Validity and Calibration of the Youth Activity Profile

Reliability, reproducibility, and feasibility of youth activity profile (YAP) questionnaire in Chilean children and adolescents

This study aimed to evaluate the reliability, reproducibility, and feasibility of the Youth Activity Profile Questionnaire (YAP-SL) in the Chilean version (YAP-C) in a sample of children and adolescents. This cross-sectional study included 160 youth, 59 children (5-11 years old), and 101 adolescents (12-17 years old) from the city of Viña del Mar (Chile). The YAP-SL is a 15-item self-report instrument which was administered twice at an interval of 7 days apart. This questionnaire was designed to capture physical activity (PA) and sedentary behaviour in youths in the last week, categorizing them into three domains: PA at school, PA out-of-school, and sedentary habits. Cronbach's α coefficients were calculated to evaluate the internal consistency (reliability), and the reproducibility was determined by test-retest and Kendall's tau b coefficients. Concerning the total YAP-C score, results indicated moderate-to-high reliability in the total sample (0.71), boys (0.76) and girls (0.66), as well as for children (0.73) and adolescents (0.70). The results also revealed variations in reliability and reproducibility across the three domains. In conclusion, the YAP-SL questionnaire presents moderate-to-high reliability in Chilean children and adolescents. However, the reliability and consistency of the YAP varied across the domains.

Are perceived barriers to physical activity related to depression, anxiety and stress among adolescents? The EHDLA study

Objective

The aim of this study was twofold: first, to examine the association between perceived barriers to physical activity (PA) practice and depression, anxiety and stress in a sample of Spanish adolescents; and second, to determine which barriers are specifically associated with depression, anxiety and stress.

Methods

This cross-sectional study was conducted with 765 adolescents aged 12-17 (55.6% girls) in the Valle of Ricote, Murcia, Spain. Depression, anxiety and stress symptoms were assessed using the Depression, Anxiety and Stress Scale (DASS-21), with validated cut points employed to determine the presence of each of these mental conditions. The perception of barriers to PA was assessed using a validated questionnaire for the Spanish adolescent population.

Results

The barrier 'Because I feel that my physical appearance is worse than that of others' was related to a higher likelihood of having depression (OR=2.41; 95% CI 1.35 to 4.28; p=0.003), anxiety (OR=2.65; 95% CI 1.51 to 4.71; p=0.001) and stress (OR=2.82; 95% CI 1.59 to 5.07; p<0.001). Similarly, the barrier 'Because nobody encourages me to engage in physical activity' was related to a higher likelihood of having depression (OR=1.92; 95% CI 1.08 to 3.43; p=0.026), anxiety (OR=1.97; 95% CI 1.11 to 3.50; p=0.021) and stress (OR=1.99; 95% CI 1.12 to 3.59; p=0.021).

Conclusion

Perceived barriers to PA related to physical appearance and social support seem to be associated with a greater likelihood of depression, anxiety and stress among Spanish adolescents.

Uncovering the roles of automatic attitudes and controlled processes in the regulation of physical activity behavior in children

Despite substantial research efforts to increase engagement in physical activity (PA), children are not sufficiently active. Dual-process theories suggest that PA behavior regulation occurs through both controlled (i.e., reflective, conscious) and automatic (i.e., non-reflective, less conscious) processes. Automatic processes depend on affective valuations and attitudes towards PA and have been shown to predict PA behavior. However, their role in PA behavior regulation in children remains unclear. Therefore, the current study investigated the unique association of automatic attitudes towards PA on self-reported seven-day PA recall, after accounting for the effects of known controlled precursors of PA (i.e., explicit attitudes, PA self-efficacy, and PA intentions). In a cross-sectional design, 69 children (age = 10.8 ± 0.6 years) completed the Single-Category Implicit Association Task (SC-IAT) and self-reported measures of PA and controlled precursors of PA. In a hierarchical regression analysis, controlled processes accounted for 28.3 % of the variance in PA behavior. Although the bivariate association between automatic attitudes and PA was not significant, the association between them became significant but negative in the fully adjusted model (b = -1.70; p = 0.025). The fully adjusted model accounted for 35.0 % of the variance in PA. In summary, the findings indicated that both controlled and automatic processes predicted PA in children, although the association with automatic attitudes was not in the expected direction in the adjusted model. Future studies are warranted to further understand the role of automatic processes in the regulation of PA behavior in children.

Meal Duration and Obesity-Related Indicators among Adolescents: Insights from the EHDLA Study

PURPOSE

This paper aims to examine the association between meal duration and obesity indicators among Spanish adolescents.

METHODS

We conducted a cross-sectional analysis using data from the Eating Healthy and Daily Life Activities (EHDLA) project involving 755 adolescents aged 12 to 17 years (54.8% girls) from three secondary schools in the Valle de Ricote Region of Murcia, Spain. To evaluate overall meal duration, participants were asked how long (on average) breakfast, morning snacks, lunch, afternoon snacks, and dinner typically last. Subsequently, global meal duration was measured, and the participants were categorized into tertiles. Obesity-related indicators, including body mass index (BMI) z score, waist circumference (WC), and skinfold thickness, were assessed. The analyses were adjusted for potential confounders such as sex, age, socioeconomic status, physical activity, sedentary behavior, diet quality, and energy intake.

RESULTS

Concerning meal duration status, adolescents with long meal durations had the lowest estimated marginal means of BMI z score, WC, and body fat percentage (using the sum of triceps and calf skinfolds). However, significant differences between adolescents with a long meal duration and those with a short meal duration were observed only for BMI z score (p = 0.008), and WC (p = 0.020). Furthermore, significant differences in BMI z score (p = 0.017) between adolescents with a long meal duration and those with a moderate meal duration were identified.

CONCLUSIONS

These findings underscore the importance of promoting slower eating habits as part of obesity prevention strategies. Future studies should explore the causality of this association and its potential for behavioral interventions.

Social Jetlag on Obesity-Related Outcomes in Spanish Adolescents: Cross-Sectional Evidence from the EHDLA Study

PURPOSE

This study aimed to investigate the association between social jetlag (SJL) and obesity-related outcomes among adolescents from Valle de Ricote (Region of Murcia, Spain). We explored the relationship between SJL and body mass index (BMI) z-score, waist circumference, and body fat percentage, as well as the odds of having excess weight, obesity, and abdominal obesity in a sample of Spanish adolescents.

METHODS

A cross-sectional study was conducted using data from the Eating Healthy and Daily Life Activities (EHDLA) project, which included 847 Spanish adolescents aged 12-17 years. SJL was assessed based on the differences in sleep patterns between weekdays and weekends. Obesity-related indicators such as BMI z-score, waist circumference, body fat percentage, excess weight, obesity, and abdominal obesity were measured. Generalized linear models with a Gaussian or binomial distribution were used to analyze the associations between SJL and obesity-related outcomes, adjusting for potential confounders.

RESULTS

The analysis revealed significant associations between SJL and BMI z-score (unstandardized beta coefficient [B] = 0.15, 95% CI: 0.05 to 0.25, p = 0.003), waist circumference (B = 1.03, 95% CI: 0.39 to 1.67, p = 0.002), and body fat percentage (B = 0.83, 95% CI: 0.31 to 1.43, p = 0.008). Additionally, the odds ratios (ORs) for excess weight (OR = 1.35, 95% CI: 1.16 to 1.57; p < 0.001), obesity (OR = 1.59, 95% CI: 1.26 to 2.00; p < 0.001), and abdominal obesity (OR = 1.46, 95% CI: 1.23 to 1.72; p < 0.001) increased significantly with each 60 min increment in SJL.

CONCLUSIONS

This study pointed out that the misalignment of sleeping times during weekdays and weekends (SJL) is significantly associated with higher BMI z-scores, waist circumference, body fat percentage, and higher odds of excess weight, obesity, and abdominal obesity among adolescents, being more significant in boys than in girls. These findings highlight the importance of addressing circadian misalignment in the prevention and management of obesity and its related metabolic disorders in this population.

Higher Numbers of Family Meals and Social Eating Behavior Are Associated with Greater Self-Esteem among Adolescents: The EHDLA

BACKGROUND

the aim of this study was to assess the associations of family meals and social eating behavior with self-esteem levels among Spanish adolescents.

METHODS

This was a secondary cross-sectional study including 706 participants (aged 12 to 17 years; 56.1% girls) from the Eating Habits and Daily Life Activities (EHDLA) study. The evaluation of the frequency of family meals involved participants providing information in physical education classes on how frequently they, along with other members of their household, had shared meals in the previous week. Social eating behavior was assessed by three different statements: "I usually have dinner with others", "Having at least one meal a day with others (family or friends) is important to me", and "I enjoy sitting down with family or friends for a meal". To assess overall self-esteem, the Rosenberg Self-Esteem Scale was used.

RESULTS

In the adjusted models, a positive association was observed between the frequency of family meals and the self-esteem score (unstandardized beta coefficient [B] = 0.06, 95% confidence interval [CI] 0.003 to 0.12, p-adjusted = 0.040). Furthermore, the same positive association was also identified between social eating behavior and the self-esteem score (B = 0.23; 95% CI 0.07 to 0.40, p-adjusted = 0.005).

CONCLUSIONS

Although self-esteem is complex and can be influenced by numerous factors, both family meals and social eating behavior may exert a relevant role in adolescents. Encouraging consistent participation in family meals and promoting positive eating practices could be valuable approaches in public health actions targeting the enhancement of self-esteem levels in adolescents.

