Systematic review and meta-analysis of physical activity interventions to increase elementary children's motor competence: a comprehensive school physical activity program perspective.

BACKGROUND: Regular participation in physical activity (PA) benefits children's health and well-being and protects against the development of unhealthy body weight. A key factor in children's PA participation is their motor competence (MC). The comprehensive school physical activity program (CSPAP) framework offers a way to classify existing PA interventions that have included children's MC development and understand the potential avenues for supporting children's MC. However, there have been no systematic reviews or meta-analyses of PA interventions and their effects on the MC of elementary school children (aged 5-12 years) from a CSPAP perspective. METHODS: This study was conducted in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) statement. We searched seven electronic databases (PubMed/Medline, Embase, ERIC, SPORTDiscus, CINAHL, Web of Science, and PsycINFO) for articles on 29 November 2021. The CSPAP framework was used to categorize the different intervention approaches. This review was registered with PROSPERO (CRD42020179866). RESULTS: Twenty-seven studies were included in the review, and twenty-six studies were included in the meta-analysis. A wide range of PA intervention approaches (e.g., single component or multicomponent) within the context of the CSPAP framework appear to be promising pathways in enhancing children's MC. The results of the aggregate meta-analysis presented that effect sizes for the development of MC from pre-and post- intervention ranged from moderate to large (Hedges' g = 0.41-0.79). The analysis revealed that the predicted moderators, including study length, delivery agent, and study design, did not result in statistically significant moderate variations in MC outcomes. There was, however, considerable heterogeneity in study design, instruments, and study context, and studies were implemented in over 11 countries across diverse settings. CONCLUSIONS: This study uniquely contributes to the literature through its primary focus on the effectiveness of PA interventions on elementary children's MC. This review emphasizes the importance of customizing CSPAP to fit the specific characteristics of each school setting, including its environmental, demographic, and resource attributes. The effectiveness of CSPAP, particularly its physical education (PE) component, is significantly enhanced when these programs are adapted to address the unique needs of each school. This adaptation can be effectively achieved through targeted professional teacher training, ensuring that PE programs are not only contextually relevant but also optimized for maximum impact in diverse educational environments. Researchers and practitioners should pursue how to effectively translate the evidence into practice to better conceptualize CSPAPs designed for children's MC development.

Development of a Fitness Surveillance System to Track and Evaluate Obesity in North Idaho.

BACKGROUND: Internationally 18% of youth are obese. Fitness testing can be used to establish fitness surveillance, which can inform policy and targeted interventions aimed at addressing obesity. The purpose of this study was to estimate the prevalence of overweight, obesity, and low fitness in Idaho school-aged youth through a pilot study. METHODS: A convenience sample of 13 teachers from 11 north Idaho rural schools collected FitnessGram fitness data: body composition (body mass index [BMI]), aerobic capacity (Progressive Aerobic Cardiovascular Endurance Run [PACER] test), muscular endurance (curl up), strength (pushup), and flexibility (sit and reach). RESULTS: A total of 761 students (aged 9-18 years) from grades 3&5, 7, and 9 to 12 participated in the study. Approximately 24% of 3&5 and 22% of 7th, and 12% of 9 to 12th-grade students were categorized as Needs Improvement/Health Risk by FitnessGram standards for BMI. Similarly, approximately 25% of 3&5, and 22% of 7 and 9 to 12th-grade students were considered Needs Improvement/Health Risk for PACER. IMPLICATIONS FOR SCHOOL HEALTH POLICY, PRACTICE, AND EQUITY: Results from fitness testing can provide school and public health representatives with a "needs assessment" of student health that can be used to help develop policies and practices to improve student health and wellbeing. CONCLUSIONS: This study provides a model for statewide annual fitness testing surveillance and reporting within K-12 public school physical education classrooms.

A qualitative evaluation of remote training to develop a fitness surveillance system.

