Implementation and dissemination of physical activity-related health competence in vocational nursing training: study protocol for a cluster-randomized controlled intervention trial.

BACKGROUND: Although the nursing sector gains growing importance in an aging society, students representing the future workforce often show insufficient health. Acknowledging the health-enhancing effects of adequate physical activity, the educational system in Bavaria, Germany, has recently integrated the promotion of physical activity-related health competence (PAHCO) into the nursing curriculum. However, it cannot be assumed that PAHCO has sufficiently permeated the educational practices and routines of the nursing schools. Therefore, the goal of the present study is to examine and compare the effectiveness as well as implementation of different intervention approaches to address PAHCO in the Bavarian nursing school system. METHODS: We randomly assign 16 nursing schools (cluster-based) to four study arms (bottom-up, top-down led by teachers, top down led by external physical activity experts, control group). Schools in intervention group 1 (IG-1) develop multicomponent inventions to target PAHCO via cooperative planning (preparation, planning, and implementation phase). Intervention groups 2 and 3 (IG-2, IG-3) receive both an expert-based intervention (developed through intervention mapping) via trained mediators to address PAHCO. External physical activity experts deliver the structured PAHCO intervention in IG-2, while teachers from the nursing schools themselves conduct the PAHCO intervention in IG-3. In line with a hybrid effectiveness implementation trial, we apply questionnaire-based pre-post measurements across all conditions (sample size calculation: nfinal = 636) to examine the effectiveness of the intervention approaches and, simultaneously, draw on questionnaires, interview, and protocol data to examine their implementation. We analyze quantitative effectiveness data via linear models (times-group interaction), and implementation data using descriptive distributions and content analyses. CONCLUSION: The study enables evidence-based decisions about the suitability of three intervention approaches to promote competencies for healthy, physically active lifestyles among nursing students. The findings inform dissemination activities to effectively reach all 185 schools of the Bavarian nursing system. TRIAL REGISTRATION: Clinical trials NCT05817396. Registered on April 18, 2023.

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.

Physical Literacy in the Context of Climate Change: Is There a Need for Further Refinement of the Concept?

The concept of physical literacy (PL) has witnessed enormous popularity in recent years and has undergone substantial theoretical evolvement during the last 2 decades. However, the research field pertaining to PL has not yet initiated discussions around the challenges of climate change and the alignment with conceptualizations of planetary health. Therefore, we argue that the consideration of an "ecological domain" for individual physical activity, in the form of ecological awareness, would further evolve the concept. We illustrate how to potentially integrate adjustments within the most frequent PL definitions of the field (eg, those in Australia, Canada, England, Ireland, the United States, or by the International Physical Literacy Association) without questioning the entire integrity of these elaborate conceptualizations. An ecological domain of PL would not only interact with the postulated physical, cognitive, psychological/affective, and social domains of PL but also have important implications for the (re)design of interventions and practices in physical activity contexts. We call the scientific community, both on national and international scales, to intensify the discussions and initiate a research agenda involving an "ecological domain" of PL.

A life span perspective on competencies for a healthy, physically active lifestyle: Findings of a data pooling initiative with over 7000 individuals.

Individuals are recommended to lead active lifestyles throughout the life course. The model of physical activity-related health competence (PAHCO) adopts a competence approach by integrating physical, cognitive, and motivational determinants for health-enhancing PA (movement competence, control competence, self-regulation competence). Drawing on a comprehensive dataset pooling, the goal of the present study was to model the idiosyncratic courses of 10 PAHCO indicators over the life span. We identified studies that empirically operationalized PAHCO, combining data of 7134 individuals (age range: 15-97 years; 61% female) from 18 different populations (prevention and rehabilitation sectors). We applied a stepwise multilevel analysis approach with disjunct sub-samples (n = 48) to examine linear and quadratic associations between age and PAHCO. Indicators of movement competence (i.e., manageability of endurance, strength, and balance demands; task-specific self-efficacy) congruently showed negative associations with age (0.054 ≤  R marg 2 ${R}_{\text{marg}}^{2}$  ≤ 0.211). However, parameters of control competence remained stable across the life span (-0.066 ≤ ß ≤ 0.028). The three indicators of self-regulation competence revealed an inconsistent relationship with age, though uncovering positive associations for self-control (ß = 0.106) and emotional attitude toward PA (ß = 0.088). The associations of some indicators varied significantly across sub-samples. The results suggest differential analyses for associations between PAHCO and age. While the physically determined PAHCO indicators (movement competence) probably decline across the life span, the ability to ensure regularity of PA (self-regulation competence) or align PAs with an individual's health (control competence) appear to remain constant or improve with increasing age. The findings reinforce a de-stigmatizing approach for PA promotion practices with considerable space for aligning activities with health also in the elderly.

Development of a Global Physical Literacy (GloPL) Action Framework: Study protocol for a consensus process.

BACKGROUND: The holistic concept of physical literacy (PL) has gained growing attention in recent research, policy, and practice. Many important policy documents of the physical activity and educational fields (e.g., Global Action Plan on Physical Activity 2018-2030 by the World Health Organization, UNESCO's Quality Physical Education guidelines for policymakers) have specified PL. However, a clear framework for action is needed, as most initiatives across the world are fragmented, lack a prospective orientation, can benefit from conceptual clarification, and are not linked to effective translation into practice. Therefore, we aim to consensually develop a Global Physical Literacy (GloPL) Action Framework to define goals and principles (asking what is needed) as well as actions and ways (asking how these can be achieved) to move PL forward. MATERIALS AND METHODS: We apply a three-stage group Delphi technique involving three representation groups: (a) geographical representatives to achieve global coverage of perspectives; (b) representatives of special thematic interest reflecting prominent gaps of current PL activities; and (c) representatives of societies from the broad field of physical activity and health to facilitate dissemination. The process will begin with an individual pre-Delphi exercise, in which experts generate initial ideas for the framework, followed by a four-eye document analysis to derive themes for the discussion. Subsequently, the experts will meet face-to-face in three online rounds to discuss and prioritize the themes. Interspersed formal voting with pre-defined agreement thresholds (via descriptive statistics) will inform the inclusion of themes within the final framework. CONCLUSIONS: A global consensus on goals, principles, actions, and ways for the development of PL has the potential to provide a largely accepted roadmap for future activities in research, policy, and practice. The co-production approach will help disseminate the GloPL Action Framework and benefit work in relevant application fields of physical activity and health worldwide.