Pedometer-determined physical activity patterns in a segmented school day among Hong Kong primary school children

Compensation of overall physical activity in (pre)adolescent girls - the CReActivity project

BACKGROUND

According to the ActivityStat hypothesis more physical activity (PA) in one timespan is compensated by increased sedentary time (ST) in the following timespan and vice versa to maintain an overall stable PA level. Until now, existing literature revealed inconsistent results regarding compensatory behaviour across children and adolescents. Thus, the aim of the present study is (1) to investigate whether ST in the morning is compensated by active behaviour in the afternoon and (2) whether ST during the week is compensated by active behaviour during the weekend in (pre)adolescent girls. Additionally, we aimed to differentiate between positive and negative compensatory behaviour and examine whether it is moderated by socioeconomic status (SES), age or weight status.

METHODS

The participants were 370 sixth grade school girls (mean age 11.6 years) from Munich that participated in the CReActivity study, a school based intervention study aiming to identify the mechanisms of behavioural changes in PA among girls. ST and PA were measured over seven consecutive days using accelerometery. Descriptive determination of compensatory behaviour, as well as Bayesian multivariate multilevel analysis were conducted with data clustered on the individual (ID), class and school level.

RESULTS

Descriptive analysis revealed rather constant compensatory behaviour of about 60% for after-school days and weekends over all observation points. However, regarding all girls, compensation was predominantly negative. Differentiated analysis indicated that all girls with low ST levels in the morning or on weekdays, compensated for this behaviour with lower PA levels in the afternoon or on weekends. Multilevel covariate analysis indicated great variability between the participants. Furthermore, differences in compensatory behaviour can also be seen on class and school levels. Interestingly, PA compensatory behaviour is not associated with age, weight status or SES.

CONCLUSION

Our findings could neither confirm nor reject the ActivityStat Hypothesis. Overall, due to the great variability across the girls, it seems that compensation depends on individual factors. In the future, to prevent negative compensation, school-based interventions that have the potential to provide opportunities to be physically active, should not neglect (pre)adolescents' leisure time behaviour.

TRIAL REGISTRATION

DRKS00015723 (date of registration: 2018/10/22 retrospectively registered).

The Associations of Active Travel to School With Physical Activity and Screen Time Among Adolescents: Do Individual and Parental Characteristics Matter?

Little is known about the relationship of active travel to school (ATS) with physical activity (PA) and screen time (ST) by individual and parental characteristics among adolescents, especially in China. To address the research gap, this study aimed to explore the difference of sex, age, living environment, parental occupation and education level in the relationship of ATS with PA and ST among students of grades 7–12 (aged 10–18 years) using cross-sectional data. In 13 cities of Hubei province, China, students from 39 public schools were recruited to engage in the survey. In total, 5,898 students (response rate = 89.6%) were invited into this study. Participants were required to report their ATS (including its types), PA and ST as well as sociodemographic information using a validated questionnaire. Descriptive analyses were used to report the information of all variables. Regression models were used to analyse the relationships of ATS and its types with PA and ST. In a total of 4,128 participants (boys: 50.9%; younger adolescents: 61.9%) included in the final analysis, the proportion of those with ATS was 47.3%. Regarding the types of ATS, walking accounted for over 30%, while cycling was 13.2%. Participants with ATS were more likely to have sufficient PA (OR = 1.26, 95% CI: 1.14–1.39), especially among boys, younger adolescents and those with lower parental education level. However, ATS was not associated with ST (OR = 0.94, 95% CI: 0.86–1.01). Participants with cycling had a higher odds ratio of being physically active (OR for cycling = 1.47, 95% CI: 1.27–1.70; OR for walking = 1.18, 95% CI: 1.06–1.32). The association of ATS types with PA and ST differed by gender, age, living environment and parental educational level as well as occupations. ATS may be a useful approach to increase PA among adolescents, but this should be explained by individual and parental characteristics.