Relationship between perceived physical literacy and obesity-related outcomes in adolescents: the EHDLA study

Purpose

The aim of the present study was to examine the relationship between perceived physical literacy and obesity-related outcomes among adolescents from Spain.

Methods

This is a secondary cross-sectional analysis including a total sample of 845 Spanish adolescents (55.3% girls) aged 12-17 years from the Valle de Ricote (Region of Murcia) from the Eating Healthy and Daily Life Activities (EHDLA) project. Physical literacy was evaluated using the Spanish Perceived Physical Literacy Instrument for adolescents (S-PPLI). Body mass index was computed by taking the participants' body weight in kilograms and dividing it by the square of their height in meters, and body mass index (z score) and overweight/obesity and obesity were computed by the World Health Organization age- and sex-specific thresholds. Waist circumference was measured using a constant tension tape. Moreover, the waist-to-height ratio was calculated, and therefore, abdominal obesity was determined. Skinfold measurements were taken at the triceps and medial calf using calibrated steel calipers.

Results

In general, the overall trend was downward (i.e., the higher the PPLI score the lower the obesity-related indicators), with the approximate significance of smooth terms being statistically significant for all models examined (p < 0.001). Adolescents with lower perceived physical literacy (PPL) showed the highest estimated marginal means of body mass index, body mass index z score, waist circumference, waist-to-height ratio, and skinfold (triceps and calf) and predictive probabilities of having excess weight, obesity, and abdominal obesity, while their counterparts with high PPL had the lowest. In addition, significant differences were observed for all the obesity-related indications between adolescents with low PPL and those with medium PPL (p-adjusted < 0.05 for all indicators), as well as with those with high PPL (p-adjusted < 0.05 for all indicators). Moreover, these significant differences were also shown for most indicators between adolescents with medium PPL and those with high PPL (except for obesity).

Conclusion

Physical literacy could play a crucial role in maintaining more desirable obesity-related outcomes in adolescents. Adolescents with high perceived physical literacy showed lower obesity-related indicators (i.e., body mass index, body mass index z score, waist circumference, waist-to-height ratio, skinfolds), as well as a lower probability of having excess weight, obesity, and abdominal obesity.

Family Meals and Social Eating Behavior and Their Association with Disordered Eating among Spanish Adolescents: The EHDLA Study

PURPOSE

The aim of this study was to examine the association of family meals and social eating behavior with disordered eating behavior in Spanish adolescents.

METHODS

This was a cross-sectional study that included 706 adolescents (43.9% boys) from the Eating Habits and Daily Life Activities (EHDLA) study (aged 12 to 17) from Valle de Ricote, Region of Murcia, Spain. The frequency of family meals was assessed by asking participants to report how often their family, or most household members, had shared meals in the past week. Social eating behavior was evaluated using three statements: "I enjoy sitting down with family or friends for a meal", "Having at least one meal a day with others (family or friends) is important to me", and "I usually have dinner with others". To evaluate disordered eating, two psychologists administered the Sick, Control, One, Fat and Food (SCOFF) questionnaire.

RESULTS

After adjusting for several covariates, for each additional family meal, the likelihood of having disordered eating behavior was lower (odds ratio (OR) = 0.96; 95% confidence interval (CI) 0.93 to 0.9997, p = 0.049). On the other hand, a lower likelihood of having disordered eating behavior was observed for each additional point in the social eating behavior scale (OR = 0.85; 95% CI 0.77 to 0.93, p = 0.001). The likelihood of having disordered eating behavior was 0.7% lower for each additional family meal (95% CI 0.01% to 1.4%, p = 0.046). Furthermore, for each additional point in the social eating behavior scale, a lower probability of having disordered eating behavior was observed (3.2%; 95% CI 1.4% to 5.0%, p < 0.001).

CONCLUSIONS

While disordered eating behavior is complex and can be shaped by various factors, both family meals and social eating behavior emerge as significant factors inversely associated with this condition among adolescents. Promoting regular engagement in family meals and fostering positive social eating experiences could serve as effective strategies in public health initiatives aimed at mitigating the incidence of disordered eating behavior among the young population.

Unveiling the relationship of physical literacy with muscular fitness and muscle-strengthening activities in adolescents: the EHDLA study

Objective

This study evaluated the relationship between physical literacy (PL) and muscular fitness (MF) as well as muscle-strengthening activities (MSA) in adolescents.

Methods

A secondary cross-sectional study included 823 adolescents (45.1% boys) from the Eating Healthy and Daily Life Activities Study. The Spanish Perceived Physical Literacy Instrument for Adolescents (S-PPLI) assessed the participants' perceived PL. The evaluation of MF in the young population was conducted using the Assessing the Levels of Physical Activity and Fitness (ALPHA-FIT) test battery. MSA were assessed by the following question: 'In the past week, how many days did you exercise to strengthen or tone the muscle, such as through push-ups, sit-ups or lifting weights?' To examine the associations between S-PPLI scores and handgrip strength, standing long jump and MSA days in adolescents, we employed generalised additive models.

Results

Participants with high perceived physical literacty (PPL) had the highest handgrip strength (mean=25.1; PPL had the highest handgrip strength (mean=25.1; bias-corrected and accelerated (BCa) bootstrapped 95% CI 24.2 to 26.0) and standing long jump (mean=149.7; confidence interval (CI) 24.2 to 26.0) and standing long jump (mean=149.7; 24.2 to 26.0) and standing long jump (mean=149.7; BCa bootstrapped 95% CI 145.8 to 153.5). Conversely, those adolescents with low PPL had the lowest handgrip strength (mean=23.1; BCa bootstrapped 95% CI 22.3 to 23.8) and standing long jump (mean=137.3; BCa bootstrapped 95% CI 133.9 to 140.6). For MSA, adolescents with high PPL had the highest mean of MSA days (mean=3.0; BCa bootstrapped 95% CI 2.8 to 3.3), while the lowest mean was observed for those with low PPL (mean=2.0; BCa bootstrapped 95% CI 1.8 to 2.2).

Conclusion

A high level of PL was associated with higher levels of MF and MSA among Spanish adolescents.

Early morning physical activity is associated with healthier white matter microstructure and happier children: the ActiveBrains project

The background of this study is to examine the associations of individual and combined early morning patterns (i.e., active commuting to school, physical activity before school, having breakfast and good sleep) with white matter microstructure (WMM) and, whether the associated white mater microstructure outcomes were related to mental health outcomes in children with overweight or obesity. 103 children with overweight or obesity (10.0 ± 1.1 years old, 42 girls) from the ActiveBrains project participated in this cross-sectional study. Early morning patterns and mental health indicators (i.e., self-esteem, optimism, positive and negative affect, stress, depression and anxiety) were self-reported by the children using validated questionnaires. WMM was assessed by magnetic resonance imaging using diffusion tensor imaging. When examined independently, early morning patterns were not related with WMM (all P > 0.05). However, the combination of early morning patterns was related with WMM (P < 0.05). Specifically, physically active early morning patterns (i.e., active commuting to school and physical activity before school) were associated with global fractional anisotropy (FA) (β = 0.298, P = 0.013) and global radial diffusivity (RD) (β = - 0.272, P = 0.021), as well as with tract-specific FA (β = 0.314, P = 0.004) and RD (β = - 0.234, P = 0.032) in the superior longitudinal fasciculus (SLF). Furthermore, combined physically active early morning pattern-associated global (i.e., FA and RD) and tract-specific (i.e., FA and RD in the SLF) WMM indicators were positively associated with happiness (β absolute value range from 0.252 to 0.298, all P < 0.05). A combination of physically active early morning patterns may positively relate to white matter microstructure in children with overweight or obesity, and, in turn, happiness.

Sociodemographic influences on youth sport participation and physical activity among children living within concentrated Hispanic/Latino rural communities

Introduction

Lack of physical activity (PA) among children living in rural communities is a documented public health problem. Although studies have examined community conditions defined by a rural-urban dichotomy, few have investigated rural community conditions with a concentration of Hispanic/Latino people. This cross-sectional study examined sociodemographic characteristics associated with youth sport (YS) participation and daily PA among children living within concentrated Hispanic/Latino rural U.S. Midwest communities.

Methods

During spring 2022, 97% of 3rd-6th grade children (n = 281, aged approximately 8-12 years) attending school in rural Midwestern communities (n = 2) with >50% concentration of Hispanic students participated in the Wellscapes Project, a community randomized trial. Participants completed the Youth Activity Profile and supplemental National Survey of Children's Health questions assessing PA behaviors and YS participation. Caregivers of a subsample of children (n = 215; males, n = 93; females, n = 122) consented to pair their child's survey results with school enrollment records (e.g., free/reduced lunch status and race and ethnicity). Mixed models with community as a random effect examined main and interaction effects of grade, sex, ethnoracial status, and family income on YS participation and these sociodemographic characteristics and YS participation on daily moderate-to-vigorous PA (MVPA).

Results

Approximately half of children participated in YS. Non-Hispanic White children (n = 82) were over five times more likely to participate in YS than Hispanic peers (n = 133) (OR = 5.54, 95% CI = 2.64-11.61, p < 0.001). YS participants accumulated 8.3 ± 2.3 more minutes of daily MVPA than non-participants (p < 0.001). Sixth graders, females, and Hispanic children reported lower daily MVPA than comparison groups (p < 0.05). Significant interaction effects on daily MVPA between grade and ethnoracial status (F(3, 204) = 3.04, p = 0.030) were also found.

Discussion

Disparities in sport participation and PA outcomes based on sociodemographic characteristics exist among children living in ethnoracially diverse rural communities. Strategies to promote YS participation, including community structural changes, may help reduce PA disparities. The research provides valuable insights for policymakers, public health professionals, and community members to address YS participation barriers, not limited to cost, while considering other PA-promotion efforts to improve child population health.

