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Robinson T, Dhamrait G, Murray K, Boruff B, Duncan J, Schipperijn J, Christian H. Association between preschooler outdoor play and home yard vegetation as measured by high resolution imagery: Findings from the PLAYCE study. Health Place 2024; 85:103178. [PMID: 38262260 DOI: 10.1016/j.healthplace.2024.103178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Revised: 12/08/2023] [Accepted: 01/15/2024] [Indexed: 01/25/2024]
Abstract
Outdoor play in the home yard is an important source of physical activity for many preschoolers. This study investigated if home yard size and vegetation are related to preschooler outdoor play time. High-resolution remotely sensed data were used to distinguish between types of vegetation coverage in the home yard. Shrub and tree cover, and yard size, were positively associated with outdoor play. Following stratification by socio-economic status (SES - parent education), only tree cover was positively associated with preschooler outdoor play in low SES households. All types of vegetation cover were positively associated with preschooler outdoor play in higher SES households. This study highlights the importance of larger yard sizes and higher levels of vegetation for facilitating outdoor play in preschoolers.
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Affiliation(s)
- Trina Robinson
- Telethon Kids Institute, The University of Western Australia, Northern Entrance, Perth Children's Hospital, 15 Hospital Ave, Nedlands, Western Australia, 6009, Australia.
| | - Gursimran Dhamrait
- Telethon Kids Institute, The University of Western Australia, Northern Entrance, Perth Children's Hospital, 15 Hospital Ave, Nedlands, Western Australia, 6009, Australia; School of Population and Global Health, The University of Western Australia, Clifton St Building, Clifton St, Nedlands, Western Australia, 6009, Australia.
| | - Kevin Murray
- School of Population and Global Health, The University of Western Australia, Clifton St Building, Clifton St, Nedlands, Western Australia, 6009, Australia.
| | - Bryan Boruff
- School of Agriculture and Environment, The University of Western Australia, Crawley, Western Australia, 6009, Australia.
| | - John Duncan
- School of Agriculture and Environment, The University of Western Australia, Crawley, Western Australia, 6009, Australia.
| | - Jasper Schipperijn
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, 5230, Odense, Denmark.
| | - Hayley Christian
- Telethon Kids Institute, The University of Western Australia, Northern Entrance, Perth Children's Hospital, 15 Hospital Ave, Nedlands, Western Australia, 6009, Australia; School of Population and Global Health, The University of Western Australia, Clifton St Building, Clifton St, Nedlands, Western Australia, 6009, Australia.
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Vanderloo LM, Saravanamuttoo K, Bourke M, Zhong S, Szpunar M, Gilliland J, Burke SM, Irwin JD, Truelove S, Tucker P. Parents' attitudes regarding their children's play during COVID-19: Impact of socioeconomic status and urbanicity. SSM Popul Health 2023; 24:101549. [PMID: 38021457 PMCID: PMC10661847 DOI: 10.1016/j.ssmph.2023.101549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Revised: 10/17/2023] [Accepted: 10/27/2023] [Indexed: 12/01/2023] Open
Abstract
Objectives The COVID-19 pandemic has had a profound impact on the daily routines of parents and children. This study explored the influence of socioeconomic status (SES) and urbanicity on parents' attitudes toward their children's active play opportunities 6 months and 1.5 years into COVID-19. Methods A sample of 239 Ontario parents of children aged 12 and younger completed two online surveys (August-December 2020; 2021) to assess parents' intentions, beliefs, and comforts concerning their child's eventual return to play, in addition to various sociodemographic and physical activity variables. Descriptive analyses were run as well as an exploratory factor analysis (EFA) was conducted to group the 14 attitude items into subscales for analysis, to ensure reliability and validity of attitude measures. Results In general, parents in communities with more urban features (e.g., densely populated areas), single-parents, full-time employed parents, and parents with lower-incomes were more hesitant to return their children to active play during the pandemic. Conclusion Findings from this work highlight SES and urbanicity disparities that continue to exist during COVID-19.
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Affiliation(s)
- Leigh M. Vanderloo
- School of Occupational Therapy, Faculty of Health Sciences, University of Western Ontario, Elborn College, 1201 Western Road, Room 2547, London, ON, N6G 1H1, Canada
- ParticipACTION, 77 Bloor Street West, Suite 1205, Toronto, ON, M5S 1M2, Canada
| | - Kendall Saravanamuttoo
- Health and Rehabilitation Sciences Program, Faculty of Health Sciences, University of Western Ontario, London, ON, N6A 5B9, Canada
| | - Matthew Bourke
- School of Occupational Therapy, Faculty of Health Sciences, University of Western Ontario, Elborn College, 1201 Western Road, Room 2547, London, ON, N6G 1H1, Canada
| | - Shiran Zhong
- Department of Geography and Environment, University of Western Ontario, London, ON, N6G 1H1, Canada
| | - Monika Szpunar
- Health and Rehabilitation Sciences Program, Faculty of Health Sciences, University of Western Ontario, London, ON, N6A 5B9, Canada
| | - Jason Gilliland
- Department of Geography and Environment, University of Western Ontario, London, ON, N6G 1H1, Canada
- School of Health Studies, Faculty of Health Sciences, University of Western Ontario, London, ON N6G 1H1, Canada
- Children's Health Research Institute, Lawson Health Research Institute, London, ON, N6C 2R5, Canada
- Department of Pediatrics, University of Western Ontario, London, ON, N6G 1H1, Canada
- Department of Epidemiology & Biostatistics, University of Western Ontario, London, ON, N6G 1H1, Canada
| | - Shauna M. Burke
- School of Health Studies, Faculty of Health Sciences, University of Western Ontario, London, ON N6G 1H1, Canada
- Children's Health Research Institute, Lawson Health Research Institute, London, ON, N6C 2R5, Canada
| | - Jennifer D. Irwin
- School of Health Studies, Faculty of Health Sciences, University of Western Ontario, London, ON N6G 1H1, Canada
| | - Stephanie Truelove
- Member Interest Groups Section, Professional Development and Practice Support, College of Family Physicians of Canada, Mississauga, ON, L4W 5A4, Canada
| | - Patricia Tucker
- School of Occupational Therapy, Faculty of Health Sciences, University of Western Ontario, Elborn College, 1201 Western Road, Room 2547, London, ON, N6G 1H1, Canada
- Children's Health Research Institute, Lawson Health Research Institute, London, ON, N6C 2R5, Canada
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Goncalves WSF, Byrne R, de Lira PIC, Viana MT, Trost SG. Parental Influences on Physical Activity and Screen Time among Preschool Children from Low-Income Families in Brazil. Child Obes 2023; 19:112-120. [PMID: 35653741 DOI: 10.1089/chi.2021.0305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Background: Children from low-middle income countries (LMIC) are disproportionately affected by obesity, and low physical activity (PA) and high screen time (ST) are major contributors. Parents are key influencers on children's PA and ST, yet, no study has investigated relationships between parenting practices and children's PA and ST in LMIC families. This study examined parental influences on PA and ST among preschool-aged children from low-income families in Brazil. Methods: Parents completed a validated, culturally adapted interviewer-administered survey assessing child ST and parenting practices. Child sedentary time, total movement, and energetic play were measured by accelerometery. Results: Data were available on 77 parent-child dyads [mean age 4.6 years (standard deviation = 0.8), 53% male, and 41% mixed-race]. Parenting practices associated with greater PA were use of PA to reward/control behavior (rho = 0.34-0.49), limiting or monitoring ST (rho = 0.30), explicit modeling/enjoyment of PA (rho = 0.24), verbal encouragement for PA (rho = 0.30), and importance and value of PA (rho = 0.24-0.38; p < 0.05). Parenting practices associated with higher ST were rules around active play indoor (rho = 0.23), use of ST to reward/control behavior (rho = 0.30), exposure to screens (rho = 0.40), and explicit modeling/enjoyment of ST (rho = 0.50; p < 0.05). Conclusion: Recognized parenting practices such as explicit modeling of PA and ST, monitoring and limiting ST, and rules and restrictions about PA and ST are associated with young children's PA and ST in low-income Brazilian families. The findings identify potential targets for family-based interventions to promote healthy lifestyle behaviors and prevent childhood obesity.
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Affiliation(s)
| | - Rebecca Byrne
- School of Exercise and Nutrition Sciences, Faculty of Health, Queensland University of Technology, Brisbane, Queensland, Australia
| | | | | | - Stewart G Trost
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Queensland, Australia
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Larouche R, Kleinfeld M, Charles Rodriguez U, Hatten C, Hecker V, Scott DR, Brown LM, Onyeso OK, Sadia F, Shimamura H. Determinants of Outdoor Time in Children and Youth: A Systematic Review of Longitudinal and Intervention Studies. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1328. [PMID: 36674085 PMCID: PMC9859594 DOI: 10.3390/ijerph20021328] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Revised: 01/08/2023] [Accepted: 01/09/2023] [Indexed: 06/17/2023]
Abstract
Spending more time outdoors can improve children's social and cognitive development, physical activity, and vision. Our systematic review summarized the determinants of outdoor time (OT) based on the social-ecological model. We searched nine databases: MEDLINE, APA PsycINFO, Web of Science, Cochrane Central Register of Controlled Trials (CENTRAL), CINAHL, SPORTDiscus, ERIC, SocINDEX, and ProQuest Dissertations and Theses. To be included, studies needed to be quantitative and longitudinal, include ≥1 potential determinant of OT among 0- to 17-year-olds, and be published in English, French, Japanese, or Spanish. We extracted the authors, publication year, country, design, sample size, OT measures, follow-up period, potential determinants, main results, and potential moderators or mediators. Fifty-five studies examining 119 potential determinants met the inclusion criteria. OT was consistently higher in warmer seasons and among participants reporting more OT at baseline. All three interventions that included both parent sessions and additional resources to promote OT (e.g., specific advice and community guides) were effective. COVID-19 restrictions and sun safety interventions discouraging midday outdoor activities led to less OT. The quality of evidence was rated as weak for 46 studies. Most potential determinants were examined in ≤3 studies; thus, more longitudinal studies are needed to enable stronger conclusions about the consistency of evidence and meta-analyses.
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Affiliation(s)
- Richard Larouche
- Faculty of Health Sciences, University of Lethbridge, Lethbridge, AB T1K 3M4, Canada
| | - Madeline Kleinfeld
- Faculty of Health Sciences, University of Lethbridge, Lethbridge, AB T1K 3M4, Canada
| | | | - Cheryl Hatten
- School of Human Services, Lethbridge College, Lethbridge, AB T1K 1L6, Canada
| | - Victoria Hecker
- Faculty of Health Sciences, University of Lethbridge, Lethbridge, AB T1K 3M4, Canada
| | - David R. Scott
- Library, University of Lethbridge, Lethbridge, AB T1K 3M4, Canada
| | - Leanna Marie Brown
- Faculty of Health Sciences, University of Lethbridge, Lethbridge, AB T1K 3M4, Canada
| | - Ogochukwu K. Onyeso
- Faculty of Health Sciences, University of Lethbridge, Lethbridge, AB T1K 3M4, Canada
| | - Farzana Sadia
- Faculty of Health Sciences, University of Lethbridge, Lethbridge, AB T1K 3M4, Canada
| | - Hanako Shimamura
- Faculty of Applied Community Studies, Douglas College, Coquitlam, BC V3B 7X3, Canada
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Adebusoye B, Chattopadhyay K, Ekezie W, Phalkey R, Leonardi-Bee J. Association of built environment constructs and physical activity among children and adolescents in Africa: a systematic review and meta-analysis. JBI Evid Synth 2022; 20:2410-2444. [PMID: 36081385 DOI: 10.11124/jbies-21-00295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
OBJECTIVE The objective of this review was to synthesize the association between built environment constructs and physical activity among children and adolescents in Africa. INTRODUCTION Previous reviews have found that several built environment constructs, such as residential density, crime safety, and availability of physical activity facilities and infrastructure, are associated with physical activity in children and adolescents; however, these reviews have tended to focus on non-African countries. Therefore, this systematic review synthesized the association between the built environment and physical activity among children and adolescents in Africa. INCLUSION CRITERIA This systematic review included comparative observational studies that assessed the relationship between built environmental constructs and physical activity among children and adolescents (between the ages of 5 and 19 years) in Africa. METHODS Comprehensive electronic searches of MEDLINE, Embase, CINAHL, Web of Science, PsycINFO, Scopus, SPORTDiscus, EThOS, and ProQuest Dissertations and Theses from inception to October 22, 2021, were conducted to identify relevant published and unpublished studies. Two reviewers independently screened papers, assessed the quality of the included studies using the JBI standard critical appraisal tool, and extracted data using a pre-piloted form. Where possible, data were synthesized using random effects meta-analyses, with effect sizes reported as mean differences (MDs) with 95% confidence intervals (CIs). The Grading of Recommendations Assessment, Development and Evaluations (GRADE) was used to assess the certainty of the findings. RESULTS Of the 10,706 identified records, six cross-sectional studies were included, which comprised 4628 children and adolescents. Three of the studies had a high-quality score of 7 or 8 out of 8. Seven built environment constructs were reported within the included studies, namely, residential density, street connectivity, crime safety, availability of physical activity facilities and infrastructure, walkability, esthetics, and traffic safety. Three of the constructs were assessed with objective measures. Results from individual studies found significant associations between physical activity and objective measure of traffic safety (MD 2.63 minutes per day; 95% CI 0.16 to 5.1; one study) and an objective measure of crime safety (MD 2.72 minutes per day; 95% CI 0.07 to 5.37; one study). No significant associations were found between active transportation and any of the built environment constructs. The GRADE evidence for all of the assessed constructs was either low (the built environment constructs may lead to little or no difference in physical activity or active transportation) or very low (it was uncertain whether the built environment constructs affect physical activity). CONCLUSION In African settings, the evidence base for the association between built environment constructs and physical activity is limited, with no consistent evidence of an association. Therefore, further high-quality studies should be conducted before firm conclusions can be drawn. SYSTEMATIC REVIEW REGISTRATION NUMBER PROSPERO CRD42019133324.
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Affiliation(s)
- Busola Adebusoye
- Division of Epidemiology and Public Health, School of Medicine, The University of Nottingham, Nottingham, UK
| | - Kaushik Chattopadhyay
- Division of Epidemiology and Public Health, School of Medicine, The University of Nottingham, Nottingham, UK.,The Nottingham Centre for Evidence-Based Healthcare: A JBI Centre of Excellence, The University of Nottingham, Nottingham, UK
| | - Winifred Ekezie
- Diabetes Research Centre, University of Leicester, Leicester, UK
| | - Revati Phalkey
- Climate Change and Health Unit, UK Health Security Agency, Oxford, UK
| | - Jo Leonardi-Bee
- Division of Epidemiology and Public Health, School of Medicine, The University of Nottingham, Nottingham, UK.,The Nottingham Centre for Evidence-Based Healthcare: A JBI Centre of Excellence, The University of Nottingham, Nottingham, UK
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Wu SY, Wang JH, Chiu CJ. Assessment of Satisfaction, Compliance and Side Effects among Long-Term Orthokeratology Wearers. J Clin Med 2022; 11:4126. [PMID: 35887890 PMCID: PMC9321806 DOI: 10.3390/jcm11144126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Revised: 07/12/2022] [Accepted: 07/14/2022] [Indexed: 02/04/2023] Open
Abstract
Purpose: This study aims to assess the satisfaction, compliance, and side effects among the long-term orthokeratology (Ortho-K) users in a tertiary hospital in Taiwan and analyze the side effects and related risk factors. Methods: Children and their guardians were assessed using a structured and validated questionnaire inquiring about background information, wear and care behaviors, daily activities, satisfaction, and related concerns. Clinical information, including refractive data and side effects, was obtained through patient medical files. Results: Three hundred and five school-aged patients were enrolled, and the average age was 13.13 ± 3.39 years, with an average wearing period of 17.1 ± 8.1 months. Over 83% of the subjects had clear daytime vision all day, around 88% felt satisfied or very satisfied with the results, and 98% exhibited a willingness to continue wearing the Ortho-K lenses. Most guardians (83%) were pleased with the controlling effect of myopic progression. Initial spherical equivalent and regular cleaning of the lens protein significantly correlated with clear day vision. Wearing >6 days/week correlated with less risk of lens binding. Based on the questionnaire, the main reasons for using Ortho-K were effectiveness, safety, and practicality, while the major concerns were discomfort, harmful to the eyes, and no effect. Conclusion: With a comprehensive care program from practitioners and good compliance of users, Ortho-K could be the most effective and satisfactory option for myopic children in Taiwan.
