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Jerebine A, Heering T, Barnett LM. Educator-Perceived Barriers and Facilitators to Structured-Physical Activity in Early Childhood Centres: A Systematic Review. RESEARCH QUARTERLY FOR EXERCISE AND SPORT 2024; 95:243-262. [PMID: 37327492 DOI: 10.1080/02701367.2023.2193243] [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: 04/27/2022] [Accepted: 03/10/2023] [Indexed: 06/18/2023]
Abstract
Purpose: Physical activity (PA) and motor competence development are vital for young children, yet many early childhood education and care (ECEC) centers struggle to successfully implement PA programs, particularly those organized and led by educators. This review aimed to synthesize qualitative literature to (1) identify educator-perceived barriers and facilitators to structured-PA in ECEC centers, and (2) map these to the COM-B model and Theoretical Domains Framework (TDF). Methods: Following PRISMA guidelines, a systematic search of five databases was conducted in April 2021 and updated in August 2022. Records were screened in Covidence software using predefined eligibility criteria. Using the framework synthesis method, data extraction and synthesis were conducted in coding forms in Excel and NVivo. Results: Of 2382 records identified, 35 studies were included, representing 2,365 educators across 268 ECEC centers in 10 countries. Using the COM-B model and TDF, an evidence-informed framework was developed. Findings revealed the greatest barriers concerned educator "opportunity" (e.g. competing time and priorities, policy tensions, indoor/outdoor space constraints) and "capability" (e.g. lack of PA knowledge and practical, hands-on skills) to implement structured-PA. Although fewer studies reported factors that influenced educator "motivation", several themes intersected across the three COM-B components illustrating the complexity of behavioral determinants in this setting. Conclusions: Interventions grounded in theory that utilize a systems approach to target multiple levels of influence on educator behavior, and are flexible and adaptable locally, are recommended. Future work should seek to address societal barriers, structural challenges in the sector, and the PA educational needs of educators. PROSPERO Registration: CRD42021247977.
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Quah PL, Loo BKG, Chia MYH, Chua TBK, Tan TSZ, Chan PC, Tan KH. Adherence to 24-hour integrated activity guidelines among infants, toddlers and preschool children in Singapore. PLoS One 2024; 19:e0298968. [PMID: 38408072 PMCID: PMC10896501 DOI: 10.1371/journal.pone.0298968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 02/01/2024] [Indexed: 02/28/2024] Open
Abstract
This study examined children's adherence to the Singapore Integrated 24-Hour Activity Guidelines for Early Childhood in infants, toddlers and preschoolers aged 0-6 years. A total of 901 caregivers, comprising 219 infants, 379 toddlers, and 303 preschoolers, provided information regarding their children's physical activity (PA), screen viewing time (SVT), and sleep durations on both weekdays and weekends. Meeting the 24-hour integrated activity guidelines was defined as follows: for infants ≥ 30 minutes per day of tummy time or floor-based play; zero SVT; total sleep of 14-17 hours per day for ages 0-3 months, 12-16 hours per day for ages 4-11 months; for toddlers ≥ 180 minutes of total PA per day; zero SVT under 2 years; <1 hour for ages 2 to less than 3 years; and a total sleep of 11-14 hours per day; for preschoolers ≥ 180 minutes of total PA per day; SVT <1 hour per day; total sleep of 10-13 hours per day for those aged 3-5 years, and 10-11 hours per day for 6-year-olds. Chi-squared tests were used to examine the differences in guideline adherence between weekdays and weekends. Compared to weekdays, during weekends there was a higher proportion of toddlers and preschoolers adhering to the PA guidelines (68.9% vs 50.1%; 78.9% vs 55.4%, respectively, p<0.05), and a lower proportion of toddlers adhering to SVT (38.8% vs 21.8%; p = 0.001). There was a declining adherence to all three activity guidelines as age groups progressed from infants (44.7%) to toddlers (15.8%) and then to preschoolers (9.4%). Concurrently, there was a decrease in adherence to SVT recommendations across the age groups, with adherence rates being highest among infants (83.1%), followed by toddlers (15.8%), and preschoolers (9.4%). Decreasing compliance with all three guidelines, coupled with a corresponding decline in adherence to SVT guidelines as children transition from toddlerhood to preschool age, is a cause for concern. This underscores the need for proactive efforts to educate caregivers about reducing or eliminating SVT among infants and young children.
