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Development and reliability of an audit tool to assess the school physical activity environment across 12 countries.

ABSTRACT: OBJECTIVES:Schools are an important setting to enable and promote physical activity. Researchers have created a variety of tools to perform objective environmental assessments (or 'audits') of other settings, such as neighborhoods and parks; yet, methods to assess the school physical activity environment are less common. The purpose of this study is to describe the approach used to objectively measure the school physical activity environment across 12 countries representing all inhabited continents, and to report on the reliability and feasibility of this methodology across these diverse settings. METHODS:The International Study of Childhood Obesity, Lifestyle and the Environment (ISCOLE) school audit tool (ISAT) data collection required an in-depth training (including field practice and certification) and was facilitated by various supporting materials. Certified data collectors used the ISAT to assess the environment of all schools enrolled in ISCOLE. Sites completed a reliability audit (simultaneous audits by two independent, certified data collectors) for a minimum of two schools or at least 5% of their school sample. Item-level agreement between data collectors was assessed with both the kappa statistic and percent agreement. Inter-rater reliability of school summary scores was measured using the intraclass correlation coefficient. RESULTS:Across the 12 sites, 256 schools participated in ISCOLE. Reliability audits were conducted at 53 schools (20.7% of the sample). For the assessed environmental features, inter-rater reliability (kappa) ranged from 0.37 to 0.96; 18 items (42%) were assessed with almost perfect reliability (?=0.80-0.96), and a further 24 items (56%) were assessed with substantial reliability (?=0.61-0.79). Likewise, scores that summarized a school's support for physical activity were highly reliable, with the exception of scores assessing aesthetics and perceived suitability of the school grounds for sport, informal games and general play. CONCLUSIONS:This study suggests that the ISAT can be used to conduct reliable objective audits of the school physical activity environment across diverse, international school settings.

SUBMITTER: Broyles ST

PROVIDER: S-EPMC4850618 | biostudies-literature | 2015 Dec

REPOSITORIES: biostudies-literature

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Development and reliability of an audit tool to assess the school physical activity environment across 12 countries.

Broyles S T ST Drazba K T KT Church T S TS Chaput J-P JP Fogelholm M M Hu G G Kuriyan R R Kurpad A A Lambert E V EV Maher C C Maia J J Matsudo V V Olds T T Onywera V V Sarmiento O L OL Standage M M Tremblay M S MS Tudor-Locke C C Zhao P P Katzmarzyk P T PT

International journal of obesity supplements 20151208 Suppl 2

<h4>Objectives</h4>Schools are an important setting to enable and promote physical activity. Researchers have created a variety of tools to perform objective environmental assessments (or 'audits') of other settings, such as neighborhoods and parks; yet, methods to assess the school physical activity environment are less common. The purpose of this study is to describe the approach used to objectively measure the school physical activity environment across 12 countries representing all inhabited ...[more]

PMID: 27152183

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Project description:BACKGROUND: Environmental characteristics are known to be associated with patterns of physical activity (PA). Although several validated tools exist, to measure the environment characteristics, these instruments are not necessarily suitable for application in all settings especially in a developing country. This study was carried out to develop and validate an instrument named the "Physical And Social Environment Scale--PASES" to assess the physical and social environmental factors associated with PA. This will enable identification of various physical and social environmental factors affecting PA in Sri Lanka, which will help in the development of more tailored intervention strategies for promoting higher PA levels in Sri Lanka. METHODS: The PASES was developed using a scientific approach of defining the construct, item generation, analysis of content of items and item reduction. Both qualitative and quantitative methods of key informant interviews, in-depth interviews and rating of the items generated by experts were conducted. A cross sectional survey among 180 adults was carried out to assess the factor structure through principal component analysis. Another cross sectional survey among a different group of 180 adults was carried out to assess the construct validity through confirmatory factor analysis. Reliability was assessed with test re-test reliability and internal consistency using Spearman r and Cronbach's alpha respectively. RESULTS: Thirty six items were selected after the expert ratings and were developed into interviewer administered questions. Exploration of factor structure of the 34 items which were factorable through principal component analysis with Quartimax rotation extracted 8 factors. The 34 item instrument was assessed for construct validity with confirmatory factor analysis which confirmed an 8 factor model (x2?=?339.9, GFI?=?0.90). The identified factors were infrastructure for walking, aesthetics and facilities for cycling, vehicular traffic safety, access and connectivity, recreational facilities for PA, safety, social cohesion and social acceptance of PA with the two non-factorable factors, residential density and land use mix. The PASES also showed good test re-test reliability and a moderate level of internal consistency. CONCLUSIONS: The PASES is a valid and reliable tool which could be used to assess the physical and social environment associated with PA in Sri Lanka.

