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Purpose : The purpose of this article was to systematically review studies that explored associations between specific curricular models, as an essential component of physical education, and to assess how the student outcomes identified in the models aligned with the national standards. Methods : Using the PRISMA guidelines to identify, screen, determine eligibility, and include relevant ones, studies were extracted by a search of six databases using terms related to physical education-specific curricular models and student outcome measures. After screening, 23 articles met the inclusion criteria. Results : Students included in these studies ranged from 3 rd -12 th grade, although the majority of studies used students from 3 rd -8 th grade. A total of 58 associations between eight physical education curricular models and student outcomes were assessed, with 41 (70.6%) of those associations being beneficial. Student outcomes included measures of physical activity and fitness, psychosocial variables, classroom behavior, and knowledge. Aligning the national standards to these studies revealed that specific standards were underrepresented compared to others. Conclusions : Results of this systematic review suggest that there is some association between curricular models and student outcomes, although results reported for specific student populations, particularly K-2 nd grade, were lacking. Furthermore, specific student outcomes related to the national standards were underrepresented compared to others. Researchers should take a standards-based approach when deciding which student outcomes to measure and should further explore the associations between curricular models and student outcomes across grade levels.

Appropriate assessment practices are recognized as a critical part of the learning process and represent a key component of quality physical education. Recent shifts in school reform efforts toward more accountability in the United States and an emerging emphasis on student-centered approaches challenge historical approaches to assessment. Purpose : Therefore, the purpose of this review was to (a) identify research conducted on physical education teachers' assessment practices during the years 2000-2020, (b) determine the impact of assessment practices on student outcomes, and (c) describe research that explores factors associated with the SHAPE America guidelines for appropriate assessment practices. Method : The Preferred Reporting Items for Systematic Reviews extension for Scoping Reviews (PRISMA-Sc) Checklist guided this review. All related empirical, peer-reviewed, English-language studies conducted in U.S. schools and published since January 1, 2000 qualified for inclusion. Results : A total of 17 articles met the inclusion criteria for this review. Most used non-experimental methods and were conducted in the secondary (grades 6-12) physical education context. Limited studies examined the relationship between assessment practices and learning outcomes. Recommendations for future research are provided based on the results. Conclusions : A diverse body of studies provides valuable, yet limited evidence related to teacher assessment practices. Systematic research is needed to better understand the impact of teacher assessment practices on student outcomes and to build a stronger foundation for evidence-based recommendations for practice.

Appropriate instruction is a key component of quality physical education, which aligns student learning activities with grade-level learning outcomes. Historically, in the 1980s and late 1990s, an abundance of research was conducted to empirically link teacher effectiveness to student learning outcomes. In recent years, however, limited research has been published. Purpose : The purpose of this study was to: (a) identify research studies examining appropriate instructional practice in K-12 physical education since 2000, (b) describe the study characteristics and summarize the findings, (c) compare research to the SHAPE America's guidelines for appropriate instruction, and (d) make recommendations for future research. Methods : This study was conducted using the Preferred Reporting Items for Systematic Reviews (PRISMA) standards of quality for reporting meta-analyses. A systematic search of five electronic databases was conducted. Two reviewers retrieved articles, assessed risk of bias, and performed data extraction. The findings were synthesized using a descriptive analysis. Results : A total of 37 articles met the inclusion criteria. A thematic analysis was conducted to reduce the included articles into four themes that influenced student outcomes: (1) student engagement and participation, (2) motivation, (3) student learning, and (4) physical activity and fitness. Conclusions : This review of the literature provides evidence of the benefits of effective teaching practices and suggests that future studies in instruction should focus on teacher effectiveness and its relation to student learning outcomes. Recommendations and future directions are discussed.

The conceptual physical education (CPE) innovation began in the mid-20th century as an alternative approach to college-level, activity-only basic instruction classes. In addition to physical activity sessions, CPE courses (classes) use text material and classroom sessions to teach kinesiology concepts and principles of health-related fitness and health-enhancing physical activity. CPE courses are now offered in nearly all college programs as either required or electives classes. Two decades later, the high school CPE innovation began, and Kindergarten-8 programs followed. In this commentary, I argue that historian Roberta Park was correct in her assessment that physical education has the potential to be the renaissance field of the 21st century. Scientific contributions of researchers in kinesiology will lead the way, but science-based CPE and companion fitness education programs that align with physical education content standards and fitness education benchmarks will play a significant role. CPE courses have been shown to be effective in promoting knowledge, attitudes, and out-of-school physical activity and have the potential to elevate physical education as we chart the course of our future., (Copyright © 2021. Production and hosting by Elsevier B.V.)

Background: The aim of the study was to evaluate the effects of intermittent hypoxic training (IHT) on anaerobic and aerobic fitness in elite, national boxers., Methods: The study was conducted over a period of 6 weeks. It comprised 30 national championship boxers, divided into 2 groups: the experimental and control. Both groups performed the same boxing training twice a day (morning and afternoon training). In the afternoon, the experimental group performed training under normobaric conditions in a hypoxic chamber (IHT), while the control group undertook exercise in standard normoxic conditions. In both groups, before and after the 6-week programme, basic anthropometric indices as well as anaerobic (Wingate Test) and aerobic (graded test) fitness were assessed., Results: There was a significant increase in anaerobic peak power (988.2 vs. 1011.8 W), mean anaerobic power (741.1 vs. 764.8 W), total work (22.84 vs. 22.39 kJ), and a decrease in fatigue index (20.33 vs. 18.6 W·s -1 ) as well as time to peak power (5.01 vs. 4.72 s). Such changes were not observed in the control group. In both groups, no significant changes in endurance performance were noted after the training session - peak oxygen uptake did not significantly vary after IHT., Conclusions: Our results have practical application for coaches, as the IHT seems to be effective in improving anaerobic performance among boxers.

Participating in outdoor sports in blue spaces is recognized to produce a range of significant social benefits. This case study empirically analyzes the social benefits associated with the School Nautical Activities project carried out in Viana do Castelo (Portugal) in school-age children and adolescents. It consisted of a 4 year program in which scholars took part in nautical activities (surfing, rowing, sailing, and canoeing) in blue spaces once a week during a semester as a part of their physical education course. The methods used for data collection were as follows: (1) a survey answered by 595 participants in the program and (2) five focus groups (FG): two FGs with participants (seven on each FG), two FGs with their parents (eight participants each), and one FG with the physical education teachers (five participants). Interviews were transcribed and qualitative analysis with NVivo software was developed. Results revealed clear evidence on the social benefits for school-age children and adolescents associated with participation in outdoor activities in blue spaces both in the overall health and in all the following analyzed categories: mental health and well-being, education, active citizenship, social behavior, and environmental awareness. More than 40% state that their overall health is much better now (13.4%) or somewhat better now (29.9%) due to their participation in the program. Thus, this article provides support for the anecdotal recognition of the benefits for school-age children and adolescents from participating in sports in the outdoors and especially in blue spaces.

