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Connect through PLAY: a randomized-controlled trial in afterschool programs to increase adolescents’ physical activity

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Abstract

The current study is a randomized controlled trial to test a novel 10-week climate-based intervention within pre-existing afterschool programs, designed to increase moderate-to-vigorous physical activity (MVPA) in underserved (low-income, minority status) middle school youth by addressing youth social developmental needs. Participants (n = 167; 56% female; 62% Black; 50% overweight/obese) enrolled in 6 middle schools were randomized to either the Connect through PLAY intervention or a wait-list control. Process evaluation measures (i.e., observations of external evaluators; staff surveys) indicated that essential elements were implemented with fidelity, and staff endorsed implementation ease/feasibility and acceptability. Regression analysis demonstrated that participation in the intervention (vs. control) was associated with an increase of 8.17 min of daily accelerometry-measured MVPA (56 min of additional weekly MVPA) at post-intervention controlling for baseline MVPA, school, gender, and weight status. The results provide support for social-motivational climate-based interventions for increasing MVPA in underserved youth that can inform future school-based health initiatives.

Trial Registration: NCT03850821: https://clinicaltrials.gov/ct2/show/study/NCT03850821?term=NCT03850821&rank=1

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Notes

  1. In Year 2, one of the initially recruited sites had to withdraw prior to implementation due to failure to renew the school’s after school program grant. A seventh ASP that met inclusion criteria was then actively recruited and agreed to participate.

Abbreviations

ASPs:

Afterschool programs

PA:

Physical activity

MVPA:

Moderate-to-vigorous physical activity

SDT:

Self-determination theory

AGT:

Achievement goal theory

BMI:

Body mass index

References

  • Abraczinskas, M., & Zarrett, N. (2020). Youth participatory action research for health equity: Increasing youth empowerment and decreasing physical activity access inequities in under-resourced programs and schools. American Journal of Community Psychology. https://doi.org/10.1002/ajcp.12433

    Article  PubMed  Google Scholar 

  • Afterschool Alliance. (2014). America after 3 PM: Afterschool programs in demand. Washington, DC: 2014. Retrieved from http://afterschoolalliance.org/documents/AA3PM-2014/AA3PM_National_Report.pdf

  • Allen, J. B. (2003). Social motivation in youth sport. Journal of Sport and Exercise Psychology., 25, 551–567.

    Article  Google Scholar 

  • Beets, M. W., Beighle, A., Erwin, H. E., & Huberty, J. L. (2009). After-school program impact on physical activity and fitness: A meta-analysis. American Journal of Preventive Medicine, 36, 527–537.

    Article  PubMed  Google Scholar 

  • Beets, M. W., Huberty, J. L., & Beighle, A. (2012). Physical activity of children attending afterschool programs: Research- and practice-based implications. American Journal of Preventive Medicine, 42, 180–184.

    Article  PubMed  Google Scholar 

  • Benson, P. L., Scales, P. C., Hamilton, S. F., & Semsa, A. Jr. (2006). Positive youth development: Theory, research, and applications. In R. M. Lerner (Ed.), Theoretical models of human development. Volume 1 of handbook of child psychology, 6. Hoboken, NJ: Wiley.

    Google Scholar 

  • Braithwaite, R., Spray, C. M., & Warburton, V. E. (2011). Motivational climate interventions in physical education: A meta-analysis. Psychology of Sport and Exercise, 12, 628–638.

    Article  Google Scholar 

  • Brown, B.B. & Larson, J. (2009). Peer relationships in adolescence. In Handbook of Adolescent Psychology (Vol. 6). Hoboken, NJ: John Wiley & Sons, 74–103.

  • Brunet, J., Gunnell, K. E., Teixeira, P. J., Sabiston, C. M., & Belanger, M. (2016). Should we be looking at the forest or the trees? Overall psychological need satisfaction and individual needs as predictors of physical activity. Journal of Sport and Exercise Psychology, 38, 317–330.

    Article  PubMed  Google Scholar 

  • Cain, K. L., Sallis, J. F., Conway, T. L., Van Dyck, D., & Calhoon, L. (2013). Using accelerometers in youth physical activity studies: A review of methods. Journal of Physical Activity and Health, 10, 437–450.

    Article  PubMed  Google Scholar 

  • Centers for Disease Control and Prevention. (2013). Comprehensive School Physical Activity Programs: A Guide for Schools. Atlanta, GA: U.S. Department of Health and Human Services.

