Leisure time activities of elementary school children

Socioeconomic Correlates of Obesity in African-American and Caribbean-Black Men and Women

The high prevalence of obesity among Black Americans warrants additional investigation into its relationship with socioeconomic position (SEP), sex, and ethnicity. This cross-sectional study utilizes 2001–2003 data from the National Survey of American Life, a nationally representative sample of 3570 African-Americans and 1621 Caribbean-Blacks aged 18 years and older. Multivariate logistic regression models stratified by ethnicity and sex describe the independent associations between obesity and multilevel socioeconomic factors after adjustment for age, other SEP measures at the individual, family and neighborhood levels, and health behaviors such as physical activity, alcohol intake, and smoking. A positive relationship was observed between obesity and family income among African-American and Caribbean-Black men. Receipt of public assistance was a strongly associated factor for obesity in Caribbean-Black men and women. Among African-American women, inverse relationships were observed between obesity and education, occupation, and family income; residence within a neighborhood with a supermarket also decreased their odds of obesity. Residence in a neighborhood with a park decreased the odds of obesity only among African-American men, whereas residence in a neighborhood with a supermarket decreased the odds of obesity among Caribbean-Black men. The social patterning of obesity by individual, household, and neighborhood socioeconomic resources differs for African-American and Caribbean-Black men and women within these cross-sectional analyses; an appreciation of these differences may be a prerequisite for developing effective weight control interventions and policies for these two populations.

More of the same or a change of scenery: an observational study of variety and frequency of physical activity in British children

BACKGROUND

Physical activity is important for children's health, but successful physical activity promotion is challenging. Whether performing many different types of activities (Variety) is associated with higher physical activity independent of the number of activity sessions (Frequency) is unknown, but this information could inform physical activity promotion and public health strategies in children.

METHODS

In the SPEEDY study we measured moderate-to-vigorous intensity physical activity (MVPA; ≥2000 counts/minute) over 7 days using GT1M Actigraph accelerometers in 1700 children from Norfolk, UK (56% girls, Mean ± SD 10.3 ± 0.3 years-old). Children reported participation in 28 leisure-time activities over the previous 7 days. Sex differences in activity participation were assessed using multilevel logistic regression, clustered by school. Associations of log-transformed MVPA with z-score-Variety (number of different activities/week) and z-score-Frequency (sum of all activity sessions/week) were examined using multilevel linear regression, adjusted for age, sex, parental education and age-standardised BMI.

RESULTS

Children's activity participation often reflected gender stereotypes. Mean ± SD Variety was 10.8 ± 5.0 activities/week, and Frequency was 24.2±15.0 sessions/week. In separate models lnMVPA had similar strength, positive associations with z-score-Variety and z-score-Frequency (Exp β(95% CI); Variety 1.04(1.02-1.06), Frequency 1.04(1.02-1.06)). lnMVPA was not associated with z-score-Variety independent of z-score-Frequency (Variety 1.01(0.98-1.04), Frequency 1.03(1.00-1.06)).

CONCLUSIONS

Future physical activity interventions and public health strategies could allow for gender specific activity preferences and could target both Variety and Frequency of activities participated in by children.

Relationship between socioeconomic status and physical fitness in junior high school students

BACKGROUND

Research on physical fitness often regards socioeconomic status (SES) as a confounding factor. However, few studies investigate the impact of SES on fitness. This study investigated the impact of SES on physical fitness in both males and females, with an economic-based construct of SES.

METHODS

The sample consisted of 954 6th, 7th, and 8th graders from a public, urban, Illinois middle school. The students participated in the FITNESSGRAM battery of fitness assessments as part of physical education. Descriptive statistics were calculated for height, weight, age, and sex. Students were grouped as high or low SES depending on whether they qualified for the federal free lunch program. A multivariate analysis of variance controlled for age and stratified by sex compared the raw scores from the fitness test for low and high SES students. Odds ratios stratified by sex were calculated for the likelihood of not achieving the FITNESSGRAM Healthy Fitness Zone standards among SES groups.

RESULTS

Girls of the low SES group had significantly lower scores on the FITNESSGRAM assessments and were significantly less likely to achieve Healthy Fitness Zone status than the girls from the high SES groups. For boys, SES was a significant main effect for body composition but not for the other fitness tests conducted.

