Improving health-enhancing physical activity in girls' physical education

Moderate-to-vigorous intensity physical activity levels of children with intellectual disability during physical education classes

Background

Physical education (PE) class is an excellent way to improve moderate-to-vigorous intensity physical activity (MVPA). Increasing number of research has explored the children's PA based on movement during PE classes, but data for children with intellectual disability (ID) is still lacking.

Purpose

The purpose of this study was to investigate the current status of MVPA levels of children with ID during PE classes in China, as well as differences of MVPA levels according to gender and grade.

Methods

Accelerometers were used to record MVPA levels of fifty-three children with severe ID from 9 to 16 years of age (mean age: 12.60 ± 1.66 years) during standard PE classes.

Results

The mean time spent in MVPA during PE classes was 8.00 ± 2.10 min, meaning only 22.88% of PE class time was spent in MVPA. As grade levels progresses, time spent in MVPA during PE classes tended to decrease; the fourth-grade children tended to spend more time in MVPA during PE classes compared with the fifth-grade and the sixth-grade (9.15 vs. 7.61 vs. 7.25 min, all p < 0.05). Boys spend significantly more time in MVPA during PE classes than girls; both in the entire sample (9.20 vs. 5.70 min) as well as in each grade (9.76 vs. 6.09 min, 9.35 vs. 5.68 min, 8.31 vs. 5.59 min, all p < 0.05).

Conclusion

Findings from this study indicate that the proportion of PE class spent in the MVPA of children with ID was lower than the 50% recommended by the U.S. Department of Health and Human Services (DHHS) and U.K. Association for Physical Education (AfPE). And the amount of MVPA participation varied by the grade and gender as well as by the activity performed. Therefore, in order to help children with ID achieve MVPA goals, educators need to reevaluate the PE curriculum as well as take due consideration of grade and gender when devising new content.

The Impact of Non-Physical Education Teachers' Perceptions on the Promotion of Active and Healthy Lifestyles: A Cross-Sectional Qualitative Study

(1) Background: In accordance with the socio-ecological model of physical education (PE), school-based interventions to promote physical activity (PA) will only be successful if a change occurs in the perceptions and attitudes of all. This study sought to analyze non-PE teachers experiences in PE and how these experiences relate to the value they attribute to PE, sports and PA, and the impact of teachers' perceptions on promoting active lifestyles in the school's context. A mixed-method study was adopted. (2) Methods: A survey about the perceptions in PE was applied to 297 teachers (58 male). From this sample, 24 teachers were selected for three focus groups considering their experiences in PE (e.g., good experiences, bad experiences). MaxQda was used for the inductive qualitative data analysis. (3) Results: Teachers who have had good experiences in PE value the role of PE and sports. Teachers who have had bad experiences do not value the importance of PE or sports. (4) Conclusions: The results support the importance of having good experiences in PE to generate positive attitudes. Thus, teachers who have had bad experiences in PE may constitute barriers that will hinder the promotion of an educational climate that promotes PA and active lifestyles in schools.

Physical activity promoting teaching practices and children’s physical activity within physical education lessons underpinned by motor learning theory (SAMPLE-PE)

Purpose

Movement competence is a key outcome for primary physical education (PE) curricula. As movement development in children emerges through physical activity (PA), it is important to determine the extent of PA promotion within movement competence focused teaching pedagogies. Therefore, this study aimed to assess children’s moderate-to-vigorous PA (MVPA) and related teaching practices in primary PE within Linear pedagogy and Nonlinear pedagogy and to compare this to current practice within PE delivery in primary schools.

Methods

Participants (n = 162, 53% females, 5-6y) were recruited from 9 primary schools within the SAMPLE-PE cluster randomised controlled trial. Schools were randomly-allocated to one of three conditions: Linear pedagogy, Nonlinear pedagogy, or control. Nonlinear and Linear pedagogy intervention schools received a PE curriculum delivered by trained deliverers over 15 weeks, while control schools followed usual practice. Children’s MVPA was measured during 3 PE lessons (44 PE lessons in total) using an ActiGraph GT9X accelerometer worn on their non-dominant wrist. Differences between conditions for children’s MVPA were analysed using multilevel model analysis. Negative binomial models were used to analyse teaching practices data.

Results

No differences were found between Linear pedagogy, Nonlinear pedagogy and the control group for children’s MVPA levels during PE. Linear and Nonlinear interventions generally included higher percentages of MVPA promoting teaching practices (e.g., Motor Content) and lower MVPA reducing teaching practices (e.g., Management), compared to the control group. Teaching practices observed in Linear and Nonlinear interventions were in line with the respective pedagogical principles.

Conclusions

Linear and Nonlinear pedagogical approaches in PE do not negatively impact MVPA compared to usual practice. Nevertheless, practitioners may need to refine these pedagogical approaches to improve MVPA alongside movement competence.

Can different physical education programs produce specific developments in psychological responses and cognitive functions? An ecological intervention in school-age children

AIMS

The aim of this study was to investigate the effects of physical education (PE) class contents on 6-8 years school-age children's perceived exertion, psychological responses and cognitive functions.

