Playground activities and gender variation in objectively measured physical activity intensity in Australian primary school children: a repeated measures study.

BACKGROUND: Recent studies have sought to address the limited time for physical activity by focusing on increasing physical activity intensity among students during non-curricula periods and specifically school break times. We objectively measured the intensity of student physical activity (PA) during recess and lunch breaks at primary schools in the Western Sydney region of New South Wales (NSW), Australia using a 12-month repeated measures observation design study. METHODS: Systematic direct observation of recess and lunch breaks over a ten-week period in 2014 and 2015. 120 recess and lunch breaks across twenty schools (2014) with 839 periodic observations and across 15 schools with 587 periodic observations in 2015. Both observation periods were conducted over 10-weeks in Term 4 (September - December). RESULTS: The mean proportion of vigorous physical activity reported as a percentage (%VPA) across both time points was 16.6% (SD = 23.4). 36.8% (SD = 26.0) of time was spent walking and the remaining time (46.6%; SD = 30.4) was spent in sedentary activities. There was a significant decline in %VPA and increase in sedentary activity (p < 0.01) between the two time periods of measurement. In 2014, boys spent twice as much time in %VPA than girls during breaks in the school day and in 2015 this increased to nearly three times as much time in %VPA. %VPA also varied on the type of surface PA took place and the types of activities the children were allowed to undertake during breaks. CONCLUSIONS: Recess and lunch breaks potentially offer an opportunity for children to participate in unstructured PA during the school day. Substantial variations in the %VPA during these periods exist. Addressing playground gender participation disparities and space usability/accessibility may be a necessary first step in promoting higher PA intensities during breaks.

An objective and cross-sectional examination of sun-safe behaviours in New South Wales primary schools.

BACKGROUND: Previous evaluations have supported the link between sun protection policies and improved sun protection behaviours. However these evaluations have relied on self-reported data. METHODS: A cross-sectional design as part of an ongoing 18-month cluster-controlled trial in primary schools (n = 20) was used. Researchers conducted direct observations to record students' hat use and teachers' use of sun protective measures during recess and lunch. Researchers also recorded the volume of sunscreen consumed in each school. RESULTS: Only 60% of primary school children wear a sun-safe hat during their breaks when observed using objective measures. Weak correlations were observed between the wearing of a sun-safe hat and a school's socio-economic status (r = 0.26). All other independent variables measured had only very weak correlations (r < 0.19) with sun-safe hat wearing behaviour of students. Sunscreen consumption by school students during the school day is negligible. CONCLUSIONS: A large percentage of NSW primary schools in this study wear sun-safe hats during the school day but this is well below what has been reported in previous national surveys. Given the finite resources of schools and the correlation, though small, with SES status for these behaviours, it behoves researchers to investigate low-cost solutions to these problems. Further qualitative data will also be needed to inform the enablers and barriers for sun-safe behaviour interventions to be adopted in NSW primary schools.

Teaching Healthy Eating to Elementary School Students: A Scoping Review of Nutrition Education Resources.

BACKGROUND: School-based programs represent an ideal setting to enhance healthy eating, as most children attend school regularly and consume at least one meal and a number of snacks at school each day. However, current research reports that elementary school teachers often display low levels of nutritional knowledge, self-efficacy, and skills to effectively deliver nutrition education. METHODS: The purpose of this review was to understand the availability and quality of resources that are accessible for elementary school teachers to use to support curriculum delivery or nutrition education programs. The review included 32 resources from 4 countries in the final analysis from 1989 to 2014. RESULTS: The 32 resources exhibited 8 dominant teaching strategies: curriculum approaches; cross-curricular approaches; parental involvement; experiential learning approaches; contingent reinforcement approaches; literary abstraction approaches; games-based approaches; and web-based approaches. The resources were accessible to elementary school teachers, with all the resources embedding curriculum approaches, and most of the resources embedding parental involvement strategies. CONCLUSIONS: Resources were less likely to embed cross-curricular and experiential learning approaches, as well as contingent reinforcement approaches, despite recent research suggesting that the most effective evidence-based strategies for improving healthy eating in elementary school children are cross-curricular and experiential learning approaches.

