activities or outcomes of physical education. The effects of policy exemptions and class size were underrepresented. Themes may explain the lack of reporting student performance as the primary outcome. Further research is needed to examine the downstream effects of physical education policy and determine whether well-written policies increase the number of physically literate individuals.
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An R, Liu J, Liu R. State laws governing school physical education in relation to attendance and physical activity among students in the USA: A systematic review and meta-analysis. JOURNAL OF SPORT AND HEALTH SCIENCE 2021; 10:277-287. [PMID: 32961302 PMCID: PMC8167326 DOI: 10.1016/j.jshs.2020.09.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 08/13/2020] [Accepted: 08/21/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND This study systematically synthesized and quantified the relationship linking state laws governing school physical education (PE) to PE attendance and physical activity (PA) in class and throughout the day and week among students in the USA. METHODS A keyword search was performed in PubMed, Web of Science, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Academic Search Complete, and EconLit. Meta-analyses were performed to estimate the effects of state PE laws. RESULTS A total of 17 studies were included in the review, and five contributed to the meta-analyses. A total of 8 studies used nationally representative school- or student-level data, three focused on multiple states, and the remaining six examined the PE laws of a single state. The presence and strength of state PE laws were positively associated with PE attendance and the frequency and duration of PA during PE classes and throughout the school day. Compared to those residing in states with weak or no PE laws, students in states with strong PE laws had an additional 0.2 days (95% confidence interval (95%CI): 0.1-0.4) of PE attendance per week and spent an additional 33.9 min (95%CI: 22.7-45.0) participating PE classes per week. State PE laws affected girls' PA more than boys'. Different aspects of state PE laws tended to affect students' PE attendance differently. Disparities in the implementation of state PE laws existed across schools. CONCLUSION Future studies should adopt objective measures on PE and PA participation and examine the roles schools and districts play in mediating the effect of state PE laws on students' PE attendance and PA.
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Affiliation(s)
- Ruopeng An
- Brown School, Washington University, St. Louis, MO 63130, USA
| | - Jianxiu Liu
- Department of Physical Education, Tsinghua University, Beijing 100084, China.
| | - Ruidong Liu
- Department of Physical Education, Tsinghua University, Beijing 100084, China
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In-School, Out-of-School, and Weekend Physical Activity Levels Vary Across Sociodemographic Subgroups of US Adolescents. J Phys Act Health 2021; 18:418-425. [PMID: 33706285 DOI: 10.1123/jpah.2020-0157] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Revised: 01/06/2021] [Accepted: 01/13/2021] [Indexed: 11/18/2022]
Abstract
BACKGROUND In response to conflicting findings for activity levels across sociodemographic groups, this study examined differences in adolescents' in-school, out-of-school, and weekend physical activity (PA) by sociodemographic subgroups using representative US data. METHODS Data were obtained from the Family Life, Activity, Sun, Health, and Eating study. Multiple regression models compared in-school, out-of-school, and weekend PA by gender and race/ethnicity, and examined potential modification of associations by grade (middle vs high school) and socioeconomic status (lower vs higher). RESULTS Final analytic sample was 1413 adolescents (Mean age = 14.5 y, 51.3% female, 64.5% white). Compared with whites, in-school PA was significantly higher among blacks and those classified as other race/ethnicity for middle school (69.8 and 71.0, respectively, vs 66.4 min/d), and among Hispanics for high school (52.7 vs 48.4 min/d). Hispanics' (vs whites') out-of-school PA was significantly lower for middle school (63.7 vs 66.6 min/d), but higher for high school (54.0 vs 51.8 min/d). In-school PA was significantly higher among adolescents of lower (vs higher) socioeconomic status among males and Hispanics (all Ps < .05). CONCLUSIONS The relation of race/ethnicity with PA varies by grade and time of day/week. Socioeconomic status findings contradict previously reported findings. Efforts to increase PA based on sociodemographic disparities should consider potential interaction effects.
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Arena R, Myers J, Kaminsky LA, Williams M, Sabbahi A, Popovic D, Axtell R, Faghy MA, Hills AP, Olivares Olivares SL, Lopez M, Pronk NP, Laddu D, Babu AS, Josephson R, Whitsel LP, Severin R, Christle JW, Dourado VZ, Niebauer J, Savage P, Austford LD, Lavie CJ. Current Activities Centered on Healthy Living and Recommendations for the Future: A Position Statement from the HL-PIVOT Network. Curr Probl Cardiol 2021; 46:100823. [PMID: 33789171 PMCID: PMC9587486 DOI: 10.1016/j.cpcardiol.2021.100823] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Accepted: 02/22/2021] [Indexed: 12/15/2022]
Abstract
We continue to increase our cognizance and recognition of the importance of healthy living (HL) behaviors and HL medicine (HLM) to prevent and treat chronic disease. The continually unfolding events precipitated by the coronavirus disease 2019 (COVID-19) pandemic have further highlighted the importance of HL behaviors, as indicated by the characteristics of those who have been hospitalized and died from this viral infection. There has already been recognition that leading a healthy lifestyle, prior to the COVID-19 pandemic, may have a substantial protective effect in those who become infected with the virus. Now more than ever, HL behaviors and HLM are essential and must be promoted with a renewed vigor across the globe. In response to the rapidly evolving world since the beginning of the COVID-19 pandemic, and the clear need to change lifestyle behaviors to promote human resilience and quality of life, the HL for Pandemic Event Protection (HL-PIVOT) network was established. The 4 major areas of focus for the network are: (1) knowledge discovery and dissemination; (2) education; (3) policy; (4) implementation. This HL-PIVOT network position statement provides a current synopsis of the major focus areas of the network, including leading research in the field of HL behaviors and HLM, examples of best practices in education, policy, and implementation, and recommendations for the future.
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Affiliation(s)
- Ross Arena
- Department of Physical Therapy, College of Applied Science, University of Illinois at Chicago, Chicago, IL; Healthy Living for Pandemic Event Protection (HL - PIVOT) Network, Chicago, IL.
