Development and implementation of a school-based nutrition and fitness promotion program for ethnically diverse middle-school girls

Iranian adolescents' insufficient physical activity: a mixed methods explanatory sequential study

BACKGROUND

Adolescents' physical activity decreases from the stage of childhood to adulthood. This study was addressed to explain adolescents' insufficient physical activity (IPA) and its related factors. The subjects were 1201 adolescents in the quantitative phase and 25 adolescents in the quantitative phase.

METHODS

An explanatory sequential mixed methods design with follow-up explanations variant was used, which involved collecting quantitative data (1201 adolescents) first and then explaining the quantitative results with in-depth interviews and written narrative (25 adolescents) during a qualitative study.

RESULTS

The quantitative results showed that 98.8% of adolescents did not have the recommended physical activity. Five themes were extracted in the qualitative phase including the inhibitory effect of the school environment and peers, as well as the inhibitory effect of the family environment, lack of availability and cultural barriers for the presence of girls in the community, the effect of self-feeling and self-understanding, and physical and mental exhaustion and permutation. According to the qualitative findings of the study, physical and mental exhaustion expressed the fact that, although adolescents had an unfavorable sense of IPA, they were under the effects of the intrinsic and extrinsic factors.

CONCLUSION

The comparison of these themes indicates that this behavior is imposable but not optional.

Modelo teórico, agentes, estrategias, duración, escenarios para la implementación, grado escolar e indicadores de resultados utilizados en los programas de promoción de la actividad física en el contexto escolar

Introducción: El propósito del presente estudio es analizar el modelo teórico, agentes, estrategias, duración, escenarios de implementación, grado escolar e indicadores de resultados, utilizados en los programas de promoción de la actividad física en el contexto escolar desarrollados en el ámbito internacional en los últimos veinticinco años. Método: Se realizó una revisión de los diferentes estudios que desarrollaron programas de actividad física encaminada a la salud en el contexto escolar. Se utilizaron y combinaron diversas estrategias de búsqueda, manuales y electrónicas. Resultados: Siete estudios utilizaron modelos teóricos para el diseño de los programas. Los principales agentes involucrados en la implementación de los programas fueron los docentes de educación física (EF), y los estudiantes. El escenario para la implementación se ubicó básicamente en la clase de educación física. Las estrategias estaban dirigidas principalmente a modificar el currículo de las clases de EF. Las intervenciones se orientaron fundamental-mente a niños de escuela elemental. La duración variaba entre 1 y 12 meses. Los indicadores utilizados para verificar el impacto del programa fueron: incremento en la cantidad de AF, IMC, y peso corporal. La mayor parte de estos estudios se llevó a cabo en escuelas de Estados Unidos, Canadá, India, Reino Unido e Irán. Conclusiones: A pesar de los resultados positivos obtenidos en cada una de las intervenciones, se identificó heterogeneidad: en la metodología, población, actores involucrados e indicadores de eficacia, lo cual no permite realizar comparaciones entre los diferentes estudios.

Children’s Perceived Cost for Exercise: Application of an Expectancy-Value Paradigm

Expectancy-value models of motivation have been applied to understanding children’s choices in areas such as academics and sports. Here, an expectancy-value paradigm is applied to exercising (defined as engaging in physical activity). The notion of perceived cost is highlighted in particular. Two hundred twenty children in third, fourth, and fifth grades were surveyed on their competence beliefs, perceived importance, interest, and perceived cost of being physically active. Results indicated that perceived cost is empirically distinct from competence beliefs and other types of value, that perceived cost is marginally related to children’s self-reported level of physical activity, and children’s beliefs and other values are related to their self-reported level of physical activity. Children’s perceptions of cost vary depending on grade and gender. Interventions based on these findings are proposed.

Aspects of self differ among physically active and inactive youths

OBJECTIVES

The aim of this paper was to explore connection between aspects of self and levels of physical activity among adolescents.

METHODS

An international sample of 501 elementary school students (mean age 14.7 ± 0.9 years, 48.5% males) from the Slovak and Czech Republics completed the Self-competence/Self-liking Scale, the Rosenberg's Self-esteem Scale, the Self-efficacy Scale and a question on their physical activity. Respondents were divided into three groups: (1) no physical activity; (2) infrequent physical activity; (3) everyday physical activity. Data were explored with one-way analysis of variance (ANOVA) separately for each gender.

RESULTS

Boys with no physical activity had lower self-liking and social self-efficacy in comparison with boys with everyday physical activity. Girls with no physical activity had lower positive self-esteem, self-liking, self-competence, general and social self-efficacy and higher negative self-esteem in comparison with girls with infrequent and everyday physical activity.

