Nine out of ten adolescents fail to achieve Healthy People 2020 recommended levels of aerobic and muscle-strengthening physical activity leading to deleterious consequences for individuals and a public health epidemic (US Department of Health and Human Services, 2011). Whereas all adolescents comprise a vulnerable population because of minimal levels of physical activity, those with an orthopedic limitation, including slipped capitol femoral epiphyses or Blount's disease, are at greater risk despite shared characteristics with the general adolescent population such as normal cognition and independent ambulation. Few, if any, interventions examine effective strategies for physical activity in this population. Therapy dog-walking is proposed as an original approach for physical activity. Although this form of human-animal interaction is a potential strategy for increasing physical activity and overall health, it lacks credibility due to a paucity of studies using well-constructed, experimental designs (Marino, 2012). The objective of this pilot study was to use a one group (n=7), prospective, pre/post design to assess feasibility and acceptability, and to serve as the foundation for future research on therapy dog-walking in this population. Feasibility and acceptability were assessed by results of the recruitment strategy, by process evaluation, and by participant satisfaction survey and interview. Descriptive statistics summarized participant demographics and protocol requirements, including the use of accelerometers. Wilcoxon matched pairs tests were used to assess participants' experience with the dogs. Paired samples t-tests compared physical activity levels before, during, and after the dog-walking intervention. Pender's health promotion model was the guiding framework for this study. Physical activity levels were significantly increased during the intervention compared to before (p=.049) and after (p=.025) as well as during the walking sessions themselves (p=.000). Participants and parents expressed high enthusiasm for the program: six of the seven participants attended 100% of the walking sessions when no restrictions to physical activity participation were present. No differences between the participant's pre and post-intervention dog experience were found. These findings indicate a therapy dog-walking program is an acceptable and feasible strategy for increasing physical activity in this population. Additional research with more rigorous methodological design and refinement of the data collection methods is required.

As interest in the public health challenge of youth inactivity increases, the ambitious Youth Physical Activity and Sedentary Behavior sets a standard for addressing a problem with worldwide implications. Drawing on the contributions of a diverse group of international experts, this reference challenges professionals, researchers, and students to implement new solutions and further their research and work. No other text addresses the causes, contributing factors, and fundamental issues in dealing with youth physical activity with such depth or comprehensive coverage. Using a multidisciplinary approach, Youth Physical Activity and Sedentary Behavior breaks away from traditional thinking that places activity and sedentary behavior on a single continuum, which may limit progress in addressing youth inactivity. Instead, the authors encourage readers to focus on how sedentary and physically active behaviors coexist and consider how the two behaviors may have different determinants. In doing so, the text also considers developmental features such as maturation, ethnicity, environment, and genetics across both childhood (through age 12) and adolescence (the teen years). By looking at a variety of psychosocial and epidemiological factors, the authors set the stage for a critical analysis of beliefs and views at a time when many assumptions are taken for granted. This book is organized in three parts that build on one another to deepen readers’ understanding of this complex problem. This text begins by addressing the fundamental issues and assumptions pertaining to youth physical activity and sedentary behavior, covering such topics as measurement of the behavior in question, health outcomes, concepts, and trends in a public health context. Once readers have grasped this foundational knowledge, they advance to part II for a comprehensive account of personal factors likely to be associated with the problem. Part III moves beyond the individual into the wider social and contextual aspects of physically active and sedentary living in young people. Through this concluding part, readers gain the latest thinking on how parents, peers, schools, organized sport, and related factors link to youth physical activity and sedentary behavior. Each chapter presents the latest theory and research, real-world approaches to implementation, and background information to encourage discussion and future directions in national policy making. Youth Physical Activity and Sedentary Behavior also contains the following features that add to an unprecedented learning experience: •An at-a-glance look at why and how research can be used in the real world helps researchers relate their work to overall solutions. •Coverage of more issues related to this subject than are available in any other reference makes this a one-stop resource. •Internationally respected foreword writer, editors, and contributors provide a cross-disciplinary perspective valuable for putting solutions into a wider context. •Applications for Professionals boxes and Applications for Researchers boxes at the end of each chapter provide practical suggestions for implementing solutions. Youth Physical Activity and Sedentary Behavior: Challenges and Solutions considers current research about youth physical activity and sedentary behavior across a range of personal factors as well as cultural and social influences. The text communicates the knowledge base on developmental, economic, psychological, and social factors related to youth physical activity and sedentary behavior and provides an overview of youth-specific approaches to addressing the problem of inactivity among youth.

This comprehensive book thoroughly covers bone health in the adolescent, offering evidence-based guidance for clinical care in the primary care setting, and includes aspects of endocrinology, nutrition, radiology, sports medicine, and rehabilitation. A Practical Approach to Adolescent Bone Health begins with an in-depth review of normal bone physiology, and explains how to optimize bone mass accrual in the healthy adolescent. The following chapters detail the importance of nutrition and physical activity to the skeletal system, while later chapters provide a bone-centric review of clinical history taking, the physical examination, laboratory assessment, and imaging to evaluate bone health. Final chapters delve into providing comprehensive care for specific conditions commonly found in the adolescent, including adolescents with multiple fractures, eating disorders, athletic involvement, chronic illness, various ambulatory limitations, and bone fragility. Clinical vignettes are woven into chapters throughout the book, providing real-world application and highlighting key concepts for practitioners. A Practical Approach to Adolescent Bone Health is a unique resource,and ideal for the primary care clinician, including pediatricians, adolescent medicine specialists, and family medicine physicians, as well as endocrinologists, orthopedic surgeons, and any other practitioner working to guide adolescents towards optimal bone health.

Physical inactivity is a key determinant of health across the lifespan. A lack of activity increases the risk of heart disease, colon and breast cancer, diabetes mellitus, hypertension, osteoporosis, anxiety and depression and others diseases. Emerging literature has suggested that in terms of mortality, the global population health burden of physical inactivity approaches that of cigarette smoking. The prevalence and substantial disease risk associated with physical inactivity has been described as a pandemic. The prevalence, health impact, and evidence of changeability all have resulted in calls for action to increase physical activity across the lifespan. In response to the need to find ways to make physical activity a health priority for youth, the Institute of Medicine's Committee on Physical Activity and Physical Education in the School Environment was formed. Its purpose was to review the current status of physical activity and physical education in the school environment, including before, during, and after school, and examine the influences of physical activity and physical education on the short and long term physical, cognitive and brain, and psychosocial health and development of children and adolescents. Educating the Student Body makes recommendations about approaches for strengthening and improving programs and policies for physical activity and physical education in the school environment. This report lays out a set of guiding principles to guide its work on these tasks. These included: recognizing the benefits of instilling life-long physical activity habits in children; the value of using systems thinking in improving physical activity and physical education in the school environment; the recognition of current disparities in opportunities and the need to achieve equity in physical activity and physical education; the importance of considering all types of school environments; the need to take into consideration the diversity of students as recommendations are developed. This report will be of interest to local and national policymakers, school officials, teachers, and the education community, researchers, professional organizations, and parents interested in physical activity, physical education, and health for school-aged children and adolescents.

The text provides information on the current levels of youth physical activity and offers an overview of theories of behavior change that have been used in developing physical activity interventions in a variety of settings. Programs and interventions are discussed in terms of their strengths, weaknesses, and level of success. Also includes sample forms to assist the reader in evaluating and designing interventions in areas where proven programs are not yet available.