Accelerometer-measured physical activity and sedentary behavior in Chinese children and adolescents: a systematic review and meta-analysis

Validity and reliability of the movement behaviour questionnaire child in Chinese preschoolers

Background

The Movement Behaviour Questionnaire Child (MBQ-C) was developed to measure physical activity, screen time, and sleep in preschool children, but the Chinese version lacked validation.

Methods

This cross-sectional study aimed to assess the validity and reliability of the open-ended version of the MBQ-C among Chinese preschoolers. Data were collected from 892 parents of children aged 0-5 years across 10 provinces via an online questionnaire. The MBQ-C includes items on physical activity, screen time, and sleep, and was validated against device-measured physical activity using accelerometers.

Results

Internal consistency was high, with Cronbach's alpha values ranging from 0.80 to 0.88 for different sections. Test-retest reliability showed moderate intraclass correlation coefficients (ICCs) between 0.52 and 0.72. Confirmatory factor analysis indicated good construct validity (CFI = 0.95). Moderate significant correlations were found between MBQ-C reported physical activity and device-measured moderate-to-vigorous physical activity (R = 0.35, p < 0.001).

Conclusion

The open-ended version of the MBQ-C demonstrates good validity and reliability in assessing movement behaviours among Chinese preschoolers. This tool is effective for proxy-reported measurements and can contribute to understanding and promoting healthy movement behaviours in early childhood.

Association Between Meeting 24-Hour Movement Guidelines and Health-Related Quality of Life in Adolescents

BACKGROUND

Evidence-based 24-hour movement guidelines have been developed to integrate recommendations for time spent on moderate to vigorous physical activity (MVPA), screen time (ST), and sleep. This study investigated the adherence to 24-hour movement guidelines and explored the relationship with health-related quality of life (HRQoL) in adolescents.

METHODS

Cross-sectional findings are based on 1774 adolescents (49.1% female) aged 13-16 years from the Shenyang region of China. MVPA, ST, and sleep duration were self-reported using the International Physical Activity Questionnaire, an ST questionnaire, and a wake-sleep time questionnaire. HRQoL was measured using the Pediatric Quality of Life Inventory, which encompasses physical, psychosocial, and total HRQoL. Adherence to 24-hour movement guidelines was classified by meeting general (eg, none, 1, 2, and 3 guidelines) and specific combinations (eg, MVPA and ST guidelines) within the 3 recommendations. Associations were examined using general linear models adjusted for age, sex, and parents' education.

RESULTS

A total of 5.1% of the sample met all three 24-hour movement guidelines. Additionally, compared with meeting no guideline, meeting all 3 guidelines was associated with better physical (β = 5.37; 95% CI, 0.69-9.49; P = .005), psychosocial (β = 3.76; 95% CI, 0.84-6.68; P = .012), and total HRQoL (β = 4.16; 95% CI, 1.35-6.98; P = .004). Compared with not meeting the specific combination guidelines, meeting MVPA and ST was associated with better physical HRQoL (β = 5.52; 95% CI, 1.30-9.74; P = .01).

CONCLUSIONS

These cross-sectional findings suggest that meeting all three 24-hour movement guidelines were associated with better HRQoL in adolescents. Since a low proportion of this sample was meeting the overall guidelines, future effort should encourage, and perhaps improve adherence to the 24-hour movement guidelines.

Association Between 24-Hour Movement Behaviors and Adiposity in Malaysian Schoolchildren: A Compositional Isotemporal Substitution Analysis

BACKGROUND

Physical activity (PA), sedentary behavior (SB), and sleep are interrelated 24-hour movement behaviors that are important for the growth and well-being of children. This cross-sectional study examined the relationship between 24-hour movement behaviors and adiposity, and predicted changes in adiposity following compositional time reallocations in 7- to 12.9-year-old Malaysian children from the South East Asian Nutrition Surveys II Malaysia.

METHODS

A total of 381 children (mean age 9.7 [1.6] y, 57% girls) provided 24-hour wrist-worn GENEActiv accelerometry data which captured time spent for sleep, SB, light PA and moderate to vigorous PA (MVPA). Indicators of adiposity were derived from anthropometry and bioelectrical impedance analysis: body-mass-index-for-age, waist circumference, waist-to-height ratio, percent body fat, and body mass index. The composition of 4-part movement behaviors was expressed as isometric log-ratio coordinates which were entered into regression models. Isotemporal substitution analysis was used to assess changes in adiposity indicators when reallocating time between movement behaviors.

