The freedom to explore: examining the influence of independent mobility on weekday, weekend and after-school physical activity behaviour in children living in urban and inner-suburban neighbourhoods of varying socioeconomic status

After-School Activities of Japanese Elementary School Children: Comparison of Children Who Attend Lessons and Cram Schools With Those Who Do Not

BACKGROUND

This study examined the after-school activities of Japanese elementary school children in which little information is available for understanding the process by which participation in organized activities leads to the decrease in children's independent mobility.

METHODS

One thousand eight hundred and twenty-four mothers of elementary school children participated in an online survey. The mothers responded to the questions on the number of lessons (or cram schools) their children attended weekdays, as well as their children's behavior after classes, and parents providing transportation when their children go out to play.

RESULTS

The proportion of children attending lessons and/or cram schools increased as their grades progressed. A significant interaction existed between the degree of parental transportation and grade in terms of whether or not the children attended lessons and/or cram schools. Parental involvement included pick up or drop-off for a large percentage of younger children without lessons, whereas the degree of parental involvement was greater for older children attending lessons. In other words, parents of children without attending lessons or cram schools tended to allow children to engage in independent activities when they reached the higher grades, whereas parents of children who frequently attended lessons and cram schools tended to remain involved in transporting their children, even when they reached the higher grades.

CONCLUSIONS

The results suggested that the participation of children in organized activities leads to a routine of parental pickup and/or drop-off, which renders difficult the facilitation of opportunities for children to independently participate in play activities.

Children's Independent Mobility, School Travel, and the Surrounding Neighborhood

INTRODUCTION

Children's active travel to and from school (AST) and children's independent mobility (CIM) are consistently positively associated with physical activity (PA); however, few researchers have investigated associations between objective measures of the environment and indicators of AST and CIM in national samples.

METHODS

A national sample of 2,067 Canadian parents of 7- to 12-year-old children was recruited in December 2020. Regression analyses were used in 2023 to assess the association between geographic information system measures of park density, blue space, population density, greenspace, intersection density, and CIM and AST to and from school.

RESULTS

Children in areas with high versus low park density (>0.025 vs. ≤0.025) had higher odds of travel to school via active modes (OR: 1.47 [1.14, 1.91], p=0.003). Children in neighborhoods in the highest quartile for neighborhood greenspace (Normalized Difference Vegetation Index) were more likely to travel to home actively than those in areas of lower greenspace (OR: 1.70 [1.18, 2.45], p=0.004). On average, children living in areas in the highest versus the lowest quartile for intersection density were more likely to engage in AST to (OR: 2.43 [1.58, 3.75], p<0.001) and from (OR: 2.77 [1.80, 4.29], p<0.001) school.

CONCLUSIONS

The observed associations underscore a need for city planners and policymakers to ensure sufficient access to parks and neighborhood greenspace, especially if findings are confirmed in longitudinal studies. More research is needed to investigate the role of intersection density in supporting AST and CIM.

Investigating social inequalities in children's independent mobility, active transportation and outdoor free play in two Canadian cities

Background

Active transportation (AT) and free play (FP) are the primary ways in which children engage in unstructured physical activity in cities, with independent mobility (IM) gaining increased attention as a potential precursor of AT and FP. However, current trends show that children are engaging in less FP and AT, and have less IM, than previous generations and it is not well understood how these practices, and their interrelatedness, differ by neighbourhood-level socio-economic stats (SES) and municipal contexts.

Objectives

This study aims to address the gaps in knowledge by quantifying, comparing, and correlating IM, AT, and FP practices in high and low-SES neighbourhoods within and across the cities of Montreal and Kingston, Canada.

Methods

584 questionnaires were distributed among children in grades 1 to 5, living in low- and high-SES neighbourhoods of these two citiesResultsEngagement in the three practices was low in every study neighbourhood, though all three practices were higher in high-SES compared to low-SES neighbourhoods in both cities. Levels of FP were higher in Kingston compared to Montreal, while AT was higher in Montreal than in Kingston.

Conclusion

This study revealed social inequalities in all three of these practices based on socioeconomic status and city. Since IM is likely a precursor to both independent FP and AT, more research is warranted into how our cities can become more conducive to IM in children, particularly in low SES neighbourhoods where children have less freedom of movement independently and otherwise.

Socioeconomic position, built environment and physical activity among children and adolescents: a systematic review of mediating and moderating effects

BACKGROUND

Physical activity behaviors among children and adolescents are socioeconomically patterned. Understanding if, and how, the built environment contributes to socioeconomic inequalities in physical activity and for whom built environments are most important, can lead to the identification of intervention entry points to reduce inequalities in physical activity.

OBJECTIVE

To summarize the existing evidence among children and adolescents on (a) whether the built environment mediates the association between socioeconomic position and physical activity and (b) whether socioeconomic position moderates the association between the built environment and physical activity.

METHODS

A systematic literature search was conducted using PubMed, Embase, PsycINFO and Web of Science. Two independent reviewers screened articles for eligibility, extracted information from included studies and assessed risk of bias with the Quality Assessment Tool for Observational Cohort and Cross-Sectional studies. We performed a narrative evidence synthesis considering the totality of the evidence and by study characteristics such as geographic region, age group, and exposure-outcome assessment methodology. The reporting was conducted in agreement with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement.

RESULTS

A total of 28 papers were included. In general, the studies were of low methodological quality. There was no evidence to support that the built environment functions as a mediator in the relationship between socioeconomic position and physical activity. We observed inconclusive moderation patterns with five studies reporting stronger associations between features of the built environment and physical activity among high socioeconomic positioned youths. Seven studies reported stronger associations among low socioeconomic positioned youth and fourteen studies reported no difference in associations. We observed different moderation patterns across geographical regions (Europe vs. US) indicating that, in Europe, having a walkable neighborhood is important for low socioeconomic positioned youth only. No differences in moderation patterns were observed for younger vs. older children or activity domains.

CONCLUSION

Current evidence does not support a strong interplay between built environment and socioeconomic position on physical activity in youth. However, given the low quality of the evidence, firm conclusions cannot be made, and additional high-quality research is likely to have substantial impact on the evidence base.

