Youth Fit For Life

Excess body weight in preadolescent and adolescent youth is a major predictor of early onset type II diabetes mellitus and obesity throughout the life span.  Based on CDC growth charts for the year 2000, 12% to 22% of preadolescent American youth are overweight. This represents a threefold increase over the last 25 years.  In addition to a diet high in fat and calories, lack of physical activity has been linked to the concern about weight increases in children.

Although most states mandate physical education (PE), and most elementary school youth participate in some form of PE instruction in the United States, many school systems are reducing PE requirements because of higher priorities for academics.  In most locations around the country, there is a need to supplement existing elementary school PE curricula with additional physical activity programming outside of the school environment.  Youth Fit For Life is an after-school care program of moderate-to-vigorous physical activity for preadolescent youth that incorporates a behavioral skills training curriculum, as recommended by the Department of Health and Human Services.

Youth Fit For Life is a 12-week after-school physical activity program for children aged 5-12 years (with parental/guardian consent) who are already enrolled in some form of after-school care. The program is administered by trained after-school counselors with little or no prior PE delivery experience for the widest potential dissemination in the community.  Children are prescreened through a parent/guardian consent form for any basic medical conditions that might prohibit physical activity. Program sessions are held in either a school multipurpose room or recreation area with a child-to-counselor ratio of 15:1.  Children are grouped by age, and the after-school counselors keep session attendance records.

Youth Fit For Life meets three times per week for 45-minute sessions that include physical resistance training (twice a week for 20 minutes each time) and cardiovascular exercise in the form of noncompetitive activities and cooperative games (all three times a week for 20 minutes each time). A nutrition and health education component is provided for 5 minutes at each session, centered on a weekly theme. Once a week for 20 minutes, there is training around interactive, behavioral life skills (such as goal-setting, recruiting social support, and positive self-talk) presented in a conversational group format.  A workbook (Goals for My Body in 5 Easy Steps, A Youth Fit For Life Activity Workbook, 2006) is provided to each child.  Some of the workbook activities require tasks to be continued outside of the program sessions. 

Trained assessors (individuals with PE or exercise science experience) support the trained after-school counselors by periodically attending a Youth Fit For Life session to help supervise activities and evaluate the adequacy of instruction using a standardized audit form.

To date, independent, Youth Fit For Life programs have been established at YMCA sites throughout Metro Atlanta, Georgia; Asheville, North Carolina; Rockford, Illinois; San Jose, California; and Calgary, Alberta, Canada.

The time required to implement Youth Fit For Life includes:

• A 6-hour training course for after-school counselors (formerly untrained in PE methods) and assessors with PE or exercise science experience
• A 2-hour additional training for quality assurance audits (that are administered five times during the 12-week program)
• A 2-hour additional training for the data analyst who handles the QA audit data
• Three 45-minute, after-school sessions a week for 12 weeks, for each child enrolled in the program

The program is intended for children aged 5-12 years.

Youth Fit For Life is suitable in any after-school care setting, such as the YMCA, schools, churches, and camps with a large multipurpose room, gym, or recreation area.

Materials necessary to implement Youth Fit For Life include:

• Youth Fit For Life Training Manual
• Nutrition/Health Information Packet
• Goals For My Body in 5 Easy Steps Activity Workbook
• Supplementing Physical Education Information Sheet
• Quality Assessment Form
• Poster samples as visual aids

A complete in-house training program is provided by the developer for about $10,000. This includes training of the after-school counselors (with a designated supervisor for the counselors) to provide direct delivery of the Youth Fit For Life program with additional specialized training of 2-4 assessors (with prior PE experience or exercise science background) and an identified program administrator for each site. The purchase of the Youth Fit For Life program with training generally comes through state, federal, or private grants.

A pre/post control study design compared the effects of two 12-week after-school care physical activity programs---the 2003 and 2005 Youth Fit for Life---with an unstructured activity control group in 165 children aged 9-12.  Each program met three times per week after school for 45 minutes per session across 12 weeks. The study measured the reported number of days with "voluntary" (not programmed or school PE) physical activity that made one "breathe harder than usual." The study also measured physical self-concept and exercise barriers self-efficacy. Exercise barriers self-efficacy were social, personal, and environmental reasons for not exercising or participating in moderate-to-vigorous physical activity. 

Sixty-four percent of the children were female, 70% were African American, 19% were White, and 11% represented other ethnic groups. The children's average age was 10.8 years, and the average Body Mass Index (BMI) was 19.4. The sample characteristics did not differ significantly (p>.05) among the three groups. Children were grouped by age with a child-to-counselor ratio of 15:1.

Physical self-concept was assessed by the Physical Self-Concept subscale of the Tennessee Self-Concept Scale: 2 Child Form, a 12-item, self-report scale intended for children aged 7-14. Exercise barriers self-efficacy were assessed by the Exercise Barriers Self-Efficacy Scale for Children, a 10-item self-report inventory adapted for children aged 9-12. Physical activity frequency was the number of days (0-7) a child could recall completing voluntary activity that made one "breathe harder than usual." These three outcomes were assessed for each child at week 1 (prior to starting either the Youth Fit For Life program or the control condition) and at week 12. 

• Reported days of voluntary physical activity increased from week 1 (M=2.39) to week 12 (M=3.24) in the 2003 Youth Fit For Life (p<.001) children. In the 2005 Youth Fit For Life group, the children reported the increase in voluntary physical activity from week 1 (M=2.18) to week 12 (M=3.42) (p<.001). This represents a significant increase (p<.05) from the 2003 study.  Reported days of voluntary physical activity at week 12 by children in the control group did not differ from week 1.

• Reported increases in voluntary physical activity across the 12-week Youth Fit For Life program were associated with increases in physical self-concept scores (p<.05) and with decreases in exercise barriers self-efficacy scores (p<.01 for the 2003 Youth Fit For Life group and p<.05 for the 2005 Youth Fit For Life group).
• Physical self-concept improved significantly from week 1 (M=34.22) to week 12 (M=35.38) in the 2005 Youth Fit For Life group only (p<.05).
• Exercise barriers self-efficacy improved significantly from week 1 (M=27.92) to week 12 (M=29.80) in the 2005 Youth Fit For Life group only (p<.001).
• The amount of improvements in exercise barriers self-efficacy and physical self-concept were, together, associated with the amount of increases in voluntary physical activity for both the 2003 (p<.01) and 2005 (p<.05) Youth Fit For Life groups.