Sports participation of children and adolescents in Germany: disentangling the influence of parental socioeconomic status

Policies and opportunities for physical activity engagement in Austrian schools: a census survey

Background

Compelling evidence suggests that schools' infrastructure and policy represent potential predictors of health and physical activity (PA) in children and adolescents. However, the translation of these findings into practice has not been examined. This study investigated the activity friendliness of Austrian schools.

Methods

Using a census sampling method, principals of Austrian schools (n = 342) were invited to participate in an online survey assessing 1) the availability of PA facilities (e.g. playgrounds, sports courts, swimming halls) and 2) applied PA policies (e.g. cooperation with sports clubs and involvement in PA projects).

Results

A total of 130 principals answered the survey which corresponds to a minimal response rate of 38%. While most schools (87.4%, n = 111) had a gymnastic hall, only one third (37%, n = 47) had access to a swimming hall. On average, the schools had 4.2 ± 2 PA facilities with significant variation between school types (i.e., high schools: 5 ± 2 vs. primary schools: 3.5 ± 2, p < 0.05). The most common facilities were meadow areas (89%, n = 113), sports fields (71.7%, n = 91), and playgrounds (64.6%, n = 82). Almost half of the schools were part of a PA project (e.g. "active break", 45%, n = 56) and offered extracurricular PA programs and courses (54%, n = 67), but only one in five (22%, n = 27) regularly conducted fitness tests. PA policies varied between school types (p < 0.05) but almost all principals (94%, n = 117) would welcome a stronger promotion of activity friendliness at their school.

Conclusion

Schools are mostly activity-friendly regarding infrastructure although the limited possibilities for swimming lessons seem worrisome. PA promotion through projects, extracurricular PA offerings and fitness tests may be expanded.

[DNVF Memorandum: Objectives and Methods of Physical Activity-Related Health Services Research]

The DNVF Memorandum: Objectives and Methods of Physical Activity-Related Health Services Research summarizes, for the first time, the highly interdisciplinary and interprofessional field of physical activity-based health care in the German healthcare system. In addition to providing a conceptual framework and definition of key measures and concepts in physical activity-related health care research, existing research gaps and needs are identified, and methods for advancing this relatively young field of research are described. A particular focus of this study is the relevant outcome parameters and their standardized assessment using established and valid measurement tools. The memorandum aims to establish a general understanding of the complex subject of promoting physical activity and sports therapy in the context of healthcare, to give an impulse to new research initiatives, and to integrate the currently available strong evidence on the effectiveness of physical activity and exercise into healthcare.

Beyond correlates: the social gradient in childhood overweight

BACKGROUND

Health (in)equity has a high priority on research and policy agendas. Even though it is known that inequalities in overweight prevalence accumulate with age and are already existent among children below the age of six, research on this topic is scarce. In this young age group, parents play an important role in preventing overweight and associated adverse consequences. This study examines the magnitude of parental misclassification of child weight status and its correlates, focussing on the factors that determine social status and equity.

METHODS

Preschool children's weight and height was measured objectively. Parents gave information on their socioeconomic background. Family education was dichotomised into tertiary and non-tertiary educational level, according to CASMIN. Binary logistic regression, adjusted for parental BMI, was applied to detect odds of childhood overweight.

RESULTS

Data on family educational level and anthropometrics were available from 643 children (4.5 ± 0.82 years, 52.7% male) and their parents of which 46.5% (n = 299) had a tertiary educational background. The groups (tertiary vs. non-tertiary educational level) differ significantly in overweight prevalence (3.7% vs. 11.9%, p ≤ 0.001). Odds of overweight were two times higher in children with non-tertiary educational background (OR: 2.123, CI: 1.010-4.461, p < 0.05), adjusted for parental BMI.

CONCLUSION

Children from families with low educational background have an elevated risk of overweight, already at a very young age. Education in general (not explicitly health education) seems to play a tremendous role in the prevention of overweight and obesity and should therefore be implied in policies enhancing health equity.

TRIAL REGISTRATION

DRKS-ID: DRKS00010089.

How the COVID-19 pandemic and related school closures reduce physical activity among children and adolescents in the WHO European Region: a systematic review and meta-analysis

BACKGROUND

Emerging research suggests that physical activity among children and adolescents decreased during the COVID-19 pandemic. However, a differentiated overview of European youth is lacking. In particular, no systematic analysis has been conducted to date on the impact of heterogeneous pandemic restrictions and school closures within European countries, and with regard to potentially vulnerable groups.

METHODS

We searched seven databases and included studies for children and adolescents (≤ 19 years) of the WHO European Region that compared physical activity during the COVID-19 pandemic with a pre-pandemic baseline using validated measurement instruments. We used the Oxford Stringency Index and School Closure Index as indicators of restriction stringency. Screening for eligibility, data extraction, assessment of the study risk of bias (using the 'Risk of Bias in Non-randomized Studies - of Exposure' [ROBINS-E]) and certainty grading of evidence (using the GRADE approach), were all done in duplicate. Unpublished data was requested from study authors. Data were pooled in random effects models. An a priori protocol was published, reporting is carried out in accordance with the 'Preferred Reporting Items for Systematic Review and Meta-Analyses' (PRISMA) statement.

