Comparison of children's physical activity profiles before and after COVID-19 lockdowns: A latent profile analysis

Physical activity is important for children's health, but moderate to vigorous physical activity (MVPA) declines with age. COVID-19 lockdowns resulted in reduced MVPA and increased sedentary time among children. Characterising children's activity patterns may help identify groups who are most likely to be inactive post-lockdown. Data were combined from a pre-COVID-19 cohort study on children aged 5-6 years (Year1: n = 1299), 8-9 years (Year4: n = 1223) and 10-11 years (Year6: n = 1296) and cross-sectional post-lockdown data from a natural experiment on 10-11-year-olds in 2021 (Year6-W1: n = 393) and 2022 (Year6-W2: n = 436). The proportions of time spent in MVPA, light physical activity (LPA) and sedentary time on weekdays and weekends were derived from accelerometer data. Latent class analysis was used to identify activity profiles pre and post-lockdown, and estimate pre-COVID-19 transitions between Year4 and Year6. We identified six pre-COVID-19 activity profiles in Year6, including a new profile characterised by very low MVPA and high sedentary time (19% of children). There was substantial movement between profiles at Year4 and Year6, with 45% moving to a profile with lower MVPA. Likelihood ratio tests suggested differences in Year6 activity profiles pre and post-lockdown, with a new post-lockdown profile emerging characterised by higher LPA. The percentage of children in the least active profiles (where under 20% meet UK physical activity guidelines), rose post-lockdown, from 34% pre-COVID-19 to 50% in 2021 and 40% in 2022. We also saw gender and socioeconomic gaps widen, and increased separation between high and low physical activity levels. Children's physical activity has changed post-COVID-19, in terms of who is being active and how. The impact varies by activity profile, which is influenced by gender and socio-economic position. A greater understanding of these differences and targeting of low active groups is needed to increase both individual and population levels of physical activity.

The status of active after-school clubs among primary school children in England (UK) after the COVD-19 lockdowns: implications for policy and practice

BACKGROUND

Children's physical activity in England is more dependent on active clubs after the COVID-19 pandemic. However, it is unclear how the COVID-19 pandemic and related cost-of-living crisis have impacted on active club participation, costs and provision. This mixed-methods natural experiment explored school-based and community-based active clubs after lockdowns, using a unique combination of data sources to highlight implications for policy and practice post-COVID-19.

METHODS

Cross-sectional questionnaire data on school and community active clubs were collected from 10-11-year-old children pre-COVID-19 in 2017-18 (N = 1,296; 50 schools), in 2021 (N = 393; 23 schools), and 2022 (N = 463; 27 schools). Club participation and attendance frequency were modelled using logistic and Poisson mixed effects models, adjusted for child age, gender and household education. In 2021 and 2022, parents reported expenditure on community-based clubs and schools provided data on school-based club provision, with data summarised descriptively. Qualitative data were collected in 2021 and 2022, with one-to-one interviews with school staff (N = 18) and parents (N = 43), and twelve child focus groups (N = 92), and analysed using the framework method.

RESULTS

School-based active club participation was higher in 2022 compared to pre-pandemic (50% /43%), while community-based club participation was lower (74%/80%). Children attended 0.3 fewer clubs per week. Those from lower education households were less likely to participate in both types of active clubs, and girls less likely to attend community clubs. In 2022, the median cost of community and school club sessions were £6.67 and £3.88 respectively, with 52% of school-based clubs free to parents. Schools offered an average of 3.4 active clubs per week for 10-11-year-olds in 2022, with 34% partly/wholly subsidised. Qualitative analysis highlighted the impact of the cost-of-living crisis and COVID-19 pandemic on family resources, encouraging a shift to more affordable and convenient school-based active clubs, which negatively impacted the community-based active club environment. However, many schools struggled to meet this increased demand.

CONCLUSIONS

Findings emphasise the importance for policymakers to support schools to meet increased demand for clubs and community clubs to increase affordable and convenient physical activity opportunities. Targeted support is needed to prevent socioeconomic and gender inequalities.

