Environmental correlates of sedentary behaviors and physical activity in Chinese preschool children: A cross-sectional study

Intergenerational care and rural childhood obesity in the digital era: Based on screen exposure perspective

Background

Rural Chinese children are experiencing increasing obesity rates, yet studies often neglect the impact of IT and screen media growth on obesity risks in the context of intergenerational care, leading to incomplete strategies for the digital era.

Methods

By comprehensively utilizing the data on rural children aged 6-17 from the China Family Panel Studies (CFPS) and the China Health and Nutrition Survey (CHNS), this study aims to test the logical chain and specific mechanisms regarding "intergenerational care - screen exposure - rural childhood obesity". We employ the Propensity Score Matching (PSM) and Generalized Propensity Score Matching (GPSM) methods to respectively address the self-selection biases associated with inter-generational care and children's screen exposure behaviors.

Results

1) Intergenerational care significantly increases screen exposure among rural children. 2) Gender bias increases the risk of screen exposure for rural boys under intergenerational care. 3) Children with higher screen exposure levels are more affected by intergenerational care, which further undermines parental supervision. 4) Children's screen exposure leads to increased sedentary time and higher probability of purchasing unhealthy foods, thereby exacerbating obesity. This process is facilitated by enhancing preferences for snacks, fast food, and beverages, and weakening preferences for physical activity. 5) GPSM analysis indicates that children's screen exposure has an inverted "U"-shaped impact on unhealthy dietary preferences and a "U"-shaped impact on activity preferences. It results in a nonlinear positive impact of screen exposure on obesity. This study reveals a positive association between screen exposure and obesity, offering new insights into how intergenerational care in the digital era may elevate obesity prevalence through excessive screen time for rural children.

Isotemporal substitution effect of 24-hour movement behavior on the mental health of Chinese preschool children

The 24-h movement behavior of preschoolers comprises a spectrum of activities, including moderate-to-vigorous intensity physical activity (MVPA), light-intensity physical activity (LPA), screen-based sedentary behavior (SCSB), non-screen-based sedentary behavior (NSCSB), and sleep. While previous research has shed light on the link between movement behaviors and children's mental health, the specific impacts on the unique demographic of Chinese preschoolers remain underexplored. This study significantly contributes to the literature by exploring how 24-h movement behavior affects the mental health of preschoolers in a Chinese context. The study involved205 Chinese preschool children (117 boys and 88 girls) between the ages of 3 and 6 years wore accelerometers to measure their LPA, MVPA, and sedentary behavior (SB), while their parents reported the time spent on sleep and SCSB. The parents also completed the Strength and Difficulties Questionnaire to assess their children's mental health. The study used compositional regression and isotemporal substitution models to examine the relationship between the various components of 24-h movement behavior and mental health. The results showed that greater NCSSB compared to MVPA, LPA, sleep, and SCSB was associated with good prosocial behavior and lower scores on externalizing problems. This highlights the potential of NSCSB as a beneficial component in the daily routine of preschoolers for fostering mental well-being. Replacing 15 min of sleep and SCSB with 15 min of NSCSB was associated with a decrease of 0.24 and 0.15 units, respectively, in externalizing problems. Reallocating 15 min of sleep to NSCSB was linked to an increase of 0.11 units in prosocial behavior. There were no significant substitution effects between LPA and MVPA time with any other movement behavior on prosocial behavior and externalizing problems. Given the positive associations observed, further longitudinal studies are necessary to explore the link between 24-h movement behavior and mental health in preschool children.

The cross-sectional and prospective associations of parental practices and environmental factors with 24-hour movement behaviours among school-aged Asian children

BACKGROUND

Parental practices and neighbourhood environmental factors may influence children's movement behaviours. We aimed to investigate the cross-sectional and prospective associations of parental practices and neighbourhood environmental factors with accelerometer-measured 24-hour movement behaviours (24 h-MBs) among school-aged children in Singapore.

METHODS

The Growing Up in Singapore Towards healthy Outcomes (GUSTO) study collected information on dimensions of parental practices and neighbourhood environment at age 5.5 years. Confirmatory factor analyses were performed to generate latent variables and used to compute overall parental practices [involvement in PA + support for PA + control of screen viewing context] and environmental scores [facilities for active play + active mobility facilitators + barriers*-1]. Children wore an accelerometer on their non-dominant wrist for seven consecutive days at ages 5.5 and 8 years. The R-package GGIR 2.6 was used to derive moderate-to-vigorous-intensity physical activity (MVPA), light-intensity physical activity (LPA), inactivity, and total-sleep (napping+night sleep) minutes per day. Associations were determined using compositional data analysis with multivariate linear regression models, taking into account potential confounders.

