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Caryl F, McCrorie P, Olsen JR, Mitchell R. Use of natural environments is associated with reduced inequalities in child mental wellbeing: A cross-sectional analysis using global positioning system (GPS) data. ENVIRONMENT INTERNATIONAL 2024; 190:108847. [PMID: 38936067 DOI: 10.1016/j.envint.2024.108847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/02/2024] [Revised: 06/13/2024] [Accepted: 06/20/2024] [Indexed: 06/29/2024]
Abstract
Exposure to natural environments may benefit child mental wellbeing whilst offering a lever to reduce health inequalities. However, understanding of these relationships is limited by evidence from indirect measures of exposure. We objectively measured children's direct use of natural environments-and use in low or high physical activity (PA) states-and associated this with their mental wellbeing. We then examined moderation by sex and household income. Using global positioning system and accelerometry data from children (n = 640), we measured mean daily time in natural environments ('total use'), which we stratified by PA level as 'passive use' (sedentary and light PA) and 'active use' (moderate and vigorous PA). Logistic regression associated exposures with dichotomised Strengths and Difficulties Questionnaire outcomes (internalising difficulties; externalising difficulties; prosocial behaviour), with interactions to examine moderation. A 10-minute increase in total use was associated with 10.5 % lower risk of abnormal internalising outcomes (OR: 0.895; 95 % CI 0.809, 0.990), and 13.2 % lower risk of abnormal externalising outcomes (OR: 0.868; 95 % CI 0.776, 0.990). This suggests that ∼ 60 min of daily total use was associated with 50 % lower risk of abnormal internalising and externalising outcomes. The relative effects of passive and active use were equal, but their associations were moderated by income independently for specific outcomes. For externalising outcomes, the risk of abnormal scores in lower-income children reduced as passive use increased (P = 0.027) but remained constant for higher-income children. For prosocial outcomes, the likelihood of normal scores increased with active use in lower-income children, but not higher-income children (P = 0.005). Sex did not moderate these associations. The findings suggest that targeted interventions supporting disadvantaged children to use natural environments could help address inequalities in mental wellbeing. Further, the moderated associations with types of use suggest the equigenic effects of natural environments may operate through multiple pathways.
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Affiliation(s)
- Fiona Caryl
- MRC/CSO Social and Public Health Sciences, University of Glasgow, Clarice Pears Building, 90 Byres Road, Glasgow, UK.
| | - Paul McCrorie
- MRC/CSO Social and Public Health Sciences, University of Glasgow, Clarice Pears Building, 90 Byres Road, Glasgow, UK
| | - Jonathan R Olsen
- MRC/CSO Social and Public Health Sciences, University of Glasgow, Clarice Pears Building, 90 Byres Road, Glasgow, UK
| | - Richard Mitchell
- MRC/CSO Social and Public Health Sciences, University of Glasgow, Clarice Pears Building, 90 Byres Road, Glasgow, UK
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Cunningham-Sabo L, Lohse B, Nigg CR, Parody RJ. Fourth-Grade Cooking and Physical Activity Intervention Reveals Associations With Cooking Experience and Sex. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2023; 55:191-204. [PMID: 36707323 DOI: 10.1016/j.jneb.2022.10.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 10/14/2022] [Accepted: 10/24/2022] [Indexed: 06/18/2023]
Abstract
OBJECTIVE Examine the impact of Fuel for Fun: Cooking with Kids Plus Parents and Play (FFF) on children's culinary self-efficacy, attitude, fruit and vegetable (FV) preferences, physical activity (PA), and body mass index. DESIGN Randomized controlled trial. SETTING Eight elementary schools in 2 Northern Colorado districts. PARTICIPANTS Fourth-grade students; 7-month interventions: school (S.FFF)-theory-based cooking + tasting lessons, active recess, lesson-driven cafeteria promotions; or school + family (S+F.FFF) with added family nights and home activities. MAIN OUTCOME MEASURE(S) Cooking self-efficacy and attitudes, FV preferences, PA, and measured height/weight. ANALYSIS Individual outcomes nested by classroom, school, and district and assessed > 12 months with repeated measures controlled by sex and baseline cooking experience, with a significance level of P < 0.05. RESULTS The sample included 1,428 youth, 38 teachers, 4 cohorts, 50% boys, 75% White, and 15% Hispanic. No intervention effect was observed. Those who cooked retained higher self-efficacy, attitude, and FV preferences (P < 0.001). Girls reported higher self-efficacy and attitude than boys. Moderate-to-vigorous PA and metabolic equivalent minutes increased for all students; boys retained higher levels (P < 0.001). Body mass index percentile remained stable. CONCLUSIONS AND IMPLICATIONS Cooking and sex were associated with all outcome measures and should be considered for intervention tailoring. Treatment impacts were not evident nesting by classroom, school, and district. Accurate assessment of school-based interventions requires rejecting student independence from group assignment assumptions.
