Children with congenital heart disease (CHD) often have inactive lifestyles and motor skill deficits beginning in infancy. The least active infants continue to be the least active children at school ...age. Enhancing physical activity and motor development in infancy, at the time of CHD treatment, may prevent inactive lifestyle habits. All children being treated, through surgery or catheterization, for congenital heart disease are eligible if they are 3 to 72 months of age at enrollment. The Peabody Motor Development Scales (Version 2) and 7-day accelerometry (Actigraph GT9X Link) assess motor skills and physical activity prior to treatment and 7 weeks, 6 months and 12 months post-treatment. Participants are randomized 3:1 to intervention:control. Until 7 weeks post-treatment, intervention activities focus on regaining pre-treatment mobility and midline crossing. From 7 weeks to 6 months post-treatment, the intervention is individualized to each child's assessment results and is parent-led, delivered at home and play-based. This feasibility study will provide essential data for a randomized controlled trial to evaluate play-based, parent-delivered interventions optimized to support age-appropriate physical activity and motor skills among young children with CHD. Preliminary intervention efficacy data will inform an evidence-based sample size calculation, optimize intervention timing, and identify hypotheses on the motor skill-physical activity connection and the impact of play-based, parent-led interventions during recovery from CHD treatment. Long-term, the goal is to optimize motor skill and active lifestyles among young children with CHD, enabling their healthy growth and development and enhancing childhood quality of life.
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Physical literacy is described as the motivation, confidence, physical competence, knowledge and understanding to value and engage in a physically active lifestyle. As such, it is expected that those ...who have greater physical literacy would be more likely to obtain the health benefits offered by habitual physical activity. A theoretical model and assessment battery, the Canadian Assessment of Physical Literacy (CAPL), for the assessment of childhood physical literacy had been proposed in theory but validity data were lacking. The purpose of this study was to explore validity evidence for the CAPL among children in grades 4 to 6.
CAPL validity was evaluated through three analyses that utilized cross-sectional data obtained through local schools in Eastern Ontario, Canada. A confirmatory factor analysis compared the data to the theoretical model. Patterns of association between self-reported age and gender and the CAPL total and domain scores were examined using regression models. Teacher ratings of participants' knowledge, attitude and physical activity competence were compared to assessment results.
The CAPL was completed by 963 children (55 % female) in grades 4, 5 and 6. Children were 8 to 12 years of age (mean 10.1 years), with 85 % of children approached agreeing to participate. A confirmatory factor analysis using data from 489 children with complete raw scores supported a model with four domains: engagement in physical activity (active and sedentary), physical competence (fitness and motor skill), motivation and confidence, and knowledge and understanding. Raw domain scores followed expected patterns for age and gender, providing evidence for their validity. Interpretive categories, developed from age and gender adjusted normative data, were not associated with age indicating that the CAPL is suitable for use across this age range. Children's gender was associated with the physical competence, motivation and engagement in physical activity domain scores, indicating that further research is required regarding the gender adjustment of the raw CAPL scores. CAPL domain and total scores were statistically significantly associated with teacher ratings of the child's motivation, attitudes, fitness, skill and overall physical activity.
CAPL offers a comprehensive assessment of engagement in physical activity, physical competence, motivation and confidence, and knowledge and understanding as components of childhood (grades 4 to 6, 8 to 12 years) physical literacy. Monitoring of these measures enhances our understanding of children's physical literacy, and assists with the identification of areas where additional supports are required.
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The Canadian Assessment of Physical Literacy (CAPL) is a 25-indicator assessment tool comprising four domains of physical literacy: (1) Physical Competence, (2) Daily Behaviour, (3) Motivation and ...Confidence, and (4) Knowledge and Understanding. The purpose of this study was to re-examine the factor structure of CAPL scores and the relative weight of each domain for an overall physical literacy factor. Our goal was to maximize content representation, and reduce construct irrelevant variance and participant burden, to inform the development of CAPL-2 (a revised, shorter, and theoretically stronger version of CAPL).
Canadian children (n = 10,034; M
= 10.6, SD = 1.2; 50.1% girls) completed CAPL testing at one time point. Confirmatory factor analysis was used.
