The relationship between physical activity, sedentary behaviour and psychological wellbeing among adolescents

Screen time among kindergarten children in the Australian Capital Territory (including a comparison of First Nations and non-Indigenous children)

BACKGROUND

Australian First Nations children have poorer outcomes across a range of health measures. High levels of screen time are associated with a range of adverse health outcomes. Gaps remain in our knowledge on the association between screen time and health outcomes for different demographic groups, including First Nations children. We aimed to describe the screen time behaviours of First Nations and non-Indigenous kindergarten children in the Australian Capital Territory (ACT) and identify any associated disparities in key health outcomes.

METHODS

5,516 children participated in the cross-sectional population-based ACT Kindergarten Health Check (KHC) survey, including 146 First Nations children. The association between screen time of more than two hours per day and health outcomes (body mass index, respiratory health, development and wellbeing) was assessed for both First Nations and non-Indigenous cohorts using comparative statistics.

RESULTS

Non-Indigenous children who had an average of more than two hours of screen time per day were 1.5 (95% CI, 1.3-1.7) times more likely to be overweight/obese, 1.2 (95% CI, 1.0-1.4) times more likely to have had a wheeze/whistle in their chest in the 12 months before the KHC, 1.5 (95% CI, 1.3-1.7) times more likely to have developmental concerns and 1.5 (95% CI, 1.3-1.8) times more likely to have reduced wellbeing measures compared to non-Indigenous children with screen time of two hours or less per day. None of these associations were statistically significant amongst First Nations children.

CONCLUSIONS

Screen time of more than two hours per day is associated adverse health outcomes in non-Indigenous children, including overweight/obesity, respiratory problems, developmental concerns, and reduced wellbeing. Further analysis is required to enable a more robust assessment of the effect of screen time on health outcomes for First Nations children.

Associations Between Intrinsic Motivation, Exercise Attitudes, Physical Activity, and Mental Health in Young Adolescents: An Integrated Motivational Perspective

Purpose: Physical activity (PA) and mental health (MH) are priorities for health promotion during early adolescence. This study explored associations between intrinsic motivation for PA, exercise attitudes, PA and MH in young adolescents. Methods: Participants were 315 students (Mage = 11.41; SD = 2.09; 45.1% girls) conveniently sampled from two private British schools in Dubai. Data were collected via a survey and analyzed using structural equation modeling. Results: As hypothesized, higher intrinsic motivation was directly associated with more favorable exercise attitudes, and attitudes was directly associated with increased PA. Unexpectedly, however, PA was not associated with better MH outcomes. A better fitting model was specified in which attitudes was directly associated with both PA and MH. Conclusions: Further research examining associations between exercise attitudes, PA, and MH in young adolescents is warranted.

Physical (in)activity and screen-based media use of adolescents with juvenile idiopathic arthritis over time - data from a German inception cohort

BACKGROUND

Regular physical activity (PA) has been proven to help prevent non-communicable diseases and is beneficial for disease management in chronically ill populations. Physical inactivity and recreational screen-based media (SBM) use are related to poor health outcomes and common among youth. This study aimed to (1) investigate PA levels and recreational SBM use of adolescents with JIA over time and (2) compare these behaviours with those of their peers.

METHODS

Data from JIA patients and their peers enrolled in the inception cohort study ICON at 11 German centers were analyzed. Individuals aged 13 and over were followed prospectively with questionnaires concerning PA level, recreational SBM use, and health-related quality of life (HRQoL) at a two-year interval. Group by time interactions were analyzed using linear mixed models.

RESULTS

Data of 214 patients (mean age at first documentation 14.4 ± 0.9 years, female 63%) and 141 peers could be considered. At first documentation, patients were less physically active compared to their peers (p < 0.001). In contrast to their peers, patients' PA levels increased over time (OR 3.69; 95% CI: 1.01-13.50, p = 0.048). Mean screen time did not differ significantly between patients and peers (first documentation: 3.5 h vs. 3.0 h, p = 0.556; follow-up: 3.6 h vs. 3.3 h, p = 0. 969). During the observation period, male patients reported higher PA levels than female patients, but also higher screen time levels. While low socioeconomic status (SES) (OR 14.40; 95%-CI: 2.84-73.15) and higher cJADAS-10 score (OR 1.31; 95%-CI: 1.03-1.66) increased the likelihood for high SBM use (≥ 4.5 h/d), higher PedsQL psychosocial health score (OR 0.93; 95%-CI: 0.88-0.99) was associated with a decreased likelihood.

CONCLUSIONS

Adolescents with JIA become more physically active over the disease course and achieve comparable levels of PA and recreational screen time to their peers. However, the vast majority appear to be insufficiently physically active. Future interventions to promote healthy lifestyles should include gender and SES as important determinants to reach most vulnerable groups.

Assessment of Motor Performance and Self-Perceived Psychophysical Well-Being in Relation to Body Mass Index in Italian Adolescents

BACKGROUND/OBJECTIVES

The relationship between psychophysical self-perception (PSP), body mass index (BMI) and motor performance (MP) levels, in quantitative and qualitative terms, can be a very interesting connection to investigate. This study aimed to assess MP and PSP according to gender and weight differences (normal weight-Nw/overweight-obese-Ov-Ob) and their relationship to BMI in Italian adolescents.

METHODS

In total, 144 students (F = 72; M = 72) aged between 11 and 13 y.o. participated in this study. They were divided into two groups by gender and into two subgroups based on weight (Nw/Ov-Ob). Standing long jump, sit-and-reach, 10 × 5 m shuttle and sit-up tests to assess MP were carried out, and an ad hoc questionnaire to evaluate PSP was administrated.

RESULTS

In comparing the Nw and Ov-Ob subgroups on the basis of BMI for each gender, statistically significant differences emerged in all motor skill tests administered. Regarding PSP, the Nw subgroup showed high and positive levels, while Ov-Ob showed low and negative levels, highlighting a relationship between high BMI and poor motor performance as well as negative psychophysical perception in the Ov-Ob subgroup.

CONCLUSIONS

this study supports the importance of physical sport activity to regulate excess weight but also contribute to better psychophysical well-being.

Late-night eating and inactivity: Links to depression and suicide risk in adolescents living in Turkey

OBJECTIVE

Depression, anxiety, and eating disorders are all common during adolescence. This study aims to investigate the potential relationship between eating at night, physical activity, and depression/suicide risk in adolescents.

METHODS

This study followed a cross-sectional descriptive design and involved collecting data from adolescents aged 13-18 years who attend four different high schools. The data collection was done through an online survey using Google Forms. Sociodemographic form, eating at night questionnaire, International Physical Activity Questionnaire (Short Form), Reynolds Adolescent Depression Scale, and Suicide Probability Scale were used for data collection. The data collected were analyzed electronically using descriptive statistics and correlation tests to examine relationships between different parameters.

RESULTS

The study revealed significant associations between academic achievement, daily sleep duration, and daily walking distance with depression and suicide probability (p < 0.05) among the participants. Adolescents who consumed food after 10 pm exhibited higher depression and suicide probability scores than their counterparts (p < 0.05). Additionally, an analysis of physical activity levels demonstrated that highly active adolescents had lower depression and suicide probability scores.

CONCLUSIONS

In conclusion, this study suggests that there is a significant relationship between eating at night, physical activity, and depression/suicide risk in adolescents. Specifically, academic success, daily sleep duration, daily walking distance, and eating habits were found to be associated with depression and suicide probability. Encouraging physical activity and healthy eating habits, particularly avoiding eating late at night, may be beneficial in reducing the risk of depression and suicide among adolescents.

Enduring maternal brain changes and their role in mediating motherhood's impact on well-being

Parenthood, particularly motherhood, is known to impact the structure and function of the brain in the short term, but the long-term effects of parenthood and their impacts on well-being are still poorly understood. This study explores the potential longer-term associations between parenthood and the brain, parenthood and well-being, and the potential role of brain modifications in influencing mothers' well-being. Using data from the UK Biobank, which includes brain imaging information from individuals aged 45-82 at the MRI scanning, we discovered differences in brain structure between mothers and non-mothers, with mothers exhibiting widely distributed higher gray matter density, particularly strong in frontal and occipital regions. No brain changes were observed in fathers. Parents reported a higher sense of life's meaning compared to their childless counterparts. Gray matter changes did not mediate the relationship between motherhood and well-being. This suggests that the alterations in gray matter associated with motherhood do not play a deterministic role in shaping long-term changes in well-being.

