Reliability of field- and laboratory-based assessments of health-related fitness in preschool-aged children.

OBJECTIVES: Reliable measurements of health-related fitness-cardiorespiratory endurance, muscular endurance, muscular strength, body composition, and flexibility-are imperative for understanding and tracking health-related fitness from the preschool age. This study aimed to examine the test-retest reliability of field-based (i.e., sit and reach [standard and back-saver], standing long jump, grip strength); and laboratory-based (i.e., Bruce Protocol Treadmill Test, Wingate Anaerobic Test) assessments of health-related fitness in preschool aged children (4-5 years). METHODS: Forty-two typically developing children participated in both assessment time points separated by 2-3 weeks. All fitness assessments were administered individually and repeated in the same order by the same assessor. Heteroscedasticity was examined for each parameter. Intraclass correlation coefficients were calculated to assess test-retest reliability. RESULTS: All parameters were homoscedastic. Test-retest reliability for the field-based tests and Bruce Protocol Treadmill Test parameters were moderate to good. Test-retest reliability for the Wingate Test parameters were good to excellent for maximum pedal rate, peak power, and peak power/kg; mean power and fatigue measured at 10 and 30 s demonstrated moderate to excellent test-retest reliability. CONCLUSION: The standard sit and reach, grip strength, and short-term muscle power from the Wingate test are reliable assessments of health-related fitness in preschool-aged children.

Physical Activity and Motor Skill Development During Early Childhood: Investigating the Role of Parent Support.

PURPOSE: This study examined the relationship between parent physical activity (PA) support and children's motor skill development and PA during early childhood and explored the potential moderating effect of child PA and motor skills on these relationships. METHODS: Participants (N = 589, 250 girls, meanage = 4.93 [0.59] y) were part of a larger, longitudinal cohort study. Motor skills were assessed using the Movement Assessment Battery for Children-Second Edition. Moderate to vigorous PA (MVPA) was measured using ActiGraph accelerometers. Five items were used to measure parent support frequency (1 = none, 3 = 3-4 times, 5 = daily). Moderation analyses were conducted to examine the moderating effect of MVPA and motor skills on the relationship between parent support and motor skills and MVPA, respectively. RESULTS: Parent support was significantly related to motor skills (B = 14.45, P = .007), and child MVPA significantly moderated this relationship (B = -0.17, P = .021). The relationship between parent support and child MVPA did not reach significance (B = 2.89, P = .051); however, motor skills had a significant moderating effect (B = -0.08, P = .022). CONCLUSIONS: These novel findings suggest parent PA support is related to child motor skills and PA during early childhood, but this relationship is context dependent. Child-level characteristics should be considered in future parent PA support research.

A Matched-Pair Analysis of Gross Motor Skills of 3- to 5-Year-Old Children With and Without a Chronic Physical Illness.

PURPOSE: The purpose of this study was to compare the gross motor skills of children with a chronic physical illness with those of their healthy peers. METHODS: Data for children with a chronic physical illness come from the Multimorbidity in Children and Youth Across the Life Course study, and data from children without a physical illness come from the Health Outcomes and Physical Activity in Preschoolers study. Multimorbidity in Children and Youth Across the Life Course and Health Outcomes and Physical Activity in Preschoolers included children ages 3-5 years and administered the Peabody Development Motor Scales-second edition. Participants were sex and age matched (20 male and 15 female pairs; Mage = 54.03 [9.5] mo). RESULTS: Gross motor skills scores were "below average" for 47% of children with a physical illness compared with 9% of children without a physical illness (P = .003). Matched-paired t tests detected significant differences in total gross motor scores (dz = -0.35), locomotor (dz = -0.31), and object control (dz = -0.39) scores, with healthy children exhibiting better motor skills, and no significant difference in stationary scores (dz = -0.19). CONCLUSIONS: This skill gap may increase burden on children with physical illness and future research should assess gross motor skills longitudinally to establish whether the gap widens with age.

