1
|
The Challenge of Incomplete Data in Accelerometer Studies: Characteristics of Nonparticipation and Noncompliance in a Nationwide Sample of Adolescents and Young Adults in Germany. J Phys Act Health 2023; 20:226-238. [PMID: 36724792 DOI: 10.1123/jpah.2022-0443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 10/26/2022] [Accepted: 12/03/2022] [Indexed: 02/03/2023]
Abstract
BACKGROUND Incomplete data due to nonparticipation and noncompliance with the study protocol can bias the results of studies. We investigated how a nationwide accelerometer sample of adolescents and young adults is affected by such incomplete data. METHODS We analyzed cross-sectional data from 6465 participants (11-31 y old) who participated in a national health survey in Germany (KiGGS Wave 2; 2014-2017). The data included information about the participation in the measurement of physical activity using accelerometers, compliance with the wear-time protocol, and sociodemographic and health-related variables. Multivariable regression analyses were conducted to detect factors associated with incomplete data. RESULTS Of the total sample, 78.0% participated in the accelerometer part of the study, and 83.5% of the participants with data available complied with the wear-time protocol. In 11- to 17-year-olds, the likelihood of having incomplete accelerometer data was higher in boys, older adolescents, adolescents with a lower sociodemographic status, adolescents with overweight, adolescents not participating in organized sport, adolescents not speaking only German at home, current smokers, and adolescents having a higher soft drink consumption. In 18- to 31-year-olds, the likelihood of having incomplete accelerometer data was higher in men, adults with a lower educational level, adults not speaking only German at home, and adults who smoke. CONCLUSIONS Our results suggest that accelerometer samples are biased such that participants with more beneficial health behaviors provide complete accelerometer data more often. This knowledge should be used to design effective recruitment strategies and should be considered when interpreting results of accelerometer studies.
Collapse
|
2
|
Andersen OK, Gebremariam MK, Kolle E, Tarp J. Socioeconomic position, built environment and physical activity among children and adolescents: a systematic review of mediating and moderating effects. Int J Behav Nutr Phys Act 2022; 19:149. [PMID: 36510203 PMCID: PMC9743748 DOI: 10.1186/s12966-022-01385-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Accepted: 11/26/2022] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Physical activity behaviors among children and adolescents are socioeconomically patterned. Understanding if, and how, the built environment contributes to socioeconomic inequalities in physical activity and for whom built environments are most important, can lead to the identification of intervention entry points to reduce inequalities in physical activity. OBJECTIVE To summarize the existing evidence among children and adolescents on (a) whether the built environment mediates the association between socioeconomic position and physical activity and (b) whether socioeconomic position moderates the association between the built environment and physical activity. METHODS A systematic literature search was conducted using PubMed, Embase, PsycINFO and Web of Science. Two independent reviewers screened articles for eligibility, extracted information from included studies and assessed risk of bias with the Quality Assessment Tool for Observational Cohort and Cross-Sectional studies. We performed a narrative evidence synthesis considering the totality of the evidence and by study characteristics such as geographic region, age group, and exposure-outcome assessment methodology. The reporting was conducted in agreement with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement. RESULTS A total of 28 papers were included. In general, the studies were of low methodological quality. There was no evidence to support that the built environment functions as a mediator in the relationship between socioeconomic position and physical activity. We observed inconclusive moderation patterns with five studies reporting stronger associations between features of the built environment and physical activity among high socioeconomic positioned youths. Seven studies reported stronger associations among low socioeconomic positioned youth and fourteen studies reported no difference in associations. We observed different moderation patterns across geographical regions (Europe vs. US) indicating that, in Europe, having a walkable neighborhood is important for low socioeconomic positioned youth only. No differences in moderation patterns were observed for younger vs. older children or activity domains. CONCLUSION Current evidence does not support a strong interplay between built environment and socioeconomic position on physical activity in youth. However, given the low quality of the evidence, firm conclusions cannot be made, and additional high-quality research is likely to have substantial impact on the evidence base.
