A Proof-of-Concept Evaluation of the 1616 Story-Based Positive Youth Development Program.

The 1616 Program is a newly developed and evidence-informed story-based positive youth development (PYD) program for young ice hockey players (10-12 years of age) in North America. The program uses elite ice hockey players as role models-through story-telling-to serve as inspirational figures to engage youth athletes and important social agents (i.e., parents, coaches) with evidence-informed PYD concepts. The objective of this study was to use a Proof-of-Concept evaluation to assess whether the 1616 Program 'worked' in enhancing PYD outcomes and to determine if the concepts were engaging and enjoyable for youth, their parents, and coaches. The 5 week Proof-of-Concept evaluation was conducted with 11 ice hockey teams (n = 160 youths, 93 parents, and 11 coaches), encompassing both qualitative (e.g., focus groups) and quantitative (e.g., retrospective pretest-posttest questionnaires) processes and outcome assessments. Results showed that the program was well received by participants and positively impacted the intended outcomes. Overall, the data presented in this Proof-of-Concept evaluation was deemed to support the development and implementation of the full-scale 1616 Program for a more comprehensive evaluation.

"It Shaped My Future in Ways I Wasn't Prepared for-in the Best Way Possible": Alumni Volunteers' Experiences in an Adapted Sports and Recreation Program.

Adapted sport participation can have many positive benefits for adults with disabilities. However, one barrier to implementing successful adapted sport programs is lack of knowledgeable volunteers who understand accessibility and disability. In fact, little is known about volunteers' experiences in adapted sport programs. The purpose of this study was to retrospectively examine experiences of able-bodied volunteers in an adapted sport program. A sample of 105 able-bodied volunteers (Mage = 24.28 ± 1.93) completed an online qualitative survey to share their experiences. Data were analyzed using qualitative thematic analysis, and seven main themes were identified. Results showed that despite differences in initial motives for volunteering, involvement in an adapted sport program was transformative and, for some, life changing. Able-bodied volunteers experienced a wide range of benefits including deeper understanding and awareness of disability and inclusion in sport. Practical recommendations are provided for volunteer-based adapted sport program leaders.

Program Evaluation and Preliminary Efficacy of Fitness and Skill-Based High-Intensity Interval Training in Physical Education.

Previous school-based high-intensity interval training (HIIT) interventions have focused on the quantity of physical activity (PA) achieved during physical education (PE) rather than students' PE experiences, including enjoyment. Purpose: To evaluate the feasibility of a fitness- and skill based HIIT intervention guided by the Self Determination Theory. Method: For this pretest-posttest randomized controlled 6-week pilot study, 4-5th grade students (15 boys, 30 girls; age = 10.5 ± 0.9 years) completed a 16-19-minute HIIT circuit (INT); whereas, 22 students (10 boys, 12 girls; age = 10.5 ± 0.9 years) engaged in regular PE (CON). Two-way mixed ANCOVA tests were performed to assess preliminary efficacy. Results: Participants reported favorable program satisfaction (mean 3.6 ± 1.5 out of 5). The physical educator reported a high feasibility survey score (31/35), and themes emerging from a program acceptability interview included positive perceptions of the HIIT program and strategies for future implementation. A large effect size was evident for cardiorespiratory fitness (ηp2 = 0.26), as VO2peak increased in INT from 53.6 ± 6.1 to 56.9 ± 7.3 ml/kg/min and decreased in CON (53.9 ± 7.0 to 52.4 ± 10.4 ml/kg/min). Students in INT exhibited greater amounts of moderate-to-vigorous PA and vigorous PA during PE versus CON, based on accelerometer data (23.4 ± 5.0 vs. 15.7 ± 4.7 min/hr, ηp2 = 0.45; 4.5 ± 2.6 vs. 2.3 ± 1.3 min/hr; ηp2 = 0.27, respectively). Conclusions: Findings support the feasibility of this fitness- and skill-based HIIT program and may be a valuable addition to elementary school PE programs.

Adolescent Patient, Parent, and Clinician Perceptions of Rehabilitation After Anterior Cruciate Ligament Reconstruction: A Qualitative Study.

