Explore the vast range of titles available.

Background Most physical activity (PA) during school occurs at recess; however, recess PA may be influenced by children’s thermal comfort and interaction with nature, neither of which have concurrently been measured reliably in previous studies. This study tests the reliability of SOPLAY-SN, an adaption of the validated System for Observing Play and Leisure Activity in Youth (SOPLAY) to measure Shade and Nature (SN) alongside PA, and associations between children’s PA and interaction with shade and nature during recess to highlight the utility of the tool. Methods Interactions with shade and nature were measured using systematic direct observation at two playgrounds (primary-grade = ages 5–8, upper-grade = ages 9–12) during recess at an elementary school in Phoenix, Arizona (USA). Pairs conducted observations over four warm days (primary = 29–34 °C, upper-grade = 32–36 °C) in May 2021 ( N  = 179 scans). Intraclass correlation coefficients (ICC) were used to calculate inter-rater reliability. Mean counts, frequencies, and Kendall rank correlation coefficient tests were used to assess relations between PA level and interactions with shade and nature. Results Reliability was good for sedentary behavior (ICC = 0.98); light PA (LPA; ICC = 0.80) and moderate-to-vigorous PA (MVPA; ICC = 0.94); shade interaction (ICC = 0.95); and nature interaction (ICC = 0.80) and average agreement was good (86% overall PA, 88% shade, 90% nature). Most (60%) primary-grade children were observed in the shade, with 64% under a covered play structure where children were mainly (47%) sedentary. Of the 11% of primary-grade students observed interacting with nature, 90% occurred in a grass field with trees. Among upper-grade children, 23% were observed in the shade with 53% in grass fields where 48% of play was light. Few (7%) upper-grade children were observed interacting with nature, with most instances (76%) in a grass field with trees. Among primary-grade children, shade was correlated with sedentary behavior ( τ b  = 0.63, p  < .05); LPA ( τ b  = 0.39, p  < .05); MVPA ( τ b  = 0.56, p  < .05); and nature interactions with sedentary behavior ( τ b  = 0.16, p  < .05). Among upper-grade children, shade was correlated with sedentary behavior ( τ b  = 0.27, p  < .05) and LPA ( τ b  = 0.21, p  < .05). Conclusions SOPLAY-SN is a reliable tool for measuring children’s interaction with shade and nature and participation in PA. Understanding how shade and nature impact movement during recess can inform playground design for children’s health and well-being.

Background Latinx children in the United States are at high risk for nature-deficit disorder, heat-related illness, and physical inactivity. We developed the Green Schoolyards Project to investigate how green features—trees, gardens, and nature trails—in school parks impact heat index (i.e., air temperature and relative humidity) within parks, and physical activity levels and socioemotional well-being of these children. Herein, we present novel methods for a) observing children’s interaction with green features and b) measuring heat index and children’s behaviors in a natural setting, and a selection of baseline results. Methods During two September weeks (high temperature) and one November week (moderate temperature) in 2019, we examined three joint-use elementary school parks in Central Texas, United States, serving predominantly low-income Latinx families. To develop thermal profiles for each park, we installed 10 air temperature/relative humidity sensors per park, selecting sites based on land cover, land use, and even spatial coverage. We measured green features within a geographic information system. In a cross-sectional study, we used an adapted version of System for Observing Play and Recreation in Communities (SOPARC) to assess children’s physical activity levels and interactions with green features. In a cohort study, we equipped 30 3rd and 30 4th grade students per school during recess with accelerometers and Global Positioning System devices, and surveyed these students regarding their connection to nature. Baseline analyses included inverse distance weighting for thermal profiles and summing observed counts of children interacting with trees. Results In September 2019, average daily heat index ranged 2.0 °F among park sites, and maximum daily heat index ranged from 103.4 °F (air temperature = 33.8 °C; relative humidity = 55.2%) under tree canopy to 114.1 °F (air temperature = 37.9 °C; relative humidity = 45.2%) on an unshaded playground. 10.8% more girls and 25.4% more boys interacted with trees in September than in November. Conclusions We found extreme heat conditions at select sites within parks, and children positioning themselves under trees during periods of high heat index. These methods can be used by public health researchers and practitioners to inform the redesign of greenspaces in the face of climate change and health inequities.