Based on weak factor loadings (λs < 0.32) and conceptual alignment, we removed body mass index, waist circumference, sit-and-reach flexibility, and grip strength as indicators of Physical Competence. Based on the factor loading (λ < 0.35) and conceptual alignment, we removed screen time as an indicator of Daily Behaviour. To reduce redundancy, we removed children's activity compared to other children as an indicator of Motivation and Confidence. Based on low factor loadings (λs < 0.35) and conceptual alignment, we removed knowledge of screen time guidelines, what it means to be healthy, how to improve fitness, activity preferences, and physical activity safety gear indicators from the Knowledge and Understanding domain. The final refined CAPL model was comprised of 14 indicators, and the four-factor correlated model fit the data well (r ranged from 0.08 to 0.76), albeit with an unexpected cross-loading from Daily Behaviour to knowledge of physical activity guidelines (mean- and variance-adjusted weighted least square WLSMV χ
= 1221.29, p < 0.001, Comparative Fit Index CFI = 0.947, root mean square error of approximation RMSEA = 0.0410.039, 0.043). Finally, our higher-order model with Physical Literacy as a factor with indicators of Physical Competence (λ = 0.68), Daily Behaviour (λ = 0.91), Motivation and Confidence (λ = 0.80), and Knowledge and Understanding (λ = 0.21) fit the data well.
The scores from the revised and much shorter 14-indicator model of CAPL can be used to assess the four correlated domains of physical literacy and/or a higher-order aggregate physical literacy factor. The results of this investigation will inform the development of CAPL-2.
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Physical literacy is defined as the motivation, confidence, physical competence, and knowledge and understanding to engage in physical activity for life. Physical literacy knowledge and understanding ...encompasses movement (how to move), performance (evaluation of movement), and health and fitness (value of exercise, need for relaxation and sleep, etc.). This paper describes the development and evaluation of a standardized assessment of physical literacy knowledge and understanding for Canadian children in grades 4, 5, and 6.
Proposed Physical Literacy Knowledge Questionnaire (PLKQ) content was identified through expert consultation and a review of provincial/territorial physical education curricula for grades 4 to 6. Open-ended questions verified language and generated response options. Feasibility was assessed via completion time and error frequency. Item validity assessed scores by age, gender, and teacher ratings of student knowledge. Test-retest reliability was assessed over short (2-day) and long (7-day) intervals.
Subsets of 678 children (54% girls, 10.1 ± 1.0 years of age) completed the feasibility and validity assessments. Response errors (missing or duplicate responses, etc.) were minimal (2% or less) except for one question (7% error) about the use of safety gear during physical activity. A Delphi process among experts in children's physical activity and fitness achieved consensus on the core content and supported an item analysis to finalize item selection. As expected, knowledge scores increased with age (partial eta
= 0.07) but were not related to gender (p = 0.63). Teacher ratings of children's knowledge of physical activity behaviour (r = 0.13, p = 0.01) and fitness (r = 0.12, p = 0.03), but not movement skill (r = 0.07, p = 0.19) were associated with PLKQ scores. Test-retest reliability for PLKQ score and individual questions was substantial to excellent for 71% of comparisons over a 2-day interval, but lower over a 7-day interval (53% substantial or excellent). Items with low reliability had high or low proportions of correct responses.
This study provides feasibility and validity evidence for the Physical Literacy Knowledge Questionnaire as an assessment of physical literacy knowledge for Canadian children in grades 4, 5, and 6. Completion rates were high and knowledge scores increased with age. Streamlining of the content in accordance with Delphi panel recommendations would further enhance feasibility, but would also focus the content on items with limited reliability. Future studies of alternative item wording and responses are recommended to enhance test-retest reliability.
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The Canadian Assessment of Physical Literacy (CAPL) assesses the capacity of children to lead a physically active lifestyle. It is comprised of a battery of standardized assessment protocols that ...reflect the Canadian consensus definition of physical literacy. The Royal Bank of Canada Learn to Play - Canadian Assessment of Physical Literacy study implemented the CAPL with 10,034 Canadian children (50.1% female), 8 to 12 years of age. Feedback during data collection, necessary changes identified by the coordinating centre, and recent data analyses suggested that a streamlined, second edition of the CAPL was required. The purpose of this paper is to describe the methods used to develop the CAPL second edition (CAPL-2).
The larger dataset created through the RBC-Learn to Play CAPL study enabled the re-examination of the CAPL model through factor analyses specific to Canadian children 8 to 12 years of age from across Canada. This comprehensive database was also used to examine the CAPL protocols for redundancy or variables that did not contribute significantly to the overall assessment. Removing redundancy had been identified as a priority in order to reduce the high examiner and participant burden. The "lessons learned" from such a large national surveillance project were reviewed for additional information regarding the changes that would be required to optimize the assessment of children's physical literacy. In addition, administrative changes, improvements, and corrections were identified as necessary to improve the quality and accuracy of the CAPL manual and training materials.
