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.

Exploring the use of experimental small area estimates to examine the relationship between individual-level and area-level community belonging and self-rated health.

Background: Small area estimation refers to statistical modelling procedures that leverage information or "borrow strength" from other sources or variables. This is done to enhance the reliability of estimates of characteristics or outcomes for areas that do not contain sufficient sample sizes to provide disaggregated estimates of adequate precision and reliability. There is growing interest in secondary research applications for small area estimates (SAEs). However, it is crucial to assess the analytic value of these estimates when used as proxies for individual-level characteristics or as distinct measures that offer insights at the area level. This study assessed novel area-level community belonging measures derived using small area estimation and examined associations with individual-level measures of community belonging and self-rated health. Data and methods: SAEs of community belonging within census tracts produced from the 2016-2019 cycles of the Canadian Community Health Survey (CCHS) were merged with respondent data from the 2020 CCHS. Multinomial logistic regression models were run between area-level SAEs, individual-level sense of community belonging, and self-rated health on the study sample of people aged 18 years and older. Results: Area-level community belonging was associated with individual-level community belonging, even after adjusting for individual-level sociodemographic characteristics, despite limited agreement between individual- and area-level measures. Living in a neighbourhood with low community belonging was associated with higher odds of reporting being in fair or poor health, versus being in very good or excellent health (odds ratio: 1.53; 95% confidence interval: 1.22, 1.91), even after adjusting for other factors such as individual-level sense of community belonging, which was also associated with self-rated health. Interpretation: Area-level and individual-level sense of community belonging were independently associated with self-rated health. The novel SAEs of community belonging can be used as distinct measures of neighbourhood-level community belonging and should be understood as complementary to, rather than proxies for, individual-level measures of community belonging.

Prioritizing a research agenda on built environments and physical activity: a twin panel Delphi consensus process with researchers and knowledge users.

BACKGROUND: The growth of urban dwelling populations globally has led to rapid increases of research and policy initiatives addressing associations between the built environment and physical activity (PA). Given this rapid proliferation, it is important to identify priority areas and research questions for moving the field forward. The objective of this study was to identify and compare research priorities on the built environment and PA among researchers and knowledge users (e.g., policy makers, practitioners). METHODS: Between September 2022 and April 2023, a three-round, modified Delphi survey was conducted among two independent panels of international researchers (n = 38) and knowledge users (n = 23) to identify similarities and differences in perceived research priorities on the built environment and PA and generate twin 'top 10' lists of the most important research needs. RESULTS: From a broad range of self-identified issues, both panels ranked in common the most pressing research priorities including stronger study designs such as natural experiments, research that examines inequalities and inequities, establishing the cost effectiveness of interventions, safety and injuries related to engagement in active transportation (AT), and considerations for climate change and climate adaptation. Additional priorities identified by researchers included: implementation science, research that incorporates Indigenous perspectives, land-use policies, built environments that support active aging, and participatory research. Additional priorities identified by knowledge users included: built environments and PA among people living with disabilities and a need for national data on trip chaining, multi-modal travel, and non-work or school-related AT. CONCLUSIONS: Five common research priorities between the two groups emerged, including (1) to better understand causality, (2) interactions with the natural environment, (3) economic evaluations, (4) social disparities, and (5) preventable AT-related injuries. The findings may help set directions for future research, interdisciplinary and intersectoral collaborations, and funding opportunities.

The ongoing impact of the COVID-19 pandemic on physical activity and screen time among Canadian youth.

Background: The COVID-19 pandemic has caused changes in health behaviours, including participation in physical activity and screen time. The purpose of this paper is to examine trends in physical activity and screen time among Canadian youth from January 2018 to February 2022. Methods: The Canadian Community Health Survey asks Canadian youth (aged 12 to 17 years) to report the time they spend active by domain: recreation, transportation, school and household. Survey respondents are also asked to report their screen time on school days and non-school days. The present analysis compares the physical activity from four cross-sectional samples collected during 2018 (January to December; n=3,952), January to March 2020 (n=911), September to December 2020 (n=1,573), and January 2021 to February 2022 (n=3,501). Screen time is compared between 2018 and 2021/2022. Sub-annual descriptive analyses examine how physical activity and screen time varied within and between these years. Results: Before the COVID-19 pandemic, half of Canadian youth met the physical activity recommendation (2018: 49.6%; January to March 2020: 53.7%). The percentage meeting the recommendation dropped in the first year of the pandemic (September to December 2020: 37.3%) and recovered slightly in 2021 (43.8%). From 2018 to 2021, total physical activity dropped by 8.3 minutes per day (58.1 minutes per week) among girls and by 2.1 minutes per day (14.7 minutes per week) among boys. The percentage of youth meeting the screen time recommendation on school days dropped from 40.7% in 2018 to 29.1% in 2021 and from 21.4% in 2018 to 13.2% in 2021 on non-school days. Interpretation: The COVID-19 pandemic had a detrimental impact on the physical activity and screen time of youth, in particular among girls. This analysis provides an update on how the pandemic has continued to affect the physical activity and screen habits of youth in 2020, 2021, and early 2022.

