Do movement behaviours influence the association between early menarche and depression symptoms among Brazilian adolescents?

Early menarche has been associated with adverse health outcomes, such as depressive symptoms. Discovering effect modifiers across these conditions in the pediatric population is a constant challenge. We tested whether movement behaviours modified the effect of the association between early menarche and depression symptoms among adolescents. This cross-sectional study included 2031 females aged 15-19 years across all Brazilian geographic regions. Data were collected using a self-administered questionnaire; 30.5% (n = 620) reported having experienced menarche before age 12 years (i.e., early menarche). We used the Patient Health Questionnaire (PHQ-9) to evaluate depressive symptoms. Accruing any moderate-vigorous physical activity during leisure time, limited recreational screen time, and having good sleep quality were the exposures investigated. Adolescents who experienced early menarche and met one (B: -4.45, 95% CI: (-5.38, -3.51)), two (B: -6.07 (-7.02, -5.12)), or three (B: -6.49 (-7.76, -5.21)), and adolescents who experienced not early menarche and met one (B: -5.33 (-6.20; -4.46)), two (B: -6.12 (-6.99; -5.24)), or three (B: -6.27 (-7.30; -5.24)) of the movement behaviour targets had lower PHQ-9 scores for depression symptoms than adolescents who experienced early menarche and did not meet any of the movement behaviours. The disparities in depressive symptoms among the adolescents (early menarche vs. not early menarche) who adhered to all three target behaviours were not statistically significant (B: 0.41 (-0.19; 1.01)). Adherence to movement behaviours modified the effect of the association between early menarche and depression symptoms.

Moderators of movement behaviour changes among Canadian toddlers and preschoolers throughout the first two years of the COVID-19 pandemic.

Primary objectives were to examine: 1) changes in movement behaviours (i.e., outdoor play (OP), organized physical activity (PA), screen time (ST), sleep) across the first two years of COVID-19 among Canadian toddlers and preschoolers, and 2) intrapersonal, interpersonal, community, and policy moderators of change in movement behaviors. Participants were 341 Canadian parents of children (start of study: 1-4 years; 48% female). Participants completed online questionnaires regarding their children's movement behaviours and intrapersonal, interpersonal, and community factors at five time-points before and throughout the pandemic (T1-T5). Data from government websites were also used for some community and policy factors. Linear mixed models were conducted. Compared to pre-COVID-19 (T1): OP was on average 30 minutes/day higher at T2 and T3, organized PA was on average 62, 44, 37 minutes/day lower at T2, T3, T4, ST was on average 67, 17, 38, 52 minutes/day higher at T2, T3, T4, T5, and sleep was on average 30, 36, 82 minutes/day lower at T3, T4, T5. Significant moderating variables were observed for OP (parental education, parental work inside home, COVID-19 restriction severity), organized PA (children's sex, started kindergarten, non-parental care, parental education, household income, parental employment status, house type, indoor home space and support for PA), ST (non-parental care, parental marital status) and sleep (children's T1 age group, started kindergarten, parental place of birth, parental employment status). All movement behaviors changed across the first two years of COVID-19 but patterns and moderators were behaviour-specific. Children from lower socioeconomic status families had the least optimal patterns.

The Associations Between Parental-Reported and Device-Based Measured Outdoor Play and Health Indicators of Physical, Cognitive, and Social-Emotional Development in Preschool-Aged Children.