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Affiliation(s)
- Phaik Ling Quah
- Division of Obstetrics & Gynaecology, KK Women's and Children's Hospital, Singapore, Singapore
- Duke-NUS Medical School, Singapore, Singapore
| | - Benny Kai Guo Loo
- General Paediatric Service, KK Women's and Children's Hospital, Singapore, Singapore
| | - Michael Yong Hwa Chia
- Physical Education & Sports Science, National Institute of Education, Nanyang Technological University, Singapore, Singapore
| | - Terence Buan Kiong Chua
- Physical Education & Sports Science, National Institute of Education, Nanyang Technological University, Singapore, Singapore
| | - Teresa Shu Zhen Tan
- Khoo Teck Puat-National University Children's Medical Institute, National University Hospital, Singapore, Singapore
| | - Poh Chong Chan
- Khoo Teck Puat-National University Children's Medical Institute, National University Hospital, Singapore, Singapore
| | - Kok Hian Tan
- Division of Obstetrics & Gynaecology, KK Women's and Children's Hospital, Singapore, Singapore
- Duke-NUS Medical School, Singapore, Singapore
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Rocke K, Howitt C, Hambleton I. Understanding the relationship between built environment features and physical activity in the Caribbean: A scoping review. DIALOGUES IN HEALTH 2023; 2:100088. [PMID: 38515496 PMCID: PMC10953899 DOI: 10.1016/j.dialog.2022.100088] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 11/30/2022] [Accepted: 11/30/2022] [Indexed: 03/23/2024]
Abstract
Background Transforming the urban infrastructure to become safe, inclusive and sustainable remains a challenge in most developing settings. The Caribbean has high burdens of physical inactivity and non-communicable diseases. Therefore, understanding the role of the built environment (BE) in modifying individual activity is important for informing the design of community interventions to improve levels of physical activity (PA). Anecdotally, there is limited evidence on the BE in the Caribbean, however evidence from other Small Island Developing States (SIDS) and from Latin America (LA) may offer useful information given their similar urbanization profiles and shared geo-collaborative histories. Objective Our review identifies and characterizes individual features of the BE and examines their relationships with PA outcomes. Methods We systematically searched a range of multi-discipline research databases, including studies from SIDS and LA that objectively measured BE features as an exposure and PA as an outcome between 2010 and 2021. Grey literature was not considered for this review. We characterized BE measures into 9 neighbourhood design domains using the Walkability for Health framework, and mapped gaps in the published evidence. We performed a narrative summary of BE-PA relationships, focusing on association strength and direction of effect. Results Fifty-one studies from published scientific literature in Brazil, Colombia, Mexico, Chile, and Singapore were included that described 306 BE-PA relationships. The BE was mostly characterized by number of and proximity to spaces for social interaction, green spaces, increasing housing density or street connectivity, and mixed residential and commercial land use. BE-PA relationships, although inconsistent, largely promoted PA. Conclusion Although the review is suggestive of the benefits of the benefits of BE interventions for promoting active commuting and leisurely PA, translational research is needed to understand whether results can be successfully adapted for SIDS, which often have an urban structure defined by a single urban centre with connections to outlying communities.
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Affiliation(s)
- Kern Rocke
- The George Alleyne Chronic Disease Research Centre, Caribbean Health Research Institute, The University of the West Indies, Barbados
- Faculty of Medical Sciences, The University of the West Indies, Cave Hill Campus, Barbados
| | - Christina Howitt
- The George Alleyne Chronic Disease Research Centre, Caribbean Health Research Institute, The University of the West Indies, Barbados
| | - Ian Hambleton
- The George Alleyne Chronic Disease Research Centre, Caribbean Health Research Institute, The University of the West Indies, Barbados
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Wu SK, Wong JE, Poh BK. Children's Attraction to Physical Activity and Its Relation to Physical Activity Level. Malays J Med Sci 2023; 30:108-119. [PMID: 38239253 PMCID: PMC10793132 DOI: 10.21315/mjms2023.30.6.11] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Accepted: 02/23/2023] [Indexed: 01/22/2024] Open
Abstract
Background Understanding of psychosocial factors of physical activity (PA) in children is crucial in encouraging sustained PA, which in turn is associated with important health outcomes. This study aimed to examine how children's attraction to physical activity (CAPA) is associated with PA. Methods This cross-sectional study was conducted among 219 primary school children (105 boys; 114 girls) aged 7 years old-10 years old in Kuala Lumpur, Malaysia in 2016-2017. Children from three main ethnicities, namely Malay, Chinese and Indian, were recruited. Weight, height and waist circumference were measured; body composition was assessed by deuterium dilution technique. CAPA and level of PA were obtained through self-administered questionnaires and reported as CAPA and PA scores. Results Median CAPA and PA scores were 3.40 (Q1 = 3.00, Q3 = 3.80) and 2.31 (Q1 = 1.95, Q3 = 2.74), respectively. Significant gender differences were found in CAPA and PA scores, with boys being more attracted to PA (3.16 [Q1 = 2.90, Q3 = 3.44]; P = 0.001) and more physically active compared with girls (2.47 [Q1 = 2.07, Q3 = 3.07]; P = 0.001). CAPA and PA scores correlated positively in both sexes. Boys scored higher than girls in 'liking of games and sports' (ρ = 0.301, P = 0.002) and 'liking of vigorous PA' (ρ = 0.227, P = 0.02) CAPA subscales, which also correlated positively with PA scores. Girls' PA scores correlated with 'peer acceptance in games and sports' (ρ = 0.329, P < 0.001). Conclusion Boys are more physically active and have higher attraction to PA compared with girls. Differences in PA scores between the sexes were related to gender differences in CAPA scores. Thus, attention should be given to gender differences in CAPA related psychosocial factors when planning interventions to promote PA among children.
