Improving Recess through Collaboration: Exploring the Facilitators and Barriers to Sustaining Positive Playground Behavior.

BACKGROUND: School recess quality is vital to children's social and emotional skill development. However, there is a research-to-practice gap where academic findings are ineffectively translated back to schools. The aims of this study were to examine how a co-designed intervention would impact negative behaviors observed during recess and to explore the facilitators and barriers to recess implementation over the course of a school year. METHODS: Utilizing a research-practice partnership, the authors collaborated with staff at an elementary school to design, implement, and assess an intervention focused on improving recess quality. The intervention offered training in research-supported recess practices through professional development training and teaching students transitions and games. The school's recess behavioral report log of negative playground behaviors across the academic year and notes from recess staff meetings were analyzed. RESULTS: Quantitative results pointed to a stable decrease in negative playground behaviors post-intervention compared to pre-intervention. Qualitative analyses suggest school leadership and practitioners should focus on "reculturing" recess prior to making structural changes, and empowering recess staff to sustain change. CONCLUSION: Prior to considering interventions at recess, there is a need to assess both school and recess culture. In doing so, reculturing around the importance of recess during the school day and the roles of adults in the process is needed to ensure the sustainability of any changes made.

"And I still remember it to this day": A qualitative exploration of retrospective memories of school-based recess.

Objectives: Previous research has shown the most common memory of physical education (PE) was embarrassment, and that childhood memories of PE relate to physical activity (PA) attitude, intention, and sedentary behavior in adulthood [13]. Recess memories may have a similar effect on adult attitudes towards PA, given that recess is a physically active part of the school day, yet is more autonomous and less supervised than PE. Recent literature has supported this, as Massey and colleagues (2021b) reported memories of recess enjoyment were associated with PA enjoyment in adulthood, whereas negative recess memories were associated with social isolation. In an effort to better understand recess memories, and how they may be related to adult behaviors, the purpose of this study was to examine qualitative descriptions of adults' worst recess memories as it related to physical and social health. Study design: Mixed methods design; inductive content analysis and analysis of covariance. Methods: As part of a larger project, 433 participants between the ages of 19 and 77 (M = 44.91; SD = 15.35) were asked to recall their worst recess memories and the grades in which those memories occurred. Participants identified as predominantly female (52%), White (72%), and college educated (46%). Data analysis was conducted via an inductive content analysis by three research team members. Results: The most common negative memories included isolating experiences, physical injuries, victimization, and contextual factors (e.g., weather). Through a series of analysis of covariance, self-reported isolation and self-efficacy of exercise were significantly related to participants with social isolation and physical injury memories respectively. Conclusions: This study adds to a growing line of research documenting the importance of recess as a developmentally impactful environment with implications for physical and emotional health.

Parents' perceptions of school recess policies and practices.

BACKGROUND: Previous research has shown that school recess can provide children with physical, social and cognitive benefits; yet, recess opportunities and experiences may be different for different groups of children, specifically for children living in lower income environments, children of different racial groups other than white, and for children with disabilities. Parent perceptions of recess are important to consider as they serve as advocates for their children's access and opportunities at school as well as an additional informant for children's experiences at recess that may be useful for policymakers and school boards to consider. OBJECTIVE: To examine parent perceptions of recess by children's disability status, children's race and ethnicity, and family household income. METHOD: Participants included 473 parents from the U.S.A. stratified across six household income levels. Data were collected through an online survey using Prolific in May of 2020]. Confirmatory factor analyses were run for measures assessing parents' perception of belonging and victimization at recess, recess policies, and recess procedures. Regression analyses were run to examine if parents' perception of recess were predicted by race, income, or child disability status. RESULTS: Results revealed that parents' perceptions of recess were predicted by child disability status but not race or income. Specifically, parents' perceptions were significantly predicted by child disability status regarding victimization (b = .13, SE = .06, p = .05), recess policies about withholding recess (b = .171, SE = .07, p = .01), and finally, student engagement at recess (b = .165, SE = .07, p = .02). CONCLUSION: Results show that parents of children with a disability perceive a different recess experience for their child that involves more instances of victimization compared to parents of typically developing children. Based on these findings, school, district, and state policy makers could consider ensuring that recess includes multiple activities, is supervised by adults, and is a space where conflict resolution occurs, for creating a more inclusive environment for children with disabilities.