Collapse
Affiliation(s)
- Oddbjørn Klomsten Andersen
- grid.412285.80000 0000 8567 2092Department of Sports Sciences, Norwegian School of Sport Sciences, PO Box 4014, Ullevaal stadion, 0806 Oslo, Norway
| | - Mekdes Kebede Gebremariam
- grid.5510.10000 0004 1936 8921Department of Community Medicine and Global Health, Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Elin Kolle
- grid.412285.80000 0000 8567 2092Department of Sports Sciences, Norwegian School of Sport Sciences, PO Box 4014, Ullevaal stadion, 0806 Oslo, Norway
| | - Jakob Tarp
- grid.7048.b0000 0001 1956 2722Department of Clinical Epidemiology, Department of Clinical Medicine, Aarhus University and Aarhus University Hospital, Aarhus, Denmark
| |
Collapse
|
3
|
Luque-García L, Corrales A, Lertxundi A, Díaz S, Ibarluzea J. Does exposure to greenness improve children's neuropsychological development and mental health? A Navigation Guide systematic review of observational evidence for associations. ENVIRONMENTAL RESEARCH 2022; 206:112599. [PMID: 34932982 DOI: 10.1016/j.envres.2021.112599] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 12/15/2021] [Accepted: 12/17/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND Contact with nature may have a key role in child brain development. Recent observational studies have reported improvements in children's neuropsychological development and mental health associated with greenness exposure. In a rapidly urbanizing word, researchers, policymakers, healthcare workers and urban planners need to work together to elaborate evidence-based policies and interventions to increase the availability of quality green space with the potential to enhance childhood development. OBJECTIVE To review the observational evidence assessing the effect of exposure to greenness on children's neuropsychological development and mental health. METHODS The protocol for the review was preregistered at PROSPERO (CRD42020213838). The Navigation Guide systematic review methodology was followed. Search strategies were formulated and adapted to each database. Searches were performed in PubMed, Scopus, Web of Science and EBSCO's GreenFILE on October 5, 2021. Additional articles were further identified by hand-searching reference lists of included papers. RESULTS A systematic search of 4 databases identified 621 studies, of which 34 were included in the review. The studies included investigated diverse domains within neuropsychological development and mental health, such as attention, working memory, intelligence, cognitive development, academic performance, well-being, attention-deficit/hyperactivity disorder symptoms, and behavior. Most of the studies were rated as having high or probably high risk of bias in the assessment. DISCUSSION Although nearly all studies showed a positive association between greenness exposure and the outcomes studied, the heterogeneity in the methods used to assess exposure and the diversity of domains within each main outcome has made it difficult to draw clear conclusions. Future studies should adopt a longitudinal design to confirm the causality of the associations and include measures to determine which characteristics of greenness have the greatest influence on each domain. Researchers should also try to explore pathways linking exposure to greenness with the neuropsychological development and mental health, by implementing mechanistic studies.
Collapse
Affiliation(s)
- L Luque-García
- Department of Preventive Medicine and Public Health, Faculty of Medicine, University of the Basque Country (UPV/EHU), Leioa, 48940, Spain; Biodonostia Health Research Institute, Environmental Epidemiology and Child Development Group, 20014, San Sebastian, Spain; Osakidetza Basque Health Service, Goierri Alto-Urola Integrated Health Organisation, Zumarraga Hospital, Zumarraga, 20700, Spain.