Effects of Attending Extracurricular Lessons and Cram School on Independent Mobility in Japanese Children

Independent mobility and its related factors were examined among Japanese elementary school children. Based on the responses of 1,824 mothers with elementary school-aged children, the effects of demographic variables such as children’s grade, gender, and birth order as well as regional characteristics, neighborhood environment, distance to and means of getting to school, children’s use of bicycles, keys and cell phones, and the number of weekdays spent attending lessons or cram schools were explored. Factor analysis revealed that independent mobility comprised activities in public places, including outings to supermarkets, and traveling by bus and train as well as activities in the school district such as visiting friends’ homes and parks. Hierarchical multiple regression analyses that comprised five steps were conducted in which the number of days of attending lessons and cram school was entered in the final step. There was a strong gender effect and grade effect for outings to public places and activities in the school district. Concerns about traffic accidents and security were associated with lower independent mobility. With regard to activities in the school district, proximity to school, use of bicycles, and possession of house keys had a positive effect. It is noteworthy that the effect of the number of days spent attending lessons or cram school was observed even after the other variables were entered, thus resulting in a negative effect. It is recommended that further comparative studies involving other Asian countries be conducted to evaluate the effects of extracurricular activities.

Socioeconomic Inequities in Youth Participation in Physical Activity and Sports

Access to opportunities for physical activity and sports, and therefore potential benefits of participation, are distributed inequitably. The aims of this study were to describe and compare youth experiences related to sport and physical activity by socioeconomic factors. A cross-sectional survey was conducted of students in 5–12th grades in King County, Washington, USA. Students were asked about physical activity and sports experiences and about demographic factors including family affluence, which was categorized as low, medium, and high. Participants were 1038 youth (50% girls, 58% non-White, and 32% from homes where languages other than English are spoken). Children from low-affluence families reported fewer days/week of physical activity, fewer sports sampled, and lower rates of ever playing sports. Greater proportions of children from low-affluence families reported these barriers to sports: (1) don’t want to get hurt, (2) don’t feel welcome on teams, (3) too expensive, and (4) transportation. Middle school children from high-affluence families had three times higher odds of meeting physical activity recommendations, and high-affluence high schoolers had three times higher odds of ever participating in sports compared to peers from low-affluence families. Socioeconomic status was inversely associated with outcomes related to youth physical activity and sports participation. The disproportionately reported barriers to sports participation are modifiable, and cross-sector solutions can help promote play equity.

Parent's sociodemographic factors, physical activity and active commuting are predictors of independent mobility to school

Background

Independent mobility (IM) provides young people with many opportunities to increase their autonomy and physical activity (PA). This study aimed to analyse whether the parent’s PA, active commuting to work and sociodemographic factors serve as predictors of IM to school in children and adolescents.

Methods

A total of 684 parents (52.8% mothers) and their offspring (56.4% girls) were included in this study, which was performed in Granada (Spain) and Valparaíso (Chile). The parents self-reported their sociodemographic characteristics, PA and mode of commuting to work. The mode of commuting to and from school and the offspring accompaniment mode were reported. T-test and chi-square test were used to study quantitative and qualitative differences by parental gender, respectively. Binary logistic regression models (odds ratio = OR) and stepwise analysis were performed to study the association between the parents’ sociodemographic variables and IM to school.

Results

Adolescents showed higher IM to school than children (58.9% vs 40.2%; p < 0.001). No car availability and shorter distance to work were positively associated with higher IM to school in children (OR = 2.22 and 2.29, respectively). Mothers' lower salary/month (OR = 2.75), no car availability (OR = 3.17), and mother passive commuting to work (OR = 2.61) were positively associated with higher IM to school in adolescents. The main predictor of IM to school in children and adolescents was no car availability (OR = 6.53).

Conclusion

Parental sociodemographic factors, such as salary, distance to work and car availability, were associated more strongly with IM than parental PA and active commuting to work.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12942-021-00280-2.

The Effect of Season and Neighbourhood-Built Environment on Home Area Sedentary Behaviour in 9-14 Year Old Children

There is little understanding of how the built environment shapes activity behaviours in children over different seasons. This study sought to establish how seasonal weather patterns, in a given year in a mid-western Canadian city, affect sedentary time (SED) in youth and how the relationship between season and SED are moderated by the built environment in their home neighbourhood. Families with children aged 9-14 years were recruited from the prairie city of Saskatoon, Canada. Location-specific, device-based SED was captured in children during three timeframes over a one-year period using GPS-paired accelerometers. Multilevel models are presented. Children accumulated significantly greater levels of SED in spring but significantly less SED in the fall months in comparison to the winter months. Children living in neighbourhoods with the highest density of destinations accumulated significantly less SED while in their home area in comparison to their counterparts, and this effect was more pronounced in the spring and summer months. On weekends, the rise in sedentariness within the home area was completely diminished in children living in neighbourhoods with the greatest number of destinations and highest activity friendliness. These results suggested that increasing neighbourhood amenities can lead to a reduced sedentariness of youth, though more so in the warmers months of the year.

Predicting psychosis-spectrum diagnoses in adulthood from social behaviors and neighborhood contexts in childhood

Research showing that risk for schizophrenia, bipolar disorder with psychosis, and other psychosis-spectrum diagnoses in adulthood is multidetermined has underscored the necessity of studying the additive and interactive factors in childhood that precede and predict future disorders. In this study, risk for the development of psychosis-spectrum disorders was examined in a 2-generation, 30-year prospective longitudinal study of 3,905 urban families against a sociocultural backdrop of changing economic and social conditions. Peer nominations of aggression, withdrawal, and likeability and national census information on neighborhood-level socioeconomic disadvantage in childhood, as well as changes in neighborhood socioeconomic conditions over the lifespan, were examined as predictors of diagnoses of schizophrenia, bipolar disorder, and other psychosis-spectrum disorders in adulthood relative to developing only nonpsychotic disorders or no psychiatric disorders. Individuals who were both highly aggressive and highly withdrawn were at greater risk for other psychosis-spectrum diagnoses when they experienced greater neighborhood disadvantage in childhood or worsening neighborhood conditions over maturation. Males who were highly aggressive but low on withdrawal were at greater risk for schizophrenia diagnoses. Childhood neighborhood disadvantage predicted both schizophrenia and bipolar diagnoses, regardless of childhood social behavior. Results provided strong support for multiple-domain models of psychopathology, and suggest that universal preventive interventions and social policies aimed at improving neighborhood conditions may be particularly important for decreasing the prevalence of psychosis-spectrum diagnoses in the future.

