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Davenport C, Kuzik N, Larouche R, Carson V. The Associations Between Parental-Reported and Device-Based Measured Outdoor Play and Health Indicators of Physical, Cognitive, and Social-Emotional Development in Preschool-Aged Children. Pediatr Exerc Sci 2025; 37:102-111. [PMID: 38561002 DOI: 10.1123/pes.2023-0119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Revised: 12/21/2023] [Accepted: 01/28/2024] [Indexed: 04/04/2024]
Abstract
PURPOSE Examine in preschool-aged children: (1) the associations between parental-reported and device-measured outdoor play (OP) and health indicators of physical, cognitive, and social-emotional development and (2) whether associations were independent of outdoor moderate- to vigorous-intensity physical activity (MVPA). METHODS This cross-sectional study included 107 participants. Children's OP was measured via a parental questionnaire and the lux feature of accelerometers. Children's growth, adiposity, and motor skills were assessed as physical development indicators. Visual-spatial working memory, response inhibition, and expressive language were assessed as cognitive development indicators. Sociability, prosocial behavior, internalizing, externalizing, and self-regulation were assessed as social-emotional development indicators. Regression models were conducted that adjusted for relevant covariates. Additional models further adjusted for outdoor MVPA. RESULTS Parental-reported total OP, OP in summer/fall months, and OP on weekdays were negatively associated (small effect sizes) with response inhibition and working memory. After adjusting for outdoor MVPA, these associations were no longer statistically significant. OP on weekdays was negatively associated with externalizing (B = -0.04; 95% confidence interval, -0.08 to -0.00; P = .03) after adjusting for outdoor MVPA. A similar pattern was observed for device-based measured total OP (B = -0.49; 95% confidence interval, -1.05 to 0.07; P = .09). CONCLUSIONS Future research in preschool-aged children should take into account MVPA and contextual factors when examining the association between OP and health-related indicators.
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Affiliation(s)
- Cody Davenport
- Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, AB,Canada
| | - Nicholas Kuzik
- Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, AB,Canada
- Children's Hospital of Eastern Ontario - Research Institute, Ottawa, ON,Canada
| | - Richard Larouche
- Faculty of Health Sciences, University of Lethbridge, Lethbridge, AB,Canada
| | - Valerie Carson
- Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, AB,Canada
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Son H, Kim J. Parental perceptions of neighborhood safety and preschool children's outdoor play: An exploration of sex and safety type differences. Soc Sci Med 2024; 357:117249. [PMID: 39153235 DOI: 10.1016/j.socscimed.2024.117249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2024] [Revised: 08/06/2024] [Accepted: 08/13/2024] [Indexed: 08/19/2024]
Abstract
Despite the growing evidence on the influence of neighborhood safety on physical activity, few studies have specifically focused on preschool-aged children and differentiated the various domains of neighborhood safety. This study investigates the relationship between parental perceptions of neighborhood safety and preschool children's time spent outdoors and explores potential sex differences in this relationship. This study analyzed nationally representative data from 1656 Korean children (848 boys and 808 girls) aged 3, 5, 6 years collected over the course of three waves of the Panel Study on Korean Children (PSKC). Outdoor playtime was measured by maternal reports of the time their children spent playing outdoors on a typical weekday. Parental perceptions of neighborhood safety were assessed using two items that inquired about neighborhood safety in terms of crime and accidents, respectively. Fixed effects estimates revealed that parental perceptions of social safety were associated with an increase in children's outdoor physical activity (b = 3.778, p < 0.05), whereas perceptions of physical safety were not. Sex-stratified models showed that the association between parental perceptions of social safety and children's outdoor play was driven largely by boys (b = 8.498, p < 0.001), with no association observed for girls. The findings of this study underscore the importance of addressing the social safety of neighborhood environments to promote outdoor play in preschool children. Moreover, sex differences should be considered when developing interventions aimed at increasing physical activity among young children.
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Affiliation(s)
- Hyewon Son
- Department of Health Policy and Management, Korea University, Seoul, Republic of Korea; Interdisciplinary Program in Precision Public Health, Korea University, Seoul, Republic of Korea
| | - Jinho Kim
- Department of Health Policy and Management, Korea University, Seoul, Republic of Korea; Interdisciplinary Program in Precision Public Health, Korea University, Seoul, Republic of Korea; Center for Demography of Health and Aging, University of Wisconsin-Madison, Madison, WI, USA.
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Larouche R, Rostami Haji Abadi M, Aubert S, Bhawra J, Brazo-Sayavera J, Carson V, Colley RC, Nyström CD, Esliger DW, Harper-Brown R, Gonzalez Cifuentes SA, Jáuregui A, Katewongsa P, Khadilkar A, Kira G, Kuzik N, Liu Y, Lof M, Loney T, Manyanga T, Mwase-Vuma TW, Oyeyemi AL, Reilly JJ, Richards J, Roberts K, Sarmiento OL, Silva DAS, Smith M, Subedi N, Vanderloo LM, Widyastari DA, Wilson OWA, Wong SH, Tremblay MS. Development and validation of the Global Adolescent and Child Physical Activity Questionnaire (GAC-PAQ) in 14 countries: study protocol. BMJ Open 2024; 14:e082275. [PMID: 39053955 PMCID: PMC11284885 DOI: 10.1136/bmjopen-2023-082275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2023] [Accepted: 07/07/2024] [Indexed: 07/27/2024] Open
Abstract
INTRODUCTION Global surveillance of physical activity (PA) of children and adolescents with questionnaires is limited by the use of instruments developed in high-income countries (HICs) lacking sociocultural adaptation, especially in low- and middle-income countries (LMICs); under-representation of some PA domains; and omission of active play, an important source of PA. Addressing these limitations would help improve international comparisons, and facilitate the cross-fertilisation of ideas to promote PA. We aim to develop and assess the reliability and validity of the app-based Global Adolescent and Child Physical Activity Questionnaire (GAC-PAQ) among 8-17 years old in 14 LMICs and HICs representing all continents; and generate the 'first available data' on active play in most participating countries. METHODS AND ANALYSIS Our study involves eight stages: (1) systematic review of psychometric properties of existing PA questionnaires for children and adolescents; (2) development of the GAC-PAQ (first version); (3) content validity assessment with global experts; (4) cognitive interviews with children/adolescents and parents in all 14 countries; (5) development of a revised GAC-PAQ; (6) development and adaptation of the questionnaire app (application); (7) pilot-test of the app-based GAC-PAQ; and, (8) main study with a stratified, sex-balanced and urban/rural-balanced sample of 500 children/adolescents and one of their parents/guardians per country. Participants will complete the GAC-PAQ twice to assess 1-week test-retest reliability and wear an ActiGraph wGT3X-BT accelerometer for 9 days to test concurrent validity. To assess convergent validity, subsamples (50 adolescents/country) will simultaneously complete the PA module from existing international surveys. ETHICS AND DISSEMINATION Approvals from research ethics boards and relevant organisations will be obtained in all participating countries. We anticipate that the GAC-PAQ will facilitate global surveillance of PA in children/adolescents. Our project includes a robust knowledge translation strategy sensitive to social determinants of health to inform inclusive surveillance and PA interventions globally.
