Additional file 1: of Associations within school-based same-sex friendship networks of children’s physical activity and sedentary behaviours: a cross-sectional social network analysis

Details and interpretation of network autocorrelation model. (DOCX 43 kb

Additional file 2: of Associations within school-based same-sex friendship networks of children’s physical activity and sedentary behaviours: a cross-sectional social network analysis

Additional Tables and Figures. Table S1. Characteristics of children included in the analysis, including imputed values. Table S2. Characteristics of children included in the analysis, observed data only. Table S3. Moran’s I statistic for network autocorrelation in the residuals from the baseline OLS regression models. Figure S1. Moran plots for MVPA and sedentary time. (DOCX 48 kb

Additional file 1: of Association of parents’ and children’s physical activity and sedentary time in Year 4 (8–9) and change between Year 1 (5–6) and Year 4: a longitudinal study

Table S1. Mean difference (95% confidence interval) in the children’s average sedentary minutes per day in Year 4 associated with parents’ sedentary time in Year 4 and Year 1 for those with complete data. Table S2. Mean difference (95% confidence interval) in the children’s average moderate-to-vigorous physical activity minutes per day in Year 4 associated with parents’ moderate-to-vigorous physical activity in Year 4 and Year 1 for those with complete data. Table S3. Mean difference (95% confidence interval) in the children’s change in sedentary minutes per day between Year 1 and Year 4 associated with parents’ change in sedentary time between Year 1 and Year 4 for those with complete data. Table S4. Mean difference (95% confidence interval) in the children’s change in moderate-to-vigorous physical activity minutes per day between Year 1 and Year 4 associated with parents’ change in moderate-to-vigorous physical activity between Year 1 and Year 4 for those with complete data. (DOCX 25 kb

Specific descriptive data in focus group participants (n = 12).

<p>Abbreviations: NVQ non-vocational qualification, GCSE General Certificate of Secondary School Education, BD twice a day, MDI Multiple Daily Injections</p><p>Specific descriptive data in focus group participants (n = 12).</p

Table_1_Rethinking children’s physical activity interventions at school: A new context-specific approach.DOCX

Physical activity is important for children’s health. However, evidence suggests that many children and adults do not meet international physical activity recommendations. Current school-based interventions have had limited effect on physical activity and alternative approaches are needed. Context, which includes school setting, ethos, staff, and sociodemographic factors, is a key and largely ignored contributing factor to school-based physical activity intervention effectiveness, impacting in several interacting ways.ConceptualizationCurrent programs focus on tightly-constructed content that ignores the context in which the program will be delivered, thereby limiting effectiveness. We propose a move away from uniform interventions that maximize internal validity toward a flexible approach that enables schools to tailor content to their specific context.Evaluation designsEvaluation of context-specific interventions should explicitly consider context. This is challenging in cluster randomized controlled trial designs. Thus, alternative designs such as natural experiment and stepped-wedge designs warrant further consideration.Primary outcomeA collective focus on average minutes of moderate-to-vigorous intensity physical activity may not always be the most appropriate choice. A wider range of outcomes may improve children’s physical activity and health in the long-term. In this paper, we argue that greater consideration of school context is key in the design and analysis of school-based physical activity interventions and may help overcome existing limitations in the design of effective interventions and thus progress the field. While this focus on context-specific interventions and evaluation is untested, we hope to stimulate debate of the key issues to improve future physical activity intervention development and implementation.</p

Superordinate and subordinate themes from focus groups.

<p>Superordinate and subordinate themes from focus groups.</p

Rethinking children’s physical activity interventions at school: A new context-specific approach

Physical activity is important for children’s health. However, evidence suggests that many children and adults do not meet international physical activity recommendations. Current school-based interventions have had limited effect on physical activity and alternative approaches are needed. Context, which includes school setting, ethos, staff, and sociodemographic factors, is a key and largely ignored contributing factor to school-based physical activity intervention effectiveness, impacting in several interacting ways. Conceptualization: Current programs focus on tightly-constructed content that ignores the context in which the program will be delivered, thereby limiting effectiveness. We propose a move away from uniform interventions that maximize internal validity toward a flexible approach that enables schools to tailor content to their specific context. Evaluation designs: Evaluation of context-specific interventions should explicitly consider context. This is challenging in cluster randomized controlled trial designs. Thus, alternative designs such as natural experiment and stepped-wedge designs warrant further consideration. Primary outcome: A collective focus on average minutes of moderate-to-vigorous intensity physical activity may not always be the most appropriate choice. A wider range of outcomes may improve children’s physical activity and health in the long-term. In this paper, we argue that greater consideration of school context is key in the design and analysis of school-based physical activity interventions and may help overcome existing limitations in the design of effective interventions and thus progress the field. While this focus on context-specific interventions and evaluation is untested, we hope to stimulate debate of the key issues to improve future physical activity intervention development and implementation.</p

Cross-sectional and prospective associations of BMI with blood pressure at age 9 years in the multiple imputation data.

<p>Cross-sectional and prospective associations of BMI with blood pressure at age 9 years in the multiple imputation data.</p

Cross-sectional and prospective associations of BMI with hypertension at age 9 years in the multiple imputation data.

<p>Cross-sectional and prospective associations of BMI with hypertension at age 9 years in the multiple imputation data.</p

Cross-sectional associations of physical activity with blood pressure at age 9 years in the multiple imputation data (N = 1223)*.

<p>Cross-sectional associations of physical activity with blood pressure at age 9 years in the multiple imputation data (N = 1223)*.</p