Physical Activity Levels During School Recess in a Nationally Representative Sample of 10- to 11-Year-Olds.

PURPOSE: School recess provides a valuable opportunity for children's daily moderate- to vigorous-intensity physical activity (MVPA). This study aimed to quantify MVPA during school recess in a representative sample of Scottish children and examine whether recess MVPA varied by gender, socioeconomic status, season, urban/rural residency, and recess length. METHOD: Five-day accelerometry MVPA data were analyzed from 773 children (53.9% girls, 46.1% boys, 10- to 11-y-olds) from 471 schools. Binary logistic regression explored associations between meeting/not meeting the recommendation to spend 40% of recess time in MVPA and the aforementioned risk factors. Descriptive recess data were also analyzed. RESULTS: Participants spent an average of 3.2 minutes (SD 2.1) in MVPA during recess. Girls engaged in 2.5 minutes (SD 1.7) of MVPA compared with 4.0 minutes (SD 2.2) for boys. Only 6% of children met the recess MVPA recommendation. The odds of girls (odds ratio 0.09; 95% confidence interval, 0.04-0.25) meeting the recommendation was lower (P < .001) compared with boys. No statistically significant differences were observed in meeting the recommendation for the other risk factors. CONCLUSION: Levels of MVPA during school recess are very low in Scottish children, and interventions aimed at increasing MVPA during recess are needed.

Inequalities in neighbourhood features within children's 20-minute neighbourhoods and variation in time spent locally, measured using GPS.

There has been a growing interest in policies that encourage local living by promoting accessible and walkable communities, such as the 20-minute neighbourhood concept. Despite the widespread adoption of this policy in cities worldwide, little research has been conducted on the characteristics of children's 20-minute neighbourhoods and their association with time spent locally. This study aimed to explore the features of Scottish children's 20-minute neighbourhoods by analysing an 800-meter road and path network buffer surrounding 687 children's homes. Based on existing literature, the study identified key features associated with children's time spent locally and the 20-minute neighbourhood policy. The study then examined variations in these features by socioeconomic status, urbanicity, and gender. The findings revealed significant inequalities in the presence of health-benefiting (e.g., green spaces, recreational facilities, healthy food outlets) and health-harming (e.g., major roads, unhealthy commodity retailers) environments within children's 20-minute neighbourhoods. Children from more deprived areas had access to more of both types of environments. The study also found that having a school within a 20-minute neighbourhood was associated with an increased amount of time spent locally (IRR 1.62, 95% CI 1.5 to 1.8, p<0.001). The study suggests that the 20-minute neighbourhood policy should extend beyond mere access to local amenities and prioritise creating healthy 20-minute neighbourhoods, particularly in socioeconomically deprived areas. The research highlights the importance of promoting equal access to quality local environments, which can contribute to improved health and well-being outcomes for children.

A qualitative study of parental strategies to enable pre-school children's outdoor and nature experiences during COVID-19 restrictions.

Outdoor and nature experiences including play have been shown to be beneficial for children's physical, cognitive, social and emotional development. Parents/carers play an important role in encouraging or impeding their child's access to the outdoor environment and participation in outdoor play. The COVID-19 pandemic and associated restrictions on free movement and social interactions placed an unprecedented pressure on families to manage the drastic change in their daily routines. This paper reports findings from two combined data sets generated in 2020 during the COVID-19 pandemic and provides a deeper understanding of the interconnected nature of how contextual factors influence parenting processes and outcomes relating to young children's outdoor and nature experiences and subsequent child health. Findings have the potential to inform the messaging of existing outdoor play policies and the content of new interventions aiming to promote the exposure of children to the natural outdoor environment.

Moderate-to-vigorous intensity physical activity during school hours in a representative sample of 10-11-year-olds in Scotland.

