Aaron Beighle

After-School Program Impact on Physical Activity and Fitness: A Meta-Analysis

CONTEXT The majority of children do not participate in sufficient amounts of daily, health-enhancing physical activity. One strategy to increase activity is to promote it within the after-school setting. Although promising, the effectiveness of this strategy is unclear. A systematic review was performed summarizing the research conducted to date regarding the effectiveness of after-school programs in increasing physical activity. EVIDENCE ACQUISITION Databases, journals, and review articles were searched for articles published between 1980 and February 2008. Meta-analysis was conducted during July of 2008. Included articles had the following characteristics: findings specific to an after-school intervention in the school setting; subjects aged <or=18 years; an intervention component designed to promote physical activity; outcome measures of physical activity, related constructs, and/or physical fitness. Study outcomes were distilled into six domains: physical activity, physical fitness, body composition, blood lipids, psychosocial constructs, and sedentary activities. Effect sizes (Hedges g) were calculated within and across studies for each domain, separately. EVIDENCE SYNTHESIS Of the 797 articles found, 13 unique articles describing findings from 11 after-school interventions were reviewed. Although physical activity was a primary component of all the tested interventions, only eight studies measured physical activity. From the six domains, positive effect sizes were demonstrated for physical activity (0.44 [95% CI=0.28-0.60]); physical fitness (0.16 [95% CI=0.01-0.30]); body composition (0.07 [95% CI=0.03-0.12]); and blood lipids (0.20 [95% CI=0.06-0.33]). CONCLUSIONS The limited evidence suggests that after-school programs can improve physical activity levels and other health-related aspects. Additional studies are required that provide greater attention to theoretical rationale, levels of implementation, and measures of physical activity within and outside the intervention.

Physical Education's Role in Public Health: Steps Forward and Backward over 20 Years and HOPE for the Future.

The 1991 paper, “Physical Educations Role in Public Health” described the importance of physical education in addressing public health problems. On its 20th anniversary, this article reviews accomplishments in improving the health impact of physical education and identifies areas lacking progress. Major accomplishments include development of evidence-based programs, documentation of health and academic benefits of physical education, and acceptance of physical education as a public health resource. Additional work is needed to evaluate the uptake of evidence-based programs, improve national surveillance of physical education quantity and quality, establish stronger policies supporting active physical education, and achieve wide acceptance of public health goals within the physical education field. These opportunities constitute an agenda for actualizing the promise of Health-Optimizing Physical Education before the next 20-year anniversary.

Review and special articleAfter-School Program Impact on Physical Activity and Fitness: A Meta-Analysis

CONTEXT The majority of children do not participate in sufficient amounts of daily, health-enhancing physical activity. One strategy to increase activity is to promote it within the after-school setting. Although promising, the effectiveness of this strategy is unclear. A systematic review was performed summarizing the research conducted to date regarding the effectiveness of after-school programs in increasing physical activity. EVIDENCE ACQUISITION Databases, journals, and review articles were searched for articles published between 1980 and February 2008. Meta-analysis was conducted during July of 2008. Included articles had the following characteristics: findings specific to an after-school intervention in the school setting; subjects aged <or=18 years; an intervention component designed to promote physical activity; outcome measures of physical activity, related constructs, and/or physical fitness. Study outcomes were distilled into six domains: physical activity, physical fitness, body composition, blood lipids, psychosocial constructs, and sedentary activities. Effect sizes (Hedges g) were calculated within and across studies for each domain, separately. EVIDENCE SYNTHESIS Of the 797 articles found, 13 unique articles describing findings from 11 after-school interventions were reviewed. Although physical activity was a primary component of all the tested interventions, only eight studies measured physical activity. From the six domains, positive effect sizes were demonstrated for physical activity (0.44 [95% CI=0.28-0.60]); physical fitness (0.16 [95% CI=0.01-0.30]); body composition (0.07 [95% CI=0.03-0.12]); and blood lipids (0.20 [95% CI=0.06-0.33]). CONCLUSIONS The limited evidence suggests that after-school programs can improve physical activity levels and other health-related aspects. Additional studies are required that provide greater attention to theoretical rationale, levels of implementation, and measures of physical activity within and outside the intervention.

