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Idowu J, Pearson N, Meades C, Cross JH, Muggeridge A, Lakhanpaul M, Robinson K, Sherar LB, Reilly C. Accelerometer and Survey Assessed Physical Activity in Children With Epilepsy: A Case-Controlled Study. Pediatr Exerc Sci 2025; 37:164-172. [PMID: 38537628 DOI: 10.1123/pes.2023-0065] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 11/06/2023] [Accepted: 02/07/2024] [Indexed: 04/17/2025]
Abstract
PURPOSE Anecdotal evidence suggests that children with epilepsy (CWE) are limited in the frequency of their daily physical activity (PA). However, there is limited research utilizing device-based measures of PA. We compared levels of PA and sedentary behavior in CWE (11-15 y) and age- and gender-matched healthy controls. METHOD Participants (n = 60 CWE [25 males, 35 females] and n = 49 controls [25 males, 24 females]) wore a Actigraph accelerometer (GT3X or GT3X+) for 7 consecutive days during waking hours and self-reported their PA and sedentary behaviors. CWE were compared with control children on time spent in different intensities of PA and on self-reported PA and sedentary behavior. Factors associated with PA were analyzed using linear regression. RESULTS CWE spent less time in accelerometer assessed light (189.15 vs 215.01 min/d, P < .05) and vigorous PA (35.14 vs 44.28 min/d, P < .05) on weekdays compared with controls. There were no significant differences between CWE and control participants in accelerometer assessed time spent sedentary or time spent in PA on weekends. Among CWE, older children engaged in more reported sedentary behavior and younger children spent more time in most domains of PA (P < .05). Furthermore, CWE reported less PA than controls (P = .006). Sixteen percent of controls met World Health Organization PA guidelines compared with 10% of CWE. There was a positive relationship between accelerometer assessed PA and quality of life for CWE. CONCLUSION CWE spent less time in light and moderate to vigorous PA on weekdays. Further research is needed to understand reasons for these differences.
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Affiliation(s)
- Joan Idowu
- Research Department, Young Epilepsy, Lingfield, Surrey,United Kingdom
| | - Natalie Pearson
- School of Sport, Exercise & Health Sciences, Loughborough University, Leicestershire,United Kingdom
| | - Collette Meades
- Research Department, Young Epilepsy, Lingfield, Surrey,United Kingdom
| | - J Helen Cross
- Research Department, Young Epilepsy, Lingfield, Surrey,United Kingdom
- UCL Great Ormond Street Institute of Child Health (ICH), London,United Kingdom
- Great Ormond Street Hospital for Children NHS Trust, London,United Kingdom
| | - Amy Muggeridge
- Research Department, Young Epilepsy, Lingfield, Surrey,United Kingdom
| | - Monica Lakhanpaul
- UCL Great Ormond Street Institute of Child Health (ICH), London,United Kingdom
| | | | - Lauren B Sherar
- School of Sport, Exercise & Health Sciences, Loughborough University, Leicestershire,United Kingdom
| | - Colin Reilly
- Research Department, Young Epilepsy, Lingfield, Surrey,United Kingdom
- UCL Great Ormond Street Institute of Child Health (ICH), London,United Kingdom
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Savage MJ, Procter EL, Hennis P, Price AG, Magistro D, James RM. Prevalence of adverse cardiometabolic health markers in UK undergraduate university students: an observational cohort study. BMJ Open 2025; 15:e089771. [PMID: 40288791 PMCID: PMC12035434 DOI: 10.1136/bmjopen-2024-089771] [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: 06/10/2024] [Accepted: 03/07/2025] [Indexed: 04/29/2025] Open
Abstract
OBJECTIVES The prevalence of adverse cardiometabolic health markers has increased substantially in UK young adults, and university students now make up a significant proportion of this population. Their health-related behaviours are poorer than age-matched normative data, and students' anthropometric outcomes deteriorate during their university career. The influence of university on cardiometabolic health markers is unclear, and men and students of Minoritised Ethnicity are often under-represented in student health research. This study aimed to determine the prevalence of adverse cardiometabolic health markers in undergraduate university students and assess differences between genders, ethnic groups and year of study. DESIGN Observational cohort study. SETTING A higher education institution in Nottingham, UK. PARTICIPANTS Three independent cohorts of undergraduate university students (total n=1,299) completed five physiological tests and provided demographic information. One-way ANOVAs assessed differences between year of study and ethnic groups, and paired samples t-tests assessed differences between genders. MAIN OUTCOME MEASURES Body mass index (BMI), waist circumference, waist to hip ratio (WHR), waist to height ratio (WHtR), blood pressure (BP) and glycated haemoglobin concentrations (HbA1c). RESULTS 34.5% had overweight or obesity, 7.6% had a 'very high' waist circumference, 11.0% had a high WHR, 25.5% had a high WHtR, 12.7% were classified as hypertensive and 3.0% had an HbA1c ≥42 mmol/mol, indicating impaired glucose regulation. Differences between year groups were present for diastolic BP and HbA1c (p<0.01). Gender and ethnic group differences (p<0.05) were present for all variables other than BMI (gender) and diastolic BP (gender and ethnic group). CONCLUSION Overall, these data demonstrate the prevalence of adverse cardiometabolic health markers in UK undergraduate university students, highlighting differences between year groups, genders and ethnic groups. These findings should be considered when developing strategies to promote healthy lifestyles in higher education.
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Affiliation(s)
- Matthew J Savage
- SHAPE Research Group, School of Science and Technology, Nottingham Trent University, Nottingham, UK
- University of Leicester Diabetes Research Centre, Leicester, UK
- NIHR Leicester Biomedical Research Centre, Leicester, UK
| | | | | | | | | | - Ruth M James
- University of Leicester Diabetes Research Centre, Leicester, UK
- NIHR Leicester Biomedical Research Centre, Leicester, UK
- Nottingham Trent University, Nottingham, UK
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Savage MJ, Procter EL, Magistro D, Hennis PJ, Donaldson J, Leslie-Walker A, Jones BA, James RM. Characterising the activity, lifestyle behaviours and health outcomes of UK university students: an observational cohort study with a focus on gender and ethnicity. BMC Public Health 2024; 24:3501. [PMID: 39696093 DOI: 10.1186/s12889-024-20911-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Accepted: 11/29/2024] [Indexed: 12/20/2024] Open
Abstract
BACKGROUND Health-related outcomes and behaviours in university students are known to be poor relative to the general population. The substantial contextual shifts related to the COVID-19 pandemic, combined with increased numbers of students from minoritised ethnicity backgrounds and presenting as trans and gender diverse (TGD), means that up-to-date information is unavailable. The primary aim of this study was therefore to characterise the current movement, dietary and lifestyle behaviours, mental health, and Body Mass Index (BMI) of UK university students and assess differences between genders and ethnic groups. METHODS An online, self-report survey was administered across three years (2021-2023). Three independent cohorts of university students' (n = 6,327) completed the survey on four key topic areas. One-way ANOVAs were used to assess differences between genders (men, women, TGD), and independent samples t-tests were used to assess differences between ethnic groups (White, Minoritised Ethnicity). RESULTS 30% of students were not meeting physical activity guidelines, 54% were sedentary for ≥ 6 h·d- 1, 83% had poor diet quality, 51% were in high or increased risk groups for alcohol consumption, 18% experienced terrible or poor sleep quality, and 32% were overweight or obese. Gender differences were present for all variables other than walking physical activity (WPA) (P < 0.05), with men having better mental health and engaging in healthier movement and sleeping behaviours, whereas women had more healthful dietary and drinking behaviours, and TGD students had poorer outcomes compared to cis-gender students in most domains. Differences between White and minoritised ethnicity students were present for all variables other than sedentary behaviour, diet quality, WPA and BMI (P < 0.05); students of minoritised ethnicity engaged in better movement, drinking and sleep behaviours in addition to having more positive mental health than White students. CONCLUSION The findings of the current study provide an update on the landscape of UK university students' health and health-related behaviours. Overall, health-related outcomes and behaviours are poor in this population and these data suggest that gender and ethnicity play a role in determining students' health and health-related behaviours. Therefore, these factors should be considered when developing strategies to promote healthy living in the context of higher education.
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Affiliation(s)
- Matthew J Savage
- SHAPE Research Group, School of Science and Technology, Nottingham Trent University, Nottingham, UK
- Diabetes Research Centre, University of Leicester, Leicester, UK
| | - Eleanor L Procter
- SHAPE Research Group, School of Science and Technology, Nottingham Trent University, Nottingham, UK
| | - Daniele Magistro
- SHAPE Research Group, School of Science and Technology, Nottingham Trent University, Nottingham, UK
| | - Philip J Hennis
- SHAPE Research Group, School of Science and Technology, Nottingham Trent University, Nottingham, UK
| | - James Donaldson
- Department of Cardiovascular Sciences, University of Leicester, Leicester, UK
| | - Anika Leslie-Walker
- SHAPE Research Group, School of Science and Technology, Nottingham Trent University, Nottingham, UK
| | - Bethany A Jones
- Department of Psychology, Nottingham Trent University, Nottingham, UK
| | - Ruth M James
- SHAPE Research Group, School of Science and Technology, Nottingham Trent University, Nottingham, UK.
- Diabetes Research Centre, University of Leicester, Leicester, UK.
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Jago R, House D, Salway R, Walker R, Emm-Collison L, Sansum K, Breheny K, Churchward S, Williams JG, Hollingworth W, de Vocht F. Assessing the impact of COVID-19 on the physical activity of 10-11-year-old children and their parents: Active-6 a mixed-methods study. PUBLIC HEALTH RESEARCH 2024; 12:1-29. [PMID: 39579379 DOI: 10.3310/wyht5821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2024] Open
Abstract
Background Physical activity is essential for long-term health, yet data from before the COVID-19 pandemic showed only 41% of 10- to 11-year-olds met the UK government's physical activity recommendations. Children's physical activity was limited during the national COVID-19 lockdowns. It is important to measure children's physical activity in the recovery period to assess the short- and medium-term impact of the lockdowns. Objectives To use mixed-methods to assess the impact of the COVID-19 pandemic on moderate-to-vigorous physical activity of year 6 children in the short-term (2021) and medium-term (2022) recovery periods by comparing these with data sampled from the same schools in 2017/18. Methods Quantitative and qualitative data were collected in two waves: wave 1 (May-December 2021), when lockdowns had finished but some COVID-19 mitigation policies were still in place, and wave 2 (January-July 2022), when most restrictions had been removed. These were compared with baseline data from similar year 6 children and parents/carers in the same schools collected between March 2017 and June 2018 (wave 0). Results In wave 1, average child accelerometer-measured weekday moderate-to-vigorous physical activity was 7-8 minutes lower than pre-pandemic while sedentary time was higher by almost 30 minutes. Child moderate-to-vigorous physical activity had recovered to pre-pandemic levels in wave 2, although sedentary time remained elevated. Across our studies, we found a new normal for child physical activity, characterised as more dependent on structured activities such as active clubs. Physical activity inequalities appear to be widening among girls and low socioeconomic position families, as they face unique barriers to participating in the new normal. Limitations Our sample includes more households with higher educational qualifications and predominantly female parents. Undertaking this research in schools while COVID-19 disruptions were ongoing created challenges to data collection which may have limited schools' and families' participation. Conclusions COVID-19 lockdowns negatively impacted child physical activity. It took almost a year of no restrictions for this to recover, and sedentary time remains high. Despite this recovery, 59% of children do not meet activity guidelines. There is a new normal to child physical activity that relies on structured activities, and some children and families may face challenges to taking part in the new normal. Strategies are needed to increase child physical activity for all. Future work Develop new ways to work in partnership with schools to design bespoke physical activity programmes that can be delivered at the school site. Develop new ways to help girls and children from lower-income households to be physically active. Find the most effective means of maximising existing school resources such as extended school provision (after-school clubs) and physical resources (equipment) to promote physical activity outside of curriculum time. Funding This synopsis presents independent research funded by the National Institute for Health and Care Research (NIHR) Public Health Research as award number NIHR131847.
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Affiliation(s)
- Russell Jago
- Centre for Exercise, Nutrition & Health Sciences, School for Policy Studies, University of Bristol, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- The National Institute for Health Research, Applied Research Collaboration West (NIHR ARC West), University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
| | - Danielle House
- Centre for Exercise, Nutrition & Health Sciences, School for Policy Studies, University of Bristol, Bristol, UK
| | - Ruth Salway
- Centre for Exercise, Nutrition & Health Sciences, School for Policy Studies, University of Bristol, Bristol, UK
| | - Robert Walker
- Centre for Exercise, Nutrition & Health Sciences, School for Policy Studies, University of Bristol, Bristol, UK
| | - Lydia Emm-Collison
- Centre for Exercise, Nutrition & Health Sciences, School for Policy Studies, University of Bristol, Bristol, UK
| | - Kate Sansum
- Centre for Exercise, Nutrition & Health Sciences, School for Policy Studies, University of Bristol, Bristol, UK
| | - Katie Breheny
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- The National Institute for Health Research, Applied Research Collaboration West (NIHR ARC West), University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
| | | | - Joanna G Williams
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- Communities and Public Health, Bristol City Council, Bristol, UK
| | - William Hollingworth
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- The National Institute for Health Research, Applied Research Collaboration West (NIHR ARC West), University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
| | - Frank de Vocht
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- The National Institute for Health Research, Applied Research Collaboration West (NIHR ARC West), University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
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Salway R, House D, Walker R, Emm-Collison L, Breheny K, Sansum K, Williams JG, Hollingworth W, de Vocht F, Jago R. School-level variation in children's moderate to vigorous intensity physical activity before and after COVID-19: a multilevel model analysis. PUBLIC HEALTH RESEARCH 2024; 12:147-168. [PMID: 39360867 DOI: 10.3310/wqjk9893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/05/2024] Open
Abstract
Background and objectives Schools play a crucial role in facilitating physical activity among children, but the COVID-19 pandemic has affected both children's physical activity and the school environment. It is essential to understand between-school differences in children's physical activity post lockdown, to determine if and how the role of schools has changed. Design and participants Active-6 is a natural experiment comparing postlockdown accelerometer-estimated physical activity to a pre-COVID-19 comparator group. Accelerometer and individual data were collected on 1296 children aged 10-11 pre-COVID-19 (2017-8), with school characteristics collected from the 50 schools they attended. Post lockdown, we collected accelerometer, individual and school data from 393 children in 23 of the same schools and 436 children in 27 of the same schools in 2021 (Wave 1) and 2022 (Wave 2), respectively. Methods Sources of variation (between-school, between-pupil and within-pupil) in child weekday moderate to vigorous physical activity at each wave were modelled using linear mixed-effects models with school-level wave random coefficients. We extended the model to estimate the proportion of between-school variation explained by school policy, curriculum and physical environment factors and school-aggregated pupil characteristics. We also explored the extent to which postlockdown differences in moderate to vigorous physical activity were mediated by individual or school factors. Results Between-school variation comprised 13% of the total variation pre-COVID-19, 7% in Wave 1 and 13% in Wave 2. School factors associated with moderate to vigorous physical activity were the following: whether physical education was compromised due to space (often: 9 minutes lower moderate to vigorous physical activity; sometimes: 5.4 minutes lower); high after-school club attendance (7 minutes higher moderate to vigorous physical activity for each additional club attended on average in the school); cycle training policy (4 minutes higher moderate to vigorous physical activity); and higher prevalence of active travel (1 minute higher moderate to vigorous physical activity for each 10% point increase in prevalence). These factors explained 22% of the between-school variation pre-COVID-19, and 72% at Wave 2. The relative importance changed, with cycle training policy and active travel being the most important pre-COVID-19 and cycle training policy, active after-school clubs and compromised physical education space most important in Wave 2. No factors were found to mediate the postlockdown differences in moderate to vigorous physical activity, except compromised physical education space, which had a suppressor effect in Wave 2. Limitations Only 27 of the initial 50 schools participated post lockdown, limiting our ability to make comparisons across waves. Sample sizes were additionally affected by missing data for some variables. Conclusions and future work While schools continue to play an important role in facilitating children's physical activity, the factors that contribute to this have changed post-COVID-19, with cycle training, active after-school clubs and ensuring physical education is prioritised even when space is limited now explaining nearly three-quarters of the between-school variation in children's moderate to vigorous physical activity. School-level interventions that focus on these areas, and policies that support them, may offer the potential to increase children's physical activity. Funding This article presents independent research funded by the National Institute for Health and Care Research (NIHR) Public Health Research programme as award number NIHR131847.
