Adolescent time use clusters: a systematic review

Do Patterns of Adolescent Participation in Arts, Culture and Entertainment Activities Predict Later Wellbeing? A Latent Class Analysis

Participation in arts, culture, and entertainment (PACE) activities may promote adolescent wellbeing. However, little is known about how such activities cluster together, and previous research has used small samples, cross-sectional designs, focused on single activities, and/or has not considered the influence of socio-demographic factors on participation. Using latent class analysis, the aims of this study were to establish: (i) classes of adolescent PACE activities; (ii) associations between socio-demographic characteristics and PACE classification; and, (iii) whether PACE classification predicts later wellbeing. Longitudinal data from the #BeeWell study (N = 18,224 adolescents; mean age at T1 = 12 years 7 months (±3.56 months); 50.54% female) were analyzed. Four latent classes were established: the 'Dynamic Doers' (high, wide-ranging participation; 11.87%); the 'Mind and Body Crew' (reading, arts, videogames, sports/exercise; 39.81%); the 'Game and Gain Squad' (videogames and sports/exercise; 29.05%); and the 'Activity Free Adolescents' (uniformly low participation; 19.27%). Associations between socio-demographic characteristics and PACE classification were observed (e.g., socio-economic disadvantage increased the likelihood of Activity Free Adolescents classification, compared to Game and Gain Squad classification). Finally, PACE classification predicted later wellbeing (e.g., Dynamic Doers reported significantly higher wellbeing than Activity Free Adolescents). These findings are discussed in relation to the need to improve accessibility and appeal of arts, culture, and entertainment provision for adolescents as a means to optimize their wellbeing. PRE-REGISTRATION: The analysis plan for this study was pre-registered on the Open Science Framework and can be found here: https://osf.io/2jtpd.

Association of Sugar-Sweetened Beverage Consumption and Moderate-to-Vigorous Physical Activity with Childhood and Adolescent Overweight/Obesity: Findings from a Surveillance Project in Jiangsu Province of China

Sugar-sweetened beverage (SSB) consumption and inadequate moderate-to-vigorous physical activity (MVPA) have been suggested as potential contributors to overweight/obesity during childhood or adolescence; however, the results of previous studies are inconsistent. It was crucial to estimate the independent and joint association of SSB consumption and inadequate MVPA for childhood and adolescent overweight/obesity. The "Surveillance for Common Disease and Health Risk Factors Among Students in Jiangsu Province 2021-2022" initiative provided us with representative population-based data that we studied. SSB consumption and inadequate MVPA were determined by self-reported SSB habit and MVPA frequency (days/week). The body mass index for each gender and age subgroup was used to identify those who were overweight or obese. With stratified analyses to ascertain differences in age or gender, we employed the logistic regression model to assess the association of SSB and MVPA with overweight/obesity and applied the likelihood ratio test to explore the interactions. Approximately 38.2% of the study population (119,467 students aged 8-17) were overweight/obese. After adjusting covariates, SSB consumption or inadequate MVPA was associated with overweight/obesity (OR = 1.05, 95% CI = 1.02-1.07; and OR = 1.07, 95% CI = 1.03-1.10). In comparison to students with "no SSB consumption and adequate MVPA", those with "SSB consumption and inadequate MVPA" had a higher risk of being overweight/obese (OR = 1.13, 95% CI = 1.08-1.18). Regardless of age and gender subgroups, the correlation of SSB and MVPA alone and together with being overweight/obese was generally similar, with the adolescent group aged 13-17 years (OR = 1.15, 95% CI = 1.09-1.22) and females (OR = 1.09, 95% CI = 1.02-1.17) being more susceptible. Moreover, there was a significant interaction between SSB consumption and gender (p < 0.001), as well as between SSB consumption and inadequate MVPA (p = 0.008). Hence, SSB consumption in students is significantly associated with overweight/obesity, especially when MVPA is inadequate. In light of the rapidly expanding childhood and adolescent obesity epidemic, proper attention should be given to these modifiable behaviors, particularly SSB and MVPA.

Clustering of physical activity, sedentary behavior, and diet associated with social isolation among brazilian adolescents

BACKGOUND

Although obesogenic behaviors have been found to be related to social isolation, evidence-based person-centered approaches are lacking. This study investigated the association between clusters of obesogenic behavior - derived from a data-driven process - and social isolation among Brazilian adolescents.

METHODS

Data from the National Adolescent School-based Health Survey (PeNSE) 2015 were analyzed. A total of 100,794 9^th-grade students (51.3% females; 14.3 ± 0.1 years old) enrolled in 3,040 public and private high schools participated in the study. Social isolation was assessed by two outcomes (i.e., perceived loneliness and lack of close friends). A two-step cluster analysis was conducted to identify patterns of obesogenic behaviors with the input of leisure-time physical activity (PA), sitting time as a proxy of sedentary behavior (SB), and the weekly consumption of healthy and unhealthy food. Crude and adjusted binary logistic regression models were applied to evaluate the associations between the clusters of obesogenic behaviors and social isolation variables in adolescents.

RESULTS

Three clusters were identified. Adolescents in the "Health-promoting SB and diet" (32.6%; OR = 0.69; 95% CI = 0.62-0.76) and "Health-promoting PA and diet" (44.9%; OR = 0.73; 95% CI = 0.67-0.79) clusters had lower odds of loneliness compared to those in the "Health-risk" cluster (22.5%). Those belonging to the "Health-promoting PA and diet" cluster were more likely to report having close friends (OR = 1.19; 95% CI = 1.00-1.41) than those in the "Health-risk" cluster.

CONCLUSION

Adolescents in clusters where positive behaviors outweighed negative ones were less likely to perceive themselves as lonely and without close connections.

A systematic review of the clustering and correlates of physical activity and sedentary behavior among boys and girls

Identifying the clustering and correlates of physical activity (PA) and sedentary behavior (SB) is very important for developing appropriate lifestyle interventions for children and adolescents. This systematic review (Prospero CRD42018094826) aimed to identify PA and SB cluster patterns and their correlates among boys and girls (0-19 years). The search was carried out in five electronic databases. Cluster characteristics were extracted in accordance with authors' descriptions by two independent reviewers and a third resolved any disagreements. Seventeen studies met the inclusion criteria and the population age ranged from six to 18 years old. Nine, twelve, and ten cluster types were identified for mixed-sex samples, boys, and girls, respectively. While girls were in clusters characterized by "Low PA Low SB" and "Low PA High SB", the majority of boys were in clusters defined by "High PA High SB" and "High PA Low SB". Few associations were found between sociodemographic variables and all cluster types. Boys and girls in "High PA High SB" clusters had higher BMI and obesity in most of the tested associations. In contrast, those in the "High PA Low SB" clusters presented lower BMI, waist circumference, and overweight and obesity. Different cluster patterns of PA and SB were observed in boys and girls. However, in both sexes, a better adiposity profile was found among children and adolescents in "High PA Low SB" clusters. Our results suggest that it is not enough to increase PA to manage the adiposity correlates, it is also necessary to reduce SB in this population.

Association of insufficient sleep and skipping breakfast with overweight/obesity in children and adolescents: Findings from a cross-sectional provincial surveillance project in Jiangsu

BACKGROUND

Insufficient sleep and skipping breakfast are very common phenomena in China and have been proposed as possible causes of overweight/obesity, but the results of former studies remain inconsistent.

OBJECTIVE

To investigate the individual and joint association of insufficient sleep and skipping breakfast with overweight/obesity among children and adolescents in Jiangsu Province, China.