MATERIALS AND METHODS

These dimensions were measured in 135 children (6.61 ± 0.58 years) before and after an 8-week different PE intervention programs [i.e. balance intervention program (BIP), game based program (GBP) or drama learning program (DLP)].

RESULTS

With regard to the physical exertion, higher perceived exertion was found in BIP than in GBP and DLP (p < .01, ES = -0.5 to -1.0, small to moderate). Regarding cognitive functions, children of the GBP and the DLP significantly improved some of the cognitive functions test scores (p < .01 or 0.05, ES = 0.5 to 1.5, small to large).

CONCLUSION

These results lead us to think that physical activity could be an effective tool for improving children's cognitive functions.

The Impact of Physical Education Classes on Health and Quality of Life during the COVID-19

The purpose of this study was to examine the effects of the COVID-19 pandemic on the well-being and the quality of life of college students participating in physical education classes. We consider this study to be relevant because during the COVID-19 pandemic we tested whether the boost in effective activity among physical education class participants affected well-being and quality of life. A sectional questionnaire survey was conducted across Taiwan in 2019–2020. Data were collected in two stages within 6 months from a sample of 1011 university students in Taiwan (328 male, 683 female). A series of one-way ANOVAs was adopted to examine each outcome across groups and time phases. The results provide support for a positive relationship between well-being (β = 0.25, p < 0.001), and quality of life (β = 0.92, p < 0.001), supporting our expectations. Findings from our study suggest that physical activity was positively associated with mental health; and participation in physical activity had an effect on the well-being and quality of life in college students.

Motivational climate, need satisfaction, self-determined motivation, and physical activity of students in secondary school physical education in China

Background

On the basis of the integration constructs from self-determination theory (SDT) and achievement goal theory (AGT), this study aims to investigate the relationship among classroom motivational climate from four perspectives (i.e. autonomy support, relatedness support, task-involving climate and ego-involving climate), three psychological needs (i.e. autonomy, competence and relatedness), self-determined motivation and physical activity (PA) in secondary physical education (PE).

Methods

Participants consisted of 1186 Chinese students aged 11 to 16 years from three secondary schools in Shanghai. Accelerometers were utilized to measure moderate to vigorous physical activity (MVPA). Questionnaires were used to measure SDT variables (i.e. classroom motivational climate, perceived competence, autonomy, relatedness and self-determined motivation). Structural equation modelling (SEM) was adopted to analyse the hypothesised relationship.

Results

SEM analysis revealed that task-involving climate and autonomy support were positively associated with autonomy, relatedness and competence. Relatedness support was positively related with autonomy and relatedness, whereas ego-involving climate was only associated with competence. The three psychological needs positively affected self-determined motivation, and self-determined motivation positively affected the MVPA time of secondary school students in PE lessons.

Conclusion

These findings support a model of motivation that integrates SDT and AGT, provides new insight into understanding MVPA in Chinese PE, and establishes a solid basis for intervention research.

Aggie Play: A Gender-Relevant Physical Activity Program for Girls

A majority of U.S. children age 6-17 years do not meet the recommended 60 min of moderate to vigorous physical activity per day. Girls are less likely to meet these daily physical activity guidelines than boys. Following a call for greater gender-relevant physical activity programming, Aggie Play, an after-school physical activity program, engaged female student athletes to serve as active role models who lead girls through high-energy activities twice a week over a school year. The purpose of this study was to explore how Aggie Play affected girls' self-efficacy and expected enjoyment for physical activity, time spent in various physical activity intensities during free play, and fitness, relative to a control group. Results revealed that the girls participating in Aggie Play increased ratings of physical activity self-efficacy and enjoyment compared with girls at a control site. Aggie Play girls also demonstrated greater improvements on the muscle-endurance test than girls at a control site. Results are consistent with prior gender-relevant physical activity and physical education research. This study extends prior results by documenting the benefits of gender-relevant physical activity programming when led by active female role models.

Convergent Validity of a Consumer-Grade Accelerometer with a Research-Grade Pedometer in a Physical Education Setting

The cost of activity monitors has substantially reduced in recent years, making them more feasible for use in physical education programs. This study examined the convergent validity of the consumer-grade Movband activity monitor with the research-grade NL-2000 pedometer. The NL-2000 was chosen as the criterion unit because it is unaffected by BMI, pedometer tilt, or waist circumference, and has been recommended for use in research [1]. One hundred and eleven elementary school aged children (53 boys, 58 girls; 9.2 ± 0.7 yr.) from three physical education classes wore an NL-2000 on their right hip and a Movband on each wrist during a 30 minute class in which participants walked or ran on a hiking trail. A repeated measures ANOVA of mean steps indicated a significant difference (p< .001) between the NL-2000 (2411.74 ± 514.87) and the Movband worn on either wrist (left= 1554.33 ± 340.81, right= 1532.26 ± 329.76). Pearson product-moment correlations indicated that NL-2000 steps and Moves were significantly and positively correlated (p< .001; left= .79, right= .85). The correlation coefficient between left and right wrists was .87. In general, the Movband can provide reasonable estimates of physical activity for physical education teachers.