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Affiliation(s)
- Richard Larouche
- Faculty of Health Sciences, University of Lethbridge, Lethbridge, Alberta, Canada
| | | | - Salomé Aubert
- Active Healthy Kids Global Alliance, Ottawa, Ontario, Canada
| | - Jasmin Bhawra
- School of Occupational and Public Health, Toronto Metropolitan University, Toronto, Ontario, Canada
| | - Javier Brazo-Sayavera
- Department of Sports and Computer Science, Universidad Pablo de Olavide, Sevilla, Spain
| | | | - Rachel C Colley
- Health Analysis Division, Statistics Canada, Ottawa, Ontario, Canada
| | | | - Dale W Esliger
- School of Sport, Exercise, and Health Sciences, Loughborough University, Loughborough, UK
| | - Ryan Harper-Brown
- Department of New Media, University of Lethbridge, Lethbridge, Alberta, Canada
| | | | - Alejandra Jáuregui
- Department of Physical Activity and Healthy Lifestyles, National Institute of Public Health, Cuernavaca, Mexico
| | - Piyawat Katewongsa
- Institute for Population and Social Research, Mahidol University, Salaya, Thailand
| | - Anuradha Khadilkar
- Hirabai Cowasji Jehangir Medical Research Institute, Jehangir Hospital, Pune, India
| | - Geoff Kira
- Te Hau Kori, Faculty of Health, Victoria University of Wellington, Wellington, Wellington, New Zealand
| | - Nicholas Kuzik
- Healthy Active Living and Obesity Research Group, CHEO Research Institute, Ottawa, Ontario, Canada
| | - Yang Liu
- School of Physical Education, Shanghai University of Sport, Shanghai, China
| | - Marie Lof
- Department of Biosciences and Nutrition, Karolinska Institutet, Huddinge, Sweden
| | - Tom Loney
- College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, UAE
| | - Taru Manyanga
- Division of Medical Sciences, University of Northern British Columbia, Prince George, British Columbia, Canada
| | - Tawonga W Mwase-Vuma
- Centre for Social Research, University of Malawi, Zomba, Malawi
- Department of Psychological Sciences and Health, University of Strathclyde, Glasgow, UK
| | - Adewale L Oyeyemi
- College of Health Solutions, Arizona State University, Tempe, Arizona, USA
- Department of Physiotherapy, Redeemer’s University, Ede, Nigeria
| | - John J Reilly
- Department of Psychological Sciences and Health, University of Strathclyde, Glasgow, UK
| | - Justin Richards
- Te Hau Kori, Faculty of Health, Victoria University of Wellington, Wellington, Wellington, New Zealand
| | - Karen Roberts
- Centre for Surveillance and Applied Research, Public Health Agency of Canada, Ottawa, Ontario, Canada
| | | | | | - Melody Smith
- The University of Auckland, Auckland, New Zealand
| | | | - Leigh M Vanderloo
- School of Occupational Therapy, University of Western Ontario, London, Ontario, Canada
- ParticipACTION, Toronto, Ontario, Canada
| | | | - Oliver W A Wilson
- Te Hau Kori, Faculty of Health, Victoria University of Wellington, Wellington, Wellington, New Zealand
| | - S H Wong
- Chinese University of Hong Kong, Hong Kong, China
| | - Mark S Tremblay
- Active Healthy Kids Global Alliance, Ottawa, Ontario, Canada
- Healthy Active Living and Obesity Research Group, CHEO Research Institute, Ottawa, Ontario, Canada
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Bhattacharya P, Edwards K, Harkin D, Schmid KL. Corneal Epithelial Cell Density Is Reduced in Young Adults With Conjunctival Ultraviolet Autofluorescence. Cornea 2024; 43:693-701. [PMID: 37713663 DOI: 10.1097/ico.0000000000003389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2023] [Accepted: 08/08/2023] [Indexed: 09/17/2023]
Abstract
PURPOSE The aim of this study was to investigate the effects of chronic ultraviolet (UV) radiation exposure on the corneal microstructure using conjunctival UV autofluorescence (CUVAF) as a marker of exposure. METHODS Young healthy adults aged 18 to 35 years were recruited. Participant's demographics and sun exposure behavior were recorded using questionnaires. Images of the bulbar conjunctiva from the right eye were captured and analyzed for the CUVAF area. Corneal microstructure was assessed by in vivo confocal microscopy and anterior segment optical coherence tomography. The presence of palisades of Vogt in all 4 limbal quadrants was recorded. RESULTS CUVAF was observed in 31 of 52 eyes (60%), with a mean (±SD) nasal, temporal, and total CUVAF area of 5.39 ± 4.16 mm 2 , 4.29 ± 4.27 mm 2 , and 9.67 ± 7.01 mm 2 , respectively. Individuals with CUVAF were significantly more likely to report undertaking moderate-intensity to high-intensity outdoor exercise ( P = 0.021). Individuals with CUVAF were less likely to have visible nasal and temporal palisades of Vogt ( P = 0.011). Corneal basal cell densities anterior to the nerve whorl ( P < 0.001) and nasally ( P = 0.005) were lower in individuals with CUVAF. Wing cell density anterior to the nerve whorl was lower in individuals with CUVAF ( P = 0.011). No significant changes in the central and limbal corneal epithelial thickness were observed. CONCLUSIONS Significant reductions in corneal epithelial cell density were observed in individuals with CUVAF, a biomarker of chronic UV exposure. This observation suggests that chronic UV exposure is damaging to the corneal microstructure.
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Affiliation(s)
- Pradipta Bhattacharya
- School of Optometry and Vision Science, Centre for Vision and Eye Research, Faculty of Health, Queensland University of Technology, Brisbane, Queensland, Australia; and
| | - Katie Edwards
- School of Optometry and Vision Science, Centre for Vision and Eye Research, Faculty of Health, Queensland University of Technology, Brisbane, Queensland, Australia; and
| | - Damien Harkin
- School of Biomedical Science, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Katrina L Schmid
- School of Optometry and Vision Science, Centre for Vision and Eye Research, Faculty of Health, Queensland University of Technology, Brisbane, Queensland, Australia; and
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Duffy RT, Larsen K, Bélanger M, Brussoni M, Faulkner G, Gunnell K, Tremblay MS, Larouche R. Children's Independent Mobility, School Travel, and the Surrounding Neighborhood. Am J Prev Med 2024; 66:819-831. [PMID: 38081375 DOI: 10.1016/j.amepre.2023.12.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 12/05/2023] [Accepted: 12/05/2023] [Indexed: 01/15/2024]
Abstract
INTRODUCTION Children's active travel to and from school (AST) and children's independent mobility (CIM) are consistently positively associated with physical activity (PA); however, few researchers have investigated associations between objective measures of the environment and indicators of AST and CIM in national samples. METHODS A national sample of 2,067 Canadian parents of 7- to 12-year-old children was recruited in December 2020. Regression analyses were used in 2023 to assess the association between geographic information system measures of park density, blue space, population density, greenspace, intersection density, and CIM and AST to and from school. RESULTS Children in areas with high versus low park density (>0.025 vs. ≤0.025) had higher odds of travel to school via active modes (OR: 1.47 [1.14, 1.91], p=0.003). Children in neighborhoods in the highest quartile for neighborhood greenspace (Normalized Difference Vegetation Index) were more likely to travel to home actively than those in areas of lower greenspace (OR: 1.70 [1.18, 2.45], p=0.004). On average, children living in areas in the highest versus the lowest quartile for intersection density were more likely to engage in AST to (OR: 2.43 [1.58, 3.75], p<0.001) and from (OR: 2.77 [1.80, 4.29], p<0.001) school. CONCLUSIONS The observed associations underscore a need for city planners and policymakers to ensure sufficient access to parks and neighborhood greenspace, especially if findings are confirmed in longitudinal studies. More research is needed to investigate the role of intersection density in supporting AST and CIM.
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Affiliation(s)
- Robert T Duffy
- School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada; Department of Geography and Environmental Studies, Toronto Metropolitan University, Toronto, ON, Canada
| | - Kristian Larsen
- Department of Geography and Environmental Studies, Toronto Metropolitan University, Toronto, ON, Canada; Health Canada, Office of Environmental Health, Healthy Environments and Consumer Safety Branch, Environmental and Radiation Health Science Directorate, Ottawa, ON, Canada; Department of Geography and Planning, University of Toronto, Toronto, ON, Canada; Department of Public Health Sciences, Queen's University, Kingston, ON, Canada; CAREX Canada, School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada.
