Publications by authors named "Jeanette Garcia"

33 Publications

Transition of a Judo Program from In-Person to Remote Delivery During COVID-19 for Youth with Autism Spectrum Disorder.

Adv Neurodev Disord 2021 Mar 6:1-6. Epub 2021 Mar 6.

School of Social Work, College of Community Innovation, and Education, University of Central Florida, Orlando, FL 32816 USA.

Objectives: To examine the feasibility of a remote judo program for high school students with autism spectrum disorder (ASD) during the COVID-19 pandemic.

Methods: Nine high school students with ASD had been participating in an in-person judo program that transitioned to a livestream format once the stay-at-home orders were mandated. The students completed surveys regarding their experience with the remote sessions. Their classroom teacher completed a semi-structured interview regarding the advantages and disadvantages of the remote format.

Results: Eight out of the nine students attended 92% of the remote classes. All nine students reported feeling satisfied with the remote judo sessions. Reported benefits of the remote format included the structured routine during the pandemic and the opportunity for physical activity. Disadvantages included a lack of space and lack of one-on-one instruction.

Conclusions: The remote judo program appeared to be both feasible and acceptable for youth with ASD.
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http://dx.doi.org/10.1007/s41252-021-00198-7DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7935692PMC
March 2021

The impact of health education on physical activity correlates in college students.

J Am Coll Health 2021 Feb 17:1-6. Epub 2021 Feb 17.

Department of Exercise Science, Florida Southern College, Lakeland, Florida, USA.

Objective: To examine the effects of a 15-week, conceptually based university health/wellness course on moderate-to-vigorous physical activity (MVPA) levels, psychosocial factors, and health-related fitness knowledge (HRFK). 125 undergraduates enrolled during spring 2016 semester. Participants completed pre- and post-course surveys with questions on MVPA levels, exercise self-efficacy (SE), exercise motivation, and HRFK. Wilcoxon rank sum tests examined changes in SE, motivation, and HFRK. A multiple regression analysis examined associations among HRFK, psychosocial factors, and MVPA. HRFK and MVPA increased from baseline to post-course assessment (p<.01). An increase in SE was associated with an increase in MVPA (p < 0.0001). Enrollment in a conceptually based health/wellness course may increase MVPA and HRFK in college students. Although the increase in SE post-course was not significant, it was associated with an increase in MVPA. These results support adoption of health/wellness programming to attenuate decreases in MVPA typically observed in college students.
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http://dx.doi.org/10.1080/07448481.2021.1879812DOI Listing
February 2021

Children's moderate-to-vigorous physical activity on weekdays versus weekend days: a multi-country analysis.

Int J Behav Nutr Phys Act 2021 02 10;18(1):28. Epub 2021 Feb 10.

MRC Epidemiology Unit & Centre for Diet and Activity Research, University of Cambridge, Cambridge, UK.

Purpose: The Structured Days Hypothesis (SDH) posits that children's behaviors associated with obesity - such as physical activity - are more favorable on days that contain more 'structure' (i.e., a pre-planned, segmented, and adult-supervised environment) such as school weekdays, compared to days with less structure, such as weekend days. The purpose of this study was to compare children's moderate-to-vigorous physical activity (MVPA) levels on weekdays versus weekend days using a large, multi-country, accelerometer-measured physical activity dataset.

Methods: Data were received from the International Children's Accelerometer Database (ICAD) July 2019. The ICAD inclusion criteria for a valid day of wear, only non-intervention data (e.g., baseline intervention data), children with at least 1 weekday and 1 weekend day, and ICAD studies with data collected exclusively during school months, were included for analyses. Mixed effects models accounting for the nested nature of the data (i.e., days within children) assessed MVPA minutes per day (min/day MVPA) differences between weekdays and weekend days by region/country, adjusted for age, sex, and total wear time. Separate meta-analytical models explored differences by age and country/region for sex and child weight-status.

Results/findings: Valid data from 15 studies representing 5794 children (61% female, 10.7 ± 2.1 yrs., 24% with overweight/obesity) and 35,263 days of valid accelerometer data from 5 distinct countries/regions were used. Boys and girls accumulated 12.6 min/day (95% CI: 9.0, 16.2) and 9.4 min/day (95% CI: 7.2, 11.6) more MVPA on weekdays versus weekend days, respectively. Children from mainland Europe had the largest differences (17.1 min/day more MVPA on weekdays versus weekend days, 95% CI: 15.3, 19.0) compared to the other countries/regions. Children who were classified as overweight/obese or normal weight/underweight accumulated 9.5 min/day (95% CI: 6.9, 12.2) and 10.9 min/day (95% CI: 8.3, 13.5) of additional MVPA on weekdays versus weekend days, respectively.

Conclusions: Children from multiple countries/regions accumulated significantly more MVPA on weekdays versus weekend days during school months. This finding aligns with the SDH and warrants future intervention studies to prioritize less-structured days, such as weekend days, and to consider providing opportunities for all children to access additional opportunities to be active.
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http://dx.doi.org/10.1186/s12966-021-01095-xDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7877033PMC
February 2021

The time course of neuromuscular impairment during short-term disuse in young women.

Physiol Rep 2021 Jan;9(1):e14677

School of Kinesiology & Physical Therapy, University of Central Florida, Orlando, FL, USA.

