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Introduction: Secondary schools have the potential to promote health-related fitness (HRF) and physical activity within and outside school hours. As such, schools are often chosen as the setting to implement child and adolescent physical activity programs. School-based programs often utilise teachers as delivery agents, but few studies examine effects on teacher-level outcomes. Purpose: The primary aim of this study was to determine the impact of teacher training embedded within a physical activity intervention on teacher-level outcomes. The secondary aim of this study was to evaluate process data, including implementation, satisfaction and fidelity. Methods: "Resistance Training for Teens" ("RT for Teens") was evaluated using a cluster randomised controlled trial in 16 secondary schools. Teachers (N = 44; 48% female/52% male; mean ± SD years teaching experience = 10.6 ± 8.0) from 16 secondary schools were assessed at baseline. Intervention group teachers (i.e. from eight schools) delivered a structured school-based physical activity program over 10-weeks. Teacher outcomes included confidence to teach health-related fitness (HRF) activities, perceived barriers to teaching HRF activities, and perceived fitness. Detailed process evaluation data were also collected. Assessments were conducted at baseline and 6-months (post-program), and outcomes were assessed using repeated measures analysis of variance. Results: There was a positive group-by-time effect for the confidence composite score (p = 0.010, partial eta squared = 0.29), but no effects for the two (contextual, interpersonal) barrier composite scores. Also, there was a significant effect for perceived 'general fitness' (p = 0.044, partial eta squared = 0.13), but not for specific fitness subdomains. Teachers were highly satisfied with both the training and the program, believing it was beneficial for students. Resource usage and adherence to the SAAFE (Supportive, Active, Autonomous, Fair, Enjoyable) delivery principles was high. Conclusion: "RT for Teens" improved teachers' confidence and perceived fitness. These findings highlight the potential for high-quality teacher training and program delivery to positively influence teacher-level outcomes. This may provide support for the use of teacher professional development to improve HRF-related pedagogy.

There is growing interest in identifying the mechanisms underpinning the effects of physical activity on executive functions (e.g. inhibitory control, cognitive flexibility) in children. Our study examined cardiorespiratory fitness, muscular fitness, and motor competence as potential mediators of this relationship. The study used baseline data from the Learning to Lead (L2L) cluster randomised controlled trial. In total, 675 children (7–11 years, 49.5% girls) completed measures of moderate-to-vigorous physical activity (MVPA), cardiorespiratory fitness, muscular fitness, motor competence, and executive functions. Structural equation modelling was used to examine the potential mediating roles of cardiorespiratory fitness, muscular fitness, and motor competence in the cross-sectional association between MVPA and executive functions. Cardiorespiratory fitness (β = 0.06, SE = 0.021, p = 0.004) partially mediated the association between MVPA and cognitive flexibility. Muscular fitness was a significant mediator of the association between MVPA and both inhibitory control (β = 0.03, SE = 0.014, p = 0.027) and cognitive flexibility (β = 0.06, SE = 0.021, p = 0.005). No significant mediated effects were found for motor competence. Our findings suggest cardiorespiratory and muscular fitness (but not motor competence) mediate the association between physical activity and executive functions in children. [ABSTRACT FROM AUTHOR]

This study aimed to examine the preliminary efficacy and feasibility of implementing a tailored version of the MASTER coach education programme in Chinese primary schools to support physical education (PE) teachers' basketball lesson design and delivery. A total of 20 primary schools in Beijing, China were recruited, with one PE teacher and their class (N = 715 students aged 10–13 yrs) from each school included in the study and randomly allocated to the MASTER intervention (n = 10) or control group (n = 10). Compared to the control group, a significant difference was observed in the MASTER group for the proportion of playing-form activities delivered during PE (27.65, 95% CI [20.27, 35.03]) and for teachers' perceptions of confidence (23.92, 95% CI [15.87, 31.92]) and competence (24.12, 95% CI [10.28, 24.71]) to teach. Significant differences between groups were observed for students' perceived athletic competence (3.56%; 95% CI [3.15, 3.96]), enjoyment (11.83%; 95% CI [10.98, 12.69]), well-being (8.51%; 95% CI [7.02, 10.00]), intrinsic motivation (+0.74%; 95% CI [0.30, 1.17]), introjected motivation (−2.24%; 95% CI [−2.77, −1.70]), and external motivation (−0.49%; 95% CI [−0.90, −0.08]). The MASTER programme was effective in improving teaching practices in Chinese primary schools, and in facilitating improvements in teacher and student outcomes. [ABSTRACT FROM AUTHOR]

