Considerations for Individual-Level Versus Whole-School Physical Activity Interventions: Stakeholder Perspectives.
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SUBMITTER: Tibbitts B
PROVIDER: S-EPMC8304121 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:BackgroundEngagement in before-school physical activity can potentially enhance health and learning-related outcomes for children and adolescents. However, influencing factors and stakeholder perceptions of before-school physical activity remain under-researched. This qualitative study aimed to examine stakeholder perceptions of: a) the suitability of the before-school segment for physical activity, b) barriers and facilitators associated with before-school physical activity, and c) strategies for schools to support before-school physical activity.MethodsTwelve focus groups and one interview were conducted with 38 participants from a range of school stakeholder groups-students, parents, teachers, school leaders, external physical activity providers, and school health and physical activity experts. Focus groups were analysed using template analysis, guided by a social-ecological model.ResultsStakeholders perceived before-school physical activity as valuable, for reasons including perceptions of meaningful contributions to students' cognitive functioning, classroom behaviours, and wellbeing. Factors influencing before-school physical activity were identified across multiple social-ecological levels, including the critical role of school leadership support, availability of facilities, and provision of qualified supervision. Proposed strategies highlighted the need for sustainable design, contextual relevance, and community engagement in before-school initiatives. Additionally, communication of the manifold benefits identified by stakeholders was suggested as a means to drive support and engagement in before-school physical activity.ConclusionsThis study provides insight for schools seeking to enhance opportunities for physical activity in the before-school hours and may inform future intervention research on the subject, taking into account its multi-faceted influences and the need for context-specific strategies.
| S-EPMC10905879 | biostudies-literature
Project description:Physical activity is influenced by individual, inter-personal and environmental factors. In this paper, we explore the variability in children's moderate-to-vigorous physical activity (MVPA) at different individual, parent, friend, school and neighbourhood levels. Valid accelerometer data were collected for 1077 children aged 9, and 1129 at age 11, and the average minutes of MVPA were derived for weekdays and weekends. We used a multiple-membership, multiple-classification model (MMMC) multilevel model to compare the variation in physical activity outcomes at each of the different levels. There were differences in the proportion of variance attributable to the different levels between genders, for weekdays and weekends, at ages 9 and 11. The largest proportion of variability in MVPA was attributable to individual variation, accounting for half of the total residual variability for boys, and two thirds of the variability for girls. MVPA clustered within friendship groups, with friends influencing peer MVPA. Including covariates at the different levels explained only small amounts (3%-13%) of variability. There is a need to enhance our understanding of individual level influences on children's physical activity.
| S-EPMC6950546 | biostudies-literature
Project description:There is little evidence regarding the effects of individual and group intervention for children with autism spectrum disorder (ASD) on important outcomes. We performed meta-analyses using a random effects model to investigate the effectiveness of the individual and group intervention studies and to compare the effectiveness of these two types if possible. The main analysis which excluded studies at a high risk of bias (Analysis I) included 14 randomised controlled trials targeting children with ASD≤6 years of age (594 children). The results suggested that both individual and group interventions showed significant effects compared to the control condition on "reciprocity of social interaction towards others" (standard mean difference[SMD] [95%confidence interval{CI}] = 0.59[0.25, 0.93], p = 0.16; 0.45[0.02, 0.88], p = 0.39, respectively). Only individual interventions showed significant effects compared to the control condition on "parental synchrony" (SMD [95%CI] = 0.99 [0.70, 1.29], p<0.01). Our results showed no significant differences between individual and group interventions in effects on "autism general symptoms" (no study available for group intervention), "developmental quotient" (no study available for group intervention), "expressive language" (p = 0.56), "receptive language" (p = 0.29), "reciprocity of social interaction towards others" (p = 0.62), or "adaptive behaviour" (p = 0.43). We also performed sensitivity analyses including studies that had been excluded due to being at a high risk of potential bias (Analysis II). The results suggested that "reciprocity of social interactions towards others" showed significant effects for individual intervention compared to the control condition (0.50[0.31,0.69], p<0.001) but not for group intervention (0.23[-0.33, 0.78], p = 0.42). Individual intervention also showed significant effects on "parental synchrony" (0.98[0.30,1.66], p = 0.005) in the sensitivity analysis. The results also suggested no significant difference on all the outcomes between the individual and group interventions. We also reanalysed the data using cluster-robust standard errors as sensitivity analyses (Analysis III). Analysis III showed no significant effects in the intervention condition compared to the control condition on all the outcomes for both individual and group interventions. When