Statewide dissemination and implementation of physical activity standards in afterschool programs: two-year results.

BACKGROUND: In 2015, YMCA afterschool programs (ASPs) across South Carolina, USA pledged to achieve the YMCA physical activity standard calling for all children to accumulate 30 min of moderate-to-vigorous physical activity (MVPA) while attending their ASPs. This study presents the final two-year outcomes from the dissemination and implementation efforts associated with achieving this MVPA standard. METHODS: Twenty ASPs were sampled from all South Carolina YMCA-operated ASPs (N = 97) and visited at baseline (2015) and first (2016) and second year (2017) follow-up. All ASPs were provided training to increase MVPA during the program by extending the scheduled time for activity opportunities and modifying commonly played games to increase MVPA. The RE-AIM framework was used to evaluate the statewide intervention. Accelerometer-derived MVPA was the primary outcome. Intent-to-treat (ITT) models were conducted summer 2017. Programs were also classified, based on changes in MVPA from 2015 to 2016 and 2016-2017, into one of three categories: gain, maintain, or lost. Implementation, within the three groups, was evaluated via direct observation and document review. RESULTS: Adoption during the first year was 45% of staff attending training, with this increasing to 67% of staff during the second year. ITT models indicated no increase in the odds of accumulating 30 min of MVPA after the first year for either boys (odds ratio [OR] 1.06, 95CI 0.86-1.31) or girls (OR 1.14, 95CI 0.87-1.50), whereas an increase in the odds was observed during the second year for boys (OR 1.31, 95CI 1.04-1.64) and girls (OR 1.50 95CI 1.01-1.80). Programs that lost MVPA (avg. - 5 to - 7.5 min/d MVPA) elected to modify their program in a greater number of non-supportive ways (e.g., reduce time for activity opportunities, less time spent outdoors), whereas ASPs that gained MVPA (avg. + 5.5 to + 10.1 min MVPA) elected to modify their program in more supportive ways. CONCLUSIONS: The statewide study demonstrated minimal improvements in overall MVPA. However, child MVPA was dramatically influenced by ASPs who elected to modify their daily program in more supportive than non-supportive ways, with no one program modifying their program consistently across the multi-year initiative. These findings have important implications for organizations seeking to achieve the MVPA standard. TRIAL REGISTRATION: Clinical Trial Registration: NCT02394717 .

Perceptions of Using Sit-to-Stand Desks in a Middle School Classroom.

The purpose of this study was to explore the feasibility of sit-to-stand desks in a middle school classroom. Participants used sit-to-stand desks during health class. Momentary time sampling was used for physical activity and behavioral observations. Results indicate students sat 37%, stood 59%, and walked 4% of the time. Misbehaviors occurred 4% of the observed period. The following themes emerged: focus, freedom, distractions, and design. Sit-to-stand desks appear to encourage standing during instruction while simultaneously limiting misbehaviors. Students indicated some distractions but were generally positive toward desk implementation and suggested they supported learning behaviors. The teacher echoed most of the student themes.

Physical activity outcomes in afterschool programs: A group randomized controlled trial.