Recess Quality and Social and Behavioral Health in Elementary School Students.

BACKGROUND: A majority of research findings have focused on recess as instrumental to achieving minutes of physical activity rather than focusing on the psycho-social benefits associated with a high-quality recess environment. The purpose of the current study was to examine the relationship between recess quality and teacher-reported social, emotional, and behavioral outcomes in children. METHODS: Data were collected from 26 schools in 4 different regions of the United States. Teachers (N = 113) completed behavioral assessments for randomly selected children in their classrooms (N = 352). Data assessors conducted live observations of recess using the Great Recess Framework-Observational Tool. A series of 2-level regression models were fit in Mplus v. 8.2 to assess how recess quality was associated with indicators of children's social, emotional, and behavioral health. RESULTS: Recess quality significantly predicted executive functioning problems (b = -.360, p = .021), resilience (b = .369, p = .016), emotional self-control (b = -.367, p = .016), and a composite of adaptive classroom behaviors (b = .321, p = .030). CONCLUSION: Results of the present study demonstrate that recess quality impacts child developmental outcomes. Schools should ensure there is adequate training and resources to facilitate a positive and meaningful recess for students.

Nowhere to Go: Parents' Descriptions of Children's Physical Activity During a Global Pandemic.

Background: Schools and outdoor public spaces play a substantial role in children's physical activity. Yet, the COVID-19 shelter-in-place mandates bound many children to their available home spaces for learning, movement, and development. The exact effect this mandate had on children's physical activity may vary among families. Objective: To understand, from the perspective of parents, how the COVID-19 shelter-in-place mandates affected children's physical activity, while also considering families' socioeconomic status. Design: Open-ended survey. Setting: Online. Method: Data were collected from 321 parents living in the United States of America. Parents answered an open-ended prompt to describe their children's physical activity during COVID-19 shelter-in-place mandates. Following data collection, inductive and deductive content analysis examined patterns in the data. Results: Analyses indicated that shelter-in-place mandates restricted children's opportunities for physical activity. However, if families had access to outdoor spaces or equipment, they could encourage and support more physical activity opportunities than those without. Families in the lower-income bracket had less access to outdoor space and subsequently those children had fewer opportunities to be physically active. Parents supported their children's physical activity through their involvement and encouragement. Conclusion: These findings underscore the importance of access to outdoor spaces and equipment for increasing children's physical activity. Findings can be used by educators and policymakers to equitably support families of lower socioeconomic status who reported less access to outdoor spaces.

From policy to practice: Examining the role of recess in elementary school.

Objectives: To examine the relationship between school recess policies, the quality of the recess environment and body mass index (BMI) among elementary school children. Study design: Observational. Methods: Data were collected at 23 schools across four geographically distinct regions of the United States. Measures included recess observations using the Great Recess Framework-Observational Tool (GRF-OT), recess policies were collected with the School Physical Activity and Policy Assessment, and BMI was obtained through height and weight measurements among 429 students in third and fifth grade. Results: Results showed that school policies related to recess access significantly predicted children's BMI, and school policies related to investment in recess significantly predicted recess quality as measured by the GRF-OT. Conclusions: Results from this study can be used to help inform future research regarding how school recess policies can impact child-level outcomes and the recess environment.

Perceived Barriers Before and After a 3-Month Period of Modified Ride-On Car Use.

PURPOSE: The purpose of the study is to examine how perceived barriers change before and after a 3-month period of modified ride-on car use. METHODS: This study used a qualitative content analysis of perceived barriers. Fourteen caregivers (13 mothers; 1 grandmother) responded to a single-question, free-response survey before and after a 3-month period of modified ride-on car use. RESULTS: A total of 11 and 20 perceived barriers were reported before and after the 3-month period. Environmental barriers were the most frequently reported before and after the 3-month period. CONCLUSIONS: Pediatric physical therapists need to be aware of the potential perceived barriers that families may experience in regard to young children with disabilities using modified ride-on cars and determine strategies to support families on an individual basis.

An observational study of recess quality and physical activity in urban primary schools.

