Contribution of youth sport participation to physical activity levels and cardiovascular disease risk factors in 5-year-old to 14-year-old children: a study protocol for systematic review and meta-analysis.

INTRODUCTION: Cardiovascular disease (CVD) accounts for 18 million deaths per year, disproportionately burdens under-represented racial and ethnic groups, and has economic costs greater than any other health condition. Participation in youth sport may be an effective strategy to improve CVD-related risk factors but studies of youth sport participation have shown mixed results for improving health outcomes. Therefore, the objective of this systematic review is to examine how participation in youth sport contributes to physical activity levels and CVD risk factors in children aged 5-14 years old. A secondary objective is to determine if outcomes are different in racial and ethnic groups. METHODS AND ANALYSIS: The search will encompass studies published in English, Spanish or Portuguese between January 1995 and April 2024, including five databases (PubMed, Medline, Embase, Cochrane Library and SPORTDiscus). Studies will be included if they are experimental or observational studies, conducted in youths of any health background and assess the relationship of sport participation to physical activity levels or CVD risk factors. Studies must report on at least one of the following outcomes: (1) physical activity levels, (2) blood pressure, (3) lipid fractions, (4) body mass index (5) central adiposity, (6) systemic inflammation and (7) glucose levels/insulin resistance. Study quality will be assessed using the Cochrane Risk of Bias version 1 tool. Narrative descriptions and summary tables will be created to describe studies, results and methodological quality and be synthesised by subsets of studies based on study design and outcomes. In the systematic review, we will categorise the included studies into two subgroups (ie, observational studies, experimental studies) and meta-analyse them separately prior to exploring sources of heterogeneity. ETHICS AND DISSEMINATION: Ethical approval is not required. The results will be disseminated via peer-reviewed publication and presentation at conferences relevant to this field. PROSPERO REGISTRATION NUMBER: CRD42023427219.

Human-centered participatory co-design with children and adults for a prototype lifestyle intervention and implementation strategy in a rural middle school.

PURPOSE: The significance of regular physical activity (PA) in reducing cardiovascular disease (CVD) risk is widely acknowledged. However, children in rural areas encounter specific barriers to PA compared to their urban counterparts. This study employs human-centered participatory co-design, involving community stakeholders in developing a multi-level PA intervention named Hoosier Sport. The primary hypothesis is the co-design sessions leading to the development of a testable intervention protocol. METHODS: Two co-design teams, each consisting of six children and six adults, were formed using human-centered participatory co-design facilitated by research faculty and graduate students. The process involved five co-design sessions addressing problem identification, solution generation, solution evaluation, operationalization, and prototype evaluation. Thematic analysis was employed to identify key themes and intervention components. RESULTS: Child co-designers (n = 6) ranged from 6th to 8th grade, averaging 12.6 years (SD = 1.8), while adult co-designers (n = 6) averaged 43.3 years (SD = 8.08). Thematic analysis revealed children emphasizing autonomy, the freedom to choose physical and non-physical activities, and the importance of building peer relationships during PA. Adult interviews echoed the importance of autonomy and choice in activities, with a focus on relatedness through positive role modeling. CONCLUSION: The prototype intervention and implementation strategies developed constitute a testable intervention aligned with Phase 1 of the ORBIT model. This testable prototype lays the groundwork for a collaborative campus-community partnership between the university and the local community, ensuring mutual benefits and sustainable impact.

Associations between adverse childhood experiences and history of weight cycling.