Teaching approaches and strategies that promote healthy eating in primary school children: a systematic review and meta-analysis.

BACKGROUND: Healthy eating by primary school-aged children is important for good health and development. Schools can play an important role in the education and promotion of healthy eating among children. The aim of this review was to: 1) perform a systematic review of randomised controlled, quasi-experimental and cluster controlled trials examining the school-based teaching interventions that improve the eating habits of primary school children; and 2) perform a meta-analysis to determine the effect of those interventions. METHODS: The systematic review was limited to four healthy eating outcomes: reduced food consumption or energy intake; increased fruit and vegetable consumption or preference; reduced sugar consumption or preference (not from whole fruit); increased nutritional knowledge. In March 2014, we searched seven electronic databases using predefined keywords for intervention studies that were conducted in primary schools which focused on the four healthy eating outcomes. Targeted internet searching using Google Scholar was also used. In excess of 200,000 possible citations were identified. Abstracts and full text of articles of potentially relevant papers were screened to determine eligibility. Data pertaining to teaching strategies that reported on healthy eating outcomes for primary school children was extracted from the 49 eligible papers. RESULTS: Experiential learning strategies were associated with the largest effects across the reduced food consumption or energy intake; increased fruit and vegetable consumption or preference; and increased nutritional knowledge outcomes. Reducing sugar consumption and preference was most influenced by cross-curricular approaches embedded in the interventions. CONCLUSIONS: As with most educational interventions, most of the teaching strategies extracted from the intervention studies led to positive changes in primary school children's healthy eating behaviours. However, given the finite resources, increased overcrowding of school curriculum and capacity of teachers in primary schools, a meta-analysis of this scope is able to provide stakeholders with the best evidence of where these resources should be focused.

Rationale and study protocol to evaluate the SunSmart policy intervention: a cluster randomised controlled trial of a primary school-based health promotion program.

BACKGROUND: Previous evaluations of the SunSmart Program have supported the link between a written sun protection policy and improved sun protection behaviours in New South Wales (NSW) primary schools. However these evaluations have relied on self-reported data and research suggests that direct observations are required to better represent schools' usual sun protective practices. METHODS/DESIGN: Data will be collected in the summer months of 2014, 2015, and 2016 as part of an 18-month cluster-controlled trial in NSW primary schools (n = 20). Researchers will conduct three direct observations to record students' hat use and teachers' use of sun protective measures during recess and lunch periods in each school. Researchers will also record the volume of sunscreen that the Year 6 classes in each school utilise over the term. At the conclusion of baseline data collection, five schools will be randomised into an intervention group that will work with researchers to develop a policy-driven intervention to improve sun safety behaviour in NSW primary schools. DISCUSSION: An initial review of relevant Australian and New Zealand literature suggests that provision of policy support is likely to improve school sun protection practices; however there is no suggested model for this support. This will be the first objective analysis of sun safe behaviours leading to a policy-driven intervention conducted in Australian primary schools since the 1990s, and will inform the future direction of sun safety in our schools. TRIAL REGISTRATION: Australian and New Zealand Clinical Trials Register ACTRN12614000926639 Registered 28(th) August 2014.

Changes in physical activity levels, lesson context, and teacher interaction during physical education in culturally and linguistically diverse Australian schools.