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Affiliation(s)
- Suet Kei Wu
- Nutritional Sciences Programme and Centre for Community Health Studies (ReaCH), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Jyh Eiin Wong
- Nutritional Sciences Programme and Centre for Community Health Studies (ReaCH), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Bee Koon Poh
- Nutritional Sciences Programme and Centre for Community Health Studies (ReaCH), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
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Loo BKG, Sirisena D, Müller-Riemenschneider F, Chia MYH, Tan B, Tan NC, Teoh OH, Lim EJK, Zainuddin MA, Gao JS, Chan PC, Tan TSZ, Visruthan NK, Rajadurai VS, Chia MS, Ahmad Hatib NAB, Cai S, Ong JL, Lo JCY, Chong MFF, Lee LY, Chew ECS, Siriamornsarp R, Lee M, Sim A, Wong CM, Sherwood SA, Toh SH, Quah PL, Ng KC, Tan KH, Lee YS. Consensus statement on Singapore integrated 24-hour activity guide for early childhood. ANNALS OF THE ACADEMY OF MEDICINE, SINGAPORE 2023; 52:310-320. [PMID: 38904512 DOI: 10.47102/annals-acadmedsg.2022315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/22/2024]
Abstract
Introduction Early childhood is a critical period for growth and development. Adopting healthy lifestyle behaviours during this period forms the foundation for future well-being and offers the best protection against non-communicable diseases. Singapore studies have shown that many young children are not achieving the recommendations on physical activity, sedentary behaviour and sleep. A workgroup was set up to develop recommendations for caregivers of infants, toddlers and preschoolers (aged <7 years) on how to integrate beneficial activities within a daily 24-hour period for optimal development and metabolic health. Method The Grading of Recommendations Assessment, Development and Evaluation (GRADE)- ADOLOPMENT approach was employed for adoption, adaption or de novo development of recommendations. International and national guidelines were used as references, and an update of the literature reviews up to September 2021 was conducted through an electronic search of PubMed, Embase and Cochrane Central Register of Controlled Trials (CENTRAL) databases. Results Four consensus statements were developed for each age group: infants, toddlers and preschoolers. The statements focus on achieving good metabolic health through regular physical activity, limiting sedentary behaviour, achieving adequate sleep and positive eating habits. The 13th consensus statement recognises that integration of these activities within a 24-hour period can help obtain the best results. Conclusion This set of recommendations guides and encourages caregivers of Singapore infants, toddlers and preschoolers to adopt beneficial lifestyle activities within each 24-hour period.
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Affiliation(s)
- Benny Kai Guo Loo
- Sport & Exercise Medicine Service, KK Women's and Children's Hospital, Singapore
| | - Dinesh Sirisena
- Department of Sports Medicine, Khoo Teck Puat Hospital, Singapore
| | | | - Michael Yong Hwa Chia
- Academic Group of Physical Education & Sports Science, National Institute of Education, Nanyang Technological University, Singapore
| | - Benedict Tan
- Department of Sport & Exercise Medicine, Changi General Hospital, Singapore
| | | | - Oon Hoe Teoh
- Department of Paediatrics, KK Women's and Children's Hospital, Singapore
| | - Ethel Jie Kai Lim
- Department of Nutrition & Dietetics, KK Women's and Children's Hospital, Singapore
| | | | - Joanne Shumin Gao
- Sport & Exercise Medicine Service, KK Women's and Children's Hospital, Singapore
| | - Poh Chong Chan
- Department of Paediatrics, Khoo Teck Puat - National University Children's Medical Institute, National University Hospital, Singapore
| | - Teresa Shu Zhen Tan
- Department of Paediatrics, Khoo Teck Puat - National University Children's Medical Institute, National University Hospital, Singapore
| | | | | | - Moira Suyin Chia
- Department of Paediatrics, KK Women's and Children's Hospital, Singapore
| | | | - Shirong Cai
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore
| | - Ju Lynn Ong
- Centre for Sleep and Cognition, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - June Chi Yan Lo
- Centre for Sleep and Cognition, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Mary Foong-Fong Chong
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore
| | - Le Ye Lee
- Department of Neonatology, Khoo Teck Puat - National University Children's Medical Institute, National University Hospital, Singapore
| | | | | | - Miriam Lee
- Division of Children & Youth Programme Development, Sport Singapore, Singapore
| | - Aaron Sim
- Division of Physical Activity & Weight Management, Health Promotion Board, Singapore
| | - Chui Mae Wong
- Department of Child Development, KK Women's and Children's Hospital, Singapore
| | | | - Siao Hui Toh
- Physiotherapy Department, KK Women's and Children's Hospital, Singapore
| | - Phaik Ling Quah
- Division of Obstetrics & Gynaecology, KK Women's and Children's Hospital, Singapore
| | - Kee Chong Ng
- Department of Emergency Medicine, KK Women's and Children's Hospital, Singapore
| | - Kok Hian Tan
- Department of Maternal Fetal Medicine, KK Women's and Children's Hospital, Singapore
| | - Yung Seng Lee
- Department of Paediatrics, Khoo Teck Puat - National University Children's Medical Institute, National University Hospital, Singapore
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Correlates of Sedentary Time Among Children and Adolescents in Ethiopia: A Cross-Sectional Study. Pediatr Exerc Sci 2023; 35:15-22. [PMID: 35894895 DOI: 10.1123/pes.2021-0077] [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] [Received: 04/17/2021] [Revised: 03/21/2022] [Accepted: 05/04/2022] [Indexed: 02/01/2023]
Abstract
PURPOSE To assess the correlates of sedentary time among children and adolescents in Ethiopia. METHODS The study was conducted in representative samples of children and adolescents in the capital city of Ethiopia, Addis Ababa. Multivariable logistic regression models were used to determine associations of sedentary time and predictor variables. RESULTS The mean sedentary time was 4.61 (95% confidence interval [CI], 4.35-4.86) hours per day. Overall, the prevalence of high sedentary time (>3 h/d) was 68.2% (95% CI, 64.2-72.2). Results of multivariable logistic regression analyses showed a statistically significant association between high sedentary time and female household head (adjusted odds ratio [AOR] = 0.50; 95% CI, 0.32-0.80), literate mothers (AOR = 1.98; 95% CI, 1.26-3.11), child attending public school (AOR = 1.79; 95% CI, 1.12-2.85), children who belonged to the poor and rich household wealth tertiles compared with medium wealth tertile (AOR = 2.30; 95% CI, 1.42-3.72 and AOR = 2.04; 95% CI, 1.14-3.65, respectively), and those families that did not have adequate indoor play space for children (AOR = 0.45; 95% CI, 0.29-0.72). CONCLUSION The study found that time spent sedentary was high in the study area as compared with other studies of similar settings. Several modifiable factors were identified that can be targeted in interventions to reduce sedentary time in the study setting.
