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Paulus FW, Joas J, Friedmann A, Fuschlberger T, Möhler E, Mall V. Familial context influences media usage in 0- to 4-year old children. Front Public Health 2024; 11:1256287. [PMID: 38274543 PMCID: PMC10808691 DOI: 10.3389/fpubh.2023.1256287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 11/20/2023] [Indexed: 01/27/2024] Open
Abstract
Background The use of digital media (e.g., smartphones, tablets, etc.) and the Internet have become omnipresent for every age group and are part of children's and parents' everyday life. Focusing on young children, the availability of media devices, their use as well as associated problems (e.g., in social, emotional and motor development) have increased in recent years. Of particular interest for prevention of these problems in early childhood is the relationship between the familial context (parental digital media use, Problematic Internet Use, school graduation, presence of siblings) and the digital media use of infants and toddlers. The present study's goal was to describe media usage in 0-4-year-old children and to identify the potential relationship between familial context factors and child media usage. Methods The sample included N = 3,035 children aged 0 to 3;11 years (M = 17.37 months, SD = 13.68; 49.13% female). Recruitment took place within the framework of a restandardization study for a German developmental test. The parents of the participants answered a questionnaire on socio-demographics, on child media use, and on parental media use. Questions on parental media use included the full version of the Short Compulsive Internet Use Scale (S-CIUS). Results Significant increases in media usage times with child age were identified, but no significant gender differences. A multiple regression analysis revealed that increasing maternal total media usage time, a higher parental S-CIUS score, lower school leaving certificate of both mother and father, and increasing child's age led to higher child media usage time. Having siblings diminished young children's media usage in this study. Having more than one child and having children aged over a year was associated with a higher parental S-CIUS score. Conclusion Family factors such as maternal media use time, Problematic Internet Use and lower school graduation are significantly associated with young children's digital media use. Parents should be aware of their personal influence on their children's media use which might be due their role in terms of model learning.
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Affiliation(s)
- Frank W. Paulus
- Child and Adolescent Psychiatry, Saarland University Hospital and Saarland University Faculty of Medicine, Homburg, Germany
| | - Jens Joas
- Child and Adolescent Psychiatry, Saarland University Hospital and Saarland University Faculty of Medicine, Homburg, Germany
| | - Anna Friedmann
- Technical University of Munich, TUM School of Medicine and Health, Chair of Social Pediatrics, München, Germany
| | - Tamara Fuschlberger
- Technical University of Munich, TUM School of Medicine and Health, Chair of Social Pediatrics, München, Germany
| | - Eva Möhler
- Child and Adolescent Psychiatry, Saarland University Hospital and Saarland University Faculty of Medicine, Homburg, Germany
| | - Volker Mall
- Technical University of Munich, TUM School of Medicine and Health, Chair of Social Pediatrics, München, Germany
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Ernst VS, Franze M, Kästner A, Hoffmann W. Cohort Profile: evaluation of the targeted individual promotion in german preschools using the revised Dortmund Developmental Screening for Preschools DESK 3-6 R (project "GIF MV"). BMC Public Health 2023; 23:414. [PMID: 36859295 PMCID: PMC9976657 DOI: 10.1186/s12889-023-15307-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Accepted: 02/22/2023] [Indexed: 03/03/2023] Open
Abstract
This dynamic cohort was established to evaluate the targeted individual promotion of children affected by developmental risks as part of the German federal state law for child day-care and preschools in Mecklenburg-Western Pomerania. The project has been conducted in preschools in regions with a low socio-economic profile since 2011. Since 2017, the revision of the standardized Dortmund Developmental Screening for Preschools (DESK 3-6 R) has been applied. Developmental risks of 3 to 6-year-old children in the domains of motor, linguistic, cognitive and social competencies are monitored. The cohort is followed up annually. In 2020, n = 7,678 children from n = 152 preschools participated. At the baseline (2017), n = 8,439 children participated. Due to the defined age range of this screening, 3,000 to 4,000 5-6-year-old children leave the cohort annually. Simultaneously, an approximately equal number of 3-year-old children enters the cohort per survey wave. N = 702 children participated in all 4 survey waves. On the basis of DESK 3-6 R scores available from survey waves 2017 to 2019 it is possible to compute expected values for the survey wave 2020 and to compare those with the measured values to evaluate the effects of the COVID-19 pandemic (i.e. parental home care due to restrictions related to COVID-19).
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Affiliation(s)
- Vanessa Sophie Ernst
- Institute for Community Medicine, Section Epidemiology of Health Care and Community Health, Research Unit Prevention, University Medicine Greifswald, Ellernholzstr. 1-2, 17487, Greifswald, Germany.
| | - Marco Franze
- Institute for Community Medicine, Section Epidemiology of Health Care and Community Health, Research Unit Prevention, University Medicine Greifswald, Ellernholzstr. 1-2, 17487, Greifswald, Germany
| | - Anika Kästner
- Institute for Community Medicine, Section Epidemiology of Health Care and Community Health, Research Unit Prevention, University Medicine Greifswald, Ellernholzstr. 1-2, 17487, Greifswald, Germany
| | - Wolfgang Hoffmann
- Institute for Community Medicine, Section Epidemiology of Health Care and Community Health, Research Unit Prevention, University Medicine Greifswald, Ellernholzstr. 1-2, 17487, Greifswald, Germany
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3
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Stiller A, Stiller C. Parental report of quality of life in autistic children and youths: the role of parents' (informal) social support, and children's active leisure time. INTERNATIONAL JOURNAL OF DEVELOPMENTAL DISABILITIES 2022; 70:354-364. [PMID: 38699505 PMCID: PMC11062282 DOI: 10.1080/20473869.2022.2092935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Accepted: 06/17/2022] [Indexed: 05/05/2024]
Abstract
Research examining the quality of life (QoL) in children with autism in relation to leisure behavior is extremely rare. An online survey of parents (N = 282) was conducted to help to fill this gap. Using structural equation model (SEM), the association between the parents' (informal) social support and children's QoL (reported by parents) was examined. In this, parental behavior, children's active leisure time, children's TV consumption, as well as children's self-worth (reported by the parents) were integrated. Findings suggested that the parents' (informal) social support, children's active leisure, and self-worth have a positive effect on children's QoL. Implications of the results are discussed.
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Affiliation(s)
- Anja Stiller
- Der Kinderschutzbund Landesverband Niedersachsen e.V., Hanover, Germany
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A Serious Game for the Prevention of Obesity in School Children–Impact of Parent’s Involvement: A Randomized Controlled Trial. Life (Basel) 2022; 12:life12060779. [PMID: 35743810 PMCID: PMC9225572 DOI: 10.3390/life12060779] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Accepted: 05/21/2022] [Indexed: 12/11/2022] Open
Abstract
Serious games convey information and use interactive components to reinforce and train behaviours. A serious game addressing nutrition, physical activity and stress coping—the Kids Obesity Prevention Program (KOP)—was previously evaluated for efficacy in children. This study aimed at evaluating the KOP-game regarding: (i) its acceptance and efficacy with respect to parents of primary school children receiving the same game intervention as the children; and (ii) whether the children could benefit by parental involvement. A randomized controlled trial with two groups of children aged 9 to 12 years was conducted which included a 6-month follow-up period. All children played the game twice in two weeks. In the family-intervention group, the parents additionally played the game. The primary outcome was the gain in knowledge in parents and children measured with a pretested questionnaire. The secondary outcomes were knowledge maintenance as well as several behavior changes. Parents and children in both groups improved and maintained their knowledge equally. The KOP-game increases knowledge of nutrition in children independently of the involvement of their parents. KOP games are well accepted in children; further research should examine the structured involvement of parents.
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Gizik J, Meister S, Hartmann M, Sahm D, Georgi M, Baumeister N, Kühne M, Haas JP, Schwirtz A. Physiotherapie und Sport bei Kinderrheuma – Shake your
bones. AKTUEL RHEUMATOL 2022. [DOI: 10.1055/a-1757-2862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
ZusammenfassungIm Rahmen kindlicher rheumatischer Erkrankungen haben die zumeist schmerzhaften
Entzündungsvorgänge am muskulo-skelettalen System
(z. B.: Gelenke, Muskeln, Sehnen, Gefäße) Auswirkungen
auf die tägliche Mobilität der Betroffenen. Immobilität,
körperliche und sportliche Inaktivität sind oft die Folge. Die
geltenden Richtlinien der Nationalen Empfehlungen für Bewegung und
Bewegungsförderung werden daher oftmals nicht erreicht.
Bewegungsreduzierte oder -inaktive Patienten können jedoch durch
verschiedene Maßnahmen in ihrem Bewegungsverhalten gefördert
werden. Die Physiotherapie bietet eine erste Möglichkeit in
geschütztem Rahmen und unter fachlicher Aufsicht körperlich und
sportlich aktiv zu sein. Neben der Wiederherstellung und Verbesserung des
physiologischen Bewegungsausmaßes liegen die Erhaltung der
Selbstständigkeit und Lebensqualität im Vordergrund der
physiotherapeutischen Behandlung. Dazu zählen Aktivierung, Anbahnung von
physiologischen Bewegungsabläufen, Korrektur von Gelenkachsen und das
Vermitteln von Körperwahrnehmung bei körperlicher
Aktivität. Medizinisches Fachwissen und Verständnis sowie Wissen
über die Anforderungen verschiedener Sportartenprofile
ermöglicht gezielte Hilfestellungen. Durch kontinuierliche, engmaschige
Begleitung und langsame Steigerung von Intensität und Umfang in der
Physiotherapie können Ängste und Bedenken bezüglich dem
Wiedereinstieg bzw. Einstieg in sportliche Betätigung abgebaut werden.
Der jeweilige Gesundheitszustand und die Situation der
Entzündungsaktivität sind maßgebend für die
Therapieinterventionen. Sport gilt heute in der Physiotherapie als
Therapieelement und hilft Beschwerden zu lindern, verbessert körperliche
Defizite und vermittelt dabei Freude an der Bewegung. Für
Alltagsaktivitäten und den Freizeitsport kann eine individuelle
Sportberatung basierend auf dem bestehenden Erkrankungsstatus, dem funktionellen
und sportmotorischen Leistungsniveau sowie den eigenen Interessen wirkungsvoll
zu einem aktiven Lebensstil beitragen. Eine weitere Möglichkeit der
angeleiteten Bewegungsförderung stellt der Schulsport dar. Individuelle,
differenzierte Schulsportteilnahmebescheinigungen verbessern die Inklusion. Ein
auf den Erkrankungsstatus angepasstes und vorgegebenes Trainingsprogramm kann
mithilfe konkreter Vorgaben bei der Umsetzung der sportlichen Ziele
unterstützen. In Zukunft soll ein digital gestütztes
professionelles Monitoring die Bewegungsempfehlungen für zuhause noch
weiter verbessern und helfen den Mangel an flächendeckenden
Beratungsstellen für Erkrankte mit kindlichem Rheuma zu verringern.
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Affiliation(s)
- Josephine Gizik
- Technische Universität München, Fakultät
für Sport- und Gesundheitswissenschaften, Professur für
Biomechanik im Sport, München, Germany
- Deutsches Zentrum für Kinder- und Jugendrheumatologie,
Garmisch-Partenkirchen, Germany
| | - Sophia Meister
- Deutsches Zentrum für Kinder- und Jugendrheumatologie,
Garmisch-Partenkirchen, Germany
| | - Matthias Hartmann
- Deutsches Zentrum für Kinder- und Jugendrheumatologie,
Garmisch-Partenkirchen, Germany
| | - Daniel Sahm
- Deutsches Zentrum für Kinder- und Jugendrheumatologie,
Garmisch-Partenkirchen, Germany
| | - Mathias Georgi
- Deutsches Zentrum für Kinder- und Jugendrheumatologie,
Garmisch-Partenkirchen, Germany
| | - Nadja Baumeister
- Technische Universität München, Fakultät
für Sport- und Gesundheitswissenschaften, Professur für
Biomechanik im Sport, München, Germany
- Deutsches Zentrum für Kinder- und Jugendrheumatologie,
Garmisch-Partenkirchen, Germany
| | - Mareike Kühne
- Technische Universität München, Fakultät
für Sport- und Gesundheitswissenschaften, Professur für
Biomechanik im Sport, München, Germany
- Deutsches Zentrum für Kinder- und Jugendrheumatologie,
Garmisch-Partenkirchen, Germany
| | - Johannes-Peter Haas
- Deutsches Zentrum für Kinder- und Jugendrheumatologie,
Garmisch-Partenkirchen, Germany
| | - Ansgar Schwirtz
- Technische Universität München, Fakultät
für Sport- und Gesundheitswissenschaften, Professur für
Biomechanik im Sport, München, Germany
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Effects of the Targeted Intervention for Five- to Six-Year-Old Children Affected by Attentional and Concentration Developmental Risks: Results of a Dynamic Prospective Cohort Study Conducted in Socially Deprived Regions in Germany. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2022; 23:996-1006. [PMID: 35353247 PMCID: PMC9343306 DOI: 10.1007/s11121-022-01362-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/24/2022] [Indexed: 11/12/2022]
Abstract
Epidemiological data reveal that there is a need for prevention measures specifically targeted at children with low SES. In the German federal state Mecklenburg-Western Pomerania preschools in socially deprived regions can apply for additional funds to support children with developmental risks. Mandatory criteria for obtaining these funds involve an annual assessment of all children using the “Dortmunder Developmental Screening for Preschools (DESK 3–6 R).” This instrument can detect and monitor developmental risks in the domains fine motor skills, gross motor skills, language, cognition, and social development. In this study, we examine the domain “Attention and concentration,” which is included for the 5 to 6-year-old age group, using data from two consecutive survey waves (sw). Research questions: (1) Does the prevalence rate ratio (PRR) improve over time? (2) Is the rate of improvements (developmental risk at sw1, no developmental risk at sw2) higher than the rate of deteriorations (no developmental risk at sw1, developmental risk at sw2)? Prospective cohort analysis (n = 940). The prevalence rate of a developmental risk in this DESK domain decreases over time (PRR = 0.78; p = 0.019). The ratio of the rate of improvements is 8.47 times higher than the rate of deteriorations. The results provide evidence of the effectiveness of targeted intervention measures in preschools focusing on skills that improve attention and concentration. This is significant considering the small-time interval and the categorization method of DESK scores. Nevertheless, over the same time period, the DESK results of some children deteriorated. Therefore, preschools also have to be aware that it is natural for some children to show modest declines in their skills over time. German Clinical Trials Register, ID: DRKS00015134, Registered on 29 October 2018, retrospectively registered.