| | - A Corrales
- Osakidetza Basque Health Service, Uribe Integrated Health Organisation, Urduliz-Alfredo Espinosa Hospital, Urduliz, 48610, Spain
| | - A Lertxundi
- Department of Preventive Medicine and Public Health, Faculty of Medicine, University of the Basque Country (UPV/EHU), Leioa, 48940, Spain; Biodonostia Health Research Institute, Environmental Epidemiology and Child Development Group, 20014, San Sebastian, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), 28029, Madrid, Spain
| | - S Díaz
- Department of Preventive Medicine and Public Health, Faculty of Medicine, University of the Basque Country (UPV/EHU), Leioa, 48940, Spain
| | - J Ibarluzea
- Biodonostia Health Research Institute, Environmental Epidemiology and Child Development Group, 20014, San Sebastian, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), 28029, Madrid, Spain; Ministry of Health of the Basque Government, Sub-Directorate for Public Health and Addictions of Gipuzkoa, 20013, San Sebastián, Spain; Faculty of Psychology of the University of the Basque Country, 20018, San Sebastian, Spain
| |
Collapse
|
4
|
Timurtaş E, Selçuk H, Çınar E, Demirbüken İ, Sertbaş Y, Polat MG. Personal, social, and environmental correlates of physical activity and sport participation in an adolescent Turkish population. BULLETIN OF FACULTY OF PHYSICAL THERAPY 2022. [PMCID: PMC8923827 DOI: 10.1186/s43161-022-00070-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Benefits of physical activity has been shown for adolescents; however, there is a decline trend in number of adolescents meeting current WHO recommendations. This trend underlines the importance of identifying factors associated with adolescents’ physical activity level (PAL) with considerations of regional and cultural differences to plan and implement effective policies. Therefore, the aim of this study was to determine personal, ecological, and social factors associated with PAL and sport participation in Turkish adolescents aged 11–14 years. A cross-sectional study was conducted by including 996 adolescents aged between 11 and 14 years from 39 secondary schools in İstanbul, Turkey. Logistic regression analyses performed to identify the significant personal (age, gender, sleep time, screen time, BMIz score, having siblings), ecological (presence of playground, type of school transportation), and social (family income, engaging a physical activity with family, and preferred activity at school breaks) predictors of PAL and sport participation.
Results
Adolescents who were active during break time at school (p < 0.001), engaging a physical activity with family (p < 0.001), and did not have a sibling (p = 0.029) were more likely to be physically active. Adolescents behaved active during break time at school (p < 0.001), had a playground at home (p < 0.001), spending time with family for physical activity (p < 0.001), and did not have a sibling (p = 0.021) were more likely to participate in a sport activity.
Conclusions
Predictors of PAL in this study indicates the need to promote active break time in school, increased physical activity time with family, and to design environmental policies to increase number of playgrounds.
Collapse
|
5
|
Benzing V, Gaillard P, Scheidegger D, Dössegger A, Nigg CR, Schmidt M. COVID-19: Physical Activity and Quality of Life in a Sample of Swiss School Children during and after the First Stay-at-Home. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:2231. [PMID: 35206418 PMCID: PMC8871913 DOI: 10.3390/ijerph19042231] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 01/27/2022] [Accepted: 02/10/2022] [Indexed: 01/26/2023]
Abstract
COVID-19 restrictions and the instructions to stay at home (SaH) may have had an impact on child behavior including physical activity (PA) and health-related quality of life (HRQoL) in Switzerland. Therefore, we investigated PA and HRQoL during and after the SaH in 57 Swiss school children aged 7 to 12 years (M = 10.44; SD = 1.34). PA was measured using accelerometry (Actigraph GT3X) and HRQoL using the Kid-KINDLR questionnaire. During and post data was compared using paired sample t-tests. Independent t-tests were used to compare the HRQoL of physically active children with non-physically active children. PA in light (d = -0.56), moderate (d = -0.44), moderate-to-vigorous (d = -0.28) as well as overall HRQoL (d = -0.66), psychological well-being (d = -0.48), self-esteem (d = -0.39), friends (d = -0.70) and everyday functioning (d = -0.44), were significantly lower during SaH than afterwards. Children who adhered to PA recommendations (+60 min of moderate-to-vigorous PA) during SaH had a better overall HRQoL (d = 0.61) and psychological well-being (d = 0.56) than those who did not. Since PA levels and HRQoL were lower during SaH compared to afterwards, it seems that the restrictions negatively impacted children's PA and HRQoL. During future SaHs, promoting children's PA and HRQoL seems important.
