A gap in perceived accessibility to play spaces for physical activity in Arizona elementary schools.

BACKGROUND: The Physical Activity Guidelines for Americans states all children should be provided with various physical activity opportunities; however, school play spaces are often unaccommodating to students with disabilities and this limitation may be exacerbated in lower-income schools. OBJECTIVE: The purpose of the study was to compare elementary school play space accessibility among children with and without disabilities at lower- and higher-income schools. METHODS: This cross-sectional study utilized an online survey assessing the perceived accessibility of play spaces for students with and without disabilities in low- and high-income schools administered to 178 physical education teachers across Arizona. Chi-square analyses were conducted to assess reported play space adequacy among students with and without disabilities, and associations by school-level income. RESULTS: There was a significant association between disability status and reported playground and play field inadequacy (p < 0.05). Without considering school income, reported inadequacy was 3x greater for students with disabilities compared to those without for both playgrounds and play fields. Among low-income schools, reported inadequacy was 3x greater for playgrounds and 7x greater for play fields for students with disabilities compared to those without. CONCLUSIONS: These results suggest a gap in access to school play spaces for students with disabilities and highlight the lack of inclusive play areas specifically among schools serving low-income populations. Our findings underscore the need for students with disabilities to be considered in the development of play spaces to ensure this at-risk population receives maximum opportunities for accessible movement and social engagement during the school day.

A natural experiment to assess recess frequency on children's physical activity in Arizona (U.S.) elementary schools.

BACKGROUND: In the United States, the number of state policies mandating recess in schools has rapidly increased over the past decade; however, few policies specify recess frequency. Informed by an ecological model of physical activity (PA) policy, this study examined and compared total amounts and intensity of PA expended during recess among children attending schools in compliance with Arizona recess policy ARS§ 15-118 mandating 2 + daily recess periods versus not. METHODS: PA during recess was measured among grade three children (ages 8-10) in four randomly selected elementary schools (two complying averaging 30 daily recess minutes; two non-complying averaging 15 daily recess minutes) in Maricopa County, Arizona. Group-level PA was assessed by direct observation using the System for Observing Play and Leisure (137 observations). A subset of students (N = 134) from all schools wore ActiGraph GT3X + devices during recess to measure individual PA. General linear mixed effects models were used to analyze the impact of recess frequency on group and individual PA during recess. RESULTS: Students attending complying schools spent significantly greater proportions of time in moderate-to-vigorous PA (MVPA) based on direct observation (5%) and accelerometry (15%) and less time being sedentary based on accelerometry (14%) during recess. Across the school day, this would equate to 5.1 more MVPA minutes based on systematic direct observation and 9.5 more MVPA minutes based on accelerometry, and 4.1 less minutes being sedentary based on accelerometry if students received two daily 15-minute recess periods compared to one. CONCLUSIONS: Students attending elementary schools implementing 2 + recesses, in accordance with state policy, demonstrated greater MVPA and less sedentary time, providing preliminary evidence that recess frequency is associated with greater PA intensity among children during recess. Schools that adhere to state-level PA policies may provide a more supportive environment for PA, resulting in increased movement among students. Specifying recess frequency should be considered in statewide recess policy.

The Relationship Between Policy Strength and Physical Activity Practices in Arizona Public Elementary Schools.

BACKGROUND: Many school-based physical activity statutes and regulations have been enacted, with the expectation that schools will comply. However, policy alone does not equate to implementation, and many policies fail for a variety of reasons. The purpose of the study was to determine whether the strength of reported state, district, and school-level physical activity policies were associated with reported recess, physical education, and other school-based physical activity practices at elementary schools in Arizona. METHODS: A modified Comprehensive School Physical Activity Program (CSPAP) Questionnaire was administered to staff at elementary schools across Arizona (N = 171). Summative indices of the number of school physical activity policies and best practices at the state, district, and school levels were created. Relationships between policy strength and best practices were examined using linear regression analyses stratified by recess, physical education, and other school-based physical activity practices. RESULTS: Stronger physical activity-related policies were associated with a greater number of recess (F1,142 = 9.87, P < .05), physical education (F4,148 = 4.58, P < .05, Adj. R2 = .09), and other school-based physical activity (F4,148 = 4.04, P < .05, Adj. R2 = .07) best practices at all levels while controlling for school-level demographic factors. CONCLUSIONS: The strength of policies may improve opportunities for comprehensive physical activity for children in schools. Strengthening policy language (eg, specifying duration and frequency) may contribute to better physical activity practices in schools, improving children's health at the population level.

