Purpose: Locomotor and object control skills are essential for children to learn due to their potential impact in aiding in future health-enhancing physical activity. Evidence indicates that out-of-school time programs (OST) can provide meaningful physical activity opportunities for children. It has been found that leaders of OST programs are not equipped with the proper training to improve children’s motor skills . The purpose of this study was to gather expert consensus on the essential motor skills that should be practiced and evidence-based strategies that should be integrated during OST programming.

Methods: A three-round Delphi method was used to establish expert consensus on the essential motor skills children (5-10 years of age) should practice and evidence-based strategies that OST leaders should integrate during OST programming to enhance child motor skill development. Surveys were conducted using Qualtrics and experts were given 14 days to complete each round. Round one analysis comprised of compiling and then listing all the essential motor skills and evidence-based practices provided by each expert. Round two analysis involved compiling and analyzing the frequency of what experts listed as the five most essential motor skills and evidence-based strategies. Round three analysis was based on if >70% of experts agreed that each essential motor skill and strategy listed was considered an essential skill to practice and integrate during OST programming.

Results: Seven experts completed three rounds and consensus was established (>70% agreement). Five essential motor skills were identified: overhand throwing, kicking, catching, jumping, and striking. Six evidence-based strategies were agreed upon: team sport play, racket sports, swimming, resistance training, jogging/walking, and game-based approaches.

Conclusion: Results from this study provide specific motor skills and evidence-based strategies that OST program leaders could integrate during programming to enhance child motor skill development. These findings could help inform OST leader practices during programming that could help create a more active environment and improve children's motor skills.

Purpose: Food insecurity is a well-known risk factor for delayed child development. Still, the contribution of other factors, such as income, home learning environment (HLE), and family socio-demographic factors, remains to be determined. Therefore, the study aimed to determine the association between food insecurity and child development and assess the role of income, HLE, and family socio-demographic factors in that association.

Methods: We used secondary data from the Nebraska Early Childhood Study, a cross-sectional study of caregivers of children under five years old in Omaha and Lincoln. Child development, food insecurity, and HLE were measured using a caregiver report of child development. We used multiple regression to analyze the data.

Results: The results showed that food insecurity was negatively related to developmental outcomes (Est = -0.217, SE = 0.091, ES = -0.109, p =.018) even after adjusting for Income (Est = -0.222, SE = 0.092, ES =-0.112, p =.048). HLE was positively associated with children’s developmental outcomes after controlling for income, child’s age, sex, race, and ethnicity (Est = 0.376, SE = 0.092, ES = 0.198, p < .001). HLE did not moderate the association between food insecurity and children’s developmental outcomes (Est = -0.287, SE = 0.185, ES = -0.095, p = .121). These results indicate that even if a child has access to a stimulating HLE, they may still experience developmental setbacks if they do not have enough nutritious food.

Conclusions: This research reveals the impact of food insecurity on childhood development and the complex factors influencing outcomes. The study highlights needs for research on causal links and differential impacts, expanded food security policies and programs, investments in early childhood education for at-risk families, screening and referrals for food assistance, and parent coaching on stimulating home activities. Most importantly, the findings underscore the urgent need to prioritize initiatives that address basic nutrition and learning opportunities for young children in poverty. Collaborative efforts across sectors are imperative to meet the needs of vulnerable children during this critical window. Access to nutritious food and nurturing early learning environments must be priorities to promote health and development.

Purpose:

Food parenting practices (FPP) and physical activity parenting practices (PAPP) are often studied independently and lack a comprehensive exploration of fathers' profiles for promoting children’s healthy lifestyles. We aimed to: 1)-identify father’s profiles combining FPP and PAPP using Latent Profile Analysis (LPA) and 2)-examine profile differences in co-parenting and household responsibility.

Methods:

We conducted a secondary analysis of cross-sectional data. A racially and ethnically diverse sample of US fathers, who lived with their 5-11-year-old child ≥50% of the time, completed reduced versions of the FPP and PAPP item banks, along with sociodemographic, co-parenting, and household responsibility questionnaires. Using an empirically-tested factor structure, we applied Bartlett’s approach to compute FPP and PAPP factor scores. We used the scores in the LPA model, estimating parameters with the expectation-maximization algorithm. We selected the “best” model using fit indices and theoretically-based criteria. We tested differences between profiles in co-parenting and household responsibility using the Kruskal-Wallis test (α=0.05) and pairwise differences using Wilcoxon test with Bonferroni correction (α=0.005).