| | - Mathieu Bélanger
- Faculté de Médecine et des Sciences de La Santé, Université de Sherbrooke, Sherbrooke, Canada
| | - Mariana Brussoni
- School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada; Department of Pediatrics, University of British Columbia, Vancouver, BC, Canada; Human Early Learning Partnership, School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada; British Columbia Children's Hospital Research Institute, Vancouver, BC, Canada
| | - Guy Faulkner
- School of Kinesiology, University of British Columbia, Vancouver, BC, Canada
| | - Katie Gunnell
- Department of Psychology, Carleton University, Ottawa, ON, Canada
| | - Mark S Tremblay
- Healthy Active Living and Obesity Research Group, CHEO Research Institute, Ottawa, ON, Canada; Department of Pediatrics, University of Ottawa, Ottawa, ON, Canada; Department of Health Sciences, Carleton University, Ottawa, ON, Canada
| | - Richard Larouche
- Faculty of Health Sciences, University of Lethbridge, Lethbridge AB, Canada
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Lyu J, Yang H, Christie S. Mommy, Can I Play Outside? How Urban Design Influences Parental Attitudes on Play. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4909. [PMID: 36981816 PMCID: PMC10048976 DOI: 10.3390/ijerph20064909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 02/27/2023] [Accepted: 03/01/2023] [Indexed: 06/18/2023]
Abstract
Although play results in physical, social, and cognitive benefits, there is a consensus that children's opportunities to play have been reduced, particularly for those who live in urban environments. What are the barriers to play, and how can we mitigate them? This review examines a critical factor in play opportunities: parents as the decision-makers with regard to children's play. Using perspectives from psychology, urban design, and cognitive science, we analyze the relationships between the design of built environments, parental attitudes and beliefs, and parental decisions on allowing children to play. For example, can a new implementation of children-centered urban design change parents' skeptical attitude toward play? By drawing from global studies, we chart (1) the three key beliefs of parents regarding play and built environments: play should benefit learning, be safe, and match the child's competence and (2) the design principles that can foster these beliefs: learning, social, and progressive challenge designs. By making the link between parents, urban design, and play explicit, this paper aims to inform parents, educators, policymakers, urban planners, and architects on the evidence-based measures for creating and increasing opportunities to play.
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Affiliation(s)
- Jinyun Lyu
- Tsinghua Laboratory of Brain and Intelligence, Tsinghua University, Beijing 100084, China
- Department of Psychology, Tsinghua University, Beijing 100084, China
| | - Huiying Yang
- Tsinghua Laboratory of Brain and Intelligence, Tsinghua University, Beijing 100084, China
- Department of Psychology, Tsinghua University, Beijing 100084, China
| | - Stella Christie
- Tsinghua Laboratory of Brain and Intelligence, Tsinghua University, Beijing 100084, China
- Department of Psychology, Tsinghua University, Beijing 100084, China
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Stevens WR, Borchard JM, Sleeper P, Dempsey D, Jeans KA, Jo CH, Tulchin-Francis K. Inclusive community playgrounds benefit typically developing children: An objective analysis of physical activity. Front Sports Act Living 2023; 4:1100574. [PMID: 36819733 PMCID: PMC9929159 DOI: 10.3389/fspor.2022.1100574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 12/28/2022] [Indexed: 02/05/2023] Open
Abstract
Purpose Limited research is available on the physical activity levels of children while playing on an inclusive playground, specifically designed to accommodate children with physical disabilities. The aims of this study were to objectively measure ambulatory activity and heart rate (HR) of children during unstructured play on an inclusive community playground. Methods Typically developing children at least 4 years of age were recruited to play freely upon entering the playground. Participants wore a StepWatch4 Activity Monitor and a Polar V800 Sport Watch. Ambulatory measures included total steps, percentage of recommended steps, total ambulatory time (TAT), bout intensity levels/duration periods. Time spent in HR zones and moderate-to-vigorous physical activity (MVPA) was determined. Results 95 children (48 males; Avg. age: 7 ± 2 years.) were included in this study. Children played for 31.8 ± 14.7 min., were ambulatory for 25.9 ± 12.0 min., took 1826 ± 824 steps, and accumulated 17 ± 8% of the recommended daily step count. Ambulatory bout intensity was predominantly lower intensity and bout durations varied in length. 99% of the play time was spent at a moderate HR or higher. Significant correlations were found between ambulatory and HR measures (ρ range from 0.23 to 0.99, p < 0.05), and 7-10 yo children spent a significantly higher percentage of TAT at higher intensity ambulation (p < 0.05). Conclusions Typically developing children can achieve moderate or higher intensity exercise and HR on an inclusive playground. Both typically developing children and those with disabilities, would benefit from a setting where they can interact and participate in parallel play with their peers.
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Affiliation(s)
- Wilshaw R. Stevens
- Movement Science Lab, Scottish Rite for Children, Dallas, TX, United States
| | | | - Paige Sleeper
- Therapeutic Recreation, Scottish Rite for Children, Dallas, TX, United States
| | - Dana Dempsey
- Therapeutic Recreation, Scottish Rite for Children, Dallas, TX, United States
| | - Kelly A. Jeans
- Movement Science Lab, Scottish Rite for Children, Dallas, TX, United States
| | - Chan-Hee Jo
- Research Department, Scottish Rite for Children, Dallas, TX, United States
| | - Kirsten Tulchin-Francis
- Department of Orthopedic Surgery, Nationwide Children’s Hospital, Columbus, OH, United States
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Goto R, Kitagaki K, Horibe K, Tamura K, Yamada N, Ono R. Relationship between Perceived Physical Competence and Outdoor Play among Children Aged 9-12 Years-Focused Sex-Specific Differences. CHILDREN (BASEL, SWITZERLAND) 2023; 10:135. [PMID: 36670685 PMCID: PMC9857092 DOI: 10.3390/children10010135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Revised: 12/22/2022] [Accepted: 01/06/2023] [Indexed: 01/12/2023]
Abstract
BACKGROUND Outdoor play (OP), which is considered important for children's development, is declining every year. Perceived physical competence (PPC) is a vital factor that promotes physical activity such as OP, sports clubs, etc., but the relationship between PPC and OP was unknown. The purpose of this research was to investigate the relationship between PPC and OP in children and consider whether there were any sex-specific changes. METHODS A cross-sectional study was conducted in Japan with 288 children (134 girls, age: 10.6 ± 1.01 years). OP was assessed using an original self-report questionnaire. Each weekday, the children reported the time of OP and were classified as "high" if they played outside for at least an hour three times. PPC was evaluated with a self-report questionnaire developed by Okazawa et al. (1996). It has 12 questions and was assessed on a 5-point Likert scale. After adjusting for age, sex, BMI, screen time, sports club participation, and the number of friends, logistic regression analyses were carried out. RESULTS Children with better PPC were significantly more likely to be classified as "high" [crude odds ratio (OR): 1.04; 95% confidence interval (CI): 1.00-1.08; adjusted OR: 1.04; 95% CI: 1.00-1.08]. Only girls with better PPC were significantly more likely to be classified as "high" in a sex-based stratified analysis [crude OR: 1.08; 95% CI: 1.01-1.15, adjusted OR 1.09; 95% CI: 1.02-1.17]. CONCLUSIONS Particularly among girls, OP could be promoted as a voluntary physical activity with improved PPC.
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Affiliation(s)
- Ryo Goto
- Graduate School of Health Sciences, Kobe University, Kobe 654-0142, Japan
| | - Kazufumi Kitagaki
- Graduate School of Health Sciences, Kobe University, Kobe 654-0142, Japan
- Faculty of Rehabilitation, Shijonawate Gakuen University, Osaka 574-0011, Japan
| | - Kana Horibe
- Graduate School of Health Sciences, Kobe University, Kobe 654-0142, Japan
| | - Kazuya Tamura
- Graduate School of Health Sciences, Kobe University, Kobe 654-0142, Japan
| | - Naoki Yamada
- Graduate School of Health Sciences, Kobe University, Kobe 654-0142, Japan
| | - Rei Ono
- Graduate School of Health Sciences, Kobe University, Kobe 654-0142, Japan
- Department of Physical Activity Research, National Institutes of Biomedical Innovation, Health and Nutrition, Tokyo 162-8636, Japan
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Correlates of Outdoor Time in Schoolchildren From Families Speaking Nonofficial Languages at Home: A Multisite Canadian Study. J Phys Act Health 2022; 19:828-836. [PMID: 36370699 DOI: 10.1123/jpah.2021-0812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 04/28/2022] [Accepted: 09/22/2022] [Indexed: 11/14/2022]
Abstract
BACKGROUND Previous research shows that children from ethnic minority groups spend less time outdoors. Using data collected in 3 regions of Canada, we investigated the correlates of outdoor time among schoolchildren who spoke a nonofficial language at home. METHODS A total of 1699 children were recruited from 37 schools stratified by area-level socioeconomic status and type of urbanization. Among these, 478 spoke a nonofficial language at home. Children's outdoor time and data on potential correlates were collected via questionnaires. Gender-stratified linear multiple regression models examined the correlates of outdoor time while controlling for age and sampling variables. RESULTS In boys, higher independent mobility, higher outdoor air temperature, mobile phone ownership, having older parents, and parents who biked to work were associated with more outdoor time. Boys living in suburban (vs urban) areas spent less time outdoors. The association between independent mobility and outdoor time became weaker with increasing age for boys. In girls, lower parental education and greater parental concerns about neighborhood safety and social cohesion were associated with less outdoor time. CONCLUSIONS Correlates of outdoor time differ by gender and span the social ecological model underscoring the need for gender-sensitized interventions targeted at individual, family, social, and physical environmental correlates to increase outdoor time.
