A protocol for coordinating rural community stakeholders to implement whole-of-community youth physical activity surveillance through school systems

Schenkelberg, Michaela A.; Essay, Ann M.; Rosen, Marisa S; Bavari, Arissa E.; Norgelas, Sara J.; Rosenkranz, Richard R.; Welk, Gregory J.; Dzewaltowski, David A.

doi:10.1016/j.pmedr.2021.101536

Cited by 12 publications

(19 citation statements)

References 26 publications

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“…This study reports results from one US rural Great Plains community in Nebraska (population=3460) with rural defined using US Department of Education definitions. 32 According to 2010 American Community Survey 5-Year estimates, 98.2% of residents in this community were non-Hispanic white, 33 and according to Nebraska Department of Education 2019–2020 Data Reports, 32.9% of students in the school district were eligible for free and reduced lunch. 34 Children and community stakeholders were recruited in 2018–2019, and a representative sample of a cohort of third through fifth graders in fall 2019 (n=144, 82.3% participation) and fall 2020 (n=174, 84.5% participation) from the community’s only elementary school completed the calibrated online Youth Activity Profile (YAP) assessment, 35 along with a supplemental assessment of out-of-school activities using items from the National Survey of Children’s Health (NSCH).…”

Section: Methodsmentioning

confidence: 99%

“…Children’s self-reported MVPA was obtained from the YAP, a calibrated 15-item tool designed to estimate children’s in-school and out-of-school PA behaviours, as well as sedentary screen time behaviour. 33 The school where this study was conducted started the academic year in August 2020 using a hybrid approach, but by the end of September 2020, the school was fully in person. In fall of 2019, the YAP was completed between 6 September 2019 and 18 September 2019; in fall of 2020, the YAP was completed between 9 October 2020 and 26 October 2020, after the school was fully reopened.…”

Section: Methodsmentioning

confidence: 99%

“…The community also received quarterly community data reports summarising the findings from the YAP. 33 …”

Section: Methodsmentioning

confidence: 99%

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The COVID-19 pandemic and changes in children’s physical activity in a rural US community: a mixed methods study

et al. 2022

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ObjectivesTo examine differences in rural community children’s moderate-to-vigorous physical activity (MVPA) and participation in out-of-school activities from fall 2019 to fall 2020 and explore enacted PA opportunity modifications post initial COVID-19 disruption.DesignMixed methods study using the validated Youth Activity Profile (YAP), administrator reports and stakeholder surveys and semistructured interviews.SettingChildren and community stakeholders from one rural US Great Plains community in the state of Nebraska were recruited.ParticipantsThird through fifth graders in fall 2019 (n=144) and fall 2020 (n=174) reported MVPA and participation in out-of-school activities using the YAP. School administrators reported weekly physical education (PE) and recess minutes. Community stakeholders reported pandemic-related changes in community social structures in semistructured interviews (n=4) and surveys (n=19).ResultsAverage daily MVPA minutes increased from 2019 to 2020 (75.0 vs 81.3, SE=1.6, p<0.05). Minutes of MVPA increased during: school hours (MD=2.7, SE=0.5, p<0.5); out-of-school time on weekdays (MD=3.9, SE=1.3, p<0.5); and on weekends (MD=5.5, SE=2.4, p<0.5). On average, fewer children participated in youth sport (42.5% vs 47.2%), youth clubs (10.3% vs 16.0%) and other out-of-school activities (24.1% vs 38.2%) in 2020, compared with 2019. Weekly PE/recess minutes increased from 208.3 to 241.7 from 2019 to 2020. Stakeholder surveys revealed community-driven modifications to PA opportunities, and interviews suggested children played outside more frequently, especially when school was closed and out-of-school activities were shut down.ConclusionsIncreased minutes of PE and recess, and decreased out-of-school activity participation may have increased children’s overall free play and MVPA during the pandemic. Free play was an important contributor to children’s PA during the pandemic and should be prioritised by educators, coaches and other leaders of child PA opportunities.Trial registration numberNCT03380143.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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The COVID-19 pandemic and changes in children’s physical activity in a rural US community: a mixed methods study

et al. 2022

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“…This study focused on a subset of those children (n = 235) who were included in the Wellscapes community randomized trial, given their involvement in classrooms, afterschool programs, youth clubs, and youth sports, which were selected for observation and accelerometer assessment. Parental consent was also obtained from trial participants (only) in order to pair children's school demographic data (e.g., date of birth, sex, free and reduced lunch status, and race/ethnicity) with their respective PA accelerometer data and surveillance instrument responses, based on a Data Sharing Agreement (DSA) established between participating schools (47). The data hub was housed within the research team.…”

