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Physical Activity Interventions in Children and Adolescents
by Dianne S. Ward, Ruth P. Saunders and Russell R. Pate
Series: Physical Activity Intervention
288 Pages
With modern conveniences and technology always beckoning, today's children are less active and more obese than ever—which leads to an ever-increasing need for more effective interventions to help them become more active. Physical Activity Interventions in Children and Adolescents addresses this problem by helping professionals in schools, health departments, recreation centers, state agencies, and not-for-profit organizations design, implement, and evaluate interventions to promote and increase physical activity among children and adolescents.
Part of the Physical Activity Intervention Series, Physical Activity Interventions in Children and Adolescents provides information on current levels of youth physical activity and presents a basic understanding of the issues associated with it. The book offers a clear and reader-friendly overview of theories of behavior change that have been used in developing physical activity interventions in a variety of settings and methods for program evaluation. Specific recommendations for physical activity from various professional and health organizations are included as well. The book also provides
-descriptive epidemiology of youth physical activity that helps identify the changes in activity as children age;
-insights into the potential role of the family and the community in providing physical activity opportunities for youth;
-guidance for the development of collaborative relationships among agencies and organizations to promote physical activity in the community; and
-a review of available instruments for measuring physical activity in youth populations, including self-report instruments and step counters.
Practical application of the information covered in Physical Activity Interventions in Children and Adolescents is demonstrated through real-world interventions that have been implemented in various settings. The programs were selected based on their demonstrated effectiveness, potential for success, or unique features. Strengths and weaknesses of each intervention are highlighted. In addition to the presentation of existing programs, guidelines for the development of new programs are presented. Sample worksheets serve as valuable tools in evaluating and designing interventions in areas where proven programs are not yet available.
The text follows a three-part progression. Part I provides an orientation to activity in young people, describing how to change behavior and introducing the settings in which such behavior change programs might be developed. In part II, documented interventions are examined for programs in schools, community organizations, and home and health care settings. Part III explores intervention design, assisting those who want to design their own interventions for specific populations. Descriptions of program evaluation, including useful measurement instruments, are detailed as well.
The result is a book that professionals can use for learning about physical activity and the role it plays in the lives of youth. It will guide readers in designing successful interventions that can change physical activity behavior for the children and adolescents with whom they work.
Physical Activity Intervention Series Preface
Preface
Acknowledgments
Part I. Physical Activity Behavior
Chapter 1. Physical Activity Behavior Unique to Children and Adolescents
-Physical Activity Definitions
-Purposes of Physical Activity
-Physical Activity Guidelines
-Summary
Chapter 2. The Role of Theory in Understanding Physical Activity Behavior
-Explaining Behavior with Theory
-Defining Social Cognitive Theory
-Applying Behavior Theory Using Theory to Facilitate Behavior Change
-Avoiding Common Mistakes when Using Theory
-Summary
Chapter 3. Physical Activity Behavior Intervention
-Types of Settings
-Choosing an Intervention Setting
-Organizing Activities
-Designing an Intervention for Skill Development
-Summary
Part II. Documented Interventions
Chapter 4. School-Based Interventions
-Making the Most of the School Setting
-Using Behavior Theory in School-Based Interventions
-Developing Quality Physical Education Programs
-Evaluating Physical Education Interventions
-Adding Physical Activity to the Classroom
-Promoting Physical Activity with Comprehensive and Coordinated Interventions
-Working Effectively with Schools
-Summary
Chapter 5. Community Interventions
-Making the Most of the Community Setting
-Using Behavior Theory in Community Interventions
-Organizing Community Interventions
-Describing Successful Community Interventions
-Working in and With Communities
-References
Chapter 6. Family-Based Interventions in Home and Health Care Settings
-Making the Most of Home and Health Care Settings
-Organizing Family-Based Interventions
-Using Behavior Theory in Family-Based Interventions
-Evaluating Home and Health Care Interventions
-Working with Families in Home and Health Care Settings
-Summary
Part III. Intervention Design
Chapter 7. Planning Physical Activity Programs
-Step 1 Identify and Engage Partners
-Step 2 Plan the Program Based on Needs
-Summary
Chapter 8. Measuring Physical Activity
-Subjective Measures of Physical Activity
-Objective Measures of Physical Activity
-Influences on Physical Activity
-Physical Fitness Measures
-Summary
Chapter 9. Planning for Physical Activity Program Evaluation
-Review of Program Planning
-Step 3 Focus the Evaluation
-Summary
Chapter 10. Implementing and Monitoring Physical Activity Programs
-Process Evaluation Elements
-Step 4 Carry Out Program and Implement Program Evaluation Plan
-Step 5 Analyze and Interpret Results
-Step 6 Disseminate Results
-Summary
Appendix
References
Index
About the Authors
Dianne Stanton Ward, EdD, is a professor and director of the Intervention and Policy Division in the department of nutrition at the University of North Carolina at Chapel Hill. Dr. Ward has more than 30 years' experience in the development and evaluation of physical activity programs for children and adolescents. She has received 10 years of National Institutes of Health (NIH) funding for intervention research and is a member of the NIH Study Section on Community Influences on Health Behavior, a Health of the Public Integrated Review Group.
Dr. Ward has received several awards, including the Distinguished Alumni Award in 2001 from the College of Health and Human Performance at the University of North Carolina at Greensboro. She is a fellow in the American College of Sports Medicine, and she is a member of the American Public Health Association, the Association for Nutrition Science, the North American Association for the Study of Obesity, the American Alliance for Health, Physical Education, Recreation and Dance (AAHPERD), and the North American Society for Pediatric Exercise Medicine. In her leisure time she enjoys hiking, playing golf and tennis, reading, and gardening.
Ruth P. Saunders, PhD, is an associate professor in the department of health promotion, education, and behavior in the Arnold School of Public Health at the University of South Carolina at Columbia. Dr. Saunders has worked with physical activity interventions for children and adolescents for more than 10 years and has taught health behavior theory and health promotion program planning and evaluation for 20 years. She has also worked with schools and school districts on health and wellness issues for 18 years.
Dr. Saunders was on the team that developed the Centers for Disease Control and Prevention guidelines for promoting physical activity in school and community settings and has been an active member of a successful research team in obtaining funding and publishing in the area of child and adolescent physical activity and interventions. She has also been an effective collaborator with community organizations and agencies, including schools.
Dr. Saunders has won teaching and research awards and is a member of the American School Health Association, AAHPERD, the Society for Public Health Education, and the American College of Sports Medicine. She enjoys jogging, cycling, gardening, and baking in her spare time.
Russell R. Pate, PhD, is a professor in the department of exercise science in the Arnold School of Public Health at the University of South Carolina at Columbia. Dr. Pate has 30 years of experience in researching the issues involved in physical activity interventions. In that time he has received 15 years of NIH funding for research in physical activity interventions. He has also served on the IOM panel for Preventing Childhood Obesity as well as the U.S. Dietary Guidelines Committee. In addition, Dr. Pate has served as president of the American College of Sports medicine and the National Coalition for Promoting Physical Activity. Dr Pate is a lifelong distance runner. He enjoys traveling and reading.
“This book is an important primer for those interested in helping children and adolescents become more active…. I heartily recommend this volume.”
The Prevention Researcher
Community PA programs can take advantage of missed opportunities
Although the nonschool period has much potential for physical activity interventions, few formal interventions have been developed to address youth who are inactive outside of the school setting.
Children and adolescents get most of their physical activity after school. They participate in sport programs, take dance or karate lessons, or just spend time riding bikes and playing with friends. On weekends and in the summers, young people are free to pursue their interests most of the day. Although many youth participate in community sports and recreation, for others, these are times of missed opportunities for physical activity (Sturm, 2005). For inactive young people, the hours between school and bedtime are time to watch TV or videos, play video games, use the computer, or talk on the telephone. Although the nonschool period has much potential for physical activity interventions, few formal interventions have been developed to address youth who are inactive outside of the school setting. As alarm grows over the increased levels of obesity in our society and the relationship of physical inactivity to this problem, employing numerous community settings and these rich time opportunities for intervention might be very useful.
Making the Most of the Community Setting
In intervention development, a community is any group of individuals connected by some aspect of their lives, including geography (neighborhood or housing development), social interaction (religious affiliation or club membership), or shared identity (ethnic group) (Pate et al., 2000). Community physical activity settings might include the following:
- Schools (during and after school)
- Religious institutions (e.g., church youth groups)
- Social and fraternal organizations (e.g., Boy Scouts)
- Neighborhood groups (e.g., housing developments or community clubhouses)
- Community-based organizations (e.g., Boys & Girls Clubs or YMCA)
- Streets, parks, and greenways (around a specific neighborhood)
- Clinical settings (e.g., physician's office or health department clinic)
- Media (e.g., TV, magazines, or billboards)
Many community intervention programs have been developed in appropriate settings to target specific communities, such as Latino youth in a soccer league or African American girls living in public housing.