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Social-Ecological Correlates of Children’s Independent Mobility: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031604. [PMID: 35162626 PMCID: PMC8835222 DOI: 10.3390/ijerph19031604] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Revised: 01/20/2022] [Accepted: 01/27/2022] [Indexed: 11/16/2022]
Abstract
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.
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Wild K, Woodward A. The bicycle as 'constructive hope': Children, climate and active transport. J Paediatr Child Health 2021; 57:1785-1788. [PMID: 34792229 DOI: 10.1111/jpc.15754] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Accepted: 09/15/2021] [Indexed: 11/30/2022]
Abstract
Children are experiencing an increase in so-called 'eco-anxiety'. Along with others, we argue that children need more concrete, meaningful opportunities to feel they can make a difference in climate. In this article, we contend that bringing back the bicycle, and the opportunities for independent and active mobility that it affords children, is an important form of climate action for young people. We assert that as well as providing sustainability and wellbeing co-benefits for children, cycling can help bolster the neighbourhood resilience and social cohesion that will be key resources for communities adapting to new climate risks.
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Affiliation(s)
- Kirsty Wild
- Department of Epidemiology and Biostatistics, School of Population Health, The University of Auckland, Auckland, New Zealand
| | - Alistair Woodward
- Department of Epidemiology and Biostatistics, School of Population Health, The University of Auckland, Auckland, New Zealand
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12
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Loebach J, Sanches M, Jaffe J, Elton-Marshall T. Paving the Way for Outdoor Play: Examining Socio-Environmental Barriers to Community-Based Outdoor Play. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18073617. [PMID: 33807263 PMCID: PMC8037806 DOI: 10.3390/ijerph18073617] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Revised: 03/16/2021] [Accepted: 03/19/2021] [Indexed: 01/03/2023]
Abstract
Outdoor play and independent, neighborhood activity, both linked with healthy childhood development, have declined dramatically among Western children in recent decades. This study examines how social, cultural and environmental factors may be hindering children’s outdoor and community-based play. A comprehensive survey was completed by 826 children (aged 10–13 years) and their parents from 12 schools (four each urban, suburban and rural) from a large county in Ontario, Canada. Five multilevel regression models, controlling for any school clustering effect, examined associations between outdoor play time per week and variable sets representing five prevalent factors cited in the literature as influencing children’s outdoor play (OP). Models predicted that younger children and boys were more likely to spend time playing outdoors; involvement in organized physical activities, other children nearby to play with, higher perception of benefits of outdoor play, and higher parental perceptions of neighborhood social cohesion also predicted more time in outdoor play. Time outdoors was less likely among children not allowed to play beyond home without supervision, felt they were ‘too busy’ with screen-based activities, and who reported higher fears related to playing outdoors. Study findings have important implications for targeting environmental, cultural and policy changes to foster child-friendly communities which effectively support healthy outdoor play.
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Affiliation(s)
- Janet Loebach
- Department of Design + Environmental Analysis, Cornell University, Ithaca, New York, NY 14853, USA;
- Correspondence:
| | - Marcos Sanches
- Krembli Centre for Neuroinformatics, Centre for Addiction and Mental Health, London, ON N6G 4X8, Canada;
| | - Julia Jaffe
- Department of Design + Environmental Analysis, Cornell University, Ithaca, New York, NY 14853, USA;
| | - Tara Elton-Marshall
- Centre for Addiction and Mental, Institute for Mental Health Policy Research, London, ON N6G 4X8, Canada;
- Campbell Family Mental Health Research Institute, Toronto, ON M5S 2S1, Canada
- Dalla Lana School of Public Health, Toronto, ON M5T 3M7, Canada
- Department of Epidemiology and Biostatistics, Western University, London, ON N6A 5C1, Canada
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13
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Huang L, Schmid KL, Yin XN, Zhang J, Wu J, Yang G, Ruan ZL, Jiang XQ, Wu CA, Chen WQ. Combination Effect of Outdoor Activity and Screen Exposure on Risk of Preschool Myopia: Findings From Longhua Child Cohort Study. Front Public Health 2021; 9:607911. [PMID: 33748061 PMCID: PMC7973103 DOI: 10.3389/fpubh.2021.607911] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Accepted: 02/01/2021] [Indexed: 01/12/2023] Open
Abstract
Evidence regarding screen use and outdoor activity during very early childhood (i. e., from aged 1 to 3 years) and their potential combined links to the later preschool myopia is limited. This information is needed to release effective public health messages and propose intervention strategies against preschool myopia. We collected information regarding very early childhood screen use, outdoor activity and the kindergartens vision screenings of 26,611 preschoolers from Longhua Child Cohort Study by questionnaires. Logistic regression models were used to examine the associations between reported outdoor activity, screen use from 1 to 3 years of age, and preschool myopia. Throughout very early childhood, from 1 to 3 years, the proportion of children exposed to screens increased (from 35.8 to 68.4%, p < 0.001), whereas the proportion of children who went outdoors ≥7 times/week (67.4–62.1%, p < 0.001) and who went outdoors for ≥60 min/time (53.3–38.0%, p < 0.001) declined. Exposure to fixed screen devices [adjusted odds ratio (AOR) = 2.66, 95% confidence interval (CI) = 2.09–3.44], mobile screen devices (AOR = 2.76, 95% CI = 2.15–3.58), and limited outdoor activity (AOR = 1.87, 95% CI = 1.42–2.51) during early childhood were associated with preschool myopia. Among children whose parents were myopic, the interactions between outdoor activity and fixed or mobile screen use on later preschool myopia were significant; the ORs and 95% CI were 3.34 (1.19–9.98) and 3.04 (1.06–9.21), respectively. Our findings suggest the possibility that the impact of screen exposure during early childhood on preschool myopia could be diminished by outdoor activity for children whose parents have myopia.
