The Modifying Effects of Race/Ethnicity and Socioeconomic Status on the Change in Physical Activity From Elementary to Middle School

Association of sleep duration with overweight and obesity among school-aged children and adolescents in Pakistan-An empirical cross-sectional study

BACKGROUND

Overweight and obesity pose significant public health challenges for children and adolescents worldwide, with escalating prevalence rates in Pakistan, leading to long-term health consequences. Proximal environments, including parental, peer, school, and community influences, are pivotal in shaping children's health behaviors during developmental stages. This study investigates the association between sleeping behaviors and overweight/obesity among Pakistani school-aged children and adolescents (9-17 years).

MATERIALS AND METHODS

A population-based cross-sectional study enrolled 4108 participants from 62 schools across randomly selected districts in central Punjab province. Overweight and obesity were determined using WHO references. Statistical analyses included Chi-square tests, Pearson correlation coefficients, and logistic regressions.

RESULTS

The study analyzed the prevalence and associations of sleep duration with body weight status among Pakistani school-aged children and adolescents. Significant differences were observed in sleep patterns across different school levels and sexes. Boys were more likely to be short or long sleepers compared to girls, with weekday short sleep significantly associated with lower rates of overweight (9.0% vs 14.6%, P < 0.001) and obesity (3.8% vs 2.6%, P < 0.001). On weekends, short sleep was linked to higher prevalence of overweight (9.6%, P = 0.019) and obesity (6.2%, P < 0.001) compared to normal sleepers. Linear regression revealed that weekday sleep duration (β = 0.213, P < 0.001), weekend sleep duration (β = 0.142, P < 0.001), and sleeping problems (β = 0.182, P < 0.001) were positively associated with higher body weight status, explaining 11.0% of the variance in weight status. Logistic regression indicated that short sleepers had significantly higher odds of being overweight (OR = 2.69, P < 0.001) and obese (OR = 5.65, P < 0.001) compared to normal sleepers. Long sleep also showed significant associations with overweight (OR = 2.41, P < 0.001) and obesity (OR = 1.73, P < 0.001).

CONCLUSIONS

Sleeping behaviors emerge as significant contributors to body weight-status issues among Pakistani school-aged children and adolescents. Understanding these factors is imperative for effective policy and program development to combat childhood obesity. Targeted intervention strategies tailored to vulnerable groups are essential for public health efforts. Insights from this study provide valuable guidance for addressing this urgent health concern.

The Relationship between Sleep and Physical Activity by Age, Race, and Gender

Cardiometabolic diseases remain the leading cause of death in the United States. Lifestyle factors contribute the majority of risk for these diseases. Although diet and exercise have been the primary focus of research on modifiable behaviors to target for interventions to prevent cardiometabolic disease, recent evidence suggests that sleep also plays an important role. Indeed, the updated American Heart Association campaign includes sleep as one of its "Essential Eight". This review details the reciprocally reinforcing positive relationship between sleep and daytime physical activity behaviors and explores how this relationship differs based on age, gender and race. For example, interventions to improve moderate intensity physical activity may be particularly beneficial to women, older adults, and Black Americans, who are at increased risk for sleep disturbances. Communicating to Americans the importance of managing their time to meet current physical activity and sleep recommendations is a challenge given that there are so many competing behaviors consuming large amounts of time (e.g., social media, gaming), but is critical given the importance of these behaviors for cardiometabolic health.

Associations of School-Level Factors and School Sport Facility Parameters with Overweight and Obesity among Children and Adolescents in Pakistan: An Empirical Cross-Sectional Study

Childhood overweight and obesity are increasingly prevalent in Pakistan, posing significant public health challenges. This study explores the associations of school-level factors and school sports facility parameters with overweight and obesity among children and adolescents in Pakistan. A cross-sectional study across seven random districts in Punjab province, Pakistan, was conducted using a representative multistage random cluster sample. Underweight (BMI < 5th percentile), overweight (85th ≤ BMI < 95th percentile), and obese (95th percentile ≤ BMI) were defined using the US Center for Disease Control (CDC) 2000 criteria. Statistical analyses including the Chi-square test, Pearson correlation coefficient, and linear regression were performed to investigate predictive characteristics. Logistic regression analysis assessed the simultaneous impact of several covariates on dichotomous outcomes, with 95% confidence intervals (CIs) computed and a significance level set at p < 0.05. The study included 4108 Pakistani school children aged 9 to 17 years (mean age = 13.92 years, 59.3% boys) from 62 schools. The prevalence of overweight and obesity was 19.4% and 10.7%, respectively. Findings revealed a concerning lack of physical education activities (60% reported 0 sessions per week), morning exercise (60%), and classroom exercises (66%) among school-aged children. Leadership attitudes toward physical education (β = 0.04, p = 0.006) and students' satisfaction with the playground (β = 0.05, p = 0.015) showed significant associations with body weight status. Conversely, provision of physical education facilities, effective fund utilization for physical education, meeting school sports facility requirements, and weekend opening of school sports grounds did not significantly impact weight status. Satisfaction with the playground was significantly associated with a lower risk of overweight (OR 0.81, 95% CI 0.69-0.95, p < 0.05), indicating reduced overweight likelihood among students satisfied with school playgrounds. The study underscores significant gaps in promoting physical activity within school environments and highlights the urgent need for interventions to enhance physical education resources and sports facilities, aiming to create healthier school environments and reduce overweight and obesity prevalence among students. Further research and interventions are crucial for promoting lifelong physical activity habits and improving student health and well-being.

Associations of family socioeconomic indicators and physical activity of primary school-aged children: a systematic review

BACKGROUND

Family socioeconomic indicators (education, occupation, and household income) are key determinants influencing children's physical activity (PA). This study aims to systematically review the current research about the association between family socioeconomic indicators and PA among primary school-aged children and to quantify the distribution of reported associations by childs' and parents' sex and according to analysis and assessment methods.

METHODS

A systematic literature research in multiple scientific databases (MEDLINE via PubMed, Web of Science, ScienceDirect, SPORTDiscus and ERIC) was performed for literature published between 1st January 2010 and 31st March 2022. Only studies reporting statistical associations between an SES indicator of at least one parent (education, occupation, income, or an SES index) and different types and intensities of PA in primary school-aged children (6 to 12 years) were included in the analysis. The distributions of the reported associations were evaluated across and differentiated by sub-group analysis of assessment methods (objectively measured vs. self-reported PA) and analysis methods (univariate vs. multivariate models).

