Trauma-adapted Comprehensive School Physical Activity Program (CSPAP)

项目总结 到目前为止，新冠肺炎大流行对那些经历了其他 社会经济劣势和不平等的交叉形式，包括认为自己是黑人的年轻人， 土著或有色人种(BIPOC)，或其家庭处于贫困线以下。在BIPOC中 对于青少年来说，这些压力源可能与其他不利的童年经历(ACE)相交， 而且他们也不太可能有资源来缓解这些压力源的影响。一键，和 支持青年在新冠肺炎内外的复原力的潜在可修改的保护性途径 大流行是指体力活动(PA)，它可以支持身体和心理健康。学校被认为是 对公平促进PA至关重要，疾控中心建议他们采用综合学校PA 项目(CSPAP)，一个循证框架，说明如何在放学前、放学期间和放学后增加PA； 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。以CSPAP为基础的干预措施在低资源学区的可持续性方面障碍最大 为经历交错形式的社会经济劣势的学生群体服务。确实有 现有的基于CSPAP的方法不能满足这一群体的需求的三个核心原因：青年 经历过创伤的人在PA环境中有独特的需求，(2)体育教师要求 对创伤敏感方法的培训和(3)人员配置限制了学校实施新方法的能力 PA的机遇。因此，迫切需要确定如何有效地支持低收入地区的学校 资源社区在增加PA机会方面的作用，特别强调满足与PA相关的 经历过王牌和新冠肺炎相关或其他创伤的青年的需求。我们有 开发并进行了对创伤敏感的CSPAP适应的可行性测试，并正在提议 使用阶梯楔形设计的创伤适应CSPAP的混合类型I实施-有效性试验 以比较处于干预和控制阶段的学校。我们假设这是 干预将增加学生参与PA的机会，他们将显著更多地参与 (加速计测量的)体力活动，显示在健康/身体素养方面有更大的进步，并报告 在干预阶段比控制阶段有更好的心理社会功能。我们还将检查 所有学生水平的结果因种族/民族、家庭社会经济地位和性别的不同而不同。 使用混合方法，我们将探索系统级别的障碍和促进者，以实现成功 实施和维护，以便为持续的干预改进、可持续性和 可扩展性。该项目将向以学校为中心的青年权力机构促进的最佳做法提供信息 减少青年不平等的目标PA的机会、健康和福祉既可扩展，又有 超越大流行的适用性。

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.