Cardiorespiratory fitness is associated with physical literacy in a large sample of Canadian children aged 8 to 12 years

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

Objective

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

Methods

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

Results

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

Conclusion

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

The validity of the Physical Literacy in Children Questionnaire in children aged 4 to 12

BACKGROUND

Given the growing evidence on the health benefits associated with physical literacy (PL), it is necessary to develop sound measures to assess the levels of PL in children. The Physical Literacy in Children Questionnaire (PL-C Quest) is the first self-report pictorial-based scale to assess children's perceived PL. It has good validity and reliability in Australian children aged 7 to 12 years, but little is known in younger children and in other cultural contexts. The aim of this study was to examine the validity and reliability in an expanded age range.

METHODS

A total of 1,870 Chinese children (girls, n = 871; 46.6%), aged 4 to 12 years (M = 8.07 ± 2.42) participated in validity testing. Structural equation modeling with the Weighted Least Squares with Mean and Variance approach was used to assess construct validity. The hypothesized theoretical model used the 30 items and four hypothesized factors: physical, psychological, social and cognitive capabilities. Multigroup confirmatory factor analysis was used to assess sex and age group (4-6 years, 7-9 years and 10-12 years) measurement invariance. Internal consistency analyses were conducted using polychoric alpha. A random subsample (n = 262) was selected to determine test-retest reliability using Intra-Class Correlations (ICC).

RESULTS

All items except one (moving with equipment-skateboarding) loaded on sub-domains with λ > 0.45. The hypothesized model had a good fit (CFI = 0.954, TLI = 0.950, RMSEA = 0.042), with measurement equivalence across sex and age groups separately. Internal consistency values were good to excellent (overall: α = 0.94; physical: α = 0.86; psychological: α = 0.83; social: α = 0.81; cognitive: α = 0.86). Test-retest reliability was adequate to excellent (overall: ICC = 0.90, physical: ICC = 0.86, psychological: ICC = 0.75, social: ICC = 0.71, cognitive: ICC = 0.72).

CONCLUSION

The Chinese version of the PL-C Quest is valid and reliable for testing the self-reported PL of Chinese children aged 4 to 12. This study provides the first evidence of validity for this tool in children aged 4-6 years and also evidence that the PL-C Quest would be a meaningful instrument to assess PL in Chinese children.

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

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

Perceived Physical Literacy Is Associated with Cardiorespiratory Fitness, Body Composition and Physical Activity Levels in Secondary School Students

BACKGROUND

Overweight and obese adolescents are often associated with lower Physical Activity (PA) levels and low Cardiorespiratory Fitness (CRF). Recently, the concept of Physical Literacy (PL), has been suggested to be associated with higher levels of active behavior and better health in adolescents. The purpose of this study is to investigate the relationships between PL, body composition, cardiorespiratory fitness and physical activity levels in French secondary school students.

METHODS

The level of PL was assessed in 85 French adolescents using a French version of the Perceived Physical Literacy Instrument (F-PPLI). Cardiorespiratory fitness was measured by the "20 m adapted walk/shuttle run test". The PA level was assessed by the Youth Risk Behavior Surveillance System questionnaire. Weight status was measured by the Body Mass Index (BMI) and the body composition data.

RESULTS

We find a significant association between the PL and the percentage Fat Mass (%FM) (r = -0.43; p ≤ 0.01), between the PL and moderate to vigorous PA (MVPA) per week (r = 0.38; p ≤ 0.01). The PL was associated (r = 0.36; p ≤ 0.01) with the percentage of Skeletal Muscle Mass (%SMM) and cardiorespiratory fitness (r = 0.40; p ≤ 0.05).

CONCLUSIONS

Developing the PL for the most disadvantaged secondary school students in a PA program could be a suitable strategy to increase their PA level, reduce their adiposity, and promote better long-term health.

