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Background: Thers is limited research examining modifiable cardiometabolic risk factors with a single-item health behavior question obtained during a clinic visit. Such information could support clinicians in identifying patients at risk for adverse cardiometabolic health. We investigated if children meeting physical activity or screen time recommendations, collected during clinic visits, have better cardiometabolic health than children not meeting recommendations. We hypothesized that children meeting either recommendation would have fewer cardiometabolic risk factors. Methods and findings: This cross-sectional study used data from electronic medical records (EMRs) between January 1, 2013 through December 30, 2017 from children (2–18 years) with a well child visits and data for ≥1 cardiometabolic risk factor (i.e., systolic and diastolic blood pressure, glycated hemoglobin, alanine transaminase, high-density and low-density lipoprotein, total cholesterol, and/or triglycerides). Physical activity and screen time were patient/caregiver-reported. Analyses included EMRs from 63,676 well child visits by 30,698 unique patients (49.3% female; 41.7% Black, 31.5% Hispanic). Models that included data from all visits indicated children meeting physical activity recommendations had reduced risk for abnormal blood pressure (odds ratio [OR] = 0.91, 95%CI 0.86, 0.97; p = 0.002), glycated hemoglobin (OR = 0.83, 95%CI 0.75, 0.91; p = 0.00006), alanine transaminase (OR = 0.85, 95%CI 0.79, 0.92; p = 0.00001), high-density lipoprotein (OR = 0.88, 95%CI 0.82, 0.95; p = 0.0009), and triglyceride values (OR = 0.89, 95%CI 0.83, 0.96; p = 0.002). Meeting screen time recommendations was not associated with abnormal cardiometabolic risk factors. Conclusion: Collecting information on reported adherence to meeting physical activity recommendations can provide clinicians with additional information to identify patients with a higher risk of adverse cardiometabolic health. [ABSTRACT FROM AUTHOR]

In this paper we explore how 15-16-year-old Norwegians experience social and cultural norms that shape their relationship with health and physical activity (PA) in a country where participation in PA is normative, in the sense that it is not only a widely shared practice but, in having significant cultural traction, is commonly understood as a 'normal' part of Norwegian daily life. The study draws upon qualitative data generated from 31 focus groups involving 148 10th graders (15-16-year-olds) in eight secondary schools in Norway. A key finding was that health was primarily viewed as synonymous with physical health and physical health as closely related to PA. A symbolic marker for physical condition - and, by extension, physical health - was physical appearance and 'looks' (in other words, physical attractiveness), revolving around gender normative bodily 'shape'. In this vein, the youngsters tended towards individualistic views of health - seeing health as a responsibility that lay largely in their hands. We argue that the significance of growing up and living in a wealthy, social democratic nation-state, with high living standards and high social and cultural expectations, can have profound implications for youngsters' perceptions of health and PA, the impact of neoliberalism notwithstanding. [ABSTRACT FROM AUTHOR]

Aims: Physical activity interventions are recommended for community‐based youth mental health services to prevent physical health disparities. Implementation is challenging, and studies focusing on the methods to achieve change are needed. This study aims to identify the context, implementation strategies, and implementation outcomes that illustrate how physical activity interventions were implemented within an early intervention service in Australia. Methods: A theoretically informed case study was undertaken. Data from a community‐based youth mental health service that delivers an early psychosis programme were collected between July and November 2020. Three data sources were accessed (1) interviews with service managers, mental health clinicians and exercise physiologists; (2) document review of organizational policies and procedures; and (3) survey using the Program Sustainability Assessment Tool. The implementation outcomes investigated were acceptability, fidelity, penetration, and sustainability. Framework analysis was used, and a logic model developed guided by an established template, to interpret findings. Results: Forty‐three contextual factors and 43 implementation strategies were identified. The data suggests that creating a new clinical team and auditing and feedback are critical for implementation. High levels of acceptability and sustainability were described, while fidelity of implementation was difficult to establish, and penetration was low. Conclusions: The relationship between constructs suggests several mechanisms underpinned implementation. These include changing professional beliefs, establishing new organizational norms, augmenting existing work processes, and aligning physical activity with priorities of the mental healthcare system and existing work tasks. This case study provides direction for future health service planning of physical activity interventions in community‐based youth mental health service. [ABSTRACT FROM AUTHOR]

This work provides an overview of injury patterns in Canadian children and youth aged 1 to 17 years. Self-reported data from the 2019 Canadian Health Survey on Children and Youth were used to calculate estimates for the percentage of Canadian children and youth who experienced a head injury or concussion, broken bone or fracture, or serious cut or puncture within the last 12 months, overall and by sex and age group. Head injuries and concussions (4.0%) were the most commonly reported, but the least likely to be seen by a medical professional. Injuries most frequently occurred while engaging in sports, physical activity or playing. [ABSTRACT FROM AUTHOR]

Patients with thalassemia (Thal) engage in less physical activity than non-Thal populations, which may contribute to pain and osteoporosis. The purpose of this study was to assess relationships between physical activity, pain, and low bone mass in a contemporary sample of patients with Thal. Seventy-one patients with Thal (50 adults ≥18 years, 61% male, 82% transfusion-dependent) completed the Brief Pain Inventory Short Form and validated physical activity questionnaires for youth and adults. Nearly half of the patients reported daily somatic pain. Using multiple regression, after controlling for age and gender, sedentary behavior was positively associated with pain severity (p = 0.017, r2 = 0.28). Only 37% of adult participants met CDC recommendations for physical activity. Spine BMD Z-score was higher (-2.1 = 0.7) in those who met activity guidelines compared to those who did not (-2.8 = 1.2, p = 0.048). A positive relationship was observed between selfreported physical activity (hours/week) and hip BMD Z-score in adults with Thal after controlling for transfusion status and sedentary activity time (p = 0.009, r2 = 0.25). These results suggest that decreased physical activity and increased sedentary behavior contribute to low bone mass, which may be related to pain severity in some patients with Thal. Studies focused on increasing physical activity may contribute to improved bone health and reduced pain in patients with Thal. [ABSTRACT FROM AUTHOR]

Background: Physical activity is a multifactorial trait, determined by both individual and environmental characteristics, it seems relevant to understand the determinants related to youth guidelines accomplishment. The present study aimed to verify the differences between the Brazilian federative units regarding to the prevalence of youth physical activity guidelines accomplishment and to investigate the determinants related to the inter-individual differences in this accomplishment.Methods: Sample comes from the 2015 Brazilian National School Health Survey (PeNSE), comprising 99,570 adolescents (51,527 girls, 13-17y), enrolled in 3039 schools. Adolescents reported the time they spend in moderate-to-vigorous physical activity daily, and they were categorized as active or inactive, if the guidelines were achieved, or not, respectively, and multilevel statistical analyses were used, including both child and school-level variables. Multilevel Binomial model was computed in the SuperMix software.Results: The majority of the adolescents did not comply with the physical activity guidelines daily, where Bahian children complied the least, while those from Amazonas, Tocantins, and Mato Grosso do Sul complied the most. Boys (OR: 2.305; 95%CI: 2.277-2.334), older adolescents (OR: 1.044; 95%CI: 1.036-1.051), and those who spent more time in active travelling to/from school (OR: 1.001; 95%CI: 1.001-1.001) complied more the physical activity guidelines. At the school level, adolescents from larger schools (OR: 0.957; 95%CI: 0.928-0.986) tended to comply less with the guidelines.Conclusion: Significant differences between Brazilian federative units in youth daily physical activity guidelines compliance were observed, highlighting the role of individual but also environmental constraints in the Brazilian adolescents' engagement in physical activity. [ABSTRACT FROM AUTHOR]

