Translational journal of the American College of Sports Medicine最新文献

{"title":"Change in Objectively Measured Activity Levels Resulting from the EMPOWER Study Lifestyle Intervention.","authors":"B Rockette-Wagner,&nbsp;J Cheng,&nbsp;Z Bizhanova,&nbsp;A M Kriska,&nbsp;S M Sereika,&nbsp;C E Kline,&nbsp;C C Imes,&nbsp;J K Kariuki,&nbsp;D D Mendez,&nbsp;L E Burke","doi":"10.1249/tjx.0000000000000184","DOIUrl":"https://doi.org/10.1249/tjx.0000000000000184","url":null,"abstract":"<p><strong>Purpose: </strong>To examine changes in physical activity (PA) during a behavioral weight-loss intervention and determine baseline factors associated with PA goal achievement.</p><p><strong>Methods: </strong>Overweight/obese community-dwelling adults with valid PA accelerometer data (N=116; mean age 51.7 years; 89% female; 83% non-Hispanic White) were recruited into a single-arm prospective cohort study examining the effects of a 12-month intervention that included 24 in-person group sessions, weight-loss, calorie, fat gram, and PA goals, self-monitoring, and feedback. Minutes of moderate-to-vigorous (MV) PA and steps were measured using a waist-worn accelerometer (ActiGraph GT3x) at baseline, 6 months, and 12 months. Achievement of the 150 minute/week MVPA goal was examined using total minutes and bout minutes (i.e., counting only PA occurring in bouts ≥10 minutes in length). Change in PA was analyzed using non-parametric tests for multiple comparisons. Associations of factors with meeting the PA goal were modeled using binary logistic regression.</p><p><strong>Results: </strong>At 6 months, there were increases from baseline in MVPA (median [p25, p75]: 5.3 [-0.9, 17.6] minutes/day) and steps (863 [-145, 2790] steps/day), both p<0.001. At 12 months, improvements were attenuated (MVPA: 2.4 [-2.0, 11.4] minutes/day, p=0.047; steps: 374[-570, 1804] p=0.14). At 6 months, 33.6% of individuals met the PA goal (using total or bout minutes). At 12 months, the percent meeting the goal using total MVPA [31%] differed from bout MVPA [22.4%]. Male gender (OR=4.14, p=0.027) and an autumn program start (versus winter; OR=3.39, p=0.011) were associated with greater odds of goal achievement at 6 months.</p><p><strong>Conclusions: </strong>The intervention increased PA goal achievement at 6 and 12 months with many making clinically meaningful improvements. Our results suggest female participants may require extra support toward improving PA levels.</p>","PeriodicalId":75243,"journal":{"name":"Translational journal of the American College of Sports Medicine","volume":"7 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8982931/pdf/nihms-1739960.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10459044","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Step Monitor Accuracy During PostStroke Physical Therapy and Simulated Activities.","authors":"Christopher E Henderson,&nbsp;Lindsay Toth,&nbsp;Andrew Kaplan,&nbsp;T George Hornby","doi":"10.1249/tjx.0000000000000186","DOIUrl":"https://doi.org/10.1249/tjx.0000000000000186","url":null,"abstract":"<p><strong>Introduction/purpose: </strong>The amount of stepping activity during rehabilitation post-stroke can predict walking outcomes, although the most accurate methods to evaluate stepping activity are uncertain with conflicting findings on available stepping monitors during walking assessments. Rehabilitation sessions also include non-stepping activities and the ability of activity monitors to differentiate these activities from stepping is unclear. The objective of this study was to examine the accuracy of different activity monitors worn by individuals post-stroke with variable walking speeds during clinical physical therapy (PT) and research interventions focused on walking.</p><p><strong>Methods: </strong>In Part I, 28 participants post-stroke wore a StepWatch, ActiGraph with and without a Low Frequency Extension (LFE) filter, and Fitbit on paretic and non-paretic distal shanks at or above the ankle during clinical PT or research interventions with steps simultaneously hand counted. Mean absolute percent errors were compared between limbs and tasks performed. In Part II, 12 healthy adults completed 8 walking and 9 non-walking tasks observed during clinical PT or research. Data were descriptively analyzed and used to assist interpretation of Part I results.</p><p><strong>Results: </strong>Part I results indicate most devices did not demonstrate an optimal limb configuration during research sessions focused on walking, with larger errors during clinical PT on the non-paretic limb. Using the limb that minimized errors for each device, the StepWatch had smaller errors than the ActiGraph and Fitbit (p<0.01), particularly in those who walked < 0.8 m/s. Conversely, errors from the ActiGraph-LFE demonstrated inconsistent differences in step counts between Fitbit and ActiGraph. Part II results indicate that errors observed during different stepping and non-stepping activities were often device-specific, with non-stepping tasks frequently detected as stepping.