The ongoing impact of the COVID-19 pandemic on physical activity and screen time among Canadian adults.

Background: Canadian and international research has shown that the COVID-19 pandemic led to changes in health behaviours, including participation in physical activity and screen time. Methods: The Canadian Community Health Survey asks Canadian adults (aged 18 to 64 years) and older adults (aged 65 and older) to report the time they spend active by domain: recreation, transportation, and household and/or occupation. Survey respondents are also asked to report their screen time on days they worked and days they did not work. The present analysis compares the physical activity from four cross-sectional samples collected during 2018 (n=50,093), January to mid-March 2020 (n=13,933), September to December 2020 (n=25,661) and January 2021 to February 2022 (n=45,742). Screen time is compared between 2018 and 2021. Sub-annual analyses examine how physical activity and screen time varied within and between years. Results: The percentage of 18- to 64-year-old women meeting the physical activity recommendation did not change from 2018 (54.3%) to 2021 (55.1%), while a slight decrease was observed among men (63.0% in 2018 to 59.8% in 2021). The percentage of adults aged 65 years and older meeting the recommendation increased from 2018 to 2021 among both men (40.7% to 43.8%) and women (33.4% to 36.9%). Total physical activity decreased by 17.5 minutes per week among 18- to 64-year-old men and increased by 8.4 minutes per week among 18- to 64-year-old women. Men and women aged 65 and older increased their total physical activity by about 30 minutes per week from 2018 to 2021. The percentage of 18- to 64-year-old adults in the lowest screen time category decreased from 53.9% in 2018 to 45.0% in 2021 on work days and from 37.8% in 2018 to 28.0% in 2021 on non-work days. The percentage of adults aged 65 and older in the lowest screen time category decreased from 49.4% in 2018 to 37.8% in 2021 on work days and from 29.4% in 2018 to 21.5% in 2021 on non-work days. Interpretation: Physical activity among men aged 18 to 64 years decreased from 2018 to 2021, while women of this age group maintained their physical activity. Older adults increased their physical activity from 2018 to 2021. Many Canadian adults shifted from the lowest screen time category (two hours or less per day) to the highest screen time category (four hours or more per day) during the 2020 and 2021 pandemic years. It is unknown whether the short-term impact of the COVID-19 pandemic on physical activity and screen time will persist over time. Ongoing surveillance of the longer-term impacts of the pandemic on the health behaviours of Canadians is important.

Intersecting risk factors for physical inactivity among Canadian adults.

Background: On average, 45% of Canadian adults meet the recommended 150 minutes per week of moderate-to-vigorous physical activity. This singular statistic masks a wide range of adherence levels among different groups within the population. The purpose of this paper is to determine how sex, age, and family arrangement intersect with known risk factors for physical inactivity to identify groups within the Canadian population most at risk of not meeting the physical activity recommendation. Methods: Using six combined cycles of the Canadian Health Measures Survey (from 2007 to 2019), this study examines how the percentage of Canadian males and females aged 18 to 79 years meeting the physical activity recommendation differs across sociodemographic, family arrangement, and health factors. Logistic regression was used to examine whether the association between specific factors and adherence to the physical activity recommendation differed by sex. Latent class analysis was used to identify sex-specific combinations of sociodemographic, family arrangement and health-related factors within the Canadian population that are associated with varying levels of adherence to the physical activity recommendation. Results: More males met the physical activity recommendation compared with females (49% versus 38%). Latent classes with the lowest adherence to the physical activity recommendation (19% among females and 29% among males) primarily included those who were single or married with no children and who had a high probability of having many risk factors for physical inactivity, including being older, having a lower education, having lower income, smoking, having central adiposity, and having poor or fair self-rated general health. Latent classes with the highest adherence to the physical activity recommendation (61% among females and 67% among males) primarily included individuals with no spouse and no children and who had a low probability of having any risk factors for physical inactivity. For females, an additional class (32% of which met the physical activity recommendation) comprised young single mothers who had several risk factors for physical inactivity, including having low income, smoking and having central adiposity. Interpretation: Understanding how risk factors for physical inactivity intersect with sex, age, and family arrangement may inform strategies aimed at increasing physical activity among those who are most vulnerable.

