Arnold School of Public Health
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Timeline: 1993 - 1998
Funding Source: NIH
Principal Investigator: Dr. Russell R. Pate
Co-Investigator(s):
Description

BACKGROUND: Physical inactivity, low physical fitness, and tobacco and alcohol use are known to be prevalent in adolescent youth. These problematic health behaviors and characteristics tend to develop during early adolescence. This study provides important information on promotion of physical activity and physical fitness in disadvantaged adolescent youth and determines the extent to which delivery of such a program can affect avoidance of problematic health behaviors such as tobacco and alcohol use.

PURPOSE: The purpose of this study was to test the effects of an after-school/summer physical activity promotion program on physical activity, behavioral determinants of physical activity participation, physical fitness, and tobacco and alcohol used in adolescent youth. Another purpose of the study was to illustrate how process evaluation could be used to enhance our understanding of how interventions effect change in mediating variables.

DESIGN AND STUDY POPULATION: A quasi-experimental research design was employed and the effects of the intervention were measured in all public school students, initially in the 5th grade, in a rural, predominantly African American community in South Carolina. All students at the same grade level in the public schools in a comparable community served as controls. Dependent variables and key intervening variables were measured during the latter halves of the 5th, 6th, and 7th grade years in students in the intervention and control groups.

INTERVENTION: The intervention program, known as Active Winners, was delivered during a 19-month period extending from the summer of 1994 following the 5th grade year and concluded midway through the seventh grade year. The intervention program was based on Pender's Health Promotion Model and emphasizes enhancement of self-efficacy, a cognitive perceptual factor in the model. The major component of the intervention was the Active Winners after-school and summer activity program. Older teenagers completed an extensive preparatory course and served as program leaders in the after-school/summer intervention program. The goal of this program was to provide participants with regular exposure to enjoyable physical activities, increase physical activity self-efficacy, and increase physical activity and fitness. The program was divided into four activity areas: fitness activities, sports skills, academic skills, and social skills. All sessions in the after-school program and the summer programs included fitness and sports skills, and the summer program (five hours per day) included academic and social skills activities every day. The after-school program (two hours per day) alternated between academic and social skills activities. The emphasis on fitness activities increased over the life of the project. Other components of the intervention included Active Homework, which linked the program to participants' home through take-home activities, newsletters, and family nights; Active School, which provided consultation to participating schools for promotion of physical activity in the school setting; and Active Community, which assisted the community in promoting physical activity and providing opportunities for all community members to be physically active.

MEASUREMENT OF PHYSICAL ACTIVITY AND FITNESS: Data were collected at baseline, at a mid-point in the intervention period, and follow-up data were collected during the spring of 1996. Physical fitness was measured using a graded, submaximal cycle ergometer protocol (PWC-170). Physical activity during the after-school time period was reported for three days using the Previous Day Physical Activity Recall (PDPAR) questionnaire. Heart rate monitoring of a small subset of the program participants was performed during the fall and spring semesters of the first year to determine the intensity of physical activity. The PDPAR was completed on three consecutive days in the classroom at baseline, mid-intervention, and at post-intervention. The data from each day were reduced to the average daily number of 30-minute blocks in which the main activity was ³ 6 METS (vigorous physical activity &emdash; VPA) and ³ 3 METS (moderate to vigorous physical activity &emdash; MVPA).

MEASUREMENT OF DETERMINANTS OF PHYSICAL ACTIVITY: Psychosocial variables included measures of social influences regarding physical activity, beliefs about physical activity, and physical activity self-efficacy. Environmental variables included perceived physical activity habits of parents and peers, access to sporting/fitness equipment at home, participation in school and community sports teams, and involvement in community physical activity organizations. Cigarette smoking, smokeless tobacco use, and alcohol use were measured using questionnaire items modified from those used in the Youth Risk Behavior Survey (YRBS).

Published Project Articles

Pate RR, Saunders RP, Ward DS, Felton G, Trost SG, Dowda M. Evaluation of a community-based intervention to promote physical activity in youth: lessons from Active Winners. Am J Health Promot. 2003;17(3):171-82.

Trost SG, Ward DS, McGraw B, Pate RR. Validity of the Previous Day Physical Activity Recall (PDPAR) in Fifth-Grade Children. Pediatric Exercise Science. 1999, 11(4), 341-348.

Weston AT, Petosa R, Pate RR. Validation of an instrument for measurement of physical activity in youth. Med Sci Sports Exerc. 1997;29(1):138-143.

Trost SG, Pate RR, Saunders R, Ward DS, Dowda M, Felton G. A prospective study of the determinants of physical activity in rural fifth-grade children. Prev Med. 1997;26(2):257-263.