Purpose: Our study explored the mediating effect of sleep‐related variables on older adolescents' mental health in the context of a school‐based physical activity intervention. Methods: We evaluated the Burn 2 Learn (B2L) intervention using a cluster randomized controlled trial, which included two cohorts. Participants for this sub‐study were from the second cohort, which included 292 older adolescents (16.0 ± 0.5 years) from 10 secondary schools in New South Wales, Australia. Teachers at intervention schools delivered two high‐intensity activity breaks (approximately 10 mins) per week to students during academic lessons. Participants completed measures of mental health (i.e., perceived stress and internalizing problems) and hypothesized mediators (i.e., sleep duration, sleep latency, awakenings, and daytime sleepiness) at baseline (February–April 2019) and post‐intervention (August–September 2019). Single mediation analyses were conducted to explore the potential mediating effects of sleep variables on mental health outcomes using a product‐of‐coefficient test. Results: We observed a small statistically significant effect for perceived stress (β = −0.11, SE = 0.034, p = 0.002), but not for internalizing problems (β = 0.02, SE = 0.051, p = 0.760). There were no significant intervention effects for sleep‐related variables. Several sleep‐related variables were associated with mental health outcomes but no mediated effects were found. Conclusion: The B2L intervention had a small beneficial effect on perceived stress, however our mediation analyses suggest this was not explained by changes in sleep‐related variables. Markers of sleep were associated with mental health constructs, highlighting the importance of sleep for good psychological health. However, in the context of a physical activity intervention, effects on mental health may be driven by other behavioral, neurobiological, or psychosocial mechanisms. [ABSTRACT FROM AUTHOR]

Purpose: This study was designed to assess the feasibility and preliminary efficacy of a teacher-facilitated high-intensity interval training intervention for older adolescents (ie, 16–18 y). Methods: Two secondary schools from New South Wales, Australia were recruited, and participants (ie, grade 11 students; 16.2 [0.4] y) were randomized at the school level to the Burn 2 Learn intervention (n = 38), or a wait-list control group (n = 30). Teachers were trained to facilitate the delivery of the novel high-intensity interval training program, which involved 3 sessions per week (∼12–20 min) for 14 weeks. A range of process measures were used to assess intervention feasibility (ie, recruitment, retention, attendance, and program satisfaction). Primary (cardiorespiratory fitness, determined using the progressive aerobic cardiovascular endurance run shuttle run test) and secondary outcomes were assessed at baseline and posttest (14-wk). Results: Sixty-eight grade 11 students were recruited at baseline (85% of target sample), 61 participants completed posttest assessments (90% retention) and on average, participants performed 1.9 sessions per week. Overall, teachers (4.0/5) and students (4.0/5) were satisfied with the Burn 2 Learn program. Group by time effects were observed for cardiorespiratory fitness (8.9 laps; 95% confidence intervals, 1.7–16.2) and a selection of secondary outcomes. Conclusion: This study provides evidence for the feasibility and preliminary efficacy of a teacher-facilitated high-intensity interval training intervention for older adolescents. [ABSTRACT FROM AUTHOR]

