1
|
Kracht CL, Beyl RA, Maher JP, Katzmarzyk PT, Staiano AE. Adolescents' sedentary time, affect, and contextual factors: An ecological momentary assessment study. Int J Behav Nutr Phys Act 2021; 18:53. [PMID: 33858416 PMCID: PMC8047569 DOI: 10.1186/s12966-021-01121-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Accepted: 04/08/2021] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Few adolescents achieve sufficient levels of physical activity, and many are spending most of their time in sedentary behavior. Affective response following sedentary time may influence motivation to remain sedentary. Ecological Momentary Assessment (EMA) is a real-time data capture methodology that can be used to identify factors influencing sedentary time, such as the context of the home setting, and resulting affective state within a free-living setting. The purpose of this study was to evaluate the relationship between context at home and adolescent sedentary time, and the relationship of sedentary time and subsequent affect. METHODS Adolescents (n = 284; 10-16 y) participated in an EMA study that used random, interval-based sampling methods. Adolescents each received 22 unannounced surveys over 7-days through a smartphone application. One survey was randomly sent within each 2-h time-period. These time-periods occurred between 4:00 pm-8:00 pm on weekdays and 8:00 am-8:00 pm on the weekend. This 15-question survey included a series of questions on context (indoors/outdoors, alone/not alone) and positive affect. Adolescents concurrently wore an accelerometer at the hip, and the 30-min bout of accelerometry data prior to each survey was used in analyses. Mixed-effect location scale models were used to examine the association between context at home and sedentary time (stage 1) and the adjusted sedentary time and positive affect (stage 2), with each model adjusted for covariates. RESULTS Adolescents were 12.6 ± 1.9 y of age on average, about half were White (58%), and engaged in high levels of sedentary behavior during the 30 min prior to the survey (21.4 ± 6.8 min). Most surveys occurred when adolescents were with others (59%) and indoors (88%). In Stage 1, both being alone and being indoors at home were positively associated with sedentary time (p < 0.001 for both). In Stage 2, adjusted sedentary time was not related to positive affect. Age was negatively related to positive affect (p < 0.001). CONCLUSIONS Both contextual factors, being alone and indoors at home, were related to additional time spent sedentary compared to being with someone or outdoors. After adjustment, sedentary time was not related to subsequent positive affect, indicating other factors may be related to adolescent's positive affect in home settings.
Collapse
Affiliation(s)
- Chelsea L Kracht
- Pennington Biomedical Research Center, 6400 Perkins Road, Baton Rouge, LA, 70808, USA
| | - Robbie A Beyl
- Pennington Biomedical Research Center, 6400 Perkins Road, Baton Rouge, LA, 70808, USA
| | - Jaclyn P Maher
- University of North Carolina Greensboro, 1408 Walker Ave., Greensboro, NC, 27412, USA
| | - Peter T Katzmarzyk
- Pennington Biomedical Research Center, 6400 Perkins Road, Baton Rouge, LA, 70808, USA
| | - Amanda E Staiano
- Pennington Biomedical Research Center, 6400 Perkins Road, Baton Rouge, LA, 70808, USA.
| |
Collapse
|
2
|
Zapata-Lamana R, Lalanza JF, Losilla JM, Parrado E, Capdevila L. mHealth technology for ecological momentary assessment in physical activity research: a systematic review. PeerJ 2020; 8:e8848. [PMID: 32257648 PMCID: PMC7103204 DOI: 10.7717/peerj.8848] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Accepted: 03/03/2020] [Indexed: 12/28/2022] Open
Abstract
OBJECTIVE To systematically review the publications on ecological momentary assessment (EMA) relating to physical activity (PA) behavior in order to classify the methodologies, and to identify the main mHealth technology-based tools and procedures that have been applied during the first 10 years since the emergence of smartphones. As a result of this review, we want to ask if there is enough evidence to propose the use of the term "mEMA" (mobile-based EMA). DESIGN A systematic review according to PRISMA Statement (PROSPERO registration: CRD42018088136). METHOD Four databases (PsycINFO, CINALH, Medline and Web of Science Core Collection) were searched electronically from 2008 to February 2018. RESULTS A total of 76 studies from 297 potential articles on the use of EMA and PA were included in this review. It was found that 71% of studies specifically used "EMA" for assessing PA behaviors but the rest used other terminology that also adjusted to the inclusion criteria. Just over half (51.3%) of studies (39) used mHealth technology, mainly smartphones, for collecting EMA data. The majority (79.5%) of these studies (31 out of 39) were published during the last 4 years. On the other hand, 58.8% of studies that only used paper-and-pencil were published during the first 3 years of the 10-year period analyzed. An accelerometer was the main built-in sensor used for collecting PA behavior by means of mHealth (69%). Most of the studies were carried out on young-adult samples, with only three studies in older adults. Women were included in 60% of studies, and healthy people in 82%. The studies lasted between 1 and 7 days in 57.9%, and between three and seven assessments per day were carried out in 37%. The most popular topics evaluated together with PA were psychological state and social and environmental context. CONCLUSIONS We have classified the EMA methodologies used for assessing PA behaviors. A total of 71% of studies used the term "EMA" and 51.3% used mHealth technology. Accelerometers have been the main built-in sensor used for collecting PA. The change of trend in the use of tools for EMA in PA coincides with the technological advances of the last decade due to the emergence of smartphones and mHealth technology. There is enough evidence to use the term mEMA when mHealth technology is being used for monitoring real-time lifestyle behaviors in natural situations. We define mEMA as the use of mobile computing and communication technologies for the EMA of health and lifestyle behaviors. It is clear that the use of mHealth is increasing, but there is still a lot to be gained from taking advantage of all the capabilities of this technology in order to apply EMA to PA behavior. Thus, mEMA methodology can help in the monitoring of healthy lifestyles under both subjective and objective perspectives. The tendency for future research should be the automatic recognition of the PA of the user without interrupting their behavior. The ecological information could be completed with voice messages, image captures or brief text selections on the touch screen made in real time, all managed through smartphone apps. This methodology could be extended when EMA combined with mHealth are used to evaluate other lifestyle behaviors.
Collapse
Affiliation(s)
| | - Jaume F. Lalanza
- Department of Basic Psychology, Universitat Autónoma de Barcelona, Bellaterra, Spain
| | - Josep-Maria Losilla
- Department of Psychobiology and Methodology of Health Science, Universitat Autónoma de Barcelona, Bellaterra, Spain
- Sport Research Institute UAB, Universitat Autònoma de Barcelona, Bellaterra, Spain
| | - Eva Parrado
- Department of Basic Psychology, Universitat Autónoma de Barcelona, Bellaterra, Spain
- Sport Research Institute UAB, Universitat Autònoma de Barcelona, Bellaterra, Spain
| | - Lluis Capdevila
- Department of Basic Psychology, Universitat Autónoma de Barcelona, Bellaterra, Spain
- Sport Research Institute UAB, Universitat Autònoma de Barcelona, Bellaterra, Spain
| |
Collapse
|
3
|
Petteway R, Mujahid M, Allen A, Morello-Frosch R. Towards a People's Social Epidemiology: Envisioning a More Inclusive and Equitable Future for Social Epi Research and Practice in the 21st Century. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E3983. [PMID: 31635327 PMCID: PMC6843593 DOI: 10.3390/ijerph16203983] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Revised: 10/13/2019] [Accepted: 10/16/2019] [Indexed: 12/17/2022]
Abstract
Social epidemiology has made critical contributions to understanding population health. However, translation of social epidemiology science into action remains a challenge, raising concerns about the impacts of the field beyond academia. With so much focus on issues related to social position, discrimination, racism, power, and privilege, there has been surprisingly little deliberation about the extent and value of social inclusion and equity within the field itself. Indeed, the challenge of translation/action might be more readily met through re-envisioning the role of the people within the research/practice enterprise-reimagining what "social" could, or even should, mean for the future of the field. A potential path forward rests at the nexus of social epidemiology, community-based participatory research (CBPR), and information and communication technology (ICT). Here, we draw from social epidemiology, CBPR, and ICT literatures to introduce A People's Social Epi-a multi-tiered framework for guiding social epidemiology in becoming more inclusive, equitable, and actionable for 21st century practice. In presenting this framework, we suggest the value of taking participatory, collaborative approaches anchored in CBPR and ICT principles and technological affordances-especially within the context of place-based and environmental research. We believe that such approaches present opportunities to create a social epidemiology that is of, with, and by the people-not simply about them. In this spirit, we suggest 10 ICT tools to "socialize" social epidemiology and outline 10 ways to move towards A People's Social Epi in practice.
Collapse
Affiliation(s)
- Ryan Petteway
- OHSU-PSU School of Public Health, Portland State University, Portland, OR 97201, USA.
| | - Mahasin Mujahid
- School of Public Health, University of California, Berkeley, CA 94720, USA.
| | - Amani Allen
- School of Public Health, University of California, Berkeley, CA 94720, USA.
| | | |
Collapse
|
4
|
Barnett TA, Kelly AS, Young DR, Perry CK, Pratt CA, Edwards NM, Rao G, Vos MB. Sedentary Behaviors in Today's Youth: Approaches to the Prevention and Management of Childhood Obesity: A Scientific Statement From the American Heart Association. Circulation 2019; 138:e142-e159. [PMID: 30354382 DOI: 10.1161/cir.0000000000000591] [Citation(s) in RCA: 79] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This scientific statement is about sedentary behavior and its relationship to obesity and other cardiometabolic outcomes in youth. A deleterious effect of sedentary behavior on cardiometabolic health is most notable for screen-based behaviors and adiposity; however, this relation is less apparent for other cardiometabolic outcomes or when sedentary time is measured with objective movement counters or position monitors. Increasing trends of screen time are concerning; the portability of screen-based devices and abundant access to unlimited programming and online content may be leading to new patterns of consumption that are exposing youth to multiple pathways harmful to cardiometabolic health. This American Heart Association scientific statement provides an updated perspective on sedentary behaviors specific to modern youth and their impact on cardiometabolic health and obesity. As we reflect on implications for practice, research, and policy, what emerges is the importance of understanding the context in which sedentary behaviors occur. There is also a need to capture the nature of sedentary behavior more accurately, both quantitatively and qualitatively, especially with respect to recreational screen-based devices. Further evidence is required to better inform public health interventions and to establish detailed quantitative guidelines on specific sedentary behaviors in youth. In the meantime, we suggest that televisions and other recreational screen-based devices be removed from bedrooms and absent during meal times. Daily device-free social interactions and outdoor play should be encouraged. In addition, parents/guardians should be supported to devise and enforce appropriate screen time regulations and to model healthy screen-based behaviors.
