Family circumstance, sedentary behaviour and physical activity in adolescents living in England: Project STIL

Influencing Factors of Women's Sports Participation Based on Self-Determination Theory: A Systematic Review and Meta-Analysis

Introduction

The lack of physical exercise is a global health concern, particularly affecting women. However, there is limited research on factors influencing women's sports participation. Recent studies on increasing women's physical activity levels differ in methodologies and conclusions. Motivation, as the cornerstone of most human behaviors, has important effects on female motor participation. Self-Determination Theory (SDT) is an important method to study human behavioral motivation and supported by empirical evidence. In the field of women's sports, the SDT is also widely used. This review explores the impact of SDT-related factors on women's sports participation, considering age variations. It aims to guide future empirical research and promote PA across demographics.

Methods

This review, by searching the existing empirical literature in Web of Science, Google Scholar, Elsevier ScienceDirect, CNKI, obtained 32 independent studies, conducted a meta-analysis after coding them, considering 11 influencing factors from the integration of SDT and Basic Psychological Needs Theory.

Results/Conclusion

The study found a significant positive correlation between autonomous motivation and women's sports participation, with identified regulation having the strongest influence. Controlled motivation showed no significant impact on women's exercise, while amotivation had an inhibitory effect. Enhancing women's perception of autonomy, competence, and relatedness significantly promotes sports participation. Age differences were observed in the relationship between autonomous motivation, basic psychological needs, and sports participation, with the strongest effects on women aged 25-40, while the impact was relatively weaker in older women. The correlation between basic psychological needs and female sports participation also has a significant age difference. Thus, different measures should be taken to improve exercise participation in women of different age groups.

Family structure and the association with physical activity-Findings from 40 countries participating in the Health Behaviour in School-aged Children (HBSC) study

BACKGROUND

The family has been acknowledged as central to developing physical activity (PA) beliefs and behaviours. However, increased diversity in family structures has developed over the last decades. This study examines the association between family structure and PA among adolescents and cross-national variations in the associations.

METHODS

The data are from the 2013/14 Health Behaviours in School-Aged Children study, involving nationally representative samples of 11-, 13- and 15-year-olds (n = 211,798) from 40 countries. Multilevel Poisson regression analysis was used to examine the associations between family structure and moderate to vigorous physical activity (MVPA) and vigorous physical activity (VPA) by age, gender, socioeconomic status (SES), and geographic region.

RESULTS

Living with one versus two parents was associated with a reduced likelihood of daily 60 min MVPA for boys (IRR = 0.96, 95% CI: 0.92, 0.99) and ≥ 4 times/week VPA (IRR 0.93, 95% CI: 0.91, 0.95). This impact on MVPA differed across individual-level SES (high SES; IRR = 0.92, (p <0.05), low SES; IRR = 1.04, (ns)), and was for VPA only significant for those with siblings (IRR = 0.93, 95% CI: 0.91, 0.96). Cross-country variations in the association between living with one versus two parents were observed, most pronounced for VPA. These differences varied by region, primarily explained by country-level SES differences between regions. The likelihood of daily 60 min MVPA also increased with siblings in the main house (IRR 1.11, 95% CI: 1.07, 1.14), and ≥ 4 times/week VPA decreased with grandparents in the main house (IRR 0.91, 95% CI: 0.89,0.94).

CONCLUSIONS

Family structure correlated with PA, but cross-country differences exist. The findings are relevant for the development of policies and programs to facilitate PA, especially in countries where living with one versus two parents was unfavourable. Additional country-specific research is needed to identify challenges for engaging in PA related to family structure.

Effect of school lockdown due to the COVID-19 pandemic on screen time among adolescents in Hungary: a longitudinal analysis

Introduction

Studies indicate that due to school lockdown during the Coronavirus Disease 2019 (COVID-19) pandemic, screen time increased more steeply than pre-pandemic years. The aim of our study was to examine changes in screen time and its components (screen time spent on videos, games, homework, and other activities) of adolescents affected by COVID-19 school closures compared to controls from pre-pandemic years and to assess the effect of family structure and family communication.

Methods

Two sets of ninth-grader boys and girls transitioning into 10th grade were included in the analysis. The 'pre-COVID classes' (controls) completed the baseline survey in February 2018 and the follow-up survey in March 2019. 'COVID classes' (cases) completed the baseline survey in February 2020 (1 month before the COVID-19-related school lockdowns) and the follow-up survey in March 2021. Linear mixed models stratified by sex were built to assess the change in screen time over one year adjusted for family structure and communication.

Results

Our study population consisted of 227 controls (128 girls, 99 boys) and 240 cases (118 girls, 122 boys). Without COVID-19, overall screen time did not change significantly for boys, but there was a decrease in screen time for gaming by 0.63 h, which was accompanied by an increase of 1.11 h in screen time for other activities (consisting mainly of social media and communication). Because of the pandemic, all components increased by 1.44-2.24 h in boys. Girls' screen time and its components remained stable without school lockdown, while it increased for videos and homework by 1.66-2.10 h because of school lockdown. Living in a single-parent household was associated with higher, while better family communication resulted in lower screen time.

Discussion

Our results indicate that COVID-19-related school lockdowns modified the age-specific increase in screen time for boys and girls as well. This trend, however, may be counterbalanced by improving communication between family members.

[Delta of neutrophil lymphocyte index and mortality in covid-19 disease]

Background

Acute respiratory distress syndrome, due to SARS-CoV-2, is a worldwide health problem. The neutrophil-lymphocyte index allows risk stratification in patients with severe and poor prognostic data, since it reflects the inflammatory state.

Objective

To determine whether the Neutrophil-Lymphocyte Index delta predicts mortality in patients with COVID-19.

Material and methods

We conducted a longitudinal, comparative study in patients with COVID-19, older than 18 years, admitted to the ICU. We evaluated HAS, DM, obesity, COPD, asthma, PaO2/FiO2, tomographic severity. On admission and on days 3 and 7 we measured Neutrophil-Lymphocyte Index, SOFA and APACHE score. For statistical analysis, we performed ROC and Kaplan-Meyer curves.

Results

We included 180 patients with COVID-19, 63 died (35%). Delta INL1(Day1-day3)>4.11 was associated with mortality (AUC:0.633); sensitivity 55.56% and specificity 77.78%, CI95 0.55-0.70, for delta INL2 (Day1-day7)>8.95 (AUC:0.623); sensitivity 44.44% and specificity 84.62%, CI95 0.54-0.69. Difference in survival was observed for Delta1. SOFA scale >6, was associated with more days of mechanical ventilation and lower PaO2/FiO2 (p<0.001).

Conclusions

INL delta between the day of ICU admission and the 3rd day of evolution is a predictor of mortality in critically ill patients.

Does Participating in Physical Exercise Make Chinese Residents Happier?-Empirical Research Based on 2018 Chinese General Social Survey

Participating in physical exercise to improve fitness, as well as experience the social and economic functions of sport, can help individuals improve their subjective well-being. The ordinary least squares (OLS) regression model was used to empirically study the impact of the frequency and intensity of physical exercise on Chinese residents' subjective well-being and its mechanisms using data from the 2018 China General Social Survey (CGSS). The findings revealed that participating in physical exercise significantly increased Chinese residents' subjective well-being; the impact of physical exercise on Chinese residents' subjective well-being varied with age, marriage, political status, and so on, and participation in physical exercise improved in rural individuals, male individuals, and individuals from the eastern regions. Higher intensity physical exercise increases the likelihood of subjective well-being; urban individuals, female individuals, and individuals in the central and eastern regions have a higher probability of improving subjective well-being.