RESULTS

Overall, 93 studies reported in 77 publications were included in this review. Most of the studies were conducted in Europe and used self-reports (questionnaires) to assess PA. Most studies used only a single SES indicator (commonly maternal education), and only two studies calculated an SES index. The majority of the studies focused on moderate-to-vigorous physical activity (MVPA), total physical activity (TPA), and organized physical activity (OPA). Results showed predominantly positive associations between SES indicators and OPA. In contrast, results regarding different intensities of daily PA (TPA, LPA, MPA, MVPA, VPA, LTPA) were heterogeneous, with overwhelmingly no associations.

CONCLUSION

Overall, the results expand the knowledge about the association between family socioeconomic indicators and children's PA and disprove the hypothesis of a clear positive association. However, large multicenter studies are lacking using a real SES index as a predictor and analyzing gender-specific multivariate models.

Determinants of Change in Physical Activity in Children during the Transition from Elementary to High School

INTRODUCTION

Effective public health interventions targeting factors that influence physical activity are urgently needed to reduce the age-related decline in physical activity in youth. The purpose of this study was to identify associations between physical activity and a set of potential influences on physical activity in children as they transition from elementary to high school.

METHODS

Participants were 951 children from South Carolina school districts who completed outcome and independent variable measures on at least two time points from the 5th to 11th grades in 2010-2017. The primary outcome variable was physical activity, measured by accelerometry. Independent variables included a comprehensive set of variables in the child, parent/home, school, and community domains. Children, parents and school administrators, and staff completed questionnaires to assess psychosocial and home, school, and neighborhood environmental influences. Growth curve analyses identified independent variables associated with physical activity over time, either as a main effect or as an interaction with age.

RESULTS

As main effects, self-efficacy, self-schema, sport participation, weekday outdoor hours, importance of child participating in sports and physical activity, safe to play outside, and Physical Activity Resource Assessment weighted score were positively associated with physical activity. The associations between physical activity and enjoyment motivation, appearance motivation, weekend outdoor time, and home equipment exhibited significant interactions with age. Enjoyment motivation influenced physical activity during the earlier years, whereas the remaining three variables influenced physical activity in the later years.

CONCLUSIONS

Interventions should target multiple domains of influences that may vary by age.

Implementation processes of social network interventions for physical activity and sedentary behavior among children and adolescents: a scoping review

BACKGROUND

The characteristics of the implementation process of interventions are essential for bridging the gap between research and practice. This scoping review aims to identify the implementation process of social network interventions (SNI) to address physical activity and sedentary behaviors in children and adolescents.

METHODS

The scoping review was conducted adhering to the established guidelines. The search was carried out in the ERIC, EBSCO, EMBASE, SCOPUS, and Lilacs databases in April 2023. Social network intervention studies in children and adolescents were included, addressing physical activity or sedentary behaviors. Replicability (TIDieR), applicability (PRECIS-2), and generalizability (RE-AIM) were the explored components of the implementation process. Each component was quantitatively and separately analyzed. Then, a qualitative integration was carried out using a narrative method.

RESULTS

Most SNI were theoretically framed on the self-determination theory, used social influence as a social mechanism, and used the individual typology of network intervention. Overall, SNI had strong replicability, tended to be pragmatic, and three RE-AIM domains (reach, adoption (staff), and implementation) showed an acceptable level of the generalizability of findings.

CONCLUSIONS

The analyzed SNI for physical activity and sedentary behaviors in adolescents tended to be reported with high replicability and were conducted pragmatically, i.e., with very similar conditions to real settings. The RE-AIM domains of reach, adoption (staff), and implementation support the generalizability of SNI. Some domains of the principles of implementation strategies of SNI had acceptable external validity (actor, action targets, temporality, dose, and theoretical justification).

Change in general and domain-specific physical activity during the transition from primary to secondary education: a systematic review

BACKGROUND

Knowledge of changes in the domains of physical activity (PA) during the transition period from primary to secondary education and the factors associated with these changes, are prerequisites for the design of effective PA promotion strategies. Therefore, the first aim of this study was to systematically review changes in general, leisure-time, school, transport, work, and home PA across the transition from primary to secondary education. The second aim was to systematically review the individual, social, and physical environmental factors that were associated with these changes.

METHODS

Records published up until September 2023 were retrieved from five electronic databases. We included longitudinal and cross-sectional studies that investigated general or domain-specific PA from 2 years before to 2 years after the transition from primary to secondary education. Information on source, study characteristics, sample characteristics, PA, and factors were extracted from the papers included. We reported the direction of change in general and domain-specific PA and the direction of association of the factors with change in general and domain-specific PA.

RESULTS

Forty-eight papers were included in the study. The evidence on changes in PA and associated factors was greatest for general PA. A limited number of the studies investigated the separate domains of leisure-time, school, and transport. Most studies on general and school PA reported a decline in PA, but there were no consistent results for the domains of leisure-time and transport. With respect to the associated factors, evidence was predominantly found for individual factors and to a lesser degree for physical environmental and social environmental factors. None of the factors were consistently associated with changes in general or domain-specific PA during the school transition.

CONCLUSIONS

For the design of targeted PA promotion strategies, further studies are warranted to explore changes in the specific domains of PA across the transition from primary to secondary education, especially in the domains of leisure-time, transport, home, and work PA. In addition, the interactions between factors at different socioecological levels to influence changes in PA need to be addressed more in the future.

TRIAL REGISTRATION

PROSPERO CRD42020190204.

Obesity Heterogeneity by Neighborhood Context in a Largely Latinx Sample

Neighborhood socioeconomic context where Latinx children live may influence body weight status. Los Angeles County and Orange County of Southern California both are on the list of the top ten counties with the largest Latinx population in the USA. This heterogeneity allowed us to estimate differential impacts of neighborhood environment on children's body mass index z-scores by race/ethnicity using novel methods and a rich data source. We geocoded pediatric electronic medical record data from a predominantly Latinx sample and characterized neighborhoods into unique residential contexts using latent profile modeling techniques. We estimated multilevel linear regression models that adjust for comorbid conditions and found that a child's place of residence independently associates with higher body mass index z-scores. Interactions further reveal that Latinx children living in Middle-Class neighborhoods have higher BMI z-scores than Asian and Other Race children residing in the most disadvantaged communities. Our findings underscore the complex relationship between community racial/ethnic composition and neighborhood socioeconomic context on body weight status during childhood.

