A repeated measurement study investigating the impact of school outdoor environment upon physical activity across ages and seasons in Swedish second, fifth and eighth graders

Multidimensional school features associated with physical activity among youth at risk of obesity: an exploratory principal component and generalized estimating equation analysis

BACKGROUND

Schools may be high-leverage points for the promotion of physical activity (PA), yet little is known about school built and social environments among youth at high risk of obesity.

PURPOSE

To characterise school built and social environments that may be salient for PA and to examine associations between school PA environments and PA in youth at risk of obesity.

METHODS

Data from youth attending 206 schools (314 youth in 2005-2008, and 129 youth in 2008-2010) within the QUALITY cohort study, a longitudinal investigation of youth at high risk of obesity were used. Features of schools, based on built, policy/programming and social environments were identified using principal components (PC) analysis. Gender-stratified generalized estimating equation (GEE) models were used to explore associations between school features and accelerometer measured mean counts per minute (MCPM), mean daily moderate-to-vigorous physical activity (MVPA) and the odds of meeting MVPA guidelines cross-sectionally and prospectively using 90% confidence intervals.

RESULTS

Nine PCs were identified. Associations were observed between PA and 7 of the 9 PCs. The social environment seemed to be particularly important. Social Norms to Promote PA was associated with an increase in girls' baseline MCPM and MVPA. High Willingness to Promote PA was associated with boys' MCPM, MVPA, and odds of meeting MVPA guidelines, at both baseline and follow-up.

CONCLUSION

School built and social contexts may be associated with PA cross-sectionally and over time. Further studies are necessary to confirm the direction and magnitude of effects and to establish their relevance to school-based health promotion efforts.

School Children's Physical Activity and Preferred Activities during Outdoor Recess in Estonia: Using Accelerometers, Recess Observation, and Schoolyard Mapping

Studies about recess have found that children have higher physical activity (PA) during outdoor recess compared to indoor recess, and well-constructed schoolyards play an important role in stimulating PA in children. This study aimed at investigating the affordances of schoolyards and outdoor recess PA in two urban and two rural primary schools in Estonia. Schoolyards were described with the geographical mapping method, children's activities during outdoor recess were registered by using observations, and PA levels were measured with accelerometers. Students from grades two to six (8-13-year-olds) were included in the study. All observed schoolyards had different spaces including various ball game areas, climbing facilities, and slacklines. The natural environment dominated in the rural schools, and artificial surfaces dominated in the urban schools. Boys in the study tended to enjoy more sport-related activities, whereas girls preferred more social and less active activities. Students participating in outdoor recess spent about twice as much time (20.4%) on moderate-to-vigorous PA (MVPA) compared to indoor recess (9.5%), although boys were more active than girls (22.9% vs. 17.3%). All schoolyards afforded more MVPA during outdoor recess compared to indoor recess, whereas schoolyards with more space per child and natural environment elements generated more varied PA and higher MVPA. These findings confirm the importance of schoolyard design and quality for the variety and intensity of students' PA during outdoor recess.

Enjoyed by Jack but Endured by Jill: An Exploratory Case Study Examining Differences in Adolescent Design Preferences and Perceived Impacts of a Secondary Schoolyard

The school grounds provide students opportunities for respite, relaxation and relief from daily stresses during breaks in the school day. However, it is unclear whether secondary schoolyard designs adequately support the diverse and evolving needs of adolescents, particularly at a time when they are experiencing rapid emotional and physical developmental change. To investigate this, quantitative methods were used to explore differences in perceptions of schoolyard attractiveness and restorative quality based on student gender and year level. A school-wide survey was administered to approximately 284 students in years 7 to 10 at a secondary school in Canberra, Australia. Results indicate significant declines in student perceptions of schoolyard attractiveness and restorative quality. Higher ratings of schoolyard likeability, accessibility, personal connection and restorative quality of 'being away' were associated with male students across all year levels. Further work is needed to explore how schoolyard environments can better support the design preferences and well-being needs of older and female students. Such information would help planners, designers and land managers develop schoolyard designs that are more equitable in their benefits to secondary school students of different genders and year levels.

Campus outdoor environment, learning engagement, and the mental health of college students during the COVID-19 pandemic: From the perspective of students in different grades

Introduction

During COVID-19, the mental health of Chinese university students has been a pressing concern. But the internal mechanism of perceived campus outdoor environment and learning engagement affecting college students' mental health during the COVID-19 pandemic has not been fully discussed.

