Systematic observation of physical activity in afterschool programs: preliminary findings from Movin' Afterschool intervention. A school-based randomized controlled trial to improve physical activity among Iranian high school girls Mediators of Physical Activity Behavior Change in the “Girls on the Move” Intervention A cluster-randomized controlled trial of strategies to increase adolescents’ physical activity and motivation during physical education lessons: the Motivating Active Learning in Physical Education (MALP) trial Apps for IMproving FITness and Increasing Physical Activity Among Young People: The AIMFIT Pragmatic Randomized Controlled Trial Mediators of physical activity behavior change among women with young children. A group-randomized controlled trial for health promotion in Girl Scouts: Healthier Troops in a SNAP (Scouting Nutrition & Activity Program) A comprehensive physical activity promotion programme at elementary school: the effects on physical activity, physical fitness and psychosocial correlates of physical activity. Changes in physical activity levels, lesson context, and teacher interaction during physical education in culturally and linguistically diverse Australian schools Design of a 20-month comprehensive, multicomponent school-based randomised trial to promote healthy weight development among 11-13 year olds: The HEalth In Adolescents study Does school-based physical activity decrease overweight and obesity in children aged 6–9 years? A two-year non-randomized longitudinal intervention study in the Czech Republic ICAPS: a multilevel program to improve physical activity in adolescents. Children, parents and pets exercising together (CPET): exploratory randomised controlled trial Effect of physical activity guidelines on physical function in older adults. Association of physical activity and dietary behaviours in relation to the body mass index in a national sample of Iranian children and adolescents: CASPIAN Study. One-year changes in physical activity and sedentary behavior among adolescents: the Croatian Physical Activity in Adolescence Longitudinal Study (CRO-PALS). Correlates of cardiorespiratory and muscular fitness among Brazilian adolescents. Physical activity and its correlates in children: a cross-sectional study (the GINIplus & LISAplus studies) Challenge! Health Promotion/Obesity Prevention Mentorship Model Among Urban, Black Adolescents Physical activity and skills intervention: SCORES cluster randomized controlled trial. A Fitbit and Facebook mHealth intervention for promoting physical activity among adolescent and young adult childhood cancer survivors: A pilot study The Effects of Physical Activity on Health and Quality of Life in Adolescent Cancer Survivors: A Systematic Review Individuals Underestimate Moderate and Vigorous Intensity Physical Activity
BACKGROUND National and state organizations have called upon afterschool programs ( 3 - 6 PM , ASP ) to promote physical activity ( PA ) .  Few strategies exist that ASPs can use to increase the PA of children enrolled . This study evaluated a policy-level intervention ( Movin ' Afterschool , MAS ) design ed to increase  PA  through staff implemented policy-level changes and ongoing technical support . METHODS Twelve preexisting community-based ASPs serving 580 children ( 5 - 12 yrs , 57 % girls ) were invited to take part in MAS . Evaluation of children 's PA , staff behaviors ( engaged or promote PA , other ASP tasks , general supervising ) , and environmental features ( equipment , organized PA ) at baseline ( Fall 2010 ) and post assessment ( Spring 2011 ) were collected using SOPLAY ( System for Observing Play and Leisure Activity in Youth ) for boys and girls , separately . R and om effects models evaluated changes in PA categories ( sedentary , walking , vigorous ) . RESULTS The percentage of boys and girls sedentary decreased by 11.8 % and 11.4 % , respectively . Girls ' walking increased by 6.9 % while boys ' vigorous PA increased by 6.5 % . Greater increases in vigorous activity were observed as post assessment in organized activities for boys and during indoor activities for girls . CONCLUSIONS Findings indicate a policy-level approach targeting staff training and ongoing technical support can produce notable increases in  PA  within the ASP setting Background  Physical activity ( PA ) rates decline precipitously during the high school years and are consistently lower among adolescent girls than adolescent boys . Due to cultural barriers , this problem might be exacerbated in female Iranian adolescents . However , little intervention research has been conducted to try to increase PA participation rates with this population . Because PA interventions in schools have the potential to reach many children and adolescents , this study reports on PA intervention research conducted in all-female Iranian high schools . Methods A r and omized controlled trial was conducted to examine the effects of two six-month tailored interventions on potential determinants of  PA and PA behavior .  Students ( N = 161 ) were r and omly allocated to one of three conditions : an intervention based on Pender 's Health Promotion model ( HP ) , an intervention based on an integration of the health promotion model and selected constructs from the Transtheoretical model ( THP ) , and a control group ( CON ) . Measures were administered prior to the intervention , at post-intervention and at a six-month follow-up . Results Repeated measure ANOVAs showed a significant interaction between group and time for perceived benefits , self efficacy , interpersonal norms , social support , behavioral processes , and PA behavior , indicating that both intervention groups significantly improved across the 24-week intervention , whereas the control group did not . Participants in the THP group showed greater use of counter conditioning and stimulus control at post-intervention and at follow-up . While there were no significant differences in PA between the HP and CON groups at follow-up , a significant difference was still found between the THP and the CON group . Conclusion This study provides the first evidence of the effectiveness of a PA intervention based on Pender 's HP model combined