Pedometer-Measured Physical Activity Patterns of Youth: A 13-Country Review

CONTEXT Insufficient physical activity among young people aged 5-18 years is a global public health issue, with considerable disparities among countries. A systematic review was conducted to identify studies reporting pedometer daily steps (steps x day(-1)) in order to compile comparative, global cross-sectional data on youth physical activity patterns. EVIDENCE ACQUISITION Articles were included if they were in English, published by April 2009, and reported steps x day(-1) for boys and girls, separately, and reported steps x day(-1) for age groupings of no more than 4 years (e.g., 5-8 years) or combined no more than three grade levels (e.g., third- to fifth-graders). Studies could have been intervention-based but had to have reported baseline steps x day(-1), which would reflect unadulterated physical activity steps x day(-1) estimates. Inverse variance weighted estimates (steps x day(-1w)) were calculated for each country, and random effects models were estimated. Analyses were conducted in May and June 2009. EVIDENCE SYNTHESIS Forty-three studies, representing young people in 13 countries (N=14,200), were included. The majority of studies were from the U.S. (17/43). Overall, there was considerable variation within and among countries in steps x day(-1w). Boys and girls from European and Western Pacific regions had significantly more steps x day(-1w) than young people from the U.S. and Canada. Significantly lower steps x day(-1w) estimates for girls were observed for studies that combined measured steps x day(-1) for weekdays and weekend days, in comparison to weekdays only. CONCLUSIONS Limited sample sizes and non-population-based data preclude definitive statements regarding projected steps x day(-1) within countries. Nevertheless, these findings provide preliminary information for policymakers and researchers on the extent of the disparities among countries in the physical activity patterns of young people.

What Are the Contributory and Compensatory Relationships Between Physical Education and Physical Activity in Children

Limited data are available on the contributory and compensatory relationships between physical education and physical activity in children. Four hundred eighty-five (280 girls) children in first through sixth grades wore sealed pedometers during waking hours, including normally scheduled physical education lessons. The least, moderately, and most active children accumulated approximately 1,700, 1,100, and 2,500 more steps/day, respectively, on school days with physical education. No compensatory increases in physical activity were found on school days that did not offer physical education. The implications of the contributory relationship are highlighted by the evidence that 50% of the least active children were at risk for overweight or overweight and that no compensatory increases in physical activity were found on school days when physical education classes were not scheduled.

Ready for Recess: A Pilot Study to Increase Physical Activity in Elementary School Children.

BACKGROUND Creating an optimal environment at recess may be necessary to maximize physical activity (PA) participation in youth. The purpose of this study was to determine the initial effectiveness of an elementary school recess intervention on the amount of moderate PA (MPA) and vigorous PA (VPA) during recess and the school day. METHODS This school-based intervention included staff training, activity zones, and playground equipment. The PA levels of third, fourth, and fifth grade students (n = 93) at two schools were measured at baseline and post-intervention using ActiGraph accelerometers. Paired t tests were used to compare percentage of time spent during recess in MPA and VPA. Multiple regressions were utilized to model the effect of intervention, age, sex, race, body mass index, and school on minutes spent in MPA and VPA. RESULTS The multiple regression results demonstrated increases of 2.5 minutes of MPA (p < .001) and 2.2 minutes of VPA (p < .001) at recess and an increase of 18.7 minutes of MPA (p < .001) and 4.7 minutes of VPA (p < .001) during the school day. These represent respective increases of 51.2% and 112.2% in the adjusted means of MPA and VPA during recess and respective increases of 92.2% and 71.6% in the adjusted mean of MPA and VPA during school day. CONCLUSION Staff training, recreational equipment, and playground markings are inexpensive, simple ways to increase PA during recess so that children can accumulate minutes of PA to meet the recommended guidelines of 60 minutes per day.

