Peer influence and physical activity behavior in young children: an experimental study

Peer influence on eating behaviour in early childhood: A scoping review

OBJECTIVE

Peers can significantly influence eating behaviours in school-aged children and adolescents. Studies vary in methodology and terminology and report inconsistent age and sex differences. No review has collated evidence within early childhood. This review aims to explore what is currently known about peer influence and eating behaviours in young children and identify knowledge gaps regarding commonly assessed eating behaviours, peer definitions, peer influence assessment methods, and theoretical frameworks.

METHODS

A search of electronic databases (Embase, ERIC, Medline, APA PsycInfo, Scopus) was conducted. The review included peer-reviewed, primary research that explored peer influence on eating behaviour in any group context, published between 1980 and 2023, available in English full-text. Participants were aged between two and seven years. Primary and secondary screening were conducted by two authors. Data extraction was conducted by one author with a second author duplicating 25%.

RESULTS

Twenty-six of the 3961 unique identified studies met inclusion criteria. Most studies (76%) report peers to influence eating behaviours. Peer influence was a primary aim in 18 studies, of which 17 were experimental, and peer influence emerged as a finding in seven studies. All phenomena of interest varied widely. Eating behaviour concept definitions were inconsistent, with four studies assessing hypothetical eating behaviours. Peers varied by age, familiarity, and in-person versus remote exposures. Six theoretical frameworks were referenced, and eleven studies lacked theoretical underpinning. No studies measured peer influence directly or obtained children's perspectives.

CONCLUSIONS

Peers may influence eating behaviours within early childhood. Peer familiarity and age potentially impact peer influence magnitude. Variations in study design and peer definitions make comparisons challenging. Future research should utilise observational designs to explore peer influence on child eating behaviours within naturalistic settings.

Intervention Satisfaction and Feasibility of the Active Children Through In-Home, Web-Based Physical Activity (ACTIWEB-PA) Pilot Randomized Controlled Trial in Children

PURPOSE

We assessed feasibility and satisfaction of the Active Children Through In-Home Web-Based Physical Activity pilot trial, delivering a web-based movement integration intervention to children.

METHOD

Eighty-two children (8-11 y), insufficiently active, were randomly assigned to either exercise intervention (n = 41) or wait-list control (n = 41). The intervention involved 20-minute exercise videos, 5 times weekly for 12 weeks, using the UNICEF Kid Power website at home. Feasibility metrics included recruitment (target: 70%), retention (target: 80%), adherence rates, and satisfaction assessed through surveys and interviews. Retention rate-1 was percentage completing posttest surveys, and retention rate-2 was percentage completing posttest accelerometry. Parent logs assessed adherence.

RESULTS

Recruitment, retention-1, and retention-2 rates were 73.6%, 93.9%, and 80.5%, respectively. The intervention group had 5 dropouts; wait-list control had none. Sixty-nine percent showed high intervention adherence. Parents consistently expressed satisfaction, finding the intervention enjoyable and beneficial. Although children initially provided positive reviews, their interest declined over time, with increasing expressions of monotony. Suggestions to increase novelty and incorporate a social component were made by participants. The intervention was also found to be particularly useful during inclement weather.

CONCLUSION

Active Children Through In-Home Web-Based Physical Activity trial exceeded feasibility targets of recruitment and retention and achieved moderate overall adherence. Future trials should emphasize novelty and peer participation for improved adherence and satisfaction.

Teachers' perception on physical activity promotion in kindergarten children in China: a qualitative study connecting social-ecological model

BACKGROUND

Globally, the majority of kindergarten-aged children face obesity issues and insufficient physical activity (PA) engagement. Regular PA participation can provide various health benefits, including obesity reduction, for kindergarten-aged children. However, limited studies have investigated the factors influencing kindergarten-aged children's PA engagement from the perspective of their teachers. This qualitative study aimed to identify factors that could help promote PA among kindergarten-aged children from teachers' perspectives, including facilitators, barriers, and teachers' recommendations.

METHODS

Fifteen kindergarten teachers (age range: 28-50 years; mean age: 38.53 years) with teaching experience ranging from 2 to 31 years (mean: 16.27 years) were recruited from Shanghai municipality, Henan, and Jiangsu provinces in China. One-on-one semi-structured interviews were conducted via face-to-face (n = 7) or telephone (n = 8) to gather insights into factors influencing PA promotion among kindergarten-aged children. The interviews were audio-recorded, transcribed, and analyzed using a constant comparison approach based on grounded theory, which involved open, axial, and selective coding processes.

RESULTS

The study revealed mutual theoretical support between themes and the social-ecological model (SEM), as factors identified in the study are distributed at various levels of the SEM. Twelve factors were identified at four levels of the SEM: (1) intrapersonal level (children's personality and skills), (2) interpersonal level (family, peers, and teachers influence), (3) organizational level (school environment and resources, opportunities for kindergarten teachers' training and children's PA, design and organization of PA, and PA that children need), (4) community level (family-school partnerships).

CONCLUSION

Various factors at different levels can influence kindergarten-aged children's PA. The study's findings revealed that these factors are distributed across the first four levels of SEM, with the majority being at the organizational level. These multilevel findings are expected to assist in developing and implementing more effective PA interventions for kindergarten-aged children. Future research is warranted to identify strategies for promoting PA among kindergarten-aged children at the policy level of the SEM.

Beliefs and Perceptions of Physical Activity Among Black Adolescents in South Florida: A Qualitative Study

INTRODUCTION

In the United States, non-Hispanic Black adolescents have a significantly higher prevalence of obesity than their peers. Though physical activity (PA) has many benefits, many adolescents fail to engage in adequate amounts of PA. Black adolescents are also more sedentary than those from other races and ethnicities. This study aimed to describe the perceptions, beliefs, and barriers to PA in South Florida Black adolescents.

METHODS

Five focus groups were conducted with self-identified non-Hispanic Black adolescents (n = 38) in South Florida. A semi-structured question guide based on the Theory of Planned Behavior was used for group discussions. The open-ended questions addressed adolescents' (1) attitudes and beliefs toward PA, (2) current PA-related behaviors, and (3) environmental, social, cultural, and racial influences on health behaviors.

RESULTS

The desire to be healthy, thoughts of the future, and self-image were among the reasons participants engaged in PA. Engagement in PA was associated with a positive social environment, including encouragement from family and friends. Race, culture, and social media were also cited as influences on PA. Perceived control beliefs, such as parental pressures and self-discipline, also impacted PA.

CONCLUSION

Adolescents recognize the importance of PA; however, their behaviors do not reflect this. Barriers and motivators for Black adolescents are multifaceted. It is critical for Public Health practitioners and local legislators to understand the complexities to serve this population. This study's findings can guide the development of tailored PA and education programs for Black adolescent populations.