Objective: The aim of this study was to investigate the association between preschool playground size, formalized physical activity (PA) policies, time spent outdoors and preschool teacher's levels of PA and children's objectively assessed levels of PA and sedentary time (ST) during preschool hours., Methods: In total, 369 children and 84 preschool teachers from 27 preschools in Södermalm municipally, Stockholm Sweden wore an Actigraph GT3X+ accelerometer during 7 consecutive days. Preschool environmental and structural characteristics were measured via the Environment and Policy Evaluation Self-Report (EPAO-SR) instrument and time in- and outdoors was recorded by preschool teachers during the PA measurements. Weight and height of children were measured via validated scales and parents filled out a questionnaire on demographical and descriptive variables. Linear mixed models, nested on preschool level, were used to assess the association between predictors and outcomes., Results: The mean child age was 4.7 years (SD 0.8) and 45% were girls. We found that children were more active in preschools with a formalized PA policy, compared to preschools without such a policy, but not less sedentary. The association between policy and activity seemed to be more pronounced when accounting for other environmental factors. Similar associations were found in children spent most time outdoors (uppermost quartile) compared with children spent least time outdoors (Lowermost quartile). Preschool teachers' light PA (LPA) (ß = 0.25, P = 0.004) and steps (ß = 0.52, P<0.001) were associated with children's LPA and steps while the preschool playground size showed no association with PA in children, when accounting for other environmental factors., Conclusion: The current study showed that preschool structural characteristics such as formalized PA policies and more time spent outdoors were positively associated with children's PA. These findings suggest that formalized PA policies and time outdoors may be of importance for promoting children's PA during preschool hours., Competing Interests: Lindhés Advokatbyrå has no competing interest in terms of its ownership of stocks, employment or consultancy, board membership, patent applications (pending or actual), research grants, travel grants or gifts. Receiving funding from Lindhés Advokatbyrå does not alter our adherence to all PLOS ONE policies on sharing data and materials.

Group-exercise instructors are a vital social determinant of exercise enjoyment, attendance, and adherence. Instructors also affect the degree to which physical cultures are socially inclusive. In order to elucidate the roles that instructors play in affecting these outcomes, we conducted a scoping review. Scoping reviews are a preliminary method for assessing the breadth and depth of existing literature in order to identify key themes and gaps therein. Based on Arksey and O'Malley's (2005) framework, we identified 52 articles and book chapters, 33 of which were older-adult specific, using a university search engine that simultaneously searches multiple databases. We conceptually mapped the literature, which revealed instructors' vital roles as: (1) constructors of group social cohesion, (2) cultural intermediaries, (3) competent practitioners, (4) leaders and communicators, and (5) educators. Of these, the instructor's educative role lacks empirical attention. We conclude with implications for future research, practice, and policy.

Context: Athletic trainers (ATs) are heavily involved in concussion assessment and return-to-play (RTP) decision making. Despite ATs' crucial role, few researchers have directly examined ATs' knowledge of concussions or whether concussion knowledge or clinical experience affects clinical concussion-management practices., Objective: To determine the overall concussion knowledge of ATs and whether concussion knowledge and clinical experience affect concussion-assessment and -management practices., Design: Cross-sectional study., Setting: Online survey., Patients or Other Participants: Random convenience sample of 8725 (15.0% response rate [1307/8725]; certified, 14.8 ± 10.6 years) ATs surveyed from the National Athletic Trainers' Association membership., Main Outcome Measure(s): The survey collected demographics, concussion-assessment and -management tools used, and concussion knowledge (patient-clinician scenarios, signs and symptoms recognition). We used multiple logistic regression models to determine the odds ratios (ORs) for using assessment and management tools based on signs and symptoms recognition and years of clinical experience., Results: The ATs correctly identified 78.0% ± 15.1% of concussion signs and symptoms. Approximately 46% (357/770) of ATs indicated an athlete could RTP if the athlete stated he or she had a "bell rung." Every additional year of clinical experience decreased the odds of using standardized sideline-assessment tools by 3% (OR = 0.97, 95% Confidence Interval [CI] = 0.95, 0.99). The odds of using standardized sideline tools (OR = 0.98, 95% CI = 0.96, 0.99) and symptom checklists (OR = 0.98, 95% CI = 0.97, 0.99) for RTP assessment were significantly decreased for each additional year of clinical experience. No other tools used for RTP assessment were influenced by signs and symptoms recognition (P ≥ .136) or clinical experience (P ≥ .158)., Conclusions: The ATs with greater clinical experience had lower odds of using concussion-assessment and -management tools. Athletic trainers should frequently review and implement current consensus guidelines into clinical practice to improve concussion recognition and prevent improper management., (© by the National Athletic Trainers' Association, Inc.)

Resistance training is becoming more important as an integral part of comprehensive sport training regimens, school physical education classes, and after-school fitness programs. The increasing number of youth who are involved in sport activities, coupled with the health problems of inactivity and being overweight, have resulted in increased interest in resistance training. Secular declines in measures of muscular fitness in modern-day youth highlight the need for participation in youth resistance training for nonathletes as well as athletes. Parents often ask pediatricians to offer advice regarding the safety, benefits, and implementation of an effective resistance-training program. This report is a revision of the 2008 American Academy of Pediatrics policy statement and reviews current information and research on the benefits and risks of resistance training for children and adolescents., Competing Interests: POTENTIAL CONFLICT OF INTEREST: The authors have indicated they have no potential conflicts of interest to disclose., (Copyright © 2020 by the American Academy of Pediatrics.)

Context: Postconcussion, student-athletes should return to the classroom using a gradual, stepwise process to ensure that symptoms are not exacerbated by cognitive activities. The National Collegiate Athletic Association (NCAA) has mandated that its affiliated institutions develop return-to-learn (RTL) policies to support the return to the classroom., Objective: To investigate athletic trainers' (ATs') perceptions of their role in the RTL policy development and implementation at NCAA Division II and III institutions., Design: Qualitative study., Setting: Individual phone interviews., Patients or Other Participants: Fifteen ATs (age = 40 ± 11 years, clinical practice experience = 16 ± 9 years, employment term = 9 ± 9 years) representing NCAA Division II (n = 6) or III (n = 9) institutions., Data Collection and Analysis: Interviews were transcribed verbatim and checked for accuracy by the principal investigator. A 2-member data-analysis team independently coded a portion of the transcripts and then met to discuss the codebook. The codebook was applied to the remaining transcripts, confirmed, and externally reviewed., Results: Five themes emerged: (1) approach, (2) collaborative practice, (3) patient advocacy, (4) institutional autonomy, and (5) barriers. Policies must allow for an individualized, evidence-based approach through facilitated, active communication among members of the RTL team and the student-athlete. Collaborative practice was described as key to successful policy implementation and should include interprofessional collaboration beyond health care providers (eg, educating academicians about the purpose of RTL). The RTL process was triggered by a specific member of the RTL team, usually a medical doctor or the head AT. Participants noted that the purpose of the RTL policy was to advocate for the student-athlete's successful postconcussion outcomes., Conclusions: For the development and implementation of a successful RTL policy, strong communication and interprofessional practice must extend beyond health care professionals. Members of the health care team must establish a network with academic partners to develop a policy that is appropriate for the institution's available resources and the needs of its student-athletes.