INTRODUCTION: Afterschool programs (ASPs) across the US are working towards achieving the standard of all children accumulating 30min of moderate-to-vigorous physical activity (MVPA) during program time. This study describes the two-year impact of an intervention designed to assist ASPs meeting the 30min/day MVPA standard. METHODS: Using a two-year delayed treatment, group randomized controlled trial, 20 ASPs serving ~1700 children/year (6-12yrs) were randomized to either an immediate (n=10, baseline-2013 and 2yrs intervention fall-2013-to-spring-2015) or delayed group (n=10, baseline 2013-2014 and 1yr intervention fall-2014-to-spring-2015). The intervention, Strategies-To-Enhance-Practice (STEPs), focused on programming MVPA in the daily schedule, training of staff and leaders, and ongoing technical support/assistance. Accelerometry-derived proportion of children meeting the 30min/day MVPA standard was measured in the spring of each year. Mixed model logistic regressions were used to examine the change in the odds of achieving the MVPA standard. Analyses were conducted in 2015. Data were collected in one southeastern US state. RESULTS: Immediate boys (n=677) and delayed girls (n=658) increased the percent achieving 30min MVPA/day from 35.9% to 47.0% (odds ratio [OR]=1.88, 95% CI 1.18-3.00) and 13.1% to 19.1% (OR=1.42, 95% CI 1.03-1.96). Immediate girls (n=613) and delayed boys (n=687) exhibited a nonsignificant increase from 19.1% to 21.6% (OR=1.20, 95% CI 0.84-1.72) and 29.0% to 31.3% (OR=1.13, 95%CI 0.80-1.58). CONCLUSIONS: STEPs can have an impact on children's MVPA and time spent sedentary, yet was unable to fully achieve the goal of all children accumulating 30minMVPA/day. Additional efforts are need to identify strategies ASPs can use to meet this important public health standard.

Strategies to Increase After-School Program Staff Skills to Promote Healthy Eating and Physical Activity.

Standards targeting children's healthy eating and physical activity (HEPA) in after-school programs call for staff to display or refrain from HEPA-promoting or -discouraging behaviors that are linked to children's HEPA. This study evaluated strategies to align staff behaviors with HEPA Standards. Staff at four after-school programs serving approximately 500 children participated in professional development training from January 2012 to May 2013. Site leaders also attended workshops and received technical support during the same time frame. Changes in staff behaviors were evaluated using the System for Observing Staff Promotion of Activity and Nutrition in a pre- (fall 2011) multiple-post (spring 2012, fall 2012, and spring 2013), no-control group study design. A total of 8,949 scans were completed across the four measurement periods. Of the 19 behaviors measured, 14 changed in the appropriate direction. For example, staff engaging in physical activity with children increased from 27% to 40% of scans and staff eating unhealthy foods decreased from 56% to 14% of days. Ongoing training and technical assistance can have a measureable impact on staff behaviors linked to child-level HEPA outcomes. Future research should explore the feasibility of disseminating ongoing trainings to after-school program staff on a large scale.

Process Evaluation of Making HEPA Policy Practice: A Group Randomized Trial.

This study examines the link between implementation of Strategies to Enhance Practice (STEPs) and outcomes. Twenty after-school programs (ASPs) participated in an intervention to increase children's accumulation of 30 minutes/day of moderate to vigorous physical activity (MVPA) and quality of snacks served during program time. Outcomes were measured via accelerometer (MVPA) and direct observation (snacks). STEPs implementation data were collected via document review and direct observation. Based on implementation data, ASPs were divided into high/low implementers. Differences between high/low implementers' change in percentage of boys accumulating 30 minutes/day of MVPA were observed. There was no difference between high/low implementers for girls. Days fruits and/or vegetables and water were served increased in the high/low implementation groups, while desserts and sugar-sweetened beverages decreased. Effect sizes (ES) for the difference in changes between the high and low group ranged from low (ES = 0.16) to high (ES = 0.97). Higher levels of implementation led to increased MVPA for boys, whereas girls MVPA benefited from the intervention regardless of high/low implementation. ESs of the difference between high/low implementers indicate that increased implementation of STEPs increases days healthier snacks are served. Programs in the high-implementation group implemented a variety of STEPs strategies, suggesting local adoption/adaptation is key to implementation.

Maximizing children's physical activity using the LET US Play principles.