Background Schools are recommended to use a whole-of-school (WOS) approach to promote physical activity opportunities before, during, and after school. Yet, the barriers and facilitators to implementing a WOS approach successfully are not well understood. The R = MC 2 heuristic, which defines readiness for implementation as a combination of an organization’s motivation and capacity to implement, can enhance our understanding of implementation in the school setting. This study examines associations between constructs from the R = MC 2 heuristic and schools’ implementation of a WOS approach. Methods We conducted a secondary analysis of cross-sectional data from U.S. elementary schools participating in the NFL PLAY60 FitnessGram Project during the 2022–23 school year. From surveys administered to school staff, we created a WOS index (range = 0–12) comprising six physical activity practices: physical education, recess, before and after-school programs, classroom-based approaches, and active transport. We also assessed how six constructs from the R = MC 2 heuristic (i.e., culture, implementation climate, leadership, priority, resources utilization, resource availability) impact physical activity implementation using a series of questions measured on a 5-point Likert scale. We used linear regression models to determine associations between R = MC 2 constructs (independent variables) and WOS index scores (dependent variable), controlling for school-level characteristics (student enrollment, percentage of race/ethnicity and economically disadvantaged students served) and state-level clustering. Results The analytic sample consisted of 132 schools across 18 states. On average, school staff rated leadership (mean = 4.1, range = 1.5–5) and organizational culture (mean = 4.0, range = 2.25–5) the highest. The mean WOS index score was 6.1. Partially adjusted models indicated significant positive associations between each R = MC 2 construct and WOS index scores. Fully adjusted regression models revealed priority ( b  = 0.88; p  = 0.010; 95% CI = 0.19–1.56) and implementation climate ( b  = 0.69; p  = 0.047; 95% CI = 0.07–1.32) were positively and significantly associated with WOS index scores. Conclusions Our study provides insights into key implementation constructs associated with providing school-based physical activity opportunities. These findings can support the development of resources and implementation strategies which, in turn, can help schools address implementation-related disparities. This will help schools improve the quality and accessibility of opportunities for physical activity provided to students across the United States.

To examine the associations between adverse childhood experiences (ACEs) and children’s obesogenic behaviors (meeting recommendations for sleep duration and screen time) in a representative sample of U.S. children and adolescents. This study assessed data from the 2019–2020 National Survey of Children’s Health. Separate multinomial logistic regressions examined the likelihood of failing to meet sleep and screen time recommendations given individual and cumulative ACE scores. 15,581 children (48% female, 32% non-White) experienced one ACE, representing 32% of the analyzed sample. Parents reported financial hardship as the most prevalent ACE (48%). After adjusting for child race/ethnicity, sex of the child, highest education in the household, and child age, we found that participants with four or more ACEs were (1) age-specific sleep recommendations compared with participants with zero ACEs (OR 1.96; 95%CI = 1.64–2.35), and (2) more likely to fall short of meeting screen use recommendations compared with participants with zero ACEs (OR 1.61; 95%CI = 1.26–2.07). U.S. children and adolescents who have experienced four or more ACEs are significantly more likely to fall short of sleep and screen time recommendations compared to their counterparts who experienced zero ACEs. Given the strong associations between ACEs and health outcomes in adulthood, screening for ACEs may better inform practitioners when attempting to improve youth health outcomes.

Rising temperatures threaten the resilience of public transit systems. We determined whether bus stop shelters and tree canopy surrounding bus stops moderated the effect of warm season temperatures on ridership in Austin, Texas, and whether shelters and trees were equitably distributed. For bus stops (n = 2271) of Capital Metropolitan Transportation Authority, boardings per bus were measured 1 April–30 September 2019. Air temperature data originated from the Camp Mabry weather station. Tree canopy was calculated by classification of high-resolution aerial imagery from the National Agriculture Imagery Program. Data on race, ethnicity, poverty level, median age, and bus commuters within census tracts of bus stops originated from the 2014–2018 American Community Survey. Using multilevel negative binomial regression models, we found that shelters did not moderate the effect of high temperatures on ridership (p > 0.05). During high temperatures, each one-percent increase in tree canopy was associated with a lesser decrease (1.6%) in ridership compared to if there were no trees (1.7%) (p < 0.001). In general, shelters and trees were equitably distributed. Insignificant or modest effects of shelters and trees on ridership during high temperatures may be attributed to the transit dependency of riders. For climate change adaptation, we recommend tree planting at bus stops to protect from ridership losses and unhealthy exposure to extreme heat.

