Predicting adolescents' continuation in club sports: A prospective cohort study of the importance of personal and contextual motivational factors in five sports in Denmark.

PURPOSE: The purpose of this prospective cohort study was to investigate the influence of types of motivation, basic psychological needs satisfaction and of a coach-created motivational climate on continued participation in youth sports across types of sport, competitive levels, ages, and gender. METHODS: Participants were 7110 adolescent (age 12-20 years) members of leisure time club organized in basketball, handball, football, badminton, and gymnastics in Denmark. Motivational regulation was measured with BRSQ-6, basic psychological needs satisfaction and frustration were measured with PNSS-S, and coach-created climate was measured with the EDMCQ-C. The participants' continuation or dropout was measured at the beginning of the following season with a short electronic questionnaire. RESULTS: Intrinsic motivation, identified behavior regulation, experiences of competence, relatedness, and autonomy, as well as a coach-created empowering motivational climate, were associated with continuation both in the sport and in the club the following season across different sports, genders, age groups, and competitive levels. Introjected and external behavior regulation, frustrations with the need to experience competence, relatedness, and autonomy, as well as a disempowering coach-created climate, were associated with dropout. CONCLUSION: In Danish youth sports, autonomous motivation, satisfaction of basic psychological needs, and an empowering coach-created motivational climate have a positive impact on the continuation of the sport and the club the following season. In contrast, controlled types of motivation, needs frustration, and a disempowering coach-created climate are associated with dropout. This is the case at both elite and recreational levels, for boys and girls, adolescents, and youth.

A cross-sectional study of the association between food literacy and dietary intake among Danish adolescents.

Food literacy is theorized to be associated with healthy dietary intake. However, empirical knowledge on the association between adolescents' food literacy and dietary intake is limited. The aim of this study was to investigate the association between food literacy and dietary intake among Danish schoolchildren aged 11-13 years. The study applied a cross-sectional design using baseline data from a cluster-based quasi-experimental controlled study in a sample (n = 377) of Danish school children. Mixed model analyses were performed to investigate the associations between overall food literacy as well as its five competencies ("to know", "to do", "to sense", "to care", and "to want") and dietary intake of vegetables, fruit, fish, meat, discretionary foods, and sugar-sweetened beverages. Positive associations were found between overall food literacy (E = 1.493, p = 0.002) as well as the competencies "to know" (E = 1.249, p = 0.027), "to do" (E = 1.236, p = 0.028), "to sense" (E = 1.183, p = 0.029), and "to care" (E = 1.249, p = 0.018) and intake of vegetables. The study also found a positive association between the competency "to want" and intake of fruit (E = 13.50, p = 0.037), "to care" and intake of fish (E = 2.050, p < 0.001), and a negative association between the competency "to want" and intake of meat (E = 0.748, p = 0.003) and sugar-sweetened beverages (E = 0.576, p = 0.0021). No associations were found between overall food literacy or any of its five competencies and intake of discretionary foods. These findings suggest that improving specific aspects of food literacy may have a potential to promote healthier dietary intake, though additional research is needed.

Efficacy and mechanisms of an education outside the classroom intervention on pupils' health and education: the MOVEOUT study protocol.

