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.

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.

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.

Gender identity and sexual attraction among Canadian youth: findings from the 2019 Canadian Health Survey on Children and Youth. / Identité de genre et attirance sexuelle chez les jeunes Canadiens : résultats de l'Enquête canadienne sur la santé des enfants et des jeunes de 2019.

Gender identity and sexual attraction are important determinants of health. This study reports distributions of gender identity and sexual attraction among Canadian youth using data from the 2019 Canadian Health Survey on Children and Youth. Among youth aged 12 to 17, 0.2% are nonbinary and 0.2% are transgender. Among youth aged 15 to 17, 21.0%, comprising more females than males, report attraction not exclusive to the opposite gender. Given known associations between health and gender and sexual attraction, oversampling of sexual minority groups is recommended in future studies to obtain reliable estimates for identifying inequities and informing policy.

Gender and sexual attraction as a dimension of sexual orientation are important determinants of health among youth. Collecting gender and sexual attraction information as a routine part of public health surveillance is important for identifying inequities and informing policy. This study provides nationally representative estimates for the distribution of gender and sexual attraction among Canadian youth. This study identifies populations (nonbinary, transgender and same gender­attracted youth) that require oversampling or other approaches to ensure that reliable estimates can be obtained in public health surveillance.

Le genre et l'attirance sexuelle en tant que dimension de l'orientation sexuelle sont des déterminants importants de la santé chez les jeunes. La collecte de renseignements sur le genre et l'attirance sexuelle dans le cadre des activités habituelles de surveillance de la santé publique est importante pour relever les iniquités et orienter les politiques. Cette étude fait état d'estimations représentatives à l'échelle nationale de la répartition des genres et de l'attirance sexuelle chez les jeunes Canadiens. Cette étude répertorie les populations (non binaires, transgenres et jeunes ayant une attirance envers des personnes du même genre) devant faire l'objet d'un suréchantillonnage ou d'autres approches afin de garantir que des estimations fiables puissent être obtenues dans le cadre de la surveillance de la santé publique.

Strength-training and balance activities in Canada: historical trends and current prevalence. / Activités de musculation et d'amélioration de l'équilibre au Canada : historique des tendances et prévalence actuelle.

INTRODUCTION: Muscle-strengthening and balance activities are associated with the prevention of illness and injury. Age-specific Canadian 24-Hour Movement Guidelines include recommendations for muscle/bone-strengthening and balance activities. From 2000-2014, the Canadian Community Health Survey (CCHS) included a module that assessed frequency in 22 physical activities. In 2020, a healthy living rapid response module (HLV-RR) on the CCHS asked new questions on the frequency of muscle/bonestrengthening and balance activities. The objectives of the study were to (1) estimate and characterize adherence to meeting the muscle/bone-strengthening and balance recommendations; (2) examine associations between muscle/bone-strengthening and balance activities with physical and mental health; and (3) examine trends (2000-2014) in adherence to recommendations. METHODS: Using data from the 2020 CCHS HLV-RR, we estimated age-specific prevalence of meeting recommendations. Multivariate logistic regressions examined associations with physical and mental health. Using data from the 2000-2014 CCHS, sex-specific temporal trends in recommendation adherence were explored using logistic regression. RESULTS: Youth aged 12 to 17 years (56.6%, 95% CI: 52.4-60.8) and adults aged 18 to 64 years (54.9%, 95% CI: 53.1-56.8) had significantly greater adherence to the muscle/ bone-strengthening recommendation than adults aged 65 years and older (41.7%, 95% CI: 38.9-44.5). Only 16% of older adults met the balance recommendation. Meeting the recommendations was associated with better physical and mental health. The proportion of Canadians who met the recommendations increased between 2000 and 2014. CONCLUSION: Approximately half of Canadians met their age-specific muscle/bonestrengthening recommendations. Reporting on the muscle/bone-strengthening and balance recommendations elevates their importance alongside the already recognized aerobic recommendation.

