Contemporary American youth fail to meet national recommendations for physical activity at alarmingly high rates despite well-established protective effects of physical activity on multiple domains of health. There is an established pattern of disparity in physical activity participation whereby girls, those of lower socioeconomic status and those of African American and Hispanic backgrounds are less apt to report regular physical activity in keeping with national recommendations. Large scale investigations to increase the proportion of highly active youth have yet to realize widespread success. In light of emerging evidence suggesting physical activity levels may begin to decline earlier than previously thought, there is a possibility that research and intervention efforts to date may have approached the problem of declining activity after the risk behavior of inactivity had already been established. Despite numerous investigations into factors associated with physical activity in youth, many questions remain unanswered. Among the considerations that are not well understood is when physical activity levels begin to decline for at-risk subgroups of youth and what modifiable individual, interpersonal and/or environmental-level factors are associated with remaining highly active in these populations. This ecologically-based cross-sectional study represents an initial step toward addressing these considerations among elementary and middle school students. Self-reported primary data were collected from a convenience sample of 321 public school students from the 4th, 6th and 8th grade. Students represent the racial/ethnic and socio-economic groups at greatest risk of not meeting national recommendations for physical activity. Study questionnaires queried a range of factors believed to be associated with physical activity, such as availability of social support, self-efficacy for activity, and perceptions of environmental attributes. In addition, two separate physical activity outcome measures were assessed. Factors associated with physical activity at the univariate level (p>0.2) were included in forward stepwise binary regression models to predict reporting of high physical activity. A significant decrease in the proportion of highly active girls was noted between the 4th and 6th grade groups while the proportion of highly active boys did not differ significantly between grade levels. Among 6th and 8th grade students, the difference in physical activity between genders was significant with males reporting more physical activity than females in each grade level. Distinct variables were associated with highly active students in each grade- and gender-specific regression model. After controlling for all other included variables, high social support was most strongly associated with reporting of high activity among girls while for boys in this sample, perceived normal weight status was the strongest predictor of high activity. Among all students, use of daily active transport to school was also strongly associated with reporting of high physical activity. Future investigations involving younger students and utilizing enhanced, longitudinal designs may provide greater insight into the preliminary findings reported in this study. / Public Health

Yes / Physically active lessons present a key paradigm shift in educational practice. However, little is known about the barriers to implementing physically active lessons. To address this, 31 practising primary teachers (23 = female) from 9 primary schools across West Yorkshire, England, were engaged in focus group interviews. Drawing on the socio-ecological model, findings revealed that barriers influencing the implementation of physically active lessons are multifaceted. Teacher’s confidence and competence, concerns over classroom space, preparation time and resources, coupled with the wider school culture that is influenced by governors and parents, reinforce a didactic approach and act as barriers to physically active lessons.

Published Article / The medical biological and ecosystemic models are two paradigms which are currently making a huge impact on education support services on an international level. The medical biological model has been dominating the way in which multidisciplinary support has been delivered within 20th-century special education. However, with the advent of inclusive education, the ecosystemic model has initially been pushed to the fore as the preferred metatheory of support services. This article specifically interrogates these two conflicting paradigms in education support services within the South African schooling and higher education bands, as well as Bronfenbrenner's integration of these models with regard to the bio-ecological model. Finally, this article proposes the bio-ecosystemic framework according to which the training of multidisciplinary education support services staff should proceed in order to ensure a sound and less conflicting theoretical framework.

Overweight and obesity in Mexican children substantiates the need to identify effective strategies and policies to address this problem. Instituto Nacional de Salud Publica (INSP) designed and implemented a randomized control trial (RCT) to assess an ecologically-based intervention program to modify the school environment to promote healthy lifestyle behaviours in children. The objectives of this thesis are to describe the design and impact of this RCT, to examine the program content through an ecological approach, and to examine policy activities that have been informed by the RCT findings. Four manuscripts address these objectives. Manuscript one is Promoting a Healthful Diet and Physical Activity in the Mexican School System for the Prevention of Obesity in Children: Rationale, Design and Methods. It describes the rationale, design, and methods of the two-year INSP-Secretaria de Educacion Publica (Secretary of Public Education, SEP) RCT. Manuscript two is Impact of a School-based Intervention Program on Obesity Risk Factors in Mexican Children. It reports on the environmental impact of the INSP-SEP intervention by comparing 16 intervention schools with 11 non-intervention schools. Results showed increased availability and food intake of healthy foods with a concomitant decrease in unhealthy food availability in intervention schools/children. Manuscript three is An Ecological and Theoretical Deconstruction of a School-based Obesity Prevention Program in Mexico. It reports on an assessment of the integration of ecological principles and theoretical constructs in the school-based behavioural change/obesity prevention intervention carried out by the INSP-SEP. Results showed that 32 intervention strategies were implemented in the school setting to engage target-groups; the most used SCT construct was Reciprocal Determinism. Manuscript four is titled Quality and Implementation of the Nutrition and Physical Activity School Policy Guidelines in Mexico City. It assesses the quality and implementation conditions of a policy and reports on the implementation and the uptake of the national school policy to prevent obesity in Mexico city through a policy analysis, WHO School Policy Framework (SPF) and indicators informed by the national policy. Findings showed that not all of the 10 implementation pre-conditions were met; School Guidelines mostly complied with SPF but were not fully implemented within our sample. / Thesis (Ph.D, Kinesiology & Health Studies) -- Queen's University, 2013-09-30 17:05:33.787

