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Background: Effective physical activity (PA) interventions are needed to counter the insufficient and declining levels of PA in youth. These require an updated, comprehensive planning framework that consolidates recent decades of progress in promoting PA in young children, children, and adolescents. Effective PA interventions require program planning and conceptual model development that target a coordinated and multilevel set of age-specific PA determinants. Accordingly, this paper presents a comprehensive planning framework that researchers can use to design intervention research to promote PA in youth. Methods: The first author conducted targeted searches through Google Scholar to compile PA models/frameworks/guides applicable to youth, a comprehensive set of PA determinants, and determinant-linked strategies to promote PA focusing on review articles. The information was summarized in tables, synthesized, and used to create a planning framework, all of which were reviewed by coauthors. Results: The APPLE Framework for Planning PA Opportunities for Youth (APPLE = Age, PA focus, Place and time, Leverage relevant influences and strategies, and ensure Enjoyable PA opportunities) incorporated all core elements from targeted reviews to create a comprehensive planning framework. The APPLE Planning Framework has a set of questions/prompts that guide the intervention planning process and conceptual model templates to organize planning efforts for designing intervention research. Conclusions: The APPLE Framework for Planning PA Opportunities for Youth will enable researchers to develop comprehensive conceptual models to guide the design of PA interventions for youth. Future research should refine the model and its components to enable PA intervention research in youth to move forward. [ABSTRACT FROM AUTHOR]

Background: Cardiorespiratory fitness (CRF) plays a significant role in health and academic performance in youth. The purpose of this study was to examine the longitudinal relationship between CRF and academic performance from fifth to eighth grade among a large, diverse, and state-wide cohort of students, and to determine the extent to which the relationship between change in CRF and academic performance is moderated by poverty status. Methods: CRF and academic performance data were obtained for a retrospective state-wide cohort of 11,013 students with baseline (fifth grade, school year 2015-2016) and follow-up (eighth grade, school year 2018-2019) data. Analysis of covariance was used to examine the association between changes in CRF over a 3-year follow-up period and eighth grade academic performance. Results: After adjusting for covariates, change in CRF and poverty status were positively and significantly associated with eighth grade academic performance. Poverty status did not significantly moderate the association between changes in CRF and academic performance. Conclusions: Schools should prioritize evidence-based policies and programs that optimize students' access to high quantity and quality physical activity throughout the school day. Such efforts can improve and maintain student CRF and thus academic performance outcomes.

This study examined individual variation in change over time in sedentary behaviour and factors associated with higher or lower sedentary behaviour and change in sedentary behaviour in 110 toddlers from 18 to 36 months of age. Mother/child dyads were recruited into the study when children were 6 months of age. Mothers completed surveys, and children were measured at 6-month intervals to 36 months. Children wore accelerometers for one week at each time point, and height and weight were measured. Growth curve modelling examined relationships between demographic, early life, and environmental factors and sedentary behaviour from 18 to 36 months. Fifty-one percent of the children were boys. The trajectory of sedentary behaviour increased from 18 to 24 months then declined. Children with higher sedentary behaviour were less likely to be enrolled in daycare (p < 0.05), and they engaged in higher TV/electronic media use (p < 0.05). Children with lower sedentary behaviour were more likely to have been breastfed (p < 0.05). Children with higher locomotion scores at 6 months were less sedentary at 18 months (p < 0.05), but this difference diminished over time. Mothers should be encouraged to breastfeed, limit their child’s TV/electronic media use, and provide opportunities for their young children to be physically active. [ABSTRACT FROM AUTHOR]

Background: The purpose of the study was to examine the associations among cardiorespiratory fitness (CRF), weight status and academic achievement in youth, and to determine if these relationships are moderated by poverty status. Methods: The sample included 5th (N = 27,791) and 8th grade (N = 16,047) South Carolina students. Academic achievement was assessed using a state-wide assessment and classified into 2 categories (ie, does not meet/approaches standards vs meets/exceeds standards). CRF was assessed and expressed as Healthy Fitness Zone (HFZ) or Needs Improvement/Needs-Improvement-Health Risk. Students' demographics and poverty status were reported. Multilevel logistic regression analyses were used to examine the association between CRF, weight status and academic achievement. Interaction terms were introduced into the final models. Analyses were performed separately by grade level and academic subject. Results: The CRF was significantly associated with the odds of meeting/exceeding academic standards after controlling for covariates and adjusting for weight status. The relationship between CRF and academic achievement varied significantly by poverty status. After adjustment for CRF, weight status was not significantly associated with academic achievement. Conclusions: The odds of achieving academic standards were significantly higher among students achieving CRF HFZ regardless of poverty status. CRF may partially mitigate the adverse effect of poverty on academic achievement.