Relationships Among Children's Independent Mobility, Active Transportation, and Physical Activity: A Multisite Cross-Sectional Study

PURPOSE

Children's independent mobility (IM) may facilitate both active transportation (AT) and physical activity (PA), but previous studies examining these associations were conducted in single regions that provided limited geographical variability.

METHOD

We recruited 1699 children (55.0% girls) in 37 schools stratified by level of urbanization and socioeconomic status in 3 regions of Canada: Ottawa, Trois-Rivières, and Vancouver. Participants wore a SC-StepRx pedometer for 7 days and completed a validated questionnaire from which we derived a 6-point IM index, the number of AT trips over a week, and the volume of AT to/from school (in kilometer per week). We investigated relationships among measures of IM, AT, and PA employing linear mixed models or generalized linear mixed models adjusted for site, urbanization, and socioeconomic status.

RESULTS

Each unit increase in IM was associated with 9% more AT trips, 19% higher AT volume, and 147 more steps per day, with consistent results across genders. Both measures of AT were associated with marginally higher PA when pooling boys' and girls' data. Children in Vancouver engaged in more AT. PA did not vary across site, urbanization, or socioeconomic status.

CONCLUSION

IM was associated with more AT and PA regardless of where children lived, underscoring a need for IM interventions.

The importance of social capital for young People's active transport and independent mobility in rural Otago, New Zealand

Social capital influences adolescents' licenses for active transport and independent mobility, through parental decision making and safety concerns, and may contribute to increasing adolescents' physical activity. Drawing on 20 parental interviews and 11 focus groups (73 adolescents) from rural New Zealand, this paper shows the importance of social capital and social trust for active transport and independent mobility in an under researched rural context. Change over time in social capital, social trust and parental safety concerns limited adolescents' active transport and independent mobility. Health policy should incorporate social capital measures to increase adolescents' active transport, independent mobility and physical activity.

Children's Transport Built Environments: A Mixed Methods Study of Associations between Perceived and Objective Measures and Relationships with Parent Licence for Independent Mobility in Auckland, New Zealand

Children's independent mobility is declining internationally. Parents are the gatekeepers of children's independent mobility. This mixed methods study investigates whether parent perceptions of the neighbourhood environment align with objective measures of the neighbourhood built environment, and how perceived and objective measures relate to parental licence for children's independent mobility. Parents participating in the Neighbourhood for Active Kids study (n = 940) answered an open-ended question about what would make their neighbourhoods better for their child's independent mobility, and reported household and child demographics. Objective measures of the neighbourhood built environment were generated using geographic information systems. Content analysis was used to classify and group parent-reported changes required to improve their neigbourhood. Parent-reported needs were then compared with objective neighbourhood built environment measures. Linear mixed modelling examined associations between parental licence for independent mobility and (1) parent neighbourhood perceptions; and (2) objectively assessed neighbourhood built environment features. Parents identified the need for safer traffic environments. No significant differences in parent reported needs were found by objectively assessed characteristics. Differences in odds of reporting needs were observed for a range of socio-demographic characteristics. Parental licence for independent mobility was only associated with a need for safer places to cycle (positive) and objectively assessed cycling infrastructure (negative) in adjusted models. Overall, the study findings indicate the importance of safer traffic environments for children's independent mobility.

Make Room for Play: An Evaluation of a Campaign Promoting Active Play

In the context of rising screen time, only a third of Canadian children are achieving adequate amounts of active play, an important source of physical activity. ParticipACTION, a national not-for-profit organization, created the "Make Room for Play" campaign targeting parents with television advertisements depicting how screen time takes away from active play. The advertisements featured children engaging in active play (e.g., jump rope) while a black screen progressively sequesters the room for them to play. This study's purpose was to evaluate the campaign using the hierarchy of effects model, a framework for conceptualizing the impact of mass media campaigns. It was hypothesized that recall would relate to intermediate (e.g., cognitions, self-efficacy) and distal (e.g., parental support) factors. Twenty-six percent of the general population and caregiver samples surveyed (N = 1576) recalled (unaided) the advertisement and 45.9% recalled when prompted. Parental support was significantly higher in those recalling the campaign, p = .009. Twenty-four percent of parents reporting unaided recall (versus 14.0% of those not) tried to engage in active play with their children and 21.2% (versus 12.0%) tried to create opportunities for children to engage in play. Strengths and limitations of mass media approaches targeting active play and screen time are discussed.

Associations between perceived social and physical environmental variables and physical activity and screen time among adolescents in four European countries

OBJECTIVES

Associations between the perceived social and physical environment and self-reported moderate-to-vigorous physical activity (MVPA) and screen time (ST) were examined among adolescents in four European countries.

METHODS

Representative samples were surveyed with standardised methodologies. Associations between environmental variables and meeting MVPA recommendations and tertiles of ST were tested in gender-specific logistic regression models. Moderation by country and country-specific relationships were also examined.

RESULTS

The most consistent findings across countries were found for the significant associations between neighbourhood social environment and MVPA in both boys and girls. Significant associations with the physical environment varied more between countries and by gender. The most consistent negative associations with ST were found for the social environmental variable of having parental rules for spending time outside the home.

CONCLUSIONS

The present findings provided evidence for the generalisability of the associations between environmental correlates and MVPA across four European countries. The findings show clear differences in correlates for MVPA and ST. Further research is needed to better understand the unique aspects of the social and physical environment which explain each of the two behaviours.

