Telework and 24-hour movement behaviours among adults living in Canada during the COVID-19 pandemic.

OBJECTIVE: To assess the association between work location and movement behaviours (physical activity [PA], screen time, sleep) and adherence to the Canadian 24-Hour Movement Guidelines (24-H Guidelines) among Canadian workers during the COVID-19 pandemic. METHODS: Using cross-sectional data from the 2021 Canadian Community Health Survey (n = 10,913 working adults 18-75 years), primary work location was categorized as: worked outside the home at a fixed location (fixed workplace), worked at home (telework), and worked outside the home at no fixed location (non-fixed workplace). Recreational, transportation and occupational/household PA, as well as leisure screen time and sleep duration were self-reported. Logistic regression assessed associations between work location and adherence to movement behaviour recommendations, adjusting for covariates. RESULTS: Compared to a fixed workplace, those teleworking reported more recreational PA (21.1 vs 17.0 min/day, p < 0.0001) and sleep (7.2 vs 7.1 h/night, p = 0.026) and were more likely to meet sleep duration recommendations (adjusted odds ratio [aOR] = 1.28, 95% CI: 1.08-1.51) and the 24-H Guidelines (aOR = 1.25, 95% CI: 1.04-1.51). Compared to fixed workplaces, those at non-fixed workplaces reported more occupational PA (62.7 vs 32.8 min/day, p < 0.0001) and less leisure screen time (2.5 vs 2.7 h/day, p = 0.021), and were more likely to meet the PA recommendation (aOR = 1.46, 95% CI: 1.15-1.85) and the 24-H Guidelines (aOR = 1.38, 95% CI: 1.09-1.75). CONCLUSIONS: Results suggest that adherence to the 24-H Guidelines varies by work location, and work location should be considered when developing strategies to promote healthy movement behaviours. Future studies could explore hybrid work arrangements, and longitudinal study designs.

Sociodemographic differences in recreational screen time before and during the COVID-19 pandemic in Canada.

Background: Over the last several years, recreational screen time has been increasing. During the COVID-19 pandemic, recreational screen time rose among Canadian youth and adults, and those who increased screen time had poorer self-reported mental health compared with those who decreased or maintained their recreational screen time levels. Data and methods: Using data from the 2017, 2018, and 2021 Canadian Community Health Survey, the prevalence of meeting the recreational screen time recommendation from the Canadian 24-Hour Movement Guidelines was compared before and during the pandemic across sociodemographic groups. Logistic regression was used to identify sociodemographic groups that were more likely to meet the recreational screen time recommendation before and during the pandemic. Results: The amount of time Canadians spent engaging in daily recreational screen time increased from 2018 to 2021, leading to fewer youth and adults meeting the recreational screen time recommendation during the pandemic compared with before. The prevalence of meeting the recommendation was lower during the pandemic compared with before the pandemic among almost all sociodemographic groups. Among youth, living in a rural area was associated with a greater likelihood of meeting the recommendation before and during the pandemic. Among adults, the following characteristics were all associated with a greater likelihood of meeting the recommendation during the pandemic: being female; living in a rural area or a small population centre; identifying as South Asian; being an immigrant to Canada; living in a two-parent household; being married or in a common-law relationship or widowed, separated, or divorced; working full time; and being a health care worker. Interpretation: The prevalence of meeting the recreational screen time recommendation during the pandemic was lower overall compared with before the pandemic. Several sociodemographic groups were more likely to meet the recommendation during the pandemic. Continued surveillance of recreational screen time is necessary to monitor the indirect effects of the pandemic and to identify population subgroups that would benefit from tailored interventions in the pandemic recovery period.

Identifying Risk Profiles for Nonadherence to the 24-Hour Movement Guidelines for Children and Youth 6 Months Into the COVID-19 Pandemic.

PURPOSE: The purposes of the current study were to identify risk profiles for nonadherence among children and youth (5-17 y) at the 6-month mark of the COVID-19 pandemic and to discuss similarities and differences between risk profiles identified in the current study and those identified at the 1-month mark of the pandemic. METHODS: Data were part of a nationally representative sample of 1143 parents (Mage = 43.07 y, SD = 8.16) of children and youth (5-17 y) living in Canada. Survey data were collected in October 2020. RESULTS: Results showed that 3.8% met all movement behavior recommendations, 16.2% met the physical activity recommendation, 27% met the screen time recommendation, and 63.8% met the sleep recommendation. Characteristics associated with nonadherence to all movement behaviors included low parental perceived capability to restrict screen time and decreased overall time spent outdoors. Characteristics associated with nonadherence to the physical activity and screen time recommendations included youth (12-17 y), low parental perceived capability to restrict screen time, decreased time spent outdoors, and increased screen time. CONCLUSION: Results emphasized the importance of parental perceived capability to restrict screen time and children's and youth's outdoor time and showed that pandemic-related factors have impacted children and youth differently.

