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      Improving health-related fitness in children: the fit-4-Fun randomized controlled trial study protocol

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      BMC Public Health
      BioMed Central

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          Abstract

          Background

          Declining levels of physical fitness in children are linked to an increased risk of developing poor physical and mental health. Physical activity programs for children that involve regular high intensity physical activity, along with muscle and bone strengthening activities, have been identified by the World Health Organisation as a key strategy to reduce the escalating burden of ill health caused by non-communicable diseases. This paper reports the rationale and methods for a school-based intervention designed to improve physical fitness and physical activity levels of Grades 5 and 6 primary school children.

          Methods/Design

          Fit-4-Fun is an 8-week multi-component school-based health-related fitness education intervention and will be evaluated using a group randomized controlled trial. Primary schools from the Hunter Region in NSW, Australia, will be invited to participate in the program in 2011 with a target sample size of 128 primary schools children (age 10-13). The Fit-4-Fun program is theoretically grounded and will be implemented applying the Health Promoting Schools framework. Students will participate in weekly curriculum-based health and physical education lessons, daily break-time physical activities during recess and lunch, and will complete an 8-week (3 × per week) home activity program with their parents and/or family members. A battery of six health-related fitness assessments, four days of pedometery-assessed physical activity and a questionnaire, will be administered at baseline, immediate post-intervention (2-months) and at 6-months (from baseline) to determine intervention effects. Details of the methodological aspects of recruitment, inclusion criteria, randomization, intervention program, assessments, process evaluation and statistical analyses are described.

          Discussion

          The Fit-4-Fun program is an innovative school-based intervention targeting fitness improvements in primary school children. The program will involve a range of evidence-based behaviour change strategies to promote and support physical activity of adequate intensity, duration and type, needed to improve health-related fitness.

          Trial Registration No

          Australia and New Zealand Clinical Trials Register (ANZCTR): ACTRN12611000976987

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          Most cited references24

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          Physical fitness in childhood and adolescence: a powerful marker of health.

          This review aims to summarize the latest developments with regard to physical fitness and several health outcomes in young people. The literature reviewed suggests that (1) cardiorespiratory fitness levels are associated with total and abdominal adiposity; (2) both cardiorespiratory and muscular fitness are shown to be associated with established and emerging cardiovascular disease risk factors; (3) improvements in muscular fitness and speed/agility, rather than cardiorespiratory fitness, seem to have a positive effect on skeletal health; (4) both cardiorespiratory and muscular fitness enhancements are recommended in pediatric cancer patients/survivors in order to attenuate fatigue and improve their quality of life; and (5) improvements in cardiorespiratory fitness have positive effects on depression, anxiety, mood status and self-esteem, and seem also to be associated with a higher academic performance. In conclusion, health promotion policies and physical activity programs should be designed to improve cardiorespiratory fitness, but also two other physical fitness components such us muscular fitness and speed/agility. Schools may play an important role by identifying children with low physical fitness and by promoting positive health behaviors such as encouraging children to be active, with special emphasis on the intensity of the activity.
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            Measuring enjoyment of physical activity in adolescent girls.

            Enjoyment has been implicated as a determinant of physical activity among youth, but advances in understanding its importance have been limited by the use of measures that were not adequately validated. The present study examined: (1) the factorial validity of the Physical Activity Enjoyment Scale (PACES), and (2) the construct validity of PACES scores. Adolescent girls (N=1797), who were randomly assigned to calibration (n=899) and cross-validation (n=898) samples, completed the PACES and measures of factors influencing enjoyment of physical education, physical activity, and sport involvement. The factorial validity of the PACES and the measure of factors influencing enjoyment of physical education was tested using exploratory and confirmatory factor analysis. The hypothesized relationships among the measures were tested using structural equation modeling. Unidimensional models fit the PACES and the measure of factors influencing enjoyment of physical education in the calibration and cross-validation samples. The hypothesized relationships between the PACES and the measures of factors influencing enjoyment of physical education, physical activity, and sport involvement were supported in the entire sample, were similar in African-American and Caucasian girls, and were independent of physical fitness. Evidence of factorial validity and convergent evidence for construct validity indicate that the PACES is a valid measure of physical activity enjoyment among adolescent girls, suitable for use as a mediator variable in interventions designed to increase physical activity.
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              Tracking of physical activity and physical fitness across the lifespan.

              Although different indicators of physical activity and different methods of analysis are used, it appears that physical activity tracks at low to moderate levels during adolescence, from adolescence into adulthood, and across various ages in adulthood. Tracking of inactivity is less often studied. Measures of performance- and health-related physical fitness (strength, flexibility, motor fitness, aerobic power) track significantly across childhood and adolescence, but correlations are low to moderate. Limited data that span adolescence into adulthood indicate somewhat higher interage correlations for flexibility, static strength, and power. Data for different periods in adulthood are not available. Presently, it is common to criticize focus on motor and sport skills in physical education and competitive sports as contrary to health and fitness goals (e.g., James, 1995; Livingstone, 1994; Simons-Morton et al., 1988). There is a need, however, to distinguish between youth or community sports and highly specialized sport for the elite. Sports activities, be they competitive or recreational, are probably the major form of physical activity during childhood and adolescence, and perhaps in young adulthood. Though low to moderate, the tracking of various activity indicators, most of which include sport participation, suggests that sport activities during childhood and youth may form the foundation for activity habits in the future.
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                Author and article information

                Journal
                BMC Public Health
                BMC Public Health
                BioMed Central
                1471-2458
                2011
                5 December 2011
                : 11
                : 902
                Affiliations
                [1 ]Priority Research Centre in Physical Activity and Nutrition, School of Education, University of Newcastle, Callaghan Campus, Newcastle, Australia
                [2 ]University of Newcastle, Newcastle, Australia
                Article
                1471-2458-11-902
                10.1186/1471-2458-11-902
                3245453
                22142435
                06b55951-87b3-4388-ab20-eac71a60c929
                Copyright ©2011 Eather et al; licensee BioMed Central Ltd.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 7 November 2011
                : 5 December 2011
                Categories
                Study Protocol

                Public health
                Public health

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