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Affiliation(s)
- Leslie Cunningham-Sabo
- Department of Food Science and Human Nutrition, Colorado State University, Fort Collins, CO.
| | - Barbara Lohse
- Wegmans School of Health and Nutrition, Rochester Institute of Technology, Rochester, NY
| | - Claudio R Nigg
- Department of Health Science, Institute of Sport Science, University of Bern, Bern, Switzerland
| | - Robert J Parody
- School of Mathematical Sciences, Rochester Institute of Technology, Rochester, NY
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Weaver RG, Hensing C, Armstrong B, Adams EL, Beets M. Seasonal Shifts in Children's Sedentary Behaviors, Physical Activity, and Sleep: A Systematic Review and meta-Analysis. Pediatr Clin North Am 2022; 69:671-693. [PMID: 35934493 DOI: 10.1016/j.pcl.2022.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Abstract
Children's movement behaviors (ie, sedentary behaviors, physical activity, and sleep) are related to obesity risk and may vary throughout the year. The purpose of this systematic review is to summarize existing literature on the seasonal variation in physical activity and sleep in children. This study found that children's behaviors fluctuate seasonally and thus, interventions must target behaviors during the times when children's behaviors are the least healthy, specifically during the summer (when children are not in school) and winter. Finally, the paucity of data on seasonal variation in sleep indicates a need for further research in this area.
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Affiliation(s)
- R Glenn Weaver
- Arnold School of Public Health, University of South Carolina, Columbia, SC, USA.
| | - Caroline Hensing
- Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Bridget Armstrong
- Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Elizabeth L Adams
- Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Michael Beets
- Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
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Pearson N, Griffiths P, van Sluijs E, Atkin AJ, Khunti K, Sherar LB. Associations between socioeconomic position and young people's physical activity and sedentary behaviour in the UK: a scoping review. BMJ Open 2022; 12:e051736. [PMID: 35501089 PMCID: PMC9062792 DOI: 10.1136/bmjopen-2021-051736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Accepted: 04/16/2022] [Indexed: 02/02/2023] Open
Abstract
OBJECTIVE To examine the evidence on the associations between socioeconomic position and young people's physical activity and sedentary behaviours in the UK. DESIGN Scoping review. DATA SOURCES PubMed, SCOPUS and Web of Science databases were searched for articles published up to and including January 2021. ELIGIBILITY CRITERIA FOR SELECTING STUDIES Observational studies in children and adolescents (aged 5-18 years) from the UK that had assessed associations between at least one indicator of socioeconomic position and at least one outcome of physical activity and/or sedentary behaviour. DATA EXTRACTION AND SYNTHESIS Data were extracted by one reviewer and 20% were double checked. Indicators of socioeconomic position were tabulated with domains of physical activity and sedentary behaviour. RESULTS Fifty-seven publications were included in the review; 37 publications from 19 studies (k=23) of children and 21 publications from 15 studies (k=23) of adolescents. Most studies were cross-sectional. 63% of studies of children, and 40% of studies of adolescents assessed Index of Multiple Deprivation. Eighteen studies measured physical activity in children, 13 measured sedentary behaviour. Eleven studies of adolescents included a measure of physical activity, 10 included a measure of sedentary behaviour. Among children and adolescents, the association between socioeconomic position and measures of either physical activity or sedentary behaviour was highly variable depending on the measure of both socioeconomic position used and the behavioural outcome, with the exception of higher family affluence which was consistently associated with higher reported physical activity among adolescents. CONCLUSION Physical activity and sedentary behaviours of children and adolescents in the UK are complex and influenced by multiple indicators of socioeconomic position that are, in most cases, different across age stages, outcomes examined and measurement tools. Greater consistency in the use and measures of socioeconomic position as well as outcomes of behaviour are required for robust country-specific meta-analyses.
