Parental psychological problems were associated with higher screen time and the use of mature-rated media in children.

AIM: Parents' psychological problems may affect children's screen time, but research has been scarce. We examined the association between parental psychological problems and children's screen media behaviours in a nationally representative sample. METHODS: The participants were from the Adolescent Brain Cognitive Development study, recruited by probability sampling from the USA population. Children reported their use of TV, videos, video games, social media and mature-rated media. The parents (85% mothers) reported psychological problems using the Adult Self-Report questionnaire. RESULTS: In 10,650 children (5112 girls, 5538 boys) aged 9.9 ± 0.6 years, the presence of parental psychological problems was associated with children spending more daily time on screen media and with meeting the recommendation of ≤2 daily hours less often than children whose parents did not have psychological problems. Parental psychological problems were associated with children's TV watching, video watching and gaming but not with using social media. Parental internalising problems were associated with children watching mature-rated movies (odds ratio [OR] = 1.14, 95% confidence interval [CI] = 1.00, 1.30) and playing mature-rated games (OR = 1.27, 95% CI = 1.11, 1.45). CONCLUSION: Presence of parental psychological problems is associated with higher screen time and use of mature-rated media in children. This cross-sectional study was not able to examine causal associations.

Is early activity resumption after paediatric concussion safe and does it reduce symptom burden at 2 weeks post injury? The Pediatric Concussion Assessment of Rest and Exertion (PedCARE) multicentre randomised clinical trial.

OBJECTIVE: Investigate whether resuming physical activity (PA) at 72 hours post concussion is safe and reduces symptoms at 2 weeks, compared with resting until asymptomatic. METHODS: Real-life conditions, multicentre, single-blinded randomised clinical trial, conducted in three Canadian paediatric emergency departments (ED). Children/youth aged 10-<18 years with acute concussion were recruited between March 2017 and December 2019, and randomly assigned to a 4-week stepwise return-to-PA protocol at 72 hours post concussion even if symptomatic (experimental group (EG)) or to a return-to-PA once asymptomatic protocol (control group (CG)). The primary outcome was self-reported symptoms at 2 weeks using the Health and Behaviour Inventory. Adherence was measured using accelerometers worn 24 hours/day for 14 days post injury. Adverse events (AE) (worsening of symptoms requiring unscheduled ED or primary care visit) were monitored. Multivariable intention-to-treat (ITT) and per-protocol analyses adjusting for prognostically important covariates were examined. Missing data were imputed for the ITT analysis. RESULTS: 456 randomised participants (EG: N=227; mean (SD) age=13.3 (2.1) years; 44.5% women; CG: N=229; mean (SD) age=13.3 (2.2) years; 43.7% women) were analysed. No AE were identified. ITT analysis showed no strong evidence of a group difference at 2 weeks (adjusted mean difference=-1.3 (95% CI:-3.6 to 1.1)). In adherent participants, initiating PA 72 hours post injury significantly reduced symptoms 2 weeks post injury, compared with rest (adjusted mean difference=-4.3 (95% CI:-8.4 to -0.2)). CONCLUSION: Symptoms at 2 weeks did not differ significantly between children/youth randomised to initiate PA 72 hours post injury versus resting until asymptomatic; however, many were non-adherent to the intervention. Among adherent participants, early PA was associated with reduced symptoms at 2 weeks. Resumption of PA is safe and may be associated with milder symptoms at 2 weeks. LEVEL OF EVIDENCE: 1b. TRIAL REGISTRATION NUMBER: NCT02893969. REGISTRY NAME: Pediatric Concussion Assessment of Rest and Exertion (PedCARE).

Profiles of mental health and their association with negative impacts and suicidal ideation during the COVID-19 pandemic: A Canadian perspective.

Background: Mental health among Canadians has worsened since the start of the COVID-19 pandemic. The purpose of this study was to identify profiles of mental health difficulties and to quantify the relationships between mental health profiles, negative impacts related to the pandemic and suicidal ideation. Data and methods: Participants were 22,721 adults (18 years and older) from the 2020 and 2021 Survey on COVID-19 and Mental Health. Latent profile analysis was used to identify patterns of anxiety, depression and psychological distress. The relationships between mental health profiles, negative impacts and suicidal ideation were examined using logistic regression models. Results: Three mental health profiles were identified. Individuals were classified as having no mental health difficulties (Profile 1, 65.70%), low-to-moderate mental health difficulties (Profile 2, 25.52%) and severe mental health difficulties (Profile 3, 8.78%). Individuals in Profiles 2 and 3 were at greater odds than individuals in Profile 1 of experiencing emotional distress; the death of a family member, friend or colleague; difficulty in meeting financial obligations or essential needs; the loss of a job or income; feelings of loneliness or isolation; physical health problems; challenges in personal relationships with household members; and other impacts. Individuals in Profile 2 (4.27%, odds ratio (OR) = 24.30) and Profile 3 (19.09%, odds ratio (OR) = 115.75) were considerably more likely to have contemplated suicide since the onset of the pandemic compared with those in Profile 1 (0.16%). Interpretation: Individuals who experienced high levels of anxiety, depression and psychological distress were most vulnerable to negative impacts related to the pandemic and suicidal ideation.