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Marckhoff M, Siebald M, Timmesfeld N, Janßen M, Romer G, Föcker M. COVID-19: Effects of Pandemic Related Restrictions on Physical Activity, Screen Time, and Mental Well-being in German adolescents. ZEITSCHRIFT FUR KINDER-UND JUGENDPSYCHIATRIE UND PSYCHOTHERAPIE 2022; 50:313-326. [PMID: 35343802 DOI: 10.1024/1422-4917/a000867] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Objective: To describe the impact of the COVID-19 pandemic-related restrictions (PR) in April and May 2020 on physical activity (PA), sedentary screen time (SST), and mental well-being (MWB) in German adolescents, and to analyze associations between these variables. Methods: The Münster District Government invited all secondary school students (aged 11-17) in the region to take part in the online survey that assessed PA, SST, and MWB. For data analysis, we calculated descriptive statistics and ran linear regression analysis. Results: 1,038 students (627 [60.4%] female; 14.18 [± 1.97] years) were included in the analysis. During the PR, a marked decline in overall PA (p < .001) and a significant increase (p < .001) in SST were observed. One-third of the students reported worrying more and being less satisfied with their lives since PR. A decrease in life satisfaction (ß = -.524, p < .001) as well as an increase in general worrying (ß = -.336, p = .015) were associated with a decrease in PA during PR. Conclusion: The results show that the restrictions led to a decrease in physical activity, which may have detrimental effects on the students' mental and physical health.
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Affiliation(s)
| | - Milena Siebald
- Department of Child and Adolescent Psychiatry, University Hospital Münster, Germany
| | - Nina Timmesfeld
- Department of Medical Informatics, Biometry, and Epidemiology, Ruhr University Bochum, Germany
| | - Marius Janßen
- Department of Child and Adolescent Psychiatry, University Hospital Münster, Germany
| | - Georg Romer
- Department of Child and Adolescent Psychiatry, University Hospital Münster, Germany
| | - Manuel Föcker
- Department of Child and Adolescent Psychiatry, University Hospital Münster, Germany
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Correlation between Language Development and Motor Skills, Physical Activity, and Leisure Time Behaviour in Preschool-Aged Children. CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9030431. [PMID: 35327803 PMCID: PMC8947720 DOI: 10.3390/children9030431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 03/06/2022] [Accepted: 03/16/2022] [Indexed: 11/16/2022]
Abstract
Sedentary behaviour has a negative impact on children’s physical and mental health. However, limited data are available on language development. Therefore, this pilot study aimed to analyse the associations between language development and possible predictors such as motor skills and leisure time behaviour in preschool-aged children. Methods: In this cross-sectional analysis, motor skills and speech development status were assessed in 49 healthy preschool children. Physical activity and screen time were assessed via a parental questionnaire. Results: On average, physical activity was 8.2 ± 6.5 h/week; mean screen time was 154.2 ± 136.2 min/week. A positive relationship between the results in the item ‘One-leg stand’ and ‘Phonological working memory for nonwords’ (β-coefficient −0.513; p < 0.001) resp. ‘Formation of morphological rules’ (β-coefficient −0.626; p = 0.004) was shown within backward stepwise regression. ‘Lateral jumping’, resp. ‘Sit and Reach’ were positively associated with ‘Understanding sentences’ (β-coefficient 0.519; p = 0.001 resp. β-coefficient 0.735; p = 0.002). ‘Physical inactivity’ correlated negatively with all language development subtests (each p < 0.05). Media consumption had a negative predictive effect on the subdomain ‘Understanding Sentences’ (β-coefficient −0.530, p = 0.003). Conclusions: An inactive lifestyle correlated negatively with selected subtests of language development in early childhood. These results should be verified in larger groups and longitudinally but support the need for early health promotion.
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Faßbender DM, Kreffter K, Götz S, Hagemeister M, Lisak-Wahl S, Nguyen TH, Stemper T, Weyers S. Is the Level of Motor Development at School Entry Related to the Use of Municipal Exercise Programs? A Social-Differential Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19053047. [PMID: 35270739 PMCID: PMC8910425 DOI: 10.3390/ijerph19053047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 02/23/2022] [Accepted: 03/03/2022] [Indexed: 01/25/2023]
Abstract
Children’s motor development is socially unevenly distributed despite many municipal exercise programs (EXP). It has not been sufficiently investigated whether and how they appeal to children from different social backgrounds. This study investigates the use of municipal EXP in preschool age and the association between participation and motor development considering social circumstances. In school entry health examinations, parents were asked about participating in various EXP (response = 65.5%; n = 6480). Motor development, i.e., body coordination and visual-motor coordination, were assessed by a social pediatric development screening, and social circumstances by migration background (MB) and parental education (PE). Poisson regression estimated adjusted Incidence Rate Ratios (IRR; 95% confidence interval, 95%—CI) for relationships between social circumstances and participation in programs and participation and body coordination/visual-motor coordination. Children with MB (IRR 0.73; 95%—CI 0.71–0.75) and low PE (IRR 0.45; 95%—CI 0.40–0.50) used EXP less often. Children participating less often have a finding in body- (IRR 0.76; 95%-CI 0.63–0.90) and visual-motor coordination (IRR 0.47; 95%—CI 0.35–0.62). Significant effects were found for children with and without MB and higher PE. Municipalities should make EXP more attractive for families with MB and low PE.
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Affiliation(s)
- Daniel M Faßbender
- Faculty of Medicine, University Hospital Duesseldorf, Centre for Health and Society, Institute of Medical Sociology, Moorenstrasse 5, 40225 Duesseldorf, Germany
| | - Katharina Kreffter
- Hamm-Lippstadt, University of Applied Sciences, Marker Allee 76-78, 59063 Hamm, Germany
| | - Simon Götz
- Faculty of Medicine, University Hospital Duesseldorf, Centre for Health and Society, Institute of Medical Sociology, Moorenstrasse 5, 40225 Duesseldorf, Germany
| | - Maurus Hagemeister
- Faculty of Medicine, University Hospital Duesseldorf, Centre for Health and Society, Institute of Medical Sociology, Moorenstrasse 5, 40225 Duesseldorf, Germany
| | - Stefanie Lisak-Wahl
- Academy of Public Health Services, Kanzlerstrasse 4, 40472 Duesseldorf, Germany
| | - Thuy Ha Nguyen
- IGES Institute, Friedrichstrasse 180, 10117 Berlin, Germany
| | - Theodor Stemper
- School of Human and Social Sciences, University of Wuppertal, Sport Science, 42119 Wuppertal, Germany
| | - Simone Weyers
- Faculty of Medicine, University Hospital Duesseldorf, Centre for Health and Society, Institute of Medical Sociology, Moorenstrasse 5, 40225 Duesseldorf, Germany
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Dirks S, Kramer P, Schleiger A, Speck HM, Wolfarth B, Thouet T, Berger F, Sallmon H, Ovroutski S. Home-Based Long-Term Physical Endurance and Inspiratory Muscle Training for Children and Adults With Fontan Circulation—Initial Results From a Prospective Study. Front Cardiovasc Med 2022; 8:784648. [PMID: 35198605 PMCID: PMC8858796 DOI: 10.3389/fcvm.2021.784648] [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] [Received: 09/28/2021] [Accepted: 12/28/2021] [Indexed: 11/13/2022] Open
Abstract
BackgroundPatients with congenital heart disease (CHD)—including those after Fontan operation—are encouraged to be physically active.AimTo prospectively determine the effects of an individually adapted, home-based cycle ergometer endurance training in combination with inspiratory muscle training (IMT) in pediatric and adult Fontan patients. We, herein, report the results of the initial 10-months follow-up (phase 1).Methods18 patients (median age 16.5 years; range 10-43 years) completed baseline check-ups, and 4 and 10 months follow-up visits, which each included cardiopulmonary exercise testing (CPET), bodyplethysmography (including measurement of respiratory muscle strength), and a quality of life questionnaire (PedsQL™). The training program consisted of a home-based cycle ergometer endurance training on a “Magbike® AM-5i/3i” (DKN Technology®, Clermont-Ferrand, France) and IMT with a handheld “POWERbreathe® Medic plus” device. Patients performed 90 min of endurance training per week in addition to IMT (30 breaths per day, 6-7 times per week). After the first 4 months, patients underwent additional interval training.ResultsAfter 10 months of training, we observed significant increases in maximum relative workload (W/kg, p = 0.003) and in maximum inspiratory (MIP, p = 0.002) and expiratory (MEP, p = 0.008) pressures. Peak VO2 values did not increase significantly as compared to baseline (p = 0.12) in the entire cohort (n = 18), but reached statistical significance in a subgroup analysis of teenage/adult patients (n = 14; p = 0.03). Patients' subjective quality of life did not show any significant changes after 10 months of training.DiscussionIn Fontan patients, an individually adapted home-based training is safe and associated with improvements in some CPET variables. However, these improvements did not translate into an improved QoL after 10 months. With an unclear, but most likely negative, impact of the COVID-19 pandemic, improvements in QoL may become evident during further follow-up (phase 2 of the study).
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Affiliation(s)
- Stefan Dirks
- Department of Congenital Heart Disease—Pediatric Cardiology, Deutsches Herzzentrum Berlin, Berlin, Germany
| | - Peter Kramer
- Department of Congenital Heart Disease—Pediatric Cardiology, Deutsches Herzzentrum Berlin, Berlin, Germany
| | - Anastasia Schleiger
- Department of Congenital Heart Disease—Pediatric Cardiology, Deutsches Herzzentrum Berlin, Berlin, Germany
| | - Hans-Martin Speck
- Department of Congenital Heart Disease—Pediatric Cardiology, Deutsches Herzzentrum Berlin, Berlin, Germany
| | - Bernd Wolfarth
- Department of Sports Medicine, Charité—Universitätsmedizin Berlin, Berlin, Germany
| | - Thomas Thouet
- Department of Sports Medicine, Charité—Universitätsmedizin Berlin, Berlin, Germany
| | - Felix Berger
- Department of Congenital Heart Disease—Pediatric Cardiology, Deutsches Herzzentrum Berlin, Berlin, Germany
- Department of Pediatric Cardiology, Charité—Universitätsmedizin Berlin, Berlin, Germany
- German Centre for Cardiovascular Research (DZHK), Berlin, Germany
| | - Hannes Sallmon
- Department of Congenital Heart Disease—Pediatric Cardiology, Deutsches Herzzentrum Berlin, Berlin, Germany
- Department of Pediatric Cardiology, Charité—Universitätsmedizin Berlin, Berlin, Germany
| | - Stanislav Ovroutski
- Department of Congenital Heart Disease—Pediatric Cardiology, Deutsches Herzzentrum Berlin, Berlin, Germany
- *Correspondence: Stanislav Ovroutski
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Associations of media use and early childhood development: cross-sectional findings from the LIFE Child study. Pediatr Res 2022; 91:247-253. [PMID: 33658656 PMCID: PMC8770129 DOI: 10.1038/s41390-021-01433-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Revised: 11/16/2020] [Accepted: 12/15/2020] [Indexed: 11/08/2022]
Abstract
BACKGROUND Excessive media usage affects children's health. This study investigated associations between children's and mother's media use, parent-child interactions, and early-childhood development outcomes. METHODS Two hundred and ninety-six healthy 2-5-year-old preschoolers (52.4% male, mean age = 3.5 years) and 224 mothers from the LIFE Child cohort study were analyzed. Screen times and parent-child interactions were assessed using standardized parental questionnaires. Developmental skills were investigated using the standardized development test ET 6-6-R. RESULTS High screen times in children (>1 h/day) were significantly associated with lower percentile ranks in cognition (b = -10.96, p < 0.01), language (b = -12.88, p < 0.01), and social-emotional skills (b = -7.80, p = 0.05). High screen times in mothers (>5 h/day) were significantly associated with high media use by children (OR = 3.86, p < 0.01). Higher parent-child interaction scores were significantly associated with better body motor (b = 0.41, p = 0.05), cognition (b = 0.57, p < 0.01), language (b = 0.48, p = 0.02), and social-emotional outcomes (b = 0.80, p < 0.01) in children. CONCLUSIONS Public health strategies should seek to educate caregivers as competent mediators for their children's media habits, with focus on the need for children to have frequent parent-child interactions. IMPACT High media usage in children is related to poorer cognition, language, and social-emotional skills. More frequent parent-child interactions are associated with better body motor, cognition, language, and social-emotional skills in children. High level of media use in mothers is not directly related to children's development outcomes but is directly related to high media usage of children. Public health strategies should seek to raise media awareness and management in both parents and children.
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Timpel P, Herrmann S, Flößel P, Beck H, Schwarz PE. Effectiveness of digital primary prevention interventions targeting physical activity, motor skills and nutrition in children aged 3-10 years in the setting of day care and primary school: protocol for a systematic review. BMJ Open 2021; 11:e053628. [PMID: 34949625 PMCID: PMC8705251 DOI: 10.1136/bmjopen-2021-053628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
INTRODUCTION Available evidence points to an association of increased screen time and the availability of digital tools during childhood with negative health outcomes in later life. For many years, public discourse focused on restricting access and use of digital technologies below certain ages. However, little is known about the specific benefit of a responsible use of digital primary prevention in the setting of (early) childhood education. The objective of this evidence synthesis is to investigate the effectiveness of digital primary prevention interventions targeting physical activity, motor skills and/or nutrition in children aged 3-10 years in day-care facilities and (pre-) schools. METHODS AND ANALYSIS We present the rationale and methodological steps of a systematic review in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses procedures. Automated searches will be conducted by applying a pretested search strategy to the databases MEDLINE/PubMed, EMBASE and PsycInfo to identify relevant interventional (randomised controlled trials, controlled trials, crossover trials and pilot and feasibility) and observational (case-control, cohort) studies in English or German, with no date restrictions. The overall search will be complemented by backward, forward and additional hand searches. Two researchers will independently screen titles/abstracts and assess full texts by applying predefined eligibility criteria. Data extraction will be conducted by using a pretested data extraction sheet. The assessment of methodological quality will be performed independently by two review authors using the Critical Appraisals Skills Programme relevant to the study design applied in the given study. Additionally, qualitative content analysis will be conducted to analyse priorities for future research extracted from the discussion sections and conclusions of included studies. PROSPERO REGISTRATION NUMBER CRD42020207682.