    Google Scholar 

  • Corder, K., Sharp, S. J., Atkin, A. J., et al. (2015). Change in objectively measured physical activity during the transition to adolescence. British Journal of Sports Medicine, 49, 730–736.

    Article  PubMed  Google Scholar 

  • Coulon, S. M., Wilson, D. K., Griffin, S., et al. (2012). Formative process evaluation for implementing a social marketing intervention to increase walking among African Americans in the positive action for today’s health trial. American Journal of Public Health, 102, 2315–2321.

    Article  PubMed  PubMed Central  Google Scholar 

  • Cox, A., Duncheon, N., & McDavid, L. (2009). Peers and teachers as sources of relatedness perceptions, motivation, and affective responses in physical education. Research Quarterly for Exercise and Sport, 80, 765–773.

    Article  PubMed  Google Scholar 

  • Dobbins, M., Husson, H., DeCorby, K., & LaRocca, R. L. (2013). School-based physical activity programs for promoting physical activity and fitness in children and adolescents aged 6 to 18. Cochrane Database Systematic Review, 2.

  • Eccles, J. S., & Gootman, J. A. (2002). Community programs to promote youth development. National Academy Press.

    Google Scholar 

  • Garcia, J. M., Sirard, J. R., Deutsch, N. L., et al. (2016). The influence of friends and psychosocial factors on physical activity and screen time behavior in adolescents: A mixed-methods analysis. Journal of Behavioral Medicine, 39, 610–623.

    Article  PubMed  Google Scholar 

  • Garcia-Hermoso, A., Saavedra, J. M., Ramírez-Vélez, R., Ekelund, U., & del Pozo-Cruz, B. (2017). Reallocating sedentary time to moderate-to-vigorous physical activity but not to light-intensity physical activity is effective to reduce adiposity among youths: A systematic review and meta-analysis. Obesity Reviews, 18, 1088–1095.

    Article  CAS  PubMed  Google Scholar 

  • Granger, R., Durlak, J., Yohalem, N., & Reisner, E. (2007). Improving after-school program quality. William T. Grant Foundation.

    Google Scholar 

  • Grieser, M., Vu, M. B., Bedimo-Rung, A. L., Neumark-Sztainer, D., Moody, J., Young, D. R., & Moe, S. G. (2006). Physical activity attitudes, preferences, and practices in African American, Hispanic, and Caucasian girls. Health Education & Behavior, 33(1), 40–51. https://doi.org/10.1177/1090198105282416.PMID:16397158;PMCID:PMC2494874

    Article  Google Scholar 

  • Guthold, R., Stevens, G. A., Riley, L. M., & Bull, F. C. (2020). Global trends in insufficient physical activity among adolescents: A pooled analysis of 298 population-based surveys with 1·6 million participants. The Lancet Child & Adolescent Health, 4, 23–35. https://doi.org/10.1016/S2352-4642(19)30323-2

    Article  Google Scholar 

  • Harding, S. K., Page, A. S., Falconer, C., & Cooper, A. R. (2015). Longitudinal changes in sedentary time and physical activity during adolescence. The International Journal of Behavioral Nutrition and Physical Activity, 12, 44.

    Article  PubMed  PubMed Central  Google Scholar 

  • Hubbard, K., Economos, C. D., Bakun, P., et al. (2016). Disparities in moderate-to-vigorous physical activity among girls and overweight and obese schoolchildren during school- and out-of-school time. International Journal of Behavioral Nutrition and Physical Activity, 13, 39. https://doi.org/10.1186/s12966-016-0358-x

    Article  Google Scholar 

  • Jago, R., Davis, L., McNeill, J., et al. (2011). Adolescent girls’ and parents’ views on recruiting and retaining girls into an after-school dance intervention: implications for extra-curricular physical activity provision. International Journal of Behavioral Nutrition and Physical Activity, 8, 91. https://doi.org/10.1186/1479-5868-8-91

    Article  Google Scholar 

  • Jago, R., Edwards, M. J., Sebire, S. J., et al. (2015). Effect and cost of an after-school dance programme on the physical activity of 11–12 year old girls: The Bristol Girls Dance Project, a school-based cluster randomised controlled trial. International Journal of Behavioral Nutrition and Physical Activity, 12, 1–15.