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Affiliation(s)
- Shang-Yen Wu
- Department of Ophthalmology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien 970, Taiwan;
| | - Jen-Hung Wang
- Department of Medical Research, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien 970, Taiwan;
| | - Cheng-Jen Chiu
- Department of Ophthalmology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien 970, Taiwan;
- Department of Ophthalmology and Visual Science, Tzu Chi University, Hualien 970, Taiwan
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Mukazhanova A, Aldasheva N, Iskakbayeva J, Bakhytbek R, Ualiyeva A, Baigonova K, Ongarbaeva D, Vinnikov D. Prevalence of refractive errors and risk factors for myopia among schoolchildren of Almaty, Kazakhstan: A cross-sectional study. PLoS One 2022; 17:e0269474. [PMID: 35657822 PMCID: PMC9165805 DOI: 10.1371/journal.pone.0269474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Accepted: 05/20/2022] [Indexed: 12/02/2022] Open
Abstract
Introduction Very little is known about the prevalence of refractive errors among children in Kazakhstan. The aim of this study was to investigate the prevalence of refractive errors and risk factors of myopia among schoolchildren in Almaty, Kazakhstan. Methods In the cross-sectional study of 2293 secondary school students (age 6–16), we examined cycloplegic autorefraction and offered a questionnaire in three age groups: 1st grade (N = 769), 5th grade (N = 768) and 9th grade (N = 756). The questionnaire covered main risk factors such as parental myopia, screen time, time outdoors, sports activities, near work, gender, grade, and school shift. Adjusted logistic regression analysis was applied to test the association of risk factors with myopia. Results The mean spherical equivalent (SER) was -0.54 ± 1.51 diopters (D). The overall prevalence of refractive errors was 31.6% (95% confidence interval (CI) 29.7; 33.5); myopia 28.3% (95% CI 26.5; 30.1); hyperopia 3.4% (95% CI 2.7–4.1) and astigmatism 2.8% (95% CI 2.1; 3.5). In the multivariate adjusted regression analysis, higher class level (5th grade (odds ratio (OR) 1.78; 95% CI 1.26; 2.52) and 9th grade (OR 3.34; 95% CI 2.31; 4.82)) were associated with myopia, whereas outdoors activity more than 2 hours a day (OR 0.64; 95% CI 0.46; 0.89) and sports (OR 0.70; 95% CI 0.52; 0.93) were associated with a lower incidence of myopia. Conclusions Myopia is a leading refractive error in schoolchildren in Almaty, Kazakhstan. Myopia prevention measures, including more time outdoors, should guide public health interventions in this population.
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Affiliation(s)
- Ainagul Mukazhanova
- Kazakh Eye Research Institute, Almaty, Kazakhstan
- Faculty of Medicine and Health Care, Al-Farabi Kazakh National University, Almaty, Kazakhstan
| | | | | | | | - Aliya Ualiyeva
- Faculty of Medicine and Health Care, Al-Farabi Kazakh National University, Almaty, Kazakhstan
| | - Kaini Baigonova
- Faculty of Medicine and Health Care, Al-Farabi Kazakh National University, Almaty, Kazakhstan
| | - Damet Ongarbaeva
- Faculty of Medicine and Health Care, Al-Farabi Kazakh National University, Almaty, Kazakhstan
| | - Denis Vinnikov
- Faculty of Medicine and Health Care, Al-Farabi Kazakh National University, Almaty, Kazakhstan
- Peoples’ Friendship University of Russia (RUDN University), Moscow, Russian Federation
- * E-mail:
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Kwon S, Tandon PS, O'Neill ME, Becker AB. Cross-sectional association of light sensor-measured time outdoors with physical activity and gross motor competency among U.S. preschool-aged children: the 2012 NHANES National Youth Fitness Survey. BMC Public Health 2022; 22:833. [PMID: 35473506 PMCID: PMC9040315 DOI: 10.1186/s12889-022-13239-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Accepted: 04/12/2022] [Indexed: 11/17/2022] Open
Abstract
Background Time spent outdoors (outdoor time) has been suggested to be beneficial for physical activity (PA) and healthy development among preschool-aged children. The aim of this study was to quantify PA level and gross motor competency associated with light sensor-measured daily outdoor time in a representative sample of U.S. children aged 3 to 5 years. Methods The study sample included 301 participants (149 girls) aged 3 to 5 years from the 2012 U.S. National Health and Examination Survey National Youth Fitness Survey. ActiGraph GT3X+ accelerometers with a built-in ambient light sensor were used to measure PA (expressed in monitor-independent movement summary [MIMS]) and outdoor time. The Test of Gross Motor Development-Second Edition (TGMD-2) was used to assess gross motor skills. Multivariable linear regression models were fit to predict daily and gross motor scores by daily outdoor time. Results Average daily outdoor time was 95 min (median of 84 min; interquartile range of 52 to 123 min). Means of daily outdoor time and daily MIMS were not significantly different between boys and girls. Among girls, every additional 10 min of daily outdoor time was associated with an additional 540 daily total MIMS (95% CI = 372, 708). Among boys, every additional 10 min of daily outdoor time was associated with an additional 296 daily total MIMS (95% CI = 131, 460). Every additional 10 min of daily outdoor time was associated with a 0.1-point (95% CI = 0.001, 0.130) higher object control standard score. Daily outdoor time was not associated with a locomotor standard score. Conclusions In a representative sample of U.S. preschool-aged children, daily outdoor time was positively associated with daily PA. The contribution of outdoor time to PA was greater among girls than boys, suggesting that providing outdoor opportunities is critical for promoting PA, particularly among girls. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-13239-0.
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Affiliation(s)
- Soyang Kwon
- Ann & Robert H. Lurie Children's Hospital of Chicago, 225 E Chicago Ave. Box 157, Chicago, IL, 60611, USA.
| | - Pooja S Tandon
- University of Washington & Seattle Children's Hospital, PO Box 5371, M/S CURE-3, Seattle, WA, 98145, USA
| | - Meghan E O'Neill
- Ann & Robert H. Lurie Children's Hospital of Chicago, 225 E Chicago Ave. Box 157, Chicago, IL, 60611, USA
| | - Adam B Becker
- Ann & Robert H. Lurie Children's Hospital of Chicago, 225 E Chicago Ave. Box 157, Chicago, IL, 60611, USA
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Oliver BE, Nesbit RJ, McCloy R, Harvey K, Dodd HF. Parent perceived barriers and facilitators of children's adventurous play in Britain: a framework analysis. BMC Public Health 2022; 22:636. [PMID: 35365107 PMCID: PMC8976306 DOI: 10.1186/s12889-022-13019-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Accepted: 03/17/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND From a public health perspective there is growing interest in children's play, including play involving risk and adventure, in relation to children's physical and mental health. Regarding mental health, it is theorised that adventurous play, where children experience thrilling, exciting emotions, offers important learning opportunities that prepare children for dealing with uncertainty and help prevent anxiety. Despite these benefits, adventurous play has decreased substantially within a generation. Parents have a key role in facilitating or limiting children's opportunities for adventurous play, but research identifying the barriers and facilitators parents perceive in relation to adventurous play is scarce. The present study therefore examined the barriers to and facilitators of adventurous play as perceived by parents of school-aged children in Britain. METHODS This study analysed data from a subsample of parents in Britain (n = 377) who participated in the nationally representative British Children's Play Survey. Parents responded to two open-ended questions pertaining to the barriers to and facilitators of children's adventurous play. Responses were analysed using a qualitative Framework Analysis, an approach suitable for managing large datasets with specific research questions. RESULTS Four framework categories were identified: Social Environment; Physical Environment; Risk of Injury; Child Factors. Social Environment included barriers and facilitators related to parents, family and peers, as well as community and society. Dominant themes within the Social Environment related to perceptions about the certainty of child safety, such as supervision and the safety of society. Beliefs about the benefits of adventurous play for development and well-being were also important in the Social Environment. Physical Environment factors focused on safety and practical issues. Risk of Injury captured concerns about children being injured during play. Child Factors included child attributes, such as play preference, developmental ability and trait-like characteristics. CONCLUSIONS Improved understanding of what influences parent perceptions of adventurous play can inform public health interventions designed to improve children's opportunities for and engagement in adventurous play, with a view to promote children's physical and mental health.
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Affiliation(s)
- Brooke E Oliver
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, UK
| | - Rachel J Nesbit
- Children and Young People's Mental Health (ChYMe), College of Medicine and Health, University of Exeter, Exeter, UK
| | - Rachel McCloy
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, UK
| | - Kate Harvey
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, UK
| | - Helen F Dodd
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, UK. .,Children and Young People's Mental Health (ChYMe), College of Medicine and Health, University of Exeter, Exeter, UK.
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10
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Almagor J, Martin A, McCrorie P, Mitchell R. How can an agent-based model explore the impact of interventions on children's physical activity in an urban environment? Health Place 2021; 72:102688. [PMID: 34628149 PMCID: PMC8633766 DOI: 10.1016/j.healthplace.2021.102688] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 09/23/2021] [Accepted: 09/28/2021] [Indexed: 12/28/2022]
Abstract
Insufficient physical activity (PA) among most children and adolescents is a global problem that is undermining the realisation of numerous developmental and health benefits. The aim of this study was to explore the potential impact of interventions on PA by using an agent-based model (ABM) simulating children's daily activities in an urban environment. Three domains for interventions were explored: outdoor play, school physical education and active travel. Simulated interventions increased children's average daily moderate-to-vigorous PA by 2–13 min and reduced the percentage of children not meeting PA guidelines, from 34% to 10%–29%, depending on the intervention. Promotion of active travel and outdoor play benefited more those in a higher socio-economic position. Agents' interactions suggested that: encouraging activity in diverse groups will reduce percentage of the least active in the population; and initiating outdoor events in neighbourhoods can generate an enhancing effect on children's engagement in PA. The ABM provided measurable outcomes for interventions that are difficult to estimate using reductionist methods. We suggest that ABMs should be used more commonly to explore the complexity of the social-environmental PA system. We developed an agent-based model simulating children's daily physical activity. Agents perform typical daily activities in a virtual urban model of Glasgow city. Simulations explore impact of interventions on outdoor play, school, active travel. Promotion of active travel had a differential impact across socio-economic position. Outdoor play intervention produced a non-linear increase in physical activity.
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Affiliation(s)
- Jonatan Almagor
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Berkeley Square, 99 Berkeley Street, G3 7HR, Glasgow, Scotland, UK.
| | - Anne Martin
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Berkeley Square, 99 Berkeley Street, G3 7HR, Glasgow, Scotland, UK
| | - Paul McCrorie
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Berkeley Square, 99 Berkeley Street, G3 7HR, Glasgow, Scotland, UK
| | - Rich Mitchell
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Berkeley Square, 99 Berkeley Street, G3 7HR, Glasgow, Scotland, UK
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11
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Bingham DD, Daly-Smith A, Hall J, Seims A, Dogra SA, Fairclough SJ, Ajebon M, Kelly B, Hou B, Shire KA, Crossley KL, Mon-Williams M, Wright J, Pickett K, McEachan R, Dickerson J, Barber SE. Covid-19 lockdown: Ethnic differences in children's self-reported physical activity and the importance of leaving the home environment; a longitudinal and cross-sectional study from the Born in Bradford birth cohort study. Int J Behav Nutr Phys Act 2021; 18:117. [PMID: 34488785 PMCID: PMC8419665 DOI: 10.1186/s12966-021-01183-y] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Accepted: 08/06/2021] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND In England, the onset of COVID-19 and a rapidly increasing infection rate resulted in a lockdown (March-June 2020) which placed strict restrictions on movement of the public, including children. Using data collected from children living in a multi-ethnic city with high levels of deprivation, this study aimed to: (1) report children's self-reported physical activity (PA) during the first COVID-19 UK lockdown and identify associated factors; (2) examine changes of children's self-reported PA prior to and during the first UK lockdown. METHODS This study is part of the Born in Bradford (BiB) COVID-19 Research Study. PA (amended Youth Activity Profile), sleep, sedentary behaviours, daily frequency/time/destination/activity when leaving the home, were self-reported by 949 children (9-13 years). A sub-sample (n = 634) also self-reported PA (Physical Activity Questionnaire for Children) pre-pandemic (2017-February 2020). Univariate analysis assessed differences in PA between sex and ethnicity groups; multivariable logistic regression identified factors associated with children's PA. Differences in children's levels of being sufficiently active prior to and during the lockdown were examined using the McNemar test; and multivariable logistic regression was used to identify factors explaining change. RESULTS During the pandemic, White British (WB) children were more sufficiently active (34.1%) compared to Pakistani Heritage children (PH) (22.8%) or 'Other' ethnicity children (O) (22.8%). WB children reported leaving the home more frequently and for longer periods than PH and O children. Modifiable variables related to being sufficiently active were frequency, duration, type of activity, and destination away from the home environment. There was a large reduction in children being sufficiently active during the first COVID-19 lockdown (28.9%) compared to pre-pandemic (69.4%). CONCLUSIONS Promoting safe extended periods of PA everyday outdoors is important for all children, in particular for children from ethnic minority groups. Children's PA during the first COVID-19 UK lockdown has drastically reduced from before. Policy and decision makers, and practitioners should consider the findings in order to begin to understand the impact and consequences that COVID-19 has had upon children's PA which is a key and vital behaviour for health and development.
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Affiliation(s)
- Daniel D Bingham
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford Royal Infirmary, Duckworth Lane, Bradford, BD9 6RJ, UK.