Skeletal muscle disuse results in rapid functional declines. Previous studies have typically been at least 1 week in duration and focused on the responsiveness of men. Herein, we report the timeline of initial impairments in strength, voluntary activation (VA), and motor unit control during 2 weeks of knee joint immobilization. Thirteen women (mean age =21 years) underwent 2 weeks of left knee joint immobilization via ambulation on crutches and use of a brace. Participants visited the laboratory for testing on seven occasions (two familiarization visits, pretest, 48 and 72 h, 1 and 2 weeks). Knee extensor isometric and concentric isokinetic strength at two velocities (180 and 360 degrees⋅s ), VA, and submaximal vastus lateralis motor unit activity were evaluated. Moderate-to-large decreases in isometric and concentric strength at 180 degrees⋅s and VA were observed within 48 hours. Isometric strength continued to decline beyond 72 h, whereas other variables plateaued. The B-term of the motor unit mean firing rate versus action potential amplitude relationship demonstrated a moderate increase 1 week into immobilization, suggesting that greater firing rates were necessary to maintain pretest torque levels. Concentric strength at a velocity of 360 degrees s was not affected. Decreases in knee extensor strength occur within a matter of days after immobilization, although the time course and magnitude vary among assessment methods. These changes are mediated by the nervous system's capacity to activate skeletal muscle. Clinically appropriate interventions which target nervous system plasticity should be implemented early to minimize the rapid functional impairments associated with disuse.
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http://dx.doi.org/10.14814/phy2.14677DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7797948PMC
January 2021

Brief report: The impact of the COVID-19 pandemic on health behaviors in adolescents with Autism Spectrum Disorder.

Disabil Health J 2021 04 5;14(2):101021. Epub 2020 Nov 5.

School of Kinesiology and Physical Therapy, College of Health Professions and Sciences, University of Central Florida, Orlando, FL, 32816, USA.

Background: There is concern that the COVID-19 pandemic may negatively affect health behaviors in youth, especially youth diagnosed with Autism Spectrum Disorder (ASD).

Objective: The purpose of this paper was to examine changes in physical activity, screen-time, and sleep in adolescents with ASD due to the COVID-19 pandemic.

Methods: Nine adolescents with ASD completed surveys measuring physical activity, screen-time, and sleep duration prior to and during the pandemic.

Results: A significant decrease in days of physical activity (4.17 vs 2.27; p = 0.0006), and a significant increase in hours of both weekday (3.69 vs 6.25; p = 0.007) and weekend screen-time (5.94 vs. 7.39; p = 0.004) was observed during the pandemic. No changes regarding sleep duration was observed.

Conclusions: Although preliminary, results suggest that physical activity and screen-time may be negatively affected by the COVID-19 outbreak in youth with ASD. The development of interventions to promote health behaviors in ASD populations during long periods of less-structured time (quarantine) should be considered.
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http://dx.doi.org/10.1016/j.dhjo.2020.101021DOI Listing
April 2021

Sweat, Sit, Sleep: A Compositional Analysis of 24-hr Movement Behaviors and Body Mass Index among Children with Autism Spectrum Disorder.

Autism Res 2021 03 13;14(3):545-550. Epub 2020 Nov 13.

Department of Behavioral Health and Nutrition, University of Delaware, Newark, Delaware, USA.

This study (a) examined the daily composition of 24-hr movement behaviors in children with ASD using objective measures, and (b) applied compositional analysis to examine the associations of the time spent in moderate-vigorous physical activity (MVPA), light physical activity (LPA), sedentary behavior (SB), and sleep duration (SD) with body mass index (BMI), relative to the time spent in the other movement behaviors in a sample of children (aged 7-19 years) with ASD. Time spent in MVPA, LPA, SB, and SD were measured using accelerometers over a 7-day period. BMI was calculated from measured height and weight. Participants (n = 46) spent 40% of time in LPA (M = 9.6 hr), 30.6% (M = 7.34 hr) in SB, 24.9% (M = 5.98 hr) asleep, and 4.5% (M = 64.8 min) in MVPA. Reallocating 30 min from LPA to SD decreased BMI by 0.471 kg/m (P = 0.003). Reallocating 30 min from MVPA to SD decreased BMI by 0.658 kg/m (P = 0.051). Reallocation of 60 min in equal proportions from SB, MVPA, and SD to LPA increased BMI by 0.418 kg/m (P = 0.021), and reallocation of 60 min in equal proportions from LPA, MVPA, and SD to SB increased BMI by 0.295 kg/m (P = 0.052). Finally, reallocation of 60 min in equal proportions from SB, LPA, and MVPA to SD decreased BMI by -0.845 kg/m (P = 0.001). LAY SUMMARY: Data was collected on time spent in light physical activity (LPA), moderate-vigorous physical activity (MVPA), sedentary behavior (SB), and sleep in 46 children with autism. The sample had insufficient sleep (a mean of 6 hr/night). We showed that replacing 30 min of LPA or MVPA with sleep decreased BMI. Also, moving 60 min to LPA or SB from the remaining movement behaviors (i.e., 20 min from each) increased BMI, and moving 60 min to sleep from the remaining behaviors decreased BMI.
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http://dx.doi.org/10.1002/aur.2434DOI Listing
March 2021

Evaluation of Diet Quality Among American Adult Cancer Survivors: Results From 2005-2016 National Health and Nutrition Examination Survey.

J Acad Nutr Diet 2021 Feb 3;121(2):217-232. Epub 2020 Nov 3.

Background: Diet quality among adult cancer survivors is low, and there is minimal information on the Healthy Eating Index (HEI)-2015 score, a measure of diet quality and adherence to the 2015-2020 Dietary Guidelines for Americans, in this population.

Objective: This study aimed to examine HEI-2015 total and component scores and associated factors among adult cancer survivors. Also, this study examined which dietary components needed the most change to improve diet quality in this population.

Design: The National Health and Nutrition Examination Survey (NHANES) is an ongoing nationally representative population-based cross-sectional study that is conducted annually.

Participants/setting: In all, 1971 adults with a self-reported cancer diagnosis in their lifetime (both individuals with cancer currently and those that are cancer-free) from NHANES 2005-2016 were included in this study.

Main Outcome Measures: HEI-2015 total and 13 component scores were calculated using the simple scoring algorithm method from the average of 2 24-hour recalls.

Statistical Analyses: The associations of the HEI-2015 total score with sociodemographic, lifestyle, and health-related factors were analyzed using the least square means comparisons. A multivariable survey regression model was used to identify associations with the HEI-2015 total score after adjustment for potential confounders. The 13 component scores were also compared by participant characteristics to identify target food groups for subgroup-specific nutrition intervention.

