Activity-related parenting practices and young people's physical activity

Despite the health benefits associated with regular physical activity only a small percentage of young people are meeting the physical activity recommendations. There is a need to further understanding of the factors that influence physical activity behaviour in young people to inform intervention programmes. This thesis provides six studies focusing on the objective measurement of young people's physical activity as well as social support for physical activity. Chapter 2.1 describes a systematic review of quantitative research examining parental influences on different types and intensities of physical activity in young people. Chapter 2.2 describes a systematic review of qualitative research examining the role of parents in young people s physical activity. Both reviews were conducted to examine the state of the current literature focused on parental influences on young people s physical activity and were used to inform the direction of the research in later chapters. Chapter 3 describes two cross-sectional studies examining the effects of key decisions researchers must make when using accelerometers on accelerometer ouput in children and adolescents. Chapter 3.1 describes a study examining the effect of epoch length on physical activity intensity in children and adolescents. Chapter 3.2 describes a study examining the impact of accelerometer processing decision rules, such as cut-points and non-wear period, on children s and adolescents physical activity. The purpose of these studies was to systematically explore the pre- and post-data collection decisions associated with accelerometer use on accelerometer output in young people and inform accelerometer use in chapters 4 and 5. Chapter 4 was designed to explore activity-related parenting practices and children s (7-10 years) objectively measured physical activity. Chapter 5 describes a study examining five sources of social support and adolescent s physical activity measured two ways. This thesis demonstrated that parents play in key role in their child's physical activity through a variety of support avenues and in adolescence support for physical activity provided by peers appears to be important in shaping physical activity behaviour. Targeting such facets of the social environment offers a potentially useful avenue for interventions designed to increase physical activity. Finally, this thesis also demonstrated that there are a number of challenges with accelerometer use particularly in the area of processing data. The rich information provided by accelerometers makes them an invaluable tool to understand the complex nature of young people's physical activity behaviour but further work needs to be conducted on standardising methods for cleaning, analysing and reporting accelerometer data.EThOS - Electronic Theses Online ServiceGBUnited Kingdo

Office workers' objectively measured sedentary behavior and physical activity during and outside working hours

OBJECTIVE: To examine objectively determined sedentary behavior and physical activity (PA) during and outside working hours in full-time office workers. METHODS: A total of 170 participants wore an ActiGraph GT1M accelerometer for 7 days. Time spent sedentary (<100 counts/min), in light-intensity PA (100 to 1951 counts/min), and moderate-to-vigorous PA (≥1952 counts/min) was calculated for workdays (including working hours and nonworking hours) and nonworkdays. RESULTS: Participants accumulated significantly higher levels of sedentary behavior (68% vs 60%) and lower levels of light-intensity activity (28% vs 36%) on workdays in comparison with nonworkdays. Up to 71% of working hours were spent sedentary. Individuals who were most sedentary at work were also more sedentary outside work. CONCLUSIONS: Those who are most sedentary at work do not compensate by increasing their PA or reducing their sedentary time outside work. Occupational interventions should address workplace and leisure-time sedentary behavior

Patterns of adolescent physical activity and dietary behaviours

<p>Abstract</p> <p>Background</p> <p>The potential synergistic effects of multiple dietary and physical activity behaviours on the risk of chronic conditions and health outcomes is a key issue for public health. This study examined the prevalence and clustering patterns of multiple health behaviours among a sample of adolescents in the UK.</p> <p>Methods</p> <p>Cross-sectional survey of 176 adolescents aged 12–16 years (49% boys). Adolescents wore accelerometers for seven days and completed a questionnaire assessing fruit, vegetable, and breakfast consumption. The prevalence of adolescents meeting the physical activity (≥ 60 minutes moderate-to-vigorous physical activity/day), fruit and vegetable (≥ 5 portions of FV per day) and breakfast recommendations (eating breakfast on ≥ 5 days per week), and clustering patterns of these health behaviours are described.</p> <p>Results</p> <p>Boys were more active than girls (p < 0.001) and younger adolescents were more active than older adolescents (p < 0.01). Boys ate breakfast on more days per week than girls (p < 0.01) and older adolescents ate more fruit and vegetables than younger adolescents (p < 0.01). Almost 54% of adolescents had multiple risk behaviours and only 6% achieved all three of the recommendations. Girls had significantly more risk factors than boys (p < 0.01). For adolescents with two risk behaviours, the most prevalent cluster was formed by not meeting the physical activity and fruit and vegetable recommendations.</p> <p>Conclusion</p> <p>Many adolescents fail to meet multiple diet and physical activity recommendations, highlighting that physical activity and dietary behaviours do not occur in isolation. Future research should investigate how best to achieve multiple health behaviour change in adolescent boys and girls.</p