RESULTS

Relative to other movement behaviors, time spent on MVPA was significantly associated with waist circumference, waist-to-height ratio, percent body fat, and fat mass index. A 15-minute one-to-one reallocation from other movement behaviors to MVPA predicted lower body-mass-index-for-age (-0.03 to -0.11), smaller waist circumference (-0.67 to -1.28 cm), lower waist-to-height ratio (-0.004 to -0.008), percent body fat (-0.87% to -1.47%), and fat mass index (-0.23 to -0.42). Replacing SB and light PA with sleep or MVPA was associated with lower adiposity.

CONCLUSIONS

The overall composition of movement behavior was significantly associated with the adiposity of Malaysian schoolchildren. Promoting MVPA and sleep and reducing SB and light PA are important for prevention of childhood obesity.

The pathway of social support in enhancing adolescents' physical fitness: The mediating roles of physical activity and self-efficacy

PURPOSE

Utilising Welk's Youth Physical Activity Promotion (YPAP) model as a foundational framework, this study investigates the intricate interplay of social support, physical activity (PA), and self-efficacy in relation to physical fitness within the context of Chinese culture. The primary objective is to identify the nuanced dynamics among social support, self-efficacy, PA, and physical fitness to enhance adolescent well-being and fitness.

METHODOLOGY

The study employed a convenience sampling method, engaging 123 adolescents aged 18-21, of which 67 were females (54.47%), and 56 were males (45.53%). Data were collected through structured questionnaires focusing on the identified variables.

RESULTS

Our study revealed significant positive associations among social support, self-efficacy, PA, and physical fitness, with correlation coefficients ranging from 0.282 to 0.419. Notably, a discernible gender disparity emerged, with females exhibiting higher levels of physical fitness. Among the key determinants of adolescent physical fitness, self-efficacy emerged as the most influential, followed by PA and gender. Utilising structural equation modelling and regression techniques, we discerned that social support indirectly influences physical fitness, primarily mediated by self-efficacy and the level of physical activity.

DISCUSSION

This study provides insight into how social support impacts adolescent physical fitness. We found that social support strongly predicts both PA and self-efficacy, and self-efficacy significantly boosts PA, ultimately leading to improved physical fitness. Both self-efficacy and PA serve as mediators in the relationship between social support and fitness. Therefore, interventions should prioritise reinforcing social support, promoting PA, and nurturing self-efficacy to optimise adolescent physical fitness outcomes.

A comparative study of the physical activity guidelines for children and adolescents from five countries and WHO

This study presented a narrative review of the six latest sets of guidelines on physical activity for children and adolescents from Australia, Canada, China, the United Kingdom, the United States and WHO, and analysed the history of the development of the guidelines; the policy context in which the guidelines were developed; and the main subjects of the guidelines. The core elements of the latest guidelines were identified and compared, including frequency, intensity, duration (time), and type of physical activity, assessment intensity of physical activity, and risk prevention for physical activity participation. There is an urgent need for obtaining the latest scientific evidence to support and update the contents of the Chinese guidelines. We therefore make the following recommendations for future revisions of the Chinese guidelines based on the findings of this study: (1) to update the recommended frequency, intensity, duration, and type of physical activities that meet the needs for Chinese children and adolescents; (2) to update the methods for assessing physical activity intensity, and identifying and managing the risk factors in participating in physical activity; and (3) to incorporate analyses and reviews of school physical education curriculum for effectively achieving the adequate levels of physical activity.

Autonomous motivation, social support, and physical activity in school children: moderating effects of school-based rope skipping sports participation

Purpose

Recent studies have shown that physical activity (PA) levels are low among children and adolescents globally. In order to reverse this trend, PA interventions are increasingly favoured. The school setting is the ideal place to address the issues that many children face. The purpose of this study was to (a) The primary focus of this study is to delve into the mediating role played by school-based rope skipping sports participation (SRSP) in the connection between social support and moderate to high-intensity physical activity (MVPA) among school children. (b) Additionally, this research aims to examine the moderating effect of within this pathway.

Methods

We conducted a survey involving 721 adolescents residing in Changsha City. The participants' ages ranged from 8 to 12 years, with an average age of 9.84 ± 1.535 years. Out of these participants, 406 were boys, and 315 were girls. To assess variables such as social support and autonomous motivation, we employed standardized measurement scales. Subsequently, we analyzed the collected data using various statistical methods, including independent s-amples t-tests, bivariate correlation analysis, descriptive statistical analysis, structural equation modeling (SEM), and the Johnson-Neyman method.

