Modelling the contribution of walking between home and school to daily physical activity in primary age children

Background The purpose of this study was to identify the independent association of frequency of walking trips between home and school with daily physical activity in a sample of school-aged children. Methods Participants were 109 children (mean age = 12.05 years [±0.71]) attending nine primary schools in Adelaide, South Australia. Physical activity was derived from accelerometers with total counts as the outcome variable. Transport patterns were self-reported for each of the previous five school days. Walking trips were summed for each day and across the school week. The relationship between the number of active transport journeys and individual school day and school week physical activity was modelled separately in boys and girls using multiple linear regression. Results Frequency of walking was positively associated with school day and school week accelerometer counts in boys, accounting for 6% and 12% of the explained variance in total counts, respectively. There were no significant associations among girls. Conclusion Despite sex-specific differences in associations between active transport to school and total physical activity, active transport is likely to have important ancillary benefits for development of independence and physical activity habits, and should continue to be promoted

Users\u27 experiences of wearable activity trackers: A cross-sectional study

Background Wearable activity trackers offer considerable promise for helping users to adopt healthier lifestyles. This study aimed to explore users’ experience of activity trackers, including usage patterns, sharing of data to social media, perceived behaviour change (physical activity, diet and sleep), and technical issues/barriers to use. Methods A cross-sectional online survey was developed and administered to Australian adults who were current or former activity tracker users. Results were analysed descriptively, with differences between current and former users and wearable brands explored using independent samples t-tests, Mann-Whitney, and chi square tests. Results Participants included 200 current and 37 former activity tracker users (total N = 237) with a mean age of 33.1 years (SD 12.4, range 18–74 years). Fitbit (67.5%) and Garmin devices (16.5%) were most commonly reported. Participants typically used their trackers for sustained periods (5–7 months) and most intended to continue usage. Participants reported they had improved their physical activity (51–81%) more commonly than they had their diet (14–40%) or sleep (11–24%), and slightly more participants reported to value the real time feedback (89%) compared to the long-term monitoring (78%). Most users (70%) reported they had experienced functionality issues with their devices, most commonly related to battery life and technical difficulties. Conclusions Results suggest users find activity trackers appealing and useful tools for increasing perceived physical activity levels over a sustained period

Physical activity and screen time behaviour in metropolitan, regional and rural adolescents: A cross-sectional study of Australians aged 9–16 years

Objectives: While there is consistent evidence that rural adults in Australia are less active than their urban counterparts, studies relating geographical remoteness to activity patterns in Australian adolescents have yielded inconsistent results. The aim of this study was to describe objectively and subjectively measured patterns of physical activity and sedentary behaviours across remoteness categories in a representative sample of 9–16 year old Australians. Design: Cross-sectional observational study. Methods: 2071 Australian adolescents provided self-report use of time data on four days and wore a pedometer for at least 6 days within the 2007 Australian National Children’s Nutrition and Physical Activity Survey. Comparisons of activity patterns were made across four objectively-determined remoteness categories (Major City, Inner Regional, Outer Regional and Remote), adjusting for household income, parental education and age. Results: Adolescents living in major cities self-reported 11–29 min less moderate to vigorous physical activity each day than their counterparts living in geographically more remote areas, and took 150–850 fewer steps each day. While there were no differences in time spent in sport or active transport, differences in free play participation were significant. Males in major cities also reported higher levels of screen time. Differences were somewhat more marked among males than among females. Conclusions: Activity levels among Australian adolescents show contrasting patterns of geographical differences to those found in Australian adults. Higher levels of free play among rural Australian adolescents may be due to more available space and less fear of traffic and stranger risks

Does home equipment contribute to socioeconomic gradients in Australian children’s physical activity, sedentary time and screen time?

Abstract Background Activity behaviours (physical activity, sedentary time and screen time) have been linked to health outcomes in childhood. Furthermore, socioeconomic disparities have been observed in both children’s activity behaviours and health outcomes. Children’s physical home environments may play a role in these relationships. This study aimed to examine the associations and interactions between children’s physical home environment, socioeconomic status and moderate-to-vigorous physical activity, sedentary time and screen time. Methods Australian children (n = 528) aged 9–11 years from randomly selected schools participated in the cross-sectional International Study of Childhood Obesity, Lifestyle and the Environment. Children’s physical home environment (access to equipment), socioeconomic status (household income and parental education) and demographic variables (gender and family structure) were determined by parental questionnaire. Moderate-to-vigorous physical activity and sedentary time were measured objectively by 7-day 24-h accelerometry. Screen time was obtained from child survey. The associations between the physical home environment, socioeconomic status and moderate-to-vigorous physical activity, sedentary time and screen time were examined for 427 children, using analysis of covariance, and linear and logistic regression, with adjustment for gender and family structure. Results The presence of TVs (p < 0.01) and video game consoles (p < 0.01) in children’s bedrooms, and child possession of handheld video games (p = 0.04), cell phones (p < 0.01) and music devices (p = 0.04) was significantly and positively associated with screen time. Ownership of these devices (with the exception of music devices) was inversely related to socioeconomic status (parental education). Children’s moderate-to-vigorous intensity physical activity (p = 0.04) and possession of active play equipment (p = 0.04) were both positively associated with socioeconomic status (household income), but were not related to each other (with the exception of bicycle ownership). Conclusions Children with less electronic devices, particularly in their bedrooms, participated in less screen time, regardless of socioeconomic status. Socioeconomic disparities were identified in children’s moderate-to-vigorous physical activity, however socioeconomic status was inconsistently related to possession of active play equipment. Home active play equipment was therefore not a clear contributor to the socioeconomic gradients in Australian children’s moderate-to-vigorous physical activity

