Abstract
Purpose:
To examine the trends in total and segmented sedentary and physical activity behaviors during a Sports, Play, and Recreation for Kids (SPARK) program in incarcerated adolescent boys.
Design:
Longitudinal trend analysis.
Setting:
Two juvenile justice facilities.
Subjects:
Eighty-six adolescent boys (mean age = 17.1 ± 1.0 years).
Intervention:
Sports, Play, and Recreation for Kids implemented over 36 weeks.
Measures:
Sedentary times and physical activity were examined at baseline and at 3 follow-up time points at 12, 24, and 36 weeks after SPARK implementation. Physical activity was assessed using the percentage of accelerometer wear time within each segment for sedentary (%SED) and moderate-to-vigorous physical activity (%MVPA).
Analysis:
Trends in %SED and %MVPA were assessed using 2 × 4 doubly multivariate analysis of variance tests.
Results:
For the total week, there was a significantly lower %SED (mean difference = −10.6%, P < .001) and significantly higher %MVPA (mean difference = +3.0%, P < .001) at the 24-week follow-up compared to baseline. There were also significantly lower %SED and higher %MVPA before school, after school, and during the weekends at 24-week follow-up compared to baseline (P < .01).
Conclusion:
There were significantly lower sedentary times and higher levels of physical activity during the middle portions of the SPARK intervention in incarcerated adolescent boys, highlighting the potential of this intervention to affect sedentary and physical activity behaviors in the population.
Purpose
A pediatric population that may benefit from increases in physical activity includes adolescents within the juvenile justice system. Juvenile justice facilities house students with criminal or rehabilitation needs and youth can be committed to any given facility for a matter of days to more than a year. 1 A recent objective study exploring physical activity of adolescents in custody suggests they are falling well short of the 60 min/d recommendation. 2 Incarcerated adolescents also tend to have significant medical and psychological problems that may be attenuated by improvements in physical activity. 3,4 The purpose of this study was to examine the trends in total and segmented sedentary and physical activity behaviors during a Sports, Play, and Recreation for Kids (SPARK) program in incarcerated adolescent boys.
Methods
Design
This study was a longitudinal trend analysis across 36 weeks with 4 observed time points: baseline, 12 weeks, 24 weeks, and 36 weeks. Project funding required all incarcerated adolescents to receive SPARK for the duration of the funding period, precluding the inclusion of a control/comparison group.
Sample
Participants included 86 male adolescents (mean age = 17.1 ± 1.0 years) incarcerated in 2 juvenile justice correctional facilities. Participant characteristics are communicated in Table 1. The sample was male due to the nature of the available incarcerated panel. Both the University Institutional Review Board and the State Health Research Board approved all procedures. Parents provided written consent and adolescents provided written assent prior to data collection.
Participant Characteristics and Ethnic/Racial Distribution.
Measures
Physical activity was monitored for 1 week at each time point using the ActiGraph (Pensacola, Florida) GT9X Link accelerometer, worn on the waist, on the right side, in line with the right kneecap. Accelerometer data were recorded in 15-second epochs at 100 Hz and processed using Evenson et al. 5 Counts per minute (CPM) cut points (sedentary = 0 to 100 CPM, moderate = 2296 to 4011 CPM, vigorous = > 4011 CPM). Inclusion criteria for analysis were at least 4 valid days of data, with at least 10 hours of wear time per day. Facility staff ensured that the accelerometers were worn for the entirety of the day. Physical activity was assessed using the percentage of wear time within each segment for sedentary (%SED) and moderate-to-vigorous physical activity (%MVPA). Segments included the total week (Monday-Sunday), weekend (Saturday and Sunday), before school and after school.
Intervention: Sports, Play and Recreation for Kids
The primary curriculum/program was the SPARK program. 6 In brief, SPARK is a physical activity program designed to increase physical activity, teach movement skills, and be enjoyable. 6 Activities in SPARK have a student-centered and health-related focus, primarily focusing on the cardiovascular system. 6 New equipment was purchased as part of the new program to correspond with the physical education, before/after school, and classroom activities that were used and implemented by facility staff. The intervention was self-managed and the research team evaluated its effectiveness. The SPARK program was implemented and overseen by facility staff and administrators. Frequency and duration of activities varied by individual unit. Each facility had a single internal team of practice that was trained by other staff trained on SPARK. Due to funding and staff availability, true control or controlled activities was not feasible.