Sociodemographic influences on youth sport participation and physical activity among children living within concentrated Hispanic/Latino rural communities

Introduction

Lack of physical activity (PA) among children living in rural communities is a documented public health problem. Although studies have examined community conditions defined by a rural-urban dichotomy, few have investigated rural community conditions with a concentration of Hispanic/Latino people. This cross-sectional study examined sociodemographic characteristics associated with youth sport (YS) participation and daily PA among children living within concentrated Hispanic/Latino rural U.S. Midwest communities.

Methods

During spring 2022, 97% of 3rd-6th grade children (n = 281, aged approximately 8-12 years) attending school in rural Midwestern communities (n = 2) with >50% concentration of Hispanic students participated in the Wellscapes Project, a community randomized trial. Participants completed the Youth Activity Profile and supplemental National Survey of Children's Health questions assessing PA behaviors and YS participation. Caregivers of a subsample of children (n = 215; males, n = 93; females, n = 122) consented to pair their child's survey results with school enrollment records (e.g., free/reduced lunch status and race and ethnicity). Mixed models with community as a random effect examined main and interaction effects of grade, sex, ethnoracial status, and family income on YS participation and these sociodemographic characteristics and YS participation on daily moderate-to-vigorous PA (MVPA).

Results

Approximately half of children participated in YS. Non-Hispanic White children (n = 82) were over five times more likely to participate in YS than Hispanic peers (n = 133) (OR = 5.54, 95% CI = 2.64-11.61, p < 0.001). YS participants accumulated 8.3 ± 2.3 more minutes of daily MVPA than non-participants (p < 0.001). Sixth graders, females, and Hispanic children reported lower daily MVPA than comparison groups (p < 0.05). Significant interaction effects on daily MVPA between grade and ethnoracial status (F(3, 204) = 3.04, p = 0.030) were also found.

Discussion

Disparities in sport participation and PA outcomes based on sociodemographic characteristics exist among children living in ethnoracially diverse rural communities. Strategies to promote YS participation, including community structural changes, may help reduce PA disparities. The research provides valuable insights for policymakers, public health professionals, and community members to address YS participation barriers, not limited to cost, while considering other PA-promotion efforts to improve child population health.

Park Area and Physical Activity Among Children and Adolescents: Findings From the Healthy Communities Study

BACKGROUND

There is currently a nationwide effort to bring parks and green spaces within a 10-minute walk of the home. We examined the association between park area within 1 km of a child's residence and self-reported park-specific physical activity (PA) along with accelerometer-derived moderate to vigorous physical activity (MVPA).

METHODS

A subsample of K through eighth-grade youth (n = 493) from the Healthy Communities Study reported whether they engaged in park-specific PA during the last 24 hours and wore an accelerometer for up to 7 days. Park area was defined as the percentage of park land in a 1 km Euclidean buffer around the participant's residence, categorized into quintiles. Analysis consisted of logistic and linear regression modeling with interaction effects that controlled for clustering within communities.

RESULTS

Regression models estimated greater park-specific PA for participants in the fourth and fifth quintiles of park land. Age, sex, race ethnicity, and family income were unrelated to park-specific PA. Accelerometer analysis indicated that total MVPA was unrelated to park area. Older children (β = -8.73, P < .001) and girls (β = -13.44, P < .001) engaged in less MVPA. Seasonality significantly predicted both park-specific PA and total MVPA.

CONCLUSION

Increasing park area is likely to improve youth PA patterns, lending support for the 10-minute walk initiative.

Disparities in physical activity in adolescent and young adult cancer survivors

PURPOSE

There is a growing population of adolescent and young adult (AYA, ages 15-39 at diagnosis) cancer survivors at heightened risk of chronic conditions. Moderate to vigorous physical activity level (MVPA) is an important modifiable factor associated with improved cardiovascular health. Little is known about the association of sociodemographic factors with MVPA in AYA survivors.

METHODS

Self-reported data from the National Health Interview Survey (2009-2018) were used to identify AYA cancer survivors (at least 2 years post-diagnosis) and age- and sex-matched controls. MVPA level based on sociodemographic (sex, race and ethnicity, income, education), medical (heart disease, stroke, and diabetes), and cardiovascular risk factors (BMI and smoking) was determined within and between survivors and controls using multivariable linear regression models.

RESULTS

A total of 4766 AYA cancer survivors and 47,660 controls were included. Less than half of survivors (41.9%) and controls (43.2%) met MVPA guideline recommendations, and one-third of survivors (33.4%) reported no MVPA. Black race was associated with reduced MVPA compared with White race (ratio: 0.58 (95% CI: 0.37-0.90). Household income < $50,000/year, education < high school, diagnoses of diabetes or heart disease, and current smoking were all significantly associated with reduced MVPA in AYA survivors. There were no differences in MVPA between survivors and controls by sociodemographic factors, medical history, and cardiovascular risk factors.

CONCLUSIONS AND IMPLICATIONS FOR CANCER SURVIVORS

We found disparities in MVPA in AYA cancer survivors by sociodemographic, medical, and cardiovascular risk factors. Understanding trajectories of MVPA among different sociodemographic populations is needed to identify opportunities for intervention.

'Football and dancing are in our blood': culture promoting sports practice among immigrants in Europe

The current state of knowledge indicates that regular sports practice helps prevent and treat non-communicable diseases. The promotion of sport is, therefore, an important community health intervention for maintaining and improving the health of individuals and populations. Culture is identified as being associated with sports practice and sedentary behaviour of ethnic and national minorities. This study aims qualitatively to analyse the potential for culture as a basis for the promotion of sport among immigrants in four regions of Mediterranean Europe. Ten focus groups (n = 62) were conducted with immigrants-adults and young people over the age of 11-and people involved in promoting sport. Thematic content analysis was conducted. The results enabled identifying two major issues: sport as a vehicle for cultural expression and synergies between sport and culture. Accordingly, sport serves to express global, local and non-ethno-national cultural belonging. Regarding synergies, culture and sport feed each other positively and contribute to immigrants' health and cultural well-being. Culture as a strategy for promoting sports practice requires an interdisciplinary approach that involves collaboration between healthcare practitioners and social sciences professionals. There is also a need to use the various axes of cultural definition-global, local and non-ethno-national-of those involved, and for them to take part themselves in designing sports activities. Moreover, promoting sport through non-ethno-national axes of cultural definition may help with immigrants' social inclusion, as intercultural relations between migrants and newcomers are promoted.