Compensation or Displacement of Physical Activity in Children and Adolescents: A Systematic Review of Empirical Studies

Regular physical activity during childhood and adolescence is associated with health benefits. Consequently, numerous health promotion programs for children and adolescents emphasize the enhancement of physical activity. However, the ActivityStat hypothesis states that increases in physical activity in one domain are compensated for by decreasing physical activity in another domain. Currently, little is known about how physical activity varies in children and adolescents within intervals of one day or multiple days. This systematic review provides an overview of studies that analyzed changes in (overall) physical activity, which were assessed with objective measurements, or compensatory mechanisms caused by increases or decreases in physical activity in a specific domain in children and adolescents. A systematic search of electronic databases (PubMed, Scopus, Web of Science, SportDiscus) was performed with a priori defined inclusion criteria. Two independent researchers screened the literature and identified and rated the methodological quality of the studies. A total of 77 peer-reviewed articles were included that analyzed changes in overall physical activity with multiple methodological approaches resulting in compensation or displacement. Of 40,829 participants, 16,265 indicated compensation associated with physical activity. Subgroup analyses separated by study design, participants, measurement instrument, physical activity context, and intervention duration also showed mixed results toward an indication of compensation. Quality assessment of the included studies revealed that they were of high quality (mean = 0.866). This review provides inconclusive results about compensation in relation to physical activity. A trend toward increased compensation in interventional studies and in interventions of longer duration have been observed.

Physical Activity Opportunities of Low-Income Elementary School-Aged Children During the Segmented School Day

BACKGROUND

In this study, we examined moderate-to-vigorous physical activity (MVPA) of children in a school district serving children from low-income and minority households.

METHODS

This observational study was conducted in 8 rural elementary schools in South Carolina. Children (N = 719, age = 7.7 years, 48.0% girls, 88.0% African American) wore accelerometers during school hours. Physical activity was distilled into time engaged in MVPA during 4 distinct opportunities. These 4 opportunities were non-activity time (eg, class-time), extended lunch (lunch recess after eating), physical education (PE), and recess. Mixed effects linear regressions estimated MVPA on days that had no activity opportunities, extended lunch, recess, PE, and multiple activity opportunities (eg, PE and recess).

RESULTS

On days with multiple activity opportunities, girls and boys accumulated 8.0 (95% CI = 4.9, 11.1) and 7.1 (95% CI = 3.6, 10.7) additional minutes of MVPA compared to a no activity day. On PE days boys accumulated 5.2 (95% CI = 0.3, 10.2) additional minutes of MVPA, whereas recess days provided girls with 3.0 (95% CI = 0.1, 6.0) additional MVPA minutes. No other activity opportunities provided statistically significant increases in school-day MVPA.

CONCLUSIONS

In low-income schools it may be necessary to provide multiple physical activity opportunities during the school day to increase boys' and girls' MVPA.

Physical Activity of Children with Visual Impairments during Different Segments of the School Day

Schools provide opportunities for children with visual impairments (VI) to accumulate recommended daily moderate-to-vigorous-intensity physical activity (MVPA). This study aimed to determine physical activity (PA) across the school day among special school children with VI in China. The study objectively measured the MVPA levels of children with VI during the recess, lunchtime, physical education (PE) classes, before-school, and after-school periods segments on PE days and non-PE days. Moreover, this research compared the gender, age, and body mass index (BMI) differences in MVPA during each segment. A total of 70 children with VI aged 7–17 years (mean age = 13.7; SD = 3.4) from the special school participated in this study. Accelerometers were utilized to measure the MVPA of children with VI. The participants with VI accumulated significantly more MVPA time on PE days than on non-PE days. Before-school periods and structured PE classes showed higher percentages of MVPA time than recess, lunch break, and after-school periods during the school day. Children with VI aged 7–12 years old were significantly more physically active than those aged 13–17 years old during recess, lunch break, and after-school periods. In conclusion, PA interventions during structured PE classes are recommended. Special attention should be provided to children with VI as they grow up to increase their MVPA.