with selected aspects of the TTM on potential determinants to increase PA among Iranian high school girls Background The minimal effect of interventions to date on increasing young adolescent girls ’ physical activity ( PA ) may be due to inadequate underst and ing of the mechanisms underlying behavior change , yet sparse research testing a PA intervention has examined the capacity of theories to explain PA , particularly when using objective measures . Objectives The aim of the study was to examine whether constructs from the health promotion model and self-determination theory mediated changes in moderate-to-vigorous physical activity ( MVPA ) following a 17-week intervention . Methods The study was a secondary analysis of data from a group r and omized trial , including 12 intervention and 12 control schools in the Midwestern United States . Data were collected in 2012–2016 . Girls ( fifth- to eighth- grade , N = 1,519 ) completed surveys on  perceived benefits and enjoyment of PA , PA self-efficacy , social support and motivation for PA , and barriers to PA and wore accelerometers . Results The final path model had a good fit : χ2(4 ) = 2.48 , p = .648 ; goodness-of-fit index = 1 ; comparative fit index = 1 ; root-mean-square error of approximation = 0 ; st and ardized root-mean-square residual = 0.01 . For MVPA change from baseline to postintervention , enjoyment ( B = 24.48 , p < .001 ) and social support ( B = 30.48 , p < .001 ) had a positive direct effect , whereas the intervention had a positive indirect effect through enjoyment and social support ( B = 9.13 , p < .001 ) . Enjoyment ( B = −13.83 , p < .001 ) and social support ( B = −17.22 , p < .001 ) had a negative indirect effect on MVPA change from postintervention to follow-up . Discussion Enjoyment of PA and social support for PA may be important mediators of  PA in young adolescent girls and warrant consideration when design ing interventions Background The physical activity ( PA ) levels of many children and adolescents in Australia are currently insufficient to promote health benefits . Physical education ( PE ) programs aim to promote PA and reach nearly all school-aged children , but PA levels within PE lessons are often low . PE teachers may influence children ’s motivation to be physically active in PE lessons , but little is known about teacher strategies that effectively motivate children to participate in PA , and few intervention studies have examined motivational strategies in PE . The purpose of this study was to compare the effect of three motivational strategies , each based on Self-Determination Theory ( SDT ) , on PA levels , and their hypothesized antecedents , during year 8 PE lessons . Methods / design This study employed a cluster-r and omized controlled trial design . Following a familiarization session , PA levels and hypothesized PA antecedents were measured during a baseline lesson and a post-intervention or control lesson .  Teachers ( n = 16 ) and their classes from five secondary schools in Sydney , Australia were r and omly assigned into four blocks and instructed to provide one of four 20-min lesson teaching strategy conditions : ( 1 ) explaining the relevance of activities ; ( 2 ) providing choice from PA options selected by the teacher ; ( 3 ) providing equipment and free choice of activities ; or ( 4 ) usual practice . The primary outcomes were lesson time spent in moderate-to-vigorous PA , and motivation towards the lesson . Secondary outcomes were perceptions of teacher behavior , psychological needs satisfaction , and lesson time spent in sedentary behavior . PA and sedentary behavior were measured during baseline and post-intervention lessons with waist-mounted Actigraph GT3X accelerometers . Teacher behavior , psychological needs satisfaction , and motivation were assessed via question naires at the end of each lesson . Linear mixed-model analyses will be run on all outcomes , with students nested within teachers as a r and om effect . Discussion Study findings will inform the development of effective SDT-based teaching strategy interventions to enhance students ’ psychological needs satisfaction , motivation , and PA levels . More effective teaching strategies may be identified that are capable of improving  adolescents ’ PA levels , and thereby provide beneficial population health outcomes .Trial registration This trial is registered with Current Controlled Trials and is traceable as IS RCT N07038258 Background Given the global prevalence of insufficient physical activity ( PA ) , effective interventions that attenuate age-related decline in PA levels are needed . Mobile phone interventions that positively affect health ( mHealth ) show promise ; however , their impact on PA levels and fitness in young people is unclear and little is known about what makes a good mHealth app . Objective The aim was to determine the effects of two commercially available smartphone apps ( Zombies , Run and Get Running ) on cardiorespiratory fitness and PA levels in insufficiently active healthy young people . A second aim was to identify the features of the app design that may contribute to improved fitness and PA levels . Methods Apps for IMproving FITness ( AIM FIT ) was a 3-arm , parallel , r and omized controlled trial conducted in Auckl and , New Zeal and . Participants were recruited through advertisements in electronic mailing lists , local newspapers , flyers posted in community locations , and presentations at schools . Eligible young people aged 14 - 17 years were allocated at r and om to 1 of 3 conditions : ( 1 ) use of an immersive app ( Zombies , Run ) , ( 2 ) use of a nonimmersive app ( Get Running ) , or ( 3 ) usual behavior ( control ) . Both smartphone apps consisted of a fully automated 8-week training program design ed to improve fitness and ability to run 5 km ; however , the immersive app featured a game-themed design and narrative . Intention-to-treat analysis was performed using data collected face-to-face at baseline and 8 weeks , and all regression models were adjusted for baseline outcome value and gender . The primary outcome was cardiorespiratory fitness , objective ly assessed as time to complete the 1-mile run/walk test at 8 weeks . Secondary outcomes were PA levels ( accelerometry and self-reported ) , enjoyment , psychological need satisfaction , self-efficacy , and acceptability and usability of the apps . Results A total of 51 participants were r and omized to the immersive app intervention ( n=17 ) , nonimmersive app intervention ( n=16 ) , or the control group ( n=18 ) . The mean age of participants was 15.7 ( SD 1.2 ) years ; participants were mostly NZ Europeans ( 61 % , 31/51 ) and 57 % ( 29/51 ) were female . Overall retention rate was 96 % ( 49/51 ) . There was no significant intervention effect on the primary outcome using either of the apps . Compared to the control , time to complete the fitness test was –28.4 seconds shorter ( 95 % CI –66.5 to 9.82 , P=.20 ) for the immersive app group and –24.7 seconds ( 95 % CI –63.5 to 14.2 , P=.32 ) for the nonimmersive app group . No significant intervention effects were found for secondary outcomes . Conclusions Although apps have the ability to increase reach at a low cost , our pragmatic approach using readily available commercial apps as a st and -alone instrument did not have a significant effect on fitness . However , interest in future use of PA apps is promising and highlights a potentially important role of these tools in a multifaceted approach to increase fitness , promote PA , and consequently reduce the adverse health outcomes associated with insufficient activity . Trial Registration Australian New Zeal and Clinical Trials Registry : ACTRN12613001030763 ; https://www.anzctr.org.au/Trial/ Registration /Trial Review .aspx?ACTRN=12613001030763 ( Archived by WebCite at http://www.webcitation.org/6aasfJVTJ ) BACKGROUND Women with children are less likely to engage in  adequate physical activity ( PA )  than women without children . This study aim ed to evaluate the efficacy of two strategies for promoting increased  PA  among mothers of preschool-aged children , and to explore the mediators of any result ing change in PA behavior . DESIGN Controlled intervention trial incorporating repeated data collection from 554 women , r and omized to one of three experimental conditions . Intervention Group 1 served as a control , while women in Groups 2 and 3 were given print information about overcoming PA barriers . Women in Group 3 were also invited to discuss the development of local strategies for the promotion of PA among mothers of young children . The primary strategies included increasing partner support , social advocacy , and capacity building , and were implemented through collaboration among participants , research ers , and community organizations . MAIN OUTCOME MEASURES Adequate physical activity ( PA ) , self-efficacy ( SE ) and partner support ( PS ) . RESULTS Following the intervention , women in Group 3 were significantly more likely to meet guidelines for PA than controls ( odds ratio [OR]=1.71 , confidence interval [CI]=1.05 - 2.77 ) ] after controlling for age and PA at baseline . After controlling for baseline PA , residualized change in SE ( OR=1.86 , CI=1.17 - 2.94 ) and PS ( OR=2.29 , CI=1.46 - 3.58 ) significantly predicted meeting guidelines . After controlling for residual change in PS and SE , the significant intervention effect was attenuated ( Group 3 OR=1.40 , CI=0.76 - 2.36 ) , indicating that partner support and self-efficacy may be mediators of physical activity behavior change . CONCLUSIONS The findings indicate that community participation approaches that facilitate increased self-efficacy and partner support can be effective in increasing PA  among mothers of young children Background  Girl Scouting may offer a viable channel for health promotion and obesity prevention programs . This study evaluated the effectiveness of an intervention program delivered through Girl Scout Junior troops that was design ed to foster healthful troop meeting environments and increase obesity prevention behaviors at home . Methods Seven Girl Scout troops were r and omized to intervention ( n = 3 , with 34 girls ) or st and ard-care control ( n = 4 , with 42 girls ) conditions . Girls ranged in age from 9 to 13 years ( mean 10.5 years ) . Intervention troop leaders were trained to implement policies promoting physical activity ( PA ) and healthful eating opportunities at troop meetings , and to implement a curriculum promoting obesity-prevention behaviors at home . The primary outcome variable was child body mass index ( BMI ) z-score . Secondary outcomes included accelerometer-assessed PA levels in troop meetings , direct observations of snack offerings , time spent in physically active meeting content , and leader encouragement of PA and healthful eating . Results The intervention was delivered with good fidelity , and intervention troops provided greater opportunities for healthful eating and PA ( x2 = 210.8 , p < .001 ) , relative to control troops . In troop meetings , intervention troop leaders promoted  PA  ( x2 = 23.46 , p < .001 ) and healthful eating ( x2 = 18.14 , p < .001 ) more frequently , and discouraged healthful eating and PA less frequently ( x2 = 9.63 , p = .002 ) compared to control troop leaders . Most effects of the intervention on individual-level variables of girls and parents were not significantly different from the control condition , including the primary outcome of child BMI z-score ( F1 , 5 = 0.42 , p = .544 ) , parent BMI ( F1 , 5 = 1.58 , p = .264 ) , and related behavioral variables . The notable exception was for objective ly assessed troop PA , wherein girls in intervention troops accumulated significantly less sedentary ( x2 = 6.3 , p = .011 ) , significantly more moderate ( x2 = 8.2 , p = .004 ) , and more moderate-to-vigorous physical activity , ( x2 = 18.4 , p < .001 ) , than girls in control troops . Conclusions Implementing a health promotion curriculum and supporting policies to provide more healthful environments in Girl Scout troop meetings appears feasible on a broader scale . Additional work is needed to bridge health promotion from such setting s to other environments if lasting individual-level behavior change and obesity prevention remain targeted outcomes . Trial registration number : OBJECTIVE To evaluate the effects of a comprehensive physical activity ( PA ) promotion programme in elementary schools on children 's total PA levels , leisure-time PA , physical fitness and psychosocial correlates of PA . DESIGN A pre-test-post-test design over two school years . SETTING AND SUBJECTS Sixteen elementary schools ( 764 children , mean age : 11.2 + /- 0.7 years ) were r and omly assigned to the intervention condition ( n = 8) and the control condition ( n = 8) . The intervention included a health-related physical education programme , an extracurricular PA promotion programme and classroom-based PA education lessons . In the total sample , leisure-time PA , psychosocial correlates of PA and physical fitness were measured using a PA question naire and the Eurofit test battery . In a sub- sample , total PA levels were measured using an accelerometer . RESULTS According to accelerometer data , children 's moderate PA and moderate-to-vigorous PA ( MVPA ) levels decreased less in the intervention schools than in the control schools ( P < 0.01 ) . The average time spent on MVPA decreased by 9 min per day in the intervention schools compared with 33 min per day in the control schools . Children in the intervention schools reported significantly more moderate PA in leisure time than the controls ( P < 0.05 ) . No overall improvement of physical fitness and no effects on the psychosocial correlates of PA were found . CONCLUSIONS The comprehensive PA promotion programme was successful in preventing a decline in children 's  total activity levels . Furthermore , the intervention increased children 's PA engagement in leisure time . Therefore , implementation needs to be encouraged Background Recent data show that only 15 % of Australian adolescents participate in adequate amounts of physical activity ( PA ) and those students from Asian and Middle-Eastern background s in Grade s 6–12 are significantly less active than their English-speaking background peers . Schools have recently been recognised as the most widely used and cost-effective setting for promoting PA among youth and one domain within schools where PA can occur regularly for all youth , regardless of cultural background or socio-economic status , is during physical education ( PE ) . Methods This study describes changes in physical activity ( PA ) , lesson context and teacher interaction in physical education over the first two years in culturally and linguistically diverse secondary schools . Grade 7 PE classes in six schools were r and omly observed using systematic direct observation ( n = 81 ) and then followed up over the same period ( n = 51 ) twelve months later . Results There was no significant decline in moderate-to-vigorous physical activity ( MVPA ) during PE ( MD = −4.8 % ; p = .777 ) , but a significant decline and medium negative effect in time spent in vigorous physical activity ( VPA ) ( MD = −7.9 % ; p = .009 ) during PE was observed . Significant declines and large negative effects over time in percentage of PE time spent in management ( MD = −8.8 % ; p < .001 ) and the number of observations where teachers promoted  PA ( MD = −20.7 % ; p < .001 ) . Conclusions The decline of VPA and teacher promotion of PA in culturally and linguistically diverse schools is of concern . Given the declines in VPA and the increases in time spent in game play , further research is needed to ascertain whether PE instruction could be improved by focussing on skill instruction and fitness in a games-based PE instruction model . Further research for increasing teacher promotion of PA during PE is needed Background and purpose : The lack of effective school-based interventions for preventing obesity in children has caused a call for longer duration of interventions and better reporting on design and evaluation methodology . The purpose of this paper is to present the development of the intervention , the design of the effectiveness study , and the test-retest reliability of the main outcome measures in the HEalth In Adolescents ( HEIA ) study . Methods / design : The HEIA intervention programme was developed based on literature review s , a social ecological framework , and focus groups . The intervention aim ed to increase total physical activity ( PA ) and consumption of fruit and vegetables and to decrease screen time and consumption of sugar-sweetened beverages . The intervention programme consisted of a classroom component , including dietary behaviour lessons , computer tailoring , fruit/vegetable and PA breaks , and posters , and an environmental component including active transport campaigns , equipment , suggestions for easy improvements of schoolyards , inspirational courses for teachers ( all with regards to PA ) , and fact sheets to parents . The effect of the intervention programme is evaluated in a cluster r and omised controlled trial design ( intervention = 12 schools , control = 25 schools ) including process evaluation . Main outcomes include anthropometry , PA , screen time , and consumption of fruit , vegetables , and sugar-sweetened beverages . A 2-week test— retest study was conducted among 114 pupils . Determinants of the behaviours were assessed . Similar data were collected from parents . Children ’s PA was measured objective ly by accelerometers . Conclusions : The HEIA study represents a theoretically informed r and omised trial comprising a comprehensive set of multilevel intervention components with a thorough evaluation using reliable outcome measures . The study will contribute to a better underst and ing of determinants of healthy weight development among young people and how such determinants can be modified Background Globally , efforts aim ed at the prevention of childhood obesity have led to the implementation of a range of school-based interventions . This study assessed whether augmenting physical activity ( PA ) within the school setting result ed in increased daily PA and decreased overweight/obesity levels in 6 - 9-year-old children . Methods Across the first to third primary school years , PA of 84 girls and 92 boys was objective ly monitored five times ( each for seven successive days ) using Yamax pedometer ( step counts ) and Caltrac accelerometer ( activity energy expenditure AEE - kcal/kg per day ) . Four schools were selected to participate in the research ( 2 intervention , 2 controls ) , comprising intervention ( 43 girls , 45 boys ) and control children ( 41 girls , 47 boys ) . The study was non-r and omized and the intervention schools were selected on the basis of existing PA-conducive environment . Analyses of variance ( ANOVA ) for repeated measures examined the PA programme and gender effects on the step counts and AEE . Logistic regression ( Enter method ) determined the obesity and overweight occurrence prospect over the course of implementation of the PA intervention . Results There was a significant increase of school-based PA during schooldays in intervention children ( from ≈ 1718 to ≈ 3247 steps per day ; and from 2.1 to ≈ 3.6 Kcal/Kg per day ) in comparison with the control children .  