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\"The U.S. Air Force asked the RAND Corporation to assist its development and validation of gender-neutral tests and standards for battlefield airmen (BA) specialties. The Air Force has conducted an extensive validation study of occupational relevance of physical fitness tests and standards. Following the fitness test validation study, one enlisted specialty (Tactical Air Control Party [TACP]) and one officer BA specialty (Air Liaison Officer [ALO]) moved forward with an implementation plan to further evaluate a set of recommended tests and continuation standards. This report describes RAND's assistance to the Air Force on two fronts: (1) conducting a preliminary evaluation of potential issues and concerns that might influence implementation effectiveness and (2) developing a framework for evaluating the implementation of occupationally relevant and specific tests and standards. This work provides the foundation for ongoing review and evaluation of Air Force fitness tests and standards, which are designed to ensure that airmen are capable of performing critical physical tasks associated with their assigned specialties\"--RAND website.

Body composition influences physical fitness (PF) and risk of musculoskeletal injury (MSKI). Assessing the relationship between body fat (BF), PF and MSKI risk in a large diverse military population may provide evidence basis informing health-care policies, practices, and programs for military and civilian populations. Evaluate the validity of expedient methods to estimate BF (e.g., circumference-based equation (CBE) and bioelectrical impedance analysis (BIA)) and investigate relationships between BF and PF with MSKI risk in a large diverse population. Participants were 1904 active-duty Soldiers (643 F) representing Army demographics sex, race/ethnicity (R/E), and age. PF, defined as the most recent Army Combat Fitness Test (ACFT) score and incidence of MSKI, were obtained from Army records. BF was determined by dual-energy x-ray absorptiometry (%BF ), bioelectrical impedance analysis (%BF ), and CBE using 3-site (Hodgdon, %BF ) and 1-site (Taylor-McClung, %BF ) equations. Results were stratified by race and sex, to evaluate differences in accuracy of estimated %BF (weighted root mean squared error from %BF ). Associations of BF and PF with MSKI risk were evaluated with logistic regression. CBE and BIA underestimated %BF compared to %BF . %BF differed from %BF overall and by sex. %BF underestimation was uniform across both sex and R/E compared to %BF . Mean differences from %BF by sex (M;F) were lower when measured by %BF (4.38; 4.59) compared to %BF (5.88; 4.39). Individuals had a greater likelihood of MSKI if they failed BF standards (odds ratio 1.32). Scoring ≥ 540 total on ACFT exhibited a 31% (95% CI: 0.52, 0.92) lower MSKI risk during the following 12 months than those with a lower score. A single-site BF equation (%BF ) maintained similar accuracy across the Soldier population by sex, age, and R/E. Implementing a PF score threshold in lieu of passing Army BF standards was associated with lower MSKI risk.

Our objective was to describe policy infrastructure of elementary school fitness testing at the state level and to assess states' readiness for implementation of the recently reinstated Presidential Fitness Test. We conducted a cross-sectional policy analysis by using data from the State of the States Policy Report and used the Classification of Laws Associated with School Students to create a standardized readiness index. Only 5 states required recommended weekly minutes of physical education, 24 had no fitness testing requirements, 6 mandated testing results reporting, and most delegated compliance monitoring locally. State policies are not positioned to support large-scale standardized fitness testing, indicating a need for coordinated reform.

This article describes the conceptual design and evaluation strategies used in the NFL PLAY 60 FITNESSGRAM® Partnership Project, a large participatory research network focused on building effective school physical education programming. The article summarizes the unique participatory design, recruitment methods, programming strategies, and analytical plans used to evaluate this large project. The study provides unique insight into how to effectively deliver large-scale school-based physical fitness and physical activity programming to support and enhance physical education programming in schools. (Autor).

Physical fitness affects our ability to function and be active.At poor levels, it is associated with such health outcomes as diabetes and cardiovascular disease.Physical fitness testing in American youth was established on a large scale in the 1950s with an early focus on performance-related fitness that gradually gave way to an emphasis on.

Background:  Comprehensive school‐based physical activity programs consist of physical education and other physical activity opportunities including recess and other physical activity breaks, intramurals, interscholastic sports, and walk and bike to school initiatives. This article describes the characteristics of school physical education and physical activity policies and programs in the United States at the state, district, school, and classroom levels. Methods:  The Centers for Disease Control and Prevention conducts the School Health Policies and Programs Study every 6 years. In 2006, computer‐assisted telephone interviews or self‐administered mail questionnaires were completed by state education agency personnel in all 50 states plus the District of Columbia and among a nationally representative sample of districts (n = 453). Computer‐assisted personal interviews were conducted with personnel in a nationally representative sample of elementary, middle, and high schools (n = 988) and with a nationally representative sample of teachers of required physical education classes and courses (n = 1194). Results:  Most states and districts had adopted a policy stating that schools will teach physical education; however, few schools provided daily physical education. Additionally, many states, districts, and schools allowed students to be exempt from participating in physical education. Most schools provided some opportunities for students to be physically active outside physical education. Staff development for physical education was offered by states and districts, but physical education teachers generally did not receive staff development on a variety of important topics. Conclusions:  To enhance physical education and physical activity in schools, a comprehensive approach at the state, district, school, and classroom levels is necessary. Policies, practices, and comprehensive staff development at the state and district levels might enable schools to improve opportunities for students to become physically active adults.

