Reliability and validity of Web‐SPAN,a web‐based method for assessing weight status,diet and physical activity in youth

Background: Web‐based surveys are becoming increasing popular. The present study aimed to assess the reliability and validity of the Web‐Survey of Physical Activity and Nutrition (Web‐SPAN) for self‐report of height and weight, diet and physical activity by youth. Methods: School children aged 11–15 years (grades 7–9; n = 459) participated in the school‐based research (boys, n = 225; girls, n = 233; mean age, 12.8 years). Students completed Web‐SPAN (self‐administered) twice and participated in on‐site school assessments [height, weight, 3‐day food/pedometer record, Physical Activity Questionnaire for Older Children (PAQ‐C), shuttle run]. Intraclass (ICC) and Pearson’s correlation coefficients and paired samples t‐tests were used to assess the test–retest reliability of Web‐SPAN and to compare Web‐SPAN with the on‐site assessments. Results: Test–retest reliability for height (ICC = 0.90), weight (ICC = 0.98) and the PAQ‐C (ICC = 0.79) were highly correlated, whereas correlations for nutrients were not as strong (ICC = 0.37–0.64). There were no differences between Web‐SPAN times 1 and 2 for height and weight, although there were differences for the PAQ‐C and most nutrients. Web‐SPAN was strongly correlated with the on‐site assessments, including height (ICC = 0.88), weight (ICC = 0.93) and the PAQ‐C (ICC = 0.70). Mean differences for height and the PAQ‐C were not significant, whereas mean differences for weight were significant resulting in an underestimation of being overweight/obesity prevalence (84% agreement). Correlations for nutrients were in the range 0.24–0.40; mean differences were small but generally significantly different. Correlations were weak between the web‐based PAQ‐C and 3‐day pedometer record (r = 0.28) and 20‐m shuttle run (r = 0.28). Conclusions: Web‐SPAN is a time‐ and cost‐effective method that can be used to assess the diet and physical activity status of youth in large cross‐sectional studies and to assess group trends (weight status).     

Prevalence of food insecurity and utilization of food assistance program: an exploratory survey of a Vermont middle school

BACKGROUND: Access to sufficient food—in terms of both quality and quantity—is especially critical for children. Undernourishment during childhood and adolescence can have health implications, both short and long term. The prevalence of food insecurity was assessed in a sample of Vermont school children, as well as the relationship between food insecurity, participation in school breakfast or lunch, exercise and body mass index (BMI), all with a goal to identify needs to improve effectiveness of current programs. METHODS: A cross‐sectional, 23‐item self‐administered survey of students attending a public middle school in Vermont. RESULTS: Twenty percent of the children were residing in a food insecure household. No statistically significant differences were observed in terms of age, sex or BMI percentile and food security status. Food insecure (with or without hunger) participants were less likely to eat breakfast at home compared to food secure participants (67.1% vs 81.4%, p = .007). However, such differences were not observed between eating school breakfast or lunch. Sixty‐two percent of food insecure (with or without hunger) participants engaged in daily exercise compared to 75.9% food secure participants (p = .014). CONCLUSION: Children in food insecure households were less likely to be physically active and to eat breakfast at home. However, the school breakfast program is negating any difference between the 2 groups in terms of eating breakfast at all. We consider this a success given the short‐ and long‐term implications of food insecurity in children. We believe these findings have important implications for schools, policy makers, and programs to reduce food insecurity.     

Development and validation of an asthma knowledge test for children 8–10 years of age

Background Although there are many instruments available to measure asthma knowledge in adult populations, a search of the literature identified the lack of valid and reliable instruments to assess the asthma knowledge of pre‐adolescent children. The aim of this study was to develop and validate an asthma knowledge test for children 8–10 years of age. Methods Three strategies were used to achieve the study objective: develop and design the asthma knowledge test; establish the content validity of test items; and conduct a pilot study to examine the validity, reliability and user friendliness of the instrument in a sample of 151 primary school children. Results A 24‐item asthma knowledge test was developed based on selected items from the Newcastle Asthma Knowledge Questionnaire and supplemented with items from other instruments. Test items were worded to ensure they could be understood by 8‐ to 10‐year‐old children, and content validity confirmed by an expert panel. A pilot study demonstrated that the test was user friendly, generated responses that reflected varying degrees of item difficulty and produced scores on the test that discriminated between ‘known groups’. Conclusion Findings from this study indicate that an asthma knowledge test designed for primary school‐age children has considerable promise. With further refinement and testing, this test will provide a valid and reliable measure of asthma knowledge in children with and without asthma that can be used in a wide range of childhood asthma studies.     

