Search

The purpose of this study was to investigate the importance of motivational climate for the satisfaction of psychological needs and dropout in recreational, intermediate and elite volleyball. 7936 volleyball players from all 321 volleyball clubs across Denmark were invited to participate in the study. Three thousand three thirty answered the questionnaire and 2150 were included in the analysis. Dropout from Volleyball was measured as the proportion of players that had stopped playing volleyball over the last year. The coach-created motivational climate was measured using the Motivational Climate Scale for Youth Sports. The satisfaction of players’ psychological needs was measured using an adapted version of the basic psychological needs in exercise scale. The psychometric scales were validated and showed good model fit. For volleyball players of all levels, the degree of mastery climate predicted the satisfaction of the players’ basic psychological needs satisfaction during volleyball which was in turn associated with lower dropout rates. Performance climate had a weak negative association with the satisfaction of psychological needs on the intermediate level only. When adjusting the models for the negative association between performance climate and mastery climate this negative association became nonsignificant and a weak positive association to needs satisfaction emerged for players at the elite level. Findings confirm that the coach-created mastery climate in volleyball teams is important for the satisfaction of players’ basic psychological needs and continuation within the sport across the recreational, intermediate and elite levels.

Introduction: In recent years, the concept of physical literacy (PL) has gained interest worldwide. Yet, only a few interventions targeting PL exist on a global scale. A promising theory-based and nationally tested intervention, Youth-Physical Activity Towards Health (Y-PATH), has proven to be effective in improving children and adolescents’ physical activity levels and motor skills in Ireland. Aim: Using this protocol we aim to context-adapt the Irish Y-PATH into an intervention that works through the schools in Denmark and targets PL among pupils in 4th and 5th grades. Methods and analysis: We apply a stepwise approach to intervention adaptation, inspired by the Medical Research Council’s guidance for developing complex interventions as well as the ‘consensus informed guidance for adapting interventions to achieve a good fit between the intervention and context’ (ADAPT) process model and its principles and actions outlined by Graham Moore and colleagues. First, we combine evidence synthesis with stakeholders and researchers’ engagement to identify relevant and tentative adaptations and to understand barriers and enablers to the promotion of physical literacy in school-based interventions. Next, we further adjust and improve our intervention adaptation ideas by collecting detailed data through interviews with purposively sampled stakeholders and pre-pilot tests of selected prototypes of materials in a ‘real-world’ setting. Finally, we clarify the intervention adaptations – its components, materials, and content – in a discussion with purposively sampled stakeholders, and finally, we test the study design. Expected results and outcomes: A Danish version of the Y-PATH intervention, ready for feasibility testing within a Danish context, and a TIDieR intervention description checklist suitable for testing and further refinement in a feasibility study. The process will further increase our knowledge and understanding of the Danish school context as well as the teacher and pupil’s needs for an intervention promoting PL.

Peer-to-peer approaches engage groups of people considered to share one or more characteristics that identify them as peers and draw on rationales of credibility, identification and role modelling in peer-to-peer interactions. Despite the popularity of the approach, the ways in which the peer leadership component specifically contributes to health promotion is not thoroughly understood. We suggest that a first step for making use of peer leader characteristics is to make explicit what the peer leadership component is expected to bring to a programme. To approach such an understanding, we investigated how peer leaders can be supported in activating their 'peerness' in health promotion programmes, using as a case the peer leader education of a youth-led, peer-to-peer community sports programme, implemented by the non-profit street sports organization, GAME. We analysed the peer leader training programme's learning objectives and field notes from observations of the training programme. The empirical material was analysed using an abductive approach by drawing upon contemporary interpretations of two forms of knowledge originally proposed by Aristotle. In so doing, this article explores how the development of techne (practical knowledge) and phronesis (practical wisdom) was supported in a peer leader training programme for young people. Findings suggest that supporting the development of both these types of knowledge can strengthen programme planners' attention to the contribution of peers. Concurrently, an emphasis on promoting phronesis in peer leader training can support and encourage peer leaders in activating their 'peerness' in peer-to-peer health promotion programmes.Peer-to-peer approaches are commonly used in the health promotion. Peer-led programmes engage groups of people considered to share one or more characteristics that identify them as peers. Peer leaders are suggested to be credible sources of information and provide identification and role modelling to their peers. However, despite the popularity of the approach, the ways in which peer leaders specifically contribute to health promotion are not thoroughly understood. It is thus unclear how the ‘peerness’ of peer leaders is activated in health promotion programmes. In this study, we investigated how peer leaders can be supported in activating their ‘peerness’ during peer-led activities. To do so, we observed and analysed the peer leader training programme of a youth-led community sport programme, implemented by the non-profit organization, GAME. As a theoretical framework, we employed two forms of knowledge originally proposed by Aristotle; namely, techne (practical knowledge) and phronesis (practical wisdom). Our results suggest that supporting the development of both these types of knowledge can strengthen programme planners’ attention to the contribution of peers. Concurrently, an emphasis on promoting phronesis in peer leader training can support and encourage peer leaders in activating their ‘peerness’ in peer-to-peer health promotion programmes.

