School-based promotion of physical literacy: a scoping review.

Introduction: The role of physical activity in children's healthy development is undisputed, with school-based interventions being seen as a priority. The promotion of physical literacy (PL) seems to be promising due to its holistic approach, combining physical, cognitive, and affective domains. To develop recommendations for possible measures, we compiled existing literature on existing school-based PL interventions. Methods: Five databases (MEDLINE, Web of Science, SPORTDiscus, ERIC, and PsycInfo) were searched between July 6 and July 10, 2023, by combining the terms "physical literacy," "school," "program," "workshop," "intervention," and "curriculum" as well as a manual search. Records were screened in a two-stage process by two independent authors using a priori criteria. Eligible studies concerned PL interventions in the school context. The included records were sorted according to school type/population, structure, content, PL domains addressed, and evaluation. Results: In total, 706 articles were found through the database search and an additional 28 articles through the manual search. After removing duplicates, 502 publications remained, which were screened by title and abstract, leaving 82 full texts. These were cut down to 37 articles describing 31 different programs (19 in primary schools, eight in secondary schools, one in both primary and secondary schools, and three unspecified). Most interventions were conducted during physical education classes (n = 12). All three PL domains were addressed by five interventions, while 11 interventions solely concerned the physical domain. In addition, 21 interventions evaluated their effects on PL. Most evaluations showed small to moderate but inconsistent effects on several PL-related constructs (e.g., self-efficacy, motivation, movement skills). Interventions incorporating all three domains reported positive effects on physical competence and enjoyment. Discussion: Although there is a growing body of data related to school-based PL promotion, their effects and practical application remains relatively underdeveloped: study designs, study quality, PL assessments, and results are heterogeneous. Corresponding research adhering to the holistic approach of PL will be crucial in clarifying the potential lifelong role of PL in promoting physical activity, increasing health and well-being and to actually enable development of recommendations for action.

BMI Z-Score (SDS) versus Calculated Body Fat Percentage: Association with Cardiometabolic Risk Factors in Obese Children and Adolescents.

INTRODUCTION: BMI or BMI-standardized deviation score (SDS) in children and adolescents is still the standard for weight classification. [BMJ. 2019;366:4293] developed a formula to calculate body fat percentage (%BF) based on age, sex, height, weight, and ethnicity. Using data from the German/Austrian APV registry, we investigated whether the calculated %BF is superior to BMI-SDS in predicting arterial hypertension, dyslipidaemia, and impaired glucose metabolism. METHODS: 94,586 children and adolescents were included (12.5 years, 48.3% male). Parental birth country (BC) was used to depict ethnicity (15.8% migration background); 95.67% were assigned to the ethnicity "white." %BF was calculated based on the Hudda formula. The relationship between BMI-SDS or %BF quartiles and outcome variables was investigated by logistic regression models, adjusted for age, sex, and migration background. Vuong test was applied to analyse predictive power. RESULTS: 58.4% had arterial hypertension, 33.5% had dyslipidaemia, and 11.6% had impaired glucose metabolism. Boys were significantly more often affected, although girls had higher calculated %BF (each p < 0.05). After adjustment, both models revealed significant differences between the quartiles (all p < 0.001). The predictive power of BMI-SDS was superior to %BF for all three comorbidities (all p < 0.05). DISCUSSION: The prediction of cardiometabolic comorbidities by calculated %BF was not superior to BMI-SDS. This formula developed in a British population may not be suitable for a central European population, which is applicable to this possibly less heterogeneous collective. Additional parameters, especially puberty status, should be taken into account. However, objective determinations such as bioimpedance analysis may possibly be superior to assess fat mass and cardiometabolic risk than calculated %BF.

Definitions and assessments of physical literacy among children and youth: a scoping review.

BACKGROUND: Despite the recognised health benefits of physical activity, the physical activity levels of children and adolescents continue to decline. The concept of physical literacy (PL) is a promising holistic approach to physical activity promotion that addresses affective and cognitive domains in addition to physical and motor domains. In Germany, however, no uniform or widely used method exists for assessing PL in children. This research was conducted to compile information on international PL assessment systems for children and adolescents (up to 18 years of age), including their underlying definitions, structural designs and development processes, for the purpose of developing such a tool in Germany. METHODS: A scoping review was conducted using PubMed, Web of Science and SPORTDiscus database entries. The initial search was conducted in July 2022, with a follow-up search performed in May 2023. Articles that operationalised the construct of PL and at least two of the three domains were identified and included. The procedure and assessment tools used to evaluate the individual domains and the overall PL construct were extracted from all selected articles. RESULTS: A total of 882 articles were identified; five were added after a manual search. After duplicates were removed, 563 articles were screened by title and abstract, and 40 articles met the inclusion criteria and were included in the review. In a review of these articles, 23 different assessment procedures were identified. Eight assessment procedures included PL as a superordinate construct. Twenty-two of the 23 procedures assessed the affective and physical domains, only 14 assessed the cognitive domain. CONCLUSION: Approximately half of the identified PL assessment systems addressed all three domains. Motor performance was most frequently integrated into the test procedures. Future developments in Germany should integrate all domains in the assessment to produce a holistic conceptualisation as the basis for appropriate funding.

