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Boman C, Bernhardsson S, Lundqvist S, Melin K, Lauruschkus K. Physical activity on prescription for children with obesity: a focus group study exploring experiences in paediatric healthcare. FRONTIERS IN HEALTH SERVICES 2024; 4:1306461. [PMID: 38638607 PMCID: PMC11024476 DOI: 10.3389/frhs.2024.1306461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Accepted: 03/21/2024] [Indexed: 04/20/2024]
Abstract
Background Insufficient physical activity is a growing public health concern and is closely linked to obesity in both adults and children. Swedish physical activity on prescription (PAP) is effective in increasing physical activity levels in adults, but knowledge about how PAP is used in paediatric healthcare is lacking. Therefore, this study aimed to explore experiences of working with PAP for children with obesity amongst paediatric staff and managers. Methods Seven focus group discussions with 26 participants from paediatric outpatient clinics in western Sweden were conducted. Data were analysed both inductively and deductively, framed by the Normalization Process Theory's four core constructs: coherence, cognitive participation, collective action, and reflexive monitoring. Results The PAP work for children with obesity was experienced to be about helping children to become physically active, and less about losing weight. Identified barriers for using PAP were the non-uniform nature of the work and a perceived lack of guidelines. Collaboration with physiotherapists and physical activity organisers outside the organisation was identified as an important facilitator. An important contextual factor for implementing PAP is the collaboration between paediatric clinics and physical activity organisers. In the transition between these stakeholders, maintaining a family-centred approach when working with PAP was experienced as challenging. Conclusions PAP is a well-known intervention that is inconsistently used for children with obesity. The intervention should include a family-centred approach for this patient group. It also needs to align better with existing collaborations with other healthcare units as well as with new forms of collaboration with physical activity organisers in the community.
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Affiliation(s)
- Charlotte Boman
- Region Västra Götaland, Centre for Physical Activity, Gothenburg, Sweden
- Unit of Physiotherapy, Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Susanne Bernhardsson
- Unit of Physiotherapy, Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Region Västra Götaland, Research, Education, Development and Education Primary Health Care, Gothenburg, Sweden
| | - Stefan Lundqvist
- Region Västra Götaland, Centre for Physical Activity, Gothenburg, Sweden
- Unit of Physiotherapy, Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Region Västra Götaland, Research, Education, Development and Education Primary Health Care, Gothenburg, Sweden
| | - Karin Melin
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Region Västra Götaland, Department of Child and Adolescent Psychiatry, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Katarina Lauruschkus
- Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden
- Department of Habilitation, Committee on Psychiatry, Habilitation and Technical Aids, Malmö, Sweden
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Sequí-Domínguez I, Cavero-Redondo I, Álvarez-Bueno C, López-Gil JF, Martínez-Vizcaíno V, Pascual-Morena C. Effectiveness of eHealth Interventions Promoting Physical Activity in Children and Adolescents: Systematic Review and Meta-Analysis. J Med Internet Res 2024; 26:e41649. [PMID: 38381490 PMCID: PMC10918549 DOI: 10.2196/41649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 05/30/2023] [Accepted: 12/19/2023] [Indexed: 02/22/2024] Open
Abstract
BACKGROUND eHealth interventions have been postulated as a feasible, acceptable, and possibly effective tool to promote physical activity (PA) among children and adolescents; however, a comprehensive quantitative analysis of the effects of eHealth interventions promoting PA is lacking. OBJECTIVE This study aims to conduct a systematic review and meta-analysis on experimental studies reporting the effects of eHealth interventions aimed at promoting PA on PA parameters and sedentary behavior parameters in children and adolescents. METHODS The CENTRAL, MEDLINE, Embase, and Web of Science databases were searched from inception to February 2022 for randomized controlled trials that analyzed the effects of eHealth interventions aimed at promoting PA on PA and sedentary parameters in children and adolescents. The Hartung-Knapp-Sidik-Jonkman random effects method was used to determine the mean differences (MDs) with their respective 95% CIs. The risk of bias was assessed using the Risk of Bias 2 (RoB2; Cochrane) tool and its extension for cluster randomized controlled trials. The certainty of evidence was evaluated using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) tool. RESULTS A total of 20 trials reporting the effects of different eHealth interventions aimed at promoting PA were included. Results for each parameter were as follows: counts per minute (MD -16.11 counts, 95% CI -122.76 to 90.53; k=3; n=402; I2=69%; favoring control), steps per day (MD 593.46 steps, 95% CI -2102.27 to 3289.19; k=2; n=152; I2=0%; favoring intervention [FI]), moderate to vigorous PA (MD -1.99 min/d, 95% CI -8.95 to 4.96; k=14; n=2336; I2=86%; favoring control), light PA (MD 3.28 min/d, 95% CI -15.48 to 22.04; k=5; n=355; I2=67%; FI), screen time (MD -31.48 min/d, 95% CI -68.62 to 5.65; k=5; n=904; I2=0%; FI), and sedentary time (MD -33.12 min/d, 95% CI -57.27 to -8.97; k=8; n=819; I2=75%; FI). Our results should be interpreted cautiously because of important limitations such as the scarcity of evidence, overall risk of bias, and low to very low certainty of evidence. CONCLUSIONS We did not find conclusive evidence regarding the impact of PA-targeted eHealth interventions on PA parameters, but the very low certainty of evidence suggests that eHealth interventions may reduce sedentary time in children and adolescents. Our results may have important scientific implications as they highlight that the rapid development of eHealth interventions to promote PA lacks robust supporting evidence. TRIAL REGISTRATION PROSPERO CRD42020211020; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=211020.
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Affiliation(s)
- Irene Sequí-Domínguez
- Health and Social Research Center, Universidad de Castilla-La Mancha, Cuenca, Spain
- Research Network on Chronicity, Primary Care and Health Promotion, Cuenca, Spain
- Facultad de Enfermería de Albacete, Universidad de Castilla-La Mancha, Albacete, Spain
| | - Iván Cavero-Redondo
- Health and Social Research Center, Universidad de Castilla-La Mancha, Cuenca, Spain
- Facultad de Ciencias de la Salud, Universidad Autónoma de Chile, Talca, Chile
| | - Celia Álvarez-Bueno
- Health and Social Research Center, Universidad de Castilla-La Mancha, Cuenca, Spain
- Universidad Politécnica y Artística del Paraguay, Asunción, Paraguay
| | | | - Vicente Martínez-Vizcaíno
- Health and Social Research Center, Universidad de Castilla-La Mancha, Cuenca, Spain
- Facultad de Ciencias de la Salud, Universidad Autónoma de Chile, Talca, Chile
| | - Carlos Pascual-Morena
- Health and Social Research Center, Universidad de Castilla-La Mancha, Cuenca, Spain
- Facultad de Enfermería de Albacete, Universidad de Castilla-La Mancha, Albacete, Spain
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Greule C, Sudeck G, Thiel A, Kastner L, Janßen P, Nieß A, Rapp F, Junne F, Krauß I. Correlates of physical activity enjoyment in children and adolescents for a new perspective on the treatment of overweight: A systematic literature review. Obes Rev 2024; 25:e13655. [PMID: 37987113 DOI: 10.1111/obr.13655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Revised: 09/13/2023] [Accepted: 10/03/2023] [Indexed: 11/22/2023]
Abstract
The purpose of this systematic literature review was to systematically compile the state of knowledge on correlates of physical activity enjoyment in children and adolescents to influence the perspective of future physical activity promotion approaches especially for children and adolescents affected by overweight or obesity. The electronic database search was executed in the five databases PubMed, PsychINFO, SPORTDiscus, Web of Science, and BISp-SURF, from inception to December 6, 2021. A semi-quantitative method was used for summarizing the resulted correlates. For final analysis, 85 studies comprising 48,144 children and adolescents were included. Fifty-seven variables could be coded for their relationship with physical activity enjoyment. Of these, 12 psychological variables, for example, the basic psychological needs, task orientation, or self-efficacy; six interpersonal variables, for example, peer/group acceptance, parental support, and autonomy support; and one behavioral variable, the higher self-reported physical activity, are consistent positively associated to physical activity enjoyment. A scientifically based overview could be extracted for the promotion of physical activity enjoyment in children and adolescents. There is a gap in literature focusing the perception of physical activity enjoyment in the subgroup of children and adolescents affected by overweight or obesity. Therefore, recommendations were made to enable the development of further innovative research approaches in this population.
