Increasing children’s physical activity : individual, social, and environmental factors associated with walking to and from school

Background. Efforts to increase the prevalence of children’s active school transport require evidence to inform the development of comprehensive interventions. This study used a multilevel ecological framework to investigate individual, social, and environmental factors associated with walking to and from school among elementary school-aged children, stratified by gender.
Method. Boys aged 10 to 13 years (n = 617) and girls aged 9 to 13 years (n = 681) attending 25 Australian primary schools located in high or low walkable neighborhoods completed a 1-week travel diary and a parent/child questionnaire on travel habits and attitudes.
Results. Boys were more likely (odds ratio [OR] = 3.37; p < .05) to walk if their school neighborhood had high connectivity and low traffic and less likely to walk if they had to cross a busy road (OR = 0.49; p < .05). For girls, confidence in their ability to walk to or from school without an adult (OR = 2.03), school encouragement (OR = 2.43), scheduling commitments (OR = 0.41), and parent-perceived convenience of driving (OR = 0.24) were significantly associated (p < .05) with walking. Irrespective of gender and proximity to school, child-perceived convenience of walking (boys OR = 2.17 and girls OR = 1.84) and preference to walk to school (child perceived, boys OR = 5.57, girls OR = 1.84 and parent perceived, boys OR = 2.82, girls OR = 1.90) were consistently associated (p < .05) with walking to and from school.
Conclusion. Although there are gender differences in factors influencing children walking to and from school, proximity to school, the safety of the route, and family time constraints are consistent correlates. These need to be addressed if more children are to be encouraged to walk to and from school.

How does perceived risk mediate associations between perceived safety and parental restriction of adolescents' physical activity in their neighborhood?

Background
There is evidence that adolescence is a critical period of decline in physical activity. However, adolescents may have limited opportunities to be physically active outdoors if their parents are concerned about neighborhood safety and restrict their adolescent’s physical activity within their neighborhood. Pathways that lead to parental restriction of adolescents’ physical activity (constrained behavior) are under-researched. This study aimed to examine perceived risk as a potential mediator of associations between perceived safety/victimization and constrained behavior.
Methods
Cross-sectional study of adolescents (43% boys) aged 15–17 years (n = 270) in Melbourne, Australia. Parents reported perceived safety (road safety, incivilities and personal safety) and prior victimization in their neighborhood, perceived risk of their children being harmed and whether they constrained their adolescent’s physical activity. Constrained behavior was categorized as ‘avoidance’ or ‘defensive’ behavior depending on a whether physical activity was avoided or modified, respectively, due to perceived risk. MacKinnon’s product-of-coefficients test of mediation was used to assess potential mediating pathways between perceived safety/victimization and constrained behavior.
Results
For girls only, perceived risk was a significant mediator of associations between perceived road safety and avoidance/defensive behavior, and between perceived incivilities, perceived personal safety, victimization and defensive behavior.
Conclusions
Associations between perceived safety/victimization and constrained behavior are complex. Findings may guide the design of interventions that aim to improve actual and perceived levels of safety and reduce perceptions of risk. This is of particular importance for adolescent girls among whom low and declining levels of physical activity have been observed worldwide.

Do the individual, social, and environmental correlates of physical activity differ between urban and rural women?

In this article, associations between individual, social, and environmental factors and physical activity among 3,669 women (18-45 years) living in socioeconomically disadvantaged urban and rural areas were compared. In 2007-2008, participants reported levels of leisure-time physical activity (LTPA) and transport-related physical activity (TRPA) as well as five individual, four social, and three environmental factors. Physical activity self- efficacy demonstrated stronger associations with LTPA among urban relative to rural women; child care was associated with LTPA and intentions with TRPA among urban women only, and enjoyment was associated with TRPA among rural women only. Correlates of physical activity among urban and rural women were generally similar, although some tailoring of physical activity promotion strategies may be warranted.

