10/29/2012

1

Grace Anne Edwards

Activity Promotion Laboratory

East Carolina University

8 th Annual Pediatric Healthy Weight Summit

November 2, 2012

Supported by a CPPW grant from Pitt County Health Department and the Centers for Disease Control and Prevention

� Children and adolescents should do 60 minutes (1 hour) or more of physical activity daily.

USDHHS. 2008

0%

5%

10%

15%

20%

25%

30%

35%

40%

45%

50%

Males Females Total

49%

35%

42%

12%

3%

8%

Ages 6-11

Ages 12-15

Troiano et al. 2008 MSSE

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2

0%

10%

20%

30%

40%

50%

60%

70%

Girls Boys

Pe

rce

nta

ge

Me

eti

ng

Gu

ide

lin

es

60 min/day of Physical Activity

Normal Weight

At Risk/Overweight

*

*

Patrick et al. 2004 APAM

* p < .01

� 8.4 million children (K-12) in US (15%)

� 179,874 children (K-12) in NC (12%)

� Number is likely to increase due to• Shifting family demographics

• Increased attention to academic performance & prevention of problem behaviors in schools

• Intensified focus on positive youth development

Afterschool Alliance. 2009

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3

0

0.1

0.2

0.3

0.4

0.5

0.6

0.7

0.8

0.9

1

HighSuccess

ModerateSuccess

Low Success

Engagement Rate

Management & Climate

Cross et al. 2010 AJCP

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

HighSuccess

ModerateSuccess

Low Success

Bachelor's or Higher

Cross et al. 2010 AJCP

Trost et al. 2008 MSSE

42.6

40.8

20.3

Physical Activity (min)

Sedentary

Light

MVPA

N = 140

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4

Move More After-School Collaboration. 2009

�To examine the effect of an after-school physical activity program on:• physical activity

• aerobic fitness

• body composition

�Participants� Youth (grades K – 8)

� Recruited from 15 after-school programs

� 9 intervention

� 6 control group

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� Pitt County Community Schools & Recreation (PCCSR) ~ 630 children � 10 Sites

� 6 Sites randomly assigned to Intervention

� 4 Sites randomly assigned to Control

� Boys’ & Girls’ Clubs ~ 740 children� 5 Sites assigned to condition based on sample size

� 3 Intervention

� 2 Control

Intervention Control

Boys’ & Girls’ Clubs 74 75

PCCSR 85 43

Total 159 118

Number of ParticipantsAssessed with Accelerometers

Intervention Control

Boys’ & Girls’ Clubs 17 18

PCCSR 35 25

Total 52 43

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� 10-week Intervention

After-School Energizers

� Physical activities that promote:�Character development

�Life skills training

�Academic enrichment

� After-School Energizers�Led by after-school leader�Received 1.5 hr training at baseline�Received 1 hr training at 10-week

follow-up

� Duration of activity 10 – 30 min� At least one activity/day

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7

8th Annual Pediatric Healthy Weight Summit

8th Annual Pediatric Healthy Weight Summit

Intervention

Group

After-School

Energizers

n = 9

programs

ASE

Training

For Leaders

Baseline

Testing

After-

School

Energizers

10-Week

Follow-Up

Testing

Control

Site

Training

&

Booster

Training

After-

School

Energizers

20 –Week

Follow-Up

Testing

ASE

Booster

Training

After-

School

Energizers

1-School

Year

Post-Test

Control

Group

n = 6

programs Baseline

Testing

10-Week

Follow-Up

Testing

20 –Week

Follow-Up

Testing

ASE

Training

After-

School

Energizers

1-School

Year

Post-Test

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�Assessments �Physical Activity

� Pedometers (Accusplit 120 XLE)� Worn entire time at after-school

site for 5 consecutive days

� Accelerometers (ActiGraph GT1M)� Worn entire time at after-school

site for 5 consecutive days

�Body Composition�Height, weight, and BMI calculations

�Percent fat (triceps and calf skinfolds)

�Aerobic Fitness�PACER 20-meter multistage shuttle run

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�Descriptive statistics.

�Effect sizes� Calculated to estimate size of the

change from baseline to follow-up for intervention and control groups using Cohen’s delta.

Group Site Baseline10- Week

Follow-Up

Intervention

B&G Clubs

PCCSR

Control

B&G Clubs

PCCSR

B&G Clubs

0100020003000400050006000

Ste

ps

Baseline Follow-up

0100020003000400050006000

Ste

ps

Baseline Follow-up

PCCSR

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10

0

10

20

30

40

50

60

Intervention Control

Min

ute

s

Baseline

Follow-up

ES = 0.41 ES = 0.36

Moderate Physical Activity

0

4

8

12

16

20

24

28

32

Intervention Control

Min

ute

s

Baseline

Follow-up

ES = 0.31 ES = 0.23

MVPA

0

5

10

15

20

25

30

35

40

Intervention Control

Min

ute

s

Baseline

Follow-up

ES = 0.12 ES = 0.23

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11

0

500

1000

1500

2000

2500

3000

Intervention Control

Co

un

ts/m

in

Baseline

Follow-up

ES = -0.22 ES = 0.10

Percent Fat

0

5

10

15

20

25

30

Intervention Control

% f

at Baseline

Follow-up

ES = -0.02 ES = 0.05

BMI Percentile

0

10

20

30

40

50

60

70

80

90

100

Intervention Control

BM

I P

erc

en

tile

Baseline

Follow-up

ES = -0.05 ES = -0.08

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Aerobic Fitness

0

5

10

15

20

25

30

Intervention Control

PA

CE

R L

ap

s

Baseline

Follow-up

ES = 0.07 ES = 0.08

Percent Meeting After-School Activity Recommendations

0

10

20

30

40

50

60

70

80

90

100

Intervention Control

% M

ee

tin

g R

eco

mm

en

da

tio

ns

Baseline

Follow-up

62% 62% 58% 67%

� Limited control over after-school leaders’ frequency of implementation and efficiency in executing the activities.

� No control over level of activity during After-School Energizers implementation.

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� After-school physical activity intervention did not show improvements, compared to control group, in:

� Physical activity level

� Aerobic fitness

� Body composition

� Students accumulated an average of 28.3 minutes of MVPA during after-school hours

� Many children do not obtain recommended level of physical activity during after-school programs.

� Future after-school interventions should examine ways to increase physical activity opportunities.

� Enhance professional development training:� Leading physical activities

� Behavior management

� Classroom management

� Enhance professional “buy-in”

� Allocate intentional time for children to be active

� Tailor intervention in some manner to fit specific facility conditions (physical resources and environmental features)