PURPOSE: Examine in preschool-aged children: (1) the associations between parental-reported and device-measured outdoor play (OP) and health indicators of physical, cognitive, and social-emotional development and (2) whether associations were independent of outdoor moderate- to vigorous-intensity physical activity (MVPA). METHODS: This cross-sectional study included 107 participants. Children's OP was measured via a parental questionnaire and the lux feature of accelerometers. Children's growth, adiposity, and motor skills were assessed as physical development indicators. Visual-spatial working memory, response inhibition, and expressive language were assessed as cognitive development indicators. Sociability, prosocial behavior, internalizing, externalizing, and self-regulation were assessed as social-emotional development indicators. Regression models were conducted that adjusted for relevant covariates. Additional models further adjusted for outdoor MVPA. RESULTS: Parental-reported total OP, OP in summer/fall months, and OP on weekdays were negatively associated (small effect sizes) with response inhibition and working memory. After adjusting for outdoor MVPA, these associations were no longer statistically significant. OP on weekdays was negatively associated with externalizing (B = -0.04; 95% confidence interval, -0.08 to -0.00; P = .03) after adjusting for outdoor MVPA. A similar pattern was observed for device-based measured total OP (B = -0.49; 95% confidence interval, -1.05 to 0.07; P = .09). CONCLUSIONS: Future research in preschool-aged children should take into account MVPA and contextual factors when examining the association between OP and health-related indicators.

Optimal Volume of Moderate-to-Vigorous Physical Activity Postconcussion in Children and Adolescents.

Importance: Determining the optimal volume of early moderate-to-vigorous-intensity physical activity (MVPA) after concussion and its association with subsequent symptom burden is important for early postinjury management recommendations. Objectives: To investigate the association between cumulative MVPA (cMVPA) over 2 weeks and subsequent symptom burden at 1 week, 2 weeks, and 4 weeks postinjury in children and examine the association between cMVPA and odds of persisting symptoms after concussion (PSAC) at 2 weeks and 4 weeks postinjury. Design, Setting, and Participants: This multicenter cohort study used data from a randomized clinical trial that was conducted from March 2017 to December 2019 at 3 Canadian pediatric emergency departments in participants aged 10.00 to 17.99 years with acute concussion of less than 48 hours. Data were analyzed from July 2022 to December 2023. Exposure: cMVPA postinjury was measured with accelerometers worn on the waist for 24 hours per day for 13 days postinjury, with measurements deemed valid if participants had 4 or more days of accelerometer data and 3 or fewer consecutive days of missing data. cMVPA at 1 week and 2 weeks postinjury was defined as cMVPA for 7 days and 13 days postinjury, respectively. Multiple imputations were carried out on missing MVPA days. Main Outcomes and measures: Self-reported postconcussion symptom burden at 1 week, 2 weeks, and 4 weeks postinjury using the Health and Behavior Inventory (HBI). PSAC was defined as reliable change on the HBI. A linear mixed-effect model was used for symptom burden at 1 week, 2 weeks, and 4 weeks postinjury with a time × cMVPA interaction. Logistic regressions assessed the association between cMVPA and PSAC. All models were adjusted for prognostically important variables. Results: In this study, 267 of 456 children (119 [44.6%] female; median [IQR] age, 12.9 [11.5 to 14.4] years) were included in the analysis. Participants with greater cMVPA had significantly lower HBI scores at 1 week (75th percentile [258.5 minutes] vs 25th percentile [90.0 minutes]; difference, -5.45 [95% CI, -7.67 to -3.24]) and 2 weeks postinjury (75th percentile [565.0 minutes] vs 25th percentile [237.0 minutes]; difference, -2.85 [95% CI, -4.74 to -0.97]) but not at 4 weeks postinjury (75th percentile [565.0 minutes] vs 25th percentile [237.0 minutes]; difference, -1.24 [95% CI, -3.13 to 0.64]) (P = .20). Symptom burden was not lower beyond the 75th percentile for cMVPA at 1 week or 2 weeks postinjury (1 week, 259 minutes; 2 weeks, 565 minutes) of cMVPA. The odds ratio for the association between 75th and 25th percentile of cMVPA and PSAC was 0.48 (95% CI, 0.24 to 0.94) at 2 weeks. Conclusions and Relevance: In children and adolescents with acute concussion, 259 minutes of cMVPA during the first week postinjury and 565 minutes of cMVPA during the second week postinjury were associated with lower symptom burden at 1 week and 2 weeks postinjury. At 2 weeks postinjury, higher cMVPA volume was associated with 48% reduced odds of PSAC compared with lower cMVPA volume.