Methods

The current study used cross-sectional data from 45 Chinese universities to explore the relationship among perceptions of campus outdoor environments, learning engagement, and college student mental health, and focused on differences among college students in different grades.

Results

Our study revealed the mental health problems of Chinese college students during the COVID-19 pandemic were more severe. The mental health of postgraduates was generally poor, and their risk of depression was higher than that of undergraduates. More importantly, for postgraduates, the direct impact of the perceived campus outdoor environment on their mental health was stronger. For undergraduates, the indirect impact of learning engagement on the effect of the perceived campus outdoor environment on their mental health was stronger.

Conclusion

The results of the study have implications for campus planners, landscape architects, and university planners to pay particular attention to the needs of postgraduates for campus outdoor environments, which is of great significance to improve the overall mental health of students during the COVID-19 pandemic.

Choose Your Own Adventure: Promoting Social and Emotional Development Through Outdoor Learning

Primary school (i.e., Kindergarten to Grade 3) educators typically support students' social and emotional learning (SEL) through targeted lessons delivered in the classroom; however, integrating SEL strategies into other subject areas both within and outside the classroom context can expand their ability to support students' SEL. Research suggests that outdoor learning (OL) can help promote students' social and emotional development. Thus, this study explored qualitative data generated through focus group interviews with 36 Canadian primary school educators who implemented OL to understand their perspectives on the benefits of OL for primary school students, including whether SEL promotion was perceived as a key benefit. Most of the themes generated through thematic analysis pertained to students' social and emotional development and aligned with SEL competencies defined in a dominant SEL framework. One overarching theme suggested that educators perceived the emergent, unstructured nature of OL as driving the SEL-related benefits. Findings suggest that educators can leverage the OL context to help integrate SEL more deeply into their teaching practice.

An unsupervised machine learning approach to evaluate sports facilities condition in primary school

Sports facilities have been acknowledged as one of the crucial environmental factors for children’s physical education, physical fitness, and participation in physical activity. Finding a solution for the effective and objective evaluation of the condition of sports facilities in schools (SSFs) with the responding quantitative magnitude is an uncertain task. This paper describes the utilization of an unsupervised machine learning method to objectively evaluate the condition of sports facilities in primary school (PSSFC). The statistical data of 845 samples with nine PSSFC indicators (indoor and outdoor included) were collected from the Sixth National Sports Facility Census in mainland China (NSFC), an official nationwide quinquennial census. The Fuzzy C-means (FCM) algorithm was applied to cluster the samples in accordance with the similarity of PSSFC. The clustered data were visualized by using t-stochastic neighbor embedding (t-SNE). The statistics results showed that the application of t-SNE and FCM led to the acceptable performance of clustering SSFs data into three types with differences in PSSFC. The effects of school category, location factors, and the interaction on PSSFC were analyzed by two-way analysis of covariance, which indicated that regional PSSFC has geographical and typological characteristics: schools in the suburbs are superior to those in the inner city, schools with more grades of students are configured with better variety and larger size of sports facilities. In conclusion, we have developed a combinatorial machine learning clustering approach that is suitable for objective evaluation on PSSFC and indicates its characteristics.

Elevating the Role of the Outdoor Environment for Adolescent Wellbeing in Everyday Life

In light of concerns about adolescent mental health, there is a need to identify and examine potential pathways to wellbeing in their daily lives. Outdoor environments can offer multiple pathways to wellbeing through opportunities for restoration, physical activity and socialising. However, urbanisation and new lifestyles revolving around the home and the internet are changing young people's access, use and relationship to the outdoor environment. The authors point out how the research related to adolescents' outdoor environments is generally not treated with the same level of importance or as comprehensively as that for younger children. The aim of this paper is to pave the way for research and planning initiatives on everyday outdoor environments promoting the wellbeing of adolescents and the authors suggest ways in which perspectives from developmental psychology might inform the study of adolescents' outdoor environments. The paper concludes by calling for an elevated focus on the role of outdoor environments in adolescents' everyday lives as a source of wellbeing and more research that makes clear the specific attributes, activities and experiences related to places outdoors which make adolescents feel good.