RESULTS

Among 425 children (48% girls, 59% Chinese), higher parental involvement in PA, parental support for PA and overall parental practices were associated with 24 h-MBs at ages 5.5 and 8 years, specifically with greater time spent in MVPA and less time being inactive relative to the remaining movement behaviours. The corresponding mean changes in the overall 24 h-MB for increasing parental practices from lowest to highest scores (- 2 to + 2 z-scores) indicated potential increases of up to 15-minutes in MVPA, 20-minutes in LPA, 5-minutes in sleep duration, and a reduction of 40-minutes in inactivity at age 5.5 years. At age 8 years, this could translate to approximately 15-minutes more of MVPA, 20-minutes more of LPA, a 20-minute reduction in sleep duration, and a 20-minute reduction in inactivity. Parental control of screen viewing contexts and neighbourhood environmental factors were not associated with 24 h-MBs.

CONCLUSIONS

Parental practices but not environmental factors were associated with higher MVPA and lower inactivity among Singaporean children, even at a later age. Further research may provide insights that support development of targeted public health strategies to promote healthier movement behaviours among children.

STUDY REGISTRATION

This study was registered on 4th August 2010 and is available online at ClinicalTrials.gov: NCT01174875.

Influence of Neighborhood Built Environments on the Outdoor Free Play of Young Children: a Systematic, Mixed-Studies Review and Thematic Synthesis

Urban environments shape early childhood exposures, experiences, and health behaviors, including outdoor free play, influencing the physical, cognitive, social, and emotional development of young children. We examined evidence for urban or suburban built environment influences on outdoor free play in 0-6-year-olds, considering potential differences across gender, culture, and geography. We systematically searched seven literature databases for relevant qualitative, quantitative, and mixed methods studies: of 5740 unique studies, 53 met inclusion criteria. We assessed methodological quality and thematically synthesized findings from included studies. Three broad themes, features of spaces for play, routes, and social factors intersected to influence the availability, accessibility, and acceptability of neighborhoods for young children's outdoor free play across diverse cultural and geographic contexts. Proximity to formal or informal space for play, protection from traffic, pedestrian environment, green and natural environments, and opportunity for social connection supported outdoor free play. Family and community social context influenced perceptions of and use of space; however, we did not find consistent, gendered differences in built environment correlates of outdoor free play. Across diverse contexts, playable neighborhoods for young children provided nearby space for play, engaging routes protected from traffic and facilitated frequent interaction between people, nature, and structures.

Preschool Children's Physical Activity and Community Environment: A Cross-Sectional Study of Two Cities in China

Research on the relationship between preschool children's physical activity (PA) and community environment is limited and inconclusive, yet understanding this relationship is important to acquire sufficient information to guide the development of intervention programs. This study aims to objectively measure preschool children's PA and examine associations between PA and the community environments. A total of 471 preschool children aged 3-6 years old were recruited from eight kindergartens in Beijing and Zhengzhou. PA was measured by accelerometers. Light PA (LPA), moderate PA (MPA), and vigorous PA (VPA) were computed on the basis of cutoff points developed for preschool children. Moderate-to-vigorous PA (MVPA), and total PA (TPA) were obtained by calculation. Children's active transportation modes were indicated by the frequency of active trips (FAT) reported by parents. The community environment was collected by parental scales. Multivariate linear regression was used to analyze the associations between PA and the community environment. In total, 304 preschool children (mean age 5.07 ± 0.94 years, 50.66% boys) were included in the final analysis. Children spent an average of 77.58 ± 18.78 min/day in MVPA and 173.26 ± 30.38 min/day in TPA. Linear regression showed that 'parental perception of appropriate walking distance' was associated with nearly half of the indicators of the children's PA. 'Public activity facilities near the community' was associated with FAT for overall children (B = 0.099, 95% CI = 0.014, 0.183). 'Community transportation environment' was associated with overall children's average day LPA (B = 4.034, 95% CI = 0.012, 8.056), weekend LPA (B = 8.278, 95% CI = 1.900, 14.657), MPA (B = 4.485, 95% CI = 0.613, 8.357), TPA (B = 14.777, 95% CI = 2.130, 27.424), and FAT for girls (B = -0.223, 95% CI = -0.443, -0.003). Furthermore, 'community personal safety' was associated with boys' weekday VPA (B = -3.012, 95% CI = -5.946, 0.079). Parental perception of appropriate walking distances, improvement of PA facilities, community personal safety, and the community transportation environment all contribute to the prevention of preschool children's PA patterns deterioration.

