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Background: Communities are wellness landscapes of geospatially and temporally bound settings where children spend their time. Improving population physical activity (PA) requires investigating available community settings for children, such as classrooms and sport teams, and the dynamic social interactions producing PA. This protocol describes a multiscale community wellness landscape monitoring and feedback system of adult-led organized group settings and PA outcomes for children. Methods: The data system assessed organized groups for third- through sixth-grade children in 2 rural communities within seasons (fall 2018–2019). Within each season, groups were identified, sampled, and recruited. Sampled group meetings were assessed for children’s PA (accelerometry) and meeting routines (video observation). A data processing protocol time-segmented data into meetings and meeting routines into smaller units (sessions). A purpose code was assigned to each meeting (eg, classroom, sport) and session (eg, academic, PA). Group accelerometer data were paired with the coded segments. Multiscale metrics (season, meeting, and session) were generated and provided to the communities in tailored reports. Results: A total of 94 groups were recruited, and 73 groups with 1302 participants were included in the data system. Data were collected from 213 meetings and 844 sessions. Most participants (83.1%) consented to link their accelerometer data with demographic data from school enrollment records. Conclusions: The community data system identified available organized group settings for children and collected video and PA data from these settings. Incorporating setting data into local data systems provides detailed accounts of whole-of-community PA social systems to inform population health improvement efforts.

Background Out-of-school time (OST) organized group youth activities (e.g., afterschool programs, clubs) can reduce health inequalities by increasing physical activity (PA). However, unlike youth sport, PA is not the primary focus of many organized activities. This study examined the association between rural children’s demographic factors and OST non-sport organized activity participation and the differences between these factors and PA. Methods During Spring 2019, children (n = 418 3rd − 6th graders, aged 8–12 years) enrolled in two rural Midwestern public schools in the United States completed the Youth Activity Profile (YAP) and supplemental National Survey of Children’s Health 2017–2018 survey questions assessing OST organized activity participation as part of the Wellscapes Project, a type 3 hybrid implementation-effectiveness community randomized trial. A subsample of 235 children (males, n = 117; females, n = 118) provided parental/guardian consent to pair YAP results with student enrollment records. Average OST moderate-to-vigorous PA (MVPA) per weekday and weekend days was estimated using an algorithm converting raw YAP scores into minutes of MVPA. Mixed models with community as a random effect examined main effects and interactions of grade, sex, and family income on OST non-sport organized activity participation and these factors and participation on MVPA. Results Most children (73.2%) participated in an OST non-sport organized activity. Males were less likely to participate in organized activities than females (OR = 0.38, 95% CI = 0.20–0.73, p = 0.004). Females and 6th graders reported lower OST MVPA on weekdays and weekends than comparison groups (p diff = -4.7 ± 2.0 minutes) and weekends (meandiff = -8.9 ± 3.8 minutes) compared with males with higher family income (p ). Conclusions Many rural children participated in OST organized activities regardless of grade and family income. However, there were inequalities in organized activity participation and OST weekday and weekend MVPA by demographic factors, including grade, sex, and family income. Designing OST organized activity settings to include PA may aid in reducing PA inequalities and promoting health equity.

ObjectivesTo examine differences in rural community children’s moderate-to-vigorous physical activity (MVPA) and participation in out-of-school activities from fall 2019 to fall 2020 and explore enacted PA opportunity modifications post initial COVID-19 disruption.DesignMixed methods study using the validated Youth Activity Profile (YAP), administrator reports and stakeholder surveys and semistructured interviews.SettingChildren and community stakeholders from one rural US Great Plains community in the state of Nebraska were recruited.ParticipantsThird through fifth graders in fall 2019 (n=144) and fall 2020 (n=174) reported MVPA and participation in out-of-school activities using the YAP. School administrators reported weekly physical education (PE) and recess minutes. Community stakeholders reported pandemic-related changes in community social structures in semistructured interviews (n=4) and surveys (n=19).ResultsAverage daily MVPA minutes increased from 2019 to 2020 (75.0 vs 81.3, SE=1.6, pConclusionsIncreased minutes of PE and recess, and decreased out-of-school activity participation may have increased children’s overall free play and MVPA during the pandemic. Free play was an important contributor to children’s PA during the pandemic and should be prioritised by educators, coaches and other leaders of child PA opportunities.Trial registration numberNCT03380143.