Body mass index and movement behaviors among schoolchildren from 13 countries across a continuum of human development indices: A multinational cross-sectional study.

OBJECTIVE: This study describes the distributions of body mass index (BMI) and movement behaviors among schoolchildren from 13 countries across a continuum of human development. METHODS: Data were from a cross-sectional study of 9-11-year-old children (n = 8055) recruited from 269 urban schools in 13 countries, and an additional 7 rural schools in one of these countries (Mozambique). BMI was derived from objectively measured heights and weights. Moderate- to vigorous-intensity physical activity (MVPA), sedentary time (SED), and sleep duration were assessed by waist-worn Actigraph GT3X+ accelerometers. Linear models were used to describe the distributions of BMI z-scores, MVPA, SED, and sleep among sites across varying Human Development Indices (HDIs). RESULTS: Mean MVPA, SED, and sleep duration were 63.1 ± 27.3 minutes/day, 508.7 ± 72.4 minutes/day, and 8.8 ± 0.9 hours/night, respectively. Overall, 2.1% of the sample were thin, 19.5% overweight, and 11.7% were obese. Density curves (BMI z-scores and SED) for urban children in Mozambique showed significantly higher mean values compared with rural children. Boys had significantly higher mean MVPA compared with girls. Mean BMI z-scores were positively associated (ß = .02; P = .004) with HDI, mean daily MVPA minutes were negatively associated (ß = -.38; P = .025) with HDI, and mean SED time was positively associated with HDI (ß = 1.18; P = .049). No significant association (ß = .01; P = .29) was observed between sleep duration and HDI. CONCLUSION: Our findings show distinct differences in BMI and movement behavior profiles between urban and rural children in Mozambique. Mean BMI z-scores, MVPA, and SED differed by country HDI. These findings support the need to include both rural and urban participants in study samples.

Relationships Among Children's Independent Mobility, Active Transportation, and Physical Activity: A Multisite Cross-Sectional Study.

PURPOSE: Children's independent mobility (IM) may facilitate both active transportation (AT) and physical activity (PA), but previous studies examining these associations were conducted in single regions that provided limited geographical variability. METHOD: We recruited 1699 children (55.0% girls) in 37 schools stratified by level of urbanization and socioeconomic status in 3 regions of Canada: Ottawa, Trois-Rivières, and Vancouver. Participants wore a SC-StepRx pedometer for 7 days and completed a validated questionnaire from which we derived a 6-point IM index, the number of AT trips over a week, and the volume of AT to/from school (in kilometer per week). We investigated relationships among measures of IM, AT, and PA employing linear mixed models or generalized linear mixed models adjusted for site, urbanization, and socioeconomic status. RESULTS: Each unit increase in IM was associated with 9% more AT trips, 19% higher AT volume, and 147 more steps per day, with consistent results across genders. Both measures of AT were associated with marginally higher PA when pooling boys' and girls' data. Children in Vancouver engaged in more AT. PA did not vary across site, urbanization, or socioeconomic status. CONCLUSION: IM was associated with more AT and PA regardless of where children lived, underscoring a need for IM interventions.

Evaluation of the process and outcomes of the Global Matrix 3.0 of physical activity grades for children and youth.

BACKGROUND/OBJECTIVE: Participation in the Active Healthy Kids Global Alliance (AHKGA) Global Matrix initiative represents a significant work and resource investment for Report Card teams. The objective of this paper was to evaluate the process and findings of the Global Matrix 3.0 and formulate recommendations for improvement. METHODS: The evaluation of the Global Matrix 3.0 was planned prior to its development and a list of potential process, impact, and outcome indicators were pre-identified. These indicators were informed by online surveys, direct reports, MailChimp's statistics, Google Analytics of the AHKGA website, and emails sent to the AHKGA Board of Directors. RESULTS: Five online surveys were completed by 88%-100% of the targeted respondents. High satisfaction ratings were observed for most of the Global Matrix 3.0 methods, key steps, concepts, and the resources (e-blasts and website) provided by the AHKGA. A total of 496 open-ended comments were provided in the five surveys, including 199 comments reporting issue(s), and 38 reporting both positive feedback and issue(s). The participating Report Card teams successfully assigned a grade to each physical activity indicator, produced a Report Card document, and wrote a short Report Card article. CONCLUSION: This evaluation process allowed for the identification of needed improvements and the formulation of recommendations for future Global Matrix initiatives. This work highlighted the need for the development of physical activity behavior assessment tools that would be internationally adopted and culturally adaptable to varying contexts to improve the standardization of physical activity surveillance at the global scale.

Testing validity of FitnessGram in two samples of US adolescents (12-15 years).

