Caroline Fusco

Active school transport, physical activity levels and body weight of children and youth: A systematic review

OBJECTIVES Active school transport (AST) may be an important source of childrens physical activity (PA). Innovative solutions that increase PA time for children, without putting added pressure on the school curriculum, merit consideration. Before implementing such solutions, it is important to demonstrate that active school transport is associated with health-related outcomes. METHODS Following a standardized protocol, we conducted a systematic review of published research to address this question and explore whether children who actively commute to school also have a healthier body weight. Online searches of 5 electronic databases were conducted. Potential studies were screened on the basis of objective measures of physical activity. RESULTS Thirteen studies were included in this review. Nine studies demonstrated that children who actively commute to school accumulate significantly more PA and two studies reported that they expended significantly more kilocalories per day. Where studies examined body weight (n=10), only one reported active commuters having a lower body weight. CONCLUSIONS These studies demonstrate that active school commuters tend to be more physically active overall than passive commuters. However, evidence for the impact of AST in promoting healthy body weights for children and youth is not compelling.

What's "quickest and easiest?": parental decision making about school trip mode

BackgroundThe potential benefits of active school travel (AST) are widely recognized, yet there is consistent evidence of a systematic decline in the use of active modes of transportation to school since the middle part of the 20th century. This study explored parental accounts of the school travel mode choice decision-making process.MethodsThirty-seven parents of children (17 who walked; 20 who were driven) from four elementary schools in Toronto, Canada participated in semi-structured interviews. The schools varied with respect to walkability of the built environment and socio-economic status. Thematic analysis of interview transcripts identified a two-stage decision-making process.ResultsAn initial decision concerned the issue of escorting or chauffeuring a child to/from school. This decision appeared to be primarily influenced by concerns about traffic, the childs personal safety, and the childs maturity and cognitive ability regarding navigating his/her way to/from school safely. Following the escort decision, parents considered mode choice, typically selecting what they perceived to be the easiest and most convenient way to travel. The ascription of convenience to the various modes of transportation was influenced by perceptions of travel time and/or distance to/from school. Convenience became a particularly salient theme for parents who found it necessary to complete multi-activity trip chains.ConclusionsThe school travel mode choice decision process is complex. Future research and practice should continue to address safety concerns that are typically the focus of active school transport initiatives while addressing more explicitly the behavioural cost of competing mode choices.

Playing for health? Revisiting health promotion to examine the emerging public health position on children's play

Concerns over dwindling play opportunities for children have recently become a preoccupation for health promotion in western industrialized countries. The emerging discussions of play seem to be shaped by the urgency to address the childrens obesity epidemic and by societal concerns around risk. Accordingly, the promotion of play from within the field appears to have adopted the following principles: (i) particular forms of play are critical for increasing childrens levels of physical activity; and (ii) play should be limited to activities that are not risky. In this article, we argue that these emerging principles may begin to re-shape childrens play: play is predominantly instrumentalized as a means to promote childrens physical health, which may result in a reduction of possibilities for children to play freely and a restriction of the kinds of play designated as appropriate for physical health. We argue that within this context some of the social and emotional elements of health and well-being that children gain through diverse forms of playing are neglected. This has implications for health promotion because it suggests a narrowing of the conception of health that was originally advocated for within the field. Additionally, this reveals a curious paradox; despite the urgency to promote physical activity through play, this position may limit the range of opportunities for children to freely engage in play, in effect reducing their activity levels. We propose an example that promotes play for children and better aligns with the conception of health as outlined in the Ottawa Charter.

The Perceptions of Caregivers Toward Physical Activity and Health in Youth With Congenital Heart Disease

Medical advances have reduced mortality in youth with congenital heart disease (CHD). Although physical activity is associated with enhanced quality of life, most patients are inactive. By addressing medical and psychological barriers, previous literature has reproduced discourses of individualism which position cardiac youth as personally responsible for physical inactivity. Few sociological investigations have sought to address the influence of social barriers to physical activity, and the insights of caregivers are absent from the literature. In this study, caregiver perceptions toward physical activity for youth with CHD were investigated at a Canadian hospital. Media representations, school liability, and parental overprotection construct cardiac youth as “at risk” during physical activity, and position their health precariously. Indeed, from the perspective of hospital staff, the findings indicate the centrality of sociological factors to the physical activity experiences of youth with CHD, and the importance of attending to the contextual barriers that constrain their health and physical activity.

I.D.ology and the technologies of public (school) space: an ethnographic inquiry into the neo-liberal tactics of social (re)production

This paper explores spatial theory, and particularly a Foucauldian analysis of space, power, and the subject, as a frame within which to examine moves toward security in North American urban schools. We bring into play empirical data from an ethnographic study of New York City and Toronto schools where policies and technologies of record-keeping, identification-verifying, and spatial arrangements are producing altered experiences of subjectivity and the ways in which youth, workers, and researchers experience public (school) space. What is possible to know in ethnographic studies of these new high-security school sites? We argue that notions of ‘risk’ and ‘otherness’ in the nation state, and the exploitation of real fears in the wake of real school violence, have permitted a culture of acute surveillance that significantly alters the enterprise of school-based, ethnographic research.

