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This study aimed to identify barriers and facilitators to comprehensive, school-based physical activity (PA) promotion among adolescents prior to and during the coronavirus disease of 2019 (COVID-19) pandemic, considering the perspectives of students, parents, and school staff. Data were collected from 2020 to 2021 using semi-structured individual interviews with students (n = 15), parents (n = 20), and school staff (n = 8) at a Title I middle school (i.e. high percentage of students from low-income families). Two theoretical frameworks guided analysis: the Comprehensive School Physical Activity Program framework and Bronfenbrenner's ecological systems theory. Using an iteratively developed codebook, data were coded, thematically analyzed, and synthesized. PA barriers and facilitators were present throughout the school day, at home, and in the community. Key determinants included pandemic-induced challenges (e.g. COVID-19 exposure); neighborhood characteristics/weather (e.g. neighborhood safety); school-family communication/collaboration; implementation climate (i.e. school staff's support for programming); time, spatial, and monetary resources (e.g. funding); staffing capacity/continuity and school champions; staffing creativity and adaptability; PA opportunities before, during, and after school; and child's motivation/engagement. Efforts to improve school-based PA programs, irrespective of pandemic conditions, should include strategies that address factors at the community, school, family and individual levels. School-family communication/collaboration, school staff programming support, and PA opportunities throughout the day can help promote comprehensive, school-based PA.

Background: Most United States schools include school-based physical fitness testing (SB-PFT), yet little evidence shows how it is implemented, perceived, and used. Purpose: 1) Explore stakeholders' experiences with SB-PFT; 2) identify: challenges in analyzing fitness data, ways schools can use fitness data, and predictors of meeting fitness benchmarks. Methods: Data were collected in a partner school district (King County, Washington, USA). We conducted and analyzed qualitative interviews with middle schoolers (n = 30), parents (n = 20), and school staff (n = 5); and identified student-level predictors of meeting fitness benchmarks with two-level mixed effects logistic regression models using district's fitness assessment data (grades 4-8). Results: Stakeholders identified challenges and provided feedback on SB-PFT, and predictors of meeting fitness benchmarks were identified. Discussion: Findings suggest SB-PFT has potential to be useful in promoting adolescents' fitness, but opportunities exist to improve the testing process and the ways that results are shared and utilized. Translation to Health Education Practice: Teachers would benefit from resources to understand and discuss the role of SB-PFT in a physically active lifestyle with students, ensure a positive testing experience by conducting assessments more privately and taking the time to practice assessments beforehand, and track testing outcomes and relevant demographics. A AJHE Self-Study quiz is online for this article via the SHAPE America Online Institute (SAOI) http:// portal.shapeamerica.org/trn-Webinars

Children who spend more time outdoors are more physically active and have fewer behavioral problems than those who spend less time outdoors. No studies to date have evaluated physical activity and behavioral outcomes in an exclusively outdoor nature preschool setting. The aim of this study was to examine differences in objectively measured physical activity and child behavior in children attending a nature preschool compared to waitlisted controls. This cross-sectional pilot study was conducted in Seattle, Washington, in 2016. Children were 3-5 years of age (n=33) at the time of enrollment; parents or primary caregivers completed assessments. Children in the intervention group were enrolled at the nature preschool. The comparison group included children that were either waitlisted at the nature preschool, or were participating in a 2-hour nature-based outdoor enrichment class at the same location once per week. All children wore Actigraph accelerometers to measure moderate-to-vigorous physical activity (MVPA; primary outcome) for 5 days; parents completed the Strengths and Difficulties Questionnaire to assess child behavior (secondary outcome). Children in the control group engaged in 16 more minutes/day of MVPA compared to children attending the nature preschool (113 minutes, SD=24; 97 minutes, SD=16, respectively). No differences were found in MVPA during preschool hours (9 am to 1 pm). Parents of children attending the nature preschool reported wanting their children to engage in more active outdoor playtime compared to controls (206 minutes, SD=136; 150 minutes, SD=87, respectively). Actual self-reported active outdoor playtime was also higher for nature preschool participants compared to controls (233 minutes, SD=61; 67 minutes, SD=52, respectively). Parents of nature preschool participants were more comfortable with lower temperatures (21 degrees F, SD=12) for their children to play outdoors than control families (30 degrees F, SD=19). In summary, both children attending more traditional childcare environments and nature preschools had high levels of MVPA and parents of children in nature preschools were more tolerant of colder conditions for outdoor play.