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Affiliation(s)
- Patrick Timpel
- Medical Faculty Carl Gustav Carus, Department of Medicine III, Prevention and Care of Diabetes, Technische Universität Dresden, Dresden, Sachsen, Germany
| | - Sandra Herrmann
- Medical Faculty Carl Gustav Carus, Department of Medicine III, Prevention and Care of Diabetes, Technische Universität Dresden, Dresden, Sachsen, Germany
| | - Philipp Flößel
- UniversityCenter for Orthopedics, Trauma & Plastic Surgery, Section Sports Medicine and Rehabilitation, Technische Universität Dresden, Dresden, Sachsen, Germany
| | - Heidrun Beck
- UniversityCenter for Orthopedics, Trauma & Plastic Surgery, Section Sports Medicine and Rehabilitation, Technische Universität Dresden, Dresden, Sachsen, Germany
| | - Peter Eh Schwarz
- Medical Faculty Carl Gustav Carus, Department of Medicine III, Prevention and Care of Diabetes, Technische Universität Dresden, Dresden, Sachsen, Germany
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A lifestyle pattern during adolescence is associated with cardiovascular risk markers in young adults: results from the DONALD cohort study. J Nutr Sci 2021; 10:e92. [PMID: 34733504 PMCID: PMC8532054 DOI: 10.1017/jns.2021.84] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Accepted: 09/17/2021] [Indexed: 11/26/2022] Open
Abstract
Lifestyle score approaches combining individual lifestyle factors, e.g. favourable diet, physical activity or normal body weight, showed inverse associations with cardiovascular disease (CVD) risk. However, research mainly focussed on adult behaviour and is scarce for vulnerable time windows for adult health like adolescence. We investigated associations between an adolescent lifestyle score and CVD risk markers in young adulthood. Overall, we analysed 270 participants of the open DONALD cohort study with 1–6 complete measurements of five lifestyle factors (healthy diet, moderate-to-vigorous physical activity, sedentary behaviour, sleep duration and BMI standard deviation score) during adolescence (females: 8⋅5–15⋅5 years and males: 9⋅5–16⋅5 years). Multivariable linear regression models were used to investigate the prospective association between the adolescent lifestyle score (0–5 points) and CVD risk markers in young adulthood (18–30 years). On average, participants obtained a mean adolescent lifestyle score of 2⋅9 (0–5) points. Inverse associations between the adolescent lifestyle score and waist circumference, waist-to-height ratio and percentage of body fat were observed (4⋅1, 4⋅1 and 9⋅2 % decrease per 1 point increase in adolescent lifestyle score, respectively, P < 0⋅05). For the remaining CVD risk markers (glucose, blood lipids, blood pressure and a proinflammatory score), no associations were observed. A healthy adolescent lifestyle is particularly associated with CVD risk-related favourable anthropometric markers in adulthood. A more comprehensive understanding of lifestyle patterns in the life course might enable earlier, targeted preventive measures to assist vulnerable groups in prevention of chronic diseases.
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[Child health in the COVID-19 pandemic: results from school entry data and a parent survey in the Hanover region]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2021; 64:1541-1550. [PMID: 34713308 PMCID: PMC8553103 DOI: 10.1007/s00103-021-03446-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 10/05/2021] [Indexed: 01/31/2023]
Abstract
Einleitung Die COVID-19-Pandemie und die damit verbundenen Kontaktbeschränkungen können für Kinder und Jugendliche besonders belastend sein. Die in Deutschland regulär durchgeführten Schuleingangsuntersuchungen liefern Daten zur Entwicklung und Gesundheit von Vorschulkindern und können Hinweise auf die Auswirkungen der Pandemie geben. Methodik Anhand der Schuleingangsdaten der Region Hannover wird überprüft, ob nach dem ersten Lockdown 2020 häufiger Entwicklungsauffälligkeiten und Gesundheitsbeeinträchtigungen auftraten als vor der Pandemie. Die Prävalenzen zu den Schuleingangsergebnissen der Einschulungsjahrgänge 2017/2018 bis 2020/2021 werden verglichen. Die Auswertung einer Elternbefragung gibt zudem Aufschlüsse über den Alltag und das Wohlergehen der Kinder und deren Familien während der Pandemie. Ergebnisse Nach dem ersten Lockdown zeigt sich, dass Auffälligkeiten in der Sprachkompetenz, der Sprachförderbedarf sowie der Anteil der Kinder, die nur eingeschränkt oder gar kein Deutsch sprechen, deutlicher zugenommen haben als in den Jahren davor. Ferner konnte eine Zunahme von Übergewicht und feinmotorischen Auffälligkeiten sowie ein Anstieg des Medienkonsums festgestellt werden. Die Befragung zeigte, dass der Anteil der Kinder, die häufiger traurig sind, im weiteren Verlauf der Pandemie auf 32,1 % und der Anteil der Kinder, die häufiger Wutanfälle haben, auf 24,9 % angestiegen sind. Kinder haben zunehmend Ein- und Durchschlafprobleme und klagen über Bauch- und Kopfschmerzen, Übelkeit oder Appetitlosigkeit. Diskussion Diese Ergebnisse decken sich mit anderen aktuellen Studien und liefern Hinweise auf mögliche Auswirkungen der COVID-19-Pandemie auf die Kindergesundheit. Um hierzu gesicherte Aussagen zu machen, sind jedoch weitere Auswertungen erforderlich. Zusatzmaterial online Zusätzliche Informationen sind in der Online-Version dieses Artikels (10.1007/s00103-021-03446-2) enthalten.
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Navidad L, Padial-Ruz R, González MC. Nutrition, Physical Activity, and New Technology Programs on Obesity Prevention in Primary Education: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph181910187. [PMID: 34639488 PMCID: PMC8507778 DOI: 10.3390/ijerph181910187] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Revised: 09/24/2021] [Accepted: 09/26/2021] [Indexed: 01/02/2023]
Abstract
Early acquisition of healthy lifestyle habits is crucial for good adult health. For this reason, the primary stage of education is a critical period to implement educational policies in this regard. The aim of this review is to compile the published evidence regarding school interventions at the primary stage aimed at preventing obesity, and which integrate as part of their action plan two features: an improvement in knowledge or nutrition habits and the promotion of physical activity (PA), and the use of new information and communications technologies (ICT) to do this. The method used for this review is the searching of different databases for publications that include these criteria. The results show beneficial effects of such interventions in improved eating habits and increased PA. The effect on BMI is limited, and the use of ICT can be of help at a motivational level for the maintenance and fulfilment of the health objectives. However, studies of this type in elementary school are very limited, so it would be necessary to continue researching on this line. In conclusion, this review demonstrates the suitability of carrying out mixed interventions (improved nutrition and PA) together with the use of new technologies to improve health and prevent obesity at an early age.
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Blume M, Rattay P. Association between Physical Activity and Sleep Difficulties among Adolescents in Germany: The Role of Socioeconomic Status. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:9664. [PMID: 34574590 PMCID: PMC8469412 DOI: 10.3390/ijerph18189664] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 09/02/2021] [Accepted: 09/08/2021] [Indexed: 11/16/2022]
Abstract
We examined sleep difficulties among adolescents in Germany and the association with physical activity (PA). Furthermore, we analyzed whether the association varied with the socioeconomic status (SES) among adolescent girls and boys in Germany. Using data from the German Health Interview Examination Survey for Children and Adolescents (KiGGS) study (Wave 2), 6599 adolescents aged 11 to 17 years were included in the analyses. We conducted sex-stratified logistic regression analyses. Dependent variables were unrecommended sleep duration (defined as a duration of sleep that does not meet the recommended duration), sleep-onset difficulties, trouble sleeping, and daytime sleepiness. Most adolescent girls and boys reported sleep difficulties. While no associations between PA and sleep difficulties were observed, a significant interaction between PA and SES was found for sleep duration in boys and daytime sleepiness in girls. Thus, adolescents with low SES had fewer sleep difficulties if they met the recommendation for PA, compared with those in other SES groups. In Germany, a large proportion of adolescents have sleep difficulties. We found that the experience of sleep difficulties varied according to PA, sex, and the family SES. Future sleep promotion programs should consider these differences.
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Affiliation(s)
- Miriam Blume
- Department of Epidemiology and Health Monitoring, Robert Koch-Institute, 13353 Berlin, Germany;
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Sitzmann L, Akrama G, Baumann C. Effekte von hochintensivem Intervalltraining (HIIT) auf Body-Mass-Index (BMI) und Körperfettanteil von übergewichtigen und adipösen Kindern – eine systematische Übersichtsarbeit. PHYSIOSCIENCE 2021. [DOI: 10.1055/a-1375-9595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Zusammenfassung
Hintergrund Mehr als 340 Millionen Kinder gelten weltweit als übergewichtig oder adipös, ihre Anzahl nahm in den letzten Jahren – auch durch die Coronapandemie – erheblich zu. Eine alternative Behandlung zur Reduzierung des Übergewichts, die in den Empfehlungen bisher keine große Beachtung findet, stellt das sogenannte hochintensive Intervalltraining (HIIT) dar.
Ziel Darstellung der Wirksamkeit von hochintensivem Intervalltraining auf den BMI und Körperfettanteil übergewichtiger und adipöser Kinder im Alter von 6–13 Jahren.
Methode Die Erstellung der systematischen Übersichtsarbeit orientierte sich an den PRISMA-Guidelines. Für die Literaturrecherche wurden die Datenbanken MEDLINE, Cochrane Library, CINAHL, Embase, Sports Medicine & Education Index und Web of Science nach Studien mit hochintensivem Intervalltraining für übergewichtige und adipöse Kinder durchsucht. Die Bewertung der methodischen Studienqualität erfolgte mittels PEDro-Skala, MINORS und Risk of Bias. Die Berichtsqualität wurde anhand von CONSORT und TREND bewertet.
Ergebnisse Es wurden 6 randomisierte kontrollierte Studien und 2 kontrollierte klinische Studien mit 479 HIIT-Teilnehmenden betrachtet. Diese zeigten, dass hochintensives Intervalltraining positive Auswirkungen auf den BMI und Körperfettanteil übergewichtiger und adipöser Kinder hat.
Schlussfolgerung Hochintensives Intervalltraining ist eine kinderfreundliche und zugleich effektive Alternative zur Behandlung von übergewichtigen und adipösen Kindern. Weitere klinische Studien sind erforderlich, um die Ergebnisse zu bekräftigen.
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Affiliation(s)
- Lennert Sitzmann
- Hochschule Fulda, Fachbereich Pflege und Gesundheit, Fulda, Deutschland
| | - Gaith Akrama
- Hochschule Fulda, Fachbereich Pflege und Gesundheit, Fulda, Deutschland
| | - Christian Baumann
- Hochschule Fulda, Fachbereich Pflege und Gesundheit, Fulda, Deutschland
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Greier K, Drenowatz C, Bischofer T, Petrasch G, Greier C, Cocca A, Ruedl G. Physical activity and sitting time prior to and during COVID-19 lockdown in Austrian high-school students. AIMS Public Health 2021; 8:531-540. [PMID: 34395703 PMCID: PMC8334643 DOI: 10.3934/publichealth.2021043] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Accepted: 07/22/2021] [Indexed: 11/24/2022] Open
Abstract
The COVID-19 pandemic has led in many countries to the implementation of policies that mandate social distancing and movement restrictions. While these measures are warranted in order to minimize the spread of the virus they may have detrimental effects on various behaviors, including physical activity (PA). The present study examined PA and sitting time in 14 to18-year-old Austrian high school students prior to and during the second COVID-19 lockdown in Austria. Data was collected via an online questionnaire during fall/winter 2020/21. Questions were based on the International Physical Activity Questionnaire, which examined frequency and duration of PA and sitting time. A total of 221 high school students provided valid data. Participants reported significantly lower moderate and vigorous PA during the lockdown while sitting time increased (p < 0.01). The frequency of walking (days/week) also decreased during COVID-19 lockdown, which also contributed to a significant decline in total walking time (p < 0.01). Further, the decline in PA was more pronounced in boys, while girls reported a greater decline in walking. These differences were due to higher PA and walking in boys and girls, respectively, prior to the lockdown. During the lockdown sex differences in PA and sitting time were limited. Taken together, these results highlight the impact of COVID-19 policies on PA in adolescents and emphasize the importance to promote an active lifestyle even in times of home confinement.
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Affiliation(s)
- Klaus Greier
- Division of Physical Education, Private Educational College (KPH-ES), Stams, Austria
- Department of Sports Science, University of Innsbruck, Innsbruck, Austria
| | - Clemens Drenowatz
- Division of Sport, Physical Activity and Health, University of Education Upper Austria, Linz, Austria
| | - Theresa Bischofer
- Department of Sports Science, University of Innsbruck, Innsbruck, Austria
| | - Gloria Petrasch
- Department of Sports Science, University of Innsbruck, Innsbruck, Austria
| | - Carla Greier
- Department of Sports Science, University of Innsbruck, Innsbruck, Austria
| | - Armando Cocca
- Department of Sports Science, University of Innsbruck, Innsbruck, Austria
| | - Gerhard Ruedl
- Department of Sports Science, University of Innsbruck, Innsbruck, Austria
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Rittsteiger L, Hinz T, Oriwol D, Wäsche H, Santos-Hövener C, Woll A. Sports participation of children and adolescents in Germany: disentangling the influence of parental socioeconomic status. BMC Public Health 2021; 21:1446. [PMID: 34294081 PMCID: PMC8299646 DOI: 10.1186/s12889-021-11284-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Accepted: 06/14/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Participation in sports and physical activity (PA) is a critical resource for children's health and social development. This study analyzes how the parental socioeconomic status (SES) of children and adolescents affects their PA in sports clubs (organized sports) and outside of sports clubs (unorganized sports) and tests whether the potential impact of parental SES is mediated by the opportunity structure of their residential area (walkability, infrastructure, etc.) and by family and peer support for PA. Furthermore, PA is analyzed respecting differences by gender and migration background. METHODS Using representative data from the MoMo/KiGGS study (2009-2012 and 2014-2017), we take into account about 8000 measurements from about 7000 subjects. We estimate hurdle regression models to analyze the minutes per week spent on sports activities. RESULTS Results show that children with a higher parental SES, children living in areas with many opportunities for PA, and children receiving family and peer support are more physically active than children without these features. Controlled for opportunities and support, status effects are small but visible. The differences regarding parental SES are much more apparent for organized sports than for unorganized sports, indicating the relevance of economic resources. Boys are more active than girls, whereas there is no clear effect of migration background. CONCLUSIONS The coefficient of parental SES on organized sports most probably relates to the resources needed to participate in sports clubs, including fees and equipment. Lower membership fees might potentially help to integrate children with low parental SES into sports clubs and thereby make organized sports more accessible to all social classes.
