1
|
Chen C, Ahlqvist VH, Henriksson P, Migueles JH, Christiansen F, Galanti MR, Berglind D. Increasing Children's physical Activity by Policy (CAP) in preschools within the Stockholm region: study protocol for a pragmatic cluster-randomized controlled trial. Trials 2022; 23:577. [PMID: 35854370 PMCID: PMC9295109 DOI: 10.1186/s13063-022-06513-4] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Accepted: 07/05/2022] [Indexed: 11/22/2022] Open
Abstract
Background Systematic reviews suggest that preschool environmental/organizational changes may be effective in increasing physical activity (PA) levels of preschool children, but evidence is scarce regarding feasible, effective, and equitable interventions that can be scaled up. Specifically, it is essential to understand whether introducing a multicomponent organizational change in terms of policy in the preschool context may be beneficial for children’s PA levels and concomitant health outcomes. To bridge this knowledge gap, our main aim is to examine the feasibility and effectiveness of a policy package in increasing PA levels in preschool children, using a large-scale pragmatic cluster-randomized controlled trial. Methods This proposed study is a pragmatic cluster-randomized controlled trial with two conditions (intervention and control with a 1:1 ratio) with preschools as clusters and the unit of randomization. We aim to recruit approximately 4000 3–5-year-old children from 90 preschools and retain more than 2800 children from 85 preschools to provide adequate statistical power for the analyses. The intervention to implement is a co-created, multicomponent policy package running for 6 months in preschools randomized to intervention. Change in accelerometer measured PA levels in children between intervention and control from pre- and post-intervention will be the primary outcome of the study, while secondary outcomes include health outcomes such as musculoskeletal fitness, psychosocial functioning, and absence due to illness in children among others. Implementation will be studied carefully using both quantitative (dose, fidelity) and qualitative (interview) methodologies. The change in primary and secondary outcomes, from pre- to post-intervention, will be analyzed with linear mixed-effect models (to allow both fixed and random effects) nested on a preschool level. Discussion This is a large-scale co-creation project involving the City of Stockholm, childcare stakeholders, preschool staff, and the research group with the potential to influence more than 30,000 preschool children within the Stockholm area. The study will add reliable evidence for the implementation of PA policies at the organizational level of preschools and clarify its potential effect on objectively measured PA and health markers in children. Trial registration ClinicalTrials.govNCT04569578. Prospectively registered on September 20, 2020. Supplementary Information The online version contains supplementary material available at 10.1186/s13063-022-06513-4.
Collapse
Affiliation(s)
- C Chen
- Department of Global Public Health, Karolinska Institutet, Solna, Sweden. .,Centre for Epidemiology and Community Medicine (CES), Region Stockholm, Stockholm, Sweden.
| | - V H Ahlqvist
- Department of Global Public Health, Karolinska Institutet, Solna, Sweden
| | - P Henriksson
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - J H Migueles
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden.,PROFITH "PROmoting FITness and Health through physical activity" Research Group, Sport and Health University Research Institute (iMUDS), Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, Granada, Spain
| | - F Christiansen
- Department of Global Public Health, Karolinska Institutet, Solna, Sweden
| | - M R Galanti
- Department of Global Public Health, Karolinska Institutet, Solna, Sweden.,Centre for Epidemiology and Community Medicine (CES), Region Stockholm, Stockholm, Sweden
| | - D Berglind
- Department of Global Public Health, Karolinska Institutet, Solna, Sweden.,Centre for Epidemiology and Community Medicine (CES), Region Stockholm, Stockholm, Sweden
| |
Collapse
|
2
|
Béghin L, Vanhelst J, Drumez E, Migueles JH, Androutsos O, Widhalm K, Julian C, Moreno LA, De Henauw S, Gottrand F. Gender influences physical activity changes during adolescence: The HELENA study. Clin Nutr 2019; 38:2900-2905. [PMID: 30718097 DOI: 10.1016/j.clnu.2018.12.027] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [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: 03/12/2018] [Revised: 12/18/2018] [Accepted: 12/21/2018] [Indexed: 11/25/2022]
Abstract
BACKGROUND We compared differences in physical activity (PA) between pre/mid-pubertal and post-pubertal participants according to gender. METHODS The study included a total of 1842 healthy participants aged 12.5-17.4 years, who participated in the Healthy Lifestyle in Europe by Nutrition in Adolescence (HELENA) study. Participants wore a uniaxial accelerometer (ActiGraph© GT1M, Pensacola, FL, USA) attached to their lower back for seven consecutive days to measure PA. Pubertal status was assessed by physical examination and the population was classified as pre/mid-pubertal (Tanner stages 1-3) or post-pubertal (Tanner stages 4-5). PA was compared between these groups according to gender during the whole week, on school-free days and on school days, before and after school, and during lessons and recesses. RESULTS When comparing the pre/mid-pubertal group with the post-pubertal group, girls' total PA did not differ between groups. However, a slight difference was observed in boys, among whom PA on school-free days showed a difference of 17.6% between the pre/mid-pubertal group and the post-pubertal group (679 kcounts vs 564 kcounts, respectively; P = 0.0007) and 20% (162 kcount vs 135 kcounts; P = 0.006) for school recess. There was no difference among girls. CONCLUSIONS A reduced level of PA in the post-pubertal groups was only observed in boys during non-organized times such as on school-free days and during school recesses, with a moderate impact on total PA.
