Adolescent physical activity levels: discrepancies with accelerometer data analysis.

This study investigated the effects of epoch length and cut point selection on adolescent physical activity intensity quantification using vertical axis and vector magnitude (VM) measurement with the ActiGraph GT3X+ accelerometer. Four hundred and nine adolescents (211 males; 198 females) aged 12-16 years of age wore accelerometers during waking hours. The GT3X+ acceleration counts were reintegrated into 1, 5, 15, 30 and 60 s epoch lengths for both vertical axis and VM counts. One cut point was applied to vertical axis counts and three different cut points were applied to VM counts for each epoch length. Significant differences (P < 0.01) in mean total counts per day were observed between vertical axis and VM counts, and between epoch lengths for VM only. Differences in physical activity levels were observed between vertical and VM cut points, and between epoch lengths across all activity intensities. Our findings illustrate the magnitude of differences in physical activity outcomes that occur between axis measurement, cut points and epoch length. The magnitude of difference across epoch length must be considered in the interpretation of accelerometer data and seen as a confounding variable when comparing physical activity levels between studies.

Acceptability of standing workstations in elementary schools: a pilot study.

OBJECTIVE: To examine the acceptability of introducing standing workstations in elementary-school classrooms; and to quantify changes in children's time spent sitting, standing, and walking; step counts; sit-to-stand transitions; and musculoskeletal discomfort. METHODS: A controlled trial was conducted in two elementary schools in Auckland, New Zealand (March-May 2012). Participants were 30 third and fourth graders (n = 23 intervention, n = 7 control). Intervention classes received standing workstations; control class retained usual sitting desks. Children wore ActivPAL monitors over 7 days at baseline and during the fourth week of the intervention. RESULTS: Children spoke enthusiastically of the standing workstations. School staffs were supportive of the standing workstations because they offered "flexibility in learning". Overall, children in the intervention group sat less (intervention: 8.27 (1.45), mean (SD); control: 9.00 (0.80) h/day), stood longer (3.75 (0.88); 2.85 (0.30) h/day), and engaged in fewer transitions from sitting to standing (93 (17); 98 (26) counts) compared to the control group. Effect size ranged from small-large (-0.49; 95% confidence limits (0.64)%, 0.71; (0.48), -0.96; (0.54)% respectively). Results for time spent stepping and step counts were unclear. CONCLUSION: Standing workstations can be successfully integrated in classroom environments and appear to decrease overall sedentariness.

Sharing good NEWS across the world: developing comparable scores across 12 countries for the Neighborhood Environment Walkability Scale (NEWS).

BACKGROUND: The IPEN (International Physical Activity and Environment Network) Adult project seeks to conduct pooled analyses of associations of perceived neighborhood environment, as measured by the Neighborhood Environment Walkability Scale (NEWS) and its abbreviated version (NEWS-A), with physical activity using data from 12 countries. As IPEN countries used adapted versions of the NEWS/NEWS-A, this paper aimed to develop scoring protocols that maximize cross-country comparability in responses. This information is also highly relevant to non-IPEN studies employing the NEWS/NEWS-A, which is one of the most popular measures of perceived environment globally. METHODS: The following countries participated in the IPEN Adult study: Australia, Belgium, Brazil, Colombia, Czech Republic, Denmark, Hong Kong, Mexico, New Zealand, Spain, the United Kingdom, and the United States. Participants (N = 14,305) were recruited from neighborhoods varying in walkability and socio-economic status. Countries collected data on the perceived environment using a self- or interviewer-administered version of the NEWS/NEWS-A. Confirmatory Factor Analysis (CFA) was used to derive comparable country-specific measurement models of the NEWS/NEWS-A. The level of correspondence between standard and alternative versions of the NEWS/NEWS-A factor-analyzable subscales was determined by estimating the correlations and mean standardized difference (Cohen's d) between them using data from countries that had included items from both standard and alternative versions of the subscales. RESULTS: Final country-specific measurement models of the NEWS/NEWS-A provided acceptable levels of fit to the data and shared the same factorial structure with six latent factors and two single items. The correspondence between the standard and alternative versions of subscales of Land use mix - access, Infrastructure and safety for walking/cycling, and Aesthetics was high. The Brazilian version of the Traffic safety subscale was highly, while the Australian and Belgian versions were marginally, comparable to the standard version. Single-item versions of the Street connectivity subscale used in Australia and Belgium showed marginally acceptable correspondence to the standard version. CONCLUSIONS: We have proposed country-specific modifications to the original scoring protocol of the NEWS/NEWS-A that enhance inter-country comparability. These modifications have yielded sufficiently equivalent measurement models of the NEWS/NEWS-A. Some inter-country discrepancies remain. These need to be considered when interpreting findings from different countries.

