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Feasibility of a Home-Delivered Internet Obesity Prevention Program for Fourth-Grade Students

Scott Owens, Laurel Lambert, Suzanne McDonough, Kenneth Green, and Mark Loftin

This pilot study examined the feasibility of an interactive obesity prevention program delivered to a class of fourth-grade students utilizing daily e-mail messages sent to the students’ home computers. The study involved a single intact class of 22 students, 17 (77%) of whom submitted parental permission documentation and received e-mail messages each school day over the course of one month. Concerns regarding Internet safety and children’s use of e-mail were addressed fairly easily. Cost/benefit issues for the school did not seem prohibitive. Providing e-mail access to students without a home computer was accomplished by loaning them personal digital assistant (PDA) devices. In larger interventions, loaning PDAs is probably not feasible economically, although cell phones may be an acceptable alternative. It was concluded that this type of interactive obesity prevention program is feasible from most perspectives. Data from a larger scale effectiveness study is still needed.

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Best Practice Recommendations for Prevention of Sudden Death in Secondary School Athletes: An Update

Riana R. Pryor, Robert A. Huggins, and Douglas J. Casa

The aim of the recent Inter-Association Task Force held in Washington, D.C. at the 2013 Youth Safety Summit determined best practice recommendations for preventing sudden death in secondary school athletics. This document highlights the major health and safety practices and policies in high school athletics that are paramount to keep student athletes safe. The purpose of this commentary is to review the findings of the document developed by the task force and to provide possible areas where research is needed to continue to educate medical practitioners, players, coaches, and parents on ways to prevent tragedies from occurring during sport.

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Physical Activity Problem-Solving Inventory for Adolescents: Development and Initial Validation

Debbe Thompson, Riddhi Bhatt, and Kathy Watson

Youth encounter physical activity barriers, often called problems. The purpose of problem solving is to generate solutions to overcome the barriers. Enhancing problem-solving ability may enable youth to be more physically active. Therefore, a method for reliably assessing physical activity problem-solving ability is needed. The purpose of this research was to report the development and initial validation of the physical activity problem-solving inventory for adolescents (PAPSIA). Qualitative and quantitative procedures were used. The social problem-solving inventory for adolescents guided the development of the PAPSIA scale. Youth (14- to 17-year-olds) were recruited using standard procedures, such as distributing flyers in the community and to organizations likely to be attended by adolescents. Cognitive interviews were conducted in person. Adolescents completed pen and paper versions of the questionnaire and/or scales assessing social desirability, self-reported physical activity, and physical activity self-efficacy. An expert panel review, cognitive interviews, and a pilot study (n = 129) established content validity. Construct, concurrent, and predictive validity were also established (n = 520 youth). PAPSIA is a promising measure for assessing youth physical activity problem-solving ability. Future research will assess its validity with objectively measured physical activity.

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Normative Values for Cardiorespiratory Fitness Testing Among US Children Aged 6-11 years

Jaime J. Gahche, Brian K. Kit, Janet E. Fulton, Dianna D. Carroll, and Thomas Rowland

Background:

Nationally representative normative values for cardiorespiratory fitness (CRF) have not been described for US children since the mid 1980s.

Objective:

To provide sex- and age-specific normative values for CRF of US children aged 6–11 years.

Methods:

Data from 624 children aged 6–11 years who participated in the CRF testing as part of the 2012 National Health and Nutrition Examination Survey National Youth Fitness Survey, a cross-sectional survey, were analyzed. Participants were assigned to one of three age-specific protocols and asked to exercise to volitional fatigue. The difficulty of the protocols increased with successive age groups. CRF was assessed as maximal endurance time (min:sec). Data analysis was conducted in 2016.

Results:

For 6–7, 8–9, 10–11 year olds, corresponding with the age-specific protocols, mean endurance time was 12:10 min:sec (95% CI: 11:49–12:31), 11:16 min:sec (95% CI: 11:00–11:31), and 10:01 min:sec (95% CI: 9:37–10:25), respectively. Youth in the lowest 20th percentile for endurance time were more likely to be obese, to report less favorable health, and to report greater than two hours of screen time per day.