Comparison of the prevalence and impact of health problems of pre-school children with and without cerebral palsy

Background The range of health problems associated with children with cerebral palsy (CP) is well documented in the literature; however, the existing data are often either reported for samples of children with all types of CP, or stratified by typology of motor disorder, rather than using the Gross Motor Function Classification System (GMFCS), which has been shown to be the most reliable way of classifying children with CP. Furthermore, availability of research on pre‐school‐aged children (under 5 years) is sparse. The aim of this study is to compare the prevalence and impact of health problems in pre‐school children with and without CP, stratified by the GMFCS. Methods Parents of 430 pre‐school‐aged children with CP (243 boys, 187 girls; mean age = 3 years 2 months, SD = 11 months) and 107 typically developing (TD) children (56 boys, 51 girls; mean age = 3 years 4 months, SD = 11 months) participated. Using the consensus definition of CP and the World Health Organization's International Classification of Functioning, Disability and Health, a parent survey was developed to assess the prevalence and impact of 16 health problems. The measure demonstrates good test–retest reliability (ICC > 0.80) and discriminant validity across GMFCS levels (P < 0.001). Results Both the prevalence and impact of health problems is greater in children with CP compared with TD children (P < 0.001). The number and impact of health problems increase with ascending GMFCS level (P≤ 0.01), except for the impact of health problems between groups GMFCS I and GMFCS II/III (P= 0.19). Children with CP have an average of between 3.4 and 6.7 health problems, compared with fewer than one in TD children. Conclusions Service providers working with pre‐school‐aged children with CP need to consider health problems and their impact when planning care.     

HENRY: development,pilot and long‐term evaluation of a programme to help practitioners work more effectively with parents of babies and pre‐school children to prevent childhood obesity

Background Despite epidemic numbers of obese and overweight pre‐school children, professionals report a lack of confidence and self‐efficacy in working with parents around lifestyle change. HENRY – Health Exercise Nutrition for the Really Young – trains health and community practitioners to work more sensitively and effectively with parents of babies and pre‐school children around obesity and lifestyle concerns. Underpinned by the Family Partnership Model, reflective practice and solution‐focused techniques, it offers face‐to‐face training and e‐learning. This paper describes the development, pilot and evaluation of HENRY Sure Start Children's Centres. Methods Twelve Children's Centres in Oxfordshire took part in the pilot involving 137 staff. Questionnaires were administered at the end of training courses. Self‐reported confidence ratings were obtained before and after training. Postal questionnaires were sent to Centre managers 2–6 months later to ascertain long‐term effects. Nine managers participated in in‐depth interviews. A further 535 learners completed the e‐learning course and online feedback. Results One hundred and thirty‐one staff (96%) completed the training course and valued it as a way of enhancing skills and knowledge. Mean (±SD) self‐reported confidence ratings increased (4.1 ± 0.7 to 7.2 ± 0.7; P < 0.00001). An influence on personal as well as professional lives was apparent. Long‐term follow‐up indicated ongoing impact attributed to HENRY on both Centres and staff. All 535 e‐learners successfully completed: 98% would recommend HENRY; 94% thought it enhanced their skills as well as knowledge. Conclusions HENRY is an innovative approach that offers some promise in tackling obesity through training community and health practitioners to work more effectively with parents of very young children. It appears to have an effect on participants' personal lives as well as professional work. A large‐scale long‐term study would be required to ascertain if there is the desired impact on young children's lifestyles and risk of obesity.     

