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Akihisa T, Kataoka H, Makabe S, Manabe S, Yoshida R, Ushio Y, Sato M, Yajima A, Hanafusa N, Tsuchiya K, Nitta K, Hoshino J, Mochizuki T. Immediate drop of urine osmolality upon tolvaptan initiation predicts impact on renal prognosis in patients with ADPKD. Nephrol Dial Transplant 2024; 39:1008-1015. [PMID: 37935473 DOI: 10.1093/ndt/gfad232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Indexed: 11/09/2023] Open
Abstract
BACKGROUND Tolvaptan, a vasopressin V2 receptor antagonist, is used for treating autosomal dominant polycystic kidney disease (ADPKD). We focused on changes in urinary osmolality (U-Osm) after tolvaptan initiation to determine whether they were associated with the therapeutic response to tolvaptan. METHODS This was a single-centre, prospective, observational cohort study. Seventy-two patients with ADPKD who received tolvaptan were recruited. We analysed the relationship between changes in U-Osm and annual estimated glomerular filtration rate (eGFR) in terms of renal prognostic value using univariable and multivariable linear regression analyses. RESULTS The mean value of U-Osm immediately before tolvaptan initiation was 351.8 ± 142.2 mOsm/kg H2O, which decreased to 97.6 ± 23.8 mOsm/kg H2O in the evening. The decrease in U-Osm was maintained in the outpatient clinic 1 month later. However, the 1-month values of U-Osm showed higher variability (160.2 ± 83.8 mOsm/kg H2O) than did those in the first evening of tolvaptan administration. Multivariate analysis revealed that the baseline eGFR, baseline urinary protein and U-Osm change in the evening of the day of admission (initial U-Osm drop) were significantly correlated with the subsequent annual change in eGFR. CONCLUSIONS U-Osm can be measured easily and rapidly, and U-Osm change within a short time after tolvaptan initiation may be a useful index for the renal prognosis in actual clinical practice.
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Affiliation(s)
- Taro Akihisa
- Department of Nephrology, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, Japan
| | - Hiroshi Kataoka
- Department of Nephrology, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, Japan
| | - Shiho Makabe
- Department of Nephrology, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, Japan
| | - Shun Manabe
- Department of Nephrology, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, Japan
| | - Rie Yoshida
- Department of Nephrology, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, Japan
| | - Yusuke Ushio
- Department of Nephrology, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, Japan
| | - Masayo Sato
- Department of Nephrology, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, Japan
| | - Aiji Yajima
- Department of Blood Purification, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, Japan
| | - Norio Hanafusa
- Department of Blood Purification, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, Japan
| | - Ken Tsuchiya
- Department of Blood Purification, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, Japan
| | - Kosaku Nitta
- Department of Nephrology, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, Japan
| | - Junichi Hoshino
- Department of Nephrology, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, Japan
| | - Toshio Mochizuki
- Department of Nephrology, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, Japan
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Alliott O, Fairbrother H, Corder K, Wilkinson P, van Sluijs E. Do socioeconomic inequities arise during school-based physical activity interventions? An exploratory case study of the GoActive trial. BMJ Open 2023; 13:e065953. [PMID: 36914195 PMCID: PMC10016273 DOI: 10.1136/bmjopen-2022-065953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/16/2023] Open
Abstract
OBJECTIVE To investigate socioeconomic inequities in the intervention and evaluation process of the GoActive school-based physical activity intervention and demonstrate a novel approach to evaluating intervention-related inequalities. DESIGN Exploratory post-hoc secondary data analysis of trial data. SETTING The GoActive trial was run in secondary schools across Cambridgeshire and Essex (UK), between September 2016 and July 2018. PARTICIPANTS 13-14 years old adolescents (n=2838, 16 schools). METHODS Socioeconomic inequities across six stages in the intervention and evaluation process were evaluated: (1) provision of and access to resources; (2) intervention uptake; (3) intervention effectiveness (accelerometer-assessed moderate-to-vigorous physical activity (MVPA)); (4) long-term compliance; (5) response in evaluation; and (6) impact on health. Data from self-report and objective measures were analysed by individual-level and school-level socioeconomic position (SEP) using a combination of classical hypothesis tests and multilevel regression modelling. RESULTS Stage: (1) There was no difference in the provision of physical activity resources by school-level SEP (eg, quality of facilities (0-3), low=2.6 (0.5); high=2.5 (0.4). (2) Students of low-SEP engaged significantly less with the intervention (eg, website access: low=37.2%; middle=45.4%; high=47.0%; p=0.001). (3) There was a positive intervention effect on MVPA in adolescents of low-SEP (3.13 min/day, 95% CI -1.27 to 7.54, but not middle/high (-1.49; 95% CI -6.54 to 3.57). (4) At 10 months post-intervention, this difference increased (low SEP: 4.90; 95% CI 0.09 to 9.70; middle/high SEP: -2.76; 95% CI -6.78 to 1.26). (5) There was greater non-compliance to evaluation measures among adolescents of low-SEP (eg, % accelerometer compliance (low vs high): baseline: 88.4 vs 92.5; post-intervention: 61.6 vs 69.2; follow-up: 54.5 vs 70.2. (6) The intervention effect on body mass index (BMI) z-score was more favourable in adolescents of low-SEP (low SEP: -0.10; 95% CI -0.19 to 0.00; middle/high: 0.03; 95% CI -0.05 to 0.12). CONCLUSIONS These analyses suggest the GoActive intervention had a more favourable positive effect on MVPA and BMI in adolescents of low-SEP, despite lower intervention engagement. However, differential response to evaluation measures may have biassed these conclusions. We demonstrate a novel way of evaluating inequities within young people's physical activity intervention evaluations. TRIAL REGISTRATION NUMBER ISRCTN31583496.
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Affiliation(s)
- Olivia Alliott
- MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
| | | | - Kirsten Corder
- MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - Paul Wilkinson
- Department of Psychiatry, University of Cambridge, Cambridge, UK
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Pulsford RM, Brocklebank L, Fenton SAM, Bakker E, Mielke GI, Tsai LT, Atkin AJ, Harvey DL, Blodgett JM, Ahmadi M, Wei L, Rowlands A, Doherty A, Rangul V, Koster A, Sherar LB, Holtermann A, Hamer M, Stamatakis E. The impact of selected methodological factors on data collection outcomes in observational studies of device-measured physical behaviour in adults: A systematic review. Int J Behav Nutr Phys Act 2023; 20:26. [PMID: 36890553 PMCID: PMC9993720 DOI: 10.1186/s12966-022-01388-9] [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: 08/09/2022] [Accepted: 11/25/2022] [Indexed: 03/10/2023] Open
Abstract
BACKGROUND Accelerometer measures of physical behaviours (physical activity, sedentary behaviour and sleep) in observational studies offer detailed insight into associations with health and disease. Maximising recruitment and accelerometer wear, and minimising data loss remain key challenges. How varying methods used to collect accelerometer data influence data collection outcomes is poorly understood. We examined the influence of accelerometer placement and other methodological factors on participant recruitment, adherence and data loss in observational studies of adult physical behaviours. METHODS The review was in accordance with the Preferred Reporting Items for Systematic Reviews and Meta Analyses (PRISMA). Observational studies of adults including accelerometer measurement of physical behaviours were identified using database (MEDLINE (Ovid), Embase, PsychINFO, Health Management Information Consortium, Web of Science, SPORTDiscus and Cumulative Index to Nursing & Allied Health Literature) and supplementary searches to May 2022. Information regarding study design, accelerometer data collection methods and outcomes were extracted for each accelerometer measurement (study wave). Random effects meta-analyses and narrative syntheses were used to examine associations of methodological factors with participant recruitment, adherence and data loss. RESULTS 123 accelerometer data collection waves were identified from 95 studies (92.5% from high-income countries). In-person distribution of accelerometers was associated with a greater proportion of invited participants consenting to wear an accelerometer (+ 30% [95% CI 18%, 42%] compared to postal distribution), and adhering to minimum wear criteria (+ 15% [4%, 25%]). The proportion of participants meeting minimum wear criteria was higher when accelerometers were worn at the wrist (+ 14% [ 5%, 23%]) compared to waist. Daily wear-time tended to be higher in studies using wrist-worn accelerometers compared to other wear locations. Reporting of information regarding data collection was inconsistent. CONCLUSION Methodological decisions including accelerometer wear-location and method of distribution may influence important data collection outcomes including recruitment and accelerometer wear-time. Consistent and comprehensive reporting of accelerometer data collection methods and outcomes is needed to support development of future studies and international consortia. Review supported by the British Heart Foundation (SP/F/20/150002) and registered (Prospero CRD42020213465).