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Affiliation(s)
- Constanze Greule
- Department of Sports Medicine, University Hospital of Tübingen, Tübingen, Germany
- Institute of Sports Science, Eberhard Karls University of Tübingen, Tübingen, Germany
- Interfaculty Research Institute for Sport and Physical Activity, Eberhard Karls University of Tübingen, Tübingen, Germany
| | - Gorden Sudeck
- Institute of Sports Science, Eberhard Karls University of Tübingen, Tübingen, Germany
- Interfaculty Research Institute for Sport and Physical Activity, Eberhard Karls University of Tübingen, Tübingen, Germany
- LEAD Graduate School and Research Network, Eberhard Karls University of Tübingen, Tübingen, Germany
| | - Ansgar Thiel
- Institute of Sports Science, Eberhard Karls University of Tübingen, Tübingen, Germany
- Interfaculty Research Institute for Sport and Physical Activity, Eberhard Karls University of Tübingen, Tübingen, Germany
- LEAD Graduate School and Research Network, Eberhard Karls University of Tübingen, Tübingen, Germany
| | - Lydia Kastner
- Institute of Sports Science, Eberhard Karls University of Tübingen, Tübingen, Germany
- Interfaculty Research Institute for Sport and Physical Activity, Eberhard Karls University of Tübingen, Tübingen, Germany
- LEAD Graduate School and Research Network, Eberhard Karls University of Tübingen, Tübingen, Germany
| | - Pia Janßen
- Department of Sports Medicine, University Hospital of Tübingen, Tübingen, Germany
- Interfaculty Research Institute for Sport and Physical Activity, Eberhard Karls University of Tübingen, Tübingen, Germany
| | - Andreas Nieß
- Department of Sports Medicine, University Hospital of Tübingen, Tübingen, Germany
- Interfaculty Research Institute for Sport and Physical Activity, Eberhard Karls University of Tübingen, Tübingen, Germany
| | - Felicitas Rapp
- Department of Anesthesiology and Intensive Care Medicine, University Hospital Ulm, Ulm University, Ulm, Germany
| | - Florian Junne
- Department of Psychosomatic Medicine and Psychotherapy, Otto von Guericke University Magdeburg, Magdeburg, Germany
| | - Inga Krauß
- Department of Sports Medicine, University Hospital of Tübingen, Tübingen, Germany
- Interfaculty Research Institute for Sport and Physical Activity, Eberhard Karls University of Tübingen, Tübingen, Germany
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Kawalec A, Mozrzymas R, Domżol A, Zachurzok A, Szczepańska M, Noczyńska A, Zwolińska D. Physical Activity and Its Potential Determinants in Obese Children and Adolescents under Specialist Outpatient Care-A Pilot Cross-Sectional Study. Healthcare (Basel) 2024; 12:260. [PMID: 38275539 PMCID: PMC10815763 DOI: 10.3390/healthcare12020260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Revised: 01/12/2024] [Accepted: 01/17/2024] [Indexed: 01/27/2024] Open
Abstract
(1) Background: this study aimed to assess the physical activity of obese pediatric patients under specialized outpatient care and its potential determinants. (2) Methods: A total of 83 subjects aged 7-18 years with simple obesity and their parents were enrolled. Data were collected with the use of physical activity questionnaires (PAQs) for children and adolescents and additional questions concerning selected socio-demographic characteristics. (3) Results: The mean final PAQ score was 2.09 ± 0.69. The most frequently chosen types of physical activity included walking, gymnastics, and jogging or running. We found a weak correlation inversely proportional between the child's age and mean final PAQ score (r = -0.25; p = 0.02). Younger children were more active during lunchtime at school and after school compared to adolescents (p = 0.03 and p = 0.04). The final PAQ score differed according to the place of residence; the lowest score was obtained by subjects living in cities >100,000 inhabitants (p = 0.025). We found a positive correlation between PAQ-Ch score and the father's physical activity, and between PAQ-A score and the mother's education. (4) Conclusions: The physical activity of obese pediatric patients is low, particularly in adolescents. It seems that age and place of residence have an impact on the physical activity of obese children and adolescents. The PAQs used in this study are useful in physical activity assessment and identification of time segments during the day in which activity might be improved. However, this requires confirmation in a larger group of pediatric patients.
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Affiliation(s)
- Anna Kawalec
- Department and Clinic of Pediatric Nephrology, Wroclaw Medical University, Borowska Street 213, 50-556 Wroclaw, Poland
| | - Renata Mozrzymas
- Research and Development Center, Regional Specialist Hospital, Kamieńskiego Street 73a, 51-124 Wroclaw, Poland
| | - Agata Domżol
- Department of Pediatrics, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, 3 Maja Street 13/15, 41-800 Zabrze, Poland
| | - Agnieszka Zachurzok
- Department of Pediatrics, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, 3 Maja Street 13/15, 41-800 Zabrze, Poland
| | - Maria Szczepańska
- Department of Pediatrics, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, 3 Maja Street 13/15, 41-800 Zabrze, Poland
| | - Anna Noczyńska
- Department and Clinic of Endocrinology and Diabetology for Children and Adolescents, Wroclaw Medical University, Chałubińskiego 2a Street, 50-368 Wroclaw, Poland
| | - Danuta Zwolińska
- Department and Clinic of Pediatric Nephrology, Wroclaw Medical University, Borowska Street 213, 50-556 Wroclaw, Poland
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Forte P, Encarnação S, Monteiro AM, Teixeira JE, Hattabi S, Sortwell A, Branquinho L, Amaro B, Sampaio T, Flores P, Silva-Santos S, Ribeiro J, Batista A, Ferraz R, Rodrigues F. A Deep Learning Neural Network to Classify Obesity Risk in Portuguese Adolescents Based on Physical Fitness Levels and Body Mass Index Percentiles: Insights for National Health Policies. Behav Sci (Basel) 2023; 13:522. [PMID: 37503969 PMCID: PMC10376847 DOI: 10.3390/bs13070522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 06/07/2023] [Accepted: 06/19/2023] [Indexed: 07/29/2023] Open
Abstract
The increasing prevalence of overweight and obesity among adults is a risk factor for many chronic diseases and death. In addition, obesity among children and adolescents has reached unprecedented levels and studies show that obese children and adolescents are more likely to become obese adults. Therefore, both the prevention and treatment of obesity in adolescents are critical. This study aimed to develop an artificial intelligence (AI) neural network (NNET) model that identifies the risk of obesity in Portuguese adolescents based on their body mass index (BMI) percentiles and levels of physical fitness. Using datasets from the FITescola® project, 654 adolescents aged between 10-19 years old, male: 334 (51%), female: n = 320 (49%), age 13.8 ± 2 years old, were selected to participate in a cross-sectional observational study. Physical fitness variables, age, and sex were used to identify the risk of obesity. The NNET had good accuracy (75%) and performance validation through the Receiver Operating Characteristic using the Area Under the Curve (ROC AUC = 64%) in identifying the risk of obesity in Portuguese adolescents based on the BMI percentiles. Correlations of moderate effect size were perceived for aerobic fitness (AF), upper limbs strength (ULS), and sprint time (ST), showing that some physical fitness variables contributed to the obesity risk of the adolescents. Our NNET presented a good accuracy (75%) and was validated with the K-Folds Cross-Validation (K-Folds CV) with good accuracy (71%) and ROC AUC (66%). According to the NNET, there was an increased risk of obesity linked to low physical fitness in Portuguese teenagers.
