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Trost SG, Terranova CO, Brookes DSK, Chai LK, Byrne RA. Reliability and validity of rapid assessment tools for measuring 24-hour movement behaviours in children aged 0-5 years: the Movement Behaviour Questionnaire Baby (MBQ-B) and child (MBQ-C). Int J Behav Nutr Phys Act 2024; 21:43. [PMID: 38654342 DOI: 10.1186/s12966-024-01596-5] [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: 10/20/2023] [Accepted: 04/11/2024] [Indexed: 04/25/2024] Open
Abstract
BACKGROUND The development of validated "fit-for-purpose" rapid assessment tools to measure 24-hour movement behaviours in children aged 0-5 years is a research priority. This study evaluated the test-retest reliability and concurrent validity of the open-ended and closed-ended versions of the Movement Behaviour Questionnaire for baby (MBQ-B) and child (MBQ-C). METHODS 300 parent-child dyads completed the 10-day study protocol (MBQ-B: N = 85; MBQ-C: N = 215). To assess validity, children wore an accelerometer on the non-dominant wrist (ActiGraph GT3X+) for 7 days and parents completed 2 × 24-hour time use diaries (TUDs) recording screen time and sleep on two separate days. For babies (i.e., not yet walking), parents completed 2 × 24-hour TUDs recording tummy time, active play, restrained time, screen time, and sleep on days 2 and 5 of the 7-day monitoring period. To assess test-retest reliability, parents were randomised to complete either the open- or closed-ended versions of the MBQ on day 7 and on day 10. Test-retest intraclass correlation coefficients (ICC's) were calculated using generalized linear mixed models and validity was assessed via Spearman correlations. RESULTS Test-retest reliability for the MBQ-B was good to excellent with ICC's ranging from 0.80 to 0.94 and 0.71-0.93 for the open- and closed-ended versions, respectively. For both versions, significant positive correlations were observed between 24-hour diary and MBQ-B reported tummy time, active play, restrained time, screen time, and sleep (rho = 0.39-0.87). Test-retest reliability for the MBQ-C was moderate to excellent with ICC's ranging from 0.68 to 0.98 and 0.44-0.97 for the open- and closed-ended versions, respectively. For both the open- and closed-ended versions, significant positive correlations were observed between 24-hour diary and MBQ-C reported screen time and sleep (rho = 0.44-0.86); and between MBQ-C reported and device-measured time in total activity and energetic play (rho = 0.27-0.42). CONCLUSIONS The MBQ-B and MBQ-C are valid and reliable rapid assessment tools for assessing 24-hour movement behaviours in infants, toddlers, and pre-schoolers. Both the open- and closed-ended versions of the MBQ are suitable for research conducted for policy and practice purposes, including the evaluation of scaled-up early obesity prevention programs.
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Affiliation(s)
- Stewart G Trost
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Australia.
- School of Exercise and Nutrition Sciences, Queensland University of Technology, Brisbane, Australia.
| | - Caroline O Terranova
- School of Exercise and Nutrition Sciences, Queensland University of Technology, Brisbane, Australia
| | - Denise S K Brookes
- School of Exercise and Nutrition Sciences, Queensland University of Technology, Brisbane, Australia
| | - Li Kheng Chai
- School of Exercise and Nutrition Sciences, Queensland University of Technology, Brisbane, Australia
- Health and Wellbeing Queensland, Queensland Government, Brisbane, Australia
| | - Rebecca A Byrne
- School of Exercise and Nutrition Sciences, Queensland University of Technology, Brisbane, Australia
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Middleton G, Johnson BJ, Dutch D, Trost SG, Byrne R, Christian HE, Henry A, Terranova CO, Williams KE, Chai LK, Brookes DSK, Simon K, Golley RK. A great way to bring up health behaviour topics at playgroup: a qualitative evaluation of the Healthy Conversations @ Playgroup program. BMC Public Health 2024; 24:890. [PMID: 38528500 PMCID: PMC10962158 DOI: 10.1186/s12889-024-17703-x] [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: 10/05/2023] [Accepted: 01/08/2024] [Indexed: 03/27/2024] Open
Abstract
BACKGROUND The early years is a critical stage to establish optimal nutrition and movement behaviours. Community playgroups are a relaxed environment for parents with a focus on social connection and supporting parents in their role as 'First Teachers'. Playgroups are therefore an opportunistic setting to promote health behaviours in the early years. To support parents with young children around healthy lifestyle behaviours, the Healthy Conversations @ Playgroup program was delivered in urban and regional areas, across three Australian jurisdictions between 2021-2023. OBJECTIVE This qualitative evaluation aimed to understand how the Healthy Conversations @ Playgroup program was experienced by parents, playgroup coordinators and peer facilitators. DESIGN Semi-structured virtual interviews and focus groups were conducted with parents, playgroup coordinators (i.e., person responsible for coordinating the playgroup) and peer facilitators (i.e., trained facilitator for the program) that participated in the Healthy Conversations @ Playgroup study. Transcripts were analysed following a thematic analysis approach. RESULTS Twenty-eight playgroup parents, coordinators or peer facilitators participated in one of 8 focus groups or 5 interviews. Four themes were developed: Program strengths and challenges; Setting strengths and challenges; Factors that impact program delivery; Participant's suggestions for future program delivery. CONCLUSIONS The Healthy Conversations @ Playgroup program was valued by parents, providing validation and normalisation of parenting practices, and fostering a shared experience of parenting. Playgroups are a convenient setting for families to attend. The dynamic and distracting nature of the playgroup setting were carefully considered when designing the program. Strategies to further enhance program engagement could include use of coordinator or parent champions, tailored delivery, and extending the reach to other family members. TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry ACTRN12621000055808, registered 22 January 2021, https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=380890.
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Affiliation(s)
- Georgia Middleton
- Flinders University, College of Nursing and Health Sciences, Caring Futures Institute, Adelaide, SA, Australia
| | - Brittany J Johnson
- Flinders University, College of Nursing and Health Sciences, Caring Futures Institute, Adelaide, SA, Australia.
| | - Dimity Dutch
- Flinders University, College of Nursing and Health Sciences, Caring Futures Institute, Adelaide, SA, Australia
| | - Stewart G Trost
- School of Human Movement and Nutrition Sciences, The University of Queensland Australia, Brisbane, QLD, Australia
| | - Rebecca Byrne
- Faculty of Health, School of Exercise and Nutrition Science, Queensland University of Technology, Brisbane, QLD, Australia
| | - Hayley E Christian
- Telethon Kids Institute, The University of Western Australia, Perth, WA, Australia
- School of Population and Global Health, The University of Western Australia, Perth, WA, Australia
| | - Anna Henry
- Telethon Kids Institute, The University of Western Australia, Perth, WA, Australia
| | - Caroline O Terranova
- Faculty of Health, School of Exercise and Nutrition Science, Queensland University of Technology, Brisbane, QLD, Australia
| | - Kate E Williams
- Centre for Child and Family Studies, School of Early Childhood and Inclusive Education, Queensland University of Technology, Brisbane, QLD, Australia
| | - Li Kheng Chai
- Faculty of Health, School of Exercise and Nutrition Science, Queensland University of Technology, Brisbane, QLD, Australia
- Health and Wellbeing Queensland, Queensland Government, Brisbane, QLD, Australia
| | - Denise S K Brookes
- Faculty of Health, School of Exercise and Nutrition Science, Queensland University of Technology, Brisbane, QLD, Australia
| | - Kate Simon
- Faculty of Health, School of Exercise and Nutrition Science, Queensland University of Technology, Brisbane, QLD, Australia
| | - Rebecca K Golley
- Flinders University, College of Nursing and Health Sciences, Caring Futures Institute, Adelaide, SA, Australia.
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Adams EK, Nathan A, George P, Trost SG, Schipperijn J, Christian H. Physical Activity-Related Practices and Psychosocial Factors of Childcare Educators: A Latent Profile Analysis. Children (Basel) 2024; 11:390. [PMID: 38671607 PMCID: PMC11049541 DOI: 10.3390/children11040390] [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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/22/2024] [Revised: 03/14/2024] [Accepted: 03/20/2024] [Indexed: 04/28/2024]
Abstract
Limited research investigates early childhood education and care (ECEC) educators' involvement in promoting physical activity. The aim was to identify distinct profiles based on physical activity-related practices and psychosocial factors in ECEC educators and examine how they relate to the amount of time allocated to children's physical activity. A secondary analysis of educator-reported survey data from the Play Active study was undertaken. Educators (n = 532) reported on four practices and four psychosocial subscales adapted from the Environment and Policy Evaluation and Observation relating to the provision of physical activity in childcare. Latent profile analysis was used to identify distinct groups of educators based on their practices and psychosocial factors. Logistic regression analysed associations between latent profiles and educator-reported time provided for children's physical activity. Five profiles of educators' physical activity-related practices and psychosocial factors were identified. Profiles with higher practice scores also had higher psychosocial scores. Educators in profiles characterised by higher scores had greater odds of meeting the best practice guidelines for daily time allocated to children for total physical activity and energetic play. This study highlights interventions which address multiple educator behaviour change determinants to improve children's physical activity in childcare.
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Affiliation(s)
- Emma K. Adams
- Telethon Kids Institute, University of Western Australia, Perth, WA 6009, Australia; (E.K.A.)
- School of Population and Global Health, University of Western Australia, Perth, WA 6009, Australia
| | - Andrea Nathan
- Telethon Kids Institute, University of Western Australia, Perth, WA 6009, Australia; (E.K.A.)
| | - Phoebe George
- Telethon Kids Institute, University of Western Australia, Perth, WA 6009, Australia; (E.K.A.)
- School of Population and Global Health, University of Western Australia, Perth, WA 6009, Australia
| | - Stewart G. Trost
- School of Human Movement and Nutrition Sciences, University of Queensland, Brisbane, QLD 4072, Australia;
| | - Jasper Schipperijn
- Department of Sports Science Clinical Biomechanics, University of Southern Denmark, 5230 Odense, Denmark
| | - Hayley Christian
- Telethon Kids Institute, University of Western Australia, Perth, WA 6009, Australia; (E.K.A.)
- School of Population and Global Health, University of Western Australia, Perth, WA 6009, Australia
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Kubler JM, Edwards C, Cavanagh E, Mielke GI, Gardiner PA, Trost SG, Fontanarosa D, Borg DJ, Kumar S, Clifton VL, Beetham KS. Maternal physical activity and sitting time and its association with placental morphology and blood flow during gestation: Findings from the Queensland Family Cohort study. J Sci Med Sport 2024:S1440-2440(24)00076-8. [PMID: 38508889 DOI: 10.1016/j.jsams.2024.02.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 02/17/2024] [Accepted: 02/28/2024] [Indexed: 03/22/2024]
Abstract
OBJECTIVES Antenatal exercise is associated with placental morphological alterations, however research in this area is limited. Given the emphasis on the beneficial effects of antenatal exercise, it is important to understand its effect on placental function and the relationship to foetal development. The aim of this study was to investigate the association between physical activity, sitting time, and placental outcomes measured during gestation. DESIGN Prospective cohort study. METHODS Pregnant women in the Queensland Family Cohort study self-reported physical activity at 24 and 36 weeks of gestation (n = 203) and were categorised into physical activity volume groups of nil-low (0-<500 metabolic equivalent of task·minutes/week), moderate (500-<1000 metabolic equivalent of task·minutes/week), or high-volume activity (≥1000 metabolic equivalent of task·minutes/week). Participants reported average daily sitting time, whereby excessive sitting time was considered as ≥8h/day. Placental stiffness, thickness, and uteroplacental blood flow resistance were measured by ultrasound imaging at each timepoint. RESULTS Physical activity volume was not associated with changes to placental morphometrics or uteroplacental blood flow resistance at 24 or 36 weeks of gestation. Excessive sitting time at 36 weeks was associated with greater placental stiffness (p = 0.046), and a lower umbilical artery pulsatility index (p = 0.001). CONCLUSIONS Placental tissue stiffness and umbilical artery resistance were altered in late gestation with higher maternal sitting time but not with physical activity volume. Overall, excessive sitting time may be a risk for suboptimal placental function and could be an important focus for antenatal care.
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Affiliation(s)
- Jade M Kubler
- Faculty of Medicine, Mater Research Institute-University of Queensland, Australia. https://twitter.com/jadekubler
| | - Christopher Edwards
- School of Clinical Sciences, Queensland University of Technology, Australia. https://twitter.com/edchris_
| | - Erika Cavanagh
- Faculty of Medicine, Mater Research Institute-University of Queensland, Australia. https://twitter.com/ejcav
| | - Gregore I Mielke
- School of Public Health, University of Queensland, Australia. https://twitter.com/GregoreMielke
| | - Paul A Gardiner
- School of Public Health, University of Queensland, Australia. https://twitter.com/drpaulgardiner
| | - Stewart G Trost
- School of Human Movement and Nutrition Sciences, University of Queensland, Australia. https://twitter.com/StewartTrost
| | - Davide Fontanarosa
- School of Clinical Sciences, Queensland University of Technology, Australia
| | - Danielle J Borg
- Faculty of Medicine, Mater Research Institute-University of Queensland, Australia. https://twitter.com/DrDanBorg
| | - Sailesh Kumar
- Faculty of Medicine, Mater Research Institute-University of Queensland, Australia. https://twitter.com/MFMresearch
| | - Vicki L Clifton
- Faculty of Medicine, Mater Research Institute-University of Queensland, Australia. https://twitter.com/VickiClifton842
| | - Kassia S Beetham
- School of Behavioural and Health Sciences, Australian Catholic University, Australia.
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Lichtwark GA, Schuster RW, Kelly LA, Trost SG, Bialkowski A. Markerless motion capture provides accurate predictions of ground reaction forces across a range of movement tasks. J Biomech 2024; 166:112051. [PMID: 38503062 DOI: 10.1016/j.jbiomech.2024.112051] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 02/28/2024] [Accepted: 03/13/2024] [Indexed: 03/21/2024]
Abstract
Measuring or estimating the forces acting on the human body during movement is critical for determining the biomechanical aspects relating to injury, disease and healthy ageing. In this study we examined whether quantifying whole-body motion (segmental accelerations) using a commercial markerless motion capture system could accurately predict three-dimensional ground reaction force during a diverse range of human movements: walking, running, jumping and cutting. We synchronously recorded 3D ground reaction forces (force instrumented treadmill or in-ground plates) with high-resolution video from eight cameras that were spatially calibrated relative to a common coordinate system. We used a commercially available software to reconstruct whole body motion, along with a geometric skeletal model to calculate the acceleration of each segment and hence the whole-body centre of mass and ground reaction force across each movement task. The average root mean square difference (RMSD) across all three dimensions and all tasks was 0.75 N/kg, with the maximum average RMSD being 1.85 N/kg for running vertical force (7.89 % of maximum). There was very strong agreement between peak forces across tasks, with R2 values indicating that the markerless prediction algorithm was able to predict approximately 95-99 % of the variance in peak force across all axes and movements. The results were comparable to previous reports using whole-body marker-based approaches and hence this provides strong proof-of-principle evidence that markerless motion capture can be used to predict ground reaction forces and therefore potentially assess movement kinetics with limited requirements for participant preparation.
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Affiliation(s)
- Glen A Lichtwark
- School of Exercise and Nutrition Sciences, Queensland University of Technology, Kelvin Grove, QLD 4059, Australia; School of Human Movement and Nutrition Sciences, The University of Queensland, St. Lucia, QLD 4072, Australia.
| | - Robert W Schuster
- School of Human Movement and Nutrition Sciences, The University of Queensland, St. Lucia, QLD 4072, Australia
| | - Luke A Kelly
- School of Human Movement and Nutrition Sciences, The University of Queensland, St. Lucia, QLD 4072, Australia; School of Health Sciences and Social Work, Griffith University, Gold Coast 4111, Australia; Griffith Centre of Biomedical and Rehabilitation Engineering, Griffith University, Gold Coast 4111, Australia
| | - Stewart G Trost
- School of Human Movement and Nutrition Sciences, The University of Queensland, St. Lucia, QLD 4072, Australia; Children's Health Queensland Health and Hospital Service, South Brisbane, QLD 4101, Australia
| | - Alina Bialkowski
- School of Electrical Engineering and Computer Science, The University of Queensland, St Lucia, QLD 4072, Australia
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Adams EK, Murray K, Trost SG, Christian H. Longitudinal effects of dog ownership, dog acquisition, and dog loss on children's movement behaviours: findings from the PLAYCE cohort study. Int J Behav Nutr Phys Act 2024; 21:7. [PMID: 38287372 PMCID: PMC10826268 DOI: 10.1186/s12966-023-01544-9] [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: 08/28/2023] [Accepted: 11/30/2023] [Indexed: 01/31/2024] Open
Abstract
INTRODUCTION Regular physical activity is important for children's physical and mental health, yet many children do not achieve recommended amounts of physical activity. Dog ownership has been associated with increased physical activity in children, however, there have been no longitudinal studies examining this relationship. This study used data from the Play Spaces and Environments for Children's Physical Activity (PLAYCE) cohort study to examine the longitudinal effects of dog ownership status on children's movement behaviours. METHODS Change in dog ownership from preschool (wave 1, age 2-5) to fulltime school (wave 2, age 5-7) was used as a natural experiment with four distinct dog ownership groups: continuing non-dog owners (n = 307), continuing dog owners (n = 204), dog acquired (n = 58), and dog loss (n = 31; total n = 600). Daily movement behaviours, including physical activity, sedentary time, sleep, and screen time, were measured using accelerometry and parent-report surveys. Differences between groups over time and by sex were tested using linear mixed effects regression models. RESULTS Girls who acquired a dog increased their light intensity activities and games by 52.0 min/day (95%CI 7.9, 96.0) and girls who lost a dog decreased their light intensity activities and games by 62.1 min/day (95%CI -119.3, -4.9) compared to no change among non-dog owners. Girls and boys who acquired a dog increased their unstructured physical activity by 6.8 (95%CI 3.2, 10.3) and 7.1 (95%CI 3.9, 10.3) occasions/week, compared to no changes among non-dog owners. Girls and boys who lost a dog reduced their unstructured physical activity by 10.2 (95%CI -15.0, -5.3) and 7.7 (95%CI -12.0, -3.5) occasions/week. Girls who lost a dog decreased their total physical activity by 46.3 min/day (95%CI -107.5, 14.8) compared to no change among non-dog owners. Continuing dog ownership was typically not associated with movement behaviours. Dog ownership group was not associated with changes in sleep and had mixed associations with screen time. CONCLUSION The positive influence of dog ownership on children's physical activity begins in early childhood and differs by child sex. Further research should examine the specific contributions dog-facilitated physical activity makes to children's overall physical activity, including the intensity and duration of dog walking and play.