BACKGROUND: To date, there is scant literature that examines the recess context concurrent with, but separate from, levels of physical activity. The primary purpose of the current study was to examine how recess quality impacted physical activity levels, and how this was moderated by gender. A secondary purpose was to examine if differences in children's engagement in activities occurred between recess sessions scored as low- or high- quality. METHODS: This was an observational study of children at 13 urban elementary schools in the U.S. Across the 13 schools, data were collected at 55 recess sessions, with 3419 child-level observations (n = 1696 boys; n = 1723 girls). Physical activity data were collected using Fitbit accelerometers, recess quality data were collected using the Great Recess Framework - Observational Tool (GRF-OT), recess engagement data were collected using the Observation of Playground Play (OPP), and basic psychological need satisfaction (BPNS) data were collected using a modified version of the BPNS for recess physical activity survey. Primary analyses were conducted using Hierarchical Linear Modeling (HLM) with children nested within recess sessions. RESULTS: Gender moderated the relationship between adult engagement and moderate-to-vigorous physical activity (MVPA) (b = .012; 95% CI .001, .024), student behavior and MVPA (b = -.014; 95% CI -.021, -.007), and student behaviors and light physical activity (b = .009, 95% CI .003, .015). Both boys and girls engaged in more play during recess sessions scored as high quality on the GRF-OT. Children reported higher levels of basic psychological need satisfaction at recesses sessions scored as high quality on the GRF-OT. CONCLUSIONS: Results of the current study showed that the quality of the recess environment, and the interactions of both adults and students in that environment, need to be taken into consideration in future school-based recess studies.

Perceived Barriers of Modified Ride-On Car Use of Young Children With Disabilities: A Content Analysis.

PURPOSE: Modified ride-on cars have emerged as an early powered mobility option for young children with disabilities. The purpose of this study was to identify, extract, and synthesize perceived barriers of modified ride-on car use reported in previous studies. METHODS: This study was descriptive using a qualitative content analysis of previously published studies identified from a systematic literature search. RESULTS: Categories of perceived barriers were identified: device, environmental, child-related perceived barriers regarding health, tolerance, and abilities, and caregiver-related perceived barriers regarding physical requirements, time, and motivation. Device and environmental perceived barriers were the most reported. CONCLUSIONS: Pediatric physical therapists play a critical role in working with families to promote their self-efficacy for using the modified ride-on car and their capacity for overcoming the inherent difficulties associated with use. Most of the reported perceived barriers are modifiable, at least to some degree, with likely effects on modified ride-on car use.

Sporting Activities for Individuals Who Experienced Trauma During Their Youth: A Meta-Study.

The purpose of this study was to critically examine the qualitative research on childhood trauma survivors' experiences of sporting activities. A comprehensive search of health and social science databases, manual journal searches, and contact with experts yielded 7,395 records. Full-text screening resulted in a final sample of 16 studies. Meta-study methodology was used as a diagnostic tool to rigorously analyze the theory, methods, and findings of the included studies. Studies with explicit connections between philosophy, theory, and methodology resulted in a more robust and critical contribution to the literature. There was much diversity in terms of methodological approaches and qualitative methods which was important in revealing the multifaceted nature of experiences in sporting activities following trauma. Findings from the reviewed studies indicated that a sense of belonging, psychological escape, embodied experience, and the physical and social environmental are important considerations in the study of sporting activities for trauma survivors.

Active Commute in Relation to Cognition and Academic Achievement in Children and Adolescents: A Systematic Review and Future Recommendations.

Active commuting to school (ACS) is an important source of physical activity among children. Recent research has focused on ACS and its benefits on cognition and academic achievement (AA), factors important for success in school. This review aims to synthesize literature on the relationship between ACS and cognition or AA among children and adolescents. Peer-reviewed articles in PubMed, Web of Science, PsycINFO and Cochrane Library assessing ACS with cognition and/or AA among children, until February 2019, were selected. Twelve studies across nine countries (age range 4-18.5 years) were included. One study used accelerometers, whereas all others used self-report measures of ACS. A wide range of objective assessments of cognitive functioning and AA domains were used. Five among eight studies, and four among six found a positive relationship between ACS and cognitive or AA measure, respectively. Four studies found dose-response relationships, and some studies found sex differences. The quantitative analysis found that ACS was not significantly associated with mathematics score (odds ratio = 1.18; CI = 0.40, 3.48). Findings are discussed in terms of methodological issues, potential confounders, and the strength of the evidence. Future studies should conduct longitudinal studies and use objective measures of ACS to understand this relationship further.