Results

An independent samples t-test revealed a statistically significant difference in MVPA between genders (p = 0.003 < 0.05), with boys exhibiting a higher level of engagement in MVPA compared to girls, Correlation analysis revealed significant positive associations among several key variables. Specifically, social support demonstrated a noteworthy positive correlation with autonomous motivation (r = 0.331, p < 0.01) as well as school children's engagement in MVPA (r = 0.308, p < 0.01). Moreover, autonomous motivation displayed a significant positive correlation with school children's involvement in MVPA (r = 0.459, p < 0.01). The moderating analysis revealed a significant influence of the interaction between increased participation in and social support on school children's engagement in MVPA.

Conclusion

Social support and autonomy support have been proven effective in enhancing school children's engagement in MVPA. They exert their influence indirectly by fostering autonomous motivation. Notably, robust social support can significantly benefit MVPA school children with high activity requirements, particularly those regularly engaged in MVPA during the school day.

Physical Activity, Body Image, and Its Relationship with Academic Performance in Adolescents

Academic success in adolescence is a strong predictor of well-being and health in adulthood. A healthy lifestyle and moderate/high levels of physical activity can influence academic performance. Therefore, we aimed to assess the relationship between the physical activity levels and body image and academic performance in public school adolescents. The sample consisted of 531 secondary school students in Porto (296 girls and 235 boys) aged between 15 and 20 years. The study variables and instruments were satisfaction with body image (The Body Image Rating Scale), assessment of physical activity (International Physical Activity Questionnaire for Adolescents (IPAQ-A), assessment of academic performance (academic achievement), school motivation (Academic Scale Motivation). The statistical analysis performed was descriptive analysis, an analysis of covariance, and a logistic regression. Regarding the results obtained, although there was no association between physical activity level and academic performance, it was observed in 10th grade students that the school average was higher for those practicing group or individual sports compared to students practicing artistic expression. Regarding the level of satisfaction with body image, we found different results in both genders. Our results support the importance of an active lifestyle, with the presence of regular physical activity being an important factor in improving academic performance.

Moderate-Vigorous Physical Activity, Screen Time and Sleep Time Profiles: A Cluster Analysis in Spanish Adolescents

The study had two aims: (1) To classify the adolescents according to their levels of moderate-vigorous physical activity, screen time and sleep time, and (2) to analyze, in a descriptive and correlational manner, the profiles of moderate-vigorous physical activity, screen time and sleep time of each cluster according to the sex and grade of the adolescents. The study design was cross-sectional, with descriptive and correlational analysis. The sample consisted of 663 adolescents in Compulsory Secondary Education from Soria (Spain). The Four by One-Day Physical Activity Questionnaire was used to measure levels of physical activity, screen time and sleep time. The results showed that the young people had an average of 67.99 ± min/day of moderate-vigorous physical activity, 112.56 min/day of screen time and 548.63 min/day of sleep time. Adolescents were classified into three clusters according to their levels of physical activity, screen time and sleep time (F_MANOVA (6,1318) = 314.439; p ≤ 0.001; β = 1; f = 1.177). In conclusion, only 28.21% of the young people accomplished the recommendations for physical activity practice, screen time and sleep time. Moreover, these results vary according to the sex and grade of the adolescents.

Compared with dietary behavior and physical activity risk, sedentary behavior risk is an important factor in overweight and obesity: evidence from a study of children and adolescents aged 13-18 years in Xinjiang, China

BACKGROUND

Malnutrition or insufficient physical activity (PA) is a risk factor for obesity and chronic disease in children and adolescents. Affected by different economic circumstance, ethnic, dietary behavior, physical activity and other factors, children and adolescents in Xinjiang, China are facing a severe situation of overweight and obesity prevention and control. It is necessary to analyze the dietary behavior and physical activity of children and adolescents with different nutritional status and the relationship between them.

METHODS

Using a stratified cluster sampling method in Xinjiang, China, 4833 middle school students aged 13-18 were selected., and tests for height and weight were conducted. Self-assessment questionnaires were completed for Dietary Behaviors, Physical Activity, and Sedentary Behaviors as well. Chi-square test, Logistic regression analysis and other methods were used to analyze the relationship between Dietary Behaviors, Physical Activity, Sedentary Behaviors and other health behavior risk factors and Weight and BMI.

