First report card on physical activity for children and adolescents in Slovakia: a comprehensive analysis, international comparison, and identification of surveillance gaps.

BACKGROUND: National surveillance of physical activity (PA) is essential to establish public health policy actions for PA promotion and evaluation, thereby promoting accountability. The main goal of this study is to comprehensively analyse surveillance data on PA behaviours, outcomes, and influencing factors among Slovakian children and adolescents by using the methodology of the Active Healthy Kids Global Alliance Global Matrix (AHKGA-GM) project. Secondary goals are to provide comparisons with international data and the identification of surveillance gaps. METHODS: A comprehensive multilevel search strategy for data about 10 core indicators and 1 additional indicator published between 2015 and 2020 (solely pre-COVID-19-pandemic data) was used. The data were then synthesised, and a set of standardised benchmarks was used to assign grades according to The Global Matrix 4.0 Grading Rubric. RESULTS: A total of 552 potentially relevant data resources were retrieved, of which 34 were identified as eligible for data extraction. Grade B was assigned to four core indicators, grade C to five core indicators, and grade D to one core indicator. The additional Sleep indicator was graded a C-. Compared with the average grades from countries with high Human Development Index scores, Slovakia received higher grades in five core indicators (Overall Physical Activity, Active Transportation, Sedentary Behaviours, School, Government), and in the aggregate Behavioural average and Overall average. Compared with global averages, Slovakia had higher grades in the aforementioned core and aggregate indicators, and in the Community and Environment core indicator and aggregate Sources of Influence average indicator. Numerous surveillance gaps were identified. CONCLUSIONS: The overall grading of the available surveillance data suggests the need for improvement in all 10 surveilled core indicators, and in additional Sleep indicator. Despite the fact that numerous identified surveillance gaps limit the overall informative value of the current grade, they provide the important information needed to enhance surveillance of PA-related indicators in Slovakia. For instance, the focus should be put on younger children and parents, on obtaining the device-measured data on various movement behaviours, on the topic of outdoor physical activities, and policy evaluation.

Sleep characteristics and adolescent physical activity-related injuries in sports clubs, leisure time and schools.

OBJECTIVE: Sleep has been identified as an important factor in relation to physical activity-related injury (PARI) in adolescents. The study aimed to explore associations between sleep duration, sleep problems and PARI among Slovak adolescents in three different settings: sports clubs, leisure time and schools. METHODS: We analysed data from the cross-sectional Health Behaviour in School-aged Children study conducted in 2022 on a representative sample of 10 163 Slovak adolescents aged from 10.5 to 18.3 (mean age 13.4 (SD=1.5); 50.9% boys). Data were collected through self-administered online questionnaires completed by respondents in schools during the classes. Multiple logistic regression models were used to assess associations between sleep duration during schooldays and weekends, sleep problems and PARI in sports clubs, leisure time and schools. RESULTS: Adolescents with normal sleep duration during schooldays and those who reported no problems with falling asleep, waking up at night and day sleepiness had a higher chance of not being injured during PA in sports clubs, leisure time and schools compared with adolescents with short sleep duration and sleep problems. Sufficient sleep duration during the weekend increased the probability of not having PARI in leisure time and schools, with the strongest association between long sleep duration and PARI in leisure time. CONCLUSION: Good sleep quality and sufficient sleep duration were found to play a protective role in relation to PARI in adolescents. The findings suggest implementing sleep interventions in PARI prevention programmes, which must be considered a key component of adolescent PA promotion.

Are adolescents' physical activity and body-related factors associated with medically attended injuries?

Background: Injuries are the major cause of disability and death during adolescence, representing a significant public health burden among youth. Body-related factors such as body composition and cardiovascular fitness (CVF) may affect adolescents' vulnerability to injuries. As evidence is lacking, we aimed to explore the associations of medically attended injuries with adolescents' physical activity (PA) and body-related factors, and whether these associations are modified by age, gender and family affluence. Methods: We used data on 888 11- to 15-year-old adolescents (mean age = 13.5, 56% boys) from the Health Behaviour in School-aged Children study conducted in 2018 in Slovakia. We used binary logistic regression analysis to assess the association of medically attended injuries with adolescents' PA and body-related factors (body composition, CVF), considering age, gender and family affluence. Results: Adolescents were more likely to report medically attended injuries if they were physically very active (odds ratio/confidence interval OR/CI:2.76/1.83-4.15) or active (OR/CI:1.91/1.27-2.87) rather than inactive. Body-related factors were not associated with medically attended injuries among adolescents. Moreover, age, gender and family affluence did not modify the association of medically attended injuries with adolescents' PA and body-related factors. The only exception was the modifying effect of gender: the association of medically attended injuries with being very active was stronger in boys (OR/CI: 3.04/1.32-6.99). Conclusion: Very physically active adolescent boys are the most vulnerable group of adolescents in terms of injuries. PA promotion programmes should further consider gender-specific strategies aimed at preventing injuries.