BACKGROUND: Staff in settings that care for children struggle to implement standards designed to promote moderate-to-vigorous physical activity (MVPA), suggesting a need for effective strategies to maximize the amount of time children spend in MVPA during scheduled PA opportunities. The purpose of this study was to compare the MVPA children accumulate during commonly played games delivered in their traditional format versus games modified according to the LET US Play principles. METHODS: Children (K-5th) participated in 1-hour PA sessions delivered on non-consecutive days (summer 2014). Using a randomized, counterbalanced design, one of the six games was played for 20min using either traditional rules or LET US Play followed by the other strategy with a 10min break in between. Physical activity was measured via accelerometry. Repeated-measures, mixed-effects regression models were used to estimate differences in percent of time spent sedentary and in MVPA. RESULTS: A total of 267 children (age 7.5years, 43% female, 29% African American) participated in 50, 1-hour activity sessions. Games incorporating LET US Play elicited more MVPA from both boys and girls compared to the same games with traditional rules. For boys and girls, the largest MVPA difference occurred during tag games (+20.3%). The largest reduction in the percent of time sedentary occurred during tag games (boys -27.7%, girls -32.4%). Overall, the percentage of children meeting 50% time in MVPA increased in four games (+18.7% to +53.1%). CONCLUSION: LET US Play led to greater accumulation of MVPA for boys and girls, and can increase the percent of children attaining the 50% of time in MVPA standard.

Making healthy eating and physical activity policy practice: process evaluation of a group randomized controlled intervention in afterschool programs.

This study describes the link between level of implementation and outcomes from an intervention to increase afterschool programs' (ASPs) achievement of healthy eating and physical activity (HE-PA) Standards. Ten intervention ASPs implemented the Strategies-To-Enhance-Practice (STEPs), a multi-component, adaptive intervention framework identifying factors essential to meeting HE-PA Standards, while 10 control ASPs continued routine practice. All programs, intervention and control, were assigned a STEPs for HE-PA index score based on implementation. Mixed-effects linear regressions showed high implementation ASPs had the greatest percentage of boys and girls achieving 30 min of moderate-to-vigorous physical activity (47.3 and 29.3%), followed by low implementation ASPs (41.3 and 25.0%), and control ASPs (34.8 and 18.5%). For healthy eating, high/low implementation programs served fruits and vegetables an equivalent number of days, but more days than control programs (74.0 and 79.1% of days versus 14.2%). A similar pattern emerged for the percent of days sugar-sweetened foods and beverages were served, with high and low implementation programs serving sugar-sweetened foods (8.0 and 8.4% of days versus 52.2%), and beverages (8.7 and 2.9% of days versus 34.7%) equivalently, but less often than control programs. Differences in characteristics and implementation of STEPs for HE-PA between high/low implementers were also identified.

Physical literacy and Comprehensive School Physical Activity Programs.

OBJECTIVE: The purpose of this paper is to make a case for Comprehensive School Physical Activity Program (CSPAP) to be the organizational framework for providing physical activity opportunities for children that is most likely to result in physical literacy. METHOD: Beginning in 2010, the authors used multiple search engines to ascertain the existent literature surrounding physical literacy and physical activity interventions to identify common approaches to providing physically activity in and around school. Grounded in the Health Belief Model and the idea that physical literacy is a desired outcome of physical education, publications focused on each of the components of the CSPAP were synthesized to describe evidence-based practice. RESULTS: There is adequate evidence to suggest that quality physical education, before/after school, during school, staff involvement, and family and community engagement can serve as logical points of intervention to provide increased opportunities for physical activity participation leading to physical literacy among children. CONCLUSIONS: Since only 6% of all children participate in daily physical education classes and only six states offer K-12 physical education, the implementation of CSPAP may be the most logical avenue for providing greater opportunities for physical activity engagement that fosters physical literacy as a health-oriented educational goal.

Impact of trained champions of comprehensive school physical activity programs on school physical activity offerings, youth physical activity and sedentary behaviors.