</p><p><strong>Conclusions: </strong>The StepWatch and ActiGraph-LFE had smaller errors than the Fitbit or ActiGraph, with greater errors in those walking at slower speeds. Inclusion of non-stepping activities affected step counts and should be considered when measuring stepping activity in individuals post-stroke to predict locomotor outcomes following rehabilitation.</p>","PeriodicalId":75243,"journal":{"name":"Translational journal of the American College of Sports Medicine","volume":"7 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9004549/pdf/nihms-1745420.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10450494","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Regular and App-enhanced Maintenance of Physical Activity among Latinas: A Feasibility Study.","authors":"Andrea S Mendoza-Vasconez, Esther Solis Becerra, Nathaniel Badii, Noe Crespo, Samantha Hurst, Britta Larsen, Bess H Marcus, Elva M Arredondo","doi":"10.1249/tjx.0000000000000188","DOIUrl":"10.1249/tjx.0000000000000188","url":null,"abstract":"<p><strong>Introduction: </strong>Few studies have focused on physical activity (PA) maintenance, particularly among minority populations; smartphone apps could provide valuable tools. This study aimed to 1) assess and understand PA maintenance among Latinas who completed a PA intervention; and 2) evaluate the feasibility, acceptability and preliminary efficacy of commercial smartphone apps as tools for PA maintenance.</p><p><strong>Methods: </strong>For this feasibility study, 27 Latinas who completed a PA intervention and increased their PA were randomly assigned to enhanced maintenance (i.e., taught to use commercial smartphone apps, N=14), or regular maintenance (i.e., no additional treatment, N=13). After 3-months, the feasibility and acceptability of using apps for PA maintenance was assessed via survey questions, analyzed using descriptive statistics. PA was reassessed via the 7-day PA Recall and analyzed using longitudinal mixed effects regression models. Qualitative data were collected via open-ended interview questions and analyzed using thematic analysis.</p><p><strong>Results: </strong>43% of enhanced maintenance participants reported using study apps at least \"a little\" and 21% using them \"a lot.\" Although not statistically significant, enhanced maintenance participants reported a smaller drop in PA from post-intervention to post-maintenance, compared to regular maintenance participants. Several participants expressed approval of the apps, while others reported on factors that kept them from using the apps for PA maintenance.</p><p><strong>Conclusion: </strong>Incorporating lessons learned from this study, larger randomized trials are warranted to evaluate the efficacy of using smartphone apps to support PA maintenance. The widespread use of apps could make them ideal tools to support PA maintenance after interventions in different settings.</p>","PeriodicalId":75243,"journal":{"name":"Translational journal of the American College of Sports Medicine","volume":"7 1","pages":""},"PeriodicalIF":1.1,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9094163/pdf/nihms-1747173.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10457861","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations between Amount of Recess, Physical Activity, and Cardiometabolic Traits in U.S. Children.","authors":"Kimberly A Clevenger, Britni R Belcher, David Berrigan","doi":"10.1249/tjx.0000000000000202","DOIUrl":"10.1249/tjx.0000000000000202","url":null,"abstract":"<p><strong>Introduction/purpose: </strong>In the United States, it is recommended that schools provide at least 20 minutes of daily recess, but the optimal amount for health benefits is unknown. We examined associations between amount of recess and health indicators using National Health and Nutrition Examination Survey data (NHANES; 2013-2016).</p><p><strong>Methods: </strong>For this cross-sectional analysis, parents/guardians of 6-11 year olds (n=738) reported recess provision which was classified as low (22.8%; approximately 10-15 min, 5 days per week), medium (54.9%; approximately 16-30 min, 5 days per week), or high (22.3%; approximately >30 min, 5 days per week). Outcomes measured included parent/guardian-reported and accelerometer-measured physical activity (PA), blood pressure, cholesterol, grip strength, bone mineral content, weight status, percent body fat, vitamin D level, and C-reactive protein level. Linear and logistic regression compared outcomes by level of recess provision accounting for the NHANES complex survey design.</p><p><strong>Results: </strong>The odds of meeting PA guidelines according to parent/guardian reports were 1.70 and 2.05 times higher in those with medium and high (respectively) versus low recess provision. Accelerometer-measured weekday activity was highest in those with high recess provision while weekend activity was highest in those with low recess provision (Cohen's <i>d</i> = 0.40-0.45). There were no other significant associations.