Expanded And Enhanced Gta 5 Pc
Teodolinda Mattson
The utility of these mechanisms, referred to as the Theory of Expanded, Extended, and Enhanced Opportunities (TEO), is demonstrated in their parsimony, logical appeal, support with empirical evidence, and the direct and immediate application to numerous settings and contexts. The TEO offers a new way to understand youth physical activity behaviors and provides a common taxonomy by which interventionists can identify appropriate targets for interventions across different settings and contexts. We believe the formalization of the TEO concepts will propel them to the forefront in the design of future intervention studies and through their use, lead to a greater impact on youth activity behaviors than what has been demonstrated in previous studies.
The value-added contribution of formalizing these mechanisms within a theoretical framework is that it provides (a) a unifying language by which the scientific field can refer to approaches that are nested within each of the three mechanisms, (b) a structure for the proposal of a priori hypotheses associated with the mechanisms that can be formally tested within empirical studies, and (c) clear explanations of what mechanisms (i.e., expanded, extended, and enhanced) are logically related to the phenomenon of interest (in this case youth physical activity) and how they are casually related. For the purpose of this article, we draw upon the criteria of what constitutes a theory proposed by Kuhn [32], Dubin [33], Wacker [34, 35], and others [36, 37] to establish the overarching theoretical foundation for the TEO. Broadly, the criteria include operational definitions, domain specificity, set of relationships, and specific predictions [35]. Importantly, theory should be pragmatic, closely linked with practice, parsimonious, and offer an understanding to previously unnoted relationships [31, 33, 35, 38]. Further, any new theory should offer a conceptually distinct set of new relationships which should serve to bridge the gap among existing theories [36]. The following sections present evidence of the utility of the TEO and demonstrate its contribution to the theoretical repertoire behavioral and social scientists can draw from in the design of theory-driven interventions.
The following section presents examples drawn from the empirical literature to illustrate the casual relationships among expansion, extension, and enhancement with changes in physical activity within youth physical activity interventions. Evidence is drawn from both observational and experimental studies to support that, either singularly or in combination, expansion, extension, and enhancement have a substantial impact on youth physical activity. A basic assumption (and testable hypothesis) underlying the TEO is that the presence of new activity opportunities (i.e., extension), the elongation of existing activity opportunities (i.e., expansion), and/or the modification of existing activity opportunities to make them more active (i.e., enhancement) will lead to increased physical activity of youth who come into contact with these opportunities. The empirical evidence presented is not intended to serve as an exhaustive review of all published studies applying/investigating one or more of these mechanisms. Rather, examples have been identified to illustrate how these mechanisms theoretically operate in observational research and function to increase youth physical activity in experimental research.
In several studies, extension has been incorporated along with another, most commonly enhancement. One of the earliest examples incorporating extension and enhancement comes from the SPARK PE group randomized control trial conducted by Sallis et al. [54, 55]. The intervention focused on providing more PE sessions per week (38 min of PE per week for control schools vs. 65 and 80 min per week for the intervention schools) as well as enhancing the delivery of PE through teacher professional development training focused on maximizing activity during scheduled PE classes. The authors found that children attending schools with the most PE minutes scheduled per week accumulated the greatest amount of MVPA per week (40.2 min per week) compared to schools with the least amount of PE scheduled per week (17.8 min per week, see Fig. 5). The comparison among conditions regarding enhancements was less dramatic, with professional development leading to approximately 50% of class time spent in MVPA, compared to 47% in classes without the enhancement. Had the control schools offered PE at the same rate as the intervention schools (3 days per week), children would have accumulated 37.6 min of MVPA per week (47% of 80 min for PE) compared to the 40 min of MVPA per week accumulated in the intervention schools. It is important to highlight that comparisons of MVPA across conditions were all made at a weekly level. Furthermore, no baseline data were presented in the original study, thus it is difficult to determine the extent of change that occurred as a result of implementing the intervention.
Although there is considerable evidence supporting that the appropriate use of the TEO leads to increases in youth physical activity, there are a number of considerations that require attention from intervention scientists, practitioners, and policy makers when incorporating them effectively within an intervention to promote youth activity. These considerations are discussed below.
The TEO targets various levels within an ecological model, thereby necessitating different intervention strategies depending on which mechanism is used. For instance, using extension (either to elongate time for a physical activity opportunity or to add additional days during the week that a physical activity opportunity occurs) requires decisions to be made by individuals other than the youth who ultimately participate in and benefit from these opportunities. These decision makers, who could be school administrators or those who oversee program operations, would need to decide whether adding more time for an existing physical activity opportunity would be beneficial, and most importantly, what existing sedentary time this extended opportunity would replace. In terms of school-based interventions, adding more time for PE or recess would be a policy-related decision and come at the cost of reduced time for other, presumably higher priority areas, such as English and Math. Thus, while allocating more time for existing physical activity opportunities like PE and recess have consistent observational and experimental support for increasing youth physical activity, the focus of the intervention should shift from children and adolescents as decision-makers to those who govern the settings or policies the intervention is hoping to alter and how one can get them to extend physical activity opportunities for youth.
An important question that has yet to be fully answered is whether expanding, extending, and/or enhancing PA opportunities in one setting are offset by decreases in activity in another. In the KISS study [87], increases in MVPA were reported during the school day for the intervention schools, yet total daily MVPA was identical from baseline to post-assessment (see Fig. 6). Moller et al. [86] examined 4.5 h per week of PE vs. 90 min per week and showed similar results to the KISS study. In-school estimates of MVPA favored schools with extended PE, but overall daily MVPA levels were identical between groups.
Prior studies suggest youth do not lower their activity levels in one setting when provided with more physical activity opportunities and volume of activity in another [100, 101]. However, other recent studies suggest youth with high amounts of activity on one day compensate by lowering their activity on a subsequent day [102]. Further, some studies suggest there is an activitystat, that hypothesizes children decrease their physical activity in some parts of the day to offset increases in physical activity during other parts of the day, which helps them to maintain a constant level of daily physical activity [101]. It is important to note that most of the studies testing the activitystat hypotheses have been cross-sectional. Although a definitive answer to this is unavailable and further experimental evidence is needed, the evidence from several interventions suggests that targeting increases in physical activity in one setting may not lead to overall improvements in youth activity levels [86, 87].
Issues of implementation also relate to monetary costs associated with selecting an approach within one of the three mechanisms. Training classroom teachers to deliver physical activity breaks with fidelity, purchasing equipment or materials, and conducting follow-up visits and trainings may be more costly from an intervention delivery standpoint than working with school or district-level officials to alter school schedules to include additional physical activity opportunities [109]. Thus, while practicality is limited using extension compared to expansion, the overall cost of delivery of extension may be substantially reduced given the targeted level of the intervention as well as a potentially higher level of implementation.
While evidence has been presented on the utility of enhancing, extending, and expanding physical activity opportunities, when improperly used or embedded within larger intervention frameworks, they can be ineffective. Hence, not all studies that incorporate one or more of these have been successful. How and where they are applied is, therefore, critical for success. Studies that expand opportunities outside of the regular school day report problems with attendance, but youth who do attend the program are more active than on non-attendance or non-program days. Approaches embedded within a compulsory environment (e.g., infusing PA into academic classrooms, enhancing required PE classes, making improvements to the playground for recess) impact all youth to increase their physical activity but issues arise with whether those in charge (e.g., school principals, after school program directors) are willing to reallocate time in a schedule to increase opportunities for youth to be active. Interventions need to be designed with these considerations in mind.
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