Models of school recess for combatting overweight in the United States.

Objectives: The aim of the study was to quantify and compare potential energy expenditure associated with school recess in the U.S. based on four scenarios: professional recommendations and state policies for the conduct of recess, previous studies that measured physical activity intensity during recess (i.e., reality), and no daily recess. Methods: Estimated energy expenditure (kcal) was modeled using secondary data over six years of elementary school for boys and girls using a standard formula: Intensity × duration × frequency × mass . Results: Boys and girls would expend similar energy under the professional recommendation (boys, 69,146 kcal; girls, 63,993 kcal) and state policy (boys, 69,532 kcal; girls, 64,351 kcal) scenarios. These values are significantly greater than a no recess scenario (boys, 26,974 kcal; girls, 24,821 kcal). The greatest energy expenditure was found for the reality scenario, based on actual studies that measured physical activity intensity (boys, 82,208 kcal; girls, 75,628 kcal). Conclusions: Professional recommendations and state policies for recess duration may be overly conservative and recommendations for percentage of MVPA may be overly liberal compared to the reality of energy expended during recess. Both potential and real estimates dwarf a scenario of withholding recess (i.e., no recess), which is discouraged in only six state policies. Mandated reporting with "groundtruthing" is needed to determine true recess frequency/duration and state policy compliance.

Promoting children's health and well-being through structured recreation during online recess.

Recess is a critical source of physical, social and emotional health and well-being for children, but generally not prioritized during online learning. A 13-week structured recreation intervention was delivered virtually during recess to students in the fifth and sixth grades (age 10-12 years; N = 71) at one elementary school (Phoenix, AZ, USA). We used embedded mixed method with a prospective pre-/post-design to measure change in student-reported emotion and qualities of engagement in an online setting. Students completed an online pre-/post-survey to measure emotion and motivational responses (enjoyment, competence and relatedness). We used narrative notes to qualitatively assess student engagement during programming. Differences in student-reported emotion were analyzed using paired t-tests. The effect of motivational responses on emotion was analyzed using multiple regression analyses. In vivo coding and concept coding were used to analyze qualitative data. We found no statistically significant differences in student-reported emotion; however, student relationships with peers predicted increased positive and decreased negative emotions after the intervention. Seven categories promoted student engagement: challenging, enjoyable, experiential, practical, purposeful, relatable and relevant. School-based health practitioners can offer structured activities virtually during recess, when in-person learning is interrupted and in all-online settings, to promote emotional well-being.

A direct observation tool to measure interactions between shade, nature, and children's physical activity: SOPLAY-SN.

BACKGROUND: Most physical activity (PA) during school occurs at recess; however, recess PA may be influenced by children's thermal comfort and interaction with nature, neither of which have concurrently been measured reliably in previous studies. This study tests the reliability of SOPLAY-SN, an adaption of the validated System for Observing Play and Leisure Activity in Youth (SOPLAY) to measure Shade and Nature (SN) alongside PA, and associations between children's PA and interaction with shade and nature during recess to highlight the utility of the tool. METHODS: Interactions with shade and nature were measured using systematic direct observation at two playgrounds (primary-grade = ages 5-8, upper-grade = ages 9-12) during recess at an elementary school in Phoenix, Arizona (USA). Pairs conducted observations over four warm days (primary = 29-34 °C, upper-grade = 32-36 °C) in May 2021 (N = 179 scans). Intraclass correlation coefficients (ICC) were used to calculate inter-rater reliability. Mean counts, frequencies, and Kendall rank correlation coefficient tests were used to assess relations between PA level and interactions with shade and nature. RESULTS: Reliability was good for sedentary behavior (ICC = 0.98); light PA (LPA; ICC = 0.80) and moderate-to-vigorous PA (MVPA; ICC = 0.94); shade interaction (ICC = 0.95); and nature interaction (ICC = 0.80) and average agreement was good (86% overall PA, 88% shade, 90% nature). Most (60%) primary-grade children were observed in the shade, with 64% under a covered play structure where children were mainly (47%) sedentary. Of the 11% of primary-grade students observed interacting with nature, 90% occurred in a grass field with trees. Among upper-grade children, 23% were observed in the shade with 53% in grass fields where 48% of play was light. Few (7%) upper-grade children were observed interacting with nature, with most instances (76%) in a grass field with trees. Among primary-grade children, shade was correlated with sedentary behavior (τb = 0.63, p < .05); LPA (τb = 0.39, p < .05); MVPA (τb = 0.56, p < .05); and nature interactions with sedentary behavior (τb = 0.16, p < .05). Among upper-grade children, shade was correlated with sedentary behavior (τb = 0.27, p < .05) and LPA (τb = 0.21, p < .05). CONCLUSIONS: SOPLAY-SN is a reliable tool for measuring children's interaction with shade and nature and participation in PA. Understanding how shade and nature impact movement during recess can inform playground design for children's health and well-being.