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Affiliation(s)
- Ruth Salway
- Centre for Exercise, Nutrition & Health Sciences, School for Policy Studies, University of Bristol, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Danielle House
- Centre for Exercise, Nutrition & Health Sciences, School for Policy Studies, University of Bristol, Bristol, UK
| | - Robert Walker
- Centre for Exercise, Nutrition & Health Sciences, School for Policy Studies, University of Bristol, Bristol, UK
| | - Lydia Emm-Collison
- Centre for Exercise, Nutrition & Health Sciences, School for Policy Studies, University of Bristol, Bristol, UK
| | - Katie Breheny
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- The National Institute for Health Research, Applied Research Collaboration West (NIHR ARC West), University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
| | - Kate Sansum
- Centre for Exercise, Nutrition & Health Sciences, School for Policy Studies, University of Bristol, Bristol, UK
| | - Joanna G Williams
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- Communities and Public Health, Bristol City Council, Bristol, UK
| | - William Hollingworth
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- The National Institute for Health Research, Applied Research Collaboration West (NIHR ARC West), University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
| | - Frank de Vocht
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- The National Institute for Health Research, Applied Research Collaboration West (NIHR ARC West), University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
| | - Russell Jago
- Centre for Exercise, Nutrition & Health Sciences, School for Policy Studies, University of Bristol, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- The National Institute for Health Research, Applied Research Collaboration West (NIHR ARC West), University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
- NIHR Bristol Biomedical Research Centre, University Hospitals Bristol and Weston NHS Foundation Trust and University of Bristol, Bristol, UK
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Liang YT, Wang C, Hsiao CK. Data Analytics in Physical Activity Studies With Accelerometers: Scoping Review. J Med Internet Res 2024; 26:e59497. [PMID: 39259962 PMCID: PMC11425027 DOI: 10.2196/59497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2024] [Revised: 05/27/2024] [Accepted: 07/16/2024] [Indexed: 09/13/2024] Open
Abstract
BACKGROUND Monitoring free-living physical activity (PA) through wearable devices enables the real-time assessment of activity features associated with health outcomes and provision of treatment recommendations and adjustments. The conclusions of studies on PA and health depend crucially on reliable statistical analyses of digital data. Data analytics, however, are challenging due to the various metrics adopted for measuring PA, different aims of studies, and complex temporal variations within variables. The application, interpretation, and appropriateness of these analytical tools have yet to be summarized. OBJECTIVE This research aimed to review studies that used analytical methods for analyzing PA monitored by accelerometers. Specifically, this review addressed three questions: (1) What metrics are used to describe an individual's free-living daily PA? (2) What are the current analytical tools for analyzing PA data, particularly under the aims of classification, association with health outcomes, and prediction of health events? and (3) What challenges exist in the analyses, and what recommendations for future research are suggested regarding the use of statistical methods in various research tasks? METHODS This scoping review was conducted following an existing framework to map research studies by exploring the information about PA. Three databases, PubMed, IEEE Xplore, and the ACM Digital Library, were searched in February 2024 to identify related publications. Eligible articles were classification, association, or prediction studies involving human PA monitored through wearable accelerometers. RESULTS After screening 1312 articles, 428 (32.62%) eligible studies were identified and categorized into at least 1 of the following 3 thematic categories: classification (75/428, 17.5%), association (342/428, 79.9%), and prediction (32/428, 7.5%). Most articles (414/428, 96.7%) derived PA variables from 3D acceleration, rather than 1D acceleration. All eligible articles (428/428, 100%) considered PA metrics represented in the time domain, while a small fraction (16/428, 3.7%) also considered PA metrics in the frequency domain. The number of studies evaluating the influence of PA on health conditions has increased greatly. Among the studies in our review, regression-type models were the most prevalent (373/428, 87.1%). The machine learning approach for classification research is also gaining popularity (32/75, 43%). In addition to summary statistics of PA, several recent studies used tools to incorporate PA trajectories and account for temporal patterns, including longitudinal data analysis with repeated PA measurements and functional data analysis with PA as a continuum for time-varying association (68/428, 15.9%). CONCLUSIONS Summary metrics can quickly provide descriptions of the strength, frequency, and duration of individuals' overall PA. When the distribution and profile of PA need to be evaluated or detected, considering PA metrics as longitudinal or functional data can provide detailed information and improve the understanding of the role PA plays in health. Depending on the research goal, appropriate analytical tools can ensure the reliability of the scientific findings.
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Affiliation(s)
- Ya-Ting Liang
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
- Institute of Health Data Analytics and Statistics, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Charlotte Wang
- Institute of Health Data Analytics and Statistics, College of Public Health, National Taiwan University, Taipei, Taiwan
- Master of Public Health Program, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Chuhsing Kate Hsiao
- Institute of Health Data Analytics and Statistics, College of Public Health, National Taiwan University, Taipei, Taiwan
- Master of Public Health Program, College of Public Health, National Taiwan University, Taipei, Taiwan
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Breheny K, Salway R, House D, Walker R, Emm-Collison L, Sansum K, Williams JG, de Vocht F, Jago R, Hollingworth W. Quality of life, capability well-being, financial strain and physical activity in the short- and medium-term COVID-19 post-lockdown phases in the UK: a repeated cross-sectional study. PUBLIC HEALTH RESEARCH 2024; 12:39-58. [PMID: 39327859 DOI: 10.3310/lyjg6305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/28/2024] Open
Abstract
Background The COVID-19 lockdowns had negative effects on children's and adults' mental and physical health. There is, however, a paucity of research that explores differences in health-related quality of life (HRQL) and well-being over time after the COVID-19 lockdowns had been lifted. Furlough during lockdowns, increases in unemployment, and the emerging cost-of-living crisis all put pressure on family finances, which could have a detrimental effect on HRQL and well-being. This study, part of the wider Active-6 study, explored how HRQL, capability well-being and family financial strain changed after the lockdowns, the relationship between these outcomes, and whether physical activity had any mediating effect on differences in HRQL and capability well-being. Methods Cross-sectional data were collected in May-December 2021 (Wave 1) and January-July 2022 (Wave 2). Children (aged 10-11) and their parent/carer were recruited from 23 to 27 schools in each wave, respectively, and completed validated questionnaires measuring HRQL (adults - EQ-5D-5L, children - CHU9D), capability well-being (adults - ICECAP-A) and family financial strain (adults - Family Economic Strain Scale, FESS). Children also completed questions on capability well-being. Weekday minutes of moderate-to-vigorous physical activity (MVPA) were measured using accelerometers. Mixed-effects regression models, adjusted for gender, age group (adults only), IMD and highest household education, were used to explore differences in HRQL and capability well-being between waves. In addition, the moderating effect of financial strain and the mediating effect of MVPA on HRQL and capability well-being were explored. Results Active-6 recruited 393 parent-child pairs in Wave 1 and 436 in Wave 2. There were no differences in HRQL (EQ-5D, CHU9D) and capability well-being (ICECAP-A) scores between waves, but financial strain was worse in Wave 2 compared to Wave 1 (FESS score difference 1.14 adjusted 95% CI 0.15 to 2.12). Increased financial strain was associated with lower (worse) EQ-5D-5L, CHU9D and ICECAP-A scores. There was no evidence of a mediating effect of MVPA. Limitations and future work Pre-COVID-19 data on HRQL were not collected, so analysis was limited to post-lockdown only. Participating parents were predominantly female and participation was lower among lower socio-economic groups, limiting our ability to explore inequalities. Intervention planning to increase physical activity and health and well-being during the COVID-19 recovery should consider the financial strain families are experiencing and the negative implications of financial strain on HRQL. Conclusions There were no differences in HRQL and capability well-being in children and adults after lockdowns lifted in 2021 and a year later in 2022. The results indicate increasing financial strain, which could reflect the UK's 'cost of living crisis'. Funding This article presents independent research funded by the National Institute for Health and Care Research (NIHR) Public Health Research programme as award number NIHR131847.
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Affiliation(s)
- Katie Breheny
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- The National Institute for Health Research, Applied Research Collaboration West (NIHR ARC West), University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
| | - Ruth Salway
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- Centre for Exercise, Nutrition & Health Sciences, School for Policy Studies, University of Bristol, Bristol, UK
| | - Danielle House
- Centre for Exercise, Nutrition & Health Sciences, School for Policy Studies, University of Bristol, Bristol, UK
| | - Robert Walker
- Centre for Exercise, Nutrition & Health Sciences, School for Policy Studies, University of Bristol, Bristol, UK
| | - Lydia Emm-Collison
- Centre for Exercise, Nutrition & Health Sciences, School for Policy Studies, University of Bristol, Bristol, UK
| | - Kate Sansum
- Centre for Exercise, Nutrition & Health Sciences, School for Policy Studies, University of Bristol, Bristol, UK
| | - Joanna G Williams
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- Communities and Public Health, Bristol City Council, Bristol, UK
| | - Frank de Vocht
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- The National Institute for Health Research, Applied Research Collaboration West (NIHR ARC West), University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
| | - Russell Jago
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- The National Institute for Health Research, Applied Research Collaboration West (NIHR ARC West), University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
- Centre for Exercise, Nutrition & Health Sciences, School for Policy Studies, University of Bristol, Bristol, UK
| | - William Hollingworth
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- The National Institute for Health Research, Applied Research Collaboration West (NIHR ARC West), University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
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Yan X, Qin Y, Yu H, Xue Z, Jiang D, Huang L. The effects of prolonged sitting behavior on resting-state brain functional connectivity in college students post-COVID-19 rehabilitation: A study based on fNIRS technology. SPORTS MEDICINE AND HEALTH SCIENCE 2024; 6:287-294. [PMID: 39234485 PMCID: PMC11369834 DOI: 10.1016/j.smhs.2024.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2024] [Revised: 05/16/2024] [Accepted: 06/03/2024] [Indexed: 09/06/2024] Open
Abstract
Functional near-infrared spectroscopy (fNIRS) was used to explore the effects of sedentary behavior on the brain functional connectivity characteristics of college students in the resting state after recovering from Corona Virus Disease 2019 (COVID-19). Twenty-two college students with sedentary behavior and 22 college students with sedentary behavior and maintenance of exercise habits were included in the analysis; moreover, 8 min fNIRS resting-state data were collected. Based on the concentrations of oxyhemoglobin (HbO2) and deoxyhemoglobin (HbR) in the time series, the resting-state functional connection strength of the two groups of subjects, including the prefrontal cortex (PFC) and the lower limb supplementary motor area (LS), as well as the functional activity and functional connections of the primary motor cortex (M1) were calculated. The following findings were demonstrated. (1) Functional connection analysis based on HbO2 demonstrated that in the comparison of the mean functional connection strength of homologous regions of interest (ROIs) between the sedentary group and the exercise group, there was no significant difference in the mean functional strength of the ROIs between the two groups ( p > 0.05 ). In the comparison of the mean functional connection strengths of the two groups of heterologous ROIs, the functional connection strengths of the right PFC and the right LS ( p = 0.009 7 ), the left LS ( p = 0.012 7 ), and the right M1 ( p = 0.030 5 ) in the sedentary group were significantly greater. The functional connection strength between the left PFC and the right LS ( p = 0.031 2 ) and the left LS ( p = 0.037 0 ) was significantly greater. Additionally, the functional connection strength between the right LS and the right M1 ( p = 0.037 0 ) and the left LS ( p = 0.043 8 ) was significantly greater. (2) Functional connection analysis based on HbR demonstrated that there was no significant difference in functional connection strength between the sedentary group and the exercise group ( p > 0.05 ) or between the sedentary group and the exercise group ( p > 0.05 ). Similarly, there was no significant difference in the mean functional connection strength of the homologous and heterologous ROIs of the two groups. Additionally, there was no significant difference in the mean ROIs functional strength between the two groups ( p > 0.05 ). Experimental results and graphical analysis based on functional connectivity indicate that in this experiment, college student participants who exhibited sedentary behaviors showed an increase in fNIRS signals. Increase in fNIRS signals among college students exhibiting sedentary behaviors may be linked to their status post-SARS-CoV-2 infection and the sedentary context, potentially contributing to the strengthened functional connectivity in the resting-state cortical brain network. Conversely, the fNIRS signals decreased for the participants with exercise behaviors, who maintained reasonable exercise routines under the same conditions as their sedentary counterparts. The results may suggest that exercise behaviors have the potential to mitigate and reduce the impacts of sedentary behavior on the resting-state cortical brain network.
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Affiliation(s)
- Xiaocong Yan
- Graduate School, Harbin Sport University, Harbin, 150008, China
| | - Ying Qin
- College of Sports and Human Sciences, Harbin Sport University, Harbin, 150008, China
| | - Haifeng Yu
- Graduate School, Harbin Sport University, Harbin, 150008, China
| | - Zhenghao Xue
- College of Sports and Human Sciences, Harbin Sport University, Harbin, 150008, China
| | - Desheng Jiang
- College of Sports and Human Sciences, Harbin Sport University, Harbin, 150008, China
| | - Limin Huang
- College of Sports and Human Sciences, Harbin Sport University, Harbin, 150008, China
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Salway R, Jago R, de Vocht F, House D, Porter A, Walker R, Kipping R, Owen CG, Hudda MT, Northstone K, van Sluijs E. School-level intra-cluster correlation coefficients and autocorrelations for children's accelerometer-measured physical activity in England by age and gender. BMC Med Res Methodol 2024; 24:179. [PMID: 39123109 PMCID: PMC11313128 DOI: 10.1186/s12874-024-02290-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Accepted: 07/17/2024] [Indexed: 08/12/2024] Open
Abstract
BACKGROUND Randomised, cluster-based study designs in schools are commonly used to evaluate children's physical activity interventions. Sample size estimation relies on accurate estimation of the intra-cluster correlation coefficient (ICC), but published estimates, especially using accelerometry-measured physical activity, are few and vary depending on physical activity outcome and participant age. Less commonly-used cluster-based designs, such as stepped wedge designs, also need to account for correlations over time, e.g. cluster autocorrelation (CAC) and individual autocorrelation (IAC), but no estimates are currently available. This paper estimates the school-level ICC, CAC and IAC for England children's accelerometer-measured physical activity outcomes by age group and gender, to inform the design of future school-based cluster trials. METHODS Data were pooled from seven large English datasets of accelerometer-measured physical activity data between 2002-18 (> 13,500 pupils, 540 primary and secondary schools). Linear mixed effect models estimated ICCs for weekday and whole week for minutes spent in moderate-to-vigorous physical activity (MVPA) and being sedentary for different age groups, stratified by gender. The CAC (1,252 schools) and IAC (34,923 pupils) were estimated by length of follow-up from pooled longitudinal data. RESULTS School-level ICCs for weekday MVPA were higher in primary schools (from 0.07 (95% CI: 0.05, 0.10) to 0.08 (95% CI: 0.06, 0.11)) compared to secondary (from 0.04 (95% CI: 0.03, 0.07) to (95% CI: 0.04, 0.10)). Girls' ICCs were similar for primary and secondary schools, but boys' were lower in secondary. For all ages, combined the CAC was 0.60 (95% CI: 0.44-0.72), and the IAC was 0.46 (95% CI: 0.42-0.49), irrespective of follow-up time. Estimates were higher for MVPA vs sedentary time, and for weekdays vs the whole week. CONCLUSIONS Adequately powered studies are important to evidence effective physical activity strategies. Our estimates of the ICC, CAC and IAC may be used to plan future school-based physical activity evaluations and were fairly consistent across a range of ages and settings, suggesting that results may be applied to other high income countries with similar school physical activity provision. It is important to use estimates appropriate to the study design, and that match the intended study population as closely as possible.
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Affiliation(s)
- Ruth Salway
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.
| | - Russell Jago
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- The National Institute for Health Research, Applied Research Collaboration West (NIHR ARC West), University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
- NIHR Bristol Biomedical Research Centre, University Hospitals Bristol and Weston NHS Foundation Trust and University of Bristol, Bristol, UK
| | - Frank de Vocht
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- The National Institute for Health Research, Applied Research Collaboration West (NIHR ARC West), University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
| | - Danielle House
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Alice Porter
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- NIHR Bristol Biomedical Research Centre, University Hospitals Bristol and Weston NHS Foundation Trust and University of Bristol, Bristol, UK
| | - Robert Walker
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Ruth Kipping
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Christopher G Owen
- Population Health Research Institute, St George's, University of London, London, UK
| | - Mohammed T Hudda
- Department of Population Health, Dasman Diabetes Institute, Kuwait City, Kuwait
| | - Kate Northstone
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Esther van Sluijs
- MRC Epidemiology Unit, School of Clinical Medicine, University of Cambridge, Cambridge, UK
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10
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Fairclough SJ, Clifford L, Foweather L, Knowles ZR, Boddy LM, Ashworth E, Tyler R. Move Well, Feel Good: Feasibility and acceptability of a school-based motor competence intervention to promote positive mental health. PLoS One 2024; 19:e0303033. [PMID: 38861557 PMCID: PMC11166299 DOI: 10.1371/journal.pone.0303033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Accepted: 04/17/2024] [Indexed: 06/13/2024] Open
Abstract
BACKGROUND In response to the adverse impacts of the COVID-19 lockdown measures Move Well, Feel Good (MWFG) was developed as a school intervention using improvement of motor competence as a mechanism for promoting positive mental health. Study objectives were to evaluate the feasibility and acceptability of MWFG and to describe changes in child-level outcomes. METHODS Five northwest England primary schools were recruited. MWFG was delivered over 10-weeks through physical education (PE) lessons, which were supplemented by optional class-time, break-time, and home activities. The intervention focused on development of 9-10 year-old children's motor competence in locomotor, object control, and stability skills, and psychosocial skills. Feasibility was evaluated against nine pre-defined criteria using surveys, interviews (teachers), and focus groups (children). Pre- and post-intervention assessments of motor competence, mental health, prosocial behaviour, wellbeing, and 24-hour movement behaviours were also completed. RESULTS The five recruited schools represented 83% of the target number, 108 children consented (54% of target) with teachers recruited in all schools (100% of target). Intervention dose was reflected by 76% of the 45 scheduled PE lessons being delivered, and adherence was strong (>85% of children attending ≥75% of lessons). Positive indicators of acceptability were provided by 86% of children, 83% of PE teachers, and 90% of class teachers. Data collection methods were deemed acceptable by 91% of children and 80% of class teachers, and children spoke positively about participating in the data collection. Child-level outcome data collection was completed by 65%-97% of children, with a 3%-35% attrition rate at post-intervention, depending on measure. Favourable changes in motor competence (+13.7%), mental health difficulties (-8.8%), and prosocial behaviour (+7.6%) were observed. CONCLUSIONS MWFG is an acceptable and feasible motor competence intervention to promote positive mental health. Content and delivery modifications could inform progression to a pilot trial with a more robust design.