BACKGROUND: Education can create better opportunities for health, and vice versa. Using a so-called 'add-in' approach, school-based physical activity (PA) promotion and prevention of sedentary behaviours can increase pupils' wellbeing and learning and, on the longer term, reduce the risk of non-communicable diseases. A PA 'add-in' approach involves integrating PA into teachers' curricular obligations without being an extra burden as opposed to an 'add-on' approach which requires additional operational resources and include activities that do not explicitly contribute towards curricular targets making them less long-term acceptable in a school-based context. Previous studies investigating education outside the classroom (EOtC) show mutual benefits for both health and education outcomes among children and adolescents. However, the evidence is of mixed quality and questionable certainty, which calls for further investigation. The aim of this study protocol is to describe and discuss the study design and methods to investigate the efficacy and mechanisms of EOtC as a vehicle for health and education. The study investigates the intervention developed and conducted in the TEACHOUT study with updated and strengthened design and measures. METHODS: The efficacy of EOtC will be investigated in a cluster randomised waitlist design. Participants will be pupils in ~54 classes, grades 4-10 (ages 10-15 years) in ~30 Danish elementary schools. Fifteen schools will be randomised to the intervention: a two-day EOtC training course targeting teachers followed by the teachers implementing EOtC >5 hours weekly over the course of one school year. Pre- and post-measures of health (PA and wellbeing) and learning (school motivation and academic achievement) will be collected. Investigation of pedagogical and motivational mechanisms will be based on observations of EOtC. DISCUSSION: The updated randomised controlled design will provide firmer evidence for the efficacy and mechanisms of EOtC and provide knowledge about how mutual benefits of health and education can be obtained. TRIAL REGISTRATION: Registered with ClinicalTrials.gov (ID NCT05237674 ) [University of Copenhagen. MOVEOUT: a Cluster RCT of the Efficacy, Mechanisms, and Mediation of an Education Outside the Classroom Intervention on Adolescents' Physical Activity, 2023], February 14, 2022. Most recently updated on November 23, 2022 (Version 2).

Factorial validity, predictive validity and measurement invariance of the Danish version of the coach-created Empowering Disempowering Motivational Climate Questionnaire (EDMCQ-C).

PURPOSE: The purpose of this study was to translate and validate a Danish version of the coach-created Empowering and Disempowering Motivational Climate Questionnaire (EDMCQ-C), retest the factor structure and provide further investigation into the psychometric properties in terms of measurement invariance across gender, age and competitive level, reliability and predictive validity. METHODS: The participants were 1719 male and 551 female Danish football players 12-20 years of age (M = 14.81) playing at recreational, medium and elite levels. Participants filled in EDMCQ-C as well as questionnaires measuring psychological needs (BPNESS) and behaviour regulation (BRSQ). Factor structure of the EDMCQ-C was tested using Exploratory Structural Equation Modelling. To test whether the factor structure differed across gender, age group and competitive level, an invariance analysis comparing configurational, metric and scalar models was conducted. RESULTS: EDMCQ-C showed good psychometric properties and measurement invariance across age, gender and competitive level. Both dimensions of EDMCQ-C were associated to needs satisfaction and behaviour regulation in expected directions and had high internal consistency. CONCLUSION: This study provides evidence for the reliability of the two dimensions of EDMCQ-C, their predictive validity and for measurement invariance across age, gender and competitive level and provides a Danish version of the EDMCQ with sound psychometric properties.

Synthesising physical literacy research for 'blank spots': A Systematic review of reviews.

The holistic concept of physical literacy (PL) has gained considerable attention worldwide and integrates different determinants (e.g., physical, affective, and cognitive) of physical activity. The purpose of this systematic review (PROSPERO registration: CRD42022312764) was to broadly synthesise PL research and determine "blank spots". We performed standardized searches for PL reviews in 23 databases. Inclusion criteria were English language, any review with a systematized search, publication by June 2023 and PL relevance in an article's main body. The content and insights of the identified reviews were assigned to six literature-driven "problem fields": (i) theory/concept, (ii) measurement/levels/trends, (iii) determinants, (iv) outcomes, (v) interventions, and (vi) policy. We employed nine items for assessing the methodological quality of the reviews (including six items from AMSTAR-2). The screening resulted in an inclusion of 41 PL reviews of different methodology. Existing reviews most frequently analysed aspects of measurement (n = 20) as well as theory/definition (n = 19), followed by interventions (n = 17). In contrast, determinants (n = 6), outcomes (n = 5) and policy aspects (n = 4) were discussed less often. Accordingly, the major "blank spots" are: empirical studies on determinants and outcomes; PL levels and trends; pivotal moderators of interventions; and policy aspects. We recommend the scientific community to address these to move the field forward.

Physical literacy in Europe: The current state of implementation in research, practice, and policy.