Assessment of environmental factors in disabled children 2–12 years: development and reliability of the Craig Hospital Inventory of Environmental Factors (CHIEF) for Children–Parent Version

Background Children with disabilities and their families experience environmental barriers in the school and community environments. There is a need to understand and appropriately measure environmental factors that influence activity and participation for disabled children. The purpose of this paper is to describe the adaptation process of the Craig Hospital Inventory of Environmental Factors (CHIEF) to make it suitable as a parent proxy measure for disabled children aged 2–12 years. Methods The adaptation process consisted of four steps using data from previous research conducted at CanChild: (i) analysis of item–total correlations from all items on the CHIEF; (ii) frequency of endorsement; (iii) determination of the representativeness of the questions; and (iv) correlations on selected items. Once the items were selected, a test–retest reliability study was conducted. Results The internal consistencies (α) for the time 1 and time 2 administrations were 0.76 and 0.78, respectively. Test–retest reliability of the questionnaire was ICC = 0.73 for the total product score. Conclusion The 10‐item CHIEF for Children–Parent Version is an acceptable, easy‐to‐complete and reliable measure of perceived environmental barriers for disabled children 2–12 years of age.     

Reliability and Validity of a Modified MEDFICTS Dietary Fat Screener in South African Schoolchildren Are Determined by Use and Outcome Measures

BackgroundIn South Africa, noncommunicable diseases and obesity are increasing and also affect children. No validated assessment tools for fat intake are available.ObjectiveTo determine test–retest reliability and relative validity of a pictorial modified meats, eggs, dairy, fried foods, fats in baked goods, convenience foods, table fats, and snacks (MEDFICTS) dietary fat screener.DesignWe determined test–retest reliability and diagnostic accuracy with the modified MEDFICTS as the index test and a 3-day weighed food record and parental completion of the screener as primary and secondary reference methods, respectively.Participants/settingGrade-six learners (aged 12 years, 4 months) in an urban, middle-class school (n=93) and their parents (n=72).Outcome measuresPortion size, frequency of intake, final score, and classification of fat intake of the modified MEDFICTS, and percent energy from fat, saturated fatty acids, and cholesterol of the food record.Statistical analysesFor categorical data agreement was based on kappa statistics, McNemar's test for symmetry, and diagnostic performance parameters. Continuous data were analyzed with correlations, mean differences, the Bland-Altman method, and receiver operating characteristics.ResultsThe classification of fat intake by the modified MEDFICTS was test–retest reliable. Final scores of the group did not differ between administrations (P=0.86). The correlation of final scores between administrations was significant for girls only (r=0.58; P=0.01). Reliability of portion size and frequency of intake scores depended on the food category. For girls the screener final score was significantly (P<0.5) correlated to total, saturated fat, and cholesterol intakes (but not to percent energy from fat and saturated fatty acids intakes). The sensitivity of the modified MEDFICTS was very high (>90%), but chance corrected agreement between the classifications was poor. Parents did not agree with their children.ConclusionsTest–retest reliability and relative validity of a modified MEDFICTS dietary fat screener in South African schoolchildren depended on the use and outcome measures applied.     

Psychometric properties of a motor skill checklist for 3- to 5-year-old children

Background Early identification of children with developmental co‐ordination disorder is important. Teachers may be very useful in this identification process. The objective of this study was to develop a motor skill checklist (MSC) for 3‐ to 5‐year‐old children to be completed by teachers, and to establish the psychometric properties of this new instrument. Methods An MSC of 28 functional items was constructed in close consideration with clinical experts and teachers. In regular schools, 366 pre‐school children were rated with the MSC by their teachers (n= 111). To determine test–retest reliability, each teacher completed 4 weeks later the MSC again for one randomly selected child. In 22 classes with two teachers sharing the job, both teachers were asked to fill in the questionnaire. A subgroup of children was also tested with the Movement Assessment Battery for Children (M‐ABC; n= 122). All teachers were invited to complete a questionnaire to evaluate the MSC. Results The internal consistency of the MSC was high. The test–retest reliability was good. Inter‐rater reliability was adequate except in the 5‐year‐old children. There was a strong correlation between the checklist and the M‐ABC, establishing concurrent validity. Most teachers judged the MSC as easy or rather easy to complete. Conclusions The MSC is a reliable, valid and useful instrument to identify and assess young children with motor difficulties.     

