Protocol for a multicenter-cluster randomized clinical trial of a motor skills intervention to promote physical activity and health in children: the CHAMP afterschool program study.

BACKGROUND: Promoting health-enhancing and sustainable physical activity levels across childhood and adolescence contribute to positive health outcomes as an adult. This study will aim to: a) examine the immediate (pre- to post-intervention) and sustained (1-year post-intervention follow-up) effects of the Children's Health Activity Motor Program-Afterschool Program (CHAMP-ASP) on physical activity, motor competence, and perceived motor competence relative to the comparison ASP, b) examine the immediate and sustained effects of CHAMP-ASP on secondary health outcomes, specifically health-related physical fitness (i.e., cardiorespiratory fitness, muscular strength, percent body fat) and weight status compared to children in the comparison ASP, and c) determine if perceived motor competence mediates the effect of CHAMP-ASP on moderate-to-vigorous physical activity. METHODS: This multicenter cluster randomized trial will be implemented by ASP staff and will be conducted in ASPs located in two city-based cohorts: East Lansing/Lansing and Ann Arbor/Ypsilanti, Michigan. Children (N = 264) who are K-2 graders will participate 35 min/day X 3 days/week for 19 weeks (1995 min) in their afterschool movement program (i.e., CHAMP-ASP vs. comparison). The research team will train ASP staff to implement the program, which will be delivered within the existing ASP offering. Measures of physical activity (accelerometer), motor competence (process and product measures of fundamental motor skills), health-related fitness, perceived motor competence, and anthropometry will be collected pre-, immediately post-, and one-year post-intervention. Random-effects models will be used to assess the clustered longitudinal effect of the intervention on outcome measures. DISCUSSION: The long-term goal is to provide a sustainable, ecologically-relevant, and evidence-based program during the early elementary years that can be delivered by ASP staff, is health-enhancing, and increases physical activity in children. Findings hold the potential to help shape public health and educational policies and interventions that support healthy development and active living during the early years. TRIAL REGISTRATION: ClinicalTrials.gov Identifier NCT05342701 . ETHICS AND DISSEMINATION: Ethical approval was obtained through the Health Sciences and Behavioral Sciences IRB, University of Michigan (HUM00208311). The CHAMP-ASP study is funded by the National Institutes of Health. Findings will be disseminated via print, online media, dissemination events, and practitioner and/or research journals.

Developmental disparities in sedentary time by period of the day among US youth: a cross-sectional study.

BACKGROUND: Definitive evidence shows sedentary time (ST) is an independent risk factor for chronic disease, irrespective of physical activity. Despite calls to limit youth ST, studies demonstrate a spike in ST at the transition from childhood to adolescence. Identifying periods of the day (e.g., before school, during school, afterschool, and evenings) during which ST is higher in adolescents vs. children-that is, specifying when within daily routines ST disparities emerge-may be important to inform intervention strategies, as periods of the day correspond with variations in setting and supervision. The purpose of this study was to examine device-assessed ST engagement by period of day and developmental stage in a nationally representative sample of United States youth. METHODS: Youth (N = 2,972 between 6-18 years) from the 2003-2004 and 2005-2006 waves of NHANES reported demographic variables and wore an accelerometer for seven consecutive days to determine ST. Linear regression analyses were applied to study associations between ST and developmental stage (childhood or adolescence) by period of the week and weekend days, while controlling for sex, race/ethnicity, annual family income, and body mass index. RESULTS: Adjusted linear regressions (p-values < 0.0001) showed that adolescents were more sedentary than children during school, afterschool, and weekday evening periods as well as all the weekend periods. However, during school (36.3 ± 7.3 vs. 28.2 ± 7.2 min/hour; b = -7.4 [-8.1, -6.6]) and afterschool periods (31.1 ± 7.7 vs. 22.7 ± 7.0 min/hour; b = -7.8 [-8.6, -7.0]) showed the largest weekly ST disparities by developmental stage. Overall, the during school and after school hours constitute most (during school = 35% and afterschool = 16%) of the weekly ST disparity between children and adolescents. CONCLUSIONS: Our data provide interventionists with estimates of the potential for ST reduction in each setting and period of the day among US adolescents. Future research should gather information about the barriers and facilitators of ST in adolescents by period of the day to help understand factors driving disparities.

The S.P.A.C.E Hypothesis: Physical Activity as Medium - Not Medicine - for Public Health Impact.

Most scientifically tested physical activity interventions end when research funding ends; interventions that last struggle to sustain benefits. We hypothesize that long-term public health impact will benefit from a shift in how interventionists conceptualize physical activity - from a form of medicine, of value for its innate health benefits, to a malleable medium, of value for the dynamic contexts it creates.