Characterization of trajectories of physical activity and cigarette smoking from early adolescence to adulthood

BACKGROUND

Cigarette smoking and physical inactivity are two critical risk factors for noncommunicable diseases and all-cause mortality. However, few studies have compared the long-term trajectories of both behaviors, as well as multilevel factors associated with trajectory patterns. Using the National Longitudinal Study of Adolescent to Adult Health (Add Health) Wave I through V survey data, this study characterized distinct subgroups of the population sharing similar behavioral patterns from adolescence to adulthood, as well as predictors of subgroup membership for physical activity (PA) and cigarette smoking behavior respectively.

METHODS

Using the Add Health Wave I through V survey data, we identified the optimal number of latent classes and class-specific trajectories of PA and cigarette smoking from early adolescence to adulthood, fitting latent growth mixture models with standardized PA score and past 30-day cigarette smoking intensity as outcome measures and age as a continuous time variable. Associations of baseline sociodemographic factors, neighborhood characteristics, and sociopsychological factors with trajectory class membership were assessed using multinomial logistic regression.

RESULTS

We identified three distinct subgroups of non-linear PA trajectories in the study population: moderately active group (N = 1067, 5%), persistently inactive group (N = 14,257, 69%) and worsening activity group (N = 5410, 26%). Foror cigarette smoking, we identified three distinct non-linear trajectory subgroups: persistent non-smoker (N = 14,939, 72%), gradual quitter (N = 2357, 11%), and progressing smoker (N = 3393, 16%). Sex, race/ethnicity, neighborhood environment and perceived peer support during adolescence were significant predictors of both physical activity and cigarette smoking trajectory subgroup membership from early adolescence to adulthood.

CONCLUSIONS

There are three distinct subgroups of individuals sharing similar PA and cigarette smoking behavioral profile respectively from adolescence to adulthood in the Add Health study population. Behavioral interventions that focus on neighborhood environment (e.g. establish community-based activity center) and relationship to peers during adolescence (e.g. peer counseling) could be key to long-term PA promotion and cigarette smoking cessation.

The Impact of the Built Environment and Social Environment on Physical Activity: A Scoping Review

This scoping review aims to provide an overview of the current state of physical activity research, focusing on the interplay between built and social environments and their respective influences on physical activity. We comprehensively searched electronic databases to identify relevant studies published between 2000 and 2022. A total of 35 articles have been reviewed based on the research question. The review found that built and social environments influence physical activity, and consideration of people's perceptions of their surroundings can provide further insight. The literature was summarized, and recommendations were made for future research. Findings suggest that interventions targeting built and social environments can promote physical activity effectively. However, limitations in the literature exist, including a need for more standardization in research methods and consistency in measurement tools.

Children's Physical Activity during COVID-19 in Ontario, Canada: Parents' Perspectives

The COVID-19 pandemic has had a large influence on children's physical activity (i.e., play and sport) opportunities. The purpose of this study was to describe parents' perspectives of their children's (ages 0-12) physical activity experiences during the pandemic (i.e., since the onset in March 2020 until follow-up survey completion date [between August to December 2021]). As part of the 'Return to Play' study conducted in Ontario, Canada, two-parent report surveys were completed online via Qualtrics. Surveys measured parents' perspectives regarding their children's physical activity since the onset of the pandemic (n = 17 items) and collected demographic information (n = 16 items). Open-ended questions were included to gather a rich understanding of parents' experiences (i.e., supports, challenges) with facilitating their children's physical activity. Descriptive statistics were calculated to describe parents' perspectives of their children's physical activity experiences and to determine parent demographics. Open-ended questions were analyzed via deductive content analysis. Parents (n = 382) reported that they noticed behavior changes in their children because of the pandemic (65.9%), and most (73.7%) reported challenges with supporting their children's activity during periods when public health measures were in place. Many parents (44.5%) stated that their children asked about returning to play/sport more than three times per week during periods when play/sport facilities were closed in Ontario. Qualitative data identified common supports parents used (e.g., getting active outdoors, forming mini social 'bubbles'), and challenges they faced (e.g., work, children's increased screen time, and home schooling), pertaining to their children's physical activity.

Effectiveness of 3D-printed models prepared from radiological data for anatomy education: A meta-analysis and trial sequential analysis of 22 randomized, controlled, crossover trials

BACKGROUND

Many academicians suggested the supplementary use of 3D-printed models reconstructed from radiological images for optimal anatomy education. 3D-printed model is newer technology available to us. The purpose of this systematic review was to capture the usefulness or effectiveness of this newer technology in anatomy education.

MATERIALS AND METHODS

Twenty-two studies met the inclusion and exclusion criteria for quantitative synthesis. The included studies were sub-grouped according to the interventions and participants. No restrictions were applied based on geographical location, language and publication years. Randomized, controlled trial, cross-sectional and cross-over designs were included. The effect size of each intervention in both participants was computed as a standardized mean difference (SMD).

RESULTS

Twenty-two randomized, controlled trials were included for quantitative estimation of effect size of knowledge acquisition as standardized mean difference in 1435 participants. The pooled effect size for 3D-printed model was 0.77 (0.45-1.09, 95% CI, P < 0.0001) with 86% heterogeneity. The accuracy score was measured in only three studies and estimated effect size was 2.81 (1.08-4.54, 95% CI, P = 0.001) with 92% heterogeneity. The satisfaction score was examined by questionnaire in 6 studies. The estimated effect size was 2.00 (0.69-3.32, 95% CI, P = 0.003) with significant heterogeneity.

CONCLUSION

The participants exposed to the 3D-printed model performed better than participants who used traditional methodologies. Thus, the 3D-printed model is a potential tool for anatomy education.

Parents' Attitudes Regarding Their Children's Play and Sport During COVID-19

The COVID-19 pandemic and associated public health measures have interrupted the daily routines of parents and children. The purpose of this study was to explore parents' attitudes regarding their children's play/sport during COVID-19. A secondary objective was to explore the influence of parent demographics and parent-reported physical activity levels and risk tolerance on these attitudes. Ontario parents of children aged 12 and younger completed an online survey (August-December 2020) that assessed their attitudes (grouped by support, safety and socialization-related attitudes; n = 14 items) regarding their child(ren)'s play/sport, their physical activity levels (n = 2 items), and demographic details (n = 16 items). Two open-ended items were used to gather a deeper understanding of attitudes. Parents' tolerance for risk was measured via the validated Tolerance of Risk in Play Scale. Descriptive statistics were calculated to describe attitudes and risk tolerance. Least Absolute Shrinkage and Selection Operator regressions were conducted to examine factors influencing parents' attitudes. Multiple linear models were computed using the identified predictors for each attitude category. Deductive content analysis was undertaken on open-ended responses. Participants (n = 819) reported the highest scores for safety-related attitude items (M = 3.54, SD = .63) followed by socialization and support, which all influenced attitudes regarding children's play/sport (p < .05). Demographics and parents' physical activity levels were identified as important predictors of parents' attitudes. Qualitative data revealed that parents had mixed levels of comfort with respect to their children's return to play/sport. Findings from this study reveal that increased support is needed to guide future play/sport decision-making.