The new normal for children's physical activity and screen viewing: a multi-perspective qualitative analysis of behaviours a year after the COVID-19 lockdowns in the UK

BACKGROUND

The COVID-19 pandemic significantly impacted children's physical activity. Recent evidence indicated children's accelerometer-measured physical activity levels have, on average, returned to near pre-pandemic levels in 2022, though sedentary behaviour remains higher. However, insufficient physical activity levels among children continues to be a critical public health issue in the UK, with only 41% meeting physical activity guidelines. This study aimed to provide in-depth analysis of how the pandemic has shaped children's physical activity patterns beyond the short-term periods following lockdowns and identify the new challenges to engaging children in physical activity.

METHODS

One-to-one interviews with parents (n = 22), school staff (n = 9), and six focus groups with children aged 10-11 years (n = 45) were conducted between February and July 2022. Topics explored changes to children's physical activity and sedentary behaviour patterns, including screen-viewing, and factors influencing any changes. The framework method was used for analysis.

RESULTS

Five themes were generated. Theme 1 described residual lockdown habits, including increased screen-viewing within the home, while activities outside the home continued to feel less spontaneous. Theme 2 highlighted an interrupted development of social, emotional, and physical skills among children compared to what would be expected pre-pandemic. This coincided with Theme 3 which reflected increased mental health challenges among families, creating complex barriers to children's physical activity. A new normal for child physical activity was evoked and explored in Theme 4, with greater dependence on structured and organised activities. However, Theme 5 highlighted that girls and children with lower socio-economic position may be especially at risk of decreased physical activity.

CONCLUSIONS

There is a new normal for children's physical activity that is characterised by increased dependence on structured and organised physical activities, such as active clubs, and less on unstructured and spontaneous physical activities, such as physical play. While this may suit many children, girls and children from lower socio-economic households face barriers to participating in the new normal. It is important that affordable and equitable opportunities are provided to all children to prevent physical activity and health inequalities.

Short and medium-term effects of the COVID-19 lockdowns on child and parent accelerometer-measured physical activity and sedentary time: a natural experiment

BACKGROUND

The COVID-19 pandemic has resulted in marked impacts on children's physical activity, with large reductions in moderate-to-vigorous physical activity (MVPA) reported during lockdowns. Previous evidence showed children's activity levels were lower and sedentary time higher immediately post-COVID lockdown, while there was little change in parental physical activity. We need to know if these patterns persist.

METHODS

Active-6 is a natural experiment using repeated cross-sectional data conducted in two waves. Accelerometer data were collected on 393 children aged 10-11 and their parents from 23 schools in Wave 1 (June 2021-December 2021), and 436 children and parents from 27 schools in Wave 2 (January 2022-July 2022). These were compared to a pre-COVID-19 comparator group (March 2017-May 2018) of 1,296 children and parents in the same schools. Mean minutes of accelerometer-measured MVPA and sedentary time were derived for week- and weekend-days and compared across waves via linear multilevel models. We also analysed the date of data collection as a time series, to explore temporal patterns via generalised additive mixed models.

RESULTS

There was no difference in children's mean MVPA in Wave 2 (weekdays: -2.3 min; 95% CI: -5.9, 1.3 and weekends: 0.6 min; 95% CI: -3.5, 4.6) when compared to the pre-COVID-19 data. Sedentary time remained higher than pre-pandemic by 13.2 min (95% CI:5.3, 21.1) on weekdays. Differences compared to pre-COVID-19 changed over time, with children's MVPA decreasing over winter, coinciding with COVID-19 outbreaks, and only returning to pre-pandemic levels towards May/June 2022. Parents' sedentary time and weekday MVPA was similar to pre-COVID-19 levels, with MVPA higher than pre-pandemic by 7.7 min (95% CI: 1.4, 14.0) on weekends.

CONCLUSION

After an initial drop, children's MVPA returned to pre-pandemic levels by July 2022, while sedentary time remained higher. Parents' MVPA remained higher, especially at weekends. The recovery in physical activity is precarious and potentially susceptible to future COVID-19 outbreaks or changes in provision, and so robust measures to protect against future disruptions are needed. Furthermore, many children are still inactive, with only 41% meeting UK physical activity guidelines, and so there is still a need to increase children's physical activity.