Assessment of Physical Tests in 6-11 Years Old Children: Findings from the Play Lifestyle and Activity in Youth (PLAY) Study

The purpose was to evaluate selected physical tests in children and to compare the outcomes by sex. A cross-sectional study design was used to evaluate children 6-11 years who completed five physical tests: hand grip, vertical jump, sit and reach, Y-balance, and obstacle course (time and score). The outcome measures including test results were descriptively examined and compared by sex. The study participants consisted of 133 children (62 males and 71 females, with a median age of 7.8 years). Girls showed superior sit and reach performance (p = 0.002) compared with boys. Boys demonstrated better Y-balance scores (p = 0.007) and faster obstacle time (p = 0.042) than girls. Sex comparison within three age groups (6-<8 years, 8-<10 years, and 10-<12 years) showed that girls performed better on the sit and reach compared with boys in the in 6-<8 years (p = 0.009). Boys demonstrated higher Y-balance scores (p = 0.017) and faster obstacle time (p = 0.007) compared with girls in the 8-<10-year age group. These data will serve to guide future efforts to evaluate normative measures of physical literacy and guide targeted training interventions to promote sustained physical activity in children with deficits relative to their age and sex norms.

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

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

Examining physical literacy in young adults: psychometric properties of the PLAYself

The PLAYself is a commonly utilized tool to assess physical literacy in child and adolescent populations. Currently, there are no measurement tools designed to examine physical literacy among adults. The purpose of this cross-sectional study was to examine the psychometric properties of PLAYself subsections in a sample of young adults. Two hundred forty-five young adults (ages 18-25) from the United States completed the PLAYself questionnaire. Multiple principal component analyses using promax rotation were utilized to assess the current factor structure of the PLAYself subsections. Each subsection was analyzed independently to explore individual summary components. PLAYself subsections were assessed for reliability using Cronbach's α, inter-item correlations, and item-total correlations. A multi-factor structure was identified for each PLAYself subsection. A 2-factor structure was identified for the Environment subsection accounting for 55.2% of the variance. A 2-factor structure was identified for the Physical Literacy Self-Description subsection accounting for 57.1% of the variance. A 3-factor structure was identified for the Relative Ranking of Literacies subsection accounting for 70.3% of the variance. The Environment, Physical Literacy Self-Description, and Relative Ranking of Literacies subsections demonstrated poor (α = 0.577), good (α = 0.89), and acceptable (α = 0.79) internal consistencies, respectively. The Physical Literacy Self-Description subsection demonstrated the best psychometric properties in our sample, and thus may be an appropriate tool to assess physical literacy in a young adult population until additional measurement tools are developed.

Associations between children's physical literacy and well-being: is physical activity a mediator?

Background

Physical literacy (PL) is a multi-dimensional concept that provides a holistic understanding of movement and physical activity. PL contains an affective, a physical, and a cognitive domain, which together lay the foundation for the individual’s capacity and the tendency for participating in physical activities currently and throughout life. PL is increasingly regarded as a ‘cause of the causes’ to health promotion. Cross-sectional studies have shown associations between children’s PL, physical activity behaviours, and well-being. This study aims to examine the associations between Danish children’s PL and their physical and psychosocial well-being and whether the associations are mediated by moderate- to vigorous intensity physical activity (MVPA).

Methods

Cross-sectional data from Danish schoolchildren aged 7–13 years were collected in Jan-Dec 2020 in the Danish Assessment of Physical Literacy (DAPL) project. PL was assessed with the DAPL which measures the affective, cognitive, and physical domains of PL. MVPA (min/day) was measured with accelerometers (Axivity), psychosocial well-being was measured with The Strengths and Difficulties Questionnaire, and physical well-being was measured with the KIDSCREEN questionnaire. Structural equation models were constructed with PL and MVPA as predictors of physical well-being and four aspects of psychosocial well-being.

Results

A positive moderate association between PL and physical well-being, partly mediated by MVPA was observed. PL was positively associated with the positive aspects of psychosocial well-being and negatively associated with the negative aspects (behaviour problems). None of the associations between PL and aspects of psychosocial well-being were mediated by MVPA.

Conclusions

The study contributes to evidence on the link between PL, physical activity, and health outcomes. The study found beneficial relations between PL and physical and psychosocial well-being. MVPA mediated part of the relationship between PL and physical well-being but not psychosocial well-being.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-022-13517-x.

