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Chinapaw MJM, Klaufus LH, Oyeyemi AL, Draper C, Palmeira AL, Silva MN, Van Belle S, Pawlowski CS, Schipperijn J, Altenburg TM. Youth-centred participatory action approach towards co-created implementation of socially and physically activating environmental interventions in Africa and Europe: the YoPA project study protocol. BMJ Open 2024; 14:e084657. [PMID: 38387985 PMCID: PMC10882351 DOI: 10.1136/bmjopen-2024-084657] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Accepted: 02/08/2024] [Indexed: 02/24/2024] Open
Abstract
INTRODUCTION The majority of adolescents do not meet guidelines for healthy behaviours, posing major risks for developing multiple non-communicable diseases. Unhealthy lifestyles seem more prevalent in urban than rural areas, with the neighbourhood environment as a mediating pathway. How to develop and implement sustainable and effective interventions focused on adolescent health and well-being in urban vulnerable life situations is a key challenge. This paper describes the protocol of a Youth-centred Participatory Action (YoPA) project aiming to tailor, implement, and evaluate social and physical environmental interventions. METHODS AND ANALYSIS In diverse urban environments in Denmark, the Netherlands, Nigeria and South Africa, we will engage a dynamic group of 15-20 adolescents (12-19 years) growing up in vulnerable life situations and other key stakeholders (eg, policy makers, urban planners, community leaders) in local co-creation communities. Together with academic researchers and local stakeholders, adolescents will take a leading role in mapping the local system; tailoring; implementing and evaluating interventions during participatory meetings over the course of 3 years. YoPA applies a participatory mixed methods design guided by a novel Systems, User perspectives, Participatory co-creation process, Effects, Reach, Adoption, Implementation and Maintenance framework assessing: (i) the local systems, (ii) user perspectives, (iii) the participatory co-creation process, (iv) effects, (v) reach, (vi) adoption, (vii) implementation and (viii) maintenance of interventions. Through a realist evaluation, YoPA will explore why and how specific outcomes were reached (or not) in each setting (n=800-1000 adolescents in total). ETHICS AND DISSEMINATION This study received approval from the ethics committees in Denmark, the Netherlands, Nigeria and South Africa and will be disseminated via various collaborative dissemination activities targeting multiple audiences. We will obtain informed consent from all participants. We envision that our YoPA co-creation approach will serve as a guide for participation of adolescents in vulnerable life situations in implementation of health promotion and urban planning in Europe, Africa and globally. TRIAL REGISTRATION NUMBER NCT06181162.
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Affiliation(s)
- Mai J M Chinapaw
- Public and Occupational Health, Amsterdam UMC Location VUmc, Amsterdam, The Netherlands
- Health Behaviours and Chronic Diseases, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Leonie H Klaufus
- Public and Occupational Health, Amsterdam UMC Location VUmc, Amsterdam, The Netherlands
- Health Behaviours and Chronic Diseases, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Adewale L Oyeyemi
- College of Health Solutions, Arizona State University, Phoenix, Arizona, USA
- Department of Physiotherapy, Redeemer's University, Ede, Nigeria
| | - Catherine Draper
- SAMRC Developmental Pathways for Health Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - António L Palmeira
- CIDEFES, Universidade Lusófona, Lisboa, Portugal
- CIFI2D, Universidade do Porto, Porto, Lisbon
| | - Marlene Nunes Silva
- CIDEFES, Universidade Lusófona, Lisboa, Portugal
- Programa Nacional para a Promoção da Atividade Física, Direcção-Geral da Saúde, Lisboa, Portugal
| | - Sara Van Belle
- Department of Public Health, Institute of Tropical Medicine, Antwerpen, Belgium
| | - Charlotte S Pawlowski
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Jasper Schipperijn
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Teatske M Altenburg
- Public and Occupational Health, Amsterdam UMC Location VUmc, Amsterdam, The Netherlands
- Health Behaviours and Chronic Diseases, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
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Arts J, Chinapaw MJM, Gubbels JS, Verhoeff AP, Brons A, Veldman S, Lettink A, Altenburg TM. Development and content validity of an application to assess 24-hour movement behaviors in 0-4-year-old children involving end-users and key stakeholders: the My Little Moves app. Int J Behav Nutr Phys Act 2024; 21:2. [PMID: 38167442 PMCID: PMC10763169 DOI: 10.1186/s12966-023-01552-9] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Accepted: 12/17/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND Recently, research focus has shifted to the combination of all 24-h movement behaviors (physical activity, sedentary behavior and sleep) instead of each behavior separately. Yet, no reliable and valid proxy-report tools exist to assess all these behaviors in 0-4-year-old children. By involving end-users (parents) and key stakeholders (researchers, professionals working with young children), this mixed-methods study aimed to 1) develop a mobile application (app)-based proxy-report tool to assess 24-h movement behaviors in 0-4-year-olds, and 2) examine its content validity. METHODS First, we used concept mapping to identify activities 0-4-year-olds engage in. Parents (n = 58) and professionals working with young children (n = 21) generated a list of activities, sorted related activities, and rated the frequency children perform these activities. Second, using multidimensional scaling and cluster analysis, we created activity categories based on the sorted activities of the participants. Third, we developed the My Little Moves app in collaboration with a software developer. Finally, we examined the content validity of the app with parents (n = 14) and researchers (n = 6) using focus groups and individual interviews. RESULTS The app has a time-use format in which parents proxy-report the activities of their child, using eight activity categories: personal care, eating/drinking, active transport, passive transport, playing, screen use, sitting/lying calmly, and sleeping. Categories are clarified by providing examples of children's activities. Additionally, 1-4 follow-up questions collect information on intensity (e.g., active or calm), posture, and/or context (e.g., location) of the activity. Parents and researchers considered filling in the app as feasible, taking 10-30 min per day. The activity categories were considered comprehensive, but alternative examples for several activity categories were suggested to increase the comprehensibility and relevance. Some follow-up questions were considered less relevant. These suggestions were adopted in the second version of the My Little Moves app. CONCLUSIONS Involving end-users and key stakeholders in the development of the My Little Moves app resulted in a tailored tool to assess 24-h movement behaviors in 0-4-year-olds with adequate content validity. Future studies are needed to evaluate other measurement properties of the app.
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Affiliation(s)
- Jelle Arts
- Public and Occupational Health, Amsterdam UMC location Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, The Netherlands.
- Health Behaviors and Chronic Diseases, Amsterdam Public Health, Amsterdam, The Netherlands.
| | - Mai J M Chinapaw
- Public and Occupational Health, Amsterdam UMC location Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, The Netherlands
- Health Behaviors and Chronic Diseases, Amsterdam Public Health, Amsterdam, The Netherlands
- Methodology, Amsterdam Public Health, Amsterdam, The Netherlands
| | - Jessica S Gubbels
- Department of Health Promotion, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, PO Box 616, Maastricht, 6200 MD, The Netherlands
| | - Arnoud P Verhoeff
- Public Health Service Amsterdam, Sarphati Amsterdam, 1018 WT, Amsterdam, The Netherlands
- Department of Sociology, University of Amsterdam, 1018 WV, Amsterdam, The Netherlands
| | - Annette Brons
- Digital Life Center, Amsterdam University of Applied Sciences, Wibautstraat 3B, Amsterdam, 1091 GM, The Netherlands
| | - Sanne Veldman
- Public and Occupational Health, Amsterdam UMC location Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, The Netherlands
- Health Behaviors and Chronic Diseases, Amsterdam Public Health, Amsterdam, The Netherlands
| | - Annelinde Lettink
- Public and Occupational Health, Amsterdam UMC location Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, The Netherlands
- Health Behaviors and Chronic Diseases, Amsterdam Public Health, Amsterdam, The Netherlands
- Methodology, Amsterdam Public Health, Amsterdam, The Netherlands
| | - Teatske M Altenburg
- Public and Occupational Health, Amsterdam UMC location Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, The Netherlands
- Health Behaviors and Chronic Diseases, Amsterdam Public Health, Amsterdam, The Netherlands
- Methodology, Amsterdam Public Health, Amsterdam, The Netherlands
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Vandendriessche A, Deforche B, Dhondt K, Altenburg TM, Verloigne M. Combining participatory action research with intervention mapping to develop and plan the implementation and evaluation of a healthy sleep intervention for adolescents. Health Promot Perspect 2023; 13:316-329. [PMID: 38235009 PMCID: PMC10790120 DOI: 10.34172/hpp.2023.37] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Accepted: 09/28/2023] [Indexed: 01/19/2024] Open
Abstract
Background Adolescents' sleep deteriorated over the last decades, urging the need to develop effective interventions. Using participatory action research (PAR) is a promising and unique approach to target adolescents' sleep. This study aims to describe the process and results of combining PAR and intervention mapping (IM) to guide future researchers on developing and planning of the implementation and evaluation of interventions promoting healthy sleep in adolescents. Methods In each of three intervention schools (two with general and technical education and one with technical and vocational education), an action team including adolescents (age 13- 15 years, n=max. 12) and a researcher was composed to develop and plan the intervention. During weekly sessions (n=ranging from 23 to 34 per school), the action team went through the six steps of IM. A short PAR was performed with parents (n=7) to develop parental intervention components. Results Combining PAR and IM resulted in interventions focusing on the importance of healthy sleep, regular sleep patterns and associated behaviors: screen behaviors, physical activity, dietary behavior and relaxation. Several differences in the participatory process (i.e. more guidance needed during brainstorms in the vocational/technical school) and developed intervention (i.e. less intrusive intervention components in the vocational/technical school) were observed between schools. Conclusion Combining PAR with IM resulted in more extensive interventions than other existing school-based sleep interventions. Future studies should investigate whether a participatory developed sleep intervention could be transferred to another setting using a shorter participatory process.
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Affiliation(s)
- Ann Vandendriessche
- Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Benedicte Deforche
- Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
- Movement and Nutrition for Health and Performance Research Group, Faculty of Physical Education and Physical Therapy, Vrije Universiteit Brussel, Brussels, Belgium
| | - Karlien Dhondt
- Department of Psychiatry: Pediatric Sleep Center, Ghent University Hospital, Ghent, Belgium
| | - Teatske M. Altenburg
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam University Medical Center, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Maïté Verloigne
- Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
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Messiha K, Chinapaw MJM, Ket HCFF, An Q, Anand-Kumar V, Longworth GR, Chastin S, Altenburg TM. Systematic Review of Contemporary Theories Used for Co-creation, Co-design and Co-production in Public Health. J Public Health (Oxf) 2023; 45:723-737. [PMID: 37147918 PMCID: PMC10470345 DOI: 10.1093/pubmed/fdad046] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Revised: 02/25/2023] [Indexed: 05/07/2023] Open
Abstract
BACKGROUND There is a need to systematically identify and summarize the contemporary theories and theoretical frameworks used for co-creation, co-design and co-production in public health research. METHODS The reporting of this systematic review follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Given substantial interest in and application of co-creation, co-design and co-production, we searched PubMed, CINAHL, Scopus and APA PsycINFO from 2012 to March-April 2022. A quality assessment and data extraction for theory content was performed. RESULTS Of the 3763 unique references identified through the comprehensive search strategy, 10 articles were included in the review: four articles named co-creation, two articles named co-creation and co-design, two articles named co-production and co-design, and two articles named co-design. Empowerment Theory was employed by two articles, whereas other theories (n = 5) or frameworks (n = 3) were employed by one article each. For the quality assessment, eight articles received a strong rating and two articles received a moderate rating. CONCLUSION There is little indication of theory applications for the approaches of co-creation, co-design and co-production in public health since 2012, given 10 articles were included in this review. Yet, the theories described in these 10 articles can be useful for developing such co-approaches in future public health research.
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Affiliation(s)
- Katrina Messiha
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Mai J M Chinapaw
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Hans C F F Ket
- Medical Library, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Qingfan An
- Department of Community Medicine and Rehabilitation, Umeå University, Umeå, Sweden
| | - Vinayak Anand-Kumar
- Department of Psychology and Methods, Jacobs University Bremen, Bremen, Germany
| | - Giuliana R Longworth
- Faculty of Psychology, Education and Sport Sciences Blanquerna, Universitat Ramon Llull, Barcelona, Spain
| | - Sebastien Chastin
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK
- Department of Movement and Sports Science, Ghent University, Ghent, Belgium
| | - Teatske M Altenburg
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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Anselma M, Altenburg TM, Twisk JWR, Wang X, Chinapaw MJM. How to Evaluate the Effectiveness of Health Promotion Actions Developed Through Youth-Centered Participatory Action Research. Health Educ Behav 2023; 50:199-210. [PMID: 34628967 PMCID: PMC10021122 DOI: 10.1177/10901981211046533] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Most actions targeting children's health behaviors have limited involvement of children in the development, potentially contributing to disappointing effectiveness. Therefore, in the 3-year "Kids in Action" study, 9- to 12-year-old children from a lower-socioeconomic neighborhood were involved as coresearchers in the development, implementation, and evaluation of actions targeting health behaviors. The current study describes the controlled trial that evaluated the effects on children's energy balance-related behaviors, physical fitness, and self-rated health, as well as experienced challenges and recommendations for future evaluations. Primary school children from the three highest grades of four intervention and four control schools were eligible for participation. Outcome measures assessed at baseline, and at 1- and 2-year follow-up were as follows: motor fitness by the MOPER test (N = 656, N = 485, N = 608, respectively), physical activity and sedentary behavior by accelerometry (N = 223, N = 149, N = 164, respectively), and consumption of sugar sweetened beverages and snacks and self-rated health by a questionnaire (N = 322, N = 281, N = 275, respectively). Mixed-model analyses were performed adjusted for clustering within schools and relevant confounders. Significant beneficial intervention effects were found on self-reported consumption of energy/sports drinks at T2 versus T0, and on total time and ≥5-minute bouts of moderate-to-vigorous physical activity at T1 versus T0. Significant adverse effects were found on "speed and agility" and "coordination and upper-limb speed." No other significant effects were found. The inconsistent intervention effects may be explained by the dynamic cohort and suboptimal outcome measures. We advise future studies with a similar approach to apply alternative evaluation designs, such as the delayed baseline design.
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Affiliation(s)
- Manou Anselma
- Amsterdam UMC, Vrije Universiteit
Amsterdam, Department of Public and Occupational Health, Amsterdam Public Health
research institute, Amsterdam, The Netherlands
- Manou Anselma, Department of Public and
Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam
Public Health research institute, Van der Boechorststraat 7, Amsterdam NL-1081
BT, Netherlands.
| | - Teatske M. Altenburg
- Amsterdam UMC, Vrije Universiteit
Amsterdam, Department of Public and Occupational Health, Amsterdam Public Health
research institute, Amsterdam, The Netherlands
| | - Jos W. R. Twisk
- Amsterdam UMC, Vrije Universiteit
Amsterdam, Department of Epidemiology and Biostatistics, Amsterdam Public Health
research institute, Amsterdam, The Netherlands
| | - Xinhui Wang
- College of Computer Science, Qinghai
Normal University, Xining, Qinghai, China
| | - Mai J. M. Chinapaw
- Amsterdam UMC, Vrije Universiteit
Amsterdam, Department of Public and Occupational Health, Amsterdam Public Health
research institute, Amsterdam, The Netherlands
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Chinapaw MJM, Altenburg TM. Knowledge in youth is wisdom in age: involving young people in research. Nat Rev Endocrinol 2023; 19:125-126. [PMID: 36627488 DOI: 10.1038/s41574-022-00796-y] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Affiliation(s)
- Mai J M Chinapaw
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, Netherlands.
| | - Teatske M Altenburg
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
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Arts J, Drotos E, Singh AS, Chinapaw MJM, Altenburg TM, Gubbels JS. Correlates of Physical Activity in 0- to 5-year-olds: A Systematic Umbrella Review and Consultation of International Researchers. Sports Med 2023; 53:215-240. [PMID: 36219386 PMCID: PMC9807466 DOI: 10.1007/s40279-022-01761-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/28/2022] [Indexed: 01/13/2023]
Abstract
BACKGROUND Many children aged 0-5 years do not meet the WHO physical activity guidelines. To develop effective, evidence-based interventions, it is necessary to understand which factors are associated with physical activity in early childhood. OBJECTIVE To summarize the current evidence on correlates of physical activity in 0- to 5-year-old children. METHODS First, a systematic umbrella review was conducted following PRISMA guidelines. PubMed, Embase, PsycINFO, and SPORTDiscus were searched up to May 2020 for systematic reviews examining the association between potential correlates and quantitatively measured physical activity in children aged 0-5.9 years. Included reviews were assessed on methodological quality, and results were categorized according to the socio-ecological model. Second, 31 international researchers of physical activity in young children participated in an expert panel to reflect on the outcomes of the umbrella review and propose directions for future research. RESULTS Twenty-one reviews were included that examined a total of 98 potential correlates. When synthesizing all reviews, 23 correlates were found with consistent evidence for an association with a physical activity outcome. For most other potential correlates there was inconsistent evidence across reviews for associations with physical activity in young children. Although there was little overlap between the correlates identified in the umbrella review and determinants suggested by the expert panel, both confirmed the importance of socio-cultural, policy, and physical environmental factors in general. CONCLUSION Multiple correlates of young children's physical activity were identified. However, various methodological challenges (e.g., measurement instruments) and the large heterogeneity (e.g., study samples, correlates, and outcome measures) hindered formulating definitive conclusions. Moreover, none of the reviews reported on the interrelatedness between correlates, which would align with more holistic understandings of behavior. Our findings indicate the urgent need for establishing a common ground in definitions, assessment methods, and analytical methods to further the field of physical activity research in this tremendously important age group. PROSPERO REGISTRATION NUMBER CRD42020184159.
