What is the meaning and nature of active play for today's children in the UK?

Children's Voices in Physical Activity Research: A Qualitative Review and Synthesis of UK Children's Perspectives

BACKGROUND

Physical activity during childhood is associated with multiple short- and long-term health benefits. Physical activity levels decline throughout primary school emphasising a need for effective strategies to promote more activity in children. Children have rarely been involved in the intervention development process. This gap is an important omission and there is much to be learnt from existing qualitative studies with children, which could serve as a starting point for specific projects. This systematic review aimed to synthesise qualitative studies with primary school children in the United Kingdom to identify children's perspectives on why physical activity is important, the factors that influence their physical activity and what they like when it comes to physical activity.

METHODS

A search of seven databases (conducted in October 2019) identified 26 papers for inclusion. Data extraction and synthesis were conducted using qualitative thematic synthesis. The quality of papers was assessed using the Critical Appraisal Skills Programme checklist for qualitative research.

RESULTS

Across the diverse range of studies, several key themes were identified in relation to the three research questions. Children have a comprehensive understanding of the various benefits of physical activity, including benefits for health, fitness and skills development. A range of social agents and practical issues influence children's physical activity, with friend and peer influences being particularly salient. Most children like to have choice over the activities they undertake and the opportunities for creative physical play such as making up active games.

CONCLUSIONS

The findings suggest that future interventions should utilize peer relationships, ensure a variety of activities are offered to cater to a broad range of children's physical activity preferences and incorporate child-led activities where possible. The included studies also highlight a need for more diversity in qualitative research in this area, particularly in terms of ethnicity and age, and combining traditional qualitative methods with creative methods, such as photography, may provide richer insights than when using a single mode of data collection. We also highlight several methodological challenges, and in particular, the need for greater acknowledgement of the role of the researcher in qualitative work with children.

Associations Between Parent Self-Reported and Accelerometer-Measured Physical Activity and Sedentary Time in Children: Ecological Momentary Assessment Study

BACKGROUND

Retrospective self-report questionnaires are the most common method for assessing physical activity (PA) and sedentary behavior (SB) in children when the use of objective assessment methods (eg, accelerometry) is cost prohibitive. However, self-report measures have limitations (eg, recall bias). The use of real-time, mobile ecological momentary assessment (EMA) has been proposed to address these shortcomings. The study findings will provide useful information for researchers interested in using EMA surveys for measuring PA and SB in children, particularly when reported by a parent or caregiver.

OBJECTIVE

This study aimed to examine the associations between the parent's EMA report of their child's PA and SB and accelerometer-measured sedentary time (ST), light-intensity PA (LPA), and moderate-to-vigorous-intensity PA (MVPA) and to examine if these associations differed by day of week, sex, and season.

METHODS

A total of 140 parent-child dyads (mean child age 6.4 years, SD 0.8; n=66 girls; n=21 African American; n=24 American Indian; n=25 Hispanic/Latino; n=24 Hmong; n=22 Somali; and n=24 white) participated in this study. During an 8-day period, parents reported child PA and SB via multiple daily signal contingent EMA surveys, and children wore a hip-mounted accelerometer to objectively measure ST, LPA, and MVPA. Accelerometer data was matched to the time period occurring before parent EMA-report of child PA and SB. Generalized estimating equations with interaction-term analyses were performed to determine whether the relationship between parent-EMA report of child PA and SB and accelerometer-measured ST and LPA and MVPA outcomes differed by day of the week, sex and season.

RESULTS

The parent's EMA report of their child's PA and SB was strongly associated with accelerometer-measured ST, LPA, and MVPA. The parent's EMA report of their child's PA was stronger during the weekend than on weekdays for accelerometer-measured ST (P≤.001) and LPA (P<.001). For the parent's EMA report of their child's SB, strong associations were observed with accelerometer-measured ST (P<.001), LPA (P=.005), and MVPA (P=.008). The findings related to sex-interaction terms indicated that the association between the parent-reported child's PA via EMA and the accelerometer-measured MVPA was stronger for boys than girls (P=.02). The association between the parent's EMA report of their child's PA and SB and accelerometer-measured ST and PA was similar across seasons in this sample (all P values >.31).

