Development of a Novel Tool for Assessing Coverage of Implementation Factors in Health Promotion Program Resources

Programs for promoting health behaviors have been developed for adoption in various settings such as schools (Hoelscher et al., 2010; Sallis et al., 1997), afterschool programs (Beets et al., 2009), child care centers (Ward et al., 2010), community health and mental health clinics (Aarons et al., 2011), and other settings (Soler et al., 2010). While many of these programs have established efficacy, implementation-related challenges often limit their impact in real-world applications (Glasgow et al., 2003; Glasgow and Emmons, 2007). As a result, an emerging body of literature has pointed to the need to better consider implementation factors related to real-world applications when developing setting-based health promotion programs (Tomoaia-Cotisel et al., 2013; Damschroder et al., 2009). Also of critical importance is to prioritize the dissemination of programs that address implementation factors, and to supplement programs that do not address such factors with appropriate and effective supports, to maximize implementation rates and quality

Physical Activity and Academic Achievement: An Analysis of Potential Student- and School-Level Moderators

Background: Many children do not engage in sufficient physical activity, and schools provide a unique venue for children to reach their recommended 60 daily minutes of moderate-to-vigorous physical activity (MVPA). Prior research examining effects of MVPA on academic achievement is inconclusive, and few studies have investigated potential moderators of this relationship. This study examined whether student-level characteristics (gender, race/ethnicity, free/reduced-price lunch status) and school-level characteristics (proportion of students qualifying for free/reduced-price lunch, physical activity environment and opportunities) moderate the relationship between MVPA and academic achievement. Methods: In a large, diverse metropolitan public school district in Georgia, 4,936 students in Grade 4 were recruited from 40 elementary schools. Students wore accelerometers to measure school-day MVPA for a total of 15 days across three semesters (fall 2018, spring 2019, fall 2019). Academic achievement data, including course marks (grades) for math, reading, spelling, and standardized test scores in writing, math, reading, and Lexile (reading assessment), were collected at baseline (Grade 3, ages 8–9) and at follow-up in Grade 4 (ages 9–10). Standardized test scores were not measured in Grade 5 (ages 10–11) due to COVID-19-related disruptions. Multilevel modeling assessed whether student-level and/or school-level characteristics were moderators in the cross-sectional and longitudinal MVPA-academic achievement relationship. Results: Cross sectional analyses indicated that the MVPA and AA relationship was moderated only by student Hispanic ethnicity for Grade 4 fall spelling marks (β = -0.159 p \u3c 0.001). The relationship for Grade 4 fall spelling marks was also moderated by school physical activity opportunities (β = -0.128 (p \u3c 0.001). Longitudinally, there was no significant moderation of the MVPA-academic achievement. A relationship by student gender, free/reduced-price lunch status, race/ethnicity; nor for school-level factors including proportion of students qualifying for free/reduced-price lunch, physical activity environment, and physical activity opportunities. Conclusions: Overall, our results did not suggest that student- or school-level characteristics moderate the MVPA-academic achievement relationship. While statistically significant results were observed for certain outcomes, practical differences were negligible. In this population, school-based MVPA does not appear to differently affect academic performance based on student gender, race/ethnicity, free/reduced-price lunch, nor school characteristics

An Exploration of Supports for Increasing Classroom Physical Activity within Elementary Schools

Classroom-based physical activity (CBPA) can significantly benefit students’ health and educational outcomes, but many teachers do not utilize CBPA. This study examined teachers’ perceptions about the value and impact of several approaches to support CBPA implementation, and teachers’ weekly self-reported CBPA use. Interviews were conducted with 35 classroom teachers (including those using and not using CBPA) at two public elementary schools, and CBPA tracking logs were collected on a weekly basis. Interview transcripts were interpreted through key domains within implementation science. On average, teachers reported using one activity every other day. Interview data revealed that utilizing professional collaboration time for peer-to-peer feedback and getting informal support from the school’s physical education teacher both have some promise for increasing implementation of CBPA. However, teachers largely felt these strategies were unnecessary. Explicit administrator support was reported by teachers as the most promising mechanism for increasing their CBPA implementation