Collapse
Affiliation(s)
- Valentin Benzing
- Institute of Sport Science, University of Bern, 3012 Bern, Switzerland; (P.G.); (D.S.); (C.R.N.); (M.S.)
| | - Patrice Gaillard
- Institute of Sport Science, University of Bern, 3012 Bern, Switzerland; (P.G.); (D.S.); (C.R.N.); (M.S.)
| | - David Scheidegger
- Institute of Sport Science, University of Bern, 3012 Bern, Switzerland; (P.G.); (D.S.); (C.R.N.); (M.S.)
| | - Alain Dössegger
- Swiss Federal Institute of Sport Magglingen (SFISM), 2532 Magglingen, Switzerland;
| | - Claudio R. Nigg
- Institute of Sport Science, University of Bern, 3012 Bern, Switzerland; (P.G.); (D.S.); (C.R.N.); (M.S.)
| | - Mirko Schmidt
- Institute of Sport Science, University of Bern, 3012 Bern, Switzerland; (P.G.); (D.S.); (C.R.N.); (M.S.)
| |
Collapse
|
6
|
Probst-Hensch N, Bochud M, Chiolero A, Crivelli L, Dratva J, Flahault A, Frey D, Kuenzli N, Puhan M, Suggs LS, Wirth C. Swiss Cohort & Biobank - The White Paper. Public Health Rev 2022; 43:1605660. [PMID: 36619237 PMCID: PMC9817110 DOI: 10.3389/phrs.2022.1605660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Accepted: 12/05/2022] [Indexed: 12/24/2022] Open
Affiliation(s)
- Nicole Probst-Hensch
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute (Swiss TPH), Allschwil, Switzerland
- University of Basel, Basel, Switzerland
- Swiss School of Public Health (SSPH+), Zürich, Switzerland
- Swiss Society for Public Health, Bern, Switzerland
- *Correspondence: Nicole Probst-Hensch,
| | - Murielle Bochud
- Swiss School of Public Health (SSPH+), Zürich, Switzerland
- Swiss Society for Public Health, Bern, Switzerland
- Department of Epidemiology and Health Systems (DESS), University Center for General Medicine and Public Health (Unisanté), Lausanne, Switzerland
| | - Arnaud Chiolero
- Swiss School of Public Health (SSPH+), Zürich, Switzerland
- Swiss Society for Public Health, Bern, Switzerland
- Population Health Laboratory (#PopHealthLab), University of Fribourg, Fribourg, Switzerland
- Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland
| | - Luca Crivelli
- Swiss School of Public Health (SSPH+), Zürich, Switzerland
- Swiss Society for Public Health, Bern, Switzerland
- Department of Business Economics, Health and Social Care, University of Applied Sciences and Arts of Southern Switzerland, Manno, Switzerland
- Institute of Public Health Università della Svizzera Italiana, Lugano, Switzerland
| | - Julia Dratva
- Swiss School of Public Health (SSPH+), Zürich, Switzerland
- Swiss Society for Public Health, Bern, Switzerland
- Institute of Public Health, Department of Health Sciences, ZHAW Zürich University of Applied Sciences, Winterthur, Switzerland
| | - Antoine Flahault
- Swiss School of Public Health (SSPH+), Zürich, Switzerland
- Swiss Society for Public Health, Bern, Switzerland
- Institute of Global Health, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Daniel Frey
- Swiss Society for Public Health, Bern, Switzerland
| | - Nino Kuenzli
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute (Swiss TPH), Allschwil, Switzerland
- University of Basel, Basel, Switzerland
- Swiss School of Public Health (SSPH+), Zürich, Switzerland
- Swiss Society for Public Health, Bern, Switzerland
| | - Milo Puhan
- Swiss School of Public Health (SSPH+), Zürich, Switzerland
- Epidemiology, Biostatistics and Prevention Institute (EBPI), University of Zurich, Zurich, Switzerland
| | - L. Suzanne Suggs
- Swiss School of Public Health (SSPH+), Zürich, Switzerland
- Swiss Society for Public Health, Bern, Switzerland
- Institute of Public Health Università della Svizzera Italiana, Lugano, Switzerland
| | - Corina Wirth
- Swiss Society for Public Health, Bern, Switzerland
| |
Collapse
|
7
|
Measuring the Built Environment in Studies of Child Health-A Meta-Narrative Review of Associations. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182010741. [PMID: 34682484 PMCID: PMC8535212 DOI: 10.3390/ijerph182010741] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Revised: 10/05/2021] [Accepted: 10/07/2021] [Indexed: 12/23/2022]
Abstract
