Feasibility, Acceptability, and Preliminary Efficacy of an Academically-Integrated Physical Activity Program on Classroom Behavior in Preschoolers

Maladaptive classroom behaviors (i.e., hyperactivity, inattention) are common in preschoolers, yet elevated levels may lead to future academic difficulties or attention-deficit/hyperactivity disorder (ADHD). Physical activity (PA) may be one way to alleviate these maladaptive behaviors within the classroom, yet preschoolers are not meeting PA guidelines. Implementing academically-integrated PA may serve a two-fold benefit of enhancing PA and classroom behavior. However, process evaluation data describing academically-integrated PA interventions are sparse. Therefore, the purpose of this study was to examine the feasibility, acceptability, and preliminary efficacy of a 12-week PA intervention integrated into early learning standards on classroom behavior in preschoolers. Two preschools were randomized to either the Preschoolers Actively Learning (PAL) group or the health-tracking control (CON) group. All children participated in their assigned activities, but children (n = 58, age = 4.0 ± 0.8 years) and teachers (n = 8) were individually recruited for participation in the assessment portion of this study. The PAL lessons were integrated into early learning standards and offered for 10-15 minutes during morning circle time four days per week for 12 weeks. The CON group was asked to maintain their typical curriculum. Feasibility, acceptability, and fidelity data were collected daily, weekly, and post-intervention. PA levels and directly observed classroom behavior were assessed at baseline, 6-weeks, and 12-weeks, while teacher-reported classroom behavior was assessed at baseline and 12-weeks. Process evaluation data indicated that 93% of lessons were implemented as intended. Modifications were made to 34% of the lessons. Children and teachers appeared to enjoy participating in the lessons 99% and 85% of the time, respectively. Children in the PAL group engaged in 5.0 ± 2.3 minutes of moderate-to-vigorous PA during circle time compared to 2.8 ± 2.8 minutes in the CON group (t = -7.12, p \u3c 0.0001). However, there were no differences in preschool-day PA or classroom behavior. While feasibility and acceptability were established, preliminary efficacy was not. Teachers expressed interest in future use of the PAL lessons, but modifications should be made to influence classroom behavior and PA. Strategies to enhance lesson intensity, preschool day PA, and assessment compliance are needed in future studies

Does Change in Physical Activity Predict Mental Health Outcomes in Pre-Adolescent African American Girls?

Pediatric obesity is a significant clinical and public health issue for African American girls in which low physical activity (PA) is a contributor. The mother-daughter relationship (MDR) has rarely been examined in the context of improving health behaviors such as PA and mental health outcomes (MHO) within this population. PURPOSE: To examine if change in PA following a 12-week culturally-tailored mother-daughter PA intervention predicts change in MHO variables (self-esteem, depressive symptoms, body image dissatisfaction) and MDR in pre-adolescent African American girls. METHODS: Mothers (n=27; age=36.0±17.0 years; body mass index (BMI)=34.0±7.4 kg/m2) and daughters (n=27; age=9.0±1.4 years; BMI=20.3±5.7 kg/m2, BMI percentile=73%) randomized to the mother-daughter dance group were examined in this analysis. Physical activity levels were assessed with Actigraph GT3X+ accelerometers for seven days and validated questionnaires. Mental health outcome variables and MDR were assessed using validated questionnaires. Spearman correlations were used to examine associations between variables. MANOVA was used to assess differences in PA levels across three time points. Paired t-tests and ANOVA were used for MHO variables and MDR across two and three time points, respectively. Simple regression was used to assess if PA self-efficacy and MDR mediated changes in PA. Hierarchical linear modeling (HLM) assessed if changes in PA variables predicted changes in MHO variables. RESULTS: Several significant correlations were observed at baseline and post-intervention such as the negative relationships between daughters’ light PA (% time) and depressive symptoms as well as a daughters’ BMI percentile and body image dissatisfaction. Significant reduction was observed in daughters’ self-reported PA (p=0.04) pre- to post-intervention. No other significant changes were observed. Change in PA did not predict change in MHO variables, but there was a negative effect of average BMI percentile on self-esteem (p=0.017) and body image dissatisfaction (p=0.002). CONCLUSION: In this sample of pre-adolescent African American girls, change in objectively measured PA did not predict change in MHO. The lack of significant findings could be attributed to low attendance of the intervention. Future studies should examine these relationships in a larger sample and explore the use of technology to combat low attendance

Is African-American Girls’ Perception of their Mother-Daughter Relationship Associated to Psychosocial and Physical Activity Variables?