Born in Bradford's Age of Wonder cohort: protocol for adolescent data collection

Background

Adolescence and transition into adulthood are periods shaping life-long mental health, cardiometabolic risk, and inequalities. However, they are poorly studied and understood. By extending and expanding the Born in Bradford (BiB) cohort study through this period using innovative, co-produced approaches to collect and analyse data, we aim to understand better the interplay of factors that influence health and wellbeing, and inform/evaluate interventions to improve them and reduce inequalities.

Protocol

BiB Age of Wonder (AoW) is a large, whole city cohort that will capture the contemporary lived experience amongst multi-ethnic adolescents progressing into young adulthood. We will collect repeated data from existing BiB participants and their peers (N~30,000 adolescents). The protocol for the first phase of the quantitative methods, involving survey measurements and health assessments in mainstream secondary schools is described here. We describe the co-production behind these methods, and lessons learned from the first year of data collection.

The availability between recreational facilities and physical activity of US adolescents

Determining the locations where adolescents tend to accumulate greater amounts of physical activity may assist policymakers to address the built environment design and promote PA. This study evaluated the association between the availability of recreational facilities and average minutes of moderate to vigorous physical activity (MVPA) per day of US adolescents in 2017 (n = 1,437). Data for this cross-sectional study were obtained from the 2017 Family Life, Activity, Sun, Health, and Eating study, an internet-based study collecting information on diet and PA of parent and adolescent dyads. Adolescents aged 12-17 from the US were included. Predicted daily minutes of MVPA were calculated. The exposure variables of interest were the availability of school recreational facilities, indoor recreational facilities, playing fields, bike/hiking/walking trails or paths or public parks. Participants were excluded if no information was provided for MVPA or availability of recreational facilities. Unadjusted and adjusted linear regression analysis was used to calculate mean daily minutes of MVPA and their corresponding 95 % confidence intervals. In fully adjusted models, we found statistically significant associations between the type of recreational facility and differences in daily minutes of MVPA for school (p-value < 0.001) and public parks p-value < 0.001), but not for the other recreational facilities. The average daily minutes of MVPA differed by 4.4 min (95 % CI 2.6, 6.2) if participants had school recreational facilities, respectively. School recreational facilities are important for engaging adolescents in PA objectives. Features within school recreational facilities should be studied to further investigate contributions to increased PA levels.

Exploring the link between perceived physical literacy and academic performance outcomes: insights from the EHDLA study

Objective

The aim of this study was to verify the relationship between perceived physical literacy (PPL) and academic performance outcomes among Spanish adolescents aged 12-17 years.

Methods

This cross-sectional study is a secondary examination utilizing data derived from the Eating Healthy and Daily Life Activities (EHDLA) project. The Spanish Perceived Physical Literacy Instrument for Adolescents (S-PPLI) was used to evaluate the PPL of the participants. To determine academic performance, the numerical grades for each subject were added together and then divided by the total number of subjects.

Results

Overall, a positive trend in the association between S-PPLI scores and academic performance was observed. We identified two significant ranges within the S-PPLI scores. First, there was a significant range between 9 and 33 points on the S-PPLI, indicating an inverse association with academic performance. Second, another significant range was observed at scores of 34 points or higher on the S-PPLI, suggesting a positive association with academic performance. Participants with low PPL had the lowest academic performance (mean = 6.4; bias-corrected and accelerated (BCa) bootstrapped 95% confidence interval (CI): 6.2-6.6). Conversely, those adolescents with high PPL had the highest academic performance (mean = 6.9; BCa bootstrapped 95% CI: 6.6-7.1). Significant differences were found between low PPL and medium PPL (p-adjusted = 0.031) and between low PPL and high PPL (p-adjusted = 0.031).

Conclusions

Increased physical literacy could be a relevant factor for achieving greater academic performance in adolescents. This study has potential implications for physical education instructors, school leaders, and healthcare practitioners.

Is chronotype linked with adherence to the Mediterranean diet among adolescents? The EHDLA study

BACKGROUND

No previous study has evaluated the relationship between chronotype and adherence to the Mediterranean diet among adolescents. The aim of the present study was to assess the association between chronotype and adherence to the Mediterranean diet in a sample of Spanish adolescents aged 12-17 years.

METHODS

This study examined secondary data from 820 adolescents (55.5% girls) from the Eating Healthy and Daily Life Activities (EHDLA) study, which included a representative sample of adolescents aged 12-17 years from the Valle de Ricote (Region of Murcia, Spain). Adolescents' chronotype was evaluated with the Morningness/Eveningness Scale in Children. Adherence to the Mediterranean diet was determined through the Mediterranean Diet Quality Index for Children and Teenagers.

RESULTS

The proportion of adolescents with an optimal Mediterranean diet was 37.6%. In relation to chronotype, we found that 24.5%, 69.4%, and 6.1% of the adolescents were classified as morning, intermediate, and evening types, respectively. After adjusting for several covariates, both evening- and intermediate-type adolescents showed lower odds of having optimal adherence to the Mediterranean diet (evening-type: odds ratio [OR] = 0.30, confidence interval [CI] 95% 0.12-0.72; intermediate-type: OR = 0.62, CI 95% 0.44-0.87) than morning-type adolescents.

CONCLUSIONS

Chronotype could affect adherence to the Mediterranean Diet in adolescents, so it should be a factor to be considered in future studies assessing eating habits.

IMPACT

No previous study has evaluated the relationship between chronotype and adherence to the Mediterranean diet among adolescents. Both evening- and intermediate-type adolescents showed lower odds of having optimal Mediterranean diet adherence than morning-type adolescents. These findings may indicate a need to promote eating healthy habits based on a more holistic approach, not only on the total energy expenditure or in specific food groups but also on the chronotype.

Cross-Sectional Association between Perceived Physical Literacy and Mediterranean Dietary Patterns in Adolescents: The EHDLA Study

PURPOSE

The objective of the current study was to analyze the relationship between perceived physical literacy (PPL) and adherence to the Mediterranean Diet (MedDiet) and its specific components in a sample of Spanish adolescents.

METHODS

In this cross-sectional study, we examined a sample of 845 adolescents (58.1% boys) aged 12-17 years from the Valle de Ricote (Region of Murcia, Spain). PPL was assessed by the Spanish Perceived Physical Literacy Instrument for adolescents (S-PPLI). To assess adherence to the MedDiet, the Mediterranean Diet Quality Index in children and adolescents (KIDMED) was applied.

RESULTS

In unadjusted analyses, adolescents with medium or high PPL were more likely to have optimal adherence to the MedDiet (medium PPL: OR = 1.69, 95% CI 1.20-2.40, p-adjusted = 0.003; high PPL: OR = 2.90, 95% CI 2.03-4.17, p-adjusted < 0.001). These findings remained significant after adjusting for sex, age, socioeconomic status, body mass index, energy intake, overall sleep duration, physical activity, and sedentary behavior (medium PPL: OR = 1.51, 95% CI 1.05-2.19, p-adjusted = 0.003; high PPL: OR = 2.27, 95% CI 1.53-3.39, p-adjusted < 0.001).

CONCLUSIONS

PPL could play a relevant role in the adoption of healthy eating habits among adolescents. Adolescents with low or medium PPL were less likely to report optimal adherence to the MedDiet. Adolescents with high PPL seem to consume more fruits, vegetables, fish, pulses, nuts, and dairies (for breakfast). Conversely, these adolescents tend to skip breakfast less, as well as to consume less commercially baked goods or pastries at this meal.

Assessment of the validity of a sedentary behavior questionnaire among university students from low-income regions

Introduction

Introduction: to reduce the prevalence of overweight and obesity, lifestyle interventions, particularly in nutritional education programs, should be prioritized among university students. Monitoring sedentary behavior is an important step toward preventing and controlling obesity. Therefore, we assessed the reliability and validity of an online questionnaire on sedentary behavior among university students from low-income regions. Methods: this cross-sectional methodological feasibility study evaluated the psychometric properties of the South American Youth/Child Cardiovascular and Environmental (SAYCARE) questionnaire. We administered this questionnaire in an online format to 195 and 117 university students (aged between 17 and 53 years) to assess its validity and reliability, respectively. The questionnaire measures the daily time spent watching TV, playing electronic games, using a computer, studying and passive commuting on weekdays and weekends. The questionnaire involved two stages (Q1 and Q2) separated by an interval of 2 weeks. Reliability was assessed using Spearman's correlation analysis. The structural validity of the construct was evaluated by exploratory factor analysis. Results: all variables showed acceptable reliability (Spearman's rho > 0.30 and p < 0.05). Regarding construct structural validity, the exploratory factor analysis identified 4 factors (variance explained: 71.4 %) and did not exclude any items. Conclusion: the online SAYCARE questionnaire exhibited acceptable reliability and structural validity for assessing sedentary behavior among university students from low-income regions.

The moderating role of recreational substance use in the association of Mediterranean diet with academic performance among adolescents

No study has examined the potential moderating role of recreational substance use in the relationship between the Mediterranean diet (MedDiet) and academic performance. The aim of this study was to test the potential moderating role of recreational substance use (i.e., alcohol, tobacco, and cannabis) in the association of adherence to the MedDiet with academic performance among adolescents. This cross-sectional study included a sample of 757 adolescents (55.6% girls) aged 12-17 years from the Valle de Ricote (Region of Murcia). The Region of Murcia is an autonomous community of Spain located in the southeast of the Iberian Peninsula, along the coast of the Mediterranean Sea. Adherence to the MedDiet was assessed by the Mediterranean Diet Quality Index for Children and Teenagers (KIDMED). Recreational substance use (i.e., tobacco, alcohol, cannabis) was self-reported by adolescents. Academic performance was assessed by the school records at the end of the academic year. The relationship between adherence to the MedDiet and academic performance was moderated by both tobacco and alcohol use (for grade point average and all school records). In conclusion, higher adherence to the MedDiet was related to greater academic performance in adolescents, but recreational substance use could moderate this association.