Race/Ethnicity Inequities in the Association Between Movement Behaviors and Suicidal Thoughts/Ideation Among Adolescents.

OBJECTIVE: We aimed to analyze the associations between movement behaviors (physical activity, screen time, and sleep), independently and jointly, and suicidal thoughts/ideation among Brazilian adolescents according to race/ethnicity. METHODS: This cross-sectional study surveyed 4,081 adolescents aged 15-19 years (49.9% females) across all Brazilian geographic regions. Data were collected using a self-administered questionnaire. Within the sample, 31.0% (n = 1,264) self-reported as White and 69.0% (n = 2,817) as Black. Adolescents who declared one or more times/week suicidal thoughts/ideation were considered as a risk group. Accruing moderate-to-vigorous physical activity during leisure time, reduced recreational screen time, and good sleep quality were the exposures investigated. We evaluated both additive and multiplicative interactions between race/ethnicity and movement behaviors. Binary logistic regression was used to estimate the odds ratio (OR), marginal means effects, and 95% confidence intervals (95% CIs). RESULTS: Black adolescents who met 1 (OR: 0.34; [95% CI: 0.22-0.52]), 2 (OR: 0.17 [0.11-0.27]), or 3 (OR: 0.13 [0.07-0.26]), and White adolescents who met 1 (OR: 0.35 [0.21-0.57]), 2 (OR: 0.14 [0.08-0.26]), or 3 (OR: 0.11 [0.04-0.31]) of the movement behavior targets had lower odds of suicidal thoughts/ideation than Black adolescents who did not meet any of the movement behavior targets. Black adolescents who did not meet any of the movement behavior targets had higher suicidal thoughts/ideation odds than the other adolescent's groups. CONCLUSIONS: We identified an inverse association between meeting individuals and combinations of movement behavior targets with suicidal thoughts/ideation. Among Black adolescents who did not meet any targets, these associations were more evident.

Associations between anxiety disorders and depression symptoms are related to 24-hour movement behaviors among Brazilian adolescents.

BACKGROUND: We tested whether 24-hour movement behaviors modified the effect of the association between anxiety and depression symptoms among adolescents. METHODS: This cross-sectional study included 4141 adolescents aged 15 to 19 years (50.0 % females) across all Brazilian geographic regions. Using self-reported data, 4.4 % (n = 180) reported having been diagnosed with anxiety disorders. We used the Patient Health Questionnaire (PHQ-9) to evaluate depressive symptoms. Accruing moderate-vigorous physical activity during leisure time, <3 h/day of recreational screen, and good sleep quality were the exposures investigated. We evaluated interactions between anxiety and movement behaviors in the association with depression symptoms adjusted by covariates. RESULTS: Adolescents diagnosed with anxiety who met two (B: -4.93; 95%CI: -6.43; -3.44) or three (B: -5.71; 95%CI: -7.85; -3.57) movement behavior targets, and adolescents without diagnosis of anxiety who met one (B: -6.97; 95%CI: -8.15; -5.79), two (B: -8.21; 95%CI: -9.38; -7.03), or three (B: -8.46; 95%CI: -9.66; -7.27) of the movement behavior targets had lower PHQ-9 scores for depression symptoms than adolescents with anxiety who did not meet any of the movement behaviors. There was a significant interaction (B: -1.89; 95%CI: -3.24; -0.55) between anxiety disorders status and meeting the movement behavior targets. LIMITATIONS: The cross-sectional design is a limitation. CONCLUSIONS: Variations in meeting movement behaviors modified the effect of the association between anxiety disorders status and depressive symptoms, with favourable modifications seen in adolescents without anxiety who met one, two or three of the movement behavior targets and in adolescents with anxiety who met two or three of the behaviors.