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Affiliation(s)
- Richard M Pulsford
- Faculty of Health and Life Sciences, University of Exeter, St Lukes Campus. EX12LU, Exeter, UK
| | - Laura Brocklebank
- Department of Behavioural Science and Health, University College London, London, WC1E 7HB, UK
| | - Sally A M Fenton
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK
| | - Esmée Bakker
- Radboud University Medical Centre, 6500 HB, Nijmegen, The Netherlands
| | - Gregore I Mielke
- School of Public Health, The University of Queensland, ST Lucia qld, Australia
| | - Li-Tang Tsai
- Center On Aging and Mobility, University Hospital Zurich, Zurich City Hospital - Waid and University of Zurich, Zurich , Switzerland.,Department of Aging Medicine and Aging Research, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - Andrew J Atkin
- Norwich Epidemiology Centre, University of East Anglia, Norwich, UK.,School of Health Sciences, Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, NR47TJ, UK
| | - Danielle L Harvey
- School of Health Sciences, Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, NR47TJ, UK
| | - Joanna M Blodgett
- Institute of Sport Exercise and Health, Division of Surgery and Interventional Science, University College London, London, W1T 7HA, UK
| | - Matthew Ahmadi
- Charles Perkins Centre, School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Le Wei
- Charles Perkins Centre, School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Alex Rowlands
- Diabetes Research Centre, University of Leicester, Leicester General Hospital, Gwendolen Road, Leicester, LE5 4PW, UK.,NIHR Leicester Biomedical Research Centre, University of Leicester, Leicester, UK.,Alliance for Research in Exercise, Nutrition and Activity (ARENA), Division of Health Sciences, Sansom Institute for Health Research, University of South Australia, Adelaide, Australia
| | - Aiden Doherty
- Big Data Institute, Department of Population Health, University of Oxford, Oxford, OX3 7LF, UK
| | - Vegar Rangul
- Department of Public Health and Nursing, HUNT Research Centre, Norwegian University of Science and Technology, Levanger, Norway
| | - Annemarie Koster
- Department of Social Medicine, CAPHRI, Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands
| | - Lauren B Sherar
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, LE113TU, UK
| | - Andreas Holtermann
- National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Mark Hamer
- Institute of Sport Exercise and Health, Division of Surgery and Interventional Science, University College London, London, W1T 7HA, UK.
| | - Emmanuel Stamatakis
- Charles Perkins Centre, School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
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The Challenge of Incomplete Data in Accelerometer Studies: Characteristics of Nonparticipation and Noncompliance in a Nationwide Sample of Adolescents and Young Adults in Germany. J Phys Act Health 2023; 20:226-238. [PMID: 36724792 DOI: 10.1123/jpah.2022-0443] [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: 08/16/2022] [Revised: 10/26/2022] [Accepted: 12/03/2022] [Indexed: 02/03/2023]
Abstract
BACKGROUND Incomplete data due to nonparticipation and noncompliance with the study protocol can bias the results of studies. We investigated how a nationwide accelerometer sample of adolescents and young adults is affected by such incomplete data. METHODS We analyzed cross-sectional data from 6465 participants (11-31 y old) who participated in a national health survey in Germany (KiGGS Wave 2; 2014-2017). The data included information about the participation in the measurement of physical activity using accelerometers, compliance with the wear-time protocol, and sociodemographic and health-related variables. Multivariable regression analyses were conducted to detect factors associated with incomplete data. RESULTS Of the total sample, 78.0% participated in the accelerometer part of the study, and 83.5% of the participants with data available complied with the wear-time protocol. In 11- to 17-year-olds, the likelihood of having incomplete accelerometer data was higher in boys, older adolescents, adolescents with a lower sociodemographic status, adolescents with overweight, adolescents not participating in organized sport, adolescents not speaking only German at home, current smokers, and adolescents having a higher soft drink consumption. In 18- to 31-year-olds, the likelihood of having incomplete accelerometer data was higher in men, adults with a lower educational level, adults not speaking only German at home, and adults who smoke. CONCLUSIONS Our results suggest that accelerometer samples are biased such that participants with more beneficial health behaviors provide complete accelerometer data more often. This knowledge should be used to design effective recruitment strategies and should be considered when interpreting results of accelerometer studies.
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GAMMON CATHERINE, ATKIN ANDREWJ, CORDER KIRSTEN, EKELUND ULF, HANSEN BJØRGEHERMAN, SHERAR LAURENB, ANDERSEN LARSBO, ANDERSSEN SIGMUND, DAVEY RACHEL, HALLAL PEDROC, JAGO RUSSELL, KRIEMLER SUSI, KRISTENSEN PETERLUND, KWON SOYANG, NORTHSTONE KATE, PATE RUSSELL, SALMON JO, SARDINHA LUISB, VAN SLUIJS ESTHERMF. Influence of Guideline Operationalization on Youth Activity Prevalence in the International Children's Accelerometry Database. Med Sci Sports Exerc 2022; 54:1114-1122. [PMID: 35195101 PMCID: PMC9208806 DOI: 10.1249/mss.0000000000002884] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
INTRODUCTION The United Kingdom and World Health Organization recently changed their youth physical activity (PA) guidelines from 60 min of moderate- to vigorous-intensity PA (MVPA) every day, to an average of 60 min of MVPA per day, over a week. The changes are based on expert opinion due to insufficient evidence comparing health outcomes associated with different guideline definitions. This study used the International Children's Accelerometry Database to compare approaches to calculating youth PA compliance and associations with health indicators. METHODS Cross-sectional accelerometer data (n = 21,612, 5-18 yr) were used to examine compliance with four guideline definitions: daily method (DM; ≥60 min MVPA every day), average method (AM; average of ≥60 min MVPA per day), AM5 (AM compliance and ≥5 min of vigorous PA [VPA] on ≥3 d), and AM15 (AM compliance and ≥15 min VPA on ≥3 d). Associations between compliance and health indicators were examined for all definitions. RESULTS Compliance varied from 5.3% (DM) to 29.9% (AM). Associations between compliance and health indicators were similar for AM, AM5, and AM15. For example, compliance with AM, AM5, and AM15 was associated with a lower BMI z-score (statistics are coefficient [95% CI]): AM (-0.28 [-0.33 to -0.23]), AM5 (-0.28 [-0.33 to -0.23], and AM15 (-0.30 [-0.35 to -0.25]). Associations between compliance and health indicators for DM were similar/weaker, possibly reflecting fewer DM-compliant participants with health data and lower variability in exposure/outcome data. CONCLUSIONS Youth completing 60 min of MVPA every day do not experience superior health benefits to youth completing an average of 60 min of MVPA per day. Guidelines should encourage youth to achieve an average of 60 min of MVPA per day. Different guideline definitions affect inactivity prevalence estimates; this must be considered when analyzing data and comparing studies.
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Affiliation(s)
- CATHERINE GAMMON
- Centre for Diet and Activity Research (CEDAR) and MRC Epidemiology Unit, University of Cambridge, Cambridge, UNITED KINGDOM
- School of Health Promotion and Human Performance, Eastern Michigan University, Ypsilanti, MI
| | - ANDREW J. ATKIN
- School of Heath Sciences, University of East Anglia, East Anglia, UNITED KINGDOM
| | - KIRSTEN CORDER
- Centre for Diet and Activity Research (CEDAR) and MRC Epidemiology Unit, University of Cambridge, Cambridge, UNITED KINGDOM
| | - ULF EKELUND
- Norwegian School of Sport Sciences, Oslo, NORWAY
| | - BJØRGE HERMAN HANSEN
- Norwegian School of Sport Sciences, Oslo, NORWAY
- Department of Sport Science and Physical Education, University of Agder, Kristiansand, NORWAY
| | - LAUREN B. SHERAR
- School of Sports, Exercise and Health Sciences, Loughborough University, Loughborough, UNITED KINGDOM
| | - LARS BO ANDERSEN
- Norwegian School of Sport Sciences, Oslo, NORWAY
- Faculty of Education, Arts and Sport, Western Norway University of Applied Sciences, Sogndal, NORWAY
| | | | - RACHEL DAVEY
- Health Research Institute, University of Canberra, Canberra, AUSTRALIA
| | | | - RUSSELL JAGO
- Centre for Exercise, Nutrition and Health Sciences, School for Policy Studies, University of Bristol, Bristol, UNITED KINGDOM
| | - SUSI KRIEMLER
- Epidemiology, Biostatistics and Public Health Institute, University of Zürich, Zürich, SWITZERLAND
| | - PETER LUND KRISTENSEN
- Department of Sports Science and Clinical Biomechanics, Research Unit for Exercise Epidemiology, Centre of Research in Childhood Health, University of Southern Denmark, Odense, DENMARK
| | - SOYANG KWON
- Stanley Manne Children’s Research Institute, Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, IL
| | - KATE NORTHSTONE
- Bristol Medical School, University of Bristol, Bristol, UNITED KINGDOM
| | - RUSSELL PATE
- Department of Exercise Science, University of South Carolina, Columbia, SC
| | - JO SALMON
- Institute for Physical Activity and Nutrition and School of Exercise and Nutrition Sciences, Deakin University, Geelong, AUSTRALIA
| | - LUIS B. SARDINHA
- Exercise and Health Laboratory, CIPER, Faculty of Human Kinetics, Universidade de Lisboa, Lisbon, PORTUGAL
| | - ESTHER M. F. VAN SLUIJS
- Centre for Diet and Activity Research (CEDAR) and MRC Epidemiology Unit, University of Cambridge, Cambridge, UNITED KINGDOM
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Bond SJ, Parikh N, Majmudar S, Pin S, Wang C, Willis L, Haga SB. A Systematic Review of the Scope of Study of mHealth Interventions for Wellness and Related Challenges in Pediatric and Young Adult Populations. Adolesc Health Med Ther 2022; 13:23-38. [PMID: 35173502 PMCID: PMC8835977 DOI: 10.2147/ahmt.s342811] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Accepted: 01/25/2022] [Indexed: 11/23/2022] Open
Abstract
Background Despite the purported advantages and potential efficacy of mHealth interventions to promote wellness in children, adolescents, and young adults, it is not clear what areas have been explored and the challenges reported in the biomedical literature. Methods We conducted a scoping review of publications between 2015 and 2019. Results We identified 54 papers that met our inclusion criteria. Studies were conducted in 21 countries and ranged in size from six to 9851 participants (median: 184). A total of 41% of studies enrolled adolescents only (n = 19). Of the seven types of mHealth interventions identified, apps were the most common intervention (59%; n = 32) evaluated and 44% of the studies evaluated two or more interventions. The most common topic of the studies reviewed was sexual and reproductive health (24%; n = 13). Conclusion Most pediatric mHealth intervention studies are conducted in adolescents in large part, and sexual and reproductive health is the most commonly studied topic. With the easy and widespread accessibility to smartphone technology, the use of mobile apps for wellness interventions will likely continue to expand to other wellness topics.