Maternal influence has been reported to play a significant role in the health behaviors of children. In Caucasian girls, it has been reported that mother-daughter relationship can influence psychosocial variables such as physical activity (PA) self-efficacy. Currently, there is very little data on the impact of African-American girls’ perception of their relationship with their mother and psychosocial variables. PURPOSE: To examine the association between mother-daughter relationship, PA self-efficacy (PA-SE) and PA levels in African-American girls. METHODS: Baseline data from mothers (n=28; age=37.0±6.7 years; BMI=33.5±10.6 kg/m2) and daughters (n=32; age=9.0±1.2 years; BMI=20.4±5.7 kg/m2, 90th percentile) participating in an afterschool mother-daughter PA study was used in this analysis. PA was measured for 7 continuous days using accelerometers. Parental Responsiveness (PR) and Adolescent Openness to Parental Socialization scales were used to assess mother-daughter relationship. Daughters’ self-esteem and depressive symptoms were assessed with the Rosenberg Self-Esteem (RSE) scale and the Child Depression Inventory (CDI), respectively. Participants’ PA-SE was assessed with validated questionnaires. Spearman correlations were used to examine associations between mother-daughter relationship, psychosocial variables, and PA levels. Daughters’ scores for the PR scale were divided into tertiles. Between group (high versus low perception of mother-daughter relationship) differences in psychosocial variables and PA were assessed with t-tests. RESULTS: Daughters’ perception of their mother-daughter relationship was positively correlated with RSE (r=0.36, p=0.04). Daughters’ percent time spent in MVPA was negatively correlated with CDI (r=-0.42, p=0.03) and positively correlated with mothers’ PA-SE (r=0.44, p=0.04). With respect to daughters’ PR scale, significant differences in RSE score (HIGH=23.82±4.33; LOW=18.20±4.87, p=0.01) and percent time spent in sedentary activity (HIGH=27.83±32.31; LOW=57.41±20.93, p=0.02) were observed between tertiles. CONCLUSION: African-American girls’ perception of their relationship with their mother seems to be associated with self-esteem, depressive symptoms and sedentary pursuits. Future studies should target interventions that improve mother-daughter relationship

Feasibility, Acceptability, and Preliminary Efficacy of a Recess-Based Fitness Intervention in Elementary School Children

International Journal of Exercise Science 12(4): 1225-1243, 2019. Although fitness may benefit cognition in youth, most attention has been given to cardiorespiratory fitness despite the health benefits of muscular fitness. Few studies have examined interventions that incorporate both cardiorespiratory and muscular fitness or have been offered during school recess. Furthermore, most fitness intervention studies examining cognitive outcomes have not reported on implementation information. The purpose of this pilot study was to examine the feasibility, acceptability, and preliminary efficacy on fitness and cognition of a recess intervention in elementary school children. Two schools were randomized to either a 3-month cardiorespiratory and muscular fitness intervention (15 minutes/weekday during recess) or control condition (standard recess activities). Process evaluation (feasibility and acceptability) measures were recorded daily (research staff questionnaire), weekly (accelerometer and heart rate monitors), and post-intervention (participant and school-staff questionnaires). Preliminary efficacy measures included pre- and post-intervention inhibition/attention, working memory, and cardiorespiratory and muscular fitness scores. Some feasibility and acceptability measures were favorable (88% of the lessons were implemented, 78% of the lessons were implemented as planned, and the majority of students and school staff were satisfied with most aspects of the intervention). However, intensity adherence during the intervention sessions based on accelerometry (% of time spent in moderate-to-vigorous activity: 41.7 ± 14.5) and participation (19.4% attendance rate) were lower than expected. Preliminary efficacy of the intervention on cognitive and fitness outcomes was not demonstrated. This study provided evidence that some aspects of the fitness intervention were acceptable during school recess. However, important implementation factors (i.e., intervention exposure) should be targeted to improve youth fitness programs offered during this school setting