Evaluating a 10-Week Family-Focused E-Health Healthy Lifestyle Program for School-Aged Children with Overweight or Obesity: A Randomized Controlled Trial Study Protocol

E-Health childhood obesity treatment interventions may serve as favorable alternatives to conventional face-to-face programs. More studies are needed to evaluate the effectiveness of such interventions beyond immediately post-program completion, including exploring program features impacting effectiveness. This randomized controlled trial with a qualitative component and waitlisted control group will evaluate the effectiveness of a 10-week family-focused e-Health program for school-aged children with overweight/obesity and explore the experience of families completing the program. The primary outcome is the change in BMI z-score and will be assessed from baseline to 10 weeks. Secondary outcomes include (the change in) waist circumference, dietary intake, physical activity, quality of life, and experiences, and will be assessed at baseline, post-10 weeks, and/or immediately, 3-, 6-, and/or 12-months post-program completion. Independent t-tests will be used to compare the differences in means and analyses of variances (ANOVAs) will be conducted to investigate the impact of the program or of being waitlisted and the effect size of the program on quantitative outcome measures. Reflexive thematic analysis will be used with qualitative data. Findings from this study are expected to provide learnings to upscale conventional childhood obesity treatment services, in the hopes of curbing the rising rate of childhood obesity.

Mediterranean Dietary Pattern and Psychosocial Health Problems in Spanish Adolescents: The EHDLA Study

The aims of the present study were twofold: to determine the association between adherence to the Mediterranean diet (MedDiet) and psychological problems and to assess the relationship between different food groups of the MedDiet and different patterns of psychosocial health problems in a sample of Spanish adolescents from the Valle de Ricote (Region of Murcia, Spain). This cross-sectional study included a representative sample of 700 adolescents (57% girls) between 12 and 17 years of age. Adherence to the MedDiet was assessed by the Mediterranean Diet Quality Index for Children and Teenagers (KIDMED). Psychosocial health problems were measured by the 25-item self-report version of the Strengths and Difficulties Questionnaire (SDQ). ANCOVA models were used to test the mean differences in psychosocial health problems (SDQ subscales) by adherence to MedDiet categories (low, medium, and high). Multiple linear regression was used to determine the association between different food groups of the MedDiet and psychosocial health problems. Adolescents with low adherence to the MedDiet had significantly higher scores in SDQ total difficulties, conduct problems, and hyperactivity problems and lower scores in pro-social behavior (p < 0.05) than their peers with medium and high adherence to the MedDiet. In relation to specific MedDiet food groups, fruit, nut, and legume intake were associated with higher psychosocial health. However, sweets, skipping breakfast, or high consumption of pasta or rice (≥5 weeks) were associated to higher psychosocial health problems. Our results show that adolescents with higher adherence to the MedDiet could benefit from greater psychosocial health. Individually, some patterns of MedDiet, such as fruit, nut, and legume intake, may reduce psychosocial health problems. These cross-sectional results should be confirmed in longitudinal and intervention studies.

Are family meals and social eating behaviour associated with depression, anxiety, and stress in adolescents? The EHDLA study

OBJECTIVE

This study examined the association between family meals and social eating behaviour with depression, anxiety and stress symptoms among Spanish adolescents.

METHODS

This was a cross-sectional study with data obtained from a representative sample of adolescents aged 12-17 years from Valle de Ricote, Murcia, Spain. Emotional symptomatology was evaluated with the Depression, Anxiety and Stress Scale. The frequency of family meals and social eating behaviour were self-reported.

RESULTS

Each additional point in social eating behaviour decreased the probability of having a higher number of depressive (OR = 0.83; 95% CI, 0.75-0.92), anxiety (OR = 0.88; 95% CI, 0.80-0.97) and stress (OR = 0.90; 95% CI, 0.82-0.99) symptoms.

CONCLUSIONS

Higher social eating behaviour was associated with lower probabilities of higher number of depressive, anxiety and stress symptoms.

Prevalence of Disordered Eating and Its Associated Factors From a Socioecological Approach Among a Sample of Spanish Adolescents: The EHDLA Study

Objectives: The aim of this study was twofold: a) to establish the prevalence of adolescents with disordered eating and b) to determine the factors associated with this prevalence in a sample of Spanish adolescents from the Valle de Ricote (Region of Murcia, Spain).

Methods: This cross-sectional study analyzed data from 730 adolescents (56.2% girls) from the EHDLA study. To determine the prevalence of disordered eating, the Sick, Control, One stone, Fat, Food (SCOFF) questionnaire was used. A socioecological approach was used to identify individual-, interpersonal-, or organizational-level factors associated with disordered eating.

Results: The prevalence of disordered eating was 30.1%. This condition was associated with female sex (odds ratio [OR] = 2.60; 95% confidence interval [CI], 1.81–3.73), immigrant status (OR = 2.22; 95% CI, 1.51–3.25), or excess weight (OR = 2.74; 95% CI, 1.93–3.89). Furthermore, for each additional hour slept, lower odds of having disordered eating were found (OR = 0.81; 95% CI, 0.67–0.98).

Discussion: Almost one-third of the sample of Spanish adolescents analyzed reported disordered eating. Female sex, immigrant status and excess weight are individual aspects that seem to be related to disordered eating among Spanish adolescents.

Sedentary Behaviour and Physical Activity Levels during Second Period of Lockdown in Chilean’s Schoolchildren: How Bad Is It?

Objective. The objective of this study was to compare the levels of sedentary behaviour and physical activity in relation to sociodemographic variables of Chilean schoolchildren before and during the COVID-19 pandemic. Methods. This retrospective study considered a non-random sample of 83 boys and 232 girls, and their respective parents, who attended public schools (n = 119) and private schools (n = 196) in Chile. A self-report instrument was applied that included sociodemographic variables, sedentary behaviour (SB), and physical activity (PA) in the second period of the pandemic in 2021. Results. The main results show that pre-pandemic SB had significant differences when compared between sexes, except for television time. During the pandemic, there was no significant difference in television time or telephone time. There were no significant differences by sex before and during the pandemic. When comparing the SB scores, video game time in boys decreased (p < 0.001), as did video game time in girls (p < 0.001), and computer time in boys (p < 0.001) and girls (p < 0.001). Telephone time increased in boys (p < 0.001) and girls (p < 0.001), as did television time (p < 0.001). Likewise, PA increased in boys (Δ + 9.51min) and girls (Δ + 3.54 min) during the pandemic (p < 0.001). Conclusions. Both PA and SB underwent changes according to sex before and during the second period of the COVID-19 pandemic in Chilean schoolchildren.

The Use of Wearable Technologies in the Assessment of Physical Activity in Preschool- and School-Age Youth: Systematic Review

In recent years, physical activity assessment has increasingly relied on wearable monitors to provide measures for surveillance, intervention, and epidemiological research. This present systematic review aimed to examine the current research about the utilization of wearable technology in the evaluation in physical activities of preschool- and school-age children. A database search (Web of Science, PubMed and Scopus) for original research articles was performed. A total of twenty-one articles met the inclusion criteria, and the Cochrane risk of bias tool was used. Wearable technology can actually be a very important instrument/tool to detect the movements and monitor the physical activity of children and adolescents. The results revealed that there are a few studies on the influence of these technologies on physical activity in schools, and most of them are descriptive. In line with previous research, the wearable devices can be used as a motivational tool to improve PA behaviors and in the evaluation of PA interventions. However, the different reliability levels of the different devices used in the studies can compromise the analysis and understanding of the results.

Nut consumption and academic performance among adolescents: the EHDLA study

PURPOSE

The aim of this study was to examine the relationship between nut consumption and academic performance in Spanish adolescents and to explore the role of sociodemographic, anthropometric, and lifestyle covariates on this association.

METHODS

A cross-sectional study was carried out using a food frequency questionnaire for estimating nut consumption in the number of 20-30 g servings per week, and academic performance data were obtained from school records. Analyses of covariance were adjusted for sociodemographic, anthropometric and lifestyle covariates, including total energy intake.

RESULTS

Among the 846 adolescents included in the analyses (55.3% girls, age range from 12 to 17 years), the mean ± standard deviation consumption of nuts was 2.7 ± 2.8 servings per week, while the mean of all school grades recorded was 6.5 ± 2.0. Furthermore, compared to no consumption, the consumption of ≥ 3 nut servings per week was consistently associated with higher grades in language (p for trend = 0.005), combination of language and math (p for trend = 0.026), grade point average (p for trend = 0.039), and combination of all school records (p for trend = 0.046). These associations were observed regardless of all covariates considered, although sex and socioeconomic level played a significant role in the completely adjusted models.

CONCLUSION

Nut consumption is associated with higher academic performance in a representative sample of Spanish adolescents. These cross-sectional results should be confirmed in longitudinal and intervention studies.

Mediterranean Dietary Patterns Related to Sleep Duration and Sleep-Related Problems among Adolescents: The EHDLA Study

PURPOSE

The aim of the present study was to examine the association of adherence to the Mediterranean Diet (MD) and its specific components with both sleep duration and sleep-related disorders in a sample of adolescents from the Valle de Ricote (Region of Murcia, Spain).