Associations of sleep duration and sleep quality with indicators of mental health among youth and adults: findings from the 2015 Canadian Community Health Survey. / Associations entre durée et qualité du sommeil et indicateurs de santé mentale chez les jeunes et les adultes : résultats de l'Enquête sur la santé dans les collectivités canadiennes de 2015.

INTRODUCTION: A growing number of Canadian studies have examined the link between sleep and mental health. This research builds upon that work by investigating associations of sleep duration and quality with positive mental health (PMH) and mental illness and suicidal ideation (MI/SI) outcomes among youth and adults from threeCanadian provinces (i.e. Ontario, Manitoba and Saskatchewan). METHODS: Using cross-sectional data from respondents 12 years and older (n = 18 683) who were asked questions on their sleep in the 2015 Canadian Community Health Survey - Annual Component, we conducted unadjusted and adjusted logistic regressionswith self-reported measures of sleep duration and sleep quality as independent variables and a range of PMH (e.g. high self-rated mental health) and MI/SI indicators (e.g. mood disorder diagnosis) as dependent variables. Analyses were conducted of allcomplete cases and also stratified by sex and age group. RESULTS: Good sleep quality was associated with higher odds of PMH indicators (adjusted odds ratio [aOR]: 1.52-4.24) and lower odds of MI/SI indicators (aOR: 0.23- 0.47); associations remained significant when analyses were stratified. Meeting sleep duration recommendations was positively associated with PMH indicators (aOR: 1.27- 1.56) and negatively associated with MI/SI indicators (aOR: 0.41-0.80), but some associations did not remain significant when stratified. CONCLUSION: This study provides support for associations between sleep duration and quality and indicators of PMH and MI/SI. Findings can inform future research and surveillance efforts that monitor sleep behaviours and indicators of PMH and MI/SI.

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.

The association between social media use and physical activity among Canadian adolescents: a Health Behaviour in School-aged Children (HBSC) study.

OBJECTIVE: To determine the association between social media use (SMU) and physical activity (PA) among Canadian adolescents. METHODS: We used data from 12,358 participants in grades 6 to 10 who responded to the Canadian component of the 2017/2018 Health Behaviour in School-aged Children (HBSC) survey. Social media intensity and problematic SMU were assessed using a 4-point mutually exclusive scale that contained three categories based on intensity (non-active, active, and intense SMU) and one category based on the presence of addiction-like symptoms irrespective of intensity (problematic SMU). PA was assessed for five domains (i.e., school curriculum, organized sport, exercise, outdoor play, and active transport) and dichotomized using the first quartile to represent high PA engagement in each domain. Meeting PA recommendation of 60 min per day of moderate-to-vigorous PA was calculated using the sum of the five domains. Logistic regression models were used to assess the association between SMU and PA, with active SMU used as the reference group for all models. RESULTS: Non-active SMU was associated with lower odds of meeting the daily PA recommendations and of high engagement in all five domains of PA when compared to active SMU. Intense SMU was associated with higher odds of meeting the daily PA recommendations. Problematic SMU was not associated with meeting daily PA recommendations, but it was significantly associated with lower odds of high PA engagement in the exercise domain. CONCLUSION: The findings of this study suggest that non-active SMU was significantly associated with lower PA levels. Problematic SMU was only significantly associated with lower PA levels in the exercise domain. Intense SMU was associated with higher odds of meeting the PA recommendation.