Collapse
|
5
|
Crossley SGM, McNarry MA, Eslambolchilar P, Knowles Z, Mackintosh KA. The Tangibility of Personalized 3D-Printed Feedback May Enhance Youths' Physical Activity Awareness, Goal Setting, and Motivation: Intervention Study. J Med Internet Res 2019; 21:e12067. [PMID: 31199322 PMCID: PMC6592490 DOI: 10.2196/12067] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Revised: 03/13/2019] [Accepted: 03/31/2019] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND In the United Kingdom, most youth fail to achieve the government guideline of 60 min of moderate to vigorous physical activity (MVPA) daily. Reasons that are frequently cited for the underachievement of this guideline include (1) a lack of awareness of personal physical activity levels (PALs) and (2) a lack of understanding of what activities and different intensities contribute to daily targets of physical activity (PA). Technological advances have enabled novel ways of representing PA data through personalized tangible three-dimensional (3D) models. OBJECTIVE The purpose of this study was to investigate the efficacy of 3D-printed models to enhance youth awareness and understanding of and motivation to engage in PA. METHODS A total of 39 primary school children (22 boys; mean age 7.9 [SD 0.3] years) and 58 secondary school adolescents (37 boys; mean age 13.8 [SD 0.3] years) participated in a 7-week fading intervention, whereby participants were given 3D-printed models of their previous week's objectively assessed PALs at 4 time points. Following the receipt of their 3D model, each participant completed a short semistructured video interview (children, 4.5 [SD 1.2] min; adolescents, 2.2 [SD 0.6] min) to assess their PA awareness, understanding, and motivation. Data were transcribed verbatim and thematically analyzed to enable key emergent themes to be further explored and identified. RESULTS Analyses revealed that the 3D models enhanced the youths' awareness of and ability to recall and self-evaluate their PA behaviors. By the end of the study, the youths, irrespective of age, were able to correctly identify and relate to the government's PA guideline represented on the models, despite their inability to articulate the government's guideline through time and intensity. Following the fourth 3D model, 72% (71/97) of the youths used the models as a goal-setting strategy, further highlighting such models as a motivational tool to promote PA. CONCLUSIONS The results suggest that 3D-printed models of PA enhanced the youths' awareness of their PA levels and provided a motivational tool for goal setting, potentially offering a unique strategy for future PA promotion.
Collapse
Affiliation(s)
- Sam Graeme Morgan Crossley
- School of Sport and Exercise Sciences, Applied Sports Technology Exercise and Medicine Research Centre, Swansea University, Swansea, United Kingdom
| | - Melitta Anne McNarry
- School of Sport and Exercise Sciences, Applied Sports Technology Exercise and Medicine Research Centre, Swansea University, Swansea, United Kingdom
| | - Parisa Eslambolchilar
- School of Computer Science and Informatics, Human Factors Technology Research Priority Area, Cardiff University, Cardiff, United Kingdom
| | - Zoe Knowles
- School of Sport and Exercise Sciences, Physical Activity Exchange, Liverpool John Moores University, Liverpool, United Kingdom
| | - Kelly Alexandra Mackintosh
- School of Sport and Exercise Sciences, Applied Sports Technology Exercise and Medicine Research Centre, Swansea University, Swansea, United Kingdom
| |
Collapse
|
6
|
Romanzini CLP, Romanzini M, Batista MB, Barbosa CCL, Shigaki GB, Dunton G, Mason T, Ronque ERV. Methodology Used in Ecological Momentary Assessment Studies About Sedentary Behavior in Children, Adolescents, and Adults: Systematic Review Using the Checklist for Reporting Ecological Momentary Assessment Studies. J Med Internet Res 2019; 21:e11967. [PMID: 31094349 PMCID: PMC6540725 DOI: 10.2196/11967] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2018] [Revised: 11/28/2018] [Accepted: 12/09/2018] [Indexed: 12/13/2022] Open
Abstract
Background The use of ecological momentary assessment (EMA) to measure sedentary behavior (SB) in children, adolescents, and adults can increase the understanding of the role of the context of SB in health outcomes. Objective The aim of this study was to systematically review literature to describe EMA methodology used in studies on SB in youth and adults, verify how many studies adhere to the Methods aspect of the Checklist for Reporting EMA Studies (CREMAS), and detail measures used to assess SB and this associated context. Methods A systematic literature review was conducted in the PubMed, Scopus, Web of Science, PsycINFO, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and SPORTDiscus databases, covering the entire period of existence of the databases until January 2018. Results This review presented information about the characteristics and methodology used in 21 articles that utilized EMA to measure SB in youth and adults. There were more studies conducted among youth compared with adults, and studies of youth included more waves and more participants (n=696) than studies with adults (n=97). Most studies (85.7%) adhered to the Methods aspect of the CREMAS. The main criteria used to measure SB in EMA were self-report (81%) with only 19% measuring SB using objective methods (eg, accelerometer). The main equipment to collect objective SB was the ActiGraph, and the cutoff point to define SB was <100 counts/min. Studies most commonly used a 15-min window to compare EMA and accelerometer data. Conclusions The majority of studies in this review met minimum CREMAS criteria for studies conducted with EMA. Most studies measured SB with EMA self-report (n=17; 81.0%), and a few studies also used objective methods (n=4; 19%). The standardization of the 15-min window criteria to compare EMA and accelerometer data would lead to a comparison between these and new studies. New studies using EMA with mobile phones should be conducted as they can be considered an attractive method for capturing information about the specific context of SB activities of young people and adults in real time or very close to it.
Collapse
Affiliation(s)
| | - Marcelo Romanzini
- Londrina State University, Department of Physical Education, Londrina, Brazil
| | | | | | - Gabriela Blasquez Shigaki
- Rio Preto University Center, Department of Physical Education, São José do Rio Preto, Brazil.,Paulista University, Department of Physical Education, São José do Rio Preto, Brazil
| | - Genevieve Dunton
- University of Southern California, Department of Preventive Medicine, Los Angeles, CA, United States
| | - Tyler Mason
- University of Southern California, Department of Preventive Medicine, Los Angeles, CA, United States
| | | |
Collapse
|
7
|
Van Rooij AJ, Nijkamp LM. Addressing problematic video game use: A multimethod, dual-context perspective on leisure-time use. J Behav Addict 2018; 7:526-530. [PMID: 30010408 PMCID: PMC6426383 DOI: 10.1556/2006.7.2018.62] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
A more integrative approach to the prevention of problematic gaming behavior is recommended in Király et al.'s review. We discuss the Dutch policy responses to problematic gaming behavior and suggest two alternatives to the dominant survey research approach to achieve this. Employing time-use/diary studies allows us to map out the full scope of leisure-time use and employing log-data analysis improves our understanding of gamer behavior within the virtual context. All of these approaches would benefit from accounting for the diversity of within-virtual context behavior. The approach is summarized as a multimethod, dual-context approach to understanding leisure-time behavior.
Collapse
Affiliation(s)
- Antonius J. Van Rooij
- Department of Youth & Risky Behavior, Trimbos Institute, Utrecht, The Netherlands,Corresponding author: Antonius J. Van Rooij, PhD; Department of Youth & Risky Behavior, Trimbos Institute, Da Costakade 45, 3521 VS, Utrecht, The Netherlands; Phone: +31 30 29 59 343; E-mail:
| | - Laura M. Nijkamp
- Department of Youth & Risky Behavior, Trimbos Institute, Utrecht, The Netherlands
| |
Collapse
|
8
|
Li M, Xue H, Wang W, Wang Y. Parental Expectations and Child Screen and Academic Sedentary Behaviors in China. Am J Prev Med 2017; 52:680-689. [PMID: 28108188 DOI: 10.1016/j.amepre.2016.12.006] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2016] [Revised: 10/27/2016] [Accepted: 12/06/2016] [Indexed: 11/19/2022]
Abstract
INTRODUCTION This study examined sociodemographic patterns of parental expectations for academic performance, terminal degree, and future occupation for middle school students in China, and how these expectations influence students' screen-based and academic-related sedentary behaviors through parenting control practices. METHODS Based on data collected in 2013-2014 from 19,487 Chinese middle school students, bivariate logistic regressions tested associations between sociodemographic variables and parental expectations; structural equation models tested associations between parental expectations and students' self-reported daily time on TV/Internet/homework, with parental controls as potential mediators. Analyses were performed in October 2015. RESULTS Chinese students spent 0.96 (SD=1.44) hours/day on TV, 0.56 (SD=1.20) on Internet use, and 2.79 (SD=2.07) on homework. Girls spent more hours/day on homework (2.98 [SD=2.07] vs 2.62 [SD=2.04]) than boys but less on TV (0.90 [SD=1.37] vs 1.02 [SD=1.50]) and Internet (0.42 [SD=0.98] vs 0.69 [SD=1.36]). More than 30% of students were expected by parents to reach the top five of their class, almost 90% were expected to earn a college degree or higher, and >80% were expected to have a professional occupation. Students in rural areas, with siblings, and with lower parental SES tended to bear lower parental expectations. Children experiencing higher parental expectations spent more time on homework but less time on TV/Internet, partially explained by stricter parental homework and screen control. CONCLUSIONS High parental expectations suppress screen use but promote academic-related sedentary behaviors for Chinese children. Interventions should attend to academic-related sedentary behaviors and call for broader policies addressing sociocultural factors fueling high parental expectations.