The unequal impact of the COVID-19 pandemic on the physical activity habits of Canadians.

Background: Canadian and international research has shown that the COVID-19 pandemic has led to changes in health behaviours, including physical activity. Methods: The Canadian Community Health Survey asked Canadian youth (12 to 17 years) and adults (18 years and older) to report the amount of time they spent in the past seven days engaged in physical activity across the following domains: recreation, transportation, household or occupation, and school (youth only). The present analysis compares the physical activity from two cross-sectional samples collected during the fall of 2018 (n=13,482) and the fall of 2020 (n=27,234). Results: Youth reported accumulating, on average, two hours less physical activity per week in the fall of 2020 compared with the fall of 2018 (-129 minutes per week). The percentage of youth meeting the Canadian physical activity recommendation for children and youth dropped from 50.8% in the fall of 2018 to 37.2% in the fall of 2020. Physical activity decreased more among youth living in urban (-135 minutes per week) compared with rural (-86 minutes per week) areas. Physical activity decreased more among youth from Ontario (-168 minutes per week), Quebec (-121 minutes per week) and the Prairies (-106 minutes per week) compared with youth from the Atlantic provinces (-38 minutes per week) and British Columbia (-75 minutes per week). There was no change in the percentage of adults aged 18 and older meeting the Canadian physical activity recommendation between the fall of 2018 (52.7%) and the fall of 2020 (53.3%). Weekly physical activity was stable between fall 2018 and fall 2020 among 18 to 49 year olds, while significant increases were observed among adults aged 50 to 64 years (+41 minutes per week), 65 to 79 years (+55 minutes per week) and 80+ years (+20 minutes per week). Increases in physical activity among adults were statistically significant only among non-immigrant, non-Indigenous, those not designated as a visible minority, those living in urban areas and those with a postsecondary degree. Interpretation: The COVID-19 pandemic had a detrimental impact on the physical activity of youth but not adults. The findings of this study add to a growing body of evidence that shows the considerable impact the pandemic has had on many aspects of Canadian life, including physical activity.

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 new Canadian 24-Hour Movement Guidelines recommendations according to body mass index classes in Canadian adults.

Background: Data on meeting the Canadian 24-Hour Movement Guidelines for adults (24-H Guidelines) and associations with health indicators by body mass index (BMI) class are needed to support public health surveillance. The aim of this study was to describe the proportion of Canadian adults meeting individual and various combinations of the 24-H Guidelines by BMI class and their association with health indicators. Data and methods: Data from the cross-sectional Canadian Health Measures Survey cycles 1 to 4 (2007 to 2015, n = 10,515 adults aged 18 to 79 years) were used. Daily time spent in moderate-to-vigorous physical activity (MVPA) and sedentary behaviour were assessed using accelerometry. Sleep duration, recreational screen time, chronic conditions, sociodemographic characteristics, and general and mental health were self-reported. The BMI, waist circumference, blood pressure and aerobic fitness were directly measured. Respondents were classified as meeting the 24-H Guidelines when: • the MVPA was 150 minutes per week or more; • sedentary time was nine hours or less per day; • recreational screen time was three hours or less per day; • sleep duration was seven to nine hours per day for individuals aged 18 to 64 years or seven to eight hours per day for individuals aged 65 years and older. Results: Significantly fewer adults with overweight (6.1%) or class I (4.3%) and class II or III (3.9%) obesity met all three 24-H Guidelines compared with those with normal weight (9.5%). Meeting all three or two recommendations of the 24-H Guidelines was generally associated with a lower waist circumference, higher aerobic physical fitness and self-perceived general health regardless of BMI class. Interpretation: Canadian adults living with overweight and obesity are less likely to meet the 24-H Guidelines. Most of the benefits associated with meeting the 24-H Guidelines are observed regardless of BMI status.