CONCLUSIONS

When the use of accelerometry-based methods is not feasible and in contexts where the parent is able to spend more proximate time observing the child's PA and SB, the parent's EMA report might be a superior method for measuring PA and SB in young children relative to self-report, given the EMA's strong associations with accelerometer-measured PA and ST.

Results from South Korea's 2018 Report Card on physical activity for children and youth

Background/Objective

South Korea's 2018 Report Card on Physical Activity for Children and Youth is the second comprehensive evaluation of physical activity and the sources of influence based on the 10 core indicators provided by the Active Healthy Kids Global Alliance. It will serve as an advocacy tool to promote physical activity among children and youth.

Methods

Three national surveillance data (i.e., 2017 Korea Youth Risk Behavior Web-based Survey, 2016 Korea National Health and Nutrition Examination Survey, 2016 Physical Activity Promotion System) were used as main sources to evaluate the indicators. Descriptive statistics were performed to obtain prevalence estimates of physical activity-related indicators. In addition, expert opinions as well as the most recently available published or unpublished relevant sources were synthesized.

Results

South Korea's 2018 Report Card, compared to the 2016 Report Card, showed favourable changes in the Active Transportation (B+), Organized Sports Participation (C), Sedentary Behaviours (D), and School (D+) indicators, while unfavourable changes were shown in Overall Physical Activity (F) and Government (D). Physical Fitness was graded as D+. In parallel with the 2016 Report Card, Active Play, Family and Peers, and Community and Environment remain ungraded due to insufficient data.

Conclusions

Successes as well as gaps and research needs were identified in the 2018 Report Card. Though some indicators have shown improvement, most children and youth continue to be insufficiently physically active with overall poor grades (Average of D+). To achieve substantial improvement in all grades in future Report Cards, more institutional and governmental support and investment is needed to promote physical activity. Furthermore, effort should be made to generate data pertaining to the indicators that were ungraded.

Parents' perspectives of change in child physical activity & screen-viewing between Y1 (5-6) & Y4 (8-9) of primary school: implications for behaviour change

Background

The aim of this study was to explore parents’ responses to changes in children’s physical activity and screen-time between Year 1 (5-6 years) and Year 4 (8-9 years of age) of primary school. A secondary aim was to identify how parents adapt their parenting to rapidly changing screen-based technology.

Methods

Data were from the longitudinal B-Proact1v Study. Semi-structured telephone interviews were conducted between July and October 2016 with a sub-sample of 51 parents who participated in the study at Year 4. The sample was drawn from 1223 families who took part in the B-Proact1v in which the children wore an accelerometer for 5 days and mean minutes of moderate to vigorous intensity physical activity (MVPA) and sedentary minutes per day were derived. This sample was stratified according to the child’s MVPA and sedentary (SED) minutes per day, and by child gender. Data were thematically analysed.

Results

Analysis yielded five main themes: 1) Parents reported how children’s interests change with free play decreasing and structured activity increasing. 2) Parents highlighted how their children’s independence and ability to make choices in relation to physical activity and screen-viewing increase, and that parental influence decreased, as the child gets older. 3) Parents reported that the transition from Year 1 to Year 4 appeared to be a time of substantial change in the screen-based devices that children used and the content that they viewed. 4) Parents reported that managing screen-viewing was harder compared to three years ago and a third of parents expressed concerns about the difficulty of managing screen-viewing in the future. 5) Parents reported using general principles for managing children’s screen-viewing including engaging the children with rule setting and encouraging self-regulation.

Conclusions

Parents reported that children’s physical activity and sedentary screen behaviours change between Year 1 and Year 4 with children obtaining increased licence to influence the type, location and frequency with which they are active or sedentary. These changes and rapid advances in screen-viewing technology are a challenge for parents to negotiate and highlight a need to develop innovative and flexible strategies to help parents adapt to a rapidly changing environment.

Indoor and Outdoor Context-Specific Contributions to Early Adolescent Moderate to Vigorous Physical Activity as Measured by Combined Diary, Accelerometer, and GPS

BACKGROUND

The distribution of adolescent moderate to vigorous physical activity (MVPA) across multiple contexts is unclear. This study examined indoor and outdoor leisure time in terms of being structured or unstructured and explored relationships with total daily MVPA.

