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Background The aim of this study was to translate the Canadian Assessment of Physical Literacy, second edition (CAPL-2) into Danish language, adapt it to Danish context and to test the measurement properties on a sample of Danish school children. Methods The CAPL-2 measurement tool was translated into Danish language and adapted for the Danish context. This Danish version of the CAPL-2 was then tested on 891 Danish school children from 50 classes in 12 different schools. Results Confirmatory factor analysis using the four-factor model, as suggested by the CAPL-2 original developers, showed an acceptable model fit for the Danish version (CFI = .973; TLI = .957; RMSEA = 0.040 (90% CI 0.033–0.054); SRMR = 0.040). Positive significant correlations between the domains were found. The domains as well as the total CAPL-2 score were found to be positively associated with physical education teachers’ assessment of their pupil’s in four central aspects of PL (i.e. enjoyment, confidence, motor skills, and diversity) indicating predictive validity. High internal consistency of the instrument used to measure motivation and confidence domain were found. Conclusion The translated and context-adapted Danish version of CAPL-2 is a valid and reliable measurement tool ready to use in Danish research studies.

Background Parents play a key role in young children’s physical activity and physical literacy development. Little research has explored parent-focused interventions to improve young children’s physical literacy. We examined if a theory-based, feasible physical literacy training workshop (PLAYshop) for parents could improve their physical literacy knowledge and confidence and improve parenting practices related to facilitating the physical literacy development of their preschool-aged child (3-5 years). The secondary objective was to explore implementation facilitators and barriers. Methods We conducted a pragmatic controlled trial in two Canadian cities (Edmonton and Victoria) from November 2019 – March 2020. A total of 143/151 parents were eligible and assigned to intervention (n = 71) or control group (n = 72). The PLAYshop included: (i) a 75-min in-person workshop with interactive activities and physical literacy educational messages, (ii) educational materials, (iii) an equipment pack, and (iv) two post-workshop booster emails. Surveys measured parents’ knowledge and confidence at baseline and follow-up. Application of PLAYshop concepts and implementation facilitators and barriers were explored with interviews of parents and workshop leaders. Repeated measures ANOVAs and thematic analyses were completed. Results Parents’ knowledge and confidence improved significantly over time; intervention group changes were significantly greater than control group changes (p < 0.001; ɳ2 = .32). Parents applied PLAYshop concepts at-home, including child-led play, making activities fun, and promoting child manipulative and locomotor skills. Time was a key parental implementation barrier. Program implementation issues varied by context (location and participants). Conclusions PLAYshop participation changed parents’ physical literacy knowledge and confidence and physical literacy enhancing play with their children. Implementation feasibility was high. The findings from this real-world trial highlight an efficacious and scalable intervention that warrants further testing. Trial registration ClinicalTrials.gov: NCT04394312. Registered 19/05/2020.

Background. Existing research indicates that spending time in nature is associated with diverse aspects of children’s health and wellbeing. Although fundamental to later life chances and health, no systematic reviews, to our knowledge, have focused specifically on the effects of interaction with nature on socioemotional functioning in childhood. Objectives. To summarise and assess the evidence for associations between spending time in and availability of nature and socioemotional function and development for children, we conducted a systematic review. Additionally, we provide a coherent, evidence-based framework that connects nature interaction and socioemotional development through child behaviours and states that independently show associations with both nature interaction and socioemotional function.Data sources. Embase, Environment Complete, MEDLINE, and PsycINFO. Eligible studies were backward and forward snowball-searched. Study eligibility criteria. Studies investigating effects of, or associations between, availability of or interaction with nature on socioemotional or proximal outcomes in children under the age of 12 years were included in this review. Study appraisal and synthesis methods. The internal validity of studies investigating socioemotional outcomes were based on assessments of elements of study design, conduct, and reporting to identify potential issues related to confounding or other biases. The number of analyses indicating positive, negative, and non-significant associations between availability or interaction with green space and the outcomes were summed.Results. A total of 222 eligible full-texts, of which 42 pertained to socioemotional outcomes and 180 to proximal outcomes, met eligibility criteria. Positive associations between availability of and spending time in green space were found with children’s intra- and interpersonal socioemotional function and development. Proportions of positive findings ranged from 14.5% to 50% across experimental and observational research, exposures, populations, and contexts. Modifying and mediating factors were identified. We found consistent evidence for improved aspects of cognition and, for children over six years, reduced risk of obesity and overweight in association with green space; consistent links between movement behaviours in the experimental, but not observational research; tentative trends suggesting associations with play, motor skills, language, screen time, and communication skills; little evidence for positive associations between green space and mood, physical wellbeing, and stress; some evidence for associations with healthy birth outcomes, and little evidence for direct associations between availability of green space and asthma and allergy prevalence, however, mediation via, for example, air pollution was likely.Limitations. We identified few studies without either probable or severe risk of bias in at least one item. Improved study quality may therefore result in different results. Restricting analyses to include only studies considered at low risk of bias indicated similar or slightly lower proportions of positive findings. Risk of bias in proximal outcomes was not assessed.Conclusions. The empirical evidence for benefits of availability of and interaction green space for child socioemotional function and development must currently be considered limited. A number of proximal indicators were identified. Systematic review registration number. PROSPERO ID: CRD42019135016.