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Vieira D, Gomes EC, Negrão ÂS, Thuany M, Gomes TN. Movement Behaviour and Health Outcomes in Rural Children: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2514. [PMID: 36767880 PMCID: PMC9915981 DOI: 10.3390/ijerph20032514] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/11/2022] [Revised: 01/27/2023] [Accepted: 01/28/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Studies with rural children are limited, and results are divergent regarding the information on movement behaviours. PURPOSE to (i) describe the physical activity and sedentary behaviour in children; (ii) synthetize the year and place of publication, methodological quality, and instruments used to measure physical activity and sedentary behaviour; and (iii) to analyse the relationship between physical activity, sedentary behaviour, and health outcomes in these children. METHODS We use the databases PubMed, Web of Science, SPORTDiscus, Scopus, Virtual Health Library, and SciELO, considering papers published until October 2021. A total of 12,196 studies were identified, and after the exclusion of duplicate, title and abstract screening, and the full-text assessment, a total of 68 were included in the study. RESULTS A cross-sectional design was dominant among the studies, with sample sizes ranging from 23 to 44,631 children of both sexes. One-third of the studies were conducted in North America and Europe, and most of them used device-based measurements. Inequalities were observed regarding sex, age, economic level, race, and physical activity domains within and between the places of residence. Sociodemographic characteristics were also related to health outcomes for children living in rural and urban areas. CONCLUSION It is necessary to increase the evidence on movement behaviours among children living in the countries of South America and Oceania, as well as to increase the level of evidence on the role of school for physical activity in children in rural areas, given the inconsistent findings.
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Affiliation(s)
- Douglas Vieira
- Post-Graduation Program of Physical Education, Department of Physical Education, Federal University of Sergipe, São Cristóvão 49100-000, Brazil
| | - Elenir Campelo Gomes
- Post-Graduation Program of Human Movement Sciences, Federal University of Pará, Belém 66075-110, Brazil
| | - Ângelo Solano Negrão
- Post-Graduation Program of Anthropic Studies in the Amazon, Federal University of Pará, Belém 66075-110, Brazil
| | - Mabliny Thuany
- Centre of Research, Education, Innovation and Intervention in Sport (CIFI2D), Faculty of Sport, University of Porto, 4200-450 Porto, Portugal
| | - Thayse Natacha Gomes
- Post-Graduation Program of Physical Education, Department of Physical Education, Federal University of Sergipe, São Cristóvão 49100-000, Brazil
- Department of Physical Education and Sports Science, University of Limerick, V94 T9PX Limerick, Ireland
- Physical Activity for Health Cluster, Health Research Institute, University of Limerick, V94 T9PX Limerick, Ireland
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Hernández ED, Cobo EA, Cahalin LP, Seron P. Impact of environmental interventions based on social programs on physical activity levels: A systematic review. Front Public Health 2023; 11:1095146. [PMID: 37033032 PMCID: PMC10078830 DOI: 10.3389/fpubh.2023.1095146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Accepted: 03/01/2023] [Indexed: 04/11/2023] Open
Abstract
Background The design of social programs at the environmental level such as in schools, parks, bicycle paths, or workspaces generates changes in the behavior of individuals and modifies lifestyles by increasing physical activity (PA) levels. Objective To determine the effectiveness of environmental interventions based on social programs by changing the population's level of PA. Methodology Natural experiment studies that involved environmental intervention programs at a social level were included. The primary outcome was PA levels with consideration of both objective and subjective measurements. An electronic search was carried out in Medline/Pubmed, SCIENCE DIRECT, WEB OF SCIENCE, and CINAHL databases up to January 2022 with two reviewers screening titles and abstracts and selecting studies for full-text reading. Two reviewers also acquired relevant data and evaluated study quality using the ROBINS I tool. A qualitative analysis was performed. Results Three thousand eight hundred and sixty-five articles were found in the 4 consulted databases. After eliminating duplication (200), two reviewers screened 3,665 titles and abstracts and excluded 3,566 that did not meet the inclusion criteria, leaving 99 articles to be read in full text. The 99 full texts were reviewed of which 24 papers met the eligibility criteria. All were natural experiments published between 2011 and 2020 and all evaluated environmental social programs revealing that social programs at the environmental level promoted PA in various populations at the community level worldwide. Conclusion The 24 reviewed studies suggest innovative proposals for social programs that seek to increase PA and promote healthy lifestyles related to public activity policies developed in the countries in which they were generated. Environmental social programs can positively impact PA levels among children and adults. Systematic review registration https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=229718, identifier: CRD42021229718.