METHODS

Between September 2012 and January 2014, 70 participants (aged 11-13 y) from 4 schools in Edinburgh wore an accelerometer and global positioning system receiver over 7 days, reporting structured physical activity using a diary. Time spent and MVPA were summarized according to indoor/outdoor location and whether activity was structured/unstructured. Independent associations between context-specific time spent and total daily MVPA were examined using a multivariate linear regression model.

RESULTS

Very little time or MVPA was recorded in structured contexts. Unstructured outdoor leisure time was associated with an increase in total daily MVPA almost twice that of unstructured indoor leisure time [b value (95% confidence interval), 8.45 (1.71 to 14.48) vs 4.38 (0.20 to 8.22) minute increase per hour spent]. The association was stronger for time spent in structured outdoor leisure time [35.81 (20.60 to 52.27)].

CONCLUSIONS

Research and interventions should focus on strategies to facilitate time outdoors during unstructured leisure time and maximize MVPA once youth are outdoors. Increasing the proportion of youth engaging in structured activity may be beneficial given that, although time spent was limited, association with MVPA was strongest.

Effect of Sex and Body Mass Index on Children's Physical Activity Intensity during Free Play at an Indoor Soft Play Center: An Exploratory Study

Background: Indoor soft play can provide a safe but exciting physical activity opportunity regardless of environmental conditions. Relatively little is known about the quality or quantity of physical activity engaged in by children during indoor free soft play. The aim of this study was to evaluate the contribution indoor free soft play can make in enabling children to meet physical activity guidelines and to evaluate the effects of sex and body mass index category. Methods: Seventy-two boys and girls aged five to 10 years engaged in un-controlled indoor free soft play with a mean duration of 120.7 (27.1) min, during which physical activity was monitored using Actigraph accelerometers. Results: Children spent an average of 61.7 (24.2) min engaging in moderate to vigorous physical activity (MVPA) and 51.4% (n = 37) achieved the recommended 60 min of MVPA through the single visit to the indoor soft play center. Boys (68.3 (25.7) min) engaged in significantly (p < 0.05) more MVPA than girls (55.8 (21.4) min). Normal weight (65.7 (23.3) min) children engaged in significantly more MVPA than overweight children (48.0 (18.9) min). Conclusions: Attendance at a soft play indoor center has the potential to support children to engage in sufficient MVPA and overcome environmental factors that can restrict physical activity opportunities.

Association of parents' and children's physical activity and sedentary time in Year 4 (8-9) and change between Year 1 (5-6) and Year 4: a longitudinal study

Background

Parents could be important influences on child physical activity and parents are often encouraged to be more active with their child. This paper examined the association between parent and child physical activity and sedentary time in a UK cohort of children assessed when the children were in Year 1 (5–6 years old) and in Year 4 (8–9 years old).

Methods

One thousand two hundred twenty three children and parents provided data in Year 4 and of these 685 participated in Year 1. Children and parents wore an accelerometer for five days including a weekend. Mean minutes of sedentary time and moderate-to-vigorous intensity physical activity (MVPA) were derived. Multiple imputation was used to impute all missing data and create complete datasets. Linear regression models examined whether parent MVPA and sedentary time at Year 4 and at Year 1 predicted child MVPA and sedentary time at Year 4. Change in parent MVPA and sedentary time was used to predict change in child MVPA and sedentary time between Year 1 and Year 4.

Results

Imputed data showed that at Year 4, female parent sedentary time was associated with child sedentary time (0.13, 95% CI = 0.00 to 0.27 mins/day), with a similar association for male parents (0.15, 95% CI = −0.02 to 0.32 mins/day). Female parent and child MVPA at Year 4 were associated (0.16, 95% CI = 0.08 to 0.23 mins/day) with a smaller association for male parents (0.08, 95% CI = −0.01 to 0.17 mins/day). There was little evidence that either male or female parent MVPA at Year 1 predicted child MVPA at Year 4 with similar associations for sedentary time. There was little evidence that change in parent MVPA or sedentary time predicted change in child MVPA or sedentary time respectively.

Conclusions

Parents who were more physically active when their child was 8–9 years old had a child who was more active, but the magnitude of association was generally small. There was little evidence that parental activity from three years earlier predicted child activity at age 8–9, or that change in parent activity predicted change in child activity.

Electronic supplementary material

The online version of this article (doi:10.1186/s12966-017-0565-0) contains supplementary material, which is available to authorized users.