Analysis II was reanalysed using cluster-robust standard errors (Analysis IV), individual interventions showed significant effects compared to the control condition on "reciprocity of social interaction towards others" and "parental synchrony" (mean estimate[95%CI], robust standard error, p = 0.50[0.20, 0.81], 0.13, 0.006; and 1.06[0.08, 2.05], 0.42, 0.04, respectively), and none of the outcomes showed significant effects under the intervention condition compared to the control condition for group interventions. The discrepancies in the results between the main analysis (Analysis I) and the sensitivity analyses (Analyses II, III, and IV) may be due to the small number of included studies. Since the outcome of "reciprocity of social interaction towards others" can be a dependent variable that is usually measured in a context-bound setting with the child's parent, we cannot conclude that individual interventions for pre-school children with ASD have significant effects on generalised skills for engaging in reciprocal interactions with others, even if the interventions have significant effects on the outcome. However, the outcomes of "reciprocity of social interaction towards others" may be promising targets for both individual and group interventions involving pre-school children with ASD. "Parental synchrony" may also be a promising target for individual interventions.Trial registration(CRD42011001349).
| S-EPMC5953451 | biostudies-literature
Project description:BackgroundScaling up population health interventions is a context-orientated, dynamic and multi-stakeholder process; understanding its influences is essential to enhance future scaling efforts. Using physical activity and nutrition interventions in Australia as case examples, the aim of this paper is to identify core influences involved in scaling up physical activity and nutrition interventions, and how these may differ by context and stakeholder.MethodsA qualitative study involving semi-structured telephone interviews with individuals representing academic, government and non-government organizations with involvement in scaling up state and national physical activity and nutrition interventions. Interview questions were derived from the WHO report "20 Questions for Developing a Scaling up Case Study", and mapped against four key principles and five core areas in the WHO ExpandNet framework for scaling up: (1) The innovation; (2) User organization; (3) Environment; (4) Resource team and; (5) Scale up strategy. Data were analyzed thematically.ResultsNineteen interviews were conducted (government = 3; non-government = 5; and academic = 11 sectors) involving eight scaled up interventions, targeting nutrition (n = 2), physical activity (n = 1) or a combination (n = 5). Most themes aligned to the "Environment", including: (i) political (e.g., personal agendas); (ii) social (e.g., lack of urgency); and (iii) sector/workforce (e.g., scale up accountability) factors. Themes relating to "Scale up strategy" (e.g., flexibility and evaluation transparency) were next most commonly occurring. Whilst themes were broadly consistent across participants, government participants had a more policy-oriented perspective on the scale up process. Academics discussed a tension between the generation and use of evidence, and the influence of political climates/interest on scale up decisions.ConclusionAttributes of the "Environment" and "Scale up strategy" consistently featured as major influences on successful outcomes, while the role of evidence differed greatly between participant groups. A multisector scale up strategy for future interventions may enable the complexities of environmental and political contexts to be incorporated into scale up planning.
| S-EPMC8995799 | biostudies-literature
Project description:Despite the plethora of empirical studies conducted to date, debate continues about whether and to what extent results should be returned to participants of genomic research. We aimed to systematically review the empirical literature exploring stakeholders' perspectives on return of individual research results (IRR) from genomic research. We examined preferences for receiving or willingness to return IRR, and experiences with either receiving or returning them. The systematic searches were conducted across five major databases in August 2018 and repeated in April 2020, and included studies reporting findings from primary research regardless of method (quantitative, qualitative, mixed). Articles that related to the clinical setting were excluded. Our search identified 221 articles that met our search criteria. This included 118 quantitative, 69 qualitative and 34 mixed methods studies. These articles included a total number of 118,874 stakeholders with research participants (85,270/72%) and members of the general public (40,967/35%) being the largest groups represented. The articles spanned at least 22 different countries with most (144/65%) being from the USA. Most (76%) discussed clinical research projects, rather than biobanks. More than half (58%) gauged views that were hypothetical. We found overwhelming evidence of high interest in return of IRR from potential and actual genomic research participants. There is also a general willingness to provide such results by researchers and health professionals, although they tend to adopt a more cautious stance. While all results are desired to some degree, those that have the potential to change clinical management are generally prioritized by all stakeholders. Professional stakeholders appear more willing to return results that are reliable and clinically relevant than those that are less reliable and lack clinical relevance. The lack of evidence for significant enduring psychological harm and the clear benefits to some research participants suggest that researchers should be returning actionable IRRs to participants.
