Features of the UK childcare environment and associations with preschooler's in-care physical activity.

OBJECTIVE: Features of the childcare environment may influence children's in-care physical activity (PA). We assessed the association between UK preschool care-provider, environmental and policy factors and 3-4-year-olds' average daily in-care sedentary behaviour (SED) and PA. METHODS: In 2013, we used accelerometers to measure the in-care SED/ PA of 201 3-4-year-old children (51% female) in 30 preschools in Cambridgeshire, UK, (average wear time: (mean ± SD) 4.2 ± 1.3 week-days). We assessed the childcare environment using the Environment and Policy Assessment and Observation tool; demographic and carer information was taken from questionnaires. We used three-level mixed-effects regression analyses (adjusted for sex, in-care time and travel mode to care) to determine the association between childcare factors and children's in-care average daily minutes/hour spent SED, in light PA (LPA) and in moderate-to-vigorous PA (MVPA). RESULTS: Children spent 5.6 ± 2.5 h in care per day on average; clustering of PA within preschools was limited (ICCs: 0.003-0.05). Fully adjusted models showed that active opportunities were positively associated with children's in-care SED. No associations with in-care LPA and MVPA were observed. CONCLUSION: Few care-provider, environmental and policy factors were associated with children's in-care activity. UK childcare policies advocating child-driven play, moving freely indoors and outdoors, may be more conducive to individual children's PA.We thank all children and their parents who participated in the SPACE study. In addition, we thank Kate Westgate and Stefanie Mayle from the physical activity technical team at the MRC Epidemiology Unit for their assistance in processing the accelerometer data, and members of the field team who conducted data collection. This work was conducted by the Medical Research Council [Unit Programme numbers MC_UU_12015/7; MC_UU_12015/4] and the Centre for Diet and Activity Research (CEDAR), a UKCRC Public Health Research Centre of Excellence. Funding from the British Heart Foundation, Economic and Social Research Council, Medical Research Council, National Institute for Health Research, and Wellcome Trust, under the auspices of the UK Clinical Research Collaboration, is gratefully acknowledged (CEDAR grant number: RES-590-28-0002). No financial disclosures were reported by the authors of this paper.This is the final version of the article. It first appeared from Elsevier via http://dx.doi.org/10.1016/j.pmedr.2015.12.00

Impact of offering cycle training in schools upon cycling behaviour: a natural experimental study.

BACKGROUND: England's national cycle training scheme, 'Bikeability', aims to give children in England the confidence to cycle more. There is, however, little evidence on the effectiveness of cycle training in achieving this. We therefore examined whether delivering Bikeability was associated with cycling frequency or with independent cycling. METHODS: We conducted a natural experimental study using information on children aged 10-11 years participating in the nationally-representative Millennium Cohort Study. We identified Cohort participants whose schools had offered Bikeability in 2011-2012 using operational Bikeability delivery data (children in London excluded, as delivery data not available). Our natural experimental design capitalised on the fact that Cohort participants were surveyed at different times during 2012 and were also offered Bikeability at different times during 2012. This allowed us to compare cycling levels between children whose schools delivered Bikeability before their survey interview ('intervention group', N = 2563) and an otherwise comparable group of children whose schools delivered Bikeability later in the year ('control group', N = 773). Parents reported whether their child had completed formal cycle training; their child's cycling frequency; whether their child ever made local cycling trips without an adult; and other child and family factors. We used Poisson regression with robust standard errors to examine whether cycling behaviour differed between the intervention and control groups. RESULTS: Children whose school had offered Bikeability were much more likely to have completed cycle training than the control group (68% vs. 28%, p < 0.001). There was, however, no evidence that delivering Bikeability in school was associated with cycling more often (49.0% cycling at least once per week in the intervention group vs. 49.6% in the control group; adjusted risk ratio 0.99, 95% CI 0.89, 1.10). There was likewise no evidence of an association with cycling independently (51.5% in the intervention group vs. 50.1% in the control group; adjusted risk ratio 0.97, 95% CI 0.89, 1.06). CONCLUSIONS: Offering high-quality cycle training free at the point of delivery in English schools encourages children to do cycle training, but we found no evidence of short-term effects on cycling frequency or independent cycling. Future evaluation should investigate longer-term effects on these and other stated Bikeability objectives such as increasing cycling safety.This study was funded by the Economic and Social Research Council (ESRC: grant no.ES/L013606/1). DO and EvS are also supported by the Medical Research Council (Unit Programme numbers MC_UU_12015/6; MC_UU_12015/7). The contributions of DO and EvS were undertaken under the auspices of the Centre for Diet and Activity Research (CEDAR), a UKCRC Public Health Research Centre of Excellence which is funded by the British Heart Foundation, Cancer Research UK, Economic and Social Research Council, Medical Research Council, the National Institute for Health Research, and the Wellcome Trust. The views presented here are those of the authors, and do not necessarily reflect those of the ESRC or the Department for TransportThis is the final version of the article. It first appeared from BioMed Central via http://dx.doi.org/10.1186/s12966-016-0356-