Adolescents with Higher Cognitive and Affective Domains of Physical Literacy Possess Better Physical Fitness: The Importance of Developing the Concept of Physical Literacy in High Schools

Physical literacy (PL) is thought to facilitate engagement in physical activity, which could lead to better physical fitness (PF). The aim of this study was to examine the reliability of the Croatian version of two frequently applied PL questionnaires that evaluate knowledge and understanding, perceived competence, environment, and value for literacy, numeracy, and PL and validity regarding correlation with objectively evaluated PF in adolescents. Five hundred forty-four high school students (403 females, 141 males) from Croatia were tested on PF (standing long jump, sit-ups for 30 s, sit-and-reach test, multilevel endurance test) and two PL questionnaires. The reliability of the Croatian version of the Canadian Assessment of Physical Literacy knowledge and understanding (CAPL-2-KU) and PLAYself was good (α = 0.71−0.81 for PLAYself subscales, κ = 0.39−0.69 for CAPL-2-KU). Genders differed in the self-description dimension of PLAYself, with higher results in boys (Z = 3.72, p < 0.001). CAPL-2-KU and PLAYself total score were associated with PF in boys and girls, with PLAYself having stronger associations with PF. This research supports the idea of PL as an essential determinant for the development of PF, highlighting the necessity of the development of cognitive and affective domains of PL in physical education throughout a specifically tailored pedagogical process.

Out-of-School Sports Participation Is Positively Associated with Physical Literacy, but What about Physical Education? A Cross-Sectional Gender-Stratified Analysis during the COVID-19 Pandemic among High-School Adolescents

Physical literacy (PL) is one of the main concepts related to lifelong physical activity (PA) and physical fitness (PF), but there is a lack of information on factors that might be associated with PL in adolescents from southeastern Europe. This study aimed to evaluate the associations between PF, participation and achievement in physical education (PE), out-of-school participation in sports, and PL in high school adolescents from Croatia. Participants were 298 high school students aged 14−18 years (191 females). Variables included school age, PE grade, sports participation, anthropometric indices, four PF tests, and PL (evidenced by CAPL-2-knowledge and understanding questionnaire (CAPL-2-KU) and PLAYself questionnaire). Gender-stratified analyses of differences were conducted using the t-test for independent samples or the Mann-Whitney test. Associations between variables were calculated with Pearson’s product moment correlation or Spearman’s rank order correlation. PF was positively correlated CAPL-2-KU in both genders. PE grade was significantly associated with PLAYself score (Pearson’s correlation = 0.36 and 0.38, p < 0.001 for boys and girls, respectively) but not with the CAPL-2-KU score. School age was not correlated with PL among boys, but there was a significant but negligible correlation between CAPL-2-KU and school age in girls (<2% of the common variance). Adolescents involved in sports had better PL and PF compared with adolescents not involved in sports. In conclusion, participation in out-of-school sports offers a good base for developing PL. Although this study took part over the COVID-19 pandemic period when the regular PE curriculum was significantly altered, the poor associations between school age and PL could lead to the assumption that the current PE curriculum does not allow for improvement of PL in later high school age, which warrants further investigation.

Association between Physical Literacy and Self-Perceived Fitness Level in Children and Adolescents

Simple Summary

Alarming data on physical inactivity and sedentary lifestyles in children and young people are increasing. The level of physical fitness is considered a predictor of morbidity and comorbidities resulting from physical inactivity. Physical literacy, which includes the assessment of physical fitness, could be considered a crucial element for understanding adolescents’ health status and physical activity-related behaviours. Moreover, the self-perceived physical fitness should also be considered. Thus, this study analysed the relationship between physical literacy and self-perceived physical fitness in children and adolescents aged 8–12 years. It could be concluded that a higher level of self-perceived physical fitness would be associated with a greater level of physical literacy.

Abstract

Background: Physical fitness is considered a predictor of mortality and comorbidities resulting from physical inactivity in children and adolescents. Physical literacy provides a robust and comprehensive assessment of physical fitness. Thus, it is considered a crucial element for understanding children and adolescents’ health status and their physical activity-related behaviours. Moreover, the self-perceived fitness should also be considered. Therefore, this study aims to analyse the relationship between physical literacy and self-perceived physical fitness in children and adolescents aged 8–12 years. Methods: A single-measure cross-sectional study was conducted with 135 children and adolescents. Anthropometric measurements and the Canadian Assessment of Physical Literacy Development (CAPL-2) were applied. Descriptive statistics and correlations were calculated. The Fitness Perception Scale for Adolescents (FP VAS A) scale was also administered to assess participants’ self-perceived fitness. Results: Moderate significant correlations were found between “physical competence”, “motivation and confidence”, and the total CAPL-2 score with FP VAS A. Conclusions: The influence of motivation on self-perceived fitness has been demonstrated. Moreover, cardiorespiratory fitness could be considered one of the most relevant and influential factors in the total CAPL-2 score. It means that higher levels of self-perceived fitness would be associated with greater levels of physical literacy.