Schoolyard Affordances for Physical Activity: A Pilot Study in 6 Nordic–Baltic Countries

Environmental settings influence children’s and adolescents’ physical activity (PA) in neighborhoods and schoolyards. This study aimed to explore the main characteristics of schoolyards in six Nordic–Baltic countries, to document how those facilities provide affordances for PA in 7–18 year–old schoolchildren, and how the schoolyard meets children’s preferences. One schoolyard was studied in each included country: Iceland, Norway, Finland, Lithuania, Latvia, and Estonia. The affordances, facilities, and equipment for PA in schoolyards were identified through orthophoto maps and standard registration forms. Children’s preferences were collected through group interviews at each participating school. A common design of schoolyards across countries indicated mostly flat topography with sparse vegetation and green areas dominated by large traditional sport arenas such as a football field, areas suitable for ball games, and track and field activities. Green spaces and varied topography were more prominent in Nordic countries. Across nationalities, the responses from pupils regarding the schoolyard were similar: they liked it though they wished for more variety of activities to do during recess. National regulations/recommendations for schoolyard design differed across the countries, being more restricted to sport fields and sport-related activities in Latvia and Lithuania, while in Nordic countries, the recommendations focused more on versatile schoolyard design.

Nature and Children's Health: A Systematic Review

CONTEXT

Daily outdoor play is encouraged by the American Academy of Pediatrics. Existing evidence is unclear on the independent effect of nature exposures on child health.

OBJECTIVE

We systematically evaluated evidence regarding the relationship between nature contact and children's health.

DATA SOURCES

The database search was conducted by using PubMed, Cumulative Index to Nursing and Allied Health Literature, PsychInfo, ERIC, Scopus, and Web of Science in February 2021.

STUDY SELECTION

We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. In all searches, the first element included nature terms; the second included child health outcome terms.

DATA EXTRACTION

Of the 10 940 studies identified, 296 were included. Study quality and risk of bias were assessed.

RESULTS

The strongest evidence for type of nature exposure was residential green space studies (n = 147, 50%). The strongest evidence for the beneficial health effects of nature was for physical activity (n = 108, 32%) and cognitive, behavioral, or mental health (n = 85, 25%). Physical activity was objectively measured in 55% of studies, and 41% of the cognitive, behavioral, or mental health studies were experimental in design.

LIMITATIONS

Types of nature exposures and health outcomes and behaviors were heterogenous. Risk of selection bias was moderate to high for all studies. Most studies were cross-sectional (n = 204, 69%), limiting our ability to assess causality.

CONCLUSIONS

Current literature supports a positive relationship between nature contact and children's health, especially for physical activity and mental health, both public health priorities. The evidence supports pediatricians in advocating for equitable nature contact for children in places where they live, play, and learn.

Associations between BMI and visual impairment of 33 407 preschool children in Germany: a pooled cross-sectional study

BACKGROUND

Prevalence of overweight and obesity in Germany is increasing. High body weight can affect children's growth and development. This paper aimed to determine the association between body mass index (BMI) and visual impairment among preschool children and explore the potential role of obesity in predicting visual developmental disorder.

METHODS

Six consecutive years of data from the School Entry Examination were collected for all preschool children aged from 4 to 6 years residing in Rhine-Neckar County and the City of Heidelberg, Germany from 2013 to 2018. Univariate and multivariate regression were used to analyze the complete data, multiple imputation was used to deal with missing data.

RESULTS

Among the group with an immigrant background, children with obesity [OR = 1.20, 99% (1.02-1.42)] were more likely to have visual impairment compared to those with normal body weight (P < 0.01) after adjusting for survey year, age, and gender of children, education and occupation of parents, screen time-frequency, whether a television was in their bedroom, and quality of preschool outdoor environment.

CONCLUSION

There were significant associations between obesity and visual impairment among German preschool children with immigrant backgrounds. Strategies to support vulnerable groups were needed across all regional schools.

Nature’s Services and Contributions: The Relational Value of Childhood Nature Experience and the Importance of Reciprocity

People depend on functioning ecosystems to meet human needs and support well-being across the life span. This article considers the interest in ecosystem service valuation, the growing interest in the benefits of nature experience for children, and ways to bridge these perspectives. We focus on embodied childhood nature experiences: the physical and multisensory experiences that intertwine child and nature. Additionally, we highlight the reciprocal quality of nature and child experience relationship as an example of how this relationship goes beyond the instrumental and demonstrates relational value. Underlying this perspective is the belief that children need to be better represented in the perception and action of ecosystem valuation in environmental policy.

Recess Behaviors of Urban Children 16 Months After a Green Schoolyard Renovation

BACKGROUND

Green schoolyard renovations lead to immediate positive changes in moderate to vigorous physical activity (MVPA) and social behavior. This pilot study examines whether these benefits are equally distributed across gender and age and maintained 16 months postgreening.