Socioeconomic and ethnic differences in children's vigorous intensity physical activity: a cross-sectional analysis of the UK Millennium Cohort Study.

OBJECTIVE: To investigate if daily vigorous physical activity (VPA), adjusted for minutes of moderate physical activity (MPA) performed, differs by socioeconomic position or ethnicity in a large sample of UK children with objectively measured physical activity. DESIGN: Nationally representative prospective cohort study. SETTING: UK children born between 2000 and 2002. PARTICIPANTS: 5172 children aged 7-8 with valid accelerometer data for ≥10 hour on ≥3 days, including 1 weekend day. MAIN OUTCOME MEASURES: Time spent in VPA (>3841 counts per min). EXPLANATORY MEASURES: Maternal education, annual household Organisation for Economic Co-Operation and Development equivalised income, ethnicity. RESULTS: Multivariable linear regression models fitted to explore differences in average daily minutes of VPA (adjusted for MPA, mean accelerometer wear time, season of measurement, age and sex), revealed significantly higher amounts of VPA accumulated as a child's socioeconomic position increased (highest vs lowest level of maternal education: β: 2.96, p: 0.00; annual household equivalised income: β: 0.58, p: 0.00, per £10 000 annual increase). Additionally, children from certain minority ethnicities (Bangladeshi and Pakistani: β: -3.34, p: 0.00; other ethnic groups: β:-2.27, p: 0.02) accrued less daily VPA compared with their white British counterparts. CONCLUSIONS: The socioeconomic and ethnic patterning of vigorous activity observed in this study mirrors parallel inequalities in rates of childhood obesity. Given the stronger association of VPA with adiposity than of MPA, intensity specific differences may be contributing to widening inequalities in obesity. Accordingly, these findings suggest that the current global focus on overall moderate-to-vigorous intensity activity may mask important behavioural inequalities.Funding for this study and the work of all authors was supported, wholly or in part, by the Centre for Diet and Activity Research (CEDAR), a UKCRC Public Health Research Centre of Excellence (087636/Z/08/Z; ES/G007462/1; MR/K023187/1). Funding from the British Heart Foundation, Department of Health, Economic and Social Research Council, Medical Research Council, and the Wellcome Trust, under the auspices of the UK Clinical Research Collaboration, is gratefully acknowledged. Rebecca Love is funded by a Gates Cambridge Scholarship. The work of Esther M F van Sluijs was supported by the Medical Research Council (MC_UU_12015/7). No funders were involved in the production of this manuscript

A cross-sectional study of awareness of physical activity: associations with personal, behavioral and psychosocial factors

<p>Abstract</p> <p>Background</p> <p>Interventions to promote physical activity frequently target hypothesized mediators of change, but these might be affected by a person's awareness of their own physical activity behavior. The paper aims to characterize a high-risk population by levels of awareness and to study associations between awareness and selected personal, behavioral and psychosocial factors.</p> <p>Methods</p> <p>Data were collected on physical activity behavior, physical activity awareness, behavioral and psychosocial factors and anthropometry cross-sectionally at 6-month follow-up in a physical activity promotion trial. Awareness was assessed by comparing dichotomous self-rated physical activity with achieving activity levels according to international guidelines. Four groups were distinguished: 'Realistic Active', 'Realistic Inactive', 'Overestimator', and 'Underestimator'. Data were analyzed with ANCOVA, correcting for previous interventions and current physical activity level.</p> <p>Results</p> <p>Of 632 participants (mean age: 56.3 years), 321 were inactive, 61.4% of whom rated themselves as active ('Overestimators'). Compared to 'Realistic Inactives', 'Overestimators' were older, less likely to be smokers or to intend to increase their physical activity level, and had a lower body mass index. Furthermore, 'Overestimators' had similar scores to the 'Realistic Actives' on the psychological factors, but differed significantly from the 'Realistic Inactives'.</p> <p>Conclusion</p> <p>People who overestimate their physical activity level appear to be healthier than people who aware of their low activity level. Overestimators also scored more positively on various psychosocial factors and were also less likely to intend to change their physical activity behavior, making awareness a potential barrier in physical activity promotion. Physical activity promotion strategies might include interventions with a focus on increasing awareness in this hard to reach population.</p

Environmental determinants of active travel in youth: a review and framework for future research.