Sleep behaviours among Canadian adults: Findings from the 2020 Canadian Community Health Survey healthy living rapid response module.

INTRODUCTION: The Canadian 24-Hour Movement Guidelines for Adults, released in October 2020, recommend 7 to 9 hours of good-quality sleep for adults aged 18 to 64 and 7 to 8 hours for adults aged 65 and older, on a regular basis, with consistent sleep and wake times for health benefits. This study assesses the sleep behaviours of Canadian adults and how these behaviours align with the recommendations. DATA AND METHODS: This cross-sectional study uses nationally representative data from the 2020 Canadian Community Health Survey healthy living rapid response module (N = 9,248), collected from January to March 2020. Sleep behaviours were self-reported by respondents, and descriptive statistics were used to calculate means or percentages for sleep duration, guideline adherence, physical activity and screen time, sleep timing, and sleep variability in the full sample. This was done by age, sex, household education, household income adequacy and employment status. RESULTS: Mean sleep duration was 7.9 hours for adults aged 18 to 64, with 77% meeting sleep duration recommendations, and 8.1 hours for adults aged 65 and older, with 55% meeting sleep duration recommendations. Among adults aged 18 to 64, 61% reported high sleep quality, compared with 71% among adults aged 65 and older. High sleep variability (≥30-minute difference between work and free days) and poor sleep-facilitating behaviours were prevalent. Adults who reported high sleep quality and high sleep variability were more likely to meet sleep duration recommendations. INTERPRETATION: To maximize health benefits, continued efforts are needed to promote good sleep behaviours among Canadian adults. Device-based measures of sleep could improve surveillance and research.

The influence of removing the 10-minute bout requirement on the demographic, behaviour and health profiles of Canadian adults who meet the physical activity recommendations.

Background: Recently, the Canadian 24-Hour Movement Guidelines for Adults were released, and included a revised physical activity (PA) recommendation. The recommendation of 150 minutes per week of moderate-to-vigorous intensity PA (MVPA) was revised, from requiring that MVPA be accrued in bouts of 10 minutes or more (bouted) to having no bout requirement (non-bouted). The objective of this study was to assess whether there were differences in sociodemographic, health and fitness characteristics of Canadians who met the bouted and non-bouted PA recommendations. Data and methods: Using adult (aged 18 to 79 years) accelerometer data from three combined cycles of the nationally representative Canadian Health Measures Survey (N = 7,102), this study compared adherence to the bouted and non-bouted recommendations. Differences in sociodemographic, health and fitness measures were assessed using independent t-tests and chi-squares. Multivariate linear and logistic regressions controlling for age, sex, household education and smoking examined associations with health and fitness measures. Results: More adults met the PA recommendation using the non-bouted versus bouted (45.3% vs. 18.5%) requirement. Characteristics of those who met the bouted and only the non-bouted recommendations were similar. Exceptions among those who met only the non-bouted recommendation compared with meeting the bouted recommendation included fewer adults aged 65 years and older; lower MVPA, recreation PA and transport PA; and higher sedentary time, light PA and grip strength. Interpretation: Although the removal of the 10-minute bout requirement increased the proportion of Canadian adults who met the PA recommendation, there were no substantial differences in the sociodemographic and health characteristics of the populations captured by the bouted and non-bouted definitions. Results help to inform the transition in reporting for PA surveillance.

Health associations with meeting the Canadian 24-hour movement guidelines for adults: Results from the Canadian Health Measures Survey.

