Quantifying physical activity, physical education and active travel in children and adolescents with visual Impairments.

Background: Meeting the physical activity (PA) guidelines for children, as set out by the World Health Organisation (WHO), has a range of physical and mental health benefits. For children who are blind or vision impaired (BVI), additional benefits include social inclusion and reduced falls risk. While previous research has demonstrated low PA levels across most demographics, little research has been done in the Irish context to quantify PA in children who are BVI. Two potential methods of increasing PA levels, active travel (AT) and physical education (PE), have additionally never been assessed in this group. Methods: Consenting parents of children who are BVI (n = 53, 55 % boys, mean age of children 12.92 ± 2.76 years) completed a questionnaire regarding PA levels, and participation in AT and PE. Results: PA levels were low, with 9.6 % achieving WHO guidelines (60 min MVPA/day). There was no statistically significant differences between genders completing either no PA in the last week (p = 1.00) or MVPA on each of the last 7 days (p = 0.157). 14.4 % used AT to get to school. Mean PE times in minutes/week were lower than the general population (58.63 min), with a low proportion of respondents meeting PE guidelines (32.1 %). Regarding barriers to PA, 17.0 % of respondents stated they were very likely to be "too tired after school to be active". 13.5 % stated they were very likely to feel "my day is so busy now I just do not think I can make time to include PA in my regular schedule". Conclusion: This study provides a valuable insight into the low levels of PA that prevail amongst BVI children. Increasing PA levels would provide individual benefits (including physical and mental health benefits) as well as population benefits (including reduced health expenditure). Future qualitative research should seek to gain a deeper understanding of the PA barriers, motivators and facilitators in this cohort.

Investigating physical activity levels in adults who are blind and vision impaired.

BACKGROUND: It is well established that meeting physical activity (PA) guidelines has a range of physical and mental health benefits. For people who are blind and vision impaired (BVI) there may be additional benefits in terms of social inclusion and the prevention of sight deterioration. OBJECTIVE: This study aimed to quantify PA levels, barriers to and motivators for PA in adults who are BVI. METHODS: PA levels, perceived barriers to, and motivators for PA were measured via questionnaire of 310 self-identifying BVI adults (n = 310 mean age = 29.77 ± 11.37, 55.8% male). RESULTS: PA levels were low, with 21.7% meeting PA guidelines. Median PA levels were not statistically significantly different between different age groups. There was no significant difference between genders, though mean days of PA for males was 0.382 days lower than for females. There was a significant difference between PA levels between the "no vision" (B1) and "useful vision" (B3) groups (p = 0.027), and the "no vision" (B1) and the "low vision" (B2) groups (p = 0.003). Transport (54.8%) and lack of access to enjoyable activities (47.0%) were the most commonly cited barriers, while "to relax" (36.4%) and "to have fun" (35.6%) were most commonly cited as very important motivators. CONCLUSIONS: This study provides a valuable insight into the low levels of PA that persist amongst adults with BVI. Future research should seek to gain a deeper understanding of the PA barriers, motivators and facilitators in this cohort.

Can Special Olympics coaches accurately report on the motor competence of children with intellectual disabilities?

BACKGROUND: Motor competence is the ability to perform goal directed human movements in a co-ordinated, accurate and error free manner. The aim of this study was to compare the accuracy of coaches' perceptions of children's motor competence with their actual motor competence. METHOD: This study examined the motor competence of children with intellectual disabilities (n = 100) and coaches' perceptions of children's motor competence (n = 10). Participants were assessed using TGMD-3. Coaches completed an adapted version of the pictorial scale of Perceived Movement Skill Competence. RESULTS: The predictive power of coaches perceived motor competence versus children's actual motor competence was assessed. CONCLUSIONS: This research will provide insight for sports organisations to determine whether coaches can accurately report on the motor competence of children with intellectual disabilities.

Assessing the Fundamental Movement Skills of Children With Intellectual Disabilities in the Special Olympics Young Athletes Program.