Children's Independent Mobility: Current Knowledge, Future Directions, and Public Health Implications

Environmental changes significantly impact health behavior. Active travel behavior is mostly affected by increasing motorization, urban sprawl, and traffic safety. Especially for children, active and independent travel can contribute to physical activity, social and motor development, and other health-related outcomes. A reduced number of children engaging in independent mobility over the last 20 years demanded researchers to further examine the construct of children’s independent mobility. By examining relevant literature, this narrative review aims to provide the current state of knowledge on children’s independent mobility, and identify future directions in research, as well as practical implications. From a public health perspective, considering children’s independent mobility in intervention programs is recommended, since it is associated with numerous health and environmental benefits. To develop interventions, multilevel socio-ecological influences on children’s independent mobility are widely examined; however, evidence is limited due to heterogeneous measurements and a lack of high-quality prospective studies. To oppose the decline in children’s independent mobility, further analysis using comparable measures is needed to understand the determinants of children’s independent mobility and to enable international comparison.

Parents' and adolescents' perception of traffic- and crime-related safety as correlates of independent mobility among Belgian adolescents

The independent mobility (IM), defined as the freedom of young people to travel without adult supervision, has been related to the physical activity time, the acquisition of personal autonomy, to less intense fear of crime, and to a stronger feeling of being part of their community and other health and social benefits. The aims of this study were to compare parents’ and adolescents’ traffic- and crime-related safety perceptions of their neighborhood and to analyze the associations of these perceptions with adolescents’ IM. A total of 291 adolescents and their parents completed the Neighborhood Environment Walkability Scale (NEWS) questionnaire. Multilevel (two-level models: individual level—neighborhood level) regression analyses were conducted to examine whether the environmental perceptions differed between parents and adolescents and the association between the parental and adolescents’ perception to the IM and the active independent mobility (AIM). Parents reported a more negative perception of traffic (except for amount and speed) and crime-related safety. Adolescents’ environmental perceptions were not associated with their IM but parental perceptions of traffic- and crime-related safety were associated with IM and with active IM, although not all associations were in the expected direction. Future urban policy efforts should address environments where parents perceive sufficient levels of safety to increase the levels of IM in adolescents.

Gender differences in the relationship between built environment and non-communicable diseases: A systematic review

Non-communicable diseases are on the rise globally. Risk factors of non-communicable diseases continue to be a growing concern in both developed and developing countries. With significant rise in population and establishment of buildings, rapid changes have taken place in the built environment. Relationship between health and place, particularly with non-communicable diseases has been established in previous literature. This systematic review assesses the current evidence on influence of gender in the relationship between built environment and non-communicable diseases. A systematic literature search using PubMed was done to identify all studies that reported relationship between gender and built environment. All titles and abstracts were scrutinised to include only articles based on risk factors, prevention, treatment and outcome of non-communicable diseases. The Gender Analysis Matrix developed by the World Health Organization was used to describe the findings of gender differences. Sex differences, biological susceptibility, gender norms/ values, roles and activities related to gender and access to/control over resources were themes for the differences in the relationship. A total of 15 out of 214 articles met the inclusion criteria. Majority of the studies were on risk factors of non-communicable diseases, particularly cardiovascular diseases. Gender differences in physical access to recreational facilities, neighbourhood perceptions of safety and walkability have been documented. Men and women showed differential preferences to walking, engaging in physical activity and in perceiving safety of the neighbourhood. Girls and boys showed differences in play activities at school and in their own neighbourhood environment. Safety from crime and safety from traffic were also perceived important to engage in physical activity. Gender norms and gender roles and activities have shown basis for the differences in the prevalence of non-communicable diseases. Sparse evidence was found on how built environment affects health seeking behaviour, preventive options or experience with health providers. Though yet unexplored in the developing or low/middle income countries, there seems to be a major role in the gendered perception of how men and women are affected by noncommunicable diseases. Large gaps still exist in the research evidence on gender-based differences in non-communicable diseases and built environment relationship. Future research directions could bring out underpinnings of how perceived and objective built environment could largely affect the health behaviour of men and women across the globe.

The home electronic media environment and parental safety concerns: relationships with outdoor time after school and over the weekend among 9-11 year old children

BACKGROUND

Time spent outdoors is associated with higher physical activity levels among children, yet it may be threatened by parental safety concerns and the attraction of indoor sedentary pursuits. The purpose of this study was to explore the relationships between these factors and outdoor time during children's discretionary periods (i.e., after school and over the weekend).

METHODS

Data from 462 children aged 9-11 years old were analysed using generalised linear mixed models. The odds of spending > 1 h outdoors after school, and > 2 h outdoors on a weekend were computed, according to demographic variables, screen-based behaviours, media access, and parental safety concerns. Interactions with sex and socioeconomic status (SES) were explored.

RESULTS

Boys, low SES participants, and children who played on their computer for < 2 h on a school day had higher odds of spending > 1 h outside after school than girls, high SES children and those playing on a computer for ≥2 h, respectively. Counterintuitive results were found for access to media devices and crime-related safety concerns as both of these were positively associated with time spent outdoors after school. A significant interaction for traffic-related concerns*sex was found; higher road safety concerns were associated with lower odds of outdoor time after school in boys only. Age was associated with weekend outdoor time, which interacted with sex and SES; older children were more likely to spend > 2 h outside on weekends but this was only significant among girls and high SES participants.

CONCLUSIONS

Our results suggest that specific groups of children are less likely to spend their free time outside, and it would seem that only prolonged recreational computer use has a negative association with children's outdoor time after school. Further research is needed to explore potential underlying mechanisms, and parental safety concerns in more detail.

Association of individual and neighbourhood socioeconomic status with physical activity and screen time in seventh-grade boys and girls in Berlin, Germany: a cross-sectional study

OBJECTIVES

Few studies have explored the impact of neighbourhood socioeconomic status (SES) on health behaviours in youths in Germany. Our aim was to investigate the association of individual and neighbourhood SES with physical activity (PA) and screen time (ST) in students aged 12-13 years in Berlin.

DESIGN

Cross-sectional study.

SETTING

Secondary schools (high schools and integrated secondary schools) in Berlin, Germany.

PARTICIPANTS

A total of 2586 students aged 12-13 years (seventh grade).

MAIN OUTCOME MEASURES

Sociodemographics, anthropometric data and health behaviours were assessed by self-report during classes. Primary outcome was the association of individual and neighbourhood SES with meeting daily PA and exceeding daily ST recommendations. Students' characteristics were described with means or percentages. Comparisons were performed using generalised linear mixed model yielding ORs with 95% CIs.