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Affiliation(s)
- Emma K Adams
- Telethon Kids Institute, University of Western Australia, 35 Stirling Hwy, Perth, Western Australia, 6009, Australia.
- School of Population and Global Health, University of Western Australia, 35 Stirling Hwy, Perth, Western Australia, 6009, Australia.
| | - Kevin Murray
- School of Population and Global Health, University of Western Australia, 35 Stirling Hwy, Perth, Western Australia, 6009, Australia
| | - Stewart G Trost
- School of Human Movement and Nutrition Sciences, University of Queensland, Brisbane, Queensland, 4072, Australia
| | - Hayley Christian
- Telethon Kids Institute, University of Western Australia, 35 Stirling Hwy, Perth, Western Australia, 6009, Australia
- School of Population and Global Health, University of Western Australia, 35 Stirling Hwy, Perth, Western Australia, 6009, Australia
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Kohler BE, Baque E, Sandler CX, Jones T, Terranova CO, Brookes DSK, Hassall T, Bradford NK, Trost SG. Goal-directed therapeutic exercise for paediatric posterior fossa brain tumour survivors: a qualitative analysis of experiences. Support Care Cancer 2024; 32:125. [PMID: 38252320 PMCID: PMC10803389 DOI: 10.1007/s00520-024-08327-3] [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: 08/22/2023] [Accepted: 01/12/2024] [Indexed: 01/23/2024]
Abstract
PURPOSE To explore child and parent experiences of a 12-week goal-directed therapeutic exercise intervention in paediatric posterior fossa brain tumours survivors and to identify features of the program that influenced program adherence and acceptability. METHODS Eleven interviews were conducted; five parent-child dyads (mothers = 83%) and one parent only (mean child age = 10.6 ± 3.0 years; 83% male). Posterior fossa brain tumour survivors, who participated in a weekly goal-directed exercise program for 12 weeks, completed semi-structured interviews to discuss their experience of the program. An inductive content analysis was undertaken. Interviews were transcribed, imported into NVivo and independently coded by two reviewers. Code and content categories were iteratively discussed and refined. RESULTS Five content categories were generated: (1) perceived improvements, (2) program logistics, (3) activity selection, (4) connection with the therapist and (5) options for technology. All participants valued the tailored exercise program and described improvements in movement competence. Children and their parents discussed preferring home- and community-based locations and favoured face-to-face delivery. Occasionally, parents reported difficulty completing the home program due to low child motivation or family time restrictions. Multiple families suggested an interactive digital application would be an effective delivery channel for the supplemental home-based program. CONCLUSION A goal-directed exercise program delivered at home and in community-based locations was considered valuable and helpful for improving movement competence in paediatric survivors of posterior fossa brain tumour. TRIAL REGISTRATION ACTRN12619000841178 June 12, 2019.
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Affiliation(s)
- Brooke E Kohler
- Faculty of Health at the Queensland Centre for Children's Health Research, Queensland University of Technology (QUT) Brisbane, Brisbane, Australia
| | - Emmah Baque
- School of Health Sciences and Social Work, Griffith University, Nathan, Australia
| | - Carolina X Sandler
- Sport and Exercise Science, School of Health Sciences, Western Sydney University, Sydney, Australia
- UNSW Fatigue Research Program, Kirby Institute, University of New South Wales, Sydney, Australia
- Menzies Health Institute Queensland, Griffith University, Brisbane, Australia
| | - Taryn Jones
- Faculty of Health at the Queensland Centre for Children's Health Research, Queensland University of Technology (QUT) Brisbane, Brisbane, Australia
| | - Caroline O Terranova
- Faculty of Health at the Queensland Centre for Children's Health Research, Queensland University of Technology (QUT) Brisbane, Brisbane, Australia
| | - Denise S K Brookes
- Faculty of Health at the Queensland Centre for Children's Health Research, Queensland University of Technology (QUT) Brisbane, Brisbane, Australia
| | | | - Natalie K Bradford
- Faculty of Health at the Queensland Centre for Children's Health Research, Queensland University of Technology (QUT) Brisbane, Brisbane, Australia
- Cancer and Palliative Care Outcomes Centre, at Centre for Children's Health Research, Queensland University of Technology, South Brisbane, Australia
| | - Stewart G Trost
- Children's Health Queensland, Brisbane, Australia.
- School of Human Movement and Nutrition Sciences, University of Queensland, Brisbane, Australia.
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Perry CK, Seguin-Fowler R, Maddock JE, Lenstra N, Dieckmann NF, Currier J, Andreyeva E, Winkle J, Trost SG. Rural libraries implementing walking groups or walking groups plus civic engagement for walkability in rural communities: a comparative effectiveness trial study protocol. BMC Public Health 2023; 23:1895. [PMID: 37784086 PMCID: PMC10544451 DOI: 10.1186/s12889-023-16788-0] [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: 07/14/2023] [Accepted: 09/19/2023] [Indexed: 10/04/2023] Open
Abstract
BACKGROUND Rural residents generally lack adequate physical activity to benefit health and reduce disparities in chronic diseases, such as cardiovascular disease and certain cancers. The Socioecological Model describes physical activity as involving a dynamic and reciprocal interaction between individual, social, and community factors. Community group-based walking programs and civic engagement interventions aimed at enhancing physical activity have been successful in rural communities but have not targeted all three socioecological levels. Public libraries can act as innovative public health partners in rural communities. However, challenges remain because rural libraries often lack the capacity to implement evidence-based health promotion programming. The goals of this study are (1) build the capacity for rural libraries to implement evidence-based health promotion programs, (2) compare changes in physical activity between a group-based walking program and a combined group-based walking and civic engagement program with rural residents, and (3) conduct an implementation evaluation. METHODS We will conduct a comparative effectiveness study of a group-based walking (standard approach) versus a group-based walking plus civic engagement program (combined approach) aimed at enhancing walkability to increase physical activity among rural adults. Key mediators between the program effects and change in outcomes will also be identified. Finally, we will evaluate program implementation, conduct a cost effectiveness evaluation, and use a positive deviance analysis to understand experiences of high and low changers on key outcomes. Twenty towns will be matched and randomized to one of the two conditions and our aim is to enroll a total of 350-400 rural residents (15-20 per town). Study outcomes will be assessed at baseline, and 6, 12, and 24 months. DISCUSSION This study will build the capacity of rural libraries to implement evidence-based walking programs as well as other health promotion programs in their communities. The study results will answer questions regarding the relative effectiveness and cost effectiveness of two multilevel physical activity interventions targeting rural communities. We will learn what works and how these multilevel interventions can be implemented in rural populations. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT05677906.
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Affiliation(s)
- Cynthia K Perry
- Oregon Health & Science University School of Nursing, 3455 SW US Veterans Hospital Rd, Portland, OR, 97239, USA.
| | - Rebecca Seguin-Fowler
- Texas A & M University Institute for Advancing Health through Agriculture, 1500 Research Parkway, Centeq Building B, College Station, TX, 77845, USA
| | - Jay E Maddock
- Texas A & M University School of Public Health, 1266 TAMU, College Station, TX, 77843, USA
| | - Noah Lenstra
- University North Carolina Greensboro School of Education, 1300 Spring Garden St, Greensboro, NC, 27412, USA
| | - Nathan F Dieckmann
- Oregon Health & Science University School of Nursing, 3455 SW US Veterans Hospital Rd, Portland, OR, 97239, USA
| | - Jessica Currier
- Knight Cancer Institute, Division of Oncological Sciences, Oregon Health & Science University, 2720 S. Moody Ave, Portland, OR, 97201, USA
| | - Elena Andreyeva
- Texas A & M University, 212 Adriance Lab Rd, College Station, TX, 77843, USA
| | - Jim Winkle
- Oregon Health & Science University School of Nursing, 3455 SW US Veterans Hospital Rd, Portland, OR, 97239, USA
| | - Stewart G Trost
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Qld, 4072, Australia
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Byrne R, Terranova CO, Chai LK, Brookes DSK, Trost SG. Cognitive Testing of Items Measuring Movement Behaviours in Young Children Aged Zero to Five Years: Development of the Movement Behaviour Questionnaires for -Baby (MBQ-B) and -Child (MBQ-C). Children (Basel) 2023; 10:1554. [PMID: 37761515 PMCID: PMC10529515 DOI: 10.3390/children10091554] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 09/08/2023] [Accepted: 09/13/2023] [Indexed: 09/29/2023]
Abstract
This paper describes the cognitive interview phase of the development of two brief surveys, the Movement Behaviour Questionnaire-Baby (MBQ-B) and Movement Behaviour Questionnaire-Child (MBQ-C), which measure the duration of physical activity, screen time, and sleep of children aged 0-5 years. The aims were (1) review the format, content, and clarity of questionnaire items and response options, (2) understand how parents retrieve, encode, and formulate responses when asked about their child's movement behaviours, and (3) identify potential sources of response error and make appropriate modifications. Interviews with parents of children aged 0-5 years were conducted using concurrent think-aloud techniques and probing questions. Parents reviewed the MBQ-B and/or MBQ-C depending on the developmental stage of their child(ren). Twenty-nine interviews were conducted with 20 parents, over four iterative rounds. Participants recalled usual family routines and rules when estimating the duration/frequency of behaviours. To estimate active play, parents referred to the child's daily routine considering wake and bedtimes, naps, and mealtimes. Participants were influenced by the examples provided, being unable to interpret these as exemplars only. Decomposing general items into specific questions with examples was well received. Use of numeracy skills when estimating duration was evident. Interviews informed revisions to item wording, examples, and recall prompts, which will be taken forward into the MBQ-B and MBQ-C validation studies. Utilising cognitive interviewing can enhance confidence that questionnaire items are correctly interpreted and understood by participants.
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Affiliation(s)
- Rebecca Byrne
- School of Exercise and Nutrition Sciences, Faculty of Health, Queensland University of Technology, Centre for Children’s Health Research, Graham St., Brisbane 4001, Australia; (R.B.); (C.O.T.); (L.K.C.); (D.S.K.B.)
| | - Caroline O. Terranova
- School of Exercise and Nutrition Sciences, Faculty of Health, Queensland University of Technology, Centre for Children’s Health Research, Graham St., Brisbane 4001, Australia; (R.B.); (C.O.T.); (L.K.C.); (D.S.K.B.)
| | - Li Kheng Chai
- School of Exercise and Nutrition Sciences, Faculty of Health, Queensland University of Technology, Centre for Children’s Health Research, Graham St., Brisbane 4001, Australia; (R.B.); (C.O.T.); (L.K.C.); (D.S.K.B.)
| | - Denise S. K. Brookes
- School of Exercise and Nutrition Sciences, Faculty of Health, Queensland University of Technology, Centre for Children’s Health Research, Graham St., Brisbane 4001, Australia; (R.B.); (C.O.T.); (L.K.C.); (D.S.K.B.)
| | - Stewart G. Trost
- School of Exercise and Nutrition Sciences, Faculty of Health, Queensland University of Technology, Centre for Children’s Health Research, Graham St., Brisbane 4001, Australia; (R.B.); (C.O.T.); (L.K.C.); (D.S.K.B.)
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane 4072, Australia
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10
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Marlow AL, King BR, Trost SG, Weaver N, Smart CE. Healthy weight and overweight adolescents with type 1 diabetes mellitus do not meet recommendations for daily physical activity and sleep. Diabetes Res Clin Pract 2023; 203:110879. [PMID: 37591344 DOI: 10.1016/j.diabres.2023.110879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2023] [Revised: 08/11/2023] [Accepted: 08/14/2023] [Indexed: 08/19/2023]
Abstract
AIMS Physical activity (PA) plays an important role in the prevention of cardiovascular disease (CVD), particularly in individuals with type 1 diabetes mellitus (T1DM) who are at increased risk. Our aim was to determine levels of moderate-to-vigorous physical activity (MVPA), sedentary behaviour and sleep in adolescents with T1DM, and identify barriers to PA. METHODS Participants aged 12-18 with T1DM wore an accelerometer and continuous glucose monitor for 24 h over 7-days. Data was processed into PA metrics and sleep. Pearson correlations were used to test associations between MVPA and metabolic measures. Barriers to PA were measured using a questionnaire. RESULTS Thirty-seven adolescents provided valid accelerometer data. Mean daily MVPA was 44.0 min [SD 17.6] with 16.2% achieving the guideline of ≥ 60 min/day. Participants had 11 h [SD 1.2] of sedentary behaviour and 7.6 h [SD 1.5] of sleep/day. There was no difference in MVPA in overweight or obese (53.8%) vs. healthy weight (44.2%) adolescents (45.0 min [SD 16.6] vs. 43.1 min [SD 18.8]). Only 39.6% reported one or more diabetes specific barrier to PA. CONCLUSION Adolescents with T1DM engage in insufficient MVPA and sleep, irrespective of body weight status, suggesting the need for targeted interventions.
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Affiliation(s)
- Alexandra L Marlow
- School of Medicine and Public Health, University of Newcastle, Callaghan, New South Wales, Australia; Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia.
| | - Bruce R King
- School of Medicine and Public Health, University of Newcastle, Callaghan, New South Wales, Australia; Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia; Department of Paediatric Endocrinology and Diabetes, John Hunter Children's Hospital, New South Wales, Australia.
| | - Stewart G Trost
- School of Exercise and Nutrition Sciences, Queensland University of Technology, Brisbane, Australia; School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Australia.
| | - Natasha Weaver
- School of Medicine and Public Health, University of Newcastle, Callaghan, New South Wales, Australia; Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia.
| | - Carmel E Smart
- School of Medicine and Public Health, University of Newcastle, Callaghan, New South Wales, Australia; Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia; Department of Paediatric Endocrinology and Diabetes, John Hunter Children's Hospital, New South Wales, Australia.
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Mclaughlin M, Nathan A, Thornton A, Schipperijn J, Trost SG, Christian H. Adaptations to scale-up an early childhood education and care physical activity intervention for real-world availability - Play Active. Int J Behav Nutr Phys Act 2023; 20:65. [PMID: 37264433 DOI: 10.1186/s12966-023-01457-7] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 04/25/2023] [Indexed: 06/03/2023] Open
Abstract
BACKGROUND Adaptations for scale-up are ubiquitous but are rarely described in detail. Adaptations may be a key reason for the "scale-up penalty" which is when there is a reduction in intervention effect size following scale-up. The Play Active intervention consists of a physical activity policy for early childhood education and care (ECEC) services, with accompanying implementation support strategies. It was first implemented with 81 ECEC services in Perth, Western Australia, in 2021 - with significant positive changes in physical activity practice uptake. The aim of this paper is to describe the extent, type, fidelity consistency, goals, size, scope, and proposed impact of proposed adaptations to the implementation support strategies for scaling-up Play Active. METHODS Proposed adaptations were defined as planned changes, made prior to making the intervention available. The authors created a list of adaptations from a comparison of the Play Active implementation support strategies, before and after adaptation for proposed statewide availability across Western Australia, Queensland and South Australia, Australia. We used the Framework for Reporting Adaptations and Modifications-Enhanced Implementation Strategies (FRAME-IS) to code adaptations to implementation support strategies. Three authors coded each adaptation and rated their size, scope and proposed impact. RESULTS Fifty-three adaptations to Play Active were identified. Most (68%) were proposed for the 'content' of implementation strategies, including aspects of their delivery. In practice, this involved changing the delivery mode of implementation support strategies from phone call and email support, to website-based delivery. More than half (56%) of adaptations involved 'adding elements' for scale-up. Most adaptations were 'fidelity consistent' (95%). The main goals for adaptations were related to 'increasing the acceptability, appropriateness, or feasibility' (45%), 'decreasing the costs' (19%) and 'increasing adoption of the evidence-based practice' (19%). Adaptations were small to medium in size, with most proposed to have a positive (87%) or neutral (8%) effect on the effectiveness of the intervention, rather than negative (4%). CONCLUSIONS A large number of small, fidelity-consistent, adaptations were proposed for Play Active scale-up. Overall, the process of reporting adaptations was found to be feasible. To understand the impact of these adaptations, it will be important to re-evaluate implementation, effectiveness and process outcomes, at-scale.
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Affiliation(s)
- Matthew Mclaughlin
- Telethon Kids Institute, The University of Western Australia, Perth, Australia.
| | - Andrea Nathan
- Telethon Kids Institute, The University of Western Australia, Perth, Australia
| | - Ashleigh Thornton
- Telethon Kids Institute, The University of Western Australia, Perth, Australia
- Division of Pediatrics, School of Medicine, The University of Western Australia, Perth, Australia
| | - Jasper Schipperijn
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Stewart G Trost
- School of Human Movement and Nutrition Sciences, The University of Queensland, Queensland, Australia
| | - Hayley Christian
- Telethon Kids Institute, The University of Western Australia, Perth, Australia
- School of Population and Global Health, The University of Western Australia, Perth, Australia
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Burgess A, Oftedal S, Boyd RN, Reedman S, Trost SG, Ware RS, Sakzewski L. Construct Validity of the Both Hands Assessment Using Wrist-Worn Accelerometers. Phys Occup Ther Pediatr 2023; 44:42-55. [PMID: 37183420 DOI: 10.1080/01942638.2023.2207635] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Accepted: 04/24/2023] [Indexed: 05/16/2023]
Abstract
AIM The aim of this study was to evaluate the construct validity of the Both Hands Assessment (BoHA) using activity of the upper limbs as detected by accelerometry in children with bilateral cerebral palsy (CP). METHODS Observational study of children with CP (n = 44, n = 27 boys, aged 9.1 ± 1.6 years; Manual Ability Classification Scale I: n = 15, II: n = 22, III: n = 7) completing a BoHA assessment while wearing a triaxial accelerometer on each wrist. BoHA Each-Hand sub-scores, BoHA percentage difference between hands, BoHA Units, mean activity for each hand, mean activity asymmetry index and total mean activity were calculated. Linear regressions were used to analyze associations between measures. RESULTS There were significant, positive associations between BoHA Units and total mean activity (B = 0.86, 95%CI: 0.32, 1.40), BoHA Percentage difference between hands and mean activity asymmetry index (B = 0.95, 95%CI: 0.75,1.15), and BoHA Each-Hand sub-score and mean activity for the non-dominant hand (B = 1.71, 95%CI: 1.16, 2.28), but not the dominant hand (B = 0.50, 95%CI: -0.45, 1.45). CONCLUSIONS This study provides further evidence for the construct validity of the BoHA as a measure of upper limb performance. Wearable wrist sensors such as accelerometers capture and quantify gross upper limb movement in children with CP but cannot measure fine finger movements captured by the BoHA. CLINICAL TRIALS REGISTRATION Australian New Zealand Clinical Trials Registry (ACTRN12616001488493 and ACTRN12618000164291).