Background/objective: The holistic concept of physical literacy (PL) embraces different person-centered qualities (physical, cognitive, affective/psychological) necessary to lead physically active lifestyles. PL has recently gained increasing attention globally and Europe is no exception. However, scientific endeavors summarizing the current state of PL in Europe are lacking. Therefore, the goal of this study was to comprehensively assess and compare the implementation of PL in research, policy, and practice across the continent. Methods: We assembled a panel of experts representing 25 European countries. Employing a complementary mixed-methods design, the experts first prepared reviews about the current state of PL in their countries (categories: research, practice/policy). The reviews underwent comparative document analysis, ensuring a transnational four-eyes principle. For re-validation purposes, the representatives completed a quantitative survey with questions reflecting the inductive themes from the document analysis. Results: The document analysis resulted in ten disjunct themes (related to "concept", "research", "practice/policy", "future/prospect") and yielded a heterogenous PL situation in Europe. The implementation state was strongly linked to conceptual discussions (e.g., existence of competing approaches), linguistic issues (e.g., translations), and country-specific traditions. Despite growing scholarly attention, PL hesitantly permeates practice and policy in most countries. Nevertheless, the experts largely anticipate increasing popularity of PL for the future. Conclusion: Despite the heterogeneous situation across Europe, the analysis has uncovered similarities among the countries, such as the presence of established yet not identical concepts. Research should intensify academic activities (conceptual-linguistic elaborations, empirical work) before PL may gain further access into practical and political spheres in the long term.

Is vegetation cover in key behaviour settings important for early childhood socioemotional function? A preregistered, cross-sectional study.

The environmental influences on early childhood development are understudied. The association between vegetation cover (i.e., trees, shrubs, grassed areas) in four key behaviour settings and socioemotional functioning was investigated in 1196 young children (2-5 years). Emotional difficulties were inversely associated with vegetation cover in the home yard (OR: 0.81 [0.69-0.96]) and neighbourhood (OR: 0.79 [0.67-0.94]), but not in early childhood education and care (ECEC) centre outdoor areas or the ECEC neighbourhood. The higher odds of emotional difficulties associated with lower levels of maternal education was reduced with higher percentages of home yard vegetation cover. There was no evidence of mediation of the relationship between emotional difficulties and vegetation cover by time spent playing outside the home, day or nighttime sleep duration, or physical activity. We found no associations between vegetation cover and conduct, hyperactivity and inattention, peer difficulties, or prosocial behaviours. A video abstract of this article can be viewed at https://www.youtube.com/watch?v=J3HeEiIjVZc.

Education outside the classroom as upstream school health promotion: 'adding-in' physical activity into children's everyday life and settings.

INTRODUCTION: It is central for public health to answer questions related to how to change health and wellbeing in populations through interdisciplinarity and health in all policies and sectors. For a school physical activity promotion initiative to be acceptable and thus feasible, the buy-in of teachers is fundamental. Therefore, school physical activity promotion should be integrated into and support teaching activities. AIMS: We discuss the use of education outside the classroom as a feasible pedagogical approach that integrates and promotes physical activity for school children. METHODS: We present and discuss theoretical arguments and empirical evidence to argue and illustrate that education outside the classroom is a promising approach for promoting physical activity. RESULTS: Education outside the classroom is characterised by regular curriculum-based experiential teaching activities outside the classroom with the inclusion of physical activity as a means to pedagogical ends. School subjects are taught outside the classroom drawing on problem-based learning and experiential education. Here, physical activity is integrated without compromising curriculum goals which increases teacher buy-in and thereby intervention acceptability and feasibility. Empirical evidence suggests that education outside the classroom increases boys' moderate to vigorous physical activity and girls' light intensity physical activity. We contend that the mechanisms are a mix of place, pedagogy and pupil motivations. CONCLUSIONS: Education outside the classroom is a feasible and acceptable approach to public health and physical activity promotion because it is integrated into children's everyday settings through curriculum time and applied broadly to child populations at a low cost. The practice of education outside the classroom is context-dependent and culturally bound, and practices therefore need to be adapted to the individual sociocultural context.

Associations between children's physical literacy and well-being: is physical activity a mediator?