| | - Jonathan Myers
- Healthy Living for Pandemic Event Protection (HL - PIVOT) Network, Chicago, IL; VA Palo Alto Health Care System and Stanford University, Palo Alto, CA
| | - Leonard A Kaminsky
- Healthy Living for Pandemic Event Protection (HL - PIVOT) Network, Chicago, IL; Ball State University, Muncie, IN
| | - Mark Williams
- Healthy Living for Pandemic Event Protection (HL - PIVOT) Network, Chicago, IL; Creighton University, Omaha, NE
| | - Ahmad Sabbahi
- Department of Physical Therapy, College of Applied Science, University of Illinois at Chicago, Chicago, IL; Healthy Living for Pandemic Event Protection (HL - PIVOT) Network, Chicago, IL
| | - Dejana Popovic
- Healthy Living for Pandemic Event Protection (HL - PIVOT) Network, Chicago, IL; Clinic for Cardiology, Clinical Center of Serbia, University of Belgrade, Belgrade, Serbia
| | - Robert Axtell
- Healthy Living for Pandemic Event Protection (HL - PIVOT) Network, Chicago, IL; Southern Connecticut State University, New Haven, CT
| | - Mark A Faghy
- Healthy Living for Pandemic Event Protection (HL - PIVOT) Network, Chicago, IL; Human Research Centre, University of Derby, Derby, United Kingdom
| | - Andrew P Hills
- Healthy Living for Pandemic Event Protection (HL - PIVOT) Network, Chicago, IL; School of Health Sciences, University of Tasmania, Tasmania, Australia
| | - Silvia Lizett Olivares Olivares
- Healthy Living for Pandemic Event Protection (HL - PIVOT) Network, Chicago, IL; Tecnologico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Monterrey, Mexico
| | - Mildred Lopez
- Healthy Living for Pandemic Event Protection (HL - PIVOT) Network, Chicago, IL; Tecnologico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Monterrey, Mexico
| | - Nicolaas P Pronk
- Healthy Living for Pandemic Event Protection (HL - PIVOT) Network, Chicago, IL; HealthPartners Institute, Bloomington, Minnesota, and Harvard TH Chan School of Public Health, Boston, MA
| | - Deepika Laddu
- Department of Physical Therapy, College of Applied Science, University of Illinois at Chicago, Chicago, IL; Healthy Living for Pandemic Event Protection (HL - PIVOT) Network, Chicago, IL
| | - Abraham Samuel Babu
- Healthy Living for Pandemic Event Protection (HL - PIVOT) Network, Chicago, IL; Department of Physiotherapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, India
| | - Richard Josephson
- Healthy Living for Pandemic Event Protection (HL - PIVOT) Network, Chicago, IL; Case Western Reserve University and University Hospitals of Cleveland, Cleveland, OH
| | - Laurie P Whitsel
- Healthy Living for Pandemic Event Protection (HL - PIVOT) Network, Chicago, IL
| | - Rich Severin
- Department of Physical Therapy, College of Applied Science, University of Illinois at Chicago, Chicago, IL; Healthy Living for Pandemic Event Protection (HL - PIVOT) Network, Chicago, IL
| | - Jeffrey W Christle
- Healthy Living for Pandemic Event Protection (HL - PIVOT) Network, Chicago, IL; Stanford University, Stanford, CA
| | - Victor Zuniga Dourado
- Healthy Living for Pandemic Event Protection (HL - PIVOT) Network, Chicago, IL; Federal University of São Paulo, Santos, São Paulo, Brazil
| | - Josef Niebauer
- Healthy Living for Pandemic Event Protection (HL - PIVOT) Network, Chicago, IL; Institute of Sports Medicine, Prevention and Rehabilitation, Paracelsus Medical University and Ludwig Boltzmann Institute for Digital Health and Prevention, Salzburg, Austria
| | - Patrick Savage
- Healthy Living for Pandemic Event Protection (HL - PIVOT) Network, Chicago, IL; University of Vermont Medical Center, Cardiac Rehabilitation Program, South Burlington, VT
| | - Leslie D Austford
- Healthy Living for Pandemic Event Protection (HL - PIVOT) Network, Chicago, IL; TotalCardiology Research Network, and TotalCardiologyTM, Calgary, Alberta, Canada
| | - Carl J Lavie
- Healthy Living for Pandemic Event Protection (HL - PIVOT) Network, Chicago, IL; Department of Cardiovascular Diseases, John Ochsner Heart and Vascular Institute, Ochsner Clinical School-University of Queensland School of Medicine, New Orleans, LA
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The Association between Perceived Adequacy and Capacity for School Food Policy Implementation with Food Availability and Policy Adherence in Nova Scotia, Canada. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16111974. [PMID: 31167362 PMCID: PMC6604017 DOI: 10.3390/ijerph16111974] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/21/2019] [Revised: 05/24/2019] [Accepted: 06/03/2019] [Indexed: 11/16/2022]
Abstract
Supporting the implementation of school food and nutrition policies is an international priority to encourage healthier eating among children and youth. Schools are an important intervention setting to promote childhood nutrition, and many jurisdictions have adopted policies, guidelines, and programs to modify the school nutrition environment and promote healthier eating. The purpose of this study was to explore the association between perceived adequacy of facilities or equipment and capacity of staff to support policy implementation with food availability and policy adherence in the province of Nova Scotia (NS), Canada, one of the first regions in Canada to launch a comprehensive school food and nutrition policy (SFNP). A cross-sectional online survey was conducted in 2014-2015 to provide a current-state assessment of policy implementation and adherence. Adequacy and capacity for food policy implementation was used to assess policy adherence through the availability of prohibited 'minimum' nutrition foods. An exploratory factor analysis was conducted on a selection of available foods, and 'slow'- and 'quick'-service food composition measures were dichotomized for food availability. Schools with above-average perceived adequacy and capacity for policy implementation had greater odds (OR = 3.62, CI = 1.56, 8.40) of adhering to a lunch policy, while schools that adhered to a snack and lunch policy had lower odds (OR = 0.48, CI = 0.23, 1.01 and OR = 0.18, CI = 0.08, 0.41) of serving quick-service foods. This study identified the need for appropriate adequacy of facilities or equipment and capacity of staff for policy implementation to ensure policy adherence and improve the school food environment. These findings highlight the relationship between school food and nutrition policies, suggesting that better supporting their implementation could increase the likelihood of their success.
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Bramante CT, Thornton RLJ, Bennett WL, Zhang A, Wilson RF, Bass EB, Tseng E. Systematic Review of Natural Experiments for Childhood Obesity Prevention and Control. Am J Prev Med 2019; 56:147-158. [PMID: 30573143 PMCID: PMC7397557 DOI: 10.1016/j.amepre.2018.08.023] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2018] [Revised: 08/06/2018] [Accepted: 08/07/2018] [Indexed: 12/16/2022]
Abstract
CONTEXT The National Academy of Medicine recommends childhood obesity prevention efforts making healthier options the passive choice. This review evaluated the effectiveness of population-level policies and programs from natural experiments for childhood obesity prevention. EVIDENCE ACQUISTION The search included PubMed, CINAHL, PsycINFO, and EconLit from 2000 to 2017 for policies evaluated by natural experiments reporting childhood BMI outcomes. The studies were analyzed in 2017-2018. Interventions were classified by environmental focus (food/beverage, physical activity, or both) and stratified by setting (school, community, both). Risk of bias was evaluated for each study. EVIDENCE SYNTHESIS Of 33 natural experiments, most (73%) took place in the school setting only. The most common environmental focus in any setting was food/beverage (48%). All four studies that focused on both food/beverage and physical activity in schools demonstrated decreased prevalence of overweight/obesity or BMI z-score by 0.04-0.17. BMI decreased in all four studies in both school and community settings. The largest effect size was a decrease in BMI z-score of 0.5, but most were <0.25. The risk of bias was high for most (76%) studies. Most (63%) of the eight studies with low/medium risk of bias took place in the school setting focused on the food/beverage environment; effects on BMI were mixed. CONCLUSIONS Natural experiments evaluating school-based policies focusing on both the food/beverage and physical activity environments (versus targeting only one) consistently showed improvement in BMI. However, most studies had high risk of bias, highlighting the need for improved methods for evaluation of natural experiments for childhood obesity prevention.
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Affiliation(s)
- Carolyn T Bramante
- Division of General Internal Medicine, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland.
| | - Rachel L J Thornton
- Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, Maryland; Department of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins Medical Institutions, Baltimore, Maryland
| | - Wendy L Bennett
- Division of General Internal Medicine, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland; Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins Medical Institutions, Baltimore, Maryland
| | - Allen Zhang
- Johns Hopkins Evidence-Based Practice Center, Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Renee F Wilson
- Johns Hopkins Evidence-Based Practice Center, Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Eric B Bass
- Division of General Internal Medicine, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland; Johns Hopkins Evidence-Based Practice Center, Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Eva Tseng
- Division of General Internal Medicine, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland; Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins Medical Institutions, Baltimore, Maryland
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12
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The Protective Effects of School Connectedness on Substance Use and Physical Activity. J Adolesc Health 2018; 63:724-731. [PMID: 30269908 DOI: 10.1016/j.jadohealth.2018.07.002] [Citation(s) in RCA: 57] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2018] [Revised: 06/28/2018] [Accepted: 07/05/2018] [Indexed: 11/22/2022]
Abstract
PURPOSE Cross-sectional evidence suggests that school connectedness is an important correlate of health-related behaviors among adolescents, but prospective studies are needed to strengthen the case for a causal relationship. This study investigated the prospective relationship between school connectedness and four health-related behaviors: cigarette smoking, marijuana use, binge drinking, and physical activity. METHODS We analyzed 4 years of data from the COMPASS study. Participants included in this analysis were 33,313 students who provided information on sociodemographic, school connectedness, and the four health-related behaviors for at least two consecutive years. Generalized Estimating Equation models were used to examine whether the change in school connectedness scores predicted the change in an individual child's trajectory of health-related behaviors across 9th, 10th, 11th, and 12th grades. RESULTS As students moved to higher grades, school connectedness decreased, and the likelihood of being a less frequent smoker, marijuana user, and binge drinker, and meeting physical activity guidelines declined. An increase in school connectedness scores was associated with an increased likelihood of meeting physical activity recommendations (OR = 1.06, p < .01), being a less frequent smoker, marijuana user, and binge drinker (OR = 1.30, 1.17, 1.10, respectively; p's < .0001) across the 4 years. CONCLUSIONS This study provides prospective evidence supporting the protective effects of school connectedness on substance abuse and physical activity, and highlights the importance of fostering school connectedness to support healthy adolescent development.
