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Beynon A, Hendry D, Lund Rasmussen C, Rohl AL, Eynon R, Thomas G, Stearne S, Campbell A, Harris C, Zabatiero J, Straker L. Measurement Method Options to Investigate Digital Screen Technology Use by Children and Adolescents: A Narrative Review. CHILDREN (BASEL, SWITZERLAND) 2024; 11:754. [PMID: 39062204 PMCID: PMC11275073 DOI: 10.3390/children11070754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/02/2024] [Revised: 06/17/2024] [Accepted: 06/18/2024] [Indexed: 07/28/2024]
Abstract
The role and potential impact of digital screen technology in the lives of children is heavily debated. Current evidence is limited by the weakness of measures typically used to characterise screen use, predominantly proxy- or self-reports with known inaccuracy and bias. However, robust and detailed evidence is needed to provide practical trustworthy guidance to families and professionals working with families. The purpose of this paper is to support researchers to select measurement method(s) that will provide robust and detailed evidence. The paper outlines the challenges in measuring contemporary screen use by children, using a child-technology interaction model to organise considerations. A range of different methods used to measure digital screen technology use in children and adolescents (i.e., questionnaires, diaries, electronically prompted sampling, direct observation, fixed room cameras, wearable/portable cameras, audio recorders, screen-device onboard logging, remote digital trace logging and proximity logging) are described along with examples of their use and constructs typically measured as well as a summary of the advantages and disadvantages of each method. A checklist and worked examples are provided to support researchers determining the best methods or combination of methods for a research project.
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Affiliation(s)
- Amber Beynon
- ARC Centre of Excellence for the Digital Child, Australia; (A.B.); (D.H.); (C.L.R.); (A.L.R.); (G.T.); (S.S.); (A.C.); (C.H.); (J.Z.)
- School of Allied Health, Curtin University, Perth, WA 6845, Australia
| | - Danica Hendry
- ARC Centre of Excellence for the Digital Child, Australia; (A.B.); (D.H.); (C.L.R.); (A.L.R.); (G.T.); (S.S.); (A.C.); (C.H.); (J.Z.)
- School of Allied Health, Curtin University, Perth, WA 6845, Australia
| | - Charlotte Lund Rasmussen
- ARC Centre of Excellence for the Digital Child, Australia; (A.B.); (D.H.); (C.L.R.); (A.L.R.); (G.T.); (S.S.); (A.C.); (C.H.); (J.Z.)
- School of Allied Health, Curtin University, Perth, WA 6845, Australia
| | - Andrew L. Rohl
- ARC Centre of Excellence for the Digital Child, Australia; (A.B.); (D.H.); (C.L.R.); (A.L.R.); (G.T.); (S.S.); (A.C.); (C.H.); (J.Z.)
- Curtin Institute for Data Science and School of Electrical Engineering, Computing and Mathematical Sciences, Curtin University, Perth, WA 6845, Australia
| | - Rebecca Eynon
- Oxford Internet Institute, University of Oxford, Oxford OX1 2JD, UK;
| | - George Thomas
- ARC Centre of Excellence for the Digital Child, Australia; (A.B.); (D.H.); (C.L.R.); (A.L.R.); (G.T.); (S.S.); (A.C.); (C.H.); (J.Z.)
- Health and Wellbeing Centre for Research Innovation, School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, QLD 4006, Australia
| | - Sarah Stearne
- ARC Centre of Excellence for the Digital Child, Australia; (A.B.); (D.H.); (C.L.R.); (A.L.R.); (G.T.); (S.S.); (A.C.); (C.H.); (J.Z.)
- School of Allied Health, Curtin University, Perth, WA 6845, Australia
| | - Amity Campbell
- ARC Centre of Excellence for the Digital Child, Australia; (A.B.); (D.H.); (C.L.R.); (A.L.R.); (G.T.); (S.S.); (A.C.); (C.H.); (J.Z.)
- School of Allied Health, Curtin University, Perth, WA 6845, Australia
| | - Courtenay Harris
- ARC Centre of Excellence for the Digital Child, Australia; (A.B.); (D.H.); (C.L.R.); (A.L.R.); (G.T.); (S.S.); (A.C.); (C.H.); (J.Z.)
- School of Allied Health, Curtin University, Perth, WA 6845, Australia
| | - Juliana Zabatiero
- ARC Centre of Excellence for the Digital Child, Australia; (A.B.); (D.H.); (C.L.R.); (A.L.R.); (G.T.); (S.S.); (A.C.); (C.H.); (J.Z.)
- School of Allied Health, Curtin University, Perth, WA 6845, Australia
| | - Leon Straker
- ARC Centre of Excellence for the Digital Child, Australia; (A.B.); (D.H.); (C.L.R.); (A.L.R.); (G.T.); (S.S.); (A.C.); (C.H.); (J.Z.)