Background: Despite the importance of assessing patient outcomes during patient care, current evidence suggests relatively limited use of patient-reported outcome measures (PROMs) by athletic trainers (ATs). Major barriers to PROM use include lack of knowledge, navigating the intricate process of assessing a wide variety of PROMs, and selecting the most appropriate PROM to use for care. A concise resource for ATs to consult when selecting and implementing PROMs may help facilitate the use of PROMs in athletic health care., Objective: To review the instrument essentials and clinical utility of PROMs used by ATs., Methods: We studied 11 lower extremity region-specific, 10 upper extremity region-specific, 6 generic, and 3 single-item PROMs based on the endorsement of at least 10% of ATs who use PROMs, as reported in a recent investigation of PROM use in athletic training. A literature search was conducted for each included PROM that focused on identifying and extracting components of the instrument essentials (ie, instrument development, reliability, validity, responsiveness and interpretability, and precision) and clinical utility (ie, acceptability, feasibility, and appropriateness). Through independent review and group consensus, we also classified each PROM question by International Classification of Functioning, Disability and Health domain and health-related quality-of-life dimensions., Key Findings: The PROMs contained in this report generally possessed appropriate instrument essentials and clinical utility. Moreover, the PROMs generally emphasized body structure and function as well as the physical functioning of the patient. Athletic trainers aiming to assess patients via a whole-person approach may benefit from combining different PROMs for use in patient care to ensure broader attention to disablement health domains and health-related quality-of-life dimensions.

Physical education (PE) is a frequent site of public health intervention to promote physical activity (PA); however, intervention research frequently overlooks the perspective of PE teachers. The purpose of this qualitative study was to explore teachers' experiences with and perceptions of a PA curriculum intervention. Six findings within three categories were identified and described in detail. In-depth one-on-one semistructured interviews were conducted with nine PE teachers from eight middle schools in Los Angeles. Feeling underappreciated and having a "muddled mission" within PE were driving factors in teacher morale and practice. Teachers had positive experiences with the curriculum, but significant barriers remained and limited the potential for PA during PE classes. PE teachers are pulled in multiple directions and perceive a lack of necessary support systems to achieve student health goals. Interventions aimed at leveraging PE as a site of PA promotion must incorporate the perspectives of PE teachers.

One of the main goals for physical education is to develop the students' moral and ethical domain, where sportsmanship promotion is considered a key curricular component to tackle the achievement of this goal. This research aims to examine the influence of sport education on sportsmanship orientations in high school students. The participants were 148 (52.70% female; M age = 17.04, SD age = 0.99) high school students who were randomized into an experimental group ( n = 74), which received 16 basketball lessons under sport education conditions, and a control group ( n = 74), which received 16 basketball lessons following a traditional teaching approach. Pre-intervention and post-intervention measures on sportsmanship orientations were collected in both groups. A 2 (time: pre-test and post-test) x 2 (group: Sport Education and Traditional Teaching) multivariate analysis of variance test was performed on the five sportsmanship orientations. The results showed, for time x group interactions, the absence of significant multivariate effects in the level of the five sportsmanship orientations among both groups at pre-test (Pillai's trace = 0.06, p = 0.145). At post-test, significant multivariate effects were found in the level of each sportsmanship orientation between both groups in favor of the Sport Education group (Pillai's trace = 0.38, p < 0.001). Furthermore, regarding within-group pre-test to post-test differences, while there were nonsignificant multivariate effects (Pillai's trace = 0.03, p = 0.469) for the Traditional Teaching group; significant multivariate effects (Pillai's trace = 0.43, p < 0.001) were found for the Sport Education group, showing an increase in the level of respect for social conventions, respect for rules and referees, and full commitment and respect for opponents. There were also nonsignificant effects across gender (inter-group analysis: Pillai's trace = 0.08, p = 0.068; time x gender interaction: Pillai's trace = 0.03, p = 0.497) and after-school sports (inter-group analysis: Pillai's trace = 0.02, p = 0.776; time x after-school interaction: Pillai's trace = 0.01, p = 0.981). In conclusion, sport education is an effective pedagogical model to be taken into consideration by physical education teachers in order to optimally promote the high school student's moral and ethical education via the development of sportsmanship orientations in the context of school physical education., Competing Interests: The authors declare no conflict of interest.

Physical education (PE), by its own characteristics, is a subject where social communication is especially promoted. However, it is necessary to have tools that evaluate the social behaviour of students during PE classes. For this reason, we propose to validate and adapt the Prosocial and Antisocial Behavior in Sport Scale to the Spanish context of PE classes. The study involved 1081 students aged 12 to 18 (M = 14.83; SD = 1.27). The psychometric properties of the Prosocial Behavior Scale were analyzed through several statistical analyses. The results of the confirmatory factorial analysis and the exploratory factorial analysis supported the internal structure of the questionnaire. In addition, the scale was invariant to gender. Cronbach's alpha values were higher than 0.70 in the factors and sub-factors, finally showing adequate levels of temporal stability. Taking into account the results achieved in the present study, PE teachers have an effective tool to assess the social and antisocial behaviour of their students' students during PE classes.

Context: Considering recent high-profile reports of malpractice and negligence by National Collegiate Athletic Association (NCAA) athletic trainers (ATs), it is prudent to investigate the psychological mechanisms that may influence ATs' ability to justify unethical behaviors. When treating injured student-athletes, ATs may undergo a cognitive process known as moral disengagement , which involves convincing oneself that ethical standards do not apply in a particular context., Objective: To explore the psychological factors and traits among ATs that may predict moral disengagement pertaining to allowing athletes to play through injuries., Design: Cross-sectional study., Setting: Online survey., Patients or Other Participants: A total of 187 Division I, II, and III ATs from 100 NCAA universities., Main Outcome Measure(s): In addition to the primary outcome variable of moral disengagement, the survey captured the AT's demographic background, sport and athletic training histories, and measures of sport ethic, contesting orientations, commitment, and social identity., Results: Cluster analysis was used to identify homogeneous subgroups of participants based on these variables. A 2-cluster solution emerged, with cluster 1 (n = 94) scoring higher in the sport-ethic and sport-contesting orientations but lower in commitment and social identity compared with cluster 2 (n = 93). An independent-samples t test revealed that moral disengagement was highest ( t 185 = 19.59, P < .001, d = 0.69) among ATs in cluster 1., Conclusions: These findings advance our understanding of the psychological processes that may predict moral disengagement of ATs in allowing student-athletes to play through injury. Although additional research is needed to test whether moral disengagement influences return-to-play decisions, we provide initial evidence that ATs who conform to sport norms (eg, "no pain, no gain") and who tend to view sport competition with a "war-like" orientation are more likely to morally disengage.

