Physical Activity and Sedentary Behaviors of Young Children: Trends from 2009 to 2018

Associations of obesity, movement behaviors, and socioeconomic status with fundamental movement skills in children: Results from the REACT project

OBJECTIVE

To investigate the relationship of biological characteristics (age, sex, and obesity), movement behaviors (physical activity and sedentary time), and family socioeconomic status with fundamental movement skills (FMS) in primary school children.

METHODS

This cross-sectional study sampled 1014 children (537 girls) aged 6 to 10 years from 25 primary schools in Matosinhos, north of Portugal. Five object control skills (dribbling, kicking, catching, throwing, and underarm rolling) were assessed with a categorical scale using the Meu Educativo® platform. Body Mass Index (BMI) was calculated and transformed into z-scores. Moderate-to-vigorous physical activity (MVPA) and sedentary time were monitored with accelerometry (ActiGraph wGT3X-BT) for seven consecutive days. Family socioeconomic status (SES) was obtained from the Portuguese social support system. Ordinal multilevel logistic regression was used to analyze the associations of weight status, MVPA, sedentary time and SES with FMS, adjusted for sex and age.

RESULTS

Boys (odds ratio (OR) = 6.54; 95% CI: 5.13-8.36) and older children (OR = 2.04; 95% CI: 1.85-2.26) were more likely to achieve higher FMS scores. Children with obesity (OR = 0.60; 95% CI: 0.45-0.80), those less active (OR = 0.56; 95% CI: 0.42-0.75) and children with more sedentary time (OR = 0.86; 95%CI: 0.77-0.97) were less likely to score high on FMS. Family SES was not significantly associated with FMS scores.

CONCLUSION

Primary school children's FMS are significantly related to biological and behavioral factors but not to family SES. These findings highlight the need for suitable strategies to enhance children's FMS proficiency, considering differences in these characteristics. Fostering adequate motor skill proficiency levels will assist in establishing a robust foundation for healthy lifestyles of all children.

Pre-school-based behaviour change intervention to increase physical activity levels amongst young children: a feasibility cluster randomised controlled trial

Background

A significant rise in childhood obesity worldwide over the past three decades highlights the urgent need for early interventions, especially in preschools as key settings for child development. This study aimed to assess the feasibility and fidelity of a randomised controlled trial of "I'm an Active Hero" (IAAH), a theory- and evidence-based multi-component behaviour change intervention targeting physical activity and sedentary behaviour amongst preschool-aged children.

Methods

Two preschools in Taif city, Saudi Arabia were randomly assigned to either the intervention (n = 3 classrooms) or the usual curriculum control group (n = 3 classrooms). The intervention ran for 10 weeks from February to April 2023 and consisted of teacher-led physical activity and sedentary behaviour sessions in preschools, with an additional interactive home component. Primary outcome measures included intervention fidelity, recruitment rates, attrition rates, and compliance with trial procedures. Secondary outcomes included body mass index (BMI), objectively measured physical activity, and sedentary time via the ActiGraph GT3X accelerometer. Outcomes were measured at baseline and at 10 weeks in both study arms.

Results

The preschool intervention component had high fidelity (93.3%), but the home component fidelity was lower (74%). A cluster-level recruitment rate of 12% (13/112 centres) was attained, whilst the individual-level recruitment rate stood at 36% (52/143 children, mean age of 4.16 years; 23 girls). Attrition was 10%. Compliance varied with 90% for BMI, 71% for accelerometery, and 45% for questionnaires. The intervention group showed small decreases in BMI, slight increases in physical activity, and decreases in sedentary time at follow-up compared to the control group. Parents, facilitators, and assistant teachers considered the intervention to be feasible and beneficial.

Conclusion

The IAAH intervention was feasible to implement in Saudi Arabian preschools. Facilitators showed high fidelity in delivering it. However, preliminary data did not demonstrate effectiveness. A more comprehensive evaluation across a broader population is warranted. The intervention could be revised to optimise recruitment, compliance, and fidelity of the home-based component. Successful elements from this pilot should be retained whilst adaptations to implementation are made to strengthen key areas.Clinical trial registration: ClinicalTrials.gov, NCT05754359.

Evaluation of physical fitness and health of young children aged between 3 and 6 based on cluster and factor analyses

BACKGROUND

As life improves and sedentary time increases, young children's physical fitness gradually declines.

