Adolescent Autonomous Motivation for Physical Activity: A Concept Analysis.

PURPOSE: The purpose of this concept analysis is to develop a clear definition of adolescent autonomous motivation for physical activity (PA) based on all existing theoretical and operational definitions of autonomous motivation noted in the literature. For providers, understanding this is essential to elucidate why some adolescents choose to participate in a health-promoting behavior like PA. Researchers need to identify if they are evaluating autonomous motivation or a different type. METHODS: Rodgers' Evolutionary Method of concept analysis was used. PubMed, CINAHL, ERIC, PsychInfo, and Sport Discus were searched. RESULTS: No concept analysis of adolescent autonomous motivation for PA was found. Autonomous motivation may include intrinsic motivation and two forms of extrinsic motivation, integrated and identified behavioral regulations. Defining attributes include being: 1) dynamic and 2) on a continuum. Adolescent autonomous motivation for PA is a personal desire to attain PA because the behavior is fun and enjoyable, or it is an important part of how the adolescent self-identifies. The adolescent views the self as being healthy so maintains a healthy lifestyle; or views the self as athletic so needs to attain adequate MVPA. CONCLUSION: Findings are that an autonomy-supportive environment and positive perceptions of PA are needed in order to have the outcome of increased PA. The information may be helpful for promoting consistency of measurement across disciplines. Future research with adolescents is warranted to examine underlying differences between males and females, by age, weight status, and developmental stage. PRACTICE IMPLICATIONS: An in-depth understanding is needed for providers who are interested in developing interventions to assist adolescents in regularly attaining adequate PA.

A School- and Home-Based Intervention to Improve Adolescents' Physical Activity and Healthy Eating: A Pilot Study.

This study evaluated feasibility, acceptability, and preliminary efficacy of a 12-week Guys/Girls Opt for Activities for Life (GOAL) intervention on 10- to 13-year-old adolescents' body mass index (BMI), percent body fat, physical activity (PA), diet quality, and psychosocial perceptions related to PA and healthy eating. Parent-adolescent dyads from two schools were enrolled. Schools were assigned to either GOAL (38 dyads) or control (43 dyads) condition. The intervention included an after-school club for adolescents 2 days/week, parent-adolescent dyad meeting, and parent Facebook group. Intervention adolescents had greater autonomous motivation for PA and self-efficacy for healthy eating than control adolescents (both p < .05). Although between-group differences were not significant, close-to-moderate effect sizes resulted for accelerometer-measured moderate-to-vigorous PA and diet quality measured via 24-hr dietary recall (d = .46 and .44, respectively). A trivial effect size occurred for percent body fat (d = -.10). No differences emerged for BMI. Efficacy testing with a larger sample may be warranted.

Intervention Effects of "Girls on the Move" on Increasing Physical Activity: A Group Randomized Trial.

BACKGROUND: Limited intervention success in increasing and sustaining girls' moderate-to-vigorous physical activity (MVPA) underscores a need for continued research. PURPOSE: The aim of this study was to evaluate the effect of a 17-week Girls on the Move (GOTM) intervention on increasing MVPA among fifth- to eighth-grade girls. METHODS: This study is a group (cluster) randomized trial, including 24 schools, pair matched and assigned to intervention (n = 12) or control (n = 12) conditions. Participants included 1,519 girls in racially diverse public schools in urban, underserved areas of the Midwestern USA. The intervention included three components: (i) 90-min after-school physical activity (PA) club offered 3 days/week; (ii) two motivational, individually tailored counseling sessions; and (iii) an interactive Internet-based session at the midpoint of the intervention. Main outcome measures were weighted mean minutes of MVPA per week post-intervention and at 9-month follow-up measured via accelerometer. RESULTS: No between-group differences occurred for weighted mean minutes of MVPA per week at post-intervention (B = -0.08, p = .207) or 9-month follow-up (B = -0.09, p = .118) while controlling for baseline MVPA. CONCLUSIONS: Research is needed to identify interventions that assist girls in attaining and maintaining adequate PA. CLINICALTRIALS.GOV IDENTIFIER: NCT01503333.

