Factors related with public open space use among adolescents: a study using GPS and accelerometers.

BACKGROUND: Low physical activity levels and high levels of sedentary time among adolescents call for population wide interventions. Public open spaces can be important locations for adolescents' physical activity. This study aimed to describe the prevalence, frequency and context of public open space visitation and to gain insight into the individual, social and physical environmental factors associated with public open space use among 12- to 16-year-old Flemish (Belgian) adolescents. METHODS: Global positioning system devices, accelerometers and one-on-one interviews were used to measure location-specific activity levels, time spent at, reasons for using and accompaniment at public open spaces among 173 adolescents. Multilevel hurdle and gamma models were used to estimate the associations between the independent variables (age, gender, ethnicity, education, sport club membership and accompaniment) and the amount of time, sedentary time, light-, moderate- to vigorous- and vigorous-intensity physical activity at public open spaces. RESULTS: Three out of four participants had visited a public open space (for recreational purposes) and participants were most often accompanied by friends/classmates. Mainly public transportation stops/stations were used, and subsequently the most reported reason for public open space use was "to wait for something or someone". Furthermore, boys, younger adolescents, non-western-European adolescents and lower educated adolescents were more likely to use public open spaces. Additionally, boys and younger adolescents were more likely to accumulate physical activity at public open spaces. The only social environmental variable associated with time spent at public open spaces was accompaniment by siblings: adolescents spent more time at public open spaces when accompanied by their siblings. CONCLUSIONS: Public open spaces may be effective areas to promote physical activity among groups at risk for physical inactivity (i.e. low educated and non-western-European adolescents). Additionally, girls and older adolescents were less likely to visit and be physically active at public open spaces. Therefore, urban planners should consider adding attractive features, in order to encourage physical activity among girls and older adolescents at public open spaces. Furthermore, creating public open spaces that are attractive for youth of all ages could contribute to adolescents visiting public open spaces accompanied by siblings.

Differences in physical environmental characteristics between adolescents' actual and shortest cycling routes: a study using a Google Street View-based audit.

BACKGROUND: The objective evaluation of the physical environmental characteristics (e.g. speed limit, cycling infrastructure) along adolescents' actual cycling routes remains understudied, although it may provide important insights into why adolescents prefer one cycling route over another. The present study aims to gain insight into the physical environmental characteristics determining the route choice of adolescent cyclists by comparing differences in physical environmental characteristics between their actual cycling routes and the shortest possible cycling routes. METHODS: Adolescents (n = 204; 46.5% boys; 14.4 ± 1.2 years) recruited at secondary schools in and around Ghent (city in Flanders, northern part of Belgium) were instructed to wear a Global Positioning System device in order to identify cycling trips. For all identified cycling trips, the shortest possible route that could have been taken was calculated. Actual cycling routes that were not the shortest possible cycling routes were divided into street segments. Segments were audited with a Google Street View-based tool to assess physical environmental characteristics along actual and shortest cycling routes. RESULTS: Out of 160 actual cycling trips, 73.1% did not differ from the shortest possible cycling route. For actual cycling routes that were not the shortest cycling route, a speed limit of 30 km/h, roads having few buildings with windows on the street side and roads without cycle lane were more frequently present compared to the shortest possible cycling routes. A mixed land use, roads with commercial destinations, arterial roads, cycle lanes separated from traffic by white lines, small cycle lanes and cycle lanes covered by lighting were less frequently present along actual cycling routes compared to the shortest possible cycling routes. CONCLUSIONS: Results showed that distance mainly determines the route along which adolescents cycle. In addition, adolescents cycled more along residential streets (even if no cycle lane was present) and less along busy, arterial roads. Local authorities should provide shortcuts free from motorised traffic to meet adolescents' preference to cycle along the shortest route and to avoid cycling along arterial roads.

Variation in population levels of sedentary time in European children and adolescents according to cross-European studies: a systematic literature review within DEDIPAC.