Aim: To describe the quality and completeness of the description and reporting of physical activity and exercise interventions delivered to young people to promote mental health or treat mental illness. Methods: We conducted a series of scoping reviews identifying 64 controlled trials of physical activity and exercise interventions delivered to young people. We extracted: intervention characteristics, personnel and delivery format, the intensity, duration, frequency and type of physical activity or exercise. Results: There was limited reporting of intervention details across studies; 52% did not provide information to confidently assess intervention intensity, 29% did not state who delivered the intervention, and 44% did not specify the intervention delivery format. Conclusions: We recommend that authors adhere to the CONSORT reporting requirements and its intervention reporting extensions, (a) the Template for Intervention Description and Replication, (b) Consensus for Exercise Reporting Template and (c) as part of this, detail the frequency, intensity, time and type of physical activity recommendations and prescriptions. Without this, future trials are unable to replicate and extend previous work to support or disconfirm existing knowledge, leading to research waste and diminishing translation and implementation potential. [ABSTRACT FROM AUTHOR]

Background: Outdoor play, sedentary behavior (SB), and moderate-to-vigorous physical activity (MVPA) are related to youth's health, however, there are research gaps regarding 1) associations between outdoor play, SB, and MVPA across a broad pediatric age range (6-17 years), and 2) longitudinal associations between outdoor play, SB, and MVPA across childhood and adolescence. Two studies were conducted to address those research gaps: Study 1 aimed to investigate relationships between outdoor play and accelerometer-assessed SB and MVPA in a cross-sectional nationwide sample of children and adolescents in Germany. Study 2 aimed to investigate prospective associations between outdoor play and self-reported screen-time SB and MVPA and in a sample of children with three measurement timepoints across 11 years.Methods: Data were obtained of the German national representative Motorik-Modul (MoMo) Study and the German Health Interview and Examination Survey for Children and Adolescents (KiGGS). In Study 1, N = 2278 participants (6-17 years) were included with self-reported outdoor play and accelerometer-assessed SB and MVPA. Associations were examined via multiple linear regressions. In Study 2, N = 570 participants (baseline: 4-7 years) were included in the longitudinal analysis with follow-ups six and 11 years later. Screen-time SB (TV watching and PC/Gaming), MVPA, and outdoor play were self-reported. Associations were investigated through a path prediction model.Results: Study 1 showed that compared to <1 h outdoor play, higher engagement in daily outdoor play was related to lower SB (1-2 h: - 9.75 min/day, P = 0.017; ≥2 h: - 17.78 min/day, P < 0.001) and higher MVPA (≥2 h: + 3.87 min/day, P = 0.001). The cross-sectional relationship between MVPA and outdoor play was moderated by sex (in favor of males) and age (in favor of younger children). Study 2 showed that outdoor play in early childhood negatively predicted PC use/Gaming in later childhood, but was unrelated to MVPA.Conclusion: In Study 1, outdoor play was negatively related to SB cross-sectionally. In Study 2, outdoor play in early childhood was negatively related to PC and Gaming time in later childhood. Thus, providing outdoor play opportunities, especially during early childhood, has potential to prevent SB. Future research should investigate longitudinal relationships using device-based assessments for SB and MVPA. [ABSTRACT FROM AUTHOR]

An editorial is presented in which the authors discuss a strategy for improving physical activity disparities and promoting physical activity for young people by improving access to transportation.

In an increasingly complex world marked by transnationalism and globalisation, the role of physical cultures in everyday life is undergoing change, as people with different orientations to movement and bodies, especially its dominant Western forms, negotiate their relationships to it. The examination of race in Europe and the United Kingdom (UK) in the current intellectual landscape is often located within a Black-White debate that often excludes the Chinese from any form of critical analysis. This lack of academic recognition and critical engagement is coupled with gendered and racialised British Chineseness in everyday discourses. The ambivalent positions of the hyper-visibility of high-achieving British Chinese students in educational research is in contrast to the invisibility of their other everyday lived experiences, such as physical activity, leisure, sport and health. This juxtaposition is reflected through the complexity of how discourses and practices, shaped by colonial and racial legacies, contribute to a form of Chineseness that remains 'at risk' and overlooked in research about their bodies and physicality. This paper calls for explorations of Chinese minority ethnic students' voices to set the impetus for a critical sociology of Chinese diaspora and health and physical cultures research agenda. It critically engages with the contestable work of cultural norming in relation to Chinese diasporic students' health and bodily experiences. In response to these challenges, this paper introduces the Rethinking Health Experiences and Active Lifestyles – Chinese Students (REHEAL-C) project in the UK (supported by Marie Skłodowska-Curie Fellowship 2019–2020) as one contribution to shifting the academic landscape. [ABSTRACT FROM AUTHOR]

The aim of the study is to shed light on how physical education (PE) is experienced among a varied group of adolescents in school, and to nurture debate related to the relationship between adolescents' lived experience of PE and their identity-formation processes. Nuanced insights can help to increase teachers' ability to perceive, react to and deal appropriately in relation to fostering healthy lives in young people, in and through PE and physical activity (PA). The empirical material is derived from interviews with four adolescents, firstly in year 7, followed-up in year 8. Two of the teenagers were characterised by a high level of PA, two by a low level. The analysis was carried out using the interpretative phenomenological analysis method. The findings give a glimpse into the unique lived experience of PE of four pupils in modern society, and into how their meaning-making experiences of the subject seem to be situated in its context, as much as in wider contexts of family, and the PA related values, norms and discourses extant in their local communities. From their unique lived experiences of PE of the four participants, two overarching themes emerge. The first, 'PE is "a bag of sweets with more sweet than sour flavors", reflects the participants' experience and understanding of PE as predominantly positive. The second theme, 'PE is in negotiation with football culture', reflects that the culture of football, as a sport-related framework for the understanding of content and mastery, appears to have a special significance for the participants' meaning-making in physical education. Our findings also point to the importance of acknowledging that meaning making experiences in PE are embedded in the wider and overall context of the life of each individual. [ABSTRACT FROM AUTHOR]

Purpose: To compare the degree to which youth with and without chronic conditions in the United States met physical activity (PA), screen time, and sleep duration guidelines.Design: A cross-sectional study using data from the 2016 National Survey of Children's Health.Participants: A total of 24 405 youth (aged 10-17 years) with and without 1 of 19 prevalent chronic health conditions who participated in the 2016 National Survey of Children's Health.Measures: Parents reported on the time spent by their children in PA, screen time, and sleep.Analysis: Descriptive and bivariate analyses were conducted to estimate and compare health behavior guideline adherence rates among children with and without chronic conditions.Results: Overall, 18.7% of children with chronic conditions did not meet any health behavior guidelines compared to 15.6% of children without chronic conditions. Children with hearing impairments, diabetes, and depression were most likely to not meet any health behavior guidelines (27.9%, 25.4%, and 21.7%, respectively). Of the 3 guidelines, children with and without chronic conditions were least likely to meet the PA guideline (18.6% and 21%, respectively).Conclusions: This study identifies specific groups of children with chronic conditions that are most at risk of not meeting health behavior guidelines. The findings highlight specific behaviors in most need of intervention for children with chronic conditions; PA was identified as the most frequently unmet guideline. Overall findings suggest a need for a more integrated, holistic view of health promotion for children with chronic conditions. [ABSTRACT FROM AUTHOR]

Aim: The aim of this narrative summary was to examine the efficacy of physical activity and exercise as a universal prevention for depression in young people. Methods: We conducted a search of the literature in the open‐access evidence database of controlled trials and systematic reviews in youth mental health, an initiative between Orygen, The National Centre of Excellence in Youth Mental Health and headspace, National Youth Mental Health Foundation. In April 2018, we searched for all papers published between 1980 and 2017 relating to "Depressive Disorder" under the "Universal Prevention" illness stage and classified as "Physical activity/Exercise" under the treatment/intervention classification. Systematic reviews, randomized control trials (RCTs) and controlled clinical trials were all included. Results: A total of 11 papers were returned. Three of these studies were observational and eight studies were controlled trials. The reviewed studies indicate that exercise and physical activity might be an effective universal depression prevention intervention for young people. Three of the controlled studies had a passive control group or no control group and only one study had longer‐term follow‐up. No trial used a longitudinal design to determine if interventions prevent the onset of new cases of depression. Conclusions: The studies reviewed in the current review demonstrate a bidirectional relationship between physical activity, exercise and adolescent mental health. The results of the current review suggest that physical activity and exercise programs designed to increase the level of activity in young people should be implemented to be attractive and achievable to young people that may have poor psychological health. [ABSTRACT FROM AUTHOR]