Study of Health and Activity in Preschool Environments (SHAPES) aimed to increase preschoolers' physical activity by engaging preschool teachers in professional development designed to modify instructional practices. SHAPES originated as a randomized controlled trial, tested in 16 preschools and disseminated to 4 control schools, and was shown to be effective in increasing preschool children's physical activity (Phase I, 2008-2012). This article describes the steps taken to translate an evidence-based physical activity intervention, SHAPES, from in-person delivery to online delivery of professional development to preschool teachers. In Phase II (2013-2016), professional development delivery was modified from an in-person to an online program for preschool teachers. Teacher implementation completeness and fidelity were examined in 10 pilot preschools and then replicated in 30 preschools. Large-scale dissemination of SHAPES began in Phase III (2017-2019), reaching 818 teachers from 228 unique centers after 2 years. The final SHAPES program consisted of six online modules, an accompanying guidebook, over 90 activities, self-assessment techniques, a video library, and an electronic community forum. The SHAPES core elements, defined in Phase I, were retained throughout all three phases. The Phase II change to online delivery was characterized by high levels of implementation completeness and fidelity. Results of Phase III statewide dissemination revealed comparable implementation completeness and fidelity. An intervention shown to be effective in a randomized controlled trial can be translated into an online professional development program and disseminated on a large scale in a timely manner.

Background Physical activity, a high-frequency health behavior, varies by where children live, learn, and play. Children accumulate physical activity in adult-led in-school and out-of-school settings. Youth sport is a potential setting for physical activity, but there are differences in youth sport participation based on age, sex, and socioeconomic status. There is a gap in understanding demographic influences on youth sport participation and how these factors interact to influence physical activity. This study examines influences of grade, sex, and family income on youth sport participation and these factors and youth sport participation on moderate-to-vigorous physical activity of children in rural communities. Methods Children (n = 418 3rd–6th graders) living in two rural communities completed the online Youth Activity Profile as part of Wellscapes, a type 3 hybrid implementation-effectiveness community randomized trial. Mixed models with community as a random effect examined main effects and interactions of grade, sex, and family income on youth sport participation and these factors and youth sport participation on moderate-to-vigorous physical activity. Results About 80% of children engaged in youth sport, and full-pay lunch students were almost four times more likely to have youth sport participation than students with free/reduced lunch (OR = 3.91, 95% CI = 1.95, 7.8). Females and 6th graders (p p Conclusions While a fairly high percentage of children participate in youth sports, there are disparities in rural communities on youth sport participation and physical activity outcomes based on age, sex, and family income.

BackgroundPhysical activity, a high-frequency health behavior, varies by where youth live, learn, and play. Youth accumulate physical activity in adult-led in-school and out-of-school settings. Youth sport is a potential setting for physical activity, but there are differences in youth sport participation based on age, gender, and socioeconomic status. There is a gap in understanding demographic influences on youth sport participation and how these factors interact to influence physical activity. This case study examines influences of grade, gender, and family income on youth sport participation and these factors and youth sport participation on moderate-to-vigorous physical activity of youth in rural communities.MethodsYouth (n=418 3rd–6th graders) living in two rural communities completed the online Youth Activity Profile as part of Wellscapes, a type 3 hybrid implementation-effectiveness community randomized trial. Mixed models with community as a random effect examined main effects and interactions of grade, gender, and family income on youth sport participation and these factors and youth sport participation on moderate-to-vigorous physical activity. ResultsAbout 80% of youth engaged in youth sport, and full pay lunch students were almost four times more likely to have youth sport participation than students with free/reduced lunch (OR = 3.91, 95% CI = 1.95, 7.8). Females and 6th graders (p th graders, high family income had less effect on physical activity than similar 3rd-5th graders (p