BACKGROUND: The Canadian 24-Hour Movement Guidelines for Adults (18-64 years and 65 years or older) were launched in October 2020 and provide evidence-based recommendations for physical activity, sedentary behaviour and sleep. The purpose of this study was to examine whether meeting the 24-Hour Movement Guidelines overall, and different combinations of recommendations within the guidelines, was associated with health indicators in a representative sample of Canadian adults. DATA AND METHODS: Participants were 8,297 adults aged 18 to 79 from cycles 1 to 3 of the Canadian Health Measures Survey. They were classified as meeting or not meeting each of the recommendations required for overall guideline adherence: moderate-to-vigorous physical activity (150 minutes or more per week), sedentary behaviour (8 hours or less per day or 9 hours or less per day of sedentary time, including 3 hours or less per day of recreational screen time) and sleep duration (7 to 9 hours per day for adults 18 to 64 years old, 7 to 8 hours per day for adults aged 65 years or older). A combination of self-reported and device-based measures were used. Indicators of adiposity (n=2), aerobic fitness (n=1) and cardiometabolic health (n=7) were measured. RESULTS: A total of 19.1% of the sample met none of the recommendations, 43.9% met one of them, 29.8% met two and 7.1% met all three. Compared with meeting no recommendations, meeting one, two and all three recommendations was associated with better health for one, six and seven health indicators, respectively (p < 0.05). Compared with adults meeting two or fewer recommendations, those who met all three recommendations had more favourable body mass index; waist circumference; aerobic fitness scores; and triglyceride, insulin, C-reactive protein and serum glucose levels (p < 0.05). INTERPRETATION: These findings provide support for the 24-Hour Movement Guidelines and show that less than 1 in 10 Canadian adults are meeting all three of the healthy movement behaviour guidelines.

How sedentary are Canadian adults? It depends on the measure.

Introduction: The new Canadian 24-Hour Movement Guidelines for Adults aged 18-64 years and Adults aged 65 years and older recommend that adults limit daily sedentary time to eight hours or less, including three hours or less of recreational screen time. The eight-hour recommendation was centred between the evidence from research using self-reported sitting time (threshold: seven hours or less per day) and accelerometer-measured sedentary time (threshold: nine hours or less per day). The purpose of this study is to compare the percentages of Canadians meeting three different sedentary thresholds (three hours or less per day of screen time, seven hours or less per day of self-reported sitting time and nine hours or less per day of accelerometer-measured sedentary time). Methods: This analysis is based on 2,511 adults (aged 18 to 79 years) from Cycle 3 of the Canadian Health Measures Survey, in 2012 and 2013. Screen time and sitting time were assessed via self-report, and average daily sedentary time was assessed using a hip-worn Actical accelerometer. Results: Adults self-reported an average daily screen time of 3.2 hours (95% confidence interval [CI]: 3.0 to 3.5) and an average daily sitting time of 5.7 hours (95% CI: 5.4 to 6.0). According to accelerometry data, adults accumulated an average of 9.8 hours per day (95% CI: 9.7 to 9.9) of sedentary time. Adherence varied, with 57.7% meeting the self-reported recreational screen time threshold of three hours or less per day, 71.7% meeting the self-reported sitting time threshold of seven hours or less per day and 26.5% meeting the accelerometer-measured sedentary time threshold of nine hours or less per day. Interpretation: The percentage of Canadian adults meeting the three different sedentary behaviour thresholds varied widely. The findings in this article highlight the difference in sedentary time between what Canadians report versus what is measured by an accelerometer.

Sedentary behaviour surveillance in Canada: trends, challenges and lessons learned.

BACKGROUND: Historical changes in the nature of sedentary activities have been observed in other countries, but it is not clear if similar trends exist in Canada. It is also unclear how changes in the measurement of sedentary behaviour affects national estimates. Our objective is to document all sources and measures of sedentary behaviour from Canadian, nationally representative surveys, and report on selected estimates of time spent in sedentary activities. Lessons learned can benefit the wider international surveillance community. METHODS: We describe and document all data sources of sedentary behaviour at the national level in Canada, and report on selected prevalence data from repeated cross-sectional surveys. We summarize amounts of total device-assessed sedentary time and self-reported sedentary activities (e.g., passive travel, leisure television, computer, video games, screen, and reading) by age group over time. RESULTS: Nineteen national surveys were identified. Changes in questions and/or response categories precluded direct assessment of trends over time for some measures; however, certain trends were observed. Accelerometer-measured sedentary time, leisure reading (among those < 50 years) and television/video viewing in younger age groups have remained relatively stable (with a possible slight decline in television/video viewing). Time spent in passive travel and leisure computer and electronic device use appears to have increased. Television and video viewing appears to have increased in older adults while their leisure reading appears to have fallen. CONCLUSIONS: Changes in measurement of sedentary behaviour can affect estimates and reduce comparability over time. Total leisure screen use appears to have increased over time, reflecting the ways in which Canadians spend their free time and technological advances. The main public health message is the need for continued efforts to reduce leisure screen use, especially among youth and older adults.

Gender and education differences in sedentary behaviour in Canada: an analysis of national cross-sectional surveys.