Prediction Model for Physical Activity Level in Primary School Students

The aim of this study was to provide an explanatory prediction model for physical activity level in children, involving a number of influencing variables. In total, 1971 people participated in the study: 657 primary school students and their respective fathers and mothers from 15 schools of Galicia (Spain). The International Questionnaire on Physical Education, Health and Lifestyle was administered. The findings revealed that school year, sex, physical perceived competence and sport practice with friends had a statistically significant relationship on physical activity index. By contrast, the association between the weekly participation of fathers or mothers in sports in the practice of children could not be confirmed. Sport practice with friends was the main predicting variable for physical activity level. Physical perceived competence showed great relevance as well. This knowledge could be of interest to help increase adherence to practice and preventing withdrawal, helping students to stay active and acquire healthy habits for the future.

Children and parents' perspectives of the impact of the COVID-19 pandemic on Ontario children's physical activity, play, and sport behaviours

Background

The COVID-19 pandemic and associated public health measures have resulted in the closure of many physical activity-supporting facilities. This study examined Ontario parents’ and children’s perspectives of COVID-19’s impact on children’s physical activity behaviours, return to play/sport during COVID-19, as well as barriers/facilitators to getting active amid extended closures of physical activity venues.

Methods

Parents/guardians of children aged 12 years and under living in Ontario, Canada were invited to participate in an interview. 12 parent/guardian and 9 child interviews were conducted via Zoom between December 2020 – January 2021, were audio-recorded, and transcribed verbatim. Thematic content analysis was undertaken to identify pronounced themes.

Results

Themes for both parent and child interviews fell into one of three categories: 1) barriers and facilitators for getting children active amid COVID-19 closures of physical activity-supporting facilities; 2) changes in children’s activity levels; and, 3) perspectives on return to play/sport during and post-pandemic. Various subthemes were identified and varied between parents and children. The most common facilitator for dealing with children’s inactivity voiced by parents/guardians was getting active outdoors. Parents/guardians noted their willingness to have their children return to play/sport in the community once deemed safe by public health guidelines, and children’s willingness to return stemmed primarily from missing their friends and other important authority figures (e.g., coaches) and sporting events (e.g., tournaments).

Conclusions

Findings from this study could inform families of feasible and realistic strategies for increasing children’s physical activity during community closures, while also providing public health experts with information regarding what supports, or infrastructure might be needed during future lockdown periods and/or pandemics.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-021-12344-w.

The Experimental Effect of Parental Attentiveness on Children’s Physical Activity Behavior

OBJECTIVES To assess children’s physical and sedentary activity behavior, enjoyment (i.e., liking), and preference during two separate experimental conditions: parent attentive and parent non-attentive.METHODS Ten children (n = 6 boys, 4 girls), 3 to 6 years old, along with one parent (n = 6 mothers, 4 fathers) per child participated in each condition on separate days for 30-minutes in which they could choose from a variety of physical and/or sedentary activities.RESULTS A greater number of accelerometer counts (p = 0.04) were accumulated during the parent attentive (96,547 ± 33,075.26 counts) condition than the parent non-attentive (48,316.30 ± 46,101.47 counts) condition. More time (p = 0.007) was allocated to sedentary activities during the parent non-attentive (19.5 ± 13.3 minutes) condition than parent attentive (2.8 ± 3.55 minutes) condition. Children liked (p = 0.004) the parent attentive (9.05 ± 1.21 cm) condition more than parent non-attentive (4.42 ± 3.18 cm) condition. A non-significant (p = 0.21) proportion of children identified the parent attentive (70%) as their preferred condition over the parent non-attentive condition.CONCLUSIONS Parental attentiveness may be an important component to take into consideration when trying to maximize children’s physical activity behavior and enjoyment while simultaneously reducing sedentary behavior.

Peer Presence Effect on Numerosity and Phonological Comparisons in 4th Graders: When Working with a SchoolMate Makes Children More Adult-like

Simple Summary

The presence of others helps us when we are good or an expert at something and hinders us when we are bad or novice. Such social facilitation or inhibition is well-documented in adults, but much less in children despite the omnipresence of peers throughout education. To explore potential peer presence effects on children’s academic performance, fourth-graders performed basic numerical and language skills (typically mastered at their age) either alone or with a schoolmate. For comparison, the same was performed in adults. We found that a schoolmate’s presence enabled children to perform more like adults, with a better response strategy and faster and less variable response times than children tested alone. This provides research-based evidence supporting pedagogical methods promoting collective practice of individually acquired knowledge. Future studies pursuing this hitherto neglected developmental exploration of peer presence effects on academic achievements might have the potential to help educators tailor their pedagogical choices to maximize peer presence when beneficial and minimize it when harmful. The present study also paves the way towards a neuroimaging investigation of how peer presence changes the way the child brain processes cognitive tasks relevant to education.

Abstract

Little is known about how peers’ mere presence may, in itself, affect academic learning and achievement. The present study addresses this issue by exploring whether and how the presence of a familiar peer affects performance in a task assessing basic numeracy and literacy skills: numerosity and phonological comparisons. We tested 99 fourth-graders either alone or with a classmate. Ninety-seven college-aged young adults were also tested on the same task, either alone or with a familiar peer. Peer presence yielded a reaction time (RT) speedup in children, and this social facilitation was at least as important as that seen in adults. RT distribution analyses indicated that the presence of a familiar peer promotes the emergence of adult-like features in children. This included shorter and less variable reaction times (confirmed by an ex-Gaussian analysis), increased use of an optimal response strategy, and, based on Ratcliff’s diffusion model, speeded up nondecision (memory and/or motor) processes. Peer presence thus allowed children to at least narrow (for demanding phonological comparisons), and at best, virtually fill in (for unchallenging numerosity comparisons) the developmental gap separating them from adult levels of performance. These findings confirm the influence of peer presence on skills relevant to education and lay the groundwork for exploring how the brain mechanisms mediating this fundamental social influence evolve during development.