For each domain of the CAPL, recommended changes based on the factor analyses, qualitative feedback and theoretical considerations significantly reduced the number of protocols. Specific protocol combinations were then evaluated for model fit within the overarching concept of physical literacy. The CAPL-2 continues to reflect the four components of the Canadian consensus definition of physical literacy: Motivation and Confidence, Physical Competence, Knowledge and Understanding, and engagement in Physical Activity Behaviour. The CAPL-2 is comprised of three Physical Competence protocols (plank, Progressive Aerobic Cardiovascular Endurance Run PACER, Canadian Agility and Movement Skill Assessment CAMSA), two Daily Behaviour protocol (pedometer steps, self-reported physical activity), and a 22-item questionnaire assessing the physical literacy domains of Motivation and Confidence, and Knowledge and Understanding. Detailed information about the CAPL-2 is available online ( www.capl-eclp.ca ).
The CAPL-2 dramatically reduces examiner and participant burden (three Physical Competence protocols, two Daily Behaviour protocols, and a 22-response questionnaire; versus eight Physical Competence protocols, three Daily Behaviour protocols and a 72-response questionnaire for the original CAPL), while continuing to be a comprehensive assessment of all aspects of children's physical literacy using the Canadian consensus definition of this term. Like the original, the CAPL-2 continues to offer maximum flexibility to practitioners, who can choose to complete the entire CAPL-2 assessment, only one or more domains, or select individual protocols. Regardless of the assessment selected, scores are available to interpret the performance of each child relative to Canadian children of the same age and sex. All of the protocols included in the CAPL-2 have published reports of validity and reliability for this age group (8 to 12 years). The detailed manual for CAPL-2 administration, along with training materials and other resources, are available free of charge on the CAPL-2 website ( www.capl-eclp.ca ). All CAPL-2 materials and resources, including the website, are available in both English and French.
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Physical activity is essential to the long-term health of children living with cardiac disease. The simplicity and cost of pedometers make them an attractive alternative to accelerometers for ...monitoring the physical activity behaviors of these children. This study compared measures obtained from commercial-grade pedometers and accelerometers.
Pediatric cardiology outpatients (n = 41, mean age = 8.4 3.7 y, 61% female) wore a pedometer and accelerometer daily for 1 week. Step counts and minutes of moderate to vigorous physical activity were compared between devices, accounting for age group, sex, and diagnostic severity, using univariate analysis of variance.
While pedometer data were significantly correlated with accelerometers (r > .74, P < .001), measurements obtained were significantly different between devices. Overall, pedometers overestimated physical activity data. The overestimation of moderate to vigorous physical activity was significantly less among adolescents than younger age groups (P < .01, ηp2=.38). For step counts, there was a significant age by sex interaction observed where preschool and adolescent males tended to have greater differences between accelerometer and step count data than females (P < .01, ηp2=.33). Differences between devices were not associated with severity of diagnosis.
The distribution of pedometers in a pediatric outpatient clinic was feasible, yet the data collected significantly overestimated physical activity, especially among younger children. Practitioners who want to introduce objective measurements as part of their physical activity counseling practice should use pedometers to monitor individual changes in physical activity and consider patient age before administering these devices for clinical care.
Background: The Canadian Assessment of Physical Literacy (CAPL) accurately and reliably assesses the physical literacy level of young children. However, in preliminary analyses ceiling effects were ...noted among 183 older children. The purposes of this study were to assess the validity of a modified CAPL designed for older children (CAPL 789) and to offer descriptive results.
Methods: CAPL 789 assessed the physical literacy of Canadian children in grades 7-9. Data were collected from schools and recreation facilities in the provinces of Alberta and Ontario (Canada), yielding a new sample of 245 participants (129 girls, 13.7 ± 0.9 years). Descriptive statistics were calculated for all CAPL domains. Age and gender effects were examined to support the validity.
Results: Physical competence score (/32) increased with age (F = 4.90, p < 0.05), the means in grades 7-9 being 18.9 ± 3.2, 20.9 ± 4.4 and 21.2 ± 3.4, respectively. Girls scored significantly higher (t = −2.29, p < 0.05) than boys (6.6 ± 1.2 vs 6.3 ± 1.3) in the knowledge assessment (/10).
Conclusion: The CAPL 789 was feasible among children from grades 7-9. Additional research is required to establish the psychometric properties in children 12 to 16 years.
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The term physical literacy is relatively new, and its definition, conceptual underpinning, how it is measured, how to change it, and its relationship with holistic health and wellness across the life ...span are a few of many foundational issues that lack consensus. At present, there are more questions than answers. The purpose of this article is to highlight 10 important research questions related to physical literacy with the hope of fueling future research activity and debate. Input was sought from international experts and practitioners on priorities and research gaps related to physical literacy. This list was supplemented by personal experience and research priorities identified in published manuscripts. From these various sources, the top 10 research questions related to physical literacy were compiled. Research related to physical literacy is in its infancy, and many important, even fundamental research questions and priorities remain unanswered. Research needs are summarized within 4 themes: monitoring physical literacy, understanding the physical literacy journey, enhancing physical literacy, and the benefits of physical literacy. Specific research questions relate to identifying measurable aspects of physical literacy and how they change across cultures and throughout the life span, as well as understanding the individual and environmental factors that describe the physical literacy journey and are effective targets for interventions. Physical literacy is increasingly recognized as the foundation for a healthy active lifestyle; however, robust research demonstrating its constitution, its relationship with health-related outcomes, and intervention strategies for its improvement remains to be completed. (Autor).