METHODS

Participants were 36 849 students aged 8-17 years from the 2019-2020 project "Surveillance for common disease and health risk factors among students." Self-reported insufficient sleep and skipping breakfast were ascertained by self-reported sleep duration and breakfast habit. Overweight/obesity was assessed according to the gender- and age-specific body mass index. We used logistic regression models to explore the association of sleep and breakfast with overweight/obesity, and stratification analyses to test age or gender differences.

RESULTS

The overall prevalence of overweight/obesity was 33.2%. Insufficient sleep (OR = 1.09, 95% CI = 1.03-1.16) or skipping breakfast (OR = 1.14, 95% CI = 1.07-1.21) was associated with overweight/obesity. Compared to participants with 'sufficient sleep and breakfast', ORs were 1.25 (95% CI = 1.15-1.35) for those with 'both insufficient sleep and skipping breakfast'. The separate and joint association of sleep and breakfast with overweight/obesity remained generally consistent across different age and gender subgroups, except that the 8-12-year-olds group and female students appear more susceptible.

CONCLUSIONS

Insufficient sleep and skipping breakfast were jointly associated with overweight/obesity in children and adolescents. Appropriate attention should be paid to these modifiable behaviours including sleep and breakfast in the context of the rapidly growing obesity epidemic among children and adolescents.

Ecological correlates related to adolescent movement behaviors: A latent class analysis

The ecological model has been widely used to help researchers understand the multiple influences in the physical activity (PA) and in the sedentary behaviors in isolated forms. To date, few correlates concerning the behavioral groupings of PA and sedentary behaviors have been studied. In this context, this study aimed to identify movement behaviors’ latent classes related to the different adolescents’ PA and sedentary time expressions, as well as their associations with individual, sociodemographic, family, and environmental correlates. This is a cross-sectional study with 309 students aged between 14 and 16. Latent Class Analysis was used to identify movement behavior classes based on light PA, moderate to vigorous PA, number of steps, sedentary time, and screen time (ST). An accelerometer was used to evaluate movement behaviors. The individual, sociodemographic, family, and environmental correlates were assessed by questionnaires. Three classes were identified: Class 1, "Active and Non-Sedentary" (8.10% of the sample), Class 2, "Active and Sedentary" (28.5%), and Class 3, "Inactive and Sedentary" (63.4%). Those with low fruit intake, low aerobic fitness, stressed and whose head of the family obtained an ‘elementary school’ level education were, respectively, 7.17, 3.59, 3.56, and 4.40 times more likely to belong to class 3 than class 1. Those with medium and high socioeconomic status were 82% and 83% less likely to belong to class 1 than classes 2 and 3, respectively. Adolescents who perceived the neighborhoods with the best access to diversified land use, street connectivity, walking/pedaling ease, and traffic safety attributes, were 84%, 85%, 82%, and 82%, respectively less likely to belong to class 1 than class 2. It is concluded that distinct correlates can be associated with the movement behaviors classes.

Gendered time use during COVID-19 among adolescents and young adults in Nairobi, Kenya

Background

Gender disparities in time use contribute to poor outcomes in women. Large-scale disruptions can affect time use. The objectives of this study were to characterize time use across the pandemic by gender and to assess how gender associates with 2021-time use, overall and by 2020 economic dependency status.

Methods

A prospective cohort of youth in Nairobi, Kenya, completed phone-based surveys in August-October 2020 and April-May 2021. Time use was characterized at both time points and 1,777 participants with complete time use data at both time points were included in the analysis. 2021-time use was regressed on gender and stratified by 2020 economic dependency status.

Findings

At both time points, significant gender differences in time use found young men with more time on paid work and less time on domestic work [1·6 h; 95% CI: 1·1, 2·2] and [-1·9 h; 95% CI: -1·1, -1·5], respectively; 2021. In adjusted models, the gender differential in unpaid domestic work were significant overall and at all levels of economic dependency (dependent, semi-dependent, independent). The gender differential in paid work was evident among semi-dependent and independent.

Interpretation

Young women spent less time on paid work and more time on domestic duties than male counterparts, consistently across a six-month period during the pandemic, suggesting gendered time poverty. Resulting gendered gaps in earnings can contribute to women's longer-term economic vulnerability.

Funding

This work was supported by the Bill & Melinda Gates Foundation [010481].

Eating behaviour, physical activity, TV exposure and sleeping habits in five year olds: a latent class analysis

BACKGROUND

Diet, physical activity, sedentary behaviours, and sleep time are considered major contributory factors of the increased prevalence of childhood overweight and obesity. The aims of this study were to (1) identify behavioural clusters of 5 year old children based on lifestyle behaviours, (2) explore potential determinants of class membership, and (3) to determine if class membership was associated with body measure outcomes at 5 years of age.

METHODS

Data on eating behaviour, engagement in active play, TV watching, and sleep duration in 1229 5 year old children from the Cork BASELINE birth cohort study was obtained through in-person interviews with parent. Latent class analysis was used to identify behavioural clusters. Potential determinants of cluster membership were investigated using multinomial logistic regression. Associations between the identified classes and cardio metabolic body measures were examined using multivariate logistic and linear regression, with cluster membership used as the independent variable.

RESULTS

51% of children belonged to a normative class, while 28% of children were in a class characterised by high scores on food avoidance scales in combination with low enjoyment of food, and 20% experienced high scores on the food approach scales. Children in both these classes had lower conditional probabilities of engaging in active play for at least 1 hour per day and sleeping for a minimum of 10 h, and higher probability of watching TV for 2 hours or more, compared to the normative class. Low socioeconomic index (SEI) and no breastfeeding at 2 months were found to be associated with membership of the class associated with high scores on the food avoidance scale, while lower maternal education was associated with the class defined by high food approach scores. Children in the class with high scores on the food approach scales had higher fat mass index (FMI), lean mass index (LMI), and waist-to-height ratio (WtHR) compared to the normative class, and were at greater risk of overweight and obesity.

CONCLUSION

Findings suggest that eating behaviour appeared to influence overweight and obesity risk to a greater degree than activity levels at 5 years old. Further research of how potentially obesogenic behaviours in early life track over time and influence adiposity and other cardio metabolic outcomes is crucial to inform the timing of interventions.

Screen media activity does not displace other recreational activities among 9-10 year-old youth: a cross-sectional ABCD study®

Background

Screen media is among the most common recreational activities engaged in by children. The displacement hypothesis predicts that increased time spent on screen media activity (SMA) may be at the expense of engagement with other recreational activities, such as sport, music, and art. This study examined associations between non-educational SMA and recreational activity endorsement in 9–10-year-olds, when accounting for other individual (i.e., cognition, psychopathology), interpersonal (i.e., social environment), and sociodemographic characteristics.

Methods

Participants were 9254 youth from the Adolescent Brain Cognitive Development Study®. Latent factors reflecting SMA, cognition, psychopathology, and social environment were entered as independent variables into logistic mixed models. Sociodemographic covariates included age, sex, race/ethnicity, education, marital status, and household income. Outcome variables included any recreational activity endorsement (of 19 assessed), and specific sport (swimming, soccer, baseball) and hobby (music, art) endorsements.