The effectiveness of school-based physical activity interventions for adolescent girls: A systematic review and meta-analysis

Physical activity (PA) decreases during the transition from childhood to adolescence, with larger declines observed in girls. School-based interventions are considered the most promising approach for increasing adolescents' PA levels although, it is unclear which types of school-based interventions have the greatest impact. The objective of this systematic review is to assess the impact and design of school-based PA interventions targeting adolescent girls. A systematic search was conducted using four electronic databases (PubMed, Web of Science, SPORTDiscus and PsychInfo). This systematic review was registered with PROSPERO (Registration number: CRD42016037428) and PRISMA guidelines (2009) were followed throughout. Twenty studies were identified as meeting the inclusion criteria and were included in a narrative synthesis. Seventeen studies were eligible for inclusion in a meta-analysis. There was a significant small positive treatment effect for school-based PA interventions for adolescent girls (k=17, g=0.37, p<0.05). After an outlier was removed (residual z=7.61) the average treatment effect was significantly reduced, indicating a very small positive effect (k=16, g=0.07, p=0.05). Subgroup analysis revealed very small significant effects for multi-component interventions (k=7, g=0.09, p<0.05), interventions underpinned by theory (k=12, g=0.07, p<0.05), and studies with a higher risk of bias (k=13, g=0.09, p<0.05). Intervention effects were very small which indicates that changing PA behaviors in adolescent girls through school-based interventions is challenging. Multi-component interventions and interventions underpinned by theory may be the most effective approaches to positively change adolescent girls' PA.

Validation of an observation tool to assess physical activity-promoting physical education lessons in high schools: SOFIT

OBJECTIVES

SOFIT+ is an observation tool to measure teacher practices related to moderate-to-vigorous physical activity (MVPA) promotion during physical education (PE). The objective of the study was to examine the validity of SOFIT+ during high school PE lessons.

DESIGN

This cross-sectional, observational study tested the construct validity of SOFIT+ in boys' and girls' high school PE lessons.

METHODS

Twenty-one PE lessons were video-recorded and retrospectively coded using SOFIT+. Students wore hip-mounted accelerometers during lessons as an objective measure of MVPA. Multinomial logistic regression was used to estimate the likelihood of students engaging in MVPA during different teacher practices represented by observed individual codes and a combined SOFIT+ index-score.

RESULTS

Fourteen individual SOFIT+ variables demonstrated a statistically significant relationship with girls' and boys' MVPA. Observed lesson segments identified as high MVPA-promoting were related to an increased likelihood of girls engaging in 5-10 (OR=2.86 [95% CI 2.41-3.40]), 15-25 (OR=7.41 [95% CI 6.05-9.06]), and 30-40 (OR=22.70 [95% CI 16.97-30.37])s of MVPA. For boys, observed high-MVPA promoting segments were related to an increased likelihood of engaging in 5-10 (OR=1.71 [95% CI 1.45-2.01]), 15-25 (OR=2.69 [95% CI 2.31-3.13]) and 30-40 (OR=4.26 [95% CI 3.44-5.29])s of MVPA.

CONCLUSIONS

Teacher practices during high school PE lessons are significantly related to students' participation in MVPA. SOFIT+ is a valid and reliable tool to examine relationships between PE teacher practices and student MVPA during PE.

Cross-sectional and prospective impact of reallocating sedentary time to physical activity on children's body composition

BACKGROUND

The amount of time children spend in sedentary behaviours may have adverse health effects.

OBJECTIVE

To examine the substitution effects of displacing a fixed duration of sedentary time with physical activity (PA) on children's body composition.

METHODS

We included 386 children (197 boys). Outcomes were body mass index, waist circumference, total body fat mass and trunk fat mass assessed by dual-energy X-ray absorptiometry. Sedentary time and PA were measured with accelerometers. Data were analysed by isotemporal analyses estimating the effect of reallocating 15 and 30 min d^-1 of sedentary time into light (light physical activity), and moderate-to-vigorous (MVPA) PA on body composition.

RESULTS

Reallocating 15 and 30 min d^-1 of sedentary time into MVPA was negatively associated with body fatness in cross-sectional analyses. Prospectively, reallocating 30 min of sedentary time into 30 min of MVPA was negatively associated with waist circumference (β = -1.11, p < 0.05), trunk fat mass (β = -0.21, p < 0.05), and total body fat mass (β = -0.48, p < 0.05) at follow-up (20 months). The magnitude of associations was half in magnitude and remained significant (p < 0.05) when reallocating 15 min of sedentary time into MVPA. Reallocating sedentary time into light physical activity was not related (p > 0.05) with body fatness outcomes.

CONCLUSIONS

Substituting sedentary time with MVPA using isotemporal analysis is associated with positive effects on body composition.

Examining the impact of a province-wide physical education policy on secondary students' physical activity as a natural experiment

Background

The purpose of this paper is to examine the impact of a province-wide physical education (PE) policy on secondary school students’ moderate to vigorous physical activity (MVPA).