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Affiliation(s)
- Jelle Arts
- Department of Public and Occupational Health, Amsterdam Public Health, Amsterdam UMC, Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, The Netherlands.
| | - Elizabeth Drotos
- Department of Health Promotion, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands
| | - Amika S Singh
- Mulier Institute, Utrecht, The Netherlands
- Center for Physically Active Learning, Faculty of Education, Arts and Sports, Western Norway University of Applied Sciences, Sogndal, Norway
| | - Mai J M Chinapaw
- Department of Public and Occupational Health, Amsterdam Public Health, Amsterdam UMC, Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, The Netherlands
| | - Teatske M Altenburg
- Department of Public and Occupational Health, Amsterdam Public Health, Amsterdam UMC, Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, The Netherlands
| | - Jessica S Gubbels
- Department of Health Promotion, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands
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Lettink A, Altenburg TM, Arts J, van Hees VT, Chinapaw MJM. Systematic review of accelerometer-based methods for 24-h physical behavior assessment in young children (0-5 years old). Int J Behav Nutr Phys Act 2022; 19:116. [PMID: 36076221 PMCID: PMC9461103 DOI: 10.1186/s12966-022-01296-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [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: 12/21/2021] [Accepted: 05/10/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Accurate accelerometer-based methods are required for assessment of 24-h physical behavior in young children. We aimed to summarize evidence on measurement properties of accelerometer-based methods for assessing 24-h physical behavior in young children. METHODS We searched PubMed (MEDLINE) up to June 2021 for studies evaluating reliability or validity of accelerometer-based methods for assessing physical activity (PA), sedentary behavior (SB), or sleep in 0-5-year-olds. Studies using a subjective comparison measure or an accelerometer-based device that did not directly output time series data were excluded. We developed a Checklist for Assessing the Methodological Quality of studies using Accelerometer-based Methods (CAMQAM) inspired by COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN). RESULTS Sixty-two studies were included, examining conventional cut-point-based methods or multi-parameter methods. For infants (0-12 months), several multi-parameter methods proved valid for classifying SB and PA. From three months of age, methods were valid for identifying sleep. In toddlers (1-3 years), cut-points appeared valid for distinguishing SB and light PA (LPA) from moderate-to-vigorous PA (MVPA). One multi-parameter method distinguished toddler specific SB. For sleep, no studies were found in toddlers. In preschoolers (3-5 years), valid hip and wrist cut-points for assessing SB, LPA, MVPA, and wrist cut-points for sleep were identified. Several multi-parameter methods proved valid for identifying SB, LPA, and MVPA, and sleep. Despite promising results of multi-parameter methods, few models were open-source. While most studies used a single device or axis to measure physical behavior, more promising results were found when combining data derived from different sensor placements or multiple axes. CONCLUSIONS Up to age three, valid cut-points to assess 24-h physical behavior were lacking, while multi-parameter methods proved valid for distinguishing some waking behaviors. For preschoolers, valid cut-points and algorithms were identified for all physical behaviors. Overall, we recommend more high-quality studies evaluating 24-h accelerometer data from multiple sensor placements and axes for physical behavior assessment. Standardized protocols focusing on including well-defined physical behaviors in different settings representative for children's developmental stage are required. Using our CAMQAM checklist may further improve methodological study quality. PROSPERO REGISTRATION NUMBER CRD42020184751.
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Affiliation(s)
- Annelinde Lettink
- Amsterdam UMC Location Vrije Universiteit Amsterdam, Public and Occupational Health, De Boelelaan 1117, Amsterdam, The Netherlands. .,Amsterdam Public Health, Methodology, Amsterdam, The Netherlands. .,Amsterdam Public Health, Health Behaviors & Chronic Diseases, Amsterdam, The Netherlands.
| | - Teatske M Altenburg
- Amsterdam UMC Location Vrije Universiteit Amsterdam, Public and Occupational Health, De Boelelaan 1117, Amsterdam, The Netherlands.,Amsterdam Public Health, Methodology, Amsterdam, The Netherlands.,Amsterdam Public Health, Health Behaviors & Chronic Diseases, Amsterdam, The Netherlands
| | - Jelle Arts
- Amsterdam UMC Location Vrije Universiteit Amsterdam, Public and Occupational Health, De Boelelaan 1117, Amsterdam, The Netherlands.,Amsterdam Public Health, Health Behaviors & Chronic Diseases, Amsterdam, The Netherlands
| | - Vincent T van Hees
- Amsterdam UMC Location Vrije Universiteit Amsterdam, Public and Occupational Health, De Boelelaan 1117, Amsterdam, The Netherlands.,, Accelting, Almere, The Netherlands
| | - Mai J M Chinapaw
- Amsterdam UMC Location Vrije Universiteit Amsterdam, Public and Occupational Health, De Boelelaan 1117, Amsterdam, The Netherlands.,Amsterdam Public Health, Methodology, Amsterdam, The Netherlands.,Amsterdam Public Health, Health Behaviors & Chronic Diseases, Amsterdam, The Netherlands
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de Vries LW, Harrington D, Grooten I, Van 't Hooft J, Deutekom AV, Roseboom TJ, Salmon J, Chinapaw M, Altenburg TM. Development of a core outcome set for school-based intervention studies on preventing childhood overweight and obesity: study protocol. BMJ Open 2022; 12:e051726. [PMID: 35835528 PMCID: PMC9289030 DOI: 10.1136/bmjopen-2021-051726] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
INTRODUCTION Prevention of childhood overweight is an important health priority. Evidence synthesis from studies evaluating school-based overweight preventive interventions is hampered by the wealth of different outcomes across studies. Therefore, consensus on a core set of outcomes for school-based overweight prevention studies is needed. This paper presents the protocol for the development of a core outcome set (COS) for school-based intervention studies aimed at childhood overweight prevention. METHODS AND ANALYSIS First, a scoping review will be performed to identify outcomes included in studies evaluating school-based overweight prevention interventions in 6-12 year-old children. Additionally, child focus groups will be organised in three countries to list the outcomes children consider important in school-based interventions. Next, an expert panel will identify all unique outcomes (eg, body composition) from the results of the scoping review and focus groups, ruling out how outcomes were defined and measured (eg, body mass index, body fat). In the next phase, a group of international stakeholders will participate in a Delphi study in which they will rate all unique outcomes on a 9-point Likert scale over three rounds to reach consensus on a COS. Participants will include healthcare professionals, policymakers, teachers, school leaders and parents of 6-12 year-olds. All rated outcomes will be presented to stakeholders in two online consensus meetings. ETHICS AND DISSEMINATION The Medical Ethics Committee of the VU Medical Center approved the child focus group study in the Netherlands (nr. 2020.071) and the Delphi study-including the consensus meeting (nr. 2022.0295). Other sites will obtain ethics approval for focus groups in their country. The University of Strathclyde School of Psychological Sciences ethics committee approved the Delphi study-including consensus meeting (nr. 72.27.04.2022 .A). The final COS will be disseminated through the diverse networks of all authors and participants. TRIAL REGISTRATION NUMBER This COS initiative is registered with the Core Outcome Measures in Effectiveness initiative (registration nr. 971).
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Affiliation(s)
- Lotte W de Vries
- Department of Public and Occupational Health, Amsterdam Public Health research institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Deirdre Harrington
- Psychological Sciences and Health, University of Strathclyde, Glasgow, UK
- Diabetes Research Centre, University of Leicester, Leicester, UK
| | - Iris Grooten
- Department of Obstetrics and Gynaecology, Amsterdam UMC, Academic Medical Centre, Amsterdam, The Netherlands
| | - Janneke Van 't Hooft
- Department of Obstetrics and Gynaecology, Amsterdam UMC, Academic Medical Centre, Amsterdam, The Netherlands
| | - Arend van Deutekom
- Department of Pediatricsm, Division of Pediatric Cardiology, Erasmus MC-Sophia Children's Hospital, Rotterdam, The Netherlands
| | - Tessa J Roseboom
- Department of Obstetrics and Gynaecology, Amsterdam UMC, Academic Medical Centre, Amsterdam, The Netherlands
- Department of Epidemiology and Data Science, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Jo Salmon
- School of Exercise and Nutrition Sciences, Deakin University, Institute for Physical Activity and Nutrition, Geelong, Victoria, Australia
| | - Mai Chinapaw
- Department of Public and Occupational Health, Amsterdam Public Health research institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Teatske M Altenburg
- Department of Public and Occupational Health, Amsterdam Public Health research institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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10
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Dogra S, Copeland JL, Altenburg TM, Heyland DK, Owen N, Dunstan DW. Start with reducing sedentary behavior: A stepwise approach to physical activity counseling in clinical practice. Patient Educ Couns 2022; 105:1353-1361. [PMID: 34556383 DOI: 10.1016/j.pec.2021.09.019] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Revised: 09/07/2021] [Accepted: 09/08/2021] [Indexed: 06/13/2023]
Abstract
UNLABELLED Recently, sedentary behavior recommendations have been included in the public health guidelines of multiple countries, pointing to new opportunities for prevention of chronic disease as well as a potential strategy for initiating long-term behavior change. OBJECTIVE To propose an evidence-informed approach to physical activity counseling that starts with a focus on reducing sedentary time. METHODS We put forward a case for addressing changes in sedentary behavior in clinical practice using a narrative review. We also propose a new approach for the assessment and counselling of patients with respect to movement behaviors. RESULTS There is evidence to support a stepwise approach to physical activity counseling that starts with targeting sedentary behavior, particularly in those who are highly sedentary, or those who have chronic disease, or physical impairments. CONCLUSIONS Our approach encourages clinicians to consider sedentary behavior counseling as a critical first step to physical activity counseling. For many patients, this initial step of reducing sedentary behavior could build a pathway to an active lifestyle. PRACTICAL IMPLICATIONS A shift from long periods of sedentary time to daily routines incorporating more light intensity physical activity could result in meaningful health improvements. Importantly, this approach may be more feasible for highly inactive patients.
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Affiliation(s)
- Shilpa Dogra
- Faculty of Health Sciences (Kinesiology), University of Ontario Institute of Technology, Canada.
| | - Jennifer L Copeland
- Department of Kinesiology, University of Lethbridge, Lethbridge, Alberta, Canada
| | - Teatske M Altenburg
- Department of Public and Occupational Health, UMC Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Daren K Heyland
- Department of Critical Care Medicine and Public Health, Queen's University, Kingston, Canada
| | - Neville Owen
- Baker Heart and Diabetes Institute, Melbourne, Australia; Centre for Urban Transitions, Swinburne University of Technology, Melbourne, Australia
| | - David W Dunstan
- Baker Heart and Diabetes Institute, Melbourne, Australia; Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia
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11
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Altenburg TM, de Vries L, Op den Buijsch R, Eyre E, Dobell A, Duncan M, Chinapaw MJM. Cross-validation of cut-points in preschool children using different accelerometer placements and data axes. J Sports Sci 2022; 40:379-385. [PMID: 35040373 DOI: 10.1080/02640414.2021.1994726] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
The present study cross-validated various cut-points to assess physical activity and sedentary behaviour in preschoolers, using hip- and wrist-worn accelerometers and both vertical axis and vector magnitude data. Secondly, we examined the influence of epoch length on time estimates of physical activity and sedentary behaviour. Sixty-four preschoolers (34 girls) wore two accelerometers, on their right hip and dominant wrist, during 1 hour of free play. Preschoolers' activities were observed by two trained researchers. Area under the curve (AUC) was calculated for the receiving operating characteristic (ROC) curves as a measure of precision. AUC ranges were 0.603-0.723 for sedentary behaviour, 0.472-0.545 for light physical activity and 0.503-0.661 for moderate-to-vigorous physical activity (MVPA), indicating poor to fair precision. Percentage of time classified as sedentary behaviour, light or MVPA according to observation and accelerometer data varied largely between cut-points, accelerometer placements and axes. The influence of epoch length on time estimates was minimal across cut-points, except for one hip-based vector magnitude cut-point. Across all accelerometer placements and data axes, no set of cut-points demonstrated adequate precision for sedentary behaviour, light physical activity and MVPA. The highly variable and omnidirectional activity pattern of preschoolers may explain the lack of adequate cut-points.
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Affiliation(s)
- Teatske M Altenburg
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam Umc, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Lotte de Vries
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam Umc, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Rianne Op den Buijsch
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam Umc, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Emma Eyre
- School of Life Sciences, Coventry University, James Starley Building, Coventry, UK
| | - Alexandra Dobell
- School of Life Sciences, Coventry University, James Starley Building, Coventry, UK
| | - Michael Duncan
- School of Life Sciences, Coventry University, James Starley Building, Coventry, UK
| | - Mai J M Chinapaw
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam Umc, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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12
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Altenburg TM, Wang X, van Ekris E, Andersen LB, Møller NC, Wedderkopp N, Chinapaw MJM. The consequences of using different epoch lengths on the classification of accelerometer based sedentary behaviour and physical activity. PLoS One 2021; 16:e0254721. [PMID: 34265011 PMCID: PMC8282067 DOI: 10.1371/journal.pone.0254721] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Accepted: 07/01/2021] [Indexed: 11/18/2022] Open
Abstract
We examined the influence of using different epoch lengths on the classification accuracy of laboratory-controlled sedentary behaviour (SB), and free-living total time and time spent in bouts of SB and moderate-to-vigorous physical activity (MVPA), in children and adolescents. We used two studies including accelerometer-derived data of: 1) controlled activities, i.e. seven sedentary, one standing and one dancing (n = 90); 2) free-living activities (n = 902). For the controlled-activity data, we calculated percentages of time classified as SB and MVPA. For the free-living data, we calculated medians (25th–75th percentiles) of total time and time spent in bouts of SB and MVPA. Applying 8counts/5seconds, 25counts/15seconds and 100counts/60seconds for SB on controlled-activity data revealed respectively (1) 92–96%, 89–99% and 98–100% of sedentary time accurately classified as SB (activity- and age-dependent); (2) 91–98%, 88–99% and 97–100% of standing time classified as SB (age-dependent); (3) 25–37%, 20–25% and 25–38% of dancing time classified as SB (age-dependent). Using longer epochs, children’s total time in SB and MVPA decreased while time accumulated in bouts of SB and MVPA accumulated in bouts increased. We conclude that a 60-second epoch seems preferable when the aim is to classify sedentary behaviour, while a shorter epoch length is needed to capture children’s short bursts of MPVA. Furthermore, we should be aware that a longer epoch results in averaging of intensities to the middle category.
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Affiliation(s)
- Teatske M Altenburg
- Department of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health research institute, Amsterdam, The Netherlands
| | - Xinhui Wang
- Department of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health research institute, Amsterdam, The Netherlands.,Luxembourg Centre for Systems Biomedicine, University of Luxembourg, Belvaux, Luxembourg.,College of Computer Science, Qinghai Normal University, Xining, Qinghai, China
| | - Evi van Ekris
- Department of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health research institute, Amsterdam, The Netherlands
| | - Lars Bo Andersen
- Faculty of Education, Arts and Sports, Campus Sogndal, Western Norway University of Applied Sciences, Bergen, Norway
| | - Niels Christian Møller
- Department of Sports Science and Clinical Biomechanics, Centre of Research in Childhood Health, University of Southern Denmark, Odense, Denmark
| | - Niels Wedderkopp
- Department of Sports Science and Clinical Biomechanics, Centre of Research in Childhood Health, University of Southern Denmark, Odense, Denmark.,Orthopedic Department, Institute of Regional Health Services Research, University of Southern Denmark, Hospital of Middelfart, Odense, Denmark
| | - Mai J M Chinapaw
- Department of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health research institute, Amsterdam, The Netherlands
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13
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Toffoli EC, Sweegers MG, Bontkes HJ, Altenburg TM, Verheul HM, van der Vliet HJ, de Gruijl TD, Buffart LM. Effects of physical exercise on natural killer cell activity during (neo)adjuvant chemotherapy: A randomized pilot study. Physiol Rep 2021; 9:e14919. [PMID: 34110712 PMCID: PMC8191403 DOI: 10.14814/phy2.14919] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [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: 04/12/2021] [Revised: 04/14/2021] [Accepted: 05/10/2021] [Indexed: 12/23/2022] Open
Abstract
Natural killer (NK) cells are a population of innate immune cells known to play a pivotal role against tumor spread. In multiple murine models, it was shown that physical exercise had the potential to increase NK cell antitumor activity through their mobilization and tissue redistribution in an interleukin (IL)-6 and epinephrine-dependent manner. The translation of this finding to patients is unclear. In this randomized pilot trial, we analyzed blood samples of patients with resectable breast or colon cancer who were randomized into an evidence-based moderate-high intensity resistance and aerobic exercise intervention (n = 8) or a control group (n = 6) during the first 9-12 weeks of (neo)adjuvant chemotherapy. In this pilot, we did not solely focus on statistical significance, but also explored whether average between-group differences reached 10%. NK cell degranulation was preserved in the exercise group whereas it decreased in the control group resulting in a between-group difference of 11.4% CD107a+ degranulated NK cells (95%CI = 0.57;22.3, p = 0.04) in the presence and 13.8% (95%CI = -2.5;30.0, p = 0.09) in the absence of an anti-epidermal growth factor receptor monoclonal antibody (EGFR-mAb). In line, the between-group difference of tumor cell lysis was 7.4% (95%CI = -9.1;23.9, p = 0.34), and 13.7% (95%CI = -10.1;37.5, p = 0.23) in favor of the exercise group in the presence or absence of EGFR mAb, respectively. Current explorative analyses showed that exercise during (neo)adjuvant chemotherapy may benefit NK cell activity. Future studies with a larger sample size are needed to confirm this finding and to establish its clinical potential. Trial registration: Dutch trial register number NTR4105.