Predicting physical activity among urban adolescent girls: A test of the health promotion model.

The purpose of this study was to test hypothesized relationships of the health promotion model (HPM) as a means of predicting moderate-to-vigorous physical activity (MVPA) among urban, adolescent girls. A secondary analysis of baseline data from a group randomized controlled trial was conducted. The study involved eight urban schools in the Midwestern United States. The sample included girls (N = 517) in the 5th-8th grades. Data were collected on age, body mass index, pubertal status, enjoyment, self-efficacy, social support, options for physical activity (PA), and commitment to PA. MVPA was measured via accelerometers worn by the girls for 7 days. Structural equation modeling was used to analyze study aims. Mean age of the sample was 11.8 years (standard deviation [SD] = 1.0). Girls attained an average of 3.0 (SD = 1.2) minutes per hour of MVPA. Self-efficacy had a positive direct (ß = .337; p < .001) and total effect (ß = .310; p < .001) on MVPA. Social support and options for PA were not significant predictors of commitment to PA or MVPA. Commitment to PA had a negative but nonsignificant effect (ß = -.056; p = .357) on MVPA. The model predicted 10.1% of the variance in MVPA with 9.6% of the variance predicted by self-efficacy. Limitations include lack of longitudinal analysis and inability to generalize the results to other populations such as boys. PA self-efficacy continues to emerge as a significant predictor of MVPA in the HPM. Continued theory testing is needed to better understand the correlates and determinants of PA among adolescent girls before designing theory-based interventions to promote PA.

Biological and Sociocultural Differences in Perceived Barriers to Physical Activity Among Fifth- to Seventh-Grade Urban Girls.

BACKGROUND: Inadequate physical activity (PA) contributes to the high prevalence of overweight and obesity among U.S. adolescent girls. Barriers preventing adolescent girls from meeting PA guidelines have not been thoroughly examined. OBJECTIVES: The threefold purpose of this study was to (a) determine pubertal stage, racial/ethnic, and socioeconomic status (SES) differences in ratings of interference of barriers to PA; (b) examine relationships between perceived barriers and age, body mass index, recreational screen time, sedentary activity, and PA; and (c) identify girls' top-rated perceived barriers to PA. METHODS: Girls (N = 509) from eight Midwestern U.S. schools participated. Demographic, pubertal stage, perceived barriers, and recreational screen time data were collected via surveys. Height and weight were measured. Accelerometers measured sedentary activity, moderate-to-vigorous PA (MVPA), and light plus MVPA. RESULTS: Girls of low SES reported greater interference of perceived barriers to PA than those who were not of low SES (1.16 vs. 0.97, p = .01). Girls in early/middle puberty had lower perceived barriers than those in late puberty (1.03 vs. 1.24, p < .001). Girls' perceived barriers were negatively related to MVPA (r = -.10, p = .03) and light plus MVPA (r = -.11, p = .02). Girls' top five perceived barriers included lack of skills, hating to sweat, difficulty finding programs, being tired, and having pain. DISCUSSION: Innovative interventions, particularly focusing on skill development, are needed to assist girls in overcoming their perceived barriers to PA.

Youth physical activity self-efficacy: a concept analysis.

