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Young people aged 10-24 years constitute 24% of the world's population; investing in their health could yield a triple benefit-eg, today, into adulthood, and for the next generation. However, in physical activity research, this life stage is poorly understood, with the evidence dominated by research in younger adolescents (aged 10-14 years), school settings, and high-income countries. Globally, 80% of adolescents are insufficiently active, and many adolescents engage in 2 h or more daily recreational screen time. In this Series paper, we present the most up-to-date global evidence on adolescent physical activity and discuss directions for identifying potential solutions to enhance physical activity in the adolescent population. Adolescent physical inactivity probably contributes to key global health problems, including cardiometabolic and mental health disorders, but the evidence is methodologically weak. Evidence-based solutions focus on three key components of the adolescent physical activity system: supportive schools, the social and digital environment, and multipurpose urban environments. Despite an increasing volume of research focused on adolescents, there are still important knowledge gaps, and efforts to improve adolescent physical activity surveillance, research, intervention implementation, and policy development are urgently needed.

Background Physical activity is related to many positive health outcomes, yet activity levels of many children are low. Researchers have suggested that family-based interventions may improve physical activity behaviors of both children and their parents. In this study, we evaluated the “Active 1 + FUN” program, which was designed based on tenets of self-determination theory. Intervention components included free sporting equipment, ten coach-led workshops and activity sessions, and one booster session. Methods We evaluated the intervention program using a randomized controlled trial. One hundred seventy-one families were randomly allocated to either an experimental group or a wait-list control group. Participants were exposed to program contents over a nine-month period, while families in the control did not receive any form of intervention. Measured constructs included moderate-to-vigorous physical activity, co-physical activity behaviors, fundamental movement skills, BMI, and several self-reported questionnaire outcomes. Hierarchical linear modeling was used to compare changes in measured outcomes across the two groups. Results No significant intervention effects were found for children’s and parents’ accelerometer-measured moderate-to-vigorous physical activity, or their co-physical activity. However, in terms of children’s fundamental movement skills, a significant Time*Group interaction (B = 0.52, 95% CI [0.07, 0.96] for Times 1 to 2; B = 0.24, 95% CI [0.01, 0.48] for Times 1 to 3) in favor of the experimental group was found. Conclusions Results suggested that the “Active 1 + FUN” program was effective in improving children’s fundamental movement skills. Additional research is needed to examine how family-based initiatives could effectively improve physical activity behaviors too. Trial registration ANZCTR, ACTRN12618001524280. Registered 11 September 2018, https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=375660.

Background The ‘Dads And Daughters Exercising and Empowered’ (DADEE) program significantly improved physical activity levels of fathers and their daughters in an efficacy trial. However, the effectiveness of interventions when delivered in real-world settings needs to be established. Purpose To evaluate the effectiveness of the DADEE intervention when delivered in community settings by trained facilitators. Methods We conducted a two-arm RCT, (baseline and 3-months post-intervention assessments), in Newcastle, Australia. In 2016, 155 fathers (27–60 years) and 189 primary-school-aged daughters (4–12 years) (n = 344) were randomly allocated to the intervention (78 fathers, 95 daughters) or waitlist-control (77 fathers, 94 daughters) groups. Trained facilitators delivered the 9-week DADEE program (weekly sessions plus home-based tasks). Primary outcomes were fathers’ and daughters’ physical activity (steps/day). Secondary outcomes included screen-time, weight status, daughters’ fundamental movement skill (FMS) proficiency, perceived sports competence, and fathers’ parenting practices. Effects were assessed using linear mixed models. Results Primary outcome follow-up data were collected from 88% of fathers and 89% of daughters. Significant group-by-time differences in mean daily steps were found for fathers’ (adjusted difference = +1,638; 95% CI: 833, 2,443, d = 0.7) and daughters’ (adjusted difference = +1,023 steps/day; 95% CI: 259, 1,787; d = 0.4) physical activity. Significant effects were observed for daughters’ screen-time, FMS, and some parenting practices. No significant effects were identified for weight status, or fathers’screen-time or self-reported MVPA. Program attendance, satisfaction and fidelity were very high. Conclusion This study established the effectiveness of the DADEE intervention when delivered in community settings by trained facilitators. Importantly, the findings were comparable to those of the efficacy RCT delivered by the research team. To maximize public health benefits, a larger-scale dissemination of the program appears warranted. Trial Registration Australian New Zealand Clinical Trial Registry: ACTRN12616001270404 Human Research Ethics Committee: H-2014-0330

Objectives While outdoor gyms are being rapidly installed around the globe, little is known about their implications on physical activity, and fitness and other health-related outcomes. The primary objective of this systematic review was to examine the effects of outdoor gyms on physical activity, fitness and other health-related outcomes. Secondary objectives were to describe outdoor gym characteristics, user characteristics, and outdoor gym usage. Design Systematic review. Methods Peer-reviewed papers published in English were obtained through online database searches of the following databases; EBSCO, SPORTdiscus, Medline, PsycINFO, Web of Science, Scopus and Informit. Searches covered the periods from database inception to January 2019. Studies that reported on the efficacy of outdoor gym use for physical activity, health-related outcomes or descriptive aspects of outdoor gyms and their users were eligible for inclusion. Results There was some support that outdoor gyms may improve physical activity, fitness and other health-related outcomes, however few experimental studies have been conducted. There was no consistency between outdoor gyms in terms types and number of installed equipment for each facility. Further, this review found discrepancies of whom were the most likely users of outdoor gyms and when they were mainly used. Conclusions This review contributes to the limited evidence on the impact and characteristics of outdoor gyms on physical activity and fitness and health-related outcomes.

This study aims to explore associations between physical activity intensity and well-being (i.e., positive and negative affect) in adolescents. A secondary aim was to determine if associations were moderated by sex. Grade 8 students from 14 government-funded secondary schools in low socio-economic areas of Western Sydney (Australia) were assessed. Data from three timepoints (baseline, 7–8 months, and 14–15 months) were combined to increase the sample size. Physical activity was objectively assessed for 1-week at each timepoint using Actigraph accelerometers. Time (minutes/day) in light, moderate and vigorous physical activity was estimated. The short form Positive and Negative Affect Scale for Children was used to measure well-being. Quantile regression was used to analyse the data. A total of 3140 observations were collected from 1223 students (mean age at baseline: 12.9(0.54); 55.1% male). Light and moderate physical activity was not associated with well-being. Higher levels of vigorous physical activity were associated with more positive affect [β(SE) = 0.307 (0.06), p < 0.001], to an estimated vigorous physical activity turning point [Point(95%CI) = 36.48 min/day (31.39–41.59)]. Similarly, higher levels of vigorous physical activity were associated with less negative affect [β(SE) = −0.250 (0.06), p < 0.001] up to the estimated vigorous physical activity turning point [Point(95%CI) = 37.35 min/day (31.27–43.44)]. The negative association between vigorous physical activity and negative affect was more pronounced in females than in males. Our findings highlight the importance of adolescents engaging in vigorous physical activity to improve positive affect and reduce negative affect.

Aim This study examined the effects of different types of classroom physical activity breaks on children's on-task behaviour, academic achievement and cognition. Methods Participants were 87 Australian primary school students (mean age 9.11 ± 0.62 years), recruited from one school. Three classes were randomly assigned either to activity breaks only (n = 29), activity breaks and mathematics combined (n = 29), or control conditions involving only mathematical content (n = 29). Students were engaged in five minutes of classroom physical activity breaks, three times per week, for four weeks (divided into two minutes at the beginning of the usual mathematics curriculum lesson and three minutes in the middle of the lesson). Assessments were conducted at baseline and post-test. Results Significant group-by-time effects were found for on-task behaviour (active engagement: activity breaks and mathematics combined versus control, p ≤ 0.001; activity breaks versus control, p ≤ 0.001; activity breaks and mathematics combined versus activity breaks, p = 0.037; passive engagement: activity breaks and mathematics combined versus control, p ≤ 0.001) and mathematics scores (activity breaks versus control, p = 0.045). Conclusion Physical activity breaks with and without integrated mathematics content were effective in improving children's on-task behaviour and learning scores.