Abstract Individuals in the USA are insufficiently active, increasing their chronic disease risk. Extreme temperatures may reduce physical activity due to thermal discomfort. Cooler climate studies have suggested climate change may have a net positive effect on physical activity, yet research gaps remain for warmer climates and within-day physical activity patterns. We determined the association between ambient temperatures (contemporary and projected) and urban trail use in a humid subtropical climate. At a trail in Austin, TX, five electronic counters recorded hourly pedestrian and cyclist counts in 2019. Weather data were acquired from World Weather Online. Generalized additive models estimated the association between temperature and trail counts. We then combined the estimated exposure–response relation with weather projections from climate models for intermediate (RCP4.5) and high (RCP8.5) emissions scenarios by NASA NEX-GDDP. From summer to autumn to spring to winter, hourly trail counts shifted from bimodal (mid-morning and early-evening peaks) to one mid-day peak. Pedestrians were more likely to use the trail between 7 and 27 °C (45–81°F) with peak use at 17 °C (63°F) and cyclists between 15 and 33 °C (59–91°F) with peak use at 27 °C (81°F) than at temperature extremes. A net decrease in trail use was estimated by 2041–2060 (RCP4.5: pedestrians =  − 4.5%, cyclists =  − 1.1%; RCP8.5: pedestrians =  − 6.6%, cyclists =  − 1.6%) and 2081–2100 (RCP4.5: pedestrians =  − 7.5%, cyclists =  − 1.9%; RCP8.5: pedestrians =  − 16%, cyclists =  − 4.5%). Results suggest climate change may reduce trail use. We recommend interventions for thermal comfort at settings for physical activity.

Parks are settings for physical activity that can support the physical and mental health of children during the COVID-19 pandemic. We determined the impact of the pandemic on the use of joint-use parks outside of school hours by children in Austin, TX, United States. In autumn of 2019 and autumn of 2020 (i.e., before and during the COVID-19 pandemic), we used an adapted version of the System for Observing Play and Recreation in Communities to observe whether children aged 1–12 participated in physical activity (i.e., sedentary, light and moderate, vigorous) at three parks located at schools serving mostly economically disadvantaged Latinx families. In 2020, we also observed whether children maintained social distance and wore face coverings. Results of negative binomial regression modeling revealed the pandemic was associated with a 46% [95% CI: 20–63%] and 62% [95% CI: 39–76%] decrease in the number of girls and boys at parks, respectively, and a 42% [95% CI: 16–59%] and 60% [95% CI: 36–75%] decrease in the number of girls and boys engaging in physical activity, respectively (p < 0.01). In total, 60.6% of girls and 73.6% of boys were not social distancing, and 91.8% of the time no children wore masks. Interventions should be considered to safely reintroduce children to parks for health benefits during pandemics.

Perceived safety remains one of the main barriers for children to participate in active commuting to school (ACS). This ecological study examined the associations between the number of police-reported crimes in school neighborhoods and ACS. The percentage of active travel trips was assessed from a teacher tally survey collected from students across 63 elementary schools that were primarily classified as high-poverty (n = 27). Geographic Information System (GIS) was used to create a detailed measure of police-reported crimes during 2018 and neighborhood covariates that occurred within a one-mile Euclidean buffer of the schools. Statistical analyses included linear fixed effects regressions and negative binomial regressions. In fully-adjusted models, reported crime did not exhibit significant associations with ACS. Medium-poverty schools were indirectly associated with ACS when compared to high- and low-poverty schools in all models (p < 0.05). Connectivity and vehicle ownership were also directly associated with ACS (p < 0.05). Low- and medium-poverty schools were indirectly associated with all types of reported crime when compared to high-poverty schools (p < 0.05). Although reported crime was not associated with school-level ACS, differences in ACS and reported crime do exist across school poverty levels, suggesting a need to develop and promote safe and equitable ACS interventions.

