Brief Report: Obesogenic Behaviors of Children with Developmental Disabilities During Summer.

The 'Structured Days Hypothesis' suggests that children's obesogenic behaviors (e.g., activity, diet, sleep, and screen time) are less favorable during times when there is less-structure to a child's day (e.g., summer). To compare obesogenic behaviors of children with developmental disabilities (DD) during summer on days with differing amounts of 'structure'. Seventeen children with DD (mean age 9.8 years) attending a day camp wore a Fitbit© activity monitor on the non-dominant wrist during summer, and parents completed a survey packet, to capture obesogenic behaviors. Participants displayed improved physical activity levels, diets, and sleep timing on camp days versus other days. Providing children with DD 'structure' over summer is a potential intervention approach requiring further investigation.

The application of mHealth to monitor implementation of best practices to support healthy eating and physical activity in afterschool programs.

BACKGROUND: Childhood obesity continues to be a global epidemic and many child-based settings (e.g. school, afterschool programs) have great potential to make a positive impact on children's health behaviors. Innovative and time-sensitive methods of gathering health behavior information for the purpose of evaluation and strategically deploying support are needed in these settings. PURPOSE: The aim is to (1) demonstrate the feasibility of mobile health (mHealth) for monitoring implementation of healthy eating and physical activity (HEPA) standards and, (2) illustrate the utility of mHealth for identifying areas where support is needed, within the afterschool setting. METHODS: Site leaders (N = 175) of afterschool programs (ASPs) were invited to complete an online observation checklist via a mobile web app (Healthy Eating and Physical Activity Mobile, HEPAm) once per week during ASP operating hours. Auto-generated weekly text reminders were sent to site leaders' mobile devices during spring and fall 2015 and 2016 and spring 2017 school semesters. Data from HEPAm was separated into HEPA variables, and expressed as a percent of checklists where an item was present. A higher percentage for a given item would indicate an afterschool has higher compliance with current HEPA standards. RESULTS: A total of 141 site leaders of ASPs completed 13,960 HEPAm checklists. The average number of checklists completed per ASP was 43 (range 1-220) for healthy eating and 50 (range 1-230) for physical activity. For healthy eating, the most common challenge for ASPs was 'Staff educating children about healthy eating', and for physical activity checklists, 'Girls only physical activity is provided at ASP'. CONCLUSION: HEPAm was widely used and provided valuable information that can be used to strategically deploy HEPA support to ASPs. This study gives confidence to the adoption of mHealth strategies as a means for public health practitioners to monitor compliance of an initiative or intervention.

Validity and Wearability of Consumer-based Fitness Trackers in Free-living Children.

Over the past decade wearable fitness trackers (WFTs) have grown in popularity with more recent versions able to capture the pulse rate noninvasively on the wrist of the wearer. Most of evidence on the validity of WFTs have explored adults in clinical settings. Thus, the purpose of this study is to 1) evaluate the validity of a wrist-placed WFT in determining heart rate, and 2) examine the wear compliance of a wrist-placed WFT, in children in free-living settings. In study 1, 19 children (5-12 yrs) wore a Fitbit Charge HR© and a Polar chest strap heart rate (HR) monitor for 2 hours while performing sedentary-to-vigorous activities at a holiday camp in December 2016. In study 2, 20 children with mild developmental disabilities (8-13 yrs) were asked to wear a Fitbit Alta HR© during summer 2017. In study 1, mean absolute percent difference between the WFT HR and criterion was 6.9%. Overall, >75% of WFT HRs were within 5-10% of the criterion. Bland Altman plots indicated a moderate-to-high level of agreement between the WFT and criterion (mean difference 4.1%; Limits of Agreement 26.8, -18.5%). In study 2, participants had the device in their possession for 43 days (SD±14, range 14 - 56 days) and wore it on 67% of those days (range: 20 - 96%) for at least 10 hours/day. Preliminary evidence suggests that WFTs can provide comparable HR estimates to a criterion field-based measure and children can wear WFTs for extended monitoring periods in free-living settings.