Impact of Activity Monitoring on Physical Activity, Sedentary Behavior, and Body Weight during the COVID-19 Pandemic

Decreases in individuals' physical activity and increases in sedentary behavior and bodyweight have been reported during the COVID-19 pandemic. The present study assessed the ability of physical activity monitoring, which may promote physical activity and discourage sedentary behavior, to mitigate these negative outcomes. An evaluation of university samples (N = 404, 40.5 ± 15.4 years) of self-reported physical activity, sedentary behavior, and bodyweight prior to the closure of campus due to the pandemic in March of 2020 and again at the time of the survey administration (May-June 2020) during pandemic-related restrictions was performed. Participants also reported whether they did (n = 172) or did not (n = 232) regularly use physical activity monitoring technology. While physical activity was unchanged during the pandemic (p ≥ 0.15), participants significantly increased sitting by 67.8 ± 156.6 min/day and gained 0.64 ± 3.5 kg from pre-campus to post-campus closure (p < 0.001). However, the use of activity monitoring did not moderate these changes. In conclusion, while physical activity was not affected, participants reported significant increases in sedentary behavior and bodyweight during the COVID-19 pandemic. These changes occurred regardless of whether participants regularly used physical activity monitoring or not.

The Experimental Effect of Parent Versus Peer Influence on Children's Physical Activity and Sedentary Behavior

PURPOSE

To assess children's physical activity, sedentary behavior, liking, and motivation during 3 separate simulated recess conditions: playing alone, with their parent participating, and with their peer participating.

METHODS

Children participated in the 3 separate conditions. During each condition, the children had access to an outdoor playground and sedentary activity options for 30 minutes. Accelerometry recorded the physical activity. Time allocated to sedentary options was monitored via a stopwatch. A visual analog scale was used to assess liking, and motivation was assessed as the children's willingness to participate in an additional 10 minutes of each condition.

RESULTS

The children sat 88% less and were 33% more physically active with their peer versus playing alone. The children also sat 65% less during the parent condition than alone. Lastly, the children reported ≥34% liking and were ≥2-fold more likely to participate in the additional 10-minute activity bout during the parent and peer conditions than alone. The differences were significant (P ≤ .05) except for the children's decision to participate in the additional 10 minutes in the parent versus the alone condition (P = .058).

CONCLUSIONS

Relative to the alone condition, the presence of a peer or parent reduced sedentary behavior and increased liking and the motivation to participate in that condition. However, only the presence of a peer increased physical activity versus alone.

Siblings' Influence on the Motor Competence of Preschoolers

The number of single-child families has been rising steadily in recent years, resulting in a childhood absent of sibling relationships. Being an only child has been shown to have a negative impact on physical fitness, somatic fitness, and motor development. In this study, we aimed to understand how living with and without siblings can impact the motor competence of children. One hundred and sixty-one children (87 boys, 74 girls) from 3.0 to 6.0 years of age (34 only children, 125 siblings) and with no known motor or cognitive disability were assessed using the Motor Competence Assessment (MCA). Their standardized results on the three MCA subscales (stability, locomotor, and manipulative) and total MCA were used to group them into high, average, and low motor competence groups. Motor competence percentile distribution of the sibling and only child group condition was compared using chi-square tests. Results showed a significative and positive association between the sibling condition and the distribution between the three MC groups (chi-square = 6.29; p = 0.043), showing that children in a household with siblings, independent of their age and sex, show a clear tendency for developing better motor competence.

VO2, Liking, and Relative Reinforcing Value of Cooperative and Competitive Exergame Play in Young Children

The purpose of the current study was to examine physiologic response, liking, and relative reinforcing value (RRV) of children playing an exergame with a friend under two goal structures: competitive and cooperative. A sample of twenty participants (8.7 ± 1.3 years old) and a self-selected friend completed three conditions: rest, competitive, and cooperative play. During the competitive condition, participants played Nintendo Wii Tennis® against their friend. During cooperative play, participants and their friend played together against a computer avatar. During each condition, oxygen consumption (VO₂, ml·kg-1·min-1) and liking (visual analog scale) were recorded. After finishing all conditions, children completed an RRV computer task to assess their motivation to play the competitive versus cooperative goal structures. During this task children performed work (button presses) to participate in additional competitive play, cooperative play, or a combination. The output maximum (Omax), or maximum work for each goal structure, was used as the measure of RRV. It was determined that VO₂ was significantly (p ≤ 0.001) greater for cooperative and competitive play than rest. Liking was significantly greater for cooperative play than rest (p ≤ 0.001) and competitive play (p = 0.03). There were no significant differences (p > 0.05) between cooperative and competitive play for VO₂ or Omax. In conclusion, while liking was greater for the cooperative condition versus competitive, motivation did not differ between goal structures. Further investigation into methods of making physical activity more reinforcing, in addition to well-liked by children, is necessary to optimize this behavior.

The Acute Effects of the COVID-19 Pandemic on Physical Activity and Sedentary Behavior in University Students and Employees

The COVID-19 pandemic has closed non-essential businesses which may alter individuals' leisure behaviors. Consequently, physical activity and sedentary behavior may be negatively impacted as many fitness and recreational centers have been closed. This study aimed to examine the impact of the pandemic on physical activity and sedentary behavior in a sample of university students and employees before and after the university cancelled face-to-face classes and closed campus. Participants (N = 398) completed the validated Godin physical activity questionnaire and the International Physical Activity Questionnaire which assessed physical activity and sedentary behavior pre- and post-cancellation of face-to-face classes. Participants were also separated in the groups (low, moderate, high physical activity) based upon a tertile split of pre-pandemic total physical activity. Physical activity group by time ANOVAs were used to assess potential changes in total physical activity and sedentary behavior. Post-cancellation sedentary behavior was greater (F (1, 388) = 9.2, p = 0.003, partial η2 = 0.032) than pre-cancellation. Physical activity group moderated (F (2, 395) = 22.0, p < 0.001, partial η2 ≥ 0.10) changes in total physical activity from pre- to post cancellation. The high activity group decreased physical activity whereas the moderate and low activity groups increased physical activity (t ≥ 2.4, p ≤ 0.02, Cohen's d = 0.23). While the university closure increased sedentary behavior across the sample, it only decreased physical activity in participants who were the most active pre-cancellation. Pandemic-related closure of facilities designed for physical activity may disproportionately impact active individuals.