BACKGROUND: This study examined the validity of the FitnessGram® criterion-reference cut-points for cardiorespiratory fitness (CRF) based on two samples of US adolescents (aged 12-15 years). This study also established the CRF cut-points for metabolically healthy weight status based on a recent national fitness survey for the purposes of cross-validating with pre-existing cut-points including FitnessGram. METHODS: Two cross-sectional data from the 2003-2004 National Health and Nutrition Examination Survey (NHANES) (n = 378) and 2012 NHANES National Youth Fitness Survey (NNYFS) (n = 451) were used. CRF (estimated V ˙ O2max in mL/kg/min) was estimated from a submaximal exercise test. CRF categories based on FitnessGram cut-points, a clustered cardiometabolic risk factors score and weight status were used. A series of Receiver Operating Characteristic (ROC) curve analyses were conducted to identify age- and sex-specific CRF cut-points that were optimal for metabolically healthy weight status. RESULTS: Based on FitnessGram cut-points, having high risk CRF, but not low risk CRF, was associated with high cardiometabolic risk (OR = 3.17, 95% CI = 1.14-8.79) and unhealthy weight status (OR = 5.81, 95% CI = 3.49-9.68). The optimal CRF cut-points for 12-13-year-olds and 14-15-year-olds were 40 and 43 mL/kg/min in males and 39 and 34 mL/kg/min in females, respectively. Compared to meeting new CRF cut-points, not meeting new CRF cut-points was associated with higher odds of showing high cardiometabolic risk (OR = 2.91, 95% CI = 1.47-5.77) and metabolically unhealthy weight status (OR = 4.47, 95% CI = 2.83-7.05). CONCLUSION: FitnessGram CRF cut-point itself has rarely been scrutinized in previous literature. Our findings provide partial support for FitnessGram based on two samples of US adolescents. CRF cut-points established in this study supports international criterion-referenced cut-points as well as FitnessGram cut-points only for males. FitnessGram should be continuously monitored and scrutinized using different samples.

Screen time and problem behaviors in children: exploring the mediating role of sleep duration.

BACKGROUND: Previous research examining the relationship between screen time (ST) and psychological health outcomes have primarily focused on one type of ST (i.e., television), while little research has considered other types of screens (e.g., videos, movies, social media), screen content (e.g., violent video games), or potential mediating variables. Therefore, the purpose of the present study was to assess ST types and content and their association with problem behaviors, and to determine whether these relationships were mediated by sleep duration. METHODS: Parents and children provided cross-sectional baseline data (2016-18) as part of the Adolescent Brain Cognitive Development study, a broadly US representative sample of 11,875 children aged 9 to 10 years. Parents self-reported their children's emotional and behavioral syndromes via the Child Behavior Checklist and sleep duration using one item from the Parent Sleep Disturbance Scale. Children self-reported their ST behavior, which comprised ST types (television/movies, videos, video games, and social media) and content (mature-rated video games and R-rated movies). RESULTS: Time spent in various ST types was positively associated with problem behaviors: watching television/movies was associated with a 5.9% increase in rule-breaking behavior (incidence rate ratio [IRR] = 1.059), 5% increase in social problems (IRR = 1.050), 4% increase in aggressive behavior (IRR = 1.040), and 3.7% increase in thought problems (IRR = 1.037). Greater time spent playing mature-rated video games was associated with greater somatic complaints (IRR = 1.041), aggressive behavior (IRR = 1.039), and reduced sleep duration (IRR = .938). Sleep duration mediated the relationship between ST (type and content) and problem behaviors, albeit the effect sizes were small. The largest effects were observed between sleep duration and all problem behaviors, with greater sleep duration predicting an 8.8-16.6% decrease in problem behaviors (IRRs ranging from .834 to .905). CONCLUSION: Greater time spent in ST behavior was associated with greater problem behaviors among children. There was strong evidence that longer sleep duration was associated with reduced problem behaviors. While sleep duration mediated the effects of ST on problem behaviors, other potential mediating variables need to be investigated in future research.

Prevalence and correlates of adherence to movement guidelines among urban and rural children in Mozambique: a cross-sectional study.