Objective Measures to Assess Active Commuting Physical Activity to School in Young People: A Systematic Review Protocol and Practical Considerations

There are no systematic reviews that have identified the existing studies assessing active commuting physical activity (PA) to and from (to/from) school using objective measures, as well as the contribution of both walking and cycling to/from school to PA levels. To fill this gap in the literature, this systematic review will aim (a) to identify existing studies that assess active commuting PA to/from school with objective measures in young people and to examine the contribution of walking and cycling to/from school to PA levels, and (b) to propose an appropriate methodology and practical considerations to assess active commuting PA to/from school based on the studies identified. The review protocol was registered in PROSPERO (CRD42020162004). We will conduct a systematic search up to 2020 in five databases: PubMed, Web of Science, SPORTdiscuss, Cochrane Library, and National Transportation Library. Both the risk of bias and the quality of the identified studies will be evaluated through different instruments according to the design of each study. This systematic review will help to choose the most appropriate objective measures to assess active commuting PA to/from school and to promote walking and cycling to/from school to increase PA levels.

A Systematic Review of Children's Physical Activity Patterns: Concept, Operational Definitions, Instruments, Statistical Analyses, and Health Implications

Despite the widespread use of the expression “physical activity pattern” (PAP), there apparently is no general consensus regarding its definition. This systematic review aimed to examine available research focussing on (1) definitions of PAP, (2) instruments/techniques used to describe PAP, (3) statistical approaches used to analyse PAP, and (4) implications of PAP on children’s health. A systematic review of the available literature was done to identify studies published up to October 2019, and 76 studies were eligible. None of the studies presented a formal definition of PAP; a wide range of instruments were used to investigate children’s PAP, and most of the revised studies did not explicitly present a formal statistical model to define PAP. Twenty-four papers purported to examine associations between PAP and health indicators. The review highlights no consensus on a clear PAP definition whatever the instrument used to capture it, and we did not find any agreement regarding how best to analyse PAP. We suggest that PAP should be used when targeting the investigation of similarities/dissimilarities, as well as stabilities and/or changes in children’s PA at an intra-personal level. In sum, PAP should be used to best describe individual streams of behaviours, and not exclusively PA levels/intensities.

Levels of Physical Activity during School Hours in Children and Adolescents: A Systematic Review

BACKGROUND

This systematic review determines the levels of physical activity (PA) during school hours in children and adolescents.

METHODS

Studies carried out from January 1987 to December 2019 were retrieved from four databases (Web of Science, Pubmed, Scopus and SportDiscus). The 29 selected studies were cross-sectional, long-term and case studies.

RESULTS

Most of them used accelerometers and showed that male and female children accumulated a mean of between 14 and 68 min of moderate-to-vigorous PA (MVPA) during school hours (3%-22% of this daily segment), and male and female adolescents accumulated a mean of between 13 and 28 min of MVPA during this daily segment (3%-8% of the school hours). Less than a quarter of children and adolescents reached the recommended 30 min of MVPA during school hours, with notable differences between sexes.

CONCLUSIONS

These results suggest that the levels of PA during school hours are not enough, and consequently, schools should develop strategies for helping children and adolescents reach the school PA recommendation.

Disentangling Physical Activity and Sedentary Behavior Patterns in Children with Low Motor Competence