The Canadian 24-Hour Movement Guidelines for Children and Youth are novel in how they integrate the guideline recommendations for the full continuum of movement behaviours, from sleep to vigorous physical activity. Research suggests that the integrated guidelines strategy is perceived favourably, and this study is the first to compare this strategy to traditional segregated guidelines on its effectiveness to disseminate health information. Specifically, this study explored (1) the influence of the integrated guidelines strategy on parents' message receipt and message enactment to support their child meet the guidelines, and (2) the relationship between message receipt and message enactment in a youth movement behaviour context. In this prospective randomized experiment, parents (n= 162) were randomized to read integrated, segregated, or control guidelines and complete pre, post, and 2-week follow-up surveys. Repeated-measures ANOVAs revealed significantly higher message enactment outcomes among participants in the integrated guidelines group (p< .05). Message receipt and enactment outcomes were significantly correlated (r> .171, p< .05). These findings highlight that parents' initial receipt of a message is important for subsequent behaviour change in a youth movement behaviour context. Furthermore, the integrated guidelines strategy may have an advantage in promoting guideline update and should continue to be explored. [ABSTRACT FROM AUTHOR]

Transportation vulnerability (lack of community/personal access to transportation that in turn increases the risk for health or financial consequences in the event of hardship/disease/disasters) may be an important mechanistic factor linking residential segregation to youth cardiovascular health inequities. This natural experiment examined the impact of transportation vulnerability on the association between changes in exposure to residential segregation and cardiovascular health among minority youth (n = 2,129, mean age 9.1 years, 54% male; 52% Hispanic, 48% non-Hispanic black [NHB]; 49% high area poverty) over two years. Two-level generalized linear mixed models with random intercepts were fit to test the effects of transportation vulnerability on the association between changes in segregation and cardiovascular health (body mass index percentile (BMIP), sum of skinfold thicknesses, 400 m run time, systolic and diastolic blood pressure percentiles (SBPP and DBPP, respectively) over two school years and across gender. After adjusting for potential confounders (individual-level race/ethnicity, age, time, and park-area poverty), improvements in cardiovascular health were greatest for girls exposed to reduced segregation with high compared with low transportation vulnerability for all outcomes. Specifically, BMIP and SBPP decreased 29% (IRR 95% CI: 0.69, 0.73) and 13% (IRR 95% CI: 0.85, 0.90) vs. 10% (IRR 95% CI: 0.84, 0.96) and no significant change (IRR 95% CI: 0.88, 1.00), for high and low transportation vulnerability, respectively. Adjusted models showed the greatest improvements in cardiovascular health for boys exposed to reduced segregation and low compared with high transportation vulnerability for BMIP and skinfold thicknesses. Specifically, BMIP and skinfold thicknesses decreased 33% (IRR 95% CI: 0.73, 0.81) and 21% (IRR 95% CI: 0.74, 0.84) vs. increased 8% (IRR 95% CI: 1.05, 1.11) and no significant change (IRR 95% CI: 0.96, 1.03), for low and high transportation vulnerability, respectively. Policy interventions that promote transportation equity should be further studied as a means to reduce youth cardiovascular health disparities, particularly for girls living in areas with high racial/ethnic segregation. [ABSTRACT FROM AUTHOR]

Purpose: Substantial research has demonstrated that assets (eg, family communication, school connectedness) protect youth from participation in numerous risk behaviors. However, very few studies have explored the relationship between assets and positive health behaviors. This study investigated prospective associations among assets and physical activity (PA) and body mass index (BMI).Design: Longitudinal design with 5 waves of data collected annually over a 4-year period.Setting: Community-based setting with participants recruited via door-to-door canvasing of homes located in stratified (by race and income) randomly selected census tracts and blocks.Participants: Participants were 1111 youth (baseline mean age = 14.3 years [SD = 1.6]; 53% female; 40.6% white, 28.6% Hispanic, 24.4% black, 6.4% other) and their parents.Measures: Weekly participation in PA, BMI, and 14 youth assets representing multiple levels of influence (individual, family, and community).Analysis: Generalized linear mixed models assessed associations among the assets and PA and BMI over the 5 waves of data.Results: There was a significant and graded relationship between assets and weekly participation in PA. For example, at the community-asset level, PA minutes were higher among youth with 2 assets ( P = .006), 3 assets ( P = .0006), and 4 to 5 assets ( P < .0001) compared to youth with 0 to 1 assets. No effects were found for BMI.Conclusion: Asset-based health promotion programs for youth may promote positive health behaviors and prevent participation in risk behaviors. [ABSTRACT FROM AUTHOR]

Introduction: To date, several meta-analyses clearly demonstrated that resistance and plyometric training are effective to improve physical fitness in children and adolescents. However, a methodological limitation of meta-analyses is that they synthesize results from different studies and hence ignore important differences across studies (i.e., mixing apples and oranges). Therefore, we aimed at examining comparative intervention studies that assessed the effects of age, sex, maturation, and resistance or plyometric training descriptors (e.g., training intensity, volume etc.) on measures of physical fitness while holding other variables constant. Methods: To identify relevant studies, we systematically searched multiple electronic databases (e.g., PubMed) from inception to March 2018. We included resistance and plyometric training studies in healthy young athletes and non-athletes aged 6 to 18 years that investigated the effects of moderator variables (e.g., age, maturity, sex, etc.) on components of physical fitness (i.e., muscle strength and power). Results: Our systematic literature search revealed a total of 75 eligible resistance and plyometric training studies, including 5,138 participants. Mean duration of resistance and plyometric training programs amounted to 8.9 ± 3.6 weeks and 7.1±1.4 weeks, respectively. Our findings showed that maturation affects plyometric and resistance training outcomes differently, with the former eliciting greater adaptations pre-peak height velocity (PHV) and the latter around- and post-PHV. Sex has no major impact on resistance training related outcomes (e.g., maximal strength, 10 repetition maximum). In terms of plyometric training, around-PHV boys appear to respond with larger performance improvements (e.g., jump height, jump distance) compared with girls. Different types of resistance training (e.g., body weight, free weights) are effective in improving measures of muscle strength (e.g., maximum voluntary contraction) in untrained children and adolescents. Effects of plyometric training in untrained youth primarily follow the principle of training specificity. Despite the fact that only 6 out of 75 comparative studies investigated resistance or plyometric training in trained individuals, positive effects were reported in all 6 studies (e.g., maximum strength and vertical jump height, respectively). Conclusions: The present review article identified research gaps (e.g., training descriptors, modern alternative training modalities) that should be addressed in future comparative studies. [ABSTRACT FROM AUTHOR]

Objectives: Learning to swim is recommended for children to prevent drowning and to promote lifelong physical activity. Dissimilar US youth swimming ability rates by demographics have been reported. Our research purpose was to examine youth swimming ability by selected variables, and to compare with similar research in 2010. Methods: USA Swimming Foundation sponsored a cross-sectional study in 5 US cities during 2017. Trained YMCA personnel administered surveys measuring self-reported swimming ability among youth, ages 4-18 (N = 1373). We compared the 2017 results with findings from the 2010 study (N = 1741). Results: In 2017, fewer respondents reported no/low swimming ability. However, groups were identified with a high percentage (greater than 50%) of no/low swimming ability including the following ones; girls, African-American boys and girls, and boys and girls who participate in free or reduced-cost lunch programs. Multivariate analysis showed that significant predictors for lower swimming ability were parent education (less than college education), qualifying for free or reduced-cost lunch programs, and being African-American. Conclusions: No/low swimming ability groups were identified and continue to need support. Interventions should target children who are African-American, qualify for free or reduced-cost lunch, and have parents with lower levels of education. [ABSTRACT FROM AUTHOR]