METHODS

Physical activity and social interactions during recess were recorded at control (n = 389) and experimental (n = 642) Title I urban elementary schools with direct observation and accelerometers.

RESULTS

Activity profiles were similar to 4-month postgreening and to baseline for experimental girls and boys, respectively. There was no difference in MVPA minutes between sexes (girls = 11.8; 95% confidence interval [CI], 11.1 to 12.5]; boys = 12.8; 95% CI, 12.0 to 13.4) and no difference in sitting minutes between age groups (first to fourth = 2.0; 95% CI, 1.5 to 2.6; fifth to sixth = 1.8; 95% CI, 1.1 to 2.4) in green areas. Experimental students spent more time in MVPA (11.2 min; 95% CI, 10.6 to 11.8 vs 8.9 min; 95% CI, 8.3 to 9.3), in small groups (10.6 min; 95% CI, 10.2 to 11.0 vs 9.2 min; 95% CI, 8.5 to 9.9), and engaged in more prosocial interactions (5.5; 95% CI, 5.1 to 6.3 vs 3.7; 95% CI, 3.0 to 4.2) than control students.

CONCLUSIONS

Green schoolyard renovations result in persistent changes to recess behavior that are characteristic of a more collaborative community and counteract age-related declines in MVPA, particularly for girls.

How Do Urban Environments Affect Young People's Mental Health? A Novel Conceptual Framework to Bridge Public Health, Planning, and Neurourbanism

Childhood and adolescence are crucial periods for mental and social development. Currently, mental illness among young people is a global epidemic, and rates of disorders such as depression and anxiety are rising. Urban living, compared with rural living, is linked with a higher risk of serious mental illness, which is important because the world is urbanizing faster than ever before. Urban environments and their landscapes, designs, and features influence mental health and well-being. However, no conceptual frameworks to date have detailed the effect of urban environments on young people's mental health, and few studies have considered the growing role of digital and social media in this relationship, leading to calls for the development of holistic approaches to describe this relationship. This article synthesizes existing knowledge on urban places (both built and natural environments) and mental health in the public health and urban planning literature and examines the emerging field of neurourbanism (a multidisciplinary study of the effect of urban environments on mental health and brain activity) to enhance current practice and research. We developed 2 novel conceptual frameworks (1 research-oriented, 1 practice-oriented), adapted from Bronfenbrenner's socioecological model, that focus on the relationship between urban environments and young people's mental health. We added a digital and social media contextual level to the socioecological model, and we applied a multilayer concept to highlight potential cross-field interactions and collaborations. The proposed frameworks can help to guide future practice and research in this area.

Pupils' use of school outdoor play settings across seasons and its relation to sun exposure and physical activity

BACKGROUND

Long outdoor stay may cause hazardous exposure to ultraviolet radiation (UVR) from the sun even at high latitudes as in Sweden (Spring to Autumn). On the other hand, long outdoor stay is a strong predictor of primary school children´s free mobility involving moderate to vigorous physical activity (MVPA). UV-protective outdoor environments enable long outdoor stay. We investigated the concurrent impact of different school outdoor play settings upon pupils´ sun exposure and levels of physical activity across different ages, genders, and seasons.

METHOD

During 1 week each in September, March, and May, UVR exposure and MVPA were measured in pupils aged 7-11 years. Erythemally effective UVR exposure was measured by polysulphone film dosimeters and MVPA by accelerometers. Schoolyard play was recorded on maps, and used areas defined as four play settings (fixed play equipment, paved surfaces, sport fields, and green settings), categorized by season and gender.

RESULTS

During the academic year, sport fields yielded the highest UVR exposures and generated most time in MVPA. In March, time outdoors and minutes in MVPA dropped and UVR exposures were suberythemal at all play settings. In May, green settings and fixed play equipment close to greenery promoted MVPA and protected from solar overexposure during long outdoor stays.

CONCLUSION

More outdoor activities in early spring are recommended. In May, greenery attractive for play could protect against overexposure to UVR and stimulate both girls and boys to vigorous play.