BACKGROUND: Canadians spend the majority of their days sedentary. Gender and education are important social determinants of health that impact health behaviours. There is evidence that gender and educational differences in sedentary behaviour exist. In Canada, while general trends suggest that leisure sedentary activities have changed; there has been no comprehensive assessment examining whether historical changes in sedentary behaviour differ by gender and education level. Our objective was to examine whether gender and educational differences in accelerometer-measured sedentary time and self-reported sedentary behaviours exist among Canadians and if differences are consistent across age groups, over time and across multiple survey sources. METHODS: We summarize amounts of total accelerometer-measured sedentary time and self-reported sedentary activities (e.g., passive travel, television, computer, video games, screen, reading) by age (i.e. children: 6-11 years, youth: 12-17 years, adults: 18-34 years, 45-49 years, 50-64 years, and older adults: ≥ 65 years), gender (girls/women, boys/men) and household education level (< post-secondary vs. ≥ post-secondary) over time in the Canadian Community Health Survey, Canadian Health Measures Survey, General Social Survey, and the Health Behaviour in School-Aged Children study. Gender and education level differences are examined using independent sample t-tests or chi-square analyses. RESULTS: While few differences were found for total accelerometer-measured sedentary time, gender and education differences in self-reported, type-specific sedentary behaviour were identified. Among youth, data from all surveys consistently identified that boys engaged in more video/computer game play (e.g., boys: 0.35-2.68 vs. girls: 0.09-2.15 h/day), while girls engaged in more leisure reading (e.g., boys: 0.45-0.65 vs. girls: 0.71-0.99 h/day). Those with a higher education or household education often reported more leisure reading and passive travel. Education level differences in screen time were often age dependent, with leisure computer use greater in higher education groups in adults only and leisure television watching generally higher in lower education groups in children and adults, but not youth. CONCLUSIONS: This information is valuable as it helps to identify segments of the population which may be at greater risk for engaging in higher volumes of sedentary behaviour. In turn, this information can identify target audiences and behaviours for policies and interventions. Future work is needed to further understand factors contributing to these differences (e.g., preferences, occupation, family structure).

Physical activity, screen time and sleep duration: Combined associations with psychosocial health among Canadian children and youth.

BACKGROUND: Canada recently adopted the 24-Hour Movement Guidelines for Children and Youth (24-Hour Guidelines) for young people aged 5 to 17 years-an international first, providing integrated recommendations for physical activity, sedentary time and sleep. Since the release of the guidelines, very few studies have examined the associations of adherence to the 24-Hour Guidelines with health outcomes-and none focus on psychosocial health. Therefore, the objective of this study was to assess the associations of meeting the 24-Hour Guidelines and their behaviour-specific recommendations with psychosocial health among Canadian children and youth. DATA AND METHODS: This cross-sectional study included 4,250 children and youth aged 5 to 17 years with valid accelerometer data. The study data were collected from 2009 to 2015 with the Canadian Health Measures Survey and pooled. Moderate-to-vigorous physical activity was measured using accelerometers; screen time, sleep duration and measures of psychosocial health were self- or proxy-reported. Multivariate logistic regression models were used to examine the associations of meeting individual or different combined recommendations from the 24-Hour Guidelines with psychosocial health. RESULTS: There was low overall adherence to all three 24-Hour Guidelines recommendations, especially among youth (children: 13.9%, youth: 4.8%). Meeting two or more of the recommendations was associated with higher odds of positive psychosocial health among youth (odds ratio [OR] = 3.10; 95% confidence interval [CI]: 1.17-8.19). Sleep duration and screen time were strongly associated with social behaviour and psychosocial health among Canadian youth. DISCUSSION: Adherence to the 24-Hour Guidelines was significantly associated with better psychosocial health among Canadian youth.

Daily physical activity and sedentary behaviour across occupational classifications in Canadian adults.

BACKGROUND: Adults spend a large proportion of their day at work. Physical activity (PA) and sedentary behaviour (SB) have been shown to vary considerably between occupations. The objective of this study is to describe occupational differences in accelerometer-measured and self-reported PA and SB for Canadian full-time workers. DATA AND METHODS: Using combined data from three cycles of the nationally representative Canadian Health Measures Survey (N = 4,080), three activity groups (high, intermediate, low) were created based on a composite ranking of accelerometer-derived steps, proportion of time spent sedentary (SED%) and moderate-to-vigorous intensity physical activity (MVPA) in bouts of ⋝10 minutes (MVPAbouted). Differences between groups were assessed for accelerometer-derived and self-reported PA and SB, and sociodemographic and clinical characteristics. RESULTS: On average, Canadians employed in full-time work were sedentary for 68.9% of their day (95% confidence interval [CI]: 68.3% to 69.6%), took 8,984 steps per day (95% CI: 8,719 to 9,249) and accumulated 79.5 minutes per week of MVPAbouted (95% CI: 71.1 to 87.9). Among Canadians employed in full-time work, 18.5% met the Canadian Physical Activity Guidelines. The high-activity group took significantly more steps and had a lower SED%, but spent a higher proportion of time in light-intensity PA compared with the intermediate- and low-activity groups. No differences were observed for MVPA. The low-activity group reported more recreational and active travel-related PA and leisure reading, while those in the high-activity group reported more work and domestic PA and leisure screen time. DISCUSSION: The majority of full-time working adults are not getting adequate MVPA and spend most of their day sedentary, regardless of occupation. Findings support workplace policies to improve MVPA levels among Canadian workers and to promote awareness for the potential benefit of occupation-specific messaging around PA and SB.