Examining the validity of the ActivPAL monitor in measuring posture and ambulatory movement in children.

BACKGROUND: Decreasing sedentary activities that involve prolonged sitting may be an important strategy to reduce obesity and other physical and psychosocial health problems in children. The first step to understanding the effect of sedentary activities on children's health is to objectively assess these activities with a valid measurement tool. PURPOSE: To examine the validity of the ActivPAL monitor in measuring sitting/lying, standing, and walking time, transition counts and step counts in children in a laboratory setting. METHODS: Twenty five healthy elementary school children (age 9.9 ± 0.3 years; BMI 18.2 ± 1.9; mean ± SD) were randomly recruited across the Auckland region, New Zealand. Children were fitted with ActivPAL monitors and observed during simulated free-living activities involving sitting/lying, standing and walking, followed by treadmill and over-ground activities at various speeds (slow, normal, fast) against video observation (criterion measure). The ActivPAL sit-to-stand and stand-to-sit transition counts and steps were also compared with video data. The accuracy of step counts measured by the ActivPAL was also compared against the New Lifestyles NL-2000 and the Yamax Digi-Walker SW-200 pedometers. RESULTS: We observed a perfect correlation between the ActivPAL monitor in time spent sitting/lying, standing, and walking in simulated free-living activities with direct observation. Correlations between the ActivPAL and video observation in total numbers of sit-to-stand and stand-to-sit transitions were high (r = 0.99 ± 0.01). Unlike pedometers, the ActivPAL did not misclassify fidgeting as steps taken. Strong correlations (r = 0.88-1.00) between ActivPAL step counts and video observation in both treadmill and over-ground slow and normal walking were also observed. During treadmill and over-ground fast walking and running, the correlations were low (r = 0.21-0.46). CONCLUSION: The ActivPAL monitor is a valid measurement tool for assessing time spent sitting/lying, standing, and walking, sit-to-stand and stand-to-sit transition counts and step counts in slow and normal walking. The device did not measure accurately steps taken during treadmill and over-ground fast walking and running in children.

Reliability and validity of the hands-up survey in assessing commuting to school in New Zealand elementary school children.

The decrease in physical activity time in and out of school increases the need for active commuting. School travel plan programs have been used internationally to increase active commuting in elementary school children. However, little research has been conducted in the reliability and validity of travel survey instruments. The purpose of this study was to evaluate the test-retest reliability and validity of the Hands-Up survey to assess active commuting to school from a random sample of children within the Auckland region, New Zealand. Test-retest reliability and criterion validity of travel modes were determined in 118 elementary school children in the Auckland region. The survey tool consisted of one question on commuting to school. Test-retest reliability and validity were evaluated using kappa coefficients. The level of agreement between the children's responses (κ = .96, 95% confidence interval = 0.92-1.00) and between children's and parents' (κ = .91, 95% confidence interval = 0.85-0.98) were almost perfect. The Hands-Up survey is a valid and reliable tool to determine travel mode to school among elementary school children.

Active commuting to school in New Zealand children (2004-2008): a quantitative analysis.

OBJECTIVE: To describe trends in active commuting to school in children from Auckland region, New Zealand following implementation of the School Travel Plan (STP) program. The program included educational initiatives, enforcement activities and urban form changes around school environments. METHODS: Active commuting to school was estimated for 57,096 students, aged 5-10 years, from 56 elementary schools. Data were drawn from surveys conducted between 2004 and 2008. RESULTS: There was an overall increase in active commuting by the third year of STP implementation when compared to baseline levels (40.5% to 42.2%), [OR = 2.65, 95% CI = 1.75-4.02]. Students of high socio-economic background improved (38.9% to 39.1%) compared to those from mid [OR=0.66, 95% CI=0.82-1.01] and low [OR = 0.47, 95% CI = 0.32-0.68]. STP appealed to senior (43.6% to 44.3%), [OR = 1.33, 95% CI = 1.15-1.53] when compared to junior elementary students. The STP was equally effective in schools with small to medium student rolls compared to large schools (34.1% to 36.5%), [OR=1.33, 95% CI = 1.09-1.63]. Schools in Auckland city (47.2% to 48.1%), [OR = 1.43, 95% CI = 1.20-1.70] showed significant improvements when compared to schools from North Shore City. CONCLUSION: The STP was associated with increased active commuting in children after three years of implementation.

