Children's after-school activity : associations with weight status and family circumstance

This study investigated children's after-school activity and associations with body mass index (BMI) and family circumstance. One thousand two hundred thirty-four parents and 854 children (age 8-13 years) completed activity diaries for the 2 hours after school. Parents reported children as more active than children reported themselves. Boys were reported to be more active than girls. Activity levels were generally not associated with BMI or family circumstance with the exception of cultural background. Parent-reported mean child METs were higher for mothers born in Australia (3.3 vs. 3.0; p = .02). Child-reported mean METs were higher for fathers born in Australia (2.9 vs. 2.6; p = .04) and where English was their main language (2.9 vs. 2.3, p = .003).

Giving young Emirati women a voice : participatory action research on physical activity

International evidence on health promotion indicates the importance of regular physical activity for preventing and reducing the incidence of obesity and chronic diseases. This study investigated the relationship between physical activity and the social milieu of young Muslim women in the United Arab Emirates. This participatory action research project included semi-structured in-depth interviews and focus groups and yielded qualitative data. Set within a context of rapid social change, perceived barriers to daily exercise influenced participants’ physical activity levels and overall well-being. Results indicated a lack of physical exercise and strategies were proposed for implementation by college staff and students.

Socioeconomic position and children's physical activity and sedentary behaviors : longitudinal findings from the CLAN study

Background: This study aimed to examine cross-sectional and longitudinal associations between socioeconomic position (SEP) and physical activity and sedentary behaviors amongst children and adolescents.

Methods: Maternal education was reported by parents of 184 5-6 year-old and 358 10-12 year-old children in 2001. In 2001 and 2004, physical activity was assessed by accelerometry. Older children self-reported and parents of younger children proxy-reported physical activity and television (TV) viewing behaviors. Linear regression was used to predict physical activity and sedentary behaviors, and changes in these behaviors, from maternal education.

Results: Among all children, accelerometer-determined and self/parent-reported moderate and vigorous physical activity declined over three years. Girls of higher SEP demonstrated greater decreases in TV viewing behaviours than those of low SEP. In general, no prospective associations were evident between SEP and objectively-assessed physical activity. A small number of prospective associations were noted between SEP and self-reported physical activity, but these were generally weak and inconsistent in direction.

Conclusions: This study did not find strong evidence that maternal education was cross-sectionally or longitudinally predictive of children’s physical activity or sedentary behaviors. Given the well-documented inverse relationship of SEP with physical activity levels in adult samples, findings suggest that such disparities may emerge after adolescence.

How do school day activity patterns differ with age and gender across adolescence?

Purpose
A knowledge of how young people use their time could be instrumental in informing health interventions, modeling consumer behaviors, and planning service delivery. The aim of the present study was to describe age- and gender-related patterns in the self-reported use of time on school days in a large sample of Australian children and adolescents aged between 10 and 18 years.

Methods
A single, detailed use-of-time diary for a school day was collected from 6024 Australians aged 10–18 from several state and regional surveys conducted in the states of South Australia (SA) and Victoria between 2001 and 2006. Time–use profiles were analyzed for a range of active and sedentary state behaviors.

Results
Boys reported higher physical activity levels (PALs), moderate-to-vigorous physical activity (MVPA), and sports than girls. There were no differences in free play, and girls used more active transport. All activity-related variables decreased with age, except active transport, which peaked at 14–15 years. Boys exhibited higher levels of screen time, whereas girls had higher levels of passive transport. Screen time and its components (television, videogames, and computer use) peaked in the peripubertal years.

Conclusion
Age- and gender-related patterns of time use vary greatly within adolescence. This may reflect a mix of biological and social factors.

Socioeconomic position and the tracking of physical activity and cardiorespiratory fitness from childhood to adulthood

This study examined the influence of childhood socioeconomic position (SEP) and social mobility on activity and fitness tracking from childhood into adulthood. In a prospective cohort of 2,185 Australian adults (aged 26–36 years), first examined in 1985 (at ages 7–15 years), self-reported physical activity and cardiorespiratory fitness (subsample only) were measured. SEP measures included retrospectively reported parental education (baseline) and own education (follow-up). There was little evidence of a relation between childhood SEP and activity tracking, but high childhood SEP (maternal education) was associated with a 59% increased likelihood of persistent fitness, and medium childhood SEP (paternal and parental education) was associated with a 33%–36% decreased likelihood of persistent fitness. Upward social mobility was associated with a greater likelihood of increasing activity (38%–49%) and fitness (90%), and persistently high SEP was associated with a greater likelihood of increasing activity (males: 58%) and fitness (males and females combined: 89%). In conclusion, persistently high SEP and upward social mobility were associated with increases in activity and fitness from childhood to adulthood. Findings highlight socioeconomic differentials in activity and fitness patterns and suggest that improvements in education may represent a pathway through which physical activity levels can be increased and health benefits achieved