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Affiliation(s)
- Stuart J. Fairclough
- Department of Sport and Physical Activity, Sport, Physical Activity, Health and Wellbeing Research Group, Edge Hill University, Ormskirk, Lancashire, United Kingdom
| | - Lauren Clifford
- Department of Sport and Physical Activity, Sport, Physical Activity, Health and Wellbeing Research Group, Edge Hill University, Ormskirk, Lancashire, United Kingdom
| | - Lawrence Foweather
- The Physical Activity Exchange, Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, United Kingdom
| | - Zoe R. Knowles
- The Physical Activity Exchange, Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, United Kingdom
| | - Lynne M. Boddy
- The Physical Activity Exchange, Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, United Kingdom
| | - Emma Ashworth
- School of Psychology, Liverpool John Moores University, Liverpool, United Kingdom
| | - Richard Tyler
- Department of Sport and Physical Activity, Sport, Physical Activity, Health and Wellbeing Research Group, Edge Hill University, Ormskirk, Lancashire, United Kingdom
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11
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Nyawornota VK, Adamba C, Tay DA, Nyanyofio OC, Muomah RC, Chukwuorji JC, Nwonyi SK, Malete L, Joachim D, Ocansey RT. Self-perception of health and physical activity levels among the youth and adults before and amidst the COVID-19 pandemic. Front Public Health 2024; 12:1298378. [PMID: 38873289 PMCID: PMC11169886 DOI: 10.3389/fpubh.2024.1298378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Accepted: 04/22/2024] [Indexed: 06/15/2024] Open
Abstract
Background Emerging research indicates that the COVID-19 pandemic and associated restrictions led to decreased physical activity levels and poorer health globally. However, most studies on this topic have focused on advanced countries, leaving a gap in understanding the impact in countries like Ghana. This study aimed to fill this gap by assessing self-perceived health status and physical activity levels among youth and adults in Ghana before, during, and after the COVID-19 restrictions. Understanding these dynamics is crucial for informing public health interventions and policies to promote well-being during and beyond the pandemic. Methods A cross-sectional survey using online data collection methods was conducted, involving 937 participants. Data included demographic information, and International Physical Activity Questionnaire-Short Form (IPAQ-SF). Analysis was done using SPSS version 25, with descriptive statistics and multinomial regression. Results Most participants (89.6%) reported good health. Male participants were significantly more likely to engage in moderate (1.78 times) and high (3.17 times) physical activity during the COVID-19 period compared to females. Conclusion This study highlights gender disparities in physical activity levels during the pandemic in Ghana. Addressing these disparities and promoting healthier lifestyles, especially during crises, is crucial for general and mental health. Further research should explore socio-demographic factors' role in health behaviors during pandemics.
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Affiliation(s)
| | - Clement Adamba
- Department of Educational Studies and Leadership, University of Ghana, Accra, Ghana
| | - Doris Akosua Tay
- Regional Institute for Population Studies, University of Ghana, Accra, Ghana
| | - Oscar C. Nyanyofio
- Department of Physical Education and Sport Studies, University of Ghana, Accra, Ghana
| | - Rosemary C. Muomah
- Department of Psychological Medicine, University of Nigeria, Nsukka, Nigeria
| | - JohnBosco C. Chukwuorji
- Department of Educational Studies and Leadership, University of Ghana, Accra, Ghana
- Department of Psychology, University of Nigeria, Nsukka, Nigeria
| | - Sampson K. Nwonyi
- Department of Psychology, Ebonyi State University, Abakaliki, Nigeria
| | - Leapetswe Malete
- Department of Kinesiology, Michigan State University, East Lansing, MI, United States
| | | | - Reginald T. Ocansey
- Department of Physical Education and Sport Studies, University of Ghana, Accra, Ghana
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12
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Fujii Y, Kitano N, Kai Y, Jindo T, Arao T. Changes in Accelerometer-measured Physical Activity and Sedentary Behavior From Before to After COVID-19 Outbreak in Workers. J Epidemiol 2024; 34:247-253. [PMID: 37574271 PMCID: PMC10999519 DOI: 10.2188/jea.je20230023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 07/26/2023] [Indexed: 08/15/2023] Open
Abstract
BACKGROUND The novel coronavirus disease 2019 (COVID-19) pandemic may have reduced opportunities for engaging in physical activity (PA) and increased sedentary behavior (SB) among workers. However, most previous studies used self-reported assessments. This study aimed to examine the changes in accelerometer-measured PA and SB from before to after COVID-19 outbreak among Japanese workers. METHODS This 1-year longitudinal study used data from the annual health check-ups of workers who lived in the Tokyo metropolitan area. Baseline and follow-up data were collected from June to November of 2019 and June to November of 2020, respectively. Participants were asked to wear the accelerometer on their hip during awake hours for at least 10 days in both the surveys. Before the analysis, considering the difference in wearing time, time spent in PA and SB were converted to the percentage of wearing time. To investigate the changes in PA or SB from before to during COVID-19 outbreak, paired t-tests were performed. RESULTS Of the 757 eligible participants, 536 were included in the analysis (70.8%). Participants' mean age was 53.3 years, 69.6% were female, and most were full-time employees. Time spent in PA decreased, regardless of weekdays or weekends, although changes on the weekends were not significant. Conversely, time spent in SB increased on both weekdays and weekends in 2020. These changes corresponded to approximately 10 minutes per day decrease in PA and increase in SB. CONCLUSION Objectively measured PA decreased and SB increased by approximately 10 minutes per day after the COVID-19 outbreak among Japanese workers.
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Affiliation(s)
- Yuya Fujii
- Physical Fitness Research Institute, Meiji Yasuda Life Foundation of Health and Welfare, Tokyo, Japan
| | - Naruki Kitano
- Physical Fitness Research Institute, Meiji Yasuda Life Foundation of Health and Welfare, Tokyo, Japan
| | - Yuko Kai
- Physical Fitness Research Institute, Meiji Yasuda Life Foundation of Health and Welfare, Tokyo, Japan
| | - Takashi Jindo
- Physical Fitness Research Institute, Meiji Yasuda Life Foundation of Health and Welfare, Tokyo, Japan
- Faculty of Health and Sport Sciences, University of Tsukuba, Ibaraki, Japan
| | - Takashi Arao
- Physical Fitness Research Institute, Meiji Yasuda Life Foundation of Health and Welfare, Tokyo, Japan
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13
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Basterfield L, Galna B, Burn NL, Batten H, Weston M, Goffe L, Lawn M, Weston KL. Back to 'normal'? BMI, physical fitness and health-related quality of life of children from North East England before, during and after the COVID-19 lockdowns. J Sports Sci 2024; 42:688-700. [PMID: 38819118 DOI: 10.1080/02640414.2024.2359259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2023] [Accepted: 05/17/2024] [Indexed: 06/01/2024]
Abstract
We assessed whether changes in children's body mass index (BMI), physical fitness and health-related quality of life observed post-2020 United Kingdom COVID-19 lockdown remained 12 and 18 months later. Twenty-metre shuttle run test (20mSRT), handgrip strength, standing broad jump, sit-and-reach, height, body mass, and health-related quality of life (Kidscreen27 questionnaire) were measured in 90 children (8-9 years) during October 2019 ("T0"), November 2020 ("T1"), November 2021 ("T2") and June 2022 ("T3"). Mixed-effects models showed age- and sex-normalised BMI increased from T0 (mean: 0.71) to T1 (0.97), remaining elevated at T2 (0.95) and T3 (0.89). Decreases in 20mSRT performance were observed from T0 (22.0) to T1 (19.3), then increased at T2 (23.5) and T3 (28.3). Standing broad jump and handgrip strength increased over time. The proportion of children with overweight/obesity increased from T0 (32%) to T3 (48%). Health-related quality of life decreased for "Physical Wellbeing" yet increased for "Autonomy & Parents". Our findings highlight that lockdowns may have had lasting implications for children's health, and the urgent need to reduce overweight and obesity in North East England. Improving health and fitness behaviours to maximise long-term health outcomes and build resilience to future emergencies and disruptions to health behaviours is also paramount.
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Affiliation(s)
- Laura Basterfield
- Human Nutrition and Exercise Research Centre, Newcastle University, Newcastle upon Tyne, UK
- Medical School, Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Brook Galna
- Human Nutrition and Exercise Research Centre, Newcastle University, Newcastle upon Tyne, UK
- Centre for Healthy Ageing and School of Allied Health (Exercise Science), Murdoch University, Murdoch, WA, Australia
| | - Naomi L Burn
- UniSA Online, University of South Australia, Adelaide, Australia
| | - Hannah Batten
- Human Nutrition and Exercise Research Centre, Newcastle University, Newcastle upon Tyne, UK
| | - Matthew Weston
- Institute for Sport, Physical Education and Health Science, Moray House School of Education and Sport, University of Edinburgh, Edinburgh, UK
- Institute of Sport, Manchester Metropolitan University, Manchester, UK
| | - Louis Goffe
- Medical School, Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
- NIHR Health Determinants Research Collaboration, Gateshead Council, Gateshead, UK
| | - Matt Lawn
- Walkergate Community School, Newcastle upon Tyne, UK
| | - Kathryn L Weston
- Department of Psychological Sciences and Health, University of Strathclyde, Glasgow, UK
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14
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Singh K, Armstrong SC, Wagner BE, Counts J, Skinner A, Kay M, Li JS, Shah S, Zucker N, Neshteruk C, Story M, Suarez L, Kraus WE, Zizzi AR, Dunn J. Physical activity and sleep changes among children during the COVID-19 pandemic. NPJ Digit Med 2024; 7:70. [PMID: 38493216 PMCID: PMC10944532 DOI: 10.1038/s41746-024-01041-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Accepted: 02/14/2024] [Indexed: 03/18/2024] Open
Abstract
Daily routines, including in-person school and extracurricular activities, are important for maintaining healthy physical activity and sleep habits in children. The COVID-19 pandemic significantly disrupted daily routines as in-person school and activities closed to prevent spread of SARS-CoV-2. We aimed to examine and assess differences in objectively measured physical activity levels and sleep patterns from wearable sensors in children with obesity before, during, and after a period of school and extracurricular activity closures associated with the COVID-19 pandemic. We compared average step count and sleep patterns (using the Mann-Whitney U Test) before and during the pandemic-associated school closures by using data from activity tracker wristbands (Garmin VivoFit 3). Data were collected from 94 children (aged 5-17) with obesity, who were enrolled in a randomized controlled trial testing a community-based lifestyle intervention for a duration of 12-months. During the period that in-person school and extracurricular activities were closed due to the COVID-19 pandemic, children with obesity experienced objectively-measured decreases in physical activity, and sleep duration. From March 15, 2020 to March 31, 2021, corresponding with local school closures, average daily step count decreased by 1655 steps. Sleep onset and wake time were delayed by about an hour and 45 min, respectively, while sleep duration decreased by over 12 min as compared with the pre-closure period. Step counts increased with the resumption of in-person activities. These findings provide objective evidence for parents, clinicians, and public health professionals on the importance of in-person daily activities and routines on health behaviors, particularly for children with pre-existing obesity. Trial Registration: Clinical trial registration: NCT03339440.
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Affiliation(s)
- Karnika Singh
- Duke University Department of Biomedical Engineering, Durham, NC, USA
- Duke Center for Childhood Obesity Research, Durham, NC, USA
| | - Sarah C Armstrong
- Duke Center for Childhood Obesity Research, Durham, NC, USA
- Duke University Department of Pediatrics, Durham, NC, USA
- Duke University Department of Population Health Sciences, Durham, NC, USA
- Duke Global Health Institute, Durham, NC, USA
| | - Brooke E Wagner
- Duke Center for Childhood Obesity Research, Durham, NC, USA
- Duke University Department of Pediatrics, Durham, NC, USA
- Duke University Department of Population Health Sciences, Durham, NC, USA
| | - Julie Counts
- Duke Center for Childhood Obesity Research, Durham, NC, USA
- Duke University Molecular Physiology Institute, Durham, NC, USA
| | - Asheley Skinner
- Duke Center for Childhood Obesity Research, Durham, NC, USA
- Duke University Department of Population Health Sciences, Durham, NC, USA
| | - Melissa Kay
- Duke Center for Childhood Obesity Research, Durham, NC, USA
- Duke University Department of Pediatrics, Durham, NC, USA
| | - Jennifer S Li
- Duke Center for Childhood Obesity Research, Durham, NC, USA
- Duke University Department of Pediatrics, Durham, NC, USA
| | - Svati Shah
- Duke Center for Childhood Obesity Research, Durham, NC, USA
- Duke University Molecular Physiology Institute, Durham, NC, USA
| | - Nancy Zucker
- Duke Center for Childhood Obesity Research, Durham, NC, USA
- Duke University Department of Psychiatry and Behavioral Science, Durham, NC, USA
| | - Cody Neshteruk
- Duke Center for Childhood Obesity Research, Durham, NC, USA
- Duke University Department of Population Health Sciences, Durham, NC, USA
| | - Mary Story
- Duke Center for Childhood Obesity Research, Durham, NC, USA
- Duke Global Health Institute, Durham, NC, USA
| | - Lilianna Suarez
- Duke Center for Childhood Obesity Research, Durham, NC, USA
- Duke University Department of Pediatrics, Durham, NC, USA
| | - William E Kraus
- Duke Center for Childhood Obesity Research, Durham, NC, USA
- Duke University Molecular Physiology Institute, Durham, NC, USA
| | - Alexandra R Zizzi
- Duke Center for Childhood Obesity Research, Durham, NC, USA
- Duke University Department of Pediatrics, Durham, NC, USA
| | - Jessilyn Dunn
- Duke University Department of Biomedical Engineering, Durham, NC, USA.
- Duke Center for Childhood Obesity Research, Durham, NC, USA.
- Duke University Department of Biostatistics, Durham, NC, USA.
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15
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Bucksch J, Möckel J, Kaman A, Sudeck G, for the HBSC Study Group Germany. Physical activity of older children and adolescents in Germany - Results of the HBSC study 2022 and trends since 2009/10. JOURNAL OF HEALTH MONITORING 2024; 9:62-78. [PMID: 38559682 PMCID: PMC10977466 DOI: 10.25646/11874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 12/01/2023] [Indexed: 04/04/2024]
Abstract
Background Physical activity is central to health, beginning in childhood and adolescence, and regular monitoring provides important information for strategic decisions on promoting physical activity in Germany. Methods The current survey cycle of the Health Behaviour in School-aged Children (HBSC) study gives an insight into the prevalence of the indicators daily recommended physical activity, high and low physical activity, and sporting activity among students aged between 11 and 15 for 2022. In addition, the data is compared to the survey cycles of the 2009/10, 2013/14, and 2017/18 school years and analysed over time. Results The results of the current survey cycle show that 10.8 % of girls, 20.9 % of boys, and 12.4 % of gender diverse adolescents fulfil the daily physical activity recommendation. There are also major gender-specific differences for the other indicators. The group of gender diverse adolescents needs to be analysed further. The changes over time between 2009/10 and 2022 are relatively small. While girls' physical activity habits decreased slightly for the various indicators between 2009/10 and 2022, boys' prevalence remained relatively stable over the same period. Conclusions Overall, in part due to the effects of the various COVID-19 lockdowns, the need for effective and population-based measures to promote physical activity in childhood and adolescence remains high.
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Affiliation(s)
- Jens Bucksch
- Heidelberg University of Education, Faculty of Natural and Social Sciences, Department of Prevention and Health Promotion
- Heidelberg University of Education, Heidelberg Centre for Prevention and Health Promotion
| | - Juliane Möckel
- Heidelberg University of Education, Faculty of Natural and Social Sciences, Department of Prevention and Health Promotion
- Heidelberg University of Education, Heidelberg Centre for Prevention and Health Promotion
| | - Anne Kaman
- University Medical Centre Hamburg-Eppendorf, Department of Child and Adolescent Psychiatry and Psychotherapy, Child Public Health Research Section
| | - Gorden Sudeck
- Eberhard Karls University of Tübingen, Institute of Sports Science
- Eberhard Karls University of Tübingen, Interfaculty Research Institute for Sport and Physical Activity
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16
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Emm-Collison L, Walker R, Salway R, House D, Sansum K, Breheny K, Churchward S, Williams JG, de Vocht F, Jago R. Exploring parents' physical activity motivation during the COVID-19 pandemic: a mixed-methods study from a self-determination theory perspective. PUBLIC HEALTH RESEARCH 2024; 12:105-146. [PMID: 38549448 DOI: 10.3310/kpkw8220] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/12/2025] Open
Abstract
Background and objectives The COVID-19 lockdowns impacted physical activity for all, but especially parents, because they had to balance home, work and leisure activities. Motivation for exercise is consistently shown to be associated with physical activity levels. Self-determination theory provides a framework through which the motivation for exercise and its social-contextual antecedents can be explored. The purpose of this study is to explore the role of motivation in determining physical activity in parents and carers of English primary school children before, during and after the COVID-19 lockdowns. Design, setting and participants This study uses a mixed-methods design combining quantitative data and individual interviews. Participants were all parents/carers of children in year 6 (aged 10-11 years) at English primary schools in the United Kingdom. Methods Quantitative data were collected on three occasions: between March 2017 and May 2018 (Wave 0, N = 1296), between May and December 2021 (Wave 1, N = 393) and between January and July 2022 (wave 2, N = 436). Motivation for exercise was assessed using the Behavioural Regulations in Exercise Questionnaire-2 and moderate-to-vigorous physical activity was estimated via waist-worn accelerometers. Data were analysed via regression models. Interviews with a subsample of parents (N = 43) were conducted on two occasions: between September and December 2021 and between February and July 2022. Interviews covered the impact of the pandemic on children and parents' physical activity and changes over time. This study focuses on discussions around the parents' own physical activity behaviour and their motivation. The framework method was used for analysis. Results In separate linear regression models, intrinsic and identified regulation were associated with higher moderate-to-vigorous physical activity in waves 0 and 2. Amotivation was associated with lower moderate-to-vigorous physical activity in waves 0 and 2. In fully adjusted multivariable regression models, identified regulation was associated with a 4.9-minute increase in moderate-to-vigorous physical activity and introjected regulation was associated with a 2.3-minute decrease in moderate-to-vigorous physical activity at wave 0. Associations with moderate-to-vigorous physical activity were different in wave 2, with introjected regulation changing direction and a negative association with amotivation, although confidence intervals were wide due to smaller sample sizes. In the interviews, parents spoke of the effects that the COVID-19 lockdowns had on their motivation to be physically active in four theoretically driven themes: (1) motivation for physical activity, (2) perceived autonomy for physical activity, (3) perceived competence for physical activity and (4) perceived relatedness for physical activity. Limitations The smaller sample sizes for waves 1 and 2 may have limited the ability to identify associations between behavioural regulations and moderate-to-vigorous physical activity post pandemic. Across all waves, parents were predominantly active, females, white and from higher socioeconomic areas and therefore may not reflect broader experiences. Conclusions and future work Autonomous motivation, especially enjoyment and the importance for mental and physical well-being, was a key driver in keeping parents active during lockdowns and remains important for physical activity post lockdown, with introjected regulation potentially playing an increased role. Parents' interviews highlighted that while for some the lockdowns promoted autonomous motivation for exercise, others had enduring negative influences on their autonomy, competence and relatedness, which could be detrimental to their well-being. Strategies that focus on offering a range of novel activities for parents and that bring parent groups together may be effective. Funding This article presents independent research funded by the National Institute for Health and Care Research (NIHR) Public Health Research programme as award number NIHR131847.
