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Introduction There are disparities in child mental health treatment access and treatment retention in terms of race and ethnicity, socioeconomic status (SES), and insurance coverage. Institutions have invested in the integrated primary care (IPC) treatment model with the goal of improving treatment access and promoting child mental health equity. Objective This study compared treatment attendance in an outpatient psychiatry clinic (OPC) versus an IPC clinic to assess whether the IPC was associated with reduced disparities in access to care and treatment retention. Methods This study assessed whether there were differences in who is connected to care from the intake appointment to first follow-up appointment. Results Results showed that the IPC clinic served a more diverse patient population than the OPC clinic in terms of SES, race, and ethnicity. Differences in treatment attendance in the IPC and OPC were also found. After controlling for race, ethnicity, insurance, and distance from patient's home zip code to clinic, the IPC treatment setting was associated with poorer intake and follow-up appointment attendance. Conclusions The IPC model may be more accessible to historically underserved youth, but the treatment setting does not inherently eliminate disparities in child mental health treatment retention. Replication of this study has the potential to contribute to the external validity of study findings, improve quality assurance policies, and develop equitable workflow policies. Future research is needed to identify factors that can improve treatment attendance for populations who face greater retention barriers and to shine light on ways that healthcare systems may inadvertently maintain disparity in treatment retention. [ABSTRACT FROM AUTHOR]

Background: Whereas effects of physical fitness and physical activity on cognitive function have been documented, little is known about how they are related. Purpose: This study assessed student aerobic fitness measured by FITNESSGRAM Mile times and/or Pacer circuits and whether the nature of the association between aerobic fitness and standardized academic performance is dose-response or threshold related. Methods: Standardized academic test scores and aerobic capacity scores were collected from two cohorts of 5th grade students over two years. The Mile run and Pacer circuits results were compared to patterns in students' academic test scores. Results: Sectioning of Mile times and Pacer circuits revealed a sharp peak in academic performance for boys who completed the Mile in 9 minutes or less. Girls' Pacer revealed peaks in academic performance at 12 and 30 circuits. Discussion: Results demonstrate that select achievements in the Mile or Pacer account for significant increases in academic performance on standardized tests. Translation to Health Education Practice: This study identifies aerobic fitness points which, if achieved, offer the greatest probability of increased academic success in fifth graders. Physical education, cross-curricular thematic units, and club activities can be portals of opportunity to increase moderate to vigorous physical activity and fitness in students. Furthermore, school-based physical activity and fitness opportunities may positively impact health risk factors associated with childhood obesity. Policies that increase aerobic activity opportunities in the school setting may increase overall academic performance, encourage positive health habits and improve immediate and future overall health. (Contains 4 tables and 2 figures.)

Purpose: To examine effects of a 10-week after-school physical activity (PA) program on academic performance of 6- to 12-year-old African American children with behavior problems. Methods: Participants were randomized to PA (n = 19) or sedentary attention control (n = 16) programs. Academic records, curriculum-based measures, and classroom observations were obtained at baseline, postintervention, and/or follow-up. Mixed models tested group × time interactions on academic records and curriculum-based measures. One-way analysis of variance or Kruskal–Wallis tested for differences in postintervention classroom observations. Results: Intent-to-treat analyses demonstrated a moderate effect within groups from baseline to postintervention on disciplinary referrals (PA: d = −0.47; attention control: d = −0.36) and a null moderate effect on academic assessments (PA: d = 0.11 to 0.36; attention control: d = 0.05 to 0.40). No significant group × time interactions emerged on direct academic assessments (all Ps ≥.05, d = −0.23 to 0.26) or academic records (all Ps ≥.05, d = −0.28 to 0.16). Classroom observations revealed that intervention participants were off-task due to moving at twice the rate of comparative classmates (F = 15.74, P <.001) and were off-task due to talking 33% more often (F = 1.39, P =.257). Conclusion: Academic outcome improvements were small within and between groups and did not sustain at follow-up. Academic benefits of after-school PA programs for children with attention-deficit hyperactivity disorder and/or disruptive behavior disorders were smaller than neurobiological, behavioral, and cognitive outcomes as previously reported. [ABSTRACT FROM AUTHOR]

Studies that examine the effects of exercise on children's intelligence, cognition, or academic achievement were reviewed and results were discussed in light of (a) contemporary cognitive theory development directed toward exercise, (b) recent research demonstrating the salutary effects of exercise on adults' cognitive functioning, and (c) studies conducted with animals that have linked physical activity to changes in neurological development and behavior. Similar to adults, exercise facilitates children's executive function (i.e., processes required to select, organize, and properly initiate goal-directed actions). Exercise may prove to be a simple, yet important, method of enhancing those aspects of children's mental functioning central to cognitive development.

