Test-retest reliability of a measure of perceived activity compensation in primary school children and their parents: a mixed methods study.

There is a lack of specific tools for assessing children's activity compensatory responses. This study 1) determined test-retest reliability and internal consistency of survey items assessing children's self-reported and parents' proxy-reported perceived compensatory responses; and 2) described children's and parents' views of potential compensatory mechanisms. Children (n = 55; mean age 10.2 ± 0.9) and their parents (n = 60) completed a survey twice, seven days apart. A sub-sample (17 parents; 13 children) participated in a short, semi-structured interview. Intraclass Correlation Coefficients (ICCs) and Cronbach's alpha assessed absolute agreement and internal consistency. Interviews were analysed via thematic analysis. Seven self- and proxy-reported survey sub-scales had excellent test-retest reliability (ICC ≥ 0.75), three had good (ICC ≥ 0.56) and one fair (ICC = 0.44). All survey items and sub-scales had acceptable internal consistency (alpha >0.67). Thematic analysis identified two overarching themes: awareness of compensation and mechanisms of compensation. After an active day at school, most participants perceived that compensation occurred later that day. Mechanisms of compensation included psychological, physiological, environmental, and interpersonal mechanisms. This reliable survey provides a new tool for assessing children's and their parents' perceptions of activity compensation and may inform future intervention designs. Future research is needed to establish concordance between perceived and device-assessed compensation.

Interventions to Change School Recess Activity Levels in Children and Adolescents: A Systematic Review and Meta-Analysis.

BACKGROUND: The school environment is globally recognised as a key setting to promote child and adolescent physical activity. School recess contributes up to 40% of the school day and recommended physical activity levels, providing a critical physical activity promotion opportunity for children and adolescents. OBJECTIVE: To examine the effectiveness of school recess interventions on children's and adolescents' physical activity (PA) and sedentary behaviour (SED) during this time. DESIGN: Systematic review and meta-analysis. DATA SOURCES: EBSCOhost (Academic Search Complete, Education Source, ERIC, Global Health, MEDLINE complete, SPORTDiscus), Scopus, and ProQuest electronic databases with full text. RESULTS: Forty-three studies were included in the systematic review, trialling eight different intervention strategies including loose equipment, structured recess, and multicomponent studies. The meta-analysis included 16 studies. Overall, between group mean difference for: (i) time spent in moderate to vigorous-intensity physical activity (MVPA) for randomised controlled trials (RCTs) (n = 6) was 0.18 (95% CI - 0.00 to 0.36) with a marginal significant effect of Z = 1.93 (p = 0.05), (ii) time spent in MVPA for non-RCTs (n = 7) was 0.52 (95% CI - 0.01 to 1.03) with an overall effect of Z = 1.99 (p = 0.05), (iii) time spent in sedentary behaviour for RCTs (n = 3) was - 0.48 (95% CI - 1.38 to 0.43) with an overall effect of Z = 1.03 (p = 0.30). All outcomes had high heterogeneity. CONCLUSION: School recess interventions show promise for increasing MVPA. It was difficult to draw strong conclusions due to low study numbers in the meta-analysis and varied intervention designs. Interventions may need to focus on single component strategies (e.g., loose equipment) to improve understanding of outcome effects for future studies.