Mastering the ability to move proficiently from a young age is an important contributor to lifelong physical activity participation. This study examined fundamental movement skill (FMS) proficiency in children with intellectual disabilities (n = 96, 60% boys, age 5-12 years) and typically developing children (n = 96, 60% boys, age 5-12 years). Participants were assessed using the Test of Gross Motor Development-3rd edition and balance subtest from the Bruininks-Oseretsky Test of Motor Proficiency 2. The FMS proficiency of typically developing children including mastery/near mastery level (combined variable representing mastery, which is achieving all criteria for the skill, over both trials and near mastery, wherein a participant performs all but one of the components of the skill correctly) was significantly higher than for children with intellectual disabilities. A similar observation was made with multiple linear regression analysis testing the interaction effect of participant group and age/gender on all three FMS subcomponents. The results presented will help establish a baseline of FMS proficiency and guidelines for future intervention for children with intellectual disabilities.

Exploring the motor skill proficiency barrier among children with intellectual disabilities: Analysis at a behavioural component level.

Models of childhood motor development began to emerge in the 1960's. Since then, numerous models have proposed the importance of obtaining a proficient level of fundamental movement skill (FMS) competence during childhood and deemed it to be critical for participation in lifelong sports and physical activity. This study examined FMS at the behavioural component level in children with intellectual disabilities (CwID) (n = 100, 60% boys, aged 5-12 years). Participants were assessed using the Test of Gross Motor Development 3rd edition (TGMD-3) and the balance subtest from Bruininks-Oseretsky Test of Motor Proficiency 2 (BOT-2). For the whole sample, 0% participants mastered all 10 FMS, 1% (n = 1) participants mastered all 4 locomotor skills while 0% (n = 100) participants mastered all ball skills. A multiple regression was carried out to investigate whether the interaction of gender and age was a predictor of FMS proficiency. Linear regressions were also carried out to investigate whether gender or age was a predictor of FMS proficiency. The results presented will help to identify weaknesses in skills at the behavioural component level and will enable researchers and practitioners to address low levels of motor skill proficiency among CwID.

LifeLab: Co-Design of an Interactive Health Literacy Intervention for Socioeconomically Disadvantaged Adolescents'.

Low socioeconomic populations, when compared to more affluent groups, are at greater risk of initiating risky behaviours and consequently developing health complications. Health literacy has been identified as a possible means to improve and sustain positive health behaviours, with adolescence being a time point when such behaviours can be embedded. To develop a meaningful health intervention, it has been recommended that relevant stakeholders be included in the design phase. This formative evaluation study was the second phase of co-design of an engaging health literacy intervention 'LifeLab' with, and for, socioeconomically disadvantaged adolescents in Ireland. In Spring 2021, a series of co-design workshops (n = 17) were facilitated with a convenience sample of adolescents from socially disadvantaged areas (n = 22) to gather their perceptions, feedback, and suggested changes on the LifeLab learning activities that had emerged from Phase 1 of the work. The data was analysed using reflexive thematic analysis, resulting in the development of three themes: (i) preferred learning engagement strategies, (ii) practical and logistical considerations and (iii) ideas for LifeLab content. The results highlight the value in adopting a participatory approach, as participants offered an array of suggestions and details to maximise the potential for LifeLab to be contextually relevant and engaging; suggestions which will directly inform the development and implementation of the intervention.

Understanding disadvantaged adolescents' perception of health literacy through a systematic development of peer vignettes.

BACKGROUND: Adolescence represents a crucial phase of life where health behaviours, attitudes and social determinants can have lasting impacts on health quality across the life course. Unhealthy behaviour in young people is generally more common in low socioeconomic groups. Nevertheless, all adolescents should have a fair opportunity to attain their full health potential. Health literacy is positioned as a potential mediating factor to improve health, but research regarding health literacy in adolescents and socially disadvantaged populations is limited. As part of Phase one of the Ophelia (OPtimising HEalth LIterAcy) framework, The purpose of this study was to explore the perceptions of socially disadvantaged Irish adolescents in relation to health literacy and related behaviours, and utilise this data to develop relevant vignettes. METHODS: A convergent mixed method design was used to co-create the vignettes. Questionnaires were completed by 962 adolescents (males n = 553, females n = 409, Mean age = 13.97 ± 0.96 years) from five participating disadvantaged schools in Leinster, Ireland. Focus groups were also conducted in each school (n = 31). Results were synthesised using cluster and thematic analysis, to develop nine vignettes that represented typical male and female subgroups across the schools with varying health literacy profiles. These vignettes were then validated through triangular consensus with students, teachers, and researchers. DISCUSSION: The co-creation process was a participatory methodology which promoted the engagement and autonomy of the young people involved in the project. The vignettes themselves provide an authentic and tangible description of the health issues and health literacy profiles of adolescents in this context. Application of these vignettes in workshops involving students and teachers, will enable meaningful engagement in the discussion of health literacy and health-related behaviours in Irish young people, and the potential co-designing of strategies to address health literacy in youth. CONCLUSION: As guided by the Ophelia framework, the use of authentic, interactive and participatory research methods, such as the co-creation of vignettes, is particularly important in groups that are underserved by traditional research methods. The approach used in this study could be adapted to other contexts to represent and understand stakeholders' perceptions of health, with a view to explore, and ultimately improve, health literacy.