Psychosocial impact of COVID-19 on caregivers and adolescents and young adult survivors of childhood cancer.

BACKGROUND: Caregivers and adolescents and young adult (AYA) cancer survivors may be at greater psychosocial risk from the COVID-19 pandemic than healthy peers due to complex and traumatic medical histories. This study describes COVID-19-related event exposures, impact, and distress among a large sample of caregivers and AYA cancer survivors and the relationship of these variables to demographic and cancer characteristics. PROCEDURE: From May 2020 to December 2021, 422 caregivers and 531 AYA survivors completed the COVID-19 Exposures and Family Impact Survey (CEFIS) and CEFIS-AYA, respectively. Total COVID-19-related exposures, average COVID-19-related impact, and COVID-19-related distress were calculated. Conventional content analysis was used to analyze free-text responses about the negative and positive effects of COVID-19. RESULTS: Caregivers and AYA reported an average of 7.4-7.8 COVID-19 exposures to pandemic-related events and a slightly negative impact of COVID-19 across psychosocial domains, with some positive impacts reported. COVID-19-related distress was moderate and clinically meaningful (4.9-5.2/10) for AYA and caregivers. Racial and ethnically minoritized AYA and caregivers reported higher COVID-19-related distress than non-Hispanic white caregivers. For AYA, distress was also higher among female, college-age (18-22 years), and long-term survivors compared with males, younger AYA, White and those recently off treatment. CEFIS outcomes remained relatively stable over time. CONCLUSIONS: COVID-19 had a significant and consistent negative impact on caregivers and AYA survivors. Racial and ethnically minoritized families and female, college-age, and long-term AYA survivors may require additional psychosocial support. Assessing for COVID-19 impact and distress is important in pediatric oncology to evaluate adjustment and plan targeted interventions.

Development and validation of a measure of adolescent and young adult goal-based quality of life (MAYA-GQOL).

PURPOSE: We developed and validated a measure assessing quality of life (QOL) through importance, attainability, and discrepancy of life goals among adolescents and young adults (AYA) with and without cancer. A specific goal-based QOL measure for AYA fills a critical gap in knowledge for AYA who are at a unique life stage, which may include shifts in priorities and goals. METHODS: Through review of our existing AYA databases on goals, the literature, and cognitive interviews we developed the MAYA-GQOL. Items were administered to AYA with cancer (on/off treatment) (n = 124) and healthy AYA controls (n = 103) aged 15-29 years old. Psychometric analyses for comparison with existing QOL measures and discrepancies in perceived importance/attainability of goals were examined. RESULTS: An item pool of 700 goals, based on prior research, was refined to 173 goals across nine categories: academic, administrative, body, health, job, leisure, interpersonal, intrapersonal, and religion. Validation between the MAYA-GQOL and existing QOL measures was supported. AYA survivors reported fewer overall current goals and fewer administrative, interpersonal, leisure, and religious goals. AYA survivors rated body goal importance significantly higher than healthy controls and intrapersonal goal importance significantly lower. Little discrepancy in importance and attainability across AYA was found. CONCLUSIONS: The MAYA-GQOL represents an innovative way of measuring QOL among AYA by focusing on the relative importance, attainability, and discrepancy of developmentally appropriate goals. The MAYA-GQOL can identify areas of resilience and competence via assessment of important and attainable goals and can further assess how AYA with chronic illness are functioning relative to peers on goal domains relevant to the AYA developmental period.

Sociodemographics, Health Competence, and Transition Readiness Among Adolescent/Young Adult Cancer Survivors.