Results/Findings:

We analyzed data from 606 fathers (age=38±8.0; Hispanic=37.5%). Most fathers self-identified as white (57.9%) or African American/black (17.7%); were overweight (41.1%) or obese (34.8%); attended college (70%); earned >$47,000 (62.7%); worked 40hrs/week (63.4%); and were biological fathers (90.1%). Most children (boys=55.5%) were 5-8-year-old (65.2%). We identified five latent-profiles that combined FPP and PAPP: 1)-Engaged Supporter (n= 94[15.5%]): positive autonomy promotion and structure (higher in PAPP), nuanced but measured control; 2)-Leveled Father (n=160[26.4%]): balanced autonomy promotion and structure, nuanced but balanced control; 3)-Autonomy-Focused Father (n=117[19.3%]): positive autonomy promotion, low to average structure, low control; 4)-Uninvolved Father (n=113[18.6%]): low autonomy promotion, structure, and control; 5)-Control-Focused Father (n=122[20.1%]): balanced to low autonomy promotion and structure, high control (higher in PAPP). We observed significant differences between profiles in co-parenting and household responsibility (p<0.005). We found more significant pairwise differences in co-parenting (n=5) than household responsibility (n=1).

Conclusions:

Understanding the interplay of fathers’ FPP and PAPP may enhance assessments for a holistic understanding of children's health environments. Recognizing characteristics and differences between fathers’ profiles may allow tailored interventions to family dynamics and needs, potentially leading to improvements in health trajectories.

Purpose: This investigation aimed to determine how a video education series comprised of community resources (i.e., childcare providers, lactation experts) can influence a mother’s self-efficacy for continuing lactation upon returning to work.
Methods: A concurrent embedded mixed methods design was employed using surveys and interviews. Subjects were eligible to participate if they had not yet returned to work and were lactating. Participants were recruited through women’s community resources, WIC, breastfeeding support services, and Facebook mothers’ groups. The survey consisted of demographic information and a previously validated lactation self-efficacy inventory. Participants were asked to complete the survey before receiving the videos and again after. Participants were also asked to complete a telephonic interview guided by feasibility constructs of demand, reach, satisfaction, and fidelity. Survey data was analyzed for descriptive findings, and pre/post-inventory scores were compared utilizing paired t-tests. Interview data was analyzed via a deductive content analysis utilizing previously developed definitions for each feasibility construct.
Results: Seventeen individuals were given the education package and completed the pre/post-survey. Out of these seventeen, ten completed a follow-up telephonic interview. The average participant was 28.2 years old and had just had their first child. Pre/post-inventory mean score differences were insignificant (80.8±4.1 vs 80.4±6.1). Qualitative findings determined that demand for the videos was high as participants that viewed the videos identified them as beneficial and as providing new information. However, video reach was limited as many participants reported not watching all the videos due to lack of time or forgetfulness. In addition, participant satisfaction for the videos was high but participants did not report any changes related to self-efficacy.
Conclusion: While qualitative findings suggest the videos were positively perceived and allowed for the dissemination of new knowledge, the video-based approach does not appear to improve perceptions of self-efficacy for continuing lactation upon return to work. Future intervention strategies should consider additional components, such as in-person education discussions or social support opportunities, to enhance video-based learning. Identifying environments to share the videos, such as clinic waiting rooms or within childcare orientations, may help alleviate barriers related to inconsistency in video viewership.