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Affiliation(s)
- Lea Rittsteiger
- Karlsruhe Institute of Technology (KIT), Institute of Sports and Sports Science (IfSS), Engler-Bunte-Ring 15, 76131 Karlsruhe, Germany
| | - Thomas Hinz
- Department for History and Sociology, University of Konstanz, Konstanz, Germany
| | - Doris Oriwol
- Karlsruhe Institute of Technology (KIT), Institute of Sports and Sports Science (IfSS), Engler-Bunte-Ring 15, 76131 Karlsruhe, Germany
| | - Hagen Wäsche
- Karlsruhe Institute of Technology (KIT), Institute of Sports and Sports Science (IfSS), Engler-Bunte-Ring 15, 76131 Karlsruhe, Germany
| | | | - Alexander Woll
- Karlsruhe Institute of Technology (KIT), Institute of Sports and Sports Science (IfSS), Engler-Bunte-Ring 15, 76131 Karlsruhe, Germany
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Wulff H, Duan Y, Wagner P. Physical Activity and Social Network Use of Adolescents in Overweight and Obesity Treatment. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:6938. [PMID: 34203513 PMCID: PMC8295853 DOI: 10.3390/ijerph18136938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 06/17/2021] [Accepted: 06/22/2021] [Indexed: 11/17/2022]
Abstract
Tackling obesity among adolescents requires the optimization of existing obesity treatment strategies. For this purpose, social and personal circumstances, individual needs and behavior of therapy participants need to be analyzed to tailor aims, content and methods of therapy interventions to the target groups. A total of 432 obesity therapy participants between 11 and 17 years completed a written survey in a national multi-center study conducted in 2015. The data collection on behavior, in terms of physical activity, media use and sociodemographic variables, was based on questionnaires from the KiGGS, HBSC and JIM studies. The results show that participants were found to be physically active together with friends (75.5%), alone (41.4%) and in sports clubs (34.9%). Girls (OR 1.55) were less likely to participate in sports clubs. Social networks, especially YouTube, WhatsApp, Instagram and Facebook, were widely used. However, differences emerged among sociodemographic groups (e.g., boys vs. girls) regarding the use of social network features. A third of participants reported that smartphone apps regularly encouraged them to exercise. The findings imply that obesity therapy approaches need to be adapted and more differentiated according to the specific needs of the target groups.
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Affiliation(s)
- Hagen Wulff
- Institute of Exercise and Public Health, University of Leipzig, 04109 Leipzig, Germany;
| | - Yanping Duan
- Department of Sport Physical Education and Health, Hong Kong Baptist University, Hong Kong, China;
| | - Petra Wagner
- Institute of Exercise and Public Health, University of Leipzig, 04109 Leipzig, Germany;
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Ist Bewegung eine Frage des Geldes? Eine Analyse des Kostengeschehens kommunaler Prävention für Kinder aus Nutzerperspektive. PRÄVENTION UND GESUNDHEITSFÖRDERUNG 2021. [DOI: 10.1007/s11553-020-00802-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Zusammenfassung
Hintergrund
Kinder mit niedrigem Sozialstatus haben häufiger motorische Defizite, gleichzeitig nehmen sie Angebote zur Bewegungsförderung seltener wahr. Die Gründe dafür sind unklar. Im Zusammenhang mit finanziellen Barrieren ist das objektive Kostengeschehen aus Nutzerperspektive bisher kaum erforscht, insbesondere nicht im Hinblick auf soziale Ungleichheit.
Ziel der Arbeit
Die Studie soll zwei Fragen beantworten: Welche Kosten müssen Eltern für die Bewegungsangebote ihrer Kinder erbringen? Wie erschwinglich sind diese Angebote für sozioökonomisch benachteiligte Familien?
Material und Methoden
Zunächst wurden 36 Angebote freigemeinnütziger Träger in Düsseldorf für Kinder bis 6 Jahre identifiziert. Zu diesen Angeboten wurde jeweils der Preis pro Kurseinheit, pro Zeitstunde und pro Monat berechnet. Für die Bestimmung der Erschwinglichkeit wurden das günstigste und das teuerste Angebot nach Ermäßigung in Relation zum frei verfügbaren Einkommen einer alleinerziehenden Familie mit Arbeitslosengeld(ALG)-II-Bezug gesetzt.
Ergebnisse
Preise für Eltern-Baby-Kurse rangieren zwischen 20,00 und 48,00 € pro Monat, für Eltern-Kind-Kurse zwischen 4,00 und 44,00 € und für Wasser- und Schwimmangebote zwischen 18,00 und 28,86 €. Ermäßigte Kurspreise können zwischen 4,10 und 21,60 % des frei zur Verfügung stehenden Einkommens einer alleinerziehenden Familie mit ALG-II-Bezug ausmachen.
Diskussion
Kommunale Bewegungsangebote werden an die finanziellen Bedürfnisse von Familien angepasst. Für sozioökonomisch benachteiligte Familien sind sie jedoch nicht immer erschwinglich. Weitere Ermäßigungen bei ausgewählten Angeboten könnten die Inanspruchnahme von Kindern mit niedrigem Sozialstatus an Bewegungsangeboten erhöhen.
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[Leisure Opportunities for Autistic Children and Adolescents: How Satisfied are Parents and what do they Think their Children Would Like?]. Prax Kinderpsychol Kinderpsychiatr 2021; 70:217-238. [PMID: 33641644 DOI: 10.13109/prkk.2021.70.3.217] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Leisure Opportunities for Autistic Children and Adolescents: How Satisfied are Parents and what do they Think their Children Would Like? Like all children and youth, autistic children and adolescents have the right to participate in cultural life including recreational, leisure and sporting activities. Therefore, arrangements have to be made to ensure access to these areas for these particular population (Art. 30 UN-BRK, §§76, 78 BTHG). Thus far, no research has been conducted that examines the need for leisure time facilities for autistic children and/or adolescents in Germany. Therefore, it is unclear if an equal participation in leisure time opportunities is provided. This study presents a first assessment of this topic based on an online-survey of parents of autistic children and adolescents (N = 327). The results indicate, that there is a substantial need for leisure opportunities. Parents of children with infantile and atypical autism show a greater need for more leisure opportunities than parents of children with Asperger Syndrome. In general, the findings show that an equal participation has not been achieved yet. Overall, there is a need for (small) group and sporting activities and especially younger parents asked for specific experiential environments. Possible approaches to a need-oriented organization of leisure facilities for autistic children and adolescents and for an enhancement of leisure opportunities are discussed. The paper further outlines the need for more research in order to provide an empirical basis for equal participation possibilities in public life for autistic children and adolescents.
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Wunsch K, Nigg C, Niessner C, Schmidt SCE, Oriwol D, Hanssen-Doose A, Burchartz A, Eichsteller A, Kolb S, Worth A, Woll A. The Impact of COVID-19 on the Interrelation of Physical Activity, Screen Time and Health-Related Quality of Life in Children and Adolescents in Germany: Results of the Motorik-Modul Study. CHILDREN (BASEL, SWITZERLAND) 2021; 8:98. [PMID: 33540824 PMCID: PMC7913083 DOI: 10.3390/children8020098] [Citation(s) in RCA: 52] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Revised: 01/15/2021] [Accepted: 01/27/2021] [Indexed: 12/20/2022]
Abstract
Reduced physical activity (PA) and prolonged screen time (ST) negatively influence health-related quality of life (HRQoL), a protective factor against illness and mortality. Studies addressing the relationship between PA, ST, and mental health in youth are scarce, especially in times with high mental health burdens like the COVID-19 pandemic. The purpose of this examination was to investigate whether PA, ST, and HRQoL before COVID-19 predict PA, ST, and HRQoL during the COVID-19 pandemic. Participants from the Motorik-Modul Study (MoMo; N = 1711; Mage = 10.36 (SD = 4.04) years, female = 49.8%; healthy weight = 76.8%) self-reported their PA and ST as well as HRQoL both before and during COVID-19. Relationships of all variables, from before to during COVID-19, were investigated through a path prediction model. Results showed all variables during COVID-19 were predicted by the respective levels before COVID-19, independent of gender and age. Cross-lags revealed a negative influence of before COVID-19 ST on during COVID-19 PA. HRQoL before COVID-19 was positively associated with during COVID-19 PA in children younger than 10 years and females, but not in adolescents and boys. As age- and gender-independent negative influence of before COVID-19 ST on during COVID-19 PA has been detected, health policy may be advised to focus on a general reduction in ST instead of PA enhancement to ensure high PA levels.
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Affiliation(s)
- Kathrin Wunsch
- Institute of Sports and Sports Science, Karlsruhe Institute of Technology, 76131 Karlsruhe, Germany; (C.N.); (S.C.E.S.); (D.O.); (A.B.); (A.E.); (S.K.); (A.W.)
| | - Carina Nigg
- Institute of Sports and Sports Science, Karlsruhe Institute of Technology, 76131 Karlsruhe, Germany; (C.N.); (S.C.E.S.); (D.O.); (A.B.); (A.E.); (S.K.); (A.W.)
| | - Claudia Niessner
- Institute of Sports and Sports Science, Karlsruhe Institute of Technology, 76131 Karlsruhe, Germany; (C.N.); (S.C.E.S.); (D.O.); (A.B.); (A.E.); (S.K.); (A.W.)
| | - Steffen C. E. Schmidt
- Institute of Sports and Sports Science, Karlsruhe Institute of Technology, 76131 Karlsruhe, Germany; (C.N.); (S.C.E.S.); (D.O.); (A.B.); (A.E.); (S.K.); (A.W.)
| | - Doris Oriwol
- Institute of Sports and Sports Science, Karlsruhe Institute of Technology, 76131 Karlsruhe, Germany; (C.N.); (S.C.E.S.); (D.O.); (A.B.); (A.E.); (S.K.); (A.W.)
- Institute of Movement and Sport, University of Education Karlsruhe, 76133 Karlsruhe, Germany; (A.H.-D.); (A.W.)
| | - Anke Hanssen-Doose
- Institute of Movement and Sport, University of Education Karlsruhe, 76133 Karlsruhe, Germany; (A.H.-D.); (A.W.)
| | - Alexander Burchartz
- Institute of Sports and Sports Science, Karlsruhe Institute of Technology, 76131 Karlsruhe, Germany; (C.N.); (S.C.E.S.); (D.O.); (A.B.); (A.E.); (S.K.); (A.W.)
| | - Ana Eichsteller
- Institute of Sports and Sports Science, Karlsruhe Institute of Technology, 76131 Karlsruhe, Germany; (C.N.); (S.C.E.S.); (D.O.); (A.B.); (A.E.); (S.K.); (A.W.)
| | - Simon Kolb
- Institute of Sports and Sports Science, Karlsruhe Institute of Technology, 76131 Karlsruhe, Germany; (C.N.); (S.C.E.S.); (D.O.); (A.B.); (A.E.); (S.K.); (A.W.)
| | - Annette Worth
- Institute of Movement and Sport, University of Education Karlsruhe, 76133 Karlsruhe, Germany; (A.H.-D.); (A.W.)
| | - Alexander Woll
- Institute of Sports and Sports Science, Karlsruhe Institute of Technology, 76131 Karlsruhe, Germany; (C.N.); (S.C.E.S.); (D.O.); (A.B.); (A.E.); (S.K.); (A.W.)
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Nigg CR, Wunsch K, Nigg C, Niessner C, Jekauc D, Schmidt SCE, Woll A. Are Physical Activity, Screen Time, and Mental Health Related During Childhood, Preadolescence, and Adolescence? 11-Year Results From the German Motorik-Modul Longitudinal Study. Am J Epidemiol 2021; 190:220-229. [PMID: 33524119 DOI: 10.1093/aje/kwaa192] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Revised: 08/26/2020] [Accepted: 08/28/2020] [Indexed: 11/14/2022] Open
Abstract
Mental health (MH) and behavioral health are fundamental to a good quality of life. Only a few studies have investigated the association between behavioral health (e.g., physical activity (PA), screen time (ST)) and MH from childhood to adolescence. Therefore, we investigated the relationships of PA and ST with MH by sex in an 11-year longitudinal cohort study of German schoolchildren during 2003-2017. A subsample (n = 686; 55.2% female) of participants from the German Motorik-Modul (MoMo) Longitudinal Study who participated in all 3 measurement phases (mean ages: time 1 (baseline; 2003-2006), 5.57 (standard deviation (SD), 1.00) years; time 2 (wave 1; 2009-2012), 11.85 (SD, 1.03) years; time 3 (wave 2; 2014-2017), 16.86 (SD, 1.04) years) were analyzed with regard to PA, ST, and MH (emotional symptoms, conduct problems, hyperactivity/inattention, peer relationship problems, prosocial behavior, and overall strengths and difficulties). Path panel prediction models were fitted with time 1, time 2, and time 3 PA, ST, and MH indicators. PA predicted less television (TV)/video watching in females, and TV/video watching predicted personal computer (PC)/Internet use in both sexes. Behavior and MH results suggested that, for females, higher TV/video watching and PC/Internet use was related to higher MH challenges over the course of maturation. Some preadolescent males' MH challenges increased ST (TV/video watching and PC/Internet use) in adolescence. Researchers should explore innovative and effective methods for reducing childhood ST, especially among females with early signs of MH issues, and addressing preadolescent males' MH challenges.