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Affiliation(s)
- Elisa C. Toffoli
- Department of Medical OncologyAmsterdam UMCVrije Universiteit AmsterdamAmsterdamThe Netherlands
| | - Maike G. Sweegers
- Department of Epidemiology and BiostatisticsAmsterdam UMCVrije Universiteit AmsterdamAmsterdam Public HealthAmsterdamThe Netherlands
| | - Hetty J. Bontkes
- Department of Clinical ChemistryAmsterdam UMCVrije Universiteit AmsterdamAmsterdamNetherlands
| | - Teatske M. Altenburg
- Department of Public and Occupational HealthAmsterdam Public Health Research InstituteAmsterdam UMCVrije Universiteit AmsterdamAmsterdamThe Netherlands
| | - Henk M.W. Verheul
- Department of Medical OncologyRadboud University Medical CenterRadboud Institute for Health SciencesNijmegenThe Netherlands
| | - Hans J. van der Vliet
- Department of Medical OncologyAmsterdam UMCVrije Universiteit AmsterdamAmsterdamThe Netherlands
- Lava TherapeuticsUtrechtNetherlands
| | - Tanja D. de Gruijl
- Department of Medical OncologyAmsterdam UMCVrije Universiteit AmsterdamAmsterdamThe Netherlands
| | - Laurien M. Buffart
- Department of PhysiologyRadboud University Medical CenterRadboud Institute for Health SciencesNijmegenThe Netherlands
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14
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Veldman SLC, Chin A Paw MJM, Altenburg TM. Physical activity and prospective associations with indicators of health and development in children aged <5 years: a systematic review. Int J Behav Nutr Phys Act 2021; 18:6. [PMID: 33413484 PMCID: PMC7791660 DOI: 10.1186/s12966-020-01072-w] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [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: 07/09/2020] [Accepted: 12/14/2020] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND Early childhood is a critical period for growth and development, yet the association with physical activity during this important period is unknown. The aim of this review is to critically summarize the evidence on the prospective associations between physical activity and health and development in children aged < 5 years. METHODS A systematic search in three electronic databases (Pubmed, PsycINFO, and Sportdiscus) was conducted to identify prospective studies examining the associations between physical activity (all types; specified by quantity) and health indicators (body composition, cardiometabolic health, bone health and risks/harm) or development (motor, cognitive and social-emotional development) in young children (mean age < 5 years at baseline). Two independent researchers assessed the methodological quality using the 'Quality Assessment Tool for Quantitative Studies' (EPHPP). This tool covers eight quality criteria: selection bias, study design, confounders, blinding, data collection methods, withdrawals and drop-outs, intervention integrity and data-analysis. RESULTS Thirty-nine studies, predominantly conducted in preschoolers (ages 3-5 years), were included of which nine were rated as high methodological quality. There was moderate evidence for a positive association between physical activity and motor (n = 11 studies) and cognitive development (n = 10 studies) based on consistent findings from studies having low-to-moderate methodological quality. There was insufficient evidence for an association between physical activity and body composition (n = 15 studies), cardiometabolic health indicators (n = 7 studies), social-emotional development (n = 2 studies) and bone health (n = 2 studies) based on inconsistent findings from studies having weak-to-high methodological quality. CONCLUSIONS There is a need for more high-quality research in order to determine the dose-response relationship between physical activity and health and development in early childhood. Special attention should be paid to studies in children below the age of 3 years.
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Affiliation(s)
- Sanne L C Veldman
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam University Medical Center, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
| | - Mai J M Chin A Paw
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam University Medical Center, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Teatske M Altenburg
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam University Medical Center, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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15
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Schönbach DMI, Altenburg TM, Marques A, Chinapaw MJM, Demetriou Y. Strategies and effects of school-based interventions to promote active school transportation by bicycle among children and adolescents: a systematic review. Int J Behav Nutr Phys Act 2020; 17:138. [PMID: 33183331 PMCID: PMC7661215 DOI: 10.1186/s12966-020-01035-1] [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] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Accepted: 10/13/2020] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND Promoting cycling to school may benefit establishing a lifelong physical activity routine. This systematic review aimed to summarize the evidence on strategies and effects of school-based interventions focusing on increasing active school transport by bicycle. METHODS A literature search based on "PICo" was conducted in eight electronic databases. Randomized and non-randomized controlled trials with primary/secondary school students of all ages were included that conducted pre-post measurements of a school-based intervention aimed at promoting active school travel by bicycle and were published in English between 2000 and 2019. The methodological quality was assessed using the "Effective Public Health Practice Project" tool for quantitative studies. Applied behavior change techniques were identified using the "BCT Taxonomy v1". Two independent researchers undertook the screening, data extraction, appraisal of study quality, and behavior change techniques. RESULTS Nine studies investigating seven unique interventions performed between 2012 and 2018 were included. All studies were rated as weak quality. The narrative synthesis identified 19 applied behavior change techniques clustered in eleven main groups according to their similarities and a variety of 35 different outcome variables classified into seven main groups. Most outcomes were related to active school travel and psychosocial factors, followed by physical fitness, physical activity levels, weight status, active travel and cycling skills. Four studies, examining in total nine different outcomes, found a significant effect in favor of the intervention group on bicycle trips to school (boys only), percentage of daily cycling trips to school, parental/child self-efficacy, parental outcome expectations, moderate-to-vigorous intensity physical activity (total, from cycling, before/after school), and total basic cycling skills. Seven of these outcomes were only examined in two studies conducting the same intervention in children, a voluntary bicycle train to/from school accompanied by adults, including the following clustered main groups of behavior change techniques: shaping knowledge, comparison of behavior, repetition and substitution as well as antecedents. CONCLUSIONS The applied strategies in a bicycle train intervention among children indicated great potential to increase cycling to school. Our findings provide relevant insights for the design and implementation of future school-based interventions targeting active school transport by bicycle. TRIAL REGISTRATION This systematic review has been registered in the international prospective register of systematic reviews "PROSPERO" at (registration number: CRD42019125192 ).
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Affiliation(s)
| | - Teatske M. Altenburg
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Adilson Marques
- CIPER, Faculty of Human Kinetics, University of Lisbon, Lisbon, Portugal
| | - Mai J. M. Chinapaw
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Yolanda Demetriou
- Department of Sport and Health Sciences, Technical University of Munich, Munich, Germany
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16
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Anselma M, Collard DCM, van Berkum A, Twisk JWR, Chinapaw MJM, Altenburg TM. Trends in Neuromotor Fitness in 10-to-12-Year-Old Dutch Children: A Comparison Between 2006 and 2015/2017. Front Public Health 2020; 8:559485. [PMID: 33102422 PMCID: PMC7544990 DOI: 10.3389/fpubh.2020.559485] [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] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Accepted: 08/20/2020] [Indexed: 11/13/2022] Open
Abstract
Children with a low level of neuromotor fitness are less skilled to participate in sports activities. Moreover, lower levels of neuromotor fitness are related to adiposity, lower cardiovascular health, and poor self-esteem in children. The aim of this paper was to determine neuromotor fitness in 10-12-year-old Dutch children over a 10-year period. Test scores measured in 2015/2017 (N = 533 in 2015, N = 941 in 2017) were compared with scores of same-aged children measured in 2006 (N = 1986). Neuromotor fitness was assessed using the MOPER fitness test battery, including speed and agility, strength, flexibility, and coordination and upper-limb speed. Data were analyzed using multilevel linear regression models and tobit regression analyses in case of skewed distributions with an excess of zeros. Analyses were stratified by age and gender, and adjusted for level of urbanization. Children in 2015/2017 performed significantly worse on speed and agility (β = 0.8 to 1.1 s), significantly better on coordination/upper-limb speed (β = -1.0 to -0.6 s), and-except for 12-year-old girls-significantly worse on flexibility vs. children in 2006 (β = -3.4 to -1.8 cm). Additionally, upper-body strength was significantly worse among 10-year olds (β = -3.2 to -2.5 s) while leg strength was significantly worse among 11-year-olds in 2015/2017 vs. 2006 (β = -1.8 to -1.7 cm). Trunk strength was worse among 11- and 12-year old boys (β = 1.1 to 1.2 s). In line with a previously observed downward trend in neuromotor fitness among children (1980-2006), we found worse scores on speed and agility, and flexibility in 2015/2017 vs. 2006, stressing the need for interventions aimed at improving neuromotor fitness in order to promote physical activity and future health.
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Affiliation(s)
- Manou Anselma
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam, Netherlands
| | | | - Anniek van Berkum
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam, Netherlands
| | - Jos W R Twisk
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, Amsterdam, Netherlands
| | - Mai J M Chinapaw
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam, Netherlands
| | - Teatske M Altenburg
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam, Netherlands
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17
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Schönbach DMI, Vondung C, Hidding LM, Altenburg TM, Chinapaw MJM, Demetriou Y. Gender Influence on Students, Parents, and Teachers' Perceptions of What Children and Adolescents in Germany Need to Cycle to School: A Concept Mapping Study. Int J Environ Res Public Health 2020; 17:E6872. [PMID: 32962261 PMCID: PMC7557880 DOI: 10.3390/ijerph17186872] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Revised: 09/09/2020] [Accepted: 09/15/2020] [Indexed: 12/16/2022]
Abstract
Active commuting to school is highly recommended for several reasons, and in the decision-making process for doing so, a child interacts with parents and teachers. Until now, these three interactors' gender-specific perspectives on children and adolescents' need for cycling to school have been unavailable. Thus, our concept mapping study analyzed the needs of 12- to 15-year-olds in Germany for cycling to and from school daily, as perceived by students, parents, and teachers stratified by gender. From November 2019 to February 2020, 136 students, 58 parents, and 29 teachers participated. Although 87.8% of girls and 100% of boys owned a bicycle, only 44.4% of girls and 72.9% of boys cycled to school. On average, girls cycled to school on 1.6 ± 2.0 days a week and boys on 2.7 ± 2.0 days a week. A "bicycle and related equipment," the "way to school," and "personal factors" were reported needs, perceived by students and teachers of both genders and by mothers. Girls reported the additional gender-specific need for "social behavior in road traffic," mothers and female teachers reported "role of parents," and female teachers reported a "sense of safety." This study's findings could inspire the development of school-based bicycle interventions.
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Affiliation(s)
| | - Catherina Vondung
- Department of Natural and Sociological Sciences, Heidelberg University of Education, 69120 Heidelberg, Germany;
| | - Lisan M. Hidding
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, 1081 BT Amsterdam, The Netherlands; (L.M.H.); (T.M.A.); (M.J.M.C.)
| | - Teatske M. Altenburg
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, 1081 BT Amsterdam, The Netherlands; (L.M.H.); (T.M.A.); (M.J.M.C.)
| | - Mai J. M. Chinapaw
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, 1081 BT Amsterdam, The Netherlands; (L.M.H.); (T.M.A.); (M.J.M.C.)
| | - Yolanda Demetriou
- Department of Sport and Health Sciences, Technical University of Munich, 80992 Munich, Germany;
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18
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Anselma M, Chinapaw MJM, Kornet-van der Aa DA, Altenburg TM. Effectiveness and promising behavior change techniques of interventions targeting energy balance related behaviors in children from lower socioeconomic environments: A systematic review. PLoS One 2020; 15:e0237969. [PMID: 32870928 PMCID: PMC7462275 DOI: 10.1371/journal.pone.0237969] [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] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Accepted: 08/06/2020] [Indexed: 01/22/2023] Open
Abstract
This systematic review aims to summarize the evidence regarding the effectiveness of interventions targeting energy balance-related behaviors in children from lower socioeconomic environments and the applied behavior change techniques. The literature search was conducted in Cochrane, Embase, Psycinfo and Pubmed. Articles had to be published between January 2000 and September 2019. Studies were included that i) targeted dietary behavior, physical activity and/or sedentary behavior; ii) had a controlled trial design; iii) included children aged 9–12 years old; iv) focused on lower socioeconomic environments; and v) took place in upper-middle or high income countries. Two independent researchers extracted data, identified behavior change techniques using the Behavior Change Technique Taxonomy v1, and performed a methodological quality assessment using the quality assessment tool of the Effective Public Health Practice Project. We included 24 studies, of which one received a high and three a moderate quality rating. Demonstration, practice and providing instructions on how to perform a behavior were the most commonly applied behavior change techniques. Seven studies reported significant beneficial intervention effects: five on physical activity, one on physical activity and sedentary behavior and one on dietary behavior. When comparing effective versus non-effective interventions, and comparing our review to previous reviews focusing on children from the general population, similar behavior change techniques were applied. More high quality research is needed to evaluate the effectiveness of interventions and their behavior change techniques targeting children of low socioeconomic environments. PROSPERO registration number: CRD42016052599
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Affiliation(s)
- Manou Anselma
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- * E-mail:
| | - Mai J. M. Chinapaw
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Daniëlle A. Kornet-van der Aa
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Teatske M. Altenburg
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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19
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Buffart LM, Sweegers MG, de Ruijter CJ, Konings IR, Verheul HMW, van Zweeden AA, Grootscholten C, Chinapaw MJ, Altenburg TM. Muscle contractile properties of cancer patients receiving chemotherapy: Assessment of feasibility and exercise effects. Scand J Med Sci Sports 2020; 30:1918-1929. [PMID: 32599670 PMCID: PMC7540386 DOI: 10.1111/sms.13758] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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: 01/29/2020] [Revised: 06/18/2020] [Accepted: 06/22/2020] [Indexed: 12/20/2022]
Abstract
Background This pilot trial explores the feasibility of measuring muscle contractile properties in patients with cancer, effects of exercise during chemotherapy on muscle contractile properties and the association between changes in contractile muscle properties and perceived fatigue. Method Patients who received (neo)adjuvant chemotherapy for breast or colon cancer were randomized to a 9‐12 week exercise intervention or a waitlist‐control group. At baseline and follow‐up, we measured knee extensor strength using maximal voluntary contraction (MVC), contractile muscle properties of the quadriceps muscle using electrical stimulation, and perceived fatigue using the Multidimensional Fatigue Inventory. Feasibility was assessed by the proportion of patients who successfully completed measurements of contractile muscle properties. Exercise effects on muscle contractile properties were explored using linear regression analyses. Between‐group differences >10% were considered potentially relevant. Pearson correlation (rp) of changes in contractile muscle properties and changes in perceived fatigue was calculated. Results Twenty two of 30 patients completed baseline and follow‐up assessments. Measurements of contractile properties were feasible except for muscle fatigability. We found a potentially relevant between‐group difference in the rate of force development favoring the intervention group (1192 N/s, 95% CI = −335; 2739). Change in rate of force development was negatively correlated with change in perceived general (rp = −0.54, P = .04) and physical (rp = −0.59, P = .02) fatigue. Conclusion Chemotherapy induces a decrease in the rate of force development, which may reflect a larger loss in type II muscle fibers. This may be attenuated with (resistance) exercise. The increase in the rate of force development was related to a decrease in perceived fatigue.