BACKGROUND: Many youth fail to meet the recommended guidelines for physical activity. Walking and cycling, forms of active travel, have the potential to contribute significantly towards overall physical activity levels. Recent research examining the associations between physical activity and the environment has shown that environmental factors play a role in determining behaviour in children and adolescents. However, links between the environment and active travel have received less attention. METHODS: Twenty four studies were identified which examined the associations between the environment (perceived or objectively measured) and active travel among youth aged 5-18 years. Findings were categorised according to the location of the environmental measure examined; attributes of the neighbourhood, destination and the route between home and destination. RESULTS: Results from the reviewed studies indicated that youth active travel is positively associated with social interactions, facilities to assist active travel and urban form in the neighbourhood as well as shorter route length and road safety en-route. A conceptual framework is presented which highlights the associations between active travel behaviours and environmental factors, drawing upon both existing and hypothesised relationships. CONCLUSION: We provide a review of the available literature and present a novel theoretical framework that integrates the environment into the wider decision making process around travel choices for children and adolescents. Further work should explore associations where gaps in understanding have been identified, and account for the main moderators of behaviour so hypothesised associations can be confirmed.RIGHTS : This article is licensed under the BioMed Central licence at http://www.biomedcentral.com/about/license which is similar to the 'Creative Commons Attribution Licence'. In brief you may : copy, distribute, and display the work; make derivative works; or make commercial use of the work - under the following conditions: the original author must be given credit; for any reuse or distribution, it must be made clear to others what the license terms of this work are

Bedroom media, sedentary time and screen-time in children:A longitudinal analysis

Background: Having electronic media in the bedroom is cross-sectionally associated with greater screen-time in children, but few longitudinal studies exist. The aim of this study was to describe longitudinal patterns of ownership and examine cross-sectional and longitudinal associations of bedroom media with children's sedentary behaviour. Methods: Data are from the Sport, Physical activity and Eating behaviour: Environmental Determinants in Young people (SPEEDY) study, collected at 3 time-points: baseline (2007, T0; age 10.3 ± 0.3 years), 1-year (T1y) and 4-year (T4y) follow-up. For each assessment, 1512 (44.9% male), 715 (41.0% male), and 319 (48.3% male) participants provided valid accelerometer data. Outcome variables were accelerometer-assessed sedentary time and self-reported screen-time. The presence of a television or computer in the bedroom was self-reported by participants and a combined bedroom media score calculated as the sum of such items. Cross-sectional and longitudinal associations between bedroom media and each outcome were examined using multi-level linear regression. Results: Bedroom TV ownership fell from 70.9% at T0 to 42.5% at T4y. Having a TV in the bedroom (beta; 95% CI*100, T0: -1.17; -1.88, -0.46. T1y: -1.68; -2.67, -0.70) and combined bedroom media (T0: -0.76; -1.26, -0.27. T1y: -0.79; -1.51, -0.07) were negatively associated with objectively measured weekly sedentary time at T0 and T1y. Having a computer in the bedroom (beta; 95% CI, T0: 0.15; 0.02, 0.29. T4y: 0.35; 0.10, 0.60) and combined bedroom media (T0: 0.09: 0.01, 0.18. T4y: 0.20; 0.05, 0.34) were positively associated with screen-time at T0 and T4y. Relative to participants without a computer throughout the study, children that had a computer in their bedroom at T0 but not at T4y (beta; 95% CI for change in screen-time: -8.02; -12.75, -3.29) reported smaller increases in screen-time. Conclusions: The bedroom media environment changes with age and exhibits a complex relationship with children's sedentary behaviour. Modifying children's bedroom media environment may impact upon screen-time but appears unlikely to influence overall sedentary time

Engaging families in physical activity research: a family-based focus group study