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Affiliation(s)
| | | | | | | | | | | | - Susanne B Haga
- Duke University, Durham, NC, 27708, USA
- Duke University School of Medicine, Durham, NC, 27708, USA
- Correspondence: Susanne B Haga, Duke University, 101 Science Drive, Box 3382, Durham, NC, 27708, USA, Tel +1 919 684 0325, Fax +1 919 681 8973, Email
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Urinary Aquaporin 2 as a Potential Indicator Predicting Tolvaptan Response in Patients With ADPKD. Kidney Int Rep 2021; 6:2436-2444. [PMID: 34514204 PMCID: PMC8418978 DOI: 10.1016/j.ekir.2021.06.033] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Revised: 06/29/2021] [Accepted: 06/29/2021] [Indexed: 11/26/2022] Open
Abstract
Introduction Tolvaptan is used to treat autosomal dominant polycystic kidney disease (ADPKD) because it inhibits binding of the antidiuretic hormone vasopressin to the vasopressin V2 receptor (V2R), which suppresses the insertion of preformed water channel aquaporin 2 (AQP2) molecules in the luminal membrane of the collecting duct cells. Methods This single-center, prospective observational cohort study investigated whether decreased AQP2 elimination in urine affects the renal prognosis of patients who received tolvaptan. We selected 92 patients with ADPKD who were administered tolvaptan in our hospital. We evaluated correlations between changes in urinary AQP2 (U-AQP2) and clinical parameters and the annual change in total kidney volume (TKV) and estimated glomerular filtration rate (eGFR) as renal prognostic factors using univariable and multivariable multiple regression analyses. Results The observation period was 2.4 ± 1.5 years. U-AQP2 per milligram of urinary creatinine (U-AQP2/Cr) decreased from 67.8 ± 50.6 to 20.7 ± 15.1 fmol/mg urinary creatinine after 1 month of tolvaptan treatment. This initial change in U-AQP2/Cr was correlated with high baseline U-AQP2/Cr, low baseline eGFR, and a large initial change in eGFR (baseline to 1 month). The initial change in U-AQP2/Cr (baseline to 1 month) was strongly correlated with the annual change in TKV and eGFR in multivariable analysis. Conclusion Initial decrease in U-AQP2/Cr in the first month of treatment reflects the pharmacologic effect of tolvaptan and could be an indicator of renal prognosis during tolvaptan treatment.
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Evenson KR, Arredondo EM, Carnethon MR, Delamater AM, Gallo LC, Isasi CR, Perreira KM, Foti SA, VAN Horn L, Vidot DC, Sotres-Alvarez D. Physical Activity and Sedentary Behavior among US Hispanic/Latino Youth: The SOL Youth Study. Med Sci Sports Exerc 2019; 51:891-899. [PMID: 30570586 DOI: 10.1249/mss.0000000000001871] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
PURPOSE Physical activity and sedentary behavior among diverse Hispanic/Latino youth in the United States is not well documented. The aim of this study was to describe physical activity and sedentary behavior among a representative sample of Hispanic/Latino youth from four US communities using accelerometry and self-reported measures. METHODS From 2012 to 2014, 1466 Hispanic/Latino youth ages 8 to 16 yr, children of participants in the Hispanic Community Health Study/Study of Latinos, enrolled in the SOL youth. Physical activity and sedentary behavior were assessed by interview. After this, youth wore an Actical accelerometer for 1 wk. All statistical analyses accounted for the complex survey design and used sampling weights. RESULTS The accelerometer wear time adjusted mean minutes per day was: 604.6, sedentary; 178.9, light; 25.4, moderate; and 10.2, vigorous. Generally, higher levels of moderate and vigorous activity occurred among males, Mexican backgrounds, and youth age 8 to 10 yr compared with older age groups. Higher levels of sedentary behavior occurred among youth age 15 to 16 yr compared with younger age groups. The most common activities (reported, ≥1 per month) were of lower intensity, including listening to music (91.9%), homework (87.0%), riding in car/bus (84.3%), and hanging out with friends (83.4%). Common active pursuits included travel by walking (74.6%), physical education class (71.7%), running (71.4%), and recess (71.3%). CONCLUSIONS Time, intensity, and type of physical activity and sedentary behavior varied among Hispanic/Latino youth. These findings can inform efforts to increase physical activity and reduce sedentary behavior among US Hispanic/Latino youth.
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Affiliation(s)
- Kelly R Evenson
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina-Chapel Hill, Chapel Hill, NC
| | - Elva M Arredondo
- Graduate School of Public Health, San Diego State University, San Diego, CA
| | - Mercedes R Carnethon
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL
| | - Alan M Delamater
- Department of Pediatrics, University of Miami Miller School of Medicine, Miami, FL
| | - Linda C Gallo
- Department of Psychology, San Diego State University, San Diego, CA
| | - Carmen R Isasi
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY
| | - Krista M Perreira
- Department of Social Medicine, University of North Carolina-Chapel Hill, Chapel Hill, NC
| | - Samantha A Foti
- Department of Psychology, University of Miami, Coral Gables, FL
| | - Linda VAN Horn
- Feinberg School of Medicine, Northwestern University, Chicago, IL
| | - Denise C Vidot
- School of Nursing and Health Studies, University of Miami, Miami, FL
| | - Daniela Sotres-Alvarez
- Collaborative Studies Coordinating Center, Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina - Chapel Hill, Chapel Hill, NC
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Love R, Adams J, Atkin A, van Sluijs E. Socioeconomic and ethnic differences in children's vigorous intensity physical activity: a cross-sectional analysis of the UK Millennium Cohort Study. BMJ Open 2019; 9:e027627. [PMID: 31133593 PMCID: PMC6549689 DOI: 10.1136/bmjopen-2018-027627] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
OBJECTIVE To investigate if daily vigorous physical activity (VPA), adjusted for minutes of moderate physical activity (MPA) performed, differs by socioeconomic position or ethnicity in a large sample of UK children with objectively measured physical activity. DESIGN Nationally representative prospective cohort study. SETTING UK children born between 2000 and 2002. PARTICIPANTS 5172 children aged 7-8 with valid accelerometer data for ≥10 hour on ≥3 days, including 1 weekend day. MAIN OUTCOME MEASURES Time spent in VPA (>3841 counts per min). EXPLANATORY MEASURES Maternal education, annual household Organisation for Economic Co-Operation and Development equivalised income, ethnicity. RESULTS Multivariable linear regression models fitted to explore differences in average daily minutes of VPA (adjusted for MPA, mean accelerometer wear time, season of measurement, age and sex), revealed significantly higher amounts of VPA accumulated as a child's socioeconomic position increased (highest vs lowest level of maternal education: β: 2.96, p: 0.00; annual household equivalised income: β: 0.58, p: 0.00, per £10 000 annual increase). Additionally, children from certain minority ethnicities (Bangladeshi and Pakistani: β: -3.34, p: 0.00; other ethnic groups: β:-2.27, p: 0.02) accrued less daily VPA compared with their white British counterparts. CONCLUSIONS The socioeconomic and ethnic patterning of vigorous activity observed in this study mirrors parallel inequalities in rates of childhood obesity. Given the stronger association of VPA with adiposity than of MPA, intensity specific differences may be contributing to widening inequalities in obesity. Accordingly, these findings suggest that the current global focus on overall moderate-to-vigorous intensity activity may mask important behavioural inequalities.