A Summary of One Research Team's Contributions to Understanding Physical Activity Behavior in Children and Youth

Schools are well-positioned to provide physical activity opportunities to help youth achieve the recommended 60 or more daily minutes of moderate-to-vigorous physical activity. The Children's Physical Activity Research Group (CPARG) at the University of South Carolina has focused on understanding physical activity in school-aged youth for 30+ years. The purpose of this article was to critically review (CPARG) contributions to the field in school settings and school-age youth. We reviewed 127 published CPARG articles from six research projects conducted between 1993-2019. The review was guided by questions in five categories: measurement of physical activity and its determinants, characteristics of physical activity behavior, correlates/determinants of physical activity, physical activity interventions, and race/ethnicity and physical activity. Results were summarized by question and synthesized across categories. CPARG contributions included assessing physical activity levels, patterns, forms, and contexts; identifying and measuring physical activity correlates/determinants; and conducting school-based physical activity interventions. Identifying multiple domains of physical activity determinants enables researchers and practitioners to select/design age-appropriate, valid, and reliable instruments to assess determinants. Focusing on determinants enables them to create effective physical activity interventions, environments, programs, and policies in schools. These efforts must address race/ethnicity differences, ensuring that measurement instruments and intervention strategies are culturally appropriate.

Influence of the Home Environment on Physical Activity Behaviors in African American Youth

Background: This study examined the relationships between components of the home environment and physical activity (PA) behaviors among African American adolescents. Methods: A community-based sample of 99 African American parent-child dyads (62% girls; 42% overweight/obese, 15.0 ± 0.2 years) were included in this analysis. The home environment (PA equipment, family support for PA, and internet access) was evaluated using the Health and Environment Survey. Child PA was measured objectively using accelerometry. Data collection occurred between 2014 and 2016. Results: Internet access was associated with 29 fewer minutes of light physical activity [p = 0.011, β = -29.25 ± 11.28 (95% confidence interval: -51.65 to -6.86)], 9 fewer minutes of moderate-to-vigorous physical activity [p = 0.045, β = -9.10 ± 4.48 (-17.98 to -0.21)], and 38 fewer minutes of total PA (TPA) [p = 0.006, β = -38.35 ± 13.38 (-65.62 to -11.08)]. Family support was associated with 2 minutes of TPA [p = 0.044, β = 2.25 ± 1.10 (-1.97 to 3.19)]. PA equipment was not significantly associated with greater PA (all p's > 0.05). Conclusions: These findings suggest that home internet access may hinder participation in PA among African American adolescents. Future research should continue to identify barriers in the home environment that contribute to physical inactivity among African American adolescents.

Considerations for a Social Media Physical Activity Program: Exploratory Study

BACKGROUND

Social media may be a powerful platform to combat parents' and children's low physical activity levels.

OBJECTIVE

This study surveyed parents' beliefs about physical activity in order to expand the extant literature concerning the interest in and the design of an effective and feasible social media physical activity (SMPA) program.

METHODS

Primary caregivers (n=250; 215 [86%] mothers, 164 [65.6%] White) of children aged 6-12 years completed an online questionnaire. Interest was examined through responses on the questionnaire; beliefs (ie, perceptions, knowledge, and support) about physical activity were examined using Spearman correlations; and to support the SMPA program design, researchers examined a combination of multiple-choice and free-response questions. For the free-response questions, the researchers performed open coding related to perceived benefits, barriers, and motivators.

RESULTS

Parent respondents (n=215, 86%) were interested in a SMPA program tailored for families. Regarding beliefs, parents exhibited a monotonic relationship between 2 questions related to perceptions of physical activity levels in their children (r_s(250)=.310, P<.001), knowledge about physical activity and motor skills (r_s(250)=.328, P<.001), and support of physical activity and motor skills (r_s(250)=.385, P<.001). Parents perceived benefits of a SMPA program, highlighting family time and health. Barriers included time constraints, a lack of motivation, and environmental factors.

CONCLUSIONS

Parents are interested in supporting healthy family behaviors using a SMPA program. An effective program should emphasize motor skill activities, be fun and family oriented, and incorporate incentives, goal setting, and advice and tips. SMPA also needs to address identified barriers, such as those regarding time and environment.

Social-Ecological Correlates of Children’s Independent Mobility: A Systematic Review

Children’s independent mobility (IM) is associated with a range of benefits and understanding the factors that influence IM can support creation of effective interventions. The review (Prospero CRD42016042174) systematically summarized the available literature for social-ecological correlates of children’s IM in school-aged children and youth (aged 5–17 years). In this case, 53 studies were included and evaluated six individual, 15 interpersonal, 12 social environment, and 19 built environment- level variables. Most studies originated from Australia (n = 15) and Canada (n = 8) with most published in 2011 or later (n = 48). Variables that were consistently (positively and/or negatively) associated with children’s IM were age, ethnicity/race, child’s perceived competence, ownership of a house/access to house keys, having siblings, parents’ attitude toward IM and perception of child’s confidence, children’s interest in environment and activities, parents’ concern around traffic, housing/residential density, length of residency in one’s home, distance to destinations, and proximity to green space. Given the inter-related social-ecological correlates identified, intervention to promote children’s IM will likely need a multi-level and multi-sectoral approach. However, focus areas of building children’s skills and confidence, helping parents gain confidence in their children’s abilities, assuaging parental traffic concerns, and building environments with shorter distances to destinations of interest for children should be prioritized.