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Affiliation(s)
- Lydia Emm-Collison
- Centre for Exercise, Nutrition & Health Sciences, School for Policy Studies, University of Bristol, Bristol, UK
| | - Robert Walker
- Centre for Exercise, Nutrition & Health Sciences, School for Policy Studies, University of Bristol, Bristol, UK
| | - Ruth Salway
- Centre for Exercise, Nutrition & Health Sciences, School for Policy Studies, University of Bristol, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Danielle House
- Centre for Exercise, Nutrition & Health Sciences, School for Policy Studies, University of Bristol, Bristol, UK
| | - Kate Sansum
- Centre for Exercise, Nutrition & Health Sciences, School for Policy Studies, University of Bristol, Bristol, UK
| | - Katie Breheny
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | | | - Joanna G Williams
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- Communities and Public Health, Bristol City Council, Bristol, UK
| | - Frank de Vocht
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- The National Institute for Health Research, Applied Research Collaboration West (NIHR ARC West), University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
| | - Russell Jago
- Centre for Exercise, Nutrition & Health Sciences, School for Policy Studies, University of Bristol, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- The National Institute for Health Research, Applied Research Collaboration West (NIHR ARC West), University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
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Brady SM, Salway R, Mariapun J, Millard L, Ramadas A, Rizal H, Skinner A, Stone C, Johnson L, Su TT, Armstrong MEG. Accelerometer-measured 24-hour movement behaviours over 7 days in Malaysian children and adolescents: A cross-sectional study. PLoS One 2024; 19:e0297102. [PMID: 38377079 PMCID: PMC10878504 DOI: 10.1371/journal.pone.0297102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Accepted: 12/21/2023] [Indexed: 02/22/2024] Open
Abstract
BACKGROUND Quantifying movement behaviours over 24-hours enables the combined effects of and inter-relations between sleep, sedentary time and physical activity (PA) to be understood. This is the first study describing 24-hour movement behaviours in school-aged children and adolescents in South-East Asia. Further aims were to investigate between-participant differences in movement behaviours by demographic characteristics and timing of data collection during Ramadan and COVID-19 restrictions. METHODS Data came from the South-East Asia Community Observatory health surveillance cohort, 2021-2022. Children aged 7-18 years within selected households in Segamat, Malaysia wore an Axivity AX6 accelerometer on their wrist for 24 hours/day over 7 days, completed the PAQ-C questionnaire, and demographic information was obtained. Accelerometer data was processed using GGIR to determine time spent asleep, inactive, in light-intensity PA (LPA) and moderate-to-vigorous PA (MVPA). Differences in accelerometer-measured PA by demographic characteristics (sex, age, ethnicity, socioeconomic group) were explored using univariate linear regression. Differences between data collected during vs outside Ramadan or during vs after COVID-19 restrictions, were investigated through univariate and multiple linear regressions, adjusted for age, sex and ethnicity. RESULTS The 491 participants providing accelerometer data spent 8.2 (95% confidence interval (CI) = 7.9-8.4) hours/day asleep, 12.4 (95% CI = 12.2-12.7) hours/day inactive, 2.8 (95% CI = 2.7-2.9) hours/day in LPA, and 33.0 (95% CI = 31.0-35.1) minutes/day in MVPA. Greater PA and less time inactive were observed in boys vs girls, children vs adolescents, Indian and Chinese vs Malay children and higher income vs lower income households. Data collection during Ramadan or during COVID-19 restrictions were not associated with MVPA engagement after adjustment for demographic characteristics. CONCLUSIONS Demographic characteristics remained the strongest correlates of accelerometer-measured 24-hour movement behaviours in Malaysian children and adolescents. Future studies should seek to understand why predominantly girls, adolescents and children from Malay ethnicities have particularly low movement behaviours within Malaysia.
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Affiliation(s)
- Sophia M. Brady
- Centre for Exercise, Nutrition & Health Sciences, School for Policy Studies, University of Bristol, Bristol, United Kingdom
| | - Ruth Salway
- Centre for Exercise, Nutrition & Health Sciences, School for Policy Studies, University of Bristol, Bristol, United Kingdom
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Jeevitha Mariapun
- Clinical School Johor Bahru, Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Malaysia, Malaysia
| | - Louise Millard
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Amutha Ramadas
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Malaysia, Malaysia
| | - Hussein Rizal
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Malaysia, Malaysia
| | - Andy Skinner
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Chris Stone
- Integrative Cancer Epidemiology Programme, MRC Integrative Epidemiology Unit, and School of Psychological Science, University of Bristol, Bristol, United Kingdom
| | - Laura Johnson
- Centre for Exercise, Nutrition & Health Sciences, School for Policy Studies, University of Bristol, Bristol, United Kingdom
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Tin Tin Su
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Malaysia, Malaysia
- South East Asia Community Observatory (SEACO), Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Malaysia, Malaysia
| | - Miranda E. G. Armstrong
- Centre for Exercise, Nutrition & Health Sciences, School for Policy Studies, University of Bristol, Bristol, United Kingdom
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18
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Porter A, Walker R, House D, Salway R, Dawson S, Ijaz S, de Vocht F, Jago R. Physical activity interventions in European primary schools: a scoping review to create a framework for the design of tailored interventions in European countries. Front Public Health 2024; 12:1321167. [PMID: 38389941 PMCID: PMC10883314 DOI: 10.3389/fpubh.2024.1321167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Accepted: 01/18/2024] [Indexed: 02/24/2024] Open
Abstract
Introduction Schools provide a unique environment to facilitate physical activity for children. However, many school-based physical activity interventions have not been effective. We propose a new approach, which allows schools to tailor interventions to their specific context. This scoping review aimed to identify intervention components from previous school-based physical activity interventions to form the basis of a tailored approach in a European setting. Methods Joanna Briggs Institute guidelines for conducting scoping reviews were followed. European school-based intervention studies aimed at increasing physical activity in children aged 7-11 years published in English since 2015 were included. Databases searched were Ovid Medline, Embase, PsycINFO, Web of Science Social Sciences Citation Index, ERIC and British Education Index. Data was extracted on intervention components, context-related factors (geographical location, school size, child socioeconomic status and ethnicity), feasibility, acceptability and cost-effectiveness. A data-driven framework was developed to summarize the identified intervention components. Results 79 articles were included, constituting 45 intervention studies. We identified 177 intervention components, which were synthesized into a framework of 60 intervention component types across 11 activity opportunities: six within the school day, three within the extended school day and two within the wider school environment. Interventions most frequently targeted physical education (21%), active and outdoor learning (16%), active breaks (15%), and school-level environmewnt (12%). Of the intervention components, 41% were delivered by school staff, 31% by the research team, and 24% by external organizations. Only 19% of intervention studies reported geographical location and only 10% reported school size. Participant ethnicity and socioeconomic information was reported by 15% and 25%, respectively. Intervention acceptability was reported in 51% of studies, feasibility in 49%, and cost effectiveness in 2%. Discussion This review offers a first step in developing a future framework to help schools to develop context-specific, tailored interventions. However, there was a lack of reporting of contextual factors within the included studies, making it difficult to understand the role of context. Future research should seek to measure and report contextual factors, and to better understand the important aspects of context within school-based physical activity.
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Affiliation(s)
- Alice Porter
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
- NIHR Bristol Biomedical Research Centre, University Hospitals Bristol and Weston NHS Foundation Trust and University of Bristol, Bristol, United Kingdom
| | - Robert Walker
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Danielle House
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Ruth Salway
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Sarah Dawson
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
- The National Institute for Health Research, Applied Research Collaboration West (NIHR ARC West), University Hospitals Bristol and Weston NHS Foundation Trust and University of Bristol, Bristol, United Kingdom
| | - Sharea Ijaz
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
- The National Institute for Health Research, Applied Research Collaboration West (NIHR ARC West), University Hospitals Bristol and Weston NHS Foundation Trust and University of Bristol, Bristol, United Kingdom
| | - Frank de Vocht
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
- The National Institute for Health Research, Applied Research Collaboration West (NIHR ARC West), University Hospitals Bristol and Weston NHS Foundation Trust and University of Bristol, Bristol, United Kingdom
| | - Russell Jago
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
- NIHR Bristol Biomedical Research Centre, University Hospitals Bristol and Weston NHS Foundation Trust and University of Bristol, Bristol, United Kingdom
- The National Institute for Health Research, Applied Research Collaboration West (NIHR ARC West), University Hospitals Bristol and Weston NHS Foundation Trust and University of Bristol, Bristol, United Kingdom
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19
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House D, Walker R, Salway R, Emm-Collison L, Breheny K, Sansum K, Churchward S, Williams JG, de Vocht F, Jago R. The impact of the COVID-19 pandemic on the physical activity environment in English primary schools: a multi-perspective qualitative analysis. PUBLIC HEALTH RESEARCH 2024; 12:59-104. [PMID: 38345271 DOI: 10.3310/klml4701] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/12/2025] Open
Abstract
Background The COVID-19 lockdowns and social distancing measures, including school closures, had a major impact on children's physical activity in England, with data showing an initial reduction in activity in the short-term post-lockdown phase of the pandemic followed by a recovery on average in the medium-term post-lockdown period. The school environment is an important context for child physical activity. The purpose of this study is to understand the changes that took place to school physical activity environments once schools reopened after lockdowns. This information will improve understanding of why changes to children's physical activity have occurred over the course of the pandemic and the implications for future promotion of physical activity in schools. Methods Interviews with parents (n = 43), school staff (n = 18) and focus groups with 10- to 11-year-old children (participant n = 92) were conducted at two time points: between September-December 2021 and February-July 2022. Interview and focus group guides covered the impact of the pandemic on child physical activity and changes to this over time. The framework method was used for analysis. Results Three themes and three subthemes were generated: (1) the return to school; (2) over-pressured staff and environment and (3) the uneven impact of the pandemic. Theme 3 consists of three subthemes: (a) retained pandemic policies, (b) impact on physical activity culture and (c) different children need different things. Limitations and future work Conducting this research in schools during ongoing COVID-19 disruptions was a challenge and may have limited school and participant participation, particularly school staff. The parent interview sample is predominantly female, active and of higher socioeconomic status, so the experiences of male, less active and lower socioeconomic parents are limited. This study suggests that the impact of COVID-19 on child physical activity is uneven, affecting some children more than others. Future work is therefore needed to explore the details of this potential diverging experience. Conclusion The COVID-19 pandemic, school closures and post-lockdown school policies have impacted upon primary school physical activity environments. The post-lockdown school environment is highly pressured, impacting the extent to which schools can support and encourage child physical activity. Future research is needed to further explore the impact of post-lockdown changes on physical activity environments in schools, particularly over the longer term, as schools continue to adapt post lockdowns. Strategies required to support school physical activity environments must be context specific and sensitive to these changes, pressures and needs. Funding This article presents independent research funded by the National Institute for Health and Care Research (NIHR) Public Health Research programme as award number NIHR131847.
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Affiliation(s)
- Danielle House
- Centre for Exercise, Nutrition and Health Sciences, School for Policy Studies, University of Bristol, Bristol, UK
| | - Robert Walker
- Centre for Exercise, Nutrition and Health Sciences, School for Policy Studies, University of Bristol, Bristol, UK
| | - Ruth Salway
- Centre for Exercise, Nutrition and Health Sciences, School for Policy Studies, University of Bristol, Bristol, UK
| | - Lydia Emm-Collison
- Centre for Exercise, Nutrition and Health Sciences, School for Policy Studies, University of Bristol, Bristol, UK
| | - Katie Breheny
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Kate Sansum
- Centre for Exercise, Nutrition and Health Sciences, School for Policy Studies, University of Bristol, Bristol, UK
| | | | - Joanna G Williams
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- Communities and Public Health, Bristol City Council, Bristol, UK
| | - Frank de Vocht
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- The National Institute for Health Research, Applied Research Collaboration West (NIHR ARC West), University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
| | - Russell Jago
- Centre for Exercise, Nutrition and Health Sciences, School for Policy Studies, University of Bristol, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- The National Institute for Health Research, Applied Research Collaboration West (NIHR ARC West), University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
- NIHR Bristol Biomedical Research Centre, University Hospitals Bristol and Weston NHS Foundation Trust and University of Bristol, Bristol, UK
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20
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Ludwig-Walz H, Siemens W, Heinisch S, Dannheim I, Loss J, Bujard M. How the COVID-19 pandemic and related school closures reduce physical activity among children and adolescents in the WHO European Region: a systematic review and meta-analysis. Int J Behav Nutr Phys Act 2023; 20:149. [PMID: 38115056 PMCID: PMC10731871 DOI: 10.1186/s12966-023-01542-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Accepted: 11/18/2023] [Indexed: 12/21/2023] Open
Abstract
BACKGROUND Emerging research suggests that physical activity among children and adolescents decreased during the COVID-19 pandemic. However, a differentiated overview of European youth is lacking. In particular, no systematic analysis has been conducted to date on the impact of heterogeneous pandemic restrictions and school closures within European countries, and with regard to potentially vulnerable groups. METHODS We searched seven databases and included studies for children and adolescents (≤ 19 years) of the WHO European Region that compared physical activity during the COVID-19 pandemic with a pre-pandemic baseline using validated measurement instruments. We used the Oxford Stringency Index and School Closure Index as indicators of restriction stringency. Screening for eligibility, data extraction, assessment of the study risk of bias (using the 'Risk of Bias in Non-randomized Studies - of Exposure' [ROBINS-E]) and certainty grading of evidence (using the GRADE approach), were all done in duplicate. Unpublished data was requested from study authors. Data were pooled in random effects models. An a priori protocol was published, reporting is carried out in accordance with the 'Preferred Reporting Items for Systematic Review and Meta-Analyses' (PRISMA) statement. RESULTS Of 14,897 non-duplicate records, 26 publications (n = 15,038 pre-pandemic, n = 13,041 during pandemic) met full inclusion criteria. Comparison before and during the COVID-19 pandemic revealed a significant reduction in total physical activity (standardized mean difference [SMD], -0.57 [95%CI, -0.95; -0.20]) and moderate-to-vigorous physical activity (SMD, -0.43 [95% CI, -0.75; -0.10]), corresponding to a decrease of 12 min per day (a 20% reduction of the WHO recommendation). A decrease in sporting activity was also recorded. Subgroup analyses suggested that middle childhood (aged 8-12) and adolescents were particularly affected by the decline. School closures were associated with a reduction in physical activity. The certainty of evidence for all outcomes was low. CONCLUSIONS A sharp decline in all forms of physical activity was recorded among European children and adolescents during the COVID-19 pandemic. This decline was higher during periods of school closure and mainly affected younger schoolchildren and adolescents. Immediate action by policy-makers and practitioners, as well as evidence-based public health strategies, are imperative in reversing this trend. TRIAL REGISTRATION PROSPERO: CRD42023395871.