Associations between the built environment, policies and curriculum in schools and primary school children’s physical activity

Background: A large proportion of children in the UK do not engage in the recommended amount of physical activity. Schools are an environment where children spend a considerable portion of their time and have the potential to facilitate more physical activity. There has been little exploration of the specific school environment factors that are most pertinent to child physical activity and sedentary behaviour. This study was intended to fill this important gap. Methods: Data were collected between March 2017 and May 2018 from 50 schools and 1223 children who participated in the B-Proact1v cohort study. School level measures were the built environment (e.g. playground equipment, cycling parking, allotments), physical activity-related policies (e.g. policy to encourage active travel) and the use of physical activity in the curriculum (e.g. regular physical activity breaks throughout day). Children’s weekday moderate-to-vigorous physical activity (MVPA) was estimated via Actigraph GT3X accelerometers. Associations between school context measures and children’s weekday MVPA were analysed using linear multilevel models, with children nested within schools, adjusted for individual characteristics. Results: On average, children at schools with allotments, a larger amount of playground equipment and where cycle training was offered, engaged in higher levels of MVPA. PE being compromised due to space was associated with lower levels of MVPA. Conclusions: Whilst there is a need for further exploration, the findings suggest that school-based provision and policies for active travel, sport and active play may be important to encouraging more primary school children to be more active more regularly.

Screen-viewing behaviours of children before and after the 2020-21 COVID-19 lockdowns in the UK: a mixed methods study

BACKGROUND

Restrictions during the COVID-19 pandemic have led to increased screen-viewing among children, especially during strict periods of lockdown. However, the extent to which screen-viewing patterns in UK school children have changed post lockdowns is unclear. The aim of this paper is to examine how screen-viewing changed in 10-11-year-old children over the 2020-21 COVID-19 pandemic, how this compares to before the pandemic, and the influences on screen-viewing behaviour.

METHODS

This is a mixed methods study with 10-11-year-olds from 50 schools in the Greater Bristol area, UK. Cross-sectional questionnaire data on minutes of weekday and weekend television (TV) viewing and total leisure screen-viewing were collected pre-COVID-19 in 2017-18 (N = 1,296) and again post-lockdowns in 2021 (N = 393). Data were modelled using Poisson mixed models, adjusted for age, gender, household education and seasonality, with interactions by gender and household education. Qualitative data were drawn from six focus groups (47 children) and 21 one-to-one parent interviews that explored screen-viewing behaviour during the pandemic and analysed using the framework method.

RESULTS

Total leisure screen-viewing was 11% (95% CI: 12%-18%) higher post-lockdown compared to pre-COVID-19 on weekdays, and 8% (95% CI: 6%-10%) on weekends, equating to around 12-15 min. TV-viewing (including streaming) was higher by 68% (95% CI: 63%-74%) on weekdays and 80% (95% CI: 75%-85%) on weekend days. Differences in both were higher for girls and children from households with lower educational attainment. Qualitative themes reflected an unavoidable increase in screen-based activities during lockdowns, the resulting habitualisation of screen-viewing post-lockdown, and the role of the parent in reducing post-2020/21 lockdown screen-viewing.

CONCLUSIONS

Although screen-viewing was higher post-lockdown compared to pre-COVID-19, the high increases reported during lockdowns were not, on average, sustained post-lockdown. This may be attributed to a combination of short-term fluctuations during periods of strict restrictions, parental support in regulating post-lockdown behaviour and age-related, rather than COVID-19-specific, increases in screen-viewing. However, socio-economic differences in our sample suggest that not all families were able to break the COVID-19-related adoption of screen-viewing, and that some groups may need additional support in managing a healthy balance of screen-viewing and other activities following the lockdowns.

A multi-perspective qualitative exploration of the reasons for changes in the physical activity among 10-11-year-old children following the easing of the COVID-19 lockdown in the UK in 2021

Background

Active-6 is exploring how the COVID-19 pandemic has impacted physical activity behaviour among Year 6 children (aged 10–11 years) and their parents in Southwest England. Initial findings from the Active-6 project have shown a 7–8 min decrease in moderate-to-vigorous physical activity and an increase in sedentary behaviour among children following the easing of restrictions in the UK in latter half of 2021. This finding suggests that the pandemic has had a persistent impact on child physical activity behaviour. This paper explored the possible mechanisms behind these changes.