Results

In unadjusted groupwise comparisons, youth who spent more time engaging with SMA were less likely to engage with other recreational activities (ps < .001). However, when variance in cognition, psychopathology, social environment, and sociodemographic covariates were accounted for, most forms of SMA were no longer significantly associated with recreational activity engagement (p > .05). Some marginal effects were observed: for every one SD increase in time spent on games and movies over more social forms of media, youth were at lower odds of engaging in recreational activities (adjusted odds ratio = 0·83, 95% CI 0·76–0·89). Likewise, greater general SMA was associated with lower odds of endorsing group-based sports, including soccer (0·93, 0·88–0·98) and baseball (0·92, 0·86–0·98). Model fit comparisons indicated that sociodemographic characteristics, particularly socio-economic status, explained more variance in rates of recreational activity engagement than SMA and other latent factors. Notably, youth from higher socio-economic families were up to 5·63 (3·83–8·29) times more likely to engage in recreational activities than youth from lower socio-economic backgrounds.

Conclusions

Results did not suggest that SMA largely displaces engagement in other recreational activities among 9–10-year-olds. Instead, socio-economic factors greatly contribute to rates of engagement. These findings are important considering recent shifts in time spent on SMA in childhood.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-020-09894-w.

Clusters of non-dietary obesogenic behaviors among adolescents in Brazil: a latent profile analysis

OBJECTIVES

To identify patterns of non-dietary obesogenic behaviors, and social and environmental factors associated with overweight and obesity (OWOB).

METHODS

A representative sample (n = 5520) of high school students (55.4% girls, 16.3 ± 1.0 years) from Pernambuco State, Brazil. Latent profile analyses were performed using self-reported daily sleep duration, television use, computer use, videogame use, seated time during the week and weekend days, physical activity, and active commuting to school during the week. Social and environmental factors and body mass index were included to identify classes. Multinomial analysis explored differences in social, environmental factors, and BMI by classes.

RESULTS

Five patterns were identified [Computer users (C1), Short sleepers (C2), Typical behaviors (C3), Techno-active-gamers (C4), and Lower screen engagement (C5)]. Three groups (C1, C3 and C4) included students from better social conditions and a more urbanized environments. The prevalence of OWOB was higher in C1 (34.5%; 95% CI 31.1-38.0) and in C2 (29.7%; 95% CI 26.1-33.5) compared to C5 (23.3% 95% CI 21.3-25.3).

CONCLUSIONS

In one of the poorest regions of Brazil, different groups of social/environmental factors and behavior patterns emerged associated with OWOB.

Clusters of diet, physical activity, television exposure and sleep habits and their association with adiposity in preschool children: the EDEN mother-child cohort

Background

Despite the growing interest in the relation between adiposity in children and different lifestyle clusters, few studies used a longitudinal design to examine a large range of behaviors in various contexts, in particular eating- and sleep-related routines, and few studies have examined these factors in young children. The objectives of this study were to identify clusters of boys and girls based on diet, sleep and activity-related behaviors and their family environment at 2 and 5 years of age, and to assess whether the clusters identified varied across maternal education levels and were associated with body fat at age 5.

Methods

At 2 and 5 years, respectively, 1436 and 1195 parents from the EDEN mother-child cohort completed a questionnaire including behavioral data. A latent class analysis aimed to uncover gender-specific behavioral clusters. Body fat percentage was estimated by anthropometric and bioelectrical impedance measurements. Association between cluster membership and body fat was assessed with mutivariable linear regression models.

Results

At 2 years, two clusters emerged that were essentially characterized by opposite eating habits. At 5 years, TV exposure was the most distinguishing feature, but the numbers and types of clusters differed by gender. An association between cluster membership and body fat was found only in girls at 5 years of age, with girls in the cluster defined by very high TV exposure and unfavorable mealtime habits (despite high outdoor playing and walking time) having the highest body fat. Girls whose mother had low educational attainment were more likely to be in this high-risk cluster. Girls who were on a cluster evolution path corresponding to the highest TV viewing time and the least favorable mealtime habits from 2 to 5 years of age had higher body fat at 5 years.

Conclusions

Efforts to decrease TV time and improve mealtime routines may hold promise for preventing overweight in young children, especially girls growing up in disadvantaged families. These preventive efforts should start as early in life as possible, ideally before the age of two, and should be sustained over the preschool years.

The Consequences of Friend-Related Stress Across Early Adolescence

The current study investigated early adolescents' experiences of friend-related stress across middle school and its developmental consequences following the transition to high school. Using a sample of approximately 1,000 middle school students, four unique friend-related stress trajectories were observed across middle school: consistently low friend-related stress (57% of the sample), consistently high friend-related stress (7%), moderate and increasing friend-related stress (22%), and moderate but decreasing friend-related stress (14%). Groups characterized by higher levels of friend-related stress across middle school were linked to subsequent poorer socioemotional well-being, lower academic engagement, and greater involvement in and expectancies around risky behaviors following the transition to high school. Increased friend-related stress across the high school transition was also linked to poorer outcomes, even after taking into account earlier stress trajectories. Gender differences highlighted the particular struggles girls experience both in friend stress and in the links between friend stress and subsequent well-being.

'Social screens' and 'the mainstream': longitudinal competitors of non-organized physical activity in the transition from childhood to adolescence

Background

Physical activity (PA) tends to decline during late childhood and adolescence. In Australia, this decline has been shown to occur particularly in non-organized PA (e.g. active play and informal sport). Using a social marketing approach, segments of youth may be identified and targeted based on their profile of alternative activities that compete with non-organized PA during the transition to adolescence. The objectives of this study were to identify and describe segments of youth whose participation in non-organized PA declined between 11 and 13 years, based on changes in other potential competing activities during this period.

Methods

Data were sourced from Waves 4 and 5 of the Longitudinal Study of Australian Children. Participation in non-organized PA and thirteen alternative activities (e.g. video games, homework, sleep) were measured using 24-h time-use diaries. Analyses were limited to participants whose non-organized PA had declined between 11 and 13 years (n = 1043). Two-stage cluster analysis was conducted and segments were described using chi-square and t-tests.

Results

Among the analytic sample, average non-organized PA participation declined by 87 min/day between 11y and 13y (p < 0.001). Two segments were identified (κ = 0.66). The ‘Social Screens’ segment (n = 143) had large increases in texting, emailing and social media use (+ 56 min/day, p < 0.001) and other internet use (+ 32 min/day, p < 0.001). Conversely, ‘the Mainstream’ segment (n = 900) had smaller increases in a wider range of activities, including other PA (organized PA, active transport, active chores/work) (+ 16.0 min/day, p < 0.001), homework/study (+ 9.5 min/day, p < 0.001) and electronic gaming (+ 6.7 min/day, p < 0.05). ‘Social Screens’ were more likely to attend public school, live in urban areas and have more advanced pubertal development (girls only). ‘The Mainstream’ were more likely to participate in PA and out-of-school activities.

Conclusions

The ‘Social Screens’ segment had a much larger increase in texting, emailing, social media and other internet use, and lower participation in overall PA and out-of-school activities, compared with ‘the Mainstream’. Future research may trial PA promotion strategies to replace benefits that this segment may seek in competing activities (e.g. social PA apps).

Healthy or Unhealthy? The Cocktail of Health-Related Behavior Profiles in Spanish Adolescents

The aim of this study was to identify the prevalence and clustering of health-related behaviors in Spanish adolescents and to examine their association with sex, body mass index (BMI), different types of sedentary screen time, and adherence to 24-hour movement guidelines. A final sample of 173 students (M = 12.99 ± 0.51) participated in this study. Cluster analysis was conducted based on five health-related behaviors: PA and sedentary time derived from accelerometers, as well as healthy diet, sedentary screen time, and sleep duration derived from self-reported scales. Recommendations for 24-hour movement guidelines (i.e., physical activity (PA), screen time, and sleep duration) were analyzed both independently and combined. A total of 8.9% of the sample did not meet any of the guidelines, whereas 72.3%, 17.3%, and 1.7% of the sample met 1, 2, or all 3 guidelines, respectively. Six distinct profiles were identified, most of them showing the co-occurrence of healthy- and unhealthy-related behaviors. Given that most of the adolescents failed to meet the combination of PA, screen time, and sleep duration guidelines, these findings suggest the necessity to implement school-based interventions that target multiple health behaviors, especially because (un)healthy behaviors do not always cluster in the same direction.