- School of Allied Health, Curtin University, Perth, WA 6845, Australia
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Bulungu ALS, Palla L, Nambooze J, Priebe J, Forsythe L, Katic P, Varley G, Galinda BD, Sarah N, Wellard K, Ferguson EL. Automated wearable cameras for improving recall of diet and time use in Uganda: a cross-sectional feasibility study. Nutr J 2023; 22:7. [PMID: 36635676 PMCID: PMC9835269 DOI: 10.1186/s12937-022-00828-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Accepted: 11/28/2022] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Traditional recall approaches of data collection for assessing dietary intake and time use are prone to recall bias. Studies in high- and middle-income countries show that automated wearable cameras are a promising method for collecting objective health behavior data and may improve study participants' recall of foods consumed and daily activities performed. This study aimed to evaluate the feasibility of using automated wearable cameras in rural Eastern Ugandan to collect dietary and time use data. METHODS Mothers of young children (n = 211) wore an automated wearable camera on 2 non-consecutive days while continuing their usual activities. The day after wearing the camera, participants' dietary diversity and time use was assessed using an image-assisted recall. Their experiences of the method were assessed via a questionnaire. RESULTS Most study participants reported their experiences with the automated wearable camera and image-assisted recall to be good (36%) or very good (56%) and would participate in a similar study in the future (97%). None of the eight study withdrawals could be definitively attributed to the camera. Fifteen percent of data was lost due to device malfunction, and twelve percent of the images were "uncodable" due to insufficient lighting. Processing and analyzing the images were labor-intensive, time-consuming, and prone to human error. Half (53%) of participants had difficulty interpreting the images captured by the camera. CONCLUSIONS Using an automated wearable camera in rural Eastern Uganda was feasible, although improvements are needed to overcome the challenges common to rural, low-income country contexts and reduce the burdens posed on both participants and researchers. To improve the quality of data obtained, future automated wearable camera-based image assisted recall studies should use a structured data format to reduce image coding time; electronically code the data in the field, as an output of the image review process, to eliminate ex post facto data entry; and, ideally, use computer-assisted personal interviews software to ensure completion and reduce errors. In-depth formative work in partnership with key local stakeholders (e.g., researchers from low-income countries, representatives from government and/or other institutional review boards, and community representatives and local leaders) is also needed to identify practical approaches to ensuring that the ethical rights of automated wearable camera study participants in low-income countries are adequately protected.
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Affiliation(s)
- Andrea L. S. Bulungu
- grid.8991.90000 0004 0425 469XDepartment of Population Health, London School of Hygiene and Tropical Medicine, Keppel St, Bloomsbury, London, WC1E 7HT UK
| | - Luigi Palla
- grid.7841.aDepartment of Public Health and Infectious Diseases, University of Roma La Sapienza, 00185 Rome, Italy ,grid.8991.90000 0004 0425 469XDepartment of Medical Statistics, London School of Hygiene and Tropical Medicine, London, WC1E 7HT UK ,grid.444715.70000 0000 8673 4005School of Tropical Medicine and Global Health, University of Nagasaki, Nagasaki, 852-8102 Japan
| | - Joweria Nambooze
- grid.450043.6Africa Innovations Institute (AfrII), P.O Box 34981, Kampala, Uganda ,grid.442642.20000 0001 0179 6299Department of Nutritional Sciences and Dietetics, Kyambogo University, Kyambogo, P.O. Box 1, Kampala, Uganda
| | - Jan Priebe
- grid.36316.310000 0001 0806 5472Natural Resources Institute (NRI), University of Greenwich, Chatham Maritime, Kent, ME4 4TB UK
| | - Lora Forsythe
- grid.36316.310000 0001 0806 5472Natural Resources Institute (NRI), University of Greenwich, Chatham Maritime, Kent, ME4 4TB UK
| | - Pamela Katic
- grid.36316.310000 0001 0806 5472Natural Resources Institute (NRI), University of Greenwich, Chatham Maritime, Kent, ME4 4TB UK
| | - Gwen Varley
- grid.36316.310000 0001 0806 5472Natural Resources Institute (NRI), University of Greenwich, Chatham Maritime, Kent, ME4 4TB UK
| | - Bernice D. Galinda
- grid.8991.90000 0004 0425 469XDepartment of Population Health, London School of Hygiene and Tropical Medicine, Keppel St, Bloomsbury, London, WC1E 7HT UK
| | - Nakimuli Sarah
- grid.8991.90000 0004 0425 469XDepartment of Population Health, London School of Hygiene and Tropical Medicine, Keppel St, Bloomsbury, London, WC1E 7HT UK
| | - Kate Wellard
- grid.36316.310000 0001 0806 5472Natural Resources Institute (NRI), University of Greenwich, Chatham Maritime, Kent, ME4 4TB UK
| | - Elaine L. Ferguson
- grid.8991.90000 0004 0425 469XDepartment of Population Health, London School of Hygiene and Tropical Medicine, Keppel St, Bloomsbury, London, WC1E 7HT UK