A systematic review of tools designed for teacher proxy-report of children's physical literacy or constituting elements

Background

Physical literacy (PL) in childhood is essential for a healthy active lifestyle, with teachers playing a critical role in guiding its development. Teachers can assist children to acquire the skills, confidence, and creativity required to perform diverse movements and physical activities. However, to detect and directly intervene on the aspects of children’s PL that are suboptimal, teachers require valid and reliable measures. This systematic review critically evaluates the psychometric properties of teacher proxy-report instruments for assessing one or more of the 30 elements within the four domains (physical, psychological, cognitive, social) of the Australian Physical Literacy Framework (APLF), in children aged 5–12 years. Secondary aims were to: examine alignment of each measure (and relevant items) with the APLF and provide recommendations for teachers in assessing PL.

Methods

Seven electronic databases (Academic Search Complete, CINAHL Complete, Education Source, Global Health, MEDLINE Complete, PsycINFO, and SPORTDiscus) were systematically searched originally in October 2019, with an updated search in April 2021. Eligible studies were peer-reviewed English language publications that sampled a population of children with mean age between 5 and 12 years and focused on developing and evaluating at least one psychometric property of a teacher proxy-report instrument for assessing one or more of the 30 APLF elements. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidance was followed for the conduct and reporting of this review. The methodological quality of included studies and quality of psychometric properties of identified tools were evaluated using the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) guidance. Alignment of each measure (and relevant items) with the APLF domains and 30 elements was appraised.

Results

Database searches generated 61,412 citations; reduced to 41 studies that evaluated the psychometric properties of 24 teacher proxy-report tools. Six tools were classified as single domain measures (i.e. assessing a single domain of the APLF), eleven as dual-domain measures, and seven as tri-domain measures. No single tool captured all four domains and 30 elements of the APLF. Tools contained items that aligned with all physical, psychological, and social elements; however, four cognitive elements were not addressed by any measure. No tool was assessed for all nine psychometric properties outlined by COSMIN. Included studies reported a median of 3 out of nine psychometric properties. Most reported psychometric properties were construct validity (n = 32; 78% of studies), structural validity (n = 26; 63% of studies), and internal consistency (n = 25; 61% of studies). There was underreporting of content validity, cross-cultural validity, measurement error, and responsiveness. Psychometric data across tools were mostly indeterminate for construct validity, structural validity, and internal consistency.

Conclusions

There is limited evidence to fully support the use of a specific teacher proxy-report tool in practice. Further psychometric testing and detailed reporting of methodological aspects in future validity and reliability studies is needed. Tools have been designed to assess some elements of the framework. However, no comprehensive teacher proxy-report tool exists to assess all 30 elements of the APLF, demonstrating the need for a new tool. It is our recommendation that such tools be developed and psychometrically tested.

Trial registration

This systematic review was registered in the PROSPERO international prospective register of systematic reviews, with registration number CRD42019130936.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12966-021-01162-3.

Big Data and Learning Analytics Model for Promoting Physical Literacy in College Students in China

Physical literacy has gained much popularity in educational circles who are working on the improvement of curriculum and overall standard of education. It involves a holistic lifelong comprehensive learning approach that includes movements and physical activities. Overall, it has positive effects on physical, psychological, social, and cognitive health of individuals, so physical literacy exemplifies the dedication to raise a healthier, more active generation. Numerous factors interacting between humanities and social sciences affect the promotion of physical literacy, so such a study will be interdisciplinary which will consider across all social and individual factors. The current research proposes a system dynamic "SD" model to promote students' physical literacy by building a complete causal loop diagram of the model to illustrate the general system. Based on the casual loop diagram, the system is then presented as four subsystems. The model is simulated by allocating 14 different changes of indexes in the physical literacy promotion system to find better allocations for optimal effectiveness in promoting physical literacy. Simulations are carried out by using the Apache Spark architecture utilizing "Big Data" tools for effective, speedy, and reliable analysis and results. The study proposes that different physical literacy indexes in different grades require attention; the optimal promotion of physical literacy can be achieved by increasing the physical knowledge of lower-grade students and increasing the physical attitude of higher-grade students. The model can be used to make decisions about efficient physical literacy management and physical literacy promotion planning.