Results: The average HEI-2015 total score was 55.6 (95% confidence interval = 54.8-56.4). Factors associated with the HEI-2015 total score included age, race/ethnicity, education, smoking status, body mass index, and oral health status. Overall, poor adherence to the 2015-2020 Dietary Guidelines for Americans was found for most HEI-2015 components, with Whole Grains, Greens and Beans, Sodium, and Fatty Acids components having less than 50% of the maximum possible scores.

Conclusions: Results indicate poor diet quality among American adult cancer survivors, with significant disparities observed across sociodemographic and lifestyle factors, particularly education levels, body mass index, and smoking status. Nutrition interventions for cancer survivors should consider focusing on improving diet quality by increasing intakes of whole grains and greens and beans, lowering sodium consumption, and achieving a healthy balance of fatty acids (ie, a favorable ratio of unsaturated fats to saturated fats).
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http://dx.doi.org/10.1016/j.jand.2020.08.086DOI Listing
February 2021

Implementation of a school-based Fitbit program for youth with Autism Spectrum Disorder: A feasibility study.

Disabil Health J 2021 Apr 11;14(2):100990. Epub 2020 Sep 11.

School of Social Work, College of Community Innovation, and Education, University of Central Florida, Orlando, FL, 32816, USA.

Background: School settings may be optimal for physical activity interventions for youth with Autism Spectrum Disorder (ASD). Additionally, consumer-based fitness trackers may encourage youth with ASD to increase their physical activity levels, however, no studies have examined whether a fitness tracker program would be feasible in youth with ASD.

Objective: To examine the feasibility of a 12-week school-based Fitbit© program for youth with ASD.

Methods: Six classroom teachers and their students (n = 45) were provided with Fitbit fitness trackers to wear over 12-weeks. Classroom teachers monitored student tracker use and completed open-ended surveys to describe both their experience and their students' experience with the fitness trackers.

Results: Out of the 45 eligible students, 42 (94%) opted to participate in the study. All six teachers and 32 (76%) of the 42 students wore the fitness tracker daily over 12 weeks. Teachers reported that students were most interested in tracking their daily steps, and the short batter life, and account set-up were the biggest challenges to students. All six teachers felt that this program could have long-term sustainability, especially if tracker use could be incorporated into school curriculum and classroom activities.

Conclusions: A school-based Fitbit program appears to be both feasible, and well-accepted by students with ASD. Future work should evaluate the preliminary efficacy of this type of program.
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http://dx.doi.org/10.1016/j.dhjo.2020.100990DOI Listing
April 2021

Health Factors, Sociability, and Academic Outcomes of Typically Developing Youth and Youth with Autism Spectrum Disorder: A Latent Class Analysis Approach.

J Autism Dev Disord 2021 Apr;51(4):1346-1352

College of Community Innovation and Education, University of Central Florida, Orlando, FL, USA.

To identify profiles of both typically developing (TD) children and children with autism spectrum disorder (ASD) based on health indicators, and academic/social engagement. Latent class analysis was conducted to identify profiles of children from the 2016 National Survey of Children's Health, based on physical activity, screen time, sleep, and academic/social engagement. A three-profile solution was the best fitting model, with children in profile 3 characterized as having excellent health, and academic/social outcomes, compared to profiles 1 and 2. Compared to TD youth, a greater percentage of youth with ASD fit into the poorer health profiles. Studies should examine whether health interventions for youth with ASD can improve factors, such as academic engagement and social interaction.
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http://dx.doi.org/10.1007/s10803-020-04572-7DOI Listing
April 2021

Brief Report: Obesogenic Behaviors of Children with Developmental Disabilities During Summer.

J Autism Dev Disord 2021 Feb;51(2):734-740

Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA.

The 'Structured Days Hypothesis' suggests that children's obesogenic behaviors (e.g., activity, diet, sleep, and screen time) are less favorable during times when there is less-structure to a child's day (e.g., summer). To compare obesogenic behaviors of children with developmental disabilities (DD) during summer on days with differing amounts of 'structure'. Seventeen children with DD (mean age 9.8 years) attending a day camp wore a Fitbit activity monitor on the non-dominant wrist during summer, and parents completed a survey packet, to capture obesogenic behaviors. Participants displayed improved physical activity levels, diets, and sleep timing on camp days versus other days. Providing children with DD 'structure' over summer is a potential intervention approach requiring further investigation.
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http://dx.doi.org/10.1007/s10803-020-04566-5DOI Listing
February 2021

Effects of an 8-Week Judo Program on Behaviors in Children with Autism Spectrum Disorder: A Mixed-Methods Approach.

Child Psychiatry Hum Dev 2020 10;51(5):734-741

Department of Health Sciences, University of Central Florida, Orlando, FL, 32816, USA.

Prior studies suggest that a combination of physical activity and mind-body exercises, often seen in martial arts, may attenuate negative behaviors in youth with Autism Spectrum Disorder (ASD). Therefore, the aim of this study was to examine the effects of an 8-week judo program on behavioral factors in children with ASD, using a mixed-methods approach. A total of 25 children (ages 8-17), diagnosed with ASD, participated in an 8-week judo program (1 × week). Parents of participants were given the Aberrant Behavior Checklist (ABC) to compare the severity of ASD-related behavior at baseline and at the end of the program. A subset of parents (n = 9) participated in semi-structured interviews that focused on their child's behaviors during the judo program. Non-parametric paired t-tests were conducted to compare differences in the ABC scores from at baseline and at the end of the program. Interviews were coded independently by two trained researchers and categorized into behavioral themes. Participants attended an average of 7.04 ± 1.06 classes (out of 8 sessions). There were no significant changes in ABC scores, however, parent interviews revealed that 78% of parents observed improvements in both social skills and self-esteem as a result of the judo program. Despite no significant differences in ABC scores pre and post-judo, data from parent interviews indicate improvements in self-esteem and social skills. Future studies should further examine the effects of judo in a larger sample of youth with ASD, and include control conditions (e.g. no-exercise group) for comparison purposes.
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http://dx.doi.org/10.1007/s10578-020-00994-7DOI Listing
October 2020

Declines in skeletal muscle quality vs. size following two weeks of knee joint immobilization.