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Affiliation(s)
| | - Waldemar Siemens
- Institute for Evidence in Medicine, Medical Center - University of Freiburg, Faculty of Medicine, Freiburg, Germany
- Cochrane Germany, Cochrane Germany Foundation, Freiburg, Germany
| | - Sarah Heinisch
- Institute for Physical Education and Sport, University of Education, Karlsruhe, Germany
| | - Indra Dannheim
- Regional Innovation Center for Health and Quality of Life in Fulda (RIGL), Fulda University of Applied Sciences, Fulda, Germany
- Department of Nutritional, Food and Consumer Sciences, Fulda University of Applied Sciences, Fulda, Germany
| | | | - Martin Bujard
- Federal Institute for Population Research (BiB), Wiesbaden, Germany
- Institute of Medical Psychology, Medical Faculty, University Heidelberg, Heidelberg, Germany
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Salway R, de Vocht F, Emm-Collison L, Sansum K, House D, Walker R, Breheny K, Williams JG, Hollingworth W, Jago R. Comparison of children's physical activity profiles before and after COVID-19 lockdowns: A latent profile analysis. PLoS One 2023; 18:e0289344. [PMID: 38011119 PMCID: PMC10681209 DOI: 10.1371/journal.pone.0289344] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 07/18/2023] [Indexed: 11/29/2023] Open
Abstract
Physical activity is important for children's health, but moderate to vigorous physical activity (MVPA) declines with age. COVID-19 lockdowns resulted in reduced MVPA and increased sedentary time among children. Characterising children's activity patterns may help identify groups who are most likely to be inactive post-lockdown. Data were combined from a pre-COVID-19 cohort study on children aged 5-6 years (Year1: n = 1299), 8-9 years (Year4: n = 1223) and 10-11 years (Year6: n = 1296) and cross-sectional post-lockdown data from a natural experiment on 10-11-year-olds in 2021 (Year6-W1: n = 393) and 2022 (Year6-W2: n = 436). The proportions of time spent in MVPA, light physical activity (LPA) and sedentary time on weekdays and weekends were derived from accelerometer data. Latent class analysis was used to identify activity profiles pre and post-lockdown, and estimate pre-COVID-19 transitions between Year4 and Year6. We identified six pre-COVID-19 activity profiles in Year6, including a new profile characterised by very low MVPA and high sedentary time (19% of children). There was substantial movement between profiles at Year4 and Year6, with 45% moving to a profile with lower MVPA. Likelihood ratio tests suggested differences in Year6 activity profiles pre and post-lockdown, with a new post-lockdown profile emerging characterised by higher LPA. The percentage of children in the least active profiles (where under 20% meet UK physical activity guidelines), rose post-lockdown, from 34% pre-COVID-19 to 50% in 2021 and 40% in 2022. We also saw gender and socioeconomic gaps widen, and increased separation between high and low physical activity levels. Children's physical activity has changed post-COVID-19, in terms of who is being active and how. The impact varies by activity profile, which is influenced by gender and socio-economic position. A greater understanding of these differences and targeting of low active groups is needed to increase both individual and population levels of physical activity.
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Affiliation(s)
- Ruth Salway
- Centre for Exercise, Nutrition & Health Sciences, School for Policy Studies, University of Bristol, Bristol, United Kingdom
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Frank de Vocht
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
- The National Institute for Health Research, Applied Research Collaboration West (NIHR ARC West), University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, United Kingdom
| | - Lydia Emm-Collison
- Centre for Exercise, Nutrition & Health Sciences, School for Policy Studies, University of Bristol, Bristol, United Kingdom
| | - Kate Sansum
- Centre for Exercise, Nutrition & Health Sciences, School for Policy Studies, University of Bristol, Bristol, United Kingdom
| | - Danielle House
- Centre for Exercise, Nutrition & Health Sciences, School for Policy Studies, University of Bristol, Bristol, United Kingdom
| | - Robert Walker
- Centre for Exercise, Nutrition & Health Sciences, School for Policy Studies, University of Bristol, Bristol, United Kingdom
| | - Katie Breheny
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Joanna G. Williams
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
- Communities and Public Health, Bristol City Council, Bristol, United Kingdom
| | - William Hollingworth
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
- The National Institute for Health Research, Applied Research Collaboration West (NIHR ARC West), University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, United Kingdom
| | - Russell Jago
- Centre for Exercise, Nutrition & Health Sciences, School for Policy Studies, University of Bristol, Bristol, United Kingdom
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
- The National Institute for Health Research, Applied Research Collaboration West (NIHR ARC West), University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, United Kingdom
- NIHR Bristol Biomedical Research Centre, University Hospitals Bristol and Weston NHS Foundation Trust and University of Bristol, Bristol, United Kingdom
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Villodres GC, Salvador-Pérez F, Chacón-Cuberos R, Muros JJ. Lifestyle Behaviours, Self-Esteem and Academic Performance in Primary Education Students-A Structural Equation Model According to Sex and School Type. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1769. [PMID: 38002861 PMCID: PMC10670622 DOI: 10.3390/children10111769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Revised: 10/25/2023] [Accepted: 10/29/2023] [Indexed: 11/26/2023]
Abstract
(1) Background: The present study aimed to examine the relationship between physical activity (PA), screen time (ST), maximal oxygen uptake (VO2max), Mediterranean diet (MD) adherence, self-esteem (SE) and academic performance (AP) in primary education students. In order to address this aim, an explanatory model was developed to examine the existing relationships between PA, ST, VO2max, MD adherence, SE and AP. Further, the proposed structural model was examined via multi-group analysis as a function of sex and school type. (2) Methods: A non-experimental, descriptive, comparative and cross-sectional study was designed with a total sample of 269 Spanish students (11.29 ± 0.62). Validated questionnaires were administered to collect data on study variables. (3) Results: Relative to boys, girls reported better academic grades and showed a stronger positive relationship between MD adherence and AP, MD adherence and PA, and VO2max and SE. Likewise, girls showed a stronger negative relationship between ST and VO2max, and ST and MD adherence. At the same time, mixed funding school (MFS) students reported higher PA engagement than state school (SS) students. However, SS students reported better MD adherence, ST and AP than MFS students. Further, a stronger positive relationship was found in SS students between MD adherence or VO2max and SE than in MFS students. Also, within the former group, ST was more negatively related to MD adherence and VO2max. (4) Conclusions: Scientific and educational communities must develop future strategies that consider potential determinants in order to target more desirable outcomes.
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Affiliation(s)
- Gracia Cristina Villodres
- Department of Didactics of Corporal Expression, Faculty of Education, University of Granada, 18071 Granada, Spain;
| | - Federico Salvador-Pérez
- Department of Didactics of Social Sciences, Faculty of Education, International University of La Rioja, 26006 Logroño, Spain;
| | - Ramón Chacón-Cuberos
- Department of Research Methods and Diagnosis in Education, Faculty of Education, University of Granada, 18071 Granada, Spain;
| | - José Joaquín Muros
- Department of Didactics of Corporal Expression, Faculty of Education, University of Granada, 18071 Granada, Spain;
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Walker R, Salway R, House D, Emm-Collison L, Breheny K, Sansum K, Churchward S, Williams JG, Vocht FD, Hollingworth W, Jago R. The status of active after-school clubs among primary school children in England (UK) after the COVD-19 lockdowns: implications for policy and practice. Int J Behav Nutr Phys Act 2023; 20:120. [PMID: 37798727 PMCID: PMC10552244 DOI: 10.1186/s12966-023-01499-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 08/05/2023] [Indexed: 10/07/2023] Open
Abstract
BACKGROUND Children's physical activity in England is more dependent on active clubs after the COVID-19 pandemic. However, it is unclear how the COVID-19 pandemic and related cost-of-living crisis have impacted on active club participation, costs and provision. This mixed-methods natural experiment explored school-based and community-based active clubs after lockdowns, using a unique combination of data sources to highlight implications for policy and practice post-COVID-19. METHODS Cross-sectional questionnaire data on school and community active clubs were collected from 10-11-year-old children pre-COVID-19 in 2017-18 (N = 1,296; 50 schools), in 2021 (N = 393; 23 schools), and 2022 (N = 463; 27 schools). Club participation and attendance frequency were modelled using logistic and Poisson mixed effects models, adjusted for child age, gender and household education. In 2021 and 2022, parents reported expenditure on community-based clubs and schools provided data on school-based club provision, with data summarised descriptively. Qualitative data were collected in 2021 and 2022, with one-to-one interviews with school staff (N = 18) and parents (N = 43), and twelve child focus groups (N = 92), and analysed using the framework method. RESULTS School-based active club participation was higher in 2022 compared to pre-pandemic (50% /43%), while community-based club participation was lower (74%/80%). Children attended 0.3 fewer clubs per week. Those from lower education households were less likely to participate in both types of active clubs, and girls less likely to attend community clubs. In 2022, the median cost of community and school club sessions were £6.67 and £3.88 respectively, with 52% of school-based clubs free to parents. Schools offered an average of 3.4 active clubs per week for 10-11-year-olds in 2022, with 34% partly/wholly subsidised. Qualitative analysis highlighted the impact of the cost-of-living crisis and COVID-19 pandemic on family resources, encouraging a shift to more affordable and convenient school-based active clubs, which negatively impacted the community-based active club environment. However, many schools struggled to meet this increased demand. CONCLUSIONS Findings emphasise the importance for policymakers to support schools to meet increased demand for clubs and community clubs to increase affordable and convenient physical activity opportunities. Targeted support is needed to prevent socioeconomic and gender inequalities.
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Affiliation(s)
- Robert Walker
- Centre for Exercise, Nutrition & Health Sciences, School for Policy Studies, University of Bristol, Bristol, BS8 ITZ, UK.
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 2PS, UK.
| | - Ruth Salway
- Centre for Exercise, Nutrition & Health Sciences, School for Policy Studies, University of Bristol, Bristol, BS8 ITZ, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 2PS, UK
| | - Danielle House
- Centre for Exercise, Nutrition & Health Sciences, School for Policy Studies, University of Bristol, Bristol, BS8 ITZ, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 2PS, UK
| | - Lydia Emm-Collison
- Centre for Exercise, Nutrition & Health Sciences, School for Policy Studies, University of Bristol, Bristol, BS8 ITZ, UK
| | - Katie Breheny
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 2PS, UK
| | - Kate Sansum
- Centre for Exercise, Nutrition & Health Sciences, School for Policy Studies, University of Bristol, Bristol, BS8 ITZ, UK
| | | | - Joanna G Williams
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 2PS, UK
- Communities and Public Health, Bristol City Council, Bristol, UK
| | - Frank de Vocht
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 2PS, UK
- The National Institute for Health Research, Applied Research Collaboration West (NIHR ARC West), University Hospitals Bristol and Weston NHS Foundation Trust and University of Bristol, Bristol, BS1 2NT, UK
| | - William Hollingworth
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 2PS, UK
- The National Institute for Health Research, Applied Research Collaboration West (NIHR ARC West), University Hospitals Bristol and Weston NHS Foundation Trust and University of Bristol, Bristol, BS1 2NT, UK
| | - Russell Jago
- Centre for Exercise, Nutrition & Health Sciences, School for Policy Studies, University of Bristol, Bristol, BS8 ITZ, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 2PS, UK
- The National Institute for Health Research, Applied Research Collaboration West (NIHR ARC West), University Hospitals Bristol and Weston NHS Foundation Trust and University of Bristol, Bristol, BS1 2NT, UK
- NIHR Bristol Biomedical Research Centre, University Hospitals Bristol and Weston NHS Foundation Trust and University of Bristol, Bristol, BS8 2BN, UK
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Cortez CA, Yuefan Shao I, Seamans MJ, Dooley EE, Pettee Gabriel K, Nagata JM. Moderate-to-vigorous intensity physical activity among U.S. adolescents before and during the COVID-19 pandemic: Findings from the Adolescent Brain Cognitive Development Study. Prev Med Rep 2023; 35:102344. [PMID: 37564120 PMCID: PMC10410239 DOI: 10.1016/j.pmedr.2023.102344] [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: 11/19/2022] [Revised: 07/20/2023] [Accepted: 07/21/2023] [Indexed: 08/12/2023] Open
Abstract
Only 16.1% percent of U.S. adolescents meet the recommendation of at least 60 minutes of moderate-to-vigorous intensity physical activity (MVPA) per day. Studies report declined levels of adolescent MVPA in early stages of the pandemic, but gaps remain in understanding changes beyond the initial three months of the pandemic. This study aims to describe and compare self-reported adolescent MVPA levels at multiple timepoints before and during the COVID-19 pandemic among 11,865 9-11-year-old U.S. adolescents from the Adolescent Brain Cognitive Development (ABCD) Study, including pre-pandemic (September 2016-October 2018), early (May, June, and August 2020), and later (October and December 2020, March 2021) stages of the pandemic. Poisson regression models with robust error variance were used to estimate crude and adjusted prevalence ratios (APRs) of the proportion of adolescents meeting national MVPA guidelines during early and later stages of the pandemic compared to pre-pandemic. The proportion of adolescents meeting MVPA guidelines decreased from pre (16.4%), early (11.0%), and later (4.7%) COVID-19 pandemic timepoints. Adolescent MVPA guideline adherence at early- and later-pandemic stages was 24% lower (APR 0.76, 95% CI 0.62, 0.93) and 68% lower (APR 0.32, 95% CI 0.24, 0.43) than pre-pandemic adherence, respectively. Weekly MVPA duration decreased throughout May 2020 to March 2021 (χ2 = 488.9, p < 0.0001). Study findings build upon existing evidence that the low achievement of national MVPA guidelines before the pandemic became even lower during the pandemic, demonstrating the need to support and improve access to adolescent MVPA opportunities during COVID-19 pandemic recovery efforts and in future pandemics.
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Affiliation(s)
- Catherine A. Cortez
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, 650 Charles E Young Dr, Los Angeles, CA 90095, USA
| | - Iris Yuefan Shao
- Department of Pediatrics, University of California, San Francisco, 550 16th Street, Box 0503, San Francisco, CA 94143, USA
| | - Marissa J. Seamans
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, 650 Charles E Young Dr, Los Angeles, CA 90095, USA
| | - Erin E. Dooley
- Department of Epidemiology, University of Alabama at Birmingham, 1665 University Boulevard, Birmingham, AL 35233, USA
| | - Kelley Pettee Gabriel
- Department of Epidemiology, University of Alabama at Birmingham, 1665 University Boulevard, Birmingham, AL 35233, USA
| | - Jason M. Nagata
- Department of Pediatrics, University of California, San Francisco, 550 16th Street, Box 0503, San Francisco, CA 94143, USA
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Ludwig-Walz H, Siemens W, Heinisch S, Dannheim I, Loss J, Bujard M. Physical activity and physical fitness among children and adolescents after the onset of the COVID-19 pandemic in the WHO European Region: a systematic review protocol. BMJ Open 2023; 13:e073397. [PMID: 37730401 PMCID: PMC10514655 DOI: 10.1136/bmjopen-2023-073397] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Accepted: 08/20/2023] [Indexed: 09/22/2023] Open
Abstract
INTRODUCTION The implementation of COVID-19 pandemic-related restrictions resulted in limitations for physical activity (PA) opportunities, which may have initiated a longer-term behavioural change. The protocol describes the methodology for a planned systematic review that aims to summarise changes in PA and physical fitness (PF) in children and adolescents in the WHO European Region after the onset of the COVID-19 pandemic. METHODS AND ANALYSIS The protocol adheres to the 'Preferred Reporting Items for Systematic Review and Meta-Analysis for Protocols' (PRISMA-P) statement. Using a peer-reviewed search strategy according to the evidence-based checklist 'Peer Review of Electronic Search Strategies' (PRESS), we will perform a systematic literature search in seven databases. Inclusion criteria are all primary studies that gathered data on children and adolescents ≤19 years living in the WHO European Region and made a comparison to pre-pandemic data. Primary outcomes are PA and PF. We will assess the risk of bias with the 'Risk of Bias Instrument for Non-Randomized Studies of Exposures' (ROBINS-E). The 'Grading of Recommendations Assessment, Development and Evaluation' (GRADE) approach will be used for the evaluation of the certainty of evidence. Also, subgroup analyses will be performed (eg, for gender, age, stringency of pandemic restrictions). ETHICS AND DISSEMINATION Ethical approval is not required, as primary data will not be collected in this study. The results will be presented in a peer-reviewed publication and at congresses relevant to the research field. PROSPERO REGISTRATION NUMBER CRD42023395871.
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Affiliation(s)
| | - Waldemar Siemens
- Faculty of Medicine, Institute for Evidence in Medicine, Medical Center - University of Freiburg, Freiburg, Germany
- Cochrane Germany Foundation, Freiburg, Germany
| | | | - Indra Dannheim
- Regional Innovative Centre of Health and Quality of Live Fulda (RIGL), Fulda University of Applied Sciences, Fulda, Germany
- Department of Nutritional, Food and Consumer Sciences, Fulda University of Applied Sciences, Fulda, Germany
| | - Julika Loss
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Martin Bujard
- Federal Institute for Population Studies, Wiesbaden, Germany
- Institute of Medical Psychology, Ruprecht-Karls-Universität Heidelberg, Heidelberg, Germany
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Ram B, van Sluijs E, Chalkley A, Hargreaves D, Saxena S. Real-world application of a scalable school-based physical activity intervention: A cross-sectional survey of the implementation of The Daily Mile in Greater London primary schools. PLoS One 2023; 18:e0288500. [PMID: 37556408 PMCID: PMC10411754 DOI: 10.1371/journal.pone.0288500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Accepted: 06/27/2023] [Indexed: 08/11/2023] Open
Abstract
School-based physical activity interventions are considered ideal given their potential to reach most children. They can help children achieve the recommended guidelines of 60 minutes of moderate-to-vigorous physical activity per day. The Daily Mile is a popular school-based active mile intervention with a global reach. It recommends ten core principles for successful implementation, three of which are key for effectiveness: that it is quick (15 minutes), the whole school participates, and that it takes place in the school day during lessons (excluding physical education lessons and scheduled breaks). Studies assessing the impacts of The Daily Mile do not often report implementation of the ten core principles which is crucial to identifying the potential impact and feasibility of scalable interventions in real-world settings. Our aim was to assess adherence to The Daily Mile's ten core principles in Greater London primary schools. We created and distributed a survey to 1717 primary schools during September 2020 and achieved a 21% (n = 369/1717) response rate by September 2021. Our sample was representative of Greater London primary schools with responses from every London borough. A total of 196/369 (53%) schools reported implementing The Daily Mile but none of them reported adherence to all ten core principles. Adherence to at least 6/10 principles in various combinations was reported by 54/196 (28%) schools. Only 19/196 (10%) schools that reported implementing The Daily Mile reported adherence to the three key principles recommended for effectiveness. Despite its popularity and global reach, our findings suggest that an implementation gap exists when The Daily Mile is adopted in real-world settings which is likely to challenge its intended purpose. Further research in school settings is needed to understand factors that can improve adherence to increase the potential public health impact of The Daily Mile and other similar interventions.