BACKGROUND: Insufficient physical activity, short sleep duration, and excessive recreational screen time are increasing globally. Currently, there are little to no data describing prevalences and correlates of movement behaviours among children in low-middle-income countries. The few available reports do not include both urban and rural respondents, despite the large proportion of rural populations in low-middle-income countries. We compared the prevalence of meeting 24-h movement guidelines and examined correlates of meeting the guidelines in a sample of urban and rural Mozambican schoolchildren. METHODS: This is cross-sectional study of 9-11 year-old children (n = 683) recruited from 10 urban and 7 rural schools in Mozambique. Moderate- to vigorous-intensity physical activity (MVPA) and sleep duration were measured by waist-worn Actigraph GT3X+ accelerometers. Accelerometers were worn 24 h/day for up to 8 days. Recreational screen time was self-reported. Potential correlates of meeting 24-h movement guidelines were directly measured or obtained from validated items of context-adapted questionnaires. Multilevel multivariable logit models were used to determine the correlates of movement behaviours. Meeting 24-h movement guidelines was defined as ≥60 min/day of MVPA, ≤2 h/day of recreational screen time, and between 9 and 11 h/night of sleep. RESULTS: More rural (17.7%) than urban (3.6%) children met all three 24-h movement guidelines. Mean MVPA was lower (82.9 ± 29.5 min/day) among urban than rural children (96.7 ± 31.8 min/day). Rural children had longer sleep duration (8.9 ± 0.7 h/night) and shorter recreational screen time (2.7 ± 1.9 h/day) than their urban counterparts (8.7 ± 0.9 h/night and 5.0 ± 2.3 h/day respectively). Parental education (OR: 0.37; CI: 0.16-0.87), school location (OR: 0.21; CI: 0.09-0.52), and outdoor time (OR: 0.67; CI: 0.53-0.85) were significant correlates of meeting all three 24-h movement guidelines. CONCLUSIONS: Prevalence and correlates of meeting movement guidelines differed between urban and rural schoolchildren in Mozambique. On average, both groups had higher daily MVPA minutes, shorter sleep duration, and higher recreational screen time than the 24-h movement guidelines recommend. These findings (e.g., higher than recommended mean daily MVPA minutes) differ from those from high-income countries and highlight the need to sample from both urban and rural areas.

Relationships between area-level socioeconomic status and urbanization with active transportation, independent mobility, outdoor time, and physical activity among Canadian children.

BACKGROUND: Active transportation (AT), independent mobility (IM), and outdoor time are promising ways to increase children's physical activity. However, in order to create interventions to increase those forms of physical activity, it is important to understand the relationships between area-level socioeconomic status (SES) and type of urbanization with AT, IM, outdoor time, and physical activity, and this was the aim of the study. METHODS: One thousand six hundred ninety-nine children in grades 4 to 6 (mean age: 10.2 ± 1.0 years) from three Canadian regions participated. AT, IM, and outdoor time were assessed using questionnaires and physical activity was measured using the SC-StepRX pedometer. Area-level SES was assessed using the median household income of the census tract in which the school was located and type of urbanization was determined for each school using standardized procedures. Generalized linear and general linear mixed models were used to examine the relationships. RESULTS: Area-level SES and the type of urbanization were generally not related to AT, IM, or physical activity for either gender. However, we observed that both boys and girls living in lower SES areas had decreased odds of spending > 2 h outdoors on weekend days compared to their peers from higher SES areas. Girls living in suburban or rural areas were more likely to spend > 2 h outdoors on weekdays compared to their urban counterparts. CONCLUSIONS: AT, IM, and physical activity are generally not associated with area-level SES or the type of urbanization in this sample of Canadian children. The finding regarding outdoor time showing that both boys and girls of lower SES areas had decreased odds of spending > 2 h outdoors on weekends compared to their peers from higher SES areas suggest that additional efforts should be implemented to offer outdoor play opportunities in lower SES areas.

An exploratory analysis of missing data from the Royal Bank of Canada (RBC) Learn to Play - Canadian Assessment of Physical Literacy (CAPL) project.

BACKGROUND: Physical literacy comprises a range of tests over four domains (Physical Competence, Daily Behaviour, Motivation and Confidence, and Knowledge and Understanding). The patterns of missing data in large field test batteries such as those for physical literacy are largely unknown. Therefore, the aim of this paper was to explore the patterns and possible reasons for missing data in the Royal Bank of Canada Learn to Play-Canadian Assessment of Physical Literacy (RBC Learn to Play-CAPL) project. METHODS: A total of 10,034 Canadian children aged 8 to 12 years participated in the RBC Learn to Play-CAPL project. A 32-variable subset from the larger CAPL dataset was used for these analyses. Several R packages ("Hmisc", "mice", "VIM") were used to generate matrices and plots of missing data, and to perform multiple imputations. RESULTS: Overall, the proportion of missing data for individual measures and domains ranged from 0.0 to 33.8%, with the average proportion of missing data being 4.0%. The largest proportion of missing data in CAPL was the pedometer step counts, followed by the components of the Physical Competence domain and the Children's Self-Perception of Adequacy in and Predilection for Physical Activity subscales. When domain scores were regressed on five imputed subsets with the original subset as the reference, there were small and statistically detectable differences in the Daily Behaviour score (ß = - 1.6 to - 1.7, p < 0.001). However, for the other domain scores the differences were negligible and statistically undetectable (ß = - 0.01 to - 0.06, p > 0.05). CONCLUSIONS: This study has implications for other researchers or educators who are creating or using large field-based assessment measures in the areas of physical literacy, physical activity, or physical fitness, as this study demonstrates where problems in data collection can arise and how missing data can be avoided. When large proportions of missing data are present, imputation techniques, correction factors, or other treatment options may be required.