Stretched Too Thin?: The Relationship Between Insufficient Resource Allocation and Physical Education Instructional Time and Assessment Practices

With provisions in the Every Student Succeeds Act, attention to physical education (PE) programs in school will be crucial for developing well-rounded students. We assessed the availability of resources that have the potential to impact PE (staffing, continuing education, annual PE equipment budgets) in a nationally-representative sample of 640 U.S. public elementary schools. Higher student-to-PE teacher ratios were associated with students not receiving adequate instruction. Equipment budgets were minimal (median = $500) and 30% of schools had no budget at all. Additional financial support from federal and state education agencies would help schools to better meet recommendations for PE

Development of a novel tool for assessing coverage of implementation factors in health promotion program resources

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.Katharine B. Richardson Research Award at Children's Mercy Kansas CityNational Institute of Diabetes and Digestive and Kidney Diseases of the National Institutes of Health under Award Number F32DK115146Institute of Education Sciences and U.S. Department of Education by grant R305A15027

Measuring maternal, foetal and neonatal mortality: Challenges and solutions.

Levels and causes of mortality in mothers and babies are intrinsically linked, occurring at the same time and often to the same mother-baby dyad, although mortality rates are substantially higher in babies. Measuring levels, trends and causes of maternal, neonatal and foetal mortality are important for understanding priority areas for interventions and tracking the success of interventions at the global, national, regional and local level. However, there are many measurement challenges. This paper provides an overview of the definitions and indicators for measuring mortality in pregnant and post-partum women (maternal and pregnancy-related mortality) and their babies (foetal and neonatal mortality). We then discuss current issues in the measurement of the levels and causes of maternal, foetal and neonatal mortality, and present options for improving measurement of these outcomes. Finally, we illustrate some important uses of mortality data, including for the development of models to estimate mortality rates at the global and national level and for audits

Study Protocol for a Cluster-Randomized Trial of a Bundle of Implementation Support Strategies to Improve the Fidelity of Implementation of Schoolwide Positive Behavioral Interventions and Supports in Rural Schools

Background: Improving the implementation of evidence-based interventions is important for population-level impacts. Positive Behavioral Interventions and Supports (PBIS) is effective for improving school climate and students’ behavioral outcomes, but rural schools often lag behind urban and suburban schools in implementing such initiatives. Methods/Design: This paper describes a Type 3 hybrid implementation-effectiveness trial of Rural School Support Strategies (RS3), a bundle of implementation support strategies selected to improve implementation outcomes in rural schools. In this two-arm parallel group trial, 40 rural public schools are randomized to receive: 1) a series of trainings about PBIS; or 2) an enhanced condition with training plus RS3. The trial was planned for two years, but due to the pandemic has been extended another year. RS3 draws from the Interactive Systems Framework, with a university-based team (support system) that works with a team at each school (school-based delivery system), increasing engagement through strategies such as: providing technical assistance, facilitating school team functioning, and educating implementers. The primary organizational-level outcome is fidelity of implementation, with additional implementation outcomes of feasibility, acceptability, appropriateness, and cost. Staff-level outcomes include perceived climate and self-reported adoption of PBIS core components. Student-level outcomes include disciplinary referrals, academic achievement, and perceived climate. Mediators being evaluated include organizational readiness, school team functioning, and psychological safety. Discussion: The study tests implementation strategies, with strengths including a theory-based design, mixed methods data collection, and consideration of mediational mechanisms. Results will yield knowledge about how to improve implementation of universal prevention initiatives in rural schools

The Longitudinal Association Between Objectively-Measured School-Day Physical Activity and Academic Achievement in US Elementary School Students