Understanding the Relationship between Activity and Neighbourhoods (URBAN) Study: research design and methodology.

BACKGROUND: Built environment attributes are recognized as being important contributors to physical activity (PA) engagement and body size in adults and children. However, much of the existing research in this emergent public health field is hindered by methodological limitations, including: population and site homogeneity, reliance on self-report measures, aggregated measures of PA, and inadequate statistical modeling. As an integral component of multi-country collaborative research, the Understanding the Relationship between Activity and Neighbourhoods (URBAN) Study seeks to overcome these limitations by determining the strengths of association between detailed measures of the neighborhood built environment with PA levels across multiple domains and body size measures in adults and children. This article outlines the research protocol developed for the URBAN Study. METHODS AND DESIGN: The URBAN Study is a multi-centered, stratified, cross-sectional research design, collecting data across four New Zealand cities. Within each city, 12 neighborhoods were identified and selected for investigation based on higher or lower walkability and Maori demographic attributes. Neighborhoods were selected to ensure equal representation of these characteristics. Within each selected neighborhood, 42 households are being randomly selected and an adult and child (where possible) recruited into the study. Data collection includes: objective and self-reported PA engagement, neighborhood perceptions, demographics, and body size measures. The study was designed to recruit approximately 2,000 adults and 250 children into the project. Other aspects of the study include photovoice, which is a qualitative assessment of built environment features associated with PA engagement, an audit of the neighborhood streetscape environment, and an individualized neighborhood walkability profile centered on each participant's residential address. Multilevel modeling will be used to examine the individual-level and neighborhood-level relationships with PA engagement and body size. DISCUSSION: The URBAN Study is applying a novel scientifically robust research design to provide urgently needed epidemiological information regarding the associations between the built environment and health outcomes. The findings will contribute to a larger, international initiative in which similar neighborhood selection and PA measurement procedures are utilized across eight countries. Accordingly, this study directly addresses the international priority issues of increasing PA engagement and decreasing obesity levels.

Daily step counts and selected coronary heart disease risk factors in adolescent girls.

Data on objectively determined physical activity (PA) behaviour of Australian adolescent girls is lacking along with known associations between PA behaviour and future risk of coronary heart disease (CHD). The purpose of this study was to measure four consecutive days of pedometer steps and the prevalence of selected CHD risk factors in a cross-sectional sample of 415 Australian adolescent girls (age 16+/-0.8 year; mean+/-S.D.). Coronary heart disease risk factors assessed were low levels of daily PA (<10,000stepsday(-1)), high-blood pressure (>95th percentile), overweight (>85th percentile) and/or obese (>95th percentile), presence of family history of heart disease, low cardio-respiratory fitness (poor estimated VO(2)max), and being a smoker. Overall, 41.2% of the sample had > or =2 factors. The mean number of steps per day was 9617+/-3108 (mean+/-S.D.). There was a significant relationship between daily ambulatory activity of <10,000 steps and poor cardiovascular fitness (Odds Ratios [OR]=2.15, confidence intervals [CI]=1.02-4.54). When girls in the highest and lowest quartiles of pedometer steps were compared, those classified as inactive were significantly more likely to be obese (OR=4.70, CI=1.17-18.60), less likely to be underweight (OR=0.29, CI=0.09-0.88), and had poor cardiovascular fitness (OR=3.27, CI=1.35-7.93). All of 47 participants who had > or =3 CHD risk factors were also classified as inactive (<7409 steps). This study demonstrates a relationship between daily step counts and selected measures of CHD risk factors in adolescent girls.

Simulated rugby performance at 1550-m altitude following adaptation to intermittent normobaric hypoxia.