Objectives: In the USA, 18% of school-aged young people are classified as obese, and rural populations appear to be particularly at risk. Achieving high levels of fitness reduces the risk of obesity and underlying health conditions. To better understand youth obesity trends and fitness levels, annual fitness testing ([FT], that is, surveillance) in schools has been recommended. Although many K-12 schools conduct FT, surveillance programmes that compile unified standardised test results are rare. Design: Qualitative design. Setting: Physical education teachers from 11 schools (n = 13; n = 4 men) participated in remote training about conducting FitnessGram FT. Methods: Data included two semi-structured interviews per teacher on experiences with distance fitness training, implementing FitnessGram, and data entry for annual surveillance. Results: Inductive analysis using axial and open coding identified four themes: (1) barriers prior to study, (2) study training, (3) implementation challenges and suggestions and (4) teacher feedback. Teachers had an interest in FT but lacked the recommended training and equipment needed to implement it annually. Conclusion: Teachers believed the training they received (as part of this study) prepared them to collect reliable and valid data, and that FT had benefits for their students and programmes. Every teacher expressed interest in reporting annual surveillance data. Efforts to train teachers for FT through virtual professional development may be a viable means of establishing a unified surveillance system.

Association of Physical Educators' Socialization Experiences and Confidence with Respect to Comprehensive School Physical Activity Program Implementation.

Comprehensive school physical activity programs (CSPAPs) are recommended to support physical education (PE) and increase the amount of physical activity (PA) youth receive each day. However, adoption of CSPAPs in the United States is low. PE teachers are well positioned to lead the implementation of CSPAPs, but research is needed to better understand (a) PE teachers' confidence to assume the multiple roles involved with CSPAP implementation and (b) the factors that are associated with such confidence. This study examined PE teachers' role breadth self-efficacy (RBSE) as a measure of PE teachers' CSPAP-related confidence and its association with seminal life experiences as framed within teacher socialization theory. A survey was emailed to a stratified-random sample of 2976 PE teachers and distributed on social media, garnering a total of 259 responses. Exploratory structural equation modeling supported a three-factor solution for teacher socialization variables (acculturation, professional socialization and organizational socialization), in line with the theoretical framework, and a single factor solution for RBSE. Professional socialization and organizational socialization were significant predictors of RBSE, and qualitative data from open-ended survey questions supported these relationships. The results highlight the importance of preservice teacher education and current employment contexts in PE teachers' CSPAP-related confidence.

A PEP grant's influence on change in a school district: One year post funding.

This study examined teachers' and administrators' perceptions of the institutionalization phase of the Carol M. White Physical Education for Progress (PEP) grant. A qualitative exploratory single case study (Yin, 2014) was utilized to examine the elements of the PEP grant that sustained or did not sustain after its conclusion, along with elements that were institutionalized and influences on this process. The findings were represented in the following three themes: (a) positive shifts, (b) backsliding, and (c) new directions, each with their own subthemes. Positive shifts includes sub-themes: (a) philosophy, (b) instruction, assessment and curriculum, (c) collaboration, and (d) respect. Backsliding includes sub-themes: (a) wellness team functioning, (b) the loss of PD and collaboration time, and (c) reduced data collection. New directions includes sub-themes: (a) mastery learning, (b) during school physical activity, (c) stress, and (d) administrative support. The factors that were institutionalized were quality physical education leadership roles, change in teachers' philosophies that influenced their instruction and assessment, and garnered administrative support. These elements were embedded into the physical education program and the school so much so that principals now expect the same type of programming from any new hire.

Recommendations for Administrators' Involvement in School-Based Health Promotion: A Scoping Review.

School administrator involvement is recognized as a key factor in the extent to which school health promotion programs and initiatives are successfully implemented. The aims of this scoping review are to: (a) Identify existing documents that contain recommendations regarding the involvement of school administrators in school-based health promotion; (b) distill and summarize the recommendations; (c) examine differences in the recommendations by targeted professional level, professional group, health promotion content focus, and by whether the recommendations are evidence-based or opinion-based; and (d) evaluate the research informing the recommendations. We drew upon the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines to conduct the review. Our team conducted a comprehensive literature search with no date or geographic restrictions from January 2018 through April 2018 using four electronic databases: Academic Search Complete, Google Scholar, Physical Education Index, and PubMed. Eligibility criteria included any online documents, in English, that contained recommendations targeting school administrators' (e.g., principals, assistant principals, superintendents) involvement (e.g., support, endorsement, advocacy) in school health programming (e.g., physical activity, nutrition, wellness). The search yielded a total of 1225 records, which we screened by title, then by abstract, and finally by full text, resulting in 61 records that met inclusion criteria. Data (e.g., recommendations, targeted contexts, targeted administrators) from these records were extracted for a content analysis. Included records contained 80 distinct recommendations, which we summarized into three themes (Collaboration, Advocacy, and Support) using a content analysis. Separate content analyses revealed no qualitative differences in the recommendations by professional level, professional group, or content focus, or by whether the recommendations were evidence-based or opinion-based. Twenty-one of the included records were peer-reviewed research articles. Using the Mixed Methods Appraisal Tool (MMAT), we appraised qualitative research articles the highest and mixed methods research articles the lowest. This review provides a basis for future research and professional practice aiming to increase school administrators' involvement in school-based health promotion.