Ecological correlates of activity-related behavior typologies among adolescents

Background

Adolescents engage in various combinations (typologies) of physical activity and sedentary behaviors, which impact their health and wellbeing in different ways. As such, there is a need to understand the factors that may inhibit or facilitate engagement in combinations of activity-related behaviors to help inform effective intervention strategies targeting those most in need. The aim of this study was to identify ecological correlates of adolescent physical activity and sedentary behavior typologies.

Methods

Cross-sectional study of 473 adolescents (15.0 ± 1.6 years, 41.4% boys) from 18 secondary schools in Melbourne, Australia. Intrapersonal, interpersonal and neighborhood-physical environmental factors were assessed via self-report surveys and Geographic Information Systems. Multinomial logistic regression models determined the relative risk ratio of membership of three homogenous activity-related behavior typologies based on the potential correlates.

Results

Higher levels of self-efficacy for physical activity, parental screen-time restriction rules, parental support for physical activity, sibling screen-time co-participation and perceptions of neighborhood pedestrian/traffic safety were associated with greater likelihood of adolescents being in the typology defined as highly active and low sedentary compared to the physically inactive, highly sedentary typology. Higher frequency of co-participation in screen-time with friends was associated with greater likelihood of adolescents being in the typology defined as moderately active, high screen-time compared to physically inactive, highly sedentary.

Conclusions

A range of intrapersonal, interpersonal and environmental correlates appear to play a role in adolescent activity-related typology membership. The findings may inform public health interventions targeting unique adolescent subgroups most at risk of poor health outcomes based on their engagement in combinations of activity-related behaviors.

Electronic supplementary material

The online version of this article (10.1186/s12889-019-7386-9) contains supplementary material, which is available to authorized users.

Leisure Activities of Healthy Children and Adolescents

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.

Activity-related behavior typologies in youth: a systematic review

BACKGROUND

Clusters of adolescents differentiated by patterns of physical activity and sedentary behavior (activity-related typologies) are common. Understanding both the characteristics of adolescents and modifiable correlates of these typologies, can help to develop interventions for those most at risk. This systematic review aimed to synthesize the socio-demographic characteristics and modifiable correlates of activity-related behavioral typologies among adolescents.

METHODS

A systematic search of seven electronic databases was conducted to identify quantitative studies using person-oriented statistical approaches to identify activity-related behavioral typologies among 12-18 year-olds. This systematic review was registered in Prospero (registration number: CRD42016046879).

RESULTS

Thirty-six studies met the inclusion criteria and were classified according to three sub-themes based on behaviors included in the typologies (1. physical activity and sedentary behavior only; 2. physical activity, sedentary behavior and risk-related behaviors; 3. physical activity, sedentary behavior and diet). Studies were mostly cross-sectional and relied on self-report measures. Methods were considerably heterogeneous, however results revealed some consistency in typologies within specific groups. For example, typologies characterized by unhealthy behavior patterns (e.g., characterized by physical inactivity, high sedentary behavior and poor diet or high risk-related behaviors) comprised more older adolescents. With the exception of socio-demographics (age, sex, body mass index and socio-economic status), very few correlates have been studied to date (mostly school-related behavioral factors and intrapersonal influences), with evidence largely from typologies comprised of physical activity, sedentary behavior and diet.

CONCLUSIONS

More research is needed to assess a range of modifiable correlates associated with activity-related behavior typologies among adolescents. This will allow for more targeted interventions, to achieve long-lasting, positive behavior change in adolescent populations.

Profiles of children's physical activity and sedentary behaviour between age 6 and 9: a latent profile and transition analysis

BACKGROUND

Physical activity is associated with improved physical and mental health among children. However, physical activity declines and sedentary time increases with age, and large proportions of older children do not meet the recommended hour per day of moderate-to-vigorous-intensity physical activity (MVPA). The aim of this paper is to identify profiles of children based on the complex relationship between physical activity and sedentary time at ages 6 and 9 and explore how those profiles are associated with other covariates and how they change over time.

METHODS

Valid accelerometer data were collected for 1132 children aged 6 and 1121 at age 9, with 565 children with data at both ages. We calculated the proportions of total wear time spent in sedentary, light and MVPA activity on both weekdays and weekends. Latent profile (class) analysis was applied separately to the two age groups to identify activity profiles. We then used latent transition analysis to explore transitions between profiles at the two time points.

RESULTS

We identified five profiles of activity at age 6 and six profiles at age 9. Although profiles were not directly equivalent, five classes captured similar patterns at both ages and ranged from very active to inactive. At both ages, active profiles, where the majority achieved the recommended MVPA guidelines, were more likely to be active at weekends than on weekdays. There was substantial movement between classes, with strongest patterns of movement to classes with no change or a decrease in MVPA. Transition between classes was associated with sex, BMI z-score, screen-viewing and participation in out-of-school activities.

CONCLUSIONS

This paper is the first to apply latent profile analysis to the physical activity of UK children as they move through primary school. Profiles were identified at ages 6 and 9, reflecting different weekday and weekend patterns of physical activity and sedentary time. There was substantial movement between profiles between ages 6 and 9, mostly to no change or less active profiles. Weekend differences suggest that greater focus on how weekend activity contributes to an average of 60 min per day of MVPA across the week may be warranted.

Typologies of adolescent activity related health behaviours

OBJECTIVES

To identify typologies of activity-related behaviours and demographic characteristics of these typologies among Australian adolescents.

DESIGN

Cross-sectional study of 473 Secondary School students (41.4% boys, mean age 14.95±1.61 years) conducted in 2014-15.

METHODS

Active travel to school, sport participation, leisure-time sedentary and demographic variables were self-reported in a survey. Duration of sedentary time and moderate-to-vigorous physical activity (mins/day) were accelerometer-derived. Latent class analysis (LCA) was conducted to identify typologies of activity-related health behaviours. One-way ANOVAs and chi-square tests were used to explore differences by demographic characteristics.

RESULTS

Three typologies were identified: (1) "Physically inactive, highly sedentary" (44%); (2) "Moderately active, high screen-time" (42%); and (3) "Highly active, low sedentary" (14%). Differences between typologies were evident for age, sex, body mass index (BMI), cultural identity, employment status and socioeconomic position (SEP). Those in typology 3 (optimal behaviour pattern) tended to be younger, of higher SEP and lower BMI.

CONCLUSIONS

This study found that older adolescents have less active, more sedentary profiles than younger adolescents. The findings support the need for targeted interventions to improve adolescent activity-related behaviour engagement.

Relationships between adolescent body mass index, physical activity, and sensory-processing patterns: Relations entre l'indice de masse corporelle, l'activité physique et les schèmes d'intégration sensorielle des adolescents

BACKGROUND

Trends show a significant decline with adolescent physical activity (PA). Knowledge regarding how sensory-processing patterns and body mass index (BMI) relate to adolescents' PA participation is scarce.

PURPOSE

This study investigated if relationships exist between adolescent BMI, sensory processing, and PA participation.

METHOD

This correlational study collected data from 141 adolescents who completed the Adolescent/Adult Sensory Profile and the Physical Activity Questionnaire-Adolescent. Their BMIs were calculated using self-reported age, height, and weight. The data were analyzed using descriptive statistics and two-tailed Spearman's rank correlation coefficients.

