Do school physical activity policies and programs have a role in decreasing multiple screen time behaviours among youth?

Before-school physical activity levels and sociodemographic correlates among Australian adolescents: A cross-sectional study

Understanding adolescents' physical activity levels and underpinning contextual factors is crucial for health promotion. This cross-sectional study, using 24-hour time use diaries and sociodemographic variables from the Longitudinal Study of Australian Children, addressed gaps in understanding of physical activity in the before-school segment (the time between waking up and commencing classes). The study examined a) adolescents' time spent in before-school physical activity, focusing on location and shared presence, and b) sociodemographic correlates of before-school physical activity. Completed diaries by 12-13 year-olds (n = 3,201) revealed that adolescents reported an average of 10.8 minutes of daily before-school physical activity (average segment length: 114 min), mostly classified as active transport (5.7 min). Most before-school physical activity occurred in a location other than home or school (6.1 min) and with peers (6.1 min). Notably, 51% of boys and 60% of girls did not report any before-school physical activity. Through two-part regression, we found that boys, adolescents from single-parent households, and those with longer before-school segments are more likely to report before-school physical activity compared to their counterparts. Before-school initiatives should promote active transport and diverse opportunities in other settings. Research into barriers and facilitators may inform more inclusive and effective promotion strategies, including school-based initiatives.

Association between excessive screen time and school-level proportion of no family rules among elementary school children in Japan: a multilevel analysis

BACKGROUND

Excessive screen time (ST) in children is a global concern. We assessed the association between individual- and school-level factors and excessive ST in Japanese children using a multilevel analysis.

METHODS

A school-based cross-sectional study was conducted in Toyama, Japan in 2018. From 110 elementary schools in Toyama Prefecture, 13,413 children in the 4th-6th grades (boys, 50.9%; mean, 10.5 years old) participated. We assessed lifestyle, recreational ST (not for study use), psychological status, and school and family environment including family rules. We defined ≥3 hours ST as excessive. We calculated the school-level proportions of no family rules and divided them into four categories (<20%, 20% to <30%, 30% to <40%, and ≥40%). A modified multilevel Poisson regression analysis was performed.

RESULTS

In total, 12,611 children were included in the analysis (94.0%). The average school-level proportion of those with no family rules was 32.1% (SD = 9.6). The prevalence of excessive ST was 29.9% (34.9% in boys; 24.8% in girls). The regression analysis showed that excessive ST was significantly associated with both individual-level factors, such as boys (adjusted prevalence ratio (aPR); 1.39), older grades (aPR; 1.18 for 5th grades and 1.28 for 6th grades), late wakeup (aPR; 1.13), physical inactivity (aPR; 1.18 for not so much and 1.31 for rarely), late bedtime (aPR; 1.43 for 10 to 11 p.m. and 1.76 for ≥11 p.m.), frequent irritability (aPR; 1.24 for sometimes and 1.46 for often), feelings of school avoidance (aPR; 1.17 for sometimes and 1.22 for often), infrequent child-parental interaction (aPR; 1.16 for rare and 1.21 for none), no family rules (aPR; 1.56), smartphone ownership (aPR; 1.18), and the school-level proportion of no family rules (aPR; 1.20 for 20% to <30%, 1.29 for 30% to <40%, and 1.43 for ≥40%, setting <20% as reference).

CONCLUSION

Besides individual factors, a higher school-level proportion of no family rules seemed influential on excessive ST. Increasing the number of households with family rules and addressing individual factors, could be deterrents against excessive ST in children.

Smartphones, social Media and Adolescent mental well-being: the impact of school policies Restricting dayTime use-protocol for a natural experimental observational study using mixed methods at secondary schools in England (SMART Schools Study)

INTRODUCTION

Smartphone and social media use is prevalent during adolescence, with high levels of use associated with lower levels of mental well-being. Secondary schools in the UK have introduced policies that restrict daytime use of smartphones and social media, but there is no evaluation on the impact of these policies on adolescent mental well-being. The SMART Schools Study aims to determine the impact of daytime restrictions of smartphone and social media use on indicators of adolescent mental well-being, anxiety, depression, physical activity, sleep, classroom behaviour, attainment and addictive social media use.