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25
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Mismatch between self-estimated and objectively assessed exercise capacity in patients with congenital heart disease varies in regard to complexity of cardiac defects. Cardiol Young 2021; 31:77-83. [PMID: 33081857 DOI: 10.1017/s1047951120003406] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
AIM Regular evaluation of physical capacity takes a crucial part in long-term follow-up in patients with congenital heart disease (CHD). This study aims to examine the accuracy of self-estimated exercise capacity compared to objective assessments by cardiopulmonary exercise testing in patients with CHD of various complexity. METHODS We conducted a single centre, cross-sectional study with retrospective analysis on 382 patients aged 8-68 years with various CHD who completed cardiopulmonary exercise tests. Peak oxygen uptake was measured. Additionally, questionnaires covering self-estimation of exercise capacity were completed. Peak oxygen uptake was compared to patient's self-estimated exercise capacity with focus on differences between complex and non-complex defects. RESULTS Peak oxygen uptake was 25.5 ± 7.9 ml/minute/kg, corresponding to 75.1 ± 18.8% of age- and sex-specific reference values. Higher values of peak oxygen uptake were seen in patients with higher subjective rating of exercise capacity. However, oxygen uptake in patients rating their exercise capacity as good (mean oxygen uptake 78.5 ± 1.6%) or very good (mean oxygen uptake 84.8 ± 4.8%) was on average still reduced compared to normal. In patients with non-complex cardiac defects, we saw a significant correlation between peak oxygen uptake and self-estimated exercise capacity (spearman-rho -0.30, p < 0.001), whereas in patients with complex cardiac defects, no correlation was found (spearman-rho -0.11, p < 0.255). CONCLUSION The mismatch between self-estimated and objectively assessed exercise capacity is most prominent in patients with complex CHD.Registration number at Charité Universitätsmedizin Berlin Ethics Committee: EA2/106/14.
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Bachner J, Sturm DJ, Demetriou Y. Accelerometer-Measured Physical Activity and Sedentary Behavior Levels and Patterns in Female Sixth Graders: The CReActivity Project. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 18:E32. [PMID: 33374568 PMCID: PMC7793121 DOI: 10.3390/ijerph18010032] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Revised: 12/16/2020] [Accepted: 12/21/2020] [Indexed: 01/19/2023]
Abstract
Regular physical activity (PA) and low levels of sedentary behavior (SB) have positive health effects on young people. Adolescent girls of low socioeconomic background represent a high-risk group with regard to physical inactivity and SB. In this study, accelerometer-measured levels of PA and SB of female sixth graders attending lower secondary schools in Germany are presented, patterns of PA and SB throughout the day are described and differences between weekdays and weekend days are analyzed. Data of 425 students of the CReActivity project were analyzed. Sampling and processing of accelerometer data followed recent recommendations, which had not been applied to data of a German-speaking sample before. The WHO recommendation of daily 60 min moderate-to-vigorous PA was fulfilled by 90.4% of the girls on weekdays and by 57.4% on weekend days. The significant weekday-weekend differences were mainly associated with active commuting to and from school. Students engaged in SB for more than 8 h on weekdays and for over 7 h on weekend days. The results suggest a strong need for interventions increasing PA and reducing SB, especially during school hours and on weekends. Furthermore, a comparison with methods and results of previous studies highlights the need to follow recent criteria in accelerometer data sampling and processing to ensure an accurate and valid differentiation between PA-related risk groups and non-risk groups.
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Affiliation(s)
- Joachim Bachner
- Department of Sport and Health Sciences, Technical University of Munich, 80992 Munich, Germany; (D.J.S.); (Y.D.)
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Ricci C, Schlarb AA, Rothenbacher D, Genuneit J. Digital media, book reading, and aspects of sleep and sleep-related fears in preschoolers: the Ulm SPATZ Health Study. SOMNOLOGIE 2020. [DOI: 10.1007/s11818-020-00290-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Abstract
Background
High levels of digital media use with screen-based devices has been found to threaten several aspects of child and adolescent health. However, the rapid change in digital media use behavior in our society over the past decade has rendered much of the existing evidence outdated.
Materials and methods
The present work reports data ascertained from 2016 to 2019 on preschoolers’ digital media use and book reading among 4‑ to 6‑year-old children from the longitudinal Ulm SPATZ Health Study. These data are supplemented by exploring the association of child digital media use and book reading with aspects of children’s sleep and sleep-related fears.
Results
After data management, 581 children participated at the age of 4 years. At the ages of 5 and 6 years, data were available for 508 and 426 participants, respectively. Median age of the mothers was 33 years (range 21–54) and 70% had graduated from high school. Most time spent using digital media was represented by passive activities in front of a screen. Time spent using digital media increased with children’s age. An increased risk of the fear of sleeping alone (RR: 1.35, [95% CI: 1.07; 1.70]) and fear of the dark (1.47 [95% CI 1.16; 1.87]) was documented for exposure to “all media” higher than the median as compared to lower levels. Exposure to “books” above the median and compared to lower levels was tentatively associated with a relevant 18% reduction in the risk of both fear of sleeping alone and fear of the dark (0.82 [95% CI 0.65; 1.03] and 0.82 [95% CI 0.64; 1.05], respectively).
Conclusion
Our results suggest that reducing time spent using digital media and potentially substituting this time by reading books, which seem to be a safe alternative, is a valid solution to reduce some common aspects of poor sleep in preschoolers.
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28
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Igel U, Gausche R, Krapf A, Lück M, Kiess W, Grande G. "Movement-enhancing footpaths" - A natural experiment on street design and physical activity in children in a deprived district of Leipzig, Germany. Prev Med Rep 2020; 20:101197. [PMID: 32983853 PMCID: PMC7495097 DOI: 10.1016/j.pmedr.2020.101197] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 07/29/2020] [Accepted: 08/25/2020] [Indexed: 11/26/2022] Open
Abstract
Despite the beneficial effects of physical activity (PA), only 26% of children in Germany meet the WHO's recommendations. Because active play contributes to PA and is accepted by families, the creation of "playable" environments could promote PA. This study is a natural experiment that was conducted to investigate whether slight changes in the physical environment can increase PA in children. In autumn 2016, 140 students from two primary schools located in a deprived district of Leipzig (Germany) gathered ideas on PA-promoting street designs. After protracted negotiations with the city administration, two footpaths were decorated with colored markings (hopscotch grids, labyrinths, "mirror me") in September 2019. 48 observations were made before (August 2019) and after (September/October 2019) the implementation using the System for Observing Play and Recreation in Communities (SOPARC). Age, gender, activity level, bike use, and interactions with the colored markings were recorded. A total of 5455 individuals (including 1099 cyclists) were observed. Almost one fifth of the observed children (0 to 12 years) interacted with the markings. There was a slight increase in vigorous activity in all observed individuals after the implementation (2.9% vs. 6.4%, p < 0.001). The chance for vigorous activity was higher on decorated footpaths (OR 2.45, CI 1.54-3.89, p < 0.001), for children (OR 19.32, CI 13.07-28.56, p < 0.001), and on Sundays (OR 3.39, CI 2.33-4.94, p < 0.001). The participatory development and design of footpaths that support spontaneous active play "on the way" might be one component that can be used to support changes in children's PA behaviors and social interactions.
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Affiliation(s)
- Ulrike Igel
- Center for Research and Transfer (FTZ) at the Leipzig University of Applied Sciences (HTWK), Leipzig, Germany
| | - Ruth Gausche
- Hospital for Children and Adolescents, University of Leipzig, Germany
| | - Almut Krapf
- Faculty of Education, University of Leipzig, Germany
| | - Martina Lück
- Faculty of Social Sciences, University of Applied Sciences Mittweida, Germany
| | - Wieland Kiess
- Hospital for Children and Adolescents, University of Leipzig, Germany
| | - Gesine Grande
- Leipzig University of Applied Sciences (HTWK), Germany
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Impact of "JolinchenKids-Fit and Healthy in Daycare" on Children's Objectively Measured Physical Activity: A Cluster-Controlled Study. J Phys Act Health 2020; 17:1025-1033. [PMID: 32858522 DOI: 10.1123/jpah.2019-0536] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Revised: 06/18/2020] [Accepted: 07/15/2020] [Indexed: 01/12/2023]
Abstract
BACKGROUND To evaluate a multicomponent health promotion program targeting preschoolers' physical activity (PA). METHODS PA of children from 23 German daycare facilities (DFs; 13 intervention DFs, 10 control DFs) was measured via accelerometry at baseline and after 12 months. Children's sedentary time, light PA, and moderate to vigorous PA were estimated. Adherence was tracked with paper-and-pencil calendars. Mixed-model regression analyses were used to assess intervention effects. RESULTS PA data were analyzed from 183 (4.2 [0.8] y, 48.1% boys) children. At follow-up, children in DF groups with more than 50% adherence to PA intervention components showed an increase of 9 minutes of moderate to vigorous PA per day (β = 9.28; 95% confidence interval [CI], -0.16 to 18.72) and a 19-minute decrease in sedentary time (β = -19.25; 95% CI, -43.66 to 5.16) compared with the control group, whereas children's PA of those who were exposed to no or less than 50% adherence remained unchanged (moderate to vigorous PA: β = 0.34; 95% CI, -13.73 to 14.41; sedentary time: β = 1.78; 95% CI, -26.54 to 30.09). Notable effects were found in children with migration background. CONCLUSIONS Only small benefits in PA outcomes were observed after 1 year. A minimum of 50% adherence to the intervention seems to be crucial for facilitating intervention effects.
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30
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Sun J, Liu Y. Using Smart Bracelets to Assess Heart Rate Among Students During Physical Education Lessons: Feasibility, Reliability, and Validity Study. JMIR Mhealth Uhealth 2020; 8:e17699. [PMID: 32663136 PMCID: PMC7439147 DOI: 10.2196/17699] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Revised: 05/02/2020] [Accepted: 06/14/2020] [Indexed: 12/18/2022] Open
Abstract
Background An increasing number of wrist-worn wearables are being examined in the context of health care. However, studies of their use during physical education (PE) lessons remain scarce. Objective We aim to examine the reliability and validity of the Fizzo Smart Bracelet (Fizzo) in measuring heart rate (HR) in the laboratory and during PE lessons. Methods In Study 1, 11 healthy subjects (median age 22.0 years, IQR 3.75 years) twice completed a test that involved running on a treadmill at 6 km/h for 12 minutes and 12 km/h for 5 minutes. During the test, participants wore two Fizzo devices, one each on their left and right wrists, to measure their HR. At the same time, the Polar Team2 Pro (Polar), which is worn on the chest, was used as the standard. In Study 2, we went to 10 schools and measured the HR of 24 students (median age 14.0 years, IQR 2.0 years) during PE lessons. During the PE lessons, each student wore a Polar device on their chest and a Fizzo on their right wrist to measure HR data. At the end of the PE lessons, the students and their teachers completed a questionnaire where they assessed the feasibility of Fizzo. The measurements taken by the left wrist Fizzo and the right wrist Fizzo were compared to estimate reliability, while the Fizzo measurements were compared to the Polar measurements to estimate validity. To measure reliability, intraclass correlation coefficients (ICC), mean difference (MD), standard error of measurement (SEM), and mean absolute percentage errors (MAPE) were used. To measure validity, ICC, limits of agreement (LOA), and MAPE were calculated and Bland-Altman plots were constructed. Percentage values were used to estimate the feasibility of Fizzo. Results The Fizzo showed excellent reliability and validity in the laboratory and moderate validity in a PE lesson setting. In Study 1, reliability was excellent (ICC>0.97; MD<0.7; SEM<0.56; MAPE<1.45%). The validity as determined by comparing the left wrist Fizzo and right wrist Fizzo was excellent (ICC>0.98; MAPE<1.85%). Bland-Altman plots showed a strong correlation between left wrist Fizzo measurements (bias=0.48, LOA=–3.94 to 4.89 beats per minute) and right wrist Fizzo measurements (bias=0.56, LOA=–4.60 to 5.72 beats per minute). In Study 2, the validity of the Fizzo was lower compared to that found in Study 1 but still moderate (ICC>0.70; MAPE<9.0%). The Fizzo showed broader LOA in the Bland-Altman plots during the PE lessons (bias=–2.60, LOA=–38.89 to 33.69 beats per minute). Most participants considered the Fizzo very comfortable and easy to put on. All teachers thought the Fizzo was helpful. Conclusions When participants ran on a treadmill in the laboratory, both left and right wrist Fizzo measurements were accurate. The validity of the Fizzo was lower in PE lessons but still reached a moderate level. The Fizzo is feasible for use during PE lessons.