Refining the Canadian Assessment of Physical Literacy based on theory and factor analyses.

BACKGROUND: The Canadian Assessment of Physical Literacy (CAPL) is a 25-indicator assessment tool comprising four domains of physical literacy: (1) Physical Competence, (2) Daily Behaviour, (3) Motivation and Confidence, and (4) Knowledge and Understanding. The purpose of this study was to re-examine the factor structure of CAPL scores and the relative weight of each domain for an overall physical literacy factor. Our goal was to maximize content representation, and reduce construct irrelevant variance and participant burden, to inform the development of CAPL-2 (a revised, shorter, and theoretically stronger version of CAPL). METHODS: Canadian children (n = 10,034; Mage = 10.6, SD = 1.2; 50.1% girls) completed CAPL testing at one time point. Confirmatory factor analysis was used. RESULTS: Based on weak factor loadings (λs < 0.32) and conceptual alignment, we removed body mass index, waist circumference, sit-and-reach flexibility, and grip strength as indicators of Physical Competence. Based on the factor loading (λ < 0.35) and conceptual alignment, we removed screen time as an indicator of Daily Behaviour. To reduce redundancy, we removed children's activity compared to other children as an indicator of Motivation and Confidence. Based on low factor loadings (λs < 0.35) and conceptual alignment, we removed knowledge of screen time guidelines, what it means to be healthy, how to improve fitness, activity preferences, and physical activity safety gear indicators from the Knowledge and Understanding domain. The final refined CAPL model was comprised of 14 indicators, and the four-factor correlated model fit the data well (r ranged from 0.08 to 0.76), albeit with an unexpected cross-loading from Daily Behaviour to knowledge of physical activity guidelines (mean- and variance-adjusted weighted least square [WLSMV] χ2(70) = 1221.29, p < 0.001, Comparative Fit Index [CFI] = 0.947, root mean square error of approximation [RMSEA] = 0.041[0.039, 0.043]). Finally, our higher-order model with Physical Literacy as a factor with indicators of Physical Competence (λ = 0.68), Daily Behaviour (λ = 0.91), Motivation and Confidence (λ = 0.80), and Knowledge and Understanding (λ = 0.21) fit the data well. CONCLUSIONS: The scores from the revised and much shorter 14-indicator model of CAPL can be used to assess the four correlated domains of physical literacy and/or a higher-order aggregate physical literacy factor. The results of this investigation will inform the development of CAPL-2.

Influence of the relative age effect on children's scores obtained from the Canadian assessment of physical literacy.

BACKGROUND: Age grouping by the imposition of a cut-off date, common in sports and education, promotes a relative age difference that is associated with developmental advantages for children who are born on the "early side" of the cut-off date and disadvantages to those born later in the same year, which is known as the relative age effect (RAE) bias. Acquiring an adequate level of physical literacy is important for children to remain active for life. The Canadian Assessment of Physical Literacy (CAPL) is an assessment protocol that encompasses measures in the domains of children's Daily Behaviours, Physical Competence, Motivation and Confidence, and Knowledge and Understanding. The purpose of this study was to ascertain whether the CAPL scores were susceptible to the RAE, which could affect our interpretation of the CAPL findings. METHODS: This cross-sectional study examined if scores obtained in the CAPL (i.e., the four domains individually and the total CAPL score) were susceptible to the RAE in children aged 8 to 12 years and, if so, which physical competence assessments (movement skills, cardiorespiratory, strength, muscular endurance, flexibility, and body composition measurements) were more susceptible. Participants (n = 8233, 49.8% boys) from the Royal Bank of Canada-CAPL Learn to Play project from 11 sites in seven Canadian provinces were tested using the CAPL protocol. RESULTS: Among boys and girls, the RAE was significantly associated with two and three of the four domain scores, respectively, after controlling for covariates. However, effect sizes were negligible for the comparisons between quarters of the year and physical literacy domains and overall scores. For the main effect of the relative age, boys and girls born in the first three months of the year were taller (F(3, 4074) = 57.0, p < 0.001, ƒ2 = 0.04 and F(3, 4107) = 58.4, p < 0.001, ƒ2 = 0.04, respectively) and demonstrated greater muscular strength (F(3, 4037) = 29.2, p < 0.001, ƒ2 = 0.02 and F(3, 4077) = 25.1, p < 0.001, ƒ2 = 0.02, respectively) compared with those born later in the same year. CONCLUSIONS: Collectively, our results suggest that the RAE bias is mainly negligible with regard to the domain scores and overall CAPL scores in this large sample of children.

Revising the motivation and confidence domain of the Canadian assessment of physical literacy.