Project description:BackgroundPhysical inactivity and unhealthy diet are key behavioral determinants underlying obesity. The neighborhood environment represents an important arena for modifying these behaviors, and hence reliable and valid tools to measure it are needed. Most existing virtual audit tools have been designed to assess either food or activity environments deemed relevant for adults. Thus, there is a need for a tool that combines the assessment of food and activity environments, and which focuses on aspects of the environment relevant for youth.ObjectiveThe aims of the present study were: (a) to adapt the SPOTLIGHT Virtual Audit Tool (S-VAT) developed to assess characteristics of the built environment deemed relevant for adults for use in an adolescent population, (b) to assess the tool's inter- and intra-rater reliability, and (c) to assess its criterion validity by comparing the virtual audit to a field audit.MethodsThe tool adaptation was based on literature review and on results of a qualitative survey investigating how adolescents perceived the influence of the environment on dietary and physical activity behaviors. Sixty streets (148 street segments) in six neighborhoods were randomly selected as the study sample. Two raters assessed the inter- and intra-rater reliability and criterion validity, comparing the virtual audit tool to a field audit. The results were presented as percentage agreement and Cohen's kappa (κ).ResultsIntra-rater agreement was found to be moderate to almost perfect (κ = 0.44-0.96) in all categories, except in the category aesthetics (κ = 0.40). Inter-rater agreement between auditors ranged from fair to substantial for all categories (κ = 0.24-0.80). Criterion validity was found to be moderate to almost perfect (κ = 0.56-0.82) for most categories, except aesthetics and grocery stores (κ = 0.26-0.35).ConclusionThe adapted version of the S-VAT can be used to provide reliable and valid data on built environment characteristics deemed relevant for physical activity and dietary behavior among adolescents.

Project description:Active school travel is an important way to promote children's physical activity, but it requires supportive environments that can safely and comfortably accommodate children's walking and biking. Few existing indices explicitly consider school neighborhood environmental factors related to children's walking to school. In this study, we used a street audit tool and Geographic Information System (GIS) to evaluate walkability near low-income elementary schools in Seattle, WA. The audit-based school walkability index was developed based on all street segments (n=841) within a 0.4km network buffer from each study school (n=18). The GIS-based school walkability, a combination of road connectivity, vehicular traffic exposure, and residential density, was also measured in a 2km network buffer around each school. The participants were individuals aged 8-11 years (n=315) who participated in the Walking School Bus randomized controlled trial project. Mixed-effects logistic and linear models were used to examine the association of the index's representations of the built environment with children's school travel mode (walking or biking to school 1+ times per week) and with objectively measured moderate-to-vigorous physical activity (MVPA, average weekday minutes during the 90-min before-school period). These associations were tested with the total sample as well as the subsample of children living within 1.5km from their schools. The audit-based school walkability index (WI) was positively associated with both active commuting to school among the subsample living within 1.5km from their schools and with children's before-school MVPA among the subsample and the total sample. The GIS-based school WI showed significant associations with children's before-school MVPA but no relationships with active school travel among the subsample and the total sample. The audit-based school walkability index can be used as a complementary tool for measuring walkability near low-income elementary schools along with existing GIS-based school walkability index.

Project description:Focused on the accelerometer-determined physical activity and sedentary time metrics in 9-11-year-old children, we sought to determine the following: (i) number of days that are necessary to achieve reliable estimates (G⩾0.8); (ii) proportion of variance attributed to different facets (participants and days) of reliability estimates; and (iii) actual reliability of data as collected in The International Study of Childhood Obesity, Lifestyle and Environment (ISCOLE).The analytical sample consisted of 6025 children (55% girls) from sites in 12 countries. Physical activity and sedentary time metrics measures were assessed for up to 7 consecutive days for 24 h per day with a waist-worn ActiGraph GT3X+. Generalizability theory using R software was used to investigate the objectives i and ii. Intra-class correlation coefficients (ICC) were computed using SAS PROC GLM to inform objective iii.The estimated minimum number of days required to achieve a reliability estimate of G⩾0.8 ranged from 5 to 9 for boys and 3 to 11 for girls for light physical activity (LPA); 5 to 9 and 3 to 10, for moderate-to-vigorous physical activity (MVPA); 5 to 10 and 4 to 10 for total activity counts; and 7 to 11 and 6 to 11 for sedentary time, respectively. For all variables investigated, the 'participant' facet accounted for 30-50% of the variability, whereas the 'days' facet accounted for ⩽5%, and the interaction (P × D) accounted for 50-70% of the variability. The actual reliability for boys in ISCOLE ranged from ICCs of 0.78 to 0.86, 0.73 to 0.85 and 0.72 to 0.86 for LPA, MVPA and total activity counts, respectively, and 0.67 to 0.79 for sedentary time. The corresponding values for girls were 0.80-0.88, 0.70-0.89, 0.74-0.86 and 0.64-0.80.It was rare that only 4 days from all participants would be enough to achieve desirable reliability estimates. However, asking participants to wear the device for 7 days and requiring ⩾4 days of data to include the participant in the analysis might be an appropriate approach to achieve reliable estimates for most accelerometer-derived metrics.