The 2022 ParticipACTION Report Card on Physical Activity for Children and Youth: Focus on the COVID-19 pandemic impact and equity-deserving groups.

Introduction: The ParticipACTION Report Card on Physical Activity for Children and Youth is the most comprehensive national assessment of physical activity and related behaviors, characteristics, and opportunities for children and youth. The 2022 Report Card assigned grades based on data gathered during the COVID-19 pandemic to reflect this extraordinary time-period in Canada. Further, while not graded, efforts were made to summarize key findings for early years children and those identifying as: having a disability, Indigenous, 2SLGBTQ+, newcomers to Canada, racialized, or girls. The purpose of this paper is to summarize the 2022 ParticipACTION Report Card on Physical Activity for Children and Youth. Methods: The best available physical activity data captured during the whole COVID-19 pandemic was synthesized across 14 different indicators in four categories. The 2022 Report Card Research Committee assigned letter grades (i.e., A-F) based on expert consensus of the evidence. Synthesis: Grades were assigned for: Daily Behaviors (Overall Physical Activity: D; Active Play: D-; Active Transportation: C-; Organized Sport: C+; Physical Education: Incomplete [INC]; Sedentary Behaviors: F; Sleep: B; 24-Hour Movement Behaviors: F), Individual Characteristics (Physical Literacy: INC; Physical Fitness: INC), Spaces and Places (Household: C, School: B-, Community and Environment: B), and Strategies and Investments (Government: B-). Compared to the 2020 Report Card, the COVID-19 specific grades increased for Active Play and Active Transportation; and decreased for Overall Physical Activity, Sedentary Behaviors, Organized Sport, and Community and Environment. There were many data gaps for equity-deserving groups. Conclusion: During the COVID-19 pandemic, the grade for Overall Physical Activity decreased from a D+ (2020) to a D, coinciding with decreases in grades reflecting fewer opportunities for sport and community/facility-based activities as well as higher levels of sedentary behaviors. Fortunately, improvements in Active Transportation and Active Play during COVID-19 prevented a worse shift in children's health behaviors. Efforts are needed to improve physical activity for children and youth during and post-pandemic, with a greater emphasis on equity-deserving groups.

Expert Appraisal of the 2022 Canadian Para Report Card on Physical Activity for Children and Adolescents With Disabilities.

This report provides an expert appraisal of the Canadian Para Report Card on physical activity (PA) for children and adolescents with disabilities. Thirteen indicators were graded by a panel of researchers, representatives from disability and PA organizations, and parents of children and adolescents with disabilities using benchmarks of the Global Matrix 4.0 and previous Canadian PA Report Cards. Facilitated panel discussions were used to appraise the available evidence based on data gaps, opportunities, and recommendations. The available data sources included four nationally generalizable or representative data sets. Grades were assigned to 8/13 indicators and ranged from B+ to F. Data gaps in measurement and national surveillance systems were identified. Ableism was an issue identified within some of the reporting benchmarks. The absence of PA from existing accessibility legislation in Canada was a policy gap of concern. Recommendations related to research, surveillance, and policy are provided to enhance PA among children and adolescents with disabilities in Canada.

Optimizing Community Participation in Healthcare Planning, Decision Making and Delivery through Rural Health Councils.

Background: The aim of this scoping study was to understand the opatimal structure and function of rural health councils (RHCs). Methods: The study used the scoping review methodology, informed by both Arksey and O'Malley's (2005) framework and the Joanna Briggs Institute Reviewers' Manual (The Joanna Briggs Institute 2015). Findings: Evidence demonstrates that the functions of RHCs range from identifying healthcare issues and priorities to local resource management. Enabling structures included the use of skills-based merit matrices to determine membership. Conclusion: We found evidence on how to build effective models to support patient involvement in healthcare planning and service delivery to lead to care that reflects the needs of rural communities.

Associations between screen time and cognitive development in preschoolers.

