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Eddy LH, Preston N, Boom S, Davison J, Brooks R, Bingham DD, Mon-Williams M, Hill LJB. The validity and reliability of school-based fundamental movement skills screening to identify children with motor difficulties. PLoS One 2024; 19:e0297412. [PMID: 38359032 PMCID: PMC10868745 DOI: 10.1371/journal.pone.0297412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Accepted: 12/27/2023] [Indexed: 02/17/2024] Open
Abstract
AIM Assess whether school-based teacher-led screening is effective at identifying children with motor difficulties. METHODS Teachers tested 217 children aged between 5 and 11 years old, after a one hour training session, using a freely available tool (FUNMOVES). Four classes (n = 91) were scored by both researchers and teachers to evaluate inter-rater reliability. Researchers assessed 22 children using the Movement Assessment Battery for Children (MABC-2; considered to be the 'gold standard' in Europe for use as part of the diagnostic process for Developmental Coordination Disorder) to assess concurrent and predictive validity. RESULTS Inter-rater reliability for all individual activities within FUNMOVES ranged from 0.85-0.97 (unweighted Kappa; with 95%CI ranging from 0.77-1). For total score this was lower (κ = 0.76, 95%CI = 0.68-0.84), however when incorporating linear weighting, this improved (κ = 0.94, 95%CI = 0.89-0.99). When evaluating FUNMOVES total score against the MABC-2 total score, the specificity (1, 95%CI = 0.63-1) and positive predictive value (1; 95%CI = 0.68-1) of FUNMOVES were high, whereas sensitivity (0.57, 95%CI = 0.29-0.82) and negative predictive values (0.57, 95%CI = 0.42-0.71) were moderate. Evaluating only MABC-2 subscales which are directly related to fundamental movement skills (Aiming & Catching, and Balance) improved these values to 0.89 (95%CI = 0.52-1) and 0.93 (95%CI = 0.67-0.99) respectively. INTERPRETATION Teacher-led screening of fundamental movement skills (via FUNMOVES) is an effective method of identifying children with motor difficulties. Such universal screening in schools has the potential to identify movement difficulties and enable earlier intervention than the current norm.
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Affiliation(s)
- Lucy H. Eddy
- Department of Psychology, University of Bradford, Bradford, United Kingdom
- Centre for Applied Education Research, Wolfson Centre for Applied Health Research, Bradford, United Kingdom
| | - Nick Preston
- Centre for Applied Education Research, Wolfson Centre for Applied Health Research, Bradford, United Kingdom
- Leeds Institute of Medical Research, University of Leeds, Leeds, United Kingdom
| | - Shania Boom
- Faculty of Health Studies, University of Bradford, Bradford, United Kingdom
| | - Jessica Davison
- Centre for Applied Education Research, Wolfson Centre for Applied Health Research, Bradford, United Kingdom
- School of Psychology, University of Leeds, Leeds, United Kingdom
| | - Rob Brooks
- Faculty of Health Studies, University of Bradford, Bradford, United Kingdom
| | - Daniel D. Bingham
- Faculty of Health Studies, University of Bradford, Bradford, United Kingdom
- Bradford Institute for Health Research, Bradford Royal Infirmary, Bradford, United Kingdom
| | - Mark Mon-Williams
- Centre for Applied Education Research, Wolfson Centre for Applied Health Research, Bradford, United Kingdom
- School of Psychology, University of Leeds, Leeds, United Kingdom
- Bradford Institute for Health Research, Bradford Royal Infirmary, Bradford, United Kingdom
| | - Liam J. B. Hill
- Centre for Applied Education Research, Wolfson Centre for Applied Health Research, Bradford, United Kingdom
- School of Psychology, University of Leeds, Leeds, United Kingdom
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McEachan RRC, Santorelli G, Watmuff A, Mason D, Barber SE, Bingham DD, Bird PK, Lennon L, Lewer D, Mon-Williams M, Shire KA, Waiblinger D, West J, Yang TC, Lawlor DA, Pickett KE, Wright J. Cohort Profile Update: Born in Bradford. Int J Epidemiol 2024; 53:dyae037. [PMID: 38552669 PMCID: PMC11065350 DOI: 10.1093/ije/dyae037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Accepted: 02/27/2024] [Indexed: 05/04/2024] Open
Affiliation(s)
- Rosemary R C McEachan
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, West Yorkshire, UK
| | - Gillian Santorelli
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, West Yorkshire, UK
| | - Aidan Watmuff
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, West Yorkshire, UK
| | - Dan Mason
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, West Yorkshire, UK
| | - Sally E Barber
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, West Yorkshire, UK
| | - Daniel D Bingham
- Faculty of Health Studies, University of Bradford, Bradford, West Yorkshire, UK
| | - Philippa K Bird
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, West Yorkshire, UK
| | - Laura Lennon
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, West Yorkshire, UK
| | - Dan Lewer
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, West Yorkshire, UK
| | - Mark Mon-Williams
- School of Psychology, University of Leeds, Leeds, West Yorkshire, UK
| | - Katy A Shire
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, West Yorkshire, UK
| | - Dagmar Waiblinger
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, West Yorkshire, UK
| | - Jane West
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, West Yorkshire, UK
| | - Tiffany C Yang
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, West Yorkshire, UK
| | - Deborah A Lawlor
- MRC Integrative Epidemiology Unit, University of Bristol, Clifton, Bristol, UK
- Bristol Medical School, University of Bristol, Clifton, Bristol, UK
| | - Kate E Pickett
- Department of Health Sciences, University of York, York, West Yorkshire, UK
| | - John Wright
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, West Yorkshire, UK
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Seims AL, Hall J, Bingham DD, Creaser A, Christoforou A, Barber S, Daly-Smith A. Interventions targeting children and young people's physical activity behavior at home: A systematic review. PLoS One 2023; 18:e0289831. [PMID: 37556477 PMCID: PMC10411747 DOI: 10.1371/journal.pone.0289831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Accepted: 07/26/2023] [Indexed: 08/11/2023] Open
Abstract
BACKGROUND AND PURPOSE Increased time at home during the COVID-19 pandemic significantly decreased children's physical activity. This systematic review aimed to evaluate the effectiveness of children's home-based physical activity interventions, and identify 'active ingredients' underpinning these. METHODS Databases searched-AMED, PsychINFO, CINAHL, Cochrane, EMBASE, PubMed/Medline, Scopus, SPORTDiscus and Web of Science, from inception until June 2022. Eligibility criteria-children aged 2-16 years, targeting home-based physical activity, a control group, and physical activity measured pre- and post- intervention. Studies were excluded if it was not possible to identify change in physical activity at home. The review was written following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidance. Study quality was evaluated using the quality assessment tool for quantitative studies. Study design, intervention characteristics, outcome data, behavior change theory, Behavior Change Techniques (BCTs) and process evaluation data were extracted and discussed using narrative syntheses. RESULTS 13 studies (including 1,182 participants) from 25,967 were included. Interventions primarily involved active video games, with the addition of coaching or telehealth support (n = 5). Three of the 13 studies significantly increased children's physical activity (1 = Moderate to vigorous physical activity, 2 = total volume, P<0.05). The largest effect size (d = 3.45) was for moderate to vigorous physical activity. 29% of BCTs were identified across included interventions; the most common being adding objects to the environment. The most effective intervention scored strong for design quality, incorporated telehealth coaching, and included the most commonly coded BCTs. Variation among studies and insufficient reporting of data made a meta-analysis unfeasible. CONCLUSION COVID-19 emphasized the importance of the home for physical activity. Whilst effectiveness of interventions was limited, building social support and self-efficacy are mechanisms that should be explored further. The review provides recommendations to improve the design and evaluation of future interventions. TRIAL REGISTRATION Prospero registration number: CRD42020193110.
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Affiliation(s)
- Amanda L. Seims
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford Royal Infirmary, Bradford, West Yorkshire, United Kingdom
- Faculty of Health Studies, University of Bradford, Bradford, West Yorkshire, United Kingdom
| | - Jennifer Hall
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford Royal Infirmary, Bradford, West Yorkshire, United Kingdom
- Faculty of Health Studies, University of Bradford, Bradford, West Yorkshire, United Kingdom
| | - Daniel D. Bingham
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford Royal Infirmary, Bradford, West Yorkshire, United Kingdom
- Faculty of Health Studies, University of Bradford, Bradford, West Yorkshire, United Kingdom
- Wolfson Centre for Applied Health Research, Bradford Royal Infirmary, Bradford, West Yorkshire, United Kingdom
| | - Amy Creaser
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford Royal Infirmary, Bradford, West Yorkshire, United Kingdom
| | | | - Sally Barber
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford Royal Infirmary, Bradford, West Yorkshire, United Kingdom
| | - Andy Daly-Smith
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford Royal Infirmary, Bradford, West Yorkshire, United Kingdom
- Faculty of Health Studies, University of Bradford, Bradford, West Yorkshire, United Kingdom
- Wolfson Centre for Applied Health Research, Bradford Royal Infirmary, Bradford, West Yorkshire, United Kingdom
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Creaser AV, Bingham DD, Bennett HAJ, Costa S, Clemes SA. The development of a family-based wearable intervention using behaviour change and co-design approaches: move and connect. Public Health 2023; 217:54-64. [PMID: 36854251 DOI: 10.1016/j.puhe.2023.01.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 10/17/2022] [Accepted: 01/19/2023] [Indexed: 02/27/2023]
Abstract
BACKGROUND Previous research has explored the effectiveness of wearable activity trackers (wearables) for increasing child physical activity (PA) levels, but there have been mixed results. The use of theoretical frameworks and co-design techniques are recognised ways of increasing an intervention's acceptability and effectiveness. AIMS This study aims to use co-design workshops and an evidence-based theoretical framework (the Behaviour Change Wheel) to develop a family-based PA intervention using wearables. METHODS Three stages of intervention development outlined by the Behaviour Change Wheel were used. Co-design workshops with seven families (11 parents and 12 children) and seven PA experts were conducted where stakeholders discussed how to overcome previously identified barriers to families being active and using wearables. This resulted in the intervention's components being developed, with each component's mechanisms of action (e.g. intervention functions and behaviour change techniques) being retrospectively identified. RESULTS The 'Move & Connect' intervention was developed, which targets family PA and wearable use. The intervention takes a flexible approach and includes eight components, including wearable devices (Fitbit Alta HR), support resources, an introductory workshop, collective challenges, goal setting and reviewing, engagement prompts, social support and health-related resources (e.g. educational videos). The intervention incorporates six intervention functions targeting PA and wearable use: education, training, modelling, persuasion, incentivisation and environmental restructuring and 24 behaviour change techniques, including goal setting, social comparison, feedback on behaviour and graded task. CONCLUSIONS This is the first known study to use an evidence-based framework and co-design to develop a family-based wearable intervention. The identification of the intervention's mechanisms of action will prove useful when implementing and evaluating the 'Move & Connect' intervention and allow researchers to replicate its components.
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Affiliation(s)
- A V Creaser
- School of Sport, Exercise, and Health Sciences, Loughborough University, Loughborough, LE11 3TU, UK; Bradford Institute for Health Research, Bradford Teaching Hospitals Foundation Trust, Bradford, BD9 6RJ, UK.
| | - D D Bingham
- Bradford Institute for Health Research, Bradford Teaching Hospitals Foundation Trust, Bradford, BD9 6RJ, UK
| | - H A J Bennett
- School of Psychology, University of Leeds, University Road, Leeds, LS2 9JU, UK
| | - S Costa
- School of Sport, Exercise, and Health Sciences, Loughborough University, Loughborough, LE11 3TU, UK
| | - S A Clemes
- School of Sport, Exercise, and Health Sciences, Loughborough University, Loughborough, LE11 3TU, UK; National Institute for Health Research (NIHR) Leicester Biomedical Research Centre, University Hospitals of Leicester NHS Trust, University of Leicester, Leicester, LE5 4PW, UK
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Helme ZE, Morris JL, Nichols J, Chalkley AE, Bingham DD, McLoughlin GM, Bartholomew JB, Daly-Smith A. Assessing the Impacts of Creating Active Schools on Organisational Culture for Physical Activity. Int J Environ Res Public Health 2022; 19:16950. [PMID: 36554831 PMCID: PMC9778943 DOI: 10.3390/ijerph192416950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 12/12/2022] [Accepted: 12/14/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND National and international guidance recommends whole-school approaches to physical activity, but there are few studies assessing their effectiveness, especially at an organisational level. This study assesses the impact of the Creating Active School's (CAS) programme on organisational changes to physical activity provision. METHODS In-school CAS leads completed a 77-item questionnaire assessing school-level organisational change. The questionnaire comprised 19 domains aligned with the CAS framework and COM-B model of behaviour change. Wilcoxon Signed Rank Tests assessed the pre-to-nine-month change. RESULTS >70% of schools (n = 53) pre-CAS had inadequate whole-school physical activity provision. After nine months (n = 32), CAS had a significant positive effect on organisational physical activity. The positive change was observed for: whole-school culture and ethos, teachers and wider school staff, academic lessons, physical education (PE) lessons, commute to/from school and stakeholder behaviour. CONCLUSIONS This study provides preliminary evidence that CAS is a viable model to facilitate system-level change for physical activity in schools located within deprived areas of a multi-ethnic city. To confirm the results, future studies are required which adopt controlled designs combined with a holistic understanding of implementation determinants and underlying mechanisms.
