Factors associated with physical activity referral completion and health outcomes

Abstract

Participant socio-demographic characteristics and referral reason were investigated in relation to completion and health outcomes in a Primary Care Physical Activity Referral Scheme using a prospective population-based longitudinal design. Participants (n = 1735) were recruited over a 2-year period. A three-stage binary logistic regression analysis identified the factors associated with the outcomes of completion (model 1), body mass reduction (model 2) and blood pressure reduction (model 3). Participant's age, gender, ethnicity, occupation and referral reason were the independent variables for model 1, with the variables of completion added in model 2 and completion and body mass reduction added in model 3. Logistic regression analysis revealed that increasing age is associated with the likelihood of completion (Odds Ratio, OR = 1.019; Confidence Interval, CI = 1.008–1.030; P = 0.001). Participants with a pulmonary condition are less likely to complete (OR = 0.546; CI = 0.346–0.860; P < 0.01) compared to those referred for cardiovascular conditions. For ethnicity, in comparison to the white category, patients in the mixed category are significantly more likely to achieve a reduction in body mass (OR = 3.991; CI = 1.191–13.373; P < 0.05). Those who complete are more likely to achieve a reduction in body mass (OR = 3.541; CI = 2.721–4.608; P < 0.001). When compared to the unemployed category, the skilled manual category had an increased likelihood of achieving a reduction in blood pressure (OR = 1.875; CI = 1.044–3.227; P < 0.05). Participants who completed also demonstrated an increased likelihood of a reduction in blood pressure (OR = 1.680; CI = 1.250–2.003; P < 0.001). Furthermore, those participants who achieved a reduction in body mass had an increased likelihood of achieving a reduction in blood pressure (OR = 1.292; CI = 1.008–1.641; P < 0.05). Completion is associated with health outcomes of reduced body mass and blood pressure.     

Executive function mediates socio-economic and racial differences in early academic achievement

Although associations between socio-economic status, race, and academic achievement are well established, the specific mechanisms that underlie the relation remain incompletely understood. This longitudinal investigation, involving a sample of 206 children from economically and racially diverse backgrounds, examined the influence of executive function and expressive vocabulary assessed in kindergarten on academic achievement in Grade 1. The use of structural equation modeling revealed that both SES and race had indirect effects on achievement test scores through their effects on executive function, even when accounting for differences in expressive vocabulary. As expected, executive function was more strongly related to math than literacy achievement. The results provide support for the importance of targeting executive skills and intervening early in efforts to improve academic performance in young children. Moreover, the findings suggest that improving executive function may mitigate the impact of social risk factors on academic achievement.     

Nonstandard maternal work schedules: Implications for African American children's early language outcomes

In this study, observed maternal positive engagement and perception of work–family spillover were examined as mediators of the association between maternal nonstandard work schedules and children's expressive language outcomes in 231 African American families living in rural households. Mothers reported their work schedules when their child was 24 months of age and children's expressive language development was assessed during a picture book task at 24 months and with a standardized assessment at 36 months. After controlling for family demographics, child, and maternal characteristics, maternal employment in nonstandard schedules at the 24-month timepoint was associated with lower expressive language ability among African American children concurrently and at 36 months of age. Importantly, the negative association between nonstandard schedules and children's expressive language ability at 24 months of age was mediated by maternal positive engagement and negative work–family spillover, while at 36 months of age, the association was mediated only by negative work–family spillover. These findings suggest complex links between mothers’ work environments and African American children's developmental outcomes.     

Exploring opportunities available and perceived barriers to physical activity engagement in children and young people with Down syndrome

Primary objective: The aim of this study was to explore physical activity (PA) amongst children and young people with Down syndrome (DS). Method and procedures: The youth physical activity promotion model (YPAP) was used to inform semi-structured interviews to explore PA of children and young people with DS. Participants were three males and five females, aged between 6 and 21?years (16.38?+?5.04?years (mean?+?SD)) who had been diagnosed with the condition DS. Dyadic interviews were conducted with the participant and their parent(s). The interviews were recorded and transcribed, and inductive and deductive analyses of the data were completed. Main outcomes and results: The results were structured around the YPAP Model’s key themes included: enabling factors (seasonal variation, transport, type of activity and independence); predisposing factors (enjoyment, social interaction, dislikes of PA, following instructions, and understanding of PA); reinforcing factors (support and opportunities, parents, and care providers); and barriers to PA engagement (ear problems). Conclusion: The children and young people with DS in the study typically only engaged in fun, unstructured activities. Key facilitators for PA participation were social interactions and parental support. Increasing the level of independence for people with DS within adolescence may have beneficial effects for PA participation in later life.     

Teachers as Leaders

Graphic novels offer an exciting new medium across the curriculum, but classroom research must be done. Anecdotal evidence is a start, but reform requires thoughtful study. Teachers are in the best place to do this research, as they have ready access, currency, and credibility. Teacher research on graphic novels, indeed all new media, is also needed for teacher professionalism in the Knowledge Society.     