Comparison of self-reported and accelerometer-measured physical activity among Canadian youth.

BACKGROUND: Generally, correlation and agreement between self-reported and accelerometer-measured physical activity are low. The objective of this study is to compare estimates of physical activity from a newly developed Canadian questionnaire with measurements by accelerometer among 12- to 17-year-olds. DATA AND METHODS: Physical activity was self-reported by domain (transportation, recreation, school, and occupational/household) as part of the new Physical Activity Youth Questionnaire (PAYQ) in the Canadian Health Measures Survey (CHMS; 2014-2017; n = 975) and the Canadian Community Health Survey (CCHS; 2015-2016; n=7,619). The CHMS also collected moderate-to-vigorous physical activity (MVPA) data using the Actical accelerometer. Descriptive statistics and correlation and agreement analyses were used to compare and contrast self-reported and accelerometer-measured physical activity variables. Linear regression was used to assess the association between physical activity and obesity. RESULTS: The average daily MVPA measured by accelerometry was 49.7 minutes per day. According to the PAYQ, Canadian youth reported an average of 78.2 minutes of physical activity per day from all domains, including recreation (31.3 minutes per day), transportation (15.5 minutes per day), school (25.8 minutes per day), and occupational/household (5.6 minutes per day). According to accelerometer-measured MVPA, 23.1% of youth met the physical activity guideline. The inclusion of all domains of self-reported physical activity resulted in a higher percentage of youth meeting the physical activity guideline (58.6%) than was the case for the recreation domain only (18.5%) or the sum of the recreation and school domains (34.0%). Overall, self-reported and accelerometer-measured physical activity estimates were poorly correlated (R ⟨ 0.2). DISCUSSION: Population-level estimates of physical activity and the percentage of youth meeting the physical activity guideline were well-aligned between the Actical and the PAYQ; however, large differences were evident at the individual level. Therefore, caution should be exercised in using data from these two methods since their values may not be interchangeable.

Comparison of self-reported and accelerometer-measured physical activity in Canadian adults.

BACKGROUND: Self-reported and accelerometer-measured physical activity levels generally exhibit low correlation and agreement. The objective of this study is to compare estimates of physical activity among adults from a newly developed Canadian questionnaire with those obtained objectively by accelerometry. DATA AND METHODS: Data for 18- to 79-year-olds (N = 2,372) were collected in 2014 and 2015 as part of the Canadian Health Measures Survey (CHMS). Moderate-to-vigorous physical activity (MVPA) was reported on the household questionnaire by domain (transportation, recreation, and occupational or household) as part of the new Physical Activity Adult Questionnaire (PAAQ) and measured objectively using the Actical accelerometer. Correlation and mean difference analyses were used to assess the relationships between measured and reported physical activity variables. Linear regression was used to test the association between measured and reported physical activity and measures of obesity. RESULTS: On average, Canadian adults reported more physical activity than they accumulated on an accelerometer (49 minutes versus 23 minutes per day). The highest correlation observed was between accelerometer-measured MVPA and the sum of self-reported recreation and transportation activity (R = 0.36, p ⟨ 0.0001). The sum of activity from all domains (recreation + transportation + occupational or household) exhibited a lower correlation with measured variables because the occupational or household domain was negatively correlated with MVPA (R = -0.04). The occupational or household domain was positively correlated with light-intensity physical activity (R = 0.20, p ⟨ 0.0001). Respondents in the least active quintile were more likely than those in the most active quintile to report more activity than was measured by the accelerometer. On average, the most active quintile reported less activity than was measured by the accelerometer. DISCUSSION: The newly developed Canadian physical activity questionnaire exhibited modest correlation and agreement with accelerometer-measured physical activity among adults. Accelerometers and questionnaires provide complementary information, about different aspects of physical activity (actual movement versus perceived time). Consequently, one should exercise caution in using estimates derived from these methods interchangeably.

