BACKGROUND After‐school programs (ASP) provide opportunities to influence children's physical activity (PA). However, little is known about the PA levels of the youngest schoolchildren. The aim of the study was to describe the level of PA intensity and sedentary time among first graders attending ASP in Norway, and to investigate factors that are associated with PA in the ASP. METHODS First graders from 14 ASPs were invited to participate in the study and 426 children were included. The children wore an accelerometer for five consecutive days during their stay in the ASP. Light, moderate, and vigorous PA and sedentary time were registered and analyzed. RESULTS On average, the children accumulated 25.8 minutes of moderate and vigorous physical activity (MVPA) during their ASP‐stay. However, there was considerable variation within the sample. Sex, as well as body mass, were associated with MVPA. The activity level increased substantially when the children had to be outside. CONCLUSIONS The findings show that on average, the children were quite physically active in the ASP. However, it seems critical to devote increased attention to the least active children and to include extensive outdoor play‐time in the ASP schedule.

A critical health literacy (CHL) approach is recommended for promoting health in the school context. This construct is complex and includes three interconnected domains: (A) appraisal of critical information, (B) awareness of the social determinants of health (SDH), and (C) collective action to promote health and well-being. In recent literature reviews, no measurement instrument that covers all three domains of CHL in the school-context was found. Our aim was to develop self-reported measurement scales for each domain of CHL. The development process reported in this study was conducted in two stages. In the first stage, an initial item pool was generated based on literature reviews and focus group interviews (N = 15) with adolescents (steps 1–2). In the next steps, items were adjusted and removed based on the feedback from an expert panel and from representatives from the target group (steps 3–5). In stage two, we aimed to reduce the number of items and develop scales for each domain. We then piloted the current draft, which consists of 28 items (N = 114). A sub-sample (N = 10) of the participants were interviewed after they completed the survey to examine the instrument’s face validity. Cronbach’s α was used to assess the internal reliability of the scales; the reliability was promising for scales A (α = 0.83) and C (α = 0.85) but was below the recommended value for scale B (α = 0.61). The model fit indices were promising (TLIscaleA = 0.97, RSMEAscaleA = 0.055, TLIscaleB = 1.05, RMSEAscaleB = 0.00, TLIscaleC = 0.95, RMSEAscaleC = 0.074). The piloted version of scales A and C were positively correlated with subjective health literacy, health-related quality of life, and subjective health; however, we found no such correlations for scale B. The post-survey group interviews led to some adjustments in scales A and B. The revised version of CHLA-Q must be tested using a larger sample; this will enable more robust statistical testing of the properties of the items and the scale.

Background: Interventions directed at after school programs (ASPs) have the potential to support physical activity (PA) in young children. Research has indicated that interventions that emphasize competence building among the ASP staff can lead to increased PA among the children. The present study evaluates the effectiveness of the Active Play in ASP intervention-a program for ASP staff aimed at supporting physical activity among first graders in ASP. Methods: We used a matched-pair cluster randomized design and included 456 first graders from 14 schools in Norway. From these, 7 ASPs received the intervention (N = 229), while 7 acted as controls (N = 227). Measurements were taken at baseline, immediately post intervention (7 month follow-up) and after a year (19 month follow-up). The primary outcome was moderate to vigorous physical activity (MVPA), which was estimated with predefined cut points of counts per minute (CPM) and expressed as minutes/hour. Secondary outcomes were vigorous and light intensity physical activity (VPA and LPA) and sedentary behavior. The analyses of intervention effects were based on between-group differences in outcome changes between the 3 measurement points and were conducted using a mixed-effects model for repeated measures using categorical time. In exploratory analyses, we investigated gender, baseline body mass index, and baseline CPM as potential effect modifiers. Results: No significant intervention effects was observed on MVPA (0.55 min/hour [99% CI-0.55:1.64]) or on the secondary outcomes, min/hour of LPA, VPA or sedentary behavior. Exploratory analyses indicated that among the 50% least physically active children at baseline, children in intervention ASPs reduced sedentary time from baseline to 19 months follow up by 1.67 min/hour (95% CI-3.12:-0.21) compared to the controls.

Background Development of motor competencies and learning of movements in children is dependent on varied physical activity (PA). After-school programs (ASP) might provide opportunities for young schoolchildren to participate in PA. The aim of the current study was to investigate the PA of first graders in ASP and to consider its contribution to the development of motor competencies and the learning of movements. Methods The study was performed utilizing a mixed methods design. A total of 42 first graders were sampled from 14 ASPs in Norway. Direct observations of the children's activities were conducted for the duration of one entire ASP day. PA intensity was measured using ActiGraph accelerometers. Qualitative data were analyzed using qualitative content analysis, while the Mann-Whitney U test and the Wilcoxon signed-rank test were used to analyze the quantitative data. Results The median PA time among the observed children was 61.5 minutes. The median stationary time was 75.9 minutes. There was considerable variation within the sample. Girls were significantly more engaged in stationary behavior than boys. Frequent changes in activity type and intensity were typical features of the children's ASP day. PA duration and intensity were significantly higher outdoors than indoors. Adult-managed time had longer periods of stationary behavior than child-managed time. The PA at all intensity levels contained barrierbreaking movements-especially at light intensity levels.

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