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

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

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

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

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

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