FINDINGS

Adolescents with different sensory-processing patterns reported participation in both similar and distinct PAs. Participation in PA and BMI shared no significant correlation. Sensory sensitivity and BMI total ( r_s = -.171, p = .044) and BMI percentile ( r_s = -.191, p = .024) demonstrated significant correlations. Analysis revealed a correlation between sensory seeking patterns and PA ( r_s = .224, p = .008) as well as correlations among sensory quadrants and participation in specific PAs.

IMPLICATIONS

Occupational therapists should consider an adolescent's sensory preferences when recommending PA interventions.

Meeting new Canadian 24-Hour Movement Guidelines for the Early Years and associations with adiposity among toddlers living in Edmonton, Canada

BACKGROUND

Canada has recently released guidelines that include toddler-specific recommendations for physical activity, screen-based sedentary behaviour, and sleep. This study examined the proportions of toddlers meeting the new Canadian 24-Hour Movement Guidelines for the Early Years (0-4 years) and associations with body mass index (BMI) z-scores in a sample from Edmonton, Canada.

METHODS

Participants included 151 toddlers (aged 19.0 ± 1.9 months) for whom there was complete objectively measured physical activity data from the Parents' Role in Establishing healthy Physical activity and Sedentary behaviour habits (PREPS) project. Toddlers' physical activity was measured using ActiGraph wGT3X-BT monitors. Toddlers' screen time and sleep were measured using the PREPS questionnaire. Toddlers' height and weight were objectively measured by public health nurses and BMI z-scores were calculated using World Health Organization growth standards. Meeting the overall 24-Hour Movement Guidelines was defined as: ≥180 min/day of total physical activity, including ≥1 min/day of moderate- to vigorous-intensity physical activity; no screen time per day (for those aged 12-23 months) or ≤1 h/day of screen time per day (ages 24-35 months); and 11-14 h of sleep per 24-h period. Frequency analyses and linear regression models were conducted.

RESULTS

Only 11.9% of toddlers met the overall 24-Hour Movement Guidelines, but this finding was largely driven by screen time. The majority of toddlers met the individual physical activity (99.3%) and sleep (82.1%) recommendations, while only 15.2% of toddlers met the screen time recommendation. No associations were observed between meeting specific and general combinations of recommendations within the guidelines and BMI z-scores.

CONCLUSIONS

Most toddlers in this sample were meeting physical activity and sleep recommendations but were engaging in more screen time than recommended. Consequently, only a small proportion of toddlers met the overall guidelines. Based on the findings of this study, identifying modifiable correlates of screen time to inform appropriate strategies to reduce screen time appears key for increasing the proportion of toddlers meeting the 24-Hour Movement Guidelines for the Early Years. Future research should examine the associations between meeting the new guidelines and other health indicators. Furthermore, future high-quality studies examining dose-response relationships between movement behaviours and health indicators are needed to inform guideline updates.

Use of time and adolescent health-related quality of life/well-being: a scoping review

Time use could profoundly affect adolescents' health-related quality of life (HRQL). Ideally, overall time use patterns would be considered, because activities within a 24-hour day are inherently correlated (more in one activity means less in another). This review focused on the associations of (i) overall time use patterns and (ii) components of time use patterns with HRQL in adolescents.

CONCLUSION

More physical activity, less screen time and more/adequate sleep, in isolation, are associated with better profile-based HRQL subscales. Greater understanding of adolescents' overall time use patterns and HRQL is, therefore, a priority for policy development.

Time-Use Patterns and Health-Related Quality of Life in Adolescents

OBJECTIVES

To describe 24-hour time-use patterns and their association with health-related quality of life (HRQoL) in early adolescence.

METHODS

The Child Health CheckPoint was a cross-sectional study nested between Waves 6 and 7 of the Longitudinal Study of Australian Children. The participants were 1455 11- to 12-year-olds (39% of Wave 6; 51% boys). The exposure was 24-hour time use measured across 259 activities using the Multimedia Activity Recall for Children and Adolescents. "Average" days were generated from 1 school and 1 nonschool day. Time-use clusters were derived from cluster analysis with compositional inputs. The outcomes were self-reported HRQoL (Physical and Psychosocial Health [PedsQL] summary scores; Child Health Utility 9D [CHU9D] health utility).

RESULTS

Four time-use clusters emerged: "studious actives" (22%; highest school-related time, low screen time), "techno-actives" (33%; highest physical activity, lowest school-related time), "stay home screenies" (23%; highest screen time, lowest passive transport), and "potterers" (21%; low physical activity). Linear regression models, adjusted for a priori confounders, showed that compared with the healthiest "studious actives" (mean [SD]: CHU9D 0.84 [0.14], PedsQL physical 86.8 [10.8], PedsQL psychosocial 79.9 [12.6]), HRQoL in "potterers" was 0.2 to 0.5 SDs lower (mean differences [95% confidence interval]: CHU9D -0.03 [-0.05 to -0.00], PedsQL physical -5.5 [-7.4 to -3.5], PedsQL psychosocial -5.8 [-8.0 to -3.5]).

CONCLUSIONS

Discrete time-use patterns exist in Australian young adolescents. The cluster characterized by low physical activity and moderate screen time was associated with the lowest HRQoL. Whether this pattern translates into precursors of noncommunicable diseases remains to be determined.

Interactions between sleep, movement and other non-movement behaviours in the pathogenesis of childhood obesity

Research examining the health effects of physical activity, sedentary behaviour and sleep on different health outcomes has largely been conducted independently or in isolation of the other behaviours. However, the fact that time is finite (i.e. 24 h) suggests that the debate on whether or not the influence of a single behaviour is independent of another one is conceptually incorrect. Time spent in one behaviour should naturally depend on the composition of the rest of the day. Recent evidence using more appropriate analytical approaches to deal with this methodological issue shows that the combination of sleep, movement and non-movement behaviours matters and all components of the 24-h movement continuum should be targeted to enhance health and prevent childhood obesity. The objective of this review is to discuss research investigating how combinations of physical activity, sedentary behaviour and sleep are related to childhood obesity. Emerging statistical approaches (e.g. compositional data analysis) that can provide a good understanding of the best 'cocktail' of behaviours associated with lower adiposity and improved health are also discussed. Finally, future research directions are provided. Collectively, it becomes clearer that guidelines and public health interventions should target all movement behaviours synergistically to optimize health of children and youth around the world.

Associations between sleep duration, sedentary time, physical activity, and health indicators among Canadian children and youth using compositional analyses

The purpose of this study was to examine the relationships between movement behaviours (sleep duration, sedentary time, physical activity) and health indicators in a representative sample of children and youth using compositional analyses. Cross-sectional findings are based on 4169 children and youth (aged 6-17 years) from cycles 1 to 3 of the Canadian Health Measures Survey. Sedentary time (SB), light-intensity physical activity (LPA), and moderate- to vigorous-intensity physical activity (MVPA) were accelerometer-derived. Sleep duration was subjectively measured. Body mass index z scores, waist circumference, blood pressure, behavioural strengths and difficulties, and aerobic fitness were measured in the full sample. Triglycerides, high-density lipoprotein-cholesterol, C-reactive protein, and insulin were measured in a fasting subsample. The composition of movement behaviours was entered into linear regression models via an isometric log ratio transformation and was found to be associated with all health indicators (p < 0.01). Relative to other movement behaviours, time spent in SB or LPA was positively associated (p < 0.04) and time spent in MVPA or sleep was negatively associated (p < 0.02) with obesity risk markers. Similarly, LPA was positively associated (p < 0.005) and sleep was negatively associated (p < 0.03) with unfavourable behavioural strengths and difficulties scores and systolic blood pressure. Relative to other movement behaviours, time spent in SB was negatively associated (p < 0.001) and time spent in MVPA (p < 0.001) was positively associated with aerobic fitness. Likewise, MVPA was also negatively associated with several cardiometabolic risk markers (p < 0.008). Compositional data analyses provide novel insights into collective health implications of 24-h movement behaviours and can facilitate interesting avenues for future investigations.