Play as a Method to Reduce Overweight and Obesity in Children: An RCT

Background: Overweight and obesity are the result of a complex interaction between genetic and environmental factors, which begins prenatally. Aim: To analyse an intervention based on play as a means of improving the body composition of children who are overweight or obese. Methods: The Kids-Play study is a randomized clinical trial (RCT) consisting of 49 children aged 8–12 years on a nine-month intervention programme based on physical activity, play and nutritional advice. Controls had another 49 children, who received only nutritional advice. Results: The play-based intervention achieved a moderate-vigorous level of physical activity in the study group of 81.18 min per day, while the corresponding level for the control group was only 37.34 min. At the start of the intervention, the children in the study group had an average body fat content of 41.66%, a level that decreased to 38.85% by the end of the programme. Among the control group, body fat increased from 38.83% to 41.4% during the same period. Conclusions: The intervention programme considered, based on both play and nutritional recommendations, produced a decrease in body fat among children aged 8–12 years. However, the control group, which received only nutritional recommendations, experienced an increase in body weight.

Designing Activating Schoolyards: Seen from the Girls' Viewpoint

Girls are typically less active in the schoolyard during recess than boys. It is therefore necessary to understand influences on girls’ recess activity in schoolyards. The aim of this qualitative study was to investigate girls’ perceptions of physical environmental factors influencing recess physical activity in re-designed schoolyards and to compare the perceptions of girls from different age groups. In 2018, 50 girls from five Danish schools were interviewed using photo-elicitation. The girls were from Grade 4 (n = 28, age 10–11) and Grade 6 (n = 22, age 12–13). Data were analysed using pen profiles constructed from verbatim transcripts. Ten factors emerged: variety, accessibility, size, designated spaces, greenery, playground markings, active play facilities, sports facilities, play equipment, and speakers. Play facilities (trampolines, obstacle courses, dancing and gymnastic appliances) were favoured over traditional sport facilities. Designated spaces, greenery and speakers were important for feeling comfortable within the schoolyard. Although similar factors were raised by the two age groups, some factors were perceived as enablers by the youngest and as barriers by the oldest girls, highlighting the complexity of designing schoolyards that cater to all ages. A greater understanding of how different designs and facilities may be perceived by girls of different ages is important for the design of future schoolyards.

Do Experiences With Nature Promote Learning? Converging Evidence of a Cause-and-Effect Relationship

Do experiences with nature - from wilderness backpacking to plants in a preschool, to a wetland lesson on frogs-promote learning? Until recently, claims outstripped evidence on this question. But the field has matured, not only substantiating previously unwarranted claims but deepening our understanding of the cause-and-effect relationship between nature and learning. Hundreds of studies now bear on this question, and converging evidence strongly suggests that experiences of nature boost academic learning, personal development, and environmental stewardship. This brief integrative review summarizes recent advances and the current state of our understanding. The research on personal development and environmental stewardship is compelling although not quantitative. Report after report - from independent observers as well as participants themselves - indicate shifts in perseverance, problem solving, critical thinking, leadership, teamwork, and resilience. Similarly, over fifty studies point to nature playing a key role in the development of pro-environmental behavior, particularly by fostering an emotional connection to nature. In academic contexts, nature-based instruction outperforms traditional instruction. The evidence here is particularly strong, including experimental evidence; evidence across a wide range of samples and instructional approaches; outcomes such as standardized test scores and graduation rates; and evidence for specific explanatory mechanisms and active ingredients. Nature may promote learning by improving learners' attention, levels of stress, self-discipline, interest and enjoyment in learning, and physical activity and fitness. Nature also appears to provide a calmer, quieter, safer context for learning; a warmer, more cooperative context for learning; and a combination of "loose parts" and autonomy that fosters developmentally beneficial forms of play. It is time to take nature seriously as a resource for learning - particularly for students not effectively reached by traditional instruction.

Omega-3 fatty acids does not affect physical activity and body weight in primary school children - a double-blind randomized placebo-controlled trial

It was hypothesized that supplementation of omega-3 fatty acids could increase physical activity (PA) levels, where traditional interventions often fail. The aim of this double-blind, randomized, placebo-controlled trail was to evaluate the effects of 15-week administration of omega-3 fatty acids on objectively measured PA and relative body weight in 8–9 year-old children. The children were randomly assigned to supplementation of omega-3 fatty acids or placebo. Primary outcome was change in PA counts per minute (cpm), and secondly change in body mass index standard deviation score (BMI SDS). Covariance models were applied adjusting for age, gender, weight status, PA and intervention season. Compliance was controlled for by analyzing fatty acid composition in plasma. The intention to treat population consisted of 362 children (omega-3 n = 177, placebo n = 185). No significant effects of omega-3 fatty acids on PA or relative body weight were observed. In covariance models no effects were observed by gender, weight status or change in PA (all p > 0.05), but inactive children increased their PA more than children classified as active at baseline (p < 0.05).

