Co-design and content validity of the movement measurement in the early years (MoveMEY) tool for assessing movement behaviour of pre-school aged children

Abstract Background Movement behaviours (physical activity, sedentary behaviour, and sleep) are important for pre-school children’s health and development. Currently, no tools with appropriate content validity exist that concurrently capture these movement behaviours in young children. The aim of this study was to co-design and assess the content validity of a novel tool to concurrently measure movement behaviours in pre-school aged children (aged 3–4 years). Methods We followed four distinct steps to develop and assess the content validity of Movement Measurement in the Early Years (MoveMEY): (1) We conducted an extensive literature search, to identify pre-existing proxy measurement tools (questionnaires and diaries) to inform the design of a novel tool, which aimed to effectively capture movement behaviour guidelines of pre-school aged children. (2) We facilitated focus group discussions with parents and carers of pre-school aged children (n = 11) and (3) a qualitative survey with free text responses was completed by topic relevant researchers (n = 6), to co-design the measurement tool. (4) We assessed the content validity of the developed tool, MoveMEY, through interviews with parents of pre-school aged children (n = 12) following piloting of the tool. Results We developed an initial version of MoveMEY based on the format of an existing questionnaire and by mapping the content of questions to the guidelines. Co-design of MoveMEY resulted in changes to the format (e.g. short questionnaire to a seven-day diary) and content (e.g. inclusion of ‘general information’ questions on illness, disabilities and sleep disturbances; question on screen time before bed). Content validity assessment demonstrated that the items of MoveMEY were relevant and comprehensive for the assessment of children’s movement behaviours. MoveMEY was felt to be comprehensible, however, parental suggestions were implemented to finalise and improve MoveMEY (e.g. adding examples to questions aiming to detect moderate to vigorous physical activity). Conclusion MoveMEY is the first co-designed measurement tool that has relevance for assessing the movement behaviour guidelines of pre-school aged children. Parent/carer and topic relevant researcher involvement throughout the development process resulted in a seven-day daily reported activity diary that is comprehensive of children’s movement behaviours and comprehensible to parents and carers

A systematic review of the validity, reliability, and feasibility of measurement tools used to assess the physical activity and sedentary behaviour of pre-school aged children

Physical activity (PA) and sedentary behaviour (SB) of pre-school aged children are associated with important health and developmental outcomes. Accurate measurement of these behaviours in young children is critical for research and practice in this area. The aim of this review was to examine the validity, reliability, and feasibility of measurement tools used to assess PA and SB of pre-school aged children. Searches of electronic databases, and manual searching, were conducted to identify articles that examined the measurement properties (validity, reliability or feasibility) of measurement tools used to examine PA and/or SB of pre-school aged children (3–7 years old). Following screening, data were extracted and risk of bias assessment completed on all included articles. A total of 69 articles, describing 75 individual studies were included. Studies assessed measurement tools for PA (n = 27), SB (n = 5), and both PA and SB (n = 43). Outcome measures of PA and SB differed between studies (e.g. moderate to vigorous activity, step count, posture allocation). Most studies examined the measurement properties of one measurement tool only (n = 65). Measurement tools examined included: calorimetry, direct observation, combined heart rate and accelerometry, heart rate monitors, accelerometers, pedometers, and proxy report (parent, carer or teacher reported) measures (questionnaires or diaries). Studies most frequently assessed the validity (criterion and convergent) (n = 65), face and content validity (n = 2), test-retest reliability (n = 10) and intra-instrument reliability (n = 1) of the measurement tools. Feasibility data was abstracted from 41 studies. Multiple measurement tools used to measure PA and SB in pre-school aged children showed some degree of validity, reliability and feasibility, but often for different purposes. Accelerometers, including the Actigraph (in particular GT3X versions), Actical, ActivPAL and Fitbit (Flex and Zip), and proxy reported measurement tools used in combination may be useful for a range of outcome measures, to measure intensity alongside contextual information

Measurement Instruments for Integration within Children and Young People Healthcare Systems and Networks: A Rapid Review of the International Literature

Introduction: Robust measures of integration are essential for assessment of the development, design and implementation of integration within healthcare systems. This review aimed to identify measurement instruments for integration within children and young people’s (CYP) healthcare systems (PROSPERO registration number CRD42021235383). Methods: We searched electronic databases (PubMED and Ovid Embase) using three main concepts: ‘(integrated care) AND (child population) AND (measurement)’, along with additional searches. Results: Fifteen studies describing 16 measurement instruments were eligible for inclusion. The majority of studies were conducted in the USA. There was a diversity of health conditions included in the studies. The most frequent type of assessment used was a questionnaire (11 identified), but interviews, patient data and healthcare records, and focus groups were also used. Integration outcomes assessed were quality of care coordination, quality of collaboration, continuity of care, completeness of care, structure of care, quality of communication, and local implementation of integrated care. Conclusion: A variety of instruments for the measurement of integration within CYP healthcare systems were identified. Further work on the standardisation of integrated care measures would be valuable; however, it is important that instruments and measures meet the needs of specific settings, populations and conditions being studied