Proportion of preschool-aged children meeting the Canadian 24-Hour Movement Guidelines and associations with adiposity: results from the Canadian Health Measures Survey.

BACKGROUND: New Canadian 24-Hour Movement Guidelines for the Early Years have been released in 2017. According to the guidelines, within a 24-h period, preschoolers should accumulate at least 180 min of physical activity (of which at least 60 min is moderate-to-vigorous physical activity), engage in no more than 1 h of screen time, and obtain between 10 and 13 h of sleep. This study examined the proportions of preschool-aged (3 to 4 years) Canadian children who met these new guidelines and different recommendations within the guidelines, and the associations with adiposity indicators. METHODS: Participants were 803 children (mean age: 3.5 years) from cycles 2-4 of the Canadian Health Measures Survey (CHMS), a nationally representative cross-sectional sample of Canadians. Physical activity was accelerometer-derived, and screen time and sleep duration were parent-reported. Participants were classified as meeting the overall 24-Hour Movement Guidelines if they met all three specific time recommendations for physical activity, screen time, and sleep. The adiposity indicators in this study were body mass index (BMI) z-scores and BMI status (World Health Organization Growth Standards). RESULTS: A total of 12.7% of preschool-aged children met the overall 24-Hour Movement Guidelines, and 3.3% met none of the three recommendations. A high proportion of children met the sleep duration (83.9%) and physical activity (61.8%) recommendations, while 24.4% met the screen time recommendation. No associations were found between meeting individual or combined recommendations and adiposity. CONCLUSIONS: Very few preschool-aged children in Canada (~13%) met all three recommendations contained within the 24-Hour Movement Guidelines. None of the combinations of recommendations were associated with adiposity in this sample. Future work should focus on identifying innovative ways to reduce screen time in this population, and should examine the associations of guideline adherence with health indicators other than adiposity.

Meeting the Canadian 24-Hour Movement Guidelines for Children and Youth.

BACKGROUND: The Canadian 24-Hour Movement Guidelines for Children and Youth: An Integration of Physical Activity, Sedentary Behaviour, and Sleep, provide specific recommendations on the amount of time over a typical 24-hour day that children and youth aged 5 to 17 should spend in moderate-to-vigorous physical activity (at least 60 minutes), recreational screen time (no more than 2 hours), and sleep (9 to 11 hours for 5- to 13-year-olds; 8 to 10 hours for 14- to 17-year-olds). DATA AND METHODS: Based on combined results of cycles 2 (2009-to-2011) and 3 (2012-to-2013) of the Canadian Health Measures Survey, this analysis examines average daily moderate-to-vigorous physical activity, screen time and sleep duration of 5- to 11-year-olds and 12- to 17-year-olds, and the percentages meeting the 24-Hour Guidelines' recommendations. Findings are presented overall and by age group and sex. Differences in average daily times between groups were tested for statistical significance, as weredifferences between groups in the percentages meeting each recommendation and combination of recommendations. RESULTS: Overall, 17.5% of children and youth met the 24-Hour Guidelines' specific time recommendations. Higher percentages of children than youth (29.6% versus 5.5%) and boys than girls (22.9% versus 11.8%) met the recommendations. About a third (36.3%) met two of the three recommendations. INTERPRETATION: Recommendations for moderate-to-vigorous physical activity, sedentary behaviour, and sleep have higher levels of adherence among children than youth.

Physical activity of Canadian children and youth, 2007 to 2015.

BACKGROUND: This study describes and compares the percentages of Canadian children and youth who adhere to different operational definitions of the moderate-to-vigorous physical activity (MVPA) recommendation of 60 minutes per day. DATA AND METHODS: Data for 6- to 17-year-olds (n = 5,608) were collected from 2007 through 2015 as part of the Canadian Health Measures Survey. MVPA was measured using the Actical accelerometer. The MVPA recommendation was operationalized as accumulating 60 minutes of MVPA every day, on most days, and on average. RESULTS: Data from the most recent cycle of the Canadian Health Measures Survey indicate that 7% of children and youth accumulated at least 60 minutes of MVPA on at least 6 out of 7 days, and 33% achieved a weekly average of at least 60 minutes per day. Boys accumulated more MVPA than did girls, and 6- to 11-year-olds accumulated more MVPA than did 12- to 17-year-olds. Regardless of how adherence to the recommendation is operationalized, MVPA levels among Canadian children and youth did not change over the 9-year period from 2007 to 2015. INTERPRETATION: The majority of Canadian children do not meet the physical activity recommendation, regardless of the operational definition used. However, the discrepancies between results based on different interpretations of the 60-minutes-per-day recommendation highlight the importance of explicitly reporting how recommendations are operationalized to avoid misinterpreting trends and comparisons.

