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      Impacts of active school design on school-time sedentary behavior and physical activity: A pilot natural experiment

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          Abstract

          Background

          Children spend a significant portion of their days in sedentary behavior (SB) and on average fail to engage in adequate physical activity (PA). The school built environment may influence SB and PA, but research is limited. This natural experiment evaluated whether an elementary school designed to promote movement impacted students’ school-time SB and PA.

          Methods

          Accelerometers measured SB and PA at pre and post time-points in an intervention group who moved to the new school (n = 21) and in a comparison group experiencing no school environmental change (n = 20). Difference-in-difference (DD) analysis examined SB and PA outcomes in these groups. Measures were also collected post-intervention from an independent, grade-matched group of students in the new school (n = 21).

          Results

          As expected, maturational increases in SB were observed. However, DD analysis estimated that the intervention attenuated increase in SB by 81.2 ± 11.4 minutes/day ( p<0.001), controlling for time in moderate to vigorous physical activity (MVPA). The intervention was also estimated to increase daily number of breaks from SB by 23.4 ± 2.6 (p < .001) and to increase light physical activity (LPA) by 67.7 ± 10.7 minutes/day ( p<0.001). However, the intervention decreased MVPA by 10.3 ± 2.3 minutes/day ( p<0.001). Results of grade-matched independent samples analysis were similar, with students in the new vs. old school spending 90.5 ± 16.1 fewer minutes/day in SB, taking 21.1 ± 2.7 more breaks from SB ( p<0.001), and spending 64.5 ± 14.8 more minutes in LPA ( p<0.001), controlling for time in MVPA. Students in the new school spent 13.1 ± 2.7 fewer minutes in MVPA ( p<0.001) than their counterparts in the old school.

          Conclusions

          This pilot study found that active school design had beneficial effects on SB and LPA, but not on MVPA. Mixed results point to a need for active classroom design strategies to mitigate SB, and quick access from classrooms to areas permissive of high-intensity activities to promote MVPA. Integrating active design with programs/policies to promote PA may yield greatest impact on PA of all intensities.

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          Most cited references25

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          Moderate-to-vigorous physical activity from ages 9 to 15 years.

          Decreased physical activity plays a critical role in the increase in childhood obesity. Although at least 60 minutes per day of moderate-to-vigorous physical activity (MVPA) is recommended, few longitudinal studies have determined the recent patterns of physical activity of youth. To determine the patterns and determinants of MVPA of youth followed from ages 9 to 15 years. Longitudinal descriptive analyses of the 1032 participants in the 1991-2007 National Institute of Child Health and Human Development Study of Early Child Care and Youth Development birth cohort from 10 study sites who had accelerometer-determined minutes of MVPA at ages 9 (year 2000), 11 (2002), 12 (2003), and 15 (2006) years. Participants included boys (517 [50.1%]) and girls (515 [49.9%]); 76.6% white (n = 791); and 24.5% (n = 231) lived in low-income families. Mean MVPA minutes per day, determined by 4 to 7 days of monitored activity. At age 9 years, children engaged in MVPA approximately 3 hours per day on both weekends and weekdays. Weekday MVPA decreased by 37 minutes per year [corrected], while weekend MVPA decreased by 39 minutes per year [corrected]. By age 15 years, adolescents were only engaging in MVPA for 50 minutes per weekday [corrected] and 36 minutes per weekend day [corrected]. Boys were more active than girls, spending 18 and 14 more minutes per day [corrected] in MVPA on the weekdays and weekends, respectively. The rate of decrease in MVPA was the same for boys and girls. The estimated age at which girls crossed below the recommended 60 minutes of MVPA per day was approximately 13.2 years for weekday [corrected] activity compared with boys at 14.9 years [corrected], and for weekend activity, girls crossed below the recommended 60 minutes of MVPA at 12.7 years [corrected] compared with boys at 13.6 years [corrected]. In this study cohort, measured physical activity decreased significantly between ages 9 and 15 years.
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            Natural and Quasi-Experiments in Economics

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              Physical activity during school recess: a systematic review.

              Interest has increased in examining the physical activity levels of young people during school recess. Identifying correlates of their recess physical activity behaviors is timely, and would inform school-based physical activity programming and intervention development. The review examined the correlates of children's and adolescent's physical activity during school recess periods. A systematic search of six electronic databases, reference lists, and personal archives identified 53 studies (47 focused on children) published between January 1990 and April 2011 that met the inclusion criteria. Data were analyzed in 2011. Correlates were categorized using the social-ecological framework. Forty-four variables were identified across the four levels of the social-ecological framework, although few correlates were studied repeatedly at each level. Positive associations were found of overall facility provision, unfixed equipment, and perceived encouragement with recess physical activity. Results revealed that boys were more active than girls. Providing access to school facilities, providing unfixed equipment, and identifying ways to promote encouragement for physical activity have the potential to inform strategies to increase physical activity levels during recess periods. Copyright © 2012 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.
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                Author and article information