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Affiliation(s)
- Bina Ram
- Department of Primary Care and Public Health, Imperial College London, London, United Kingdom
| | - Esther van Sluijs
- MRC Epidemiology Unit, School of Clinical Medicine, University of Cambridge, Cambridge, United Kingdom
| | - Anna Chalkley
- Centre for Physically Active Learning, Western Norway University of Applied Sciences, Bergen, Norway
- Centre for Applied Education Research, Wolfson Centre for Applied Health Research, Bradford Royal Infirmary, Bradford, West Yorkshire, United Kingdom
| | - Dougal Hargreaves
- Mohn Centre for Children’s Health and Wellbeing, Imperial College London, United Kingdom
| | - Sonia Saxena
- Department of Primary Care and Public Health, Imperial College London, London, United Kingdom
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Walker R, House D, Salway R, Emm-Collison L, Hollander LE, Sansum K, Breheny K, Churchward S, Williams JG, de Vocht F, Hollingworth W, Foster C, Jago R. The new normal for children's physical activity and screen viewing: a multi-perspective qualitative analysis of behaviours a year after the COVID-19 lockdowns in the UK. BMC Public Health 2023; 23:1432. [PMID: 37495976 PMCID: PMC10373375 DOI: 10.1186/s12889-023-16021-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 05/31/2023] [Indexed: 07/28/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic significantly impacted children's physical activity. Recent evidence indicated children's accelerometer-measured physical activity levels have, on average, returned to near pre-pandemic levels in 2022, though sedentary behaviour remains higher. However, insufficient physical activity levels among children continues to be a critical public health issue in the UK, with only 41% meeting physical activity guidelines. This study aimed to provide in-depth analysis of how the pandemic has shaped children's physical activity patterns beyond the short-term periods following lockdowns and identify the new challenges to engaging children in physical activity. METHODS One-to-one interviews with parents (n = 22), school staff (n = 9), and six focus groups with children aged 10-11 years (n = 45) were conducted between February and July 2022. Topics explored changes to children's physical activity and sedentary behaviour patterns, including screen-viewing, and factors influencing any changes. The framework method was used for analysis. RESULTS Five themes were generated. Theme 1 described residual lockdown habits, including increased screen-viewing within the home, while activities outside the home continued to feel less spontaneous. Theme 2 highlighted an interrupted development of social, emotional, and physical skills among children compared to what would be expected pre-pandemic. This coincided with Theme 3 which reflected increased mental health challenges among families, creating complex barriers to children's physical activity. A new normal for child physical activity was evoked and explored in Theme 4, with greater dependence on structured and organised activities. However, Theme 5 highlighted that girls and children with lower socio-economic position may be especially at risk of decreased physical activity. CONCLUSIONS There is a new normal for children's physical activity that is characterised by increased dependence on structured and organised physical activities, such as active clubs, and less on unstructured and spontaneous physical activities, such as physical play. While this may suit many children, girls and children from lower socio-economic households face barriers to participating in the new normal. It is important that affordable and equitable opportunities are provided to all children to prevent physical activity and health inequalities.
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Affiliation(s)
- Robert Walker
- Centre for Exercise, Nutrition & Health Sciences, School for Policy Studies, University of Bristol, Bristol, BS8 ITZ, UK.
| | - Danielle House
- Centre for Exercise, Nutrition & Health Sciences, School for Policy Studies, University of Bristol, Bristol, BS8 ITZ, UK
| | - Ruth Salway
- Centre for Exercise, Nutrition & Health Sciences, School for Policy Studies, University of Bristol, Bristol, BS8 ITZ, UK
| | - Lydia Emm-Collison
- Centre for Exercise, Nutrition & Health Sciences, School for Policy Studies, University of Bristol, Bristol, BS8 ITZ, UK
| | - Lara E Hollander
- Centre for Exercise, Nutrition & Health Sciences, School for Policy Studies, University of Bristol, Bristol, BS8 ITZ, UK
| | - Kate Sansum
- Centre for Exercise, Nutrition & Health Sciences, School for Policy Studies, University of Bristol, Bristol, BS8 ITZ, UK
| | - Katie Breheny
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 2PS, UK
| | | | - Joanna G Williams
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 2PS, UK
- Communities and Public Health, Bristol City Council, Bristol, BS1 9NE, UK
| | - Frank de Vocht
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 2PS, UK
- The National Institute for Health Research, Applied Research Collaboration West (NIHR ARC West), University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, BS1 2NT, UK
| | - William Hollingworth
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 2PS, UK
- The National Institute for Health Research, Applied Research Collaboration West (NIHR ARC West), University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, BS1 2NT, UK
| | - Charlie Foster
- Centre for Exercise, Nutrition & Health Sciences, School for Policy Studies, University of Bristol, Bristol, BS8 ITZ, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 2PS, UK
| | - Russell Jago
- Centre for Exercise, Nutrition & Health Sciences, School for Policy Studies, University of Bristol, Bristol, BS8 ITZ, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 2PS, UK
- The National Institute for Health Research, Applied Research Collaboration West (NIHR ARC West), University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, BS1 2NT, UK
- NIHR Bristol Biomedical Research Centre, University Hospitals Bristol and Weston NHS Foundation Trust and University of Bristol, Bristol, UK
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28
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Scales J, Chavda J, Ikeda E, Tsocheva I, Dove RE, Wood HE, Kalsi H, Colligan G, Griffiths L, Day B, Crichlow C, Keighley A, Fletcher M, Newby C, Tomini F, Balkwill F, Mihaylova B, Grigg J, Beevers S, Eldridge S, Sheikh A, Gauderman J, Kelly F, Randhawa G, Mudway IS, van Sluijs E, Griffiths CJ. Device-Measured Change in Physical Activity in Primary School Children During the UK COVID-19 Pandemic Lockdown: A Longitudinal Study. J Phys Act Health 2023; 20:639-647. [PMID: 37142406 PMCID: PMC7614900 DOI: 10.1123/jpah.2022-0434] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Revised: 02/28/2023] [Accepted: 03/04/2023] [Indexed: 05/06/2023]
Abstract
BACKGROUND Lockdown measures, including school closures, due to the COVID-19 pandemic have caused widespread disruption to children's lives. The aim of this study was to explore the impact of a national lockdown on children's physical activity using seasonally matched accelerometry data. METHODS Using a pre/post observational design, 179 children aged 8 to 11 years provided physical activity data measured using hip-worn triaxial accelerometers worn for 5 consecutive days prepandemic and during the January to March 2021 lockdown. Multilevel regression analyses adjusted for covariates were used to assess the impact of lockdown on time spent in sedentary and moderate to vigorous physical activity. RESULTS A 10.8-minute reduction in daily time spent in moderate to vigorous physical activity (standard error: 2.3 min/d, P < .001) and a 33.2-minute increase in daily sedentary activity (standard error: 5.5 min/d, P < .001) were observed during lockdown. This reflected a reduction in daily moderate to vigorous physical activity for those unable to attend school (-13.1 [2.3] min/d, P < .001) during lockdown, with no significant change for those who continued to attend school (0.4 [4.0] min/d, P < .925). CONCLUSION These findings suggest that the loss of in-person schooling was the single largest impact on physical activity in this cohort of primary school children in London, Luton, and Dunstable, United Kingdom.
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Affiliation(s)
- James Scales
- Asthma and Lung UK Centre for Applied Research, Edinburgh,United Kingdom
- Wolfson Institute of Population Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London,United Kingdom
| | - Jasmine Chavda
- Asthma and Lung UK Centre for Applied Research, Edinburgh,United Kingdom
- Institute for Health Research, University of Bedfordshire, Luton,United Kingdom
| | - Erika Ikeda
- MRC Epidemiology Unit, University of Cambridge, Cambridge,United Kingdom
| | - Ivelina Tsocheva
- Asthma and Lung UK Centre for Applied Research, Edinburgh,United Kingdom
- Institute for Health Research, University of Bedfordshire, Luton,United Kingdom
| | - Rosamund E Dove
- Asthma and Lung UK Centre for Applied Research, Edinburgh,United Kingdom
- Wolfson Institute of Population Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London,United Kingdom
| | - Helen E Wood
- Asthma and Lung UK Centre for Applied Research, Edinburgh,United Kingdom
- Wolfson Institute of Population Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London,United Kingdom
| | - Harpal Kalsi
- Asthma and Lung UK Centre for Applied Research, Edinburgh,United Kingdom
- Wolfson Institute of Population Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London,United Kingdom
| | - Grainne Colligan
- Asthma and Lung UK Centre for Applied Research, Edinburgh,United Kingdom
- Wolfson Institute of Population Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London,United Kingdom
| | - Lewis Griffiths
- MRC Epidemiology Unit, University of Cambridge, Cambridge,United Kingdom
| | - Bill Day
- Asthma and Lung UK Centre for Applied Research, Edinburgh,United Kingdom
| | - Cheryll Crichlow
- Asthma and Lung UK Centre for Applied Research, Edinburgh,United Kingdom
| | - Amanda Keighley
- Asthma and Lung UK Centre for Applied Research, Edinburgh,United Kingdom
| | - Monica Fletcher
- Asthma and Lung UK Centre for Applied Research, Edinburgh,United Kingdom
- Usher Institute, The University of Edinburgh, Edinburgh,United Kingdom
| | - Chris Newby
- Asthma and Lung UK Centre for Applied Research, Edinburgh,United Kingdom
- University of Nottingham, Nottingham,United Kingdom
| | - Florian Tomini
- Asthma and Lung UK Centre for Applied Research, Edinburgh,United Kingdom
- Wolfson Institute of Population Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London,United Kingdom
| | - Fran Balkwill
- Centre of the Cell, Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London,United Kingdom
| | - Borislava Mihaylova
- Asthma and Lung UK Centre for Applied Research, Edinburgh,United Kingdom
- Wolfson Institute of Population Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London,United Kingdom
| | - Jonathan Grigg
- Asthma and Lung UK Centre for Applied Research, Edinburgh,United Kingdom
- Wolfson Institute of Population Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London,United Kingdom
| | - Sean Beevers
- MRC Centre for Environment and Health, Imperial College London, London,United Kingdom
| | - Sandra Eldridge
- Asthma and Lung UK Centre for Applied Research, Edinburgh,United Kingdom
- Wolfson Institute of Population Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London,United Kingdom
| | - Aziz Sheikh
- Asthma and Lung UK Centre for Applied Research, Edinburgh,United Kingdom
- Usher Institute, The University of Edinburgh, Edinburgh,United Kingdom
- MRC-Asthma UK Centre in Allergic Mechanisms of Asthma, London,United Kingdom
| | - James Gauderman
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA,USA
| | - Frank Kelly
- Asthma and Lung UK Centre for Applied Research, Edinburgh,United Kingdom
- MRC Centre for Environment and Health, Imperial College London, London,United Kingdom
| | - Gurch Randhawa
- Asthma and Lung UK Centre for Applied Research, Edinburgh,United Kingdom
- Institute for Health Research, University of Bedfordshire, Luton,United Kingdom
| | - Ian S Mudway
- Asthma and Lung UK Centre for Applied Research, Edinburgh,United Kingdom
- MRC Centre for Environment and Health, Imperial College London, London,United Kingdom
| | - Esther van Sluijs
- MRC Epidemiology Unit, University of Cambridge, Cambridge,United Kingdom
| | - Christopher J Griffiths
- Asthma and Lung UK Centre for Applied Research, Edinburgh,United Kingdom
- Wolfson Institute of Population Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London,United Kingdom
- MRC-Asthma UK Centre in Allergic Mechanisms of Asthma, London,United Kingdom
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Hatch LM, Widnall EC, Albers PN, Hopkins GL, Kidger J, de Vocht F, Kaner E, van Sluijs EMF, Fairbrother H, Jago R, Campbell RM. Conducting school-based health surveys with secondary schools in England: advice and recommendations from school staff, local authority professionals, and wider key stakeholders, a qualitative study. BMC Med Res Methodol 2023; 23:142. [PMID: 37322415 PMCID: PMC10273669 DOI: 10.1186/s12874-023-01957-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Accepted: 05/23/2023] [Indexed: 06/17/2023] Open
Abstract
BACKGROUND Improving the health and well-being of young people is a public health priority. Schools present an ideal setting to implement strategies to improve young people's health and well-being. A key strategy involves conducting surveys to assess student health needs, inform interventions, and monitor health over time. Conducting research in schools is, however, challenging. Schools can find it difficult to participate and adhere to research processes, even when they are keen to be involved in research, because of competing priorities (e.g., attendance and educational achievement), as well as time and resource constraints. There is a lack of literature on the perspectives of school staff and other key stakeholders working in young people's health on how best to work with schools to conduct health research, and in particular, health surveys. METHODS Participants (n = 26) included members of staff from 11 secondary schools (covering students aged 11-16 years), 5 local authority professionals, and 10 wider key stakeholders in young people's health and well-being (e.g., a school governor, a national government member), based in South West England. Participants took part in semi-structured interviews that were conducted either over the phone or via an online platform. Data were analysed using the Framework Method. RESULTS Three main themes were identified: Recruitment and Retention, Practicalities of Data Collection in Schools, and Collaboration from Design to Dissemination. It is important to acknowledge the role of local authorities and academy trusts in the English education system, and work closely with these when conducting school-based health surveys. School staff prefer to be contacted about research via email and in the summer term, following exams. Researchers should contact a member of staff involved in student health/well-being, as well as senior leadership, during recruitment. Data collection during the start and end of the school year is undesirable. Research should be collaborative with school staff and young people, consistent with school priorities and values, and flexible and tailored to school timetables and resources. CONCLUSIONS Overall the findings demonstrate that survey-based research methods should be school-led and tailored to each school.
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Affiliation(s)
- Lorna M Hatch
- Population Health Sciences, Bristol Medical School, University of Bristol, Canynge Hall, Bristol, BS8 2PL, UK.
| | - Emily C Widnall
- Population Health Sciences, Bristol Medical School, University of Bristol, Canynge Hall, Bristol, BS8 2PL, UK
| | - Patricia N Albers
- Population Health Sciences, Bristol Medical School, University of Bristol, Canynge Hall, Bristol, BS8 2PL, UK
| | - Georgina L Hopkins
- Population Health Sciences, Bristol Medical School, University of Bristol, Canynge Hall, Bristol, BS8 2PL, UK
| | - Judi Kidger
- Population Health Sciences, Bristol Medical School, University of Bristol, Canynge Hall, Bristol, BS8 2PL, UK
| | - Frank de Vocht
- Population Health Sciences, Bristol Medical School, University of Bristol, Canynge Hall, Bristol, BS8 2PL, UK
| | - Eileen Kaner
- Faculty of Medical Sciences, Newcastle University, Newcastle Upon Tyne, UK
| | - Esther M F van Sluijs
- MRC Epidemiology Unit, School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | | | - Russell Jago
- Population Health Sciences, Bristol Medical School, University of Bristol, Canynge Hall, Bristol, BS8 2PL, UK
- Centre for Exercise Nutrition & Health Sciences, School for Policy Studies, University of Bristol, Bristol, UK
| | - Rona M Campbell
- Population Health Sciences, Bristol Medical School, University of Bristol, Canynge Hall, Bristol, BS8 2PL, UK
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Nigg C, Petersen E, MacIntyre T. Natural environments, psychosocial health, and health behaviors in a crisis - A scoping review of the literature in the COVID-19 context. JOURNAL OF ENVIRONMENTAL PSYCHOLOGY 2023; 88:102009. [PMID: 37065613 PMCID: PMC10082968 DOI: 10.1016/j.jenvp.2023.102009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 04/03/2023] [Accepted: 04/04/2023] [Indexed: 05/03/2023]
Abstract
The COVID-19 outbreak led to major restrictions globally, affecting people's psychosocial health and their health behaviors. Thus, the purpose of this scoping review was to summarize the available research regarding nature and health in the COVID-19 context. Keywords relating to natural environments and COVID-19 were combined to conduct a systematic online search in six major databases. Eligibility criteria were a) published since 2020 with data collected in the COVID-19 context b) peer-reviewed, c) original empirical data collected on human participants, d) investigated the association between natural environments and psychosocial health or health behaviors, and e) English, German, or Scandinavian languages. Out of 9126 articles being screened, we identified 188 relevant articles, representing 187 distinct studies. Most research focused on adults in the general population and was predominantly conducted in the USA, Europe, and China. Overall, the findings indicate that nature may mitigate the impact of COVID-19 on psychological health and physical activity. Through a systematic thematic analysis of the extracted data, three primary themes were identified: 1) type of nature assessed, 2) psychosocial health and health behaviors investigated, and 3) heterogeneity in the nature-health relationship. Research gaps in the COVID-19 context were identified regarding I) nature characteristics that promote psychosocial health and health behaviors, II) investigations of digital and virtual nature, III) psychological constructs relating to mental health promotion, IV) health-promoting behaviors other than physical activity, V) underlying mechanisms regarding heterogeneity in the nature-health relationship based on human, nature, and geographic characteristics, and VI) research focusing on vulnerable groups. Overall, natural environments demonstrate considerable potential in buffering the impact of stressful events on a population level on mental health. However, future research is warranted to fill the mentioned research gaps and to examine the long-term effects of nature exposure during COVID-19.