AIM: To report an analysis of the concept of youth physical activity self-efficacy. BACKGROUND: Physical activity self-efficacy is a concept that has been frequently examined as a key variable in research aimed at increasing physical activity among youth. Different conceptual definitions and empirical measures indicate the need for concept analysis to advance knowledge of the concept. DESIGN: Rodger's evolutionary method of concept analysis was used to collect and analyse the data. Social cognitive theory guided the analysis. DATA SOURCES: The PubMed, Cumulative Index of Nursing and Allied Health Literature, PsychInfo, Educational Resources Information Center and Sociological Abstracts databases were searched for publications from 1990-2013. Search terms included self-efficacy, physical activity, youth, children, adolescent and teen. REVIEW METHODS: A total of 276 articles were identified. Fifty-five articles meeting inclusion criteria were included in the review. Data were analysed with particular focus on the attributes, antecedents and consequences of the concept. RESULTS: Defining attributes of physical activity self-efficacy were identified as personal cognition/perception, self-appraisal process, related action, power to choose physical activity, dynamic state and bi-dimensional nature. Antecedents and consequences were consistent with social cognitive theory. Youth physical activity self-efficacy is defined as a youth's belief in his/her capability to participate in physical activity and to choose physical activity despite existing barriers. CONCLUSIONS: This concept analysis provided an in-depth analysis and clarification of youth physical activity self-efficacy. Future research should be aimed at establishing consistency in conceptual definitions and empirical measurement to further develop the concept across disciplines.

Feasibility and Preliminary Effectiveness of the INSPIRE Pilot Study for Adolescent Girls.

INTRODUCTION: This pilot study evaluated the feasibility and preliminary effectiveness of the Intervention to Support Physical Activity Independence and Routine Everyday program. METHOD: This quasi-experimental single-group pretest/posttest study included adolescent girls (n = 15) who received a Fitbit Inspire 2 wearable activity tracker and participated in the seven-week Intervention to Support Physical Activity Independence and Routine Everyday program on a college campus in the Midwest. Feasibility outcomes included intervention participation, fidelity, and satisfaction. Preliminary effectiveness outcomes included moderate-to-vigorous physical activity, cardiorespiratory fitness, and resting heart rate. RESULTS: For intervention sessions, the mean attendance rate was 83.42%, the mean minutes of moderate-to-vigorous physical activity was 62.03, and the mean satisfaction score was 28.90. Moderate-to-vigorous physical activity and resting heart rate improved significantly from baseline to postintervention, but cardiorespiratory fitness did not. DISCUSSION: Results suggest the need for a pilot randomized controlled trial to improve cardiorespiratory fitness and incorporating an objective measure of moderate-to-vigorous physical activity.

Effects of the Girls on the Move randomized trial on adiposity and aerobic performance (secondary outcomes) in low-income adolescent girls.

BACKGROUND: Limited, mixed evidence exists regarding the effectiveness of physical activity interventions on adiposity and aerobic performance in adolescent underrepresented populations. OBJECTIVE: To examine effects of Girls on the Move on body mass index z-scores (BMI-z), percent (%) body fat, and aerobic performance in fifth- to eighth-grade underrepresented girls. METHODS: A group randomized trial, involving 12 intervention and 12 control schools in low-income areas, was conducted. Participants (n = 1519) were low-active girls. The 17-week intervention included (a) a physical activity club, (b) two motivational interviewing sessions, and (c) one Internet-based session. BMI-z was determined from measured height and weight; % body fat was assessed using bioelectric impedance. Aerobic performance was assessed using a shuttle run. Demographics, physical activity (accelerometer), and pubertal development were assessed. Linear mixed models, adjusting for baseline, were used to examine group differences in postintervention. RESULTS: No significant between-group differences in BMI-z existed at postintervention, but % body fat increased less among intervention than control group girls (Mchange = 0.43% vs 0.73%). Aerobic performance decreased less in intervention vs control (Mchange = -0.39 vs -0.57). CONCLUSIONS: Although the intervention positively impacted % body fat and aerobic performance in underrepresented girls, more research is necessary to determine optimal implementation for yielding greater effects.

Effect of Physical Activity Interventions for Girls on Objectively Measured Outcomes: A Systematic Review of Randomized Controlled Trials.