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Kahan D, McKenzie TL. Correlates of Private Secondary Schools Meeting Physical Education Guidelines. THE JOURNAL OF SCHOOL HEALTH 2018; 88:508-515. [PMID: 29864205 DOI: 10.1111/josh.12633] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/14/2016] [Revised: 08/24/2017] [Accepted: 12/20/2017] [Indexed: 06/08/2023]
Abstract
BACKGROUND Although there are over 26,000 private schools in the United States, little is known about the relationship of their characteristics to mandated and recommended time allocations for physical education (PE). METHODS Private secondary schools (N = 450; grades 6-12) in California completed a 15-item questionnaire related to school characteristics and PE policies and practices. Using correlational analysis and predictive modeling, we assessed the associations and influences of various factors relative to the schools meeting state (California) and national professional time targets for PE. RESULTS Whereas most schools fell short of meeting PE weekly time recommendations, 5 of 10 tested variables were significantly associated with schools meeting PE minutes/week targets: school enrollment, school level, having a fitness testing policy, PE class size, and not permitting exemptions for PE. Large schools and those serving high school students provided more PE and were more likely to meet PE time allocation standards. Having policies for PE minutes/week and no exemptions for PE were significantly associated with a school having all its PE classes taught by a specialist. CONCLUSIONS Private secondary schools should consider the adoption of professional guidelines related to PE time allocations, class size, conducting physical fitness testing, employing PE specialists, and not permitting exemptions for PE.
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Affiliation(s)
- David Kahan
- School of Exercise and Nutritional Sciences, San Diego State University, 5500 Campanile Drive, San Diego, CA 92182-7251
| | - Thomas L McKenzie
- School of Exercise and Nutritional Sciences, San Diego State University, 5127 Walsh Way, San Diego, CA 92115
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14
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Diep CS, Leung R, Thompson D, Gor BJ, Baranowski T. Physical Activity Behaviors and Influences Among Chinese-American Children Aged 9-13 Years: A Qualitative Study. J Immigr Minor Health 2018; 19:358-366. [PMID: 27384684 DOI: 10.1007/s10903-016-0457-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Low physical activity is a major health issue among Chinese Americans. This study explored Chinese-American children's physical activity behaviors and influencing factors. Twenty-five children of Chinese or Taiwanese descent were interviewed to understand their favorite sports or physical activities, physical activity environments, and influences on their physical activity. All were between the ages of 9 and 13. Interviews were transcribed and coded using thematic data analysis procedures. Major themes included: (1) team sports, particularly basketball, were commonly listed as favorite sports or activities; (2) physical activity occurred mostly at school or an after-school setting; and (3) family played a major role in physical activity. Some trends/differences were detected based on age, sex, and socioeconomic status. Interventions to promote physical activity among Chinese-American children should emphasize team sports and encourage physical activity in schools, but also explore ways to involves families outside of school.
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Affiliation(s)
- Cassandra S Diep
- Department of Pediatrics, USDA/ARS Children's Nutrition Research Center, Baylor College of Medicine, Houston, TX, USA. .,Department of Health Disparities Research - Unit 1440, The University of Texas MD Anderson Cancer Center, P.O. Box 301402, Houston, TX, 77230-1402, USA.
| | - Randall Leung
- Department of Health Sciences, Boston University, Boston, MA, USA
| | - Debbe Thompson
- Department of Pediatrics, USDA/ARS Children's Nutrition Research Center, Baylor College of Medicine, Houston, TX, USA
| | - Beverly J Gor
- Houston Health Department, Office of Planning, Evaluation and Research for Effectiveness, Houston, TX, USA
| | - Tom Baranowski
- Department of Pediatrics, USDA/ARS Children's Nutrition Research Center, Baylor College of Medicine, Houston, TX, USA
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15
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Sanchez-Vaznaugh EV, Goldman Rosas L, Fernández-Peña JR, Baek J, Egerter S, Sánchez BN. Physical education policy compliance and Latino children's fitness: Does the association vary by school neighborhood socioeconomic advantage? PLoS One 2017; 12:e0178980. [PMID: 28591139 PMCID: PMC5462408 DOI: 10.1371/journal.pone.0178980] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2016] [Accepted: 05/22/2017] [Indexed: 12/04/2022] Open
Abstract
OBJECTIVES To investigate the contribution of school neighborhood socioeconomic advantage to the association between school-district physical education policy compliance in California public schools and Latino students' physical fitness. METHODS Cross-sectional Fitnessgram data for public-school students were linked with school- and district-level information, district-level physical education policy compliance from 2004-2005 and 2005-2006, and 2000 United States Census data. Multilevel logistic regression models examined whether income and education levels in school neighborhoods moderated the effects of district-level physical education policy compliance on Latino fifth-graders' fitness levels. RESULTS Physical education compliance data were available for 48 California school districts, which included 64,073 Latino fifth-graders. Fewer than half (23, or 46%) of these districts were found to be in compliance, and only 16% of Latino fifth-graders attended schools in compliant districts. Overall, there was a positive association between district compliance with physical education policy and fitness (OR, 95%CI: 1.38, 1.07, 1.78) adjusted for covariates. There was no significant interaction between school neighborhood socioeconomic advantage and physical education policy compliance (p>.05): there was a positive pattern in the association between school district compliance with physical education policy and student fitness levels across levels of socioeconomic advantage, though the association was not always significant. CONCLUSIONS Across neighborhoods with varying levels of socioeconomic advantage, increasing physical education policy compliance in elementary schools may be an effective strategy for improving fitness among Latino children.
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Affiliation(s)
- Emma V. Sanchez-Vaznaugh
- Health Education Department and Health Equity Institute, San Francisco State University; Center on Social Disparities in Health, University of California San Francisco, San Francisco, California, United States of America
- Family Community Medicine, Center on Social Disparities in Health, University of California San Francisco School of Medicine, San Francisco, California, United States of America
| | - Lisa Goldman Rosas
- Stanford Prevention Research Center, Program on Prevention Outcomes and Practices, Palo Alto, California, United States of America
| | - José Ramón Fernández-Peña
- Health Education Department and Health Equity Institute, San Francisco State University; Center on Social Disparities in Health, University of California San Francisco, San Francisco, California, United States of America
| | - Jonggyu Baek
- Center for Social Epidemiology and Population Health, University of Michigan, Ann Arbor, United States of America
| | - Susan Egerter
- Family Community Medicine, Center on Social Disparities in Health, University of California San Francisco School of Medicine, San Francisco, California, United States of America
| | - Brisa N. Sánchez
- Department of Biostatistics, School of Public Health, University of Michigan, Ann Arbor, United States of America
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16
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Shah S, Allison KR, Schoueri‐Mychasiw N, Pach B, Manson H, Vu‐Nguyen K. A Review of Implementation Outcome Measures of School-Based Physical Activity Interventions. THE JOURNAL OF SCHOOL HEALTH 2017; 87:474-486. [PMID: 28463446 PMCID: PMC5518226 DOI: 10.1111/josh.12514] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/17/2016] [Revised: 09/13/2016] [Accepted: 12/25/2016] [Indexed: 06/07/2023]
Abstract
BACKGROUND Measuring the implementation of school-based physical activity (PA) interventions is an important prerequisite in assessing their impact. Prior to conducting a study to assess the implementation of the daily physical activity (DPA) policy in Ontario, Canada, a literature review was conducted to identify existing survey instruments to measure 5 implementation outcomes: adoption, fidelity, implementation cost, reach, and sustainability. METHODS A search for survey instruments to assess these implementation outcomes at the teacher and school administrator levels was conducted in 7 bibliographic databases, as well as the gray literature. Each survey instrument was coded as assessing 1 of the 5 implementation outcomes if it included at least 1 item measuring the construct. RESULTS Twenty-three survey instruments were identified. None of the instruments were specifically developed to measure the implementation outcomes. Fidelity was the most common implementation outcome measured, followed by adoption. The least common implementation outcome measured was sustainability. Thirty-five percent of survey instruments assessed were previously tested for validity and 26% were previously tested for reliability. CONCLUSIONS Based on this review, a gap in available instruments to measure implementation outcomes of school-based PA programs was identified. An adapted theoretical framework, presented here, has potential application in future implementation studies.