RéSUMé: OBJECTIF: Établir la relation entre l'utilisation des médias sociaux et l'activité physique chez les adolescents canadiens. MéTHODES: Nous avons utilisé les données de 12 358 participants de la 6e à la 10e année qui ont répondu au volet canadien de l'Enquête sur les comportements de santé des jeunes d'âge scolaire de 2017­2018 (HBSC). L'intensité des médias sociaux et leur utilisation problématique ont été évaluées à l'aide d'une échelle à quatre points mutuellement exclusifs contenant trois catégories basées sur l'intensité (utilisation non active, active et intense des médias sociaux) et une catégorie basée sur la présence de symptômes de dépendance indépendamment de l'intensité (utilisation problématique des médias sociaux). L'activité physique a été évaluée pour cinq domaines (c'est-à-dire le programme scolaire, le sport organisé, l'exercice, le jeu en plein air et le transport actif) et dichotomisée en utilisant le premier quartile pour représenter la participation à une activité physique élevée dans chaque domaine. Le respect de la recommandation de 60 min par jour d'activité physique modérée à vigoureuse a été calculé en utilisant la somme des cinq domaines. Des modèles de régression logistique ont été utilisés pour évaluer la relation entre l'utilisation des médias sociaux et l'activité physique, l'utilisation active des médias sociaux étant utilisée comme groupe de référence pour tous les modèles. RéSULTATS: L'utilisation non active des médias sociaux était associée à une probabilité plus faible de respecter les recommandations en matière d'activité physique quotidienne et à une participation élevée dans les cinq domaines de l'activité physique, par rapport à l'utilisation active des médias sociaux. Une utilisation intense des médias sociaux était associée à une probabilité plus élevée de respecter les recommandations en matière d'activité physique quotidienne. Une utilisation problématique des médias sociaux n'était pas associée au respect des recommandations en matière d'activité physique quotidienne, mais elle était fortement associée à une probabilité moindre de participation élevée à une activité physique dans le domaine de l'exercice. CONCLUSION: Les résultats de cette étude suggèrent que l'utilisation non active des médias sociaux est fortement associée à des niveaux d'activité physique plus faibles. Une utilisation problématique des médias sociaux n'était fortement associée à des niveaux d'activité physique plus faibles que dans le domaine de l'exercice. Une utilisation intense des médias sociaux était associée à une probabilité plus élevée de respecter la recommandation en matière d'activité physique.

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.

Top 10 International Priorities for Physical Fitness Research and Surveillance Among Children and Adolescents: A Twin-Panel Delphi Study.

BACKGROUND: The measurement of physical fitness has a history that dates back nearly 200 years. Recently, there has been an increase in international research and surveillance on physical fitness creating a need for setting international priorities that could help guide future efforts. OBJECTIVE: This study aimed to produce a list of the top 10 international priorities for research and surveillance on physical fitness among children and adolescents. METHODS: Using a twin-panel Delphi method, two independent panels consisting of 46 international experts were identified (panel 1 = 28, panel 2 = 18). The panel participants were asked to list up to five priorities for research or surveillance (round 1), and then rated the items from their own panel on a 5-point Likert scale of importance (round 2). In round 3, experts were asked to rate the priorities identified by the other panel. RESULTS: There was strong between-panel agreement (panel 1: rs = 0.76, p < 0.01; panel 2: rs = 0.77, p < 0.01) in the priorities identified. The list of the final top 10 priorities included (i) "conduct longitudinal studies to assess changes in fitness and associations with health". This was followed by (ii) "use fitness surveillance to inform decision making", and (iii) "implement regular and consistent international/national fitness surveys using common measures". CONCLUSIONS: The priorities identified in this study provide guidance for future international collaborations and research efforts on the physical fitness of children and adolescents over the next decade and beyond.

Investigating the association between sleep and aspects of mental health in children: findings from the Canadian Health Survey on Children and Youth. / Étude de l'association entre sommeil et composantes de la santé mentale des enfants : résultats de l'Enquête canadienne sur la santé des enfants et des jeunes.

INTRODUCTION: Sufficient sleep and good quality sleep are crucial aspects of children's healthy development. While previous research has suggested associations between sleep and positive mental health, few studies have been conducted in Canadian children. METHODS: This study used data from the 2019 Canadian Health Survey on Children and Youth. Parents of children aged 5 to 11 years (N = 16 170) reported on their children's sleep habits and mental health. Descriptive statistics were used to calculate means and percentages for sleep and mental health indicators. Logistic regression was used to compare mental health outcomes by meeting sleep duration recommendations (9-11 hours of sleep vs. < 9 or > 11 hours of sleep), sleep quality (difficulties getting to sleep) and having enforced rules for bedtime. RESULTS: Overall, 86.2% of children aged 5 to 11 years met sleep duration recommendations (9-11 hours of sleep), 90.0% had high sleep quality and 83.1% had enforced rules for bedtime. While 83.0% of children had high general mental health, mental health diagnoses were reported for 9.5% of children, and 15.8% of children required or received mental health care. High sleep quality was consistently associated with better mental health, enforced rules for bedtime were associated with some negative mental health outcomes and meeting sleep duration recommendations tended not to be associated with mental health outcomes. CONCLUSION: Sleep quality was strongly associated with mental health among children in this study. Future research should explore longitudinal associations between sleep and mental health in Canadian children.