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Affiliation(s)
- Rebecca Love
- Centre for Diet and Activity Research (CEDAR), MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - Jean Adams
- Centre for Diet and Activity Research (CEDAR), MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - Andrew Atkin
- Centre for Diet and Activity Research (CEDAR), MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK
- University of East Anglia Faculty of Medicine and Health Sciences, Norwich, UK
| | - Esther van Sluijs
- Centre for Diet and Activity Research (CEDAR), MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK
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Breslin G, Shannon S, Rafferty R, Fitzpatrick B, Belton S, O’Brien W, Chambers FC, Haughey T, Hanna D, Gormley R, McCullagh D, Brennan D. The effect of sport for LIFE: all island in children from low socio-economic status: a clustered randomized controlled trial. Health Qual Life Outcomes 2019; 17:66. [PMID: 30992012 PMCID: PMC6469044 DOI: 10.1186/s12955-019-1133-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2018] [Accepted: 03/29/2019] [Indexed: 01/30/2023] Open
Abstract
BACKGROUND School-based interventions offer the opportunity to increase physical activity, health-related quality of life (HRQOL) and nutritional behaviours, yet methodological limitations hinder current research, particularly among under-represented children from low socio-economic status (SES). The aim was to determine the effect of a 12-week physical activity programme, Sport for LIFE: All Island (SFL:AI), on physical activity levels, HRQOL, and nutritional attitudes and behaviours in children of low SES across the island of Ireland. METHODS A 2 (groups) × 4 (data collection points) clustered randomised controlled trial was conducted comprising an intervention group who received SFL:AI for 12 weeks, and a waiting-list control condition. In total 740 children (381 boys, 359 girls) aged 8-9 years (mean = 8.7; SD = .50) from 27 schools across four regions of Ireland (Ulster, Leinster, Connacht and Munster) took part. Physical activity was measured by accelerometers, and children completed a validated questionnaire at baseline, mid (i.e. 6-weeks), post-intervention (i.e. 12 weeks) and follow-up (i.e. 3 months post-intervention). RESULTS No significant interaction effects for the intervention were found on any of the study outcomes. Main effects were reported for physical well-being, parental relations and autonomy and financial resources, as well as sweetened beverages, environment and intake, and attitude to vegetables. However, these changes were not statistically attributable to the intervention. CONCLUSIONS It remains unclear if school-based physical activity interventions can improve HRQOL through physical activity with children from low SES. Logistical and methodological considerations are outlined to explore the null effect of the programme, and to provide suggestions for future research and practice. TRIAL REGISTRATION Trial registration number: ISRCTN76261698 . Name of registry: ICRCTN. Date of registration: 23/08/2017. Date of enrolment: September 2014.
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Affiliation(s)
- Gavin Breslin
- Sport and Exercise Sciences Research Institute, Ulster University, Jordanstown, Newtownabbey, Northern Ireland, UK
| | - Stephen Shannon
- Sport and Exercise Sciences Research Institute, Ulster University, Jordanstown, Newtownabbey, Northern Ireland, UK
| | - Ruth Rafferty
- Sport and Exercise Sciences Research Institute, Ulster University, Jordanstown, Newtownabbey, Northern Ireland, UK
| | - Ben Fitzpatrick
- Sport and Exercise Sciences Research Institute, Ulster University, Jordanstown, Newtownabbey, Northern Ireland, UK
| | - Sarahjane Belton
- School of Health and Human Performance, Dublin City University, Dublin, Ireland
| | - Wesley O’Brien
- School of Education, Sports Studies and Physical Education Department, University College Cork, Cork, Ireland
| | - Fiona C. Chambers
- School of Education, Sports Studies and Physical Education Department, University College Cork, Cork, Ireland
| | - Tandy Haughey
- Sport and Exercise Sciences Research Institute, Ulster University, Jordanstown, Newtownabbey, Northern Ireland, UK
| | - Donncha Hanna
- School of Psychology, Queen’s University Belfast, Belfast, Northern Ireland, UK
| | - Richard Gormley
- Sport and Exercise Sciences Research Institute, Ulster University, Jordanstown, Newtownabbey, Northern Ireland, UK
| | - Darryl McCullagh
- Sport and Exercise Sciences Research Institute, Ulster University, Jordanstown, Newtownabbey, Northern Ireland, UK
| | - Deirdre Brennan
- Sport and Exercise Sciences Research Institute, Ulster University, Jordanstown, Newtownabbey, Northern Ireland, UK
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11
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Are active children and young people at increased risk of injuries resulting in hospital admission or accident and emergency department attendance? Analysis of linked cohort and electronic hospital records in Wales and Scotland. PLoS One 2019; 14:e0213435. [PMID: 30969971 PMCID: PMC6457613 DOI: 10.1371/journal.pone.0213435] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Accepted: 02/21/2019] [Indexed: 12/21/2022] Open
Abstract
Introduction Children and young people (CYP) are encouraged to increase time spent being physically active, especially in moderate and vigorous intensity pursuits. However, there is limited evidence on the prospective association of activity levels with injuries resulting in use of hospital services. We examined the relationship between objectively-measured physical activity (PA) and subsequent injuries resulting in hospital admissions or accident and emergency department (A&E) attendances, using linked electronic hospital records (EHR) from a nationally representative prospective cohort of CYP in Wales and Scotland. Methods We analysed accelerometer-based estimates of moderate to vigorous (MVPA) and vigorous PA (VPA) from 1,585 (777 [46%] boys) seven-year-old Millennium Cohort Study members, living in Wales or Scotland, whose parents consented to linkage of cohort records to EHRs up until their 14th birthday. Negative binomial regression models adjusted by potential individual, household and area-level confounders, were fitted to estimate associations between average daily minutes of MVPA, and VPA (in 10-minute increments), and number of injury-related hospital admissions and/or A&E attendances from age nine to 14 years. Results CYP spent a median of 59.5 and 18.1 minutes in MVPA and VPA/day respectively, with boys significantly more active than girls; 47.3% of children experienced at least one injury-related admission or A&E attendance during the study period. Rates of injury-related hospital admission and/or A&E attendance were positively associated with MVPA and VPA in boys but not in girls: respective adjusted incidence rate ratios (95% CI) for boys: 1.09 (1.01, 1.17) and 1.16 (1.00, 1.34), and for girls: 0.94 (0.86, 1.03) and 0.85 (0.69, 1.04). Conclusion Boys but not girls who engage in more intense PA at age seven years are at higher risk of injury-related hospital admission or A&E attendance when aged nine to 14 years than their less active peers. This may reflect gender differences in the type and associated risks of activities undertaken. EHRs can make a useful contribution to injury surveillance and prevention if routinely augmented with information on context and setting of the injuries sustained. Injury prevention initiatives should not discourage engagement in PA and outdoor play given their over-riding health and social benefits.
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12
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Rowlands AV, Harrington DM, Bodicoat DH, Davies MJ, Sherar LB, Gorely T, Khunti K, Edwardson CL. Compliance of Adolescent Girls to Repeated Deployments of Wrist-Worn Accelerometers. Med Sci Sports Exerc 2019; 50:1508-1517. [PMID: 29474208 DOI: 10.1249/mss.0000000000001588] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
PURPOSE This study aimed to determine the cross-sectional and cumulative compliance of adolescent girls to accelerometer wear at three deployment points and to identify variables associated with compliance. METHODS Girls from 20 secondary schools were recruited: 10 schools were participating in the "Girls Active" intervention and 10 were control schools. Physical activity was measured using the GENEActiv accelerometer worn on the nondominant wrist 24 h·d for up to 7 d at baseline, 7 months, and 14 months. Demographic and anthropometric characteristics were recorded. RESULTS Seven valid days (≥16 h) of accelerometer wear was obtained from 83%, 77%, and 68% of girls at baseline (n = 1734), 7 months (n = 1381), and 14 months (n = 1326), respectively. Sixty-eight percent provided 7 valid days for both baseline and 7 months, 59% for baseline and 14 months, and 52% for all three deployment points. Estimates of physical activity level from 3 d of measurement could be considered equivalent to a 7-d measure (i.e., they fell within a ±5% equivalence zone). Cross sectionally, 3 valid days was obtained from at least 91% of girls; cumulatively, this was obtained from ≥88% of girls across any two deployment points and 84% of girls across all three deployment points. When controlling for clustering at school level and other potential predictors, physical activity level, being South Asian, being in the intervention group, and prior compliance were positively associated with monitor wear. CONCLUSIONS Compliance reduced across deployment points, with the reduction increasing as the deployment points got further apart. High prior compliance and high physical activity level were associated with the most additional wear time.
