Resilience and green spaces: Association with stress among contact centre workers in the Philippines.

ISSUE ADDRESSED: Philippine contact centres are rife with factors that contribute to work-related stress; health promotion strategies are needed to mitigate the impacts. With a transactional framework with the environment, this study examined the relationship of stress with resilience and the presence of urban green spaces (UGS) in the environment, while accounting for individual characteristics (ie, age, household income, exercise frequency). METHODS: Participants include employees (Stage 1 N = 186; Stage 2 N = 89) from six contact centres in the capital region of the Philippines. A two-stage online survey included standardised instruments to measure stress (10-item Perceived Stress Scale) and resilience (Connor-Davidson Resilience Scale), customised questions to gather demographic information and probe on participants' insights. Google Earth Pro was used for satellite mapping of UGS, followed by on-site ocular inspection. RESULTS: Participants' average stress level was categorised as high; primary stressors included client demands and workload. The objectively measured percentages of UGS in the study sites' vicinity were categorised as low. Participants found UGS visible after careful observation, and majority were aware of UGS in their workplace vicinity. Resilience, household income and awareness of UGS in the vicinity significantly predicted stress levels. CONCLUSION: Contact centre workers experienced high stress levels and their workplaces had little accessible UGS. Resilience, household income and awareness of UGS are significant contributors to stress levels. SO WHAT?: Health promotion in Philippine contact centres could consider strategies that include building resilience, enhancing income security and promoting the awareness of UGS within the workplace vicinity.

Significant others and students' leisure-time physical activity intention: A prospective test of the social influence in sport model.

This two-wave prospective study applied the Social Influence in Sport Model to investigate whether the social influences of parents, physical education (PE) teachers, and peers were predictive of students' intention to engage in leisure-time physical activity (PA). Participants were 2,484 secondary school students (11-18 years old) who completed a questionnaire assessing positive influence, punishment, and dysfunction from the three social agents (parents, PE teachers, and peers) at baseline, and PA intention at a 1-month follow-up. Structural equation modelling (SEM) yielded excellent goodness-of-fit and consistent pathways between the three social agents. Students' leisure-time PA intention (R2 = .103 to 0.112) was positively associated with positive influence (ß = .223 to 0.236, p < .001) and punishment (ß = .214 to 0.256, p < .01), and negatively associated with dysfunction (ß = - 0.281 to -.335, p < .001). Multi-group SEM showed that the predictions were invariant between parents, PE teachers, and peers. Furthermore, no significant differences in students' gender were found between perceived social influence and PA intention. The findings supported the application of the Social Influence in Sport Model in explaining the role of significant others on students' intention to take part in leisure-time PA.

Teletherapy for children with developmental disorders during the COVID-19 pandemic in the Philippines: A mixed-methods evaluation from the perspectives of parents and therapists.

OBJECTIVES: As a response to the lockdown associated with COVID-19 in the Philippines, therapy services for children with developmental disorders shifted to telehealth (i.e., teletherapy). This study evaluated the delivery of teletherapy from the perspectives of parents and therapists. METHODS: Participants consisted of parents (n = 47) and therapists (n = 102) of children with developmental disorders who were receiving teletherapy during the lockdown. A mixed-methods triangulation design-convergence model was adopted; participants were invited to respond to an online survey with closed- and open-ended questions. Quantitative data were analysed using descriptive and non-parametric inferential tests, while qualitative data were examined using thematic analysis. RESULTS: Overall satisfaction with teletherapy was positive, with parents reporting significantly higher satisfaction compared with therapists. Satisfaction was positively associated with the frequency of teletherapy sessions for parents and with their years of experience for therapists. The top enabling factors were family participation and effective communication. The main challenges were time constraints and difficulty with instruction and monitoring associated with the two-dimensional nature of teletherapy. The benefits included parents' empowerment and enhanced understanding of their children's needs. DISCUSSION: Delivery of teletherapy was enabled by a heightened focus on family-centred care. The evaluation findings suggest that the general satisfaction with teletherapy and the benefits associated with family-centred care would potentially promote teletherapy as a service delivery mode to continue beyond the pandemic.