Measurement Instruments for Integration within Children and Young People Healthcare Systems and Networks: A Rapid Review of the International Literature

Introduction: Robust measures of integration are essential for assessment of the development, design and implementation of integration within healthcare systems. This review aimed to identify measurement instruments for integration within children and young people’s (CYP) healthcare systems (PROSPERO registration number CRD42021235383).Methods: We searched electronic databases (PubMED and Ovid Embase) using three main concepts: ‘(integrated care) AND (child population) AND (measurement)’, along with additional searches.Results: Fifteen studies describing 16 measurement instruments were eligible for inclusion. The majority of studies were conducted in the USA. There was a diversity of health conditions included in the studies. The most frequent type of assessment used was a questionnaire (11 identified), but interviews, patient data and healthcare records, and focus groups were also used. Integration outcomes assessed were quality of care coordination, quality of collaboration, continuity of care, completeness of care, structure of care, quality of communication, and local implementation of integrated care.Conclusion: A variety of instruments for the measurement of integration within CYP healthcare systems were identified. Further work on the standardisation of integrated care measures would be valuable; however, it is important that instruments and measures meet the needs of specific settings, populations and conditions being studied

A description of interventions promoting healthier ready-to-eat meals (to eat in, to take away, or to be delivered) sold by specific food outlets in England: a systematic mapping and evidence synthesis

Abstract Background Ready-to-eat meals (to eat in, to take away or to be delivered) sold by food outlets are often more energy dense and nutrient poor compared with meals prepared at home, making them a reasonable target for public health intervention. The aim of the research presented in this paper was to systematically identify and describe interventions to promote healthier ready-to-eat meals (to eat in, to take away, or to be delivered) sold by specific food outlets in England. Methods A systematic search and sift of the literature, followed by evidence mapping of relevant interventions, was conducted. Food outlets were included if they were located in England, were openly accessible to the public and, as their main business, sold ready-to-eat meals. Academic databases and grey literature were searched. Also, local authorities in England, topic experts, and key health professionals and workers were contacted. Two tiers of evidence synthesis took place: type, content and delivery of each intervention were summarised (Tier 1) and for those interventions that had been evaluated, a narrative synthesis was conducted (Tier 2). Results A total of 75 interventions were identified, the most popular being awards. Businesses were more likely to engage with cost neutral interventions which offered imperceptible changes to price, palatability and portion size. Few interventions involved working upstream with suppliers of food, the generation of customer demand, the exploration of competition effects, and/or reducing portion sizes. Evaluations of interventions were generally limited in scope and of low methodological quality, and many were simple assessments of acceptability. Conclusions Many interventions promoting healthier ready-to-eat meals (to eat in, to take away, or to be delivered) sold by specific food outlets in England are taking place; award-type interventions are the most common. Proprietors of food outlets in England that, as their main business, sell ready-to-eat meals, can be engaged in implementing interventions to promote healthier ready-to-eat-food. These proprietors are generally positive about such interventions, particularly when they are cost neutral and use a health by stealth approach

This needs to be a journey that we’re actually on together’—the introduction of integrated care systems for children and young people in England: a qualitative study of the views of local system stakeholders during winter 2021/22

Background: Integrated care has become a central feature of health system reform worldwide. In England, Integrated Care Systems (ICS) are intended to improve integration across public health, the National Health Service (NHS), education and social care. By April 2021, England had been divided into 42 geographical areas, each tasked with developing local ICS provision. However, it was not clear how ICSs would address the specific needs of children and young people (CYP). This study elicited the views of senior professional stakeholders in the first year of the ICS national roll out, to learn how integrated care for CYP was being implemented within the ICSs and future plans for service provision. Methods: A qualitative analysis of in-depth interviews with stakeholders, including healthcare professionals, NHS managers and local authority leaders (n = 25) selected from a diverse sample of ICSs (n = 7) across England, conducted during winter 2021/22. Reflexive thematic analysis involving a collaborative coding approach was used to analyse interview transcripts. Results: Four themes were identified, indicating challenges and opportunities for ICSs in relation to the health of CYP: 1) Best start in life (a more holistic approach to health afforded by integrated care); 2) Local and national contexts (tensions between local and national settings and priorities); 3) Funding and planning (instituting innovative, long-term plans using limited existing CYP funding streams); 4) Organisational complexities (integrating the work of diverse organisations). Conclusions: The views of stakeholders, provided at the beginning of the journey towards developing local ICS CYP provision, revealed a common aspiration to change focus from provision of acute, largely adult-orientated services towards one with a broader, population health remit, including prevention and early intervention. This would be delivered by integration of a range of local services, including health, education, housing and social care, to set CYP on a life-long path towards improved health and wellbeing. Yet there was an awareness that change would take place over time within existing national policy and funding frameworks, and would require overcoming organisational barriers through further developing local collaborations and partnerships. As ICSs mature, the experiences of stakeholders should continue to be canvassed to identify practical lessons for successful CYP integrated care

'This needs to be a journey that we're actually on together'—the introduction of integrated care systems for children and young people in England: a qualitative study of the views of local system stakeholders during winter 2021/22

