Interventions to promote physical activity and healthy digital media use in children and adolescents: A systematic review

Objectives: To identify effective interventions that promote healthy screen time use and reduce sedentary behavior in school-aged children and adolescents (SACA) in all settings, over the last 20 years. Methods: Searches were conducted from 2000 until March 2021 using PubMed, Embase, Medline, PsycINFO, Ovid SP, The Cochrane Library, Cochrane Central Register of Controlled Trials, Cochrane Methodology Register, and the WHO regional databases, including Google Scholar and reference lists of relevant articles and reviews. Randomized-controlled trials and quasi-experimental studies assessing interventions to reduce sedentary behaviors and screen time in healthy SACA (aged 5-19.9 years) globally. Data were extracted by 2 reviewers and where possible, pooled with a random-effects model. Results: The review included 51 studies, of which 23 were included in meta-analyses with 16 418 children and adolescents. Nondigital randomized-controlled trials reported a small, but significant reduction of TV-specific screen time (minutes per day) (mean difference, -12.46;95% confidence interval, -20.82 to -4.10;moderate quality of evidence) and sedentary behavior (minutes per day) (mean difference, -3.86;95% confidence interval, -6.30 to -1.41;participants = 8920;studies = 8;P = .002;moderate quality of evidence) as compared with control groups. For quasi-experimental studies, nondigital interventions may make little or no difference on screen time (minutes per day) or sedentary behavior (minutes per day), given the high uncertainty of evidence. Most studies were conducted in a high-income country. Generalizability of results to low- and middle- income countries remain limited. Conclusions: Public health policies and programs will be necessary to reduce excessive sedentary behavior and screen time, especially in the post-coronavirus disease 2019 reality. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

Social-Ecological Factors Predict College Students’ Physical Activities and Sedentary Behavior

Guided by the socio-ecological model, the aim of this study was to investigate the predictive strengths of individual, social, and physical environmental factors toward different intensities of physical activity (PA;vigorous PA, moderate PA, walking) and sedentary behavior (SB) among college students. A cross-sectional research design was used. There were 287 college students (Mage = 20.75 ± 2.91;54% female) recruited from a public research university in the Southwestern United States. Participants completed previously validated questionnaires assessing their PA, SB, and perceptions of self-efficacy, social support, and physical environment variables. Correlation and hierarchical regression analyses were performed to examine the associations and the relative contributions of those individual, social, and physical environmental factors to PA and SB, respectively. The findings indicated that self-efficacy, social support from friends, and convenience of using exercise facilities were positively correlated with vigorous PA. Self-efficacy and physical environmental factor such as convenience of using exercise facilities were significantly associated with students’ moderate PA. Physical environmental factors, including convenience of using exercise facilities, satisfaction with neighborhood services, ease of walking to public transportation stop, and detached single-family residence were significantly related to walking, while only detached single-family residence was associated to SB. The results highlight PA interventions may do well to focus on the promotion of individual and environmental variables to increase PA in college students. More evidence is needed to determine the relationships between social ecological factors and SB.

Changes in Physical Fitness among Elementary and Middle School Students in Korea before and after COVID-19.

The present study aimed to analyze changes in health-related physical fitness among Korean elementary and middle school students before (2019) and after (2021) the COVID-19 pandemic. Data collection was completed by requesting the physical activity promotion system (PAPS) data from elementary and middle school students. This information is obtained annually by the Goyang Office of Education in Gyeonggi-do, Korea. The collected data were measured in 2019 and 2021. Data were collected from 17,000 children in the fifth and sixth grades of elementary school and about 24,000 boys and girls in the first, second, and third grades of middle school. Chi-square analyses were used to examine data from each school's health-related physical fitness examinations. Our results indicated that physical fitness levels were significantly lower in 2021 than in 2019 across the following six areas: cardiorespiratory endurance, power, muscular strength, flexibility, obesity, and overall health-related physical fitness (p < 0.05). In addition, the ratio of students with excellent physical fitness (PAPS Grades 1 and 2) significantly decreased from 2019 to 2021, while the ratio of students with poor physical fitness (PAPS Grades 3, 4, and 5) increased (p < 0.05). In addition, there were some differences according to grade and gender. Discussions regarding the impact of decreases in physical activity on physical fitness, interpretations of physical fitness in the context of a pandemic, and practical measures that can be implemented to improve health and fitness among children and adolescents in such situations remain essential.

