A Pilot Study of a Comprehensive School Physical Activity Program in Elementary Schools: Be a Champion!

OBJECTIVE: In the present study, we sought to determine if a comprehensive school physical activity program (CSPAP) delivered using the Be a Champion! (BAC) framework was effective in increasing moderate-to-vigorous physical activity (MVPA) and decreasing sedentary time in elementary school youth. METHODS: We implemented a CSPAP in 3 elementary schools to determine its effectiveness to youth behaviors compared to 2 control schools. Youth physical activity was assessed via accelerometry in spring 2015 and spring 2016 during school hours on school days. Implementation of the BAC components and youth behavior was assessed through direct observation from fall 2015 through winter 2016. RESULTS: In a multilevel, mixed model examining the effects of intervention, we found no statistically significant effect of the intervention on overall MVPA. However, a significant increase in MVPA was observed among girls (but not boys) in the intervention schools relative to controls. No differences in sedentary behaviors were observed by group. CONCLUSION: CSPAP implementation may be effective in reducing sedentary time and increasing MVPA in girls, but not boys. Research is necessary to increase implementation dose and fidelity to best practices in physical activity promotion.

Social Media in Public Health: Strategies to Distill, Package, and Disseminate Public Health Research.

The worldwide expansion of users on the Internet has popularized the access of individuals to information that may not be obtained otherwise. Social media has fostered interactions between individuals and health organizations by changing the nature and speed of engagement. While it is known that many public health organizations use social media to engage their audiences, little is known about effective strategies and best practices for the dissemination of knowledge and audience engagement. Many barriers exist in the dissemination of public health messages, including limited funds to support information sharing. Blogs and social media networking sites can be dynamic, cost-effective communication tools with the potential to reach scientific, practitioner, and public audiences who may be missed through traditional outlets. This article describes rudimentary processes of developing a blog and using social media to disseminate public health information and potential applications in the day-to-day activities for other public health organizations. With the growing demand for instant communication and concise information, a strong Internet presence could help organizations maximize their reach and impact.

A Clinical Trial to Increase Self-Monitoring of Physical Activity and Eating Behaviors Among Adolescents: Protocol for the ImPACT Feasibility Study.

BACKGROUND: Severe obesity among youths (BMI for age≥120th percentile) has been steadily increasing. The home environment and parental behavioral modeling are two of the strongest predictors of child weight loss during weight loss interventions, which highlights that a family-based treatment approach is warranted. This strategy has been successful in our existing evidence-based pediatric weight management program, Brenner Families in Training (Brenner FIT). However, this program relies on face-to-face encounters, which are limited by the time constraints of the families enrolled in treatment. OBJECTIVE: This study aims to refine and test a tailored suite of mobile health (mHealth) components to augment an existing evidence-based pediatric weight management program. METHODS: Study outcomes will include acceptability from a patient and clinical staff perspective, feasibility, and economic costs relative to the established weight management protocol alone (ie, Brenner FIT vs Brenner FIT + mHealth [Brenner mFIT]). The Brenner mFIT intervention will consist of 6 mHealth components designed to increase patient and caregiver exposure to Brenner FIT programmatic content including the following: (1) a mobile-enabled website, (2) dietary and physical activity tracking, (3) caregiver podcasts (n=12), (4) animated videos (n=6) for adolescent patients, (5) interactive messaging, and (6) in-person tailored clinical feedback provided based on a web-based dashboard. For the study, 80 youths with obesity (aged 13-18 years) and caregiver dyads will be randomized to Brenner FIT or Brenner mFIT. All participants will complete baseline measures before randomization and at 3- and 6-month follow-up points. RESULTS: This study was approved by the Institutional Review Board in July 2019, funded in August 2019, and will commence enrollment in April 2020. The results of the study are expected to be published in the fall/winter of 2021. CONCLUSIONS: The results of this study will be used to inform a large-scale implementation-effectiveness clinical trial. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/18098.