Recess in schools is a critical opportunity for children to engage in important behaviors that can promote their health and well-being, and daily recess is recommended by the American Academy of Pediatrics and other national organizations. In Washington state, school recess is not equitably provided, with parents reporting a wide range from as little as 10 minutes to >45 minutes daily. State laws can help promote equitable and high-quality recess, but most states in the United States do not have recess laws. In 2023, a bill (Senate Bill 5257) mandating a minimum of 30 minutes of daily recess for all elementary students with provisions for other recess best practices (including not withholding recess as punishment and encouraging movement breaks for middle/high-schoolers) passed with bipartisan support in the Washington state Legislature and was signed into law. In this case study, we describe the process undertaken and lessons learned by the cross-sector coalition that spearheaded the advocacy efforts, which included pediatricians, parents, educators, community organizations, and youth. [ABSTRACT FROM AUTHOR]

AbstractBackgroundChildren in households of lower socioeconomic status (SES) are more likely to be overweight/obese. We aimed to determine if home physical activity (PA) environments differed by SES and to explore home environment mediators of the relation of family SES to children’s PA and sedentary behavior.MethodsParticipants were 715 children aged 6 to 11 from the Neighborhood Impact on Kids (NIK) Study. Household SES was examined using highest educational attainment and income. Home environment was measured by parent report on a survey. Outcomes were child’s accelerometer-measured PA and parent-reported screen time. Mediation analyses were conducted for home environment factors that varied by SES.ResultsChildren from lower income households had greater media access in their bedrooms (TV 52% vs. 14%, DVD player 39% vs. 14%, video games 21% vs. 9%) but lower access to portable play equipment (bikes 85% vs. 98%, jump ropes 69% vs. 83%) compared to higher income children. Lower SES families had more restrictive rules about PA (2.5 vs. 2.0). Across SES, children watched TV/DVDs with parents/siblings more often than they engaged in PA with them. Parents of lower SES watched TV/DVDs with their children more often (3.1 vs. 2.5 days/week). Neither total daily and home-based MVPA nor sedentary time differed by SES. Children’s daily screen time varied from 1.7 hours/day in high SES to 2.4 in low SES families. Media in the bedroom was related to screen time, and screen time with parents was a mediator of the SES--screen time relationship.ConclusionsLower SES home environments provided more opportunities for sedentary behavior and fewer for PA. Removing electronic media from children’s bedrooms has the potential to reduce disparities in chronic disease risk.

Objectives Child care is an important setting for the promotion of physical activity (PA) in early childhood. The purpose of this study was to examine the associations between specific PA environments and recommended practices in child care settings as well as the degree to which child care settings met recommended standards for total PA time. Methods In 2013, all programs licensed to care for children ages 2-5 in WA state were surveyed about their PA related practices. Logistic regression was used to determine odds of meeting best-practice standards for outdoor time and PA. Results The response rate was 45.8 % from centers (692/1511) and 32.1 % from homes (1281/3991). Few programs reported meeting best-practice standards for the amount of time children spend being physically active (centers: 12.1 %, homes: 20.1 %) and outdoor time (centers: 21.8 %, homes: 21.7 %). Programs where children go outside regardless of weather and those reporting more adult-led PA had higher odds of meeting best-practice standards for both PA and outdoor time. Meeting best-practice standards for outdoor time was the strongest predictor of meeting best-practice standards for total PA time [centers: OR 15.9 (9.3-27.2), homes: OR 5.2 (3.8-7.1)]. Conclusions for Practice There is considerable room for improvement in licensed child care settings in WA to meet best-practice standards for young children's outdoor and PA time. Initiatives that create policies and environments encouraging outdoor play and adult-led PA in child care have the potential to increase physical activity in substantial numbers of young children., Author(s): Pooja S. Tandon [sup.1] [sup.2] , Kelly M. Walters [sup.1] [sup.2] , Bridget M. Igoe [sup.3] , Elizabeth C. Payne [sup.2] , Donna B. Johnson [sup.2] Author Affiliations: (1) [...]

Objective: To describe and compare obesity prevention practices related to physical activity and beverages in home- and center-based child care programs. Methods: A telephone survey of licensed home- and center-based child care programs in Florida, Massachusetts, Michigan, and Washington between October and December 2008. Results: Most programs reported almost universal access to outdoor play areas and staff who frequently engage in and lead physical activities. About half of the programs reported less than or equal to 60 minutes of outdoor play time per day for preschoolers. Fewer home-based programs offered a variety of fixed and portable play equipment. Over a third of the programs did not have adequate indoor space for all physical activities. Over two thirds of programs offered juice 3 or 4 times per week or more. Conclusions and Implications: Many child care programs could increase active opportunities (by increasing outdoor time and providing better spaces for indoor physical activity) and decrease juice provision. (Contains 2 tables.)