Introduction: Primary school-based physical activity interventions, such as The Daily Mile initiative, have the potential to increase children's physical activity levels over time, which is associated with a variety of health benefits. Comparing interventions or combining results of several studies of a single intervention is challenging because previous studies have examined different outcomes or used different measures that are not feasible or relevant for researchers in school settings. The development and implementation of a core outcome set (COS) for primary school-based physical activity interventions would ensure outcomes important to those involved in implementing and evaluating interventions are standardised., Methods and Analysis: Our aim is to develop a COS for studies of school-based physical activity interventions. We will achieve this by undertaking a four-stage process:(1) identify a list of outcomes assessed in studies through a systematic review of international literature; (2) establish domains from these outcomes to produce questionnaire items; (3) prioritise outcomes through a two-stage Delphi survey with four key stakeholder groups (researchers, public health professionals, educators and parents), where stakeholders rate the importance of each outcome on a 9-point Likert scale (consensus that the outcomes should be included in the COS will be determined as 70% or more of all stakeholders scoring the outcome 7%-9% and 15% or less scoring 1 to 3); (4) achieve consensus on a final COS in face-to-face meetings with a sample of stakeholders and primary school children., Ethics and Dissemination: We have received ethical approval from Imperial College London (ref: 19IC5428). The results of this study will be disseminated via conference presentations/public health meetings, peer-reviewed publications and through appropriate media channels., Trial Registration Number: Core Outcome Measures in Effectiveness Trials Initiative (COMET) number: 1322., Competing Interests: Competing interests: SS, BR and KF have received funding from 'The Daily MIle Foundation' supported by INEOS., (© Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Considering the benefits that students report when evaluating physical education classes, the purpose of the present study was to analyse the relationships between the assignment of student responsibility in the evaluation, motivational variables and the satisfaction with the physical education classes, using The Theory of Self-determination as a support method. The sample for this study was 922 students, of both genres and in Compulsory Secondary Education, aged between 14 and 18 years. To carry out the study, the Student's Scale of Responsibility was used in the physical education assessment, the Basic Psychological Needs Measuring Scale, the Percentage Scale for Physical Education Causality and the Satisfaction Scale in Physical Education. The results of the structural equations model revealed a good adjustment to the data. This finding highlights the importance of giving responsibilities to the students in the evaluation process, in order to satisfy the psychological needs of the students and, therefore, self-determined motivation. Additionally, the satisfaction of psychological needs and self-determined motivation increase satisfaction towards physical education classes., Competing Interests: The authors have declared that no competing interests exist.

Obesity and lack of physical activity among children and adolescents are public health problems in the United States. This Presidential Youth Fitness Program (PYFP) evaluation measured program implementation in 13 middle schools and its effect on physical education practices, student fitness knowledge, and student physical activity and fitness levels. PYFP, a free program with the potential to positively affect student health and fitness outcomes, was designed to improve fitness education practices that are easily integrated into existing physical education programs. We used a 2-group (13 PYFP and 13 comparison schools) quasi-experimental design to collect FitnessGram assessments, accelerometry data, and surveys of students, physical education teachers, and administrators. Although the program was positively associated with student cardiovascular endurance and physical activity gains during the semester, schools underused professional development courses and fitness recognition resources.

Objective: We aimed to confirm whether the practice of exergames produces an effect on children's mood states during school physical education (PE) classes. Materials and Methods: The children were allocated to experimental group (EG) and control group (CG). The EG performed exergames during PE classes, and the CG attended regular school PE classes. The Brunel Mood Scale, which evaluates six mood dimensions (tension, mental confusion, anger, vigor, depression, and fatigue), was used to assess the children's moods before (pre) and immediately after the third lesson (acute effect). Results: The practice of exergames during PE classes produced an acute effect on children's moods. The results indicated that playing exergames helped to increase vigor ( P  < 0.01; effect size [ES]: 0.50; confidence interval [CI]: 0.16-0.84) and fatigue ( P  < 0.01; ES: 0.50; CI: 0.16-0.84). Conclusion: Three exergame sessions produced an acute effect and improved children's moods during school PE classes. More research is needed to evaluate the long-term effect of exergames on children and adolescents.

Background: State policies influence the quantity and quality of educational programs delivered in schools. This study examined state physical education policy changes from 2001 to 2016 by analyzing data reported in The Shape of the Nation Report., Methods: Policies related to state mandates for physical education, time/credit requirements, assessment and fitness testing requirements, adoption of state standards, and allowance of substitutions were analyzed over 5 editions of the report using repeated measures statistics., Results: A majority of state physical education-related policies have not changed over the past 15 years despite calls by numerous public health agencies for enhanced physical education in schools. There was, however, a significant increase in the number of states adopting teaching standards and requiring assessment and fitness testing in physical education, mirroring a broader shift in education toward standards, assessment, and accountability., Conclusions: Despite improved rigor in physical education through the adoption of standards and assessment practices, physical education continues to be marginalized in schools by a lack of curricular time and inappropriate substitution policies. Stronger policies are needed for physical education to have a substantial impact on school health., (© 2019, American School Health Association.)

Background: We assessed the extent to which schools in the United States implement physical education policies identified in SHAPE America's Essential Components of Physical Education document and how implementation of these policies varies by school characteristics., Methods: School policy data were collected as part of the 2014 School Health Policies and Practices Study via computer-assisted personal interviews in a nationally representative sample of K-12 schools and were linked to extant data on school characteristics. Bivariate analyses and Poisson regression model were used to examine how physical education policies differed by school characteristics., Results: Five physical education policies varied by region and 3 varied by school level. Requiring certified, licensed, or endorsed physical education teachers varied by all school characteristics except school level and percentage of students eligible for free or reduced-price lunch. The average number of physical education policies implemented by schools was 3.0. The number of policies varied by metropolitan status and school level., Conclusions: The findings suggest many schools are only implementing a few of the physical education policies that can strengthen their physical education programs. These findings can be used to target professional development and technical assistance for physical education practitioners on policy and implementation., (© 2019, American School Health Association.)

Introduction: Concussions are a commonly reported injury in youth and high school sports and much of the responsibility related to concussion identification and response for young athletes is allocated to sports coaches. This paper presents findings on concussion-related education, access to resources, experiences, and attitudes among a large number of youth and high school sports coaches across a variety of sports nationwide., Methodology: Data were collected among coaches who completed the Centers for Disease Control and Prevention's (CDC) HEADS UP online concussion training pre-test between November 2016 and November 2017. Coaches' concussion-related education, access to resources, experiences, and attitudes were compared by age of athlete coached and level of contact of sport. Medium and large effect sizes were considered of practical significance for interpretation., Results: During the study period, 187,801 youth sports or high school sports coaches completed the CDC HEADS UP online training and corresponding pre-test. Access to previous concussion training significantly varied among respondents by age of athlete coached. For example, 27.4% of coaches of athletes aged 5 and younger had taken previous training compared to 72.9% of coaches of athletes aged 14-18. About one-quarter (27.4%) of all coaches reported ever having had to pull an athlete out of a game because of a possible concussion and 19.5% reported access to an athletic trainer at all games and practices. These variables differed significantly among coaches by age of athletes coached; coaches of older athletes were more likely to report access to an athletic trainer and having had to pull an athlete out of a game compared to coaches of younger athletes. No statistical differences by level of contact were considered to be of practical significance based on effect size., Conclusion: Most coaches in this study report having access to education and hold attitudes consistent with best practices about concussion safety; however, overall access to concussion-related resources is limited. While differences in access to concussion-related education, experience, resources, and attitudes among coaches of varying levels of contact were small, medium to large variations were identified by age of athlete coached. Practical applications: Coaches bear an important part of the responsibility to prevent, identify, and manage concussions in young athletes. Tailored educational efforts may assist coaches of young athletes with recognition of concussion signs and symptoms and with feeling comfortable deciding whether an athlete needs to be evaluated for a possible concussion., (Published by Elsevier Ltd.)