Ten Years of 'Flying the Flag': An Overview and Retrospective Consideration of the Active School Flag Physical Activity Initiative for Children-Design, Development & Evaluation.

Whole-school physical activity (PA) promotion programmes are recommended to increase youth PA. Evaluation of programmes is essential to ensure practice is guided by evidence. This paper evaluates the Active School Flag (ASF), a whole-school PA promotion programme in Ireland, using the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework. ASF was evaluated across three levels-(1) administration, (2) application, (3) outcomes-using a mi✗ed-methods case study design. E✗isting data sources were reviewed, the programme coordinator was interviewed, and a pilot study was conducted to investigate impact on 3rd and 5th class students (3 schools, n = 126 students, age range 8-12 years). In-school Moderate to Vigorous Physical Activity (MVPA; by accelerometery), motivation for PA (BREQ), PA self-efficacy (PASES), school affect and peer social support (Kidscreen27) were measured pre-programme (0 months), post-programme (8 months), and at retention (12 months). Teacher perceptions of classroom behaviour (CBAST) were also measured pre- and post-programme. ASF has been successful in engaging 46% of primary schools nationally. Students' in-school moderate-vigorous PA increased in all pilot-study schools from pre-programme to retention (η2 = 0.68-0.84). ASF programme design facilitates implementation fidelity, adoption and maintenance through buy in from schools and government stakeholders. ASF presents as an effective PA promotion programme in the short-to-medium term for primary schools. This RE-AIM evaluation provides evidence of ASF effectiveness, alongside valuable findings that could support programme improvement, and inform future similar programmes.

A comparison of physical activity, physical fitness levels, BMI and blood pressure of adults with intellectual disability, who do and do not take part in Special Olympics Ireland programmes: Results from the SOPHIE study.

People with an intellectual disability are less physically active, live more sedentary lives, have lower fitness levels and are more likely to be overweight or obese than the general population. No evidence exists on the impact of participation in Special Olympics Ireland (SOI) on physical activity and physical fitness levels. Adults with intellectual disabilities (16-64 years) were recruited from services and SOI clubs. Physical measures included waist circumference, height, weight, blood pressure, heart rate and 6-min walking test. Self-report questionnaires gathered data on physical activity levels. Actigraph (GT3X) accelerometers were used to gain an objective measure of physical activity. SOI participants accumulated more moderate to vigorous physical activity per day, had higher fitness levels and more positive health profile scores than those not taking part in SOI. SOI has the potential to make a positive difference to people's physical health and subsequently their overall health and well-being.

An examination of the nutritional intake and anthropometric status of individuals with intellectual disabilities: Results from the SOPHIE study.

The prevalence of obesity appears greater in people with intellectual disabilities than those in the general population. This study aimed to examine the nutritional intake and anthropometric status of individuals with intellectual disabilities. Participants aged 16-64 years were recruited from intellectual disability service provider organizations ( n = 131). Data were collected using questionnaires; 4-day food dairies and weight, height and waist circumference measurements. Participants' mean body mass index (BMI) was 29.4 kg/m2 ± 6.1, 2.4% were underweight, 22.6% were normal weight, 28.2% were overweight and 46.8% were obese. Having a diagnosis of Down syndrome ( p = 0.03) was associated with increasing BMI. Increasing waist circumference was associated with increasing severity of ID ( p = 0.04). The mean-reported energy intake was 1890 kcal/day. Mean energy intakes from sugar, fat and saturated fat were above recommendations and few participants met micronutrient recommended daily amounts. This study highlights the alarming prevalence of overweight and obesity and poor diet quality of individuals with intellectual disabilities.

People with intellectual disability and their families' perspectives of Special Olympics Ireland: Qualitative findings from the SOPHIE study.