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Affiliation(s)
- Lihua Huang
- Department of Medical Statistics and Epidemiology, Guangzhou Key Laboratory of Environmental Pollution and Health Assessment, Guangdong Provincial Key Laboratory of Food, Nutrition and Health, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Katrina L Schmid
- School of Optometry and Vision Science, Faculty of Health, Queensland University of Technology, Brisbane, QLD, Australia
| | - Xiao-Na Yin
- Longhua District Maternal and Child Health Hospital, Shenzhen, China
| | - Jingyu Zhang
- Longhua District Maternal and Child Health Hospital, Shenzhen, China
| | - Jianbo Wu
- Department of Medical Statistics and Epidemiology, Guangzhou Key Laboratory of Environmental Pollution and Health Assessment, Guangdong Provincial Key Laboratory of Food, Nutrition and Health, School of Public Health, Sun Yat-sen University, Guangzhou, China.,Longhua District Maternal and Child Health Hospital, Shenzhen, China
| | - Guiyou Yang
- Department of Medical Statistics and Epidemiology, Guangzhou Key Laboratory of Environmental Pollution and Health Assessment, Guangdong Provincial Key Laboratory of Food, Nutrition and Health, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Zeng-Liang Ruan
- Department of Medical Statistics and Epidemiology, Guangzhou Key Laboratory of Environmental Pollution and Health Assessment, Guangdong Provincial Key Laboratory of Food, Nutrition and Health, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Xiao-Qin Jiang
- Longhua District Maternal and Child Health Hospital, Shenzhen, China
| | - Chuan-An Wu
- Longhua District Maternal and Child Health Hospital, Shenzhen, China
| | - Wei-Qing Chen
- Department of Medical Statistics and Epidemiology, Guangzhou Key Laboratory of Environmental Pollution and Health Assessment, Guangdong Provincial Key Laboratory of Food, Nutrition and Health, School of Public Health, Sun Yat-sen University, Guangzhou, China.,Department of Information Management, Xinhua College of Sun Yat-sen University, Guangzhou, China
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14
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Zougheibe R, Xia JC, Dewan A, Gudes O, Norman R. Children's outdoor active mobility behaviour and neighbourhood safety: a systematic review in measurement methods and future research directions. Int J Health Geogr 2021; 20:2. [PMID: 33413433 PMCID: PMC7792091 DOI: 10.1186/s12942-020-00254-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Accepted: 12/17/2020] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Numerous studies have examined the association between safety and primary school-aged children's forms of active mobility. However, variations in studies' measurement methods and the elements addressed have contributed to inconsistencies in research outcomes, which may be forming a barrier to advancing researchers' knowledge about this field. To assess where current research stands, we have synthesised the methodological measures in studies that examined the effects of neighbourhood safety exposure (perceived and measured) on children's outdoor active mobility behaviour and used this analysis to propose future research directions. METHOD A systematic search of the literature in six electronic databases was conducted using pre-defined eligibility criteria and was concluded in July 2020. Two reviewers screened the literature abstracts to determine the studies' inclusion, and two reviewers independently conducted a methodological quality assessment to rate the included studies. RESULTS Twenty-five peer-reviewed studies met the inclusion criteria. Active mobility behaviour and health characteristics were measured objectively in 12 out of the 25 studies and were reported in another 13 studies. Twenty-one studies overlooked spatiotemporal dimensions in their analyses and outputs. Delineations of children's neighbourhoods varied within 10 studies' objective measures, and the 15 studies that opted for subjective measures. Safety perceptions obtained in 22 studies were mostly static and primarily collected via parents, and dissimilarities in actual safety measurement methods were present in 6 studies. The identified schematic constraints in studies' measurement methods assisted in outlining a three-dimensional relationship between 'what' (determinants), 'where' (spatial) and 'when' (time) within a methodological conceptual framework. CONCLUSIONS The absence of standardised measurement methods among relevant studies may have led to the current diversity in findings regarding active mobility, spatial (locality) and temporal (time) characteristics, the neighbourhood, and the representation of safety. Ignorance of the existing gaps and heterogeneity in measures may impact the reliability of evidence and poses a limitation when synthesising findings, which could result in serious biases for policymakers. Given the increasing interest in children's health studies, we suggested alternatives in the design and method of measures that may guide future evidence-based research for policymakers who aim to improve children's active mobility and safety.
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Affiliation(s)
- Roula Zougheibe
- School of Earth and Planetary Sciences, Curtin University, Kent Street, Perth, WA, 6102, Australia.
| | - Jianhong Cecilia Xia
- School of Earth and Planetary Sciences, Curtin University, Kent Street, Perth, WA, 6102, Australia
| | - Ashraf Dewan
- School of Earth and Planetary Sciences, Curtin University, Kent Street, Perth, WA, 6102, Australia
| | - Ori Gudes
- School of Public Health and Community Medicine, UNSW Medicine, Sydney, NSW, Australia
| | - Richard Norman
- School of Public Health, Curtin University, Perth, WA, Australia
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15
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Johansen C, Reynolds KD, Wolch J, Byrne J, Chou CP, Boyle S, Spruijt-Metz D, Lienemann BA, Weaver S, Jerrett M. The Association of Trail Features With Self-Report Trail Use by Neighborhood Residents. J Phys Act Health 2020; 17:715-722. [PMID: 32464596 PMCID: PMC8274481 DOI: 10.1123/jpah.2019-0347] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Revised: 02/11/2020] [Accepted: 04/21/2020] [Indexed: 11/18/2022]
Abstract
BACKGROUND Urban trails are a useful resource to promote physical activity. This study identified features of urban trails that correlated with trail use. METHODS Multiuse urban trails were selected in Chicago, Dallas, and Los Angeles. An audit of each trail was completed using the Systematic Pedestrian and Cyclist Environmental Scan for Trails instrument, identifying built environmental features. A self-report of trail use was obtained from trailside residents (N = 331) living within 1 mile of each trail. Univariate and multivariate Poisson regressions controlled for trail time from home and motivation for physical activity. RESULTS Positive associations with the past month's hours on the trail were observed for the presence of distance signs, vegetation height, vegetation maintenance, and trail crowding, and a negative association was observed for the presence of crossings on the trail. Positive associations with dichotomous trail use were observed for the presence of distance signs, vegetation height, and vegetation maintenance, and a negative association was observed for the presence of crossings on the trail. CONCLUSIONS These correlates should be confirmed in other studies and, if supported, should be considered in the promotion and design of urban trails.
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Affiliation(s)
| | - Kim D. Reynolds
- School of Community and Global Health, Claremont Graduate University
| | - Jennifer Wolch
- College of Environmental Design, University of California Berkeley
| | - Jason Byrne
- School of Technology, Environments and Design, University of Tasmania
| | | | - Sarah Boyle
- School of Community and Global Health, Claremont Graduate University
| | - Donna Spruijt-Metz
- Dornsife College of Letters, Arts and Sciences, University of Southern California
| | | | | | - Michael Jerrett
- Fielding School of Public Health, University of California Los Angeles
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16
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Development and Testing of a Brief Play Space Audit Tool. J Phys Act Health 2020; 17:13-20. [PMID: 31698335 DOI: 10.1123/jpah.2018-0686] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2018] [Revised: 07/22/2019] [Accepted: 08/30/2019] [Indexed: 11/18/2022]
Abstract
BACKGROUND Spaces that promote play are important for the physical, social, and psychological growth of children. Public spaces, including playgrounds, provide an important venue for children to engage in play. A simple tool is needed to evaluate playground features and conditions. METHODS A simple play space audit instrument to assess the presence and condition of playground features was tested on a sample of 70 playgrounds during the summer of 2017, in Chicago, IL. Duplicate observations were collected on 17 playgrounds. Frequencies of features were tabulated, and reliability of variables was assessed using percent agreement and kappa statistic. Scores were created to summarize playground "playability," overall and within domains of general overview, surface, path, and play equipment/structure features. RESULTS The tool demonstrated acceptable reliability with high kappa values between .79 and .90 for all items in domains. The overall score, general overview score, and play equipment/structure scores were correlated with mean playground usage. CONCLUSIONS This brief instrument allows reliable assessment of playground features and their conditions. The scoring method generates a summary of playground conditions and features, which facilitates comparison of playgrounds. This tool has the potential to assist communities in evaluating their play spaces and identifying where to focus resources for improvements.
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17
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Porskamp T, Ergler C, Pilot E, Sushama P, Mandic S. The importance of social capital for young People's active transport and independent mobility in rural Otago, New Zealand. Health Place 2019; 60:102216. [PMID: 31590078 DOI: 10.1016/j.healthplace.2019.102216] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Revised: 09/08/2019] [Accepted: 09/18/2019] [Indexed: 12/23/2022]
Abstract
Social capital influences adolescents' licenses for active transport and independent mobility, through parental decision making and safety concerns, and may contribute to increasing adolescents' physical activity. Drawing on 20 parental interviews and 11 focus groups (73 adolescents) from rural New Zealand, this paper shows the importance of social capital and social trust for active transport and independent mobility in an under researched rural context. Change over time in social capital, social trust and parental safety concerns limited adolescents' active transport and independent mobility. Health policy should incorporate social capital measures to increase adolescents' active transport, independent mobility and physical activity.
