Trauma-adapted Comprehensive School Physical Activity Program (CSPAP)

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.