Exploring gender differences within forest schools as a physical activity intervention

This study investigated whether children engaged in more physical activity (PA) on school days that included Forest School (FS) sessions than a regular school day or a school day with a Physical Education (PE) lesson. How FS sessions influenced children’s general levels of PA and wellbeing was also explored across gender. A mixed-methods study followed a sample of 59 child participants aged 7 to 9 years old, from four primary schools, whilst taking part in twelve weekly FS sessions. Measures included the PA Questionnaire for Older Children and accelerometry data together with an individual Write and Draw task to inform focus groups. Children had significantly greater levels of light PA on a FS day and a PE school day compared to a regular school day and children reported feeling both happier and relaxed as a consequence of the intervention. From the qualitative data, boys and girls reported different likes of the FS interventions, whereas their dislikes of FS were comparable. Findings from this research provide evidence for such outdoor, nature-based learning within the school curriculum contributing to daily PA in children

Parental perceptions on children's out-of-school physical activity and family-based physical activity interventions

This study explored parents' physical activity knowledge and perceptions of children’s out-of school physical activity to formatively contribute to a family-based intervention design. Parents were largely unaware of the UK child physical activity guidelines and whether their child achieved the guidelines daily. Physical activity for many parents was attributed to healthy weight status, and the neighbourhood environment was perceived as unconducive to children’s outdoor play which consequently increased the attractiveness of adult supervised organised activities. Family-based intervention engagement was considered as an important opportunity to increase physical activity knowledge, family time, and receive feedback on activity behaviours. Parental concerns related to intervention content and logistic and timing barriers. Consulting with parents in a formative sense prior to familial physical activity intervention facilitates intervention content to be aligned with family-specific perceptions and needs, and offers opportunities to communicate the relevance of programs to parents. This may aid subsequent intervention recruitment and engagement

Physical activity patterns in youth with intellectual disabilities

The aim of this study was to assess the physical activity (PA) patterns of youth with intellectual disabilities (ID). PA was monitored for 7 days in 70, 5 – 15 year old participants using accelerometers. Thirty two participants were included in the final analysis. Habitual PA and the number of continuous bouts accrued for a range of bout lengths (5-600 seconds) for light (LPA), moderate (MPA) and vigorous (VPA) intensity PA were calculated. Multivariate analysis of covariance was used to assess differences in the number of continuous bouts by sex, age, ID group and between week and weekend days. Participants exhibited short sporadic bursts of activity. The number of continuous bouts decreased as the intensity and duration increased. Few differences in PA patterns were reported by sex, ID group, age group and between week and weekend days, possibly due to the generally low PA levels within this population

Comparison of children's free-living physical activity derived from wrist and hip raw accelerations during the segmented week.

This study assessed children's physical activity (PA) levels derived from wrist-worn GENEActiv and hip-worn ActiGraph GT3X+ accelerometers and examined the comparability of PA levels between the two devices throughout the segmented week. One hundred and twenty-nine 9-10-year-old children (79 girls) wore a GENEActiv (GAwrist) and ActiGraph GT3X+ (AGhip) accelerometer on the left wrist and right hip, respectively, for 7 days. Mean minutes of light PA (LPA) and moderate-to-vigorous PA (MVPA) per weekday (whole-day, before-school, school and after-school) and weekend day (whole-day, morning and afternoon-evening) segments were calculated, and expressed as percentage of segment time. Repeated measures analysis of variance examined differences in LPA and MVPA between GAwrist and AGhip for each time segment. Bland-Altman plots assessed between-device agreement for LPA and MVPA for whole weekday and whole weekend day segments. Correlations between GAwrist and AGhip were weak for LPA (r = 0.18-0.28), but strong for MVPA (r = 0.80-0.86). LPA and MVPA levels during all weekday and weekend day segments were significantly higher for GAwrist than AGhip (p < 0.001). The largest inter-device percent difference of 26% was observed in LPA during the school day segment. Our data suggest that correction factors are needed to improve raw PA level comparability between GAwrist and AGhip