Introduction: In recent years, the concept of physical literacy (PL) has gained interest worldwide. Yet, only a few interventions targeting PL exist on a global scale. A promising theory-based and nationally tested intervention, Youth-Physical Activity Towards Health (Y-PATH), has proven to be effective in improving children and adolescents’ physical activity levels and motor skills in Ireland. Aim: Using this protocol we aim to context-adapt the Irish Y-PATH into an intervention that works through the schools in Denmark and targets PL among pupils in 4th and 5th grades. Methods and analysis: We apply a stepwise approach to intervention adaptation, inspired by the Medical Research Council’s guidance for developing complex interventions as well as the ‘consensus informed guidance for adapting interventions to achieve a good fit between the intervention and context’ (ADAPT) process model and its principles and actions outlined by Graham Moore and colleagues. First, we combine evidence synthesis with stakeholders and researchers’ engagement to identify relevant and tentative adaptations and to understand barriers and enablers to the promotion of physical literacy in school-based interventions. Next, we further adjust and improve our intervention adaptation ideas by collecting detailed data through interviews with purposively sampled stakeholders and pre-pilot tests of selected prototypes of materials in a ‘real-world’ setting. Finally, we clarify the intervention adaptations – its components, materials, and content – in a discussion with purposively sampled stakeholders, and finally, we test the study design. Expected results and outcomes: A Danish version of the Y-PATH intervention, ready for feasibility testing within a Danish context, and a TIDieR intervention description checklist suitable for testing and further refinement in a feasibility study. The process will further increase our knowledge and understanding of the Danish school context as well as the teacher and pupil’s needs for an intervention promoting PL.

Background Peer-to-peer approaches are widely used in health promotion. Peer leaders are suggested to increase credibility and identification through role modelling. We suggest that to meet the rationales of peer education, peer leaders should be able to interpret and rework their delivery, based on programme rationales. This entails a need for implementation studies to compare programme theory with the realities of implementation. The purpose of this study was therefore to conceptualise a youth-led programme and to explore how peer leaders engage with the peer leader education and subsequently implement activities. Methods The case of study was the Danish street sport organisation, GAME. GAME educates and supports youth peer leaders (age 16-25) in providing life skills-based community sports activities for younger peers (age 8-15) in less advantaged neighbourhoods. A theory of change was developed in partnership with professionals from GAME to conceptualise their programme and its rationales. To study implementation, we observed three two-day peer leader education camps and 49 peer-led GAME activities focusing on specific elements of the theory of change. Results We present a theory of change to illustrate the content, rationale, expected outcomes and key assumptions of a peer-led community sport programme. We compare this conceptualisation to the implementation of peer-led activities; i.e., GAME's operationalisation of the peer leader education and peer leaders' enactment of the programme in practice, focusing on role modelling, pedagogical approaches and interactions with participating children. As expected, implementation style varied considerably across settings and thereby the ways in which delivery corresponded with the intentions described in the theory of change. Conclusions The study provided insight into how youth peer leaders in community sport interpret their role and interact with peers of relevance to peer leadership research and practice. Key messages The rationales behind peer education call for programmes that allow youth peer leaders to interpret and adjust activity implementation with an ensuing need for implementation studies. Initiatives to educate and support peer leaders should be modified based on insights into peer leaders’ interpretation and implementation of peer-led activities.