BACKGROUND: A high amount of sedentary time has been proposed as a risk factor for various health outcomes in adults. While the evidence is less clear in children and adolescents, monitoring sedentary time is important to understand the prevalence rates and how this behaviour varies over time and by place. This systematic literature review aims to provide an overview of existing cross-European studies on sedentary time in children (0-12y) and adolescents (13-18y), to describe the variation in population levels of sedentary time, and to discuss the impact of assessment methods. METHODS: Six literature databases were searched (PubMed, EMBASE, CINAHL, PsycINFO, SportDiscus and OpenGrey), followed by backward- and forward tracking and searching authors' and experts' literature databases. Included articles were observational studies reporting on levels of sedentary time in the general population of children and/or adolescents in at least two European countries. Population levels were reported separately for children and adolescents. Data were reviewed, extracted and assessed by two researchers, with disagreements being resolved by a third researcher. The review protocol is published under registration number CRD42014013379 in the PROSPERO database. RESULTS: Forty-two eligible articles were identified, most were cross-sectional (n = 38). The number of included European countries per article ranged from 2 to 36. Levels of sedentary time were observed to be higher in East-European countries compared to the rest of Europe. There was a large variation in assessment methods and reported outcome variables. The majority of articles used a child-specific questionnaire (60%). Other methods included accelerometers, parental questionnaires or interviews and ecological momentary assessment tools. Television time was reported as outcome variable in 57% of included articles (ranging from a mean value of 1 h to 2.7 h in children and 1.3 h to 4.4 h in adolescents), total sedentary time in 24 % (ranging from a mean value of 192 min to 552 min in children and from 268 min to 506 min in adolescents). CONCLUSION: A substantial number of published studies report on levels of sedentary time in children and adolescents across European countries, but there was a large variation in assessment methods. Questionnaires (child specific) were used most often, but they mostly measured specific screen-based activities and did not assess total sedentary time. There is a need for harmonisation and standardisation of objective and subjective methods to assess sedentary time in children and adolescents to enable comparison across countries.

Variation in population levels of physical activity in European children and adolescents according to cross-European studies: a systematic literature review within DEDIPAC.

BACKGROUND: Regular physical activity is associated with physical, social and mental health benefits, whilst insufficient physical activity is associated with several negative health outcomes (e.g. metabolic problems). Population monitoring of physical activity is important to gain insight into prevalence of compliance to physical activity recommendations, groups at risk and changes in physical activity patterns. This review aims to provide an overview of all existing studies that measure physical activity in youth, in cross-European studies, to describe the variation in population levels of physical activity and to describe and define challenges regarding assessment methods that are used. METHODS: A systematic search was performed on six databases (PubMed, EMBASE, CINAHL, PsycINFO, SportDiscus and OpenGrey), supplemental forward- and backward tracking was done and authors' and experts' literature databases were searched to identify relevant articles. Journal articles or reports that reported levels of physical activity in the general population of youth from cross-European studies were included. Data were reviewed, extracted and assessed by two researchers, with disagreements being resolved by a third researcher. The review protocol of this review is published under registration number CRD42014010684 in the PROSPERO database. RESULTS: The search resulted in 9756 identified records of which 30 articles were included in the current review. This review revealed large differences between countries in prevalence of compliance to physical activity recommendations (i.e. 60 min of daily moderate- to vigorous-intensity physical activity (MVPA)) measured subjectively (5-47%) and accelerometer measured minutes of MVPA (23-200 min). Overall boys and children were more active than girls and adolescents. Different measurement methods (subjective n = 12, objective n = 18) and reported outcome variables (n = 17) were used in the included articles. Different accelerometer intensity thresholds used to define MVPA resulted in substantial differences in MVPA between studies conducted in the same countries when assessed objectively. CONCLUSIONS: Reported levels of physical activity and prevalence of compliance to physical activity recommendations in youth showed large variation across European countries. This may reflect true variation in physical activity as well as variation in assessment methods and reported outcome variables. Standardization across Europe, of methods to assess physical activity in youth and reported outcome variables is warranted, preferably moving towards a pan-European surveillance system combining objective and self-report methods.