INTRODUCTION: Most girls are not meeting physical activity (PA) guidelines, and 30% are overweight or obese. The purpose of this systematic review was to evaluate the evidence for PA intervention effects on accelerometer-measured PA, body mass index (BMI), and percent body fat (% BF) among girls. METHODS: The Cumulative Index of Nursing and Allied Health Literature, PubMed, PsychInfo, and SportDISCUS databases were searched for randomized controlled trials published from 1985-2014. Studies with a PA intervention and outcomes of accelerometer-measured PA, BMI, or % BF were included. RESULTS: Fifteen studies were reviewed. PA, BMI, and % BF were measured in 5, 15, and 10 studies, respectively. Effect sizes (ES) were highly variable. In one intervention, PA increased (ES = -0.17 to 0.08); in two interventions, BMI was reduced (ES = -0.11 to 0.62); and in five interventions, % BF was lowered (ES = 0.12 to 0.93). DISCUSSION: Future research should involve preadolescent girls, improve methods for handling missing data, include objective measures of PA, and increase intervention attendance rates.

Comparing the Psychometric Properties of Two Physical Activity Self-Efficacy Instruments in Urban, Adolescent Girls: Validity, Measurement Invariance, and Reliability.

Aims: This study compared the psychometric properties of two self-efficacy instruments related to physical activity. Factorial validity, cross-group and longitudinal invariance, and composite reliability were examined. Methods: Secondary analysis was conducted on data from a group randomized controlled trial investigating the effect of a 17-week intervention on increasing moderate to vigorous physical activity among 5th-8th grade girls (N = 1,012). Participants completed a 6-item Physical Activity Self-Efficacy Scale (PASE) and a 7-item Self-Efficacy for Exercise Behaviors Scale (SEEB) at baseline and post-intervention. Confirmatory factor analyses for intervention and control groups were conducted with Mplus Version 7.4 using robust weighted least squares estimation. Model fit was evaluated with the chi-square index, comparative fit index, and root mean square error of approximation. Composite reliability for latent factors with ordinal indicators was computed from Mplus output using SAS 9.3. Results: Mean age of the girls was 12.2 years (SD = 0.96). One-third of the girls were obese. Girls represented a diverse sample with over 50% indicating black race and an additional 19% identifying as mixed or other race. Both instruments demonstrated configural invariance for simultaneous analysis of cross-group and longitudinal invariance based on alternative fit indices. However, simultaneous metric invariance was not met for the PASE or the SEEB instruments. Partial metric invariance for the simultaneous analysis was achieved for the PASE with one factor loading identified as non-invariant. Partial metric invariance was not met for the SEEB. Longitudinal scalar invariance was achieved for both instruments in the control group but not the intervention group. Composite reliability for the PASE ranged from 0.772 to 0.842. Reliability for the SEEB ranged from 0.719 to 0.800 indicating higher reliability for the PASE. Reliability was more stable over time in the control group for both instruments. Conclusions: Results suggest that the intervention influenced how girls responded to indicator items. Neither of the instruments achieved simultaneous metric invariance making it difficult to assess mean differences in PA self-efficacy between groups.

Chronic Student Absenteeism: The Critical Role of School Nurses.

Routine school attendance is necessary for youth to develop into well-educated, successful adult citizens who will make significant contributions to society. Yet over 5 million students in the United States are chronically absent missing more than 10% of school in a year. The growing problem of chronic absenteeism among youth can be linked to increases in chronic health conditions in childhood such as allergies, asthma, diabetes, and obesity. School nurses are in an ideal position to play a vital role in reducing chronic student absenteeism, enabling youth to achieve their maximum learning potential. However, the role of the school nurse has not historically been recognized as a key factor for assisting youth to be present and regularly engaged in school. This feature article highlights a hospital-funded school nurse program within the state of Michigan that has reduced chronic absenteeism rates by placing school nurses into schools where previously there were none. The program implemented a number of initiatives that were instrumental in increasing the health and safety of students and provides a unique "before and after" glimpse of how school nursing reduces chronic student absenteeism rates and validates the essential role of the nurse within the educational system.