OBJECTIVE: Fewer than one-third of childhood cancer survivors receive follow-up from an adult provider, and adolescent and young adults (AYAs) from structurally minoritized sociodemographic groups often face health disparities that can impact transition to adult-oriented care. The primary aim of this study was to determine the relation among sociodemographic factors, cumulative effects, and transition beliefs/expectations and goals, and the moderating role of health competence beliefs in AYA survivors of childhood cancer. METHODS: A total of 195 AYAs (aged 15-29) reported sociodemographic information, completed the Transition Readiness Inventory assessing positive beliefs/expectations and goals related to transition, and completed the Health Competence Beliefs Inventory assessing health perceptions, healthcare satisfaction, cognitive competence, and autonomy. A cumulative sociodemographic factor variable was computed to investigate the potential additive effects of multiple sociodemographic factors associated with disparities. T-tests, Pearson correlations, and multivariate linear regressions were used. RESULTS: Cumulative sociodemographic factors were not related to transition readiness, and insurance type was the only factor associated with health competence beliefs and transition readiness, such that AYAs with public insurance reported lower healthcare satisfaction, cognitive competence, and transition goals relative to those with private insurance. There were no interaction effects; however, health competence beliefs were significantly associated with transition beliefs/expectations and goals. CONCLUSION: Public insurance is a barrier to holding positive beliefs/expectations and goals about transition, yet other sociodemographic factors associated with risks for poor transfer were not related to transition readiness. Multi-level interventions to reduce disparities and improve transition readiness should target health competence beliefs and barriers created by insurance.

COVID-19 Exposure and Family Impact Scales for Adolescents and Young Adults.

OBJECTIVE: To understand the impact of the coronavirus disease 2019 (COVID-19) pandemic on adolescents and young adults (AYAs), we adapted the COVID-19 Exposure and Family Impact Scales (CEFIS; Kazak et al., 2021) for AYAs. Here, we report on the development, structure, and psychometric properties of the CEFIS-AYA. METHODS: The CEFIS-AYA was developed by a multidisciplinary, multi-institutional team using a rapid iterative process. Data from 3,912 AYAs from 21 programs at 16 institutions across the United States were collected from May 2020 to April 2021. We examined the underlying structure of the CEFIS-AYA using principal component analysis (PCA), calculated internal consistencies, and explored differences in scores by gender and age. RESULTS: Participants reported exposure to a range of COVID-19-related events (M = 9.08 events, of 28). On the bidirectional 4-point Impact scale, mean item scores were mostly above the midpoint, indicating a slightly negative impact. Kuder-Richardson 20/Cronbach's Alpha was good for Exposure (α = .76) and excellent for Impact (α = .93). PCA identified seven factors for Exposure (Severe COVID-19, Loss of Income, Limited Access to Essentials, COVID-19 Exposure, Disruptions to Activities, Disruptions to Living Conditions, and Designation as an Essential Worker) and five for Impact (Self and Family Relationships, Physical Well-Being, Emotional Well-Being, Social Well-Being, and Distress). Gender and age differences in CEFIS-AYA scores were identified. DISCUSSION: Initial reliability data are strong and support use of the CEFIS-AYA for measuring the effect of the COVID-19 pandemic on AYAs in research and clinical care.

Effects of Comorbid Developmental Coordination Disorder and Symptoms of Attention Deficit Hyperactivity Disorder on Physical Activity in Children Aged 4-5 Years.

Developmental coordination disorder (DCD) is often comorbid with attention-deficit/hyperactivity disorder (ADHD). While children with DCD engage in less moderate-to-vigorous physical activity (MVPA) compared to typically developing (TD) children, research pertaining to how ADHD affects this relationship is limited. We investigated the effect of ADHD on MVPA among children at risk for DCD (DCDr). 507 children aged 4-5 years (DCDr = 233, TD = 274) participated. Motor skills were assessed using the Movement Assessment Battery for Children-2nd edition (DCDr; ≤ 16th percentile), ADHD symptoms were assessed using the Child Behaviour Checklist, and Actigraph accelerometers measured MVPA over seven days. DCD did not negatively affect MVPA, however, after adjusting for ADHD symptoms, the effect of DCD became significant and was driven by symptoms of inattention. Symptoms of ADHD may be suppressing the negative effects of DCD on MVPA, highlighting the importance of assessing and controlling for ADHD symptoms in this population.