Although the built environment (BE) is important for children’s health, there is little consensus about which features are most important due to differences in measurement and outcomes across disciplines. This meta-narrative review was undertaken by a multi-disciplinary team of researchers to summarise ways in which the BE is measured, and how this links to children’s health. A structured search of four databases across the relevant disciplines retrieved 108 relevant references. The most commonly addressed health-related outcomes were active travel, physical activity and play, and obesity. Many studies used objective (GIS and street audits) or standardised subjective (perceived) measurements of the BE. However, there was a wide variety, and sometimes inconsistency, in their definition and use. There were clear associations between the BE and children’s health. Objective physical activity and self-reported active travel, or obesity, were positively associated with higher street connectivity or walkability measures, while self-reported physical activity and play had the strongest association with reduced street connectivity, indicated by quieter, one-way streets. Despite the high heterogeneity found in BE measures and health outcomes, the meta-narrative approach enabled us to identify ten BE categories that are likely to support children’s health and be protective against some non-communicable disease risk factors. Future research should implement consistent BE measures to ensure key features are explored. A systems approach will be particularly relevant for addressing place-based health inequalities, given potential unintended health consequences of making changes to the BE.
Collapse
|
8
|
Fyfe-Johnson AL, Hazlehurst MF, Perrins SP, Bratman GN, Thomas R, Garrett KA, Hafferty KR, Cullaz TM, Marcuse EK, Tandon PS. Nature and Children's Health: A Systematic Review. Pediatrics 2021; 148:e2020049155. [PMID: 34588297 DOI: 10.1542/peds.2020-049155] [Citation(s) in RCA: 40] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/20/2021] [Indexed: 11/24/2022] Open
Abstract
CONTEXT Daily outdoor play is encouraged by the American Academy of Pediatrics. Existing evidence is unclear on the independent effect of nature exposures on child health. OBJECTIVE We systematically evaluated evidence regarding the relationship between nature contact and children's health. DATA SOURCES The database search was conducted by using PubMed, Cumulative Index to Nursing and Allied Health Literature, PsychInfo, ERIC, Scopus, and Web of Science in February 2021. STUDY SELECTION We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. In all searches, the first element included nature terms; the second included child health outcome terms. DATA EXTRACTION Of the 10 940 studies identified, 296 were included. Study quality and risk of bias were assessed. RESULTS The strongest evidence for type of nature exposure was residential green space studies (n = 147, 50%). The strongest evidence for the beneficial health effects of nature was for physical activity (n = 108, 32%) and cognitive, behavioral, or mental health (n = 85, 25%). Physical activity was objectively measured in 55% of studies, and 41% of the cognitive, behavioral, or mental health studies were experimental in design. LIMITATIONS Types of nature exposures and health outcomes and behaviors were heterogenous. Risk of selection bias was moderate to high for all studies. Most studies were cross-sectional (n = 204, 69%), limiting our ability to assess causality. CONCLUSIONS Current literature supports a positive relationship between nature contact and children's health, especially for physical activity and mental health, both public health priorities. The evidence supports pediatricians in advocating for equitable nature contact for children in places where they live, play, and learn.
Collapse
Affiliation(s)
- Amber L Fyfe-Johnson
- Elson S. Floyd College of Medicine, Washington State University, Spokane, Washington
| | | | | | - Gregory N Bratman
- School of Environmental and Forest Sciences, University of Washington, Seattle, Washington
| | - Rick Thomas
- National Academy of Sciences, Washington, District of Columbia
| | - Kimberly A Garrett
- Seattle Children's Research Institute, Seattle Children's Hospital, Seattle, Washington
| | - Kiana R Hafferty
- Seattle Children's Research Institute, Seattle Children's Hospital, Seattle, Washington
| | - Tess M Cullaz
- Elson S. Floyd College of Medicine, Washington State University, Spokane, Washington
| | | | - Pooja S Tandon
- Pediatrics
- Seattle Children's Research Institute, Seattle Children's Hospital, Seattle, Washington
| |
Collapse
|