Conduct problems, hyperactivity, and screen time among community youth: can mindfulness help? an exploratory study

Background

The influence of mindfulness-based intervention (MBI) programs on behavioural problems among community youth is largely understudied. While technology continues to evolve and the prevalence of screen-based activities is rising, limited studies have accounted for screen time when examining the efficacy of an MBI. Accordingly, this study investigated the impact of MBI on conduct problems and hyperactivity among community youth, accounting for sociodemographic characteristics and four types of screen time.

Method

Linear regression models were used to investigate 1) the association between four types of screen time and behavioural problems (i.e., conduct problems and hyperactivity) and 2) the efficacy of online mindfulness programs in reducing behavioural problems among community youth. The data were collected at baseline, intervention completion and 1-month follow-up (Spring 2021 to Spring 2022) in Ontario, Canada (n=117, mean age=16.82, male=22%, non-White=21%).

Results

The average score for conduct problems was within the normal range, while the average score for hyperactivity was considered borderline at baseline. Accounting for other types of screen time, time spent playing video games was significantly associated with increased conduct problems (β= 1.75, p=.03), albeit rendering non-significant after correcting for multiple comparisons. The online mindfulness program was significantly associated with reduced hyperactivity, controlling for baseline mental health, age, sex and screen time.

Conclusion

The current findings suggest a 12-week online mindfulness program may play a positive role in reducing hyperactivity even when accounting for screen time. Our findings advocate the evidence base on the efficacy of MBI in managing hyperactivity.

Relationship between physical activity and behaviour challenges of adolescents in South Africa

Background

Four out of five adolescents worldwide are physically inactive based on recommended standards.

Aim

We determined whether physical activity is associated with lower behavioural challenges in adolescents to promote buy-in from stakeholders.

Setting

KwaZulu-Natal province, South Africa, from January 2020 to March 2020.

Methods

A cross-sectional study was conducted among 187 adolescent learners (12-18 years) from three government schools in KwaZulu-Natal Province, South Africa, from January to March 2020. We fitted linear regression models between the Strengths and Difficulties Questionnaire scores (total, internalising, externalising, and prosocial) and hours of physical activity exposure, adjusting for demographic covariates, and depression history.

Results

The median age was 14.4 years (interquartile range = 1.36) and 75.9% of the participants were females. Overall average and weekday physical activity were each associated with lower total and externalising but higher pro-social scores. Depression was associated with higher inactivity scores (total, internalising and externalising).

Conclusions

The article shows that physical activity can reduce the behavioural and emotional problems in adolescents.

Contribution

Physical activity is critical for a healthy adolescent hood and needs to be actively included in childhood development.

Cook like a Boss Online: an adapted intervention during the COVID-19 pandemic that effectively improved children's perceived cooking competence, movement competence and wellbeing

BACKGROUND

The COVID-19 pandemic has further exacerbated physical inactivity, poor dietary intake and reduced mental wellbeing, contributing factors to non-communicable diseases in children. Cooking interventions are proposed as having a positive influence on children's diet quality. Motor skills have been highlighted as essential for performance of cooking skills, and this movement may contribute to wellbeing. Additionally, perceived competence is a motivator for behaviour performance and thus important for understanding intervention effectiveness. Therefore, this research aimed to assess the effectiveness of an adapted virtual theory-based cooking intervention on perceived cooking competence, perceived movement competence and wellbeing.

METHODS

The effective theory-driven and co-created 'Cook Like A Boss' was adapted to a virtual five day camp-styled intervention, with 248 children across the island of Ireland participating during the pandemic. Pre- and post-intervention assessments of perceived cooking competence, perceived movement competence and wellbeing using validated measurements were completed through online surveys. Bivariate Correlations, paired samples t-tests and Hierarchical multiple regression modelling was conducted using SPSS to understand the relationships between the variables and the effect of the intervention.

RESULTS

210 participants had matched survey data and were included in analysis. Significant positive correlations were shown between perceived cooking competence, perceived movement competence and wellbeing (P < 0.05). Children's perceived cooking competence (P < 0.001, medium to large effect size), perceived movement competence (P < 0.001, small to medium effect size) and wellbeing (P = 0.013, small effect size) all significantly increased from pre to post intervention. For the Hierarchical regression, the final model explained 57% of the total variance in participants' post-intervention perceived cooking competence. Each model explained a significant amount of variance (P < 0.05). Pre-intervention perceived cooking competence, wellbeing, age and perceived movement competence were significant predictors for post-intervention perceived cooking competence in the final model.

CONCLUSION

The 'Cook Like A Boss' Online intervention was an adapted virtual outreach intervention. It provides initial evidence for the associations between perceived cooking competence, perceived movement and wellbeing as well as being effective in their improvement. This research shows the potential for cooking to be used as a mechanism for targeting improvements in not only diet quality but also movement and wellbeing.

TRIAL REGISTRATION

NCT05395234. Retrospectively registered on 26th May 2022.

Recommendations for Identifying Valid Wear for Consumer-Level Wrist-Worn Activity Trackers and Acceptability of Extended Device Deployment in Children

BACKGROUND

Self-reported physical activity is often inaccurate. Wearable devices utilizing multiple sensors are now widespread. The aim of this study was to determine acceptability of Fitbit Charge HR for children and their families, and to determine best practices for processing its objective data.

METHODS

Data were collected via Fitbit Charge HR continuously over the course of 3 weeks. Questionnaires were given to each child and their parent/guardian to determine the perceived usability of the device. Patterns of data were evaluated and best practice inclusion criteria recommended.

RESULTS

Best practices were established to extract, filter, and process data to evaluate device wear, r and establish minimum wear time to evaluate behavioral patterns. This resulted in usable data available from 137 (89%) of the sample.

CONCLUSIONS

Activity trackers are highly acceptable in the target population and can provide objective data over longer periods of wear. Best practice inclusion protocols that reflect physical activity in youth are provided.

The Value of Sport: Wellbeing Benefits of Sport Participation during Adolescence

Insight into the unique benefits of sport participation above and beyond those associated with participation in other physical activities among adolescents is limited in Aotearoa New Zealand (NZ). The purpose of this study was to examine the association between wellbeing and organised sport participation among adolescents whilst accounting for demographic characteristics and other recreational physical activity. Demographic characteristics (age, gender, ethnicity, deprivation, (dis)ability status), organized sport, recreational physical activity, and wellbeing were assessed in cohorts of NZ adolescents (11–17 years) between 2017 and 2019. After adjusting for demographics, better wellbeing was associated with participation in any recreational physical activity (OR = 2.49, 95%CI = 1.97–3.13), meeting physical activity recommendations (OR = 1.63, 95%CI = 1.47–1.81), and each additional hour of recreational physical activity (OR = 1.03, 95%CI = 1.02–1.04). After adjusting for demographics and overall recreational physical activity participation, better wellbeing was also associated with participation in any organized sport (OR = 1.66, 95%CI = 1.49–1.86), and each additional hour of organized sport (OR = 1.09, 95%CI = 1.07–1.11). Although participation in recreational physical activity appears to be beneficial for wellbeing, organized sport appears to offer unique additional wellbeing benefits. Positive experiences of organized sport participation may offer additional wellbeing value above and beyond other recreational physical activity types in young people who are active.

Physical Activity Levels, Perceived Body Appearance, and Body Functioning in Relation to Perceived Wellbeing Among Adolescents

This study aimed to investigate self-reported physical activity levels, perceived body appearance, and body functioning in relation to perceived wellbeing among adolescents. A cross-sectional survey was performed in four upper secondary schools in one municipality in southern Sweden. Data were obtained from questionnaires completed by 1,491 adolescents (55.4% females; median age 16; range 15–17 years) during school hours. The participation rate was 71.4%. Logistic regression analyses were carried out with wellbeing as the dependent variable. The independent variables included gender, perceived family financial situation, perceived body appearance, perceived body function, and physical activity level. Perceived positive wellbeing was associated with being satisfied with their body's appearance (OR 3.4; CI 2.6–4.4) and function (OR 3.1; CI 2.2–4.2), being physically active three or more times per week (OR 1.5; CI 1.1–2.0), and a good perceived family financial situation (OR 3.3; CI 1.6–6.7). Gender was not significantly associated with wellbeing. A positive body image, which include both body appearance and body function, and high physical activity levels were significantly associated with wellbeing in adolescents, corroborating the importance of promoting physical activity among younger populations.