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Physical literacy is an emerging construct in children's health promotion, and may impact their lifelong physical activity habits. However, recent data reveal that only a small portion of Canadian ...children are regularly physically active and/or meet sedentary behaviour guidelines. To our knowledge, no study has investigated the association between physical literacy and movement behaviour guidelines. Therefore, the purpose of this study was to examine the relationship between physical literacy scores in Canadian children who meet or do not meet physical activity and sedentary behaviour guidelines.
Children (n = 2956; 56.6% girls) aged 8-12 years from 10 Canadian cities had their physical literacy levels measured using the Canadian Assessment of Physical Literacy, which consists of four domains (Physical Competence; Daily Behaviour; Knowledge and Understanding; and Motivation and Confidence) that are aggregated to provide a composite physical literacy score. Physical activity levels were measured by pedometers, and sedentary behaviour was assessed through self-report questionnaire. Analyses were conducted separately for each guideline, comparing participants meeting versus those not meeting the guidelines. Comparisons were performed using MANOVA and logistic regression to control for age, gender, and seasonality.
Participants meeting physical activity guidelines or sedentary behaviour guidelines had higher physical literacy domain scores for Physical Competence and for Motivation and Confidence compared to those not meeting either guideline (both p < 0.0001). Participants had increased odds of meeting physical activity guidelines and sedentary behaviour guidelines if they met the minimum recommended level of the Physical Competence and Motivation and Confidence domains. Significant age (OR 0.9; 95% CI: 0.8, 0.9), gender (OR 0.4; 95% CI: 0.3, 0.5) and seasonality effects (OR 1.6; 95% CI: 1.2, 2.2 spring and OR 1.7; 95% CI: 1.2, 2.5 summer, reference winter) were seen for physical activity guidelines, and age (OR 0.8; 95% CI: 0.7, 0.8) and gender effects (OR 1.7; 95% CI: 1.4, 2.0) for sedentary behaviour guidelines. Knowledge and Understanding of physical activity principles was not related to guideline adherence in either model.
These cross-sectional findings demonstrate important associations between physical literacy and guideline adherence for physical activity and sedentary behaviour. Future research should explore the causality of these associations.
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The primary aim of this study was to develop an assessment of the fundamental, combined, and complex movement skills required to support childhood physical literacy. The secondary aim was to ...establish the feasibility, objectivity, and reliability evidence for the assessment.
An expert advisory group recommended a course format for the assessment that would require children to complete a series of dynamic movement skills. Criterion-referenced skill performance and completion time were the recommended forms of evaluation. Children, 8–12 years of age, self-reported their age and gender and then completed the study assessments while attending local schools or day camps. Face validity was previously established through a Delphi expert (n = 19, 21% female) review process. Convergent validity was evaluated by age and gender associations with assessment performance. Inter- and intra-rater (n = 53, 34% female) objectivity and test–retest (n = 60, 47% female) reliability were assessed through repeated test administration.
Median total score was 21 of 28 points (range 5–28). Median completion time was 17 s. Total scores were feasible for all 995 children who self-reported age and gender. Total score did not differ between inside and outside environments (95% confidence interval (CI) of difference: −0.7 to 0.6; p = 0.91) or with/without footwear (95%CI of difference: −2.5 to 1.9; p = 0.77). Older age (p < 0.001, η2 = 0.15) and male gender (p < 0.001, η2 = 0.02) were associated with a higher total score. Inter-rater objectivity evidence was excellent (intraclass correlation coefficient (ICC) = 0.99) for completion time and substantial for skill score (ICC = 0.69) for 104 attempts by 53 children (34% female). Intra-rater objectivity was moderate (ICC = 0.52) for skill score and excellent for completion time (ICC = 0.99). Reliability was excellent for completion time over a short (2–4 days; ICC = 0.84) or long (8–14 days; ICC = 0.82) interval. Skill score reliability was moderate (ICC = 0.46) over a short interval, and substantial (ICC = 0.74) over a long interval.
The Canadian Agility and Movement Skill Assessment is a feasible measure of selected fundamental, complex and combined movement skills, which are an important building block for childhood physical literacy. Moderate-to-excellent objectivity was demonstrated for children 8–12 years of age. Test–retest reliability has been established over an interval of at least 1 week. The time and skill scores can be accurately estimated by 1 trained examiner.
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