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Affiliation(s)
- Natalie Pearson
- School of Sport, Exercise & Health Sciences, Loughborough University, Loughborough, UK
| | - Paula Griffiths
- School of Sport, Exercise & Health Sciences, Loughborough University, Loughborough, UK
| | | | - Andrew J Atkin
- School of Health Sciences, University of East Anglia, Norwich, UK
| | - Kamlesh Khunti
- Diabetes Research Centre, University of Leicester, Leicester, UK
| | - Lauren B Sherar
- School of Sport, Exercise & Health Sciences, Loughborough University, Loughborough, UK
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Almagor J, Martin A, McCrorie P, Mitchell R. How can an agent-based model explore the impact of interventions on children's physical activity in an urban environment? Health Place 2021; 72:102688. [PMID: 34628149 PMCID: PMC8633766 DOI: 10.1016/j.healthplace.2021.102688] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 09/23/2021] [Accepted: 09/28/2021] [Indexed: 12/28/2022]
Abstract
Insufficient physical activity (PA) among most children and adolescents is a global problem that is undermining the realisation of numerous developmental and health benefits. The aim of this study was to explore the potential impact of interventions on PA by using an agent-based model (ABM) simulating children's daily activities in an urban environment. Three domains for interventions were explored: outdoor play, school physical education and active travel. Simulated interventions increased children's average daily moderate-to-vigorous PA by 2–13 min and reduced the percentage of children not meeting PA guidelines, from 34% to 10%–29%, depending on the intervention. Promotion of active travel and outdoor play benefited more those in a higher socio-economic position. Agents' interactions suggested that: encouraging activity in diverse groups will reduce percentage of the least active in the population; and initiating outdoor events in neighbourhoods can generate an enhancing effect on children's engagement in PA. The ABM provided measurable outcomes for interventions that are difficult to estimate using reductionist methods. We suggest that ABMs should be used more commonly to explore the complexity of the social-environmental PA system. We developed an agent-based model simulating children's daily physical activity. Agents perform typical daily activities in a virtual urban model of Glasgow city. Simulations explore impact of interventions on outdoor play, school, active travel. Promotion of active travel had a differential impact across socio-economic position. Outdoor play intervention produced a non-linear increase in physical activity.
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Affiliation(s)
- Jonatan Almagor
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Berkeley Square, 99 Berkeley Street, G3 7HR, Glasgow, Scotland, UK.
| | - Anne Martin
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Berkeley Square, 99 Berkeley Street, G3 7HR, Glasgow, Scotland, UK
| | - Paul McCrorie
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Berkeley Square, 99 Berkeley Street, G3 7HR, Glasgow, Scotland, UK
| | - Rich Mitchell
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Berkeley Square, 99 Berkeley Street, G3 7HR, Glasgow, Scotland, UK
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Olsen JR, Leung KY, Nicholls N, Loo BP. Do neighbourhood characteristics matter in understanding school children’s active lifestyles? A cross-region multi-city comparison of Glasgow, Edinburgh and Hong Kong. CHILDREN'S GEOGRAPHIES 2021; 19:488-504. [PMID: 34790065 PMCID: PMC7611993 DOI: 10.1080/14733285.2020.1828826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Many studies have explored the influence of individual and neighbourhood factors on active school travel (AST), this novel study is the first to examine how AST and formal extracurricular activities are associated with children’s active lifestyles. The aims of this study were to (a) create an active lifestyle variable (ALIFE) measured in terms of total weekly minutes of AST and extracurricular activities, and (b) explore how ALIFE is associated with different attributes at the individual, household and neighbourhood levels, and how these relationships differ for children aged 10 and 11 years old across the three cities: Glasgow, Edinburgh and Hong Kong. We found environmental factors to be important indicators of lower AST, for example greater parking facility density. The most substantial contribution to children’s overall ALIFE was household income, those from the lowest household group having almost 2 h less ALIFE per-week than those from the highest income.