Unlike interventions that take place at school, community interventions take place in programs that children and adolescents are not required to attend. Youth can choose to attend or not attend, can come late and leave early, or can drop out entirely. Young people might have more motivation for physical activity in a community-based program than in school because they chose to attend it. In addition, community settings might be able to provide a greater variety of physical activity opportunities compared to those available at school because they are not constrained by geography. Other beneficial aspects of community-based physical activity programs include opportunities to make physical activity the social norm, or the "thing to do." Included in community programs are important adults like coaches, family members, or church leaders. Community programs or initiatives might also institute permanent changes in the physical environment, such as the development of a playground or a walking trail or the development of policies that provide greater access to physical activity programs or spaces (e.g., opening school gyms during the evening for community use).
Using Behavior Theory in Community Interventions
Community-based, youth-oriented physical activity programs should focus not only on the individual child, but also on other components of the environment that affect young people's physical activity. These include the social setting, the physical environment, policies and regulations, and transportation. An effective community physical activity intervention might also include such components as promotions, marketing, and complementary family programs. Using the ecological model allows program planners to simultaneously focus on multiple levels of influence around a child, increasing an intervention program's ability to address the various factors that appear to affect physical activity behavior. Table 5.1 illustrates how the ecological model can be applied to interventions that occur in the community.
Organizing Community Interventions
Community physical activity interventions can be organized around a single purpose, such as the promotion of physical activity in youth or decreased inactivity through encouraging youth to watch less television. Some community interventions are more complex and focus on such multiple outcomes as diet and physical activity behavior. Programs that attempt to intervene directly on a health outcome, such as decreasing or preventing overweight in children, are the most complex and intensive. To make a measurable impact, great effort, resources, and often multiple years of intervention may be required. This chapter includes these more comprehensive, and often more costly, interventions because the information might be useful for the development of new and less elaborate physical activity interventions.
Two approaches can be taken to design community physical activity interventions for children or adolescents. One approach is for interested organizations such as a university or government agency to organize, sponsor, and administer a program. Such an effort would be considered a physical activity program located in the community. The other approach is for interested organizations to partner and conduct the intervention collaboratively. This approach would be considered a physical activity program conducted with the community. Advantages of the first approach include expediency and control, whereas the second approach gets high marks for local identity and sustainability. Development of a program located in the community consists of finding an appropriate location, collecting local information, designing a community-specific program, and implementing the program for a specified period of time.
Ideally, community groups should be involved in designing programs and environments in order to provide the best opportunities for physical activity. Table 5.2 lists goals for community physical activity programs and guidelines for their achievement adapted from Guidelines for a Comprehensive Program to Promote Healthy Eating and Physical Activity (Nutrition and Physical Activity Work Group, 2002).
Learn more about Physical Activity Interventions in Children and Adolescents.
Parents have role to play in encouraging healthy behaviors
Parents set the stage for health behaviors, provide reinforcement for such behavior, and serve as emotional supports in the behavior change process.
Parents are in a unique position to influence the health of their children. Parents set the stage for health behaviors, provide reinforcement for such behavior, and serve as emotional supports in the behavior change process. In an intervention, parents can serve three roles: providing support, serving as role models, and setting limits.
Providing Support
Most children like to be active, but often something more is needed to make it happen. Parents can provide tangible assistance, sometimes called instrumental support, for children to engage in physical activities. In order to find a safe place to ride a bike, it might be necessary to drive the child to a park or field. Enrolling youth in sport programs or paying for tennis lessons can also aid in the child's quest for an active life. Family support is important for sustaining a child's interest in activity. Attending games, watching pickup play in the backyard, asking questions, and generally demonstrating interest add support to the youth's participation in physical activity (Gustafson & Rhodes, 2006).
Role Modeling
Active adults present a consistent and enduring reminder of the role of physical activity in health and happiness. Parents and guardians who participate in exercise or activity have children who are more likely to be active (Trost, Kerr, Ward, & Pate, 2001; Sallis et al., 1992). It is not important, however, to be athletic, to engage in any specialized sports, or to be a highly successful performer (Sallis, Prochaska, & Taylor, 2000). Regular walking (with the dog or with others), working in the yard, and doing living room calisthenics illustrate the role physical activity plays in the life of an adult. With the knowledge that role modeling might influence child behavior, negative behavior must be considered as well (Fogelholm, Nuutinen, Pasanen, Myöhänen, & Säätelä, 1999). Fathers who spend much of their time after work in front of the TV and mothers who do not have a regular physical activity pattern might present an adverse model for their offspring. Care should be taken to minimize negative role modeling. Parental involvement has been shown to be particularly relevant for girls, as evidenced by the impact of parental activity levels and parental encouragement. It has been shown that mothers provide greater support and facilitation for physical activity, while fathers tend to demonstrate personal involvement in the activity (Davison, Cutting, & Birch, 2003).
Although it seems logical that children who see active parents would be inclined to imitate them, demonstrated support for physical activity is more important. Work by Welk and colleagues (Welk, Wood, & Morss, 2003; Welk, 1999b) showed that parental facilitation, encouragement, and involvement were more important to a child's physical activity participation than role modeling an active lifestyle. Role modeling was useful, but primarily as a function of support. More active parents tended to provide more support for the physical activities of their children (Gustafson & Rhodes, 2006).
Setting Limits
Parents play important roles in a child's activity level not only through promoting physical activity, but also through their efforts to minimize inactivity. Requiring a child to be active might, in the long run, be an ineffective way to create positive feelings about physical activity. It is often easier to set household rules or policies focusing on household objects that create inactivity than to try to force kids to be active. One example is to limit the amount of TV viewing allowed through a TV viewing policy. The average American child spends nearly 6 hours per day watching television and using other electronic media such as video games and computers (Roberts, Foehr, Rideout, & Brodie, 1999)! The relationship between inactivity and physical activity seems to be one of opposite behaviors. Decreasing the time spent in sedentary pursuits such as watching TV, playing computer games, or watching videos will surely provide more time for active pursuits. However, the choice between physical activity and sedentary pursuits seems to respond to different stimuli (Ford et al., 2002). Screen time plays a major role in the sedentary behavior of American youth. Parents and guardians can monitor and control children's and adolescents' access to the TV and computer; and, as already discussed, family-based programs to support such behaviors exist.
Learn more about Physical Activity Interventions in Children and Adolescents.
Community PA programs can take advantage of missed opportunities
Although the nonschool period has much potential for physical activity interventions, few formal interventions have been developed to address youth who are inactive outside of the school setting.
Children and adolescents get most of their physical activity after school. They participate in sport programs, take dance or karate lessons, or just spend time riding bikes and playing with friends. On weekends and in the summers, young people are free to pursue their interests most of the day. Although many youth participate in community sports and recreation, for others, these are times of missed opportunities for physical activity (Sturm, 2005). For inactive young people, the hours between school and bedtime are time to watch TV or videos, play video games, use the computer, or talk on the telephone. Although the nonschool period has much potential for physical activity interventions, few formal interventions have been developed to address youth who are inactive outside of the school setting. As alarm grows over the increased levels of obesity in our society and the relationship of physical inactivity to this problem, employing numerous community settings and these rich time opportunities for intervention might be very useful.
Making the Most of the Community Setting
In intervention development, a community is any group of individuals connected by some aspect of their lives, including geography (neighborhood or housing development), social interaction (religious affiliation or club membership), or shared identity (ethnic group) (Pate et al., 2000). Community physical activity settings might include the following:
- Schools (during and after school)
- Religious institutions (e.g., church youth groups)
- Social and fraternal organizations (e.g., Boy Scouts)
- Neighborhood groups (e.g., housing developments or community clubhouses)
- Community-based organizations (e.g., Boys & Girls Clubs or YMCA)
- Streets, parks, and greenways (around a specific neighborhood)
- Clinical settings (e.g., physician's office or health department clinic)
- Media (e.g., TV, magazines, or billboards)
Many community intervention programs have been developed in appropriate settings to target specific communities, such as Latino youth in a soccer league or African American girls living in public housing.
Unlike interventions that take place at school, community interventions take place in programs that children and adolescents are not required to attend. Youth can choose to attend or not attend, can come late and leave early, or can drop out entirely. Young people might have more motivation for physical activity in a community-based program than in school because they chose to attend it. In addition, community settings might be able to provide a greater variety of physical activity opportunities compared to those available at school because they are not constrained by geography. Other beneficial aspects of community-based physical activity programs include opportunities to make physical activity the social norm, or the "thing to do." Included in community programs are important adults like coaches, family members, or church leaders. Community programs or initiatives might also institute permanent changes in the physical environment, such as the development of a playground or a walking trail or the development of policies that provide greater access to physical activity programs or spaces (e.g., opening school gyms during the evening for community use).