Self-Reported Pre-Pandemic Physical Activity and Likelihood of COVID-19 Infection: Data from the First Wave of the CoCo-Fakt Survey.

OBJECTIVES: To investigate the potential protective role of exercise on the odds of COVID-19 infection in unvaccinated contact persons (CPs) who were at higher risk of infection due to confirmed contact with infected persons. METHODS: Before the onset of the vaccination campaign, the first wave of the CoCo-Fakt online survey was conducted with SARS-CoV-2-positive persons and their confirmed contacts who were isolated/quarantined between 1 March 2020 and 9 December 2020. Within this analysis, 5338 CPs were included and divided into those who subsequently tested positive (CP-P) and those who remained negative (CP-N). We assessed demographics as well as pre-pandemic lifestyle characteristics including physical activity (PA; type, frequency, time, intensity; duration clustered as 'below PA guidelines', 'meeting PA guidelines', and 'above PA guidelines'; intensity clustered as 'low intensity' and 'moderate-to-vigorous intensity') and sedentary behaviour. RESULTS: A greater percentage of CP-Ns reported being active before the pandemic compared to CP-Ps (69% vs. 63%; p = .004). Moreover, CP-Ns reported higher PA duration (164.1 min/week vs. 143.2 min/week; p = .038) and higher PA intensities than CP-Ps (67% vs. 60% moderate-to-vigorous intensity, 33% vs. 40% low intensity; p = .003). Adjusting for age, sex, socioeconomic status, migration background, and pre-existing chronic diseases, the odds of infection were negatively associated with exercise (yes/no) (Nagelkerke R2 = 1.9%), PA levels above PA guidelines (Nagelkerke R2 = 2.0%), and PA intensity (Nagelkerke R2 = 1.8%). CONCLUSION: Due to the beneficial effects of PA on the odds of infection, an active lifestyle should be promoted especially during possible subsequent pandemics (while taking into account necessary hygiene measures). Moreover, inactive and chronically ill persons should be especially encouraged to adopt a healthier lifestyle.

Ensuring Networks Work Well: Development of a Self-evaluation Tool for Network Quality in Community Health Promotion.

BACKGROUND: Networks are an essential component of community-based health research. Community-based networks require a high degree of collaboration, and the quality of this collaboration is a key factor for intervention success. As such, it is important to measure collaboration quality through network evaluation. Established tools, such as social network analysis, primarily measure connections between network members as opposed to network quality. Additionally, only few tools developed for this purpose are used in practice. METHODS: This paper describes the process of developing a network assessment tool to measure the quality of network collaboration in practice. To this end, we collaborated with practice partners from a community-based health promotion network and the community health service. We adopted a mixed-methods approach consisting of a literature review and a needs assessment involving practical experts in Germany. On this basis, we developed a new network evaluation tool, the Self-Evaluation Tool for Network Quality Assessment by Practitioners in Community Health Promotion (SNAP-HP), in cyclic-iterative collaboration with our practice partners. CONCLUSIONS: The next steps include piloting, evaluating, and adapting the SNAP-HP for final open access.

Development of a German Physical Literacy Assessment for Children in the Context of Health Promotion-An Explorative Approach.

Addressing physical literacy (PL) has become increasingly relevant to counteract sedentary behaviour in children and youth. We developed an assessment tool to measure and evaluate the promotion of individual PL and its four subdomains: motivation and confidence (the affective dimension), physical competence (physical dimension), knowledge and understanding (cognitive dimension), and participation in physical activity. Within this cross-sectional study, we tested 567 children aged 6−12 years from four primary schools that differed in socioeconomic status (SES). A subsequent exploratory factor analysis conducted to examine the conformity revealed a five-factor structure. The five factors explained 39.8% of the total cumulative variance. Children with a low SES yielded lower scores in all subdomains except participation in physical activity. This effect was most pronounced in motor skills (p < 0.001, r = 0.28). Among the children with a low SES, 16.9% were overweight and 17.4% were obese, compared to 11.5% and 5.4%, respectively, for those with a high SES (p < 0.001). In conclusion, although the assessment tool was largely in line with the postulated structure, further adjustments are necessary in terms of participation and motivation. Nevertheless, this holistic view of PL, taking SES into account, should enable the focused promotion of health and health literacy.

Impact of physical activity on COVID-19-related symptoms and perception of physical performance, fatigue and exhaustion during stay-at-home orders.

Objectives: The measures used to contain the COVID-19 pandemic led to a significant reduction in physical activity. Due to the health benefits of exercise, recommendations were made for lockdown restrictions. Within the CoCo-Fakt study (Cologne-Corona counselling and support for index and contacts during the quarantine period), we aimed to determine how these recommendations were implemented, especially by individuals who were officially quarantined due to an infected persons (IPs) or as close contacts (CPs), and how this affected their physical and psychological condition. Methods: From 12 December 2020 to 6 January 2021, all IPs and CPs registered by Cologne's public health department up to the survey period were surveyed online. Of 10 547 people in the CoCo-Fakt sample, 8102 were integrated into the current analysis. In addition to demographic data, information regarding COVID-19-specific and persistent symptoms or conditions and their association with the amount and type of exercise and screen time before and during the quarantine were collected. Results: Before quarantine, 66.9% of IPs and 69% of CPs were physically active; during quarantine, this decreased by 49.4% in IPs depending on the course of the disease and by 30.6% in CPs. Physically active IPs and CPs felt less exhausted and more fit during their quarantine periods than those who were inactive, with active IPs significantly less likely to report prolonged physical and psychological symptoms than their more sedentary counterparts. Conclusion: Given the acute and long-term positive effects of exercise on quarantined individuals, corresponding recommendations should be communicated to those affected, especially CPs. Recommendations for IPs depend on their health status.