School day segmented physical activity patterns of high and low active children

Background

Variability exists in children's activity patterns due to the association with environmental, social, demographic, and inter-individual factors. This study described accelerometer assessed physical activity patterns of high and low active children during segmented school week days whilst controlling for potential correlates.
Methods

Two hundred and twenty-three children (mean age: 10.7 +/- 0.3 yrs, 55.6% girls, 18.9% overweight/obese) from 8 north-west England primary schools wore ActiGraph GT1M accelerometers for 7 consecutive days during autumn of 2009. ActiGraph counts were converted to minutes of moderate (MPA), vigorous (VPA) and moderate-to-vigorous (MVPA) physical activity. Children were classified as high active (HIGH) or low active (LOW) depending on the percentage of week days they accumulated at least 60 minutes of MVPA. Minutes spent in MPA and VPA were calculated for school time and non-school time and for five discrete school day segments (before-school, class time, recess, lunchtime, and after-school). Data were analysed using multi-level modelling.
Results

The HIGH group spent significantly longer in MPA and/or VPA before-school, during class time, lunchtime, and after-school (P < .05), independent of child and school level factors. The greatest differences occurred after-school (MPA = 5.5 minutes, VPA = 3.8 minutes, P < 0.001). MPA and VPA were also associated with gender, BMI z-score, number of enrolled children, playground area per student, and temperature, depending on the segment analysed. The additive effect of the segment differences was that the HIGH group accumulated 12.5 minutes per day more MVPA than the LOW group.
Conclusions

HIGH active children achieved significantly more MPA and VPA than LOW active during four of the five segments of the school day when analyses were adjusted for potential correlates. Physical activity promotion strategies targeting low active children during discretionary physical activity segments of the day, and particularly via structured after-school physical activity programs may be beneficial.

Preschoolers' physical activity, screen time, and compliance with recommendations

Purpose: Little evidence exists about the prevalence of adequate levels of physical activity and of appropriate screen-based entertainment in preschool children. Previous studies have generally relied on small samples. This study investigates how much time preschool children spend being physically active and engaged in screen-based entertainment. The study also reports compliance with the recently released Australian recommendations for physical activity (>=3 h·d-1) and screen entertainment (<=1 h·d-1) and the National Association for Sport and Physical Education physical activity guidelines (>=2 h·d-1) and American Academy of Pediatrics screen-based entertainment recommendations (<=2 h·d-1) in a large sample of preschool children.

Methods: Participants were 1004 Melbourne preschool children (mean age = 4.5 yr, range = 3–5 yr) and their families in the Healthy Active Preschool Years study. Physical activity data were collected by accelerometry during an 8-d period. Parents reported their child’s television/video/DVD viewing, computer/Internet, and electronic game use during a typical week. A total of 703 (70%) had sufficient accelerometry data, and 935 children (93%) had useable data on time spent in screen-based entertainment.

Results: Children spent 16% (approximately 127 min·d-1) of their time being physically active. Boys and younger children were more active than were girls and older children, respectively. Children spent an average of 113 min·d-1 in screen-based entertainment. Virtually no children (<1%) met both the Australian recommendations and 32% met both the National Association for Sport and Physical Education and American Academy of Pediatrics recommendations.

Conclusions: The majority of young children are not participating in adequate amounts of physical activity and in excessive amounts of screen-based entertainment. It is likely that physical activity may decline and that screen-based entertainment may increase with age. Compliance with recommendations may be further reduced. Strategies to promote physical activity and reduce screen-based entertainment in young children are required.

Do parents’ and children’s concerns about sports safety and injury risk relate to how much physical activity children do?