Study design and protocol for a mixed methods evaluation of an intervention to reduce and break up sitting time in primary school classrooms in the UK: the CLASS PAL (Physically Active Learning) Programme

Introduction: Children engage in a high volume of sitting in school, particularly in the classroom. A number of strategies, such as physically active lessons (termed movement integration (MI)), have been developed to integrate physical activity into this learning environment; however, no single approach is likely to meet the needs of all pupils and teachers. This protocol outlines an implementation study of a primary school-based MI intervention: CLASS PAL (Physically Active Learning) programme. This study aims to (A) determine the degree of implementation of CLASS PAL, (B) identify processes by which teachers and schools implement CLASS PAL and (C) investigate individual (pupil and teacher) level and school-level characteristics associated with implementation of CLASS PAL. Methods and analysis: The intervention will provide teachers with a professional development workshop and a bespoke teaching resources website. The study will use a single group before-and-after design, strengthened by multiple interim measurements. Six state-funded primary schools will be recruited within Leicestershire, UK. Evaluation data will be collected prior to implementation and at four discrete time points during implementation: At measurement 0 (October 2016), school, teacher and pupil characteristics will be collected. At measurements 0 and 3 (June-July 2017), accelerometry, cognitive functioning, self-reported sitting and classroom engagement data will be collected. At measurements 1(December 2016-March 2017) and 3, teacher interviews (also at measurement 4; September-October 2017) and pupil focus groups will be conducted, and at measurements 1 and 2 (April-May 2017), classroom observations. Implementation will be captured through website analytics and ongoing teacher completed logs. Ethics and dissemination: Ethical approval was obtained through the Loughborough University Human Participants Ethics Sub-Committee (Reference number: R16-P115). Findings will be disseminated via practitioner and/or research journals and to relevant regional and national stakeholders through print and online media and dissemination event(s)

Maturational timing, physical self-perceptions and physical activity in UK adolescent females: Investigation of a mediated effects model

Background: Advanced (early) biological maturation may be a risk factor for inactivity among adolescent girls. The aim of the present paper was to test the mediational effects of body attractiveness and physical self-worth on the relationship between biological maturity and accelerometer assessed moderate-to-vigorous physical activity (MVPA) in a large multi-ethnic sample of girls from the Midlands area in the UK (11-14 years). Methods: Biological maturity (predicting age at peak height velocity (APHV)); self-perceptions of body attractiveness, physical self-worth, and minutes spent in MVPA were assessed in 1062 females aged 11 to 14 years. Results: Structural equation modeling using maximum likelihood estimation and boot- strapping procedures supported the hypothesized model. Later maturation predicted higher perceptions of body attractiveness (β=.25, p<.001) which, in turn, predicted higher perceptions of physical self-worth (β=.91, p<.001) and, significantly higher MVPA (β=.22, p<.001). Examination of the bootstrap-generated bias-corrected confidence intervals suggested that perceptions of body attractiveness and physical self-worth partially mediated a positive association between predicted APHV and MVPA (β=.05, p Conclusions: Greater biological maturity (i.e. early maturity) in adolescent girls is associated with less involvement in MVPA and appears to be partly explained by lower perceptions of body attractiveness and physical self-worth. Physical activity interventions should consider girls perceptions of their pubertal related physiological changes during adolescence, particularly among early maturing girls. </p

Activity Intensity, Volume, and Norms:Utility and Interpretation of Accelerometer Metrics

This is the author accepted manuscript. The final version is available from Lippincott, Williams & Wilkins via the DOI in this recordPurpose: The physical activity profile can be described from accelerometer data using two population- independent metrics: average acceleration (ACC, volume) and intensity gradient (IG, intensity). This paper aims to: 1) demonstrate how these metrics can be used to investigate the relative contributions of volume and intensity of physical activity for a range of health markers across datasets; and 2) illustrate the future potential of the metrics for generation of age and sexspecific percentile norms. Methods: Secondary data analyses were carried out on five diverse datasets using wrist-worn accelerometers (ActiGraph/GENEActiv/Axivity): children (N=145), adolescent girls (N=1669), office workers (N=114), pre- (N=1218) and post- (N=1316) menopausal women, and adults with type 2 diabetes (T2D) (N=475). Open-source software (GGIR) was used to generate ACC and IG. Health markers were: a) zBMI (children); b) %fat (adolescent girls and adults); c) bone health (pre- and post-menopausal women); and d) physical function (adults with T2D). Results: Multiple regression analyses showed the IG, but not ACC, was independently associated with zBMI/%fat in children and adolescents. In adults, associations were stronger and the effects of ACC and IG were additive. For bone health and physical function, interactions showed associations were strongest if IG was high, largely irrespective of ACC. Exemplar illustrative percentile ‘norms’ showed the expected age-related decline in physical activity, with greater drops in IG across age than ACC. Conclusion: The ACC and IG accelerometer metrics facilitate investigation of whether volume and intensity of physical activity have independent, additive or interactive effects on health markers. Future, adoption of data-driven metrics would facilitate the generation of age- and sexspecific norms that would be beneficial to researchers.National Institute for Health Research (NIHR)Collaboration for leadership in Applied Health Research and Care (CLAHRC) East Midland

