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

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)

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 Randomised Controlled Trial to Reduce Sedentary Time in Young Adults at Risk of Type 2 Diabetes Mellitus: Project STAND (Sedentary Time ANd Diabetes)

Aims&nbsp; &nbsp;Type 2 diabetes mellitus (T2DM), a serious and prevalent chronic disease, is traditionally associated with older age. However, due to the rising rates of obesity and sedentary lifestyles, it is increasingly being diagnosed in the younger population. Sedentary (sitting) behaviour has been shown to be associated with greater risk of cardio-metabolic health outcomes, including T2DM. Little is known about effective interventions to reduce sedentary behaviour in younger adults at risk of T2DM. We aimed to investigate, through a randomised controlled trial (RCT) design, whether a group-based structured education workshop focused on sitting reduction, with self-monitoring, reduced sitting time.&nbsp; Methods&nbsp; &nbsp;Adults aged 18&ndash;40 years who were either overweight (with an additional risk factor for T2DM) or obese were recruited for the Sedentary Time ANd Diabetes (STAND) RCT. The intervention programme comprised of a 3-hour group-based structured education workshop, use of a self-monitoring tool, and follow-up motivational phone call. Data were collected at three time points: baseline, 3 and 12 months after baseline. The primary outcome measure was accelerometer-assessed sedentary behaviour after 12 months. Secondary outcomes included other objective (activPAL) and self-reported measures of sedentary behaviour and physical activity, and biochemical, anthropometric, and psycho-social variables.&nbsp; Results&nbsp; &nbsp;187 individuals (69% female; mean age 33 years; mean BMI 35 kg/m2) were randomised to intervention and control groups. 12 month data, when analysed using intention-to-treat analysis (ITT) and per-protocol analyses, showed no significant difference in the primary outcome variable, nor in the majority of the secondary outcome measures.&nbsp; Conclusions&nbsp; A structured education intervention designed to reduce sitting in young adults at risk of T2DM was not successful in changing behaviour at 12 months. Lack of change may be due to the brief nature of such an intervention and lack of focus on environmental change. Moreover, some participants reported a focus on physical activity rather than reductions in sitting per se. The habitual nature of sedentary behaviour means that behaviour change is challenging

Associations of objectively measured moderate-to-vigorous-intensity physical activity and sedentary time with all-cause mortality in a population of adults at high risk of type 2 diabetes mellitus

The relationships of physical activity and sedentary time with all-cause mortality in those at high risk of type 2 diabetes mellitus (T2DM) are unexplored. To address this gap in knowledge,we examined the associations of objectively measured moderate-to-vigorous-intensity physical activity (MVPA) and sedentary time with all-cause mortality in a population of adults at high risk of T2DM. In 2010–2011, 712 adults (Leicestershire, U.K.), identified as being at high risk of T2DM, consented to be followed up for mortality.MVPA and sedentary time were assessed by accelerometer; those with valid data (≥10 hours of wear-time/day with ≥4 days of data) were included. Cox proportional hazards regression models, adjusted for potential confounders, were used to investigate the independent associations of MVPA and sedentary time with all-cause mortality. 683 participants (250 females (36.6%)) were included and during a mean follow-up period of 5.7 years, 26 deaths were registered. Every 10% increase in MVPA time/day was associated with a 5% lower risk of all-cause mortality [Hazard Ratio (HR): 0.95 (95% Confidence Interval (95% CI): 0.91, 0.98); p=0.004]; indicating that for the average adult in this cohort undertaking approximately 27.5 minutes of MVPA/day, this benefit would be associated with only 2.75 additional minutes of MVPA/day. Conversely, sedentary time showed no association with all-cause mortality [HR (every 10-minute increase in sedentary time/day): 0.99 (95% CI: 0.95, 1.03); p=0.589]. These data support the importance of MVPA in adults at high risk of T2DM. The association between sedentary time and mortality in this population needs further investigation

Protocol for an implementation evaluation of an intervention to reduce and break-up sitting time in the school classroom: the CLASS PAL (Physically Active Learning) Project

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 schoollevel 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 (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