Objective To see whether concerns about injury risk relate to children's physical activity (PA).
Methods Two cohorts were recruited from 19 Australian schools and assessed in 2001 (T1), 2004 (T2) and 2006 (T3). The younger (n=162) was assessed at 6, 9 and 11years old, and the older (n=259) at 11, 14 and 16 years old. At T1 and T2, parents of the younger cohort reported on fear of child being injured, and whether child would be at risk of injury if they played organised sport; the older cohort self-reported injury fear. Accelerometers assessed PA at each time point. Linear regression models examined cross-sectional associations, and also associations between T1 injury fear and risk and T2 PA, and T2 injury fear and risk and T3 PA.
Results In the younger cohort at T2 (9 years), fear and risk were both negatively associated with moderate to vigorous PA (MVPA) (β=−0.17, 95% CI −0.30 to −0.03 and β=−0.26, 95% CI −0.41 to −0.10) and also vigorous PA (VPA). Fear was also associated with moderate PA (MPA). For the older cohort at T1, injury fear was negatively associated with MVPA (β=−0.21, 95% CI −0.35 to −0.07) and also MPA and VPA. Parental perception of risk at T1 (6 years) was negatively associated with children's MPA at T2 (9 years) (β=−0.17, 95% CI −0.32 to −0.02). Sex did not moderate any association.
Conclusions Younger children and their parents need to know which sports have low injury risks. Some children may need increased confidence to participate.

Intergenerational differences in food, physical activity, and body size perceptions among African migrants

We assessed intergenerational differences in food, physical activity, and body size perceptions among refugees and migrants from the Horn of Africa living in Victoria, Australia. We used a qualitative design and obtained data from 48 participants (18 individual interviews; 3 semistructured focus groups). Three major themes emerged: (a) food and physical activity, (b) preference of body size and social expectations, and (c) perceived consequences of various body sizes. For parents, large body size was perceived to equate with being beautiful and wealthy; slimness was associated with chronic illness and poverty. Parents adopted strategies that promoted weight gain in children. These included tailored food practices and restricting children’s involvement in physical activity. For young people, slimness was the ideal body size endorsed by their peers, and they adopted strategies to resist parental pressure to gain weight. Obesity-prevention programs in this subpopulation need to adopt a multigenerational approach.

Five-year changes in school recess and lunchtime and the contribution to children’s daily physical activity

Objective To investigate the longitudinal changes in children's recess and lunchtime physical activity levels and in the contribution of recess and lunchtime to daily physical activity levels over 5 years among 5–6- and 10–12-year olds.

Methods Data were drawn from two longitudinal studies that were conducted in metropolitan Melbourne, Australia. Boys and girls (n=2782) aged 5–6 years and 10–12 years participated in baseline (T0) measures. Physical activity (n=2490) was measured every 60 s for eight consecutive days using hip-mounted accelerometry. Subsequent measurements were taken at 3-year (T1; n=773) and 5-year (T2; n=634) follow-up. Physical activity intensities were derived using age-adjusted cut-points. Sedentary time was defined as 100 counts/min. Longitudinal data were analysed using three-level (time, child, school) multilevel analyses, stratified by sex and cohort, and adjusted for potential confounding variables.

Results Significant decreases in recess and lunchtime moderate and vigorous physical activity were observed (p<0.001), with larger decreases occurring in the older cohort. Associated increases were observed in sedentary time over time (p<0.01). Although the contribution of recess to daily moderate intensity physical activity increased in the younger cohort over time (p<0.001), significant decreases were observed in the older cohort (p<0.001).

Conclusion Physical activity levels during recess and lunchtime decreased in both cohorts over time. Decreases in the contribution of recess and lunchtime to older children's daily physical activity were also observed. Interventions are needed in both primary and secondary schools to promote physical activity levels during recess and lunchtime, particularly during the early years of secondary school.

Physical activity levels and patterns of 19-month-old children

Purpose: It is a commonly held perception that most young children are naturally active and meet physical activity recommendations. However, there is no scientific evidence available on which to confirm or refute such perceptions. The purpose of this study was to describe the physical activity levels and patterns of Australian toddlers.


Methods: Physical activity and demographic data of two hundred ninety-five 19-month-old children from the Melbourne InFANT Program were measured using accelerometers and parent surveys. Validated cut points of 192–1672 and >1672 counts per minute were used to determine time spent in light- (LPA) and moderate-to-vigorous- (MVPA) intensity physical activity, respectively. To be included in the analysis, children were required to have four valid days of accelerometer data to provide an acceptable (>0.70) reliability estimate of LPA and MVPA. Physical activity data for different periods of the day were examined.