INTRODUCTION: Un sommeil suffisant et un sommeil de bonne qualité sont des composantes cruciales du développement sain des enfants. Si des recherches antérieures laissent entrevoir des associations entre le sommeil et une bonne santé mentale, peu d'études ont été menées chez les enfants canadiens. MÉTHODOLOGIE: Cette étude se fonde sur les données de l'Enquête canadienne sur la santé des enfants et des jeunes de 2019. Des parents d'enfants âgés de 5 à 11 ans (N = 16 170) ont fait état des habitudes de sommeil et de la santé mentale de leurs enfants. Des statistiques descriptives ont servi à calculer les moyennes et les pourcentages des indicateurs du sommeil et de la santé mentale. Une régression logistique a été utilisée pour comparer les résultats en matière de santé mentale en fonction du respect des recommandations sur la durée du sommeil (9 à 11 heures de sommeil contre moins de 9 heures ou plus de 11 heures), la qualité du sommeil (difficulté à s'endormir) et l'application de règles relatives à l'heure du coucher. RÉSULTATS: Dans l'ensemble, 86,2 % des enfants de 5 à 11 ans respectaient les recommandations sur la durée du sommeil (9 à 11 heures de sommeil), 90,0 % avaient un sommeil de grande qualité et 83,1 % avaient des règles à respecter concernant l'heure du coucher. Si 83,0 % des enfants avaient un niveau élevé de santé mentale générale, des diagnostics en matière de santé mentale ont tout de même été déclarés pour 9,5 % des enfants, et 15,8 % ont eu besoin de soins de santé mentale ou en ont reçus. Un sommeil de grande qualité a été systématiquement associé à une meilleure santé mentale, l'application de règles relatives à l'heure du coucher a été associée à certains effets négatifs sur la santé mentale et le respect des recommandations sur la durée du sommeil ne semble pas avoir d'incidence sur la santé mentale. CONCLUSION: Cette étude révèle une forte association entre la qualité du sommeil et la santé mentale chez les enfants. Les recherches futures devraient se pencher sur les associations longitudinales entre le sommeil et la santé mentale des enfants canadiens.

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.

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.

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.

Sociodemographic Factors Associated With Meeting the Canadian 24-Hour Movement Guidelines Among Adults: Findings From the Canadian Health Measures Survey.

BACKGROUND: This study examined associations between sociodemographic factors and meeting versus not meeting the new Canadian 24-Hour Movement Guidelines recommendations. METHODS: The study is based on 7651 respondents aged 18-79 years from the 2007 to 2013 Canadian Health Measures Survey, a nationally representative, cross-sectional survey. Sociodemographic factors included age, sex, household education, household income, race, having a chronic condition, smoking status, alcohol consumption, and body mass index. Participants were classified as meeting or not meeting each of the time-specific recommendations for moderate to vigorous physical activity, sedentary behavior, and sleep duration. RESULTS: Being an adult aged 18-64 years, normal weight, nonsmoker, and not having a chronic condition were associated with meeting the integrated guidelines. Being aged 18-64 years, male, normal weight, nonsmoker, not having a chronic condition, having a higher household education, and higher household income were associated with meeting the moderate to vigorous physical activity recommendation; being aged 18-64 years was associated with meeting the sedentary behavior recommendation; and being white, not having a chronic condition, and having a higher household income were associated with meeting the sleep duration recommendation. CONCLUSIONS: Few Canadian adults met the 2020 Canadian 24-Hour Movement Guidelines, and disparities across sociodemographic factors exist. Implementation strategies and dissemination approaches to encourage uptake and adoption are necessary.