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Affiliation(s)
- Alex V Rowlands
- Diabetes Research Centre, University of Leicester, Leicester General Hospital, Leicester, UNITED KINGDOM.,NIHR Leicester Biomedical Research Centre, Leicester, UNITED KINGDOM.,Alliance for Research in Exercise, Nutrition and Activity (ARENA), Sansom Institute for Health Research, Division of Health Sciences, University of South Australia, Adelaide, AUSTRALIA
| | - Deirdre M Harrington
- Diabetes Research Centre, University of Leicester, Leicester General Hospital, Leicester, UNITED KINGDOM.,NIHR Leicester Biomedical Research Centre, Leicester, UNITED KINGDOM
| | - Danielle H Bodicoat
- Diabetes Research Centre, University of Leicester, Leicester General Hospital, Leicester, UNITED KINGDOM.,NIHR Leicester Biomedical Research Centre, Leicester, UNITED KINGDOM.,NIHR Collaboration for Leadership in Applied Health Research and Care East Midlands, Leicester General Hospital, Leicester, UNITED KINGDOM
| | - Melanie J Davies
- Diabetes Research Centre, University of Leicester, Leicester General Hospital, Leicester, UNITED KINGDOM.,NIHR Leicester Biomedical Research Centre, Leicester, UNITED KINGDOM
| | - Lauren B Sherar
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UNITED KINGDOM
| | - Trish Gorely
- Department of Nursing, School of Health, Social Care and Life Sciences, University of the Highlands and Islands, Inverness, UNITED KINGDOM
| | - Kamlesh Khunti
- Diabetes Research Centre, University of Leicester, Leicester General Hospital, Leicester, UNITED KINGDOM.,NIHR Leicester Biomedical Research Centre, Leicester, UNITED KINGDOM.,NIHR Collaboration for Leadership in Applied Health Research and Care East Midlands, Leicester General Hospital, Leicester, UNITED KINGDOM
| | - Charlotte L Edwardson
- Diabetes Research Centre, University of Leicester, Leicester General Hospital, Leicester, UNITED KINGDOM.,NIHR Leicester Biomedical Research Centre, Leicester, UNITED KINGDOM
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13
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Stephens S, Beyene J, Tremblay MS, Faulkner G, Pullnayegum E, Feldman BM. Strategies for Dealing with Missing Accelerometer Data. Rheum Dis Clin North Am 2018; 44:317-326. [PMID: 29622298 DOI: 10.1016/j.rdc.2018.01.012] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Missing data is a universal research problem that can affect studies examining the relationship between physical activity measured with accelerometers and health outcomes. Statistical techniques are available to deal with missing data; however, available techniques have not been synthesized. A scoping review was conducted to summarize the advantages and disadvantages of identified methods of dealing with missing data from accelerometers. Missing data poses a threat to the validity and interpretation of trials using physical activity data from accelerometry. Imputation using multiple imputation techniques is recommended to deal with missing data and improve the validity and interpretation of studies using accelerometry.
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Affiliation(s)
- Samantha Stephens
- Neurosciences and Mental Health, Pediatric M.S., Neuroinflammatory Disorders Program, Center for Brain and Mental Health, Peter Gilgan Centre for Research and Learning, The Hospital for Sick Children, 686 Bay Street, Room 8.9830, Toronto, Ontario M5G 0A4, Canada.
| | - Joseph Beyene
- Department of Clinical Epidemiology and Biostatistics, 208 Michael G. DeGroote Centre for Learning, McMaster University, 1280 Main Street W., Hamilton, Ontario L8S 4K1, Canada
| | - Mark S Tremblay
- Children's Hospital of Eastern Ontario Research Institute, University of Ottawa, Ottawa, Ontario, Canada
| | - Guy Faulkner
- Canadian Institutes of Health Research, Public Health Agency of Canada, Applied Public Health, University of British Columbia, D. H. Copp Building, Room 4606 2146 Health Sciences Mall, Vancouver, BC V6T1Z3, Canada
| | - Eleanor Pullnayegum
- Child Health Evaluative Sciences, The Hospital for Sick Children, Public Health Sciences, The University of Toronto, Toronto, Ontario, Canada
| | - Brian M Feldman
- Child Health Evaluative Sciences, The Hospital for Sick Children, Department of Pediatrics, Institute of Health Policy Management and Evaluation, The Dalla Lana School of Public Health, The University of Toronto, Toronto, Ontario, Canada
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14
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Borde R, Smith JJ, Sutherland R, Nathan N, Lubans DR. Methodological considerations and impact of school-based interventions on objectively measured physical activity in adolescents: a systematic review and meta-analysis. Obes Rev 2017; 18:476-490. [PMID: 28187241 DOI: 10.1111/obr.12517] [Citation(s) in RCA: 85] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2016] [Revised: 12/05/2016] [Accepted: 12/20/2016] [Indexed: 11/28/2022]
Abstract
OBJECTIVE The aims of this systematic review and meta-analysis are (i) to determine the impact of school-based interventions on objectively measured physical activity among adolescents and (ii) to examine accelerometer methods and decision rule reporting in previous interventions. METHODS A systematic search was performed to identify randomized controlled trials targeting adolescents (age: ≥10 years), conducted in the school setting, and reporting objectively measured physical activity. Random effects meta-analyses were conducted to determine the pooled effects of previous interventions on total and moderate-to-vigorous physical activity. Potential moderators of intervention effects were also explored. RESULTS Thirteen articles met the inclusion criteria, and twelve were included in the meta-analysis. The pooled effects were small and non-significant for both total physical activity (standardized mean difference = 0.02 [95% confidence interval = -0.13 to 0.18]) and moderate-to-vigorous physical activity (standardized mean difference = 0.24 [95% confidence interval = -0.08 to 0.56]). Sample age and accelerometer compliance were significant moderators for total physical activity, with a younger sample and higher compliance associated with larger effects. CONCLUSION Previous school-based physical activity interventions targeting adolescents have been largely unsuccessful, particularly for older adolescents. There is a need for more high-quality research using objective monitoring in this population. Future interventions should comply with best-practice recommendations regarding physical activity monitoring protocols.
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Affiliation(s)
- R Borde
- Division of Training and Movement Sciences, University of Potsdam, Potsdam, Germany
| | - J J Smith
- Priority Research Centre in Physical Activity and Nutrition, University of Newcastle, Callaghan, NSW, Australia
| | - R Sutherland
- Hunter New England Population Health, Wallsend, NSW, Australia.,School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, Australia.,Hunter Medical Research Institute, Lambton, NSW, Australia
| | - N Nathan
- Hunter New England Population Health, Wallsend, NSW, Australia.,School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, Australia.,Hunter Medical Research Institute, Lambton, NSW, Australia
| | - D R Lubans
- Priority Research Centre in Physical Activity and Nutrition, University of Newcastle, Callaghan, NSW, Australia
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15
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Lubans DR, Smith JJ, Plotnikoff RC, Dally KA, Okely AD, Salmon J, Morgan PJ. Assessing the sustained impact of a school-based obesity prevention program for adolescent boys: the ATLAS cluster randomized controlled trial. Int J Behav Nutr Phys Act 2016; 13:92. [PMID: 27542825 PMCID: PMC4992277 DOI: 10.1186/s12966-016-0420-8] [Citation(s) in RCA: 61] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2016] [Accepted: 08/08/2016] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Obesity prevention interventions targeting 'at-risk' adolescents are urgently needed. The aim of this study is to evaluate the sustained impact of the 'Active Teen Leaders Avoiding Screen-time' (ATLAS) obesity prevention program. METHODS Cluster RCT in 14 secondary schools in low-income communities of New South Wales, Australia. Participants were 361 adolescent boys (aged 12-14 years) 'at risk' of obesity. The intervention was based on Self-Determination Theory and Social Cognitive Theory and involved: professional development, fitness equipment for schools, teacher-delivered physical activity sessions, lunch-time activity sessions, researcher-led seminars, a smartphone application, and parental strategies. Assessments for the primary (body mass index [BMI], waist circumference) and secondary outcomes were conducted at baseline, 8- (post-intervention) and 18-months (follow-up). Analyses followed the intention-to-treat principle using linear mixed models. RESULTS After 18-months, there were no intervention effects for BMI or waist circumference. Sustained effects were found for screen-time, resistance training skill competency, and motivational regulations for school sport. CONCLUSIONS There were no clinically meaningful intervention effects for the adiposity outcomes. However, the intervention resulted in sustained effects for secondary outcomes. Interventions that more intensively target the home environment, as well as other socio-ecological determinants of obesity may be needed to prevent unhealthy weight gain in adolescents from low-income communities. TRIAL REGISTRATION Australian Clinical Trial Registry ACTRN12612000978864.