Collapse
Affiliation(s)
- Miao Li
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, State University of New York, Buffalo, New York
| | - Hong Xue
- Fisher Institute of Health and Well-Being, Ball State University, Muncie, Indiana
| | - Weidong Wang
- Department of Sociology, Renmin University of China, Haidian District, Beijing, China
| | - Youfa Wang
- Fisher Institute of Health and Well-Being, Ball State University, Muncie, Indiana.
| |
Collapse
|
9
|
Sedentary Behavior Is Independently Related to Fat Mass among Children and Adolescents in South China. Nutrients 2016. [DOI: 10.3390/nu8110667 pmid: 27792134] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
|
10
|
Xue H, Tian G, Duan R, Quan L, Zhao L, Yang M, Libuda L, Muckelbauer R, Cheng G. Sedentary Behavior Is Independently Related to Fat Mass among Children and Adolescents in South China. Nutrients 2016; 8:E667. [PMID: 27792134 PMCID: PMC5133055 DOI: 10.3390/nu8110667] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2016] [Revised: 10/12/2016] [Accepted: 10/17/2016] [Indexed: 11/17/2022] Open
Abstract
We aim to explore the independent associations of sedentary behaviors (SB) with body mass distribution among Chinese children. Data on the screen-based sedentary time (television viewing and computer use) and doing homework, physical activities and dietary intake of 1586 Chinese children (50.3% girls) aged 7-15 years were obtained through validated questionnaires. Skin-fold thickness, body height, and weight were measured to calculate percent body fat (%BF), fat mass index (FMI), and fat-free mass index (FFMI). Parental characteristics were collected by questionnaires. Among girls, time of SB (screen time or doing homework) was positively related to %BF, FMI, and FFMI (p < 0.03) after adjusting for maternal overweight, the average annual income of family, moderate-to-vigorous physical activity energy expenditure, and energy intake: Girls in the highest tertile of screen time/homework had 16.7%/23.3% higher relative FMI and 2.9%/2.9% higher relative FFMI than girls in the lowest tertile. Among boys, screen time was positively associated with FFMI (p < 0.003), but not related to %BF and FMI (p > 0.09), while time of doing homework was positively related to %BF and FMI (p = 0.03). Sedentary behaviors might be positively and independently related to fat mass among Chinese children, and were more pronounced in girls.
Collapse
Affiliation(s)
- Hongmei Xue
- Department of Nutrition, Food Safety and Toxicology, West China School of Public Health, Sichuan University, Chengdu 610041, China.
| | - Guo Tian
- Department of Nutrition, Food Safety and Toxicology, West China School of Public Health, Sichuan University, Chengdu 610041, China.
| | - Ruonan Duan
- Department of Clinical Nutrition, Jincheng People's Hospital, Jincheng 048026, China.
| | - Liming Quan
- Office of Scientific Research Management, West China School of Public Health, Sichuan University, Chengdu 610041, China.
| | - Li Zhao
- West China Research Center for Rural Health Development, Sichuan University Huaxi Medical Center, Chengdu 610041, China.
| | - Min Yang
- West China Research Center for Rural Health Development, Sichuan University Huaxi Medical Center, Chengdu 610041, China.
| | - Lars Libuda
- Department of Child and Adolescent Psychiatry, University Hospital Essen, University of Duisburg-Essen, Essen, Duisburg 47057, Germany.
- Department of Pediatrics, Research Institute for the Prevention of Allergies and Respiratory Diseases in Childhood, Marien-Hospital Wesel, Wesel 46483, Germany.
| | - Rebecca Muckelbauer
- Berlin School of Public Health, Charité-Universitätsmedizin, Berlin 10117, Germany.
| | - Guo Cheng
- Department of Nutrition, Food Safety and Toxicology, West China School of Public Health, Sichuan University, Chengdu 610041, China.
| |
Collapse
|
11
|
Engel SG, Crosby RD, Thomas G, Bond D, Lavender JM, Mason T, Steffen KJ, Green DD, Wonderlich SA. Ecological Momentary Assessment in Eating Disorder and Obesity Research: a Review of the Recent Literature. Curr Psychiatry Rep 2016; 18:37. [PMID: 26893235 DOI: 10.1007/s11920-016-0672-7] [Citation(s) in RCA: 107] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Our current understanding of the etiology and maintenance of eating disorders and obesity continues to be far from complete. Similarly, our understanding of determinants of both successful and unsuccessful weight loss surgery is also quite limited. While a number of research methodologies have been applied to these areas, one methodology that has recently seen a rise in popularity is the use of ecological momentary assessment (EMA). EMA allows one to study a variety of variables of interest in the natural environment. The study of eating disorders, obesity, and bariatric surgery has all been conducted using EMA recently. The current study is a review of these areas and summarizes the recent literature (past 3 years) in eating disorders, obesity, and bariatric surgery using EMA methodology.
Collapse
Affiliation(s)
- Scott G Engel
- Neuropsychiatric Research Institute, Fargo, ND, USA. .,University of North Dakota School of Medicine, University of North Dakota, Grand Forks, ND, USA.
| | - Ross D Crosby
- Neuropsychiatric Research Institute, Fargo, ND, USA.,University of North Dakota School of Medicine, University of North Dakota, Grand Forks, ND, USA
| | - Graham Thomas
- Department of Psychiatry and Human Behavior, Brown Alpert Medical School/The Miriam Hospital, Weight Control and Diabetes Research Center, Brown University, Providence, RI, USA
| | - Dale Bond
- Department of Psychiatry and Human Behavior, Brown Alpert Medical School/The Miriam Hospital, Weight Control and Diabetes Research Center, Brown University, Providence, RI, USA
| | | | - Tyler Mason
- Neuropsychiatric Research Institute, Fargo, ND, USA
| | - Kristine J Steffen
- Neuropsychiatric Research Institute, Fargo, ND, USA.,School of Pharmacy/Pharmaceutical Sciences, North Dakota State University, Fargo, ND, USA
| | - Dan D Green
- Neuropsychiatric Research Institute, Fargo, ND, USA
| | - Stephen A Wonderlich
- Neuropsychiatric Research Institute, Fargo, ND, USA.,University of North Dakota School of Medicine, University of North Dakota, Grand Forks, ND, USA
| |
Collapse
|
12
|
Baygi F, Heshmat R, Kelishadi R, Mohammadi F, Motlagh ME, Ardalan G, Asayesh H, Larijani B, Qorbani M. Regional Disparities in Sedentary Behaviors and Meal Frequency in Iranian Adolescents: The CASPIAN-III Study. IRANIAN JOURNAL OF PEDIATRICS 2015. [PMID: 26195993 PMCID: PMC4505997 DOI: 10.5812/ijp.182] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND The prevalence of obesity is increasing among Iranian youngsters like other developing countries. OBJECTIVES This study was conducted to assess regional disparities in sedentary behaviors and meal frequency in Iranian adolescents. PATIENTS AND METHODS In this national survey, 5682 students aged 10 - 18 years from urban and rural districts of 27 provinces of Iran were selected via stratified multi-stage sampling method. The country was classified into four sub-national regions, based on criteria of the combination of geography and socioeconomic status (SES). Mean of meal frequency and physical activity levels as well as prevalence of omitting meals and sedentary behavior were compared across regions with different SES after stratifying with sex and age group. RESULTS Meal frequency in lower socio-economic regions was significantly higher than two other regions in 10 - 13 and 10 - 18 years old groups (P trend < 0.001). However, the mean of working hours with computer was linearly increased with increasing the SES in studied regions (P trend < 0.001), whereas the corresponding figure was not significant for the mean of watching TV (P trend > 0.05). Frequency of adolescents omitting their meals was higher in higher SES regions especially in West Iran (P < 0.001) in 10 - 13 years old age group. Having personal computer and working with it more than two hours per day mainly was observed in central Iran which ranked as the highest SES group. CONCLUSIONS Efforts to ensure Iranian youth meet healthy food habits and screen time guidelines include limiting access to screen technologies and encouraging parents to monitor their own screen time is required.