Lack of sleep as a contributor to obesity in adolescents: impacts on eating and activity behaviors

Background

Sleep is an important contributor to physical and mental health; however, chronic sleep deprivation has become common in adolescents, especially on weekdays. Adolescents aged 14–17 years are recommended to sleep between 8 and 10 h per night to maximize overall health and well-being. Although sleep needs may vary between individuals, sleep duration recommendations are important for surveillance and help inform policies, interventions, and the population of healthy sleep behaviors. Long sleepers are very rare among teenagers and sleeping too much is not a problem per se; only insufficient sleep is associated with adverse health outcomes in the pediatric population. Causes of insufficient sleep are numerous and chronic sleep deprivation poses a serious threat to the academic success, health and safety of adolescents. This article focuses on the link between insufficient sleep and obesity in adolescents.

Discussion

This “call to action” article argues that sleep should be taken more seriously by the public health community and by our society in general, i.e., given as much attention and resources as nutrition and physical activity. Not only that having a good night’s sleep is as important as eating a healthy diet and being regularly physically active for overall health, but sleeping habits also impact eating and screen time behaviors and, therefore, can influence body weight control.

Summary

Short sleep duration, poor sleep quality, and late bedtimes are all associated with excess food intake, poor diet quality, and obesity in adolescents. Sleep, sedentary behavior, physical activity and diet all interact and influence each other to ultimately impact health. A holistic approach to health (i.e., the whole day matters) targeting all of these behaviors synergistically is needed to optimize the impact of our interventions. Sleep is not a waste of time and sleep hygiene is an important factor to consider in the prevention and treatment of obesity.

Gender differences in the prevalence and clustering of multiple health risk behaviours in young adults

AIMS

To estimate the sex-stratified prevalence and clustering of 14 behavioural and metabolic health risk factors in emerging adulthood.

BACKGROUND

The high prevalence and the clustering of risk factors multiply health consequences and increase the threat to the future health and quality of life of young adults.

DESIGN

Descriptive cross-sectional study.

METHODS

During November-December 2012, we assessed 14 lifestyle characteristics of 1058 1st year university students' that were classified as: healthy (score = 0), unhealthy (score = 1) and high-risk unhealthy (score = 2). We subsequently created a Multiple Health Risk Behaviours Index by summing the score of each behaviour adjusted to 0-100.

RESULTS

Only 0·3% of the students had one risk behaviour and 21·3% (male: 31·5%; female: 12·6%) had ≥10 of 14. Male students had higher risk index score. In adjusted regression analyses, female students had higher odds of reporting healthier behaviours in oral hygiene (tooth brushing), red meat and junk food consumption, binge drinking, cannabis/hashish/marijuana use and lower number of sexual partners and Body Mass Index. Male students reported higher physical activity. No statistically significant gender differences were noted for screen time/sedentary behaviours, condom use, smoking, sunburns, breakfast and fruit and vegetable consumption.

CONCLUSION

Although health-compromising behaviours are highly prevalent in both men and women, they are gender-related, with males engaging in more health risk behaviours than females. Preventive interventions may need to focus on gender-informed approaches when targeting multiple health risk behaviours.

[Prevalence of sedentary behavior and its correlates among primary and secondary school students]

OBJECTIVE

To determine the students' exposure to four different sedentary behavior (SB) indi-cators and their associations with gender, grade, age, economic status and physical activity level.

METHODS

A cross-sectional study was conducted in 2013. The SB was collected using the HELENA instrument, composed by screen time questions (TV, video games and internet) and sitting activ-ities on school opposite shift. The cut point of ≥2h/day was used to categorize the outcome. The Poisson regression was used for associations between the outcome and the independent variables (95% significance level), controlling for confounding variables and the possible design effect.

RESULTS

The sample was composed by 8661 students. The overall prevalence of SB was 69.2% (CI95% 68.1-70.2) on weekdays, and 79.6% (CI95% 78.7-80.5) on weekends. Females were more associated with the outcome, except to electronic games. Advanced grades students were more involved in sitting tasks when compared to the early grades. Older students were more likely to surf on net for ≥2h/day. Higher economic level students were more likely to engage in video games and internet. Active individuals were less likely to engage in SB on weekdays.

CONCLUSIONS

The prevalence of SB was high, mainly on weekends. The associations with sex, age, grade and physical activity level should be considered into elaboration of more efficient interventions on SB control.

Health complaints among adolescents: Associations with more screen-based behaviours and less physical activity

In this study, we investigated the relationship between screen-based behaviours, physical activity, and health complaints (headaches, feeling low, irritability, and nervousness). Screen-based behaviour included TV viewing, computer use, and time spent playing video games. Data were collected from 4462 Portuguese adolescents (2394 girls) aged 11-16 years. Girls who reported engaging in more screen-based behaviour (hours/day) also reported having more headaches, feeling lower, being more irritable, and feeling more nervous. Boys who reported more screen time were more irritable. Physical activity (times/week) was negatively associated with reports of feeling nervous among girls, and with headaches, feeling low, irritability, and feeling nervous among boys. Considering that time spent using the computer is related with more health complaints, and physical activity was related with fewer health complaints among boys, it is important to develop strategies to reduce adolescents' computer screen time, and to promote physical activity.

Patterns of time use among low-income urban minority adolescents and associations with academic outcomes and problem behaviors

Time budgets represent key opportunities for developmental support and contribute to an understanding of achievement gaps and adjustment across populations of youth. This study assessed the connection between out-of-school time use patterns and academic performance outcomes, academic motivations and goals, and problem behaviors for 504 low-income urban African American and Latino adolescents (54% female; M = 16.6 years). Time use patterns were measured across eight activity types using cluster analysis. Four groups of adolescents were identified, based on their different profiles of time use: (1) Academic: those with most time in academic activities; (2) Social: those with most time in social activities; (3) Maintenance/work: those with most time in maintenance and work activities; and (4) TV/computer: those with most time in TV or computer activities. Time use patterns were meaningfully associated with variation in outcomes in this population. Adolescents in the Academic cluster had the highest levels of adjustment across all domains; adolescents in the Social cluster had the lowest academic performance and highest problem behaviors; and adolescents in the TV/computer cluster had the lowest levels of intrinsic motivation. Females were more likely to be in the Academic cluster, and less likely to be in the other three clusters compared to males. No differences by race or gender were found in assessing the relationship between time use and outcomes. The study's results indicate that time use patterns are meaningfully associated with within-group variation in adjustment for low-income minority adolescents, and that shared contexts may shape time use more than individual differences in race/ethnicity for this population.