Sociodemographic disparities in sedentary time among US youth vary by period of the day.

INTRODUCTION: Studies have reported sex and race/ethnicity disparities in sedentary time (ST), but none have evaluated ST by well-defined periods of the weekday (before school, during school, afterschool, and evening) and weekend day (morning, afternoon, and evening). Comparing sex and race/ethnicity disparities in ST at different periods of a weekday and weekend day can deepen our understanding of disparities and inform intervention efforts. This study tests sex and race/ethnicity disparities in ST by period of day in a representative sample of US youth. METHODS: Youth (N = 2,972) from the 2003-2006 NHANES waves reported demographic variables and wore an accelerometer for 7 consecutive days to assess ST. Linear regressions were conducted to test relationships between sex and race/ethnicity and ST (min/hour) during each period of a weekday and weekend day. ST differences by sex and race/ethnicity were calculated to identify the periods of the day presenting the largest opportunity to reduce disparities. RESULTS: Females were more sedentary than males during school (p < 0∙0001), afterschool (p < 0∙0001), and weekday evenings (p < 0∙0001) after controlling for covariates. After controlling for covariates, race/ethnicity only was a significant predictor of ST during weekend mornings (p < 0∙0001). During school and afterschool emerged as the periods with the largest opportunities to reduce sex disparities in ST. Weekend mornings were identified as the largest opportunity to reduce race/ethnic disparities in ST. CONCLUSIONS: Sex disparities in ST appear to be driven mostly by the during school period of the day, while race/ethnic disparities in ST seem to be driven by the weekend morning period. Future intervention work should consider these periods when aiming to reduce ST disparities in youth.

The convergent effects of primary school physical activity, sleep, and recreational screen time on cognition and academic performance in grade 9.

Lab-based experiments and randomized controlled trials consistently demonstrate improvements in youth cognition following physical activity (PA), while cross-sectional studies suggest that sedentary behavior (especially recreational screen time [RST]) and poor sleep are inversely related to cognition. However, little is known about how these 24-h movement behaviors-sleep, PA, and sedentary behavior-converge to affect youth cognition. Therefore, the purpose of this study is to test the associations between childhood 24-h movement behaviors and adolescent cognition using a longitudinal design and examine moderating effects of each behavior. This study utilized structural equation modeling with data from the NICHD Study of Early Child Care and Youth Development (N = 1,364, 52% female, 80% White). Independent variables-sleep, RST, and PA-were collected in grade 5. Dependent variables of cognitive and academic performance were collected at grade 9, including the Stroop task, Woodcock-Johnson, and Tower of London. Grade 5 PA was inversely associated with grade 9 cognition, but this relationship was no longer significant once grade 5 cognition was controlled for in analyses. Grade 5 sleep was positively related to grade 9 cognition, whether baseline cognition was controlled for or not. Finally, grade 5 RST was inversely related to cognition and academic performance, regardless of whether baseline values were controlled. Moderation analyses showed the relationship between grade 5 RST and grade 9 cognition was moderated by grade 5 PA, while the relationship between grade 5 PA and grade 9 cognition was moderated by grade 5 sleep. In each case, more PA and sleep blunted the negative relationships. These findings extend evidence that greater sleep promotes cognition and greater RST impairs cognition, by affirming these relationships over a longer period. They extend the evidence by demonstrating that the longitudinal relationship between individual 24-h movement behavior and cognition is moderated by other behaviors.

Device-Based Movement Behaviors, Executive Function, and Academic Skills among African American Children with ADHD and Disruptive Behavior Disorders.

BACKGROUND: Physical activity (PA) has been identified as a promising intervention to improve executive function (EF) and reduce ADHD symptoms in children. Few African American children with ADHD and Disruptive Behavior Disorders (DBDs) from families with low incomes are represented in this literature. The purpose of this study is to test the relationships between PA and sedentary time (ST), and EF and academic skills among African American children with ADHD and DBD from low-income families. METHODS: Children (n = 23, 6-13 years old) wore an ActiGraph for one week to measure PA and ST. EF was measured through parent report and direct neuropsychological tests. Academic skills were measured with the Curriculum-Based Measurement System. Bivariate correlations tested relationships between PA, ST, EF, and academic skills. RESULTS: A significant correlation was observed between vigorous PA time and parent reported EF (r = -0.46, p = 0.040). Light PA and moderate PA were not related to EF or academic skills, and neither was ST. CONCLUSIONS: Vigorous PA may prove useful as an adjunct treatment to improve EF in African American children with ADHD and DBD in low-income neighborhoods. Research using experimental and longitudinal designs, and examining qualitative features of PA experiences, will be critical for understanding relationships between PA, academic skills, and EF in this population.