Background: Integrated care has become a central feature of health system reform worldwide. In England, Integrated Care Systems (ICS) are intended to improve integration across public health, the National Health Service (NHS), education and social care. By April 2021, England had been divided into 42 geographical areas, each tasked with developing local ICS provision. However, it was not clear how ICSs would address the specific needs of children and young people (CYP). This study elicited the views of senior professional stakeholders in the first year of the ICS national roll out, to learn how integrated care for CYP was being implemented within the ICSs and future plans for service provision. / Methods: A qualitative analysis of in-depth interviews with stakeholders, including healthcare professionals, NHS managers and local authority leaders (n = 25) selected from a diverse sample of ICSs (n = 7) across England, conducted during winter 2021/22. Reflexive thematic analysis involving a collaborative coding approach was used to analyse interview transcripts. / Results: Four themes were identified, indicating challenges and opportunities for ICSs in relation to the health of CYP: 1) Best start in life (a more holistic approach to health afforded by integrated care); 2) Local and national contexts (tensions between local and national settings and priorities); 3) Funding and planning (instituting innovative, long-term plans using limited existing CYP funding streams); 4) Organisational complexities (integrating the work of diverse organisations). / Conclusions: The views of stakeholders, provided at the beginning of the journey towards developing local ICS CYP provision, revealed a common aspiration to change focus from provision of acute, largely adult-orientated services towards one with a broader, population health remit, including prevention and early intervention. This would be delivered by integration of a range of local services, including health, education, housing and social care, to set CYP on a life-long path towards improved health and wellbeing. Yet there was an awareness that change would take place over time within existing national policy and funding frameworks, and would require overcoming organisational barriers through further developing local collaborations and partnerships. As ICSs mature, the experiences of stakeholders should continue to be canvassed to identify practical lessons for successful CYP integrated care

Interventions to prevent obesity in children aged 5 to 11 years old

Objectives: This is a protocol for a Cochrane Review (intervention). The objectives are as follows:. The overall aim of the review is to determine the effectiveness of interventions to prevent obesity in 5 to 11-year-old children. The four objectives are:. to evaluate the effects of interventions that aim to modify dietary intake on changes in zBMI score, BMI and serious adverse events among children; to evaluate the effects of interventions that aim to modify physical activity, sedentary behaviour, sleep, play and/or structured exercise on changes in zBMI score, BMI and serious adverse events among children; to evaluate the combined effects of interventions that aim to modify both dietary intake and physical activity/movement behaviours on changes in zBMI score, BMI and serious adverse events among children; to compare the effects of interventions that aim to modify dietary interventions with those that aim to modify physical activity/movement behaviours on changes in zBMI score, BMI and serious adverse events among children. The secondary objectives are designed to explore if, how, and why the effectiveness of interventions on zBMI/BMI varies depending on the following PROGRESS factors. Place of residence Race/ethnicity/culture/language Occupation Gender/sex Religion Education Socioeconomic status Social capital. The PROGRESS acronym is intended to ensure that there is explicit consideration of health inequity, the unfair difference in disease burden, when conducting research and adapting research evidence to inform the design of new interventions (O'Neill 2014). The PROGRESS acronym describes factors that contribute to health inequity. Recent work on race and religion in the UK suggests that consideration of these factors is critical to the design of new interventions (Rai 2019). We will also collect, from RCTs, information about the costs of interventions so that policymakers can use the review as a source of information from which they may prepare cost-effectiveness analyses

Interventions to prevent obesity in children aged 12 to 18 years old

Objectives: This is a protocol for a Cochrane Review (intervention). The objectives are as follows:. The overall aim of the review is to determine the effectiveness of interventions to prevent obesity in 12 to 18-year-old children and adolescents. The four objectives are:. to evaluate the effects of interventions that aim to modify dietary intake on changes in zBMI score, BMI and serious adverse events among children and adolescents; to evaluate the effects of interventions that aim to modify physical activity, sedentary behaviour, sleep, play and/or structured exercise on changes in zBMI score, BMI and serious adverse events among children and adolescents; to evaluate the combined effects of interventions that aim to modify both dietary intake and physical activity/movement behaviours on changes in zBMI score, BMI and serious adverse events among children and adolescents; to compare the effects of interventions that aim to modify dietary interventions with those that aim to modify physical activity/movement behaviours on changes in zBMI score, BMI and serious adverse events among children. The secondary objectives are designed to explore if, how, and why the effectiveness of interventions on zBMI/BMI varies depending on the following PROGRESS factors. Place of residence Race/ethnicity/culture/language Occupation Gender/sex Religion Education Socioeconomic status Social capital. The PROGRESS acronym is intended to ensure that there is explicit consideration of health inequity, the unfair difference in disease burden, when conducting research and adapting research evidence to inform the design of new interventions (O'Neill 2014). The PROGRESS acronym describes factors that contribute to health inequity. Recent work on race and religion in the UK suggested that consideration of these factors is critical to the design of new interventions (Rai 2019). We will also collect, from RCTs, information about the costs of interventions so that policymakers can use the review as a source of information from which they may prepare cost-effectiveness analyses