Changes in chronic disease risk factors and current exercise habits among Canadian adults living with and without a child during the COVID-19 pandemic.

Background: Canadians have been gravely impacted by the COVID-19 pandemic, and adults living with children may have been disproportionately impacted. The objective of this study was to describe changes in chronic disease risk factors and current exercise habits among adults living with and without a child younger than 18 years old. Data and Methods: A repeated cross-sectional study was conducted using data collected from Canadians aged 15 and older via the Canadian Perspective Survey Series (CPSS) in late March (CPSS1, N=4,383), early May (CPSS2, N=4,367) and mid-July 2020 (CPSS4, N=4,050). This analysis included participants aged 25 and older. At three points during 2020, participants reported whether they increased, decreased, or had not changed their consumption of alcohol, tobacco and junk food or sweets, their screen use, and whether they currently exercised indoors or outdoors. Behaviours were compared for adults living with and without a child, and unadjusted odds ratios (OR) and 95% confidence intervals (CI) were estimated using logistic regression. Results: The presence of a child in the household was associated with higher odds of increased (compared with decreased or no change) alcohol consumption at all three time points, consumption of junk food and sweets at CPSS1 (OR: 1.69, 95% CI: 1.09-2.60), and time on the Internet at CPSS1 (OR: 1.59, 95% CI: 1.05-2.41) and CPSS4 (OR: 1.56, 95% CI: 1.05-2.29). Compared with older adults (aged 55 and older), younger adults (aged 25 to 54) were more likely to exhibit increases in chronic disease risk factors regardless of the presence of a child in the household. Interpretation: A substantial proportion of Canadian adults reported increased chronic disease risk factors during the pandemic, with greater increases noted among adults living with a child, compared with those living without a child. Public health interventions are urgently needed to mitigate the long-term impact of the pandemic on population health.

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.

A pan-Canadian dataset of neighbourhood retail food environment measures using Statistics Canada's Business Register.

BACKGROUND: The objective of this study was to create the Canadian Food Environment Dataset (Can-FED) and to demonstrate its validity. DATA AND METHODS: Food outlet data were extracted from Statistics Canada's Business Register (BR) in 2018. Retail food environment access measures (both absolute and relative measures) were calculated using network buffers around the centroid of 56,589 dissemination areas in Canada. A k-medians clustering approach was used to create categorical food environment variables that were easy to use and amenable to dissemination. Validity of the measures was assessed by comparing the food environment measures from Can-FED with measures created using Enhanced Points of Interest data by DMTI Spatial Inc. and data from a municipal health inspection list. Validity was also assessed by calculating the geographic variability in food environments across census metropolitan areas (CMAs) and assessing associations between CMA-level food environments and CMA-level health indicators. RESULTS: Two versions of Can-FED were created: a researcher file that must be accessed within a secure Statistics Canada environment and a general-use file available online. Agreement between Can-FED food environment measures and those derived from a proprietary dataset and a municipal health inspection list ranged from rs=0.28 for convenience store density and rs=0.53 for restaurant density. At the CMA level, there is wide geographic variation in the food environment with evidence of patterning by health indicators. INTERPRETATION: Can-FED is a valid and accessible dataset of pan-Canadian food environment measures that was created from the BR, a data source that has not been explored fully for health research.

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.

Data profile: Expanding the research potential of the Canadian Health Measures Survey using paired respondent data.

The family environment is an important influence on the health and behaviours of children. Few large-scale datasets include detailed and objectively measured health data about multiple individuals from the same family who are living in the same household. The Canadian Health Measures Survey (CHMS) is a repeating, cross-sectional survey that selects two members of a household-a child and a randomly selected older member of the household aged 12 to 79 years-with at least one child aged 3 to 11 years in residence. These paired respondent records, available in the CHMS relationship files, provide unique opportunities to researchers interested in examining associations between two members of the same household for health behaviours and outcomes. A range of pairings are captured in the relationship files (e.g., parent and child, siblings, grandchild and grandparent) with birth parent-child pairs being the most common. These paired respondent data are an important analytical asset of the CHMS and enhance the research potential of the survey significantly.

Do fit kids have fit parents?