This study aimed to identify barriers and facilitators to comprehensive, school-based physical activity (PA) promotion among adolescents prior to and during the coronavirus disease of 2019 (COVID-19) pandemic, considering the perspectives of students, parents, and school staff. Data were collected from 2020 to 2021 using semi-structured individual interviews with students (n  = 15), parents (n  = 20), and school staff (n  = 8) at a Title I middle school (i.e. high percentage of students from low-income families). Two theoretical frameworks guided analysis: the Comprehensive School Physical Activity Program framework and Bronfenbrenner's ecological systems theory. Using an iteratively developed codebook, data were coded, thematically analyzed, and synthesized. PA barriers and facilitators were present throughout the school day, at home, and in the community. Key determinants included pandemic-induced challenges (e.g. COVID-19 exposure); neighborhood characteristics/weather (e.g. neighborhood safety); school–family communication/collaboration; implementation climate (i.e. school staff's support for programming); time, spatial, and monetary resources (e.g. funding); staffing capacity/continuity and school champions; staffing creativity and adaptability; PA opportunities before, during, and after school; and child's motivation/engagement. Efforts to improve school-based PA programs, irrespective of pandemic conditions, should include strategies that address factors at the community, school, family and individual levels. School–family communication/collaboration, school staff programming support, and PA opportunities throughout the day can help promote comprehensive, school-based PA. [ABSTRACT FROM AUTHOR]

Most United States schools include school-based physical fitness testing (SB-PFT), yet little evidence shows how it is implemented, perceived, and used. 1) Explore stakeholders' experiences with SB-PFT; 2) identify: challenges in analyzing fitness data, ways schools can use fitness data, and predictors of meeting fitness benchmarks. Data were collected in a partner school district (King County, Washington, USA). We conducted and analyzed qualitative interviews with middle schoolers (n = 30), parents (n = 20), and school staff (n = 5); and identified student-level predictors of meeting fitness benchmarks with two-level mixed effects logistic regression models using district's fitness assessment data (grades 4–8). Stakeholders identified challenges and provided feedback on SB-PFT, and predictors of meeting fitness benchmarks were identified. Findings suggest SB-PFT has potential to be useful in promoting adolescents' fitness, but opportunities exist to improve the testing process and the ways that results are shared and utilized. Translation to Health Education Practice: Teachers would benefit from resources to understand and discuss the role of SB-PFT in a physically active lifestyle with students, ensure a positive testing experience by conducting assessments more privately and taking the time to practice assessments beforehand, and track testing outcomes and relevant demographics. A AJHE Self-Study quiz is online for this article via the SHAPE America Online Institute (SAOI) [ABSTRACT FROM AUTHOR]

Background: Children with attention deficit hyperactivity disorder (ADHD) are at increased risk for poor health and obesity. The authors describe obesity-related movement behaviors in children with ADHD, determine higher risk groups, and compare with children with other disorders. Methods: Physical activity (PA), sleep, and screen time of children with ADHD (aged 6–18 y) were compared with recommendations and with behaviors of children with autism, asthma, and a normative group using 2011 National Survey of Child Health data. Results: Approximately one-third of children with ADHD participated in daily PA and half in sports in the past year. Older children with ADHD were less likely to get daily PA, get enough sleep, and limit screen time to <2 hours per day. Obese children had lower odds of daily PA. Children who had lower socioeconomic status, or severe ADHD, had lower odds of sports participation. Children with ADHD had 50% lower odds of sports participation than children with asthma. Conclusions: Children with ADHD did not engage in recommended amounts of PA, sleep, and screen time. Children with ADHD who are older, poor, obese, and/or with more severe symptoms are at higher risk for suboptimal movement behaviors. These domains represent novel treatment targets in ADHD youth. [ABSTRACT FROM AUTHOR]

Background: At a time of increasing disconnectedness from nature, scientific interest in the potential health benefits of nature contact has grown. Research in recent decades has yielded substantial evidence, but large gaps remain in our understanding. Objectives: We propose a research agenda on nature contact and health, identifying principal domains of research and key questions that, if answered, would provide the basis for evidence-based public health interventions. Discussion: We identify research questions in seven domains: a) mechanistic biomedical studies; b) exposure science; c) epidemiology of health benefits; d) diversity and equity considerations; e) technological nature; f economic and policy studies; and g) implementation science. Conclusions: Nature contact may offer a range of human health benefits. Although much evidence is already available, much remains unknown. A robust research effort, guided by a focus on key unanswered questions, has the potential to yield high-impact, consequential public health insights. https://doi.org/10.1289/EHP1663, Introduction Humans are increasingly disconnected from nature. Most people--over half globally, and approximately four in five Americans--live in urban areas, where nature contact is typically limited (United Nations 2015). Surveys [...]