Background and Purpose
In the United States, rates of overweight and obesity among Latino children (39%) are higher than those among their White peers (28%).(2) Physical activity is important for good health, physical and cognitive growth and development, and maintaining a healthy weight. Latino children are less likely than other groups to get the recommended 60 minutes of physical activity per day, which adds to the problem of higher than normal Body Mass Index’s (BMI) and obesity rates within the Latino community—and puts them at an increased risk of developing chronic diseases at a young age.(3) Many factors may contribute to less activity among Latino children, yet limited understanding of the reasons for this gap remains. To address this, Salud America! The Robert Wood Johnson Foundation Research Network to Prevent Obesity Among Latino Children, which aims to increase the number of stakeholders conducted research and community change to reduce and prevent Latino childhood obesity (LCO), has synthesized research and developed policy recommendations on “Active Play and Latino Kids” to fuel discussions and stimulate changes in policies that will increase out-of-school and out-of-class play time among Latino kids.

Objectives
The main objectives of this study were to: (1) review and consolidate the field of evidence related to initiatives and research focused on out-of-school and out-of-class play time and its impact on physical activity levels among Latino children in underserved communities; and (2) based on the evidence, create policy recommendations for increasing active play time in predominantly Latino communities.

Methods
A comprehensive review of studies, policy statements, and legislation published between 2000 and 2012 was conducted using Google Scholar and PubMed, as well as government and organization websites, to identify literature relevant to increasing physical activity among Latino children. Terms like Hispanic Americans, Mexican Americans, Latino, adolescent, child, community, neighborhood, obesity, motor activity, physical activity, recreation, and schools were used during electronic searches; and only studies written in English and conducted among youth up to 19 years of age, from the US, were analyzed. Survey-based research comprised most of the studies reviewed; however randomized control trials of physical activity were also included.

Results
Fewer Parks & Places of Recreation Available to Latinos; Neighborhood Safety Remains A Concern. Latino children are more likely to live in poverty (34.1% vs. 12.5%) and less likely to have access to parks and places of recreation, when compared to White children.(4) They are also more likely to live in unsafe neighborhoods.(5) Conditions of the built environment and neighborhood safety may affect how often families use active transportation to get to recreation sites and how frequent children participate in outdoor activities.(6) Also, fewer schools (29% vs 35%) provided access to their physical activity facilities in 2006 than in 2000.(7)

Mixed Results on How Levels of Assimilation Affect Physical Activity. While some studies found that first- and second- generation adolescents were less likely to get recommended amounts of physical activity than third generation Latinos, others found that those who were more acculturated had a greater tendency to be sedentary.(8)

Culturally-Relevant Structured Programs, Parental Involvement & Walking School Buses May Increase Activity Levels. Schools with a predominantly Latino population were less likely to offer daily P.E., allot at least 150 minutes per week to physical activity, and have access to recreational facilities.(9) Walking school buses and structured physical activity programs in school settings have shown promise for increasing physical activity among children; however, a lack of parent volunteers has been cited as a challenge in organizing these programs. Culturally relevant community based interventions and marketing campaigns may also increase out-of-school physical activity time.

Because parenting styles, perceptions, and behaviors may influence the amount of physical activity Latino children receive, interventions aimed at parents may help increase levels of activity.(10-11) Children whose parents monitored and rewarded healthy behaviors demonstrated increased levels of physical activity compared to those who did not.

Conclusions
Improving neighborhood infrastructure and neighborhood safety; changing Latino parents’ perceptions about healthy weights and empowering them to reinforce more active play time; and developing collaborative partnerships, are important for the development and proper implementation of policies to increase physical activity in Latino children.

Implications for Practice and Policy

1. Programs are needed to educate Latino parents on strategies for improving physical activity among their children. The physical activity and eating scale (PEAS) is a valid and reliable tool that may be a useful tool for developing interventions.(12)
2. Communities should collaborate on ways for Latino children to receive the recommended 60 minutes of daily physical activity for all children.
3. Maps created using GIS systems can help organizers: locate the safest routes to school; find the nearest resources; identify areas of greatest need; and determine the location of new parks and recreation spaces, in Latino communities.
4. Complete Streets policies and Safe Routes to School programs may help improve neighborhood infrastructure and safety in Latino Communities.

References

1. Salud America! The Robert Wood Johnson Research Network to Prevent Obesity Among Latino Children. Increasing Out-of-School and Out-of-Class Physical Activity among Latino Children. 2013.
2. Ogden CL, Carroll MD, Kit BK, and Flegal KM. Prevalence of obesity and trends in body mass index among US children and adolescents, 1999-2010. JAMA, 2012. 307(5): p. 483-90.
3. Centers for Disease Control and Prevention. Physical activity levels among children aged 9-13 years--United States, 2002. MMWR Morb Mortal Wkly Rep 2003;52:785-788.
4. United States Census Bureau. Income, poverty and health insurance coverage in the United States: 2011.2012.
5. Zhu X, Lee C. Walkability and safety around elementary schools economic and ethnic disparities. Am J Prev Med 2008;34:282-290.
6. Brownson RC, Hoehner CM, Day K, Forsyth A, Sallis JF. Measuring the built environment for physical activity: state of the science. Am J Prev Med 2009;36:S99-123.
7. US Department of Health and Human Services. Healthy People 2010 Final Review. 2010.
8. Liu J, Probst JC, Harun N, Bennett KJ, Torres ME. Acculturation, physical activity, and obesity among Hispanic adolescents. Ethn Health 2009;14:509-525.
9. Richmond TK, Hayward RA, Gahagan S, Field AE, Heisler M. Can school income and racial/ethnic composition explain the racial/ethnic disparity in adolescent physical activity participation? Pediatrics 2006;117:2158-2166.
10. Ward CL. Parental perceptions of childhood overweight in the Mexican American population: an integrative review. J Sch Nurs 2008;24:407-416.
11. Arredondo EM, Elder JP, Ayala GX, Campbell N, Baquero B, Duerksen S. Is parenting style related to children's healthy eating and physical activity in Latino families? Health Educ Res 2006;21:862-871.
12. Larios SE, Ayala GX, Arredondo EM, Baquero B, Elder JP. Development and validation of a scale to measure Latino parenting strategies related to children's obesigenic behaviors. The parenting strategies for eating and activity scale (PEAS). Appetite 2009;52:166-172.

Support / Funding Source
Salud America! The Robert Wood Johnson Foundation Research Network to Prevent Obesity Among Latino Children is funded by the Robert Wood Johnson Foundation (ID 70208).