Contextual Predictors of Engagement in a Tailored mHealth Intervention for Adolescent and Young Adult Cancer Survivors.

BACKGROUND: Despite the promise of mobile health (mHealth), engagement is often too low for durable health behavior change, and little is known regarding why certain individuals abandon mHealth tools. PURPOSE: Guided by a mHealth engagement framework, we evaluated contextual predictors of objective engagement with an app for adolescents and young adults (AYA) who survived cancer. METHODS: One hundred and ten AYA survivors (M age = 20.5, 43% female, 30% racial/ethnic minority) were randomized to receive a disease self-management app that delivered 1-2 tailored messages/day for 16 weeks, and contained a survivorship care plan (SCP). Demographic, disease, psychosocial, and setting characteristics were examined as predictors of three objective engagement outcomes: (a) % of active app days, (b) % of messages read, and (c) viewed SCP in the app versus not. A subsample (n = 10) completed qualitative interviews to further assess engagement barriers. RESULTS: Self-reported uninterrupted app access (ß = -0.56, p < .001), iPhone (vs. Android) ownership (ß = 0.30, p < .001), and receiving the intervention in the summer (ß = -0.20, p = .01) predicted more active days. Lower depressed mood (ß = -0.30, p = .047) and uninterrupted app access (ß = -0.50, p < .001) predicted more messages read. Qualitatively, technical glitches and competing priorities were described as engagement barriers, whereas certain types of messages (e.g., health goal messages) were perceived as engaging. Among participants who had uninterrupted app access (n = 76), higher baseline motivation to change, better health perceptions, using the app during the summer, and iPhone ownership predicted higher engagement. CONCLUSIONS: Findings demonstrate the importance of comprehensively assessing and planning for multi-level ecological determinants of mHealth engagement in future trials. CLINICALTRIALS.GOV IDENTIFIER: NCT03363711.

Acceptability and feasibility of survivorship care plans and an accompanying mobile health intervention for adolescent and young adult survivors of childhood cancer.

BACKGROUND: Self-management interventions for adolescent and young adult (AYA) survivors of childhood cancer are needed. The present study reports on the acceptability and feasibility of delivering survivorship care plans (SCPs) and an accompanying app to AYA. PROCEDURE: AYA (n = 224) ages 15-29 who completed treatment for cancer were randomized and received a digital SCP only or an SCP plus a mobile app intended to enhance self-management. For 16 weeks, the app delivered one to two daily messages complementing information in their SCP and tailored based on age, treatment, and health goal. Data are presented on feasibility, self-reported acceptability (including satisfaction and perceived benefits) and its relationship to app engagement (for those in app group), and feedback from qualitative interviews conducted with 10 AYA. RESULTS: The SCP and app proved feasible as evidenced by high recruitment and retention, access to technology, time analysis, moderate app engagement, and minimal technical issues. However, 12% reported never reading the SCP and 8% never used the app. The app and SCP were acceptable to AYA, and SCP acceptability ratings did not differ between groups. For those with the app, acceptability was positively related to message engagement. AYA recommended enhanced individualization and design features of the SCP and app. CONCLUSIONS: Results support the use of tailored SCPs and mobile health interventions for most AYA, as well as the need for further refinement and research. Delivery of SCPs and digital interventions are acceptable and feasible to AYA survivors, and may help promote health-related knowledge and survivorship self-management.

Perceptions of Ability Mediate the Effect of Motor Coordination on Aerobic and Musculoskeletal Exercise Performance in Young Children at Risk for Developmental Coordination Disorder.