CONCLUSION

SES is related to physical fitness in girls but not in boys. A potential explanation for this is that boys are more likely to engage in vigorous leisure time activity regardless of SES than girls.

Physical activity in the prevention of childhood obesity

The current high prevalence of childhood obesity and its co-morbidities is concomitant with a low level of physical activity and an abundance of sedentary pastimes for Westernised children. To increase the participation of a majority of children in a sustained physical activity, interventions require a fair understanding and consideration of the influences of this behaviour, especially as children are overweight or obese. Basically, the physical activity behaviour of children depends on biological, sociocultural and psychosocial factors and their interplay. The recent literature lends support to the fact that some psychosocial factors such as self-efficacy and physical competence may be solid anchor points upon which to improve the participation of overweight and obese children in free-living physical activity. Thus, interventionists should first concentrate on improving these personal dimensions around which physiological and environmental factors might revolve. The development of motor skills may be a good means for enhancing the self-image of obese children.

Ten Years of TAKE 10!(®): Integrating physical activity with academic concepts in elementary school classrooms

OBJECTIVE

Current literature supports the link between physical activity (PA) or fitness and a child's ability to achieve academically; however, little structured activity time is incorporated into elementary school classrooms. This paper explores the impact of a classroom-based PA program, TAKE 10!, and health-academic integration through existing state and federal policy and programming.

METHODS

Evidence from journal articles, published abstracts, and reports were examined to summarize the impact of TAKE 10! on student health and other outcomes. This paper reviews 10 years of TAKE 10! studies and makes recommendations for future research.

RESULTS

Teachers are willing and able to implement classroom-based PA integrated with grade-specific lessons (4.2 days/wk). Children participating in the TAKE 10! program experience higher PA levels (13%>), reduced time-off-task (20.5%), and improved reading, math, spelling and composite scores (p<0.01). Furthermore, students achieved moderate energy expenditure levels (6.16 to 6.42 METs) and studies suggest that BMI may be positively impacted (decreases in BMI z score over 2 years [P<0.01]).

CONCLUSION

TAKE 10! demonstrates that integrating movement with academics in elementary school classrooms is feasible, helps students focus on learning, and enables them to realize improved PA levels while also helping schools achieve wellness policies.

The type and prevalence of activities performed by Australian children during the lunchtime and after school periods

OBJECTIVES

The aim of this study was to identify the most prevalent reported activities performed by Australian children during the lunchtime and after school periods; and estimate the mean duration of a typical bout of the most prevalent activities performed during the lunchtime and after school periods.

DESIGN

This study was a secondary data analysis of the 2007 Australian National Children's Nutrition and Physical Activity Survey.

METHOD

Use of time data were collected from Australian children aged 10.0-13.9 years (n=794) using the Multimedia Activity Recall for Children and Adults (MARCA). The most prevalent self-reported activities for the lunchtime and after school period on school days were determined by mean duration across the sample. The estimated energy cost for each of the activities was reported based on the Compendium of Energy Expenditures for Youth.

RESULTS

A list of the 20 most prevalent lunchtime activities and 30 most prevalent after school activities is presented. Of the most prevalent lunchtime activities, 35% were classified as sedentary and 65% as moderate to vigorous physical activities. During the after school period, 57% of the most prevalent activities were classified as sedentary and only 43% as moderate to vigorous physical activities.

CONCLUSIONS

These data may assist in the development or refinement of activity checklists with greater content validity, which may be used in combination with objective measures to provide important contextual information about the types of activities being performed and inform the development of appropriately targeted interventions.

Development of a compendium of energy expenditures for youth

BACKGROUND

This paper presents a Compendium of Energy Expenditures for use in scoring physical activity questionnaires and estimating energy expenditure levels in youth.

METHOD/RESULTS

Modeled after the adult Compendium of Physical Activities, the Compendium of Energy Expenditures for Youth contains a list of over 200 activities commonly performed by youth and their associated MET intensity levels. A review of existing data collected on the energy cost of youth performing activities was undertaken and incorporated into the compendium. About 35% of the activity MET levels were derived from energy cost data measured in youth and the remaining MET levels estimated from the adult compendium.

CONCLUSION

The Compendium of Energy Expenditures for Youth is useful to researchers and practitioners interested in identifying physical activity and energy expenditure values in children and adolescents in a variety of settings.