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Affiliation(s)
- Laurien M Buffart
- Department of Physiology, Radboudumc, Radboud Institute for Health Sciences, Nijmegen, The Netherlands.,Department of Epidemiology and Biostatistics and Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.,Department of Medical Oncology, Cancer Center Amsterdam, Amsterdam UMC, Vrije Universiteit Amsterdam, The Netherlands
| | - Maike G Sweegers
- Department of Epidemiology and Biostatistics and Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Cornelis J de Ruijter
- Faculty of Behavioural and Movement Sciences, Amsterdam Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Inge R Konings
- Department of Medical Oncology, Cancer Center Amsterdam, Amsterdam UMC, Vrije Universiteit Amsterdam, The Netherlands
| | - Henk M W Verheul
- Department of Medical Oncology, Radboudumc, Nijmegen, The Netherlands
| | - Annette A van Zweeden
- Department of Medical Oncology, Cancer Center Amsterdam, Amsterdam UMC, Vrije Universiteit Amsterdam, The Netherlands.,Department of Internal Medicine, Amstelland Hospital, Amstelveen, The Netherlands
| | - Cecile Grootscholten
- Department of Gastrointestinal Oncology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Mai J Chinapaw
- Department of Public and Occupational Health and Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Teatske M Altenburg
- Department of Public and Occupational Health and Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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van Ekris E, Wijndaele K, Altenburg TM, Atkin AJ, Twisk J, Andersen LB, Janz KF, Froberg K, Northstone K, Page AS, Sardinha LB, van Sluijs EMF, Chinapaw M. Tracking of total sedentary time and sedentary patterns in youth: a pooled analysis using the International Children's Accelerometry Database (ICAD). Int J Behav Nutr Phys Act 2020; 17:65. [PMID: 32423404 PMCID: PMC7236462 DOI: 10.1186/s12966-020-00960-5] [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] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Accepted: 04/24/2020] [Indexed: 11/15/2022] Open
Abstract
Background To gain more understanding of the potential health effects of sedentary time, knowledge is required about the accumulation and longitudinal development of young people’s sedentary time. This study examined tracking of young peoples’ total and prolonged sedentary time as well as their day-to-day variation using the International Children’s Accelerometry Database. Methods Longitudinal accelerometer data of 5991 children (aged 4-17y) was used from eight studies in five countries. Children were included if they provided valid (≥8 h/day) accelerometer data on ≥4 days, including ≥1 weekend day, at both baseline and follow-up (average follow-up: 2.7y; range 0.7–8.2). Tracking of total and prolonged (i.e. ≥10-min bouts) sedentary time was examined using multilevel modelling to adjust for clustering of observations, with baseline levels of sedentary time as predictor and follow-up levels as outcome. Standardized regression coefficients were interpreted as tracking coefficients (low: < 0.3; moderate: 0.3–0.6; high: > 0.6). Results Average total sedentary time at study level ranged from 246 to 387 min/day at baseline and increased annually by 21.4 min/day (95% confidence interval [19.6–23.0]) on average. This increase consisted almost entirely of prolonged sedentary time (20.9 min/day [19.2–22.7]). Total (standardized regression coefficient (B) = 0.48 [0.45–0.50]) and prolonged sedentary time (B = 0.43 [0.41–0.45]) tracked moderately. Tracking of day-to-day variation in total (B = 0.04 [0.02–0.07]) and prolonged (B = 0.07 [0.04–0.09]) sedentary time was low. Conclusion Young people with high levels of sedentary time are likely to remain among the people with highest sedentary time as they grow older. Day-to-day variation in total and prolonged sedentary time, however, was rather variable over time.
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Affiliation(s)
- Evi van Ekris
- Department of Public and Occupational Health, Amsterdam Public Health research institute, VU University Medical Center, van der Boechorststraat 7, 1081BT, Amsterdam, the Netherlands.
| | | | - Teatske M Altenburg
- Department of Public and Occupational Health, Amsterdam Public Health research institute, VU University Medical Center, van der Boechorststraat 7, 1081BT, Amsterdam, the Netherlands
| | - Andrew J Atkin
- Centre for Diet and Activity Research (CEDAR), MRC Epidemiology Unit, University of Cambridge, Cambridge, UK.,School of Health Sciences, Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, UK
| | - Jos Twisk
- Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, the Netherlands
| | - Lars B Andersen
- Faculty of Teacher Education and Sport, Western Norway University of Applied Sciences, Sogndal, Norway
| | - Kathleen F Janz
- Department of Health and Human Physiology, University of Iowa, Iowa City, USA
| | - Karsten Froberg
- Research of Childhood Health, University of Southern Denmark, Odense, Denmark
| | - Kate Northstone
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Angie S Page
- Centre for Exercise, Nutrition and Health Sciences, University of Bristol, Bristol, UK.,NIHR Bristol Biomedical Research Centre, University Hospitals Bristol NHS FoundationTrust and University of Bristol, Bristol, UK
| | - Luis B Sardinha
- Exercise and Health Laboratory, CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Lisbon, Portugal
| | - Esther M F van Sluijs
- Centre for Diet and Activity Research (CEDAR), MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - Mai Chinapaw
- Department of Public and Occupational Health, Amsterdam Public Health research institute, VU University Medical Center, van der Boechorststraat 7, 1081BT, Amsterdam, the Netherlands
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21
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Hidding LM, Chinapaw MJM, Belmon LS, Altenburg TM. Co-creating a 24-hour movement behavior tool together with 9-12-year-old children using mixed-methods: MyDailyMoves. Int J Behav Nutr Phys Act 2020; 17:63. [PMID: 32410623 PMCID: PMC7226934 DOI: 10.1186/s12966-020-00965-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [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: 12/04/2019] [Accepted: 05/01/2020] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND All 24-h movement behaviors, i.e. physical activity, sedentary behavior and sleep, are important for optimal health in children. Currently, no tools exist that include all 24-h behaviors and have been proven to be both reliable and valid. Potential reasons for the inadequate validity and reliability of existing questionnaires are the lack of focus on the content validity and lack of involvement of children in the development. Therefore, the aim of this study was to co-create a 24-h movement behavior tool together with 9-12-year-old children. METHODS Concept mapping and photovoice meetings were held to identify children's physical activity behaviors. During concept mapping meetings with four groups of children (n = 40), children generated an extensive list of physical activities they engaged in, sorted the activities in categories and rated the frequency and perceived intensity of these activities. Using photovoice, three groups of children (n = 24) photographed their physical activities during one weekday and one weekend day, named the photographs, and placed them on a timeline. Furthermore, researchers obtained information on relevant items regarding sleep and sedentary behavior by screening existing questionnaires. Thereafter, we developed the first version of MyDailyMoves. Subsequently, we examined the content validity of the tool together with three groups of children (n = 22) and one group of researchers (n = 7) using focus group meetings. RESULTS MyDailyMoves has a timeline format, onto which children add the activities they performed the previous day. Based on the concept mapping and photovoice studies, eight physical activity categories were included: playing inside, playing outside, sports, hobbies, chores, personal care, transport, and others. Sleep questions and two more sedentary categories (schoolwork and screen time) were added to MyDailyMoves to define and complete the timeline. The content validity study showed that all items in the tool were relevant. However, children mentioned that the activity category 'eating' was missing and the understandability of how to use the tool should be improved by adding an explanatory video. Both suggestions were adopted in the second version. CONCLUSION Including the children's perceptions throughout the tool development process resulted in a comprehensive and practical tool which is easy for children to use.
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Affiliation(s)
- Lisan M Hidding
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Public and Occupational Health, Amsterdam Public Health research institute, van der Boechorststraat 7, 1081BT, Amsterdam, the Netherlands.
| | - Mai J M Chinapaw
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Public and Occupational Health, Amsterdam Public Health research institute, van der Boechorststraat 7, 1081BT, Amsterdam, the Netherlands
| | - Laura S Belmon
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Public and Occupational Health, Amsterdam Public Health research institute, van der Boechorststraat 7, 1081BT, Amsterdam, the Netherlands.,Department of Epidemiology & Health Promotion, Section Youth, Municipal Health Service Amsterdam, Nieuwe Achtergracht 100, 1018WT, Amsterdam, the Netherlands
| | - Teatske M Altenburg
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Public and Occupational Health, Amsterdam Public Health research institute, van der Boechorststraat 7, 1081BT, Amsterdam, the Netherlands
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22
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Anselma M, Altenburg TM, Emke H, van Nassau F, Jurg M, Ruiter RAC, Jurkowski JM, Chinapaw MJM. Co-designing obesity prevention interventions together with children: intervention mapping meets youth-led participatory action research. Int J Behav Nutr Phys Act 2019; 16:130. [PMID: 31831006 PMCID: PMC6909512 DOI: 10.1186/s12966-019-0891-5] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [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: 01/15/2019] [Accepted: 11/25/2019] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Youth-led Participatory Action Research (YPAR) involves children throughout the process of developing and implementing interventions. Combining YPAR with a structural approach for designing and planning interventions, such as Intervention Mapping (IM), may further improve implementation and effectiveness of interventions. This paper describes how YPAR and IM were combined in the Kids in Action study. METHODS The Kids in Action study aims to improve health behaviors of 9-12-year old children living in a low socioeconomic neighborhood in Amsterdam, by co-designing interventions with these children. At each of four schools 6-8 children (N = 18-24 total per year) and two academic researchers formed participatory groups that met weekly or every fortnight during two school years. An IM expert panel advised the participatory groups on the application of IM. RESULTS Following the IM protocol, we conducted a participatory needs assessment with children, parents and professionals, in IM-step 1. In IM-step 2, the IM expert panel constructed matrices of program objectives, and the children provided feedback. In collaboration with children programs were designed and produced using an iterative process during IM-steps 3-4. In IM-step 5, the participatory groups and professional community partners designed the implementation plan. Finally, in IM-step 6, the protocol of the process and effect evaluation - executed by academic researchers with input from children - was developed. CONCLUSIONS By combining YPAR and IM, several interventions have been developed and implemented, varying from a school water policy to extracurricular sports activities. Sharing responsibility with children was challenging when combining IM with YPAR. In YPAR children are given as much autonomy as possible, while traditional IM development work is primarily done by academic researchers. Strengths in combining IM and YPAR include the involvement of the end-users - children - throughout the process while at the same time developing interventions based on existing evidence. Time-management, a multidisciplinary team, and flexibility are important conditions when combining IM with YPAR. A strong community project group, with professionals who were willing to help children develop and execute their ideas, was an important success factor. This study can serve as an example to other YPAR studies developing interventions using the IM protocol.
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Affiliation(s)
- Manou Anselma
- Department of Public and Occupational Health, Amsterdam Public Health research institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Van der Boechorststraat 7, NL-1081 BT Amsterdam, The Netherlands
| | - Teatske M. Altenburg
- Department of Public and Occupational Health, Amsterdam Public Health research institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Van der Boechorststraat 7, NL-1081 BT Amsterdam, The Netherlands
| | - Helga Emke
- Department of Public and Occupational Health, Amsterdam Public Health research institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Van der Boechorststraat 7, NL-1081 BT Amsterdam, The Netherlands
| | - Femke van Nassau
- Department of Public and Occupational Health, Amsterdam Public Health research institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Van der Boechorststraat 7, NL-1081 BT Amsterdam, The Netherlands
| | - Merlin Jurg
- InReturn, Sustainable employability and vitality, Koog aan de Zaan, The Netherlands
| | - Robert A. C. Ruiter
- Department of Work and Social Psychology, Maastricht University, P.O. Box 616, NL-6200 MD Maastricht, the Netherlands
| | - Janine M. Jurkowski
- Department of Health Policy, Management, & Behavior, University at Albany School of Public Health, State University of New York, Albany, New York USA
| | - Mai J. M. Chinapaw
- Department of Public and Occupational Health, Amsterdam Public Health research institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Van der Boechorststraat 7, NL-1081 BT Amsterdam, The Netherlands
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23
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Douma JAJ, de Beaufort MB, Kampshoff CS, Persoon S, Vermaire JA, Chinapaw MJ, van Mechelen W, Nollet F, Kersten MJ, Smit JH, Verdonck-de Leeuw IM, Altenburg TM, Buffart LM. Physical activity in patients with cancer: self-report versus accelerometer assessments. Support Care Cancer 2019; 28:3701-3709. [PMID: 31820127 PMCID: PMC7316671 DOI: 10.1007/s00520-019-05203-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [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: 08/25/2019] [Accepted: 11/22/2019] [Indexed: 12/19/2022]
Abstract
Purpose The level of daily physical activity in patients with cancer is frequently assessed by questionnaires, such as the Physical Activity Scale for the Elderly (PASE). Objective assessments, with for example accelerometers, may be a good alternative. The aim of this study was to investigate the agreement between the PASE questionnaire and accelerometer-assessed physical activity in a large group of patients with different types of cancer. Methods Baseline accelerometer and PASE questionnaire data of 403 participants from the REACT (Resistance and Endurance Exercise After Chemotherapy, n = 227), the EXIST (Exercise Intervention After Stem-Cell Transplantation, n = 74), and NET-QUBIC (NEtherlands QUality of Life And Biomedical Cohort Studies In Cancer, n = 102) studies were available for the current analyses. Physical activity was assessed by the PASE questionnaire (total score) and accelerometers (total minutes per day > 100 counts). Linear mixed models regression analysis was used to assess the agreement between the PASE questionnaire and accelerometer-assessed physical activity. Results The mean (SD) PASE score was 95.9 (75.1) points and mean (SD) time in physical activity measured with the accelerometer was 256.6 (78.8) min per day. The agreement between the PASE score and the accelerometer data was significant, but poor (standardized regression coefficient (B) = 0.36, 95%CI = 0.27; 0.44, p < 0.01). Conclusion Agreement between the PASE questionnaire and accelerometer-assessed physical activity was poor. The poor agreement indicates that they measure different physical activity constructs and cannot be used interchangeably to assess the level of daily physical activity in patients with cancer.
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Affiliation(s)
- Joeri A J Douma
- Department of Medical Oncology, Cancer Center Amsterdam, Amsterdam UMC, Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, The Netherlands
| | - Maaike B de Beaufort
- Department of Medical Oncology, Cancer Center Amsterdam, Amsterdam UMC, Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, The Netherlands
| | - Caroline S Kampshoff
- Department of Medical Oncology, Cancer Center Amsterdam, Amsterdam UMC, Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, The Netherlands
| | - Saskia Persoon
- Knowledge Institute of the Dutch Association of Medical Specialists, Mercatorlaan 1200, Utrecht, The Netherlands
| | - Jorine A Vermaire
- Department of Radiation Oncology, Division of Medical Imaging, University Medical Center Utrecht, Utrecht University, Heidelberglaan 100, Utrecht, The Netherlands
| | - Mai J Chinapaw
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, De Boelelaan 1089a, Amsterdam, The Netherlands
| | - Willem van Mechelen
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, De Boelelaan 1089a, Amsterdam, The Netherlands
- School of Human Movement and Nutrition Sciences, Faculty of Health and Behavioural Sciences, University of Queensland, Brisbane, Australia
- Division of Exercise Science and Sports Medicine (ESSM), Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
- School of Public Health, Physiotherapy and Population Sciences, University College Dublin, Dublin, Ireland
| | - Frans Nollet
- Department of Rehabilitation, Amsterdam Movement Sciences Research Institute, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, Amsterdam, Netherlands
| | - Marie José Kersten
- Department of Hematology, Amsterdam UMC, University of Amsterdam, Cancer Center Amsterdam and LYMMCARE (Lymphoma and Myeloma Center Amsterdam), Meibergdreef 9, Amsterdam, Netherlands
| | - Jan H Smit
- Department of Psychiatry, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Oldenaller 1, Amsterdam, The Netherlands
| | - Irma M Verdonck-de Leeuw
- Department of Otolaryngology-Head and Neck Surgery, Cancer Center Amsterdam, Amsterdam UMC, Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, The Netherlands
- Department of Clinical, Neuro- and Developmental Psychology, Section Clinical Psychology, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, De Boelelaan 1089a, Amsterdam, The Netherlands
| | - Teatske M Altenburg
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, De Boelelaan 1089a, Amsterdam, The Netherlands
| | - Laurien M Buffart
- Department of Medical Oncology, Cancer Center Amsterdam, Amsterdam UMC, Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, The Netherlands.
- Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, De Boelelaan 1089a, Amsterdam, The Netherlands.
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24
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Abstract
PURPOSE To date, epidemiological studies have focused on the potential health effects of total volume of physical activity (PA) or sedentary behavior (SB). However, two persons may have the same volume of PA or SB but accumulated in a completely different sequence. The pattern of accumulating PA and SB might be more important for health effects than the total volume. Therefore, the aim was to develop a sophisticated algorithm translating accelerometer data into detailed sequence maps considering how PA and SB are accumulated throughout the day. METHODS We developed a novel algorithm to convert accelerometer counts into a sequence map based on behavior states defined by a combination of intensity (SB, light, moderate, and vigorous intensity) and duration (sporadic accumulation or in bouts of different duration). In addition, hierarchical cluster analysis was applied to identify clusters of children with similar behavioral sequence maps. RESULTS Clustering resulted in seven clusters of children with similar PA and SB sequence maps: an average cluster (33% of children); a cluster with relatively more SB, light, and moderate PA in bouts (SB and PA bouters, 31%); a cluster characterized by more sporadic SB and light PA (light activity breakers, 26%); and four smaller clusters with 7% of the children or less. CONCLUSION This novel algorithm is a next step in more sophisticated analyses of accelerometer data considering how PA and SB are accumulated throughout the day. The next step is identifying whether specific patterns of accumulating PA and SB are associated with improved health outcomes.