Background: Adverse childhood experiences (ACEs) predict obesity onset; however, the relationship between ACEs and history of weight cycling has not been adequately explored. This gap is problematic given the difficulty in weight loss maintenance and the impact of ACEs on obesity development, chronicity, and associated weight stigma. The objective of this study was to examine associations between self-reported history of ACEs and weight cycling in a sample of weight loss treatment-seeking adults with overweight/obesity. Methods: The number of participants in the analyzed sample was 78, mostly white educated adult women (80% female, 81% Caucasian, 75% ≥ bachelor's degree) with excess adiposity enrolled in the Cognitive and Self-regulatory Mechanisms of Obesity Study. ACEs were measured at baseline using the ACEs Scale. History of weight cycling was measured using the Weight and Lifestyle Inventory that documented weight loss(es) of 10 or more pounds. Results: Higher ACE scores were associated with a greater likelihood of reporting a history of weight cycling. Participants with four or more ACEs had 8 times higher odds (OR = 8.301, 95% CI = 2.271-54.209, p = 0.027) of reporting weight cycling compared with participants with no ACEs. The association of weight cycling for those who endorsed one to three ACEs was not significant (OR = 2.3, 95% CI = 0.771-6.857, p = 0.135) in this sample. Conclusions: The role of ACEs in health may be related to associations with weight cycling. Results indicated that those who reported four or more ACEs had significantly higher odds of reporting weight cycling compared with those with no ACEs. Further research is needed to further explore how ACEs predict the likelihood of weight cycling, which may be prognostic for sustained weight loss treatment response and weight stigma impacts.

Multilevel needs assessment of physical activity, sport, psychological needs, and nutrition in rural children and adults.

Introduction: Physical activity yields significant benefits, yet fewer than 1 in 4 youth meet federal guidelines. Children in rural areas from low socioeconomic (SES) backgrounds face unique physical activity contextual challenges. In line with Stage 0 with the NIH Stage Model for Behavioral Intervention Development, the objective of the present study was to conduct a community-engaged needs assessment survey with middle school children and adults to identify perceptions, barriers, and facilitators of physical activity, sport, psychological needs, and nutrition from a multi-level lens. Methods: A cross-sectional survey data collection was conducted with children (n = 39) and adults (n = 63) from one middle school community in the Midwestern United States. The child sample was 33% 6th grade; 51% 7th grade and was 49% female. The adult sample was primarily between 30 and 39 years old (70%) and comprised predominantly of females (85%). Multi-level survey design was guided by the psychological needs mini-theory within self-determination theory and aimed to identify individual perceptions, barriers, and facilitators in line with the unique context of the community. Results: At the individual level, 71.8% of children and 82.2% of the overall sample (children and adults) were interested in new physical activity/sport programming for their school. Likewise, 89.7% of children and 96.8% of adults agree that PA is good for physical health. For basic psychological needs in the overall sample, relatedness was significantly greater than the autonomy and competence subscales. Children's fruit and vegetable intake were below recommended levels, yet only 43.6% of children were interested in nutritional programming. Conversely, 61.5% indicated interest at increasing leadership skills. At the policy-systems-environmental level, the respondents' feedback indicated that the condition and availability of equipment are areas in need of improvement to encourage more physical activity. Qualitative responses are presented within for physical activity-related school policy changes. Discussion: Interventions addressing children's physical activity lack sustainability, scalability, and impact due to limited stakeholder involvement and often neglect early behavioral intervention stages. The present study identified perspectives, barriers, and facilitators of physical activity, sport, psychological needs, and nutrition in a multi-level context and forms the initial campus-community partnership between scientists and community stakeholders.

Hoosier Sport: a research protocol for a multilevel physical activity-based intervention in rural Indiana.