Predicting bicycle setup for children based on anthropometrics and comfort

Bicycling is a popular activity for children. In order for children to enjoy cycling and to minimize injury, it is important that they are positioned appropriately on the bicycle. The purpose of this study was therefore to identify a suitable bicycle setup for children aged between 7 and 16 years which accommodates developmental differences in anthropometrics, flexibility and perceptions of comfort. Using an adjustable bicycle fitting rig, we found the most comfortable position of 142 children aged 7 to 16. In addition, a number of anthropometric measures were recorded. Seat height and the horizontal distance between seat and handlebars were strongly predictable (R² > 0.999, p < 0.001 and R² = 0.649, p < 0.001 respectively), whilst the predictability of the vertical distance between seat and handlebars was weaker (R² = 0.231, p < 0.001). These results have practical implications for children and parents, paediatric researchers and clinicians as well as bicycle manufacturers.

An intergenerational study of perceptions of changes in active free play among families from rural areas of Western Canada

BACKGROUND

Children's engagement in active free play has declined across recent generations. Therefore, the purpose of this study was to examine perceptions of intergenerational changes in active free play among families from rural areas. We addressed two research questions: (1) How has active free play changed across three generations? (2) What suggestions do participants have for reviving active free play?

METHODS

Data were collected via 49 individual interviews with members of 16 families (15 grandparents, 16 parents, and 18 children) residing in rural areas/small towns in the Province of Alberta (Canada). Interview recordings were transcribed verbatim and subjected to thematic analysis guided by an ecological framework of active free play.

RESULTS

Factors that depicted the changing nature of active free play were coded in the themes of less imagination/more technology, safety concerns, surveillance, other children to play with, purposeful physical activity, play spaces/organized activities, and the good parenting ideal. Suggestions for reviving active free play were coded in the themes of enhance facilities to keep kids entertained, provide more opportunities for supervised play, create more community events, and decrease use of technology.

CONCLUSIONS

These results reinforce the need to consider multiple levels of social ecology in the study of active free play, and highlight the importance of community-based initiatives to revive active free play in ways that are consistent with contemporary notions of good parenting.

Individual, family, and neighborhood correlates of independent mobility among 7 to 11-year-olds

Objective. Independent mobility refers to the freedom that children have to move around their neighborhood without adult supervision. It is related to their physical activity and health. We examined the intrapersonal, family, and neighborhood correlates of independent mobility within children. Methods. 497 American parents of 6.9–11.9 year olds completed a survey (November, 2014) that assessed their child's independent mobility range, several intrapersonal characteristics of their child (gender, age, race, etc.), several characteristics of their family (family structure, socioeconomic status, parental physical activity, etc.), and their perceptions of the safety of their neighborhood (18 questions reduced to 4 components). Associations were determined using ordinal logistic regression. Results. Children's age, parent's perception that their neighborhood is safe for children, and parent's fear of neighborhood crime were the independent correlates of independent mobility. Compared to 6.9–7.9 year olds, the odds ratio (95% CI) for increasing independent mobility were 2.31 (1.47–3.64) in 8.0–9.9 year olds and 3.38 (2.13–5.36) in 10.0–11.9 year olds. Compared to children whose parents who did not perceive that their neighborhood was safe for children, the odds ratio for increasing independent mobility was 4.24 (2.68–6.70) for children whose parents perceived their neighborhood was safe for children. Compared to children whose parents had the lowest fear of neighborhood crime, the odds ratio for increasing independent mobility was 0.41 (0.27–0.62) for children whose parents had the highest fear of crime. Conclusions. Children's independent mobility was associated with their age, their parent's perception that their neighborhood was safe for children, and their parent's fear of crime.

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This study examined the correlates of independent mobility with 7–11 year olds.

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Several intrapersonal, family, neighborhood and community correlates were considered.

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Child's age was the only intrapersonal factor that correlated with mobility.

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Parent's perceptions of neighborhood safety and crime were important correlates.