BACKGROUND: Physical literacy (PL) is a multi-dimensional concept that provides a holistic understanding of movement and physical activity. PL contains an affective, a physical, and a cognitive domain, which together lay the foundation for the individual's capacity and the tendency for participating in physical activities currently and throughout life. PL is increasingly regarded as a 'cause of the causes' to health promotion. Cross-sectional studies have shown associations between children's PL, physical activity behaviours, and well-being. This study aims to examine the associations between Danish children's PL and their physical and psychosocial well-being and whether the associations are mediated by moderate- to vigorous intensity physical activity (MVPA). METHODS: Cross-sectional data from Danish schoolchildren aged 7-13 years were collected in Jan-Dec 2020 in the Danish Assessment of Physical Literacy (DAPL) project. PL was assessed with the DAPL which measures the affective, cognitive, and physical domains of PL. MVPA (min/day) was measured with accelerometers (Axivity), psychosocial well-being was measured with The Strengths and Difficulties Questionnaire, and physical well-being was measured with the KIDSCREEN questionnaire. Structural equation models were constructed with PL and MVPA as predictors of physical well-being and four aspects of psychosocial well-being. RESULTS: A positive moderate association between PL and physical well-being, partly mediated by MVPA was observed. PL was positively associated with the positive aspects of psychosocial well-being and negatively associated with the negative aspects (behaviour problems). None of the associations between PL and aspects of psychosocial well-being were mediated by MVPA. CONCLUSIONS: The study contributes to evidence on the link between PL, physical activity, and health outcomes. The study found beneficial relations between PL and physical and psychosocial well-being. MVPA mediated part of the relationship between PL and physical well-being but not psychosocial well-being.

Improved food literacy among schoolchildren as an effect of a food camp intervention: Results of a controlled effectiveness trial.

Food literacy (FL) refers to an individual's prerequisites for their engagement with food. Schoolchildren's FL has been defined in terms of five competencies: "to know"(e.g food-related knowledge), "to do" (e.g cooking skills), "to sense" (e.g. less well-explored sensory experiences), "to care" (e.g. taking care of oneself and others) and "to want" (e.g. willingness to take a stand and act). A cluster-based quasi-experimental effectiveness trial on the effects of a school-based intervention, "FOODcamp," on FL, health literacy, and school well-being was conducted. A total of 640 school children in grades 6 and 7 (mean age = 12 years) attended this one-week camp and participated in different food-related classes and activities. Linear mixed models controlling for the nested structure of data showed small but significant effects for the following FL dimensions: "to do (E = 0.098, CI (0.035-0.161), p = 0.002), "to sense" (E = 0.152, CI (0.073-0.232), p < 0.001), and "to know" (E = 0.086, CI (0.022-0.150), p = 0.009) as well as for overall FL (E = 0.078, CI (0.034-0.122), p = 0.001). No effects were found for the dimensions "to want" or "to care". The intervention also had a small but significant effect on children's health literacy but not on school well-being. These findings demonstrate the value of FOODcamp and the positive impacts of a relatively brief intervention on children's FL.

Translation and validation of the Canadian assessment of physical literacy-2 in a Danish sample.

BACKGROUND: The aim of this study was to translate the Canadian Assessment of Physical Literacy, second edition (CAPL-2) into Danish language, adapt it to Danish context and to test the measurement properties on a sample of Danish school children. METHODS: The CAPL-2 measurement tool was translated into Danish language and adapted for the Danish context. This Danish version of the CAPL-2 was then tested on 891 Danish school children from 50 classes in 12 different schools. RESULTS: Confirmatory factor analysis using the four-factor model, as suggested by the CAPL-2 original developers, showed an acceptable model fit for the Danish version (CFI = .973; TLI = .957; RMSEA = 0.040 (90% CI 0.033-0.054); SRMR = 0.040). Positive significant correlations between the domains were found. The domains as well as the total CAPL-2 score were found to be positively associated with physical education teachers' assessment of their pupil's in four central aspects of PL (i.e. enjoyment, confidence, motor skills, and diversity) indicating predictive validity. High internal consistency of the instrument used to measure motivation and confidence domain were found. CONCLUSION: The translated and context-adapted Danish version of CAPL-2 is a valid and reliable measurement tool ready to use in Danish research studies.

Exploring the importance of diversified physical activities in early childhood for later motor competence and physical activity level: a seven-year longitudinal study.

