Dr Emma Pollock

Background: Children can internalise social and parental gender stereotypes and this may influence their perceived motor competence (PMC). This study aimed to examine the association between father and daughter gender-stereotyped attitudes/beliefs and girls¿ PMC. Methods: Girls (N = 68, M age = 8.9 years, SD = 1.7) and their fathers were recruited at baseline from a physical activity intervention. Girls¿ PMC was assessed using the pictorial scale of Perceived Movement Skill Competence. Gender-stereotyped attitudes/beliefs of girls and fathers were assessed using the Occupation, Activity, and Trait¿Attitude/Personal instrument. The girls¿ questions were interviewer administered to ensure comprehension, whilst fathers completed an online survey. Correlations were calculated, followed by linear regressions adjusted for girls¿ age and fathers¿ education. Regression models were used to investigate associations between father-daughter gender-stereotyped attitudes/beliefs, and whether these attitudes/beliefs were associated with girls¿ perceptions of their object control/locomotor, active play, and overall skill competence. Results: Girls¿ gender-stereotyped attitudes negatively correlated with overall PMC, r(60) = ¿.36, p =.004, and object control perception, r(60) = ¿.36, p =.004. These associations remained evident in linear regression analysis. No other associations were found. Conclusions: Girls with more gender-stereotyped attitudes have lower motor skill perceptions, which may impact negatively on physical activity and sport participation. Future interventions aimed at reducing sociocultural gender stereotypes in children may improve girls¿ motor skill perception and positively impact physical activity.

Background: The 'Dads And Daughters Exercising and Empowered' (DADEE) program significantly improved physical activity levels of fathers and their daughters in an efficacy trial. However, the effectiveness of interventions when delivered in real-world settings needs to be established. Purpose: To evaluate the effectiveness of the DADEE intervention when delivered in community settings by trained facilitators. Methods: We conducted a two-arm RCT, (baseline and 3-months post-intervention assessments), in Newcastle, Australia. In 2016, 155 fathers (27-60 years) and 189 primary-school-aged daughters (4-12 years) (n = 344) were randomly allocated to the intervention (78 fathers, 95 daughters) or waitlist-control (77 fathers, 94 daughters) groups. Trained facilitators delivered the 9-week DADEE program (weekly sessions plus home-based tasks). Primary outcomes were fathers' and daughters' physical activity (steps/day). Secondary outcomes included screen-time, weight status, daughters' fundamental movement skill (FMS) proficiency, perceived sports competence, and fathers' parenting practices. Effects were assessed using linear mixed models. Results: Primary outcome follow-up data were collected from 88% of fathers and 89% of daughters. Significant group-by-time differences in mean daily steps were found for fathers' (adjusted difference = +1,638; 95% CI: 833, 2,443, d = 0.7) and daughters' (adjusted difference = +1,023 steps/day; 95% CI: 259, 1,787; d = 0.4) physical activity. Significant effects were observed for daughters' screen-time, FMS, and some parenting practices. No significant effects were identified for weight status, or fathers'screen-time or self-reported MVPA. Program attendance, satisfaction and fidelity were very high. Conclusion: This study established the effectiveness of the DADEE intervention when delivered in community settings by trained facilitators. Importantly, the findings were comparable to those of the efficacy RCT delivered by the research team. To maximize public health benefits, a larger-scale dissemination of the program appears warranted. Trial Registration Australian New Zealand Clinical Trial Registry: ACTRN12616001270404 Human Research Ethics Committee: H-2014-0330

Background: The effect of fathers on dietary intake in preschool-aged children is under-explored. The aims were to: (i) evaluate the efficacy of a family-based lifestyle intervention, Healthy Youngsters, Healthy Dads, on change in dietary intake in fathers and their preschool-aged children post-intervention (10 weeks) and at 9 months follow-up compared to a waitlist control group and (ii) investigate associations in father¿child dietary intakes. Methods: Linear mixed models estimated group-by-time effects for all dietary outcomes, measured by food frequency questionnaires. Cohen¿s d determined effect sizes, while correlation tests determined associations in father¿child dietary intakes. Results: For children, medium group-by-time effects sizes were identified at 10 weeks for sodium intake (d = 0.38) and percentage energy from core foods (d = 0.43), energy-dense, nutrient-poor (EDNP) foods (d = 0.43) and prepacked snacks (d = 0.45). These findings were sustained at 9 months follow-up. For fathers, medium to large, group-by-time effect sizes were identified at 10 weeks for energy intake (d = 0.55), sodium intake (d = 0.64) and percentage energy from core foods (d = 0.49), EDNP foods (d = 0.49), and confectionary (d = 0.36). For all of these dietary variables, except sodium, effects were sustained at 9 months. Moderate to strong associations existed in father¿child dietary intakes for some of the dietary variables. Conclusions: Although further research is required, this study provides preliminary support for targeting fathers as agents of change to improve dietary intakes in their preschool-aged children.