Seasonal variations in physical activity among Norwegian elementary school children in Arctic regions

The aim of this study was to measure seasonal variations in physical activity (PA) during Polar Nights (PN) and Polar Days (PD) among elementary school children in the Arctic regions of Norway. One hundred and seventy-eight schoolchildren from 1st, 3rd, 5thand 7th grade participated in the study. Physical activity was measured for seven consecutive days with an ActiGraph GT3X-BT accelerometer and is expressed as total PA incounts per minute (cpm) and moderate-to-vigorous activity (MVPA) (min∙day-1). During PN, 51% of boys and 33% of girls met the PA recommendations, whereas 36% of boys and 34% of girls met the recommendations during PD. Time spent doing MVPA did not differ between the two seasons (all p ≥ 0.073). Overall, the children accumulated 613 ±154 cpm during PN, which was lower than during PD 704 ± 269 cpm, p < 0.001). A larger proportion of boys than girls met the PA recommendations during PN compared with PD. Our findings did not show any clear seasonal variation for MVPA or total PA among children,except for some differences within sexes in different grades. This study indicates that interventions aimed at increasing PA should be implemented throughout the year in the Arctic regions. .

Supporting Physical Activity in Patients and Populations During Life Events and Transitions: A Scientific Statement From the American Heart Association

Achieving recommended levels of physical activity is important for optimal cardiovascular health and can help reduce cardiovascular disease risk. Emerging evidence suggests that physical activity fluctuates throughout the life course. Some life events and transitions are associated with reductions in physical activity and, potentially, increases in sedentary behavior. The aim of this scientific statement is to first provide an overview of the evidence suggesting changes in physical activity and sedentary behavior across life events and transitions. A second aim is to provide guidance for health care professionals or public health workers to identify changes and promote physical activity during life events and transitions. We offer a novel synthesis of existing data, including evidence suggesting that some subgroups are more likely to change physical activity behaviors in response to life events and transitions. We also review the evidence that sedentary behavior changes across life events and transitions. Tools for health care professionals to assess physical activity using simple questions or wearable devices are described. We provide strategies for health care professionals to express compassion as they ask about life transitions and initiate conversations about physical activity. Last, resources for life phase-specific, tailored physical activity support are included. Future research needs include a better characterization of physical activity and sedentary behavior across life events and transitions in higher-risk subgroups. Development and testing of interventions designed specifically to combat declines in physical activity or increases in sedentary behavior during life events and transitions is needed to establish or maintain healthy levels of these cardiovascular health-promoting behaviors.

Examining current physical activity interventions in Black school-age children and parents: A systematic review

Obesity is prevalent in Black children and adults; increasing physical activity (PA) can aid in reducing childhood obesity in both age groups. The purpose of this systematic review is to examine current research on PA interventions in school-age Black children. Adhering to PRISMA guidelines, a systematic search was conducted in six databases for PA interventions in Black children. A total of 13 articles met inclusion criteria (n = 7 randomized controlled trial, n = 5 quasi-experimental, n = 1 cross-sectional). The majority of the articles were on a combination of diet and PA programs (n = 9). Four articles targeted PA and parental role modeling of PA as the outcome showing positive intervention effects. Nine additional studies included PA as an outcome variable along with at least one additional obesity-related predictor. PA interventions for Black school-age children typically use a parent-child dyadic approach (n = 13), are guided by theory (n = 11) and are high quality. However, continued investigation is warranted to draw definitive conclusions and determine how to best involve parents within the PA interventions. Theory-driven higher quality trials that clearly describe the structured PA component and outcomes among Black parent-child dyads are needed.

The Roles of Sex and Minority Status in Children's Motivation and Psychomotor Learning

In this study, we had two inter-related goals: (a) to examine sex and minority status differences on children's motivation for physical education (PE; i.e., their expectancy beliefs, subjective task values, and situational interest) and their psychomotor learning outcomes (i.e., motor competence, cardiorespiratory fitness, and in-class physical activity); and (b) to examine the relationships between children's motivation and their psychomotor learning outcomes while testing the moderation effects of sex and minority status. We recruited 195 fourth and fifth-grade students (101 boys; 94 girls; M_age = 10.7, SD = 0.7 years) from three elementary schools in North Texas. Using multivariate analysis of variance, we identified a significant sex difference that favored boys in motivation and psychomotor learning outcomes, with no significant minority status difference in relation to these variables. Regression analysis revealed that children's expectancy beliefs were significantly associated with both motor competence (R² = 11%) and cardiorespiratory fitness (R² = 16%), while both situational interest and sex were associated with in-class physical activity (R² = 18%). Thus, improving children's expectancy beliefs may be a means of enhancing psychomotor learning outcomes in PE, especially for girls. Enhancing children's beliefs in their own ability and offering diversified PE content so as to generate greater interest may facilitate psychomotor learning.

Adapting the InPACT Intervention to Enhance Implementation Fidelity and Flexibility

Adapting classroom-based physical activity interventions are critical for program feasibility and fidelity in low-resource elementary schools. The purpose of this pilot study was to use Replicating Effective Programs (REP) framework to tailor the Interrupting Prolonged sitting with ACTivity (InPACT) intervention and evaluate its effectiveness on program fidelity in classrooms within a low-resource school. REP was applied to adapt program packaging, teacher training, and technical assistance to disseminate Tailored InPACT, a 20-week intervention where teachers implemented 5 × 4-min activity breaks per day. Tailored InPACT was implemented in nine, 3rd-6th grade classrooms in one low-resource school in Detroit Michigan (80% qualified for free/reduced lunch). Intervention fidelity was measured via daily, weekly, and end-of-study self-report questionnaires and direct observation. Throughout the 20-week intervention period, 3rd-5th grade teachers achieved intervention dose (5 activity breaks per day at an average duration of 4 min 8 s). Sixth grade teachers did not achieve intervention dose as they were only able to implement 2 activity breaks per day at an average duration of 4 min 12 s. These findings suggest 5 × 4-min classroom activity breaks per day is a feasible dose of classroom activity that 3rd-5th grade teachers can implement in low-resource classroom settings. Additional adaptations are needed to maximize fidelity in 6th grade classrooms.