METHODS AND ANALYSIS

This is a natural experimental observational study using mixed methods. Secondary schools within a 100 mile radius of the recruiting centre in the West Midlands (UK) have been categorised into two groups: Schools that restrict (intervention) and permit (comparator) daytime use of smartphones. We aim to recruit 30 schools (20 restrictive, 10 permissive) and 1170 pupils aged 12-13 and 14-15 years. We will collect data on mental well-being, anxiety and depressive symptoms, phone and social media use, sleep and physical activity from pupil surveys, and accelerometers. Policy implementation measures and data on individual pupil factors will be collected through school staff surveys, and website/policy analysis. Six case study schools will explore individual, school and family/home factors that influence relationships between school smartphone policies, smartphone/social media use, and mental well-being. Economic evaluation will be completed through a cost-consequence analysis from an education sector perspective.

ETHICS AND DISSEMINATION

Ethical approval was obtained from the University of Birmingham's Research Ethics Committee (ERN_22-0723). Parents/carers of pupil participants can complete a form to opt their child out of the study. Pupil, school staff and parent/carer participants are asked to complete online/written consent (or assent). Findings will be disseminated through policy briefings, resources for schools, social media, reports, and open access publications.

TRIAL REGISTRATION NUMBER

ISRCTN77948572.

Adolescents' media usage and self-reported exposure to advertising across six countries: implications for less healthy food and beverage marketing

OBJECTIVES

The study objectives were to examine: (1) adolescents' media viewing habits, (2) associations with media viewing and self-reported exposure to unhealthy food and beverage advertising and (3) differences in trends among younger and older adolescents in six high and upper middle-income countries.

DESIGN

Repeat cross-sectional online survey.

SETTING

Australia, Canada, Chile, Mexico, the United Kingdom (UK) and the United States of America (USA).

PARTICIPANTS

Respondents to the International Food Policy Study who provided information on all variables of interest in November-December 2019 aged 10-17 years (n=9171).

OUTCOME MEASURES

Self-reported exposure to screen-based media (screen time by media channel), use of social media platforms and self-reported location and frequency of exposure to unhealthy food and beverage advertising.

RESULTS

The average amount of time spent in front of various screens ranged from 7.6 hours to 10.2 hours across countries per week day, which may include possible viewing of multiple media channels simultaneously. Overall, Instagram was the most popular social media platform (52%-68% by country), followed by Facebook (42%-79%) and Snapchat (28%-52%). The percentage of respondents who self-reported having seen unhealthy food advertisements in the past 30 days was highest on television (43%-69%), followed by digital media (27%-60%) and gaming applications (10%-17%). Self-reported daily exposure to advertising varied between countries for sugary drinks (10%-43%) and fast food (19%-44%) and was positively associated with self-reported screen time. Self-reported exposure to screen-based media and social media platforms differed by sociodemographic characteristics and was higher among older adolescents than younger adolescents.

CONCLUSIONS

The important amount of time spent on screen-based media reported by adolescents and large percentage of adolescents reporting social media usage, coupled with high rates of self-reported advertising exposure, support the need for policies to restrict marketing of unhealthy food and beverages appealing to adolescents on screen-based media.

A quasi-experimental examination of how changes in school-level intramurals are associated with physical activity among a sample of Canadian secondary school students from the COMPASS study

Introduction

Intramurals in schools may encourage physical activity among youth. Schools are continuously making changes to these intramurals, yet it is not well understood how these changes impact youth physical activity. The main objective of this research was to examine if changes in the number of intramurals were associated with youth physical activity over time with a secondary objective to explore the association between sport participation and physical activity among youth over time.

Methods

This study used three years of linked longitudinal school- and student-level data from Ontario schools in year 5 (Y5: 2016–2017), year 6 (Y6: 2017–2018) and year 7 (Y7: 2018–2019) of the COMPASS study. Data on intramurals from 55 schools were collected from the School Programs and Policies questionnaire to determine intramural changes that were made from Y5 to Y6. Using the COMPASS Student Questionnaire, baseline demographics were collected and data on physical activity and sport participation were measured at Y5, Y6 and Y7 on 4417 students. Hierarchical linear mixed regression models were used to estimate how changes in intramurals were associated with youth physical activity over time.

Results

Changes in school-specific intramurals were not significantly associated with physical activity over time. Intramural, varsity and community sport participation were all positively and significantly associated with youth physical activity among female and males.

Conclusions

Intramural, varsity and community sport participation are important opportunities for youth physical activity. Schools should offer a variety of intramural and varsity sports to encourage physical activity. Although adding intramurals may not be effective at increasing youth physical activity, they may be effective when used in combination with other strategies to increase physical activity.