Socioeconomic and Familial Factors Associated with Gross Motor Skills among US Children Aged 3-5 Years: The 2012 NHANES National Youth Fitness Survey

The first aim of this study was to examine the prevalence of below average gross motor skills in a representative sample of US children aged 3 to 5 years. The second aim was to identify socioeconomic and familial characteristics that are associated with below average gross motor skills. Secondary analysis was conducted using the datasets from the 2012 National Health and Examination Survey National Youth Fitness Survey (NNYFS). The NNYFS assessed gross motor skills among 329 children aged 3-5 years, using the Test of Gross Motor Development-Second Edition (TGMD-2). Socioeconomic and familial characteristics of interest, such as family income and family structure, were asked in an in-person interview. This study estimated that one in three US children age 3 to 5 years old (33.9%) scored below average for gross motor quotient. In the gross motor subsets, one in four (24.4%) scored below average for locomotion and two in five (39.9%) scored below average for object control. Children living below the poverty threshold were more likely to have a higher gross motor quotient (odds ratio, OR = 2.76; 95% confidence interval, CI = 1.09-7.00). Girls were more likely to have a higher locomotor score (OR = 2.17; 95% CI = 1.10-4.25). Those living with other child(ren) aged ≤5 years were more likely to have a higher locomotor score (OR = 2.36; 95% CI = 1.01-5.54), while those living with child(ren) aged 6-17 years were more likely to have a higher object control score (OR = 1.83; 95% CI = 1.24-2.69). This study revealed risk factors associated with poor gross motor development, furthering our understanding of gross motor development in early childhood.

Modifiable factors which predict children's gross motor competence: a prospective cohort study

BACKGROUND

Fundamental motor skills (FMS) are important for physical activity and healthy weight status in children, yet it is unclear which early childhood factors facilitate subsequent motor skill. The aim of this prospective study was to investigate which modifiable family and home environment factors in the early years predict children's FMS at age five.

METHODS

Mothers from the Melbourne InFANT program (registered with the International Standard Randomised Controlled Trial Number Register (ISRCTN81847050)) completed questionnaires when child was aged 4, 9, 19 months old, and 3.5 years old on factors hypothesised to predict motor skills. Some factors were grouped in tertiles (high, medium, low) due to the nature of the distribution. At 5 years old children were assessed on 6 locomotor and 6 object control skills (Test of Gross Motor Development-2). Eight regression models examined the association between factors at each time-point and children's skills (object control and locomotor) at 5 years old.

RESULTS

The sample varied by time-point (178 to 259 children). Maternal physical activity optimism (4 months; β = 2.43), home physical activity equipment (9 months; β = 0.82), time outdoors - middle (9 months; β = 2.50) and highest tertile (9 months; β = 2.86), time free to move about - highest tertile (19 months; β = 2.41), time with older children - middle (19 months; β = 3.15) and highest tertile (3.5 years; β = 3.00) were predictive of better locomotor scores. Mothers' own physical activity (9 months; β = - 0.01) and time active with mum - highest tertile (3.5 years; β = - 3.73) were negatively associated with locomotor skill. Time with older children - highest (4 months; β = 2.27) and middle tertile (19 months; β = 2.97), time free to move about - middle (19 months; β = 2.55) and highest tertile (19 months; β = 2.47), and more home equipment (9 months; β = 0.83); (3.5 years; β = 0.17) were predictive of better object control skills. Maternal physical activity knowledge (3.5 years; β = - 3.05) was negatively associated with object control skill.

CONCLUSIONS

Providing a supportive environment with older children and equipment, and allowing toddlers' freedom to move, appears important. Opportunities exist to educate parents on their important role in developing children's motor skills. Clinicians could advise parents that the home environment can make a difference to their child's FMS starting from infancy.

Social Support and Modelling in Relation to Physical Activity Participation and Outdoor Play in Preschool Children

Physical activity during early childhood is a prerequisite for healthy development in many cases. The aim of this study was to assess the relationships of social modelling and support from parents, peers, and siblings and domain-specific physical activity participation in a nationwide sample of preschool boys and girls from Germany. 519 preschool children aged 4-6 and one of their parents participated in the 'MoMo' Wave 1 Study between 2009 and 2012. Participants and their parents provided self-reported data on social support modelling, and domain-specific physical activity participation (physical activity in sports clubs, physical activity outside of sports clubs, and outdoor play). Parental, peer, and sibling support and modelling were related to domain-specific physical activity: Parental support was particularly relevant for physical activity in sports clubs, and peer support for outdoor play. Parental modelling was only related to physical activity outside of sports clubs: Maternal modelling was a positive correlate in girls and paternal modelling in boys, respectively. Sibling and peer modelling were especially relevant for physical activity in sports clubs. The results were heterogeneous regarding types and providers of support and modelling. Thus, different providers and types of support should be targeted in physical activity promotion programs for preschool children.

Obese Peers' Influence on Students' BMI: Heterogeneity in Race and Sex

Objectives

In this study, we investigate peer influence on obesity, with a focus on race and sex.

Methods

We conducted econometric analysis of longitudinal health data of 277,566 public school students, ages 5-13 years.

Results

A percentage point increase in the proportion of obese students within the same grade increased a student's BMI z-scores by about 4 one-thousandths of a standard deviation. On racial peers, the standard deviation increase in BMI z-score is 3.9 one-thousandths for Hispanics or Caucasians and 4.9 one-thousandths for African Americans. Influence of obese peers is nearly identical for boys and girls.

Conclusions

Such a small magnitude of obese peers' estimate suggests that classroom peers do not play a substantial role in weight gain or loss in elementary schools.

Understanding Youths' Ability to Interpret 3D-Printed Physical Activity Data and Identify Associated Intensity Levels: Mixed-Methods Study

Background

A significant proportion of youth in the United Kingdom fail to meet the recommended 60 minutes of moderate-to-vigorous physical activity every day. One of the major barriers encountered in achieving these physical activity recommendations is the perceived difficulty for youths to interpret physical activity intensity levels and apply them to everyday activities. Personalized physical activity feedback is an important method to educate youths about behaviors and associated outcomes. Recent advances in 3D printing have enabled novel ways of representing physical activity levels through personalized tangible feedback to enhance youths’ understanding of concepts and make data more available in the everyday physical environment rather than on screen.

Objective

The purpose of this research was to elicit youths’ (children and adolescents) interpretations of two age-specific 3D models displaying physical activity and to assess their ability to appropriately align activities to the respective intensity.

Methods

Twelve primary school children (9 boys; mean age 7.8 years; SD 0.4 years) and 12 secondary school adolescents (6 boys; mean age 14.1 years; SD 0.3 years) participated in individual semistructured interviews. Interview questions, in combination with two interactive tasks, focused on youths’ ability to correctly identify physical activity intensities and interpret an age-specific 3D model. Interviews were transcribed verbatim, content was analyzed, and outcomes were represented via tables and diagrammatic pen profiles.

Results

Youths, irrespective of age, demonstrated a poor ability to define moderate-intensity activities. Moreover, children and adolescents demonstrated difficulty in correctly identifying light- and vigorous-intensity activities, respectively. Although youths were able to correctly interpret different components of the age-specific 3D models, children struggled to differentiate physical activity intensities represented in the models.