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Affiliation(s)
- Edgar D. Hernández
- Facultad de Medicina, Human Movement Department, Universidad Nacional de Colombia, Bogotá, Colombia
- *Correspondence: Edgar D. Hernández
| | - Elisa A. Cobo
- Facultad de Ciencias de la Salud, Universidad de Boyacá, Tunja, Colombia
| | - Lawrence P. Cahalin
- Department of Physical Therapy, University of Miami, Coral Gables, FL, United States
| | - Pamela Seron
- Facultad de Medicina, Universidad de La Frontera, Temuco, Chile
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Loo BKG, Okely A, Taylor R, Novotny R, Wickramasinghe P, Müller-Riemenschneider F, Waqa G, Pulungan A, Kusuda S, Tan KH. Asia-Pacific consensus statement on integrated 24-hour activity guidelines for the early years. THE LANCET REGIONAL HEALTH. WESTERN PACIFIC 2022; 32:100641. [PMID: 36785856 PMCID: PMC9918766 DOI: 10.1016/j.lanwpc.2022.100641] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 10/07/2022] [Accepted: 10/25/2022] [Indexed: 11/25/2022]
Abstract
Background Early childhood is a vital period for development and growth. Promoting beneficial lifestyle behaviours in early childhood can help optimise children's health, development and learning, shape their behaviours in adulthood and offer the best protection against future non-communicable diseases (NCDs). In the Asia-Pacific region, NCDs are significant causes of healthcare burden and mortality. Furthermore, there is also a high prevalence of adverse metabolic risk factors and unhealthy lifestyle behaviours among these children. Method Representatives from 19 Asia-Pacific nations and/or jurisdictions developed a consensus statement on integrated 24-hour activity guidelines for the early years using the GRADE-ADOLOPMENT framework. Findings These guidelines apply to all infants, toddlers and pre-schoolers below 5 years of age. The guidelines aim to provide a holistic and practical approach to lifestyle activities by framing physical activity, sedentary behaviour and sleep within a 24-hour period. Dietary patterns were included as they play an integral role in metabolic health and energy balance. Interpretation Aligned with the World Health Organization's Global Action Plan for the Prevention and Control of NCDs through health promotion interventions in early life, through cultivating healthy lifestyle behaviours in the children's early years, we aim to provide children with the best start in life and reduce the burden of future NCDs in the Asia-Pacific region. Funding Funded by Integrated platform for research in advancing metabolic health outcomes of women and children.
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Affiliation(s)
- Benny Kai Guo Loo
- Sport and Exercise Medicine Service, KK Women’s and Children’s Hospital, Singapore,Corresponding author. Department of Paediatrics, KK Women's and Children's Hospital, 100 Bukit Timah Road, Singapore, 229899, Singapore.
| | - Anthony Okely
- School of Health and Society, University of Wollongong, Sydney, New South Wales, Australia
| | - Rachael Taylor
- Department of Medicine, University of Otago, Dunedin, Otago, New Zealand
| | - Rachel Novotny
- Department of Human Nutrition, Food and Animal Sciences, University of Hawaiʻi at Mānoa, Honolulu, HI, USA
| | | | | | - Gade Waqa
- School of Public Health and Primary Care, Fiji National University, Suva, Fiji
| | - Aman Pulungan
- Endocrinology Division, Child Health Department, Faculty of Medicine, Universitas Indonesia – Dr Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - Satoshi Kusuda
- Department of Pediatrics, Kyorin University, Mitaka, Tokyo, Japan
| | - Kok Hian Tan
- Department of Maternal Fetal Medicine, KK Women’s and Children’s Hospital, Singapore
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Associations of Childcare Arrangements with Adiposity Measures in a Multi-Ethnic Asian Cohort: The GUSTO Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182212178. [PMID: 34831933 PMCID: PMC8622483 DOI: 10.3390/ijerph182212178] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Revised: 11/17/2021] [Accepted: 11/18/2021] [Indexed: 01/02/2023]
Abstract
Childcare arrangements shape behavioural patterns that influence the risk of childhood obesity. However, little is known of its influence on childhood obesity in Singapore. We aim to examine the associations between childcare arrangements at the age of 5 years and childhood adiposity at age 6 years. Children from the GUSTO study were grouped into three childcare arrangements at age 5: full-time centre-based childcare (FC), partial centre-based with parental care (PCP), and partial centre-based with non-parents (grandparents and domestic helpers) as caregivers (PCN). Diet, physical activity and sedentary behaviour information were collected at age 5, while anthropometric measurements were collected at age 6. Associations were analysed using multivariable regression models. Among 540 children, those in PCN had higher BMI z-scores (β: 0.34; 95% CI: 0.01, 0.66), greater sum of skinfold thicknesses (mm) (β: 3.75; 95% CI: 0.53, 6.97) and were 3.55 times (95% CI: 1.78, 7.05) more likely to be overweight/obese than those in FC. Adiposity measures in PCP children did not differ from those in FC. PCN children were reported to have more screen time and greater fast-food intake. Children in PCN tended to have higher adiposity measures. Greater engagement of non-parental caregivers should be considered in interventions targeting child obesity.
