Richard W. Christiana

Pediatrician prescriptions for outdoor physical activity among children: A pilot study

Research indicates that promoting time spent in the outdoors and outdoor physical activity increases childrens daily physical activity and improves health. One method showing promise is doctor prescriptions for outdoor physical activity for children; however, no empirical evidence currently exists on prescriptions for childrens outdoor physical activity. A pilot study was conducted at one pediatric practice in western North Carolina during 2015 to test the feasibility and potential effectiveness of conducting an outdoor physical activity prescription program for children aged 5–13 years. Three pediatricians wrote prescriptions for children (n = 38), discussed benefits of outdoor physical activity, and provided information packets to parents on nearby places for physical activity. Parents of patients of five pediatricians served as control (n = 32). Prior to seeing a pediatrician, parents completed a baseline survey that asked height and weight, assessed their views of childrens physical activity, and their personal and childs physical activity/sedentary behaviors. A nurse measured childrens height and weight. Parents were emailed one-month and three-month follow-up surveys that asked the questions listed above. Changes in childrens physical activity, outdoor physical activity, time spent in the outdoors, and sedentary activities were not significant between intervention and control groups. About half of parents (49%) viewed prescriptions as beneficial for their children and most used the intervention materials at home (70%). A larger study is needed to assess whether prescriptions increase childrens physical activity. A critical examination of the intervention, pilot study design, and suggestions for a larger future study are provided.

Active living in rural Appalachia: Using the rural active living assessment (RALA) tools to explore environmental barriers

People residing in rural communities are more likely to be physically inactive and subsequently have elevated risks for chronic disease. Recent evidence has shown this could stem from environmental barriers, inadequate programming and policies directed at the promotion of physical activity (PA) in rural settings. The objective of this research was to assess active living features in rural towns and townships (n = 16) across seven counties in northwestern North Carolina (NC). The study utilized the Town-Wide and Street Segment components of the Rural Active Living Assessment (RALA) as well as the 2014 American Community Survey results. The assessments were conducted in the summer of 2016 in the rural Appalachia region of NC. Using the RALA town-wide assessment scoring system (0 − 100), the range of scores was 18–84, with the mean being 50.06. Three towns had no sidewalks, nine towns had sidewalks on only one side of the main streets, and four had sidewalks on both sides of the main streets. One town was rated as highly walkable, seven towns as moderately walkable, five towns as moderately unwalkable, and three towns as highly unwalkable. The rural Appalachia region of NC offers unique topographic, geographic and environmental barriers to PA. However, our findings indicate many rural towns offer common PA amenities. Future research should utilize qualitative methods and a community-based participatory research approach to more fully understand the challenges with increasing PA in the rural and often isolated Appalachia communities.

The Role of Competition in Leisure-Time Physical Activity Among Middle School Youth: Implications for Park and Recreation Professionals

A better understanding of the types and contexts of activities that young adolescents participate in during their leisure time is needed in order to foster the early development of positive leisure behaviors and recreation choices that can influence maintenance of leisure-time physical activity (LTPA) throughout life. The purpose of this study was to examine differences in intention to participate and current participation in competitive and noncompetitive forms of LTPA among young adolescents by gender and socioeconomic status. The results are intended to inform community recreation professionals as they often have responsibility for making programmatic decisions that directly influence LTPA. Intention and current participation in competitive and noncompetitive LTPA was assessed in a rural sample of 838 young adolescents aged 10–14 years through a self-administered questionnaire. Among all participants, intention to participate in noncompetitive LTPA and competitive LTPA were found to be significant predictors of current participation in each respective form of LTPA. Boys participated in both forms of LTPA more often than girls; however, no statistically significant difference was found among boys between either their intention to participate in noncompetitive and competitive LTPA or current participation in noncompetitive and competitive LTPA. Among girls, intention to participate in noncompetitive LTPA was significantly greater than intention to participate in competitive LTPA and current participation in noncompetitive LTPA was significantly greater than current participation in competitive LTPA. Among low-income youth, no statistically significant difference was found between noncompetitive and competitive LTPA in either intention or current participation. The study results point to the ongoing gender disparity that exists in LTPA participation and provide further context to competitive and noncompetitive recreation choices for how leisure time is spent. The results indicate that community recreation agencies should be sure their recreation programs include noncompetitive program choices designed specifically to meet girls’ interests, but to also consider the value of offering a diverse range of noncompetitive and competitive programming for all youth. Subscribe to JPRA

Prescribing Outdoor Physical Activity to Children: Health Care Providers’ Perspectives:

Little evidence exists on health care provider (HCP) prescriptions for children’s outdoor physical activity (PA). Semistructured interviews were conducted with 15 children’s HCPs to explore perspectives on outdoor PA prescription programs for children and barriers to implementation. Thematic analytic techniques were used to analyze the data. Most participants reported an awareness of health benefits to children being in the outdoors. Ten themes emerged from the data related to 3 thematic categories: (1) current strategies that HCPs are using to promote PA among children, (2) barriers that HCPs see to prescribing outdoor PA, and (3) potential strategies for promoting outdoor PA among children. Assessment of the local outdoor PA environment and resource development must be done prior to a prescription program. HCPs should be skilled in conducting conversations and setting goals related to outdoor PA tailored to the patient. Developing a system for follow-up with patients on established goals should also be included.

P36 Physical activity among rural high school students with a previous history of ankle sprain

Study Design Cross-sectional. Objectives To determine the effect of ankle sprain on self-reported physical activity (PA) among rural high school students. Background Ankle sprains and their long-term sequelae are believed to deter individuals from PA, negatively affecting health. College-aged individuals with chronic ankle instability (CAI) have demonstrated decreased PA; however, no evidence exists describing PA levels of high school-aged individuals with ankle injuries. Methods and Measures An electronic survey was distributed to students at a high school in northwestern North Carolina. The instrument collected demographics, ankle injury history, Identification of Functional Ankle Instability (IdFAI), International Physical Activity Questionnaire, functional questionnaires, and participation in recreational activities. Respondents were stratified into 4 groups in accordance with International Ankle Consortium guidelines: uninjured (no history of ankle sprain), unstable (history of sprain and IdFAI ≥11); copers (history of sprain and IdFAI ≤10); and recently injured (history of ankle sprain within previous year). Body mass index (BMI), total MET-minutes per week, and activity choices were compared across groups using analysis of variance, Kruskal-Wallis test, or Pearson’s chi-squared (α=0.05). Results BMI was not significantly different across groups (F=0.41, p=0.74); however, significant differences were detected for total MET-minutes per week (χ2=11.65, p<0.01) as unstable respondents reported more PA than uninjured respondents (unstable=4706.1±4610.6; uninjured=2592.9±2946.0), with no differences between other groups. Groups were not significantly different for participation in high school sports (χ2=4.38, p=0.22); however respondents with a history of ankle injury reported greater participation in jogging and running activities (χ2=3.99, p=0.04); team sports (χ2=8.37, p<0.01); and motor sports (χ2=4.99, p=0.03). Conclusion Despite a history of injury and sensations of instability in the ankle, respondents with CAI reported higher activity levels than uninjured participants. As this is contrary to pre-existing hypotheses, it is possible continued PA after injury may serve to heighten sensations of instability assessed by self-reported questionnaires.