Impact of Virtual vs. In-Person School on Children Meeting the 24-h Movement Guidelines during the COVID-19 Pandemic.

The pandemic mitigation strategy of closing schools, while necessary, may have unintentionally impacted children's moderate-to-vigorous physical activity (MVPA), sleep, and time spent watching screens. In some locations, schools used hybrid attendance models, with some days during the week requiring in-person and others virtual attendance. This scenario offers an opportunity to evaluate the impact of attending in-person school on meeting the 24-h movement guidelines. Children (N = 690, 50% girls, K-5th) wore wrist-placed accelerometers for 14 days during October/November 2020. Parents completed daily reports on child time spent on screens and time spent on screens for school. The schools' schedule was learning for 2 days/week in-person and 3 days/week virtually. Using only weekdays (M-F), the 24-h movement behaviors were classified, and the probability of meeting all three was compared between in-person vs. virtual learning and across grades. Data for 4956 weekdays (avg. 7 d/child) were collected. In-person school was associated with a greater proportion (OR = 1.70, 95% CI: 1.33-2.18) of days that children were meeting the 24-h movement guidelines compared to virtual school across all grades. Students were more likely to meet the screen time (OR = 9.14, 95% CI: 7.05-11.83) and MVPA (OR = 1.50, 95% CI: 1.25-1.80) guidelines and less likely to meet the sleep (OR = 0.73, 95% CI: 0.62-0.86) guidelines on the in-person compared to the virtual school days. Structured environments, such as school, have a protective effect on children's movement behaviors, especially physical activity and screen time.

"We Don't Have to Do Things the Way They've Been Done Before"; Mixed-Method Evaluation of a National Grant Program Tackling Physical Inactivity through Sport.

National strategies are needed to continue to promote the broader benefits of participating in sport and organised physical activity to reduce physical inactivity and related disease burden. This paper employs the RE-AIM framework to evaluate the impact of the federally funded $150 million Move it AUS program in engaging inactive people in sport and physical activity through the Participation (all ages) and Better Ageing (over 65 years) funding streams. A pragmatic, mixed-methods evaluation was conducted to understand the impact of the grant on both the participants, and the funded organisations. This included participant surveys, case studies, and qualitative interviews with funded program leaders. A total of 75% of participants in the Participation stream, and 65% in the Better Ageing stream, were classified as inactive. The largest changes in overall physical activity behaviour were seen among socioeconomically disadvantaged participants and culturally and linguistically diverse participants. Seven key insights were gained from the qualitative interviews: Clarity of who, Partnerships, Communication, Program delivery, Environmental impacts, Governance, and that Physical inactivity must be a priority. The Move It AUS program successfully engaged physically inactive participants. Additional work is needed to better engage inactive people that identify as culturally and linguistically diverse, Aboriginal and/or Torres Strait Islander and those that live in disadvantaged communities in sport and physical activities. Tangible actions from the seven key insights should be adopted into workforce capability planning for the sport sector to effectively engage physically inactive communities.

The Influence of Pulmonary Rehabilitation and Counselling on Perceptions of Physical Activity in Individuals with COPD - A Qualitative Study.