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Affiliation(s)
- Tessa Porskamp
- Department of Health, Ethics and Society, Care and Public Health Research Institute (CAPHRI), Medicine and Life Sciences, Maastricht University, Peter Debyeplein 1, 6229HA, Maastricht, the Netherlands; School of Geography, University of Otago, PO Box 56, Dunedin, 9054, New Zealand; Maastricht Centre for Global Health, Maastricht University, Peter Debyeplein 1, 6229HA, Maastricht, the Netherlands; Active Living Laboratory, School of Physical Education, Sport and Exercise Sciences, University of Otago, PO Box 56, Dunedin, 9054, New Zealand.
| | - Christina Ergler
- School of Geography, University of Otago, PO Box 56, Dunedin, 9054, New Zealand.
| | - Eva Pilot
- Department of Health, Ethics and Society, Care and Public Health Research Institute (CAPHRI), Medicine and Life Sciences, Maastricht University, Peter Debyeplein 1, 6229HA, Maastricht, the Netherlands; Maastricht Centre for Global Health, Maastricht University, Peter Debyeplein 1, 6229HA, Maastricht, the Netherlands
| | - Preeti Sushama
- Department of Health, Ethics and Society, Care and Public Health Research Institute (CAPHRI), Medicine and Life Sciences, Maastricht University, Peter Debyeplein 1, 6229HA, Maastricht, the Netherlands; Maastricht Centre for Global Health, Maastricht University, Peter Debyeplein 1, 6229HA, Maastricht, the Netherlands
| | - Sandra Mandic
- Active Living Laboratory, School of Physical Education, Sport and Exercise Sciences, University of Otago, PO Box 56, Dunedin, 9054, New Zealand; Centre for Sustainability, University of Otago, PO Box 56, Dunedin, 9054, New Zealand
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18
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Vlaar J, Brussoni M, Janssen I, Mâsse LC. Roaming the Neighbourhood: Influences of Independent Mobility Parenting Practices and Parental Perceived Environment on Children's Territorial Range. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16173129. [PMID: 31466293 PMCID: PMC6747532 DOI: 10.3390/ijerph16173129] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Revised: 08/26/2019] [Accepted: 08/27/2019] [Indexed: 02/06/2023]
Abstract
Children’s independent mobility (IM), their freedom to move about their neighbourhood without supervision by adults, has been in steady decline in recent decades. Previous research has linked perceptions of the environment with various measures of IM, but recently concerns have been raised regarding inconsistency in measuring IM. This study used various measures of IM and aimed to address how parental perceptions of the neighbourhood environment are associated with children’s territorial range (actual IM), as well as how this relationship is mediated by IM parenting practices (allowed IM). A sample of 105 child/parent dyads from Vancouver, Canada participated in this study. Children (age 10–13) wore a global positioning system (GPS) watch and an accelerometer and completed an activity diary for seven days to assess their territorial range. Parents completed a questionnaire that assessed perceptions of their neighbourhood environment and IM parenting practices—license for IM and roaming allowance. Path analyses were used to address the research aims. License for IM and roaming allowance mediated the relationship between perceived walking facilities, crime safety, and neighbourhood relations and children’s territorial range. Findings suggest that future interventions to increase children’s territorial range should focus primarily on attitude and behaviour change among parents to grant children more freedom.
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Affiliation(s)
- Janae Vlaar
- School of Population and Public Health, University of British Columbia, 2329 West Mall, Vancouver, BC V6T 1Z4, Canada
| | - Mariana Brussoni
- School of Population and Public Health, University of British Columbia, 2329 West Mall, Vancouver, BC V6T 1Z4, Canada.
- British Columbia Children's Hospital Research Institute, 4480 Oak St., Vancouver, BC V6H 3N1, Canada.
- Department of Pediatrics, University of British Columbia, 2329 West Mall, Vancouver, BC V6T 1Z4, Canada.
| | - Ian Janssen
- School of Kinesiology and Health Studies, Queen's University, 99 University Ave., Kingston, ON K7L 3N6, Canada
| | - Louise C Mâsse
- School of Population and Public Health, University of British Columbia, 2329 West Mall, Vancouver, BC V6T 1Z4, Canada.
- British Columbia Children's Hospital Research Institute, 4480 Oak St., Vancouver, BC V6H 3N1, Canada.
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19
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Riazi NA, Blanchette S, Trudeau F, Larouche R, Tremblay MS, Faulkner G. Correlates of Children's Independent Mobility in Canada: A Multi-Site Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16162862. [PMID: 31405110 PMCID: PMC6727085 DOI: 10.3390/ijerph16162862] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/26/2019] [Revised: 08/04/2019] [Accepted: 08/06/2019] [Indexed: 11/16/2022]
Abstract
Globally, physical inactivity is a concern, and children’s independent mobility (CIM) may be an important target behavior for addressing the physical inactivity crisis. The aim of this study was to examine correlates of CIM (8–12 years old) in the Canadian context to inform future interventions. CIM was measured via parent surveys. Individual, social, and environmental correlates of CIM were examined using a social–ecological framework. 1699 participants’ data were analyzed using descriptive statistics and gender-stratified linear mixed-effects models while controlling for site, area-level socioeconomic status, and type of urbanization. Individual correlates including child grade (β = 0.612, p < 0.001), language spoken at home (β = −0.503, p < 0.001), car ownership (β = −0.374, p < 0.05), and phone ownership (β = 0.593, p < 0.001) were associated with CIM. For boys, parental gender (β = −0.387, p < 0.01) was negatively associated with CIM. Parents’ perceptions of safety and environment were significantly associated with CIM. Location (i.e., site) was significantly associated with CIM (ref: Trois-Rivières; Ottawa (β = −1.188, p < 0.001); Vancouver (β = −1.216, p < 0.001)). Suburban environments were negatively associated with boys’ independent mobility (β = −0.536, p < 0.05), while walkability (400 m β = 0.064, p < 0.05; 1600 m β = −0.059, p < 0.05) was significantly associated with girls’ independent mobility only. Future research and interventions should consider targeting “modifiable factors” like children’s and parents’ perceptions of neighborhood safety and environment.
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Affiliation(s)
- Negin A Riazi
- School of Kinesiology, Faculty of Education, The University of British Columbia, Vancouver, BC V6T 1Z4, Canada.
| | - Sébastien Blanchette
- Département des sciences de l'activité physique, Université du Québec à Trois-Rivières, Trois-Rivières, QC G8Z 4M3, Canada
| | - François Trudeau
- Département des sciences de l'activité physique, Université du Québec à Trois-Rivières, Trois-Rivières, QC G8Z 4M3, Canada
| | - Richard Larouche
- Faculty of Health Sciences, University of Lethbridge, Lethbridge, AB T1K 3M4, Canada
| | - Mark S Tremblay
- Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON K1H 8L1, Canada
| | - Guy Faulkner
- School of Kinesiology, Faculty of Education, The University of British Columbia, Vancouver, BC V6T 1Z4, Canada
- Centre for Hip Health and Mobility, Vancouver Coastal Health Research Centre, Vancouver, BC V5Z 1M9, Canada
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20
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Relationships Between Outdoor Time, Physical Activity, Sedentary Time, and Body Mass Index in Children: A 12-Country Study. Pediatr Exerc Sci 2019; 31:118-129. [PMID: 30304983 DOI: 10.1123/pes.2018-0055] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
PURPOSE This study investigated the relationship between outdoor time and physical activity (PA), sedentary time (SED), and body mass index z scores among children from 12 lower-middle-income, upper-middle-income, and high-income countries. METHODS In total, 6478 children (54.4% girls) aged 9-11 years participated. Outdoor time was self-reported, PA and SED were assessed with ActiGraph GT3X+ accelerometers, and height and weight were measured. Data on parental education, neighborhood collective efficacy, and accessibility to neighborhood recreation facilities were collected from parent questionnaires. Country latitude and climate statistics were collected through national weather data sources. Gender-stratified multilevel models with parental education, climate, and neighborhood variables as covariates were used to examine the relationship between outdoor time, accelerometry measures, and body mass index z scores. RESULTS Each additional hour per day spent outdoors was associated with higher moderate- to vigorous-intensity PA (boys: +2.8 min/d; girls: +1.4 min/d), higher light-intensity PA (boys: +2.0 min/d; girls: +2.3 min/d), and lower SED (boys: -6.3 min/d; girls: -5.1 min/d). Effect sizes were generally weaker in lower-middle-income countries. Outdoor time was not associated with body mass index z scores. CONCLUSIONS Outdoor time was associated with higher PA and lower SED independent of climate, parental education, and neighborhood variables, but effect sizes were small. However, more research is needed in low- and middle-income countries.