Variation in population levels of sedentary time in European adults according to cross-European studies: a systematic literature review within DEDIPAC.

BACKGROUND: Sedentary behaviour is increasingly recognized as a public health risk that needs to be monitored at the population level. Across Europe, there is increasing interest in assessing population levels of sedentary time. This systematic literature review aims to provide an overview of all existing cross-European studies that measure sedentary time in adults, to describe the variation in population levels across these studies and to discuss the impact of assessment methods. METHODS: Six literature databases (PubMed, EMBASE, CINAHL, PsycINFO, SportDiscus and OpenGrey) were searched, supplemented with backward- and forward tracking and searching authors' and experts' literature databases. Articles were included if they reported on observational studies measuring any form of sedentary time in the general population in two or more European countries. Each record was reviewed, extracted and assessed by two independent researchers, and disagreements were resolved by a third researcher. The review protocol of this review is registered in the PROSPERO database under registration number CRD42014010335. RESULTS: Of the 9,756 unique articles that were identified in the search, twelve articles were eligible for inclusion in this review, reporting on six individual studies and three Eurobarometer surveys. These studies represented 2 to 29 countries, and 321 to 65,790 participants. Eleven studies focused on total sedentary time, while one studied screen time. The majority of studies used questionnaires to assess sedentary time, while two studies used accelerometers. Total sedentary time was reported most frequently and varied from 150 (median) to 620 (mean) minutes per day across studies and countries. CONCLUSIONS: One third of European countries were not included in any of the studies. Objective measures of European adults are currently limited, and most studies used single-item self-reported questions without assessing sedentary behaviour types or domains. Findings varied substantially between studies, meaning that population levels of sedentary time in European adults are currently unknown. In general, people living in northern Europe countries appear to report more sedentary time than southern Europeans. The findings of this review highlight the need for standardisation of the measurement methods and the added value of cross-European surveillance of sedentary behaviour.

Variation in population levels of physical activity in European adults according to cross-European studies: a systematic literature review within DEDIPAC.

BACKGROUND: Physical inactivity is a well-known public health risk that should be monitored at the population level. Physical activity levels are often surveyed across Europe. This systematic literature review aims to provide an overview of all existing cross-European studies that assess physical activity in European adults, describe the variation in population levels according to these studies, and discuss the impact of the assessment methods. METHODS: Six literature databases (PubMed, EMBASE, CINAHL, PsycINFO, SportDiscus and OpenGrey) were searched, supplemented with backward- and forward tracking and searching authors' and experts' literature databases. Articles were included if they reported on observational studies measuring total physical activity and/or physical activity in leisure time in the general population in two or more European countries. Each record was reviewed, extracted and assessed by two independent researchers and disagreements were resolved by a third researcher. The review protocol of this review is registered in the PROSPERO database under registration number CRD42014010334. RESULTS: Of the 9,756 unique identified articles, twenty-five were included in this review, reporting on sixteen different studies, including 2 to 35 countries and 321 to 274,740 participants. All but two of the studies used questionnaires to assess physical activity, with the majority of studies using the IPAQ-short questionnaire. The remaining studies used accelerometers. The percentage of participants who either were or were not meeting the physical activity recommendations was the most commonly reported outcome variable, with the percentage of participants meeting the recommendations ranging from 7% to 96% across studies and countries. CONCLUSIONS: The included studies showed substantial variation in the assessment methods, reported outcome variables and, consequently, the presented physical activity levels. Because of this, absolute population levels of physical activity in European adults are currently unknown. However, when ranking countries, Ireland, Italy, Malta, Portugal, and Spain generally appear to be among the less active countries. Objective data of adults across Europe is currently limited. These findings highlight the need for standardisation of the measurement methods, as well as cross-European monitoring of physical activity levels.

Changes in weight and body composition during the first semester at university. A prospective explanatory study.