PeerJ 2020 13;8:e8224. Epub 2020 Jan 13.

School of Kinesiology and Physical Therapy, University of Central Florida, Orlando, FL, United States of America.

Background: Disuse of a muscle group, which occurs during bedrest, spaceflight, and limb immobilization, results in atrophy. It is unclear, however, if the magnitude of decline in skeletal muscle quality is similar to that for muscle size. The purpose of this study was to examine the effects of two weeks of knee joint immobilization on vastus lateralis and rectus femoris echo intensity and cross-sectional area.

Methods: Thirteen females (mean ± SD age = 21 ± 2 years) underwent two weeks of left knee joint immobilization via ambulating on crutches and use of a brace. B-mode ultrasonography was utilized to obtain transverse plane images of the immobilized and control vastus lateralis and rectus femoris at pretest and following immobilization. Effect size statistics and two-way repeated measures analyses of variance were used to interpret the data.

Results: No meaningful changes were demonstrated for the control limb and the rectus femoris of the immobilized limb. Analyses showed a large increase in vastus lateralis echo intensity (i.e., decreased muscle quality) for the immobilized limb ( = .006, Cohen's  = .918). For vastus lateralis cross-sectional area, no time × limb interaction was observed ( = .103), but the effect size was moderate ( = .570). There was a significant association between the increase in vastus lateralis echo intensity and the decrease in cross-sectional area ( =  - .649,  = .016).

Conclusion: In female participants, two weeks of knee joint immobilization resulted in greater deterioration of muscle quality than muscle size. Echo intensity appears to be an attractive clinical tool for monitoring muscle quality during disuse.
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http://dx.doi.org/10.7717/peerj.8224DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6964688PMC
January 2020

The association among demographic factors, health behaviors and sleep quality in youth with Autism Spectrum Disorder.

Disabil Health J 2020 07 20;13(3):100885. Epub 2019 Dec 20.

Department of Nursing and Health Sciences, Florida Southern College, Lakeland, FL, 33801, USA.

Background: A majority of youth with Autism Spectrum Disorder (ASD) have disrupted sleep patterns, but there has been limited research examining factors associated with sleep in this population.

Objective: The objective of this study was to compare demographic and lifestyle behaviors with sleep quality in youth with ASD.

Methods: A total of 49 children (12.44 years; 78% male) with ASD wore the Actigraph GT9X accelerometer over seven days and nights to assess moderate to vigorous physical activity (MVPA), sedentary behavior (SB), total sleep duration, and sleep efficiency. Parents reported their child's weekly amount of screen time and demographic information. Participants were classified according to whether they met sleep criteria for duration and efficiency (8-9 h of sleep duration and ≥85% sleep efficiency). T-tests and ANOVA were used to compare demographic and lifestyle factors between the groups.

Results: Participants who meet both sleep duration and efficiency criteria had greater minutes of MVPA per day (113.65 min/day) than participants who only met sleep efficiency criteria (40.27 min/day) and participants who did not meet either sleep criteria (67.5 min/day; p < 0.0001). Additionally, participants who met both sleep criteria had fewer minutes of SB compared to those who only met sleep efficiency criteria (384.79 vs 526.05 min/day; p = 0.02).

Conclusions: Youth who had indicators of good sleep quality had greater amounts of MVPA and lower amounts of SB. Studies should further examine the relationship between sleep and health behaviors in youth with ASD to determine causal mechanisms, leading to more effective sleep interventions.
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http://dx.doi.org/10.1016/j.dhjo.2019.100885DOI Listing
July 2020

Brief Report: Preliminary Efficacy of a Judo Program to Promote Participation in Physical Activity in Youth with Autism Spectrum Disorder.

J Autism Dev Disord 2020 Apr;50(4):1418-1424

School of Kinesiology and Physical Therapy, College of Health Professions and Sciences, University of Central Florida, Orlando, FL, 32827, USA.

To examine the preliminary efficacy of an 8-week judo program to promote moderate-to-vigorous physical activity (MVPA) and reduce sedentary behavior (SB) in youth with Autism Spectrum Disorder (ASD). Fourteen children diagnosed with ASD participated in a weekly judo program over a period of 8 weeks. Participants wore an Actigraph accelerometer to measure activity levels at baseline and post-judo. All 14 children attended at least 75% of the 8 judo classes. Percentage of time spent in daily MVPA (8% vs 4%, p = .05) increased following the intervention. A high rate of participation and an increase in time spent in MVPA was observed following the 8-week program. Further research to examine causal mechanisms is warranted.
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http://dx.doi.org/10.1007/s10803-019-04338-wDOI Listing
April 2020

Breaking tradition: Increasing physical activity and reducing sedentary time of children with developmental disabilities.

Disabil Health J 2020 04 20;13(2):100869. Epub 2019 Nov 20.

Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA.

Background: Children with developmental disabilities (DD) are less active and more sedentary than their typically developing peers. There is a lack of research exploring strategies to increase physical activity and reduce sedentary time in children with DD.

Objective/hypothesis: The purpose of this quasi-experimental study was to compare moderate-to-vigorous physical activity (MVPA) and sedentary time of children with DD attending a summer day camp in modified versus traditional physical activity sessions. It was hypothesized that youth with DD would spend a greater amount of time in MVPA and less time sedentary during modified compared to traditional activity sessions.

Methods: Fifty-two children (mean age 11.5 years, 84% male, 81% non-Hispanic white, 90% DD diagnosis) attending a specialized summer day camp participated in counterbalanced physical activity sessions for 8 weeks receiving either games/activities in their 'traditional' manner versus a modified approach. The modified approach incorporated a physical activity promotion strategy with a social narrative. Repeated measures mixed-effects regression models were used to estimate accelerometer-derived MVPA and sedentary time.