Influence of Family Environment on the Scientific Fitness Literacy of Preschool and School Children in China: A National Cross-Sectional Study

Scientific fitness literacy (SFL) is a holistic concept based on physical literacy but has a smaller scope and is more specific to exercise and scientific fitness. We developed an instrument to assess SFL and explored the differences and similarities in the effects of the home environment on children’s SFL. Data from a nationwide stratified random sample of children were analyzed using multiple linear regression. SFL scores were significantly lower for preschoolers than for school-age children. The family environment has an impact throughout the preschool and school years, with school-age children’s SFL being less influenced by family members than preschool children; screen time has a negative impact on their SFL but reducing the number of electronic devices and increasing parental physical activity and modeling can alleviate its impact. The economic status of the family is crucial, with sports consumption expenditure and household sports equipment ownership being favourable factors for children’s SFL. Positive parental attitudes and sporting habits have a positive impact on their children’s SFL. The findings of this study can be used to improve children’s SFL in the home environment and to take effective measures to avoid the risk factors.

Associations between socioeconomic position and young people's physical activity and sedentary behaviour in the UK: a scoping review

OBJECTIVE

To examine the evidence on the associations between socioeconomic position and young people's physical activity and sedentary behaviours in the UK.

DESIGN

Scoping review.

DATA SOURCES

PubMed, SCOPUS and Web of Science databases were searched for articles published up to and including January 2021.

ELIGIBILITY CRITERIA FOR SELECTING STUDIES

Observational studies in children and adolescents (aged 5-18 years) from the UK that had assessed associations between at least one indicator of socioeconomic position and at least one outcome of physical activity and/or sedentary behaviour.

DATA EXTRACTION AND SYNTHESIS

Data were extracted by one reviewer and 20% were double checked. Indicators of socioeconomic position were tabulated with domains of physical activity and sedentary behaviour.

RESULTS

Fifty-seven publications were included in the review; 37 publications from 19 studies (k=23) of children and 21 publications from 15 studies (k=23) of adolescents. Most studies were cross-sectional. 63% of studies of children, and 40% of studies of adolescents assessed Index of Multiple Deprivation. Eighteen studies measured physical activity in children, 13 measured sedentary behaviour. Eleven studies of adolescents included a measure of physical activity, 10 included a measure of sedentary behaviour. Among children and adolescents, the association between socioeconomic position and measures of either physical activity or sedentary behaviour was highly variable depending on the measure of both socioeconomic position used and the behavioural outcome, with the exception of higher family affluence which was consistently associated with higher reported physical activity among adolescents.

CONCLUSION

Physical activity and sedentary behaviours of children and adolescents in the UK are complex and influenced by multiple indicators of socioeconomic position that are, in most cases, different across age stages, outcomes examined and measurement tools. Greater consistency in the use and measures of socioeconomic position as well as outcomes of behaviour are required for robust country-specific meta-analyses.

Early-Life Socioeconomic Circumstances and Physical Activity in Older Age: Women Pay the Price

Health in older age is shaped by early-life socioeconomic circumstances (SECs) and sex. However, whether and why these factors interact is unclear. We examined a cultural explanation of this interaction by distinguishing cultural and material aspects of SECs in the context of physical activity-a major determinant of health. We used data from 56,331 adults between 50 and 96 years old from the Survey of Health, Ageing and Retirement in Europe (SHARE), a 13-year, large-scale, population-based cohort. Confounder-adjusted logistic linear mixed-effects models showed an association between the cultural aspects of early-life SEC disadvantage and physical activity among women, but it was not consistently observed in men. Furthermore, these associations were compensated for only partially by adult-life socioeconomic trajectories. The material aspects of early-life SECs were not associated with adult-life physical activity. These findings highlight the need to distinguish different aspects of SECs because they may relate to health behaviors in diverse ways.

Socioeconomic disparities in physical activity, sedentary behavior and sleep patterns among 6- to 9-year-old children from 24 countries in the WHO European region

Physical activity, sedentary behavior, and sleep are important predictors of children's health. This paper aimed to investigate socioeconomic disparities in physical activity, sedentary behavior, and sleep across the WHO European region. This cross-sectional study used data on 124,700 children aged 6 to 9 years from 24 countries participating in the WHO European Childhood Obesity Surveillance Initiative between 2015 and 2017. Socioeconomic status (SES) was measured through parental education, parental employment status, and family perceived wealth. Overall, results showed different patterns in socioeconomic disparities in children's movement behaviors across countries. In general, high SES children were more likely to use motorized transportation. Low SES children were less likely to participate in sports clubs and more likely to have more than 2 h/day of screen time. Children with low parental education had a 2.24 [95% CI 1.94-2.58] times higher risk of practising sports for less than 2 h/week. In the pooled analysis, SES was not significantly related to active play. The relationship between SES and sleep varied by the SES indicator used. Importantly, results showed that low SES is not always associated with a higher prevalence of "less healthy" behaviors. There is a great diversity in SES patterns across countries which supports the need for country-specific, targeted public health interventions.

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.

How Does the Family Influence the Physical Condition and Health of Children in a Rural Environment?

The aim of this cross-sectional study was to assess physical conditions related to health status and establish relationships with influencing factors such as family structure, educational level, and parental professional occupation in the infant stage of three to five years in a rural setting. The sample included 205 children between 3 and 5 years of age from rural areas (<10,000 inhabitants) from the region of Castilla-La Mancha (Spain). Fitness level was measured using the PREFIT battery; influencing factors were assessed with a family information questionnaire. The results showed significant differences in all the analyzed variables of physical condition and between genders at each of the educational levels except for body mass index. Boys performed better than girls on cardio-respiratory fitness tests, muscle strength in both hands, speed-agility, and longitudinal jump tests for boys aged three, while girls performed the test better at four years. The type of family structure was not correlated with any of the variables of physical condition; a lower level of education of the father and mother and the professional occupation of the mother were correlated with a higher body mass index. As a main conclusion, physical condition related to health seems to be affected by influencing factors such as educational level and family professional occupation, especially of the mother, but the type of family structure does not have as much influence. There are few studies in children from three to five years of age in exclusively rural areas, so the data in this study provides relevant and innovative information, while opening research to cater to this population group.

Development of a consensus statement on the role of the family in the physical activity, sedentary, and sleep behaviours of children and youth

BACKGROUND

Children and youth who meet the physical activity, sedentary, and sleep behaviour recommendations in the Canadian 24-Hour Movement Guidelines are more likely to have desirable physical and psychosocial health outcomes. Yet, few children and youth actually meet the recommendations. The family is a key source of influence that can affect lifestyle behaviours. The purpose of this paper is to describe the process used to develop the Consensus Statement on the Role of the Family in the Physical Activity, Sedentary, and Sleep Behaviours of Children and Youth (0-17 years) and present, explain, substantiate, and discuss the final Consensus Statement.