Health care barriers and perceived mental health among adults in Canada during the COVID-19 pandemic: a population-based cross-sectional study. / Obstacles en matière de soins de santé et santé mentale perçue chez les adultes au Canada pendant la pandémie de COVID-19 : étude transversale fondée sur la population.

INTRODUCTION: The perceived mental health of individuals in Canada who faced health care barriers during the COVID-19 pandemic is underexplored. METHODS: We analyzed data collected March to June 2021 from adults who reported needing health care services within the past 12 months in the Survey on Access to Health Care and Pharmaceuticals during the Pandemic. Unadjusted and adjusted logistic regression analyses examined the associations between health care barriers (appointment scheduling problems, delaying contacting health care) and high self-rated mental health and perceived worsening mental health compared to before the pandemic, overall and stratified by gender, age group, number of chronic health conditions and household income tertile. RESULTS: Individuals who experienced pandemic-related appointment changes or had appointments not yet scheduled were less likely to have high self-rated mental health (aOR = 0.81 and 0.64, respectively) and more likely to have perceived worsening mental health (aOR = 1.50 and 1.94, respectively) than those with no scheduling problems. Adults who delayed contacting health care for pandemic-related reasons (e.g. fear of infection) or other reasons were less likely to have high self-rated mental health (aOR = 0.52 and 0.45, respectively) and more likely to have perceived worsening mental health (aOR = 2.31 and 2.43, respectively) than those who did not delay. Delaying contacting health care for pandemic-related reasons was associated with less favourable perceived mental health in all subgroups, while the association between perceived mental health and pandemic-related appointment changes was significant in some groups. CONCLUSION: Health care barriers during the pandemic were associated with less favourable perceived mental health. These findings could inform health care resource allocation and public health messaging.

Sedentary time at school and work in Canada.

OBJECTIVES: High levels of sedentary time (ST) are associated with poor physical and mental health. Given that Canadians spend a large portion of their days at school and work, they may be important targets for reducing ST. Our objectives are to estimate the daily amount of school and work ST among Canadians, examine differences by subgroups, and determine associations with health. METHODS: Using the 2020 Canadian Community Health Survey Healthy Living Rapid Response module (N = 5242), the amount of time spent sitting while at school and work was estimated among youth (12-17 years) and adults (18-34 and 35-64 years). Differences by sociodemographics and 24-Hour Movement Guideline adherence were assessed with independent t-tests. Associations between school and work ST and health indicators were assessed using adjusted logistic regression. RESULTS: Canadian youth aged 12-17 years and adults aged 18-34 years reported an average of 4.5 and 5.2 h/day of school ST, respectively. Adults 18-34 years and 35-64 years reported an average of 3.9 and 4.0 h/day of work ST, respectively. School and work ST differed within several subgroups. Among adults 18-34 years, higher school ST was associated with a reduced odds of 'excellent/very good' mental health, whereas higher work ST was associated with a greater likelihood of reporting 'excellent/very good' general health. CONCLUSION: Canadian youth and working-age adults report an average of 4-5 h/day sedentary at school or work. This is the first study estimating school and work ST in a representative sample of Canadians and will aid in increasing awareness of setting-specific behaviours to better inform targeted interventions including addressing inequalities in ST.