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Affiliation(s)
- Jiangang Sun
- School of Physical Education and Sport Training, Shanghai University of Sport, Shanghai, China
| | - Yang Liu
- School of Physical Education and Sport Training, Shanghai University of Sport, Shanghai, China.,Shanghai Research Center for Physical Fitness and Health of Children and Adolescents, Shanghai University of Sport, Shanghai, China
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Mack I, Reiband N, Etges C, Eichhorn S, Schaeffeler N, Zurstiege G, Gawrilow C, Weimer K, Peeraully R, Teufel M, Blumenstock G, Giel KE, Junne F, Zipfel S. The Kids Obesity Prevention Program: Cluster Randomized Controlled Trial to Evaluate a Serious Game for the Prevention and Treatment of Childhood Obesity. J Med Internet Res 2020; 22:e15725. [PMID: 32329742 PMCID: PMC7210499 DOI: 10.2196/15725] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Revised: 12/02/2019] [Accepted: 12/16/2019] [Indexed: 12/12/2022] Open
Abstract
Background Health games provide opportunities for the treatment and prevention of childhood obesity. We developed a motion-controlled serious game for children that addresses 3 core topics of nutrition, physical activity, and stress coping. It is the first serious game that extensively targets the dietary energy density principle (DED-P) in relation to nutrition. The game is intended to provide an additional educational component for the prevention and treatment of obesity in children. Objective The Kids Obesity Prevention study aimed to evaluate the newly developed game and to evaluate how well children are able to understand and apply the DED-P. Methods This cluster randomized controlled trial collected data from 82 primary school children aged 9 to 12 years and their parents at baseline (T0), at 2 weeks after study commencement (T1), and at the 4-week follow-up (T2). The dropout rate was 3.6%. The intervention group (IG) played the game within 2 weeks (2 sessions with different game modules). One part of the game involves selection of food with the lower energy density when presented with a pair of foods. This allows assessment of whether the children have understood the DED-P and whether they can apply it to unknown foods under time pressure. The control group (CG) received a brochure about the food pyramid concept and physical activity. The primary outcome was the gain in knowledge (nutrition and stress coping) and measured with a pretested questionnaire. The secondary outcomes were the maintenance of knowledge, application of the DED-P, feelings during game play, game acceptance, and behavioral measures (physical activity, media consumption, and dietary intake). Results The knowledge score ranging from 0 to 100 increased from T0 (IG: 53 [SD 10], CG: 50 [SD 11]) to T1 (IG: 69 [SD 11], CG: 52 [SD 12]) in IG versus CG (P<.001). At T2, the knowledge score of IG remained at the same level as that of T1. Game data showed that after DED-P education, the classification under time pressure of unknown versus known food pairs according to their DED category was similar (hit rate around 70%). Overall, 95% of the children liked the game very much or much. No group changes were observed at the behavioral level. Conclusions The Kids Obesity Prevention program sustainably increased knowledge in the areas of nutrition and stress coping, and children were able to apply the DED-P. Trial Registration ClinicalTrials.gov NCT02551978; https://clinicaltrials.gov/ct2/show/NCT02551978
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Affiliation(s)
- Isabelle Mack
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Hospital, Tübingen, Germany
| | - Nadine Reiband
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Hospital, Tübingen, Germany.,Department of School Psychology, University of Tübingen, Tübingen, Germany
| | - Carolin Etges
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Hospital, Tübingen, Germany
| | - Sabrina Eichhorn
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Hospital, Tübingen, Germany
| | - Norbert Schaeffeler
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Hospital, Tübingen, Germany
| | - Guido Zurstiege
- Department of Media Studies Tübingen, University of Tübingen, Tübingen, Germany
| | - Caterina Gawrilow
- Department of School Psychology, University of Tübingen, Tübingen, Germany
| | - Katja Weimer
- Department of Psychosomatic Medicine and Psychotherapy, Ulm University Medical Center, Ulm, Germany
| | - Riyad Peeraully
- Department of Paediatric Surgery, Nottingham Children's Hospital, Nottingham, United Kingdom
| | - Martin Teufel
- LVR-Clinic for Psychosomatic Medicine and Psychotherapy, University of Duisburg-Essen, Essen, Germany
| | - Gunnar Blumenstock
- Institute for Clinical Epidemiology and Applied Biometry, University of Tübingen, Tübingen, Germany
| | - Katrin Elisabeth Giel
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Hospital, Tübingen, Germany
| | - Florian Junne
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Hospital, Tübingen, Germany
| | - Stephan Zipfel
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Hospital, Tübingen, Germany
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Dauben L, Weber KS, Nießen L, Verket M, Spörkel O, Strassburger K, Roden M, Kronsbein P, Müssig K. Associations Between Migration Background and Media and Information Behavior in Primary School Children. Exp Clin Endocrinol Diabetes 2020; 129:813-820. [PMID: 32164030 DOI: 10.1055/a-1114-5871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
BACKGROUND Children with migration background and from low socio-economic status are at higher risk for overweight. To determine appropriate media channels to possibly reach children with targeted health information, it has to be considered that the media and information behavior of children has changed during the last decades. OBJECTIVE We examined the media and information behavior of children in low socio-economic districts, focusing on those with migration background. METHODS Fourteen 3rd grade classes (n=250 children, 68.0% with migration background) completed a questionnaire regarding their media consumption, which was based on existing validated surveys. RESULTS ≥ 50% of the children watched TV and around 40% used both mobile phones and computers/tablets/internet for ≥1 h/day. Books were the most popular analogue media (61.6% of children), whereas magazines/newspapers and radio (18.4 and 16.0% of children, respectively) were used less frequently. Furthermore, they regularly used internet, TV and their teachers (63.0, 48.8 and 44.8% of children, respectively) as information source. Especially children with compared to those without migration background less likely used the radio (P=0.0002) and their family as information source (P=0.0017). CONCLUSIONS Children attending 3rd grade class, especially with migration background, can be addressed through digital media rather than the radio. This may help to sustainably support children outside school with targeted health information.
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Affiliation(s)
- Laura Dauben
- Institute for Clinical Diabetology, German Diabetes Center at Heinrich Heine University, Leibniz Center for Diabetes Research, Düsseldorf, Germany.,German Center for Diabetes Research (DZD), München-Neuherberg, Germany
| | - Katharina S Weber
- Institute for Clinical Diabetology, German Diabetes Center at Heinrich Heine University, Leibniz Center for Diabetes Research, Düsseldorf, Germany.,German Center for Diabetes Research (DZD), München-Neuherberg, Germany
| | - Lisa Nießen
- Institute for Clinical Diabetology, German Diabetes Center at Heinrich Heine University, Leibniz Center for Diabetes Research, Düsseldorf, Germany.,German Center for Diabetes Research (DZD), München-Neuherberg, Germany.,Faculty of Food, Nutrition and Hospitality Sciences, Niederrhein University of Applied Sciences, Mönchengladbach, Germany
| | - Marlo Verket
- Institute for Clinical Diabetology, German Diabetes Center at Heinrich Heine University, Leibniz Center for Diabetes Research, Düsseldorf, Germany.,German Center for Diabetes Research (DZD), München-Neuherberg, Germany
| | - Olaf Spörkel
- Institute for Clinical Diabetology, German Diabetes Center at Heinrich Heine University, Leibniz Center for Diabetes Research, Düsseldorf, Germany.,German Center for Diabetes Research (DZD), München-Neuherberg, Germany
| | - Klaus Strassburger
- German Center for Diabetes Research (DZD), München-Neuherberg, Germany.,Institute for Biometrics and Epidemiology, German Diabetes Center at Heinrich Heine University, Leibniz Institute for Diabetes Research, Düsseldorf, Germany
| | - Michael Roden
- Institute for Clinical Diabetology, German Diabetes Center at Heinrich Heine University, Leibniz Center for Diabetes Research, Düsseldorf, Germany.,German Center for Diabetes Research (DZD), München-Neuherberg, Germany.,Division of Endocrinology and Diabetology, Medical Faculty, Heinrich Heine University, Düsseldorf, Germany
| | - Peter Kronsbein
- Faculty of Food, Nutrition and Hospitality Sciences, Niederrhein University of Applied Sciences, Mönchengladbach, Germany
| | - Karsten Müssig
- Institute for Clinical Diabetology, German Diabetes Center at Heinrich Heine University, Leibniz Center for Diabetes Research, Düsseldorf, Germany.,German Center for Diabetes Research (DZD), München-Neuherberg, Germany.,Division of Endocrinology and Diabetology, Medical Faculty, Heinrich Heine University, Düsseldorf, Germany.,Department of Internal Medicine, Niels-Stensen-Kliniken, Franziskus-Hospital Harderberg, Georgsmarienhütte, Germany
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Krist L, Roll S, Stroebele-Benschop N, Rieckmann N, Müller-Nordhorn J, Bürger C, Willich SN, Müller-Riemenschneider F. Determinants of Physical Activity and Screen Time Trajectories in 7th to 9th Grade Adolescents-A Longitudinal Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17041401. [PMID: 32098117 PMCID: PMC7068460 DOI: 10.3390/ijerph17041401] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/28/2019] [Revised: 02/18/2020] [Accepted: 02/19/2020] [Indexed: 01/01/2023]
Abstract
Physical activity (PA) in youth tends to decline with increasing age, while sedentary behaviour including screen time (ST) increases. There are adolescents, however, whose PA and ST do not follow this pattern. The aim of this study is (i) to examine trajectories in PA and ST from grade 7-9 among students in Berlin, and (ii) to investigate the relationship of these trajectories with individual factors and school type. For the present analyses, changes in students' PA and ST across three time points from 7th to 9th grade were assessed via self-report questionnaires. Positive and negative trajectories were defined for both PA (positive: increasing or consistently high, negative: decreasing or consistently low) and ST (vice versa). Multivariable logistic regression analyses were performed to identify possible predictors of PA and ST trajectories. In total, 2122 students were included (50.2% girls, mean age 12.5 (standard deviation 0.7) years). Compared to grade 7, less students of grade 9 fulfilled PA and ST recommendations (PA: 9.4% vs. 13.2%; ST: 19.4% vs. 25.0%). The positive PA trajectory included 44% of all students (63% boys), while the positive ST trajectory included 21% of all students (30% boys). Being a boy was significantly associated with a positive PA trajectory, while being a girl, having a high socioeconomic status, and attending a high school, were significantly associated with a positive ST trajectory. Different PA and ST trajectories among adolescents should be taken into account when implementing prevention programs for this target group.
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Affiliation(s)
- Lilian Krist
- Institute for Social Medicine, Epidemiology and Health Economics, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, 10117 Berlin, Germany; (S.R.); (C.B.); (S.N.W.)
- Correspondence:
| | - Stephanie Roll
- Institute for Social Medicine, Epidemiology and Health Economics, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, 10117 Berlin, Germany; (S.R.); (C.B.); (S.N.W.)
| | | | - Nina Rieckmann
- Institute of Public Health, Charité-Universitätsmedizin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, 10117 Berlin, Germany; (N.R.); (J.M.-N.)
| | - Jacqueline Müller-Nordhorn
- Institute of Public Health, Charité-Universitätsmedizin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, 10117 Berlin, Germany; (N.R.); (J.M.-N.)
| | - Christin Bürger
- Institute for Social Medicine, Epidemiology and Health Economics, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, 10117 Berlin, Germany; (S.R.); (C.B.); (S.N.W.)
| | - Stefan N. Willich
- Institute for Social Medicine, Epidemiology and Health Economics, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, 10117 Berlin, Germany; (S.R.); (C.B.); (S.N.W.)
| | - Falk Müller-Riemenschneider
- Berlin Institute of Health (BIH), Charité-Universitätsmedizin Berlin, 10178 Berlin, Germany;
- Saw Swee Hock School of Public Health, National University of Singapore; Singapore 117549, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, Singapore
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Bittlingmayer UH, Dadaczynski K, Sahrai D, van den Broucke S, Okan O. [Digital health literacy-conceptual contextualization, measurement, and promotion]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2020; 63:176-184. [PMID: 31950230 DOI: 10.1007/s00103-019-03087-6] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
The concept of digital health literacy can be regarded as the result of the increasing social permeation of digital media and their use in everyday life. Due to increasing accessibility and ubiquity, there is an increasing need not only for searching and finding, but especially for assessing the reliability as well as selecting and applying health information for one's own health concerns. In the context of digitization, it needs to be emphasized that users are not just passive recipients, but rather actively participate in the communication process by interacting with existing content or by sharing their own health-related information.With particular focus on children and adolescents, this paper provides an overview of the current state of research on digital health literacy. In addition to its terminological and conceptual foundations and its links with media literacy, the relationship between digital health literacy and social and health inequality is discussed. Inequalities are not only generated by access to digital media but, above all, by the skills required for their use. After an overview of available instruments is provided, initial reflections on how to promote the individual and structural dimension of digital health literacy with focus on school settings is given.
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Affiliation(s)
- Uwe H Bittlingmayer
- Institut für Soziologie, Pädagogische Hochschule Freiburg, Kunzenweg 21, 79117, Freiburg, Deutschland.
| | - Kevin Dadaczynski
- Fachbereich Pflege und Gesundheit, Hochschule Fulda, Fulda, Deutschland.,Leuphana Universität Lüneburg, Zentrum für Angewandte Gesundheitswissenschaften, Lüneburg, Deutschland
| | - Diana Sahrai
- Institut Spezielle Pädagogik und Psychologie, Pädagogische Hochschule FHNW, Muttenz, Schweiz
| | - Stephan van den Broucke
- Psychological Sciences Research Institute, Université catholique de Louvain, Louvain-la-Neuve, Belgien
| | - Orkan Okan
- Fakultät für Erziehungswissenschaft, Universität Bielefeld, Bielefeld, Deutschland
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35
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Physical activity levels and sedentary time during school hours of 6th-grade girls in Germany. J Public Health (Oxf) 2020. [DOI: 10.1007/s10389-019-01190-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Abstract
Aim
Regular physical activity and low levels of sedentary time have positive health effects on youth, and data are needed to base public health recommendations on. Here, findings of device-based physical activity and sedentary time in sixth graders are presented. Data below are presented as mean (SD).
Subject and methods
Three hundred and eight sixth-grade girls [11.6 (0.6) years] from the CReActivity study in Germany wore accelerometers (ActiGraph GT3X) for 7 consecutive days. Moderate to vigorous physical activity (MVPA), light physical activity (LPA), and sedentary time (ST) was obtained during school days with a focus on recess times.
Results
Girls spent 79.9 (23.2) minutes in MVPA and 9.4 (1.2) hours in ST during schooldays, of which 20.5 (8.2) minutes and 3.8 (0.4) hours respectively were accumulated during school hours. On average, students had 35.4 (4.5) minutes break, of which 6.3 (3.2) minutes (17.8%) were spent in MVPA activity and 16.5 (6.2) minutes (46.6%) in ST.
Conclusion
School setting is an important factor for physical activity and sedentary time. Therefore policy, curriculums, and school environment should promote physical activity und reduce sedentary time during school hours.
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Spengler S, Kuritz A, Rabel M, Mess F. Are primary school children attending full-day school still engaged in sports clubs? PLoS One 2019; 14:e0225220. [PMID: 31756210 PMCID: PMC6874300 DOI: 10.1371/journal.pone.0225220] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Accepted: 10/30/2019] [Indexed: 11/23/2022] Open
Abstract
PURPOSE Schools and organized sports both offer great chances to promote physical activity among children. Full-day schools particularly allow for extensive participation in extra-curricular physical activities. However, due to time reasons, full-day schools may also prevent children from engagement in organized sports outside school. There is only little national and international research addressing the possible competition of full-day schools and providers of organized sports outside school and the potential effects on children's physical activity behavior. In Germany's educational system, a transformation towards more full-day schools is currently taking place. The existence of both, half-day and full-day schools, gave occasion to the following research question: Do students attending half-day and full-day school differ with respect to a) sports club membership rate and b) weekly amount of sports club training? METHODS Data were collected in eleven German primary schools. Selected schools offered both half-day and full-day (minimum three days/week with at least seven hours) care. 372 students' data (grades 1-4; N = 153 half-day, N = 219 full-day; 47.4% male, 8.8±1.2y) were eligible for analyses. We assessed sports club membership and weekly training duration via questionnaire. Statistical analyses included Chi-square and Mann-Whitney-U-Tests. RESULTS 83% of half-day school students and 67% of full-day school students were sports club members (χ2(1) = 12.31, p<.001). Weekly duration of training in sports clubs among sports club members (N = 266) also differed between the groups (mdn = 150 min in half-day, mdn = 120 min in full-day school students; z = -2.37, p = .018). Additional analyses stratified for age and gender showed similar results. CONCLUSION Primary school students attending full-day schools engage less in organized sports outside school than half-day school students, regardless of age and gender. Future studies should examine if the detected lower engagement in sports club physical activity is compensated by physical activities in other settings such as school or non-organized leisure time.