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Affiliation(s)
- Andrea Burgess
- Queensland Cerebral Palsy and Rehabilitation Research Centre, Faculty of Medicine, The University of Queensland, Brisbane, Australia
| | - Stina Oftedal
- Queensland Cerebral Palsy and Rehabilitation Research Centre, Faculty of Medicine, The University of Queensland, Brisbane, Australia
| | - Roslyn N Boyd
- Queensland Cerebral Palsy and Rehabilitation Research Centre, Faculty of Medicine, The University of Queensland, Brisbane, Australia
| | - Sarah Reedman
- Queensland Cerebral Palsy and Rehabilitation Research Centre, Faculty of Medicine, The University of Queensland, Brisbane, Australia
| | - Stewart G Trost
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Australia
| | - Robert S Ware
- Menzies Health Institute Queensland, Griffith University, Brisbane, Australia
| | - Leanne Sakzewski
- Queensland Cerebral Palsy and Rehabilitation Research Centre, Faculty of Medicine, The University of Queensland, Brisbane, Australia
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Nathan A, Schipperijn J, Robinson T, George P, Boruff B, Trost SG, Christian H. The moderating role of parent perceptions in relationships between objectively measured neighbourhood environment attributes and pre-schooler's physical activity: Findings from the PLAYCE study. Health Place 2023; 81:103030. [PMID: 37116253 DOI: 10.1016/j.healthplace.2023.103030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 03/22/2023] [Accepted: 04/19/2023] [Indexed: 04/30/2023]
Abstract
We examined the moderating effects of parent perceptions of the neighbourhood environment on associations between objectively measured neighbourhood environment attributes and physical activity among pre-schoolers. The number of neighbourhood parks was positively associated with pre-schooler energetic play when parents had above average perceptions of access to services. Objectively measured street connectivity was associated with fewer minutes of energetic play when pedestrian and traffic safety was perceived to be below average by parents. Greater understanding of the role played by parents in pre-schooler's exposure to physically active supportive environments is needed to inform environmental interventions for specific age groups.
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Affiliation(s)
- Andrea Nathan
- Telethon Kids Institute, The University of Western Australia, Perth, Western Australia, Australia.
| | - Jasper Schipperijn
- Department of Sport Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Trina Robinson
- Telethon Kids Institute, The University of Western Australia, Perth, Western Australia, Australia
| | - Phoebe George
- Telethon Kids Institute, The University of Western Australia, Perth, Western Australia, Australia; School of Population and Global Health, The University of Western Australia, Perth, Western Australia, Australia
| | - Bryan Boruff
- School of Agriculture and Environment, The University of Western Australia, Perth, Western Australia, Australia
| | - Stewart G Trost
- School of Human Movement and Nutrition Sciences, University of Queensland, Brisbane, Australia
| | - Hayley Christian
- Telethon Kids Institute, The University of Western Australia, Perth, Western Australia, Australia; School of Population and Global Health, The University of Western Australia, Perth, Western Australia, Australia
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Adams EK, Nathan A, Trost SG, Schipperijn J, Shilton T, Trapp G, Maitland C, Thornton A, Mclaughlin M, George P, Wenden E, Christian H. Play Active physical activity policy intervention and implementation support in early childhood education and care: results from a pragmatic cluster randomised trial. Int J Behav Nutr Phys Act 2023; 20:46. [PMID: 37081560 PMCID: PMC10118225 DOI: 10.1186/s12966-023-01442-0] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 03/17/2023] [Indexed: 04/22/2023] Open
Abstract
BACKGROUND Policy interventions to increase physical activity in early childhood education and care (ECEC) services are effective in increasing physical activity among young children. However, a large proportion of ECEC services do not have nor implement a physical activity policy. Play Active is an evidence-informed physical activity policy intervention with implementation support strategies to enable ECEC services to successfully implement their policy. This study examined the effectiveness, implementation, and process outcomes of Play Active. METHODS A pragmatic cluster randomised trial in 81 ECEC services in Perth, Western Australia was conducted in 2021. Services implemented their physical activity policy over a minimum of three months. The effectiveness outcomes were changes in educator practices related to daily time provided for total physical activity and energetic play. Implementation outcomes included changes in director- and educator-reported uptake of policy practices and director-reported uptake of high impact and low effort policy practices. Process evaluation outcomes included awareness, fidelity, reach, and acceptability of the intervention and implementation strategies. Analysis involved descriptive statistics and generalised linear mixed effects models. RESULTS There was a significant increase in the uptake of director-reported policy practices (p = 0.034), but no change in the uptake of the subset of high impact and low effort policy practices. Intervention group educators reported high awareness of the Play Active policy recommendations (90%). Play Active acceptability was high among educators (83%) and directors (78%). Fidelity and reach were high for most implementation support strategies (> 75%). There were no significant changes in the amount of physical activity or energetic play educators provided to children or in the proportion of educators providing the policy recommended ≥ 180 min of physical activity/day or ≥ 30 min of energetic play/day for intervention compared to wait-listed comparison services. CONCLUSIONS Play Active resulted in significantly higher uptake of physical activity practices. However, there was no change in the amount of physical activity provided to children, which may be explained by the relatively short policy implementation period. Importantly, Play Active had high awareness, fidelity, reach, and acceptability. Future research should investigate the effectiveness of Play Active over longer implementation periods and its scalability potential. TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry (reference number 12620001206910, registered 13/11/2020, https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=378304&isReview=true ).
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Affiliation(s)
- Emma K Adams
- Telethon Kids Institute, University of Western Australia, 35 Stirling Hwy, Perth, 6009, WA, Australia.
- School of Population and Global Health, University of Western Australia, 35 Stirling Hwy, Perth, 6009, WA, Australia.
| | - Andrea Nathan
- Telethon Kids Institute, University of Western Australia, 35 Stirling Hwy, Perth, 6009, WA, Australia
| | - Stewart G Trost
- School of Human Movement and Nutrition Sciences, University of Queensland, Brisbane, 4072, QLD, Australia
| | - Jasper Schipperijn
- Department of Sports Science Clinical Biomechanics, University of Southern Denmark, Campusvej 55, Odense, 5230, Denmark
| | - Trevor Shilton
- School of Population and Global Health, University of Western Australia, 35 Stirling Hwy, Perth, 6009, WA, Australia
| | - Georgina Trapp
- Telethon Kids Institute, University of Western Australia, 35 Stirling Hwy, Perth, 6009, WA, Australia
- School of Population and Global Health, University of Western Australia, 35 Stirling Hwy, Perth, 6009, WA, Australia
| | - Clover Maitland
- School of Human Sciences, The University of Western Australia, 35 Stirling Hwy, Perth, 6009, WA, Australia
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, 615 St Kilda Rd, Melbourne, 3004, VIC, Australia
| | - Ashleigh Thornton
- Telethon Kids Institute, University of Western Australia, 35 Stirling Hwy, Perth, 6009, WA, Australia
- School of Human Sciences, The University of Western Australia, 35 Stirling Hwy, Perth, 6009, WA, Australia
| | - Matthew Mclaughlin
- Telethon Kids Institute, University of Western Australia, 35 Stirling Hwy, Perth, 6009, WA, Australia
- School of Population and Global Health, University of Western Australia, 35 Stirling Hwy, Perth, 6009, WA, Australia
| | - Phoebe George
- Telethon Kids Institute, University of Western Australia, 35 Stirling Hwy, Perth, 6009, WA, Australia
- School of Population and Global Health, University of Western Australia, 35 Stirling Hwy, Perth, 6009, WA, Australia
| | - Elizabeth Wenden
- Telethon Kids Institute, University of Western Australia, 35 Stirling Hwy, Perth, 6009, WA, Australia
- School of Population and Global Health, University of Western Australia, 35 Stirling Hwy, Perth, 6009, WA, Australia
| | - Hayley Christian
- Telethon Kids Institute, University of Western Australia, 35 Stirling Hwy, Perth, 6009, WA, Australia
- School of Population and Global Health, University of Western Australia, 35 Stirling Hwy, Perth, 6009, WA, Australia
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Goncalves WSF, Byrne R, de Lira PIC, Viana MT, Trost SG. Parental Influences on Physical Activity and Screen Time among Preschool Children from Low-Income Families in Brazil. Child Obes 2023; 19:112-120. [PMID: 35653741 DOI: 10.1089/chi.2021.0305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Background: Children from low-middle income countries (LMIC) are disproportionately affected by obesity, and low physical activity (PA) and high screen time (ST) are major contributors. Parents are key influencers on children's PA and ST, yet, no study has investigated relationships between parenting practices and children's PA and ST in LMIC families. This study examined parental influences on PA and ST among preschool-aged children from low-income families in Brazil. Methods: Parents completed a validated, culturally adapted interviewer-administered survey assessing child ST and parenting practices. Child sedentary time, total movement, and energetic play were measured by accelerometery. Results: Data were available on 77 parent-child dyads [mean age 4.6 years (standard deviation = 0.8), 53% male, and 41% mixed-race]. Parenting practices associated with greater PA were use of PA to reward/control behavior (rho = 0.34-0.49), limiting or monitoring ST (rho = 0.30), explicit modeling/enjoyment of PA (rho = 0.24), verbal encouragement for PA (rho = 0.30), and importance and value of PA (rho = 0.24-0.38; p < 0.05). Parenting practices associated with higher ST were rules around active play indoor (rho = 0.23), use of ST to reward/control behavior (rho = 0.30), exposure to screens (rho = 0.40), and explicit modeling/enjoyment of ST (rho = 0.50; p < 0.05). Conclusion: Recognized parenting practices such as explicit modeling of PA and ST, monitoring and limiting ST, and rules and restrictions about PA and ST are associated with young children's PA and ST in low-income Brazilian families. The findings identify potential targets for family-based interventions to promote healthy lifestyle behaviors and prevent childhood obesity.
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Affiliation(s)
| | - Rebecca Byrne
- School of Exercise and Nutrition Sciences, Faculty of Health, Queensland University of Technology, Brisbane, Queensland, Australia
| | | | | | - Stewart G Trost
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Queensland, Australia
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Pedrick-Case R, Bailey R, Beck B, Beesley B, Boruff B, Brophy S, Cross D, Dhamrait G, Duncan J, Gething P, Johnson RD, Lyons RA, Mizen A, Murray K, Pouliou T, Rafferty J, Robinson T, Rosenberg M, Schipperijn J, Thompson DA, Trost SG, Watkins A, Stratton G, Fry R, Christian H, Griffiths LJ. Built Environments And Child Health in WalEs and AuStralia (BEACHES): a study protocol. BMJ Open 2022; 12:e061978. [PMID: 36283749 PMCID: PMC9608521 DOI: 10.1136/bmjopen-2022-061978] [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: 12/03/2022] Open
Abstract
INTRODUCTION Childhood obesity and physical inactivity are two of the most significant modifiable risk factors for the prevention of non-communicable diseases (NCDs). Yet, a third of children in Wales and Australia are overweight or obese, and only 20% of UK and Australian children are sufficiently active. The purpose of the Built Environments And Child Health in WalEs and AuStralia (BEACHES) study is to identify and understand how complex and interacting factors in the built environment influence modifiable risk factors for NCDs across childhood. METHODS AND ANALYSIS This is an observational study using data from five established cohorts from Wales and Australia: (1) Wales Electronic Cohort for Children; (2) Millennium Cohort Study; (3) PLAY Spaces and Environments for Children's Physical Activity study; (4) The ORIGINS Project; and (5) Growing Up in Australia: the Longitudinal Study of Australian Children. The study will incorporate a comprehensive suite of longitudinal quantitative data (surveys, anthropometry, accelerometry, and Geographic Information Systems data) to understand how the built environment influences children's modifiable risk factors for NCDs (body mass index, physical activity, sedentary behaviour and diet). ETHICS AND DISSEMINATION This study has received the following approvals: University of Western Australia Human Research Ethics Committee (2020/ET000353), Ramsay Human Research Ethics Committee (under review) and Swansea University Information Governance Review Panel (Project ID: 1001). Findings will be reported to the following: (1) funding bodies, research institutes and hospitals supporting the BEACHES project; (2) parents and children; (3) school management teams; (4) existing and new industry partner networks; (5) federal, state and local governments to inform policy; as well as (6) presented at local, national and international conferences; and (7) disseminated by peer-reviewed publications.
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Affiliation(s)
| | - Rowena Bailey
- Population Data Science, Swansea University Medical School, Swansea, UK
| | - Ben Beck
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Bridget Beesley
- School of Population and Global Health, University of Western Australia, Perth, Western Australia, Australia
| | - Bryan Boruff
- School of Agriculture and Environment, University of Western Australia, Perth, Western Australia, Australia
| | - Sinead Brophy
- Population Data Science, Swansea University Medical School, Swansea, UK
| | - Donna Cross
- School of Population and Global Health, University of Western Australia, Perth, Western Australia, Australia
- Telethon Kids Institute, University of Western Australia, Perth, Western Australia, Australia
| | - Gursimran Dhamrait
- Telethon Kids Institute, University of Western Australia, Perth, Western Australia, Australia
- School of Health and Society, University of Wollongong, Wollongong, New South Wales, Australia
| | - John Duncan
- School of Agriculture and Environment, University of Western Australia, Perth, Western Australia, Australia
| | - Peter Gething
- Telethon Kids Institute, University of Western Australia, Perth, Western Australia, Australia
- Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia
| | - Rhodri D Johnson
- Population Data Science, Swansea University Medical School, Swansea, UK
| | - Ronan A Lyons
- Population Data Science, Swansea University Medical School, Swansea, UK
| | - Amy Mizen
- Population Data Science, Swansea University Medical School, Swansea, UK
| | - Kevin Murray
- School of Population and Global Health, University of Western Australia, Perth, Western Australia, Australia
| | - Theodora Pouliou
- Population Data Science, Swansea University Medical School, Swansea, UK
| | - James Rafferty
- Population Data Science, Swansea University Medical School, Swansea, UK
| | - Trina Robinson
- Telethon Kids Institute, University of Western Australia, Perth, Western Australia, Australia
| | - Michael Rosenberg
- School of Human Sciences, University of Western Australia, Perth, Western Australia, Australia
| | - Jasper Schipperijn
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Daniel A Thompson
- Population Data Science, Swansea University Medical School, Swansea, UK
| | - Stewart G Trost
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Queensland, Australia
| | - Alan Watkins
- Population Data Science, Swansea University Medical School, Swansea, UK
| | - Gareth Stratton
- Research Centre in Applied Sports, Technology, Exercise and Medicine, Swansea University, Swansea, UK
| | - Richard Fry
- Population Data Science, Swansea University Medical School, Swansea, UK
| | - Hayley Christian
- School of Population and Global Health, University of Western Australia, Perth, Western Australia, Australia
- Telethon Kids Institute, University of Western Australia, Perth, Western Australia, Australia
| | - Lucy J Griffiths
- Population Data Science, Swansea University Medical School, Swansea, UK
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Goncalves WSF, Byrne R, de Lira PIC, Viana MT, Trost SG. Adherence to 24-hour movement guidelines among rural Brazalian preschool children: associations with parenting practices. Int J Behav Nutr Phys Act 2022; 19:133. [PMID: 36271449 PMCID: PMC9587598 DOI: 10.1186/s12966-022-01369-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 04/19/2022] [Accepted: 09/22/2022] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Young children residing in rural areas of low-and-middle income countries (LMICs) such as Brazil are at greater risk of obesity and related chronic health conditions. Yet, the extent to which rural preschool children from Brazil aged 3- to 6-years meet the World Health Organisation (WHO) 24-hour movement guidelines is unknown. Parents play a central role in the development of children's movement behaviors with logistic support, co-participation, modelling, and setting rules and limits recognized as influential parenting practices. However, the bulk of parenting research has been conducted in families from high income countries (HICs) and little is known about the relationship between parenting practices and children's movement behaviors in LMIC communities. Therefore, the aims of this study were two-fold: (1) report the proportion of preschool children from low-income families in rural Brazil meeting the WHO 24-hour movement guidelines; and (2) determine associations with theory-based parenting practices related to physical activity, screen time, and sleep. METHODS A representative sample of 324 families from a rural district in north-eastern Brazil completed a validated, culturally adapted interviewer-administered survey assessing child physical activity, screen time and sleep, and associated parenting practices. The proportion of children meeting the physical activity, screen time, and sleep recommendations and all combinations of these recommendations was calculated. Forward selection logistic regression was used to determine which parenting practices were associated with meeting the individual recommendations and the 24-hour movement guidelines. RESULTS Less than half of the children (47.5%) met the physical activity recommendation, 22% met the screen time recommendation, 62% met the sleep recommendation, with just over 10% meeting all three recommendations in the 24-h movement guidelines. Having fewer rules and restrictions around indoor and outdoor play, limiting, or monitoring screen time, and maintaining a consistent bedtime routine were key parenting practices associated with children´s adherence to the 24-hour movement guidelines. CONCLUSION Only 1 in 10 rural Brazilian preschool children meet the 24-hour movement guidelines. These findings underscore the need for family-based interventions targeting parenting practices to support healthful movement behaviors in young children from LMICs.
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Affiliation(s)
| | - Rebecca Byrne
- School of Exercise and Nutrition Sciences, Queensland University of Technology, Brisbane, Australia
| | | | | | - Stewart G. Trost
- School of Exercise and Nutrition Sciences, Queensland University of Technology, Brisbane, Australia
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Australia
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18
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Kohler BE, Sandler CX, Baque E, Bradford NK, Trost SG. Therapeutic exercise interventions in pediatric survivors of brain cancer and other solid tumors: A scoping review. Front Pediatr 2022; 10:979292. [PMID: 36210932 PMCID: PMC9535626 DOI: 10.3389/fped.2022.979292] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Accepted: 08/25/2022] [Indexed: 11/19/2022] Open
Abstract
Background Improved survival rates for children with solid tumors presents an ongoing challenge of how to maximize quality of survivorship and effectively manage the short- and long-term complications of disease and treatment. To gain an understanding of the extent and nature of research pertaining to therapeutic exercise interventions and identify knowledge gaps, we conducted a scoping review of exercise training studies conducted in pediatric survivors of brain cancer and other solid tumors. Method A systematic literature search was performed across four electronic databases. Papers were selected for full-text review if they included participants treated for brain cancer or other solid tumors, with at least 50% of participants aged ≤ 21 years, evaluated an exercise intervention ≥2-weeks in duration, and were published in an English, peer-reviewed journal. We included the following quantitative study designs; randomized controlled trials, non-randomized trials, and single-arm pre-test-post-test. Results Of the 7,482 citations identified, 17 papers met the inclusion criteria (presenting findings from eleven studies). Two studies were randomized controlled trials, five studies were non-randomized controlled trials, and four studies were a single-arm pre-test post-test design. Average age of participants ranged from 7.3-15.5 years, and time since diagnosis ranged from 3 to 70 months. Five studies included participants with brain tumors exclusively, three studies included other solid tumors, and three studies included a mixed sample (brain and other solid tumors). A wide range of exercise modalities were employed, including cycle ergometry, resistance training, sport, yoga, and active gaming. The length of the exercise program ranged from 3-40 weeks and frequency from 3-11 sessions per week. Exercise session duration ranged from 15-180 min, with most studies reporting 30-90-min sessions. Adherence ranged from 77 to 100%, with none of the studies reporting adverse events. Studies reported improvements in cardiorespiratory fitness, functional strength, physical activity, and quality of life. Conclusions A small number of mostly low methodological quality studies have examined the effects of therapeutic exercise in pediatric survivors of solid tumors. Although limited, the extant literature supports the feasibility and safety of therapeutic exercise interventions for pediatric survivors of brain cancer and other solid tumors.
