Environmental correlates of physical activity among children 10 to 13 years old in Wallonia (Belgium)

"All the fun stuff, the teachers say, 'that's dangerous!'" Hearing from children on safety and risk in active play in schools: a systematic review

Background

Active play is vital for healthy child development, and schools are a valuable setting to promote this behaviour. Understanding the determinants of children’s physical activity behaviour during recess, particularly the role of risk-taking and the influence safety concerns have on active play, is required. This systematic review aimed to 1) synthesise qualitative research with children that explored their perceptions of safety and risk in active play during recess in elementary and/or middle school, and 2) develop a model from the findings to guide efforts in schools to optimise children’s active play opportunities during recess.

Methods

Six online databases were systematically searched for articles published between January 2000 and March 2021. Following PRISMA guidelines, records were screened against eligibility criteria using Covidence software, and data extraction and synthesis was conducted using customised forms in Excel and NVivo software. Framework synthesis methodology was employed, conceptually guided by Bronfenbrenner’s socio-ecological model and Gibson’s affordance theory.

Results

Of 9664 records, 31 studies met inclusion criteria, representing 1408 children across 140 schools from 11 countries. An emergent conceptual framework was developed encompassing 23 risk and safety themes and 10 risky play types that children desired in schools. Individual characteristics (age, gender, physical literacy) influenced children’s engagement with risk and how they kept themselves safe. Across outer SEM levels, factors interacted to constrain or afford children’s active play. Socio-cultural factors (supervision practices, rules, equipment restrictions) constrained active play, which children perceived were driven by adults’ concern with physical safety. These factors contributed to a cycle of risk-averse decision making and diminished play affordances, which could inadvertently exacerbate safety issues. A model for risk tolerance in children’s active play has been proposed.

Conclusions

The findings show a disparity between the active play children want in schools and what they are able to do. Future work should balance the concerns of adults against the active play children want, involve children in decisions about playground policy, and foster a risk-tolerant culture in schools.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12966-022-01305-0.

How can an agent-based model explore the impact of interventions on children's physical activity in an urban environment?

Insufficient physical activity (PA) among most children and adolescents is a global problem that is undermining the realisation of numerous developmental and health benefits. The aim of this study was to explore the potential impact of interventions on PA by using an agent-based model (ABM) simulating children's daily activities in an urban environment. Three domains for interventions were explored: outdoor play, school physical education and active travel. Simulated interventions increased children's average daily moderate-to-vigorous PA by 2–13 min and reduced the percentage of children not meeting PA guidelines, from 34% to 10%–29%, depending on the intervention. Promotion of active travel and outdoor play benefited more those in a higher socio-economic position. Agents' interactions suggested that: encouraging activity in diverse groups will reduce percentage of the least active in the population; and initiating outdoor events in neighbourhoods can generate an enhancing effect on children's engagement in PA. The ABM provided measurable outcomes for interventions that are difficult to estimate using reductionist methods. We suggest that ABMs should be used more commonly to explore the complexity of the social-environmental PA system.

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We developed an agent-based model simulating children's daily physical activity.

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Agents perform typical daily activities in a virtual urban model of Glasgow city.

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Simulations explore impact of interventions on outdoor play, school, active travel.

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Promotion of active travel had a differential impact across socio-economic position.

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Outdoor play intervention produced a non-linear increase in physical activity.