Associations between self-rated health, life satisfaction and physical activity among adolescents in Saudi Arabia

Empirical evidence has shown that health status and life satisfaction are strongly correlated and connected to physical activity. However, no previous research has examined the association of physical activity (PA) with self-rated health (SRH) and life satisfaction (LS) among adolescents in Saudi Arabia. Therefore, a cross-sectional study was conducted among a sample of male adolescents (n=453; age 15–20 years) in Riyadh, Saudi Arabia. The objective was to investigate the association between LS and SRH with PA in adolescents, taking into account socio-demographic variables. A pre-tested validated questionnaire was used to collect data using a stratified sampling technique. An estimated 354 (78.5%) adolescents reported being healthy, and 98 (21.7%) were satisfied with their lives. The logistic regression analysis revealed that adolescents’ SRH was independently associated with their sense of LS (AOR=2.5, 95%CI: 1.5-4.3, P≤0.001). Also, the odds of reporting being healthy increased 2.5 times for being moderate active (95%CI: 1.5-4.3, P<0.001) and 3.4 times for being highly active (95%CI: 2.0-5.8, P≤0.001), as compared to non-active adolescents. Moreover, adjusted logistic regression showed that adolescents’ LS was independently associated with high level of their father’s education (AOR=1.8, 95%CI: 1.2-3.0, P=0.023); studying in private schools (AOR=1.9, 95%CI: 1.3-2.9, P≤0.011) and being highly active (AOR=3.0, 95%CI: 1.6-4.2, P=0.007). SRH and LS are determinants of each other, and both variables were independently associated with PA levels. Programs that increase PA may promote life satisfaction and health status in the adolescent population. Therefore, it is important to promote physical activity amongst them, create a sport-friendly environment, and engage adolescents in physical activity during their free time by broadening access to more sports classes and other forms of assistance. This is also an important method of enhancing adolescents’ life satisfaction and better health.

Self-perceived social relationships are related to health risk behaviors and mental health in adolescents

Although changes have been observed in social relationships in the recent years, especially among younger generations, little evidence is available concerning factors associated with adolescents' perceived social relationships. In this study we investigated the association between self-perceived social relationships, health-related behaviors, biological maturation, and mental health in adolescents. This is a cross-sectional study conducted with 1,336 adolescents (605 boys and 731 girls) aged between 10 to 17 years from public schools. Self-perceived social relationships (family, friends, and teachers), feelings of stress and sadness, academic performance, tobacco smoking, alcohol and fat consumption, physical activity, and screen time were evaluated by a questionnaire. Biological maturation was assessed by the peak height velocity. We observed that worse perceived social relationships were associated with tobacco smoking (family and teachers), alcohol drinking (teachers), higher consumption of fat (teachers), greater feelings of stress (family and teachers) and sadness (family and friends), and poor academic achievement (friends and teachers).

Associations between Physical Activity and Mental Health in Iranian Adolescents during the COVID-19 Pandemic: An Accelerometer-Based Study

Using self-reported questionnaires, several studies found that social isolation during the COVID-19 pandemic has significantly changed the level of physical activity (PA) in children and adolescents. Since the objectivity of self-reported PA is limited in several ways, we used modern accelerometers in this study to assess the PA levels of male and female adolescents during the pandemic-related lockdown. Moreover, the association of PA with mental health of the adolescents were analyzed. A total of 136 students (76 girls, mean age of 16.28 ± 0.97 years) from various schools in Iran wore the accelerometer (ActiGraph GT3X-BT) for seven consecutive days. Mental health was measured through the Depression, Anxiety, Stress Scale-21 of Lovibond and Lovibond (1995). Descriptive statistics and independent t-tests were used to analyze the PA levels of male and female students, and linear regressions were computed to examine whether PA predicts mental health status. On average, the daily time spent in moderate-to-vigorous PA (MVPA) was 18.47 min, which is clearly below the WHO guideline of at least 60 min of MVPA per day. Only 4% of adolescents showed MVPA for more than 30 min per day. Male students were significantly more active than their female peers (p = 0.015). As expected, MVPA was negatively associated with mental health issues such as depression, anxiety, and stress. However, the majority of adolescents reported symptoms of mild-to-moderate mental health disorders. These results emphasize the need for targeted strategies and offerings geared to young people's needs and preferences to promote an adequate level of PA and good mental health during and after the ongoing pandemic.

A Short Version of the Physical Activity Enjoyment Scale: Development and Psychometric Properties

Objective: The purposes of this paper were to (a) develop a new short, theory-driven, version of the physical activity enjoyment scale (PACES-S) using content analysis; and (b) subsequently to measure the psychometric properties (construct validity, internal consistency, test–retest reliability, and concurrent validity) of the PACES-S for adolescents. Methods: Six experts used a four-point Likert scale to assess the content validity of each of the 16 items of the physical activity enjoyment scale according to a provided definition of physical activity enjoyment. Based on the results, exploratory factor analysis was used to analyze survey data from a longitudinal study of 182 individuals (Measure 1 of Study 1: 15.75 ± 3.39 yrs; 56.6% boys, 43.4% girls), and confirmatory factor analysis (Measure 2 of Study 1: 15.69 ± 3.44 yrs; 56.3% boys, 43.7% girls) was used to analyze the survey data from a cross-sectional study of 3219 individuals (Study 2; 15.99 ± 3.10 yrs; 47.8% boys, 52.2% girls) to assess the construct validity of the new measure. To assess the reliability, test–retest reliability was assessed in Study 1 and internal consistency in Study 1 and 2. For the concurrent validity, correlations with self-reported and device-based physical activity behavior were assessed in both studies. Results: Four out of sixteen items were selected for PACES-S. Exploratory factor analysis and confirmatory factor analyses identified and supported its factorial validity (χ² = 53.62, df = 2, p < 0.001; RMSEA = 0.073; CFI = 0.99; RFI = 0.96; NFI = 0.99; TLI = 0.96; IFI = 0.99). Results showed good test–retest reliability (r = 0.76) and internal consistency (a = 0.82 to 0.88). Regarding concurrent validity, the results showed positive correlations with a physical activity questionnaire (Study 1: r = 0.36), with a physical activity diary (Study 1: r = 0.44), and with accelerometer-recorded data (Study 1: r = 0.32; Study 2: r = 0.21). Conclusions: The results indicate that PACES-S is a reliable and valid instrument that may be particularly useful to measure physical activity enjoyment in large-scale studies. It shows comparable measurement properties as the long version of PACES.

Physical activity participation, flourishing and academic engagement in adolescents with obesity

BACKGROUND

Adolescents with obesity are less likely to flourish and be academically engaged in comparison to their healthy weight peers. However, it is unknown how participation in physical activity influences flourishing and academic engagement in adolescents with obesity. The current study examined engagement in varying levels of physical activity and the likelihood of flourishing and academic engagement in adolescents with obesity.

METHODS

Analyses included 26 764 adolescents, ages 10-17 years, from the parent-reported, combined 2016-2017 National Survey of Children's Health. Participants were grouped by physical activity levels (none, low, moderate, daily). Outcome variables included flourishing (finishing tasks, staying calm when faced with a challenge and showing interest in new things) and academic engagement (completing all required homework and caring about doing well in school). Logistic regression models, adjusted for age, sex, race, household income, highest level of education in the household, behavioural conduct problems and depression assessed the likelihood of each outcome comparing physical activity levels among adolescents with obesity.

RESULTS

Adolescents with obesity who participated in any amount of physical activity (low, moderate and daily) or sports had significantly greater likelihood of flourishing and academic engagement compared those that did not engage in any physical activity (p's < 0.05).

CONCLUSIONS

Participation in even low amounts of physical activity or participation in sports increases the likelihood of flourishing and academic engagement in adolescents with obesity, which expands on previous findings that adolescents with obesity are less likely to flourish and be academically engaged in comparison to their healthy weight peers.

Autonomous motivation and action planning are longitudinally associated with physical activity during adolescence and early adulthood

We examined the associations of autonomous motivation, controlled motivation, and physical activity (PA) planning with PA participation over six years across the adolescent-to-adult transition. Participants from the NEXT Generation Health Study, a nationally representative cohort study of U.S. 10th graders (N=2785), completed surveys yearly from 2010 to 2016 (four years post-high school). This study used data from Waves 2 (W2) through 7 (W7). Data were analyzed using growth models accounting for the complex survey design and controlling for sex, race/ethnicity, and body mass index. A piecewise growth model with two pieces (Piece 1: W2-W4; Piece 2: W4-W7) indicated that PA declined during late adolescence (W2-W4) (b=-0.31, β=-0.22, p<.001), but did not decline after the transition into early adulthood (W4-W7) (b=-0.08, β=-0.04, p=.052). Autonomous motivation was positively associated with PA at all waves (b=0.23-0.33, β=1.90-4.37, p<.001). Controlled motivation was only positively associated with PA at W3 (12th grade) (b=0.13, β=1.54, p=.011). PA planning varied significantly between individuals and significantly predicted PA (b=0.44, β=0.21, p<.001). Although PA decreased significantly during late adolescence, PA did not decrease significantly after transitioning into early adulthood (one to four years post-high school). Elevated autonomous motivation and PA planning were consistently and significantly associated with higher PA, suggesting that these may be useful intervention targets during this adolescent-to-adult transition.

