Esbelle M. Jowers

Physically Active Academic Lessons and Time on Task: The Moderating Effect of Body Mass Index

UNLABELLED Physically active classroom lessons have been found to increase on-task behavior in children. Given that physical activity has been associated with an increased time on task (TOT) and that overweight children take fewer steps than normal weight children do, it was expected that benefits of the physical activity would differentially impact those children of higher weight status. PURPOSE To examine the effects of a physically active classroom lesson and body mass index (BMI) category on TOT in a sample of elementary-aged children (N = 97). METHODS Behavior was assessed through direct observations before and after a physically active classroom lesson and before and after a traditional inactive classroom lesson. TOT was calculated through momentary time sampling for each student by dividing the number of on-task observations by the total number of observations per student (interrater reliability = 94%). RESULTS TOT decreased significantly from before to after the lesson for all BMI categories in the inactive control condition, with no change for the active condition. Post hoc analyses found a significant linear effect for the reduction in TOT with each level of BMI in the inactive condition, with the greatest magnitude of effect for the overweight group. CONCLUSIONS Physically active classroom lessons provide a buffer to prevent the steep reduction in TOT experienced after a period of inactivity in all children, especially those who are overweight.

The benefits of exercise training for quality of life in HIV/AIDS in the post-HAART era.

The use of highly active antiretroviral therapy (HAART) has served to significantly reduce the mortality of HIV-infected persons. However, this treatment is associated with a host of adverse effects: fatigue, nausea, pain, anxiety and depression. Rather than utilise traditional pharmacological treatments for these effects, many HIV/AIDS patients are utilising adjunct therapies to maintain their quality of life while they undergo treatment. Exercise has consistently been listed as one of the most popular self-care therapies and a small number of studies have been conducted to examine the impact of exercise on the most common self-reported symptoms of HIV and AIDS and the adverse effects of treatment. Although the results are generally positive, there are clear limitations to this work. The existing studies have utilised small samples and experienced high rates of attrition. In addition, the majority of the studies were conducted prior to the widespread use of HAART, which limits the ability to generalise these data. As a result, data from other chronic disease and healthy samples are used to suggest that exercise has the potential to be a beneficial treatment across the range of symptoms and adverse effects experienced by HIV-infected individuals. However, additional research is required with this population to demonstrate these effects.

Physically active academic lessons in elementary children

BACKGROUND Although schools are an ideal location to conduct interventions that target children, the emphasis on standardized testing makes it difficult to implement interventions that do not directly support academic instruction. In response, physically active academic lessons have been developed as a strategy to increase physical activity while also addressing core educational goals. Texas I-CAN! is one incarnation of this approach. METHODS We will review the on-going research on the impact of these active lessons on: teacher implementation, child step count, child attention control, and academic performance. RESULTS The collected studies support the impact of physically active academic lessons on each area of interest. CONCLUSIONS If these data can be replicated, it suggests that teachers might find these lessons of benefit to their primary role as educators, which should ease dissemination of these and other physically active lessons in elementary schools.

Physically active vs. sedentary academic lessons: A dose response study for elementary student time on task.

BACKGROUND Physically active academic lessons are an effective intervention to reduce sedentary time and increase student physical activity. They have also been shown to enhance task engagement, as indicated by observations of attention and behavior control, time on task (TOT). However, it is not clear if the improved TOT stems from the physical activity or if it is the result of an enjoyable break from traditional instruction. If it is due to physical activity, what dose of intensity is required for the effect? This study was designed to test these questions. METHODS Participants were 320 children (7-9years) recruited from school districts in Central Texas in 2012. They were assigned by classroom (n=20) to one of four conditions: 1) sedentary, standard lesson (n=72); 2) sedentary academic game (n=87); 3) low to moderate intensity PA (LMPA), academic game (n=81); and 4) moderate to vigorous intensity PA (MVPA), academic game (n=76). Measures included PA via accelerometer and TOT. RESULTS Mixed-method RMANOVA indicated TOT decreased following the standard lesson (p<0.001), showed no change following the sedentary academic game (p=0.68), and increased following the LMPA (p<0.01) and MVPA (p<0.001) academic games. CONCLUSIONS While the sedentary, academic game prevented the reduction in TOT observed in the standard lesson, PA resulted in increased TOT. Future research should be designed to examine the potential academic benefits of the change in TOT.