Physical activity and associations with clinical outcome measures in adults with cystic fibrosis; A systematic review

Background: Physical activity (PA) is important in the management of Cystic Fibrosis (CF) and is associated with a number of beneficial effects. PA assessment is not commonplace or consistent clinical practice, therefore understanding of PA in adults with CF remains limited. The purpose of this review was to evaluate PA levels in this population and compare PA to global recommendations and non-CF peers. Methods: The Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines were utilised to inform the review process. Original research was identified and screened against inclusion/exclusion criteria. Quality was assessed, data extracted and a narrative synthesis undertaken to describe the findings. Results: Adults with CF did not achieve recommended PA guidelines and step count targets in 5/8 studies where assessment was possible. No significant differences in PA were found between CF and non-CF peers in 3/5 studies. Associations between PA and improved lung function were inconsistent with 4/9 studies finding a positive association. Evidence for an association between PA and higher exercise capacity was stronger with all 4 studies reviewed reporting a positive association. Quality ratings were low across all studies. Conclusions: PA in adults with CF is largely comparable to their non-CF peers, despite being insufficiently active to achieve PA recommendations. Assessment tools used and outcomes reported are variable, many of which do not provide sufficient information to assess relevant components of PA. There is a requirement for high quality studies designed specifically to explore PA in adults with CF, ideally employing standardised PA assessment methods

The backwards comparability of wrist worn GENEActiv and waist worn ActiGraph accelerometer estimates of sedentary time in children

Objectives: To examine the backward comparability of a range of wrist-worn accelerometer estimates of sedentary time (ST) with ActiGraph 100 count∙min-1 waist ST estimates. Design: Cross-sectional, secondary data analysis Method: One hundred and eight 10-11-year-old children (65 girls) wore an ActiGraph GT3X+ accelerometer (AG) on their waist and a GENEActiv accelerometer (GA) on their non-dominant wrist for seven days. GA ST data were classified using a range of thresholds from 23-56 mg. ST estimates were compared to AG ST 100 count∙min-1 data. Agreement between the AG and GA thresholds was examined using Cronbach’s alpha, intraclass correlation coefficients (ICC), limits of agreement (LOA), Kappa values, percent agreement, mean absolute percent error (MAPE) and equivalency analysis. Results: Mean AG total ST was 492.4 minutes over the measurement period. Kappa values ranged from 0.31-0.39. Percent agreement ranged from 68-69.9%. Cronbach’s alpha values ranged from 0.88-0.93. ICCs ranged from 0.59-0.86. LOA were wide for all comparisons. Only the 34 mg threshold produced estimates that were equivalent at the group level to the AG ST 100 count∙min-1 data though sensitivity and specificity values of ~64% and ~74% respectively were observed. Conclusions: Wrist-based estimates of ST generated using the 34 mg threshold are comparable with those derived from the AG waist mounted 100 count∙min-1 threshold at the group level. The 34 mg threshold could be applied to allow group-level comparisons of ST with evidence generated using the ActiGraph 100 count∙min-1 method though it is important to consider the observed sensitivity and specificity results when interpreting findings