This study evaluates whether parental provision of transportation for physical activity is associated with child/adolescent moderate-to-vigorous physical activity, while also evaluating community-level poverty. Self- and parental-reported surveys were administered with parents/caregivers and children in the Healthy Communities Study (N = 5138). Associations between individual-level demographics, community-level poverty, parental provision of transportation for physical activity, and moderate-to-vigorous physical activity were examined in multi-level models. Even when accounting for community-level poverty, which was significantly associated with lower moderate-to-vigorous physical activity, parental provision of transportation for physical activity was positively associated with greater moderate-to-vigorous physical activity. This study provides evidence for the importance of considering multiple systems of influence (e.g., community and individual factors) and considering how gaps in physical activity transportation for youth can be addressed in future health policies., Author(s): Allison M. Sweeney [sup.1] , Dawn K. Wilson [sup.2] , Russell Pate [sup.3] , M. Lee Van Horn [sup.4] , Kerry McIver [sup.3] , Marsha Dowda [sup.3] Author Affiliations: [...]

Summary: Background: The prevalence of childhood obesity in the U.S. has increased, likely due to decreased physical activity, increased sedentary behaviour and unhealthy diets. Little is known about the relationships between these factors and weight gain in those under the age of three. Objectives: This study aimed to understand the longitudinal associations of weight gain over 6‐month intervals with child and parent characteristics as children develop from 6 to 36 months. Methods: Mother and infant data were collected at 6‐month intervals from 6 to 36 months. Weight (kg) was the primary outcome variable, and potential explanatory variables included child and parent characteristics, physical activity, motor development, diet and sleep. Structural equation modelling was used to assess associations between explanatory variables and 6‐month weight gain. Results: Weight increased ~1 kg per 6‐month interval (p < 0.001) from 6 to 36 months. Childcare outside of the home at 12 months was associated with 0.272 kg (p = 0.002) greater weight gain at 18 months, while children's physical activity was associated with 0.228 kg (per 2 SD, p = 0.051) less weight gain during the same time period. Mother's TV and screen media use (0.102 kg per hour/day, p = 0.046) and child's intake of high‐energy beverages at 18 months (0.387 kg, p = 0.037) were both associated with greater weight gain at 24 months. Conclusion: Childcare, physical activity, screen media use and high‐energy beverage consumption might affect weight gain at different time points in early childhood. These insights can inform efforts to prevent excessive weight gain and childhood obesity effectively. [ABSTRACT FROM AUTHOR]

Introduction: Effective public health interventions targeting factors that influence physical activity are urgently needed to reduce the age-related decline in physical activity in youth. The purpose of this study was to identify associations between physical activity and a set of potential influences on physical activity in children as they transition from elementary to high school. Methods: Participants were 951 children from South Carolina school districts who completed outcome and independent variable measures on at least two time points from the 5th to 11th grades in 2010-2017. The primary outcome variable was physical activity, measured by accelerometry. Independent variables included a comprehensive set of variables in the child, parent/home, school, and community domains. Children, parents and school administrators, and staff completed questionnaires to assess psychosocial and home, school, and neighborhood environmental influences. Growth curve analyses identified independent variables associated with physical activity over time, either as a main effect or as an interaction with age. Results: As main effects, self-efficacy, self-schema, sport participation, weekday outdoor hours, importance of child participating in sports and physical activity, safe to play outside, and Physical Activity Resource Assessment weighted score were positively associated with physical activity. The associations between physical activity and enjoyment motivation, appearance motivation, weekend outdoor time, and home equipment exhibited significant interactions with age. Enjoyment motivation influenced physical activity during the earlier years, whereas the remaining three variables influenced physical activity in the later years. Conclusions: Interventions should target multiple domains of influences that may vary by age. [ABSTRACT FROM AUTHOR]