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Tran PTM, Adam MG, Balasubramanian R. Assessment and mitigation of toddlers' personal exposure to black carbon before and during the COVID-19 pandemic: A case study in Singapore. ENVIRONMENTAL RESEARCH 2021; 202:111711. [PMID: 34280416 PMCID: PMC9749899 DOI: 10.1016/j.envres.2021.111711] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/25/2021] [Revised: 07/13/2021] [Accepted: 07/14/2021] [Indexed: 05/17/2023]
Abstract
Black carbon (BC), an important indicator of traffic-related air pollution (TRAP) in urban environments, is receiving increased attention because of its adverse health effects. Personal exposure (PE) of adults to BC has been widely studied, but little is known about the exposure of young children (toddlers) to BC in cities. We carried out a pilot study to investigate the integrated daily PE of toddlers to BC in a city-state with a high population density (Singapore). We studied the impact of urban traffic on the PE of toddlers to BC by comparing and contrasting on-road traffic flow (i.e., volume and composition) in Singapore in 2019 (before the COVID-19 pandemic) and in 2020 (during the COVID-19 pandemic). Our observations indicate that the daily BC exposure levels and inhaled doses increased by about 25% in 2020 (2.9 ± 0.3 μg m-3 and 35.5 μg day-1) compared to that in 2019 (2.3 ± 0.4 μg m-3 and 28.5 μg day-1 for exposure concentration and inhaled dose, respectively). The increased BC levels were associated with the increased traffic volume on both weekdays and weekends in 2020 compared to the same time period in 2019. Specifically, we observed an increase in the number of trucks as well as cars/taxis and motorcycles (private transport) and a decline in the number of buses (public transport) in 2020. The implementation of lockdown measures in 2020 resulted in significant changes in the time, place and duration of PE of toddlers to BC. The recorded daily time-activity patterns indicated that toddlers spent almost all the time in indoor environments during the measurement period in 2020. When we compared different ventilation options (natural ventilation (NV), air conditioning (AC), and portable air cleaner (PAC)) for mitigation of PE to BC in the home environment, we found a significant decrease (>30%) in daily BC exposure levels while using the PAC compared to the NV scenario. Our case study shows that the PE of toddlers to BC is of health concern in indoor environments in 2020 because of the migration of the increased TRAP into naturally ventilated residential homes and more time spent indoors than outdoors. Since toddlers' immune system is weak, technological intervention is necessary to protect their health against inhalation exposure to air pollutants.
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Affiliation(s)
- Phuong T M Tran
- Department of Civil and Environmental Engineering, National University of Singapore, Singapore, 117576, Singapore; Faculty of Environment, University of Science and Technology, The University of Danang, 54 Nguyen Luong Bang Street, Lien Chieu District, Danang City, Viet Nam
| | - Max G Adam
- Department of Civil and Environmental Engineering, National University of Singapore, Singapore, 117576, Singapore
| | - Rajasekhar Balasubramanian
- Department of Civil and Environmental Engineering, National University of Singapore, Singapore, 117576, Singapore.
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Tay GWN, Chan MJ, Kembhavi G, Lim J, Rebello SA, Ng H, Lin C, Shek LP, Lança C, Müller-Riemenschneider F, Chong MFF. Children's perceptions of factors influencing their physical activity: a focus group study on primary school children. Int J Qual Stud Health Well-being 2021; 16:1980279. [PMID: 34661503 PMCID: PMC8525992 DOI: 10.1080/17482631.2021.1980279] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Purpose Establishing healthy lifestyle behaviours in primary school children is important, as these behaviours are likely to track into adulthood. This study aimed to explore the factors influencing physical activity (PA) in primary school children through their perspectives. Approach Eleven focus group discussions and one interview were conducted with 52 children (n = 29 girls) aged 9–12 years from two primary schools in Singapore. Data analyses were conducted using thematic analysis, deductively following the socio-ecological model (SEM) and inductively for themes at each SEM level. Results At individual level, children’s perceived enjoyment, health benefits and expectation of rewards motivated them to engage in PA, while time constraints and their apathy towards PA hindered PA engagement. Children’s PA occasions at home were reported to be influenced by parental permission, priorities and availability, and the availability of preferred peers. Physical environmental factors such as opportunities for PA in school, access to facilities for PA and weather influenced children’s time spent on PA and the types of activities they engaged in. Conclusion This study summarized some factors that children have reported to influence their PA behaviour. These findings could help inform future interventions aimed at promoting PA among primary school children in Singapore.