Methods

Policy: In fall 2008, Manitoba expanded a policy requiring a PE credit for students in grades 11 and 12 for the first time in Canada. The PE curriculum requires grades 11 and 12 students to complete a minimum of 55 h (50% of course hours) of MVPA (e.g., ≥30 min/day of MVPA on ≥5 days a week) during a 5-month semester to achieve the course credit.

Study Designs: A natural experimental study was designed using two sub-studies: 1) quasi-experimental controlled pre-post analysis of self-reported MVPA data obtained from census data in intervention and comparison [Prince Edward Island (PEI)] provinces in 2008 (n = 33,619 in Manitoba and n = 2258 in PEI) and 2012 (n = 41,169 in Manitoba and n = 4942 in PEI); and, 2) annual objectively measured MVPA in cohorts of secondary students in intervention (n = 447) and comparison (Alberta; n = 224) provinces over 4 years (2008 to 2012).

Analysis: In Study 1, two logistic regressions were conducted to model the odds that students accumulated: i) ≥30 min/day of MVPA, and ii) met Canada's national recommendation of ≥60 min/day of MVPA, in Manitoba versus PEI after adjusting for grade, sex, and BMI. In Study 2, a mixed effects model was used to assess students’ minutes of MVPA per day per semester in Manitoba and Alberta, adjusting for age, sex, BMI, school location and school SES.

Results

In Study 1, no significant differences were observed in students achieving ≥30 (OR:1.13, 95% CI:0.92, 1.39) or ≥60 min/day of MVPA (OR:0.92, 95% CI: 0.78, 1.07) from baseline to follow-up between Manitoba and PEI. In Study 2, no significant policy effect on students’ MVPA trajectories from baseline to last follow-up were observed between Manitoba and Alberta overall (−1.52, 95% CI:-3.47, 0.42), or by covariates.

Conclusions

The Manitoba policy mandating PE in grades 11 and 12 had no effect on student MVPA overall or by key student or school characteristics. However, the effect of the PE policy may be underestimated due to the use of a nonrandomized research design and lack of data assessing the extent of policy implementation across schools. Nevertheless, findings can provide evidence about policy features that may improve the PE policy in Manitoba and inform future PE policies in other jurisdictions.

A systematic review and meta-analysis of moderate-to-vigorous physical activity levels in secondary school physical education lessons

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.

A non-equivalent group pilot trial of a school-based physical activity and fitness intervention for 10-11 year old english children: born to move

Background

PE lessons are the formal opportunity in schools for promotion of physical activity and fitness. This study aimed to evaluate the effectiveness of a pilot PE intervention on physical activity, fitness, and psychosocial outcomes.

Methods

Participants were 139 children aged 10–11 years from four schools. For six weeks children in two schools received a twice-weekly pilot ‘Born to Move’ (BTM) physical activity (PA) and fitness intervention alongside one regular PE lesson. Children in the two comparison (COM) schools received their regular twice weekly PE lessons. Outcomes were lesson time and whole-day light (LPA), moderate (MPA), vigorous (VPA), and MVPA, and sedentary time, muscular fitness, cardiorespiratory fitness (CRF), and lesson-specific perceived exertion, enjoyment, and perceived competence. Outcomes were assessed at baseline (T0), midway through the intervention (T1), and at the end (T2) using ANOVAs and ANCOVAs. Intervention fidelity was measured using child and teacher surveys at T2 and analysed using Chi-square tests.

Results

The BTM group engaged in moderate PA for significantly more lesson time (29.4 %) than the COM group (25.8 %; p = .009, d = .53). The amount of moderate-to-vigorous PA (MVPA) during the T1 BTM lesson contributed 14.0 % to total MVPA, which was significantly more than the COM group’s T1 PE lesson (11.4 %; p < .001, d = .47). The BTM group were significantly more active during the whole-day (p < .05) and the school-day (p < .01). In both groups push-up test performance increased (p < .001) and CRF test performance decreased (p < .01). Perceived exertion, enjoyment, and perceived competence increased in both groups (p < .05), but the BTM group rated their enjoyment of the T1 BTM lesson higher than the COM group rated their PE lesson (p = .02, d = .56). The children’s and teachers’ responses to the intervention indicated that the delivery aims of enjoyment, engagement, inclusivity, and challenge were satisfied.

Conclusions

The BTM pilot programme has potential to positively impact on physical activity, fitness, and psychosocial outcomes. Further, BTM was enjoyed by the children, and valued by the teachers. This study can inform the design of a modified larger-scale cluster RCT evaluation.

Physical Activity Levels and Domains Assessed by Accelerometry in German Adolescents from GINIplus and LISAplus

BACKGROUND

Physical activity (PA) is a well-known and underused protective factor for numerous health outcomes, and interventions are hampered by lack of objective data. We combined accelerometers with diaries to estimate the contributions to total activity from different domains throughout the day and week in adolescents.