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Affiliation(s)
- David R Lubans
- Priority Research Centre in Physical Activity and Nutrition, School of Education, University of Newcastle, Callaghan, NSW, Australia.
| | - Jordan J Smith
- Priority Research Centre in Physical Activity and Nutrition, School of Education, University of Newcastle, Callaghan, NSW, Australia
| | - Ronald C Plotnikoff
- Priority Research Centre in Physical Activity and Nutrition, School of Education, University of Newcastle, Callaghan, NSW, Australia
| | - Kerry A Dally
- Priority Research Centre in Physical Activity and Nutrition, School of Education, University of Newcastle, Callaghan, NSW, Australia
| | - Anthony D Okely
- Interdisciplinary Educational Research Institute, University of Wollongong, Wollongong, NSW, Australia
| | - Jo Salmon
- Centre for Physical Activity and Nutrition Research, Deakin University, Burwood, VIC, Australia
| | - Philip J Morgan
- Priority Research Centre in Physical Activity and Nutrition, School of Education, University of Newcastle, Callaghan, NSW, Australia
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16
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Sutherland RL, Campbell EM, Lubans DR, Morgan PJ, Nathan NK, Wolfenden L, Okely AD, Gillham KE, Hollis JL, Oldmeadow CJ, Williams AJ, Davies LJ, Wiese JS, Bisquera A, Wiggers JH. The Physical Activity 4 Everyone Cluster Randomized Trial: 2-Year Outcomes of a School Physical Activity Intervention Among Adolescents. Am J Prev Med 2016; 51:195-205. [PMID: 27103495 DOI: 10.1016/j.amepre.2016.02.020] [Citation(s) in RCA: 62] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2015] [Revised: 01/21/2016] [Accepted: 02/18/2016] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Few interventions have been successful in reducing the physical activity decline typically observed among adolescents. The aim of this paper is to report the 24-month effectiveness of a multicomponent school-based intervention (Physical Activity 4 Everyone) in reducing the decline in moderate to vigorous physical activity (MVPA) among secondary school students in disadvantaged areas of New South Wales, Australia. STUDY DESIGN A cluster RCT was conducted in five intervention and five control schools with follow-up measures taken at 24 months post-randomization. SETTING/PARTICIPANTS The trial was undertaken within secondary schools located in disadvantaged communities in New South Wales, Australia. INTERVENTION A multicomponent school-based intervention based on the Health Promoting Schools Framework was implemented. The intervention consisted of seven physical activity promotion strategies that targeted the curriculum (teaching strategies to increase physical activity in physical education lessons, student physical activity plans, and modification of school sport program); school environment (recess/lunchtime activities, school physical activity policy); parents (parent newsletters); and community (community physical activity provider promotion). Six additional strategies supported school implementation of the physical activity intervention strategies. MAIN OUTCOME MEASURE Minutes per day spent in MVPA, objectively measured by accelerometer. RESULTS Participants (N=1,150, 49% male) were a cohort of students aged 12 years (Grade 7) at baseline (March-June 2012) and 14 years (Grade 9) at follow-up (March-July 2014). At 24-month follow-up, there were significant effects in favor of the intervention group for daily minutes of MVPA. The adjusted mean difference in change in daily MVPA between groups was 7.0 minutes (95% CI=2.7, 11.4, p<0.002) (analysis conducted December 2014-February 2015). Sensitivity analyses based on multiple imputation were consistent with the main analysis (6.0 minutes, 95% CI=0.6, 11.3, p<0.031). CONCLUSIONS The intervention was effective in increasing adolescents' minutes of MVPA, suggesting that implementation of the intervention by disadvantaged schools has the potential to slow the decline in physical activity. TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry ACTRN12612000382875.
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Affiliation(s)
- Rachel L Sutherland
- Hunter New England Population Health, Wallsend, New South Wales, Australia; School of Medicine and Public Health, University of Newcastle, Newcastle, New South Wales, Australia; Hunter Medical Research Institute, Newcastle, New South Wales, Australia.
| | - Elizabeth M Campbell
- Hunter New England Population Health, Wallsend, New South Wales, Australia; School of Medicine and Public Health, University of Newcastle, Newcastle, New South Wales, Australia; Hunter Medical Research Institute, Newcastle, New South Wales, Australia
| | - David R Lubans
- Priority Research Centre in Physical Activity and Nutrition, School of Education, University of Newcastle, Newcastle, New South Wales, Australia
| | - Philip J Morgan
- Priority Research Centre in Physical Activity and Nutrition, School of Education, University of Newcastle, Newcastle, New South Wales, Australia
| | - Nicole K Nathan
- Hunter New England Population Health, Wallsend, New South Wales, Australia; School of Medicine and Public Health, University of Newcastle, Newcastle, New South Wales, Australia; Hunter Medical Research Institute, Newcastle, New South Wales, Australia
| | - Luke Wolfenden
- Hunter New England Population Health, Wallsend, New South Wales, Australia; School of Medicine and Public Health, University of Newcastle, Newcastle, New South Wales, Australia; Hunter Medical Research Institute, Newcastle, New South Wales, Australia
| | - Anthony D Okely
- Early Start Research Institute and School of Education, University of Wollongong, Wollongong, New South Wales, Australia; Illawarra Health and Medical Research Institute, Wollongong, New South Wales, Australia
| | - Karen E Gillham
- Hunter New England Population Health, Wallsend, New South Wales, Australia; Hunter Medical Research Institute, Newcastle, New South Wales, Australia
| | - Jenna L Hollis
- Rowett Institute of Nutrition and Health, University of Aberdeen, Scotland, United Kingdom
| | - Chris J Oldmeadow
- School of Medicine and Public Health, University of Newcastle, Newcastle, New South Wales, Australia; Hunter Medical Research Institute, Newcastle, New South Wales, Australia
| | - Amanda J Williams
- Hunter New England Population Health, Wallsend, New South Wales, Australia; School of Medicine and Public Health, University of Newcastle, Newcastle, New South Wales, Australia; Hunter Medical Research Institute, Newcastle, New South Wales, Australia
| | - Lynda J Davies
- Hunter New England Population Health, Wallsend, New South Wales, Australia; Hunter Medical Research Institute, Newcastle, New South Wales, Australia
| | - Jarrod S Wiese
- Hunter New England Population Health, Wallsend, New South Wales, Australia; Hunter Medical Research Institute, Newcastle, New South Wales, Australia
| | - Alessandra Bisquera
- School of Medicine and Public Health, University of Newcastle, Newcastle, New South Wales, Australia; Hunter Medical Research Institute, Newcastle, New South Wales, Australia
| | - John H Wiggers
- Hunter New England Population Health, Wallsend, New South Wales, Australia; School of Medicine and Public Health, University of Newcastle, Newcastle, New South Wales, Australia; Hunter Medical Research Institute, Newcastle, New South Wales, Australia
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17
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Lowe J, Watkins WJ, Kotecha SJ, Kotecha S. Physical Activity and Sedentary Behavior in Preterm-Born 7-Year Old Children. PLoS One 2016; 11:e0155229. [PMID: 27168339 PMCID: PMC4864195 DOI: 10.1371/journal.pone.0155229] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2015] [Accepted: 04/26/2016] [Indexed: 11/19/2022] Open
Abstract
Background Previous studies of preterm-born children (<37 weeks’ gestation) have demonstrated decrements in lung function, exercise capacity, and increased respiratory symptoms compared to their term-born peers. However, it is unclear if these children have decreased levels of physical activity (PA) and increased sedentary behavior as a consequence of this increased respiratory morbidity. We therefore compared objectively measured PA in 7-year old preterm-born children with those born at term. Methods Children in the Millennium Cohort Study underwent assessment of PA at 7 years of age using accelerometry. 6422/12781 (50%) provided valid accelerometry and had gestational age data. A series of general linear models adjusted for confounders investigated the association between gestational age and levels of Total PA (average accelerometer counts per minute over the period of the recording), Moderate-to-Vigorous PA (MVPA) and sedentary behavior. Mediation analysis was performed to specifically investigate whether the observed association of gestational age on PA was mediated by respiratory symptoms. Results PA data were available for 79, 119, 275 and 5949 children born at 25–32, 33–34, 35–36 and 37–43 weeks’ gestation respectively. Boys born at ≤32 weeks’ gestation had modest but statistically significant reductions in MVPA when compared to term controls. This equated to a reduction of 9 minutes per day. No differences were found for Total PA or sedentary behavior. The association between gestational age and MVPA was not mediated by respiratory symptoms. In females, there was no association between gestational age and any measure of PA or sedentary behavior. Conclusions Boys born at ≤32 weeks’ gestation took part in less MVPA than their term-born peers at 7 years of age. The differences were modest, but equated to a reduction of over 1 hour per week. Since PA levels have been shown to decline during childhood and adolescence, this vulnerable group deserves further surveillance.