A novel mixed-method approach to assess children's sedentary behaviours

Purpose: Accurately measuring sedentary behavior (SB) in children is challenging by virtue of its complex nature. While self-report questionnaires are susceptible to recall errors, accelerometer data lacks contextual information. This study aimed to explore the efficacy of using accelerometry combined with the Digitising Children’s Data Collection (DCDC) for Health application (app), to capture SB comprehensively. Methods: 74 children (9–10 years old) wore ActiGraph GT9X accelerometers for 7 days. Each received a SAMSUNG Galaxy Tab4 (SM-T230) tablet, with the DCDC app installed and a specially designed sedentary behavior study downloaded. The app uses four data collection tools: 1) Questionnaire, 2) Take a photograph, 3) Draw a picture, and 4) Record my voice. Children self-reported their SB daily. Accelerometer data were analyzed using R-package GGIR. App data were downloaded and individual participant profiles created. SBs reported were grouped into categories and reported as frequencies. Results: Participants spent, on average, 629 min (i.e., 73% of their waking time) sedentary. App data revealed most of their out-of-school SB consisted of screen time (112 photos, 114 drawings, and screen time mentioned 135 times during voice recordings). Playing with toys, reading, arts and crafts, and homework were also reported across all four data capturing tools on the app. On an individual level, data from the app often explained irregular patterns in physical activity and SB observed in accelerometer data. Conclusion: This mixed methods approach to assessing SB adds context to accelerometer data, providing researchers with information needed for intervention design

Exploring teachers' perceptions on physical activity engagement for children and young people with intellectual disabilities

Aim: To explore teacher’s perceptions of barriers and facilitators to physical activity, including enabling, reinforcing and predisposing factors amongst children and young people (CYP) with intellectual disabilities (ID). Method and procedures: The Youth Physical Activity Promotion (YPAP) model was used to inform semi-structured focus groups to explore physical activity of CYP with ID. Participants were 23 (9 male) teachers and teaching assistants, from 3 special educational needs (SEN) schools (1 = Primary, 2 = Secondary) within North West England. Three focus groups were held with between 6 and 8 participants, audio and video recorded and data transcribed. Data were inductively and deductively analysed using Nvivo and represented through pen profiles. Results: Three pen profiles were developed and structured around YPAP model to display themes within the data. Enabling factors (facilities (n=23) and activity type (n=39)); reinforcing factors (influences of peers (n=23), family (n=10) and teachers (n=19) to physical activity engagement); predisposing factors (healthy lifestyle (n=15), enjoyment of physical activity (n=14), adaptations for physical activity (n=10), structured play (n=10), effects of disability on physical activity (n=8) and the CYPs attitudes towards physical activity (n=8)). Conclusion: CYP with ID enjoy engaging in physical activity, particularly activities that are of a fun and unstructured nature which allow for progression of skills and promote independence. Participants recognised that they, as teachers, had an influence on the CYP’s physical activity engagement, however suggested that parents have the most influential role. Similar to previous research, participants noted that CYP with ID had a lack of understanding as regards the importance of physical activity engagement and its benefits to health. It is suggested a strong home-school link for CYP within SEN schools could prove to be a key facilitator for active and healthy lifestyles education and choices

Validating the Sedentary Sphere method in children: does wrist or accelerometer brand matter?

This study aimed to validate the Sedentary Sphere posture classification method from wrist-worn accelerometers in children. Twenty-seven 9-10-year-old children wore ActiGraph GT9X (AG) and GENEActiv (GA) accelerometers on both wrists, and activPAL on the thigh while completing prescribed activities: five sedentary activities, standing with phone, walking (criterion for all 7: observation) and ten minutes free-living play (criterion: activPAL). In an independent sample, 21 children wore AG and GA accelerometers on the non-dominant wrist and activPAL for two days of free-living. Percent accuracy, pairwise 95% equivalence tests (±10% equivalence zone) and intra-class correlation coefficients (ICC) analyses were completed. Accuracy was similar, for prescribed activities irrespective of brand (non-dominant wrist: 77%-78%; dominant wrist: 79%). Posture estimates were equivalent between wrists within brand (±6%, ICC>0.81, lower 95% CI>0.75), between brands worn on the same wrist (±5%, ICC>0.84, lower 95% CI>0.80) and between brands worn on opposing wrists (±6%, ICC>0.78, lower 95% CI>0.72). Agreement with activPAL during free-living was 77%, but sedentary time was underestimated by 7% (GA) and 10% (AG). The Sedentary Sphere can be used to classify posture from wrist-worn AG and GA accelerometers for group-level estimates in children, but future work is needed to improve the algorithm for better individual-level results