Using Behavior Theory in Community Interventions
Community-based, youth-oriented physical activity programs should focus not only on the individual child, but also on other components of the environment that affect young people's physical activity. These include the social setting, the physical environment, policies and regulations, and transportation. An effective community physical activity intervention might also include such components as promotions, marketing, and complementary family programs. Using the ecological model allows program planners to simultaneously focus on multiple levels of influence around a child, increasing an intervention program's ability to address the various factors that appear to affect physical activity behavior. Table 5.1 illustrates how the ecological model can be applied to interventions that occur in the community.
Organizing Community Interventions
Community physical activity interventions can be organized around a single purpose, such as the promotion of physical activity in youth or decreased inactivity through encouraging youth to watch less television. Some community interventions are more complex and focus on such multiple outcomes as diet and physical activity behavior. Programs that attempt to intervene directly on a health outcome, such as decreasing or preventing overweight in children, are the most complex and intensive. To make a measurable impact, great effort, resources, and often multiple years of intervention may be required. This chapter includes these more comprehensive, and often more costly, interventions because the information might be useful for the development of new and less elaborate physical activity interventions.
Two approaches can be taken to design community physical activity interventions for children or adolescents. One approach is for interested organizations such as a university or government agency to organize, sponsor, and administer a program. Such an effort would be considered a physical activity program located in the community. The other approach is for interested organizations to partner and conduct the intervention collaboratively. This approach would be considered a physical activity program conducted with the community. Advantages of the first approach include expediency and control, whereas the second approach gets high marks for local identity and sustainability. Development of a program located in the community consists of finding an appropriate location, collecting local information, designing a community-specific program, and implementing the program for a specified period of time.
Ideally, community groups should be involved in designing programs and environments in order to provide the best opportunities for physical activity. Table 5.2 lists goals for community physical activity programs and guidelines for their achievement adapted from Guidelines for a Comprehensive Program to Promote Healthy Eating and Physical Activity (Nutrition and Physical Activity Work Group, 2002).
Learn more about Physical Activity Interventions in Children and Adolescents.
Parents have role to play in encouraging healthy behaviors
Parents set the stage for health behaviors, provide reinforcement for such behavior, and serve as emotional supports in the behavior change process.
Parents are in a unique position to influence the health of their children. Parents set the stage for health behaviors, provide reinforcement for such behavior, and serve as emotional supports in the behavior change process. In an intervention, parents can serve three roles: providing support, serving as role models, and setting limits.
Providing Support
Most children like to be active, but often something more is needed to make it happen. Parents can provide tangible assistance, sometimes called instrumental support, for children to engage in physical activities. In order to find a safe place to ride a bike, it might be necessary to drive the child to a park or field. Enrolling youth in sport programs or paying for tennis lessons can also aid in the child's quest for an active life. Family support is important for sustaining a child's interest in activity. Attending games, watching pickup play in the backyard, asking questions, and generally demonstrating interest add support to the youth's participation in physical activity (Gustafson & Rhodes, 2006).
Role Modeling
Active adults present a consistent and enduring reminder of the role of physical activity in health and happiness. Parents and guardians who participate in exercise or activity have children who are more likely to be active (Trost, Kerr, Ward, & Pate, 2001; Sallis et al., 1992). It is not important, however, to be athletic, to engage in any specialized sports, or to be a highly successful performer (Sallis, Prochaska, & Taylor, 2000). Regular walking (with the dog or with others), working in the yard, and doing living room calisthenics illustrate the role physical activity plays in the life of an adult. With the knowledge that role modeling might influence child behavior, negative behavior must be considered as well (Fogelholm, Nuutinen, Pasanen, Myöhänen, & Säätelä, 1999). Fathers who spend much of their time after work in front of the TV and mothers who do not have a regular physical activity pattern might present an adverse model for their offspring. Care should be taken to minimize negative role modeling. Parental involvement has been shown to be particularly relevant for girls, as evidenced by the impact of parental activity levels and parental encouragement. It has been shown that mothers provide greater support and facilitation for physical activity, while fathers tend to demonstrate personal involvement in the activity (Davison, Cutting, & Birch, 2003).
Although it seems logical that children who see active parents would be inclined to imitate them, demonstrated support for physical activity is more important. Work by Welk and colleagues (Welk, Wood, & Morss, 2003; Welk, 1999b) showed that parental facilitation, encouragement, and involvement were more important to a child's physical activity participation than role modeling an active lifestyle. Role modeling was useful, but primarily as a function of support. More active parents tended to provide more support for the physical activities of their children (Gustafson & Rhodes, 2006).
Setting Limits
Parents play important roles in a child's activity level not only through promoting physical activity, but also through their efforts to minimize inactivity. Requiring a child to be active might, in the long run, be an ineffective way to create positive feelings about physical activity. It is often easier to set household rules or policies focusing on household objects that create inactivity than to try to force kids to be active. One example is to limit the amount of TV viewing allowed through a TV viewing policy. The average American child spends nearly 6 hours per day watching television and using other electronic media such as video games and computers (Roberts, Foehr, Rideout, & Brodie, 1999)! The relationship between inactivity and physical activity seems to be one of opposite behaviors. Decreasing the time spent in sedentary pursuits such as watching TV, playing computer games, or watching videos will surely provide more time for active pursuits. However, the choice between physical activity and sedentary pursuits seems to respond to different stimuli (Ford et al., 2002). Screen time plays a major role in the sedentary behavior of American youth. Parents and guardians can monitor and control children's and adolescents' access to the TV and computer; and, as already discussed, family-based programs to support such behaviors exist.
Learn more about Physical Activity Interventions in Children and Adolescents.
Community PA programs can take advantage of missed opportunities
Although the nonschool period has much potential for physical activity interventions, few formal interventions have been developed to address youth who are inactive outside of the school setting.
Children and adolescents get most of their physical activity after school. They participate in sport programs, take dance or karate lessons, or just spend time riding bikes and playing with friends. On weekends and in the summers, young people are free to pursue their interests most of the day. Although many youth participate in community sports and recreation, for others, these are times of missed opportunities for physical activity (Sturm, 2005). For inactive young people, the hours between school and bedtime are time to watch TV or videos, play video games, use the computer, or talk on the telephone. Although the nonschool period has much potential for physical activity interventions, few formal interventions have been developed to address youth who are inactive outside of the school setting. As alarm grows over the increased levels of obesity in our society and the relationship of physical inactivity to this problem, employing numerous community settings and these rich time opportunities for intervention might be very useful.
Making the Most of the Community Setting
In intervention development, a community is any group of individuals connected by some aspect of their lives, including geography (neighborhood or housing development), social interaction (religious affiliation or club membership), or shared identity (ethnic group) (Pate et al., 2000). Community physical activity settings might include the following:
- Schools (during and after school)
- Religious institutions (e.g., church youth groups)
- Social and fraternal organizations (e.g., Boy Scouts)
- Neighborhood groups (e.g., housing developments or community clubhouses)
- Community-based organizations (e.g., Boys & Girls Clubs or YMCA)
- Streets, parks, and greenways (around a specific neighborhood)
- Clinical settings (e.g., physician's office or health department clinic)
- Media (e.g., TV, magazines, or billboards)
Many community intervention programs have been developed in appropriate settings to target specific communities, such as Latino youth in a soccer league or African American girls living in public housing.
Unlike interventions that take place at school, community interventions take place in programs that children and adolescents are not required to attend. Youth can choose to attend or not attend, can come late and leave early, or can drop out entirely. Young people might have more motivation for physical activity in a community-based program than in school because they chose to attend it. In addition, community settings might be able to provide a greater variety of physical activity opportunities compared to those available at school because they are not constrained by geography. Other beneficial aspects of community-based physical activity programs include opportunities to make physical activity the social norm, or the "thing to do." Included in community programs are important adults like coaches, family members, or church leaders. Community programs or initiatives might also institute permanent changes in the physical environment, such as the development of a playground or a walking trail or the development of policies that provide greater access to physical activity programs or spaces (e.g., opening school gyms during the evening for community use).
Using Behavior Theory in Community Interventions
Community-based, youth-oriented physical activity programs should focus not only on the individual child, but also on other components of the environment that affect young people's physical activity. These include the social setting, the physical environment, policies and regulations, and transportation. An effective community physical activity intervention might also include such components as promotions, marketing, and complementary family programs. Using the ecological model allows program planners to simultaneously focus on multiple levels of influence around a child, increasing an intervention program's ability to address the various factors that appear to affect physical activity behavior. Table 5.1 illustrates how the ecological model can be applied to interventions that occur in the community.
Organizing Community Interventions
Community physical activity interventions can be organized around a single purpose, such as the promotion of physical activity in youth or decreased inactivity through encouraging youth to watch less television. Some community interventions are more complex and focus on such multiple outcomes as diet and physical activity behavior. Programs that attempt to intervene directly on a health outcome, such as decreasing or preventing overweight in children, are the most complex and intensive. To make a measurable impact, great effort, resources, and often multiple years of intervention may be required. This chapter includes these more comprehensive, and often more costly, interventions because the information might be useful for the development of new and less elaborate physical activity interventions.