RéSUMé: OBJECTIFS: Des niveaux élevés de sédentarité sont associés à une mauvaise santé physique et mentale. Étant donné que les Canadiens passent une grande partie de leur journée à l'école et au travail, ils peuvent représenter des cibles privilégiées sur la question de la sédentarité. Nos objectifs sont les suivants : estimer le temps que les Canadiens passent assis par jour à l'école et au travail, c'est-à-dire le temps de sédentarité, examiner les différences qui existent entre les sous-groupes et déterminer les effets sur la santé. MéTHODES: À l'aide du module de réponse rapide concernant un mode de vie sain de l'Enquête sur la santé dans les collectivités canadiennes de 2020 (N = 5 242), nous avons estimé le temps passé assis à l'école et au travail chez les jeunes (12­17 ans) et chez les adultes (18­34 ans et 35­64 ans). Nous avons évalué les différences en fonction des données sociodémographiques et en fonction du respect (ou non) des directives en matière de mouvement sur 24 heures, ce à l'aide de tests indépendants. Grâce à une régression logistique ajustée, nous avons évalué le lien entre la sédentarité à l'école et au travail et les indicateurs de santé. RéSULTATS: Les jeunes Canadiens âgés de 12 à 17 ans et les adultes âgés de 18 à 34 ans ont déclaré un temps moyen de sédentarité par jour à l'école de 4,5 heures et de 5,2 heures respectivement. Les adultes de 18 à 34 ans et de 35 à 64 ans ont déclaré un temps moyen de sédentarité par jour au travail de 3,9 heures et de 4 heures respectivement. Le temps de sédentarité à l'école et au travail varie selon les sous-groupes. Chez les adultes de 18 à 34 ans, un temps de sédentarité plus élevé à l'école réduit la probabilité d'avoir une santé mentale « excellente/très bonne ¼, tandis qu'un temps de sédentarité plus élevé au travail est associé à une plus grande probabilité de déclarer une santé générale « excellente/très bonne ¼. CONCLUSION: Les jeunes Canadiens et les adultes en âge de travailler déclarent un temps de sédentarité moyen de 4 à 5 heures par jour à l'école ou au travail. Il s'agit de la première étude qui estime le temps de sédentarité à l'école et au travail dans un échantillon représentatif de Canadiens. Elle contribuera à mieux faire connaître les comportements spécifiques sur la question, afin de mieux guider les interventions ciblées, notamment la lutte contre les inégalités en matière de sédentarité.

Physical activity, organized sport participation and active transportation to school among Canadian youth by gender identity and sexual attraction. / Activité physique, participation à des sports organisés et utilisation du transport actif pour se rendre à l'école chez les adolescents canadiens par identité de genre et par orientation sexuelle.

INTRODUCTION: Regular physical activity is associated with a wide range of health benefits in youth. While previous studies have identified disparities in physical activity among youth by gender identity and sexual attraction, these have seldom been explored in Canadian youth. METHODS: Data from the 2019 Canadian Health Survey on Children and Youth were used to assess prevalence of and time spent in organized sports participation, total physical activity and active transportation by gender identity (non-cisgender vs. cisgender) among youth aged 12 to 17, and by sexual attraction (nonheterosexual attraction vs. heterosexual attraction) among youth aged 15 to 17. RESULTS: There was no difference in average minutes of total physical activity per week between non-cisgender and cisgender Canadian youth. Non-cisgender youth (which represent 0.5% of the population) averaged significantly fewer minutes of organized sports per week than their cisgender counterparts. There was some evidence of increased active transportation to school among non-cisgender youth, but insufficient power to detect significant differences. Canadian youth reporting any nonheterosexual attraction (which represent 21.2% of the population, including mostly heterosexual youth) were less likely to be regularly physically active and participate in organized sports than youth reporting exclusive heterosexual attraction. Differences were larger among males than females. Males reporting nonheterosexual attraction were more likely to use active transportation to get to school than their heterosexual counterparts. CONCLUSION: Non-cisgender youth and youth reporting nonheterosexual attraction tended to participate less in organized sports than their counterparts, but may have engaged in more active transportation. Mitigating the barriers associated with sport participation could increase physical activity among these groups.

Social isolation, loneliness and positive mental health among older adults in Canada during the COVID-19 pandemic. / Isolement social, solitude et santé mentale positive chez les aînés au Canada pendant la pandémie de COVID-19.

INTRODUCTION: Social isolation and loneliness are associated with poorer mental health among older adults. However, less is known about how these experiences are independently associated with positive mental health (PMH) during the COVID-19 pandemic. METHODS: We analyzed data from the 2020 and 2021 cycles of the Survey on COVID-19 and Mental Health to provide estimates of social isolation (i.e. living alone), loneliness and PMH outcomes (i.e. high self-rated mental health, high community belonging, mean life satisfaction) in the overall older adult population (i.e. 65+ years) and across sociodemographic groups. We also conducted logistic and linear regressions to separately and simultaneously examine how social isolation and loneliness are associated with PMH. RESULTS: Nearly 3 in 10 older adults reported living alone, and over a third reported feelings of loneliness due to the pandemic. When examined separately, living alone and loneliness were each associated with lower PMH. When assessed simultaneously, loneliness remained a significant independent factor associated with all three PMH outcomes (overall and across all sociodemographic groups), but living alone was only a significant factor for high community belonging in the overall population, for males and for those aged 65 to 74 years. CONCLUSION: Overall, social isolation and loneliness were associated with poorer wellbeing among older adults in Canada during the pandemic. Loneliness remained a significant factor related to all PMH outcomes after adjusting for social isolation, but not vice versa. The findings highlight the need to appropriately identify and support lonely older adults during (and beyond) the pandemic.