BACKGROUND: Research indicates that childhood motor competence (MC) can predict physical activity (PA) levels later in life and it has been argued that frequently engaging in a wide diversity of physical activities will eventually improve children's MC. However, no longitudinal or experimental studies have confirmed this theoretical rationale. The aims of this study are to explore the longitudinal associations between diversified physical activities at age six and later MC and PA (time spent in moderate-to-vigorous PA) (age nine and 13). Furthermore, we explore to what extent the longitudinal association between diversified physical activity and PA is mediated by MC. METHODS: Longitudinal data from the Copenhagen School Intervention Study were used for this analysis, where 704 participated (69% response rate). Diversified physical activity (self-reported), MC (The Körperkoordinationstest für Kinder battery of postural stability and locomotor skills) and PA (accelerometer) were assessed in the children at age six, age nine and age 13. A total of 654 participated in at least two of the measures and, therefore, were included in the analysis. Two structural equation models were constructed, with diversified physical activity at age six and MC and PA at age nine as predictors of PA and MC at age 13. RESULTS: The data from both models demonstrated good model fit. Diversified physical activity at 6 years of age was significantly associated with physical activity and MC at age 13, when adjusting for sex, age, intervention, weight, height, and previous levels of PA and MC. Diversified physical activity at age six was also positively associated with PA and MC at age nine, which were, in turn, positively related to PA at age 13 but to a lesser degree than diversified PA at age six. The association between diversified physical activity at age six and PA at age 13 was not mediated by MC at age nine. CONCLUSIONS: The results of this study indicate that diversified physical activity at age six is important for the development of MC and PA in adolescence. Increasing the diversity of children's daily physical activities, not only the amount and intensity, seems important for future PA behavior and thereby health promotion in a life course perspective.

Associations between previous sport and exercise experience and physical literacy elements among physically inactive Danes.

BACKGROUND: Physical inactivity is recognized as a leading global public health threat. Physical Literacy, a concept describing an individual's prerequisites to participate in and adhere to physical activities, has been suggested to be a key concept in understanding physical activity in various populations. The aim of this study was to describe the prerequisites for physical activity among inactive adults in terms of their physical literacy and previous experience with sport and exercise and how these are interrelated. METHODS: Sample: 1033 physical inactive Danes. MEASURES: BREQ-3, ESES, the Levels of knowledge questionnaire and the physical self-confidence scale. RESULTS: Inactive Danish adult's physical literacy scores are generally low compared to samples in other studies. Inactive adults with no or little previous experience with sport and exercise had lower levels of competences, self-efficacy and autonomous motivation for exercise and sport than the inactive with more experience. Previous sport and exercise experience was positively associated to the physical and affective domain of PL. CONCLUSION: Previous experience with sport and exercise is very important to consider when developing sport and exercise activities for currently inactive adults as individuals with low previous experience have lower competences and autonomous motivation and therefore need lower challenges and other important attention to the motivational climate in order to ensure that the activities are motivating enough to secure continued engagement.

Development and validation of a food literacy instrument for school children in a Danish context.

Food literacy (FL) is an aim of food education and cooking interventions, but is defined and measured in different ways. In this study we developed, tested, and validated a FL instrument targeting children aged 12-14 years that builds on a broad 5-dimensional FL concept that includes the competencies of knowing and doing, as well as the rarely investigated competencies of using the senses, caring for others, and wanting to participate as a citizen regarding food issues. The study had 3 phases: 1) item development involving an expert panel; 2) scale testing comprising a face validity test with 12 pupils and a test with 817 pupils, of which 267 took part in a retest; and 3) scale validation including testing dimensionality by confirmatory factor analysis (CFA), internal reliability by Cronbach α, external reliability by intraclass coefficient (ICC), and convergent and predictive validity by regression analysis. CFA showed an acceptable model fit, confirming the concept of FL as 1 factor and its 5 distinct competencies as subfactors. There was good internal reliability for total FL score (α = 0.85) and good external test-retest reliability (ICC = 0.92). Convergent validity for a similar health literacy construct was significant for the total FL scale and its 5 competencies; this was also true for the predictive validity of FL with food intake as an outcome. This 37-item, 5-dimensional FL instrument can be used to assess FL levels in children and can guide food and nutrition education.