</p><p><strong>Conclusion: </strong>At least 30 minutes of daily recess is associated with two-fold greater odds of achieving recommended PA levels according to parent/guardian reports; accelerometer data suggest this is through increased weekday activity. This finding suggests current national recess recommendations are insufficient for PA promotion. More detailed data on the frequency and duration of recess are needed to quantify optimal provision more precisely.</p>","PeriodicalId":75243,"journal":{"name":"Translational journal of the American College of Sports Medicine","volume":"7 3","pages":""},"PeriodicalIF":1.1,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9531844/pdf/nihms-1798041.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9722787","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Protocol for a Longitudinal Study of the Determinants of Metabolic Syndrome Risk in Young Adults.","authors":"Alexander Pomeroy,&nbsp;Lauren C Bates,&nbsp;Lee Stoner,&nbsp;Mark A Weaver,&nbsp;Justin B Moore,&nbsp;Svetlana Nepocatych,&nbsp;Simon Higgins","doi":"10.1249/tjx.0000000000000197","DOIUrl":"https://doi.org/10.1249/tjx.0000000000000197","url":null,"abstract":"<p><strong>Context: </strong>As many as 76.7% of U.S. young adults have at least one metabolic syndrome risk factor. Often undetected, metabolic syndrome risk factors cluster with other risk factors increasing risk of future cardiometabolic disease. The prevention of metabolic syndrome risk accrual through early behavioral interventions is crucial for at-risk populations.</p><p><strong>Objectives: </strong>This paper outlines the protocol for the Health E Start study, including the objectives, methodology, ethics, and dissemination. Additionally, we discuss the goals of the National Institutes of Health Research Enhancement Award (R15) that funded this project and how this funding will facilitate the comprehensive training of undergraduate researchers. The long-term goal of the study is to develop a theoretically driven intervention for the prevention of metabolic syndrome risk development in college students. To facilitate this goal, the aims are to identify 1) behavioral targets for the prevention of metabolic syndrome risk development and 2) the motivations behind such behaviors to develop a theoretical framework for use in intervention design.</p><p><strong>Design: </strong>Longitudinal observational design.</p><p><strong>Setting: </strong>Transition from living at home to independent living at colleges across the U.S.</p><p><strong>Participants: </strong>High school seniors (n = 150) who will be transitioning to college within 3 months of graduating.</p><p><strong>Main outcome measure: </strong>For aim 1, metabolic syndrome risk will be quantified into a risk score using a principal components analysis of traditional risk factors. Associations between changes in lifestyle behaviors and changes in the risk score will identify population-specific behavioral targets. For aim 2, changes in psychological, social, and environmental antecedents of observed behaviors will be identified.</p><p><strong>Conclusions: </strong>Identifying the relationship between behavior change and metabolic syndrome risk, and the psychosocial and environmental predictors of observed behavior changes will facilitate the design of targeted interventions for the prevention of metabolic syndrome risk progression in the early college years.</p>","PeriodicalId":75243,"journal":{"name":"Translational journal of the American College of Sports Medicine","volume":"7 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9022630/pdf/nihms-1781292.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9613145","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acute Effect of Height-Adjustable Workstations on Blood Glucose Levels in Women With Impaired Fasting Glucose Levels While Working: A Pilot Study.","authors":"A. Bonikowske, K. Carpenter, S. Stovitz, D. Bandyopadhyay, Mark A Pereira, B. Lewis","doi":"10.1249/tjx.0000000000000171","DOIUrl":"https://doi.org/10.1249/tjx.0000000000000171","url":null,"abstract":"ABSTRACT Objective This study aimed to examine the effect on continuously monitored blood glucose (BG) among participants with impaired fasting glucose (IFG) who used a height-adjustable desk while working. Methods The study was a repeated-measures pilot study in overweight or obese women who had IFG (BG >100 mg·dL−1) and a sedentary job. BG was monitored with continuous glucose monitoring devices during two 1-wk periods at work: 1 wk in the seated position and 1 wk using alternate bouts of sitting and standing (by adjusting their desks) throughout the workday. Results Ten women completed the study. Sedentary time significantly predicted BG independently of diet and overall physical activity (P = 0.02). Dietary carbohydrates, protein, and fat were significant predictors of BG (P < 0.001). Conclusions Sedentary time is a strong predictor of increased BG in women