Objective: To analyze the environmental factors (nutritional status, levels of physical activity and nutritional habits) and their possible association with bone mass in a population of young adults. Methods: The study population consisted of 200 subjects (117 women and 83 men) aged between 18 and 25 years (mean age 20.4 years ±2.2 years). Body composition parameters were measured by an electronic balance (TANITA BC-418MA), nutritional habits were estimated by 72-h dietary recall, level of physical activity was assessed by the International Physical Activity Questionnaire (IPAQ) and bone mass was measured by ultrasonography at the calcaneus. Results: There were significant differences in bone mass values according to gender (p= 0.013). Despite the fact that 70% of the subjects had a body mass index (BMI) within the normal range, 20% had overweight or obesity. 49% of the individuals had a moderate level of physical activity, although women had lower levels of physical activity than men (17.9% vs 8.4%). Most diets among young adults were hyperprotic, hyperlipidic and low-carbohydrates, with low-calcium and fiber intakes and high-phosphorus. Analysis of bone mass according to BMI showed higher values as the weight category rises, with significant differences in women. Higher values of bone mass were shown as the level of physical activity was higher, showing significant differences in males. Conclusion: Our results show that BMI and level of physical activity are significantly associated with bone health in a population of young adults, suggesting the relevance of promoting healthy lifestyles as a strategy for the early prevention of osteoporosis. [ABSTRACT FROM AUTHOR]

Obesity, overweight and overall inadequate habits have alarmingly increased across the world over the past four decades. More worrisome is the increase in the number of obese children and adolescents. Obesity in childhood in a Public Health problem worldwide, and its association with other diseases, both in childhood and in adult life, as well as its high prevalence, makes it essential to develop early and precise intervention from different areas. The TAS program, (Tú y Alicia por la Salud-Alice and you for Health), aims to promote healthy eating and physical activity through cooking and active leisure. An educational intervention was carried out in the classroom, measured by food surveys and the Physical Activity Questionnaire for Adolescents PAQ-A questionnaire (before and after) in 2,516 students aged 13 and 14 yrs. from 79 schools distributed in the 17 Autonomous Regions in Spain. Overall, adolescents do not comply with the dietary guidelines and recommendations for physical activity by the Spanish Society of Community Nutrition (SENC) and the World Health Organization (WHO), respectively. In the vast majority of the participants, intake of fruit and vegetables was less than recommended, while the consumption of meat, pastries, snacks and fried foods exceeded recommendations. As for physical activity, there was a generalized lack of attention and little dedication to non-sedentary activities. In conclusion, Spanish adolescents show low adherence to recommendations given by SENC and WHO. [ABSTRACT FROM AUTHOR]

Looking back over the 50 years since Aerobics was published, I could never have expected for there to have been a major change in physicians' attitudes toward the value of exercise in the practice of medicine. In my lifetime, I never thought I would see a stress test be considered a mandatory component of a complete examination, inactivity classified as importantly as high blood pressure and high cholesterol, and cigarette smoking considered a coronary risk factor. I have tried in this Research Quarterly for Exercise and Sport (RQES) Lecture presentation to document how this slow but gradual transition took place due to my work and the work of many of my colleagues in this field, along with the important work of The Cooper Institute. In June 1970, I chartered the institute 6 months before I saw my first patient at the Cooper Clinic, but now with the Cooper Center Longitudinal Study being the largest database in the world comparing measured levels of fitness, instead of relying only on questionnaires and correlating fitness and health in our more than 700 published peer-review articles, we have proven and can safely say that "exercise is medicine." In greater detail, I want this lecture to present what we and others have done in this scientific endeavor, and even the harshest critics are now saying that "these results are too impressive to be ignored." [ABSTRACT FROM AUTHOR]

Educational institutions have been identified as ideal locations to implement health promotion strategies that aim to prevent and treat youth obesity. However, the tertiary training of future health promoters currently lacks health and nutrition instruction. This study sought to investigate attitudes towards youth obesity and perceptions of the roles of schools and educators in strategies to treat and prevent youth obesity. Participants (n = 155) were tertiary students who enrolled in a general-level health and nutrition elective that housed an intervention to increase awareness of obesity. Baseline and post-intervention responses to the Perceptions of Youth Obesity and Health Education questionnaire were collected and compared spanning the 12 weeks. Agreement that health is linked to being of normal weight and that general educators should have a major role in school strategies did not waver over the course of the intervention. The belief that schools are ideal places for obesity prevention strategies was higher at baseline than post-intervention. It was desired that obesity awareness would increase but perceived importance of involvement of school staff in youth obesity strategies did not increase. Further research is required to investigate the influence of attitudes and perceptions held by future health promoters towards their roles in prevention and treatment strategies on professional practice. [ABSTRACT FROM AUTHOR]

Predisposing factors of perceived physical education (PE) ability and perceived PE worth within the Youth Physical Activity Promotion Model are positively associated with young people’s daily physical activity. The aim of this study was to qualitatively investigate the origins of students’ perceived PE ability (perceived competence and self-esteem) and perceived PE worth (attitude and enjoyment). Fifty-three PE students, aged 12–14 years (mean = 13.18), participated in semi-structured focus group interviews, which were recorded, transcribed and analysed inductively and deductively and represented as pen profiles. Analysis revealed three higher order themes relating to perceived PE ability (external feedback, perceptions of (in)competence and comparison against peers), and three higher order themes underpinning perceived PE worth (PE teachers, expectancy–value relationship and the physical experience of PE). PE should be perceived as interesting, relevant and meaningful by students and provide appropriate opportunities for success so as to influence lifetime physical activity habits. [ABSTRACT FROM AUTHOR]

The purpose of the current study was to simultaneously examine commonly proposed risk and protective factors for sleep deprivation over time among a large cohort of Ontario and Alberta secondary school students. Using 4-year linked longitudinal data from youth in years 1 through 4 (Y1[2012/2013], Y2[2013/2014], Y3[2014/2015], Y4[2015/2016]) of the COMPASS study (n=26,205), the likelihood of students meeting contemporary sleep recommendations was tested based on their self-reported substance use, bullying victimization, physical activity, and homework and screen time. Models controlled for the effect of student-reported gender, race/ethnicity, grade, school clustering, and all other predictor variables. Relative to baseline, students became less likely to meet the sleep recommendations if at follow-up they had initiated binge drinking, experienced cyber bullying victimization, or were spending more time doing homework, with other factors held constant. The likelihood of reporting sufficient sleep increased if students had begun engaging in resistance training at least three times a week. No longitudinal effect was observed when students increased their caffeine consumption (energy drinks, coffee/tea), initiated cannabis or tobacco use, experienced other forms of bullying victimization (physical, verbal, or belongings), engaged in more moderate-vigorous physical activity, or increased their screen use of any type. Few of the commonly purported modifiable risk and protective factors for youth sleep deprivation held in multinomial longitudinal analyses. Causal conclusions appear premature, with further research required to confirm the targets likely to be most effective in assisting more youth in meeting the sleep recommendations. [ABSTRACT FROM AUTHOR]

Introduction: The Canadian 24-Hour Movement Guidelines for Children and Youth were released in 2016. They contain specific recommendations on the daily time that 5- to 17-year-olds should devote to moderate-to-vigorous physical activity, recreational screen time, and sleep. The objective of this study was to estimate the proportion of Canadians aged 10 to 17 years that meet the recommendations contained within the 24-Hour Movement Guidelines for Children and Youth. Methods: A nationally representative sample of 22 115 young people was examined. Movement behaviour data were self-reported. Adherence to the guideline recommendations were based on the following: accumulation of at least 60 minutes per day of moderate- to-vigorous physical activity, no more than 2 hours per day of recreational screen time, and 9 to 11 hours/night of uninterrupted sleep for those aged 10 to 13 years or 8 to 10 hours/night for those aged 14 to 17 years. Results: Only 3% of the sample met all three of the key recommendations contained in the guidelines. Twenty-five percent met two of the recommendations, 51% met one of the recommendations, and 21% met none of the three recommendations. More children and youth met recommendations for sleep duration (66%) than for moderate-to-vigorous physical activity (35%) and screen time (8%). Conclusion: A small minority (< 3%) of Canadians aged 10 to 17 years met all three of the key recommendations contained in the 24-Hour Movement Guidelines for Children and Youth. [ABSTRACT FROM AUTHOR]