METHODS

Multi-stage stratified whole cluster sampling was utilized to sample 5584 preschoolers. Young infants' morphology, function, and quality were revealed using cluster and factor analysis.

RESULTS

The cluster analysis separated 3-6-year-olds into two genders: 1,551 men in group A "high physical fitness" 1,499 men in group B "low physical fitness"; 1,213 women in group A and 1,321 women in group B. Young children's fitness was measured by standing long jump(1.00), weight(1.00), and height(1.00). A cluster analysis of 3-4-year-olds classified them into three groups: 272 "muscular strength," 75 "average physical fitness," and 250 "low agility." Young children's health depends on weight (1.00), height (0.57), and chest circumference (0.54). A cluster analysis of the 4-5-year-olds classified them into two groups: 1070 "balance" and 806 "muscular strength." Young children's health depends on weight (1.00), height (0.74), and chest circumference (0.71). A cluster analysis of the 5-6-year-olds divided them into three groups: 1762 "high physical fitness," 384 "obese," and 105 "low physical fitness." Young children's physical health depends on BMI (1.00), weight (1.00), and chest circumference (1.00). Factor analysis demonstrated that muscle strength, body shape, cardiovascular variables, and physical fitness composite components affected young children's health.

CONCLUSION

Women should focus on motor function and strength, while men on flexibility. Male group B "low physical fitness" should focus on strength, motor function, and balance, whereas male group A "high physical fitness" should focus on flexibility. Then, female group A "high physical fitness" should emphasize variety.2) For 3-4-year-olds, group A "muscular strength" should focus on flexibility, and group C "low agility" on motor function. 3) For 4-5-year-olds, group A "balanced" should focus on strength and motor function; 4) For 5-6-year-olds, group B "obese" should emphasize weight loss, and group C "low fitness" should emphasize strength, motor function, and flexibility; 5) Young children's physical fitness depends on muscle strength, body shape, cardiovascular factors, and physical fitness composite.

Which behaviour change techniques are associated with interventions that increase physical activity in pre-school children? A systematic review

BACKGROUND

Insufficient physical activity (PA) is a significant risk factor that contributes to several health problems and there is a need to improve our understanding of how to increase PA, particularly among young children. This review (PROSPERO registration: CRD42022328841) investigated the relationship between behaviour change techniques (BCTs) and interventions that increased PA among pre-school children aged < 6 years old.

METHODS

Systematic searches of six databases were undertaken from inception to July 2022, updated in December 2022, to locate studies that evaluated interventions and reported a positive change in PA levels in children aged < 6 years old.

RESULTS

A total of 5,304 studies were screened, and 28 studies involving 10,605 subjects aged 2.5 to 5.9 years met the eligibility criteria. Each eligible study (n = 28) was independently appraised by two researchers using the Cochrane risk of bias tool. The BCT Taxonomy v1 and the Template for Intervention Description and Replication (TIDieR) guided the extraction and analysis of data, and this process led to the identification of 27 BCTs.

CONCLUSIONS

Potentially promising BCTs for increasing PA among young children included 'shaping knowledge,' 'antecedents,' 'goals and planning,' and 'comparison of behaviour.' Future PA interventions that target young children should consider integrating these promising BCTs into their programmes. However, such consideration needs to be tempered by the fact that most of the reviewed studies were deemed to have a high or unclear risk of bias and/or were limited with respect to the populations that they targeted. Further research using rigorous methodologies is required to establish a higher standard that addresses the needs of young children who are expected to have insufficient levels of physical activity.

The Portuguese economic crisis is associated with socioeconomic and sex disparities on children's health-related behaviors and obesity: A cross-sectional study

OBJECTIVES

Our objective was to examine the relationship between the 2008 and 2015 economic crisis and children's physical activity (PA) outcomes, eating behaviors and obesity prevalence, while considering sex inequalities and familial socioeconomic status.

METHOD

This is a cross-sectional study, including data collected in 2016/2017 among 5134 children aged 6-11 years (mean age: 8.11 ± 1.24; 50.0% boys). Children's height, weight, and waist circumference were objectively measured. Children's sleep- and screen-time, participation in organized sports, and specific dietary habits were reported parental-reported using a standardized questionnaire. An economic crisis impact score, with data from 10 indicators of economic needs in the family, was used to characterize the crisis' impact.