Sleep is Inversely Associated with Sedentary Time among Youth with Obesity

Objective: Pathways underlying the sleep-obesity relationship in youth are poorly understood. In this study, we examined associations of sleep with sedentary time and moderate-to-vigorous physical activity (MVPA) among youth, stratified by weight category (obesity versus no obesity). A sub-aim examined whether controlling for screen time changed the sleep-sedentary time association. Methods: Methods entailed secondary analysis of baseline data collected June-August 2014-2017 during a school-based healthy weight management trial in Minneapolis/St. Paul, Minnesota. Participants (N = 114) were 8-to-12 years old with BMI ≥ 75th percentile, most of whom were members of racial/ethnic minority groups (57%) or from households receiving economic assistance (55%). Mean nightly sleep duration and daily screen time were measured by survey, MVPA and sedentary time by accelerometer, and height and weight by research staff. Multivariate linear regression examined associations of sleep with sedentary time and MVPA. Results: Sleep was inversely associated with hours of sedentary time (β = -1.34 [-2.11, -0.58] p = .001) and percent of time spent sedentary (β = -2.92 [-4.83, -1.01], p = .004), for youth with obesity only. The association was unchanged by screen time. Sleep was not significantly associated with MVPA in total sample or stratified models. Conclusions: Associations among sleep, activity levels, and obesity may differ based upon movement type (sedentary time vs MVPA) and weight category (obesity vs no obesity).

Physical Activity, Sport and Physical Education in Northern Ireland School Children: A Cross-Sectional Study

Internationally, insufficient physical activity (PA) is a major health concern. Children in Northern Ireland (NI) are recorded as having the lowest levels of PA in the United Kingdom (UK). To date, validated and representative data on the PA levels of NI school children are limited. The aim of this study was to provide surveillance data on self-reported PA, sport and physical education (PE) participation of school children in NI. Differences between genders and factors associated with PA were also examined. A representative sample of primary (n = 446) and post-primary (n = 1508) children was surveyed in school using validated self-report measures. Findings suggest that PA levels are low, with a minority of children (13%) meeting the PA guidelines (primary pupils 20%, post-primary pupils 11%). NI school children have lower levels of PA, PE and sports participation than UK and European peers. A trend of age-related decline across all the domains of PA was apparent. The data presented highlighted that females are less likely to achieve PA guidelines, children from lower socio-economic background participate in school and community sport less often, and that enjoyment and social support are important variables in PA adherence. Policy solutions that would support implementation e.g., mandatory minimum PE time, whole school approaches to PA promotion and targeted investment in schools, particularly in areas of deprivation and for females, are suggested.

Disparities in physical fitness of 6-11-year-old children: the 2012 NHANES National Youth Fitness Survey

Background

Children’s physical fitness is an important predictor of metabolic health, physical function, and academic achievement. Although fitness is determined partially by heritable factors, it can be maintained and improved through regular physical activity. Because physical activity is known to vary by socioeconomic status, physical fitness may be expected to vary similarly. With this in mind, the purpose of this study was to examine disparities in physical fitness performance among a nationally-representative sample of 6–11 year-old children living in the United States.

Methods

We conducted secondary analysis of physical fitness data of children ages 6–11 years (n = 686) from the nationally representative National Health and Nutrition Survey (NHANES) Youth Fitness Survey (NNYFS) 2012. We estimated sex-stratified weighted means of four fitness performance tests: cardiorespiratory endurance, upper-, lower-, and core-muscular strength. The weighted mean for each fitness assessment was compared by income groups (federal income to poverty ratio – FIPR) accounting for complex sampling design and adjusting for age.

Results

Income disparities in physical fitness performance were evident among girls but not among boys. Girls from lower income groups (< 130% FIPR and 130–349% FIPR groups) showed significantly lower cardiorespiratory endurance and core muscle strength compared to those from the highest income group (≥ 350% FIPR).

Conclusion

These findings highlight the need to support health-promoting physical activity among girls from disadvantaged backgrounds prior to the adolescent period.

Social Cognitive Orientations, Social Support, and Physical Activity among at-Risk Urban Children: Insights from a Structural Equation Model

This study investigates the effects of cognitive orientations associated with social cognitive theory (SCT) and exercise enjoyment on physical activity (PA) of urban at-risk children, accounting for mediating effects associated with various sources of social support. We use 2016–2017 survey data from 725 school-age children in an urban school district in Akron, Ohio in the United States (US) to inform a structural equation model, which assesses direct and indirect effects of self-efficacy, behavioral intention, and exercise enjoyment on children’s PA, using mediating variables that measure social support that children report receiving from parents, Physical Education (PE) teachers, and peers. We find that self-efficacy and exercise enjoyment have notable direct and indirect effects on the children’s PA. We also find that the support children receive from PE teachers and peers appears to have greater effects on PA than does the children’s reported social support from parents. These findings suggest that children’s social cognitive orientations may influence both sources of perceived social support and the extent to which children engage in PA. While these findings have potential implications for intervention strategies to increase PA among at-risk children, further research is appropriate to improve our understanding of the determinants of PA among at-risk urban children.

The impact of life events and transitions on physical activity: A scoping review

BACKGROUND

Physical activity (PA) is a fluctuating behavior and prone to change across the life course. Changes in PA may be particularly due to the experience of life events and transitions. For well-timed and successful PA interventions, it is important to understand when and why individuals take up or terminate PA.

OBJECTIVES

This scoping review aims to examine the extent, range, and nature of research on the impact of life events and transitions on PA and to summarize key findings.

METHODS

A systematic literature search was conducted in PubMed, PsycINFO, PsycARTICLES, SPORTDiscus, and Web of Science. Articles were included if they had been published in peer-reviewed journals between 1998 and 2020 and assessed the impact of at least one life event or transition on PA.

RESULTS

107 studies that assessed 72 distinct life events and transitions were included and summarized in ten categories. Events and transitions that are primarily associated with decreases in PA were starting cohabitation, getting married, pregnancy, evolving parenthood, and the transitions from kindergarten to primary school, from primary to secondary school, and from high school to college or into the labor market. Retirement was associated with increases in PA; yet, long-term trajectories across retirement indicated a subsequent drop in activity levels. Divorce was associated with no changes in PA. No trends could be identified for changing work conditions, quitting or losing a job, starting a new relationship, widowhood, moving, and diagnosis of illness.

CONCLUSION

Life events and transitions can be conceptualized as natural interventions that occur across the life course and that are oftentimes associated with changes in PA behavior. Our study indicates that, despite some emerging trends, similar events do not necessarily have similar impacts on PA across individuals. It also shows that the research landscape is characterized by a lack of conceptual clarity and by disparate methodologies, making it difficult to synthesize results across studies.

Self-Efficacy, Not Peer or Parent Support, Is Associated With More Physical Activity and Less Sedentary Time Among 8- to 12-Year-Old Youth With Elevated Body Mass Index

BACKGROUND

Youth experience a decrease in physical activity (PA) and an increase in sedentary time during adolescence. Better understanding of factors associated with activity levels during preadolescence may inform interventions to minimize decline. This study compared the association of self-efficacy for PA, parent support for PA, and peer support for PA with moderate-to-vigorous PA (MVPA) and sedentary time among 8- to 12-year-old children with body mass index ≥75th percentile.