Developing strategic learners

This paper derives from an ongoing project on the teaching and learning of reading in English and Irish primary classrooms. The project is seeking to understand how reading, and indeed, learning, are conceptualised by pupils and teachers and, particularly, to understand how pedagogy supports (and hinders) the acquisition of metacognitive awareness and strategies among 9 year olds. This paper focuses on teaching in one classroom, the purpose being to develop teachers’ and researchers’ understanding of metacognition by holding up for analysis, incidents from one classroom. It is not our intention to criticise the teacher's practice with the benefit of hindsight — rather we are concerned to enhance awareness of some of the processes of learning in general and of metacognition in reading, in particular. We begin by reviewing briefly some of the literature on metacognition and by noting the implications for practice. We proceed by investigating the opportunities for metacognitive development in two reading lessons.     

Infant and Toddler Child-Care Quality and Stability in Relation to Proximal and Distal Academic and Social Outcomes

This study considered the quality and stability of infant and toddler nonparental child care from 6 to 36 months in relation to language, social, and academic skills measured proximally at 36 months and distally at kindergarten. Quality was measured separately as caregiver–child verbal interactions and caregiver sensitivity, and stability was measured as having fewer sequential child-care caregivers. This longitudinal examination involved a subsample (N = 1,055) from the Family Life Project, a representative sample of families living in rural counties in the United States. Structural equation modeling revealed that children who experienced more positive caregiver–child verbal interactions had higher 36-month language skills, which indirectly led to higher kindergarten academic and social skills. Children who experienced more caregiver stability had higher kindergarten social skills.     

Comparison of children’s free-living physical activity derived from wrist and hip raw accelerations during the segmented week

This study assessed children’s physical activity (PA) levels derived from wrist-worn GENEActiv and hip-worn ActiGraph GT3X+ accelerometers and examined the comparability of PA levels between the two devices throughout the segmented week. One hundred and twenty-nine 9–10-year-old children (79 girls) wore a GENEActiv (GAwrist) and ActiGraph GT3X+ (AGhip) accelerometer on the left wrist and right hip, respectively, for 7 days. Mean minutes of light PA (LPA) and moderate-to-vigorous PA (MVPA) per weekday (whole-day, before-school, school and after-school) and weekend day (whole-day, morning and afternoon–evening) segments were calculated, and expressed as percentage of segment time. Repeated measures analysis of variance examined differences in LPA and MVPA between GAwrist and AGhip for each time segment. Bland–Altman plots assessed between-device agreement for LPA and MVPA for whole weekday and whole weekend day segments. Correlations between GAwrist and AGhip were weak for LPA (r = 0.18–0.28), but strong for MVPA (r = 0.80–0.86). LPA and MVPA levels during all weekday and weekend day segments were significantly higher for GAwrist than AGhip (p < 0.001). The largest inter-device percent difference of 26% was observed in LPA during the school day segment. Our data suggest that correction factors are needed to improve raw PA level comparability between GAwrist and AGhip.     

Different research programs on metacognition: Are the boundaries imaginary?

This commentary asks whether the term “metacognition” means different things to researchers working in different subareas of cognitive and developmental psychology or whether they are just studying different aspects of the same underlying construct. The four articles in this special issue seem to be addressing phenomena that frequently share little except a label. Some of the phenomena that are called metacognitive necessarily involve conscious processing; however, other phenomena addressed in this issue, such as self-regulating behaviors, are typically executed without conscious awareness.     

Women Returners to Further Education: employment and gender relations in the home

The education and retraining of ‘women returners’ to the labour market was an innovative development in further education in Britain in the 1980s. Fifty‐six women who undertook a part‐time information technology course at a college of further education in Birmingham were the subjects of this study. They were the respondents to a questionnaire sent to all women who had studied on the courses run between early 1987 and late 1989. A small number were subsequently interviewed. The aims of the research were twofold: firstly, to study their current employment situations and secondly to investigate the impact of employment on gender relations in the home. Almost all the women had been able to re‐enter employment, most using the skills they had learned on the course. However the course had not been instrumental in breaking down gender segregation in computing and few women worked in professional or male dominated jobs. The majority were in clerical, secretarial or administrative work, though this did mean that most had been able to rejoin the labour force at the same occupational level at which they had left. Some women, including half the black women in the study, improved their occupational position. It is argued that training for women who are in employment needs to be more available, otherwise the women in the study will not be able to progress into better jobs as their confidence grows and family commitments lessen. The study confirmed the continued pervasiveness of ideologies which prioritise men's employment and position of ‘breadwinners’ and women's continued responsibility for home and children. The conclusion of the study is that although feminists and others keen to promote equality for women in employment have made child care and more flexible working conditions the central issues, marriage and the sexual division of labour in the home, whilst equally significant, have been neglected and need to be given more consideration, both theoretically and strategically.