Physical activity and disordered eating behaviours: Are Caribbean adolescents at risk?

Excessive physical activity (PA) has been linked to increased risk for disordered eating behaviours and eating disorders. This study investigates the relationship between PA and disordered eating behaviours and attitudes (DEBAs) among Jamaican adolescents. This cross-sectional study included 521 adolescents, 12-19 years. Anthropometric measurements were collected, and adolescents completed questionnaires on disordered eating behaviours (EAT-26), physical activity, self-esteem and affect. Associations were assessed using sex-specific mixed-effect linear and logistic regression models. Participants reported exercising an average of 3 days per week. Adolescents who exercised for a longer duration had greater odds of having elevated EAT-26 scores (at least 1 hour-OR = 2.04; 95% CI = 1.03, 4.06; p = .042), while a higher exercise frequency among males (3-5 days per week) was protective against DEBAs (OR 0.38; 95% CI = 0.16, 0.88; p = .025). Female adolescents reported higher prevalence of elevated EAT-26 scores than males (p < .01). Increased negative affect increased odds of an elevated EAT-26 score. Exercise duration and frequency play a role in disordered eating behaviours in Jamaican adolescents and vary by gender. Our findings have implications for weight management interventions and policies, encouraging healthcare providers to monitor PA levels as well as negative affect in adolescents who display disordered eating behaviours.

Continued Participation of Israeli Adolescents in Online Sports Programs during the COVID-19 Pandemic Is Associated with Higher Resilience

Background: Coronavirus disease 2019 (COVID-19) has forced adolescents to adapt rapidly to a new reality of physical and social distancing, while introducing a range of new sources of stress and adversity. Our primary aim was to study the relationship between adolescents' resilience and their participation in online sports programs during the COVID-19 pandemic lockdown period. Our secondary aims were to assess the associations between the organized sports programs' determinants and resilience. Methods: Online surveys designed to examine resilience, lifestyle, psychosocial health and characteristics of the organized sports programs were administered to 473 adolescents who were enrolled in organized sports programs before the COVID-19 pandemic. Results: Adolescents who continued to participate in online structured programs during the lockdown period were significantly more resilient and physically active, had higher self-related health, satisfaction with life, and ability to cope during the pandemic, compared to those who did not participate. Relationships with the adult instructor and levels of physical activity were the most important factors of the programs that were associated with resilience. Conclusions: Participation of adolescents in sports programs is an important resource associated with higher levels of resilience. Youth programs should continue their activities during globally challenging times, such as the COVID-19 pandemic.

Body surveillance prospectively linked with physical activity via body shame in adolescent girls

The socialization of girls to habitually monitor their bodies, via the process of body surveillance, contributes to an increased risk of negative physical and psychological experiences. The present study examined if body surveillance may also contribute to the decrease in physical activity that is observed in girls during adolescence, and if this association is mediated by body shame (operationalized as both experienced and anticipated shame when imagining changes to one's body in the future). Physically active adolescent girls (n = 206) reported body surveillance at baseline, and measures of experienced and anticpated body shame, and physical activity two years later. Body surveillance was indirectly associated with physical activity via the experience and anticipation of body shame. Specifically, the experience of body shame was associated with lower reported engagement in physical activity (b = -0.13, 95 % CI [-0.23, -0.03]), whereas the anticipation of body shame was associated with higher physical activity (b = 0.07, 95 % CI [0.01, 0.15]), possibly for the purpose of appearance management. Due to the opposing directional effects of experienced versus anticipated body shame, it is important to consider both facets of this emotional experience in understanding how vigilant bodily monitoring impacts physical activity engagement in adolescent girls.

The Big Three Health Behaviors and Mental Health and Well-Being Among Young Adults: A Cross-Sectional Investigation of Sleep, Exercise, and Diet

BACKGROUND

Sleep, physical activity, and diet have been associated with mental health and well-being individually in young adults. However, which of these "big three" health behaviors most strongly predicts mental health and well-being, and their higher-order relationships in predictive models, is less known. This study investigated the differential and higher-order associations between sleep, physical activity, and dietary factors as predictors of mental health and well-being in young adults.

METHOD

In a cross-sectional survey design, 1,111 young adults (28.4% men) ages 18-25 from New Zealand and the United States answered an online survey measuring typical sleep quantity and quality; physical activity; and consumption of raw and processed fruit and vegetables, fast food, sweets, and soda, along with extensive covariates (including demographics, socioeconomic status, body mass index, alcohol use, smoking, and health conditions) and the outcome measures of depressive symptoms [measured by the Center for Epidemiological Depression Scale (CES-D)] and well-being (measured by the Flourishing Scale).

RESULTS

Controlling for covariates, sleep quality was the strongest predictor of depressive symptoms and well-being, followed by sleep quantity and physical activity. Only one dietary factor-raw fruit and vegetable consumption-predicted greater well-being but not depressive symptoms when controlling for covariates. There were some higher-order interactions among health behaviors in predicting the outcomes, but these did not survive cross-validation.

CONCLUSION

Sleep quality is an important predictor of mental health and well-being in young adults, whereas physical activity and diet are secondary but still significant factors. Although strictly correlational, these patterns suggest that future interventions could prioritize sleep quality to maximize mental health and well-being in young adults.

International clinical practice recommendations on the definition, diagnosis, assessment, intervention, and psychosocial aspects of developmental coordination disorder - Chinese (Mandarin) translation

目的

本国际临床指南由欧洲残疾儿童学会（the European Academy of Childhood Disability，EACD）牵头制定，旨在解决发育性协调障碍（developmental coordination disorder，DCD）的定义、诊断、评估、干预以及与社会心理方面的临床应用关键问题。

方法

本指南针对五个领域的关键问题，通过文献综述和专家团队的正式讨论达成共识。为保证指南的循证基础，以“机制”、“评估”和“干预”为检索词, 对2012年更新以来提出的最新建议以及新增的“社会心理问题”和“青少年/成人”为检索词进行检索。根据牛津大学循证医学中心证据等级 (证据水平 [level of evidence, LOE]1–4) 将结果进行分类，最终转化为指南建议。并由国际、多学科专家小组举行了两次会议，5个回合的Delphi 专家问卷调查，制定了高质量临床应用实践 (good clinical practice，GCP) 。

结果

本指南共制定35条建议。其中8条以文献综述为依据 (3 条涉及“评估”，5条涉及“干预”)； 22 条在 2012 年指南的基础上进行了更新；其他为涉及诊断、评估 (3条GCP) 及社会心理问题 (2 条 GCP) 的新建议。此外，其中有1条(LOE)新建议提出视频游戏可作为以活动和参与为导向的传统干预措施的辅助手段，并针对青少年和成人DCD提出了 2 条新建议 (1 条 GCP，1 条 LOE)。

结论

本指南是基于当前的研究证据和专家共识对DCD进行全面概述。它反映了不同学科临床和科研人员的最新科技水平。本国际指南可作为各国制定指南的基础。

Psychological symptoms are associated with screen and exercise time: a cross-sectional study of Chinese adolescents

Background

Mental disorders among adolescents have become a worldwide public health problem. This study aimed to estimate the best combination of exercise time and screen time to promote the mental health of Chinese adolescents.

Methods

Participants included 7200 Chinese adolescents aged 13–18 years from six regions of China. Screen and exercise time data were collected via a self-rated questionnaire. Psychological symptoms (e.g., often feeling depressed, school-weary) were evaluated with the “Multidimensional Sub-health Questionnaire of Adolescents”. Chi-squared tests and logistic regression analysis were conducted to investigate the differences in and correlations among screen time, exercise time, and psychological symptoms.

Results

The overall detection rate of psychological symptoms among Chinese adolescents was 21.4% (22.1% for boys and 20.6% for girls). Psychological symptom detection rates were lowest among adolescents with 1–2 h/d of screen time (19.5%) and those with 30–60 min/d of exercise time (17.3%). Screen time > 2 h/d (OR = 1.38, P < 0.001) and exercise time < 30 min/d (OR = 1.62, P < 0.001) were positively correlated with psychological symptoms.

Conclusion

Screen and exercise time are associated with psychological symptoms in Chinese adolescents. A combination of 1–2 h/d of screen time and 30–60 min/d of exercise time is provided as a reference for better mental health.