Previous research has highlighted that while involvement in Special Olympics can have benefits for athletes and their families, there can also be many barriers to participation. This qualitative study, which was part of a large mixed-method study, examined the experiences and perspectives of people with intellectual disability, their families and staff who work with them, about Special Olympics Ireland (SOI). A total of 47 participants (15 athletes, 6 non-athletes, 18 family members and 8 staff members) participated in focus group and individual interviews. Supplemental data, gathered as part of the larger study extracted from open-ended survey questions completed by 97 family members also informed this element. Findings revealed four main themes: impact of participation on athletes, impact of involvement on families, barriers to participation and how to enhance participation rates. Involvement in Special Olympics impacted positively on the quality of life of athletes and families. Enhanced availability of user-friendly information and service accessibility were important drivers identified for enhancing participation rates in Special Olympics.

Youth-Physical Activity Towards Health: evidence and background to the development of the Y-PATH physical activity intervention for adolescents.

BACKGROUND: Despite known benefits of regular physical activity for health and well-being, many studies suggest that levels of physical activity in young people are low, and decline dramatically during adolescence. The purpose of the current research was to gather data on adolescent youth in order to inform the development of a targeted physical activity intervention. METHODS: Cross-sectional data on physical activity levels (using self report and accelerometry), psychological correlates of physical activity, anthropometic characteristics, and the fundamental movement skill proficiency of 256 youth (53% male, 12.40 ± 0.51 years) were collected. A subsample (n = 59) participated in focus group interviews to explore their perceptions of health and identify barriers and motivators to participation in physical activity. RESULTS: Findings indicate that the majority of youth (67%) were not accumulating the minimum 60 minutes of physical activity recommended daily for health, and that 99.5% did not achieve the fundamental movement skill proficiency expected for their age. Body mass index data showed that 25% of youth were classified as overweight or obese. Self-efficacy and physical activity attitude scores were significantly different (p < 0.05) between low, moderate and high active participants. Active and inactive youth reported differences in their perceived understanding of health and their barriers to physical activity participation, with active youth relating nutrition, exercise, energy and sports with the definition of 'being healthy', and inactive youth attributing primarily nutritional concepts to 'being healthy'. CONCLUSIONS: Data show a need for targeting low levels of physical activity in youth through addressing poor health related activity knowledge and low fundamental movement skill proficiency. The Y-PATH intervention was developed in accordance with the present study findings; details of the intervention format are presented.

Pedometer step count and BMI of Irish primary school children aged 6-9 years.

OBJECTIVE: (1) To assess step count and Body Mass Index in Irish children, (2) to examine variation in (i) weekday and weekend activity, (ii) during-school and after-school activity, and (3) to evaluate the utility of pedometer based PA recommendations for health in predicting Body Mass Index. METHODS: Three hundred and one Irish primary school children aged 6-9 years wore a sealed pedometer for seven consecutive days in 2008, had their height and weight measured, and completed a short Physical Activity questionnaire. RESULTS: The majority of children were classed as of normal weight, and met the age and sex specific pedometer recommendations for health. Children took significantly more steps at weekends than on weekdays, and after school than during school. A child being classed as normal or overweight/obese based on Body Mass Index did not predict the likelihood of them meeting the pedometer recommendations. CONCLUSIONS: The majority of children were achieving sufficient steps/day for health but interventions to target those falling short should be considered. Further research examining the relationship between steps per day and Body Mass Index is warranted.

Gross motor skill acquisition in adolescents with Down syndrome.

The purpose of this study was to assess whether verbal-motor performances deficits exhibited by individuals with Down syndrome limited their ability to acquire gross motor skills when given visual and verbal instruction together and then transferred to either a visual or verbal instructional mode to reproduce the movement. Nine individuals with Down syndrome (6 males, 3 females) performed 3 gross motor skills. Both visual and verbal instructional guidance was given to the participants over a 4-day period. Twenty-four hours later, the participants were video recorded as they produced the movements (used as baseline measures). On Day 6, they were randomly assigned into verbal and visual groups and required to reproduce the skills while the experimenter provided either visual demonstration or verbal instructions depending on the group. Based on skill performance scores, participants in the verbal-motor performance group demonstrated a lower level of proficiency and an increased number of performance errors when compared to participants in the visual-motor performance group. Moreover, while the visual group demonstrated an increase in performance levels compared to baseline measures, the opposite effect was seen for the verbal group.