Objectives: To examine the cross-sectional associations between screen time and cognitive development in preschoolers. Methods: Participants were 97 preschoolers (36 to 60 months) in Alberta and Ontario, Canada in the supporting Healthy physical AcTive Childcare setting (HATCH) study. The time that children spent watching television, videos or DVDs (television time) or playing video or computer games (video game time) on a television, computer, or portable device was assessed using a parental questionnaire. Television time and video game time were summed to calculate total screen time. Adherence to the screen time recommendation (≤1 hour/day) of the Canadian 24-Hour Movement Guidelines was calculated. Expressive vocabulary and working memory were assessed using the Early Years Toolbox. Due to the distribution of working memory, it was categorized as a binary variable based on the median score. The associations between screen time and cognitive development were examined using mixed models (expressive vocabulary) or generalized mixed models (working memory). Results: Screen time was not associated with expressive vocabulary. Preschoolers who had higher total screen time were less likely to have better working memory (OR=0.52; 95%CI:0.31, 0.88), despite the null associations for television time (P=0.155) and video game time (P=0.079). Preschoolers who met the screen time recommendation were more likely to have higher working memory capacity (OR=3.48; 95%CI:1.06, 11.47), compared to those who did not meet the recommendation. Conclusion: Limiting total screen time to no more than one hour per day may facilitate working memory development in preschoolers. Screen time may be unrelated to expressive language development in this age group.

School-related sedentary behaviours and indicators of health and well-being among children and youth: a systematic review.

BACKGROUND: The purpose of this systematic review was to examine the associations between school-related sedentary behaviours and indicators of health and well-being in children and youth (~ 5-18 years) attending school. METHODS: This review was conducted to inform the development of School-Related Sedentary Behaviour Recommendations. Peer-reviewed, published, or in-press articles in English were included. Reviews, meta-analyses, and case studies were excluded; all other study designs were eligible. Further, articles had to meet the a priori study criteria for population, intervention, comparator (PROSPERO ID: CRD42021227600). Embase, MEDLINE® ALL, and PsycINFO were searched. Risk of bias was assessed for individual experimental studies using the Cochrane risk of bias assessment tool, and in observational studies based on the GRADE framework and in line with previous systematic reviews examining sedentary behaviours in children. Overall quality of evidence was assessed using the GRADE framework for each outcome category and study design. Results were synthesized narratively, grouped by study design and outcome category. Further, several high-level summaries were conducted to help interpret results. RESULTS: Evidence was synthesized from 116 reports, including 1,385,038 participants and 1173 extracted associations. More school-related sedentary behaviour was favourably associated with nearly one-third of extracted associations for cognitive (33%) and social-emotional (32%) indicators (e.g., less anxiety), but unfavourably associated with other movement behaviours (e.g., less physical activity) (35%). Active lessons were favourable (72%), compared to more school-related sedentary behaviours, when examining associations for all health and well-being indicators. More homework was favourable across all health and well-being indicators in 4% of extracted associations for primary school children, and 25% of extracted associations for secondary school children. However, ≥2 h/day of homework appeared to be unfavourable for health and well-being. Limitations for synthesized studies included generally low quality of evidence and a lack of studies in South American, African, or low-middle income countries. CONCLUSIONS: Findings can help inform policy makers, schools, and teachers, regarding the amount of homework assigned and the introduction of active lessons into the classroom to enhance health and well-being of children. More research is needed examining school-related sedentary behaviours and indicators of health and well-being in low- and middle-income countries.

International school-related sedentary behaviour recommendations for children and youth.