Physical literacy (PL) is a comprehensive concept covering motivation, confidence, physical competence, knowledge and understanding of individuals’ physical activity throughout life. PL has three overlapping domains, such as: an affective, a physical and a cognitive domain. So far, PL has not been measured in the adults and no complete measurement has been developed to date.ObjectivesThe aim of this scoping review was to review existing self-reported instruments measuring different elements of domains of PL.MethodWe reviewed Education Research Complete, Cochrane, Medline, ScienceDirect, Scopus and SPORTDiscus. The reporting followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews guidelines. Studies were coded using a thematic framework, which was based on the three domains of PL. The eligibility criteria were as follows: (1) age groups between 18 and 60 years; (2) meta-analyses, reviews or quantitative studies focusing on the measurement of at least one of the three domains of PL and (3) instrument that was self-reported. We finalised search on 1 August 2021ResultsIn total, 67 articles were identified as studies describing instruments reflecting the three domains of PL. Following full-text reading, 21 articles that met our inclusion criteria were included. Several instruments of relevance to PL are available for assessing motivation, confidence and the physical domain. However, few instruments exist that measure elements of the cognitive domain.ConclusionThis review showed that a range of existing and validated instruments exists, covering two out of the three domains of PL, namely affective and physical domains. However, for the knowledge domain no valid measurement tools could be found. This scoping review has identified gaps in the research (namely the cognitive domain) and also a gap in the research as no measures that consider the inter-relatedness of the three domains (holistic nature of the concept).

Background Since youth's participation rates in sport drop throughout adolescence, approaches to engage and retain this age group in physical activities are needed. Peers are highly influential on youth's behaviour, and peer education is widely used for youth health promotion purposes to harness this peer influence. Peer education builds on the rationale that youth who share characteristics that identify them as peers will have increased credibility, identification, and role modelling in their interactions. However, it is often unclear how the rationales of peer education are activated in peer-led programmes. We therefore asked: How can peer leaders be supported in activating their? peerness' in health promotion programmes? Methods The study was conducted in a non-profit organisation, GAME, where youth (age 16-25) are trained to lead street sport activities for younger children (age 8-15) in low resource neighbourhoods. The youth leaders were often locals and thus shared a peer relation with the participating children based on age and growing up in the same community. The empirical material consisted of learning objectives for GAME's peer leader training programme and field notes from observations (approximately 54 hours) of the peer leader training. To explore educational content that can support the rationales of peer education, the qualitative analysis drew on contemporary interpretations of two forms of knowledge;techne (practical knowledge) and phronesis (practical wisdom), originally proposed by Aristotle. Results Techne was supported in training activities that prepared peer leaders for making decisions related to the implementation of street sport activities while taking contextual factors (e.g. the weather or the participants' experience) into consideration. Phronesis was supported in training activities that encouraged peer leaders to reflect on their position and leadership approach and to support positive social relations among the participants. Training that supported phronesis encouraged experience-based critical reflection and decision-making rather than providing a recipe of how to act. Conclusion Supporting phronesis in peer leader training will encourage peer leaders to use their peerness actively. To meet the rationales of peer education, peer leaders' practical wisdom should be acknowledged as a key component in peer leadership and this should be reflected in peer leader training.

Background Club-based sports participation through adolescent years is associated with improved health and wellbeing and is therefore considered and important part of health promotion in Scandinavian welfare states. Participation rates are very high among children whereas dropout rates increase during the adolescent years. Many studies have shown how intentions to continue in sport is dependent on autonomous motivation, which is dependent on basic psychological needs satisfaction and hence needs support in the social environment of the team. It has also been shown that the coach has central influence on social environment of the team. The SATS study is a prospective study on the influence of coach-created social climate on young club-sport participants’ psychological needs satisfaction, motivation and continuation the following season. Methods Participants were 6400 adolescent members of leisure time club-organized Basketball, Handball, Football and Gymnastics in Denmark. In the baseline-season coach-created climate was measured with the EDMCQ-C, Basic Psychological needs satisfaction and frustration was measured with PNSS-S and behavioral regulation (motivation) was measured with BRSQ. The participants’ continuation or dropout the next season was measured with a short SMS based questionnaire the next season. Results Task oriented, social supportive and autonomy supportive coach behaviors were associated with higher basic needs satisfaction, autonomous motivation and continuation the next season across sports, ages, levels and genders. Ego-oriented and controlling coaching behaviors were associated with needs frustration, controlled motivation and dropout. Conclusions Empowering Coaching behavior is important for young sports participants’ wellbeing and continuation in sport.