Most family-based physical activity interventions have been modestly successful and failed to engage fathers. Also, program impact on family functioning and psychosocial outcomes are rarely measured. We explored the impact of an innovative father¿daughter physical activity program on family functioning and psychosocial outcomes for girls using qualitative methods. Of the 115 fathers who participated in the ¿Dads And Daughters Exercising and Empowered¿ (DADEE) pilot study, a random sample (stratified by baseline physical activity status) of 23 fathers (mean (SD) age: 41.4 (4.8) years) participated in semi-structured telephone interviews. Audio recordings were transcribed and analyzed by an independent researcher using a mixed inductive and deductive thematic approach. Seven themes were identified highlighting improvements in: (i) daughters¿ social-emotional well-being, (ii) father involvement and engagement with their daughter, (iii) fathers¿ parenting skills, (iv) the father¿daughter relationship, (v) co-parenting, (vi) family relationship dynamics, and (vii) knowledge and understanding of gender stereotypes and gender bias. A number of strategies were also identified as to how the program improved these outcomes. Engaging fathers and daughters in physical activity programs may have substantive benefits for daughters¿ mental health as well as broader outcomes for fathers and families. Enhancing fathers¿ and daughters¿ knowledge and skills through evidence-based strategies may be a useful approach to optimize the well-being of families.

Objective: To increase girls' well-being, strategies are needed to optimize their social-emotional competence during childhood. Although positive fathering is important for girls, many fathers discount their unique influence and few participate in interventions. The Dads And Daughters Exercising and Empowered (DADEE) program was developed to engage fathers and their daughters through shared physical activity experiences. This study examined the program's impact on girls' well-being and the father-daughter relationship. Method: Overall, 115 fathers (age range: 29-53 years) and 153 daughters (age range: 4-12 years) were randomized to (1) the DADEE program (9 weekly educational and practical sessions plus home-based challenges) or (2) a wait-list control. Assessments were baseline, 2 months (postintervention), and 9 months (94% retention). Daughters' social-emotional well-being was measured with the Devereux Student Strengths Assessment composite. Secondary outcomes included additional well-being indicators (e.g., global self-perception) plus validated measures of father involvement and father-daughter relationship quality. Results: At 2 months, intervention daughters showed a medium-to-large improvement in overall well-being (+24.9 units, 95% CI [8.6, 41.1], d = 0.6), when compared with controls. Intervention daughters were also more likely to show clinically meaningful improvements in well-being (54%) than controls (18%). Medium-to-large effects were observed for: seven of eight social-emotional competencies (e.g., personal responsibility, d = 0.4-0.9), father-daughter relationship quality (d = 0.8, father-report; d = 0.5, daughter-report), daughters' prosocial behavior (d = 0.3) and several indicators of father involvement. Most outcomes had improved by 9 months. No effects were observed for daughters' emotional difficulties or global self-perception. Conclusions: This study provided the first experimental evidence that father-daughter physical activity programs may improve girls' well-being and the father-daughter relationship.

Background: Existing strategies to increase girls' physical activity levels have seen limited success. Fathers may influence their children's physical activity, but often spend more time with their sons and rarely participate in family-based programs. Purpose: To test a novel program designed to increase the physical activity levels of fathers and their daughters. Methods: In a two-arm RCT, 115 fathers (29-53 years) and 153 daughters (4-12 years) were randomized to (i) the "Dads And Daughters Exercising and Empowered" (DADEE) program, or (ii) a wait-list control. The 8-week program included weekly educational and practical sessions plus home tasks. Assessments were at baseline, 2 months (postintervention), and 9 months. The primary outcomes were father-daughter physical activity levels (pedometry). Secondary outcomes included screen-time, daughters' fundamental movement skill proficiency (FMS: perceived and objective), and fathers' physical activity parenting practices. Results: Primary outcome data were obtained from 88% of daughters and 90% of fathers at 9 months. Intentionto-treat analyses revealed favorable group-by-time effects for physical activity in daughters (p = .02, d = 0.4) and fathers (p < .001, d = 0.7) at postintervention, which were maintained at 9 months. At postintervention and follow-up, significant effects (p < .05) were also identified for daughters' FMS competence (objective: d = 1.1-1.2; perceived: d = 0.4-0.6), a range of fathers' physical activity parenting practices (d = 0.3-0.8), and screen-time for daughters (d = 0.5-0.8) and fathers (d = 0.4-0.6, postintervention only). Program satisfaction and attendance were very high. Conclusions: This study provided the first experimental evidence that efforts to increase physical activity behavior in preadolescent girls would benefit from a meaningful engagement of fathers.