Team-sport athletes who normally reside at sea level occasionally play games at altitudes sufficient to impair endurance performance. To investigate the effect of intermittent normobaric hypoxic exposure on performance in generic and game-specific tests at altitude, 22 senior club level rugby players performed baseline tests before single-blind random assignment to one of three groups: hypoxia-altitude (n=9), normoxia-altitude (n=6), and normoxia-sea level (n=7). The hypoxia-altitude group underwent 9-13 sessions of intermittent hypoxic exposure (concentration of inspired oxygen=13-10%) over 15 days, then repeated the performance tests within 12h of travelling to 1550m. The normoxia-altitude group underwent placebo exposures by breathing room air before repeating the tests at altitude, whereas the normoxia-sea level group underwent placebo exposures before repeating the tests at sea level. Hypoxic exposure consisted of alternately breathing 6min hypoxic gas and 4min ambient air for 1h at rest. Performance measures gathered at each testing session were maximum speed, sub-maximum heart-rate speed and sub-maximum lactate speed during a 20-m incremental running test, mean time in six 70-m sprints, repetitive explosive power and other measures from seven 5.5-min circuits of a rugby simulation. Repetitive explosive power ( approximately -16%) and 20-m shuttle performance ( approximately -3%) decreased substantially at altitude compared to sea level. Acclimatisation to hypoxia had a beneficial effect on sub-maximum heart rate and lactate speed but little effect on other performance measures. In conclusion, 1550-m altitude substantially impaired some measures of performance and the effects of prior adaptation via 9-13 sessions of intermittent hypoxia were mostly unclear.

Associations Between the Neighborhood Environment and Moderate-to-Vigorous Walking in New Zealand Children: Findings from the URBAN Study.

BACKGROUND: Urban design may affect children's habitual physical activity by influencing active commuting and neighborhood play. PURPOSE: Our objective was to examine associations between neighborhood built-environment features near children's homes and objectively measured physical activity. METHODS: We used geographical information system (GIS) protocols to select 2016 households from 48 low- and high-walkability neighborhoods within four New Zealand cities. Children (n = 227; mean age ± standard deviation [SD] 9.3 ± 2.1 years) from the selected households wore accelerometers that recorded physical activity in the period 2008-2010. We used multilevel linear models to examine the associations of GIS and street-audit measures, using the systematic pedestrian and cycling environmental scan (SPACES), of the residential environment (ranked into tertiles) on children's hourly step counts and proportions of time spent at moderate-to-vigorous intensity on school and non-school days. RESULTS: During school-travel times (8:00-8:59 a.m. and 15:00-15:59 p.m.), children in the mid-tertile distance from school (~1 to 2 km) were more active than children with shorter or longer commute distances (1290 vs. 1130 and 1140 steps·h(-1); true between-child SD 440). After school (16:00-17:59 p.m.), children residing closest to school were more active (890 vs. 800 and 790 steps·h(-1); SD 310). Neighborhoods with more green space, attractive streets, or low-walkability streets showed a moderate positive association on non-school day moderate-to-vigorous steps, whereas neighborhoods with additional pedestrian infrastructure or more food outlets showed moderate negative associations. Other associations of residential neighborhoods were unclear but, at most, small. CONCLUSIONS: Designing the urban environment to promote safe child-pedestrian roaming may increase children's moderate-to-vigorous physical activity.

Reliability of time to exhaustion analyzed with critical-power and log-log modeling.

PURPOSE: The large variability of time to exhaustion between repeated tests at constant power output or speed gives an impression that these tests are unsuitable for monitoring athletic performance. We have addressed this issue using critical-power and log-log models of the speed-duration relationship to analyze treadmill runs. METHODS: Application of differential calculus to the models provided factors for converting variability in time to exhaustion into variability in equivalent time-trial time. We estimated values for the factors and variabilities from a reliability study. Eight male competitive runners performed a test consisting of three constant-speed runs to exhaustion lasting approximately 2, 4, and 8 min, with a 30-min rest between runs. A pair of such tests 5 d apart was repeated 7 and 14 wk later within a summer competitive season. We also used the models to predict times for fixed distances from each set of three runs. Repeated-measures analysis of log-transformed times provided estimates of variability expressed as coefficients of variation. RESULTS: Variabilities of time to exhaustion were 9.2, 13, and 16% (shortest to longest runs). Converted to their equivalents in time-trial time, the variabilities were 2.6, 1.7, and 1.0% via critical-power modeling, and 1.3, 1.7, and 2.2% via log-log modeling (90% likely limits x//1.2). The conversion factors varied typically by 28% (x//1.5) from runner to runner. Variabilities in times predicted for fixed distances were similar, but more uniform, for the log-log model. CONCLUSION: Runs to exhaustion are inherently reliable, but conversion of changes in time to exhaustion at a single fixed speed into changes in equivalent time-trial time is model and individual specific, and therefore only approximate. Combining runs at several speeds with log-log modeling provides accurate conversion.