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Affiliation(s)
- Pedro Forte
- CI-ISCE, Higher Institute of Educational Sciences of the Douro (ISCE Douro), 4560-708 Penafiel, Portugal
- Department of Sport Sciences, Instituto Politécnico de Bragança (IPB), 5300-253 Bragança, Portugal
- Research Centre in Sports Sciences, Health Sciences and Human Development (CIDESD), 5001-801 Vila Real, Portugal
| | - Samuel Encarnação
- CI-ISCE, Higher Institute of Educational Sciences of the Douro (ISCE Douro), 4560-708 Penafiel, Portugal
- Department of Sport Sciences, Instituto Politécnico de Bragança (IPB), 5300-253 Bragança, Portugal
- Research Centre in Sports Sciences, Health Sciences and Human Development (CIDESD), 5001-801 Vila Real, Portugal
- Department of Pysical Activity and Sport Sciences, Universidad Autónoma de Madrid, Ciudad Universitaria de Cantoblanco, 28049 Madrid, Spain
| | - António Miguel Monteiro
- Department of Sport Sciences, Instituto Politécnico de Bragança (IPB), 5300-253 Bragança, Portugal
- Research Centre in Sports Sciences, Health Sciences and Human Development (CIDESD), 5001-801 Vila Real, Portugal
| | - José Eduardo Teixeira
- Department of Sport Sciences, Instituto Politécnico de Bragança (IPB), 5300-253 Bragança, Portugal
- Research Centre in Sports Sciences, Health Sciences and Human Development (CIDESD), 5001-801 Vila Real, Portugal
- Department of Sport Sciences, Polytechnic Institute of Guarda, 6300-559 Guarda, Portugal
| | - Soukaina Hattabi
- CI-ISCE, Higher Institute of Educational Sciences of the Douro (ISCE Douro), 4560-708 Penafiel, Portugal
- High Institute of Sports and Physical Education of Elkef, University of Jendouba, Kef 7100, Tunisia
| | - Andrew Sortwell
- School of Health Sciences and Physiotherapy, University of Notre Dame Australia, Sydney 2007, Australia
- Department of Sports Sciences, University of Beria Interior, 6201-001 Covilhã, Portugal
| | - Luís Branquinho
- CI-ISCE, Higher Institute of Educational Sciences of the Douro (ISCE Douro), 4560-708 Penafiel, Portugal
- Research Centre in Sports Sciences, Health Sciences and Human Development (CIDESD), 5001-801 Vila Real, Portugal
| | - Bruna Amaro
- CI-ISCE, Higher Institute of Educational Sciences of the Douro (ISCE Douro), 4560-708 Penafiel, Portugal
| | - Tatiana Sampaio
- Department of Sport Sciences, Instituto Politécnico de Bragança (IPB), 5300-253 Bragança, Portugal
- Research Centre in Sports Sciences, Health Sciences and Human Development (CIDESD), 5001-801 Vila Real, Portugal
| | - Pedro Flores
- CI-ISCE, Higher Institute of Educational Sciences of the Douro (ISCE Douro), 4560-708 Penafiel, Portugal
- Research Centre in Sports Sciences, Health Sciences and Human Development (CIDESD), 5001-801 Vila Real, Portugal
| | - Sandra Silva-Santos
- CI-ISCE, Higher Institute of Educational Sciences of the Douro (ISCE Douro), 4560-708 Penafiel, Portugal
- Research Center in Sports Performance, Recreation, Innovation and Technology (SPRINT-IPVC), Polytechnic Institute of Viana do Castelo, 4960-320 Viana do Castelo, Portugal
| | - Joana Ribeiro
- CI-ISCE, Higher Institute of Educational Sciences of the Douro (ISCE Douro), 4560-708 Penafiel, Portugal
- Research Centre in Sports Sciences, Health Sciences and Human Development (CIDESD), 5001-801 Vila Real, Portugal
| | - Amanda Batista
- CI-ISCE, Higher Institute of Educational Sciences of the Douro (ISCE Douro), 4560-708 Penafiel, Portugal
| | - Ricardo Ferraz
- Research Centre in Sports Sciences, Health Sciences and Human Development (CIDESD), 5001-801 Vila Real, Portugal
- Department of Sports Sciences, University of Beria Interior, 6201-001 Covilhã, Portugal
| | - Filipe Rodrigues
- ESECS-Polytechnic of Leiria, 2411-901 Leiria, Portugal
- Life Quality Research Center (CIEQV), 2040-413 Leiria, Portugal
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Nezondet C, Gandrieau J, Bourrelier J, Nguyen P, Zunquin G. The Effectiveness of a Physical Literacy-Based Intervention for Increasing Physical Activity Levels and Improving Health Indicators in Overweight and Obese Adolescents (CAPACITES 64). CHILDREN (BASEL, SWITZERLAND) 2023; 10:956. [PMID: 37371188 DOI: 10.3390/children10060956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 05/19/2023] [Accepted: 05/23/2023] [Indexed: 06/29/2023]
Abstract
Recently, the concept of Physical Literacy (PL) has emerged as a key concept for promoting active behavior and improving health indicators in adolescents. Overweight and obese adolescents have a low level of Physical Activity (PA), low cardiorespiratory capacity, and high Body Fat percentage (%BF). However, the development of PL in the interest of health improvement has never been studied in overweight and obese adolescents. The objective of this study was to evaluate the impact of an intervention developing PL in overweight and obese adolescents in order to increase their (PA) and improve their health. The study was a prospective, single-arm, non-randomized interventional study. The intervention brings together different actions in PA and dietary education in different adolescent living environments. The study took place over a 9-month period with two data collection times (0; +9 months) and measured Body Mass Index (BMI) and BMI z score, %BF and Skeletal Muscle Mass (%SMM), Moderate-to-Vigorous intensity Physical Activity (MVPA) by accelerometry, CRF, as well as PL by the CAPL-2 tool. Thirteen adolescents (age 11.7 (±1.09) years old) improved their PL scores (+8.3 (±9.3) pts; p ≤ 0.01). BMI z score (-0.3 (±0.3), p ≤ 0.01), their %BF (-3.8 (±4.9); p ≤ 0.01), their CRF (+1.5 (±1.7) mL·min·kg-1; p ≤ 0.01), and their MVPA (+4.6 (±13.7) min/day; p = 0.36). Initiating multidimensional interventions to develop PL in overweight and obese adolescents may be a promising prospect to enable an increase in their MVPA and improve their long-term health. Longer-term randomized controlled interventional studies are needed to confirm these findings.
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Affiliation(s)
- Charlie Nezondet
- Laboratoire Mouvement, Equilibre, Performance, Santé (MEPS), Université de Pau et des Pays de l'Adour, Campus Montaury, EA 4445, 64600 Anglet, France
| | - Joseph Gandrieau
- L'unité de Recherche Pluridisciplinaire Sport, Santé, Société (URePSSS), Université de Lille, URL 7369, 59000 Lille, France
- Laboratoire Motricité Humaine Expertise Sport Santé (LAMHESS), UPR 6312, 06000 Nice, France
| | - Julien Bourrelier
- Cognition, Action et Plasticité Sensorimotrice, INSERM UMR 1093, Université UFR STAPS Bourgogne, 21000 Dijon, France
| | - Philippe Nguyen
- Departement "Unité Transversale des Activités Physiques pour la Santé" (UTAPS), Centre Hospitalier de la Côte Basque (CHCB), 64100 Bayonne, France
| | - Gautier Zunquin
- Laboratoire Mouvement, Equilibre, Performance, Santé (MEPS), Université de Pau et des Pays de l'Adour, Campus Montaury, EA 4445, 64600 Anglet, France
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Paponetti MK, Zwolski C, Porter R, Paterno MV. Leveraging the construct of physical literacy to promote physical activity for youth with obesity - A qualitative analysis of physical therapists' perceptions. OBESITY PILLARS (ONLINE) 2023; 5:100054. [PMID: 37990742 PMCID: PMC10662039 DOI: 10.1016/j.obpill.2022.100054] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 12/23/2022] [Accepted: 12/28/2022] [Indexed: 11/23/2023]
Abstract
Background Promoting physical activity has been identified as a pillar of obesity treatment and prevention. However, youth with obesity often present with physical, affective, and environmental barriers to physical activity engagement. The construct of physical literacy, which has garnered international attention as a holistic approach to understanding human movement, may improve physical activity promotion strategies for youth with obesity. However, literature has shown that healthcare providers are not engaged with the construct of physical literacy. Methods This qualitative study utilized a phenomenological approach and interpretivist epistemology. Three phases of data collection included member checks, semi-structured interviews, and a focus group with physical therapists treating youth with orthopedic and sport injuries. Simultaneous data collection and inductive analysis was designed to identify themes reflecting how participants utilized the construct of physical literacy to promote physical activity in a clinical setting. Results Four overarching themes were identified in our analysis as strategies for promoting activity and physical literacy development: 1) Movement Experience, 2) Individualized Care, 3) Movement Momentum, and 4) External Factors. Conclusion The findings from this study highlight the usefulness of applying a physical literacy lens within physical activity promotion efforts among youth, which may be particularly important for youth with obesity. A high value was placed on the affective and behavioral determinants of physical activity. By applying a physical literacy lens, healthcare providers treating youth with obesity may be better equipped to address barriers and promote participation in physical activities that are enjoyable and build confidence. The findings from this study provide a foundation for future studies examining how healthcare providers can leverage the construct of physical literacy to improve physical activity outcomes among youth.