with IFG and a sedentary job.","PeriodicalId":75243,"journal":{"name":"Translational journal of the American College of Sports Medicine","volume":"6 4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"66085394","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Physical Activity Interventions for Racial and Ethnic Minority Children: A Systematic Review","authors":"Benjamin C Zacks, K. Calhoun, Kimberly G Montez, Callie L. Brown, J. Skelton","doi":"10.1249/tjx.0000000000000170","DOIUrl":"https://doi.org/10.1249/tjx.0000000000000170","url":null,"abstract":"ABSTRACT Pediatric obesity is a growing epidemic, and children of ethnic or racial minority background are at greatest risk. The purpose of this review is to identify disparities in PA levels among racial and ethnic minority children and identify successful interventions. We searched MEDLINE (PubMed) for the following mesh terms: population groups, obesity, child, infant, adolescent, exercise, or sports. Studies were included if written in English and reported on racial and ethnic families, physical activity (PA) parameters, and children <18 yr. Studies were excluded for lack of comparison with national recommendations or another racial group. Three main categories of studies (N = 24) were found: (a) assessment of PA levels by race/ethnicity, (b) analysis of PA interventions, and (c) parental influences on child PA. A variety of methods were used to measure the amount of PA. Studies using measured objective data for PA levels generally found no difference among races and ethnicities, whereas studies using self-reported PA levels suggested differences among them. The common strategies used in most successful interventions were tailoring activities to the specific target population, including family members, and making the activities enjoyable. Studies also indicated that parental behaviors were strongly associated with the behaviors of their children. The studies included in this systematic review suggest that children of racial and ethnic minority backgrounds may perform less PA than other populations and national recommendations. However, there are several different types of interventions and strategies that can increase PA in these children.","PeriodicalId":75243,"journal":{"name":"Translational journal of the American College of Sports Medicine","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"66085377","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Many Papers but Limited Policy Impact? A Bibliometric Review of Physical Activity Research","authors":"Karen Lee, D. Ding, A. Grunseit, L. Wolfenden, A. Milat, A. Bauman","doi":"10.1249/tjx.0000000000000167","DOIUrl":"https://doi.org/10.1249/tjx.0000000000000167","url":null,"abstract":"ABSTRACT Scientific publications on physical activity (PA) have proliferated in recent years. Previous work has shown that descriptive studies dominate the literature with disappointingly fewer studies reporting on interventions or dissemination. This study updates trends in PA research to determine changes, if any, in publications that are more likely to contribute to facilitating research translation to scale-up interventions that might influence population levels of PA. A bibliometric review of a random sample of published PA studies (n = 4069) across three periods (2008–2009, 2013–2014, and 2017–2018) was conducted using the SCOPUS database. A four-stage coding strategy was used, including 1) identifying PA as exposure or primary outcome, 2) classifying PA studies into data-based and non–data-based studies, 3) classifying data-based PA studies into intervention and nonintervention studies, and 4) classifying intervention studies into six research translation categories. Descriptive PA studies dominated in all three time periods (52.1%–61.9%). Intervention studies increased only slightly from 14.8% to 19.2%. Within intervention studies, most focused on testing efficacy or effectiveness, and these increased over time across the time periods from 38% to 50.5%. Research relevant for scale-up such as replication and dissemination studies declined from the first to the most recent period (28.1% to 16.7%). The prevailing trend of descriptive studies and efficacy and/or effectiveness studies on a small scale continues in published PA literature, contrary to the increasing recognition of the need for scale-up and dissemination research. More dissemination research is required to translate known efficacious interventions to population-level implementation. There is a need for cultural shifts in research where real-world impact on population health should be valued more than the volume of publications.","PeriodicalId":75243,"journal":{"name":"Translational journal of the American College of Sports Medicine","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"66085365","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Free-Living Validation and Harmonization of 10 Wearable Step Count Monitors","authors":"Susan Park, Robert T Marcotte, Lindsay P