Two approaches can be taken to design community physical activity interventions for children or adolescents. One approach is for interested organizations such as a university or government agency to organize, sponsor, and administer a program. Such an effort would be considered a physical activity program located in the community. The other approach is for interested organizations to partner and conduct the intervention collaboratively. This approach would be considered a physical activity program conducted with the community. Advantages of the first approach include expediency and control, whereas the second approach gets high marks for local identity and sustainability. Development of a program located in the community consists of finding an appropriate location, collecting local information, designing a community-specific program, and implementing the program for a specified period of time.
Ideally, community groups should be involved in designing programs and environments in order to provide the best opportunities for physical activity. Table 5.2 lists goals for community physical activity programs and guidelines for their achievement adapted from Guidelines for a Comprehensive Program to Promote Healthy Eating and Physical Activity (Nutrition and Physical Activity Work Group, 2002).
Learn more about Physical Activity Interventions in Children and Adolescents.
Parents have role to play in encouraging healthy behaviors
Parents set the stage for health behaviors, provide reinforcement for such behavior, and serve as emotional supports in the behavior change process.
Parents are in a unique position to influence the health of their children. Parents set the stage for health behaviors, provide reinforcement for such behavior, and serve as emotional supports in the behavior change process. In an intervention, parents can serve three roles: providing support, serving as role models, and setting limits.
Providing Support
Most children like to be active, but often something more is needed to make it happen. Parents can provide tangible assistance, sometimes called instrumental support, for children to engage in physical activities. In order to find a safe place to ride a bike, it might be necessary to drive the child to a park or field. Enrolling youth in sport programs or paying for tennis lessons can also aid in the child's quest for an active life. Family support is important for sustaining a child's interest in activity. Attending games, watching pickup play in the backyard, asking questions, and generally demonstrating interest add support to the youth's participation in physical activity (Gustafson & Rhodes, 2006).
Role Modeling
Active adults present a consistent and enduring reminder of the role of physical activity in health and happiness. Parents and guardians who participate in exercise or activity have children who are more likely to be active (Trost, Kerr, Ward, & Pate, 2001; Sallis et al., 1992). It is not important, however, to be athletic, to engage in any specialized sports, or to be a highly successful performer (Sallis, Prochaska, & Taylor, 2000). Regular walking (with the dog or with others), working in the yard, and doing living room calisthenics illustrate the role physical activity plays in the life of an adult. With the knowledge that role modeling might influence child behavior, negative behavior must be considered as well (Fogelholm, Nuutinen, Pasanen, Myöhänen, & Säätelä, 1999). Fathers who spend much of their time after work in front of the TV and mothers who do not have a regular physical activity pattern might present an adverse model for their offspring. Care should be taken to minimize negative role modeling. Parental involvement has been shown to be particularly relevant for girls, as evidenced by the impact of parental activity levels and parental encouragement. It has been shown that mothers provide greater support and facilitation for physical activity, while fathers tend to demonstrate personal involvement in the activity (Davison, Cutting, & Birch, 2003).
Although it seems logical that children who see active parents would be inclined to imitate them, demonstrated support for physical activity is more important. Work by Welk and colleagues (Welk, Wood, & Morss, 2003; Welk, 1999b) showed that parental facilitation, encouragement, and involvement were more important to a child's physical activity participation than role modeling an active lifestyle. Role modeling was useful, but primarily as a function of support. More active parents tended to provide more support for the physical activities of their children (Gustafson & Rhodes, 2006).
Setting Limits
Parents play important roles in a child's activity level not only through promoting physical activity, but also through their efforts to minimize inactivity. Requiring a child to be active might, in the long run, be an ineffective way to create positive feelings about physical activity. It is often easier to set household rules or policies focusing on household objects that create inactivity than to try to force kids to be active. One example is to limit the amount of TV viewing allowed through a TV viewing policy. The average American child spends nearly 6 hours per day watching television and using other electronic media such as video games and computers (Roberts, Foehr, Rideout, & Brodie, 1999)! The relationship between inactivity and physical activity seems to be one of opposite behaviors. Decreasing the time spent in sedentary pursuits such as watching TV, playing computer games, or watching videos will surely provide more time for active pursuits. However, the choice between physical activity and sedentary pursuits seems to respond to different stimuli (Ford et al., 2002). Screen time plays a major role in the sedentary behavior of American youth. Parents and guardians can monitor and control children's and adolescents' access to the TV and computer; and, as already discussed, family-based programs to support such behaviors exist.
Learn more about Physical Activity Interventions in Children and Adolescents.
Community PA programs can take advantage of missed opportunities
Although the nonschool period has much potential for physical activity interventions, few formal interventions have been developed to address youth who are inactive outside of the school setting.
Children and adolescents get most of their physical activity after school. They participate in sport programs, take dance or karate lessons, or just spend time riding bikes and playing with friends. On weekends and in the summers, young people are free to pursue their interests most of the day. Although many youth participate in community sports and recreation, for others, these are times of missed opportunities for physical activity (Sturm, 2005). For inactive young people, the hours between school and bedtime are time to watch TV or videos, play video games, use the computer, or talk on the telephone. Although the nonschool period has much potential for physical activity interventions, few formal interventions have been developed to address youth who are inactive outside of the school setting. As alarm grows over the increased levels of obesity in our society and the relationship of physical inactivity to this problem, employing numerous community settings and these rich time opportunities for intervention might be very useful.
Making the Most of the Community Setting
In intervention development, a community is any group of individuals connected by some aspect of their lives, including geography (neighborhood or housing development), social interaction (religious affiliation or club membership), or shared identity (ethnic group) (Pate et al., 2000). Community physical activity settings might include the following:
- Schools (during and after school)
- Religious institutions (e.g., church youth groups)
- Social and fraternal organizations (e.g., Boy Scouts)
- Neighborhood groups (e.g., housing developments or community clubhouses)
- Community-based organizations (e.g., Boys & Girls Clubs or YMCA)
- Streets, parks, and greenways (around a specific neighborhood)
- Clinical settings (e.g., physician's office or health department clinic)
- Media (e.g., TV, magazines, or billboards)
Many community intervention programs have been developed in appropriate settings to target specific communities, such as Latino youth in a soccer league or African American girls living in public housing.
Unlike interventions that take place at school, community interventions take place in programs that children and adolescents are not required to attend. Youth can choose to attend or not attend, can come late and leave early, or can drop out entirely. Young people might have more motivation for physical activity in a community-based program than in school because they chose to attend it. In addition, community settings might be able to provide a greater variety of physical activity opportunities compared to those available at school because they are not constrained by geography. Other beneficial aspects of community-based physical activity programs include opportunities to make physical activity the social norm, or the "thing to do." Included in community programs are important adults like coaches, family members, or church leaders. Community programs or initiatives might also institute permanent changes in the physical environment, such as the development of a playground or a walking trail or the development of policies that provide greater access to physical activity programs or spaces (e.g., opening school gyms during the evening for community use).
Using Behavior Theory in Community Interventions
Community-based, youth-oriented physical activity programs should focus not only on the individual child, but also on other components of the environment that affect young people's physical activity. These include the social setting, the physical environment, policies and regulations, and transportation. An effective community physical activity intervention might also include such components as promotions, marketing, and complementary family programs. Using the ecological model allows program planners to simultaneously focus on multiple levels of influence around a child, increasing an intervention program's ability to address the various factors that appear to affect physical activity behavior. Table 5.1 illustrates how the ecological model can be applied to interventions that occur in the community.
Organizing Community Interventions
Community physical activity interventions can be organized around a single purpose, such as the promotion of physical activity in youth or decreased inactivity through encouraging youth to watch less television. Some community interventions are more complex and focus on such multiple outcomes as diet and physical activity behavior. Programs that attempt to intervene directly on a health outcome, such as decreasing or preventing overweight in children, are the most complex and intensive. To make a measurable impact, great effort, resources, and often multiple years of intervention may be required. This chapter includes these more comprehensive, and often more costly, interventions because the information might be useful for the development of new and less elaborate physical activity interventions.
Two approaches can be taken to design community physical activity interventions for children or adolescents. One approach is for interested organizations such as a university or government agency to organize, sponsor, and administer a program. Such an effort would be considered a physical activity program located in the community. The other approach is for interested organizations to partner and conduct the intervention collaboratively. This approach would be considered a physical activity program conducted with the community. Advantages of the first approach include expediency and control, whereas the second approach gets high marks for local identity and sustainability. Development of a program located in the community consists of finding an appropriate location, collecting local information, designing a community-specific program, and implementing the program for a specified period of time.
Ideally, community groups should be involved in designing programs and environments in order to provide the best opportunities for physical activity. Table 5.2 lists goals for community physical activity programs and guidelines for their achievement adapted from Guidelines for a Comprehensive Program to Promote Healthy Eating and Physical Activity (Nutrition and Physical Activity Work Group, 2002).