METHODS

Accelerometric and diary data from 1403 adolescents (45% male, mean age 15.6 ± 0.5 years) were combined to evaluate daily levels and domains of sedentary, light, and moderate-to-vigorous activity (MVPA) during a typical week. Freedson's cutoff points were applied to determine levels of activity. Total activity was broken down into school physical education (PE), school outside PE, transportation to school, sport, and other time.

RESULTS

About 2/3 of adolescents' time was spent sedentary, 1/3 in light activity, and about 5% in MVPA. Boys and girls averaged 46 (SD 22) and 38 (23) minutes MVPA per day. Adolescents were most active during leisure sport, spending about 30% of it in MVPA, followed by PE (about 20%) transport to school (14%) and either school class time or other time (3%). PE provided 5% of total MVPA, while leisure sport provided 16% and transportation to school 8%. School was the most sedentary part of the day with over 75% of time outside PE spent sedentary.

CONCLUSIONS

These German adolescents were typical of Europeans in showing low levels of physical activity, with significant contributions from leisure sport, transportation and school PE. Leisure sport was the most active part of the day, and participation did not vary significantly by sex, study center (region of Germany) or BMI. Transportation to school was frequent and thus accounted for a significant fraction of total MVPA. This indicates that even in a population with good access to dedicated sporting activities, frequent active transportation can add significantly to total MVPA.

Evaluation of physical activity interventions in youth via the Reach, Efficacy/Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework: A systematic review of randomised and non-randomised trials

CONTEXT

An identified limitation of existing reviews of physical activity interventions in school-aged youth is the lack of reporting on issues related to the translatability of the research into health promotion practice.

OBJECTIVE

This review used the Reach, Efficacy/Effectiveness, Adoption, Implementation and Maintenance framework to determine the extent to which intervention studies promoting physical activity in youth report on factors that inform generalizability across settings and populations.

METHODS AND RESULTS

A systematic search for controlled interventions conducted within the last ten years identified 50 studies that met the selection criteria. Based on Reach, Efficacy/Effectiveness, Adoption, Implementation and Maintenance criteria, most of these studies focused on statistically significant findings and internal validity rather than on issues of external validity. Due to this lack of information, it is difficult to determine whether or not reportedly successful interventions are feasible and sustainable in an uncontrolled, real-world setting.

CONCLUSIONS

Areas requiring further research include costs associated with recruitment and implementation, adoption rate, and representativeness of participants and settings. This review adds data to support recommendations that interventions promoting physical activity in youth should include assessment of adoption and implementation issues.

A cluster randomised controlled trial to investigate the effectiveness and cost effectiveness of the 'Girls Active' intervention: a study protocol

BACKGROUND

Despite the health benefits of physical activity, data from the UK suggest that a large proportion of adolescents do not meet the recommended levels of moderate-to-vigorous physical activity (MVPA). This is particularly evident in girls, who are less active than boys across all ages and may display a faster rate of decline in physical activity throughout adolescence. The 'Girls Active' intervention has been designed by the Youth Sport Trust to target the lower participation rates observed in adolescent girls. 'Girls Active' uses peer leadership and marketing to empower girls to influence decision making in their school, develop as role models and promote physical activity to other girls. Schools are provided with training and resources to review their physical activity, sport and PE provision, culture and practices to ensure they are relevant and attractive to adolescent girls.

METHODS/DESIGN

This study is a two-arm cluster randomised controlled trial (RCT) aiming to recruit 20 secondary schools. Clusters will be randomised at the school level (stratified by school size and proportion of Black and Minority Ethnic (BME) pupils) to receive either the 'Girls Active' intervention or carry on with usual practice (1:1). The 20 secondary schools will be recruited from state secondary schools within the Midlands area. We aim to recruit 80 girls aged 11-14 years in each school. Data will be collected at three time points; baseline and seven and 14 months after baseline. Our primary aim is to investigate whether 'Girls Active' leads to higher objectively measured (GENEActiv) moderate-to-vigorous physical activity in adolescent girls at 14 months after baseline assessment compared to the control group. Secondary outcomes include other objectively measured physical activity variables, adiposity, physical activity-related psychological factors and the cost-effectiveness of the 'Girls Active' intervention. A thorough process evaluation will be conducted during the course of the intervention delivery.

DISCUSSION

The findings of this study will provide valuable information on whether this type of school-based approach to increasing physical activity in adolescent girls is both effective and cost-effective in the UK.

TRIAL REGISTRATION

ISRCTN10688342. Registered 12 January 2015.

Effectiveness of school-initiated physical activity program on secondary school students' physical activity participation

BACKGROUND

The promotion of physical activity and health has become a universal challenge. The Sotkamo Physical Activity as Civil Skill Program was implemented to increase students' physical activity by promoting supportive psychological and physical school environment. The aim of this study was to evaluate the effectiveness of the school-initiated physical activity program on secondary school students' self-reported physical activity.

METHODS

The sample included 847 students (experimental condition school = 208, control school = 639) at the age of 12 to 14 years from northeast and central Finland. The program was conducted across 1 academic year and 2 measurement phases were carried out using self-report questionnaires in April 2011 and 2012.