This study examined the effects of perceptions of motor abilities on aerobic and musculoskeletal exercise performance in young children at risk for developmental coordination disorder (rDCD). The participants (N = 539) were part of a larger cohort study, the Coordination and Activity Tracking in Children (CATCH) study. The Movement Assessment Battery for Children (2nd Edition) was used to determine rDCD children. Perceptions of motor abilities were measured by the Perceived Efficacy and Goals Setting system. Aerobic exercise performance was measured using the Bruce Protocol treadmill test, and musculoskeletal exercise performance was assessed using the standing long jump and the Wingate Anaerobic test. The rDCD children reported lower Perceived Efficacy and Goals Setting scores and performed worse on all exercise performance measures. Perceptions of ability also mediated the relationship between developmental coordination disorder and each exercise performance test. It is concerning that children with low motor coordination report lower perceptions of ability even at a very young age.

Physical activity in young children at risk for developmental coordination disorder.

AIM: To examine cross-sectional differences in patterns of daily physical activity accumulation between preschool children at risk for developmental coordination disorder (DCD) compared to typically developing children. METHOD: In total, 514 children (292 males, 222 females; 4-5y) were recruited as part of the Coordination and Activity Tracking in CHildren (CATCH) study. Motor competence was assessed using the Movement Assessment Battery for Children, Second Edition; children scoring ≤5th centile comprised the probable DCD group (pDCD, n=87), between the 6th and 16th centile were considered to be at risk for DCD (rDCD, n=149), and >16th centile were considered typically developing (n=278). Seven-day physical activity was measured using hip-worn accelerometers. Average daily intensity of activity, frequency, and duration of moderate-to-vigorous physical activity (MVPA) bouts, and triaxial activity counts per minute were determined. RESULTS: No differences in daily activity in any intensity or axis of movement were found among the three groups. However, young children with pDCD accumulated their MVPA in slightly shorter bouts compared to typically developing children. INTERPRETATION: Young children at risk for DCD are not yet in an activity deficit. This may be because of the low motor skill demands of play in this age group. Early motor interventions may be able to promote continued physical activity participation in children with DCD. WHAT THIS PAPER ADDS: Preschool children at risk for developmental coordination disorder (DCD) are not less active than their peers. Overall intensity and frequency of daily activity bouts are similar among motor groups. Children with probable DCD accumulate their activity in shorter bouts.

ACTIVIDAD FÍSICA EN NIÑOS PEQUEÑOS CON RIESGO DE TRASTORNO DEL DESARROLLO DE LA COORDINACIÓN: OBJETIVO: Examinar por medio de un corte transversal las diferencias en los patrones de actividad física entre los niños en edad preescolar con riesgo de trastorno del desarrollo de la coordinación (TDC) en comparación con niños con un desarrollo típico MÉTODO: En total, se reclutaron 514 niños (292 varones, 222 mujeres; de 4 y 5 años) como parte del estudio Coordinación y Seguimiento de Actividad en niños (CATCH). Las capacidades motrices se evaluaron utilizando el test MABC 2 (Movement Assessment Battery for Children). Los niños con puntaje ≤5 percentilo formaron el grupo con TDC probable (pTDC, n = 87), entre percentilos 6 y 16 se consideraron en riesgo de TDC (rTDC, n = 149), y > percentilo 16 se consideraron con desarrollo típico (o normal, n = 278). La actividad física a lo largo de siete días se midió utilizando acelerómetros portados en la cadera. Se determinó la intensidad diaria promedio de la actividad, la frecuencia y la duración de los momentos de actividad física moderada a intensa (MVPA), y los recuentos de actividad triaxial por minuto. RESULTADOS: No se encontraron diferencias en la actividad diaria en ninguna intensidad o eje de movimiento entre los tres grupos. Sin embargo, los niños pequeños con pTDC desarrollaron su MVPA (actividad física moderada a intensa) en episodios ligeramente más cortos en comparación con los niños con un desarrollo típico. INTERPRETACIÓN: Los niños pequeños en riesgo de TDC aún no presentan un déficit de actividad. Esto puede ser debido a las bajas exigencias motrices del juego en este grupo etario. Las intervenciones motoras tempranas pueden promover la participación en actividades físicas de los niños con TDC.