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Affiliation(s)
- Matthew K. Paponetti
- Sports and Orthopedic Physical Therapy, Nationwide Children's Hospital, 584 County Line Road West, Westerville, OH, 43082, United States
- Center for Healthy Weight and Nutrition, Nationwide Children's Hospital, Columbus, OH, United States
| | - Christin Zwolski
- Division of Occupational Therapy and Physical Therapy, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States
- Department of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, OH, United States
| | - Rose Porter
- Doctor of Physical Therapy Program, College of Allied Health Sciences, University of Cincinnati, Cincinnati, OH, United States
| | - Mark V. Paterno
- Division of Occupational Therapy and Physical Therapy, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States
- Department of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, OH, United States
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Beets MW, Weaver RG, Ioannidis JPA, Pfledderer CD, Jones A, von Klinggraeff L, Armstrong B. Influence of pilot and small trials in meta-analyses of behavioral interventions: a meta-epidemiological study. Syst Rev 2023; 12:21. [PMID: 36803891 PMCID: PMC9938611 DOI: 10.1186/s13643-023-02184-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Accepted: 02/03/2023] [Indexed: 02/19/2023] Open
Abstract
BACKGROUND Pilot/feasibility or studies with small sample sizes may be associated with inflated effects. This study explores the vibration of effect sizes (VoE) in meta-analyses when considering different inclusion criteria based upon sample size or pilot/feasibility status. METHODS Searches were to identify systematic reviews that conducted meta-analyses of behavioral interventions on topics related to the prevention/treatment of childhood obesity from January 2016 to October 2019. The computed summary effect sizes (ES) were extracted from each meta-analysis. Individual studies included in the meta-analyses were classified into one of the following four categories: self-identified pilot/feasibility studies or based upon sample size but not a pilot/feasibility study (N ≤ 100, N > 100, and N > 370 the upper 75th of sample size). The VoE was defined as the absolute difference (ABS) between the re-estimations of summary ES restricted to study classifications compared to the originally reported summary ES. Concordance (kappa) of statistical significance of summary ES between the four categories of studies was assessed. Fixed and random effects models and meta-regressions were estimated. Three case studies are presented to illustrate the impact of including pilot/feasibility and N ≤ 100 studies on the estimated summary ES. RESULTS A total of 1602 effect sizes, representing 145 reported summary ES, were extracted from 48 meta-analyses containing 603 unique studies (avg. 22 studies per meta-analysis, range 2-108) and included 227,217 participants. Pilot/feasibility and N ≤ 100 studies comprised 22% (0-58%) and 21% (0-83%) of studies included in the meta-analyses. Meta-regression indicated the ABS between the re-estimated and original summary ES where summary ES ranged from 0.20 to 0.46 depending on the proportion of studies comprising the original ES were either mostly small (e.g., N ≤ 100) or mostly large (N > 370). Concordance was low when removing both pilot/feasibility and N ≤ 100 studies (kappa = 0.53) and restricting analyses only to the largest studies (N > 370, kappa = 0.35), with 20% and 26% of the originally reported statistically significant ES rendered non-significant. Reanalysis of the three case study meta-analyses resulted in the re-estimated ES rendered either non-significant or half of the originally reported ES. CONCLUSIONS When meta-analyses of behavioral interventions include a substantial proportion of both pilot/feasibility and N ≤ 100 studies, summary ES can be affected markedly and should be interpreted with caution.
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Affiliation(s)
- Michael W Beets
- Arnold School of Public Health, University of South Carolina, SC, Columbia, USA.
| | - R Glenn Weaver
- Arnold School of Public Health, University of South Carolina, SC, Columbia, USA
| | - John P A Ioannidis
- Department of Medicine, Stanford University, Stanford, CA, USA.,Department of Health Research and Policy, Stanford University, Stanford, CA, USA.,Department of Biomedical Data Science, Stanford University, Stanford, CA, USA.,Department of Statistics, Stanford University, Stanford, CA, USA.,Departments of Medicine, of Health Research and Policy, of Biomedical Data Science, and of Statistics, Meta-Research Innovation Center at Stanford (METRICS), Stanford University, Stanford, CA, USA
| | | | - Alexis Jones
- Arnold School of Public Health, University of South Carolina, SC, Columbia, USA
| | | | - Bridget Armstrong
- Arnold School of Public Health, University of South Carolina, SC, Columbia, USA
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9
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Time-specific intervention effects on objectively measured physical activity in school children. J Public Health (Oxf) 2023. [DOI: 10.1007/s10389-023-01840-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2023] Open
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10
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Bernhardsson S, Boman C, Lundqvist S, Arvidsson D, Börjesson M, Larsson MEH, Lundh H, Melin K, Nilsen P, Lauruschkus K. Implementation of physical activity on prescription for children with obesity in paediatric health care (IMPA): protocol for a feasibility and evaluation study using quantitative and qualitative methods. Pilot Feasibility Stud 2022; 8:117. [PMID: 35650617 PMCID: PMC9158137 DOI: 10.1186/s40814-022-01075-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Accepted: 05/24/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Physical inactivity is a main cause of childhood obesity which tracks into adulthood obesity, making it important to address early in life. Physical activity on prescription (PAP) is an evidence-based intervention that has shown good effect on physical activity levels in adults, but has not been evaluated in children with obesity. This project aims to evaluate the prerequisites, determinants, and feasibility of implementing PAP adapted to children with obesity and to explore children's, parents', and healthcare providers' experiences of PAP. METHODS In the first phase of the project, healthcare providers and managers from 26 paediatric clinics in Region Västra Götaland, Sweden, will be invited to participate in a web-based survey and a subset of this sample for a focus group study. Findings from these two data collections will form the basis for adaptation of PAP to the target group and context. In a second phase, this adapted PAP intervention will be evaluated in a clinical study in a sample of approximately 60 children with obesity (ISO-BMI > 30) between 6 and 12 years of age and one of their parents/legal guardians. Implementation process and clinical outcomes will be assessed pre- and post-intervention and at 8 and 12 months' follow-up. Implementation outcomes are the four core constructs of the Normalization Process Theory; coherence, cognitive participation, collective action, and reflexive monitoring; and appropriateness, acceptability, and feasibility of the PAP intervention. Additional implementation process outcomes are recruitment and attrition rates, intervention fidelity, dose, and adherence. Clinical outcomes are physical activity pattern, BMI, metabolic risk factors, health-related quality of life, sleep, and self-efficacy and motivation for physical activity. Lastly, we will explore the perspectives of children and parents in semi-structured interviews. Design and analysis of the included studies are guided by the Normalization Process Theory. DISCUSSION This project will provide new knowledge regarding the feasibility of PAP for children with obesity and about whether and how an evidence-based intervention can be fitted and adapted to new contexts and populations. The results may inform a larger scale trial and future implementation and may enhance the role of PAP in the management of obesity in paediatric health care in Sweden. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT04847271 , registered 14 April 2021.
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Affiliation(s)
- Susanne Bernhardsson
- Region Västra Götaland, Research, Education, Development and Innovation, Primary Health Care, Gothenburg, Sweden. .,Unit of Physiotherapy, Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
| | - Charlotte Boman
- Unit of Physiotherapy, Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Region Västra Götaland, Centre for Physical Activity, Gothenburg, Sweden
| | - Stefan Lundqvist
- Region Västra Götaland, Research, Education, Development and Innovation, Primary Health Care, Gothenburg, Sweden.,Unit of Physiotherapy, Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Region Västra Götaland, Centre for Physical Activity, Gothenburg, Sweden
| | - Daniel Arvidsson
- Department of Food and Nutrition and Sport Science, Faculty of Education, Center for Health and Performance, University of Gothenburg, Gothenburg, Sweden
| | - Mats Börjesson
- Department of Molecular and Clinical Medicine & Center for Health and Performance, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Maria E H Larsson
- Region Västra Götaland, Research, Education, Development and Innovation, Primary Health Care, Gothenburg, Sweden.,Unit of Physiotherapy, Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Hannah Lundh
- Region Västra Götaland, Centre for Physical Activity, Gothenburg, Sweden.,School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Karin Melin
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Region Västra Götaland, Department of Child and Adolescent Psychiatry, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Per Nilsen
- Division of Health and Society, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Katarina Lauruschkus
- Faculty of Medicine, Institution of Health Sciences, Lund University, Lund, Sweden
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11
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Ng M, Wenden E, Lester L, Westgarth C, Christian H. A mobile health intervention to encourage physical activity in children: a randomised controlled trial. BMC Pediatr 2022; 22:276. [PMID: 35562656 PMCID: PMC9103068 DOI: 10.1186/s12887-022-03336-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Accepted: 04/26/2022] [Indexed: 11/10/2022] Open
Abstract
Background Despite immense benefits of physical activity on health and developmental outcomes, few children achieve recommended daily levels of physical activity. Given more than half of families with children own a dog, we investigated the effect of a mobile health (mHealth) intervention to encourage dog-facilitated physical activity through increased family dog walking and children’s active play with their dog. Methods The PLAYCE PAWS study was a three-armed randomised pilot trial conducted in Perth, Western Australia. Children aged 5-10 years with a family dog were randomised to 4 weeks of either 1) SMS-only intervention, 2) ‘SMS + pedometer’ intervention or 3) ‘usual care’ control. The mHealth intervention involved SMS messages to parents; the ‘SMS + pedometer’ group also received a dog pedometer and personalised dog steps diary. Parent-reported measures were collected at baseline, 1- and 3-months post intervention. The primary outcome was weekly frequency of family dog walking and dog play; secondary outcomes were child attachment to the dog and feasibility of the intervention. Results A total of 150 children were randomised in staggered blocks to SMS-only (n = 50), ‘SMS + pedometer’ (n = 50) or usual care (n = 50). No differences were observed in family dog walking and dog play at 1-month. SMS-only children (OR 2.6, 95% CI 1.17, 5.83, P = 0.019) and all intervention children (OR 1.97, 95% CI 1.01, 3.86, P = 0.048) were more likely to increase total dog-facilitated physical activity (sum of family dog walking and dog play responses) at 3-months. The positive associations with total dog-facilitated physical activity disappeared (all P > 0.05) after adjusting for socio-demographic factors. Conclusions The PLAYCE PAWS mHealth intervention did not significantly affect dog-facilitated physical activity in children. Given high levels of dog ownership in the community, SMS prompts could be a low-cost intervention to encourage more physical activity in children. Further research is needed to understand how increased interaction with the family dog impacts on children’s overall physical activity and other health and development outcomes. Trial registration ANZCTR, ACTRN12620000288921, retrospectively registered on 4/3/2020.