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Swindell N, Wachira LJ, Okoth V, Kagunda S, Owino G, Ochola S, Brophy S, Summers H, Richards A, Fairclough SJ, Onywera V, Stratton G. Prevalence and correlates of compliance with 24-h movement guidelines among children from urban and rural Kenya-The Kenya-LINX project. PLoS One 2022; 17:e0279751. [PMID: 36584149 PMCID: PMC9803245 DOI: 10.1371/journal.pone.0279751] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Accepted: 12/14/2022] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Like many countries in sub-Saharan Africa, Kenya has experienced rapid urbanization in recent years. Despite the distinct socioeconomic and environmental differences, few studies have examined the adherence to movement guidelines in urban and rural areas. This cross-sectional study aimed at examining compliance to the 24-hour movement guidelines and their correlates among children from urban and rural Kenya. METHOD Children (n = 539) aged 11.1 ± 0.8 years (52% female) were recruited from 8 urban and 8 rural private and public schools in Kenya. Physical activity (PA) and sleep duration were estimated using 24-h raw data from wrist-worn accelerometers. Screen time (ST) and potential correlates were self- reported. Multi-level logistic regression was applied to identify correlates of adherence to combined and individual movement guidelines. RESULTS Compliance with the combined movement guidelines was low overall (7%), and higher among rural (10%) than urban (5%) children. Seventy-six percent of rural children met the individual PA guidelines compared to 60% urban children while more rural children also met sleep guidelines (27% vs 14%). The odds of meeting the combined movement guidelines reduced with age (OR = 0.55, 95% CI = 0.35-0.87, p = 0.01), was greater among those who could swim (OR = 3.27, 95% CI = 1.09-9.83, p = 0.04), and among those who did not engage in ST before school (OR = 4.40, 95% CI = 1.81-10.68, p<0.01). The odds of meeting PA guidelines increased with the number of weekly physical education sessions provided at school (OR = 2.1, 95% CI = 1.36-3.21, p<0.01) and was greater among children who spent their lunch break walking (OR = 2.52, 95% CI = 1.15-5.55, p = 0.02) or running relative to those who spent it sitting (OR = 2.33, 95% CI = 1.27-4.27, p = 0.01). CONCLUSIONS Prevalence of meeting movement guidelines among Kenyan children is low and of greatest concern in urban areas. Several correlates were identified, particularly influential were features of the school day, School is thus a significant setting to promote a healthy balance between sleep, sedentary time, and PA.
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Affiliation(s)
- Nils Swindell
- Applied Sports Technology Exercise and Medicine Research Centre, Swansea University, Swansea, Wales, United Kingdom
- * E-mail:
| | - Lucy-Joy Wachira
- Department of Physical Education, Exercise and Sports Science, Kenyatta University, Nairobi, Kenya
| | - Victor Okoth
- Department of Physical Education, Exercise and Sports Science, Kenyatta University, Nairobi, Kenya
| | - Stanley Kagunda
- Department of Physical Education, Exercise and Sports Science, Kenyatta University, Nairobi, Kenya
| | - George Owino
- Department of Sociology, Gender and Development Studies, Kenyatta University, Nairobi, Kenya
| | - Sophie Ochola
- Department of Food, Nutrition and Dietetics, Kenyatta University, Nairobi, Kenya
| | - Sinead Brophy
- National Centre for Population Health and Wellbeing Research, Swansea University Medical School, Swansea, Wales, United Kingdom
| | - Huw Summers
- Department of Biomedical Engineering, Swansea University, Swansea, Wales, United Kingdom
| | - Amie Richards
- Applied Sports Technology Exercise and Medicine Research Centre, Swansea University, Swansea, Wales, United Kingdom
| | - Stuart J. Fairclough
- Department of Sport and Physical Activity, Movement Behaviours, Nutrition, Health, & Wellbeing Research Group, Edge Hill University, Ormskirk, United Kingdom
| | - Vincent Onywera
- Department of Physical Education, Exercise and Sports Science, Kenyatta University, Nairobi, Kenya
| | - Gareth Stratton
- Applied Sports Technology Exercise and Medicine Research Centre, Swansea University, Swansea, Wales, United Kingdom
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Marchant E, Lowthian E, Crick T, Griffiths LJ, Fry R, Dadaczynski K, Okan O, James M, Cowley L, Torabi F, Kennedy J, Akbari A, Lyons R, Brophy S. Pre-COVID-19 pandemic health-related behaviours in children (2018-2020) and association with being tested for SARS-CoV-2 and testing positive for SARS-CoV-2 (2020-2021): a retrospective cohort study using survey data linked with routine health data in Wales, UK. BMJ Open 2022; 12:e061344. [PMID: 36691170 PMCID: PMC9453425 DOI: 10.1136/bmjopen-2022-061344] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Accepted: 08/07/2022] [Indexed: 01/27/2023] Open
Abstract