Healthy Dads Healthy Kids (HDHK) was the first program internationally to specifically target overweight and obese fathers to improve their children's health. In previous randomized controlled trials, HDHK generated meaningful short-term improvements in the adiposity, physical activity, and eating behaviors of both fathers and children. The aim of this dissemination trial was to evaluate the 12-month impact of HDHK when delivered by trained facilitators across four low socioeconomic and regional communities in the Hunter Region, Australia. The study was a nonrandomized, prospective trial with minimal eligibility criteria (i.e., father body mass index [BMI] ≥ 25 kg/m2 and children aged 4-12 years). HDHK included eight weekly practical and theoretical sessions. Assessments were baseline, 3 months (post-intervention), 6-months, and 12-months. The primary outcome was fathers' weight. Secondary outcomes included child BMI z-score and validated lifestyle behavior measures (e.g., physical activity, diet). Overall, 189 fathers (mean age: 40.2 years, BMI: 32.6 kg/m2) and 306 children (mean age: 8.1 years) participated in one of 10 HDHK programs in four areas. Intention-to-treat linear mixed models revealed a significant mean reduction in fathers' weight at post-intervention (-3.6 kg, 95% confidence interval: -4.3, -2.9), which was maintained at 12 months (71% retention). Corresponding improvements were also detected in children's BMI z-score and a range of lifestyle behaviors for both fathers and children. Attendance and satisfaction levels were high. Positive intervention effects observed in previous randomized controlled trials were largely replicated and sustained for 12 months when HDHK was delivered by trained local facilitators in underserved communities. Further investigation into the key systems, processes, and contextual factors required to deliver HDHK at scale appears warranted.

Objectives The primary aim of this study was to evaluate the preliminary efficacy and feasibility of an 8-week high-intensity interval training program (Uni-HIIT) for young adult students in a university setting. Design Randomised controlled trial. Method Uni-HIIT was conducted at the University of Newcastle, Australia (February-June, 2017). Participants were university students 18-25yrs (n = 53; 20.38 ± 1.88yrs) randomized into the Uni HIIT program (n = 26) or wait-list control (n = 27) condition. Participants were required to attend up to three HIIT sessions/week for 8-weeks which included a variety of aerobic and muscular fitness exercise combinations lasting 8–12 minutes (using 30:30 sec rest:work intervals). The primary outcome was cardio-respiratory fitness (CRF) (20mSRT), and secondary outcomes included muscular fitness (standing jump, push-ups), body composition (InBody), executive function (Trail Making Test), anxiety levels (State Trait Anxiety Inventory) and perceived stress (Perceived Stress Scale). Linear mixed models were used to analyse outcomes and Cohen’s d effect sizes were calculated. Process evaluation measures of recruitment, retention, attendance and satisfaction were conducted. Results A large significant group-by-time effect resulted for CRF [8.4 shuttles (95% CI(2.9-13.9), P = 0.004,d = 1.08] and muscular fitness [4.0 repetitions (95% CI(1.2-6.8), P = 0.006,d = 0.99], and moderate effect size was observed for Trail B [-5.9 seconds (95% CI(-11.8-0.1.0), P = 0.052, d = 0.63]. No significant intervention effects were found for body composition, standing jump, anxiety or perceived stress (P > 0.05). High ratings of participant satisfaction (4.73), enjoyment (4.54) and perceived value (4.54) were observed. Conclusion This study demonstrates the efficacy and feasibility of delivering a novel HIIT program in the university setting.

Introduction: Secondary schools have the potential to promote health-related fitness (HRF) and physical activity within and outside school hours. As such, schools are often chosen as the setting to implement child and adolescent physical activity programs. School-based programs often utilise teachers as delivery agents, but few studies examine effects on teacher-level outcomes.\ud Purpose: The primary aim of this study was to determine the impact of teacher training embedded within a physical activity intervention on teacher-level outcomes. The secondary aim of this study was to evaluate process data, including implementation, satisfaction and fidelity.\ud Methods: Resistance Training for Teens (RT for Teens) was evaluated using a cluster randomised controlled trial in 16 secondary schools. Teachers (N=44; 48% female/52% male; mean±SD years teaching experience=10.6±8.0) from 16 secondary schools were assessed at baseline. Intervention group teachers (i.e., from eight schools) delivered a structured school-based physical activity program over 10-weeks. Teacher outcomes included confidence to teach health-related fitness (HRF) activities, perceived barriers to teaching HRF activities, and perceived fitness. Detailed process evaluation data were also collected. Assessments were conducted at baseline and 6-months (post-program), and outcomes were assessed using repeated measures analysis of variance.\ud Results: There was a positive group-by-time effect for the confidence composite score (p = .010, partial eta squared = 0.29), but no effects for the two (contextual, interpersonal) barrier composite scores. Also, there was a significant effect for perceived ‘general fitness’ (p = 0.044, partial eta squared = 0.13), but not for specific fitness subdomains. Teachers were highly satisfied with both the training and the program, believing it was beneficial for students. Resource usage and adherence to the SAAFE (Supportive, Active, Autonomous, Fair, Enjoyable) delivery principles was high.\ud Conclusion: RT for Teens improved teachers’ confidence and perceived fitness. These findings highlight the potential for high-quality teacher training and program delivery to positively influence teacher-level outcomes. This may provide support for the use of teacher professional development to improve HRF-related pedagogy.

Objectives The aim of the present study was to investigate the effects of specifically designed physical activities on primary school children’s foreign language vocabulary learning and attentional performance. Design A total of 104 children aged between 8 and 10 years were assigned to either (a) an embodied learning condition consisting of task-relevant physical activities, (b) a physical activity condition involving task-irrelevant physical activities, or (c) a control condition consisting of a sedentary teaching style. Within a 2-week teaching program, consisting of four learning sessions, children had to learn 20 foreign language words. Method Children were tested on their memory performance (cued recall test) after completion of the program and on their focused attention (d2-R test of attention) immediately after one learning session. Results Linear mixed model analyses revealed both the embodied learning (d = 1.12) and the physical activity condition (d = 0.51) as being more effective in teaching children new words than the control condition. Children’s focused attention, however, did not differ between the three conditions. Conclusions The results are discussed in the light of embodied cognition and cognitive load theory. Implications for the inclusion of specific physical activities during the school day are proposed.

Background Adolescents with disability are less active and have lower levels of physical fitness than their typically developing peers. Schools are ideal settings to address this; however, few school-based interventions have been designed and evaluated among this group. Therefore, the aim of this pilot study was to determine the feasibility of a time-efficient school-based physical activity intervention for adolescents with disability. Methods A non-randomized pilot trial was conducted with adolescents in the special education unit at one secondary school in New South Wales, Australia. Sixteen grade 11 and 12 students (aged 17.3 ± 0.7 years) participated in the 2-month physical activity intervention. Two classroom teachers were trained to facilitate the delivery of a high-intensity interval training (HIIT) program, known as Burn 2 Learn adapted (B2La). Teachers were asked to deliver 2–3 weekly HIIT sessions for a period of 2 months. Four domains of feasibility (acceptability, implementation, adaptability, and practicality) were assessed using quantitative measures at the student and teacher levels (e.g., observations, process evaluation questionnaires, and heart rate [HR] monitoring). Data were also collected from three learning and support teachers who assisted classroom teachers with intervention delivery. Preliminary efficacy of the intervention on measures of adolescents’ functional capacity (6-min walk/run test) and muscular fitness (sit-to-stand test and modified push-up test) were analyzed using paired sample t-tests. Results Moderate-to-high levels of program satisfaction were reported by both students (80% rated “Good” or “Excellent”) and teachers (100% rated “Good” or “Excellent”). Teachers reported delivering 2.5 ± 0.7 sessions per week during the study. Based on researcher session observations, the program was delivered effectively by teachers (14/20). However, HR data indicated session intensity was lower than intended. The program was considered “adaptable” by teachers, with several observed modifications to HIIT sessions to cater for the needs of adolescents with disability. No adverse events were reported. We observed improvements in preliminary efficacy measures. Conclusions Our findings suggest it is feasible to train teachers to deliver a school-based HIIT program for adolescents with disability. Evaluation of B2La within a larger-scale effectiveness trial is warranted. Trial registration ACTRN12621000219886.