CONTEXT: Rehabilitation after anterior cruciate ligament reconstruction (ACLR) is challenging for adolescent patients concurrently experiencing growth and development, changes in attitudes and social interactions, and a gradual shift toward independence. OBJECTIVE: To examine the perceptions of information sharing and interpersonal communication among adolescent patients going through ACLR, their parents, and physical therapists (PTs) treating adolescent patients with ACLR. DESIGN: Cross-sectional study. SETTING: University-affiliated sports medicine clinic. PATIENTS OR OTHER PARTICIPANTS: Nine adolescent patients who had recently completed physical rehabilitation after ACLR, one of their parents, and PTs who treated adolescent patients with ACLR were recruited and enrolled. MAIN OUTCOME MEASURE(S): Participants completed semistructured interviews. The interview scripts for patients, parents, and PTs intentionally addressed the same topics, with only minor modifications in wording as appropriate for each role. All interviews were recorded, transcribed verbatim, and analyzed using a hybrid of deductive and inductive coding by trained members of the study team. RESULTS: Patients, parents, and PTs perceived that interpersonal dynamics (eg, communication, external motivation) and stakeholder knowledge (eg, understanding of the psychological consequences of injury) influenced intrapersonal experiences (eg, emotional response, intrinsic motivation) during rehabilitation after ACLR. Additionally, patients and parents indicated that a lack of information about the rehabilitation process hindered their ability to obtain additional information from the PT and surgeon. CONCLUSIONS: Participants from all stakeholder groups reported that orthopaedic surgeons and other members of the health care team may consider being more consistent when setting expectations, physical restrictions, and recovery timelines.

Use of a spatiotemporal approach for understanding preschoolers' playground activity.

This study used spatiotemporal hot-spot analysis to characterize physical activity on the childcare center playground. Preschool-aged children (N = 34) wore a GPS and accelerometer during 2-3 outdoor periods on one day. A spatiotemporal weights matrix was generated so that points within a specified distance in meters (space) and 3 min (time) were considered neighbors. The Getis-Ord G* statistic was calculated to detect locations of significant hot/cold spots in vector magnitude counts/15­sec. Hot/cold spots changed within a single outdoor period and between outdoor periods, highlighting the importance of time. This approach can be used to identify points of intervention during provided outdoor time.

Gender Differences in Psychological Responses to Recovery After Anterior Cruciate Ligament Reconstruction Before Return to Sport.

CONTEXT: Female patients with anterior cruciate ligament reconstruction (ACLR) are less likely to return to sport than males. Psychological readiness predicts successful return to sport, but it is unclear if psychological experiences differ between males and females during recovery. OBJECTIVE: To explore gender differences in psychological readiness factors of return to sport after ACLR. DESIGN: Qualitative study. SETTING: Laboratory. PATIENTS OR OTHER PARTICIPANTS: A total of 12 male (months since surgery = 6.2 ± 1.2) and 13 female (months since surgery = 6.4 ± 1.3) high school athletes with a history of ACLR. DATA COLLECTION AND ANALYSIS: Participants were interviewed before physician clearance to return to activity. Transcribed interviews were analyzed using deductive thematic coding of 5 themes identified from previous research (psychological distress, self-efficacy, locus of control, athletic identity, and fear of reinjury) and inductive secondary subthematic coding. Gender comparisons were generated within primary themes and secondary subthemes. RESULTS: All deductive themes were consistently reinforced. Male and female participants reported fear of movement, loss of athletic identity, and motivational mindsets for return to sport and self-improvement. Males reported a stronger sense of internal locus of control using positive internal reinforcement, whereas females described balancing internal and external control and valuing external support systems. Male participants described mood changes influenced by physical and social limitations. Female participants closely monitored their emotions throughout recovery and were influenced by rehabilitation fluctuations. CONCLUSIONS: Male and female high school athletes described different psychological factors related to return to sport and locus of control as well as psychological distress. Gender-specific psychological interventions may be warranted to overcome psychological barriers after ACLR.