Background: The purpose of this study was to characterize the temporal, social, and physical contexts for physical activities commonly reported in a diverse cohort of 753 boys and girls from fifth to seventh grade. Methods: Data were obtained from a multilevel longitudinal study, the Transitions and Activity Changes in Kids. The Physical Activity Choices instrument assessed previous 5-day participation in specific physical activities and their temporal, social, and physical contexts. Mixed model repeated measure analyses of variance and multinomial analyses examined sex differences and change over time. Results: Fifth grade boys and girls reported participation in similar activities at similar frequencies, which declined significantly by seventh grade. One temporal pattern, playing with younger children, changed over time from "both inside/outside" to "outside" school. Boys and females reported more activities performed in class/team groups over time. Most activities took place primarily at home for all participants in both grades. Conclusions: Boys and girls reported declines in the variety and frequency of activities from fifth to seventh grade. There were sex-specific patterns in physical activities and groups; however, all participants reported home as the primary location and a shift to class/team groups over time. Schools are well-positioned to provide additional physical activity opportunities.

This study investigated the utility of the Study of Health and Activity in Preschool Environments (SHAPES) conceptual model, which targeted physical activity (PA) behavior in preschool children, by examining the relationship between implementation monitoring data and child PA during the school day. We monitored implementation completeness and fidelity based on multiple elements identified in the conceptual model. Comparing high-implementing, low-implementing, and control groups revealed no association between implementation and outcomes. We performed post hoc analyses, using process data, to refine our conceptual model's depiction of an effective preschool PA-promoting environment. Results suggest that a single component of the original four-component conceptual model, providing opportunities for moderate-to-vigorous physical activity through recess for 4-year-old children in preschool settings, may be a good starting place for increasing moderate-to-vigorous physical activity. Interventions that are implemented with optimal levels of completeness and fidelity are more likely to achieve behavior change if they are based on accurate conceptual models. Examining the mechanisms through which an intervention produces its effects, as articulated in the conceptual model that guides it, is particularly important for environmentally focused interventions because they are guided by emerging frameworks. The results of this study underscore the utility of using implementation monitoring data to examine the conceptual model on which the intervention is based.

Background: We examined longitudinal changes in children's physical activity during the school day, afterschool, and evening across fifth, sixth, and seventh grades. Methods: The analytical sample included children who had valid accelerometer data in fifth grade and at least one other time-point, and provided complete sociodemographic information (N = 768, 751, and 612 for the 3 time-periods studied). Accelerometer-derived total physical activity (TPA) and moderate-to-vigorous physical activity (MVPA) were expressed in minutes per hour for the school day (~7:45 am to 3:30 pm), afterschool (~2:25 to 6:00 pm), and evening (6:00 to 10:00 pm) periods. We used growth curve analyses to examine changes in TPA and MVPA. Results: School day TPA and MVPA declined significantly; we observed a greater decrease from fifth to sixth grades than from sixth to seventh grades. Afterschool TPA declined significantly, but MVPA increased significantly among girls and remained stable for boys. Evening TPA decreased significantly and MVPA declined significantly in girls and remained stable among boys. Conclusions: To inform the development of effective intervention strategies, research should focus on examining factors associated with the decline in physical activity during the transition from elementary to middle school, particularly during the hours when children are in school.

Background: Preschool settings vary greatly, and research has shown that interventions are more successful when they can be adapted to individual settings. This is a descriptive case study of how 2 teachers successfully adapted and implemented a preschool physical activity intervention. Methods: The Study of Health and Activity in Preschool Environments (SHAPES) was a 3-year physical activity intervention. A detailed case study of 2 high-implementing teachers was conducted. Multiple data sources included accelerometry, direct observation, teacher surveys, and intervention staff field notes. Results: Teacher A focused on integrating physical activity into a wide range of activities, including parent and community events. Teacher B focused on high-intensity, structured activities. Both teachers supported the intervention, worked closely with intervention staff, and operated their classroom as an autonomous unit with support from their directors. Teacher A provided an average of 31.5, 78.0, and 67.5 min of physical activity opportunity per day of observation during years 1, 2, and 3. Teacher B provided an average of 2.7, 33.5, and 73.3 minutes of physical activity opportunity per day of observation. Conclusion: Successful implementation of physical activity interventions may look different in different contexts; thus, interventions should allow for flexible implementation.