METHODS

The development of the Consensus Statement included the establishment of a multidisciplinary Expert Panel, completion of six reviews (three literature, two scoping, one systematic review of reviews), custom data analyses of Statistics Canada's Canadian Health Measures Survey, integration of related research identified by Expert Panel members, a stakeholder consultation, establishment of consensus, and the development of a media, public relations, communications and launch plan.

RESULTS

Evidence from the literature reviews provided substantial support for the importance of family on children's movement behaviours and highlighted the importance of inclusion of the entire family system as a source of influence and promotion of healthy child and youth movement behaviours. The Expert Panel incorporated the collective evidence from all reviews, the custom analyses, other related research identified, and stakeholder survey feedback, to develop a conceptual model and arrive at the Consensus Statement: Families can support children and youth in achieving healthy physical activity, sedentary and sleep behaviours by encouraging, facilitating, modelling, setting expectations and engaging in healthy movement behaviours with them. Other sources of influence are important (e.g., child care, school, health care, community, governments) and can support families in this pursuit.

CONCLUSION

Family is important for the support and promotion of healthy movement behaviours of children and youth. This Consensus Statement serves as a comprehensive, credible, and current synopsis of related evidence, recommendations, and resources for multiple stakeholders.

mHealth technology for ecological momentary assessment in physical activity research: a systematic review

OBJECTIVE

To systematically review the publications on ecological momentary assessment (EMA) relating to physical activity (PA) behavior in order to classify the methodologies, and to identify the main mHealth technology-based tools and procedures that have been applied during the first 10 years since the emergence of smartphones. As a result of this review, we want to ask if there is enough evidence to propose the use of the term "mEMA" (mobile-based EMA).

DESIGN

A systematic review according to PRISMA Statement (PROSPERO registration: CRD42018088136).

METHOD

Four databases (PsycINFO, CINALH, Medline and Web of Science Core Collection) were searched electronically from 2008 to February 2018.

RESULTS

A total of 76 studies from 297 potential articles on the use of EMA and PA were included in this review. It was found that 71% of studies specifically used "EMA" for assessing PA behaviors but the rest used other terminology that also adjusted to the inclusion criteria. Just over half (51.3%) of studies (39) used mHealth technology, mainly smartphones, for collecting EMA data. The majority (79.5%) of these studies (31 out of 39) were published during the last 4 years. On the other hand, 58.8% of studies that only used paper-and-pencil were published during the first 3 years of the 10-year period analyzed. An accelerometer was the main built-in sensor used for collecting PA behavior by means of mHealth (69%). Most of the studies were carried out on young-adult samples, with only three studies in older adults. Women were included in 60% of studies, and healthy people in 82%. The studies lasted between 1 and 7 days in 57.9%, and between three and seven assessments per day were carried out in 37%. The most popular topics evaluated together with PA were psychological state and social and environmental context.

CONCLUSIONS

We have classified the EMA methodologies used for assessing PA behaviors. A total of 71% of studies used the term "EMA" and 51.3% used mHealth technology. Accelerometers have been the main built-in sensor used for collecting PA. The change of trend in the use of tools for EMA in PA coincides with the technological advances of the last decade due to the emergence of smartphones and mHealth technology. There is enough evidence to use the term mEMA when mHealth technology is being used for monitoring real-time lifestyle behaviors in natural situations. We define mEMA as the use of mobile computing and communication technologies for the EMA of health and lifestyle behaviors. It is clear that the use of mHealth is increasing, but there is still a lot to be gained from taking advantage of all the capabilities of this technology in order to apply EMA to PA behavior. Thus, mEMA methodology can help in the monitoring of healthy lifestyles under both subjective and objective perspectives. The tendency for future research should be the automatic recognition of the PA of the user without interrupting their behavior. The ecological information could be completed with voice messages, image captures or brief text selections on the touch screen made in real time, all managed through smartphone apps. This methodology could be extended when EMA combined with mHealth are used to evaluate other lifestyle behaviors.

Self-reported physical activity status among adolescents in Debre Birhan town, Ethiopia: Cross-sectional study

BACKGROUND

Regular physical activity reduces the risk of ischaemic heart disease, stroke, diabetes, and breast and colon cancer. But, adolescents are insufficiently physically active. Therefore, this study was aimed to assess self- reported physical activity status and associated factors among adolescents in Debre Birhan town, Ethiopia.

METHODS

School based cross-sectional study was conducted from April 20 to May 10/2019 in Debre Berhan town Secondary schools. Multi-stage sampling technique was used to select 580 study participants from three secondary schools. Physical activity was assessed using questions adopted from recreation, sport, and leisure-time physical activity assessment section of international physical activity questionnaire (IPAQ). Adolescents who have done moderate to vigorous exercise for 60 minutes per day for at least three days in the last seven days were categorized as physically active. Descriptive statistics, bivariable and multivariable logistic regression analysis was done. Probability value less than 0.05 was used as a cut of point to determined statistically significant association.

RESULT

A total of 580 students participated in this study. Less than 1 in 5 (17.2%, 95% confidence interval (CI) = 14.13%-20.27%) students were physically active. Male student (Adjusted odds ratio (AOR): 2.63, 95%CI = 1.5-4.59), age less than or equal to 16 (AOR: 2.04, 95% CI = 1.12-3.71) and access to sports center (gymnasium) (AOR: 2.09, 95% CI = 1.12-3.89 were positively associated with physical activity.

CONCLUSION

Physical activity status was very low. Therefore, the local, regional and national administrators in collaboration with sport and health offices administrators should make facilities accessible.

Magnitude of sedentary behavior and associated factors among secondary school adolescents in Debre Berhan town, Ethiopia

BACKGROUND

Sedentary life style is becoming increasingly common in this industrial age due to changes on the way people manufacture, transport and communicate. Sedentary lifestyle is associated with chronic diseases (diabetes, cardiovascular disease, and cancer), depression, obesity and premature mortality. The objective of this study was to assess the magnitude and associated factors of sedentary behavior.

METHODS

School based cross sectional study was conducted among 580 students from April 20 to May 10, 2019 in secondary schools in Debre Berhan City Administration. Sedentary behavior was measured using time spent on four activities (watching TV/Video, listening to music, surfing internet and playing games). Adolescents are considered sedentary if they spend two or more hours in one or all listed activities per day. Data was entered to Epidata version 4.2.2.1 and exported to SPSS version 20 for analysis.

RESULT

A total of 580 (44.3% male and 55.7% female) students participated in this study. The magnitude of sedentary behavior (≥2 h per day) was 65.5% (95% CI = 61.32% - 69.08). Family monthly income greater than 8000 birr (AOR: 6.42, 95%CI = 2.18-18.78), maternal education (AOR: 5.12, 95%CI = 1.09-23.83), access to TV (AOR: 4.87, 95%CI = 1.99-11.87), access to mobile internet (AOR: 2.37, 95% CI = 1.14-4.93) and utilization of social media (AOR: 2.98, 95%CI = 1.43-6.17) were positively associated with adolescent sedentary behavior.