Primary Care and Physical Literacy: A Non-Randomized Controlled Pilot Study to Combat the High Prevalence of Physically Inactive Adults in Austria

The multidimensional concept of physical literacy is fundamental for lifelong physical activity engagement. However, physical literacy-based interventions are in their infancy, especially among adults. Therefore, the purpose of this pilot study was to assess the association of a physical literacy-based intervention with changes in self-reported physical literacy among inactive adults. A non-randomized controlled study (2 × 2 design) was conducted, comparing pre- vs. postintervention. Twenty-eight inactive healthy participants in the intervention group (89% female, 53 ± 10 years) entered a physical literacy-based intervention once weekly for 14 weeks. The non-treated control group consisted of 22 inactive adults (96% female, 50 ± 11 years). Physical literacy was evaluated with a questionnaire encompassing five domains: physical activity behavior, attitude/understanding, motivation, knowledge, and self-efficacy/confidence. ANOVA models were applied to evaluate changes by time and condition. Following the intervention, significant improvements were seen for overall physical literacy and in four out of five physical literacy domains, including physical activity behavior, attitude/understanding, knowledge, and self-efficacy/confidence (all p < 0.01, Cohen's d = 0.38-0.83). No changes by time x condition were found for motivation. The physical literacy-based intervention applied in this study may be a promising approach to help inactive adults to adopt an active lifestyle.

Associations between previous sport and exercise experience and physical literacy elements among physically inactive Danes

Background

Physical inactivity is recognized as a leading global public health threat. Physical Literacy, a concept describing an individual’s prerequisites to participate in and adhere to physical activities, has been suggested to be a key concept in understanding physical activity in various populations. The aim of this study was to describe the prerequisites for physical activity among inactive adults in terms of their physical literacy and previous experience with sport and exercise and how these are interrelated.

Methods

Sample: 1033 physical inactive Danes. Measures: BREQ-3, ESES, the Levels of knowledge questionnaire and the physical self-confidence scale.

Results

Inactive Danish adult’s physical literacy scores are generally low compared to samples in other studies. Inactive adults with no or little previous experience with sport and exercise had lower levels of competences, self-efficacy and autonomous motivation for exercise and sport than the inactive with more experience. Previous sport and exercise experience was positively associated to the physical and affective domain of PL.

Conclusion

Previous experience with sport and exercise is very important to consider when developing sport and exercise activities for currently inactive adults as individuals with low previous experience have lower competences and autonomous motivation and therefore need lower challenges and other important attention to the motivational climate in order to ensure that the activities are motivating enough to secure continued engagement.

Understanding physical literacy in the context of health: a rapid scoping review

BACKGROUND

Physical literacy is a multidimensional concept that describes a holistic foundation for physical activity engagement. Understanding the utilization and effectiveness of physical literacy in the context of health and the health care setting will support clinical and population health programming. The purpose of this rapid scoping review was to: 1) map the conceptualization of physical literacy as it relates to health; 2) identify and describe the utilization of physical literacy in the context of health and engagement of health care providers; and 3) better understand the relationship between physical literacy, physical activity, and health.

METHODS

Following established scoping review methods adapted for a rapid review approach, we searched electronic databases Medline OVID, CINAHL Ebsco, PsycInfo Ebsco, Web of Science ISI, and ERIC Ebsco from conception until September 2019. Tabulation coding was used to identify the key themes across included articles and synthesize findings. The review follows an integrated knowledge translation approach based on a partnership between the health system, community organizations, and researchers.

RESULTS

Following removal of duplicates, our search identified 475 articles for title and abstract screening. After full text review, 17 articles were included (12 original research papers and five conceptual or review papers). There was near consensus among included papers with 16 of 17 using the Whiteheadian definition of physical literacy. There was limited involvement of health care providers in the concept of physical literacy. Physical literacy was connected to the following health indicators: BMI and body weight, waist circumference, cardiorespiratory fitness, physical activity, and sedentary behaviour. The primary demographic focus of included studies was children and there was a conceptual focus on the physical domain of physical literacy.