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Affiliation(s)
- Zoe E. Helme
- Faculties of Life Sciences and Health Studies, University of Bradford, Richmond Road, Bradford BD7 IDP, UK
- Centre for Applied Education Research, Wolfson Centre for Applied Health Research, Bradford Royal Infirmary, Bradford BD9 6TP, UK
| | - Jade L. Morris
- Faculties of Life Sciences and Health Studies, University of Bradford, Richmond Road, Bradford BD7 IDP, UK
- Centre for Applied Education Research, Wolfson Centre for Applied Health Research, Bradford Royal Infirmary, Bradford BD9 6TP, UK
| | - Joanna Nichols
- Faculties of Life Sciences and Health Studies, University of Bradford, Richmond Road, Bradford BD7 IDP, UK
- Centre for Applied Education Research, Wolfson Centre for Applied Health Research, Bradford Royal Infirmary, Bradford BD9 6TP, UK
| | - Anna E. Chalkley
- Centre for Applied Education Research, Wolfson Centre for Applied Health Research, Bradford Royal Infirmary, Bradford BD9 6TP, UK
- Centre for Physically Active Learning, Faculty of Education, Arts and Sports, Western Norway University of Applied Sciences, 5063 Bergen, Norway
| | - Daniel D. Bingham
- Faculties of Life Sciences and Health Studies, University of Bradford, Richmond Road, Bradford BD7 IDP, UK
- Centre for Applied Education Research, Wolfson Centre for Applied Health Research, Bradford Royal Infirmary, Bradford BD9 6TP, UK
- Born in Bradford, Bradford Institute for Health Research, Bradford Teaching Hospitals Foundation Trust, Bradford BD9 6RJ, UK
| | - Gabriella M. McLoughlin
- College of Public Health, Temple University, Philadelphia, PA 19140, USA
- Implementation Science Center for Cancer Control and Prevention Research Center, Brown School, Washington University, St. Louis, MO 63130, USA
| | - John B. Bartholomew
- Department of Kinesiology and Health Education, The University of Texas at Austin, Austin, TX 78712, USA
| | - Andrew Daly-Smith
- Faculties of Life Sciences and Health Studies, University of Bradford, Richmond Road, Bradford BD7 IDP, UK
- Centre for Applied Education Research, Wolfson Centre for Applied Health Research, Bradford Royal Infirmary, Bradford BD9 6TP, UK
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Creaser AV, Frazer MT, Costa S, Bingham DD, Clemes SA. The Use of Wearable Activity Trackers in Schools to Promote Child and Adolescent Physical Activity: A Descriptive Content Analysis of School Staff's Perspectives. Int J Environ Res Public Health 2022; 19:14067. [PMID: 36360944 PMCID: PMC9654652 DOI: 10.3390/ijerph192114067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Accepted: 10/25/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND The school environment is an ideal setting for promoting physical activity (PA). Wearable activity trackers (wearables) have previously been implemented, in research, as intervention tools within the school-environment. However, the large-scale use and acceptance of wearables, in schools, is unknown. METHODS This study distributed a cross-sectional survey to school staff to investigate the prevalence of child and adolescent wearable use in schools, including when and how they are used, and school staff's willingness to use them in the future (as implemented by school staff). This survey consisted of between 13 and 22 items, including closed-ended and open-ended questions. Closed-ended responses were displayed descriptively (wearable prevalence and characteristics), and open-ended qualitative responses were categorised using descriptive content analysis (how wearables are used). RESULTS 1087 school staff provided valid responses. Of those, 896 (82.4%) had never used a wearable as a teaching or support tool for their students, and 120 (11%) currently used- and 71 (6.5%) had previously used- a wearable as a teaching or support tool for their students. When wearables were used, school staff implemented their use regularly and during physical education lessons or throughout the entire school day. Wearables were used to monitor or increase student's PA levels, or for student and staff educational purposes (e.g., academic learning, movement breaks). Most school staff were willing to use a wearable as a teaching or support tool to promote student's PA, and/or learning about PA, in the future. CONCLUSIONS This study is the first study to explore the widescale use and acceptance of children and adolescents using wearables in the school-setting. Findings may inform the development of future school-based interventions and public health initiatives for physical activity promotion, using wearables.
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Affiliation(s)
- Amy V. Creaser
- School of Sport, Exercise, and Health Sciences, Loughborough University, Loughborough LE11 3TU, UK
- Bradford Institute for Health Research, Bradford Teaching Hospitals Foundation Trust, Bradford BD9 6RJ, UK
| | - Marie T. Frazer
- Bradford Institute for Health Research, Bradford Teaching Hospitals Foundation Trust, Bradford BD9 6RJ, UK
- Faculty of Health Studies, University of Bradford, Richmond Road, Bradford BD7 1DP, UK
| | - Silvia Costa
- School of Sport, Exercise, and Health Sciences, Loughborough University, Loughborough LE11 3TU, UK
| | - Daniel D. Bingham
- Bradford Institute for Health Research, Bradford Teaching Hospitals Foundation Trust, Bradford BD9 6RJ, UK
| | - Stacy A. Clemes
- School of Sport, Exercise, and Health Sciences, Loughborough University, Loughborough LE11 3TU, UK
- National Institute for Health Research (NIHR) Leicester Biomedical Research Centre, University Hospitals of Leicester NHS Trust, University of Leicester, Leicester LE5 4PW, UK
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Bingham DD, Daly-Smith A, Seims A, Hall J, Eddy L, Helme Z, Barber SE. A study protocol for evaluating the effectiveness of a whole-system intervention (Join Us: Move Play, JUMP) implemented at the neighbourhood level, to increase children’s (aged 5-11 years) accelerometer measured physical activity: a quasi-experimental trial (Preprint). JMIR Res Protoc 2022; 12:e43619. [PMID: 37000512 PMCID: PMC10131718 DOI: 10.2196/43619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 12/08/2022] [Accepted: 12/22/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Daily physical activity is vital for the health and development of children. However, many children are inactive. Previous attempts to achieve sustained increases in daily physical activity in children have been ineffective. Join Us: Move Play (JU:MP) is a whole-system, complex, community-based intervention aiming to increase the physical activity levels of children aged 7 to 11 years who live in areas of Bradford, England, which are multicultural and have high levels of deprivation. OBJECTIVE The purpose of this quasiexperimental controlled trial is to assess whether the JU:MP program increases primary school children's physical activity. METHODS The study has a 2-arm, quasiexperimental, nonblinded, nonequivalent group design and will be conducted with primary school children aged 5 to 11 years at 3 timepoints, including baseline (before intervention), 24 months (during intervention), and 36 months (after intervention). Children attending primary schools within the intervention area will be invited to participate. Children attending similar schools within similar neighborhoods based on school and community census demographics (deprivation, free school meals, and ethnicity) outside of the JU:MP geographical area will be invited to participate in the control condition. At each timepoint, consenting participants will wear an accelerometer for 7 consecutive days (24 hours a day) to measure the primary outcome (average daily moderate-to-vigorous physical activity). Multivariable mixed effects linear regression will be applied to estimate differences in the primary outcome between the 2 arms at 24 months and 36 months on an intention-to-treat basis. The secondary outcome analysis will explore changes in socioemotional well-being (teacher reported), quality of life (parental/carer reported), and other contextual factors (parents/carer reported), as well as segments of the day activity, sleep, sedentary screen time, frequency of places to be active, parent practices (nondirective support and autonomy support), social cohesion, and neighborhood walking/exercise environment. RESULTS Recruitment occurred from July 2021 to March 2022, and baseline data were collected from September 2021 to March 2022. As of March 2022 (end of baseline data collection), a total of 1454 children from 37 schools (17 intervention schools and 20 control schools) have been recruited. The first follow-up data collection will occur from September 2023 to March 2024, and the second and final follow-up data collection will occur from September 2024 to March 2025. Data analysis has not begun, and the final results will be published in December 2025. CONCLUSIONS This article describes the protocol for a quasiexperimental controlled trial examining a novel whole-system intervention. TRIAL REGISTRATION ISRCTN ISRCTN14332797; https://www.isrctn.com/ISRCTN14332797. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/43619.
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Affiliation(s)
- Daniel D Bingham
- Faculty of Health Studies, University of Bradford, Bradford, United Kingdom
- Centre for Applied Education Research, Wolfson Centre for Applied Health Research, Bradford Royal Infirmary, Bradford, United Kingdom
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford Royal Infirmary, Bradford, United Kingdom
| | - Andy Daly-Smith
- Faculty of Health Studies, University of Bradford, Bradford, United Kingdom
- Centre for Applied Education Research, Wolfson Centre for Applied Health Research, Bradford Royal Infirmary, Bradford, United Kingdom
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford Royal Infirmary, Bradford, United Kingdom
| | - Amanda Seims
- Faculty of Health Studies, University of Bradford, Bradford, United Kingdom
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford Royal Infirmary, Bradford, United Kingdom
| | - Jennifer Hall
- Faculty of Health Studies, University of Bradford, Bradford, United Kingdom
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford Royal Infirmary, Bradford, United Kingdom
| | - Lucy Eddy
- Faculty of Health Studies, University of Bradford, Bradford, United Kingdom
- Centre for Applied Education Research, Wolfson Centre for Applied Health Research, Bradford Royal Infirmary, Bradford, United Kingdom
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford Royal Infirmary, Bradford, United Kingdom
| | - Zoe Helme
- Faculty of Health Studies, University of Bradford, Bradford, United Kingdom
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford Royal Infirmary, Bradford, United Kingdom
| | - Sally E Barber
- Faculty of Health Studies, University of Bradford, Bradford, United Kingdom
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford Royal Infirmary, Bradford, United Kingdom
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8
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Creaser AV, Hall J, Costa S, Bingham DD, Clemes SA. Exploring Families' Acceptance of Wearable Activity Trackers: A Mixed-Methods Study. Int J Environ Res Public Health 2022; 19:ijerph19063472. [PMID: 35329166 PMCID: PMC8950917 DOI: 10.3390/ijerph19063472] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 03/02/2022] [Accepted: 03/12/2022] [Indexed: 12/30/2022]
Abstract
Background: The family environment plays a crucial role in child physical activity (PA). Wearable activity trackers (wearables) show potential for increasing children’s PA; however, few studies have explored families’ acceptance of wearables. This study investigated the acceptability of using wearables in a family setting, aligning experiences with components of the Technology Acceptance Model and Theoretical Domains Framework. Methods: Twenty-four families, with children aged 5–9 years, took part in a 5-week study, where all members were provided with a Fitbit Alta HR for 4 weeks. Acceptability was measured using weekly surveys and pre-post-questionnaires. Nineteen families participated in a focus group. Quantitative and qualitative data were integrated using the Pillar Integration Process technique. Results: Pillars reflected (1) external variables impacting wearable use and PA and (2) wearable use, (3) ease of use, (4) usefulness for increasing PA and other health outcomes, (5) attitudes, and (6) intention to use a wearable, including future intervention suggestions. Conclusions: Families found the Fitbit easy to use and acceptable, but use varied, and perceived impact on PA were mixed, with external variables contributing towards this. This study provides insights into how wearables may be integrated into family-based PA interventions and highlights barriers and facilitators of family wearable use.
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Affiliation(s)
- Amy V. Creaser
- School of Sport, Exercise, and Health Sciences, Loughborough University, Loughborough LE11 3TU, UK; (A.V.C.); (S.C.)
- Bradford Institute for Health Research, Bradford Teaching Hospitals Foundation Trust, Bradford BD9 6RJ, UK; (J.H.); (D.D.B.)
| | - Jennifer Hall
- Bradford Institute for Health Research, Bradford Teaching Hospitals Foundation Trust, Bradford BD9 6RJ, UK; (J.H.); (D.D.B.)
| | - Silvia Costa
- School of Sport, Exercise, and Health Sciences, Loughborough University, Loughborough LE11 3TU, UK; (A.V.C.); (S.C.)
| | - Daniel D. Bingham
- Bradford Institute for Health Research, Bradford Teaching Hospitals Foundation Trust, Bradford BD9 6RJ, UK; (J.H.); (D.D.B.)
| | - Stacy A. Clemes
- School of Sport, Exercise, and Health Sciences, Loughborough University, Loughborough LE11 3TU, UK; (A.V.C.); (S.C.)
- National Institute for Health Research (NIHR) Leicester Biomedical Research Centre, University Hospitals of Leicester NHS Trust, University of Leicester, Leicester LE5 4PW, UK
- Correspondence:
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Hall J, Bingham DD, Seims A, Dogra SA, Burkhardt J, Nobles J, McKenna J, Bryant M, Barber SE, Daly-Smith A. Correction to: A whole system approach to increasing children’s physical activity in a multi-ethnic UK city: a process evaluation protocol. BMC Public Health 2022; 22:69. [PMID: 35016653 PMCID: PMC8750830 DOI: 10.1186/s12889-022-12514-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Hall J, Bingham DD, Seims A, Dogra SA, Burkhardt J, Nobles J, McKenna J, Bryant M, Barber SE, Daly-Smith A. A whole system approach to increasing children's physical activity in a multi-ethnic UK city: a process evaluation protocol. BMC Public Health 2021; 21:2296. [PMID: 34922508 PMCID: PMC8684063 DOI: 10.1186/s12889-021-12255-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Accepted: 11/17/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Engaging in regular physical activity requires continued complex decision-making in varied and dynamic individual, social and structural contexts. Widespread shortfalls of physical activity interventions suggests the complex underlying mechanisms of change are not yet fully understood. More insightful process evaluations are needed to design and implement more effective approaches. This paper describes the protocol for a process evaluation of the JU:MP programme, a whole systems approach to increasing physical activity in children and young people aged 5-14 years in North Bradford, UK. METHODS This process evaluation, underpinned by realist philosophy, aims to understand the development and implementation of the JU:MP programme and the mechanisms by which JU:MP influences physical activity in children and young people. It also aims to explore behaviour change across wider policy, strategy and neighbourhood systems. A mixed method data collection approach will include semi-structured interview, observation, documentary analysis, surveys, and participatory evaluation methods including reflections and ripple effect mapping. DISCUSSION This protocol offers an innovative approach on the use of process evaluation feeding into an iterative programme intended to generate evidence-based practice and deliver practice-based evidence. This paper advances knowledge regarding the development of process evaluations for evaluating systems interventions, and emphasises the importance of process evaluation.