Conclusions:

These data may serve as baseline estimates to monitor trends over time in CRF among US children aged 6–11 years.

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Correlates of Sedentary Time Among Children and Adolescents in Ethiopia: A Cross-Sectional Study

Sibhatu Biadgilign, Tennyson Mgutshini, Bereket Gebremichael, Demewoz Haile, Lioul Berhanu, Stanley Chitekwe, and Peter Memiah

Purpose: To assess the correlates of sedentary time among children and adolescents in Ethiopia. Methods: The study was conducted in representative samples of children and adolescents in the capital city of Ethiopia, Addis Ababa. Multivariable logistic regression models were used to determine associations of sedentary time and predictor variables. Results: The mean sedentary time was 4.61 (95% confidence interval [CI], 4.35–4.86) hours per day. Overall, the prevalence of high sedentary time (>3 h/d) was 68.2% (95% CI, 64.2–72.2). Results of multivariable logistic regression analyses showed a statistically significant association between high sedentary time and female household head (adjusted odds ratio [AOR] = 0.50; 95% CI, 0.32–0.80), literate mothers (AOR = 1.98; 95% CI, 1.26–3.11), child attending public school (AOR = 1.79; 95% CI, 1.12–2.85), children who belonged to the poor and rich household wealth tertiles compared with medium wealth tertile (AOR = 2.30; 95% CI, 1.42–3.72 and AOR = 2.04; 95% CI, 1.14–3.65, respectively), and those families that did not have adequate indoor play space for children (AOR = 0.45; 95% CI, 0.29–0.72). Conclusion: The study found that time spent sedentary was high in the study area as compared with other studies of similar settings. Several modifiable factors were identified that can be targeted in interventions to reduce sedentary time in the study setting.

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The Effect of Physical Exertional Testing on Postconcussion Symptom Scale Scores in Male and Female High School Students

Lauren N. Miutz, Carolyn A. Emery, Amanda M. Black, Matthew J. Jordan, Jonathan D. Smirl, and Kathryn J. Schneider

Purpose: Symptom scores commonly measured following concussion were compared between male and female adolescents with (Hx+) and without (Hx−) a history of concussion, pre and post physical exertion testing. Methods: Eighty (males [n = 60; Hx+ = 19], female [n = 20; Hx+ = 5]) high school students (ages 15–17 y) completed the Buffalo Concussion Treadmill Test once and the modified shuttle run test twice. Symptom scores were collected using the 22-point Symptom Evaluation Scale on the Sport Concussion Assessment Tool (version 5) immediately pre and post physical exertion testing. Results: The symptoms most reported during preexertional testing were fatigue/low energy, feeling slowed down, and nervous/anxious, whereas feeling slowed down, fatigue/low energy, “pressure in head” (males only), and headache (females only) were most frequently reported during postexertion testing. Conclusion: An understanding of the common exertion-related symptoms at baseline in a laboratory or field-based setting in adolescents may be advantageous for clinicians as they manage individual recovery postconcussion. This is particularly important during an adolescent’s recovery and return to play when exertional testing may be implemented, especially since symptoms were reported pre and post exertional testing in both males and females regardless of concussion history.

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Feasibility and Utility of a Fitbit Tracker Among Ambulatory Children and Youth With Disabilities

Emily Bremer, Kelly P. Arbour-Nicitopoulos, Brianna Tsui, Kathleen A. Martin Ginis, Sarah A. Moore, Krista L. Best, and Christine Voss