Conclusions

These findings support the potential use of age-specific 3D models of physical activity to enhance youths’ understanding of the recommended guidelines and associated intensities.

Perceptions of Visualizing Physical Activity as a 3D-Printed Object: Formative Study

Background

The UK government recommends that children engage in moderate-to-vigorous physical activity for at least 60 min every day. Despite associated physiological and psychosocial benefits of physical activity, many youth fail to meet these guidelines partly due to sedentary screen-based pursuits displacing active behaviors. However, technological advances such as 3D printing have enabled innovative methods of visualizing and conceptualizing physical activity as a tangible output.

Objective

The aim of this study was to elicit children’s, adolescents’, parents’, and teachers’ perceptions and understanding of 3D physical activity objects to inform the design of future 3D models of physical activity.

Methods

A total of 28 primary school children (aged 8.4 [SD 0.3] years; 15 boys) and 42 secondary school adolescents (aged 14.4 [SD 0.3] years; 22 boys) participated in semistructured focus groups, with individual interviews conducted with 8 teachers (2 male) and 7 parents (2 male). Questions addressed understanding of the physical activity guidelines, 3D model design, and both motivation for and potential engagement with a 3D physical activity model intervention. Pupils were asked to use Play-Doh to create and describe a model that could represent their physical activity levels (PAL). Data were transcribed verbatim and thematically analyzed, and key emergent themes were represented using pen profiles.

Results

Pupils understood the concept of visualizing physical activity as a 3D object, although adolescents were able to better analyze and critique differences between low and high PAL. Both youths and adults preferred a 3D model representing a week of physical activity data when compared with other temporal representations. Furthermore, all participants highlighted that 3D models could act as a motivational tool to enhance youths’ physical activity. From the Play-Doh designs, 2 key themes were identified by pupils, with preferences indicated for models of abstract representations of physical activity or bar charts depicting physical activity, respectively.

Conclusions

These novel findings highlight the potential utility of 3D objects of physical activity as a mechanism to enhance children’s and adolescents’ understanding of, and motivation to increase, their PAL. This study suggests that 3D printing may offer a unique strategy for promoting physical activity in these groups.

Association Between Self-Reported and Objective Activity Levels by Demographic Factors: Ecological Momentary Assessment Study in Children

BACKGROUND

To address the limitations of the retrospective self-reports of activity, such as its susceptibility to recall bias, researchers have shifted toward collecting real-time activity data on mobile devices via ecological momentary assessment (EMA). Although EMA is becoming increasingly common, it is not known how EMA self-reports of physical activity and sedentary behaviors relate to the objective measures of activity or whether there are factors that may influence the strength of association between these two measures. Understanding the relationship between EMA and accelerometry can optimize future instrument selection in studies assessing activity and health outcomes.

OBJECTIVE

The aim of this study was to examine the associations between EMA-reported sports or exercise using the accelerometer-measured moderate-to-vigorous physical activity (MVPA) and EMA-reported TV, videos, or video games with the accelerometer-measured sedentary time (ST) in children during matched 2-h windows and test potential moderators.

METHODS

Children (N=192; mean age 9.6 years; 94/192, 49.0% male; 104/192, 54.2% Hispanic; and 73/192, 38.0% overweight or obese) wore an accelerometer and completed up to 7 EMA prompts per day for 8 days during nonschool time, reporting on past 2-h sports or exercise and TV, videos, or video games. Multilevel models were used to assess the relationship between the accelerometer-measured ST and EMA-reported TV, videos, or video games. Given the zero-inflated distribution of MVPA, 2-part models were used assess the relationship between the accelerometer-measured MVPA and EMA-reported sports or exercise.

RESULTS

EMA-reported TV, videos, or video games were associated with a greater accelerometer-measured ST (beta=7.3, 95% CI 5.5 to 9.0, P<.001). This relationship was stronger in boys (beta=9.9, 95% CI 7.2 to 12.6, P<.001) than that in girls (beta=4.9, 95% CI 2.6 to 7.2, P≤.001). EMA-reported sports or exercise was associated with a greater accelerometer-measured MVPA (zero portion P<.001; positive portion P<.001). This relationship was stronger on weekends, in older children, and in non-Hispanic children (zero portion all P values<.001; positive portion all P values<.001).

CONCLUSIONS

EMA reports highly relate to accelerometer measures. However, the differences in the strength of association depending on various demographic characteristics suggest that future research should use both EMA and accelerometers to measure activity to collect complementary activity data.

Comparison of Path Length and Ranges of Movement of the Center of Pressure and Reaction Time and Between Paired-Play and Solo-Play of a Virtual Reality Game

AIMS

To test whether paired-play will induce longer path length and ranges of movement of the center of pressure (COP), which reflects on balance performance and stability, compared to solo-play and to test the difference in the path length and ranges of movement of the COP while playing the virtual reality (VR) game with the dominant hand compared to playing it with the nondominant hand.

METHODS

In this cross-sectional study 20 children (age 6.1 ± 0.7 years old) played an arm movement controlled VR game alone and with a peer while each of them stood on a pressure measuring pad to track the path length and ranges of movement of the COP.

RESULTS

The total COP path was significantly higher during the paired-play (median 295.8 cm) compared to the COP path during the solo-play (median 189.2 cm). No significant differences were found in the reaction time and the mediolateral and anterior-posterior COP ranges between solo-play and paired-play. No significant differences were found between the parameters extracted during paired-play with the dominant or nondominant hand.

DISCUSSION

Our findings imply that the paired-play is advantageous compared to solo-play since it induces a greater movement for the child, during which, higher COP velocities are reached that may contribute to improving the balance control of the child. Apart from the positive social benefits of paired-play, this positive effect on the COP path length is a noteworthy added value in the clinical setting when treating children with balance disorder.

The social context moderates the relationship between neighborhood safety and adolescents' activities

Studies of neighborhood safety and physical activity have typically neglected to consider the youth's peer context as a modifier of these relationships. This study fills this gap in testing the independent and interactive effects of perceived neighborhood safety and time spent with friends and peers on young adolescents' physical activity and sedentary behavior. Participants (N = 80; ages 13-17) completed the Pedestrian/Traffic Safety and Crime Safety subscales of the adolescent version of the Neighborhood Environment Walkability Scale (NEWS). An experience sampling methodology was used to assess sedentary behaviors/screen time and the social context in which physical activity and sedentary time/behavior occurred. Physical activity was assessed via accelerometry. Multilevel models were used to estimate the relationships between predictors (neighborhood safety and social context) and outcomes (physical activity and sedentary time/behavior). Frequency of peer/friend interactions moderated the relationships between neighborhood safety and adolescents' physical activity and sedentary behavior. Specifically, physical activity was more strongly influenced by neighborhood safety among adolescents who reported spending less time with peers and friends than among those who reported frequent peer interactions. Among youths who perceived that their neighborhoods were safer, spending more time with friends and peers was related to greater engagement in sedentary activities, whereas this was not the case among adolescents who perceived that their neighborhoods were less safe. The peer social context moderates the relationship between perceived neighborhood safety and adolescents' physical activity and sedentary behavior. Improving social interactions at the individual level within neighborhoods may decrease concerns of safety.