Reliability and validity of the system for observing children's activity and relationships during play (SOCARP)

Background: Children frequently engage in diverse activities that are broadly defined as play, but little research has documented children’s activity levels during play and how they are influenced by social contexts. Assessing potentially modifiable conditions that influence play behavior is needed to design optimal physical activity interventions.

Methods: System for Observing Children’s Activity and Relationships during Play (SOCARP) was developed to simultaneously assess children’s physical activity, social group sizes, activity type, and social behavior during play. One hundred and fourteen children (48 boys, 66 girls; 42% overweight) from 8 elementary schools were observed during recess over 24 days, with 12 days videotaped for reliability purposes. Ninety-nine children wore a uni-axial accelerometer during their observation period.

Results: Estimated energy expenditure rates from SOCARP observations and mean accelerometer counts were significantly correlated (r = .67; P < .01), and interobserver reliabilities (ie, percentage agreement) for activity level (89%), group size (88%), activity type (90%) and interactions (88%) met acceptable criteria. Both physical activity and social interactions were influenced by group size, activity type, and child gender and body weight status.

Conclusions: SOCARP is a valid and reliable observation system for assessing physical activity and play behavior in a recess context.

Assessing physical activity during recess using accelerometry

Background : Physical activity guidelines recommend children should engage in 60 min of moderate-to-vigorous physical activity (MVPA) a day. School recess presents an opportunity for children to be physically active during the school day. Limited research has investigated children's activity levels during recess and its contribution to physical activity recommendations. Moreover, no target for physical activity during recess has been set.

Methods : One hundred sixteen boys and 112 girls (aged 5–10 years) from 23 schools had their physical activity during recess quantified using a uniaxial accelerometer during three recess breaks on one school day. The percentage of time spent engaged in moderate, high, and very high intensity activity was calculated using existing thresholds.

Results : Boys engaged in more moderate, high, and very high intensity activity than girls. On average, boys and girls spent 32.9% and 23% of recess engaged in physical activity, respectively.

Conclusions : Boys engaged in higher intensity activities than girls. The results suggest that recess can contribute 28 min for boys and 21.5 min for girls toward the accumulation of recommended daily physical activity. However, the physical activity intensities that children engaged in were low during recess. On average, children in this study did not achieve 50% of recess time in physical activity. Interventions for increasing the physical activity of children in the playground are warranted.

An exploratory study of the factors that influence physical activity for prostate cancer survivors

Purpose To gain an understanding of the factors that influence participation in physical activity for survivors of prostate cancer and to examine changes in participation in physical activity pre- and post-diagnosis.
Methods Eighteen men who had completed treatment for prostate cancer 6 months prior were interviewed for this study. Constant comparison was used to examine the main themes arising from the interviews.
Results Barriers to physical activity tended not to be related to the physical side effects of treatment, however lack of confidence following treatment, co-morbidities, older age physical decline and lack of time were barriers. Motivations for physical activity included psychological benefits, physical benefits, and the context of the activity. Participants did not recall receiving information about physical activity from clinicians and few were referred to exercise specialists. Physical activity 6 months post-treatment was similar to physical activity levels prior to diagnosis, although there was some decline in terms of the intensity of participation.
Conclusions Interventions to increase physical activity for this group will need to take into account co-morbidities and decline associated with older age, as well as treatment side effects and psychological issues associated with a cancer diagnosis. Encouragement from health care professionals
and referral to an exercise specialist is likely to give men more confidence to participate in physical activity.

Day-to-day and seasonal variability of physical activity during school recess

Objective : Children's physical activity levels are difficult to establish on a day-to-day or season-to-season basis. Most studies have attempted to measure reliability in habitual settings. This study investigated the variability in children's physical activity during recess.