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Affiliation(s)
- Brooke E. Kohler
- Faculty of Health at the Queensland Centre for Children's Health Research, Queensland University of Technology (QUT), Brisbane, QLD, Australia
| | - Carolina X. Sandler
- Sport and Exercise Science, School of Health Sciences, Western Sydney University, Sydney, NSW, Australia
- UNSW Fatigue Research Program, Kirby Institute, University of New South Wales, Sydney, NSW, Australia
- Menzies Health Institute Queensland, Griffith University, Brisbane, QLD, Australia
| | - Emmah Baque
- School of Health Sciences and Social Work, Griffith University, Nathan, QLD, Australia
| | - Natalie K. Bradford
- Faculty of Health at the Queensland Centre for Children's Health Research, Queensland University of Technology (QUT), Brisbane, QLD, Australia
- Cancer and Palliative Care Outcomes Centre, at Centre for Children's Health Research, Queensland University of Technology, South Brisbane, QLD, Australia
| | - Stewart G. Trost
- Faculty of Health at the Queensland Centre for Children's Health Research, Queensland University of Technology (QUT), Brisbane, QLD, Australia
- School of Human Movement and Nutrition Sciences, University of Queensland, Brisbane, QLD, Australia
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Christian H, Murray K, Trost SG, Schipperijn J, Trapp G, Maitland C, Divitini M. Meeting the Australian 24-Hour Movement Guidelines for the Early Years is associated with better social-emotional development in preschool boys. Prev Med Rep 2022; 27:101770. [PMID: 35321215 PMCID: PMC8935500 DOI: 10.1016/j.pmedr.2022.101770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2021] [Revised: 01/24/2022] [Accepted: 03/13/2022] [Indexed: 11/18/2022] Open
Abstract
Only 8% of preschool children meet all three 24-hour movement guidelines. Meeting 24-hour movement guidelines associated with boy’s social-emotional development. Dose–response evidence needed to identify guideline thresholds for health outcomes.
24-hour Movement Guidelines for the Early Years promote that achieving all three-movement behaviour (sleep, sedentary behaviour and physical activity) recommendations is important for child health and development. We examined the association between meeting all, none and combinations of the Australian 24-Hour Movement Guidelines for the Early Years and social-emotional development in 1363 preschool (2–5 years) boys (52%) and girls. The PLAYCE study (Perth, Western Australia) parent survey collected data on children’s social-emotional development (Strengths & Difficulties Questionnaire), screen time, sleep and socio-demographic factors. Physical activity was measured using seven-day accelerometry. Only 8% of preschoolers met all three guidelines (5% met none). A higher proportion of boys than girls met physical activity-related guideline combinations (physical activity only, physical activity plus screen, physical activity plus sleep, all), while more girls than boys met sleep only guidelines (all p < 0.05). In boys, meeting all guidelines, compared with none, was associated with a lower total difficulties score (adjusted difference in means −1.90; 95%CI: −3.88, −0.10). Meeting the screen only guideline or the screen plus sleep guidelines, compared with none, were associated with lower total difficulties, conduct problems and hyperactivity scores in boys (all p < 0.05). Meeting the physical activity plus sleep guidelines, compared with none, were associated with lower total difficulties and conduct problems scores in boys (all p < 0.05). No significant associations were found for girls. These findings highlight the positive impact for boys social-emotional development in meeting all guidelines. Future guideline development should consider dose–response evidence to identify guideline thresholds for specific health and developmental outcomes for boys and girls.
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Affiliation(s)
- Hayley Christian
- Telethon Kids Institute, University of Western Australia, Nedlands WA 6009, Australia
- School of Population and Global Health, University of Western Australia, Nedlands WA 6009, Australia
- Corresponding author at: Telethon Kids Institute, PO Box 855, West Perth, WA 6872, Australia.
| | - Kevin Murray
- School of Population and Global Health, University of Western Australia, Nedlands WA 6009, Australia
| | - Stewart G. Trost
- School of Human Movement and Nutrition Sciences, University of Queensland, Brisbane QLD 4001, Australia
| | - Jasper Schipperijn
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense DK-5230, Denmark
| | - Georgina Trapp
- Telethon Kids Institute, University of Western Australia, Nedlands WA 6009, Australia
- School of Population and Global Health, University of Western Australia, Nedlands WA 6009, Australia
| | - Clover Maitland
- School of Human Sciences (Exercise and Sport Science), University of Western Australia, Perth WA 6009, Australia
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne, VIC 3004, Australia
| | - Mark Divitini
- School of Population and Global Health, University of Western Australia, Nedlands WA 6009, Australia
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20
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Trost SG, Brookes DSK, Ahmadi MN. Evaluation of Wrist Accelerometer Cut-Points for Classifying Physical Activity Intensity in Youth. Front Digit Health 2022; 4:884307. [PMID: 35585912 PMCID: PMC9108175 DOI: 10.3389/fdgth.2022.884307] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2022] [Accepted: 04/13/2022] [Indexed: 11/13/2022] Open
Abstract
Background Wrist worn accelerometers are convenient to wear and provide greater compliance. However, methods to transform the resultant output into predictions of physical activity (PA) intensity have been slow to evolve, with most investigators continuing the practice of applying intensity-based thresholds or cut-points. The current study evaluated the classification accuracy of seven sets of previously published youth-specific cut-points for wrist worn ActiGraph accelerometer data. Methods Eighteen children and adolescents [mean age (± SD) 14.6 ± 2.4 years, 10 boys, 8 girls] completed 12 standardized activity trials. During each trial, participants wore an ActiGraph GT3X+ tri-axial accelerometer on the wrist and energy expenditure (Youth METs) was measured directly using the Oxycon Mobile portable calorimetry system. Seven previously published sets of ActiGraph cut-points were evaluated: Crouter regression vertical axis, Crouter regression vector magnitude, Crouter ROC curve vertical axis, Crouter ROC curve vector magnitude, Chandler ROC curve vertical axis, Chandler ROC curve vector magnitude, and Hildebrand ENMO. Classification accuracy was evaluated via weighted Kappa. Confusion matrices were generated to summarize classification accuracy and identify patterns of misclassification. Results The cut-points exhibited only moderate agreement with directly measured PA intensity, with Kappa ranging from 0.45 to 0.58. Although the cut-points classified sedentary behavior accurately (> 95%), classification accuracy for the light (3-51%), moderate (12-45%), and vigorous-intensity trials (30-88%) was generally poor. All cut-points underestimated the true intensity of the walking trials, with error rates ranging from 35 to 100%, while the intensity of activity trials requiring significant upper body and/or arm movements was consistently overestimated. The Hildebrand cut-points which serve as the default option in the popular GGIR software package misclassified 30% of the light intensity trials as sedentary and underestimated the intensity of moderate and vigorous intensity trials 75% of the time. Conclusion Published ActiGraph cut-points for the wrist, developed specifically for school-aged youth, do not provide acceptable classification accuracy for estimating daily time spent in light, moderate, and vigorous intensity physical activity. The development and deployment of more robust accelerometer data reduction methods such as functional data analysis and machine learning approaches continues to be a research priority.
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Affiliation(s)
- Stewart G. Trost
- School of Human Movement and Nutrition Sciences, University of Queensland, Brisbane, QLD, Australia
- School of Exercise and Nutrition Sciences, Queensland University of Technology, Brisbane, QLD, Australia
| | - Denise S. K. Brookes
- School of Exercise and Nutrition Sciences, Queensland University of Technology, Brisbane, QLD, Australia
| | - Matthew N. Ahmadi
- Charles Perkins Centre, Faculty of Medicine and Health, School of Health Sciences, The University of Sydney, NSW, Australia
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21
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Reedman SE, Sakzewski L, McNamara L, Sherrington C, Beckman E, West K, Trost SG, Thomas R, Chatfield MD, Dutia I, Gennen A, Dodds B, Cotton Z, Boyd RN. Study protocol for Running for health (Run4Health CP): a multicentre, assessor-blinded randomised controlled trial of 12 weeks of two times weekly Frame Running training versus usual care to improve cardiovascular health risk factors in children and youth with cerebral palsy. BMJ Open 2022; 12:e057668. [PMID: 35487751 PMCID: PMC9058783 DOI: 10.1136/bmjopen-2021-057668] [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: 11/04/2022] Open
Abstract
INTRODUCTION Children and youth with moderate-severe (Gross Motor Function Classification System (GMFCS) levels II-V) cerebral palsy (CP) participate less frequently in physical activities compared with peers without CP and have elevated risk of cardiorespiratory morbidity and mortality in adulthood. Frame Running (RaceRunning) is a new athletics discipline that is an accessible option for physical activity participation for people with moderate-severe CP. There is no high-quality evidence for the effect of Frame Running on cardiovascular disease in children and young people with CP. The primary aim of this study is to conduct a randomised controlled trial of the effect of 12 weeks of Frame Running training on risk factors for cardiovascular disease. METHODS AND NALYSIS Sixty-two children and youth with CP (age 8-20 years) in GMFCS levels II-V will be recruited across four sites and randomised to receive either 12 weeks of Frame Running training two times weekly for 60 min, or usual care. Outcomes will be measured at baseline, immediately postintervention (primary endpoint) and 12 weeks later for retention of training effects. The primary outcome is cardiorespiratory fitness as measured by distance covered on Six Minute RaceRunner Test with 1 min heart rate recovery. Other outcomes include blood pressure, objectively measured physical activity, body mass index, waist circumference, percentage body fat, gross motor function capacity, community participation, feasibility, tolerability and safety. Adverse events will be monitored, and participants and their caregivers will be interviewed to discern their experiences of participation in Frame Running. ETHICS AND DISSEMINATION The Children's Health Queensland Hospital and Health Service and the University of Queensland Human Research Ethics Committees have approved this study. Results will be disseminated in peer-reviewed journals and scientific conferences; through professional and athletic organisations; and to people with CP and their families. TRIAL REGISTRATION NUMBER ACTRN12621000317897; Australian New Zealand Clinical Trials Registry number.
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Affiliation(s)
- Sarah E Reedman
- Child Health Research Centre, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
| | - Leanne Sakzewski
- Child Health Research Centre, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
| | - Lynda McNamara
- Physiotherapy Department, Cairns and Hinterland Hospital and Health Service, Cairns, Queensland, Australia
| | - Catherine Sherrington
- Institute for Musculoskeletal Health, School of Public Health, University of Sydney, Sydney, New South Wales, Australia
| | - Emma Beckman
- School of Human Movement and Nutrition Sciences, Faculty of Health and Behavioural Sciences, The University of Queensland, Brisbane, Queensland, Australia
| | - Kerry West
- Physiotherapy Department, Children's Hospital at Westmead, Sydney, New South Wales, Australia
| | - Stewart G Trost
- School of Human Movement and Nutrition Sciences, Faculty of Health and Behavioural Sciences, The University of Queensland, Brisbane, Queensland, Australia
| | - Rachel Thomas
- Queensland Paediatric Rehabilitation Service, Department of Rehabilitation, Queensland Children's Hospital, Brisbane, Queensland, Australia
| | - Mark D Chatfield
- Child Health Research Centre, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
| | - Iain Dutia
- School of Human Movement and Nutrition Sciences, Faculty of Health and Behavioural Sciences, The University of Queensland, Brisbane, Queensland, Australia
| | - Alix Gennen
- Child Health Research Centre, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
| | - Bridget Dodds
- Child Health Research Centre, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
| | - Zoë Cotton
- Child Health Research Centre, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
| | - Roslyn N Boyd
- Child Health Research Centre, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
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22
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Ahmadi MN, Trost SG. Device-based measurement of physical activity in pre-schoolers: Comparison of machine learning and cut point methods. PLoS One 2022; 17:e0266970. [PMID: 35417492 PMCID: PMC9007358 DOI: 10.1371/journal.pone.0266970] [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] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 03/30/2022] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION Machine learning (ML) accelerometer data processing methods have potential to improve the accuracy of device-based assessments of physical activity (PA) in young children. Yet the uptake of ML methods by health researchers has been minimal and the use of cut-points (CP) continues to be the norm, despite evidence of significant misclassification error. The lack of studies demonstrating a relative advantage for ML approaches over CP methods maybe a key contributing factor. PURPOSE The current study compared the accuracy of PA intensity predictions provided by ML classification models and previously published CPs for preschool-aged children. METHODS In a free-living study, 31 preschool-aged children (mean age = 4.0 ± 0.9 y) wore wrist and hip ActiGraph GT3X+ accelerometers while completing a video recorded 20-minute free play session. Ground truth PA intensity was coded continuously using the Children's Activity Rating Scale (CARS). Accelerometer data was classified as sedentary (SED), light intensity (LPA), or moderate-to-vigorous intensity (MVPA) using ML random forest PA classifiers and published CPs for preschool-aged children. Performance differences were evaluated in a hold-out sample by comparing weighted kappa statistics, classification accuracy for each intensity band, and equivalence testing. RESULTS ML classification models (hip: κ = 0.76; wrist: κ = 0.72) exhibited significantly higher agreement with ground truth PA intensity than CP methods (hip: κ = 0.38-0.49; wrist: κ = 0.31-0.44). For the ML models, classification accuracy for SED and LPA ranged from 83% - 88%, while classification accuracy for MVPA ranged from 68% - 78%. For the CP's, classification accuracy ranged from 50% - 94% for SED, 19% - 75% for LPA, and 44% - 76.1% for MVPA. ML classification models showed equivalence (within ± 0.5 SD) with directly observed time in SED, LPA, and MVPA. None of the CP's exhibited evidence of equivalence. CONCLUSIONS Under free living conditions, ML classification models for hip or wrist accelerometer data provide more accurate assessments of PA intensity in young children than CP methods. The results demonstrate the relative advantage of ML methods over threshold-based approaches and adds to a growing evidence base supporting the feasibility and accuracy of ML accelerometer data processing methods.
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Affiliation(s)
- Matthew N. Ahmadi
- Charles Perkins Centre, School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Stewart G. Trost
- School of Human Movement and Nutrition Sciences, University of Queensland, St Lucia, QLD, Australia
- School of Exercise and Nutrition Sciences, Queensland University of Technology, Brisbane, QLD, Australia
- * E-mail:
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23
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Jones T, O’Grady KAF, Goyal V, Masters IB, McCallum G, Drovandi C, Lung T, Baque E, Brookes DSK, Terranova CO, Chang AB, Trost SG. Bronchiectasis - Exercise as Therapy (BREATH): rationale and study protocol for a multi-center randomized controlled trial. Trials 2022; 23:292. [PMID: 35410363 PMCID: PMC8996596 DOI: 10.1186/s13063-022-06256-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Accepted: 03/29/2022] [Indexed: 11/23/2022] Open
Abstract
Background Globally, bronchiectasis (BE) unrelated to cystic fibrosis (CF) is recognized as a major cause of respiratory morbidity, mortality, and healthcare utilization. Children with BE regularly experience exacerbations of their condition resulting in frequent hospitalizations and decreased health-related quality of life (HR-QoL). Guidelines for the treatment and management of BE call for regular exercise as a means of improving aerobic fitness and HR-QoL. Moreover, research in adults with BE has shown that exercise can reduce the frequency of exacerbations, a potent predictor of future lung function decline and respiratory morbidity. Yet, to date, the health benefits resulting from therapeutic exercise have not been investigated in children with BE. The BREATH, Bronchiectasis - Exercise as Therapy, trial will test the efficacy of a novel 8-week, play-based therapeutic exercise program to reduce the frequency of acute exacerbations over 12 months in children with BE (aged ≥ 4 and < 13 years). Secondary aims are to determine the cost-effectiveness of the intervention and assess the program’s impact on aerobic fitness, fundamental movement skill (FMS) proficiency, habitual physical activity, HR-QoL, and lung function. Methods This multi-center, observer-blinded, parallel-group (1:1 allocation), randomized controlled trial (RCT) will be conducted at three sites. One hundred and seventy-four children ≥ 4 and < 13 years of age with BE will be randomized to a developmentally appropriate, play-based therapeutic exercise program (eight, 60-min weekly sessions, supplemented by a home-based program) or usual care. After completing the baseline assessments, the number of exacerbations and secondary outcomes will be assessed immediately post-intervention, after 6 months of follow-up, and after 12 months of follow-up. Monthly, parental contact and medical review will document acute respiratory exacerbations and parameters for cost-effectiveness outcomes. Discussion The BREATH trial is the first fully powered RCT to test the effects of a therapeutic exercise on exacerbation frequency, fitness, movement competence, and HR-QoL in children with bronchiectasis. By implementing a developmentally appropriate, play-based exercise program tailored to the individual needs of children with bronchiectasis, the results have the potential for a major paradigm shift in the way in which therapeutic exercise is prescribed and implemented in children with chronic respiratory conditions. The exercise program can be readily translated. It does not require expensive equipment and can be delivered in a variety of settings, including the participant’s home. The program has strong potential for translation to other pediatric patient groups with similar needs for exercise therapy, including those with obesity, childhood cancers, and neurological conditions such as cerebral palsy. Trial registration Australian and New Zealand Clinical Trials Register (ANZCTR) ACTRN12619001008112
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Joschtel B, Gomersall SR, Tweedy S, Petsky H, Chang AB, Trost SG. Effects of a therapeutic exercise program in children with non-cystic fibrosis bronchiectasis: A pilot randomized controlled trial. Front Pediatr 2022; 10:953429. [PMID: 36186646 PMCID: PMC9520333 DOI: 10.3389/fped.2022.953429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Accepted: 08/29/2022] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND In the absence of randomized controlled trials (RCTs) on the benefits of therapeutic exercise programs involving children with bronchiectasis, we undertook a pilot RCT to evaluate the effects of a play-based therapeutic exercise program on fundamental movement skill (FMS) proficiency. The effects of the program on cardiorespiratory fitness, perceived competence, and health-related quality of life (HR-QoL) were examined as secondary outcomes. METHODS Children [median (IQR) age: 6.8 (5.3-8.8) years] with bronchiectasis unrelated to cystic fibrosis were randomized to a 7-week therapeutic exercise program (n = 11) or wait-list control (n = 10). The exercise program comprised 7 × 60-min weekly sessions and was supplemented by a home-based program 2-days/week. Participants were assessed on: FMS (locomotor and object control skills) using the Test of Gross Motor Development 2nd Edition (TGMD-2); cardiovascular fitness by calculating the percent change in heart rate (%ΔHR) from rest to completion of the first stage of a submaximal treadmill test; perceived competence using Harter's athletic competence subscale; and QoL with the PedsQL. RESULTS Significant group by time interactions were observed for locomotor and object control skills. Children completing the therapeutic exercise program exhibited significant improvements in both locomotor (pre 29.0 ± 2.0, post 35.2 ± 2.2, p = 0.01) and object control (pre 27.0 ± 2.0, post 35.5 ± 2.2, p = 0.01) skills, with no significant change in controls (pre 31.6 ± 2.1, post 31.8 ± 2.3 and pre 31.0 ± 2.1, post 32.3 ± 2.3, respectively). Among children completing the program, %ΔHR declined by 6% points, while %ΔHR declined only marginally among controls (0.9% points), but the group by time interaction was not statistically significant. The program had a small positive impact on competence perceptions (Cohen's d = 0.2) and HR-QoL (Cohen's d = 0.3). CONCLUSION This pilot RCT provides preliminary evidence for the efficacy of a play-based therapeutic exercise program to improve proficiency in FMS and fitness in children with bronchiectasis. The results are sufficiently positive to warrant conducting a larger RCT testing the efficacy of the exercise program in children with bronchiectasis and/or other chronic respiratory conditions.