Learn more about Physical Activity Interventions in Children and Adolescents.
Parents have role to play in encouraging healthy behaviors
Parents set the stage for health behaviors, provide reinforcement for such behavior, and serve as emotional supports in the behavior change process.
Parents are in a unique position to influence the health of their children. Parents set the stage for health behaviors, provide reinforcement for such behavior, and serve as emotional supports in the behavior change process. In an intervention, parents can serve three roles: providing support, serving as role models, and setting limits.
Providing Support
Most children like to be active, but often something more is needed to make it happen. Parents can provide tangible assistance, sometimes called instrumental support, for children to engage in physical activities. In order to find a safe place to ride a bike, it might be necessary to drive the child to a park or field. Enrolling youth in sport programs or paying for tennis lessons can also aid in the child's quest for an active life. Family support is important for sustaining a child's interest in activity. Attending games, watching pickup play in the backyard, asking questions, and generally demonstrating interest add support to the youth's participation in physical activity (Gustafson & Rhodes, 2006).
Role Modeling
Active adults present a consistent and enduring reminder of the role of physical activity in health and happiness. Parents and guardians who participate in exercise or activity have children who are more likely to be active (Trost, Kerr, Ward, & Pate, 2001; Sallis et al., 1992). It is not important, however, to be athletic, to engage in any specialized sports, or to be a highly successful performer (Sallis, Prochaska, & Taylor, 2000). Regular walking (with the dog or with others), working in the yard, and doing living room calisthenics illustrate the role physical activity plays in the life of an adult. With the knowledge that role modeling might influence child behavior, negative behavior must be considered as well (Fogelholm, Nuutinen, Pasanen, Myöhänen, & Säätelä, 1999). Fathers who spend much of their time after work in front of the TV and mothers who do not have a regular physical activity pattern might present an adverse model for their offspring. Care should be taken to minimize negative role modeling. Parental involvement has been shown to be particularly relevant for girls, as evidenced by the impact of parental activity levels and parental encouragement. It has been shown that mothers provide greater support and facilitation for physical activity, while fathers tend to demonstrate personal involvement in the activity (Davison, Cutting, & Birch, 2003).
Although it seems logical that children who see active parents would be inclined to imitate them, demonstrated support for physical activity is more important. Work by Welk and colleagues (Welk, Wood, & Morss, 2003; Welk, 1999b) showed that parental facilitation, encouragement, and involvement were more important to a child's physical activity participation than role modeling an active lifestyle. Role modeling was useful, but primarily as a function of support. More active parents tended to provide more support for the physical activities of their children (Gustafson & Rhodes, 2006).
Setting Limits
Parents play important roles in a child's activity level not only through promoting physical activity, but also through their efforts to minimize inactivity. Requiring a child to be active might, in the long run, be an ineffective way to create positive feelings about physical activity. It is often easier to set household rules or policies focusing on household objects that create inactivity than to try to force kids to be active. One example is to limit the amount of TV viewing allowed through a TV viewing policy. The average American child spends nearly 6 hours per day watching television and using other electronic media such as video games and computers (Roberts, Foehr, Rideout, & Brodie, 1999)! The relationship between inactivity and physical activity seems to be one of opposite behaviors. Decreasing the time spent in sedentary pursuits such as watching TV, playing computer games, or watching videos will surely provide more time for active pursuits. However, the choice between physical activity and sedentary pursuits seems to respond to different stimuli (Ford et al., 2002). Screen time plays a major role in the sedentary behavior of American youth. Parents and guardians can monitor and control children's and adolescents' access to the TV and computer; and, as already discussed, family-based programs to support such behaviors exist.
Learn more about Physical Activity Interventions in Children and Adolescents.
Community PA programs can take advantage of missed opportunities
Although the nonschool period has much potential for physical activity interventions, few formal interventions have been developed to address youth who are inactive outside of the school setting.
Children and adolescents get most of their physical activity after school. They participate in sport programs, take dance or karate lessons, or just spend time riding bikes and playing with friends. On weekends and in the summers, young people are free to pursue their interests most of the day. Although many youth participate in community sports and recreation, for others, these are times of missed opportunities for physical activity (Sturm, 2005). For inactive young people, the hours between school and bedtime are time to watch TV or videos, play video games, use the computer, or talk on the telephone. Although the nonschool period has much potential for physical activity interventions, few formal interventions have been developed to address youth who are inactive outside of the school setting. As alarm grows over the increased levels of obesity in our society and the relationship of physical inactivity to this problem, employing numerous community settings and these rich time opportunities for intervention might be very useful.
Making the Most of the Community Setting
In intervention development, a community is any group of individuals connected by some aspect of their lives, including geography (neighborhood or housing development), social interaction (religious affiliation or club membership), or shared identity (ethnic group) (Pate et al., 2000). Community physical activity settings might include the following:
- Schools (during and after school)
- Religious institutions (e.g., church youth groups)
- Social and fraternal organizations (e.g., Boy Scouts)
- Neighborhood groups (e.g., housing developments or community clubhouses)
- Community-based organizations (e.g., Boys & Girls Clubs or YMCA)
- Streets, parks, and greenways (around a specific neighborhood)
- Clinical settings (e.g., physician's office or health department clinic)
- Media (e.g., TV, magazines, or billboards)
Many community intervention programs have been developed in appropriate settings to target specific communities, such as Latino youth in a soccer league or African American girls living in public housing.
Unlike interventions that take place at school, community interventions take place in programs that children and adolescents are not required to attend. Youth can choose to attend or not attend, can come late and leave early, or can drop out entirely. Young people might have more motivation for physical activity in a community-based program than in school because they chose to attend it. In addition, community settings might be able to provide a greater variety of physical activity opportunities compared to those available at school because they are not constrained by geography. Other beneficial aspects of community-based physical activity programs include opportunities to make physical activity the social norm, or the "thing to do." Included in community programs are important adults like coaches, family members, or church leaders. Community programs or initiatives might also institute permanent changes in the physical environment, such as the development of a playground or a walking trail or the development of policies that provide greater access to physical activity programs or spaces (e.g., opening school gyms during the evening for community use).
Using Behavior Theory in Community Interventions
Community-based, youth-oriented physical activity programs should focus not only on the individual child, but also on other components of the environment that affect young people's physical activity. These include the social setting, the physical environment, policies and regulations, and transportation. An effective community physical activity intervention might also include such components as promotions, marketing, and complementary family programs. Using the ecological model allows program planners to simultaneously focus on multiple levels of influence around a child, increasing an intervention program's ability to address the various factors that appear to affect physical activity behavior. Table 5.1 illustrates how the ecological model can be applied to interventions that occur in the community.
Organizing Community Interventions
Community physical activity interventions can be organized around a single purpose, such as the promotion of physical activity in youth or decreased inactivity through encouraging youth to watch less television. Some community interventions are more complex and focus on such multiple outcomes as diet and physical activity behavior. Programs that attempt to intervene directly on a health outcome, such as decreasing or preventing overweight in children, are the most complex and intensive. To make a measurable impact, great effort, resources, and often multiple years of intervention may be required. This chapter includes these more comprehensive, and often more costly, interventions because the information might be useful for the development of new and less elaborate physical activity interventions.
Two approaches can be taken to design community physical activity interventions for children or adolescents. One approach is for interested organizations such as a university or government agency to organize, sponsor, and administer a program. Such an effort would be considered a physical activity program located in the community. The other approach is for interested organizations to partner and conduct the intervention collaboratively. This approach would be considered a physical activity program conducted with the community. Advantages of the first approach include expediency and control, whereas the second approach gets high marks for local identity and sustainability. Development of a program located in the community consists of finding an appropriate location, collecting local information, designing a community-specific program, and implementing the program for a specified period of time.
Ideally, community groups should be involved in designing programs and environments in order to provide the best opportunities for physical activity. Table 5.2 lists goals for community physical activity programs and guidelines for their achievement adapted from Guidelines for a Comprehensive Program to Promote Healthy Eating and Physical Activity (Nutrition and Physical Activity Work Group, 2002).
Learn more about Physical Activity Interventions in Children and Adolescents.
Parents have role to play in encouraging healthy behaviors
Parents set the stage for health behaviors, provide reinforcement for such behavior, and serve as emotional supports in the behavior change process.
Parents are in a unique position to influence the health of their children. Parents set the stage for health behaviors, provide reinforcement for such behavior, and serve as emotional supports in the behavior change process. In an intervention, parents can serve three roles: providing support, serving as role models, and setting limits.
Providing Support
Most children like to be active, but often something more is needed to make it happen. Parents can provide tangible assistance, sometimes called instrumental support, for children to engage in physical activities. In order to find a safe place to ride a bike, it might be necessary to drive the child to a park or field. Enrolling youth in sport programs or paying for tennis lessons can also aid in the child's quest for an active life. Family support is important for sustaining a child's interest in activity. Attending games, watching pickup play in the backyard, asking questions, and generally demonstrating interest add support to the youth's participation in physical activity (Gustafson & Rhodes, 2006).