ATIVIDADE FÍSICA EM CRIANÇAS PEQUENAS COM RISCO DE TRANSTORNO DO DESENVOLVIMENTO DA COORDENAÇÃO: OBJETIVO: Observar as diferenças transversais nos padrões de acumulação de atividade física diária entre crianças na idade pré-escolar com risco de transtorno do desenvolvimento da coordenação (TDC) e crianças de desenvolvimento típico. MÉTODOS: Um total de 512 crianças (292 meninos, 222 meninas; de idade entre 4 e 5 anos) foram recrutadas como parte do estudo Acompanhamento da Coordenação e de Atividades de Crianças (Coordination and Activity Tracking in CHildren - CATCH). As competências motoras foram avaliadas por meio da Bateria de Avaliação do Movimento para Crianças (Movement Assessment Battery for Children - MABC) segunda edição. Crianças com pontuação abaixo do quinto percentil compunham o provável grupo com TDC (pDDC, n=87), entre o percentil 6 e 16 foram consideradas com risco de DDC (rTDC, n=149), e aquelas com pontuação acima do percentil 16 foram consideradas de desenvolvimento típico (n=278). A atividade física ao longo de 7 dias foi mensurada utilizando-se acelerômetros posicionados no quadril. Foram avaliadas a média de intensidade da atividade diária, frequência e duração das atividades físicas moderadas a vigorosas e contagem das atividades triaxiais por minuto. RESULTADOS: Não foram encontradas diferenças entre os três grupos avaliados para intensidade ou eixo de movimento. Entretanto, crianças do grupo pTDC acumularam suas atividades físicas moderadas a vigorosas em blocos ligeiramente mais curtos do que crianças de desenvolvimento típico. INTERPRETAÇÃO: Crianças mais novas com risco de TDC ainda não apresentam déficits de atividade física. Isso pode ser devido às baixas demandas motoras de brincar nessa faixa etária. Intervenções motoras precoces podem ser capazes de promover participação em atividades físicas continuada em crianças com TDC.

Assessing the Validity of Standing Long Jump to Predict Muscle Power in Children With and Without Motor Delays.

PURPOSE: To determine the validity of standing long jump (SLJ) for predicting muscle power in children with and without developmental coordination disorder (DCD). METHODS: A total of 589 children were recruited as part of the Coordination and Activity Tracking in CHildren study (251 girls and 338 boys; mean age 59.2 mo). Children were classified as typically developing (>16th percentile), at risk for DCD (sixth to 16th percentile), or probable DCD (

MovingU: A prospective cohort study to understand behavioural and environmental contexts influencing physical activity during the transition into emerging adulthood.

BACKGROUND: Children and youth are often considered the most active segment of the population, however, research indicates that physical activity (PA) tends to peak during the adolescent years, declining thereafter with age. In particular, the acute transition out of high school is a period for which individuals appear to be at high-risk for becoming less active. Relatively few studies have investigated the factors influencing the changes in PA during this transition period. Therefore the purpose of the MovingU study is to gain a comprehensive understanding of the behavioural patterns and the socio-ecological factors related to the changes in PA during the transition out of high school. METHODS/DESIGN: MovingU is comprised of two phases. Phase I is a prospective cohort design and aims to follow 120 students in their last year of high school through to their first year out of high school. Students will be asked to complete questionnaires measuring various psychosocial and socio-environmental variables (e.g., self-efficacy and distress) four times throughout this transition period. Students will also be given a wrist-worn accelerometer to wear for 7-days at each of the four assessments. Phase II is a cross-sectional study involving 100 first-year university students. Students will be asked to complete the same questionnaire from phase I, wear a wrist-worn accelerometer for 5-days, and complete ecological momentary assessments (EMA) using their smartphones at randomly selected times throughout the day for 5-days. EMA items will capture information regarding contextual and momentary correlates of PA. DISCUSSION: The MovingU study represents the first to evaluate the social and environmental influences of PA behaviour changes, including the use of intensive real-time data capture strategies during the transition out of high school. This information will be critical in the development of interventions aimed to prevent or attenuate such drastic declines in PA during emerging adulthood period.