Background A considerable number of Danish children and adolescents do not currently meet the national physical activity (PA) recommendations. In recent years, the concept of physical literacy (PL), has gained popularity worldwide, and it is considered as a proximal measure for lifelong PA. However, only a few interventions targeting PL exist on a global scale. In Denmark, the development of theoretically driven and evidence-based PL interventions that aim to increase PL among children and adolescents has not begun. Yet, a promising, theory-based, and internationally tested intervention, the Youth Physical Activity Towards Health (Y-PATH), has proven to be effective on children and adolescents’ PA levels and motor skills. This presentation introduces the Promoting Pupils’ Physical Literacy (3PL) project which aims to test the feasibility and acceptability of the Y-PATH intervention in a Danish context among pupils 9-11 years of age. Methods and Results The hypothesis is that a revised and adapted 3PL intervention protocol that aims to increase pupils’ PL is ready for effectiveness testing by the end of this project. Two public schools will be recruited and randomly assigned to intervention or control condition following a waitlist design. The primary outcomes include the feasibility and acceptability of the intervention. The feasibility of the practicality and the recruitment process will be assessed within a document log administered by research assistants. The acceptability, including demand and experiences, and the intervention implementation degree will be evaluated by short bimonthly questionnaires to teachers, and interviews with pupils, teachers, parents, and school managers. The preliminary effectiveness will be tested by comparing changes in pupils’ PL over time, assessed with the validated Danish Assessment of Physical Literacy tool. Discussion A revised PL intervention, a Template for Intervention Description and Replication TIDieR checklist, and a protocol that offers a solid empirical and theoretical foundation for a future upscaled effectiveness study. Additionally, the development of such protocol and checklist provides a national as well as an international opportunity for researchers to use and compare effectiveness of the intervention across countries.

The burden of non communicable diseases is a rising global problem and the increasing inactivity seen all over the world is extremely costly to societies (Ding et al., 2016). A recent Danish evaluation on physical activity (PA) showed that a considerable number of Danish children and adolescents do not meet national PA recommendations (The Ministry of Health, 2019). Viewing this problem through a life course perspective points to the solution of making sustainable behavioural changes with children (Frohlich & Potvin, 2010). Across the life span, there is clear evidence of the health-enhancing benefits of PA (Lee et al., 2012). However, at the same time, ample empirical evidence supports that extrinsic motives for participating in PA, such as increasing health, are insufficient when long term participation is the goal. This means that prevention and health promotion interventions should not blindly target the factors and behaviours that predict adult health, such as PA, but move towards intervening on the ‘so-called’ causes of the causes such as factors enabling a physical active lifestyle throughout life. Physical literacy (PL) is a comprehensive multidimensional concept that has been identified as a ‘cause of the causes’. PL consists of dimensions that lay the foundation for an individual’s capacity and tendency for engaging in physical activities throughout life (Whitehead, 2001). In this symposium, we aim to present four research and interventions projects from the education, sport and public health sectors that have emerged in the last couple of years, and through the presentation of these projects, how we in Denmark have established a PL ecosystem between research and practice – and how our national collaboration, PL-net, has contributed to this. Program 1) Introduction to the symposium 2) Physical literacy, physical activity and wellbeing in Danish children 3) The Child-COOP Denmark study: using physical literacy to guide and evaluate a systemic approach to health promotion 4) Staying active together in sports: the importance of and how to promote the emotional domain of physical literacy 5) 3PL: Promoting pupils’ physical literacy: a pilot study testing feasibility and acceptability of the Y-PATH intervention in a Danish school setting 6) The symposium will be ended by a panel debate where it also will be possible for the participants to comment and ask questions.

Background 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 (PA) behaviors and well-being. This presentation aims to present empirical evidence from a large-scale research project in Denmark assessing children’s physical literacy. Results from two studies will be presented and discussed. The first 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-high intensity physical activity (MVPA). The second aim is to examine the synergies between movement behaviors and levels of PL. Methods Cross-sectional data from Danish school children aged 7-13 years were collected in Jan-Dec 2020 in the Danish Assessment of Physical Literacy (DAPL) project. PL was assessed with DAPL which measures the affective, cognitive, and physical domains of PL. Sedentary time and time spent in different PA intensities was measured with accelerometers (Axivity), psychosocial well-being was measured with The Strengths and Difficulties Questionnaire (SDQ), and physical wellbeing was measured with the KIDSCREEN questionnaire. In study 1, structural equation models were constructed with PL and MVPA as predictors of physical well-being and four aspects of psychosocial well-being. In study 2 a compositional analysis was applied with average weekly time spent sedentary, in low PA, moderate PA and vigorous PA as the compositional response and levels of PL as predictor. 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 wellbeing and negatively associated with the negative aspects (behavior problems). None of the associations between PL and aspects of psychosocial wellbeing were mediated by MVPA. Results from study 2 are ongoing. Conclusions The studies contribute 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.

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.

Aims: This study aims to identify physical inactivity-related challenges and motives, based on reviews and supplemented by expert interviews with Danish national experts on physical inactivity, providing a general discussion of the subject ultimately generating knowledge useable in a Scandinavian context. Methods: This study is framed as a narrative review of scientific review literature on physical inactivity, limited to the general population. The review is supplemented by expert interviews with Danish national experts on physical inactivity. We used thematic coding of the included reviews, while using hermeneutic interpretation analysis for the expert interviews. Results: Based on 11 included reviews, we highlighted four themes based on our analysis of reviews: (a) socioeconomic determinants of physical activity; (b) life-course perspective; (c) physical inactivity and older adults aged 60+ years; and (d) intervention recommendations. The supplementary expert interviews revealed three additional themes: (a) the individual history with physical activity; (b) sporting organisation importance; and (c) society responsibility for physical inactivity. Conclusions: Collectively this study concludes, based on review and expert interviews, that a number of determinants and correlations for physical inactivity affect the individual from various socioecological levels. Based on this review, we suggest moving beyond the ‘upstream’ public health approach of randomised controlled trials and consider complex interventions targeting physical inactivity from several levels. Physical inactivity should be acknowledged as a ‘wicked problem’ that requires a systems-based approach instead of a single quick fix. Future work with physical inactivity would profit from focus on the life-course perspective, sporting clubs’ responsiveness and physical literacy.