Identification of evidence-based treatments (EBTs) has been an important development; however recently, some shortcomings of the approach have been highlighted. These complexities have led to a surge in transportability research in mental health services science with goals of identifying needed strategies to encourage the adoption of innovations. The mental health system ecological (MHSE) model is an approach necessary to assist with closing this gap effectively as it integrates mental health contexts: client-level, provider-level, intervention-specific, service delivery, organizational, and service system characteristics. The aim of this study is to use the MHSE model to examine perspectives of mental health stakeholders on their needs. Data consists of qualitative transcripts from parent, therapist, and administrator interviews/focus groups. Mixed methods were used to develop and analyze codes according to the MHSE model. Results suggested that stakeholder groups mentioned needs relevant to the group of interest and thus have implications for future dissemination efforts.

Research suggests parental home and school involvement improves multiple outcomes for middle school students, including academic achievement, school engagement, motivation, self-efficacy, and prosocial behaviors. Little is known, however, about multilevel factors associated with Latino/a parental involvement in the middle school learning environment. In the current study, multilevel analysis was used to explore student, family, and school factors associated with Latino/a parental involvement. Results from the hierarchical linear modeling analyses found (a) Latino/a parental home and school involvement varied within schools and between schools, (b) student gender, prosocial behavior, and academic achievement were positively associated with parental home involvement, and (c) student gender, problem behavior, prosocial behavior, academic achievement, and family socioeconomic status were positively associated with parental school involvement. Percentages of Latino/a students and low-income students in schools did not significantly moderate the average parental home or school involvement across students and across schools. The results of this study have implications for educators and policy makers to promote Latino/a parent-teacher collaboration in the middle school learning environment.

Only one third of children and youth meet current physical activity (PA) guidelines. Low levels of PA can impact future PA, the probability of obesity, and delay fundamental motor skill (FMS) development. One environment associated with children’s PA is the school playground. Limited research has explored how motor skill development and other child level factors may influence playground behavior. The purpose of this study was to explore playground behaviour and determine if children’s motor skills predicted playground behavior (e.g. enjoyment, frequency, intensity and type of play). A secondary objective was to explore whether other individual level variables influenced these playground behaviours (e.g. sex, physical activity, strength). All grade 2 and 3 children from one school were recruited to participate in this cross-sectional mixed-methods study. Information about PA was collected using the Physical Activity Questionnaire for Children and the Children’s Assessment of Participation and Enjoyment. Playground behavior information was collected using the Playground Enjoyment Questionnaire. The Test of Gross Motor Development - 2 and the stork stand were used to assess FMS and a handheld dynamometer assessed grip strength. Descriptive statistics and a one-way analysis of variance were calculated to determine if children’s PA differed between playground areas and sex. Pearson product moment correlation coefficients examined associations among children’s individual factors and playground play. Linear regression examined if children’s FMS and significant individual correlates predicted playground engagement. A total of 54 children with a mean age of 8.46yrs (SD = 0.68) participated. The sample included 31 boys (M = 8.48yrs of age (SD = 0.73) and 23 girls (M = 8.43, SD = 0.59). Correlation coefficients revealed that FMS were not significantly related to children’s playground engagement. Boys frequented the field more than girls (F (1, 52) = 5.18, p = .027), enjoyed the field (F (1, 52) = 4.07, p = .049), the courts (F (1, 52) = 6.74, p = .012) and the nature space (F (1, 52) = 4.19, p = .046) more than girls. Object control skills negatively predicted built structure play frequency (B = -.267, t = -2.39, p = .022). Gross motor quotient predicted the type of activities children engaged in the built structures (B = .055, t = 2.178, p = .035). Children’s overall PA positively predicted their play frequency, intensity, and enjoyment in court areas and intensity in the field. Grip strength predicted enjoyment in field areas. Recreational PA level negatively predicted play frequency on tarmac areas. Although, children’s FMS rarely predicted where and how children engaged on school playground spaces, other child factors (i.e. sex, PA, and grip strength) did. Children’s self-reports showed that friends also influenced their play behaviours. FMS development did not have a significant impact on where or how children played on the playground, which suggests that children of varying FMS may engage in the same play spaces. In the context of the ecological model there were child level factors that influenced their interaction with the playground as a micro-environment which requires further investigation. / Graduate