METHODS

This study analyzed baseline data from a school-based healthy weight management intervention trial, conducted in metropolitan Minnesota. Self-efficacy for PA, parent support for PA, and peer support for PA were measured by child survey using reliable tools. MVPA and sedentary time were measured using accelerometer.

RESULTS

Participants included 114 children; mean age was 9.4 (0.9) years, 51% were females, 55% received public assistance, and 57% were racial/ethnic minorities. Self-efficacy for PA was positively associated with moderate to vigorous PA for girls (β = 1.83, P < .01) and inversely with sedentary time for the total sample (β = -7.00, P = .03). Parent support for PA was positively associated with sedentary time for girls (β = 9.89, P = .04) and the total sample (β = 7.83, P = .04).

CONCLUSIONS

Interventions for preadolescents with elevated body mass index may improve activity levels by increasing self-efficacy for PA.

Are Correlates of Physical Activity in Adolescents Similar Across Ethnicity/Race and Sex: Implications for Interventions

BACKGROUND

This study tested for differences in personal, social, and environmental correlates of moderate to vigorous physical activity (MVPA) across ethnicity/race in male and female adolescents.

METHODS

Self-reported MVPA and 47 potential correlates of MVPA were measured in an ethnically/racially diverse cross-sectional sample of adolescents, in Minnesota, who participated in EAT-2010 (Eating and Activity in Teens). Interactions of potential correlates with ethnicity/race on MVPA were tested in linear hierarchical regression models in boys and girls.

RESULTS

Boys reported 1.7 more weekly hours of MVPA than girls. White adolescents reported 1.1 to 2.1 more weekly hours of MVPA than nonwhite adolescents. Among girls, neighborhood road connectivity was negatively correlated with MVPA among Hispanic and Asian participants. Among boys, sports participation was positively correlated with MVPA among all ethnicities/races, except Asians. Home media equipment was positively correlated with MVPA among Hispanic boys, but negatively correlated among white boys.

CONCLUSIONS

A few correlates of physical activity among adolescents differed intersectionally by ethnicity/race and sex. Sports participation and home media equipment may have differing impacts on physical activity across ethnicities and races in boys, whereas neighborhood features like road connectivity may have differing impacts on physical activity across ethnicities and races in girls.

Toward Active Living: SES- and Race-Based Disparities in Knowledge and Behaviors

OBJECTIVE

The purpose of this study was to examine the potential differences in knowledge and behaviors related to active living between two schools with contrasting socioeconomic status (SES) and racial characteristics.

DESIGN

The sample involved 523 adolescents from two public middle schools in a southern US state including 243 Black (46.5%), 223 White (42.6%), and 67 others (12.8%). Physical activity (PA) and sedentary behavior (SB) were measured using the validated Youth Activity Profile (YAP), while knowledge of physical activity and fitness (PAF knowledge) was measured using the grade-appropriate PE Metrics written test. Socio-demographic characteristics were self-reported or obtained via secondary government database.

RESULTS

The medium SES school showed higher PA outside of school (ΔM = 0.27, d = 0.26), lower SB (ΔM = - 0.35, d = - 0.45), and higher PAF knowledge (ΔM = 8.3%, d = 0.54) than the low SES school. Statistically significant differences were observed for after-school PA, evening PA, weekend PA, TV viewing, video games, and cell phone use (d = - 0.38 to 0.39). Group difference by race was also found with White participants demonstrating higher PA outside of school, lower SB, and higher PAK knowledge than Black participants (d = - 0.43 to 0.57).

CONCLUSIONS

The lower SES school (mostly Black) showed less favorable PA, SB, and knowledge results than the higher SES school. SES is a significant school-level characteristic influencing the determinants (i.e., knowledge and behaviors) of the active living habit in youth.

Adolescent and Young Adult Recreational, Occupational, and Transportation Activity: Activity Recommendation and Weight Status Relationships

PURPOSE

Physical activity can occur in many settings, or domains, including recreation, occupation, and transportation. We described patterns of adolescent and young adult (YA) activity in each domain, and the extent that accounting for different domains impacts activity recommendation adherence. We also examined activity domain associations with weight status.

METHODS

We examined physical activity among 11,157 adolescents and YAs in recreational, occupational, and transportation domains in the 2007-2016 National Health and Nutrition Examination Survey. We calculated proportions meeting weekly activity recommendations (adolescents: 420 minutes; YAs: 150 minutes) by domain. We compared adjusted odds of performing any activity in each domain by weight status. All estimates are weighted and stratified by age (adolescents: 12-19 years; YAs: 20-29 years) and sex.

RESULTS

Most adolescents (90.9%) and YAs (86.7%) reported activity in at least one domain. Recreational activity accounted for an average of 60.2% (adolescents) and 42.5% (YAs) of an individual's total activity. Approximately half of YAs (50.2%) reported any occupational activity, which accounted for 44.6% (males) and 37.4% (females) of total activity minutes. Transportation accounted for 18.1% (adolescents) and 16.2% (YAs) of total activity. Activity recommendation adherence estimates increased when adding domains: recreation alone (34.9% adolescents, 45.6% YAs); recreation and occupation (47.2% adolescents, 68.7% YAs); and recreation, occupation, and transportation (53.5% adolescents, 74.7% YAs). Weight status was generally not associated with activity domains.

CONCLUSIONS

Adolescents and YAs accumulate substantial occupational and some transportation-related physical activity, resulting in more youth meeting activity recommendations when accounting for these activity domains than recreation alone.

Exploring Racial Disparities in Physical Activity and Quality of Life Through an Expectancy-Value Perspective

OBJECTIVES

Alleviating racial/ethnic disparities in physical activity (PA) and health outcomes during childhood becomes an important public health priority as the nation's populace continues to diversify. Guided by expectancy-value model, the purposes of this study were (a) to examine the potential differences in expectancy-value beliefs, PA and health-related quality of life (HRQOL) between African-American (AA) children and their American-Caucasian (AC) peers, and (b) to determine how the relationships among these variables might differ between the two racial groups.