What can be learned from adolescent time diary research

Time use is increasingly being recognized as a determinant and indicator of adolescent well-being internationally. Three existing literature reviews of time-use research with children and adolescents have identified time-use diaries as the preferred data collection method. Furthermore, they have encouraged researchers to examine multidimensional patterns of overall time use in large-sample whole child populations to better understand the health, well-being, and quality of life of children and young people. However, these three existing reviews differ in the time frames covered; the age ranges targeted; the categories of time use examined; and the time-use data collection and analysis methods used. This study aimed to map the extent and nature of time diary studies with well adolescents (aged 10-19 years) and the use of person-centered data analysis of overall time use as a multidimensional unit. Finally, it explores whether and how the included studies analyzed the relationship between time use and health, well-being, and quality of life. A scoping review method was employed using Arksey and O'Malley's five-step framework. Thirty-three studies met the inclusion criteria. Most studies were secondary analyses of cross-sectional population-level time-use or lifestyle survey data. One-third of studies (n = 11) captured data representing 24 hours of the day. Two studies (6%) used person-centered analyses, while six studies (18%) empirically examined time use in relation to health and well-being. No studies examined adolescent 24-hour time use and quality of life. Adolescent time-use researchers are encouraged to be explicit in identifying the stage of adolescence to which their studies relate; capture 24-hour time-use data; analyze overall activity patterns as multidimensional units using person-centered methods; and use robust, reliable, valid, sensitive, and age-appropriate instruments to empirically examine time use and health, well-being, and quality of life. Through this, healthy patterns of everyday activity for adolescents can be illuminated.

Adolescent diet and time use clusters and associations with overweight and obesity and socioeconomic position

Risk factors for adolescent overweight and obesity include low levels of physical activity, high levels of sedentary behavior, low fruit and vegetable intake, and low socioeconomic position (SEP). To date, the vast majority of research investigating associations between lifestyle behaviors and weight status analyze dietary and time use factors separately. Our research aimed to describe Australian youth time use and diet clusters and explore relationships with weight status and SEP (parental education and income). Cluster analysis of the National Children's Nutrition and Physical Activity Survey data from Australians aged 9 to 16 years (random sample n = 1,853) was conducted. Time use data (17 age-adjusted time use variables) and dietary data (7 age-adjusted diet variables) were collected via 24-hour recalls. Two clusters were associated with a reduced frequency of overweight and obesity (the boys' Active Sitter and girls' Healthy Academic clusters) and one with an increased frequency of overweight and obesity (the boys' Unhealthy cluster). Of these three clusters, two demonstrated associations with parental income and/or parental education level. The boys' Unhealthy cluster was associated with low SEP status (parental income and education), and the girls' Healthy Academic cluster was associated with high parental income. Not all unhealthy adolescent clusters were associated with overweight and obesity. The findings suggest sex-specific diet and activity clusters can be used to identify at-risk subgroups and inform multifaceted interventions to address overweight and obesity.

Is the association between screen-based behaviour and health complaints among adolescents moderated by physical activity?

OBJECTIVES

The aim of this study was to assess the association between screen-based (SB) behaviour and selected health complaints in adolescents and whether physical activity (PA) moderates this association.

METHODS

Data from the cross-sectional Health Behaviour of School-aged Children study collected in 2010 among Slovak adolescents (age 11-15 years, N = 8,042, 48.6% boys) were used. Logistic regression models adjusted for age and gender were used to analyse the associations between watching TV, working with a computer or playing computer games and headache, backache, sleep difficulties, feeling low, irritability and feeling nervous. Next, we assessed the interactions of SB behaviours and PA regarding health complaints.

RESULTS

Watching TV more than 3 h is associated with increased chance of reporting headache, feeling low, being irritable or feeling nervous, while working with computer or playing computer games for more than 3 h does so in all of the explored health complaints. Being physically active does not moderate the associations of SB activities with health complaints.

CONCLUSIONS

SB behaviours are associated with health complaints among adolescents, and these associations are not moderated by PA.

Importance of all movement behaviors in a 24 hour period for overall health

Physical inactivity and childhood obesity are well-recognized public health concerns that are associated with a range of adverse health outcomes. Historically, the benefits of physical activity (e.g., moderate-to-vigorous physical activity-MVPA) to overall health have dominated discussions and emerging evidence indicates that a broader, more integrated approach is needed to better understand and address current public health crises. Existing guidelines for children and youth around the world only focus on MVPA, and recently sedentary behavior, despite an accumulating body of evidence showing that light-intensity physical activity (LPA) such as walking can provide important health benefits. Furthermore, there is accumulating support for the importance of adequate sleep and that these behaviors moderate the health impact of each other. Ignoring the other components of the movement continuum (i.e., sleep, sedentary time, LPA) while focusing efforts exclusively on MVPA (accounting for <5% of the time in a 24 h period) limits the potential to optimize the health benefits of movement behaviors. In order to address this limitation, experts in Canada are currently developing the world's first Integrated 24 Hour Movement Behaviour Guidelines for Children and Youth to help advance an integrated healthy active living agenda that has the potential to significantly improve the overall health and well-being of children and youth.

A person-centred analysis of the time-use, daily activities and health-related quality of life of Irish school-going late adolescents

PURPOSE

The health, well-being and quality of life of the world's 1.2 billion adolescents are global priorities. A focus on their patterns or profiles of time-use and how these relate to health-related quality of life (HRQoL) may help to enhance their well-being and address the increasing burden of non-communicable diseases in adulthood. This study sought to establish whether distinct profiles of adolescent 24-h time-use exist and to examine the relationship of any identified profiles to self-reported HRQoL.

METHOD

This cross-sectional study gathered data from a random sample of 731 adolescents (response rate 52%) from 28 schools (response rate 76%) across Cork city and county. A person-centred approach, latent profile analysis, was used to examine adolescent 24-h time-use and relate the identified profiles to HRQoL.

RESULTS

Three male profiles emerged, namely productive, high leisure and all-rounder. Two female profiles, higher study/lower leisure and moderate study/higher leisure, were identified. The quantitative and qualitative differences in male and female profiles support the gendered nature of adolescent time-use. No unifying trends emerged in the analysis of probable responses in the HRQoL domains across profiles. Females in the moderate study/higher leisure group were twice as likely to have above-average global HRQoL.

CONCLUSION

Distinct time-use profiles can be identified amongst adolescents, but their relationship with HRQoL is complex. Rich mixed-method research is required to illuminate our understanding of how quantities and qualities of time-use shape lifestyle patterns and how these can enhance the HRQoL of adolescents in the twenty-first century.

The impact of parenthood on Canadians' objectively measured physical activity: an examination of cross-sectional population-based data

BACKGROUND

Parenthood has been associated with declines in leisure-time exercise and moderate-to-vigorous physical activity (MVPA), but less is known about its impact on sedentary time and light-intensity activity. Although the health benefits of MVPA are well established, a growing body of research has been showing that even after controlling for MVPA levels, a detrimental dose-response association exists between sedentary time and adverse health outcomes and a beneficial dose-response association exists for light-intensity activity.

METHODS

This study examined the impact of parenthood, the number of children in the home, and the age of the youngest child on objectively measured physical activity (i.e., accelerometer derived daily minutes of sedentary, light, and MVPA) among a nationally representative cross-sectional sample of 2234 men and women who participated in the 2009-2011 Canadian Health Measures Survey.

RESULTS

After controlling for sociodemographic variables, ANCOVAs indicated that parents engaged in more light activity but less MVPA than non-parents and women whose youngest child was aged 12-15 years were more sedentary than women without children. Among both men and women, having a child <6 years of age in the home was associated with the greatest amount of light activity and lowest MVPA.

CONCLUSIONS

Modest differences emerged between the physical activity level of parents and non-parents for both genders and across intensity levels. In general, parenthood was associated with less MVPA and more light-intensity activity, and more differences emerged among women compared to men. More research is needed before conclusions can be drawn regarding the health consequences of these differences.