OBJECTIVES Examine if pre-COVID-19 pandemic (prior March 2020) health-related behaviours during primary school are associated with (1) being tested for SARS-CoV-2 and (2) testing positive between 1 March 2020 and 31 August 2021. DESIGN Retrospective cohort study using an online cohort survey (January 2018 to February 2020) linked with routine PCR SARS-CoV-2 test results. SETTING Children attending primary schools in Wales (2018-2020), UK, who were part of the Health and Attainment of Pupils in a Primary Education Network (HAPPEN)_school network. PARTICIPANTS Complete linked records of eligible participants were obtained for n=7062 individuals. 39.1% (n=2764) were tested (age 10.6±0.9; 48.9% girls) and 8.1% (n=569) tested positive for SARS-CoV-2 (age 10.6±1.0; 54.5% girls). MAIN OUTCOME MEASURES Logistic regression of health-related behaviours and demographics were used to determine the ORs of factors associated with (1) being tested for SARS-CoV-2 and (2) testing positive for SARS-CoV-2. RESULTS Consuming sugary snacks (1-2 days/week OR=1.24, 95% CI 1.04 to 1.49; 5-6 days/week OR=1.31, 95% CI 1.07 to 1.61; reference 0 days), can swim 25 m (OR=1.21, 95% CI 1.06 to 1.39) and age (OR=1.25, 95% CI 1.16 to 1.35) were associated with an increased likelihood of being tested for SARS-CoV-2. Eating breakfast (OR=1.52, 95% CI 1.01 to 2.27), weekly physical activity ≥60 min (1-2 days OR=1.69, 95% CI 1.04 to 2.74; 3-4 days OR=1.76, 95% CI 1.10 to 2.82; reference 0 days), out-of-school club participation (OR=1.06, 95% CI 1.02 to 1.10), can ride a bike (OR=1.39, 95% CI 1.00 to 1.93), age (OR=1.16, 95% CI 1.05 to 1.28) and girls (OR=1.21, 95% CI 1.00 to 1.46) were associated with an increased likelihood of testing positive for SARS-CoV-2. Living in least deprived areas (quintile 4 OR=0.64, 95% CI 0.46 to 0.90; quintile 5 OR=0.64, 95% CI 0.46 to 0.89) compared with the most deprived (quintile 1) was associated with a decreased likelihood. CONCLUSIONS Associations may be related to parental health literacy and monitoring behaviours. Physically active behaviours may include coparticipation with others and exposure to SARS-CoV-2. A risk-versus-benefit approach must be considered in relation to promoting these health behaviours, given the importance of health-related behaviours such as childhood physical activity for development.
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Affiliation(s)
- Emily Marchant
- Population Data Science, Medical School, Swansea University, Swansea, UK
- Department of Education and Childhood Studies, Swansea University, Swansea, UK
| | - Emily Lowthian
- Population Data Science, Medical School, Swansea University, Swansea, UK
- Department of Education and Childhood Studies, Swansea University, Swansea, UK
| | - Tom Crick
- Department of Education and Childhood Studies, Swansea University, Swansea, UK
| | - Lucy J Griffiths
- Population Data Science, Medical School, Swansea University, Swansea, UK
| | - Richard Fry
- Population Data Science, Medical School, Swansea University, Swansea, UK
- National Centre for Population Health and Wellbeing Research, Medical School, Swansea University, Swansea, UK
| | - Kevin Dadaczynski
- Department of Nursing and Health Science, Fulda University of Applied Sciences, Fulda, Germany
- Center for Applied Health Sciences, Leuphana University of Lüneburg, Lüneburg, Germany
| | - Orkan Okan
- Faculty of Sport and Health Sciences, Technical University of Munich, München, Germany
| | - Michaela James
- Population Data Science, Medical School, Swansea University, Swansea, UK
- National Centre for Population Health and Wellbeing Research, Medical School, Swansea University, Swansea, UK
| | - Laura Cowley
- Population Data Science, Medical School, Swansea University, Swansea, UK
| | - Fatemeh Torabi
- Population Data Science, Medical School, Swansea University, Swansea, UK
| | - Jonathan Kennedy
- Population Data Science, Medical School, Swansea University, Swansea, UK
- National Centre for Population Health and Wellbeing Research, Medical School, Swansea University, Swansea, UK
| | - Ashley Akbari
- Population Data Science, Medical School, Swansea University, Swansea, UK
| | - Ronan Lyons
- Population Data Science, Medical School, Swansea University, Swansea, UK
| | - Sinead Brophy
- Population Data Science, Medical School, Swansea University, Swansea, UK
- National Centre for Population Health and Wellbeing Research, Medical School, Swansea University, Swansea, UK
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Li X, Holiday S, Cribbet M, Bharadwaj A, White S, Sazonov E, Gan Y. Non-Invasive Screen Exposure Time Assessment Using Wearable Sensor and Object Detection. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2022; 2022:4917-4920. [PMID: 36086530 DOI: 10.1109/embc48229.2022.9871903] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Cumulative screen exposure has been increased due to the explosion of digital technology ownership in the past decade for all people, including children who face exposure related risks such as obesity, eye problems, and disrupted sleep. Screen exposure is linked to physical and mental health risks among both children and adults. Current methods of screen exposure assessment have their limitations, mostly in the prospective of objectiveness, robustness, and invasiveness. In this paper, we propose a novel method to measure screen exposure time using a wearable sensor and computer vision technology. We use a customized, lightweight, wearable senor to capture egocentric images and use deep learning-based object detection module to identify the existence of electronic screens. The duration of screen exposure is further estimated using post-processing technology to filter consecutive frames regarding to the screen usage. Our method is non-invasive and robust, providing an objective and accurate means to screen exposure measurement. We conduct experiments on various environments to identify the existence of three types of screens and duration of screen exposure. The experimental results demonstrate the feasibility of automatically assessing screen time exposure and great potential to be applied in large scale experiments for behavioral study.