RESULTS

The findings highlighted that the program appeared to be effective as an approach to change the sharp decline in the pattern of Grade 7 students' self-reported physical activity across 1 school year. Specifically, change in the experimental condition students' self-reported physical activity was 13.4% higher compared the students in the control condition.

CONCLUSION

On the basis of current findings, increased opportunities for school day physical activities have the potential to affect large number of students and are an efficient strategy for promoting regular physical activity.

The effectiveness of interventions to increase physical activity among adolescent girls: a meta-analysis

BACKGROUND

Research has shown that a clear decline in physical activity among girls starting in early adolescence. Therefore, adolescent girls have been identified as a key target population for physical activity behavior change. The quantification of intervention effectiveness for this group has not been previously reported in a meta-analysis, and this therefore was the objective of the current meta-analysis.

STUDY SELECTION

Included were interventions in which the main component, or 1 of the components, was aimed at promoting physical activity through behavior change in any setting. Interventions had to include a non-physical activity control group or comparison group, and include a quantitative outcome assessment of physical activity behavior in girls aged 12 to 18 years.

DATA SOURCES

Science Direct, PubMed, PsychINFO, Web of Science, Cochrane Libraries, and EPPI Centre databases were searched up to and including May 2013.

DATA EXTRACTION AND SYNTHESIS

Forty-five studies (k = 34 independent samples) were eligible from an initial 13,747 references. A random-effects meta-analysis was conducted.

RESULTS

The average treatment effect for adolescent girls involved in physical activity interventions was significant but small (g = 0.350, 95% confidence interval 0.12, 0.58, P < .001). Moderator analyses showed larger effects for interventions that were theory based, performed in schools, were girls only, with younger girls, used multicomponent strategies, and involved targeting both physical activity and sedentary behavior.

CONCLUSIONS

Interventions to increase physical activity in adolescent girls show small but significant effects, suggesting that behavior change may be challenging. Results suggest some approaches that appear to be successful.

Associations between showering behaviours following physical education, physical activity and fitness in English schoolchildren

We aimed to describe the frequency of showering after physical education (PE) in English high-school pupils. We examined differences in physical activity (PA) and cardiorespiratory fitness according to showering behaviours and examined predictors of showering. We measured PA and cardiorespiratory fitness of n = 3921 pupils (11-16 years, 53.5% males) from eight high schools. Pupils self-reported showering behaviour and parental PA levels. We calculated deprivation and distance travelled to school from their home postcode. Overall, 53% of boys and 68% of girls said they never shower after PE. Pupils who did not shower after PE were less physically active and engaged in fewer team sports. Girls who did not shower also had lower cardiorespiratory fitness than those who did. Showering behaviour varied greatly by school, so we adjusted for clustering at the school level. Pupils were more likely to shower if they were active with their parents [odds ratio (OR) = 1.72; 95% CI: 1.43, 2.07] and less likely to shower if they were from deprived areas (OR = 0.68; 95% CI: 0.52, 0.88). Showering after PE is relatively rare in English schoolchildren, particularly girls. While we cannot infer causality regarding the relationships found here, the low rates of showering and the lower PA and cardiorespiratory fitness (in girls) observed in schoolchildren who do not shower suggest research is needed to determine whether showering is a barrier to being physically active during PE.

Process evaluation and proximal impact of an affect-based exercise intervention among adolescents

The objective of this study was to evaluate the implementation and proximal impact of an intervention designed to enhance adolescents' affective experience during Physical Education (PE). Healthy adolescents (N = 74) were randomly assigned to an affect-based or a traditional exercise prescription. Intervention logs, observations and interviews documented the implementation of the intervention. Participants completed a 30-min exercise task at an intensity that felt "good" to them before and after the intervention. Study procedures were implemented successfully and students enjoyed study participation. The intervention had no impact on exercise intensity during PE or during the "feels-good" exercise task. Among adolescents who manifested a negative affective response to moderate-intensity exercise at baseline, the selected intensity during the "feels-good" task increased over time. The intervention may have been too weak to impact behavior over and above a high-quality PE program. The results do suggest, however, that reluctant exercisers may choose to exercise at a higher intensity after experiencing a high-quality PE program in combination with heart rate monitoring.

Increasing girls' physical activity during an organised youth sport basketball program: a randomised controlled trial protocol

BACKGROUND

Participation in organised youth sports (OYS) has been recommended as an opportunity to increase young peoples' moderate-to-vigorous physical activity (MVPA) levels. Participants, however, spend a considerable proportion of time during OYS inactive. The purpose of this study, therefore, was to investigate whether coaches who attended coach education sessions (where education on increasing MVPA and decreasing inactivity during training was delivered) can increase players' MVPA during training sessions over a 5-day basketball program compared to coaches who did not receive coach education sessions.