CONCLUSION

The prevalence of sedentary behavior was high among adolescents of Debre Berhan town. Therefore, schools in the town should work towards creating awareness on the wise use of screen based entertainments.

How socio-demographic and familiar circumstances are associated with total and domain-specific sedentary behaviour in youth? The UP&DOWN study

Objective: The aims of the present study were to analyze the associations between the socio-demographic and familiar circumstances with: (i) the total leisure-time sedentary behavior (SB) assessed by accelerometry, and (ii) the domain-specific leisure-time SB (i.e., screen-based, educational-based, social-based, and other-based SB), in a sample of Spanish youth. Method: The sample consisted of 1,543 youth (12.02 ± 2.51 years) included in the UP&DOWN study. SB was evaluated by accelerometry and questionnaire. Nationality, location of school, type of school, socio-economic status, parental educational level, parental occupation status, family structure, number of siblings and position among siblings were self-reported by participants or their parents. Linear mixed models, including school and city as random effects, were performed. Results: Several associations were found; however, socio-demographic and family circumstances differently associated with SB according to the domain-specific SB, the sex and the type of day. For example, participants with a father holding a high-skilled occupation spent lower time in screen-based SB during weekdays; and mother occupation status of high qualification was related to higher educational-based SB in boys. Having three or more sibling was associated with lower total SB in boys, while having an obese mother was related to higher screen-based SB on weekends both in boys and girls. Conclusions: Socio-demographic and familiar circumstances are associated with SB in young people, so future interventions should consider multiple and sex-specific factors for reduce SB of young people, focusing especially on youth with a low number of siblings and with parents holding low-skilled employments.

A Longitudinal Study of the Associations of Family Structure with Physical Activity across the Week in Boys and Girls

The aim of this study was to examine how family structure is associated with moderate-to-vigorous-intensity physical activity (MVPA) for children aged between 6 and 11. At 6, 9 and 11 years, children wore an accelerometer and parents/carers completed questionnaires on demographics and family structure. Linear regression models examined cross-sectional associations between family structure and MVPA at age 9 and 11. Linear multilevel models examined longitudinal associations between age 6 and 11, differences in change over time were examined using interaction terms. No associations between exposures and MVPA were evident at age 9. Compared to boys living in one home, eleven-year-old boys who lived in multiple homes performed 15.99 (2.46-29.52) fewer minutes of MVPA on weekend days. In longitudinal analyses, the evidence was unclear whether the association with family structure changed over time. Models that assumed associations with family structure remained constant over time, found that boys who lived in multiple homes performed 11.02 (0.76-21.28) fewer minutes of MVPA per weekend day, while for each additional sibling, girls performed an extra 1.89 (0.25-3.53) minutes of MVPA per weekend day. Findings indicate a small number of associations, varying in magnitude, between family structure and children's MVPA. Therefore, families of all structures should be supported to help their children meet MVPA recommendations.

Methodology Used in Ecological Momentary Assessment Studies About Sedentary Behavior in Children, Adolescents, and Adults: Systematic Review Using the Checklist for Reporting Ecological Momentary Assessment Studies

Background

The use of ecological momentary assessment (EMA) to measure sedentary behavior (SB) in children, adolescents, and adults can increase the understanding of the role of the context of SB in health outcomes.

Objective

The aim of this study was to systematically review literature to describe EMA methodology used in studies on SB in youth and adults, verify how many studies adhere to the Methods aspect of the Checklist for Reporting EMA Studies (CREMAS), and detail measures used to assess SB and this associated context.

Methods

A systematic literature review was conducted in the PubMed, Scopus, Web of Science, PsycINFO, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and SPORTDiscus databases, covering the entire period of existence of the databases until January 2018.

Results

This review presented information about the characteristics and methodology used in 21 articles that utilized EMA to measure SB in youth and adults. There were more studies conducted among youth compared with adults, and studies of youth included more waves and more participants (n=696) than studies with adults (n=97). Most studies (85.7%) adhered to the Methods aspect of the CREMAS. The main criteria used to measure SB in EMA were self-report (81%) with only 19% measuring SB using objective methods (eg, accelerometer). The main equipment to collect objective SB was the ActiGraph, and the cutoff point to define SB was <100 counts/min. Studies most commonly used a 15-min window to compare EMA and accelerometer data.

Conclusions

The majority of studies in this review met minimum CREMAS criteria for studies conducted with EMA. Most studies measured SB with EMA self-report (n=17; 81.0%), and a few studies also used objective methods (n=4; 19%). The standardization of the 15-min window criteria to compare EMA and accelerometer data would lead to a comparison between these and new studies. New studies using EMA with mobile phones should be conducted as they can be considered an attractive method for capturing information about the specific context of SB activities of young people and adults in real time or very close to it.

Associations between family structure and young people's physical activity and screen time behaviors

Background

Identifying factors that can influence young peoples’ physical activity and sedentary behaviors is important for the development of effective interventions. The family structure in which children grow up may be one such factor. As the prevalence of single parent and reconstituted families have increased substantially over the last decades, the objective of this study was to examine whether these family structures are differentially associated with young people’s MVPA, participation in organized sports and screen-time activities (screen-based passive entertainment, gaming, other screen-based activities) as compared to traditional nuclear families.

Methods

The data stem from the 2013/2014 “Health Behaviour in School- aged Children (HBSC) study”. A large Norwegian sample of 11–16 years old students (n = 4509) participated. Cluster-adjusted regression models were estimated using full information maximum likelihood with robust standard errors (MLR).

Results

After adjusting for covariates, living with a single parent was negatively associated with days/week with 60 min MVPA (b = −.39, 95%CI: −.58, −.20), and positively associated with hours/weekday of total screen time (b = .50, 95%CI: .08, .93). Young people living with a single parent were also more likely to report no participation in organized sports (OR = 1.40, 95%CI: 1.09, 1.79). Living in a reconstituted family was negatively associated with days/week with 60 min MVPA (b = −.31, 95%CI: −.53, −.08), and positively associated with hours/weekday of total screen time (b = .85, 95%CI: .37, 1.33). For all outcomes, the interaction effects of family structure with sex, and with having siblings were not statistically significant. For material affluence, a significant interaction effect was found for participation in organized sports (χ² [4] =13.9, p = .008). Those living in a reconstituted family with low or high material affluence had an increased risk for not participating in organized sports whereas those with medium material affluence did not.

Conclusion

This study suggests that living with a single parent or in reconstituted families was unfavorably associated with physical activity, sport participation and screen-based behaviors among Norwegian youth. The findings indicate that family structure could be an important factor to take into account in the development and testing of interventions. More in-depth research is needed to identify the mechanisms involved.