Results: Children increased the percent of time spent in MVPA and reduced sedentary time in 3 out of the 4 modified physical activities compared to traditional activity physical sessions across (p < 0.05). Modified soccer and kickball presented the highest increase in MVPA (5.9, 95%CI: 2.9, 8.8%) and reduction in sedentary time (-8.9, 95%CI: -13.9, -4.0%), respectively.

Conclusion: Modifying existing physical activities by combining a physical activity-promoting strategy with a social narrative is a promising approach to increase MVPA and reduce sedentary time in children with DD.
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http://dx.doi.org/10.1016/j.dhjo.2019.100869DOI Listing
April 2020

Types of Sedentary Behavior and Risk of Cardiovascular Events and Mortality in Blacks: The Jackson Heart Study.

J Am Heart Assoc 2019 07 26;8(13):e010406. Epub 2019 Jun 26.

2 Center for Behavioral Cardiovascular Health Columbia University Medical Center New York NY.

Background Previous cross-sectional studies have shown conflicting results regarding the effects of television viewing and occupational sitting on cardiovascular disease ( CVD ) risk factors. The purpose of this study was to compare the association of both television viewing and occupational sitting with CVD events and all-cause mortality in blacks. Methods and Results Participants included 3592 individuals enrolled in the Jackson Heart Study, a community-based study of blacks residing in Jackson, Mississippi. Television viewing (<2, 2-4, and >4 h/day) and occupational sitting (never/seldom, sometimes, often/always) were self-reported. Over a median follow-up of 8.4 years, there were 129 CVD events and 205 deaths. The highest category of television viewing (>4 h/day) was associated with a greater risk for a composite CVD events/all-cause mortality end point compared with the lowest category (<2 h/day; hazard ratio, 1.49; 95% CI , 1.13-1.97). In contrast, the highest category of occupational sitting (often/always) was not associated with risk for a composite CVD events/all-cause mortality end point compared with the lowest category (never/seldom; hazard ratio, 0.90; 95% CI , 0.69-1.18). Moderate-to-vigorous physical activity moderated the association of television viewing with CVD events/all-cause mortality such that television viewing was not associated with greater risk among those with high moderate-to-vigorous physical activity levels. Conclusions Television viewing was associated with greater risk of CVD events and all-cause mortality, while occupational sitting had no association with these outcomes. These findings suggest that minimizing television viewing may be more effective for reducing CVD and mortality risk in blacks compared with reducing occupational sedentary behavior.
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http://dx.doi.org/10.1161/JAHA.118.010406DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6662345PMC
July 2019

The association between neighborhood factors and physical activity and screen-time among youth with visual impairments.

Disabil Health J 2019 07 21;12(3):509-513. Epub 2019 Feb 21.

Behavioral Health and Nutrition, University of Delaware, Newark, DE, 19711, USA. Electronic address:

Background: Youth with visual impairments tend to be at an elevated risk for developing health-related conditions. A thorough understanding of factors associated with health-related behaviors is crucial for the development of effective interventions. Little research has examined the importance of neighborhood factors for physical activity and screen-time behaviors of individuals with visual impairments.

Objective: The purpose of this study was to examine the associations between neighborhood factors and physical activity and screen-time among youth with and without visual impairments.

Methods: Cross-sectional data from the 2011-2012 National Survey of Children's Health (NSCH), which is composed of a cross-sectional probability sample of noninstitutionalized youth aged 0-17 years in the United States, were utilized for this study. This study included 1536 youth aged 6-17 with visual impairments. Behavioral variables and environmental factors were recorded via parent report. Descriptive statistics, one-way ANOVAs and multiple regression models were computed to examine the research questions.

Results: Youth with severe visual impairments had lower levels of physical activity compared to youth with without visual impairments, as well as those with mild or moderate visual impairments. Among youth with mild visual impairments and those without visual impairments, perceiving the neighborhood to be safe was associated with greater amounts of physical activity. For youth with moderate visual impairments, perceiving the neighborhood to be less safe was associated with increased screen-time. No environmental factors were associated with physical activity or screen time for youth with severe visual impairments.

Conclusions: Neighborhood safety appeared to be an important factor associated with health behaviors among youth without visual impairments, as well as those with mild or moderate visual impairments. Interestingly, no relationship existed between environmental factors and youth with severe visual impairment, suggesting that further research is needed to identify factors that influence physical activity and screen-time among youth with more severe visual impairments.
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http://dx.doi.org/10.1016/j.dhjo.2019.02.004DOI Listing
July 2019

Adolescent Weight and Health Behaviors and Their Associations With Individual, Social, and Parental Factors.

J Phys Act Health 2018 Nov 19:1-6. Epub 2018 Nov 19.

Background: To examine the associations and differences between gender and weight classification for physical activity (PA) and individual, social, and parental factors.

Methods: Data from wave 2 of the "Growing up in Ireland" national study were used, resulting in a sample of 7525 13-year-old adolescents. Information on factors affecting adolescents' social, emotional, cognitive, and physical development was collected.

Results: Overweight (OW) adolescents were more likely to exercise and restrict food for weight loss and less likely to perform moderate to vigorous PA than normal weight adolescents. Parent body mass index was associated with adolescent body mass index for OW and normal weight adolescents, with the strongest association seen with OW females. Parents of OW adolescents considered themselves to be more OW and less physically active than parents of normal weight adolescents. Furthermore, for all groups, a greater amount of moderate to vigorous PA was associated with less television viewing, greater PA of parents, and a greater number of friends.

Conclusion: Parental health behaviors play a significant role in adolescents' bodyweight, representing the necessity for more constructive health behaviors and PA among parents. Future interventions may be strengthened by focusing specifically on gender and body mass index, while taking into consideration the importance of parental behaviors on adolescents.
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http://dx.doi.org/10.1123/jpah.2017-0279DOI Listing
November 2018

Environmental Factors Associated with Physical Activity and Screen Time Among Children With and Without Autism Spectrum Disorder.