Stability of leisure participation from school-age to adolescence in individuals with cerebral palsy

With increasing age, youth with disabilities are at risk for decreased participation in leisure activities, a key component for physical and mental health. This prospective study describes changes in leisure participation and leisure preferences from school-age to adolescence in children with cerebral palsy (CP). Participants were recruited at school-age (6-12 years) for a study on participation and reassessed for a second study on adolescents (12-19 years) if >12 years. Thirty-eight children (24 males) with CP who could actively participate in the completion of the Children's Assessment of Participation and Enjoyment (CAPE) and the Preferences for Activities of Children (PAC) comprised the sample. Average time between assessments was 5.0 ± 1.3 years. Most children were ambulatory (32/38 Gross Motor Function Classification System I-II). In addition to the CAPE and PAC, children were evaluated using the Gross Motor Function Measure-66 and parents completed a socio-demographic questionnaire. Paired t-tests revealed a significant decline in leisure participation diversity and intensity (CAPE) for recreation (p<.0001), skill-based (p<.0001) and self-improvement (p<.05) activities, whereas social participation remained stable (p>.05). Diversity of active-physical activities increased modestly (p=.06) although intensity of participation in this activity domain decreased (p=.003). There was also a decline in enjoyment of leisure activities. Preferences for these leisure activities remained unchanged between school-age and adolescence, except for recreational activities. Gender, maternal education, family income and gross motor ability were not related to differences in CAPE/PAC scores with increasing age. Findings suggest that over time, children with CP's participation in leisure activities diminishes, which is of concern to their functioning and well-being. Parents may be more involved in early childhood in facilitating participation whereas in adolescence, youth may be faced with more environmental barriers and a greater awareness of challenges to participation. Adolescents demonstrated a persisting desire to do these activities, challenging rehabilitation specialists to prioritize strategies to promote greater participation as children transition to adolescence.

A meta-study of qualitative research examining determinants of children's independent active free play

PURPOSE

To produce a meta-study by completing a systematic review of qualitative research examining determinants of independent active free play in children.

METHOD

Following systematic electronic and manual searches and application of inclusion/exclusion criteria, 46 studies were retained and subjected to meta-method, meta-theory, and meta-data analyses, followed by a final meta-synthesis.

RESULTS

Identified determinants of independent active free play were child characteristics (age, competence, and gender), parental restrictions (safety concerns and surveillance), neighborhood and physical environment (fewer children to play with, differences in preferences for play spaces between parents and children, accessibility and proximity, and maintenance), societal changes (reduced sense of community, good parenting ideal, changing roles of parents, privatization of playtime and play spaces), and policy issues (need to give children voice). An ecological model depicting these factors, and the relationships therein, was created.

CONCLUSIONS

This comprehensive meta-study helps establish a knowledge base for children's independent active free play research by synthesizing a previously fragmented set of studies. Parents' perceived safety concerns are the primary barrier to children's active free play. These safety concerns are moderated by child-level factors (age, competence, gender) and broader social issues. Interventions should focus on community-level solutions that include children's perspectives. From a methods perspective, the reviewed studies used a range of data collection techniques, but methodological details were often inadequately reported. The theoretical sophistication of research in this area could be improved. To this end, the synthesis reported in this study provides a framework for guiding future research.

The Dynamic Family Home: a qualitative exploration of physical environmental influences on children's sedentary behaviour and physical activity within the home space

Background

Recent changes in home physical environments, such as decreasing outdoor space and increasing electronic media, may negatively affect health by facilitating sedentariness and reducing physical activity. As children spend much of their time at home they are particularly vulnerable. This study qualitatively explored family perceptions of physical environmental influences on sedentary behaviour and physical activity within the home space.

Methods

Home based interviews were conducted with 28 families with children aged 9–13 years (total n = 74 individuals), living in Perth, Australia. Families were stratified by socioeconomic status and selected to provide variation in housing. Qualitative methods included a family interview, observation and home tour where families guided the researcher through their home, enabling discussion while in the physical home space. Audio recordings were transcribed verbatim and thematically analysed.

Results

Emergent themes related to children’s sedentariness and physical activity included overall size, space and design of the home; allocation of home space; equipment within the home space; perceived safety of the home space; and the changing nature of the home space. Families reported that children’s activity options were limited when houses and yards were small. In larger homes, multiple indoor living rooms usually housed additional sedentary entertainment options, although parents reported that open plan home layouts could facilitate monitoring of children’s electronic media use. Most families reported changing the allocation and contents of their home space in response to changing priorities and circumstances.