Background: Mobile app-based interventions have the potential for wide-reach and therefore may be a useful tool in up-scaling physical activity interventions. In larger-scale interventions, face-to-face assessments are less cost-effective, and researchers often rely on surveys or activity trackers to assess outcomes. However, there is limited evidence of valid muscular fitness assessments that can be self-administered within mHealth interventions. As such, this study will evaluate the concurrent validity of upper and lower body muscular fitness that have been independently assessed by participants via the ecofit app, and face-to-face assessments conducted by a trained researcher. Methods: This study compared baseline data from two muscular fitness tests from the ecofit two-armed randomised controlled trial and self-assessed data collected via the ecofit smartphone app (i.e., validated 90-degree push-up and 60-second sit-to-stand test). To assess the concurrent validity, the self-assessed push-up and sit-to-stand tests (i.e., collected via the ecofit app) were correlated using Spearman's correlation coefficient against the researcher-assessed results (i.e., objective results collected during baseline assessment for the ecofit trial). Bland-Altman plots were also used to allow visualisation of the differences between the self- and research-assessed tests. Results: Participants (N = 54) completed the push-up (24.1%) and sit-to-stand (100%) tests within 14-days of receiving the app. The results revealed a strong significant correlation for the push-up test (0.83, p<0.001) and a moderate significant correlation for the sit-to-stand test (0.63, p<0.001). Conclusion: This study provides support for the concurrent validity of self-reported upper and lower body muscular fitness assessments (i.e., the push-up and sit-to-stand tests) in mHealth. While these tests may be a feasible option for large scale physical activity interventions, more research is needed to determine the generalisability of these results. [ABSTRACT FROM AUTHOR]

Process evaluations can help to optimise the implementation of school-based physical activity interventions. The purpose of this paper is to describe the process evaluation of a school-based high-intensity interval training (HIIT) program for older adolescent students, known as Burn 2 Learn (B2L). B2L was evaluated via a cluster randomised controlled trial in 20 secondary schools (10 intervention, 10 control) in New South Wales, Australia. Teachers (n = 22 (55% female)) from the 10 intervention schools, delivered the program over three phases (Phases 1 and 2, 6 months; Phase 3, 6 months) to older adolescent students (n = 337 (50% female); mean ± standard deviation (SD) age = 16.0 ± 0.4 years). Process evaluation data were collected across the 12-month study period. Teachers delivered 2.0 ± 0.8 and 1.7 ± 0.6 sessions/week in Phases 1 and 2 respectively (mean total 25.9 ± 5.2), but only 0.6 ± 0.7 sessions/week in Phase 3. Observational data showed that session quality was high, however heart rate (HR) data indicated that only half of the students reached the prescribed threshold of ≥85% predicted HRmax during sessions. Over 80% of teachers reported they intended to deliver the B2L program to future student cohorts. Almost 70% of students indicated they intended to participate in HIIT in the future. Teachers considered the program to be adaptable, and both students and teachers were satisfied with the intervention. B2L was implemented with moderate-to-high fidelity in Phases 1 and 2, but low in Phase 3. Our findings add to the relatively scant process evaluation literature focused on the delivery of school-based physical activity programs. [ABSTRACT FROM AUTHOR]

The feasibility requirements of administering field-based cognitive assessments are rarely reported. We examined the feasibility of administering a group-based cognitive test battery in a school setting with older adolescents. Several types of reliability were also assessed in the control group. Preliminary efficacy and the relationship between changes in fitness and changes in cognitive control were also explored following a 14-week HIIT intervention (3 sessions/week). Participants completed a cognitive test battery measuring inhibition (flanker), and working memory (n-back) at baseline and post-test. Health-related fitness assessments were also conducted. Test administration took approximately 30.8 ± 1.5 minutes to complete with up to six participants simultaneously. The test battery demonstrated acceptable reliability (ICC = 0.5–0.81), with significant changes observed for flanker incongruent accuracy, and 2-back non-target accuracy from baseline to post-test. Regarding efficacy, small-to-moderate effects were observed for accuracy outcomes, while several small associations were found between changes in fitness and changes in cognition. Findings from the current study suggest a cognitive test battery can be administered with older adolescents in a school setting. However, there remains a lack of adequate reporting of administration requirements for field-based cognitive assessments. Efficacy findings should be confirmed with a larger and more representative sample of older adolescents. [ABSTRACT FROM AUTHOR]