Purpose: This study describes the development and pilot testing of the Observational System for Recording Physical Activity-Elementary School (OSRAC-E) Version. Method: This system was developed to observe and document the levels and types of physical activity and physical and social contexts of physical activity in elementary school students during the school day. Interobserver agreement scores and summary data were calculated. Results: All categories had Kappa statistics greater than .80, with the exception of the activity initiator category. Interobserver agreement scores were 96% or greater. The OSRAC-E was shown to be a reliable observation system that allows researchers to assess physical activity behaviors, the contexts of those behaviors, and the effectiveness of physical activity interventions in the school environment. Conclusion: The OSRAC--E can yield data with high interobserver reliability and provide relatively extensive contextual information about the physical activity of students in elementary schools.

Background: The prevalence of childhood obesity is higher in economically and socially deprived areas. Higher levels of physical activity reduce the risk of excessive weight gain in youth, and research has focused on environmental factors associated with children's physical activity, though the term "physical activity desert" has not come into wide use. Methods: This exploratory study operationalized the term "physical activity desert" and tested the hypothesis that children living in physical activity deserts would be less physically active than children who do not. A cross-sectional study design was applied with 992 fifth-grade students who had provided objectively measured physical activity data. Five of 12 possible elements of the built environment were selected as descriptors of physical activity deserts, including no commercial facilities, no parks, low play spaces, no cohesion, and the presence of incivilities. Results: Univariate and multivariate analyses showed that only the absence of parks was associated with less physical activity in children. Conclusion: Children living in a "no park" zone were less active than their counterparts who lived near a park. This study contributes preliminary conceptual and operational definitions of "physical activity desert." Future studies of physical activity deserts should be undertaken in larger and more diverse samples. [ABSTRACT FROM AUTHOR]

Background: Little is known about the influence of Montessori methods on children's physical activity (PA). This cross-sectional study compared PA of children attending Montessori and traditional preschools. Methods: We enrolled 301 children in 9 Montessori and 8 traditional preschools in Columbia, South Carolina. PA was measured by accelerometry on weekdays during preschool (In-School), non-school (Non-School), and all day (All Day). Minutes/hour of light, moderate-to-vigorous (MVPA), and total PA (light?+?MVPA) were calculated. Results: Children attending Montessori preschools accumulated more In-School light (7.7 vs. 6.5?minute/hour), MVPA (7.7 versus 6.5?minute/hour), and total PA (15.4 versus 13.0?minute/hour) than children attending traditional preschools, after adjusting for sex, race/ethnicity, body mass index, parent education and neighborhood poverty index. For Non-School (8.5 versus 6.2?minute/hour) and All Day (8.5 versus 7.6?minute/hour), children in Montessori preschools accumulated more MVPA than children in traditional preschools. In-School PA was higher for children in private Montessori than public Montessori preschools (8.1 versus 7.0?minute/hour; 8.1 versus 6.7?minute/hour; 16.1 versus 13.6?minute/hour, for light, MVPA, and total PA, respectively). Conclusions: Children attending Montessori preschools were more active than children attending traditional preschools. Adopting the Montessori system may be an important strategy for promoting PA in children.

Background: Interventions promoting physical activity (PA) in youth have had limited success, in part because studies with methodological challenges have yielded an incomplete understanding of personal, social, and environmental influences on PA. This study described changes in these factors for subgroups of youth with initially high PA that decreased (Active-Decline) compared with children with initially low PA that decreased (Inactive-Decline) from fifth to ninth grades. Methods: Observational, prospective cohort design. Participants (n = 625) were fifth-grade children recruited in 2 school districts and followed from elementary to high school. Students and their parents responded to questionnaires to assess personal, social, and perceived physical environmental factors in the fifth (mean age = 10.5 [.5] y) and ninth (mean age = 14.7 [.6] y) grades. Analyses included a mixed-model 2-way repeated analysis of variances. Results: Children in the Active-Decline compared with those in the Inactive-Decline group showed a more favorable profile in 6 of 8 personal variables (perceived barriers, self-efficacy, selfschema, enjoyment, competence, and fitness motives) and 4 of 6 social variables (friend support, parent encouragement, parent support, and parent-reported support). Conclusions: The results suggest efforts to promote PA should target selected personal, social, and perceived environmental factors beginning before age 10 and continuing through adolescence. [ABSTRACT FROM AUTHOR]