BACKGROUND: Physical fitness is an important indicator of current and future health status. This analysis examines the relationships among child-parent dyads in physical fitness measures. DATA AND METHODS: The analysis is based on biological child-parent dyads from three cycles of the Canadian Health Measures Survey (Cycle 1: 2007 to 2009, Cycle 2: 2009 to 2011, and Cycle 5: 2016 to 2017). Physical fitness components-cardiorespiratory (CRF) (n = 615), muscular strength (n = 1,319) and flexibility (n = 1,295)-were measured at mobile examination centres using standardized fitness tests. Descriptive, correlation and regression analyses were used to examine relationships among child-parent dyads. RESULTS: CRF (R = 0.12), muscular strength (R = 0.23) and flexibility (R = 0.22) measures were weakly correlated among child-parent dyads. Modest increases in the physical fitness levels of children were observed with increases in the fitness rating scores of their parents. According to unadjusted and adjusted regression models, CRF (p< 0.05), muscular strength (p< 0.001) and flexibility (p< 0.001) were positively associated among child-parent dyads. When examined by sex of parent and child, CRF was significantly associated in mother-son dyads only, grip strength was associated in all dyad types except father-son pairings, and flexibility was associated in mother-son and father-son pairings only. DISCUSSION: A significant and positive association was evident in measured physical fitness among parents and children. Some variation in the presence and strength of associations existed according to child and parent sex.

Trends in physical fitness among Canadian adults, 2007 to 2017.

BACKGROUND: The fitness levels of Canadian adults declined substantially between 1981 and the years 2007 to 2009, suggesting a reduction in population health. This paper updates the fitness trends of Canadians aged 20 to 69 years by extending the time period to 2017. DATA AND METHODS: The Canadian Health Measures Survey is a repeated cross-sectional survey that is conducted to produce nationally representative health estimates. Descriptive statistics are presented for fitness measures in 2016 and 2017 by age and sex, and trends in fitness were calculated spanning a period of 10 years (2007 to 2017). The associations between fitness measures and meeting the 2020 Canadian physical activity recommendations were also assessed. RESULTS: From 2007 to 2017, there were few statistically significant changes in the fitness levels of Canadian adults. When all ages were combined, there were declining trends in predicted cardiorespiratory fitness, from 39.5 to 36.7 mL•kg⁻¹â€¢min⁻¹ among men and 34.0 to 32.2 mL•kg⁻¹â€¢min⁻¹ among women. Trends indicated declining flexibility among men. In general, meeting the current Canadian moderate-to-vigorous physical activity recommendation was associated with better fitness, particularly in the categories of predicted cardiorespiratory fitness and body composition. INTERPRETATION: The periodic assessment of fitness in Canadians provides valuable insight into population health. The present update provides evidence that fitness levels among adults have generally stabilized over the past 10 years. Taken with the reported declines in fitness that occurred from 1981 to the 2007-to-2009 period, this study shows that the fitness of Canadian adults remained low between 2007 to 2009 and 2016 to 2017. It is necessary to explore new ways to help improve the fitness levels of the Canadian population.

Exercise and screen time during the COVID-19 pandemic.

BACKGROUND: The objective of this paper is to describe the exercise and changes in screen time habits, and their relationship with health, among participants of the Canadian Perspectives Survey Series (CPSS). DATA AND METHODS: Between March 29th and April 3rd 2020, CPSS participants (n = 4,524) reported whether they were exercising outdoors or indoors and whether they increased, decreased or maintained their TV, Internet and video game use. Participants also reported their self-perceived general and mental health. RESULTS: More women reported very good or excellent mental health if they were exercising outdoors (54%) compared with those who were not (41%). More women reported very good or excellent general health if they were exercising outdoors (75%) compared with those who were not (49%), with the same trend evident for those exercising indoors (69%) compared to those who were not (62%). More men (65%) and women (62%) rated their mental and general health as very good or excellent if they maintained or decreased TV time compared with those who increased TV time (57% and 43%, respectively), with the same evident for Internet use in women only (maintained/decreased: 61% versus increased: 44%). More men (63%) and women (52%) rated their mental health as very good or excellent if they maintained or decreased video game time compared with those who increased video game time (48% and 29%, respectively). More men and women reported very good or excellent mental and general health if they increased none or one type of screen and/or were exercising outdoors compared with those who increased 2 or 3 types of screens and who were not exercising outdoors, with the exception of general health among men. DISCUSSION: Maintaining opportunities for outdoor exercise and limiting screen time may promote better mental and general health during periods of confinement.

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.