OBJECTIVE: A quasi-experimental cluster-controlled design was used to test the impact of comprehensive school physical activity program (CSPAP) professional development on changes in school physical activity (PA) offerings, moderate-to-vigorous physical activity (MVPA) and sedentary behaviors of 9-14 year-old children during school. METHODS: Two groups of Louisiana elementary and middle school physical education teachers (N=129) attended a CSPAP summer workshop (95 in 2012=intervention, 34 in 2013=control) and were assessed on school PA offerings (teacher-reported; pre, mid, and post). During the 2012-2013 school year, intervention teachers received CSPAP support while implementing new school PA programs. MVPA and sedentary behaviors were assessed (accelerometry; baseline and post) on a sample of 231 intervention, 120 control students from 16 different schools. RESULTS: Multivariate analysis of covariance indicated that intervention teachers reported significantly more PA offerings during school (3.35 vs. 2.37) and that involve staff (1.43 vs. 0.90). Three-level, mixed model regressions (stratified by sex) indicated that students overall spent less time in MVPA and more time being sedentary during school, but the effects were significantly blunted among intervention students, especially boys. CONCLUSIONS: This study provides preliminary evidence for CSPAP professional development programs to influence school-level PA offerings and offset student-level declines in MVPA and increases in sedentary behavior.

A comprehensive professional development training's effect on afterschool program staff behaviors to promote healthy eating and physical activity.

OBJECTIVE: Evaluate a comprehensive intervention designed to support staff and program leaders in the implementation of the YMCA of USA healthy eating and physical activity (HEPA) standards for their afterschool programs (3-6 pm). DESIGN: Pre- (fall 2011) and postassessment (spring 2012) no-control group. SETTING/PARTICIPANTS: Four large-scale YMCA afterschool programs serving approximately 500 children. INTERVENTION: Professional development training founded on the 5Ms (ie, Mission, Model, Manage, Monitor, and Maximize) and LET US Play principles (ie, Lines, Elimination, Team size, Uninvolved staff/kids, and Space, equipment, and rules), on-site booster training sessions, workshops, and ongoing technical support for staff and program leaders from January to May 2012. MAIN OUTCOME MEASURES: System for Observing Staff Promotion of Activity and Nutrition. ANALYSIS: Multilevel mixed-effects linear (ie, staff behaviors expressed as a percentage of the number of scans observed) and logistic regression. RESULTS: A total of 5328 System for Observing Staff Promotion of Activity and Nutrition scans were completed over the 2 measurement periods. Of the 20 staff behaviors identified in HEPA standards and measured in this study, 17 increased or decreased in the appropriate direction. For example, the proportion staff engaged in physical activity with children increased from 26.6% to 37% and the proportion of staff eating unhealthy foods decreased from 42.1% to 4.5%. CONCLUSIONS: Comprehensive professional development training, founded on the 5Ms and LET US Play principles, and ongoing technical assistance can have a sizable impact on key staff behaviors identified by HEPA standards for afterschool programs.

Effects of a policy-level intervention on children's pedometer-determined physical activity: preliminary findings from Movin' Afterschool.

OBJECTIVES: Although evidence supports the benefits of incorporating physical activity (PA) after school and standards for quality after-school programs (ASPs) include PA, evaluation of policies to increase PA after school is nonexistent. The purpose of this study was to examine the effect of an evidence-informed policy-level ASP intervention on youth pedometer-determined PA. DESIGN: This study was a quasi-experimental community-based intervention (Movin' Afterschool), with a pre-/posttest design, without a control. SETTING: Movin' Afterschool took place in the after-school setting. PARTICIPANTS: Participants were children (5-12 years old) attending 1 of 12 ASPs in Nebraska during the fall and spring of 2010-2011. INTERVENTION: Movin' Afterschool was an evidence-informed policy-level intervention. MAIN OUTCOME MEASURES: Physical activity was measured using pedometers. RESULTS: Children averaged 3145 steps per day at baseline and 3042 steps per day at postassessment. There were no effects of sex, body mass index percentile, age, or the interaction of these covariates on steps. Three ASPs experienced substantial declines in PA compared with the remaining 9 ASPs. Excluding these 3 sites, there was an average increase in steps per day in the remaining 9 sites. No significant contribution was observed with the covariates. CONCLUSION: This was the first study to provide evidence for the initial effectiveness of a policy-level intervention on youth PA participation while attending an ASP despite the failed attempt by some ASPs to improve PA. Further research may help determine the following: (1) the amount of support necessary to help ASPs modify their planning to meet policies, and (2) strategies that should be emphasized during staff training to ensure that staff are able to implement PA policies.