OBJECTIVES: Growing concern about children and adolescent physical inactivity has made the promotion of physical activity a public health priority. International recommendations suggest children should accumulate at least 30 min of moderate-to-vigorous physical activity (MVPA) during school hours. This study assessed levels of objectively-measured MVPA in a large nationally representative sample of Scottish children aged 10-11. Risk factors for not meeting the school-hours MVPA recommendation were examined. DESIGN: Cross-sectional. METHODS: Mean time spent in MVPA during school hours across five weekdays was measured using Actigraph accelerometry (May 2015-May 2016). Binary logistic regression, presented as odds ratio (O.R.) and confidence intervals (C.I.), explored associations between meeting/not meeting the recommendation by sex, socioeconomic status (SES), season, and urban/rural residence in 2022. RESULTS: Valid data were obtained from 773 children (53.9% girls, 46.1% boys) from 471 schools. Mean daily school-hours MVPA was 29 (SD 11) minutes; 42.7% of children reached the recommendation. The odds of girls (O.R. 0.43; C.I. 0.32, 0.57) meeting the recommendation was significantly lower (p < 0.001) compared to boys. Children living in rural areas had higher odds (O.R. 1.49; C.I. 1.04, 2.15) of meeting the recommendation compared with those in urban areas (p = 0.032). No significant differences in meeting the recommendation by SES (p = 0.700). The overall trend for season was significant (p < 0.001), with lower odds of meeting the recommendation in winter compared to summer. CONCLUSIONS: Most Scottish children aged 10-11 did not meet the 30 minute MVPA recommendation. Interventions to increase MVPA during school hours are essential to promote public health.

Outdoor nature-based play in early learning and childcare centres: Identifying the determinants of implementation using causal loop diagrams and social network analysis.

Nature-based play benefits children's health and development. However, the delivery of this in early learning and childcare centres (ELC) is extremely diverse, and implementation is not well understood. We applied a systems science perspective to understand the factors crucial to implementing nature-based outdoor play in ELC settings. Through Group Model Building workshops with 20 participants in managerial and practitioner roles, crucial factors were appraised using Causal Loops Diagrams. Twelve thematic causal loops emerged. Network analysis was employed to analyse the diagram. Exponential Random graph models explained the diagram construction process. Centrality measures alongside conditional uniform tests identified six leverage factors: use of outdoor space, culture of being outdoors, ELC culture of outdoor play, perceived child safety and enjoyment, educator confidence and educator agency. This research brings novel and practically relevant evidence about the important factors, and interdependencies, involved in the implementation of outdoor play practice within ELC settings.

Parental Assessment of Benefits and of Dangers Determines Children's Permission to Play Outdoors.

During the early years, children's outdoor play is dependent on parental supervision. Parents' perceptions are likely to influence what the child is permitted to do. To better understand the involved mechanisms in parents' decision making in such contexts, an online photo-based questionnaire was administered. The tool investigates, in different situations, parents and their children's experience, parents' perceptions, and permission to play. A total of 417 parents of children aged from 1.5 and 6.0 completed the questionnaire. Results showed that parents, overall, have a positive attitude towards outdoor play. Main concerns were about risk of injury but in most cases, perceived benefits outweigh perceived dangers. "Sawing wood" was the only situation with a negative benefits/dangers balance. A linear regression analysis revealed that permission to play outdoors is based on parental assessment of benefits and dangers. Perceived benefits appeared to have more influence on parental decision than perceived dangers, while perceived competence had only a small influence. The results also showed that parents' childhood experience of outdoor play was an important determinant for adults' perceptions, perhaps demonstrating intergenerational concerns, as outdoor play is in decline. To overcome a negative intergenerational effect on children's outdoor play, interventions and communication should focus on associated benefits.

A Low-Cost Method for Understanding How Nature-Based Early Learning and Childcare Impacts Children's Health and Wellbeing.

Nature-based play and learning provision is becoming increasingly popular across the early learning and childcare (ELC) sector in Scotland. However, there remains a lack of understanding of how the program is expected to function. This has implications for program learning and may affect wider rollout of the program. Secondary data analysis of parent interviews (n = 22) and observations (n = 7) in Scottish ELC settings, and review of internationally published studies (n = 33) were triangulated to develop a program theory using the Theory of Change approach. This approach makes a program's underlying assumptions explicit by systematically demonstrating the relationship between each component: inputs, activities, outcomes, impact, and the contexts of the program. Findings suggested that location of outdoor nature space, affordances, availability of trained practitioners, and transport to location lead to activities such as free play, educator-led activities, and interactions with nature, resulting in longer durations of physical activity, interactions with peers and educators, and increased engagement with the natural environment. These activities are vital for supporting children's physical, cognitive, social, and emotional development. Our results demonstrate the value of using secondary data analysis to improve our understanding of the underlying theory of nature-based ELC which can support future evaluation designs. These findings will be of interest to program evaluators, researchers, practitioners, and funders, who find themselves with limited resources and want to better understand their program before investing in an evaluation. We encourage researchers and evaluators in the field of early years and outdoor play in other countries to refine this logic model in their own context-specific setting.