Whole-day and segmented-day physical activity variability of northwest England school children

OBJECTIVE

This study aimed to (1) assess the day-to-day variability of children's weekday physical activity for the whole-day, and when segmented into discrete periods of the day; and (2) compare boys' and girls' physical activity variability.

METHOD

Fifty-eight children (aged 7-11 years; 31 boys) from a northwest England city wore accelerometers for 4 consecutive weekdays during November and December 2005. Intra-class correlations (ICCs) were calculated for 1 and 4 monitored days and segments of days to determine reliable estimates of moderate-to-vigorous physical activity (MVPA). The Spearman-Brown prophecy formula established the number of monitoring days required for 80% reliability.

RESULTS

Higher ICC coefficients were typically observed among boys. Eight days of boys' whole-day monitoring were needed to achieve a reliability of 0.8, while 10 days were required for girls. The pre-school segment was the most stable (boys' ICC=0.862; girls' ICC=0.770). Compared to girls, fewer days of boys' monitoring would be required during all segments other than the school day.

CONCLUSION

Day-to-day physical activity variability was sex-specific, with boys' MVPA generally more stable than girls'. The greatest reliability occurred between 7 am and 3 pm, suggesting that physical activity behaviors are more consistent in the school environment.

The Interaction Model of Client Health Behavior as a Conceptual Guide in the Explanation of Children's Health Behaviors

This study used the Interaction Model of Client Health Behavior (IMCHB) as a conceptual guide to explain the correlates of children's diet and physical activity and explore the relationships of sex with their diet and physical activity of the school-aged child. A descriptive correlational study was conducted on 371 fifth-grade students and their parents. Information on the family's demographics, health experience, social influence, and environmental resources was collected, as well as data on the children's intrinsic motivation, cognitive appraisal, and affective response to food/physical activity. Children's self-reports on diet and physical activity were collected, as were parents' self-reports on health habits. Food preferences and diet self-efficacy explained the most variance in diet behavior for girls and boys. Girls scored healthier on food preferences and diet self-efficacy than did boys, but no difference was detected in their diet behavior. Girls participated in more low-intensity physical activity, but boys participated in more high-intensity physical activity than did girls. Findings provide strong support for the use of the IMCHB to explain children's diet but weak support for the explanation of children's physical activity. Further study of additional factors predictive of physical activity is indicated.

Assessing physical activity in adolescents: common activities of children in 6th-8th grades

OBJECTIVES

To provide data for physical activity assessment in practice by describing the leisure time activities of adolescents and determining if the activities and the metabolic equivalents (MET levels) of those activities differ for boys and girls.

DATA SOURCES

The study was conducted in five middle schools in three rural counties in North Carolina. Subjects were 1,211 6th, 7th, and 8th graders aged 11-14 (mean 12.2) years. Half (52.5%) were girls. The sample was 64% white, 24% African-American and 12% other races.

RESULTS

The top five activities of boys were football, basketball, bicycling, running, and baseball; the top five activities of girls were talking, running, walking, bicycling, and dancing. The average MET was 5.3 for boys and 4.3 for girls (p = 0.000). By grade levels, 6th graders had an average MET of 4.9 and the MET of 8th graders was 4.5 (p < 0.05). Older youth, girls, and children of parents with more education reported significantly more sedentary activities than the other youth.

IMPLICATIONS FOR PRACTICE

Physical activity is an integral component of overall health. Once activities and activity levels are known, current practices can be augmented or changed to accommodate improved understanding of physical activity. Because an active lifestyle is important in preventing obesity and other chronic conditions and for general health, nurse practitioners (NPs) should ask adolescents about their common activities and encourage them to continue the more vigorous activities and reduce time spent in sedentary pursuits. Prescriptive physical activity can be included for primary, secondary, or even tertiary prevention, thus crossing all levels of NP practice.