"Monkey see, monkey do": Peers' behaviors predict preschoolers' physical activity and dietary intake in childcare centers

Preschoolers observe and imitate the behaviors of those who are similar to them. Therefore, peers may be role models for preschoolers' dietary intake and physical activity in childcare centers. This study examined whether peers' behaviors predict change in preschoolers' dietary intake and physical activity in childcare centers over 9months. A total of 238 preschoolers (3 to 5years old) from 23 childcare centers in two Canadian provinces provided data at the beginning (October 2013 and 2014) and the end (June 2014 and 2015) of a 9-month period for this longitudinal study. Dietary intake was collected at lunch using weighed plate waste and digital photography on two consecutive weekdays. Physical activity was assessed using accelerometers over five days. Multilevel linear regressions were used to estimate the influence of peers' behaviors on preschoolers' change in dietary intake and physical activity over 9months. Results showed that preschoolers whose dietary intake or physical activity level deviated the most from those of their peers at the beginning of the year demonstrated greater change in their intakes and activity levels over 9months, which enabled them to become more similar to their peers (all β 95% CI ranged from -0.835 to -0.074). This study suggests that preschoolers' dietary intake and physical activity may be influenced by the behaviors of their peers in childcare centers. Since peers could play an important role in promoting healthy eating behaviors and physical activity in childcare centers, future studies should test interventions based on positive role modeling by children.

Physical Activity During the Early Years: A Systematic Review of Correlates and Determinants

CONTEXT

Being physically active during the early years (age 0-6 years) is vital for healthy development. Identifying correlates and determinants of physical activity (PA) is crucial to guide effective interventions. This systematic review synthesized studies investigating potential correlates and determinants of PA during the early years, accounting for different types of PA assessment.

EVIDENCE ACQUISITION

Nine electronic databases were searched from inception year (1900) until September 2014; data were analyzed/interpreted in April 2015. The following inclusion criteria were used: written in English, published in peer-reviewed journals, participants not in statutory/school education, and an observational design investigating associations between an exposure/variable, and a quantitative measure of PA. Correlates/determinants of total, moderate to vigorous, and light PA were reported using an ecologic model.

EVIDENCE SYNTHESIS

Of 22,045 identified studies, 130 were included. All took place in high-income countries and few (6%) were of high quality. Correlates of total PA were sex (male, ++); parental PA (+); parental support (+); and time outdoors (+). Determinants of total PA were sex (+) and time spent playing with parents (+). The only correlate of moderate to vigorous PA was sex (male, ++). No determinants of moderate to vigorous or light PA were found. PA correlates/determinants were relatively consistent between objective and subjective PA measures.

CONCLUSIONS

Numerous studies investigated potential correlates and determinants of PA, but overall quality was low. A small number of demographic/biological and social/cultural factors were associated with PA. There is a need for high-quality studies exploring correlates/determinants across all domains of the ecologic model.

Social influences on eating and physical activity behaviours of urban, minority youths

OBJECTIVE

Social relationships can impact youths' eating and physical activity behaviours; however, the best strategies for intervening in the social environment are unknown. The objectives of the present study were to provide in-depth information on the social roles that youths' parents and friends play related to eating and physical activity behaviours and to explore the impact of other social relationships on youths' eating and physical activity behaviours.

DESIGN

Convergent parallel mixed-methods design.

SETTING

Low-income, African American, food desert neighbourhoods in Baltimore City, MD, USA.

SUBJECTS

Data were collected from 297 youths (53 % female, 91 % African American, mean age 12·3 (sd 1·5) years) using structured questionnaires and combined with in-depth interviews from thirty-eight youths (42 % female, 97 % African American, mean age 11·4 (sd 1·5) years) and ten parents (80 % female, 50 % single heads of house, 100 % African American).

RESULTS

Combined interpretation of the results found that parents and caregivers have multiple, dynamic roles influencing youths' eating and physical activity behaviours, such as creating health-promoting rules, managing the home food environment and serving as a role model for physical activity. Other social relationships have specific, but limited roles. For example, friends served as partners for physical activity, aunts provided exposure to novel food experiences, and teachers and doctors provided information related to eating and physical activity.

CONCLUSIONS

Obesity prevention programmes should consider minority youths' perceptions of social roles when designing interventions. Specifically, future research is needed to test the effectiveness of intervention strategies that enhance or expand the supportive roles played by social relationships.

Movement Synchrony Forges Social Bonds across Group Divides

Group dynamics play an important role in the social interactions of both children and adults. A large amount of research has shown that merely being allocated to arbitrarily defined groups can evoke disproportionately positive attitudes toward one's in-group and negative attitudes toward out-groups, and that these biases emerge in early childhood. This prompts important empirical questions with far-reaching theoretical and applied significance. How robust are these inter-group biases? Can biases be mitigated by behaviors known to bond individuals and groups together? How can bonds be forged across existing group divides? To explore these questions, we examined the bonding effects of interpersonal synchrony on minimally constructed groups in a controlled experiment. In-group and out-group bonding were assessed using questionnaires administered before and after a task in which groups performed movements either synchronously or non-synchronously in a between-participants design. We also developed an implicit behavioral measure, the Island Game, in which physical proximity was used as an indirect measure of interpersonal closeness. Self-report and behavioral measures showed increased bonding between groups after synchronous movement. Bonding with the out-group was significantly higher in the condition in which movements were performed synchronously than when movements were performed non-synchronously between groups. The findings are discussed in terms of their importance for the developmental social psychology of group dynamics as well as their implications for applied intervention programs.

Meals of differing caloric content do not alter physical activity behavior during a subsequent simulated recess period in children

OBJECTIVE

Research on adults and animals has demonstrated that chronic and acute overfeeding can alter physical activity behavior. However, there are no assessments of the acute effects of high-calorie (HC) meals on physical activity behavior in children. This is of importance as a typical school lunch is HC. If this type of meal negatively impacts subsequent physical activity behavior, the ability of post-lunch recess periods as a means to increase energy expenditure may be lessened.

PURPOSE

To assess the effect of two meals of differing caloric content, HC and low calorie (LC), on children's subsequent physical activity behavior.