Purpose Guidelines recommend that young people engage in muscle-strengthening activities on at least 3 d⋅wk-1. The purpose of this study was to examine the effect of a school-based intervention focused on resistance training (RT) for adolescents. Methods The "Resistance Training for Teens" intervention was evaluated using a cluster-randomized, controlled trial with 607 adolescents (50.1% girls; 14.1 ± 0.5 yr) from 16 secondary schools. Teachers were trained to deliver the intervention, which included the following: (i) an interactive student seminar; (ii) a structured physical activity program, focused on RT; (iii) lunchtime fitness sessions; and (iv) Web-based smartphone apps. The primary outcome was muscular fitness (MF) and secondary outcomes included body mass index, RT skill competency, flexibility, physical activity, self-efficacy, and motivation. Assessments were conducted at baseline, 6 months (postprogram; primary end point), and 12 months (follow-up). Outcomes were assessed using linear mixed models, with three potential moderators tested using interaction terms (and subgroup analyses where appropriate). Results For the primary outcome (MF), a group-time effect was observed at 6 months for the upper body (2.0 repetitions; 95% confidence interval (CI), 0.8-3.2), but not the lower body (-1.4 cm; 95% CI, -4.7-1.9). At 6 months, there were intervention effects for RT skill competency and self-efficacy, but no other secondary outcomes. Effects for upper body MF and RT skill competency were sustained at 12 months. Despite overall no effect for body mass index, there was a group-time effect at 12 months among students who were overweight/obese at baseline (-0.55 kg⋅m-2; 95% CI, -1.01 to -0.08). Conclusions The school-based RT intervention resulted in immediate and sustained improvements in upper body MF and RT skill competency, demonstrating an effective and scalable approach to delivering RT within secondary schools. [ABSTRACT FROM AUTHOR]

Introduction: The primary objective was to evaluate the impact of the 'Switch-off 4 Healthy Minds' (S4HM) intervention on recreational screen-time in adolescents.Methods: Cluster randomized controlled trial with study measures at baseline and 6-months (post-intervention). Eligible participants reported exceeding recreational screen-time recommendations (i.e., >2h/day). In total, 322 adolescents (mean age=14.4±0.6years) from eight secondary schools in New South Wales, Australia were recruited. The S4HM intervention was guided by Self-Determination Theory and included: an interactive seminar, eHealth messaging, a behavioral contract and parental newsletters. The primary outcome was recreational screen-time. Secondary outcomes included mental health (i.e., well-being, psychological distress, self-perceptions), objectively measured physical activity, and body mass index (BMI). Outcome analyses were conducted using linear mixed models and mediation was examined using a product-of-coefficients test.Results: At post-intervention, significant reductions in screen-time were observed in both groups, with a greater reduction observed in the intervention group (-50min/day versus -29min, p<0.05 for both). However, the adjusted difference in change between groups was not statistically significant (mean=-21.3min/day, p=0.255). There were no significant intervention effects for mental health outcomes, physical activity or BMI. Significant mediation effects for autonomous motivation were found.Conclusions: Participants in both the S4HM intervention and control groups significantly reduced their screen-time, with no group-by-time effects. Enhancing autonomous motivation might be a useful intervention target for trials aimed at reducing adolescents' recreational screen-time.Trial Registration: ACTRN12614000163606. [ABSTRACT FROM AUTHOR]

Background: Obesity prevention interventions targeting 'at-risk' adolescents are urgently needed. The aim of this study is to evaluate the sustained impact of the 'Active Teen Leaders Avoiding Screen-time' (ATLAS) obesity prevention program. Methods: Cluster RCT in 14 secondary schools in low-income communities of New South Wales, Australia. Participants were 361 adolescent boys (aged 12-14 years) 'at risk' of obesity. The intervention was based on Self-Determination Theory and Social Cognitive Theory and involved: professional development, fitness equipment for schools, teacher-delivered physical activity sessions, lunch-time activity sessions, researcher-led seminars, a smartphone application, and parental strategies. Assessments for the primary (body mass index [BMI], waist circumference) and secondary outcomes were conducted at baseline, 8- (post-intervention) and 18-months (follow-up). Analyses followed the intention-to-treat principle using linear mixed models. Results: After 18-months, there were no intervention effects for BMI or waist circumference. Sustained effects were found for screen-time, resistance training skill competency, and motivational regulations for school sport. Conclusions: There were no clinically meaningful intervention effects for the adiposity outcomes. However, the intervention resulted in sustained effects for secondary outcomes. Interventions that more intensively target the home environment, as well as other socio-ecological determinants of obesity may be needed to prevent unhealthy weight gain in adolescents from low-income communities. [ABSTRACT FROM AUTHOR]