School day segmented physical activity patterns of high and low active children

BackgroundVariability exists in children’s activity patterns due to the association with environmental, social, demographic, and inter-individual factors. This study described accelerometer assessed physical activity patterns of high and low active children during segmented school week days whilst controlling for potential correlates.MethodsTwo hundred and twenty-three children (mean age: 10.7 ± 0.3 yrs, 55.6% girls, 18.9% overweight/obese) from 8 north-west England primary schools wore ActiGraph GT1M accelerometers for 7 consecutive days during autumn of 2009. ActiGraph counts were converted to minutes of moderate (MPA), vigorous (VPA) and moderate-to-vigorous (MVPA) physical activity. Children were classified as high active (HIGH) or low active (LOW) depending on the percentage of week days they accumulated at least 60 minutes of MVPA. Minutes spent in MPA and VPA were calculated for school time and non-school time and for five discrete school day segments (before-school, class time, recess, lunchtime, and after-school). Data were analysed using multi-level modelling.ResultsThe HIGH group spent significantly longer in MPA and/or VPA before-school, during class time, lunchtime, and after-school (P < .05), independent of child and school level factors. The greatest differences occurred after-school (MPA = 5.5 minutes, VPA = 3.8 minutes, P < 0.001). MPA and VPA were also associated with gender, BMI z-score, number of enrolled children, playground area per student, and temperature, depending on the segment analysed.The additive effect of the segment differences was that the HIGH group accumulated 12.5 minutes per day more MVPA than the LOW group.ConclusionsHIGH active children achieved significantly more MPA and VPA than LOW active during four of the five segments of the school day when analyses were adjusted for potential correlates. Physical activity promotion strategies targeting low active children during discretionary physical activity segments of the day, and particularly via structured afterschool physical activity programs may be beneficial.

Effect of a Low-Cost, Teacher-Directed Classroom Intervention on Elementary Students' Physical Activity.

BACKGROUND Effective physical activity (PA) interventions are warranted for youth, and schools have been identified as logical locations for such involvement. Experts and professionals in the field promote comprehensive school PA programs, including classroom PA. The purpose of this study was to determine the effect of a low-cost, teacher-directed classroom-based intervention on the school PA of elementary children. METHODS Nine classroom teachers were provided inexpensive curricula and trained to implement and instruct PA breaks (2 × 30 minute training sessions). The teachers were encouraged to lead 1 activity break per day after the training. One hundred and six elementary students wore pedometers up to 12 days over 3 monitoring periods during the school year (baseline, follow-up, post follow-up) to assess the effectiveness and the sustainability of the intervention. The teachers self-reported the frequency of activity breaks instructed. RESULTS The teachers (n = 5) who complied with the recommended 1 activity break per day had students who accrued ∼33% more mean school steps/day at follow-up (∼1100) and post follow-up (∼1350) compared to controls. Teachers (n = 4) in the intervention who did not comply with the 1 activity break per day recommendation had students accrue similar mean school steps/day as controls. CONCLUSION Inexpensive, teacher-directed classroom-based PA interventions can be effective in improving childrens PA levels if teachers implement 1 activity break per school day. We recommend promoting the notion of 1 activity break per day in the classroom as part of a comprehensive school PA program that includes quality physical education, recess, and before/after school programs.

A Quantitative Review of Physical Activity, Health, and Learning Outcomes Associated With Classroom-Based Physical Activity Interventions

Research suggests that physical activity may foster improved academic performance, yet schools are receiving more pressure to achieve high academic standards. It is important for classroom teachers, administrators and school psychologists to understand the benefits of incorporating physical activity into the school day. This article serves as a quantitative review of classroom physical activity interventions in terms of their physical activity, health and learning outcomes for students, with implications of findings discussed for school personnel.

Physical Activity of Children Attending Afterschool Programs Research- and Practice-Based Implications

BACKGROUND Afterschool programs (3PM-6PM; ASPs) are positioned to play a vital role in the improvement of childrens daily physical activity. Recent guidelines specify that children should accumulate 4600 steps per day while attending an ASP. The extent to which ASPs currently meet this goal and how many steps per day children naturally accumulate within the ASP setting is unknown. PURPOSE The purpose of this study was to describe the pedometer-determined physical activity of a large sample of children attending a diverse range of ASPs and evaluate the extent to which ASPs are meeting current physical activity guidelines. METHODS Children (N=934, 51% girls, average 8.2 years; range 4-14 years) enrolled across 25 ASPs wore Walk4Life MVPa pedometers (number of steps accumulated, time spent active [hours:minutes:seconds]) up to 4 days. Data were collected in fall/spring 2010-2011 and analyzed in summer 2011. RESULTS On average, children attended ASPs for 125 minutes per day, accumulated 2944 steps per day, and spent approximately 26.6 minutes per day in physical activity. Only 16.5% of the 1819 daily observations met the 4600 steps per day guideline. No differences in steps per day, minutes per day in physical activity, or demographics were observed among children measured a single day versus 2, 3, or 4 days. Based on current practice, children would need to spend approximately 3.4 hours per day at an ASP to reach 4600 steps per day. CONCLUSIONS Activity levels in ASPs are well below recommendations. Substantial effort is needed to identify strategies ASPs can employ to ensure children are sufficiently active.