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The use of an indicator variable in multi-level modeling is a novel method to evaluate a natural experiment.

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Intramural, varsity and community sport participation were positively associated with youth physical activity.

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Intramural changes were not associated with youth physical activity over time.

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Intramurals may be a useful part of a more comprehensive approach to increasing youth physical activity.

The Effect of Season and Neighbourhood-Built Environment on Home Area Sedentary Behaviour in 9-14 Year Old Children

There is little understanding of how the built environment shapes activity behaviours in children over different seasons. This study sought to establish how seasonal weather patterns, in a given year in a mid-western Canadian city, affect sedentary time (SED) in youth and how the relationship between season and SED are moderated by the built environment in their home neighbourhood. Families with children aged 9-14 years were recruited from the prairie city of Saskatoon, Canada. Location-specific, device-based SED was captured in children during three timeframes over a one-year period using GPS-paired accelerometers. Multilevel models are presented. Children accumulated significantly greater levels of SED in spring but significantly less SED in the fall months in comparison to the winter months. Children living in neighbourhoods with the highest density of destinations accumulated significantly less SED while in their home area in comparison to their counterparts, and this effect was more pronounced in the spring and summer months. On weekends, the rise in sedentariness within the home area was completely diminished in children living in neighbourhoods with the greatest number of destinations and highest activity friendliness. These results suggested that increasing neighbourhood amenities can lead to a reduced sedentariness of youth, though more so in the warmers months of the year.

The neighbourhood social environment correlates with meeting 24-h movement behaviour recommendations in females: a cross-sectional study using the 2019 National Survey of Children's Health

The purpose of this study was to examine the association between the neighbourhood social environment and meeting recommendations for 24-h movement behaviours in youth. Participants were a sample of children and adolescents from the 2019 National Survey of Children's Health (N = 21 259; 48.2% female). Knowing where to go for help (odds ratio (OR) = 2.66, p = 0.006) and a safe school environment (OR = 1.99, p = 0.020) correlated with high probability of meeting 24-h movement behaviour recommendations in females. Novelty: The neighbourhood social environment associates with meeting 24-h movement recommendations in females.

Disentangling individual, school, and neighborhood effects on screen time among adolescents and young adults in the United States

OBJECTIVES

To examine the association between individual, neighborhood, and school-level influences on individual screen time among adolescents and young adults (AYAs) in the National Longitudinal Study of Adolescent to Adult Health.

METHODS

We classified screen time continuously as self-reported total hours per week of television, videos, and video/computer games at baseline and categorical as extended screen time (≥14 h per week). We fit cross-classified multilevel models (CCMM) to examine to examine the individual-, school- and neighborhood-level demographic and socioeconomic factors associated with screen time. Models were fit using MLwiN with Bayesian estimation procedures.

RESULTS

AYAs reported an average of 22.8 (SD = 19.4) and 21.9 (SD = 20.3) hours of screen time, respectively. At the individual level, younger age, male sex, Black/multiracial race, receipt of public assistance, and lower parental education were associated with higher screen time. At the school level, being out of session (i.e., school and national holidays including summer), having a higher proportion of non-White students, and having a lower proportion of parents with a college education were associated with higher individual screen time.

CONCLUSIONS

We found that individual-level factors most influence youth screen time, with smaller contributions from school factors.

A cross-sectional examination of the association between co-ed and gender-specific school intramural programs and intramural participation among a sample of Canadian secondary school students

Intramurals are an important part of the physical activity offerings in secondary schools; however, it is not well understood how co-ed and gender-specific intramural programs impact intramural participation among male and female students. Therefore, the objective of this research was to examine if the number of co-ed, male-only, and female-only intramurals offered at a school was associated with student participation in intramurals. A large sample of Canadian secondary school students (N = 59,370) completed the COMPASS survey in 2017-2018. School staff reported the number of co-ed, male-only, and female-only intramurals offered at each school. Students reported whether they participated in school intramurals. Hierarchical models were used to assess associations. Intramural participation was marginally higher among male students (36%) than female students (32%; p < 0.0001). Female students attending schools that offered female-only intramurals were 17% (OR 1.17 [95% CI: 1.05-1.30]) more likely to participate. The number of co-ed and male-only intramurals offered were not significantly associated with student participation. We found a positive association between offering female-only intramurals and female intramural participation, highlighting the importance of these programs for female students. Offering female-only intramurals may be a way for schools to improve participation and physical activity levels of female students. More research is needed on the impact of specific sports or activities on male and female student participation.