Children's nutritional intake as part of the Eat Well Do Well scheme in Kingston‐upon‐Hull – a pilot study

In April 2004 Hull City Council introduced free healthy school meals for all primary and special schools in an attempt to reduce health inequalities. This pilot study aimed to compare nutritional intake between those children consuming a free healthy school meal and those consuming a packed lunch brought from home. The study compared two schools from different socio‐economic areas and considered the impact of lunch on total daily food and nutrient intakes in these children. Fieldwork was undertaken over five consecutive days in each school. Seven hundred and thirty‐five lunches were weighed and photographed before and after consumption to assess actual food intake vs. wastage. One hundred and forty‐seven children aged 8‐to‐11‐years participated from two primary schools. Five‐day food diaries were completed by a small number of participants (n = 20) receiving school meals (n = 10) and packed lunches (n = 10) from the two schools selected. While the lunches provided at the two schools met the majority of the nutritional guidelines for school meals, children ate only a small amount, often leaving the potatoes and vegetables behind; therefore, their intakes were below recommended levels. Children from both schools who opted for packed lunch consumed significantly more energy, fat, sugar and sodium but with this more micronutrients than children who had a free healthy school meal. Statistical differences (P < 0.01) were found between the two schools, with children from the less affluent school consuming less food from the school meal and therefore obtaining a lower nutrient intake from lunch than children from the more affluent school. Findings from a small number of food diaries suggest that the differences in intakes between those having a school meal and those having a packed lunch were compensated for by other food consumed during the day, such that daily nutrient intakes were not significantly different. This study suggests that many children may not be consuming sufficient amounts of the food provided in schools. Therefore, it cannot be assumed that the provision of school meals that conform to the School Food Trust guidelines will be of nutritional benefit to all children concerned. Bearing this in mind, more needs to be done to provide menus that are both healthy and enjoyable for children, so that they will want to consume the foods provided. Parents also need more advice regarding how they can provide their children with a healthy packed lunch, possibly via the introduction of a government‐led packed lunch policy, particularly in schools from areas of lower socio‐economic status. Although there was only a small sample of food diaries in this study, the findings suggest that socio‐economic demographics may exert more of an influence on the total daily nutrient intake of children than the type of lunch consumed.     

The Development of Adolescent and Young Adult Participation Sort – Taiwanese Version

The purpose of this pilot research was to translate the Adolescent and Young Adult Participation Sort into Taiwanese (AYAPS‐T), an assessment tool measuring the activity participation and the self‐identified barriers of youth transitioning into adulthood. The study included five phases: translation, cultural adaptation, taking photographs, field testing for content validity and pilot testing of test–retest reliability. A literature review, expert review and translation with back‐translation were conducted for the initial activities. The activities were then edited on the basis of the feedback of 23Taiwanese youth for content validity. Test–retest reliability (intraclass correlation coefficient = 0.91) of the AYAPS‐T reported by 22 Taiwanese youth was high. With the activities designed to meet the developmental needs of young adults, the methodology of sorting photographs, the barrier list to identify possible obstacles and some psychometric properties established, the AYAPS‐T serves as a reliable and valid tool to identify engagement of young adults in their occupations. Because of the nature of a pilot study, results are limited by a small sample size and limited evidence of psychometric properties. Psychometric properties such as interrater reliability and internal consistency as well as construct validity and concurrent validity need to be tested on a larger sample size. Copyright © 2013 John Wiley & Sons, Ltd.     