RESULTS

Mean (±SD) age was 12.5±0.5 years, 50.5% were girls and 34.1% had a migrant background. When adjusting for individual covariates, associations of low versus high individual SES were 0.85 (0.48; 1.52) for PA and 2.08 (1.26; 3.43) for ST. Associations of low versus high neighbourhood SES were 1.76 (1.12; 2.75) for PA and 1.54 (1.10; 2.17) for ST. After additional adjustment for school type and school neighbourhood SES, associations comparing low versus high individual and neighbourhood SES were attenuated for PA (individual SES 0.74 (0.41; 1.33) and neighbourhood SES 1.51 (0.93; 2.46)) and ST (individual SES 1.88 (1.12; 3.14) and neighbourhood SES 1.40(0.98; 2.00).

CONCLUSIONS

Lower individual and neighbourhood SES were associated with higher ST. Lower neighbourhood but not individual SES was associated with higher PA. After consideration of school type and school neighbourhood SES associations were attenuated and became insignificant for the relationship between neighbourhood SES, PA and ST. Further research is warranted to unravel the complex relationships between individual SES, neighbourhood SES and school environment to develop more targeted health promotion strategies in the future.

What Influences Parents' Fear about Children's Independent Mobility? Evidence from a State-Wide Survey of Australian Parents

PURPOSE

To identify factors associated with generalized and stranger-specific parental fear (PF) about children's independent mobility (CIM), a critical aspect of physical activity.

DESIGN

Cross-sectional survey; random sampling frame, minimum quotas of fathers, rural residents.

SETTING

State of Victoria, Australia.

SUBJECTS

Parents of children aged 9 to 15 years (n = 1779), 71% response rate.

MEASURES

Validated measures of PF and fear of strangers (FoS); parent, child, social, and environmental factors.

ANALYSIS

Unadjusted and adjusted linear regression stratified by child age (9-10; 11-13; 14-15).

RESULTS

Adjusted models explained a substantial proportion of variance across all age groups (PF: 33.6%-36.7%; FoS: 39.1%-44.0%). Perceived disapproval from others was consistently associated with both outcomes (PF: β =.11 to 23, p ≤ .05; FoS: β =.17-.21, p ≤ .001) as was parents' perception of children's competence to travel safely (PF: β = -.24 to -.11, p ≤ .05; FoS: β = -.16 to -.13, p ≤ .01). Factors associated with FoS included having a female child (β = -.21 to -.13, p ≤ .001), language other than English (β = .09 to.11, p ≤ .01), and low levels of parent education (β = -.14 to -08, p ≤ .05).

CONCLUSION

The current study suggests that social norms, child competence, and perceptions about the benefits of CIM underpin PF. This evidence informs the development of interventions to reduce PF and promote CIM and children's physical activity.

Understanding differences between summer vs. school obesogenic behaviors of children: the structured days hypothesis

BACKGROUND

Although the scientific community has acknowledged modest improvements can be made to weight status and obesogenic behaviors (i.e., physical activity, sedentary/screen time, diet, and sleep) during the school year, studies suggests improvements are erased as elementary-age children are released to summer vacation. Emerging evidence shows children return to school after summer vacation displaying accelerated weight gain compared to the weight gained occurring during the school year. Understanding how summer days differ from when children are in school is, therefore, essential.

DISCUSSION

There is limited evidence on the etiology of accelerated weight gain during summer, with few studies comparing obesogenic behaviors on the same children during school and summer. For many children, summer days may be analogous to weekend days throughout the school year. Weekend days are often limited in consistent and formal structure, and thus differ from school days where segmented, pre-planned, restrictive, and compulsory components exist that shape obesogenic behaviors. The authors hypothesize that obesogenic behaviors are beneficially regulated when children are exposed to a structured day (i.e., school weekday) compared to what commonly occurs during summer. This is referred to as the 'Structured Days Hypothesis' (SDH). To illustrate how the SDH operates, this study examines empirical data that compares weekend day (less-structured) versus weekday (structured) obesogenic behaviors in U.S. elementary school-aged children. From 190 studies, 155 (~80%) demonstrate elementary-aged children's obesogenic behaviors are more unfavorable during weekend days compared to weekdays.

CONCLUSION

In light of the SDH, consistent evidence demonstrates the structured environment of weekdays may help to protect children by regulating obesogenic behaviors, most likely through compulsory physical activity opportunities, restricting caloric intake, reducing screen time occasions, and regulating sleep schedules. Summer is emerging as the critical period where childhood obesity prevention efforts need to be focused. The SDH can help researchers understand the drivers of obesogenic behaviors during summer and lead to innovative intervention development.

Does parental support influence children's active school travel?

Today's 'backseat generation' of children is more often driven to school. Active school travel (AST) can contribute up to 30% of recommended daily physical activity. Although governed by a complex set of factors, parents are considered 'gatekeepers' of children's travel mode decisions. Therefore, we investigate the relationship between parental support and children's AST. Data were from Active Streets, Active People-Junior (British Columbia, Canada). Children self-reported travel mode to/from school for 1 week (10 trips). We assessed parental perceived neighborhood traffic and crime safety (Neighborhood Environmental Walkability Scale-Youth) and frequency of parental support for AST (0-5 ×/week). We investigated the association between daily AST behaviour and parental support using logistic regression (controlling for age, sex, distance to school and perceived neighborhood safety). In our sample (n = 179, 11.0 ± 1.0 years, 59% girls), 57% reported daily AST and 63% of parents provided daily support. Bivariate analyses showed AST behaviour was significantly associated with parental support frequency and parents' perceived safety. In adjusted analysis, daily parental support remained significantly associated with daily AST (OR 9.0, 95% CI 4.2, 19.7). The relationship between parental support and AST was independent of noted correlates of AST. Thus, interventions that focus solely on changes to the built environment may not be enough to encourage AST. Therefore, interventions that aim to increase AST should involve parents and children in the planning process.

A systematic review of the prevalence of sedentary behavior during the after-school period among children aged 5-18 years

BACKGROUND

Independent of physical activity levels, youth sedentary behaviors (SB) have negative health outcomes. SB prevalence estimates during discretionary periods of the day (e.g., after-school), inform the need for targeted period-specific interventions. This systematic review aimed to determine children's and adolescents' SB prevalence during the after-school period.