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Affiliation(s)
- Sonam Shah
- Faculty of Medicine, University of Toronto, 1 King's College CircleTorontoOntario M5S 1A8
| | - Kenneth R. Allison
- Dalla Lana School of Public HealthUniversity of TorontoTorontoOntario M5T 3M7
| | - Nour Schoueri‐Mychasiw
- Health Promotion, Chronic Disease & Injury Prevention, Public Health Ontario, 480 University Avenue, Suite 300TorontoOntario M5G1V2
| | - Beata Pach
- Library Services, Public Health Ontario, 480 University Avenue, Suite 300TorontoOntario M5G1V2
| | - Heather Manson
- Health Promotion, Chronic Disease & Injury Prevention, Public Health Ontario, 480 University Avenue, Suite 300TorontoOntario M5G1V2
| | - Karen Vu‐Nguyen
- Health Promotion, Chronic Disease & Injury Prevention, Public Health Ontario, 480 University Avenue, Suite 300TorontoOntario M5G1V2
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17
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Hollis JL, Sutherland R, Williams AJ, Campbell E, Nathan N, Wolfenden L, Morgan PJ, Lubans DR, Gillham K, Wiggers J. A systematic review and meta-analysis of moderate-to-vigorous physical activity levels in secondary school physical education lessons. Int J Behav Nutr Phys Act 2017; 14:52. [PMID: 28438171 PMCID: PMC5402678 DOI: 10.1186/s12966-017-0504-0] [Citation(s) in RCA: 100] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2016] [Accepted: 04/05/2017] [Indexed: 11/24/2022] Open
Abstract
Background Schools play an important role in physical activity promotion for adolescents. The systematic review aimed to determine the proportion of secondary (middle and high) school physical education (PE) lesson time that students spend in moderate to vigorous physical activity (MVPA), and to assess if MVPA was moderated by school level (middle and high school), type of physical activity measurement and type of PE activities. Methods A systematic search of nine electronic databases was conducted (PROSPERO2014:CRD42014009649). Studies were eligible if they were published between 2005 and 2014; written in English; assessed MVPA in PE lessons of secondary (middle and high) school students; and used a quantitative MVPA measure (i.e., accelerometry, heart rate monitoring, pedometers or observational measures). Two reviewers examined the retrieved articles, assessed risk of bias, and performed data extraction. Random effects meta-analysis was used to calculate a pooled estimate of the percent of PE lesson time spent in MVPA and to assess moderator effects where data allowed. Results The search yielded 5,132 potentially relevant articles; 28 articles representing 25 studies (7 middle and 18 high school) from seven countries were included. Twelve studies measured MVPA through observational measures, seven used accelerometers, five used heart rate monitors and four used pedometers (including three studies using a mix of measures). Meta-analysis of 15 studies found that overall, students spent a mean (95% CI) of 40.5% (34.8–46.2%) of PE in MVPA. Middle school students spent 48.6% (41.3–55.9%) of the lesson in MVPA (n = 5 studies) and high school students 35.9% (28.3–43.6%) (n = 10 studies). Studies measuring MVPA using accelerometers (n = 5) showed that students spent 34.7% (25.1–44.4%) of the lesson in MVPA, while 44.4% (38.3–50.5%) was found for lessons assessed via observation (n = 9), 43.1% (24.3–61.9%) of the lesson for a heart rate based study, and 35.9% (31.0–40.8%) for a pedometer-measured study. Conclusions The proportion of PE spent in MVPA (40.5%) is below the US Centre for Disease Control and Prevention and the UK Associations for Physical Education recommendation of 50%. Findings differed according to the method of MVPA assessment. Additional strategies and intervention research are needed to build more active lesson time in PE. Electronic supplementary material The online version of this article (doi:10.1186/s12966-017-0504-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Jenna L Hollis
- Hunter New England Population Health, Locked Bag 10, Wallsend, NSW, 2287, Australia. .,School of Medicine and Public Health, University of Newcastle, Callaghan, 2308, Australia.
| | - Rachel Sutherland
- Hunter New England Population Health, Locked Bag 10, Wallsend, NSW, 2287, Australia.,School of Medicine and Public Health, University of Newcastle, Callaghan, 2308, Australia.,Hunter Medical Research Institute, Lambton, NSW, 2305, Australia
| | - Amanda J Williams
- Hunter New England Population Health, Locked Bag 10, Wallsend, NSW, 2287, Australia.,School of Medicine and Public Health, University of Newcastle, Callaghan, 2308, Australia.,Hunter Medical Research Institute, Lambton, NSW, 2305, Australia
| | - Elizabeth Campbell
- Hunter New England Population Health, Locked Bag 10, Wallsend, NSW, 2287, Australia.,School of Medicine and Public Health, University of Newcastle, Callaghan, 2308, Australia.,Hunter Medical Research Institute, Lambton, NSW, 2305, Australia
| | - Nicole Nathan
- Hunter New England Population Health, Locked Bag 10, Wallsend, NSW, 2287, Australia.,School of Medicine and Public Health, University of Newcastle, Callaghan, 2308, Australia.,Hunter Medical Research Institute, Lambton, NSW, 2305, Australia
| | - Luke Wolfenden
- Hunter New England Population Health, Locked Bag 10, Wallsend, NSW, 2287, Australia.,School of Medicine and Public Health, University of Newcastle, Callaghan, 2308, Australia.,Hunter Medical Research Institute, Lambton, NSW, 2305, Australia
| | - Philip J Morgan
- Priority Research Centre in Physical Activity and Nutrition, School of Education, University of Newcastle, Callaghan, 2308, Australia
| | - David R Lubans
- Priority Research Centre in Physical Activity and Nutrition, School of Education, University of Newcastle, Callaghan, 2308, Australia
| | - Karen Gillham
- Hunter New England Population Health, Locked Bag 10, Wallsend, NSW, 2287, Australia.,School of Medicine and Public Health, University of Newcastle, Callaghan, 2308, Australia
| | - John Wiggers
- Hunter New England Population Health, Locked Bag 10, Wallsend, NSW, 2287, Australia.,School of Medicine and Public Health, University of Newcastle, Callaghan, 2308, Australia.,Hunter Medical Research Institute, Lambton, NSW, 2305, Australia
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18
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Gamble A, Chatfield SL, Cormack ML, Hallam JS. Not Enough Time in the Day: A Qualitative Assessment of In-School Physical Activity Policy as Viewed by Administrators, Teachers, and Students. THE JOURNAL OF SCHOOL HEALTH 2017; 87:21-28. [PMID: 27917482 DOI: 10.1111/josh.12464] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/09/2016] [Revised: 04/06/2016] [Accepted: 07/11/2016] [Indexed: 06/06/2023]
Abstract
BACKGROUND In recent decades, the alignment of health and education has been at the forefront of school reform. Whereas the establishment of national in-school physical activity (ISPA) recommendations and state-level mandates demonstrates success, there has been less achievement in areas that address health disparities. The purpose of this investigation was to explore barriers and facilitators to implementing state-mandated ISPA policies in the Mississippi Delta. METHODS Focus groups or interviews were conducted with district administrators, school principals, teachers, and students. A total of 2 semistructured moderator guides were developed to focus on (1) student ISPA practices and preferences and (2) facilitators and barriers to implementing ISPA policies and practices. RESULTS A total of 6 themes were developed. In that, 2 themes addressed participant-described barriers (primary challenges and interferences and excuses). Three themes highlighted participant-described facilitators (compromises, things that work, and being active at school). Finally, 1 theme encompassed the participant-described need to address educating the whole child. CONCLUSIONS There is a critical need for meaningful and relevant solutions to circumvent challenges to implementing ISPA policies and practices in the Mississippi Delta. The Whole School, Whole Community, Whole Child model offers a broad means of visualizing rural, low-income, racially concentrated schools to circumvent challenges and foster ISPA policies and practices.