Dropout at Danish vocational schools: does the school's health promotion capacity play a role? A survey- and register-based prospective study.

BACKGROUND: School dropout rates and risky health behavior is common among students in vocational education and training (VET) schools. Students with poor physical and mental health are more likely to drop out, and as such VET schools may be an important setting for health promotion initiatives, not only to support a healthy lifestyle, but also to assure completion of education. A common feature of successful health promotion at VET schools is a high health promotion capacity at the school level. This study aimed to investigate the association between VET school's health promotion capacity and later student dropout rates. Secondary, we explored other school characteristics associated with student dropout rates. METHODS: This prospective study comprised 58 Danish VET schools offering basic programs. Health promotion capacity was assessed using questionnaire data from 2017 from school managers and teachers, and this was combined with register-based data on student dropouts the following year. Health promotion capacity was assessed using six scales, representing six underlying domains, and managers and teachers' ratings of these were compared using t-test. Associations between health promotion capacity and student dropout rates as well as associations between school characteristics and student dropout rates were analyzed using multiple linear regression. RESULTS: No associations between VET schools' health promotion capacity and student dropout rates were observed, neither for the schools' overall health promotion capacity or for any of the six underlying domains (p = 0.17-0.84). School managers assessed health promotion capacity significantly higher than teachers overall and within all domains (p < 0.05). Moreover, student dropout rates were significantly lower at schools with a higher proportion of ethnic Danish students, VET-students at higher educational level and schools located in the Western part of Denmark (p < 0.05). CONCLUSION: No associations between VET schools' health promotion capacity and student dropout rates were observed. This may be due to a relatively short follow-up time in our study and future research may reveal if VET school health promotion capacity may affect dropout rates over a longer time period. Moreover, more work is needed to further develop instruments for measuring health promotion capacity in a VET school context as well as other contexts.

Sports-based recreation as a means to address social inequity in health: why, when, where, who, what, and how.

The rising global burden of noncommunicable diseases (NCDs) among people with low socioeconomic status (SES) has heightened awareness of the need for primary prevention programs in low-SES neighborhoods. Social inequity in health is apparent in mental, social and physical aspects of health among people living in low-SES neighborhoods. Viewing this problem from a life course perspective and adopting a vulnerable population approach points to the importance of inducing sustainable health behavior changes in children and young people living in low-SES neighborhoods. One important factor in lowering the risk of many NCDs while improving mental health is the promotion of physical activity (PA). In this paper, we argue that lowering the risk of many NCDs and improving mental health is best achieved through setting-based programs that facilitate long-term PA behavior changes in children and adolescents living in marginalized neighborhoods. Empirical evidence indicates that extrinsic motives for participating in physical activities, such as improving health, are insufficient when long-term participation is the goal. Therefore, we argue that interventions with the aim of affecting long-term PA in low-SES neighborhoods and thereby reducing social inequities in health should include activities that aim to create more intrinsic and autonomous motivations by building on more broad and positive understandings of health and participation. Here, we advocate that sports-based recreation (SR) holds several advantages. If implemented well, SR has the potential to be a health-promoting activity that is meaningful and motivating in itself and that involves physiological health-promoting aspects (e.g., PA), a social aspect (e.g., positive relations with others), and a psychological aspect (e.g., positive experiences of oneself). Further, we suggest four practicalities that should be considered when conducting interventions: the cost of participating, the location, the facilities required, and the suitability of the SR activities.

Smoke-free-school-hours at vocational education and training schools in Denmark: attitudes among managers and teaching staff - a national cross-sectional study.