Can Instagram be used to deliver an evidence-based exercise program for young women A process evaluation

Background Instagram provides an opportunity to deliver low cost, accessible and appealing physical activity content. This study evaluated the feasibility of delivering an exercise program for young women using Instagram. Methods A single-group pre- and post-intervention trial examined the feasibility and preliminary efficacy of a 12-week Instagram-delivered program with young inactive women (n = 16; M = 23 years), which prescribed running and body weight exercises to complete three times per week. Daily Instagram posts delivered the exercises, video demonstrations and motivational content. Feasibility was evaluated by examining exposure (Instagram posts viewed per week), engagement (likes, comments and tags on Instagram posts; number of exercise sessions completed per week; retention, defined as completion of the online survey at weeks 6 and 12), and acceptability [whether the program increased participants’ motivation to exercise (1 = strongly disagree-5 = strongly agree); satisfaction with the program (1 = not satisfied-5 = very satisfied)]. Preliminary efficacy was evaluated by comparing baseline and 12-week self-reported physical activity (IPAQ short-form) and fitness (cardiorespiratory and muscle strength; 1 = very poor-5 = very good, International Fitness Scale) using the Exact sign test. Results On average, participants reported seeing six posts in their Instagram feed per week. Posts received an average of five likes (IQR = 3–6). A total of four comments and one tag were observed across all posts. On average, participants reported completing two exercise sessions per week. Retention was 88% at 6 weeks but dropped to 56% at 12 weeks. Participants reported increased motivation to exercise (Mdn = 4, IQR = 3–4) and were satisfied with the program (Mdn = 4, IQR = 3–4). Only self-reported cardiorespiratory fitness showed a meaningful, though nonsignificant, improvement (MdnΔ = 1, IQR = 0–1, p = .06). Conclusions Although Instagram has the potential to deliver a low cost, convenient exercise program for young women, additional research is needed to identify methods of improving engagement (interaction with the Instagram content, exercise sessions completed, and retention in the program). Future research could examine the use of behaviour change theory and provide information that enables participants to tailor the exercises to their interests and needs. Additionally, the use of objective assessments of physical activity and fitness among a larger participants sample is needed

Validity and bias on the online active Australia survey: Activity level and participant factors associated with self-report bias

Background This study examined the criterion validity of the online Active Australia Survey, using accelerometry as the criterion, and whether self-report bias was related to level of activity, age, sex, education, body mass index and health-related quality of life. Methods The online Active Australia Survey was validated against the GENEActiv accelerometer as a direct measure of activity. Participants (n = 344) wore an accelerometer for 7 days, completed the Active Australia Survey, and reported their health and demographic characteristics. A Spearman’s rank coefficient examined the association between minutes of moderate-to-vigorous physical activity recorded on the Active Australia Survey and GENEActiv accelerometer. A Bland-Altman plot illustrated self-report bias (the difference between methods). Linear mixed effects modelling was used to examine whether participant factors predicted self-report bias. Results The association between moderate-to-vigorous physical activity reported on the online Active Australia Survey and accelerometer was significant (rs = .27, p \u3c .001). Participants reported 4 fewer minutes per day on the Active Australia Survey than was recorded by accelerometry (95% limits of agreement −104 – 96 min) but the difference was not significant (t(343) = −1.40, p = .16). Self-report bias was negatively associated with minutes of accelerometer-recorded moderate-to-vigorous physical activity and positively associated with mental health-related quality of life. Conclusions The online Active Australia Survey showed limited criterion validity against accelerometry. Self-report bias was related to activity level and mental health-related quality of life. Caution is recommended when interpreting studies using the online Active Australia Survey

'Active Team' a social and gamified app-based physical activity intervention : randomised controlled trial study protocol