Background: Pilot/feasibility studies play an important role in the development and refinement of behavioral interventions by providing information about feasibility, acceptability, and potential efficacy. Despite their importance and wide-spread use, the approaches taken by behavioral scientists to scale-up early-stage studies to larger-scale trials has received little attention. The aim of our study was to understand the role that pilot studies play in the development and execution of larger-scale trials.Methods: We conducted interviews with behavioral interventionists identified in a systematic review as the lead author of a published pilot study that had also published larger-scale trial on a topic related to childhood obesity. Questions were asked about the role of pilot studies in developing larger-scale trials and the challenges encountered when scaling-up an intervention based upon pilot findings. Data were coded and analyzed using an inductive analytic approach to identify themes.Results: 24 Interventionists (54% women, 37-70 yrs old, mean 20 years since terminal degree) completed a total of 148 pilot studies across their careers (mean 6.4, range 1-20), of which 59% were scaled-up. Scaling was described as resource intensive and pilot work was considered essential to successfully competing for funding by 63% of the sample (n=15). When asked to define a high-quality pilot study, interventionists described studies that allowed them to evaluate components of their intervention (e.g., acceptability, feasibility) and study parameters (e.g., sample size, measures). Interventionists expressed that more process implementation measures, different study designs, and additional iterations could improve decisions to scale-up. Most agreed that pilot studies were likely to produce inflated estimates of potential efficacy though only nine interventionists provided potential solutions for decreasing inflated measures of efficacy. Suggested major causes of inflated effects included high levels of oversight in pilot studies (e.g., researcher support), reliance on subjective measures, and utilizing convenience or highly motivated samples. Potential solutions included designing pilots for real-world implementation, only conducting randomized controlled pilot studies, and pre-registering pilot studies. Conclusions: Pilot studies purposes are multifaceted and deemed essential to obtaining funding for larger-scale trials. Clarifying the form and function of preliminary, early-stage research may enhance the productive utilization of early-stage studies and reduced “voltage drop”.

Importance Cardiorespiratory fitness is an important marker of childhood health and low fitness levels are a risk factor for disease later in life. Levels of children's fitness have declined in recent decades. Whether school-based physical activity interventions can increase fitness at the population level remains unclear. Objective To evaluate the effect of an internet-based intervention on children’s cardiorespiratory fitness across a large number of schools. Design, Setting, and Participants In this cluster randomized clinical trial, 22 government-funded elementary schools (from 137 providing consent) including 1188 students stratified from grades 3 and 4 in New South Wales, Australia, were randomized. The other schools received the intervention but were not included in the analysis. Eleven schools received the internet-based intervention and 11 received the control intervention. Recruitment and baseline testing began in 2016 and ended in 2017. Research assistants, blinded to treatment allocation, completed follow-up outcome assessments at 12 and 24 months. Data were analyzed from July to August 2020. Interventions The internet-based intervention included standardized online learning for teachers and minimal in-person support from a project mentor (9-10 months). Main Outcomes and Measures Multistage 20-m shuttle run test for cardiorespiratory fitness. Results Of 1219 participants (49% girls; mean [SD] age, 8.85 [0.71] years) from 22 schools, 1188 students provided baseline primary outcome data. At 12 months, the number of 20-m shuttle runs increased by 3.32 laps (95% CI, 2.44-4.20 laps) in the intervention schools and 2.11 laps (95% CI, 1.38-2.85 laps) in the control schools (adjusted difference = 1.20 laps; 95% CI, 0.17-2.24 laps). By 24 months, the adjusted difference was 2.22 laps (95% CI, 0.89-3.55 laps). The cost per student was AUD33 (USD26). Conclusions and Relevance In this study, a school-based intervention improved children's cardiorespiratory fitness when delivered in a large number of schools. The low cost and sustained effect over 24 months of the intervention suggests that it may have potential to be scaled at the population level. Trial Registration http://anzctr.org.au Identifier: ACTRN12616000731493

Participation in regular physical activity has significant physical, psychological, and social benefits, including the prevention and treatment of Type 2 Diabetes (T2D). The primary aim of this paper was to evaluate the impact of theeCoFit physical activity intervention on depression and anxiety symptoms among adults at risk of, or diagnosed with, T2D. The primary outcomes were assessed using Patient Health Questionnaire-9, and Generalised Anxiety Disorder-7. The secondary aim was to test for the potential mediators for the intervention effect on mental health. The 20-week intervention was evaluated using a two-arm randomised controlled trial with await list control group. The intervention included two phases: Phase 1 integrated group face-to-face sessions and the use of the eCoFit smartphone application (app); and Phase 2 that included the use of the app only. Participants (n = 84) were assessed at baseline and 10- and 20-weeks post-baseline. Social support, self-efficacy, nature-relatedness, and perceived sleep quality were examined as potential mechanisms for the intervention effects on mental health. A significant interaction for depression severity was observed at 20-weeks (-1.76, CI -3.48, -05, p= .044, d= -0.35). There were no significant intervention effects for anxiety or any of the potential mechanisms.

Objectives To determine the impact of bushfires on children’s physical activity. Design Natural experiment comparing device-measured physical activity and air quality index data for schools exposed and not exposed to the Australian bushfires. Methods Participants were drawn from 22 schools participating in a cluster randomised controlled trial of a school-based physical activity intervention that coincided with the 2019 Australian bushfires. Students in Years 3 and 4 (8–10 years old) provided data. We used propensity score matching to match 245 exposed and 344 control participants. Main outcome measures Minutes of moderate and vigorous physical activity. Results The bushfires had minimal effect on children’s average weekly physical activity. Analysis of acute effects showed children maintained their levels of physical activity up to an estimated turning point of air quality index of 737.08 (95% CI = 638.63, 835.53), beyond which daily physical activity levels dropped sharply. Similar results were found for girls and boys and for children from low-to-average and higher socio-economic backgrounds. Conclusions Children’s physical activity was not strongly influenced by the presence of smoke and targeted public health advice during the bushfires might not have had the intended effect of reducing children’s outdoor physical activity. Only when air quality deteriorated to approximately 3.5 times the Air Quality index threshold (>200) deemed ‘hazardous’ by the Australian Department of Health did children’s physical activity decline. Public health agencies should re-evaluate the effectiveness of health messages during bushfires and develop strategies to mitigate risks to children’s health.

Over the last decade, a growing body of research has examined the link between physical activity, fitness, and cognitive function in children and adolescents. Physical activity experimental research conducted with children and adolescents has identified selectively greater effects for tasks requiring higher order executive functions. As such, the primary aim of our chapter is to provide an overview of findings from systematic reviews and meta-analyses that have examined the effects of physical activity on measures of executive function in child and adolescent populations. We begin our chapter with definitions of key concepts associated with physical activity, fitness and cognitive function. We then provide a synthesis of systematic reviews and meta-analyses that have examined the acute and chronic effect of physical activity on EFs. Following this, we discuss the quantitative (e.g., time, intensity) and qualitative (e.g., type) characteristics of physical activity that may moderate effects. The next section focuses on the neurobiological, psychosocial and behavioral mechanisms responsible for the effect of physical activity on executive functions. We conclude by highlighting the limitations of the existing evidence base and providing recommendations for future research.