Purpose: This pilot randomized trial tested the feasibility, acceptability, and efficacy of a remotely-delivered high intensity interval training (HIIT) program during COVID-19 to improve cardiometabolic, mental, and cognitive health indicators in underrepresented youth with overweight/obesity. Feasibility was defined by >50% of participants completing: 1) 70% of exercise min/week; 2) 70% of the exercise sessions; 3) a target heart rate (HR) for ≥85% per session. We explored the efficacy of the intervention on body composition, physical activity (PA) measures, mental health, and cognitive outcomes.
Methods: The control group completed self-directed yoga stretches. The intervention group completed 8 weeks of HIIT 3x/week on a stationary bicycle via Zoom. Each 20-minute HIIT session was comprised of seven 1-minute exercise intervals at 90% HRmax followed by a 2-minute recovery period. At post-test we collected self-reported intervention acceptability, appropriateness, and feasibility. Efficacy measures collected pre- and post-study were: % body fat, self-reported exercise score, PA self-efficacy, perceived stress, and cognitive function.
Results: Adolescents (N=6, mean(SD): age=13.5(1.5) yrs, BMIz=2.4(0.7)) were 67% male and 50% were Hispanic and 50% were Black. All intervention participants (N=3) reported that HIIT was convenient and welcomed, with 67% reporting that HIIT was appealing, likable, and a good match for their needs. Target heart rate (90%HRmax) was reached for an average of 37% of all HIIT intervals, with only 1 visit with a target HR >85% for the entire session. All intervention participants attended >70% of sessions (range: 79-92%) but none averaged >70% of weekly exercise minutes (range: 33-44%). From pre- to post-intervention: body fat decreased by 7.1(4.6)%, exercise score increased by 29(12.5), and 67% reported increases in PA self-efficacy and decreases in perceived stress. There were no changes in cognitive function.
Conclusions: This pilot study provides preliminary evidence that a remotely-delivered HIIT program is feasible and acceptable for adolescents with overweight/obesity who have limited access to exercise facilities. Utilizing a home-based virtual program may increase feasibility and longevity of exercise intervention programs. This work provides the basis for a larger and longer trial to test the efficacy of HIIT to improve cardiometabolic and mental health outcomes in underrepresented youth with obesity.

Introduction: Outdoor play spaces (OPS) offers unique opportunities for unstructured play, allowing children to freely explore, experiment, and move their bodies in different ways within a natural and unrestricted area. Outdoor play fosters the development of fundamental movement skills (FMS)—including locomotor, object control, and stability skills—that are important for overall physical development and participation in physical activity (PA). Loose parts (LP) are open-ended materials that can be moved and manipulated in various ways, enriching children’s outdoor play experiences. Integrating LP into OPS not only enhances play opportunities but increases movement possibilities. There is currently limited research looking at the role of OPS and LP within it, and their influence on children’s FMS and PA behaviours. Purpose: This study aimed to explore how OPS and LP within it, influence FMS and PA behaviours in school-aged children. Methods: This study used a multi-site, case study approach to examine the impact of an outdoor LP play intervention at two after school sites in Nova Scotia, Canada. Children’s FMS (locomotor, object control, stability) and PA behaviours (sedentary, light activity, moderate activity, high activity) were recorded through the process of behavioural mapping. Children’s FMS and PA behaviours were observed and recorded, comparing the observations pre-post the LP intervention. In total, 59 children were observed: n=43 at Site A and n=16 at Site B. A descriptive and spatial analysis will be conducted using ArcGIS, to understand the distribution of the behaviours observed and to determine how LP are used with the OPS, to support FMS and PA behaviours. The output will be an analysis of the relationship between LP and FMS and PA behaviours, illustrated via maps. Anticipated Results and Conclusion: It is anticipated that clusters of FMS and PA behaviours will be associated with specific features of the OPS. These findings will demonstrate the types of LP materials that are used in these areas to support these behaviours. The findings from this study will shed light on how LP, in tandem with OPS, can influence FMS and PA behaviours, all which are important for children's physical development and for promoting active living.

Authors: Clifton J. Holmes (corresponding and presenting author), Dong Zhang, Daphne Gaulden, Elisabet Børsheim, Aline Andres, Taren Swindle

Purpose: Sedentary behavior is a primary contributor to the rise in childhood obesity seen in the U.S. Moreover, children with a higher body mass index have demonstrated lower motor coordination and deficiencies in learning fundamental movement skills. Previous studies implementing physical-activity programs for children have suggested that incorporating family members into the programs, with parental monitoring and role modeling, may significantly influence children’s activity behavior. The purpose of this pilot study was to test a 6-week physical activity intervention to assess concepts and gross motor skills progressions in mother-child pairs.