Purpose: To examine the feasibility and utility of the Fitbit Charge HR to estimate physical activity among ambulatory children and youth with disabilities. Method: Participants (4–17 y old) with disabilities were recruited and asked to wear a Fitbit for 28 days. Feasibility was assessed as the number of participants who adhered to the 28-day protocol. Heat maps were generated to visually examine variability in step count by age, gender, and disability group. Between-group differences for wear time and step counts by age, gender, and disability type were assessed by independent sample t tests for gender and disability group, and a 1-way analysis of variance for age group. Results: Participants (N = 157; median age = 10 y; 71% boys; 71% nonphysical disabilities) averaged 21 valid days of wear time. Wear time was higher in girls than boys (mean difference = 18.0; 95% confidence interval [CI], 6.8 to 29.1), and in preadolescents (mean difference = 27.6; 95% CI, 15.5 to 39.7) and adolescents (mean difference = −21.2; 95% CI, −33.6 to −8.7) than children. More daily steps were taken by boys than girls (mean difference = −1040; 95% CI, −1465 to −615) and individuals with a nonphysical disability than a physical disability (mean difference = −1120; 95% CI, −1474 to −765). The heat maps showed peaks in physical activity on weekdays before school, at recess, lunchtime, and after school. Conclusion: The Fitbit is a feasible tool for monitoring physical activity among ambulatory children and youth with disabilities and may be useful for population-level surveillance and intervention.

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Independent and Combined Associations of Physical Activity and Screen Time With Biomarkers of Inflammation in Children and Adolescents With Overweight/Obesity

Yijian Ding and Xi Xu

overweight/obesity, especially in terms of inflammation regulation and reducing the risk of developing obesity-associated complications. Methods Study Population The NHANES, carried out by the Centers for Disease Control and Prevention’s (CDC) National Center for Health Statistics, is a national cross

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Physical Activity Levels and Adiposity in Ambulant Children and Adolescents With Cerebral Palsy Compared With Their Typically Developing Peers

Leticia Janzen, Clodagh M. Toomey, Laura K. Brunton, Elizabeth G. Condliffe, Shane Esau, Adam Kirton, Carolyn A. Emery, and Gregor Kuntze

Purpose: This study assessed physical activity (PA) and body composition of ambulatory children and adolescents with cerebral palsy (CP) and their typically developing peers. Methods: Participants included youth with CP (ages 8–18 y and Gross Motor Function Classification System [GMFCS] levels I–III) and their typically developing peers. Outcomes included PA (actigraphy) and fat/lean mass index (FMI/LMI; dual-energy X-ray absorptiometry). Statistical analyses included linear mixed effects models with Bonferroni adjustment. Fixed effects were study group (CP and typically developing); random effects were participant clusters (sex and age). Exploratory analyses included association of body composition and PA, GMFCS level, and CP involvement (unilateral and bilateral). Results: Seventy-eight participants (CP: n = 40, girls: n = 29; GMFCS I: n = 20; GMFCS II: n = 14; GMFCS III: n = 6) met inclusion criteria. Individuals with CP had lower moderate to vigorous PA (MVPA; β = −12.5; 98.3% confidence interval, −22.6 to −2.5 min; P = .004) and lower LMI (β = −1.1; 97.5% confidence interval, −2.1 to −0.0 kg/m2; P = .020). Exploratory analyses indicated increased LMI with greater MVPA (P = .001), reduced MVPA for GMFCS II (P = .005) and III (P = .001), increased sedentary time for GMFCS III (P = .006), and greater fat mass index with unilateral motor impairment (P = .026). Conclusions: The findings contribute to the knowledge base of increasing MVPA and LMI deficits with the greater functional impact of CP. Associations of increasing LMI with greater MVPA support efforts targeting enhanced PA participation to promote independent mobility.

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Predictors of Dietary Supplement Use among Adolescent Athletes

R. Todd Bartee, Burke Grandjean, Michael S. Dunn, James M. Eddy, and Min Qi Wang

This study sought to predict the use of dietary supplements marketed to enhance athletic performance among 1,737 adolescent athletes. An anonymous, paper-and-pencil, self-report survey was administered to the participants. Grade level, participation in multiple sports, and scales representing attitudes, subjective norms, and intention were all significant predictors of current dietary supplement use. The results of this study allow for the development of more appropriate prevention and intervention strategies that can target specific groups of adolescent athletes. We recommend that attitudes of adolescent athletes be addressed in interventions and that salient others be included in program planning.