Assessments of the duration of concussion recovery have primarily been limited to sport-related concussions and male contact sports. Furthermore, whereas durations of symptoms and return-to-activity (RTA) protocols encompass total recovery, the trajectory of each duration has not been examined separately. To identify individual (eg, demographics, medical history), initial concussion injury (eg, symptoms), and external (eg, site) factors associated with symptom duration and RTA-protocol duration after concussion. Cohort study. Three US military service academies. A total of 10 604 cadets at participating US military service academies enrolled in the study and completed a baseline evaluation and up to 5 postinjury evaluations. A total of 726 cadets (451 men, 275 women) sustained concussions during the study period. Number of days from injury (1) until the participant became asymptomatic and (2) to complete the RTA protocol. Varsity athlete cadets took less time than nonvarsity cadets to become asymptomatic (hazard ratio [HR] = 1.75, 95% confidence interval = 1.38, 2.23). Cadets who reported less symptom severity on the Sport Concussion Assessment Tool, third edition (SCAT3), within 48 hours of concussion had 1.45 to 3.77 times shorter symptom-recovery durations than those with more symptom severity. Similar to symptom duration, varsity status was associated with a shorter RTA-protocol duration (HR = 1.74, 95% confidence interval = 1.34, 2.25), and less symptom severity on the SCAT3 was associated with a shorter RTA-protocol duration (HR range = 1.31 to 1.47). The academy that the cadet attended was associated with the RTA-protocol duration (P < .05). The initial total number of symptoms reported and varsity athlete status were strongly associated with symptom and RTA-protocol durations. These findings suggested that external (varsity status and academy) and injury (symptom burden) factors influenced the time until RTA.

There is significant global interest in promoting wellness, with digital solutions like mobile health apps being broadly downloaded; yet, there is a challenge in maintaining engagement for long-term behavior change. Developing a widely accepted mobile wellness app is imperative for advancing personalized wellness interventions. The primary objective of this study was to evaluate the Aspire2B wellness app (powered by Salus Optima), designed to exceed industry standards for participant engagement by incorporating evidence-based behavior change strategies and to assess its acceptability (eg, liking the face scan) and utility (eg, willing to use the face scan technology for other health insights) as a digital health solution. Participants aged 18-65 years, who were smartphone and fitness tracker users, were recruited in the United States during March-May 2022. Participants received US $5 compensation for downloading the app, with no further incentive for usage. Following completion of onboarding (ie, survey questions about lifestyle behaviors), participants were placed in either a nutrition, sleep, or fitness 4-week challenge. During the challenge, participants used various app features at their own will, such as a facial scan for wellness insights (eg, heart rate and biological age), recipes, and workout videos. These interactions with the app were cumulatively evaluated as engagement metrics. Participants were also asked to answer offboarding questions to evaluate any changes to lifestyle behaviors and experience using the app features (eg, acceptability of face scan experience). Out of the 398 people who created an account, 85.9% (342/398) completed onboarding and a face scan. Following this, 74.9% (298/398) of users completed additional survey questions about current wellness behaviors. Notably, interaction with the app was relatively stable from week 2 to 4 (173/398, 43.5%), outperforming industry standards by roughly 3×. In addition, on average, participants completed 2.1-2.7 face scans per week, with approximately 7% (24/342) of participants maintaining regular use of face scan technology for 4 weeks. In users who completed offboarding questions, 88.8% (111/125) found Aspire2B credible, 64.8% (81/125) liked the face scan experience, 7.2% (9/125) disliked the face scan experience, and 83.2% (104/125) said they would use face scan technology for other insights into their health. These findings highlight strong initial engagement with Aspire2B, followed by significant sustained user engagement over a 4-week period. Furthermore, users indicated high levels of credibility and willingness to use face scan technology for wellness insights. These findings collectively demonstrate the capability of a personalized wellness app using AI-enabled digital biomarkers and evidence-supported behavior change techniques to yield positive user perception and provide long-term engagement.

The AAHPER Youth Fitness Test, the first U.S. national fitness test, was published 50 years ago. The seminal work of Krause and Hirschland influenced the fitness world and continues to do so today. Important youth fitness test initiatives in the last half century are summarized. Key elements leading to continued interest in youth fitness testing at the start of the 21st century include (a) concerns about children and youth fitness levels, (b) AAHPER(D)-led youth fitness battery development, (c) differentiation between performance-related and health-related fitness testing, (d) the numerous youth fitness tests developed, (e) collaborative discussions on development and adoption of a unified national youth fitness battery, (f) computerization of youth fitness test results, (g) differentiation between norm-referenced and criterion-referenced evaluation of student results, and (h) concern about youth fitness levels (again, but with a focus on health). We have come full circle on youth fitness interests. This article summarizes the key youth fitness tests in the second half of the 20th century and projects future considerations.

Background: Funded by the Centers for Disease Control and Prevention Racial and Ethnic Approaches to Community Health Initiative, Live Well Allegheny: Lifting Wellness for African Americans (LWA) in Allegheny County, Pennsylvania, aims to enhance health equity by addressing chronic disease in six African American communities via three key strategies: nutrition, physical activity, and community–clinical linkages. Objectives: This manuscript describes the coalition's partnership dynamics and evaluation methods with a focus on nutrition strategies. Methods: We have a network of committed partners implementing the strategies and we are evaluating our efforts using community asset mapping, county population-based survey data, qualitative process interviews, focus groups, and program performance measures. Results: The LWA coalition is the culmination of years of partnership building, which allows for more targeted activities related to health equity in the region. Thus far, the LWA coalition is thriving. The network of committed and talented partners in the nutrition strategy (healthy nutrition standards, food systems, and breastfeeding) reached 22 sites and more than 46,000 people during the first 2 years of the project. Process interviews conducted as part of the evaluation identified challenges and successes of implementation, and development of the coalition. Conclusions: This comprehensive evaluation approach supports formative processes, evaluation metrics, and prolonged sustainability plans of this community-based coalition.