Children with low motor competence (MC) are at high-risk for physical inactivity, yet little is known about their physical activity (PA) and sedentary behavior (SB) patterns throughout the day. The purpose of this study is to disentangle PA and SB patterns among children with low MC across segmented day periods taking into account differences in gender and age. Data collection took place between May and July 2017. The Athletic Skills Track was used to measure MC. PA levels were objectively measured using accelerometers (ActiGraph, GT3X+) on school days. Data were segmented for (1) time before school, (2) time during school (based on school schedules), and (3) time after school. In total, data from 117 7-to-11 years-old children with low MC were eligible for analyses (N = 58 girls; N = 59 boys). Differences in moderate-to-vigorous PA (MVPA) and SB between segmented periods, gender, and grade were analyzed by ANOVAs with post hoc tests (Tukey) and Independent Sample T-tests respectively. Time spent at school is the major contributor of time spent in SB in children with low MC. Low MC is equally distributed among gender, but large differences exist among boys and girls in both MVPA and SB, indicating low-MC girls as most inactive group. This pattern is found in all segmented periods of the school day, i.e., before, during, and after school. This study stresses the negative contribution of current school curricula on PA and SB in children with low MC, indicating the most efficient period of the day to intervene. Future school-based PA and SB interventions should particularly focus on specific high-risk populations, i.e., children with low MC, and girls in particular.

Does school physical education really contribute to accelerometer-measured daily physical activity and non sedentary behaviour in high school students?

Physical education has been highlighted as an important environment for physical activity promotion, however, to our knowledge there are no previous studies examining the contribution of physical education to daily accelerometer-measured physical activity and non sedentary behaviour. The purpose was to compare the accelerometer-measured physical activity and sedentary behaviour between physical education, non-physical education and weekend days in adolescents. Of the 394 students from a Spanish high school that were invited to participate, 158 students (83 boys and 75 girls) aged 13-16 years were analyzed (wear time ≥ 600 min). Participants' physical activity and sedentary behaviour were objectively-measured by GT3X+ accelerometers during physical education (one session), non-physical education and weekend days. Results indicated that overall adolescents had statistically significant greater physical activity levels and lower values of sedentary behaviour on physical education days than on non-physical education and weekend days (e.g., moderate-to-vigorous physical activity = 71, 54 and 57 min; sedentary = 710, 740 and 723 min) (p < 0.05). Physical education contributes significantly to reducing students' daily physical inactivity and sedentary behaviour. Increasing the number of physical education classes seems to be an effective strategy to reduce the high current prevalence of physical inactivity and sedentary behaviour in adolescence.

Local environment and social factors in primary school children's afterschool commute in China

The rapid decline in young children's active commutes to and from school has prompted investigations into ways to raise activity levels. The period after school is recognized as very important in the daily activity regime of primary school children. In this study, we examine the relative effects of local environmental factors and socio-economic status on children's after-school commute mode choice. Environmental factors are pedestrian priority streets, street intersection density, motorways, shops, and play spaces. Property values are used as a proxy for income. Twenty-four school districts are selected using intersection density and motorway length as criteria. All children's exit behaviors were film-recorded on October weekdays and extracted as four choices-alone, in a group of children, on foot with a parent or guardian, on e-bike driven by an adult. A multinomial logistic regression reveals that gated communities, higher priced housing, motorways and bus stops are associated with children accompanied by adults. The presence of pedestrian streets is associated with children travelling alone and in groups. Greater travel distance is also associated with parents accompanying children on foot or on e-bike. The amount of play space is associated with children leaving school in groups. Overall, social and environmental factors are influential in the independent travel of primary school children after the school day ends in south China.

Factors of physical activity among Chinese children and adolescents: a systematic review

Background

Lack of physical activity is a growing problem in China, due to the fast economic development and changing living environment over the past two decades. The aim of this review is to summarize the factors related to physical activity in Chinese children and adolescents during this distinct period of development.

Methods

A systematic search was finished on Jan 10^th, 2017, and identified 2200 hits through PubMed and Web of Science. English-language published studies were included if they reported statistical associations between factors and physical activity. Adapted criteria from the Strengthening The Reporting of OBservational studies in Epidemiology (STROBE) statement and evaluation of the quality of prognosis studies in systematic reviews (QUIPS) were used to assess the risk of bias of the included studies. Related factors that were reported in at least three studies were summarized separately for children and adolescents using a semi-quantitative method.