A cluster randomized controlled trial of an after-school playground curriculum intervention to improve children's physical, social, and emotional health: study protocol for the PLAYground project.

BACKGROUND: The public health benefits of physical activity for children are well known including contributions to metabolic and cardiorespiratory health. Along with physical benefits, engaging in physical activity can support the social and emotional health of youth and promote health and well-being into adulthood. This cluster-randomized controlled trial assesses the impact of an after-school curriculum aimed at improving physically active and inclusive play to promote physical, social, and emotional health. A secondary focus is on the implementation (appropriateness, feasibility, fidelity, sustainability) of the curriculum. METHODS: The PLAYground (Play and Learning Activities for Youth) project utilizes a social-ecological approach, targeting personal, behavioral, and environmental conditions, and Social Cognitive Theory (SCT) to study how a playground curriculum impacts children's health. All elementary schools with an existing after-school program in a large, public school district in Mesa, Arizona will be eligible to participate. Seven schools will be allocated to the intervention arm in year one using random sampling stratified by school-income. In year two, the seven control schools will receive the intervention. Intervention schools will implement the research-based PlayOn!® playground curriculum to promote active and inclusive play. After-school staff will be trained to teach activities that address social and emotional skills (e.g., conflict resolution) through physical activity. Participating students will be trained as peer leaders to extend the playground activities to the recess setting. This trial will assess between-group differences in physical activity, social and emotional health indicators, and number of health and behavior incidents among students attending intervention schools and control schools. Implementation outcomes will also be assessed among program facilitators at each school site. DISCUSSION: Enhancement of physical activity opportunities at schools has the potential for high impact and reach due to practicality. Enhancements can also improve quality pedagogy and curricula in after-school settings. Results of this project can inform practical strategies to improve existing after-school programs to prepare leaders (adults and children) to facilitate physical activity, positive social interactions, and emotional well-being. TRIAL REGISTRATION: ClinicalTrials.gov, NCT ID NCT05470621 , Registered July 22, 2022.

Building School Connectedness Through Structured Recreation During School: A Concurrent Mixed-Methods Study.

BACKGROUND: School connectedness (SC) is associated with improved health and academic outcomes. The purposes of this study were to explore factors contributing to students' perceptions of SC and if participation in structured recreation at school was associated with SC. METHODS: We used concurrent mixed-methods including cross-sectional qualitative data to explore factors contributing to SC among fifth- and sixth-grade students at 2 schools in Phoenix, AZ, USA (N = 330), and quantitative measures to explore the association between SC and recreation participation (N = 129). Students completed a journaling activity to identify factors contributing to feelings of SC. Responses were analyzed using both deductive and inductive approaches. Student surveys were analyzed using 1-way analyses of variance to assess differences between participation level and SC. RESULTS: Eight themes contributing to SC emerged: Relationships (peer, adult), Competence (competence), Autonomy (choice), Relax (relax), Recreation (structured, play), Fun (fun), Academics (academic learning), and Environment (food and safety). Participation in structured recreation programming in the classroom and at recess were associated with higher levels of SC (p < .05). CONCLUSIONS: School practitioners can integrate opportunities for structured recreation in the classroom and at recess as a fun and engaging strategy to foster adult support and peer relationships, enhancing SC.