| S-EPMC8575249 | biostudies-literature
Project description:BackgroundBehaviour change interventions that promote physical activity have major implications for health and well-being. Measuring intervention fidelity is crucial in determining the extent to which an intervention is delivered as intended, therefore increasing scientific confidence about effectiveness. However, we lack a clear overview of how well intervention fidelity is typically assessed in physical activity trials.MethodsA systematic literature search was conducted to identify peer - reviewed physical activity promotion trials that explicitly measured intervention fidelity. Methods used to assess intervention fidelity were categorised, narratively synthesised and critiqued using assessment criteria from NIH Behaviour Change Consortium (BCC) Treatment Fidelity Framework (design, training, delivery, receipt and enactment).ResultsTwenty eight articles reporting of twenty one studies used a wide variety of approaches to measure intervention fidelity. Delivery was the most common domain of intervention fidelity measured. Approaches used to measure fidelity across all domains varied from researcher coding of observational data (using checklists or scales) to participant self-report measures. There was considerable heterogeneity of methodological approaches to data collection with respect to instruments used, attention to psychometric properties, rater-selection, observational method and sampling strategies.ConclusionsIn the field of physical activity interventions, fidelity measurement is highly heterogeneous both conceptually and methodologically. Clearer articulation of the core domains of intervention fidelity, along with appropriate measurement approaches for each domain are needed to improve the methodological quality of fidelity assessment in physical activity interventions. Recommendations are provided on how this situation can be improved.
| S-EPMC5625828 | biostudies-literature
Project description:BackgroundManaged problem solving (MAPS) is an evidence-based intervention that can boost HIV medication adherence and increase viral suppression, but it is not widely used in community clinics. Deploying community health workers to deliver MAPS could facilitate broader implementation, in support of the Ending the HIV Epidemic (EHE) initiative's goal of reducing new HIV infections in the US by 90% by 2030.SettingRyan White-funded clinics in Philadelphia, 1 of 48 US counties prioritized in the EHE.MethodsSemistructured stakeholder interviews were conducted with 13 clinics and 4 stakeholder groups: prescribing clinicians, nonprescribing clinical team members (eg, medical case managers), clinic administrators, and policymakers. Interviews were based on the Consolidated Framework for Implementation Research and investigated perceived barriers to and facilitators of MAPS delivery by community health workers. Rapid qualitative analytic techniques were used to synthesize interview data and identify key categories along an implementation pathway. Core determinants (ie, barriers and facilitators) of MAPS implementation were grouped within each category.ResultsStakeholders were receptive to CHW-delivered MAPS and offered critical information on potential implementation determinants including preferences for identification and referral of patients, and the importance of integration and communication within the care team.ConclusionsThis study elucidates insights regarding barriers and facilitators to delivering an evidence-based behavioral intervention in clinics serving people with HIV (PWH) and extends a rapid qualitative approach to HIV care that rigorously incorporates stakeholder data into the development of implementation strategies. It also offers insights for national implementation efforts associated with EHE.