Role Modeling
Active adults present a consistent and enduring reminder of the role of physical activity in health and happiness. Parents and guardians who participate in exercise or activity have children who are more likely to be active (Trost, Kerr, Ward, & Pate, 2001; Sallis et al., 1992). It is not important, however, to be athletic, to engage in any specialized sports, or to be a highly successful performer (Sallis, Prochaska, & Taylor, 2000). Regular walking (with the dog or with others), working in the yard, and doing living room calisthenics illustrate the role physical activity plays in the life of an adult. With the knowledge that role modeling might influence child behavior, negative behavior must be considered as well (Fogelholm, Nuutinen, Pasanen, Myöhänen, & Säätelä, 1999). Fathers who spend much of their time after work in front of the TV and mothers who do not have a regular physical activity pattern might present an adverse model for their offspring. Care should be taken to minimize negative role modeling. Parental involvement has been shown to be particularly relevant for girls, as evidenced by the impact of parental activity levels and parental encouragement. It has been shown that mothers provide greater support and facilitation for physical activity, while fathers tend to demonstrate personal involvement in the activity (Davison, Cutting, & Birch, 2003).
Although it seems logical that children who see active parents would be inclined to imitate them, demonstrated support for physical activity is more important. Work by Welk and colleagues (Welk, Wood, & Morss, 2003; Welk, 1999b) showed that parental facilitation, encouragement, and involvement were more important to a child's physical activity participation than role modeling an active lifestyle. Role modeling was useful, but primarily as a function of support. More active parents tended to provide more support for the physical activities of their children (Gustafson & Rhodes, 2006).
Setting Limits
Parents play important roles in a child's activity level not only through promoting physical activity, but also through their efforts to minimize inactivity. Requiring a child to be active might, in the long run, be an ineffective way to create positive feelings about physical activity. It is often easier to set household rules or policies focusing on household objects that create inactivity than to try to force kids to be active. One example is to limit the amount of TV viewing allowed through a TV viewing policy. The average American child spends nearly 6 hours per day watching television and using other electronic media such as video games and computers (Roberts, Foehr, Rideout, & Brodie, 1999)! The relationship between inactivity and physical activity seems to be one of opposite behaviors. Decreasing the time spent in sedentary pursuits such as watching TV, playing computer games, or watching videos will surely provide more time for active pursuits. However, the choice between physical activity and sedentary pursuits seems to respond to different stimuli (Ford et al., 2002). Screen time plays a major role in the sedentary behavior of American youth. Parents and guardians can monitor and control children's and adolescents' access to the TV and computer; and, as already discussed, family-based programs to support such behaviors exist.
Learn more about Physical Activity Interventions in Children and Adolescents.
Community PA programs can take advantage of missed opportunities
Although the nonschool period has much potential for physical activity interventions, few formal interventions have been developed to address youth who are inactive outside of the school setting.
Children and adolescents get most of their physical activity after school. They participate in sport programs, take dance or karate lessons, or just spend time riding bikes and playing with friends. On weekends and in the summers, young people are free to pursue their interests most of the day. Although many youth participate in community sports and recreation, for others, these are times of missed opportunities for physical activity (Sturm, 2005). For inactive young people, the hours between school and bedtime are time to watch TV or videos, play video games, use the computer, or talk on the telephone. Although the nonschool period has much potential for physical activity interventions, few formal interventions have been developed to address youth who are inactive outside of the school setting. As alarm grows over the increased levels of obesity in our society and the relationship of physical inactivity to this problem, employing numerous community settings and these rich time opportunities for intervention might be very useful.
Making the Most of the Community Setting
In intervention development, a community is any group of individuals connected by some aspect of their lives, including geography (neighborhood or housing development), social interaction (religious affiliation or club membership), or shared identity (ethnic group) (Pate et al., 2000). Community physical activity settings might include the following:
- Schools (during and after school)
- Religious institutions (e.g., church youth groups)
- Social and fraternal organizations (e.g., Boy Scouts)
- Neighborhood groups (e.g., housing developments or community clubhouses)
- Community-based organizations (e.g., Boys & Girls Clubs or YMCA)
- Streets, parks, and greenways (around a specific neighborhood)
- Clinical settings (e.g., physician's office or health department clinic)
- Media (e.g., TV, magazines, or billboards)
Many community intervention programs have been developed in appropriate settings to target specific communities, such as Latino youth in a soccer league or African American girls living in public housing.
Unlike interventions that take place at school, community interventions take place in programs that children and adolescents are not required to attend. Youth can choose to attend or not attend, can come late and leave early, or can drop out entirely. Young people might have more motivation for physical activity in a community-based program than in school because they chose to attend it. In addition, community settings might be able to provide a greater variety of physical activity opportunities compared to those available at school because they are not constrained by geography. Other beneficial aspects of community-based physical activity programs include opportunities to make physical activity the social norm, or the "thing to do." Included in community programs are important adults like coaches, family members, or church leaders. Community programs or initiatives might also institute permanent changes in the physical environment, such as the development of a playground or a walking trail or the development of policies that provide greater access to physical activity programs or spaces (e.g., opening school gyms during the evening for community use).
Using Behavior Theory in Community Interventions
Community-based, youth-oriented physical activity programs should focus not only on the individual child, but also on other components of the environment that affect young people's physical activity. These include the social setting, the physical environment, policies and regulations, and transportation. An effective community physical activity intervention might also include such components as promotions, marketing, and complementary family programs. Using the ecological model allows program planners to simultaneously focus on multiple levels of influence around a child, increasing an intervention program's ability to address the various factors that appear to affect physical activity behavior. Table 5.1 illustrates how the ecological model can be applied to interventions that occur in the community.
Organizing Community Interventions
Community physical activity interventions can be organized around a single purpose, such as the promotion of physical activity in youth or decreased inactivity through encouraging youth to watch less television. Some community interventions are more complex and focus on such multiple outcomes as diet and physical activity behavior. Programs that attempt to intervene directly on a health outcome, such as decreasing or preventing overweight in children, are the most complex and intensive. To make a measurable impact, great effort, resources, and often multiple years of intervention may be required. This chapter includes these more comprehensive, and often more costly, interventions because the information might be useful for the development of new and less elaborate physical activity interventions.
Two approaches can be taken to design community physical activity interventions for children or adolescents. One approach is for interested organizations such as a university or government agency to organize, sponsor, and administer a program. Such an effort would be considered a physical activity program located in the community. The other approach is for interested organizations to partner and conduct the intervention collaboratively. This approach would be considered a physical activity program conducted with the community. Advantages of the first approach include expediency and control, whereas the second approach gets high marks for local identity and sustainability. Development of a program located in the community consists of finding an appropriate location, collecting local information, designing a community-specific program, and implementing the program for a specified period of time.
Ideally, community groups should be involved in designing programs and environments in order to provide the best opportunities for physical activity. Table 5.2 lists goals for community physical activity programs and guidelines for their achievement adapted from Guidelines for a Comprehensive Program to Promote Healthy Eating and Physical Activity (Nutrition and Physical Activity Work Group, 2002).
Learn more about Physical Activity Interventions in Children and Adolescents.
Parents have role to play in encouraging healthy behaviors
Parents set the stage for health behaviors, provide reinforcement for such behavior, and serve as emotional supports in the behavior change process.
Parents are in a unique position to influence the health of their children. Parents set the stage for health behaviors, provide reinforcement for such behavior, and serve as emotional supports in the behavior change process. In an intervention, parents can serve three roles: providing support, serving as role models, and setting limits.
Providing Support
Most children like to be active, but often something more is needed to make it happen. Parents can provide tangible assistance, sometimes called instrumental support, for children to engage in physical activities. In order to find a safe place to ride a bike, it might be necessary to drive the child to a park or field. Enrolling youth in sport programs or paying for tennis lessons can also aid in the child's quest for an active life. Family support is important for sustaining a child's interest in activity. Attending games, watching pickup play in the backyard, asking questions, and generally demonstrating interest add support to the youth's participation in physical activity (Gustafson & Rhodes, 2006).
Role Modeling
Active adults present a consistent and enduring reminder of the role of physical activity in health and happiness. Parents and guardians who participate in exercise or activity have children who are more likely to be active (Trost, Kerr, Ward, & Pate, 2001; Sallis et al., 1992). It is not important, however, to be athletic, to engage in any specialized sports, or to be a highly successful performer (Sallis, Prochaska, & Taylor, 2000). Regular walking (with the dog or with others), working in the yard, and doing living room calisthenics illustrate the role physical activity plays in the life of an adult. With the knowledge that role modeling might influence child behavior, negative behavior must be considered as well (Fogelholm, Nuutinen, Pasanen, Myöhänen, & Säätelä, 1999). Fathers who spend much of their time after work in front of the TV and mothers who do not have a regular physical activity pattern might present an adverse model for their offspring. Care should be taken to minimize negative role modeling. Parental involvement has been shown to be particularly relevant for girls, as evidenced by the impact of parental activity levels and parental encouragement. It has been shown that mothers provide greater support and facilitation for physical activity, while fathers tend to demonstrate personal involvement in the activity (Davison, Cutting, & Birch, 2003).