Process evaluation of a culturally-tailored physical activity intervention in African-American mother-daughter dyads

The purpose of this study was to describe process evaluation data including intervention fidelity, dosage, quality, participant responsiveness, and program reach for the Mothers And dauGhters daNcing togEther Trial (MAGNET) in Springfield, MA, in Spring 2013 and 2014. Seventy-six mother-daughter dyads were randomized to the mother-daughter group (CH-M, n = 28), the child-only group (CH, n = 25), or the health education group (CON, n = 23). CH-M consisted of 60 min of moderate-to-vigorous culturally-tailored dance classes for dyads. CH consisted of dance classes for the child. All groups received homework tutoring and weekly health newsletters. Process evaluation data were assessed at each intervention session (three days/week, 6-months) with semi-structured questionnaires by researchers. CH dance classes were slightly longer (58.2 ± 3.5 min) than CH-M (54.4 ± 5.5 min). In both groups, participants spent the majority of the dance intervention in light intensity physical activity (PA). Participants in the CH-M group enjoyed participating in MAGNET \u3e 90% of the time. Mothers (92%) indicated that they wanted to continue dance as a form of PA. Mothers expressed that transportation, time commitment, and assessments were barriers to participation. Participants suggested future interventions should include longer intervention length and more communications between research staff and mothers. The MAGNET intervention matched the originally intended program in most aspects. A lower intervention dose was delivered to the CH-M group potentially due to barriers described by mothers. Because mother-daughter interventions have shown minimal effects on increasing PA, it is imperative that researchers utilize process evaluation data to shape future studies

Examining the Association of Second Grade Children\u27s Sleep and Screen Time Recommendations

Background: Adequate sleep is essential for various health outcomes (e.g., obesity, diabetes, and cardiovascular disease). However, sleep time is threatened by the increased opportunities for unsupervised screen time available to children of all ages. The American Academy of Sleep Medicine recommends that elementary-aged children sleep between 9-12 hours per night. Further, the American Academy of Pediatrics recommends that children\u27s recreational screen time be limited to less than two hours per day. Excess screen use can delay bedtime and lead to less restful sleep. The purpose of this study was to examine the association between adhering to screentime guidelines (/day) and the likelihood of meeting sleep guidelines (9-12 hours/day) in 2nd-grade children. Methods: This study utilized two waves (2015-2016 and 2019-2020) of 2nd graders\u27 parent-reported weighted survey data from the Texas School Physical Activity and Nutrition (SPAN) cross-sectional survey. Results: The final analytic sample included (n=3,193) individuals (53% female, 62% Hispanic) across two years of data collection. 65% of parents/guardians reported their children met the sleep guidelines, while 33% of parents/guardians reported their children meeting the screentime guideline. After controlling for BMI, race/ethnicity, school disadvantage, education, sex, and year of collection, parents who reported their children met the screentime guideline had 1.53 greater odds of meeting sleep guidelines compared to children whose parent/guardians reported their children did not meet the screentime guidelines OR (1.53 95%CI = 1.18, 1.99). In stratified analyses, we found that the associations between meeting sleep and screen time guidelines were primarily true for White children. A higher proportion of white children were more likely to meet both sleep time and screen time recommendations compared to black and Hispanic children, while Black and Hispanic children were as likely to meet screen time guidelines as White children; both groups had significantly lower odds of meeting sleep guidelines compared to White children OR 0.32 (95%CI = 0.18, 0.58) and OR 0.49 (95%CI = 0.29, 0.83) respectively. Discussion: Children\u27s ability to meet the recommended sleep guidelines is associated with screentime guideline adherence. Further exploration is needed to understand racial/ethnic differences in guideline adherence for screentime and sleep. Interventions targeting sleep characteristics (e.g., duration, quality, and timing) should consider concomitantly targeting screentime adherence in elementary-aged children

