Gavin T. Colquitt

The Personalized System of Instruction in Fitness Education

JOPERD • Volume 82 No. 6 • August 2011 P ersonal fitness courses are required in many high schools in the United States and are offered by many colleges as physical activity courses. These courses are vital for the development of lifelong personal fitness behaviors in adolescents. The importance of these courses is compounded by the fact that only 54 percent of high school students attended physical education classes in 2007 (Centers for Disease Control and Prevention [CDC], 2008). These courses usually follow one of two instructional approaches. In teacherfocused fitness courses, students often follow the teacher’s example in group activities, whereas student-focused courses generally allow the student to choose among various activities in the hope of promoting enjoyment and personal meaning. However, the typical approaches to personal fitness have not translated into positive changes in the health status of today’s youths, as the obesity rate among adolescents has increased from 6.5 to 17.0% over the past three decades (Ogden, Carroll, & Flegal, 2008), and physical activity has decreased with age (National Center for Health Statistics, 2004). This is possibly due to physical education teachers’ inability to promote, in activitybased courses, the necessary fitness concepts that might lead to permanent lifestyle changes (Ross, 1994). Personal fitness courses must result in cognitive gains as well as enjoyment and personal application in order to produce lifestyle changes in high school students. To achieve this, physical education teachers need to meet the following guidelines to promote activity among their students: (1) provide planned, sequential physical education that promotes lifelong activity, (2) develop student knowledge and positive attitudes toward physical activity, and (3) develop mastery of skills and confidence in physical activity among students (CDC, 1997). One approach that physical education teachers could take to meet these guidelines is the personalized system of instruction (PSI; Keller & Sherman, 1974). Most physical education classes focus on student learning in the psychomotor domain, since teachers aim to increase the activity levels of students (Harrison, Blakemore, Buck, & Pellett, 1996). While students may experience direct benefits from such a narrow approach, it does not promote lifestyle changes. During a personal fitness course, students must engage in physical activity and develop the knowledge, motivation, and self-confidence to engage in fitness activities outside the physical education setting. This can be done only by making personal fitness “personal.” The PSI allows students to progress “as fast as they can or as slowly as they need” (Metzler, 2005, p. 217). Increasing the personal application of fitness content and improving student learning in all domains will make students more likely to continue to participate in the activity throughout life. An instructional model used in physical education settings, the PSI has been defined as a “plan or pattern that can be used to shape curriculums (long-term courses of studies), to design instructional materials, and to guide instruction in the classroom or other settings” (Joyce & Weil, 1980, p. 1). When selecting an instrucThe Personalized System of Instruction in Fitness Education

VERB™ Summer Scorecard: Increasing Tween Girls' Vigorous Physical Activity

OBJECTIVE We assessed changes in the frequency of self-reported physical activity (PA) among tween girls exposed and not exposed to the VERB™ Summer Scorecard (VSS) intervention in Lexington, Kentucky, during 2004, 2006, and 2007. METHODS Girls who reported 0-1 day per week of PA were classified as having little or no PA. Girls who reported 2-3 days of PA were classified as low PA performers; 4-5 days of PA were labeled as moderate performers; and 6-7 days of PA were identified as high performers. Logit regression analysis of survey data from girls identified trends in PA frequency across time. RESULTS In 2004, participant girls were more likely than girls unfamiliar with VSS (reference group girls) to report high frequency of PA (OR = 1.44, CI = 1.18, 1.70). In 2006, participants were statistically less likely than reference group girls to report low frequency of PA (OR = 1.75, CI = 1.33, 2.21). In 2007, VSS participants were consistently more likely to report moderate frequency (OR = 1.56, CI = 1.35, 1.77) and high frequency of PA (OR = 1.44, CI = 1.24, 1.64) than reference group girls. CONCLUSION An innovative, community-driven intervention demonstrated promise for increasing PA among tween girls. VSS may have transportability to other communities to help reverse the secular trend of declining PA for this population segment.