Physical education (PE) can improve student health. Schools with credentialed PE teachers receive more PE. However, many schools have reduced PE funding, resulting in fewer teachers and potentially poorer student health. We examined if PE teachers are equally available across school districts, and if availability is associated with higher student cardiorespiratory fitness. We contacted California districts educating students in grades K-6 (n = 894) to determine the number of credentialed elementary PE teachers per district in 2016-17. Public datasets provided demographics and student fitness. Generalized linear models examined associations between district-level demographic characteristics and PE teacher-to-student ratio. Linear regression assessed the relationship between PE teacher-to-student ratio and student fitness. Seventy-five percent of districts (n = 669) responded. On average, there were 0.6 PE teachers for every 500 students, including the half (51%) of districts without elementary PE teachers. Each additional100 students of all racial/ethnic backgrounds in the district was associated with a 0.1% (95% CI -0.2%, -0.1%) decrease in the ratio. Each 10% increase in African American and Latino students was associated with 29% (95% CI -47%, -5%) and 18% (95% CI -31%, -3%) decreases in the ratio, respectively. Each additional PE teacher per 500 students was associated with a 3% increase in aerobically fit students (95% CI 1%, 4%). Elementary PE teachers are lacking in California, particularly in districts with a high proportion of African American and Latino students, which may be contributing to health disparities. Creative action to fund PE should be explored to ensure all students benefit from quality PE., (Copyright © 2019 Elsevier Inc. All rights reserved.)

Background and Objective: Several reviews have summarised studies on secondary school students' moderate-to-vigorous physical activity (MVPA) in physical education (PE), but no systematic review with semiquantitative assessment has been conducted to specifically identify the correlates of their MVPA. This review aims to systematically summarise the existing literature, which investigated correlates of MVPA of secondary school students during their PE lessons., Methods: A systematic search using ERIC, SPORTDiscus, PubMed, PsycINFO, Academic Search Premier, and Web of Science was conducted to identify the correlates of the MVPA of secondary school students in PE. Studies were eligible if they were English published articles and examined the association with MVPA during secondary school PE lessons and cross-sectional and prospective longitudinal quantitative studies. Two reviewers independently examined the articles, assessed their methodological quality, and performed data extraction. The correlates of MVPA were synthesised and further assessed semiquantitatively., Results: Fifty-five studies were identified to correlate with secondary school students' MVPA in PE lessons. Further analysis only included 43 studies (78.2%) that were of medium and high quality by methodological quality assessment. Out of 54 variables identified from these medium and high-quality studies, 11 were consistently associated with the MVPA. Sex (boys), ethnicity (White), class gender (boys-only), PE activities (team games), lesson location (outdoors), expectancy beliefs, subjective task values, and enjoyment were consistently and positively associated with MVPA. Other variables, namely, class gender (girls-only), PE activities (movement activities), and lesson context (knowledge), were consistently and negatively related to MVPA., Conclusions: Interventions focusing on the consistent variables are needed to build active lesson time in PE. This review also provides insights for future research.

Background: Data systems for surveillance and monitoring are essential to develop understanding of the levels of physical activity (PA) occurring at the population levels. To comprehensively understand PA in medical schools, a suitable surveillance tool might be useful to present and monitor key PA-related metrics. This study investigated PA-related metrics in a Thai medical school and summarised the findings using a newly developed tool-the Medical School Physical Activity Report Card (MSPARC)., Methods: A mixed methods study was carried out at three campuses of a medical school in Southern Thailand. Data analysis included descriptive statistics and qualitative reviews. All 285 medical students from a medical school were the target population. The prevalence of PA (≥ 150 min/week of moderate- to vigorous-intensity PA) and sedentary behaviours (SB) (≥ 8 h/day of sedentary time) among medical students were analysed using data from a self-administered questionnaire. Usage patterns, quality, and accessibility of walkable neighbourhoods; bicycle facilities; and recreational areas were assessed. PA promotion programmes, education, and investment related to PA promotion were reviewed from the school documents., Results: Of 279 participants, 138 (49.5%) met PA recommendation, but 71.7% met criteria for SB. Male students were more active (61.8 vs. 42.4%) and less sedentary (65.7 vs. 75.1%) than female students. Bicycle facilities were rated as having the lowest quality and accessibility among PA-related facilities. Most PA promotion programmes were sports clubs and sport competitions. A total of 25 h of PA education was taught throughout the entire curriculum, which provided minimal PA counselling training. The school invested 2136.14 Baht/student/year (US $64.34) in PA promotion, or 2.4% of the annual tuition. The MSPARC presented the summary of the findings by using simple symbols, infographics, and short texts., Conclusions: To increase PA and decrease SB among medical students, there is a need to improve the quality and accessibility of the built environment as well as the natural environment, so as to establish health promoting policies. PA counselling training is required to develop the medical students' essential skills and awareness for future practices. Monitoring and subsequent surveillance of PA in medical school are needed.

Background: Local wellness policies (LWPs) are mandated among school systems to enhance nutrition/physical activity opportunities in schools. Prior research notes disparities in LWP implementation. This study uses mixed methods to examine barriers/enablers to LWP implementation, comparing responses by student body income., Method: Schools ( n = 744, 24 systems) completed an LWP implementation barriers/enablers survey. Semistructured interviews ( n = 20 random subsample) described barriers/enablers. Responses were compared by majority of lower (≥50% free/reduced-price meals; lower income [LI]) versus higher income (HI) student body., Results: In surveys, LI and HI schools identified common barriers (parents/families, federal/state regulations, students, time, funding) and enablers (school system, teachers, food service, physical education curriculum/resources, and staff). Interviews further elucidated how staffing and funding served as enablers for all schools, and provide context for how and why barriers differed by income: time, food service (HI schools), and parents/families (LI schools)., Conclusions: Findings support commonalities in barriers and enablers among all schools, suggesting that regardless of economic context, schools would benefit from additional supports, such as physical education and nutrition education resources integrated into existing curricula, additional funding, and personnel time dedicated to wellness programming. LI schools may benefit from additional funding to support parent and community involvement.

Introduction: In 2014, 60 million youth ages 6-18 participated in some form of generalized athletics. Around 3.5 million children are injured annually participating in organized sport or recreational activities. While sound physical education can decrease the burden of youth sports injuries, the median annual physical education budget of $ 764 for USA elementary, middle, and high schools may not allow enough flexibility to apply evidenced-based guidelines., Evidence Acquisition: The topics were selected after a careful review of the 2016 National Strength and Conditioning Association Position Statement on Long-Term Athletic Development. Articles used to summarize the topics were located by using and cross-referencing sources from this statement. PubMed searches were also conducted using the key words "youth sports injuries," "early sports specialization," "training and maturation," "training versus developmental stage," and "long-term athletic development.", Evidence Synthesis: Youth resistance training has been shown to decrease not only the risk of injury, but also of the development of diabetes and metabolic syndrome. Adequate recovery time also decreases injury risk, and resources such as the RESTQ-Sport are available to help coaches identify stress-recovery imbalances, which can be detected two months before an athlete becomes overreached. Through early detection of overtraining, a significant proportion of overuse injuries can be prevented. Early specialization causes fewer muscle groups to be worked and increased repetition, theoretically increasing the risk of injury and early sport dropout. Prior to puberty, increased neuronal activation and adaptation can be achieved through focusing on agility, balance and coordination, thus taking advantage of increased synaptoplasticity. In these early years, neuronal stimulation is more important than muscle hypertrophy, which plays a greater role in athletic development after puberty., Conclusions: A substantial proportion of youth injuries are preventable. Coaches and physical educators who correctly understand and apply the principles outlined in this review can help youth under their supervision engage in healthy training for sport.