Purpose The purpose of this study was to describe associations between physical and social environmental features of preschools and physical activity behaviors of young children with developmental disabilities. Methods A sample of 34 preschool-age children (mean age, 4.28 ± 1.07; male, 64.7%) with developmental disabilities participated in this study. Physical activity and preschool environmental factors were measured through direct observation using the Observational System for Recording Physical Activity in Children-Developmental Disabilities version. Children were observed approximately eight times over the course of a week, yielding a total of 11, 310 observation intervals. The number of intervals and percentage of time spent in physical activity across environmental contexts were calculated. Logistic regression analyses were conducted to determine associations between time spent in physical activity and features of the physical and social environment. Results Children with disabilities were sedentary for most of the observed intervals (81.5%). Children were 4.8 times (confidence interval (CI), 4.25-5.50) more likely to be physically active while outdoors compared with indoors. Physical activity was more likely to occur in open spaces (odds ratio [OR], 3.3; CI, 2.59-4.19) and when using portable play equipment (OR, 2.7; CI, 1.31-5.64) compared with fixed playground equipment. While indoors, children in this study were 5.6 times (CI, 3.78-8.03) more likely to be active when in therapy compared with group time activities. Physical activity was more likely to occur when in solitary (OR, 3.4; CI, 2.87-4.10) or one-on-one group contexts (OR, 1.7-2.9) compared with in groups with an adult present. Conclusions Certain features of the preschool setting, such as location and social group composition, were more conducive to physical activity than others. Children with disabilities would benefit from more time outdoors and in smaller group settings during preschool.

Purpose: To determine if weight status modifies the relationship between motor skill (MS) performance and physical activity (PA) in preschoolers. Methods: Preschoolers (N = 227, age 3–5 y) were recruited from 22 preschools. Preschoolers’ MS (locomotor, object control, and total MS) were assessed with the Children’s Activity and Movement in Preschool Study MS protocol. PA was measured by accelerometry. Mixed linear models were used to examine the relationship of MS performance and body mass index (BMI) z score to PA. Models were adjusted for age, race, sex, and parent education, with preschool as a random effect. Results: There was a significant correlation between MS performance and PA (r = .14–.17, P z score and object control, and between BMI z score and total MS score on PA (P = .03). Preschoolers with higher BMI z scores and high object control scores engaged in significantly (P = .03) more PA than preschoolers with lower BMI z scores and high object control scores (PA = 15.04 min/h and 13.54 min/h, respectively). Similarly, preschoolers with higher BMI z scores and high total MS scores spent significantly (P = .01) more time in PA compared with those with lower BMI z scores and high total MS scores (PA = 15.65 min/h and 13.91 min/h, respectively). Conclusion: Preschool children’s MS performance is positively correlated with PA, and BMI z score modified the relationship between MS performance and PA.

Supplemental digital content is available in the text., Purpose Physical activity (PA) promotion among youth is a public health priority, and there is a need for robust surveillance systems to help support such initiatives. Existing youth PA self-report instruments that are used for surveillance lack information regarding the types and contexts of activity. Further, these instruments have limited validity with accelerometry. The purpose of the present study was to develop a self-report instrument, with sound psychometric properties, for monitoring compliance with PA guidelines in youth. Methods In focus groups, 162 middle school students identified 30 forms of PA that are highly prevalent in that age-group. We incorporated these activities into three preliminary forms of a self-report instrument. An independent sample of middle school students (n = 537) was randomly assigned to complete one of the three preliminary versions of the instrument. Rasch analysis was applied to the responses to the three formats, and a yes/no plus frequency format emerged as the preferred method. A third sample of 342 middle school students then completed the yes/no plus frequency instrument twice after a 7-d period during which they wore an accelerometer. Using both Rasch analysis and traditional correlational methods, validity and reliability of a 14-item instrument were established. Data were collected during 2012–2015. Results Spearman correlation coefficient for the association between the cumulative score for the 14 items and minutes per day of accelerometry-derived moderate-to-vigorous physical activity was 0.33 (95% confidence interval = 0.22–0.43, P < 0.001). The sensitivity and specificity values of the 14-item instrument were 0.90 and 0.44, respectively. Conclusions The study produced a PA self-report instrument for youth that was found to be reliable (r = 0.91), valid versus accelerometry (r = 0.33), and with acceptable specificity and sensitivity in detecting compliance with PA guidelines.