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Affiliation(s)
- Mai J Chinapaw
- Department of Public and Occupational Health and Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, THE NETHERLANDS
| | - Xinhui Wang
- Department of Public and Occupational Health and Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, THE NETHERLANDS.,College of Computer Science, Qinghai Normal University, Xining, Qinghai, CHINA
| | - Lars Bo Andersen
- Faculty of Education, Arts and Sports, Western Norway University of Applied Sciences, Campus Sogndal, NORWAY
| | - Teatske M Altenburg
- Department of Public and Occupational Health and Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, THE NETHERLANDS
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25
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Schönbach DMI, Altenburg TM, Chinapaw MJM, Marques A, Demetriou Y. Strategies and effects of promising school-based interventions to promote active school transportation by bicycle among children and adolescents: protocol for a systematic review. Syst Rev 2019; 8:296. [PMID: 31783785 PMCID: PMC6884831 DOI: 10.1186/s13643-019-1216-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Accepted: 10/29/2019] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Active school travel by bike may provide appropriate means to promote physical activity through commuting to and from school, expanding the mobility during leisure time, and integrating a lifelong positive behavior routine. However, bicycling seems to be a less common form of active school transport and declining cycling to school trends in some European countries have been observed. Therefore, effective interventions aiming at promoting biking to school are warranted. To gain a better understanding of effective programs, the systematic review will summarize strategies and effects of school-based interventions targeted on positively influencing active school travel by bicycle. METHODS The databases ERIC, PsycINFO, PSYNDEX, PubMed, Scopus, SPORTDiscus, SURF, and Web of Science will be searched utilizing a detailed search strategy according to "PICo". Consequently, there will be no restriction regarding the outcomes measured in studies. For inclusion in the review, the identified primary studies (i.e. randomized and non-randomized controlled trials) should be published between 2000 and 2019 due to their current relevance, and written in English. The screening, data extraction, and appraisal of study quality as well as behavior change techniques will be undertaken by two independent researchers. To assess the methodological quality of every included study, the quality assessment tool "Effective Public Health Practice Project" for quantitative studies will be used. Behavior change techniques will be identified by utilizing the "BCT Taxonomy v1". If data permits, meta-analyses for intervention effects will be conducted where appropriate. DISCUSSION The planned systematic review can provide information about how bicycling is considered in school-based interventions as an effective strategy to promote active commuting to school among students. In this regard, the conclusions drawn from the review will establish a basis for researchers to plan and implement a comprehensive cycling intervention in the school setting. SYSTEMATIC REVIEW REGISTRATION PROSPEROCRD42019125192.
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Affiliation(s)
- Dorothea M I Schönbach
- Department of Sport and Health Sciences, Technical University of Munich, Georg-Brauchle-Ring 62, D-80992, Munich, Germany.
| | - Teatske M Altenburg
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Public and Occupational Health, Amsterdam Public Health research institute, Amsterdam, The Netherlands
| | - Mai J M Chinapaw
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Public and Occupational Health, Amsterdam Public Health research institute, Amsterdam, The Netherlands
| | - Adilson Marques
- Interdisciplinary Centre for the Study of Human Performance, Faculty of Human Kinetics, University of Lisbon, Lisbon, Portugal
| | - Yolanda Demetriou
- Department of Sport and Health Sciences, Technical University of Munich, Georg-Brauchle-Ring 62, D-80992, Munich, Germany
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26
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Abstract
Background and Objective This review is an update of a previous review published in 2010, and aims to summarize the available studies on the measurement properties of physical activity questionnaires for young people under the age of 18 years. Methods Systematic literature searches were carried out using the online PubMed, EMBASE, and SPORTDiscus databases up to 2018. Articles had to evaluate at least one of the measurement properties of a questionnaire measuring at least the duration or frequency of children’s physical activity, and be published in the English language. The standardized COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) checklist was used for the quality assessment of the studies. Results This review yielded 87 articles on 89 different questionnaires. Within the 87 articles, 162 studies were conducted: 103 studies assessed construct validity, 50 assessed test–retest reliability, and nine assessed measurement error. Of these studies, 38% were of poor methodological quality and 49% of fair methodological quality. A questionnaire with acceptable validity was found only for adolescents, i.e., the Greek version of the 3-Day Physical Activity Record. Questionnaires with acceptable test–retest reliability were found in all age categories, i.e., preschoolers, children, and adolescents. Conclusion Unfortunately, no questionnaires were identified with conclusive evidence for both acceptable validity and reliability, partly due to the low methodological quality of the studies. This evidence is urgently needed, as current research and practice are using physical activity questionnaires of unknown validity and reliability. Therefore, recommendations for high-quality studies on measurement properties of physical activity questionnaires were formulated in the discussion. PROSPERO Registration Number CRD42016038695. Electronic supplementary material The online version of this article (10.1007/s40279-018-0987-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Lisan M Hidding
- Department of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health research institute, Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands.
| | - Mai J M Chinapaw
- Department of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health research institute, Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands
| | - Mireille N M van Poppel
- Department of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health research institute, Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands
- Institute of Sport Science, University of Graz, Mozartgasse 14, 8010, Graz, Austria
| | - Lidwine B Mokkink
- Department of Epidemiology and Biostatistics, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health research institute, Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands
| | - Teatske M Altenburg
- Department of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health research institute, Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands
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Sweegers MG, Buffart LM, Huijsmans RJ, Konings IR, van Zweeden AA, Brug J, Chinapaw MJM, Altenburg TM. From accelerometer output to physical activity intensities in breast cancer patients. J Sci Med Sport 2019; 23:176-181. [PMID: 31537492 DOI: 10.1016/j.jsams.2019.09.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [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: 03/15/2019] [Revised: 08/30/2019] [Accepted: 09/02/2019] [Indexed: 10/26/2022]
Abstract
OBJECTIVES We aimed to investigate accelerometer output corresponding to physical activity intensity cut-points based on percentage of peak oxygen consumption (%VO2peak) and Metabolic Equivalent of Task (MET) value in women treated for breast cancer. DESIGN Laboratory study. METHODS Fifty female patients shortly after completion of treatment for breast cancer were included. VO2peak was determined during a cardiopulmonary exercise test. Subsequently, patients performed ten activities with different intensities while wearing an accelerometer on the right hip and a mobile oxycon to assess oxygen consumption. We studied the relationship between energy expenditure (expressed as %VO2peak and MET-value) and accelerometer output (in counts per minute (cpm)) with linear regression analyses. We determined accelerometer output corresponding to physical activity intensity cut-points (40% and 60%VO2peak; 3 and 6 MET) using regression equations. RESULTS VO2peak was 22.4mL/kg/min (SD 5.2) and resting metabolic rate was 3.1mL/kg/min (SD 0.6). Accelerometer output corresponding to the cut-points for moderate (40% VO2peak) and vigorous intensity (60% VO2peak) were 1123 and 1911, respectively. The analyses based on MET-values resulted in accelerometer output of 1189cpm for the moderate (3 MET) and 2768 cpm for the vigorous intensity cut-point (6 MET). CONCLUSIONS Accelerometer outputs for moderate and vigorous intensity physical activity were lower than commonly used cut-points (i.e. 1952 and 5724 cpm), irrespective of the method used to express energy expenditure (%VO2peak versus MET-value). Thus, categorizing physical activity intensities based on general-population cut-points, may underestimate physical activity intensities for women treated for breast cancer.
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Affiliation(s)
- Maike G Sweegers
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Epidemiology and Biostatistics, Amsterdam Public Health, The Netherlands; Amsterdam UMC, Vrije Universiteit Amsterdam, Cancer Center Amsterdam, Amsterdam, The Netherlands
| | - Laurien M Buffart
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Epidemiology and Biostatistics, Amsterdam Public Health, The Netherlands; Amsterdam UMC, Vrije Universiteit Amsterdam, Cancer Center Amsterdam, Amsterdam, The Netherlands; Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Medical Oncology, The Netherlands
| | - Rosalie J Huijsmans
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Rehabilitation Medicine, The Netherlands
| | - Inge R Konings
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Medical Oncology, The Netherlands
| | - Annette A van Zweeden
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Medical Oncology, The Netherlands; Amstelland Hospital, Department of Internal Medicine, The Netherlands
| | - Johannes Brug
- National Institute for Public Health and the Environment (RIVM), The Netherlands
| | - Mai J M Chinapaw
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Public and Occupational health, Amsterdam Public Health, The Netherlands
| | - Teatske M Altenburg
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Public and Occupational health, Amsterdam Public Health, The Netherlands.
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Sweegers MG, Boyle T, Vallance JK, Chinapaw MJ, Brug J, Aaronson NK, D'Silva A, Kampshoff CS, Lynch BM, Nollet F, Phillips SM, Stuiver MM, van Waart H, Wang X, Buffart LM, Altenburg TM. Which cancer survivors are at risk for a physically inactive and sedentary lifestyle? Results from pooled accelerometer data of 1447 cancer survivors. Int J Behav Nutr Phys Act 2019; 16:66. [PMID: 31420000 PMCID: PMC6698042 DOI: 10.1186/s12966-019-0820-7] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [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: 01/25/2019] [Accepted: 07/18/2019] [Indexed: 12/22/2022] Open
Abstract
Background Physical activity has beneficial effects on the health of cancer survivors. We aimed to investigate accelerometer-assessed physical activity and sedentary time in cancer survivors, and describe activity profiles. Additionally, we identify demographic and clinical correlates of physical activity, sedentary time and activity profiles. Methods Accelerometer, questionnaire and clinical data from eight studies conducted in four countries (n = 1447) were pooled. We calculated sedentary time and time spent in physical activity at various intensities using Freedson cut-points. We used latent profile analysis to identify activity profiles, and multilevel linear regression analyses to identify demographic and clinical variables associated with accelerometer-assessed moderate to vigorous physical activity (MVPA), sedentary time, the highly active and highly sedentary profile, adjusting for confounders identified using a directed acyclic graph. Results Participants spent on average 26 min (3%) in MVPA and 568 min (66%) sedentary per day. We identified six activity profiles. Older participants, smokers and participants with obesity had significantly lower MVPA and higher sedentary time. Furthermore, men had significantly higher MVPA and sedentary time than women and participants who reported less fatigue had higher MVPA time. The highly active profile included survivors with high education level and normal body mass index. Haematological cancer survivors were less likely to have a highly active profile compared to breast cancer survivors. The highly sedentary profile included older participants, males, participants who were not married, obese, smokers, and those < 12 months after diagnosis. Conclusions Cancer survivors engage in few minutes of MVPA and spend a large proportion of their day sedentary. Correlates of MVPA, sedentary time and activity profiles can be used to identify cancer survivors at risk for a sedentary and inactive lifestyle. Electronic supplementary material The online version of this article (10.1186/s12966-019-0820-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- M G Sweegers
- Department of Epidemiology and Biostatistics, Amsterdam Public Health research institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.,Cancer Center Amsterdam, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - T Boyle
- Australian Centre for Precision Health, School of Health Sciences, University of South Australia Cancer Research Institute, Adelaide, Australia
| | - J K Vallance
- Faculty of Health Disciplines, Athabasca University, Athabasca, Canada
| | - M J Chinapaw
- Department of Public and Occupational Health, Amsterdam Public Health research institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - J Brug
- National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - N K Aaronson
- Division of Psychosocial Research and Epidemiology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - A D'Silva
- Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
| | - C S Kampshoff
- Department of Medical Oncology, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - B M Lynch
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Australia.,Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global health, The University of Melbourne, Melbourne, Australia.,Physical Activity Laboratory, Baker Heart and Diabetes Institute, Melbourne, Australia
| | - F Nollet
- Department of Rehabilitation, Amsterdam Movement Sciences institute, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - S M Phillips
- Department of Behavioural Medicine, Northwestern University, Chicago, USA
| | - M M Stuiver
- Center for Quality of Life, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - H van Waart
- Division of Psychosocial Research and Epidemiology, Netherlands Cancer Institute, Amsterdam, The Netherlands.,Department of Anesthesiology, University of Auckland, Auckland, New Zealand
| | - X Wang
- Department of Public and Occupational Health, Amsterdam Public Health research institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - L M Buffart
- Department of Epidemiology and Biostatistics, Amsterdam Public Health research institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.,Cancer Center Amsterdam, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.,Department of Medical Oncology, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - T M Altenburg
- Department of Public and Occupational Health, Amsterdam Public Health research institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
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Dobell AP, Eyre ELJ, Tallis J, Chinapaw MJM, Altenburg TM, Duncan MJ. Examining accelerometer validity for estimating physical activity in pre-schoolers during free-living activity. Scand J Med Sci Sports 2019; 29:1618-1628. [PMID: 31206785 DOI: 10.1111/sms.13496] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [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: 10/02/2018] [Revised: 05/29/2019] [Accepted: 06/07/2019] [Indexed: 01/01/2023]
Abstract
The present study examined the efficacy of accelerometers for the assessment of free play physical activity (PA) in pre-school-aged children with consideration of epoch length and wear location. Following ethics approval, parental informed consent, and child assent, 66 pre-schoolers aged 3-4 years (30 females and 36 males) wore an accelerometer (ActiGraph GT3X; sampling at 100 Hz) on their non-dominant wrist and their right hip during 1 hour of free play. Concurrently, direct observation, using the OSRAC-P, was used to determine sedentary behavior (SB), light (LPA), or moderate-to-vigorous (MVPA) intensity PA. For the ActiGraph, vertical axis counts and summed vector magnitude (VM) for hip, and VM for wrist, were downloaded using 5-, 10-, 15-, and 30-second epoch lengths. Accelerometer counts were averaged over each 30 seconds to match the observation periods. Receiver operating curve analysis was used to evaluate the ability of the ActiGraph to predict SB, LPA, and MVPA. SB and MVPA obtained from wrist- and hip-worn accelerometers demonstrated fair agreement with direct observation (AUC => 0.7). LPA determined by accelerometer had poor agreement with observed LPA, for both the hip and wrist placement (AUC = 0.53-0.56), with weak levels of specificity (0.34-0.43), although sensitivity was fair (0.74-0.84). This study is the first to examine accelerometer validity, considering wear location and epoch in pre-schoolers during free play, and suggests that the ActiGraph is a fair measure for SB and MVPA in pre-school children. Neither placement performed predominantly better irrespective of epochs or used count data (vertical axis, VM).
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Affiliation(s)
| | - Emma L J Eyre
- School of Life Sciences, Coventry University, Coventry, UK
| | - Jason Tallis
- School of Life Sciences, Coventry University, Coventry, UK
| | - Marijke J M Chinapaw
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam University Medical Center, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Teatske M Altenburg
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam University Medical Center, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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30
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Buffart LM, Sweegers MG, Huijsmans R, Brug J, Chin A Paw MJ, Altenburg TM. Relationship Between Accelerometer Output And Oxygen Consumption In Patients With Breast Cancer After Chemotherapy Treatment. Med Sci Sports Exerc 2019. [DOI: 10.1249/01.mss.0000563127.84926.c3] [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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Leask CF, Sandlund M, Skelton DA, Altenburg TM, Cardon G, Chinapaw MJM, De Bourdeaudhuij I, Verloigne M, Chastin SFM. Framework, principles and recommendations for utilising participatory methodologies in the co-creation and evaluation of public health interventions. Res Involv Engagem 2019; 5:2. [PMID: 30652027 PMCID: PMC6327557 DOI: 10.1186/s40900-018-0136-9] [Citation(s) in RCA: 169] [Impact Index Per Article: 33.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/04/2018] [Accepted: 12/10/2018] [Indexed: 05/23/2023]
Abstract
PLAIN ENGLISH SUMMARY Background: Society has to cope with a large burden of health issues. There is need to find solutions to prevent diseases and help individuals live healthier lifestyles. Individual needs and circumstances vary greatly and one size fit all solutions do not tend to work well. More tailored solutions centred on individuals' needs and circumstances can be developed in collaboration with these individuals. This process, known as co-creation, has shown promise but it requires guiding principles to improve its effectiveness. The aim of this study was to identify a key set of principles and recommendations for co-creating public health interventions.Methods: These principles were collaboratively developed through analysing a set of case studies targeting different health behaviours (such as reducing sitting and improving strength and balance) in different groups of people (such as adolescent schoolgirls and older adults living in the community).Results: The key principles of co-creation are presented in four stages: Planning (what is the purpose of the co-creation; and who should be involved?); Conducting (what activities can be used during co-creation; and how to ensure buy-in and commitment?); Evaluating (how do we know the process and the outcome are valid and effective?) and Reporting (how to report the findings?). Three models are proposed to show how co-created solutions can be scaled up to a population level.Conclusions: These recommendations aim to help the co-creation of public health interventions by providing a framework and governance to guide the process. ABSTRACT Background: Due to the chronic disease burden on society, there is a need for preventive public health interventions to stimulate society towards a healthier lifestyle. To deal with the complex variability between individual lifestyles and settings, collaborating with end-users to develop interventions tailored to their unique circumstances has been suggested as a potential way to improve effectiveness and adherence. Co-creation of public health interventions using participatory methodologies has shown promise but lacks a framework to make this process systematic. The aim of this paper was to identify and set key principles and recommendations for systematically applying participatory methodologies to co-create and evaluate public health interventions. Methods: These principles and recommendations were derived using an iterative reflection process, combining key learning from published literature in addition to critical reflection on three case studies conducted by research groups in three European institutions, all of whom have expertise in co-creating public health interventions using different participatory methodologies. Results: Key principles and recommendations for using participatory methodologies in public health intervention co-creation are presented for the stages of: Planning (framing the aim of the study and identifying the appropriate sampling strategy); Conducting (defining the procedure, in addition to manifesting ownership); Evaluating (the process and the effectiveness) and Reporting (providing guidelines to report the findings). Three scaling models are proposed to demonstrate how to scale locally developed interventions to a population level. Conclusions: These recommendations aim to facilitate public health intervention co-creation and evaluation utilising participatory methodologies by ensuring the process is systematic and reproducible.