RESULTS

Children and adolescents aged 13-18 in Xinjiang, China, girls had a lower BMI compared with boys(19.49 VS. 20.41). The proportions of Underweight, Overweight and Obese among girls were lower (Underweight: 11.8 VS. 14.5; Overweight: 7.6 VS. 12.7; Obese 2.3 VS. 7.0).Boys with higher risk of sedentary had a 1.46-fold higher risk of developing Overweight/Obese than those with lower risk of sedentary (95%CI: 1.07-2.01).Girls with higher risky diet had a 1.56-fold higher risk of developing Underweight than those with lower risky diet (95%CI: 1.11-2.19). For all participants, the risk of Overweight/Obese in children and adolescents with higher risk of sedentary was 1.45 times more than that of children and adolescents with lower Risk sedentary (95%CI: 1.12 ~ 1.88). Overall, Weight had a significant correlation with PA risk (r = 0.076, P < 0.01) and sedentary behavior risk (r = 0.035, P < 0.05). BMI had a key correlation with PA risk (r = 0.064, P < 0.01) and sedentary behavior risk (r = 0.037, P < 0.05).

CONCLUSIONS

The detection rate of Underweight among children and adolescents aged 13-18 in Xinjiang, China is higher, while the detection rate of Overweight and Obese is lower than that of the whole country. Static behavior was an important factor affecting the occurrence of Overweight and Obese in children and adolescents, and the performance of boys was more obvious than that of girls.The results further improve the data on the weight status of Chinese children and adolescents and their influencing factors, and call on Chinese society and schools to continue their efforts to prevent and reduce malnutrition and obesity among children and adolescents in Xinjiang.

The Relationships between Physical Activity, Screen Time and Sleep Time According to the Adolescents' Sex and the Day of the Week

This study had two aims: (1) to identify the levels of physical activity, screen time and sleep time of adolescents according to the sex of the participant and the day of the week; (2) to find out the relationships between physical activity, screen time and sleep time according to the sex of the participant and the day of the week. The study design was non-experimental, descriptive-correlational and cross-sectional. The sample consisted of 694 adolescents in Compulsory Secondary Education from Soria (Spain). Four by One-Day Physical Activity Questionnaires were used to measure levels of physical activity, screen time and sleep time. Levene’s test and Student’s t-test were used to calculate the difference between the means of the variables. Pearson’s test was used to calculate bivariate correlations between variables. Results showed higher levels of screen time in males (136.93 min/day ± 81.548). Screen time, sleep time and moderate−vigorous physical activity are higher during the weekend. Positive relationships were found between screen time and light physical activity (rmales = 0.274; p ≤ 0.01; rfemales = 0.065; p > 0.05). The correlations between moderate−vigorous physical activity and screen time were negative (rmales = −0.282; p ≤ 0.01; rfemales = −0.187; p ≤ 0.05). The relationship between screen time and sleep time was negative in males (r = −0.135; p ≤ 0.05). In conclusion, the levels of physical activity, screen time and sleep time vary according to the sex of the participants and the day of the week.

Effectiveness of an adapted physical activity intervention for weight management in adolescents with intellectual disability: A randomized controlled trial

OBJECTIVE

To evaluate the effectiveness of a 9-month school-based adapted physical activity (APA) program for reducing weight among adolescents with intellectual disability (ID).

METHODS

In this randomized controlled trial, adolescents with ID, aged 12-18 years, who were overweight/or with obesity were randomly assigned into intervention and control groups. The APA intervention consisted of aerobic and resistance exercises with an overall moderate intensity and was delivered at a frequency of two sessions per week for 9 months. Changes in body mass index (BMI, primary outcome) and changes in BMIz, weight, percent body fat, waist circumference and waist-to-height ratio (secondary outcomes) were examined using general linear models.

RESULTS

In total 61 subjects (39 in the intervention and 22 in the control) completed the study and were included in the analyses. At 9 months, the intervention group exhibited a reduced BMI of -0.66 kg/m² (95% CI -1.06 to -0.25 kg/m² , p = 0.002), while a significant increase in BMI was observed in the control group. A significant post-intervention between-group difference in change in BMI (-1.31 kg/m² [95% CI -1.99 to -0.63], p < 0.01) was found in favour of the intervention group. Similar results were also observed for all secondary outcomes.

CONCLUSIONS

This study provides evidence that a 9-month APA intervention induced clinically meaningful effects on weight loss in adolescents with ID.