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Affiliation(s)
- Jennifer Hall
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford Royal Infirmary, Duckworth Lane, Bradford, BD9 6RJ, UK. .,Faculties of Life Sciences and Health Studies, University of Bradford, Richmond Road, Bradford, BD7 1DP, UK.
| | - Daniel D Bingham
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford Royal Infirmary, Duckworth Lane, Bradford, BD9 6RJ, UK.,Faculties of Life Sciences and Health Studies, University of Bradford, Richmond Road, Bradford, BD7 1DP, UK
| | - Amanda Seims
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford Royal Infirmary, Duckworth Lane, Bradford, BD9 6RJ, UK.,Faculties of Life Sciences and Health Studies, University of Bradford, Richmond Road, Bradford, BD7 1DP, UK
| | - Sufyan Abid Dogra
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford Royal Infirmary, Duckworth Lane, Bradford, BD9 6RJ, UK.,Faculties of Life Sciences and Health Studies, University of Bradford, Richmond Road, Bradford, BD7 1DP, UK
| | - Jan Burkhardt
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford Royal Infirmary, Duckworth Lane, Bradford, BD9 6RJ, UK
| | - James Nobles
- The National Institute for Health Research Applied Research Collaboration West (NIHR ARC West) at University Hospitals Bristol National Health Service Foundation Trust, Bristol, UK.,Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Jim McKenna
- School of Sport, Carnegie, Leeds Beckett University, Leeds, LS6 3QT, UK
| | - Maria Bryant
- Department of Health Sciences, Seebohm Rowntree Building, University of York, Heslington, York, YO10 5DD, UK.,The Hull York Medical School, University of York, York, YO10 5DD, UK
| | - Sally E Barber
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford Royal Infirmary, Duckworth Lane, Bradford, BD9 6RJ, UK.,Faculties of Life Sciences and Health Studies, University of Bradford, Richmond Road, Bradford, BD7 1DP, UK
| | - Andy Daly-Smith
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford Royal Infirmary, Duckworth Lane, Bradford, BD9 6RJ, UK.,Faculties of Life Sciences and Health Studies, University of Bradford, Richmond Road, Bradford, BD7 1DP, UK.,Centre for Applied Education Research, Wolfson Centre for Applied Health Research, Bradford Royal Infirmary, Bradford, West Yorkshire, UK
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11
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Bingham DD, Daly-Smith A, Hall J, Seims A, Dogra SA, Fairclough SJ, Ajebon M, Kelly B, Hou B, Shire KA, Crossley KL, Mon-Williams M, Wright J, Pickett K, McEachan R, Dickerson J, Barber SE. Covid-19 lockdown: Ethnic differences in children's self-reported physical activity and the importance of leaving the home environment; a longitudinal and cross-sectional study from the Born in Bradford birth cohort study. Int J Behav Nutr Phys Act 2021; 18:117. [PMID: 34488785 PMCID: PMC8419665 DOI: 10.1186/s12966-021-01183-y] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Accepted: 08/06/2021] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND In England, the onset of COVID-19 and a rapidly increasing infection rate resulted in a lockdown (March-June 2020) which placed strict restrictions on movement of the public, including children. Using data collected from children living in a multi-ethnic city with high levels of deprivation, this study aimed to: (1) report children's self-reported physical activity (PA) during the first COVID-19 UK lockdown and identify associated factors; (2) examine changes of children's self-reported PA prior to and during the first UK lockdown. METHODS This study is part of the Born in Bradford (BiB) COVID-19 Research Study. PA (amended Youth Activity Profile), sleep, sedentary behaviours, daily frequency/time/destination/activity when leaving the home, were self-reported by 949 children (9-13 years). A sub-sample (n = 634) also self-reported PA (Physical Activity Questionnaire for Children) pre-pandemic (2017-February 2020). Univariate analysis assessed differences in PA between sex and ethnicity groups; multivariable logistic regression identified factors associated with children's PA. Differences in children's levels of being sufficiently active prior to and during the lockdown were examined using the McNemar test; and multivariable logistic regression was used to identify factors explaining change. RESULTS During the pandemic, White British (WB) children were more sufficiently active (34.1%) compared to Pakistani Heritage children (PH) (22.8%) or 'Other' ethnicity children (O) (22.8%). WB children reported leaving the home more frequently and for longer periods than PH and O children. Modifiable variables related to being sufficiently active were frequency, duration, type of activity, and destination away from the home environment. There was a large reduction in children being sufficiently active during the first COVID-19 lockdown (28.9%) compared to pre-pandemic (69.4%). CONCLUSIONS Promoting safe extended periods of PA everyday outdoors is important for all children, in particular for children from ethnic minority groups. Children's PA during the first COVID-19 UK lockdown has drastically reduced from before. Policy and decision makers, and practitioners should consider the findings in order to begin to understand the impact and consequences that COVID-19 has had upon children's PA which is a key and vital behaviour for health and development.
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Affiliation(s)
- Daniel D Bingham
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford Royal Infirmary, Duckworth Lane, Bradford, BD9 6RJ, UK.
- Faculties of Life Sciences and Health Studies, University of Bradford, Richmond Road, Bradford, BD7 1DP, UK.
| | - Andy Daly-Smith
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford Royal Infirmary, Duckworth Lane, Bradford, BD9 6RJ, UK
- Faculties of Life Sciences and Health Studies, University of Bradford, Richmond Road, Bradford, BD7 1DP, UK
- Centre for Applied Education Research, Wolfson Centre for Applied Health Research, Bradford Royal Infirmary, Bradford, West Yorkshire, UK
| | - Jennifer Hall
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford Royal Infirmary, Duckworth Lane, Bradford, BD9 6RJ, UK
- Faculties of Life Sciences and Health Studies, University of Bradford, Richmond Road, Bradford, BD7 1DP, UK
| | - Amanda Seims
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford Royal Infirmary, Duckworth Lane, Bradford, BD9 6RJ, UK
- Faculties of Life Sciences and Health Studies, University of Bradford, Richmond Road, Bradford, BD7 1DP, UK
| | - Sufyan A Dogra
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford Royal Infirmary, Duckworth Lane, Bradford, BD9 6RJ, UK
- Faculties of Life Sciences and Health Studies, University of Bradford, Richmond Road, Bradford, BD7 1DP, UK
| | - Stuart J Fairclough
- Health Research Institute and Movement Behaviours, Health, and Wellbeing Research Group, Department Sport and Physical Activity, Edge Hill University, Ormskirk, L39 4QP, UK
| | - Mildred Ajebon
- Department of Health Sciences, SeebohmRowntree Building, University of York, University of York, Heslington, YO10 5DD, York, UK
| | - Brian Kelly
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford Royal Infirmary, Duckworth Lane, Bradford, BD9 6RJ, UK
| | - Bo Hou
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford Royal Infirmary, Duckworth Lane, Bradford, BD9 6RJ, UK
| | - Katy A Shire
- Centre for Applied Education Research, Wolfson Centre for Applied Health Research, Bradford Royal Infirmary, Bradford, West Yorkshire, UK
- Department of Health Sciences, SeebohmRowntree Building, University of York, University of York, Heslington, YO10 5DD, York, UK
| | - Kirsty L Crossley
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford Royal Infirmary, Duckworth Lane, Bradford, BD9 6RJ, UK
| | - Mark Mon-Williams
- Centre for Applied Education Research, Wolfson Centre for Applied Health Research, Bradford Royal Infirmary, Bradford, West Yorkshire, UK
- School of Psychology, University of Leeds, Leeds, West Yorkshire, UK
| | - John Wright
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford Royal Infirmary, Duckworth Lane, Bradford, BD9 6RJ, UK
| | - Kate Pickett
- Department of Health Sciences, SeebohmRowntree Building, University of York, University of York, Heslington, YO10 5DD, York, UK
| | - Rosemary McEachan
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford Royal Infirmary, Duckworth Lane, Bradford, BD9 6RJ, UK
- Faculties of Life Sciences and Health Studies, University of Bradford, Richmond Road, Bradford, BD7 1DP, UK
| | - Josie Dickerson
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford Royal Infirmary, Duckworth Lane, Bradford, BD9 6RJ, UK
| | - Sally E Barber
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford Royal Infirmary, Duckworth Lane, Bradford, BD9 6RJ, UK
- Faculties of Life Sciences and Health Studies, University of Bradford, Richmond Road, Bradford, BD7 1DP, UK
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12
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Creaser AV, Clemes SA, Costa S, Hall J, Ridgers ND, Barber SE, Bingham DD. The Acceptability, Feasibility, and Effectiveness of Wearable Activity Trackers for Increasing Physical Activity in Children and Adolescents: A Systematic Review. Int J Environ Res Public Health 2021; 18:ijerph18126211. [PMID: 34201248 PMCID: PMC8228417 DOI: 10.3390/ijerph18126211] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 06/03/2021] [Accepted: 06/06/2021] [Indexed: 02/08/2023]
Abstract
Wearable activity trackers (wearables) embed numerous behaviour change techniques (BCTs) that have previously been shown to increase adult physical activity (PA). With few children and adolescents achieving PA guidelines, it is crucial to explore ways to increase their PA. This systematic review examined the acceptability, feasibility, and effectiveness of wearables and their potential mechanisms of action for increasing PA in 5 to 19-year-olds. A systematic search of six databases was conducted, including data from the start date of each database to December 2019 (PROSPERO registration: CRD42020164506). Thirty-three studies were included. Most studies (70%) included only adolescents (10 to 19 years). There was some-but largely mixed-evidence that wearables increase steps and moderate-to-vigorous-intensity PA and reduce sedentary behaviour. There were no apparent differences in effectiveness based on the number of BCTs used and between studies using a wearable alone or as part of a multi-component intervention. Qualitative findings suggested wearables increased motivation to be physically active via self-monitoring, goal setting, feedback, and competition. However, children and adolescents reported technical difficulties and a novelty effect when using wearables, which may impact wearables' long-term use. More rigorous and long-term studies investigating the acceptability, feasibility, and effectiveness of wearables in 5 to 19-year-olds are warranted.
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Affiliation(s)
- Amy V. Creaser
- School of Sport, Exercise, and Health Sciences, Loughborough University, Loughborough LE11 3TU, UK; (S.A.C.); (S.C.)
- Bradford Institute for Health Research, Bradford Teaching Hospitals Foundation Trust, Bradford BD9 6RJ, UK; (J.H.); (S.E.B.); (D.D.B.)
- Correspondence:
| | - Stacy A. Clemes
- School of Sport, Exercise, and Health Sciences, Loughborough University, Loughborough LE11 3TU, UK; (S.A.C.); (S.C.)
- Leicester Biomedical Research Centre, National Institute for Health Research (NIHR), University Hospitals of Leicester NHS Trust and University of Leicester, Leicester LE5 4PW, UK
| | - Silvia Costa
- School of Sport, Exercise, and Health Sciences, Loughborough University, Loughborough LE11 3TU, UK; (S.A.C.); (S.C.)
| | - Jennifer Hall
- Bradford Institute for Health Research, Bradford Teaching Hospitals Foundation Trust, Bradford BD9 6RJ, UK; (J.H.); (S.E.B.); (D.D.B.)
| | - Nicola D. Ridgers
- School of Exercise and Nutrition Sciences, Institute for Physical Activity and Nutrition, Deakin University, Geelong 3125, Australia;
| | - Sally E. Barber
- Bradford Institute for Health Research, Bradford Teaching Hospitals Foundation Trust, Bradford BD9 6RJ, UK; (J.H.); (S.E.B.); (D.D.B.)
| | - Daniel D. Bingham
- Bradford Institute for Health Research, Bradford Teaching Hospitals Foundation Trust, Bradford BD9 6RJ, UK; (J.H.); (S.E.B.); (D.D.B.)
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13
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Eddy LH, Preston N, Mon-Williams M, Bingham DD, Atkinson JMC, Ellingham-Khan M, Otteslev A, Hill LJB. Developing and validating a school-based screening tool of Fundamental Movement Skills (FUNMOVES) using Rasch analysis. PLoS One 2021; 16:e0250002. [PMID: 33861769 PMCID: PMC8051776 DOI: 10.1371/journal.pone.0250002] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Accepted: 03/29/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND A large proportion of children are not able to perform age-appropriate fundamental movement skills (FMS). Thus, it is important to assess FMS so that children needing additional support can be identified in a timely fashion. There is great potential for universal screening of FMS in schools, but research has established that current assessment tools are not fit for purpose. OBJECTIVE To develop and validate the psychometric properties of a FMS assessment tool designed specifically to meet the demands of universal screening in schools. METHODS A working group consisting of academics from developmental psychology, public health and behavioural epidemiology developed an assessment tool (FUNMOVES) based on theory and prior evidence. Over three studies, 814 children aged 4 to 11 years were assessed in school using FUNMOVES. Rasch analysis was used to evaluate structural validity and modifications were then made to FUNMOVES activities after each study based on Rasch results and implementation fidelity. RESULTS The initial Rasch analysis found numerous psychometric problems including multidimensionality, disordered thresholds, local dependency, and misfitting items. Study 2 showed a unidimensional measure, with acceptable internal consistency and no local dependency, but that did not fit the Rasch model. Performance on a jumping task was misfitting, and there were issues with disordered thresholds (for jumping, hopping and balance tasks). Study 3 revealed a unidimensional assessment tool with good fit to the Rasch model, and no further issues, once jumping and hopping scoring were modified. IMPLICATIONS The finalised version of FUNMOVES (after three iterations) meets standards for accurate measurement, is free and able to assess a whole class in under an hour using resources available in schools. Thus FUNMOVES has the potential to allow schools to efficiently screen FMS to ensure that targeted support can be provided and disability barriers removed.