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Affiliation(s)
- Jonathan R. Olsen
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - Kevin Y.K. Leung
- Department of Geography, University of Hong Kong, Hong Kong, Hong Kong
| | - Natalie Nicholls
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - Becky P.Y. Loo
- Department of Geography, University of Hong Kong, Hong Kong, Hong Kong
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McCrorie P, Mitchell R, Macdonald L, Jones A, Coombes E, Schipperijn J, Ellaway A. The relationship between living in urban and rural areas of Scotland and children's physical activity and sedentary levels: a country-wide cross-sectional analysis. BMC Public Health 2020; 20:304. [PMID: 32156285 PMCID: PMC7065337 DOI: 10.1186/s12889-020-8311-y] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Accepted: 01/31/2020] [Indexed: 12/02/2022] Open
Abstract
Background Living in urban or rural environments may influence children’s levels of physical activity and sedentary behaviours. We know little about variations in device-measured physical activity and sedentary levels of urban and rural children using nationally representative samples, or if these differences are moderated by socioeconomic factors or seasonal variation. Moreover, little is known about the influence of ‘walkability’ in the UK context. A greater understanding of these can better inform intervention strategies or policy initiatives at the population level. Methods Country-wide cross-sectional study in Scotland in which 774 children (427 girls, 357 boys), aged 10/11 years, wore an accelerometer on one occasion for at least four weekdays and one weekend day. Mean total physical activity, time spent in sedentary, light, and moderate-to-vigorous physical activity (MVPA), per day were extracted for weekdays, weekend days, and all days combined. Regression analyses explored associations between physical activity outcomes, urban/rural residence, and a modified walkability index (dwelling density and intersection density); with interactions fitted for household equivalised income and season of data collection. Sensitivity analyses assessed variation in findings by socioeconomic factors and urbanicity. Results Rural children spent an average of 14 min less sedentary (95% CI of difference: 2.23, 26.32) and 13 min more in light intensity activity (95% CI of difference, 2.81, 24.09) per day than those from urban settlements. No urban-rural differences were found for time spent in MVPA or in total levels of activity. Our walkability index was not associated with any outcome measure. We found no interactions with household equivalised income, but there were urban/rural differences in seasonal variation; urban children engaged in higher levels of MVPA in the spring months (difference: 10 mins, p = 0.06, n.s) and significantly lower levels in winter (difference: 8.7 mins, p = 0.036). Conclusions Extrapolated across one-year, rural children would accumulate approximately 79 h (or just over 3 days) less sedentary time than urban children, replacing this for light intensity activity. With both outcomes having known implications for health, this finding is particularly important. Future work should prioritise exploring the patterns and context in which these differences occur to allow for more targeted intervention/policy strategies.
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Affiliation(s)
- Paul McCrorie
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, Scotland.
| | - Rich Mitchell
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, Scotland
| | - Laura Macdonald
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, Scotland
| | - Andrew Jones
- Norwich Medical School, University of East Anglia, Norwich, UK
| | - Emma Coombes
- Norwich Medical School, University of East Anglia, Norwich, UK
| | - Jasper Schipperijn
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Anne Ellaway
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, Scotland
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Macdonald L, McCrorie P, Nicholls N, Olsen JR. Active commute to school: does distance from school or walkability of the home neighbourhood matter? A national cross-sectional study of children aged 10-11 years, Scotland, UK. BMJ Open 2019; 9:e033628. [PMID: 31874893 PMCID: PMC7008418 DOI: 10.1136/bmjopen-2019-033628] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
OBJECTIVES To study the extent to which home-to-school distance and neighbourhood walkability were associated with self-reported active travel to school (ATS) (eg, walking, cycling), and to explore how distance moderates the effect of walkability on ATS, among 10-11 years old. DESIGN Cross-sectional study. SETTING Data were collected between May 2015 and May 2016 in partnership with the Growing Up in Scotland Study, a nationally representative longitudinal cohort study. PARTICIPANTS 713 children (male (n=330) and female (n=383) 10-11 years old) from Studying Physical Activity in Children's Environments across Scotland. PRIMARY AND SECONDARY OUTCOME MEASURES Children who actively travelled to/from school categorised as active all (100% of ATS) and active 60%+ (at least 60% of ATS); home-to-school road/path network distance (<0.5 km, 0.5 to <1 km, 1 to <1.5 km, 1.5 to <2 km, 2 km+); home neighbourhood walkability (i.e., composite measure of road/path intersection density and dwelling density) (in quintiles). RESULTS Distance and walkability were both associated with ATS. The likelihood of ATS for all or most journeys decreased with increasing distance. Compared with 'most' walkable areas (Q1), the odds of active all were significantly lower within least walkable areas (Q5 OR 0.45, 95% CI 0.21 to 0.99), and odds of active 60%+ were significantly less in Q2-Q5 (lowest odds Q5 OR 0.20, 95% CI 0.07 to 0.47). Regarding walkability and distance interactions, for all distance categories, higher walkability increased the probability of ATS (for most school journeys). CONCLUSION Walkability was positively associated with ATS within all distance categories, with the relationship between walkability and ATS more complex than the clear-cut association between distance and ATS. A more walkable environment had a larger effect on the probability of reaching the 60% threshold of school journeys using ATS than the probability of always travelling in an active manner. Investment is needed in existing less walkable neighbourhoods to provide infrastructure to support opportunities for children's ATS.