Self-rated mental health, community belonging, life satisfaction and perceived change in mental health among adults during the second and third waves of the COVID-19 pandemic in Canada. / Santé mentale autoévaluée, sentiment d'appartenance à la communauté, satisfaction à l'égard de la vie et changement perçu en matière de santé mentale chez les adultes pendant la deuxième et la troisième vagues de la pandémie de COVID-19 au Canada.

Findings from the 2020 Survey on COVID-19 and Mental Health (SCMH) suggested that the positive mental health of adults in Canada was lower during the second wave of the pandemic (fall 2020) than in 2019. With 2021 SCMH data from winter/spring 2021, we find in the current study that average life satisfaction and the prevalence of high self-rated mental health, high community belonging and perceptions of stable/improved mental health were even lower during the third wave of the pandemic as compared to the second wave in the overall adult population and in most sociodemographic groups.

Fewer adults in Canada reported high self-rated mental health in winter/spring 2021 (51.5%) compared to fall 2020 (59.9%). Fewer adults reported high community belonging in winter/spring 2021 (57.3%) compared to fall 2020 (63.7%). Rated from 0 (very dissatisfied) to 10 (very satisfied), average life satisfaction was lower in winter/spring 2021 (6.9) compared to fall 2020 (7.2). Fewer adults in winter/spring 2021 (58.1%) compared to fall 2020 (66.5%) reported that their mental health was better or about the same compared to before the COVID-19 pandemic.

Le nombre d'adultes au Canada ayant fait état d'un niveau élevé de santé mentale autoévaluée s'est révélé moindre à l'hiver et au printemps 2021 (51,5 %) par rapport à l'automne 2020 (59,9 %). Le nombre d'adultes ayant fait état d'un fort sentiment d'appartenance à la communauté s'est révélé moindre à l'hiver et au printemps 2021 (57,3 %) par rapport à l'automne 2020 (63,7 %). Notée de 0 (très insatisfait) à 10 (très satisfait), la satisfaction moyenne à l'égard de la vie s'est révélée plus faible à l'hiver et au printemps 2021 (6,9) qu'elle ne l'était à l'automne 2020 (7,2). Le nombre d'adultes qui ont déclaré que leur santé mentale était meilleure ou à peu près la même qu'avant la pandémie de COVID-19 était moindre à l'hiver et au printemps 2021 (58,1 %) par rapport à l'automne 2020 (66,5 %).

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.

Meeting Canadian 24-Hour Movement Guideline recommendations and risk of all-cause mortality.

This study determined if meeting the Canadian 24-Hour Movement Guidelines recommendations are associated with all-cause mortality. Participants were 3471 adults from the 2005-2006 U.S. National Health and Nutrition Examination Survey followed for mortality over 11 years. They were classified as meeting or not meeting recommendations for sleep duration, sedentary behaviour, and moderate-to-vigorous physical activity (MVPA). A total of 63.8%, 35.3%, and 41.5% of participants met recommendations for sleep, sedentary behaviour, and physical activity while 12.3% met all 3 recommendations. The hazard ratio (HR) for all-cause mortality in participants meeting the recommendations relative to those not meeting the recommendations were 0.91 (0.72, 1.16) for sleep, 0.92 (0.61, 1.40) for sedentary behaviour, and 0.42 (0.24, 0.74) for MVPA. The HR for meeting none, any 1, any 2, and all 3 recommendations were 1.00, 0.86 (0.65, 1.14), 0.49 (0.28, 0.86), and 0.72 (0.34, 1.50). When the cut-point used to denote acceptable sedentary time was changed from ≤8 to ≤10 hours/day, the HR for meeting none, any 1, any 2, and all 3 recommendations were 1.00, 0.83 (0.59, 1.15), 0.57 (0.34, 0.96), and 0.43 (0.20, 0.93). These findings provide some support of the ability of the 24-hour Movement Guidelines to predict mortality risk. Novelty: The 24-Hour Movement Guidelines provide recommendations for sleep, sedentary behaviour, and physical activity. The findings of this study provide some support of the ability of these new guidelines to predict mortality risk.