Sport-based youth development interventions in the United States: a systematic review.

BACKGROUND: The growing number of sport-based youth development interventions provide a potential avenue for integrating sport meaningfully into the U.S. public health agenda. However, efficacy and quality must be reliably established prior to widespread implementation. METHODS: A comprehensive search of databases, peer-reviewed journals, published reviews, and both published and unpublished documents yielded 10,077 distinct records. Title and abstract screening, followed by full-text screening using 6 criteria, resulted in 56 distinct studies (coalescing into 10 sport-based youth development intervention types) included in the synthesis. These studies were then independently assessed and critically appraised. RESULTS: Limited efficacy data were identified, with the quality of methods and evidence largely classified as weak. Processes likely to contribute to the outcomes of sport-based youth development interventions were identified (e.g., predictors of ongoing engagement, alignment between target population and intervention, intervention design), although more rigorous research is needed on these and other processes. Physical health outcomes were only studied in 3 of the 10 intervention types. CONCLUSIONS: The evidence base does not yet warrant wide-scale implementation of sport-based youth development interventions for public health goals within the U. S., although there is promising research that identifies areas for further exploration.

Examination of the Responsiveness of the Great Recess Framework-Observational Tool.

The purpose of this study was to test the responsiveness of the great recess framework-observational tool (GRF-OT) to detect changes in recess quality. GRF-OT data were collected at two time points (fall 2017 and spring 2018) in four geographically distinct regions of the United States. Following recommendations by Massey et al. (2018), a three-day average of recess observations was used for each data point. Data analysis was conducted on nine schools contracted to receive services from Playworks, a national non-profit organization specializing in recess implementation, for the first time; eight schools with returning Playworks services (i.e., multiple years of service) and five schools with no intervention services. Analysis of the change in GRF-OT scores from fall to spring revealed a large effect for first-year intervention schools (g = 1.19; 95% CI 0.13, 2.25) and multi-year intervention schools (g = 0.788; 95% CI -0.204, 1.78). GRF-OT scores decreased for schools not receiving an intervention (g = -0.562; 95% CI, -2.20, 1.07). New intervention schools (odds ratio= 21.59; 95% CI 4.27, 109.15) and multi-year intervention schools (odds ratio= 7.34; 95% CI 1.50, 35.97) were more likely to meet the threshold for meaningful positive change than non-intervention schools. The results of the current study suggest that GRF-OT is a responsive tool that researchers, practitioners, and policy makers can use to measure and assess changes in the quality of the recess environment.

Observations of playground play during elementary school recess.

OBJECTIVE: The purpose of the current study was to examine reliability and validity evidence for an observational measure of playground play during recess. Observational data of what children played at recess were collected at 236 recess sessions across 26 urban elementary schools. An inductive content analysis of children's type of play and activity engagement during recess was conducted to categorize activities. Inter-rater reliability of observations was assessed at 49 points that spanned 22 unique recess periods at four different schools. Reliability data were collected during the winter and spring seasons. A multivariate analysis of variance was conducted to examine differences in play and activity patterns between genders, and between schools implementing recess interventions (e.g., structured play environment) and schools with no recess intervention. RESULTS: Results of the content analysis yielded eight playground play and activity categories, all with high levels of inter-rater reliability (ICCs > .90). Significant differences in children's play and activity patterns emerged between genders and across recess intervention conditions. Engagement in 'sports and organized activities' and 'non-engagement in play' contributed most to the separation between boys and girls, while 'non-engagement in play' contributed most to the separation between recess intervention and non-intervention schools.

Individual and environmental correlates of school-based recess engagement.