RESULTS

Of 14,897 non-duplicate records, 26 publications (n = 15,038 pre-pandemic, n = 13,041 during pandemic) met full inclusion criteria. Comparison before and during the COVID-19 pandemic revealed a significant reduction in total physical activity (standardized mean difference [SMD], -0.57 [95%CI, -0.95; -0.20]) and moderate-to-vigorous physical activity (SMD, -0.43 [95% CI, -0.75; -0.10]), corresponding to a decrease of 12 min per day (a 20% reduction of the WHO recommendation). A decrease in sporting activity was also recorded. Subgroup analyses suggested that middle childhood (aged 8-12) and adolescents were particularly affected by the decline. School closures were associated with a reduction in physical activity. The certainty of evidence for all outcomes was low.

CONCLUSIONS

A sharp decline in all forms of physical activity was recorded among European children and adolescents during the COVID-19 pandemic. This decline was higher during periods of school closure and mainly affected younger schoolchildren and adolescents. Immediate action by policy-makers and practitioners, as well as evidence-based public health strategies, are imperative in reversing this trend.

TRIAL REGISTRATION

PROSPERO: CRD42023395871.

Compensation of overall physical activity in (pre)adolescent girls - the CReActivity project

BACKGROUND

According to the ActivityStat hypothesis more physical activity (PA) in one timespan is compensated by increased sedentary time (ST) in the following timespan and vice versa to maintain an overall stable PA level. Until now, existing literature revealed inconsistent results regarding compensatory behaviour across children and adolescents. Thus, the aim of the present study is (1) to investigate whether ST in the morning is compensated by active behaviour in the afternoon and (2) whether ST during the week is compensated by active behaviour during the weekend in (pre)adolescent girls. Additionally, we aimed to differentiate between positive and negative compensatory behaviour and examine whether it is moderated by socioeconomic status (SES), age or weight status.

METHODS

The participants were 370 sixth grade school girls (mean age 11.6 years) from Munich that participated in the CReActivity study, a school based intervention study aiming to identify the mechanisms of behavioural changes in PA among girls. ST and PA were measured over seven consecutive days using accelerometery. Descriptive determination of compensatory behaviour, as well as Bayesian multivariate multilevel analysis were conducted with data clustered on the individual (ID), class and school level.

RESULTS

Descriptive analysis revealed rather constant compensatory behaviour of about 60% for after-school days and weekends over all observation points. However, regarding all girls, compensation was predominantly negative. Differentiated analysis indicated that all girls with low ST levels in the morning or on weekdays, compensated for this behaviour with lower PA levels in the afternoon or on weekends. Multilevel covariate analysis indicated great variability between the participants. Furthermore, differences in compensatory behaviour can also be seen on class and school levels. Interestingly, PA compensatory behaviour is not associated with age, weight status or SES.

CONCLUSION

Our findings could neither confirm nor reject the ActivityStat Hypothesis. Overall, due to the great variability across the girls, it seems that compensation depends on individual factors. In the future, to prevent negative compensation, school-based interventions that have the potential to provide opportunities to be physically active, should not neglect (pre)adolescents' leisure time behaviour.

TRIAL REGISTRATION

DRKS00015723 (date of registration: 2018/10/22 retrospectively registered).

Psychosocial aspects of sports medicine in pediatric athletes: Current concepts in the 21st century

Behavioral aspects of organized sports activity for pediatric athletes are considered in a world consumed with winning at all costs. In the first part of this treatise, we deal with a number of themes faced by our children in their sports play. These concepts include the lure of sports, sports attrition, the mental health of pediatric athletes (i.e., effects of stress, anxiety, depression, suicide in athletes, ADHD and stimulants, coping with injuries, drug use, and eating disorders), violence in sports (i.e., concepts of the abused athlete including sexual abuse), dealing with supervisors (i.e., coaches, parents), peers, the talented athlete, early sports specialization and sports clubs. In the second part of this discussion, we cover ergolytic agents consumed by young athletes in attempts to win at all costs. Sports doping agents covered include anabolic steroids (anabolic-androgenic steroids or AAS), androstenedione, dehydroepiandrostenedione (DHEA), human growth hormone (hGH; also its human recombinant homologue: rhGH), clenbuterol, creatine, gamma hydroxybutyrate (GHB), amphetamines, caffeine and ephedrine. Also considered are blood doping that includes erythropoietin (EPO) and concepts of gene doping. In the last section of this discussion, we look at disabled pediatric athletes that include such concepts as athletes with spinal cord injuries (SCIs), myelomeningocele, cerebral palsy, wheelchair athletes, and amputee athletes; also covered are pediatric athletes with visual impairment, deafness, and those with intellectual disability including Down syndrome. In addition, concepts of autonomic dysreflexia, boosting and atlantoaxial instability are emphasized. We conclude that clinicians and society should protect our precious pediatric athletes who face many challenges in their involvement with organized sports in a world obsessed with winning. There is much we can do to help our young athletes find benefit from sports play while avoiding or blunting negative consequences of organized sport activities.