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Affiliation(s)
- Carina Nigg
- Institute of Sport Science, University of Bern, Bremgartenstrasse 145, 3012, Bern, Switzerland
- Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Engler-Bunte-Ring 15, 76131, Karlsruhe, Germany
| | - Evi Petersen
- Department of Sports, Physical Education and Outdoor Life, University of South-Eastern Norway, 3800, Bø i, Telemark, Norway
- Department of Early Childhood Education, Oslo Metropolitan University, Pilestredet 42, 0167, Oslo, Norway
| | - Tadhg MacIntyre
- Department of Psychology, Faculty of Science & Engineering, Maynooth University, North Campus, W23 F2K8, Maynooth, Ireland
- Insight SFI Research Centre for Data Analytics, Maynooth University, North Campus, W23 F2k8, Maynooth, Ireland
- TechPA Research Group, Department of Public Health and Sport Sciences, Faculty of Social and Health Sciences, Inland Norway University of Applied Sciences, Elverum, Norway
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Arnaiz P, Seelig H, Gerber M, Adams L, Degen J, Dolley D, Joubert N, Nienaber M, Nqweniso S, Steinmann P, Utzinger J, du Randt R, Walter C, Pühse U, Müller I. Intervention effects and long-term changes in physical activity and cardiometabolic outcomes among children at risk of noncommunicable diseases in South Africa: a cluster-randomized controlled trial and follow-up analysis. Front Public Health 2023; 11:1199381. [PMID: 37304085 PMCID: PMC10250595 DOI: 10.3389/fpubh.2023.1199381] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 05/12/2023] [Indexed: 06/13/2023] Open
Abstract
Introduction Risk factors for noncommunicable diseases such as insufficient physical activity (PA), overweight or hypertension are becoming increasingly predominant among children globally. While school-based interventions are promising preventive strategies, evidence of their long-term effectiveness, especially among vulnerable populations, is scarce. We aim to assess the short-term effects of the physical and health KaziKidz intervention on cardiometabolic risk factors and the long-term, pre-and post-COVID-19 pandemic changes thereof in high-risk children from marginalized communities. Methods The intervention was tested in a cluster-randomized controlled trial between January and October 2019 in eight primary schools near Gqeberha, South Africa. Children with overweight, elevated blood pressure, pre-diabetes, and/or borderline dyslipidemia were identified and re-assessed 2 years post-intervention. Study outcomes included accelerometry-measured PA (MVPA), body mass index (BMI), mean arterial pressure (MAP), glucose (HbA1c), and lipid levels (TC to HDL ratio). We conducted mixed regression analyses to assess intervention effects by cardiometabolic risk profile, and Wilcoxon signed-rank tests to evaluate longitudinal changes in the high-risk subpopulation. Results We found a significant intervention effect on MVPA during school hours for physically inactive children, and among active as well as inactive girls. In contrast, the intervention lowered HbA1c and TC to HDL ratio only in children with glucose or lipid values within the norm, respectively. At follow-up, the intervention effects were not maintained in at-risk children, who showed a decline in MVPA, and an increase in BMI-for-age, MAP, HbA1c and TC to HDL ratio. Conclusion We conclude that schools are key settings in which to promote PA and improve health; however, structural changes are necessary to ensure that effective interventions reach marginalized school populations and achieve sustainable impact.
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Affiliation(s)
- Patricia Arnaiz
- Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
| | - Harald Seelig
- Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
| | - Markus Gerber
- Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
| | - Larissa Adams
- Department of Human Movement Science, Nelson Mandela University, Gqeberha, South Africa
| | - Jan Degen
- Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
| | - Danielle Dolley
- Department of Human Movement Science, Nelson Mandela University, Gqeberha, South Africa
| | - Nandi Joubert
- Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Madeleine Nienaber
- Department of Human Movement Science, Nelson Mandela University, Gqeberha, South Africa
| | - Siphesihle Nqweniso
- Department of Human Movement Science, Nelson Mandela University, Gqeberha, South Africa
| | - Peter Steinmann
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Jürg Utzinger
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Rosa du Randt
- Department of Human Movement Science, Nelson Mandela University, Gqeberha, South Africa
| | - Cheryl Walter
- Department of Human Movement Science, Nelson Mandela University, Gqeberha, South Africa
| | - Uwe Pühse
- Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
| | - Ivan Müller
- Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
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Wu Y, Ye S. Longitudinal Association of Changes in Parental Correlates With Screen Time in Chinese Preschoolers. J Phys Act Health 2023:1-8. [PMID: 37156542 DOI: 10.1123/jpah.2022-0085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2022] [Revised: 12/10/2022] [Accepted: 03/27/2023] [Indexed: 05/10/2023]
Abstract
BACKGROUND This study aimed to explore the relationship between the changes in parent-related factors and preschoolers exceeding screen time (ST) recommendations. METHODS A longitudinal analysis using 2-year follow-up data from 4 kindergartens (n = 409) was conducted in Zhejiang, China, from 2019 to 2021. Multivariate logistic regression models were used to determine the potential parental modifiable predictors. RESULTS The significant associations of baseline ST, change in screen accessibility, and the interaction of preschooler ST with maternal ST change with preschooler follow-up ST were observed. For preschool-aged children with baseline ST ≤ 1 hour per day, the follow-up of preschoolers with ST > 1 hour per day increased significantly when parental clarity of their ST rules decreased or remained low. For preschool children with baseline ST > 1 hour per day, follow-up ST increased significantly when their father kept ST >2 hours per day, when the screen accessibility became or remained easy, or when parental awareness of the ST decreased. CONCLUSIONS Changes in parental correlates played an important role in preschooler ST based on 2-year longitudinal data. Early interventions should focus on improving the clarity of parental rules and perceptions, as well as on reducing parental ST and accessibility of home screens.
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Affiliation(s)
- Yan Wu
- Department of Preschool Education, Jiaxing University Pinghu Normal College, Jiaxing,China
| | - Sunyue Ye
- Institute of Child Development, Jiaxing University Pinghu Normal College, Jiaxing,China
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Jago R, Salway R, House D, Walker R, Emm-Collison L, Sansum K, Breheny K, Reid T, Churchward S, Williams JG, Foster C, Hollingworth W, de Vocht F. Short and medium-term effects of the COVID-19 lockdowns on child and parent accelerometer-measured physical activity and sedentary time: a natural experiment. Int J Behav Nutr Phys Act 2023; 20:42. [PMID: 37101270 PMCID: PMC10132917 DOI: 10.1186/s12966-023-01441-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 03/17/2023] [Indexed: 04/28/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic has resulted in marked impacts on children's physical activity, with large reductions in moderate-to-vigorous physical activity (MVPA) reported during lockdowns. Previous evidence showed children's activity levels were lower and sedentary time higher immediately post-COVID lockdown, while there was little change in parental physical activity. We need to know if these patterns persist. METHODS Active-6 is a natural experiment using repeated cross-sectional data conducted in two waves. Accelerometer data were collected on 393 children aged 10-11 and their parents from 23 schools in Wave 1 (June 2021-December 2021), and 436 children and parents from 27 schools in Wave 2 (January 2022-July 2022). These were compared to a pre-COVID-19 comparator group (March 2017-May 2018) of 1,296 children and parents in the same schools. Mean minutes of accelerometer-measured MVPA and sedentary time were derived for week- and weekend-days and compared across waves via linear multilevel models. We also analysed the date of data collection as a time series, to explore temporal patterns via generalised additive mixed models. RESULTS There was no difference in children's mean MVPA in Wave 2 (weekdays: -2.3 min; 95% CI: -5.9, 1.3 and weekends: 0.6 min; 95% CI: -3.5, 4.6) when compared to the pre-COVID-19 data. Sedentary time remained higher than pre-pandemic by 13.2 min (95% CI:5.3, 21.1) on weekdays. Differences compared to pre-COVID-19 changed over time, with children's MVPA decreasing over winter, coinciding with COVID-19 outbreaks, and only returning to pre-pandemic levels towards May/June 2022. Parents' sedentary time and weekday MVPA was similar to pre-COVID-19 levels, with MVPA higher than pre-pandemic by 7.7 min (95% CI: 1.4, 14.0) on weekends. CONCLUSION After an initial drop, children's MVPA returned to pre-pandemic levels by July 2022, while sedentary time remained higher. Parents' MVPA remained higher, especially at weekends. The recovery in physical activity is precarious and potentially susceptible to future COVID-19 outbreaks or changes in provision, and so robust measures to protect against future disruptions are needed. Furthermore, many children are still inactive, with only 41% meeting UK physical activity guidelines, and so there is still a need to increase children's physical activity.
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Affiliation(s)
- Russell Jago
- Centre for Exercise, Nutrition and Health Sciences, School for Policy Studies, University of Bristol, 8 Priory Rd, Bristol, BS8 1TZ UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 2PS UK
- The National Institute for Health Research, Applied Research Collaboration West (NIHR ARC West), University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, BS1 2NT UK
- NIHR Bristol Biomedical Research Centre, University Hospitals Bristol and Weston NHS Foundation Trust and University of Bristol, Bristol, UK
| | - Ruth Salway
- Centre for Exercise, Nutrition and Health Sciences, School for Policy Studies, University of Bristol, 8 Priory Rd, Bristol, BS8 1TZ UK
| | - Danielle House
- Centre for Exercise, Nutrition and Health Sciences, School for Policy Studies, University of Bristol, 8 Priory Rd, Bristol, BS8 1TZ UK
| | - Robert Walker
- Centre for Exercise, Nutrition and Health Sciences, School for Policy Studies, University of Bristol, 8 Priory Rd, Bristol, BS8 1TZ UK
| | - Lydia Emm-Collison
- Centre for Exercise, Nutrition and Health Sciences, School for Policy Studies, University of Bristol, 8 Priory Rd, Bristol, BS8 1TZ UK
| | - Kate Sansum
- Centre for Exercise, Nutrition and Health Sciences, School for Policy Studies, University of Bristol, 8 Priory Rd, Bristol, BS8 1TZ UK
| | - Katie Breheny
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 2PS UK
| | - Tom Reid
- Centre for Exercise, Nutrition and Health Sciences, School for Policy Studies, University of Bristol, 8 Priory Rd, Bristol, BS8 1TZ UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 2PS UK
| | | | - Joanna G. Williams
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 2PS UK
- Communities and Public Health, Bristol City Council, Bristol, BS1 9NE UK
| | - Charlie Foster
- Centre for Exercise, Nutrition and Health Sciences, School for Policy Studies, University of Bristol, 8 Priory Rd, Bristol, BS8 1TZ UK
| | - William Hollingworth
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 2PS UK
- The National Institute for Health Research, Applied Research Collaboration West (NIHR ARC West), University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, BS1 2NT UK
| | - Frank de Vocht
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 2PS UK
- The National Institute for Health Research, Applied Research Collaboration West (NIHR ARC West), University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, BS1 2NT UK
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Frazer M, Seims A, Tatterton MJ, Lockyer B, Bingham D, Barber S, Daly-Smith A, Hall J. Child and family experiences of a whole-systems approach to physical activity in a multiethnic UK city: a citizen science evaluation protocol. BMJ Open 2023; 13:e069334. [PMID: 36810182 PMCID: PMC9945040 DOI: 10.1136/bmjopen-2022-069334] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Accepted: 02/03/2023] [Indexed: 02/23/2023] Open
Abstract
INTRODUCTION Whole-systems approaches are being adopted to tackle physical inactivity. The mechanisms contributing to changes resulting from whole-systems approaches are not fully understood. The voices of children and families that these approaches are designed for need to be heard to understand what is working, for whom, where and in what context. This paper describes the protocol for the children and families' citizen science evaluation of the Join Us: Move, Play (JU:MP) programme, a whole-systems approach to increasing physical activity in children and young people aged 5-14 years in Bradford, UK. METHODS AND ANALYSIS The evaluation aims to understand the lived experiences of children and families' relationship with physical activity and participation in the JU:MP programme. The study takes a collaborative and contributory citizen science approach, including focus groups, parent-child dyad interviews and participatory research. Feedback and data will guide changes within this study and the JU:MP programme. We also aim to examine participant experience of citizen science and the suitability of a citizen science approach to evaluate a whole-systems approach. Data will be analysed using framework approach alongside iterative analysis with and by citizen scientists in the collaborative citizen science study. ETHICS AND DISSEMINATION Ethical approval has been granted by the University of Bradford: study one (E891-focus groups as part of the control trial, E982-parent-child dyad interviews) and study two (E992). Results will be published in peer-reviewed journals and summaries will be provided to the participants, through schools or directly. The citizen scientists will provide input to create further dissemination opportunities.
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Affiliation(s)
- Marie Frazer
- Born in Bradford, Bradford Institute for Health Research, Bradford, UK
- Faculty of Health Studies, University of Bradford, Bradford, UK
- Centre for Applied Education Research, Wolfson Centre for Applied Health Research, Bradford, UK
| | - Amanda Seims
- Born in Bradford, Bradford Institute for Health Research, Bradford, UK
- Faculty of Health Studies, University of Bradford, Bradford, UK
| | - Michael J Tatterton
- Faculty of Health Studies, University of Bradford, Bradford, UK
- Centre for Applied Education Research, Wolfson Centre for Applied Health Research, Bradford, UK
| | - Bridget Lockyer
- Born in Bradford, Bradford Institute for Health Research, Bradford, UK
| | - Daniel Bingham
- Born in Bradford, Bradford Institute for Health Research, Bradford, UK
- Faculty of Health Studies, University of Bradford, Bradford, UK
- Centre for Applied Education Research, Wolfson Centre for Applied Health Research, Bradford, UK
| | - Sally Barber
- Born in Bradford, Bradford Institute for Health Research, Bradford, UK
| | - Andy Daly-Smith
- Born in Bradford, Bradford Institute for Health Research, Bradford, UK
- Faculty of Health Studies, University of Bradford, Bradford, UK
- Centre for Applied Education Research, Wolfson Centre for Applied Health Research, Bradford, UK
| | - Jennifer Hall
- Born in Bradford, Bradford Institute for Health Research, Bradford, UK
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Salway R, Walker R, Sansum K, House D, Emm-Collison L, Reid T, Breheny K, Williams JG, de Vocht F, Hollingworth W, Foster C, Jago R. Screen-viewing behaviours of children before and after the 2020-21 COVID-19 lockdowns in the UK: a mixed methods study. BMC Public Health 2023; 23:116. [PMID: 36650495 PMCID: PMC9843116 DOI: 10.1186/s12889-023-14976-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Accepted: 01/02/2023] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Restrictions during the COVID-19 pandemic have led to increased screen-viewing among children, especially during strict periods of lockdown. However, the extent to which screen-viewing patterns in UK school children have changed post lockdowns is unclear. The aim of this paper is to examine how screen-viewing changed in 10-11-year-old children over the 2020-21 COVID-19 pandemic, how this compares to before the pandemic, and the influences on screen-viewing behaviour. METHODS This is a mixed methods study with 10-11-year-olds from 50 schools in the Greater Bristol area, UK. Cross-sectional questionnaire data on minutes of weekday and weekend television (TV) viewing and total leisure screen-viewing were collected pre-COVID-19 in 2017-18 (N = 1,296) and again post-lockdowns in 2021 (N = 393). Data were modelled using Poisson mixed models, adjusted for age, gender, household education and seasonality, with interactions by gender and household education. Qualitative data were drawn from six focus groups (47 children) and 21 one-to-one parent interviews that explored screen-viewing behaviour during the pandemic and analysed using the framework method. RESULTS Total leisure screen-viewing was 11% (95% CI: 12%-18%) higher post-lockdown compared to pre-COVID-19 on weekdays, and 8% (95% CI: 6%-10%) on weekends, equating to around 12-15 min. TV-viewing (including streaming) was higher by 68% (95% CI: 63%-74%) on weekdays and 80% (95% CI: 75%-85%) on weekend days. Differences in both were higher for girls and children from households with lower educational attainment. Qualitative themes reflected an unavoidable increase in screen-based activities during lockdowns, the resulting habitualisation of screen-viewing post-lockdown, and the role of the parent in reducing post-2020/21 lockdown screen-viewing. CONCLUSIONS Although screen-viewing was higher post-lockdown compared to pre-COVID-19, the high increases reported during lockdowns were not, on average, sustained post-lockdown. This may be attributed to a combination of short-term fluctuations during periods of strict restrictions, parental support in regulating post-lockdown behaviour and age-related, rather than COVID-19-specific, increases in screen-viewing. However, socio-economic differences in our sample suggest that not all families were able to break the COVID-19-related adoption of screen-viewing, and that some groups may need additional support in managing a healthy balance of screen-viewing and other activities following the lockdowns.