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Affiliation(s)
- Abigail Gamble
- University of Mississippi Medical Center, 2500 North State Street, Jackson, MS 39216
| | | | - Michael L Cormack
- Barksdale Reading Institute, 1003 Jefferson Avenue, Oxford, MS 38655
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Weaver RG, Moore JB, Turner-McGrievy B, Saunders R, Beighle A, Khan MM, Chandler J, Brazendale K, Randell A, Webster C, Beets MW. Identifying Strategies Programs Adopt to Meet Healthy Eating and Physical Activity Standards in Afterschool Programs. HEALTH EDUCATION & BEHAVIOR 2016; 44:536-547. [PMID: 27852666 DOI: 10.1177/1090198116676252] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND The YMCA of USA has adopted Healthy Eating and Physical Activity (HEPA) Standards for its afterschool programs (ASPs). Little is known about strategies YMCA ASPs are implementing to achieve Standards and these strategies' effectiveness. AIMS (1) Identify strategies implemented in YMCA ASPs and (2) evaluate the relationship between strategy implementation and meeting Standards. METHOD HEPA was measured via accelerometer (moderate-to-vigorous-physical-activity [MVPA]) and direct observation (snacks served) in 20 ASPs. Strategies were identified and mapped onto a capacity building framework ( Strategies To Enhance Practice [STEPs]). Mixed-effects regression estimated increases in HEPA outcomes as implementation increased. Model-implied estimates were calculated for high (i.e., highest implementation score achieved), moderate (median implementation score across programs), and low (lowest implementation score achieved) implementation for both HEPA separately. RESULTS Programs implemented a variety of strategies identified in STEPs. For every 1-point increase in implementation score 1.45% (95% confidence interval = 0.33% to 2.55%, p ≤ .001) more girls accumulated 30 min/day of MVPA and fruits and/or vegetables were served on 0.11 more days (95% confidence interval = 0.11-0.45, p ≤ .01). Relationships between implementation and other HEPA outcomes did not reach statistical significance. Still regression estimates indicated that desserts are served on 1.94 fewer days (i.e., 0.40 vs. 2.34) in the highest implementing program than the lowest implementing program and water is served 0.73 more days (i.e., 2.37 vs. 1.64). CONCLUSIONS Adopting HEPA Standards at the national level does not lead to changes in routine practice in all programs. Practical strategies that programs could adopt to more fully comply with the HEPA Standards are identified.
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Behrens TK, Schuna JM, Liebert ML, Davis SK, Rice KR. Evaluation of an unstructured afterschool physical activity programme for disadvantaged youth. J Sports Sci 2016; 34:2140-2144. [PMID: 27007028 DOI: 10.1080/02640414.2016.1161216] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
The purpose of the study was to conduct an evaluation of an unstructured afterschool physical activity (PA) programme (Keep it Moving!; KIM) in an ethnically diverse and low socio-economic status (SES) school district. PA of students in 3rd-5th grades (N = 205) at four elementary schools were assessed during spring 2012. An ActiGraph accelerometer was utilised to examine objectively measured time and steps in differing intensity levels. Standard data reduction procedures were used to process collected data and characterise PA. Students averaged approximately 54 min of accelerometer wear-time during the KIM programme, 10.4 ± 6.1 min (19.2%) of which were spent in sedentary behaviour, 28.2 ± 8.3 min (52.1%) in light PA and 15.6 ± 6.6 min (28.7%) in moderate-to-vigorous intensity PA. Within the cadence band of 1-19 steps/min participants accumulated the highest time-derived PA (16.4 ± 6.3 min). In total, children averaged 1811.9 ± 527.5 steps during the entire KIM programme. Results from the programme indicated that elementary-aged students received additional PA through the KIM programme. The mean value of accumulated steps during the afterschool PA programme represented 12-16.5% of the minimum steps/day target (depending upon gender) identified for elementary-aged school children. These data represent unique findings from a high-need population that may be helpful for researchers and practitioners alike.
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Affiliation(s)
- Timothy K Behrens
- a Department of Health Sciences , Northern Arizona University , Flagstaff , AZ , USA.,b Department of Health Sciences , University of Colorado Colorado Springs , Colorado Springs , CO , USA
| | - John M Schuna
- c School of Biological and Population Health Sciences , Oregon State University , Corvallis , OR , USA
| | - Mina L Liebert
- d LiveWell Colorado Springs , Colorado Springs , CO , USA.,e El Paso County Public Health , Colorado Springs , CO , USA
| | - Stacy K Davis
- b Department of Health Sciences , University of Colorado Colorado Springs , Colorado Springs , CO , USA
| | - Kelly R Rice
- f Division of Physical Activity and Health , Eastern Oregon University , La Grande , OR , USA
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Hoelscher DM, Butte NF, Barlow S, Vandewater EA, Sharma SV, Huang T, Finkelstein E, Pont S, Sacher P, Byrd-Williams C, Oluyomi AO, Durand C, Li L, Kelder SH. Incorporating primary and secondary prevention approaches to address childhood obesity prevention and treatment in a low-income, ethnically diverse population: study design and demographic data from the Texas Childhood Obesity Research Demonstration (TX CORD) study. Child Obes 2015; 11:71-91. [PMID: 25555188 PMCID: PMC4696423 DOI: 10.1089/chi.2014.0084] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND There is consensus that development and evaluation of a systems-oriented approach for child obesity prevention and treatment that includes both primary and secondary prevention efforts is needed. This article describes the study design and baseline data from the Texas Childhood Obesity Research Demonstration (TX CORD) project, which addresses child obesity among low-income, ethnically diverse overweight and obese children, ages 2-12 years; a two-tiered systems-oriented approach is hypothesized to reduce BMI z-scores, compared to primary prevention alone. METHODS Our study aims are to: (1) implement and evaluate a primary obesity prevention program; (2) implement and evaluate efficacy of a 12-month family-centered secondary obesity prevention program embedded within primary prevention; and (3) quantify the incremental cost-effectiveness of the secondary prevention program. Baseline demographic and behavioral data for the primary prevention community areas are presented. RESULTS Baseline data from preschool centers, elementary schools, and clinics indicate that most demographic variables are similar between intervention and comparison communities. Most families are low income (≤$25,000) and Hispanic/Latino (73.3-83.8%). The majority of parents were born outside of the United States. Child obesity rates exceed national values, ranging from 19.0% in preschool to 35.2% in fifth-grade children. Most parents report that their children consume sugary beverages, have a television in the bedroom, and do not consume adequate amounts of fruits and vegetables. CONCLUSIONS Interventions to address childhood obesity are warranted in low-income, ethnically diverse communities. Integrating primary and secondary approaches is anticipated to provide sufficient exposure that will lead to significant decreases in childhood obesity.
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Affiliation(s)
- Deanna M. Hoelscher
- Michael & Susan Dell Center for Healthy Living, The University of Texas School of Public Health, Austin, TX
| | - Nancy F. Butte
- Department of Pediatrics, USDA/ARS Children's Nutrition Research Center, Baylor College of Medicine, Houston, TX
| | - Sarah Barlow
- Department of Pediatric Medicine, GI, Hepatology and Nutrition, Texas Children's Hospital, Baylor College of Medicine, Houston, TX
| | - Elizabeth A. Vandewater
- Michael & Susan Dell Center for Healthy Living, The University of Texas School of Public Health, Austin, TX
| | - Shreela V. Sharma
- Michael & Susan Dell Center for Healthy Living, The University of Texas School of Public Health, Houston, TX
| | - Terry Huang
- Department of Health Promotion, University of Nebraska Medical Center, Omaha, NE
| | - Eric Finkelstein
- Program in Health Services Systems Research, Duke University Global Health Institute, Singapore
| | - Stephen Pont
- Texas Center for the Prevention and Treatment of Childhood Obesity, Dell Children's Medical Center, University of Texas Southwestern–Austin, Austin, TX
| | - Paul Sacher
- Childhood Nutrition Research Center, University College, London, United Kingdom
| | - Courtney Byrd-Williams
- Michael & Susan Dell Center for Healthy Living, The University of Texas School of Public Health, Austin, TX
| | - Abiodun O. Oluyomi
- Michael & Susan Dell Center for Healthy Living, The University of Texas School of Public Health, Austin, TX
| | - Casey Durand
- Michael & Susan Dell Center for Healthy Living, The University of Texas School of Public Health, Houston, TX
| | - Linlin Li
- Michael & Susan Dell Center for Healthy Living, The University of Texas School of Public Health, Austin, TX
| | - Steven H. Kelder
- Michael & Susan Dell Center for Healthy Living, The University of Texas School of Public Health, Austin, TX
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Galaviz KI, Harden SM, Smith E, Blackman KC, Berrey LM, Mama SK, Almeida FA, Lee RE, Estabrooks PA. Physical activity promotion in Latin American populations: a systematic review on issues of internal and external validity. Int J Behav Nutr Phys Act 2014; 11:77. [PMID: 24938641 PMCID: PMC4073811 DOI: 10.1186/1479-5868-11-77] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2013] [Accepted: 06/11/2014] [Indexed: 02/08/2023] Open
Abstract
The purpose of this review was to determine the degree to which physical activity interventions for Latin American populations reported on internal and external validity factors using the RE-AIM framework (reach & representativeness, effectiveness, adoption, implementation, maintenance). We systematically identified English (PubMed; EbscoHost) and Spanish (SCIELO; Biblioteca Virtual en Salud) language studies published between 2001 and 2012 that tested physical activity, exercise, or fitness promotion interventions in Latin American populations. Cross-sectional/descriptive studies, conducted in Brazil or Spain, published in Portuguese, not including a physical activity/fitness/exercise outcome, and with one time point assessment were excluded. We reviewed 192 abstracts and identified 46 studies that met the eligibility criteria (34 in English, 12 in Spanish). A validated 21-item RE-AIM abstraction tool was used to determine the quality of reporting across studies (0-7 = low, 8-14 = moderate, and 15-21 = high). The number of indicators reported ranged from 3–14 (mean = 8.1 ± 2.6), with the majority of studies falling in the moderate quality reporting category. English and Spanish language articles did not differ on the number of indicators reported (8.1 vs. 8.3, respectively). However, Spanish articles reported more across reach indicators (62% vs. 43% of indicators), while English articles reported more across effectiveness indicators (69% vs 62%). Across RE-AIM dimensions, indicators for reach (48%), efficacy/effectiveness (67%), and implementation (41%) were reported more often than indicators of adoption (25%) and maintenance (10%). Few studies reported on the representativeness of participants, staff that delivered interventions, or the settings where interventions were adopted. Only 13% of the studies reported on quality of life and/or potential negative outcomes, 20% reported on intervention fidelity, and 11% on cost of implementation. Outcomes measured after six months of intervention, information on continued delivery and institutionalization of interventions, were also seldom reported. Regardless of language of publication, physical activity intervention research for Latin Americans should increase attention to and measurement of external validity and cost factors that are critical in the decision making process in practice settings and can increase the likelihood of translation into community or clinical practice.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Paul A Estabrooks
- 9Professor of Human Nutrition, Foods, & Exercise, Virginia Tech, Co-Director of the Fralin Translational Obesity Research Center, Professor of Family Medicine, Virginia Tech Carilion School of Medicine, Senior Director of Research, Carilion Clinic, 1 Riverside Circle SW Suite #104, Roanoke, VA 24016, USA.