Schools are recommended to use a whole-of-school (WOS) approach to promote physical activity opportunities before, during, and after school. Yet, the barriers and facilitators to implementing a WOS approach successfully are not well understood. The R = MC heuristic, which defines readiness for implementation as a combination of an organization's motivation and capacity to implement, can enhance our understanding of implementation in the school setting. This study examines associations between constructs from the R = MC heuristic and schools' implementation of a WOS approach. We conducted a secondary analysis of cross-sectional data from U.S. elementary schools participating in the NFL PLAY60 FitnessGram Project during the 2022-23 school year. From surveys administered to school staff, we created a WOS index (range = 0-12) comprising six physical activity practices: physical education, recess, before and after-school programs, classroom-based approaches, and active transport. We also assessed how six constructs from the R = MC heuristic (i.e., culture, implementation climate, leadership, priority, resources utilization, resource availability) impact physical activity implementation using a series of questions measured on a 5-point Likert scale. We used linear regression models to determine associations between R = MC constructs (independent variables) and WOS index scores (dependent variable), controlling for school-level characteristics (student enrollment, percentage of race/ethnicity and economically disadvantaged students served) and state-level clustering. The analytic sample consisted of 132 schools across 18 states. On average, school staff rated leadership (mean = 4.1, range = 1.5-5) and organizational culture (mean = 4.0, range = 2.25-5) the highest. The mean WOS index score was 6.1. Partially adjusted models indicated significant positive associations between each R = MC construct and WOS index scores. Fully adjusted regression models revealed priority (b = 0.88; p = 0.010; 95% CI = 0.19-1.56) and implementation climate (b = 0.69; p = 0.047; 95% CI = 0.07-1.32) were positively and significantly associated with WOS index scores. Our study provides insights into key implementation constructs associated with providing school-based physical activity opportunities. These findings can support the development of resources and implementation strategies which, in turn, can help schools address implementation-related disparities. This will help schools improve the quality and accessibility of opportunities for physical activity provided to students across the United States.

This dissertation investigates the relationship between extreme summer heat and outdoor, indoor, and total (i.e., outdoor + indoor) physical activity levels of US adults. With the lack of physical activity across the US, public health practitioners and city planners are making concerted efforts to promote physical activity through formal interventions and the design of spaces, respectively. To inform physical activity interventions, researchers examine which factors associate with physical activity, one of which is temperature. The majority of studies exhibit a significant positive association between temperature and physical activity, yet no studies examine exceptionally hot summer days, which disproportionately impact cities and are set to become more prevalent in the future. This dissertation tests three novel questions: 1) how do hot days associate with outdoor, indoor, and total physical activity; 2) how do hot days influence the effect of built environment factors on outdoor physical activity; and 3) how do heat waves – consecutive hot days – associate with outdoor, indoor, and total physical activity?This work made use of self-reported physical activity and demographic data collected during summer 2016 for a National Science Foundation project (NSF award number: 1520803). The study sample included a spatial and demographic mix of ~50 adults per study city (i.e., Atlanta, Detroit, and Phoenix). Heat was measured as both hot days and heat waves (i.e., two or more consecutive hot days), utilizing air temperature and relative humidity data collected at each city’s major airport. The examined built environment factors (i.e., density, safety, trees, hilliness, connectivity, access to parks, and access to shops + services) were primarily collected from government sources and calculated within an 800m Euclidean distance of each study participant’s home address. Separate two-level growth curve models were run for each research question, version of the dependent variable (i.e., Any Activity and Recommended Activity), and location of physical activity (i.e., outdoor, indoor, and total).Multilevel modeling predicted that 1) hot days do not exhibit a significant association with indoor, outdoor, or total physical activity; 2) hot days do not significantly influence the effect of built environment factors on outdoor physical activity; and 3) heat waves do not exhibit a significant association with outdoor, indoor, or total physical activity. These findings refute the study hypotheses that extreme summer heat would decrease outdoor and total physical activity, while shifting physical activity to indoor, thermally comfortable environments. With high temperatures potentially not serving as a barrier to physical activity, cities should allocate resources to reducing the risk of exertional heat illness, an adverse health event expected to become more frequent with physical activity promotion and climate change.