title: The ACT-i-Pass study protocol: How does free access to recreation opportunities impact children's physical activity levels?
abstract: BACKGROUND
  Physical activity during childhood is associated with a multitude of physical, behavioural, and psychological health benefits. Identification of effective population level strategies for increasing children's physical activity levels is critical for improving the overall health of Canadians. The overall objective of this study is to assess how a naturally-occurring, community-level intervention which offers Grade 5 children in London, Canada a free access pass to physical activity opportunities (facilities and programs) for an entire school year can lead to increased physical activity among recipients.
  
  
  METHODS
  This study adopts a longitudinal cohort study design to assess the effectiveness of improving children's access to physical activity opportunities for increasing their physical activity levels. To meet our overall objective we have three aims: (1) to assess whether the provision of free access increases children's physical activity levels during and after the intervention compared to a control group; (2) to assess how and why child-specific trajectories of physical activity (between-children differences in level of physical activity measured across time) in the intervention group differ according to children's individual and household characteristics; and (3) to explore additional factors that are unaccounted for in the theoretical model to gain a further understanding of why the free access intervention had varying effects on changing physical activity levels. We will be addressing these aims using a mixed methods approach, including: a series of youth surveys conducted before, during, immediately after, and 4-months after the intervention; parent surveys before, during, and post-intervention; real-time tracking of the access pass use during the intervention; and focus groups at the conclusion of the intervention. Data compiled from the youth surveys will provide a subjective measure of physical activity to be used as our outcome measure to address our primary aims.
  
  
  CONCLUSIONS
  The results of this study can inform policy- and decision-makers about the sub-groups of the population that benefitted the most (or least) from the intervention to provide more specific information on how to develop and target future interventions to have a greater impact on the physical activity levels and overall health of children.
authors.affiliation: Human Environments Analysis Lab, University of Western Ontario, Social Science Centre, London, N6A 5C2, ON, Canada. heal@uwo.ca.|Children's Health Research Institute, 800 Commissioners Rd. E., London, N6C 2V5, ON, Canada. heal@uwo.ca.|Lawson Health Research Institute, 268 Grosvenor St, London, N6A 4V2, ON, Canada. heal@uwo.ca.|Department of Geography, University of Western Ontario, Social Science Centre, London, N6A 5C2, ON, Canada. heal@uwo.ca.|Department of Paediatrics, University of Western Ontario, 800 Commissioners Rd. E., London, N6C 2R6, ON, Canada. heal@uwo.ca.|School of Health Studies, University of Western Ontario, Arthur and Sonia Labatt Health Sciences Building, London, N6A 5B9, ON, Canada. heal@uwo.ca.
authors.forename: Jason A
authors.initials: JA
authors.lastname: Gilliland
authors.affiliation: Human Environments Analysis Lab, University of Western Ontario, Social Science Centre, London, N6A 5C2, ON, Canada.|Children's Health Research Institute, 800 Commissioners Rd. E., London, N6C 2V5, ON, Canada.|Department of Geography, University of Western Ontario, Social Science Centre, London, N6A 5C2, ON, Canada.
authors.forename: Andrew F
authors.initials: AF
authors.lastname: Clark
authors.affiliation: School of Occupational Therapy, University of Western Ontario, Elborn College, London, N6G 1H1, ON, Canada.
authors.forename: Patricia
authors.initials: P
authors.lastname: Tucker
authors.affiliation: School of Kinesiology, University of Western Ontario, Thames Hall, London, N6A 5B9, ON, Canada.
authors.forename: Harry
authors.initials: H
authors.lastname: Prapavessis
authors.affiliation: Children's Health Research Institute, 800 Commissioners Rd. E., London, N6C 2V5, ON, Canada.|Lawson Health Research Institute, 268 Grosvenor St, London, N6A 4V2, ON, Canada.|Department of Paediatrics, University of Western Ontario, 800 Commissioners Rd. E., London, N6C 2R6, ON, Canada.|Department of Sociology, University of Western Ontario, Social Science Centre, London, N6A 5C2, ON, Canada.|Department of Epidemiology & Biostatistics, University of Western Ontario, Kresge Bldg, London, N6A 5C1, ON, Canada.
authors.forename: William
authors.initials: W
authors.lastname: Avison
authors.affiliation: Human Environments Analysis Lab, University of Western Ontario, Social Science Centre, London, N6A 5C2, ON, Canada.|Children's Health Research Institute, 800 Commissioners Rd. E., London, N6C 2V5, ON, Canada.|Lawson Health Research Institute, 268 Grosvenor St, London, N6A 4V2, ON, Canada.|Department of Paediatrics, University of Western Ontario, 800 Commissioners Rd. E., London, N6C 2R6, ON, Canada.|Department of Epidemiology & Biostatistics, University of Western Ontario, Kresge Bldg, London, N6A 5C1, ON, Canada.
authors.forename: Piotr
authors.initials: P
authors.lastname: Wilk
mesh_terms: D000293:Adolescent; D002170:Canada; D002648:Child; D002652:Child Behavior / Q000523:psychology*; D015331:Cohort Studies; D015444:Exercise / Q000523:psychology*; D005260:Female; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D009043:Motor Activity; D010287:Parent-Child Relations; D010290:Parents / Q000193:education*; D011998:Recreation; D012574:Schools