Alterations in physique among young children after the Great East Japan Earthquake: Results from a nationwide survey

Background

Data for earthquake-related alterations in physique among young children in developed countries is lacking. The Great East Japan Earthquake caused severe damage in Iwate, Miyagi, and Fukushima Prefectures in northeastern Japan.

Methods

We retrospectively obtained anthropometric measurements in nursery school from 40,046 (cohort 1, historical control) and 53,492 (cohort 2) children aged 3.5–4.5 years without overweight in October 2008, and in October 2010, respectively. At the time of the earthquake in March, 2011, children in cohort 1 had already graduated from nursery school; however, children in cohort 2 were still enrolled in nursery school at this time. We compared the onset of overweight at 1 year after the baseline between children enrolled in their school located in one of the three target prefectures versus those in other prefectures using a logistic regression model, with adjustment for sex, age, history of disease, and obesity index at baseline. Overweight was defined as an obesity index of >+15%, which was calculated as (weight minus sex- and height-specific standard weight)/sex- and height-specific standard weight.

Results

The odds ratio (OR) for the onset of overweight in the three target prefectures was significant in cohort 2 (OR 1.25; 95% confidence interval [CI], 1.01–1.55) but not in cohort 1. When the two cohort were pooled (n = 93,538), the OR of the interaction term for school location × cohort was significant (OR 1.56; 95% CI, 1.09–2.23).

Conclusions

Incident overweight in young children was significantly more common in the three prefectures affected by the Great East Japan Earthquake than in other prefectures after the disaster.

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We obtained anthropometric data from 93,538 children aged 3.5–4.5 years.

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Anthropometric data were measured before and after the Great East Japan Earthquake.

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We compared the data in Iwate, Miyagi, and Fukushima vs. the other prefectures.

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Incident overweight was higher in the three prefectures than the other prefectures.

Schoolyard upgrade in a randomized controlled study design-how are school interventions associated with adolescents' perception of opportunities and recess physical activity

School recess physical activity is important for adolescent s health and development, and several studies have established evidence based on cross-sectional studies that it is influenced by the environment in the schoolyard. The aim of this study was to investigate the effect and variation across schools of a school-based intervention on students perceived opportunities for physical activity in the schoolyard, and to evaluate if an improved collective perception of opportunities was followed by an increase in PA during recess for the 13-15 year-old students. The intervention components included schoolyard renovation; mandatory outdoor recess; and increased adult supervision and support. Students collective perceptions were evaluated by a newly developed Schoolyard index (SYi) with seven items, and physical activity was objectively measured with accelerometer. We found variations in the change of student perceptions across the intervention schools, and that a one unit increase in the Schoolyard index (SYi) led to a 12% increase in recess PA. This study shows that adolescent PA during recess can be increased through a multicomponent intervention. The prospect for making an impact is low and according to the process analysis dependent on direct involvement; active and supportive adults; and varied, connected and well located facilities.

Levels of physical activity during physical education lessons in Sweden

AIM

The aim of this study was to measure the percentage of sedentary light and moderate-to-vigorous physical activity (%MVPA) provided by physical education (PE) lessons for Swedish second, fifth and eighth grade students, aged eight, 11 and 14.

METHODS

We observed 39 PE lessons and divided them into seven lesson categories: ball play, ball games, dance, fitness, playing games, orienteering and gymnastics. Physical activity (PA) during PE was estimated using accelerometers and the height and weight of the children were measured.

RESULTS

We studied 149 children: 63 in the second grade, 66 in the fifth grade and 19 in the eighth grade. On average, 25% of the PE lessons were spent in MVPA and the mean %MVPA varied with the lesson content, with fitness, orienteering and playing games being the most intense. The highest %MVPA was in the fitness category, providing 33% (8-62%) for girls and 37% (7-72%) for boys. With the exception of the second grade, no significant gender differences in %MVPA were seen.

CONCLUSION

The content of Swedish PE lessons affected the %MVPA in all age groups. In some content, individuals reached two-thirds of their daily PA recommendations, highlighting the potential that PE contributes to public health goals.

Places where children are active: A longitudinal examination of children's physical activity

Using two-year longitudinal data, we examined locations where children spent time and were active, whether location patterns were stable, and relationships between spending time in their home neighborhood and moderate to vigorous physical activity (MVPA). At two time points (2007-2009 and 2009-2011), children living in the metropolitans areas of either San Diego, CA or Seattle, WA wore an accelerometer, and parents recorded their child's locations for seven days. Across two years, global average proportion of time spent in each location was stable, but total time and proportion of time in each location spent in MVPA decreased significantly across all locations. Children spent the largest proportion of time in MVPA in their home neighborhood at both time points, although they spent little time in their home neighborhood.