Collapse
Affiliation(s)
- Fereshteh Baygi
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, IR Iran
| | - Ramin Heshmat
- Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, IR Iran
| | - Roya Kelishadi
- Department of Pediatrics, Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-Communicable Disease, Isfahan University of Medical Sciences, Isfahan, IR Iran
| | - Fatemeh Mohammadi
- Department of Food and Nutrition Policy and Planning Research, National Nutrition and Food Technology Research Institute, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran
| | | | - Gelayol Ardalan
- Department of School Health, Bureau of Population, Family and School Health, Ministry of Health and Medical Education, Tehran, IR Iran
| | - Hamid Asayesh
- Department of Medical Emergencies, Qom University of Medical Sciences, Qom, IR Iran
| | - Bagher Larijani
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, IR Iran
| | - Mostafa Qorbani
- Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, IR Iran
- Department of Community Medicine, Alborz University of Medical Sciences, Karaj, IR Iran
- Corresponding author: Mostafa Qorbani, Department of Community Medicine, Alborz University of Medical Sciences, P. O. Box: 1599666615, Karaj, IR Iran. Tel: +98-2188913543, E-mail:
| |
Collapse
|
13
|
Using ecological momentary assessment to evaluate current physical activity. BIOMED RESEARCH INTERNATIONAL 2014; 2014:915172. [PMID: 25126580 PMCID: PMC4122013 DOI: 10.1155/2014/915172] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/24/2014] [Revised: 06/04/2014] [Accepted: 06/30/2014] [Indexed: 11/17/2022]
Abstract
Objective. The purpose of this study was to assess the value of ecological momentary assessment in evaluating physical activity among children, adolescents, and adults. It also determines whether ecological momentary assessment fulfills the criteria of validity, reliability, objectivity, norms, and standardization applied to the tools used for the evaluation of physical activity. Methods. The EBSCO-CINHAL, Medline, PsycINFO, PubMed, and SPORTDiscuss databases were reviewed in December 2012 for articles associated with EMA. Results. Of the 20 articles examined, half (10) used electronic methods for data collection, although various methods were used, ranging from pen and paper to smartphone applications. Ten studies used objective monitoring equipment. Nineteen studies were performed over 4 days. While the validity of the EMA method was discussed in 18 studies, only four found it to be objective. In all cases, the EMA procedures were precisely documented and confirmed to be feasible. Conclusions. Ecological momentary assessment is a valid, reliable, and feasible approach to evaluate activity and sedentary behavior. Researchers should be aware that while ecological momentary assessment offers many benefits, it simultaneously imposes many limitations which should be considered when studying physical activity.
Collapse
|
14
|
Bergh IH, van Stralen MM, Bjelland M, Grydeland M, Lien N, Klepp KI, Anderssen SA, Ommundsen Y. Post-intervention effects on screen behaviours and mediating effect of parental regulation: the HEalth In Adolescents study--a multi-component school-based randomized controlled trial. BMC Public Health 2014; 14:200. [PMID: 24568125 PMCID: PMC3946033 DOI: 10.1186/1471-2458-14-200] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2014] [Accepted: 02/13/2014] [Indexed: 11/27/2022] Open
Abstract
Background To improve effectiveness of future screen behaviour interventions, one needs to know whether an intervention works via the proposed mediating mechanisms and whether the intervention is equally effective among subgroups. Parental regulation is identified as a consistent correlate of screen behaviours, but prospective evidence as well as the mediation role of parental regulation is largely lacking. This study investigated post-intervention main effects on screen behaviours in the HEIA-intervention – a Norwegian school-based multiple-behaviour study, as well as mediation effects of parental regulation by adolescents’ and parents’ report. In addition, moderating effects of gender and weight status on the intervention and mediating effects were explored. Methods Participating schools were randomized to control (n = 25) or intervention (n = 12) condition. Adolescents (n = 908 Control; 510 Intervention) self-reported their weekday and weekend TV-viewing and computer/game-use. Change in adolescents’ behaviours was targeted through school and parents. Adolescents, mothers (n = 591 Control; 244 Interventions) and fathers (n = 469 Control; 199 Intervention) reported parental regulation of the screen behaviours post-intervention (at 20 month). The product-of-coefficient test using linear regression analysis was conducted to examine main and mediating effects. Results There was no intervention effect on the screen behaviours in the total sample. Gender moderated effect on weekend computer/game-use, while weight status moderated the effect on weekday TV-viewing and computer/game-use. Stratified analyses showed a small favourable intervention effect on weekday TV-viewing among the normal weight. Parental regulation did not mediate change in the screen behaviours. However, stronger parental regulation was associated with less TV-viewing and computer/game-use with effects being conditional on adolescents’ versus parental reports. Parental regulation of the screen behaviours, primarily by the parental report, was associated with change in the respective behaviours. Conclusion Multiple behaviour intervention may not affect all equally well, and the effect may differ by weight status and gender. In future interventions parents should be encouraged to regulate their adolescents’ TV-viewing and computer/game-use on both weekdays and weekends as parental regulation was identified as a determinant of these screen behaviours. However, future intervention studies may need to search for more effective intervention strategies targeting parental regulation. Trial registration Current Controlled Trials ISRCTN98552879
Collapse
Affiliation(s)
- Ingunn H Bergh
- Department of Coaching and Psychology, Norwegian School of Sport Sciences, PB 4014 Ullevaal Stadion, Oslo NO-0886, Norway.
| | | | | | | | | | | | | | | |
Collapse
|
15
|
Owens CS, Crone D, De Ste Croix MBA, Gidlow CJ, James DVB. Physical activity and screen time in adolescents transitioning out of compulsory education: a prospective longitudinal study. J Public Health (Oxf) 2013; 36:599-607. [PMID: 24365762 DOI: 10.1093/pubmed/fdt123] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Within the UK context, it is unclear whether physical activity and screen time changes between completing compulsory education and the period afterwards, and the factors associated with any change. METHODS A prospective population-based longitudinal design among adolescents (n = 2204 at baseline) was adopted. A self-report questionnaire was administered at baseline (final year of compulsory education) and follow-up (i.e. post compulsory education) to measure physical activity over the previous 7 days and screen time (weekday and weekend) in relation to recommended guidelines. Magnitude of change in physical activity and screen time and key influencing variables associated with changes were analysed. RESULTS For physical activity, there was a significant change in participants meeting guidelines at baseline but not meeting guidelines at follow-up with 81.0% not meeting guidelines at baseline and follow-up. For screen time, there was no significant change between baseline and follow-up, with 70.6% not meeting guidelines at baseline and follow-up. Gender was associated with the change in physical activity with a decline less likely in females. CONCLUSIONS Findings reinforce the importance of reducing physical inactivity and sedentary behaviour during this transition. Factors associated with changes in physical inactivity and sedentary behaviour need further investigation.
Collapse
Affiliation(s)
- C S Owens
- Faculty of Medicine and Health Sciences, School of Medicine, Division of Epidemiology and Public Health, University of Nottingham, Nottingham NG5 1PB, UK
| | - D Crone
- Faculty of Applied Sciences, School of Sport and Exercise, University of Gloucestershire, Gloucester GL2 9HW, UK
| | - M B A De Ste Croix
- Faculty of Applied Sciences, School of Sport and Exercise, University of Gloucestershire, Gloucester GL2 9HW, UK
| | - C J Gidlow
- Centre for Sport, Health and Exercise Research, Staffordshire University, Stoke-on-Trent ST4 2DF, UK
| | - D V B James
- Faculty of Applied Sciences, School of Sport and Exercise, University of Gloucestershire, Gloucester GL2 9HW, UK
| |
Collapse
|
16
|
Jago R, Sebire SJ, Bentley GF, Turner KM, Goodred JK, Fox KR, Stewart-Brown S, Lucas PJ. Process evaluation of the Teamplay parenting intervention pilot: implications for recruitment, retention and course refinement. BMC Public Health 2013; 13:1102. [PMID: 24289111 PMCID: PMC4219518 DOI: 10.1186/1471-2458-13-1102] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2013] [Accepted: 11/27/2013] [Indexed: 11/13/2022] Open
Abstract
Background Parenting programs could provide effective routes to increasing children’s physical activity and reducing screen-viewing. Many studies have reported difficulties in recruiting and retaining families in group parenting interventions. This paper uses qualitative data from the Teamplay feasibility trial to examine parents’ views on recruitment, attendance and course refinement. Methods Semi-structured interviews were conducted with 16 intervention and 10 control group parents of 6–8 year old children. Topics discussed with the intervention group included parents’ views on the recruitment, structure, content and delivery of the course. Topics discussed with the control group included recruitment and randomization. Interviews were digitally recorded, transcribed and thematically analyzed. Results Many parents in both the intervention and control group reported that they joined the study because they had been thinking about ways to improve their parenting skills, getting ideas on how to change behavior, or had been actively looking for a parenting course but with little success in enrolling on one. Both intervention and control group parents reported that the initial promotional materials and indicative course topics resonated with their experiences and represented a possible solution to parenting challenges. Participants reported that the course leaders played an important role in helping them to feel comfortable during the first session, engaging anxious parents and putting parents at ease. The most commonly reported reason for parents returning to the course after an absence was because they wanted to learn new information. The majority of parents reported that they formed good relationships with the other parents in the group. An empathetic interaction style in which leaders accommodated parent’s busy lives appeared to impact positively on course attendance. Conclusions The data presented indicate that a face-to-face recruitment campaign which built trust and emphasized how the program was relevant to families positively affected recruitment in Teamplay. Parents found the parenting component of the intervention attractive and, once recruited, attendance was facilitated by enjoyable sessions, empathetic leaders and support from fellow participants. Overall, data suggest that the Teamplay recruitment and retention approaches were successful and with small refinements could be effectively used in a larger trial.