BACKGROUND: The Motivation and Confidence domain questionnaire in the Canadian Assessment of Physical Literacy (CAPL) was lengthy (36 single items that aggregate to five subscales), and thus burdensome to both participants and practitioners. The purpose of this study was to use factor analysis to refine the Motivation and Confidence domain to be used in the CAPL-Second Edition (CAPL-2). METHODS: Children, primarily recruited through free-of-charge summer day camps (n = 205, Mage = 9.50 years, SD = 1.14, 50.7% girls), completed the CAPL-2 protocol, and two survey versions of the Motivation and Confidence questionnaire. Survey 1 contained the Motivation and Confidence questionnaire items from the original CAPL, whereas Survey 2 contained a battery of items informed by self-determination theory to assess motivation and confidence. First, factor analyses were performed on individual questionnaires to examine validity evidence (i.e., internal structure) and score reliability (i.e., coefficient H and omega total). Second, factor analyses were performed on different combinations of questionnaires to establish the least burdensome yet well-fitted and theoretically aligned model. RESULTS: The assessment of adequacy and predilection, based on 16 single items as originally conceptualized within the CAPL, was not a good fit to the data. Therefore, a revised and shorter version of these scales was proposed, based on exploratory factor analysis. The self-determination theory items provided a good fit to the data; however, identified, introjected, and external regulation had low score reliability. Overall, a model comprising three single items for each of the following subscales was proposed for use within the CAPL-2: adequacy, predilection, intrinsic motivation, and perceived competence satisfaction. This revised domain fit well within the overall CAPL-2 model specifying a higher-order physical literacy factor (MLRχ2(63) = 81.45, p = 0.06, CFI = 0.908, RMSEA = 0.038, 90% CI (0.00, 0.060)). CONCLUSIONS: The revised and much shorter questionnaire of 12 items that aggregate to four subscales within the domain of Motivation and Confidence is recommended for use in the CAPL-2. The revised domain is aligned with the definition of motivation and confidence within physical literacy and has clearer instructions for completion.

Canadian Assessment of Physical Literacy Second Edition: a streamlined assessment of the capacity for physical activity among children 8 to 12 years of age.

BACKGROUND: The Canadian Assessment of Physical Literacy (CAPL) assesses the capacity of children to lead a physically active lifestyle. It is comprised of a battery of standardized assessment protocols that reflect the Canadian consensus definition of physical literacy. The Royal Bank of Canada Learn to Play - Canadian Assessment of Physical Literacy study implemented the CAPL with 10,034 Canadian children (50.1% female), 8 to 12 years of age. Feedback during data collection, necessary changes identified by the coordinating centre, and recent data analyses suggested that a streamlined, second edition of the CAPL was required. The purpose of this paper is to describe the methods used to develop the CAPL second edition (CAPL-2). METHODS: The larger dataset created through the RBC-Learn to Play CAPL study enabled the re-examination of the CAPL model through factor analyses specific to Canadian children 8 to 12 years of age from across Canada. This comprehensive database was also used to examine the CAPL protocols for redundancy or variables that did not contribute significantly to the overall assessment. Removing redundancy had been identified as a priority in order to reduce the high examiner and participant burden. The "lessons learned" from such a large national surveillance project were reviewed for additional information regarding the changes that would be required to optimize the assessment of children's physical literacy. In addition, administrative changes, improvements, and corrections were identified as necessary to improve the quality and accuracy of the CAPL manual and training materials. RESULTS: For each domain of the CAPL, recommended changes based on the factor analyses, qualitative feedback and theoretical considerations significantly reduced the number of protocols. Specific protocol combinations were then evaluated for model fit within the overarching concept of physical literacy. The CAPL-2 continues to reflect the four components of the Canadian consensus definition of physical literacy: Motivation and Confidence, Physical Competence, Knowledge and Understanding, and engagement in Physical Activity Behaviour. The CAPL-2 is comprised of three Physical Competence protocols (plank, Progressive Aerobic Cardiovascular Endurance Run [PACER], Canadian Agility and Movement Skill Assessment [CAMSA]), two Daily Behaviour protocol (pedometer steps, self-reported physical activity), and a 22-item questionnaire assessing the physical literacy domains of Motivation and Confidence, and Knowledge and Understanding. Detailed information about the CAPL-2 is available online ( www.capl-eclp.ca ). CONCLUSIONS: The CAPL-2 dramatically reduces examiner and participant burden (three Physical Competence protocols, two Daily Behaviour protocols, and a 22-response questionnaire; versus eight Physical Competence protocols, three Daily Behaviour protocols and a 72-response questionnaire for the original CAPL), while continuing to be a comprehensive assessment of all aspects of children's physical literacy using the Canadian consensus definition of this term. Like the original, the CAPL-2 continues to offer maximum flexibility to practitioners, who can choose to complete the entire CAPL-2 assessment, only one or more domains, or select individual protocols. Regardless of the assessment selected, scores are available to interpret the performance of each child relative to Canadian children of the same age and sex. All of the protocols included in the CAPL-2 have published reports of validity and reliability for this age group (8 to 12 years). The detailed manual for CAPL-2 administration, along with training materials and other resources, are available free of charge on the CAPL-2 website ( www.capl-eclp.ca ). All CAPL-2 materials and resources, including the website, are available in both English and French.