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Affiliation(s)
- Lucy H. Eddy
- School of Psychology, University of Leeds, Leeds, United Kingdom
- Bradford Institute for Health Research, Bradford Royal Infirmary, Bradford, United Kingdom
- Centre for Applied Education Research, Wolfson Centre for Applied Health Research, Bradford Royal Infirmary, Bradford, West Yorkshire, United Kingdom
| | - Nick Preston
- Centre for Applied Education Research, Wolfson Centre for Applied Health Research, Bradford Royal Infirmary, Bradford, West Yorkshire, United Kingdom
- Academic Department of Rehabilitation Medicine, University of Leeds, Leeds, United Kingdom
| | - Mark Mon-Williams
- School of Psychology, University of Leeds, Leeds, United Kingdom
- Bradford Institute for Health Research, Bradford Royal Infirmary, Bradford, United Kingdom
- Centre for Applied Education Research, Wolfson Centre for Applied Health Research, Bradford Royal Infirmary, Bradford, West Yorkshire, United Kingdom
- National Centre for Optics, Vision and Eye Care, University of South-Eastern Norway, Notodden, Norway
| | - Daniel D. Bingham
- Bradford Institute for Health Research, Bradford Royal Infirmary, Bradford, United Kingdom
- Centre for Applied Education Research, Wolfson Centre for Applied Health Research, Bradford Royal Infirmary, Bradford, West Yorkshire, United Kingdom
| | - Jo M. C. Atkinson
- Centre for Applied Education Research, Wolfson Centre for Applied Health Research, Bradford Royal Infirmary, Bradford, West Yorkshire, United Kingdom
- School of Allied Health Professions and Midwifery, University of Bradford, Bradford, United Kingdom
| | - Marsha Ellingham-Khan
- Centre for Applied Education Research, Wolfson Centre for Applied Health Research, Bradford Royal Infirmary, Bradford, West Yorkshire, United Kingdom
| | - Ava Otteslev
- Centre for Applied Education Research, Wolfson Centre for Applied Health Research, Bradford Royal Infirmary, Bradford, West Yorkshire, United Kingdom
| | - Liam J. B. Hill
- School of Psychology, University of Leeds, Leeds, United Kingdom
- Bradford Institute for Health Research, Bradford Royal Infirmary, Bradford, United Kingdom
- Centre for Applied Education Research, Wolfson Centre for Applied Health Research, Bradford Royal Infirmary, Bradford, West Yorkshire, United Kingdom
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14
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Eddy L, Hill LJ, Mon-Williams M, Preston N, Daly-Smith A, Medd G, Bingham DD. Fundamental Movement Skills and Their Assessment in Primary Schools from the Perspective of Teachers. Meas Phys Educ Exerc Sci 2021; 25:236-249. [PMID: 34381304 PMCID: PMC8300520 DOI: 10.1080/1091367x.2021.1874955] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
Evidence suggests that children struggle to acquire age-appropriate fundamental movement skills (FMS), despite their importance for facilitating physical activity. This has led to calls for routine school-based screening of children's FMS. However, there is limited research exploring schools' capacity to conduct such assessments. This study investigated what factors might affect the adoption and implementation of FMS assessments in primary schools. School staff (n = 853) completed an online questionnaire developed using the Capability, Opportunity, Motivation and Behavior (COM-B) model. A majority reported that knowledge of pupils' FMS ability would be beneficial (65.3%), and 71.8% would assess FMS if support was provided. Barriers included: Capability - few possessed knowledge of FMS (15%); Opportunity - teachers reported 30-60 minutes as acceptable for assessing a class, a substantially shorter period than current assessments require; Motivation - 57.2% stated FMS assessments would increase workload stress. Solutions to these issues are discussed using the COM-B theoretical framework.
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Affiliation(s)
- Lucy Eddy
- School of Psychology, University of Leeds, LeedsUK, UK
- Bradford Institute for Health Research, Bradford Royal Infirmary, Bradford, UK
- Centre for Applied Education Research, Wolfson Centre for Applied Health Research, West Yorkshire, UK
- CONTACT Lucy Eddy School of Psychology, University of Leeds
| | - Liam J.B. Hill
- Bradford Institute for Health Research, Bradford Royal Infirmary, Bradford, UK
- Centre for Applied Education Research, Wolfson Centre for Applied Health Research, West Yorkshire, UK
| | - Mark Mon-Williams
- School of Psychology, University of Leeds, LeedsUK, UK
- Bradford Institute for Health Research, Bradford Royal Infirmary, Bradford, UK
- Centre for Applied Education Research, Wolfson Centre for Applied Health Research, West Yorkshire, UK
- National Centre for Optics, Vision and Eye Care, University of South-Eastern Norway, Kongsberg, Norway
| | - Nick Preston
- Centre for Applied Education Research, Wolfson Centre for Applied Health Research, West Yorkshire, UK
- Academic Department of Rehabilitation Medicine, University of Leeds, Leeds, UK
| | - Andy Daly-Smith
- Centre for Applied Education Research, Wolfson Centre for Applied Health Research, West Yorkshire, UK
- Faculty of Health Studies, University of Bradford, Bradford, UK
- Center for Physically Active Learning, Faculty of Education, Arts and Sports, Western Norway University of Applied Sciences, Sogndal, Norway
| | - Gareth Medd
- Centre for Applied Education Research, Wolfson Centre for Applied Health Research, West Yorkshire, UK
- Institute of Education, University College London, London, UK
- Beckfoot Mutli-Academy Trust, Bradford, UK
| | - Daniel D. Bingham
- Bradford Institute for Health Research, Bradford Royal Infirmary, Bradford, UK
- Centre for Applied Education Research, Wolfson Centre for Applied Health Research, West Yorkshire, UK
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15
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Sherry AP, Pearson N, Ridgers ND, Johnson W, Barber SE, Bingham DD, Nagy LC, Clemes SA. Impacts of a Standing Desk Intervention within an English Primary School Classroom: A Pilot Controlled Trial. Int J Environ Res Public Health 2020; 17:ijerph17197048. [PMID: 32993142 PMCID: PMC7579086 DOI: 10.3390/ijerph17197048] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 09/19/2020] [Accepted: 09/23/2020] [Indexed: 12/26/2022]
Abstract
Traditional classroom furniture dictates that children predominantly sit during class time. This study evaluated the impact of providing standing desks within a deprived UK primary school setting over 8 months using mixed-method approaches. All children within a Year 5 class (9–10-year-olds, n = 30) received an adjustable sit–stand desk, while another Year 5 class (n = 30) in a nearby school retained traditional furniture as a control classroom. At baseline, 4 months, and 8 months, activPAL monitors (PAL Technologies, Glasgow, UK) were worn for 7 days to provide time spent sitting and standing. Behavior-related mental health, musculoskeletal discomfort surveys, and a cognitive function test battery were also completed at all three timepoints. Intervention experiences from pupils and the teacher were captured using focus groups, interviews, and classroom observations. At both 4 months and 8 months, multi-level models revealed a reduction in class time sitting in the intervention group compared to the control group ((β (95%CI) 4 months −25.3% (−32.3, −18.4); 8 months −19.9% (−27.05, −12.9)). Qualitative data revealed challenges to teaching practicalities and a gradual decline in behavior-related mental health was observed (intervention vs. control: 4 months +5.31 (+2.55, +8.08); 8 months +7.92 (+5.18, +10.66)). Larger trials within similar high-priority settings are required to determine the feasibility and cost-effectiveness of providing standing desks to every child in the classroom.
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Affiliation(s)
- Aron P. Sherry
- National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough LE11 3TU, UK; (N.P.); (W.J.); (S.A.C.)
- NIHR Leicester Biomedical Research Centre—Lifestyle Theme, Loughborough University, Loughborough LE11 3TU, UK
- Correspondence: ; Tel.: +44-1509-228462
| | - Natalie Pearson
- National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough LE11 3TU, UK; (N.P.); (W.J.); (S.A.C.)
| | - Nicola D. Ridgers
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong 3220, Australia;
| | - William Johnson
- National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough LE11 3TU, UK; (N.P.); (W.J.); (S.A.C.)
| | - Sally E. Barber
- Bradford Institute for Health Research, Bradford Teaching Hospitals Foundation Trust, Bradford BD9 6RJ, UK; (S.E.B.); (D.D.B.)
| | - Daniel D. Bingham
- Bradford Institute for Health Research, Bradford Teaching Hospitals Foundation Trust, Bradford BD9 6RJ, UK; (S.E.B.); (D.D.B.)
- Centre for Applied Education Research, Wolfson Centre for Applied Health Research, Bradford Teaching Hospitals Foundation Trust, Bradford BD9 6RJ, UK
| | - Liana C. Nagy
- Faculty of Health and Life Sciences, Oxford Brookes University, Oxford OX3 0BP, UK;
| | - Stacy A. Clemes
- National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough LE11 3TU, UK; (N.P.); (W.J.); (S.A.C.)
- NIHR Leicester Biomedical Research Centre—Lifestyle Theme, Loughborough University, Loughborough LE11 3TU, UK
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16
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Eddy LH, Bingham DD, Crossley KL, Shahid NF, Ellingham-Khan M, Otteslev A, Figueredo NS, Mon-Williams M, Hill LJB. The validity and reliability of observational assessment tools available to measure fundamental movement skills in school-age children: A systematic review. PLoS One 2020; 15:e0237919. [PMID: 32841268 PMCID: PMC7447071 DOI: 10.1371/journal.pone.0237919] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Accepted: 08/05/2020] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Fundamental Movement Skills (FMS) play a critical role in ontogenesis. Many children have insufficient FMS, highlighting the need for universal screening in schools. There are many observational FMS assessment tools, but their psychometric properties are not readily accessible. A systematic review was therefore undertaken to compile evidence of the validity and reliability of observational FMS assessments, to evaluate their suitability for screening. METHODS A pre-search of 'fundamental movement skills' OR 'fundamental motor skills' in seven online databases (PubMed, Ovid MEDLINE, Ovid Embase, EBSCO CINAHL, EBSCO SPORTDiscus, Ovid PsycINFO and Web of Science) identified 24 assessment tools for school-aged children that: (i) assess FMS; (ii) measure actual motor competence and (iii) evaluate performance on a standard battery of tasks. Studies were subsequently identified that: (a) used these tools; (b) quantified validity or reliability and (c) sampled school-aged children. Study quality was assessed using COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) checklists. RESULTS Ninety studies were included following the screening of 1863 articles. Twenty-one assessment tools had limited or no evidence to support their psychometric properties. The Test of Gross Motor Development (TGMD, n = 34) and the Movement Assessment Battery for Children (MABC, n = 37) were the most researched tools. Studies consistently reported good evidence for validity, reliability for the TGMD, whilst only 64% of studies reported similarly promising results for the MABC. Twelve studies found good evidence for the reliability and validity of the Bruininks-Oseretsky Test of Motor Proficiency but poor study quality appeared to inflate results. Considering all assessment tools, those with promising psychometric properties often measured limited aspects of validity/reliability, and/or had limited feasibility for large scale deployment in a school-setting. CONCLUSION There is insufficient evidence to justify the use of any observational FMS assessment tools for universal screening in schools, in their current form.
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Affiliation(s)
- Lucy H. Eddy
- School of Psychology, University of Leeds, Leeds, West Yorkshire, United Kingdom
- Bradford Institute for Health Research, Bradford Royal Infirmary, Bradford, West Yorkshire, United Kingdom
- Centre for Applied Education Research, Wolfson Centre for Applied Health Research, Bradford Royal Infirmary, Bradford, West Yorkshire, United Kingdom
| | - Daniel D. Bingham
- Bradford Institute for Health Research, Bradford Royal Infirmary, Bradford, West Yorkshire, United Kingdom
- Centre for Applied Education Research, Wolfson Centre for Applied Health Research, Bradford Royal Infirmary, Bradford, West Yorkshire, United Kingdom
| | - Kirsty L. Crossley
- Bradford Institute for Health Research, Bradford Royal Infirmary, Bradford, West Yorkshire, United Kingdom
- Centre for Applied Education Research, Wolfson Centre for Applied Health Research, Bradford Royal Infirmary, Bradford, West Yorkshire, United Kingdom
| | - Nishaat F. Shahid
- Bradford Institute for Health Research, Bradford Royal Infirmary, Bradford, West Yorkshire, United Kingdom
| | - Marsha Ellingham-Khan
- Bradford Institute for Health Research, Bradford Royal Infirmary, Bradford, West Yorkshire, United Kingdom
- Centre for Applied Education Research, Wolfson Centre for Applied Health Research, Bradford Royal Infirmary, Bradford, West Yorkshire, United Kingdom
| | - Ava Otteslev
- Bradford Institute for Health Research, Bradford Royal Infirmary, Bradford, West Yorkshire, United Kingdom
- Centre for Applied Education Research, Wolfson Centre for Applied Health Research, Bradford Royal Infirmary, Bradford, West Yorkshire, United Kingdom
| | - Natalie S. Figueredo
- Bradford Institute for Health Research, Bradford Royal Infirmary, Bradford, West Yorkshire, United Kingdom
- Centre for Applied Education Research, Wolfson Centre for Applied Health Research, Bradford Royal Infirmary, Bradford, West Yorkshire, United Kingdom
| | - Mark Mon-Williams
- School of Psychology, University of Leeds, Leeds, West Yorkshire, United Kingdom
- Bradford Institute for Health Research, Bradford Royal Infirmary, Bradford, West Yorkshire, United Kingdom
- Centre for Applied Education Research, Wolfson Centre for Applied Health Research, Bradford Royal Infirmary, Bradford, West Yorkshire, United Kingdom
- National Centre for Optics, Vision and Eye Care, University of South-Eastern Norway, Notodden, Norway
| | - Liam J. B. Hill
- School of Psychology, University of Leeds, Leeds, West Yorkshire, United Kingdom
- Bradford Institute for Health Research, Bradford Royal Infirmary, Bradford, West Yorkshire, United Kingdom
- Centre for Applied Education Research, Wolfson Centre for Applied Health Research, Bradford Royal Infirmary, Bradford, West Yorkshire, United Kingdom
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17
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Sherry AP, Pearson N, Ridgers ND, Barber SE, Bingham DD, Nagy LC, Clemes SA. activPAL-measured sitting levels and patterns in 9-10 years old children from a UK city. J Public Health (Oxf) 2020; 41:757-764. [PMID: 30346570 DOI: 10.1093/pubmed/fdy181] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Revised: 09/23/2018] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND There is insufficient evidence of sitting time in UK children from validated objective measures. This study explored sitting patterns in primary school children from Bradford, UK, using the validated activPAL inclinometer. METHODS Overall, 79 children (9.8 (SD 0.3) years old, 52% boys; 70% South Asian) wore activPALs for 7 days. Total sitting time, sitting time accumulated in different bout lengths, and the proportion of wear time spent in these variables were explored and compared across different periods of the week. RESULTS Children spent 614 ± 112 (median ± IQR) min/day on school days and 690 ± 150 min/day on weekend days sitting. The proportion of time spent sitting was significantly higher on weekend days compared to school days (mean±SD: 74 ± 10% versus 68 ± 8%,P < 0.001), as was the proportion of time accumulated in >30 min sitting bouts (mean±CI: 28 ± 27-33% versus 20 ± 20-22%, P < 0.001). The proportion of time spent sitting after school was significantly higher than during school time (mean±SD: 70 ± 8.4% versus 63 ± 8.3%,P < 0.001), as was the proportion of time spent in prolonged (>30 min) sitting bouts (mean±CI: 19 ± 16-22% versus 11 ± 10-14%, P < 0.001). CONCLUSIONS Children spent large proportions of their waking day sitting, often accumulated in prolonged uninterrupted bouts and particularly after school and on weekends. Interventions to reduce sitting time in children are urgently needed.