Collapse
Affiliation(s)
- Russell Jago
- Centre for Exercise, Nutrition & Health Sciences, School for Policy Studies, University of Bristol, Bristol, UK.
| | | | | | | | | | | | | | | |
Collapse
|
17
|
Klitsie T, Corder K, Visscher TLS, Atkin AJ, Jones AP, van Sluijs EMF. Children's sedentary behaviour: descriptive epidemiology and associations with objectively-measured sedentary time. BMC Public Health 2013; 13:1092. [PMID: 24274070 PMCID: PMC4222753 DOI: 10.1186/1471-2458-13-1092] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2013] [Accepted: 11/18/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Little is known regarding the patterning and socio-demographic distribution of multiple sedentary behaviours in children. The aims of this study were to: 1) describe the leisure-time sedentary behaviour of 9-10 year old British children, and 2) establish associations with objectively-measured sedentary time. METHODS Cross-sectional analysis in the SPEEDY study (Sport, Physical activity and Eating behaviour: Environmental Determinants in Young people) (N=1513, 44.3% boys). Twelve leisure-time sedentary behaviours were assessed by questionnaire. Objectively-measured leisure-time sedentary time (Actigraph GT1M, <100 counts/minute) was assessed over 7 days. Differences by sex and socioeconomic status (SES) in self-reported sedentary behaviours were tested using Kruskal-Wallis tests. The association between objectively-measured sedentary time and the separate sedentary behaviours (continuous (minutes) and categorised into 'none' 'low' or 'high' participation) was assessed using multi-level linear regression. RESULTS Sex differences were observed for time spent in most sedentary behaviours (all p ≤ 0.02), except computer use. Girls spent more time in combined non-screen sedentary behaviour (median, interquartile range: girls: 770.0 minutes, 390.0-1230.0; boys: 725.0, 365.0 - 1182.5; p = 0.003), whereas boys spent more time in screen-based behaviours (girls: 540.0, 273.0 - 1050.0; boys: 885.0, 502.5 - 1665.0; p < 0.001). Time spent in five non-screen behaviours differed by SES, with higher values in those of higher SES (all p ≤ 0.001). Regression analyses with continuous exposures indicated that reading (β = 0.1, p < 0.001) and watching television (β = 0.04, p < 0.01) were positively associated with objectively-measured sedentary time, whilst playing board games (β = -0.12, p < 0.05) was negatively associated. Analysed in categorical form, sitting and talking (vs. none: 'low' β = 26.1,ns; 'high' 30.9, p < 0.05), playing video games (vs. none: 'low' β = 49.1, p < 0.01; 'high' 60.2, p < 0.01) and watching television (vs. lowest tertile: middle β = 22.2,ns; highest β = 31.9, p < 0.05) were positively associated with objectively-measured sedentary time whereas talking on the phone (vs. none: 'low' β = -38.5, p < 0.01; 'high' -60.2, p < 0.01) and using a computer/internet (vs. none: 'low' β = -30.7, p < 0.05; 'high' -4.2,ns) were negatively associated. CONCLUSIONS Boys and girls and children of different socioeconomic backgrounds engage in different leisure-time sedentary behaviours. Whilst a number of behaviours may be predictive of total sedentary time, collectively they explain little overall variance. Future studies should consider a wide range of sedentary behaviours and incorporate objective measures to quantify sedentary time where possible.
Collapse
Affiliation(s)
- Tessa Klitsie
- Department of Earth and Life Sciences, VU University Amsterdam, Amsterdam, The Netherlands
| | - Kirsten Corder
- Medical Research Council, Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - Tommy LS Visscher
- Research Centre for the Prevention of Overweight Zwolle, Windesheim University of Applied Sciences and VU University, Zwolle, The Netherlands
| | - Andrew J Atkin
- UKCRC Centre for Diet and Activity Research (CEDAR), MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - Andrew P Jones
- School of Environmental Sciences, University of East Anglia, Norwich, UK
| | - Esther MF van Sluijs
- Medical Research Council, Epidemiology Unit, University of Cambridge, Cambridge, UK
- UKCRC Centre for Diet and Activity Research (CEDAR), MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
| |
Collapse
|
18
|
Müller AM, Khoo S, Lambert R. Review of Physical Activity Prevalence of Asian School-Age Children and Adolescents. Asia Pac J Public Health 2013; 25:227-38. [DOI: 10.1177/1010539513481494] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Overweight and obese populations in Asia are high and increasing rapidly. Physical activity prevalence studies have found low physical activity rates among Asian school-age children and adolescents. The purpose of this review is to establish a baseline for physical activity rates in Asian school-age children and adolescents and serve as a platform for additional research. Thirty articles published between 2000 and 2011 on physical activity prevalence of school-age children and adolescents were included in the review. Fourteen studies were conducted in East Asia, 10 in Southeast Asia, 2 in South Asia, and 2 in West Asia. Studies used subjective methods (questionnaires or diaries) and objective methods (accelerometers or heart rate monitors). Although nearly all studies found low physical activity levels, it was not possible to provide an accurate picture due to an absence of standardized, reliable, and economically viable measurement tools.
Collapse
Affiliation(s)
| | - Selina Khoo
- University of Malaya, Kuala Lumpur, Malaysia
| | | |
Collapse
|
19
|
Jago R, Sebire SJ, Turner KM, Bentley GF, Goodred JK, Fox KR, Stewart-Brown S, Lucas PJ. Feasibility trial evaluation of a physical activity and screen-viewing course for parents of 6 to 8 year-old children: Teamplay. Int J Behav Nutr Phys Act 2013; 10:31. [PMID: 23510646 PMCID: PMC3598924 DOI: 10.1186/1479-5868-10-31] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2012] [Accepted: 02/20/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Many children spend too much time screen-viewing (watching TV, surfing the internet and playing video games) and do not meet physical activity (PA) guidelines. Parents are important influences on children's PA and screen-viewing (SV). There is a shortage of parent-focused interventions to change children's PA and SV. METHODS Teamplay was a two arm individualized randomized controlled feasibility trial. Participants were parents of 6-8 year old children. Intervention participants were invited to attend an eight week parenting program with each session lasting 2 hours. Children and parents wore an accelerometer for seven days and minutes of moderate-to-vigorous intensity PA (MVPA) were derived. Parents were also asked to report the average number of hours per day that both they and the target child spent watching TV. Measures were assessed at baseline (time 0) at the end of the intervention (week 8) and 2 months after the intervention had ended (week 16). RESULTS There were 75 participants who provided consent and were randomized but 27 participants withdrew post-randomization. Children in the intervention group engaged in 2.6 fewer minutes of weekday MVPA at Time 1 but engaged in 11 more minutes of weekend MVPA. At Time 1 the intervention parents engaged in 9 more minutes of weekday MVPA and 13 more minutes of weekend MVPA. The proportion of children in the intervention group watching ≥ 2 hours per day of TV on weekend days decreased after the intervention (time 0 = 76%, time 1 = 39%, time 2 = 50%), while the control group proportion increased slightly (79%, 86% and 87%). Parental weekday TV watching decreased in both groups. In post-study interviews many mothers reported problems associated with wearing the accelerometers. In terms of a future full-scale trial, a sample of between 80 and 340 families would be needed to detect a mean difference of 10-minutes of weekend MVPA. CONCLUSIONS Teamplay is a promising parenting program in an under-researched area. The intervention was acceptable to parents, and all elements of the study protocol were successfully completed. Simple changes to the trial protocol could result in more complete data collection and study engagement.
Collapse
Affiliation(s)
- Russell Jago
- Centre for Exercise, Nutrition & Health Sciences, School for Policy Studies, University of Bristol, Bristol, UK.
| | | | | | | | | | | | | | | |
Collapse
|
20
|
Garcia-Continente X, Pérez-Giménez A, Espelt A, Nebot Adell M. Factors associated with media use among adolescents: a multilevel approach. Eur J Public Health 2013; 24:5-10. [PMID: 23397582 DOI: 10.1093/eurpub/ckt013] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND During the last few years, several studies have reported a high screen time use among adolescents that can be related to negative health effects. The aims of this study were to describe screen time use among secondary school students and to identify individual- and school-level factors associated with media use. METHODS A cross-sectional study based on a self-reported questionnaire was performed among a representative sample of 2675 secondary school students (13-19 years old). Adolescents reported the amount of time spent viewing television, playing videogames and using the computer as well as other health-related behaviours and attitudes. Multilevel analysis was carried out and prevalence ratios were calculated to determine the association between media use and related factors. RESULTS Around 50% of the students reported watching television for ≥2 h/day during weekdays. Boys reported playing videogames for ≥2 h/weekday much more often than girls (14.6 and 1.5%, respectively). 68.2% of boys and 61.7% of girls reported using the computer for ≥2 h/weekday. In the multilevel analysis, the main factors associated with screen-related sedentary behaviours were attending schools from a low socio-economic status neighbourhood, eating unhealthy food and not reading books frequently. CONCLUSION The prevalence of adolescents reporting an excessive use of media devices is high, especially among students attending schools from deprived areas. Interventions to reduce screen time among adolescents may be necessary to reduce the risk of some metabolic and cardiovascular diseases such as being overweight and obesity in late adolescence or early adulthood.
Collapse
|
21
|
Baggott C, Gibson F, Coll B, Kletter R, Zeltzer P, Miaskowski C. Initial evaluation of an electronic symptom diary for adolescents with cancer. JMIR Res Protoc 2012; 1:e23. [PMID: 23612521 PMCID: PMC3626160 DOI: 10.2196/resprot.2175] [Citation(s) in RCA: 55] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2012] [Revised: 07/18/2012] [Accepted: 10/04/2012] [Indexed: 11/29/2022] Open
Abstract
Background The delivery of optimal care depends on accurate communication between patients and clinicians regarding untoward symptoms. Documentation of patients’ symptoms necessitates reliance on memory, which is often imprecise. We developed an electronic diary (eDiary) for adolescents and young adults (AYAs) with cancer to record symptoms. Objective The purpose of this paper is to describe the utility of an eDiary designed for AYAs with cancer, including dependability of the mobile application, the reasons for any missing recorded data, patients’ adherence rates to daily symptom queries, and patients’ perceptions of the usefulness and acceptability of symptom data collection via mobile phones. Methods Our team developed an electronic symptom diary based on interviews conducted with AYAs with cancer and their clinicians. This diary included daily severity ratings of pain, nausea, vomiting, fatigue, and sleep. The occurrence of other selected physical sequelae was assessed daily. Additionally, patients selected descriptors of their mood. A 3-week trial of the eDiary was conducted with 10 AYA cancer patients. Mobile phones with service plans were loaned to patients who were instructed to report their symptoms daily. Patients completed a brief questionnaire and were interviewed to elicit their perceptions of the eDiary and any technical difficulties encountered. Results Overall adherence to daily symptom reports exceeded 90%. Young people experienced few technical difficulties and reported benefit from daily symptom reports. Symptom occurrence rates were high and considerable inter- and intra-patient variability was noted in symptom and mood reports. Conclusions We demonstrated the utility of an eDiary that may contribute insight into patients’ symptom patterns to promote effective symptom management.