Migrant domestic workers' character strengths and the role of work-related factors: A strengths-based perspective.

Most studies on migrant domestic workers (MDW) focus on their problems and vulnerabilities, whereas not much is known about their positive attributes and character strengths. Hence, this study intends to deviate from the usual deficit-based view of MDW, which portrays them as victims, to a strengths-based perspective, which highlights their character strengths. In this study, we examined MDW's character strengths (i.e. positive human attributes that contribute to the thriving of oneself and others) and work-related factors associated with it. The participants of the study were 631 Filipino female MDW in Hong Kong. We examined how work-related factors (employer support and working conditions) predicted different character strength domains (courage, humanity, justice, moderation, transcendence and wisdom) through strengths use. Results of structural equation modelling revealed that employer support consistently predicted all six domains of character strengths through increased strengths use. These findings highlight the important role of employer support on MDW's character strengths. More importantly, it can raise critical awareness on MDW's strengths and well-being, and provide a platform for future strengths-based programmes and policies.

Results from the Philippines' 2022 report card on physical activity for children and adolescents.

Background/Objective: The 2022 Philippine Report Card on Physical Activity for Children and Adolescents provides a comprehensive assessment of physical activity and other related behaviors, including the various factors and settings that influence these behaviors. It serves as an advocacy tool to increase awareness of the physical activity situation among children and young people in the country. This article describes the development and results of the first Philippine Report Card on Physical Activity for Children and Adolescents. Methods: Following a systematic process provided by the Active Healthy Kids Global Alliance, a team consisting of 25 sports and physical activity specialists identified and reviewed the best available nationally representative data related to physical activity indicators. These data were then used to inform the grades of the ten (10) physical activity indicators. Results: Sufficient data were identified to assign grades to five (5) indicators: Overall Physical Activity (F), Active Transportation (D), Sedentary Behavior (B), School (C-), and Government (B). Insufficient data existed to assign grades to the remaining five (5) indicators: Organized Sport and Physical Activity, Active Play, Physical Fitness, Family and Peers, and Community and Environment. Conclusion: Despite government policies related to physical activity in the country, the majority of children and adolescents in the Philippines do not meet the recommended amount of physical activity for health. More work is needed to improve the translation of these policies into measurable programs, highlighting the need to create better physical activity opportunities and develop national surveillance mechanisms.

Movement skills, perception, and physical activity of young children: A mediation analysis.

BACKGROUND: Fundamental movement skill proficiency and perceived physical competence have been shown to influence the physical activity of children. However, the mechanisms and patterns of their relationships in early childhood need to be investigated. This study examined the direct and indirect effects of fundamental movement skills and the mediating role of perceived physical competence on the physical activity of young children. METHODS: Participants were 4- to 6-year-old children (N = 230; 121 girls, 109 boys). Fundamental movement skill components (i.e., locomotor, object control) were measured using the Test of Gross Motor Development-2; perceived physical competence was measured using the physical skills domain of the Pictorial Scale of Perceived Competence for young children; and physical activity was monitored using pedometers over a 5-day period (n = 115). Conditional process analysis was performed to examine mediation. RESULTS: Object control skill proficiency had a significant positive effect on perceived physical competence (B = 0.28, P = 0.02), and a significant positive effect on daily step counts (B = 0.18, P = 0.04). Perceived physical competence had a significant negative effect on daily step counts (B = -0.31, P = 0.003) and mediated the indirect effect of object control skills on daily step counts (B = -0.09, 95% confidence interval: -0.17 to -0.002). CONCLUSIONS: Object control skill proficiency had a significant direct effect on physical activity, and perceived physical competence mediates an indirect effect. The findings contribute to the evidence base supporting the development of object control skills as a factor that enables adequate physical activity in young children.