METHODS/DESIGN

A convenience sample of 80 female players and 8 coaches were recruited into the UWS School Holiday Basketball Program in Greater Western Sydney, Australia. A two-arm, parallel-group randomised controlled trial was employed to investigate whether coaches who attended 2 coach education sessions (compared with a no-treatment control) can increase their players' MVPA during training sessions over a 5-day basketball program. Objectively measured physical activity, directly observed lesson context and leader behaviour, player motivation, players' perceived autonomy support, and coaching information (regarding training session planning, estimations on player physical activity and lesson context during training, perceived ability to modify training sessions, perceived importance of physical activity during training, intention to increase physical activity/reduce inactivity, and likelihood of increasing physical activity/reducing inactivity) were assessed at baseline (day 1) and at follow-up (day 5). Linear mixed models will be used to analyse between arm differences in changes from baseline to follow-up on all outcomes.

DISCUSSION

The current trial protocol describes, to our knowledge, the first trial conducted in an OYS context to investigate the efficacy of an intervention, relative to a control, in increasing MVPA. This study's findings will provide evidence to inform strategies targeting coaches to increase MVPA in OYS, which could have major public health implications, given the high proportion of children and adolescents who participate in OYS globally.

TRIAL REGISTRATION

This trial is registered with the Australian New Zealand Clinical Trials Registry, ACTRN12613001099718.

Girls' physical activity levels during organized sports in Australia

PURPOSE

The primary aim of this study was to objectively examine the physical activity (PA) levels of girls during organized sports (OS) and to compare the levels between games and practices for the same participants. The secondary aims of this study were to document lesson context and coach behavior during practices and games.

METHODS

Participants were 94 girls recruited from 10 teams in three OS (netball, basketball, and soccer) from the western suburbs of Sydney. Each participant wore an ActiGraph GT3X monitor for the duration of one practice and one game. The System for Observing Fitness Instruction Time was concurrently used to document lesson context and coach behavior.

RESULTS

Girls spent a significantly higher percentage of time in moderate-to-vigorous PA (MVPA) during practices compared with games (33.8% vs 30.6%; t = 2.94, P < 0.05). Girls spent approximately 20 min·h(-1) in MVPA during practices and approximately 18 min·h(-1) in MVPA during games. An average of 2957 and 2702 steps per hour were accumulated during practices and games, respectively. However, girls spent roughly two-thirds of their OS time in light PA or sedentary. On the basis of the System for Observing Fitness Instruction Time findings, coaches spent a large proportion of practice time in management (15.0%) and knowledge delivery (18.5%). An average of 13.0 and 15.8 occurrences per hour were observed during games and practices where coaches promoted PA.

CONCLUSIONS

For every hour of game play or practice time, girls accumulated approximately one third of the recommended 60 min of MVPA time and approximately one quarter of the 12,000 steps that girls are recommended to accumulate daily. For this population, OS seems to make a substantial contribution to the recommended amounts of MVPA and steps for participating girls. OS alone, however, does not provide amounts of PA sufficient to meet daily recommendations for adolescent girls.

A systematic review and meta-analysis of interventions designed to increase moderate-to-vigorous physical activity in school physical education lessons

OBJECTIVES

Physical education (PE) that allows students to engage in moderate-to-vigorous physical activity (MVPA) can play an important role in health promotion. Unfortunately, MVPA levels in PE lessons are often very low. In this review, we aimed to determine the effectiveness of interventions designed to increase the proportion of PE lesson time that students spend in MVPA.

METHODS

In March 2012, we searched electronic databases for intervention studies that were conducted in primary or secondary schools and measured the proportion of lesson time students spent in MVPA. We assessed risk of bias, extracted data, and conducted meta-analyses to determine intervention effectiveness.

RESULTS

From an initial pool of 12,124 non-duplicate records, 14 studies met the inclusion criteria. Students in intervention conditions spent 24% more lesson time in MVPA compared with students in usual practice conditions (standardized mean difference=0.62).

CONCLUSIONS

Given the small number of studies, moderate-to-high risk of bias, and the heterogeneity of results, caution is warranted regarding the strength of available evidence. However, this review indicates that interventions can increase the proportion of time students spend in MVPA during PE lessons. As most children and adolescents participate in PE, these interventions could lead to substantial public health benefits.

A multilevel examination of gender differences in the association between features of the school environment and physical activity among a sample of grades 9 to 12 students in Ontario, Canada

Background

Creating school environments that support student physical activity (PA) is a key recommendation of policy-makers to increase youth PA. Given males are more active than females at all ages, it has been suggested that investigating gender differences in the features of the environment that associate with PA may help to inform gender-focused PA interventions and reduce the gender disparity in PA. The purpose of this cross-sectional study was to explore gender differences in the association between factors of the school environment and students' time spent in PA.

Methods

Among a sample of 10781 female and 10973 male students in grades 9 to 12 from 76 secondary schools in Ontario, Canada, student- and school-level survey PA data were collected and supplemented with GIS-derived measures of the built environment within 1-km buffers of the 76 schools.

Results

Findings from the present study revealed significant differences in the time male and female students spent in PA as well as in some of the school- and student-level factors associated with PA. Results of the gender-specific multilevel analyses indicate schools should consider providing an alternate room for PA, especially for providing flexibility activities directed at female students. Schools should also consider offering daily physical education programming to male students in senior grades and providing PA promotion initiatives targeting obese male students.