Cross-Sectional Associations of 24-Hour Sedentary Time, Physical Activity, and Sleep Duration Compositions with Sleep Quality and Habits in Preschoolers

Although some studies indicate physical activity and sleep quality are positively associated in children, most reports examined physical activity independent of other 24-h behaviors and focused on older children. The aim of this cross-sectional study was to examine the predicted changes in sleep efficiency and habits when reallocating time between movement behaviors using compositional isotemporal substitution in preschool-aged children. Accelerometers were worn by 288 participants (51.6 ± 9.5 months) for up to 16 days. Sleep outcomes included sleep efficiency, nap frequency, sleep disturbances, and bedtime resistance. Compositional isotemporal substitution analyses demonstrated that the combined effect of 24-h movement behaviors was associated with sleep efficiency (p \u3c 0.001) and nap frequency (p \u3c 0.003). When sleep increased by 30 min at the expense of stationary time or light physical activity, estimates of sleep efficiency and bedtime resistance decreased while nap frequency increased. When stationary time increased by 30 min from moderate to vigorous physical activity, estimated sleep efficiency increased and sleep disturbances decreased. Although this study presents preliminary evidence that 24-h movement behavior compositions in early childhood are associated with sleep quality and nap frequency, estimated effects from theoretical time reallocations across sleep outcomes were mixed

The impact of a randomized controlled trial of a lifestyle intervention on postpartum physical activity among at-risk hispanic women: Estudio PARTO

AIMS: To assess the impact of a culturally modified, motivationally targeted, individually-tailored intervention on postpartum physical activity (PA) and PA self-efficacy among Hispanic women. METHODS: Estudio PARTO was a randomized controlled trial conducted in Western Massachusetts from 2013-17. Hispanic women who screened positive for gestational diabetes mellitus were randomized to a Lifestyle Intervention (LI, n = 100) or to a comparison Health and Wellness (HW, n = 104) group during late pregnancy. Exercise goals in LI were to meet American College of Obstetrician and Gynecologists guidelines for postpartum PA. The Pregnancy Physical Activity Questionnaire (PPAQ) and the Self-Efficacy for Physical Activity Questionnaire were administered at 6 weeks, 6 months, and 1 year postpartum. RESULTS: Compared to baseline levels, both groups had significant increases in moderate-to-vigorous PA at 6 months and one year postpartum (i.e., LI: mean change = 30.9 MET-hrs/wk, p = 0.05; HW: 27.6 MET-hrs/wk, p = 0.01), with only LI group experiencing significant increases in vigorous PA (mean change = 1.3 MET-hrs/wk, p = 0.03). Based on an intent-to-treat analysis using mixed effects models, we observed no differences in pattern of change in PA intensity and type over time between intervention groups (all p \u3e 0.10). However, there was the suggestion of a greater decrease in sedentary activity in the LI group compared to the HW group (beta = -3.56, p = 0.09). CONCLUSIONS: In this randomized trial among high-risk Hispanic women, both groups benefitted from participation in a postpartum intervention

Estimating Physical Activity and Sleep using the Combination of Movement and Heart Rate: A Systematic Review and Meta-Analysis