School day segmented physical activity patterns of high and low active children.

BACKGROUND: Variability exists in children's activity patterns due to the association with environmental, social, demographic, and inter-individual factors. This study described accelerometer assessed physical activity patterns of high and low active children during segmented school week days whilst controlling for potential correlates. METHODS: Two hundred and twenty-three children (mean age: 10.7 ± 0.3 yrs, 55.6% girls, 18.9% overweight/obese) from 8 north-west England primary schools wore ActiGraph GT1M accelerometers for 7 consecutive days during autumn of 2009. ActiGraph counts were converted to minutes of moderate (MPA), vigorous (VPA) and moderate-to-vigorous (MVPA) physical activity. Children were classified as high active (HIGH) or low active (LOW) depending on the percentage of week days they accumulated at least 60 minutes of MVPA. Minutes spent in MPA and VPA were calculated for school time and non-school time and for five discrete school day segments (before-school, class time, recess, lunchtime, and after-school). Data were analysed using multi-level modelling. RESULTS: The HIGH group spent significantly longer in MPA and/or VPA before-school, during class time, lunchtime, and after-school (P < .05), independent of child and school level factors. The greatest differences occurred after-school (MPA = 5.5 minutes, VPA = 3.8 minutes, P < 0.001). MPA and VPA were also associated with gender, BMI z-score, number of enrolled children, playground area per student, and temperature, depending on the segment analysed.The additive effect of the segment differences was that the HIGH group accumulated 12.5 minutes per day more MVPA than the LOW group. CONCLUSIONS: HIGH active children achieved significantly more MPA and VPA than LOW active during four of the five segments of the school day when analyses were adjusted for potential correlates. Physical activity promotion strategies targeting low active children during discretionary physical activity segments of the day, and particularly via structured afterschool physical activity programs may be beneficial.

Physical education's contribution to daily physical activity among middle school youth.

Little is known about the exact contribution of physical education (PE) to total daily physical activity (PA) among children and adolescents. Therefore, the purpose of this study was to describe the PA of middle school students during PE and non-PE days and determine if children would compensate for a lack of PE by increasing their PA later in the day. Two hundred seventy nine students (159 boys, 120 girls) wore pedometers (Walk4Life LS252, Plainfield, IL) during 5 school days, with at least two of the days including scheduled PE. The least (~1,575; 31% increase), moderately (~2,650; 20% increase), and most highly active students (~5,950; 34% increase) accumulated significantly more daily step counts on days when they participated in PE. Nearly three times the percent of boys (37%) and more than two times the percent of girls (61%) met the recommended steps/day guidelines on days when PE was offered. Rather than a compensatory effect, the most highly active students were more active on school days with PE, even after accounting for the steps they accrued in PE. The evidence is consistent with other studies that have found that PE contributes meaningfully to daily PA, that youth do not compensate when they are not provided opportunities to be physically active in school-based programs, and some youth are stimulated to be more active when they participate in school-based PA programs.

Does the effect of a school recess intervention on physical activity vary by gender or race? Results from the Ready for Recess pilot study.

BACKGROUND AND OBJECTIVES: The recess environment in schools has been identified as an integral part of school-based programs to enhance physical activity (PA). The purpose of this study was to report pilot findings on the extent to which the Ready for Recess intervention was associated with a different amount of increase in moderate to vigorous PA (MPVA) during recess and the rest of the school day between girls and boys, and between nonwhites and whites. METHODS: The Ready for Recess intervention modified the recess environment of schools by providing staff training and recreational equipment. The MPVA levels of 3rd, 4th, and 5th grade students (n = 93) at 2 schools were measured pre- and post-intervention using ActiGraph accelerometers. Multiple regression models with robust variance were utilized to test for the interaction of intervention with gender and race/ethnicity. RESULTS: The intervention was associated with an adjusted increase of 4.7 minutes (P <.001) in moderate/vigorous PA during recess. There was no evidence that this effect varied by gender (P = .944) or race (P = .731). The intervention was also associated with an adjusted increase of 29.6 minutes (P < .001) in moderate/vigorous PA during rest of the school day. While this effect did not vary by gender, there was some evidence (P = .034) that nonwhites benefited more from the intervention than whites. CONCLUSION: Simple strategies such as staff training and recreational equipment may be an effective way to increase PA in children (despite gender or ethnicity) during recess time as well as during the rest of the school day.