Methods

Interviews with parents (n = 21), members of school staff (n = 9) and focus groups with children aged 10–11 years (n = 47) were conducted between August and December 2021 to discuss the impact of the pandemic on child physical activity behaviour. The framework method was used for analysis.

Results

Five themes spanning two key stages of the pandemic were described. Three themes related to the period of lockdowns and fluctuating restrictions (March 2020 – April 2021). These included: Theme 1) Lockdown: A short-lived adventure; Theme 2) Access to facilities during restrictions; and Theme 3) The importance of the parent. A further two themes were identified related to the period following the gradual easing of restrictions in April 2021. These included: Theme 4) An overwhelming return to normal; and Theme 5) Reopening fatigue.

Conclusions

The analysis suggested that feelings of novelty experienced during the initial stages of lockdown waned as restrictions were prolonged, creating an increasingly challenging period for parents and their children. However, during periods of restrictions, the importance of parental encouragement and access to appropriate facilities in the local and home environment helped facilitate physical activity. Following the easing of COVID-19 restrictions, emotional overwhelm and physical fatigue among children, stemming from a sedentary and socially isolated life in lockdown and other restrictions, were key contributors to the decreased moderate to vigorous physical activity and increased sedentary behaviour that was observed in a related quantitative study.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12966-022-01356-3.

Accelerometer-measured physical activity and sedentary time among children and their parents in the UK before and after COVID-19 lockdowns: a natural experiment

BACKGROUND

Restrictions due to the coronavirus disease 2019 (COVID-19) pandemic reduced physical activity provision for both children and their parents. Recent studies have reported decreases in physical activity levels during lockdown restrictions, but these were largely reliant on self-report methods, with data collected via unrepresentative self-report surveys. The post-pandemic impacts on children's activity levels remain unknown. A key question is how active children become once lockdown restrictions are lifted.

METHODS

Active-6 is a repeated cross-sectional natural experiment. Accelerometer data from 1296 children aged 10-11 and their parents were collected in 50 schools in the Greater Bristol area, UK in March 2017-May 2018 (pre-COVID-19 comparator group), and compared to 393 children aged 10-11 and parents in 23 of the same schools, collected in May-December 2021. Mean minutes of accelerometer-measured moderate-to-vigorous physical activity (MVPA) were derived for weekdays and weekend and compared pre- and post-lockdown via linear multilevel models.

RESULTS

After adjusting for seasonality, accelerometer wear time and child/parent demographics, children's mean weekday and weekend MVPA were 7.7 min (95% CI: 3.5 to 11.9) and 6.9 min (95% CI: 0.9 to 12.9) lower in 2021 than in 2018, respectively, while sedentary time was higher by 25.4 min (95% CI: 15.8 to 35.0) and 14.0 min (95% CI: 1.5 to 26.5). There was no evidence that differences varied by child gender or household education. There was no significant difference in parents' MVPA or sedentary time, either on weekdays or weekends.

CONCLUSIONS

Children's MVPA was lower by 7-8 min/day in 2021 once restrictions were lifted than before the pandemic for all groups, on both weekdays and weekends. Previous research has shown that there is an undesirable age-related decline in children's physical activity. The 8-min difference reported here would be broadly comparable to the decline that would have previously been expected to occur over a three-year period. Parents' physical activity was similar to pre-pandemic levels. Our results suggest that despite easing of restrictions, children's activity levels have not returned to pre-pandemic levels. There is an urgent need to understand why these changes have occurred and how long they are maintained.