Urban vs. rural differences in insurance coverage and impact on employment among families caring for a child with cerebral palsy

Abstract Background: The purpose of this study was to examine urban vs. rural differences on the relationship between family contextual variables and adequacy of insurance coverage and impact on employment for among families with a child with Cerebral Palsy from a nationally representative sample. Methods: A retrospective, observational study was carried out using data from the National Survey of Children with Special Healthcare Needs. Results: A total of 744 participants reported as having a child with a diagnosis of Cerebral Palsy and were included in the sample. Logistic regression analyses, adjusting for urban and rural setting revealed different predictors of adequacy of insurance coverage and impact on employment. Among urban respondents, three variables with odds ratios ranging from 1.33 to 1.58 served as protective factors, increasing the likelihood of adequate insurance coverage. Four variables with odds ratios ranging from 1.41 to 1.79 decreased the likelihood of negatively impacting employment. Among rural families, there was only one significant protective factor for adequacy of insurance coverage (odds ratio 1.80) and one for decreasing the chances of impact on employment (odds ratio 2.53). Conclusion: Families in rural areas caring for a child with CP have few protective factors for adequate insurance coverage and impact on familial employment.

Parent Perspectives on Health and Functioning of School-Aged Adolescents With Disabilities

BACKGROUND Youth living with disabilities are at risk of experiencing poor health outcomes. Coordinated school health programs have an opportunity to help youth with disabilities and their families through health education, health services, and community engagement. The World Health Organization developed the International Classification of Functioning, Disability, and Health (ICF) as a framework to analyze factors related to health conditions. We used the ICF to examine parental perceptions of health and function among students with disabilities living in rural and urban areas. METHODS We surveyed parents (N = 71) using the parent-report versions of the Pediatric Outcomes Data Collection Instrument and Child Health and Illness Profile. From this group, parents were asked to volunteer to participate in in-depth, individual interviews (N = 18). The interviews were audio-recorded and transcribed verbatim. Researchers used the ICF linking rules to analyze and code the transcriptions. Emergent themes were assigned numerical ICF codes. RESULTS There were more similarities than differences among rural and urban families. Children living with disabilities face significant environmental barriers regardless of context. CONCLUSIONS Schools can facilitate education to improve the quality of life of parents and families of children with disabilities. School authorities should consider the many environmental barriers both urban and rural these families face in the community. The ICF can be used as a framework for program planning for community-based, health education for this population.

Predictors of Coordinated and Comprehensive Care Within a Medical Home for Children With Special Healthcare (CHSCN) Needs

The purpose of this study was to examine predictors of coordinated and comprehensive care within a medical home among children with special health care needs (CSHCN). The latest version of the National Survey of Children with Special Health Care Needs (NS-CSHCN) employed a national random-digit-dial sample whereby US households were screened, resulting in 40,242 eligible respondents. Logistic regression analyses were performed modeling the probability of coordinated, comprehensive care in a medical home based on shared decision-making and other factors. A total of 29,845 cases were selected for inclusion in the model. Of these, 17,390 cases (58.3%) met the criteria for coordinated, comprehensive care in a medical home. Access to a community-based service systems had the greatest positive impact on coordinated, comprehensive care in a medical home. Adequate insurance coverage and being White/Caucasian were also positively associated with the dependent variable. Shared decision-making was reported by 72% of respondents and had a negative, but relatively negligible impact on coordinated, comprehensive care in a medical home. Increasing age, non-traditional family structures, urban residence, and public insurance were more influential, and negatively impacted the dependent variable. Providers and their respective organizations should seek to expand and improve health and support services at the community level.

Comparing impact on the family and insurance coverage in children with cerebral palsy and children with another special healthcare need

BACKGROUND Families and caregivers of children with special healthcare needs (CSHCN) often experience financial difficulties, have unmet physical and mental health needs, and are at increased risk of marital problems due to the stress caused by carrying for their child. Within the larger population of CHSCN, young people with cerebral palsy (CP) have more unmet needs due to the complexity and potential severity of the disability. The purpose of this study was to identify factors associated with differences in insurance coverage and impact on the family of children with CP and other CHSCN. METHODS The data were taken from the National Survey of Children with Special Health Care Needs, which was designed to examine state- and national-level estimates of CSHCN. Three variables examined differences in insurance coverage between those children diagnosed with CP versus all other CSHCN: insurance coverage for the previous year, current insurance coverage, and adequacy of insurance coverage. Four variables representing different indicators of family impact were used to assess differences between children with CP versus all other CSHCN: out-of-pocket expenses for healthcare, family financial burden, hours per week that family members spent caring for the child, and impact on family work life. RESULTS The results of this study showed significant differences between households with a child with CP and a child with another health special need in terms of insurance coverage, indicating a tendency of children with CP to be insured the entire year. As for the impact on the family in households with children with CP versus other CSHCN, there were significant differences in all four variables that were analysed. CONCLUSIONS There is limited evidence highlighting differences between the impact of caring for a child with CP and caring for other CSHCN. Caring for a child with CP has a significant impact on the family, despite insurance coverage.