Association of Sedentary Behaviour with Metabolic Syndrome: A Meta-Analysis

Background: In recent years there has been a growing interest in the relationship between sedentary behaviour (sitting) and health outcomes. Only recently have there been studies assessing the association between time spent in sedentary behaviour and the metabolic syndrome. The aim of this study is to quantify the association between sedentary behaviour and the metabolic syndrome in adults using meta-analysis. Methodology/Principal Findings: Medline, Embase and the Cochrane Library were searched using medical subject headings and key words related to sedentary behaviours and the metabolic syndrome. Reference lists of relevant articles and personal databases were hand searched. Inclusion criteria were: (1) cross sectional or prospective design; (2) include adults &ge;18 years of age; (3) self-reported or objectively measured sedentary time; and (4) an outcome measure of metabolic syndrome. Odds Ratio (OR) and 95% confidence intervals for metabolic syndrome comparing the highest level of sedentary behaviour to the lowest were extracted for each study. Data were pooled using random effects models to take into account heterogeneity between studies. Ten cross-sectional studies (n = 21393 participants), one high, four moderate and five poor quality, were identified. Greater time spent sedentary increased the odds of metabolic syndrome by 73% (OR 1.73, 95% CI 1.55-1.94, p&lt;0.0001). There were no differences for subgroups of sex, sedentary behaviour measure, metabolic syndrome definition, study quality or country income. There was no evidence of statistical heterogeneity (I2 = 0.0%, p = 0.61) or publication bias (Eggers test t = 1.05, p = 0.32). Conclusions: People who spend higher amounts of time in sedentary behaviours have greater odds of having metabolic syndrome. Reducing sedentary behaviours is potentially important for the prevention of metabolic syndrome

Modelling the Reallocation of Time Spent Sitting into Physical Activity: Isotemporal Substitution vs. Compositional Isotemporal Substitution.

Isotemporal substitution modelling (ISM) and compositional isotemporal modelling (CISM) are statistical approaches used in epidemiology to model the associations of replacing time in one physical behaviour with time in another. This study's aim was to use both ISM and CISM to examine and compare associations of reallocating 60 min of sitting into standing or stepping with markers of cardiometabolic health. Cross-sectional data collected during three randomised control trials (RCTs) were utilised. All participants (n = 1554) were identified as being at high risk of developing type 2 diabetes. Reallocating 60 min from sitting to standing and to stepping was associated with a lower BMI, waist circumference, and triglycerides and higher high-density lipoprotein cholesterol using both ISM and CISM (p < 0.05). The direction and magnitude of significant associations were consistent across methods. No associations were observed for hemoglobin A1c, total cholesterol, or low-density lipoprotein cholesterol for either method. Results of both ISM and CISM were broadly similar, allowing for the interpretation of previous research, and should enable future research in order to make informed methodological, data-driven decisions

Devices for self-monitoring sedentary time or physical activity: a scoping review.

It is well documented that meeting the guideline levels (150 minutes per week) of moderate-to-vigorous physical activity (PA) is protective against chronic disease. Conversely, emerging evidence indicates the deleterious effects of prolonged sitting. Therefore, there is a need to change both behaviors. Self-monitoring of behavior is one of the most robust behavior-change techniques available. The growing number of technologies in the consumer electronics sector provides a unique opportunity for individuals to self-monitor their behavior.The aim of this study is to review the characteristics and measurement properties of currently available self-monitoring devices for sedentary time and/or PA.To identify technologies, four scientific databases were systematically searched using key terms related to behavior, measurement, and population. Articles published through October 2015 were identified. To identify technologies from the consumer electronic sector, systematic searches of three Internet search engines were also performed through to October 1, 2015.The initial database searches identified 46 devices and the Internet search engines identified 100 devices yielding a total of 146 technologies. Of these, 64 were further removed because they were currently unavailable for purchase or there was no evidence that they were designed for, had been used in, or could readily be modified for self-monitoring purposes. The remaining 82 technologies were included in this review (73 devices self-monitored PA, 9 devices self-monitored sedentary time). Of the 82 devices included, this review identified no published articles in which these devices were used for the purpose of self-monitoring PA and/or sedentary behavior; however, a number of technologies were found via Internet searches that matched the criteria for self-monitoring and provided immediate feedback on PA (ActiGraph Link, Microsoft Band, and Garmin Vivofit) and sedentary time (activPAL VT, the Lumo Back, and Darma).There are a large number of devices that self-monitor PA; however, there is a greater need for the development of tools to self-monitor sedentary time. The novelty of these devices means they have yet to be used in behavior change interventions, although the growing field of wearable technology may facilitate this to change