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Affiliation(s)
- John Lowe
- Department of Child Health, School of Medicine, Cardiff University, Cardiff, UK
| | - W. John Watkins
- Department of Child Health, School of Medicine, Cardiff University, Cardiff, UK
| | - Sarah J. Kotecha
- Department of Child Health, School of Medicine, Cardiff University, Cardiff, UK
| | - Sailesh Kotecha
- Department of Child Health, School of Medicine, Cardiff University, Cardiff, UK
- * E-mail:
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18
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Griffiths LJ, Sera F, Cortina-Borja M, Law C, Ness A, Dezateux C. Objectively measured physical activity and sedentary time: cross-sectional and prospective associations with adiposity in the Millennium Cohort Study. BMJ Open 2016; 6:e010366. [PMID: 27067891 PMCID: PMC4838720 DOI: 10.1136/bmjopen-2015-010366] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVE To examine whether physical activity (PA) and sedentary time (ST) in primary school-aged children are associated with adiposity at the start of secondary school, and whether these associations differ by sex or ethnic group. DESIGN Nationally representative prospective cohort study. SETTING Children born across the UK, between 2000 and 2002. PARTICIPANTS 6497 singleton children. OUTCOME MEASURES Measures of adiposity (body mass index (BMI), fat mass index (FMI) and fat free mass index (FFMI))--obtained at 7 and 11 years. EXPLANATORY MEASURES Total daily PA (mean counts per minute (cpm)); minutes of moderate-to-vigorous PA (MVPA); and ST. All assessed at 7 years using accelerometers. RESULTS In cross-sectional analyses, total PA was inversely associated with FMI (3.7% (95% CI 2.7% to 4.7%) reduction per 150 cpm increase), as was MVPA (4.2% (CI 3.2% to 5.2%) reduction per 20 min/day increase). Associations were stronger in black and South Asian ethnic groups. Total PA and MVPA were not associated with FFMI. ST was positively associated with FMI (1.3% (CI 0.2% to 2.3%) increase per 50 min/day increase) and inversely associated with FFMI (0.5% (CI 0.2% to 0.7%) reduction per 50 min/day increase). Longitudinally, MVPA at age 7 years remained inversely associated with FMI at age 11 years (1.5% (CI 0.4% to 2.6%) reduction per 20 min/day increase). No association was found between total PA and ST and any of the later adiposity measures. CONCLUSIONS 7-year-old children who are more physically active are less likely to be obese at that age and at age 11 years. These associations were particularly evident in children from black or South Asian ethnicity at age 7 years and in boys at age 11 years. Measurements of fat mass provide valuable insights into ethnic differences in associations between adiposity and activity.
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Affiliation(s)
- Lucy J Griffiths
- Life Course Epidemiology and Biostatistics, UCL Institute of Child Health, London, UK
| | - Francesco Sera
- Life Course Epidemiology and Biostatistics, UCL Institute of Child Health, London, UK
| | - Mario Cortina-Borja
- Clinical Epidemiology, Nutrition and Biostatistics, UCL Institute of Child Health, London, UK
| | - Catherine Law
- Life Course Epidemiology and Biostatistics, UCL Institute of Child Health, London, UK
| | - Andrew Ness
- Department of Oral and Dental Science, University of Bristol, Bristol, UK
| | - Carol Dezateux
- Life Course Epidemiology and Biostatistics, UCL Institute of Child Health, London, UK
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Cohen KE, Morgan PJ, Plotnikoff RC, Callister R, Lubans DR. Physical activity and skills intervention: SCORES cluster randomized controlled trial. Med Sci Sports Exerc 2015; 47:765-74. [PMID: 25051389 DOI: 10.1249/mss.0000000000000452] [Citation(s) in RCA: 83] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
PURPOSE Physical activity (PA) declines dramatically during adolescence, and activity levels are consistently lower among children living in low-income communities. Competency in a range of fundamental movement skills (FMS) may serve as a protective factor against the decline in PA typically observed during adolescence. The purpose of this study was to evaluate the effect of a 12-month multicomponent PA and FMS intervention on children attending primary schools in low-income communities. METHODS The Supporting Children's Outcomes using Rewards, Exercise, and Skills intervention was evaluated using a cluster randomized controlled trial. The sample included 25 classes from eight primary schools located in low-income communities. Participants were 460 children (54.1% girls) age 8.5 ± 0.6 yr. Primary outcomes were objectively measured PA (ActiGraph GT3X and GT3X+ accelerometers), FMS competency (Test of Gross Motor Development 2, six locomotor and six object control skills), and cardiorespiratory fitness (20-m multistage fitness test) assessed at baseline, midprogram (6-months), and at posttest (12 months). Linear mixed models, adjusted for sex, age, body mass index z-score, socioeconomic status, ethnicity, and school class as a random factor, were used to assess the effect of the intervention. RESULTS At midprogram, there were no significant intervention effects for any of the outcomes. At posttest (study's primary time point), there were intervention effects for daily moderate-to-vigorous PA (MVPA) (adjusted mean difference, 12.7 min·d of MVPA; 95% confidence interval (CI), 5.0-20.5), overall FMS competency (4.9 units; 95% CI, -0.04 to 9.8), and cardiorespiratory fitness (5.4 laps; 95% CI, 2.3-8.6). CONCLUSIONS A school-based multicomponent PA and FMS intervention maintained daily MVPA, improved overall FMS competency, and increased cardiorespiratory fitness among children attending primary schools in low-income communities.
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Affiliation(s)
- Kristen E Cohen
- 1Priority Research Centre in Physical Activity and Nutrition, School of Education, University of Newcastle, Callaghan Campus, New South Wales, AUSTRALIA; and 2Priority Research Centre in Physical Activity and Nutrition, School of Biomedical Sciences and Pharmacy, University of Newcastle, Callaghan Campus, New South Wales, AUSTRALIA
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Sutherland R, Campbell E, Lubans DR, Morgan PJ, Okely AD, Nathan N, Wolfenden L, Wiese J, Gillham K, Hollis J, Wiggers J. 'Physical Activity 4 Everyone' school-based intervention to prevent decline in adolescent physical activity levels: 12 month (mid-intervention) report on a cluster randomised trial. Br J Sports Med 2015; 50:488-95. [PMID: 26359346 PMCID: PMC4853531 DOI: 10.1136/bjsports-2014-094523] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/17/2015] [Indexed: 11/04/2022]
Abstract
BACKGROUND Adolescence is a recognised period of physical activity decline, particularly among low-income communities. We report the 12-month (midpoint) effects of a 2-year multicomponent physical activity intervention implemented in disadvantaged secondary schools. METHODS A cluster randomised trial was undertaken in 10 secondary schools located in disadvantaged areas in New South Wales, Australia. Students in Grade 7 were recruited, with follow-up in Grade 8. The intervention was guided by socioecological theory and included seven physical activity strategies, and six implementation adoption strategies. The primary outcome was mean minutes of moderate-to-vigorous physical activity (MVPA) per day assessed using Actigraph GT3X accelerometers. Outcome data were analysed using repeated measures linear mixed models. RESULTS At baseline, 1150 (93%) students participated in the data collection (mean age 12 years, 48% boys) and 1050 (79%) students participated at 12-month follow-up. By the 12-month follow-up, the six implementation adoption strategies had been used to support schools to deliver four of the seven physical activity elements. There was a significant group-by-time interaction for mean minutes of MVPA per day in favour of the intervention group (adjusted difference between groups at follow-up=3.85 min, 95% CI (0.79 to 6.91), p ≤ 0.01), including significantly more vigorous physical activity (2.45 min, p ≤ 0.01), equating to 27 min more MVPA per week. SUMMARY At 12-month follow-up, the intervention had reduced the decline in physical activity among adolescents from disadvantaged schools. The intervention may assist students to meet physical activity guidelines.
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Affiliation(s)
- Rachel Sutherland
- Hunter New England Population Health, Wallsend, New South Wales, Australia School of Medicine and Public Health, University of Newcastle, New South Wales, Australia Hunter Medical Research Institute, Newcastle, New South Wales, Australia
| | - Elizabeth Campbell
- Hunter New England Population Health, Wallsend, New South Wales, Australia School of Medicine and Public Health, University of Newcastle, New South Wales, Australia Hunter Medical Research Institute, Newcastle, New South Wales, Australia
| | - David R Lubans
- Priority Research Centre in Physical Activity and Nutrition, School of Education, University of Newcastle, Newcastle, New South Wales, Australia
| | - Philip J Morgan
- Priority Research Centre in Physical Activity and Nutrition, School of Education, University of Newcastle, Newcastle, New South Wales, Australia
| | - Anthony D Okely
- Early Start Research Institute and School of Education, University of Wollongong, Wollongong, New South Wales, Australia Illawarra Health and Medical Research Institute, Wollongong, New South Wales, Australia
| | - Nicole Nathan
- Hunter New England Population Health, Wallsend, New South Wales, Australia School of Medicine and Public Health, University of Newcastle, New South Wales, Australia Hunter Medical Research Institute, Newcastle, New South Wales, Australia
| | - Luke Wolfenden
- Hunter New England Population Health, Wallsend, New South Wales, Australia School of Medicine and Public Health, University of Newcastle, New South Wales, Australia Hunter Medical Research Institute, Newcastle, New South Wales, Australia
| | - Jarrod Wiese
- Hunter New England Population Health, Wallsend, New South Wales, Australia School of Medicine and Public Health, University of Newcastle, New South Wales, Australia
| | - Karen Gillham
- Hunter New England Population Health, Wallsend, New South Wales, Australia Hunter Medical Research Institute, Newcastle, New South Wales, Australia
| | - Jenna Hollis
- Rowett Institute of Nutrition and Health, University of Aberdeen, Scotland, UK
| | - John Wiggers
- Hunter New England Population Health, Wallsend, New South Wales, Australia School of Medicine and Public Health, University of Newcastle, New South Wales, Australia Hunter Medical Research Institute, Newcastle, New South Wales, Australia
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Geraci M, Farcomeni A. Probabilistic principal component analysis to identify profiles of physical activity behaviours in the presence of non-ignorable missing data. J R Stat Soc Ser C Appl Stat 2015. [DOI: 10.1111/rssc.12105] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Cohen KE, Morgan PJ, Plotnikoff RC, Barnett LM, Lubans DR. Improvements in fundamental movement skill competency mediate the effect of the SCORES intervention on physical activity and cardiorespiratory fitness in children. J Sports Sci 2015; 33:1908-18. [PMID: 25716899 DOI: 10.1080/02640414.2015.1017734] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Numerous studies have identified a positive association between fundamental movement skill (FMS) competency and physical activity in children; however, the causal pathways have not been established. The aim of this study is to determine if changes in FMS competency mediated the effect of the Supporting Children's Outcomes using Rewards, Exercise and Skills (SCORES) intervention on physical activity and cardiorespiratory fitness in children. Eight primary schools (25 classes) and 460 children (aged 8.5 ± 0.6, 54% girls) were randomised to the SCORES intervention or control group for the 12-month study. The outcomes were accelerometer-determined moderate-to-vigorous physical activity (MVPA) and cardiorespiratory fitness. The hypothesised mediators were actual FMS competency and perceived sport competence. Mediation analyses were conducted using multilevel linear analysis in MPlus. From the original sample, 138 (30.0%) and 370 (80.4%) children provided useable physical activity and cardiorespiratory fitness data at post-test assessments. There were significant treatment effects for locomotor skills and overall FMSs. Changes in MVPA were associated with changes in object-control skills, overall FMSs and perceived competence. The overall FMSs had a significant mediating effect on MVPA (AB = 2.09, CI = 0.01-4.55). Overall FMSs (AB = 1.19, CI = 0.002-2.79) and locomotor skills (AB = 0.74, CI = 0.01-1.69) had a significant mediating effect on cardiorespiratory fitness. The results of this study conclude that actual but not perceived movement skill competency mediated the effect of the SCORES intervention on physical activity and cardiorespiratory fitness.