Conclusions

The physical home environment can enhance or limit opportunities for children’s sedentary behaviour and physical activity. However, the home space is a dynamic ecological setting that is amenable to change and is largely shaped by the family living within it, thus differentiating it from other settings. While size and space were considered important, how families prioritise the use of their home space and overcome the challenges posed by the physical environment may be of equal or greater importance in establishing supportive home environments. Further research is required to tease out how physical, social and individual factors interact within the family home space to influence children’s sedentary behaviour and physical activity at home.

Electronic supplementary material

The online version of this article (doi:10.1186/s12966-014-0157-1) contains supplementary material, which is available to authorized users.

Problematizing "play-for-health" discourses through children's photo-elicited narratives

There are growing concerns in many industrialized Western societies about declining opportunities for children to play, and fears that this will have adverse health consequences for them. Informed by anti-obesity efforts, public health institutions have recently begun to advance active forms of play as a way of improving children's physical health; however, promoting play for physical health might reshape meanings of play for children. We conducted photography and interview sessions with 25 Canadian children aged 7 to 11 years to examine their representations of play. Our findings suggest that for children, (a) play is an end in itself, (b) play involves but is more than active play, (c) there is ambivalence about scheduled play, and (d) risk is considered a pleasurable component of play. These findings point to a dissonance between children's play promoted for physical health and the meaning of play for children as emotionally contingent, intrinsically motivated, and purposeless.

Who children spend time with after school: associations with objectively recorded indoor and outdoor physical activity

Background

Understanding how the determinants of behaviour vary by context may support the design of interventions aiming to increase physical activity. Such factors include independent mobility, time outdoors and the availability of other children. At present little is known about who children spend their time with after school, how this relates to time spent indoors or outdoors and activity in these locations. This study aimed to quantify who children spend their time with when indoors or outdoors and associations with moderate to vigorous physical activity (MVPA).

Methods

Participants were 427 children aged 10–11 from Bristol, UK. Physical activity was recorded using an accelerometer (Actigraph GT1M) and matched to Global Positioning System receiver (Garmin Foretrex 201) data to differentiate indoor and outdoor location. Children self-reported who they spent time with after school until bed-time using a diary. Each 10 second epoch was coded as indoors or outdoors and for ‘who with’ (alone, friend, brother/sister, mum/dad, other grown-up) creating 10 possible physical activity contexts. Time spent and MVPA were summarised for each context. Associations between time spent in the different contexts and MVPA were examined using multiple linear regression adjusting for daylight, age, deprivation and standardised body mass index.

Results

During the after school period, children were most often with their mum/dad or alone, especially when indoors. When outdoors more time was spent with friends (girls: 32.1%; boys: 28.6%) than other people or alone. Regression analyses suggested hours outdoors with friends were positively associated with minutes of MVPA for girls (beta-coefficient [95% CI]: 17.4 [4.47, 30.24]) and boys (17.53 [2.76, 32.31]). Being outdoors with brother/sister was associated with MVPA for girls (21.2 [14.17, 28.25]) but not boys. Weaker associations were observed for time indoors with friends (girls: 4.61 [1.37, 7.85]; boys: (7.42 [2.99, 11.85]) and other adults (girls: 5.33 [2.95, 7.71]; boys: (4.44 [1.98, 6.90]). Time spent alone was not associated with MVPA regardless of gender or indoor/outdoor location.

Conclusions

Time spent outdoors with other children is an important source of MVPA after school. Interventions to increase physical activity may benefit from fostering friendship groups and limiting the time children spend alone.

Physical activity maintenance in the transition to adolescence: a longitudinal study of the roles of sport and lifestyle activities in British youth

BACKGROUND

Promoting physical activity in youth is important for health, but existing physical activity interventions have had limited success. We aimed to inform intervention design by i) describing drop-out, continuation and uptake of specific activities over the transition to adolescence; and ii) examining Variety (number of different activities/week) and Frequency (number of activity session/week) of activity participation and their associations with changes in objectively measured physical activity from childhood to adolescence.

METHODS

At age 10.2±0.3 and 14.2±0.3 years, 319 children in the SPEEDY study (46% boys) wore GT1M Actigraph accelerometers for 7 days and provided self-reported participation (never, once, 2 to 3 times or four or more times, over the last 7 days) in 23 leisure-time activities. Associations of change in moderate-to-vigorous intensity PA (MVPA) (≥2000 counts/minute) and change in total physical activity (TPA) (average accelerometer counts/minute) with exposure variables Z-score transformed (change in) Variety and Frequency were examined using multilevel linear regression, clustered by school, in simple and adjusted models.