METHODS

This cross-sectional study included a sample of 847 Spanish adolescents (55.3% girls) aged 12-17 years. Adherence to the MD was assessed by the Mediterranean Diet Quality Index for Children and Teenagers. Sleep duration was reported by adolescents for weekdays and weekend days separately. The BEARS (Bedtime problems, Excessive daytime sleepiness, Awakenings during the night, Regularity and duration of sleep, and Sleep-disordered breathing) screening was used to evaluate issues related to sleep, which include difficulties at bedtime, excessive drowsiness during the day, waking up frequently during the night, irregularity, length of sleep, and breathing issues while sleeping.

RESULTS

Adolescents who presented a high adherence to the MD were more likely to meet the sleep recommendations (OR = 1.52, 95% CI 1.12-2.06, p = 0.008) and less likely to report at least one sleep-related problem (OR = 0.56, 95% CI 0.43-0.72, p < 0.001). These findings remained significant after adjusting for sex, age, socioeconomic status, waist circumference, energy intake, physical activity, and sedentary behavior, indicating a significant association of adherence to the MD with sleep outcomes (meeting sleep recommendations: OR = 1.40, 95% CI 1.00-1.96, p = 0.050; sleep-related problems: OR = 0.68, 95% CI 0.50-0.92, p = 0.012).

CONCLUSIONS

Adolescents with high adherence to the MD were more likely to report optimal sleep duration and fewer sleep-related problems. This association was more clearly observed for specific MD components, such as fruits, pulses, fish, having breakfast, dairies, sweets, and baked goods/pastries.

The relationship between health literacy and correlates of adolescents' obesogenic and substance use behaviors

PURPOSE

Risk perception (RP) and self-efficacy are targeted in adolescent health behavior interventions, however these variables have not been explored in relation to health literacy (HL). HL may affect how adolescents assess, prioritize, and integrate information when forming RP and self-efficacy and, ultimately, their health behaviors. This study assessed the relationship between functional, interactive, and critical HL and adolescents' behavior-specific RP and self-efficacy and health behaviors.

DESIGN AND METHODS

Cross-sectional data were collected from 380 adolescents attending high school via an online survey. Survey measures included demographics, functional, interactive, and critical HL, and substance use and obesogenic behavior-related beliefs, attitudes, and behaviors. Pearson correlations and regressions were estimated.

RESULTS

The relationship between HL and RP, self-efficacy, and behaviors varied by behavior and HL type. Critical HL was related to obesogenic-specific RP and behaviors, while interactive and critical HL were related to self-efficacy. Interactive and critical HL were related to substance use-specific RP and self-efficacy while functional and interactive HL were related to substance use behaviors. HL moderated several RP/behavior and self-efficacy/behavior relationships.

CONCLUSIONS

The significant relationships between HL and RP and self-efficacy highlight how HL may be an underlying factor or help shape adolescents' perceptions and beliefs adolescents have about behaviors and themselves, which ultimately influence their behaviors.

PRACTICAL IMPLICATIONS

Adolescent interventions should be assessed to determine what underlying HL skills are needed for behavior change and assess and address HL directly as adolescents with low HL may be at a disadvantage for intervention uptake and outcomes.

The Association Between Adolescent Active Commuting to School and Parent Walking Behavior: The FLASHE Study

PURPOSE

To examine the relationship between adolescent active commuting to school (ACS; walking or biking to/from school) and parent walking activity.

DESIGN

Cross-sectional.

SETTING

US nationwide online surveys.

SAMPLE

1367 parent-adolescent (12-17 years) dyads among the Family Life, Activity, Sun, Health, and Eating (FLASHE) study participants (29.4% response rate).

MEASURES

Online surveys asked about adolescent ACS and parent walking activity in the past week. Adolescents who reported ACS at least once in the past week were categorized as engaging in ACS. Parent walking frequency was categorized into 0-2, 3-5, and 6-7 days.

ANALYSIS

Logistic regression analysis was conducted to compare the probability of adolescent ACS by parent walking activity, adjusted for sociodemographic factors and adolescent-, parent-, and neighborhood-level covariates.

RESULTS

28.5% of adolescents engaged in ACS at least once in the past week. Compared to 0-2 days/week of parent walking activity, ORs for adolescent ACS for 3-5 and 6-7 days/week of parent walking activity were 1.98 (95% CI=1.38-2.87) and 1.81 (1.23-2.68), respectively. In stratified analyses by parent and adolescent sex, father-son dyads presented the strongest association between adolescent ACS and parent walking 3-5 and 6-7 days/week (ORs=4.17 [1.46-11.91] and 3.95 [1.45-10.77], respectively).

CONCLUSIONS

Adolescents with parents who engaged in walking activity ≥3 days/week were more likely to actively commute to school. Parent walking activity may have positive intergenerational effects on adolescent ACS and physical activity.

Development of the Children and Adolescents Physical Activity and Sedentary Questionnaire (CAPAS-Q): Psychometric Validity and Clinical Interpretation

BACKGROUND

Pediatricians' clinical practice and health interventions in youths require instruments with adequate psychometric properties to assess physical activity (PA), sedentary behaviors (SB), and their subdomains.

OBJECTIVE

To assess the psychometric properties of the Children and Adolescents Physical Activity and Sedentary-Questionnaire (CAPAS-Q) in healthy French children and adolescents.

METHODS

The CAPAS-Q has been developed through a rigorous collective procedure and consists of a 31 items self-administered questionnaire evaluating children's 7-day PA and SB dimensions and subdomains. Participants (n = 103, aged 8-18 years old) completed the questionnaire twice (7 days apart) and wore an ActiGraph GT3X&nbsp;+ accelerometer for 7 days. Anthropometric measurements and body composition were assessed.

RESULTS

Cronbach alpha for PA and SB dimensions were 0.71 and 0.68, respectively. Reproducibility was found moderate to good, with Lin's coefficients of 0.69 and 0.68 for PA and SB dimensions, respectively. Reproducibility was higher for adolescents compared to children. PA dimension was positively correlated with moderate PA, vigorous PA, moderate to vigorous PA, and total PA times and negatively correlated with SB time (p < 0.05). SB dimension and screen time were positively correlated with SB time and negatively correlated with LPA, MPA, MVPA, and total PA times (p < 0.05). Spearman correlation coefficients were fair to moderate, ranging between 0.23-0.45.

CONCLUSION

The CAPAS-Q proposes a reliable and valid evaluation of French children and adolescents' PA and SB, providing clinicians with potential intervention levels to improve youth movement behaviors.

Are adherence to the Mediterranean diet and siesta individually or jointly associated with blood pressure in Spanish adolescents? Results from the EHDLA study

Background

Both dietary and sleep patterns can influence both blood pressure levels and heart rate, but these associations have been understudied in adolescents. Furthermore, it is not known whether diet and sleep could exert a synergistic effect with respect to the maintenance of optimal BP levels in this population.

Objective

To investigate the relationship of blood pressure levels with the combination of higher adherence to the Mediterranean diet and the habit of siesta (daytime napping) in Spanish adolescents.

Methods

A cross-sectional study was conducted with data obtained through personal interviews and physical examination from a representative sample of 1,378 adolescents (12-17 years of age) from the Valle de Ricote (Region of Murcia, Spain) selected using a simple random sampling technique. Adherence to the Mediterranean diet was assessed with the Mediterranean Diet Quality Index in Children and Adolescents, and the frequency and duration of siesta were self-reported. Objective measurements of systolic and diastolic blood pressure were obtained under standardized conditions. Statistical procedures were performed with SPSS software (v.25) and included logistic and generalized regression models adjusted for sex, age, socioeconomic status, body mass index, total energy intake, nighttime sleep duration, and moderate-to-vigorous physical activity.

Results

Of the 698 adolescents finally studied (mean age 13.9 ± 1.5 years; 56.2% female), 37.1% (n = 259) had high adherence to the Mediterranean diet and 19.6% (n = 137) reported frequent siesta. In the completely adjusted models, compared to adolescents with low Mediterranean diet adherence and no or infrequent siesta, those with high Mediterranean diet adherence and frequent siesta were less likely to have high-normal blood pressure or hypertension (odds ratio = 0.47; 95% confidence interval: 0.26, 0.88) and showed slightly lower systolic blood pressure (ß-coef. = -2.60; 95% CI: -5.18, -0.02).

Conclusion

Greater adherence to the Mediterranean diet and frequent siesta have a synergistic effect on maintaining lower blood pressure levels in adolescence. These findings reinforce that adherence to both Mediterranean lifestyle behaviors early in life may be an important strategy to prevent hypertension throughout adulthood.