A Systematic Review and Qualitative Synthesis Resulting in a Typology of Elementary Classroom Movement Integration Interventions.

BACKGROUND/OBJECTIVE: Movement integration (MI) involves infusing physical activity into normal classroom time. A wide range of MI interventions have succeeded in increasing children's participation in physical activity. However, no previous research has attempted to unpack the various MI intervention approaches. Therefore, this study aimed to systematically review, qualitatively analyze, and develop a typology of MI interventions conducted in primary/elementary school settings. SUBJECTS/METHODS: Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed to identify published MI interventions. Irrelevant records were removed first by title, then by abstract, and finally by full texts of articles, resulting in 72 studies being retained for qualitative analysis. A deductive approach, using previous MI research as an a priori analytic framework, alongside inductive techniques were used to analyze the data. RESULTS: Four types of MI interventions were identified and labeled based on their design: student-driven, teacher-driven, researcher-teacher collaboration, and researcher-driven. Each type was further refined based on the MI strategies (movement breaks, active lessons, other: opening activity, transitions, reward, awareness), the level of intrapersonal and institutional support (training, resources), and the delivery (dose, intensity, type, fidelity). Nearly half of the interventions were researcher-driven, which may undermine the sustainability of MI as a routine practice by teachers in schools. An imbalance is evident on the MI strategies, with transitions, opening and awareness activities, and rewards being limitedly studied. Delivery should be further examined with a strong focus on reporting fidelity. CONCLUSIONS: There are distinct approaches that are most often employed to promote the use of MI and these approaches may often lack a minimum standard for reporting MI intervention details. This typology may be useful to effectively translate the evidence into practice in real-life settings to better understand and study MI interventions.

Facilitators and Barriers to Movement Integration in Elementary Classrooms: A Systematic Review.

PURPOSE: A systematic review was conducted to identify facilitators and barriers to movement integration (MI) in elementary school classrooms. METHOD: Online databases (Educational Resources Information Center, Google Scholar, PsycINFO, and PubMed) served as data sources for the study. Following the PRISMA guidelines, relevant published research on MI was identified and screened for inclusion in a qualitative synthesis. Content analysis of the included articles (N = 28) was used to identify themes of MI facilitators and barriers. Facilitators and barriers were then categorized using a social-ecological framework. RESULTS: A total of 12 themes of MI facilitators and barriers were identified and categorized into two social-ecological levels: institutional factors (e.g., administrative support, resources) and intrapersonal factors (e.g., teacher confidence, ease of implementation). CONCLUSION: This review can inform research and practice aimed at supporting the implementation of MI in elementary classrooms.

Evaluation of a classroom movement integration training delivered in a low socioeconomic school district.

Movement integration (MI), which involves infusing physical activity (PA) into general education classrooms, is an evidence-based strategy within whole-of-school approaches for helping children meet the national PA guideline of at least 60 min per day. This study evaluated an MI training delivered in a low socioeconomic elementary school that had recently invested in three movement facilitative classrooms (a kinesthetic classroom and two activity labs). We investigated (a) the training's fidelity in meeting recommended best practices for professional development and (b) school professionals' perspectives of the training. Eight school professionals participated in the study, including five classroom teachers, two activity lab supervisors, and the principal. The researchers used a video of the training to rate the fidelity of the training to best practice recommendations. Interviews, field notes, and informal conversations with participants were qualitatively analyzed for themes. The training received a total fidelity score of 42%. Qualitative findings highlighted participants' varied perspectives of the training's purpose, challenges associated with the training and future recommendations for MI trainings. For MI trainings to be a valuable asset in increasing teachers' value and effective implementation of MI, trainings need to be designed to be in line with best practice recommendations and teachers' perceived needs.