J Autism Dev Disord 2020 May;50(5):1572-1579

Department of Human Movement Sciences, Old Dominion University, Norfolk, VA, USA.

This study aimed to examine how environmental factors are associated with physical activity (PA) and screen-time (ST) among children with and without ASD (n = 1380 and 1411, respectively). For TD children, the absence of a bedroom television and neighborhood support were associated with PA. For children with ASD, no environmental factors were associated with PA. Regarding ST, the presence of a bedroom television, absence of limits on ST, lack of neighborhood amenities and support, and adverse neighborhood factors were all associated with ST among TD children. For children with ASD, the presence of a bedroom television and the absence of limits on ST were associated with ST. Potential explanations for this dichotomy and suggestions for future research are discussed.
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http://dx.doi.org/10.1007/s10803-018-3818-0DOI Listing
May 2020

The Influence of Friends and Psychosocial Factors on Physical Activity and Screen Time in Normal and Overweight Adolescents: A Mixed-Methods Analysis.

Am J Health Promot 2019 01 16;33(1):97-106. Epub 2018 May 16.

5 Department of Kinesiology, University of Virginia, Charlottesville, VA, USA.

Background: Understanding factors that influence physical activity (PA) and sedentary behavior is crucial to develop interventions to improve adolescents' health-related behaviors.

Purpose: To compare the influence of friends and psychosocial factors on moderate-to-vigorous physical activity (MVPA) and screen time (ST) between normal weight (NW) and overweight (OW) adolescents.

Methods: In all, 21 OW and 21 NW adolescents wore accelerometers and completed questionnaires assessing MVPA, ST, and psychosocial variables. The MVPA and ST were assessed in nominated friends. Adolescents participated in focus groups assessing influence on activity behaviors.

Results: There were no differences in MVPA; however, NW adolescents reported less ST than OW adolescents (8.9 vs 13.1 h/wk, P = .04). For OW adolescents, friends' ST ( P = .002) and psychosocial factors ( P = .05) were associated with ST, while only PA self-efficacy was associated with MVPA. For NW adolescents, only friends' MVPA ( P = .04) was associated with self-reported PA. Exploratory analyses revealed differences among weight status and gender. Focus group discussions revealed that friends influenced both OW and NW adolescents' MVPA; however, this appeared to be more apparent for NW males, while psychosocial factors played a role in both OW and NW females. The OW adolescents reported that friends were more of an influence on their ST levels, while NW adolescents indicated that their ST was not affected by their friends' behaviors.

Conclusions: Interventions to increase MVPA and/or decrease ST may need to be tailored for NW and OW adolescents.
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http://dx.doi.org/10.1177/0890117118771313DOI Listing
January 2019

Impacts of active school design on school-time sedentary behavior and physical activity: A pilot natural experiment.

PLoS One 2017 7;12(12):e0189236. Epub 2017 Dec 7.

City University of New York, School of Public Health, Graduate Center, New York, NY, United States of America.

Background: Children spend a significant portion of their days in sedentary behavior (SB) and on average fail to engage in adequate physical activity (PA). The school built environment may influence SB and PA, but research is limited. This natural experiment evaluated whether an elementary school designed to promote movement impacted students' school-time SB and PA.

Methods: Accelerometers measured SB and PA at pre and post time-points in an intervention group who moved to the new school (n = 21) and in a comparison group experiencing no school environmental change (n = 20). Difference-in-difference (DD) analysis examined SB and PA outcomes in these groups. Measures were also collected post-intervention from an independent, grade-matched group of students in the new school (n = 21).

Results: As expected, maturational increases in SB were observed. However, DD analysis estimated that the intervention attenuated increase in SB by 81.2 ± 11.4 minutes/day (p<0.001), controlling for time in moderate to vigorous physical activity (MVPA). The intervention was also estimated to increase daily number of breaks from SB by 23.4 ± 2.6 (p < .001) and to increase light physical activity (LPA) by 67.7 ± 10.7 minutes/day (p<0.001). However, the intervention decreased MVPA by 10.3 ± 2.3 minutes/day (p<0.001). Results of grade-matched independent samples analysis were similar, with students in the new vs. old school spending 90.5 ± 16.1 fewer minutes/day in SB, taking 21.1 ± 2.7 more breaks from SB (p<0.001), and spending 64.5 ± 14.8 more minutes in LPA (p<0.001), controlling for time in MVPA. Students in the new school spent 13.1 ± 2.7 fewer minutes in MVPA (p<0.001) than their counterparts in the old school.

Conclusions: This pilot study found that active school design had beneficial effects on SB and LPA, but not on MVPA. Mixed results point to a need for active classroom design strategies to mitigate SB, and quick access from classrooms to areas permissive of high-intensity activities to promote MVPA. Integrating active design with programs/policies to promote PA may yield greatest impact on PA of all intensities.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0189236PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5720751PMC
January 2018

3D Bioprinting: New Directions in Articular Cartilage Tissue Engineering.

ACS Biomater Sci Eng 2017 Nov 8;3(11):2657-2668. Epub 2017 Feb 8.

Joint Preservation Institute, 2825 J Street #440, Sacramento, California 95816, United States.

Bioprinting is a growing field with significant potential for developing engineered tissues with compositional and mechanical properties that recapitulate healthy native tissue. Much of the current research in tissue and organ bioprinting has focused on complex tissues that require vascularization. Cartilage tissue engineering has been successful in developing tissues using homogeneous scaffolds. However, as research moves toward clinical application, engineered cartilage will need to maintain homogeneous nutrient diffusion in larger scaffolds and integrate with surrounding tissues. Bioprinting techniques have provided promising results to address these challenges in cartilage tissue engineering. The purpose of this review was to evaluate 3D extrusion-based bioprinting research for developing engineered cartilage. Specifically, we reviewed the potential impact of 3D bioprinting on nutrient diffusion in larger scaffolds, development of scaffolds with spatial variation in cell distribution or mechanical properties, and cultivation of more complex tissues using multiple materials. Finally, we discuss current limitations and challenges in using 3D bioprinting for cartilage tissue engineering and regeneration.
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http://dx.doi.org/10.1021/acsbiomaterials.6b00587DOI Listing
November 2017

Physical Activity Interventions for Children with Social, Emotional, and Behavioral Disabilities-A Systematic Review.