Wakeful Prone "Tummy Time" During Infancy: How Can We Help Parents?

AIMS: This study's purpose is to present facilitators and barriers for wakeful prone positioning or "tummy time" during infancy by exploring the personal perspectives of infant caregivers attempting to provide daily tummy time. METHODS: The study was qualitative in design, using thematic analysis to identify major and minor themes from semi-structured interviews. The Capability, Opportunity, Motivation - Behavior Model provided a conceptual framework for the interview guide and categorization of major themes. RESULTS: Within capability, opportunity, and motivation, the major themes of self-efficacy, scheduling, variations, siblings, committed adult help, social responses of acquaintances, and caregiver enjoyment could be barriers or facilitators, depending on the context. Optimized physical circumstances, caregiver interest, perceived benefits to the infant, pride and accomplishment, and obligation were identified as facilitators only. Barriers included negative infant affect. CONCLUSIONS: These results offer preliminary guidance in a knowledge gap: tummy time support that addresses the self-identified concerns of infant caregivers.

Exploring Coaches' Perceptions of Youth Sport Specialization: A Comparison of High School and Club Sport Contexts.

CONTEXT: Previous researchers have identified sport specialization as being associated with various negative outcomes (eg, overuse injuries and adverse psychosocial outcomes). However, little is known regarding how the underlying attitudes, beliefs, and values of sport stakeholders may be shaping this trend. OBJECTIVE: To examine the perceptions of coaches in the high school versus club sport setting and compare their attitudes and behaviors toward sport specialization. DESIGN: Cross-sectional survey. PATIENTS OR OTHER PARTICIPANTS: A total of 769 coaches (497 high school coaches, 272 club sport coaches). MAIN OUTCOME MEASURE(S): Participants completed a novel measure that surveyed their perceptions regarding various aspects of youth sport specialization. Additionally, each coach completed a questionnaire detailing his or her relevant demographic and sport background information. RESULTS: High school coaches and club sport coaches differed in their perceptions of sport specialization (t767 = 1.41, P < .001); club coaches (2.43 ± 0.25) were more likely than high school coaches (2.31 ± 0.21) to rate specialization as a positive, adaptive practice. The multiple linear regression equations for both the high school and club coaches indicated that no educational, experiential, or demographic factors predicted coaches' perceptions of specialization (P values > .05). CONCLUSIONS: Club sport coaches were more likely to possess attitudes in favor of sport specialization. Additionally, coaches' background characteristics did not predict their perceptions of specialization, suggesting that the competitive context itself (high school versus club) may be the most salient influencer of these perceptions. Athletes and sports medicine practitioners should be aware of the heightened expectation of specialized participation and resulting increased injury risk in these contexts. Pediatric sport researchers and practitioners should continue to explore how these different group perceptions manifest in participation behaviors and may link to overall athlete health, wellbeing, and development.

Youth sport specialization: a multidisciplinary scoping systematic review.

Despite continued interest in youth sport participation, the consensus among researchers is that a thorough understanding of the phenomenon of youth sport specialization is still lacking. The popular and scholarly narratives regarding sport specialization challenge the adaptive nature of this practice. However, the lack of synthesis of youth sport specialization research makes existing practical recommendations potentially tenuous. This scoping review utilized a multidisciplinary lens to survey and integrate the full spectrum of youth sport specialization research by summarizing empirical findings and examining the characteristics of empirical research (e.g., field of publication, participant role, study design). Multiple databases were utilized to span the various disciplines in which sport specialization has been studied. The systematic review protocol yielded 906 publications for screening. After analysis of these records through inclusion/exclusion criteria, 40 empirical research publications examining youth sport specialization were included in this review. Analysis of these empirical findings indicated two higher-order emerging themes of this research: 1) Sport specialization participation behaviours; 2) Sport specialization outcomes. Descriptive results of the research characteristics are also explored. This review examined key findings that underlie recommendations for structuring youth sport participation, and highlighted future research avenues vital towards a more holistic understanding of this phenomenon.

Use of dynamic systems methods to characterize dyadic interactions in smoking cessation behavioural support sessions: A feasibility study.