Introduction: Currently, only 1 in 4 children in the U.S. engage in the recommended amount of physical activity (PA) and disparities in PA participation increase as income inequities increase. Moreover, leading health organizations have identified rural health as a critical area of need for programming, research, and policy. Thus, there is a critical need for the development and testing of evidence-based PA interventions that have the potential to be scalable to improve health disparities in children from under-resourced rural backgrounds. As such, the present study utilizes human-centered design, a technique that puts community stakeholders at the center of the intervention development process, to increase our specific understanding about how the PA-based needs of children from rural communities manifest themselves in context, at the level of detail needed to make intervention design decisions. The present study connects the first two stages of the NIH Stage Model for Behavioral Intervention Development with a promising conceptual foundation and potentially sustainable college student mentor implementation strategy. Methods: We will conduct a three-phase study utilizing human-centered community-based participatory research (CBPR) in three aims: (Aim 1) conduct a CBPR needs assessment with middle school students, parents, and teachers/administrators to identify perceptions, attributes, barriers, and facilitators of PA that are responsive to the community context and preferences; (Aim 2) co-design with children and adults to develop a prototype multi-level PA intervention protocol called Hoosier Sport; (Aim 3) assess Hoosier Sport's trial- and intervention-related feasibility indicators. The conceptual foundation of this study is built on three complementary theoretical elements: (1) Basic Psychological Needs mini-theory within Self-Determination Theory; (2) the Biopsychosocial Model; and (3) the multilevel Research Framework from the National Institute on Minority Health and Health Disparities. Discussion: Our CBPR protocol takes a human-centered approach to integrating the first two stages of the NIH Stage Model with a potentially sustainable college student mentor implementation strategy. This multidisciplinary approach can be used by researchers pursuing multilevel PA-based intervention development for children.

Association Between Head Impact Exposure, Psychological Needs, and Indicators of Mental Health Among U.S. High School Tackle Football Players.

PURPOSE: Age of first exposure to tackle football and head impact kinematics have been used to examine the effect of head impacts on mental health outcomes. These measures coupled with retrospective and cross-sectional designs have contributed to conflicting results. The purpose of this study was to identify the effect of one season of head impact exposure, age of first exposure to football, and psychological need satisfaction on acute mental health outcomes in adolescent football players. METHODS: This prospective single-season cohort study used sensor-installed mouthguards to collect head impact exposure along with surveys to assess age of first exposure to football, psychological satisfaction, depressive symptoms, anxiety symptoms, and thriving from football players at four high schools (n = 91). Linear regression was used to test the association of head impact exposure, age of first exposure, and psychological satisfaction with acute mental health outcomes. RESULTS: A total of 9,428 impacts were recorded with a mean of 102 ± 113 impacts/player. Cumulative head impact exposure and age of first exposure were not associated with acute mental health outcomes at postseason or change scores from preseason to postseason. Greater psychological satisfaction was associated with fewer depressive symptoms (ß = -0.035, SE = 0.008, p = < .001), fewer anxiety symptoms (ß = -0.021, SE = 0.008, p = .010), and greater thriving scores (ß = 0.278, SE = 0.040, p = < .001) at postseason. DISCUSSION: This study does not support the premise that greater single-season head impact exposure or earlier age of first exposure to tackle football is associated with worse acute mental health indicators over the course of a single season in adolescent football players.

Profiling Physical Activity Motivation Based on Reasons for Exercise: A Cluster Analysis Approach.

The purpose of this study is to identify profiles based on the reasons adults have for being physically active. A secondary purpose was to examine how profiles differ on motivational regulation and physical activity (PA). A total of 1275 (46.5 ± 16.8 years) participants were solicited from a hospital-affiliated wellness center, social media promotions, and a research volunteer registry. The Reasons to Exercise (REX-2) scale, International PA Questionnaire, Behavioral Regulation in Exercise Questionnaire-3, and demographic questionnaire were utilized to assess variables of interest with a cross-sectional survey. Using SPSS Version 26, K-cluster analysis was used to identify profiles based on the reasons for exercise that individuals identified as important. Multivariate analysis of variance (MANOVA) was used to assess profile differences followed by ANOVA. Four profiles were derived based on reason for exercise scores: a multi-reason positive (N = 361), a multi-reason negative (N = 232), an autonomous-focused (N = 259), and a control-focused cluster (N = 382) (p < .001). These unique clusters differed significantly (p < .001) from each other with respect to motivation to be active and PA. The multi-reason positive cluster engaged in higher levels of total moderate and vigorous PA minutes/week compared to the other clusters. Therefore, adult's motivation for PA may be likely to be affected by a combination of different informal goals and valuing a number of goals that are both extrinsic/controlling (e.g., to look good) and autonomous/intrinsic (e.g., to feel good), may promote greater autonomous motivation regulation and greater PA levels than highly autonomous/intrinsic goals alone.