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Affiliation(s)
- Calum F. Leask
- Glasgow Caledonian University, School of Health and Life Sciences, Institute of Applied Health Research, Glasgow, UK
- NHS Grampian, Health Intelligence Department, Aberdeen, UK
| | - Marlene Sandlund
- Department of Community Medicine and Rehabilitation, Umea University, Umea, Sweden
| | - Dawn A. Skelton
- Glasgow Caledonian University, School of Health and Life Sciences, Institute of Applied Health Research, Glasgow, UK
| | - Teatske M. Altenburg
- Department of Public and Occupational Health, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
| | - Greet Cardon
- Department of Movement and Sports Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Mai J. M. Chinapaw
- Department of Public and Occupational Health, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
| | - Ilse De Bourdeaudhuij
- Department of Movement and Sports Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Maite Verloigne
- Department of Movement and Sports Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Sebastien F. M. Chastin
- Glasgow Caledonian University, School of Health and Life Sciences, Institute of Applied Health Research, Glasgow, UK
- Department of Movement and Sports Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - on behalf of the GrandStand, Safe Step and Teenage Girls on the Move Research Groups
- Glasgow Caledonian University, School of Health and Life Sciences, Institute of Applied Health Research, Glasgow, UK
- NHS Grampian, Health Intelligence Department, Aberdeen, UK
- Department of Community Medicine and Rehabilitation, Umea University, Umea, Sweden
- Department of Public and Occupational Health, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
- Department of Movement and Sports Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
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Sweegers MG, Buffart LM, van Veldhuizen WM, Geleijn E, Verheul HMW, Brug J, Chinapaw MJM, Altenburg TM. How Does a Supervised Exercise Program Improve Quality of Life in Patients with Cancer? A Concept Mapping Study Examining Patients' Perspectives. Oncologist 2018; 24:e374-e383. [PMID: 30425179 DOI: 10.1634/theoncologist.2017-0613] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [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: 11/21/2017] [Accepted: 08/31/2018] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Previous systematic reviews and meta-analyses demonstrated beneficial effects of exercise during or following cancer treatment on quality of life (QoL). Aiming to understand how exercise contributes to a patient's QoL, we examined patients' perspectives via a process called concept mapping. This unique method provides structure and objectivity to rich qualitative data. METHODS Patients with cancer who were participating in an exercise program were invited to enroll. Eleven meetings with 3-10 patients were organized in which patients generated ideas in response to the question "How has participating in a supervised exercise program contributed positively to your QoL?" Next, patients individually clustered (based on similarity) and rated (based on importance) the ideas online. The online assessments were combined, and one concept map was created, visualizing clusters of ideas of how patients perceive that participating in a supervised exercise program improved their QoL. The research team labelled the clusters of ideas, and physiotherapists reflected on the clusters during semistructured interviews. RESULTS Sixty patients attended the meetings; of these, one patient was not able to generate an idea in response to the statement. Forty-four patients completed the online clustering and rating of ideas. The resulting concept map yielded six clusters: personalized care, coaching by a physiotherapist, social environment, self-concept, coping, and physical fitness and health. Personalized care was rated as most important. Overall, physiotherapists recognized these clusters in practice. CONCLUSION Patients with cancer reported that participating in a supervised exercise program improved their physical fitness and influenced social, mental, and cognitive factors, resulting in improvements in QoL. These results can be used to increase the awareness of the importance of supervised exercise programs for the QoL of patients with cancer. IMPLICATIONS FOR PRACTICE According to patients, a supervised exercise program contributes positively to their quality of life by improving physical fitness and health and providing personalized care, coaching by a physiotherapist, and improved social environment, self-concept, and coping. This knowledge could help to increase physicians' and patients' awareness of the importance of an exercise program during or following cancer treatment, possibly improving referral, participation, and adherence rates to these programs. Furthermore, patients' perspectives may be used to improve supervised exercise programs, taking into account the importance of personalized care, the supervision of a physiotherapist, the social environment, self-concept, and coping.
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Affiliation(s)
- Maike G Sweegers
- Department of Epidemiology and Biostatistics, Amsterdam Public Health Institute, Amsterdam University Medical Center, Amsterdam, The Netherlands
- Cancer Center Amsterdam, Amsterdam University Medical Center, Amsterdam, The Netherlands
| | - Laurien M Buffart
- Department of Epidemiology and Biostatistics, Amsterdam Public Health Institute, Amsterdam University Medical Center, Amsterdam, The Netherlands
- Department of Medical Oncology, Amsterdam University Medical Center, Amsterdam, The Netherlands
- Cancer Center Amsterdam, Amsterdam University Medical Center, Amsterdam, The Netherlands
| | - Wouke M van Veldhuizen
- Department of Epidemiology and Biostatistics, Amsterdam Public Health Institute, Amsterdam University Medical Center, Amsterdam, The Netherlands
| | - Edwin Geleijn
- Department of Rehabilitation, Amsterdam University Medical Center, Amsterdam, The Netherlands
| | - Henk M W Verheul
- Department of Medical Oncology, Amsterdam University Medical Center, Amsterdam, The Netherlands
- Cancer Center Amsterdam, Amsterdam University Medical Center, Amsterdam, The Netherlands
| | - Johannes Brug
- Amsterdam School of Communication Research, University of Amsterdam, Amsterdam, The Netherlands
| | - Mai J M Chinapaw
- Department of Public and Occupational Health, Amsterdam Public Health Institute, Amsterdam University Medical Center, Amsterdam, The Netherlands
| | - Teatske M Altenburg
- Department of Public and Occupational Health, Amsterdam Public Health Institute, Amsterdam University Medical Center, Amsterdam, The Netherlands
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Hidding LM, Chinapaw MJM, Altenburg TM. An activity-friendly environment from the adolescent perspective: a concept mapping study. Int J Behav Nutr Phys Act 2018; 15:99. [PMID: 30326895 PMCID: PMC6192111 DOI: 10.1186/s12966-018-0733-x] [Citation(s) in RCA: 8] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2018] [Accepted: 10/09/2018] [Indexed: 01/19/2023] Open
Abstract
Background In today’s society, few adolescents meet physical activity guidelines and effects of physical activity promoting programmes are disappointing. In studies exploring determinants of physical activity, the perspective of adolescents themselves is largely lacking. Also, there is a lack of knowledge on potential environmental determinants of adolescent physical activity. Therefore, this study aimed to explore adolescents’ perspectives on characteristics of an activity-friendly environment. Methods Concept mapping meetings were conducted with four secondary school classes, including 115 adolescents (13–17 years). Each student generated ideas regarding the characteristics of an activity-friendly environment. For each school class, ideas were combined and identical ideas were removed. Next, students individually sorted all ideas, based on self-perceived similarity, and rated their importance on a five-point Likert-scale. A concept map was created for each school class using multidimensional scaling and hierarchical cluster analysis. Finally, the researchers named the potential environmental determinants within the clusters. Results The concept maps depicted 23 unique potential determinants of activity friendliness, of which 15 were similar across all school classes. Potential determinants were categorized in the physical-, social-, economic-, and motivational domain. The most frequent and important adolescent-perceived determinants of activity friendliness across all school classes belonged to the physical domain, e.g. a suitable area including a proper surface for a variety of sports, and good lighting in the playground. Conclusions Our findings show that adolescents perceive potential determinants in the physical and economic domain as most important for activity friendliness, indicating that future interventions might benefit from targeting potential determinants within these domains. Electronic supplementary material The online version of this article (10.1186/s12966-018-0733-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- L M Hidding
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Van der Boechorststraat 7, NL-1081, BT, Amsterdam, The Netherlands.
| | - M J M Chinapaw
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Van der Boechorststraat 7, NL-1081, BT, Amsterdam, The Netherlands
| | - T M Altenburg
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Van der Boechorststraat 7, NL-1081, BT, Amsterdam, The Netherlands
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Sweegers MG, Altenburg TM, Brug J, May AM, van Vulpen JK, Aaronson NK, Arbane G, Bohus M, Courneya KS, Daley AJ, Galvao DA, Garrod R, Griffith KA, Van Harten WH, Hayes SC, Herrero-Román F, Kersten MJ, Lucia A, McConnachie A, van Mechelen W, Mutrie N, Newton RU, Nollet F, Potthoff K, Schmidt ME, Schmitz KH, Schulz KH, Sonke G, Steindorf K, Stuiver MM, Taaffe DR, Thorsen L, Twisk JW, Velthuis MJ, Wenzel J, Winters-Stone KM, Wiskemann J, Chin A Paw MJ, Buffart LM. Effects and moderators of exercise on muscle strength, muscle function and aerobic fitness in patients with cancer: a meta-analysis of individual patient data. Br J Sports Med 2018; 53:812. [DOI: 10.1136/bjsports-2018-099191] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/06/2018] [Indexed: 01/10/2023]
Abstract
ObjectiveTo optimally target exercise interventions for patients with cancer, it is important to identify which patients benefit from which interventions.DesignWe conducted an individual patient data meta-analysis to investigate demographic, clinical, intervention-related and exercise-related moderators of exercise intervention effects on physical fitness in patients with cancer.Data sourcesWe identified relevant studies via systematic searches in electronic databases (PubMed, Embase, PsycINFO and CINAHL).Eligibility criteriaWe analysed data from 28 randomised controlled trials investigating the effects of exercise on upper body muscle strength (UBMS) and lower body muscle strength (LBMS), lower body muscle function (LBMF) and aerobic fitness in adult patients with cancer.ResultsExercise significantly improved UBMS (β=0.20, 95% Confidence Interval (CI) 0.14 to 0.26), LBMS (β=0.29, 95% CI 0.23 to 0.35), LBMF (β=0.16, 95% CI 0.08 to 0.24) and aerobic fitness (β=0.28, 95% CI 0.23 to 0.34), with larger effects for supervised interventions. Exercise effects on UBMS were larger during treatment, when supervised interventions included ≥3 sessions per week, when resistance exercises were included and when session duration was >60 min. Exercise effects on LBMS were larger for patients who were living alone, for supervised interventions including resistance exercise and when session duration was >60 min. Exercise effects on aerobic fitness were larger for younger patients and when supervised interventions included aerobic exercise.ConclusionExercise interventions during and following cancer treatment had small effects on UBMS, LBMS, LBMF and aerobic fitness. Demographic, intervention-related and exercise-related characteristics including age, marital status, intervention timing, delivery mode and frequency and type and time of exercise sessions moderated the exercise effect on UBMS, LBMS and aerobic fitness.
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Busch V, Altenburg TM, Harmsen IA, Chinapaw MJ. Interventions that stimulate healthy sleep in school-aged children: a systematic literature review. Eur J Public Health 2018; 27:53-65. [PMID: 28177474 DOI: 10.1093/eurpub/ckw140] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Background Healthy sleep among children has social, physical and mental health benefits. As most of today’s children do not meet the healthy sleep recommendations, effective interventions are urgently needed. This systematic review summarizes the characteristics and effectiveness of interventions aiming to stimulate healthy sleeping in a general population of school-aged children. Methods The search engines PubMed, Embase, Web of Science, PsycInfo and the Cochrane Database Library were systematically searched up to March 2016. We included all studies evaluating interventions targeting healthy sleep duration and/or bedtime routines of children aged 4–12 years. All steps in this systematic review, i.e. search, study selection, quality assessment and data extraction, were performed following CRD Guidelines and reported according to the PRISMA Statement. Results Eleven studies were included, of which only two were of strong quality. The interventions varied in terms of targeted determinants and intervention setting. Overall, no evidence was found favoring a particular intervention strategy. One intervention that delayed school start time and two multi-behavioral interventions that targeted both the school and home setting showed promising effects in terms of increasing sleep duration. Conclusion Due to few high quality studies, evidence for the effectiveness of any particular intervention strategy to stimulate healthy sleep in children is still inconclusive. However, the more effective interventions in stimulating healthy sleep duration and adherence to regular bedtimes were mostly multi-behavioral interventions that included creating daily healthy routines and combined intervention settings (e.g. home and school). In conclusion, high-quality studies evaluating systematically developed interventions are needed to move this field forward.
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Affiliation(s)
- Vincent Busch
- Department of Epidemiology & Health Promotion, Section Youth, Municipal Health Service Amsterdam, Amsterdam, The Netherlands
| | - Teatske M Altenburg
- Department of Public and Occupational Health, VU University Medical Center, EMGO Institute for Health and Care Research, Amsterdam, The Netherlands
| | - Irene A Harmsen
- Department of Epidemiology & Health Promotion, Section Youth, Municipal Health Service Amsterdam, Amsterdam, The Netherlands
| | - Mai J Chinapaw
- Department of Public and Occupational Health, VU University Medical Center, EMGO Institute for Health and Care Research, Amsterdam, The Netherlands
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Sweegers MG, Altenburg TM, Chinapaw MJ, Kalter J, Verdonck-de Leeuw IM, Courneya KS, Newton RU, Aaronson NK, Jacobsen PB, Brug J, Buffart LM. Which exercise prescriptions improve quality of life and physical function in patients with cancer during and following treatment? A systematic review and meta-analysis of randomised controlled trials. Br J Sports Med 2017; 52:505-513. [PMID: 28954800 DOI: 10.1136/bjsports-2017-097891] [Citation(s) in RCA: 136] [Impact Index Per Article: 19.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/18/2017] [Indexed: 12/17/2022]
Abstract
OBJECTIVE Certain exercise prescriptions for patients with cancer may improve self-reported quality of life (QoL) and self-reported physical function (PF). We investigated the effects of exercise on QoL and PF in patients with cancer and studied differences in effects between different intervention-related and exercise-related characteristics. DESIGN We searched four electronic databases to identify randomised controlled trials investigating exercise effects on QoL and PF in patients with cancer. Pooled effects (Hedges' g) were calculated using Comprehensive Meta-Analysis software. Subgroup analyses were conducted based on intervention dimensions, including timing, duration and delivery mode, and exercise dimensions, including frequency, intensity, type and time (FITT factors). RESULTS We included 74 exercise arms. Patients who were randomised to exercise interventions had significantly improved QoL (g=0.15, 95% CI (0.10 to 0.20), n=67 exercise arms) and PF (g=0.21, 95% CI (0.15 to 0.27), n=59 exercise arms) compared with patients in control groups. We found a significant between-group difference for exercise delivery mode, with significant beneficial effects for supervised exercise interventions (g=0.20, 95% CI (0.14 to 0.26) for QoL and g=0.27, 95% CI (0.20 to 0.33) for PF), but not for unsupervised interventions (g=0.04, 95% CI (-0.06 to 0.13) for QoL and g=0.09, 95% CI (-0.01 to 0.19) for PF). No statistically significant differences in intervention effects were found for variations in intervention timing, duration or exercise FITT factors. Unsupervised exercise with higher weekly energy expenditure was more effective than unsupervised exercise with lower energy expenditure (z=2.34, p=0.02). CONCLUSIONS Exercise interventions, especially when supervised, have statistically significant and small clinical benefit on self-reported QoL and PF in patients with cancer. Unsupervised exercise intervention effects on PF were larger when prescribed at a higher weekly energy expenditure.