METHODS

Nineteen healthy children (aged 6-10) completed two laboratory sessions where they were fed lunch with HC or LC content, but equivalent macronutrient distribution. Children had 15 min to consume as much of the meal as possible per session. Children consumed 659.5 ± 101.3 kcal in the HC condition and 291.8 ± 12.1 kcal in the LC condition. After the meal, children went to a gymnasium for 40 min. In the gymnasium children had free-choice access to obstacle courses, various sports equipment, and a table with sedentary activities. Children could play with any of the activities in any amount they wished for the entire activity session. Children's physical activity was monitored with accelerometers and that data was converted into caloric expenditure. Each child ate all meals and participated in the free-choice activity sessions with no other children present.

RESULTS

Caloric expenditure during the free-choice activity sessions was not significantly different (p = 0.4) between the HC (89.2 ± 27.3 kcals) and LC (83.4 ± 34.9 kcals) conditions. However, caloric balance (kcals eaten-kcals expended) was 2.74-fold greater (p < 0.001) in the HC condition (Δ 570.3 ± 92.2 kcals) than the LC condition (Δ 208.4 ± 32.0 kcals).

CONCLUSION

Children did not alter their physical activity behavior during a free-choice activity session after consuming a HC meal versus a LC meal. Because activity was not different across the two conditions, children had a much greater caloric surplus during the HC condition than the LC condition.

Write, draw, show, and tell: a child-centred dual methodology to explore perceptions of out-of-school physical activity

BACKGROUND

Research to increase children's physical activity and inform intervention design has, to date, largely underrepresented children's voices. Further, research has been limited to singular qualitative methods that overlook children's varied linguistic ability and interaction preference. The aim of this study was to use a novel combination of qualitative techniques to explore children's current views, experiences and perceptions of out-of-school physical activity as well as offering formative opinion about future intervention design.

METHODS

Write, draw, show and tell (WDST) groups were conducted with 35 children aged 10-11 years from 7 primary schools. Data were analysed through a deductive and inductive process, firstly using the Youth Physical Activity Promotion Model as a thematic framework, and then inductively to enable emergent themes to be further explored. Pen profiles were constructed representing key emergent themes.

RESULTS

The WDST combination of qualitative techniques generated complimentary interconnected data which both confirmed and uncovered new insights into factors relevant to children's out-of-school physical activity. Physical activity was most frequently associated with organised sports. Fun, enjoyment, competence, and physical activity provision were all important predictors of children's out-of-school physical activity. Paradoxically, parents served as both significant enablers (i.e. encouragement) and barriers (i.e. restricting participation) to physical activity participation. Some of these key findings would have otherwise remained hidden when compared to more traditional singular methods based approaches.

CONCLUSIONS

Parents are in a unique position to promote health promoting behaviours serving as role models, physical activity gatekeepers and choice architects. Given the strong socialising effect parents have on children's physical activity, family-based physical activity intervention may offer a promising alternative compared to traditional school-based approaches. Parents' qualitative input is important to supplement children's voices and inform future family-based intervention design. The WDST method developed here is an inclusive, interactive and child-centred methodology which facilitates the exploration of a wide range of topics and enhances data credibility.

Relationship between eating behaviors and physical activity of preschoolers and their peers: a systematic review

OBJECTIVES

Children learn by observing and imitating others, meaning that their eating behaviors and physical activity may be influenced by their peers. This paper systematically reviews how preschoolers' eating behaviors and physical activity relate to their peers' behaviors, and discusses avenues for future research.

METHODS

Six databases were searched for quantitative, peer-reviewed studies published up to July 2015 reporting on the correlates, predictors or effectiveness of peers on eating behaviors and physical activity in preschoolers. Risk of bias was independently assessed by two evaluators using the Quality Assessment Tool for Quantitative Studies.

RESULTS

Thirteen articles were included: six measured physical activity, and seven assessed eating behaviors. Four of the six physical activity studies reported that children were more active when peers were present, while large peer group size was negatively associated with physical activity in two cross-sectional studies. All nutrition interventions reported that children's eating behaviors may be influenced by their peers.

CONCLUSIONS

Although supported by weak evidence, peers appear to influence children's eating behaviors and physical activity. However, this influence may be moderated by the number of peers, gender, age and the perceived status of the role models. Future obesity prevention interventions should consider involving peers as agents for positive eating behaviors and physical activity in preschoolers.

The Effect of Parental Involvement on Children's Physical Activity

OBJECTIVES

To assess the amount, intensity, enjoyment, and preference of children's physical activity in a controlled gymnasium setting under 3 experimental, social conditions: alone, with a parent watching, and with a parent participating.

STUDY DESIGN

Children (n = 10 girls, 10 boys), 3-6 years old, along with 1 parent (n = 17 mothers, 3 fathers) per child participated in each social condition on separate days for 30 minutes in which they could choose from a variety of physical and/or sedentary activities.

RESULTS

A greater number of accelerometer counts (P ≤ .02) were accumulated during the parent participating (109,523 ± 32,155 counts) condition than the alone (67,938 ± 37,857 counts) and parent watching (85,624 ± 44,985 counts) conditions. Counts during parent watching were also greater (P = .01) than alone. More time (P ≤ .008) was allocated to sedentary activities during the alone (16.2 ± 9.6 minutes) condition than parent watching (9.6 ± 9.3 minutes) and parent participating (3.8 ± 5.1 minutes). Children liked (P ≤ .02) the parent participating (9.9 ± 0.45 cm) condition more than alone (8.0 ± 2.72 cm) and parent watching (8.7 ± 1.52 cm). A greater (P < .001) proportion of children identified the parent participating (80%) as their preferred condition over either the parent watching (10%) or alone (10%) conditions.

CONCLUSIONS

Parental participation during physical activity (or at minimum direct supervision) may be an important component in the development of physical activity environments intended to maximize physical activity behavior in children.

Current perspectives on physical activity and exercise for youth with diabetes

Regular physical activity (PA) for youth with diabetes improves cardiorespiratory fitness, body composition, bone health, insulin sensitivity, and psychosocial well-being. However many youth with diabetes or pre-diabetes fail to meet minimum PA guidelines and a large percentage of youth with diabetes are overweight or obese. Active youth with type 1 diabetes tend to have lower HbA1c levels and reduced insulin needs, whereas activity in adolescents at-risk for type 2 diabetes improves various measures of metabolism and body composition. Insulin and nutrient adjustments for exercise in type 1 diabetes is complex because of varied responses to exercise type and because of the different times of day that exercise is performed. This review highlights the benefits of exercise and the established barriers to exercise participation in the pediatric diabetes population. A new exercise management algorithm for insulin and carbohydrate intake strategies for active youth with type 1 diabetes is presented.