Changes in Motor Performance and BMI of Primary School Children over Time-Influence of the COVID-19 Confinement and Social Burden.

During the COVID-19 pandemic, physical inactivity and being overweight increased in children, especially those from lower socioeconomic backgrounds. Additionally, a decrease in motor performance has been increasingly reported; however, there is a lack of meaningful data on the relationship between these findings and socioeconomic status. Therefore, we examined the BMI, BMI z score, the prevalence of overweight/obesity, and motor performance (based on lateral jumping, the standing long jump, and the 6-min run) among three cohorts from timelines before (2016) and during the pandemic (2020, 2021), using a cohort sequential design. Our analysis revealed that all parameters examined showed a significant negative trend over time. For children with a low social burden, the trend was statistically detectable only for lateral jumping and the 6-min run. For children with a high social burden, the prevalence of overweight/obesity increased from 4.2% to 5.4% between 2016 and 2021. The prevalence of being underweight also increased from 3.4% to 4.3% during this time. Motor performance decreased from 11.3% to 12.3%, except in the standing long jump. Children with a high social burden showed significantly lower results (7.4% to 9.6%). Thus, our data confirm an increase in both measurements of overweight/obesity and underweight, as well as a decrease in motor performance under the pandemic conditions, especially in children from socioeconomically deprived backgrounds. These findings affirm the urgent need for action regarding health promotion measures, especially for children with high social burdens.

Changes in Alcohol Consumption, Eating Behaviors, and Body Weight during Quarantine Measures: Analysis of the CoCo-Fakt Study.

INTRODUCTION: Public health measures enacted to reduce COVID-19 transmission have affected individuals' lifestyles, mental health, and psychological well-being. To date, little is known how stay-at-home orders have influenced the eating behaviors, weight development, and alcohol consumption of quarantined persons. The CoCo-Fakt cohort study analyzed these parameters and their association with psychological distress and coping strategies. METHODS: An online survey was conducted of all persons who tested positive for SARS-CoV-2 (infected persons [IP]) between December 12, 2020, and January 6, 2021, as well as their close contacts (contact persons [CP]) registered by the public health department of Cologne. 8,075 of 33,699 individuals were included in the analysis. In addition to demographic data, psychological distress, and coping strategies, information on changes in body weight, eating, and drinking behaviors was collected. RESULTS: IP lost 1.2 ± 4.4 kg during the quarantine period, and CP gained 1.6 ± 4.1 kg. The reasons given by IP for weight change were mainly loss of taste and feeling sick, whereas CP were more likely than IP to eat out of boredom. Higher psychological burden and lower coping strategies were associated with both weight gain and loss. Of the 30.8% of participants who changed their alcohol consumption during the quarantine period, CP in particular drank more alcohol (IP 15.2%; CP 47.7%). Significantly less alcohol was consumed by individuals with higher coping scores. CONCLUSION: In this short but psychologically stressful period of stay-at-home orders, changes in eating and drinking behavior as well as weight development are evident, mainly in high-risk contacts. To avoid possible long-term sequelae, health authorities should take these findings into account during the quarantine period; in particular, general practitioners should consider these findings during follow-up.

Closing the gap between practice and science in school- and community-based participatory physical literacy promotion: study protocol of the StuPs project.

BACKGROUND: The role of physical activity in the promotion of children's well-being and health is widely known. However, research indicates that the time spent physically exercising and participating in organized sport activities is decreasing among children. Although there is currently no gold standard for promoting sustainable physical activity in children, community-based approaches, particularly those that are multicomponent, appear to be the most successful. The project StuPs: a school- and community-based participatory approach for promoting physical activity in children and their families aims to develop a community-based approach to promoting physical activity by increasing physical literacy among elementary school children and their household members. METHODS: The project is built upon the intervention mapping approach and consists of two periods with an overall duration of 3 years. Period I will last 9 months and include an assessment of needs, wants, strengths, and weaknesses regarding physical activity and health promotion at the community- and school-based level according to the keywords "capacity building" and "physical literacy." Based on the knowledge gained in this stage, measures for capacity building to promote healthy lifestyles and physical literacy in children will be developed using the community-based participatory research and capacity building approach. In Period II, the measures will be applicated, implemented and evaluated using a pre-/post-design to assess efficacy. DISCUSSION: Although the efficacy of using community-based and capacity building approaches to reach children is promising, there remains a gap regarding best practices for changing existing structures and habits over the long term and in the sense of promoting physical literacy.