Results from the Japan 2022 report card on physical activity for children and youth

Background/Objective: The 2020 Tokyo Olympics and Paralympic was held in 2021, although postponed due to the spread of COVID-19. This event might have an impact on physical activity (PA) of children and adolescents, but the national data on PA during the pandemic were not available. Therefore, the goal of the 2022 Japan Report Card on Physical Activity for Children and Youth (The 2022 Japan Report Card) is to assess and track levels of health behaviors related to PA, and health outcomes in Japanese children and adolescents, and environments and government strategy for PA just before the pandemic.

Methods

The 2022 Japan Report Card consists of health behaviors and outcomes (8 indicators), and influences on health behaviors (4 indicators). Nationally representative data were used to score the indicators.

Results

The key five health behaviors and outcomes (Overall PA: B⁻; Organized Sport: B⁻; Active Transportation: A⁻; Physical fitness: B, Weight status: A) were favorable. Sedentary Behavior and Sleep received C⁻ and D⁻ grades, respectively. Active Play could not be graded (INC). In the influences domain, Family and Peers was graded as C⁻, while School (B⁺), Community and Environment (B), and Government (B) were favorable.

Conclusions

The 2022 Japan Report Card shows that Japanese children and adolescents had favorable levels of overall PA, active transportation to and from school, and weight status, and there was a generally favorable environment for PA and health, though sedentary behavior and sleep were unfavorable. Future nationally representative surveys on active play are needed.

Development and Validation of Parental Support Scale of Children’s Sports Training in China: Socio-Ecological Approach

Objectives

To promote Chinese children participation in sports training and acquisition of sports skills, we combined a social ecological research framework with parental support to develop the Parental Support for Children’s Sports Training Scale (PSCSTS).

Methods

The scale was initially developed based on literature review, group interviews, and expert evaluations. A complete reliability and validity test was conducted on 1,594 parents of primary and secondary schools in Shanghai.

Results

The PSCSTS has 37 questions, and exploratory factor analysis has formed 10 factors: policy support, parents’ financial support, community support, media support, sports development, school activity participation, parents’ exercise habits, training quality support, development of school sports activities, learning skills. The higher-order models constructed by validated factor analysis fit well (χ²/df = 2.130, RMSEA = 0.038, SRMR = 0.042, GFI = 0.911, CFI = 0.928). The Parents of children of different sexes have measurement invariance in the PSCSTS.

Conclusion

The PSCSTS developed in this study based on a social-ecological framework has high reliability and validity, and can be used as a comprehensive measure of parental support for their children’s sports training.

Organized Sport Activities of 11 to 15-Year-Old Adolescents: Trends from 2010-2018 and Socioeconomic Context

The aim of this paper was to analyse the trends in the participation of Czech adolescents in organized sport activities in relation to the socioeconomic status (SES) of their families. The sample consisted of 11, 13 and 15-year-old children (N = 4425 (2010), 10,361 (2014) and 13,377 (2018)); the data were collected as part of the HBSC Study in the Czech Republic. The findings suggest that adolescents from affluent families tend to participate more often in organized sports—both team activities and individual activities. Fifteen-year-old adolescents from families with a high SES are 3.01 times more likely to participate in individual organized sports than adolescents from low-SES families. The gap between participation in sport activities increases with the children’s age but does not change significantly during the observed period. The findings suggest that public health policy should be oriented towards children from less-affluent families.

Anthropometric Measurements, Sociodemographics, and Lifestyle Behaviors among Saudi Adolescents Living in Riyadh Relative to Sex and Activity Energy Expenditure: Findings from the Arab Teens Lifestyle Study 2 (ATLS-2)

The aim of the study was to examine the anthropometric measurements, sociodemographics, and lifestyle behaviors among Saudi adolescents relative to sex and physical activity (PA). A random cross-sectional survey conducted on Saudi adolescents from secondary schools in Riyadh, using a multistage stratified cluster sampling technique. Measurements included demographics, weight, height, waist circumference, PA, sedentary behaviors (SB), sleep duration, and dietary habits using a validated questionnaire. A total of 1262 adolescents (16.4 ± 0.95 years; 52.4% males) were studied. Overweight/obesity was more than 40%. Physical inactivity among adolescents was 53%, which indicates some improvement over the past years, especially among females. More than 80% of adolescents had over three hours/day of screen time, with no significant sex differences. Insufficient sleep was highly prevalent with gender differences. A large proportion of the participants did not consume daily breakfast (65.7%), vegetables (73.2%), fruits (84.2%), or milk/dairy products (62.4%), whereas significant proportions of the adolescents consumed sugar-sweetened drinks, fast food, French fries/potato chips, cake/donuts, and chocolates/candy on at least three days or more per week. It was concluded that non-daily intake of breakfast and vegetables was significantly associated with lower PA. The updated information can aid in effectively planning and implementing promotional programs toward improving the lifestyle behaviors of Saudi adolescent.