"He's a little skinny and he's a little wide.": a mixed design investigation of American Indian student perceptions of healthy bodies.

BACKGROUND: Childhood is a critical developmental time of wellness patterns, yet little is known about what children know and believe. Even less is known about non-majority cultures like American Indian youth. The purpose of this study was to explore American Indian students' understandings of nutrition and physical activity. METHODS: This mixed methods study took place in 10 schools in an American Indian community in the Southwestern U.S. Ninety American Indian students in grades 3-12 (8-19 years old) were interviewed. The interview included an 8-point body size chart. Numerical data were analyzed via t-test statistics while a constant comparison process and analysis was used for the interview data. RESULTS: Students rated approximately 85% of students in Category 5 or smaller on the scale while placing 60% of adults at or above that size. There was a general trend of a larger body type for boys seen as healthy compared to that for girls. Students generally believed that their classmates were larger than the healthy body size. For students, a healthy body was the result of compliance with "eat right and exercise" rules. They exhibited little understanding of nutrition or physical activity and there were few developmental differences in understanding. Health was a corporeal concept and violators of the eat right and exercise rules were seen as lazy. CONCLUSIONS: Students held narrow and corporeal focused notions of health focused on simple rules. People who violated the rules were "lazy", a concept that seemed to underlie multiple constructs and a finding that holds true in other investigations. Students also reported few adult role models, a topic that should be explored with expanded family groups to better represent the multi-generational (e.g. grandparents, uncles, aunts) family housing common in the community. The findings are limited to a single American Indian community and a mixed design of relatively small numbers. This addition to the literature from a non-majority cultural group expands our knowledge of student perspectives on health. These findings can be used to create more effective curricula and interventions. Schools need more effective, but also alternately framed approaches that promote broader views of health.

Concordance Between Accelerometer-Measured and Self-Reported Physical Activity and Sedentary Time in Adults with Autism.

This study examined the concordance between accelerometry-measured and self-reported physical activity (PA) and sedentary time in adults with autism. Twenty-four participants wore an ActiGraph GT3X + accelerometer for seven consecutive days and completed the International Physical Activity Questionnaire-Short Form (IPAQ-SF) on the last day of their study participation. Bland-Altman plots assessed the magnitude of agreement between the two measures. Nearly 80% of the participants accumulated the recommended ≥ 150 min of moderate to vigorous PA (MVPA)/week, but were also sedentary for over nine hours/day according to accelerometry data. Findings showed that adults with autism tended to overreport MVPA (b = 1.606, p < 0.01) and underreport sedentary time (b = 1.161, p = 0.03) via the IPAQ-SF, as compared to objective measurements.

Effects of a Gamified, Behavior Change Technique-Based Mobile App on Increasing Physical Activity and Reducing Anxiety in Adults With Autism Spectrum Disorder: Feasibility Randomized Controlled Trial.

BACKGROUND: Physical activity (PA) has an impact on physical and mental health in neurotypical populations, and addressing these variables may improve the prevalent burden of anxiety in adults with autism spectrum disorder (ASD). Gamified mobile apps using behavior change techniques present a promising way of increasing PA and reducing sedentary time, thus reducing anxiety in adults with ASD. OBJECTIVE: This study aimed to compare the effectiveness of a gamified and behavior change technique-based mobile app, PuzzleWalk, versus a commercially available app, Google Fit, on increasing PA and reducing sedentary time as an adjunct anxiety treatment for this population. METHODS: A total of 24 adults with ASD were assigned to either the PuzzleWalk or Google Fit group for 5 weeks using a covariate-adaptive randomization design. PA and anxiety were assessed over 7 days at 3 different data collection periods (ie, baseline, intervention start, and intervention end) using triaxial accelerometers and the Beck Anxiety Inventory. Group differences in outcome variables were assessed using repeated-measures analysis of covariance, adjusting for age, sex, and BMI. RESULTS: The findings indicated that the PuzzleWalk group spent a significantly longer amount of time on app use compared with the Google Fit group (F2,38=5.07; P=.01; partial η2=0.21), whereas anxiety was unfavorably associated with increases in light PA and decreases in sedentary time after intervention (all P<.05). CONCLUSIONS: Further research is needed to clarify the determinants of physical and mental health and their interrelationship in adults with ASD to identify the factors that facilitate the use and adoption of mobile health technologies in these individuals. Despite these mixed results, the small changes in PA or anxiety may be clinically significant for adults with ASD. TRIAL REGISTRATION: ClinicalTrials.gov NCT05466617; https://clinicaltrials.gov/show/NCT05466617.