Objectives: The aim of the presented study is to provide age- and gender-related normative values and MQ values for a motor skills test, the Athletic Skills Track, among 4- to 12-year-old children., Design: Cross-sectional., Methods: In 2016, a total of 7977 Dutch children, 4036 boys (mean age 8.6 years, SD 2.1) and 3941 girls (mean age 8.6 years, SD 2.1), performed an age-related version of the Athletic Skills Track (AST). The AST is a track consisting of 5-7 fundamental movement skill tasks that should be completed as fast as possible. The children performed the test during a regular physical education (PE) lesson under the supervision of their own PE teacher. For each version of the AST (AST-1: n=917; AST-2: n=3947; AST-3: n=3213) age- and gender-related reference centiles were derived from the gathered data using the Lambda, Mu, Sigma (LMS) method., Results: All children completed the AST within 60s (mean 29.6s, SD 7.7). An independent samples t-test showed that boys were significantly faster in completing the track than girls, except for the 4-year-old boys. Therefore, age- and gender-related reference centiles were derived. The reference curves demonstrate an almost linear decrease in time to complete AST-1 and AST-2 with increasing age., Conclusions: The present study provides age- and gender-related normative values and MQ values for the AST among 4- to 12-year-old Dutch children. With these normative values PE teachers can interpret children's performance on the AST., (Copyright © 2018 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.)

Background: Although there are over 26,000 private schools in the United States, little is known about the relationship of their characteristics to mandated and recommended time allocations for physical education (PE)., Methods: Private secondary schools (N = 450; grades 6-12) in California completed a 15-item questionnaire related to school characteristics and PE policies and practices. Using correlational analysis and predictive modeling, we assessed the associations and influences of various factors relative to the schools meeting state (California) and national professional time targets for PE., Results: Whereas most schools fell short of meeting PE weekly time recommendations, 5 of 10 tested variables were significantly associated with schools meeting PE minutes/week targets: school enrollment, school level, having a fitness testing policy, PE class size, and not permitting exemptions for PE. Large schools and those serving high school students provided more PE and were more likely to meet PE time allocation standards. Having policies for PE minutes/week and no exemptions for PE were significantly associated with a school having all its PE classes taught by a specialist., Conclusions: Private secondary schools should consider the adoption of professional guidelines related to PE time allocations, class size, conducting physical fitness testing, employing PE specialists, and not permitting exemptions for PE., (© 2018, American School Health Association.)

Objective: Introduction: Different forms of physical education lessons organization, including swimming classes were introduced in education process without studying of its healthsaving effectiveness. The aim of this study was hygienic assessment of different forms of physical education lessons organization in primary school., Patients and Methods: Materials and methods: Cross-sectional study was conducted in two schools with different organization of physical education lessons. The experimental group (E) consisted of 408 children of 1‑4 year of study (210 girls and 198 boys) who were engaged in swimming in the school basin during one of the lessons of physical education. Control group (C) consisted of 279 primary school children (210 girls and 156 boys) from a neighboring educational institution where all physical education lessons were organized in the gym. The integral estimation of physical education classes was performed. Action timing with pulse measurement during gym and swimming lessons was held. Target heart rate level was calculated using Carvonen formula. Heart rate variability parameters were measured using diagnostic complex FAZAGRAF® ., Results: Results: A low level of physical load in E and C groups causes functional tension of cardio-vascular system. Pulse restitution and distribution on the types of vegetative regulation indicates that children attended one swimming lesson per week recovered better after physical load comparing to the C group., Conclusion: Conclusions: Primary schoolchildren have low physical endurance. Attending one swimming lesson per week contributes to better recovery after physical load and improves vegetative regulation.

Personal trainers are well placed to provide nutrition care in line with their recommended scope of practice. However, providing nutrition care beyond their recommended scope of practice has been identified as an industry risk. The International Confederation of Registers for Exercise Professionals (ICREPs) have international standards for nutrition knowledge and skills that are recommended for all fitness professionals, including personal trainers. This study investigates whether the ICREPs standards align with i) national nutrition education standards and ii) national nutrition occupational standards and scopes of practice for personal trainers within ICREPs affiliated countries. Content analysis of each standard and/or scope of practice was undertaken to extract nutrition statements. Extracted statements were matched with nutrition components of the ICREPs standards to result in a score based on the number of aligned ICREPs knowledge and skills criteria. Ten countries, with 16 organizations, were identified as being involved in the development of national education standards, occupational standards, or scopes of practice for personal trainers. The educational and occupational standards varied widely among countries and had minimal alignment with the ICREPs standards. As such, the expected role of personal trainers in providing nutrition care appeared to differ between countries. Further work is required to support personal trainers to develop a level of knowledge and skills that enables the provision of safe, consistent, and effective nutrition care.

Introduction: Although comprehensive school-based physical activity interventions are efficacious when tested under research conditions, they often require adaptation in order for implementation at scale. This paper reports the effectiveness of an adapted efficacious school-based intervention in improving children's moderate to vigorous physical activity. The impact of strategies to support program implementation was also assessed., Design: A cluster RCT of low socioeconomic elementary schools in New South Wales, Australia., Setting/participants: Consenting schools were randomized (25 intervention, 21 control) using a computerized random number function. Follow-up measures were taken at 6 months post-randomization (May-August 2015) by blinded research assistants. The multicomponent school-based intervention, based on an efficacious school-based physical activity program (Supporting Children's Outcomes using Rewards, Exercise and Skills), consisted of four physical activity strategies and seven implementation support strategies. The intervention was adapted for scalability and delivery by a local health service over 6 months. The primary outcome was accelerometer assessed, student mean daily minutes spent in moderate to vigorous physical activity. Physical education lesson quality and other school physical activity practices were also assessed., Results: Participants (n=1,139, 49% male) were third- through sixth-grade students at follow-up (May-August 2015). Valid wear time and analysis of data were provided for 989 (86%) participants (571 intervention, 568 control). At 6-month follow-up, there were no significant effects in overall daily minutes of moderate to vigorous physical activity between groups (1.96 minutes, 95% CI= -3.49, 7.41, p=0.48). However, adjusted difference in mean minutes of overall vigorous physical activity (2.19, 95% CI=0.06, 4.32, p=0.04); mean minutes of school day moderate to vigorous physical activity (2.90, 95% CI=0.06, 5.85, p=0.05); and mean minutes of school day vigorous physical activity (1.81, 95% CI=0.78, 2.83, p≤0.01) were significantly different in favor of the intervention group. Physical education lesson quality and school physical activity practices were significantly different favoring the intervention group (analyzed October 2015-January 2016)., Conclusions: The modified intervention was not effective in increasing children's overall daily minutes of moderate to vigorous physical activity, when adapted for implementation at scale. However, the intervention did improve daily minutes of vigorous physical activity and school day moderate to vigorous physical activity, lesson quality, and school physical activity practices., Trial Registration: Australian New Zealand Clinical Trials Registry: ACTRN12615000437561., (Copyright © 2017 American Journal of Preventive Medicine. All rights reserved.)