Association between Physical Activity and Mood States of Children and Adolescents in Social Isolation during the COVID-19 Epidemic

The COVID-19 epidemic adversely affects the lifestyle of people. This study aimed to examine the impacts of social isolation on physical activity (PA) levels and mood states of children and adolescents and to explore the correlation between them during the COVID-19 epidemic. A total of 9979 children and adolescents (11.63 ± 1.23 years old) from Yan’an, China volunteered to participate in this study and completed online questionnaires. PA and mood states were measured by International Physical Activity Questionnaire Short Form (IPAQ-SF) and Profile of Mood States (POMS), respectively. The results showed that the mean of students’ moderate-to-vigorous PA (MVPA) was 23.19 min per day. The total mood disturbance in the moderate and high-level PA groups were significantly lower than those in the low-level PA group (p < 0.05). Additionally, boys and girls had significant differences in PA levels (p < 0.01), and the PA levels of students in different grades were also significantly different (p < 0.01). Meanwhile, boys’ mood states were worse than girls’. The Grade 4 in primary schools had the worst mood states while Grade 5 had the best mood states. The results suggested that the MVPA of students has dropped badly, compared with the results of previous studies investigated in normal times. In addition, the PA level had a significantly positive impact on the mood states of children and adolescents during the COVID-19 epidemic. Sex and grades were factors which affected the PA levels and mood states. This study can help policymakers and healthcare professionals understand PA and mood states of Chinese children and adolescents during the epidemic. We should pay attention to the changes in PA levels and mood states of children and adolescents.

Psychological impacts of "screen time" and "green time" for children and adolescents: A systematic scoping review

Technological developments in recent decades have increased young people's engagement with screen-based technologies (screen time), and a reduction in young people's contact with nature (green time) has been observed concurrently. This combination of high screen time and low green time may affect mental health and well-being. The aim of this systematic scoping review was to collate evidence assessing associations between screen time, green time, and psychological outcomes (including mental health, cognitive functioning, and academic achievement) for young children (<5 years), schoolchildren (5-11 years), early adolescents (12-14 years), and older adolescents (15-18 years). Original quantitative studies were identified in four databases (PubMed, PsycInfo, Scopus, Embase), resulting in 186 eligible studies. A third of included studies were undertaken in Europe and almost as many in the United States. The majority of studies were cross-sectional (62%). In general, high levels of screen time appeared to be associated with unfavourable psychological outcomes while green time appeared to be associated with favourable psychological outcomes. The ways screen time and green time were conceptualised and measured were highly heterogeneous, limiting the ability to synthesise the literature. The preponderance of cross-sectional studies with broadly similar findings, despite heterogeneous exposure measures, suggested results were not artefacts. However, additional high-quality longitudinal studies and randomised controlled trials are needed to make a compelling case for causal relationships. Different developmental stages appeared to shape which exposures and outcomes were salient. Young people from low socioeconomic backgrounds may be disproportionately affected by high screen time and low green time. Future research should distinguish between passive and interactive screen activities, and incidental versus purposive exposure to nature. Few studies considered screen time and green time together, and possible reciprocal psychological effects. However, there is preliminary evidence that green time could buffer consequences of high screen time, therefore nature may be an under-utilised public health resource for youth psychological well-being in a high-tech era.

Accelerometer based assessment of daily physical activity and sedentary time in adolescents with idiopathic scoliosis

BACKGROUND

Studies have shown a positive correlation between higher physical activity (PA) and health benefits. However, device-based assessment of PA and sedentary time (ST) in people with adolescent idiopathic scoliosis (AIS) has not been deeply investigated.

OBJECTIVE

Analysis and comparison of weekend and weekdays PA and ST using multiple accelerometers in people with AIS with different curvature severity compared to healthy controls.

METHODS

24 participants with AIS divided into 2 groups of 12 with Cobb angles < 40° and > 40°, along with 12 age and BMI matched healthy controls. Daily PA and ST during four consecutive days were measured using four tri-axial accelerometers. Clinical functional assessment was performed using the scoliosis research society (SRS-22) questionnaire.

RESULTS

The combined weekend and weekdays average daily step count was found to be 22% and 29% lower in the AIS groups with Cobb angle < 40° and > 40°, respectively, compared to the controls. The average ST was also reported to be 5% and 7% higher in the AIS groups with Cobb angle < 40° and > 40°, respectively, compared to the controls. The reported differences were significant in the AIS group with higher Cobb angle (p≤0.05). No significant differences in PA or ST were reported between the AIS groups based on curvature severity.

CONCLUSIONS

Decreased PA and increased ST observed in patients with AIS may have long term health implications and may play a role in the disease process. The device-based assessment of PA to understand potential benefits in clinical practice is recommended.

Behavioral classes related to physical activity and sedentary behavior on the evaluation of health and mental outcomes among Brazilian adolescents

Latent Class Analysis can assist researchers interested in a better understanding of behavioral patterns and their association with health outcomes. This study aimed to identify lifestyle latent classes related to distinct domains of physical activity (PA) and sedentary behavior (SB) among adolescents and their association with health outcomes. This cross-sectional study included 217 Brazilian adolescents (15 to 18 years old, 49.3% female). The classes were based on moderate-to-vigorous physical activity (MVPA), light physical activity (LPA), number of steps, sedentary behavior (SB), and screen time (ST). To assess these behaviors, participants wore an accelerometer for one week. ST, demographic characteristics, socioeconomic status, and signs of common mental disorders (CMD) were evaluated through questionnaires. Latent Class Analysis was used to identify lifestyle classes. Three classes were recognized: “Active—Non-sedentary” (class 1) with 28.1% of adolescents; “Inactive—Non-sedentary” (class 2), 48.85%; and “Inactive—Sedentary” (class 3), 23.04%. Sex and signs of CMD were associated with the prevalence of the classes. Female adolescents presented 4.48 (95% CI 2.04–9.77) times more chance of belonging to the “Inactive—Sedentary” (class 3). Adolescents who presented CMD had 11.35 (95% CI 3.45–101.1) times more chance of belonging to the “Inactive—Non-sedentary” (class 2). The interaction between sex and signs of CMD showed that girls with signs of CMD were 9.20 (95% CI 1.17–71.52) more likely to belong to the Inactive—Sedentary class than the “Active—Non-sedentary”. Results indicate that sex and signs of CMD can affect the prevalence of the classes. Our findings highlight that physical inactivity and SB can be associated with signs of CMD, especially in female adolescents.

A two-week summer program promoting physical activity: quality of life assessment in Italian children

Physical activity (PA) can be associated with better health-related quality of life (HRQoL). This study aimed to assess HRQoL before and after a two-week summer program promoting PA in Italian school-aged children. Participants were recruited during the Giocampus summer2017 (Parma, Italy), from June to July. Before (T0) and after (T1) the program, children and one of their parents answered the Kindl questionnaire. For each domain, least-square mean changes (LSmc) at T1 were derived from linear regression models stratified by responder and adjusted for child gender, age group, time spent in PAs and HRQoL score of the responder at T0. 350 children (7-13 years, 52% males) and 342 parents answered the questionnaire at both T0 and T1. At T1, the HRQoL score of the children significantly improved in the emotional (LSmc 2.9, p<0.001), self-esteem (LSmc 3.3, p<0.001), family (LSmc 4.2, p<0.001) and friend (LSmc 3.1, p<0.001) domains. Parents reported significantly more improvement in self-esteem than children (LSmc 6.7 vs 3.3, p=0.012). Children spending more time in PA reported significantly more improvement in self-esteem than those doing less PA (LSmc 4.4 [p<0.001] vs 2.2 [p=0.181]). A short summer program promoting PA may improve HRQoL in the general population of school-aged children.

The Relation Between Early Adolescent Physical Activity and Internalizing Problems: Variations in Exercise Motivations as a Critical Moderator

Inconsistencies exist regarding the relation between physical activity (PA) and internalizing symptomology in early adolescence, and there is need for investigation of potential moderators that may account for these discrepancies. The current study utilized a Self-Determination Theory Framework to investigate the main effects of five key motivations to exercise and their moderating effects between PA and internalizing problems in an underserved sample of adolescents (n = 167; mean age = 12.19 years; 73% African American). Analyses showed that intrinsic motivations were negatively related to internalizing problems and extrinsic motivations were positively related. PA was only protective against internalizing problems when intrinsic motivations were high and had iatrogenic effects when these were low. Exploratory analyses further delineated the unique effects of motivational orientations. Clinical implications and future research directions are discussed.