Healthy Dads Healthy Kids (HDHK) was the first program internationally to specifically target overweight and obese fathers to improve their children's health. In previous randomized controlled trials, HDHK generated meaningful short-Term improvements in the adiposity, physical activity, and eating behaviors of both fathers and children. The aim of this dissemination trial was to evaluate the 12-month impact of HDHK when delivered by trained facilitators across four low socioeconomic and regional communities in the Hunter Region, Australia. The study was a nonrandomized, prospective trial with minimal eligibility criteria (i.e., father body mass index [BMI] ? 25 kg/m2 and children aged 4-12 years). HDHK included eight weekly practical and theoretical sessions. Assessments were baseline, 3 months (post-intervention), 6-months, and 12-months. The primary outcome was fathers' weight. Secondary outcomes included child BMI z-score and validated lifestyle behavior measures (e.g., physical activity, diet). Overall, 189 fathers (mean age: 40.2 years, BMI: 32.6 kg/m2) and 306 children (mean age: 8.1 years) participated in one of 10 HDHK programs in four areas. Intention-To-Treat linear mixed models revealed a significant mean reduction in fathers' weight at post-intervention (?3.6 kg, 95% confidence interval: ?4.3, ?2.9), which was maintained at 12 months (71% retention). Corresponding improvements were also detected in children's BMI z-score and a range of lifestyle behaviors for both fathers and children. Attendance and satisfaction levels were high. Positive intervention effects observed in previous randomized controlled trials were largely replicated and sustained for 12 months when HDHK was delivered by trained local facilitators in underserved communities. Further investigation into the key systems, processes, and contextual factors required to deliver HDHK at scale appears warranted.

Purpose: Guidelines recommend that young people engage in muscle-strengthening activities on at least 3 dIwkj1. The purpose of this study was to examine the effect of a school-based intervention focused on resistance training (RT) for adolescents. Methods: The ''Resistance Training for Teens'' intervention was evaluated using a cluster-randomized, controlled trial with 607 adolescents (50.1% girls; 14.1 T 0.5 yr) from 16 secondary schools. Teachers were trained to deliver the intervention, which included the following: (i) an interactive student seminar; (ii) a structured physical activity program, focused on RT; (iii) lunchtime fitness sessions; and (iv) Web-based smartphone apps. The primary outcome was muscular fitness (MF) and secondary outcomes included body mass index, RT skill competency, flexibility, physical activity, self-efficacy, and motivation. Assessments were conducted at baseline, 6 months (postprogram; primary end point), and 12 months (follow-up). Outcomes were assessed using linear mixed models, with three potential moderators tested using interaction terms (and subgroup analyses where appropriate). Results: For the primary outcome (MF), a group-time effect was observed at 6 months for the upper body (2.0 repetitions; 95% confidence interval (CI), 0.8-3.2), but not the lower body (j1.4 cm; 95% CI, j4.7-1.9). At 6 months, there were intervention effects for RT skill competency and self-efficacy, but no other secondary outcomes. Effects for upper body MF and RT skill competency were sustained at 12 months. Despite overall no effect for body mass index, there was a group-time effect at 12 months among students whowere overweight/obese at baseline (j0.55 kgImj2; 95% CI, j1.01 toj0.08). Conclusions: The school-based RT intervention resulted in immediate and sustained improvements in upper body MF and RT skill competency, demonstrating an effective and scalable approach to delivering RT within secondary schools.

Fundamental movement skill (FMS) proficiency is positively associated with a range of health outcomes, and is a predictor of lifelong participation in physical activities and sport. Yet low FMS proficiency levels in children prevail, particularly among girls performing object-control skills (e.g., kicking, catching). To identify where girls require the most support and inform future teaching resources and interventions, this cross-sectional study investigated proficiency levels of object-control skills and their specific performance components (subskills) in girls; and aimed to determine whether patterns in subskill mastery were evident in girls from two different developmental stages. This study included 153 girls (aged 4¿12 years; mean age = 7.7, SD = 1.8) from the Hunter Region, Australia. Six object-control skills were video-assessed using the Test of Gross Motor Development (TGMD-2, TGMD-3); overall skill proficiency levels and mastery levels of subskills were determined. In summary, <5% (of the total group, 4¿8 years or 9¿12 years) demonstrated mastery or advanced skill level in the strike, stationary dribble, overhand throw or kick. Mastery levels were also poor for the majority of the 24 subskills, with mastery levels below 40% for the total group for 17 of the 24 subskills. Deficiencies in specific subskills were evident in the preparation, action and recovery phases of the six object-control skills. Only 6 of the 24 subskills mastery levels were significantly higher in the older age-group. Our investigation provides new evidence that may be useful for practitioners and researchers looking to support the optimal development of FMS proficiency among girls. Australian New Zealand Clinical Trials Registry: ACTRN12615000022561.