Background: Research suggests significant health differences between rural dwelling youth and their urban counterparts with relation to cardiovascular risk factors. This study was conducted to (1) determine relationships between physical activity and markers of metabolic syndrome, and (2) to explore factors relating to physical activity in a diverse sample of rural youth. Methods: Data were collected from 4th, 6th, 8th, and 11th grade public school students in the rural Southeastern United States in the spring of 2002. Physiological data included anthropometrics, fasting glucose, lipids, hemodynamics, and skinfold measurements. Psychosocial data included parental support for physical activity, accessibility of physical activity facilities, and safety concerns for physical activity. Behavioral data included self-reported physical activity and sedentary behaviors. Results: After adjusting for sex, race, and age, subjects with low level of physical activity were 3 times more likely to be positive for metabolic syndrome compared to those reporting a high level of physical activity. Subjects reporting a low level of physical activity were 2.4 times more likely to be overweight compared to subjects reporting a high level of physical activity. Students with high levels of physical activity were more likely to have parents who provided money for physical activity lessons and sports teams. Conclusions: Rural youth with low levels of physical activity participation were at increased risks for metabolic syndrome and overweight. Effective physical activity promotions addressing supports for physical activity are urgently needed in rural America.

The study tested the effect of aerobic exercise training on executive function in overweight children. Ninety-four sedentary, overweight but otherwise healthy children (mean age = 9.2 years, body mass index [greater than or equal to] 85th percentile) were randomized to a low-dose (20 min/day exercise), high-dose (40 min/day exercise), or control condition. Exercise sessions met 5 days/week for 15 weeks. The Cognitive Assessment System (CAS), a standardized test of cognitive processes, was administered individually before and following intervention. Analysis of covariance on posttest scores revealed effects on executive function. Group differences emerged for the CAS Planning scale (p = 0.03). Planning scores for the high-dose group were significantly greater than those of the control group. Exercise may prove to be a simple, yet important, method of enhancing aspects of children's mental functioning that are central to cognitive and social development. (Contains 2 tables.)

Purpose: This study tested whether participation in organized physical activity (active vs. inactive) or weight status (normal weight vs. overweight or obese) independently relate to children's cognition, using a matched-pairs design. Design and Methods: Normal weight, active children (8-11 yrs, 5th-75th percentile BMI) were recruited from extracurricular physical activity programs while normal weight inactive (5th-75th percentile BMI) and overweight inactive children (BMI ≥85th percentile) were recruited from local Augusta, Georgia area schools. Measures included the Cognitive Assessment System, anthropometrics, and parent- and self-report of physical activity. Paired t tests compared cognition scores between matched groups of normal weight active vs. normal weight inactive (N= 24 pairs), normal weight inactive vs. overweight inactive (N = 21 pairs), and normal weight active vs. overweight inactive children (N = 16 pairs). Children in each comparison were matched for race, gender, age, and socioeconomic status. Results: Normal weight active children had higher Planning (M± SD = 109 ± 11 vs. 100 ±11,p = .011) and Attention scores (108 ± 11 vs. 100 ±11,p= .013) than overweight inactive children. Normal weight inactive children had higher Attention scores than overweight inactive children (105 ± 13 vs. 93 ±12,p = .008). When compared with normal weight inactive children, normal weight active children had higher Planning (113 ± 10 vs. 102 ± 13, p = .008) and marginally higher Attention scores (111 ± 11 vs. 104 ± 12,p = .06). Conclusion: Findings suggest independent associations of children's weight status with selective attention, and physical activity with higher-order processes of executive function. [ABSTRACT FROM AUTHOR]