Although it seems logical that children who see active parents would be inclined to imitate them, demonstrated support for physical activity is more important. Work by Welk and colleagues (Welk, Wood, & Morss, 2003; Welk, 1999b) showed that parental facilitation, encouragement, and involvement were more important to a child's physical activity participation than role modeling an active lifestyle. Role modeling was useful, but primarily as a function of support. More active parents tended to provide more support for the physical activities of their children (Gustafson & Rhodes, 2006).
Setting Limits
Parents play important roles in a child's activity level not only through promoting physical activity, but also through their efforts to minimize inactivity. Requiring a child to be active might, in the long run, be an ineffective way to create positive feelings about physical activity. It is often easier to set household rules or policies focusing on household objects that create inactivity than to try to force kids to be active. One example is to limit the amount of TV viewing allowed through a TV viewing policy. The average American child spends nearly 6 hours per day watching television and using other electronic media such as video games and computers (Roberts, Foehr, Rideout, & Brodie, 1999)! The relationship between inactivity and physical activity seems to be one of opposite behaviors. Decreasing the time spent in sedentary pursuits such as watching TV, playing computer games, or watching videos will surely provide more time for active pursuits. However, the choice between physical activity and sedentary pursuits seems to respond to different stimuli (Ford et al., 2002). Screen time plays a major role in the sedentary behavior of American youth. Parents and guardians can monitor and control children's and adolescents' access to the TV and computer; and, as already discussed, family-based programs to support such behaviors exist.
Learn more about Physical Activity Interventions in Children and Adolescents.
Community PA programs can take advantage of missed opportunities
Although the nonschool period has much potential for physical activity interventions, few formal interventions have been developed to address youth who are inactive outside of the school setting.
Children and adolescents get most of their physical activity after school. They participate in sport programs, take dance or karate lessons, or just spend time riding bikes and playing with friends. On weekends and in the summers, young people are free to pursue their interests most of the day. Although many youth participate in community sports and recreation, for others, these are times of missed opportunities for physical activity (Sturm, 2005). For inactive young people, the hours between school and bedtime are time to watch TV or videos, play video games, use the computer, or talk on the telephone. Although the nonschool period has much potential for physical activity interventions, few formal interventions have been developed to address youth who are inactive outside of the school setting. As alarm grows over the increased levels of obesity in our society and the relationship of physical inactivity to this problem, employing numerous community settings and these rich time opportunities for intervention might be very useful.
Making the Most of the Community Setting
In intervention development, a community is any group of individuals connected by some aspect of their lives, including geography (neighborhood or housing development), social interaction (religious affiliation or club membership), or shared identity (ethnic group) (Pate et al., 2000). Community physical activity settings might include the following:
- Schools (during and after school)
- Religious institutions (e.g., church youth groups)
- Social and fraternal organizations (e.g., Boy Scouts)
- Neighborhood groups (e.g., housing developments or community clubhouses)
- Community-based organizations (e.g., Boys & Girls Clubs or YMCA)
- Streets, parks, and greenways (around a specific neighborhood)
- Clinical settings (e.g., physician's office or health department clinic)
- Media (e.g., TV, magazines, or billboards)
Many community intervention programs have been developed in appropriate settings to target specific communities, such as Latino youth in a soccer league or African American girls living in public housing.
Unlike interventions that take place at school, community interventions take place in programs that children and adolescents are not required to attend. Youth can choose to attend or not attend, can come late and leave early, or can drop out entirely. Young people might have more motivation for physical activity in a community-based program than in school because they chose to attend it. In addition, community settings might be able to provide a greater variety of physical activity opportunities compared to those available at school because they are not constrained by geography. Other beneficial aspects of community-based physical activity programs include opportunities to make physical activity the social norm, or the "thing to do." Included in community programs are important adults like coaches, family members, or church leaders. Community programs or initiatives might also institute permanent changes in the physical environment, such as the development of a playground or a walking trail or the development of policies that provide greater access to physical activity programs or spaces (e.g., opening school gyms during the evening for community use).
Using Behavior Theory in Community Interventions
Community-based, youth-oriented physical activity programs should focus not only on the individual child, but also on other components of the environment that affect young people's physical activity. These include the social setting, the physical environment, policies and regulations, and transportation. An effective community physical activity intervention might also include such components as promotions, marketing, and complementary family programs. Using the ecological model allows program planners to simultaneously focus on multiple levels of influence around a child, increasing an intervention program's ability to address the various factors that appear to affect physical activity behavior. Table 5.1 illustrates how the ecological model can be applied to interventions that occur in the community.
Organizing Community Interventions
Community physical activity interventions can be organized around a single purpose, such as the promotion of physical activity in youth or decreased inactivity through encouraging youth to watch less television. Some community interventions are more complex and focus on such multiple outcomes as diet and physical activity behavior. Programs that attempt to intervene directly on a health outcome, such as decreasing or preventing overweight in children, are the most complex and intensive. To make a measurable impact, great effort, resources, and often multiple years of intervention may be required. This chapter includes these more comprehensive, and often more costly, interventions because the information might be useful for the development of new and less elaborate physical activity interventions.
Two approaches can be taken to design community physical activity interventions for children or adolescents. One approach is for interested organizations such as a university or government agency to organize, sponsor, and administer a program. Such an effort would be considered a physical activity program located in the community. The other approach is for interested organizations to partner and conduct the intervention collaboratively. This approach would be considered a physical activity program conducted with the community. Advantages of the first approach include expediency and control, whereas the second approach gets high marks for local identity and sustainability. Development of a program located in the community consists of finding an appropriate location, collecting local information, designing a community-specific program, and implementing the program for a specified period of time.
Ideally, community groups should be involved in designing programs and environments in order to provide the best opportunities for physical activity. Table 5.2 lists goals for community physical activity programs and guidelines for their achievement adapted from Guidelines for a Comprehensive Program to Promote Healthy Eating and Physical Activity (Nutrition and Physical Activity Work Group, 2002).
Learn more about Physical Activity Interventions in Children and Adolescents.
Parents have role to play in encouraging healthy behaviors
Parents set the stage for health behaviors, provide reinforcement for such behavior, and serve as emotional supports in the behavior change process.
Parents are in a unique position to influence the health of their children. Parents set the stage for health behaviors, provide reinforcement for such behavior, and serve as emotional supports in the behavior change process. In an intervention, parents can serve three roles: providing support, serving as role models, and setting limits.
Providing Support
Most children like to be active, but often something more is needed to make it happen. Parents can provide tangible assistance, sometimes called instrumental support, for children to engage in physical activities. In order to find a safe place to ride a bike, it might be necessary to drive the child to a park or field. Enrolling youth in sport programs or paying for tennis lessons can also aid in the child's quest for an active life. Family support is important for sustaining a child's interest in activity. Attending games, watching pickup play in the backyard, asking questions, and generally demonstrating interest add support to the youth's participation in physical activity (Gustafson & Rhodes, 2006).
Role Modeling
Active adults present a consistent and enduring reminder of the role of physical activity in health and happiness. Parents and guardians who participate in exercise or activity have children who are more likely to be active (Trost, Kerr, Ward, & Pate, 2001; Sallis et al., 1992). It is not important, however, to be athletic, to engage in any specialized sports, or to be a highly successful performer (Sallis, Prochaska, & Taylor, 2000). Regular walking (with the dog or with others), working in the yard, and doing living room calisthenics illustrate the role physical activity plays in the life of an adult. With the knowledge that role modeling might influence child behavior, negative behavior must be considered as well (Fogelholm, Nuutinen, Pasanen, Myöhänen, & Säätelä, 1999). Fathers who spend much of their time after work in front of the TV and mothers who do not have a regular physical activity pattern might present an adverse model for their offspring. Care should be taken to minimize negative role modeling. Parental involvement has been shown to be particularly relevant for girls, as evidenced by the impact of parental activity levels and parental encouragement. It has been shown that mothers provide greater support and facilitation for physical activity, while fathers tend to demonstrate personal involvement in the activity (Davison, Cutting, & Birch, 2003).
Although it seems logical that children who see active parents would be inclined to imitate them, demonstrated support for physical activity is more important. Work by Welk and colleagues (Welk, Wood, & Morss, 2003; Welk, 1999b) showed that parental facilitation, encouragement, and involvement were more important to a child's physical activity participation than role modeling an active lifestyle. Role modeling was useful, but primarily as a function of support. More active parents tended to provide more support for the physical activities of their children (Gustafson & Rhodes, 2006).