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Affiliation(s)
- Laura Macdonald
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - Paul McCrorie
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - Natalie Nicholls
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - Jonathan R Olsen
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
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Caryl F, Shortt NK, Pearce J, Reid G, Mitchell R. Socioeconomic inequalities in children's exposure to tobacco retailing based on individual-level GPS data in Scotland. Tob Control 2019; 29:tobaccocontrol-2018-054891. [PMID: 31278083 PMCID: PMC7116585 DOI: 10.1136/tobaccocontrol-2018-054891] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Revised: 05/02/2019] [Accepted: 05/16/2019] [Indexed: 11/04/2022]
Abstract
BACKGROUND Identifying factors shaping knowledge of and attitudes towards tobacco products in preadolescence is a key component supporting tobacco control policies aimed at preventing smoking initiation. This study quantified exposure to tobacco retailing environments within the individual-level activity spaces of children across a socioeconomic gradient. METHODS One week of global positioning system (GPS) tracking data were collected at 10 s intervals from a nationally representative sample of 10-11-year olds (n=692). Proximity of GPS locations (n=~16 M) to the nearest tobacco retailer (n=9030) was measured and exposure defined when a child came within 10 m of a retailer. Duration, frequency, timing and source of exposure were compared across income deprivation quintiles, along with retail density within children's home neighbourhoods. RESULTS On average, children were exposed to tobacco retailing for 22.7 min (95% CI 16.8 to 28.6) per week in 42.7 (35.2-50.1) independent encounters. However, children from the most deprived areas accumulated six times the duration and seven times the frequency of exposure as children from the least deprived areas. Home neighbourhood retail densities were 2.6 times higher in deprived areas, yet the average number of businesses encountered did not differ. Most exposure came from convenience stores (35%) and newsagents (15%), with temporal peaks before and after school hours. CONCLUSIONS By accounting for individual mobility, we showed that children in socially disadvantaged areas accumulate higher levels of exposure to tobacco retailing than expected from disparities in home neighbourhood densities. Reducing tobacco outlet availability, particularly in areas frequently used by children, might be crucial to policies aimed at creating 'tobacco-free' generations.
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Affiliation(s)
- Fiona Caryl
- MRC/CSO Social & Public Health Sciences, Insistute of Health & Wellbeing, University of Glasgow, Glasgow, UK
| | - Niamh K Shortt
- School of Geosciences, Univerity of Edinburgh, Edinburgh, UK
| | - Jamie Pearce
- School of Geosciences, Univerity of Edinburgh, Edinburgh, UK
| | - Garth Reid
- Public Health Science Directorate, NHS Health Scotland, Edinburgh, UK
| | - Richard Mitchell
- MRC/CSO Social & Public Health Sciences, Insistute of Health & Wellbeing, University of Glasgow, Glasgow, UK
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Strain T, Milton K, Dall P, Standage M, Mutrie N. How are we measuring physical activity and sedentary behaviour in the four home nations of the UK? A narrative review of current surveillance measures and future directions. Br J Sports Med 2019; 54:1269-1276. [PMID: 31118181 PMCID: PMC7116237 DOI: 10.1136/bjsports-2018-100355] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/26/2019] [Indexed: 12/12/2022]
Abstract
Background/objectives To explore and describe the comparability between the surveys of the UK home nations (England, Northern Ireland, Scotland, Wales) that monitor compliance with the Chief Medical Officers’ physical activity (PA) recommendations. We also suggest ways to improve the UK national PA and sedentary behaviour (SB) surveillance systems. Methods We identified national surveys that monitor PA and SB through searching UK-wide and devolved administration websites, the Global Observatory for Physical Activity Country Cards and the Active Healthy Kids Report Cards. Subsequently, we extracted information from survey documentation on the survey commissioners and contractors, method of administration, current questionnaire details relevant to the PA recommendations, questionnaire changes over the previous decade and the most recent prevalence figures. Results For adults and older adults, five surveys assess the moderate-to-vigorous PA (MVPA) recommendation, three assess muscle strengthening and three assess SB. For older adults only, three assess balance and co-ordination. For children, seven assess MVPA, none assess muscle strengthening and five assess SB. Only one survey reports on the under 5 PA recommendation. There is no part of the recommendations for which comparable estimates can be calculated across all four home nations. The greatest variation is among the SB questions and reporting. No survey has regularly used device-based measures. Conclusion UK surveillance of the PA recommendations is complex, undertaken separately in the home nations, using multiple surveys that cover adults and children separately. We recommend that the costs and benefits of harmonising the existing questionnaires are considered, along with the potential introduction of device-based measures.