BACKGROUND: Recent data show that only 15% of Australian adolescents participate in adequate amounts of physical activity (PA) and those students from Asian and Middle-Eastern backgrounds in Grades 6-12 are significantly less active than their English-speaking background peers. Schools have recently been recognised as the most widely used and cost-effective setting for promoting PA among youth and one domain within schools where PA can occur regularly for all youth, regardless of cultural background or socio-economic status, is during physical education (PE). METHODS: This study describes changes in physical activity (PA), lesson context and teacher interaction in physical education over the first two years in culturally and linguistically diverse secondary schools. Grade 7 PE classes in six schools were randomly observed using systematic direct observation (n = 81) and then followed up over the same period (n = 51) twelve months later. RESULTS: There was no significant decline in moderate-to-vigorous physical activity (MVPA) during PE (MD = -4.8%; p = .777), but a significant decline and medium negative effect in time spent in vigorous physical activity (VPA) (MD = -7.9%; p = .009) during PE was observed. Significant declines and large negative effects over time in percentage of PE time spent in management (MD = -8.8%; p < .001) and the number of observations where teachers promoted PA (MD = -20.7%; p < .001). CONCLUSIONS: The decline of VPA and teacher promotion of PA in culturally and linguistically diverse schools is of concern. Given the declines in VPA and the increases in time spent in game play, further research is needed to ascertain whether PE instruction could be improved by focussing on skill instruction and fitness in a games-based PE instruction model. Further research for increasing teacher promotion of PA during PE is needed.

Physical activity levels and movement skill instruction in secondary school physical education.

OBJECTIVE: To determine the levels of physical activity (PA), lesson context and teacher interaction students receive during physical education (PE) in secondary schools in New South Wales, Australia. DESIGN: Baseline cross-sectional study. METHODS: Systematic direct observation of Year 7 PE classes over a six-month period. Eighty one (81) PE lessons across six schools were observed. RESULTS: The mean (SD) percentage of class time spent in moderate to vigorous physical activity (MVPA) was 56.9% (18.7). However, only 60% of the 81 met the recommended 50% of class time spent in moderate to vigorous physical activity (MVPA). Just over 6% of class time was spent in skill instruction. Game play made up nearly half of the lesson context (44%) and teachers spent just under one-third (31%) of class time promoting PA. CONCLUSIONS: Substantial variations in the PA, lesson context and teacher interaction exist within PE. As a large proportion of classes, especially girls' only classes, did not meet the Centers of Disease Control and Prevention (CDC) recommendation of 50% of class time in MVPA, ways need to be found to promote PA in PE classes. Levels of skill instruction and practice were well below international comparisons and may have implications for PA participation later in life. Numerous possibilities exist for improving PE in Australia as a way of improving the activity levels and experiences of our young people.

A school-based intervention to promote physical activity among adolescent girls: rationale, design, and baseline data from the Girls in Sport group randomised controlled trial.

BACKGROUND: Physical activity levels decline markedly among girls during adolescence. School-based interventions that are multi-component in nature, simultaneously targeting curricular, school environment and policy, and community links, are a promising approach for promoting physical activity. This report describes the rationale, design and baseline data from the Girls in Sport group randomised trial, which aims to prevent the decline in moderate-to-vigorous intensity physical activity (MVPA) among adolescent girls. METHODS/DESIGN: A community-based participatory research approach and action learning framework are used with measurements at baseline and 18-month follow-up. Within each intervention school, a committee develops an action plan aimed at meeting the primary objective (preventing the decline in accelerometer-derived MVPA). Academic partners and the State Department of Education and Training act as critical friends. Control schools continue with their usual school programming. 24 schools were matched then randomized into intervention (n = 12) and control (n = 12) groups. A total of 1518 girls (771 intervention and 747 control) completed baseline assessments (86% response rate). Useable accelerometer data (≥ 10 hrs/day on at least 3 days) were obtained from 79% of this sample (n = 1199). Randomisation resulted in no differences between intervention and control groups on any of the outcomes. The mean age (SE) of the sample was 13.6 (± 0.02) years and they spent less than 5% of their waking hours in MVPA (4.85 ± 0.06). DISCUSSION: Girls in Sport will test the effectiveness of schools working towards the same goal, but developing individual, targeted interventions that bring about changes in curriculum, school environment and policy, and community links. By using community-based participatory research and an action learning framework in a secondary school setting, it aims to add to the body of literature on effective school-based interventions through promoting and sustaining increased physical activity participation among adolescent girls. TRIAL REGISTRATION NUMBER: Australia and New Zealand Clinical Trials Register (ANZCTR): ACTRN12610001077055.