Introduction: Physical activity (PA) is important in promoting health, as well as in the treatment and prevention of diseases. However, insufficient PA is still a global health problem and it is also a problem in medical schools. PA training in medical curricula is still sparse or non-existent. There is a need for a comprehensive understanding of the extent of PA in medical schools through several indicators, including people, places and policies. This study includes a survey of the PA prevalence in a medical school and development of a tool, the Medical School Physical Activity Report Card (MSPARC), which will contain concise and understandable infographics and information for exploring, monitoring and reporting information relating to PA prevalence., Methods and Analysis: This mixed methods study will run from January to September 2017. We will involve the School of Medicine, Walailak University, Thailand, and its medical students (n=285). Data collection will consist of both primary and secondary data, divided into four parts: general information, people, places and policies. We will investigate the PA metrics about (1) people: the prevalence of PA and sedentary behaviours; (2) place: the quality and accessibility of walkable neighbourhoods, bicycle facilities and recreational areas; and (3) policy: PA promotion programmes for medical students, education metrics and investments related to PA. The MSPARC will be developed using simple symbols, infographics and short texts to evaluate the PA metrics of the medical school., Ethics and Dissemination: This study has been approved by the Human Research Ethics Committee of Walailak University (protocol number: WUEC-16-005-01). Findings will be published in peer-reviewed journals and presented at national or international conferences. The MSPARC and full report will be disseminated to relevant stakeholders, policymakers, staff and clients., Competing Interests: Competing interests: None declared., (© Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.)

Context:   Athletic trainers have the opportunity to treat unique populations. Determining athletes' satisfaction with the athletic training services supplied can offer insights into how to improve the health care provided to athletes., Objective:   To explore Deaflympians' satisfaction with athletic training services at the 2013 Deaflympic Summer Games., Design:   Cross-sectional survey., Setting:   The 2013 Deaflympic Summer Games in Sofia, Bulgaria., Patients or Other Participants:   Of the 115 Deaflympians contacted, 55 completed the questionnaire, for a 48% response rate (women = 33, men = 22)., Main Outcome Measure(s):   The Medical Interview Satisfaction Survey-Athletic Training was used. The questionnaire gathered demographic data and included 25 Likert-scale items that assessed 6 components of athletic training. Descriptive statistics were calculated as normalized scores to adjust for the different numbers of questions for each item. On a 5-point scale, the scores ranged from 3.82 (management) to 4.24 (environment), with an overall satisfaction score of 3.89. We conducted comparison tests to assess possible differences in overall satisfaction and satisfaction components. Satisfaction with frequency of use of the athletic training room and knowledge were the only areas that showed statistically significant differences. Other differences were in perceptions of medical coverage among age groups and management between sexes., Results:   Satisfaction with the athletic training services provided was lower among these Deaflympians than among collegiate athletes in other studies. However, we observed no differences in overall satisfaction scores by age, sex, race, previous Deaflympic experience, or individual or team sport. Deaflympians who used and visited the athletic training facility more often had higher overall satisfaction scores than individuals who used and visited the facility less., Conclusions:   Deaflympians were satisfied with the athletic training services provided at the 2013 Deaflympic Summer Games.

Personal trainers are well placed to provide basic nutrition care in line with national dietary guidelines. However, many personal trainers provide nutrition care beyond their scope of practice and this has been identified as a major industry risk due to a perceived lack of competence in nutrition. This paper explores the context in which personal trainers provide nutrition care, by understanding personal trainers' perceptions of nutrition care in relation to their role and scope of practice. Semistructured telephone interviews were conducted with 15 personal trainers working within Australia. Thematic analysis was used to identify key themes. All personal trainers reported to provide nutrition care and reported that nutrition care was an important component of their role. Despite this, many were unaware or uncertain of the scope of practice for personal trainers. Some personal trainers reported a gap between the nutrition knowledge they received in their formal education, and the knowledge they needed to optimally support their clients to adopt healthy dietary behaviors. Overall, the personal training context is likely to be conducive to providing nutrition care. Despite concerns about competence personal trainers have not modified their nutrition care practices. To ensure personal trainers provide nutrition care in a safe and effective manner, greater enforcement of the scope of practice is required as well as clear nutrition competencies or standards to be developed during training.

Schools are important settings for not only providing and promoting children's physical activity (PA) but also for reducing PA disparities. We investigated associations between school-level demographic characteristics (racial/ethnic and socioeconomic composition, urban-rural status, and student-to-teacher ratio) and 16 PA-promoting practices in 347 Nevada public elementary, middle, and high schools in 2014. We found that low-cost and easy-to-implement practices are most prevalent. There is relative demographic equity in ten of 16 PA practices and significant differences in six PA practices in Nevada schools. Schools with comparatively larger percentages of Black students are the most disadvantaged, as they have the fewest PA-supportive practices in place. Higher percent black was associated with lower odds of providing classroom activity breaks (AOR=0.632, 95% CI=0.453-0.881) and bike racks (AOR=0.60, 95% CI=0.362-0.996), greater odds of withholding recess/PE for disciplinary reasons (AOR=1.377, 95% CI=1.006-1.885), and lower odds of having recess supervisors who are trained to promote PA (AOR=0.583, 95% CI=0.374-0.909). Schools with greater percentages of Hispanic students have lower odds of providing before-school PA programs (AOR=0.867, 95% CI=0.761-0.987), whereas schools with greater percentages of low-SES students have greater odds of providing after-school PA programs (AOR=1.135, 95% CI=1.016-1.268). Higher student-to-teacher ratio was also associated with greater odds of providing after-school PA programs (AOR=1.135, 95% CI=1.016-1.268). Urban-rural status was unrelated to all PA practices., Competing Interests: None for all authors, (Copyright © 2016 Elsevier Inc. All rights reserved.)

Background: Physical education (PE) is mandated in most states, but few studies of PE in private schools exist., Methods: We assessed selected PE policies and practices in private secondary schools (grades 6 to 12) in California using a 15-item questionnaire related to school characteristics and their PE programs., Results: Responding schools (n = 450; response rate, 33.8%) were from 37 counties. Most were coeducational (91.3%) and had a religious affiliation (83%). Secular schools had more PE lessons, weekly PE min, and smaller class sizes. Most schools met guidelines for class size, but few met national recommendations for weekly PE minutes (13.7%), not permitting substitutions for PE (35.6%), and programs being taught entirely by PE specialists (29.3%)., Conclusions: Private schools, which serve about 5 million US children and adolescents, may be falling short in providing quality PE. School stakeholders should encourage adoption and implementation of policies and practices that abide by professional guidelines and state statutes.

Background: Public schools provide students with opportunities to participate in many discretionary, unmandated wellness programs. Little is known about the number of these programs, their distribution across schools, and the kinds of students served. We provide evidence on these questions for New York City (NYC) public schools., Methods: Data on wellness programs were collected from program websites, NYC's Office of School Food and Wellness, and direct contact with program sponsors for 2013. Programs were grouped into categories, nutrition, fitness, and comprehensive, and were combined with data on school characteristics available from NYC's Department of Education. Numbers of programs and provision of programs were analyzed for relationships with demographic and school structural characteristics, using descriptive statistics and multiple regression., Results: Discretionary wellness programs are numerous, at 18 programs. Little evidence supports inequity according to student race/ethnicity, income, or nativity, but high schools, new schools, co-located schools, small schools, and schools with larger proportions of inexperienced teachers are less likely to provide wellness programs., Conclusions: Opportunities exist to further the reach of wellness programs in public schools by modifying them for high school adoption and building capacity in schools less likely to have the administrative support to house them., (© 2016, American School Health Association.)