European Psychiatric Association (EPA) guidance on prevention of mental disorders

There is considerable evidence that various psychiatric conditions can be prevented through the implementation of effective evidence-based interventions. Since a large proportion of lifetime mental illness starts before adulthood, such interventions are particularly important during childhood and adolescence. Prevention is important for the sustainable reduction of the burden of mental disorder since once it has arisen, treatment can only reduce a relatively small proportion of such burden. The challenge for clinicians is to incorporate such interventions into non-clinical and clinical practice as well as engaging with a range of other service providers including public health. Similar strategies can be employed in both the European and global contexts. Promotion of mental well-being can prevent mental disorder but is also important in the recovery from mental disorder. This guidance should be read in conjunction with the EPA Guidance on Mental Health Promotion. This guidance draws on preparatory work for the development of England policy on prevention of mental disorder which used a wide range of sources.

A good beginning: study protocol for a group-randomized trial to investigate the effects of sit-to-stand desks on academic performance and sedentary time in primary education

BACKGROUND

Sedentary behavior is associated with health risks and academic under-achievement in children. Still, children spend a large part of their waking hours sitting at a desk at school. Recent short-term studies demonstrated the potential of sit-to-stand desks to reduce sitting time in primary education. The program of "A Good Beginning" was conceived to assess the long-term effects of sit-to-stand desks on sitting time in primary education, and to examine how sit-to-stand desks versus regular desks relate to academic performance, and measures of executive functioning, health and wellbeing. The present paper describes the design of this group-randomized trial, which started in 2017 and will be completed in 2019.

METHODS

Children of two grade-three groups (age 8-9) following regular primary education in Leiden, The Netherlands, were recruited. A coin toss determined which group is the experimental group; the other group is the control group. All children in the experimental group received sit-to-stand desks. They are invited and motivated to reduce sedentary time at school, however, it is their own choice to sit or stand. Children in the control group use regular desks. Otherwise, both groups receive regular treatment. Outcomes are assessed at baseline (T0) and at five follow-up sessions (T1-T5) alternately in winter and summer seasons over three academic years. Primary outcome measures are academic performance, and the proportion of sitting time at school, measured with a 3D accelerometer. Secondary outcome measures are a number of measures related to executive functioning (e.g., N-back task for working memory), health (e.g., height and weight for BMI), and wellbeing (e.g., KIDSCREEN-52 for Quality of Life).

DISCUSSION

A Good Beginning is a two-and-a-half-year research program, which aims to provide a better understanding of the long-term effects of sit-to-stand desks on sedentary time at school and the relation between sitting time reduction and academic performance, executive functioning, health and wellbeing. The findings may serve as useful information for policy making and practical decision making for school and classroom environments.

TRIAL REGISTRATION

The program of "A Good Beginning" is registered at the Netherlands Trial Register (NTR, https://www.trialregister.nl), number NL6166, registration date 24 November 2016.

Physical activity, nutrition, and psychological well-being among youth with visual impairments and their siblings

PURPOSE

The primary purpose of this study was to examine physical activity, nutritional intake, and psychological well-being differences between youth with visual impairments and their siblings residing in the same household. A secondary purpose was to examine the relationship between physical activity behavior and psychological well-being among youth with visual impairments.

MATERIALS AND METHODS

A sample of 22 dyads of youth with visual impairments and siblings completed this study. Data were collected through parent-reported demographic and psychological well-being questionnaires, nutritional intake questionnaires, and accelerometry. Data were analyzed descriptively and inferentially, examining proportion difference using McNemar's z-test, and mean differences using multivariate analyses of variance.

RESULTS

Siblings without visual impairments had higher but not significantly higher daily average moderate-to-vigorous physical activity (d = 0.46), significantly higher prosocial score (d = 0.63), and lower but not significantly lower difficulty scores (d = 0.39), than youth with visual impairments. Small, not statistically significant, nutritional intake differences between siblings were found.

CONCLUSIONS

Differences in physical activity and nutritional habits between those with visual impairments and their siblings were not significant, supporting the environmentally driven nature of these variables. Associations between physical activity and well-being were not apparent in this study but may be partially explained by low participant physical activity.Implications for RehabilitationYouth with visual impairments and the siblings may be influenced by the same familial factors and molded in a similar fashion by parenting behaviors regarding health-related behaviors.In this study, youth with visual impairments engaged in similar physical activity and nutritional behaviors to their siblings without visual impairments.Efforts to improve health-related behaviors among those with visual impairments may be most effective at the family level.Small subsets of youth with visual impairments gain mental health benefits from physical activity engagement.

A systematic review of measures for psychological well-being in physical activity studies and identification of critical issues

BACKGROUND

The health benefits of physical activity (PA) have been well documented in the literature. The relationship between PA and psychological well-being (PWB) has received increasing attention.

AIM

This study aimed to systematically review the measurement of PWB in PA studies and examine the major findings of these studies.

METHODS

We conducted a systematic search in PubMed/Medline, Web of Science, PsycINFO, and SportDiscus for articles published from their inception to October 2018 to identify empirical studies that investigated the relationship between PA and PWB. For each study meeting the inclusion criteria, we identified its measure for PWB and reviewed its main findings.

RESULTS

The literature search identified 53 studies examining the relationship between PA and PWB and 48 measurement scales for assessing various domains of PWB. The measurement scales were further classified as measures of hedonic well-being (n = 11), eudaimonic well-being (n = 10), mental ill-being (n = 18), or multifaceted well-being (n = 9). Twenty-seven out of 29 observational studies and nineteen out of 24 intervention studies found favorable associations between PA and at least one domain of PWB.

CONCLUSIONS

Although the findings in the empirical studies generally support a positive relationship between PA and PWB, the specific psychological domains measured in these studies vary considerably. In addition, the definition of PWB in these studies is incomplete and unclear. Future studies are suggested to choose measurement scales based on a clear and theoretically based definition of PWB and focus more on hedonic well-being and eudaimonic well-being.

Daily Bicycle and Pedestrian Activity as an Indicator of Disaster Recovery: A Hurricane Harvey Case Study

Changes in levels and patterns of physical activity might be a mechanism to assess and inform disaster recovery through the lens of wellbeing. However, few studies have examined disaster impacts on physical activity or the potential for physical activity to serve as an indicator of disaster recovery. In this exploratory study, we examined daily bicycle and pedestrian counts from four public bicycle/pedestrian trails in Houston, before and after Hurricane Harvey landfall, to assess if physical activity returned to pre-Harvey levels. An interrupted time series analysis was conducted to examine the immediate impact of Harvey landfall on physical activity; t-tests were performed to assess if trail usage returned to pre-Harvey levels. Hurricane Harvey was found to have a significant negative impact on daily pedestrian and bicycle counts for three of the four trails. Daily pedestrian and bicycle counts were found to return to pre-Harvey or higher levels at 6 weeks post-landfall at all locations studied. We discuss the potential for further research to examine the trends, feasibility, validity, and limitations of using bicycle and pedestrian use levels as a proxy for disaster recovery and wellbeing among affected populations.

Classifying Diverse Physical Activities Using "Smart Garments"

Physical activities can have important impacts on human health. For example, a physically active lifestyle, which is one of the most important goals for overall health promotion, can diminish the risk for a range of physical disorders, as well as reducing health-related expenditures. Thus, a long-term goal is to detect different physical activities, and an important initial step toward this goal is the ability to classify such activities. A recent and promising technology to discriminate among diverse physical activities is the smart textile system (STS), which is becoming increasingly accepted as a low-cost activity monitoring tool for health promotion. Accordingly, our primary aim was to assess the feasibility and accuracy of using a novel STS to classify physical activities. Eleven participants completed a lab-based experiment to evaluate the accuracy of an STS that featured a smart undershirt (SUS) and commercially available smart socks (SSs) in discriminating several basic postures (sitting, standing, and lying down), as well as diverse activities requiring participants to walk and run at different speeds. We trained three classification methods—K-nearest neighbor, linear discriminant analysis, and artificial neural network—using data from each smart garment separately and in combination. Overall classification performance (global accuracy) was ~98%, which suggests that the STS was effective for discriminating diverse physical activities. We conclude that, overall, smart garments represent a promising area of research and a potential alternative for discriminating a range of physical activities, which can have positive implications for health promotion.

The association between physical fitness and health in a nationally representative sample of Canadian children and youth aged 6 to 17 years

INTRODUCTION

This study explored the relationship between physical fitness and indicators of physical and psychosocial health in a nationally representative sample of Canadian children and youth aged 6-17 years.

METHODS

We conducted a secondary data analysis of Canadian Health Measures Survey (Cycles 1 and 2; 2007-2011) data. The physical fitness measures included cardiorespiratory fitness (CRF; modified Canadian Aerobic Fitness Test), strength (handgrip strength), flexibility (sit-and-reach), and muscular endurance (partial curl-ups). The physical health indicators included directly measured biomarkers (total and HDL [high-density lipoprotein] cholesterol, C-reactive protein, glucose, and HbA1c [glycohaemoglobin]) and measures of adiposity, resting heart rate, and blood pressure. Psychosocial health was assessed using the Strengths and Difficulties Questionnaire. Multiple linear regressions were used to determine the association between variables, stratified by age groups and sex.