Evaluating Outdoor Nature-Based Early Learning and Childcare Provision for Children Aged 3 Years: Protocol of a Feasibility and Pilot Quasi-Experimental Design.

Systematic reviews have demonstrated the scarcity of well-designed evaluations investigating outdoor nature-based play and learning provision for children in the early learning and childcare (ELC) sector among global Western countries. This study will examine the feasibility and acceptability of the programme and the evaluation design of outdoor nature-based play and learning provision across urban ELC settings in a Scottish metropolitan city. Six ELC settings with different outdoor nature-based play delivery models will be recruited. One trial design will be tested: a quasi-experimental comparison of children attending three different models of outdoor play and learning provision. Measures will be assessed at baseline and five weeks later. Key feasibility questions include: recruitment and retention of ELC settings and children; suitability of statistical matching based on propensity score; completeness of outcome measures. Process evaluation will assess the acceptability of trial design methods and provision of outdoor nature-based play among ELC educators. These questions will be assessed against pre-defined progression criteria. This feasibility study will inform a powered effectiveness evaluation and support policy making and service delivery in the Scottish ELC sector.

Nature-Based Early Childhood Education and Children's Physical Activity, Sedentary Behavior, Motor Competence, and Other Physical Health Outcomes: A Mixed-Methods Systematic Review.

BACKGROUND: The purpose was to synthesize evidence on the association between nature-based Early Childhood Education (ECE) and children's physical activity (PA) and motor competence (MC). METHODS: A literature search of 9 databases was concluded in August 2020. Studies were eligible if (1) children were aged 2-7 years old and attending ECE, (2) ECE settings integrated nature, and (3) assessed physical outcomes. Two reviewers independently screened full-text articles and assessed study quality. Synthesis was conducted using effect direction (quantitative), thematic analysis (qualitative), and combined using a results-based convergent synthesis. RESULTS: 1370 full-text articles were screened and 39 (31 quantitative and 8 qualitative) studies were eligible; 20 quantitative studies assessed PA and 6 assessed MC. Findings indicated inconsistent associations between nature-based ECE and increased moderate to vigorous PA, and improved speed/agility and object control skills. There were positive associations between nature-based ECE and reduced sedentary time and improved balance. From the qualitative analysis, nature-based ECE affords higher intensity PA and risky play, which could improve some MC domains. The quality of 28/31 studies was weak. CONCLUSIONS: More controlled experimental designs that describe the dose and quality of nature are needed to better inform the effectiveness of nature-based ECE on PA and MC.

Nature-Based Early Childhood Education and Children's Social, Emotional and Cognitive Development: A Mixed-Methods Systematic Review.

This systematic review synthesised evidence on associations between nature-based early childhood education (ECE) and children's social, emotional, and cognitive development. A search of nine databases was concluded in August 2020. Studies were eligible if: (a) children (2-7 years) attended ECE, (b) ECE integrated nature, and (c) assessed child-level outcomes. Two reviewers independently screened full-text articles and assessed study quality. Synthesis included effect direction, thematic analysis, and results-based convergent synthesis. One thousand three hundred and seventy full-text articles were screened, and 36 (26 quantitative; 9 qualitative; 1 mixed-methods) studies were eligible. Quantitative outcomes were cognitive (n = 11), social and emotional (n = 13), nature connectedness (n = 9), and play (n = 10). Studies included controlled (n = 6)/uncontrolled (n = 6) before-after, and cross-sectional (n = 15) designs. Based on very low certainty of the evidence, there were positive associations between nature-based ECE and self-regulation, social skills, social and emotional development, nature relatedness, awareness of nature, and play interaction. Inconsistent associations were found for attention, attachment, initiative, environmentally responsible behaviour, and play disruption/disconnection. Qualitative studies (n = 10) noted that nature-based ECE afforded opportunities for play, socialising, and creativity. Nature-based ECE may improve some childhood development outcomes, however, high-quality experimental designs describing the dose and quality of nature are needed to explore the hypothesised pathways connecting nature-based ECE to childhood development (Systematic Review Registration: CRD42019152582).