Relation of School Environment and Policy to Adolescent Physical Activity*

Background: Physical activity (PA) declines as children and adolescents age. The purpose of this study was to examine how specific school factors relate to youth PA, TV viewing, and body mass index (BMI). Methods: A sample of 12‐ to 18‐year‐old adolescents in 3 cities (N = 165, 53% females, mean age 14.6 ± 1.7 years, 44% nonwhite) completed surveys assessing days of physical education (PE) class per week, school equipment accessibility, after‐school supervised PA, and after‐school field access. Regression analyses were conducted to examine relationships between these school factors and PA at school facilities open to the public (never active vs active), overall PA level (days per week physically active for 60 minutes), BMI z score, and TV watching (hours per week). Results: Adjusting for demographics, days of PE per week and access to school fields after school were correlated with overall PA (β= 0.286, p = .002, semipartial correlation .236 and β= 0.801, p = .016, semipartial correlation .186, respectively). The association between after‐school field access and overall PA was mediated by use of publicly accessible school facilities for PA. After‐school supervised PA and school PA equipment were not associated with overall PA. In adjusted regression analyses including all school factors, days of PE remained correlated to overall PA independent of other school factors (β= 0.264, p = .007, semipartial correlation = .136). There were no associations between school factors and BMI or TV watching. Conclusions: Based on these study findings, PE is a promising intervention to address improving overall adolescent PA within the school setting.     

A Meal High in Saturated Fat Evokes Postprandial Dyslipemia,Hyperinsulinemia, and Altered Lipoprotein Expression in Obese Children With and Without Nonalcoholic Fatty Liver Disease

Background: Hyperinsulinemia and altered lipid and lipoprotein metabolism induced by fast‐food diets may contribute to nonalcoholic fatty liver disease (NAFLD). We hypothesized that a high saturated fat (SFA) meal would evoke prolonged postprandial lipemia and hyperinsulinemia, increased inflammation, and altered lipoprotein expression in obese children with NAFLD when compared with healthy children. Methods: We prospectively studied 31 children (NAFLD, 13.1 ± 2.6 years, n = 11; age‐matched obese, 14.3 ± 1.7 years, n = 9; lean, 13.6 ± 2.6 years, n = 11) following consumption of a high SFA (18.8%) meal. Prior to and at 1, 3, and 6 hours after meal consumption, blood was collected for analysis of alanine aminotransferase (ALT); aspartate aminotransferase (AST); γ‐glutamyltransferase; leptin; C‐reactive protein; (fasting) insulin; glucose; triglycerides (TGs); total, high‐density lipoprotein, and low‐density lipoprotein cholesterol; adiponectin; nonesterified fatty acids (NEFAs); inflammatory markers (TNF‐α, IL‐6, IL‐10); apolipoproteins‐B48, B100, and CIII; and fatty acid (FA) composition of TG fractions. Results: Children with NAFLD had significantly higher fasting levels of ALT (87 ± 54 U/L), AST (52 ± 33.5 U/L), and apolipoprotein‐CIII (20.6 ± 11.3 mg/dL) with postprandial hyperinsulinemia (iAUC insulin: 225 ± 207 [NAFLD] vs 113 ± 73 [obese] vs 47 ± 19.9 [lean] mU/L‐h; P < .001); suppression of NEFA (iAUC‐NEFA: 1.7 ± 0.9 [NAFLD] vs 0.6 ± 0.3 [obese] vs 1 ± 0.7 [lean] mEq/L‐h); and prolonged elevations in apolipoprotein‐B48 3–6 hours after meal consumption when compared with obese and lean controls (P < .05). Conclusion: A meal high in saturated fat evokes postprandial dyslipemia, hyperinsulinemia, and altered lipoprotein expression in obese children with and without NAFLD.     

The contribution of school meals and packed lunch to food consumption and nutrient intakes in UK primary school children from a low income population

Background: The Low Income Diet and Nutrition Survey described the food consumption and nutrient intake of UK children in low income households in 2003–2005. Methods: To describe food consumption and nutrient intake associated with school meals and packed lunches, based on a cross‐sectional analysis of 680, 24‐h dietary recalls from 311 school children aged 4–11 years. Results: In children from low income households, pupils who took a packed lunch consumed more white bread, fats and oils, crisps and confectionery and fewer potatoes (cooked with or without fat) at lunchtime compared to other pupils. Many of these differences persisted when diet was assessed over the day. For younger pupils (4–7 years), packed lunches provided the least amount of folate, the highest amount of sodium, and the highest average percentage of food energy from fat and saturated fatty acids (SFA) compared to free school meals (FSMs). Over the whole day, in both younger (4–7 years) and older (8–11 years) children, there were no notable differences in energy or nutrient intake between those eating a packed lunch or a school meal. Older children’s packed lunches contributed a significantly higher proportion of fat, SFA, calcium and sodium to the day’s nutrient intake compared to a FSM. Conclusions: In children from low income households, packed lunches are less likely to contribute towards a ‘healthier’ diet compared to a school meal. The difference was more apparent in younger children. Key differences were the high consumption of sodium, SFA and non‐milk extrinsic sugars by pupils who had packed lunches.     