We investigated how pupils experience education outside the classroom (EOtC) as it relates to their social and academic well-being. A Danish 6th grade class were taught twice a week for nine months...

Background The aim of this study was to translate the Canadian Assessment of Physical Literacy, second edition (CAPL-2) into Danish language, adapt it to Danish context and to test the measurement properties on a sample of Danish school children. Methods The CAPL-2 measurement tool was translated into Danish language and adapted for the Danish context. This Danish version of the CAPL-2 was then tested on 891 Danish school children from 50 classes in 12 different schools. Results Confirmatory factor analysis using the four-factor model, as suggested by the CAPL-2 original developers, showed an acceptable model fit for the Danish version (CFI = .973; TLI = .957; RMSEA = 0.040 (90% CI 0.033–0.054); SRMR = 0.040). Positive significant correlations between the domains were found. The domains as well as the total CAPL-2 score were found to be positively associated with physical education teachers’ assessment of their pupil’s in four central aspects of PL (i.e. enjoyment, confidence, motor skills, and diversity) indicating predictive validity. High internal consistency of the instrument used to measure motivation and confidence domain were found. Conclusion The translated and context-adapted Danish version of CAPL-2 is a valid and reliable measurement tool ready to use in Danish research studies.

Background: Research indicates that childhood fundamental movement skills (FMS) can predict physical activity (PA) later in life and it has been argued that frequently engaging in a wide diversity of physical activities will eventually improve children’s FMS. However, no longitudinal or experimental studies have confirmed this hypothesis. The aims of this study are to investigate the longitudinal associations between diversified physical activities at age six and later FMS and PA (age nine and 13). Furthermore, we explore to what extent the longitudinal association between diversified physical activity and PA is mediated by FMS.Methods: Longitudinal data from the Copenhagen School Intervention Studywere used for this analysis, where 704 participated (69% response rate). Diversified physical activity (self-reported), FMS (The Körperkoordinationstest für Kinder battery of postural stability and locomotor skills) and PA (accelerometer) were assessed in the children at age six, age nine and age 13. A total of 991 participated in at least one of the measure years. Two structural equation models were constructed, with diversified physical activity at age six and FMS and PA at age nine as predictors of PA and FMS at age 13. Results: The data from both models demonstrated good model fit. Diversified physical activity at six years of age was significantly associated with physical activity and FMS at age 13, when adjusting for sex, age, intervention, weight, height, and previous levels of PA and FMS. Diversified physical activity at age six was also positively associated with PA and FMS at age nine, which were, in turn, positively related to PA at age 13 but to a lesser degree than diversified PA at age six. The association between diversified physical activity at age six and PA at age 13 was not mediated by FMS at age nine. Conclusions: The results of this study indicate that diversified physical activity at age six is important for the development of FMS and PA in adolescence. Increasing the diversity of children’s daily physical activities, not only the amount and intensity, seems important for future PA behavior and thereby health promotion in a life course perspective.

Introduction: It is central for public health to answer questions related to how to change health and wellbeing in populations through interdisciplinarity and health in all policies and sectors. For a school physical activity promotion initiative to be acceptable and thus feasible, the buy-in of teachers is fundamental. Therefore, school physical activity promotion should be integrated into and support teaching activities. Aims: We discuss the use of education outside the classroom as a feasible pedagogical approach that integrates and promotes physical activity for school children. Methods: We present and discuss theoretical arguments and empirical evidence to argue and illustrate that education outside the classroom is a promising approach for promoting physical activity. Results: Education outside the classroom is characterised by regular curriculum-based experiential teaching activities outside the classroom with the inclusion of physical activity as a means to pedagogical ends. School subjects are taught outside the classroom drawing on problem-based learning and experiential education. Here, physical activity is integrated without compromising curriculum goals which increases teacher buy-in and thereby intervention acceptability and feasibility. Empirical evidence suggests that education outside the classroom increases boys’ moderate to vigorous physical activity and girls’ light intensity physical activity. We contend that the mechanisms are a mix of place, pedagogy and pupil motivations. Conclusions: Education outside the classroom is a feasible and acceptable approach to public health and physical activity promotion because it is integrated into children’s everyday settings through curriculum time and applied broadly to child populations at a low cost. The practice of education outside the classroom is context-dependent and culturally bound, and practices therefore need to be adapted to the individual sociocultural context.