Philosophiae Doctor - PhD / The importance of health enhancing physical activity participation (HEPA) has always been emphasized globally, as one of the means to reduce the risk of Non-Communicable Diseases (NCDs) occurrence. In Africa, it is more relevant currently, due to the growing burden of NCDs that is coupled with the existing encumbrance of communicable diseases. In Rwanda, specifically, there are limited national strategies to promote health-enhancing physical activity. Consequently, the level of physical activity among Rwandans, especially government office workers, is likely to diminish, which could possibly be attributed to the rapid urbanization that comes with lifestyle changes. Basically, most people tend to abandon the traditional labour-intensive activities, which are associated with high energy expenditure, to more sedentary activities. Therefore, the need to promote health enhancing physical activity participation is crucial. Physical activity participation is an intricate and multifaceted behaviour that may not be viewed from a linear perspective. This current study adopted a socio-ecological framework to assess the factors that influence Leisure Time Physical Activity (LTPA) among government employees in Kigali City. The study used an exploratory, sequential, mixed methods of qualitative and quantitative designs, in order to comprehensively explore and understand the research problem. Qualitatively, a Case study and exploratory design was used to collect data, specifically from the Rwanda Sport Policy and its implementing stakeholders. Quantitatively, a cross-sectional, descriptive design was used to assess and describe the levels of LTPA among government workers in Kigali City, as well as highlight the various factors that influence, or limit, their participation.

Sports-related concussions are a growing public health concern affecting numerous varsity football student-athletes. This study used the social ecological model to identify intrapersonal, interpersonal, and environmental factors. The purpose of this study is to identify constraints and facilitators in academic and athletic settings for varsity football student-athletes with a sport-related concussion. Twelve current varsity football student-athletes from one institution who suffered a sport-related concussion took part in semi-structured interviews. Data were thematically analyzed. Results indicate that varsity football student-athletes with a sport-related concussion perceived numerous constraining and facilitating social ecological factors in the academic and athletic settings. Intrapersonal constraints revolved around loss of motivation, loss of social identification, stress, anxiety and depression, injury-specific issues (i.e. difficulty thinking clearly, remembering, drowsiness), internal pressure to return, while intrapersonal facilitators included prior experiences of enjoyment in academic and athletic activities, seeing improvements in the recovery process, and not giving up. Interpersonal constraints related to insufficient social support, lack of awareness and guidance on concussion knowledge, external pressure to return, and lack of academic support post-concussion, while interpersonal facilitators included passionate therapy staff, and sport psychologist. Environmental constraints pertained to return-to-play and return-to-learn protocols, while environmental facilitators included having access to concussion-based resources. Findings suggest that there remains a need to address constraining and facilitating factors in the academic and athletic settings for varsity football student-athletes with a sport-related concussion

Low birth weight (LBW) is a major public health concern globally. Despite its negative social and economic impact on the family and community at large, it has remained relatively unexplored at population level in Zimbabwe. The purpose of the study was to establish determinants of LBW using data from the 2015 Zimbabwe Demographic and Health Survey. The socioecological model was the conceptual framework for the study. A secondary analysis was conducted on 4,227 mother-infant dyads. Independent variables were duration of pregnancy, number of births within the past 5-year period, exposure to mass media, type of fuel used for cooking in the household, and intimate partner violence. Covariates were maternal age at delivery, place of residence, anemia, marital status, education, wealth index, ever terminated pregnancy, infant sex, and alcohol consumption. For parsimony, statistical significance was set at p < 0.05 at the 95% confidence interval (CI). Multivariable logistic regression analysis showed that mild maternal anemia (adjusted odds ratio [aOR] 1.83 CI 1.17-2.87 p = 0.01), moderate to severe anemia (aOR 1.80 CI 1.01-3.19 p = 0.05), and being a female neonate (aOR 1.48 CI 1.17-2.87 p = 0.008) had higher odds for LBW. Pregnancy duration of 8 months (aOR 0.01 CI 0.003-0.039 p < 0.001) and of 9 months (aOR 0.12 CI 0.04-0.33 p = 0.001) had lower odds for LBW. Birth of 2 infants within a 5-year period (aOR 2.40 CI 1.24-4.66 p = 0.01) was associated with LBW. Implications for positive social change include coming up with a health policy on the management of anemia during pregnancy and health promotion messages to promote optimal birth spacing, including strategies that reduce chances for preterm deliveries.