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Affiliation(s)
- Barbara Joschtel
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, QLD, Australia
| | - Sjaan R Gomersall
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, QLD, Australia.,School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, QLD, Australia
| | - Sean Tweedy
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, QLD, Australia
| | - Helen Petsky
- Faculty of Health, Centre for Children's Health Research, Queensland University of Technology, Brisbane, QLD, Australia.,Department of Respiratory and Sleep Medicine, Queensland Children's Hospital, Children's Health Queensland, Brisbane, QLD, Australia
| | - Anne B Chang
- Faculty of Health, Centre for Children's Health Research, Queensland University of Technology, Brisbane, QLD, Australia.,Department of Respiratory and Sleep Medicine, Queensland Children's Hospital, Children's Health Queensland, Brisbane, QLD, Australia.,Child Health Division, Menzies School of Health Research, Charles Darwin University, Tiwi, NT, Australia
| | - Stewart G Trost
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, QLD, Australia.,Faculty of Health, Centre for Children's Health Research, Queensland University of Technology, Brisbane, QLD, Australia
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Jones T, Baque E, O'Grady KAF, Goyal V, Chang AB, Trost SG. Barriers and facilitators of physical activity in children with bronchiectasis: Perspectives from children and parents. Front Pediatr 2022; 10:974363. [PMID: 36275072 PMCID: PMC9579271 DOI: 10.3389/fped.2022.974363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Accepted: 09/13/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Current bronchiectasis management guidelines recommend regular physical activity but a large proportion of children with bronchiectasis do not meet public health recommendations which call for 60 min or more of moderate-to-vigorous intensity physical activity daily. Knowing the factors that influence physical activity in children with bronchiectasis is necessary for the development of effective interventions to increase physical activity in this patient group. The objective of this study was to identify facilitators and barriers to physical activity in children with bronchiectasis unrelated to cystic fibrosis (CF) from the perspectives of children and their parents. MATERIALS AND METHODS This was a qualitative study informed by the theoretical domains framework (TDF). Children aged 7-15 years (8.8 years, 8.4-11.0) (median, interquartile range) and parents (45.8 years, 39.7-48.3) completed separate, semi-structured interviews (n = 21). Recordings were transcribed verbatim, and barriers and facilitators related to each TDF domain deductively coded. Emergent themes were inductively derived via consensus moderation. RESULTS From the perspectives of children, fun with friends, organized sport and activities, and family co-participation in physical activity emerged as facilitators. Inability to keep up with their peers and time on technology emerged as barriers. From the perspectives of parents, instrumental and logistic support for physical activity and supportive social and physical activity environments emerged as facilitators, while management of symptoms associated with bronchiectasis emerged as a barrier. CONCLUSION Programs to increase physical activity in children with bronchiectasis should be fun, accessible, provide opportunities for social interaction and address barriers related to exercise tolerance, perceived competence, and presence of respiratory symptoms.
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Affiliation(s)
- Taryn Jones
- School of Exercise and Nutrition Sciences, Queensland University of Technology, Brisbane, QLD, Australia
| | - Emmah Baque
- School of Health Sciences and Social Work, Griffith University, Brisbane, QLD, Australia
| | - Kerry-Ann F O'Grady
- School of Exercise and Nutrition Sciences, Queensland University of Technology, Brisbane, QLD, Australia.,Australian Centre for Health Services Innovation, Queensland University of Technology, Kelvin Grove, QLD, Australia
| | - Vikas Goyal
- Australian Centre for Health Services Innovation, Queensland University of Technology, Kelvin Grove, QLD, Australia.,Department of Respiratory and Sleep Medicine, Queensland Children's Hospital, Brisbane, QLD, Australia.,Gold Coast University Hospital, Gold Coast, QLD, Australia.,Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia
| | - Anne B Chang
- Australian Centre for Health Services Innovation, Queensland University of Technology, Kelvin Grove, QLD, Australia.,Department of Respiratory and Sleep Medicine, Queensland Children's Hospital, Brisbane, QLD, Australia.,Child Health Division, Menzies School of Health Research, Darwin, NT, Australia
| | - Stewart G Trost
- School of Exercise and Nutrition Sciences, Queensland University of Technology, Brisbane, QLD, Australia.,School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, QLD, Australia
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Hall A, Wolfenden L, Shoesmith A, McCarthy N, Wiggers J, Bauman AE, Rissel C, Sutherland R, Lecathelinais C, Brown H, Trost SG, Nathan N. The impact of an implementation intervention that increased school's delivery of a mandatory physical activity policy on student outcomes: A cluster-randomised controlled trial. J Sci Med Sport 2021; 25:321-326. [DOI: 10.1016/j.jsams.2021.12.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 11/08/2021] [Accepted: 12/13/2021] [Indexed: 01/12/2023]
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Christian H, Lester L, Trost SG, Schipperijn J, Pereira G, Franklin P, Wheeler AJ. Traffic exposure, air pollution and children's physical activity at early childhood education and care. Int J Hyg Environ Health 2021; 240:113885. [PMID: 34847452 DOI: 10.1016/j.ijheh.2021.113885] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 10/22/2021] [Accepted: 11/23/2021] [Indexed: 11/20/2022]
Abstract
BACKGROUND A significant number of children attend Early Childhood Education and Care (ECEC). ECEC is an important environment and behaviour setting for young children. Time spent outdoors is positively associated with children's physical activity levels, yet increased time spent physically active outdoors may expose young children to traffic-related air pollution, particularly in ECEC centres located in high traffic areas. METHODS This study was part of the Play Spaces and Environments for Children's Physical Activity (PLAYCE) study, Perth, Western Australia. Data from 22 ECEC centres and 478 children were collected. Continuous measures of indoor and outdoor fine particulate matter (PM2.5) were conducted for 48-72 h in each ECEC. Children wore ActiGraph GT3X + accelerometers to measure their physical activity at ECEC. The total length of high traffic roads within a 300m road network service area buffer around each ECEC was used to identify high and low traffic centres. RESULTS Outdoor PM2.5 concentrations peaked in the afternoon (1pm, 2pm and 6pm) at ECEC centres. Outdoor and indoor PM2.5 concentrations were significantly higher for centres located in high compared with low traffic areas (both p < 0.05). There was no significant association between a centre being located in a high or low traffic area and the time preschoolers spent outdoors or their physical activity levels. DISCUSSION Time periods when air pollution concentrations in ECECs are highest correspond with times when preschoolers are likely to be physically active outdoors. Children's potential exposure to traffic-related air pollutants is occurring during a period of rapid lung development. Given there is no evidence of a safe level of exposure to PM2.5 or a threshold below which no adverse health effects occur, careful planning should be a consideration to avoid locating ECEC centres in high traffic areas.
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Affiliation(s)
- Hayley Christian
- Telethon Kids Institute, University of Western Australia, Perth, Australia; School of Population and Global Health, University of Western Australia, Perth, Australia.
| | - Leanne Lester
- School of Human Sciences, University of Western Australia, Perth, Australia.
| | - Stewart G Trost
- School of Human Movement and Nutrition Sciences, University of Queensland, Brisbane, Australia.
| | - Jasper Schipperijn
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark.
| | - Gavin Pereira
- Telethon Kids Institute, University of Western Australia, Perth, Australia; School of Public Health, Curtin University, Perth, Australia; Centre for Fertility and Health (CeFH), Norwegian Institute of Public Health, Oslo, Norway.
| | - Peter Franklin
- School of Population and Global Health, University of Western Australia, Perth, Australia.
| | - Amanda J Wheeler
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia.
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Trost SG, Byrne R, Williams KE, Johnson BJ, Bird A, Simon K, Chai LK, Terranova CO, Christian HE, Golley RK. Study protocol for Healthy Conversations @ Playgroup: a multi-site cluster randomized controlled trial of an intervention to promote healthy lifestyle behaviours in young children attending community playgroups. BMC Public Health 2021; 21:1757. [PMID: 34565369 PMCID: PMC8474833 DOI: 10.1186/s12889-021-11789-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Accepted: 09/15/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Early childhood is a critical window for preventing obesity and chronic disease. Yet, 1 in 4 Australian children aged 5 years and under are affected by overweight or obesity; and significant proportions of children under 5 years fail to meet guidelines for diet quality, physical activity (PA), screen time, and sleep. Consequently, effective interventions to promote healthy lifestyle behaviors and prevent obesity during early childhood are needed. Community playgroups provide an opportunity for parents, carers, and children to meet in a safe and relaxed environment to play and share information. The structure, low cost and reach of playgroups provide a unique platform to engage parents in a scalable program to promote healthful lifestyle behaviors and prevent childhood obesity. However, the evidence base for the effectiveness of health promotion programs delivered in community playgroup settings is limited and lacking credible evidence from rigorously conducted randomized controlled trials. METHODS The Healthy Conversations @ Playgroup randomized controlled trial (RCT) aims to address the underlying behavioral risk factors for obesity by helping parents take effective steps to improve their child's dietary, PA, screen time, and sleep behaviors. The intervention program comprises 10 "healthy conversations" led by a trained peer facilitator, designed to increase parents' behavioral capability and self-efficacy to implement autonomy-supportive parenting practices. The program will be delivered biweekly during regularly scheduled playgroup sessions over 10-weeks. Effectiveness will be tested in a 2-arm cluster RCT involving 60 community playgroups in three states across Australia. After baseline assessments, participating playgroups will be randomly allocated to either intervention or wait-list control conditions. Primary outcomes (vegetable intake, discretionary foods, daily PA, screen time, sleep duration, and body mass index [BMI] z-score) will be assessed at baseline, immediately post-intervention (10-weeks; T2) and 6-months post-intervention (T3). Outcomes will be assessed for differential change at T2 and T3. DISCUSSION The Healthy Conversations @ Playgroup trial will rigorously evaluate a novel peer-led intervention program to promote healthful lifestyle behaviors and prevent obesity in children and families attending community playgroups. If effective, the program could be immediately scaled-up and delivered in community playgroups across Australia. TRIAL REGISTRATION Trial registered 22nd January 2021 with the Australian and New Zealand Clinical Trials Registry ( ACTRN12621000055808 ).
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Affiliation(s)
- Stewart G Trost
- Faculty of Health, School of Exercise and Nutrition Science, Queensland University of Technology at the Centre for Children's Health Research (CCHR), South Brisbane, Queensland, Australia.
| | - Rebecca Byrne
- Faculty of Health, School of Exercise and Nutrition Science, Queensland University of Technology at the Centre for Children's Health Research (CCHR), South Brisbane, Queensland, Australia
| | - Kate E Williams
- Faculty of Education, School of Early Childhood and Inclusive Education, Queensland University of Technology, Kelvin Grove, Queensland, Australia
| | - Brittany J Johnson
- College of Nursing and Health Sciences, Caring Futures Institute, Flinders University, Bedford Park, South Australia, Australia
| | - Anna Bird
- Telethon Kids Institute, Nedlands, Western Australia, Australia
| | - Kate Simon
- Faculty of Health, School of Exercise and Nutrition Science, Queensland University of Technology at the Centre for Children's Health Research (CCHR), South Brisbane, Queensland, Australia
| | - Li Kheng Chai
- Faculty of Health, School of Exercise and Nutrition Science, Queensland University of Technology at the Centre for Children's Health Research (CCHR), South Brisbane, Queensland, Australia.,Health and Wellbeing Queensland, Queensland Government, Milton, Queensland, Australia
| | - Caroline O Terranova
- Faculty of Health, School of Exercise and Nutrition Science, Queensland University of Technology at the Centre for Children's Health Research (CCHR), South Brisbane, Queensland, Australia
| | | | - Rebecca K Golley
- College of Nursing and Health Sciences, Caring Futures Institute, Flinders University, Bedford Park, South Australia, Australia
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Joschtel B, Gomersall SR, Tweedy S, Petsky H, Chang AB, Trost SG. Fundamental movement skill proficiency and objectively measured physical activity in children with bronchiectasis: a cross-sectional study. BMC Pulm Med 2021; 21:269. [PMID: 34404362 PMCID: PMC8371810 DOI: 10.1186/s12890-021-01637-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Accepted: 08/06/2021] [Indexed: 12/04/2022] Open
Abstract
Background Bronchiectasis is a major contributor to respiratory morbidity and healthcare utilization in children. Children with bronchiectasis exhibit low levels of physical activity (PA) and poor fundamental movement skills (FMS) may be a contributing factor. However, there are no data on FMS’s in this population. The current study assessed FMS proficiency in children with bronchiectasis and examined associations with objectively measured PA. Methods Forty-six children with bronchiectasis (mean age 7.5 ± 2.6 year, 63% Male) were recruited from the Queensland Children’s Hospital, Brisbane. PA was measured using the ActiGraph GT3X + accelerometer. Raw accelerometer data were processed into daily time spent in sedentary activities, light-intensity activities and games, walking, running, and moderate-to-vigorous activities and games using a random forest (RF) PA classification algorithm specifically developed for children. Daily MVPA was calculated by summing time spent in walking, running, and moderate-to-vigorous activities and games. FMS were assessed using the Test of Gross Motor Development 2nd Edition (TGMD-2). Results Fewer than 5% of children demonstrated mastery in the run, gallop, hop, and leap; while fewer than 10% demonstrated mastery for the two-handed strike, overarm throw, and underarm throw. Only eight of the 46 children (17.4%) achieved their age equivalency for locomotor skills, while just four (8.7%) achieved their age equivalency for object control skills. One-way ANCOVA revealed that children achieving their age equivalency for FMS had significantly higher levels of MVPA than children not achieving their age equivalency (51.7 vs 36.7 min/day). When examined by the five activity classes predicted by the RF algorithm, children achieving their age equivalency exhibited significantly greater participation moderate-to-vigorous intensity activities and games (22.1 vs 10.7 min/day). No significant differences were observed for sedentary activities, light-intensity activities and games, walking, and running. Conclusion Children with bronchiectasis exhibit significant delays in their FMS development. However, those who meet their age equivalency for FMS proficiency participate in significantly more daily MVPA than children who do not meet their age-equivalency. Therapeutic exercise programs designed to improve FMS proficiency are thus likely to be beneficial in this population.
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Affiliation(s)
- Barbara Joschtel
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Australia
| | - Sjaan R Gomersall
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Sean Tweedy
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Australia
| | - Helen Petsky
- School of Nursing and Midwifery, Griffith University, Brisbane, Australia
| | - Anne B Chang
- Child Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, Australia.,Department of Respiratory and Sleep Medicine, Queensland Children's Hospital, Brisbane, Australia
| | - Stewart G Trost
- School of Exercise and Nutrition Sciences, Queensland University of Technology, Brisbane, Australia. .,QLD Centre for Children's Health Research (CCHR), Level 6, 62 Graham Street, South Brisbane, QLD, 4101, Australia.
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Abstract
The impact of screen-based devices on children's health and development cannot be properly understood without valid and reliable tools that measure screen time within the evolving digital landscape. This review aimed to summarize characteristics of measurement tools used to assess screen time in young children; evaluate reporting of psychometric properties; and examine time trends related to measurement and reporting of screen time. A systematic review of articles published in English across three databases from January 2009 to April 2020 was undertaken using PROSPERO protocol (registration: CRD42019132599) and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Included articles measured screen time as outcome, exposure, or confounder in children 0-6 years. The search identified 35,868 records, 1035 full-text articles were screened for eligibility, and 622 met inclusion criteria. Most measures (60%) consisted of one to three items and assessed duration of screen time on a usual day. Few measures assessed content (11%) or coviewing (7%). Only 40% of articles provided a citation for the measure, and only 69 (11%) reported psychometric properties-reliability n = 58, validity n = 19, reliability and validity n = 8. Between 2009 and 2019, the number of published articles increased from 28 to 71. From 2015, there was a notable increase in the proportion of articles published each year that assessed exposure to mobile devices in addition to television. The increasing number of published articles reflects increasing interest in screen time exposure among young children. Measures of screen time have generally evolved to reflect children's contemporary digital landscape; however, the psychometric properties of measurement tools are rarely reported. There is a need for improved measures and reporting to capture the complexity of children's screen time exposures.
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Affiliation(s)
- Rebecca Byrne
- School of Exercise and Nutrition Sciences, Faculty of Health, Centre for Children's Health Research (CCHR)Queensland University of Technology (QUT)South BrisbaneQueenslandAustralia
| | - Caroline O. Terranova
- School of Exercise and Nutrition Sciences, Faculty of Health, Centre for Children's Health Research (CCHR)Queensland University of Technology (QUT)South BrisbaneQueenslandAustralia
| | - Stewart G. Trost
- School of Exercise and Nutrition Sciences, Faculty of Health, Centre for Children's Health Research (CCHR)Queensland University of Technology (QUT)South BrisbaneQueenslandAustralia
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Prochnow T, Umstattd Meyer MR, Patterson MS, Trost SG, Gómez L, Sharkey J. Active Play Network Influences on Physical Activity Among Children Living in Texas Colonias. Fam Community Health 2021; 44:154-161. [PMID: 33464765 DOI: 10.1097/fch.0000000000000296] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Physical activity (PA) is beneficial for child health; however, few children meet PA guidelines. Social relationships impact child PA behaviors; however, little is known about this effect in Mexican-heritage populations. This study aims to understand associations between self-reported play networks and PA among Mexican-heritage children. Mexican-heritage children from colonias along the Texas-Mexico border (n = 44; 54.5% girls; mean age = 9.89 years, SD = 0.97) reported information on up to 5 people they played with most often. Linear regression was used to analyze the relationship between composition of children's social network and minutes of moderate- to vigorous-intensity PA (MVPA) and sedentary minutes per day measured by accelerometers. Children who reported a higher percentage of friends as opposed to family members attained significantly more minutes of MVPA per day (β = .27, P = .04). Children who reported playing with individuals in their network more often (β = ‒.28, P = .03) were sedentary for fewer minutes per day. Increasing the connections between children in the neighborhood or community, as well as increasing a child's frequency of active play, may be promising approaches to increasing MVPA and decreasing sedentary behaviors among Mexican-heritage children.