Global Matrix 4.0 Physical Activity Report Card Grades for Children and Adolescents: Results and Analyses From 57 Countries.

BACKGROUND: The Global Matrix 4.0 on physical activity (PA) for children and adolescents was developed to achieve a comprehensive understanding of the global variation in children's and adolescents' (5-17 y) PA, related measures, and key sources of influence. The objectives of this article were (1) to summarize the findings from the Global Matrix 4.0 Report Cards, (2) to compare indicators across countries, and (3) to explore trends related to the Human Development Index and geo-cultural regions. METHODS: A total of 57 Report Card teams followed a harmonized process to grade the 10 common PA indicators. An online survey was conducted to collect Report Card Leaders' top 3 priorities for each PA indicator and their opinions on how the COVID-19 pandemic impacted child and adolescent PA indicators in their country. RESULTS: Overall Physical Activity was the indicator with the lowest global average grade (D), while School and Community and Environment were the indicators with the highest global average grade (C+). An overview of the global situation in terms of surveillance and prevalence is provided for all 10 common PA indicators, followed by priorities and examples to support the development of strategies and policies internationally. CONCLUSIONS: The Global Matrix 4.0 represents the largest compilation of children's and adolescents' PA indicators to date. While variation in data sources informing the grades across countries was observed, this initiative highlighted low PA levels in children and adolescents globally. Measures to contain the COVID-19 pandemic, local/international conflicts, climate change, and economic change threaten to worsen this situation.

Eating-Disordered Behavior in Adolescents: Associations with Body Image, Body Composition and Physical Activity.

Eating disorders (EDs) represent a disparate group of mental health problems that significantly impair physical health or psychosocial functioning. The aim of this study was to present some evidence about the prevalence of eating-disordered behavior (EDB) in adolescents, and explore its associations with body image (BI), body composition (BC) and physical activity (PA) in this age group. Data from 780 adolescents participating in a health behavior in school-aged children (HBSC) study conducted in Slovakia in 2018 were used (mean age 13.5 ± 1.3; 56% boys). Differences in mean values of numerical indicators were evaluated using the independent samples t-test. Differences between nominal variables were assessed by the chi-square test. Pearson correlation was used to describe the associations between all the selected variables. EDB was positively screened in 26.7% (208/780) of adolescents, with a higher prevalence in girls (128/344, 37.2%) than in boys (80/436, 18.3%). Significantly higher means of BI, body weight (BW), body mass index (BMI), body fat mass (BFM), body fat percentage (BFP), body fat mass index (BFMI), fat free mass index (FFMI), and SCOFF questionnaire score (SCOFF QS) were found in those positively screened for EDB. Pearson correlation analysis revealed positive associations between EDB and BI, BW, BMI, BFM, BFP and BFMI. The prevalence of EDB is high in Slovak adolescents. Positive associations between EDB, BI, BMI and fat-related body composition parameters support the idea of a more integrated approach in EDs and obesity prevention and treatment. At the same time, gender differences suggest the need for considering gender-specific strategies aimed at girls and boys separately.

Medically Attended Injuries among Slovak Adolescents: Relationships with Socio-Economic Factors, Physical Fighting, and Physical Activity.

There is a worrisome increase in the reporting of medically attended injuries in Slovak adolescents. The aim of this study is to examine the relationships between socio-economic factors, physical fighting, and physical activity with frequency of medically attended injuries among this population group. Data from 8902 adolescents participating in the Health Behavior in School-Aged Children study were used (mean age 13.37; 50.9% boys). The effects of family affluence, registered unemployment rate, average nominal monthly earnings of employees, physical fighting, and physical activity on frequency of medically attended injury were explored using linear regression analysis. Pearson's correlation was used to describe the associations between all selected variables. The selected model of linear regression explained 15.8% of the variance in the frequency of medically attended injuries. All variables except the registered unemployment rate showed linear positive relationships with medically attended injuries. The correlation analysis confirmed linear positive associations between medically attended injuries and physical fighting, family affluence, physical activity, and average nominal monthly earnings of employees. Further research on these variables is needed in the Slovak context. This may include analyses of the nature of the relationships between socio-economic factors and medically attended injuries, as well as systematic evaluation of applied physical fighting and physical-activity-related injury interventions to support evidence-based policy making.