Associations Between Socio-Economic Status and Child Health: Findings of a Large German Cohort Study

The familial social background of a child can significantly impact their behavior and health. We investigated associations between socio-economic status (SES) and health parameters and behaviors in German children and adolescents. Data were collected between 2011 and 2018 in the framework of the LIFE Child study. Participants included 2998 children aged 3⁻18 years. SES was represented by an index combining information on parental education, occupation, and income. Associations between SES and health outcomes were estimated using linear and logistic regression analyses. In a moderator analysis, all associations were checked for interactions between SES and age or sex. A higher SES composite score was associated with better health (lower body mass index (β = -0.26), fewer behavioral difficulties (β = -0.18), higher quality of life (β = 0.21), fewer critical life events (odds ratio (OR) = 0.93); all p < 0.05) and a healthier lifestyle (healthier nutrition (β = 0.16), less excessive television use (OR = 0.87), less nicotine consumption (OR = 0.93), and more physical activity (OR = 1.18); all p < 0.05). However, SES was not associated with alcohol consumption (OR = 1.02) or sleep problems (β = -0.04). The strengths of the associations between SES and child health did not differ depending on SES indicator (education, occupation, income). The associations between SES and parent-reported behavioral difficulties and physical activity were stronger in older vs. younger children. In contrast, none of the observed associations were moderated by sex. This study highlights the strong association between socio-economic status and child health, even in modern Western societies.

Cross-sectional and longitudinal associations of screen time and physical activity with school performance at different types of secondary school

Background

Previous studies have already reported associations of media consumption and/or physical activity with school achievement. However, longitudinal studies investigating independent effects of physical activity and media consumption on school performance are sparse. The present study fills this research gap and, furthermore, assesses relationships of the type of secondary school with media consumption and physical activity.

Methods

The consumption of screen-based media (TV/video, game console, PC/internet, and mobile phone) and leisure physical activity (organized and non-organized) of 10 – to 17-year old adolescents participating in the LIFE Child study in Germany were related to their school grades in two major school subjects (Mathematics and German) and in Physical Education. In addition to a cross-sectional analysis at baseline (N = 850), a longitudinal analysis (N = 512) investigated the independent effects of these activities on the school grades achieved 12 months later. All associations were adjusted for age, gender, socio-economic status, year of data assessment, body-mass-index, and school grades at baseline. A further analysis investigated differences in the consumption of screen-based media and physical activity as a function of the type of secondary school (highest vs. lower secondary school).

Results

Adolescents of lower secondary schools reported a significantly higher consumption of TV/video and game consoles than adolescents attending the highest secondary school. Independently of the type of school, a better school performance in Mathematics was predicted by a lower consumption of computers/internet, and a better performance in Physical Education was predicted by a lower consumption of TV/video and a higher frequency of non-organized physical activity. However, the association between non-organized physical activity and subsequent grades in Physical Education was significant in girls only.

Conclusion

The present results suggest that media consumption has a negative effect on school achievement, whereas physical activity has a positive effect, which, however, is restricted to the subject Physical Education. Future studies might explore the relationship between media consumption and school career, for example, the choice or change of the secondary school type, in more detail.

Trial registration

LIFE Child study: ClinicalTrials.gov, clinical trial number NCT02550236

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.

Awareness of wearing an accelerometer does not affect physical activity in youth

BACKGROUND

This study aimed to investigate whether awareness of being monitored by an accelerometer has an effect on physical activity in young people.

METHODS

Eighty healthy participants aged 10-18 years were randomized between blinded and nonblinded groups. The blinded participants were informed that we were testing the reliability of a new device for body posture assessment and these participants did not receive any information about physical activity. In contrast, the nonblinded participants were informed that the device was an accelerometer that assessed physical activity levels and patterns. The participants were instructed to wear the accelerometer for 4 consecutive days (2 school days and 2 school-free days).

RESULTS

Missing data led to the exclusion of 2 participants assigned to the blinded group. When data from the blinded group were compared with these from the nonblinded group, no differences were found in the duration of any of the following items: (i) wearing the accelerometer, (ii) total physical activity, (iii) sedentary activity, and (iv) moderate-to-vigorous activity.

CONCLUSIONS

Our study shows that the awareness of wearing an accelerometer has no influence on physical activity patterns in young people. This study improves the understanding of physical activity assessment and underlines the objectivity of this method.

TRIAL REGISTRATION

NCT02844101 (retrospectively registered at July 13th 2016).

Ecological Momentary Assessment of Adolescent Problems, Coping Efficacy, and Mood States Using a Mobile Phone App: An Exploratory Study

BACKGROUND

Mobile technologies have the potential to be used as innovative tools for conducting research on the mental health and well-being of young people. In particular, they have utility for carrying out ecological momentary assessment (EMA) research by capturing data from participants in real time as they go about their daily lives.

OBJECTIVE

The aim of this study was to explore the utility of a mobile phone app as a means of collecting EMA data pertaining to mood, problems, and coping efficacy in a school-based sample of Irish young people.

METHODS

The study included a total of 208 participants who were aged 15-18 years, 64% female (113/208), recruited from second-level schools in Ireland, and who downloaded the CopeSmart mobile phone app as part of a randomized controlled trial. On the app, participants initially responded to 5 single-item measures of key protective factors in youth mental health (formal help-seeking, informal help-seeking, sleep, exercise, and sense of belonging). They were then encouraged to use the app daily to input data relating to mood states (happiness, sadness, anger, stress, and worry), daily problems, and coping self-efficacy. The app automatically collected data pertaining to user engagement over the course of the 28-day intervention period. Students also completed pen and paper questionnaires containing standardized measures of emotional distress (Depression, Anxiety, and Stress Scale; DASS-21), well-being (World Health Organization Well-Being Index; WHO-5), and coping (Coping Strategies Inventory; CSI).

RESULTS

On average the participants completed 18% (5/28) of daily ratings, and engagement levels did not differ across gender, age, school, socioeconomic status, ethnicity, or nationality. On a scale of 1 to 10, happiness was consistently the highest rated mood state (overall mean 6.56), and anger was consistently the lowest (overall mean 2.11). Pearson correlations revealed that average daily ratings of emotional states were associated with standardized measures of emotional distress (r_happiness=-.45, r_sadness=.51, r_anger=.32, r_stress=.41, r_worry=.48) and well-being (r_happiness=.39, r_sadness =-.43, r_anger=-.27, r_stress=-.35, r_worry=-.33)_. Inferential statistics indicated that single-item indicators of key protective factors were related to emotional distress, well-being, and average daily mood states, as measured by EMA ratings. Hierarchical regressions revealed that greater daily problems were associated with more negative daily mood ratings (all at the P<.001 level); however, when coping efficacy was taken into account, the relationship between problems and happiness, sadness, and anger became negligible.

CONCLUSIONS

While engagement with the app was low, overall the EMA data collected in this exploratory study appeared valid and provided useful insights into the relationships between daily problems, coping efficacy, and mood states. Future research should explore ways to increase engagement with EMA mobile phone apps in adolescent populations to maximize the amount of data captured by these tools.

TRIAL REGISTRATION

Clinicaltrials.gov NCT02265978; http://clinicaltrials.gov/ct2/show/NCT02265978 (Archived by WebCite at http://www.webcitation.org/6mMeYqseA).