Despite well-established benefits, the majority of young people around the globe are not sufficiently active. In many countries, including Australia, physical activity (i.e. physical education and school sport) is not mandatory in the final two years of high school (i.e. senior school years). The aim of this study was to assess the impact of a time-efficient physical activity intervention on senior school students��� on-task behaviour and subjective vitality. This was a sub-study of the Burn 2 Learn (B2L) cluster randomised controlled trial, which included two cohorts. Participants for this sub-study (N���=���221) were from 10 secondary schools (23 classes) located in New South Wales, Australia (Cohort 2). Teachers allocated to the B2L intervention group were provided with training, resources and support to facilitate the delivery of two high-intensity activity breaks per week during lesson time for five weeks. A wait-list control was used as comparison group. On-task behaviour was assessed at baseline and post-test, using a momentary time sampling procedure and expressed as a percentage of lesson time. At post-test, subjective vitality was assessed at the start and end of the lesson using a validated questionnaire. Significant group-by-time effects were observed for students��� on-task behaviour in favour of the B2L group [adjusted mean difference���=���19.3% of lesson time (95% CI, 0.8 to 37.8), p���=���0.042, d���=���0.43]. At post-test, significant group-by-time effects were observed for students��� subjective vitality favouring the B2L group [adjusted mean difference���=���0.67 units (95% CI, 0.3 to 1.0), p���

usc Estimations of time spent sedentary and in various physical activity intensities may vary according to data reduction methods applied. This study compared associations between children's accelerometer data and adiposity and fitness markers using open source (mean amplitude deviation, MAD) and proprietary (counts) data reduction methods. Complete-case accelerometer, adiposity (Body Mass Index z-score, waist circumference), and fitness (cardiorespiratory, musculoskeletal) data from 118 children (10.4 ± 0.6 years, 49% girls) were analyzed. Estimates of sedentary behavior, light-, moderate-, vigorous- (VPA), and moderate- to vigorous-intensity (MVPA) physical activity were calculated using count- and MAD-based data reduction methods. Linear regression models between time in movement behaviours and fitness and adiposity markers were conducted. Significant differences in estimates of time spent in all intensities were observed between MAD-based and count-based methods. Both methods produced evidence to suggest that sedentary behavior was detrimentally, and physical activity(any intensity) was beneficially, associated with waist circumference. MVPA and VPA were beneficially associated with fitness markers using both data reduction measures. Overall, findings suggest that estimates of sedentary time and physical activity were not comparable. However, the strength and direction of the associations obtained between the different data reduction methods and adiposity and fitness outcomes were fairly comparable, with both methods finding stronger associations for VPA compared to MVPA. This suggests that future studies maybe able to pool data using different data reduction approaches when examining associations between activity and health risk factors, albeit with caution. Refereed/Peer-reviewed

The authors thank the study participants and collaborators on the individual studies that provided data for this pooled IPD analysis., Objectives To determine if subpopulations of students benefit equally from school-based physical activity interventions in terms of cardiorespiratory fitness and physical activity. To examine if physical activity intensity mediates improvements in cardiorespiratory fitness. Design Pooled analysis of individual participant data from controlled trials that assessed the impact of school-based physical activity interventions on cardiorespiratory fitness and device-measured physical activity. Participants Data for 6621 children and adolescents aged 4-18 years from 20 trials were included. Main outcome measures Peak oxygen consumption (VO2Peak mL/kg/min) and minutes of moderate and vigorous physical activity. Results Interventions modestly improved students’ cardiorespiratory fitness by 0.47 mL/kg/min (95% confidence interval 0.33 to 0.61), but the effects were not distributed equally across subpopulations. Girls and older students benefited less than boys and younger students, respectively. Students with lower levels of initial fitness, and those with higher levels of baseline physical activity benefitted more than those who were initially fitter and less active, respectively. Interventions had a modest positive effect on physical activity with approximately one additional minute per day of both moderate and vigorous physical activity. Changes in vigorous, but not moderate intensity, physical activity explained a small amount (~5%) of the intervention effect on cardiorespiratory fitness. Conclusions Future interventions should include targeted strategies to address the needs of girls and older students. Interventions may also be improved by promoting more vigorous intensity physical activity. Interventions could mitigate declining youth cardiorespiratory fitness, increase physical activity, and promote cardiovascular health if they can be delivered equitably and their effects sustained at the population level.

Purpose: The aim of this study was to determine the feasibility of generalist school teachers delivering curriculum connected high-intensity interval training in a school’s physical education class time. Method: Two schools volunteered to participate. A total of 84 students (11.9 [0.5] y, M = 64 and F = 19) volunteered to participate. Four classes from 2 schools were randomized to either intervention (n = 53) or control (n = 31) for one school term (8 wk). Intervention class teachers participated in a 1-day workshop instructing them how to deliver twice weekly, high-intensity interval training sessions. The control classes continued with their usual physical education curriculum. Recruitment, intervention fidelity, and program satisfaction were assessed. Preliminary efficacy (primary outcome cardiorespiratory fitness) was quantified using generalized linear mixed models, expressed as effect size. A range of secondary outcomes was also assessed. Results: The recruitment rate was 88%. About 84% of the sessions were delivered. The heart rate peak over all sessions was 89.6% (13%) of the predicted maximum. The intervention teachers reported high levels of satisfaction. Almost all student participants were positive about participating. No adverse events occurred. The adjusted between-group difference for cardiorespiratory fitness was trivial (effect size 0.02). Conclusions: This teacher-delivered high-intensity interval training program was feasible and acceptable to both teachers and student participants. It is therefore potentially scalable.

Process evaluations can help to optimise the implementation of school-based physical activity interventions., The purpose of this paper is to describe the process evaluation of a school-based high-intensity interval training (HIIT) program for older adolescent students, known as Burn 2 Learn (B2L). B2L was evaluated via a cluster randomised controlled trial in 20 secondary schools (10 intervention, 10 control) in New South Wales, Australia., Teachers (n = 22 (55% female)) from the 10 intervention schools, delivered the program over three phases (Phases 1 and 2, 6 months, Phase 3, 6 months) to older adolescent students (n = 337 (50% female), mean &plusmn, standard deviation (SD) age = 16.0 &plusmn, 0.4 years)., Process evaluation data were collected across the 12-month study period. Teachers delivered 2.0 &plusmn, 0.8 and 1.7 &plusmn, 0.6 sessions/week in Phases 1 and 2 respectively (mean total 25.9 &plusmn, 5.2), but only 0.6 &plusmn, 0.7 sessions/week in Phase 3., Observational data showed that session quality was high, however heart rate (HR) data indicated that only half of the students reached the prescribed threshold of &ge, 85% predicted HRmax during sessions., Over 80% of teachers reported they intended to deliver the B2L program to future student cohorts., Almost 70% of students indicated they intended to participate in HIIT in the future., Teachers considered the program to be adaptable, and both students and teachers were satisfied with the intervention., B2L was implemented with moderate-to-high fidelity in Phases 1 and 2, but low in Phase 3., Our findings add to the relatively scant process evaluation literature focused on the delivery of school-based physical activity programs.

Cardiorespiratory fitness (CRF) refers to the capacity of the circulatory and respiratory systems to supply oxygen to skeletal muscle mitochondria for energy production needed during physical activity. CRF is an important marker of physical and mental health and academic achievement in youth. However, only 40% of US youth are currently believed to have healthy CRF. In this statement, we review the physiological principles that determine CRF, the tools that are available to assess CRF, the modifiable and nonmodifiable factors influencing CRF, the association of CRF with markers of health in otherwise healthy youth, and the temporal trends in CRF both in the United States and internationally. Development of a cost-effective CRF measurement process that could readily be incorporated into office visits and in field settings to screen all youth periodically could help identify those at increased risk.