Results

Forty two papers (published 2002–2016) were included. Most designs were cross-sectional (79%), and most studies used questionnaires to assess physical activity. Sample size was above 1000 in 18 papers (43%). Thirty seven studies (88%) showed acceptable quality by methodological quality assessment. Most studies reported a low level of physical activity. Boys were consistently more active than girls, the parental physical activity was positively associated with children and adolescents’ physical activity, children in suburban/rural regions showed less activity than in urban regions, and, specifically in adolescents, self-efficacy was positively associated with physical activity. Family socioeconomic status and parental education were not associated with physical activity in children and adolescents.

Conclusions

The studies included in this review were large but mostly of low quality in terms of study design (cross-sectional) and methods (questionnaires). Parental physical activity and self-efficacy are promising targets for future physical activity promotion programmes. The low level of physical activity raises concern, especially in suburban/rural regions. Future research is required to enhance our understanding of other influences, such as the physical environment, especially in early childhood.

Electronic supplementary material

The online version of this article (doi:10.1186/s12966-017-0486-y) contains supplementary material, which is available to authorized users.

Psychological Correlates of Self-Reported and Objectively Measured Physical Activity among Chinese Children-Psychological Correlates of PA

This study aimed to explore the associations among psychological correlates and physical activity (PA) in Chinese children and to further examine whether these associations varied by different PA measures. PA self-efficacy, motivation, and preference were reported in 449 8–13-year-old Chinese children (252 males). Moderate- to vigorous- intensity PA (MVPA) was measured by the Physical Activity Questionnaire for Older Children (PAQ-C) and with an ActiGraph GT3X accelerometer. Correlations and hierarchical regressions were performed to explore their associations. The study psychological variables were all positively related to PAQ-C and objective MVPA (r: 0.22–0.63). The associations with PAQ-C were all substantially stronger than those with accelerometry. Beyond the explained variance accounted for by demographics and social desirability, the addition of the psychological correlates accounted for 45% of the variance of the PAQ-C score, while only 13% for accelerometry-based MVPA. The associations of specific variables with the PAQ-C score (age, PA self-efficacy, autonomous motivation and preference) were somewhat different from those associated with objective MVPA (PA self-efficacy, autonomous motivation, and negatively associated with female gender). This study demonstrated the importance of self-efficacy and autonomous motivation in association with PA and indicated the difference in level of their associations with different PA measures.

Accelerometry-Derived Physical Activity of First Through Third Grade Children During the Segmented School Day

BACKGROUND

Schools should provide children 30 minutes/day of moderate-to-vigorous-physical-activity (MVPA). Determining school day segments that contribute to children's MVPA can inform school-based activity promotion. The purpose of this paper was to identify the proportion of children accumulating 30 minutes/day of school-based MVPA, and to identify school day segments' contribution to children's MVPA.

METHODS

First-third graders (N = 323 [173 girls and 150 boys]) accelerometer-derived sedentary behaviors, light activity, and MVPA were measured for 1 to 5 school days. Children's activity was estimated during class time, lunch, physical education (PE), and recess. To explore disparities in MVPA, children were stratified into high/low-active groups.

RESULTS

Girls and boys accumulated 30.4 and 34.4 minutes/day of MVPA on PE days and 23.5 and 27.3 minutes/day of MVPA on non-PE days. This translated to 36.5 and 44.1% of girls and boys accumulating 30 minutes of MVPA on PE days and 16.3 and 36.5% on non-PE days. On PE days, PE contributed the most MVPA for girls and boys (11.8 and 13.0 minutes/day), followed by class time (11.4 and 12.5 minutes/day), recess (5.2 and 6.5 minutes/day), and lunch (2.0 and 2.4 minutes/day). Disparities between high/low children were greatest during PE and class time.

CONCLUSIONS

Most children were not accumulating 30 minutes/day of MVPA. PE and class time are promising school day segments for promoting MVPA.