‘You have to do 60 minutes of physical activity per day … I saw it on TV’: Children's constructions of play in the context of Canadian public health discourse of playing for health.

Public health institutions in many industrialised countries have been launching calls to address childhood obesity. As part of these efforts, Canadian physical activity campaigns have recently introduced childrens play as a critical component of obesity prevention strategies. We consider this approach problematic as it may reshape the meanings and affective experiences of play for children. Drawing on the analytical concept of biopedagogies, we place Canadian public health discourse on play in dialogue with childrens constructions of play to examine first, how play is promoted within obesity prevention strategies and second, whether children take up this public health discourse. Our findings suggest that: (i) the public health discourse on active play is taken up and reproduced by some children. However, for other children sedentary play is important for their social and emotional wellbeing; (ii) while active play is deemed to be a solution to the risk of obesity, it also embodies contradictions over risk in play, which children have to negotiate. We argue that the active play discourse, which valorises some representations of play (that is, active) while obscuring others (that is, sedentary), is reshaping meanings of play for children, and that this may have unintended consequences for childrens wellbeing.

Problematizing “Play-for-Health” Discourses Through Children’s Photo-Elicited Narratives

There are growing concerns in many industrialized Western societies about declining opportunities for children to play, and fears that this will have adverse health consequences for them. Informed by anti-obesity efforts, public health institutions have recently begun to advance active forms of play as a way of improving children’s physical health; however, promoting play for physical health might reshape meanings of play for children. We conducted photography and interview sessions with 25 Canadian children aged 7 to 11 years to examine their representations of play. Our findings suggest that for children, (a) play is an end in itself, (b) play involves but is more than active play, (c) there is ambivalence about scheduled play, and (d) risk is considered a pleasurable component of play. These findings point to a dissonance between children’s play promoted for physical health and the meaning of play for children as emotionally contingent, intrinsically motivated, and purposeless.

Children's outdoor playtime, physical activity, and parental perceptions of the neighbourhood environment

The purpose of this study was to examine the association between the hours of outdoor play and objective measures of physical activity and identify the correlates of outdoor playing time in terms of parental perceptions of the neighbourhood environment. Time spent in outdoor play, both on a typical weekday and a typical weekend day, and neighbourhood perceptions, was assessed by parental self-report for 889 students attending grades 5 and 6 in Toronto, Canada (mean age: 10.50 ± 0.72 years). Physical activity was assessed by accelerometry. Ordered logit models were estimated to explore the influence of neighbourhood perceptions on the time spent playing outdoors. Regardless of a childs age and sex, duration of play was significantly correlated with minutes of moderate-to-vigorous physical activity. Parental concerns about strangers and fast drivers were inversely associated with duration of play on a typical weekday. Parental safety concerns continue to present a formidable barrier to greater outdoor play.

The place of play: from playground to policy to classroom well-being

In 2010 the Provincial Government of Ontario, Canada introduced a new play-based learning curriculum. Educational stakeholders (i.e. teachers, early childhood educators and student teachers) have been charged with the task of implementing the play-based curriculum, which upholds childrens fundamental right to play, as a means to health and well-being. In this paper, we examine educators experiences with the new play-based curriculum in Toronto, ON, Canadas largest city. While we found that a play-based curriculum has been championed with respect to health and well-being in educational policy, there are many challenges integrating play into teaching practices, especially in an era of standardized testing. We conclude that while there are benefits to play-based learning for childrens health, it is important to further investigate whether current iterations of play-based curricula are a new pedagogical site for governing childrens bodies or whether play-based curricula allow children to experience, and engage with the pleasure and ambiguities of play in their daily lives in schools.

Keep fit: marginal ideas in contemporary therapeutic exercise

Abstract Exercise has a long history as a therapeutic modality and has existed, in some form, in all cultures throughout recorded history. In recent years, therapeutic exercise has taken on new significance as a relatively low cost medical intervention designed to improve people’s health and well-being and reduce the downstream effects of comorbidity. Drawing our inspiration from Foucault and Deleuze, we argue that seeing therapeutic exercise as primarily ‘medical’ carries with it consequences – some recognised, others unseen – that are problematic and worthy of consideration. Our focus is on the acts of marginalisation, exile and exclusion implicit in the quotidian practice of therapeutic exercise, and how these acts mediate people’s daily lives. In the paper we explore how therapeutic exercise is being instrumentalised, normalised and constrained, arguing for much greater critical attention towards its putative ‘goodness’ and virtue as a health intervention.