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Lee C, Barroso CS, Troped PJ. Revolution/evolution of Active Living Research: perspectives from interdisciplinary grantees. Am J Health Promot 2014; 28:S125-7. [PMID: 24380459 DOI: 10.4278/ajhp.28.3s.s125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Cradock AL, Barrett JL, Carter J, McHugh A, Sproul J, Russo ET, Dao-Tran P, Gortmaker SL. Impact of the Boston Active School Day Policy to Promote Physical Activity among Children. Am J Health Promot 2014; 28:S54-64. [DOI: 10.4278/ajhp.130430-quan-204] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose. To test effectiveness of Active School Day policy implementation on physical activity outcomes and estimate school-level implementation costs. Design. The design of the study was quasi-experimental (pretest–posttest matched controls). Setting. The study took place in six elementary schools with three matched pairs in Boston, Massachusetts, February to June 2011. Subjects. Subjects were 455 consenting fourth- and fifth-grade students among 467 eligible. Intervention. Active School Day policy implementation provided equipment, curricular materials, and training to physical educators and school wellness champions to promote 150 weekly minutes of quality physical education, recess, and physical activity integrated into classrooms. Measures. Accelerometer assessments of accumulated minutes and bouts of moderate, vigorous, and sedentary physical activity on 5 school days before and after implementation were used. Implementation costs were collected by record review and reported resource utilization. Analysis. Analysis was conducted using multivariate mixed models estimated with repeated measures of daily physical activity, adjusted for student demographics and other confounding and design/clustering variables. Results. Accelerometer data were provided by 201 intervention and 192 comparison students for an average of 4 days per period (84% response). During school time, students in intervention schools demonstrated greater increases in minutes per day of moderate-to-vigorous physical activity (3.9, 95% confidence interval [CI] 1.8–6.0; p < .001) and vigorous physical activity (1.8, 95% CI.7–3.0; p < .001), and greater decreases in minutes per day of sedentary time (–10.6, 95% CI—15.3– −5.8; p < .001) than controls. Ongoing annual implementation costs totaled $4,523/school ($14/student). Conclusion. Active School Day implementation increased student moderate-to-vigorous physical activity levels by 24% and decreased sedentary time during school at modest cost.
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Taber DR, Chriqui JF, Perna FM, Powell LM, Slater SJ, Chaloupka FJ. Association between state physical education (PE) requirements and PE participation, physical activity, and body mass index change. Prev Med 2013; 57:629-33. [PMID: 23978523 DOI: 10.1016/j.ypmed.2013.08.018] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2013] [Revised: 08/07/2013] [Accepted: 08/14/2013] [Indexed: 10/26/2022]
Abstract
OBJECTIVE To determine if state physical education (PE) laws are associated with student physical education attendance and physical activity (PA), and whether physical education and competitive food laws, in conjunction, are associated with lower BMI change. METHOD State laws regarding physical education time requirements and competitive foods in 2003 and 2006 were classified as strong, weak, or none, based on codified law ratings obtained from the Classification of Laws Associated with School Students. Laws were linked to student data on PE attendance and physical activity (8th grade, Spring 2007) and BMI change (5th-8th grade, 2004-2007), obtained from the Early Childhood Longitudinal Study (n=5510 students in 40 states). RESULTS Girls reported 0.31 more days of activity (95% CI: 0.02, 0.61) and were more likely to attend physical education ≥ 3 days/week (74.1% versus 52.1%, difference=22.0, 95% CI: 2.1, 42.0) if they resided in states with strong physical education laws compared to no physical education laws. Weak physical education laws had modest associations with PE and activity, and there was no evidence that weak laws reduce BMI gain regardless of competitive food laws. CONCLUSION Strong physical education laws with specific time requirements may increase physical education attendance and activity in girls. There is insufficient evidence that physical education laws reduce student weight gain.
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Affiliation(s)
- Daniel R Taber
- Institute for Health Research and Policy, University of Illinois at Chicago, 1747 W. Roosevelt Rd., Chicago, IL 60608, USA.
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Turner L, Chriqui JF, Chaloupka FJ. Withholding recess from elementary school students: policies matter. THE JOURNAL OF SCHOOL HEALTH 2013; 83:533-541. [PMID: 23834604 DOI: 10.1111/josh.12062] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/19/2012] [Revised: 07/03/2012] [Accepted: 08/12/2012] [Indexed: 06/02/2023]
Abstract
BACKGROUND Recess is a key aspect of a healthy elementary school environment and helps to keep students physically active during the school day. Although national organizations recommend that students not be withheld from recess, this practice occurs in schools. This study examined whether district policies were associated with school practices regarding the withholding of recess for behavior management or academic reasons, as well as the use of physical activity (eg, running laps) for behavior management. METHODS Data were gathered from administrators at US public elementary schools by mail-back surveys conducted during the spring of the 2008-2009, 2009-2010, and 2010-2011 school years. Corresponding school district policies were gathered and coded. Each year's sample was nationally representative and data were analyzed as a stacked cross-sectional sample. A total of 1,919 surveys were received (61.2% response rate). RESULTS Averaged over the 3 years, students were not withheld from recess for poor behavior or academic reasons at 28.3% and 26.7% of elementary schools, respectively. Strong district policy was associated with an increased odds of not withholding students from recess for poor behavior (adjusted odds ratio [OR] = 2.27, p < .001) or completing schoolwork (adjusted OR = 1.99, p < .001). Withholding recess was less common in the South versus the West, Midwest, and Northeast. Use of physical activity for behavior management was rare and not associated with district policy. CONCLUSIONS Strengthening district policies may be an effective strategy for changing school practices pertaining to withholding of recess, and to ensure that all students have opportunities to be physically active during the school day.
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Affiliation(s)
- Lindsey Turner
- Institute for Health Research and Policy, University of Illinois at Chicago, 1747 West Roosevelt Road, M/C 275, Room 558, Chicago, IL 60608, USA.