Purpose Youth physical activity (PA) levels differ by race/ethnicity and socioeconomic status (SES). It is well established that various multilevel factors may influence changes in PA. The present study examined whether the association between the change in individual, interpersonal, and environmental factors and the change in PA is modified by race/ethnicity or SES. Methods This study followed 643 youths and their parents from suburban and rural South Carolina participating in the Transitions and Activity Changes in Kids (TRACK) Study in 2008–2009 and 2010–2011. We assessed total PA in youth using accelerometry and categorized youth and parent survey data into blocks based on the socioecological model. Multivariate regression growth curve models evaluated whether the association between change in independent variables and change in PA was modified by race/ethnicity or SES. Results PA declined from fifth to seventh grade among all racial/ethnic and SES groups. Associations between the range of variables and change in PA were modified by race/ethnicity but not SES. Blacks did not share any common predictors of change in PA with whites or Hispanics. However, child-reported number of active friends was associated with total PA, and enjoyment of PA was associated with change in PA among both whites and Hispanics. Significant interactions by time varied by racial/ethnic group. Conclusions The factors that influence changes in youth PA vary by race/ethnicity but not SES. These findings reinforce the complex nature of addressing PA behavior in diverse samples and further support the need for culturally appropriate interventions to promote PA in youth.

Background Early childhood education programs provide a setting to reach children and parents to modify home environments to prevent obesity. The Healthy Opportunities for Physical Activity and Nutrition Home (HOP’N) Home project was a novel approach that linked Family Child Care Homes (FCCH) to home environments by developing children’s asking skills for healthful home environmental change through curricular activities. Objective To evaluate the feasibility of engaging parents in obesity prevention practices through building children's asking skills at FCCH. Methods FCCHs (n = 5 settings) and children (n = 25; aged 3−5 years; female = 36 %; non-Hispanic white = 91 %; low socioeconomic status = 28 %; overweight/obese = 52 %) and parents (n = 25) participated in a pre-post cohort design. We assessed children's body mass index and self-report variables at three time points. HOP'N Home included continuous staff training, group time, dramatic play, meal prompts, songs, and home activities. Results FCCH providers implemented 83%–100% of intervention activities. All parents (100 %) adopted the program, most (87 %) returned completed homework activities to FCCHs, and over 90 % implemented changes in the home. Percent of overweight/obese children decreased from pre-intervention (50 %) to post-intervention (29 %,p = 0.06) and follow-up (38 %,p = 0.06). Conclusions It is feasible to build children's asking skills and pair this strategy with home activities to engage parents to prevent obesity.