Increased school-based PA  of intervention children during schooldays contributed to them achieving > 10,500 steps and > 10.5 Kcal/Kg per school day across the 2 years of the study , and result ed in a stop of the decline in PA levels that is known to be associated with the increasing age of children .  Increased school-based PA  had also positive impact on leisure time PA of schooldays and on PA at weekends of intervention children . One year after the start of the PA intervention , the odds of being overweight or obese in the intervention children was almost three times lower than that of control children ( p < 0.005 ) , and these odds steadily decreased with the duration of the intervention . Conclusions The findings suggest that school-based PA ( Physical Education lessons , PA during short breaks and longer recesses , PA at after-school nursery ) in compatible active environments ( child-friendly gym and school playground , corridors with movement and playing around corners and for games ) has a vital role in obesity and overweight reduction among younger pupils OBJECTIVES ICAPS ( Intervention Centred on Adolescents ' Physical activity and Sedentary behaviour ) is aim ed at preventing excessive weight gain and cardiovascular risk in adolescents by promoting physical activity ( PA ) with an emphasis on recreational and daily-life PA , with a lifelong perspective . DESIGN R and omized study design ed to last for four years . Study cohort constituted of 954 first-level students ( 91 % of eligible pupils ) , aged 11.7 + /- 0.6 y ( mean + /- SD ) from four pairs of schools r and omly selected in eastern France , after sociogeographical stratification . In each pair , intervention status was r and omised at school-level . The program , not limited to school setting s , involves multiple partners with three objectives : 1 ) changing attitudes through debates and access to attractive activities during breaks and after-school hours , 2 ) encouraging social support , 3 ) providing environmental conditions that enable PA . Adapted times and places , open participation , emphasis on fun , meeting with others and absence of competitive aspects are used to reduce usual barriers to PA .  Accessibility and safety are permanent concerns . RESULTS Prevalence of overweight was 23.7 % . High participation rates were attained ( 50 % participated in at least one weekly activity ) . At six-month , the proportion of intervention adolescents  not performing supervised PA out of academic PA  was reduced by half ( 36 % to 17 % vs 42 % to 42 % in controls P < 10 - 4 ) ; the proportion of those spending > 3 h/day in sedentary occupations decreased ( 34 % to 28 % vs 27 % to 36 % ; P < 10 - 4 ) . CONCLUSION These data demonstrate the feasibility of implementing a multilevel PA intervention program in adolescents . Six-month results document increased PA  and decreased sedentary behaviour Background Levels of physical activity ( PA ) in UK children are much lower than recommended and novel approaches to its promotion are needed . The Children , Parents and Pets Exercising Together ( CPET ) study is the first exploratory r and omised controlled trial ( RCT ) to develop and evaluate an intervention aim ed at dog-based PA promotion in families . CPET aim ed to assess the feasibility , acceptability and potential efficacy of a theory-driven , family-based , dog walking intervention for 9–11 year olds . Methods Twenty-eight families were allocated r and omly to either receive a 10-week dog based PA intervention or to a control group . Families in the intervention group were motivated and supported to increase the frequency , intensity and duration of dog walking using a number of behaviour change techniques . Parents in the intervention group were asked to complete a short study exit question naire . In addition , focus groups with parents and children in the intervention group , and with key stakeholders were undertaken . The primary outcome measure was 10 week change in total volume of PA using the mean accelerometer count per minute ( cpm ) . Intervention and control groups were compared using analysis of covariance . Analysis was performed on an intention to treat basis . Results Twenty five families were retained at follow up ( 89 % ) and 97 % of all outcome data were collected at baseline and follow up . Thirteen of 14 ( 93 % ) intervention group parents available at follow up completed the study exit question naire and noted that study outcome measures were acceptable . There was a mean difference in child total volume of PA of 27 cpm ( 95 % CI -70 , 123 ) and -3 cpm ( 95 % CI -60 , 54 ) for intervention and control group children , respectively . This was not statistically significant . Approximately 21 % of dog walking time for parents and 39 % of dog walking time for children was moderate-vigorous PA . Conclusions The acceptability of the CPET intervention and outcome measures was high . Using pet dogs as the agent of lifestyle change in PA interventions in children and their parents is both feasible and acceptable , but did not result in a significant increase in child PA in this exploratory trial . Trial registration IS RCT OBJECTIVES To determine whether elderly people who meet national guidelines have higher physical function ( PF ) scores than those who do not and the effect on functional trajectory when physical activity ( PA ) levels change from above to below this threshold , or