Associations of objectively measured built-environment attributes with youth moderate-vigorous physical activity: a systematic review and meta-analysis.

BACKGROUND: Understanding attributes of the built environment that influence children's and adolescents' habitual physical activity can inform urban design. OBJECTIVE: To conduct a systematic review and meta-analysis of studies linking aspects of the built environment with youth moderate-vigorous activity, including walking. DATA SOURCES: The PubMed, Embase, and Cumulative Index to Nursing and Allied Health Literature (CINAHL) databases were searched using relevant key words for articles published between January 2000 and March 2013. STUDY SELECTION: The included articles reported associations between children's or adolescents' objectively measured physical activity and residential neighbourhoods or activity settings defined with geographical information systems (GIS), street audits or global positioning systems (GPS). Excluded articles did not delineate neighbourhoods by residential address or were not written in English. Of 320 potentially relevant articles, 31 met the inclusion criteria, but only 23 (with a total of 6,175 participants, aged 8-17 years) provided sufficient data to derive effects (associations) of built-environment features on child or adolescent habitual moderate-vigorous activity. STUDY APPRAISAL AND SYNTHESIS METHODS: Ten criteria were used to appraise the inclusion of studies. The effects were analysed as the difference in mean minutes of daily moderate-vigorous activity either between two levels of a dichotomous variable (e.g., neighbourhood park available or not within 800 m) or between predicted means corresponding to a difference of two standard deviations of a simple linear numeric variable (e.g., housing density per square kilometre). The magnitude of the difference in means was evaluated via standardization. The meta-analysis was performed with the 14 studies using GIS or street audits to relate a total of 58 specific built-environment features to daily activity. Each feature was categorized with two dichotomous variables to indicate whether the feature promoted playing and/or walking, and these variables were included in the meta-analytic model as moderators interacting with age and proportion of males in the study as linear numeric covariates. RESULTS: The meta-analysed effects of built-environment features that encourage play (including sports and fitness) and/or walking on youth moderate-vigorous activity ranged between trivial and small. There was a moderate effect of age (15 versus 9 years) whereby play facilities, parks, playgrounds and features that facilitate walking had negative effects on children's activity but positive effects on adolescents' activity. In studies that located youth physical activity with GPS, walking to school produced small increases in activity compared with transport by car or bus, greater proportions of activity took place in streets and urban venues (40-80%) than in green spaces (20-50%), and more than half of children's outdoor activity occurred with a parent nearby. LIMITATIONS: The meta-analysis cannot quantify the additive effect when several built-environment features are provided in a given neighbourhood. CONCLUSIONS: Children do not benefit to the same extent as adolescents from built-environment features that encourage walking and those designed or used for neighbourhood play.

Distance to School is Associated with Sedentary Time in Children: Findings from the URBAN Study.

Sedentary behavior is associated with overweight and obesity in children, and distance to school has been negatively associated with active commuting to school. It is not known how distance to school relates to sedentary behavior in children. The aim of this study was to investigate the association between distance to school and children's sedentary behavior during weekdays at times where children interact with the neighborhood environment. Children (5-13 years, n = 295) who participated in the understanding relationships between activity and neighborhoods study (2008-2010) across four New Zealand cities wore a hip-mounted accelerometer for 7 days. Minutes spent sedentary (accelerometer count <100 min(-1)) were derived for the school travel periods (0800-0859 and 1500-1559) and after school discretionary time (1600-1759). Shortest street network distance to school was calculated from residential addresses using geographical information systems and parsed into tertiles for analysis. Children completed a daily travel log including mode of transport to and from school, which was dichotomized into active (walking and cycling) and passive (motorized) modes. Children living in the second tertile of distance from school were the least sedentary during the school traveling periods (42 ± 10%, mean ± true between-child SD) compared to those living in the first or third distance tertiles (47 ± 10 and 49 ± 10%, respectively); the differences were clear and likely substantial (90% confidence limits ± 6%). Children who traveled by motorized transport were more sedentary for each of the distance tertiles (50 versus 44%, 46 versus 39%, and 54 versus 27% for first, second, and third tertiles, respectively; 90% confidence limits ± 7%). In the period of 1600-1759, girls in the third distance tertile were the most sedentary. The combined effects of 1-2 km distance from school and active commuting to school contributed to least sedentary time in children.