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Affiliation(s)
- Tessa Strain
- MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - Karen Milton
- Norwich Medical School, University of East Anglia, Norwich, UK
| | - Philippa Dall
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK
| | - Martyn Standage
- Centre for Motivation and Health Behaviour Change, Department for Health, University of Bath, Bath, UK
| | - Nanette Mutrie
- Physical Activity for Health Research Centre, Moray House School of Education, University of Edinburgh, Edinburgh, UK
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Williamson C, Kelly P, Strain T. Different analysis methods of Scottish and English child physical activity data explain the majority of the difference between the national prevalence estimates. BMC Public Health 2019; 19:171. [PMID: 30744604 PMCID: PMC6371508 DOI: 10.1186/s12889-019-6517-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2018] [Accepted: 02/06/2019] [Indexed: 11/16/2022] Open
Abstract
Background The percentages of children in Scotland and England meeting the aerobic physical activity (PA) recommendation differ greatly according to estimates derived from the respective national health surveys. The Scottish Health Survey (SHeS) usually estimates over 70% meeting the recommendation; Health Survey for England (HSE) estimates are usually below 25%. It is plausible that these differences originate from different analysis methods. The HSE monitors the percentage of children in England that undertake 60 min of moderate-to-vigorous PA on each day of the week (‘Daily Minimum Method’ (DMM)). The SHeS monitors the proportion that undertakes at least seven sessions of moderate-to-vigorous PA, with an average daily duration ≥60 min in Scotland (‘Weekly Average Method’ (WAM)). We aimed to establish how much this difference in analysis methods influences prevalence estimates. Methods PA data from 5 to 15 year olds in the 2015 HSE and SHeS were reanalysed (weighted n = 3840 and 965, respectively). Two comparable pairs of estimates were derived: a DMM and WAM estimate from the HSE not including travel to/from school, and WAM estimates from the HSE and the SHeS including travel to/from school. It is not possible to calculate a DMM estimate from the SHeS due to questionnaire design. Results were presented for the total samples, and by sex and age sub-groups. Results The HSE WAM estimate was 31.7 (95% CI: 30.2–33.3) percentage points higher than the DMM estimate (54.3% (95% CI: 52.6–56.0) and 22.6% (95% CI: 21.2–24.1) respectively). The magnitude of this difference differed by age group but not sex. When comparable WAM estimates were derived from the SHeS and the HSE, the SHeS was 11.8 percentage points higher (73.6% (95% CI: 69.8–77.1) and 61.8% (95% CI: 60.2–63.5) respectively). The magnitude of this difference differed by age group and sex. Conclusions The results indicate that the difference in the analysis method explains the majority (approximately 30 percentage points) of the difference in the child PA prevalence estimates between Scotland and England (leaving approximately 12 percentage points representing true differences or related to questionnaire differences). These results will help national surveillance determine how to increase comparability between the U.K. home nations.
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Affiliation(s)
- Chloë Williamson
- Physical Activity for Health Research Centre, Institute of Sport, Physical Education, and Health Sciences, Moray House School of Education and Sport, University of Edinburgh, Edinburgh, UK.
| | - Paul Kelly
- Physical Activity for Health Research Centre, Institute of Sport, Physical Education, and Health Sciences, Moray House School of Education and Sport, University of Edinburgh, Edinburgh, UK
| | - Tessa Strain
- Physical Activity for Health Research Centre, Institute of Sport, Physical Education, and Health Sciences, Moray House School of Education and Sport, University of Edinburgh, Edinburgh, UK.,MRC Epidemiology Unit, University of Cambridge, Cambridge, CB2 0QQ, UK
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