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Affiliation(s)
- Aron P Sherry
- National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK.,NIHR Leicester Biomedical Research Centre-Lifestyle Theme, Loughborough University, Loughborough, UK
| | - Natalie Pearson
- National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Nicola D Ridgers
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
| | - Sally E Barber
- Bradford Institute for Health Research, Bradford Teaching Hospitals Foundation Trust, Bradford, UK
| | - Daniel D Bingham
- Bradford Institute for Health Research, Bradford Teaching Hospitals Foundation Trust, Bradford, UK
| | - Liana C Nagy
- Bradford Institute for Health Research, Bradford Teaching Hospitals Foundation Trust, Bradford, UK.,Faculty of Health Studies, Bradford University, Richmond Road, Bradford, UK
| | - Stacy A Clemes
- National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK.,NIHR Leicester Biomedical Research Centre-Lifestyle Theme, Loughborough University, Loughborough, UK
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18
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Clemes SA, Bingham DD, Pearson N, Chen YL, Edwardson C, McEachan R, Tolfrey K, Cale L, Richardson G, Fray M, Altunkaya J, Bandelow S, Jaicim NB, Barber SE. Sit–stand desks to reduce sedentary behaviour in 9- to 10-year-olds: the Stand Out in Class pilot cluster RCT. Public Health Res 2020. [DOI: 10.3310/phr08080] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Background
Sedentary behaviour (sitting) is a highly prevalent negative health behaviour, with individuals of all ages exposed to environments that promote prolonged sitting. The school classroom represents an ideal setting for environmental change through the provision of sit–stand desks.
Objectives
The aim of this study was to undertake a pilot cluster randomised controlled trial of the introduction of sit–stand desks in primary school classrooms, to inform a definitive trial. Objectives included providing information on school and participant recruitment and retention, acceptability of the intervention, and outcome measures. A preliminary estimate of the intervention’s effectiveness on the proposed primary outcome (change in weekday sitting time) for inclusion in a definitive trial was calculated, along with a preliminary assessment of potential cost-effectiveness. A full process evaluation was also undertaken.
Design
A two-armed pilot cluster randomised controlled trial with economic and qualitative evaluations. Schools were randomised on a 1 : 1 basis to the intervention (n = 4) or control (n = 4) trial arms.
Setting
Primary schools in Bradford, West Yorkshire, UK.
Participants
Children in Year 5 (i.e. aged 9–10 years).
Intervention
Six sit–stand desks replaced three standard desks (sitting six children) in the intervention classrooms for 4.5 months. Teachers were encouraged to ensure that all pupils were exposed to the sit–stand desks for at least 1 hour per day, on average, using a rotation system. Schools assigned to the control arm continued with their usual practice.
Main outcome measures
Trial feasibility outcomes included school and participant recruitment and attrition, acceptability of the intervention, and acceptability of and compliance with the proposed outcome measures [including weekday sitting measured using activPAL™ (PAL Technologies Ltd, Glasgow, UK) accelerometers, physical activity, adiposity, blood pressure, cognitive function, musculoskeletal comfort, academic progress, engagement and behaviour].
Results
Thirty-three per cent of schools approached and 75% (n = 176) of eligible children took part. At the 7-month follow-up, retention rates were 100% for schools and 97% for children. Outcome measure completion rates ranged from 63% to 97%. A preliminary estimate of intervention effectiveness, from a weighted linear regression model (adjusting for baseline sitting time and wear time) revealed a mean difference in change in sitting of –30.6 minutes per day (95% confidence interval –56.42 to –4.84 minutes per day) between the intervention and control trial arms. The process evaluation revealed that the intervention, recruitment and evaluation procedures were acceptable to teachers and children, with the exception of minor issues around activPAL attachment. A preliminary within-trial economic analysis revealed no difference between intervention and control trial arms in health and education resource use or outcomes. Long-term modelling estimated an unadjusted incremental cost-effectiveness ratio of Stand Out in Class of £78,986 per quality-adjusted life-year gained.
Conclusion
This study has provided evidence of the acceptability and feasibility of the Stand Out in Class intervention and evaluation methods. Preliminary evidence suggests that the intervention may have a positive direction of effect on weekday sitting time, which warrants testing in a full cluster randomised controlled trial. Lessons learnt from this trial will inform the planning of a definitive trial.
Trial registration
Current Controlled Trials ISRCTN12915848.
Funding
This project was funded by the National Institute for Health Research (NIHR) Public Health Research programme and will be published in full in Public Health Research; Vol. 8, No. 8. See the NIHR Journals Library website for further project information.
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Affiliation(s)
- Stacy A Clemes
- National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
- National Institute for Health Research Leicester Biomedical Research Centre, Leicester, UK
| | - Daniel D Bingham
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
| | - Natalie Pearson
- National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Yu-Ling Chen
- National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Charlotte Edwardson
- National Institute for Health Research Leicester Biomedical Research Centre, Leicester, UK
- Diabetes Research Centre, University of Leicester, Leicester, UK
| | - Rosemary McEachan
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
| | - Keith Tolfrey
- National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
- National Institute for Health Research Leicester Biomedical Research Centre, Leicester, UK
| | - Lorraine Cale
- National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | | | - Mike Fray
- Loughborough Design School, Loughborough University, Loughborough, UK
| | | | - Stephan Bandelow
- National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | | | - Sally E Barber
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
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19
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Clemes SA, Bingham DD, Pearson N, Chen YL, Edwardson CL, McEachan RRC, Tolfrey K, Cale L, Richardson G, Fray M, Altunkaya J, Bandelow S, Jaicim NB, Salmon J, Dunstan DW, Barber SE. Stand Out in Class: restructuring the classroom environment to reduce sitting time - findings from a pilot cluster randomised controlled trial. Int J Behav Nutr Phys Act 2020; 17:55. [PMID: 32349761 PMCID: PMC7189432 DOI: 10.1186/s12966-020-00958-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Accepted: 04/15/2020] [Indexed: 12/01/2022] Open
Abstract
Background Excessive sedentary behaviour (sitting) is a risk factor for poor health in children and adults. Incorporating sit-stand desks in the classroom environment has been highlighted as a potential strategy to reduce children’s sitting time. The primary aim of this study was to examine the feasibility of conducting a cluster randomised controlled trial (RCT) of a sit-stand desk intervention within primary school classrooms. Methods We conducted a two-armed pilot cluster RCT involving 8 primary schools in Bradford, United Kingdom. Schools were randomised on a 1:1 basis to the intervention or usual practice control arm. All children (aged 9–10 years) in participating classes were eligible to take part. Six sit-stand desks replaced three standard desks (sitting 6 children) in the intervention classrooms for 4.5-months. Teachers were encouraged to use a rotation system to ensure all pupils were exposed to the sit-stand desks for > 1 h/day on average. Trial feasibility outcomes (assessed using quantitative and qualitative measures) included school and participant recruitment and attrition, intervention and outcome measure completion rates, acceptability, and preliminary effectiveness of the intervention for reducing sitting time. A weighted linear regression model compared changes in weekday sitting time (assessed using the activPAL accelerometer) between trial arms. Results School and child recruitment rates were 33% (n = 8) and 75% (n = 176). At follow-up, retention rates were 100% for schools and 97% for children. Outcome measure completion rates ranged from 63 to 97%. A preliminary estimate of intervention effectiveness revealed a mean difference in change in sitting of − 30.6 min/day (95% CI: − 56.42 to − 4.84) in favour of the intervention group, after adjusting for baseline sitting and wear time. Qualitative measures revealed the intervention and evaluation procedures were acceptable to teachers and children, except for some problems with activPAL attachment. Conclusion This study provides evidence of the acceptability and feasibility of a sit-stand desk intervention and evaluation methods. Preliminary evidence suggests the intervention showed potential in reducing children’s weekday sitting but some adaptations to the desk rotation system are needed to maximize exposure. Lessons learnt from this trial will inform the planning of a definitive trial. Trial registration ISRCTN12915848 (registered: 09/11/16).
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Affiliation(s)
- Stacy A Clemes
- National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK. .,NIHR Leicester Biomedical Research Centre, Leicester, UK.
| | - Daniel D Bingham
- Bradford Institute for Health Research, Bradford Teaching Hospitals Foundation Trust, Bradford, UK
| | - Natalie Pearson
- National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Yu-Ling Chen
- National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Charlotte L Edwardson
- NIHR Leicester Biomedical Research Centre, Leicester, UK.,Diabetes Research Centre, University of Leicester, Leicester, UK
| | - Rosemary R C McEachan
- Bradford Institute for Health Research, Bradford Teaching Hospitals Foundation Trust, Bradford, UK
| | - Keith Tolfrey
- National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK.,NIHR Leicester Biomedical Research Centre, Leicester, UK
| | - Lorraine Cale
- National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Gerry Richardson
- Centre for Health Economics, University of York, Heslington, York, UK
| | - Mike Fray
- Loughborough Design School, Loughborough University, Loughborough, UK
| | - James Altunkaya
- Centre for Health Economics, University of York, Heslington, York, UK
| | - Stephan Bandelow
- National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK.,Department of Physiology, Neuroscience and Behavioral Sciences, St. George's University, West Indies, Grenada
| | | | - Jo Salmon
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Melbourne, Australia
| | - David W Dunstan
- Baker Heart and Diabetes Institute, Melbourne, Australia.,Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia
| | - Sally E Barber
- Bradford Institute for Health Research, Bradford Teaching Hospitals Foundation Trust, Bradford, UK
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20
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Daly-Smith A, Quarmby T, Archbold VSJ, Corrigan N, Wilson D, Resaland GK, Bartholomew JB, Singh A, Tjomsland HE, Sherar LB, Chalkley A, Routen AC, Shickle D, Bingham DD, Barber SE, van Sluijs E, Fairclough SJ, McKenna J. Using a multi-stakeholder experience-based design process to co-develop the Creating Active Schools Framework. Int J Behav Nutr Phys Act 2020; 17:13. [PMID: 32028968 PMCID: PMC7006100 DOI: 10.1186/s12966-020-0917-z] [Citation(s) in RCA: 65] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Accepted: 01/23/2020] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND UK and global policies recommend whole-school approaches to improve childrens' inadequate physical activity (PA) levels. Yet, recent meta-analyses establish current interventions as ineffective due to suboptimal implementation rates and poor sustainability. To create effective interventions, which recognise schools as complex adaptive sub-systems, multi-stakeholder input is necessary. Further, to ensure 'systems' change, a framework is required that identifies all components of a whole-school PA approach. The study's aim was to co-develop a whole-school PA framework using the double diamond design approach (DDDA). METHODOLOGY Fifty stakeholders engaged in a six-phase DDDA workshop undertaking tasks within same stakeholder (n = 9; UK researchers, public health specialists, active schools coordinators, headteachers, teachers, active partner schools specialists, national organisations, Sport England local delivery pilot representatives and international researchers) and mixed (n = 6) stakeholder groupings. Six draft frameworks were created before stakeholders voted for one 'initial' framework. Next, stakeholders reviewed the 'initial' framework, proposing modifications. Following the workshop, stakeholders voted on eight modifications using an online questionnaire. RESULTS Following voting, the Creating Active Schools Framework (CAS) was designed. At the centre, ethos and practice drive school policy and vision, creating the physical and social environments in which five key stakeholder groups operate to deliver PA through seven opportunities both within and beyond school. At the top of the model, initial and in-service teacher training foster teachers' capability, opportunity and motivation (COM-B) to deliver whole-school PA. National policy and organisations drive top-down initiatives that support or hinder whole-school PA. To the authors' knowledge, this is the first time practitioners, policymakers and researchers have co-designed a whole-school PA framework from initial conception. The novelty of CAS resides in identifying the multitude of interconnecting components of a whole-school adaptive sub-system; exposing the complexity required to create systems change. The framework can be used to shape future policy, research and practice to embed sustainable PA interventions within schools. To enact such change, CAS presents a potential paradigm shift, providing a map and method to guide future co-production by multiple experts of PA initiatives 'with' schools, while abandoning outdated traditional approaches of implementing interventions 'on' schools.
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Affiliation(s)
- Andy Daly-Smith
- School of Sport, Leeds Beckett University, Headingley Campus, Leeds, LS17 7TL, UK.
- Center for Physically Active Learning, Faculty of Education, Arts and Sports, Western Norway University of Applied Sciences, Sogndal, Norway.