The Physical Activity Messaging Framework (PAMF) and Checklist (PAMC): International consensus statement and user guide.

Effective physical activity messaging plays an important role in the pathway towards changing physical activity behaviour at a population level. The Physical Activity Messaging Framework (PAMF) and Checklist (PAMC) are outputs from a recent modified Delphi study. This sought consensus from an international expert panel on how to aid the creation and evaluation of physical activity messages. In this paper, we (1) present an overview of the various concepts within the PAMF and PAMC, (2) discuss in detail how the PAMF and PAMC can be used to create physical activity messages, plan evaluation of messages, and aid understanding and categorisation of existing messages, and (3) highlight areas for future development and research. If adopted, we propose that the PAMF and PAMC could improve physical activity messaging practice by encouraging evidence-based and target population-focused messages with clearly stated aims and consideration of potential working pathways. They could also enhance the physical activity messaging research base by harmonising key messaging terminologies, improving quality of reporting, and aiding collation and synthesis of the evidence.

How can an agent-based model explore the impact of interventions on children's physical activity in an urban environment?

Insufficient physical activity (PA) among most children and adolescents is a global problem that is undermining the realisation of numerous developmental and health benefits. The aim of this study was to explore the potential impact of interventions on PA by using an agent-based model (ABM) simulating children's daily activities in an urban environment. Three domains for interventions were explored: outdoor play, school physical education and active travel. Simulated interventions increased children's average daily moderate-to-vigorous PA by 2-13 min and reduced the percentage of children not meeting PA guidelines, from 34% to 10%-29%, depending on the intervention. Promotion of active travel and outdoor play benefited more those in a higher socio-economic position. Agents' interactions suggested that: encouraging activity in diverse groups will reduce percentage of the least active in the population; and initiating outdoor events in neighbourhoods can generate an enhancing effect on children's engagement in PA. The ABM provided measurable outcomes for interventions that are difficult to estimate using reductionist methods. We suggest that ABMs should be used more commonly to explore the complexity of the social-environmental PA system.

Neighbourhood natural space and the narrowing of socioeconomic inequality in children's social, emotional, and behavioural wellbeing.

INTRODUCTION: The natural environment may benefit children's social, emotional and behavioural wellbeing, whilst offering a lever to narrow socioeconomic health inequalities. We investigated whether immediate neighbourhood natural space and private gardens were related to children's wellbeing outcomes and whether these relationships were moderated by household income. METHODS: A nationally representative sample of 774 children (55% female, 10/11 years old) from the Studying Physical Activity in Children's Environments across Scotland study. Social, emotional and behavioural difficulty scores (Strengths and Difficulties Questionnaire) represented wellbeing outcomes. Percentage of total natural space and private gardens within 100m of the child's residence was quantified using Ordnance Survey's MasterMap Topography Layer®. Linear regression, including interaction terms, explored the two main research questions. RESULTS: A 10% increase in residential natural space was associated with a 0.08 reduction (-0.15, -0.01; 95%CI) in Emotional Problem scores and a 0.09 improvement (0.02, 0.16; 95%CI) in Prosocial Behaviour scores. Household income moderated the associations between % natural space and private gardens on Prosocial Behaviour scores: for natural space, there was a positive relationship for those in the lowest income quintile (0.25 (0.09, 0.41; 95%CI)) and a null relationship for those in the highest quintile (-0.07 (-0.16, 0.02; 95%CI)). For private garden space, there was a positive relationship for those in the highest quintile (0.15 (0.05, 0.26; 95%CI)) and negative relationship with those in the lowest quintile (-0.30 (-0.50, -0.07, 95%CI)). CONCLUSION: The natural environment could be a lever to benefit those from less advantaged backgrounds, particularly the development of prosocial behaviours.