RESULTS

3,800 (48.9% female) children and youth were retained for this analysis. CRF displayed significant favourable associations with most physical health indicators in male and female participants. There were less significant favourable associations with flexibility and muscular endurance compared with CRF across age and sex groups. Strength was associated with higher adiposity in males and females, and lower heart rate in male children (β = -1.9; 95% CI: -2.9, -1.0) and female youth (β = -2.0; 95% CI: -2.7, -1.2). There were few significant favourable associations between measures of physical fitness and psychosocial health in this sample of children and youth.

CONCLUSION

These findings suggest that physical fitness, and especially CRF, is a significant indicator of physical health among Canadian children and youth aged 6-17 years.

'Who Am I?': An Exploratory Study of the Relationships Between Identity, Acculturation and Mental Health in Autistic Adolescents

Autistic adolescents are at increased risk of mental health difficulties. One potential factor contributing to this is identity development, although this hypothesis has been little explored. These adolescents also have to consider how autism forms their identity, a process called acculturation. This exploratory study examined the relationships between identity, acculturation and mental health in autistic adolescents. Twenty-four participants completed measures investigating identity, acculturation and mental health. Findings suggested mental health was not related to personal identity. Mental health scores did not differ between acculturation groups, however those aligned to non-autistic culture tended to generate more positive self-statements than those aligned to neither culture. These findings suggest autistic adolescents should be encouraged to explore autistic culture and supported in constructing their identity.

International and Spanish Findings in Scientific Literature about Minors' Mental Health: Predictive Factors Using the Strengths and Difficulties Questionnaire

Minors' mental health is a subject of high global concern. Understanding the factors that influence their mental health is essential to improving the health of future generations. In this study, an analysis of the Strengths and Difficulties Questionnaire's usefulness is carried out, as a validated tool, recognized in Spain and internationally, for the measurement of minors' mental health. In turn, the influence of the variables of gender, age, and physical health, along with the occupational social class of parents on Spanish minors' mental health, has been analyzed. Spanish minors with good physical health and of parents with middle and higher education, as well as in an occupational social class, are less likely to suffer mental health problems. On the other hand, it seems that internalizing symptoms are more likely in girls, and externalizing symptoms are more likely in boys. However, when a global measure of mental health is made without specific subscales, the effects of gender and age diverge greatly, according to the studies. Although there are examples of current research using the same measurement tool, there is still a need for many more international studies that are coordinated using the same methodology. This study identifies the factors which the international and Spanish scientific literature has revealed as being determinants in minors' mental health. Finally, it is essential that the influence of these factors be assessed in the areas of primary care and mental health to facilitate better detection, intervention, or prevention of mental health problems in today's children, as well as the children of future generations.

Association between physical exercise and psychosocial problems in 96 617 Dutch adolescents in secondary education: a cross-sectional study

Background

Psychosocial problems negatively affect school performance, social skills and mental development. In recent years, researchers have investigated the relationship between physical activity and psychological health. With this large school-based study, we examined whether physically inactive adolescents and slightly active adolescents experience more psychosocial problems compared with active adolescents.

Methods

This study is based on the Dutch National Youth Health Monitor. This monitor uses a, school-based, cross-sectional questionnaire conducted among 96 617 adolescents in 2015. To examine the association between physical exercise and psychosocial problems, multi-level linear regression was carried out.

Results

The weighted average Strengths and Difficulties Questionnaire score of active adolescents was lower than that of inactive adolescents. Adolescents who are inactive had 12% (β = 1.12; 95% CI: 1.10-1.14; P <0 .001) more psychosocial problems compared with active adolescents. Further, inactive adolescents had a higher score on the subscales emotional problems (β = 1.19; 95% CI: 1.17-1.22; P < 0.001) and problems with peers (β = 1.16; 95% CI: 1.14-1.19; P < 0.001). There was no statistical significant difference in total score of the Strengths and Difficulties Questionnaire between active and slightly active adolescents.

Conclusion

Physically active adolescents have fewer psychosocial problems compared with physically inactive adolescents. Not only is this association significant, but there is an indication that it is also of clinical relevance.

International clinical practice recommendations on the definition, diagnosis, assessment, intervention, and psychosocial aspects of developmental coordination disorder

AIM

These international clinical practice recommendations (CPR) for developmental coordination disorder (DCD), initiated by the European Academy of Childhood Disability (EACD), aim to address key questions on the definition, diagnosis, assessment, intervention, and psychosocial aspects of DCD relevant for clinical practice.

METHOD

Key questions in five areas were considered through literature reviews and formal expert consensus. For recommendations based on evidence, literature searches on 'mechanisms', 'assessment', and 'intervention' were updated since the last recommendations in 2012. New searches were conducted for 'psychosocial issues' and 'adolescents/adults'. Evidence was rated according to the Oxford Centre for Evidence-Based Medicine (level of evidence [LOE] 1-4) and transferred into recommendations. For recommendations based on formal consensus, two meetings of an international, multidisciplinary expert panel were conducted with a further five Delphi rounds to develop good clinical practice (GCP) recommendations.

RESULTS

Thirty-five recommendations were made. Eight were based on the evidence from literature reviews (three on 'assessment', five on 'intervention'). Twenty-two were updated from the 2012 recommendations. New recommendations relate to diagnosis and assessment (two GCPs) and psychosocial issues (three GCPs). Additionally, one new recommendation (LOE) reflects active video games as adjuncts to more traditional activity-oriented and participation-oriented interventions, and two new recommendations (one GCP, one LOE) were made for adolescents and adults with DCD.

INTERPRETATION

The CPR-DCD is a comprehensive overview of DCD and current understanding based on research evidence and expert consensus. It reflects the state of the art for clinicians and scientists of varied disciplines. The international CPR-DCD may serve as a basis for national guidelines.

WHAT THIS PAPER ADDS

Updated international clinical practice guidelines on developmental coordination disorder (DCD). Refined and extended recommendations on clinical assessment and intervention for DCD. A critical synopsis of current research on mechanisms of DCD. A critical synopsis of psychosocial issues in DCD, with implications for clinical practice. The first international recommendations to consider adolescents and adults with DCD.

Measuring connectedness to nature in preschool children in an urban setting and its relation to psychological functioning

BACKGROUND

The urban environment has been criticized for promoting 'nature-deficit' and 'child-nature disconnectedness'. Keeping in mind the importance of nature exposure and its extensive health benefits, many environmental programs around the world hope to (re)connect children with nature. To evaluate the effectiveness of such efforts, valid tools to measure Connectedness to Nature (CN) are needed but do not exist today, especially for use with pre-schoolers.

METHODS

The original CN Index was modified and tested among the Parents of Preschool Children (CNI-PPC) in an urban setting (Hong Kong) for its internal consistency (n = 299) and external validity (n = 194). The 'Strength and Difficulties Questionnaire' (SDQ) was chosen for divergent and convergent analysis. Conventional recommendations for test adaptation and translation were used.

RESULTS

Confirmatory factor analysis (CFA) revealed that the 16-item scale adequately captured four major dimensions: enjoyment of nature, empathy for nature, responsibility toward nature, and awareness of nature (Cronbach's α were respectively .86, .87, .75 and .80). When tested against the SDQ, a validated measure for child psychological functioning, and identification of children's problem behaviours, three CNI-PPC factors influenced the SDQ outcomes: (1) the more enjoyment of nature children displayed the less overall distress and impairment they exhibited (β = -.64); (2) greater responsibility toward nature in children was associated with less hyperactivity (β = -.50), fewer behavioural and peer difficulties (β = -.62 and β = -.65 respectively) and improved prosocial behaviour (β = .77); (3) the more aware children were of nature, the less emotional difficulties they exhibited (β = -.51). The variance explained was large (range R2 = .42 to .80).

CONCLUSIONS

Thus, CNI-PPC factors have meaningful and substantive associations with the strengths and difficulties parents perceive in their children. This indicates that the CNI-PPC is a valid and reliable instrument to measure CN at an age when children cannot respond for themselves. Further, this simple tool can help researchers/practitioners to better understand how connectedness to nature affects child psychological functioning and wellbeing.

TRIAL REGISTRATION

ClinicalTrials.gov Identifier: NCT02715544. Registered 8 March 2016.

Physical Activity and Mental Disorder Among Adolescents in the United States

OBJECTIVE

To estimate associations between physical activity (PA) and a broad range of lifetime mental disorders among adolescents, and to evaluate whether the context of sports participation impacts these associations.