Intentional self‐harm and assault hospitalisations and treatment cost of children in Australia over a 10‐year period

Objective: To examine the magnitude, 10‐year temporal trends and treatment cost of intentional injury hospitalisations of children aged ≤16 years in Australia. Method: A retrospective examination of linked hospitalisation and mortality data for children aged ≤16 years during 1 July 2001 to 30 June 2012 with self‐harm or assault injuries. Negative binomial regression examined temporal trends. Results: There were 18,223 self‐harm and 13,877 assault hospitalisations, with a treatment cost of $64 million and $60.6 million, respectively. The self‐harm hospitalisation rate was 59.8 per 100,000 population (95%CI 58.96–60.71) with no annual decrease. The assault hospitalisation rate was 29.9 per 100,000 population (95%CI 29.39–30.39) with a 4.2% annual decrease (95%CI ?6.14– ?2.31, p<0.0001). Poisoning was the most common method of self‐harm. Other maltreatment syndromes were common for children ≤5 years of age. Assault by bodily force was common for children aged 6–16 years. Conclusions: Health professionals can play a key role in identifying and preventing the recurrence of intentional injury. Psychosocial care and access to support services are essential for self‐harmers. Parental education interventions to reduce assaults of children and training in conflict de‐escalation to reduce child peer‐assaults are recommended. Implications for public health: Australia needs a whole‐of‐government and community approach to prevent intentional injury.     

Evaluation of children's creativity: psychometric properties of Torrance's ‘Thinking Creatively in Action and Movement’ test

The purpose of this study was to examine the test–retest reliability of Torrance's ‘Thinking Creatively in Action and Movement’ (TCAM) test and the relationship between TCAM and the Divergent Movement Ability (DMA) test. The TCAM and DMA tests were used for a sample of 115 children, while the whole experimental procedure included three testing sessions: first and second testing sessions for the TCAM test and retest, and third testing session for the DMA test. The time interval between the two testing sessions was two weeks and each testing session lasted approximately 10 days. The results for the comparison between the test and the retest session for TCAM showed a high intra‐class correlation coefficient, and also the paired simple t‐test indicated that there were no statistically significant differences between the two testing sessions. Canonical correlation analysis revealed a high correlation between TCAM variables and DMA variables. A low value has been only reported concerning the variable of TCAM imagination. In conclusion, the present results are encouraging and seem to support the psychometric properties of TCAM for preschool‐aged children, showing that TCAM is a valid and reliable instrument to measure creative movement in preschool children.     

Is ideal body image related to obesity and lifestyle behaviours in African American adolescents?

Background Childhood obesity epidemic has become a public health issue in the USA, especially among African American youths. Research on the association between ideal body image (IBI) and obesity and related lifestyle factors among African American children and adolescents is limited. Methods Data collected from 402 low‐income African American adolescents aged 10–14 years in four Chicago public schools were used. Questionnaires were used to assess IBI, weight perception, weight control practices, and self‐efficacy towards food and physical activity. Body mass index was calculated using measured weight and height. Associations between IBI and weight perception, overweight/obesity and lifestyle behaviours were assessed using linear and logistic regression models. Results The most frequently chosen ideal body size was the fourth of eight silhouettes (from thinnest to heaviest) for boys (55%) and girls (49%). Overweight and obese girls selected larger ideal body figures than the others (trend test: P < 0.001). Compared with those with middle ideal body figures, girls who selected smaller ones were twice as likely to have an unhealthy diet as indicated by less fruit and milk consumption; the odds ratios (ORs) and 95% confidence intervals (95% CIs) were 2.40 (1.15–5.02) for fruits intake (P < 0.05). Overweight and obese boys and girls appeared to have better food choice intentions and food self‐efficacy than their non‐overweight peers (trend test: both P < 0.01). Conclusions Ideal body image is associated with weight status, food self‐efficacy and lifestyle behaviours among low‐income African American adolescents.     