- Faculties of Life Sciences and Health Studies, University of Bradford, Richmond Road, Bradford, BD7 1DP, UK.
| | - Andy Daly-Smith
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford Royal Infirmary, Duckworth Lane, Bradford, BD9 6RJ, UK
- Faculties of Life Sciences and Health Studies, University of Bradford, Richmond Road, Bradford, BD7 1DP, UK
- Centre for Applied Education Research, Wolfson Centre for Applied Health Research, Bradford Royal Infirmary, Bradford, West Yorkshire, UK
| | - Jennifer Hall
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford Royal Infirmary, Duckworth Lane, Bradford, BD9 6RJ, UK
- Faculties of Life Sciences and Health Studies, University of Bradford, Richmond Road, Bradford, BD7 1DP, UK
| | - Amanda Seims
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford Royal Infirmary, Duckworth Lane, Bradford, BD9 6RJ, UK
- Faculties of Life Sciences and Health Studies, University of Bradford, Richmond Road, Bradford, BD7 1DP, UK
| | - Sufyan A Dogra
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford Royal Infirmary, Duckworth Lane, Bradford, BD9 6RJ, UK
- Faculties of Life Sciences and Health Studies, University of Bradford, Richmond Road, Bradford, BD7 1DP, UK
| | - Stuart J Fairclough
- Health Research Institute and Movement Behaviours, Health, and Wellbeing Research Group, Department Sport and Physical Activity, Edge Hill University, Ormskirk, L39 4QP, UK
| | - Mildred Ajebon
- Department of Health Sciences, SeebohmRowntree Building, University of York, University of York, Heslington, YO10 5DD, York, UK
| | - Brian Kelly
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford Royal Infirmary, Duckworth Lane, Bradford, BD9 6RJ, UK
| | - Bo Hou
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford Royal Infirmary, Duckworth Lane, Bradford, BD9 6RJ, UK
| | - Katy A Shire
- Centre for Applied Education Research, Wolfson Centre for Applied Health Research, Bradford Royal Infirmary, Bradford, West Yorkshire, UK
- Department of Health Sciences, SeebohmRowntree Building, University of York, University of York, Heslington, YO10 5DD, York, UK
| | - Kirsty L Crossley
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford Royal Infirmary, Duckworth Lane, Bradford, BD9 6RJ, UK
| | - Mark Mon-Williams
- Centre for Applied Education Research, Wolfson Centre for Applied Health Research, Bradford Royal Infirmary, Bradford, West Yorkshire, UK
- School of Psychology, University of Leeds, Leeds, West Yorkshire, UK
| | - John Wright
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford Royal Infirmary, Duckworth Lane, Bradford, BD9 6RJ, UK
| | - Kate Pickett
- Department of Health Sciences, SeebohmRowntree Building, University of York, University of York, Heslington, YO10 5DD, York, UK
| | - Rosemary McEachan
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford Royal Infirmary, Duckworth Lane, Bradford, BD9 6RJ, UK
- Faculties of Life Sciences and Health Studies, University of Bradford, Richmond Road, Bradford, BD7 1DP, UK
| | - Josie Dickerson
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford Royal Infirmary, Duckworth Lane, Bradford, BD9 6RJ, UK
| | - Sally E Barber
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford Royal Infirmary, Duckworth Lane, Bradford, BD9 6RJ, UK
- Faculties of Life Sciences and Health Studies, University of Bradford, Richmond Road, Bradford, BD7 1DP, UK
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12
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Oakley J, Peters RL, Wake M, Grobler AC, Kerr JA, Lycett K, Cassim R, Russell M, Sun C, Tang MLK, Koplin JJ, Mavoa S. Backyard benefits? A cross-sectional study of yard size and greenness and children's physical activity and outdoor play. BMC Public Health 2021; 21:1402. [PMID: 34266397 PMCID: PMC8283889 DOI: 10.1186/s12889-021-11475-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Accepted: 06/21/2021] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND The home environment is the most important location in young children's lives, yet few studies have examined the relationship between the outdoor home environment and child physical activity levels, and even fewer have used objectively measured exposures and outcomes. This study examined relationships between objectively assessed home yard size and greenness, and child physical activity and outdoor play. METHODS Data were drawn from the HealthNuts study, a longitudinal study of 5276 children in Melbourne, Australia. We used cross-sectional data from a sample at Wave 3 (2013-2016) when participants were aged 6 years (n = 1648). A sub-sample of 391 children had valid accelerometer data collected from Tri-axial GENEActive accelerometers worn on their non-dominant wrist for 8 consecutive days. Yard area and greenness were calculated using geographic information systems. Objective outcome measures were minutes/day in sedentary, light, and moderate-vigorous physical activity (weekday and weekend separately). Parent-reported outcome measures were minutes/day playing outdoors (weekend and weekday combined). Multi-level regression models (adjusted for child's sex, mother's age at the birth of child, neighbourhood socioeconomic index, maternal education, and maternal ethnicity) estimated effects of yard size and greenness on physical activity. RESULTS Data were available on outdoor play for 1648 children and usable accelerometer data for 391. Associations between yard size/greenness and components of physical activity were minimal. For example, during weekdays, yard size was not associated with daily minutes in sedentary behaviour (β: 2.4, 95% CI: - 6.2, 11.0), light physical activity (β: 1.4, 95% CI: - 5.7, 8.5) or MVPA (β: -2.4, 95% CI: - 6.5, 1.7), with similar patterns at weekends. There was no relationship between median annual yard greenness and physical activity or play. CONCLUSION In our study of young children residing in higher socio-economic areas of Melbourne yard characteristics did not appear to have a major impact on children's physical activity. Larger studies with greater variation in yard characteristics and identification of activity location are needed to better understand the importance of home outdoor spaces and guide sustainable city planning.
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Affiliation(s)
- Jessica Oakley
- Murdoch Children's Research Institute, Parkville, VIC, Australia
- Department of Paediatrics, University of Melbourne, Parkville, VIC, Australia
| | - Rachel L Peters
- Murdoch Children's Research Institute, Parkville, VIC, Australia
| | - Melissa Wake
- Murdoch Children's Research Institute, Parkville, VIC, Australia
- Department of Paediatrics, University of Melbourne, Parkville, VIC, Australia
| | - Anneke C Grobler
- Murdoch Children's Research Institute, Parkville, VIC, Australia
- Department of Paediatrics, University of Melbourne, Parkville, VIC, Australia
| | - Jessica A Kerr
- Murdoch Children's Research Institute, Parkville, VIC, Australia
- Department of Paediatrics, University of Melbourne, Parkville, VIC, Australia
| | - Kate Lycett
- Murdoch Children's Research Institute, Parkville, VIC, Australia
- Department of Paediatrics, University of Melbourne, Parkville, VIC, Australia
- School of Psychology, Faculty of Health, Deakin University, Burwood, VIC, Australia
| | - Raisa Cassim
- Murdoch Children's Research Institute, Parkville, VIC, Australia
- Melbourne School of Population and Global Health, Faculty of Medicine, Dentistry, and Health Sciences, University of Melbourne, Parkville, VIC, 3010, Australia
| | - Melissa Russell
- Melbourne School of Population and Global Health, Faculty of Medicine, Dentistry, and Health Sciences, University of Melbourne, Parkville, VIC, 3010, Australia
| | - Cong Sun
- Murdoch Children's Research Institute, Parkville, VIC, Australia
| | - Mimi L K Tang
- Murdoch Children's Research Institute, Parkville, VIC, Australia
- Department of Paediatrics, University of Melbourne, Parkville, VIC, Australia
| | | | - Suzanne Mavoa
- Murdoch Children's Research Institute, Parkville, VIC, Australia.
- Melbourne School of Population and Global Health, Faculty of Medicine, Dentistry, and Health Sciences, University of Melbourne, Parkville, VIC, 3010, Australia.
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13
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Patience FE, Downing KL, Hesketh KD, Hnatiuk JA. The reliability and validity of a physical activity and sedentary behaviour home audit tool for children aged 2-5 years. J Sci Med Sport 2021; 24:1143-1148. [PMID: 34140228 DOI: 10.1016/j.jsams.2021.05.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Revised: 05/06/2021] [Accepted: 05/14/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVES To test the reliability and validity of a physical activity and sedentary behaviour home environment audit tool for young children (2-5 years old). DESIGN Cross-sectional. METHODS Parents of children aged 2-5 years were recruited through online methods (i.e., social media and blogs). Reliability of the SPACES home audit tool was assessed using self-reported surveys (n = 55) completed on two separate occasions, approximately 12 days apart. Validity of the home audit tool was assessed in a separate sample via home observations by researchers conducted after parents completed the self-report survey (n = 21). The audit tool measured indoor and outdoor home environment characteristics hypothesised to influence young children's physical activity and sedentary behaviour. Data were analysed using intraclass correlations (ICCs) and Kappas. RESULTS The majority of items demonstrated acceptable reliability and validity (80.4% and 53.4%, respectively). Size of the child's bedroom showed substantial agreement for reliability (ICC = 0.85), and slight agreement for validity (ICC = 0.23). Physical activity equipment items within the indoor environment showed slight to moderate agreement for reliability (ICC = 0.32-0.68) and slight agreement for validity (ICC = 0.15-0.35). Screen time equipment showed substantial agreement for reliability (ICC = 0.83) and fair for validity (ICC = 0.38). Outdoor items (e.g., backyard size, availability and condition of physical activity equipment, outdoor features) showed substantial agreement for reliability and validity (ICC = 0.84-0.95). CONCLUSIONS The home audit tool was found to be reliable and valid for many items. This tool could be used in future research to understand the impact of the home environment on young children's physical activity and sedentary behaviour.
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Affiliation(s)
- Fiona E Patience
- School of Exercise and Nutrition Sciences, Deakin University, Australia
| | - Katherine L Downing
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Australia
| | - Kylie D Hesketh
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Australia
| | - Jill A Hnatiuk
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Australia.
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14
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Holland I, DeVille NV, Browning MHEM, Buehler RM, Hart JE, Hipp JA, Mitchell R, Rakow DA, Schiff JE, White MP, Yin J, James P. Measuring Nature Contact: A Narrative Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18084092. [PMID: 33924490 PMCID: PMC8069863 DOI: 10.3390/ijerph18084092] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 04/09/2021] [Accepted: 04/12/2021] [Indexed: 12/14/2022]
Abstract
While many studies suggest evidence for the health benefits of nature, there is currently no standardized method to measure time spent in nature or nature contact, nor agreement on how best to define nature contact in research. The purpose of this review is to summarize how nature contact has been measured in recent health research and provide insight into current metrics of exposure to nature at individual and population scales. The most common methods include surrounding greenness, questionnaires, and global positioning systems (GPS) tracking. Several national-level surveys exist, though these are limited by their cross-sectional design, often measuring only a single component of time spent in nature, and poor links to measures of health. In future research, exposure assessment combining the quantifying (e.g., time spent in nature and frequency of visits to nature) and qualifying (e.g., greenness by the normalized difference of vegetation index (NDVI) and ratings on perception by individuals) aspects of current methods and leveraging innovative methods (e.g., experience sampling methods, ecological momentary assessment) will provide a more comprehensive understanding of the health effects of nature exposure and inform health policy and urban planning.
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Affiliation(s)
- Isabel Holland
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA 02215, USA;
- Correspondence: (I.H.); (N.V.D.)
| | - Nicole V. DeVille
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA 02215, USA;
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
- Correspondence: (I.H.); (N.V.D.)
| | | | - Ryan M. Buehler
- Division of Cancer Genetics and Prevention, Dana-Farber Cancer Institute, Boston, MA 02215, USA;
| | - Jaime E. Hart
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA 02215, USA;
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA 02215, USA; (J.E.S.); (J.Y.); (P.J.)
| | - J. Aaron Hipp
- Department of Parks, Recreation, and Tourism Management, North Carolina State University, Raleigh, NC 27695, USA;
- Center for Geospatial Analytics, North Carolina State University, Raleigh, NC 27695, USA
| | - Richard Mitchell
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow G3 7HR, UK;
| | - Donald A. Rakow
- Section of Horticulture, School of Integrative Plant Science, Cornell University, Ithaca, NY 14853, USA;
| | - Jessica E. Schiff
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA 02215, USA; (J.E.S.); (J.Y.); (P.J.)
| | - Mathew P. White
- European Centre for Environment and Human Health, University of Exeter, Cornwall TR1 3HD, UK;
- Urban and Environmental Psychology Group, University of Vienna, Vienna 1010, Austria
| | - Jie Yin
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA 02215, USA; (J.E.S.); (J.Y.); (P.J.)
- College of Architecture and Urban Planning, Tongji University, Shanghai 200092, China
| | - Peter James
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA 02215, USA; (J.E.S.); (J.Y.); (P.J.)
- Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA 02115, USA
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15
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Loebach J, Sanches M, Jaffe J, Elton-Marshall T. Paving the Way for Outdoor Play: Examining Socio-Environmental Barriers to Community-Based Outdoor Play. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18073617. [PMID: 33807263 PMCID: PMC8037806 DOI: 10.3390/ijerph18073617] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Revised: 03/16/2021] [Accepted: 03/19/2021] [Indexed: 01/03/2023]
Abstract
Outdoor play and independent, neighborhood activity, both linked with healthy childhood development, have declined dramatically among Western children in recent decades. This study examines how social, cultural and environmental factors may be hindering children’s outdoor and community-based play. A comprehensive survey was completed by 826 children (aged 10–13 years) and their parents from 12 schools (four each urban, suburban and rural) from a large county in Ontario, Canada. Five multilevel regression models, controlling for any school clustering effect, examined associations between outdoor play time per week and variable sets representing five prevalent factors cited in the literature as influencing children’s outdoor play (OP). Models predicted that younger children and boys were more likely to spend time playing outdoors; involvement in organized physical activities, other children nearby to play with, higher perception of benefits of outdoor play, and higher parental perceptions of neighborhood social cohesion also predicted more time in outdoor play. Time outdoors was less likely among children not allowed to play beyond home without supervision, felt they were ‘too busy’ with screen-based activities, and who reported higher fears related to playing outdoors. Study findings have important implications for targeting environmental, cultural and policy changes to foster child-friendly communities which effectively support healthy outdoor play.
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Affiliation(s)
- Janet Loebach
- Department of Design + Environmental Analysis, Cornell University, Ithaca, New York, NY 14853, USA;
- Correspondence:
| | - Marcos Sanches
- Krembli Centre for Neuroinformatics, Centre for Addiction and Mental Health, London, ON N6G 4X8, Canada;
| | - Julia Jaffe
- Department of Design + Environmental Analysis, Cornell University, Ithaca, New York, NY 14853, USA;
| | - Tara Elton-Marshall
- Centre for Addiction and Mental, Institute for Mental Health Policy Research, London, ON N6G 4X8, Canada;
- Campbell Family Mental Health Research Institute, Toronto, ON M5S 2S1, Canada
- Dalla Lana School of Public Health, Toronto, ON M5T 3M7, Canada
- Department of Epidemiology and Biostatistics, Western University, London, ON N6A 5C1, Canada
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16
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Lee EY, Bains A, Hunter S, Ament A, Brazo-Sayavera J, Carson V, Hakimi S, Huang WY, Janssen I, Lee M, Lim H, Silva DAS, Tremblay MS. Systematic review of the correlates of outdoor play and time among children aged 3-12 years. Int J Behav Nutr Phys Act 2021; 18:41. [PMID: 33736668 PMCID: PMC7972019 DOI: 10.1186/s12966-021-01097-9] [Citation(s) in RCA: 43] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Accepted: 02/01/2021] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Due to the myriad of benefits of children's outdoor play and time, there is increasing concern over its decline. This systematic review synthesized evidence on the correlates of outdoor play and outdoor time among children aged 3-12 years. METHODS A total of 12 electronic databases in five different languages (Chinese, English, Korean, Spanish, Portuguese) were searched between October 28, 2019 and July 27, 2020. Covidence software was used for screening and Microsoft Excel with a predesigned coding form was used for data extraction. Evidence was synthesized and correlates were categorized using the socioecological model framework. RESULTS Based on 107 studies representing 188,498 participants and 422 childcare centers from 29 countries, 85 studies examined potential correlates of outdoor play while 23 studies examined that of outdoor time (one examined both). The duration of outdoor play and outdoor time ranged between 60 and 165 min/d and 42-240 min/d, respectively. Out of 287 (outdoor play) and 61 (outdoor time) potential correlates examined, 111 correlates for outdoor play and 33 correlates for outdoor time were identified as significant correlates. Thirty-three variables were identified as key/common correlates of outdoor play/time, including eight correlates at the individual level (e.g., sex/gender, race/ethnicity, physical activity), 10 correlates at the parental level (e.g., parental attitude/support/behavior, parenting practice), nine at the microsystem level (e.g., proximal home/social environment such as residence type, peer influence), three at the macrosystem/community level (e.g., availability of space children can play), and three at the physical ecology/pressure for macrosystem change level (e.g., seasonality, rurality). No key correlates were found at the institutional level. CONCLUSIONS Individual, parental, and proximal physical (home) and social environments appear to play a role in children's outdoor play and time. Ecological factors (i.e., seasonality, rurality) also appear to be related to outdoor play/time. Evidence was either inconsistent or lacking at institutional and macrosystem/community levels. Standardizing terminology and measures of outdoor play/time is warranted. Future work should investigate the interactions and processes of multiple variables across different levels of socioecological modelling to better understand the mechanisms through which outdoor play/time opportunities can be optimized for children while paying special attention to varying conditions in which children are born, live, and play.