CONCLUSION

Regular physical activity is connected with psychological aspects of self among adolescents, especially girls. Incorporating physical activity into the life of youths on a regular basis might lead to the enhancement of their feelings of self-worth and self-efficacy.

Using community-based participatory research to identify potential interventions to overcome barriers to adolescents' healthy eating and physical activity

Using a community-based participatory research approach, we explored adolescent, parent, and community stakeholder perspectives on barriers to healthy eating and physical activity, and intervention ideas to address adolescent obesity. We conducted 14 adolescent focus groups (n = 119), 8 parent focus groups (n = 63), and 28 interviews with community members (i.e., local experts knowledgeable about youth nutrition and physical activity). Participants described ecological and psychosocial barriers in neighborhoods (e.g., lack of accessible nutritious food), in schools (e.g., poor quality of physical education), at home (e.g., sedentary lifestyle), and at the individual level (e.g., lack of nutrition knowledge). Participants proposed interventions such as nutrition classes for families, addition of healthy school food options that appeal to students, and non-competitive physical education activities. Participants supported health education delivered by students. Findings demonstrate that community-based participatory research is useful for revealing potentially feasible interventions that are acceptable to community members.

Why are early maturing girls less active? Links between pubertal development, psychological well-being, and physical activity among girls at ages 11 and 13

Previous research has shown that early maturing girls at age 11 have lower subsequent physical activity at age 13 in comparison to later maturing girls. Possible reasons for this association have not been assessed. This study examines girls' psychological response to puberty and their enjoyment of physical activity as intermediary factors linking pubertal maturation and physical activity. Participants included 178 girls who were assessed at age 11, of whom 168 were reassessed at age 13. All participants were non-Hispanic white and resided in the US. Three measures of pubertal development were obtained at age 11 including Tanner breast stage, estradiol levels, and mothers' reports of girls' development on the Pubertal Development Scale (PDS). Measures of psychological well-being at ages 11 and 13 included depression, global self-worth, perceived athletic competence, maturation fears, and body esteem. At age 13, girls' enjoyment of physical activity was assessed using the Physical Activity Enjoyment Scale and their daily minutes of moderate-to-vigorous physical activity (MVPA) were assessed using objective monitoring. Structural Equation Modeling was used to assess direct and indirect pathways between pubertal development at age 11 and MVPA at age 13. In addition to a direct effect of pubertal development on MVPA, indirect effects were found for depression, global self-worth and maturity fears controlling for covariates. In each instance, more advanced pubertal development at age 11 was associated with lower psychological well-being at age 13, which predicted lower enjoyment of physical activity at age 13 and in turn lower MVPA. Results from this study suggest that programs designed to increase physical activity among adolescent girls should address the self-consciousness and discontent that girls' experience with their bodies during puberty, particularly if they mature earlier than their peers, and identify activities or settings that make differences in body shape less conspicuous.

Dissemination of physical activity promotion interventions in underserved populations

Achieving minimum physical activity levels of 30 or more minutes per day will require a variety of intervention strategies to engage each segment of an aging and increasingly ethnically diverse U.S. population. This article presents a focused review of the sparse literature on the diffusion of evidence-based physical activity interventions that are culturally appropriate for underserved populations. Related literature and experiential insights inform this discussion, because so few published studies report outcome data beyond the first diffusion phase of intervention development and evaluation. Three brief case studies are presented to further illustrate and exemplify key concepts and processes at several different stages in diffusing physical activity interventions. Successful engagement of underserved populations reflects a delicate balance between embracing group customs and values and recognizing the nonmonolithic nature of any sociodemographically defined group. The costs of failing to promulgate effective physical activity interventions in these groups continue to mount, in dollars, health, and lives. Researchers, practitioners, decision makers, and policymakers must partner to bridge the evidentiary gap so that the physically active lifestyle choices become the easier choices.

Physical activity: what do high school students think?

PURPOSE

To explore the views high school students have about various physical activity contexts and their ideas of potential physical activity promoting strategies.

METHODS

Forty-four students from New Zealand high schools with a low decile rating participated in one of nine focus groups. All groups were separated by gender and ethnicity (Maori, New Zealand European). A standardized semi-structured schedule that included key questions and prompts was used. Thematic induction of the raw data was conducted using the long table approach.

RESULTS

Perceived benefits of physical activity participation centered on fun, achievement, and physical-related factors. Key barriers to physical activity engagement included lack of peer social support and low accessibility to, and availability of, physical activity opportunities. The structure of physical education (PE) classes was a barrier noted by females. Distance was consistently articulated as a barrier to commuting actively to school. Reflective of the barriers raised by participants, self-identified strategies to promote physical activity participation included environmental modifications such as (1) increasing social support from peers, (2) improving availability of, and accessibility to, activities at school and in their neighborhood, (3) providing organized activities at school, and (4) restructuring physical education classes.