Background: Physical activity (PA) provides important health benefits to children, and a large percentage of children's PA occurs at home. The purpose of this study was to examine the associations between psychosocial, home, and neighborhood environmental factors and children's reported PA at home and in the neighborhood, during the transition from elementary to high school. Methods: A total of 555 participants (44% boys) were recruited in grade 5 and followed through grades 6, 7, and 9. Children self-reported PA in 3 locations--at home, in the neighborhood, and on the street. Children reported parent support and neighborhood environment, parents reported PA equipment, and a windshield survey assessed incivilities and outside PA equipment. Longitudinal Poisson models evaluated the relationships between environmental variables and 3 self-reported PA variables, adjusting for gender, race/ethnicity, and parent education. Results: Parent support and PA equipment were significant positive predictors of home PA. Child's perceived environment (positive) and incivilities (negative) were significant predictors of neighborhood PA. Parental support, perceived environment, and outside PA equipment were positive significant predictors of street PA. Conclusions: This study supports the need for both family and community/neighborhood PA interventions that encourage parents to support child PA and for communities to reduce incivilities. [ABSTRACT FROM AUTHOR]

Background A large body of research has established an association between parental support for children's physical activity (PA) and children's PA. However, there has been little attention to the relative influences of parent and child perceptions of that parental support. Purpose To examine agreement among parent and child perceptions of parent support for PA and whether these perceptions are associated with objectively-measured moderate-to-vigorous physical activity (MVPA) among those children. Methods Cross-sectional associations between PA of children measured via accelerometers and child-reported and mother-reported perceptions of parental support for children's PA were assessed via mixed-model regression analyses in a cohort of 693 5th graders. Results Children's perceptions of parental support for PA were consistent with those of their mothers. Nonetheless, in models that included both children's and mothers' perceptions of parental support for PA, mothers' perceptions, but not children's perceptions, were significantly associated with children's PA. Associations were consistent for Total MVPA, After School MVPA, and Evening MVPA, with stronger associations among males than among females. Conclusion Maternal support may influence children's PA. Studies which consider only children's accounts of parental support may overlook important mechanisms., Author(s): Melinda Forthofer[sup.1] , Marsha Dowda[sup.2] , Kerry McIver[sup.2] , Daheia J. Barr-Anderson[sup.3] , Russell Pate[sup.2] Author Affiliations: (1) Department of Epidemiology and Biostatistics, Arnold School of Public Health, University [...]

The purpose of this study was to develop a valid and reliable tool for use in assessing motor skills in preschool children in field-based settings. The development of the Children's Activity and Movement in Preschool Study Motor Skills Protocol included evidence of its reliability and validity for use in field-based environments as part of large epidemiological studies. Following pilot work, 297 children (3-5 years old) from 22 preschools were tested using the final version of the Children's Activity and Movement in Preschool Study Motor Skills Protocol and the Test of Gross Motor Development (2nd Edition). Reliability of the Children's Activity and Movement in Preschool Study Motor Skills Protocol and interobserver reliability were determined using intraclass correlation procedures (intraclass correlation coefficients; ANOVA). Concurrent validity was assessed using Pearson correlation coefficients to compare the Children's Activity and Movement in Preschool Study Motor Skills Protocol to the original Test of Gross Motor Development (2nd Edition). Results indicated that test reliability, interobserver reliability, and validity coefficients were all high, generally above R/r = 0.90. Significant age differences were found. Outcomes indicate that the Children's Activity and Movement in Preschool Study Motor Skills Protocol is an appropriate tool for assessing motor development of 3-, 4-, and 5-year-old children in field-based settings that are consistent with large-scale trials. (Contains 6 tables.)