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Affiliation(s)
- Tyler Prochnow
- Robbins College of Health and Human Sciences, Baylor University, Waco, Texas (Mr Prochnow and Dr Umstattd Meyer); Department of Health and Kinesiology (Dr Patterson) and Health Promotion and Community Health Sciences (Mr Gómez and Dr Sharkey), Texas A&M University, College Station; and Queensland University of Technology, Exercise and Nutrition Sciences, Brisbane, Queensland, Australia (Dr Trost)
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Goncalves WSF, Byrne R, de Lira PIC, Viana MT, Trost SG. Psychometric properties of instruments to measure parenting practices and children's movement behaviors in low-income families from Brazil. BMC Med Res Methodol 2021; 21:129. [PMID: 34162323 PMCID: PMC8223314 DOI: 10.1186/s12874-021-01320-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Accepted: 05/18/2021] [Indexed: 11/10/2022] Open
Abstract
Background Childhood obesity has increased remarkably in low and middle-income (LMIC) countries. Movement behaviors (physical activity, screen time, and sleep) are crucial in the development of overweight and obesity in young children. Yet, few studies have investigated the relationship between children’s movement behaviors and parenting practices because validated measures for use among families from LMIC are lacking. This study evaluated the psychometric properties of previously validated measures of young children’s physical activity, screen time, and sleep and parenting practices, translated and culturally adapted to Brazilian families. Methods A total of 78 parent-child dyads completed an interviewer-administered survey twice within 7 days. Child physical activity, sedentary time and sleep were concurrently measured using a wrist-worn accelerometer. Internal consistency and test-retest reliability was assessed using McDonald’s Omega and Intraclass Correlation Coefficients (ICC’s). Concurrent validity was evaluated by calculating Spearman correlations between parent reported child behaviors and accelerometer measured behaviors. Results Seventeen of the 19 parenting practices scales exhibited acceptable internal consistency reliability (Ω ≥ 0.70). Test-retest reliability ICC’s were acceptable and ranged from 0.82 - 0.99. Parent reported child physical activity was positively correlated with objectively measured total movement (rho= 0.29 - 0.46, p < .05) and energetic play (rho= 0.29 – 0.40, p < .05). Parent reported child screen time was positively correlated with objectively measured sedentary time; (rho = 0.26, p < .05), and inversely correlated with total movement (rho = - 0.39 – - 0.41, p < .05) and energetic play (rho = - 0.37 – - 0.41, p < .05). Parent reported night-time sleep duration was significantly correlated with accelerometer measured sleep duration on weekdays (rho = 0.29, p < .05), but not weekends. Conclusions Measurement tools to assess children’s movement behaviors and parenting practices, translated and culturally adapted for use in Brazilian families, exhibited acceptable evidence of concurrent validity, internal consistency, and test-retest reliability. Supplementary Information The online version contains supplementary material available at 10.1186/s12874-021-01320-y.
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Affiliation(s)
- Widjane Sheila Ferreira Goncalves
- Centre for Children's Health Research, School of Exercise and Nutrition Sciences, Queensland University of Technology, Brisbane, Australia
| | - Rebecca Byrne
- Centre for Children's Health Research, School of Exercise and Nutrition Sciences, Queensland University of Technology, Brisbane, Australia
| | | | | | - Stewart G Trost
- Centre for Children's Health Research, School of Exercise and Nutrition Sciences, Queensland University of Technology, Brisbane, Australia. .,Centre for Children's Health Research (CCHR), Level 6, 62 Graham St, South Brisbane, QLD, 4101, Australia.
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33
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Murawski B, Reilly KL, Hope K, Hall AE, Sutherland RL, Trost SG, Yoong SL, McCarthy N, Lecathelinais C, Wolfenden L, Nathan NK. Exploring the effect of a school-based cluster-randomised controlled trial to increase the scheduling of physical activity for primary school students on teachers' physical activity. Health Promot J Austr 2021; 33:373-378. [PMID: 33949031 DOI: 10.1002/hpja.499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Accepted: 04/30/2021] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND To determine if a school-based physical activity (PA) intervention that supported primary school teachers to schedule PA during school hours impacted their own PA. METHODS A 2x2 factorial group cluster-randomised controlled trial was undertaken in 12 Australian primary schools. The nine-month intervention supported classroom teachers to increase scheduled weekly PA for their class via physical education, sport, Energisers and integrated lessons. Teachers' PA (n = 76) was measured at follow-up only using accelerometers (Actigraph GT3X or GT9X). Linear mixed models were used to estimate between-group differences in teachers' mean minutes of sedentary, light, moderate-to-vigorous-intensity physical activity (MVPA) across the school day and during class-time. RESULTS At follow-up, there were non-significant between-group differences favouring intervention teachers, compared to controls, for light PA (4.9 minutes, 95% CI: -6.3, 16.0; P = .33) and MVPA (0.4 minutes, 95% CI: -10.9, 11.6; P = .94) across the school day; although not favouring the intervention for sedentary behaviour (5.1 minutes, 95% CI: -11.4, 21.7; P = .48). Similar patterns were seen during class-time for light PA and sedentary time, but not for MVPA. CONCLUSIONS Supporting teachers with the scheduling of PA for their class may impact on their own PA. Fully powered studies are needed to better understand the impact of the intervention on teachers' PA. TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry (ANZCTR) ACTRN12616001228471 (http://www.anzctr.org.au/).
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Affiliation(s)
- Beatrice Murawski
- School of Medicine and Public Health, The University of Newcastle, Callaghan, NSW, Australia.,Priority Research Centre for Health Behaviour, The University of Newcastle, Callaghan, NSW, Australia.,Hunter Medical Research Institute, New Lambton Heights, NSW, Australia.,Hunter New England Population Health, Hunter New England Area Health Service, Newcastle, Wallsend, NSW, Australia
| | - Kathryn L Reilly
- School of Medicine and Public Health, The University of Newcastle, Callaghan, NSW, Australia.,Priority Research Centre for Health Behaviour, The University of Newcastle, Callaghan, NSW, Australia.,Hunter Medical Research Institute, New Lambton Heights, NSW, Australia.,Hunter New England Population Health, Hunter New England Area Health Service, Newcastle, Wallsend, NSW, Australia
| | - Kirsty Hope
- School of Medicine and Public Health, The University of Newcastle, Callaghan, NSW, Australia.,Priority Research Centre for Health Behaviour, The University of Newcastle, Callaghan, NSW, Australia.,Hunter Medical Research Institute, New Lambton Heights, NSW, Australia.,Hunter New England Population Health, Hunter New England Area Health Service, Newcastle, Wallsend, NSW, Australia
| | - Alix E Hall
- School of Medicine and Public Health, The University of Newcastle, Callaghan, NSW, Australia.,Priority Research Centre for Health Behaviour, The University of Newcastle, Callaghan, NSW, Australia.,Hunter Medical Research Institute, New Lambton Heights, NSW, Australia.,Hunter New England Population Health, Hunter New England Area Health Service, Newcastle, Wallsend, NSW, Australia
| | - Rachel L Sutherland
- School of Medicine and Public Health, The University of Newcastle, Callaghan, NSW, Australia.,Priority Research Centre for Health Behaviour, The University of Newcastle, Callaghan, NSW, Australia.,Hunter Medical Research Institute, New Lambton Heights, NSW, Australia.,Hunter New England Population Health, Hunter New England Area Health Service, Newcastle, Wallsend, NSW, Australia
| | - Stewart G Trost
- Institute of Health and Biomedical Innovation at Queensland Centre for Children's Health Research, Queensland University of Technology, Brisbane, QLD, Australia
| | - Sze Lin Yoong
- School of Medicine and Public Health, The University of Newcastle, Callaghan, NSW, Australia.,Priority Research Centre for Health Behaviour, The University of Newcastle, Callaghan, NSW, Australia.,Hunter Medical Research Institute, New Lambton Heights, NSW, Australia.,Hunter New England Population Health, Hunter New England Area Health Service, Newcastle, Wallsend, NSW, Australia
| | - Nicole McCarthy
- Hunter Medical Research Institute, New Lambton Heights, NSW, Australia.,Hunter New England Population Health, Hunter New England Area Health Service, Newcastle, Wallsend, NSW, Australia
| | - Christophe Lecathelinais
- Hunter Medical Research Institute, New Lambton Heights, NSW, Australia.,Hunter New England Population Health, Hunter New England Area Health Service, Newcastle, Wallsend, NSW, Australia
| | - Luke Wolfenden
- School of Medicine and Public Health, The University of Newcastle, Callaghan, NSW, Australia.,Priority Research Centre for Health Behaviour, The University of Newcastle, Callaghan, NSW, Australia.,Hunter Medical Research Institute, New Lambton Heights, NSW, Australia.,Hunter New England Population Health, Hunter New England Area Health Service, Newcastle, Wallsend, NSW, Australia
| | - Nicole K Nathan
- School of Medicine and Public Health, The University of Newcastle, Callaghan, NSW, Australia.,Priority Research Centre for Health Behaviour, The University of Newcastle, Callaghan, NSW, Australia.,Hunter Medical Research Institute, New Lambton Heights, NSW, Australia.,Hunter New England Population Health, Hunter New England Area Health Service, Newcastle, Wallsend, NSW, Australia
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Karinharju KS, Boughey AM, Tweedy SM, Clanchy KM, Trost SG, Gomersall SR. Validity of the Apple Watch ® for monitoring push counts in people using manual wheelchairs. J Spinal Cord Med 2021; 44:212-220. [PMID: 30811310 PMCID: PMC7952070 DOI: 10.1080/10790268.2019.1576444] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Abstract
Objective: A recent Apple Watch® activity-monitoring innovation permits manual wheelchair users to monitor daily push counts. This study evaluated the validity of the Apple Watch® push count estimate.Design: Criterion validity.Setting: Southern Finland and Southeast Queensland, Australia.Participants: Twenty-six manual wheelchair users from Finland and Australia were filmed completing a standardized battery of activities while wearing the Apple Watch® (dominant wrist).Outcome Measures: Wheelchair pushes as determined by the Apple Watch® were compared to directly observed pushes.Results: Agreement between Apple Watch® push counts and directly observed pushes was evaluated using Intraclass correlation coefficients (ICC), Pearson correlations and Bland-Altman analyses. Apple Watch® pushes and directly observed push counts were strongly correlated (ICC = 0.77, P < 0.01) (r = 0.84, P < 0.01). Bland Altman plots indicated that the Apple Watch® underestimated push counts (M = -103; 95% ULoA = 217; LLoA = -423 pushes). Mean absolute percentage error was 13.5% which is comparable to studies evaluating agreement between pedometer-based step counts and directly observed steps.Conclusion: Apple Watch® push-count estimates are acceptable for personal, self-monitoring purposes and for research entailing group-level analyses, but less acceptable where accurate push-count measures for an individual is required.
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Affiliation(s)
- Kati S. Karinharju
- School of Human Movement and Nutrition Sciences, The University of Queensland, St Lucia, QLD, Australia
- Satakunta University of Applied Sciences, Pori, Finland
| | - Alexandra M. Boughey
- School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, QLD, Australia
| | - Sean M. Tweedy
- School of Human Movement and Nutrition Sciences, The University of Queensland, St Lucia, QLD, Australia
- I.M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - Kelly M. Clanchy
- School of Allied Health Sciences, Griffith University, Southport, QLD, Australia
| | - Stewart G. Trost
- Institute of Health and Biomedical Innovation at Queensland Centre for Children’s Health, Research, Queensland University of Technology, South Brisbane, QLD, Australia
| | - Sjaan R. Gomersall
- School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, QLD, Australia
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Kohler BE, Baque E, Sandler CX, Brookes DSK, Terranova CO, Rixon M, Hassall T, Trost SG. Physical ACTivity in Survivorship (PACTS): study protocol for a randomized controlled trial evaluating a goal-directed therapeutic exercise program in pediatric posterior fossa brain tumor survivors. BMC Pediatr 2021; 21:105. [PMID: 33648474 PMCID: PMC7919081 DOI: 10.1186/s12887-021-02566-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Accepted: 02/22/2021] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Posterior fossa brain tumors (PFBT) are the most common solid tumor in children. Recent increases in survival rates are encouraging; however, survivors may experience a plethora of disease- and treatment-related complications that can persist into adulthood. Therapeutic exercise interventions have been shown to improve quality of survivorship in other pediatric cancer diagnoses. There is also evidence that goal-directed interventions are effective at improving motor activities, function, and self-care in children with complex health conditions. Yet, there is currently no evidence on the efficacy of goal-directed therapeutic exercise in pediatric PFBT survivors. The Physical ACTivity in Survivorship (PACTS) study aims to investigate the effects of a novel goal-directed therapeutic exercise program on cardiorespiratory fitness and physical activity-related goal attainment in pediatric survivors of PFBT. METHOD PFBT survivors, aged five to 17 years, who underwent surgery at least 12 months earlier and completed radiation therapy and/or chemotherapy at least 6 months prior will be recruited from the Queensland Children's Hospital (Brisbane, Australia) (target n = 48). Following baseline assessment, participants are randomized into either the intervention or usual care group. The intervention group will receive weekly individualized, goal-directed exercise therapy delivered face-to-face for 12 weeks, along with an accompanying home-based program (three sessions per week). Outcomes will be assessed at baseline, immediately post-intervention, and at 6- and 12-months post-intervention. The primary outcomes are cardiorespiratory fitness (Peak VO2) and physical activity-related goal attainment. Secondary outcomes are cardiorespiratory endurance, high-level mobility skills, functional muscle strength, habitual physical activity, gait, balance, quality of life, fatigue, participation, perceived movement skill competence and parameters of body composition. DISCUSSION PACTS is the first study to investigate the efficacy of goal-directed therapeutic exercise in children with PFBT and provide evidence needed to inform clinical practice recommendations for managing quality of survivorship in PFBT survivors. TRIAL REGISTRATION ACTRN12619000841178 .
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Affiliation(s)
- Brooke E Kohler
- Institute of Health and Biomedical Innovation at the Queensland Centre for Children's Health Research, Queensland University of Technology (QUT), Brisbane, Queensland, Australia
- School of Exercise and Nutrition Science, Queensland University of Technology (QUT), Brisbane, Queensland, Australia
| | - Emmah Baque
- Institute of Health and Biomedical Innovation at the Queensland Centre for Children's Health Research, Queensland University of Technology (QUT), Brisbane, Queensland, Australia
- School of Allied Health Sciences, Griffith University, Gold Coast, Queensland, Australia
| | - Carolina X Sandler
- Institute of Health and Biomedical Innovation at the Queensland Centre for Children's Health Research, Queensland University of Technology (QUT), Brisbane, Queensland, Australia
- School of Exercise and Nutrition Science, Queensland University of Technology (QUT), Brisbane, Queensland, Australia
- UNSW Fatigue Research Program, Kirby Institute, University of New South Wales, Sydney, NSW, Australia
| | - Denise S K Brookes
- Institute of Health and Biomedical Innovation at the Queensland Centre for Children's Health Research, Queensland University of Technology (QUT), Brisbane, Queensland, Australia
- School of Exercise and Nutrition Science, Queensland University of Technology (QUT), Brisbane, Queensland, Australia
| | - Caroline O Terranova
- Institute of Health and Biomedical Innovation at the Queensland Centre for Children's Health Research, Queensland University of Technology (QUT), Brisbane, Queensland, Australia
- School of Exercise and Nutrition Science, Queensland University of Technology (QUT), Brisbane, Queensland, Australia
| | - Matthew Rixon
- School of Clinical Sciences, Queensland University of Technology (QUT), Brisbane, Queensland, Australia
| | - Tim Hassall
- Queensland Children's Hospital, Brisbane, Queensland, Australia
| | - Stewart G Trost
- Institute of Health and Biomedical Innovation at the Queensland Centre for Children's Health Research, Queensland University of Technology (QUT), Brisbane, Queensland, Australia.
- School of Exercise and Nutrition Science, Queensland University of Technology (QUT), Brisbane, Queensland, Australia.
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Ahmadi MN, Brookes D, Chowdhury A, Pavey T, Trost SG. Free-living Evaluation of Laboratory-based Activity Classifiers in Preschoolers. Med Sci Sports Exerc 2020; 52:1227-1234. [PMID: 31764460 DOI: 10.1249/mss.0000000000002221] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Machine learning classification models for accelerometer data are potentially more accurate methods to measure physical activity in young children than traditional cut point methods. However, existing algorithms have been trained on laboratory-based activity trials, and their performance has not been investigated under free-living conditions. PURPOSE This study aimed to evaluate the accuracy of laboratory-trained hip and wrist random forest and support vector machine classifiers for the automatic recognition of five activity classes: sedentary (SED), light-intensity activities and games (LIGHT_AG), walking (WALK), running (RUN), and moderate to vigorous activities and games (MV_AG) in preschool-age children under free-living conditions. METHODS Thirty-one children (4.0 ± 0.9 yr) were video recorded during a 20-min free-living play session while wearing an ActiGraph GT3X+ on their right hip and nondominant wrist. Direct observation was used to continuously code ground truth activity class and specific activity types occurring within each class using a bespoke two-stage coding scheme. Performance was assessed by calculating overall classification accuracy and extended confusion matrices summarizing class-level accuracy and the frequency of specific activities observed within each class. RESULTS Accuracy values for the hip and wrist random forest algorithms were 69.4% and 59.1%, respectively. Accuracy values for hip and wrist support vector machine algorithms were 66.4% and 59.3%, respectively. Compared with the laboratory cross validation, accuracy decreased by 11%-15% for the hip classifiers and 19%-21% for the wrist classifiers. Classification accuracy values were 72%-78% for SED, 58%-79% for LIGHT_AG, 71%-84% for MV_AG, 9%-15% for WALK, and 66%-75% for RUN. CONCLUSION The accuracy of laboratory-based activity classifiers for preschool-age children was attenuated when tested on new data collected under free-living conditions. Future studies should train and test machine learning activity recognition algorithms using accelerometer data collected under free-living conditions.