BACKGROUND: Existing sedentary behaviour guidelines for children and youth target overall sedentary behaviour and recreational screen time, without any specific recommendations regarding school-related sedentary behaviours (i.e., sedentary behaviours performed during the school day, or within the influence of school). The purpose of this paper is to describe the development of international evidence-based recommendations for school-related sedentary behaviours for children and youth, led by the Sedentary Behaviour Research Network (SBRN). METHODS: A panel of international experts was convened by SBRN in November 2020 to guide the development of these recommendations for children and youth aged ~ 5-18 years. The recommendations were informed by 1) age-relevant existing sedentary behaviour guidelines, 2) published research on the relationship between overall sedentary behaviour and health, 3) a de novo systematic review on the relationship between school-related sedentary behaviours and health and/or academic outcomes, and 4) a de novo environmental scan of the grey literature to identify existing recommendations for school-related sedentary behaviours. Draft recommendations were presented to the Expert Panel in June 2021. Following thorough discussion and modifications, updated recommendations were distributed for stakeholder feedback from July 9-26. Feedback was received from 148 stakeholders across 23 countries, leading to additional updates to the recommendations. Following further rounds of discussion and updates with the Expert Panel in August and September 2021, consensus was achieved on the final recommendations. RESULTS: A healthy day includes breaking up extended periods of sedentary behaviour and incorporating different types of movement into homework whenever possible, while limiting sedentary homework. School-related screen time should be meaningful, mentally or physically active, and serve a specific pedagogical purpose that enhances learning. Replacing sedentary learning activities with movement-based learning activities, and replacing screen-based learning activities with non-screen-based learning activities, can further support students' health and wellbeing. DISCUSSION: This paper presents the first evidence-based recommendations for school-related sedentary behaviours for children and youth. These recommendations will support the work of parents, caregivers, educators, school system administrators, policy makers, researchers and healthcare providers interested in promoting student health and academic success.

The impact of new government childcare accreditation standards on children's in-care physical activity and sedentary time.

BACKGROUND: A new physical activity and sedentary behaviour accreditation standard criterion for childcare settings was introduced by the provincial government in Alberta, Canada. The primary objective of this study was to examine if changes for in-care physical activity and sedentary time (ST) differed between centres in and around Edmonton, Alberta after implementing the new accreditation standards and non-accredited control centres in and around Ottawa, Ontario. Secondary objectives were to examine whether baseline age group (toddler, preschooler) or the childcare environment moderated any group differences in change of the primary outcomes. Furthermore, accreditation and control group differences in change of children's body mass index (BMI) Z-scores or cognitive development as well as educators' perceptions of the primary outcomes were explored. METHODS: Participants were 252 toddlers (19-35 months) and preschoolers (36-60 months) in childcare centres from Alberta (n = 11) and Ontario (n = 8) in the supporting Healthy physical AcTive CHildcare setting (HATCH) study. In-care ST, light-intensity physical activity (LPA), and moderate- to vigorous-intensity physical activity (MVPA) were accelerometer-derived before and 6 months after the implementation of the new standards. At both time points, cognitive development (working memory, expressive vocabulary), heights, and weights were measured, and BMI Z-scores were calculated. Additionally, the childcare environment was observed using the Environment and Policy Assessment and Observation (EPAO) and Movement Environment Rating Scale (MOVERS) tools. Demographic characteristics were parent-reported and weather variables were derived from Environment Canada data. Mixed models were conducted. RESULTS: In adjusted models (n = 241), change in children's in-care ST (B = -0.07, 95%CI: - 1.43,1.29), LPA (B = 0.08, 95%CI: - 0.89,1.05), and log-transformed MVPA (B = 0.01, 95%CI: - 0.09,0.11) were not significantly different between accreditation and control groups. Age group and the childcare environment were not moderators. Significant increases in BMI Z-score (B = 0.19, 95%CI: 0.03,0.35) and high working memory (OR = 3.24, 95%CI: 1.32,7.97) were observed in the accreditation group and significant increases in expressive vocabulary (B = 3.18, 95%CI: 0.05,6.30) were observed in the control group. CONCLUSIONS: The new accreditation criterion may not significantly change physical activity or ST in childcare settings and therefore may not explain findings for BMI Z-scores and cognitive development. Additional training and resources may be needed.