Background Peer-to-peer approaches are widely used in health promotion. Peer leaders are suggested to increase credibility and identification through role modelling. We suggest that to meet the rationales of peer education, peer leaders should be able to interpret and rework their delivery, based on programme rationales. This entails a need for implementation studies to compare programme theory with the realities of implementation. The purpose of this study was therefore to conceptualise a youth-led programme and to explore how peer leaders engage with the peer leader education and subsequently implement activities. Methods The case of study was the Danish street sport organisation, GAME. GAME educates and supports youth peer leaders (age 16-25) in providing life skills-based community sports activities for younger peers (age 8-15) in less advantaged neighbourhoods. A theory of change was developed in partnership with professionals from GAME to conceptualise their programme and its rationales. To study implementation, we observed three two-day peer leader education camps and 49 peer-led GAME activities focusing on specific elements of the theory of change. Results We present a theory of change to illustrate the content, rationale, expected outcomes and key assumptions of a peer-led community sport programme. We compare this conceptualisation to the implementation of peer-led activities; i.e., GAME's operationalisation of the peer leader education and peer leaders' enactment of the programme in practice, focusing on role modelling, pedagogical approaches and interactions with participating children. As expected, implementation style varied considerably across settings and thereby the ways in which delivery corresponded with the intentions described in the theory of change. Conclusions The study provided insight into how youth peer leaders in community sport interpret their role and interact with peers of relevance to peer leadership research and practice. Key messages The rationales behind peer education call for programmes that allow youth peer leaders to interpret and adjust activity implementation with an ensuing need for implementation studies. Initiatives to educate and support peer leaders should be modified based on insights into peer leaders’ interpretation and implementation of peer-led activities.

Background: An emerging field of research indicates that the use of learning environments other than the classroom can improve pupils’ academic achievement in several subjects, including their skil...

The use of education outside the classroom (EOtC) in schools is increasing; however, there are currently few studies assessing the longer-term impacts on academic achievement. The aim of the present study was to investigate the association between one school-year of regular (more than 2.0 h a week) participation in EOtC and Danish primary school children’s reading performance. We conducted a quasi-experimental study involving 20 EOtC intervention group classes and 10 comparison group parallel classes (Grades 3–6). Children were tested pre- and post-intervention in reading performance. We found that exposure to EOtC had a small positive impact on test scores. The implication that regular EOtC is positively associated with reading performance is discussed.

This study is the first to investigate education outside the classroom (EOtC) and pupils’ social relations in a large-sample experimental design. Social Cognitive Mapping was used to collect data on informal peer affiliation groups among pupils, aged 9–13 years, at the start and end of the school year. 332 pupils from 16 classes that were regularly exposed to EOtC, were compared with 158 pupils from 8 comparable classes that were not. Regular exposure to EOtC was positively associated to a gain in new peer affiliations, but not to increases in the total number of relations. In conclusion, regular exposure to EOtC is related to minor positive changes in pupils’ informal peer affiliations in their class networks.

The aim of this quasi-experimental intervention study was to investigate the association between primary school students’ (9–13 years) school motivation and regular participation in education outside the classroom (EOtC). School motivation of 311 Danish public students from 24 intervention classes and 88 students from seven parallel comparison classes was measured at the start and end of the 2014–2015 school year using the Academic Self-Regulation Questionnaire (SRQ-A). Exposure to EOtC was monitored by intervention and comparison teachers. Multilevel analyses showed that regular exposure to EOtC was associated with improvement in intrinsic motivation and was moderated by prior intrinsic motivation in favor of students with higher prior intrinsic motivation. Results were independent of gender and socio-economic-status.

This article presents the results of a questionnaire survey conducted in a Danish upper secondary school where alternative options of physical activity have been provided to the students. The purpose of the study is to gain knowledge about the perspectives of the students concerning physical education (PE), sport and exercise. The study illustrates young people’s practices, preferences and perceptions when physical activity is a gender-integrated activity as is the case in Denmark. The results are discussed in a figurational perspective viewing PE, sport and exercise as interdependent dimensions influencing young people’s participation in and views on physical activity. The study shows that even though we have a long tradition of gender-integrated PE in Denmark, very traditional gender differences similar to countries with gender-segregated PE prevails. The article, therefore, discusses the significance of cultural rather than structural circumstances while studying practices, preferences and perceptions of physical activity among young people.

This chapter describes, exemplifies, and advocates for education outside the classroom (EOtC) as an ‘add-in’ holistic school-based health promotion approach for child and youth populations. We draw on Danish udeskole as an illustrative example of EOtC. This chapter aims to provide a source of inspiration for developing state-of-the-art interventions to support the practice of EOtC in order to promote children’s movement, and positive experiences in green and blue spaces as a key strategy for both education and public health.

The rising global burden of noncommunicable diseases (NCDs) among people with low socioeconomic status (SES) has heightened awareness of the need for primary prevention programs in low-SES neighborhoods. Social inequity in health is apparent in mental, social and physical aspects of health among people living in low-SES neighborhoods. Viewing this problem from a life course perspective and adopting a vulnerable population approach points to the importance of inducing sustainable health behavior changes in children and young people living in low-SES neighborhoods. One important factor in lowering the risk of many NCDs while improving mental health is the promotion of physical activity (PA). In this paper, we argue that lowering the risk of many NCDs and improving mental health is best achieved through setting-based programs that facilitate long-term PA behavior changes in children and adolescents living in marginalized neighborhoods. Empirical evidence indicates that extrinsic motives for participating in physical activities, such as improving health, are insufficient when long-term participation is the goal. Therefore, we argue that interventions with the aim of affecting long-term PA in low-SES neighborhoods and thereby reducing social inequities in health should include activities that aim to create more intrinsic and autonomous motivations by building on more broad and positive understandings of health and participation. Here, we advocate that sports-based recreation (SR) holds several advantages. If implemented well, SR has the potential to be a health-promoting activity that is meaningful and motivating in itself and that involves physiological health-promoting aspects (e.g., PA), a social aspect (e.g., positive relations with others), and a psychological aspect (e.g., positive experiences of oneself). Further, we suggest four practicalities that should be considered when conducting interventions: the cost of participating, the location, the facilities required, and the suitability of the SR activities.