Children's Voices in Physical Activity Research: A Qualitative Review and Synthesis of UK Children's Perspectives

BACKGROUND

Physical activity during childhood is associated with multiple short- and long-term health benefits. Physical activity levels decline throughout primary school emphasising a need for effective strategies to promote more activity in children. Children have rarely been involved in the intervention development process. This gap is an important omission and there is much to be learnt from existing qualitative studies with children, which could serve as a starting point for specific projects. This systematic review aimed to synthesise qualitative studies with primary school children in the United Kingdom to identify children's perspectives on why physical activity is important, the factors that influence their physical activity and what they like when it comes to physical activity.

METHODS

A search of seven databases (conducted in October 2019) identified 26 papers for inclusion. Data extraction and synthesis were conducted using qualitative thematic synthesis. The quality of papers was assessed using the Critical Appraisal Skills Programme checklist for qualitative research.

RESULTS

Across the diverse range of studies, several key themes were identified in relation to the three research questions. Children have a comprehensive understanding of the various benefits of physical activity, including benefits for health, fitness and skills development. A range of social agents and practical issues influence children's physical activity, with friend and peer influences being particularly salient. Most children like to have choice over the activities they undertake and the opportunities for creative physical play such as making up active games.

CONCLUSIONS

The findings suggest that future interventions should utilize peer relationships, ensure a variety of activities are offered to cater to a broad range of children's physical activity preferences and incorporate child-led activities where possible. The included studies also highlight a need for more diversity in qualitative research in this area, particularly in terms of ethnicity and age, and combining traditional qualitative methods with creative methods, such as photography, may provide richer insights than when using a single mode of data collection. We also highlight several methodological challenges, and in particular, the need for greater acknowledgement of the role of the researcher in qualitative work with children.

“I feel proper self-conscious all the time”: A qualitative study of adolescent girls’ views of menstruation and physical activity

Background: Many children and adolescents do not engage in sufficient physical activity. Girls are less active than boys, and their activity levels decline more steeply with age. Menstruation may be associated with the decline in girls’ activity but there are few person-centred studies examining adolescent girl’s experiences of menstruation and physical activity. These are needed to understand the influence that menstruation has on the physical activity experiences of girls to inform effective interventions. Methods: Focus groups were conducted with 46 girls aged 13-15 years across three schools. The discussions explored; experiences of, barriers to and facilitators of being active during menstruation; experiences in physical education/sports teams; and talking with others about periods and being active. Data were analysed using thematic analysis. Results: Four themes were identified: 1) balancing perceived barriers and benefits 2) motivation and enjoyment, 3) social influences and 4) coping strategies. Participants reported using diverse strategies to overcome barriers to being active posed by menstruation and the importance of peer-support and enjoyable forms of activity. Conclusions: Menstruation has a strong influence on girls’ physical activity experiences through intra- and inter-personal factors. The implications for how these can be addressed in efforts to increase girls’ physical activity are discussed.

Associations of body mass index, physical activity and sedentary time with blood pressure in primary school children from south-west England: A prospective study

Elevated blood pressure in children is a significant risk factor for the development of cardiovascular disease in adulthood. We examined how children’s body mass index (BMI), physical activity and sedentary time at ages 9 and 11 are associated with blood pressure at age 11. Data were from 1283 children from Bristol, UK, who participated in the study aged 11 years, 797 of whom also participated in the study aged 9 years. Child height, weight and blood pressure were measured, and children wore accelerometers for five days, from which moderate-to-vigorous-intensity physical activity and sedentary minutes per day were derived. Multiple imputation of missing data and adjusted linear and logistic regression models were used to examine associations. Child BMI at 11 years was cross-sectionally associated with higher systolic and diastolic blood pressure (mean difference [95% confidence interval]: 0.91 [0.32 to 1.50] mm Hg and 1.08 [0.54 to 1.62] mm Hg, respectively, per standard deviation (SD) of BMI). BMI at age 9 was also positively associated with diastolic blood pressure at age 11 (1.16 mmHg per two years [0.49 to 1.84], per SD of BMI). For girls, sedentary time at age 9 years was associated with increased odds of having high systolic blood pressure at age 11 (odds ratio: 1.08 [1.01 to 1.16], per 10 minutes per day). There was no evidence of associations between sedentary time and blood pressure among boys. Similarly, there was little evidence that physical activity was associated with blood pressure in either cross-sectional or prospective analyses. Effective strategies are needed to prevent excess bodyweight among children in order to reduce cardiovascular disease risk.