vice versa . DESIGN Pooled data . SETTING Two 6-month r and omized controlled trials aim ed at increasing PA in adults . PARTICIPANTS Adults aged 65 to 94 ( N=357 ) . INTERVENTION PA counseling over the telephone and through mailed material s. MEASUREMENTS  Self-reported PA  dichotomized at 150 minutes/week and PF using the Medical Outcomes Study 36-item Short Form Question naire PF subscale . RESULTS At baseline , individuals reporting 150 minutes or more of moderate PA/week had mean PF scores that were 20.3 points higher than those who did not ( P<.001 ) . Change in PA minutes from above threshold to below threshold or from below threshold to above threshold from baseline to 6 months result ed in an average change in PF of -11.18 ( P<.001 ) and + 5.10 ( P=.05 ) , respectively . CONCLUSION These findings suggest that PA is an important predictor of functional status . Older sedentary adults can improve PF by meeting recommended PA levels . Conversely , dropping below recommended PA levels has a deleterious effect on PF . Given the importance of PF in maintenance of independence and quality of life in older adults , adherence to recommended PA guidelines should be endorsed OBJECTIVE To examine the relation of dietary and physical activity ( PA ) patterns with the body mass index ( BMI ) , and the associations between these patterns among children . METHODS A representative sample of 21 111 school students aged 6 - 18 years was selected by multistage r and om cluster sampling from 23 provinces in the Islamic Republic of Iran .  PA and dietary pattern  were assessed by self-administered vali date d question naires . FINDINGS Fruit and vegetables , dairy products and snacks ( salty , fatty or sweet ) had a similar consumption frequency of approximately twice a day . The type of fat most frequently consumed was hydrogenated solid fat ( consumed by 73.8 % of families ) . The  PA level was significantly higher among boys than girls , in rural than in urban residents , and in intermediate students than high-school students . Among boys , the frequency of consumption of vegetables and plant proteins  ( R(2 ) = 0.46 ) ; and among girls , the frequency of consumption of dairy products and fruits  , as well as  high PA level had a significant inverse association with BMI ( R(2 ) = 0.57 ) . Among boys , the low frequency of consumption of fruits , the time spent on PA and the energy expenditure ; and among girls , the time spent on PA and the energy expenditure , had significant relationships with overweight . When controlling for covariates ,  PA levels had significant relationships with the frequency of consumption of all food groups . CONCLUSION Unhealthy lifestyles make Iranian young people prone to chronic diseases later in life . When examining their health benefits , the interrelationship of dietary and PA behaviours should be considered Background Little is known about the concurrent change in  physical activity ( PA )  ,  sedentary behavior ( SB ) and  sport participation  ( SP ) during adolescence . The main purpose of this prospect i ve and partly objective study was to simultaneously investigate PA , SBs and SP changes between the 1st and 2nd grade s of high school in urban adolescents . Methods In this 1-year follow-up study , the participants were 81 secondary -school students ( 28 boys and 53 girls ) aged 15.5 years at the baseline .  PA was assessed with the SenseWear Armb and multi-sensor activity monitor , while SBs were assessed by using School Health Action , Planning and Evaluation System ( SHAPES ) PA question naire . The SHAPES question naire was supplemented with two questions inquiring about SP in organized sports in school and outside of school . Results PA decreased markedly in both genders between the 1st and 2nd grade s of high school . Total energy expenditure ( TEE ) was reduced by 13 kcal/kg/day on average in boys and by 10 kcal/kg/day in girls ( p for both < 0.001 ) , while mean daily active energy expenditure ( AEE ) decreased by 7 kcal/kg/day ( p < 0.001 ) and 3 kcal/kg/day ( p = 0.04 ) in boys and girls , respectively . Similarly , the amount of moderate PA declined by 49 min/day in boys and 21 min/day in girls ( p for both < 0.001 ) . At the same time vigorous PA was cut by 14 min/day ( p < 0.001 ) and 3 min/day ( p = 0.003 ) in boys and girls , respectively . Conversely , time spent in SBs did not show any change . Conclusion In conclusion , a decline in PA between the 1st and 2nd grade s of high school was marked but was not accompanied with an increase in SBs . Policies aim ed at increasing PA should be targeting the period of entering secondary school to offset the observed drop in PA OBJECTIVE To analyze socioeconomic indicators , physical activity ( PA ) opportunities , and behavioral correlates of cardiorespiratory and muscular fitness among Brazilian boys and girls . METHODS A sample of 1555 adolescents was r and omly selected . Age- and sex-specific st and ard scores were calculated for each fitness component . RESULTS Among boys , head of household 's schooling , involvement in organized PA , meeting the PA recommendations , and computer/games use were associated with cardiorespiratory fitness . Involvement in organized PA and active time in Physical Education ( PE ) classes were predictors of muscular fitness . Among girls , active time in PE classes and TV watching were predictors of cardiorespiratory fitness . Meeting the PA recommendations was associated with muscular fitness . CONCLUSION PA variables and sedentary behaviors should be independently considered for physical fitness promotion in youth Background Physical inactivity  among children is an increasing problem that adversely affects children ’s health . A better underst and ing of factors which affect  physical activity ( PA ) will help create effective interventions aim ed at raising the activity levels of children . This cross-sectional study examined the associations of PA with individual ( biological , social , behavioral , psychological ) and environmental ( East vs. West Germany , rural vs. urban regions ) characteristics in children . Methods Information on PA and potential correlates was collected from 1843 girls and 1997 boys using question naires during the 10-year follow-up of two prospect i ve birth cohort studies ( GINIplus and LISAplus ) . Study regions represent urban and rural sites as well as East and West of Germany . Logistic regression modeling was applied to examine cross-sectional associations between individual as well as environmental factors and  PA levels . Results Five of fourteen variables were significantly associated with  PA .  