***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Background Underst and ing the correlates of dietary intake is necessary in order to effectively promote healthy dietary behavior among children and adolescents . A literature review was conducted on the correlates of the following categories of dietary intake in children and adolescents :  Fruit , Juice and Vegetable Consumption , Fat in Diet , Total Energy Intake , Sugar Snacking , Sweetened Beverage Consumption , Dietary Fiber , Other Healthy Dietary Consumption , and Other Less Healthy Dietary Consumption in children and adolescents . Methods Cross-sectional and prospect i ve studies were identified from PubMed , PsycINFO and PsycArticles by using a combination of search terms . Quantitative research examining determinants of dietary intake among children and adolescents aged 3–18 years were included . The selection and review process yielded information on country , study design , population , instrument used for measuring intake , and quality of research study . Results Seventy-seven articles were included . Many potential correlates have been studied among children and adolescents . However , for many hypothesized correlates substantial evidence is lacking due to a dearth of research . The correlates best supported by the literature are : perceived modeling , dietary intentions , norms , liking and preferences . Perceived modeling and dietary intentions have the most consistent and positive associations with eating behavior . Norms , liking , and preferences were also consistently and positively related to eating behavior in children and adolescents . Availability , knowledge , outcome expectations , self-efficacy and social support did not show consistent relationships across dietary outcomes . Conclusion This review examined the correlates of various dietary intake ; Fruit , Juice and Vegetable Consumption , Fat in Diet , Total Energy Intake , Sugar Snacking , Sweetened Beverage Consumption , Dietary Fiber , Other Healthy Dietary Consumption , and Other Less Healthy Dietary Consumption in cross-sectional and prospect i ve studies for children and adolescents . The correlates most consistently supported by evidence were perceived modeling , dietary intentions , norms , liking and preferences . More prospect i ve studies on the psychosocial determinants of eating behavior using broader theoretical perspectives should be examined in future research OBJECTIVE To evaluate the feasibility , acceptability , and efficacy of an after-school team sports program for reducing weight gain in low-income overweight children . DESIGN Six-month , 2-arm , parallel-group , pilot r and omized controlled trial . SETTING Low-income , racial/ethnic minority community . PARTICIPANTS Twenty-one children in grade s 4 and 5 with a body mass index at or above the 85th percentile . INTERVENTIONS The treatment intervention consisted of an after-school soccer program . The " active placebo " control intervention consisted of an after-school health education program . MAIN OUTCOME MEASURES Implementation , acceptability , body mass index , physical activity measured using accelerometers , reported television and other screen time , self-esteem , depressive symptoms , and weight concerns . RESULTS All 21 children completed the study . Compared with children receiving health education , children in the soccer group had significant decreases in body mass index z scores at 3 and 6 months and significant increases in total daily , moderate , and vigorous physical activity at 3 months . CONCLUSION An after-school team soccer program for overweight children can be a feasible , acceptable , and efficacious intervention for weight control BACKGROUND Policies to require  afterschool programs ( ASPs , 3 PM to 6 PM ) to provide children a minimum of 30 minutes of moderate-to-vigorous physical activity ( MVPA ) exist . With few low-cost , easy-to-use measures of MVPA available to the general public , ASP providers are limited in their ability to track progress toward achieving this policy- goal . Pedometers may fill this gap , yet there are no step-count guidelines for ASPs linked to 30 minutes of MVPA . METHODS  Steps and accelerometer estimates of MVPA  were collected concurrently over multiple days on 245 children ( 8.2 years , 48 % boys , BMI -percentile 68.2 ) attending 3 community-based ASPs . R and om intercept logit models and receiver operating characteristic ( ROC ) analyses were used to identify a threshold of steps that corresponded with attaining 30 minutes of MVPA . RESULTS Children accumulated an average of 2876 steps ( st and ard error [ SE ] 79 ) and 16.1 minutes ( SE0.5 ) of MVPA over 111 minutes ( SE1.3 ) during the ASP . A threshold of 4600 steps provided high specificity ( 0.967 ) and adequate sensitivity ( 0.646 ) for discriminating children who achieved the 30 minutes of MVPA ; 93 % of the children were correctly classified . The total area under the