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PLAY - Promoting Lifelong Activity in Youth - an Osteopathic Approach to Engage Children in Physical Activity While Incorporating Step Tracking Devices

Freund K, Carroll H, Von Harten E, Stoner, Ph.D A, Sahhar, md H
Edward Via College of Osteopathic Medicine – Carolinas Campus, Spartanburg, SC, United states

Objective:
Low socioeconomic status (SES) children are less physically active than higher SES children, leading to unfavorable health risk factors at an early age including having a higher BMI. The disparities between children of low and high SES that factor into these health outcomes include access to safe parks, sports facilities, and neighborhoods.
The PLAY (Promoting Lifelong Activity in Youth) Program was created with the goal of increasing physical activity (PA) levels by making a lasting impression on health and wellness that young, low SES students could apply in their daily lives. This study seeks to determine whether PLAY increases PA levels as measured by step tracking devices.

Materials and Methods:
PLAY is a bi-monthly after-school program for 3rd grade low SES students of Spartanburg County, SC. Each event utilized the osteopathic philosophy by incorporating the mind, body and spirit and was led by osteopathic medical students. The children were educated on a topic prior to physical exercise to involve holistic health, such as nutrition or physical wellbeing. Team leaders mentored and encouraged teams of four students, utilizing teamwork and self-motivation to help increase their PA levels.
All students were given a Garmin Vivofit step tracking device to wear, allowing their steps to be tracked during and outside of school hours. A five-week baseline was collected before initiation of the PLAY program. Information collected was a daily total step count for each student. A prize was awarded at each event to the team and individual student that accumulated the greatest percent increase in steps above baseline.
Initial descriptive statistics compared the average trend between baseline and subsequent months, and between weekends and weekdays. Values were removed for students that took less than 1000 steps/day due to loss of follow up for that day. Further analysis will be performed upon completion of the study in March 2018.

Results:
A total of 20 participants were enrolled in the study. The preliminary results from the first quarter of the study (October-December) indicate there was a significant decrease in the overall average number of steps from baseline (mean: 7810.73, 95% CI: 7531.44 - 8090.03) compared to the end of first quarter (mean: 7344.30, 95% CI: 7156.37 - 7532.23). While the number of steps increased from baseline to October (mean: 7940.31, 95% CI: 7612.48 - 8268.15), there was a significant decrease from baseline to November (mean: 7132.32, 95% CI: 6811.95 - 7452.70) and December (mean: 6810.80, 95% CI: 6500.91 - 7120.68). Throughout the preliminary study period, more steps were taken during weekdays (mean 7616.41, 95% CI: 7439.93 - 7792.88) compared to weekends (mean: 7115.97, 95% CI: 6789.82 - 7442.11).

Conclusion:
While the preliminary analysis indicates a trend opposite of what was expected, there are many variables that can impact PA levels among low SES children. Through the collection of data for the next quarter, we anticipate increased PA levels over baseline, as the children will have more opportunity to use the physical activities learned in PLAY during the warmer months.


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