    Article  Google Scholar 

  • Janssen, I., & LeBlanc, A. G. (2010). Systematic review of the health benefits of physical activity and fitness in school-aged children and youth. International Journal Of Behavioral Nutrition and Physical Activity, 7, 40. https://doi.org/10.1186/1479-5868-7-40

    Article  Google Scholar 

  • Kann, L., McManus, T., Harris, W. A., Shanklin, S. L., Flint, K. H., & Queen, B…Ethier, K. A. . (2018). Youth risk behavior surveillance United States, 2017. MMWR Surveillance Summary, 67, 1–114.

    Article  Google Scholar 

  • Lerner, R., & Steinberg, L. (Eds.). (2004). Handbook of adolescent psychology (2nd ed.). New York: Wiley.

    Google Scholar 

  • Lerner, R. M., Lerner, J. V., Almerigi, J., Theokas, C., Phelps, E., Gestsdottir, S., et al. (2005). Positive youth development, participation in community youth development programs, and community contributions of fifth grade adolescents: Findings from the first wave of the 4-H Study of Positive Youth Development. Journal of Early Adolescence, 25(1), 17–71.

    Article  Google Scholar 

  • Lubans, D. R., Foster, C., & Biddle, S. J. H. (2008). A review of mediators of behavior in interventions to promote physical activity among children and adolescents. Preventive Medicine, 47, 463–470.

    Article  PubMed  Google Scholar 

  • McCleary, L. (2002). Using multiple imputation for analysis of incomplete data in clinical research. Nursing Research, 51, 339–343.

    Article  PubMed  Google Scholar 

  • Mears, R., & Jago, R. (2016). Effectiveness of after-school interventions at increasing moderate-to-vigorous physical activity levels in 5-to 18-year olds: A systematic review and meta-analysis. British Journal of Sports Medicine, 50, 1315–1324.

    Article  PubMed  Google Scholar 

  • Metcalf, B., Henley, W., & Wilkin, T. (2012). Effectiveness of intervention on physical activity of children: systematic review and meta-analysis of controlled trials with objectively measured outcomes (EarlyBird 54). BMJ, 345, e5888.

    Article  PubMed  Google Scholar 

  • Metcalf, B.S., Hosking, J., Jeffrey, A.N., Henley, W.E., & Wilkin, T.J. (2015). Exploring the adolescent fall in physical activity: A 10-yr cohort study (EarlyBird 41). Medicine & Science in Sports and Exercise, 58, 2084–2092.

  • Mitchell, J. A., Pate, R. R., Espana-Romero, V., et al. (2013). Moderate-to-vigorous physical activity is associated with decreases in body mass index from ages 9 to 15 years. Obesity, 21, E280–E286.

    Article  CAS  PubMed  Google Scholar 

  • Nader, P. R., Bradley, R. H., Houts, R. M., McRitchie, S. L., & O’Brien, M. (2008). Moderate-to-vigorous physical activity from ages 9 to 15 years. JAMA, 300, 295–305.

    Article  CAS  PubMed  Google Scholar 

  • National Physical Activity Plan Alliance. (2018). The 2018 United States report card on physical activity for children and youth. National Physical Activity Plan Alliance.

    Google Scholar 

  • Nelson, E. E., Leibenluft, E., McClure, E. B., & Pine, D. S. (2005). The social re-orientation of adolescence: A neuroscience perspective on the process and its relation to psychopathology. Psychological Medicine, 35, 163–174.

    Article  PubMed  Google Scholar 

  • Nicholls, J. G. (1989). The competitive ethos and democratic education. Cambridge, MA: Harvard University Press.

    Google Scholar 

  • Pate, R. R., Ward, D. S., Saunders, R. P., et al. (2005). Promotion of physical activity among high-school girls: A randomized controlled trial. American Journal of Public Health, 95, 1582–1587.

    Article  PubMed  PubMed Central  Google Scholar 

  • Pearson, N., Braithwaite, R., & Biddle, S. J. H. (2014). The effectiveness of interventions to increase physical activity among adolescent girls: A meta-analysis. Academic Pediatrics, 15, 9–18.

    Article  PubMed  Google Scholar 

  • Puyau, M. R., Adolph, A. L., Vohra, F. A., Zakeri, I., & Butte, N. F. (2004). Prediction of activity energy expenditure using accelerometers in children. Medicine and Science in Sports and Exercise, 36, 1625–1631.

    PubMed  Google Scholar 

  • Ridgers, N. D., Stratton, G., & McKenzie, T. L. (2010). Reliability and validity of the system for observing children’s activity and relationships during play (SOCARP). Journal of Physical Activity and Health, 7, 17–25.