Investigating Changes in Real-time Conscious Postural Processing by Older Adults during Different Stance Positions Using Electroencephalography Coherence.

Background/Study Context: Adjustments of posture in response to balance challenges may lead to subsequent increases in conscious posture processing. If cognitive resources are stretched by conscious processing of postural responses fewer resources will be available to attend to environmental trip or fall hazards. The objective of the study was to explore brain activity related to conscious processing of posture as a function of movement specific reinvestment and fear of falling. Method: Forty-three older adults (M = 71.4, SD = 4.1) stood with a wide or narrow stance on a force-plate while neural coherence between verbal-analytical (T3) and motor planning (Fz) regions of the brain was assessed using electroencephalography. The propensity for movement specific reinvestment was assessed using the Chinese version Movement Specific Reinvestment Scale (MSRS-C) and fear of falling was assessed using the Chinese version Fall Efficacy Scale International (FES-I[CH]). Results: Scores from the MSRS-C were negatively correlated with changes in T3-Fz coherence that occurred when participants shifted from wide to narrow stance. Together, MSRS-C and FES-I(CH) uniquely predicted the percentage change in T3-Fz coherence between the two stance conditions. Conclusion: Presented with two postural tasks of different complexities, participants with a lower propensity for conscious control of their movements (movement specific reinvestment) exhibited larger changes in real-time brain activity (neural coherence) associated with conscious postural processing.

Test of gross motor development-2 for Filipino children with intellectual disability: validity and reliability.

This study aimed to examine aspects of validity and reliability of the Test of Gross Motor Development-2 (TGMD-2) in Filipino children with intellectual disability. Content and construct validity were verified, as well as inter-rater and intra-rater reliability. Two paediatric physiotherapists tested 81 children with intellectual disability (mean age = 9.29 ± 2.71 years) on locomotor and object control skills. Analysis of covariance, confirmatory factor analysis and analysis of variance were used to test validity, while Cronbach's alpha, intra-class correlation coefficients (ICC) and Bland-Altman plots were used to examine reliability. Age was a significant predictor of locomotor and object control scores (P = 0.004). The data fit the hypothesised two-factor model with fit indices as follows: χ(2) = 33.525, DF = 34, P = 0.491, χ(2)/DF = 0.986. As hypothesised, gender was a significant predictor for object control skills (P = 0.038). Participants' mean scores were significantly below mastery (locomotor, P < 0.001; object control, P < 0.001). Cronbach's alpha was 0.830 for locomotor and 0.792 for object control components. ICC for locomotor and object control scores ranged from 0.995 to 0.998, suggesting excellent intra-rater and inter-rater reliability, confirmed by Bland-Altman analysis. This study provides evidence of sufficient content and construct validity, internal consistency and rater reliability of TGMD-2 for Filipino children with intellectual disability.

Effects of Fundamental Movement Skills Training on Children With Developmental Coordination Disorder.

The purpose of this study was to examine the effects of fundamental movement skills (FMS) training on FMS proficiency, self-perceived physical competence (SPC), physical activity (PA), and sleep disturbance in children with developmental coordination disorder (DCD) compared with children with typical development (TD). A total of 84 children were allocated into either experimental group (DCD[exp], TD[exp]) who received 6 weeks of FMS training or control groups (DCD[con], TD[con]). FMS were assessed using the Test of Gross Motor Development-2, whereas PA was monitored using accelerometers. SPC and sleep disturbance were evaluated using questionnaires. Results showed that the DCD[exp] group had significantly higher scores in FMS and SPC compared with the DCD[con] group at posttest. The DCD[exp] group scored lower in sleep disturbance at follow-up when compared with posttest. It is suggested that short-term FMS training is effective in improving FMS and SPC and reducing sleep disturbances for children with DCD.

Physical activity and movement skills proficiency of young Filipino children.