The purpose of this study was to examine individual variables associated with children's levels of recess physical activity (PA), as well as environmental influences that influence children's engagement during recess. Participants (n = 146) were 4-6th grade students across seven schools. PA data were collected using the Fitbit Flex. Psychological need satisfaction at recess data were collected with a basic psychological need satisfaction for recess PA survey. Observations of recess activity engagement and the quality of the recess environment were also collected at 134 recess periods (n = 8340 children) across nine schools. Results of multi-level regression analyses indicated that gender and recess time were significant predictors of physical activity during recess. In examination of the environmental level factors, multi-level regression analyses revealed that 'adult engagement and supervision' was the only significant predictor for recess engagement in boys and girls. These findings suggest the amount of time allocated, and the quality of the recess environment must be included in evaluation of the critical factors relevant to engagement of students in physically active recesses.

Development of the great recess framework - observational tool to measure contextual and behavioral components of elementary school recess.

BACKGROUND: Physical activity (PA) remains the primary behavioral outcome associated with school recess, while many other potentially relevant indicators of recess remain unexamined. Few studies have assessed observations of teacher/student interactions, peer conflict, social interactions, or safety within the recess environment. Furthermore, a psychometrically-sound instrument does not exist to examine safety, resources, student engagement, adult engagement, pro-social/anti-social behavior, and student empowerment on the playground. The purpose of the current study was to develop a valid, and reliable, assessment tool intended for use in measurement of the contextual factors associated with recess. METHODS: An iterative and multi-step process was used to develop a tool that measures safety and structure, adult engagement and supervision, student behaviors, and transitions at recess. Exploratory structural equation modeling (Mplus v. 7.4) was used to examine the underlying measurement model with observational data of the recess environment collected at 649 school-based recess periods that spanned across 22 urban/metropolitan areas in the USA. Data were also collected by two researchers at 162 recess sessions across 9 schools to examine reliability. RESULTS: A 17-item observation instrument, the Great Recess Framework - Observational Tool (GRF-OT), was created. Findings of exploratory structural equation modeling (ESEM) analyses supported factorial validity for a 4-factor solution and linear regressions established convergent validity where 'structure and safety', 'adult engagement and supervision', and 'student behaviors' were all significantly related to observed activity levels. Each sub-scale of the GRF-OT showed adequate levels of inter-rater reliability and test-retest reliability analysis indicated a higher level of stability for the GRF-OT when using a three-day average across two time points as compared to a two-day average. CONCLUSIONS: Initial evidence for a valid, and reliable, assessment tool to observationally measure the recess environment with a specific focus on safety, resources, student engagement, adult engagement, pro-social/anti-social behavior, and student empowerment was established in this study. Use of the GRF-OT can inspire evaluation, and subsequent intervention, to strategically create consistent, appropriate, and engaging school recess that impact children's physical, cognitive, social and emotional development.

Role of sport medicine professionals in addressing psychosocial aspects of sport-injury rehabilitation: professional athletes' views.

CONTEXT: Research from the sport medicine professional's (SMP's) perspective indicates that SMPs are often required to address psychosocial aspects of injuries during treatment. However, only a few authors have investigated injured athletes' experiences with these concerns. OBJECTIVE: To explore injured professional athletes' views on the role of SMPs in the psychosocial aspects of sport-injury rehabilitation. Design : Qualitative study. SETTING: Professional association football and rugby union clubs. PATIENTS OR OTHER PARTICIPANTS: Ten professional, male football (n = 4; 40%) and rugby union (n = 6; 60%) players (age = 22.4 ± 3.4 years). Data Collection and Analysis : We collected data using a semistructured interview guide, and the data were then transcribed and analyzed following the interpretative phenomenological analysis guidelines. We peer reviewed and triangulated the established emergent themes to establish trustworthiness. RESULTS: Athletes in our study viewed injuries as "part and parcel" of their sports. Despite normalizing sport injuries, athletes reported frequent feelings of frustration and self-doubt throughout the rehabilitation process. However, athletes' perceived the role of SMPs in injury rehabilitation as addressing physical concerns; any intervention aimed at psychosocial outcomes (eg, motivation, confidence) needed to be subtle and indirect. CONCLUSIONS: The SMPs working with injured athletes need to understand the psychosocial principles that underpin athletes' sport-injury processes and the effect psychosocial reactions can have on athletes. Moreover, SMPs must understand the self-regulatory processes that may take place throughout injury rehabilitation and be able to apply psychological principles in natural and subtle ways to aid athletes' self-regulatory abilities.

Control of fingertip forces in young and older adults pressing against fixed low- and high-friction surfaces.