Digital media: Promoting healthy screen use in school-aged children and adolescents

Digital media are integrated into the everyday lives of children and adolescents, with potential benefits and risks for learning, mental and physical health, and for social life. This statement examines the cognitive, psychosocial, and physical effects of digital media on school-aged children and adolescents, with a focus on family routines, context, and activities. Evidence-based guidance for clinicians and families involves four principles: healthy management, meaningful screen use, positive modelling, and balanced, informed monitoring of screen time and behaviours.

Les médias numériques : la promotion d'une saine utilisation des écrans chez les enfants d'âge scolaire et les adolescents

Les médias numériques font partie du quotidien des enfants et des adolescents. Ils comportent des bienfaits potentiels et des risques pour leur apprentissage, leur santé mentale et physique et leur vie sociale. Le présent document de principes aborde les effets cognitifs, psychosociaux et physiques de ces médias sur les enfants d'âge scolaire et les adolescents, notamment sur les habitudes, le contexte et les activités de la famille. Les conseils fondés sur des données probantes destinés aux cliniciens et aux familles reposent sur quatre principes : une gestion saine, une utilisation constructive, un exemple positif et une surveillance équilibrée et éclairée du temps d'écran et des comportements s'y rapportant.

A gender-stratified, multilevel latent class assessment of chronic disease risk behaviours' association with Body Mass Index among youth in the COMPASS study

This paper sought to examine chronic disease risk behaviour latent classes and their association with Body Mass Index (BMI), assessing for gender differences. Participants were youth (n = 116,086; grades 9-12) enrolled in the COMPASS study (Ontario, Canada) during 2013, 2014, 2015. Multilevel latent class analysis was used to identify underlying, homogenous classes of youths' engagement in physical activity, smoking, binge drinking and marijuana use. Adjusted multilevel models regressed BMI on the latent classes controlling for ethnicity and grade. Three latent classes were identified: active experimenters (ACE), inactive clean youth (INC) and inactive substance users (INSU). This study found that gender differences are apparent in chronic disease risk behaviour latent classes and their association with BMI. INC males (OR = 0.85, 95% CI = 0.78, 0.93) were associated with a lower odds of overweight/obesity relative to active males who experimented with substance use. As for females, the class with the highest proportion of youth using substances were associated with higher odds (Females: OR = 1.2, 95% CI = 1.1, 1.4) of overweight/obesity relative to their active experimenting peers. As such, youth in latent classes with substance use are associated with higher BMI and weight status. Successful interventions may include school policies/programs that limit screen time use, as they were seen to have a positive effect on PA engagement and including social-influences approaches for substance use. Future research and interventions should be gender-specific as our results show that different latent classes are associated with obesity across genders.

The association of school connectedness and bullying involvement with multiple screen-time behaviours among youth in two Canadian provinces: a COMPASS study

INTRODUCTION

Screen time, a proxy for sedentary behaviours, has emerged as a critical health determinant among youth in contemporary societies, where most aspects of youth life involve access to screen-time devices. An understudied approach to reducing screen time among youth is bullying reduction. This study aims to understand the association between bullying perpetration, victimization, youth perception of the school environment and multiple screen-time behaviours.

METHODS

A total of 44,861 youth aged between 13 and 18 years in two Canadian provinces completed a validated questionnaire that collected student data on health behaviours and outcomes, including multiple screen-time behaviours, bullying perpetration and victimization, and school connectedness. The outcome variables were total screen time, time spent watching television, playing video games, internet surfing, and communication- based screen-time behaviours. Using a random intercept, the final models were built using PROC MIXED in SAS 9.4. These models were adjusted for age, ethnicity, weekly disposable income, daylight hours, and weather variables.

RESULTS

Compared to youth who reported non-involvement in bullying, youth who were bullies, victims, or both bullies and victims spent on average more minutes per day in front of screens across all screen time categories. Youth who felt happy and safe at school, and who perceived their teachers as being fair, reported lower levels of multiple screen-time behaviours.

CONCLUSION

With non-involvement in bullying showing a strong negative association with multiple screen-time behaviours, school policies to address bullying and screen time through school connectedness could offer a novel approach in minimizing these harmful behaviours.