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Affiliation(s)
- Michelle Ng
- Telethon Kids Institute, University of Western Australia, Perth, WA, Australia.
| | - Elizabeth Wenden
- Telethon Kids Institute, University of Western Australia, Perth, WA, Australia.,School of Population and Global Health, University of Western Australia, Perth, WA, Australia
| | - Leanne Lester
- School of Human Sciences, University of Western Australia, Crawley, WA, Australia
| | - Carri Westgarth
- Department of Livestock and One Health, Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Leahurst Campus, Neston, UK
| | - Hayley Christian
- Telethon Kids Institute, University of Western Australia, Perth, WA, Australia.,School of Population and Global Health, University of Western Australia, Perth, WA, Australia
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12
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Nigg C, Burchartz A, Reichert M, Woll A, Niessner C. Children and adolescents do not compensate for physical activity but do compensate for sedentary behavior. GERMAN JOURNAL OF EXERCISE AND SPORT RESEARCH 2022. [DOI: 10.1007/s12662-022-00808-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
AbstractLittle is known about behavioral transfer and compensation within and between moderate-to-vigorous physical activity (MVPA) and sedentary behavior. Thus, taking a within-person perspective, this study investigated across 1 week whether (a) children and adolescents compensate for increased MVPA and sedentary behavior with less of the respective behavior the next day and (b) transfer and compensation occur between these behaviors within 1 day and across 2 days. We obtained data from 2676 participants (6–17 years) of the national Motorik-Modul (MoMo) study in Germany. Participants wore an ActiGraph accelerometer (Pensacola, FL, USA) for 7 days. We analyzed within- and between-day associations using hierarchical linear modeling. If youth engaged in 2 h more sedentary behavior than typical on any given day, they engaged in 37.20 min less MVPA the same day (B = −0.31, p < 0.001) as well as in 4.80 min more MVPA (B = 0.04, p < 0.001) and 7.20 min less sedentary behavior (B = −0.06, p < 0.001) the next day. If youth engaged in 1 h more MVPA than typical on any given day, they engaged in 97.80 min less sedentary behavior the same day (B = −1.63, p < 0.001) and in 5.40 min less sedentary behavior the next day (B = −0.09, p < 0.001). No association with next-day MVPA was observed. Our results indicate that children do not compensate for enhanced MVPA but transfer to less sedentary behavior, while more sedentary behavior is compensated with less sedentary behavior and more MVPA the next day. This provides essential information for the design of intervention studies to tackle physical inactivity and sedentary behavior.
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13
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Berleze A, Valentini NC. Intervention for Children with Obesity and Overweight and Motor Delays from Low-Income Families: Fostering Engagement, Motor Development, Self-Perceptions, and Playtime. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19052545. [PMID: 35270238 PMCID: PMC8909693 DOI: 10.3390/ijerph19052545] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 02/12/2022] [Accepted: 02/17/2022] [Indexed: 02/01/2023]
Abstract
Obesity is increasing globally, affecting children’s health and development. This study examines the influence of a motor skill intervention on the daily routine, self-perceptions, body mass index, motor development, and engagement in physical education lessons of children with obesity and overweight with motor delays. Children were randomly assigned to intervention and control groups. The daily routine at home, self-perceptions, motor development, BMI, and engagement were assessed. Significant group by time interactions were found for play (p < 0.0001) and television (p < 0.0001) time, perceived social (p = 0.003) and motor (p < 0.0001) competence, global self-worth (p < 0.0001), BMI (p = 0.001), motor development (p < 0.0001), and engagement (p = 0.029). From pre-to-post intervention, children with obesity and overweight in the intervention group increased (1) playtime at home; (2) self-perceptions of social and motor competence and global worth; (4) engagement in the lessons, and improved scores, in motor skills; and (6) reduced BMI and screen time. The intervention promoted the health and improved the self-concept of children with obesity/ overweight.
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14
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Boman C, Bernhardsson S, Lauruschkus K, Lundqvist S, Melin K. Prerequisites for implementing physical activity on prescription for children with obesity in paediatric health care: A cross-sectional survey. FRONTIERS IN HEALTH SERVICES 2022; 2:1102328. [PMID: 36925834 PMCID: PMC10012761 DOI: 10.3389/frhs.2022.1102328] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Accepted: 12/30/2022] [Indexed: 01/31/2023]
Abstract
Background Physical inactivity is a main driver of childhood obesity that tracks into adulthood, making it crucial to address early in life. Swedish physical activity on prescription (PAP) is an effective intervention for increasing physical activity levels in adults and is being implemented in primary care in Sweden. Before implementing PAP for children, both intervention effectiveness and implementation prerequisites need to be examined. Framed by the Normalization Process Theory (NPT) domains, this study aimed to investigate perceptions of PAP amongst paediatric staff and managers working with children with obesity, as well as acceptability, appropriateness, feasibility, and barriers and facilitators for implementing PAP in paediatric health care. Methods Staff and managers in 28 paediatric outpatient clinics in western Sweden were surveyed using validated implementation instruments and open-ended questions. Data were analysed using Mann-Whitney U tests and Kruskal-Wallis tests. Qualitative data were categorised into NPT domains. Results The survey response rate was 54% (125/229). Most respondents (82%) reported PAP to be familiar and many (56%) perceived it as a normal part of work; nurses and physiotherapists to a greater extent (p < 0.001). This was anticipated to increase in the future (82%), especially amongst those with the longest work experience (p = 0.012). Respondents reported seeing the potential value in their work with PAP (77%), being open to working in new ways to use PAP (94%), and having confidence in their colleagues' ability to use PAP (77%). Barriers and facilitators were found in all the NPT domains, mainly collective action and reflexive monitoring, where, for example, inadequacies of education, resources, and research on PAP for children were reported as barriers. Most respondents agreed that PAP was acceptable, appropriate, and feasible (71% to 88%). Conclusions PAP is familiar and perceived as an acceptable, appropriate, and feasible intervention, and by many viewed as a normal part of clinical routines in paediatric outpatient clinics in western Sweden, especially by physiotherapists and nurses. Barriers and faciliators are mainly related to collective action and reflexive monitoring. The wide acceptance demonstrates receptiveness to PAP as an intervention to promote an active lifestyle for children with obesity.