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Affiliation(s)
| | - Denise Brookes
- Institute of Health and Biomedical Innovation at Queensland Centre for Children's Health Research, Queensland University of Technology, South Brisbane, AUSTRALIA
| | - Alok Chowdhury
- Faculty of Science and Engineering, School of Computer Science and Electrical Engineering, Queensland University of Technology, Brisbane, AUSTRALIA
| | - Toby Pavey
- Faculty of Health, School of Exercise and Nutrition Sciences, Queensland University of Technology, Brisbane, AUSTRALIA
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Shoesmith A, Hall A, Hope K, Sutherland R, Hodder RK, Trost SG, Lecathelinais C, Lane C, McCarthy N, Nathan N. Associations between in-school-hours physical activity and child health-related quality of life: A cross-sectional study in a sample of Australian primary school children. Prev Med Rep 2020; 20:101179. [PMID: 32884897 PMCID: PMC7452118 DOI: 10.1016/j.pmedr.2020.101179] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2020] [Revised: 08/04/2020] [Accepted: 08/08/2020] [Indexed: 01/22/2023] Open
Abstract
The aim of the current study was to examine the association between Australian primary school children's objectively measured in-school-hours weekly physical activity (PA) and their health-related quality of life (HRQoL). A cross-sectional study of 1128 Grade 2 and 3 children, aged 7-9 years, from 62 primary schools was conducted in New South Wales, Australia between October 2017 and April 2018. Children's PA was assessed via an accelerometer worn for five days during school hours. Their parents completed a telephone interview, answering demographic, child HRQoL and out-of-school-hours PA questions. Children's in-school-hours PA was classified as total PA and moderate-to-vigorous PA (MVPA). HRQoL scores were aggregated and reported at the high construct level domains (Total Quality of Life (Total HRQoL), Physical and Psychosocial Health Summary Scores). Multiple linear mixed regression analyses accounting for clustering were conducted to evaluate the association between children's in-school-hours weekly PA and their HRQoL. After adjusting for potential confounders, significant positive associations were found between children's in-school-hours weekly total PA and Total HRQoL (0.62 units, 95% CI: 0.29; 0.94, p < 0.001), Physical (0.71 units, 95% CI: 0.38; 1.04, p ≤ 0.001) and Psychosocial (0.58 units, 95% CI: 0.19; 0.97, p = 0.004) scores, with a stronger association observed between average weekly MVPA than average weekly total PA. There were also positive associations between PA and HRQoL for each sex when analysed separately. Our findings demonstrate a positive association between children's objectively-measured in-school-hours PA and parent-reported child HRQoL, strengthening evidence supporting the continued implementation of school-based PA programs for broader health outcomes.
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Affiliation(s)
- Adam Shoesmith
- Hunter New England Population Health, Hunter New England Local Health District, Newcastle, Australia
- School of Medicine and Public Health, The University of Newcastle, Newcastle, NSW, Australia
- Priority Research Centre for Health Behaviour, The University of Newcastle, Newcastle, NSW, Australia
| | - Alix Hall
- Hunter New England Population Health, Hunter New England Local Health District, Newcastle, Australia
- School of Medicine and Public Health, The University of Newcastle, Newcastle, NSW, Australia
- Priority Research Centre for Health Behaviour, The University of Newcastle, Newcastle, NSW, Australia
- Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
| | - Kirsty Hope
- Hunter New England Population Health, Hunter New England Local Health District, Newcastle, Australia
- School of Medicine and Public Health, The University of Newcastle, Newcastle, NSW, Australia
- Priority Research Centre for Health Behaviour, The University of Newcastle, Newcastle, NSW, Australia
| | - Rachel Sutherland
- Hunter New England Population Health, Hunter New England Local Health District, Newcastle, Australia
- School of Medicine and Public Health, The University of Newcastle, Newcastle, NSW, Australia
- Priority Research Centre for Health Behaviour, The University of Newcastle, Newcastle, NSW, Australia
- Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
| | - Rebecca K. Hodder
- Hunter New England Population Health, Hunter New England Local Health District, Newcastle, Australia
- School of Medicine and Public Health, The University of Newcastle, Newcastle, NSW, Australia
- Priority Research Centre for Health Behaviour, The University of Newcastle, Newcastle, NSW, Australia
- Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
| | - Stewart G. Trost
- Institute of Health and Biomedical Innovation at QLD Centre for Children's Health Research, School of Exercise and Nutrition Sciences, Queensland University of Technology, Brisbane, Australia
| | - Christophe Lecathelinais
- Hunter New England Population Health, Hunter New England Local Health District, Newcastle, Australia
| | - Cassandra Lane
- Hunter New England Population Health, Hunter New England Local Health District, Newcastle, Australia
- School of Medicine and Public Health, The University of Newcastle, Newcastle, NSW, Australia
| | - Nicole McCarthy
- Hunter New England Population Health, Hunter New England Local Health District, Newcastle, Australia
- School of Medicine and Public Health, The University of Newcastle, Newcastle, NSW, Australia
| | - Nicole Nathan
- Hunter New England Population Health, Hunter New England Local Health District, Newcastle, Australia
- School of Medicine and Public Health, The University of Newcastle, Newcastle, NSW, Australia
- Priority Research Centre for Health Behaviour, The University of Newcastle, Newcastle, NSW, Australia
- Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
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Christian HE, Cross D, Rosenberg M, Schipperijn J, Shilton T, Trapp G, Trost SG, Nathan A, Maitland C, Thornton A, Wenden EJ, George P. Development of physical activity policy and implementation strategies for early childhood education and care settings using the Delphi process. Int J Behav Nutr Phys Act 2020; 17:131. [PMID: 33066798 PMCID: PMC7566154 DOI: 10.1186/s12966-020-01034-2] [Citation(s) in RCA: 5] [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: 07/19/2020] [Accepted: 10/05/2020] [Indexed: 01/26/2023] Open
Abstract
Background The aim of this study was to gain consensus on an evidence informed physical activity policy template for early childhood education and care (ECEC) and determine best-practice dissemination and implementation strategies using the Delphi process. Methods Three-round modified Delphi methodology. During round one an expert working group developed an evidence informed ECEC specific physical activity policy template. Rounds two and three involved national online surveys to seek insight from a group of experts on the draft physical activity policy template. Results Ninety per cent of experts reported ECEC services are fully responsible for having a physical activity policy. There was consensus on the components of the policy and key physical activity and sedentary behaviour statements and recommendations. The most effective methods for disseminating a physical activity policy to ECEC providers included online (websites, social and electronic media), ECEC targeted launch events, direct mail outs and via professional associations. Twenty five key strategies related to management, supervisors and educators; the ECEC physical environment; communicating with families; and accreditation, monitoring and review, were identified as necessary for the successful implementation of physical activity policy in ECEC. Experts reached consensus on nine of these strategies indicating they were both easy to implement and likely to have a high level of influence. Key barriers and enablers to implementing ECEC-specific physical activity were also identified. Conclusions This evidence informed physical activity policy template for ECEC provides recommendations on the amount of physical activity and sedentary time (including screen time) children should have whilst attending ECEC and aligns with national/international guidelines. A number of effective physical activity policy implementation strategies for ECEC were identified. An important next step is advocating for the introduction of legislative requirements for services to have and implement a physical activity policy.
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Affiliation(s)
- Hayley E Christian
- Telethon Kids Institute, University of Western Australia, 35 Stirling Highway, Crawley, WA, 6009, Australia. .,School of Population and Global Health, University of Western Australia, Perth, Australia.
| | - Donna Cross
- Telethon Kids Institute, University of Western Australia, 35 Stirling Highway, Crawley, WA, 6009, Australia
| | - Michael Rosenberg
- School of Human Sciences (Exercise and Sport Science), University of Western Australia, Perth, Australia
| | - Jasper Schipperijn
- Institute of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Trevor Shilton
- School of Population and Global Health, University of Western Australia, Perth, Australia
| | - Georgina Trapp
- Telethon Kids Institute, University of Western Australia, 35 Stirling Highway, Crawley, WA, 6009, Australia.,School of Population and Global Health, University of Western Australia, Perth, Australia
| | - Stewart G Trost
- Institute of Health and Biomedical Innovation - Centre for Children's Health Research, Queensland University of Technology, Brisbane, Australia
| | - Andrea Nathan
- Telethon Kids Institute, University of Western Australia, 35 Stirling Highway, Crawley, WA, 6009, Australia
| | - Clover Maitland
- School of Human Sciences (Exercise and Sport Science), University of Western Australia, Perth, Australia.,Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne, Australia
| | - Ashleigh Thornton
- School of Human Sciences (Exercise and Sport Science), University of Western Australia, Perth, Australia
| | - Elizabeth J Wenden
- Telethon Kids Institute, University of Western Australia, 35 Stirling Highway, Crawley, WA, 6009, Australia.,School of Population and Global Health, University of Western Australia, Perth, Australia
| | - Phoebe George
- Telethon Kids Institute, University of Western Australia, 35 Stirling Highway, Crawley, WA, 6009, Australia
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Trost SG, Brookes DSK. Effectiveness of a novel digital application to promote fundamental movement skills in 3- to 6-year-old children: A randomized controlled trial. J Sports Sci 2020; 39:453-459. [DOI: 10.1080/02640414.2020.1826657] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Stewart G. Trost
- Institute of Health and Biomedical Innovation at Queensland Centre for Children’s Health Research, School of Exercise and Nutrition Sciences Queensland University of Technology (QUT), Brisbane, Australia
| | - Denise S. K. Brookes
- Institute of Health and Biomedical Innovation at Queensland Centre for Children’s Health Research, School of Exercise and Nutrition Sciences Queensland University of Technology (QUT), Brisbane, Australia
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Goodlich BI, Armstrong EL, Horan SA, Baque E, Carty CP, Ahmadi MN, Trost SG. Machine learning to quantify habitual physical activity in children with cerebral palsy. Dev Med Child Neurol 2020; 62:1054-1060. [PMID: 32420632 DOI: 10.1111/dmcn.14560] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/07/2020] [Indexed: 12/27/2022]
Abstract
AIM To investigate whether activity-monitors and machine learning models could provide accurate information about physical activity performed by children and adolescents with cerebral palsy (CP) who use mobility aids for ambulation. METHOD Eleven participants (mean age 11y [SD 3y]; six females, five males) classified in Gross Motor Function Classification System (GMFCS) levels III and IV, completed six physical activity trials wearing a tri-axial accelerometer on the wrist, hip, and thigh. Trials included supine rest, upper-limb task, walking, wheelchair propulsion, and cycling. Three supervised learning algorithms (decision tree, support vector machine [SVM], random forest) were trained on features in the raw-acceleration signal. Model-performance was evaluated using leave-one-subject-out cross-validation accuracy. RESULTS Cross-validation accuracy for the single-placement models ranged from 59% to 79%, with the best performance achieved by the random forest wrist model (79%). Combining features from two or more accelerometer placements significantly improved classification accuracy. The random forest wrist and hip model achieved an overall accuracy of 92%, while the SVM wrist, hip, and thigh model achieved an overall accuracy of 90%. INTERPRETATION Models trained on features in the raw-acceleration signal may provide accurate recognition of clinically relevant physical activity behaviours in children and adolescents with CP who use mobility aids for ambulation in a controlled setting. WHAT THIS PAPER ADDS Machine learning may assist clinicians in evaluating the efficacy of surgical and therapy-based interventions. Machine learning may help researchers better understand the short- and long-term benefits of physical activity for children with more severe motor impairments.
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Affiliation(s)
- Benjamin I Goodlich
- School of Allied Health Sciences, Griffith University, Gold Coast, Queensland, Australia
| | - Ellen L Armstrong
- School of Allied Health Sciences, Griffith University, Gold Coast, Queensland, Australia.,Centre for Children's Health Research, Brisbane, Queensland, Australia
| | - Sean A Horan
- School of Allied Health Sciences, Griffith University, Gold Coast, Queensland, Australia
| | - Emmah Baque
- School of Allied Health Sciences, Griffith University, Gold Coast, Queensland, Australia
| | - Christopher P Carty
- School of Allied Health Sciences, Griffith University, Gold Coast, Queensland, Australia.,Centre for Children's Health Research, Brisbane, Queensland, Australia
| | - Matthew N Ahmadi
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Stewart G Trost
- Centre for Children's Health Research, Brisbane, Queensland, Australia.,Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia
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Ahmadi MN, Pavey TG, Trost SG. Machine Learning Models for Classifying Physical Activity in Free-Living Preschool Children. Sensors (Basel) 2020; 20:s20164364. [PMID: 32764316 PMCID: PMC7472058 DOI: 10.3390/s20164364] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [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: 06/26/2020] [Revised: 07/23/2020] [Accepted: 08/04/2020] [Indexed: 01/14/2023]
Abstract
Machine learning (ML) activity classification models trained on laboratory-based activity trials exhibit low accuracy under free-living conditions. Training new models on free-living accelerometer data, reducing the number of prediction windows comprised of multiple activity types by using shorter windows, including temporal features such as standard deviation in lag and lead windows, and using multiple sensors may improve the classification accuracy under free-living conditions. The objective of this study was to evaluate the accuracy of Random Forest (RF) activity classification models for preschool-aged children trained on free-living accelerometer data. Thirty-one children (mean age = 4.0 ± 0.9 years) completed a 20 min free-play session while wearing an accelerometer on their right hip and non-dominant wrist. Video-based direct observation was used to categorize the children’s movement behaviors into five activity classes. The models were trained using prediction windows of 1, 5, 10, and 15 s, with and without temporal features. The models were evaluated using leave-one-subject-out-cross-validation. The F-scores improved as the window size increased from 1 to 15 s (62.6%–86.4%), with only minimal improvements beyond the 10 s windows. The inclusion of temporal features increased the accuracy, mainly for the wrist classification models, by an average of 6.2 percentage points. The hip and combined hip and wrist classification models provided comparable accuracy; however, both the models outperformed the models trained on wrist data by 7.9 to 8.2 percentage points. RF activity classification models trained with free-living accelerometer data provide accurate recognition of young children’s movement behaviors under real-world conditions.
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Affiliation(s)
- Matthew N. Ahmadi
- Institute of Health and Biomedical Innovation at Queensland Centre for Children’s Health Research, Queensland University of Technology, South Brisbane 4101, Australia;
- Faculty of Health, School of Exercise and Nutrition Sciences, Queensland University of Technology, Kelvin Grove 4059, Australia;
| | - Toby G. Pavey
- Faculty of Health, School of Exercise and Nutrition Sciences, Queensland University of Technology, Kelvin Grove 4059, Australia;
| | - Stewart G. Trost
- Institute of Health and Biomedical Innovation at Queensland Centre for Children’s Health Research, Queensland University of Technology, South Brisbane 4101, Australia;
- Faculty of Health, School of Exercise and Nutrition Sciences, Queensland University of Technology, Kelvin Grove 4059, Australia;
- Correspondence: ; Tel.: +61-7-3069-7301
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Ahmadi MN, O’Neil ME, Baque E, Boyd RN, Trost SG. Machine Learning to Quantify Physical Activity in Children with Cerebral Palsy: Comparison of Group, Group-Personalized, and Fully-Personalized Activity Classification Models. Sensors (Basel) 2020; 20:s20143976. [PMID: 32708963 PMCID: PMC7411900 DOI: 10.3390/s20143976] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Revised: 07/09/2020] [Accepted: 07/16/2020] [Indexed: 11/16/2022]
Abstract
Pattern recognition methodologies, such as those utilizing machine learning (ML) approaches, have the potential to improve the accuracy and versatility of accelerometer-based assessments of physical activity (PA). Children with cerebral palsy (CP) exhibit significant heterogeneity in relation to impairment and activity limitations; however, studies conducted to date have implemented “one-size fits all” group (G) models. Group-personalized (GP) models specific to the Gross Motor Function Classification (GMFCS) level and fully-personalized (FP) models trained on individual data may provide more accurate assessments of PA; however, these approaches have not been investigated in children with CP. In this study, 38 children classified at GMFCS I to III completed laboratory trials and a simulated free-living protocol while wearing an ActiGraph GT3X+ on the wrist, hip, and ankle. Activities were classified as sedentary, standing utilitarian movements, or walking. In the cross-validation, FP random forest classifiers (99.0–99.3%) exhibited a significantly higher accuracy than G (80.9–94.7%) and GP classifiers (78.7–94.1%), with the largest differential observed in children at GMFCS III. When evaluated under free-living conditions, all model types exhibited significant declines in accuracy, with FP models outperforming G and GP models in GMFCS levels I and II, but not III. Future studies should evaluate the comparative accuracy of personalized models trained on free-living accelerometer data.
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Affiliation(s)
- Matthew N. Ahmadi
- Institute of Health and Biomedical Innovation at Queensland Centre for Children’s Health Research, Queensland University of Technology, South Brisbane 4101, Australia; (M.N.A.); (E.B.)
- Faculty of Health, School of Exercise and Nutrition Sciences, Queensland University of Technology, Kelvin Grove 4059, Australia
| | - Margaret E. O’Neil
- Department of Rehabilitation and Regenerative Medicine, Columbia University Irving Medical Center, New York, NY 10032, USA;
| | - Emmah Baque
- Institute of Health and Biomedical Innovation at Queensland Centre for Children’s Health Research, Queensland University of Technology, South Brisbane 4101, Australia; (M.N.A.); (E.B.)
- School of Allied Health Sciences, Griffith University, Gold Coast 4215, Queensland, Australia
| | - Roslyn N. Boyd
- Queensland Cerebral Palsy and Rehabilitation Research Centre, UQ Child Health Research Centre, Faculty of Medicine, The University of Queensland, South Brisbane 4101, Australia;
| | - Stewart G. Trost
- Institute of Health and Biomedical Innovation at Queensland Centre for Children’s Health Research, Queensland University of Technology, South Brisbane 4101, Australia; (M.N.A.); (E.B.)
- Faculty of Health, School of Exercise and Nutrition Sciences, Queensland University of Technology, Kelvin Grove 4059, Australia
- Correspondence: ; Tel.: +61-7-3069-7301
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Ahamdi MN, Chowdhury AK, Brookes DK, Trost SG. Machine Learning Activity Classification Models For Preschool-aged Children: The Need For Free-living Training Data. Med Sci Sports Exerc 2020. [DOI: 10.1249/01.mss.0000684364.93781.ff] [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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Affiliation(s)
- Stewart G Trost
- Institute of Health and Biomedical Innovation at QLD Centre for Children's Health Research, Queensland University of Technology, Level 6, 62 Graham Street, South Brisbane, QLD, 4101, Australia.