- Born in Bradford, Bradford Institute for Health Research, Bradford Teaching Hospitals Foundation Trust, Bradford, UK.
| | - Thomas Quarmby
- School of Sport, Leeds Beckett University, Headingley Campus, Leeds, LS17 7TL, UK
| | | | - Nicola Corrigan
- Public Health England (Yorkshire and Humber Centre), London, UK
| | - Dan Wilson
- Yorkshire Sport Foundation, Gildersome, UK
| | - Geir K Resaland
- Center for Physically Active Learning, Faculty of Education, Arts and Sports, Western Norway University of Applied Sciences, Sogndal, Norway
| | - John B Bartholomew
- Department of Kinesiology and Health Education, The University of Texas at Austin, Austin, TX, USA
| | - Amika Singh
- Department of Public and Occupational Health, Amsterdam UMC, Amsterdam Public Health, Amsterdam, The Netherlands
- Mulier Institute, Utrecht, the Netherlands
| | - Hege E Tjomsland
- Center for Physically Active Learning, Faculty of Education, Arts and Sports, Western Norway University of Applied Sciences, Sogndal, Norway
| | - Lauren B Sherar
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Anna Chalkley
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Ash C Routen
- NIHR Applied Research Collaboration East Midlands (ARC EM), Diabetes Research Centre, University of Leicester, Leicester, UK
| | - Darren Shickle
- Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
| | - Daniel D Bingham
- Born in Bradford, Bradford Institute for Health Research, Bradford Teaching Hospitals Foundation Trust, Bradford, UK
| | - Sally E Barber
- Born in Bradford, Bradford Institute for Health Research, Bradford Teaching Hospitals Foundation Trust, Bradford, UK
| | - Esther van Sluijs
- Centre for Diet and Activity Research, MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
| | | | - Jim McKenna
- School of Sport, Leeds Beckett University, Headingley Campus, Leeds, LS17 7TL, UK
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21
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Collings PJ, Dogra SA, Costa S, Bingham DD, Barber SE. Objectively-measured sedentary time and physical activity in a bi-ethnic sample of young children: variation by socio-demographic, temporal and perinatal factors. BMC Public Health 2020; 20:109. [PMID: 31992249 PMCID: PMC6986109 DOI: 10.1186/s12889-019-8132-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Accepted: 12/30/2019] [Indexed: 12/26/2022] Open
Abstract
Background Evidence suggests that South Asian school-aged children and adults are less active compared to the white British population. It is unknown if this generalises to young children. We aimed to describe variability in levels of physical activity and sedentary time in a bi-ethnic sample of young children from a deprived location. Methods This observational study included 202 South Asian and 140 white British children aged 1.5 to 5y, who provided 3181 valid days of triaxial accelerometry (Actigraph GT3X+). Variability in sedentary time and physical activity levels were analysed by linear multilevel modelling. Logistic multilevel regression was used to identify factors associated with physical inactivity (failing to perform ≥180 min of total physical activity including ≥60 min moderate-to-vigorous physical activity (MVPA) per day). Results There were no significant ethnic differences in the overall levels of behaviours; South Asian and white British children spent half of daily time sedentary, just over 40% in light physical activity, and the remaining 7.5 to 8% of time in MVPA. Sedentary time was lower and physical activity levels were higher in older children, and levels of MVPA and vector magnitude counts per minute (CPM) were higher on weekends compared to weekdays. In South Asian children, sedentary time was lower on weekends. Sedentary time was lower and physical activity levels were higher in spring compared to winter in white British children, and in all seasons compared to winter in South Asian children. South Asian children born at high birth weight performed more MVPA, and in both ethnicities there was some evidence that children with older mothers were more sedentary and less active. Sedentary time was higher and light physical activity was lower in South Asian children in the highest compared to the lowest income families. South Asian girls performed less MVPA, registered fewer vector magnitude CPM, and were 3.5 times more likely to be physically inactive than South Asian boys. Conclusions Sedentary time and physical activity levels vary by socio-demographic, temporal and perinatal characteristics in young children from a deprived location. South Asian girls have the most to gain from efforts to increase physical activity levels. Trial registration The Pre-schoolers in the Playground (PiP) pilot randomized controlled trial is registered with the ISRCTN (ISRCTN54165860; http://www.isrctn.com).
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Affiliation(s)
- Paul J Collings
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK. .,Department of Health Sciences, University of York, York, UK.
| | - Sufyan A Dogra
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
| | - Silvia Costa
- School of Sport, Exercise and Health Sciences, Loughborough University, Leicestershire, UK
| | - Daniel D Bingham
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
| | - Sally E Barber
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
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22
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Eddy LH, Wood ML, Shire KA, Bingham DD, Bonnick E, Creaser A, Mon-Williams M, Hill LJB. A systematic review of randomized and case-controlled trials investigating the effectiveness of school-based motor skill interventions in 3- to 12-year-old children. Child Care Health Dev 2019; 45:773-790. [PMID: 31329292 DOI: 10.1111/cch.12712] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2018] [Revised: 05/18/2019] [Accepted: 06/23/2019] [Indexed: 11/26/2022]
Abstract
BACKGROUND Research suggests that children identified with impaired motor skills can respond well to intensive therapeutic interventions delivered via occupational and physical therapy services. There is, however, a need to explore alternative approaches to delivering interventions outside traditional referral-based clinic settings because limited resources mean such health services often struggle to meet demand. This review sets out to systematically assess the evidence for and against school-based interventions targeted at improving the motor skills of children aged between 3 and 12 years old. METHOD Five electronic databases were searched systematically (AMED, CINAHL, Cochrane, Medline, and PsycINFO) for peer-reviewed articles published between January 2012 and July 2018. Studies were eligible if they implemented a school-based motor skill intervention with a randomized or case-controlled trial design that objectively measured motor skills as an outcome, which were not specific to an athletic or sporting skill. Participants had to be aged between 3 and 12 years old and free from neurological disorders known to affect muscle function. Risk of bias was assessed using the Cochrane risk of bias tool. RESULTS Twenty-three studies met the inclusion criteria. These studies encompassed interventions targeted at training: fundamental movement skills, handwriting, fine, and global motor skills. The majority of these studies reported beneficial impact on motor function specifically, but some interventions also assessed subsequent impacts on activity and participation (but not well-being). A number of the studies had methodological shortcomings that means these results need to be interpreted with caution. CONCLUSIONS Schools appear to be an effective setting for motor skill interventions, but the extent of benefit likely depends on the type of intervention. Moreover, confirmation is needed as to whether benefits extend beyond motor function into everyday activities, participation, and well-being. Future research should include follow-up measures to assess the longer term efficacy of school-based interventions.
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Affiliation(s)
- Lucy H Eddy
- School of Psychology, University of Leeds, Leeds, UK.,Bradford Institute for Health Research, Bradford Teaching Hospitals Foundation Trust, Bradford, UK
| | - Megan L Wood
- School of Psychology, University of Leeds, Leeds, UK.,Bradford Institute for Health Research, Bradford Teaching Hospitals Foundation Trust, Bradford, UK
| | - Katy A Shire
- Bradford Institute for Health Research, Bradford Teaching Hospitals Foundation Trust, Bradford, UK
| | - Daniel D Bingham
- Bradford Institute for Health Research, Bradford Teaching Hospitals Foundation Trust, Bradford, UK
| | - Emma Bonnick
- Bradford Institute for Health Research, Bradford Teaching Hospitals Foundation Trust, Bradford, UK
| | - Amy Creaser
- Bradford Institute for Health Research, Bradford Teaching Hospitals Foundation Trust, Bradford, UK
| | - Mark Mon-Williams
- School of Psychology, University of Leeds, Leeds, UK.,Bradford Institute for Health Research, Bradford Teaching Hospitals Foundation Trust, Bradford, UK
| | - Liam J B Hill
- School of Psychology, University of Leeds, Leeds, UK.,Bradford Institute for Health Research, Bradford Teaching Hospitals Foundation Trust, Bradford, UK
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23
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Clemes SA, Bingham DD, Pearson N, Chen YL, Edwardson C, McEachan R, Tolfrey K, Cale L, Richardson G, Fray M, Bandelow S, Jaicim NB, Salmon J, Dunstan D, Barber SE. Stand Out in Class: restructuring the classroom environment to reduce sedentary behaviour in 9-10-year-olds - study protocol for a pilot cluster randomised controlled trial. Pilot Feasibility Stud 2018; 4:103. [PMID: 29850027 PMCID: PMC5966899 DOI: 10.1186/s40814-018-0295-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2018] [Accepted: 05/10/2018] [Indexed: 11/10/2022] Open
Abstract
Background Sedentary behaviour (sitting) is a highly prevalent negative health behaviour, with individuals of all ages exposed to environments that promote prolonged sitting. Excessive sedentary behaviour adversely affects health in children and adults. As sedentary behaviour tracks from childhood into adulthood, the reduction of sedentary time in young people is key for the prevention of chronic diseases that result from excessive sitting in later life. The sedentary school classroom represents an ideal setting for environmental change, through the provision of sit-stand desks. Whilst the use of sit-stand desks in classrooms demonstrates positive effects in some key outcomes, evidence is currently limited by small samples and/or short intervention durations, with few studies adopting randomised controlled trial (RCT) designs. This paper describes the protocol of a pilot cluster RCT of a sit-stand desk intervention in primary school classrooms. Methods/Design A two-arm pilot cluster RCT will be conducted in eight primary schools (four intervention, four control) with at least 120 year 5 children (aged 9-10 years). Sit-stand desks will replace six standard desks in the intervention classrooms. Teachers will be encouraged to ensure all pupils are exposed to the sit-stand desks for at least 1 h/day on average using a rotation system. Schools assigned to the control arm will continue with their usual practice, no environmental changes will be made to their classrooms. Measurements will be taken at baseline, before randomisation, and at the end of the schools' academic year. In this study, the primary outcomes of interest will be school and participant recruitment and attrition, acceptability of the intervention, and acceptability and compliance to the proposed outcome measures (including activPAL-measured school-time and school-day sitting, accelerometer-measured physical activity, adiposity, blood pressure, cognitive function, academic progress, engagement, and behaviour) for inclusion in a definitive trial. A full process evaluation and an exploratory economic evaluation will also be conducted to further inform a definitive trial. Discussion The primary output of this study will be acceptability data to inform the development of a definitive cluster RCT designed to examine the efficacy of this intervention on health- and education-related outcomes in UK primary school children. Trial registration ISRCTN12915848 (retrospectively registered, date registered 9 November 2016).
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Affiliation(s)
- Stacy A Clemes
- 1National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK.,NIHR Leicester Biomedical Research Centre, Leicester, UK
| | - Daniel D Bingham
- Bradford Institute for Health Research, Bradford Teaching Hospitals Foundation Trust, Bradford, UK
| | - Natalie Pearson
- 1National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Yu-Ling Chen
- 1National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Charlotte Edwardson
- NIHR Leicester Biomedical Research Centre, Leicester, UK.,4Diabetes Research Centre, University of Leicester, Leicester, UK
| | - Rosemary McEachan
- Bradford Institute for Health Research, Bradford Teaching Hospitals Foundation Trust, Bradford, UK
| | - Keith Tolfrey
- 1National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK.,NIHR Leicester Biomedical Research Centre, Leicester, UK
| | - Lorraine Cale
- 1National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Gerry Richardson
- 5Centre for Health Economics, University of York, Heslington, York, UK
| | - Mike Fray
- 6Loughborough Design School, Loughborough University, Loughborough, UK
| | - Stephan Bandelow
- 1National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | | | - Jo Salmon
- 8Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Melbourne, Australia
| | - David Dunstan
- 9Baker IDI Heart and Diabetes Institute, Melbourne, Australia.,10Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia
| | - Sally E Barber
- Bradford Institute for Health Research, Bradford Teaching Hospitals Foundation Trust, Bradford, UK
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Clark CCT, Barnes CM, Swindell NJ, Holton MD, Bingham DD, Collings PJ, Barber SE, Summers HD, Mackintosh KA, Stratton G. Profiling Movement and Gait Quality Characteristics in Pre-School Children. J Mot Behav 2017; 50:557-565. [DOI: 10.1080/00222895.2017.1375454] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Cain C. T. Clark
- HE Sport, University Centre Hartpury, United Kingdom
- Applied Sports Science Technology and Medicine Research Centre (A-STEM), College of Engineering, Bay Campus, Swansea University, United Kingdom
- Engineering Behaviour Analytics in Sport and Exercise (E-BASE) Research Group, College of Engineering, Bay Campus, Swansea University, United Kingdom
| | - Claire M. Barnes
- Engineering Behaviour Analytics in Sport and Exercise (E-BASE) Research Group, College of Engineering, Bay Campus, Swansea University, United Kingdom
- Centre for Nanohealth, College of Engineering, Swansea University, United Kingdom
| | - Nils J. Swindell
- Applied Sports Science Technology and Medicine Research Centre (A-STEM), College of Engineering, Bay Campus, Swansea University, United Kingdom
- Engineering Behaviour Analytics in Sport and Exercise (E-BASE) Research Group, College of Engineering, Bay Campus, Swansea University, United Kingdom
| | - Mark D. Holton
- Engineering Behaviour Analytics in Sport and Exercise (E-BASE) Research Group, College of Engineering, Bay Campus, Swansea University, United Kingdom
- Centre for Nanohealth, College of Engineering, Swansea University, United Kingdom
| | - Daniel D. Bingham
- Born in Bradford Cohort Study, Bradford Institute for Health Research, Bradford Royal Infirmary, United Kingdom
| | - Paul J. Collings
- Born in Bradford Cohort Study, Bradford Institute for Health Research, Bradford Royal Infirmary, United Kingdom
| | - Sally E. Barber
- Born in Bradford Cohort Study, Bradford Institute for Health Research, Bradford Royal Infirmary, United Kingdom
| | - Huw D. Summers
- Engineering Behaviour Analytics in Sport and Exercise (E-BASE) Research Group, College of Engineering, Bay Campus, Swansea University, United Kingdom
- Centre for Nanohealth, College of Engineering, Swansea University, United Kingdom
| | - Kelly A. Mackintosh
- Applied Sports Science Technology and Medicine Research Centre (A-STEM), College of Engineering, Bay Campus, Swansea University, United Kingdom
- Engineering Behaviour Analytics in Sport and Exercise (E-BASE) Research Group, College of Engineering, Bay Campus, Swansea University, United Kingdom
| | - Gareth Stratton
- Applied Sports Science Technology and Medicine Research Centre (A-STEM), College of Engineering, Bay Campus, Swansea University, United Kingdom
- Engineering Behaviour Analytics in Sport and Exercise (E-BASE) Research Group, College of Engineering, Bay Campus, Swansea University, United Kingdom
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Collings PJ, Brage S, Bingham DD, Costa S, West J, McEachan RRC, Wright J, Barber SE. Physical Activity, Sedentary Time, and Fatness in a Biethnic Sample of Young Children. Med Sci Sports Exerc 2017; 49:930-938. [PMID: 28060034 DOI: 10.1249/mss.0000000000001180] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
PURPOSE This study aimed to investigate associations of objectively measured physical activity (PA) and sedentary time with adiposity in a predominantly biethnic (South Asian and White British) sample of young children. METHODS The sample included 333 children age 11 months to 5 yr who provided 526 cross-sectional observations for PA and body composition. Total PA volume (vector magnitude counts per minute), daily time at multiple intensity levels (the cumulative time in activity >500, >1000, >1500, …, >6000 counts per minute), and time spent sedentary (<820 counts per minute), in light PA (820-3907 counts per minute) and in moderate-to-vigorous PA (≥3908 counts per minute) were estimated with triaxial accelerometry. Indicators of adiposity included body mass index, waist circumference, and the sum of subscapular and triceps skinfold thicknesses. Statistical analyses were performed using multilevel regression and isotemporal substitution models adjusted for confounders. Effect modification by ethnicity was examined. RESULTS There was no evidence for effect modification by ethnicity (P interaction ≥ 0.13). In the whole sample, the accumulated time spent above 3500 counts per minute (i.e., high light-intensity PA) was inversely associated with the sum of skinfolds (β = -0.60 mm, 95% confidence interval [CI] = -1.19 to -0.021, per 20 min·d), and the magnitude of association increased dose dependently with PA intensity (peaking for time spent >6000 counts per minute = -1.57 mm, 95% CI = -3.01 to -0.12, per 20 min·d). The substitution of 20 min·d of sedentary time with moderate-to-vigorous PA was associated with a lower sum of skinfolds (-0.77 mm, 95% CI = -1.46 to -0.084). CONCLUSIONS High light-intensity PA appears to be beneficial for body composition in young South Asian and White British children, but higher-intensity PA is more advantageous.