J Dev Behav Pediatr 2017 Jul/Aug;38(6):431-445

*Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA; †Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA; ‡Department of Health Sciences, Merrimack College, North Andover, MA; §Department of Educational and Human Sciences, University of Central Florida, Orlando, FL.

Objective: Perform a systematic review of the available literature regarding the effectiveness of exercise interventions on children with any type of social, emotional, or behavioral disability (SEBD), with attention to a range of physiological, behavioral, and mood outcomes.

Methods: Six databases were searched using a systematic methodology. References of included studies, as well as relevant reviews, were also examined. The review was limited to studies published since 2000 reporting a quantitative analysis of the effects of a physical activity (PA) intervention on at least 1 behavioral, psychological, or cognitive outcome in children aged 21 and under, diagnosed with a SEBD. Only studies with a control group were included.

Results: We identified 24 eligible studies. Studies varied in design, participant characteristics, and intervention characteristics (single-bout vs repeated exposure, duration, intensity level, mode of exercise). Of the 20 behavioral outcome assessments, there was 1 negative finding, 12 null findings, 5 positive findings, and 2 mixed findings. For the 25 executive functioning outcome assessments, there were 5 null findings, 18 positive findings, and 2 mixed findings. For the remaining outcome domains, 1 of 2 studies looking at academic performance, 3 of 6 studies looking at objective neurological measures, and 1 of 3 studies looking at affect outcomes found positive results. All other results were null or mixed.

Conclusion: Although additional research is warranted to further understand the mechanisms by which PA affects behavioral and cognitive outcome measures in children with SEBDs, PA offers a safe and alternative form of treatment for this population.
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http://dx.doi.org/10.1097/DBP.0000000000000452DOI Listing
April 2018

Association of physiological and psychological health outcomes with physical activity and sedentary behavior in adults with type 2 diabetes.

BMJ Open Diabetes Res Care 2017 29;5(1):e000306. Epub 2017 Mar 29.

School of Nursing and Health Sciences, Florida Southern College , Lakeland, Florida , USA.

Purpose: To examine the association between change in moderate-to-vigorous physical activity (MVPA) and sedentary behavior (SB) over a 6-month period with physiological and psychological factors in adults with type 2 diabetes (T2D).

Methods: Participants included 26 middle-aged (mean age=56.1±10.8 years; 42% women), overweight/obese (mean body mass index (BMI) =37.22±8.78 kg/m) adults who had been diagnosed with T2D within the past 5 years (mean HbA1c=7.81%). Participants underwent a physical examination, blood tests, and psychological questionnaires, including a self-report questionnaire that assessed the consumption of high glycemic and low glycemic load foods. Participants wore an Actigraph accelerometer for 7 days to assess MVPA and SB. All measures were collected at baseline and at the 6-month follow-up. Spearman rank correlations and regression models were conducted to examine the relationship between activity variables, and the association of activity measures with health outcomes at the 6-month follow-up.

Results: Decreases in duration of SB bouts and increases in MVPA were associated with decreased levels of HbA1c (p<0.05). Over 50% of the variance in HbA1c levels could be attributed to changes in MVPA and SB.

Conclusions: MVPA and SB were independently associated with diabetes-related health outcomes. Results suggest that emphasis should be placed on increasing MVPA while decreasing SB, particularly duration of SB bouts. This suggests that even small changes in daily behavior may contribute to improvement in diabetes-related health outcomes.
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http://dx.doi.org/10.1136/bmjdrc-2016-000306DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5372078PMC
March 2017

Psychosocial and Friend Influences on Objective Sedentary Behavior and Screen Time: A Mixed Methods Analysis.

J Phys Act Health 2017 03 5;14(3):213-221. Epub 2016 Dec 5.

Background: Sedentary behavior (SB) increases throughout adolescence, and is associated with adverse health outcomes.

Purpose: Examine psychosocial and friend influences on SB and screen time in adolescents using a mixed-methods design.

Methods: 108 middle and high school students wore accelerometers to measure objective SB, completed screen time and psychosocial questionnaires, and nominated friends to complete activity questionnaires. Focus groups centered around influences on SB behavior. Regression analyses and NVivo software analyzed quantitative and qualitative data.

Results: Screen time was associated with greater screen time enjoyment, lower self-efficacy, and friends' screen time (r = .21, P < .0001). Friends influenced whether adolescents engaged in screen time behaviors, with active friends encouraging less screen time.

Conclusion: Active friends influenced adolescents to engage in less SB. Interventions should place an emphasis on encouraging less screen time, and providing opportunities for adolescents and their friends to engage in activities that promote physical activity rather than SB.
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http://dx.doi.org/10.1123/jpah.2016-0035DOI Listing
March 2017

Comparison of the Effects of Stable and Dynamic Furniture on Physical Activity and Learning in Children.

J Prim Prev 2016 Dec;37(6):555-560

Kinesiology Department, University of Massachusetts at Amherst, Amherst, MA, 01003, USA.

We compared the effects of traditional (stable) and non-traditional (dynamic) school furniture on children's physical activity (PA), energy expenditure (EE), information retention, and math skills. Participants were 12 students (8.3 years, 58 % boys) in grades 1-5. Participants wore an Actigraph GT3X+ accelerometer (to assess PA), and an Oxycon Mobile indirect calorimetry device (to assess EE) for 40 min (20 min for each session). Each session consisted of a nutrition lecture, multiple choice questions related to the lecture, and grade-appropriate math problems. We used paired t tests to examine differences between the stable and dynamic furniture conditions. Average activity counts were significantly greater in the dynamic than the stable furniture condition (40.82 vs. 9.81, p < 0.05). We found no significant differences between conditions for average oxygen uptake (p = 0.34), percentage of nutrition questions (p = 0.5), or math problems (p = 0.93) answered correctly. Movement was significantly greater in the dynamic than the stable furniture condition, and did not impede information acquisition or concentration. Future studies should compare the long-term effects of traditional and dynamic furniture on health and academic outcomes in schools and other settings.
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http://dx.doi.org/10.1007/s10935-016-0451-6DOI Listing
December 2016

The Individual, Social, and Environmental Correlates of Physical Activity and Screen Time in Irish Children: Growing Up in Ireland Study.