Setting Limits
Parents play important roles in a child's activity level not only through promoting physical activity, but also through their efforts to minimize inactivity. Requiring a child to be active might, in the long run, be an ineffective way to create positive feelings about physical activity. It is often easier to set household rules or policies focusing on household objects that create inactivity than to try to force kids to be active. One example is to limit the amount of TV viewing allowed through a TV viewing policy. The average American child spends nearly 6 hours per day watching television and using other electronic media such as video games and computers (Roberts, Foehr, Rideout, & Brodie, 1999)! The relationship between inactivity and physical activity seems to be one of opposite behaviors. Decreasing the time spent in sedentary pursuits such as watching TV, playing computer games, or watching videos will surely provide more time for active pursuits. However, the choice between physical activity and sedentary pursuits seems to respond to different stimuli (Ford et al., 2002). Screen time plays a major role in the sedentary behavior of American youth. Parents and guardians can monitor and control children's and adolescents' access to the TV and computer; and, as already discussed, family-based programs to support such behaviors exist.
Learn more about Physical Activity Interventions in Children and Adolescents.
Community PA programs can take advantage of missed opportunities
Although the nonschool period has much potential for physical activity interventions, few formal interventions have been developed to address youth who are inactive outside of the school setting.
Children and adolescents get most of their physical activity after school. They participate in sport programs, take dance or karate lessons, or just spend time riding bikes and playing with friends. On weekends and in the summers, young people are free to pursue their interests most of the day. Although many youth participate in community sports and recreation, for others, these are times of missed opportunities for physical activity (Sturm, 2005). For inactive young people, the hours between school and bedtime are time to watch TV or videos, play video games, use the computer, or talk on the telephone. Although the nonschool period has much potential for physical activity interventions, few formal interventions have been developed to address youth who are inactive outside of the school setting. As alarm grows over the increased levels of obesity in our society and the relationship of physical inactivity to this problem, employing numerous community settings and these rich time opportunities for intervention might be very useful.
Making the Most of the Community Setting
In intervention development, a community is any group of individuals connected by some aspect of their lives, including geography (neighborhood or housing development), social interaction (religious affiliation or club membership), or shared identity (ethnic group) (Pate et al., 2000). Community physical activity settings might include the following:
- Schools (during and after school)
- Religious institutions (e.g., church youth groups)
- Social and fraternal organizations (e.g., Boy Scouts)
- Neighborhood groups (e.g., housing developments or community clubhouses)
- Community-based organizations (e.g., Boys & Girls Clubs or YMCA)
- Streets, parks, and greenways (around a specific neighborhood)
- Clinical settings (e.g., physician's office or health department clinic)
- Media (e.g., TV, magazines, or billboards)
Many community intervention programs have been developed in appropriate settings to target specific communities, such as Latino youth in a soccer league or African American girls living in public housing.
Unlike interventions that take place at school, community interventions take place in programs that children and adolescents are not required to attend. Youth can choose to attend or not attend, can come late and leave early, or can drop out entirely. Young people might have more motivation for physical activity in a community-based program than in school because they chose to attend it. In addition, community settings might be able to provide a greater variety of physical activity opportunities compared to those available at school because they are not constrained by geography. Other beneficial aspects of community-based physical activity programs include opportunities to make physical activity the social norm, or the "thing to do." Included in community programs are important adults like coaches, family members, or church leaders. Community programs or initiatives might also institute permanent changes in the physical environment, such as the development of a playground or a walking trail or the development of policies that provide greater access to physical activity programs or spaces (e.g., opening school gyms during the evening for community use).
Using Behavior Theory in Community Interventions
Community-based, youth-oriented physical activity programs should focus not only on the individual child, but also on other components of the environment that affect young people's physical activity. These include the social setting, the physical environment, policies and regulations, and transportation. An effective community physical activity intervention might also include such components as promotions, marketing, and complementary family programs. Using the ecological model allows program planners to simultaneously focus on multiple levels of influence around a child, increasing an intervention program's ability to address the various factors that appear to affect physical activity behavior. Table 5.1 illustrates how the ecological model can be applied to interventions that occur in the community.
Organizing Community Interventions
Community physical activity interventions can be organized around a single purpose, such as the promotion of physical activity in youth or decreased inactivity through encouraging youth to watch less television. Some community interventions are more complex and focus on such multiple outcomes as diet and physical activity behavior. Programs that attempt to intervene directly on a health outcome, such as decreasing or preventing overweight in children, are the most complex and intensive. To make a measurable impact, great effort, resources, and often multiple years of intervention may be required. This chapter includes these more comprehensive, and often more costly, interventions because the information might be useful for the development of new and less elaborate physical activity interventions.
Two approaches can be taken to design community physical activity interventions for children or adolescents. One approach is for interested organizations such as a university or government agency to organize, sponsor, and administer a program. Such an effort would be considered a physical activity program located in the community. The other approach is for interested organizations to partner and conduct the intervention collaboratively. This approach would be considered a physical activity program conducted with the community. Advantages of the first approach include expediency and control, whereas the second approach gets high marks for local identity and sustainability. Development of a program located in the community consists of finding an appropriate location, collecting local information, designing a community-specific program, and implementing the program for a specified period of time.
Ideally, community groups should be involved in designing programs and environments in order to provide the best opportunities for physical activity. Table 5.2 lists goals for community physical activity programs and guidelines for their achievement adapted from Guidelines for a Comprehensive Program to Promote Healthy Eating and Physical Activity (Nutrition and Physical Activity Work Group, 2002).
Learn more about Physical Activity Interventions in Children and Adolescents.
Parents have role to play in encouraging healthy behaviors
Parents set the stage for health behaviors, provide reinforcement for such behavior, and serve as emotional supports in the behavior change process.
Parents are in a unique position to influence the health of their children. Parents set the stage for health behaviors, provide reinforcement for such behavior, and serve as emotional supports in the behavior change process. In an intervention, parents can serve three roles: providing support, serving as role models, and setting limits.
Providing Support
Most children like to be active, but often something more is needed to make it happen. Parents can provide tangible assistance, sometimes called instrumental support, for children to engage in physical activities. In order to find a safe place to ride a bike, it might be necessary to drive the child to a park or field. Enrolling youth in sport programs or paying for tennis lessons can also aid in the child's quest for an active life. Family support is important for sustaining a child's interest in activity. Attending games, watching pickup play in the backyard, asking questions, and generally demonstrating interest add support to the youth's participation in physical activity (Gustafson & Rhodes, 2006).
Role Modeling
Active adults present a consistent and enduring reminder of the role of physical activity in health and happiness. Parents and guardians who participate in exercise or activity have children who are more likely to be active (Trost, Kerr, Ward, & Pate, 2001; Sallis et al., 1992). It is not important, however, to be athletic, to engage in any specialized sports, or to be a highly successful performer (Sallis, Prochaska, & Taylor, 2000). Regular walking (with the dog or with others), working in the yard, and doing living room calisthenics illustrate the role physical activity plays in the life of an adult. With the knowledge that role modeling might influence child behavior, negative behavior must be considered as well (Fogelholm, Nuutinen, Pasanen, Myöhänen, & Säätelä, 1999). Fathers who spend much of their time after work in front of the TV and mothers who do not have a regular physical activity pattern might present an adverse model for their offspring. Care should be taken to minimize negative role modeling. Parental involvement has been shown to be particularly relevant for girls, as evidenced by the impact of parental activity levels and parental encouragement. It has been shown that mothers provide greater support and facilitation for physical activity, while fathers tend to demonstrate personal involvement in the activity (Davison, Cutting, & Birch, 2003).
Although it seems logical that children who see active parents would be inclined to imitate them, demonstrated support for physical activity is more important. Work by Welk and colleagues (Welk, Wood, & Morss, 2003; Welk, 1999b) showed that parental facilitation, encouragement, and involvement were more important to a child's physical activity participation than role modeling an active lifestyle. Role modeling was useful, but primarily as a function of support. More active parents tended to provide more support for the physical activities of their children (Gustafson & Rhodes, 2006).
Setting Limits
Parents play important roles in a child's activity level not only through promoting physical activity, but also through their efforts to minimize inactivity. Requiring a child to be active might, in the long run, be an ineffective way to create positive feelings about physical activity. It is often easier to set household rules or policies focusing on household objects that create inactivity than to try to force kids to be active. One example is to limit the amount of TV viewing allowed through a TV viewing policy. The average American child spends nearly 6 hours per day watching television and using other electronic media such as video games and computers (Roberts, Foehr, Rideout, & Brodie, 1999)! The relationship between inactivity and physical activity seems to be one of opposite behaviors. Decreasing the time spent in sedentary pursuits such as watching TV, playing computer games, or watching videos will surely provide more time for active pursuits. However, the choice between physical activity and sedentary pursuits seems to respond to different stimuli (Ford et al., 2002). Screen time plays a major role in the sedentary behavior of American youth. Parents and guardians can monitor and control children's and adolescents' access to the TV and computer; and, as already discussed, family-based programs to support such behaviors exist.
Learn more about Physical Activity Interventions in Children and Adolescents.
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