Parent reports of sun safety communication and behaviour for students in a randomised trial on a school policy implementation intervention

Objective : Schools are an important setting for skin cancer prevention. An intervention for implementation of school sun safety policy, Sun Safety Schools (SSS), was evaluated. Methods : Primary schools (n=118) in California school districts that had already adopted a sun safety policy were enrolled in a study with a randomised controlled design. Half of the schools were randomised to SSS intervention (N=58). Parents completed an online post‐test. Results : More parents in intervention schools received information about sun safety (mean=26.3%, sd=3.1%, p=0.017) and children more frequently wore sun‐protective clothing when not at school (mean=2.93, sd=0.03, p=0.033) than in control schools (mean=18.0%, sd=2.5%; mean=2.83, sd=0.03, respectively). In schools where principals reported implementing sun safety practices, parents reported that children spent less time outdoors at midday (mean=14.78 hours, sd=0.25, p=0.033) and fewer were sunburned (mean=12.7%, sd=1.1%, p=0.009) than in non‐implementing schools (M=16.3 hours, sd=0.67; mean=21.2%, sd=3.8%, respectively). Parents who received sun safety information (mean=3.08, sd=0.04, p=0.008) reported more child sun protection than parents not receiving information (mean=2.96, sd=0.02). Conclusions : A school district sun protection policy and support for implementation increased dissemination of sun safety information to parents and student sun safety. Implications for public health : Technical assistance for sun safety policies may increase sun protection of children.     

The Quest for an Instructional Delivery Framework for Children with Gerstmann's Syndrome

This study aimed to develop a new scale, the ‘Supports Scale For Preschool Inclusion’ (SSPI), to assess pre‐school teachers’ perceptions of necessary factors and availability of supports for a successful inclusion in pre‐school educational settings. Pre‐school teachers (n = 183, mean age = 32.81, standard deviation = 8.29) from all regions of Turkey participated in the study. They were asked to fill in each item of the SSPI for two dimensions, namely necessity and support dimensions, by rating on a four‐point Likert‐type scale from 1 (none) to 4 (completely). A number of reliability and validity analyses—such as internal consistency, test–retest reliabilities and factor and criterion validities—were conducted to examine the psychometric properties of the SSPI. The results showed that the 34‐item respondent‐based scale is a reliable and valid instrument to assess pre‐school teachers’ perception of necessities and availabilities of supports for successful inclusion. Findings were discussed in relation to the usage of the scale in inclusive settings.     

The validation of a self‐report measure and physical activity of Australian Aboriginal and Torres Strait Islander and non‐Indigenous rural children

Purpose: To validate a self‐report measure of physical activity for both Australian Aboriginal and Torres Strait Islander and non‐Indigenous rural children, and to describe their physical activity participation. Methods: In this cross‐sectional study, 84 Aboriginal and Torres Strait Islander and 146 non‐Indigenous children aged 10–12 years old completed the Many Rivers Physical Activity Recall Questionnaire (MRPARQ), a modified version of the Adolescent Physical Activity Recall Questionnaire (APARQ). A sub‐group (n=86) wore an accelerometer for seven consecutive days in order to validate the instrument. Results: Pearson and Intra Class Correlation coefficients between the survey and acceleromtery for weekdays only are 0.31 and 0.16, respectively, for Aboriginal and Torres Strait Islander children, and 0.38 and 0.31, respectively, for non‐Indigenous children, and demonstrate a modest (p<0.05) correlation. Self‐reported MVPA for Aboriginal and Torres Strait Islander children is between 162 and 172 minutes/day, and is 125 minutes by accelerometer; for non‐Indigenous children MVPA is between 123 and 149 minutes (survey) and 107 minutes (accelerometer). Conclusion: Australian Aboriginal and Torres Strait Islander children's self‐report of physical activity is at least as valid as non‐Indigenous children, given culturally appropriate support; they tend to be more active than non‐Indigenous children. Implications: The MRPARQ can be administered with Aboriginal and Torres Strait Islander and non‐Indigenous children.