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Affiliation(s)
- Paul J Collings
- 1Bradford Institute for Health Research, Bradford NHS Foundation Trust, Bradford, UNITED KINGDOM; 2MRC Epidemiology Unit, University of Cambridge, Cambridge, UNITED KINGDOM; 3School of Sport, Exercise and Health Sciences, Loughborough University, Leicestershire, UNITED KINGDOM; and 4UKCRC Centre for Diet and Activity Research (CEDAR), School of Clinical Medicine, University of Cambridge, Cambridge, UNITED KINGDOM
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Bingham DD, Costa S, Hinkley T, Shire KA, Clemes SA, Barber SE. Physical Activity During the Early Years: A Systematic Review of Correlates and Determinants. Am J Prev Med 2016; 51:384-402. [PMID: 27378255 DOI: 10.1016/j.amepre.2016.04.022] [Citation(s) in RCA: 70] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2015] [Revised: 04/11/2016] [Accepted: 04/26/2016] [Indexed: 10/21/2022]
Abstract
CONTEXT Being physically active during the early years (age 0-6 years) is vital for healthy development. Identifying correlates and determinants of physical activity (PA) is crucial to guide effective interventions. This systematic review synthesized studies investigating potential correlates and determinants of PA during the early years, accounting for different types of PA assessment. EVIDENCE ACQUISITION Nine electronic databases were searched from inception year (1900) until September 2014; data were analyzed/interpreted in April 2015. The following inclusion criteria were used: written in English, published in peer-reviewed journals, participants not in statutory/school education, and an observational design investigating associations between an exposure/variable, and a quantitative measure of PA. Correlates/determinants of total, moderate to vigorous, and light PA were reported using an ecologic model. EVIDENCE SYNTHESIS Of 22,045 identified studies, 130 were included. All took place in high-income countries and few (6%) were of high quality. Correlates of total PA were sex (male, ++); parental PA (+); parental support (+); and time outdoors (+). Determinants of total PA were sex (+) and time spent playing with parents (+). The only correlate of moderate to vigorous PA was sex (male, ++). No determinants of moderate to vigorous or light PA were found. PA correlates/determinants were relatively consistent between objective and subjective PA measures. CONCLUSIONS Numerous studies investigated potential correlates and determinants of PA, but overall quality was low. A small number of demographic/biological and social/cultural factors were associated with PA. There is a need for high-quality studies exploring correlates/determinants across all domains of the ecologic model.
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Affiliation(s)
- Daniel D Bingham
- School of Sport, Exercise and Health Sciences, Loughborough University, Leicestershire, United Kingdom; Bradford Institute for Health Research, Bradford, United Kingdom.
| | - Silvia Costa
- Centre for Diet and Activity Research (CEDAR), MRC Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom
| | - Trina Hinkley
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
| | - Katy A Shire
- Institute of Psychological Sciences, University of Leeds, West Yorkshire, United Kingdom
| | - Stacy A Clemes
- School of Sport, Exercise and Health Sciences, Loughborough University, Leicestershire, United Kingdom
| | - Sally E Barber
- Bradford Institute for Health Research, Bradford, United Kingdom
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McEachan RRC, Santorelli G, Bryant M, Sahota P, Farrar D, Small N, Akhtar S, Sargent J, Barber SE, Taylor N, Richardson G, Farrin AJ, Bhopal RS, Bingham DD, Ahern SM, Wright J. The HAPPY (Healthy and Active Parenting Programmme for early Years) feasibility randomised control trial: acceptability and feasibility of an intervention to reduce infant obesity. BMC Public Health 2016; 16:211. [PMID: 26931491 PMCID: PMC4774160 DOI: 10.1186/s12889-016-2861-z] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2015] [Accepted: 02/12/2016] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND The prevalence of infant obesity is increasing, but there is a lack of evidence-based approaches to prevent obesity at this age. This study tested the acceptability and feasibility of evaluating a theory-based intervention aimed at reducing risk of obesity in infants of overweight/obese women during and after pregnancy: the Healthy and Active Parenting Programme for Early Years (HAPPY). METHODS A feasibility randomised controlled trial was conducted in Bradford, England. One hundred twenty overweight/obese pregnant women (Body Mass Index [BMI] ≥25 kg/m(2)) were recruited between 10-26 weeks gestation. Consenting women were randomly allocated to HAPPY (6 antenatal, 6 postnatal sessions: N = 59) or usual care (N = 61). Appropriate outcome measures for a full trial were explored, including: infant's length and weight, woman's BMI, physical activity and dietary intake of the women and infants. Health economic data were collected. Measurement occurred before randomisation and when the infant was aged 6 months and 12 months. Feasibility outcomes were: recruitment/attrition rates, and acceptability of: randomisation, measurement, and intervention. Intra-class correlations for infant weight were calculated. Fidelity was assessed through observations and facilitator feedback. Focus groups and semi-structured interviews explored acceptability of methods, implementation, and intervention content. RESULTS Recruitment targets were met (~20 women/month) with a recruitment rate of 30 % of eligible women (120/396). There was 30 % attrition at 12 months; 66 % of recruited women failed to attend intervention sessions, but those who attended the first session were likely to continue to attend (mean 9.4/12 sessions, range 1-12). Reaction to intervention content was positive, and fidelity was high. Group clustering was minimal; an adjusted effect size of -0.25 standard deviation scores for infant weight at 12 months (95 % CI: -0.16-0.65) favouring the intervention was observed using intention to treat analyses. No adverse events were reported. CONCLUSIONS The HAPPY intervention appeared feasible and acceptable to participants who attended and those delivering it, however attendance was low; adaptations to increase initial attendance are recommended. Whilst the study was not powered to detect a definitive effect, our results suggest a potential to reduce risk of infant obesity. The evidence reported provides valuable lessons to inform progression to a definitive trial. TRIAL REGISTRATION Current Controlled Trials ISRCTN56735429.
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Affiliation(s)
- Rosemary R. C. McEachan
- />Bradford Institute for Health Research, Bradford Teaching Hospital NHS Foundation Trust, Bradford Royal Infirmary, Duckworth Lane, Bradford, BD9 6RJ UK
| | - Gillian Santorelli
- />Bradford Institute for Health Research, Bradford Teaching Hospital NHS Foundation Trust, Bradford Royal Infirmary, Duckworth Lane, Bradford, BD9 6RJ UK
- />Leeds Institute of Clinical Trials Research, University of Leeds, Leeds, LS2 9JT UK
| | - Maria Bryant
- />Bradford Institute for Health Research, Bradford Teaching Hospital NHS Foundation Trust, Bradford Royal Infirmary, Duckworth Lane, Bradford, BD9 6RJ UK
- />Leeds Institute of Clinical Trials Research, University of Leeds, Leeds, LS2 9JT UK
| | - Pinki Sahota
- />Institute for Health and Wellbeing, Leeds Beckett University, Leeds, LS1 3HE UK
| | - Diane Farrar
- />Bradford Institute for Health Research, Bradford Teaching Hospital NHS Foundation Trust, Bradford Royal Infirmary, Duckworth Lane, Bradford, BD9 6RJ UK
- />Department of Health Sciences, University of York, York, YO10 5DD UK
| | - Neil Small
- />Faculty of Health Studies, University of Bradford, Bradford, BD7 1DP UK
| | - Shaheen Akhtar
- />Bradford Institute for Health Research, Bradford Teaching Hospital NHS Foundation Trust, Bradford Royal Infirmary, Duckworth Lane, Bradford, BD9 6RJ UK
| | | | - Sally E. Barber
- />Bradford Institute for Health Research, Bradford Teaching Hospital NHS Foundation Trust, Bradford Royal Infirmary, Duckworth Lane, Bradford, BD9 6RJ UK
| | - Natalie Taylor
- />Australian Institute of Health Innovation, Macquarie University, Sydney, NSW 2109 Australia
| | - Gerry Richardson
- />Centre for Health Economics, University of York, York, YO10 5DD UK
| | - Amanda J. Farrin
- />Leeds Institute of Clinical Trials Research, University of Leeds, Leeds, LS2 9JT UK
| | - Raj S. Bhopal
- />Edinburgh Migration, Ethnicity and Health Research Group, Centre for Population Health Sciences, Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, EH8 9AG UK
| | - Daniel D. Bingham
- />Bradford Institute for Health Research, Bradford Teaching Hospital NHS Foundation Trust, Bradford Royal Infirmary, Duckworth Lane, Bradford, BD9 6RJ UK
- />School of Sport, Health and Exercise Science, Loughborough University, Leicestershire, LE11 3TT UK
| | - Sara M. Ahern
- />Bradford Institute for Health Research, Bradford Teaching Hospital NHS Foundation Trust, Bradford Royal Infirmary, Duckworth Lane, Bradford, BD9 6RJ UK
| | - John Wright
- />Bradford Institute for Health Research, Bradford Teaching Hospital NHS Foundation Trust, Bradford Royal Infirmary, Duckworth Lane, Bradford, BD9 6RJ UK
| | - on behalf of the BiB childhood obesity scientific group
- />Bradford Institute for Health Research, Bradford Teaching Hospital NHS Foundation Trust, Bradford Royal Infirmary, Duckworth Lane, Bradford, BD9 6RJ UK
- />Leeds Institute of Clinical Trials Research, University of Leeds, Leeds, LS2 9JT UK
- />Institute for Health and Wellbeing, Leeds Beckett University, Leeds, LS1 3HE UK
- />Department of Health Sciences, University of York, York, YO10 5DD UK
- />Faculty of Health Studies, University of Bradford, Bradford, BD7 1DP UK
- />Barnardo’s, Bradford, BD8 7BS UK
- />Australian Institute of Health Innovation, Macquarie University, Sydney, NSW 2109 Australia
- />Centre for Health Economics, University of York, York, YO10 5DD UK
- />Edinburgh Migration, Ethnicity and Health Research Group, Centre for Population Health Sciences, Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, EH8 9AG UK
- />School of Sport, Health and Exercise Science, Loughborough University, Leicestershire, LE11 3TT UK
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Bingham DD, Costa S, Clemes SA, Routen AC, Moore HJ, Barber SE. Accelerometer data requirements for reliable estimation of habitual physical activity and sedentary time of children during the early years - a worked example following a stepped approach. J Sports Sci 2016; 34:2005-10. [DOI: 10.1080/02640414.2016.1149605] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Barber SE, Jackson C, Hewitt C, Ainsworth HR, Buckley H, Akhtar S, Bingham DD, Routen AC, Summerbell C, Richardson G, Moore HJ, Pickett KE, O'Malley C, Brierley S, Wright J. Assessing the feasibility of evaluating and delivering a physical activity intervention for pre-school children: a pilot randomised controlled trial. Pilot Feasibility Stud 2016; 2:12. [PMID: 27965832 PMCID: PMC5154100 DOI: 10.1186/s40814-016-0052-4] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2015] [Accepted: 02/10/2016] [Indexed: 12/03/2022] Open
Abstract
Background Few evidence-based physical activity interventions for pre-school children are available. This two-armed pilot cluster randomised controlled trial aimed to evaluate the feasibility of conducting a full-scale trial and of delivering an outdoor physical activity intervention for pre-school children. Methods School was the unit of randomisation, and follow-up occurred at 10 and 52 weeks. Trial feasibility was assessed by recruitment, retention and completion rates of primary (daily moderate-to-vigorous physical activity (MVPA)) and secondary (anthropometric, quality of life, self-efficacy) outcomes. Potential effectiveness was assessed for the primary outcome using a linear regression model comparing MVPA between trial arms adjusting for clustering by school. Feasibility of delivering the intervention was assessed by intervention fidelity and attendance. Semi-structured interviews with parents, intervention facilitators, and head teachers explored acceptability and capability to deliver the intervention as well as acceptability of the study design. Results Recruitment rates were 37 % of schools (n = 10 schools) and 48 % of pre-school children (n = 164 children). Retention of children to the trial at 52 weeks was 83.5 %. Thirty-nine percent of children had valid primary outcome accelerometer data at baseline and 52 weeks. Response rates for secondary outcome measures ranged from 52 to 88 % at 10 weeks and 59 to 80 % at 52 weeks. The mean difference in daily MVPA between trial arms at 52 weeks was 0.4, 95 % CI 16.3 to 17.0; p = 0.96. Fidelity of intervention implementation was 81 %. Intervention attendance was higher (82 %) during the summer initiation phase compared to autumn/spring initiation (50 %). Parents, facilitators and head teachers found the intervention acceptable and beneficial. Conclusions Recruitment and retention rates suggest a trial in this outdoor setting with this population was feasible but is weather sensitive. However, strategies to increase accelerometer wear-time would need to be implemented for reliable primary outcome data to be obtained. There was high implementation fidelity by facilitators, and the intervention was seen as acceptable and deliverable. However, attendance was low and preliminary data showed no evidence of intervention effectiveness. A revised intervention, building on the successful elements of this pilot alongside adapting implementation strategies to improve attendance, should therefore be considered. Trial registration Trial registry name and number: Current Controlled Trials, ISRCTN54165860. Date of registration: 4 September 2012.