The Coordination and Activity Tracking in CHildren (CATCH) study: rationale and design.

BACKGROUND: Past studies have found that children with Developmental Coordination Disorder (DCD) engage in less physical activity than typically developing children. This "activity deficit" may result in children with DCD being less physically fit and more likely to be overweight or obese, potentially increasing later risk for poor cardiovascular health. Unfortunately, the majority of DCD research has been limited to cross-sectional designs, leading to questions about the complex relationship among motor ability, inactivity and health-related fitness. Of the few longitudinal studies on the topic, determining precedence amongst these factors is difficult because study cohorts typically focus on mid to late childhood. By this age, both decreased physical fitness and obesity are often established. The Coordination and Activity Tracking in CHildren (CATCH) study will examine the pathways connecting DCD, physical activity, physical fitness, and body composition from early to middle childhood. METHODS: The CATCH study is a prospective cohort study. We aim to recruit a cohort of 600 children aged 4 to 5 years (300 probable DCD [pDCD] and 300 controls) and test them once a year for 4 years. At Phase 1 of baseline testing, we assess motor skills, cognitive ability (IQ), basic anthropometry, flexibility and lower body muscle strength, while parents complete an interview and questionnaires regarding family demographics, their child's physical activity, and behavioural characteristics. Children who move on to Phase 2 (longitudinal cohort) have their body fat percentage, foot structure, aerobic and anaerobic fitness assessed. An accelerometer to measure physical activity is then given to the child and interested family members. The family also receives an accelerometer logbook and 3-day food dairy. At years 2 to 4, children in the longitudinal cohort will have all baseline assessments repeated (excluding the IQ test), and complete an additional measure of perceived self-efficacy. Parents will complete an ADHD index twice within the follow-up period. To assess the association between DCD, fitness and adiposity, our primary analysis will involve longitudinal growth models with fixed effects. DISCUSSION: The CATCH study will provide a clearer understanding of pathways between DCD and health-related fitness necessary to determine the types of interventions children with DCD require.

Accelerometer techniques for capturing human movement validated against direct observation: a scoping review.

INTRODUCTION: Accelerometers are devices commonly used to measure human physical activity and sedentary time. Accelerometer capabilities and analytical techniques have evolved rapidly, making it difficult for researchers to keep track of advances and best practices for data processing and analysis. OBJECTIVE: The objective of this scoping review is to determine the existing methods for analyzing accelerometer data for capturing human movement which have been validated against the criterion measure of direct observation. METHODS: This scoping review searched 14 academic and 5 grey databases. Two independent raters screened by title and abstract, then full text. Data were extracted using Microsoft Excel and checked by an independent reviewer. RESULTS: The search yielded 1039 papers and the final analysis included 115 papers. 71 unique accelerometer models were used across a total of 4217 participants. While all studies underwent validation from direct observation, most direct observation occurred live (55%) or using recordings (42%). Analysis techniques included machine learning approaches (22%), the use of existing cut-points (18%), ROC curves to determine cut-points (14%), and other strategies including regressions and non-machine learning algorithms (8%). DISCUSSION: Machine learning techniques are becoming more prevalent and are often used for activity identification. Cut-point methods are still frequently used. Activity intensity is the most assessed activity outcome; however, both the analyses and outcomes assessed vary by wear location. CONCLUSIONS: This scoping review provides a comprehensive overview of accelerometer analysis and validation techniques using direct observation and is a useful tool for researchers using accelerometers.

Ethical considerations in using sensors to remotely assess pediatric health behaviors.