Nature-based early childhood education for child health, wellbeing and development: a mixed-methods systematic review protocol.

BACKGROUND: Several systematic reviews have reviewed the evidence relating to nature on aspects of children and adolescent's health and wellbeing; however, none have looked at the associations or effectiveness of attending nature-based early childhood education (ECE). The main objective is to systematically review and synthesise the evidence to determine if nature-based ECE enhances children's health, wellbeing and development. METHODS: We will search the following electronic databases (from inception onwards): MEDLINE, Scopus, PsycINFO, ERIC, SportDiscus, Australian Education Index, British Education Index, Child Development and Adolescent studies, and Applied Social Sciences Index and Abstracts. Grey literature will be identified searching dissertations and reports (e.g. Open Grey, Dissertations Theses Database [ProQuest], and Google Scholar). All types of studies (quantitative and qualitative) conducted in children (aged 2-7 years old) attending ECE who had not started education at primary or elementary school will be included. The exposure of interest will be nature-based ECE settings that integrate nature into their philosophy and/or curriculum and environment. The outcomes of interest will be all aspects of the child's physical, cognitive, social and emotional health wellbeing and development. Two reviewers will independently screen full-text articles. The study methodological quality (or bias) will be appraised using appropriate tools. If feasible, a meta-analysis will be conducted using a random-effect model for studies similar in exposure and outcome. Where studies cannot be included in a meta-analysis, findings will be summarised based on the effect directions and a thematic analysis will be conducted for qualitative studies. DISCUSSION: This systematic review will capture the state of the current literature on nature-based ECE for child health, wellbeing and development. The results of this study will be of interest to multiple audiences (including researchers and policy makers). Results will be published in a peer-reviewed journal. Gaps for future research will be identified and discussed. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42019152582.

The relationship between living in urban and rural areas of Scotland and children's physical activity and sedentary levels: a country-wide cross-sectional analysis.

BACKGROUND: Living in urban or rural environments may influence children's levels of physical activity and sedentary behaviours. We know little about variations in device-measured physical activity and sedentary levels of urban and rural children using nationally representative samples, or if these differences are moderated by socioeconomic factors or seasonal variation. Moreover, little is known about the influence of 'walkability' in the UK context. A greater understanding of these can better inform intervention strategies or policy initiatives at the population level. METHODS: Country-wide cross-sectional study in Scotland in which 774 children (427 girls, 357 boys), aged 10/11 years, wore an accelerometer on one occasion for at least four weekdays and one weekend day. Mean total physical activity, time spent in sedentary, light, and moderate-to-vigorous physical activity (MVPA), per day were extracted for weekdays, weekend days, and all days combined. Regression analyses explored associations between physical activity outcomes, urban/rural residence, and a modified walkability index (dwelling density and intersection density); with interactions fitted for household equivalised income and season of data collection. Sensitivity analyses assessed variation in findings by socioeconomic factors and urbanicity. RESULTS: Rural children spent an average of 14 min less sedentary (95% CI of difference: 2.23, 26.32) and 13 min more in light intensity activity (95% CI of difference, 2.81, 24.09) per day than those from urban settlements. No urban-rural differences were found for time spent in MVPA or in total levels of activity. Our walkability index was not associated with any outcome measure. We found no interactions with household equivalised income, but there were urban/rural differences in seasonal variation; urban children engaged in higher levels of MVPA in the spring months (difference: 10 mins, p = 0.06, n.s) and significantly lower levels in winter (difference: 8.7 mins, p = 0.036). CONCLUSIONS: Extrapolated across one-year, rural children would accumulate approximately 79 h (or just over 3 days) less sedentary time than urban children, replacing this for light intensity activity. With both outcomes having known implications for health, this finding is particularly important. Future work should prioritise exploring the patterns and context in which these differences occur to allow for more targeted intervention/policy strategies.

Considerations in Processing Accelerometry Data to Explore Physical Activity and Sedentary Time in Older Adults.