Farm to Work: Development of a Modified Community-Supported Agriculture Model at Worksites, 2007-2012.

Background The Farm to Work program is a modified community-supported agriculture model at worksites in Texas. Community Context The objective of the Farm to Work program is to increase fruit and vegetable intake among employees and their households by decreasing cost, improving convenience, and increasing access while also creating a new market for local farmers at worksites. The objectives of this article were to describe the development, implementation, and outcome of a 5-year participation trend analysis and to describe the community relationships that were formed to enable the successful implementation of the program. Methods The Farm to Work program began in November 2007 as a collaborative effort between the nonprofit Sustainable Food Center, the Texas Department of State Health Services, the Web development company WebChronic Consulting LLC, and Naegelin Farm. The program provides a weekly or biweekly opportunity for employees to order a basket of produce online to be delivered to the worksite by a local farmer. A 5-year participation trend analysis, including seasonal variation and sales trends, was conducted using sales data from November 2007 through December 2012. Outcome The total number of baskets delivered from November 2007 through December 2012 was 38,343; of these, 37,466 were sold and 877 were complimentary. The total value of sold and complimentary baskets was

A cluster randomized control trial to assess the impact of active learning on child activity, attention control, and academic outcomes: The Texas I-CAN trial

851,035 and

Active learning improves on-task behaviors in 4th grade children

21,925, respectively. Participation in the program increased over time and was highest in 2012. Interpretation The Farm to Work program increased access to locally grown fruits and vegetables for employees and created a new market for farmers. Increased program participation indicates that Farm to Work can increase employees’ fruit and vegetable consumption and thus help prevent chronic diseases in this population

Strategies to Modify School-Based Foods to Lower Obesity and Disease Risk

BACKGROUND Active learning is designed to pair physical activity with the teaching of academic content. This has been shown to be a successful strategy to increase physical activity and improve academic performance. The existing designs have confounded academic lessons with physical activity. As a result, it is impossible to determine if the subsequent improvement in academic performance is due to: (1) physical activity, (2) the academic content of the active learning, or (3) the combination of academic material taught through physical activity. METHODS/DESIGN The Texas I-CAN project is a 3-arm, cluster randomized control trial in which 28 elementary schools were assigned to either control, math intervention, or spelling intervention. As a result, each intervention condition serves as an unrelated content control for the other arm of the trial, allowing the impact of physical activity to be separated from the content. That is, schools that perform only active math lessons provide a content control for the spelling schools on spelling outcomes. This also calculated direct observations of attention and behavior control following periods of active learning. DISCUSSION This design is unique in its ability to separate the impact of physical activity, in general, from the combination of physical activity and specific academic content. This, in combination with the ability to examine both proximal and distal outcomes along with measures of time on task will do much to guide the design of future, school-based interventions.

Increasing frequency of lower-fat entrees offered at school lunch: an environmental change strategy to increase healthful selections.

While increased opportunities for physical activity (PA) are a critical, public health need for children, school-based interventions often place teachers in the position to choose between PA and time spent on academic lessons. Active learning is designed to overcome this by combining PA with academic material. Moreover, teachers are likely to be more responsive to change in academic-related outcomes than in PA. This study utilizes a large, cluster randomized control trial in which student attention, or time on task (TOT) and accelerometer-based PA is assessed in conjunction with active learning. Participants were 2716 children (46% male, 46% white) from 28 elementary schools in Central Texas that were assigned to either: 1) active learning (math n = 10; spelling n = 9); or 2) traditional, sedentary academic lessons (n = 9). PA was measured with accelerometers. TOT was measured through a momentary time sampling protocol. A series of three-level (student, classroom, school) regression models estimated the effect of the intervention. The intervention lead to significantly increased TOT. Moreover, the dose of PA (steps) during the intervention was positively associated with the increase in TOT. In contrast, a greater dose of PA was associated with reduced TOT for students in control schools. Race, gender, and SES did not moderate these effects. Planned PA - as a part of an active, academic lesson - positively impacted TOT. In contrast, a traditional, sedentary lesson was associated with lower TOT. This differential impact offers intriguing possibilities to better understand the relationship between PA and academic performance.

Validation of the Physical Activity Self-Efficacy Scale: Testing Measurement Invariance Between Hispanic and Caucasian Children

• School-based interventions to modify dietary practices in children are generally supported as a means to reduce obesity and to combat obesity-related disease.