Among children aged 10 , girls tended to be less active than boys , especially with respect to vigorous PA ( OR = 0.72 for summer ) . Children who were not a member of a sports club showed a substantially reduced amount of PA in winter ( OR = 0.15 ) . Rural environments promote moderate PA  , particularly in winter ( OR = 1.88 ) , whereas an increased time outdoors primarily promotes moderate PA in summer ( OR = 12.41 ) . Children with abnormal emotional symptoms  exhibited reduced physical activity , particularly in winter ( OR = 0.60 ) . BMI , puberty , parental BMI , parental education , household income , siblings , TV/PC consumption , and method of arriving school , were not associated with PA . Conclusions When considering correlates of PA from several domains simultaneously , only few factors ( sex , sports club membership , physical environment , time outdoors , and emotional symptoms ) appear to be relevant . Although the causality needs to be ascertained in longitudinal studies , variables which can not be modified should be used to identify risk groups while modifiable variables , such as sports club activities , may be addressed in intervention programs OBJECTIVES : The objective of this study was to evaluate a 12-session home/community-based health promotion/obesity prevention program ( Challenge ! ) on changes in BMI status , body composition , physical activity , and diet . METHODS : A total of 235 black adolescents ( aged 11–16 years ; 38 % overweight/obese ) were recruited from low-income urban communities . Baseline measures included weight , height , body composition , physical activity ( PA ) , and diet . PA was measured by 7-day play-equivalent physical activity ( ≥1800 activity counts per minute ) . Participants were r and omly assigned to health promotion/obesity prevention that is anchored in social cognitive theory and motivational interviewing and was delivered by college-aged black mentors or to control . Postintervention ( 11 months ) and delayed follow-up ( 24 months ) evaluations were conducted . Longitudinal analyses used multilevel models with r and om intercepts and generalized estimating equations , controlling for baseline age/gender . Stratified analyses examined baseline BMI category . RESULTS : Retention was 76 % over 2 years ; overweight/obese status declined 5 % among intervention adolescents and increased 11 % among control adolescents . Among overweight/obese youth , the intervention reduced total percentage of body fat and fat mass and increased fat-free mass at delayed follow-up and increased play-equivalent physical activity at postintervention but not at delayed follow-up . Intervention adolescents declined significantly more in snack/dessert consumption than control adolescents at both follow-up evaluations . CONCLUSIONS : At postintervention , there were intervention effects on diet and PA but not BMI category or body composition . At delayed follow-up , dietary changes were sustained and the intervention prevented an increase in BMI category . Body composition was improved for overweight/obese youth . Changes in body composition follow changes in diet and PA and may not be detected immediately after intervention PURPOSE  Physical activity ( PA  ) declines dramatically during adolescence , and activity levels are consistently lower among children living in low-income communities . Competency in a range of fundamental movement skills ( FMS ) may serve as a protective factor against the decline in PA typically observed during adolescence . The purpose of this study was to evaluate the effect of a 12-month multicomponent PA and FMS intervention on children attending primary schools in low-income communities . METHODS The Supporting Children 's Outcomes using Rewards , Exercise , and Skills intervention was evaluated using a cluster r and omized controlled trial . The sample included 25 classes from eight primary schools located in low-income communities . Participants were 460 children ( 54.1 % girls ) age 8.5 ± 0.6 yr . Primary outcomes were objective ly measured PA ( ActiGraph GT3X and GT3X+ accelerometers ) , FMS competency ( Test of Gross Motor Development 2 , six locomotor and six object control skills ) , and cardiorespiratory fitness ( 20-m multistage fitness test ) assessed at baseline , midprogram ( 6-months ) , and at posttest ( 12 months ) . Linear mixed models , adjusted for sex , age , body mass index z-score , socioeconomic status , ethnicity , and school class as a r and om factor , were used to assess the effect of the intervention . RESULTS At midprogram , there were no significant intervention effects for any of the outcomes . At posttest ( study 's primary time point ) , there were intervention effects for daily moderate-to-vigorous PA ( MVPA ) ( adjusted mean difference , 12.7 min·d of MVPA ; 95 % confidence interval ( CI ) , 5.0 - 20.5 ) , overall FMS competency ( 4.9 units ; 95 % CI , -0.04 to 9.8 ) , and cardiorespiratory fitness ( 5.4 laps ; 95 % CI , 2.3 - 8.6 ) . CONCLUSIONS A school-based multicomponent PA and FMS intervention maintained daily MVPA , improved overall FMS competency , and increased cardiorespiratory fitness among children attending primary schools in low-income communities BACKGROUND Physical activity ( PA ) may be important for preventing chronic diseases for adolescent and young adult ( AYA ) childhood cancer survivors . R and omized controlled trials ( RCTs ) of PA interventions for AYA survivors are sparse , but necessary to determine effective programs for increasing PA among this population . Thus , we conducted a pilot RCT , testing the feasibility of a mobile health ( mHealth ) intervention to promote PA among AYA survivors . PROCEDURE We recruited 14- to 18-year-olds who were ≥1-year post cancer therapy from Seattle Children 's Hospital . The 10-week