METHODS

A computerized search was conducted in October 2015 (analysed November 2015). Inclusion criteria were: published in a peer-reviewed English journal; participants aged 5-18 years; measured overall after-school sedentary time (ST) objectively, and/or specific after-school SBs (e.g., TV viewing) objectively or subjectively; and provided the percentage of the after-school period spent in ST/SB or duration of behavior and period to calculate this. Where possible, findings were analyzed by location (e.g., after-school care/'other' locations). The PRISMA guidelines were followed.

RESULTS

Twenty-nine studies were included: 24 included children (≤12 years), four assessed adolescents (>12 years) and one included both; 20 assessed ST and nine assessed SB. On average, children spent 41% and 51% of the after-school period in ST when at after-school care and other locations respectively. Adolescents spent 57% of the after-school period in ST. SBs that children and adolescents perform include: TV viewing (20% of the period), non-screen based SB (including homework; 20%), screen-based SB (including TV viewing; 18%), homework/academics (13%), motorised transport (12%), social SB (9%), and screen-based SB (excluding TV viewing; 6%).

CONCLUSION

Children spent up to half of the after-school period in ST and this is higher among adolescents. A variety of screen- and non-screen based SBs are performed after school, providing key targets for interventions.

TRIAL REGISTRATION

PROSPERO registration number CRD42015010437.

Insights into children's independent mobility for transportation cycling-Which socio-ecological factors matter?

OBJECTIVES

To assess the associations of socio-ecological factors with independent mobility for transportation cycling among 10-to-12-year-old boys and girls. Additionally, we examined whether associations differed across family socio-economic status (SES) and urbanization level.

DESIGN

Cross-sectional survey.

METHODS

Parents (n=1286) were recruited via 45 primary schools across Flanders, Belgium. They completed an online questionnaire assessing demographic and psychosocial factors, neighborhood environmental perceptions, as well as some characteristics of their child. Independent mobility was assessed as the distance children were allowed to cycle for transport without adult supervision. Multilevel gamma regression analyses stratified by gender were performed to examine the associations between the independent variables and children's independent mobility and the moderating effects of family SES and urbanization level.

RESULTS

Independent mobility was higher among boys compared to girls. Perception of children's cycling and traffic skills and children's grade were positively associated with independent mobility among boys and girls. Perceptions of neighborhood traffic safety were positively associated with independent mobility among girls, but not among boys. Perceptions of cycling skills were positively associated with independent mobility among boys living in high urbanized areas, but not in low urbanized areas. Parental cycling for transport was negatively associated with independent mobility among girls with a low family SES, but not among girls with a high family SES.

CONCLUSIONS

Our findings suggest that interventions targeting increases in children's cycling and traffic skills may be effective to increase independent mobility. Few differences in associations were found according to children's gender, family SES or urbanization level.

The correlates of after-school sedentary behavior among children aged 5-18 years: a systematic review

BACKGROUND

Children and adolescents spend a large proportion of the after-school period in sedentary behaviors (SB). Identifying context-specific correlates is important for informing strategies to reduce these behaviors. This paper systematically reviews the correlates of children's and adolescents' after-school SB.

METHODS

A computerized literature search was performed in October 2015 for peer-reviewed original research journal articles published in English before October 2015. Eligibility criteria included: 1) sample aged 5-18 years; 2) quantified the amount of SB or component of this that the children/adolescents were performing after school; 3) a measure of SB as the dependent outcome; and 4) the association between potential correlates and after-school SB.

RESULTS

Data were synthesized in October 2015. Thirty-one studies met the eligibility criteria: 22 studies among children (≤ 12 years), six among adolescents (>12 years), two had a combined sample of children and adolescents and one cohort followed children from childhood to adolescence. Findings were separated by after-school location i.e. after-school programs (n = 4 studies) and unidentified locations (n = 27). There was insufficient evidence to draw conclusions on all but two of the 58 potential correlates: sex and age. Among children at unidentified locations there was a null association between sex (male) and overall after-school SB, a null association between sex (male) and after-school TV viewing, a positive association between age and overall after-school SB and an inconsistent association between age and after-school TV viewing. No correlates of after-school sedentary behaviour while at after-school programs were identified.

CONCLUSIONS

Only two correlates have been investigated frequently enough to determine an overall association; neither correlate is modifiable. Due to the lack of consistent investigation of potential correlates, further evidence is required to accurately identify potential intervention targets.

PROSPERO REGISTRATION NUMBER

CRD42014009180.

Cross-sectional associations between high-deprivation home and neighbourhood environments, and health-related variables among Liverpool children

OBJECTIVES

(1) To investigate differences in health-related, home and neighbourhood environmental variables between Liverpool children living in areas of high deprivation (HD) and medium-to-high deprivation (MD) and (2) to assess associations between these perceived home and neighbourhood environments and health-related variables stratified by deprivation group.

DESIGN

Cross-sectional study.

SETTING

10 Liverpool primary schools in 2014.

PARTICIPANTS

194 children aged 9-10 years.

MAIN OUTCOME MEASURES

Health-related variables (self-reported physical activity (PA) (Physical Activity Questionnaire for Older Children, PAQ-C), cardiorespiratory fitness, body mass index (BMI) z-scores, waist circumference), home environment variables: (garden/backyard access, independent mobility, screen-based media restrictions, bedroom media) and neighbourhood walkability (Neighbourhood Environment Walkability Scale for Youth, NEWS-Y).

EXPLANATORY MEASURES

Area deprivation.

RESULTS

There were significant differences between HD and MD children's BMI z-scores (p<0.01), waist circumference (p<0.001) and cardiorespiratory fitness (p<0.01). HD children had significantly higher bedroom media availability (p<0.05) and independent mobility scores than MD children (p<0.05). MD children had significantly higher residential density and neighbourhood aesthetics scores, and lower crime safety, pedestrian and road traffic safety scores than HD children, all of which indicated higher walkability (p<0.01). HD children's BMI z-scores (β=-0.29, p<0.01) and waist circumferences (β=-0.27, p<0.01) were inversely associated with neighbourhood aesthetics. HD children's PA was negatively associated with bedroom media (β=-0.24, p<0.01), and MD children's PA was positively associated with independent mobility (β=0.25, p<0.01). MD children's independent mobility was inversely associated with crime safety (β=-0.28, p<0.01) and neighbourhood aesthetics (β=-0.24, p<0.05).