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Affiliation(s)
- Charlotte Boman
- Centre for Physical Activity, Region Västra Götaland, Gothenburg, Sweden.,Unit of Physiotherapy, Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Susanne Bernhardsson
- Unit of Physiotherapy, Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Research, Education, Development and Innovation, Primary Health Care, Region Västra Götaland, Gothenburg, Sweden
| | - Katarina Lauruschkus
- Faculty of Medicine, Institution of Health Sciences, Lund University, Lund, Sweden.,Department of Habilitation, Committee on Psychiatry, Habilitation and Technical Aids, Region Skåne, Lund, Sweden
| | - Stefan Lundqvist
- Centre for Physical Activity, Region Västra Götaland, Gothenburg, Sweden.,Unit of Physiotherapy, Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Research, Education, Development and Innovation, Primary Health Care, Region Västra Götaland, Gothenburg, Sweden
| | - Karin Melin
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Department of Child and Adolescent Psychiatry, Sahlgrenska University Hospital, Region Västra Götaland, Gothenburg, Sweden
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15
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Can a Multicomponent-Overnight Camp Increase Physical Activity Among Danish Children? A Retrospective Cross-Sectional Study. J Phys Act Health 2021; 18:37-43. [PMID: 33373978 DOI: 10.1123/jpah.2020-0101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Revised: 08/25/2020] [Accepted: 10/06/2020] [Indexed: 11/18/2022]
Abstract
BACKGROUND In Denmark, most children are not sufficiently physically active and only a few interventions have been found to increase long-term physical activity among overweight and obese children. The aim of our study was to investigate if children are physically active in correspondence to Danish recommendations after attending a multicomponent-overnight camp. METHODS A questionnaire was developed to estimate children's physical activity level and behavior and investigate how transport, economy, availability, time, motivation, and knowledge about physical activity affect children's physical activity level and behavior. RESULTS In this study, 60.9% of the children did vigorous physical activity (VPA) minimum 30 minutes 3 times per week up to 3 years after camp. Most children were physically active at a sports club (44.3%) and only 5.7% of the children did not participate in physical activity. Parental physical activity and child motivation toward physical activity were significantly (P < .05) associated with children doing VPA. CONCLUSION Our findings suggest that 60.9% of children who attended camp engage in VPA after camp, which compared with a recent Danish study, is more frequent than children who did not attend camp. Further investigations are needed to determine the long-term health effects in children attending interventions such as multicomponent-overnight camps.
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16
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Gråstén A, Huhtiniemi M, Hakonen H, Jaakkola T. Development of accelerometer-based light to vigorous physical activity in fitness profiles of school-aged children. Scand J Med Sci Sports 2021; 31:2343-2355. [PMID: 34536979 DOI: 10.1111/sms.14056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Revised: 08/26/2021] [Accepted: 09/08/2021] [Indexed: 11/30/2022]
Abstract
This study examined the developmental trajectories of light (LPA) and moderate-to-vigorous physical activity (MVPA) in fitness profiles derived from motor competence, perceived motor competence, health-related fitness, and MVPA behavior. Locomotor, stability, and object control skills, muscular and cardiovascular fitness, and physical activity were assessed in 510 (girls 285 and boys 225) Finnish school-aged children (Mage = 11.26 ± 33 years) over three years. Physical activity was measured using hip-mounted accelerometers. Fitness profiles were identified using latent profile analysis, and the development of physical activity levels across four assessments was analyzed with latent growth curve models. Results showed that (1) three homogeneous profiles were identified: At-risk, Intermediate, and Desirable; (2) the Desirable group was more physically active than the other groups, the Intermediate group was more physical active than the At-risk group; and (3) LPA decreased similarly over time, while MVPA remained stable in all three profiles. Initial more advanced motor competence, perceived motor competence, health-related fitness, and higher MVPA behavior were associated with higher levels of long-term LPA and MVPA. This finding supports the importance of motor competence skills acquisition in the early school years. Attention should also be paid to increasing engagement in light physical activities, especially in inactive or insufficiently active children with low motor competence skills.
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Affiliation(s)
- Arto Gråstén
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Mikko Huhtiniemi
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | | | - Timo Jaakkola
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
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17
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Smith KE, Mason TB, O'Connor SM, Wang S, Dzubur E, Crosby RD, Wonderlich SA, Salvy SJ, Feda DM, Roemmich JN. Bi-Directional Associations Between Real-Time Affect and Physical Activity in Weight-Discordant Siblings. J Pediatr Psychol 2021; 46:443-453. [PMID: 33313910 DOI: 10.1093/jpepsy/jsaa121] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 11/18/2020] [Accepted: 11/18/2020] [Indexed: 12/14/2022] Open
Abstract
Pediatric obesity confers increased risk for a host of negative psychological and physical health consequences and is reliably linked to low levels of physical activity. Affective antecedents and consequences of physical activity are thought to be important for the development and maintenance of such behavior, though research examining these associations in youth across the weight spectrum remains limited. OBJECTIVE This study examined bi-directional associations between affect and physical activity (i.e., moderate-to-vigorous physical activity [MVPA] and total activity counts), and the extent to which weight (body mass index z-score [z-BMI]) moderated these associations. METHODS Participants were drawn from a prior study of siblings (N = 77; mean age = 15.4 ± 1.4 years) discordant for weight status (39 nonoverweight siblings, 38 siblings with overweight/obesity) who completed ecological momentary assessment (EMA) with accelerometer-assessed physical activity. RESULTS Generalized linear mixed models indicated z-BMI moderated trait-level and momentary associations. When adolescents with higher z-BMI reported momentary negative affect, they evidenced less MVPA within the next hour. Across the sample, greater overall activity was associated with lower negative affect. However, at the momentary level, when adolescents with higher (but not lower) z-BMI evidenced greater activity, they reported decreases in negative affect. CONCLUSIONS Findings indicate affective experiences surrounding physical activity differ according to z-BMI. Specifically, momentary negative affect may impede momentary MVPA among youth with higher z-BMI. Further research is warranted to elucidate factors influencing these momentary associations and the extent to which these momentary associations prospectively predict weight change.
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Affiliation(s)
- Kathryn E Smith
- Department of Psychiatry and Behavioral Sciences, University of Southern California
| | - Tyler B Mason
- Department of Preventive Medicine, University of Southern California
| | | | - Shirlene Wang
- Department of Preventive Medicine, University of Southern California
| | | | - Ross D Crosby
- Sanford Center for Bio-behavioral Research, Sanford Health.,Department of Psychiatry and Behavioral Science, University of North Dakota School of Medicine and Health Sciences
| | - Stephen A Wonderlich
- Sanford Center for Bio-behavioral Research, Sanford Health.,Department of Psychiatry and Behavioral Science, University of North Dakota School of Medicine and Health Sciences
| | | | - Denise M Feda
- Department of Epidemiology and Environmental Health, University at Buffalo, The State University of New York
| | - James N Roemmich
- Agricultural Research Service, United States Department of Agriculture, Grand Forks Human Nutrition Research Center
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18
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Arlinghaus KR, Ledoux TA, Johnston CA. Randomized Controlled Trial to Increase Physical Activity Among Hispanic-American Middle School Students. THE JOURNAL OF SCHOOL HEALTH 2021; 91:307-317. [PMID: 33655526 DOI: 10.1111/josh.13004] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/31/2020] [Revised: 11/03/2020] [Accepted: 11/25/2020] [Indexed: 06/12/2023]
Abstract
BACKGROUND Moderate-to-vigorous physical activity (MVPA) declines during adolescence, particularly among girls. In this randomized control trial, we examined MVPA in a physical activity intervention compared to physical education (PE) class as usual (TAU), stratified by sex and weight classification. Standardized BMI (zBMI) overtime was also examined. METHODS Hispanic-American middle school students (N = 193) were recruited from a school district in Houston, Texas. Participants were randomized to either a circuit-based physical activity intervention or TAU (PE class as usual). MVPA was assessed using accelerometry at baseline and 6 months. Repeated measures ANCOVA were conducted to examine changes in MVPA, overall and stratified by sex and weight classification. This procedure was repeated for zBMI. RESULTS Participants were 12.10 ± 0.63 years old and 53% were girls. Overall those in intervention increased weekday MVPA more than TAU (F(1,190) = 7.03, p < .01). Intervention girls increased weekday MVPA; whereas TAU girls decreased weekday MVPA (F(1,99) = 7.36, p < .01). Among those with obesity, there was no difference in MVPA between conditions (F(1, 56) = 0.33, p = .57), but Intervention decreased zBMI significantly more than TAU (F(1, 56) = 6.16, p < .05). CONCLUSIONS Structured PE classes grounded in behavioral theory may be an important strategy to prevent typical decreases in MVPA during adolescence, particularly among girls and for youth with obesity.