METHODS

The sample included 6,483 13-18 year-olds from the National Comorbidity Survey Adolescent Supplement. Adolescents completed face-to-face psychiatric interviews and a parent provided diagnostic and other family-level information on the participating adolescent by completing a self-administered questionnaire. PA was measured by adolescent self-report and dichotomized to indicate vigorous exercise several times a week. Nineteen psychiatric disorders were assessed using the Diagnostic and Statistical Manual of Mental Disorders criteria. Multiple logistic regression analyses were used to estimate associations of PA with mental disorders, suicidality, and psychological distress.

RESULTS

Two thirds of adolescents reported being physically active. Active adolescents had significantly lower odds of mood disorder (Odds ratio[OR] = .74, 95% confidence interval [CI]=.58-.94), bipolar II disorder (OR = .54, 95% CI=.30-.99), and general psychological distress (OR = .71, 95% CI=.52-.96) than less/inactive adolescents. In contrast, adolescents who engaged in PA were more likely to have lifetime alcohol use disorder (OR = 1.78, 95% CI = 1.11-2.85), bulimia (OR = 5.84, 95% CI = 2.48-13.79), generalized anxiety disorder (OR = 2.04, 95% CI = 1.16-3.58), and posttraumatic stress disorder (OR = 1.65, 95% CI = 1.07-2.55). The direct associations between PA and alcohol use disorder and bulimia appeared to be specific to adolescents who participated in organized sports.

DISCUSSION

Associations between PA and lifetime mental disorder among adolescents may differ according to both disorder type and the context in which PA occurs. Longitudinal studies that assess the context of PA may be able to explain apparent discrepant associations between PA and mental disorder.

Profiles of Physical Fitness Risk Behaviours in School Adolescents from the ASSO Project: A Latent Class Analysis

The aim of the present investigation was to describe profiles of adolescents’ fitness level, identify latent classes of fitness-related risk behaviours, and describe their sociodemographic and environmental predictors. In total, 883 adolescents (16.4 ± 1.4 years; 167.3 ± 10.4 cm; 62.8 ± 13.5 kg; 62.2% males) were assessed for personal and lifestyle information and for physical fitness components. Eleven possible fitness determinants and seven predictors were included. Latent class analysis (LCA) was used to determine fitness-related risk behaviours. Logistic regressions predicted class membership and assessed associations with fitness levels and fitness components. Five latent classes were recognised: 1—virtuous, 30.7% of respondents; 2—low physical activity/sport, 18.8%; 3—incorrect alcohol/food habits, 25.8%; 4—health risk/overweight, 15.9%; 5—malaise/diseases, 8.8%. Sex, age, parents’ overweightness/obesity and education, and school type predicted most classes significantly. Compared to class 1, class 2 had higher odds of having all poor fitness components except upper body maximal strength; class 4 had higher risk of low muscular endurance; and class 5 was likely to have lower maximal strength, muscular endurance, and speed/agility. Educating adolescents to reach a sufficient practice of PA/sport could help decreasing the risk of low health-related fitness more than discouraging them from using alcohol, addressing proper food behaviours and habits, and helping them understand their psychophysical malaise symptoms.

Impact of health behaviours and deprivation on well-being in a national sample of English young people

OBJECTIVE

To determine the modifiable factors influencing well-being in boys and girls by accounting for deprivation, ethnicity and clustering within local authorities.

METHODS

We used data from a very large nationally representative survey, the What About Youth study involving 120 115 adolescents aged 15 years. Our outcome measure of mental well-being was the Warwick-Edinburgh Mental Wellbeing Scale (WEMWBS). Potential explanatory factors included substance abuse, screen time, eating habits, reading, bullying, sleeping pattern, physical activity and area-level deprivation. We ran unadjusted and adjusted multilevel models for each explanatory factor, after adjusting for ethnicity, deprivation and including a random effect for the local authority.

RESULTS

Boys had a higher overall mean WEMWBS score than girls (p<0.0001). In the adjusted model, each of multiple risk behaviours, eating habits, sleep, bullying, physical activity, screen-time and reading were independently associated with mental well-being in both boy and girls (p<0.0001 for both). Sleep and eating behaviours had a stronger association in both sexes than bullying, physical activity and screen time. Young people from black ethnic groups had significantly higher well-being in both sexes. Deprivation was not associated with well-being among boys but was among girls.

CONCLUSION

The largest contributors to adolescent well-being appear to be sleep, eating behaviours and bullying when considered in a multivariable framework. While adolescents from black ethnic groups had higher overall well-being scores, area deprivation did not affect male well-being but had a small effect on female well-being. Future longitudinal studies and health policies need to consider a range of behavioural factors to drive improvements in adolescent well-being.

Associations between objectively measured physical activity and later mental health outcomes in children: findings from the UK Millennium Cohort Study

Background

The beneficial effect of physical activity (PA) on mental health in adults is well established, but less is known about this relationship in children. We examine associations between objectively measured sedentary time, PA and mental health in 11-year-olds from the UK Millennium Cohort Study (MCS).

Methods

Longitudinal data from MCS sweeps 4 (age 7) and 5 (age 11) were used (n=6153). Accelerometer data were collected at MCS4, and mental health was measured at MCS4 and MCS5 using subscales (peer, emotional, conduct, hyperactivity) of the Strengths and Difficulties Questionnaire (SDQ). Associations between mean daily PA minutes at different intensities (sedentary, light, moderate-to-vigorous) at MCS4 and SDQ outcomes at MCS5 (score range 0–10) were estimated using multiple linear regression models, adjusting for SDQ at MCS4 and individual and family characteristics, and stratified by gender.

Results

In fully adjusted models, increased PA at MCS4 was associated with fewer peer problems in boys and girls at MCS5. For each additional 15 min in moderate-to-vigorous physical activity (MVPA), peer problems decreased −0.077 points (95% CI −0.133 to –0.022) in boys. For girls, light PA was associated with decreased peer problems (−0.071 points/30 min, 95% CI −0.130 to –0.013). Greater sedentary time was associated with more peer problems and fewer hyperactivity symptoms in boys and girls. Increased MVPA was associated with more conduct and hyperactivity problems in boys and more hyperactivity in girls.

Conclusions

Increased sedentary time is associated with more peer problems in children, and PA, generally, is beneficial for peer relations in children aged 11.

The influence of physical activity, sedentary behavior on health-related quality of life among the general population of children and adolescents: A systematic review

BACKGROUND

The association between physical activity, sedentary behavior and health-related quality of life in children and adolescents has been mostly investigated in those young people with chronic disease conditions. No systematic review to date has synthesized the relationship between physical activity, sedentary behavior and health-related quality of life in the general healthy population of children and adolescents. The purpose of this study was to review systematically the existing literature that evaluated the relations between physical activity, sedentary behavior and health-related quality of life in the general population of children and adolescents.

METHODS

We conducted a computer search for English language literature from databases of MEDLINE, EMBASE, PSYCINFO and PubMed-related articles as well as the reference lists of existing literature between 1946 and the second week of January 2017 to retrieve eligible studies. We included the studies that assessed associations between physical activity and/or sedentary behavior and health-related quality of life among the general population of children and adolescents aged between 3-18 years. The study design included cross-sectional, longitudinal and health intervention studies. We excluded the studies that examined associations between physical activity, sedentary behavior and health-related quality of life among children and adolescents with specific chronic diseases, and other studies and reports including reviews, meta-analyses, study protocols, comments, letters, case reports and guidelines. We followed up the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) statement in the reporting of this review. The risk of bias of the primary studies was assessed by the Newcastle-Ottawa Scale. We synthesized the difference in health-related quality of life scores between different levels of physical activity and sedentary time.

RESULTS

In total, 31 studies met the inclusion criteria and were synthesized in the review. Most of the included studies used a cross-sectional design (n = 21). There were six longitudinal studies and three school-based physical activity intervention studies. One study used both cross-sectional and longitudinal designs. We found that higher levels of physical activity were associated with better health-related quality of life and increased time of sedentary behavior was linked to lower health-related quality of life among children and adolescents. A dose-response relation between physical activity, sedentary behavior and health-related quality of life was observed in several studies suggesting that the higher frequency of physical activity or the less time being sedentary, the better the health-related quality of life.

CONCLUSIONS

The findings in this study suggest that school health programs promoting active lifestyles among children and adolescents may contribute to the improvement of health-related quality of life. Future research is needed to extend studies on longitudinal relationships between physical activity, sedentary behavior and health-related quality of life, and on effects of physical activity interventions on health-related quality of life among children and youth.