CONCLUSIONS

Children living in HD areas had the least favourable health-related variables and were exposed to home and neighbourhood environments that are unconducive to health-promoting behaviours. Less access to bedroom media equipment and greater independent mobility were strongly associated with higher PA in HD and MD children, respectively. Facilitating independent mobility and encouraging outdoor play may act as effective strategies to enhance PA levels and reduce sedentary time in primary school-aged children.

Physical Activity Design Guidelines for School Architecture

Increasing children's physical activity at school is a national focus in the U.S. to address childhood obesity. While research has demonstrated associations between aspects of school environments and students' physical activity, the literature currently lacks a synthesis of evidence to serve as a practical, spatially-organized resource for school designers and decision-makers, as well as to point to pertinent research opportunities. This paper describes the development of a new practical tool: Physical Activity Design Guidelines for School Architecture. Its aims are to provide architects and designers, as well as school planners, educators, and public health professionals, with strategies for making K-12 school environments conducive to healthy physical activity, and to engage scientists in transdisciplinary perspectives toward improved knowledge of the school environment's impact. We used a qualitative review process to develop evidence-based and theory-driven school design guidelines that promote increased physical activity among students. The design guidelines include specific strategies in 10 school design domains. Implementation of the guidelines is expected to enable students to adopt healthier physical activity behaviors. The tool bridges a translational gap between research and environmental design practice, and may contribute to setting new industry and education standards.

Socio-demographic factors and neighbourhood social cohesion influence adults' willingness to grant children greater independent mobility: A cross-sectional study

Background

In developed countries, children’s independent mobility levels are low. Built environmental factors and parental safety concerns are well-known to predict the level of independent mobility adults grant to children. In contrast, the influence of adults’ socio-demographic characteristics and neighbourhood social cohesion on children’s independent mobility is largely unexplored. This study investigated the influence of adults’ socio-demographic factors and neighbourhood social cohesion on distances they would permit children for independent travel and outdoor play.

Methods

In 2013, a random sample of 1293 Australian adults (mean age: 56.1 years, 52 % male, 81 % parents) participated in the Queensland Social Survey (QSS) via computer-assisted telephone interview. Socio-demographic factors measured included age, sex, parental status, education and area-level socio-economic disadvantage. Perceived neighbourhood social cohesion was assessed using a standardised scale. Adults reported the distances children aged 8–12 years should be allowed to walk/cycle to places, and play outdoors without adults. Responses were categorised into ‘within sight’, < 0.5 kilometres (km) , 0.5-1 km and >1 km. Ordinal logistic regression was used to assess associations of socio-demographic factors and neighbourhood social cohesion with distances adults would permit for children’s independent travel and outdoor play.

Results

Parents and adults with lower education were less likely to permit greater distances for children’s independent travel (OR = 0.57 and OR = 0.59, respectively). Women, parents and adults with lower education were less likely to grant children greater distances for independent outdoor play (OR = 0.61, OR = 0.50 and OR = 0.60, respectively). In contrast, adults with higher perceptions of neighbourhood social cohesion were more likely to permit children greater distances for independent travel (OR = 1.05)and outdoor play (OR = 1.05). Adult age and area-level socio-economic disadvantage were not associated with distances adults would permit for independent travel and outdoor play.

Conclusions

Women, parents (particularly those of younger children), adults with lower education and those who perceived neighbourhood social cohesion as being lower were less willing to let children independently travel further away from home. Interventions to increase children’s independent mobility may be more effective if targeted to these groups. In addition, increasing neighbourhood social cohesion may help increase adults’ willingness to grant children greater independent mobility.

What is the Relationship between Risky Outdoor Play and Health in Children? A Systematic Review

Risky outdoor play has been associated with promoting children’s health and development, but also with injury and death. Risky outdoor play has diminished over time, concurrent with increasing concerns regarding child safety and emphasis on injury prevention. We sought to conduct a systematic review to examine the relationship between risky outdoor play and health in children, in order to inform the debate regarding its benefits and harms. We identified and evaluated 21 relevant papers for quality using the GRADE framework. Included articles addressed the effect on health indicators and behaviours from three types of risky play, as well as risky play supportive environments. The systematic review revealed overall positive effects of risky outdoor play on a variety of health indicators and behaviours, most commonly physical activity, but also social health and behaviours, injuries, and aggression. The review indicated the need for additional “good quality” studies; however, we note that even in the face of the generally exclusionary systematic review process, our findings support the promotion of risky outdoor play for healthy child development. These positive results with the marked reduction in risky outdoor play opportunities in recent generations indicate the need to encourage action to support children’s risky outdoor play opportunities. Policy and practice precedents and recommendations for action are discussed.

Position Statement on Active Outdoor Play

A diverse, cross-sectorial group of partners, stakeholders and researchers, collaborated to develop an evidence-informed Position Statement on active outdoor play for children aged 3–12 years. The Position Statement was created in response to practitioner, academic, legal, insurance and public debate, dialogue and disagreement on the relative benefits and harms of active (including risky) outdoor play. The Position Statement development process was informed by two systematic reviews, a critical appraisal of the current literature and existing position statements, engagement of research experts (N = 9) and cross-sectorial individuals/organizations (N = 17), and an extensive stakeholder consultation process (N = 1908). More than 95% of the stakeholders consulted strongly agreed or somewhat agreed with the Position Statement; 14/17 participating individuals/organizations endorsed it; and over 1000 additional individuals and organizations requested their name be listed as a supporter. The final Position Statement on Active Outdoor Play states: “Access to active play in nature and outdoors—with its risks— is essential for healthy child development. We recommend increasing children’s opportunities for self-directed play outdoors in all settings—at home, at school, in child care, the community and nature.” The full Position Statement provides context for the statement, evidence supporting it, and a series of recommendations to increase active outdoor play opportunities to promote healthy child development.