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Affiliation(s)
- Eun-Young Lee
- School of Kinesiology and Health Studies, Queen’s University, Kingston, ON Canada
- Department of Gender Studies, Queen’s University, Kingston, ON Canada
| | - Ajaypal Bains
- School of Kinesiology and Health Studies, Queen’s University, Kingston, ON Canada
| | - Stephen Hunter
- Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, Canada
| | - Alyssa Ament
- School of Kinesiology and Health Studies, Queen’s University, Kingston, ON Canada
| | | | - Valerie Carson
- Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, Canada
| | - Shawn Hakimi
- School of Kinesiology and Health Studies, Queen’s University, Kingston, ON Canada
| | - Wendy Y. Huang
- Centre for Health and Exercise Science Research, Department of Sport, Physical Education and Health, Hong Kong Baptist University, Hong Kong, China
| | - Ian Janssen
- School of Kinesiology and Health Studies, Queen’s University, Kingston, ON Canada
- Department of Health Sciences, Queen’s University, Kingston, Canada
| | - Mikyung Lee
- School of Kinesiology and Health Studies, Queen’s University, Kingston, ON Canada
| | - Heejun Lim
- School of Kinesiology and Health Studies, Queen’s University, Kingston, ON Canada
| | | | - Mark S. Tremblay
- Healthy Active Lifestyle and Obesity (HALO) research group, Children’s Hospital of Eastern Ontario Research Institute, Ottawa, Canada
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Reuben A, Rutherford GW, James J, Razani N. Association of neighborhood parks with child health in the United States. Prev Med 2020; 141:106265. [PMID: 33035547 PMCID: PMC8034548 DOI: 10.1016/j.ypmed.2020.106265] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Revised: 08/27/2020] [Accepted: 09/19/2020] [Indexed: 12/18/2022]
Abstract
While there is evidence that parks support pediatric health, there have been no national studies looking at both physical and mental health. We assessed whether the presence of a neighborhood park is associated with pediatric physical or mental health across the U.S. using a nationally representative cross-sectional random sample of American children ages 0-17. Caregivers reported on the park presence in their child's neighborhood and the child's physical activity, screen-time, sleep, weight, and diagnosis of anxiety, depression, or attention deficit hyperactivity disorder (ADHD). Covariates included child and family sociodemographics and, for 29 states, neighborhood urbanicity. Caregivers reported on 49,146 children (mean age 9.4 years; 49% female). There were 11,791 (24%) children living in neighborhoods lacking a park; children in non-urban locations (aOR 2.19, 95% CI 1.40-1.67) or below the federal poverty level (aOR = 1.48, 95%CI 1.38-1.58) had higher odds of lacking a park. Irrespective of sociodemographics, children lacking parks were more likely to be physically inactive (aOR1.36, 95% CI 1.24, 1.48), have excessive screen-time (aOR = 1.19, 95% CI 1.14, 1.25), or obtain inadequate sleep (aOR = 1.23, 95% CI 1.18, 1.29). Children without parks were more likely obese (aOR = 1.32, 95% CI 1.21, 1.43), overweight (aOR 1.25, 95%CI 1.17, 1.33), or diagnosed with ADHD (aOR 1.20, 95% CI 1.12, 1.29), but not more anxious or depressed (aOR = 1.04, 95%CI 0.97, 1.11). Associations between parks and pediatric physical and mental health suggests that the provision of neighborhood parks could represent a low-cost childhood health intervention.
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Affiliation(s)
- Aaron Reuben
- Department of Psychology and Neuroscience, Duke University, Durham, NC, USA
| | - George W Rutherford
- Department of Pediatrics, University of California, San Francisco, San Francisco, CA, USA; Department of Epidemiology and Biostatistics, University of California at San Francisco, San Francisco, CA, USA
| | - Jameze James
- School of Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Nooshin Razani
- Department of Pediatrics, University of California, San Francisco, San Francisco, CA, USA; Department of Epidemiology and Biostatistics, University of California at San Francisco, San Francisco, CA, USA; Center for Health and Nature, UCSF Benioff Children's Hospital, Oakland, Oakland, CA, USA.
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18
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The Associations between Outdoor Playtime, Screen-Viewing Time, and Environmental Factors in Chinese Young Children: The "Eat, Be Active and Sleep Well" Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17134867. [PMID: 32640658 PMCID: PMC7369825 DOI: 10.3390/ijerph17134867] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 06/23/2020] [Accepted: 06/28/2020] [Indexed: 01/15/2023]
Abstract
The purpose of this study is to identify regional differences in outdoor activity time and screen-viewing time of preschool children in urban and rural areas and to provide data on the environmental factors to identify modifiable determinants for each region. This cross-sectional study was conducted on 1772 out of 2790 children between the age of 3 to 6 years living in northern China, with their consent. A cross-sectional study was conducted among preschool children living in urban (n = 1114) and rural areas (n = 658) in northern China. To assess environmental factors, the International Physical Activity Questionnaire was used for neighborhood environments, and the questionnaire included three items each for the physical home environment and socio-cultural environment domains. We observed the associations between outdoor play for urban children and sidewalks in the neighborhood, paths for cycles, aesthetic qualities, and “motor vehicles. In addition, in rural areas, screen-viewing time and environmental factors were found to be positively correlated with traffic, limited place and method of outdoor play, and were negatively correlated with the importance of academics and need for company in outdoor play. This has important implications for the development of effective intervention programs for preschool children in China in the future.
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Pagels P, Wester U, Mårtensson F, Guban P, Raustorp A, Fröberg A, Söderström M, Boldemann C. Pupils' use of school outdoor play settings across seasons and its relation to sun exposure and physical activity. PHOTODERMATOLOGY PHOTOIMMUNOLOGY & PHOTOMEDICINE 2020; 36:365-372. [PMID: 32187730 DOI: 10.1111/phpp.12558] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Revised: 02/24/2020] [Accepted: 03/14/2020] [Indexed: 12/29/2022]
Abstract
BACKGROUND Long outdoor stay may cause hazardous exposure to ultraviolet radiation (UVR) from the sun even at high latitudes as in Sweden (Spring to Autumn). On the other hand, long outdoor stay is a strong predictor of primary school children´s free mobility involving moderate to vigorous physical activity (MVPA). UV-protective outdoor environments enable long outdoor stay. We investigated the concurrent impact of different school outdoor play settings upon pupils´ sun exposure and levels of physical activity across different ages, genders, and seasons. METHOD During 1 week each in September, March, and May, UVR exposure and MVPA were measured in pupils aged 7-11 years. Erythemally effective UVR exposure was measured by polysulphone film dosimeters and MVPA by accelerometers. Schoolyard play was recorded on maps, and used areas defined as four play settings (fixed play equipment, paved surfaces, sport fields, and green settings), categorized by season and gender. RESULTS During the academic year, sport fields yielded the highest UVR exposures and generated most time in MVPA. In March, time outdoors and minutes in MVPA dropped and UVR exposures were suberythemal at all play settings. In May, green settings and fixed play equipment close to greenery promoted MVPA and protected from solar overexposure during long outdoor stays. CONCLUSION More outdoor activities in early spring are recommended. In May, greenery attractive for play could protect against overexposure to UVR and stimulate both girls and boys to vigorous play.
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Affiliation(s)
- Peter Pagels
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden.,Department of Sport Sciences, Linneaus University, Kalmar, Sweden
| | - Ulf Wester
- Swedish Radiation Safety Authority, Stockholm, Sweden
| | - Fredrika Mårtensson
- Department of Work science, Business Economics and Environmental Psychology, Swedish University of Agricultural Sciences, Alnarp, Sweden
| | - Peter Guban
- Center for Epidemiology and Community Medicine, Stockholm County Council, Stockholm, Sweden
| | - Anders Raustorp
- Department of Food and Nutrition and Sport Science, University of Gothenburg, Gothenburg, Sweden
| | - Andreas Fröberg
- Department of Food and Nutrition and Sport Science, University of Gothenburg, Gothenburg, Sweden
| | - Margareta Söderström
- Section of General Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.,Department of Clinical Sciences in Lund, University of Lund, Lund, Sweden
| | - Cecilia Boldemann
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
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20
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Lifestyle Patterns Begin in Early Childhood, Persist and Are Socioeconomically Patterned, Confirming the Importance of Early Life Interventions. Nutrients 2020; 12:nu12030724. [PMID: 32182889 PMCID: PMC7146362 DOI: 10.3390/nu12030724] [Citation(s) in RCA: 60] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Revised: 02/28/2020] [Accepted: 03/05/2020] [Indexed: 11/17/2022] Open
Abstract
Traditional approaches to understanding the behavioural determinants of adiposity have considered diet, physical activity and sedentary behaviour in isolation. Although integrative approaches have identified a variety of lifestyle patterns in children at preschool-age or older, along with some variability by socio-economic positions, this has rarely been examined in younger cohorts. We aimed to identify lifestyle patterns at 1.5, 3.5 and 5 years, including dietary intake, outdoor time and television viewing time, to assess associations with maternal education (as a proxy for socio-economic position), and to investigate their persistence between toddlerhood and preschool age. Participants were 417 and 293 children aged 1.5 y from the Melbourne Infant Feeding Activity and Nutrition Trial (InFANT) and InFANT Extend Programs, respectively. Data were collected using questionnaires at child ages 1.5, 3.5 and 5 y (InFANT); and 1.5 and 3.5 y (InFANT Extend). Principal component analysis was undertaken at each time point on the separate and pooled datasets. Associations between the lifestyle patterns scores and maternal education were assessed with multivariable regression analysis. Two lifestyle patterns ("Discretionary consumption and TV" and "Fruit, vegetables and outdoor") were identified as early as 1.5 y. They remained consistent across ages and were evident in both datasets. These patterns were inversely and positively associated with maternal education, respectively. Such early clustering of obesity related energy balance behaviours and tracking during early childhood suggests there may be shared antecedents common to the individual behaviours that could be targeted for intervention. Our findings provide support for interventions targeting multiple behaviours and tailored to the level of family socio-economic disadvantage.
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Saldanha-Gomes C, Marbac M, Sedki M, Cornet M, Plancoulaine S, Charles MA, Lioret S, Dargent-Molina P. Clusters of diet, physical activity, television exposure and sleep habits and their association with adiposity in preschool children: the EDEN mother-child cohort. Int J Behav Nutr Phys Act 2020; 17:20. [PMID: 32050975 PMCID: PMC7014717 DOI: 10.1186/s12966-020-00927-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Accepted: 02/07/2020] [Indexed: 12/25/2022] Open
Abstract
Background Despite the growing interest in the relation between adiposity in children and different lifestyle clusters, few studies used a longitudinal design to examine a large range of behaviors in various contexts, in particular eating- and sleep-related routines, and few studies have examined these factors in young children. The objectives of this study were to identify clusters of boys and girls based on diet, sleep and activity-related behaviors and their family environment at 2 and 5 years of age, and to assess whether the clusters identified varied across maternal education levels and were associated with body fat at age 5. Methods At 2 and 5 years, respectively, 1436 and 1195 parents from the EDEN mother-child cohort completed a questionnaire including behavioral data. A latent class analysis aimed to uncover gender-specific behavioral clusters. Body fat percentage was estimated by anthropometric and bioelectrical impedance measurements. Association between cluster membership and body fat was assessed with mutivariable linear regression models. Results At 2 years, two clusters emerged that were essentially characterized by opposite eating habits. At 5 years, TV exposure was the most distinguishing feature, but the numbers and types of clusters differed by gender. An association between cluster membership and body fat was found only in girls at 5 years of age, with girls in the cluster defined by very high TV exposure and unfavorable mealtime habits (despite high outdoor playing and walking time) having the highest body fat. Girls whose mother had low educational attainment were more likely to be in this high-risk cluster. Girls who were on a cluster evolution path corresponding to the highest TV viewing time and the least favorable mealtime habits from 2 to 5 years of age had higher body fat at 5 years. Conclusions Efforts to decrease TV time and improve mealtime routines may hold promise for preventing overweight in young children, especially girls growing up in disadvantaged families. These preventive efforts should start as early in life as possible, ideally before the age of two, and should be sustained over the preschool years.
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Affiliation(s)
- Cécilia Saldanha-Gomes
- Université de Paris, CRESS, INSERM, INRA, F-75004, Paris, France. .,Paris-Saclay University, Faculty of Medicine, F-94276, Kremlin-Bicêtre, France. .,INSERM, UMR1153 Center of Epidemiology and StatisticS (CRESS), Research Team on Early Life Origins of Health (EARoH), Bat Inserm 15-16, Avenue Paul Vaillant Couturier, 94807, Villejuif Cedex, France.
| | - Matthieu Marbac
- Rennes University, Ensai, CNRS, CREST - UMR 9194, F-35000, Rennes, France
| | - Mohammed Sedki
- Paris-Saclay University, INSERM UMR1018, CESP, F-94807, Villejuif, France
| | - Maxime Cornet
- Université de Paris, CRESS, INSERM, INRA, F-75004, Paris, France.,INSERM, UMR1153 Center of Epidemiology and StatisticS (CRESS), Research Team on Early Life Origins of Health (EARoH), Bat Inserm 15-16, Avenue Paul Vaillant Couturier, 94807, Villejuif Cedex, France
| | - Sabine Plancoulaine
- Université de Paris, CRESS, INSERM, INRA, F-75004, Paris, France.,INSERM, UMR1153 Center of Epidemiology and StatisticS (CRESS), Research Team on Early Life Origins of Health (EARoH), Bat Inserm 15-16, Avenue Paul Vaillant Couturier, 94807, Villejuif Cedex, France
| | - Marie-Aline Charles
- Université de Paris, CRESS, INSERM, INRA, F-75004, Paris, France.,INSERM, UMR1153 Center of Epidemiology and StatisticS (CRESS), Research Team on Early Life Origins of Health (EARoH), Bat Inserm 15-16, Avenue Paul Vaillant Couturier, 94807, Villejuif Cedex, France
| | - Sandrine Lioret
- Université de Paris, CRESS, INSERM, INRA, F-75004, Paris, France.,INSERM, UMR1153 Center of Epidemiology and StatisticS (CRESS), Research Team on Early Life Origins of Health (EARoH), Bat Inserm 15-16, Avenue Paul Vaillant Couturier, 94807, Villejuif Cedex, France
| | - Patricia Dargent-Molina
- Université de Paris, CRESS, INSERM, INRA, F-75004, Paris, France.,INSERM, UMR1153 Center of Epidemiology and StatisticS (CRESS), Research Team on Early Life Origins of Health (EARoH), Bat Inserm 15-16, Avenue Paul Vaillant Couturier, 94807, Villejuif Cedex, France
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Razani N, Hills NK, Thompson D, Rutherford GW. The Association of Knowledge, Attitudes and Access with Park Use before and after a Park-Prescription Intervention for Low-Income Families in the U.S. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17030701. [PMID: 31973173 PMCID: PMC7037040 DOI: 10.3390/ijerph17030701] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Revised: 01/13/2020] [Accepted: 01/15/2020] [Indexed: 01/14/2023]
Abstract
We conducted secondary data analyses of pooled data from a clinical trial that prescribed park visits to children and their caregivers in a low-income, urban setting. Data were collected at the prescribing visit (baseline) and at one and three months of follow up from 78 families. Family characteristics were identified at baseline; regression models were used to explore changes during follow up in associations of park use with knowledge, attitudes and perceived access to parks. At baseline, park users differed from non-users in demographics, knowledge of park locations, attitudes about the value of park visits, but not affinity for nature. Park users were also more likely than non-users to feel that their neighborhood was safe for children to play in. Changes in knowledge of park locations, nature affinity, and perceived access to parks were each significantly associated with increased park use by families at one and three months after the park prescription. Adjusting for age, gender, race, poverty, and US birth, increases in knowing the location of parks were associated with an increase of 0.27 weekly park visits (95% CI 0.05, 0.49; p = 0.016); increases in feeling a caregiver had money to visit parks were associated with 0.48 more weekly park visits (95% CI 0.28, 0.69; p < 0.001); increases in perceived money for park outings were associated with 0.24 increased park visits per week (95% CI 0.05, 0.42; p = 0.01); each unit increase in nature affinity was associated with 0.34 more weekly park visits (95% CI 0.09, 0.59; p = 0.007). In other words, knowing where to go, valuing nature, and having time, and money contributed to increased likelihood of visiting a park. We discuss in terms of health behavior theory how demographics, knowledge, attitudes and perceived barriers to park use can inform park prescription interventions.