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Malnes L, Haugen T, Hansen BH, Kolle E, Berntsen S. Establishing the Convergent Validity of the Travel Habit Questions in the Health Behavior in School-Aged Children Questionnaire by Quantifying Active Travel in Norwegian Adolescents. Front Sports Act Living 2022; 4:761723. [PMID: 35463834 PMCID: PMC9030510 DOI: 10.3389/fspor.2022.761723] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Accepted: 02/23/2022] [Indexed: 11/23/2022] Open
Abstract
Background Active travel (cycling or walking to school) can be a substantial part of adolescents' daily physical activity. Research on transport activities primarily relies on self-reported indices of travel mode and travel time. However, many researchers do not report the psychometric properties of their instruments. The Health Behavior in School-aged Children (HBSC) questionnaire is a commonly used instrument, but the items in this questionnaire on travel habits have not yet been validated. The present study was conducted to investigate the convergent validity and agreement between the HBSC items and a travel diary on (1) transport mode to and from school and (2) travel time to school. Methods The study sample consisted of 50 participants in the 9th grade (15 ± 0.3 years, 62% girls) from seven Norwegian schools. Outcome variables included transport mode and travel time derived from the HBSC items and a five-day travel diary. Convergent validity was assessed by evaluating Cohen's kappa for travel mode and the correlation coefficient (Spearman Rho) for travel time. Simple agreement calculations between the two measurement methods were also conducted. Results The association between the HBSC questionnaire and the diary for travel mode to and from school was κ = 0.63 (P < 0.001) and κ = 0.77 (P < 0.001), respectively. The total agreement between the HBSC questionnaire and the diary for was 78%. However, the agreement was higher for walking (88%) and cycling (91%) than for motorized transport (67%). For travel time, the Spearman correlation coefficient was ρ = 0.60 (P < 0.001) between the HBSC questionnaire and the diary. The total agreement on travel time was 67%; however, active commuters (86%) seemed to more accurately estimated travel time than motorized commuters (55%). Conclusion Although the overall agreement between the HBSC questionnaire and the diary for mode of transport was 78%, the HBSC questionnaire may underestimate the prevalence of motorized transport compared to walking and cycling. Trial Registration ClinicalTrials.gov, identifier: NCT03817047.
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Affiliation(s)
- Lena Malnes
- Department of Sport Science and Physical Education, University of Agder, Kristiansand, Norway
- *Correspondence: Lena Malnes
| | - Tommy Haugen
- Department of Sport Science and Physical Education, University of Agder, Kristiansand, Norway
| | - Bjørge Herman Hansen
- Department of Sport Science and Physical Education, University of Agder, Kristiansand, Norway
| | - Elin Kolle
- Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway
| | - Sveinung Berntsen
- Department of Sport Science and Physical Education, University of Agder, Kristiansand, Norway
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Thomas G, Bennie JA, De Cocker K, Dwi Andriyani F, Booker B, Biddle SJH, Lonsdale C, Biddle S. Using Wearable Cameras to Categorize the Type and Context of Screen-Based Behaviors Among Adolescents: Observational Study. JMIR Pediatr Parent 2022; 5:e28208. [PMID: 35311672 PMCID: PMC8981006 DOI: 10.2196/28208] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Revised: 09/19/2021] [Accepted: 01/26/2022] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND Automated wearable cameras present a new opportunity to accurately assess human behavior. However, this technology is seldom used in the study of adolescent's screen exposure, and the field is reliant on poor-quality self-report data. OBJECTIVE This study aimed to examine adolescents' screen exposure by categorizing the type and context of behaviors using automated wearable cameras. METHODS Adolescents (mean age 15.4 years, SD 1.6 years; n=10) wore a camera for 3 school evenings and 1 weekend day. The camera captured an image every 10 seconds. Fieldwork was completed between February and March 2020, and data were analyzed in August 2020. Images were date and time stamped, and coded for screen type, content, and context. RESULTS Data representing 71,396 images were analyzed. Overall, 74.0% (52,842/71,396) of images contained screens and 16.8% (11,976/71,396) of images contained multiple screens. Most screen exposures involved television sets (25,950/71,396, 36.3%), smartphones (20,851/71,396, 29.2%), and laptop computers (15,309/71,396, 21.4%). The context of screen use differed by device type, although most screen exposures occurred at home (62,455/64,856, 96.3%) and with solitary engagement (54,430/64,856, 83.9%). The immediate after-school period saw high laptop computer use (4785/15,950, 30.0%), while smartphone use (2059/5320, 38.7%) peaked during prebedtime hours. Weekend screen exposure was high, with smartphone use (1070/1927, 55.5%) peaking in the early morning period and fluctuating throughout the day. CONCLUSIONS There was evidence for high screen use during the after-school and weekend period, mostly through solitary engagement, and within the home environment. The findings may inform the basis of larger studies aimed at examining screen exposure in free-living conditions.