Promoting children's health through physically active math classes: a pilot study.

School-based interventions are encouraged to support youth physical activity (PA). Classroom-based PA has been incorporated as one component of school wellness policies. The purpose of this pilot study is to examine the effects of integrating PA with mathematics content on math class and school day PA levels of elementary students. Participants include four teachers and 75 students. Five math classes are taught without PA integration (i.e., baseline) followed by 13 math classes that integrate PA. Students wear pedometers and accelerometers to track PA during math class and throughout the school day. Students perform significantly more PA on school days and in math classes during the intervention. In addition, students perform higher intensity (step min(-1)) PA during PA integration math classes compared with baseline math classes. Integrating PA into the classroom is an effective alternative approach to improving PA levels among youth and is an important component of school-based wellness policies.

A Pilot Study of a Comprehensive School Physical Activity Program in Elementary Schools: Be a Champion!

OBJECTIVE: In the present study, we sought to determine if a comprehensive school physical activity program (CSPAP) delivered using the Be a Champion! (BAC) framework was effective in increasing moderate-to-vigorous physical activity (MVPA) and decreasing sedentary time in elementary school youth. METHODS: We implemented a CSPAP in 3 elementary schools to determine its effectiveness to youth behaviors compared to 2 control schools. Youth physical activity was assessed via accelerometry in spring 2015 and spring 2016 during school hours on school days. Implementation of the BAC components and youth behavior was assessed through direct observation from fall 2015 through winter 2016. RESULTS: In a multilevel, mixed model examining the effects of intervention, we found no statistically significant effect of the intervention on overall MVPA. However, a significant increase in MVPA was observed among girls (but not boys) in the intervention schools relative to controls. No differences in sedentary behaviors were observed by group. CONCLUSION: CSPAP implementation may be effective in reducing sedentary time and increasing MVPA in girls, but not boys. Research is necessary to increase implementation dose and fidelity to best practices in physical activity promotion.

Evaluation of policies to promote physical activity in afterschool programs: are we meeting current benchmarks?

BACKGROUND: Policies now recommend afterschool programs (ASP, 3-6 pm) provide children a minimum amount of physical activity daily. We examined the extent to which children attending ASPs meet existing national and state-level policies that specify expected levels of physical activity (PA). METHODS: Accelerometer-derived physical activity (light and moderate-to-vigorous, MVPA) of 253 children (5-13 years) was compared to policies that recommend varying amounts of PA children should achieve during an ASP. RESULTS: The proportion of children achieving a policy ranged from 0.0% (California 60 min MVPA and North Carolina 20% of daily program time devoted to MVPA), 1.2% (California 30 min MVPA), to 48.2% (National Afterschool Association 30 min light plus MVPA). Random effects logistic models indicated boys (odds ratio [OR] range 2.0 to 6.27) and children from a minority background (Black/Hispanic, OR range 1.87 to 3.98) were more likely to achieve a recommended level of physical activity, in comparison to girls and White children. Neither age nor BMI were related to achieving a policy. CONCLUSIONS: The PA of children attending ASP falls below policy recommended levels; however, these policies were developed in absence of data on expected PA levels during ASPs. Thus, concerted effort towards building a stronger ASP evidence-base for policy refinement is required.

Rationale and development of the Move More North Carolina: Recommended Standards for After-School Physical Activity.