Results: On average, toddlers engaged in 184 min of LPA and 47 min of MVPA daily, and 90.5% met the current Australian physical activity recommendations for 0- to 5-yr-olds (180 min of LPA/MVPA per day). Physical activity levels during mid morning and mid afternoon were higher than those during other periods. Physical activity patterns for boys and girls were similar, although boys engaged in more physical activity during the morning hours than girls did.


Conclusions: Most children meet the physical activity recommendations, although the majority of activity undertaken in the study was of light intensity. Boys were more active than girls were in the morning hours, but there were no differences between sexes over the entire day. Certain periods of the day may hold more promise for intervention implementation than others do.

Associations between fruit and vegetable intake, leisure-time physical activity, sitting time and self-rated health among older adults : cross-sectional data from the WELL study

Background
Lifestyle behaviours, such as healthy diet, physical activity and sedentary behaviour, are key elements of healthy ageing and important modifiable risk factors in the prevention of chronic diseases. Little is known about the relationship between these behaviours in older adults. The purpose of this study was to explore the relationship between fruit and vegetable (F&V) intake, leisure-time physical activity (LTPA) and sitting time (ST), and their association with self-rated health in older adults.

Methods
This cross-sectional study comprised 3,644 older adults (48% men) aged 55-65 years, who participated in the Wellbeing, Eating and Exercise for a Long Life ("WELL") study. Respondents completed a postal survey about their health and their eating and physical activity behaviours in 2010 (38% response rate). Spearman's coefficient (rho) was used to evaluate the relationship between F&V intake, LTPA and ST. Their individual and shared associations with self-rated health were examined using ordinal logistic regression models, stratified by sex and adjusted for confounders (BMI, smoking, long-term illness and socio-demographic characteristics).

Results
The correlations between F&V intake, LTPA and ST were low. F&V intake and LTPA were positively associated with self-rated health. Each additional serving of F&V or MET-hour of LTPA were associated with approximately 10% higher likelihood of reporting health as good or better among women and men. The association between ST and self-rated health was not significant in the multivariate analysis. A significant interaction was found (ST*F&V intake). The effect of F&V intake on self-rated health increased with increasing ST in women, whereas the effect decreased with increasing ST in men.

Conclusion
This study contributes to the scarce literature related to lifestyle behaviours and their association with health indicators among older adults. The findings suggest that a modest increase in F&V intake, or LTPA could have a marked effect on the health of older adults. Further research is needed to fully understand the correlates and determinants of lifestyle behaviours, particularly sitting time, in this age group.

Do food and physical activity environments vary between disadvantaged urban and rural areas? Findings from the READI study

Issues addressed: The presence or absence of amenities in local neighbourhood environments can either promote or restrict access to opportunities to engage in healthy and/or less healthy behaviours. Rurality is thought to constrain access to facilities and services. This study investigated whether the presence and density of environmental amenities related to physical activity and eating behaviours differs between socioeconomically disadvantaged urban and rural areas in Victoria, Australia.

Methods: We undertook cross-sectional analysis of environmental data collected in 2007-08 as part of the Resilience for Eating and Activity Despise Inequality (READI) study. These data were sourced and analysed for 40 urban and 40 rural socioeconomically disadvantaged areas. The variables examined were the presence, raw count, count/km², and count/'000 population of a range of environmental amenities (fast-food restaurants, all supermarkets (also separated by major chain and other supermarkets), greengrocers, playgrounds, gyms/leisure centres, public swimming pools and public open spaces).

Results: A greater proportion of urban areas had a fast-food restaurant and gym/leisure centre present while more rural areas contained a supermarket and public swimming pool. All amenities examined (with the exception of swimming pools) were more numerous per km² in urban areas, however rural areas had a greater number of all supermarkets, other supermarkets, playgrounds, swimming pools and public open area per '000 population.

Conclusion: Although opportunities to engage in healthy eating and physical activity exist in many rural areas, a lower density per km² suggests a greater travel distance may be required to reach these.