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Affiliation(s)
- George Thomas
- School of Allied Health, Curtin University, Bentley, Australia.,Centre for Health Research, University of Southern Queensland, Springfield Central, Australia
| | - Jason A Bennie
- Centre for Health Research, University of Southern Queensland, Springfield Central, Australia
| | - Katrien De Cocker
- Centre for Health Research, University of Southern Queensland, Springfield Central, Australia.,Department of Movement and Sports Sciences, University of Gent, Gent, Belgium
| | - Fitria Dwi Andriyani
- Centre for Health Research, University of Southern Queensland, Springfield Central, Australia.,Department of Sports Education, Yogyakarta State University, Yogyakarta, Indonesia
| | - Bridget Booker
- Institute for Positive Psychology and Education, Australian Catholic University, North Sydney, Australia
| | - Stuart J H Biddle
- Centre for Health Research, University of Southern Queensland, Springfield Central, Australia
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Richards AB, Klos L, Swindell N, Griffiths LJ, De Martelaer K, Edwards LC, Brophy S, Stratton G. Associations between swimming & cycling abilities and fitness in 9-11 year old boys and girls. J Sports Sci 2021; 40:658-666. [PMID: 34937493 DOI: 10.1080/02640414.2021.2013616] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
The associations between swimming and cycling abilities and fitness levels in 9-11-year-old children were examined. A cross-sectional study involving 2258 children (50.7% boys; aged 10.52 ± 0.6 years) from 33 schools across Wales, participated in Swan/BridgeLinx health, fitness, and lifestyle programmes between 2013-2019. Health and fitness data were collected; namely body composition, cardiorespiratory fitness, muscular strength, flexibility, power, and speed using standardised measures. Children completed an online survey collecting data on swimming and cycling abilities and sports club attendance. Multivariate multilevel regressions were used to examine the associations between measures. The ability to swim and cycle was significantly (p < 0.05) associated with all components of fitness when accounting for age, body mass index (BMI), deprivation, gender, and sports club attendance. Boys outperformed girls with significant interactions between swimming, cycling and cardiorespiratory fitness for gender by swim (p = 0.001) and gender by cycle (p = 0.015). The gender by cycle interaction significantly predicted grip strength and power (p < 0.05). Swimming and cycling are important "milestones" in the journey of motor development and are associated with higher levels of fitness. These activities should be promoted to allow for an optimal development of motor skills, fitness, and health.