Background: It is recommended that school-aged children accrue 30 minutes of daily moderate-to-vigorous physical activity (MVPA) in school. Current literature is inconclusive about the long-term associations between school-based physical activity and academic achievement. In this study, we use a large sample and longitudinal design to rigorously evaluate whether school-day MVPA is associated with academic achievement. Methods: In a diverse suburban public school district, 4936 Grade 4 students were recruited in 40 elementary schools. Students wore accelerometers to measure school-day MVPA for 15 days across three semesters. Academic performance data was collected across Grade 3 fall to Grade 5 spring, including teacher-assigned grades and standardized test scores. Multilevel modeling was conducted controlling for student demographics and school characteristics. Results: Cross-sectional analyses found small negative associations in Grade 4. Grade 4 full-year mean daily school-day MVPA had β = −-0.066, β = −-0.063, β = −-0.066, and β = −-0.058 associations (p \u3c  0.001) with Grade 4 math, reading, spelling, and writing grades respectively, and Grade 4 full-year mean daily school-day MVPA had β = −-0.206 and β = −-0.283 (p \u3c  0.001) associations with Grade 4 math and English Language Arts (ELA) standardized test scores respectively out of approximately 500 points. Longitudinal analyses found no significant associations between Grade 4 full-year mean daily school-day MVPA and Grade 5 Fall course grades. Results also indicated small negative associations for students attaining 30+ minutes of daily school-day MVPA compared to those attaining less than 15 minutes, but only in Grade 4 Fall cross-sectional analyses where teacher-assigned reading, spelling, and writing grades were − 1.666, − 1.638, and − 1.993 points lower respectively (p \u3c  0.001). Conlcusion: The cross-sectional findings, while statistically significant in a negative direction, have a negligible association when translated practically. For example, even if students attained twice the recommended amount of school-day MVPA – which would constitute an approximately 300% increase from current levels – results suggest that grades would only decrease by 2 points on a 100-point scale. Furthermore, longitudinal analyses suggest school-day MVPA does not have a predictive association with course grades or standardized test scores. Findings suggest school-based MVPA implemented in accordance with recommendations does not meaningfully detract from academic progress. Trial registration: ClinicalTrials.gov, NCT03765047. Registered 05 December 2018 - Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT0376504

A Locus on Chromosome 5 Is Associated with Dilated Cardiomyopathy in Doberman Pinschers

Dilated cardiomyopathy (DCM) is a heterogeneous group of heart diseases with a strong genetic background. Currently, many human DCM cases exist where no causative mutation can be identified. DCM also occurs with high prevalence in several large dog breeds. In the Doberman Pinscher a specific DCM form characterized by arrhythmias and/or echocardiographic changes has been intensively studied by veterinary cardiologists. We performed a genome-wide association study in Doberman Pinschers. Using 71 cases and 70 controls collected in Germany we identified a genome-wide significant association to DCM on chromosome 5. We validated the association in an independent cohort collected in the United Kingdom. There is no known DCM candidate gene under the association signal. Therefore, DCM in Doberman Pinschers offers the chance of identifying a novel DCM gene that might also be relevant for human health

Revisiting the Twentieth Century Through the Lens of Generation X and Digital Games: A Scoping Review

Video games have been around since the 1960s and have impacted upon society in a myriad of different ways. The purpose of this scoping review is to identify existing literature within the domain of video games which recruited participants from the Generation X (1965–1980) cohort. Six databases were searched (ACM, CINHAL Google Scholar, PubMed, Scopus, and Web of Science) focusing on published journal papers between 1970 and 2000. Search results identified 3186 articles guided by the PRISMA Extension for Scoping Reviews (PRISMA-ScR); 4 papers were irretrievable, 138 duplicated papers were removed, leaving 3048 were assessed for eligibility and 3026 were excluded. Articles (n = 22) were included into this review, with four papers primarily published in 1997 and in 1999. Thematic analysis identified five primary themes: purpose and objectives, respective authors’ reporting, technology, ethics and environment) and seven secondary themes: populations, type of participants (e.g. children, students), ethical approval, study design, reimbursement, language, type of assessments. This scoping review is distinctive because it primarily focuses on Generation X, who have experienced and grown-up with videogames, and contributes to several disciplines including: game studies, gerontology and health, and has wider implications from a societal, design and development perspective of video games