Recent reports indicate an increasing prevalence of overweight among Filipino children. Considering the known association of physical activity (PA) with obesity, this study reports the findings of an objective monitoring of PA in a sample of Filipino children. The study also explores the relationship of PA with fundamental movement skills (FMS) proficiency. Thirty-two children (6.54 ± 2.45 years old) wore an accelerometer for 7 days of PA monitoring and were assessed on five FMS (throw, catch, kick, run, jump). The children met the World Health Organization's recommendation of 60 min of PA per day, with more active time being accrued during weekdays than weekends. Children with greater FMS proficiency were found to spend more time in PA than those who were less skillful during weekends. Further research is recommended to examine PA and FMS proficiency associations, exploring the role of social interactions on weekends and weekdays.

Integrating Fundamental Movement Skills and Mathematics in Early Childhood: A Pilot Study.

This project involved a co-design process involving researchers and kindergarten teachers to produce learning activities that integrated fundamental movement skills (FMS) and mathematics. We piloted the co-designed activities (i.e., motor-math program) in a local kindergarten and examined the effects on FMS proficiency, mathematics skills, and accrued physical activity (PA). The participants comprised pupils (N = 39) from two matched kindergarten classes, in which we compared the motor-math program with typical mathematics lessons. All participants wore pedometers to measure their number of steps during class, one day per week. FMS proficiency (i.e., locomotor, object control) and mathematics skills (numeracy, geometry, math problem solving) were measured before and after implementation. Significant improvements in locomotor and object control skills were found only in the pilot group (p < 0.001); there were no differences in the changes in mathematics skills between the pilot and comparison groups. During implementation days, the participants in the pilot group accrued significantly greater step counts (p < 0.001) than those in the comparison group. Participating in the motor-math program appears to have benefits associated with improvements in FMS proficiency and accrued PA time, suggesting a promising potential for integrated activities as a means of PA promotion in kindergarten settings. Future work that examines the effects of the integration of movement with mathematics should consider randomization, greater sample size, and a longer intervention period.

Effect of wearable activity trackers on physical activity in children and adolescents: a systematic review and meta-analysis.

BACKGROUND: Physical inactivity in children and adolescents has become a pressing public health concern. Wearable activity trackers can allow self-monitoring of physical activity behaviour and promote autonomous motivation for exercise. However, the effects of wearable trackers on physical activity in young populations remain uncertain. METHODS: In this systematic review and meta-analysis, we searched PubMed, Embase, SPORTDiscus, and Web of Science for publications from database inception up to Aug 30, 2023, without restrictions on language. Studies were eligible if they were randomised controlled trials or clustered randomised controlled trials that examined the use of wearable activity trackers to promote physical activity, reduce sedentary behaviours, or promote overall health in participants with a mean age of 19 years or younger, with no restrictions on health condition or study settings. Studies were excluded if children or adolescents were not the primary intervention cohort, or wearable activity trackers were not worn on users' bodies to objectively track users' physical activity levels. Two independent reviewers (WWA and FR) assessed eligibility of studies and contacted authors of studies if more information was needed to assess eligibility. We also searched reference lists from relevant systematic reviews and meta-analyses. Systematic review software Covidence was used for study screening and data extraction. Study characteristics including study setting, participant characteristics, intervention characteristics, comparator, and outcome measurements were extracted from eligible studies. The two primary outcomes were objectively measured daily steps and moderate-to-vigorous physical activity. We used a random-effects model with Hartung-Knapp adjustments to calculate standardised mean differences. Between-study heterogeneity was examined using Higgins I2 and Cochran Q statistic. Publication bias was assessed using Egger's regression test. This systematic review was registered with PROSPERO, CRD42023397248. FINDINGS: We identified 9619 studies from our database research and 174 studies from searching relevant systematic reviews and meta-analyses, of which 105 were subjected to full text screening. We included 21 eligible studies, involving 3676 children and adolescents (1618 [44%] were female and 2058 [56%] were male, mean age was 13·7 years [SD 2·7]) in our systematic review and meta-analysis. Ten studies were included in the estimation of the effect of wearable activity trackers on objectively measured daily steps and 11 were included for objectively measured moderate-to-vigorous physical activity. Compared with controls, we found a significant increase in objectively measured daily steps (standardised mean difference 0·37 [95% CI 0·09 to 0·65; p=0·013]; Q 47·60 [p<0·0001]; I2 72·7% [95% CI 53·4 to 84·0]), but not for moderate-to-vigorous physical activity (-0·08 [-0·18 to 0·02; p=0·11]; Q 10·26 [p=0·74]; I2 0·0% [0·0 to 53·6]). INTERPRETATION: Wearable activity trackers might increase daily steps in young cohorts of various health statuses, but not moderate-to-vigorous physical activity, highlighting the potential of wearable trackers for motivating physical activity in children and adolescents. More rigorously designed trials that minimise missing data are warranted to validate our positive findings on steps and to explore possible long-term effects. FUNDING: The Hong Kong University Grants Committee and Seed Fund for Basic Research of the University of Hong Kong.