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Affiliation(s)
- Amie B Richards
- Applied Sports Technology Exercise and Medicine Research Centre, Swansea University, Swansea, UK
| | - Leon Klos
- Karlsruhe Institute of Technology, Institute of Sports and Sports Science, Karlsruhe, Germany
| | - Nils Swindell
- Applied Sports Technology Exercise and Medicine Research Centre, Swansea University, Swansea, UK
| | - Lucy J Griffiths
- Population Data Science, Swansea University Medical School, Swansea, UK
| | - Kristine De Martelaer
- Department of Movement and Sport Sciences, Vrije Universiteit Brussel, Brussels, Belgium
| | - Lowri C Edwards
- School of Sport and Health Sciences (Sport), Cardiff Metropolitan University, Wales, UK
| | - Sinead Brophy
- Population Data Science, Swansea University Medical School, Swansea, UK
| | - Gareth Stratton
- Applied Sports Technology Exercise and Medicine Research Centre, Swansea University, Swansea, UK
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9
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James M, Marchant E, Defeyter MA, Woodside J, Brophy S. Impact of school closures on the health and well-being of primary school children in Wales UK: a routine data linkage study using the HAPPEN Survey (2018-2020). BMJ Open 2021; 11:e051574. [PMID: 34625414 PMCID: PMC8503919 DOI: 10.1136/bmjopen-2021-051574] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Accepted: 09/01/2021] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES This study aimed to explore the relationship between initial school closures and children's health by comparing health and well-being outcomes collected during school closures (April-June 2020) via HAPPEN (the Health and Attainment of Pupils in a Primary Education Network) with data from the same period in 2019 and 2018 via the HAPPEN Survey. SETTING The study was conducted online with 161 primary schools across Wales involved in the 'HAPPEN At Home' Survey. PARTICIPANTS Data were collected via the 'HAPPEN At Home' Survey capturing the typical health behaviours of children aged 8-11 years from 1333 participants across Wales. These data were compared with data in 2018 and 2019 also collected between April and June, from HAPPEN (2019 (n=1150) and 2018 (n=475)). PRIMARY AND SECONDARY OUTCOME MEASURES Primary outcomes included validated measures of physical activity, screen time, diet and dental health, as well as well-being, competency and autonomy. Free school meal (FSM) status was used as a proxy for socioeconomic deprivation. Analyses were repeated stratifying by FSM. RESULTS Comparing responses between April-June in 2020 (n=1068), 2019 (n=1150) and 2018 (n=475), there were improvements in physical activity levels, sleep time, happiness and general well-being for children during school closures compared with previous years. However, children on FSM ate fewer fruits and vegetables (21% less at five or more portions of fruits and vegetables (95% CI: 5.7% to 37%)) and had lower self-assessed school competence compared with 2019. Compared with those not on FSM, they also spent less time doing physical activity (13.03%, 95% CI: 3.3% to 21.7%) and consumed more takeaways (16.3%, 95% CI: 2% to 30%) during school closures. CONCLUSIONS This study suggests that schools are important in reducing inequalities in physical health. The physical health (eg, physical activity and diet) of children eligible for FSM may be affected by prolonged school closures.
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Affiliation(s)
| | | | | | - Jayne Woodside
- Centre for Public Health, Queen's University Belfast, Belfast, UK
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10
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Langlet B, Maramis C, Diou C, Maglaveras N, Fagerberg P, Heimeier R, Lekka I, Delopoulos A, Ioakimidis I. Formative Evaluation of a Smartphone App for Monitoring Daily Meal Distribution and Food Selection in Adolescents: Acceptability and Usability Study. JMIR Mhealth Uhealth 2020; 8:e14778. [PMID: 32706684 PMCID: PMC7404017 DOI: 10.2196/14778] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Revised: 09/14/2019] [Accepted: 05/14/2020] [Indexed: 01/12/2023] Open
Abstract
Background Obesity interventions face the problem of weight regain after treatment as a result of low compliance. Mobile health (mHealth) technologies could potentially increase compliance and aid both health care providers and patients. Objective This study aimed to evaluate the acceptability and usability and define system constraints of an mHealth system used to monitor dietary habits of adolescents in real life, as a first step in the development of a self-monitoring and lifestyle management system against adolescent obesity. Methods We recruited 26 students from a high school in Stockholm, Sweden. After a 30-minute information meeting and 5-minute individual instruction on how to use an mHealth system (smartphone with app and two external sensors), participants used it for 2-3 weeks to objectively collect dietary habits. The app and sensors were used by the participants, without supervision, to record as many main meals and snacks as possible in real life. Feasibility was assessed following the “mHealth evidence reporting and assessment checklist,” and usability was assessed by questionnaires. Compliance was estimated based on system use, where a registration frequency of 3 main meals (breakfast, lunch, and dinner) per day for the period of the experiment, constituted 100% compliance. Results Participants included in the analysis had a mean age of 16.8 years (SD 0.7 years) and BMI of 21.9 kg/m2 (SD 4.1 kg/m2). Due to deviations from study instructions, 2 participants were excluded from the analysis. During the study, 6 participants required additional information on system use. The system received a ‘Good’ grade (77.1 of 100 points) on the System Usability Scale, with most participants reporting that they were comfortable using the smartphone app. Participants expressed a willingness to use the app mostly at home, but also at school; most of their improvement suggestions concerned design choices for the app. Of all main meals, the registration frequency increased from 70% the first week to 76% the second week. Participants reported that 40% of the registered meals were home-prepared, while 34% of the reported drinks contained sugar. On average, breakfasts took place at 8:30 AM (from 5:00 AM to 2:00 PM), lunches took place at 12:15 PM (from 10:15 AM to 6:15 PM), and dinners took place at 7:30 PM (from 3:00 PM to 11:45 PM). When comparing meal occurrence during weekdays vs weekends, breakfasts and lunches were eaten 3 hours later during weekends, while dinner timing was unaffected. Conclusions From an infrastructural and functional perspective, system use was feasible in the current context. The smartphone app appears to have high acceptability and usability in high school students, which are the intended end-users. The system appears promising as a relatively low-effort method to provide real-life dietary habit measurements associated with overweight and obesity risk.