Methods: Three mom-child pairs (limited number due to COVID-19 pandemic) participated in a 6-week physical activity intervention where participants were asked to attend two, 1-hour in-person or virtual sessions per week. Mothers with BMI ≥30 kg/m2 and their child (aged 3-5), neither having an exercise restriction, were enrolled. The Test of Gross Motor Development-2 (TGMD-2) was used to assess the children’s competence for 6 locomotor and 6 object control motor skills pre and post-intervention. The intervention included a variety of games and activities based on TGMD-2 specific gross motor skills.

Results: Of the 12 total sessions, compliance was 9.7 ± 2.5 sessions, or 80.6 ± 21.0%. Individual session compliance rates (58.3%, 83.3%, and 100.0%) were associated with TGMD-2 score changes (-9.9%, 4.5%, 6.8%, respectively), where the dyad with the lowest compliance had the lowest score, while the dyad with the highest compliance showed an increase in score. In a post-intervention maternal focus group interview, the participants stated a preference for in-person sessions and enjoyment of activities with other mother-child pairs. Participants noted this being the first opportunity to observe their child’s motor and social skills compared to other similar-aged children and viewed the intervention as an introduction to sports and extra-curricular activities without financial burden.

Conclusion: The >70% average compliance, increased mean TGMD-2 scores, positive feedback from participants, and key lessons learned from this pilot study will support the expansion to a larger, 18-week program in this population.

Purpose: The purpose of this study was to describe physical activity (PA) behaviors among children (aged 6-17) in the United States (U.S.) and explore potential differences by U.S. region (Northeast, Midwest, South, and West).

Methods: Data from the 2022 National Health Interview Survey (NHIS) was used to examine the prevalence of meeting PA recommendations (i.e., 60 minutes or more of moderate to vigorous PA every day), participating in strengthening activity (i.e., activity to strengthen or tone muscles on most days of the week), playing on a sports team (i.e., sports team or sports lessons in the last 12 months), and attending a physical education class (i.e., took a physical education or gym class in the past 12 months). Prevalence of the PA metrics was estimated overall and by geographic region; they were weighted for survey nonresponse and post-stratified to the U.S. population.

Results/Findings: The sample was comprised of 4,964 children with a mean age of 11.64, (95% CI: 11.54, 11.74). There were statistically significant differences across all regions for all variables, excluding participating in strengthening exercises. Less than one-third of the sample met PA guidelines. The lowest percentage of children meeting the PA guidelines was in the Northeast (26.28%), while the highest was in the South (33.04%). The same trend was present for strengthening activity. The region with the lowest percentage of children playing on a sports team was the South (49.06%), compared to the highest in the Midwest (63.14%).

Conclusions: In the U.S., youth PA behaviors differ significantly by region.

Purpose: Guidelines recommend intensive weight management for treatment of child obesity. Reliable, pragmatic measurement of changes in diet, physical activity (PA) and sleep resulting from program participation is difficult. We describe the use, acceptability, feasibility and cost of diet, sleep and PA measures used to evaluate an intensive weight management program for obese children in Latino immigrant families.

Methods: Data were collected via pre/post surveys and ActiGraph GT9X-BT accelerometers. We measured diet with the Texas School Physical Activity and Nutrition (SPAN) Survey, Block Kids 2-17 Screener (BLOCK) and the Home Food Inventory (HFI). We measured PA with one question and accelerometry. We measured sleep with items from the Children's Report of Sleep Patterns (CRSP) and accelerometry.

Results: 39 parent/child dyads completed the study. Survey questions were free except for the BLOCK and available in Spanish except for CRSP. We had CRSP questions professionally translated and reviewed by an expert panel. BLOCK questions cost $5.20/participant and $52.00/month for maintenance. Accelerometers cost $326 (we needed 30) plus staff time for delivery and retrieval. The BLOCK and HFI took a mean of 9 and 60 minutes, respectively, to administer. BLOCK analysis demonstrated a wide range of daily calories (336-1622); other diet components (e.g. g/fiber/day) were less variable but not meaningful to families. SPAN responses were used to create a family report to support behavior change. Families enjoyed the HFI as an opportunity to review food purchasing practices. Accelerometers were worn a mean of 84% of the time and none were lost. Measurements for sleep and activity were highly variable.