The purpose of this article is to describe the rationale and procedure employed in developing the Move More North Carolina: Recommended Standards for After-School Physical Activity, which was publicly released statewide in April 2009. The Standards outline evidenced-based best practices for after-school programs to implement in order to increase amount and quality of physical activity (PA) among program participants. The Standards can be applied in any after-school program and were developed to benefit the approximately 152,000 school-aged children who are served by NC after-school programs each year. These programs often serve children at high risk for physical inactivity, including children from racial/ethnic minorities, impoverished areas, with disabilities, and/or living in neighborhoods with limited PA opportunities. The rationale for developing standards for PA in after-school programs is threefold: (1) such programs can provide enjoyable, safe, and age-appropriate PA; (2) they can facilitate family involvement, community partnership, and increase access to PA resources; and (3) they serve children at risk for inactivity. Recommended best practices are included for the following categories: time/intensity, qualified staff/training, curriculum, program size, facilities, equipment, and evaluation. Methods used to inform The Standards included a planning team, on-line surveys, focus groups, a systematic literature review, a consensus panel, and external expert review. The impact of The Standards is yet to be seen, but the collaborative process used in their creation can serve as a model for the development of similar PA standards in other states.

Implementation evaluation of a professional development program for comprehensive school physical activity leaders.

The purpose of this study was to conduct an implementation monitoring evaluation of a yearlong comprehensive school physical activity program (CSPAP) professional development program across eight multi-state physical education (PE) teacher cohorts. Mixed-method data were collected during a three-year implementation period via workshop attendance sheets and evaluations, post-workshop implementation plans and artifacts, and follow-up phone interviews to enumerate and evaluate the program's process of recruitment, reach, dose delivered, dose received, fidelity, and context. Recruitment strategies reached a total of 234 PE teacher attendees across eight workshops, with 77 PE teachers (primarily female, elementary, public school teachers) completing all program requirements. Facilitators among full program completers were participation incentives and network opportunities, while common inhibitors were difficulty with online technology and perceptions of added workload. Completers submitted implementation plans with at least three action steps, ranging from 4 to 7 months to accomplish, that predominately commenced with securing administration approval as the first step (81%), focused on implementing student physical activity initiatives beyond PE (76%), and evidenced with mostly picture artifacts (78%). Implementation was facilitated by the presence of multilevel support at school and an elevated image of PE and PE teachers at school, and was inhibited by scheduling constraints, unrealistic planning, and conflicting perceptions of physical activity and PE. Overall, this evaluation reveals unique perspectives of PE teachers regarding schoolwide PA promotion and informs future efforts to target and effectively support CSPAP leaders.

Identifying and Quantifying the Unintended Variability in Common Systematic Observation Instruments to Measure Youth Physical Activity.

BACKGROUND: Direct observation protocols may introduce variability in physical activity estimates. METHODS: Thirty-five physical education lessons were video recorded and coded using the System for Observing Fitness Instruction Time (SOFIT). A multistep process examined variability in moderate to vigorous physical activity (MVPA%; walking + vigorous/total scans). Initially, per-SOFIT protocol MVPA% (MVPA%SOFIT) estimates were produced for each lesson. Second, true MVPA% (mean MVPA% of all students using all observations, MVPA%true) estimates were calculated. Third, MVPA% (MVPA%perm) was calculated based on all permutations of students and observation order. Fourth, physical education lessons were divided into 2 groups with 5 lessons from each group randomly selected 10,000 times. Group MVPA%perm differences between the 10 selected lessons were compared with the MVPA%true difference between group 1 and group 2. RESULTS: Across all lessons, 10,212,600 permutations were possible (average 291,789 combinations per lesson; range = 73,440-570,024). Across lessons, the average absolute difference between MVPA%true and MVPA%SOFIT estimates was ±4.8% (range = 0.1%-17.5%). Permutations, based on students selected and observation order, indicated that the mean range of MVPA%perm estimates was 41.6% within a lesson (range = 29.8%-55.9%). Differences in MVPA% estimates between the randomly selected groups of lessons varied by 32.0%. CONCLUSION: MVPA% estimates from focal child observation should be interpreted with caution.