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Hales D, Stevens J, Murray DM, Taber DR, Roberts A. Identifying state-level policy and provision domains for physical education and physical activity in high school. Int J Behav Nutr Phys Act 2013; 10:86. [PMID: 23815860 PMCID: PMC3711838 DOI: 10.1186/1479-5868-10-86] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2012] [Accepted: 05/17/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND It is important to quickly and efficiently identify policies that are effective at changing behavior; therefore, we must be able to quantify and evaluate the effect of those policies and of changes to those policies. The purpose of this study was to develop state-level physical education (PE) and physical activity (PA) policy domain scores at the high-school level. Policy domain scores were developed with a focus on measuring policy change. METHODS Exploratory factor analysis was used to group items from the state-level School Health Policies and Programs Study (SHPPS) into policy domains. Items that related to PA or PE at the High School level were identified from the 7 SHPPS health program surveys. Data from 2000 and 2006 were used in the factor analysis. RESULTS From the 98 items identified, 17 policy domains were extracted. Average policy domain change scores were positive for 12 policy domains, with the largest increases for "Discouraging PA as Punishment", "Collaboration", and "Staff Development Opportunities". On average, states increased scores in 4.94 ± 2.76 policy domains, decreased in 3.53 ± 2.03, and had no change in 7.69 ± 2.09 policy domains. Significant correlations were found between several policy domain scores. CONCLUSIONS Quantifying policy change and its impact is integral to the policy making and revision process. Our results build on previous research offering a way to examine changes in state-level policies related to PE and PA of high-school students and the faculty and staff who serve them. This work provides methods for combining state-level policies relevant to PE or PA in youth for studies of their impact.
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Affiliation(s)
- Derek Hales
- Center for Health Promotion and Disease Prevention, University of North Carolina at Chapel Hill, 1700 Martin Luther King Jr. BLVD. CB#7426, Chapel Hill, NC 27599, USA
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Johnston CA, Papaioannou MA. Lifestyle Approach for Increasing Physical Activity in Youth. Am J Lifestyle Med 2013. [DOI: 10.1177/1559827613492087] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Although physical activity (PA) provides children with various health benefits, many children do not engage in regular PA. Health care professionals can effectively encourage children and their families to participate in more PA through lifestyle changes. The strategies that clinicians can employ to promote PA are discussed in this article.
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Affiliation(s)
- Craig A. Johnston
- USDA/ARS Children’s Nutrition Research Center, Department of Pediatrics–Nutrition, Baylor College of Medicine, Houston, Texas (CAJ)
- Department of Medicine, Baylor College of Medicine, Houston, Texas (CAJ, MAP)
| | - Maria A. Papaioannou
- USDA/ARS Children’s Nutrition Research Center, Department of Pediatrics–Nutrition, Baylor College of Medicine, Houston, Texas (CAJ)
- Department of Medicine, Baylor College of Medicine, Houston, Texas (CAJ, MAP)
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Roles and Strategies of State Organizations Related to School-Based Physical Education and Physical Activity Policies. JOURNAL OF PUBLIC HEALTH MANAGEMENT AND PRACTICE 2013; 19:S34-40. [DOI: 10.1097/phh.0b013e3182840da2] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Carlson JA, Sallis JF, Chriqui JF, Schneider L, McDermid LC, Agron P. State policies about physical activity minutes in physical education or during school. THE JOURNAL OF SCHOOL HEALTH 2013; 83:150-156. [PMID: 23343315 DOI: 10.1111/josh.12010] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/01/2011] [Revised: 04/03/2012] [Accepted: 04/15/2012] [Indexed: 06/01/2023]
Abstract
BACKGROUND School policies can change practices on a relatively permanent basis. This study investigated adoption and implementation of state-level policies specifying minutes (or percent) of physical activity in physical education (PE) or during school. METHODS Policies were identified from existing databases and rated as having weak, moderate, or strong wording. Interviews with state-level PE coordinators were conducted to investigate the level of implementation, monitoring, and enforcement of the identified policies. RESULTS Sixteen states had a policy that met inclusion criteria (19 policies total); 11 states had a policy addressing minutes of physical activity during school, 2 had a policy addressing percent of PE time to be spent in physical activity, and 3 had policies addressing both. None of the 19 policies were rated as having strong wording and 5 were rated as having moderate wording. The range in minutes of physical activity per week addressed in the policies was 60 to 300. Four of the 5 (elementary) and 5 of 5 (middle) policies addressing percent of PE spent physically active specified 50%. The only monitoring efforts reported consisted of schools self-reporting progress to the state. CONCLUSIONS More states need to adopt school physical activity policies and policy language needs to be more specific to prevent potential loopholes. Monitoring and evaluation strategies, beyond school self-report, are likely needed for these policies to lead to increases in physical activity.
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Affiliation(s)
- Jordan A Carlson
- Joint Doctoral Program in Public Health, San Diego State University & University of California, San Diego, PO Box 3900, Fifth Avenue, Suite 310, San Diego, CA 92103, USA.
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Lafleur M, Strongin S, Cole BL, Bullock SL, Banthia R, Craypo L, Sivasubramanian R, Samuels S, García R. Physical Education and Student Activity: Evaluating Implementation of a New Policy in Los Angeles Public Schools. Ann Behav Med 2013; 45 Suppl 1:S122-30. [DOI: 10.1007/s12160-012-9431-0] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Lounsbery MAF, McKenzie TL, Morrow JR, Monnat SM, Holt KA. District and School Physical Education Policies: Implications for Physical Education and Recess Time. Ann Behav Med 2013; 45 Suppl 1:S131-41. [DOI: 10.1007/s12160-012-9427-9] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
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Robertson-Wilson JE, Dargavel MD, Bryden PJ, Giles-Corti B. Physical activity policies and legislation in schools: a systematic review. Am J Prev Med 2012; 43:643-9. [PMID: 23159260 DOI: 10.1016/j.amepre.2012.08.022] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2012] [Revised: 05/25/2012] [Accepted: 08/14/2012] [Indexed: 11/17/2022]
Abstract
CONTEXT Current physical activity levels of youth are alarmingly low. One way to promote higher levels of physical activity to youth is through school-based government policies. The current review examines evaluation of school-based physical activity policies for youth over the past 10 years. EVIDENCE ACQUISITION Articles included met the following criteria: was an original research study published in an academic journal in English; examined or was related to physical activity behavior; applied to a youth population in a school setting; highlighted a law, bill, or policy reflective of physical activity based on government initiatives; and involved an evaluation. After searching five databases in January 2011, a total of 13 articles were selected for inclusion. EVIDENCE SYNTHESIS All policies came from the U.S.; seven studies highlighted the federal Child Nutrition and Women, Infants, and Children Reauthorization Act of 2004 whereas the other six studies highlighted state-level policies dealing with safe routes to schools, physical activity-only initiatives, or physical activity as well as other initiatives. Eight articles evaluated policy implementation, three examined policy implementation and impact, and two articles considered only policy impact. CONCLUSIONS This evaluation of the impact of policies on school-based physical activity indicates that such policies can affect health outcomes, specifically by increasing levels of physical activity. This study highlights the value of policy reform and calls attention to the need for independent evaluation of such policies.
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Perna FM, Oh A, Chriqui JF, Mâsse LC, Atienza AA, Nebeling L, Agurs-Collins T, Moser RP, Dodd KW. The association of state law to physical education time allocation in US public schools. Am J Public Health 2012; 102:1594-9. [PMID: 22594746 DOI: 10.2105/ajph.2011.300587] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We examined whether public schools in states with specific and stringent physical education (PE) laws, as assessed by the Physical Education-Related State Policy Classification System (PERSPCS), available on the Classification of Laws Associated with School Students (C.L.A.S.S.) Web site, reported more weekly PE time in the most recent School Health Policies and Programs Survey (SHPPS). METHODS Schools (n=410) were grouped by their state's PERSPCS time requirement scores (none, nonspecific requirement, or specific requirement). Average weekly school-level PE was calculated using the SHPPS-reported PE minutes. Weighted analyses determined if PE minutes/week differed by PERSPCS group. RESULTS Schools in states with specific requirement laws averaged over 27 and 60 more PE minutes/week at the elementary and middle school levels, respectively, compared with schools within states with nonspecific laws and over 40 and 60 more PE minutes per week, respectively, compared with elementary and middle schools in states with no laws. High school results were nonsignificant. CONCLUSIONS Public health guidelines recommend at least 60 minutes of daily physical activity for children, and PE may further this goal. Strong codified law with specific time requirements for PE may be an important tool contributing toward adequate PE time and daily physical activity recommendations.
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Affiliation(s)
- Frank M Perna
- Health Behaviors Research Branch, Behavioral Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute (NCI), Bethesda, MD 20892-7236, USA.