Impact of the COVID-19 Pandemic on Sedentary Time and Behaviour in Children and Adults: A Systematic Review and Meta-Analysis

The aim of this meta-analysis was to quantify the change in sedentary time during the COVID-19 pandemic and its effect on health outcomes in the general population. One thousand six hundred and one articles published after 2019 were retrieved from five databases, of which 64 and 40 were included in the systematic review and meta-analysis, respectively. Studies were grouped according to population: children (<18 years), adults (18–64 years) and older adults (>65 years). Average sedentary time was calculated, with sub-analyses performed by country, behaviour type and health outcomes. Children were most affected, increasing their sedentary time by 159.5 ± 142.6 min day⁻¹, followed by adults (+126.9 ± 42.2 min day⁻¹) and older adults (+46.9 ± 22.0 min day⁻¹). There were no sex differences in any age group. Screen time was the only consistently measured behaviour and accounted for 46.8% and 57.2% of total sedentary time in children and adults, respectively. Increases in sedentary time were negatively correlated with global mental health, depression, anxiety and quality of life, irrespective of age. Whilst lockdown negatively affected all age groups, children were more negatively affected than adults or older adults, highlighting this population as a key intervention target. As lockdowns ease worldwide, strategies should be employed to reduce time spent sedentary. Trial registration: PROSPERO (CRD42020208909).

Predictive Analysis of Health/Physical Fitness in Health-Promoting Lifestyle of Adolescents

Objective: Explore the correlation and predictive power of health physical fitness on health-promoting lifestyle of adolescents to provide an important reference for reform in middle school physical education classroom teaching. Methods: Taking some junior and senior high school students in Nanchong City of Sichuan Province as survey objects, a stratified random sampling method was used to carry out a health/fitness test and conduct a questionnaire survey. SPSS17.0, amos 21.0, and other statistical analysis software were used to process the relevant data. Results: (1) Male adolescents had 14.4% predictive power for their overall health-promoting lifestyle through the combined effects of cardiopulmonary endurance, muscle strength, and explosive strength, while female adolescents had 16.8% predictive power for their overall health-promoting lifestyle through the combined effects of cardiopulmonary endurance, flexibility, and body mass index (BMI). (2) Ten percent of the variation in the health-promoting lifestyle of men under 14 years old was caused by the combined effects of muscle endurance and muscle strength, while 14.4% of the variation in the health-promoting lifestyle of female adolescents was caused by the combined effects of muscle endurance, muscle strength, flexibility, and cardiopulmonary endurance. (3) Some 10.9 and 17.6% of the variation in health-promoting lifestyle of male and female adolescents aged between 14 and 17 was caused by the combined effects of cardiopulmonary endurance, muscle strength, and flexibility, respectively. (4) Some 20.7% of the variation in health promoting lifestyle of male adolescents aged 17 years or above was caused by cardiopulmonary endurance, explosive force, and muscle endurance, while 16.8% of the variation in health-promoting lifestyle of female adolescents was caused by the combined effect of cardiopulmonary endurance, BMI, and muscle endurance. Conclusion: Health and physical fitness of adolescents can significantly predict their health-promoting lifestyle, and the predictive power and typical correlation between them are affected by demographic factors.

Adaptation and evaluation of the neighborhood environment walkability scale for youth for Chinese children (NEWS-CC)

Background

The physical activity-environment relationship has been infrequently investigated in Chinese children. Reliable and valid environmental measures specific to the age group and the local context are crucial for better understanding this relationship. The purposes of this study were to adapt the Neighborhood Environment Walkability Scale for youth (NEWS-Y) for Chinese children (termed NEWS-CC), and to examine the reliability and factorial validity of the NEWS-CC.

Methods

The development of the NEWS-CC involved the translation of the NEWS-Y to Chinese and the addition of nine new items capturing Hong Kong specific environmental attributes which were generated in our previous study. A total of 953 Hong Kong children aged 9–14 years volunteered to complete the NEWS-CC twice with 7–14 days apart. Confirmatory factor analysis (CFA) was performed to examine the factorial validity of the NEWS-CC. Test-retest reliability of subscales and individual items in the NEWS-CC was examined by intraclass correlation coefficients (ICCs).

Results

The CFA identified a 7-factor measurement model for the NEWS-CC which fitted the data well, with an additional “pollution” factor not included in the original NEWS-Y. The final NEWS-CC consisted of 67 items in 10 subscales. The test-retest reliability of subscales (range of ICC = 0.47–0.86) and individual items (range of ICC = 0.41–0.79) in the final NEWS-CC was moderate to good.

Conclusion

The results of this study support the psychometric properties of the NEWS-CC. The NEWS-CC can be used to assess physical activity-related neighborhood environment among children in Hong Kong, as well as cities that share similar urban forms with Hong Kong.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-021-10530-4.

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

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