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Affiliation(s)
| | - Mei Jun Chan
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | | | - Jubilee Lim
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Salome A Rebello
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Hazyl Ng
- Health Promotion Board, Singapore
| | | | - Lynette P Shek
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.,Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore
| | | | | | - Mary Foong-Fong Chong
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore.,Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore
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Changes in Dietary Habits and Exercise Pattern of Korean Adolescents from Prior to during the COVID-19 Pandemic. Nutrients 2021; 13:nu13103314. [PMID: 34684315 PMCID: PMC8541287 DOI: 10.3390/nu13103314] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Revised: 09/18/2021] [Accepted: 09/19/2021] [Indexed: 01/24/2023] Open
Abstract
This study aimed to investigate changes in the exercise pattern and dietary habits in adolescents during the COVID-19 pandemic. The 12–18-year-old population in the Korea Youth Risk Behavior Web-Based Survey data of 2019 and 2020 was enrolled. The exercise pattern and dietary habits of 105,600 participants (53,461 in the 2019 group and 52,139 in the 2020 group) were compared. The odds ratios (ORs) for the dietary habits and exercise pattern of the 2020 group compared to the 2019 group were analyzed using multiple logistic regression analysis with complex sampling. The odds of eating fruit, drinking soda, drinking sweet drinks, and consuming fast food were lower in the 2020 group than in the 2019 group (all p < 0.001). The odds of eating breakfast were higher in the 2020 group than in the 2019 group (all p < 0.001). The 2020 group showed lower odds of frequent vigorous and moderate aerobic exercise and higher odds of frequent anaerobic exercise than the 2019 group (all p < 0.001). During the COVID-19 pandemic, adolescents consumed less fruit, soda, and sweet drinks, while they had more breakfast. The frequency of aerobic exercise was lower, while the frequency of anaerobic exercise were higher during the COVID-19 pandemic period.
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[Level of physical activity, sedentary behavior, and sleep in the early childhood population]. NUTR HOSP 2021; 38:1149-1154. [PMID: 34503337 DOI: 10.20960/nh.03488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
INTRODUCTION the daily general activity pattern of preschool aged children is composed of sleep time, sedentary time, and physical activity of mild, moderate, or vigorous intensity. OBJECTIVE to determine the compliance with the recommendations for physical activity, sedentary behavior, and sleep according to the days of the week, sex, and age in children aged from 2 to 5 years. METHODS a cross-sectional study in 361 preschool aged boys and girls. The Questionnaire for the Measurement of Physical Activity and Sedentary Behavior in Children from Preschool to 4th grade (C-MAFYCS) was used, which inquires about three behaviors (physical activity, sedentary behavior, and sleep). The statistical analysis was carried out using the SPSS, version 24 program (Simón Bolívar University license). RESULTS on average, children perform 132.4 95.2 minutes of physical activity and spend 70.4 63.4 minutes per day in sedentary behaviors. The time dedicated to active play and organized sport is greater on Saturdays and Sundays (175.1 140 minutes) (p = 0.0001). The time spent watching television was greater during the weekend (70.7 69.4 minutes). On average, preschoolers sleep 10.2 0.9 hours per day, less during the week (9.3 0.7 minutes). CONCLUSIONS balance between these behaviors is essential for the health of children in this first stage of life. It is essential that parents, caregivers, and the community in general attend to the healthy lifestyles of this population since these are patterns that are learned and acquired to remain in the following stages of the life cycle.
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Quah PL, Loo BKG, Razali NS, Razali NS, Teo CC, Tan KH. Parental perception and guideline awareness of children's lifestyle behaviours at ages 5 to 14 in Singapore. ANNALS OF THE ACADEMY OF MEDICINE, SINGAPORE 2021; 50:695-702. [PMID: 34625757 DOI: 10.47102/annals-acadmedsg.2021134] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
INTRODUCTION There are limited data on the descriptive lifestyle behaviour of school-age children in Singapore. METHODS A total of 100 parents of children ages 5 to 14 participated in a parents' proxy-reported survey. Frequency of moderate physical activity (PA) and vigorous PA was assessed, while t-tests or chi-square test was used to examine differences between weekdays and weekends for sleep, screen viewing time (SVT) and sedentary behaviour (SB). RESULTS Of the 100 children (68% of Chinese ethnicity, 59% boys, mean age 9.1±2.9 years), 31% were overweight or obese, with body mass index z-score of >1. For moderate and vigorous PA participation in a typical week, 32.0% and 43.0%, respectively, did not participate, while median (interquartile range) days of participation were 3 (2-3) days/week and 2 (1-3) days/week for a duration of 60 (interquartile range 30-120) minutes/session. When comparing weekends with weekdays, the means (standard deviation) of both SVT and sleep duration were higher on weekends (SVT: 4.1 [2.9] versus 3.3 [3.1] hours/day, P=0.07; sleep: 8.8 [1.5] vs 8.3 [1.3] hours/day, P=0.02), while there were no significant differences for SB. A higher proportion of children had SB of ≥10 hours/day and slept <8 hours/day on weekdays compared with on weekends (SB: 23.5% vs 20.6%, P>0.05; sleep:18.8% vs 2.1%, P<0.05), while the proportion exceeding SVT of 2 hours/day were higher on weekends than on weekdays (63.8% vs 45.4%, P=0.03). Overall, there was higher parental awareness of sleep guidelines (80.0%), but lower awareness of PA (51.0%) and SVT (59.0%) guidelines. CONCLUSION Lifestyle behaviours were suboptimal in Singapore children compared with existing overseas guidelines, indicating a need for an integrated guideline with greater dissemination.