Background ‘Physical Activity 4 Everyone’ (PA4E1) was an efficacious multi-component school-based physical activity (PA) program targeting adolescents. PA4E1 has seven PA practices. It is essential to scale-up, evaluate effectiveness and assess implementation of such programs. Therefore, the aim is to assess the impact of implementation support on school practice uptake of the PA4E1 program at 12 and 24 months. Methods A cluster randomised controlled trial, utilising a type III hybrid implementation-effectiveness design, was conducted in 49 randomly selected disadvantaged Australian Government and Catholic secondary schools. A blinded statistician randomly allocated schools to a usual practice control (n = 25) or the PA4E1 program group (n = 24), with the latter receiving seven implementation support strategies to support school PA practice uptake of the seven practices retained from the efficacy trial. The primary outcome was the proportion of schools adopting at least four of the seven practices, assessed via telephone surveys with Head Physical Education Teachers and analysed using exact logistic regression modelling. This paper reports the 12-month outcomes. Results Schools were recruited from May to November 2017. At baseline, no schools implemented four of the seven practices. At 12 months significantly more schools in the program group had implemented four of the seven practices (16/24, 66.7%) than the control group (1/25, 4%) (OR = 33.0[4.15–1556.4], p p 80%). Conclusions Through the application of multiple implementation support strategies, secondary schools were able to overcome commonly known barriers to implement evidence based school PA practices. As such practices have been shown to result in an increase in adolescent PA and improvements in weight status, policy makers and practitioners responsible for advocating PA in schools should consider this implementation approach more broadly when working with schools. Follow-up is required to determine whether practice implementation is sustained. Trial registration Australian New Zealand Clinical Trials Registry ACTRN12617000681358 registered 12th May 2017.

The feasibility requirements of administering field-based cognitive assessments are rarely reported. We examined the feasibility of administering a group-based cognitive test battery in a school setting with older adolescents. Several types of reliability were also assessed in the control group. Preliminary efficacy and the relationship between changes in fitness and changes in cognitive control were also explored following a 14-week HIIT intervention (3 sessions/week). Participants completed a cognitive test battery measuring inhibition (flanker), and working memory (n-back) at baseline and post-test. Health-related fitness assessments were also conducted. Test administration took approximately 30.8 ± 1.5 minutes to complete with up to six participants simultaneously. The test battery demonstrated acceptable reliability (ICC = 0.5-0.81), with significant changes observed for flanker incongruent accuracy, and 2-back non-target accuracy from baseline to post-test. Regarding efficacy, small-to-moderate effects were observed for accuracy outcomes, while several small associations were found between changes in fitness and changes in cognition. Findings from the current study suggest a cognitive test battery can be administered with older adolescents in a school setting. However, there remains a lack of adequate reporting of administration requirements for field-based cognitive assessments. Efficacy findings should be confirmed with a larger and more representative sample of older adolescents.

High-intensity interval training (HIIT) has emerged as a time-efficient strategy to improve children's and adolescents' health-related fitness in comparison to traditional training methods. However, little is known regarding the effects on cognitive function and mental health. Therefore, the aim of this systematic review was to evaluate the effect of HIIT on cognitive function (basic information processing, executive function) and mental health (well-being, ill-being) outcomes for children and adolescents.A systematic search was conducted, and studies were eligible if they 1) included a HIIT protocol, 2) examined cognitive function or mental health outcomes, and 3) examined children or adolescents (5-18 yr). Separate meta-analyses were conducted for acute and chronic studies, with potential moderators (i.e., study duration, risk of bias, participant age, cognitive demand, and study population) also explored.A total of 22 studies were included in the review. In acute studies, small to moderate effects were found for executive function (standardized mean difference [SMD], 0.50, 95% confidence interval [CI], 0.03-0.98; P = 0.038) and affect (SMD, 0.33; 95% CI, 0.05-0.62; P = 0.020), respectively. For chronic studies, small significant effects were found for executive function (SMD, 0.31; 95% CI, 0.15-0.76, P0.001), well-being (SMD, 0.22; 95% CI, 0.02-0.41; P = 0.029), and ill-being (SMD, -0.35; 95% CI, -0.68 to -0.03; P = 0.035).Our review provides preliminary review evidence suggesting that participation in HIIT can improve cognitive function and mental health in children and adolescents. Because of the small number of studies and large heterogeneity, more high-quality research is needed to confirm these findings.

This chapter aims to provide an overview of the research literature regarding exercise for children and adolescents. It outlines seminal and contemporary research evidence of the benefits of aerobic, resistance, and flexibility training, as well as recommendations for exercise prescription in this population. The chapter focuses on the ways in which various forms of exercise can be utilized to improve health-related fitness in young people. It also provides detail regarding the application of the principles to aerobic, resistance, and flexibility training, and examine an overview of prior research related to each of the specific forms of exercise conducted with children and adolescents. Children and adolescents have a greater capacity than adults to recover when performing resistance training, and it has been suggested that a 1-minute rest period between sets is sufficient for most youth. There is growing recognition of the importance of structured exercise programs for children and adolescents, which is reflected in national and international physical activity guidelines.

Background: The majority of children internationally are not sufficiently active. Integrating physical activity into academic lesson time may not only help increase children’s activity levels but also improve learning. The aim of this study was to assess the impact of a classroom-based physical activity intervention on primary school students’ physical activity levels and academic outcomes (i.e., on-task behavior, literacy and executive function skills). Methods: This cluster randomized controlled trial included students ( N = 283) from nine primary schools located in New South Wales, Australia. Schools were allocated to a control (n = 5 schools) or Thinking while Moving in English (TWM-E) (n = 4 schools) conditions. Teachers received professional learning (i.e. one day workshop), resources (e.g. drill ladders, lettered bean bags), and mentoring from the research team. Teachers in the TWM-E condition delivered three 40-min physically active English lessons per week for six weeks, whereas the control condition continued with the usual lessons. For both conditions, assessments occurred at baseline and post-test (six weeks). Children wore accelerometers on their wrists (Axivity) for one week during school time to measure their intensity of physical activity intensity (primary outcome). On-task behavior was assessed using a momentary time sampling procedure and expressed as a percentage of lesson time. Standardized tests were used to assess literacy skills (i.e., spelling, grammar and punctuation) and executive functioning (i.e, inhibition and task shifting). Results: No significant group differences were observed for physical activity outcomes, spelling or executive functions. Compared to the control group, the TWM-E group displayed improved on-task behavior (adjusted mean difference = 18.1% of lesson time, 95% CI [10.12 to 26.02], p < .001, d = 0.53), and improved grammar and punctuation scores (adjusted mean difference = 3.0, 95% CI [ 0.7 to 5.4], p = 0.018, d = 0.16). Conclusions: Despite minimal effect on overall physical activity levels, active lessons have important benefits for students’ on-task behavior and literacy.

Background ecofit is an evidence-based multi-component physical activity intervention that integrates smartphone technology, the outdoor environment, and social support. In a previous efficacy trial, significant improvements were found across several clinical, fitness, and mental health outcomes among adults at risk of (or with) type 2 diabetes. Methods The aim of the present pilot study was to evaluate a number of patient-centered and feasibility outcomes of the ecofit intervention in a “real-world” setting, using a scalable implementation model. ecofit was adapted and implemented by a rural municipal council in the Upper Hunter Shire, New South Wales, Australia, and evaluated using a single-group pre-post design. Inactive middle-aged and older adults (N=59) were recruited and assessed at 6 (primary time-point) and 20 weeks (follow-up). Results Improvements were found in this predominantly overweight and obese sample for aerobic fitness, functional mobility, upper and lower body muscular fitness, systolic blood pressure, and waist circumference at 6 weeks. At 20 weeks, effects were found for aerobic fitness, functional mobility, upper and lower body muscular fitness, and systolic blood pressure. Overall, participants were satisfied with the ecofit program. Participants attended the 6-week primary time-point (66.1%) and follow-up at 20 weeks (41.6%). Conclusions Our findings support the preliminary effectiveness and feasibility of the ecofit intervention delivered by municipal council staff following a brief training from the research team. This study provides valuable preliminary evidence to support a larger implementation trial.