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21
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Jelleyman C, McPhee J, Brussoni M, Bundy A, Duncan S. A Cross-Sectional Description of Parental Perceptions and Practices Related to Risky Play and Independent Mobility in Children: The New Zealand State of Play Survey. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16020262. [PMID: 30658496 PMCID: PMC6352286 DOI: 10.3390/ijerph16020262] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/21/2018] [Revised: 01/09/2019] [Accepted: 01/11/2019] [Indexed: 11/19/2022]
Abstract
The potential for risky play and independent mobility to increase children’s physical activity, and enhance cognitive development and emotional wellbeing has been recognised for some time. The aim of this study was to describe the attitudes of New Zealand parents towards such risky play practices and independent mobility, the barriers preventing them from allowing their children to participate, and how often their children engaged in risky play activities. An online survey comprised mostly of validated scales and standardised questions was completed by a nationally representative sample of 2003 parents. We found that parents had neutral feelings about the risk of injury to their child through play, rather they were concerned about road safety and “stranger danger”. There was strong agreement that there are multiple benefits to be gained from exposure to risk and challenge, and that health and safety rules are too strict. However, 73% of respondents stated that their 5–12 year old child seldom or never engaged in four or more risky activities, and only 14.3% engaged in four or more often or always. While parents agree that their child is likely to benefit from risky play, they do not have the confidence to allow their children to engage in such activities. Future research should address barriers and fears when implementing strategies to facilitate risky play.
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Affiliation(s)
- Charlotte Jelleyman
- Human Potential Centre, School of Sport and Recreation, Auckland University of Technology, Auckland 0632, New Zealand.
| | - Julia McPhee
- Human Potential Centre, School of Sport and Recreation, Auckland University of Technology, Auckland 0632, New Zealand.
| | - Mariana Brussoni
- Department of Pediatrics, School of Population and Public Health, University of British Columbia, British Columbia Children's' Hospital Research Institute, British Columbia Injury Research and Prevention Unit, Vancouver, BC V6H 3V4, Canada.
| | - Anita Bundy
- Professor and Department Head, Occupational Therapy, Colorado State University, Fort Collins, CO 80523, USA.
- Professor of Occupational Therapy, Faculty of Health Sciences, University of Sydney, Camperdown, NSW 2006, Australia.
| | - Scott Duncan
- Human Potential Centre, School of Sport and Recreation, Auckland University of Technology, Auckland 0632, New Zealand.
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22
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Boxberger K, Reimers AK. Parental Correlates of Outdoor Play in Boys and Girls Aged 0 to 12-A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E190. [PMID: 30641874 PMCID: PMC6351982 DOI: 10.3390/ijerph16020190] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Revised: 01/03/2019] [Accepted: 01/08/2019] [Indexed: 11/16/2022]
Abstract
Outdoor play is one major source of physical activity (PA) in children. In particular, parents act as gatekeepers, because they can enable their children's outdoor play. This systematic review aims to provide an overview of parental correlates of outdoor play. A systematic literature research of six electronic databases (ERIC, PsycARTICLES, PsycINFO, PubMed/Medline, SCOPUS, and Web of Science Core Collection) was conducted with previously defined search terms, focusing on children 0⁻12 years old. In total, 1719 potentially publications were screened based on eligibility criteria. Included studies were scored for overall study quality. Findings were summarized using a semi-quantitative method. Twenty-one peer-reviewed publications which examined the relationship of parental correlates and outdoor play were included. Overall, five parental correlates were associated with children's amount of outdoor play: mothers' ethnicity, mothers' employment status, parents' education level, the importance parents assign to outdoor play, and perceived social cohesion in the neighborhood. Merely four studies reported sex/gender-stratified results. In summary, only parents' encouragement/support provided evidence for girls' amount of outdoor play. The findings are considered to be of public health relevance for developing intervention programs to increase outdoor play and for improving child's health. More research, especially considering sex/gender of the child, is required.
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Affiliation(s)
- Karolina Boxberger
- Institute of Human Movement Science and Health, Faculty of Behavioral and Social Sciences, Chemnitz University of Technology, 09111 Chemnitz, Germany.
| | - Anne Kerstin Reimers
- Institute of Human Movement Science and Health, Faculty of Behavioral and Social Sciences, Chemnitz University of Technology, 09111 Chemnitz, Germany.
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23
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Children's Independent Mobility: Current Knowledge, Future Directions, and Public Health Implications. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15112441. [PMID: 30388880 PMCID: PMC6267483 DOI: 10.3390/ijerph15112441] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/05/2018] [Revised: 10/29/2018] [Accepted: 10/30/2018] [Indexed: 12/03/2022]
Abstract
Environmental changes significantly impact health behavior. Active travel behavior is mostly affected by increasing motorization, urban sprawl, and traffic safety. Especially for children, active and independent travel can contribute to physical activity, social and motor development, and other health-related outcomes. A reduced number of children engaging in independent mobility over the last 20 years demanded researchers to further examine the construct of children’s independent mobility. By examining relevant literature, this narrative review aims to provide the current state of knowledge on children’s independent mobility, and identify future directions in research, as well as practical implications. From a public health perspective, considering children’s independent mobility in intervention programs is recommended, since it is associated with numerous health and environmental benefits. To develop interventions, multilevel socio-ecological influences on children’s independent mobility are widely examined; however, evidence is limited due to heterogeneous measurements and a lack of high-quality prospective studies. To oppose the decline in children’s independent mobility, further analysis using comparable measures is needed to understand the determinants of children’s independent mobility and to enable international comparison.
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Spruijt-Metz D, Wen CKF, Bell BM, Intille S, Huang JS, Baranowski T. Advances and Controversies in Diet and Physical Activity Measurement in Youth. Am J Prev Med 2018; 55:e81-e91. [PMID: 30135037 PMCID: PMC6151143 DOI: 10.1016/j.amepre.2018.06.012] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2018] [Revised: 05/09/2018] [Accepted: 06/15/2018] [Indexed: 11/16/2022]
Abstract
Technological advancements in the past decades have improved dietary intake and physical activity measurements. This report reviews current developments in dietary intake and physical activity assessment in youth. Dietary intake assessment has relied predominantly on self-report or image-based methods to measure key aspects of dietary intake (e.g., food types, portion size, eating occasion), which are prone to notable methodologic (e.g., recall bias) and logistic (e.g., participant and researcher burden) challenges. Although there have been improvements in automatic eating detection, artificial intelligence, and sensor-based technologies, participant input is often needed to verify food categories and portions. Current physical activity assessment methods, including self-report, direct observation, and wearable devices, provide researchers with reliable estimations for energy expenditure and bodily movement. Recent developments in algorithms that incorporate signals from multiple sensors and technology-augmented self-reporting methods have shown preliminary efficacy in measuring specific types of activity patterns and relevant contextual information. However, challenges in detecting resistance (e.g., in resistance training, weight lifting), prolonged physical activity monitoring, and algorithm (non)equivalence remain to be addressed. In summary, although dietary intake assessment methods have yet to achieve the same validity and reliability as physical activity measurement, recent developments in wearable technologies in both arenas have the potential to improve current assessment methods. THEME INFORMATION This article is part of a theme issue entitled Innovative Tools for Assessing Diet and Physical Activity for Health Promotion, which is sponsored by the North American branch of the International Life Sciences Institute.
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Affiliation(s)
- Donna Spruijt-Metz
- Center for Economic and Social Research, University of Southern California, Los Angeles, California; Department of Psychology, University of Southern California, Los Angeles, California; Department of Preventive Medicine, University of Southern California, Los Angeles, California.
| | - Cheng K Fred Wen
- Department of Preventive Medicine, University of Southern California, Los Angeles, California
| | - Brooke M Bell
- Department of Preventive Medicine, University of Southern California, Los Angeles, California
| | - Stephen Intille
- College of Computer and Information Science, Northeastern University, Boston, Massachusetts; Department of Health Sciences, Bouvé College of Health Sciences, Northeastern University, Boston, Massachusetts
| | - Jeannie S Huang
- Department of Pediatrics, School of Medicine, University of California at San Diego, San Diego, California; Rady Children's Hospital, San Diego, California
| | - Tom Baranowski
- Department of Pediatrics, Baylor College of Medicine, Houston, Texas
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Huertas-Delgado FJ, Mertens L, Chillon P, Van Dyck D. Parents' and adolescents' perception of traffic- and crime-related safety as correlates of independent mobility among Belgian adolescents. PLoS One 2018; 13:e0204454. [PMID: 30265694 PMCID: PMC6162083 DOI: 10.1371/journal.pone.0204454] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2018] [Accepted: 09/08/2018] [Indexed: 11/19/2022] Open
Abstract
The independent mobility (IM), defined as the freedom of young people to travel without adult supervision, has been related to the physical activity time, the acquisition of personal autonomy, to less intense fear of crime, and to a stronger feeling of being part of their community and other health and social benefits. The aims of this study were to compare parents’ and adolescents’ traffic- and crime-related safety perceptions of their neighborhood and to analyze the associations of these perceptions with adolescents’ IM. A total of 291 adolescents and their parents completed the Neighborhood Environment Walkability Scale (NEWS) questionnaire. Multilevel (two-level models: individual level—neighborhood level) regression analyses were conducted to examine whether the environmental perceptions differed between parents and adolescents and the association between the parental and adolescents’ perception to the IM and the active independent mobility (AIM). Parents reported a more negative perception of traffic (except for amount and speed) and crime-related safety. Adolescents’ environmental perceptions were not associated with their IM but parental perceptions of traffic- and crime-related safety were associated with IM and with active IM, although not all associations were in the expected direction. Future urban policy efforts should address environments where parents perceive sufficient levels of safety to increase the levels of IM in adolescents.