Educator perspectives on concussion management in the college classroom: a grounded theory introduction to collegiate return-to-learn.

OBJECTIVES: To gather the perspectives of collegiate instructors regarding how concussion is managed within the college classroom. To introduce the themes surrounding collegiate return-to-learn (RTL) and the classroom management of students with concussion. DESIGN: Qualitative grounded theory. SETTING: Large, public university in the Midwest. PARTICIPANTS: Twenty-three college instructors participated in a private, semistructured, audio-recorded, one-on-one interview. Participants included 12 males and 11 females. Interview recordings were transcribed verbatim, followed by an iterative process of open-coding and axial-coding, performed by two researchers. RESULTS: Three themes emerged from the coded data: (1) awareness-external knowledge of concussion and previous experiences, (2) legitimacy-medical note provided and no note provided and (3) accommodating the student-instructor's role and feasibility of the accommodation. Psychosocial factors such as small class sizes, graduate-level students and an instructor's empathy appeared to influence an instructor's decision making when accommodating a student recovering from concussion. CONCLUSION: These novel data provide foundational evidence regarding how college instructors perceive and subsequently manage concussion within the classroom, while also offering accuracy to aims of subsequent collegiate RTL investigations ARTICLE SUMMARY: RTL is an emerging field within concussion management, yet is grossly underexplored within the college setting. By utilising a grounded theory approach, this article introduces the themes that dictate the landscape of RTL for a college student.

Usability inquiry of a gamified behavior change app for increasing physical activity and reducing sedentary behavior in adults with and without autism spectrum disorder.

The purpose of this study was to conduct the first usability inquiry of a gamified, behavior change theory-guided mobile app PuzzleWalk for increasing physical activity and reducing sedentary behavior in adults with and without autism spectrum disorder (ASD). Eighteen adults with and without ASD participated in a mixed-methods study that consisted of cognitive walkthrough, system usability assessment, and qualitative interviews. The results of the system usability testing indicated satisfactory quality of the PuzzleWalk system that can be readily applicable to both adults with and without ASD. Several notable issues were identified from the qualitative interviews that address critical insights into unique health and social needs in adults with ASD. Future work is warranted to examine the long-term effects of the PuzzleWalk system on increasing physical activity and reducing sedentary behavior in adults with and without ASD in real-world settings.

Students' reports of misbehavior in physical education.

The purpose of this study was to examine students' reports of misbehavior in physical education class. Secondary school participants (N = 2,309) completed a previously validated instrument designed to measure students' reports of 59 student behaviors occurring in classes that might affect class management (e.g., from talking to bringing weapons to class). Three-way repeated measures analysis of variance results suggested that students' reports of misbehaviors occurring in physical education classes differed by gender, grade level, and ethnic background. Chi-square results also suggested there were differences in participants' views about why students misbehave by gender, grade level, and environment. Descriptive findings indicated most student misbehaviors were mild and moderate in nature.

Teachers' reports of student misbehavior in physical education.

Classroom management, and, more specifically, the management of student behavior, is an essential skill for and central concern of physical education teachers. Surprisingly little information is known, however about the specific nature of student behaviors that might negatively affect the class environment. The purpose of this study was to examine teachers' reports of student behaviors that may create management issues in physical education classes. Over 300 teachers representing a range of grade levels and school contexts completed a survey related to the frequency of potentially negative student behaviors. Many types of misbehaviors were reported, but the most common were mild. Teachers' reports varied by sex, years of teaching experience, and school context.

A cross-cultural investigation of the use of teaching styles.

Teacher beliefs are a major influence on teacher actions. Because context influences beliefs, it was the purpose of this study to explore teachers' beliefs about Mosston's Spectrum of Teaching Styles from an international perspective. Over 1,400 teachers from 7 countries completed a survey related to their self-reported use of and beliefs about various teaching styles. Data suggested a shared core of reproduction teaching style use. The use of and beliefs about the production styles of teaching were more varied. Teachers' use of styles was significantly related to their beliefs about the styles.