Built environment and physical activity in New Zealand adolescents: a protocol for a cross-sectional study.

INTRODUCTION: Built-environment interventions have the potential to provide population-wide effects and the means for a sustained effect on behaviour change. Population-wide effects for adult physical activity have been shown with selected built environment attributes; however, the association between the built environment and adolescent health behaviours is less clear. This New Zealand study is part of an international project across 10 countries (International Physical Activity and the Environment Network-adolescents) that aims to characterise the links between built environment and adolescent health outcomes. METHODS AND ANALYSES: An observational, cross-sectional study of the associations between measures of the built environment with physical activity, sedentary behaviour, body size and social connectedness in 1600 New Zealand adolescents aged 12-18 years will be conducted in 2013-2014. Walkability and neighbourhood destination accessibility indices will be objectively measured using Geographic Information Systems (GIS). Physical activity and sedentary behaviours will be objectively measured using accelerometers over seven consecutive days. Body mass index will be calculated as weight divided by squared height. Demographics, socioeconomic status, active commuting behaviours and perceived neighbourhood walkability will be assessed using the Neighbourhood Environment Walkability Scale for Youth and psychosocial indicators. A web-based computer-assisted personal interview tool Visualisation and Evaluation of Route Itineraries, Travel Destinations, and Activity Spaces (VERITAS) and Global Positioning System (GPS) receivers will be used in a subsample of 300 participants. A qualitative research component will explore barriers and facilitators for physical activity in adolescents with respect to the built and social environment in a subsample of 80 participants. ETHICS AND DISSEMINATION: The study received ethical approval from the Auckland University of Technology Ethics Committee (12/161). Data will be entered and stored into a secure (password protected) database. Only the named researchers will have access to the data. Data will be stored for 10 years and permanently destroyed thereafter. The results papers will be submitted for publication in peer-reviewed journals.

Week-to-week differences of children's habitual activity and postural allocation as measured by the ActivPAL monitor.

BACKGROUND: Quantification of sitting and standing is possible with the ActivPAL accelerometer, using algorithms to classify activity into time spent sitting, standing and stepping. The purpose of this study was to determine children's week-to-week differences in time spent sitting/lying and standing along with other measures as provided by the ActivPAL accelerometer during continuous wearing of the ActivPAL monitor. METHODS: Fifty-six children (age 10.2±0.9 years, mean±SD) were recruited from 30 urban schools in Auckland, New Zealand. Children wore the monitor for 24h per day up to 14 days. Analyses were performed with mixed modeling. Reliability was expressed as change in the mean from week to week, intraclass correlation coefficient (ICC) and standard error of measurement (SEM). RESULTS: Mean week-to-week differences in percent time spent sitting/lying, standing and stepping on week days and weekend days for girls and boys were typically small. Step and sit-to-stand counts differences were small and unclear respectively. ICC values ranged from 0.40 to 0.79 during week days and 0.25-0.60 during weekends. SEM for time spent sitting/lying, standing and stepping were ∼3.5%, ∼2.5% and ∼1.5% respectively. CONCLUSION: The ActivPAL showed moderate to low week-to-week reliability for habitual activity and postural allocation under free living conditions in boys and girls. Interventions aimed at a moderate reduction in sitting time (∼5% of the day) will require modest sample sizes for adequate precision.

Physical activity, dietary habits and overall health in overweight and obese children and youth with intellectual disability or autism.