Physical Activity Interventions to Alleviate Depressive Symptoms in Children and Adolescents: A Systematic Review and Meta-analysis.

Importance: Depression is the second most prevalent mental disorder among children and adolescents, yet only a small proportion seek or receive disorder-specific treatment. Physical activity interventions hold promise as an alternative or adjunctive approach to clinical treatment for depression. Objective: To determine the association of physical activity interventions with depressive symptoms in children and adolescents. Data Sources: PubMed, CINAHL, PsycINFO, EMBASE, and SPORTDiscus were searched from inception to February 2022 for relevant studies written in English, Chinese, or Italian. Study Selection: Two independent researchers selected studies that assessed the effects of physical activity interventions on depressive symptoms in children and adolescents compared with a control condition. Data Extraction and Synthesis: A random-effects meta-analysis using Hedges g was performed. Heterogeneity, risk of bias, and publication bias were assessed independently by multiple reviewers. Meta-regressions and sensitivity analyses were conducted to substantiate the overall results. The study followed the PRISMA reporting guideline. Main Outcomes and Measures: The main outcome was depressive symptoms as measured by validated depression scales at postintervention and follow-up. Results: Twenty-one studies involving 2441 participants (1148 [47.0%] boys; 1293 [53.0%] girls; mean [SD] age, 14 [3] years) were included. Meta-analysis of the postintervention differences revealed that physical activity interventions were associated with a reduction in depressive symptoms compared with the control condition (g = -0.29; 95% CI, -0.47 to -0.10; P = .004). Analysis of the follow-up outcomes in 4 studies revealed no differences between the physical activity and control groups (g = -0.39; 95% CI, -1.01 to 0.24; P = .14). Moderate study heterogeneity was detected (Q = 53.92; df = 20; P < .001; I2 = 62.9% [95% CI, 40.7%-76.8%]). The primary moderator analysis accounting for total physical activity volume, study design, participant health status, and allocation and/or assessment concealment did not moderate the main treatment effect. Secondary analyses demonstrated that intervention (ie, <12 weeks in duration, 3 times per week, unsupervised) and participant characteristics (ie, aged ≥13 years, with a mental illness and/or depression diagnosis) may influence the overall treatment effect. Conclusions and Relevance: Physical activity interventions may be used to reduce depressive symptoms in children and adolescents. Greater reductions in depressive symptoms were derived from participants older than 13 years and with a mental illness and/or depression diagnosis. The association with physical activity parameters such as frequency, duration, and supervision of the sessions remains unclear and needs further investigation.

Physical activity and exercise for cancer-related cognitive impairment among individuals affected by childhood cancer: a systematic review and meta-analysis.