                Contributors
                Role: ConceptualizationRole: Data curationRole: Formal analysisRole: InvestigationRole: MethodologyRole: Project administrationRole: ValidationRole: VisualizationRole: Writing – original draftRole: Writing – review & editing
                Role: ConceptualizationRole: Data curationRole: Formal analysisRole: InvestigationRole: MethodologyRole: Project administrationRole: ValidationRole: VisualizationRole: Writing – review & editing
                Role: ConceptualizationRole: Data curationRole: Formal analysisRole: InvestigationRole: MethodologyRole: Writing – review & editing
                Role: ConceptualizationRole: Data curationRole: Funding acquisitionRole: InvestigationRole: MethodologyRole: Project administrationRole: ResourcesRole: SupervisionRole: Writing – review & editing
                Role: ConceptualizationRole: Data curationRole: InvestigationRole: Project administrationRole: Writing – review & editing
                Role: ConceptualizationRole: Data curationRole: Formal analysisRole: InvestigationRole: ValidationRole: Writing – review & editing
                Role: ConceptualizationRole: Project administrationRole: Writing – review & editing
                Role: ConceptualizationRole: Funding acquisitionRole: MethodologyRole: ResourcesRole: Writing – review & editing
                Role: ConceptualizationRole: Funding acquisitionRole: MethodologyRole: Project administrationRole: ResourcesRole: SupervisionRole: ValidationRole: Writing – review & editing
                Role: Editor
                Journal
                PLoS One
                PLoS ONE
                plos
                plosone
                PLoS ONE
                Public Library of Science (San Francisco, CA USA )
                1932-6203
                7 December 2017
                2017
                : 12
                : 12
                : e0189236
                Affiliations
                [1 ] HDR, Department of Built Environment Research, Omaha, NE, United States of America
                [2 ] University of Nebraska-Lincoln, College of Architecture, Department of Interior Design, Lincoln, NE, United States of America
                [3 ] University of North Carolina-Chapel Hill, School of Public Health, Department of Health Policy and Management, Chapel Hill, NC, United States of America
                [4 ] University of Massachusetts-Amherst, School of Public Health and Health Sciences, Department of Kinesiology, Amherst, MA, United States of America
                [5 ] Cornell University, College of Human Ecology, Department of Design and Environmental Analysis, Ithaca, NY, United States of America
                [6 ] University of Central Florida, College of Education and Human Sciences, Department of Educational and Human Services, Orlando, FL, United States of America
                [7 ] VMDO Architects, Charlottesville, VA, United States of America
                [8 ] University of Virginia, School of Medicine, Department of Emergency Medicine, Charlottesville, VA, United States of America
                [9 ] City University of New York, School of Public Health, Graduate Center, New York, NY, United States of America
                University of Auckland, NEW ZEALAND
                Author notes

                Competing Interests: The authors have declared that no competing interests exist. TH and JB have served as consultants to VMDO Architects, unrelated to this project or manuscript. Distinct from work on this manuscript, DS is employed by VMDO Architects, and JB is employed by HDR, both architecture firms. This does not alter our adherence to PLOS ONE policies on sharing data and materials.

                Author information
                http://orcid.org/0000-0002-1316-6451
                Article
                PONE-D-17-18396
                10.1371/journal.pone.0189236
                5720751
                29216300
                6d52d6ab-f5a5-4c33-af3a-03e0931fd1fe
                © 2017 Brittin et al

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                : 12 May 2017
                : 21 November 2017
                Page count
                Figures: 2, Tables: 3, Pages: 13
                Funding
                Funded by: Youth-Nex, the Center to Promote Effective Youth Development at the University of Virginia
                Award ID: no number
                Award Recipient :
                Funded by: funder-id http://dx.doi.org/10.13039/100000867, Robert Wood Johnson Foundation;
                Award ID: Active Living Research Program #69550
                Award Recipient :
                Funded by: funder-id http://dx.doi.org/10.13039/100009165, Food and Nutrition Service;
                Award ID: CN-CGP-11-0047
                Award Recipient :
                Funded by: Cornell University Agricultural Experiment Station
                Award ID: NYC-327-465
                Award Recipient :
                Funded by: Cornell University Atkinson Center for a Sustainable Future
                Award Recipient :
                Funded by: Cornell University Bronfenbrenner Center for Translational Research
                Award Recipient :
                The work in Virginia was partially supported by funding from Youth-Nex, the Center to Promote Effective Youth Development at the University of Virginia (co-PIs: Huang and Trowbridge). The New York data collection (PI: Wells) was funded in part by the Robert Wood Johnson Foundation through its Active Living Research Program (#69550). Federal funding was provided by the U.S. Department of Agriculture (USDA) through the Food & Nutrition Service (FNS) People's Garden pilot program (Project #CN-CGP-11-0047) and by the Cornell University Agricultural Experiment Station (Hatch funds) (#NYC-327- 465) and Cornell Cooperative Extension (Smith Lever funds) through the National Institutes for Food and Agriculture (NIFA) USDA. Additional funding for the New York data came from: Cornell University's Atkinson Center for a Sustainable Future (ACSF); The College of Human Ecology, Cornell University; The Bronfenbrenner Center for Translational Research (BCTR), Cornell University; and the Cornell Cooperative Extension Summer Intern Program. Funding organizations played no role in the design, implementation, or publication of this study. HDR and VMDO provided support in the form of salaries for JB and DS, respectively, but did not have any additional role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript.
                Categories
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                Social Sciences
                Sociology
                Education
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                Public and Occupational Health
                Physical Activity
                Physical Fitness
                Exercise
                Medicine and Health Sciences
                Sports and Exercise Medicine
                Exercise
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                Exercise
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                Engineering and Technology
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                Accelerometers
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