intervention consisted of a wearable PA-tracking device ( Fitbit Flex ) and a peer-based virtual support group ( Facebook group ) . Research staff helped set step goals and awarded badges weekly . Controls received usual care . Baseline assessment s occurred before r and omization and follow-up assessment s occurred during weeks 8 - 10 of the intervention period . Feasibility criteria are defined below . Qualitative interviews assessed acceptability . Exploratory outcomes included PA , quality of life , and motivation for PA . RESULTS All feasibility criteria were met : we recruited 60 survivors , intervention participants wore the Fitbit  on the majority ( 71.5 % ) of intervention days , and ≥90 % of all participants completed question naires . Qualitative data confirmed intervention acceptability . Exploratory analyses found no significant adjusted group differences for change in moderate-to-vigorous PA ( 4.4 vs. 5.0 min/day ; P = 0.92 ) or sedentary time ( -4.5 vs. 1.0 min/day ; P = 0.73 ) , comparing intervention subjects to controls . Some modest differences were found for select subscales of quality of life and motivation for PA . CONCLUSIONS This mHealth PA intervention was feasible and acceptable to AYA childhood cancer survivors and warrants a fully powered RCT Background There are numerous published controlled trials assessing the safety and the benefits of physical activity ( PA ) for child and adult cancer survivors . However , trials exclusively comprised of adolescent cancer survivors aged 13 - 19 years , who may experience different health and quality of life ( QOL ) effects as a function of their developmental status , are lacking . Rather , some trials have included both adolescent and child cancer survivors together . Objective The aim of this systematic review was to synthesize the findings from r and omized controlled trails ( RCTs ) and controlled clinical trials ( CCTs ) investigating the effects of PA on health and QOL outcomes in sample s comprised of > 50 % adolescent cancer survivors to summarize the current state of evidence , identify knowledge gaps , and highlight areas in need of additional research within this population . Methods Using a search strategy developed for this review , 10 electronic data bases were search ed for RCTs and CCTs that reported on the effects of PA on at least 1 health and /or QOL outcome in sample s comprised of > 50 % adolescent cancer survivors . Results From the 2249 articles identified , 2 CCTs met the predetermined eligibility criteria and were included in this review . Combined , 28 adolescents ( of 41 participants ) who were receiving active treatment participated in the 2 studies review ed . A total of 4 health and QOL outcomes ( ie , bone mass , fatigue , grip strength , QOL ) were assessed pre- and post-PA intervention . Conclusions On the basis of the 2 studies review ed , PA appears to be safe and feasible .  PA also shows promise to mitigate reductions in bone mass and might be a viable strategy to improve fatigue , grip strength , and QOL . High- quality controlled trials with larger sample s exclusively comprised of adolescent cancer survivors that assess a wide range of outcomes are needed to determine the effects of PA on health and QOL outcomes in this population Background It is unclear whether the common physical activity ( PA ) intensity descriptors used in PA guidelines worldwide align with the associated percent heart rate maximum method used for prescribing relative PA intensities consistently between sexes , ethnicities , age categories and across body mass index ( BMI ) classifications . Objectives The objectives of this study were to determine whether individuals properly select light , moderate and vigorous intensity PA using the intensity descriptions in PA guidelines and determine if there are differences in estimation across sex , ethnicity , age and BMI classifications . Methods 129 adults were instructed to walk/jog at a “ light , ” “ moderate ” and “ vigorous effort ” in a r and omized order . The PA intensities were categorized as being below , at or above the following % HRmax ranges of : 50–63 % for light , 64–76 % for moderate and 77–93 % for vigorous effort . Results On average , people correctly estimated light effort as 51.5±8.3%HRmax but underestimated moderate effort as 58.7±10.7%HRmax and vigorous effort as 69.9±11.9%HRmax . Participants walked at a light intensity ( 57.4±10.5%HRmax ) when asked to walk at a pace that provided health benefits , wherein 52 % of participants walked at a light effort pace , 19 % walked at a moderate effort and 5 % walked at a vigorous effort pace . These results did not differ by sex , ethnicity or BMI class . However , younger adults  underestimated moderate and vigorous intensity more so than middle-aged adults ( P<0.05 ) . Conclusion When the common PA guideline descriptors were aligned with the associated % HRmax ranges , the majority of participants underestimated the intensity of PA that is needed to obtain health benefits . Thus , new subjective descriptions for moderate and vigorous intensity may be warranted to aid individuals in correctly interpreting PA intensities
Commonly employed behaviour change techniques within successful interventions included goals and planning , feedback and monitoring , social support and repetition and substitution .
Conclusions Walking interventions , particularly those conducted in the school environment , have the potential to increase PA in children and adolescents .
Conclusions on which interventions most effectively increased walking behaviours in this population were hindered by the limited number of identified interventions and the short duration of interventions evaluated .
Background  Physical activity ( PA ) levels decline as children move into adolescence , with this decline more notable in girls .
As a consequence , many young people are failing to meet current PA guidelines .
Walking has been a cornerstone of PA promotion in adults and may provide an effective means of increasing PA levels among younger people .
Objective Our objective was to conduct a systematic review of interventions aim ed at promoting increased levels of walking  among children and adolescents .