Family Structure as a Correlate of Organized Sport Participation among Youth

Organized sport is one way that youth participate in physical activity. There are disparities in organized sport participation by family-related factors. The purpose of this study was to determine whether non-traditional family structure and physical custody arrangements are associated with organized sport participation in youth, and if so whether this relationship is mediated by socioeconomic status. Data were from the 2009–10 Health Behaviour in School-aged Children survey, a nationally representative cross-section of Canadian youth in grades 6–10 (N = 21,201). Information on family structure was derived from three survey items that asked participants the number of adults they lived with, their relationship to these adults, and if applicable, how often they visited another parent outside their home. Participants were asked whether or not they were currently involved in an organized sport. Logistic regression was used to compare the odds of organized sport participation according to family structure. Bootstrap-based mediation analysis was used to assess mediation by perceived family wealth. The results indicated that by comparison to traditional families, boys and girls from reconstituted families with irregular visitation of a second parent, reconstituted families with regular visitation of a second parent, single-parent families with irregular visitation of a second parent, and single-parent families with regular visitation of a second parent were less likely to participate in organized sport than those from traditional families, with odds ratios ranging from 0.48 (95% confidence interval: 0.38–0.61) to 0.78 (95% confidence interval: 0.56–1.08). The relationship between family structure and organized sport was significantly mediated by perceived family wealth, although the magnitude of the mediation was modest (ie, <20% change in effect estimate). In conclusion, youth living in both single-parent and reconstituted families experienced significant disparities in organized sport participation that was partially mediated by perceived family wealth.

Family structure as a predictor of screen time among youth

The family plays a central role in the development of health-related behaviors among youth. The objective of this study was to determine whether non-traditional parental structure and shared custody arrangements predict how much time youth spend watching television, using a computer recreationally, and playing video games. Participants were a nationally representative sample of Canadian youth (N = 26,068) in grades 6–10 who participated in the 2009/10 Health Behaviour in School-aged Children Survey. Screen time in youth from single parent and reconstituted families, with or without regular visitation with their non-residential parent, was compared to that of youth from traditional dual-parent families. Multiple imputation was used to account for missing data. After multiple imputation, the relative odds of being in the highest television, computer use, video game, and total screen time quartiles were not different in boys and girls from non-traditional families by comparison to boys and girls from traditional dual-parent families. In conclusion, parental structure and child custody arrangements did not have a meaningful impact on screen time among youth.

Single parent status and children's objectively measured level of physical activity

BACKGROUND

Single-parent family status has been investigated as a possible psychosocial determinant of children's level of physical activity (PA)-although with mixed and inconclusive results. Prevailing evidence of the importance of two-parent family status as a resource for children's PA is based on a mix of subjective and objective measurements of PA. Objectives: To investigate if the level of PA among children living with a single parent was lower compared to children living with two parents by means of a meta-analysis of published and unpublished studies. We restricted our analysis to studies with objective measurements of PA.

METHODS

Data sources: The databases, Social Science Citation Index, PsycINFO, PubMed, and EBSCO were searched (1987-2013). Study eligibility criteria: Observational studies comparing objectively measured PA between single-parent children and children from two-parent families. Study appraisal and synthesis methods: We used guidelines from the Cochrane Handbook of Systematic Reviews of Interventions and a modified version of the Newcastle-Ottawa Scale overall to assess the quality of the included studies. We refrained from calculation of summary scores.

RESULTS

Twelve studies met the following inclusion criteria of which six were unpublished: (a) child age (6-18 years) and (b) objectively measured level of PA. Meta-analysis revealed pooled estimates of -0.01 for boys (95 % CI -0.04-0.03, p = 0.77, I2 = 6.5 %, p = 0.38) and 0.01 for girls (95 % CI -0.03-0.04, p = 0.62, I2 = 21.0 %, p = 0.24), respectively. Estimates show no differences in objectively measured physical activity between children living in single-parent families compared to children living with two parents. Analyses investigating seven potential moderators did not yield any statistical significant effect size estimates. No evidence of heterogeneity between studies was observed. Limitations: Retrieved articles were assessed by several of the authors. Blinding of the authors was not feasible, as most of the authors have been involved in the studies.

CONCLUSIONS

No evidence was found suggesting that children of single-parent families are in special need of extraordinary measures to facilitate their level of PA.

Built environment and active play among Washington DC metropolitan children: A protocol for a cross-sectional study

Background

Research has demonstrated that children who participate in active play are more likely to be physically active, thereby improving long-term health outcomes. Many adult studies have also shown that neighborhood built environments can encourage or discourage routine physical activity. Limited evidence has demonstrated that children who reside in neighborhoods with a built environment that is more inviting to active play exhibit lower overweight and obesity rates as well as an overall better state of well-being. This Built Environment and Active Play (BEAP) Study aims to develop a neighborhood playability rating system in the Washington, DC (DMV) area. Similar to walkability scores, these playability scores will estimate how affable a neighborhood is to active play. The BEAP Study will attempt to provide a broad view of factors influencing the level and type of active play among children.

Methods/Design

Using a cross-sectional design, the BEAP Study will collect data using a mail questionnaire administered to the parents and/or guardians of 2000 children aged 7-12 years residing in select DMV areas in October of 2014. Questionnaire data, including information on active play, home and neighborhood characteristics, parental perceptions, and sociodemographic characteristics will be merged through a geographic information system (GIS) with objective built environment measures in the participants’ neighborhoods. An ordered logit model will be used to regress an ordinal active play outcome on built environment exposure variables while adjusting for potential confounders. Upon the construction of the final model, predictor coefficients will be used as parameters in the scoring system to develop neighborhood playability scores.

Discussion

The BEAP Study intends to generate a neighborhood playability index by characterizing and quantifying children’s active play using parent-reported physical activity data in children, GIS data and built environment measures in participant neighborhoods. The BEAP Study will improve our understanding of the built environment and childhood playability relationship while also contributing to the body of evidence-based built environment and physical activity research.

Electronic supplementary material

The online version of this article (doi:10.1186/s13690-015-0070-3) contains supplementary material, which is available to authorized users.

Using ecological momentary assessment to evaluate current physical activity

Objective. The purpose of this study was to assess the value of ecological momentary assessment in evaluating physical activity among children, adolescents, and adults. It also determines whether ecological momentary assessment fulfills the criteria of validity, reliability, objectivity, norms, and standardization applied to the tools used for the evaluation of physical activity. Methods. The EBSCO-CINHAL, Medline, PsycINFO, PubMed, and SPORTDiscuss databases were reviewed in December 2012 for articles associated with EMA. Results. Of the 20 articles examined, half (10) used electronic methods for data collection, although various methods were used, ranging from pen and paper to smartphone applications. Ten studies used objective monitoring equipment. Nineteen studies were performed over 4 days. While the validity of the EMA method was discussed in 18 studies, only four found it to be objective. In all cases, the EMA procedures were precisely documented and confirmed to be feasible. Conclusions. Ecological momentary assessment is a valid, reliable, and feasible approach to evaluate activity and sedentary behavior. Researchers should be aware that while ecological momentary assessment offers many benefits, it simultaneously imposes many limitations which should be considered when studying physical activity.

School travel mode, parenting practices and physical activity among UK Year 5 and 6 children

Background

School travel mode and parenting practices have been associated with children’s physical activity (PA). The current study sought to examine whether PA parenting practices differ by school travel mode and whether school travel mode and PA parenting practices are associated with PA.

Methods

469 children (aged 9-11) wore accelerometers from which mean weekday and after-school (3.30 to 8.30 pm) minutes of moderate-to-vigorous intensity PA (MVPA) and counts per minute (CPM) were derived. Mode of travel to and from school (passive vs. active) and PA parenting practices (maternal and paternal logistic support and modelling behaviour) were child-reported.