RESULTS

First, the prevalence of overweight and obesity was higher in children whose families had a higher impact of the crisis. Second, children's intake of fruit and high-fat food, screen-time, sleep-time, and participation in organized sports differed according to the level of impact of the economic crisis. Third, the association between health-related behaviors and the impact of the economic crisis was stronger for girls compared to boys.

CONCLUSION

Our findings give us an indication of how economic crises may drive changes in health outcomes.

Global Prevalence of Meeting Screen Time Guidelines Among Children 5 Years and Younger: A Systematic Review and Meta-analysis

IMPORTANCE

Pediatric guidelines suggest that infants younger than 2 years avoid screen time altogether, while children aged 2 to 5 years receive no more than 1 hour per day. Although these guidelines have been adopted around the world, substantial variability exists in adherence to the guidelines, and precise estimates are needed to inform public health and policy initiatives.

OBJECTIVE

To derive the pooled prevalence via meta-analytic methods of children younger than 2 years and children aged 2 to 5 years who are meeting guidelines about screen time.

DATA SOURCES

Searches were conducted in MEDLINE, PsycINFO, and Embase up to March 2020.

STUDY SELECTION

Studies were included if participants were 5 years and younger and the prevalence of meeting (or exceeding) screen time guidelines was reported.

DATA EXTRACTION AND SYNTHESIS

Data extraction followed Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. Two independent reviewers extracted all relevant data. Random-effects meta-analyses were used to derive the mean prevalence rates.

MAIN OUTCOMES AND MEASURES

Prevalence of meeting screen time guidelines.

RESULTS

From 63 studies, 95 nonoverlapping samples with a total of 89 163 participants were included. For children younger than 2 years, the pooled prevalence of meeting the screen time guideline (0 h/d) was 24.7% (95% CI, 19.0%-31.5%). Moderator analyses revealed that prevalence of meeting screen time guidelines varied as a function of year of data collection (increased over time), measurement method (higher when questionnaires compared with interview), and type of device use (higher when a combination of screen use activities compared with television/movies only). For children aged 2 to 5 years, the mean prevalence of meeting the screen time guideline (1 h/d) was 35.6% (95% CI, 30.6%-40.9%). Moderator analyses revealed that the prevalence of meeting screen time guidelines varied as a function of type of device use (higher when screen time was television/movies only compared with a combination of screen use activities).

CONCLUSIONS AND RELEVANCE

The findings of this meta-analysis indicate that only a minority of children 5 years and younger are meeting screen time guidelines. This highlights the need to provide support and resources to families to best fit evidence-based recommendations into their lives.

The 2008 Financial Crisis and Changes in Lifestyle-Related Behaviors in Italy, Greece, Spain, and Portugal: A Systematic Review

Italy, Greece, Spain, and Portugal have all been strongly affected by the 2008 financial crisis, which has had a negative impact on health. We systematically evaluated the effects of the crisis on lifestyle and socioeconomic inequalities. We conducted a literature search using MEDLINE, Embase, the Cochrane Library, and health economics databases for studies reporting quantitative comparisons before and after (or during) the crisis on the following risk behaviors: alcohol consumption, smoking habit, healthy diet, physical activity, and psychotropic drugs and substance abuse, without setting any age restrictions. We selected 34 original articles published between 2011 and 2020. During/after the crisis, alcohol consumption and substance abuse decreased, while psychotropic drug use increased. We also observed a deterioration in healthy eating behavior, with a reduction in fruit and vegetable consumption. Smoking habit and physical activity showed a more complex, controversial trend. Socioeconomic inequalities were affected by the recession, and the negative effects on unhealthy lifestyle tended to be more pronounced among the disadvantaged. These results suggest the need to implement health policies and interventions aimed at monitoring risk behaviors, with special regard to disadvantaged people, and considering the potential additional impact of the COVID-19 pandemic.