Collapse
Affiliation(s)
- Christina Baggott
- University of California, San Francisco, Department of Physiological Nursing, San Francisco, CA, United States.
| | | | | | | | | | | |
Collapse
|
22
|
Atkin AJ, Gorely T, Clemes SA, Yates T, Edwardson C, Brage S, Salmon J, Marshall SJ, Biddle SJH. Methods of Measurement in epidemiology: sedentary Behaviour. Int J Epidemiol 2012; 41:1460-71. [PMID: 23045206 PMCID: PMC3465769 DOI: 10.1093/ije/dys118] [Citation(s) in RCA: 344] [Impact Index Per Article: 28.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/02/2012] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Research examining sedentary behaviour as a potentially independent risk factor for chronic disease morbidity and mortality has expanded rapidly in recent years. METHODS We present a narrative overview of the sedentary behaviour measurement literature. Subjective and objective methods of measuring sedentary behaviour suitable for use in population-based research with children and adults are examined. The validity and reliability of each method is considered, gaps in the literature specific to each method identified and potential future directions discussed. RESULTS To date, subjective approaches to sedentary behaviour measurement, e.g. questionnaires, have focused predominantly on TV viewing or other screen-based behaviours. Typically, such measures demonstrate moderate reliability but slight to moderate validity. Accelerometry is increasingly being used for sedentary behaviour assessments; this approach overcomes some of the limitations of subjective methods, but detection of specific postures and postural changes by this method is somewhat limited. Instruments developed specifically for the assessment of body posture have demonstrated good reliability and validity in the limited research conducted to date. Miniaturization of monitoring devices, interoperability between measurement and communication technologies and advanced analytical approaches are potential avenues for future developments in this field. CONCLUSIONS High-quality measurement is essential in all elements of sedentary behaviour epidemiology, from determining associations with health outcomes to the development and evaluation of behaviour change interventions. Sedentary behaviour measurement remains relatively under-developed, although new instruments, both objective and subjective, show considerable promise and warrant further testing.
Collapse
Affiliation(s)
- Andrew J Atkin
- British Heart Foundation National Centre for Physical Activity and Health, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK.
| | | | | | | | | | | | | | | | | |
Collapse
|
23
|
Foley L, Maddison R, Olds T, Ridley K. Self-report use-of-time tools for the assessment of physical activity and sedentary behaviour in young people: systematic review. Obes Rev 2012; 13:711-22. [PMID: 22429291 DOI: 10.1111/j.1467-789x.2012.00993.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
UNLABELLED Regular physical activity and limiting extended periods of sitting are two behaviours critical for the prevention of obesity in young people. The purpose of the systematic review was to synthesize the psychometric evidence for self-report use-of-time tools that assess these behaviours. Articles were retrieved that reported reliability and/or validity for use-of-time tools in participants aged 18 years or under. Outcome variables were physical activity, sedentary behaviour and energy expenditure. Study quality was appraised, and the results summarized narratively. Sixteen studies and six different tools were identified. The tools were the Previous Day Physical Activity Recall, the Three-Day Physical Activity Recall, the Physical Activity Interview, the Computerized Activity Recall, the Activitygram, and the Multimedia Activity Recall for Children and Adolescents. Overall, tools indicated moderate validity compared with objective and criterion comparison methods. Generally, validity correlation coefficients were in the range of 0.30-0.40. Correlation coefficients for test-retest reliability ranged widely from 0.24 to 0.98. CONCLUSION Use-of-time tools have indicated moderate reliability and validity for the assessment of physical activity and energy expenditure. Future research should focus on using criterion methods and on validating specifically for sedentary behaviour outcomes. Implementation of these tools for population surveillance should be considered.
Collapse
Affiliation(s)
- L Foley
- Clinical Trials Research Unit, University of Auckland, Auckland, New Zealand.
| | | | | | | |
Collapse
|
24
|
Jago R, Steeds JK, Bentley GF, Sebire SJ, Lucas PJ, Fox KR, Stewart-Brown S, Turner KM. Designing a physical activity parenting course: parental views on recruitment, content and delivery. BMC Public Health 2012; 12:356. [PMID: 22591593 PMCID: PMC3390270 DOI: 10.1186/1471-2458-12-356] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2012] [Accepted: 05/16/2012] [Indexed: 12/02/2022] Open
Abstract
Background Many children do not engage in sufficient levels of physical activity (PA) and spend too much time screen-viewing (SV). High levels of SV (e.g. watching TV, playing video games and surfing the internet) and low levels of PA have been associated with adverse health outcomes. Parenting courses may hold promise as an intervention medium to change children’s PA and SV. The current study was formative work conducted to design a new parenting programme to increase children’s PA and reduce their SV. Specifically, we focussed on interest in a course, desired content and delivery style, barriers and facilitators to participation and opinions on control group provision. Methods In-depth telephone interviews were conducted with thirty two parents (29 female) of 6–8 year olds. Data were analysed thematically. An anonymous online survey was also completed by 750 parents of 6–8 year old children and descriptive statistics calculated. Results Interview participants were interested in a parenting course because they wanted general parenting advice and ideas to help their children be physically active. Parents indicated that they would benefit from knowing how to quantify their child’s PA and SV levels. Parents wanted practical ideas of alternatives to SV. Most parents would be unable to attend unless childcare was provided. Schools were perceived to be a trusted source of information about parenting courses and the optimal recruitment location. In terms of delivery style, the majority of parents stated they would prefer a group-based approach that provided opportunities for peer learning and support with professional input. Survey participants reported the timing of classes and the provision of childcare were essential factors that would affect participation. In terms of designing an intervention, the most preferred control group option was the opportunity to attend the same course at a later date. Conclusions Parents are interested in PA/SV parenting courses but the provision of child care is essential for attendance. Recruitment is likely to be facilitated via trusted sources. Parents want practical advice on how to overcome barriers and suggest advice is provided in a mutually supportive group experience with expert input.
Collapse
Affiliation(s)
- Russell Jago
- Centre for Exercise, Nutrition & Health Sciences, School for Policy Studies, University of Bristol, Bristol, UK.
| | | | | | | | | | | | | | | |
Collapse
|
25
|
Steeves JA, Thompson DL, Bassett DR, Fitzhugh EC, Raynor HA. A review of different behavior modification strategies designed to reduce sedentary screen behaviors in children. J Obes 2012; 2012:379215. [PMID: 21811678 PMCID: PMC3143427 DOI: 10.1155/2012/379215] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2011] [Revised: 05/24/2011] [Accepted: 05/26/2011] [Indexed: 12/04/2022] Open
Abstract
Previous research suggests that reducing sedentary screen behaviors may be a strategy for preventing and treating obesity in children. This systematic review describes strategies used in interventions designed to either solely target sedentary screen behaviors or multiple health behaviors, including sedentary screen behaviors. Eighteen studies were included in this paper; eight targeting sedentary screen behaviors only, and ten targeting multiple health behaviors. All studies used behavior modification strategies for reducing sedentary screen behaviors in children (aged 1-12 years). Nine studies only used behavior modification strategies, and nine studies supplemented behavior modification strategies with an electronic device to enhance sedentary screen behaviors reductions. Many interventions (50%) significantly reduced sedentary screen behaviors; however the magnitude of the significant reductions varied greatly (-0.44 to -3.1 h/day) and may have been influenced by the primary focus of the intervention, number of behavior modification strategies used, and other tools used to limit sedentary screen behaviors.
Collapse
Affiliation(s)
- Jeremy A. Steeves
- Department of Kinesiology, Recreation, and Sport Studies, University of Tennessee, 1914 Andy Holt Avenue, Knoxville, TN 37996, USA
- *Jeremy A. Steeves:
| | - Dixie L. Thompson
- Department of Kinesiology, Recreation, and Sport Studies, University of Tennessee, 1914 Andy Holt Avenue, Knoxville, TN 37996, USA
| | - David R. Bassett
- Obesity Research Center, University of Tennessee, Knoxville, TN 37996, USA
| | - Eugene C. Fitzhugh
- Department of Kinesiology, Recreation, and Sport Studies, University of Tennessee, 1914 Andy Holt Avenue, Knoxville, TN 37996, USA
| | - Hollie A. Raynor
- Department of Nutrition, University of Tennessee, Knoxville, TN 37996, USA
| |
Collapse
|
26
|
Veloso SM, Matos MG, Carvalho M, Diniz JA. Psychosocial factors of different health behaviour patterns in adolescents: association with overweight and weight control behaviours. J Obes 2012; 2012:852672. [PMID: 22811890 PMCID: PMC3395179 DOI: 10.1155/2012/852672] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2012] [Accepted: 05/03/2012] [Indexed: 12/15/2022] Open
Abstract
Physical activity, nutrition, and sedentary behaviour combine to influence the risk of overweight among adolescents. This paper aims to identify psychosocial factors of different health behaviour patterns in adolescents and its association with overweight and weight control behaviours. The 3069 adolescents of both genders (average of 14.8 years old) from the 2010 Portuguese survey of Health Behaviour School-Aged Children (HBSC) answered the 2010 HBSC self-reported questionnaire. It used the cluster k-means (nonhierarchy method), qui-square, one-way ANOVA, and logistic regression. Three clusters with different behavioural patterns (physical activity, sedentary, and eating) composed the results obtained. The sedentary group (34%) had lower self-regulation, body satisfaction, health and wellness, family and classmates relationships, communication with the father than the other two groups. The active gamers (25%) had a smaller BMI but used more unhealthy weight control strategies than the other two groups. The healthy group (41%) was more motivated and more satisfied with school but was not different than the active gamers in most psychosocial variables. Differences were found between clusters for weight control behaviours and psychosocial variables. Different strategies for different patterns were necessary in order to promote obesity prevention and, simultaneously, target healthy lifestyle and wellbeing in adolescents.