Background: Physical education (PE) can be considered an instrument for active lifestyle promotion, and PE teachers can motivate youths to continue their studies in the field of Movement Sciences (MS)., Methods: To evaluate the role of PE in higher secondary school in promoting physical activity (PA) and MS careers, previous PE experiences and current PA practice were investigated in a sample of Italian freshmen enrolled in different university degree courses., Results: A total of 7033 questionnaires were completed by students from 14 universities (41.3% males, mean age 20 ± 2.76 years). Recreation seemed to be the principal aim (42.2%) pursued during PE lessons, which are based mainly on practical activities (51.7%). Of all respondents, 67.2% were satisfied with the PE received during higher secondary school, and 51.6% participated in extracurricular PA. Current practice of PA was reported by 58.1% of the sample. Extracurricular activities were associated with choice of MS curricula (odds ratio: 2.15; 95% confidence interval, 1.85-2.50) and with current practice of PA (odds ratio: 1.68, 95% confidence interval, 1.51-1.87). Geographical differences concerning lessons organization and satisfaction were registered (P < .01)., Conclusions: To enhance its role in health promotion, PE teaching should be improved by increasing the time allocated to PE and by strengthening the provision of school-based extracurricular PA.

Context: Research is limited on the transition to practice of newly credentialed athletic trainers (ATs). Understanding this transition could provide insight to assist employers and professional programs in developing initiatives to enhance the transition., Objective: To explore newly credentialed ATs' experiences and feelings during their transition from student to autonomous practitioner., Design: Qualitative study., Setting: Individual phone interviews., Patients or Other Participants: Thirty-four ATs certified between January and September 2013 participated in this study (18 women, 16 men; age = 23.8 ± 2.1 years; work settings were collegiate, secondary school, clinic, and other). Data saturation guided the number of participants., Data Collection and Analysis: Participants were interviewed via phone using a semistructured interview guide. All interviews were recorded and transcribed verbatim. Data were analyzed through phenomenologic reduction, with data coded for common themes and subthemes. Credibility was established via member checks, peer review, and intercoder reliability., Results: The 3 themes that emerged from the data were (1) transition to practice preparation, (2) orientation, and (3) mentoring. Transition to practice was rarely discussed during professional preparation, but information on the organization and administration or capstone course (eg, insurance, documentation) assisted participants in their transition. Participants felt that preceptors influenced their transition by providing or hindering the number and quality of patient encounters. Participants from larger collegiate settings reported more formal orientation methods (eg, review policies, procedures manual), whereas those in secondary school, clinic/hospital, and smaller collegiate settings reported informal orientation methods (eg, independent review of policies and procedures, tours). Some participants were assigned a formal mentor, and others engaged in peer mentoring., Conclusions: Employers could enhance the transition to practice by providing formal orientation and mentorship. Professional programs could prepare students for the transition by discussing how to find support and mentoring and by involving preceptors who provide students with opportunities to give patient care.

Promoting health by sport has now gone one step further. Integrated into the 2015 Health Act, medical prescription of sport activities is organized locally, as illustrated by the Strasbourg “sport-health prescription” programme, which promotes physical activity for patients with stable chronic diseases within local sports structures. Observation of the real functioning of this programme, based on the practices and descriptions of six sports educators in various structures, reveals demedicalisation in favour of sportification, as sports educators translate the prescription according to their specific institution and policies. Although there is a general consensus about the need for physical education to fight against inactivity and isolation of patients, the expected effects of physical activity are redefined according to a political economy of local structures. Implementation of the sport-health programme is subject to the social and political conditions of the local sports movement.

The purpose of this commentary is to provide an overview of national physical activity recommendations and policies (e.g., from the Institute of Medicine, National Physical Activity Plan, and Centers for Disease Control and Prevention) and to discuss how these important initiatives can be implemented in local schools. Successful policies are illustrated. Specific strategies and ideas are shared regarding how physical educators can assert themselves and impart their knowledge in an effort to build support for policy implementations that enhance the delivery of physical education and physical activity in their schools and communities.

Objectives: In Part II of a two-part series, we develop a phenomenological model of a negative outcome of U.S. Army Basic Combat Training that affects a large proportion of trainees. Previous models have been epidemiological in nature and have focused on trainee risk factors such as previous injury, gender, and initial fitness. This approach is limited due to difficulties extrapolating results to other cohorts. In addition, training regimen is often neglected, limiting accuracy when applied to novel scenarios., Methods: The prognostic Training Adaptation Injury Model (TAIM) developed accounts for both individual characteristics as well as regimen by integrating validated submodels of physiological and biomechanical principles known to be important for tibial stress fracture., Results: We find that when used to predict any type of overuse injury, the TAIM is most accurate when the effect of training activities on both overall fitness as well as muscle fatigue during activities is accounted for area under the receiver-operator curve of 0.65. This compares favorably with statistical-based models that do not account for training regimen (area under the receiver-operator curve ≈ 0.56., Conclusions: The TAIM has the potential to both identify trainees at overuse injury risk as well as make recommendations on regimen changes to reduce that risk., (Reprint & Copyright © 2016 Association of Military Surgeons of the U.S.)

Objectives: The U.S. Army Basic Combat Training (BCT) is the first step in preparing soldier trainees for the physical demands of the military. Unfortunately, a substantial number of trainees fail BCT due to failure on the final Army Physical Fitness Test (also known as the "end of cycle" APFT). Current epidemiological studies have used statistics to identify several risk factors for poor APFT performance, but these studies have had limited utility for guiding regimen design to maximize APFT outcome. This is because such studies focus on intrinsic risks to APFT failure and do not utilize detailed BCT activity data to build models which offer guidance for optimizing the training regimen to improve graduation rates., Methods: In this study, a phenomenological run performance model that accounts for physiological changes in fitness and fatigue due to training was applied to recruits undergoing U.S. Army BCT using high resolution (minute-by-minute) activity data., Results: The phenomenological model was better at predicting both the final as well as intermediate APFTs (R(2) range = 0.55-0.59) compared to linear regression models (LRMs) that used the same intrinsic input variables (R(2) range = 0.36-0.50)., Conclusions: Unlike a statistical approach, a phenomenological model accounts for physiological changes and, therefore, has the potential to not only identify trainees at risk of failing BCT on novel training regimens, but offer guidance to regimen planners on how to change the regimen for maximizing physical performance. This paper is Part I of a 2-part series on physical training outcome predictions., (Reprint & Copyright © 2016 Association of Military Surgeons of the U.S.)

This article describes the conceptual design and evaluation strategies used in the NFL PLAY 60 FITNESSGRAM Partnership Project, a large participatory research network focused on building effective school physical education programming. The article summarizes the unique participatory design, recruitment methods, programming strategies, and analytical plans used to evaluate this large project. The study provides unique insight into how to effectively deliver large-scale school-based physical fitness and physical activity programming to support and enhance physical education programming in schools.