Objective: The aim of this study was to explore to what extent a combined counselling and pulmonary rehabilitation program (PR) influences the perception of physical activity (PA) and motivation for behavioral change in PA in individuals with COPD. The results of previous quantitative trial that investigated the effect of this combined treatment on daily PA were inconclusive. It is conjectured that a more targeted tailoring of the counselling and PR intervention could improve its effectiveness. Patients and Methods: Eighteen individuals with COPD (median age 69, 8 females) who had participated in the PneumoReha program were interviewed twice (following PR and at three-month follow-up). These interviews were transcribed and analyzed thematically. Based on the codes thus identified, three categories 'perception of PA intensity', 'quality of motivation to perform PA', and 'strategies to cope with barriers' were used to differentiate 'types' of participants. Results: Four different types of COPD individuals were distinguished. Study findings indicate that those individuals who participated in the PR program combined with embedded counselling tended to be more active and intrinsically motivated. Conclusion: A typology of four types of people with COPD was developed, characterized by their perception of activity, individual motivation and strategies for managing barriers. The patients' physical activity level might be influenced by their concept of physical activity and the quality of motivation. Recognizing patients' different activity behaviors is important for improving the quality of outpatient PR programs and developing tailored (according to each type) counselling interventions embedded in outpatient PR programs. Clinical Trial Registration: The study was registered on the website of https://www.clinicaltrials.gov/ with the identifier NCT02455206 (27/05/2015), as well as on the Swiss National Trails Portal SNCTP000001426 (05/21/2015).

Results from Poland's 2022 Report Card on Physical Activity for Children and Youth.

This paper presents the methodology and results of Poland's 2022 Report Card on physical activity (PA) of children and adolescents, as part of the Global Matrix (GM) 4.0 project. The aim of this paper is to discuss the current state of PA of children and adolescents in Poland. Grades were assigned to ten indicators of behaviors, physical fitness and sources of influence or settings, based on a synthesis of the best available data. In Poland two indicators: Overall Physical Activity (OPA) and Active Play were not assessed. Out of the other indicators, School received the highest score B+, whereas the other indicators had generally moderate to weak scores (between C+ and D). Scores for Organized Sport and Physical Activity, School and Physical Fitness indicators were improved compared with the previous GM, whereas scores for Active Transport and Government were lower. No positive changes regarding OPA or Sedentary Behaviors were observed. One of the limitations of PA promotion in Poland is that government-level PA policies are overly focused on organized PA and sport. Recommendations for improving PA monitoring in Poland, influencing PA behaviors and strengthening PA settings and sources of influence are also discussed.

Developing a Home-Based Body Weight Physical Activity/Exercise Program

Apply It! center dot Research shows barriers to PA exist due to varieties of intrinsic and extrinsic factors. The COVID-19 pandemic has further confounded public engagement in PA. Home-based body weight exercise training may be a potential intervention to remedy these barriers. center dot Fitness professionals can educate their clients in a remote setting using the information related to home-based exercise programming and body weight exercise options presented in this article, supplemental information, and freely accessible resources also provided. center dot Home-based video personal training can be implemented to increase the interaction between fitness professionals and clients.

Preparation for and implementation of a Physical Activity Education Program (PEP) in a primary care setting

Background: Physical activity is one of the most important behaviors that humans can engage in to improve their health, yet population rates of physical activity remain considerably low. Additional research on physical activity interventions is necessary, specifically group-based interventions in primary care. Purpose: The purpose of this study was to design and provide an illustration of a group-based physical activity intervention in primary care, called the Physical Activity Education Program (PEP). The aim of Phase 1 was to gather qualitative information from primary care physicians (PCPs) and patients to assist in designing PEP. The aim of Phase 2 was to implement a pilot PEP program and assess its acceptability, feasibility, and impact on physical activity and health outcomes. Methods: PCPs and patients from a family medicine practice (FMMS) were recruited to participate in Phase 1 key informant interviews. The four-week PEP program was implemented in Phase 2. Four patients from FMMS were recruited over the span of a month to participate. The first PEP session occurred in-person, after which the program continued virtually in response to social distancing measures put in place during the COVID-19 pandemic. Case descriptions for each participant were used to illustrate the feasibility, acceptability and impact of PEP. Results: Phase 1 key informant interviews helped design the PEP program. Of the four PEP participants, two (50%) completed the program. The PEP program was found to be very satisfactory by completers;satisfaction was slightly lower among non-completers. Physical activity engagement was shown to increase among completers by the end of PEP;at follow-up, physical activity remained at similar levels or higher. Depressive, anxiety, and somatic symptoms decreased among all participants by the end of PEP;one completer exhibited an increase in symptoms at follow-up. Conclusions: This study indicated that implementing a multi-disciplinary, group-based physical activity intervention in primary care is possible. Although the sample size was very small, the impact that the PEP program has on physical activity and health outcomes is promising. Future research is necessary to better understand the feasibility and acceptability of in-person and virtual group-based physical activity interventions in primary care. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