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Affiliation(s)
- Sarah Spengler
- Department of Sport and Health Sciences, Technical University of Munich, Munich, Germany
| | - Arvid Kuritz
- Department of Sports Science, University of Konstanz, Konstanz, Germany
| | - Matthias Rabel
- Department of Sport and Health Sciences, Technical University of Munich, Munich, Germany
| | - Filip Mess
- Department of Sport and Health Sciences, Technical University of Munich, Munich, Germany
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Steenbock B, Buck C, Zeeb H, Rach S, Pischke CR. Impact of the intervention program "JolinchenKids - fit and healthy in daycare" on energy balance related-behaviors: results of a cluster controlled trial. BMC Pediatr 2019; 19:432. [PMID: 31722702 PMCID: PMC6852984 DOI: 10.1186/s12887-019-1817-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Accepted: 10/31/2019] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND The purpose of this study was to evaluate the multi-component health promotion program, JolinchenKids - fit and healthy in daycare, designed to promote physical activity (PA), healthy eating, and mental wellbeing among 3- to 6-year-old preschoolers. METHODS For this cluster controlled trial, 62 daycare facilities (DFs) from thirteen different federal states in Germany were recruited (31 intervention, 31 control DFs). Outcome measures were children's habitual PA, fruits and vegetable consumption, consumption of unsweetened beverages and snacks with parents as raters. Study nurses assessed children's body composition and motor skills. Data was collected at baseline and 12 months later. To track adherence to the implementation of intervention modules at individual DF groups, an implementation calendar was used from baseline to follow-up. Linear mixed models were used to investigate effects for survey, group and their interaction at the individual level while accounting for clustering. RESULTS Samples of 831 (baseline) and 641 (follow-up) children aged 4.3 ± 0.8 and 5.2 ± 0.8 years were analysed. More than half of the intervention DFs chose the nutrition or PA module for the first year of implementation while an implementation level of > 50% was only achieved in less than a third. A significant intervention effect (survey × group interaction) was found for the standing long jump favouring children at intervention DFs (β = 3.08; 95% Confidence interval [CI]: (0.09; 6.07)). No significant intervention effects were found for time spent on PA, total screen time, dietary habits, and body composition, i.e. body-mass-index and percentage of body fat. CONCLUSIONS Participation in JolinchenKids - fit and healthy in daycare led to improvements in some indicators for motor skills. However, other health outcomes and behaviours were not affected by program participation over the course of 1 year. TRIAL REGISTRATION German Clinical Trials Register DRKS00011065 (Date of registration 16-09-2016).
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Affiliation(s)
- Berit Steenbock
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Achterstrasse 30, 28359, Bremen, Germany. .,Center for Clinical Psychology and Rehabilitation, University of Bremen, Bremen, Germany.
| | - Christoph Buck
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Achterstrasse 30, 28359, Bremen, Germany
| | - Hajo Zeeb
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Achterstrasse 30, 28359, Bremen, Germany.,Health Sciences Bremen, University of Bremen, Bremen, Germany
| | - Stefan Rach
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Achterstrasse 30, 28359, Bremen, Germany
| | - Claudia R Pischke
- Centre for Health and Society, Medical Faculty, Institute of Medical Sociology, Heinrich Heine University Duesseldorf, Moorenstrasse 5, 40225, Duesseldorf, Germany
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38
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Waldhauer J, Kuntz B, Lampert T. [Differences in subjective health, mental health, and health behavior among 11- to 17-year-olds at secondary schools in Germany : Results of the German health interview and examination survey for children and adolescents: first follow-up (KiGGS Wave 1)]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2019; 61:374-384. [PMID: 29470591 DOI: 10.1007/s00103-018-2704-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Social inequalities in health can already be found among children and adolescents to the disadvantage of socially deprived population groups. This paper aims to detect, whether differences in subjective health, mental health and health behavior among young people are due to the secondary school type attended and whether these associations exist independently of the family's socioeconomic position (SEP). METHODS The data basis was the German Health Interview and Examination Survey for Children and Adolescents (KiGGS Wave 1, 2009-2012). Data of 11- to 17-year-old girls and boys (n = 4665) who attend different types of secondary schools in Germany were analyzed. The dependent variables were self-rated health, findings of the Strengths and Difficulties Questionnaire (SDQ) for the detection of psychological abnormalities, as well as self-reported information regarding leisure sport, tobacco, and alcohol consumption. Prevalence and odds ratios (ORs) based on logistic regressions are shown. RESULTS For the majority of the examined indicators, it can be shown that adolescents in lower secondary schools are more likely to report worse self-rated health and mental problems and engage in unhealthy behavior than peers in grammar schools ("Gymnasium"). The differences decrease after controlling for family's SEP but mostly remain statistically significant. Adolescents who don't attend grammar schools are most strongly disadvantaged in terms of inattention/hyperactivity for both gender (OR: 2.29 [1.70-3.08]), smoking among girls (2.91 [1.85-4.57]) and physical inactivity (no leisure sport) among boys (OR: 2.71 [1.85-3.95]). DISCUSSION Unequal health opportunities should be viewed in relation to people's living conditions. For adolescents, school constitutes an important setting for learning, experience, and health. The results indicate divergent needs of school-based health promotion and prevention regarding differences among gender and type of school.
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Affiliation(s)
- Julia Waldhauer
- Fachgebiet Soziale Determinanten der Gesundheit, Abteilung für Epidemiologie und Gesundheitsmonitoring, Robert Koch-Institut, General-Pape-Str. 62-66, 12101, Berlin, Deutschland.
| | - Benjamin Kuntz
- Fachgebiet Soziale Determinanten der Gesundheit, Abteilung für Epidemiologie und Gesundheitsmonitoring, Robert Koch-Institut, General-Pape-Str. 62-66, 12101, Berlin, Deutschland
| | - Thomas Lampert
- Fachgebiet Soziale Determinanten der Gesundheit, Abteilung für Epidemiologie und Gesundheitsmonitoring, Robert Koch-Institut, General-Pape-Str. 62-66, 12101, Berlin, Deutschland
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39
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Auhuber L, Vogel M, Grafe N, Kiess W, Poulain T. Leisure Activities of Healthy Children and Adolescents. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E2078. [PMID: 31212786 PMCID: PMC6617342 DOI: 10.3390/ijerph16122078] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Revised: 06/07/2019] [Accepted: 06/09/2019] [Indexed: 11/16/2022]
Abstract
The objective of the present study was to give a detailed overview on the leisure behavior of adolescents (frequency, differences between gender, age groups and social class, time trends, and inter-relations). In total, 1449 10- to 18-year-old German adolescents were included in the study. Participants answered questionnaires about their media use, physical activity, outdoor time, engagement in choir/orchestra and theater/dancing, social life and socio-economic status (SES). The results revealed that girls, children with lower SES as well as older children reported to use screen-based media more often and that girls, older children and children with lower SES were less physically active. In addition, boys and children with lower SES engaged less frequently in choir/orchestra and theater/dancing, while children with higher SES met their friends more often. The time trend analysis showed that mobile phone use increased drastically from 2011 to 2017, while engagement in choir/orchestra and theater/dancing decreased. Regarding the inter-relation between leisure activities, high screen times were significantly associated with less physical activity and less outdoor time. Physical activity, in contrast, was significantly related to better social life and more outdoor time. These findings highlight the growing importance of electronic media in adolescents' lives and their tendency to displace other leisure activities.
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Affiliation(s)
- Lea Auhuber
- LIFE Leipzig Research Center for Civilization Diseases, Leipzig University, Philipp-Rosenthal-Strasse 27, 04103 Leipzig, Germany.
| | - Mandy Vogel
- LIFE Leipzig Research Center for Civilization Diseases, Leipzig University, Philipp-Rosenthal-Strasse 27, 04103 Leipzig, Germany.
- Department of Women and Child Health, Hospital for Children and Adolescents and Center for Pediatric Research (CPL), Leipzig University, Liebigstrasse 20a, 04103 Leipzig, Germany.
| | - Nico Grafe
- LIFE Leipzig Research Center for Civilization Diseases, Leipzig University, Philipp-Rosenthal-Strasse 27, 04103 Leipzig, Germany.
| | - Wieland Kiess
- LIFE Leipzig Research Center for Civilization Diseases, Leipzig University, Philipp-Rosenthal-Strasse 27, 04103 Leipzig, Germany.
- Department of Women and Child Health, Hospital for Children and Adolescents and Center for Pediatric Research (CPL), Leipzig University, Liebigstrasse 20a, 04103 Leipzig, Germany.
| | - Tanja Poulain
- LIFE Leipzig Research Center for Civilization Diseases, Leipzig University, Philipp-Rosenthal-Strasse 27, 04103 Leipzig, Germany.
- Department of Women and Child Health, Hospital for Children and Adolescents and Center for Pediatric Research (CPL), Leipzig University, Liebigstrasse 20a, 04103 Leipzig, Germany.
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40
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Böhm B, Karwiese SD, Böhm H, Oberhoffer R. Effects of Mobile Health Including Wearable Activity Trackers to Increase Physical Activity Outcomes Among Healthy Children and Adolescents: Systematic Review. JMIR Mhealth Uhealth 2019; 7:e8298. [PMID: 31038460 PMCID: PMC6658241 DOI: 10.2196/mhealth.8298] [Citation(s) in RCA: 60] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2017] [Revised: 06/18/2018] [Accepted: 02/07/2019] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Children and adolescents do not meet the current recommendations on physical activity (PA), and as such, the health-related benefits of regular PA are not achieved. Nowadays, technology-based programs represent an appealing and promising option for children and adolescents to promote PA. OBJECTIVE The aim of this review was to systematically evaluate the effects of mobile health (mHealth) and wearable activity trackers on PA-related outcomes in this target group. METHODS Electronic databases such as the Cochrane Central Register of Controlled Trials, PubMed, Scopus, SPORTDiscus, and Web of Science were searched to retrieve English language articles published in peer-reviewed journals from January 2012 to June 2018. Those included were articles that contained descriptions of interventions designed to increase PA among children (aged 6 to 12 years) only, or adolescents (aged 13 to 18 years) only, or articles that include both populations, and also, articles that measured at least 1 PA-related cognitive, psychosocial, or behavioral outcome. The interventions had to be based on mHealth tools (mobile phones, smartphones, tablets, or mobile apps) or wearable activity trackers. Randomized controlled trials (RCTs) and non-RCTs, cohort studies, before-and-after studies, and cross-sectional studies were considered, but only controlled studies with a PA comparison between groups were assessed for methodological quality. RESULTS In total, 857 articles were identified. Finally, 7 studies (5 with tools of mHealth and 2 with wearable activity trackers) met the inclusion criteria. All studies with tools of mHealth used an RCT design, and 3 were of high methodological quality. Intervention delivery ranged from 4 weeks to 12 months, whereby mainly smartphone apps were used as a tool. Intervention delivery in studies with wearable activity trackers covered a period from 22 sessions during school recess and 8 weeks. Trackers were used as an intervention and evaluation tool. No evidence was found for the effect of mHealth tools, respectively wearable activity trackers, on PA-related outcomes. CONCLUSIONS Given the small number of studies, poor compliance with accelerometers as a measuring instrument for PA, risk of bias, missing RCTs in relation to wearable activity trackers, and the heterogeneity of intervention programs, caution is warranted regarding the comparability of the studies and their effects. There is a clear need for future studies to develop PA interventions grounded on intervention mapping with a high methodological study design for specific target groups to achieve meaningful evidence.
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Affiliation(s)
- Birgit Böhm
- Institute of Preventive Pediatrics, Technical University of Munich, Munich, Germany
| | - Svenja D Karwiese
- Institute of Preventive Pediatrics, Technical University of Munich, Munich, Germany
| | - Harald Böhm
- Orthopaedic Hospital for Children, Behandlungszentrum Aschau GmbH, Aschau im Chiemgau, Germany
| | - Renate Oberhoffer
- Institute of Preventive Pediatrics, Technical University of Munich, Munich, Germany
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Active Transport, Not Device Use, Associates with Self-Reported School Week Physical Activity in Adolescents. Behav Sci (Basel) 2019; 9:bs9030032. [PMID: 30901905 PMCID: PMC6466846 DOI: 10.3390/bs9030032] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2019] [Revised: 03/13/2019] [Accepted: 03/18/2019] [Indexed: 12/20/2022] Open
Abstract
The purpose of this study was to examine the relationships among active transport, electronic device-use, and self-reported school week moderate-to-vigorous physical activity (MVPA) in a sample of adolescents. The sample consisted of 1445 adolescents enrolled in the Family Life, Activity, Sun, Health, and Eating study. A panel research organization invited panel members balanced to the US population on sex, census division, household income and size, and race/ethnicity. Web-based surveys were administered to each selected adolescent. Adolescents answered questions pertaining to out-of-school electronic device-use and active transport to and from school. Predicted weekly minutes of MVPA were calculated from the Youth Activity Profile. The outcome variable was predicted school week MVPA (in minutes). The predictive utility of device-use and active transport variables on self-reported school week MVPA were examined using weighted multiple linear regression models. After adjusting for age, sex, and BMI, active transport to school (b = 12.32, 95% CI [9.72–14.93], p < 0.001) and from school (b = 7.18, 95% CI [4.79–5.57], p < 0.001) were significantly associated with self-reported school week MVPA. No device-use variables were significantly associated with school week MVPA. Active transport to and from school may have an impact on school week MVPA in adolescents.
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42
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Germany’s 2018 report card on physical activity for children and youth. GERMAN JOURNAL OF EXERCISE AND SPORT RESEARCH 2019. [DOI: 10.1007/s12662-019-00578-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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43
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Associations Between Socio-Economic Status and Child Health: Findings of a Large German Cohort Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16050677. [PMID: 30813530 PMCID: PMC6427670 DOI: 10.3390/ijerph16050677] [Citation(s) in RCA: 72] [Impact Index Per Article: 14.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Revised: 02/08/2019] [Accepted: 02/22/2019] [Indexed: 02/07/2023]
Abstract
The familial social background of a child can significantly impact their behavior and health. We investigated associations between socio-economic status (SES) and health parameters and behaviors in German children and adolescents. Data were collected between 2011 and 2018 in the framework of the LIFE Child study. Participants included 2998 children aged 3⁻18 years. SES was represented by an index combining information on parental education, occupation, and income. Associations between SES and health outcomes were estimated using linear and logistic regression analyses. In a moderator analysis, all associations were checked for interactions between SES and age or sex. A higher SES composite score was associated with better health (lower body mass index (β = -0.26), fewer behavioral difficulties (β = -0.18), higher quality of life (β = 0.21), fewer critical life events (odds ratio (OR) = 0.93); all p < 0.05) and a healthier lifestyle (healthier nutrition (β = 0.16), less excessive television use (OR = 0.87), less nicotine consumption (OR = 0.93), and more physical activity (OR = 1.18); all p < 0.05). However, SES was not associated with alcohol consumption (OR = 1.02) or sleep problems (β = -0.04). The strengths of the associations between SES and child health did not differ depending on SES indicator (education, occupation, income). The associations between SES and parent-reported behavioral difficulties and physical activity were stronger in older vs. younger children. In contrast, none of the observed associations were moderated by sex. This study highlights the strong association between socio-economic status and child health, even in modern Western societies.