Mobile computing devices (e.g., smartphones and tablets) that have low-friction surfaces require well-directed fingertip forces of sufficient and precise magnitudes for proper use. Although general impairments in manual dexterity are well-documented in older adults, it is unclear how these sensorimotor impairments influence the ability of older adults to dexterously manipulate fixed, low-friction surfaces in particular. 21 young and 18 older (65+ yrs) adults produced maximal voluntary contractions (MVCs) and steady submaximal forces (2.5 and 10% MVC) with the fingertip of the index finger. A Teflon covered custom-molded splint was placed on the fingertip. A three-axis force sensor was covered with either Teflon or sandpaper to create low- and high-friction surfaces, respectively. Maximal downward forces (F(z)) were similar (p = .135) for young and older adults, and decreased by 15% (p<.001) while pressing on Teflon compared to sandpaper. Fluctuations in F(z) during the submaximal force-matching tasks were 2.45× greater (p<.001) for older adults than in young adults, and reached a maximum when older adults pressed against the Teflon surface while receiving visual feedback. These age-associated changes in motor performance are explained, in part, by altered muscle activity from three hand muscles and out-of-plane forces. Quantifying the ability to produce steady fingertip forces against low-friction surfaces may be a better indicator of impairment and disability than the current practice of evaluating maximal forces with pinch meters. These age-associated impairments in dexterity while interacting with low-friction surfaces may limit the use of the current generation of computing interfaces by older adults.

Sensitivity of EMG-EMG coherence to detect the common oscillatory drive to hand muscles in young and older adults.

Multichannel surface electromyograms (EMGs) were used to examine the sensitivity of EMG-EMG coherence to infer changes in common oscillatory drive to hand muscles in young and older adults. Previous research has shown that measures of coherence calculated from different neurophysiological signals are influenced by the age of the subject, the visual feedback provided to the subject, and the task being performed. The change in the magnitude of EMG-EMG coherence across experimental conditions is often interpreted as a change in the oscillatory drive to motoneuron pools of a pair of muscles. However, signal processing (e.g., full-wave rectification) and electrode location are also reported to influence EMG-EMG coherence, which could decrease the sensitivity of EMG-EMG coherence to infer a change in common oscillatory drive to motoneurons. In this study, multichannel EMGs were used to compare EMG-EMG coherence in young (n = 11) and older (n = 10) adults during index finger abduction and pinch grip tasks performed at 2 and 3.5 N with a low and a high visual feedback gain. We found that, across all conditions, EMG-EMG coherence was influenced by electrode location (P < 0.001) but not by subject age, visual feedback gain, task, or signal processing. These results suggest that EMG-EMG coherence is most sensitive to electrode location. The results are discussed in terms of the potential issues related to inferring a common oscillatory drive to hand muscles with surface EMGs.

Coherence between surface electromyograms is influenced by electrode placement in hand muscles.

We used multi-channel surface electromyograms (EMGs) to examine if electrode location influences coherence measures derived from pairs of EMGs recorded from two hand muscles during a pinch task. A linear probe of 16 electrodes was used to estimate the location of the innervation zone in first dorsal interosseous (FDI) and abductor pollicis brevis (APB). Four electrodes were then placed on the skin overlying each muscle and three bipolar electrode configurations were constructed with their center points directly over the innervation zone, and 15mm distal and proximal to the innervation zone. Ten subjects performed two force-matching tasks for 120s at 2N and 3.5N by pressing a force sensor held between the thumb and index finger. Coherence spectra were calculated from pairs of EMGs recorded from the two muscles. Maximal coherence from 1 to 15Hz and 16 to 32Hz was calculated at both force levels from the EMGs with electrodes centered over the innervation zones of FDI and APB. These values were compared to the maximal coherence from all other EMG comparisons across muscles recorded with electrodes that avoided the innervation zones. ANOVA revealed significant main effects only for electrode location, with a 58.1% increase (p=0.001) in maximal coherence for EMGs detected from pairs of electrodes that avoided the innervation zone (from 0.11±0.02 to 0.18±0.03; mean±95% confidence interval). These results indicate that electrode location relative to the innervation zone influences EMG-EMG coherence and should be carefully considered when placing EMG electrodes on hand muscles.