Measurement of screen time among young children aged 0-6 years: A systematic review

The impact of screen-based devices on children's health and development cannot be properly understood without valid and reliable tools that measure screen time within the evolving digital landscape. This review aimed to summarize characteristics of measurement tools used to assess screen time in young children; evaluate reporting of psychometric properties; and examine time trends related to measurement and reporting of screen time. A systematic review of articles published in English across three databases from January 2009 to April 2020 was undertaken using PROSPERO protocol (registration: CRD42019132599) and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Included articles measured screen time as outcome, exposure, or confounder in children 0-6 years. The search identified 35,868 records, 1035 full-text articles were screened for eligibility, and 622 met inclusion criteria. Most measures (60%) consisted of one to three items and assessed duration of screen time on a usual day. Few measures assessed content (11%) or coviewing (7%). Only 40% of articles provided a citation for the measure, and only 69 (11%) reported psychometric properties-reliability n = 58, validity n = 19, reliability and validity n = 8. Between 2009 and 2019, the number of published articles increased from 28 to 71. From 2015, there was a notable increase in the proportion of articles published each year that assessed exposure to mobile devices in addition to television. The increasing number of published articles reflects increasing interest in screen time exposure among young children. Measures of screen time have generally evolved to reflect children's contemporary digital landscape; however, the psychometric properties of measurement tools are rarely reported. There is a need for improved measures and reporting to capture the complexity of children's screen time exposures.

Sociodemographic Correlates of Parental Co-Participation in Digital Media Use and Physical Play of Preschool-Age Children

Young children’s digital media use and physical activity have gained attention in recent research. Parental co-participation has a major impact on children’s health consequences. This study addressed a gap in the research by investigating daily parental co-participation in children’s digital media use and physical play, using the family ecological model theoretical framework. The participants in this nationally representative cross-sectional study were 2512 Finnish parents with two- to six-year-old children. Parents completed a questionnaire. Sociodemographic correlates of co-participation and of the awareness of guidelines regarding co-participation and correlation between co-participation in digital media use and physical play were analysed. Parental co-participation in physical play and digital media use correlated positively. Lower parental age, male parental gender, Finnish and Swedish languages, a fewer number of children, and a male child gender were associated with more co-participation in one or both activities, and parental female gender and low family income were associated with more awareness. The awareness of guidelines was not associated with co-participation in digital media use. There were sociodemographic differences in parental co-participation. From a health counselling perspective, parents may benefit from national recommendations on digital media use and physical activity, but adherence to guidelines depends on the family context.

Teaching Methodologies and School Organization in Early Childhood Education and Its Association with Physical Activity

Early childhood represents a crucial period for child development. Physical activity is essential in this process, but studies show that children are very inactive and do not meet the recommended minimums. Due to the large proportion of time they spend at school, it is necessary to examine active and sedentary behaviors in these environments. The aim of the study is to analyze the amount and intensity of physical activity in preschool children during the school day according to the methodology used. Using accelerometry, the amount and intensity of physical activity and sedentary behavior of 156 children aged 4-6 years at different times of the school day were evaluated. The results revealed that preschoolers spend most of their class time sedentary, with children participating in active methodologies registering the highest amount and intensity of physical activity. Recess and specific motor sessions are the most active times, although the latter should increase the time of intense activity that they imply. To increase physical activity during the school day, it is necessary to establish movement integration methodologies, while increasing the number and adjusting the duration of specific motor sessions and of recesses, so that the maximum possible use is made of them.

Versão brasileira do Preschool-age Children’s Physical Activity Questionnaire (Pre-PAQ)

RESUMO Foi realizada a tradução e a adaptação transcultural do Preschool-age Children’s Physical Activity Questionnaire para a língua portuguesa do Brasil. O questionário foi traduzido em duas versões diferentes por dois profissionais proficientes na língua inglesa. Baseada nessas duas traduções independentes, foi criada a tradução única, então retrotraduzida para o inglês por outros dois tradutores. As retrotraduções passaram por novo processo de consenso, que gerou uma versão única, que foi comparada com o questionário em inglês original. A versão do questionário em português do Brasil, denominada Questionário de Atividade Física de Crianças em Idade Pré-Escolar (Pre-PAQ), foi revisada por uma comissão de especialistas para verificação do conteúdo e gerou a segunda versão de concordância. Em seguida, 28 profissionais da área avaliaram o questionário quanto à adequação para a língua portuguesa do Brasil e à adaptação cultural para crianças brasileiras de 3 a 5 anos de idade. Conclui-se que as etapas de tradução e adaptação cultural foram concluídas com sucesso, ainda que futuros estudos para testar a confiabilidade e validade do conteúdo da versão brasileira do Pre-PAQ sejam necessários para garantir a acurácia da aplicação na população-alvo.