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Affiliation(s)
- Billy Langlet
- The Innovative Use of Mobile Phones to Promote Physical Activity and Nutrition Across the Lifespan Research Group, Department of Biosciences and Nutrition, Karolinska Institutet, Huddinge, Sweden
| | - Christos Maramis
- Lab of Computing, Medical Informatics and Biomedical Imaging Technologies, Department of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Christos Diou
- Department of Electrical and Computer Engineering, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Nikolaos Maglaveras
- Lab of Computing, Medical Informatics and Biomedical Imaging Technologies, Department of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Petter Fagerberg
- The Innovative Use of Mobile Phones to Promote Physical Activity and Nutrition Across the Lifespan Research Group, Department of Biosciences and Nutrition, Karolinska Institutet, Huddinge, Sweden
| | | | - Irini Lekka
- Lab of Computing, Medical Informatics and Biomedical Imaging Technologies, Department of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Anastasios Delopoulos
- Department of Electrical and Computer Engineering, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Ioannis Ioakimidis
- The Innovative Use of Mobile Phones to Promote Physical Activity and Nutrition Across the Lifespan Research Group, Department of Biosciences and Nutrition, Karolinska Institutet, Huddinge, Sweden
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11
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Asaka Y, Sekine M, Yamada M, Tatsuse T, Sano M. Association of short sleep duration and long media use with caries in school children. Pediatr Int 2020; 62:214-220. [PMID: 31793160 DOI: 10.1111/ped.14075] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2019] [Revised: 10/16/2019] [Accepted: 11/28/2019] [Indexed: 12/11/2022]
Abstract
BACKGROUND Individual lifestyle factors are associated with dental caries in children. The aim of this study was to investigate comprehensively the association between dental caries in elementary school children and lifestyle factors of the children and their parents. METHODS Children from five elementary schools in Takaoka city, Toyama Prefecture, Japan (1,699: 848 boys, 851 girls, age range 6-12 years) participated in a survey conducted in March 2016. Questions on socioeconomic status (SES) and lifestyle factors in the children and their parents were included. Children who received treatment for three or more dental caries were defined as having many caries. Logistic regression analysis was performed to evaluate whether these factors were associated with the number of caries. RESULTS The percentage of children with many caries (≥3) was 38.4%. In univariate analysis, being in 5th or 6th grade, frequent snacking, short sleep duration, long hours of media use, paternal smoking, and parental skipping of breakfast were significantly associated with many caries. Lack of affluence was marginally significant. In multivariate analysis, the association of short hours of sleep and long hours of media use remained significant. The adjusted odds ratio (OR) for media use of 1-2 h and more than 2 h were 1.79 (95% confidence interval [CI]: 1.30-2.46) and 2.24 (95% CI: 1.61-3.11) respectively. The adjusted OR for less than 8 h of sleep was 1.49 (95% CI: 1.07-2.06). CONCLUSIONS Long duration of media use and short duration of sleep were associated with dental caries. Establishing a healthy lifestyle is necessary for preventing dental caries in children.
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Affiliation(s)
- Yukiko Asaka
- Department of Epidemiology and Health Policy, University of Toyama, Toyama, Japan.,Asunaro Pediatric Dentistry, Toyama, Japan.,Division of Pediatric Dentistry, Department of Human Development and Fostering, Meikai University School of Dentistry, Saitama, Japan
| | - Michikazu Sekine
- Department of Epidemiology and Health Policy, University of Toyama, Toyama, Japan
| | - Masaaki Yamada
- Department of Epidemiology and Health Policy, University of Toyama, Toyama, Japan
| | - Takashi Tatsuse
- Department of Epidemiology and Health Policy, University of Toyama, Toyama, Japan
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12
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Associations between the Home Physical Environment and Children's Home-Based Physical Activity and Sitting. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16214178. [PMID: 31671849 PMCID: PMC6862192 DOI: 10.3390/ijerph16214178] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Revised: 10/16/2019] [Accepted: 10/24/2019] [Indexed: 12/11/2022]
Abstract
It is important to understand the correlates of children's physical activity (PA) and sitting at home, where children spend significant time. The home social environment has an important influence; however, much less is known about the home physical environment. Therefore, the study aimed to assess relationships between the physical environment and children's sitting and PA at home. In total, 235 child-parent dyads were included in the analyses. Children spent 67% of their time at home sitting. Linear regression analyses examined associations between physical home environmental factors obtained via an audit and children's (55% girl, 10.2 ± 0.7) objective PA and sitting at home. Following adjustment for socio-demographics and social environmental factors, an open plan living area (OPLA), musical instrument accessibility and availability, and perceived house size were negatively and positively associated, whereas media equipment accessibility and availability was positively and negatively associated with sitting and standing, respectively. Additionally, an OPLA was positively associated with total and moderate-to-vigorous PA. Furthermore, sitting breaks were positively associated with objective garden size and negatively associated with digital TV. The physical home environment may have an important influence on children's sitting, standing and PA at home; therefore, interventions that target this environment are needed.
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