Analysis
Trends in %SED and %MVPA were assessed using a doubly multivariate analysis of variance test. Effect sizes were determined using Cohen delta (d). 7 Alpha was P ≤ .01 to control for multiple comparisons and all analyses were conducted using STATA version 14.0 statistical software package (College Station, Texas).
Results
The multivariate model was statistically significant (Wilks’ λ = 0.16, F = 41.3, P < .001). Time main effects for %SED and %MVPA across segments are presented in Table 2. Across the total week, there was significantly lower %SED at 24 weeks compared to baseline (d = 2.1). There were also significantly lower %SED before school (d = 0.93), after school (d = 0.72), and during the weekend (d = 0.52) at 24 weeks compared to baseline. Regarding %MVPA, there was higher %MVPA across the total week (d = 1.2), before school (d = 0.75), and after school (d = 0.61) at 24 weeks compared to baseline. No significant differences compared to baseline were found at the 12-week or 36-week follow-up during any segment.
Observed Sedentary and Physical Activity Behaviors Across Time Points in Incarcerated Adolescents During SPARK (Means and Standard Deviations).a
Abbreviation: SPARK, Sports, Play, and Recreation for Kids.
a Note: %SED is percentage of wear time in sedentary; %MVPA is percentage of wear time in moderate-to-vigorous physical activity.
b Bold denotes statistical differences compared to baseline.
c P < .001.
d P = .007.
e P = .003.
f P = .009.
Discussion
Summary
Our findings suggest that increasing physical activity is possible using SPARK in juvenile justice facilities, but the lack of consistent improvement is concerning. An issue with implementation appeared to be the roles and responsibilities of facility staff. The job of these staff members is a challenge and adding another responsibility takes training and coaching. In-service training was available periodically but needs to be more regular and new job descriptions need to be established to add physical activity promotion. It may have taken time for the staff to receive and be trained on all the equipment needed for SPARK to be effective. 8 The age of the sample and the fact that the sample was entirely male may also explain the differences found in this study compared to others using SPARK. 6 Furthermore, physical activity enjoyment is an important motivational construct in school-based physical activity programming. 9 It could be that after 24 weeks, the novelty effect of the SPARK program was attenuated. This phenomenon could have also been activity-specific, as many different types of activities can be implemented using SPARK methodology with each activity affecting motivational constructs across time. Program novelty may be enhanced through the use of goal-setting and providing adolescents more choice in the mode of physical activity. 10
Limitations
The project funding did not allow for a true control or comparison group, making it difficult to attribute any changes in sedentary behavior or physical activity to the SPARK program. Also, no qualitative process information was collected, which could have helped explain some of the mixed results across the follow-up time points. Additionally, the inclusion of other objective assessments of physical activity, such as heart rate, may have provided pertinent information related to intensity. The lack of standardized staff training could have significantly affected the results. The discordance in training was partial to time constraints and other priorities of the respective facilities. Finally, there is no universal agreement to accelerometer methodology. Therefore, the results may have differed if other procedural parameters were set regarding the assessment of physical activity.
So What?
This study provides some evidence that SPARK can be effectively implemented within juvenile justice facilities. Despite the positive finding yielded at 24 weeks, more work has to be done to implement SPARK more efficiently and effectively within the juvenile justice system. The methodological issues stated previously may have impacted the inconsistent results observed in this study, but given the research design and lack of qualitative process data, links between program fidelity and observed findings is only speculative. Methodological control and ensuring program fidelity are difficult within the juvenile justice system and thus should be a priority for improvement in future interventions targeting this pediatric population.
Significance
This the first study to show the potential to decrease sedentary times and increase physical activity within the juvenile justice system using SPARK. This study suggests that student-centered physical activity interventions like SPARK can be implemented effectively in incarcerated adolescents.
Footnotes
Acknowledgments
The authors would like to thank the staff members at each facility for SPARK implantation and facilitating the data collection process.
Declaration of Conflicting Interests
The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Funding
The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This study was funded by the State of Utah.