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Affiliation(s)
- Nooshin Razani
- Department of Pediatrics, UCSF Benioff Children’s Hospital Oakland, University of California at San Francisco, 5220 Claremont Ave, Oakland, CA 94608, USA
- Correspondence: ; Tel.: +1-415-722-1915
| | - Nancy K. Hills
- Department of Epidemiology and Biostatistics, University of California, San Francisco, 675 Nelson Rising Lane, Sandler Neurosciences Center, San Francisco, CA 94158, USA
| | - Doug Thompson
- San Francisco Department of Public Health, San Francisco Human Services Agency 170 Otis Street, San Francisco, CA 94103, USA
| | - George W. Rutherford
- Department of Epidemiology and Biostatistics, University of California, San Francisco, 550 16th Street, Box 1224, San Francisco, CA 94143-1224, USA
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23
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Razani N, Niknam K, Wells NM, Thompson D, Hills NK, Kennedy G, Gilgoff R, Rutherford GW. Clinic and park partnerships for childhood resilience: A prospective study of park prescriptions. Health Place 2019; 57:179-185. [PMID: 31060017 DOI: 10.1016/j.healthplace.2019.04.008] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Revised: 03/04/2019] [Accepted: 04/22/2019] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Pediatricians need community resources for childhood stress. We examined the association of weekly park visits and resilience amongst children receiving a park prescription at a clinic for low-income families. MATERIALS AND METHODS A prospective longitudinal clinical trial was conducted amongst children ages 7-17 at a safety-net primary care clinic with measures at zero, one and three months out. Parents reported their child's park visits per week, baseline ACE score, their own stress (PSS10) and coping; children reported resilience (Brief Resiliency Scale) and stress (PSQ8-11 scale). RESULTS Enrolled children (N = 54; mean (sd) age 10.3 (2.4) years), had a median (IQR) ACE score of 2 (1, 4). Child resilience improved with each one-day increase in weekly park visits (0.04 points, 95% CI 0.01, 0.08) at every level of ACEs. Child stress partially mediated this relationship. CONCLUSION Parks are a community resource for pediatric resilience; park prescriptions may be a way to deal with pediatric stress.
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Affiliation(s)
- Nooshin Razani
- UCSF Benioff Children's Hospital Oakland, 747 52nd Street, Oakland, CA, 94705, USA.
| | - Kian Niknam
- University of California at San Francisco, 550 16th Street, San Francisco CA, 94158, USA
| | - Nancy M Wells
- Cornell University, 2429 Martha Van Rensselaer Hall, Ithaca, NY, 14853, USA
| | - Doug Thompson
- UCSF Benioff Children's Hospital Oakland, 747 52nd Street, Oakland, CA, 94705, USA
| | - Nancy K Hills
- University of California at San Francisco, 550 16th Street, San Francisco CA, 94158, USA
| | - Gail Kennedy
- University of California at San Francisco, 550 16th Street, San Francisco CA, 94158, USA
| | - Rachel Gilgoff
- UCSF Benioff Children's Hospital Oakland, 747 52nd Street, Oakland, CA, 94705, USA
| | - George W Rutherford
- University of California at San Francisco, 550 16th Street, San Francisco CA, 94158, USA
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24
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McCrann S, Flitcroft I, Lalor K, Butler J, Bush A, Loughman J. Parental attitudes to myopia: a key agent of change for myopia control? Ophthalmic Physiol Opt 2019; 38:298-308. [PMID: 29691921 DOI: 10.1111/opo.12455] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2017] [Accepted: 03/13/2018] [Indexed: 12/21/2022]
Abstract
PURPOSE With the increasing prevalence in myopia there is growing interest in active myopia prevention. This study aims to increase our understanding of parental attitudes to myopia development and control, as a means to inform future health planning and policy. It evaluates, for the first time, the attitude of parents to myopia and its associated risks, as well as assessing the exposure of Irish children to environmental factors that may influence their risk profile for myopia development. METHODS Parents of 8-13 year old children in eight participating schools completed a questionnaire designed to assess their knowledge of and attitudes towards myopia and its risk factors. A structured diary was also used to capture daily activities of children in relation to myopia risk factors. RESULTS Of 329 parents, just 46% considered that myopia presented a health risk to their children, while an identical number (46%) regarded it as an optical inconvenience. Myopia was also, but less frequently, considered an expense (31% of parents), a cosmetic inconvenience (14% of parents) and, by some, as a sign of intelligence (4% of parents) 76% of parents recognised the potential of digital technology to impact the eye, particularly as a cause of eyestrain and need for spectacles. Only 14% of parents expressed concern should their child be diagnosed with myopia. Compared to non myopic parents, myopic parents viewed myopia as more of an optical inconvenience (p < 0.001), an expense (p < 0.005) and a cosmetic inconvenience (p < 0.001). There was a trend for myopic parents to limit screen time use in their household more than non-myopic parents (p = 0.05). Parents who considered myopia a health risk sought to limit screen time more than parents who did not regard myopia as a health risk to their child (p = 0.01). Children spent significantly longer performing indoor proximal tasks (255 min) compared to time spent outdoors (180 min; p < 0.0001) daily. Older (p = 0.001), urban (p = 0.0005) myopic (=0.04) children spent significantly more time at digital screens compared to younger non-myopic children from a rural background. CONCLUSION Parental attitudes to myopia were typically nonchalant in relation to health risk. This is of particular concern given the impact parents have on children's behaviour and choices with respect to such risk factors, demonstrating an acute need for societal sensitisation to the public health importance of myopia.
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Affiliation(s)
- Saoirse McCrann
- School of Physics and Clinical and Optometric Sciences, Dublin Institute of Technology, Dublin, Ireland
| | - Ian Flitcroft
- School of Physics and Clinical and Optometric Sciences, Dublin Institute of Technology, Dublin, Ireland.,Childrens University Hospital, Dublin, Ireland
| | - Kevin Lalor
- School of Languages, Law and Social Sciences, Dublin Institute of Technology, Dublin, Ireland
| | - John Butler
- School of Mathematical Sciences, Dublin Institute of Technology, Dublin, Ireland
| | - Aaron Bush
- Lincoln Memorial University-DeBusk College of Osteopathic Medicine, Harrogate, USA
| | - James Loughman
- School of Physics and Clinical and Optometric Sciences, Dublin Institute of Technology, Dublin, Ireland.,African Vision Research Institute, University of KwaZulu Natal, Durban, South Africa
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25
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Boxberger K, Reimers AK. Parental Correlates of Outdoor Play in Boys and Girls Aged 0 to 12-A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E190. [PMID: 30641874 PMCID: PMC6351982 DOI: 10.3390/ijerph16020190] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Revised: 01/03/2019] [Accepted: 01/08/2019] [Indexed: 11/16/2022]
Abstract
Outdoor play is one major source of physical activity (PA) in children. In particular, parents act as gatekeepers, because they can enable their children's outdoor play. This systematic review aims to provide an overview of parental correlates of outdoor play. A systematic literature research of six electronic databases (ERIC, PsycARTICLES, PsycINFO, PubMed/Medline, SCOPUS, and Web of Science Core Collection) was conducted with previously defined search terms, focusing on children 0⁻12 years old. In total, 1719 potentially publications were screened based on eligibility criteria. Included studies were scored for overall study quality. Findings were summarized using a semi-quantitative method. Twenty-one peer-reviewed publications which examined the relationship of parental correlates and outdoor play were included. Overall, five parental correlates were associated with children's amount of outdoor play: mothers' ethnicity, mothers' employment status, parents' education level, the importance parents assign to outdoor play, and perceived social cohesion in the neighborhood. Merely four studies reported sex/gender-stratified results. In summary, only parents' encouragement/support provided evidence for girls' amount of outdoor play. The findings are considered to be of public health relevance for developing intervention programs to increase outdoor play and for improving child's health. More research, especially considering sex/gender of the child, is required.
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Affiliation(s)
- Karolina Boxberger
- Institute of Human Movement Science and Health, Faculty of Behavioral and Social Sciences, Chemnitz University of Technology, 09111 Chemnitz, Germany.
| | - Anne Kerstin Reimers
- Institute of Human Movement Science and Health, Faculty of Behavioral and Social Sciences, Chemnitz University of Technology, 09111 Chemnitz, Germany.
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Largo-Wight E, Guardino C, Wludyka PS, Hall KW, Wight JT, Merten JW. Nature contact at school: The impact of an outdoor classroom on children's well-being. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2018; 28:653-666. [PMID: 30047798 DOI: 10.1080/09603123.2018.1502415] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/12/2018] [Accepted: 07/16/2018] [Indexed: 06/08/2023]
Abstract
Nature contact facilitates healthy child development and a disconnect with nature presents potential health risks. This study was designed to test a nature intervention at an elementary school among children. An experimental crossover design was implemented over six weeks; two teachers taught their respective kindergarten classes the daily language arts lesson in either the control (indoor classroom) or nature treatment (outdoor classroom) conditions. Child well-being measures were compared in the two conditions. Teachers' redirections of child behavior were significantly fewer in the nature condition (t = 2.49, p < 0.05) compared to the control. Also, fewer children were off task in the nature condition on average. There were mixed well-being results; children reported no significance difference in happiness in the two conditions, but teachers reported modest benefit in child well-being in the nature condition. The outdoor classroom is a promising method for increasing nature contact and promoting student well-being.
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Affiliation(s)
- Erin Largo-Wight
- a Department of Public Health , Brooks College of Health, University of North Florida , Jacksonville , Florida , USA
| | - Caroline Guardino
- b Department of Exceptional, Deaf, and Interpreter Education, College of Education and Human Services , University of North Florida , Jacksonville , Florida , USA
| | - Peter S Wludyka
- c Department of Mathematics and Statistics , College of Arts and Science, University of North Florida , Jacksonville , Florida , USA
| | - Katrina W Hall
- d Department of Childhood Education, Literacy, and TESOL, College of Education and Human Services , University of North Florida , Jacksonville , Florida , USA
| | - Jeff T Wight
- e Department of Applied Health Sciences , Brooks Rehabilitation College of Healthcare Sciences Jacksonville University , Jacksonville , Florida , USA
| | - Julie W Merten
- a Department of Public Health , Brooks College of Health, University of North Florida , Jacksonville , Florida , USA
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Monsur M, Mansur M, Islam MZ. Are children living on dead-end streets more active? Near-home street patterns and school-going children's time spent outdoors in Dhaka, Bangladesh. Prev Med 2017; 103S:S73-S80. [PMID: 27939267 DOI: 10.1016/j.ypmed.2016.11.016] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2016] [Revised: 10/01/2016] [Accepted: 11/24/2016] [Indexed: 10/20/2022]
Abstract
This study aimed to investigate relationships between near-home street patterns and children's time spent outdoors (TSO). Participants were 60 (n=60) school-age Dhaka children, 7-11years old (16 girls and 44 boys) selected by a two-phase cluster sampling method. Data were collected from September 2010 to June 2011 by visiting each of 60 children's homes. Children's mean TSOs (in minutes) were reported by parents' face-to-face interviews, and near-home street pattern data were collected by systematic direct observations. The researchers also collected data on seven socio-demographic variables and three neighborhood built-environment variables. A backward selection based multiple linear regression was used to examine association between children's TSO and near-home street patterns. Results (adjusted R2=0.66 for weekdays and 0.68 for weekend) suggested that children's TSO were significantly associated with near-home street type: dead-end instead of through streets (28min on weekdays, p<0.01 and 66min on weekend, p<0.01). The width of the street, level of its branching and availability of an open space or playground near the house are also positively associated with TSO. Near-home street features significantly contribute to TSO in school-going children of Dhaka.
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Affiliation(s)
- Muntazar Monsur
- Natural Learning Initiative (NLI), College of Design, NC State University, Campus Box 7701, 101 Leazar Hall, Raleigh, NC 27695-7701, USA.
| | - Mohaimen Mansur
- Alliance Manchester Business School, The University of Manchester, Booth Street West, Manchester M15 6PB, UK
| | - Mohammed Zakiul Islam
- Department of Architecture, Bangladesh University of Engineering and Technology (BUET), Dhaka 1000, Bangladesh
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28
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Richardson EA, Pearce J, Shortt NK, Mitchell R. The role of public and private natural space in children's social, emotional and behavioural development in Scotland: A longitudinal study. ENVIRONMENTAL RESEARCH 2017; 158:729-736. [PMID: 28750342 PMCID: PMC5571194 DOI: 10.1016/j.envres.2017.07.038] [Citation(s) in RCA: 62] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/19/2016] [Revised: 07/15/2017] [Accepted: 07/18/2017] [Indexed: 05/21/2023]
Abstract
INTRODUCTION Poor mental health in childhood has implications for health and wellbeing in later life. Natural space may benefit children's social, emotional and behavioural development. We investigated whether neighbourhood natural space and private garden access were related to children's developmental change over time. We asked whether relationships differed between boys and girls, or by household educational status. METHODS We analysed longitudinal data for 2909 urban-dwelling children (aged 4 at 2008/9 baseline) from the Growing Up in Scotland (GUS) survey. The survey provided social, emotional and behavioural difficulty scores (Strengths and Difficulties Questionnaire (SDQ)), and private garden access. Area (%) of total natural space and parks within 500m of the child's home was quantified using Scotland's Greenspace Map. Interactions for park area, total natural space area, and private garden access with age and age2 were modelled to quantify their independent contributions to SDQ score change over time. RESULTS Private garden access was strongly related to most SDQ domains, while neighbourhood natural space was related to better social outcomes. We found little evidence that neighbourhood natural space or garden access influenced the trajectory of developmental change between 4 and 6 years, suggesting that any beneficial influences had occurred at younger ages. Stratified models showed the importance of parks for boys, and private gardens for the early development of children from low-education households. CONCLUSION We conclude that neighbourhood natural space may reduce social, emotional and behavioural difficulties for 4-6 year olds, although private garden access may be most beneficial.