The aim of the study was to summarize the evidence of the effects of reallocating time spent in sedentary behaviours in different activity intensities on youth's adiposity. Five databases were searched. Studies that reported the effects of replacing sedentary behaviour with light-intensity physical activity (LIPA) and/or moderate-to-vigorous physical activity (MVPA) on at least one adiposity parameter. The estimated regression coefficients ( β) and 95% CIs were combined and meta-analysed. Data from 7,351 youths and five studies were analysed. Pooled analysis from cross-sectional studies shows that replacing sedentary time with LIPA showed no significant associations with any adiposity-related outcomes. Replacing sedentary time with MVPA was statistically associated with total body fat percentage ( β = −2.512; p = 0.003), but not with body mass index or waist circumference. In subgroup analysis, the greatest magnitude of association was observed from studies where 60 min of sedentary behaviour was reallocated to 60 min of MVPA ( β = −4.535; p < 0.001). Our results highlight the importance of promoting MVPA, which may improve body composition phenotypes in young people. This information can be used to develop more effective lifestyle interventions. [ABSTRACT FROM AUTHOR]

Background: This study aimed to investigate whether awareness of being monitored by an accelerometer has an effect on physical activity in young people.Methods: Eighty healthy participants aged 10-18 years were randomized between blinded and nonblinded groups. The blinded participants were informed that we were testing the reliability of a new device for body posture assessment and these participants did not receive any information about physical activity. In contrast, the nonblinded participants were informed that the device was an accelerometer that assessed physical activity levels and patterns. The participants were instructed to wear the accelerometer for 4 consecutive days (2 school days and 2 school-free days).Results: Missing data led to the exclusion of 2 participants assigned to the blinded group. When data from the blinded group were compared with these from the nonblinded group, no differences were found in the duration of any of the following items: (i) wearing the accelerometer, (ii) total physical activity, (iii) sedentary activity, and (iv) moderate-to-vigorous activity.Conclusions: Our study shows that the awareness of wearing an accelerometer has no influence on physical activity patterns in young people. This study improves the understanding of physical activity assessment and underlines the objectivity of this method.Trial Registration: NCT02844101 (retrospectively registered at July 13th 2016). [ABSTRACT FROM AUTHOR]

Background/aim: This study aimed to describe the cultural adaptation of the Turkish Physical Activity Scale for the Elderly (PASE) and to examine the reliability and validity of the scale in older Turkish adults. Materials and methods: Eighty elderly people were recruited for the study. The assessments included the PASE, the International Physical Activity Questionnaire (IPAQ), the Short Physical Performance Battery and Short Form-36 Quality of Life Questionnaire (SF- 36), and the Mini Mental State Test. Outcome measures were conducted twice within a week (test-retest) for reliability. Results: Cronbach's a coefficient was 0.714 for the initial evaluation. The intraclass correlation coefficient for the test-retest reliability was 0.995 with a 95% confidence interval of 0.993-0.997. A high level of positive correlation (0.742, P < 0.001) was found between the total score of PASE and the total scores of IPAQ. There were strong positive correlations between the PASE and the total score of SPPB (0.622, P < 0.001), while an average level of positive correlation with SF-36 was found (0.432, P < 0.001). Conclusion: The results of the study suggest that the Turkish version of the PASE has powerful measurement qualities, which makes it a reliable and valid scale for the fields of research and practice. [ABSTRACT FROM AUTHOR]

Peak oxygen uptake ([Formula: see text]2) is internationally recognized as the criterion measure of youth aerobic fitness, but despite pediatric data being available for almost 80 years, its measurement and interpretation in relation to growth, maturation, and health remain controversial. The trainability of youth aerobic fitness continues to be hotly debated, and causal mechanisms of training-induced changes and their modulation by chronological age, biological maturation, and sex are still to be resolved. The daily physical activity of youth is characterized by intermittent bouts and rapid changes in intensity, but physical activity of the intensity and duration required to determine peak [Formula: see text]2 is rarely (if ever) experienced by most youth. In this context, it may therefore be the transient kinetics of pulmonary [Formula: see text]2 that best reflect youth aerobic fitness. There are remarkably few rigorous studies of youth pulmonary [Formula: see text]2 kinetics at the onset of exercise in different intensity domains, and the influence of chronological age, biological maturation, and sex during step changes in exercise intensity are not confidently documented. Understanding the trainability of the parameters of youth pulmonary [Formula: see text]2 kinetics is primarily based on a few comparative studies of athletes and nonathletes. The underlying mechanisms of changes due to training require further exploration. The aims of the present article are therefore to provide a brief overview of aerobic fitness during growth and maturation, increase awareness of current controversies in its assessment and interpretation, identify gaps in knowledge, raise 10 relevant research questions, and indicate potential areas for future research. [ABSTRACT FROM AUTHOR]

The purpose of the present study was to identify physical activity distribution of Korean adolescents and explore differences in cognitive and behavioral processes of change by the stages of physical activity among Korean adolescents. A total of 988 adolescents randomly selected from junior high and high schools in Seoul were surveyed. Stage of physical activity change questionnaire and processes of change questionnaire were used to identify the stages of physical activity and the processes of change construct of adolescents. Results indicated that physical activity pattern of Korean adolescents were different by each stage of physical activity. Female adolescents were more likely to be in the contemplation stage, whereas males were more likely to be in the maintenance. In addition, significant differences were revealed in use of processes of change constructs through stages of physical activity. The use of cognitive and behavioral strategies increased from precontemplation through maintenance. This study provides some insights into the physical activity habits and the TTM components of increasing physical activity levels in the adolescent populations. [ABSTRACT FROM AUTHOR]

Physical inactivity is one of the most critical issues in our society. Several studies have pointed that during adolescence Physical Activity levels decline the most, becoming a critical period in the acquisition of active lifelong habits. This study aims an understanding of the variables that predict the intention of being physically active (IPA) in high school students after completing their education, comparing two different methodologies: Lineal Models (LM) and Comparative Qualitative Analysis (QCA). No research has combined these methodologies before to see the intention of being physically active in high school. 307 adolescents from 14 to 19 years old (Mean=15.64 ±1.12), 55.5% boys, participated in the research. To get the results, a Hierarchical Regression Model with two steps; 1: Attitude toward the Behaviour (ATB), Perceived Behavioural Control (PBC) and Subjective Norm (SN); 2: Athletic Identity (AI) and Physical Self-concept (PSC) and a Fuzzy-set Qualitative Comparative Analysis (fsQCA) were performed. The first step explain 26% of IPA while the addition on step to explains 65% (R² = .38), AI is the most influential aspect (β=.74). Considering the fsQCA results, none of the conditions is crucial condition of IPA, although low levels of PBC seem to be the most important condition of not having IPA. Regarding sufficiency, five combinations explain 70% of IPA. The three most important combinations where having high levels of PSC and PBC; high levels of AI and ATB; and high levels PBC and ATB (explaining 45%; 60% and 43% respectively of IPA). In general QCA is more explanatory than LM. [ABSTRACT FROM AUTHOR]

The current study was to identify health risk perceptions and perception bias in adolescents. Moreover, the study investigated the relationship of risk perceptions with physical activity. A total of 625 adolescents (314 male and 311 female) were voluntarily participated from the Nowon district, geographically located in northern Seoul. In order to measure health risk perceptions a Korean version of self-other risk judgments profile and leisure time exercise questionnaire were used. Results indicated that the study participants, regardless of gender and age, tend to underestimate their vulnerability to the majority of health risk events. The finding revealed that there were significant differences in perception bias toward to health risks by gender and the physical activity level. Furthermore, it is revealed that risk perceptions are directly associated with physical activity participation. The significance of this study lies in the fact that it made a unique contribution to the existing knowledge in exercise and health psychology on relationship between risk perceptions and physical activity. [ABSTRACT FROM AUTHOR]