| S-EPMC9473662 | biostudies-literature
Project description:Introduction: Few studies have examined the association between the individual-, family-, and school-level ecological correlates and physical fitness among Chinese children and adolescents, which is the purpose of the present study. Methods: A total of 157,168 children and adolescents, 10-18 years of age, with physical fitness data in 2014, participated in the study. Physical fitness was assessed, using six tests: forced vital capacity, standing long jump, sit and reach, body muscle strength, 50-m dash, and endurance running. Scores were aggregated to form a summary physical fitness indicator (PFI), which was then classified into five levels: low, low-middle, middle, middle-high, and high. Each option of individual-, family-, and school-level measures were constructed into a positive or negative correlate of physical fitness and then accumulated as a composite ecological score. Results: Among the 20 individual-, family-, and school-level correlates, 18 were found to be significantly associated with PFI, with high PFI levels being correlated with the positive group of correlates and low PFI levels correlated with the negative group of correlates (p < 0.05). High scores of ecological correlates were associated with a high level of PFI [adjusted odds ratio (OR) = 1.06, 95% CI: 1.06, 1.07)] whereas low scores were associated with a low level of PFI (OR = 0.95, 95% CI:0.95, 0.95). The ecological correlates at the individual, school- and family-levels were shown to be significantly related to high PFI among Chinese children and adolescents aged 10-18 years with different ORs of 5.97 (95% CI: 5.51, 6.47), 3.94 (3.66, 4.24), and 1.25 (1.19, 1.31). The PAR% of 20 cumulative factors effects due to the negative and positive responses for low PFI levels were 35.9 and 16.1%, and, for high PFI levels, were 15.3 and 24.1%, among Chinese children and adolescents, respectively. Compared with the correlates at family and school levels, the correlates at individual levels had the largest PAR%. Conclusion: Individual-, family-, and school-multilevel factors had a significant cumulative association with either improving or worsening aspects of physical fitness. Individual level factors remain at the core of physical fitness improvement. Comprehensive policies and measures are urgently needed to enhance the physical fitness of Chinese children and adolescents through involving further individual and environmental factors.
| S-EPMC8424096 | biostudies-literature
Project description:BackgroundCommunity based providers are well place to deliver behavioural interventions to improve health. Good project management and reliable outcome data are needed to efficiently deliver and evaluate such interventions, and Management information systems (MIS) can facilitate these processes. We explored stakeholders perspectives on the use of MIS in community based behavioural interventions.MethodsStakeholders, purposively selected to provide a range of MIS experience in the delivery of community based behavioural interventions to improve health (public health commissioners, intervention service managers, project officers, health researchers and MIS designers), were invited to participate in individual semi-structured interviews. We used a topic guide and encouraged stakeholders to reflect on their experiences.: Interviews were recorded, transcribed and analysed using five steps of Framework analysis. We applied an agreed coding framework and completed the interviews when no new themes emerged.ResultsWe interviewed 15 stakeholders. Key themes identified were: (i) MIS access; (ii) data and its function; (iii) MIS development and updating. Within these themes the different experiences, needs, use, training and expertise of stakeholders and the variation and potential of MIS were evidenced. Interviews advised the need to involve stakeholders in MIS design and development, build-in flexibility to accommodate MIS refinement and build on effective MIS.ConclusionsFindings advised involving stakeholders, early in the design process. Designs should build on existing MIS of proven utility and ensure flexibility in the design, to incorporate adaptations and ongoing system development in response to early MIS use and evolving stakeholder needs.
| S-EPMC6343312 | biostudies-literature
Project description:BackgroundHealth-related fitness knowledge (HRFK) has been an essential concept for many health and physical education programs. There has been limited understanding and longitudinal investigation on HRFK growth. This longitudinal study examined HRFK growth and its individual- and school-level correlates in middle school years under 1 curriculum condition: Five for Life.MethodsParticipants were 12,044 students from 47 middle schools. Data were collected at both individual/participant and school/institution levels. Individual-level variables included gender, grade, and HRFK test scores. School-level variables included percentage of students receiving free and reduced meals (FARM), student-to-faculty ratio for physical education, and school academic performance (SAP). We used hierarchical linear modeling to examine HRFK 3-year growth in relation to individual- and school-level correlates.ResultsThe average HRFK score at 6th grade for females was 42.81% ± 1.32%. The predicted HRFK growth was 17.06% ± 1.02% per year, holding other factors constant. A 1-standard deviation increase in FARM correlated with a 14.68%-point decrease in predicted test score (p = 0.02). A 1-standard deviation increase in SAP was associated with an 11.90%-point increase in HRFK score. Males had a significantly lower growth rate than females during the middle school years (0.78%/year, p = 0.02).ConclusionThe result showed that both individual- and school-level variables such as gender, FARM, and SAP influenced HRFK growth. Educators should heed gender differences in growth curves and recognize the correlates of school-level variables.
| S-EPMC7749269 | biostudies-literature