Processing decisions for accelerometry data can have important implications for outcome measures, yet little evidence exists exploring these in older adults. The aim of the current study was to investigate the impact of three potentially important criteria on older adults, physical activity, and sedentary time. Participants (n = 222: mean age 71.75 years [SD = 6.58], 57% male) wore ActiGraph GT3X+ for 7 days. Eight data processing combinations from three criteria were explored: low-frequency extension (on/off), nonwear time (90/120 min), and intensity cut points (moderate-to-vigorous physical activity ≥1,041 and >2,000 counts/min). Analyses included Wilcoxon signed-rank test, paired t tests, and correlation coefficients (significance, p < .05). Results for low-frequency extension on 90-min nonwear time and >1,041 counts/min showed significantly higher light and moderate-to-vigorous physical activity and lower sedentary time. Cut points had the greatest impact on physical activity and sedentary time. Processing criteria can significantly impact physical activity and/or sedentary time, potentially leading to data inaccuracies, preventing cross-study comparisons and influencing the accuracy of population surveillance.

Active commute to school: does distance from school or walkability of the home neighbourhood matter? A national cross-sectional study of children aged 10-11 years, Scotland, UK.

OBJECTIVES: To study the extent to which home-to-school distance and neighbourhood walkability were associated with self-reported active travel to school (ATS) (eg, walking, cycling), and to explore how distance moderates the effect of walkability on ATS, among 10-11 years old. DESIGN: Cross-sectional study. SETTING: Data were collected between May 2015 and May 2016 in partnership with the Growing Up in Scotland Study, a nationally representative longitudinal cohort study. PARTICIPANTS: 713 children (male (n=330) and female (n=383) 10-11 years old) from Studying Physical Activity in Children's Environments across Scotland. PRIMARY AND SECONDARY OUTCOME MEASURES: Children who actively travelled to/from school categorised as active all (100% of ATS) and active 60%+ (at least 60% of ATS); home-to-school road/path network distance (<0.5 km, 0.5 to <1 km, 1 to <1.5 km, 1.5 to <2 km, 2 km+); home neighbourhood walkability (i.e., composite measure of road/path intersection density and dwelling density) (in quintiles). RESULTS: Distance and walkability were both associated with ATS. The likelihood of ATS for all or most journeys decreased with increasing distance. Compared with 'most' walkable areas (Q1), the odds of active all were significantly lower within least walkable areas (Q5 OR 0.45, 95% CI 0.21 to 0.99), and odds of active 60%+ were significantly less in Q2-Q5 (lowest odds Q5 OR 0.20, 95% CI 0.07 to 0.47). Regarding walkability and distance interactions, for all distance categories, higher walkability increased the probability of ATS (for most school journeys). CONCLUSION: Walkability was positively associated with ATS within all distance categories, with the relationship between walkability and ATS more complex than the clear-cut association between distance and ATS. A more walkable environment had a larger effect on the probability of reaching the 60% threshold of school journeys using ATS than the probability of always travelling in an active manner. Investment is needed in existing less walkable neighbourhoods to provide infrastructure to support opportunities for children's ATS.

Children's mobility and environmental exposures in urban landscapes: A cross-sectional study of 10-11 year old Scottish children.

Research into how the environment affects health and related behaviour is typically limited in at least two ways: it represents the environment to which people are exposed using fixed areal units, and, it focuses on one or two environmental characteristics only. This study developed a methodology for describing children's mobility and the complexity of their environmental exposure across a 1934 km2 study area, including urban, suburban and rural zones. It conceptualised and modelled this area as a landscape, comprised of spatially discrete amenities, infrastructure features, differing land covers/use and broader environmental contexts. The model used a 25 m2 grid system (∼3 million cells). For each cell, there was detailed built-environment information. We joined data for 100 10/11-year-old children who had worn GPS trackers to provide individual-level mobility information for one week during 2015/16 to our model. Using negative binomial regression, we explored which landscape features were associated with a child visiting that space and time spent there. We examined whether relationships between the features across our study area and children's use of the space differed by their sociodemographic characteristics. We found that children often used specific amenities outside their home neighbourhood, even if they were also available close to home. They spent more time in cells containing roads/transportation stops, food/drink retail (Incidence rate ratio (IRR):4.02, 95%CI 2.33 to 6.94), places of worship (IRR:5.98, 95%CI 3.33 to 10.72) and libraries (IRR:7.40, 95%CI 2.13 to 25.68), independently of proximity to home. This has importance for the optimal location of place-based health interventions. If we want to target children, we need to understand that using fixed neighbourhood boundaries may not be the best way to do it. The variations we found in time spent in certain areas by sex and socio-economic position also raise the possibility that interventions which ignore these differences may exacerbate inequalities.