The present study describes the development and validation of an instrument to measure volition in the exercise context. Volition describes an individual’s self-regulatory mental processes that are responsible for taking and maintaining a desirable action (e.g., exercising regularly). The scale structure was developed in an exploratory factor analysis which resulted in a reliable structure of the following six factors: Volitional Inhibition—Reasons, Volitional Inhibition—Postponing Training, Volitional Facilitation—Self-Confidence, Volitional Inhibition—Unrelated Thoughts, Volitional Inhibition—Approval From Others, and Volitional Facilitation—Coping with Failure. A sound theoretical explanation for these six factors is based on the Personal System Interaction Theory. This six-factor structure was also confirmed in a new sample in a confirmatory factor analysis, delivering an 18-item questionnaire with strong model fit and good internal consistency. In addition, the Volition in Exercise Questionna...

Background Education Outside the Classroom (EOtC) is a teaching method that is gaining traction, aiming to promote learning and well-being. However, research on the association between EOtC and well-being is limited. Methods This quasi-experimental trial involved pupils (9-13 years) from 16 Danish public schools which implemented EOtC in some classes. Pupils (N = 511) from 27 classes were regularly exposed to EOtC (2-7 hours per week), and pupils (N = 120) from 7 parallel comparison classes were much less exposed (less than 2 hours per week). The pupils' psychosocial well-being was measured at the beginning and end of the school year using the Strengths and Difficulties Questionnaire. The results were compared between the groups. Results Pupils regularly exposed to EOtC showed the greatest improvement in prosocial behavior. Negative associations were seen between EOtC and hyperactivity-inattention and peer problems in pupils of low socioeconomic status (SES). The observed improvements were smaller when the EOtC was spread over a larger number of sessions. Results were independent of sex. Conclusions Regular exposure to EOtC was found to promote social well-being, especially for pupils of low SES, and was most beneficial when concentrated in fewer, longer sessions.

The aim of this study was to explore how and why participants in structured exercise intervention programs continue or stop exercising after the program is finished. We conducted four focus group interviews with four groups of middle-aged and elderly men (total n = 28) who had participated in exercise interventions involving playing either a team sport (football) or a more individually focused activity (spinning and crossfit). Our results show that different social, organizational and material structures inherent in the different activities shape the subjects' enjoyment of exercise participation, as well as their intention and ability to continue being active. In conclusion, team sport activities seem to be intrinsically motivating to the participants through positive social interaction and play. They are therefore more likely to result in exercise continuation than activities that rely primarily on extrinsic motivation such as the expectation of improved health and well-being.

This study investigates the enjoyment and cohesion of school children participating in a school-based high-intensity physical activity (PA) intervention. Both enjoyment and cohesion have been found to be important factors for adherence to regular physical and sport activity, an important outcome of PA interventions. The sample consisted of 300 pupils (mean age: 9.3 years; 52.7% female) assigned to a team sport intervention, an individual sport intervention, or a control group for 10 months. The Physical Activity Enjoyment Scale and Youth Sport Environment Questionnaire were used to measure enjoyment and cohesion. The Yo-Yo IR1C test determined fitness improvements. Results showed that enjoyment and cohesion (social) measured at the beginning of the intervention significantly predict fitness improvements achieved after 10 months. No differing developmental effects over time could be found in the intervention groups with regard to cohesion and enjoyment when comparing them to the control group. However, enjoyment and cohesion (social) significantly decreased in the groups that performed individual sports. Team sports seem to be more advantageous for the development of enjoyment and cohesion, which are both factors that positively impact the health outcomes of the intervention.

The aim of this study was to investigate the influence of narrative-collaborative group coaching on career development, self-reflection and the general functioning of young sports talents with the goal of achieving integration of their sports careers, educational demands and private lives. The intervention was based on a narrative-collaborative approach, with the intention of inviting the participants to share with and learn from each other. The randomised control design was based on 77 participants (questionnaire measuring recovery/stress, motivation and action control). A qualitative interview study included six participants. The group-coaching intervention had a significant effect on the scores for social recovery and general well-being. The qualitative study showed that group-coaching participants valued the shared process of meaning-making as especially valuable. Narrative-collaborative group coaching can be understood as a community psychological intervention that helps to support the development of...