Case study of a health optimizing physical education-based comprehensive school physical activity program.

In this article, we report a qualitative case study, in which we examined enablers and barriers related to the development, implementation, and sustainability of a comprehensive school physical activity program (CSPAP) aligned with the Health Optimizing Physical Education (HOPE) curriculum model at a middle school. Literature on program-diffusion and school-university partnerships guided data collection and analysis. Data sources included semi-structured interviews with the program implementation team (n = 9) and the school's health and physical education teachers (n = 7); a focus group interview with students; documents (e.g., lesson plans), and observations. Constant comparison techniques were used to code and draw out themes from the data. Findings revealed the extensive effort needed for program implementation and highlighted the importance of strong external support mechanisms, conducting needs assessments, and training teachers to market physical activity programming. Partnerships may provide critical support for schools in their efforts to generate and sustain CSPAPs.

Systematically Observed Movement Integration in a Low Socioeconomic School District: A Cross-Sectional, Observational Study.

PURPOSE: To describe teacher's integration of activity into general education classroom time (ie, movement integration-MI). DESIGN: Cross-sectional, observational. SETTING: Eight elementary schools in a rural, low-income school district. PARTICIPANTS: Elementary classroom teachers (N = 48). MEASURE: Classroom teachers were observed using the System for Observing Student Movement in Academic Routines and Transitions (SOSMART) on random, unannounced days during the 2015-16 academic year. ANALYSIS: Descriptive statistics were calculated for the frequency and types of MI being used. RESULTS: Of the 9398 SOSMART scans completed, students engaged in movement in 41.3% of the scans. Student movement was observed to be teacher directed in 14.4% and nonteacher directed in 26.9% of scans. Nonteacher-directed movement consisted mostly of transitions ( M = 99.5%) in which movement occurred as a result of preestablished classroom rules, protocols, and organization. CONCLUSION: This is one of the first studies to provide objective information about MI. These descriptive data lay the groundwork for future correlational and experimental research that can lead to the development of effective intervention design to increase MI use in schools.

Two-year process evaluation of a pilot program to increase elementary children's physical activity during school.

The purpose of this study was to examine implementation processes in elementary classrooms during a 2-year (Fall 2014 to Spring 2016) pilot intervention program, Partnerships for Active Children in Elementary Schools (PACES). We examined (a) the effect of PACES on the extent of movement integration (MI) and (b) changes in teachers' perceptions regarding MI. Purposively selected classrooms (grades 1-3) across four schools (3 intervention, 1 control) participated in the study. The sample included classroom teachers (N = 12) in Fall 2014 and Spring 2015, but the number of participants dropped to eight in Fall 2015 and Spring 2016. PACES consisted of three partnership approaches (a virtual community of practice, community-based participatory research, and university service learning) intended to increase the extent of MI in the intervention classrooms. We collected process data using the System for Observing Student Movement in Academic Routines and Transitions (SOSMART) and teacher interviews. PACES did not significantly impact the extent of observed MI. Interviews indicated that the intervention had both strengths and limitations. Building interpersonal support for teachers is important to their use of MI. A different measurement schedule (e.g., collecting MI data each day of the school week) may be required to more thoroughly capture MI instances.

Partnerships for Active Children in Elementary Schools (PACES): First year process evaluation.

Movement integration (MI) is a strategy within comprehensive school physical activity programs (CSPAP). School-university partnerships are recommended to leverage teachers' capacity to use MI. A mixed method process evaluation was conducted of the first year of implementing Partnerships for Active Children in Elementary Schools (PACES). Classroom teachers (N=12) from four schools participated. Data were collected in Fall 2014 (baseline) and Spring 2015 (∼ four months of intervention) using the System for Observing Student Movement in Academic Routines and Transitions and semi-structured interviews. There were no significant differences between intervention classrooms and control classrooms MI promotion. Differences approaching significance (U=5, p=0.04, d=1.2) were observed when comparing classrooms that received two (community of practice, community-based participatory research) or three components (two components plus service learning) of the intervention and classrooms that received one (community of practice) or no components. Qualitative findings revealed that teachers in classrooms that were more successful responded more favorably to the intervention components than teachers in classrooms that were less successful. Quantitative and qualitative results supported the effectiveness of community-based participatory research as a component of PACES. This study provides information about MI process variables in the context of a CSPAP intervention.