Sensors, including accelerometer-based and electronic adherence monitoring devices, have transformed health data collection. Sensors allow for unobtrusive, real-time sampling of health behaviors that relate to psychological health, including sleep, physical activity, and medication-taking. These technical strengths have captured scholarly attention, with far less discussion about the level of human touch involved in implementing sensors. Researchers face several subjective decision points when collecting health data via sensors, with these decisions posing ethical concerns for users and the public at large. Using examples from pediatric sleep, physical activity, and medication adherence research, we pose critical ethical questions, practical dilemmas, and guidance for implementing health-based sensors. We focus on youth given that they are often deemed the ideal population for digital health approaches but have unique technology-related vulnerabilities and preferences. Ethical considerations are organized according to Belmont principles of respect for persons (e.g., when sensor-based data are valued above the subjective lived experiences of youth and their families), beneficence (e.g., with sensor data management and sharing), and justice (e.g., with sensor access and acceptability among minoritized pediatric populations). Recommendations include the need to increase transparency about the extent of subjective decision making with sensor data management. Without greater attention to the human factors involved in sensor research, ethical risks could outweigh the scientific promise of sensors, thereby negating their potential role in improving child health and care. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Stability of M-ABC-2-measured motor functioning in early childhood: Evidence from a large prospective cohort.

AIM: Some studies have reported that children with poor motor functioning tend to improve over time. However, much existing research does not account for regression towards the mean (RTM). Here, we examine measurement stability among 589 children aged 4-5 years. METHOD: We administered the Movement Assessment Battery for Children 2nd Edition annually to 269 children initially scoring above and 252 at or below the 16th percentile. We measured agreement between year 1 and year 2 standard scores using Pearson correlation and derived expected regression towards the mean (RTM). We then regressed follow-up on baseline scores, controlling for relative age, sex, and exact interval between assessments. Finally, we performed a small illustrative simulation. OUTCOMES AND RESULTS: The mean score in the poor-coordination group rose from 5.6 (SD = 1.5) to 7.2 (SD = 2.8). Year 1 and year 2 scores were correlated at r = 0.66, corresponding to predicted RTM in the MI group of 1.56, close to the observed change of 1.57. Degree of change was not associated with time between assessments. INTERPRETATION: Observed improvements in motor functioning were consistent with measurement error. The stability of motor functioning may be greater than it appears from past research, and reported functional improvements in some studies may be illusory. WHAT THIS PAPER ADDS?

Physical Activity Trajectories in Early Childhood: Investigating Personal, Environmental, and Participation Factors.

INTRODUCTION/PURPOSE: To determine personal, environmental, and participation factors that predict children's physical activity (PA) trajectories from preschool through to school years. METHODS: Two hundred seventy-nine children (4.5 ± 0.9 yr, 52% boys) were included in this study. Physical activity was collected via accelerometry at six different timepoints over 6.3 ± 0.6 yr. Time-stable variables were collected at baseline and included child's sex and ethnicity. Time-dependent variables were collected at six timepoints (age, years) and included household income (CAD), parental total PA, parental influence on PA, and parent-reported child's quality of life, child's sleep, and child's amount of weekend outdoor PA. Group-based trajectory modeling was applied to identify trajectories of moderate-to-vigorous PA (MVPA) and total PA (TPA). Multivariable regression analysis identified personal, environmental, and participation factors associated with trajectory membership. RESULTS: Three trajectories were identified for each of MVPA and TPA. Group 3 in MVPA and TPA expressed the most PA over time, with increased activity from timepoints 1 to 3, and then declining from timepoints 4 to 6. For the group 3 MVPA trajectory, male sex (ß estimate, 3.437; P = 0.001) and quality of life (ß estimate, 0.513; P < 0.001) were the only significant correlates for group membership. For the group 3 TPA trajectory, male sex (ß estimate, 1.970; P = 0.035), greater household income (ß estimate, 94.615; P < 0.001), and greater parental total PA (ß estimate, 0.574; P = 0.023) increased the probability of belonging to this trajectory group. CONCLUSIONS: These findings suggest a need for interventions and public health campaigns to increase opportunities for PA engagement in girls starting in the early years. Policies and programs to address financial inequities, positive parental modeling, and improving quality of life are also warranted.