CONCLUSION

In line with the current understandings of barriers to physical activity participation, youth perceptions were focused toward environmental factors, both social and physical, thereby supporting further development of environment-focused interventions. The potential of the peer, school, neighborhood, and home strategies reported in our study need to be considered in future initiatives targeting youth physical activity.

Scale development for perceived school climate for girls' physical activity

OBJECTIVES

To test an original scale assessing perceived school climate for girls' physical activity in middle school girls.

METHODS

Confirmatory factor analysis (CFA) and structural equation modeling (SEM).

RESULTS

CFA retained 5 of 14 original items. A model with 2 correlated factors, perceptions about teachers' and boys' behaviors, respectively, fit the data well in both sixth and eighth graders. SEM detected a positive, significant direct association of the teacher factor, but not the boy factor, with girls' self-reported physical activity.

CONCLUSIONS

School climate for girls' physical activity is a measurable construct, and preliminary evidence suggests a relationship with physical activity.

Increasing Activity to Reduce Obesity in Adolescent Girls: A Research Review

OBJECTIVE

To provide a systematic review of physical activity intervention research conducted with adolescent girls (12-19 years of age and/or in middle or high school) in the United States and Canada during the past two decades.

DATA SOURCES

Published articles in English were identified in searches using MEDLINE, Cumulative Index to Nursing and Allied Health Literature, PsycLIT, EMBASE, Science Citation Index, and the Cochrane Controlled Trials Register, with the keywords adolescent health, obesity, physical activity, and exercise, between the dates of May 1980 and November 2003.

STUDY SELECTION

Research studies with interventions that started within the adolescent time period. Only 7 studies met the inclusion criteria.

DATA EXTRACTION

The publication year, sample description, study design, interventions used, and outcomes were extracted from each study.

DATA SYNTHESIS

The 7 studies were published between 1989 and 2003, included girls and boys in the overall sample (no studies with girl-only samples), used randomized controlled trial or quasi-experimental designs, and included multicomponent interventions. Body mass index, fitness levels, exercise, and weight were measured as outcomes.

CONCLUSIONS

Although the results were not consistent across studies, they suggest that school-based, multicomponent interventions that were also designed to decrease sedentary behavior were effective in increasing physical activity in adolescent girls. Future research should focus on determinants of long-term adherence and the duration and intensity of interventions necessary to prevent obesity in adolescent girls.

Barriers to physical activity perceived by adolescent girls

Girls in the United States are at high risk for inactivity and resultant overweight or obesity. Perceived barriers to physical activity are critical factors for health care professionals to consider when intervening with this population to increase physical activity. This descriptive study identified barriers to physical activity reported by girls in middle school. Participants were recruited from two middle schools in the Midwest. Using a Likert-type scale, a total of 77 ethnically diverse girls, ages 11 to 14, responded to 23 items representing barriers to physical activity participation. Mean scores and percentages were computed for each barrier statement. The top barriers to physical activity that emerged for the girls in this investigation were "I am self-conscious about my looks when I exercise" and "I am not motivated to be active." Strategies that health professionals can use to counsel girls of this age in overcoming barriers to physical activity are presented. This health-related information can enhance anticipatory guidance to girls.

Residential camps as a setting for nutrition education of Australian girls

OBJECTIVE

To implement a planned nutrition education program aiming to promote healthy eating and consumption of a variety of foods in a residential camp setting for Australian girls aged 9-15 years.

METHODS

1,600 girls attending a seven-day residential camp in Queensland (2000) participated in a program involving the provision of healthy, tasty foods based on the Australian Dietary Guidelines for Children and Adolescents and a nutrition education package for use at the camp restaurants each evening that included nutrition information together with individual 'passport booklets involving puzzles and questions with incentives for completion. Process and impact evaluations were conducted by surveying a sample of participants using questionnaires and focus groups.

RESULTS

Of those surveyed, 77% felt they had leamed something from the health promotion material; 94% said they had changed their eating habits to include more core food groups during the camp, with more than 40% stating they had increased vegetable consumption compared with their usual intake. However, approximately 60% of campers were apparently unaware of the incentives offered and less than 30% demonstrated completion of their passports.

CONCLUSIONS

Barriers to the involvement of this target group in the health promotion activities need to be explored further. Involvement and training of key personnel is suggested to ensure consistent implementation and encouragement for all participants. Long-term behaviour changes outside the camp environment should also be assessed in any future programs.

IMPLICATIONS

Using residential camp settings to target children is an innovative strategy for nutrition education. Integration of such strategies into longer time frame programs may benefit participants and improve effectiveness of nutrition education programs aimed at this group.