Evidence-based Referral: Effects of the Revised Youth Fit 4 Life Protocol on Physical Activity Outputs

James J. Annesi, Kennesaw State University
Linda L. Vaughn, YMCA of Metropolitan Atlanta


Background: Lack of physical activity is prevalent in youths. Pediatricians seek referrals to reliably increase outputs, especially in their overweight and underactive patients. Objective: Within a randomized controlled trial, we contrasted 2 physical activity/nutrition treatments on the basis of social cognitive and self-efficacy theory, and a comparison condition, on time in moderate-to-vigorous physical activity (MVPA) during the 45-min/day physical activity segment of elementary afterschool care. Methods: In youths ranging in age from 9 to 12 years (9.7 ± 0.8 years, overall), the Original Youth Fit For Life treatment (Original YFFL; n = 49), the Revised Youth Fit 4 Life treatment (Revised YF4L, n = 43), and a comparison condition of typical care (Comparison, n = 46) were contrasted using a 3 (groups) × 2 (sexes) analysis of variance incorporating means of 3 accelerometer measurements over 12 weeks. Results: There was a significantly greater amount of time in MVPA in the Revised YF4L group than either the Original YFFL or Comparison groups (F2, 132 = 281.20, p < 0.001). Boys completed significantly more time in MVPA than girls (F2, 132 = 16.43, p < 0.001); however, there was not a significant group × sex interaction. Supplementary analyses indicated sedentary time was significantly less by 29% in the Revised YF4L when contrasted with the Comparison group. Conclusion: The Revised YF4L protocol that sought to maximize participants' cardiovascular physical activity appeared to improve upon the Original YFFL treatment on time in MVPA. Thus, pediatricians might have confidence in referring their patients to such evidence-based approaches. Future research should also evaluate the effects of YF4L on psychosocial predictors of physical activity and change in body mass index.