curve was 0.919 . Children accumulating 4600 steps were 25times more likely to accumulate 30 minutes of MVPA . CONCLUSIONS This step threshold will provide ASP leaders with an objective , low-cost , easy-to-use tool to monitor progress toward policy-related goals PURPOSE This intervention compares the effectiveness of daily step count targets with time-based prescription for increasing the health-related physical activity of low-active adolescent girls . METHODS We assigned participants ( N = 85 , mean age 15.8 + /- 0.8 yr ) depending on school attended to a control ( CON ) , pedometer ( PED ) , or minutes ( MIN ) group . The intervention groups were involved in a 12-wk physical activity self-monitoring and educative program . The only difference between the intervention groups was that the PED group set daily step count targets whereas the MIN group set daily time-based goals for physical activity involvement . Pre- , mid- , and postintervention changes in physical activity ( 4-d blinded step count and 3-d physical activity recall ) and body mass index ( BMI ) were assessed using a series of 3 ( group assignment ) x 3 ( time ) ANOVA . Where significant interactions were found , separate follow-up simple main effects tests were used . RESULTS At postintervention , only the PED group had significantly increased their total activity as measured by a 4-d step count , when compared with the control ( P = 0.03 , ES = 0.13 ) . The group , time , and interaction effects for 4-d step count were significant , indicating that although both the participants in the PED and the MIN groups significantly increased their step count across the 12-wk intervention ( P = 0.00 - 0.01 ) , the participants in the PED group had a greater increase at the midintervention time point ( P = 0.04 , ES = 0.10 ) . No pre- , mid- , or postintervention changes were reported in any group for BMI ( F = 1.18 , P = 0.32 ) . CONCLUSION The use of pedometers and daily step count targets with low-active adolescent girls may result in short-term ( 6 wk ) enhanced physical activity related outcomes when compared with traditional time-based physical activity prescriptions . However , both interventions appear to result in similar improvements in physical activity when duration of the observation is extended to 12 wk PURPOSE This study evaluated the effects of a classroom-based physical activity program on  children 's in-school physical activity levels  and on-task behavior during academic instruction . METHODS Physical activity of 243 students was assessed during school hours . Intervention-group students ( N = 135 ) received a classroom-based program ( i.e. , Energizers ) . The control group ( N = 108 ) did not receive Energizers .  On-task behavior during academic instruction time was observed for 62 third- grade ( N = 37 ) and fourth- grade students ( N = 25 ) before and after Energizers activities . An independent groups t-test compared in-school physical activity levels between intervention and control classes . A multiple-baseline across-classrooms design was used to evaluate the effectiveness of the Energizers on on-task behavior . Additionally , a two-way ( time [ pre- vs postobservation ] x period [ baseline vs intervention ] ) repeated- measures analysis of variance compared on-task behavior between observation periods . Magnitudes of mean differences were evaluated with Cohen 's delta ( ES ) . RESULTS Students in the intervention group took significantly ( P < 0.05 ) more in-school steps ( 5587 + /- 1633 ) than control-group students ( 4805 + /- 1543 ) , and the size of this difference was moderate ( ES = 0.49 ) . The intervention was effective in improving on-task behavior ; after the Energizers were systematic ally implemented , on-task behavior systematic ally improved . The improvement in on-task behavior of 8 % between the pre-Energizers and post-Energizers observations was statistically significant ( P < 0.017 ) , and the difference was moderate ( ES = 0.60 ) . Likewise , the least on-task students improved on-task behavior by 20 % after Energizers activities . This improvement was statistically significant ( P < 0.001 ) and meaningful ( ES = 2.20 ) . CONCLUSION A classroom-based physical activity program was effective for increasing daily in-school physical activity and improving on-task behavior during academic instruction BACKGROUND Policies now recommend afterschool programs ( ASP , 3 - 6 pm ) provide children a minimum amount of physical activity daily . We examined the extent to which children attending ASPs meet existing national and state-level policies that specify expected levels of physical activity ( PA ) . METHODS Accelerometer-derived physical activity ( light and moderate-to-vigorous , MVPA ) of 253 children ( 5 - 13 years ) was compared to policies that recommend varying amounts of PA children should achieve during an ASP . RESULTS The proportion of children achieving a policy ranged from 0.0 % ( California 