CONCLUSIONS

Despite growing popularity, the empirical evidence base linking physical literacy and health outcomes is limited and the relationship remains theoretical. Physical literacy may present a novel and holistic framework for health-enhancing physical activity interventions that consider factors vital to sustained participation in physical activity across the life course. Future work should continue to explore the nature and direction of the relationship between physical activity and physical literacy to identify appropriate focused approaches for health promotion.

Physical Literacy, Physical Activity, and Health Indicators in School-Age Children

It has been theorized that physical literacy is associated with physical activity and health. The purpose of this study is to investigate the associations between physical literacy and health, and if this relationship is mediated by moderate-to-vigorous physical activity (MVPA). Two hundred and twenty-two children (113 girls, 10.7 ± 1.0 years old) participated in this cross-sectional study. A physical literacy composite score was computed from measures of PLAYfun, PLAYparent, and PLAYself. Physical activity was measured over seven days with accelerometers, expressed as MVPA (min/day). Health indicators included: body composition (percent body fat), aerobic fitness (treadmill time and 60s heart rate recovery), resting systolic blood pressure, and quality of life. Physical literacy was significantly associated (p < 0.001) with percent body fat (R² = 0.23), treadmill time (R² = 0.21), 60 s heart rate recovery (R² = 0.36), systolic blood pressure (R² = 0.11), and quality of life (R² = 0.11). The relationships between physical literacy and aerobic fitness, but not other health indicators, were directly mediated by MVPA. Higher physical literacy in children is associated with favorable health indicators, and the relationships between physical literacy and aerobic fitness were influenced by MVPA. Future work should examine these relationships longitudinally and determine if changes in physical literacy leads to changes in health.

The Development of Chinese Assessment and Evaluation of Physical Literacy (CAEPL): A Study Using Delphi Method

The aim of this study is to introduce the development of the Chinese Assessment and Evaluation of Physical Literacy (CAEPL), to present the theoretical model of the CAEPL, and to quantify the weight of each domain of the CAEPL. 34 experts took part in the Delphi survey, and 23 experts completed all the three rounds of the survey. Experts’ opinions are used to develop the theoretical model of the CAEPL. The analytical hierarchy process (AHP) was employed for determining the weights of subdomains and items of the CAEPL. The CAEPL is a comprehensive model, including intention of physical activity (IPA), knowledge of physical activity (KPA), motor/sport skill (MSS), behavior of physical activity (BPA) and physical fitness (PF). Specific weights of IPA, KPA, MSS, BPA and PF are 17.25%, 16.23%, 27.01%, 23.72% and 15.79%, respectively. The CAEPL provides an important and useful instrument to measure and improve physical literacy (PL) among young Chinese people. Studies on the feasibility, reliability, validity and sensitivity of the CAEPL should be conducted to improve it in the future.

Sports participation and sports injuries in Dutch boys with haemophilia

INTRODUCTION

Sports participation in children with hemophilia is generally considered to be associated with increased injury risk, which is generally considered highest in severe hemophilia.

AIM

To assess sports participation according to age and severity in children with hemophilia and its association with sports injuries.

METHODS

In a retrospective single-center study, sports participation, injuries, and bleeding data from three consecutive annual clinic visits were collected for young patients with hemophilia (PWH, aged 6-18). Sports in categories 2.5 and 3 of 3 according to the National Hemophilia Foundation classification were considered high-risk. Groups were compared using chi-square testing.

RESULTS

105 PWH (median age: 13(IQR 10-14); 53% severe; bleeding rate: 1/y) were identified; three were unable to perform sports and were excluded. The majority of PWH (77%) played sports weekly, of which 80% high-risk sports. Sports participation (median 3.0x/wk), and the proportion of injured PWH was similar in severe (42%) and non-severe (33%) PWH. Sports injuries were rare (65% no injuries in 3 years, median 0/y (IQR 0-1)). Annually, PWH did not report more injuries (15%) than age-matched boys (28%). Sports injuries were not associated with frequency and type of sports.