Collapse
Affiliation(s)
- Susana M. Veloso
- Faculdade de Motricidade Humana, Universidade Técnica de Lisboa, Estrada da Costa, Cruz Quebrada, 1495-688 Lisboa, Portugal
- Centro de Malária e Outras Doenças Tropicais (CMDT), Instituto de Higiene e Medicina Tropical, Universidade Nova de Lisboa, Rua da Junqueira, 100, 1349-008 Lisboa, Portugal
- Universidade Lusófona de Humanidade e Tecnologias, Avenida do Campo Grande, 376, 1749-024 Lisboa, Portugal
- *Susana M. Veloso:
| | - Margarida G. Matos
- Faculdade de Motricidade Humana, Universidade Técnica de Lisboa, Estrada da Costa, Cruz Quebrada, 1495-688 Lisboa, Portugal
- Centro de Malária e Outras Doenças Tropicais (CMDT), Instituto de Higiene e Medicina Tropical, Universidade Nova de Lisboa, Rua da Junqueira, 100, 1349-008 Lisboa, Portugal
| | - Marina Carvalho
- Centro de Malária e Outras Doenças Tropicais (CMDT), Instituto de Higiene e Medicina Tropical, Universidade Nova de Lisboa, Rua da Junqueira, 100, 1349-008 Lisboa, Portugal
- Departamento de Saúde Mental, Centro Hospitalar do Barlavento Algarvio, Sítio do Poço Seco, 8500-338 Portimão, Portugal
| | - José A. Diniz
- Faculdade de Motricidade Humana, Universidade Técnica de Lisboa, Estrada da Costa, Cruz Quebrada, 1495-688 Lisboa, Portugal
| |
Collapse
|
27
|
Roydhouse JK, Allman-Farinelli M, McGeechan K, Ferrar K, Olds T. An exploratory analysis of active and low energy behaviour in Australian adolescents. Aust J Prim Health 2012; 18:248-57. [DOI: 10.1071/py11115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2011] [Accepted: 10/14/2011] [Indexed: 11/23/2022]
Abstract
Adolescents engage in a complex range of low energy-consuming and active behaviours not easily captured by single behavioural measures. This study aims to describe the associations among adolescent active and low energy behaviours. Data were obtained from adolescents aged 12–16 years (n = 1532) participating in a nationally representative survey. Thirty-nine variables measuring activities were stratified by sex and age and then analysed using principal components analysis with Varimax rotation. Four components were derived for younger girls (21.7% of the variance) and younger boys (20.2%), six for older girls (29.7%) and five for older boys (25.6%). Academic-related behaviours positively correlated with each other and negatively with television use for all age–sex groups. Computer use correlated positively with academic-related behaviours for older boys but negatively with active behaviours for younger boys and girls. Active behaviours correlated positively with each other. For older girls, low energy expenditure, household-based behaviours were negatively correlated with active behaviours. Computer use appears to differ across age groups, and leisure and academic use should be differentiated. The positive associations among different active behaviours and their negative associations with home-based, low energy expenditure behaviours are of interest for intervention development.
Collapse
|
28
|
Television viewing and variations in energy intake in adults and children in the USA. Public Health Nutr 2011; 15:609-17. [PMID: 22067577 DOI: 10.1017/s1368980011002916] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
OBJECTIVE Examine the association between energy intake and television (TV) viewing in Americans. DESIGN Nationally representative, cross-sectional study of 2003-2006 National Health and Nutrition Examination Survey. SETTING Total energy intake was determined by two 24 h recalls. TV viewing was reported as low (≤1 h/d), middle (2-3 h/d), and high (≥4 h/d). Multivariate linear regression models were used to analyse TV viewing and energy intake, adjusted for BMI (percentile for children 2-18 years), age, ethnicity and physical activity. SUBJECTS Pre-school children (2-5 years; n 1369), school-age children (6-11 years; n 1759), adolescents (12-18 years; n 3233) and adults (≥19 years; n 7850) in the USA. RESULTS There was a significant association between TV viewing and energy intake for adolescent girls (high v. low: β = 195·2, P = 0·03) and men (high v. low: β = -113·0, P = 0·02; middle v. low: β = -131·1, P = 0·0002). Mean adjusted energy intake for adolescent girls was 7801·0, 8088·5 and 8618·2 kJ/d for low, middle and high TV viewing, respectively. Mean adjusted energy intake for men was 9845·9, 9297·2 and 9372·8 kJ/d for low, middle and high TV viewing. CONCLUSIONS TV viewing was associated with energy intake in US children and adults only in 12-18-year-old girls and men. For girls, the high TV viewing category consumed more energy daily (816·3 kJ (195 kcal)) than the low category. In men, the middle and high TV viewing categories consumed less energy daily (548·4 kJ (131 kcal) and 473·0 kJ (113 kcal), respectively) than the low category. Our findings support some, but not all previous research. Future research is needed to explore this complicated relationship with rigorous measures of energy intake and TV viewing.
Collapse
|
29
|
Hart CN, Raynor HA, Osterholt KM, Jelalian E, Wing RR. Eating and activity habits of overweight children on weekdays and weekends. INTERNATIONAL JOURNAL OF PEDIATRIC OBESITY : IJPO : AN OFFICIAL JOURNAL OF THE INTERNATIONAL ASSOCIATION FOR THE STUDY OF OBESITY 2011; 6:467-72. [PMID: 21774578 PMCID: PMC5425949 DOI: 10.3109/17477166.2011.590204] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE To determine whether eating, sedentary, and physical activity behaviors differ on weekdays and weekends in a sample of children who are overweight and obese. METHODS Eighty-one children aged 6-9 years old who were overweight or obese and enrolled in a weight management program completed three-day food diaries and three-day Previous Day Physical Activity Recalls (PDPARs) for two weekdays and one weekend day. All data were obtained at baseline prior to intervention delivery. RESULTS Children consumed a greater percentage of calories from fat (t = 2.15, p = 0.04) and fewer fruits (t = 6.83, p < 0.001), vegetables (t = 2.91, p = 0.002), non-nutrient dense (NND) snack foods (t = 5.58, p < 0.001), and sweetened drinks (t = 2.91, p = 0.005) on weekends. Children watched more television (t = 5.25, p < 0.001), expended more energy (t = 4.37, p < 0.001), and spent a greater percentage of time in moderate-to-vigorous physical activity (p < 0.001) on weekends compared to weekdays. CONCLUSIONS Findings demonstrate a number of differences in children's eating and activity habits on weekends and weekdays. They also suggest that attending to differences in food intake and activity habits on weekdays and weekends separately may help to identify periods of high risk, which could be modified with effective intervention approaches. TRIAL REGISTRATION NUMBERS NCT00259324, NCT00200265.
Collapse
Affiliation(s)
- Chantelle N Hart
- Department of Psychiatry & Human Behavior, The Warren Alpert Medical School of Brown University, Providence.
| | | | | | | | | |
Collapse
|
30
|
Cui Z, Hardy LL, Dibley MJ, Bauman A. Temporal trends and recent correlates in sedentary behaviours in Chinese children. Int J Behav Nutr Phys Act 2011; 8:93. [PMID: 21867565 PMCID: PMC3182955 DOI: 10.1186/1479-5868-8-93] [Citation(s) in RCA: 102] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2011] [Accepted: 08/26/2011] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Sedentary behaviours (television, video and computer) are related to health outcomes independent of physical activity. Few studies have examined trends and correlates of sedentary behaviours among youth in developing nations. The current study is to examine temporal trends in sedentary behaviours and recent correlates of screen use in Chinese children during a period of economic transition. METHODS Secondary analysis of China Health and Nutrition Surveys. Cross-sectional data on sedentary behaviours including screen use among children aged 6-18 years from four surveys in 1997 (n = 2,469), 2000 (n = 1,838), 2004 (n = 1,382) and 2006 (n = 1,128). Temporal trends in screen use by socio-demographic characteristics were examined. The correlates of spending more than 2 hours per day on screen time in the most recent survey data (2006, n = 986) were analysed using survey logistic regression analysis. RESULTS Daily screen time significantly increased in each subgroup by age, sex and urban/rural residence, with the largest increase for urban boys aged 13-18 years from 0.5 hours to 1.7 hours, and for rural boys aged 6-12 years from 0.7 hours to 1.7 hours (p < 0.0001). Daily time in both homework and extracurricular cultural activity increased significantly from 2000 to 2004 but was stable from 2004 to 2006. Boys (OR: 1.41, 95%CI: 1.09 -1.82), having a TV in the bedroom (OR: 1.86, 95%CI: 1.15 - 3.01), having access to internet at home (OR: 1.93, 95%CI: 1.12 - 3.31) or at internet cafés (OR: 2.01, 95%CI: 1.21 - 3.34), or often watching TV with parents (OR: 2.27, 95%CI: 1.37 - 3.74) were all associated with being more likely to be high screen users (≥ 2 hours/day). While children aged 13-18 years (OR: 0.67, 95%CI: 0.46-0.97) were less likely to be high screen users. Children whose parents often have rules on their TV viewing (OR: 0.64, 95%CI: 0.37 - 1.10) were slightly but not significantly less likely to be high screen users. CONCLUSION This study confirms sedentary behaviour has increased over the last decade in Chinese children. Efforts to ensure Chinese youth meet screen time guidelines include limiting access to screen technologies and encouraging parents to monitor their own screen time and to set limits on their child's screen time.