During late adolescence and youth, physical exercise (PE) could support the formation of a stable personality. However, it has reported a 7% annual decline in the practice of PE for boys and girls, beginning in childhood and continuing through adolescence and youth. The study examined differences by level of education among the benefits, barriers and social support for exercise in university. Based on the Health Promotion Model of Pender. Descriptive comparative design. A sample of 928 young people aged 15 to 26 years stratified by university level. The average years of education was higher among those who reported no exercise practice (t = -3.28, p = .001). Differences between education level were found for exercise benefits (z = 4.955, p <.05) and exercise barriers (z = -2.388, p < .05). The analysis of the items on the scales showed significant differences by level of education among autonomous benefits (z = -. 960, p > .05) regarding barriers to the option "not wanting to do" (z = 2498, p < 0.05) and for "not having adequate clothing or shoes "(z = 1,978, p < .05). The study results allow us to conclude that most young people who study not perform PE and more scholarship youth report lower PE. The young college perceives more benefits and influence of friends but also more barriers to the practice of PE. [ABSTRACT FROM AUTHOR]

ObjectiveSocial relationships can impact youths’ eating and physical activity behaviours; however, the best strategies for intervening in the social environment are unknown. The objectives of the present study were to provide in-depth information on the social roles that youths’ parents and friends play related to eating and physical activity behaviours and to explore the impact of other social relationships on youths’ eating and physical activity behaviours.DesignConvergent parallel mixed-methods design.SettingLow-income, African American, food desert neighbourhoods in Baltimore City, MD, USA.SubjectsData were collected from 297 youths (53 % female, 91 % African American, mean age 12·3 (sd 1·5) years) using structured questionnaires and combined with in-depth interviews from thirty-eight youths (42 % female, 97 % African American, mean age 11·4 (sd 1·5) years) and ten parents (80 % female, 50 % single heads of house, 100 % African American).ResultsCombined interpretation of the results found that parents and caregivers have multiple, dynamic roles influencing youths’ eating and physical activity behaviours, such as creating health-promoting rules, managing the home food environment and serving as a role model for physical activity. Other social relationships have specific, but limited roles. For example, friends served as partners for physical activity, aunts provided exposure to novel food experiences, and teachers and doctors provided information related to eating and physical activity.ConclusionsObesity prevention programmes should consider minority youths’ perceptions of social roles when designing interventions. Specifically, future research is needed to test the effectiveness of intervention strategies that enhance or expand the supportive roles played by social relationships. [ABSTRACT FROM AUTHOR]

Objectives: The objective of this study was to examine the effects of activity type and sex during structured after-school physical activity (PA) sessions. Methods: Accelerometer-based PA was measured during 6 different activities (4 traditional; 2 novel), as part of an after-school program for youth (N = 46). Results: Boys were found to obtain more PA than girls (+64.0 kcals) although the effects were not consistent across all activities. In particular, one novel activity (Kin-ball) eliminated sex-based differences in PA and produced the greatest amount of overall PA (~250 kcal). Conclusions: Structured activity sessions should consider the effects of activity type and sex, when attempting to increase PA in individuals that may be marginalized in traditional activities. [ABSTRACT FROM AUTHOR]

Objective: School recess is a key setting for children's daily physical activity (PA). To maximize recess potential, it is important to have school recess staff members who understand the value of PA during playtime. We examined school recess staff members' perceptions of their role, especially in facilitating or discouraging children's participation in PA. Methods: Qualitative interviews were conducted with recess staff from 4 elementary schools in central Missouri. Results: Three overall themes emerged related to the staff's role in PA of children - school culture, recess environment, and PA as a bargaining chip. Conclusions: The findings illustrate possible ways to address the recess staff members' challenges through training and support that can improve the potential of recess as a tool for PA. [ABSTRACT FROM AUTHOR]

Background The operationalization of opportunities for physical activity (PA) in parks has not been studied extensively. Objectives To explore associations between park types, PA and adiposity in youth. Methods Data were from an ongoing cohort study in children at risk of obesity. Data were collected in 512 participants (2005–2008). Analyses were restricted to 380 participants living within ≥ 1000 m of ≥ 1 park (n parks = 576). Park types were identified using principal component and cluster analyses. Linear and logistic regressions were used to explore associations between park types, and PA and adiposity. The reference category was children living near smaller-sized parks with no team PA features. Results Nine park types were identified. Compared to the reference group, children living near esthetically pleasing parks with few team sports installations reported more 15-minute bouts of PA/week (bouts of PA) ( β = 5.2 [90% CI: 2.3; 8.1]) and variety of PA (1.6 [0.1; 3.1]), and had less % truncal fat (− 3.4 [− 6.4; − 0.5]). Children living near parks that were low on safety items with cycling infrastructure reported more bouts of PA (2.2 [0; 4.3]) and variety of PA (0; 2.2]). Children living near parks with a variety of PA installations reported more bouts of PA (2.5 [0.2; 4.7]) and variety of PA (1.4 [0.2; 2.5]). Children living near parks that had team sports and pool features reported more bouts of PA (2.5 [0.4; 4.7]). No significant associations were found for objectively-measured PA. Conclusion Parks that emphasize unstructured activities may increase self-reported PA and be associated with less % truncal fat among youth at risk of obesity. [ABSTRACT FROM AUTHOR]

Background: Youth's physical activity (PA) may change across developmental periods. Although previous studies have observed a decline in levels of PA during adolescence, few studies have explored trends in PA during the transition from adolescence to young adulthood and what factors may impact the transitional change. The purpose of this study was to examine changes and predictors of change over time in PA from 10(th) grade to post-high school.Methods: The NEXT Generation Health Study recruited a nationally-representative cohort of US 10(th)-graders, and administered longitudinal surveys in four waves (years) to follow up the participants to their first year after high school. Using transition models, the self-reported outcomes, moderate-to-vigorous PA (MVPA) and vigorous PA (VPA) each of which was repeatedly measured by one question, were modelled in association with wave-4 environmental-status variables and time-varying covariates.Results: There was a continuous decline in the proportion of respondents who met or exceeded the minimum recommended level for either MVPA (from 55.97 to 34.33 %) or VPA (from 65.96 to 54.90 %) from W1 to W4. Higher scores of peer PA, family support and VPA planning were prospectively associated with higher likelihood of meeting the MVPA/VPA recommendations. At wave 4, compared to those not working, attending 4-year colleges, or living on campus, participants working full/part time, not attending school or attending community-college level schools, and living at home or in own place were more likely to engage in MVPA.Conclusions: Peer PA, family support, self-regulatory skills, and environmental status after high school are critical factors that can promote MVPA/VPA among adolescents and emerging adults. [ABSTRACT FROM AUTHOR]

Physical activity is associated with numerous health benefits in youth; however, these benefits could extend further than health, into education. Our aim was to systematically review and combine in meta-analyses evidence concerning the association between physical activity and the dimensions of school engagement, including behavior (e.g., time-on-task), emotions (e.g., lesson enjoyment), and cognition (e.g., self-regulated learning). We conducted meta-analyses using structural equation modeling on results from 38 studies. Overall, physical activity had a small, positive association with school engagement (d= .28,I2= .86), 95% confidence interval [.12, .46]. This association was moderated by study design, with significant associations shown in randomized controlled trials but not in studies employing other designs. Risk of bias was also a significant effect moderator, as studies with a low risk of bias showed significant associations but not high risk of bias studies. Altogether, these results suggest that physical activity could improve school engagement. [ABSTRACT FROM PUBLISHER]