Associations between domains of physical literacy by weight status in 8- to 12-year-old Canadian children.

BACKGROUND: The Canadian Assessment of Physical Literacy (CAPL) is divided into four domains (Physical Competence, Daily Behaviour, Motivation and Confidence, and Knowledge and Understanding) and provides a robust and comprehensive assessment of physical literacy. As weight status is known to influence health-related behaviours such as physical fitness and activity, it is important to investigate whether the associations between the domains of physical literacy vary among children of different weight status. The aim of this study was to determine the associations among the four domains of physical literacy stratified by weight status. METHODS: Canadian children aged 8 to 12 years (n = 8343, 63.6% healthy-weight) completed the CAPL. Differences in domain scores and overall physical literacy score by weight status (children of healthy weight versus children with overweight/obese) were assessed using MANOVA (multivariate analysis of variance). Partial correlations between the four domains were calculated, adjusting for gender and age, and correlation coefficients of both weight status groups were compared using the Steiger test. RESULTS: For all four domains as well as overall physical literacy, healthy-weight children had higher scores than their overweight/obese peers (Cohen's d ranged from 0.05 to 0.44). Weak to moderate correlations were found between all of the domains for both groups. Correlation coefficients for Physical Competence and Daily Behaviour as well as for Physical Competence and Knowledge and Understanding were generally stronger in the healthy-weight children (r = 0.29 and 0.22, respectively) compared with the overweight/obese children (r = 0.23 and 0.17, respectively). CONCLUSIONS: All of the domains of the CAPL correlate positively with each other regardless of weight status, with a trend for these correlation coefficients to be slightly stronger in the healthy-weight children. The overall weak to moderate correlations between the domains in both groups suggest that the CAPL domains are not measuring the same constructs, thus providing support for CAPL's psychometric architecture in both healthy-weight and overweight/obese children.

Canada's Physical Literacy Consensus Statement: process and outcome.

BACKGROUND: Healthy movement behaviours of Canadian children and youth have been found to be suboptimal; this is associated with declines in physical fitness, increases in obesity, and elevated chronic disease risk. Physical literacy is an evolving construct representing foundational domains upon which physically active lifestyles are based. Many sectors and organizations in Canada are embracing physical literacy in their programs, practices, policies, and research; however, the use of inconsistent definitions and conceptualizations of physical literacy had been identified by stakeholders as hindering promotion and advancement efforts. METHODS: With leadership from ParticipACTION, organizations from the physical activity, public health, sport, physical education, and recreation sectors collaborated to create a physical literacy consensus definition and position statement for use by all Canadian organizations and individuals. The process involved an environmental scan, survey of related evidence, stakeholder consultations, and creation of a Steering Committee. From this background work a consensus statement was drafted, shared with stakeholders, revised, and ratified. RESULTS: Canada's Physical Literacy Consensus Statement was launched in June 2015 at the International Physical Literacy Conference in Vancouver, British Columbia. To further promote the Consensus Statement, the Sport for Life Society developed and simultaneously released the "Vancouver Declaration", which contained additional guidance on physical literacy. Both the Consensus Statement and the Declaration endorsed the International Physical Literacy Association's definition of physical literacy, namely "the motivation, confidence, physical competence, knowledge and understanding to value and take responsibility for engagement in physical activities for life". CONCLUSIONS: Sector partners hope that the Consensus Statement, with its standardized definition, brings greater harmony, synergy, and consistency to physical literacy efforts in Canada and internationally. Going forward, the impact of this initiative on the sector, and the more distal goal of increasing habitual physical activity levels, should be assessed.

A cross-sectional study exploring the relationship between age, gender, and physical measures with adequacy in and predilection for physical activity.

BACKGROUND: Physical literacy is a complex construct influenced by a range of physical, behavioural, affective, and cognitive factors. Researchers are interested in relationships among these constituent factors. The purpose of this study was to investigate how age, gender, and physical competence components of physical literacy relate to a child's adequacy in and predilection for physical activity. METHODS: A sample of 8530 Canadian youth (50% girl) aged 8.0 to 12.9 years participated in the study. Participants completed the Canadian Assessment of Physical Literacy (CAPL) protocol, which assesses physical literacy in four domains: Physical Competence, Daily Behaviour, Motivation and Confidence, and Knowledge and Understanding. Stepwise multiple regression analyses were conducted to investigate the relationship between physical competence components of physical literacy (Progressive Aerobic Cardiovascular Endurance Run [PACER], Canadian Agility and Movement Skill Assessment [CAMSA], sit and reach, handgrip, plank, and body mass index) and children's perceived adequacy and predilection toward physical activity as measured by subscales from the Children's Self-Perceptions of Adequacy in and Predilection for Physical Activity scale (CSAPPA). RESULTS: The variable most strongly associated with adequacy and predilection was the PACER shuttle run score. The PACER accounted for 10.9% of the variance in adequacy and 9.9% of the variance in predilection. Participants' age was inversely related to adequacy (ß = - 0.374) and predilection (ß = - 0.621). The combination of other variables related to adequacy brought the total variance explained to 14.7%, while the model for predilection explained a total of 13.7%. CONCLUSIONS: Results indicate an association between cardiorespiratory fitness and measures of physical activity adequacy and predilection. These findings suggest that practitioners should consider the physiological and psychological makeup of the child, and ways to enhance adequacy and predilection among children with limited cardiorespiratory fitness, in order to create the best possible environment for all children to participate in physical activity.