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Affiliation(s)
- Elizabeth A Richardson
- Centre for Research on Environment, Society and Health, Research Institute of Geography and the Lived Environment, University of Edinburgh, Drummond Street, Edinburgh EH8 9XP, United Kingdom.
| | - Jamie Pearce
- Centre for Research on Environment, Society and Health, Research Institute of Geography and the Lived Environment, University of Edinburgh, Drummond Street, Edinburgh EH8 9XP, United Kingdom.
| | - Niamh K Shortt
- Centre for Research on Environment, Society and Health, Research Institute of Geography and the Lived Environment, University of Edinburgh, Drummond Street, Edinburgh EH8 9XP, United Kingdom.
| | - Richard Mitchell
- Centre for Research on Environment, Society and Health, Institute of Health and Wellbeing, University of Glasgow, 1 Lilybank Gardens, Glasgow G12 8RZ, United Kingdom.
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Mothers' Perceived Neighbourhood Environment and Outdoor Play of 2- to 3.5-Year-Old Children: Findings from the Healthy Beginnings Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14091082. [PMID: 28927015 PMCID: PMC5615619 DOI: 10.3390/ijerph14091082] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/02/2017] [Revised: 09/12/2017] [Accepted: 09/15/2017] [Indexed: 12/31/2022]
Abstract
Background: This study aims to investigate whether mothers’ perceived neighbourhood environment is associated with outdoor playtime of 2- to 3.5-year-old children. Methods: Cross-sectional analyses were conducted using data from the Healthy Beginnings Trial (HBT). Data on children’s outdoor playtime and mothers’ perceived neighbourhood environment were collected through face-to-face interviews with mothers when their children were 2 and 3.5 years old. Walk score was obtained from a publicly available website and population density data were obtained from Australian Census data. Multiple logistic regression models were built to investigate these associations. Results: A total of 497 and 415 mother-child dyads were retained at 2 years and 3.5 years. After adjusting for intervention group allocation and other confounding factors, at 2 years, mothers’ perceptions that ‘the neighbourhood is a good place to bring up children’, ‘it is safe to play outside during the day’, and ‘there are good parks or playgrounds in neighbourhood’ were positively associated with children’s outdoor playtime. At 3.5 years, living in a free-standing house was associated with more children’s outdoor playtime. Conclusions: Children may benefit from living in a neighbourhood that supports active lifestyle. Improving social and physical environments in neighbourhoods could be an important strategy for improving young children’s physical activity.
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Moran MR, Plaut P, Merom D. Is the Grass Always Greener in Suburban Neighborhoods? Outdoors Play in Suburban and Inner-City Neighborhoods. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:E759. [PMID: 28696375 PMCID: PMC5551197 DOI: 10.3390/ijerph14070759] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/12/2017] [Revised: 07/03/2017] [Accepted: 07/04/2017] [Indexed: 11/16/2022]
Abstract
Children's outdoors play (OP) is an important source of physical activity that has been decreasing in recent years due to changes in neighborhood design, parent safety concerns and child sedentary leisure. However, few studies examined such determinants from children's perspectives. This study explores environmental and socio-cultural aspects of children's OP using a qualitative and quantitative approach. Data was collected in two phases: (1) a survey on OP and related variables among 5th and 6th graders (10-12 years old) (n = 573); and (2) a mapping activity and semi-structured interview among a subsample of the survey (n = 80). The most common locations for routine OP were parks (40%) followed by public facilities (26%) and streets (17%). OP was significantly associated with perceived environment, independent mobility and gender, but not with neighborhood type. Inner-city participants reported a higher number and greater variety of OP areas (23 vs. 14). Three main barriers of OP were identified-low quality and poorly maintained play areas, other people in public spaces, and social norms that undermine OP. Thus, in order to encourage routine OP, environmental change to create safe and attractive OP settings should be accompanied by community interventions to enhance social norms that are supportive of OP.
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Affiliation(s)
- Mika R Moran
- Faculty of Architecture and Town Planning, Technion-Israel Institute of Technology, Haifa 320003, Israel.
| | - Pnina Plaut
- Faculty of Architecture and Town Planning, Technion-Israel Institute of Technology, Haifa 320003, Israel.
| | - Dafna Merom
- School of Science and Health, Western Sydney University, Penrith, NSW 2751, Australia.
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Abstract
Studies support the use of exercise prescriptions in adults, but few studies have evaluated their use in children. One common barrier to effective physical activity counseling is lack of resources. Outdoors Rx is a collaboration between the Appalachian Mountain Club and the Massachusetts General Hospital for Children that pairs exercise prescriptions with guided outdoor programs to increase physical activity among children. This article describes the design and implementation of Outdoors Rx at 2 community health centers serving ethnically diverse, low-income, urban families, as well as evaluates feedback from participating pediatricians regarding the utility of the program, barriers to success, and suggestions for improvement. Our results illustrate the feasibility of implementing a pediatric physical activity prescription program in community health centers serving traditionally underserved populations. Our data suggest that physical activity prescription programs are well received by both pediatricians and families and are a useful tool for facilitating physical activity counseling.
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Affiliation(s)
- Aisha K James
- 1 Massachusetts General Hospital for Children, Boston, MA, USA
| | - Pam Hess
- 2 Appalachian Mountain Club, Boston, MA, USA
| | | | - Elsie M Taveras
- 1 Massachusetts General Hospital for Children, Boston, MA, USA
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Associations between Parental and Friend Social Support and Children's Physical Activity and Time Spent outside Playing. Int J Pediatr 2017; 2017:7582398. [PMID: 28348605 PMCID: PMC5350297 DOI: 10.1155/2017/7582398] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2016] [Revised: 01/19/2017] [Accepted: 02/15/2017] [Indexed: 01/26/2023] Open
Abstract
The purpose of this study was to examine the structural validity of a parent and a child questionnaire that assessed parental and friends' influences on children's physical activity and investigate the associations between the derived factors, physical activity, and time spent outside. Children (N = 154, mean age = 11.7) and 144 of their parents completed questionnaires assessing parental and friends' influences on children's physical activity. Children wore a pedometer for six days. Exploratory factor analyses revealed four factors for the parental and five for the child's questionnaire that explained 66.71% and 63.85% of the variance, respectively. Five factors were significantly associated with physical activity and five significantly associated with time spent outside. Higher correlations were revealed between “general friend support,” “friends' activity norms,” and physical activity (r = 0.343 and 0.333 resp., p < 0.001) and between “general friend support” and time spent outside (r = 0.460, p < 0.001). Obtaining information relating to parental and friends' influences on physical activity from both parents and children may provide a more complete picture of influences. Parents and friends seem to influence children's physical activity behavior and time spent outside, but friends' influences may have a stronger impact on children's behaviors.
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Perry CK, Ackert E, Sallis JF, Glanz K, Saelens BE. Places where children are active: A longitudinal examination of children's physical activity. Prev Med 2016; 93:88-95. [PMID: 27658898 PMCID: PMC5785088 DOI: 10.1016/j.ypmed.2016.09.015] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2016] [Revised: 09/07/2016] [Accepted: 09/19/2016] [Indexed: 11/30/2022]
Abstract
Using two-year longitudinal data, we examined locations where children spent time and were active, whether location patterns were stable, and relationships between spending time in their home neighborhood and moderate to vigorous physical activity (MVPA). At two time points (2007-2009 and 2009-2011), children living in the metropolitans areas of either San Diego, CA or Seattle, WA wore an accelerometer, and parents recorded their child's locations for seven days. Across two years, global average proportion of time spent in each location was stable, but total time and proportion of time in each location spent in MVPA decreased significantly across all locations. Children spent the largest proportion of time in MVPA in their home neighborhood at both time points, although they spent little time in their home neighborhood.
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Affiliation(s)
- Cynthia K Perry
- Oregon Health & Science University School of Nursing, 3455 SW US Veterans Hospital Rd. Portland, OR 97239, USA; University of Washington Family & Child Nursing, 1959 NE Pacific St Seattle, WA 98195, USA.
| | - Elizabeth Ackert
- University of Washington Department of Sociology, 211 Savery Hall, Box 353340, Seattle, WA 98195-3340, United States; University of Texas at Austin, 305 E. 23rd Street, Stop G1800, Austin, TX 78712-1699, United States
| | - James F Sallis
- University of California, San Diego, United States; Department of Family Medicine & Public Health, 3900 Fifth Avenue, Suite 310, San Diego, CA 92103, United States
| | - Karen Glanz
- University of Pennsylvania Perelman School of Medicine and School of Nursing, 423 Guardian Drive, Philadelphia, PA 19104, United States
| | - Brian E Saelens
- University of Washington Department of Pediatrics and Seattle Children's Hospital Research Institute, P.O. Box 5371, Seattle, WA 98145, USA
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Saldanha-Gomes C, Heude B, Charles MA, de Lauzon-Guillain B, Botton J, Carles S, Forhan A, Dargent-Molina P, Lioret S. Prospective associations between energy balance-related behaviors at 2 years of age and subsequent adiposity: the EDEN mother-child cohort. Int J Obes (Lond) 2016; 41:38-45. [PMID: 27528250 DOI: 10.1038/ijo.2016.138] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2015] [Revised: 06/01/2016] [Accepted: 07/23/2016] [Indexed: 12/20/2022]
Abstract
BACKGROUND/OBJECTIVES Sedentary behavior, physical activity and dietary behavior are formed early during childhood and tend to remain relatively stable into later life. No longitudinal studies have assessed the independent influence of these three energy balance-related behaviors during toddlerhood on later adiposity. We aimed to analyze the associations between TV/DVD watching time, outdoor play time and dietary patterns at the age of 2 years and child adiposity at the age of 5 years, in boys and girls separately. SUBJECTS/METHODS This study included 883 children from the French EDEN mother-child cohort. TV/DVD watching time, outdoor play time and dietary intakes were reported by parents in questionnaires when the child was aged 2 years. Two dietary patterns, labeled 'Guidelines' and 'Processed, fast foods', were identified in a previous study. The percentage of body fat (%BF) based on bioelectrical impedance analysis and body mass index were measured at the age of 5 years. RESULTS In boys, TV/DVD watching time at the age of 2 years was positively associated with %BF at the age of 5 years (β=0.50 (95% confidence interval: 0.001, 1.00) for those boys with ⩾60 min per day of TV/DVD watching time vs those with ⩽15 min per day, P-value for trend 0.05). In girls, outdoor play was inversely associated with %BF (β=-0.96 (95% confidence interval: -1.60, -0.32) for those in the highest tertile of outdoor play time vs those in the lowest tertile, P=0.001). Overall, at the age of 2 years, dietary patterns were associated with both TV/DVD watching time and outdoor play time, but no significant and independent association was observed between dietary patterns and later adiposity. CONCLUSION This study shows longitudinal and gender-differentiated relations between both TV/DVD watching time and outdoor play time in toddlerhood and later adiposity, whereas evidence for a relation between dietary patterns and subsequent fat development was less conclusive. Early childhood-by the age of 2 years-should be targeted as a critical time for promoting healthy energy balance-related behaviors.
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Affiliation(s)
- C Saldanha-Gomes
- INSERM, UMR1153 Epidemiology and Biostatistics Sorbonne Paris Cité Center (CRESS), Early ORigin of the Child's Health and Development Team (ORCHAD), Paris, France.,Paris-Sud University, Faculty of medicine, Kremlin-Bicêtre, France
| | - B Heude
- INSERM, UMR1153 Epidemiology and Biostatistics Sorbonne Paris Cité Center (CRESS), Early ORigin of the Child's Health and Development Team (ORCHAD), Paris, France.,Paris Descartes University, Paris, France
| | - M-A Charles
- INSERM, UMR1153 Epidemiology and Biostatistics Sorbonne Paris Cité Center (CRESS), Early ORigin of the Child's Health and Development Team (ORCHAD), Paris, France.,Paris Descartes University, Paris, France
| | - B de Lauzon-Guillain
- INSERM, UMR1153 Epidemiology and Biostatistics Sorbonne Paris Cité Center (CRESS), Early ORigin of the Child's Health and Development Team (ORCHAD), Paris, France.,Paris Descartes University, Paris, France
| | - J Botton
- INSERM, UMR1153 Epidemiology and Biostatistics Sorbonne Paris Cité Center (CRESS), Early ORigin of the Child's Health and Development Team (ORCHAD), Paris, France.,Paris-Sud University, Faculty of Pharmacy, Châtenay-Malabry, France
| | - S Carles
- INSERM, UMR1153 Epidemiology and Biostatistics Sorbonne Paris Cité Center (CRESS), Early ORigin of the Child's Health and Development Team (ORCHAD), Paris, France.,Paris-Sud University, Faculty of medicine, Kremlin-Bicêtre, France
| | - A Forhan
- INSERM, UMR1153 Epidemiology and Biostatistics Sorbonne Paris Cité Center (CRESS), Early ORigin of the Child's Health and Development Team (ORCHAD), Paris, France.,Paris Descartes University, Paris, France
| | - P Dargent-Molina
- INSERM, UMR1153 Epidemiology and Biostatistics Sorbonne Paris Cité Center (CRESS), Early ORigin of the Child's Health and Development Team (ORCHAD), Paris, France.,Paris Descartes University, Paris, France
| | - S Lioret
- INSERM, UMR1153 Epidemiology and Biostatistics Sorbonne Paris Cité Center (CRESS), Early ORigin of the Child's Health and Development Team (ORCHAD), Paris, France.,Paris Descartes University, Paris, France
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Schoeppe S, Trost SG. Maternal and paternal support for physical activity and healthy eating in preschool children: a cross-sectional study. BMC Public Health 2015; 15:971. [PMID: 26415527 PMCID: PMC4587864 DOI: 10.1186/s12889-015-2318-9] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2015] [Accepted: 09/22/2015] [Indexed: 12/31/2022] Open
Abstract
Background Parental support is a key influence on children’s health behaviours; however, no previous investigation has simultaneously explored the influence of mothers’ and fathers’ social support on eating and physical activity in preschool-aged children. This study evaluated the singular and combined effects of maternal and paternal support for physical activity (PA) and fruit and vegetable consumption (FV) on preschoolers’ PA and FV. Methods A random sample comprising 173 parent–child dyads completed validated scales assessing maternal and paternal instrumental support and child PA and FV behaviour. Pearson correlations, controlling for child age, parental age, and parental education, were used to evaluate relationships between maternal and paternal support and child PA and FV. K-means cluster analysis was used to identify families with distinct patterns of maternal and paternal support for PA and FV, and one-way ANOVA examined the impact of cluster membership on child PA and FV. Results Maternal and paternal support for PA were positively associated with child PA (r = 0.37 and r = 0.36, respectively; P < 0.001). Maternal but not paternal support for FV was positively associated with child FV (r = 0.35; P < 0.001). Five clusters characterised groups of families with distinct configurations of maternal and paternal support for PA and FV: 1) above average maternal and paternal support for PA and FV, 2) below average maternal and paternal support for PA and FV, 3) above average maternal and paternal support for PA but below average maternal and paternal support for FV, 4) above average maternal and paternal support for FV but below average maternal and paternal support for PA, and 5) above average maternal support but below average paternal support for PA and FV. Children from families with above average maternal and paternal support for both health behaviours had higher PA and FV levels than children from families with above average support for just one health behaviour, or below average support for both behaviours. Conclusions The level and consistency of instrumental support from mothers and fathers for PA and FV may be an important target for obesity prevention in preschool-aged children.