BACKGROUND: Education Outside the Classroom (EOTC) is a teaching method that aims to promote schoolchildren's learning, physical activity (PA), social relations, motivation, and well-being. EOTC activities are characterized by teachers using the local environment in their teaching, and involve innovative teaching methods, child-led approaches to problem-solving, experimentation, cooperation, PA, and play. EOTC has become common practice for many teachers in Scandinavia; however, only case studies have evaluated its impacts. The TEACHOUT study aims to evaluate the impacts of EOTC on Danish schoolchildren's PA, social relations, motivation, well-being, and learning.METHODS: TEACHOUT is a quasi-experimental, cross-disciplinary study. Sixteen schools participated, containing 19 EOTC school classes and 19 parallel non-EOTC classes, with a total of 834 children aged 9 to 13 years. Measures of the children's social relations, motivation for school, well-being, and academic performance were collected at the beginning and end of the school year. Data on PA levels were collected over ten-day periods during the school year using accelerometers. The amount and characteristics of the actual EOTC provided in both EOTC and non-EOTC classes were monitored day-to-day throughout the school year, using an online teacher survey platform. The effects of EOTC are mainly analysed by comparing EOTC pupils to non-EOTC (i.e. control) pupils based on their scores on the outcome variables (i.e. school performance, well-being, motivation, and social relations) at the end of the school year, adjusting for the baseline values (from the beginning of the year). The impacts of EOTC on PA are evaluated by comparing the total as well as context-specific amounts of PA of children participating in EOTC to those of children in their parallel non-EOTC classes. Furthermore, the interdependencies between PA, social relations, well-being, motivation, and learning are explored using path analysis. To help describe and understand the processes that have led to the quantitative outcomes, qualitative case observations of children's practices and interactions in EOTC as well as classroom teaching were carried out and combined with qualitative interviews about children's perceptions of these practices.DISCUSSION: The TEACHOUT study represents a holistic multidisciplinary approach to educational and school health-promotion research through its study design and combination of scientific disciplines and methods, as well as its focus on the interdependent relations between learning, PA, social relations, well-being, and motivation. This will result in a comprehensive picture of school health promotion and children's health and well-being, which will broaden the understanding of the potential benefits of EOTC in school health promotion and primary education. These results can be used to inform and guide future policy and practice.

This study investigated the effect of increased high-intensity interval training (HIT) at the expense of total training volume on the stress and recovery levels of elite swimmers. Forty-one elite swimmers participated in the study and were randomly assigned to either a HIT or a control group (CON). Eleven swimmers did not complete the questionnaires. For 12 weeks both groups trained ~12 h per week. The amount of HIT was ~5 h vs. 1 h, and total distance was ~17 km vs. ~35 km per week for HIT and CON, respectively. HIT was performed as 6-10 × 10-30 s maximal effort interspersed by 2-4 min of rest. The Recovery Stress Questionnaire - Sport was used to measure the swimmers' stress and recovery levels. After the 12 week intervention, the general stress level was 16.6% (2.6-30.7%; mean and 95% CI) lower and the general recovery level was 6.5% (0.7-12.4%) higher in HIT compared to the CON, after adjusting for baseline values. No significant effects could be observed in sports-specific stress or sports-specific recovery. The results indicate that increasing training intensity and reducing training volume for 12 weeks can reduce general stress and increase general recovery levels in competitive swimmers.

School grounds and children’s daily physical activityThis study investigates the influence of school playgrounds on children’s daily physical activity by combining results of comparable studies on children’s physical activity and playground facilities in two suburban municipalities in Denmark and in seven rural communities in New Zealand. Physical activity data were obtained using accelerometers and related to the number of permanent play facilities in school grounds. Children had high levels of physical activity during organized sports and PE as well as during recess and after school daycare. However boys had higher levels of self-organized physical activity during school recess and afterschool daycare resulting in a higher total amount of activity. In both studies the number of play facilities in the school grounds was positively associated with all measures of children’s amounts of activity, independent of gender and socioeconomic background. Increasing the number of play facilities in primary school playgrounds may increase the level of children’s daily physical activity.

Background:To investigate whether the number of permanent playground facilities in schools influences objectively measured physical activity.Methods:Physical activity was measured using Actical accelerometers over 2 to 5 days in 417 children (5–12 years) from 7 schools. The number of permanent play facilities likely to encourage physical activity in individuals or groups of children (eg, adventure playgrounds, swings, trees, playground markings, courts, sandpits) were counted on 2 occasions in each school. The surface area of each playground (m2) was also measured.Results:The number of permanent play facilities in schools ranged from 14 to 35 and was positively associated with all measures of activity. For each additional play facility, average accelerometry counts were 3.8% (P < .001) higher at school and 2.7% (P < .001) higher overall. Each additional play facility was also associated with 2.3% (P = .001) or 4 minutes more moderate/vigorous activity during school hours and 3.4% (P < .001) more (9 minutes) over the course of the day. School playground area did not affect activity independent of the number of permanent play facilities. Findings were consistent across age and sex groups.Conclusion:Increasing the number of permanent play facilities at schools may offer a cost-effective and sustainable option for increasing physical activity in young children.