Conclusions: In this study population the SPAN was easy to use and provided actionable diet information for families. Wearing accelerometers was acceptable but data reliability and validity for sleep/activity was uncertain. Pragmatic evaluation in the future will involve use of the SPAN and HFI for diet. It remains unclear how best to measure sleep/PA particularly given the cost of accelerometry. More and better measures of diet and PA validated in Spanish for Latino immigrants from Mexico and Central America are needed given that Latino children in immigrant families experience disproportionately high rates of obesity.

Purpose: Worldwide recommendations encourage exclusive breastfeeding from birth until 6 months of age, and maintaining breastfeeding combined with complementary foods for at least the following two years. Despite the high breastfeeding initiation rate observed in Quebec (89%), the duration remains an issue, with a reported rate of approximately 50% at 6 months. Since no prior review exists on the topic, our scoping review aims to identify effective interventions to improve breastfeeding duration in primiparous women, essential for the health of future populations by: 1) assessing interventions' effectiveness during prenatal and postnatal periods separately or combined, and 2) exploring the role of sociodemographic characteristics in primiparous mothers and their families in order to guide future interventions. Methods: Grey litterature and several databases (MEDLINE, Embase, CINAHL, Cochrane, Web of Science, Cab Abstract, Sociological abstract and Social Science abstract) were used, applying a keyword search strategy. A first selection of articles is ongoing (n= 16 167, 99% of selection has been completed by 2 reviewers) by screening titles and abstracts. From the first selection, a second selection is also ongoing, established on the full-text review of articles (n=267 articles currently retained, 36% of the selection has been completed). Articles are selected by two evaluators independently, based on pre-established eligibility criteria, using Covidence software. An assessment of articles quality will then be performed using the Revised Cochrane risk of bias tool for randomized studies (RoB2). Data extraction will be conducted using Excel for subsequent analysis. Preliminary findings: Eleven articles have been retained so far, proposing interventions in the prenatal period (2 studies), postnatal period (5 studies), as well as both periods combined (4 studies). Most common approaches varied from in-person to online and involved either professionals or peer support. The observed similar demographic characteristics indicate that most mothers were in the age range of 22 to 32 years old, had the intention of breastfeeding and were married. Conclusion: By identifying the most promising or effective strategies, this study will contribute to the development of effective and accessible services to increase breastfeeding duration and to establish a robust dietary foundation for mothers and children.

Purpose: The first two years of life are fundamental in the physical and cognitive development of children. During this period, solid foods are introduced into their diet, alongside breastmilk or infant formula to meet their increasing nutritional needs. Despite the availability of educational resources, parental adherence to guidelines regarding complementary feeding (CF) remains low worldwide and very few studies have investigated factors surrounding parental decisions during this period. This qualitative study thus seeks to gain a deeper understanding of the determinants of CF practices in Quebec from the perspective of first and non-first-time parents. More specifically, we aim to describe overall timing and ordering of CF introduction, to explore individual and interpersonal factors as well as medical/public health messages as determinants of CF, and to explore the roles of each parent in the decision-making process. Methods: Twenty-four English or French speaking parent dyads of children aged 3-6 months with no significant pregnancy or birth complications were recruited during their postnatal follow-up at the Obstetrics and Gynecology Center of the Sainte-Justine Hospital or through social media. Of those, 12 dyads were first-time and 12 dyads were non-first-time parents. Socio-demographic, medical, and breastfeeding-related data were collected at inclusion. When the child was around 8 months, we collected data on breastfeeding and CF practices with a phone-questionnaire. At 9 months of age, a single interviewer conducted individual semi-structured interviews using a pre-tested questionnaire based on the Social-Ecological Model (SEM) to understand each parent’s perspective on factors influencing CF and adherence to guidelines. Interviews were recorded and transcribed. Qualitative analysis is under way (combination of inductive and deductive approaches based on the SEM) and will provide insight on parent’s experiences during CF. Preliminary findings: Of the 48 parents included, 41% were first or second-generation immigrants. CF was introduced at 5.5 months on average and only 33% of children were breastfed exclusively during 6 months (n=18). Conclusions: This project will be the first qualitative study on the determinants of CF practices in Quebec, and will inform the design of nutrition interventions that aim to support optimal growth and the development of healthy eating habits.