Patterns of neighborhood environment attributes in relation to children's physical activity

Characterizing neighborhood environments in relation to physical activity is complex. Latent profiles of parents' perceptions of neighborhood characteristics were examined in relation to accelerometer-measured moderate-to-vigorous physical activity (MVPA) among 678 children (ages 6-12) in two US regions. Neighborhood environment profiles derived from walkability, transit access, aesthetics, crime and traffic safety, pedestrian infrastructure, and recreation/park access were created for each region. The San Diego County profile lowest on walkability and recreation/park access was associated with an average of 13 fewer min/day of children's out-of-school MVPA compared to profiles higher on walkability and recreation/park access. Seattle/King County profiles did not differ on children's MVPA. Neighborhood environment profiles were associated with children's MVPA in one region, but results were inconsistent across regions.

Impact of travel mode shift and trip distance on active and non-active transportation in the São Paulo Metropolitan Area in Brazil

Background

Changes in urban mobility play a major role in transforming metropolitan areas into healthier places. This study quantified the impact of changes in travel mode shift and trip distance on active and non-active transportation of working age adult population of São Paulo.

Methods and findings

Through different scenarios, we estimated the daily time spent in transportation per inhabitant (divided in active and non-active transportation time) and the proportion of inhabitants accumulating 30 min or more of daily active transportation. The replacement of individual for collective motorized modes in long distance trips (> 1000 m) in combination with the substitution of long for short trips positively impacted all outcomes. Compared to the current situation, there was an increase in the active transportation time (from 19.4 to 26.7 min/inhabitant), which also increased the proportion of adults active for transportation (from 27.6% to 35.4%). Additionally, the non-active transportation time decreased (from 67.0 to 26.2 min/inhabitant), which helped to reduce the total time spent in transportation (from 86.4 to 52.9 min/inhabitant).

Conclusion

Transport and urban planning policies to reduce individual motorized trips and the number of long trips might produce important health benefits, both by increasing population levels of active transportation and reducing the non-active and the total time of daily trips.

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Changes in urban mobility could increase population levels of physical activity.

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Shorter trip distances reduce total and non-active daily commuting time.

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Less car based transportation reduces total and non-active daily commuting time.

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Increasing connectivity and compactness of cities could reduce car-based trips.

A cross-sectional examination of socio-demographic and school-level correlates of children's school travel mode in Ottawa, Canada

Background

Active school transport (AST) is an important source of children’s daily physical activity (PA). However, decreasing rates of AST have been reported in multiple countries during the last decades. The purpose of the present study was to examine the socio-demographic and school-level correlates of AST.

Methods

A stratified sample of children (N = 567, mean age = 10.0 years; 57.8% female) was recruited in the Ottawa area. Four sources of data were used for analyses: 1) child questionnaire including questions on school travel mode and time; 2) parent questionnaire providing information on household socio-demographic characteristics; 3) school administrator survey assessing school policies and practices pertaining to PA; and 4) school site audit performed by the study team. Generalized linear mixed models were used to identify socio-demographic and school-level correlates of AST while controlling for school clustering.

Results

Individual factors associated with higher odds of AST were male gender (OR = 1.99; 95% CI = 1.30-3.03), journey time <5 minutes vs. >15 minutes (OR = 2.26; 95% CI = 1.17-4.37), and 5–15 minutes vs. >15 minutes (OR = 2.27; 95% CI = 1.27-4.03). Children were more likely to engage in AST if school administrators reported that crossing guards were employed (OR = 2.29; 95% CI = 1.22-4.30), or if they expressed major or moderate concerns about crime in the school neighbourhood (OR = 3.34; 95% CI = 1.34-8.32). In schools that identified safe routes to school and where traffic calming measures were observed, children were much more likely to engage in AST compared to schools without these features (OR = 7.87; 95% CI = 2.85-21.76). Moreover, if only one of these features was present, this was not associated with an increased likelihood of AST.

Conclusion

These findings suggest that providing crossing guards may facilitate AST. Additionally, there was a synergy between the identification of safe routes to school and the presence of traffic calming measures, suggesting that these strategies should be used in combination.

The freedom to explore: examining the influence of independent mobility on weekday, weekend and after-school physical activity behaviour in children living in urban and inner-suburban neighbourhoods of varying socioeconomic status

BACKGROUND

Children's independent mobility (CIM) is critical to healthy development in childhood. The physical layout and social characteristics of neighbourhoods can impact opportunities for CIM. While global evidence is mounting on CIM, to the authors' knowledge, Canadian data on CIM and related health outcomes (i.e., physical activity (PA) behaviour) are missing. The purpose of this study was to examine if CIM is related to multiple characteristics of accelerometry-measured PA behaviour (total PA, light PA, moderate-to-vigorous PA, time spent sedentary) and whether associations between CIM and PA behaviour systematically vary by place of residence, stratifying by gender and type of day/period (weekdays, after-school, weekend).

METHODS

Participants were recruited through Project BEAT (Built Environment and Active Transport; http://www.beat.utoronto.ca). Children (n = 856) were stratified into four neighbourhood classifications based on the period of neighbourhood development (urban built environment (BE) (old BE) versus inner-suburban BE (new BE)) and socioeconomic status (SES; low SES and high SES). Physical activity was measured via accelerometry (ActiGraph GT1M). CIM was assessed via parental report and two categories were created (low CIM, n = 332; high CIM, n = 524). A series of two-factor ANOVAs were used to determine gender-specific differences in PA for weekdays, weekend days and the after-school period, according to level of CIM, across four neighbourhood classifications.

RESULTS

Children who were granted at least some independent mobility (high CIM) had more positive PA profiles across the school week, during the after-school period, and over the weekend; they were also less sedentary. The influence of CIM on PA behaviour was particularly salient during the after-school period. Associations of CIM with PA varied by gender, and also by neighbourhood classification. CIM seemed to matter more in urban neighbourhoods for boys and suburban neighbourhoods for girls.

CONCLUSION

Our findings highlight the importance of independent mobility to multiple characteristics of children's PA behaviour across the week. Furthermore, they emphasize that independent mobility-activity relationships need to be considered by gender and the type of neighbourhood independent mobility is offered in. Future work will focus on developing a predictive model of CIM that could be used to inform decision-making around alleviating barriers to CIM.