    Article  PubMed  Google Scholar 

  • Robinson, T. N., Matheson, D. M., Kraemer, H. C., et al. (2010). A randomized controlled trial of culturally tailored dance and reducing screen time to prevent weight gain in low- income african american girls. Archives of Pediatrics and Adolescent Medicine, 164, 995–1004.

    Article  PubMed  Google Scholar 

  • Rosenkranz, R. R., Welk, G. J., & Dzewaltowski, D. A. (2011). Environmental correlates of objectively measured physical activity and sedentary behavior in aftereschool recreation sessions. Journal of Physical Activity and Health, 8, S214–S221.

    Article  PubMed  Google Scholar 

  • Ryan, R. M., & Deci, E. L. (2000). Self-determination theory and the facilitation of intrinsic motivation, social development, and well-being. American Psychologist, 55, 68–78.

    Article  CAS  Google Scholar 

  • Sallis, J. F., & Saelens, B. E. (2000). Assessment of physical activity by self-report: Status, limitations, and future directions. Research Quarterly for Exercise and Sport, 71, S1–S14.

    Article  CAS  PubMed  Google Scholar 

  • Scaccia, J. P., Cook, B. S., Lamont, A., Wandersman, A., Castellow, J., Katz, J., & Beidas, R. S. (2015). A practical implementation science heuristic for organizational readiness: R=MC^2. Journal of Community Psychology, 43, 484–501.

    Article  PubMed  PubMed Central  Google Scholar 

  • Sebire, S. J., Jago, R., Fox, K. R., Edwards, M. J., & Thompson, J. L. (2013). Testing a self-determination theory model of children’s physical activity motivation: A cross-sectional study. International Journal of Behavioral Nutrition and Physical Activity, 10, 111.

    Article  Google Scholar 

  • Sirard, J. R., Bruening, M., Wall, M. M., Eisenberg, M. E., Kim, S. K., & Neumark-Stzainer, D. (2013). Physical activity and screen time in adolescents and their friends. American Journal of Preventive Medicine, 14, 48–55.

    Article  Google Scholar 

  • Skinner, A. C., Ravanbakht, S. N., Skelton, J. A., Perrin, E. M., & Armstrong, S. C. (2018). Prevalence of obesity and severe obesity in US children, 1999–2016. Pediatrics, 141, e20173459.

    Article  PubMed  PubMed Central  Google Scholar 

  • Smith, A. L. (2003). Peer relationships in physical activity contexts: A road less traveled in youth sport and exercise psychology research. Psychology of Sport and Exercise, 4, 25–39.

    Article  Google Scholar 

  • Smith, A. L., Ullrich-French, S., Walker, E., & Hurley, K. S. (2006). Peer relationship profiles and motivation in youth sport. Journal of Sport and Exercise Psychology, 28, 362–382.

    Article  Google Scholar 

  • Steinberg, L. (2005). Cognitive and affective development in adolescence. Trends in Cognitive Sciences., 9, 69–74.

    Article  PubMed  Google Scholar 

  • Stuntz, C. P., & Weiss, M. R. (2009). Achievement goal orientations and motivational outcomes in youth sport: The role of social orientations. Psychology of Sport and Exercise, 10, 255–262.

    Article  Google Scholar 

  • Troiano, R. P., & Berrigan, D. (2008). Physical activity in the United States measured by accelerometer. Medicine and Science in Sports and Exercise, 40, 181–188.

    Article  PubMed  Google Scholar 

  • U.S. Department of Health and Human Services. (2008). Physical activity guidelines for Americans. Washington, D.C.: U.S. Department of Health and Human Services.

    Google Scholar 

  • Urdan, T. C., & Maehr, M. L. (1995). Beyond a two-goal theory of motivation and achievement: A case for social goals. Review of Educational Research, 65, 213–243.

    Article  Google Scholar 

  • Vandell, D., & Shumow, L. (1999). After-school child care programs. The Future of Children, 9(2), 64–80. https://doi.org/10.2307/1602707

    Article  CAS  PubMed  Google Scholar 

  • van Buuren, S., & Groothuis-Oudshoorn, K. (2011). mice: Multivariate imputation by chained equations in R. Journal of Statistical Software, 45, 1–67.

    Article  Google Scholar 

  • Vazou, S., Ntoumanis, N., & Duda, J. L. (2005). Peer motivational climate in youth sport: A qualitative inquiry. Psychol Sport Exercise, 6, 497–516.

    Article  Google Scholar 

  • Wang, C. C. (2006). Youth participation in photovoice as a strategy for community change. Journal of Community Practice, 14, 147–161.