Schoolyard Characteristics, Physical Activity, and Sedentary Behavior: Combining GPS and Accelerometry

BACKGROUND

Physical activity (PA) is decreasing among children, while sedentary behavior (SB) is increasing. Schoolyards seem suitable settings to influence children's PA behavior. This study investigated the associations between schoolyard characteristics and moderate-to-vigorous physical activity (MVPA) and SB of children aged 8-11 years at schoolyards.

METHODS

Twenty primary schools in the Netherlands were involved. A total of 257 children wore an accelerometer and global positioning system (GPS) device for 5 consecutive days to objectively assess their PA levels and presence at the schoolyard, respectively. Accelerometer and GPS data were merged using the personal activity and location measurement system. Multilevel linear regression analyses were used to study correlates of MVPA and SB at schoolyards.

RESULTS

On average, children spent 54 minutes a day at the schoolyard, 9 minutes of which were spent in MVPA and 20 minutes in SB. Boys engaged in MVPA longer than girls at the schoolyard. Fixed equipment, such as high bars and soccer goals, teacher-initiated activities, and the presence of a ball games policy were correlates of more MVPA and less SB.

CONCLUSION

Well-designed schoolyards, including PA-enhancing fixed equipment, a supportive PA climate created by teachers, and supportive schoolyard policies may contribute to increased PA and decreased SB during school recess among school-aged children.

Physical activity and sedentary behavior in Belgium (BNFCS2014): design, methods and expected outcomes

Background

There is strong evidence to indicate that regular moderate intensity physical activity is associated with health benefits. Furthermore, sedentary behavior has been related with an increased risk for all-cause mortality. The accurate measurement of physical activity and sedentary behavior is therefore vital to evaluate their health impact and provide evidence for the development of public health recommendations. This paper describes the methodology used for assessing physical activity and sedentary behavior in the Belgian population in the context of the Belgian National Food Consumption Survey 2014 (BNFCS2014).

Results

Data about physical activity and sedentary behavior were collected as part of the cross-sectional BNFCS2014 between February 2014 and May 2015. A nationally-representative sample of children (3–9 years) and adolescents (10–17 years) were asked to wear an accelerometer (Actigraph® GT3X) during their waking hours for 7 consecutive days. Data were recorded in 15-second epochs and respondents with at least 2 valid week days (i.e., 10 h of wear-time) and 1 valid week-end day (i.e., 8 h of wear-time) were retained for the analyses. The Evenson cut points were used to assess the time spent in each physical activity intensity level: sedentary, low, moderate and vigorous. Complementary, diaries were provided to register the activities performed when the accelerometer was removed; these activities were added to the measures provided by the accelerometers. In addition, age-specific self-reported questionnaires (ToyBox and FPAQ) were completed to provide contextual information about the type of activities performed. Due to financial constraints, physical activity in adults (18–64 years) was assessed and described through the self-reported International Physical Activity Questionnaire (IPAQ long version) only.

Conclusion

Data were collected in the context of the BNFCS2014 to provide a comprehensive picture of the physical activity and sedentary behavior in the Belgian population, with a special focus on children (3–9 years) and adolescents (10–17 years). Levels of physical activity and sedentary behavior can be compared to international guidelines and analyzed according to several background variables, such as age, gender, Body Mass Index, education level and region. Such results are aimed to underpin future policies in the field of physical activity.

Permanent play facility provision is associated with children's time spent sedentary and in light physical activity during school hours: A cross-sectional study

Objective: To study the associations between: 1) number of permanent outdoor play facilities per pupil and 2) the size of the outdoor play area per pupil with sedentary time and physical activity (PA) during school hours in six-, nine-, and 15-year olds. We conducted a cross-sectional study of nationally representative samples of Norwegian six- (n = 1071), nine- (n = 1421) and 15-year-olds (n = 1106) in 2011 (the Physical Activity Among Norwegian Children Study). The participation rates were 56.4%, 73.1% and 57.8% for six-, nine- and 15-year olds, respectively. We assessed PA objectively for seven consecutive days using accelerometers, the size of a school's outdoor play area (SOPA) using an online map service and the permanent play facility (PPF) provision using a standardized form during school site visits. We successfully measured SOPA and PPF in 99 schools, from which 3040 participants provided valid accelerometer data. We used generalized least-squares random-effects models with robust variance estimation to assess associations. Our results indicate that better provision of permanent play facilities may reduce sedentary time and increase time spent in light PA among six-year-olds. Permanent play facility provision was not associated with sedentary time or PA among nine- and 15-year-olds. Associations found between outdoor play area size, physical activity and sedentary time were negligible. Future research should investigate what types of permanent play facilities may be associated with physical activity in both children and adolescents.