[Effect of socioeconomic status on the physical activity of prepubertal children]

In order to assess possible influences of socioeconomic status and gender on habitual physical activity (HPA) of prepubertal French children, daily heart rate was 24-hr-monitored in 65 normal subjects for 2 days in the same school week. HPA was evaluated as the mean daily time spent at heart rates greater than 140 bpm (tFC > 140), 160 bpm (tF C > 160), 50% (tFC > 50%), and 70% (tFC > 70%) of the heart rate reserve. An effect of socioeconomic status (determined by questionnaire) was found in boys, with HPA being greater in the underprivileged ones (tFC > 140: 51.8 +/- 30.1 vs 33.0 +/- 14.1 min, p < .05; tFC > 160: 22.7 +/- 16.6 vs 11.1 +/- 7.4 min, p < .05; tFC > 50%: 61.4 +/- 33.5 vs 46.5 +/- 17.1 min, p < .06; tFC > 70%: 20.1 +/- 15.2 vs 10.6 +/- 7.1, p < .05). Boys were more active than girls, but only in the underprivileged group (tFC > 140: 51.8 +/- 30.1 vs 32.8 +/- 26.0 min, tFC > 160: 22.7 +/- 16.6 vs 9.9 +/- 8.2 min, p < .05; tFC > 50%: 61.4 +/- 33.5 vs 37.4 +/- 23.8 min, p < .05; tFC > 70%: 20.1 +/- 15.2 vs 8.1 +/- 6.3, p < .05). Cultural factors could be involved in these results.

Adolescent health promotion scale: development and psychometric testing

The purpose of this study was to assess the psychometric properties of a newly devised instrument, the Adolescent Health Promotion scale (AHP), a 40-item Likert-type self-report instrument used to detect unhealthy lifestyles in adolescents. Content validity was considered to be supported based on the findings of previous studies and the observations of a panel of 14 content experts. This study examined the construct validity and reliability of the instrument. The psychometric properties of the AHP, including item analysis, factor analysis, and reliability measures, were assessed based on the responses of 1,128 Taiwanese adolescents. Kaiser-Meyer-Olkin (KMO) measures and Bartlett's sphericity test showed that the samples met the criteria for factor analysis. Factor analysis yielded a six-factor instrument that explained 51.14% of the variance in the 40 items. The six factors were social support, life appreciation, health responsibility, nutritional behaviors, exercise behaviors, and stress management. The Cronbach alpha reliability coefficient for the total scale was 0.932, and alpha coefficients for the subscales ranged from 0.75 to 0.88. The results of this study indicate that the AHP has good construct validity and reliability in Taiwanese and that its use by school health nurses to assess adolescent health promotion programs is warranted.

Home environmental influences on children's television watching from early to middle childhood

Identifying correlates of children's television (TV) watching could help identify strategies to reduce children's TV watching and impact children's weight status. Children's TV time and home environment factors were assessed longitudinally among 169 families with children followed from 6 to 12 years of age. TV watching increased with age, as did the number of in-home TVs and the presence of videocassette recorders (VCRs), the frequency of meal eating while watching TV, and the percentage of children with bedroom TVs. Greater meal eating while watching TV was consistently related to overall TV watching and increases in TV watching over time. The number of in-home TVs and the presence of a bedroom TV were less consistent correlates. TV watching was related to weight status when children were younger, and when children were older, more than 2 hours of TV daily was a risk factor for higher weight. Modifying TV access, particularly by reducing the frequency of meals eaten while watching TV, could promote lower children's TV watching and adiposity.

Patterns of physical activity among American Indian children: an assessment of barriers and support

Estimates indicate that 10% to 50% of American Indian and non-Indian children in the U.S. are obese, defined as a body mass index > or = 95th percentile of the NHANES II reference data. Pathways is a two-phase, multi-site study to develop and test a school-based obesity prevention program in American Indian schoolchildren in grades three through five. During Phase I feasibility prior to initiation of the Pathways trial, data were collected related to physical activity patterns, and the supports of, and barriers to, physical activity. Nine schools from communities representing six different tribal groups participated in this study. Multiple measures were used for data collection including direct observation, paired child interviews, and in-depth interviews and focus groups with adults. Students completed the self-administered Knowledge, Attitudes, and Behaviors (KAB) survey, and a Physical Activity Questionnaire (PAQ). Barriers to physical activity at schools included a lack of facilities, equipment, and trained staff persons for PE. Adults were not consistently active with their children, but they were highly supportive of their children's activity level. Children reported a strong enjoyment of physical activity and strong peer support to be physically active. Weather conditions, safety concerns, and homework/chores were common barriers to physical activity reported by children and adult caregivers. The information was used to design culturally and age-appropriate, practical interventions including the five physical activity programs for schoolchildren in the Pathways study.