    Article  Google Scholar 

  • Webber, L. S., Catellier, D. J., Lytle, L. A., et al. (2008). Promoting physical activity in middle school girls: Trial of activity for adolescent girls (TAAG). American Journal of Preventive Medicine, 34, 173–184.

    Article  PubMed  PubMed Central  Google Scholar 

  • Weiss, M. R., & Stuntz, C. P. (2004). A little friendly competition: Peer relationships and psychosocial development in youth sport and physical activity contexts. In M. R. Weiss (Ed.), Developmental sport and exercise psychology: A lifespan perspective (pp. 165–196). Fitness Information Technology: Morgantown, WV.

    Google Scholar 

  • Wiecha JL, Hall G, Gannett E, Roth B. (2011). National after school association standards for healthy eating and physical activity. http://www.niost.org/Standards-andGuidelines/national-afterschool-association-standards-for-healthy-eating-andphysical-activity-in-out-of-school-time-programs.

  • Wilson, D. K., Griffin, S., Saunders, R. P., Kitzman-Ulrich, H., Meyers, D. C., & Mansard, L. (2009). Using process evaluation for program improvement in dose, fidelity and reach: the ACT trial experience. International Journal of Behavioral Nutrition and Physical Activity, 6, 79.

    Article  Google Scholar 

  • Wilson, D. K., Van Horn, M. L., Kitzman-Ulrich, H., et al. (2011). Results of the “Active by Choice Today” (ACT) randomized trial for increasing physical activity in low-income and minority adolescents. Health Psychology, 30, 463–471.

    Article  PubMed  PubMed Central  Google Scholar 

  • Zarrett, N., Abraczinskas, M., Skiles-Cook, B., Wilson, D. K., & Ragaban, F. (2018). Promoting physical activity within underresourced afterschool programs: A qualitative investigation of staff experiences and motivational strategies for engaging youth. Applied Developmental Science, 22, 1–16.

    Article  Google Scholar 

  • Zarrett, N., Abraczinskas, M., Wilson, D. K., & Cook, B. (2020). A formative process evaluation of the “Connect” physical activity feasibility trial for adolescents. Clinical Medicine Insights: Pediatrics, 14, 1–11. https://doi.org/10.1177/1179556520918902

    Article  Google Scholar 

  • Zarrett, N., Skiles, B., Wilson, D. K., & McClintock, L. (2012). A qualitative study of staff’s perspectives on implementing an after school program promoting youth physical activity. Evaluation and Program Planning, 35(3), 417–426.

    Article  PubMed  Google Scholar 

  • Zarrett, N., Sorensen, C., & Skiles, B. (2013). Environmental and social-motivational contextual factors related to youth physical activity: Systematic observations of summer day camps. International Journal of Behavioral Nutrition and Physical Activity, 10, 63.

    Article  Google Scholar 

  • Zarrett, N., Skiles, B., & Sorensen, C. (2015). Physical and social-motivational contextual correlates of youth physical activity in underserved afterschool programs. Health Education and Behavior, 42, 518–529.

    Article  PubMed  Google Scholar 

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Acknowledgements

Research reported in this publication was supported by the Eunice Kennedy Shriver National Institute Of Child Health & Human Development of the National Institutes of Health under Award Number R21HD077357 (Zarrett, PI) and the National Institute of Nursing Research of the National Institutes of Health under Award Number 1R01NR017619-01 (Zarrett, PI). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. We also thank our after school program community partners and our intervention, measurement, and process evaluation teams.

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  1. Department of Psychology, University of South Carolina, 1512 Pendleton Street, Columbia, SC, 29208, USA

    Nicole Zarrett, Lauren H. Law, Dawn K. Wilson, Stephen Taylor, Brittany S. Cook & Alex Roberts

  2. Department of Family, Youth, and Community Sciences, University of Florida, Gainesville, FL, USA

    Michelle Abraczinskas

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  1. Nicole Zarrett
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  2. Lauren H. Law
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Correspondence to Nicole Zarrett.

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All procedures performed in this study involving human participants were in accordance with the ethical standards of the institutional research committee (Pro00037559) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This article does not contain any studies with animals performed by any of the authors. Informed consent was obtained from all individual participants included in the study.

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Zarrett, N., Law, L.H., Wilson, D.K. et al. Connect through PLAY: a randomized-controlled trial in afterschool programs to increase adolescents’ physical activity. J Behav Med 44, 379–391 (2021). https://doi.org/10.1007/s10865-021-00206-0

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