BACKGROUND: Individuals affected by childhood cancer can have cognitive dysfunction that persists into adulthood and negatively affects quality of life. In this study, we aimed to evaluate the effects of physical activity and exercise on cognitive function among individuals affected by childhood cancer. METHODS: In this systematic review and meta-analysis, we searched seven databases (CINAHL Plus, Cochrane Library, Embase, MEDLINE, PsycINFO, SPORTDiscus, and Web of Science) and two clinical trial registries (ClinicalTrials.gov and the International Clinical Trials Registry Platform) for randomised controlled trials (RCTs) and non-randomised studies of interventions (NRSIs) published (or registered) from database inception to Jan 30, 2022, with no language restrictions. We included studies that compared the effects of physical activity or exercise interventions with controls (no intervention or usual care) on cognitive function among individuals diagnosed with any type of cancer at age 0-19 years. Two reviewers (JDKB and FR) independently screened records for eligibility and searched references of the selected studies; extracted study-level data from published reports; and assessed study risk of bias of RCTs and NRSIs using the Cochrane risk of bias tool for randomised trials (RoB 2) and Risk Of Bias In Non-randomised Studies-of Interventions (ROBINS-I) tools, certainty of the evidence using the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) approach, and any adverse events. We used intention-to-treat data and unpublished data if available. Cognitive function was assessed by standardised cognitive performance measures (primary outcome) and by validated patient-reported measures (secondary outcome). A random-effects meta-analysis model using the inverse-variance and Hartung-Knapp methods was used to calculate pooled estimates (Hedges' g) and 95% CI values. We estimated the heterogeneity variance by the restricted maximum likelihood method and calculated I2 values to measure heterogeneity. We examined funnel plots and used Egger's regression test to assess for publication bias. This study is registered with PROSPERO, CRD42021261061. FINDINGS: We screened 12 425 titles and abstracts, which resulted in full-text assessment of 131 potentially relevant reports. We evaluated 22 unique studies (16 RCTs and six NRSIs) with data on 1277 individuals affected by childhood cancer and low-to-moderate risk of bias. Of the 1277 individuals, 674 [52·8%] were male and 603 [47·2%] were female; median age at study start was 12 (IQR 11-14) years, median time since the end of cancer treatment was 2·5 (IQR -1·1 to 3·0) years, and median intervention period was 12 [IQR 10-24] weeks. There was moderate-quality evidence that, compared with control, physical activity and exercise improved cognitive performance measures (five RCTs; Hedges' g 0·40 [95% CI 0·07-0·73], p=0·027; I2=18%) and patient-reported measures of cognitive function (13 RCTs; Hedges' g 0·26 [0·09-0·43], p=0·0070; I2=40%). No evidence of publication bias was found. Nine mild adverse events were reported. INTERPRETATION: There is moderate-certainty evidence that physical activity and exercise improves cognitive function among individuals affected by childhood cancer, which supports the use of physical activity for managing cancer-related cognitive impairment. FUNDING: Research Impact Fund of Research Grants Council of the Hong Kong University Grants Committee (R7024-20) and Seed Fund for Basic Research of the University of Hong Kong. COPYRIGHT: © 2022 Published by Elsevier Ltd. All rights reserved.

Effects of Single-Task, Dual-Task and Analogy Training during Gait Rehabilitation of Older Adults at Risk of Falling: A Randomized Controlled Trial.

It has been suggested that implicit motor learning via dual-task or analogy training during gait rehabilitation may yield better outcomes in older adults by reducing the propensity for the conscious processing of movements (movement-specific reinvestment). The current study investigated the immediate effects of single-task, dual-task, and analogy training on reinvestment propensity and fall-related rehabilitation outcomes among older adults at risk of falling. Seventy-one older adults were randomly allocated to the single-task (ST), dual-task (DT), or analogy (AG) training conditions and received 12 training sessions. We assessed the reinvestment propensity, functional gait and balance, functional mobility, balance ability, single-task and dual-task walking abilities, and fear of falling at baseline (before training) and immediately after training. Our findings revealed a lack of training effect on reinvestment propensity for all groups. However, all groups displayed significant improvements in functional gait and balance (p < 0.001), functional mobility (p = 0.02), and balance ability (p = 0.01) after training. AG appeared to be superior to DT and ST, as it was the only condition that resulted in significant improvements in both single-task and dual-task walking abilities (p < 0.001). Implementing movement analogies could be a feasible and useful gait rehabilitation strategy for fall prevention and wellbeing promotion among older adults.