60 min MVPA and North Carolina 20 % of daily program time devoted to MVPA ) , 1.2 % ( California 30 min MVPA ) , to 48.2 % ( National Afterschool Association 30 min light plus MVPA ) . R and om effects logistic models indicated boys ( odds ratio [ OR ] range 2.0 to 6.27 ) and children from a minority background ( Black/Hispanic , OR range 1.87 to 3.98 ) were more likely to achieve a recommended level of physical activity , in comparison to girls and White children . Neither age nor BMI were related to achieving a policy . CONCLUSIONS The PA of children attending ASP falls below policy recommended levels ; however , these policies were developed in absence of data on expected PA levels during ASPs . Thus , concerted effort towards building a stronger ASP evidence -base for policy refinement is required BACKGROUND Substantial differences exist in how and where physical education ( PE ) is conducted in elementary schools throughout the United States . Few effectiveness studies of large-scale interventions to improve PE have been reported . DESIGN Multicenter r and omized trial . SETTING / PARTICIPANTS The Child and Adolescent Trial for Cardiovascular Health ( CATCH ) was implemented in PE classes in 96 schools ( 56 intervention , 40 control ) in four study centers : California , Louisiana , Minnesota , and Texas . INTERVENTION The 2.5-year PE intervention consisted of professional development sessions , curricula , and follow-up consultations . MAIN OUTCOME MEASURES Intervention effects on student physical activity and lesson context in PE were examined by  teacher type  ( PE specialists and classroom teachers ) and lesson location ( indoors and outdoors ) . RESULTS Differential effects by teacher type and lesson location were evidence d for both physical activity and lesson context . Observations of 2016 lessons showed that intervention schools provided more moderate-to-vigorous physical activity ( p=0.002 ) and vigorous physical activity ( p=0.02 ) than controls . Classroom teachers  improved physical activity relatively more than PE specialists , but PE specialists still provided longer lessons and more physical activity .  Classroom teachers  increased lesson length ( p=0.02 ) and time for physical fitness ( p=0.03 ) . CONCLUSIONS The intervention improved PE of both specialists ' and classroom teachers ' lessons . States and districts should ensure that the most qualified staff teaches PE . Interventions need to be tailored to meet local needs and conditions , including teacher type and location of lessons PURPOSE School physical education ( PE ) is highly recommended as a means of promoting physical activity , and r and omized studies of health-related PE interventions in middle schools have not been reported . We developed , implemented , and assessed an intervention to increase physical activity  during middle-school PE classes . METHODS Twenty-four middle schools ( approximately 25,000 students , 45 % nonwhite ) in Southern California participated in a r and omized trial . Schools were assigned to intervention ( N = 12 ) or control ( N = 12 ) conditions , and school was the unit of analysis . A major component of the intervention was a 2-yr PE program , which consisted of curricular material s , staff development , and on-site follow-up . Control schools continued usual programs . Student activity and lesson context were observed in 1849 PE lessons using a vali date d instrument during baseline and intervention years 1 and 2 . RESULTS The intervention significantly ( P = 0.02 ) improved student moderate to vigorous physical activity ( MVPA ) in PE , by approximately 3 min per lesson . Effects were cumulative ; by year 2 intervention schools increased MVPA by 18 % . Effect sizes were greater for boys ( d = 0.98 ; large ) than girls ( d = 0.68 ; medium ) . CONCLUSIONS A st and ardized program increased MVPA in middle schools without requiring an increase in frequency or duration of PE lessons . Program components were well received by teachers and have the potential for generalization to other schools . Additional strategies may be needed for girls OBJECTIVES This study evaluated a health-related physical education program for fourth- and fifth- grade students design ed to increase physical activity during physical education classes and outside of school . METHODS Seven 
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These elements were distilled into 5 primary categories and conceptually referred to as the 5 Ms : mission-clearly defined policy/st and ards for PAaN ; motivate-providing choices , developmentally appropriate activities , feedback , and encouragement ; manage-structuring and managing the environment for safety , routines , and discipline ; monitor-ongoing evaluation of PAaN ; and maximize-incorporating all former Ms. CONCLUSIONS The application of this training framework should lead to improved implementation and eventual achievement of policy goals for PAaN in ASPs .