Background Physical activity (PA) behaviors during preschool settings can influence the health and development of children with developmental disabilities (DD). There is a need for a direct observation system that simultaneously assesses PA and preschool environmental contexts. Objective The purpose of this study was to develop an observation instrument for measuring PA and related contextual factors of preschoolers with DD, and to establish content validity and reliability. Methods Content validity was established through consultation with experts, informal observations in inclusive and special education preschools, and literature reviews. Categories and codes were identified and modified from existing observational systems for young children. Reliability was assessed in a convenience sample of preschool children with DD using a cross-sectional design. Data were collected using a momentary time sampling system (5-sec observe, 25-sec record) following a focal child. Inter-rater reliability was assessed during 20% of the observation sessions. Results The instrument development process resulted in ten coding categories that accounted for PA levels, types, and social and physical environmental contexts relevant to preschoolers with disabilities. Observers completed 137.5 observation sessions, yielding 5498 30-s observation intervals. Interval-by-interval percent agreement was excellent (91%–100%) and kappa values were high (0.82–0.99). Conclusions The instrument was found to be a reliable measure of PA of preschoolers with DD and provided important contextual information about PA behaviors in early childhood special education settings. Additionally, it allowed for the simultaneous measurement of specific types and contexts of PA behaviors of preschoolers with DD and will be useful for describing PA and informing future interventions.

Background and purpose Preschool/childcare settings offer a practical target for physical activity interventions. Online learning programs have the potential for greater public health reach and impact. The SHAPES-Dissemination (SHAPES-D) project adapted the original SHAPES in-person intervention for online delivery to teachers. The purpose of this paper is to describe the implementation monitoring and process evaluation for the SHAPES-D project. Methods Nine preschools with 26 classrooms participated. A total of 41 teachers were trained via online learning to implement the SHAPES-D program in their classrooms. The dose received, completeness, and fidelity of implementation were assessed through website metrics, teacher surveys and interviews, and classroom observations. Results Dose received was adequate (73%). Observed completeness and physical activity enjoyment fidelity were high (100%), although moderate-to-vigorous physical activity fidelity and social environment fidelity were low (25% each). Overall implementation was high (91%). Discussion Results indicate that the online method of delivery is viable for dissemination. The online delivery system provides an easy method of monitoring dose received. This may be the first structural intervention to monitor dose received through web metrics. Conclusion The adaptation of an in-person intervention to an online delivery system increases the potential for dissemination of a successful program to increase physical activity in preschool settings.

This pilot study compared sedentary behavior (SB) of children with autism (ASD) to typically developing peers (TD), and evaluated the influence of social contexts within free play (FP) and organized activity settings on SB of children with ASD during an inclusive summer camp. Participants with ASD were matched with TD peers by age and gender, and a modified OSRAC-P was utilized to assess SB and social context by setting. SB did not differ by diagnosis (ASD, TD), setting, or social contexts. In FP, children with ASD spent significantly more time in SB within social contexts compared to solitary contexts. ASD-related social deficits may facilitate SB in children with ASD during summer camp FP social contexts, compared to a solitary context.

Recently the Institute of Medicine (Early childhood obesity prevention policies, Washington, DC, 2011) established a US guideline for preschool children and recommended 15 min or more of total physical activity (i.e., total accumulated light, moderate, and vigorous activity) per hour or 3 h per day assuming 12 h of wake time. Nevertheless, researchers have found that many young children do not meet the proposed guideline in early care and education programs.

Background:Children with Autism Spectrum Disorders (ASD) may be at greater risk for not meeting physical activity (PA) guidelines than neurotypical children (NT). The purpose of this study was to explore setting (free play versus organized) and social group composition influences on PA of children with ASD during summer camp.Methods:Data were collected on 6 ASD and 6 NT boys (aged 5 to 6 years) attending an inclusive summer camp. During free play and organized activity, research assistants observed the camp’s social environment and children’s PA using a modified version of the Observational System for Recording Physical Activity of Children—Preschool version.Results:In free play, children with ASD spent significantly less time in Moderate-Vigorous PA (MVPA) while with a peer (1.2%), compared with a peer group (11.5%) or alone (13.2%). They demonstrated significantly more Light-Moderate-Vigorous PA (LMVPA) while in a solitary social context (68.2%) compared with alone with an adult (25.8%), alone with a peer (34.8%), or with a peer group (28.2%). No significant differences were noted during organized activity.Conclusion:Features of the social environment may influence PA levels of children with ASD. Specifically, certain social group contexts may be more PA-promoting than others depending on the setting.