Protocol for a randomized controlled feasibility study of a coordinated parent/child weight loss intervention: Dyad Plus.

The prevalence of in youth with overweight and obesity is a global health concern, necessitating clinical interventions to treat obesity effectively through lifestyle modification. Interventions in adolescents have demonstrated improvements in healthy eating and physical activity with only modest weight loss outcomes. Consequently, there is growing interest in developing strategies to enhance the effectiveness of clinical interventions in adolescents. Targeting the family system can be an effective approach, but existing studies have failed to examine the impact of co-enrolling both the adolescent and adult in individually tailored weight loss programs and coordinating the adolescent/adult weight loss efforts. PURPOSE: This paper reports on the design and conceptual framework of the Dyad Plus study, which utilizes two weight loss clinics of the Wake Forest Baptist Medical Center: Brenner Families in training (Brenner FIT®; adolescents) and By Design (adults). Dyad Plus is a coordinated program designed to facilitate self-monitoring, positive communication, joint problem solving, and social support to increase physical activity, healthy eating, and weight loss relative to Brenner FIT alone. METHODS: A total of 45 parent/adolescent dyads are randomized to one of three conditions (n = 15 for each): Brenner FIT only, Dyad (adolescent and parent both enroll simultaneously in the age appropriate program), and Dyad Plus (both parent and adolescent enroll simultaneously, but with a coordinated component for adolescent and caregiver). This study aims to develop and pilot the coordinated intervention, establish feasibility of the intervention, and determine costs associated with implementation. RESULTS: The results of the study are expected in winter of 2021. CONCLUSION: If proven feasible and acceptable, Dyad Plus will be tested for effectiveness in a large-scale implementation-effectiveness clinical trial.

Evaluation of a comprehensive school physical activity program: Be a Champion!

BACKGROUND: Comprehensive School Physical Activity Programs (CSPAPs) are widely supported to increase physical activity (PA) in schools, but little has been reported to inform a comprehensive evaluation effort. The purpose of this report is to describe a comprehensive evaluation and monitoring strategy for CSPAP implementation. METHODS: The System for Observing Staff Promotion of Activity and Nutrition (SOSPAN), System for Observing Student Movement in Academic Routines and Transitions (SOSMART), and System for Observing Play and Leisure Activity (SOPLAY) were employed to record student and staff behaviors (2642 total scans). To assess policies, practices, and environments, a CSPAP Policies and Practices questionnaire was used, which included components of the School Health Index, the School PA Policy Assessment, the School Environment and Policies Survey, and the School Health Policies and Practices Study. Youth PA (minutes/day) was assessed using accelerometers. RESULTS: Working with school sites to ascertain the number of opportunities that are provided for PA and the amount of PA students engage in is challenging but feasible. The use of systematic observation, accelerometers, and questionnaires can provide a comprehensive representation of policies, practices, and behaviors to aid in establishing targeted PA action items. CONCLUSIONS: Developing an evaluation framework that was rigorous enough to assess the physical, social, and policy environment of a school in order to answer the overarching research questions of the study but flexible enough to be feasibly streamlined for utilization by a school implementation team proved to be challenging but possible.

The Application of an Implementation Science Framework to Comprehensive School Physical Activity Programs: Be a Champion!

Comprehensive school physical activity programs (CSPAPs) have been endorsed as a promising strategy to increase youth physical activity (PA) in school settings. A CSPAP is a five-component approach, which includes opportunities before, during, and after school for PA. Extensive resources are available to public health practitioners and school officials regarding what should be implemented, but little guidance and few resources are available regarding how to effectively implement a CSPAP. Implementation science provides a number of conceptual frameworks that can guide implementation of a CSPAP, but few published studies have employed an implementation science framework to a CSPAP. Therefore, we developed Be a Champion! (BAC), which represents a synthesis of implementation science strategies, modified for application to CSPAPs implementation in schools while allowing for local tailoring of the approach. This article describes BAC while providing examples from the implementation of a CSPAP in three rural elementary schools.