RESULTS

The number of children ever reporting a specific activity ranged from 30 ('Hockey') to 279 ('Running or jogging'). Some activities were susceptible to drop-out (e.g. 'Skipping') but others were commonly continued or taken up (e.g. 'Household chores'). Overall, Variety and Frequency declined (mean±SD ΔVariety -3.1±4.4 activities/week; ΔFrequency -7.2±12.0 session/week). ΔMVPA and ΔTPA were not associated with Variety or Frequency at baseline, nor with ΔVariety or ΔFrequency (p>0.29 in all models).

CONCLUSIONS

Popularity of specific activities as well as drop-out, continuation and uptake should be considered in future intervention development. Activities that are commonly continued or taken up may be more valuable to encourage in interventions than those with low participation or high drop-out. We did not find evidence to support the idea that Variety and Frequency may be key elements to include in future interventions.

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.

Socio-demographic and behavioral risk factors associated with the high prevalence of overweight and obesity in Portuguese children

OBJECTIVES

Childhood obesity is a public health concern in Portugal. Socio-demographic and behavioral factors are highly associated with obesity but are not clearly understood. This article aims to update the prevalence of overweight and obesity in Portuguese children and to explore the influence and risks of socio-demographic factors and behavioral factors.

METHODS

A cross-sectional study of Portuguese children aged 3-10 years from all 18 mainland districts took place between March 2009 and January 2010. The sample was composed by 17,136 children, 3-10 years of age (8,455 boys; 8,681 girls). Height, weight, and other anthropometric measurements were obtained by trained technicians. Body mass index (BMI) was calculated along with other anthropometric variables. Data analyses took place between April and September 2012. The overweight/obesity classification was established by age-and sex-specific BMI cut-off points as defined by the International obesity task force (IOTF). Parents completed questionnaires about socio-demographic and behavioral characteristics of the family.

RESULTS

Almost 28% of the Portuguese children were overweight or obese (19.7% overweight; 8.2% obese). Prevalence was greater in girls than in boys. Logistic regression models found that the odds of childhood obesity were significantly affected by biological, socio-demographic, and behavioral factors.

CONCLUSIONS

The protective factors against childhood overweight/obesity in this sample of Portuguese children are: (i) being male; (ii) having been breastfeed; (iii) having been born from mothers who did not smoke during pregnancy; (iv) engaging in little sedentary behaviors (TV, PC, and playing electronic games); (iv) performing at least 1 h of moderate physical activity every day; and (v) having parents with higher educational levels who also have their BMI within the healthy ranges.

Results from the active healthy kids Canada 2012 report card on physical activity for children and youth

The present article summarizes the results from the Active Healthy Kids Canada 2012 Report Card on Physical Activity for Children and Youth. The Report Card assessed the physical activity levels of Canadian children and youth nationally, and the initiatives of public and nongovernment sectors to promote and facilitate physical activity opportunities for children and youth in Canada. Based on a comprehensive collection of data that were analyzed and/or published in 2011, 24 indicators relating to physical activity were graded. The Physical Activity Levels indicator, the core indicator of the Report Card, was graded an 'F' for the sixth consecutive year. Although the majority of grades remained unchanged from the previous year, four grades improved and two worsened. These results suggest that few Canadian children and youth have sufficient physical activity levels, and that greater efforts are required across sectors to promote and facilitate physical activity opportunities for children and youth in Canada.

Joint physical activity and sedentary behavior in parent-child pairs

PURPOSE

The research examined joint physical activity and sedentary behavior among 291 parent-child pairs who both wore an accelerometer and Global Positioning System (GPS) device during the same 7-d period.

METHODS

Children were 52.2% female, 8-14 yr, and 43.0% Hispanic. Parents were 87.6% female. An ActiGraph GT2M accelerometer and GlobalSat BT-335 GPS device collected activity and global positioning data, respectively. Linear distance between the parent and child for each 30-s epoch was calculated using geographic coordinates from the GPS. Joint behavior was defined as a separation distance less than 50 m between parents and children.