In children and youth with disability, the risk of obesity is higher and is associated with lower levels of physical activity, inappropriate eating behaviors, and chronic health conditions. We determined the effectiveness of a program in managing weight, through changes in physical activity and nutrition behaviors in overweight and obese New Zealand children and youth with intellectual disability or autism. Twenty-two children and youth 14±4 y (mean±SD) and their families participated in a 10-week school-based program. The program consisted of 18 sessions focusing on physical activity and nutrition. Changes were measured immediately after completion of the program (post 1) and at 24 weeks (follow up). Fitness was assessed with the six-minute walk-test (6MWT) and body fatness via waist circumference and BMI. Physical activity and nutrition changes were measured by means of proxy reporting and interviews with parents. Individual interviews were conducted with school teachers and program leaders at 24 weeks to gain feedback regarding the program. Most quantitative outcomes were either unclear or trivial. The only possible change was observed in the six-minute walk-test where 24 weeks post program where participants walked 51 m further. There was however, a substantial reduction in the consumption of confectionery and chocolate at the two measurement points. Parents commented that during the program there were less hospital visits and absences from school related to illness. The program assisted in the development of a supportive community network and participants' abilities to partake in family and community activities. This the first study to report on the results of a physical activity and nutrition program targeted in children and youth with intellectual disability and autism. The results of this study may support and inform future developments of an integrated weight management and prevention program to enhance the health and well being in children and youth with disabilities.

Physical activity is not play: perceptions of children and parents from deprived areas.

AIMS: To explore the perceptions of primary school aged children (n=9) and parents (n=21) from areas of socioeconomic deprivation in New Zealand in order to determine the factors which influence healthy and overweight children's after school activities. METHOD: We held focus groups with children, utilising photo-voice prompts for discussion. Focus groups and semi-structured interviews were also conducted with parents. Content analysis of data was undertaken. RESULTS: Both children and parents described physical activity and play as different constructs; physical activity was considered as an organised activity and play was identified as fun. Parents perceived that time, money and transport were all barriers to children participating in physical activities after school. Parents explained that children's enjoyment of a particular activity as well as self-esteem influenced whether or not children participated in physical activity. Community support and communication were also identified as important in creating safer communities and places to play for children. CONCLUSION: When developing after school community activity programmes, the emphasis should be on active play rather than physical activity.

School travel plans: preliminary evidence for changing school-related travel patterns in elementary school children.

PURPOSE: In New Zealand, the School Travel Plan (STP) program was developed to increase school-related active travel rates and decrease traffic congestion. The plan was developed through collaboration among the school, community, and local council. The STP was tailored to each school's specific needs and incorporated educational initiatives, physical infrastructural changes in the vicinity of schools, and policy development. The purpose of this study was to determine the effectiveness of the STP program in changing school travel modes in children. DESIGN: Effectiveness was assessed by determining the difference between pre-STP and follow-up travel mode data in schools. The differences were assessed using multilinear regression analysis, including decile (measure of socioeconomic status), school roll at baseline, and STP year of implementation as predictors. SETTING: Thirty-three elementary schools from the Auckland region participated in the study. School size ranged from 130 to 688 students. SUBJECTS: The final 2006 sample consisted of 13,631 students. MEASURES: On a set day (pre- and post-STP), students indicated their mode of transport to school and intended mode for returning home that day. RESULTS: Differences are reported as percentage points: there was an increase in active transport by 5.9% ± 6.8% when compared to baseline travel modes. School roll, STP year of implementation, and baseline values predicted engagement with active transport. CONCLUSION: Preliminary findings suggest that the STP program may be successful in creating mode shift changes to favor school-related active travel in elementary-school children.

Measuring physical activity and sedentary behaviour at work: a review.

OBJECTIVE: To identify methods used to assess physical activity and sedentary behaviour at the workplace and review the validity and reliability of these measures. METHODS: Databases were searched for relevant published articles including MEDLINE, SPORT Discus, ProQuest and Google Scholar. Keywords used were physical-activity, workplace, sedentary-behaviour, measurement and questionnaire. Studies included were original, written in English, published between 1990 and 2009, and focused on validated physical activity and sedentary behaviour measures at work. Eleven papers were identified in which three used criterion standards, three objective measures, and five subjective measures. RESULTS: The most common method of data collection was through self-report, surveys or questionnaires. Physical activity measured with motion sensors, ranged from 4,422 to 10,334 steps/day (pedometers) and sedentary time ranged from 1.8 to 6 hours/day (h/d) (accelerometers). Self-report measures provided information relevant to the perception of physical activity at work (∼ 0.5 h/d), sitting time (> 3 h/d) and calculated energy expenditure (< 800 kcal/d). CONCLUSION: Physical activity levels at work were low while sedentary behaviour was high. This was largely a function of occupation (white-collar vs. blue-collar). None of the studies assessed validity or reliability of measures used however, instruments as assessed by others showed moderate to strong validity and reliability values.