Methods : Fifteen boys and 19 girls (aged 6 to 11 years) from 2 schools in North West England wore heart rate monitors for 5 consecutive days in summer and winter terms to assess day-to-day and seasonal variability during school recess. Data were collected in 2004. Repeated measures ANOVA's and intraclass correlations (ICC) analysed the day-to-day and seasonal variability in children's moderate-to-vigorous (MVPA) and vigorous physical activity (VPA) data.

Results : There were no significant differences in children's MVPA and VPA across days and seasons. ICCs for MVPA across 2 days ranged from 0.75 to 0.85 in summer, and from 0.53 to 0.81 in winter. Three-day MVPA ICCs were 0.83 in summer and 0.71 in winter.

Conclusions : The results revealed no significant variation in children's recess physical activity levels across days and seasons. Whilst children were free to choose their recess activities in school, the results suggested that children were relatively consistent in their choices, limiting physical activity variability.

Differences in physical activity during school recess

BACKGROUND: School recess provides a daily opportunity for physical activity engagement. The purpose of this study was to examine physical activity levels during recess by gender, ethnicity, and grade, and establish the contribution of recess to daily school physical activity levels.
METHODS: Two hundred and ten children (45% boys) from grades 3 to 6 in 4 elementary schools had their physical activity during school quantified using uni-axial accelerometry every 5 seconds for 5 consecutive school days. Data were collected in fall 2009. The proportion of time spent engaged in physical activity during daily school recess was determined using existing age-appropriate cutpoints. The relative contribution of recess to school day physical activity was also determined.
RESULTS: Boys were more active than girls during recess. Girls engaged in more sedentary activity than boys. No main effects for ethnicity were observed. Children in grades 3 and 5 were more active than children in grades 4 and 6. Recess contributed 17.9% and 15.5% toward boys’ and girls’ school day moderate-to-vigorous physical activity, respectively.
CONCLUSION: Children engaged in physical activity during recess, though interventions may be needed to increase the intensity of activity in this context.

How is active transport associated with children's and adolescents' physical activity over time?

Background : As few longitudinal studies have examined how active transport is associated with physical activity among children and adolescents over time, and how active transport tracks through childhood and adolescence, it is important to understand whether physically active children retain their activity patterns through adolescence. This study aimed to examine (a) tracking of active transport and of moderate-to-vigorous physical activity (MVPA) across childhood and adolescence in two age cohorts; and (b) associations between active transport and MVPA at three distinct time-points, over five years.

Methods : This longitudinal study of two cohorts aged 5-6 years (n = 134) and 10-12 years (n = 201) at baseline (T1), in Melbourne, Australia, gathered follow-up data at three (T2) and five years (T3). Walking/cycling to local destinations was survey-reported; while MVPA was recorded using accelerometers and mean time spent daily in MVPA on week days and on weekends was computed. Tracking of these behaviours was examined over five years using General Estimating Equations. Linear regression analyses were performed to examine associations between active transport and MVPA at each time-point.

Results : Active transport tracked moderately among children (boys, bs = 0.36; girls, bs = 0.51) but not among adolescents. Physical activity tracked moderately (bs value range: 0.33-0.55) for both cohorts. Active transport was not associated with children’s MVPA at any time-point, but was associated with adolescent boys’ MVPA on week days at T1 (B = 1.37 (95% CI: 0.15, 2.59)), at T2 (B = 1.27 (95% CI: 0.03, 2.51)) and at T3 (B = 0.74 (95% CI: 0.01, 1.47)), and with adolescent girls’ MVPA on week days (B = 0.40 (95% CI: 0.04, 0.76)) and on weekends (B = 0.54 (95% CI:0.16, 0.93)) at T3 only.

Conclusion : Active transport was associated only with boys’ MVPA during early adolescence and with boys’ and girls’ MVPA during late adolescence. While active transport should be encouraged among all school-aged children, it may provide an important source of habitual physical activity for adolescent girls, in particular, among whom low and declining physical activity levels have been reported world-wide.

Using formative research to develop CHANGE! : a curriculum-based physical activity promoting intervention

Background : Low childhood physical activity levels are currently one of the most pressing public health concerns. Numerous school-based physical activity interventions have been conducted with varied success. Identifying effective child-based physical activity interventions are warranted. The purpose of this formative study was to elicit subjective views of children, their parents, and teachers about physical activity to inform the design of the CHANGE! (Children's Health, Activity, and Nutrition: Get Educated!) intervention programme.