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Affiliation(s)
- Kristen E Cohen
- a Priority Research Centre in Physical Activity and Nutrition, School of Education, Faculty of Education and Arts , University of Newcastle , Australia
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Wickel EE. Reporting the reliability of accelerometer data with and without missing values. PLoS One 2014; 9:e114402. [PMID: 25478692 PMCID: PMC4257690 DOI: 10.1371/journal.pone.0114402] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2014] [Accepted: 11/06/2014] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVES Participants with complete accelerometer data often represent a low proportion of the total sample and, in some cases, may be distinguishable from participants with incomplete data. Because traditional reliability methods characterize the consistency of complete data, little is known about reliability properties for an entire sample. This study employed Generalizability theory to report an index of reliability characterizing complete (7 days) and observable (1 to 7 days) accelerometer data. DESIGN Cross-sectional. METHODS Accelerometer data from the Study of Early Child Care and Youth Development were analyzed in this study. Missing value analyses were conducted to describe the pattern and mechanism of missing data. Generalizability coefficients were derived from variance components to report reliability parameters for complete data and also for the entire observable sample. Analyses were conducted separately by age (9, 11, 12, and 15 yrs) and daily wear time criteria (6, 8, 10, and 12 hrs). RESULTS Participants with complete data were limited (<34%) and, most often, data were not considered to be missing completely at random. Across conditions, reliability coefficients for complete data were between 0.74 and 0.87. Relatively lower reliability properties were found across all observable data, ranging from 0.52 to 0.67. Sample variability increased with longer wear time criteria, but decreased with advanced age. CONCLUSIONS A reliability coefficient that includes all participants, not just those with complete data, provides a global perspective of reliability that could be used to further understand group level associations between activity and health outcomes.
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Affiliation(s)
- Eric E. Wickel
- Exercise and Sports Science, University of Tulsa, Tulsa, OK, United States of America
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Wells SL, Kipping RR, Jago R, Brown J, Hucker D, Blackett A, Lawlor DA. Characteristics associated with requested and required accelerometer wear in children. BMJ Open 2013; 3:e003402. [PMID: 23975106 PMCID: PMC3753482 DOI: 10.1136/bmjopen-2013-003402] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVE To investigate characteristics associated with wearing an accelerometer for the required and requested time among 8-year-old to 10-year-old children. DESIGN Cross-sectional. SETTING 60 Bristol and North Somerset primary schools taking part in the 'Active for Life Year 5' randomised controlled trial (RCT) in 2011. PARTICIPANTS 2048 children, aged 8-10 years, invited to wear an accelerometer for 5 days of recording. PRIMARY OUTCOME MEASURE Numbers meeting required wear-time for inclusion in main RCT analysis (≥8 h/day ≥3 days) and numbers meeting requested wear-time (≥8 h/day for all 5 days). RESULTS 817 (40%) of the children wore the accelerometer for the requested time and 1629 (80%) for the required time. In adjusted multivariable analyses the odds of wearing the accelerometer for the required time were greater in females as compared with males (OR 1.76 (1.42-2.18)), those with higher scores for reporting their mother restricted time on sedentary behaviours (1.26 (1.04-1.52) per increase of 1 on a 1-4 scale) and in children from schools with larger year group sizes (1.01 (1.00-1.02) per additional child). Living in a neighbourhood with higher levels of deprivation (0.49 (0.33-0.72) comparing highest to lowest third of the deprivation score) or reporting higher levels of weekday outdoor play (0.97 (0.94, 1.00) per 30 min more) were associated with reduced odds of meeting required time. Results were essentially the same for requested wear-time. Other characteristics, including child body mass index, were not associated with required or requested wear-time. CONCLUSIONS Only 40% of children wore the accelerometer for the requested time but 80% fulfilled the required criteria to be included in the main study analyses. Knowing which characteristics are associated with accelerometer wear could help target interventions to increase wear-time.
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Affiliation(s)
- Sian L Wells
- School of Social & Community Medicine, University of Bristol, Bristol, UK
| | - Ruth R Kipping
- School of Social & Community Medicine, University of Bristol, Bristol, UK
| | - Russell Jago
- Centre for Exercise, Nutrition & Health, School for Policy Studies, University of Bristol, Bristol, UK
| | - Judith Brown
- School of Social & Community Medicine, University of Bristol, Bristol, UK
| | - Daniel Hucker
- School of Social & Community Medicine, University of Bristol, Bristol, UK
| | - Ali Blackett
- School of Social & Community Medicine, University of Bristol, Bristol, UK
| | - Debbie A Lawlor
- School of Social & Community Medicine, University of Bristol, Bristol, UK
- MRC Centre for Causal Analyses in Translational Epidemiology, University of Bristol, Bristol, UK
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Griffiths LJ, Cortina-Borja M, Sera F, Pouliou T, Geraci M, Rich C, Cole TJ, Law C, Joshi H, Ness AR, Jebb SA, Dezateux C. How active are our children? Findings from the Millennium Cohort Study. BMJ Open 2013; 3:e002893. [PMID: 23965931 PMCID: PMC3752053 DOI: 10.1136/bmjopen-2013-002893] [Citation(s) in RCA: 138] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE To describe levels of physical activity, sedentary time and adherence to Chief Medical Officers (CMO) physical activity guidelines among primary school-aged children across the UK using objective accelerometer-based measurements. DESIGN Nationally representative prospective cohort study. SETTING Children born across the UK, between 2000 and 2002. PARTICIPANTS 6497 7-year-old to 8-year-old singleton children for whom reliable accelerometer data were available for at least 10 h a day for at least 2 days. MAIN OUTCOME MEASURES Physical activity in counts per minute (cpm); time spent in sedentary and moderate-to-vigorous intensity physical activity (MVPA); proportion of children meeting CMO guidelines (≥60 min/day MVPA); average daily steps. EXPLANATORY MEASURES Gender, ethnicity, maternal current/most recent occupation, lone parenthood status, number of children in the household and country/region of residence. RESULTS The median daily physical activity level was 595 cpm (IQR 507, 697). Children spent a median of 60 min (IQR 47-76) in MVPA/day and were sedentary for a median of 6.4 h/day (IQR 6-7). Only 51% met CMO guidelines, with girls (38%) less active than boys (63%). Children took an average of 10 229 (95% CI (8777 to 11 775)) steps each day. Children of Indian ethnicity were significantly less active overall than all other ethnic groups. Children of Bangladeshi origin and those living in Northern Ireland were least likely to meet CMO guidelines. CONCLUSIONS Only half of 7-year-old children in the UK achieve recommended levels of physical activity, with significant gender, ethnic and geographic variations. Longitudinal studies are needed to better understand the relevance of these (in)activity patterns for long-term health and well-being. In the meantime population-wide efforts to boost physical activity among young people are needed which are likely to require a broad range of policy interventions.
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Affiliation(s)
- Lucy J Griffiths
- MRC Centre of Epidemiology for Child Health, UCL Institute of Child Health, London, UK
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