Maintaining everyday life praxis in the time of COVID-19 pandemic measures (ELP-COVID-19 survey).

BACKGROUND: The extreme social circumstances caused by declared COVID-19 pandemic deeply intervene people's everyday life and should not be neglected but seen through the view of social reality pinpointing the 'ordinary' people. In this article, authors explored basic segments of everyday and their subjective perception to what extent sleeping habits, physical inactivity, physical activity, nutritional habits and smoking have changed. METHODS: The online survey was conducted in nine European countries (Bosnia and Herzegovina, Croatia, Greece, Kosovo*, Italy, Serbia, Slovakia, Slovenia and Spain) in 4108 participants, aged 15-82 years. The survey took place 30-40 days after World Health Organization declared COVID-19 pandemic state, from 15 April to 3 May 2020. RESULTS: The results have shown 30 min longer sleeping time, 50% longer physical inactivity time, 65% longer screen time, 43% shorter walking time, 24% shorter sport time and 37% longer physical work time. Additionally, body mass gains (0.3 kg) could be explained in 20.6% with meals sizes, unhealthy food consumption, screen time and sport time. Further, respondents reported more regular meals (44%) and healthier meals with less alcohol consumption and less smoking, which have been positive outcomes of home confinement. CONCLUSION: The findings draw attention to negative changes in everyday praxis (inactivity, body mass gain) after such a short period. Because of possible risk to population's health (especially of countries such as Italy and Spain with serious threat and more stringent measures), findings enable development of recommendations for maintaining healthy lifestyle habits with minimal negative health consequences in similar pandemic circumstances.

A randomized controlled trial to evaluate utilization of physical activity recommendations among patients of cardiovascular healthcare centres in Eastern Slovakia: study design and rationale of the AWATAR study.

BACKGROUND: Guidelines on modifiable risk factors regarding cardiological patients are poorly implemented in clinical practice perhaps due to low health literacy. Several digital tools for improving lifestyle and behavioural intervention were developed. Our primary aim is to evaluate the effectiveness of a digital exercise prescription tool on the adherence to physical activity recommendations among patients with cardiovascular diseases. METHODS: A randomized controlled trial will be realized in cooperation with Cardiovascular Health Centres in Eastern Slovakia. Patients recruited through their cardiologists, will be randomised at 1:1 ratio to the three-months' experimental condition or control condition. The experimental group will receive standard lifestyle consultation leading to individually optimized prescription of physical activity. The control group will receive standard, usual-cardio-care lifestyle counselling, also in the domain of physical activity. The digital system will be used for optimized exercise prescription. The primary outcome is a change in the patient's adherence to exercise recommendations. Data will be collected in both groups prior to consultation and after 3 months. DISCUSSION: This study protocol presents background and design of a randomized control trial to investigate the effectiveness of a digital system-provide exercise prescription tool on the adherence to physical activity recommendations. An optimized exercise prescription that better reflects patient's diagnosis, comorbidities and medication can have a significant impact on secondary prevention of cardiovascular disease. This trial can provide important evidence about the effectiveness of digital exercise guidance in everyday practice of cardiovascular healthcare. TRIAL REGISTRATION: The study was registered on 1st November, 2017 and is available online at ClinicalTrials.gov (ID: NCT03329053 ).

Movement Activity Determination with Health-related Variables of University Students in Kosice.

INTRODUCTION: There is currently a strong scientific evidence about the negative health consequences of physical inactivity. One of the potential tools for promoting physical activity at the institutional level of the Ecological model is to create conditions and settings that would enable pupils, students and employees engage in some form of physical activity. However, physical activities as a subject are being eliminated from the study programs at Slovak universities. The purpose of the study was to find current evidence about the level of structured physical activity and health-related variables in university students in Kosice. MATERIAL AND METHODS: The sample consisted of 1,993 or, more precisely, 1,398 students who attended two universities in Kosice. To collect data, students completed a questionnaire and were tested for body height, body weight, circumferential measures and percentage body fat. RESULTS: The university students did not sufficiently engage in a structured physical activity. A large number of students had either low or high values of percentage body fat and BMI and high WHR values. CONCLUSIONS: Our findings have shown that the research into physical activity of university students should receive more attention.