Organized sport is one way that youth participate in physical activity. There are disparities in organized sport participation by family-related factors. The purpose of this study was to determine whether non-traditional family structure and physical custody arrangements are associated with organized sport participation in youth, and if so whether this relationship is mediated by socioeconomic status. Data were from the 2009–10 Health Behaviour in School-aged Children survey, a nationally representative cross-section of Canadian youth in grades 6–10 (N = 21,201). Information on family structure was derived from three survey items that asked participants the number of adults they lived with, their relationship to these adults, and if applicable, how often they visited another parent outside their home. Participants were asked whether or not they were currently involved in an organized sport. Logistic regression was used to compare the odds of organized sport participation according to family structure. Bootstrap-based mediation analysis was used to assess mediation by perceived family wealth. The results indicated that by comparison to traditional families, boys and girls from reconstituted families with irregular visitation of a second parent, reconstituted families with regular visitation of a second parent, single-parent families with irregular visitation of a second parent, and single-parent families with regular visitation of a second parent were less likely to participate in organized sport than those from traditional families, with odds ratios ranging from 0.48 (95% confidence interval: 0.38–0.61) to 0.78 (95% confidence interval: 0.56–1.08). The relationship between family structure and organized sport was significantly mediated by perceived family wealth, although the magnitude of the mediation was modest (ie, <20% change in effect estimate). In conclusion, youth living in both single-parent and reconstituted families experienced significant disparities in organized sport participation that was partially mediated by perceived family wealth. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to calibrate and cross-validate the Youth Activity Profile (YAP), a self-report tool designed to capture physical activity (PA) and sedentary behaviors (SB) in youth. Methods: Eight schools in the Midwest part of the U.S. were involved and a total of 291 participants from grades 4–12 agreed to wear an accelerometer (SWA Armband) and complete the YAP in two separate weeks (5–7 days apart). Individual YAP items capture PA behavior during specific segments of the week and these items were combined with temporally matched estimates of moderate-to-vigorous PA (MVPA) and sedentary time from the SWA to enable calibration. Quantile regression procedures yielded YAP prediction algorithms that estimated MVPA at School, MVPA at Out-of-School, MVPA on Weekend, as well as time spent in SB. The YAP estimates of time spent in MVPA and SB were cross-validated using Pearson product correlations and limits of agreement, as indicative of individual error and, equivalence testing techniques as indicative of group-level error. Result: Following calibration, the correlations between YAP and SWA estimates of MVPA were low to moderate (rrange = .19 to .58) and individual-level YAP estimates of MVPA ranged from -134.9% to +110.0% of SWA MVPA values. Differences between aggregated YAP and SWA MVPA ranged from -3.4 to 21.7 minutes of MVPA at the group-level and predicted YAP MVPA estimates were within 15%, 20%, and 30%, of values from the SWA for the School, Out-of-School, and Weekend time periods, respectively. Estimates of time spent in SB were highly correlated with each other (r = .75). The individual estimates of SB ranged from -54.0% to +44.0% of SWA sedentary time, and the aggregated group-level estimates differed by 49.7 minutes (within 10% of the SWA aggregated estimates). Conclusions: This study provides preliminary evidence that the calibration procedures enabled the YAP to provide estimates of MVPA and SB that approximated values from an objective monitor. The YAP provides a simple, low-cost and educationally sound method to accurately estimate children’s MVPA and SB at the group level. [ABSTRACT FROM AUTHOR]

Background: Several approaches have been used to express energy expenditure in youth, but no consensus exists as to which best normalizes data for the wide range of ages and body sizes across a range of physical activities. This study examined several common metrics for expressing energy expenditure to determine whether one metric can be used for all healthy children. Such a metric could improve our ability to further advance the Compendium of Physical Activities for Youth. Methods: A secondary analysis of oxygen uptake (VO2) data obtained from five sites was completed, that included 947 children ages 5 to 18 years, who engaged in 14 different activities. Resting metabolic rate (RMR) was computed based on Schofield Equations [Hum Nutr Clin Nut. 39(Suppl 1), 1985]. Absolute oxygen uptake (ml.min-1), oxygen uptake per kilogram body mass (VO2 in ml.kg-1.min-1), net oxygen uptake (VO2 – resting metabolic rate), allometric scaled oxygen uptake (VO2 in ml.kg-0.75.min-1) and YOUTH-MET (VO2.[resting VO2] -1) were calculated. These metrics were regressed with age, sex, height, and body mass. Results: Net and allometric-scaled VO2, and YOUTH-MET were least associated with age, sex and physical characteristics. For moderate-to-vigorous intensity activities, allometric scaling was least related to age and sex. For sedentary and low-intensity activities, YOUTH-MET was least related to age and sex. Conclusions: No energy expenditure metric completely eliminated the influence of age, physical characteristics, and sex. The Adult MET consistently overestimated EE. YOUTH-MET was better for expressing energy expenditure for sedentary and light activities, whereas allometric scaling was better for moderate and vigorous intensity activities. From a practical perspective, The YOUTH-MET may be the more feasible metric for improving of the Compendium of Physical Activities for Youth. [ABSTRACT FROM AUTHOR]

Background: Health promotion provides a key opportunity to empower young people to make informed choices regarding key health-related behaviours such as tobacco and alcohol use, sexual practices, dietary choices and physical activity. This paper describes the evaluation of a pilot School Youth Health Nurse (SYHN) Program, which aims to integrate a Registered Nurse into school communities to deliver health promotion through group education and individual sessions. Methods: The evaluation was guided by the RE-AIM (reach, effectiveness, adoption, implementation, maintenance) framework. The objectives were to explore: 1) whether the Program was accessible to the high school students; 2) the impacts of the Program on key stakeholders; 3) which factors affected adoption of the Program; 4) whether implementation was consistent with the Program intent; and 5) the long-term sustainability of the Program. Research included retrospective analysis of Program records, administration of a survey of student experiences and interviews with 38 stakeholders. Results: This evaluation provided evidence that the SYHN Program is reaching students in need, is effective, has been adopted successfully in schools, is being implemented as intended and could be maintained with sustained funding. The nurses deliver an accessible and acceptable primary health care service, focused on health promotion, prevention and early intervention. After some initial uncertainty about the scope and nature of the role, the nurses are a respected source of health information in the schools, consulted on curriculum development and contributing to whole-of-school health activities. Conclusions: Findings demonstrate that the SYHN model is feasible and acceptable to the students and schools involved in the pilot. The Program provides health promotion and accessible primary health care in the school setting, consistent with the Health Promoting Schools framework. [ABSTRACT FROM AUTHOR]

It is not clear how best to support youth with type 1 diabetes to participate in physical education (PE) at school. The aim of this study was to explore perceptions of facilitators and barriers to PE in youth with type 1 diabetes and to determine how schools can help these individuals to be physically active. Interviews and focus groups were conducted with youth with type 1 diabetes aged 7–9 (n = 8) and 12–14 (n = 8) years with type 1 diabetes, their parents (n = 16), diabetes professionals (n = 9) and schoolteachers (n = 37).Data were thematically analysed. Four main themes were identified relating to support needs of youth with diabetes in school in general and specifically in PE lessons: (1) differences between primary and secondary schools; (2) areas requiring address in all schools; (3) what teachers can do to help accommodate youth with type 1 diabetes; and (4) what schools can do to help accommodate youth with type 1 diabetes.Diabetes support varied across schools. Primary schools in particular could improve communication between schools and primary specialist PE teachers regarding youth with type 1 diabetes to aid participation in PE. Diabetes knowledge was limited among all teachers. Participants felt that diabetes could be used as an excuse to sit out of PE and that teachers’ fears could facilitate this.Improved and consistent diabetes management training and guidance on the responsibilities of teachers is necessary. Better communication between schools, teachers, parents, youth with type 1 diabetes and diabetes professionals is also required. The findings have helped produce suggestions for practice and research on how to improve support for youth with type 1 diabetes in schools in general and specifically in PE lessons. [ABSTRACT FROM PUBLISHER]

