R01NR020441

Trauma-Adapted Comprehensive School Physical Activity Program (CSPAP) - Project Summary

The COVID-19 pandemic has disproportionately negatively impacted those who experience other intersecting forms of socioeconomic disadvantage and inequity. This includes youth who identify as Black, Indigenous, or as a person of color (BIPOC), or whose families are below the poverty line. Among BIPOC youth, these stressors may be experienced in intersection with other adverse childhood experiences (ACEs), and they are also less likely to have resources to mitigate the impact of these stressors.

One key, and potentially modifiable, protective pathway to supporting youth resilience during and beyond the COVID-19 pandemic is physical activity (PA), which can support both physical and mental health. Schools are considered central to equitable promotion of PA, and the CDC recommends they adopt a Comprehensive School PA Program (CSPAP), an evidence-based framework for how to increase PA before, during, and after school. However, only about 3% of US secondary schools have PA practices that include all domains of the CSPAP framework.

CSPAP-based interventions have the most barriers to sustainability in low resource school districts that serve student populations experiencing intersecting forms of socioeconomic disadvantage. There are three core reasons why existing CSPAP-based approaches are not meeting the needs of this population: youth who have experienced trauma have unique needs in PA settings, physical education teachers require training in trauma-sensitive approaches, and staffing constrains the ability of schools to implement new opportunities for PA.

There is thus a critical need to determine how to effectively support schools in low resource communities in increasing PA opportunities, with a particular emphasis on meeting the PA-related needs of youth who have experienced ACEs and trauma related to COVID-19 or otherwise. We have developed and conducted feasibility testing of a trauma-sensitive adaptation of CSPAP and are proposing a hybrid type I implementation-effectiveness trial of this trauma-adapted CSPAP using a stepped-wedge design to compare schools when they are in the intervention versus control phases.

We hypothesize that this intervention will increase PA opportunities for students, and they will engage in significantly more (accelerometer-measured) physical activity, demonstrate greater gains in fitness/physical literacy, and report better psychosocial functioning during the intervention phase versus the control phase. We will also examine differential effects of all student-level outcomes by race/ethnicity, family socioeconomic status, and gender.

Using a mixed-methods approach, we will explore systems-level barriers and facilitators to successful implementation and maintenance so as to inform continued intervention improvement, sustainability, and scalability. This project would inform best practices related to school-centered promotion of youth PA with the goal of decreasing inequities in youth PA opportunities, health, and well-being that is both scalable and has applicability beyond a pandemic.