Conclusions

Although most variation in male and female students' time spent in PA lies between students within schools, there is sufficient between-school variation to be of interest to practitioners and policy-makers. More research investigating gender differentials in environment factors associated with youth PA are warranted.

Interventions to promote physical activity among young and adolescent girls: a systematic review

A narrative systematic review was conducted to describe the available evidence from physical activity (PA) interventions that targeted girls aged 5-18 years and to determine their effectiveness and key characteristics of success. Systematic literature searches were conducted using four databases: PubMed, Web of Science, PsychInfo and SPORTDiscus and by examining the reference lists of included articles and published relevant reviews, to identify studies published in English from 2000 to July 2010. Randomized controlled trials or quasi-experimental designs with pre-test and post-test behavioral outcome data (objective or self-report measure) were included. Methodological quality was assessed using a checklist and conclusions were made concerning effectiveness. A total of 29 articles were reviewed, describing the evaluation of 21 interventions. Ten studies reported a favorable intervention effect upon PA outcomes, seven of which were rated as having a high methodological quality. Multi-component school-based interventions that also offer a physical education that address the unique needs of girls seemed to be the most effective. Although family support is revealed as ineffective, peer strategies showed promising evidence. The review finishes highlighting possible intervention strategies and reporting areas where further investigation is required.

Enrollment in physical education is associated with health-related behavior among high school students

BACKGROUND

Physical education (PE) plays a critical role in the healthy development of youth; however, the influence of PE classes in helping to provide students with health-related behavior patterns is not clear. This study aims to analyze whether participation in PE classes is associated with health-related behavior among high school students.

METHODS

A total of 4210 students attending public high schools in Pernambuco (northeast of Brazil) were selected using random 2-stage cluster sampling. Data were collected by using the Global School-based Student Health Survey. The independent variable was the frequency of participation in PE classes, whereas physical activity, television viewing, smoking, and alcohol, fruit, vegetables and soda consumption were dependent variables. Logistic regressions were carried out to perform crude and adjusted analysis of the association between enrollment in PE classes and health-related behaviors.

RESULTS

Sixty-five percent of students do not take part in PE classes, with a significantly higher proportion among females (67.8%). It was observed that enrollment in PE classes was positively associated with physical activity, TV viewing, and fruit consumption, but was negatively associated with soda drinking. The likelihood of reporting being active and eating fruit on a daily basis was 27% and 45% higher, respectively, among those who participate in at least 2 classes per week in comparison with those who do not. Students who participate in PE classes had 28-30% higher likelihood of reporting lower TV viewing during week days.

CONCLUSIONS

Findings suggest that higher levels of enrollment in PE classes could play a role in the promotion of health-related behaviors among high school students.

Increasing physical activity and decreasing sedentary activity in adolescent girls--the Incorporating More Physical Activity and Calcium in Teens (IMPACT) study

BACKGROUND

Lack of regular physical activity and consequent sub-optimal bone mass acquisition in youth has been implicated as a primary cause of adult-onset osteoporosis. IMPACT was a behavioral theory-based 1 1/2 year randomized controlled field study aimed at increasing bone accretion in middle school girls. The objective of this study was to determine the intervention effects of the IMPACT program upon key physical and sedentary activity endpoints among schools that participated in the IMPACT study. Endpoints examined included weight bearing physical activity (WBPA); moderate to vigorous physical activity (MVPA); vigorous physical activity (VPA); MET (metabolic equivalent) - weighted WBPA and MVPA; sedentary activity; before/after-school physical activity; and weekend physical activity.

METHODS

Primary data analysis using a pretest-posttest control group design was conducted utilizing mixed model analysis of covariance. Data gathered from the IMPACT cohort from 2000-2002 were analyzed to determine baseline versus follow-up differences in activity endpoints. Confounders investigated included ethnicity, body mass index, menarcheal status, participation in 7th grade PE/athletics, friend/familial support and neighborhood safety.

RESULTS

Follow-up means were higher for participating intervention schools relative to control schools for all physical activity variables but were statistically significant only for the following variables: daily minutes of vigorous physical activity (mean difference between Intervention (I) and Control (C) = 6.00 upward arrow minutes, 95% CI = 5.82-6.18, p = 0.05), daily after school activity minutes (mean difference between I and C = 8.95 upward arrow minutes, 95% CI = 8.69-9.21, p = 0.04), and daily weekend activity minutes (mean difference between I and C = 19.00 upward arrow minutes, 95% CI = 18.40-19.60, p = 0.05). The intervention significantly reduced duration of student daily TV/Video watching (mean difference between I and C = 12.11 downward arrow minutes, 95% CI = 11.74-12.48, p = 0.05) and total daily sedentary activity minutes (mean difference between I and C = 16.99 downward arrow minutes, 95% CI = 16.49-17.50, p = 0.04).

CONCLUSION

A well designed and implemented school based health and physical activity intervention can result in a positive influence upon increasing physical activity levels and decreasing sedentary activity. Future interventions should consider a more structured intervention component to obtain significant changes in WBPA.