Results

Children engaged in an average of 59.7 minutes of MVPA per weekday. Active travel to school by girls was associated with 5.9 more minutes of MVPA per day compared with those who travelled to school passively (p = 0.004). After-school CPM and MVPA did not differ by school travel mode. There was no evidence that physical activity parenting practices were associated with school travel mode.

Conclusions

For girls, encouraging active travel to school is likely to be important for overall PA. Further formative research may be warranted to understand how both parental logistic support and active travel decisions are operationalized in families as a means of understanding how to promote increased PA among pre-adolescent children.

Influence of family structure on obesogenic behaviors and placement of bedroom TVs of American children: National Survey of Children's Health 2007

OBJECTIVE

To explore the relation between family structure and obesogenic attributes.

METHODS

Publicly available data from the 2007 National Survey of Children's Health (n=55,094; 11.6 ± 0.04 years; 51.2% male) was analyzed in fall 2012. Predictor variables included marital status (two-parent biological [referent], two-parent blended, single-mother, and other) and number of children. Outcome variables included the presence of a bedroom television (BTV), elevated television (TV) viewing time, insufficient physical activity, and infrequent family meals.

RESULTS

Analysis of family structure revealed 63% biological, 11% blended, and 20% single-mother families. Twenty-three percent of children did not have siblings. When family structure variables were considered independently, children in blended (odds ratio (OR): 1.75; 95% confidence interval (CI) 1.45, 2.10) and single-mother homes (1.49; 1.28, 1.74) had higher odds of BTV. Children in blended families had higher odds of elevated TV viewing time (1.28; 1.08, 1.51). Single-mother homes had higher odds of infrequent family meals (1.28; 1.07, 1.52). Families with ≥ 2 children were less likely to have BTV (0.60; 0.54, 0.66) or elevated TV viewing time (0.74; 0.67, 0.82), and to irregularly dine together (0.89; 0.80, 0.99).

CONCLUSION

Diverse family structure was associated with more obesogenic behaviors and environments. The presence of siblings diminished, but did not eliminate, the risk.

Bedroom media, sedentary time and screen-time in children: a longitudinal analysis

BACKGROUND

Having electronic media in the bedroom is cross-sectionally associated with greater screen-time in children, but few longitudinal studies exist. The aim of this study was to describe longitudinal patterns of ownership and examine cross-sectional and longitudinal associations of bedroom media with children's sedentary behaviour.

METHODS

Data are from the Sport, Physical activity and Eating behaviour: Environmental Determinants in Young people (SPEEDY) study, collected at 3 time-points: baseline (2007, T0; age 10.3 ± 0.3 years), 1-year (T1y) and 4-year (T4y) follow-up. For each assessment, 1512 (44.9% male), 715 (41.0% male), and 319 (48.3% male) participants provided valid accelerometer data. Outcome variables were accelerometer-assessed sedentary time and self-reported screen-time. The presence of a television or computer in the bedroom was self-reported by participants and a combined bedroom media score calculated as the sum of such items. Cross-sectional and longitudinal associations between bedroom media and each outcome were examined using multi-level linear regression.

RESULTS

Bedroom TV ownership fell from 70.9% at T0 to 42.5% at T4y. Having a TV in the bedroom (beta; 95% CI*100, T0: -1.17; -1.88, -0.46. T1y: -1.68; -2.67, -0.70) and combined bedroom media (T0: -0.76; -1.26, -0.27. T1y: -0.79; -1.51, -0.07) were negatively associated with objectively measured weekly sedentary time at T0 and T1y. Having a computer in the bedroom (beta; 95% CI, T0: 0.15; 0.02, 0.29. T4y: 0.35; 0.10, 0.60) and combined bedroom media (T0: 0.09: 0.01, 0.18. T4y: 0.20; 0.05, 0.34) were positively associated with screen-time at T0 and T4y. Relative to participants without a computer throughout the study, children that had a computer in their bedroom at T0 but not at T4y (beta; 95% CI for change in screen-time: -8.02; -12.75, -3.29) reported smaller increases in screen-time.

CONCLUSIONS

The bedroom media environment changes with age and exhibits a complex relationship with children's sedentary behaviour. Modifying children's bedroom media environment may impact upon screen-time but appears unlikely to influence overall sedentary time.

Determinants of change in children's sedentary time

BACKGROUND

Understanding the determinants of sedentary time during childhood contributes to the development of effective intervention programmes.

PURPOSE

To examine family and home-environmental determinants of 1-year change in objectively measured sedentary time after-school and at the weekend.

METHODS

Participants wore accelerometers at baseline and 1 year later. Longitudinal data for after-school and weekend analyses were available for 854 (41.5%male, mean ± SD age 10.2 ± 0.3 years) and 718 (41.8%male, age 10.2 ± 0.3 years) participants. Information on 26 candidate determinants, including socioeconomic status (SES), availability of electronic media and parental rules for sedentary behaviours was self-reported by children or their parents at baseline. Change in the proportion of registered time spent sedentary was used as the outcome variable in multi-level linear regression models, adjusted for age, sex, body mass index and baseline sedentary time. Simple and multiple models were run and interactions with sex explored.

RESULTS

Children from higher socioeconomic status families exhibited greater increases in after-school (beta; 95% CI for change in % time spent sedentary 1.02; 0.37, 1.66) and weekend (1.42; 0.65, 2.18) sedentary time. Smaller increases in after-school sedentary time were observed in children with more siblings (-1.00; -1.69, -0.30), greater availability of electronic media (-0.81; -1.29, -0.33) and, for boys, more frequent family visits to the park (-1.89; -3.28, -0.51) and family participation in sport (-1.28; -2.54, -0.02). Greater maternal weekend screen-time (0.45; 0.08, 0.83) and, in girls, greater parental restriction on playing outside (0.91; 0.08, 1.74) were associated with larger increases in weekend sedentary time. The analytical sample was younger, more likely to be female, had lower BMI and was of higher SES than the original baseline sample.

CONCLUSIONS

Intervention strategies aimed at reducing parents' weekend screen-time, increasing family participation in sports or recreation (boys) and promoting freedom to play outside (girls) may contribute towards preventing the age-related increase in sedentary time.

Sedentary behaviors among Hispanic children: influences of parental support in a school intervention program

PURPOSE

To examine the effect of parental support on sedentary behaviors among Hispanic children.

DESIGN AND SETTING

A longitudinal quasi-experimental design with five waves of data collection was used to examine the effect of parental support on children's sedentary behaviors in a school-based intervention program in west Texas.

SUBJECTS

Hispanic low-income parents and their children of 5 to 9 years (N = 416 child-parent dyads) over a 22-month period (1217 observations).

INTERVENTION

Transformacion Para Salud was a multicomponent intervention program aimed at prevention and control of childhood overweight and obesity. It used a community-based participatory research approach, including nutrition education, physical exercise, gardening, and family involvement.

MEASURES

Sedentary behaviors were measured by parents' report of their children's daily screen time per week, including TV/DVD, computer, Internet, and video games. Parental support was measured with parents' reported support for active living.