Seattle Children's Hospital

NURSES UNDERSTAND THAT IMPROVING HEALTH AND WELL-BEING MEANS ADDRESSING PEOPLE'S NEEDS IN MULTIPLE SETTINGS, CONTEXTS, AND OVER THE WHOLE LIFE COURSE. SCIENCE SUPPORTED BY THE NATIONAL INSTITUTE OF NURSING RESEARCH (NINR) USES THIS HOLISTIC PERSPECTIVE TO IMPROVE INDIVIDUAL AND POPULATION HEALTH AND ADVANCE HEALTH EQUITY. NINR-SUPPORTED RESEARCH PROMOTES HEALTH AND WELL-BEING BY ADDRESSING NEEDS AT MULTIPLE LEVELS INDIVIDUAL, FAMILY, COMMUNITY, AND SOCIETAL LEVELS AND DEVELOPING TREATMENT AND PREVENTION STRATEGIES THAT ARE RESPONSIVE TO THE REALITY OF PEOPLE'S LIVES. NURSES KNOW PEOPLE, AND PEOPLE TRUST NURSES. PATIENT AND FAMILIES INTERACT WITH NURSES MORE THAN ANY OTHER CLINICIANS. NURSING SCIENCE USES THIS SPECIAL RELATIONSHIP TO BETTER UNDERSTAND PATIENTS, FAMILIES, AND COMMUNITIES AND THE MANY FACTORS THAT INFLUENCE THEIR HEALTH. NURSING SCIENCE SUPPORTED BY NINR USES THIS KNOWLEDGE TO DEVELOP STRATEGIES FOR IMPROVING HEALTH AND WELLNESS ACROSS POPULATIONS, HEALTH CARE SETTINGS, AND THE LIFESPAN, WITH AN EMPHASIS ON ACHIEVING HEALTH EQUITY. NINR-SUPPORTED SCIENTISTS HAVE DEVELOPED INTERVENTIONS FOR: SUPPORTING PARENTS OF PREMATURE INFANTS, PROMOTING HIV PREVENTION IN UNDERSERVED POPULATIONS, IMPROVING TRANSITIONAL CARE LEADING TO BETTER OUTCOMES AND COST-SAVINGS, AND HELPING INNER-CITY CHILDREN MANAGE ASTHMA. NURSING SCIENCE TRANSCENDS THE BOUNDARIES OF DISEASE AND RESEARCH DISCIPLINES TO BETTER UNDERSTAND THE EXPERIENCES OF INDIVIDUALS AND FAMILIES LIVING WITH ILLNESS AND TO DEVELOP PERSONALIZED APPROACHES THAT MAXIMIZE HEALTH AND WELL-BEING FOR INDIVIDUALS AT ALL STAGES OF LIFE, ACROSS DIVERSE POPULATIONS AND SETTINGS. NINR-SUPPORTED SCIENCE USES NURSING SCIENCE'S UNIQUE, PATIENT AND COMMUNITY-FOCUSED PERSPECTIVE AND WIDE REACH ACROSS CLINICAL AND COMMUNITY SETTINGS TO ADVANCE OUR UNDERSTANDING OF THE SOCIAL DETERMINANTS OF HEALTH: THOSE FACTORS THAT ARE AT THE ROOT OF THE INEQUITIES THAT WE SEE, SUCH AS FOOD INSECURITY AND ACCESS TO HEALTHCARE. NINR RESEARCH EFFORTS IN WELLNESS INVESTIGATE THE KEY BIOLOGICAL, BEHAVIORAL, AND SOCIAL FACTORS THAT PROMOTE LONG-TERM HEALTH AND HEALTHY BEHAVIORS AND PREVENT THE DEVELOPMENT OF ILLNESS ACROSS HEALTH CONDITIONS, SETTINGS, AND THE LIFESPAN. RESEARCH IN WELLNESS IS ALSO FOCUSED ON DEVELOPING AND TESTING CULTURALLY APPROPRIATE INTERVENTIONS TO PROMOTE HEALTH AND PREVENT ILLNESS IN MINORITY AND UNDERSERVED GROUPS. NINR ALSO SUPPORTS SCIENCE TO ASSIST INDIVIDUALS, FAMILIES, AND HEALTH CARE PROFESSIONALS IN MANAGING ADVANCED, SERIOUS ILLNESS, AND PLANNING FOR END-OF-LIFE DECISIONS. IN ADDITION, NINR PROMOTES TECHNOLOGICAL ADVANCEMENTS THAT ADDRESS A RANGE OF HEALTH CARE CHALLENGES AND FACILITATE THE DELIVERY OF REAL-TIME PERSONALIZED INFORMATION TO INDIVIDUALS AND FAMILIES, HEALTH CARE PROVIDERS, AND COMMUNITIES. FINALLY, NINR HAS A LONGSTANDING AND CONTINUING COMMITMENT TO DEVELOPING THE NEXT GENERATION OF NURSE SCIENTISTS: THOSE INDIVIDUALS AND TEAM MEMBERS WHO WILL CARRY THE FIELD OF NURSING SCIENCE INTO THE FUTURE. IN ORDER TO PREPARE AN INNOVATIVE, DIVERSE, AND TALENTED NEXT GENERATION OF NURSE SCIENTISTS, NINR SUPPORTS A VARIETY OF TRAINING OPPORTUNITIES FOR SCIENTISTS AND TRAINEES AT ALL CAREER LEVELS, PARTICULARLY THOSE AT AN EARLY CAREER STAGE WHO ARE SO CRITICAL TO SUSTAINING THE FUTURE OF INNOVATIVE RESEARCH AND HIGH QUALITY HEALTH CARE.

93.361 - Nursing Research

National Institute of Nursing Research (NINR) [HHS - NIH]

Seattle, Washington 981011425 United States

Single Zip Code

Community Interventions to Address the Consequences of the COVID-19 Pandemic among Health Disparity and Vulnerable Populations (R01- Clinical Trial Optional) (PAR-20-237)

Amendment Since initial award the total obligations have increased 340% from $838,913 to $3,695,310.