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Affiliation(s)
- Katherine R Arlinghaus
- Assistant Professor, , Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, 1300 South Second Street Suite 300, Minneapolis, MN, 55454., USA
| | - Tracey A Ledoux
- Associate Professor, , Department of Health and Human Performance, University of Houston, 3875 Holman St. Rm 104 Garrison, Houston, TX, 77204-6015., USA
| | - Craig A Johnston
- Associate Professor, , Department of Health and Human Performance, University of Houston, 3875 Holman St. Rm 104 Garrison, Houston, TX, 77204-6015., USA
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19
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He Z, Wu H, Yu F, Fu J, Sun S, Huang T, Wang R, Chen D, Zhao G, Quan M. Effects of Smartphone-Based Interventions on Physical Activity in Children and Adolescents: Systematic Review and Meta-analysis. JMIR Mhealth Uhealth 2021; 9:e22601. [PMID: 33522980 PMCID: PMC7884215 DOI: 10.2196/22601] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2020] [Revised: 08/28/2020] [Accepted: 01/12/2021] [Indexed: 12/22/2022] Open
Abstract
Background About 70% of children and adolescents worldwide do not meet the recommended level of physical activity (PA), which is closely associated with physical, psychological, and cognitive well-being. Nowadays, the use of technologies to change PA is of interest due to the need for novel, more effective intervention approaches. The previous meta-analyses have examined smartphone-based interventions and their impact on PA in adults, but evidence in children and adolescents still needs further research. Objective This systematic review and meta-analysis aimed to determine the effectiveness of smartphone-based interventions for improving PA in children and adolescents. Methods Five electronic databases (PubMed, Web of Science, OVID, Scopus, and the China National Knowledge Infrastructure) were searched up to June 29, 2020. Randomized controlled trials with a control group that examine the effect of smartphone interventions on PA among children and adolescents were included. Bias risks were assessed using the Cochrane collaboration tool. Meta-analysis was performed to assess the pooled effect on PA using a random effects model. Subgroup analyses were conducted to examine the potential modifying effects of different factors (eg, types of intervention, intervention duration, age, measurement, study quality). Results A total of 9 studies were included in this review, including 4 mobile app interventions, 3 SMS text messaging interventions, and 2 app + SMS text messaging interventions. In general, the risk of bias of included studies was low. Compared with the control group, the use of smartphone intervention significantly improved PA (standardized mean difference [SMD] 0.44, 95% CI 0.11-0.77, P=.009), especially for total PA (TPA; weighted mean difference [WMD] 32.35, 95% CI 10.36-54.33, P=.004) and daily steps (WMD 1185, 95% CI 303-2068, P=.008), but not for moderate-to-vigorous PA (WMD 3.91, 95% CI –1.99 to 9.81, P=.19). High statistical heterogeneity was detected (I2=73.9%, P<.001) for PA. Meta-regression showed that duration (β=–.08, 95% CI –0.15 to –0.01, n=16) was a potential factor for high heterogeneity. The results of subgroup analyses indicated that app intervention (SMD 0.76, 95% CI 0.23-1.30, P=.005), children (SMD 0.64, 95% CI 0.10-1.18, P=.02), “≤8 weeks” (SMD 0.76, 95% CI 0.23-1.30, P=.005), objective measurement (SMD 0.50, 95% CI 0.09-0.91, P=.02), and low risk of bias (SMD 0.96, 95% CI 0.38-1.54, P=.001) can significantly improve PA. Conclusions The evidence of meta-analysis shows that smartphone-based intervention may be a promising strategy to increase TPA and steps in children and adolescents. Currently, app intervention may be a more effective strategy among smartphone intervention technologies. To extend the promise of smartphone intervention, the future needs to design comparative trials among different smartphone technologies. Trial Registration PROSPERO CRD42019148261; https://tinyurl.com/y5modsrd
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Affiliation(s)
- Zihao He
- School of Physical Education, NanChang University, NanChang, China
| | - Hua Wu
- Rehabilitation Medicine Center, The Second Affiliated Hospital of Jiaxing University, Jiaxing, China
| | - Fengyu Yu
- School of Physical Education, NanChang University, NanChang, China
| | - Jinmei Fu
- JiangXi Institute of Sport Science, NanChang, China
| | - Shunli Sun
- JiangXi Institute of Sport Science, NanChang, China
| | - Ting Huang
- School of Physical Education, NanChang University, NanChang, China
| | - Runze Wang
- School of Physical Education, NanChang University, NanChang, China
| | - Delong Chen
- School of Physical Education, NanChang University, NanChang, China
| | - Guanggao Zhao
- School of Physical Education, NanChang University, NanChang, China
| | - Minghui Quan
- School of Kinesiology, Shanghai University of Sport, Shanghai, China
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Association between Physical Activity and Age among Children with Overweight and Obesity: Evidence from the 2016-2017 National Survey of Children's Health. BIOMED RESEARCH INTERNATIONAL 2020; 2020:9259742. [PMID: 33029532 PMCID: PMC7532403 DOI: 10.1155/2020/9259742] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Revised: 09/11/2020] [Accepted: 09/15/2020] [Indexed: 12/28/2022]
Abstract
Physical activity participation in children declines with age. It is not clear yet whether the age-related trends vary by weight status. This study is aimed at investigating the association between physical activity participation and age among children with healthy weight, overweight, or obesity, using data from the 2016-2017 National Survey of Children's Health (NSCH). Physical activity participation was evaluated by days participated in physical activity for at least 60 minutes out of 7 days. Weight status was categorized from body mass index (BMI) percentiles. Data were analyzed on 33,056 US children age 10-17 years. The percentages of been active 0 day out of 7 days in BMI5th < 85th (healthy weight), 85th < 95th (overweight), and ≥95th percentile (obese) groups were 8.9%, 11.5%, and 18.2%, respectively. Among all groups, been active 0 day out of 7 days was positively associated with age, while the strongest associations were observed in the BMI85th < 95th group (age 17 years vs. age 10 years: OR = 7.48, p < 0.0001). Older age was significantly associated with been active less than 4 days out of 7 days in the BMI5th < 85th and 85th < 95th groups, but those associations were attenuated in the BMI ≥ 95th group. This study found that physical activity participation was inversely associated with age among children with healthy weight, overweight, or obese, and the association was strongest among children with overweight and weakest among children with obesity. Interventions aimed at promoting physical activity among children should take these patterns of association into account.
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Jurado-Castro JM, Gil-Campos M, Gonzalez-Gonzalez H, Llorente-Cantarero FJ. Evaluation of Physical Activity and Lifestyle Interventions Focused on School Children with Obesity Using Accelerometry: A Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17176031. [PMID: 32825085 PMCID: PMC7503305 DOI: 10.3390/ijerph17176031] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 08/13/2020] [Accepted: 08/17/2020] [Indexed: 01/11/2023]
Abstract
Despite the existence of global recommendations for physical activity and lifestyle to avoid childhood obesity, there are no specific recommendations for school-age children. The aim of this meta-analysis was to measure the effects of current interventions with a physical activity component on body mass index (BMI) Z-score and on the moderate and vigorous physical activity (MVPA) time, measured by accelerometry, and focused on children with obesity. Randomized controlled trial studies (RCTs) based on physical activity interventions focused on children with obesity (6 to 12 years old) from January 1991 to August 2018 were included. The post-intervention mean and standard deviation of the BMI Z-score and MVPA engaged time were extracted to calculate the results using random effects models. Of a total of 229 studies considered potentially eligible, only 10 RCTs met the inclusion criteria. There were improvements in the BMI Z-score for physical activity intervention groups, compared with non-intervention children in addition to a significant increase in time engaged in MVPA. In conclusion, interventions with a physical activity component in school-children with obesity seem to be effective at reducing BMI and producing an increase in time spent engaged in physical activity. Therefore, interventions based on physical activity should be considered one of the main strategies in treating childhood obesity.
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Affiliation(s)
- Jose Manuel Jurado-Castro
- Metabolism and Investigation Unit, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, 14004 Córdoba, Spain; (J.M.J.-C.); (F.J.L.-C.)
| | - Mercedes Gil-Campos
- Metabolism and Investigation Unit, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, 14004 Córdoba, Spain; (J.M.J.-C.); (F.J.L.-C.)
- CIBEROBN, (Physiopathology of Obesity and Nutrition), Institute of Health Carlos III (ISCIII), 28029 Madrid, Spain
- Unit of Metabolism and Pediatric Research, Reina Sofia University Hospital, 14004 Córdoba, Spain
- Correspondence: ; Tel.: +34-9577-36467
| | | | - Francisco Jesus Llorente-Cantarero
- Metabolism and Investigation Unit, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, 14004 Córdoba, Spain; (J.M.J.-C.); (F.J.L.-C.)