Background: Physical inactivity is a leading preventable cause of chronic disease and premature death globally, yet over half of the adult Australian population is inactive. To address this, web-based physical activity interventions, which have the potential to reach large numbers of users at low costs, have received considerable attention. To fully realise the potential of such interventions, there is a need to further increase their appeal to boost engagement and retention, and sustain intervention effects over longer periods of time. This randomised controlled trial aims to evaluate the efficacy of a gamified physical activity intervention that connects users to each other via Facebook and is delivered via a mobile app. Methods: The study is a three-group, cluster-RCT. Four hundred and forty (440) inactive Australian adults who use Facebook at least weekly will be recruited in clusters of three to eight existing Facebook friends. Participant clusters will be randomly allocated to one of three conditions: (1) waitlist control condition, (2) basic experimental condition (pedometer plus basic app with no social and gamification features), or (3) socially-enhanced experimental condition (pedometer plus app with social and gamification features). Participants will undertake assessments at baseline, three and nine months. The primary outcome is change in total daily minutes of moderate-to-vigorous physical activity at three months measured objectively using GENEActive accelerometers [Activeinsights Ltd., UK]. Secondary outcomes include self-reported physical activity, depression and anxiety, wellbeing, quality of life, social-cognitive theory constructs and app usage and engagement. Discussion: The current study will incorporate novel social and gamification elements in order to examine whether the inclusion of these components increases the efficacy of app-based physical activity interventions. The findings will be used to guide the development and increase the effectiveness of future health behaviour interventions

Patient and health professions student team perceptions of patient-centeredness in an inter-professional education home-visit program: An exploratory study

The purpose of this study was to compare patient and health professions student team perceptions of patient-centeredness in an inter-professional clinical education home-visit program. Following an inter-professional clinical education home-visit program, patient and health professions student team perceptions of patient-centeredness were compared using a modified version of the Patient Perception of Patient Centeredness Questionnaire. The results showed both patient and student team participants perceived that student teams focused on how much they cared about the patient as a person and the opportunity to discuss any questions. Patients, however, reported significantly higher levels of patient-centered clinical method used during the visits than did health professions and osteopathic medical/dental student participants. The study reveals more practice and focus on patient feedback and the patient’s central role in their healthcare decisions is recommended for this inter-professional clinical education program as well as for any program that includes team-based care. Patient-centeredness also requires instruction to the patient about their role in their own healthcare. Health and medical professions educators need to continue to motivate students through inter-professional education programs and activities to adopt a more patient-centered practice. For future research as a follow-up study, adding independent observations of the home visit interactions may allow for a better understanding of which specific behaviors contribute the most to the experienced patient-centeredness

Life on Holidays: Study Protocol for a 3-Year Longitudinal Study Tracking Changes in Children\u27s Fitness and Fatness during the In-School Versus Summer Holiday Period

Background: Emerging evidence suggests that children become fatter and less fit over the summer holidays but get leaner and fitter during the in-school period. This could be due to differences in diet and time use between these distinct periods. Few studies have tracked diet and time use across the summer holidays. This study will measure rates of change in fatness and fitness of children, initially in Grade 4 (age 9 years) across three successive years and relate these changes to changes in diet and time use between in-school and summer holiday periods. Methods: Grade 4 Children attending Australian Government, Catholic and Independent schools in the Adelaide metropolitan area will be invited to participate, with the aim of recruiting 300 students in total. Diet will be reported by parents using the Automated Self-Administered 24-h Dietary Assessment Tool. Time use will be measured using 24-h wrist-worn accelerometry (GENEActiv) and self-reported by children using the Multimedia Activity Recall for Children and Adults (e.g. chores, reading, sport). Measurement of diet and time use will occur at the beginning (Term 1) and end (Term 4) of each school year and during the summer holiday period. Fitness (20-m shuttle run and standing broad jump) and fatness (body mass index z-score, waist circumference, %body fat) will be measured at the beginning and end of each school year. Differences in rates of change in fitness and fatness during in-school and summer holiday periods will be calculated using model parameter estimate contrasts from linear mixed effects model. Model parameter estimate contrasts will be used to calculate differences in rates of change in outcomes by socioeconomic position (SEP), sex and weight status. Differences in rates of change of outcomes will be regressed against differences between in-school and summer holiday period diet and time use, using compositional data analysis. Analyses will adjust for age, sex, SEP, parenting style, weight status, and pubertal status, where appropriate. Discussion: Findings from this project may inform new, potent avenues for intervention efforts aimed at addressing childhood fitness and fatness. Interventions focused on the home environment, or alternatively extension of the school environment may be warranted. Trial registration: Australia New Zealand Clinical Trials Registry, identifier ACTRN12618002008202. Retrospectively registered on 14 December 2018

Multiplex ligation-dependent probe amplification (MLPA) analysis is an effective tool for the detection of novel intragenic PLA2G6 mutations: Implications for molecular diagnosis

Phospholipase associated neurodegeneration (PLAN) comprises a heterogeneous group of autosomal recessive neurological disorders caused by mutations in the PLA2G6 gene. Direct gene sequencing detects 85% mutations in infantile neuroaxonal dystrophy. We report the novel use of multiplex ligation-dependent probe amplification (MLPA) analysis to detect novel PLA2G6 duplications and deletions. The identification of such copy number variants (CNVs) expands the PLAN mutation spectrum and may account for up to 12.5% of PLA2G6 mutations. MLPA should thus be employed to detect CNVs of PLA2G6 in patients who show clinical features of PLAN but in whom both disease-causing mutations cannot be identified on routine sequencin