International Journal of Exercise Science 16(7): 1514-1539, 2023. The purpose of this meta-analysis was to quantify the difference in physical activity and sleep estimates assessed via 1) movement, 2) heart rate (HR), or 3) the combination of movement and HR (MOVE+HR) compared to criterion indicators of the outcomes. Searches in four electronic databases were executed September 21-24 of 2021. Weighted mean was calculated from standardized group-level estimates of mean percent error (MPE) and mean absolute percent error (MAPE) of the proxy signal compared to the criterion measurement method for physical activity, HR, or sleep. Standardized mean difference (SMD) effect sizes between the proxy and criterion estimates were calculated for each study across all outcomes, and meta-regression analyses were conducted. Two-One-Sided-Tests method were conducted to meta-analytically evaluate the equivalence of the proxy and criterion. Thirty-nine studies (physical activity k = 29 and sleep k = 10) were identified for data extraction. Sample size weighted means for MPE were -38.0%, 7.8%, -1.4%, and -0.6% for physical activity movement only, HR only, MOVE+HR, and sleep MOVE+HR, respectively. Sample size weighted means for MAPE were 41.4%, 32.6%, 13.3%, and 10.8% for physical activity movement only, HR only, MOVE+HR, and sleep MOVE+HR, respectively. Few estimates were statistically equivalent at a SMD of 0.8. Estimates of physical activity from MOVE+HR were not statistically significantly different from estimates based on movement or HR only. For sleep, included studies based their estimates solely on the combination of MOVE+HR, so it was impossible to determine if the combination produced significantly different estimates than either method alone

Vertical profiles of light absorption and scattering associated with black carbon particle fractions in the springtime Arctic above 79◦ N

Despite the potential importance of black carbon (BC) for radiative forcing of the Arctic atmosphere, ver- tically resolved measurements of the particle light scatter- ing coefficient (σsp ) and light absorption coefficient (σap ) in the springtime Arctic atmosphere are infrequent, espe- cially measurements at latitudes at or above 80◦ N. Here, re- lationships among vertically distributed aerosol optical prop- erties (σap, σsp and single scattering albedo or SSA), par- ticle microphysics and particle chemistry are examined for a region of the Canadian archipelago between 79.9 and 83.4◦ N from near the surface to 500 hPa. Airborne data collected during April 2015 are combined with ground- based observations from the observatory at Alert, Nunavut and simulations from the Goddard Earth Observing Sys- tem (GEOS) model, GEOS-Chem, coupled with the TwO- Moment Aerosol Sectional (TOMAS) model (collectively GEOS-Chem–TOMAS; Kodros et al., 2018) to further our knowledge of the effects of BC on light absorption in the Arctic troposphere. The results are constrained for σsp less than 15 Mm−1, which represent 98 % of the observed σsp, be- cause the single scattering albedo (SSA) has a tendency to be lower at lower σsp, resulting in a larger relative contribution to Arctic warming. At 18.4 m2 g−1, the average BC mass ab- sorption coefficient (MAC) from the combined airborne and Alert observations is substantially higher than the two aver- aged modelled MAC values (13.6 and 9.1 m2 g−1) for two different internal mixing assumptions, the latter of which is based on previous observations. The higher observed MAC value may be explained by an underestimation of BC, the presence of small amounts of dust and/or possible differences in BC microphysics and morphologies between the obser- vations and model. In comparing the observations and simulations, we present σap and SSA, as measured, and σap/2 and the corresponding SSA to encompass the lower modelled MAC that is more consistent with accepted MAC values. Me- dian values of the measured σap, rBC and the organic com- ponent of particles all increase by a factor of 1.8 ± 0.1, going from near-surface to 750 hPa, and values higher than the sur- face persist to 600 hPa. Modelled BC, organics and σap agree with the near-surface measurements but do not reproduce the higher values observed between 900 and 600 hPa. The dif- ferences between modelled and observed optical properties follow the same trend as the differences between the mod- elled and observed concentrations of the carbonaceous com- ponents (black and organic). Model-observation discrepan- cies may be mostly due to the modelled ejection of biomass burning particles only into the boundary layer at the sources. For the assumption of the observed MAC value, the SSA range between 0.88 and 0.94, which is significantly lower than other recent estimates for the Arctic, in part reflecting the constraint of σsp < 15 Mm−1. The large uncertainties in measuring optical properties and BC, and the large differ- ences between measured and modelled values here and in the literature, argue for improved measurements of BC and light absorption by BC and more vertical profiles of aerosol chemistry, microphysics and other optical properties in the Arctic