Associations between teacher training and measures of physical literacy among Canadian 8- to 12-year-old students.

BACKGROUND: Quality physical education (PE) contributes to the development of physical literacy among children, yet little is known about how teacher training relates to this development. We assessed the association between teacher training, and the likelihood that children met recommended achievement levels for components of physical literacy as defined by the Canadian Assessment of Physical Literacy (CAPL). METHODS: Canadian children (n = 4189; M = 10.72 years, SD = 1.19) from six provinces completed the CAPL. Logistic regression was used to examine the relationship between teacher training (generalist/PE specialist), adjusting for children's age and gender, and physical competence protocols (sit and reach, handgrip, plank, Progressive Aerobic Cardiovascular Endurance Run [PACER], body mass index [BMI], waist circumference, Canadian Agility and Movement Skill Assessment [CAMSA]), the four CAPL domain scores, and the total CAPL score. RESULTS: Teacher training, in addition to children's age and gender, explained only a very small proportion of variance in each model (all R2 < 0.03). Children taught by a generalist were less likely to reach recommended levels of motivation and confidence (OR = 0.83, 95% CI, 0.72-0.95) or CAMSA scores (OR = 0.77, 95% CI, 0.67-0.90), even when accounting for a significant increase in CAMSA score with age (OR = 1.18, 95% CI, 1.12-1.26). All other associations between measures of components of physical literacy and teacher training were not significant. CONCLUSIONS: While teacher training is hypothesized to contribute to the development of physical literacy among elementary school students, the observed effects in this study were either small or null. Children taught by PE specialists were more likely than those taught by generalists to demonstrate recommended levels of motivation and confidence, and to have better movement skills, which are hypothesized to be critical prerequisites for the development of a healthy lifestyle. Further research with more robust designs is merited to understand the impact of teachers' training on the various components of physical literacy development.

The relationship between sedentary behaviour and physical literacy in Canadian children: a cross-sectional analysis from the RBC-CAPL Learn to Play study.

BACKGROUND: Physical literacy is the foundation of a physically active lifestyle. Sedentary behaviour displays deleterious associations with important health indicators in children. However, the association between sedentary behaviour and physical literacy is unknown. The purpose of this study was to identify the aspects of physical literacy that are associated with key modes of sedentary behaviour among Canadian children participating in the RBC-CAPL Learn to Play study. METHODS: A total of 8,307 children aged 8.0-12.9 years were included in the present analysis. Physical literacy was assessed using the Canadian Assessment of Physical Literacy, which measures four domains (Physical Competence, Daily Behaviour, Motivation and Confidence, Knowledge and Understanding). Screen-based sedentary behaviours (TV viewing, computer and video game use), non-screen sedentary behaviours (reading, doing homework, sitting and talking to friends, drawing, etc.) and total sedentary behaviour were assessed via self-report questionnaire. Linear regression models were used to determine significant (p<0.05) correlates of each mode of sedentary behaviour. RESULTS: In comparison to girls, boys reported more screen time (2.7±2.0 vs 2.2±1.8 hours/day, Cohen's d=0.29), and total sedentary behaviour (4.3±2.6 vs 3.9±2.4 hours/day, Cohen's d=0.19), but lower non-screen-based sedentary behaviour (1.6±1.3 vs 1.7±1.3 hours/day, Cohen's d=0.08) (all p< 0.05). Physical Competence (standardized ß's: -0.100 to -0.036, all p<0.05) and Motivation and Confidence (standardized ß's: -0.274 to -0.083, all p<0.05) were negatively associated with all modes of sedentary behaviour in fully adjusted models. Knowledge and Understanding was negatively associated with screen-based modes of sedentary behaviour (standardized ß's: -0.039 to -0.032, all p<0.05), and positively associated with non-screen sedentary behaviour (standardized ß: 0.098, p<0.05). Progressive Aerobic Cardiovascular Endurance Run score and log-transformed plank score were negatively associated with all screen-based modes of sedentary behaviour, while the Canadian Agility and Movement Skill Assessment score was negatively associated with all modes of sedentary behaviour other than TV viewing (all p<0.05). CONCLUSIONS: These results highlight differences in the ways that screen and non-screen sedentary behaviours relate to physical literacy. Public health interventions should continue to target screen-based sedentary behaviours, given their potentially harmful associations with important aspects of physical literacy.