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Affiliation(s)
- Maike G Sweegers
- Department of Epidemiology and Biostatistics, Amsterdam Public Health Institute, VU University Medical Center, Amsterdam, The Netherlands.,Cancer Center Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
| | - Teatske M Altenburg
- Department of Public and Occupational Health, Amsterdam Public Health Institute, VU University Medical Center, Amsterdam, The Netherlands
| | - Mai J Chinapaw
- Department of Public and Occupational Health, Amsterdam Public Health Institute, VU University Medical Center, Amsterdam, The Netherlands
| | - Joeri Kalter
- Department of Epidemiology and Biostatistics, Amsterdam Public Health Institute, VU University Medical Center, Amsterdam, The Netherlands.,Cancer Center Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
| | - Irma M Verdonck-de Leeuw
- Cancer Center Amsterdam, VU University Medical Center, Amsterdam, The Netherlands.,Department of Otolaryngology-Head and Neck Surgery, VU University Medical Center, Amsterdam, The Netherlands.,Department of Clinical Psychology, Vrije Universiteit, Amsterdam, The Netherlands
| | - Kerry S Courneya
- Faculty of Physical Education and Recreation, University of Alberta, Edmonton, Alberta, Canada
| | - Robert U Newton
- Exercise Medicine Research Institute, Edith Cowan University, Joondalup, Western Australia, Australia
| | - Neil K Aaronson
- Division of Psychosocial Research and Epidemiology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Paul B Jacobsen
- Division of Population Science, Moffitt Cancer Center and Research Institute, Amsterdam, The Netherlands
| | - Johannes Brug
- Department of Epidemiology and Biostatistics, Amsterdam Public Health Institute, VU University Medical Center, Amsterdam, The Netherlands.,Amsterdam School of Communication Research (ASCoR), University of Amsterdam, Amsterdam, The Netherlands
| | - Laurien M Buffart
- Department of Epidemiology and Biostatistics, Amsterdam Public Health Institute, VU University Medical Center, Amsterdam, The Netherlands.,Cancer Center Amsterdam, VU University Medical Center, Amsterdam, The Netherlands.,Exercise Medicine Research Institute, Edith Cowan University, Joondalup, Western Australia, Australia.,Department of Medical Oncology, VU University Medical Center, Amsterdam, The Netherlands
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37
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Verloigne M, Ridgers ND, Chinapaw M, Altenburg TM, Bere E, Van Lippevelde W, Cardon G, Brug J, De Bourdeaudhuij I. Patterns of objectively measured sedentary time in 10- to 12-year-old Belgian children: an observational study within the ENERGY-project. BMC Pediatr 2017; 17:147. [PMID: 28615079 PMCID: PMC5471712 DOI: 10.1186/s12887-017-0894-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2016] [Accepted: 05/31/2017] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND This study examined the frequency of and differences in sedentary bouts of different durations and the total time spent in sedentary bouts on a weekday, a weekend day, during school hours, during after-school hours and in the evening period in a sample of 10- to 12-year-old Belgian children. METHODS Accelerometer data were collected as part of the ENERGY-project in Belgium (n = 577, 10.9 ± 0.7 years, 53% girls) in 2011. Differences in total sedentary time, sedentary bouts of 2-5, 5-10, 10-20, 20-30 and ≥30 min and total time accumulated in those bouts were examined on a weekday, a weekend day, during school hours, during after-school hours and in the evening period, using multilevel analyses in MLwiN 2.22. RESULTS More than 60% of the participants' waking time was spent sedentary. Children typically engaged in short sedentary bouts of 2-5 and 5-10 min, which contributed almost 50% towards their total daily sedentary time. Although the differences were very small, children engaged in significantly fewer sedentary bouts of nearly all durations during after-school hours compared to during school hours and in the evening period. Children also engaged in significantly fewer sedentary bouts of 5-10, 10-20, and 20-30 min per hour on a weekend day than on a weekday. CONCLUSIONS Although primary school children spend more than 60% of their waking time sedentary, they generally engaged in short sedentary bouts. Children's sedentary bouts were slightly longer on weekdays, particularly during school hours and in the evening period, although the differences were very small. These results suggest that in this age group, interventions focusing on reducing total sedentary time rather than interrupting prolonged sedentary time are needed.
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Affiliation(s)
- Maïté Verloigne
- Department of Movement and Sport Sciences, Ghent University, Watersportlaan 2, 9000, Ghent, Belgium. .,Research Foundation Flanders (FWO), Egmontstraat 5, 1000, Brussel, Belgium.
| | - Nicola D Ridgers
- Deakin University, Geelong, Australia, Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Burwood, Australia
| | - Mai Chinapaw
- Department of Public and Occupational Health and the EMGO Institute for Health & Care Research, VU Medical Center, Amsterdam, the Netherlands
| | - Teatske M Altenburg
- Department of Public and Occupational Health and the EMGO Institute for Health & Care Research, VU Medical Center, Amsterdam, the Netherlands
| | - Elling Bere
- Department of Public Health, Sport and Nutrition, University of Agder, Kristiansand, Norway
| | | | - Greet Cardon
- Department of Movement and Sport Sciences, Ghent University, Watersportlaan 2, 9000, Ghent, Belgium
| | - Johannes Brug
- Department of Epidemiology and Biostatistics and the EMGO Institute for Health & Care Research, VU University Medical Center, Amsterdam, the Netherlands
| | - Ilse De Bourdeaudhuij
- Department of Movement and Sport Sciences, Ghent University, Watersportlaan 2, 9000, Ghent, Belgium
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Tremblay MS, Aubert S, Barnes JD, Saunders TJ, Carson V, Latimer-Cheung AE, Chastin SF, Altenburg TM, Chinapaw MJ. Sedentary Behavior Research Network (SBRN) - Terminology Consensus Project process and outcome. Int J Behav Nutr Phys Act 2017; 14:75. [PMID: 28599680 PMCID: PMC5466781 DOI: 10.1186/s12966-017-0525-8] [Citation(s) in RCA: 1771] [Impact Index Per Article: 253.0] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2017] [Accepted: 05/16/2017] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND The prominence of sedentary behavior research in health science has grown rapidly. With this growth there is increasing urgency for clear, common and accepted terminology and definitions. Such standardization is difficult to achieve, especially across multi-disciplinary researchers, practitioners, and industries. The Sedentary Behavior Research Network (SBRN) undertook a Terminology Consensus Project to address this need. METHOD First, a literature review was completed to identify key terms in sedentary behavior research. These key terms were then reviewed and modified by a Steering Committee formed by SBRN. Next, SBRN members were invited to contribute to this project and interested participants reviewed and provided feedback on the proposed list of terms and draft definitions through an online survey. Finally, a conceptual model and consensus definitions (including caveats and examples for all age groups and functional abilities) were finalized based on the feedback received from the 87 SBRN member participants who responded to the original invitation and survey. RESULTS Consensus definitions for the terms physical inactivity, stationary behavior, sedentary behavior, standing, screen time, non-screen-based sedentary time, sitting, reclining, lying, sedentary behavior pattern, as well as how the terms bouts, breaks, and interruptions should be used in this context are provided. CONCLUSION It is hoped that the definitions resulting from this comprehensive, transparent, and broad-based participatory process will result in standardized terminology that is widely supported and adopted, thereby advancing future research, interventions, policies, and practices related to sedentary behaviors.
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Affiliation(s)
- Mark S. Tremblay
- Healthy Active Living and Obesity Research Group, Children’s Hospital of Eastern Ontario Research Institute, 401 Smyth Road, Ottawa, ON K1H 8L1 Canada
| | - Salomé Aubert
- Healthy Active Living and Obesity Research Group, Children’s Hospital of Eastern Ontario Research Institute, 401 Smyth Road, Ottawa, ON K1H 8L1 Canada
| | - Joel D. Barnes
- Healthy Active Living and Obesity Research Group, Children’s Hospital of Eastern Ontario Research Institute, 401 Smyth Road, Ottawa, ON K1H 8L1 Canada
| | - Travis J. Saunders
- Department of Applied Human Sciences, University of Prince Edward Island, Charlottetown, PEI C1A 4P3 Canada
| | - Valerie Carson
- Faculty of Physical Education and Recreation, University of Alberta, Edmonton, AB T6G 2H9 Canada
| | - Amy E. Latimer-Cheung
- School of Kinesiology and Health Studies, Queen’s University, Kingston, ON K7L 3N6 Canada
| | - Sebastien F.M. Chastin
- Institute of Applied Health Research, Glasgow Caledonian University, Glasgow, Scotland
- Department of Movement and Sport Sciences, Ghent University, Ghent, Belgium
| | - Teatske M. Altenburg
- VU University Medical Center, Amsterdam Public Health Research Institute, Amsterdam, Netherlands
| | - Mai J.M. Chinapaw
- VU University Medical Center, Amsterdam Public Health Research Institute, Amsterdam, Netherlands
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van Ekris E, Altenburg TM, Singh AS, Proper KI, Heymans MW, Chinapaw MJM. An evidence-update on the prospective relationship between childhood sedentary behaviour and biomedical health indicators: a systematic review and meta-analysis. Obes Rev 2017; 18:712-714. [PMID: 28474511 DOI: 10.1111/obr.12526] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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40
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Kornet-van der Aa DA, Altenburg TM, van Randeraad-van der Zee CH, Chinapaw MJM. The effectiveness and promising strategies of obesity prevention and treatment programmes among adolescents from disadvantaged backgrounds: a systematic review. Obes Rev 2017; 18:581-593. [PMID: 28273680 DOI: 10.1111/obr.12519] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [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: 08/15/2016] [Revised: 01/06/2017] [Accepted: 01/06/2017] [Indexed: 02/06/2023]
Abstract
This review aimed to summarize the evidence on the effectiveness of obesity prevention and treatment programmes for adolescents from socioeconomically disadvantaged backgrounds. A secondary aim was to identify potential successful intervention strategies for this target group. PubMed, EMBASE, PsycINFO and Cochrane Library were searched from January 2000 up to February 2016. Intervention studies targeting adolescents from disadvantaged backgrounds were included, with body mass index as outcome. Secondary outcomes were other adiposity measures, physical activity, diet, sedentary behaviour and screen time. Two independent reviewers extracted data, coded intervention strategies and conducted quality assessments. Fourteen studies were included: nine obesity prevention and five obesity treatment studies. Two preventive and four treatment studies showed significant beneficial effects on body mass index. Five of six studies (four preventive, one treatment studies) measuring dietary behaviour reported significant intervention effects. Evidence on other secondary outcomes was inconclusive. We found no conclusive evidence for which specific intervention strategies were particularly successful in preventing or treating obesity among disadvantaged adolescents. However, the current evidence suggests that involving adolescents in the development and delivering of interventions, the use of experiential activities and involvement of parents seem to be promising strategies. More high quality studies are needed. PROSPERO registration number: CRD42016041612.
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Affiliation(s)
- D A Kornet-van der Aa
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, The Netherlands
| | - T M Altenburg
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, The Netherlands
| | - C H van Randeraad-van der Zee
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, The Netherlands
| | - M J M Chinapaw
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, The Netherlands
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41
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Altenburg TM, Singh AS, Te Velde S, De Bourdeaudhuij I, Lien N, Bere E, Molnár D, Jan N, Fernández-Alvira JM, Manios Y, Bringolf-Isler B, Brug J, Chinapaw MJ. Actual and perceived weight status and its association with slimming and energy-balance related behaviours in 10- to 12-year-old European children: the ENERGY-project. Pediatr Obes 2017; 12:137-145. [PMID: 26916601 DOI: 10.1111/ijpo.12120] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [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: 01/06/2015] [Revised: 12/17/2015] [Accepted: 01/17/2016] [Indexed: 11/27/2022]
Abstract
BACKGROUND Both parents' and children's perception of children's weight status may be important predictors of slimming and energy-balance related behaviours, independent of children's actual weight status. OBJECTIVES We examined the cross-sectional association of children's self-reported slimming and energy-balance related behaviours with children's (i) actual, (ii) self-perceived and (iii) parent-perceived weight status. METHODS Data of 10- to 12-year-old European children and their parents were used. Multilevel logistic and linear regression analyses were performed, adjusting for age, gender, parental weight controlling behaviours, education, marital status and ethnicity. RESULTS Independent of their actual weight status, a higher proportion of children reported slimming when they or their parents perceived them as too fat. Children's self-perceived weight status was more strongly associated with slimming than their parents' perception or their actual weight status. Moreover, children who perceive themselves as overweight reported less physical activity and more screen time. Children whose parents perceive them as overweight reported less physical activity. CONCLUSIONS Children's own perception of their weight status appears to be more important for their self-reported slimming than their actual or their parent's perceptions of their weight status. Additionally, children's self-perceived weight status seems important in engaging more physical activity and reduces screen time.
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Affiliation(s)
- T M Altenburg
- EMGO Institute for Health and Care Research, Department of Public and Occupational Health, VU University Medical Center, Amsterdam, The Netherlands
| | - A S Singh
- EMGO Institute for Health and Care Research, Department of Public and Occupational Health, VU University Medical Center, Amsterdam, The Netherlands
| | - S Te Velde
- EMGO Institut1e for Health and Care Research, Department of Epidemiology & Biostatistics, VU University Medical Center, Amsterdam, The Netherlands
| | - I De Bourdeaudhuij
- Department of Movement and Sport Sciences, Ghent University, Ghent, Belgium
| | - N Lien
- Department of Nutrition, University of Oslo, Oslo, Norway
| | - E Bere
- Department of Public Health, Sport and Nutrition, University of Agder, Kristiansand, Norway
| | - D Molnár
- Department of Paediatrics, University of Pécs, Pécs, Hungary
| | - N Jan
- Slovenian Heart Foundation, Ljubljana, Slovenia
| | - J M Fernández-Alvira
- Faculty of Health Sciences, Department of Physical Medicine and Nursing, University of Zaragoza, Zaragoza, Spain
| | - Y Manios
- School of Health Science and Education, Department of Nutrition-Dietetics, Harokopio University Athens, Athens, Greece
| | - B Bringolf-Isler
- Department of Epidemiology and Public Health, Swiss TPH, Basel, Switzerland.,University of Basel, Basel, Switzerland
| | - J Brug
- EMGO Institut1e for Health and Care Research, Department of Epidemiology & Biostatistics, VU University Medical Center, Amsterdam, The Netherlands
| | - M J Chinapaw
- EMGO Institute for Health and Care Research, Department of Public and Occupational Health, VU University Medical Center, Amsterdam, The Netherlands
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Altenburg TM, Rotteveel J, Serné EH, Chinapaw MJM. Effects of Multiple Sedentary Days on Metabolic Risk Factors in Free-Living Conditions: Lessons Learned and Future Recommendations. Front Physiol 2016; 7:616. [PMID: 28018243 PMCID: PMC5145882 DOI: 10.3389/fphys.2016.00616] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [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: 05/06/2016] [Accepted: 11/25/2016] [Indexed: 11/17/2022] Open
Abstract
Background: Recent experimental studies in adults have demonstrated that interruptions to prolonged sitting have beneficial effects on metabolic risk factors in adults, compared to prolonged sitting. We explored the hypothesis that multiple consecutive days of predominantly prolonged sedentary time may have an unfavorable effect on the postprandial response of C-peptide, glucose, and triglycerides in free-living healthy young men. Methods: In this explorative pilot study, healthy young men (n = 7; 18–23 years) consumed standardized mixed meals at 1 and 5 h during two experimental laboratory-sitting days, with 6 days of predominantly prolonged sedentary time in between. Serum and plasma samples were obtained hourly from 0 to 8 h for measurement of glucose, C-peptide, and triglycerides. Participant's sedentary time was monitored using an accelerometer during the prolonged sedentary days as well as during 6 normal days prior to the first laboratory day. Differences in postprandial levels were assessed using generalized estimating equations analysis. Due to the explorative nature of this study and the small sample size, p-value was set at <0.10. Results: Overall, when expressed as % of wear time, sedentary time was 5% higher during the 6 prolonged sedentary days, which was not significantly different compared to the 6 normal days (n = 4). Following 6 prolonged sedentary days, postprandial levels of C-peptide were significantly higher than at baseline (B = 0.11; 90%CI = [0.002; 0.22]; n = 7). Postprandial levels of glucose and triglycerides were not significantly different between the 2 laboratory days. Conclusions: Due to the relatively high sedentary time at baseline, participants were unable to increase their sedentary time substantially. Nevertheless, postprandial C-peptide levels were slightly higher after 6 prolonged sedentary days than after 6 normal days.