Associations between socioeconomic position and changes in children's screen-viewing between ages 6 and 9: a longitudinal study

OBJECTIVES

To explore socioeconomic differences in screen-viewing at ages 6 and 9, and how these are related to different media uses.

DESIGN

Longitudinal cohort study.

SETTING

Children recruited from 57 state-funded primary schools in Southwest England, UK.

PARTICIPANTS

1299 children at ages 5-6, 1223 children at ages 8-9, including 685 children at both time points.

OUTCOME MEASURES

Children's total screen-viewing time (parent-reported) and time spent using multiple screen devices simultaneously (multiscreen viewing), for weekdays and weekends.

METHODS

Negative binomial regression was used to model associations between socioeconomic variables (highest household education and area deprivation) and total screen-viewing at age 6 and the change from age 6 to 9. We additionally adjusted for child characteristics, parental influences and media devices in the home. Multiscreen viewing was analysed separately.

RESULTS

Household education was associated with children's screen-viewing at age 6 with lower screen-viewing in higher socioeconomic groups (21%-27% less in households with a Degree or Higher Degree, compared with General Certificate of Secondary Education: GCSE). These differences were explained by the presence of games consoles, parental limits on screen-viewing and average parent screen-viewing. Between ages 6 and 9, there were larger increases in screen-viewing for children from A level and Degree households (13% and 6%, respectively, in the week) and a decrease in Higher Degree households (16%), compared with GCSE households. Differences by household education remained when adjusting for media devices and parental factors.

CONCLUSIONS

Children's screen-viewing patterns differ by parental education with higher levels of viewing among children living in households with lower educational qualifications. These differences are already present at age 6, and continue at age 9. Strategies to manage child sedentary time, and particularly screen-viewing, may need to take account of the socioeconomic differences and target strategies to specific groups.

A Multilevel Analysis of Neighbourhood, School, Friend and Individual-Level Variation in Primary School Children's Physical Activity

Physical activity is influenced by individual, inter-personal and environmental factors. In this paper, we explore the variability in children's moderate-to-vigorous physical activity (MVPA) at different individual, parent, friend, school and neighbourhood levels. Valid accelerometer data were collected for 1077 children aged 9, and 1129 at age 11, and the average minutes of MVPA were derived for weekdays and weekends. We used a multiple-membership, multiple-classification model (MMMC) multilevel model to compare the variation in physical activity outcomes at each of the different levels. There were differences in the proportion of variance attributable to the different levels between genders, for weekdays and weekends, at ages 9 and 11. The largest proportion of variability in MVPA was attributable to individual variation, accounting for half of the total residual variability for boys, and two thirds of the variability for girls. MVPA clustered within friendship groups, with friends influencing peer MVPA. Including covariates at the different levels explained only small amounts (3%-13%) of variability. There is a need to enhance our understanding of individual level influences on children's physical activity.

Association of BMI category with change in children's physical activity between ages 6 and 11 years: a longitudinal study

BACKGROUND/OBJECTIVES

To examine the association of body mass index (BMI) with change in children's physical activity and sedentary time between ages 6 and 11.

PARTICIPANTS

A total of 2132 children participated from 57 schools in Southwest England, from the B-PROACT1V study.

METHODS

Mean minutes of MVPA and sedentary time per day were derived from accelerometer-based measurements at ages 6, 9 and 11. Linear multilevel models examined the association of BMI categories with MVPA and sedentary time between 6 and 11, adjusting for seasonality, wear time, gender and household education. Differences in change over time were examined using interaction terms.

RESULTS

Average weekday MVPA decreased between ages 6 and 11 by 2.2 min/day/year (95% CI: 1.9 to 2.5), with a steeper decline at weekends. Average sedentary time increased at a rate of 12.9 min/day/year (95% CI: 12.2 to 13.6). There were no differences in mean levels of MVPA by BMI categories at age 6, but differences emerged as children aged, with the gap between children who were healthy weight and overweight increasing by 1.7 min/day (95% CI: 0.8-2.6) every year, and between healthy and obese by 2.0 min/day (95% CI: 0.9-3.1) each year. Children who were overweight/obese engaged in less average weekday sedentary time at age 6 than those of healthy weight, but the gap closed by age 11.