RESULTS

On average, during nonschool waking hours, parents and children spent 2.4 ± 4.1 min·d (mean ± SD) performing moderate-to-vigorous physical activity (MVPA) together and 92.9 ± 40.1 min·d in sedentary behavior together. Children engaged in an average of 10 min·d of MVPA during nonschool waking hours when their parent was nearby but not engaging in MVPA. During this same period, parents engaged in 4.6 min·d of MVPA when their child was nearby but not engaging in MVPA. Household income level and the child's age were negatively associated with joint MVPA. Girls engaged in a greater percentage of their total MVPA together with their parent than boys. Girls and older children engaged in more sedentary behavior together with their parent than boys and younger children. Older parents engaged in a greater percentage of their sedentary behavior together with their children than younger parents.

CONCLUSIONS

Replacing the time that parents and children spend together in sedentary pursuits with joint physical activity could have health benefits, especially for girls, older children, older parents, and higher income families.

Adolescent girls' and parents' views on recruiting and retaining girls into an after-school dance intervention: implications for extra-curricular physical activity provision

Background

Many adolescents are not sufficiently active and girls are less active than boys. Physical activity interventions delivered during curriculum time have reported weak effects. More sustained changes in physical activity may be obtained by facilitating participation in enjoyable activities. Dance is the favourite activity of UK girls but there is a shortage of dance provision. Dance sessions delivered after the school day could prove to be an effective means of engaging adolescent girls in physical activity. There is a lack of information about the factors that would affect girls' recruitment and retention in an after-school dance programme.

Methods

Focus groups were conducted with 65, Year 7 (11-12 year old) girls from 4 secondary schools in Bristol. In-depth phone interviews were also conducted with 16 (4 per school) of the girls' parents. Interviews and focus groups examined issues that would affect recruitment into the intervention, strategies that could be used to attract girls who have little or no previous experience in dance, any factors that would increase their interest in participating in an after-school dance programme and any factors that would affect retention in the programme. All interviews and focus groups were digitally recorded and thematically analysed.

Results

Girls reported that a taster session in which they had an opportunity to sample the intervention content and "word of mouth" campaigns by peers, who did not need to be their friends, would encourage them to participate in an after-school dance programme. Sessions that maximised enjoyment and facilitated socialisation opportunities would enhance retention. Parents reported that encouraging groups of friends to join the programme, and stressing the enjoyment of the session would increase participation.

Conclusions

Recruitment and retention campaigns that focus on enjoyment, socialisation, mastery, goal setting and relating to other girls may be effective strategies for recruiting and retaining girls in an after-school dance programme. These factors are consistent with well-established theories of individual behaviour change such as self-determination theory and social cognitive theory. Recruitment and retention campaigns that are targeted to address theoretically derived mediators of behaviour may be more effective than traditional approaches.

Children's active play: self-reported motivators, barriers and facilitators

BACKGROUND

Physical activity has important benefits for children's physical health and mental wellbeing, but many children do not meet recommended levels. Research suggests that active play has the potential to make a valuable contribution to children's overall physical activity, whilst providing additional cognitive, social and emotional benefits. However, relatively little is known about the determinants of UK children's active play. Understanding these factors provides the critical first step in developing interventions to increase children's active play, and therefore overall physical activity.

METHODS

Eleven focus groups were conducted with 77, 10-11 year old children from four primary schools in Bristol, UK. Focus groups examined: (i) factors which motivate children to take part in active play; (ii) factors which limit children's active play and (iii) factors which facilitate children's active play. All focus groups were audio-taped and transcribed verbatim. Data were analysed using a thematic approach.

RESULTS

Children were motivated to engage in active play because they perceived it to be enjoyable, to prevent boredom, to have physical and mental health benefits and to provide freedom from adult control, rules and structure. However, children's active play was constrained by a number of factors, including rainy weather and fear of groups of teenagers in their play spaces. Some features of the physical environment facilitated children's active play, including the presence of green spaces and cul-de-sacs in the neighbourhood. Additionally, children's use of mobile phones when playing away from home was reported to help to alleviate parents' safety fears, and therefore assist children's active play.

CONCLUSIONS

Children express a range of motivational and environmental factors that constrain and facilitate their active play. Consideration of these factors should improve effectiveness of interventions designed to increase active play.