J Phys Act Health 2016 12 24;13(12):1285-1293. Epub 2016 Aug 24.

Background: The aim of this study was to use a social-ecological approach to examine the influence of individual, social, and environmental factors on moderate-to-vigorous physical activity (MVPA) and screen-time in a sample of 9-year-old children in Ireland.

Methods: The sample was 1509 boys and girls from the Growing Up in Ireland (GUI) national study. MVPA, screen time, and individual, social, and environmental variables were assessed via questionnaires completed by children, their parents, and their teachers. Multiple regression was used to identify factors that correlated with children's MVPA and screen-time levels.

Results: For boys, factors such as activity with friends (P < .0001) and popularity (P < .01) were associated with MVPA, while factors such as BMI (P < .01) and MVPA (P < .01) were associated with screen time. Similarly for girls, factors such as activity with friends (P < .0001) and sociability were associated with MVPA, however factors such as BMI (P < .05), and access to play space (P < .05) were more closely associated with screen time.

Conclusion: Social factors were more closely associated with MVPA, while individual factors were significantly correlated with screen time for both boys and girls. Correlates differed for boys and girls, suggesting that interventions should consider both the target population as well as the activity behavior.
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http://dx.doi.org/10.1123/jpah.2015-0659DOI Listing
December 2016

Feasibility and Reliability of the System for Observing Play and Leisure Activity in Youth (SOPLAY) for Measuring Moderate to Vigorous Physical Activity in Children Visiting an Interactive Children's Museum Exhibition.

Am J Health Promot 2018 01 5;32(1):210-214. Epub 2016 Oct 5.

2 Nutrition Program, Hunter College School of Urban Public Health, City University of New York, New York, NY, USA.

Purpose: To test the feasibility and reliability of a direct observation method for measuring moderate to vigorous physical activity (MVPA) in children visiting an interactive children's museum exhibition.

Design: Direct observation was used to assess MVPA in children visiting an interactive children's museum exhibition on 2 weekend days in winter 2013.

Setting: The Children's Museum of Manhattan's EatSleepPlay™: Building Health Every Day exhibition.

Participants: Children (group level) visiting the museum exhibition.

Measures: System for Observing Play and Leisure Activity in Youth (SOPLAY).

Analyses: Interobserver reliability was analyzed for MVPA and activity type. Two-group analyses were conducted using a series of Wilcoxon rank sum tests.

Results: A total of 545 children were observed over 288 observations. No significant differences were found between observers for MVPA ( r = .91, P = .6804) or activity type (κ = .90, P = .6334). Children participated in MVPA during 35.2% of all observations. No significant differences were found for participation in MVPA between boys (37.6%) and girls (32.8%, P = .1589).

Conclusion: The SOPLAY may be a useful tool for measuring MVPA in interactive children's museum exhibitions. Research with multiple museum settings and diverse groups of children over longer periods of time is warranted to further establish the feasibility and reliability of the SOPLAY for measuring MVPA in this novel setting.
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http://dx.doi.org/10.1177/0890117116671074DOI Listing
January 2018

Physical Activity, Screen-Time Behavior, and Obesity Among 13-Year Olds in Ireland with and without Autism Spectrum Disorder.

J Autism Dev Disord 2017 Jan;47(1):49-57

Department of Educational and Human Services, University of Central Florida, Florida, USA.

The primary purposes of this study were to compare (a) physical activity participation, screen-time habits, obesity, and (b) reported reasons for lack of participation in sport, between a nationally representative sample of Irish children with and without autism spectrum disorder (ASD). Participation in moderate to vigorous activity, light activity, and sports was significantly lower among the group with ASD. On examination of screen time variables, no significant differences were seen between groups. However, time spent watching TV was higher among children with ASD. Overweight or obese status was more prevalent among the group with ASD (34.4 vs. 24.7 %). The findings are discussed in relation to international statistics on youth physical activity, screen-time, and weight status, and recommendations are provided for future research.
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http://dx.doi.org/10.1007/s10803-016-2920-4DOI Listing
January 2017

A cybercycling intervention to improve behavioral regulation and classroom functioning among children with behavioral health disorders: Pragmatic randomized trial design for Manville Moves.

Contemp Clin Trials 2016 07 31;49:40-6. Epub 2016 May 31.

Manville School, Judge Baker Children's Center, United States.

While positive and clinically meaningful effects of exercise on cognition and behavior in children have been demonstrated in controlled experimental settings, they have rarely been translated and rigorously evaluated in real-world environments. In particular, there is a lack of research on school-based approaches to sustainable physical activity and exercise interventions targeting children with behavioral health disorders. Manville Moves is an exercise intervention designed to improve behavioral regulation and classroom functioning among children with neurodevelopmental and affective disorders within a therapeutic day-school environment. The curriculum is built around virtual-reality exergaming bicycles (cybercycles) and integrated into physical education (PE) classes. Manville Moves was developed using community based participatory research (CBPR) and implemented as a pragmatic trial. In this paper, we describe (a) the background, theoretical framework and intervention setting, (b) the Manville Moves curriculum, (c) the study design and outcome and process measures, and (d) the strategies used to support implementation compliance and intervention uptake by a population with a variety of behavioral challenges. We conclude with a detailed description of the participatory process by which the intervention was developed and integrated into school programming and a review of the program's key innovations and approaches to addressing threats to internal and external validity.
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http://dx.doi.org/10.1016/j.cct.2016.05.008DOI Listing
July 2016