BACKGROUND: Understanding how behaviour change techniques (BCTs) operate in practice requires a method for characterizing the reciprocal, dynamic, and real-time nature of behavioural support interactions between practitioners and clients. State space grids (SSGs) are an observational, dynamic systems methodology used to map the trajectory of dyadic interactions in real time. By mapping the flow of events in terms of practitioner and client actions, SSGs are potentially well suited to characterize behavioural support sessions. PURPOSE: To develop reliable methods and examine the feasibility of using the SSG methodology for characterizing practitioners' delivery of and clients' response to BCTs in smoking cessation behavioural support sessions. METHODS: Smoking cessation behavioural support sessions were video-recorded and transcribed verbatim (n = 6 recordings; 2,916 statements). All speech was coded independently by two researchers for content and duration using published frameworks for specifying practitioner-delivered and client-received BCTs in smoking cessation interactions. Inter-rater reliability was assessed. Indices of practitioner-client interaction dynamics were derived: (1) reciprocity (i.e., attractor states, content congruence, conditional pairing) and (2) temporal patterning (i.e., variability, inter-grid distance, combinatory micro-patterning, sessional macropatterning). The extent to which indices can describe differences between sessions involving different practitioners and clients was examined. RESULTS: Inter-rater reliability was moderate at 72% agreement. Indices of reciprocity and temporal patterning characterized differences between sessions involving different practitioners and clients. CONCLUSIONS: State space grids provide a method for characterizing the complexity and variability of practitioner-delivered and client-received BCTs in behavioural support sessions. This method has potential to add explanatory value to smoking cessation intervention outcomes. Statement of Contribution What is already known on this subject? Frameworks exist for characterizing practitioner-delivered and client-received behaviour change techniques (BCTs). Methods are still needed to investigate which BCTs are effective under what conditions. State space grids (SSGs) are a dynamic systems method that may better characterize behavioural support interactions. What does this study add? First reliable, dynamic systems, SSG coding procedures, methods, and measures to characterize behavioural support. A method for examining reciprocality and temporal patterning of BCT delivery and receipt. Establishes a dynamic systems method that adds explanatory value to the outcomes of interventions.

Perceptions of Rehabilitation and Return to Sport Among High School Athletes With Anterior Cruciate Ligament Reconstruction: A Qualitative Research Study.

BACKGROUND: Adolescent athletes struggle to return to sport following anterior cruciate ligament reconstruction (ACLR) for physical and psychosocial reasons. The ability to integrate contextual evidence obtained directly from patients with the growing body of quantitative rehabilitation research may aid clinicians in taking an evidence-based approach to rehabilitation and return to sport within the adolescent population. OBJECTIVES: To assess perceived barriers to return to sport, as well as positive and negative factors influencing recovery, among high school athletes with recent history of ACLR. METHODS: This phenomenographic cross-sectional study included a sample of 10 high school-aged individuals (7 female, 3 male; mean ± SD age, 16.8 ± 1.1 years; time since surgery, 5.5 ± 1.4 months) who underwent ACLR and had not returned to sports. Participants completed a semi-structured interview focused on attitudes related to return to sport, perceived physical or psychosocial barriers to physical activity and return to sport, and rehabilitation characteristics that may facilitate or hinder return to sport. RESULTS: Participants reported psychosocial barriers to return to sport with greater consistency than physical barriers. Consistently reported barriers included the feeling that sport-based activities were now associated with injury, a persistent sense of uncertainty regarding full recovery, and the sense that comparison to others with ACLR by parents or coaches hindered their ability to make progress in rehabilitation. CONCLUSION: Early identification of athletes at risk for persistent psychosocial barriers, such as fear of reinjury and uncertainty regarding full recovery, and establishment of peer mentoring groups to facilitate psychosocial support throughout the rehabilitation process may be key components of a gradual, patient-centered approach to improving mental and physical readiness for return to sport. J Orthop Sports Phys Ther 2018;48(12):951-959. Epub 22 Jun 2018. doi:10.2519/jospt.2018.8277.