Introduction The primary objective was to evaluate the impact of the ¿Switch-off 4 Healthy Minds¿ (S4HM) intervention on recreational screen-time in adolescents. Methods Cluster randomized controlled trial with study measures at baseline and 6-months (post-intervention). Eligible participants reported exceeding recreational screen-time recommendations (i.e., >¿2¿h/day). In total, 322 adolescents (mean age¿=¿14.4¿±¿0.6¿years) from eight secondary schools in New South Wales, Australia were recruited. The S4HM intervention was guided by Self-Determination Theory and included: an interactive seminar, eHealth messaging, a behavioral contract and parental newsletters. The primary outcome was recreational screen-time. Secondary outcomes included mental health (i.e., well-being, psychological distress, self-perceptions), objectively measured physical activity, and body mass index (BMI). Outcome analyses were conducted using linear mixed models and mediation was examined using a product-of-coefficients test. Results At post-intervention, significant reductions in screen-time were observed in both groups, with a greater reduction observed in the intervention group (-¿50¿min/day versus -¿29¿min, p¿<¿0.05 for both). However, the adjusted difference in change between groups was not statistically significant (mean¿=¿-¿21.3¿min/day, p¿=¿0.255). There were no significant intervention effects for mental health outcomes, physical activity or BMI. Significant mediation effects for autonomous motivation were found. Conclusions Participants in both the S4HM intervention and control groups significantly reduced their screen-time, with no group-by-time effects. Enhancing autonomous motivation might be a useful intervention target for trials aimed at reducing adolescents' recreational screen-time. Trial registration ACTRN12614000163606.

Current physical activity and fitness levels among adolescents are low, increasing the risk of chronic disease. Although the efficacy of high intensity interval training (HIIT) for improving metabolic health is now well established, it is not known if this type of activity can be effective to improve adolescent health. The primary aim of this study is to assess the effectiveness and feasibility of embedding HIIT into the school day. A 3-arm pilot randomized controlled trial was conducted in one secondary school in Newcastle, Australia. Participants (n= 65; mean age = 15.8(0.6) years) were randomized into one of three conditions: aerobic exercise program (AEP) (n = 21), resistance and aerobic exercise program (RAP) (n = 22) and control (n = 22). The 8-week intervention consisted of three HIIT sessions per week (8-10. min/session), delivered during physical education (PE) lessons or at lunchtime. Assessments were conducted at baseline and post-intervention to detect changes in cardiorespiratory fitness (multi-stage shuttle-run), muscular fitness (push-up, standing long jump tests), body composition (Body Mass Index (BMI), BMI-z scores, waist circumference) and physical activity motivation (questionnaire), by researchers blinded to treatment allocation. Intervention effects for outcomes were examined using linear mixed models, and Cohen's d effect sizes were reported. Participants in the AEP and RAP groups had moderate intervention effects for waist circumference (p = 0.024), BMI-z (p = 0.037) and BMI (not significant) in comparison to the control group. A small intervention effect was also evident for cardiorespiratory fitness in the RAP group.

Introduction: Excessive recreational screen time (i.e., screen use for entertainment) is a global public health issue associated with adverse mental and physical health outcomes. Considering the growing popularity of screen-based recreation in adolescents, there is a need to identify effective strategies for reducing screen time among adolescents. The aim of this paper is to report the rationale and study protocol for the 'Switch-off 4 Healthy Minds' (S4HM) study, an intervention designed to reduce recreational screen time among adolescents. Methods: The S4HM intervention will be evaluated using a cluster randomized controlled trial in eight secondary schools (. N=. 322 students) in New South Wales, Australia. The 6-month multi-component intervention will encourage adolescents to manage their recreational screen time using a range of evidence-based strategies. The intervention is grounded in Self-Determination Theory (SDT) and includes the following components: an interactive seminar for students, eHealth messaging, behavioral contract and parental newsletters. All outcomes will be assessed at baseline and at 6-months (i.e., immediate post-test). The primary outcome is recreational screen time measured by the Adolescent Sedentary Activity Questionnaire (ASAQ). Secondary outcomes include: self-reported psychological well-being, psychological distress, global physical self-concept, resilience, pathological video gaming and aggression, and objectively measured physical activity (accelerometry) and body mass index (BMI). Hypothesized mediators of behavior change will also be explored. Discussion: The S4HM study will involve the evaluation of an innovative, theory-driven, multi-component intervention that targets students and their parents and is designed to reduce recreational screen time in adolescents. The intervention has been designed for scalability and dissemination across Australian secondary schools.