METHOD

Participants were 321 (152 boys; 189 AC) children from three schools who completed a previously validated questionnaire assessing their expectancy-value beliefs in physical education, leisure-time PA (PAQ-C), and HRQOL.

RESULTS

Students' PA was positively associated with HRQOL among AC and AA children (p < .01). AA children had significant higher expectancy-value beliefs but lower HRQOL than AC children. The regression results revealed that both racial groups had a nearly identical effect of expectancy beliefs on their self-reported PA (β = .34 in AA group, β = .33 in AC group, respectively). The regression analysis also suggests that expectancy-value belief was a significant predictor of HRQOL while controlling for all other variables (β = .36; p < .001) for the AC group, but not the AA group.

CONCLUSIONS

The growing health disparities across racial/ethnic subgroups are of great public health concern. Thus, this study provided valuable insights regarding how to promote AA children's PA and HRQOL through an expectancy-value approach.

Measuring change in trials of physical activity interventions: a comparison of self-report questionnaire and accelerometry within the PACE-UP trial

Background

Few trials have compared estimates of change in physical activity (PA) levels using self-reported and objective PA measures when evaluating trial outcomes. The PACE-UP trial offered the opportunity to assess this, using the self-administered International Physical Activity Questionnaire (IPAQ) and waist-worn accelerometry.

Methods

The PACE-UP trial (N = 1023) compared usual care (n = 338) with two pedometer-based walking interventions, by post (n = 339) or with nurse support (n = 346). Participants wore an accelerometer at baseline and 12 months and completed IPAQ for the same 7-day periods. Main outcomes were weekly minutes, all in ≥10 min bouts as per UK PA guidelines of: i) accelerometer moderate-to-vigorous PA (Acc-MVPA) ii) IPAQ moderate+vigorous PA (IPAQ-MVPA) and iii) IPAQ walking (IPAQ-Walk). For each outcome, 12 month values were regressed on baseline to estimate change.

Results

Analyses were restricted to 655 (64%) participants who provided data on all outcomes at baseline and 12 months. Both intervention groups significantly increased their accelerometry MVPA minutes/week compared with control: postal group 42 (95% CI 22, 61), nurse group 43 (95% CI 24, 63). IPAQ-Walk minutes/week also increased: postal 57 (95% CI 2, 112), nurse 43 (95% CI -11, 97) but IPAQ-MVPA minutes/week showed non-significant decreases: postal -11 (95% CI -65, 42), nurse -34 (95% CI -87, 19).

Conclusions

Our results demonstrate the necessity of using a questionnaire focussing on the activities being altered, as with IPAQ-Walk questions. Even then, the change in PA was estimated with far less precision than with accelerometry. Accelerometry is preferred to self-report measurement, minimising bias and improving precision when assessing effects of a walking intervention.

Trial registration: ISRCTN, ISRCTN98538934. Registered 2 March 2012.

Utility of the Youth Compendium of Physical Activities

PURPOSE

The purposes of this article are to: (a) describe the rationale and development of the Youth Compendium of Physical Activities (Youth Compendium); and (b) discuss the utility of the Youth Compendium for audiences in research, education, community, health care, public health, and the private sector.

METHODS

The Youth Compendium provides a list of 196 physical activities (PA) categorized by activity types, specific activities, and metabolic costs (youth metabolic equivalents of task [MET_y]) as measured by indirect calorimetry. The utility of the Youth Compendium was assessed by describing ways in which it can be used by a variety of audiences.

RESULTS

Researchers can use MET_y values to estimate PA levels and determine changes in PA in intervention studies. Educators can ask students to complete PA records to determine time spent in physical activities and to identify health-enhancing activities for classroom PA breaks. Community leaders, parents, and health care professionals can identify activity types that promote healthful behaviors. Public health agencies can use the MET_y values for surveillance and as a resource to inform progress toward meeting national physical activity guidelines. Applications for the private sector include the use of MET_y in PA trackers and other applications.

CONCLUSION

The National Collaborative on Childhood Obesity Research Web site presents the Youth Compendium and related materials to facilitate measurement of the energy cost of nearly 200 physical activities in children and youth. The Youth Compendium provides a way to standardize energy costs in children and youth and has application for a wide variety of audiences.

Association of individual and neighbourhood socioeconomic status with physical activity and screen time in seventh-grade boys and girls in Berlin, Germany: a cross-sectional study

OBJECTIVES

Few studies have explored the impact of neighbourhood socioeconomic status (SES) on health behaviours in youths in Germany. Our aim was to investigate the association of individual and neighbourhood SES with physical activity (PA) and screen time (ST) in students aged 12-13 years in Berlin.

DESIGN

Cross-sectional study.

SETTING

Secondary schools (high schools and integrated secondary schools) in Berlin, Germany.

PARTICIPANTS

A total of 2586 students aged 12-13 years (seventh grade).

MAIN OUTCOME MEASURES

Sociodemographics, anthropometric data and health behaviours were assessed by self-report during classes. Primary outcome was the association of individual and neighbourhood SES with meeting daily PA and exceeding daily ST recommendations. Students' characteristics were described with means or percentages. Comparisons were performed using generalised linear mixed model yielding ORs with 95% CIs.

RESULTS

Mean (±SD) age was 12.5±0.5 years, 50.5% were girls and 34.1% had a migrant background. When adjusting for individual covariates, associations of low versus high individual SES were 0.85 (0.48; 1.52) for PA and 2.08 (1.26; 3.43) for ST. Associations of low versus high neighbourhood SES were 1.76 (1.12; 2.75) for PA and 1.54 (1.10; 2.17) for ST. After additional adjustment for school type and school neighbourhood SES, associations comparing low versus high individual and neighbourhood SES were attenuated for PA (individual SES 0.74 (0.41; 1.33) and neighbourhood SES 1.51 (0.93; 2.46)) and ST (individual SES 1.88 (1.12; 3.14) and neighbourhood SES 1.40(0.98; 2.00).

CONCLUSIONS

Lower individual and neighbourhood SES were associated with higher ST. Lower neighbourhood but not individual SES was associated with higher PA. After consideration of school type and school neighbourhood SES associations were attenuated and became insignificant for the relationship between neighbourhood SES, PA and ST. Further research is warranted to unravel the complex relationships between individual SES, neighbourhood SES and school environment to develop more targeted health promotion strategies in the future.