Trauma-adapted Comprehensive School Physical Activity Program (CSPAP)

项目摘要 迄今为止，COVID-19大流行对那些经历其他疾病的人产生了不成比例的负面影响。 交叉形式的社会经济劣势和不平等，包括自认为是黑人的青年， 土著人或有色人种（BIPOC），或其家庭低于贫困线。BIPOC之间 这些压力源可能与其他不良童年经历（ACE）交叉， 他们也不太可能有资源来减轻这些压力因素的影响。一把钥匙， 在2019冠状病毒病期间及之后， 大流行病是体力活动（PA），它可以支持身心健康。学校被认为 中央公平促进PA和疾病预防控制中心建议他们采用综合学校PA 计划（CSPAP），一个以证据为基础的框架，如何增加PA之前，期间和之后的学校; 然而，只有大约3%的美国中学有包括CSPAP所有领域的PA实践 框架.在资源匮乏的学区，基于社区战略和行动计划的干预措施在可持续性方面面临的障碍最大 服务于那些经历交叉形式的社会经济劣势的学生群体。有 现有的基于《社区战略和行动计划》的办法不能满足这一群体的需要的三个核心原因： 经历过创伤的人在PA环境中有独特的需求，（2）体育教师需要 培训创伤敏感的方法和（3）人员配备限制了学校实施新的 机会PA。因此，迫切需要确定如何有效地支持低收入学校， 资源社区在增加PA机会，特别强调满足PA相关 需要经历过ACE和与COVID-19或其他有关的创伤的年轻人。我们有 开发并进行了CSPAP创伤敏感适应的可行性测试，并提出了一个 采用阶梯楔形设计的创伤适应性CSPAP的混合I型实施有效性试验 比较学校在干预阶段和控制阶段的情况。我们假设这 干预将增加学生的PA机会，他们将参与更多 （加速度计测量）身体活动，表现出更大的健身/体育素养的收益，并报告 更好的心理社会功能，在干预阶段与控制阶段。我们亦会研究 按种族/民族、家庭社会经济地位和性别对所有学生水平成果的不同影响。 使用混合方法的方法，我们将探讨系统级的障碍和促进因素，以成功地 实施和维护，以便为持续的干预改进、可持续性和 可伸缩性该项目将为以学校为中心的促进青年PA的最佳做法提供信息， 减少青年PA机会、健康和福祉方面的不平等的目标， 适用范围超越流行病。

PROJECT SUMMARY The COVID-19 pandemic has to-date disproportionately negatively impacted those that experience other intersecting forms of socioeconomic disadvantage and inequity, including 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 that experience intersecting forms of socioeconomic disadvantage. There are three core reasons that existing CSPAP-based approaches are not meeting the needs of this population: youth who have experienced trauma have unique needs in PA settings, (2) physical education teachers require training in trauma-sensitive approaches and (3) 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.