Community-based lifestyle intervention may offer the best means of reducing the global epidemic of childhood obesity and its consequences, yet few successful interventions have been reported. The objective was to determine whether increasing extra-curricular levels of activity could reduce weight gain in children.A controlled intervention study was conducted using standardised methods to assess outcomes. Two comparable relatively rural communities in Otago, New Zealand formed intervention and control settings. Height, weight, waist circumference and participation in physical activity (by accelerometry) were measured at baseline and at 1 year in 384 children aged 5 to 12 years representing the majority of children in this age group in intervention and control communities. Community Activity Co-ordinators were employed at each school in the intervention area. Their brief was to widen exposure to activity and engage children not interested in traditional sporting activities by encouraging lifestyle-based activities (e.g. walking) and non-traditional sports (e.g. golf and taekwondo) during extra-curricular time at school, after school and during vacations. Simple dietary advice was offered and the wider community was encouraged to participate.Average accelerometry counts at 1 year were 28% (95% CI: 11 to 47%) higher in intervention compared with control children after adjusting for age, sex, baseline values and school. Intervention children spent less time in sedentary activity (ratio 0.91, p = 0.007) and more time in moderate (1.07, p = 0.001) and moderate/vigorous (1.10, p = 0.01) activity. Adjusted mean BMI Z-score was lower in intervention relative to control children by -0.12 units (95% CI: -0.22 to -0.02).. An intervention designed to maximise opportunities for physical activity during extra-curricular time at school and during leisure time through the provision of community-based Activity Co-ordinators significantly increased participation in physical activity and slowed unhealthy weight gain in primary school-aged children.

Patients with homozygous homocystinuria are at greatly increased risk for development of atherosclerosis and thrombosis [1] . Elevated plasma levels of homocysteine (HCY) are caused by reduced enzymatic catabolism or reduced enzymatic remethylation of HCY, due to either hereditary enzyme defects or to nutrional deficiencies of vitamins functioning as cofactors. However, several recent studies have suggested that persons with mildly elevated plasma levels of HCY also are at increased risk for coronary heart disease. 2 , 3 , 4 . There are some indications that dietary n-3 polyunsaturated fatty acids (PUFAs) may offer protection against coronary heart disease 5 , 6 . Several mechanisms may be involved, including beneficial effects of n-3 PUFAs on plasma lipids, platelet and leukocyte reactivity, blood pressure and vasoreactivity [7] . Interestingly, Olszewski et al. recently found HCY-levels to be lowered 36% in 15 type IIa or IIb hyperlipemic men by n-3 PUFA supplementation. A possible beneficial effect of n-3 PUFA on the incidence of coronary heart disease was initially suggested from studies in Greenland Inuits by our group [8] . We therefore investigated plasma levels of homocystein in a group of traditionally living Greenland Inuits with a diet consisting mainly of marine food and with a very high content of n-3 PUFAs. © 1997 Elsevier Science Ltd

The effects of dietary supplementation with n-3 fatty acids on the level of cytokines and complement activation in plasma from patients with rheumatoid arthritis were examined. Thirty-two patients with active rheumatoid arthritis were included in a 12-week double-blind, randomized study of dietary supplementation with n-3 fatty acids (3.6 g per day) or placebo. The cytokines were measured in plasma before and after treatment with fish oil or placebo. In general, cytokine values at the upper limits of the calculated normal areas were found. The Interleukin-1 beta concentration in plasma was reduced significantly after 12 weeks of dietary supplementation with fish oil (p0.03). No significant difference was observed in the placebo group. The tumour necrosis factor alpha activity in plasma did not change significantly (p = 0.167). No significant changes were observed in the degree of complement activation. The clinical status of the patients was improved in the fish oil group, but not in the placebo group, judged by Ritchie's articular index (p0.02). We conclude that dietary supplementation with n-3 fatty acids results in significantly reduced plasma IL-1 beta levels in patients with rheumatoid arthritis. Even though the cytokine levels were low, the anti-inflammatory effect of n-3 fatty acids could in part be explained by their ability to decrease cytokine production.

Study objective: To determine the effect of dietary supplementation with n-3 polyunsaturated fatty acids (n-3 PUFA) on disease variables in patients with rheumatoid arthritis. Design: Multicenter, ran- domized, placebo controlled, double blind. Setting: Three Danish hospital Departments of Rheumato- logy. Patients: Fifty-one patients with active rheuma- toid arthritis. Intervention: Random allocation to 12 weeks of treatment with either six n-3 PUFA capsules (3.6 g) or six capsules with fat composition as the average Danish diet. Main results: Significant im- provement of morning stiffness and joint tenderness. No significant effect on the four other assessed clinical parameters. No serious side effects. Conclusions: Die- tary supplementation with n-3 PUFA in patients with rheumatoid arthritis improved two out of six patient reported disease parameters. Further studies are needed to clarify the more precise role of n-3 PUFA in the treatment of rheumatoid arthritis.

Studies on the effects of organized club sports on children’s total amount of physical activity (PA) show varying results. This may be partly due to different sports having different activity levels, but also different possibilities for being played outside club settings. This study investigates how playing football as a club sport is associated to the total amount of daily PA among children and how increased school recess activity impacts on this. Using accelerometers, the average daily amount of children’s PA as well the activity levels in specific contexts, such as during club-sports and school recess, was measured on a sample of 518 Danish children aged 9–10. The study found that children playing club football had higher total daily amounts of PA than both children taking part in other club-sports and children not taking part in club-sports at all. About half of the difference in total PA could be explained by higher activity levels during school recess. The association between club football and total PA, and the mediating effect of school recess PA, can be interpreted as the result of two main factors: the high activity levels during club football, and that Danish school grounds have football facilities which allow able and interested children to play football for many hours each week during school recess. On a more general level, the results indicate that the influence leisure-time club sport participation has on PA may differ due to how well the sport can be transferred to and played in other daily contexts for children’s self-organized PA, such as school recess.