Collapse
Affiliation(s)
- Zhaohui Cui
- Sydney School of Public Health, Sydney Medical School, University of Sydney, Australia.
| | | | | | | |
Collapse
|
31
|
Measuring physical activity using accelerometry in 13-15-year-old adolescents: the importance of including non-wear activities. Public Health Nutr 2011; 14:2124-33. [PMID: 21835080 DOI: 10.1017/s1368980011001868] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE The present study aimed to examine the impact of non-wear activities registered in diaries when using accelerometers to assess physical activity (PA) in young adolescents. DESIGN Data arise from a large-scale cross-sectional study on PA. PA was objectively assessed using Actigraph™ accelerometers (Actigraph MTI, Manufacturing Technology Inc., Pensacola, FL, USA) during seven consecutive days. Non-wear time activity diaries were provided to register the activities for which the accelerometer was removed. After correction to deal with over-reporting, the registered minutes of PA were used to replace periods of non-wear time measured by the accelerometer. SETTING Between October 2008 and May 2009 adolescents were recruited by home visits in Ghent (Belgium). SUBJECTS Young adolescents (n 513; 48·6% boys) aged 13 to 15 years. RESULTS Of the total sample, 49·9% registered at least one activity of moderate to vigorous intensity in the non-wear time activity diary. More adolescents registered an activity performed on a weekday than on a weekend day and the registered mean number of minutes of moderate to vigorous PA were higher on weekend days. Repeated-measures (M)ANOVA tests revealed a significant difference between the mean minutes with and without non-wear activities for all PA intensities, regardless of adolescents' socio-economic status or gender. More adolescents achieved the PA recommendations after inclusion of the non-wear activities irrespective of accelerometer thresholds used. CONCLUSIONS The collection of information regarding non-wear time by non-wear time activity diaries when using accelerometers in 13-15-year-old adolescents can lead to different PA outcomes at the individual level and therefore can improve the ability to accurately measure PA.
Collapse
|
32
|
Jago R, Sebire SJ, Gorely T, Cillero IH, Biddle SJH. "I'm on it 24/7 at the moment": a qualitative examination of multi-screen viewing behaviours among UK 10-11 year olds. Int J Behav Nutr Phys Act 2011; 8:85. [PMID: 21812945 PMCID: PMC3224594 DOI: 10.1186/1479-5868-8-85] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2011] [Accepted: 08/03/2011] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Screen-viewing has been associated with increased body mass, increased risk of metabolic syndrome and lower psychological well-being among children and adolescents. There is a shortage of information about the nature of contemporary screen-viewing amongst children especially given the rapid advances in screen-viewing equipment technology and their widespread availability. Anecdotal evidence suggests that large numbers of children embrace the multi-functionality of current devices to engage in multiple forms of screen-viewing at the same time. In this paper we used qualitative methods to assess the nature and extent of multiple forms of screen-viewing in UK children. METHODS Focus groups were conducted with 10-11 year old children (n = 63) who were recruited from five primary schools in Bristol, UK. Topics included the types of screen-viewing in which the participants engaged; whether the participants ever engaged in more than one form of screen-viewing at any time and if so the nature of this multiple viewing; reasons for engaging in multi-screen-viewing; the room within the house where multi-screen-viewing took place and the reasons for selecting that room. All focus groups were transcribed verbatim, anonymised and thematically analysed. RESULTS Multi-screen viewing was a common behaviour. Although multi-screen viewing often involved watching TV, TV viewing was often the background behaviour with attention focussed towards a laptop, handheld device or smart-phone. There were three main reasons for engaging in multi-screen viewing: 1) tempering impatience that was associated with a programme loading; 2) multi-screen facilitated filtering out unwanted content such as advertisements; and 3) multi-screen viewing was perceived to be enjoyable. Multi-screen viewing occurred either in the child's bedroom or in the main living area of the home. There was considerable variability in the level and timing of viewing and this appeared to be a function of whether the participants attended after-school clubs. CONCLUSIONS UK children regularly engage in two or more forms of screen-viewing at the same time. There are currently no means of assessing multi-screen viewing nor any interventions that specifically focus on reducing multi-screen viewing. To reduce children's overall screen-viewing we need to understand and then develop approaches to reduce multi-screen viewing among children.
Collapse
Affiliation(s)
- Russell Jago
- Centre for Exercise, Nutrition & Health Sciences, School for Policy Studies, University of Bristol, 8 Priory Rd, Bristol, BS8 1TZ, UK
| | - Simon J Sebire
- Centre for Exercise, Nutrition & Health Sciences, School for Policy Studies, University of Bristol, 8 Priory Rd, Bristol, BS8 1TZ, UK
| | - Trish Gorely
- School of Sport, Exercise & Health Sciences, Loughborough University, UK
| | | | - Stuart JH Biddle
- School of Sport, Exercise & Health Sciences, Loughborough University, UK
| |
Collapse
|
33
|
Salmon J, Tremblay MS, Marshall SJ, Hume C. Health risks, correlates, and interventions to reduce sedentary behavior in young people. Am J Prev Med 2011; 41:197-206. [PMID: 21767728 DOI: 10.1016/j.amepre.2011.05.001] [Citation(s) in RCA: 161] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2010] [Revised: 04/05/2011] [Accepted: 05/04/2011] [Indexed: 11/25/2022]
Abstract
CONTEXT Opportunities for young people to be sedentary have increased during leisure time, study time, and transportation time. PURPOSE This review paper focuses on sedentary behaviors among young people aged 2-18 years and includes evidence of the relationship between sedentary behavior and health risk indicators, an overview of public health recommendations, the prevalence of key sedentary behaviors, evidence of correlates of sedentary behavior and the effectiveness of interventions to reduce sedentary behaviors. EVIDENCE ACQUISITION Although this is a narrative style review and not systematic, where possible, findings from relevant review papers were summarized and a search of more recent literature was performed using computer-based databases such as PubMed, Google Scholar, ERIC, PsycINFO, Social Science Index, SportDiscus, and Health Reference Center - Academic. EVIDENCE SYNTHESIS Young people spend 2-4 hours per day in screen-based behaviors and 5-10 hours per day sedentary. Ethnicity, sociodemographic status, having a TV set in the bedroom, and parental behavior appear to be the most consistent correlates of TV viewing time; however, few recent studies aiming to reduce TV viewing or sedentary time among young people have been successful. CONCLUSIONS A growing body of evidence supports the development of public health recommendations to limit the time spent in screen-based behaviors. More research is needed to examine the prospective and experimental evidence of associations between overall sedentary time and health, determinants of sedentary behaviors other than screen-based behaviors, and interventions to reduce overall sedentary time or even alternative sedentary behaviors, such as transport- or education-related sitting time.
Collapse
Affiliation(s)
- Jo Salmon
- Centre for Physical Activity and Nutrition Research, Deakin University, Melbourne, Australia.
| | | | | | | |
Collapse
|
34
|
Tremblay MS, Colley RC, Saunders TJ, Healy GN, Owen N. Physiological and health implications of a sedentary lifestyle. Appl Physiol Nutr Metab 2011; 35:725-40. [PMID: 21164543 DOI: 10.1139/h10-079] [Citation(s) in RCA: 757] [Impact Index Per Article: 58.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Sedentary behaviour is associated with deleterious health outcomes, which differ from those that can be attributed to a lack of moderate to vigorous physical activity. This has led to the field of "sedentary physiology", which may be considered as separate and distinct from exercise physiology. This paper gives an overview of this emerging area of research and highlights the ways that it differs from traditional exercise physiology. Definitions of key terms associated with the field of sedentary physiology and a review of the self-report and objective methods for assessing sedentary behaviour are provided. Proposed mechanisms of sedentary physiology are examined, and how they differ from those linking physical activity and health are highlighted. Evidence relating to associations of sedentary behaviours with major health outcomes and the population prevalence and correlates of sedentary behaviours are reviewed. Recommendations for future research are proposed.
Collapse
Affiliation(s)
- Mark Stephen Tremblay
- Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, 401 Smyth Road, Ottawa, ON K1H 8L1 Canada.
| | | | | | | | | |
Collapse
|
35
|
Parental factors associated with walking to school and participation in organised activities at age 5: analysis of the Millennium Cohort Study. BMC Public Health 2011; 11:14. [PMID: 21210998 PMCID: PMC3027134 DOI: 10.1186/1471-2458-11-14] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2010] [Accepted: 01/06/2011] [Indexed: 11/17/2022] Open
Abstract
Background Physical activity is associated with better health. Two sources of activity for children are walking to school and taking part in organised sports and activities. This study uses a large national cohort to examine factors associated with participation in these activities. Methods The Millennium Cohort study contains 5 year follow-up of 17,561 singleton children recruited between 2000-2002 in the UK. All participants were interviewed in their own homes at 9 months, 3 years and 5 years follow-up and all measures were self reports. Logistic regression and likelihood ratio tests were used. Results Children are less likely to walk to school as income and parental education increase [Adjusted odds: 0.7 (95%CI: 0.6-0.8) for higher income/education compared to low income/no qualifications]. However, if the parent plays with the child in high income families the child is more likely to walk to school [Adjusted odds: 1.67 (95%CI: 1.3-2.1)]. Children taking part in organised activities are from higher income, higher education families, with a car, in a "good" area with non-working mothers. However, in low socio-economic families where the parent plays with the child the child is more likely to take part in organised activities [Adjusted odds: 2.0 (95% CI: 1.5-2.7)]. Conclusions Income is an important determinant of the type of activity available to children. Families that report good health behaviours (non-smoking, low TV viewing) and play with their children show higher levels of physical activity. Thus, parenting practice appears to have a strong impact on their child's physical activity.
Collapse
|