Using the Personalized System of Instruction to Differentiate Instruction in Fitness

The purpose of this article is to provide an overview of how PE teachers can personalize learning to meet a variety of student needs. Differentiated instruction (DI) is a term frequently used in classroom-based learning to describe a method of personalization for individual students. The term can also describe a theoretical model for teaching and research, an instructional model, and a philosophy. Teachers must have a firm understanding of student readiness, interest, and learning profile to differentiate four areas of instruction: content, process, product, and the environment. Students in PE can benefit from DI, but there is a lack of formal methods to differentiate PE content. The Personalized System of Instruction (PSI) is an instructional model that provides a complete framework for PE teachers to personalize learning for all students. Fitness-related content such as resistance, plyometric, and agility training provides a context for applying the PSI model to DI in the secondary school setting. Subscribe to TPE

Urban Versus Rural Differences in the Effects of Providing Care to Children With Cerebral Palsy on Family Member's Employment

focuses on personal and family unmet needs and support preferences. Results: Several themes emerged from the focus groups, and needs differed by phase of care (initial vs ongoing). Isolation and coping with trauma were themes of both care phases, with some unique features. Immediately after injury, caregivers spoke of isolation from close family members and friends and an overwhelming gulf of emotions coping with the trauma of the injury. After this initial phase, caregivers spoke of experiencing isolation from others living with SCI, for both themselves and their child. They also reported persistent emotional challenges for themselves and their family that peak and wane. Further, they described challenges balancing caregiving with other family roles and maintaining their physical and emotional stamina. Caregivers desired more support from professionals during both the initial and ongoing phases of care. Early on, they reported needing help finding appropriate pediatric SCI rehabilitation centers and processing the large amount of information and emotions. They also wanted more orientation and preparation for specialty care needs and secondary conditions. Care coordination and help navigating benefits and insurance were reported as ongoing needs. Caregivers were unanimous in the need for more peer support as soon as possible and over the “long haul.” They spoke of the power of hearing and receiving support from others who have “been there and done that.” Having formal and informal opportunities to connect with others living with SCI was highly desired. Conclusions/Significance: Results indicate that additional peer and professional social support is needed in order to help caregivers navigate the different phases of caring for their child with SCI. Support: The Craig H. Neilsen Foundation, Grant #288993. SP 48 Urban versus rural differences in the effects of providing care to children with cerebral palsy on family member’s employment B SCHAIBLE, G COLQUITT, L LI, N MOREAU, M CACIULA Georgia Southern University, Statesboro, GA, USA; ACSM, NAK, ISB, Statesboro, GA, USA; Louisiana State University Health Sciences Center – New Orleans, New Orleans, LA, USA; Georgia Southern University, New York, NY, USA Background and Objective(s): Context (urban vs rural) can mediate the impact on the family among other childhood populations with special healthcare needs. To date, few studies have examined the role of context in caring for a child with CP; therefore, we analyzed data from the National Survey of Children with Special Health Care Needs (NS-CSHCN). Study Design: Cross-sectional. Study Participants & Setting: Participants were parents of children (< 18y old) with CP. Children’s mean age of rural respondents was 10.17 (SD=4.69), while 73% were white, 13.5% Hispanic, 11% black, and 2.5% other (non-Hispanic). Among rural families, 33.05% were living in households with incomes below the Federal Poverty Level (FPL). For those respondents living in urban areas, children’s mean age was 9.74 (SD=4.50) and 63% were white, 13% Hispanic, 16% black, and 8% other (non-Hispanic). Overall 21.1% of urban families lived in households with incomes below the FPL. Materials/Methods: The NS-CSHCN was designed to examine stateand national-level estimates of CSHCN. A national random-digit-dial sample of US households were screened for children with special healthcare needs aged 0–17 years. Households reporting a CSHCN participated in an interview for one randomly selected child with a special healthcare need. Of 40 242 completed interviews from 2009 to 2011, 744 reported as having a child with a diagnosis of CP and were included in the sample. We performed logistic regression analyses, in the context of multiply imputed data to address missing data concerns, modeling the probability that family member’s employments were unaffected by the child’s health. Results: Our analysis indicated significant differences between families with children with CP living in an urban environment and those living in a rural setting concerning the impact that the child’s health had on family member’s work lives. There were six significant variables impacting the employment of family members for families living in an urban setting categories relating to missed school days, financial burden, and