DISCUSSION

This retrospective study showed high sports participation (including high-risk sports) and low injury rates. Sports participation was similar across severities and injury rates were not higher than among the general population. Injuries were not associated with frequency or type of sports. A prospective study with objective assessment of sports participation and injuries is warranted to confirm these findings and avoid recall bias.

Physical Activity Assessment and Counseling in Pediatric Clinical Settings

Physical activity plays an important role in children's cardiovascular health, musculoskeletal health, mental and behavioral health, and physical, social, and cognitive development. Despite the importance in children's lives, pediatricians are unfamiliar with assessment and guidance regarding physical activity in children. With the release of the 2018 Physical Activity Guidelines by the US Department of Health and Human Services, pediatricians play a critical role in encouraging physical activity in children through assessing physical activity and physical literacy; providing guidance toward meeting recommendations by children and their families; advocating for opportunities for physical activity for all children in schools, communities, and hospitals; setting an example and remaining physically active personally; advocating for the use of assessment tools and insurance coverage of physical activity and physical literacy screening; and incorporating physical activity assessment and prescription in medical school curricula.

How physically literate are children today? A baseline assessment of Greek children 8-12 years of age

Developing Physical Literacy (PL) in children is considered a promising concept for establishing active lifestyle habits; yet research evidence is scarce. This study aimed at comprehensively assessing PL in 8-12-year-old Greek children. For that purpose, the Canadian Assessment of Physical Literacy (CAPL-2) was administered to 715 children (M age = 10.2, SD = 1.3 years). Analyses of variance were applied on participants' total, domain and individual measures scores, examining potential gender and age differences; whereas, participants' classification and proportion across CAPL-2 interpretive categories were computed. Results revealed that there were no practically important differences (η² < .14) between boys and girls or younger (grades 3 & 4) and older children (grades 5 & 6). Greek children presented insufficient levels of PL (their total score classified them into "progressing" PL level). CAPL-2 domains and individual measures scores showed that participants were highly motivated and felt confident to participate in physical activity (PA); however, they exhibited low PA as well as unsatisfactory physical competence, knowledge, and understanding to value and take responsibility for engagement in PA. Although further research is needed for a comprehensive picture of PL correlates, our findings highlight the need for providing Greek children with ample opportunities to enhance their PL.

Canada's Physical Literacy Consensus Statement: process and outcome

BACKGROUND

Healthy movement behaviours of Canadian children and youth have been found to be suboptimal; this is associated with declines in physical fitness, increases in obesity, and elevated chronic disease risk. Physical literacy is an evolving construct representing foundational domains upon which physically active lifestyles are based. Many sectors and organizations in Canada are embracing physical literacy in their programs, practices, policies, and research; however, the use of inconsistent definitions and conceptualizations of physical literacy had been identified by stakeholders as hindering promotion and advancement efforts.

METHODS

With leadership from ParticipACTION, organizations from the physical activity, public health, sport, physical education, and recreation sectors collaborated to create a physical literacy consensus definition and position statement for use by all Canadian organizations and individuals. The process involved an environmental scan, survey of related evidence, stakeholder consultations, and creation of a Steering Committee. From this background work a consensus statement was drafted, shared with stakeholders, revised, and ratified.

RESULTS

Canada's Physical Literacy Consensus Statement was launched in June 2015 at the International Physical Literacy Conference in Vancouver, British Columbia. To further promote the Consensus Statement, the Sport for Life Society developed and simultaneously released the "Vancouver Declaration", which contained additional guidance on physical literacy. Both the Consensus Statement and the Declaration endorsed the International Physical Literacy Association's definition of physical literacy, namely "the motivation, confidence, physical competence, knowledge and understanding to value and take responsibility for engagement in physical activities for life".

CONCLUSIONS

Sector partners hope that the Consensus Statement, with its standardized definition, brings greater harmony, synergy, and consistency to physical literacy efforts in Canada and internationally. Going forward, the impact of this initiative on the sector, and the more distal goal of increasing habitual physical activity levels, should be assessed.

A cross-sectional study exploring the relationship between age, gender, and physical measures with adequacy in and predilection for physical activity

BACKGROUND

Physical literacy is a complex construct influenced by a range of physical, behavioural, affective, and cognitive factors. Researchers are interested in relationships among these constituent factors. The purpose of this study was to investigate how age, gender, and physical competence components of physical literacy relate to a child's adequacy in and predilection for physical activity.