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Affiliation(s)
- Ruth Salway
- Centre for Exercise, Nutrition & Health Sciences, School for Policy Studies, University of Bristol, Bristol, BS8 1TZ, United Kingdom.
| | - Robert Walker
- grid.5337.20000 0004 1936 7603Centre for Exercise, Nutrition & Health Sciences, School for Policy Studies, University of Bristol, Bristol, BS8 1TZ United Kingdom
| | - Kate Sansum
- grid.5337.20000 0004 1936 7603Centre for Exercise, Nutrition & Health Sciences, School for Policy Studies, University of Bristol, Bristol, BS8 1TZ United Kingdom
| | - Danielle House
- grid.5337.20000 0004 1936 7603Centre for Exercise, Nutrition & Health Sciences, School for Policy Studies, University of Bristol, Bristol, BS8 1TZ United Kingdom
| | - Lydia Emm-Collison
- grid.5337.20000 0004 1936 7603Centre for Exercise, Nutrition & Health Sciences, School for Policy Studies, University of Bristol, Bristol, BS8 1TZ United Kingdom
| | - Tom Reid
- grid.5337.20000 0004 1936 7603Centre for Exercise, Nutrition & Health Sciences, School for Policy Studies, University of Bristol, Bristol, BS8 1TZ United Kingdom ,grid.5337.20000 0004 1936 7603Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 2PS United Kingdom
| | - Katie Breheny
- grid.5337.20000 0004 1936 7603Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 2PS United Kingdom
| | - Joanna G. Williams
- grid.5337.20000 0004 1936 7603Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 2PS United Kingdom ,grid.33692.3d0000 0001 0048 3880 Communities and Public Health, Bristol City Council, Bristol, BS1 9NE United Kingdom
| | - Frank de Vocht
- grid.5337.20000 0004 1936 7603Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 2PS United Kingdom ,grid.410421.20000 0004 0380 7336Applied Research Collaboration West (NIHR ARC West), The National Institute for Health Research, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, BS1 2NT United Kingdom
| | - William Hollingworth
- grid.5337.20000 0004 1936 7603Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 2PS United Kingdom ,grid.410421.20000 0004 0380 7336Applied Research Collaboration West (NIHR ARC West), The National Institute for Health Research, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, BS1 2NT United Kingdom
| | - Charlie Foster
- grid.5337.20000 0004 1936 7603Centre for Exercise, Nutrition & Health Sciences, School for Policy Studies, University of Bristol, Bristol, BS8 1TZ United Kingdom
| | - Russell Jago
- grid.5337.20000 0004 1936 7603Centre for Exercise, Nutrition & Health Sciences, School for Policy Studies, University of Bristol, Bristol, BS8 1TZ United Kingdom ,grid.5337.20000 0004 1936 7603Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 2PS United Kingdom ,grid.410421.20000 0004 0380 7336Applied Research Collaboration West (NIHR ARC West), The National Institute for Health Research, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, BS1 2NT United Kingdom ,grid.410421.20000 0004 0380 7336NIHR Bristol Biomedical Research Centre, University Hospitals Bristol and Weston NHS Foundation Trust and University of Bristol, Bristol, United Kingdom
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Heller S, Kalo K, Werner AM, Eisenbarth L, Reichel JL, Mülder LM, Schäfer M, Letzel S, Simon P, Rigotti T, Dietz P. Sedentary time of university students before and during the COVID-19 pandemic: Risk groups and pre-pandemic predictors using cross-sectional and longitudinal data. Front Public Health 2023; 11:1138442. [PMID: 37089509 PMCID: PMC10113436 DOI: 10.3389/fpubh.2023.1138442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Accepted: 02/16/2023] [Indexed: 04/25/2023] Open
Abstract
Background The present study aimed to (1) assess and compare sedentary time (ST) of university students before and during the COVID-19 pandemic, (2) examine risk groups with regard to ST and the "extent of change" in ST (from before to during the pandemic) in association with sociodemographic (gender, age), study-related (degree aspired to, field of study, semester), and pre-pandemic physical health-related [pre-pandemic physical activity (PA) and ST levels, pre-pandemic BMI class] variables, and (3) investigate whether the change in ST was predicted by these variables. Methods Two online surveys were conducted among students at the University of Mainz, Germany-the first in 2019 (before the pandemic) and the second in 2020 (during the pandemic). Participants of both surveys were included in a longitudinal sample. With the longitudinal sample's data, paired t-tests, single factor, and mixed analyses of variances were used to examine group differences in ST and the "extent of change" in ST. A linear regression analysis was computed to investigate the influence of the abovementioned sociodemographic, study-related, and pre-pandemic physical health-related variables on the change in ST. Results Of the N = 4,351 (pre-pandemic) and N = 3,066 (in-pandemic) participants of the online surveys, N = 443 entered the longitudinal sample. ST increased by 1.4 h/day to critical levels (≥8 h/day) in all subgroups analyzed-even among students who were highly physically active before the pandemic. Students with a low pre-pandemic ST had the largest increase in ST. Pre-pandemic PA level negatively predicted the change in ST. Conclusion Even during a global pandemic lockdown, individuals who were previously more physically active and had less ST showed more health-promoting behavior in terms of ST. Therefore, it can be stated that efforts to promote PA and reduce ST are always valuable. Since ST increased and was worryingly high in all subgroups analyzed, all university students should be targeted by multidimensional approaches to tackle ST and promote their health.
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Affiliation(s)
- Sebastian Heller
- Institute of Occupational, Social and Environmental Medicine, University Medical Center of the University of Mainz, Mainz, Germany
| | - Kristin Kalo
- Department of Sports Medicine, Rehabilitation and Disease Prevention, Institute of Sport Science, Johannes Gutenberg University Mainz, Mainz, Germany
| | - Antonia M. Werner
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the University of Mainz, Mainz, Germany
| | - Laura Eisenbarth
- Institute of Occupational, Social and Environmental Medicine, University Medical Center of the University of Mainz, Mainz, Germany
| | - Jennifer L. Reichel
- Institute of Occupational, Social and Environmental Medicine, University Medical Center of the University of Mainz, Mainz, Germany
| | - Lina M. Mülder
- Department of Work, Organizational, and Business Psychology, Institute for Psychology, Johannes Gutenberg University Mainz, Mainz, Germany
| | - Markus Schäfer
- Department of Communication, Johannes Gutenberg University Mainz, Mainz, Germany
| | - Stephan Letzel
- Institute of Occupational, Social and Environmental Medicine, University Medical Center of the University of Mainz, Mainz, Germany
| | - Perikles Simon
- Department of Sports Medicine, Rehabilitation and Disease Prevention, Institute of Sport Science, Johannes Gutenberg University Mainz, Mainz, Germany
| | - Thomas Rigotti
- Department of Work, Organizational, and Business Psychology, Institute for Psychology, Johannes Gutenberg University Mainz, Mainz, Germany
- Leibniz Institute for Resilience Research, Mainz, Germany
| | - Pavel Dietz
- Institute of Occupational, Social and Environmental Medicine, University Medical Center of the University of Mainz, Mainz, Germany
- *Correspondence: Pavel Dietz
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Jago R, Salway R, House D, Beets M, Lubans DR, Woods C, de Vocht F. Rethinking children's physical activity interventions at school: A new context-specific approach. Front Public Health 2023; 11:1149883. [PMID: 37124783 PMCID: PMC10133698 DOI: 10.3389/fpubh.2023.1149883] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 03/21/2023] [Indexed: 05/02/2023] Open
Abstract
Physical activity is important for children's health. However, evidence suggests that many children and adults do not meet international physical activity recommendations. Current school-based interventions have had limited effect on physical activity and alternative approaches are needed. Context, which includes school setting, ethos, staff, and sociodemographic factors, is a key and largely ignored contributing factor to school-based physical activity intervention effectiveness, impacting in several interacting ways. Conceptualization Current programs focus on tightly-constructed content that ignores the context in which the program will be delivered, thereby limiting effectiveness. We propose a move away from uniform interventions that maximize internal validity toward a flexible approach that enables schools to tailor content to their specific context. Evaluation designs Evaluation of context-specific interventions should explicitly consider context. This is challenging in cluster randomized controlled trial designs. Thus, alternative designs such as natural experiment and stepped-wedge designs warrant further consideration. Primary outcome A collective focus on average minutes of moderate-to-vigorous intensity physical activity may not always be the most appropriate choice. A wider range of outcomes may improve children's physical activity and health in the long-term. In this paper, we argue that greater consideration of school context is key in the design and analysis of school-based physical activity interventions and may help overcome existing limitations in the design of effective interventions and thus progress the field. While this focus on context-specific interventions and evaluation is untested, we hope to stimulate debate of the key issues to improve future physical activity intervention development and implementation.
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Affiliation(s)
- Russell Jago
- Centre for Exercise, Nutrition and Health Sciences, School for Policy Studies, University of Bristol, Bristol, United Kingdom
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
- The National Institute for Health Research, Applied Research Collaboration West (NIHR ARC West), University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, United Kingdom
- NIHR Bristol Biomedical Research Centre, University Hospitals Bristol and Weston NHS Foundation Trust and University of Bristol, Bristol, United Kingdom
- *Correspondence: Russell Jago,
| | - Ruth Salway
- Centre for Exercise, Nutrition and Health Sciences, School for Policy Studies, University of Bristol, Bristol, United Kingdom
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Danielle House
- Centre for Exercise, Nutrition and Health Sciences, School for Policy Studies, University of Bristol, Bristol, United Kingdom
| | - Michael Beets
- Arnold School of Public Health, University of South Carolina, Columbia, SC, United States
| | - David Revalds Lubans
- Centre for Active Living and Learning, College of Human and Social Futures, University of Newcastle, Callaghan, NSW, Australia
- Hunter Medical Research Institute, Newcastle, NSW, Australia
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Catherine Woods
- Physical Activity for Health Research Centre, Health Research Institute, University of Limerick, Limerick, Ireland
| | - Frank de Vocht
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
- The National Institute for Health Research, Applied Research Collaboration West (NIHR ARC West), University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, United Kingdom
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Walker R, House D, Emm-Collison L, Salway R, Tibbitts B, Sansum K, Reid T, Breheny K, Churchward S, Williams JG, de Vocht F, Hollingworth W, Foster C, Jago R. A multi-perspective qualitative exploration of the reasons for changes in the physical activity among 10-11-year-old children following the easing of the COVID-19 lockdown in the UK in 2021. Int J Behav Nutr Phys Act 2022; 19:114. [PMID: 36064548 PMCID: PMC9444096 DOI: 10.1186/s12966-022-01356-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2022] [Accepted: 08/23/2022] [Indexed: 11/14/2022] Open
Abstract
Background Active-6 is exploring how the COVID-19 pandemic has impacted physical activity behaviour among Year 6 children (aged 10–11 years) and their parents in Southwest England. Initial findings from the Active-6 project have shown a 7–8 min decrease in moderate-to-vigorous physical activity and an increase in sedentary behaviour among children following the easing of restrictions in the UK in latter half of 2021. This finding suggests that the pandemic has had a persistent impact on child physical activity behaviour. This paper explored the possible mechanisms behind these changes. Methods Interviews with parents (n = 21), members of school staff (n = 9) and focus groups with children aged 10–11 years (n = 47) were conducted between August and December 2021 to discuss the impact of the pandemic on child physical activity behaviour. The framework method was used for analysis. Results Five themes spanning two key stages of the pandemic were described. Three themes related to the period of lockdowns and fluctuating restrictions (March 2020 – April 2021). These included: Theme 1) Lockdown: A short-lived adventure; Theme 2) Access to facilities during restrictions; and Theme 3) The importance of the parent. A further two themes were identified related to the period following the gradual easing of restrictions in April 2021. These included: Theme 4) An overwhelming return to normal; and Theme 5) Reopening fatigue. Conclusions The analysis suggested that feelings of novelty experienced during the initial stages of lockdown waned as restrictions were prolonged, creating an increasingly challenging period for parents and their children. However, during periods of restrictions, the importance of parental encouragement and access to appropriate facilities in the local and home environment helped facilitate physical activity. Following the easing of COVID-19 restrictions, emotional overwhelm and physical fatigue among children, stemming from a sedentary and socially isolated life in lockdown and other restrictions, were key contributors to the decreased moderate to vigorous physical activity and increased sedentary behaviour that was observed in a related quantitative study. Supplementary Information The online version contains supplementary material available at 10.1186/s12966-022-01356-3.
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Affiliation(s)
- Robert Walker
- Centre for Exercise, Nutrition & Health Sciences, School for Policy Studies, University of Bristol, Bristol, BS8 ITZ, UK
| | - Danielle House
- Centre for Exercise, Nutrition & Health Sciences, School for Policy Studies, University of Bristol, Bristol, BS8 ITZ, UK
| | - Lydia Emm-Collison
- Centre for Exercise, Nutrition & Health Sciences, School for Policy Studies, University of Bristol, Bristol, BS8 ITZ, UK
| | - Ruth Salway
- Centre for Exercise, Nutrition & Health Sciences, School for Policy Studies, University of Bristol, Bristol, BS8 ITZ, UK
| | - Byron Tibbitts
- Centre for Exercise, Nutrition & Health Sciences, School for Policy Studies, University of Bristol, Bristol, BS8 ITZ, UK
| | - Kate Sansum
- Centre for Exercise, Nutrition & Health Sciences, School for Policy Studies, University of Bristol, Bristol, BS8 ITZ, UK
| | - Tom Reid
- Centre for Exercise, Nutrition & Health Sciences, School for Policy Studies, University of Bristol, Bristol, BS8 ITZ, UK.,Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 2PS, UK
| | - Katie Breheny
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 2PS, UK
| | | | - Joanna G Williams
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 2PS, UK.,Communities and Public Health, Bristol City Council, Bristol, BS1 9NE, UK
| | - Frank de Vocht
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 2PS, UK.,The National Institute for Health Research, Applied Research Collaboration West (NIHR ARC West), University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, BS1 2NT, UK
| | - William Hollingworth
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 2PS, UK.,The National Institute for Health Research, Applied Research Collaboration West (NIHR ARC West), University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, BS1 2NT, UK
| | - Charlie Foster
- Centre for Exercise, Nutrition & Health Sciences, School for Policy Studies, University of Bristol, Bristol, BS8 ITZ, UK
| | - Russell Jago
- Centre for Exercise, Nutrition & Health Sciences, School for Policy Studies, University of Bristol, Bristol, BS8 ITZ, UK. .,Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 2PS, UK. .,The National Institute for Health Research, Applied Research Collaboration West (NIHR ARC West), University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, BS1 2NT, UK. .,NIHR Bristol Biomedical Research Centre, University Hospitals Bristol and Weston NHS Foundation Trust and University of Bristol, Bristol, UK.
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Ostermeier E, Tucker P, Tobin D, Clark A, Gilliland J. Parents' perceptions of their children's physical activity during the COVID-19 pandemic. BMC Public Health 2022; 22:1459. [PMID: 35915418 PMCID: PMC9340749 DOI: 10.1186/s12889-022-13829-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Accepted: 06/17/2022] [Indexed: 11/30/2022] Open
Abstract
Background COVID-19 has drastically changed the everyday lives of children, including limiting interactions with peers, loss of regularly organized activities, and closure of schools and recreational facilities. While COVID-19 protocols are in place to reduce viral transmission, they have affected children’s access to physical activity opportunities. The purpose of this study was to understand how COVID-19 has affected children’s engagement in physical activity and to identify strategies that can support children’s return to physical activity programming in public places. Methods Parents of past participants in the Grade 5 ACT-i-Pass Program in London, Ontario, Canada were invited to participate in a semi-structured interview online (in November and December 2020) via Microsoft Teams. The script was comprised of questions about their child’s physical activity levels (before, current, and anticipated following COVID-19), lifestyle changes due to COVID-19, and what service providers can do to assist children’s return to public programming. Interviews were transcribed in Microsoft Teams, reviewed by a member of the research team, and analyzed in NVivo 12 using thematic analysis. Results Twenty-seven parents participated in an interview. Four themes and two subthemes were identified during analysis: (1) modifications to everyday life (a. activity options available and b. altered social environment), (2) safety in public spaces, (3) accessibility of activities, and (4) utilizing outdoor spaces. Conclusions COVID-19 protocols have decreased children’s physical activity levels due to the loss of their regular activities, recreational spaces, and peer support. Implementing facility and activity-specific health protocols, providing outdoor activity options, and offering a variety of activity types, times, and locations are three strategies recommended by parents to help facilitate their children’s return to public recreational places. Due to the negative consequences of physical inactivity on children’s health and well-being, service providers need to implement programming and safety protocols that support children’s engagement in physical activity throughout the remainder of, and the years following, the COVID-19 pandemic. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-13829-y.
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Affiliation(s)
- Emma Ostermeier
- Health and Rehabilitation Sciences, Faculty of Health Sciences, The University of Western Ontario, London, ON, Canada.,Child Health and Physical Activity Laboratory, School of Occupational Therapy, The University of Western Ontario, London, ON, Canada.,Human Environments Analysis Laboratory, Department of Geography and Environment, The University of Western Ontario, Social Science Centre, Rm 2333-1151 Richmond Street Western University, ON, N6A 3K7, London, Canada
| | - Patricia Tucker
- Child Health and Physical Activity Laboratory, School of Occupational Therapy, The University of Western Ontario, London, ON, Canada.,Human Environments Analysis Laboratory, Department of Geography and Environment, The University of Western Ontario, Social Science Centre, Rm 2333-1151 Richmond Street Western University, ON, N6A 3K7, London, Canada.,School of Occupational Therapy, Faculty of Health Sciences, The University of Western Ontario, London, ON, Canada.,Children's Health Research Institute, N6C 2V5, London, ON, Canada
| | - Danielle Tobin
- Human Environments Analysis Laboratory, Department of Geography and Environment, The University of Western Ontario, Social Science Centre, Rm 2333-1151 Richmond Street Western University, ON, N6A 3K7, London, Canada
| | - Andrew Clark
- Human Environments Analysis Laboratory, Department of Geography and Environment, The University of Western Ontario, Social Science Centre, Rm 2333-1151 Richmond Street Western University, ON, N6A 3K7, London, Canada.,Children's Health Research Institute, N6C 2V5, London, ON, Canada
| | - Jason Gilliland
- Human Environments Analysis Laboratory, Department of Geography and Environment, The University of Western Ontario, Social Science Centre, Rm 2333-1151 Richmond Street Western University, ON, N6A 3K7, London, Canada. .,Children's Health Research Institute, N6C 2V5, London, ON, Canada. .,Department of Epidemiology & Biostatistics, The University of Western Ontario, London, ON, Canada. .,Department of Paediatrics, The University of Western Ontario, London, ON, Canada. .,Department of Geography and Environment, The University of Western Ontario, London, ON, Canada. .,School of Health Studies, The University of Western Ontario, London, ON, Canada. .,Lawson Health Research Institute, London, ON, Canada.
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