The Effect of an Upper Extremity Power Training Intervention on Pain and Power Among Young People With Cerebral Palsy

careful with challenging the children during this type of training. The mechanical demands of cycling change with pedaling requirements. Such changes in requirements may induce movement inefficiencies and exacerbate ineffective joint torques. The purpose of this study is to describe the biomechanics of pedaling under different pedaling conditions, specifically changes in cycling cadence, to evaluate the biomechanics of these task constraints for children with CP. Study Design: Multiple-case design. Study Participants and Setting: Eight children with quadriplegic (q), diplegic (d) and hemiplegic (h)CP between 5–7 years of age (GMFCS I to IV) were compared to 8 matched neurotypical (NT) peers in a laboratory setting. Materials/Methods: The children performed cycling cadences ranging between 30 and 80 revolutions per minute (RPM) at a low resistance setting of 5 Watts. The maximum cadence was dependent upon each child. Pedal forces, joint kinematics, smoothness (jerk cost) and joint torques were compared between the children with CP and NT peers. Results: Data showed that both groups applied the same patterns of crank torque to accelerate the crank, however, those with CP showed increased lateral sheer forces on the pedal eccentric to the sagittal plane of motion (CP: 15 N compared to NT: 5 N). Kinematics revealed that children with hCP cycled with an increased “toe-down”-position and showed more out-of-plane motion on the affected side than their peers; children with qCP and dCP had more increased motion out of the sagittal plane in both legs. Altered kinematics led to more jerk in their cycling motion than their NT peers during both flexion and extension phase (CP: ranging from 1.1 9 108 to 7.1 9 1011 deg2/s5 compared to NT: 6.7 9 107 to 2.5 9 109 deg2/s5). The differences were larger when cadence increased. Furthermore, out-of-plane joint torques were increased in children with CP. In qCP and dCP, both sides were affected; in hCP especially the joint torques on the non-affected side were increased. For the joint kinematics and kinetics, no cadence effect was found. Conclusions/Significance: All parameters demonstrated that young children with CP are less efficient in cycling than NT peers. Cadence did not have an effect on joint torques, so it will not lead to higher stress in the joints of children with CP. However, since jerk cost is affected by cadence, it will be physiological very challenging for children with CP when cadence increases. The young children that participated in this study were only able to cycle with low resistance. More research should be done to study the effect of changes in resistance on the joint kinetics. Results of this study indicate increased out-of-plane joint torques during cycling; which may exacerbate the negative effects of muscle forces applied repetitively to the atypical joint morphology associated with CP. G8 The effect of an upper extremity power training intervention on pain and power among young people with cerebral palsy G COLQUITT, N MOREAU, L LI, K KENDALL, R VOGEL, T DIPITA Georgia Southern University, Statesboro, GA, USA; Louisiana State University Health Sciences Center, New Orleans, LA, USA; Bodybuilding.com, Boise, ID, USA

Becoming the Physical Activity Champion: Empowerment through Social Marketing

Physical education teachers can champion their profession through marketing the importance of physical activity to children and families in the communities they serve. Social marketing, a consumer-based approach to behavior change, is an excellent choice for physical education teachers who want to ‘sell’ physical activity to their ‘audiences’. This article describes how teachers can apply the concept of social marketing to advocate for what they do.