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Like father, like son. Physical Activity, Dietary Intake, and Media Consumption in Pre-School-Aged Children. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16030306. [PMID: 30678117 PMCID: PMC6388281 DOI: 10.3390/ijerph16030306] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/22/2018] [Revised: 01/18/2019] [Accepted: 01/19/2019] [Indexed: 12/25/2022]
Abstract
An imbalance between energy input and energy needs contributes to the growing incidence of overweight children. Pre-schoolers normally like to move, but even at this young age, they are already affected by a lack of physical activity and a high amount of screen time. Media consumption contributes to unhealthy diets and extends the length of time spent sitting. Longer periods of sitting are, independent of the level of activity, seen as a risk factor for the development of obesity. In the present study, 160 pre-schoolers and their parents (128 mothers, 121 fathers) were examined. The results show deviations from actual recommendations regarding physical activity, time spent sitting, dietary intake, and media consumption. Increased screen time was associated with a higher weight status among pre-school-aged children. To provide a healthy upbringing, prevention and intervention measures should be implemented on a behavioral and relational level.
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Isensee B, Suchert V, Hansen J, Weisser B, Hanewinkel R. Effects of a School-Based Pedometer Intervention in Adolescents: 1-Year Follow-Up of a Cluster-Randomized Controlled Trial. THE JOURNAL OF SCHOOL HEALTH 2018; 88:717-724. [PMID: 30203479 DOI: 10.1111/josh.12676] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/14/2017] [Revised: 11/09/2017] [Accepted: 12/27/2017] [Indexed: 06/08/2023]
Abstract
BACKGROUND Physical activity (PA) is one of the most important health behaviors that may be modified by each individual. To foster PA in adolescents, a school-based intervention was evaluated. METHODS A cluster-randomized controlled trial with preassessment in 2014 and follow-up assessment in 2015 included 29 schools with 1020 students (47.6% girls, mean age = 13.69 years). Intervention students received pedometers and monitored their steps for 12 weeks. Classes with the most steps were awarded. Primary outcomes included moderate-to-vigorous PA, out-of-school sports activities, active transport assessed through questionnaires, as well as cardiorespiratory fitness measured using the 20-m shuttle-run test and anthropometric data (weight, height, body fat, and waist circumference) assessed by study staff. RESULTS Significant interaction terms between group and time were found for all 3 indicators of PA; intervention students showed a higher increase of PA than control students. The same pattern was shown for cardiorespiratory fitness, but the effect missed significance. A more favorable development for the intervention students was shown for body fat and waist-to-height ratio, while there was no effect on body mass index percentile. CONCLUSIONS An easy way to administer school-based PA program may enhance students' leisure-time PA even 1 year after the intervention has ended.
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Affiliation(s)
- Barbara Isensee
- Institute for Therapy and Health Research, Harmsstrasse 2, 24114 Kiel, Germany
| | - Vivien Suchert
- Institute for Therapy and Health Research, Harmsstrasse 2, 24114 Kiel, Germany
| | - Julia Hansen
- Institute for Therapy and Health Research, Harmsstrasse 2, 24114 Kiel, Germany
| | - Burkhard Weisser
- Institute of Sports Science, Department of Sports Medicine, Christian-Albrechts-University of Kiel, Olshausenstraße 74, 24098 Kiel, Germany
| | - Reiner Hanewinkel
- Institute for Therapy and Health Research, Harmsstrasse 2, 24114 Kiel, Germany
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Differences in Motor Competence by TV Consumption and Participation in Club Sports in Children Starting Elementary School. INTERNATIONAL JOURNAL OF SCHOOL HEALTH 2018. [DOI: 10.5812/intjsh.68454] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Braig S, Genuneit J, Walter V, Brandt S, Wabitsch M, Goldbeck L, Brenner H, Rothenbacher D. Screen Time, Physical Activity and Self-Esteem in Children: The Ulm Birth Cohort Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:E1275. [PMID: 29914149 PMCID: PMC6025387 DOI: 10.3390/ijerph15061275] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/11/2018] [Revised: 06/08/2018] [Accepted: 06/14/2018] [Indexed: 01/17/2023]
Abstract
Screen time is a central activity of children’s daily life and jeopardizes mental health. However, results appear inconclusive and are often based on small cross-sectional studies. We aimed to investigate the temporal sequence of the association between screen time and self-esteem taking into account further indirect effects through family or friendship relationship. In our population-based birth cohort study (baseline November 2000⁻November 2001, Ulm, Germany), these relationships were explored in n = 519 11- and 13-year-old children and their parents who both provided information on children’s screen time: time spent watching television or videos (TV), time spent on computers, video game consoles, mobile devices, or cell phones; so called “other screen time”, and children’s self-esteem (KINDL-R). Time watching TV (self-reported) at age 11 was negatively associated with girls’ self-esteem at the same age but positively with an increase of self-esteem between age 11 and 13. However, the latter association was restricted to low to moderate TV viewers. In boys, a higher increase of other screen time between age 11 and age 13 was associated with lower self-reported self-esteem at age 13. Additionally, friendship relationship mediated the association between watching TV and self-esteem in girls. For parental reports similar associations were observed. These findings indicate that time sequence and potential mediators need further investigation in cohort studies with multiple assessments of screen time and self-esteem.
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Affiliation(s)
- Stefanie Braig
- Institute of Epidemiology and Medical Biometry, Ulm University; Helmholtzstraße 22, 89081 Ulm, Germany.
| | - Jon Genuneit
- Institute of Epidemiology and Medical Biometry, Ulm University; Helmholtzstraße 22, 89081 Ulm, Germany.
| | - Viola Walter
- Division of Clinical Epidemiology and Ageing Research, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 581, 69120 Heidelberg, Germany.
| | - Stephanie Brandt
- Division of Pediatric Endocrinology and Diabetes, Department of Pediatrics and Adolescent Medicine, Ulm University, Eythstraße 24, 89075 Ulm, Germany.
| | - Martin Wabitsch
- Division of Pediatric Endocrinology and Diabetes, Department of Pediatrics and Adolescent Medicine, Ulm University, Eythstraße 24, 89075 Ulm, Germany.
| | - Lutz Goldbeck
- Department of Child and Adolescent Psychiatry/Psychotherapy, Ulm University, Steinhövelstraße 5, 89075 Ulm, Germany.
| | - Hermann Brenner
- Division of Clinical Epidemiology and Ageing Research, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 581, 69120 Heidelberg, Germany.
- Division of Preventive Oncology, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), Im Neuenheimer Feld 581, 69120 Heidelberg, Germany.
- German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Im Neuenheimer Feld 581, 69120 Heidelberg, Germany.
| | - Dietrich Rothenbacher
- Institute of Epidemiology and Medical Biometry, Ulm University; Helmholtzstraße 22, 89081 Ulm, Germany.
- Division of Clinical Epidemiology and Ageing Research, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 581, 69120 Heidelberg, Germany.
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Cross-sectional and longitudinal associations of screen time and physical activity with school performance at different types of secondary school. BMC Public Health 2018; 18:563. [PMID: 29703168 PMCID: PMC5924472 DOI: 10.1186/s12889-018-5489-3] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2017] [Accepted: 04/20/2018] [Indexed: 01/09/2023] Open
Abstract
Background Previous studies have already reported associations of media consumption and/or physical activity with school achievement. However, longitudinal studies investigating independent effects of physical activity and media consumption on school performance are sparse. The present study fills this research gap and, furthermore, assesses relationships of the type of secondary school with media consumption and physical activity. Methods The consumption of screen-based media (TV/video, game console, PC/internet, and mobile phone) and leisure physical activity (organized and non-organized) of 10 – to 17-year old adolescents participating in the LIFE Child study in Germany were related to their school grades in two major school subjects (Mathematics and German) and in Physical Education. In addition to a cross-sectional analysis at baseline (N = 850), a longitudinal analysis (N = 512) investigated the independent effects of these activities on the school grades achieved 12 months later. All associations were adjusted for age, gender, socio-economic status, year of data assessment, body-mass-index, and school grades at baseline. A further analysis investigated differences in the consumption of screen-based media and physical activity as a function of the type of secondary school (highest vs. lower secondary school). Results Adolescents of lower secondary schools reported a significantly higher consumption of TV/video and game consoles than adolescents attending the highest secondary school. Independently of the type of school, a better school performance in Mathematics was predicted by a lower consumption of computers/internet, and a better performance in Physical Education was predicted by a lower consumption of TV/video and a higher frequency of non-organized physical activity. However, the association between non-organized physical activity and subsequent grades in Physical Education was significant in girls only. Conclusion The present results suggest that media consumption has a negative effect on school achievement, whereas physical activity has a positive effect, which, however, is restricted to the subject Physical Education. Future studies might explore the relationship between media consumption and school career, for example, the choice or change of the secondary school type, in more detail. Trial registration LIFE Child study: ClinicalTrials.gov, clinical trial number NCT02550236
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Mauz E, Hoffmann R, Houben R, Krause L, Kamtsiuris P, Gößwald A. Mode Equivalence of Health Indicators Between Data Collection Modes and Mixed-Mode Survey Designs in Population-Based Health Interview Surveys for Children and Adolescents: Methodological Study. J Med Internet Res 2018; 20:e64. [PMID: 29506967 PMCID: PMC5859740 DOI: 10.2196/jmir.7802] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2017] [Revised: 10/14/2017] [Accepted: 11/16/2017] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The implementation of an Internet option in an existing public health interview survey using a mixed-mode design is attractive because of lower costs and faster data availability. Additionally, mixed-mode surveys can increase response rates and improve sample composition. However, mixed-mode designs can increase the risk of measurement error (mode effects). OBJECTIVE This study aimed to determine whether the prevalence rates or mean values of self- and parent-reported health indicators for children and adolescents aged 0-17 years differ between self-administered paper-based questionnaires (SAQ-paper) and self-administered Web-based questionnaires (SAQ-Web), as well as between a single-mode control group and different mixed-mode groups. METHODS Data were collected for a methodological pilot of the third wave of the "German Health Interview and Examination Survey for Children and Adolescents". Questionnaires were completed by parents or adolescents. A population-based sample of 11,140 children and adolescents aged 0-17 years was randomly allocated to 4 survey designs-a single-mode control group with paper-and-pencil questionnaires only (n=970 parents, n=343 adolescents)-and 3 mixed-mode designs, all of which offered Web-based questionnaire options. In the concurrent mixed-mode design, both questionnaires were offered at the same time (n=946 parents, n=290 adolescents); in the sequential mixed-mode design, the SAQ-Web was sent first, followed by the paper questionnaire along with a reminder (n=854 parents, n=269 adolescents); and in the preselect mixed-mode design, both options were offered and the respondents were asked to request the desired type of questionnaire (n=698 parents, n=292 adolescents). In total, 3468 questionnaires of parents of children aged 0-17 years (SAQ-Web: n=708; SAQ-paper: n=2760) and 1194 questionnaires of adolescents aged 11-17 years (SAQ-Web: n=299; SAQ-paper: n=895) were analyzed. Sociodemographic characteristics and a broad range of health indicators for children and adolescents were compared by survey design and data collection mode by calculating predictive margins from regression models. RESULTS There were no statistically significant differences in sociodemographic characteristics or health indicators between the single-mode control group and any of the mixed-mode survey designs. Differences in sociodemographic characteristics between SAQ-Web and SAQ-paper were found. Web respondents were more likely to be male, have higher levels of education, and higher household income compared with paper respondents. After adjusting for sociodemographic characteristics, only one of the 38 analyzed health indicators showed different prevalence rates between the data collection modes, with a higher prevalence rate for lifetime alcohol consumption among the online-responding adolescents (P<.001). CONCLUSIONS These results suggest that mode bias is limited in health interview surveys for children and adolescents using a mixed-mode design with Web-based and paper questionnaires.
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Affiliation(s)
- Elvira Mauz
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Robert Hoffmann
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Robin Houben
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Laura Krause
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Panagiotis Kamtsiuris
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Antje Gößwald
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
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Wulff H, Wagner P. Media Use and Physical Activity Behaviour of Adolescent Participants in Obesity Therapy: Impact Analysis of Selected Socio-Demographic Factors. Obes Facts 2018; 11:307-317. [PMID: 30064131 PMCID: PMC6189527 DOI: 10.1159/000490178] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2017] [Accepted: 05/18/2018] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND To address the challenge of juvenile obesity, effective therapeutic concepts focusing on lifestyle changes are necessary. A relevant aspect is the media use, which is associated with nutrition and physical activity patterns and is influenced by socio-demographic factors. To optimise obesity therapy, the use of media depending on these socio-demographic factors needs to be analysed to adjust the aims, content and methods of interventions as well as to harness the potential of media use in obesity therapy. The question considered in this research is: What media and physical activity patterns show 11- to 17-year-old obesity therapy participants in dependence on socio-demographic factors? METHODS A national multicentre study was conducted in 2015. A questionnaire was used to survey 432 participants' aged 13.75 ± 1.4 years. Standardised instruments were used to assess the variables: physical activity, media use and socio-demographic factors. RESULTS The participants were 1-hour physically active for 3.9 ± 1.9 days/week, 14.1% daily. Televisions, mobile phones and computers were available in all socio-demographic groups and used for 2 h/day. Socio-demographic differences emerged in the duration of media use (h/day). Girls were found to use mobile phones for longer (2.49 vs. 1.90; p < 0.01) and spend less time on game consoles than boys (0.55 vs. 1.65; p < 0.01). CONCLUSION Compared to current recommendations, the sample shows reduced physical activity and increased media use, which vary between the groups. Hence, differentiated therapy approaches appear recommendable. Future research needs to evaluate, how media (despite its risks) can facilitate therapy, training and aftercare concepts.
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Affiliation(s)
- Hagen Wulff
- *Hagen Wulff, Institute of Exercise and Public Health, University of Leipzig, Jahnallee 59, 04109 Leipzig, Germany,
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