Demographic, parental and home environment correlates of traditional and mobile screen time in preschool-aged children.

OBJECTIVES: Research on the correlates of screen time in young children, that could be targeted in future interventions to improve healthy development, has primarily focused on TV viewing with little consideration of mobile devices. The objectives of this study were to examine the associations between a range of demographic, parental, and home environment correlates and preschool-aged children's TV/video viewing, video/computer game playing, and total screen time across traditional and mobile devices. METHODS: The results of this cross-sectional study are based on 106 preschool-aged children (3-5 years) and their parents recruited in 2018 in Edmonton, Alberta. Children's and parental demographic information, home characteristics, and information about parental and children's screen time use was measured using a parent questionnaire. Simple and multiple linear regression models were conducted. RESULTS: Each additional hour/day of parental screen time was associated with 12 (95%CI = 5.2, 19.8) minutes/day of children's TV/video, 6 (95%CI = 1.5, 11.0), minutes/day of video/computer game playing, and 19 (95%CI = 8.9, 29.2) minutes/day of total screen time. Additionally, significant associations of technology interference and presence of electronics in the bedroom with children's screen time were attenuated in the multiple regression models. CONCLUSIONS: Parental screen time appears important to target in future family-based screen time interventions and initiatives. Future studies should explore potential mediating or moderating variables between parental screen time and children's screen time.

Ambient air pollution and movement behaviours: A scoping review.

This scoping review summarizes the literature about how ambient (outdoor) air pollution impacts movement behaviours (i.e., physical activity, sedentary behaviour, and sleep), or beliefs about movement behaviours. Of 6552 potential documents, 58 documents and 218 findings were included in the final synthesis. Most studies were from the United States and China, involved cross-sectional designs, and included mixed age groups. Overall, unfavourable changes/associations (i.e., decreased/lower physical activity, increased/higher sedentary-related behaviour, and decreased/lower sleep duration and quality) or no change/association in movement behaviours in relation to ambient air pollution were identified. Our findings suggest that more attention should be given to understanding the impact of ambient air pollution on movement behaviours in general and in diverse countries and vulnerable populations such as children or older adults.

Associations between sleep duration, adiposity indicators, and cognitive development in young children.

OBJECTIVE: This study aimed to examine the associations between sleep duration, adiposity indicators, and cognitive development in young children. METHODS: Participants were 217 children aged 19-60 months in Canada in the supporting Healthy physical AcTive Childcare setting (HATCH) study. Nap duration and nighttime sleep duration were assessed using a parent questionnaire and were summed up as total sleep duration. Body mass index (BMI) z-scores and weight status were determined using the World Health Organization growth standards. Expressive vocabulary and working memory were assessed using the Early Years Toolbox in preschoolers only (36-60 months; n = 101). Mixed models (BMI z-score, expressive vocabulary) and generalized mixed models (weight status, working memory) were conducted. RESULTS: A linear association between total sleep duration and BMI z-score (B = -0.12; 95% CI: -0.23, -0.01) were observed. Compared to children having nighttime sleep within ±1SD (9.13-11.13 h/d) of the mean, those having shorter nighttime sleep had higher BMI z-scores (B = 0.39; 95% CI: 0.06, 0.73) and an increased risk of being overweight (OR = 4.54; 95% CI: 1.39, 14.81). Nap duration was not associated with adiposity indicators. In preschoolers, sleep duration was not associated with expressive vocabulary. Total sleep duration and nap duration were not associated with working memory. However, non-nappers were more likely to have greater working memory (OR = 4.04; 95% CI: 1.09, 14.92) compared to those having nap duration within ±1SD (0.46-2.18 h/d) of the mean. CONCLUSION: Promoting longer total sleep, including more than nine hours of nighttime sleep, appears important for maintaining healthy adiposity levels in young children. Cessation of napping may be associated with better working memory in preschoolers.

The association between parent-child technology interference and cognitive and social-emotional development in preschool-aged children.