Purpose To examine the effects of the Self-determined Exercise and Learning For FITness (SELF-FIT) intervention on students' moderate-to-vigorous physical activity (MVPA) and motivation in physical education (PE). Methods In a clustered randomized controlled trial, 667 students (mean age, 14.4 yr; SD, 0.78) from 26 schools (i.e., clusters) were randomized into either an experimental group or a waitlist control group. Students in the experimental group received the SELF-FIT intervention, a school-based intervention designed to infuse fitness and game-like elements into PE using self-determination theory principles, whereas those in the control continued their classes using usual practices. Intervention content was provided by teachers who received training from the research team. The primary outcome was percentage of time spent in MVPA during PE. Secondary outcomes included basic psychological need satisfaction, motivation toward PE, leisure-time MVPA, and mental well-being. Data were analyzed using multilevel regression analyses and prespecified interactions were tested (i.e., group-time-sex). Results Positive intervention effects were found on MVPA during PE (B, 4.00; 95% confidence interval, 2.96-5.04; d = 0.36). Regarding the participants' competence and autonomy need satisfaction, and autonomous motivation, the intervention effects were stronger in girls, compared with boys. Conclusions Fitness infusion and game-like elements, used according to self-determination theory principles, can enhance students' physical activity and motivation toward PE. This low-cost intervention has the potential to be scaled up and disseminated in secondary schools.

Background Preliminary evaluations of behavioral interventions, referred to as pilot studies, predate the conduct of many large-scale efficacy/effectiveness trial. The ability of a pilot study to inform an efficacy/effectiveness trial relies on careful considerations in the design, delivery, and interpretation of the pilot results to avoid exaggerated early discoveries that may lead to subsequent failed efficacy/effectiveness trials. “Risk of generalizability biases (RGB)” in pilot studies may reduce the probability of replicating results in a larger efficacy/effectiveness trial. We aimed to generate an operational list of potential RGBs and to evaluate their impact in pairs of published pilot studies and larger, more well-powered trial on the topic of childhood obesity. Methods We conducted a systematic literature review to identify published pilot studies that had a published larger-scale trial of the same or similar intervention. Searches were updated and completed through December 31st, 2018. Eligible studies were behavioral interventions involving youth (≤18 yrs) on a topic related to childhood obesity (e.g., prevention/treatment, weight reduction, physical activity, diet, sleep, screen time/sedentary behavior). Extracted information included study characteristics and all outcomes. A list of 9 RGBs were defined and coded: intervention intensity bias, implementation support bias, delivery agent bias, target audience bias, duration bias, setting bias, measurement bias, directional conclusion bias, and outcome bias. Three reviewers independently coded for the presence of RGBs. Multi-level random effects meta-analyses were performed to investigate the association of the biases to study outcomes. Results A total of 39 pilot and larger trial pairs were identified. The frequency of the biases varied: delivery agent bias (19/39 pairs), duration bias (15/39), implementation support bias (13/39), outcome bias (6/39), measurement bias (4/39), directional conclusion bias (3/39), target audience bias (3/39), intervention intensity bias (1/39), and setting bias (0/39). In meta-analyses, delivery agent, implementation support, duration, and measurement bias were associated with an attenuation of the effect size of − 0.325 (95CI − 0.556 to − 0.094), − 0.346 (− 0.640 to − 0.052), − 0.342 (− 0.498 to − 0.187), and − 0.360 (− 0.631 to − 0.089), respectively. Conclusions Pre-emptive avoidance of RGBs during the initial testing of an intervention may diminish the voltage drop between pilot and larger efficacy/effectiveness trials and enhance the odds of successful translation.

Purpose: We aimed to explore associations between guideline-concordant muscle-strengthening activity (MSA) and demographic, biological, psychosocial, and behavioral factors among Australian adolescents. Methods: We used baseline data from the ‘Resistance Training for Teens’ cluster randomized controlled trial (collected April–June 2015). Adolescents (n = 602, mean age = 14.1 ± 0.5 years, 50% female) from 16 schools in New South Wales, Australia self-reported their sex, primary language spoken at home, postal code (for socioeconomic status), resistance training (RT) self-efficacy, motivation for RT, perceived strength, moderate-to-vigorous physical activity (MVPA), screen-time, and sleep. Participants also completed tests of height, weight, cardiorespiratory and muscular fitness, flexibility, and RT skills. MSA was self-reported and participants were dichotomized as ‘meeting’ (3–7 days) or ‘not meeting’ (0–2 days) the MSA guideline. Binary logistic regression with odds ratios (OR) was used to determine associations with adolescents' MSA. Results: Analyses for each variable group explained a small-to-moderate proportion of the variance in MSA. Sex, muscular fitness, RT self-efficacy, perceived strength, and total MVPA emerged as statistically significant factors. However, only RT self-efficacy (OR = 2.48 [1.37 to 4.50]) and total MVPA (OR = 1.48 [1.22 to 1.79]) were associated with guideline-concordant MSA in the full model, which explained 52% of the variance. Conclusions: Our study adds to the limited understanding of adolescents' MSA behavior. RT self-efficacy and total MVPA were independently associated with guideline-concordant MSA among Australian adolescents. The findings have implications for the design and delivery of future interventions targeting adolescents’ MSA behavior Refereed/Peer-reviewed

This study involved the design and evaluation of the High-Intensity Interval Training Self-Efficacy Questionnaire (HIIT-SQ). Phase 1: Questionnaire items were developed. Phase 2: Australian adolescents (N = 389, 16.0 ± 0.4 years, 41.10% female) completed the HIIT-SQ, and factorial validity of the measurement model was explored. Phase 3: Adolescents (N = 100, age 12–14 years, 44% female) completed the HIIT-SQ twice (1 week apart) to evaluate test–retest reliability. Confirmatory factor analysis of the final six items (mean = 3.43–6.73, SD = 0.99–25.30) revealed adequate fit, χ2(21) = 21, p = .01, comparative fit index = .99, Tucker–Lewis index = .99, root mean square of approximation = .07, 90% confidence interval [.04, .11]. Factor loading estimates showed that all items were highly related to the factor (estimates range: 0.81–0.90). Intraclass coefficients and typical error values were .99 (95% confidence interval [.99, 1.00]) and .22, respectively. This study provides preliminary evidence for the validity and reliability of scores derived from the HIIT-SQ in adolescents.

Physical activity interventions that promote cardiorespiratory (CRF) and muscular fitness (MF) may improve mental health in young adolescents. However, less is known about the links between fitness and mental health in older adolescents, as they are an understudied population. In addition, the association between MF and adolescents' mental health is less clear than it is for CRF. Our primary aim was to investigate whether MF is independently associated with mental health in a sample of older adolescents. Our secondary aim was to determine if the association between fitness and mental health was moderated by sex, socio-economic status (SES) or weight status. Participants were 670 students (16.0 [0.4] years, 44.6% female) from 20 secondary schools in New South Wales, Australia. Mental health (well-being and internalizing problems) was self-reported using the Short Warwick-Edinburgh Mental Wellbeing Scale and the Strengths and Difficulties Questionnaire. We assessed CRF using the Progressive Aerobic Cardiovascular Endurance Run and MF using the push-up and standing long jump tests. After controlling for CRF, MF was not associated with mental health. CRF was associated with well-being (β = 0.20, p < .001) and internalizing problems (β = −0.27, p < .001). The strength of association between CRF and mental health was stronger in girls, than boys. No interaction effects were observed for SES or weight status. Although cross-sectional, our findings provide further evidence of the potential benefits of CRF for adolescents' mental health (i.e., well-being and internalizing problems), particularly girls. However, MF may be less relevant for mental health among this population.

