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BACKGROUND: Community-based coalitions are a common strategy for community engagement efforts targeting the improvement of a variety of population health outcomes. The typical processes that coalitions follow to organize efforts include steps that are sequential, slow, and time intensive. These processes also limit local decision-making to the selection of evidence-based policies or programs. METHODS: We present a process control theory-based Community Action Process, Investigate-Design-Practice-Reflect (IDPR), where community hubs (i.e., coalitions) organize agile efforts in a non-sequential, rapid, and efficient manner to harness local assets and data to make decisions regarding the provision and production of population health services. Using qualitative methods, we illustrate and analyze the use of IDPR in a one community case study as part of Wellscapes, a Type 3-hybrid implementation-effectiveness community randomized controlled trial to improve children's population health physical activity. RESULTS: We found community members followed the IDPR Community Action Process to rapidly design, organize, deliver, and receive feedback on a community-based, children's population physical activity prototype, an afterschool Play-in-the-Park opportunity for all children. DISCUSSION: Following IDPR afforded the community coalition timely learning through feedback within a process that coordinated decisions regarding what community services met community needs (provision decisions) and how to organize the production of the population health services (production decisions).
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BACKGROUND: Communities are wellness landscapes of geospatially and temporally bound settings where children spend their time. Improving population physical activity (PA) requires investigating available community settings for children, such as classrooms and sport teams, and the dynamic social interactions producing PA. This protocol describes a multiscale community wellness landscape monitoring and feedback system of adult-led organized group settings and PA outcomes for children. METHODS: The data system assessed organized groups for third- through sixth-grade children in 2 rural communities within seasons (fall 2018-2019). Within each season, groups were identified, sampled, and recruited. Sampled group meetings were assessed for children's PA (accelerometry) and meeting routines (video observation). A data processing protocol time-segmented data into meetings and meeting routines into smaller units (sessions). A purpose code was assigned to each meeting (eg, classroom, sport) and session (eg, academic, PA). Group accelerometer data were paired with the coded segments. Multiscale metrics (season, meeting, and session) were generated and provided to the communities in tailored reports. RESULTS: A total of 94 groups were recruited, and 73 groups with 1302 participants were included in the data system. Data were collected from 213 meetings and 844 sessions. Most participants (83.1%) consented to link their accelerometer data with demographic data from school enrollment records. CONCLUSIONS: The community data system identified available organized group settings for children and collected video and PA data from these settings. Incorporating setting data into local data systems provides detailed accounts of whole-of-community PA social systems to inform population health improvement efforts.
Assuntos
Exercício Físico , Estudantes , Humanos , Criança , Retroalimentação , Estações do AnoRESUMO
OBJECTIVES: To examine differences in rural community children's moderate-to-vigorous physical activity (MVPA) and participation in out-of-school activities from fall 2019 to fall 2020 and explore enacted PA opportunity modifications post initial COVID-19 disruption. DESIGN: Mixed methods study using the validated Youth Activity Profile (YAP), administrator reports and stakeholder surveys and semistructured interviews. SETTING: Children and community stakeholders from one rural US Great Plains community in the state of Nebraska were recruited. PARTICIPANTS: Third through fifth graders in fall 2019 (n=144) and fall 2020 (n=174) reported MVPA and participation in out-of-school activities using the YAP. School administrators reported weekly physical education (PE) and recess minutes. Community stakeholders reported pandemic-related changes in community social structures in semistructured interviews (n=4) and surveys (n=19). RESULTS: Average daily MVPA minutes increased from 2019 to 2020 (75.0 vs 81.3, SE=1.6, p<0.05). Minutes of MVPA increased during: school hours (MD=2.7, SE=0.5, p<0.5); out-of-school time on weekdays (MD=3.9, SE=1.3, p<0.5); and on weekends (MD=5.5, SE=2.4, p<0.5). On average, fewer children participated in youth sport (42.5% vs 47.2%), youth clubs (10.3% vs 16.0%) and other out-of-school activities (24.1% vs 38.2%) in 2020, compared with 2019. Weekly PE/recess minutes increased from 208.3 to 241.7 from 2019 to 2020. Stakeholder surveys revealed community-driven modifications to PA opportunities, and interviews suggested children played outside more frequently, especially when school was closed and out-of-school activities were shut down. CONCLUSIONS: Increased minutes of PE and recess, and decreased out-of-school activity participation may have increased children's overall free play and MVPA during the pandemic. Free play was an important contributor to children's PA during the pandemic and should be prioritised by educators, coaches and other leaders of child PA opportunities. TRIAL REGISTRATION NUMBER: NCT03380143.
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COVID-19 , Criança , Humanos , COVID-19/epidemiologia , COVID-19/prevenção & controle , Exercício Físico , Pandemias/prevenção & controle , Educação Física e Treinamento , População Rural , Instituições AcadêmicasRESUMO
Accurate and effective local data collection systems are needed to inform community change on youth health behaviors such as physical activity (PA). Systematic methods are particularly important for understanding PA behaviors that may be influenced by individual, interpersonal, organizational, and regional factors. The purpose of this study was to describe a protocol for coordinating community stakeholders to implement an online youth PA surveillance instrument. The research team collaborated with local health departments (LHDs) from two rural communities to coordinate schools in implementing school-wide youth PA surveillance. A data sharing agreement was established between all partners. School administrators and teachers attended in-person training sessions for an online PA survey and how to use the data. Following the training, students were provided individualized logins to complete the survey once a semester over a two-year academic period. Across both communities, 23 teachers and administrators attended the training sessions that were facilitated by the LHDs and research team. In Year 1 (Y1), a total of 465 3rd through 6th grade students were enrolled in the participating schools (community 1 = 227; community 2 = 238). Survey response rates ranged from 86.1% to 95.4% completion, depending on the community and semester. In Year 2 (Y2), a total of 501 3rd through 6th grade students were enrolled (community 1 = 260; community 2 = 241). Response rates ranged from 86.3% to 89.6% in the fall term. A protocol for coordinating LHD and community stakeholders was an effective strategy for implementing population-level youth PA surveillance with high levels of reach.
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School Wellness Integration Targeting Child Health (SWITCH®) is a school wellness implementation initiative focused on building capacity for schools to plan and coordinate wellness programming. Grounded in Social Cognitive Theory (SCT), the purpose of this study was to evaluate the utility of the web-based, self-regulation system on physical activity (PA) behavior outcomes. At pre-test and post-test, students in SWITCH® schools (n = 8) completed the online Youth Activity Profile (YAP) to assess PA and sedentary behavior (SB). Students (n = 513) were categorized into high or low self-monitoring groups (using a median split) based on their use of the web-based self-regulation platform. Linear mixed models were used to assess differences in moderate-to-vigorous PA (MVPA) and sedentary behavior, with school, classroom, student, time-by-school, and time-by-classroom random effects and main and interaction fixed effects for student self-monitoring, gender, and time. Significant self-monitoring-by-time interactions were observed for estimates of PA F(1, 477) = 5.55, p = 0.02 and SB F(1, 477) = 4.90, p = 0.03. Students in the high self-monitoring group had larger gains in PA per day and larger declines in hours per day of sedentary screen time behavior compared to students in the low self-monitoring group. These findings support the utility of web-based self-regulation for facilitating PA change in youth.