Project description:BackgroundAlthough 80% of children with disabilities live in developing countries, there are few culturally appropriate developmental assessment tools available for these settings. Often tools from the West provide misleading findings in different cultural settings, where some items are unfamiliar and reference values are different from those of Western populations.Methods and findingsFollowing preliminary and qualitative studies, we produced a draft developmental assessment tool with 162 items in four domains of development. After face and content validity testing and piloting, we expanded the draft tool to 185 items. We then assessed 1,426 normal rural children aged 0-6 y from rural Malawi and derived age-standardized norms for all items. We examined performance of items using logistic regression and reliability using kappa statistics. We then considered all items at a consensus meeting and removed those performing badly and those that were unnecessary or difficult to administer, leaving 136 items in the final Malawi Developmental Assessment Tool (MDAT). We validated the tool by comparing age-matched normal children with those with malnutrition (120) and neurodisabilities (80). Reliability was good for items remaining with 94%-100% of items scoring kappas >0.4 for interobserver immediate, delayed, and intra-observer testing. We demonstrated significant differences in overall mean scores (and individual domain scores) for children with neurodisabilities (35 versus 99 [p<0.001]) when compared to normal children. Using a pass/fail technique similar to the Denver II, 3% of children with neurodisabilities passed in comparison to 82% of normal children, demonstrating good sensitivity (97%) and specificity (82%). Overall mean scores of children with malnutrition (weight for height <80%) were also significantly different from scores of normal controls (62.5 versus 77.4 [p<0.001]); scores in the separate domains, excluding social development, also differed between malnourished children and controls. In terms of pass/fail, 28% of malnourished children versus 94% of controls passed the test overall.ConclusionsA culturally relevant developmental assessment tool, the MDAT, has been created for use in African settings and shows good reliability, validity, and sensitivity for identification of children with neurodisabilities.

Project description:Background To address low state physical education (PE) quantity and quality law implementation in elementary schools, the New York City Department of Education (NYCDOE) delivered a multilevel intervention (PE Works; 2015-2019), which included a district-led audit of school PE-law implementation, feedback, and coaching with principals. Using the Reach, Effectiveness, Adoption, Implementation, Maintenance (RE-AIM) implementation science framework, we assessed the primary multilevel drivers of success for this approach in increasing adherence to PE quantity and quality law. Methods We conducted in-depth, semi-structured interviews with district-level personnel (n=17), elementary school administrators (n=18), and PE teachers (n=6) in 2020-21. Results Interview results suggested several key RE-AIM drivers of successful PE law implementation. Reach: Ensure higher-need schools receive the necessary initial support to improve PE and later focus on lower-need schools. Effectiveness: Provide support tailored to school needs, not penalties, to improve PE. Adoption: Increase the priority of PE at both district and school levels (e.g., audit and feedback, themselves, appear to elevate PE’s priority). Streamline data collection and feedback reports; collecting/reporting too much information is burdensome and leads to lack of focus. Involve qualified (i.e., skilled in both school administration and PE programming/pedagogy) district-level personnel to work collaboratively with schools. Implementation: Build strong, trusting district-school relationships. Maintenance: Provide ongoing district-level support to schools and involve parents to advocate for quality PE. Conclusions PE audits, feedback, and coaching (PEAFC) can guide schools in establishing long-term plans for successfully implementing PE-related law. Future research should examine the impact of PEAFC elsewhere (e.g., secondary schools, other districts). Supplementary Information The online version contains supplementary material available at 10.1186/s12966-023-01479-1.

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Development and reliability of an audit tool to assess the school physical activity environment across 12 countries.

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Development and reliability of an audit tool to assess the school physical activity environment across 12 countries.

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