The purpose of this study was to examine the mediating effect of resistance training skill competency on percentage of body fat, muscular fitness and physical activity among a sample of adolescent boys participating in a school-based obesity prevention intervention. Participants were 361 adolescent boys taking part in the Active Teen Leaders Avoiding Screen-time (ATLAS) cluster randomised controlled trial: a school-based program targeting the health behaviours of economically disadvantaged adolescent males considered “at-risk” of obesity. Body fat percentage (bioelectrical impedance), muscular fitness (hand grip dynamometry and push-ups), physical activity (accelerometry) and resistance training skill competency were assessed at baseline and post-intervention (i.e., 8 months). Three separate multi-level mediation models were analysed to investigate the potential mediating effects of resistance training skill competency on each of the study outcomes using a product-of-coefficients test. Analyses followed the intention-to-treat principle. The intervention had a significant impact on the resistance training skill competency of the boys, and improvements in skill competency significantly mediated the effect of the intervention on percentage of body fat and the combined muscular fitness score. No significant mediated effects were found for physical activity. Improving resistance training skill competency may be an effective strategy for achieving improvements in body composition and muscular fitness in adolescent boys. [ABSTRACT FROM PUBLISHER]

Abstract: Introduction: The negative consequences of unhealthy weight gain and the high likelihood of pediatric obesity tracking into adulthood highlight the importance of targeting youth who are ‘at risk’ of obesity. The aim of this paper is to report the rationale and study protocol for the ‘Active Teen Leaders Avoiding Screen-time’ (ATLAS) obesity prevention intervention for adolescent boys living in low-income communities. Methods/design: The ATLAS intervention will be evaluated using a cluster randomized controlled trial in 14 secondary schools in the state of New South Wales (NSW), Australia (2012 to 2014). ATLAS is an 8-month multi-component, school-based program informed by self-determination theory and social cognitive theory. The intervention consists of teacher professional development, enhanced school-sport sessions, researcher-led seminars, lunch-time physical activity mentoring sessions, pedometers for self-monitoring, provision of equipment to schools, parental newsletters, and a smartphone application and website. Assessments were conducted at baseline and will be completed again at 9- and 18-months from baseline. Primary outcomes are body mass index (BMI) and waist circumference. Secondary outcomes include BMI z-scores, body fat (bioelectrical impedance analysis), physical activity (accelerometers), muscular fitness (grip strength and push-ups), screen-time, sugar-sweetened beverage consumption, resistance training skill competency, daytime sleepiness, subjective well-being, physical self-perception, pathological video gaming, and aggression. Hypothesized mediators of behavior change will also be explored. Discussion: ATLAS is an innovative school-based intervention designed to improve the health behaviors and related outcomes of adolescent males in low-income communities. [Copyright &y& Elsevier]

Exercise in natural environments can improve cognition, positive affect, and reduce psychological stress. However, it remains unclear whether these benefits are subject to a gradient effect, whereby more natural features confer greater cognitive and psychological benefits. This study examined the influence of the exercise environment (i.e., the degree of nature) on cognition, and psychological outcomes in a sample of adolescents (n = 90; mean age = 14.3 ±.05 years). Four groups were randomised to one of the following experimental conditions: a non-exercise indoor control, indoor exercise, park exercise, and exercise in a nature reserve. Participants' self-reported their stress, affect, and vitality and completed two measures of cognition ('Rapid Visual Information Processing' and 'Spatial Working Memory') immediately before and ~6 min after exercise. All exercise conditions participated in a group-based circuit lasting ~20 min, which included a mixture of aerobic and body-weight resistance activities. Linear mixed models were used to examine changes within and between groups. The indoor group increased sustained attention accuracy compared to the park group. There were no between-group differences in working memory. The indoor and nature groups increased cognitive arousal compared to control. The park group improved in state-level vitality compared to control. The mixed-results of this research do not support our 'nature gradient' hypothesis, whereby cognitive and psychological outcomes would improve in accordance with the degree of nature present in the exercise environment. • Improvements in sustained attention accuracy favoured indoor over park exercise. • Park exercise resulted in improvements in state-level vitality. • No evidence that exercise environment influences working memory. • No conclusive nature gradient effects on cognitive and psychological outcomes. [ABSTRACT FROM AUTHOR]