The effects of fatigued working memory functions on hypothesis testing during acquisition of a motor skill.

Implicit motor learning paradigms aim to minimize verbal-analytical engagement in motor performance. Some paradigms do this by decreasing working memory activity during practice, which reduces explicit processes associated with the search for motor solutions (e.g., hypothesis testing). Here we designed a mentally demanding motor task to fatigue working memory prior to motor practice and then tested whether it reduced hypothesis testing. Fifty-nine participants were randomly assigned to complete the mentally demanding motor task (cognitive fatigue group) or to complete an undemanding motor task (nonfatigued control group). Feelings of fatigue, working memory functions, electroencephalography (EEG) Fz power, and vagal control were assessed pre- and posttask to quantify the effect of the mentally demanding motor task on cognitive fatigue. Thereafter, an adapted shuffleboard task was completed to determine the impact on hypothesis testing. Hypothesis testing was assessed by self-report, technique changes, and equipment-use solutions. Additionally, verbal-analytical engagement in motor performance was (indirectly) gauged with EEG T7-Fz connectivity and T7 power measures. Participants in the cognitive fatigue group reported more fatigue and displayed moderated working memory functions and Fz theta power. During practice of the shuffleboard task, participants also displayed more technique changes and higher verbal-analytical engagement in motor planning (EEG T7-Fz connectivity), compared with participants in the control group. The mentally demanding motor task suppressed working memory functions, but resulted in more, rather than less, hypothesis testing during shuffleboard practice. The implications are discussed in the context of implicit motor learning theory. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Movement guidelines for young children: Engaging stakeholders to design dissemination strategies in the Hong Kong early childhood education context.

Background: Early childhood is a critical period during which patterns of movement behaviors are formed. The World Health Organization had endorsed guidelines for physical activity, sedentary behavior and sleep over a 24-h time period, which had been adopted by the Center for Health Protection of Hong Kong. This paper reports on stakeholder engagements that were conducted to inform the design of strategies to disseminate the guidelines in early childhood education (ECE) settings. Methods: Using a mixed-methods study design, we sought to (a) assess the stakeholders' levels of awareness and knowledge of the Hong Kong movement guidelines for young children and (b) identify the factors that influence the uptake of the said guidelines. We conducted an online survey of early childhood education teachers (N =314), twelve focus groups involving teachers (N = 18) and parents (N = 18), and individual interviews of key informants (N = 7) and domestic workers who provide care for preschool-aged children (N = 7). Descriptive statistics were used for the quantitative data, and thematic analysis was performed on the qualitative data using an inductive and semantic approach following a realist framework. Findings: Our findings show that teachers were aware of the movement guidelines for young children, but their knowledge of the specific guidelines was deficient; parents and domestic workers had limited awareness and knowledge of the guidelines. Uptake of the movement guidelines is enabled by parent engagement, activities in the ECE centers, home-school cooperation, and community activities for children. The challenges include the time poverty of parents, local curriculum requirements, limited physical spaces, social values, and pandemic-related restrictions. Conclusion: We recommend that dissemination strategies in the ECE context should deliver knowledge content and support stakeholders in mitigating the challenges associated with time, space, and social conditions.

Parental Influence on Child and Adolescent Physical Activity Level: A Meta-Analysis.