Intergenerational Determinants of Weight Status Concordance and Discordance in Parent/Adolescent Dyads from the Family Life, Activity, Sun, Health, and Eating Study

Background: Studies have shown that obesity (OB) has strong intergenerational linkages and tends to cluster in families, but there is a dearth of research examining the socioecological factors predictive of weight status concordance and discordance among parents and adolescents. Methods: We ran a stepwise multinomial logistic regression to assess for sociodemographic, individual-, and family-level predictors of four dyadic weight status groups using data from 1516 parent/adolescent dyads from the National Cancer Institute's Family Life, Activity, Sun, Health, and Eating Study. We categorized parent/adolescent dyads into one of four groups based on their BMI: (1) Healthy Weight Concordance (i.e., both parent and adolescent in the normal weight range); (2) overweight (OW)/OB Concordance (i.e., both parent and adolescent with OW or OB); (3) Discordance-Parent OW/OB (i.e., parent with OW/OB and adolescent in the normal weight range); or (4) Discordance-Adolescent OW/OB (i.e., adolescent with OW/OB and parent in the normal weight range). Results: There were 475 parent/adolescent dyads (31.3%) in the Healthy Weight Concordance group, 351 (23.2%) in the OW/OB Concordance group, 604 (39.8%) in the Discordance-Parent OW/OB group, and 86 (5.7%) in the Discordance-Adolescent OW/OB group. Being from a low socioeconomic family, identifying as a minority, and identifying as a male parent were associated with an OW/OB dyadic BMI. Higher levels of adolescent and parent emotional eating were significantly associated with parent/adolescent dyads being in the OW/OB Concordance group. Parent emotional eating was also associated with Discordance-Parent OW/OB. In contrast, parents' and adolescents' physical activity self-efficacy was associated with a Healthy Weight dyadic BMI vs. OW/OB Concordance or Discordance-Parent OW/OB. Conclusions: Our findings highlight the strength of OW/OB concordance in families, especially among lower socioeconomic and ethnic minority families and the significance of emotional eating and physical activity self-efficacy in contributing to BMI patterns among parents and adolescents.

Reexamining the Motivational Transfer Hypothesis of the Trans-Contextual Model Using Motivational Profiles

Purpose: The purpose of the study was to reexamine the motivational transfer hypothesis of the trans-contextual model from the perspective of individuals' motivational profiles. Methods: A total of 348 eighth-grade students participated in this study. Participants' motivation for physical education (PE) and physical activity (PA) and their out-of-school PA were measured. Results: Latent profile analysis revealed four similar motivational profiles for PE and PA-Motivated, Autonomous, Average, and Low-motivation. Proportion of agreement index showed that 43% of students had consistent motivational profiles for PE and PA. ANOVA and MANOVA showed that students with the Motivated, Autonomous, and Average profiles had the similar levels of out-of-school PA, which suggested that students with higher levels of self-determined types of motivation tended to have higher levels of out-of-school PA, no matter how high/low the level of their controlled types of motivation. Conclusion: These results partially support the propositions of the trans-contextual model.

Levels and Patterns of Physical Activity and Sedentary Behaviour of Primary School Learners in Lagos State, Nigeria

BACKGROUND

Physical activity (PA) and sedentary behaviour (SB) assessment in children is critical for the prevention of noncommunicable diseases. African studies examining PA and SB of primary school-age children are few. This study investigated PA, SB levels and their correlates among primary school children in Lagos, Nigeria.

METHOD

In a cross-sectional study of 733 learners, their self-reported PA and SB were assessed using the Children PA Questionnaire (CPAQ) (6-9 years age category) and Youth Activity Profile (YAP) (10-12 years age category) while pedometers were used for objective PA and SB assessment, and socioeconomic status (SES) index were measured using a structured questionnaire. Standardised procedures were used for anthropometric and cardiovascular measures. Results Based on CPAQ, 87.5% and 100% of the learners aged 6-9 years met the recommended PA and SB guidelines, respectively which were lower with pedometers (72.8% and 87.3%). The proportion of boys aged 6-9 years who met the guidelines for PA and SB (using pedometer) was significantly higher than that of the girls(PA: 80.7% vs. 64%, p = 0.018; SB: 94% vs. 80%, p = 0.008). Self-reported PA was positively associated with age (CPAQ: B = 455.39, p < 0.001; YAP: B = 1.638, p = 0.009) and negatively with SES (CPAQ: B = -201.39, p < 0.001; YAP: B = -1.000, p < 0.001). Objective PA was positively associated with waist to hip ratio(WHR) (6-9 years: B = 66090.24, p = 0.032) and negatively with sex (6-9 years: B = -5533.41, p = 0.027) and hip circumference (10-12 years: B = -1269.13, p = 0.017). SB was associated with SES in learners aged 10-12 years (B = -0.282, p = 0.003).

CONCLUSION

High SES is a major predictor of reduced PA among these cohort of learners.

Physical fitness and disordered eating among adolescents: Results from the EHDLA study

The aim of this study was to examine the association between a comprehensive spectrum of physical fitness components and disordered eating symptoms in a sample of Spanish adolescents. This cross-sectional study analysed a representative sample of 741 adolescents (55.1% girls) from the Eating Healthy and Daily Life Activities (EHDLA) study (Valle de Ricote, Region of Murcia, Spain). Objective physical fitness (i.e., cardiorespiratory fitness, upper body strength, lower body strength, speed-agility, and flexibility) was assesed by the ALPHA-FIT Test Battery for a young population. Disordered eating symptoms were assessed with the Sick, Control, One, Fat, Food (SCOFF) questionnaire. An incremental inverse association was found in participants with low cardiorespiratory fitness (OR = 2.33; 95% CI: 1.56-3.50), low handgrip strength (OR = 1.99; 95% CI: 1.33-2.97), low lower body strength (OR = 1.91; 95% CI: 1.28-2.86), low speed-agility (OR = 1.75; 95% CI: 1.17-2.62), and low global physical fitness (OR = 2.03; 95% CI: 1.37-3.01) and disordered eating symptoms, compared to participants with a high level of each of these physical fitness components. Our study provides evidence that, in Spanish adolescents, disordered eating symptoms are inversely associated with a comprehensive set of physical fitness components. Hence, it could be relevant to promote physical fitness, e.g., by a multifactorial approach, since it seems to be related to lower disordered eating symptoms in adolescents.

Cardiac cycle: an observational/interventional study protocol to characterise cardiopulmonary function and evaluate a home-based cycling program in children and adolescents born extremely preterm

INTRODUCTION

Extremely preterm (EP)/extremely low birthweight (ELBW) individuals may have an increased risk for adverse cardiovascular outcomes. Compared with term-born controls, these individuals have poorer lung function and reduced exercise capacity. Exercise interventions play an important role in reducing cardiopulmonary risk, however their use in EP/ELBW cohorts is unknown. This study, cardiac cycle, aims to characterise the cardiopulmonary system of children and adolescents who were born EP compared with those born at term, following acute and chronic exercise bouts.

METHODS AND ANALYSIS

The single-centre study comprises a home-based exercise intervention, with physiological characterisation at baseline and after completion of the intervention. Fifty-eight children and adolescents aged 10-18 years who were born EP and/or with ELBW will be recruited. Cardiopulmonary function assessed via measures of blood pressure, arterial stiffness, capillary density, peak oxygen consumption, lung clearance indexes and ventricular structure/function, will be compared with 58 age-matched and sex-matched term-born controls at baseline and post intervention. The intervention will consist of a 10-week stationary cycling programme, utilising Zwift technology.

ETHICS AND DISSEMINATION

The study is approved by the Ethics Committee of the Royal Children's Hospital Melbourne under HREC2019.053. Results will be disseminated via peer-reviewed journal regardless of outcome.

TRIAL REGISTRATION NUMBER

12619000539134, ANZCTR.

The Impact of Stand-Biased Desks on Afterschool Physical Activity Behaviors of Elementary School Children

The purpose of this secondary analysis was to assess whether students’ use of stand-biased desks during the school day influenced physical activity (PA) and sedentary behaviors (SB) during the afterschool period. By using a crossover design consisting of two 9-week intervention periods, 99 participants from grades 3, 4, and 6 were randomly assigned by their teacher to either a traditional (Group 1; sit−stand) or stand-biased (Group 2; stand−sit) desk in the classroom. The desk type then switched between intervention periods. Afterschool PA and SB were measured by accelerometry at baseline (fall) and following both intervention periods at post I (winter) and post II (spring). Independent sample t-tests and mixed-effects modeling were applied at a significance value of p < 0.05 to detect differences between groups. No significant differences in afterschool SB, light-intensity PA (LPA), or moderate- to vigorous-intensity PA (MVPA) were found between groups. There were also no significant two- or three-way interaction effects detected between desk assignment, time, and afterschool SB, LPA, or MVPA. Stand-biased desks in the classroom were not detrimental to children’s afterschool PA and SB.

Changes in children's wellbeing in Bradford during COVID-19: The Born in Bradford COVID-19 longitudinal research study

Background: Concerns have been raised about the potential impact of COVID-19 and associated lockdown measures on child mental wellbeing, but emerging evidence suggests mixed results and there is a dearth of information from ethnically diverse samples. The current study aims to explore the impact of the pandemic on wellbeing using longitudinal data collected from the multi-ethnic Born in Bradford family cohort study. Methods: Within-child changes in wellbeing were explored using data collected pre-pandemic and again during the first UK lockdown for 500 children aged 7-13 from a range of ethnic and socioeconomic backgrounds, using self-reported feelings of happiness and sadness. Associations between changes in wellbeing, demographic factors, quality of social relationships and physical activity levels were explored using multinomial logistic regression models. Results: In this sample, 55% of children reported no change in their wellbeing from pre-pandemic to during the first lockdown (n=264). Children of Pakistani heritage were more than twice as likely to report feeling sad less often than White British children (RRR: 2.61, 95% CI: 1.23, 5.51) during the first lockdown. Those who reported being left out by other children before the pandemic were over three times as likely than those who did not (RRR: 3.72: 1.51, 9.20) to report feeling sad less often during the pandemic. Around a third of children reported feeling happier (n=152, 31.6%), but these changes did not relate to any of the explanatory variables included in this analysis. Conclusion: Many children in this study reported no changes in their wellbeing during the first UK lockdown compared to before the pandemic and some described improved wellbeing. These findings suggest that children have coped well with the significant changes over the past year, though targeted support, particularly for those children who felt excluded before the pandemic, would be beneficial.