Physical activity and adhd: evidence on developmental trajectories, transient and durable neurocognitive effects, and real-world applications / Actividad física y tdah: evidencia sobre el desarrollo, efectos neurocognitivos a corto y largo plazo y sus aplicaciones / Atividade física e tdah: evidências sobre o desenvolvimento, efeitos neurocognitivos de curto e longo prazo e suas aplicações

Abstract Attention-Deficit/Hyperactivity Disorder (ADHD) is characterized by neurodevelopmental delays. Physical activity (PA) may influence many of the same neurocognitive systems affected by ADHD. Therefore, PA may be a potential tool in treatment and management plans. This review synthesizes findings from studies investigating PA, fitness, and motor coordination. Studies of PA in youth on the spectrum for ADHD were considered in this paper. Main results include: a) cross-sectional studies: children with ADHD evidence PA levels higher than children that seem to be healthy. Childhood coincides with opportunities to free play; however, this advantage dissipates by adolescence, as PA programs become increasingly structured and less inclusive. In adulthood, individuals with ADHD are more likely to be obese and less likely to meet healthy lifestyle guidelines; b) longitudinal studies: PA at earlier stages predicts symptom severity in subsequent stages; and c) further studies: moderate PA activity of limited duration offers neurocognitive benefits. Multi-week intervention studies have tested diverse formats with results that differ based upon the chosen outcome and comparison group utilized. PA interventions that challenge cognition and fundamental movement skills in childhood provide benefits to children with ADHD. They also encourage children and adolescents to participate in structured programs, meet PA guidelines, and include short-term AF as part of daily routines.

Resumen El trastorno por déficit de atención e hiperactividad (TDAH) está caracterizado por retrasos en el desarrollo neurobiológico. La actividad física (AF) puede influir en varios de los mecanismos neurocognitivos que también son afectados por el TDAH; por lo tanto, puede considerarse parte de su tratamiento y manejo. Esta revisión sobre el trastorno resumirá estudios que evaluaron AF, aptitud física y coordinación motora. Fueron incluidos artículos sobre AF en la niñez en el espectro de TDAH. Entre los resultados se encuentran a) estudios transversales: los niños con TDAH presentan niveles de AF más altos que aquellos niños aparentemente saludables. La niñez coincide con oportunidades para participar en juego libre, pero esta ventaja es reducida durante la adolescencia, en la cual la AF es estructurada y menos inclusiva. Durante la adultez, las personas con TDAH están más propensas a ser obesas y a no adoptar las recomendaciones de estilos de vida saludables; b) estudios longitudinales: AF durante etapas tempranas predice la severidad de los síntomas del TDAH en etapas subsecuentes y c) otros estudios: la AF moderada de corta duración brinda beneficios neurocognitivos. Los resultados sobre intervenciones de varias semanas difieren según la variable de interés y el grupo con el cual es comparada la intervención. Las intervenciones de AF que retan las habilidades cognitivas y destrezas de movimientos brindan beneficios a los niños con TDAH. Además, estimulan a niños, niñas y adolescentes a participar en AF estructurada, a cumplir con la recomendación de AF y a incluir AF de corta duración como parte de las rutinas diarias.

Resumo O transtorno do déficit de atenção com hiperatividade (TDAH) caracteriza-se por retardo no desenvolvimento neurobiológico. A atividade física (AF) pode influenciar em vários dos mecanismos neurocognitivos que também são afetados pelo TDAH, portanto, pode ser considerada como parte de seu tratamento e manejo. Esta revisão sobre o transtorno resumirá os estudos que avaliaram a AF, a aptidão física e a coordenação motora. Artigos sobre AF infantil foram incluídos no espectro de TDAH. Entre os resultados estão a) estudos transversais: crianças com TDAH têm níveis mais altos de AF do que aquelas aparentemente saudáveis. A infância coincide com as oportunidades de participar de jogos livres, mas essa vantagem é reduzida durante a adolescência, na qual a AF é estruturada e menos inclusiva. Durante a idade adulta, as pessoas com TDAH são mais propensas a serem obesas e a não adotar as recomendações para terem estilos de vida saudáveis; b) Estudos longitudinais: A fase inicial de AF prediz a gravidade dos sintomas de TDAH nos estágios subsequentes e c) Outros estudos: A AF moderada de curta duração proporciona benefícios neurocognitivos. Os resultados em intervenções de várias semanas diferem segundo a variável de interesse e o grupo com o qual a intervenção é comparada. As intervenções de AF que desafiam habilidades cognitivas e habilidades de movimento proporcionam benefícios às crianças com TDAH. Além disso, estimulam crianças e adolescentes a participarem de AF estruturada, a cumprir a recomendação de AF e a incluir AF de curta duração como parte das rotinas diárias.