BACKGROUND: The increased adoption and dependence of electronic devices have potential implications on parent-child relationships, including parental responsiveness. Few studies have examined the association between parent-child technology interference and developmental outcomes. The objective of this study was to examine the associations between parent-child technology interference and cognitive and social-emotional development in preschool-aged children (3-5 years). METHODS: Participants were 100 parents and their preschool-aged child from Edmonton, Canada. Parent-child technology interference across six different devices (i.e., cell phone/smartphone, tablet, iPod, television, computer and video game console) was parental reported using an adapted version of the Technology Device Interference Scale, and a total score was calculated. Cognitive development was objectively measured using three iPad-based tasks from the Early Years Toolbox to capture executive functions (i.e., working memory and response inhibition) and language development (i.e., expressive vocabulary). Social-emotional development was parental reported using the Child Self-Regulation and Social Behaviour Questionnaire, and seven subscales (i.e., sociability, externalizing, internalizing, prosocial and behavioural, cognitive, and emotional self-regulation) were calculated. Multiple linear regression models that adjusted for several potential confounders were conducted. RESULTS: The mean total parent-child technology interference score was 4.2 units, which equates to approximately 12-16 interruptions per day due to an electronic device. Approximately 60% of the score was due to interference by a cell phone/smartphone. After removing influential cases based on Cook's distance values, higher parent-child technology interference was significantly associated with lower response inhibition (B = -0.015, 95% CI: -0.028, -0.002) and emotional self-regulation (B = -0.095, 95% CI: -0.163, -0.028) scores and higher log externalizing (B = 0.033, 95% CI: 0.002, 0.063) and log internalizing (B = 0.034, 95% CI: 0.013, 0.056) scores. CONCLUSIONS: Electronic devices, in particular the cell phone/smartphone, appear to interrupt parents' conversations and activities with their preschool-aged child multiple times per day. Higher parent-child technology interference may be adversely associated with several subdomains of early childhood development. Future longitudinal and experimental research is needed to confirm these findings.

Levels and correlates of physical activity and screen time among early years children (2-5 years): Cross-cultural comparisons between Canadian and South Korean data.

BACKGROUND: Cross-cultural research can provide insight into whether levels and correlates of movement behaviours among early years children vary across different cultural contexts. This study (1) compared children's physical activity (PA) and screen time (ST) and parental and environmental correlates of PA and ST between samples of Canadian and South Korean (Korean thereafter) early years children (2-5 years) and (2) investigated parental and environmental correlates of PA and ST and whether country moderates the relationships. METHODS: Cross-sectional data from 121 Canadian children (3.4 years; 49.6% girls) and 101 Korean children (3.4 years; 54.9% girls) who participated in the Parents' Role in Establishing healthy Physical activity and Sedentary behaviour habits (PREPS) study were used. Demographic information, children's PA, ST, PA- or ST-specific parental cognitions and behaviours, and home and neighbourhood environments were measured using a proxy-reported questionnaire. Two-tailed independent samples T test or Mann Whitney U test, chi-square tests, linear regression and moderation analyses were performed. RESULTS: Canadian children spent more time in non-organized PA compared to Korean children (111 vs. 63 min/day), whereas time spent in organized PA was higher in Korean children than Canadian children (25 vs. 9 min/day). Canadian children had more ST than Korean children (159 vs. 110 min/day). Similarly, Canadian parents reported higher screen (142 vs. 116 min/day) and sitting time (317 vs. 286 min/day) than Korean parents. Though children's behaviours, as well as parental cognitions and behaviours, varied between the two samples, similar correlates of children's PA and ST were observed. The relationship between presence of electronics in children's bedrooms and children's ST was moderated by country, with Canadian children showing a stronger relationship than Korean children. CONCLUSIONS: Supporting parents to adopt cognitions and behaviours that are conducive to healthy PA and ST patterns of their own and their early years children may be important for both Canada and Korea.