Fuel for Fun: a cluster-randomized controlled study of cooking skills, eating behaviors, and physical activity of 4th graders and their families.

BACKGROUND: Childhood obesity remains a serious concern in the United States and in many other countries. Direct experience preparing and tasting healthful foods and increasing activity during the school day are promising prevention approaches. Engaging parents and families remains an important challenge. Fuel for Fun: Cooking with Kids Plus Parents and Play is a multi-component school- and family-based intervention for 4th graders and their families intended to promote positive food and activity environments, policies and behaviors at the individual, family and school levels. This paper describes the design and evaluation plan. METHODS/DESIGN: Four cohorts of 4th-graders and their parents from 8 schools in 2 districts in the same Northern Colorado region are participating in a 4-arm cluster randomized controlled trial. Theory-based Fuel for Fun consists of 5 components delivered over 1 school year: 1) Cooking with Kids - Colorado; an experiential classroom-based cooking and tasting curriculum, 2) Cafeteria Connections; cafeteria-based reinforcements of classroom food experiences using behavioral economic strategies, 3) SPARK active recess; a playground intervention to engage children in moderate to vigorous activity, 4) Fuel for Fun Family; multi-element supports targeting parents to reinforce the 3 school-based components at home, and 5) About Eating; an online interactive program for parents addressing constructs of eating competence and food resource management. Outcomes include child and parent measures of fruit and vegetable preferences and intake, cooking, physical activity, sedentary behaviors and attitudes. School level data assess lunch plate waste and physical activity at recess. In-depth diet and accelerometry assessments are collected with a subsample of parent-child dyads. Data are collected at baseline, immediately post-intervention at 7 months, and at 12 month follow-up. We anticipate recruiting 1320-1584 children and their parents over the length of the project. DISCUSSION: The Fuel for Fun study design allows for impact assessment of school-, family- and online parent-based intervention components separately and in combination. Study strengths include use of theory- and evidence-based programs, valid child and parent self-report instruments, and objective measures of food, cooking, and physical activity behaviors at the individual, family and school levels. Parent involvement and engagement is examined through multiple strategies. TRIAL REGISTRATION: Clinicaltrials.gov registration number NCT02491294 . Registered 7 July, 2015.

Establishing wrist-based cutpoints for the Actical accelerometer in elementary school-aged children.

BACKGROUND: The wrist has become a standard location for accelerometry (ACC) data collection, primarily to optimize compliance, yet interpretation of wrist ACC data is limited due to a lack of calibration studies. This study aimed to establish cutpoints for a wrist-mounted Actical accelerometer in 6- to 11-year-old children using 2 methods. METHODS: Metabolic and ACC data (15-sec epoch) were collected during 8 activities in 22 children ages 6-11. Linear regression (LR) and Receiver Operator Characteristics (ROC) were used to examine the relationship between METs and ACC counts. Cutpoints were established at < 1.5, 1.5-2.99, 3-5.99, and ≥ 6 METs for sedentary, light, moderate, and vigorous activity, respectively. Cutpoints were applied to a large, multiday sample of children (n = 269) to examine differences in cutpoints on minutes of moderate to vigorous PA (MVPA). RESULTS: LR and ROC yielded moderate cutpoints of 574 and 388, respectively. When applied to the large sample, LR and ROC cutpoints resulted in an estimated 83 and 140 minutes of daily MVPA, respectively. CONCLUSIONS: This study established wrist-mounted Actical cutpoints for children using 2 methods. The differences in cutpoints and their effect on estimates of MVPA in an independent sample highlight challenges associated with establishing cutpoints, suggesting that standardized calibration procedures be developed.

Changes in physical activity and sedentary behavior in a randomized trial of an internet-based versus workbook-based family intervention study.

BACKGROUND: The America on the Move (AOM) Family Intervention Program has been shown to prevent excess weight gain in overweight children. Providing intervention materials via the internet would have the potential to reach more families but may increase sedentary behavior. The purpose was to evaluate whether delivering the AOM Family Intervention via the internet versus printed workbook would have a similar impact on sedentary behaviors in children. METHODS: 131 children (age 8-12) were randomized to receive the AOM Family Intervention via the internet or workbook for 12 weeks. Changes in objectively measured sedentary time and moderate-to vigorous physical activity (MVPA) as well as self-reported screen time were compared between groups. RESULTS: There were no significant differences between groups in screen time, sedentary time, or MVPA at the end of the 12 week intervention. Families receiving the intervention via the internet were more likely to remain in the study (98% vs. 82%, P = .016). CONCLUSIONS: Using the internet to deliver the lifestyle intervention did not increase sedentary behavior in children. Attrition rates were lower when the program was delivered by internet versus via printed materials. These results provide support for using the internet to deliver healthy lifestyle programs for children.

A microgeographic analysis of physical activity behavior within elementary school grounds.

PURPOSE: There is little scholarship on physical activity among children within outdoor spaces and work is needed to advance the design of these spaces from "best practices" towards evidence-based design. This project examined how playground feature density relates to children's physical activity. DESIGN: We used the System for Observing Play and Leisure Activity to observe children's physical activity. SETTING: We observed children during school recess on 24 school grounds in the Denver metropolitan area of Colorado, in spring of 2010 and 2011. SUBJECTS: A total of 31,069 observations were made from an estimated 9900 children aged 5 to 12. These were aggregated and analyzed in 397 playground zones. MEASURES: We examined utilization, the number of children present in a particular activity zone during an observation, and the percentage of children engaged in moderate to vigorous physical activity as they relate to the density of constructed features on school playgrounds. ANALYSIS: Ordinary least-squares linear regression model assessed the relationship between playground feature density and the utilization and moderate to vigorous physical activity. RESULTS: Significant positive associations were observed between utilization and feature density among all children (ß = .20; p < .001) and a statistically significant but small association was observed between moderate to vigorous physical activity and feature density for girls (ß = .12; p = .013), but not for boys. CONCLUSION: This analysis contributes to evidence that design features of play spaces may influence children's behavior within school grounds.

Architectural design and physical activity: an observational study of staircase and elevator use in different buildings.

BACKGROUND: The indoor built environment has the potential to influence levels of physical activity. However, the extent to which architectural design in commercial buildings can influence the percentage of people choosing to use the stairs versus elevators is unknown. The purpose of this study was to determine if buildings with centrally located, accessible, and aesthetically pleasing staircases result in a greater percentage of people taking the stairs. METHODS: Direct observations of stair and elevator use were conducted in 3 buildings on a university campus. One of the buildings had a bank of 4 centrally located elevators and a fire escape stairwell behind a steel door. The other 2 buildings had centrally located staircases and out-of-the-way elevators. RESULTS: The percentage of people who ascended the stairs was 8.1% in the elevator-centric building, compared with 72.8% and 81.1% in the 2 stair-centric buildings (P < .001). In addition, the percentage of people who descended the stairs was 10.8% in the first building, compared with 89.5% and 93.7% in the stair-centric buildings (P < .001). CONCLUSIONS: The results of the current study suggest that if buildings are constructed with centrally located, accessible, and aesthetically pleasing staircases, a greater percentage of people will choose to take the stairs.

Automatic recognition of postural allocations.

A significant part of daily energy expenditure may be attributed to non-exercise activity thermogenesis and exercise activity thermogenesis. Automatic recognition of postural allocations such as standing or sitting can be used in behavioral modification programs aimed at minimizing static postures. In this paper we propose a shoe-based device and related pattern recognition methodology for recognition of postural allocations. Inexpensive technology allows implementation of this methodology as a part of footwear. The experimental results suggest high efficiency and reliability of the proposed approach.