Methods : Semi-structured mixed-gender interviews (group and individual) were conducted in 11 primary schools, stratified by socioeconomic status, with 60 children aged 9-10 years (24 boys, 36 girls), 33 parents (4 male, 29 female) and 10 teachers (4 male, 6 female). Questions for interviews were structured around the PRECEDE stage of the PRECEDE-PROCEDE model and addressed knowledge, attitudes and beliefs towards physical activity, as well as views on barriers to participation. All data were transcribed verbatim. Pen profiles were constructed from the transcripts in a deductive manner using the Youth Physical Activity Promotion Model framework. The profiles represented analysis outcomes via a diagram of key emergent themes.

Results : Analyses revealed an understanding of the relationship between physical activity and health, although some children had limited understanding of what constitutes physical activity. Views elicited by children and parents were generally consistent. Fun, enjoyment and social support were important predictors of physical activity participation, though several barriers such as lack of parental support were identified across all group interviews. The perception of family invested time was positively linked to physical activity engagement.

Conclusions : Families have a powerful and important role in promoting health-enhancing behaviours. Involvement of parents and the whole family is a strategy that could be significant to increase children's physical activity levels. Addressing various perceived barriers to such behaviours therefore, remains imperative.

Physical activity among cancer survivors : a literature review

Aim Physical activity offers a variety of health benefits to cancer survivors, both during and post-treatment. The aim here is to review: the preferences of cancer survivors regarding exercise counselling and participation in a physical activity programme; adherence rates among cancer survivors to physical activity programmes; and predictors of adherence to exercise training.

Methods Two electronic databases, Ovid MEDLINE(R) 1950 to Present with Daily Update and SCOPUS, were used to undertake literature searches for studies examining exercise preferences of adult cancer survivors, and physical activity programmes for adults at any point of the cancer trajectory.

Results Studies suggest that, while physical activity levels are low among cancer survivors, most are interested in increasing their participation. Preferences and adherence to physical activity programmes differ across a range of demographic, medical, and behavioural variables, suggesting the importance of tailoring exercise programmes to patient-specific and disease-specific needs.

Conclusions Current evidence supports the benefits of physical activity for improving risk factors associated with cancer prognosis. Physical activity programmes developed for oncology patients and cancer survivors need to take into account the needs of the target population in order to optimise adherence, outcomes, and long-term behavioural changes in this population.

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.

Differences between 9-11 year old British Pakistani and White British girls in physical activity and behavior during school recess

Background School recess provides an important opportunity for children to engage in physical activity. Previous studies indicate that children and adults of South Asian origin are less active than other ethnic groups in the United Kingdom, but have not investigated whether activity differs within the shared school environment. The aim of this study was to test the hypothesis that British Pakistani girls aged 9–11 years are less active during recess than White British girls.

Methods In Study One, the proportion of recess spent by 137 White British (N = 70) and British Pakistani (N = 67) girls in sedentary behavior, moderate-to-vigorous activity (MVPA) and vigorous activity (VPA) was determined using accelerometry. In Study Two, 86 White British (N = 48) and British Pakistani (N = 38) girls were observed on the playground using the System for Observing Children’s Activity and Relationships during Play (SOCARP). Accelerometry data were collected during observations to allow identification of activities contributing to objectively measured physical activity.

Results Accelerometry data indicated that British Pakistani girls spent 2.2% (95% CI: 0.2, 4.3) less of their total recess time in MVPA and 1.3% (95% CI: 0.2, 2.4) less in VPA than White British girls. Direct observation showed that British Pakistani girls spent 12.0% (95% CI: 2.9, 21.1) less playground time being very active, and 12.3% (95% CI: 1.7, 23.0) less time playing games. Time spent being very active according to direct observation data correlated significantly with accelerometer-assessed time spent in MVPA and VPA, and time spent playing games correlated significantly with accelerometer-assessed time spent in VPA, suggesting that differences in behavior observed in Study Two may have contributed to the differences in time spent in MVPA and VPA in Study One.

Conclusions British Pakistani girls were less active than White British girls during school recess. Recess has been identified as a potentially important target for the delivery of physical activity interventions; such interventions should consider ways in which the activity levels of British Pakistani girls could be increased.