No time for the gym? Housework and other non-labor market time use patterns are associated with meeting physical activity recommendations among adults in full-time, sedentary jobs

Physical activity and inactivity have distinct cardio-metabolic consequences, suggesting that combinations of activities can impact health above and beyond the effects of a single activity. However, little work has examined patterns of non-labor market time activity in the US population, particularly among full-time employees in sedentary occupations, who are at increased risk of adverse health consequences associated with a sedentary lifestyle. Identification of these patterns, and how they are related to total physical activity levels, is important for developing effective, attainable physical activity recommendations among sedentary employees, who typically have less time available for exercise. This is especially the case for low-income employees who face the highest time and financial barriers to achieving physical activity goals. This study uses cluster analysis to examine patterns of non-labor market time use among full-time (≥40 h/week) employed adults in sedentary occupations (<3 MET-h) on working days in the American Time Use Study. We then examine whether these patterns are associated with higher likelihood of meeting physical activity recommendations and higher overall physical activity (MET-h). We find that non-labor market time use patterns include those characterized by screen activities, housework, caregiving, sedentary leisure, and exercise. For both genders, the screen pattern was the most common and increased from 2003 to 2012, while the exercise pattern was infrequent and consistent across time. Screen, sedentary leisure, and community patterns were associated with lower likelihoods of meeting physical activity recommendations, suggesting that interventions targeting screen time may miss opportunities to improve physical activity among similarly sedentary groups. Alternately, non-labor market time use patterns characterized by housework and caregiving represented feasible avenues for increasing overall physical activity levels, especially for those with low financial and time resources. Consideration of non-labor market time use patterns may improve strategies to increase physical activity and decrease inactivity among full-time employed adults in sedentary jobs.

A scoping review of time-use research in occupational therapy and occupational science

BACKGROUND

Time use is a defining interest within occupational therapy and occupational science. This is evident through the range of contributions to the disciplinary knowledge base. Indeed it has been suggested that time-use methods are amongst the most established research techniques used to explore aspects of human occupation. However, the extent and nature of such activity in occupational therapy and occupational science has not been examined to date.

AIM

This study sought to map the extent and nature of time-use research in occupational therapy and occupational science journals and the extent to which studies explored the relationship between time-use and health.

METHOD

A scoping review method was used.

RESULTS

Sixty-one studies were included. Scandinavian countries contributed the largest number of studies (n = 16, 26%). While time-use diaries were used most frequently (n = 30, 49%) occupational therapists and occupational scientists have developed a range of data-collection instruments. Forty-nine studies (80%) focused on time-use in clinical or defined population sub-groups. Ten studies (16%) included an empirical examination of the relationship between time-use and health.

CONCLUSION

Future research should examine time-use and health amongst well populations across the lifespan and in different parts of the world.

Promoting leisure participation as part of health and well-being in children and youth with cerebral palsy

Participation in leisure is a human right and is central to the health of children and youth. The World Health Organization's International Classification of Functioning, Disability and Health for Children and Youth supported a change in thinking about what outcomes are most relevant in the context of children's health and places participation as one of the constituent elements of health. Participation is also a fundamental rehabilitation and health promotion outcome for children with cerebral palsy as identified by youth, parents, and health professionals. Several studies have identified individual and environmental factors related to participation in leisure; new studies are now determining the best interventions to promote participation. This article summarizes recent findings and proposes important topics for neurologists to consider in exploring leisure pursuits with children with cerebral palsy and their families and in working with rehabilitation professionals to promote engagement in leisure opportunities as part of integrated care.

Breadth of participation in organized and unstructured leisure activities over time and rural adolescents' functioning

Discretionary time outside of school offers a distinct context that can promote adolescent development; however, potential for growth depends in part on how this time is used. In this study, person-centered analyses were used to examine patterns of breadth of participation in both organized and unstructured leisure activities among rural adolescents (N = 276, 49% female) across grades 7, 8, and 10. Adjusting for self-selection factors, the study associated these patterns with 10th grade outcomes. Three profiles of participation emerged: consistently low breadth, consistently average breadth, and consistently high breadth of involvement in both organized and unstructured leisure activities over time. The most popular activity types across profile groups were hanging out with friends, team sports, and outdoor activities. Adolescents involved in a greater breadth of organized activities reported the greatest breadth of involvement in unstructured leisure and the best functioning. Adolescents with low breadth of involvement in both organized and unstructured leisure activities consistently showed poorer outcomes. Adolescents in the high breadth of involvement profile were engaged in all activity types at higher rates than adolescents in the average and low breadth of involvement profiles. We advocate for continued efforts to increase adolescent participation in a variety of different types of out-of-school activities.

Screen-based media use clusters are related to other activity behaviours and health indicators in adolescents

Background

Screen-based media (SBM) occupy a considerable portion of young peoples’ discretionary leisure time. The aim of this paper was to investigate whether distinct clusters of SBM use exist, and if so, to examine the relationship of any identified clusters with other activity/sedentary behaviours and physical and mental health indicators.

Methods

The data for this study come from 643 adolescents, aged 14 years, who were participating in the longitudinal Western Australian Pregnancy Cohort (Raine) Study through May 2003 to June 2006. Time spent on SBM, phone use and reading was assessed using the Multimedia Activity Recall for Children and Adults. Height, weight, muscle strength were measured at a clinic visit and the adolescents also completed questionnaires on their physical activity and psychosocial health. Latent class analysis (LCA) was used to analyse groupings of SBM use.

Results

Three clusters of SBM use were found; C1 ‘instrumental computer users’ (high email use, general computer use), C2 ‘multi-modal e-gamers’ (both high console and computer game use) and C3 ‘computer e-gamers’ (high computer game use only). Television viewing was moderately high amongst all the clusters. C2 males took fewer steps than their male peers in C1 and C3 (-13,787/week, 95% CI: -4619 to -22957, p = 0.003 and -14,806, 95% CI: -5,306 to -24,305, p = 0.002) and recorded less MVPA than the C1 males (-3.5 h, 95% CI: -1.0 to -5.9, p = 0.005). There was no difference in activity levels between females in clusters C1 and C3.

Conclusion

SBM use by adolescents did cluster and these clusters related differently to activity/sedentary behaviours and both physical and psychosocial health indicators. It is clear that SBM use is not a single construct and future research needs to take consideration of this if it intends to understand the impact SBM has on health.

More than just physical activity: time use clusters and profiles of Australian youth

OBJECTIVE

To describe time use clusters and correlate-cluster profiles of Australian youth.

DESIGN

Secondary analysis of cross-sectional national survey.

METHODS

Data were from the National Children's Nutrition and Physical Activity Survey, a random sample (n=1853) of 9-16 years old Australians (February-August 2007). Time use data were collected using the Multimedia Activity Recall for Children and Adults, and collapsed into 17 age-adjusted variables for sex-specific cluster analysis. Cluster associations with socio-demographic, anthropometric, health and dietary variables were analysed.

RESULTS

For boys (n=930), the Social tasker cluster was characterised by social interaction and chores & work, the Techno-active cluster by team sport and TV and the Techno-studious cluster by video games and study. Average daily pedometer steps, age and remoteness were significant cluster correlates. For the girls (n=923), the Social screenie cluster was characterised by TV and social interaction, the Quiet actives cluster by quiet time and non-team sport and the Techno-studious cluster by video games and study. Pedometer steps, age, parental income and education, parent-child age difference, "extra foods", fat and fruit intakes were significant correlates.

CONCLUSIONS

Distinct sex-specific time use clusters and profiles exist among Australian youth. These findings may assist the development of targeted time use interventions to improve health and well-being.