Correlates of sedentary behavior in Asian preschool-aged children: A systematic review

This systematic review aims to identify the multilevel correlates of sedentary behavior (SB) and its sub-domains among preschool-aged children aged 0-7 years in Asia. We systematically searched for studies published from 2000 onwards using terms related to SB correlates and Asia in six databases. Eligible studies were observational and used quantitative methods to examine correlates of total, and domain-specific SB (screen viewing [SV] and non-screen-based SB) in Asian children living in Asia. Two reviewers independently screened identified references. Following quality assessment of included studies, we performed narrative synthesis to summarize the evidence on the intrapersonal, interpersonal, environmental correlates of total and domain-specific SB (PROSPERO: CRD42018095268). Twenty-two studies from 4 regions and 12 countries/territories were included. Out of the 94 correlates explored, the following associations were consistent: older age, being a boy, non-Chinese ethnicity (Southeast Asia), younger maternal age, higher maternal and paternal television-viewing time with higher SV; higher SV at earlier age with higher SV and total SB; and presence of TV/computer in the bedroom with higher leisure-time SB. We encourage more studies from low- and middle-income Asian countries with an increased focus on different SB domains, further exploration of environmental correlates, and the use of objective measurements to capture SB.

Individual, parental and built environmental features as influencing factors of active travel to school in northeast China: findings from a cross-sectional study

OBJECTIVES

Active travel to school (ATS)-associated factors had been studied in some developed countries but rarely in China. We studied the associated factors of ATS at individual, parental and built environment domains in northeast China.

DESIGN AND PARTICIPANTS

A cross-sectional survey was conducted among 4-6 grade students in 2017. Sociodemographic features and information of parents were collected using questionnaires, and SuperMap (a geographical information system software) was used to catch built environment features. Logistic regression models were used to examine the relationship between multilevel factors and ATS.

RESULTS

Our study sample comprised 3670 primary school students aged from 8 to 15 (boys=51.0%, ATS=48.8%). Perceived to be fat (OR 1.25, 95% CI 1.00 to 1.55, p<0.05), feeling easy to walk for a short distance (OR 1.63, 95% CI 1.21 to 2.20, p<0.05), mother unemployed (OR 1.52, 95% CI 1.13 to 2.06, p<0.05), higher land use mix (OR 1.23, 95% CI 1.11 to 1.37, p<0.001) and higher density of public transport stations (OR 1.22, 95% CI 1.09 to 1.37, p<0.05) were positively associated with increased possibility of ATS, while higher household annual income (OR 0.60, 95% CI 0.44 to 0.83, p<0.05) and possession of private vehicles (OR 0.56, 95% CI 0.45 to 0.69, p<0.001) were negatively associated with possibility of ATS.

CONCLUSIONS

The significant factors associated with ATS were at every examined level, which implies multilevel interventions are needed to encourage ATS. Further interventions could focus on the children's willingness to lead students to opt for healthy behaviours, and children from wealthier families should be encouraged to choose ATS. Also, the government should improve built environment walkability so as to encourage ATS.

Parental Perception of the Social and Physical Environment Contributes to Gender Inequalities in Children's Screen Time

BACKGROUND

This cross-sectional study aimed to explore how parental perceptions of the social and physical environment of the neighborhood was associated with 3- to 10-year-old children's use of traditional and modern screen devices.

METHODS

Participants were recruited under the scope of the project ObesInCrisis, conducted in 2016-2017 in the cities of Porto, Coimbra, and Lisbon (Portugal). Data from 6347 children aged 3-10 years were analyzed (3169 boys [49.9%]). A parental questionnaire was used to collect data on children's screen time (dependent variable) and parents' perceived social and physical environment (from the Environmental Module of the International Physical Activity Prevalence Study questionnaire; independent variable), parental education, and urbanization (used as covariates).

RESULTS

Neighborhood features were more correlated with girls' screen time, than with boys', particularly among younger children. Also, more social than physical characteristics of the neighborhood were positively associated with children's use of television and mobile devices (ie, tablet and smartphone).

CONCLUSIONS

Community-based approaches should improve the social environment and implement supervised after-school programs to encourage and support children to be outdoors and spend less time in sedentary pursuits.

Patterns of Active Commuting to School in Spanish Preschool Children and Its Associations with Socio-Economic Factors: The PREFIT Project

The aims of this study were to describe patterns of active commuting to school (ACS) of preschool children, and to analyse the relationship between ACS and family socio-economic factors. A total of 2636 families of preschoolers (3-to-5 years old) were asked to complete a questionnaire at home about the mode of commuting to school of their children and marital status, educational level, and profession of both father and mother. Chi-square analyses were applied to compare ACS between school grades and gender of the children. To analyse the association of ACS with socio-economic factors, logistic regression analyses were performed. Almost 50% of participants reported ACS of their offspring, with a higher rate in 3rd preprimary grade (5 years old) than in 1st and 2nd preprimary grades (3- and 4-years old. All, p < 0.05). Those preschool children who had parents with lower educational level and no managerial work had higher odds to ACS than those who had parents with higher educational level and managerial work (all, p ≤ 0.001). Around half of the Spanish preschool children included in this study commuted actively to school and families with lower educational levels or worse employment situation were related to active commuting to school.