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Sanchez-Vaznaugh EV, Sánchez BN, Rosas LG, Baek J, Egerter S. Physical education policy compliance and children's physical fitness. Am J Prev Med 2012; 42:452-9. [PMID: 22516484 DOI: 10.1016/j.amepre.2012.01.008] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2011] [Revised: 10/15/2011] [Accepted: 01/06/2012] [Indexed: 10/28/2022]
Abstract
BACKGROUND Physical education policies have received increased attention as a means for improving physical activity levels, enhancing physical fitness, and contributing to childhood obesity prevention. Although compliance at the school and district levels is likely to be critical for the success of physical education policies, few published studies have focused on this issue. PURPOSE This study investigated whether school district-level compliance with California physical education policies was associated with physical fitness among 5th-grade public-school students in California. METHODS Cross-sectional data from FITNESSGRAM(®) 2004-2006, district-level compliance with state physical education requirements for 2004-2006, school- and district-level information, and 2000 U.S. Census data were combined to examine the association between district-level compliance with physical education policies and children's fitness levels. The analysis was completed in 2010. RESULTS Of the 55 districts with compliance data, 28 (50%) were in compliance with state physical education mandates; these districts represented 21% (216) of schools and 18% (n=16,571) of students in the overall study sample. Controlling for other student-, school-, and district-level characteristics, students in policy-compliant districts were more likely than students in noncompliant districts to meet or exceed physical fitness standards (AOR=1.29, 95% CI=1.03, 1.61). CONCLUSIONS Policy mandates for physical education in schools may contribute to improvements in children's fitness levels, but their success is likely to depend on mechanisms to ensure compliance.
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Teacher awareness and implementation of food and physical activity policies in Utah elementary schools, 2010. Prev Chronic Dis 2011; 9:E18. [PMID: 22172185 PMCID: PMC3277404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
INTRODUCTION Schools are a key venue for childhood obesity prevention policies. The objective of this study was to examine factors associated with elementary school teacher awareness and implementation of their schools' food and physical activity policies.. METHODS We collected data through an online survey of teachers at Utah elementary schools with food and physical activity policies. We used bivariate analysis and logistic regression to assess association of variables with teacher awareness and implementation. RESULTS Of 1,243 teacher respondents, 546 (44%) were aware of the food policy and 550 (44%) were aware of the physical activity policy. Food policy awareness was associated with knowing where written policies were located (odds ratio [OR], 2.7; 95% confidence interval [CI], 2.0-3.5), knowing the school health program coordinator (OR, 1.9; 95% CI, 1.4-2.7), and being reminded of policies at least once per semester (OR, 2.3; 95% CI, 1.7-2.9). Policy awareness was associated with both food (OR, 4.6; 95% CI, 3.6-6.0) and physical activity (OR, 1.6, 95% CI, 1.2-2.3) policy implementation. Helping develop the physical activity policy was associated with its implementation (OR, 2.4; 95% CI, 1.2-4.7). Thinking that students were more overweight than in the past was associated with food policy implementation (OR, 1.6; 95% CI, 1.1-2.5). CONCLUSION Establishing food and physical activity policies at schools does not ensure teacher awareness or implementation. To promote policy awareness and implementation, school leaders should involve teachers in policy development, remind teachers of policies at least once per semester, and continue to educate teachers about childhood obesity.
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Slater SJ, Nicholson L, Chriqui J, Turner L, Chaloupka F. The impact of state laws and district policies on physical education and recess practices in a nationally representative sample of US public elementary schools. ACTA ACUST UNITED AC 2011; 166:311-6. [PMID: 22147763 DOI: 10.1001/archpediatrics.2011.1133] [Citation(s) in RCA: 108] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
OBJECTIVE To examine the impact of state- and school district-level policies on the prevalence of physical education (PE) and recess in a nationally representative sample of US public elementary schools. DESIGN Analyses from annual, nationally representative, cross-sectional surveys of school administrators in the United States. SETTING Data were collected through surveys conducted between February and June during the 2006-2007 through 2008-2009 school years. State laws and district policies were compiled annually by researchers at the University of Illinois at Chicago using established legal research techniques. PARTICIPANTS The sample size was 47 states, 690 districts, and 1761 schools. MAIN EXPOSURES State- and school district-level PE and recess-related laws. MAIN OUTCOME MEASURES Twenty minutes of daily recess and 150 min/wk of PE. RESULTS The odds of schools having 150 min/wk of PE increased if they were located in states (odds ratio [OR], 2.8; 95% CI, 1.3-5.7) or school districts (OR, 2.4; 95% CI, 1.3-4.3) having a law or policy requiring 150 min/wk of PE. Schools located in states with laws encouraging daily recess were significantly more likely to have 20 minutes of recess daily (OR, 1.8; 95% CI, 1.2-2.8). District policies were not significantly associated with school-level recess practices. Adequate PE time was inversely associated with recess and vice versa, suggesting that schools are substituting one form of physical activity for another rather than providing the recommended amount of both recess and PE. CONCLUSION By mandating PE or recess, policy makers can effectively increase school-based physical activity opportunities for youth.
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Affiliation(s)
- Sandy J Slater
- Institute for Health Research and Policy and Department of Health Policy & Administration, School of Public Health, University of Illinois at Chicago, 1747 W Roosevelt Rd, Chicago, IL 60608, USA.
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Pérez A, Hoelscher DM, Springer AE, Brown HS, Kelder SH, Barroso CS, Castrucci BC. Physical activity, watching television, and the risk of obesity in students, Texas, 2004-2005. Prev Chronic Dis 2011; 8:A61. [PMID: 21477501 PMCID: PMC3103566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
INTRODUCTION The epidemic of childhood obesity has been well-documented. Prevalence of obesity among students in Texas is higher than the US prevalence. Our objective was to understand the combined influence of physical activity and television viewing on weight status of students in Texas. METHODS Students in grades 4, 8, and 11 participated in the School Physical Activity and Nutrition survey during the 2004-2005 academic year. Multinomial logistic regression tested the associations between both being overweight and obese (vs underweight/normal weight) and the combined influence of physical activity and watching television, adjusting for age, grade, race/ethnicity, language spoken at home, and percentage of economically disadvantaged students in the school. We used 5 physical activity indicators to describe students' physical activity. RESULTS Girls who participated in less than 3 days of exercise per week to strengthen or tone muscles and watched 2 hours or less per day of television had increased odds of being obese (adjusted odds ratio, 1.8; 95% confidence interval, 1.1-3.0) compared with girls who participated in 3 or more days per week of exercise to strengthen or tone muscles and watched 2 hours or less per day of television. Boys in our study who watched 3 or more hours per day of television and did not meet physical activity recommendations had increased odds of being obese in all of our 5 physical activity indicators. CONCLUSION Although results varied by physical activity indicator and sex, our findings provide further evidence for the combined effect of high television watching and low physical activity engagement on the risk for obesity in children and adolescents.
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Affiliation(s)
- Adriana Pérez
- The University of Texas Health Science Center at Houston, School of Public Health, Austin Regional Campus
| | - Deanna M. Hoelscher
- The University of Texas Health Science Center at Houston, School of Public Health and Michael and Susan Dell Center for the Advancement of Healthy Living, Austin, Texas
| | - Andrew E. Springer
- The University of Texas Health Science Center at Houston, School of Public Health, Austin, Texas
| | - H. Shelton Brown
- The University of Texas Health Science Center at Houston, School of Public Health, Austin, Texas
| | - Steven H. Kelder
- The University of Texas Health Science Center at Houston, School of Public Health, Austin, Texas
| | - Cristina S. Barroso
- The University of Texas Health Science Center at Houston, School of Public Health, Brownsville, Texas
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Abstract
PURPOSE OF REVIEW Maintaining recommended levels of physical activity throughout the lifespan is an important public health objective, considering this behaviour is positively associated with both physical and mental health across all age groups. This article provides an overview of selected publications with an exclusive focus on research relating to physical activity promotion published in the past 18 months. RECENT FINDINGS Physical activity can be integrated during the life-course of individuals through recreational, transportation and occupational activities. A growing body of research on social-cognitive theories continues to inform the conceptualization and development of physical activity interventions. SUMMARY Transitions during the life-course provide numerous challenges and opportunities for physical activity interventions. Multiple-level approaches across various settings and modes of delivery need to be taken into account to keep individuals active.
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Story M, Sallis JF, Orleans CT. Adolescent obesity: towards evidence-based policy and environmental solutions. J Adolesc Health 2009; 45:S1-5. [PMID: 19699432 DOI: 10.1016/j.jadohealth.2009.06.022] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2009] [Accepted: 06/30/2009] [Indexed: 11/25/2022]
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