Using Implementation Mapping to develop and test an implementation strategy for active learning to promote physical activity in children: a feasibility study using a hybrid type 2 design

BACKGROUND

Incorporating physical movement in the teaching of academic content (active learning) is a promising approach to improve children's health and academic performance. Despite documented benefits, implementation of active learning remains challenging for schools. The aims of this study are to develop an implementation strategy to support the delivery of active learning in elementary schools and examine the impact of the developed implementation strategy on the implementation and effectiveness of active learning.

METHODS

Aim 1 will use Implementation Mapping, which is a multi-step approach that guides the use of theory, stakeholder input, and existing literature to develop a scientifically based implementation strategy for active learning in elementary schools. Aim 2 will feature a feasibility study to examine the impact of the implementation strategy on both implementation and effectiveness outcomes, consistent with a Hybrid Type 2 design. Acceptability and implementation fidelity will be the primary implementation outcomes, and student physical activity levels will be the primary effectiveness outcome. We will recruit two elementary schools within our partner district, and one will be randomly assigned to receive usual support while the other will receive the newly developed implementation strategy. Participants from each school will complete baseline, 6-, and 12-month assessments. Bayesian statistical approaches will quantitatively examine preliminary effectiveness outcomes. We will also use an embedded mixed methods approach to triangulate findings.

DISCUSSION

This study's innovative overarching conceptual framework (centered on Implementation Mapping) will inform the development and testing of the implementation strategy. This study also uses methodological approaches optimal for feasibility studies, including mixed methods and Bayesian statistics. As a result, we will be able to gain a thorough understanding about the feasibility and preliminary effectiveness of the implementation strategy, which will inform subsequent research and practice for implementing active learning in schools.

TRIAL REGISTRATION

ClinicalTrials.gov, NCT05048433 , registered on September 8, 2021.

The Eating Healthy and Daily Life Activities (EHDLA) Study

BACKGROUND

Childhood obesity is one of the greatest public health concerns facing advanced societies, Spain being one of the countries with the highest incidence. In this sense, the Region of Murcia has been pointed out as the Spanish autonomous community with the highest prevalence of excess weight among young people. More specifically, the Valle de Ricote has shown an even greater proportion of excess weight among young people. Several sociodemographic, environmental, lifestyle, health-related, cognitive, and psychological factors are related to excess weight. Based on the lack of information, this research project will try to provide relevant information to design intervention programs, as well as to implement effective public policies to try and reverse this alarming situation. Therefore, this research project aims (1) to obtain cross-sectional and longitudinal data on the excess weight and their potential sociodemographic, environmental, lifestyle, health-related, cognitive, and psychological factors associated among adolescents from the Valle de Ricote (Region of Murcia, Spain) (aged 12-17 years), and (2) to examine the association between excess weight and their potential sociodemographic, environmental, lifestyle, health-related, cognitive, and psychological factors associated among this population.

METHODS

A cross-sectional study and follow-up study will be performed. This research project will involve adolescents using a simple random sampling technique. A total of three secondary schools from the Valle de Ricote (Region of Murcia, Spain) will be included in this project. The minimum sample size will be 1138, establishing a 95% confidence interval, a 40% prevalence of excess weight, a 3% margin of error, and a non-response rate of 10%. Primary outcome measures will be: (1) anthropometric measurements, (2) sociodemographic factors, (3) environmental factors, (4) lifestyle factors, (5) health-related factors, (6) cognitive factors, and (7) psychological factors.

CONCLUSION

This research project will aim to determine the prevalence of excess weight and interrelate their potential sociodemographic, environmental, lifestyle, health-related, cognitive, and psychological factors associated. The obtained results will help to manage and propose possible multidisciplinary interventions and strategies in order to prevent and reduce the excess weight in adolescents from the Valle de Ricote. Furthermore, orientations will be given to transfer the obtained results to the public sector to evaluate or change the adopted policies.

Patterns of Screen Time Parenting Practices among Parent-Adolescent Dyads Who Participated in a Cross-Sectional Internet-Based Study

Background: Little is known about the simultaneous use of screen time (ST) parenting practices in children. Hence, study objectives were to determine patterns of ST parenting practices and associations with demographic, anthropometric, and sedentary behavior measures in parents and their adolescent children (12-17 years). Methods: Dyadic survey data from Family Life, Activity, Sun, Health, and Eating, a cross-sectional, internet-based study, conducted in 2014 were analyzed using latent class analysis on six ST parenting practices-permissive, rules/limits, monitoring, modeling, accessibility, and negotiated rules. Self-report model covariates included adolescent age and parent and adolescent sex, body weight category, and sedentary behavior. Results: Based on 1200 parent-adolescent dyads, five latent classes were identified representing a continuum of practice use (high to low)-Complete Influencers (16%, reference class), Disagreeing Influencers (18%), Positive Influencers (24%), Negative Influencers (23%), and Indifferent Influencers (20%). Disagreeing, Indifferent, and Negative Influencers were 50%-81% and 45%-49% less likely to contain younger adolescent dyads and male adolescent dyads, respectively. Dyads with adolescent overweight/obesity had twice the odds of belonging to one of the other four classes. Odds of belonging to one of the other four classes were 3%-9% lower for every 1 minute/day increase in adolescent sedentary behavior. Conclusions: Parents utilize distinct patterns of ST practices, which are differentially associated with adolescent age, sex, weight, and sedentary behavior. Advocating for parental use of combinations of practices, like rules/limits and monitoring, to decrease their adolescents' ST may prove more beneficial than no practice use.

Adolescents' Behaviors, Fitness, and Knowledge Related to Active Living before and during the COVID-19 Pandemic: A Repeated Cross-Sectional Analysis

Background: Nearly all schools in the United States experienced shutdown followed by phased reopening during the COVID-19 pandemic, thereby limiting students’ opportunities for physical activity (PA). This study aimed to examine adolescents’ PA at school (PAS) and PA out-of-school (PAO), screen-based sedentary behaviors (SbSB), health-related fitness, and knowledge understanding about PA and fitness before and during the pandemic. Methods: Three rounds of data were collected: Time 1 pre-pandemic (January 2020; n = 405), Time 2 schools partially reopened (February 2021; n = 412), and Time 3 schools fully reopened (March 2021; n = 450). Adolescents completed the Youth Activity Profile, the 20 m Progressive Aerobic Cardiovascular Endurance Run (PACER) test and Plank test, and a written test, to measure the behaviors (T1, T2, T3), fitness (T2–T3), and knowledge (T1, T2, T3), respectively. Results: Inferential statistical analyses revealed a significant time effect for the behaviors and fitness. From T1 to T2 PAO decreased but PAS increased; whereas SbSB decreased at T3 compared to T1 and T2. Health-related fitness improved from T2 to T3. Further, the change patterns for SbSB varied by grade, and those for knowledge understanding varied by gender. Conclusion: The findings confirm the disruptive impact of the COVID-19 pandemic on adolescents’ active living but varied by school grade and gender. The favorable changes from T2 to T3 observed for fitness and other constructs may be partially attributable to an interrupted fitness education intervention. The findings may guide the design and evaluation of future interventions addressing the physical inactivity pandemic during public health crises (e.g., COVID-19).

Changes in children's wellbeing in Bradford during COVID-19: The Born in Bradford COVID-19 longitudinal research study

Background: Concerns have been raised about the potential impact of COVID-19 and associated lockdown measures on child mental wellbeing, but emerging evidence suggests mixed results and there is a dearth of information from ethnically diverse samples. The current study aims to explore the impact of the pandemic on wellbeing using longitudinal data collected from the multi-ethnic Born in Bradford family cohort study. Methods: Within-child changes in wellbeing were explored using data collected pre-pandemic and again during the first UK lockdown for 500 children aged 7-13 from a range of ethnic and socioeconomic backgrounds, using self-reported feelings of happiness and sadness. Associations between changes in wellbeing, demographic factors, quality of social relationships and physical activity levels were explored using multinomial logistic regression models. Results: In this sample, 55% of children reported no change in their wellbeing from pre-pandemic to during the first lockdown (n=264). Children of Pakistani heritage were more than twice as likely to report feeling sad less often than White British children (RRR: 2.61, 95% CI: 1.23, 5.51) during the first lockdown, and those who reported being left out by other children before the pandemic were over three times as likely than those who did not (RRR: 3.72: 1.51, 9.20) to report feeling sad less often during the pandemic. Around a third of children reported feeling happier (n=152, 31.6%), but these changes did not relate to any of the explanatory variables included in this analysis. Conclusion: Many children in this study reported no changes in their wellbeing during the first UK lockdown compared to before the pandemic and some described improved wellbeing. These findings suggest that children have coped well with the significant changes over the past year, though targeted support, particularly for those children who felt excluded before the pandemic, would be beneficial.

Changes in Physical Activity Patterns Due to the Covid-19 Pandemic: A Systematic Review and Meta-Analysis

With the outbreak of the Corona Virus Disease 19 (Covid-19) in late 2019, governments increasingly imposed containment strategies, including social distancing as well as restricted population movement, potentially having negative impacts on mental and physical health. A growing number of studies have examined the impact of the pandemic on different facets of physical activity (PA); an overview combining these (mixed) results, however, is missing. Thus, the objective of this systematic review and meta-analysis was to investigate whether and to which extent PA changed from before to during the Covid-19 pandemic, taking age, gender, and measurement method into account. The literature search was conducted using PubMed, Web of Science, and Scopus. Results of the main characteristics were descriptively synthesized and analyzed in a meta-analysis quantifying effects of the pandemic on PA divided by age groups, with additional subgroup analyses of the characteristics age, gender, and measurement method being narratively synthesized. Overall, 57 studies with a total sample size of 119,094 participants (N between 10 and 60,560 subjects) from 14 countries worldwide with participants aged between four and 93 years were included. Thirty-two studies revealed a significant decline in PA, whereas only five studies found a significant increase in PA during the Covid-19 pandemic. Fourteen studies revealed mixed results. PA decreased in all age groups, independent of gender. Most self-reported and all device-based measurement methods showed a reduction in PA. However, effects were not found to be significant in all age groups. Nevertheless, the declining trend should be noted and governments should strive to enable PA within periods of pandemic restrictions, or promote alternatives such as digital training to avoid negative health consequences within the population.