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Permanent play facility provision was associated with sedentary time.

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Permanent play facility provision was associated with light PA.

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Permanent play facility provision was not associated with MVPA.

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Outdoor play area size was not associated with sedentary time or PA.

Compulsory School In- and Outdoors-Implications for School Children's Physical Activity and Health during One Academic Year

Regulated school days entail less free-living physical activity (PA) and outdoor stay, which may jeopardize the opportunities for cohesive moderate-to-vigorous physical activity (MVPA) and, by extension, children’s health. The role of outdoor stay during school time for pupils’ free-living PA vs. physical education (PE) and indoor stay was studied during one academic year in 196 pupils aged 7–14 years at four schools in mid-southern Sweden during five consecutive days each in September, March, and May. Actigraph GT3X+ Activity monitors were used. Predictors for PA during school stay were expressed as mean daily accelerometer counts and were measured per season, day, grade, gender, weather, and time outdoors. Overall, free-living PA outdoors generated the highest mean accelerometer counts for moderate and vigorous PA. Outdoor PA and PE, representing 23.7% of the total school time contributed to 50.4% of total mean accelerometer counts, and were the greatest contributors to moderate and vigorous PA. Age and weather impacted PA, with less PA in inclement weather and among older pupils. More time outdoors, at all seasons, would favorably increase school children’s chances of reaching recommended levels of PA.

Suberythemal Sun Exposures at Swedish Schools Depend on Sky Views of the Outdoor Environments - Possible Implications for Pupils' Health

More scheduled outdoor stay is increasingly advocated for school children. This study measured 2(nd) , 5(th) and 8(th) graders' erythemal UV-exposure in September, March and May at four Swedish schools. We related those exposures, as fractions of total available ambient radiation, to the schools outdoor environments differing in amount of shade, vegetation, and peripheral city-scape quantified as percentage of free sky view calculated from fish-eye photographs. Exposures correlated with the sky views (with exceptions in May) and were suberythemal. The exposures were also below the threshold limit of the International Commission on Non-Ionizing Radiation Protection (ICNIRP) for hazard evaluation of UVR but were potentially enough for adequate vitamin D formation according to a cited model calculation - as illustrated in the results and discussed. The school environments, typical in southern and middle Sweden, offer enough shade to protect children from overexposure during seasons with potentially harmful solar UV radiation. Pupils' outdoor stay may be extended during September and March. In May extended outdoor stay of the youngest pupils requires a more UVR-protective environment.

Physical activity decreased by a quarter in the 11- to 12-year-old Swedish boys between 2000 and 2013 but was stable in girls: a smartphone effect?

AIM

This study explored physical activity, body mass index (BMI) and overweight and obesity from 2000 to 2013 using a convenience sample of second- and fifth-grade Swedish schoolchildren aged 8-9 years and 11-12 years, respectively.

METHODS

We examined cross-sectional cohorts of 126 second-grade children in 2000, 84 in 2006 and 44 in 2013 and 105 fifth-grade children in 2000 and 38 in 2013. No fifth graders were available in 2006. Physical activity data were collected based on pedometer readings over four consecutive weekdays, and height and weight were measured. Identical instruments and procedures were used in all three years.

RESULTS

There was an increase in physical activity in second-grade girls from 2000 to 2006 (p < 0.01), which then stabilised between 2006 and 2013, but second-grade boys and fifth-grade girls were stable throughout the study period. Fifth-grade boys decreased significantly (24%) from 16 670 to 12 704 steps per day (p < 0.01) from 2000 to 2013. Mean BMI scores remained stable over time.

CONCLUSION

Time trends in physical activity differed between boys and girls. Second-grade boys and fifth-grade girls were stable throughout, whereas second-grade girls increased from 2000 to 2006 before stabilising. Fifth-grade boys showed a significant 24% reduction from 2000 to 2013. Changes in recess and leisure time habits, such as smartphone use, may have influenced the result.