Type 2 diabetes mellitus (T2DM) accounts for approximately 90% of diabetes cases globally. Regular physical activity is regarded as one of the key components in T2DM management. Aerobic exercise was traditionally recommended; however, there is a growing body of research examining the independent effect of resistance training (RT) on glycemic control. This systematic review and meta-analysis aimed to conduct an update on the effects of RT on glycosylated hemoglobin (HbA1c) in adults with T2DM and examine the moderating effects of training effect (ie, muscular strength improvements), risk of bias and intervention duration. Peer-reviewed articles published in English were searched across MEDLINE, Embase, CINAHL, Scopus and SPORTDiscus from database inception until January 19, 2021. Each online database was systematically searched for randomized controlled trials reporting on the effects of RT on HbA1c in individuals with T2DM. Twenty studies (n=1172) were included in the meta-analysis. RT significantly reduced HbA1c compared with controls (weighted mean difference=−0.39, 95% CI −0.60 to −0.18, p2=69.20). Training effect significantly (pPROSPERO registration number CRD42020134046.

Background Poor diet, alcohol use, and tobacco smoking have been identified as strong determinants of chronic diseases, such as cardiovascular disease, diabetes, and cancer. Smartphones have the potential to provide a real-time, pervasive, unobtrusive, and cost-effective way to measure these health behaviors and deliver instant feedback to users. Despite this, the validity of using smartphones to measure these behaviors is largely unknown. Objective The aim of our review is to identify existing smartphone-based approaches to measure these health behaviors and critically appraise the quality of their measurement properties. Methods We conducted a systematic search of the Ovid MEDLINE, Embase (Elsevier), Cochrane Library (Wiley), PsycINFO (EBSCOhost), CINAHL (EBSCOHost), Web of Science (Clarivate), SPORTDiscus (EBSCOhost), and IEEE Xplore Digital Library databases in March 2020. Articles that were written in English; reported measuring diet, alcohol use, or tobacco use via a smartphone; and reported on at least one measurement property (eg, validity, reliability, and responsiveness) were eligible. The methodological quality of the included studies was assessed using the Consensus-Based Standards for the Selection of Health Measurement Instruments Risk of Bias checklist. Outcomes were summarized in a narrative synthesis. This systematic review was registered with PROSPERO, identifier CRD42019122242. Results Of 12,261 records, 72 studies describing the measurement properties of smartphone-based approaches to measure diet (48/72, 67%), alcohol use (16/72, 22%), and tobacco use (8/72, 11%) were identified and included in this review. Across the health behaviors, 18 different measurement techniques were used in smartphones. The measurement properties most commonly examined were construct validity, measurement error, and criterion validity. The results varied by behavior and measurement approach, and the methodological quality of the studies varied widely. Most studies investigating the measurement of diet and alcohol received very good or adequate methodological quality ratings, that is, 73% (35/48) and 69% (11/16), respectively, whereas only 13% (1/8) investigating the measurement of tobacco use received a very good or adequate rating. Conclusions This review is the first to provide evidence regarding the different types of smartphone-based approaches currently used to measure key behavioral risk factors for chronic diseases (diet, alcohol use, and tobacco use) and the quality of their measurement properties. A total of 19 measurement techniques were identified, most of which assessed dietary behaviors (48/72, 67%). Some evidence exists to support the reliability and validity of using smartphones to assess these behaviors; however, the results varied by behavior and measurement approach. The methodological quality of the included studies also varied. Overall, more high-quality studies validating smartphone-based approaches against criterion measures are needed. Further research investigating the use of smartphones to assess alcohol and tobacco use and objective measurement approaches is also needed. International Registered Report Identifier (IRRID) RR2-https://doi.org/10.1186/s13643-020-01375-w

Participation in lifelong physical activities, such as yoga, golf, tennis, or running, are common endeavors in adolescence and adulthood. However, there is a lack of understanding of how competent individuals are in the skills needed for these activities and how competency in these skills relates to physical activity and fitness. This study aimed to determine the initial predictive validity of the Lifelong Physical Activity Skills Battery related to physical activity and health-related fitness. One-hundred and nine adolescents from four schools (55 males, 54 females; Mage = 15.82 years, SD = 0.37 years) completed: demographic information (survey), height (stadiometer), weight (digital scale), motor skill assessment (jog, grapevine, squat, push-up, upward dog, warrior one, tennis forehand, golf swing), health-related fitness (standing long jump, back-saver sit and reach, 3-min submaximal step test, 90° push-up test), and physical activity (GENEActiv accelerometers). Correlations and multiple regression models were conducted in SPSS version 24.0. Motor competence was associated with muscular fitness (standing long jump, β = 0.24, p = .002; push-ups, β = 0.42, p p = .031), and flexibility (β = 0.23, p = .025), but not physical activity (β = 0.17, p = .154) or body mass index (β = −0.05, p = .622). Motor competence has a stronger association with health-related fitness parameters rather than physical activity.

Objective To examine the impact of a school-based physical activity intervention on adolescents' self-esteem and subjective well-being, and to explore moderators and mediators of intervention effects. Methods Resistance Training for Teens was evaluated using a cluster RCT in 16 schools located in New South Wales, Australia. Adolescents (N = 508; 14.1 ± 0.5 years; 49.6% female) completed measures of global self-esteem, subjective well-being, and hypothesized mediators (i.e., perceived fitness, resistance training self-efficacy, and autonomous motivation) at baseline (April–June, 2015) and post-intervention (October–December). The school-based physical activity program was delivered by teachers over 10-weeks via Physical Education, co-curricular school sport, or an elective subject known as Physical Activity and Sport Studies, and involved once-weekly fitness sessions and additional lunch-time sessions. Intervention effects and moderator analyses were tested using multi-level linear regression analyses with interaction terms. Multi-level mediation analyses were used to explore potential mediators of changes in well-being outcomes. Results Intervention effects for self-esteem (β = 0.05, p = .194) and wellbeing (β = 0.03, p = .509) were not statistically significant. Moderator analyses showed effects for self-esteem were greater for the overweight/obese subgroup (p = .069 for interaction), and resistance training self-efficacy was a significant mediator of changes in self-esteem (product-of-coefficients [AB] = 0.021, SE = 0.010, 95% CIs = 0.002 to 0.040). No other significant indirect effects were observed. Conclusion Overall, Resistance Training for Teens did not improve adolescents' self-esteem or subjective well-being. However, our mediation findings lend support to resistance training self-efficacy as a mechanism explaining the positive effect of resistance training on self-esteem.

Many adults without a diagnosed sleep disorder report poor sleep health, which is defined by dissatisfactory levels of sleep duration, sleep quality, or the timing of sleep. No previous review has summarized and described interventions targeting poor sleep health in this population. This meta-analysis aimed to quantify the efficacy of behavioral and cognitive sleep interventions in adults with poor sleep health, who do not have a sleep disorder. Electronic databases (Medline, Embase, PsycInfo, Cinahl) were searched with restrictions for age (18-64 y) and English language full-text, resulting in 18,009 records being screened and 592 full-texts being assessed. Eleven studies met inclusion criteria, seven of which reported a measure of overall sleep health (Pittsburgh sleep quality index [PSQI]). Following appraisal for risk of bias, extracted data were meta-analyzed using random-effects models. Meta-analyses showed interventions had a medium effect on sleep quality (Hedge's g = -0.54, [95% confidence interval (CI)] -0.90 to -0.19, p 0.01). Baseline sleep health was the only significant effect moderator (p = 0.01). The most frequently used intervention components were stress management and relaxation practice, stimulus control, sleep hygiene, and exercise. Interventions targeting cognitive and behavioral self-regulation improve sleep quality in adults without clinical sleep disorder.