Abstract Background Family-based interventions present a much-needed opportunity to increase children’s physical activity levels. However, little is known about how best to engage parents and their children in physical activity research. This study aimed to engage with the whole family to understand how best to recruit for, and retain participation in, physical activity research. Methods Families (including a ‘target’ child aged between 8 and 11 years, their parents, siblings, and others) were recruited through schools and community groups. Focus groups were conducted using a semi-structured approach (informed by a pilot session). Families were asked to order cards listing the possible benefits of, and the barriers to, being involved in physical activity research and other health promotion activities, highlighting the items they consider most relevant, and suggesting additional items. Duplicate content analysis was used to identify transcript themes and develop a coding frame. Results Eighty-two participants from 17 families participated, including 17 ‘target’ children (mean age 9.3 ± 1.1 years, 61.1 % female), 32 other children and 33 adults (including parents, grandparents, and older siblings). Social, health and educational benefits were cited as being key incentives for involvement in physical activity research, with emphasis on children experiencing new things, developing character, and increasing social contact (particularly for shy children). Children’s enjoyment was also given priority. The provision of child care or financial reward was not considered sufficiently appealing. Increased time commitment or scheduling difficulties were quoted as the most pertinent barriers to involvement (especially for families with several children), but parents commented these could be overcome if the potential value for children was clear. Conclusions Lessons learned from this work may contribute to the development of effective recruitment and retention strategies for children and their families. Making the wide range of potential benefits clear to families, providing regular feedback, and carefully considering family structure, may prove useful in achieving desired research participation. This may subsequently assist in engaging families in interventions to increase physical activity in children

"The thing is, kids don't grow the same": Parent perspectives on preschoolers' weight and size in Soweto, South Africa.

The prevalence of overweight and obesity is high among preschool age (3-5 years) children in South Africa, and children in urban low-income settings are particularly at risk. A better understanding of how parents or caregivers of young children perceive children's weight and size, as well as contextual factors influencing perceptions, is needed to inform interventions. The aim of this study was to examine how parents of preschool children in Soweto, South Africa, view childhood obesity, and to situate these perspectives in the context of the home environment in which preschool age children in Soweto live. Semi-structured in-depth interviews were conducted with 16 parents in four neighbourhoods of Soweto. Interviews were audio-recorded, transcribed verbatim, and analysed using reflexive thematic analysis following a contextualist approach. Three themes were developed: growing differently, the 'right' way to be, and weight is not health. These themes capture parents' views on complex and reportedly inevitable causes of obesity, ideas about acceptable and preferred body sizes, and the low priority of weight per se compared to health. The findings suggest that childhood obesity prevention in South Africa needs to be done in a non-stigmatising way that recognises environmental and contextual factors, such as parents' limited sense of agency in relation to their children's health and weight, and concrete resource constraints. Environmental barriers to healthy behaviours need to be addressed in order to overcome the coexisting challenges of childhood undernutrition and obesity in urban low-income South African settings

School grounds and physical activity: Associations at secondary schools, and over the transition from primary to secondary schools.

This paper aims to further understanding of the physical environments of secondary schools and their associations with young peoples' physical activity. Accelerometer-derived physical activity measurements from 299 participants in the SPEEDY study (Norfolk, UK) were obtained from baseline measurements (age 9-10y) and +4y follow-up. These were linked to objective measures of primary and secondary school environments as measured by the SPEEDY grounds audit tool. We saw considerable differences in the nature of school grounds between primary and secondary schools. Cross-sectional associations were seen between active travel provision scores and commuting time moderate-to-vigorous physical activity (MVPA) for 13-14 year old boys and adolescents living further from school. However, few associations were seen between changes in school grounds scores and changes in school-based MVPA.Funding: The SPEEDY study is funded by the National Prevention Research Initiative (http://www.npri.org.uk), consisting of the following Funding Partners: British Heart Foundation; Cancer Research UK; Department of Health; Diabetes UK; Economic and Social Research Council; Medical Research Council; Health and Social Care Research and Development Office for the Northern Ireland; Chief Scientist Office, Scottish Government Health Directorates; Welsh Assembly Government and World Cancer Research Fund. This work was also supported by the Medical Research Council (Unit Programme numbers MC_UU_12015/7, MC_UU_12015/4, and MC_UU_12015/3) and the Centre for Diet and Activity Research (CEDAR), a UKCRC Public Health Research: Centre of Excellence. Funding from the British Heart Foundation, Economic and Social Research Council, Medical Research Council, the National Institute for Health Research, and the Wellcome Trust, under the auspices of the UK Clinical Research Collaboration, is gratefully acknowledged (grant code RES-590-28-002).This is the final version of the article. It first appeared from Elsevier via https://doi.org/10.1016/j.healthplace.2016.02.00