A school-based intervention ('Girls Active') to increase physical activity levels among 11- to 14-year-old girls: cluster RCT

Background: Physical activity (PA) levels among adolescent girls in the UK are low. ‘Girls Active’, developed by the Youth Sport Trust (YST), has been designed to increase girls’ PA levels. Objective: To understand the effectiveness and cost-effectiveness of the Girls Active programme. Design: A two-arm cluster randomised controlled trial. Setting: State secondary schools in the Midlands, UK. Participants: Girls aged between 11 and 14 years. Intervention: Girls Active involves teachers reviewing PA, sport and physical education provision, culture and practices in their school; attending training; creating action plans; and effectively working with girls as peer leaders to influence decision-making and to promote PA to their peers. Support from a hub school and the YST is offered. Main outcome measures: The change in objectively measured moderate to vigorous intensity PA (MVPA) levels at 14 months. Secondary outcomes included changes in overall PA level (mean acceleration), light PA levels, sedentary time, body composition and psychosocial outcomes. Cost-effectiveness and process evaluation (qualitative and quantitative) data were collected. Results: Twenty schools and 1752 pupils were recruited; 1211 participants provided complete primary outcome data at 14 months. No difference was found in mean MVPA level between groups at 14 months [1.7 minutes/day, 95% confidence interval (CI) –0.8 to 4.3 minutes/day], but there was a small difference in mean MVPA level at 7 months (2.4 minutes/day, 95% CI 0.1 to 4.7 minutes/day). Significant differences between groups were found at 7 months, but not at 14 months, in some of the objective secondary outcomes: overall PA level represented by average acceleration (1.39 mg, 95% CI 0.1 to 2.2 mg), after-school sedentary time (–4.7 minutes/day, 95% CI –8.9 to –0.6 minutes/day), overall light PA level (5.7 minutes/day, 95% CI 1.0 to 10.5 minutes/day) and light PA level on school days (4.5 minutes/day, 95% CI 0.25 to 8.75 minutes/day). Minor, yet statistically significant, differences in psychosocial measures at 7 months were found in favour of control schools. Significant differences in self-esteem and identified motivation in favour of intervention schools were found at 7 and 14 months, respectively. Subgroup analyses showed a significant effect of the intervention for those schools with higher numbers of pupils at 14 months. Girls Active was well received by teachers, and they reported that implemented strategies and activities were having a positive impact in schools. Barriers to implementation progress included lack of time, competing priorities and the programme flexibility. Implementation costs ranged from £2054 (£23/pupil) to £8545 (£95/pupil) per school. No differences were found between groups for health-related quality-of-life scores or frequencies, or for costs associated with general practitioner, school nurse and school counsellor use. Conclusions: Girls Active may not have had an effect on the random 90 girls per school included in the evaluation. Although we included a diverse sample of schools, the results may not be generalisable to all schools. Girls Active was viewed positively but teachers did not implement as many aspects of the programme as they wanted. The intervention was unlikely to have a wide impact and did not have an impact on MVPA level at 14 months. Capitalising on the opportunities of a flexible programme like this, while also learning from the stated barriers to and challenges of long-term implementation that teachers face, is a priority for research and practice. Trial registration: Current Controlled Trials ISRCTN10688342. Funding: This project was funded by the National Institute for Health Research (NIHR) Public Health Research programme and will be published in full in Public Health Research; Vol. 7, No. 5. See the NIHR Journals Library website for further project information. The YST funded the intervention. This study was undertaken in collaboration with the Leicester Clinical Trials Unit, a UK Clinical Research Collaboration-registered clinical trials unit in receipt of NIHR Clinical Trials Unit support funding. Neither the YST nor the NIHR Clinical Trials Unit had any involvement in the Trial Steering Committee, data analysis, data interpretation, data collection or writing of the report. The University of Leicester authors are supported by the NIHR Leicester–Loughborough Biomedical Research Unit (2012–17), the NIHR Leicester Biomedical Research Centre (2017–22) and the Collaboration for Leadership in Applied Health Research and Care East Midlands. These funders had no involvement in the Trial Steering Committee, the data analysis, data interpretation, data collection or writing of the report