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Affiliation(s)
- Stephanie Schoeppe
- Centre for Children's Health Research, Institute of Health and Biomedical Innovation, Queensland University of Technology, 62 Graham Street, South Brisbane, QLD, 4101, Australia.
| | - Stewart G Trost
- School of Exercise and Nutrition Sciences, Institute of Health and Biomedical Innovation, Queensland University of Technology, 60 Musk Avenue, Kelvin Grove, Brisbane, QLD, 4059, Australia.
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Bocarro JN, Floyd MF, Smith WR, Edwards MB, Schultz CL, Baran P, Moore RA, Cosco N, Suau LJ. Social and Environmental Factors Related to Boys' and Girls' Park-Based Physical Activity. Prev Chronic Dis 2015; 12:E97. [PMID: 26086610 PMCID: PMC4473603 DOI: 10.5888/pcd12.140532] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION Parks provide opportunities for physical activity for children. This study examined sex differences in correlates of park-based physical activity because differences may indicate that a standard environmental intervention to increase activity among children may not equally benefit boys and girls. METHODS The System for Observation Play and Recreation in Communities was used to measure physical activity among 2,712 children and adolescents in 20 neighborhood parks in Durham, North Carolina, in 2007. Sedentary activity, walking, vigorous park activity, and energy expenditure were the primary outcome variables. Hierarchical logit regression models of physical activity were estimated separately for boys and girls. RESULTS Type of activity area and presence of other active children were positively associated with boys' and girls' physical activity, and presence of a parent was negatively associated. A significant interaction involving number of recreation facilities in combination with formal activities was positively associated with girls' activity. A significant interaction involving formal park activity and young boys (aged 0-5 y) was negatively associated with park-based physical activity. CONCLUSION Activity area and social correlates of park-based physical activity were similar for boys and girls; findings for formal park programming, age, and number of facilities were mixed. Results show that girls' physical activity was more strongly affected by social effects (eg, presence of other active children) whereas boys' physical activity was more strongly influenced by the availability of park facilities. These results can inform park planning and design. Additional studies are necessary to clarify sex differences in correlates of park-based physical activity.
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Affiliation(s)
- Jason N Bocarro
- Department of Parks, Recreation, and Tourism Management, North Carolina State University, Box 8004, Biltmore Hall, Raleigh, NC 27695.
| | - Myron F Floyd
- North Carolina State University, Raleigh, North Carolina
| | | | | | | | - Perver Baran
- North Carolina State University, Raleigh, North Carolina
| | - Robin A Moore
- North Carolina State University, Raleigh, North Carolina
| | - Nilda Cosco
- North Carolina State University, Raleigh, North Carolina
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Perceptions of the Neighborhood Environment and Children's Afterschool Moderate-to-Vigorous Physical Activity. Pediatr Exerc Sci 2015; 27:243-51. [PMID: 25679820 PMCID: PMC4642443 DOI: 10.1123/pes.2014-0139] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Previous research suggests the neighborhood environment may be an important influence on children's physical activity (PA) behaviors; however, findings are inconsistent. The purpose of this study was to further understand the relationship between perceptions of the neighborhood environment and children's afterschool moderate-to-vigorous PA. Utilizing a structural equation modeling technique, we tested a conceptual model linking parent and child perceptions of the neighborhood environment, parent support for PA, and child outdoor PA with children's afterschool moderate-to vigorous PA. We found that child perception of the neighborhood environment and outdoor PA were positively associated with afterschool moderate-to-vigorous PA. In addition, parent support for PA positively influenced children's outdoor PA. The neighborhood environment and outdoor activity appear to play an influential role on children's afterschool PA behaviors.
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Bernhard MC, Kent ST, Sloan ME, Evans MB, McClure LA, Gohlke JM. Measuring personal heat exposure in an urban and rural environment. ENVIRONMENTAL RESEARCH 2015; 137:410-8. [PMID: 25617601 PMCID: PMC4355189 DOI: 10.1016/j.envres.2014.11.002] [Citation(s) in RCA: 59] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/27/2014] [Revised: 10/22/2014] [Accepted: 11/03/2014] [Indexed: 05/18/2023]
Abstract
Previous studies have linked heat waves to adverse health outcomes using ambient temperature as a proxy for estimating exposure. The goal of the present study was to test a method for determining personal heat exposure. An occupationally exposed group (urban groundskeepers in Birmingham, AL, USA N=21), as well as urban and rural community members from Birmingham, AL (N=30) or west central AL (N=30) wore data logging temperature and light monitors clipped to the shoe for 7 days during the summer of 2012. We found that a temperature monitor clipped to the shoe provided a comfortable and feasible method for recording personal heat exposure. Ambient temperature (°C) recorded at the nearest weather station was significantly associated with personal heat exposure [β 0.37, 95%CI (0.35, 0.39)], particularly in groundskeepers who spent more of their total time outdoors [β 0.42, 95%CI (0.39, 0.46)]. Factors significantly associated with lower personal heat exposure include reported time indoors [β -2.02, 95%CI (-2.15, -1.89)], reported income>20K [β -1.05, 95%CI (-1.79, -0.30)], and measured % body fat [β -0.07, 95%CI (-0.12, -0.02)]. There were significant associations between income and % body fat with lower indoor and nighttime exposures, but not with outdoor heat exposure, suggesting modifications of the home thermal environment play an important role in determining overall heat exposure. Further delineation of the effect of personal characteristics on heat exposure may help to develop targeted strategies for preventing heat-related illness.
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Affiliation(s)
- Molly C Bernhard
- Department of Environmental Health Sciences, School of Public Health, University of Alabama at Birmingham (UAB), Birmingham, AL 35294, USA
| | - Shia T Kent
- Department of Epidemiology, School of Public Health, UAB, Birmingham, AL 35294, USA
| | | | - Mary B Evans
- Center for the Study of Community Health, School of Public Health, UAB, Birmingham, AL 35294, USA
| | - Leslie A McClure
- Department of Biostatistics, School of Public Health, UAB, Birmingham, AL 35294, USA
| | - Julia M Gohlke
- Department of Environmental Health Sciences, School of Public Health, University of Alabama at Birmingham (UAB), Birmingham, AL 35294, USA
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Xu H, Wen LM, Rissel C. Associations of parental influences with physical activity and screen time among young children: a systematic review. J Obes 2015; 2015:546925. [PMID: 25874123 PMCID: PMC4383435 DOI: 10.1155/2015/546925] [Citation(s) in RCA: 222] [Impact Index Per Article: 24.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2014] [Revised: 11/14/2014] [Accepted: 11/24/2014] [Indexed: 11/17/2022] Open
Abstract
Parents play a critical role in developing and shaping their children's physical activity (PA) and sedentary behaviours, particularly in the early years of life. The aim of this systematic review is to identify current literature investigating associations of parental influences with both PA and screen time in young children. This systematic review was conducted in November 2013 using 6 electronic databases covering research literature from January 1998 to November 2013. Thirty articles that met inclusion criteria were identified. These studies covered five important aspects of parenting: (1) parenting practices; (2) parents' role modelling; (3) parental perceptions of children's PA and screen viewing behaviours; (4) parental self-efficacy; and (5) general parenting style. Findings suggest that parents' encouragement and support can increase children's PA, and reducing parents' own screen time can lead to decreased child screen time. Improving parenting practices, parental self-efficacy or changing parenting style may also be promising approaches to increasing PA time and decreasing screen time of young children.
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Affiliation(s)
- Huilan Xu
- Sydney School of Public Health, University of Sydney, Sydney, NSW 2006, Australia
- Health Promotion Service, Sydney Local Health District, Level 9, King George V Building, Missenden Road, Camperdown, NSW 2050, Australia
- *Huilan Xu:
| | - Li Ming Wen
- Sydney School of Public Health, University of Sydney, Sydney, NSW 2006, Australia
- Health Promotion Service, Sydney Local Health District, Level 9, King George V Building, Missenden Road, Camperdown, NSW 2050, Australia
- Shanghai 10th People's Hospital, University of Tongji, Shanghai, China
| | - Chris Rissel
- Sydney School of Public Health, University of Sydney, Sydney, NSW 2006, Australia
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40
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Remmers T, Van Kann D, Gubbels J, Schmidt S, de Vries S, Ettema D, Kremers SPJ, Thijs C. Moderators of the longitudinal relationship between the perceived physical environment and outside play in children: the KOALA birth cohort study. Int J Behav Nutr Phys Act 2014; 11:150. [PMID: 25496008 PMCID: PMC4271341 DOI: 10.1186/s12966-014-0150-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2014] [Accepted: 11/25/2014] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVES Promoting unstructured outside play is a promising vehicle to increase children's physical activity (PA). This study investigates if factors of the social environment moderate the relationship between the perceived physical environment and outside play. STUDY DESIGN 1875 parents from the KOALA Birth Cohort Study reported on their child's outside play around age five years, and 1516 parents around age seven years. Linear mixed model analyses were performed to evaluate (moderating) relationships among factors of the social environment (parenting influences and social capital), the perceived physical environment, and outside play at age five and seven. Season was entered as a random factor in these analyses. RESULTS Accessibility of PA facilities, positive parental attitude towards PA and social capital were associated with more outside play, while parental concern and restriction of screen time were related with less outside play. We found two significant interactions; both involving parent perceived responsibility towards child PA participation. CONCLUSION Although we found a limited number of interactions, this study demonstrated that the impact of the perceived physical environment may differ across levels of parent responsibility.
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Affiliation(s)
- Teun Remmers
- Maastricht University (Medical Center+), CAPHRI School for Public Health and Primary Care, Department of Epidemiology, P.O. Box 616, 6200MD, Maastricht, The Netherlands.
| | - Dave Van Kann
- Maastricht University (Medical Center+), CAPHRI School for Public Health and Primary Care, Department of Health Promotion, Maastricht, The Netherlands.
| | - Jessica Gubbels
- Maastricht University (Medical Center+), NUTRIM School for Nutrition, Toxicology and Metabolism, Department of Health Promotion, Maastricht, The Netherlands.
| | - Swantje Schmidt
- Maastricht University (Medical Center+), CAPHRI School for Public Health and Primary Care, Department of Epidemiology, P.O. Box 616, 6200MD, Maastricht, The Netherlands.
| | - Sanne de Vries
- TNO Department of Life Style, Leiden, The Netherlands. .,The Hague University of Applied Sciences, The Hague, The Netherlands.
| | - Dick Ettema
- Department of Social Geography, Utrecht University, Utrecht, The Netherlands.
| | - Stef P J Kremers
- Maastricht University (Medical Center+), NUTRIM School for Nutrition, Toxicology and Metabolism, Department of Health Promotion, Maastricht, The Netherlands.
| | - Carel Thijs
- Maastricht University (Medical Center+), CAPHRI School for Public Health and Primary Care, Department of Epidemiology, P.O. Box 616, 6200MD, Maastricht, The Netherlands.
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Child and environmental factors associated with leisure participation in adolescents born extremely preterm. Early Hum Dev 2014; 90:665-72. [PMID: 25194835 DOI: 10.1016/j.earlhumdev.2014.08.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2014] [Revised: 08/07/2014] [Accepted: 08/11/2014] [Indexed: 11/21/2022]
Abstract
BACKGROUND Developmental impairments persist among adolescents born extremely preterm, and these individuals are at an increased risk for chronic disease later in life. Participating in active and positive leisure activities may act as a buffer against negative outcomes, but involvement in active-physical and skill-based activities is low in youth born preterm. AIMS To explore the child and environmental determinants of leisure participation among adolescents born extremely preterm. STUDY DESIGN Cross-sectional study. SUBJECTS Participants were recruited from the hospital's Neonatal Follow-Up Program and included 128 adolescents born preterm (mean gestational age: 26.5 weeks). OUTCOME MEASURES Leisure participation was assessed using the Children's Assessment of Participation and Enjoyment. Potential determinants were assessed using standardized tests and questionnaires. Selected factors were entered into five separate multivariable regression models. RESULTS Child and environmental factors contributed between 21% (skill-based) and 52% (active physical) of the adjusted variance for participation intensity. Lower gestational age was associated with greater participation in recreational activities. Male sex, higher maternal education and better motor competence were associated with involvement in active-physical activities. Being older and feeling socially accepted were associated with participation in social activities. Families oriented to hobbies and higher maternal education were associated with participation in skill-based activities. Preference was the strongest determinant of participation in all five leisure activities. CONCLUSIONS Activities should be adapted to individual skill level, include family and peers, foster social acceptance and be driven by the adolescent's preferences. Although certain factors cannot be modified, they can be used to identify adolescents at risk for low participation.
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Remmers T, Broeren SML, Renders CM, Hirasing RA, van Grieken A, Raat H. A longitudinal study of children's outside play using family environment and perceived physical environment as predictors. Int J Behav Nutr Phys Act 2014; 11:76. [PMID: 24934086 PMCID: PMC4075777 DOI: 10.1186/1479-5868-11-76] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2014] [Accepted: 06/02/2014] [Indexed: 12/04/2022] Open
Abstract
Background A natural and cheap way of increasing children’s physical activity is stimulating unstructured outside play. Purpose This study examined whether characteristics of the family and perceived physical environment were associated with the duration of children’s outside play. Methods Parents participating in the “Be Active, Eat Right” cluster RCT control group (N = 2007) provided information on potential predictors of outside play (i.e. family and perceived physical environment) of their 5-year-old child by questionnaire. Child outside play was assessed by parental reports both at five and seven years. Linear regression analyses, adjusted for seasonality, were performed to evaluate associations between potential predictors and child outside play. Linear mixed models were fitted to evaluate the relationship between potential predictors and the development of outside play over two years, with season entered as a random factor. Results Family environment was the strongest construct predicting child outside play, while parent perceived physical environment had no significant association with child outside play. Parental habit strength and the presence of rules were the strongest predictors of increased outside play. Parent perceived difficulty in improving child outside play was the strongest predictor of decreased outside play. Conclusion Family environment predicted child outside play and not perceived physical environment. Parental rules and habit strength regarding improving outside play were associated with an improvement of child’s engagement in outside play.
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Affiliation(s)
- Teun Remmers
- Department of Public Health, Erasmus MC University Medical Center, P,O, Box 2040, 3000 Rotterdam, CA, The Netherlands.