ANALYSIS

Growth curve analysis was used to examine trajectories of sedentary behaviors of children.

RESULTS

Response rate was over 70%. Parental support reduced children's sedentary behaviors. Girls were less sedentary than boys, but girls were less affected by parental support. The intervention was effective in reducing children's sedentary behaviors over time.

CONCLUSION

It is important for school intervention programs to mobilize parents to provide more support to reduce sedentary behaviors.

An exploratory analysis of active and low energy behaviour in Australian adolescents

Adolescents engage in a complex range of low energy-consuming and active behaviours not easily captured by single behavioural measures. This study aims to describe the associations among adolescent active and low energy behaviours. Data were obtained from adolescents aged 12–16 years (n = 1532) participating in a nationally representative survey. Thirty-nine variables measuring activities were stratified by sex and age and then analysed using principal components analysis with Varimax rotation. Four components were derived for younger girls (21.7% of the variance) and younger boys (20.2%), six for older girls (29.7%) and five for older boys (25.6%). Academic-related behaviours positively correlated with each other and negatively with television use for all age–sex groups. Computer use correlated positively with academic-related behaviours for older boys but negatively with active behaviours for younger boys and girls. Active behaviours correlated positively with each other. For older girls, low energy expenditure, household-based behaviours were negatively correlated with active behaviours. Computer use appears to differ across age groups, and leisure and academic use should be differentiated. The positive associations among different active behaviours and their negative associations with home-based, low energy expenditure behaviours are of interest for intervention development.

Prevalence of high screen time in English youth: association with deprivation and physical activity

BACKGROUND

Physical activity (PA) and deprivation are major determinants of health. We estimated the prevalence of high screen time (ST) among English youth and examined whether deprivation mediated the relationship between ST and PA.

METHODS

It is a cross-sectional study of 6240 participants (53% boys, aged 10-15 years) enrolled in the East of England Healthy Hearts study. The participants were categorized into three groups based on daily ST: <2, 2-4 or >4 h. Participants were classified as 'active' or 'inactive' based on PA z-scores.

RESULTS

Prevalence of >2 h ST was 36%. Participants reporting <2 h daily ST were more likely to be active than those reporting 2-4 h (adjusted OR: 1.51, 95% CI: 1.26-1.82, P< 0.001) or >4 h (adjusted OR: 2.26, 95% CI: 1.91-2.67, P< 0.001). Analysis of covariance demonstrated a significant main effect for ST on PA (F = 85.7, P< 0.001) with lower PA in each ascending ST group (P< 0.001). Deprivation was not significantly associated with PA and did not mediate the relationship between ST and PA.

CONCLUSIONS

There is high prevalence of >2 h ST in English schoolchildren. PA is lower in children reporting 2-4 versus <2 h daily ST and lower still in those classified as heavy users (>4 h) independent of deprivation.

Accelerometry measured ethnic differences in activity in rural adolescents

BACKGROUND

To determine if there are differences in time spent in physical activity and sedentary behavior between rural African American and Caucasian children.

METHODS

Children wore accelerometers for 3 weekdays. The students were randomly selected from a larger sample of children participating in a weight gain prevention intervention. Usable data were obtained from 272 of the 310 students who agreed to participate. The outcome data included counts per minute (CPM), time spent in moderate to vigorous (MVPA), light (LPA), and sedentary (SED) activity. The equation and cutoff used to analyze national accelerometry data were used for the current study.

RESULTS

The sample had an average age of 10.4 (1.1) years and 76% were African American. Lower SES African Americans had more CPM (P=.012) and spent more time in MVPA (P=.008) compared with middle SES African American and lower SES Caucasian children. Lower SES African American children also spent fewer minutes in SED activity (P=.044) compared with middle SES African American children.

CONCLUSIONS

These findings support recent results that also used objective activity measures. Children appeared less active and more sedentary than a national sample, warranting interventions in minority and rural populations.

Children's screen viewing is related to psychological difficulties irrespective of physical activity

OBJECTIVE

We hypothesized that greater screen use would be associated with greater psychological difficulties and that children with high levels of screen entertainment use and low levels of physical activity would have the most-negative psychological profiles.

METHODS

Participants were 1013 children (age, mean ± SD: 10.95 ± 0.41 years), who self-reported average daily television hours and computer use and completed the Strengths and Difficulties Questionnaire. Sedentary time (minutes per day with <100 cpm) and moderate/vigorous physical activity (MVPA) (minutes with ≥ 2000 cpm) were measured by using accelerometers. Multivariate regression models examined the association between television viewing, computer use, sedentary time, and Strengths and Difficulties Questionnaire scores, with adjustment for MVPA, age, gender, level of deprivation, and pubertal status.

RESULTS

Greater television and computer use were related to higher psychological difficulty scores after adjustment for MVPA, sedentary time, and confounders. However, sedentary time was inversely related to psychological difficulties after adjustment. Children who spent >2 hours per day watching television or using a computer were at increased risk of high levels of psychological difficulties (television, odds ratio [OR]: 1.61 [95% confidence interval [CI]: 1.20-2.15]; computer, OR: 1.59 [95% CI: 1.32-1.91]), and this risk increased if the children also failed to meet physical activity guidelines (television, OR: 1.70 [95% CI: 1.09-2.61]; computer, OR: 1.81 [95% CI: 1.02-3.20]).

CONCLUSION

Both television viewing and computer use are important independent targets for intervention for optimal well-being for children, irrespective of levels of MVPA or overall sedentary time.

The effects of adolescence sports and exercise on adulthood leisure-time physical activity in educational groups

Background

Physical inactivity has become a major public health problem and clear educational differences in physical activity have been reported across Europe and USA. The origins of adulthood physical activity are suggested to be in childhood and adolescence physical activity. Hardly any studies have, however, examined if the educational differences in physical activity might also be due to educational differences in early experiences in physical activity. Thus, our aim was to examine how competitive sports in youth, and exercise in late adolescence, and opinions on physical education (PE) in childhood determined adulthood leisure-time physical activity (LTPA) in different educational groups.

Methods

We used cross-sectional population-based National FINRISK 2002 data for 1918 men and 2490 women aged 25 to 64 years. Competitive sports in youth, exercise in late adolescence, and opinions on PE in childhood were assessed retrospectively via self-reports. Adulthood LTPA was collected with 12-month recall. In 2008, we calculated structural equation models including latent variables among the low- (<12 years) and high- (≥12 years) educated.

Results

Men more often than women reported that their experience of PE was interesting and pleasant as well as having learned useful skills during PE classes. Men, compared to women, had also been more active in the three selected competitive sports in youth and exercised in late adolescence. Participation in competitive sports in youth among the low-educated and exercise in late adolescence among the high-educated had a direct effect on adulthood LTPA. Among the low-educated, opinions on PE in childhood had an indirect effect on adulthood LTPA through participation in competitive sports in youth whereas among the high-educated, the indirect effect went through exercise in late adolescence. The effects were mainly similar between genders.

Conclusions

Our study answers to a strong need to assess the determinants of leisure-time physical activity to promote physical activity in low-educated individuals. The pathways of physical activity from childhood to adulthood LTPA may be different depending on the pursued educational career. Further prospective studies are needed to confirm our results.