OBJECTIVE: The purpose of this study was to objectively assess changes in weight, BMI, body composition and waist circumference during the first semester at university in Belgian students, as well as to identify correlates of change in BMI and fat%. METHODS: Weight, height, body composition and waist circumference were measured at baseline (October/November 2011) and follow-up (February/March 2012) in 101 first year university students. Additionally, a health behaviour questionnaire was completed at follow-up. RESULTS: After one semester at university, students gained on average 1.0 kg (range=-4.1 kg, +7.7 kg) of body weight consisting of 0.8 kg of fat mass. In contrast, fat free mass and waist circumference did not change. Regression models showed that being male, higher amount of TV/DVD watching and higher frequency of eating at a friends' place were contributors of BMI increase, whereas living in a student residence and lower frequency of reading and studying was related with higher increases in fat%. CONCLUSIONS: This is the first European study demonstrating that the first semester at university is a critical period for weight and fat gain. Future intervention studies should have special attention for male students and students living in student residences, and focus on promoting healthier food choices when eating out-of-home.

Public open space characteristics influencing adolescents' use and physical activity: A systematic literature review of qualitative and quantitative studies.

The objective of this systematic review was to provide insight into the specific characteristics of public open spaces (POS) associated with adolescents' POS visitation and physical activity (PA). Qualitative research suggests many characteristics to be associated with POS visitation and PA. Quantitative evidence confirmed a positive association between presence of trails, playgrounds and specific types of sports fields (e.g. basketball) with POS visitation and PA, whereas safety and aesthetics seemed subordinate. Suggestions for future research, as well as some methodological recommendations are provided.

Active Use of Parks in Flanders (Belgium): An Exploratory Observational Study.

Parks have the potential to increase physical activity at the community level by providing opportunities to be active. In order to inform interventions to promote physical activity in parks, insight is needed concerning park user characteristics, the activity level of park users, the types of activities performed and associations between park areas and temporal variables with observed physical activity levels. Park user characteristics (sex, age, ethnicity and activity level) were recorded within pre-defined park areas in two parks in Ghent (Belgium) using the System for Observing Play and Recreation in Communities (SOPARC). Most park users were male, adult, and engaged in vigorous-intensity physical activity (48%). Most popular activities were biking (38%), sitting (23%) and walking (15%); accordingly, trails were used most and had the highest levels of physical activity compared to other park areas. Parks were used least frequently in the morning, during the weekend and by seniors. Therefore, active park use during morning periods, on weekend days and by seniors should be promoted and urban planners should consider that different park areas can possibly elicit varying activity levels among park users.

Social and Physical Environmental Factors Influencing Adolescents' Physical Activity in Urban Public Open Spaces: A Qualitative Study Using Walk-Along Interviews.

Most previous studies examining physical activity in Public Open Spaces (POS) focused solely on the physical environment. However, according to socio-ecological models the social environment is important as well. The aim of this study was to determine which social and physical environmental factors affect adolescents' visitation and physical activity in POS in low-income neighbourhoods. Since current knowledge on this topic is limited, especially in Europe, qualitative walk-along interviews were used to obtain detailed and context-specific information. Participants (n = 30, aged 12-16 years, 64% boys) were recruited in POS in low-income neighbourhoods in Brussels, Ghent and Antwerp (Belgium). Participants were interviewed while walking in the POS with the interviewer. Using this method, the interviewer could observe and ask questions while the participant was actually experiencing the environment. All audio-recorded interviews were transcribed and analysed using Nvivo 10 software and thematic analysis was used to derive categories and subcategories using a grounded theory approach. The most important subcategories that were supportive of visiting POS and performing physical activity in POS were; accessibility by foot/bicycle/public transport, located close to home/school, presence of (active) friends and family, cleanliness of the POS and features, availability of sport and play facilities, large open spaces and beautiful sceneries. The most important subcategories that were unsupportive of visiting POS and physical activity in POS were; presence of undesirable users (drug users, gangs and homeless people), the behaviour of other users and the cleanliness of the POS and features. Social factors appeared often more influential than physical factors, however, it was the combination of social and physical factors that affected adolescents' behaviour in POS. Easily accessible POS with high quality features in the proximity of adolescents' home or school may stimulate physical activity, if adolescents also experience a safe and familiar social environment.