METHODS

A sample of 8530 Canadian youth (50% girl) aged 8.0 to 12.9 years participated in the study. Participants completed the Canadian Assessment of Physical Literacy (CAPL) protocol, which assesses physical literacy in four domains: Physical Competence, Daily Behaviour, Motivation and Confidence, and Knowledge and Understanding. Stepwise multiple regression analyses were conducted to investigate the relationship between physical competence components of physical literacy (Progressive Aerobic Cardiovascular Endurance Run [PACER], Canadian Agility and Movement Skill Assessment [CAMSA], sit and reach, handgrip, plank, and body mass index) and children's perceived adequacy and predilection toward physical activity as measured by subscales from the Children's Self-Perceptions of Adequacy in and Predilection for Physical Activity scale (CSAPPA).

RESULTS

The variable most strongly associated with adequacy and predilection was the PACER shuttle run score. The PACER accounted for 10.9% of the variance in adequacy and 9.9% of the variance in predilection. Participants' age was inversely related to adequacy (β = - 0.374) and predilection (β = - 0.621). The combination of other variables related to adequacy brought the total variance explained to 14.7%, while the model for predilection explained a total of 13.7%.

CONCLUSIONS

Results indicate an association between cardiorespiratory fitness and measures of physical activity adequacy and predilection. These findings suggest that practitioners should consider the physiological and psychological makeup of the child, and ways to enhance adequacy and predilection among children with limited cardiorespiratory fitness, in order to create the best possible environment for all children to participate in physical activity.

Physical literacy levels of Canadian children aged 8-12 years: descriptive and normative results from the RBC Learn to Play-CAPL project

BACKGROUND

The current physical literacy level of Canadian children is unknown. The Royal Bank of Canada (RBC) Learn to Play - Canadian Assessment of Physical Literacy (CAPL) project, which is anchored in the Canadian consensus statement definition of physical literacy, aimed to help establish the current physical literacy level of Canadian children.

METHODS

The CAPL was used to assess the physical literacy (and component domains: Daily Behaviour, Physical Competence, Knowledge and Understanding, and Motivation and Confidence) of Canadian children aged 8-12 years. Data were collected from 11 sites across Canada, yielding a sample of 10,034 participants (5030 girls). Descriptive statistics by age and gender were calculated and percentile distributions of physical literacy scores, including each domain and individual measure, were derived.

RESULTS

The mean age of participants was 10.1 ± 1.2 years. Total physical literacy scores (out of 100) were on average 63.1 ± 13.0 for boys and 62.2 ± 11.3 for girls. For boys and girls respectively, domain scores were 19.9 ± 4.7 and 19.3 ± 4.1 (out of 32) for Physical Competence; 18.6 ± 7.9 and 18.5 ± 7.4 (out of 32) for Daily Behaviour; 12.7 ± 2.8 and 12.2 ± 2.6 (out of 18) for Motivation and Confidence; and 11.8 ± 2.8 and 12.2 ± 2.6 (out of 18) for Knowledge and Understanding. Physical Competence measures were on average 28.1 ± 8.4 cm (sit-and-reach flexibility), 33.5 ± 9.4 kg (grip strength, right + left), 23.4 ± 14.1 laps (Progressive Aerobic Cardiovascular Endurance Run [PACER] shuttle run), 61.8 ± 43.8 s (isometric plank), 19.0 ± 3.8 kg/m2 (body mass index), 67.3 ± 10.8 cm (waist circumference), and 20.6 ± 3.9 out of 28 points for the Canadian Agility and Movement Skill Assessment (CAMSA), with scores for boys higher than girls and older children higher than younger children for grip strength, PACER, plank, and CAMSA score. Girls and younger children had better scores on the sit-and-reach flexibility than boys and older children. Daily pedometer step counts were higher in boys than girls (12,355 ± 4252 vs. 10,779 ± 3624), and decreased with age.

CONCLUSIONS

These results provide the largest and most comprehensive assessment of physical literacy of Canadian children to date, providing a "state of the nation" baseline, and can be used to monitor changes and inform intervention strategies going forward.