The Unanticipated Challenges Associated With Implementing an Observational Study Protocol in a Large-Scale Physical Activity and Global Positioning System Data Collection.

BACKGROUND: Large-scale primary data collections are complex, costly, and time-consuming. Study protocols for trial-based research are now commonplace, with a growing number of similar pieces of work being published on observational research. However, useful additions to the literature base are publications that describe the issues and challenges faced while conducting observational studies. These can provide researchers with insightful knowledge that can inform funding proposals or project development work. OBJECTIVES: In this study, we identify and reflectively discuss the unforeseen or often unpublished issues associated with organizing and implementing a large-scale objectively measured physical activity and global positioning system (GPS) data collection. METHODS: The SPACES (Studying Physical Activity in Children's Environments across Scotland) study was designed to collect objectively measured physical activity and GPS data from 10- to 11-year-old children across Scotland, using a postal delivery method. The 3 main phases of the project (recruitment, delivery of project materials, and data collection and processing) are described within a 2-stage framework: (1) intended design and (2) implementation of the intended design. RESULTS: Unanticipated challenges arose, which influenced the data collection process; these encompass four main impact categories: (1) cost, budget, and funding; (2) project timeline; (3) participation and engagement; and (4) data challenges. The main unforeseen issues that impacted our timeline included the informed consent process for children under the age of 18 years; the use of, and coordination with, the postal service to deliver study information and equipment; and the variability associated with when participants began data collection and the time taken to send devices and consent forms back (1-12 months). Unanticipated budgetary issues included the identification of some study materials (AC power adapter) not fitting through letterboxes, as well as the employment of fieldworkers to increase recruitment and the return of consent forms. Finally, we encountered data issues when processing physical activity and GPS data that had been initiated across daylight saving time. CONCLUSIONS: We present learning points and recommendations that may benefit future studies of similar methodology in their early stages of development.

Comparison of two methods to assess physical activity prevalence in children: an observational study using a nationally representative sample of Scottish children aged 10-11 years.

OBJECTIVES: To describe the objectively measured levels of physical activity (PA) and sedentary time in a nationally representative sample of 10-11-year-old children, and compare adherence estimates to the UK PA guidelines using two approaches to assessing prevalence. DESIGN: Nationally representative longitudinal cohort study. SETTING: Scotland wide in partnership with the Growing up in Scotland (GUS) study. Data collection took place between May 2015 and May 2016. PARTICIPANTS: The parents of 2402 GUS children were approached and 2162 consented to contact. Consenting children (n=1096) wore accelerometers for 8 consecutive days and 774 participants (427 girls, 357 boys) met inclusion criteria. PRIMARY AND SECONDARY OUTCOME MEASURES: Total PA (counts per minute, cpm); time spent sedentary and in moderate-to-vigorous PA (MVPA); proportion of children with ≥60 min MVPA on each day of wear (daily approach); proportion of children with ≥60 min of MVPA on average across days of wear (average approach)-presented across boys and girls, index of multiple deprivation and season. RESULTS: Mean PA level was 648 cpm (95% CI, 627 to 670). Children spent 7.5 hours (7.4-7.6) sedentary/day and 72.6 min (70.0-75.3) in MVPA/day. 11% (daily) and 68% (average) of children achieved the recommended levels of PA (P<0.05 for difference); a greater proportion of boys met the guidelines (12.5% vs 9.8%, NS; 75.9% vs 59.5%, P<0.001); guideline prevalence exhibited seasonal variation. No significant socioeconomic patterning existed across any outcome measure. CONCLUSIONS: PA estimates are significantly influenced by the analytical method used to assess prevalence. This could have a substantial impact on the evaluation of interventions, policy objectives and public health investment. Existing guidelines, which focus on daily PA only may not further our understandings about the underlying construct itself. Gender differences exist within this age-group, suggesting greater investment, with particular consideration of seasonality, is needed for targeted intervention work in younger children.