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Affiliation(s)
- Francisco Javier Huertas-Delgado
- PA-Help "Physical Activity for Health Promotion" research group, Teaching Centre La Inmaculada, University of Granada, Granada, Spain
- * E-mail:
| | - Lieze Mertens
- Ghent University, Faculty of Medicine and Health Sciences, Department of Movement and Sports Sciences, Gent, Belgium
- Research Foundation Flanders, Brussels, Belgium
| | - Palma Chillon
- PROFITH “Promoting FITness and Health through physical activity” research group, Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Granada, Spain
| | - Delfien Van Dyck
- Ghent University, Faculty of Medicine and Health Sciences, Department of Movement and Sports Sciences, Gent, Belgium
- Research Foundation Flanders, Brussels, Belgium
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Marzi I, Demetriou Y, Reimers AK. Social and physical environmental correlates of independent mobility in children: a systematic review taking sex/gender differences into account. Int J Health Geogr 2018; 17:24. [PMID: 29970117 PMCID: PMC6029402 DOI: 10.1186/s12942-018-0145-9] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Accepted: 06/24/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Children's independent mobility (CIM) is an important contributor to physical activity and health in children. However, in the last 20 years CIM has significantly decreased. To develop effective intervention programs to promote CIM, the impact of the environment on CIM must be identified. This review seeks to provide an overview of sex/gender-specific socio-ecological correlates of CIM. METHODS A systematic literature search of five databases (PubMed, PsycInfo, Scopus, Medline, Web of Science) was conducted with a priori defined eligibility criteria and identified 1838 potential articles published between January 1990 and November 2017. Two independent reviewers screened the literature and identified and rated methodological quality of the studies. Related factors of CIM were summarized separately for CIM license (parental permission to travel independently) and CIM destination (destinations to which a child travels independently), and separately for boys and girls using a semi-quantitative method. RESULTS Twenty-seven peer-reviewed journal articles were identified which examined the relationship between the social and physical environment and CIM. Only seven studies reported results divided by sex/gender. Most associations between the environment and CIM were found in the expected direction (positive or negative) or not associated at all. The social environment seemed to be more influential for ensuring CIM than the physical environment. Neighborhood safety, fear of crime and stranger, parental support, and perception of traffic were important social environmental factors influencing CIM, while car ownership, distance, and neighborhood design were relevant physical environmental attributes. Few studies examined sex/gender-related environmental correlates of independent mobility, and those findings were inconsistent. CONCLUSION The findings of this systematic review serve as suggestions for intervention programs to increase CIM and to identify future directions in research. To establish a robust comprehension of the impact of the social and physical environment on CIM, further sex/gender-sensitive studies using comparable measurements for CIM and environmental correlates are needed.
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Affiliation(s)
- Isabel Marzi
- Faculty of Behavioral and Social Sciences, Chemnitz University of Technology, Chemnitz, Germany
| | - Yolanda Demetriou
- Department of Sport and Health Sciences, Technical University of Munich, Munich, Germany
| | - Anne Kerstin Reimers
- Faculty of Behavioral and Social Sciences, Chemnitz University of Technology, Chemnitz, Germany
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Wilkie HJ, Standage M, Gillison FB, Cumming SP, Katzmarzyk PT. The home electronic media environment and parental safety concerns: relationships with outdoor time after school and over the weekend among 9-11 year old children. BMC Public Health 2018; 18:456. [PMID: 29621981 PMCID: PMC5887248 DOI: 10.1186/s12889-018-5382-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2017] [Accepted: 03/27/2018] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Time spent outdoors is associated with higher physical activity levels among children, yet it may be threatened by parental safety concerns and the attraction of indoor sedentary pursuits. The purpose of this study was to explore the relationships between these factors and outdoor time during children's discretionary periods (i.e., after school and over the weekend). METHODS Data from 462 children aged 9-11 years old were analysed using generalised linear mixed models. The odds of spending > 1 h outdoors after school, and > 2 h outdoors on a weekend were computed, according to demographic variables, screen-based behaviours, media access, and parental safety concerns. Interactions with sex and socioeconomic status (SES) were explored. RESULTS Boys, low SES participants, and children who played on their computer for < 2 h on a school day had higher odds of spending > 1 h outside after school than girls, high SES children and those playing on a computer for ≥2 h, respectively. Counterintuitive results were found for access to media devices and crime-related safety concerns as both of these were positively associated with time spent outdoors after school. A significant interaction for traffic-related concerns*sex was found; higher road safety concerns were associated with lower odds of outdoor time after school in boys only. Age was associated with weekend outdoor time, which interacted with sex and SES; older children were more likely to spend > 2 h outside on weekends but this was only significant among girls and high SES participants. CONCLUSIONS Our results suggest that specific groups of children are less likely to spend their free time outside, and it would seem that only prolonged recreational computer use has a negative association with children's outdoor time after school. Further research is needed to explore potential underlying mechanisms, and parental safety concerns in more detail.
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Affiliation(s)
- Hannah J Wilkie
- Centre for Motivation and Health Behaviour Change, Department for Health, University of Bath, Bath, UK
| | - Martyn Standage
- Centre for Motivation and Health Behaviour Change, Department for Health, University of Bath, Bath, UK.
| | - Fiona B Gillison
- Centre for Motivation and Health Behaviour Change, Department for Health, University of Bath, Bath, UK
| | - Sean P Cumming
- Centre for Motivation and Health Behaviour Change, Department for Health, University of Bath, Bath, UK
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Insights into children's independent mobility for transportation cycling-Which socio-ecological factors matter? J Sci Med Sport 2016; 20:267-272. [PMID: 27566898 DOI: 10.1016/j.jsams.2016.08.002] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2015] [Revised: 07/14/2016] [Accepted: 08/02/2016] [Indexed: 11/22/2022]
Abstract
OBJECTIVES To assess the associations of socio-ecological factors with independent mobility for transportation cycling among 10-to-12-year-old boys and girls. Additionally, we examined whether associations differed across family socio-economic status (SES) and urbanization level. DESIGN Cross-sectional survey. METHODS Parents (n=1286) were recruited via 45 primary schools across Flanders, Belgium. They completed an online questionnaire assessing demographic and psychosocial factors, neighborhood environmental perceptions, as well as some characteristics of their child. Independent mobility was assessed as the distance children were allowed to cycle for transport without adult supervision. Multilevel gamma regression analyses stratified by gender were performed to examine the associations between the independent variables and children's independent mobility and the moderating effects of family SES and urbanization level. RESULTS Independent mobility was higher among boys compared to girls. Perception of children's cycling and traffic skills and children's grade were positively associated with independent mobility among boys and girls. Perceptions of neighborhood traffic safety were positively associated with independent mobility among girls, but not among boys. Perceptions of cycling skills were positively associated with independent mobility among boys living in high urbanized areas, but not in low urbanized areas. Parental cycling for transport was negatively associated with independent mobility among girls with a low family SES, but not among girls with a high family SES. CONCLUSIONS Our findings suggest that interventions targeting increases in children's cycling and traffic skills may be effective to increase independent mobility. Few differences in associations were found according to children's gender, family SES or urbanization level.
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