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Affiliation(s)
- Teatske M Altenburg
- Department of Public and Occupational Health, EMGO Institute for Health and Care Research, VU University Medical Center Amsterdam, Netherlands
| | - Joost Rotteveel
- Department of Pediatrics, VU University Medical Center Amsterdam, Netherlands
| | - Erik H Serné
- Department of Internal Medicine, VU University Medical Center Amsterdam, Netherlands
| | - Mai J M Chinapaw
- Department of Public and Occupational Health, EMGO Institute for Health and Care Research, VU University Medical Center Amsterdam, Netherlands
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van Ekris E, Altenburg TM, Singh AS, Proper KI, Heymans MW, Chinapaw MJM. An evidence-update on the prospective relationship between childhood sedentary behaviour and biomedical health indicators: a systematic review and meta-analysis. Obes Rev 2016; 17:833-49. [PMID: 27256486 DOI: 10.1111/obr.12426] [Citation(s) in RCA: 120] [Impact Index Per Article: 15.0] [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: 02/08/2016] [Revised: 04/06/2016] [Accepted: 04/18/2016] [Indexed: 12/01/2022]
Abstract
Evidence for adverse health effects of excessive sedentary behaviour in children is predominantly based on cross-sectional studies, measuring TV viewing as proxy for sedentary behaviour. This systematic review and meta-analysis summarizes the evidence on the prospective relationship between childhood sedentary behaviour and biomedical health indicators, overall and stratified by type of sedentary behaviour (TV viewing, computer use/games, screen time and objective sedentary time). PubMed, EMBASE, PsycINFO and Cochrane were systematically searched till January 2015. Methodological quality of all included studies was scored, and a best evidence synthesis was applied. We included 109 studies of which 19 were of high quality. We found moderate-to-strong evidence for a relationship of overall sedentary time with some anthropometrics (overweight/obesity, weight-for-height), one cardiometabolic biomarker (HDL-cholesterol) and some fitness indicators (fitness, being unfit). For other health indicators, we found no convincing evidence because of inconsistent or non-significant findings. The evidence varied by type of sedentary behaviour. The meta-analysis indicated that each additional baseline hour of TV viewing (β = 0.01, 95%CI = [-0.002; 0.02]) or computer use (β = 0.00, 95%CI = [-0.004; 0.01]) per day was not significantly related with BMI at follow-up. We conclude that the evidence for a prospective relationship between childhood sedentary behaviour and biomedical health is in general unconvincing.
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Affiliation(s)
- E van Ekris
- Department of Public and Occupational Health, VU University Medical Center, EMGO Institute for Health and Care Research, Amsterdam, The Netherlands
| | - T M Altenburg
- Department of Public and Occupational Health, VU University Medical Center, EMGO Institute for Health and Care Research, Amsterdam, The Netherlands
| | - A S Singh
- Department of Public and Occupational Health, VU University Medical Center, EMGO Institute for Health and Care Research, Amsterdam, The Netherlands
| | - K I Proper
- Department of Public and Occupational Health, VU University Medical Center, EMGO Institute for Health and Care Research, Amsterdam, The Netherlands
| | - M W Heymans
- Department of Epidemiology and Biostatistics, VU University Medical Center, EMGO Institute for Health and Care Research, Amsterdam, The Netherlands
| | - M J M Chinapaw
- Department of Public and Occupational Health, VU University Medical Center, EMGO Institute for Health and Care Research, Amsterdam, The Netherlands
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Terwee CB, Mokkink LB, Hidding LM, Altenburg TM, van Poppel MN, Chinapaw MJM. Comment on "Should we reframe how we think about physical activity and sedentary behavior measurement? Validity and reliability reconsidered". Int J Behav Nutr Phys Act 2016; 13:66. [PMID: 27287522 PMCID: PMC4901471 DOI: 10.1186/s12966-016-0392-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2016] [Accepted: 06/04/2016] [Indexed: 11/13/2022] Open
Abstract
With great interest we read the article by Kelly et al. on the measurement of physical activity (PA) and sedentary behavior (SB) (Kelly P et al. Int J Behav Nutr Phys Act 13:(1) 32, 2016). We appreciate the invitation of the authors to provide feedback on their ideas and we take this opportunity to contribute to the discussion. Our main proposition is that this field can learn much from the field of quality of life research and the methodology developed for validating quality of life questionnaires.
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Affiliation(s)
- Caroline B Terwee
- Department of Epidemiology and Biostatistics and the EMGO Institute for Health and Care Research, VU University Medical Center, F-building MedFac, P.O. box 7057, 1007 MB, Amsterdam, The Netherlands.
| | - L B Mokkink
- Department of Epidemiology and Biostatistics and the EMGO Institute for Health and Care Research, VU University Medical Center, F-building MedFac, P.O. box 7057, 1007 MB, Amsterdam, The Netherlands
| | - L M Hidding
- Department of Public and Occupational Health and the EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
| | - T M Altenburg
- Department of Public and Occupational Health and the EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
| | - M N van Poppel
- Department of Public and Occupational Health and the EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
| | - M J M Chinapaw
- Department of Public and Occupational Health and the EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
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45
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van Ekris E, Altenburg TM, Vos EE, Chinapaw MJM. [An evidence-update on the prospective relationship between childhood sedentary behaviour and biomedical health indicators: a systematic review and meta-analysis]. Ned Tijdschr Geneeskd 2016; 160:D805. [PMID: 27552938] [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] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
This systematic review and meta-analysis summarizes the evidence on the prospective relationship between childhood sedentary behaviour and biomedical health indicators, overall and stratified by type of sedentary behaviour (TV viewing, computer use/games, screen time and objective sedentary time).
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Affiliation(s)
- E van Ekris
- *Dit is een bewerking van een artikel dat eerder werd gepubliceerd in Obesity Reviews (3 juni 2016; epub) met als titel 'An evidence-update on the prospective relationship between childhood sedentary behaviour and biomedical health indicators: a systematic review and meta-analysis'. Afgedrukt met toestemming
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Altenburg TM, Chinapaw MJM, Singh AS. Effects of one versus two bouts of moderate intensity physical activity on selective attention during a school morning in Dutch primary schoolchildren: A randomized controlled trial. J Sci Med Sport 2015; 19:820-4. [PMID: 26724833 DOI: 10.1016/j.jsams.2015.12.003] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [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: 11/20/2014] [Revised: 10/16/2015] [Accepted: 12/06/2015] [Indexed: 12/13/2022]
Abstract
OBJECTIVES Evidence suggests that physical activity is positively related to several aspects of cognitive functioning in children, among which is selective attention. To date, no information is available on the optimal frequency of physical activity on cognitive functioning in children. The current study examined the acute effects of one and two bouts of moderate-intensity physical activity on children's selective attention. DESIGN Randomized controlled trial (ISRCTN97975679). METHODS Thirty boys and twenty-six girls, aged 10-13 years, were randomly assigned to three conditions: (A) sitting all morning working on simulated school tasks; (B) one 20-min physical activity bout after 90min; and (C) two 20-min physical activity bouts, i.e. at the start and after 90min. Selective attention was assessed at five time points during the morning (i.e. at baseline and after 20, 110, 130 and 220min), using the 'Sky Search' subtest of the 'Test of Selective Attention in Children'. We used GEE analysis to examine differences in Sky Search scores between the three experimental conditions, adjusting for school, baseline scores, self-reported screen time and time spent in sports. RESULTS Children who performed two 20-min bouts of moderate-intensity physical activity had significantly better Sky Search scores compared to children who performed one physical activity bout or remained seated the whole morning (B=-0.26; 95% CI=[-0.52; -0.00]). CONCLUSIONS Our findings support the importance of repeated physical activity during the school day for beneficial effects on selective attention in children.
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Affiliation(s)
- Teatske M Altenburg
- Department of Public and Occupational Health EMGO Institute for Health and Care Research, VU University Medical Center, The Netherlands.
| | - Mai J M Chinapaw
- Department of Public and Occupational Health EMGO Institute for Health and Care Research, VU University Medical Center, The Netherlands
| | - Amika S Singh
- Department of Public and Occupational Health EMGO Institute for Health and Care Research, VU University Medical Center, The Netherlands
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Gebremariam MK, Altenburg TM, Lakerveld J, Andersen LF, Stronks K, Chinapaw MJ, Lien N. Associations between socioeconomic position and correlates of sedentary behaviour among youth: a systematic review. Obes Rev 2015; 16:988-1000. [PMID: 26317685 DOI: 10.1111/obr.12314] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [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: 06/02/2015] [Revised: 07/24/2015] [Accepted: 07/24/2015] [Indexed: 10/23/2022]
Abstract
Existing research evidence indicates that children and adolescents of parents with a low socioeconomic position spend more time on sedentary behaviour than their counterparts. However, the mechanisms driving these differences remain poorly understood. The main aim of this systematic review was to summarize the evidence regarding the association between socioeconomic position and correlates of sedentary behaviour among youth (0-18 years) from developed countries. The literature search was conducted using MEDLINE, Embase, CINAHL and PsycINFO. A total of 37 studies were included. All but three studies examined screen-based sedentary behaviours only. Methodological quality ranged from low to moderate. Education was the most commonly used indicator of socioeconomic position, followed by income. Socioeconomic position was inversely related to the presence of a TV in the child's bedroom, parental modelling for TV viewing, parental co-viewing and eating meals in front of the TV. We found no/indeterminate evidence for an association between socioeconomic position and rules and regulations about screen time. The findings suggest possible factors that could be targeted in future intervention studies to decrease screen-based sedentary behaviour in lower socioeconomic groups in particular.
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Affiliation(s)
- M K Gebremariam
- Department of Nutrition, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - T M Altenburg
- Department of Public and Occupational Health, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
| | - J Lakerveld
- Department of Epidemiology and Biostatistics and the EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
| | - L F Andersen
- Department of Nutrition, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - K Stronks
- Department of Public Health, Faculty of Medicine, University of Amsterdam, Amsterdam, The Netherlands
| | - M J Chinapaw
- Department of Public and Occupational Health, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
| | - N Lien
- Department of Nutrition, Faculty of Medicine, University of Oslo, Oslo, Norway
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van der Willik EM, Vrijkotte TGM, Altenburg TM, Gademan MGJ, Kist-van Holthe J. Exclusively breastfed overweight infants are at the same risk of childhood overweight as formula fed overweight infants. Arch Dis Child 2015; 100:932-7. [PMID: 26044134 DOI: 10.1136/archdischild-2015-308386] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [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: 02/05/2015] [Accepted: 05/13/2015] [Indexed: 11/03/2022]
Abstract
BACKGROUND AND OBJECTIVE Several early life determinants play a role in childhood obesity. Rapid weight gain and overweight in infancy increases the risk while breast feeding seems to protect against childhood overweight. However, should we worry about exclusively breastfed overweight infants? The aim of the study is to examine the association of feeding type (exclusive breast feeding (EBF), formula feeding or mixed feeding) and overweight at the age of 6 months with the risk of overweight at the age of 5-6 years. METHODS The Amsterdam Born Children and their Development study is a large prospective population-based birth cohort study conducted in Amsterdam, the Netherlands. Children with complete information pertaining to feeding type and weight status at the age of 6 months and 5-6 years were included (N=3367). EBF was defined as receiving only breast feeding for at least 3 months. Overweight at the ages of 6 months and 5-6 years were defined by the WHO child growth standards and the International Obesity Task Force guidelines, respectively. The association of feeding type and overweight at 6 months with overweight at 5-6 years was assessed using logistic regression analyses. RESULTS Overweight infants have a 4.10-fold (95% CI 2.91 to 5.78) higher odds of childhood overweight compared with those who were not overweight, independent of feeding type. EBF did not affect the association between infant overweight and childhood overweight. CONCLUSIONS Overweight in infancy increases the odds of childhood overweight, equally for exclusively breastfed and formula fed infants. Overweight prevention should start before or at birth and applies to formula fed children as well as exclusively breastfed children.
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Affiliation(s)
- Esmee M van der Willik
- Department of Public and Occupational Health, EMGO Institute for Health and Care Research-VU University Medical Center, Amsterdam, The Netherlands
| | - Tanja G M Vrijkotte
- Department Public Health, Academic Medical Center, Amsterdam, The Netherlands
| | - Teatske M Altenburg
- Department of Public and Occupational Health, EMGO Institute for Health and Care Research-VU University Medical Center, Amsterdam, The Netherlands
| | - Maaike G J Gademan
- Department Public Health, Academic Medical Center, Amsterdam, The Netherlands
| | - Joana Kist-van Holthe
- Department of Public and Occupational Health, EMGO Institute for Health and Care Research-VU University Medical Center, Amsterdam, The Netherlands
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Altenburg TM, de Niet M, Verloigne M, De Bourdeaudhuij I, Androutsos O, Manios Y, Kovacs E, Bringolf-Isler B, Brug J, Chinapaw MJM. Occurrence and duration of various operational definitions of sedentary bouts and cross-sectional associations with cardiometabolic health indicators: the ENERGY-project. Prev Med 2015; 71:101-6. [PMID: 25535676 DOI: 10.1016/j.ypmed.2014.12.015] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [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: 07/17/2014] [Revised: 11/16/2014] [Accepted: 12/13/2014] [Indexed: 01/27/2023]
Abstract
OBJECTIVE This study examined the occurrence and duration of sedentary bouts and explored the cross-sectional association with health indicators in children applying various operational definitions of sedentary bouts. METHODS Accelerometer data of 647 children (10-13 years old) were collected in five European countries. We analyzed sedentary time (<100 cpm) accumulated in bouts of at least 5, 10, 20 or 30 min based on four operational definitions, allowing 0, 30 or 60s ≥100 cpm within bouts. Health indicators included anthropometrics (i.e. waist circumference and body mass index (BMI)) and in a subsample from two European countries (n=112) fasting capillary blood levels of glucose, C-peptide, high-density- and low-density cholesterol, and triglycerides. Data collection took place from March to July 2010. Associations were adjusted for age, gender, moderate-to-vigorous physical activity, total wear time and country. RESULTS Occurrence of sedentary bouts varied largely between the various definitions. Children spent most of their sedentary time in bouts of ≥5 min while bouts of ≥20 min were rare. Linear regression analysis revealed few significant associations of sedentary time accumulated in bouts of ≥5-30 min with health indicators. Moreover, we found that more associations became significant when allowing no tolerance time within sedentary bouts. CONCLUSION Despite a few significant associations, we found no convincing evidence for an association between sedentary time accumulated in bouts and health indicators in 10-13 year old children.
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Affiliation(s)
- T M Altenburg
- VU University Medical Center, EMGO Institute for Health and Care Research, Department of Public and Occupational Health, Amsterdam, The Netherlands.
| | - M de Niet
- Science Support, Utrecht, The Netherlands.
| | - M Verloigne
- Ghent University, Department of Movement and Sport Sciences, Ghent, Belgium.
| | - I De Bourdeaudhuij
- Ghent University, Department of Movement and Sport Sciences, Ghent, Belgium.
| | - O Androutsos
- Department of Nutrition-Dietetics, School of Health Science and Education, Harokopio University Athens, Athens, Greece.
| | - Y Manios
- Department of Nutrition-Dietetics, School of Health Science and Education, Harokopio University Athens, Athens, Greece.
| | - E Kovacs
- Department of Paediatrics, University of Pécs, Pécs, Hungary.
| | - B Bringolf-Isler
- Department of Epidemiology and Public Health, Swiss TPH, Basel, Switzerland; University of Basel, Basel, Switzerland.
| | - J Brug
- VU University Medical Center, EMGO Institute for Health and Care Research, Department of Epidemiology & Biostatistics, Amsterdam, The Netherlands.
| | - M J M Chinapaw
- VU University Medical Center, EMGO Institute for Health and Care Research, Department of Public and Occupational Health, Amsterdam, The Netherlands.
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Chinapaw MJM, de Niet M, Verloigne M, De Bourdeaudhuij I, Brug J, Altenburg TM. From sedentary time to sedentary patterns: accelerometer data reduction decisions in youth. PLoS One 2014; 9:e111205. [PMID: 25369021 PMCID: PMC4219709 DOI: 10.1371/journal.pone.0111205] [Citation(s) in RCA: 70] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2014] [Accepted: 09/29/2014] [Indexed: 11/28/2022] Open
Abstract
Aim This study aims to establish evidence-based accelerometer data reduction criteria to accurately assess total sedentary time and sedentary patterns in children. Methods Participants (n = 1057 European children; 9–13 yrs) were invited to wear an accelerometer for at least 6 consecutive days. We explored 1) non-wear time criteria; 2) minimum daily valid wear time; 3) differences between weekday and weekend day; and 4) minimum number of days of accelerometer wear by comparing the effects of commonly used data reduction decisions on total sedentary time, and duration and number of prolonged sedentary bouts. Results More than 60 consecutive minutes of zero counts was the optimal criterion for non-wear time. Increasing the definition of a valid day from 8 to 10 hours wear time hardly influenced the sedentary outcomes, while the sample size of children with more than 4 valid days increased from 69 to 81%. On weekdays, children had on average 1 hour more wear time, 50 minutes more total sedentary time, 26 minutes more sedentary time accumulated in bouts, and 1 more sedentary bout. At least 6 days of accelerometer data were needed to accurately represent weekly sedentary time and patterns. Conclusions Based on our results we recommend 1) a minimum of 60 minutes of consecutive zeros as the most realistic criterion for non-wear time; and 2) including at least six days with minimum eight valid hours to characterize children's usual total sedentary time and patterns, preferably including one weekend day.
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Affiliation(s)
- Mai J. M. Chinapaw
- Department of Public and Occupational Health and the EM GO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
- * E-mail:
| | | | - Maïté Verloigne
- Department of Movement and Sport Science, Ghent University, Ghent, Belgium
| | | | - Johannes Brug
- Department of Epidemiology and Biostatistics and EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
| | - Teatske M. Altenburg
- Department of Public and Occupational Health and the EM GO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
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