Toth, Paige Paulus, Lindsey P. Lauricella, A. Kim, S. Crouter, Cary M. Springer, J. Staudenmayer, D. Bassett","doi":"10.1249/tjx.0000000000000172","DOIUrl":"https://doi.org/10.1249/tjx.0000000000000172","url":null,"abstract":"ABSTRACT This study aimed 1) to determine the step count accuracy of numerous wrist-, hip-, and thigh-worn consumer and research monitors (and their corresponding algorithms) compared with the StepWatch (SW) across all waking hours under free-living conditions and 2) to develop correction methods to calibrate all monitors to the SW. Forty-eight participants 28 ± 12 yr old (mean ± SD) wore monitors across two waking days. Different wrist (Apple Watch Series 2, Fitbit Alta, Garmin vivofit 3, and ActiGraph GT9X), hip (Yamax Digiwalker SW-200, Omron HJ-325, GT9X, and Fitbit Zip), and thigh (activPAL) monitors were worn across 2 d, with the exception of the SW, which was worn on both days. Monitor estimates were compared with SW to compute percent of SW steps, absolute percent error, mean difference, root-mean-square error, and Pearson correlations. Monitor-specific correction factor linear regression models were fit to estimate SW steps and evaluated using leave-one-subject-out cross validation. All monitors were significantly different from the SW (P < 0.05). Consumer wrist and hip monitors underestimated SW steps (72%–91% of SW steps per day), whereas step estimates from research monitors ranged widely (67%–189%). Mean absolute percent error across all devices were greater than 10%. After a correction method was applied, all monitor estimates were not significantly different from SW steps. Overall, some consumer monitors produced step estimates that are closer to the validated SW than research-grade monitors (and their corresponding algorithms) and could be used to measure steps for healthy adults under free-living conditions. The specific correction methods may facilitate comparisons across studies and support research efforts using consumer and research monitors for large-scale population surveillance and epidemiological studies.","PeriodicalId":75243,"journal":{"name":"Translational journal of the American College of Sports Medicine","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"66085408","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"Waiving\" Goodbye to PE: State Law and School Exemption and Substitution Practices in the United States.","authors":"Jamie F Chriqui, Julien Leider, Elizabeth Piekarz-Porter, Wanting Lin, Lindsey Turner, Shannon L Michael, Nancy Brener, Frank Perna","doi":"10.1249/tjx.0000000000000161","DOIUrl":"10.1249/tjx.0000000000000161","url":null,"abstract":"<p><strong>Purpose: </strong>The importance of schools providing physical education (PE) and promoting physical activity (PA) and the benefits of PA for children are well documented. However, a majority of students do not get the nationally recommended 60 min of daily PA. Many states grant waivers, substitutions, or exemptions from PE despite national recommendations. This study examined the association between state laws allowing for the use of PE substitutions and exemptions and school-level substitution and exemption practices.</p><p><strong>Methods: </strong>School-level PE exemption and substitution data from the 2014 School Health Policies and Practices Study were linked to state law data from the National Wellness Policy Study and the National Cancer Institute's 2013 Classification of Laws Associated with School Students. The analytic sample included 320 schools located in 42 states. Separate multivariable logistic regression models linked five types of school PE exemptions/substitutions to corresponding state laws, controlling for school characteristics.</p><p><strong>Results: </strong>Overall, 24 of the 42 states had laws addressing PE waivers, exemptions, or substitutions. Schools had higher odds of allowing PE substitutions for school sports (adjusted odds ratio (AOR), 3.59; 95% confidence interval (CI), 1.33-9.68), other school activities (AOR, 8.52; 95% CI, 2.90-25.03), and community sports (AOR, 4.30; 95% CI, 1.43-12.96) and allowing exemptions for fitness test scores (AOR, 4.67; 95% CI, 1.49-14.62) or vocational training (AOR, 5.92; 95% CI, 1.04-33.68) if state law allowed it, compared with schools in states that did not allow such practices.</p><p><strong>Conclusions: </strong>Given the connection between PA and beneficial outcomes for children, decision makers, school administrators, practitioners, advocates, and researchers should consider and further examine how PE waiver, exemption, and substitution policies and practices may affect students' PA and related outcomes.</p>","PeriodicalId":75243,"journal":{"name":"Translational journal of the American College of Sports Medicine","volume":"6 2","pages":""},"PeriodicalIF":1.1,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10282692/pdf/nihms-1891126.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10088478","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}