Section: Study Samplementioning

confidence: 99%

“…With permission from the school district, administration, and staff, all 3rd through 6th -grade public education classrooms (n = 21) across communities (n = 2) were eligible to participate in Wave 1's social epidemiology study, which consisted of the administration of an online PA surveillance instrument near the beginning and end of each school year during designated class time. Previous work has documented the protocol (47) and summarized descriptive patterns at the population level (48). In the present study, we concentrated on the second administration of the instrument in May 2019, as opposed to the rst administration in September 2018, to capture children's PA behaviors that occurred during the school year.…”

Section: Study Samplementioning

confidence: 99%

The association between children’s participation in out-of-school time organized activities and physical activity in rural communities: a cross-sectional study

Seggern

Schenkelberg

Essay

et al. 2022

Preprint

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Background Out-of-school time (OST) organized group youth activities (e.g., afterschool programs, clubs) can reduce health inequalities by increasing physical activity (PA). However, unlike youth sport, PA is not the primary focus of many organized activities. This study examined the association between rural children’s demographic factors and OST non-sport organized activity participation and the differences between these factors and PA. Methods During Spring 2019, children (n = 418 3rd − 6th graders, aged 8–12 years) enrolled in two rural Midwestern public schools in the United States completed the Youth Activity Profile (YAP) and supplemental National Survey of Children’s Health 2017–2018 survey questions assessing OST organized activity participation as part of the Wellscapes Project, a type 3 hybrid implementation-effectiveness community randomized trial. A subsample of 235 children (males, n = 117; females, n = 118) provided parental/guardian consent to pair YAP results with student enrollment records. Average OST moderate-to-vigorous PA (MVPA) per weekday and weekend days was estimated using an algorithm converting raw YAP scores into minutes of MVPA. Mixed models with community as a random effect examined main effects and interactions of grade, sex, and family income on OST non-sport organized activity participation and these factors and participation on MVPA. Results Most children (73.2%) participated in an OST non-sport organized activity. Males were less likely to participate in organized activities than females (OR = 0.38, 95% CI = 0.20–0.73, p = 0.004). Females and 6th graders reported lower OST MVPA on weekdays and weekends than comparison groups (p < 0.001). Males with lower family income accumulated significantly fewer minutes of MVPA on weekdays (meandiff = -4.7 ± 2.0 minutes) and weekends (meandiff = -8.9 ± 3.8 minutes) compared with males with higher family income (p < 0.05). Conclusions Many rural children participated in OST organized activities regardless of grade and family income. However, there were inequalities in organized activity participation and OST weekday and weekend MVPA by demographic factors, including grade, sex, and family income. Designing OST organized activity settings to include PA may aid in reducing PA inequalities and promoting health equity.

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Community-engaged Systems for Population Health Improvement: A Novel Approach to Improve Diabetes Outcomes in Rural Communities

Pullyblank,

Rosen,

Wichman

et al. 2024

J Community Health

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Background Approaches to prevent and manage diabetes at a community population level are hindered because current strategies are not aligned with the structure and function of a community system. We describe a community-driven process based on local data and rapid prototyping as an alternative approach to create diabetes prevention and care management solutions appropriate for each community. We report on the process and provide baseline data for a 3-year case study initiative to improve diabetes outcomes in two rural Nebraska communities. Methods We developed an iterative design process based on the assumption that decentralized decision-making using local data feedback and monitoring will lead to the innovation of local sustainable solutions. Coalitions act as community innovation hubs and meet monthly to work through a facilitated design process. Six core diabetes measures will be tracked over the course of the project using the electronic health record from community clinics as a proxy for the entire community. Results Baseline data indicate two-thirds of the population in both communities are at risk for prediabetes based on age and body mass index. However, only a fraction (35% and 12%) of those at risk have been screened. This information led both coalitions to focus on improving screening rates in their communities. Discussion In order to move a complex system towards an optimal state (e.g., improved diabetes outcomes), stakeholders must have access to continuous feedback of accurate, pertinent information in order to make informed decisions. Conventional approaches of implementing evidence-based interventions do not facilitate this process.

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A protocol for coordinating rural community stakeholders to implement whole-of-community youth physical activity surveillance through school systems

Cited by 12 publications

References 26 publications

The COVID-19 pandemic and changes in children’s physical activity in a rural US community: a mixed methods study

The COVID-19 pandemic and changes in children’s physical activity in a rural US community: a mixed methods study

The association between children’s participation in out-of-school time organized activities and physical activity in rural communities: a cross-sectional study

Community-engaged Systems for Population Health Improvement: A Novel Approach to Improve Diabetes Outcomes in Rural Communities

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