Collapse
Affiliation(s)
- L Béghin
- Univ. Lille, CHU Lille, LIRIC UMR 995 Inserm, Clinical Investigation Center, CIC-1403-Inserm-CHU, F-59000 Lille, France.
| | - J Vanhelst
- Univ. Lille, CHU Lille, LIRIC UMR 995 Inserm, Clinical Investigation Center, CIC-1403-Inserm-CHU, F-59000 Lille, France
| | - E Drumez
- Univ. Lille, CHU Lille, Department of Biostatistics, EA 2694 - Santé publique: épidémiologie et qualité des soins, F-59000 Lille, France
| | - J H Migueles
- PROFITH ''PROmoting FITness and Health through physical Activity'' Research Group, Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, Ctra. Alfacar s/n, 18011 Granada, Spain
| | - O Androutsos
- Department of Nutrition and Dietetics, School of Health Science & Education, Harokopio University, Athens, Greece
| | - K Widhalm
- Department of Pediatrics, School of Medicine, Vienna University, Vienna, Austria
| | - C Julian
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, Facultad de Ciencias de la Salud, Zaragoza University, Zaragoza, Spain
| | - L A Moreno
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, Facultad de Ciencias de la Salud, Zaragoza University, Zaragoza, Spain
| | - S De Henauw
- Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - F Gottrand
- Univ. Lille, CHU Lille, LIRIC UMR 995 Inserm, Clinical Investigation Center, CIC-1403-Inserm-CHU, F-59000 Lille, France
| | | |
Collapse
|
3
|
Rodriguez-Ayllon M, Cadenas-Sanchez C, Esteban-Cornejo I, Migueles JH, Mora-Gonzalez J, Henriksson P, Martín-Matillas M, Mena-Molina A, Molina-García P, Estévez-López F, Enriquez GM, Perales JC, Ruiz JR, Catena A, Ortega FB. Physical fitness and psychological health in overweight/obese children: A cross-sectional study from the ActiveBrains project. J Sci Med Sport 2017; 21:179-184. [PMID: 29031643 DOI: 10.1016/j.jsams.2017.09.019] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2016] [Revised: 09/14/2017] [Accepted: 09/20/2017] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To examine the associations of physical fitness (i.e. cardiorespiratory fitness, muscular strength, and speed/agility) with psychological distress and psychological well-being in overweight/obese pre-adolescent children. DESIGN 110 overweight/obese children (10.0±1.1years old, 61 boys) from the ActiveBrains project (http://profith.ugr.es/activebrains) participated in this cross-sectional study. METHODS Physical fitness was evaluated by the ALPHA battery test. Cardiorespiratory fitness was additionally evaluated by a maximal incremental treadmill. Stress was assessed by the Children's Daily Stress Inventory, anxiety by the State-Trait Anxiety Inventory, depression by the Children Depression Inventory, positive affect and negative affect by the Positive and Negative Affect Scale for Children, happiness by the Subjective Happiness Scale, optimism by the Life Orientation Test, and self-esteem by the Rosenberg Self-Esteem questionnaire. Linear regression adjusted for sex and peak height velocity was used to examine associations. RESULTS Absolute upper-body muscular strength was negatively associated with stress and negative affect (β=-0.246, p=0.047; β=-0.329, p=0.010, respectively). Furthermore, absolute lower-body muscular strength was negatively associated with negative affect (β=-0.301, p=0.029). Cardiorespiratory fitness, expressed by the last completed lap, and relative upper-body muscular strength were positively associated with optimism (β=0.220, p=0.042; β=0.240, p=0.017, respectively). Finally, absolute upper-body muscular strength was positively associated with self-esteem (β=0.362, p=0.003) independently of sex and weight status (p for interactions >0.3), and absolute lower-body muscular strength was also positively associated with self-esteem (β=0.352, p=0.008). CONCLUSIONS Muscular strength was associated with psychological distress (i.e. stress and negative affect) and psychological well-being (i.e. optimism and self-esteem) as well as cardiorespiratory fitness was associated with optimism. Therefore, increased levels of physical fitness, specifically muscular strength, could have significant benefits for overweight/obese children psychological health.