The effectiveness of health promotion counseling for overweight adolescent nursing students in taiwan

This study examined the effectiveness of health promotion counseling for overweight adolescent nursing students. The Chinese version of an established health promotion counseling booklet developed by the author of this study was used in the counseling. The study employed a one-group pre- and post-quasi-experimental research design from September 1997 to June 1999. A total of 166 (17%) first-year, junior college nursing students were found to be overweight according to the results of a health examination at the school health center at a junior college in the Taipei Metropolitan Area. Of these 166 students, 58 were randomly selected and 49 of these had complete participation records for the 2-year study. All subjects received 8 hours of whole group and 12 hours of small group health promotion counseling over a 1-year period. The results show that health promotion counseling enabled subjects to adopt healthier lifestyles and most of the physiological variables (WLI, HDL, SBP, TC) were significantly improved. This research outcome supports the value of health promotion counseling in school health centers, which incorporates material to help overweight adolescent students live a healthier life.

Examining television as an influence on children's health behaviors

This article is a review of select empirical research studies examining television as an influence on children's health behaviors. The reader is first provided with an overview of the research on the role of television in children's lives. This is followed by an in-depth presentation of the research related to television content and its effect on risk-taking and the role of television commercials and their influence on nutrition and dietary behaviors.

The influence of physical activity, socioeconomic status, and ethnicity on the weight status of adolescents

OBJECTIVE

This study examined the effects of physical activity, television viewing, video game play, socioeconomic status (SES), and ethnicity on body mass index (BMI).

RESEARCH METHODS AND PROCEDURES

The sample was 2389 adolescents, 10 to 16 years of age (12.7 +/- 1.0 years); 1240 (52%) females and 1149 (48%) males; 77% white and 23% African American; from rural (77%) and urban (23%) settings. BMI and skinfolds were directly assessed. All other data were obtained from questionnaires.

RESULTS

Watching television on non-school days was related to being overweight (p < 0.005). However, when BMI analyses were adjusted for ethnicity and SES, there were no significant effects of television viewing on BMI (p > 0.061). Increased hours of video game play enhanced the risk of being overweight for both genders when analyses were adjusted for ethnicity and SES (p < 0.019). In males, participation in as little as one high-intensity physical activity 3 to 5 days a week decreased the ethnic- and SES-adjusted relative risk of being overweight (RR = 0.646; CI: 0.427 to 0.977). For females, the ethnic- and SES-adjusted relative risk for being overweight was not significantly altered by physical activity. The logistic analyses further indicated the influence of low SES and African American ethnicity overshadowed any direct effect of television or videos.

DISCUSSION

Because weight status of male adolescents appears to be more related to exercise habits than to television or video game habits, increased participation in high-intensity exercise appears to be important. For females, neither videos nor exercise habits appear to be related to risk of being overweight. However, ethnicity and SES may be important factors that can influence body weight status, while television viewing may be of some importance. Thus, programs to reduce obesity in female adolescent should focus their efforts in lower SES communities.

Obesity: a growing problem

Obesity, defined as a body mass index (BMI) of 30 kg/m2 or more, is common in many parts of the world, especially in the established market economies, the former socialist economies of Europe, Latin America, the Caribbean and the Middle Eastern Crescent. As many as 250 million people worldwide may be obese (7% of the adult population) and two to three times as many may be considered overweight. The prevalence of obesity seems to be increasing in most parts of the world, even where it used to be rare. Increased fatness, measured by a high BMI, a large waist circumference or a high waist/hip circumference ratio, is associated with many chronic diseases as well as with poor physical functioning. Assessments of the prevalence of obesity, and trends in this prevalence over time, are more difficult in children than adults, due to the lack of international criteria for classifying individuals as overweight or obese. The World Health Organization has now recommended the use of BMI-for-age percentiles, but the reference curves are still under development. France. The Netherlands, the UK and the USA are among the countries that have reported recent increases in the prevalence of obesity in children and adolescents. Although there are no accurate estimates of the components of energy balance and their changes over time, the available evidence suggests that the trends in obesity rates are related more to a reduction in energy expenditure than to an increase in caloric intake. Prevention of obesity through the promotion of a healthy lifestyle is among the important challenges for the new millennium, and should start in childhood.