Parents are often regarded as one of the significant social agents who are important to the participation of physical activity (PA) among children and adolescents. However, within the literature, the relationships between parental influences and child and adolescent PA have been inconclusive and discordant. The purpose of this meta-analysis was to quantify and synthesize the associations between parental social influences (positive parental influence, punishment, and discouragement) and the PA level of children and adolescents. Through a systematic literature search using PsycINFO, Web of Science, PubMed, ProQuest, and SPORTDiscus databases, we identified 112 eligible studies and subsequently extracted 741 effect sizes for our analysis. Multilevel meta-analysis showed that the corrected zero-order correlation of positive parental influence was positive and statistically significant, r = 0.202, SE = 0.014, t = 14.975, p < 0.001, 95% confidence interval (CI) = [0.176, 0.228]. Further moderation analysis also found that this was significantly moderated by parental gender (maternal vs. paternal), respondent of influence measure (parent-reported vs. child-reported), and type of PA measure (subjective vs. objective). The corrected zero-order correlations of negative parental influences (i.e., punishment and discouragement) were not statistically significant, and no significant moderation effects were observed. The findings of our meta-analysis showed that children and adolescents had higher PA levels when their parents supported PA participation by exerting positive social influence. Punishment and discouragement against PA by parents did not appear to be significantly associated with the PA level of children and adolescents. The findings of negative parental social influence were mixed and required further investigations.

Strategies for Teachers to Promote Physical Activity in Early Childhood Education Settings-A Scoping Review.

Recent evidence has emphasized the importance of the early childhood years for developing lifelong physical activity patterns. As such, evidence-informed programs that create opportunities for young children to engage in physical activity are needed and education settings present an important context. This review aimed to identify strategies that are implemented by teachers to promote physical activity in early childhood education and care settings. This is a scoping review that followed the framework proposed by the Joanna Briggs Institute. Searches were conducted using the databases of PubMed, SCOPUS, PsycINFO, SPORT Discus, ERIC and Web of Science for publications up to September 2020. From a total of 8974 articles, 19 were deemed eligible. Ten types of strategies, performed by teachers with the intention to improve physical activity-related primary outcomes, were identified. Physical activity promotion by teachers in early childhood settings is recommended to take a multi-strategy approach, in conjunction with professional development training opportunities and continuous follow-up support for teachers. Future work is warranted to fill the evidence gap in other regions (e.g., Asia, Africa and South America) and strengthen the evidence base to establish best practice standards.

Examining the Antecedent Role of Movement Proficiency in Child Development: Study Protocol.

Background: Decades of research, largely from associational studies, show that the relationships of movement proficiency with the cognitive and social aspects of development are particularly strong in early childhood. Children who move proficiently tend to have better cognitive skills and social behaviors. However, the mechanisms that underpin these relationships remain unclear and research that explores causation is necessary. This study will explore the antecedent role of movement proficiency in the cognitive and social domains of child development, by examining whether a targeted movement skills training program facilitates improvements in cognitive and social skills. Methods: A group-randomized controlled trial will be conducted, implementing a fundamental movement skills training program in Hong Kong kindergartens. Participants will consist of children aged 3-5 years (N = 158) who will be randomly allocated by class to either a training or active control condition. The training program (10 weeks × 2 bouts) will be informed by an error-reduced approach to skills learning, which will involve careful design and manipulation of equipment and training environment to minimize practice errors. The active control condition will consist of typical movement activities implemented in the kindergartens in the context of the local curriculum guide. Outcomes will be measured using standardized tests of gross motor skills proficiency, executive functioning, and social skills. Measurements will occur at baseline, mid-training, post-training, and follow-up. Latent variable longitudinal modeling will be used to analyze changes in the outcomes, with covariates that include sex, body composition, fine motor skills, and physical activity. Expected Results: The findings will subsequently be reported consistent with the Consolidated Standards of Reporting Trials (CONSORT) statement. Contributions to knowledge and understanding of child development are expected, through evidence of causal mechanisms surrounding the relationship of motor with cognitive and social development. The findings will also inform policy and practice related to early childhood development and education.