Collapse
Affiliation(s)
- M Rodriguez-Ayllon
- PROFITH "PROmoting FITness and Health through physical activity" Research Group, Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, Spain.
| | - C Cadenas-Sanchez
- PROFITH "PROmoting FITness and Health through physical activity" Research Group, Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, Spain
| | - I Esteban-Cornejo
- PROFITH "PROmoting FITness and Health through physical activity" Research Group, Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, Spain
| | - J H Migueles
- PROFITH "PROmoting FITness and Health through physical activity" Research Group, Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, Spain
| | - J Mora-Gonzalez
- PROFITH "PROmoting FITness and Health through physical activity" Research Group, Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, Spain
| | - P Henriksson
- PROFITH "PROmoting FITness and Health through physical activity" Research Group, Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, Spain
| | - M Martín-Matillas
- PROFITH "PROmoting FITness and Health through physical activity" Research Group, Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, Spain
| | - A Mena-Molina
- PROFITH "PROmoting FITness and Health through physical activity" Research Group, Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, Spain
| | - P Molina-García
- PROFITH "PROmoting FITness and Health through physical activity" Research Group, Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, Spain
| | - F Estévez-López
- Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Spain; Department of Psychology, Faculty of Social and Behavioural Sciences, Utrecht University, The Netherlands
| | - G M Enriquez
- PROFITH "PROmoting FITness and Health through physical activity" Research Group, Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, Spain
| | - J C Perales
- Mind, Brain, and Behaviour Research Centre-CIMCYC, University of Granada, Spain; Department of Experimental Psychology, University of Granada, Spain
| | - J R Ruiz
- PROFITH "PROmoting FITness and Health through physical activity" Research Group, Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, Spain; Department of Biosciences and Nutrition, Karolinska Institutet, Sweden
| | - A Catena
- Mind, Brain, and Behaviour Research Centre-CIMCYC, University of Granada, Spain; Department of Experimental Psychology, University of Granada, Spain
| | - F B Ortega
- PROFITH "PROmoting FITness and Health through physical activity" Research Group, Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, Spain; Department of Biosciences and Nutrition, Karolinska Institutet, Sweden
| |
Collapse
|
4
|
Delisle Nyström C, Pomeroy J, Henriksson P, Forsum E, Ortega FB, Maddison R, Migueles JH, Löf M. Evaluation of the wrist-worn ActiGraph wGT3x-BT for estimating activity energy expenditure in preschool children. Eur J Clin Nutr 2017; 71:1212-1217. [PMID: 28745334 DOI: 10.1038/ejcn.2017.114] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2016] [Revised: 05/09/2017] [Accepted: 06/12/2017] [Indexed: 11/09/2022]
Abstract
BACKGROUND/OBJECTIVES Easy-to-use and accurate methods to assess free-living activity energy expenditure (AEE) in preschool children are required. The aims of this study in healthy preschool children were to (a) evaluate the ability of the wrist-worn ActiGraph wGT3x-BT to predict free-living AEE and (b) assess wear compliance using a 7-day, 24-h protocol. SUBJECTS/METHODS Participants were 40 Swedish children (5.5±0.2 years) in the Mobile-based intervention intended to stop obesity in preschoolers (MINISTOP) obesity prevention trial. Total energy expenditure (TEE) was assessed using the doubly labeled water method during 14 days. AEE was calculated as (TEEx0.9) minus predicted basal metabolic rate. The ActiGraph accelerometer was worn on the wrist for 7 days and outputs used were mean of the daily and awake filtered vector magnitude (mean VM total and mean VM waking). RESULTS The ActiGraph was worn for 7 (n=34, 85%), 6 (n=4, 10%), 5 (n=1, 2.5%) and 4 (n=1, 2.5%) days (a valid day was ⩾600 awake minutes). Alone, mean VM total and mean VM waking were able to explain 14% (P=0.009) and 24% (P=0.001) of the variation in AEE, respectively. By incorporating fat and fat-free mass in the models 58% (mean VM total) and 62% (mean VM waking) in the variation of AEE was explained (P<0.001). CONCLUSIONS The wrist-worn ActiGraph wGT3x-BT in combination with body composition variables explained up to the 62% of the variation in AEE. Given the high wear compliance, the wrist-worn ActiGraph has the potential to provide useful information in studies where physical activity in preschool children is measured.
Collapse
Affiliation(s)
- C Delisle Nyström
- Department of Biosciences and Nutrition, NOVUM, Karolinska Institutet, Huddinge, Sweden
| | - J Pomeroy
- Marshfield Clinic Research Institute, Marshfield, WI, USA
| | - P Henriksson
- Department of Biosciences and Nutrition, NOVUM, Karolinska Institutet, Huddinge, Sweden.,PROFITH PROmoting FITness and Health through physical activity Research Group, Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Granada, Spain
| | - E Forsum
- Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden
| | - F B Ortega
- Department of Biosciences and Nutrition, NOVUM, Karolinska Institutet, Huddinge, Sweden.,PROFITH PROmoting FITness and Health through physical activity Research Group, Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Granada, Spain
| | - R Maddison
- School of Exercise and Nutrition Sciences, Deakin University
| | - J H Migueles
- PROFITH PROmoting FITness and Health through physical activity Research Group, Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Granada, Spain
| | - M Löf
- Department of Biosciences and Nutrition, NOVUM, Karolinska Institutet, Huddinge, Sweden
| |
Collapse
|