BACKGROUND: Tobacco is the main cause of non-communicable disease and premature death globally. Implementing restrictive school tobacco policies such as smoke-free-school-hours (SFSH) may have the potential to reduce smoking among Vocational Education and Training (VET) school students. To be effective, school tobacco policies that largely involve strict and consistent enforcement by both managers and teaching teaching staff must be implemented. This study investigated the attitudes towards the implementation of SFSH among the managers and teaching staff at Danish VET schools. METHODS: The analyses were based on cross-sectional survey data collected with an online survey among managers and teaching staff at Danish VET schools. The data was collected from March to June 2017. RESULTS: Managers and teaching staff (n = 571) from 71 out of 87 Danish VET schools (81.6%) took part in the survey. In the adjusted analysis, teaching staff were twice as likely as managers to have a favourable attitude towards SFSH. Furthermore, being female and of increasing age correlated with having a favourable attitude. A trend towards schools in favour of SFSH having more health promotion facilities, policy and practice, was identified. CONCLUSION AND IMPLICATIONS: Existing health promotion facilities and activities at the schools were associated with a favorable attitude among the management towards implementing SFSH. Thus, implementing other health promotion activities and policies might be an important first step to establish readiness to implement SFSH.

Relationship between volition, physical activity and weight loss maintenance: Study rationale, design, methods and baseline characteristics.

AIMS: To investigate the relationship between volition, physical activity and weight loss maintenance. METHODS: We recruited 84 sedentary (maximal oxygen uptake: 25 ± 5 ml/min), overweight and obese (Body mass index (BMI) 38 ± 7 m/h2, fat 44 ± 7 %) women ( n = 55) and men ( n = 29) for an interdisciplinary prospective study with follow-up. The change in lifestyle and weight loss is promoted via a 3-month intensive lifestyle intervention at a private health school. The intervention consists of supervised training (1-3 hours/day), a healthy hypo-caloric diet (-500 to -700 kCal/day) and education in healthy lifestyle in classes/groups. The participants' body weight and composition (Dual Energy X-ray absorptiometry), volitional skills (questionnaire), physical activity level (heart rate accelerometer/questionnaire) and maximal oxygen uptake (indirect calorimetry) are to be monitored before, after, and 3 and 12 months after the intervention. RESULTS: At the 12-month follow-up, three different groups will be established: Clinical weight loss maintenance (> 10% weight loss from baseline), moderate weight loss maintenance (1-10% weight loss) and no weight loss (or weight regain). A linear mixed model analysis will be used to compare levels of volitional skills, physical activity and maximal oxygen uptake over time, between the three groups. Correlational analyses will be used to investigate possible associations between volition, maximal oxygen uptake, physical activity level and weight loss maintenance. CONCLUSIONS: If specific volitional skills are identified as predictors of adherence to physical activity and success in clinical weight loss maintenance, these can be trained in future intensive lifestyle interventions in order to optimize the success rate.

The Role of Physical Literacy in the Association Between Weather and Physical Activity: A Longitudinal Multilevel Analysis With 951 Children.

BACKGROUND: Numerous studies showed an effect of weather on physical activity (PA) levels in children. However, no study has yet examined the relevance of personal factors in this relationship. Therefore, this study analyzes (1) whether there are systematic interindividual differences in the extent to which weather affects the PA behavior and (2) whether physical literacy (PL) moderates the weather-PA association in children. METHODS: A total of 951 children in 12 Danish schools (age 9.76 [1.59] y; 54.3% girls) completed objective PA assessments via accelerometry (moderate to vigorous PA, light PA, and sedentary behavior). Local weather data (precipitation, wind speed, temperature, and sunshine duration) were provided by the Danish Meteorological Institute. Participants' PL was measured employing the Danish version of the Canadian Assessment of Physical Literacy-2. The 4116 accelerometer days underwent longitudinal multilevel analyses while considering their nesting into pupils and school classes (n = 51). RESULTS: Fluctuations in all PA indicators were significantly explained by variations in weather conditions, especially precipitation (P ≤ .035). Significant interindividual differences were found for 9 of 12 analytical dimensions, suggesting that weather changes influence PA behavior differently across individuals (especially moderate to vigorous PA, χ2[4] ≥ 11.5, P ≤ .021). However, PL moderated the relationship between weather and PA in only 2 of the 48 analytical constellations. CONCLUSIONS: Despite the varying impact of weather on PA across individuals, the present study favors a main effect model in which weather and PL exert independent effects on children's PA. The insufficient support for PL as a moderating factor calls for future studies to test alternative mechanisms in the weather-PA association.