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To QG, Gallegos D, Do DV, Tran HTM, To KG, Wharton L, Trost SG. Correlates of physical activity in fifth-grade students in Ho Chi Minh City, Vietnam. Sports Medicine and Health Science 2020; 2:33-37. [PMID: 35783334 PMCID: PMC9219262 DOI: 10.1016/j.smhs.2020.02.002] [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] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Accepted: 02/07/2020] [Indexed: 11/28/2022] Open
Abstract
Studies investigating correlates of physical activity (PA) using objective PA measurements among primary school-aged children are limited in Asia, particularly Vietnam. This study examined psychosocial and environmental factors associated with PA among fifth-grade students in eight primary schools in Ho Chi Minh city, Vietnam. Bivariate analyses showed that for every month increase in students’ age, an increase of 66 steps/day (p<0.05) was found; boys had 1442 more steps/day than girls (p<0.001); and students from lower income households had 1169 steps/day less than those from higher income households (p<0.01). For every unit increase in self-efficacy, perceived social influences, intention to be physically active, and parental support for PA, an increase of 220, 200, 522, and 117 steps/day (p<0.01) was found respectively. In multivariable analysis, only intention and parental support for PA remained significant (p<0.01). About 21% of variation in daily steps was explained by demographic characteristics and an additional 13% by psychosocial influences. In conclusion, intention to be physically active and parental support are important factors and should be considered when designing PA interventions in school/community-based settings.
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Affiliation(s)
- Quyen G. To
- Appleton Institute, School of Health, Medical and Applied Sciences, Central Queensland University, Australia
- School of Exercise and Nutrition Sciences, Queensland University of Technology, Brisbane, Australia
- Corresponding author. Central Queensland University, Rockhampton, Australia.
| | - Danielle Gallegos
- School of Exercise and Nutrition Sciences, Institute for Health and Biomedical Innovation at QLD Centre for Children's Health Research, Queensland University of Technology, Brisbane, Australia
| | - Dung V. Do
- Faculty of Public Health, University of Medicine and Pharmacy at Ho Chi Minh City, Viet Nam
| | | | - Kien G. To
- Faculty of Public Health, University of Medicine and Pharmacy at Ho Chi Minh City, Viet Nam
| | - Lee Wharton
- School of Exercise and Nutrition Sciences, Queensland University of Technology, Brisbane, Australia
| | - Stewart G. Trost
- School of Exercise and Nutrition Sciences, Institute for Health and Biomedical Innovation at QLD Centre for Children's Health Research, Queensland University of Technology, Brisbane, Australia
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Okely AD, Stanley RM, Jones RA, Cliff DP, Trost SG, Berthelsen D, Salmon J, Batterham M, Eckermann S, Reilly JJ, Brown N, Mickle KJ, Howard SJ, Hinkley T, Janssen X, Chandler P, Cross P, Gowers F. 'Jump start' childcare-based intervention to promote physical activity in pre-schoolers: six-month findings from a cluster randomised trial. Int J Behav Nutr Phys Act 2020; 17:6. [PMID: 31948454 PMCID: PMC6966838 DOI: 10.1186/s12966-020-0910-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [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: 03/28/2019] [Accepted: 01/07/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Participation in adequate levels of physical activity during the early years is important for health and development. We report the 6-month effects of an 18-month multicomponent intervention on physical activity in early childhood education and care (ECEC) settings in low-income communities. METHODS A cluster randomised controlled trial was conducted in 43 ECEC settings in disadvantaged areas of New South Wales, Australia. Three-year-old children were recruited and assessed in the first half of 2015 with follow-up 6 months later. The intervention was guided by Social Cognitive Theory and included five components. The primary outcome was minutes per hour in total physical activity during ECEC hours measured using Actigraph accelerometers. Intention-to-treat analysis of the primary outcome was conducted using a generalized linear mixed model. RESULTS A total of 658 children were assessed at baseline. Of these, 558 (85%) had valid accelerometer data (mean age 3.38y, 52% boys) and 508 (77%) had valid accelerometry data at 6-month follow-up. Implementation of the intervention components ranged from 38 to 72%. There were no significant intervention effects on mins/hr. spent in physical activity (adjusted difference = - 0.17 mins/hr., 95% CI (- 1.30 to 0.97), p = 0.78). A priori sub-group analyses showed a greater effect among overweight/obese children in the control group compared with the intervention group for mins/hr. of physical activity (2.35mins/hr., [0.28 to 4.43], p = 0.036). CONCLUSIONS After six-months the Jump Start intervention had no effect on physical activity levels during ECEC. This was largely due to low levels of implementation. Increasing fidelity may result in higher levels of physical activity when outcomes are assessed at 18-months. TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry ACTRN12614000597695.
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Affiliation(s)
- Anthony D Okely
- Early Start, Faculty of Social Sciences, University of Wollongong, Northfields Ave, Wollongong, New South Wales, 2522, Australia.
| | - Rebecca M Stanley
- Early Start, Faculty of Social Sciences, University of Wollongong, Northfields Ave, Wollongong, New South Wales, 2522, Australia
| | - Rachel A Jones
- Early Start, Faculty of Social Sciences, University of Wollongong, Northfields Ave, Wollongong, New South Wales, 2522, Australia
| | - Dylan P Cliff
- Early Start, Faculty of Social Sciences, University of Wollongong, Northfields Ave, Wollongong, New South Wales, 2522, Australia
| | - Stewart G Trost
- Institute of Health and Biomedical Innovation at Queensland Centre for Children's Health Research, School of Exercise and Nutrition Science, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Donna Berthelsen
- School of Early Childhood, Queensland University of Technology, Kelvin Grove, Queensland, 4059, Australia
| | - Jo Salmon
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
| | - Marijka Batterham
- Early Start, Faculty of Social Sciences, University of Wollongong, Northfields Ave, Wollongong, New South Wales, 2522, Australia
| | - Simon Eckermann
- Early Start, Faculty of Social Sciences, University of Wollongong, Northfields Ave, Wollongong, New South Wales, 2522, Australia
| | - John J Reilly
- School of Psychological Science and Health, University of Strathclyde, Glasgow, Scotland, UK
| | - Ngiare Brown
- Early Start, Faculty of Social Sciences, University of Wollongong, Northfields Ave, Wollongong, New South Wales, 2522, Australia
| | - Karen J Mickle
- Institute of Health and Sport, Victoria University, Melbourne, Australia
| | - Steven J Howard
- Early Start, Faculty of Social Sciences, University of Wollongong, Northfields Ave, Wollongong, New South Wales, 2522, Australia
| | - Trina Hinkley
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
| | - Xanne Janssen
- School of Psychological Science and Health, University of Strathclyde, Glasgow, Scotland, UK
| | - Paul Chandler
- Early Start, Faculty of Social Sciences, University of Wollongong, Northfields Ave, Wollongong, New South Wales, 2522, Australia
| | - Penny Cross
- Early Start, Faculty of Social Sciences, University of Wollongong, Northfields Ave, Wollongong, New South Wales, 2522, Australia
| | - Fay Gowers
- Early Start, Faculty of Social Sciences, University of Wollongong, Northfields Ave, Wollongong, New South Wales, 2522, Australia
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47
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Chai LK, Rice-McNeil K, Trost SG. Patterns and Correlates of Sedentary Behavior in Children Attending Family Child Care. Int J Environ Res Public Health 2020; 17:ijerph17020549. [PMID: 31952208 PMCID: PMC7014021 DOI: 10.3390/ijerph17020549] [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] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Revised: 01/10/2020] [Accepted: 01/13/2020] [Indexed: 11/16/2022]
Abstract
Public health authorities recommend young children should not be sedentary for more than one hour at a time. This study assessed the frequency and duration of sedentary bouts in children attending family child care homes (FCCHs); and examined associations with FCCH provider practices related to sedentary behaviors. Overall, 127 children (aged 3.5 ± 1.1 years) from 41 FCCHs participated in the study. Sedentary bouts were measured using an accelerometer worn for the duration of FCCHs attendance over a randomly selected week. Provider practices were assessed using the Nutrition and Physical Activity Self-Assessment for Child Care self-assessment instrument. Children attending FCCHs mostly accumulated short sedentary bouts (<5 min) with very few lasting more than 10 min. Boys exhibited significantly fewer sedentary bouts, and significantly less sedentary time in bouts than girls. Children attending FCCHs that met or exceeded childcare standards for outdoor active play, had portable play equipment, offered a variety of fixed play equipment, and/or adequate indoor play space exhibited significantly fewer sedentary bouts and significantly less sedentary time accumulated in short and medium length bouts. Programs encouraging FCCHs to adopt physical activity promoting practices could potentially reduce child sedentary time while in care.
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Affiliation(s)
- Li Kheng Chai
- Institute of Health and Biomedical Innovation (IHBI) at Queensland Centre for Children’s Health Research, Queensland University of Technology, South Brisbane, QLD 4101, Australia;
- Children’s Health Queensland Hospital and Health Service, South Brisbane, QLD 4101, Australia
| | - Kelly Rice-McNeil
- Department of Health and Human Performance, Eastern Oregon University, La Grande, OR 97850, USA;
| | - Stewart G. Trost
- Institute of Health and Biomedical Innovation (IHBI) at Queensland Centre for Children’s Health Research, Queensland University of Technology, South Brisbane, QLD 4101, Australia;
- Correspondence:
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48
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Ng M, Rosenberg M, Thornton A, Lester L, Trost SG, Bai P, Christian H. The Effect of Upgrades to Childcare Outdoor Spaces on Preschoolers' Physical Activity: Findings from a Natural Experiment. Int J Environ Res Public Health 2020; 17:E468. [PMID: 31936783 PMCID: PMC7014450 DOI: 10.3390/ijerph17020468] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/30/2019] [Revised: 01/03/2020] [Accepted: 01/08/2020] [Indexed: 12/31/2022]
Abstract
Physical inactivity is a significant risk factor for childhood obesity. Preventing obesity in the early years reduces the risk of developing chronic health conditions later. Early childhood education and care (ECEC) services are important settings to establish good preschooler physical activity behaviors. This natural experiment investigated the influence of ECEC outdoor physical environment upgrade on preschoolers' physical activity (aged 2-5 years). Centers implemented upgrades without researcher input. Physical activity was measured by 7-day accelerometry for intervention (n = 159; 6 centers) and control (n = 138; 5 centers) groups. ECEC outdoor space was assessed using a modified Environment and Policy Assessment and Observation (EPAO) Instrument. Key outcomes were measured at baseline and 6-12 months follow-up. Fixed sandboxes, balls, portable slides, portable floor play equipment (e.g., tumbling mats), and natural grassed areas were positively associated with activity levels; fixed tunnels and twirling equipment were negatively associated with activity levels (all p < 0.05). Post-upgrade portable play equipment (balls, twirling equipment, slides, floor play equipment) increased intervention preschoolers' moderate-vigorous physical activity (MVPA) levels compared to control (p < 0.05). Intervention preschoolers were more active than control at follow-up (58.09 vs. 42.13 min/day increase in total physical activity; 30.46 vs. 19.16 min/day increase in MVPA (all p < 0.001)). Since few preschoolers meet daily activity recommendations while at ECEC, the findings may help ECEC providers to optimize outdoor physical environments and encourage more active play among preschoolers.
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Affiliation(s)
- Michelle Ng
- Telethon Kids Institute, University of Western Australia, Perth 6009, Australia; (P.B.); (H.C.)
| | - Michael Rosenberg
- School of Human Sciences M408, University of Western Australia, Crawley, Perth 6009, Australia; (M.R.); (A.T.); (L.L.)
| | - Ashleigh Thornton
- School of Human Sciences M408, University of Western Australia, Crawley, Perth 6009, Australia; (M.R.); (A.T.); (L.L.)
| | - Leanne Lester
- School of Human Sciences M408, University of Western Australia, Crawley, Perth 6009, Australia; (M.R.); (A.T.); (L.L.)
| | - Stewart G. Trost
- Institute of Health and Biomedical Innovation, Centre for Children’s Health Research, Queensland University of Technology, Brisbane 4101, Australia;
| | - Pulan Bai
- Telethon Kids Institute, University of Western Australia, Perth 6009, Australia; (P.B.); (H.C.)
| | - Hayley Christian
- Telethon Kids Institute, University of Western Australia, Perth 6009, Australia; (P.B.); (H.C.)
- School of Population and Global Health M431, University of Western Australia, Perth 6009, Australia
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49
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Fuller AB, Byrne RA, Golley RK, Trost SG. Supporting healthy lifestyle behaviours in families attending community playgroups: parents' perceptions of facilitators and barriers. BMC Public Health 2019; 19:1740. [PMID: 31881955 PMCID: PMC6935103 DOI: 10.1186/s12889-019-8041-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [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: 10/20/2019] [Accepted: 12/04/2019] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Establishing healthy nutrition, activity, and sleep behaviours early in life is a key strategy in childhood obesity prevention. Parents are the primary influence on the development and establishment of obesity-related behaviours in young children. There is evidence that autonomy supporting parenting practices are crucial for the development of self-regulation and the internalisation of healthy behaviours in children. It is therefore imperative that parenting practices are targeted as part of an obesity prevention intervention. However, there is limited understanding of barriers and facilitators to parents using autonomy supporting parenting practices with their children aged 0-5 years. Therefore, the aim of the study was to identify barriers and facilitators to using autonomy supporting parenting practices. A secondary aim was to determine parent preferences in respect to an intervention program to be delivered in community playgroups. METHODS Parents were recruited through Playgroup Queensland (PGQ), a not-for-profit organisation in Brisbane, Australia, to attend a focus group during their usual playgroup session. The focus group interview guide was designed to promote discussion among the participants in respect to their shared experiences as parents of young children. The focus group transcripts were coded and analysed using qualitative content analysis. Five focus groups with parents (n = 30) were conducted in May 2018. Most of the participants were mothers [1], and the majority (76%) had a child at playgroup aged between 2 and 4 years. RESULTS The support and guidance received from other parents at playgroup was a facilitator to autonomy supporting parenting practices. Barriers included beliefs around the need to use rewards to encourage child eating, beliefs around the need for screens as babysitters, and feeling disempowered to change sleep behaviours. Parents were enthusiastic about a potential program that would leverage off the existing playgroup support networks, but they did not want to be "educated", or to lose their "playgroup time" to an intervention. Rather they wanted strategies and support to deal with the frustrations of food, screen and sleep parenting. CONCLUSION These results will be used to inform the development of a childhood obesity prevention intervention to be delivered in a community playgroup setting.
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Affiliation(s)
- Andrea B Fuller
- Institute of Health and Biomedical Research, Queensland University of Technology, Centre for Children's Health Research, 62 Graham St, South Brisbane, QLD 4101, Australia.,NHMRC Centre of Research Excellent in the Early Prevention of Obesity in Childhood, Sydney School of Public Health, Level 6, Charles Perkins Centre, University of Sydney, Sydney, Australia
| | - Rebecca A Byrne
- Institute of Health and Biomedical Research, Queensland University of Technology, Centre for Children's Health Research, 62 Graham St, South Brisbane, QLD 4101, Australia.,NHMRC Centre of Research Excellent in the Early Prevention of Obesity in Childhood, Sydney School of Public Health, Level 6, Charles Perkins Centre, University of Sydney, Sydney, Australia
| | - Rebecca K Golley
- NHMRC Centre of Research Excellent in the Early Prevention of Obesity in Childhood, Sydney School of Public Health, Level 6, Charles Perkins Centre, University of Sydney, Sydney, Australia.,College of Nursing and Health Sciences, Flinders University, Adelaide, Australia
| | - Stewart G Trost
- Institute of Health and Biomedical Research, Queensland University of Technology, Centre for Children's Health Research, 62 Graham St, South Brisbane, QLD 4101, Australia. .,NHMRC Centre of Research Excellent in the Early Prevention of Obesity in Childhood, Sydney School of Public Health, Level 6, Charles Perkins Centre, University of Sydney, Sydney, Australia.
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50
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Ahmadi MN, Nathan N, Sutherland R, Wolfenden L, Trost SG. Non-wear or sleep? Evaluation of five non-wear detection algorithms for raw accelerometer data. J Sports Sci 2019; 38:399-404. [PMID: 31826746 DOI: 10.1080/02640414.2019.1703301] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Detection of non-wear periods is an important step in accelerometer data processing. This study evaluated five non-wear detection algorithms for wrist accelerometer data and two rules for non-wear detection when non-wear and sleep algorithms are implemented in parallel. Non-wear algorithms were based on the standard deviation (SD), the high-pass filtered acceleration, or tilt angle. Rules for differentiating sleep from non-wear consisted of an override rule in which any overlap between non-wear and sleep was deemed non-wear; and a 75% rule in which non-wear periods were deemed sleep if the duration was < 75% of the sleep period. Non-wear algorithms were evaluated in 47 children who wore an ActiGraph GT3X+ accelerometer during school hours for 5 days. Rules for differentiating sleep from non-wear were evaluated in 15 adults who wore a GeneActiv Original accelerometer continuously for 24 hours. Classification accuracy for the non-wear algorithms ranged between 0.86-0.95, with the SD of the vector magnitude providing the best performance. The override rule misclassified 37.1 minutes of sleep as non-wear, while the 75% rule resulted in no misclassification. Non-wear algorithms based on the SD of the acceleration signal can effectively detect non-wear periods, while application of the 75% rule can effectively differentiate sleep from non-wear when examined concurrently.
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Affiliation(s)
- Matthew N Ahmadi
- Institute of Health and Biomedical Innovation at QLD Centre for Children's Health Research, School of Exercise and Nutrition Sciences, Queensland University of Technology, Brisbane, Australia
| | - Nicole Nathan
- Hunter New England Population Health, Hunter New England Area Health Service, Newcastle, Australia.,School of Medicine and Public Health, The University of Newcastle, Newcastle, Australia.,Priority Research Centre for Health Behaviour, The University of Newcastle, Newcastle, Australia.,Hunter Medical Research Institute, New Lambton Heights NSW, Newcastle, Australia
| | - Rachel Sutherland
- Hunter New England Population Health, Hunter New England Area Health Service, Newcastle, Australia.,School of Medicine and Public Health, The University of Newcastle, Newcastle, Australia.,Priority Research Centre for Health Behaviour, The University of Newcastle, Newcastle, Australia.,Hunter Medical Research Institute, New Lambton Heights NSW, Newcastle, Australia
| | - Luke Wolfenden
- Hunter New England Population Health, Hunter New England Area Health Service, Newcastle, Australia.,School of Medicine and Public Health, The University of Newcastle, Newcastle, Australia.,Priority Research Centre for Health Behaviour, The University of Newcastle, Newcastle, Australia.,Hunter Medical Research Institute, New Lambton Heights NSW, Newcastle, Australia
| | - Stewart G Trost
- Institute of Health and Biomedical Innovation at QLD Centre for Children's Health Research, School of Exercise and Nutrition Sciences, Queensland University of Technology, Brisbane, Australia
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