Testing the Youth Physical Activity Promotion Model during the COVID-19 Pandemic, with Partial Least Squares Second-Order Latent Constructs.

We tested the Youth Physical Activity Promotion (YPAP) framework on Romanian students in order to identify actionable determinants to support participation in physical activity. Our sample consisted of 665 responses to an online survey, with participants aged 18-23 (mean = 19 years); 70% were women. We used the partial least squares algorithm to estimate the relationships between students' behavior and possible predictors during the COVID-19 pandemic. Our results indicate that all the theoretical dimensions of YPAP (predisposing, enabling and reinforcing) have a positive and significant impact on physical activity, with two mediating mechanisms expressed as predisposing factors: able and worth. Unlike previous research, we used second-order latent constructs, unveiling a particular structure for the enabling dimension that only includes sport competence, fitness and skills, but not the environmental factors.

France's 2020 Report Card on Physical Activity and Sedentary Behaviors in Children and Youth: Results and Progression.

BACKGROUND: There is an alarming and constant worldwide progression of physical inactivity and sedentary behaviors in children and adolescents. The present paper summarizes findings from France's 2020 Report Card on physical activity for children and youth, comparing its results to its 2 previous editions (2016 and 2018). METHODS: France's 2020 Report Card follows the standardized methodology established by the Active Healthy Kids Global Matrix, grading 10 common physical activity indicators using the best available evidence. The grades were informed by national surveys, peer-reviewed literature, government and nongovernment reports, and online information. RESULTS: The expert panel awarded the following grades: Overall Physical Activity: D; Organized Sport Participation and Physical Activity: C-; Active Play: INC; Active Transportation: C-; Sedentary Behaviors: D-; Family and Peers: D-; Physical Fitness: D; School: B-; Community and the Built Environment: F; Government: C. CONCLUSIONS: This 2020 edition of France's Report Card again highlights the alarming levels of physical activity and sedentary behaviors among French children and adolescents, calling for the development of effective national action. It also draws attention to the particular deleterious effects of the COVID-19 confinement on youth's movement behaviors, which significantly worsened the situation.

Development and Implementation of a "Music Beeps" Program to Promote Physical Fitness in Adolescents.

This study aimed to develop a physical education fitness program for adolescents to counteract the declining physical activity levels caused by the COVID-19 pandemic, as well as to investigate the program's effect. This mixed-methods study developed and implemented a five-component "Music Beeps" (MB) program to promote adolescents' physical fitness. A total of 240 students from two high schools in South Korea-divided into experimental and control groups-participated in 32 sessions over 16 weeks. The changes in students' fitness were analyzed, and the educational effects were examined via inductive analysis of the observation logs and group and in-depth interviews. The results demonstrated that, whereas the comparison group demonstrated no statistically significant changes in power, muscular strength and endurance, or cardiopulmonary endurance, the experimental group showed changes in all these variables, along with changes in flexibility. Further, the MB program had significant educational effects. First, students reported that musical cues enhanced their fitness motivation and sense of responsibility. Second, record-keeping and active participation contributed to self-led fitness management. Third, activity in a small space with few pieces of equipment led to the positive perception that the program was efficient and enabled regular exercise regardless of climate conditions.