- CIBEROBN, (Physiopathology of Obesity and Nutrition), Institute of Health Carlos III (ISCIII), 28029 Madrid, Spain
- Department of Specific Didactics, Faculty of Education, University of Cordoba, 14071 Córdoba, Spain
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Smith DM, Duque L, Huffman JC, Healy BC, Celano CM. Text Message Interventions for Physical Activity: A Systematic Review and Meta-Analysis. Am J Prev Med 2020; 58:142-151. [PMID: 31759805 PMCID: PMC6956854 DOI: 10.1016/j.amepre.2019.08.014] [Citation(s) in RCA: 51] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2019] [Revised: 08/07/2019] [Accepted: 08/08/2019] [Indexed: 01/28/2023]
Abstract
CONTEXT Despite clear health benefits, many individuals fail to achieve the recommended levels of physical activity. Text message interventions to promote physical activity hold promise owing to the ubiquity of cell phones and the low expense of text message delivery. EVIDENCE ACQUISITION A systematic review and meta-analysis were performed to examine the impact of text message interventions on physical activity. Searches of PubMed, PsycINFO, Scopus, Cochrane, and ClinicalTrials.gov databases from inception to December 2017 were performed to identify studies investigating one-way text message interventionss to promote physical activity. A subset of RCTs, including an objective (accelerometer-based) physical activity outcome, were included in random-effects meta-analyses in 2018. EVIDENCE SYNTHESIS The systematic search revealed 944 articles. Of these, 59 were included in the systematic review (12 1-arm trials and 47 controlled trials; n=8,742; mean age, 42.2 years; 56.2% female). In meta-analyses of 13 studies (n=1,346), text message interventionss led to significantly greater objectively measured postintervention steps/day (Cohen's d=0.38, 95% CI=0.19, 0.58, n=10 studies). Analysis of postintervention moderate-to-vigorous physical activity found a similar but not statistically significant effect (Cohen's d=0.31, 95% CI= -0.01, 0.63, n=5 studies). Interventions with more components, tailored content, and interventions in medical populations led to nonsignificantly larger effect sizes compared with text message interventions without these features. CONCLUSIONS Text message interventions lead to higher objectively measured postintervention physical activity compared with control groups. More extensive, well-controlled studies are needed to examine this relationship further and identify characteristics of effective text message interventions.
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Affiliation(s)
- Diana M Smith
- Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts
| | - Laura Duque
- Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts
| | - Jeff C Huffman
- Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts
| | - Brian C Healy
- Harvard Medical School, Boston, Massachusetts; Department of Neurology, Brigham and Women's Hospital, Boston, Massachusetts
| | - Christopher M Celano
- Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts.
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Differences in Physical Behaviour between Obese and Normal Weight Saudi Arabian Boys and Girls: What is Worth Noting? PHYSICAL ACTIVITY AND HEALTH 2018. [DOI: 10.5334/paah.25] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Robbins LB, Ling J, Clevenger K, Voskuil VR, Wasilevich E, Kerver JM, Kaciroti N, Pfeiffer KA. A School- and Home-Based Intervention to Improve Adolescents' Physical Activity and Healthy Eating: A Pilot Study. J Sch Nurs 2018; 36:121-134. [PMID: 30068245 DOI: 10.1177/1059840518791290] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
This study evaluated feasibility, acceptability, and preliminary efficacy of a 12-week Guys/Girls Opt for Activities for Life (GOAL) intervention on 10- to 13-year-old adolescents' body mass index (BMI), percent body fat, physical activity (PA), diet quality, and psychosocial perceptions related to PA and healthy eating. Parent-adolescent dyads from two schools were enrolled. Schools were assigned to either GOAL (38 dyads) or control (43 dyads) condition. The intervention included an after-school club for adolescents 2 days/week, parent-adolescent dyad meeting, and parent Facebook group. Intervention adolescents had greater autonomous motivation for PA and self-efficacy for healthy eating than control adolescents (both p < .05). Although between-group differences were not significant, close-to-moderate effect sizes resulted for accelerometer-measured moderate-to-vigorous PA and diet quality measured via 24-hr dietary recall (d = .46 and .44, respectively). A trivial effect size occurred for percent body fat (d = -.10). No differences emerged for BMI. Efficacy testing with a larger sample may be warranted.
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Affiliation(s)
| | - Jiying Ling
- College of Nursing, Michigan State University, East Lansing, MI, USA
| | - Kimberly Clevenger
- Department of Kinesiology, Michigan State University, East Lansing, MI, USA
| | | | | | - Jean M Kerver
- Department of Epidemiology and Biostatistics, Michigan State University, East Lansing, MI, USA
| | - Niko Kaciroti
- Center for Human Growth and Development, University of Michigan, Ann Arbor, MI, USA.,Department of Biostatistics, Center for Computational Medicine and Bioinformatics, University of Michigan, Ann Arbor, MI, USA
| | - Karin A Pfeiffer
- Department of Kinesiology, Michigan State University, East Lansing, MI, USA
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A randomized controlled trial of orthodontist-based brief advice to prevent child obesity. Contemp Clin Trials 2018; 70:53-61. [PMID: 29747047 DOI: 10.1016/j.cct.2018.05.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2018] [Revised: 04/23/2018] [Accepted: 05/02/2018] [Indexed: 11/22/2022]
Abstract
OBJECTIVE We conducted a randomized controlled trial to test whether brief exercise and diet advice provided during child patient visits to their orthodontic office could improve diet, physical activity, and age-and-gender-adjusted BMI. METHODS We enrolled orthodontic offices in Southern California and Tijuana, Mexico, and recruited their patients aged 8-16 to participate in a two-year study. At each office visit, staff provided the children with "prescriptions" for improving diet and exercise behaviors. Multilevel models, which adjusted for clustering, determined differential group effects on health outcomes, and moderation of effects. RESULTS We found differential change in BMI favoring the intervention group, but only among male participants (p < 0.001; Cohen's d = 0.085). Of four dietary variables, only junk food consumption changed differentially, in favor of the intervention group (p = 0.020; d = 0.122); the effect was significant among overweight/obese (p = 0.001; d = 0.335) but not normal weight participants. Physical activity declined non-differentially in both groups and both genders. CONCLUSION The intervention, based on the Geoffrey Rose strategy, had limited success in achieving its aims. IMPLICATIONS Orthodontists can deliver non-dental prevention advice to complement other health-practitioner-delivered advice. Higher fidelity to trial design is needed to adequately test the efficacy of clinician-based brief advice on preventing child obesity and/or reversing obesity.
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Nooijen CFJ, Del Pozo-Cruz B, Nyberg G, Sanders T, Galanti MR, Forsell Y. Are changes in occupational physical activity level compensated by changes in exercise behavior? Eur J Public Health 2018; 28:940-943. [DOI: 10.1093/eurpub/cky007] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Carla F J Nooijen
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
- Department of Physical Activity and Health, The Swedish School of Sport and Health Sciences (GIH), Stockholm, Sweden
| | - Borja Del Pozo-Cruz
- Institute for Positive Psychology and Education, Australian Catholic University, Sydney, Australia
| | - Gisela Nyberg
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
- Centre for Epidemiology and Community Medicine, Stockholm Health Care District, Stockholm, Sweden
| | - Taren Sanders
- Institute for Positive Psychology and Education, Australian Catholic University, Sydney, Australia
| | - Maria R Galanti
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
- Centre for Epidemiology and Community Medicine, Stockholm Health Care District, Stockholm, Sweden
| | - Yvonne Forsell
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
- Centre for Epidemiology and Community Medicine, Stockholm Health Care District, Stockholm, Sweden
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Bidirectional association between weight status and motor skills in adolescents : A 4-year longitudinal study. Wien Klin Wochenschr 2018; 130:314-320. [PMID: 29362883 DOI: 10.1007/s00508-017-1311-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2017] [Accepted: 12/27/2017] [Indexed: 10/18/2022]
Abstract
BACKGROUND Despite considerable efforts the prevalence of overweight and obesity in youth remains high. Poor motor skills have been associated with increased body weight but there is still limited information on the longitudinal association of these health parameters. AIM This study examined the prospective association between motor skills and body weight in 10- to 14-year-old youth. METHODS Body weight, height and motor skills, assessed via the German motor test 16-18 (Deutscher Motorik Test, DMT6-18), were measured in 213 middle school students (57% male) every year over a 4‑year period. Club sports participation and migration status were assessed via a questionnaire. RESULTS Besides an inverse cross-sectional association between body weight and motor skills, excess body weight was associated with impaired development of motor skills (p < 0.05). Furthermore, weight loss was associated with enhanced motor development and allowed previously overweight students to catch up with their normal weight peers. High motor skills at baseline also reduced the odds of becoming overweight/obese during the observation period. These results were independent of club sports participation. CONCLUSION There is a bidirectional, synergistic association between body weight and motor skills. Facilitating the development of motor skills in children and adolescents may therefore be a viable intervention strategy targeting weight management and physical activity in youth.
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