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Affiliation(s)
- Sally E Barber
- Born in Bradford Cohort Study, BiB Project Office, Temple Bank House, Bradford Royal Infirmary, Bradford Institute for Health Research, Duckworth Lane, Bradford, BD9 6RJ UK
| | - Cath Jackson
- Department of Health Sciences, University of York, York, UK
| | | | | | - Hannah Buckley
- Department of Health Sciences, University of York, York, UK
| | - Shaheen Akhtar
- Born in Bradford Cohort Study, BiB Project Office, Temple Bank House, Bradford Royal Infirmary, Bradford Institute for Health Research, Duckworth Lane, Bradford, BD9 6RJ UK
| | - Daniel D Bingham
- Born in Bradford Cohort Study, BiB Project Office, Temple Bank House, Bradford Royal Infirmary, Bradford Institute for Health Research, Duckworth Lane, Bradford, BD9 6RJ UK.,National Centre for Sport and Exercise Medicine (NCSEM), School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Ash C Routen
- National Centre for Sport and Exercise Medicine (NCSEM), School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Carolyn Summerbell
- School of Medicine, Pharmacy and Health, Durham University Queens Campus, Stockton-on-Tees, Durham UK
| | | | - Helen J Moore
- School of Medicine, Pharmacy and Health, Durham University Queens Campus, Stockton-on-Tees, Durham UK
| | - Kate E Pickett
- Department of Health Sciences, University of York, York, UK
| | - Claire O'Malley
- School of Medicine, Pharmacy and Health, Durham University Queens Campus, Stockton-on-Tees, Durham UK
| | - Shirley Brierley
- Public Health, City of Bradford Metropolitan District Council, Bradford, UK
| | - John Wright
- Born in Bradford Cohort Study, BiB Project Office, Temple Bank House, Bradford Royal Infirmary, Bradford Institute for Health Research, Duckworth Lane, Bradford, BD9 6RJ UK
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Clemes SA, Barber SE, Bingham DD, Ridgers ND, Fletcher E, Pearson N, Salmon J, Dunstan DW. Reducing children's classroom sitting time using sit-to-stand desks: findings from pilot studies in UK and Australian primary schools. J Public Health (Oxf) 2015; 38:526-533. [PMID: 26076699 DOI: 10.1093/pubmed/fdv084] [Citation(s) in RCA: 64] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND This research examined the influence of sit-to-stand desks on classroom sitting time in primary school children. METHODS Pilot controlled trials with similar intervention strategies were conducted in primary schools in Melbourne, Australia, and Bradford, UK. Sit-to-stand desks replaced all standard desks in the Australian intervention classroom. Six sit-to-stand desks replaced a bank of standard desks in the UK intervention classroom. Children were exposed to the sit-to-stand desks for 9-10 weeks. Control classrooms retained their normal seated desks. Classroom sitting time was measured at baseline and follow-up using the activPAL3 inclinometer. RESULTS Thirty UK and 44 Australian children provided valid activPAL data at baseline and follow-up. The proportion of time spent sitting in class decreased significantly at follow-up in both intervention groups (UK: -9.8 ± 16.5% [-52.4 ± 66.6 min/day]; Australian: -9.4 ± 10% [-43.7 ± 29.9 min/day]). No significant changes in classroom sitting time were observed in the UK control group, while a significant reduction was observed in the Australian control group (-5.9 ± 11.7% [-28.2 ± 28.3 min/day]). CONCLUSIONS Irrespective of implementation, incorporating sit-to-stand desks into classrooms appears to be an effective way of reducing classroom sitting in this diverse sample of children. Longer term efficacy trials are needed to determine effects on children's health and learning.
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Affiliation(s)
- Stacy A Clemes
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough LE11 3TU, UK NIHR Leicester-Loughborough Diet, Lifestyle and Physical Activity, Biomedical Research Unit, Loughborough University, Loughborough LE11 3TU, UK
| | - Sally E Barber
- Bradford Institute for Health Research, Bradford Teaching Hospitals Foundation Trust, Bradford BD9 6RJ, UK
| | - Daniel D Bingham
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough LE11 3TU, UK Bradford Institute for Health Research, Bradford Teaching Hospitals Foundation Trust, Bradford BD9 6RJ, UK
| | - Nicola D Ridgers
- Centre for Physical Activity and Nutrition Research (C-PAN), School of Exercise and Nutrition Sciences, Deakin University, Melbourne 3125, Australia
| | - Elly Fletcher
- Centre for Physical Activity and Nutrition Research (C-PAN), School of Exercise and Nutrition Sciences, Deakin University, Melbourne 3125, Australia
| | - Natalie Pearson
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough LE11 3TU, UK
| | - Jo Salmon
- Centre for Physical Activity and Nutrition Research (C-PAN), School of Exercise and Nutrition Sciences, Deakin University, Melbourne 3125, Australia
| | - David W Dunstan
- Centre for Physical Activity and Nutrition Research (C-PAN), School of Exercise and Nutrition Sciences, Deakin University, Melbourne 3125, Australia Baker IDI Heart and Diabetes Institute, Melbourne 3004, Australia
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Barber SE, Akhtar S, Ainsworth H, Bingham DD, Brierley S, Buckley H, Giannopoulou C, Hewitt C, Jackson C, Moore H, O’Malley C, Pickett KE, Richardson G, Routen A, Summerbell C, Wright J. Feasibility, Acceptability And Effectiveness Of An Outdoor Pre-school Physical Activity Intervention. Med Sci Sports Exerc 2015. [DOI: 10.1249/01.mss.0000477862.77653.c1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Barber SE, Akhtar S, Jackson C, Bingham DD, Hewitt C, Routen A, Richardson G, Ainsworth H, Moore HJ, Summerbell CD, Pickett KE, O’Malley C, Brierley S, Wright J. Preschoolers in the Playground: a pilot cluster randomised controlled trial of a physical activity intervention for children aged 18 months to 4 years. Public Health Research 2015. [DOI: 10.3310/phr03050] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BackgroundThe preschool years are considered critical for establishing healthy lifestyle behaviours such as physical activity. Levels of physical activity track through childhood into adulthood and establishing habitual physical activity early in life is therefore vital. Time spent outdoors is associated with greater physical activity and playground interventions have been shown to increase physical activity in school-aged children. There are few preschool, playground-based interventions and these have given inconclusive results. A report published by the UK’s Chief Medical Officer (CMO) highlighted the need for new interventions to promote movement in the early years (0–5 years).ObjectivesThis study aimed to undertake a pilot cluster randomised controlled trial (RCT) of an outdoor playground-based physical activity intervention for parents and their children aged from 18 months to 4 years (Preschoolers in the Playground or PiP) and to assess the feasibility of conducting a full-scale cluster RCT.DesignThe study was a two-armed pilot cluster RCT with economic and qualitative evaluations. Participants were randomised on a 1 : 1 basis to the PiP intervention (n = 83) or usual practice (control;n = 81).SettingBradford, West Yorkshire, UK.ParticipantsChildren aged from 18 months to 4 years.InterventionThe PiP intervention is grounded in behavioural theory (social cognitive theory) and is in accordance with CMO guidance for physical activity in the early years. It is informed by existing literature and data collected from focus groups with parents. The intervention was delivered in primary school playgrounds. Six 30-minute PiP sessions per week were available for 30 weeks; families were encouraged to come to three a week. The 10-week initiation phase was facilitated by a member of school staff and the maintenance phase was unsupervised.Main outcome measuresRecruitment and retention of schools and families to the trial were the main outcome measures. The acceptability of trial procedures and the intervention, the feasibility of collecting health outcome data and the fidelity of the implementation of the intervention were also evaluated. A preliminary assessment of cost-effectiveness and a sample size calculation for a full trial were conducted.ResultsIn total, 37% of schools and 48% of parents approached agreed to take part. Levels of retention were good at 10 and 52 weeks’ follow-up (82.3% and 83.5% respectively). Both the trial procedures and the intervention were acceptable. However, attendance was low during the autumn and winter/spring initiation phases but somewhat better in the summer initiation phase. Attendance was poor throughout all maintenance phases. The accelerometry protocol for measuring physical activity requires modification. The fidelity of intervention implementation was good (81% adherence). The intervention was borderline cost-effective. A sample size of 600 children from 38 schools is required for a full trial.ConclusionA full RCT of the PiP intervention is feasible. The PiP intervention requires some modification, for example running the intervention during the summer term only, but was found to be acceptable to schools and families.Trial registrationCurrent Controlled Trials ISRCTN54165860.FundingThis project was funded by the NIHR Public Health Research programme and will be published in full inPublic Health Research; Vol. 3, No. 5. See the NIHR Journals Library website for further project information.
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Affiliation(s)
| | | | - Cath Jackson
- Department of Health Sciences, University of York, York, UK
| | - Daniel D Bingham
- Bradford Institute for Health Research, Bradford, UK
- School of Sport Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | | | - Ash Routen
- School of Medicine and Health, University of Durham, Durham, UK
| | | | | | - Helen J Moore
- School of Medicine and Health, University of Durham, Durham, UK
| | | | - Kate E Pickett
- Department of Health Sciences, University of York, York, UK
| | - Claire O’Malley
- School of Medicine and Health, University of Durham, Durham, UK
| | - Shirley Brierley
- Public Health, City of Bradford Metropolitan District Council, Bradford, UK
| | - John Wright
- Bradford Institute for Health Research, Bradford, UK
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Barber SE, Jackson C, Akhtar S, Bingham DD, Ainsworth H, Hewitt C, Richardson G, Summerbell CD, Pickett KE, Moore HJ, Routen AC, O’Malley CL, Brierley S, Wright J. "Pre-schoolers in the playground" an outdoor physical activity intervention for children aged 18 months to 4 years old: study protocol for a pilot cluster randomised controlled trial. Trials 2013; 14:326. [PMID: 24107473 PMCID: PMC3852746 DOI: 10.1186/1745-6215-14-326] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2013] [Accepted: 09/27/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The pre-school years are considered critical for establishing healthy lifestyle behaviours such as physical activity. Levels of physical activity track through childhood into adulthood, thus establishing habitual physical activity early in life is vital. Time spent outdoors is associated with greater physical activity and playground interventions have been shown to increase physical activity in school aged children. There are few pre-school, playground-based interventions, and evaluations of these have found mixed results. A recent report published by the UK Chief Medical Officer (CMO) highlighted that new interventions to promote movement in the early years (0-5 years old) are needed. The aim of this study is to undertake a pilot cluster randomised controlled trial (RCT) of an outdoor playground-based physical activity intervention for parents and their children aged 18 months to 4 years old ("Pre-schoolers in the Playground"; PiP) and to assess the feasibility of conducting a full scale cluster RCT. The PiP intervention is grounded in behavioural theory (Social Cognitive Theory), and is in accordance with the CMO guidance for physical activity in the early years. It is informed by existing literature and data collected from focus groups with parents. METHODS/DESIGN One hundred and fifty pre-school children affiliated to 10 primary schools will be recruited. Schools will be randomised to either the PiP intervention arm or the control arm (usual practice). Children in the intervention arm will be invited to attend three 30 minute outdoor play sessions per week for 30 weeks (3 school terms) at the school. Feasibility will be assessed by examining recruitment rates, attendance, attrition, acceptability of the trial and of the PiP intervention to parents, fidelity of intervention implementation, capability and capacity for schools to deliver the intervention. Health outcomes and the feasibility of outcome measurement tools will be assessed. These include physical activity via triaxial, accelerometry (Actigraph GT3X+), anthropometry (height, body mass, BMI, waist and upper arm circumference), health related quality of life for child (PedsQL) and parent (EQ5D), parent wellbeing (ComQol-A5), injuries and health service use. A health economic evaluation will also be undertaken. DISCUSSION It is anticipated that results of this pilot trial will be published in spring 2015. TRIAL REGISTRATION Current controlled trials: ISRCTN54165860.
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Affiliation(s)
- Sally E Barber
- Born in Bradford Cohort Study, Bradford Institute for Health Research, Bradford, UK
| | - Cath Jackson
- Department of Health Sciences, University of York, York, UK
| | - Shaheen Akhtar
- Born in Bradford Cohort Study, Bradford Institute for Health Research, Bradford, UK
| | - Daniel D Bingham
- Born in Bradford Cohort Study, Bradford Institute for Health Research, Bradford, UK
- School of Sport Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | | | | | | | | | - Kate E Pickett
- Department of Health Sciences, University of York, York, UK
| | - Helen J Moore
- School of Medicine and Health, University of Durham, Durham, UK
| | - Ash C Routen
- School of Education, University of Durham, Durham, UK
| | | | - Shirley Brierley
- Public Health, City of Bradford Metropolitan District Council, Bradford, UK
| | - John Wright
- Born in Bradford Cohort Study, Bradford Institute for Health Research, Bradford, UK
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Bingham DD, Varela-Silva MI, Ferrão MM, Augusta G, Mourão MI, Nogueira H, Marques VR, Padez C. Socio-demographic and behavioral risk factors associated with the high prevalence of overweight and obesity in Portuguese children. Am J Hum Biol 2013; 25:733-42. [PMID: 24000096 DOI: 10.1002/ajhb.22440] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2013] [Revised: 06/10/2013] [Accepted: 07/05/2013] [Indexed: 01/22/2023] Open
Abstract
OBJECTIVES Childhood obesity is a public health concern in Portugal. Socio-demographic and behavioral factors are highly associated with obesity but are not clearly understood. This article aims to update the prevalence of overweight and obesity in Portuguese children and to explore the influence and risks of socio-demographic factors and behavioral factors. METHODS A cross-sectional study of Portuguese children aged 3-10 years from all 18 mainland districts took place between March 2009 and January 2010. The sample was composed by 17,136 children, 3-10 years of age (8,455 boys; 8,681 girls). Height, weight, and other anthropometric measurements were obtained by trained technicians. Body mass index (BMI) was calculated along with other anthropometric variables. Data analyses took place between April and September 2012. The overweight/obesity classification was established by age-and sex-specific BMI cut-off points as defined by the International obesity task force (IOTF). Parents completed questionnaires about socio-demographic and behavioral characteristics of the family. RESULTS Almost 28% of the Portuguese children were overweight or obese (19.7% overweight; 8.2% obese). Prevalence was greater in girls than in boys. Logistic regression models found that the odds of childhood obesity were significantly affected by biological, socio-demographic, and behavioral factors. CONCLUSIONS The protective factors against childhood overweight/obesity in this sample of Portuguese children are: (i) being male; (ii) having been breastfeed; (iii) having been born from mothers who did not smoke during pregnancy; (iv) engaging in little sedentary behaviors (TV, PC, and playing electronic games); (iv) performing at least 1 h of moderate physical activity every day; and (v) having parents with higher educational levels who also have their BMI within the healthy ranges.
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Affiliation(s)
- Daniel D Bingham
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, Leicestershire, United Kingdom; Bradford Institute for Health Research, Bradford, United Kingdom
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