Associations of Social Jetlag with Dietary Behavior, Physical Activity and Obesity among Chinese Adolescents

This study aimed to investigate the associations between social jetlag (SJL), dietary behavior, physical activity, and weight status in Chinese youth. Data were derived from a cross-sectional survey in Wuhan, China in 2019. Information on SJL, the frequency of food and beverage consumption, physical activity, and BMI category were collected via a self-reported questionnaire. The Kruskal-Wallis test and ANOVA were conducted to determine differences in daily consumption frequency of food and beverage groups, BMI category, and physical activity among SJL groups. Logistic regressions and restricted cubic splines were performed to test the association between SJL and the incidence of overweight or obesity. A final sample of 3567 Chinese adolescents [mean (SD) age, 14.67 (1.72) years; 47.41% (1691) female] were included. Our findings demonstrated that adolescents with SJL may consume more unhealthy foods and fewer beneficial foods, while engaging in less moderate to vigorous physical activity (MVPA) and reporting higher BMIs. In addition, adolescents who experience more than 2 h of SJL had significant greater risk of overweight or obesity. Our findings on SJL of Chinese adolescents confirm the harmful effects of SJL and also provide insights into the etiology of obesity in Chinese adolescents.

Associations Between Parents’ Health and Social Control Behaviors and Their Adolescent’s Self-Efficacy and Health Behaviors: Insights From the Family Life, Activity, Sun, Health, and Eating (FLASHE) survey

Background

Parents can influence their children to live healthier lifestyles by modeling healthy behaviors and/or trying to persuade their children to engage in healthier activities. Adolescents and their parents tend to have similar eating and exercise patterns, but less is known about the simultaneous influence of parent’s health behavior and social control on adolescents’ self-efficacy and health behaviors, including whether their effect is moderated by parenting style.

Purpose

We examine the degree to which parents’ social control and health behaviors are associated with their adolescent’s self-efficacy and health behaviors, including whether parenting styles moderate these associations.

Method

We analyzed data from the Family Life, Activity, Sun, Health, and Eating project.

Results

We found that parents’ own health behaviors are positively and strongly associated with their adolescent’s health behaviors across four domains: fruit/vegetable consumption, junk food consumption, physical activity, and nonacademic screen time. We found positive, moderate-to-strong associations between parents’ use of social control and their adolescents’ fruit/vegetable and junk food consumption, small negative associations with screen time, and no associations with physical activity. The effects of social control for junk food consumption and screen time, however, depended on parents’ own behavior in those domains. Parent responsiveness moderated the relation between parents’ social control and their adolescent children’s self-efficacy and health behaviors.

Conclusions

The health behaviors parents model and their social control efforts are associated with their adolescents’ beliefs and behavior. Efforts to leverage parents as sources of influence must consider the context in which influence is enacted.

Time spent in different sedentary activity domains across adolescence: a follow-up study

OBJECTIVE

This longitudinal study aimed to verify possible changes in the time spent in sedentary activities occurring as screen-time, educational, cultural, social, and transportation domains in a sample of Brazilian adolescents between 2015 and 2017.

METHODS

It is a longitudinal prospective study with 586 adolescents from 12 to 15 years old at the Baseline (2015) enrolled in 14 public schools from Curitiba, Brazil. The Adolescent Sedentary Activity Questionnaire assessed the time spent in sedentary activities in five domains (recreational screen-time, educational, cultural, social, and transportation). A series of linear random effects regressions analyzed changes in the sedentary time between 2015 and 2017, with p < .05.

RESULTS

Overall, 323 adolescents dropped out of the study resulting in a retention rate of 44.9%. The overall sedentary time remained stable from 2015 to 2017 (-3.98 min/day, 95%CI: -15.39; 7.42). The screen-time decreased (-22.22 min/day, 95%CI: -30.30; -14.15), and educational (8.29 min/day, 95% CI: 3.52; 13.06), cultural (3.41 min/day, 95% CI: 0.66; 6.15) and social sedentary activities (8.20 min/day, 95% CI: 2.06; 14.34) increased from 2015 to 2017.

CONCLUSION

Significant reductions in screen-time were evidenced along with increases in time spent on other sedentary activities of educational, cultural, and social nature. KeywordsSedentary behavior, Adolescent health, Longitudinal studies.

A protocol for coordinating rural community stakeholders to implement whole-of-community youth physical activity surveillance through school systems

Accurate and effective local data collection systems are needed to inform community change on youth health behaviors such as physical activity (PA). Systematic methods are particularly important for understanding PA behaviors that may be influenced by individual, interpersonal, organizational, and regional factors. The purpose of this study was to describe a protocol for coordinating community stakeholders to implement an online youth PA surveillance instrument. The research team collaborated with local health departments (LHDs) from two rural communities to coordinate schools in implementing school-wide youth PA surveillance. A data sharing agreement was established between all partners. School administrators and teachers attended in-person training sessions for an online PA survey and how to use the data. Following the training, students were provided individualized logins to complete the survey once a semester over a two-year academic period. Across both communities, 23 teachers and administrators attended the training sessions that were facilitated by the LHDs and research team. In Year 1 (Y1), a total of 465 3rd through 6th grade students were enrolled in the participating schools (community 1 = 227; community 2 = 238). Survey response rates ranged from 86.1% to 95.4% completion, depending on the community and semester. In Year 2 (Y2), a total of 501 3rd through 6th grade students were enrolled (community 1 = 260; community 2 = 241). Response rates ranged from 86.3% to 89.6% in the fall term. A protocol for coordinating LHD and community stakeholders was an effective strategy for implementing population-level youth PA surveillance with high levels of reach.

Covid-19 lockdown: Ethnic differences in children's self-reported physical activity and the importance of leaving the home environment; a longitudinal and cross-sectional study from the Born in Bradford birth cohort study

BACKGROUND

In England, the onset of COVID-19 and a rapidly increasing infection rate resulted in a lockdown (March-June 2020) which placed strict restrictions on movement of the public, including children. Using data collected from children living in a multi-ethnic city with high levels of deprivation, this study aimed to: (1) report children's self-reported physical activity (PA) during the first COVID-19 UK lockdown and identify associated factors; (2) examine changes of children's self-reported PA prior to and during the first UK lockdown.

METHODS

This study is part of the Born in Bradford (BiB) COVID-19 Research Study. PA (amended Youth Activity Profile), sleep, sedentary behaviours, daily frequency/time/destination/activity when leaving the home, were self-reported by 949 children (9-13 years). A sub-sample (n = 634) also self-reported PA (Physical Activity Questionnaire for Children) pre-pandemic (2017-February 2020). Univariate analysis assessed differences in PA between sex and ethnicity groups; multivariable logistic regression identified factors associated with children's PA. Differences in children's levels of being sufficiently active prior to and during the lockdown were examined using the McNemar test; and multivariable logistic regression was used to identify factors explaining change.

RESULTS

During the pandemic, White British (WB) children were more sufficiently active (34.1%) compared to Pakistani Heritage children (PH) (22.8%) or 'Other' ethnicity children (O) (22.8%). WB children reported leaving the home more frequently and for longer periods than PH and O children. Modifiable variables related to being sufficiently active were frequency, duration, type of activity, and destination away from the home environment. There was a large reduction in children being sufficiently active during the first COVID-19 lockdown (28.9%) compared to pre-pandemic (69.4%).

CONCLUSIONS

Promoting safe extended periods of PA everyday outdoors is important for all children, in particular for children from ethnic minority groups. Children's PA during the first COVID-19 UK lockdown has drastically reduced from before. Policy and decision makers, and practitioners should consider the findings in order to begin to understand the impact and consequences that COVID-19 has had upon children's PA which is a key and vital behaviour for health and development.

Calibration of the Online Youth Activity Profile Assessment for School-Based Applications

A balance between the feasibility and validity of measures is an important consideration for physical activity research - particularly in school-based research with youth. The present study extends previously tested calibration methods to develop and test new equations for an online version of the Youth Activity Profile (YAP) tool, a self-report tool designed for school applications. Data were collected across different regions and seasons to develop more robust, generalizable equations. The study involved a total of 717 youth from 33 schools (374 elementary (ages 9-11), 224 middle (ages 11-14), and 119 high school (ages 14-18)) in two different states in the U.S. Participants wore a Sensewear monitor for a full week and then completed the online YAP at school to report physical activity (PA) and sedentary behaviors (SB) in school and at home. Accelerometer data were processed using an R-based segmentation program to compute PA and SB levels. Quantile regression models were used with half of the sample to develop item-specific YAP calibration equations and these were cross validated with the remaining half of the sample. Computed values of Mean Absolute Percent Error (MAPE) ranged from 15-25% with slightly lower error observed for the middle school sample. The new equations had improved precision compared to the previous versions when tested on the same sample. The online version of the YAP provides an efficient and effective way to capture school level estimates of PA and SB in youth.