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Are context-specific measures of parental-reported physical activity and sedentary behaviour associated with accelerometer data in 2-9-year-old European children? Public Health Nutr 2014; 18:860-8. [PMID: 24887315 DOI: 10.1017/s136898001400086x] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The aim of the present study was to investigate if context-specific measures of parental-reported physical activity and sedentary behaviour are associated with objectively measured physical activity and sedentary time in children. DESIGN Cross-sectional study. SETTING Seven European countries taking part in the IDEFICS (Identification and Prevention of Dietary- and Lifestyle-induced Health Effects in Children and Infants) study. SUBJECTS Data were analysed from 2-9-year-old children (n 5982) who provided both parental-reported and accelerometer-derived physical activity/sedentary behaviour measures. Parents reported their children's daily screen-time, weekly sports participation and daily outdoor playtime by means of the Outdoor Playtime Checklist (OPC) and Outdoor Playtime Recall Questions (OPRQ). RESULTS Sports participation, OPC- and OPRQ-derived outdoor play were positively associated with accelerometer-derived physical activity. Television viewing and computer use were positively associated with accelerometer-derived sedentary time. All parental-reported measures that were significantly associated with accelerometer outcomes explained only a minor part of the variance in accelerometer-derived physical activity or sedentary time. CONCLUSIONS Parental-reported measures of physical activity and sedentary behaviour are not useful as a proxy for 2-9-year-old children's physical activity and sedentary time. Findings do not preclude the use of context-specific measures but imply that conclusions should be limited to the context-specific behaviours that are actually measured. Depending on the aim of the study, future research should carefully consider the choice of measurements, including the use of subjective or objective measures of the behaviour of interest or a combination of both.
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Zhou Z, Ren H, Yin Z, Wang L, Wang K. A policy-driven multifaceted approach for early childhood physical fitness promotion: impacts on body composition and physical fitness in young Chinese children. BMC Pediatr 2014; 14:118. [PMID: 24886119 PMCID: PMC4108008 DOI: 10.1186/1471-2431-14-118] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2014] [Accepted: 05/01/2014] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND The prevalence of obesity increased while certain measures of physical fitness deteriorated in preschool children in China over the past decade. This study tested the effectiveness of a multifaceted intervention that integrated childcare center, families, and community to promote healthy growth and physical fitness in preschool Chinese children. METHODS This 12-month study was conducted using a quasi-experimental pretest/posttest design with comparison group. The participants were 357 children (mean age = 4.5 year) enrolled in three grade levels in two childcare centers in Beijing, China. The intervention included: 1) childcare center intervention (physical activity policy changes, teacher training, physical education curriculum and food services training), 2) family intervention (parent education, internet website for support, and family events), and 3) community intervention (playground renovation and community health promotion events). The study outcome measures included body composition (percent body fat, fat mass, and muscle mass), Body Mass Index (BMI) and BMI z-score and physical fitness scores in 20-meter agility run (20M-AR), broad jump for distance (BJ), timed 10-jumps, tennis ball throwing (TBT), sit and reach (SR), balance beam walk (BBW), 20-meter crawl (20M-C)), 30-meter sprint (30M-S)) from a norm referenced test. Measures of process evaluation included monitoring of children's physical activity (activity time and intensity) and food preparation records, and fidelity of intervention protocol implementation. RESULTS Children in the intervention center significantly lowered their body fat percent (-1.2%, p < 0.0001), fat mass (-0.55 kg, p <0.0001), and body weight (0.36 kg, p <0.02) and increased muscle mass (0.48 kg, p <0.0001), compared to children in the control center. They also improved all measures of physical fitness except timed 10-jumps (20M-AR: -0.74 seconds, p < 0.0001; BJ: 8.09 cm, p < 0.0001; TBT: 0.52 meters, p < 0.006; SR: 0.88 cm, p < 0.03; BBW: -2.02 seconds, p <0.0001; 30M-S: -0.45 seconds, p < 0.02; 20M-C: -3.36 seconds, p < 0.0001). Process evaluation data showed that the intervention protocol was implemented with high fidelity. CONCLUSIONS The study demonstrated that a policy-driven multi-faceted intervention can improve preschool children's body composition and physical fitness. Program efficacy should be tested in a randomized trial. TRIAL REGISTRATION ChiCTR-ONRC-14004143.
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Affiliation(s)
- Zhixiong Zhou
- School Of Physical Education and Coaching Science, Capital University of Physical Education and Sports, Beijing, China
- Graduate School of Being Sport University, Beijing, China
| | - Hong Ren
- School of Sport Sciences, Beijing Sport University, Beijing, China
| | - Zenong Yin
- Department of Health and Kinesiology, University of Texas at San Antonio, San Antonio, Texas, USA
| | - Lihong Wang
- Department of Physical Education Physical Education College of Zhengzhou University, Zhengzhou, China
| | - Kaizhen Wang
- School of Recreation and Community Sports, Capital University of Physical Education and Sports, Beijing, China
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Kim HH, Lee CS, Jeon JM, Yu SD, Lee CW, Park JH, Shin DC, Lim YW. Analysis of the association between air pollution and allergic diseases exposure from nearby sources of ambient air pollution within elementary school zones in four Korean cities. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2013; 20:4831-4846. [PMID: 23299970 DOI: 10.1007/s11356-012-1358-2] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/21/2012] [Accepted: 11/21/2012] [Indexed: 06/01/2023]
Abstract
The objectives of this study were to survey elementary school students regarding the environmental conditions of their elementary schools and to assess the relationship between air pollution and allergic disease using the International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire. Therefore, this study was designed as a cross-sectional study. In this study, seven elementary schools were selected and they were classified into three categories. The selection included one school with no traffic-related or other pollutants, three with traffic-related pollutants, and three with traffic-related and other pollutants from industrial and filling station sources. The ISAAC questionnaire survey was given to all of the students except to those in the 1st grade who were presumed to be less likely to be exposed to the school environment than the remainder of the students attending those seven schools. The assessment of allergic disease was conducted on a total of 4,545 students. Three school zones with critical exposure were selected within each school and they were evaluated based on the levels of black carbon (BC), PM10, SO2, NO2, and O3. There was a significant increase in the risks based on the odds ratios of treatment experiences (within 1 year) for allergy-related diseases such as asthma and allergic rhinitis (a) in the school group with traffic-related pollutants and the school group with complex pollutants were 2.12 (1.41-3.19) and 1.59 (1.06-2.37), respectively, in comparison to the school groups with no exposure to pollutants. This was determined based on the odds ratio of symptoms and treatment experiences for allergy-related diseases by group based on the home town zone as a reference. Also, in the case of atopic dermatitis, the odds ratio of treatment experiences (within 1 year) was 1.42 (1.02-1.97), which indicated elevated risks compared to the students in the S1 school. A regression analysis was used to assess the relationship between the substances and the symptomatic experiences within the last year. There were significant increases in the odds ratio of the symptoms associated with allergic rhinitis and the BC and SO2 in the complex pollution areas. The results of the assessment of the relationship between atopic dermatitis-associated symptoms and O3 showed that the odds ratio increased with statistical significance.
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Affiliation(s)
- H-H Kim
- Institute for Environmental Research, Yonsei University College of Medicine, Seoul, South Korea.
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Arundell L, Ridgers ND, Veitch J, Salmon J, Hinkley T, Timperio A. 5-year changes in afterschool physical activity and sedentary behavior. Am J Prev Med 2013; 44:605-11. [PMID: 23683978 DOI: 10.1016/j.amepre.2013.01.029] [Citation(s) in RCA: 60] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2012] [Revised: 11/29/2012] [Accepted: 01/31/2013] [Indexed: 11/30/2022]
Abstract
BACKGROUND The afterschool period holds promise for the promotion of physical activity, yet little is known about the importance of this period as children age. PURPOSE To examine changes in physical activity of children aged 5-6 years and 10-12 years and their sedentary time in the afterschool period over 3 and 5 years, and to determine the contribution of this period to daily physical activity and sedentary behavior over time. METHODS Data from two longitudinal studies conducted in Melbourne, Australia, were used. Accelerometer data were provided for 2053 children at baseline (Children Living in Active Neighbourhoods Study [CLAN]: 2001; Health, Eating and Play Study [HEAPS]: 2002/2003); 756 at 3-year follow-up (time point 2 [T2]); and 622 at 5-year follow-up (T3). Light (LPA), moderate (MPA) and vigorous (VPA) physical activity were determined using age-adjusted cut-points. Sedentary time was defined as ≤ 100 counts/minute. Multilevel analyses, conducted in April 2012, assessed change in physical activity and sedentary time and the contributions of the afterschool period to overall levels. RESULTS Afterschool MPA and VPA decreased among both cohorts, particularly in the younger cohort, who performed less than half of their baseline levels at T3 (MPA: T1=24 minutes; T3=11 minutes; VPA: T1=12 minutes; T3=4 minutes). LPA also declined in the older cohort. Afterschool sedentary time increased among the younger (T1=42 minutes; T3=64 minutes) and older cohorts (T1=57 minutes; T3=84 minutes). The contribution of the afterschool period to overall MPA and VPA increased in the older cohort from 23% to 33% over 5 years. In the younger cohort, the contribution of the afterschool period to daily MPA and VPA decreased by 3% over 5 years. CONCLUSIONS The importance of the afterschool period for children's physical activity increases with age, particularly as children enter adolescence.
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Affiliation(s)
- Lauren Arundell
- Centre for Physical Activity and Nutrition Research (C-PAN), Deakin University, Melbourne, Australia
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Timperio AF, van Stralen MM, Brug J, Bere E, Chinapaw MJM, De Bourdeaudhuij I, Jan N, Maes L, Manios Y, Moreno LA, Salmon J, Te Velde SJ. Direct and indirect associations between the family physical activity environment and sports participation among 10-12 year-old European children: testing the EnRG framework in the ENERGY project. Int J Behav Nutr Phys Act 2013; 10:15. [PMID: 23374374 PMCID: PMC3621808 DOI: 10.1186/1479-5868-10-15] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2012] [Accepted: 01/15/2013] [Indexed: 11/20/2022] Open
Abstract
Background Sport participation makes an important contribution to children’s overall physical activity. Understanding influences on sports participation is important and the family environment is considered key, however few studies have explored the mechanisms by which the family environment influences children’s sport participation. The purpose of this study was to examine whether attitude, perceived behavioural control, health belief and enjoyment mediate associations between the family environment and 10–12 year-old children’s sports participation. Methods Children aged 10–12 years ( = 7234) and one of their parents (n = 6002) were recruited from 175 schools in seven European countries in 2010. Children self-reported their weekly duration of sports participation, physical activity equipment items at home and the four potential mediator variables. Parents responded to items on financial, logistic and emotional support, reinforcement, modelling and co-participation in physical activity. Cross-sectional single and multiple mediation analyses were performed for 4952 children with complete data using multi-level regression analyses. Results Availability of equipment (OR = 1.16), financial (OR = 1.53), logistic (OR = 1.47) and emotional (OR = 1.51) support, and parental modelling (OR = 1.07) were positively associated with participation in ≥ 30mins/wk of sport. Attitude, beliefs, perceived behavioural control and enjoyment mediated and explained between 21-34% of these associations. Perceived behavioural control contributed the most to the mediated effect for each aspect of the family environment. Conclusions Both direct (unmediated) and indirect (mediated) associations were found between most family environment variables and children’s sports participation. Thus, family-based physical activity interventions that focus on enhancing the family environment to support children’s sport participation are warranted.
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Affiliation(s)
- Anna F Timperio
- Centre for Physical Activity and Nutrition Research (C-PAN), Deakin University, 221 Burwood Hwy, Burwood, VIC 3125, Australia.
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Sleddens EFC, Kremers SPJ, Hughes SO, Cross MB, Thijs C, De Vries NK, O'Connor TM. Physical activity parenting: a systematic review of questionnaires and their associations with child activity levels. Obes Rev 2012; 13:1015-33. [PMID: 22845791 DOI: 10.1111/j.1467-789x.2012.01018.x] [Citation(s) in RCA: 73] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Insufficient physical activity (PA) is considered a critical contributor to childhood overweight. Parents are a key in influencing their child's PA through various mechanisms of PA parenting, including support, restriction of PA and facilitation of enrolment in PA classes or activities. However, study findings are difficult to compare because instruments vary in terms of constructs, psychometric assessment and type of PA assessed. The goal of the current review was to identify existing PA parenting questionnaires and report on the validation of these measures through findings of their psychometric performance and correlation to youth's PA. The search of eligible studies was restricted to instruments with multiple items. Eleven unique PA parenting questionnaires were identified, and 46 studies that used these instruments were included. Extracted data include sample characteristics, as well as type and assessment methods of parental influence and PA. Findings highlight the tremendous variation in the conceptualization and measurement of PA parenting, common use of non-validated instruments and lack of comprehensive measures. The development of theory-based PA parenting measures (preferably multidimensional) should be prioritized to guide the study of the parental role in promoting child's PA as well as the design of family-based PA interventions.
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Affiliation(s)
- E F C Sleddens
- Department of Health Promotion, Nutrition and Toxicology Research Institute Maastricht (NUTRIM), Maastricht University Medical Center, Maastricht, The Netherlands.
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Amount and environmental predictors of outdoor playtime at home and school: a cross-sectional analysis of a national sample of preschool-aged children attending Head Start. Health Place 2012; 18:1224-30. [PMID: 23000895 DOI: 10.1016/j.healthplace.2012.08.004] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2012] [Revised: 06/28/2012] [Accepted: 08/16/2012] [Indexed: 01/03/2023]
Abstract
Outdoor play is an important contributor to children's physical activity and the prevalence, correlates, and environmental predictors of it among young children are not well characterized. This study aims to estimate the amount of time preschool-aged children attending Head Start spend playing outdoors at home and school, and whether aspects of the home and school environment are associated with greater outdoor play. We analyzed data (n=2529) collected in spring 2007 in the Head Start Family and Child Experiences Survey (FACES). Overall, 37.5% of children played outside at home >2h per weekday. Children who had a yard near home to play in or who had visited a park or playground or gone on a picnic with a family member in the last month were more likely to have >2h per weekday outdoor play at home, but having a playground within walking distance of the home was not related to home outdoor playtime. On average children played outdoors at Head Start for 36 min per day. The amount of time children played outdoors at home was not related to school outdoor time.
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Aarts MJ, de Vries SI, van Oers HA, Schuit AJ. Outdoor play among children in relation to neighborhood characteristics: a cross-sectional neighborhood observation study. Int J Behav Nutr Phys Act 2012; 9:98. [PMID: 22901102 PMCID: PMC3478217 DOI: 10.1186/1479-5868-9-98] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2011] [Accepted: 07/25/2012] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Although environmental characteristics as perceived by parents are known to be related to children's outdoor play behavior, less is known about the relation between independently measured neighborhood characteristics and outdoor play among children. The purpose of this study was to identify quantitative as well as qualitative neighborhood characteristics related to outdoor play by means of neighborhood observations. METHODS Questionnaires including questions on outdoor play behavior of the child were distributed among 3,651 parents of primary school children (aged 4-12 years). Furthermore, neighborhood observations were conducted in 33 Dutch neighborhoods to map neighborhood characteristics such as buildings, formal outdoor play facilities, public space, street pattern, traffic safety, social neighborhood characteristics, and general impression. Data of the questionnaires and the neighborhood observations were coupled via postal code of the respondents. Multilevel GEE analyses were performed to quantify the correlation between outdoor play and independently measured neighborhood characteristics. RESULTS Parental education was negatively associated with outdoor play among children. Neither the presence nor the overall quality of formal outdoor play facilities were (positively) related to outdoor play among children in this study. Rather, informal play areas such as the presence of sidewalks were related to children's outdoor play. Also, traffic safety was an important characteristic associated with outdoor play. CONCLUSIONS This study showed that, apart from individual factors such as parental education level, certain modifiable characteristics in the neighborhood environment (as measured by neighborhood observations) were associated with outdoor play among boys and girls of different age groups in The Netherlands. Local policy makers from different sectors can use these research findings in creating more activity-friendly neighborhoods for children.
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Affiliation(s)
- Marie-Jeanne Aarts
- Department Tranzo, Scientific Center for Care and Welfare, Tilburg University, Tilburg, The Netherlands.
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