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Affiliation(s)
- Phaik Ling Quah
- Division of Obstetrics and Gynaecology, KK Women's and Children's Hospital, Singapore
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Watterworth JC, Korsiak J, Keya FK, Arbour-Nicitopoulos KP, Al Mahmud A, Tam V, Roth DE. Physical Activity and the Home Environment of Pre-School-Aged Children in Urban Bangladesh. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:3362. [PMID: 33805120 PMCID: PMC8036728 DOI: 10.3390/ijerph18073362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 03/17/2021] [Accepted: 03/19/2021] [Indexed: 11/19/2022]
Abstract
Physical activity (PA) is a key determinant of health and development, yet few studies have examined PA levels and risk factors for low PA among young children in low- and middle-income countries. This study aimed to describe the PA and sedentary (SED) behavior levels of preschool-aged children in Dhaka, Bangladesh, and to estimate the associations between potential risk factors in the home built environment and moderate to vigorous PA (MVPA). In a sample of preschool-aged children (n = 65) in Dhaka, PA and SED behavior were measured for 7 days using ActiGraph GT3X-BT accelerometers. Characteristics of the home built environment, socioeconomic factors, and anthropometry were also measured. Linear mixed-effects models were used to estimate multivariable-adjusted associations between characteristics of the home environment and MVPA. Preschool-aged children spent a mean (±standard deviation) 421 ± 48 and 82 ± 23 min per day sedentary and in MVPA, respectively. There were no statistically significant associations between factors in the home built environment (indoor area, presence of an open stairwell, and presence of gross motor activity facilitating items) and MVPA. These findings suggest that the studied characteristics of the home built environment may not significantly influence the MVPA observed among preschool-aged children in Dhaka. Future research should focus on other structural and behavioral factors that facilitate PA among young children in dense urban settings.
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Affiliation(s)
- Jessica C. Watterworth
- Department of Nutritional Sciences, University of Toronto, Toronto, ON M5S 1A8, Canada;
- Centre for Global Child Health, The Hospital for Sick Children, Toronto, ON M5G 2L3, Canada; (J.K.); (V.T.)
| | - Jill Korsiak
- Centre for Global Child Health, The Hospital for Sick Children, Toronto, ON M5G 2L3, Canada; (J.K.); (V.T.)
| | - Farhana K. Keya
- International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR,B), Dhaka 1212, Bangladesh; (F.K.K.); (A.A.M.)
| | | | - Abdullah Al Mahmud
- International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR,B), Dhaka 1212, Bangladesh; (F.K.K.); (A.A.M.)
| | - Vivian Tam
- Centre for Global Child Health, The Hospital for Sick Children, Toronto, ON M5G 2L3, Canada; (J.K.); (V.T.)
| | - Daniel E. Roth
- Department of Nutritional Sciences, University of Toronto, Toronto, ON M5S 1A8, Canada;
- Centre for Global Child Health, The Hospital for Sick Children, Toronto, ON M5G 2L3, Canada; (J.K.); (V.T.)
- Division of Paediatric Medicine, Department of Paediatrics, The Hospital for Sick Children, 686 Bay Street, Toronto, ON M5G 1X8, Canada
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Lahuerta-Contell S, Molina-García J, Queralt A, Martínez-Bello VE. The Role of Preschool Hours in Achieving Physical Activity Recommendations for Preschoolers. CHILDREN-BASEL 2021; 8:children8020082. [PMID: 33504052 PMCID: PMC7911937 DOI: 10.3390/children8020082] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 01/15/2021] [Accepted: 01/20/2021] [Indexed: 11/24/2022]
Abstract
Research on physical activity (PA) in different educational settings could elucidate which interventions promote a healthy school lifestyle in early childhood education (ECE). The aims of this study were: (a) to analyse the PA levels of preschoolers during school hours, as well as the rate of compliance with specific recommendations on total PA (TPA) and moderate-vigorous PA (MVPA); (b) to examine the role of structured movement sessions and recess time in the MVPA levels during school hours; (c) to evaluate the sociodemographic correlates of preschoolers and the school environment on MVPA behaviour during school hours. PA was evaluated with Actigraph accelerometers. Our main findings were that: (a) preschoolers engaged in very little TPA and MVPA during school hours; (b) children showed significantly higher MVPA levels on days with versus without structured movement sessions, and the contribution of the structured sessions to MVPA was significantly higher than that of recess time; (c) gender and age were associated with PA, and a high density of young children on the playground was associated with high levels of vigorous PA, whereas in the classroom, high density was associated with more sedentary behaviour. Structured PA could reduce the gap in achieving international recommendations.
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Affiliation(s)
- Sara Lahuerta-Contell
- Conselleria d’Educació, Generalitat Valenciana, 46015 Valencia, Spain;
- COS Research Group, Body, Movement, Music and Curricular Practices, University of Valencia, 46022 Valencia, Spain
| | - Javier Molina-García
- Department of Teaching of Musical, Visual and Corporal Expression, University of Valencia, Avda. dels Tarongers, 4, 46022 Valencia, Spain;
- AFIPS Research Group, University of Valencia, 46022 Valencia, Spain;
| | - Ana Queralt
- AFIPS Research Group, University of Valencia, 46022 Valencia, Spain;
- Department of Nursing, University of Valencia, Jaume Roig, s/n, 46010 Valencia, Spain
| | - Vladimir E. Martínez-Bello
- COS Research Group, Body, Movement, Music and Curricular Practices, University of Valencia, 46022 Valencia, Spain
- Department of Teaching of Musical, Visual and Corporal Expression, University of Valencia, Avda. dels Tarongers, 4, 46022 Valencia, Spain;
- Correspondence: ; Tel.: +34-961625473
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