The risk and prevalence of Type 2 Diabetes (T2D) has dramatically increased over the past decade. The aim of this study was to develop, implement and evaluate a physical activity intervention to improve aerobic and muscular fitness among adults at risk of, or diagnosed with T2D. A 20-week, assessor blinded, parallel-group randomized controlled trial (RCT) was conducted at the University of Newcastle (June-December 2015). Adults were randomized to the intervention (n=42) or wait-list control group (n=42). The theory-based intervention included: Phase 1 (weeks 1-10) integrated group sessions (outdoor physical activity and cognitive mentoring), and the eCoFit smartphone application (app). Phase 2 (weeks 11-20) only included the eCoFit app. Participants were assessed at baseline, 10weeks and 20weeks. Linear mixed models (intention-to-treat) were used to determine group-by-time interactions at 10weeks (primary time-point) and 20weeks for the primary outcomes. Several secondary outcomes were also assessed. After 10weeks, significant group-by-time effects were observed for aerobic fitness (4.5mL/kg/min; 95% CI [1.3, 7.7], d=0.68) and muscular fitness (lower body) (3.4 reps, 95% CI [2.7, 4.2], d=1.45). Intervention effects for secondary outcomes included significant increased physical activity (1330steps/week), improved upper body muscular fitness (5 reps; arm-curl test), improved functionality (-1.8s; timed-up and go test) reduced waist circumference (2.8cm) and systolic blood pressure (-10.4mmHg). After 20weeks, significant effects were observed for lower body muscular fitness and health outcomes. eCoFit is an innovative lifestyle intervention which integrates smartphone technology, social support, and the outdoor environment to improve aerobic and muscular fitness. [ABSTRACT FROM AUTHOR]

Introduction The prevalence and risk of Type 2 Diabetes (T2D) has dramatically increased over the past decade. Physical activity (PA) has significant benefits for the treatment and prevention of T2D. The aim of this study is to develop, implement and evaluate a community-based PA intervention to improve aerobic and muscular fitness among adults at risk of, or diagnosed with T2D. Research design and methods The eCoFit pilot intervention will be evaluated using a randomized controlled trial (RCT) design. The 20-week (Phases 1 and 2) multi-component intervention was guided by Social Cognitive Theory, Health Action Process Approach Model, and Cognitive Behavior Therapy strategies. Phase 1 (Weeks 1–10) includes: i) 5 group face-to-face sessions consisting of outdoor training and cognitive mentoring; and ii) the use of the eCoFit smartphone application with a description of where and how to use the outdoor environment to be more physically active. Phase 2 (Weeks 11–20) includes the use of the eCoFit smartphone application only. Assessments are to be conducted at baseline, 10-weeks (primary end-point) and 20-weeks (secondary end-point) post-baseline. Primary outcomes are cardio-respiratory fitness and muscular fitness (lower body). Secondary outcomes include physical, behavioral, mental health and quality of life, and social–cognitive outcomes. Discussion eCoFit is an innovative, multi-component intervention, which integrates smartphone technology, social support and the outdoor physical environment to promote aerobic and resistance training PA among adults at risk of, or diagnosed with T2D. The findings will be used to guide future interventions and to develop and implement effective community-based prevention programs. Trial registration Australian New Zealand Clinical Trials Registry No: ACTRN12615000990527. [ABSTRACT FROM AUTHOR]