Background Existing strategies to increase girls' physical activity levels have seen limited success. Fathers may influence their children's physical activity, but often spend more time with their sons and rarely participate in family-based programs. Purpose To test a novel program designed to increase the physical activity levels of fathers and their daughters. Methods In a two-arm RCT, 115 fathers (29-53 years) and 153 daughters (4-12 years) were randomized to (i) the "Dads And Daughters Exercising and Empowered" (DADEE) program, or (ii) a wait-list control. The 8-week program included weekly educational and practical sessions plus home tasks. Assessments were at baseline, 2 months (postintervention), and 9 months. The primary outcomes were father-daughter physical activity levels (pedometry). Secondary outcomes included screen-time, daughters' fundamental movement skill proficiency (FMS: perceived and objective), and fathers' physical activity parenting practices. Results Primary outcome data were obtained from 88% of daughters and 90% of fathers at 9 months. Intention-to-treat analyses revealed favorable group-by-time effects for physical activity in daughters (p = .02, d = 0.4) and fathers (p < .001, d = 0.7) at postintervention, which were maintained at 9 months. At postintervention and follow-up, significant effects (p < .05) were also identified for daughters' FMS competence (objective: d = 1.1-1.2; perceived: d = 0.4-0.6), a range of fathers' physical activity parenting practices (d = 0.3-0.8), and screen-time for daughters (d = 0.5-0.8) and fathers (d = 0.4-0.6, postintervention only). Program satisfaction and attendance were very high. Conclusions This study provided the first experimental evidence that efforts to increase physical activity behavior in preadolescent girls would benefit from a meaningful engagement of fathers. Clinical Trial information: Australian New Zealand Clinical Trials Registry: ACTRN12615000022561.

Numerous skill batteries assess fundamental motor skill (e.g., kick, hop) competence. Few skill batteries examine lifelong physical activity skill competence (e.g., resistance training). This study aimed to develop and assess the content validity, test-retest and inter-rater reliability of the "Lifelong Physical Activity Skills Battery". Development of the skill battery occurred in three stages: i) systematic reviews of lifelong physical activity participation rates and existing motor skill assessment tools, ii) practitioner consultation and iii) research expert consultation. The final battery included eight skills: grapevine, golf swing, jog, push-up, squat, tennis forehand, upward dog and warrior I. Adolescents (28 boys, 29 girls; M = 15.8 years, SD = 0.4 years) completed the Lifelong Physical Activity Skills Battery on two occasions two weeks apart. The skill battery was highly reliable (ICC = 0.84, 95% CI = 0.72-0.90) with individual skill reliability scores ranging from moderate (warrior I; ICC = 0.56) to high (tennis forehand; ICC = 0.82). Typical error (4.0; 95% CI 3.4-5.0) and proportional bias (r = -0.21, p = .323) were low. This study has provided preliminary evidence for the content validity and reliability of the Lifelong Physical Activity Skills Battery in an adolescent population.

Evidence supports a positive association between competence in fundamental movement skills (e.g., kicking, jumping) and physical activity in young people. Whilst important, fundamental movement skills do not reflect the broad diversity of skills utilized in physical activity pursuits across the lifespan. Debate surrounds the question of what are the most salient skills to be learned which facilitate physical activity participation across the lifespan. In this paper, it is proposed that the term 'fundamental movement skills' be replaced with 'foundational movement skills'. The term 'foundational movement skills' better reflects the broad range of movement forms that increase in complexity and specificity and can be applied in a variety of settings. Thus, 'foundational movement skills' includes both traditionally conceptualized 'fundamental' movement skills and other skills (e.g., bodyweight squat, cycling, swimming strokes) that support physical activity engagement across the lifespan. A proposed conceptual model outlines how foundational movement skill competency can provide a direct or indirect pathway, via specialized movement skills, to a lifetime of physical activity. Foundational movement skill development is hypothesized to vary according to culture and/or geographical location. Further, skill development may be hindered or enhanced by physical (i.e., fitness, weight status) and psychological (i.e., perceived competence, self-efficacy) attributes. This conceptual model may advance the application of motor development principles within the public health domain. Additionally, it promotes the continued development of human movement in the context of how it leads to skillful performance and how movement skill development supports and maintains a lifetime of physical activity engagement.

Objective The present study examined the effect of a school-based multicomponent physical activity intervention on aggression in adolescent males from low-income areas, and explored potential mediators of change in aggression. Methods Participants were adolescent males (N = 361; 12.7 ± 0.5 years) enrolled in the ‘Active Teen Leaders Avoiding Screen-time’ cluster RCT. Self-report measures for aggression, perceived strength and recreational screen-time were collected at baseline and 8-months. The effect of the intervention on aggression was tested using multi-level linear regression and potential mediators (i.e., screen-time and perceived strength) were explored using a product-of-coefficients test. Results There was no significant intervention effects for aggression (C [SE] = -0.038 [0.044], p = .384) or perceived strength (A [SE] = -0.0 [0.0], p = .884). However, a statistically significant effect was found for screen-time (A [SE] = -0.160 [0.04], p= Conclusion Limiting recreational screen-time may help to reduce aggression in adolescent boys. Interventions targeting adolescents' recreational screen-time should examine their ‘flow-on’ effects on externalising behaviours in adolescent populations.

Adolescent boys living in disadvantaged communities are considered a vulnerable group at risk for developing obesity and associated health problems, such as cardiovascular disease, hypertension and type-2 diabetes. While short-term health promotion programmes often produce effective results during the implementation of the intervention, according to self-determination theory (SDT), changes in autonomous motivation are required if programmes are to have sustained effects on health behaviours. This article describes the ATLAS (Active Teen Leaders Avoiding Screen-time) programme, based on SDT, which was developed to engage adolescent boys from low socio-economic backgrounds in physical activity, reduce their consumption of sugar-sweetened beverages and limit recreational screen-time. The article reports a post-hoc analysis of the perceptions and experiences of a representative group of ATLAS participants to investigate whether the boys’ general impressions of the programme reflected the need-supportive teaching strategies on which the programme was based. The results of this analysis suggested that students’ comments about increased feelings of autonomy, competence and relatedness were often linked to corresponding need-supportive teacher behaviours. The findings suggest that embedding health promotion programmes in a need-supportive context can help to foster the motivation and self-regulation that is required to maintain newly adopted healthier behaviours.

Physical activity guidelines recommend young people engage in regular muscle-strengthening activities (e.g., resistance training [RT]). However, few school-based physical activity interventions have been delivered at-scale or promoted RT. The aim of this study was to evaluate the reach, effectiveness, adoption, implementation and maintenance of the Resistance Training for Teens (RT for Teens) program.Data were collected between August 2015 and October 2020. RE-AIM was operationalized as: (i) Reach: number and characteristics of students estimated to be exposed to the program; (ii) Effectiveness: impact of the program on student-level outcomes measured in a subsample of 750 students from 17 schools; (iii) Adoption: number and representativeness of schools with one or more teachers trained to deliver the program; (iv) Implementation: extent to which the program was delivered as intended; and (v) Maintenance: extent to which the program was sustained in schools.The estimated program reach was ~ 10,000 students, out of a total student population of ~ 200,000 (~ 5%). Students were from diverse socioeconomic and ethnic backgrounds. Improvements in muscular fitness, RT self-efficacy, perceived cardiorespiratory fitness and flexibility, and participation in muscle-strengthening physical activities were documented. A total of 30 workshops were delivered, involving 468 teachers from 249 schools from diverse geographical regions. Implementation varied considerably, with teachers adapting the program to suit the context of their school and student cohorts. However, RT skill development and the promotion of muscular fitness were the session components delivered most during sessions. Teachers' adherence to the SAAFE (Supportive, Active, Autonomous, Fair and Enjoyable) teaching principles was high. Approximately 30% of teachers (144/476) registered to use the RT for Teens app. At the school-level, 37% (93/249) of schools had at least one registered user (teacher and/or student). A total of 2,336 workouts and 3,116 fitness tests were completed by registered users. Of the 249 schools represented, 51 (20.5%) sent an additional (previously untrained) teacher to a second workshop.The RT for Teens program had broad reach and adoption. However, intervention delivery varied considerably across schools and additional support strategies are required to optimize intervention implementation and maintain program delivery over time. Future studies will benefit from the utilization of accepted frameworks, recommendations and guidelines for implementation research.Australian New Zealand Clinical Trials Registry (ACTRN12621000352808), retrospectively registered 1