CONCLUSION

MVPA declines and sedentary time increases on average for all children between ages 6 and 11. While there are no differences in activity levels by BMI category at age 6, differences in MVPA emerge over time for those who are overweight and obese. Developing interventions that support children to retain activity levels as they approach older childhood, particularly those who are overweight/obese could improve public health.

The association of school-related active travel and active after-school clubs with children's physical activity: a cross-sectional study in 11-year-old UK children

BACKGROUND

Physical activity is associated with improved physical and mental health among children, but many children do not meet the recommended hour per day of moderate-to-vigorous-intensity physical activity (MVPA). The aim of this paper is to investigate participation in active after-school clubs and active travel to and from school at age 11 and estimate the average daily minutes of MVPA associated with active club attendance and active travel.

METHODS

Accelerometer data were collected on three weekdays for 1296 11-year-old children in a cross-sectional study. Children reported attendance at active after-school clubs and how they travelled to and from school for each day of the week. To account for repeat days within child and clustering within schools we used multilevel models with random effects at the school and child level, and fixed effects for all covariates. We calculated odds ratios for participation in active after-school clubs and active travel for gender, measures of socio-economic position and BMI category. We also explored the association between active club attendance, active travel and daily average MVPA.

RESULTS

Boys and girls were equally likely to attend active after-school clubs. Boys were more likely to travel to school using active modes. Attendance at active after-school clubs and active travel home were not associated with each other. Attending an active after-school club was associated with an additional 7.6 min (95% CI: 5.0 to 10.3) average MVPA on that day among both boys and girls. Active travel was associated with an additional 4.7 min (95% CI: 2.9 to 6.5) average MVPA per journey for boys and 2.4 min (95% CI: 1.0 to 3.7) for girls.

CONCLUSIONS

Both active after-school clubs and active travel are associated with greater physical activity on the day that children participate in these, and we saw no evidence that those attending active clubs do so at the expense of active travel home afterwards. While the increased daily MVPA is small to moderate, active after-school clubs and active travel on multiple days of the week could make important contributions as part of complex interventions aimed at increasing population levels of physical activity in children.

Profiles of children's physical activity and sedentary behaviour between age 6 and 9: a latent profile and transition analysis

BACKGROUND

Physical activity is associated with improved physical and mental health among children. However, physical activity declines and sedentary time increases with age, and large proportions of older children do not meet the recommended hour per day of moderate-to-vigorous-intensity physical activity (MVPA). The aim of this paper is to identify profiles of children based on the complex relationship between physical activity and sedentary time at ages 6 and 9 and explore how those profiles are associated with other covariates and how they change over time.

METHODS

Valid accelerometer data were collected for 1132 children aged 6 and 1121 at age 9, with 565 children with data at both ages. We calculated the proportions of total wear time spent in sedentary, light and MVPA activity on both weekdays and weekends. Latent profile (class) analysis was applied separately to the two age groups to identify activity profiles. We then used latent transition analysis to explore transitions between profiles at the two time points.

RESULTS

We identified five profiles of activity at age 6 and six profiles at age 9. Although profiles were not directly equivalent, five classes captured similar patterns at both ages and ranged from very active to inactive. At both ages, active profiles, where the majority achieved the recommended MVPA guidelines, were more likely to be active at weekends than on weekdays. There was substantial movement between classes, with strongest patterns of movement to classes with no change or a decrease in MVPA. Transition between classes was associated with sex, BMI z-score, screen-viewing and participation in out-of-school activities.

CONCLUSIONS

This paper is the first to apply latent profile analysis to the physical activity of UK children as they move through primary school. Profiles were identified at ages 6 and 9, reflecting different weekday and weekend patterns of physical activity and sedentary time. There was substantial movement between profiles between ages 6 and 9, mostly to no change or less active profiles. Weekend differences suggest that greater focus on how weekend activity contributes to an average of 60 min per day of MVPA across the week may be warranted.