Objective For optimal health, physical activity should be an integral and routine part of daily life. Youth spend a significant amount of time at school yet rarely achieve the recommended 60 min of moderate and vigorous physical activity in physical education (PE) classes or recess. This study assessed the following types of school-based opportunities to improve physical activity for youth: after-school programs, before-school programs, PE classes, extended-day PE, and short physical activity breaks during the school day. Method An economic analysis conducted in 2013 compared school-based approaches to increasing physical activity. Analysis factors included costs, reach, effects on physical activity gains, cost-effectiveness, and other potentially augmenting benefits. Results Two programs were significantly superior in terms of reach and cost per student: (1) extending the school day with mandatory PE participation and (2) offering short (10-minute) physical activity breaks during regular classroom hours. After-school program costs per student are high and the programs have a smaller reach, but they offer benefits (such as childcare) that may justify their higher costs. Before-school programs did not appear feasible. Conclusion Incorporating short physical activity breaks into the existing school day would be a cost-effective way to increase school-based activity. This type of program is inexpensive and has broad reach. Inserting activity breaks throughout the day is appropriate, especially when youth are otherwise largely sedentary. [ABSTRACT FROM AUTHOR]

Introduction: Previous studies suggest that the physical environment is associated with youth physical activity levels. Objective: The present study aimed at assessing the reliability and validity of an adapted version of the ALPHA environmental questionnaire (short version) to adults for application with Spanish youth. Methods: The reliability was evaluated in a sample (n = 190, 80 girls, 14.08 ± 1.38 years) using the Intraclass Correlation Coefficient (ICC) and Weighted kappa. In other sample (n = 140,61 girls, 13.03 ± 1.40 years) the validity was assessed using the Spearman correlation (rho) for its association with self-reported and objective (accelerometers) physical activity (PA). Results: The test-retest reliability showed ICC = 0.69 for the total questionnaire score, ranging from k = 0.42 to 0.77 for individual items. The total score showed significant correlations with PA reported by PACE questionnaire (rho = 0.18, p = 0.040), the Finnish Physical Activity Index (rho = 0.26, p = 0.002) and active commuting for girls (rho = 0.34, p = 0.010), as well as vigorous PA measured by accelerometry (rho = 0.18, p = 0.038). Discussion: The adapted version of the ALPHA environmental questionnaire has moderate to good reliability and acceptable validity to assess environmental factors that may influence PA in youth. [ABSTRACT FROM AUTHOR]

The Get Youth Moving (GYM) program was developed through a joint collaborative of community recreation, coordinated school health, and hospital outreach to offer overweight and obese children an effective behavior change program during the summer school break. The purpose of this study was to document the effects of the GYM program on health-related physical fitness and behavior in overweight and obese youth. Participants (N = 28) between the ages of 9 and 12 years were tested before and after the GYM intervention on aerobic fitness (one-mile run), body composition (body mass index), muscular fitness (curl-up), and lower-body flexibility (sit- and-reach). Participants and their parents were also administered a validated physical activity and nutrition behaviors survey prior to and following the GYM intervention. Findings demonstrated improved scores on aerobic fitness, muscular fitness, and lower-body flexibility, while body mass index remained unchanged. Additionally, survey data revealed a marked increase in weekly exercise frequency and a substantial decrease in sweetened beverage use after the GYM intervention, whereas gains in parental nutritional decision-making were more modest. Finally, feedback from community partners provided insights on the benefits and limitations of the program model. Overall, the impact of the GYM intervention on health status was similar to that observed for summer residential weight loss programs of similar duration and highlights the importance of community collaboration to combat obesity in youth during the summer months. [ABSTRACT FROM AUTHOR]

Purpose:A signature characteristic of positive youth development (PYD) programs is the opportunity to develop life skills, such as social, behavioral, and moral competencies, that can be generalized to domains beyond the immediate activity. Although context-specific instruments are available to assess developmental outcomes, a measure oflife skills transferwould enable evaluation of PYD programs in successfully teaching skills that youth report using in other domains. The purpose of our studies was to develop and validate a measure of perceived life skills transfer, based on data collected withThe First Tee,a physical activity-based PYD program.Method:In 3 studies, we conducted a series of steps to provide content and construct validity and internal consistency reliability for theLife Skills Transfer Survey (LSTS),a measure of perceived life skills transfer.Results:Study 1 provided content validity for theLSTSthat included 8 life skills and 50 items. Study 2 revealed construct validity (structural validity) through a confirmatory factor analysis and convergent validity by correlating scores on theLSTSwith scores on an assessment tool that measures a related construct. Study 3 offered additional construct validity by reassessing youth 1 year later and showing that scores during both time periods were invariant in factor pattern, loadings, and variances and covariances. Studies 2 and 3 demonstrated internal consistency reliability of theLSTS.Conclusion:Results from 3 studies provide evidence of content and construct validity and internal consistency reliability for theLSTS,which can be used in evaluation research with youth development programs. [ABSTRACT FROM AUTHOR]

Background:Obesity in youth remains a major public health issue. Yet no effective long-term preventive strategy exists. We previously showed that a school-based socio-ecological approach targeting behavior and social/environmental influences on physical activity (PA) prevented 4-year excessive weight gain in 12-year olds. In this study, we investigated if this efficacy persists 30 months after intervention cessation.Methods and Findings:The program targeted students, family, school and the living environment to promote/support PA and prevent sedentary behavior (SB). A total of 732 students from eight randomized middle schools completed the 4-year trial. At the 30-month post-trial follow-up, body mass index (BMI), fat mass index (FMI), leisure PA (LPA), home/school/workplace active commuting, TV/video time (TVT), and attitudes toward PA were measured in 531 adolescents. The beneficial effects of the intervention on the excess BMI increase (+0.01 vs +0.34 kg m−2 in the intervention and control groups, respectively) and on the overweight incidence in initially non-overweight students (4.3% vs 8.6%; odds ratio=0.48 (95% confidence interval: 0.23-1.01)) were maintained at the post-trial follow-up. LPA was not maintained at the level achieved during the trial. However, we still observed a prevention of the age-related decrease of the adolescents' percentage reporting regular LPA (−14.4% vs −26.5%) and a higher intention to exercise in the intervention group. The intervention promoted lower TVT (−14.0 vs +13.6 min per day) and higher active commuting changes (+11.7% vs −4.8%). Trends in higher BMI reduction in students with high initial TVT and in the least wealthy group were noted. TVT changes throughout the follow-up predicted excess BMI and FMI changes.Conclusions:Long-term multilevel approach targeting PA and SB prevents excessive weight gain up to 30 months after intervention cessation. The efficacy may be higher in the most sedentary and least wealthy adolescents. Healthy PA-related behavior inducing long-lasting weight effects can be promoted in youth providing that an ecological approach is introduced in the prevention strategy. [ABSTRACT FROM AUTHOR]

Objective:To examine the longitudinal associations between different physical activity (PA) intensities and cardiometabolic risk factors among a sample of Canadian youth.Methods:The findings are based on a 2-year prospective cohort study in a convenience sample of 315 youth aged 9-15 years at baseline from rural and urban schools in Alberta, Canada. Different intensities (light, moderate and vigorous) of PA were objectively assessed with Actical accelerometers. The main outcome measures were body mass index (BMI) z-score, waist circumference, cardiorespiratory fitness and systolic blood pressure at 2-year-follow-up and conditional BMI z-score velocity. A series of linear regression models were conducted to investigate the associations after adjusting for potential confounders.Results:At follow-up, cardiorespiratory fitness increased (quartile 1 vs quartile 4=43.3 vs 50.2; Ptrend<0.01) and waist circumference decreased (quartile 1 vs quartile 4=79.0 vs 72.6; Ptrend=0.04; boys only) in a dose-response manner across quartiles of baseline vigorous-intensity PA. A similar trend was observed for systolic blood pressure (quartile 1 vs quartile 4=121.8 vs 115.3; Ptrend=0.07; boys only). Compared with quartile 1 of vigorous-intensity PA, BMI z-score at follow-up and conditional BMI z-score velocity were significantly lower in the quartile 2 and 3 (P<0.05). Waist circumference at follow-up also decreased (quartile 1 vs quartile 4=75.3 vs 73.8; Ptrend=0.04) across quartiles of baseline moderate-intensity PA.Conclusions:Time spent in vigorous-intensity PA was associated with several positive health outcomes 2 years later. These findings suggest that high-intensity activities in youth help to reduce the risk for several chronic diseases. [ABSTRACT FROM AUTHOR]