Nature and Children's Health: A Systematic Review

CONTEXT

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

OBJECTIVE

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

DATA SOURCES

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

STUDY SELECTION

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

DATA EXTRACTION

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

RESULTS

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

LIMITATIONS

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

CONCLUSIONS

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

Levels of Physical Activity and Mental Health in Adolescents in Ireland

The benefits of physical activity for the physical health of individuals are well documented. Less is known about the benefits of physical activity for mental health. This paper explores the associations between physical activity and positive mental health and mental health problems. The paper utilises data collected from a representative sample of 10-17-year-old adolescents in Ireland. Physical activity in the study is measured using moderate-to-vigorous physical activity (MVPA) and vigorous physical activity (VPA). Mental health was measured using the Cantril Leader of Life Satisfaction, the WHO-5 index, Mental Health Inventory (MHI-5) and the Health Behaviour in School-Aged Children (HBSC) Symptom Checklist (HBSC-SCL). Data were analysed using bivariate (Pearson Correlation, t-test, one-way ANOVA) and multivariate (two-way ANOVA, ordinary least squares (OLS) regressions) analyses. In total, 8636 adolescents were included in this analysis. Higher participation in physical activity was associated with higher scores on the positive mental health indicators and lower scores on the mental health problems indicators. When modelled together, VPA was a stronger predictor of mental health than MVPA, especially in girls. For example, standardised beta coefficients for predicting MHI-5 were -0.09 for MVPA (p < 0.001) and -0.13 for VPA (p < 0.001) To our knowledge, this is the first study that looks at levels of physical activity as well as both positive mental health and mental health problems. The study highlights the need to encourage and enable adolescents, and especially girls, to participate in vigorous exercising as way of promoting positive mental health.

Cardiorespiratory fitness in adolescents before and after the COVID-19 confinement: a prospective cohort study

Long periods of free-movement restrictions may negatively affect cardiorespiratory fitness and health. The present study investigated changes after the COVID-19 confinement in maximal oxygen intake (VO₂ max) levels in a sample of 89 Spanish school children aged 12 and 14 years at baseline (49.8% girls). The 20-m shuttle run test served to estimate VO₂ max before and after the COVID-19 confinement. Paired t-tests estimated an overall difference of - 0.5 ml.kg^-1.min^-1 (SD 0.3) (p = 0.12), whereas the highest significant reductions were observed for girls aged 14 years (- 1.5 ml.kg^-1.min^-1 (SD 0.6) (p < 0.05)). Boys aged 14 years showed a slight increase (0.4 ml.kg^-1.min^-1 (SD 0.5) (p = 0.44)), whereas boys aged 12 years presented an important decrease (- 1.2 ml.kg^-1.min^-1 (SD 0.7) (p = 0.14)). Healthy Fitness Zone (HFZ) levels also experienced a decrease of - 3.4% as regards baseline levels over the examined period. All the examined subgroups showed lower levels in relation to a normal VO₂ max rate development, although girls aged 14 and boys aged 12 years accounted for the highest part.Conclusion: The results indicate that COVID-19 confinement might delay the normal development of VO₂ max in adolescents. Strategies to tackle this concerning decline are warranted. What is Known: • First study analyzing cardiorespiratory fitness levels in teenagers after COVID-19 confinement. What is New: • Important delay in maximal oxygen intake identified in a sample of Spanish teenagers. • These results should be considered to develop strategies of a more active lifestyle in teenagers during and after confinements.

The effect of residential greenness and city park visiting habits on preschool Children's mental and general health in Lithuania: A cross-sectional study

AIM

The aim of this study was to determine the association between levels of residential surrounding greenness, preschool children's park use, sedentary behaviour, and mental and general health.

METHODS

This cross-sectional study included 1489 4-6-year-old children - residents of Kaunas city, Lithuania. Responses to the questionnaires completed by parents were used to ascertain children's general and mental health. We estimated exposure to greenness by the normalised difference vegetation index (NDVI), and time spent in a park (i.e. park use). We used multivariate logistic regression models to explore the independent associations between health outcomes and surrounding greenness and time spent in the nearest city park, controlling for potential confounders.

RESULTS

Of all the studied children, 14% had poor perceived general health, and 44.7% spent 5 or more hours per week in city parks. A significant increase in sedentary behaviour was observed in children with poor health. Every additional hour of time spent in parks was associated with decreased sedentary behaviour and a lower risk of poor health; meanwhile, lower residential greenness was associated with poorer mental and general health. Compared with NDVI-100 m > median and park use exceeding 5 h per week, lower greenness exposure and shorter park usage were associated with the risk of poor health (adjusted odds ratio 2.32 (95% CI: 1.43, 3.78) and the general risk of mental difficulties (adjusted odds ratio 1.43 (95% CI: 1.03, 2.18) in 4-6-year-old children.

CONCLUSIONS

Lower residential greenness levels and less time spent in a park were associated with poorer general and mental health among 4-6-year-old children. Physical activity in green spaces is recommended as a measure to prevent poor general and mental health among children.