The burden of non communicable diseases is a rising global problem and the increasing inactivity seen all over the world is extremely costly to societies (Ding et al., 2016). A recent Danish evaluation on physical activity (PA) showed that a considerable number of Danish children and adolescents do not meet national PA recommendations (The Ministry of Health, 2019). Viewing this problem through a life course perspective points to the solution of making sustainable behavioural changes with children (Frohlich & Potvin, 2010). Across the life span, there is clear evidence of the health-enhancing benefits of PA (Lee et al., 2012). However, at the same time, ample empirical evidence supports that extrinsic motives for participating in PA, such as increasing health, are insufficient when long term participation is the goal. This means that prevention and health promotion interventions should not blindly target the factors and behaviours that predict adult health, such as PA, but move towards intervening on the ‘so-called’ causes of the causes such as factors enabling a physical active lifestyle throughout life. Physical literacy (PL) is a comprehensive multidimensional concept that has been identified as a ‘cause of the causes’. PL consists of dimensions that lay the foundation for an individual’s capacity and tendency for engaging in physical activities throughout life (Whitehead, 2001). In this symposium, we aim to present four research and interventions projects from the education, sport and public health sectors that have emerged in the last couple of years, and through the presentation of these projects, how we in Denmark have established a PL ecosystem between research and practice – and how our national collaboration, PL-net, has contributed to this. Program 1) Introduction to the symposium 2) Physical literacy, physical activity and wellbeing in Danish children 3) The Child-COOP Denmark study: using physical literacy to guide and evaluate a systemic approach to health promotion 4) Staying active together in sports: the importance of and how to promote the emotional domain of physical literacy 5) 3PL: Promoting pupils’ physical literacy: a pilot study testing feasibility and acceptability of the Y-PATH intervention in a Danish school setting 6) The symposium will be ended by a panel debate where it also will be possible for the participants to comment and ask questions.

IntroductionThe prevalence of mental and physical disorders amongst children and adolescents is high and is, for many disorders, on the rise. Innovative public health interventions are needed to address this. Despite the existence of multifarious health promotion and prevention interventions targeting children, adolescents, and families, few have proven effective. The family unit is considered essential for the formation of health, wellbeing, and health behaviors over the lifespan. It is especially important for interventions to target families that are socially disadvantaged considering the well-established social gradient in health and wellbeing. Unfortunately, previous interventions have had limited success. This protocol outlines the three-phased approach we plan to use to develop the intervention; 1) Synthesis and prototyping, 2) Testing and feedback, and 3) Refinements and description. The intervention will subsequently be tested, and further developed and adapted, in a feasibility study. We consider this a fourth phase although this document focuses on the formal three-phased development process.ObjectivesWe aim to carefully develop an intervention that works through established civil society platforms (i.e., Young Men's Christian Association (YMCA)’s Social Work’s (YSW) social cafes and kindergartens in Denmark) and targets both health competences and the social, relational dynamics that underlie health and wellbeing deficits within socially disadvantaged families. The process described will ensure that the intervention is based on the best available evidence, is informed by theory and practice, and increase the likelihood of acceptability amongst users, providers, commissioners, and those with community interest.Methods and AnalysisOur three-phased approach is inspired by the revised Medical Research Council (MRC) guidance for developing complex interventions and the key principles and actions for consideration described by O’Cathain et al. (1) and McQueen et al. (2). First, we will combine evidence synthesis with stakeholder and research expert engagement to develop a tentative program theory and to understand barriers and enablers to health promotion, family-based interventions amongst socially disadvantaged populations. Next, we further develop our intervention ideas and adapt our emerging program theory by collecting detailed data through interviews with purposively sampled stakeholders (i.e., users, providers, and commissioners) as well as observations and piloting of intervention components in existing YSW family groups. Finally, we test and refine our program theory, develop intervention materials, map, and clarify our intervention and its intersecting components in a discussion with purposively sampled stakeholders. OutcomeHealth-promoting, family-based intervention targeted socially disadvantaged populations; Evidence-based program theory; Intervention content and materials; TIDIER checklist suitable for testing and further refinement in a feasibility study.