Associations between Neighborhood Deprivation Index, Parent Perceptions and Preschooler Lifestyle Behaviors

Parental perceptions and use of neighborhood facilities are important factors that are related to children’s dietary intake and physical activity. The aim of this study was to examine the association between neighborhood deprivation index, parents’ perceptions of their neighborhood environment, and healthy/unhealthy markers of child dietary intake, physical activity, and TV screen time. This cross-sectional study was conducted in Dublin, Ireland. The lifestyle behaviors among children and parental perceptions of their neighborhood environment were reported by the parents of 276 children aged 3–5 years by using parent-completed questionnaires. Deprivation index was assessed using the geographic information system (GIS). Data were analyzed using binary logistic regression, adjusting for socio-demographic confounders. In adjusted models, high deprivation index was associated with parental perception of the neighborhood as unsafe for walking and cycling due to crime (OR 1.59, 95% CI 1.04–2.43, p = 0.031) and children’s low engagement in structured physical activity (OR 0.35, 95% CI 0.17–0.72, p = 0.004). Parental perceptions of an unsafe neighborhood due to heavy traffic were negatively correlated with children’s active play (OR 0.73, 95% CI 0.55–0.95, p = 0.022). Children whose parents reported high satisfaction with the number of local sit-in and takeaway restaurants were 41% more likely to consume confectionary/sugar sweetened beverages (SSBs) weekly. In this age group, parents play an important role in children’s lifestyle behaviors; therefore, a better understanding of parents’ perceptions and their use of neighborhood facilities could contribute to creating a healthy environment for this age group.

Prevalence and Trends of Physical Activity in Thai Children and Young People: Pooled Panel Data Analysis from Thailand's Surveillance on Physical Activity 2012-2020

This study aims to describe the level and trends of physical activity (PA) in Thai children and young people and examine PA changes during transitional periods. Employing nine rounds of Thailand's Surveillance on Physical Activity (SPA) 2012-2020, this study pooled three sets of data and included children and young people aged 6-17 years in the analysis: 1595 in SPA2012-2016, 1287 in SPA2017-2019, and 853 persons in SPA2020. Face-to-face interviews were conducted in five regions, 13 provinces, and 36 villages in SPA2012-2019, whereas an online survey was administered in all provinces in SPA2020. The prevalence of sufficient moderate-to-vigorous PA (MVPA) among Thais aged 6-17 years ranged from 19.0 percent to 27.6 percent, with a significant drop during the period of COVID-19 spread in 2020. The average daily MVPA ranged from 46 to 57 min and dropped to 36 min during the pandemic. Boys were consistently more active than girls in all nine rounds of the SPA, and girls had more difficulty in maintaining or improving their PA level. A significant increase in the proportion of Thai children and young people with sufficient MVPA was observed during their transition from late primary to early secondary school grades.

The Association Between Sedentary Screen Time, Non-screen-based Sedentary Time, and Overweight in Chinese Preschool Children: A Cross-Sectional Study

Introduction: Less is known about the effects of the different domains of sedentary behaviors on healthy weight in young children. This cross-sectional study examined the association between sedentary screen time (SST), non-screen-based sedentary time (NSST), and overweight (and obesity) in Chinese preschoolers. Methods: Data were collected from the Physical Activity and Health in Tianjin Chinese Children study (PATH-CC), involving healthy children 3-6 years old and their families. Children's overweight status was classified according to the international (IOTF) childhood BMI cut-offs. SST and NSST were reported in minutes/day by parents using the leisure-time sedentary behaviors questionnaire. Logistic regression models adjusted by sex, age, socioeconomic status, outdoor play, and sleep duration were used. Results: In a total of 971 children (55.4% boys), 11.8% were overweight. Generally, children spent 1 h/day in SST and 1 h/day in NSST. Multiple models showed that children who spent more time in SST were more likely to be overweight [OR and 95% CI: 1.22 (1.03-1.45)]. No correlation between time spent on NSST and children with overweight was found (P > 0.05). Conclusions: This study indicated that children who spent more time in SST were more likely to be overweight, but a null correlation between NSST and overweight was found. Longitudinal studies designed to identify associations between exposures to screen media and changes in metabolic parameters during a child's early years are needed.