Child and youth physical activity throughout the COVID-19 pandemic: The changing role of the neighbourhood built and social environments.

We explored associations between neighbourhood environments and children and youths' moderate-to-vigorous physical activity (MVPA) during three different waves of the COVID-19 pandemic: spring 2020, fall 2020 and spring 2021, using three nationally representative cross-sectional surveys. In wave 2, higher dwelling density was associated with lower odds of a child achieving higher-level MVPA, however, the odds were higher in neighbourhoods with higher density that also had better access to parks. With regard to the social environment, ethnic concentration (wave 3) and greater deprivation (waves 1 and 3) were associated with lower odds of a child achieving higher-level MVPA. Results indicate that built and social environments were differently associated with MVPA levels depending on pandemic restrictions.

Impact of an outdoor loose parts play intervention on Nova Scotian preschoolers' physical literacy: a mixed-methods randomized controlled trial.

BACKGROUND: Physical activity participation among preschoolers in childcare settings are low, and interventions to increase physical activity levels have produced mixed results. The Physical Literacy in the Early Years (PLEY) project implemented a six-month childcare-based outdoor loose parts play intervention in childcare centres in Nova Scotia, Canada. The purpose of this study was to examine the impact of the PLEY project on the development of domains of physical literacy (physical activity, physical competence, confidence and motivation, knowledge and understanding) in preschoolers attending childcare centres using mixed-methods. METHODS: Preschoolers (3-5 years) were recruited from 19 childcare centres in Nova Scotia and centres were randomized (parallel design) to the outdoor loose parts play intervention group (n = 11) or control (n = 8) group for 6 months. Participants, early childhood educators, and assessors were not blinded to group assignment. Quantitative and qualitative measures were used to comprehensively assess the impact of the PLEY project on all domains of physical literacy. At 3- and 6-months, early childhood educators participated in focus groups to assess how the intervention supported the development of 4 physical literacy domains: physical activity, physical competence, confidence and motivation, and knowledge and understanding. Physical activity and physical competence were also assessed with accelerometry and the Test of Gross Motor Development-3, respectively. RESULTS: Two hundred and nine preschoolers participated in the study (intervention group: n = 115; control group: n = 94). Accelerometer data showed that while baseline physical activity was similar between groups, children in the intervention group had higher physical activity at 3- (F(1,187) = 8.30, p = 0.004) and 6-months (F(1,187) = 9.90, p = 0.002) post-intervention. There was no intervention effect on physical competence scores. Thematic analysis of focus group data revealed that outdoor loose parts play contributed to development in all 4 physical literacy domains, including increased movement repertoires, social development, and enjoyment of physical activity. No adverse events or side effects of the intervention were reported. CONCLUSIONS: Participation in the PLEY project was associated with increased development of various domains of physical literacy and perceived physical literacy among preschoolers, and outdoor loose parts play may be encouraged as an effective strategy to increase physical literacy in early learning settings. TRIAL REGISTRATION: Biomed Central (ISRCTN14058106), 20/10/2017.

Early childhood educator perceptions of risky play in an outdoor loose parts intervention.

Free play is important in early childhood and offers physical and mental health benefits. Outdoor play offers opportunity for children to use natural elements and promotes physical activity, among other health benefits, including exploring their environment and taking risks. Risky outdoor play may involve challenges, heights, speed, and the potential for injury, but has been associated with increased physical activity levels, decreased sedentary behaviour, improved mental health, and social benefits. The integration of loose parts, or open-ended, unstructured materials, into play environments, has been associated with positive social behaviours, creativity, and improved problem-solving, confidence, and resilience. As opportunities for risky play in early childhood are determined by adults, including early childhood educators, it is important to understand their perspectives on these types of play. The purpose of this study was to explore early childhood educators' perspectives of risky play, in the context of the Physical Literacy in the Early Years (PLEY) intervention. PLEY was a mixed methods study that aimed to evaluate a loose parts intervention in early childcare settings. This paper used Qualitative Description to explore educators' perspectives. Data were collected from 15 focus groups with early childhood educators. Four themes were identified through thematic analysis. The first explains how risky play with loose parts contributes to evolution in educator perceptions; the second describes how educators' perceptions of risk are connected to institutions and systems; the third illustrates how educators developed strategies to facilitate risky play with loose parts; and the fourth demonstrates how educators perceive risky play as beneficial for children's healthy development. This project highlights societal shifts in play and how loose parts and risky play fit into the ongoing evolution in play, from the perspectives of early childhood educators.

A Loose Parts Randomized Controlled Trial to Promote Active Outdoor Play in Preschool-aged Children: Physical Literacy in the Early Years (PLEY) Project.

BACKGROUND: The Physical Literacy in the Early Years (PLEY) intervention is a randomized mixed-methods controlled trial focused on embedding loose parts materials into the outdoor play spaces of regulated child care centres across Nova Scotia. The aim is to evaluate the efficacy of the PLEY intervention versus standard regulated childcare practice in influencing thoughts and behaviors of children, parents, and educators. METHODS: Participating early child care centres (n = 19) were randomly assigned to intervention or control sites. Intervention sites received loose parts kits at the beginning of the project while control sites received kits upon project completion. The kits included items such as rocks, tree cookies, balls, wood planks, tubes, tires, ropes, and pulleys. Children (n = 183 at baseline) had their physical activity (accelerometers) and movement skills (TGMD-3 and PGMQ) measured before and after the intervention. All centres provided responses to environmental surveys (Go NAP SACC and Site Context Questionnaire), and educators in intervention sites participated in focus group and photovoice sessions. Educators were also provided with a full day professional development opportunity (plus ongoing mentoring) focused on physical activity, physical literacy, outdoor play, risk-taking, and loose parts. Parents participated in an interview addressing active outdoor play, physical literacy, and attitudes towards risk taking during play. DISCUSSION: This study will provide a better understanding of how integrating loose parts materials into outdoor play spaces impacts children's health, and the impact on educator and parent attitudes, beliefs, and understanding around physical literacy, active outdoor play and risk-taking during play.

Accelerometry-measured physical activity and sedentary behaviour of preschoolers in Nova Scotia, Canada.

The objective of this study was to describe the levels and bouts of physical activity (PA) and sedentary behaviour (SB) among preschoolers in Nova Scotia, Canada, and the proportion meeting PA and step guidelines. Children (75 boys, 49 girls; mean age = 4.2 (range = 3-5 years)) participating in the Physical Literacy in the Early Years (PLEY) study provided data. Average time (minutes, % of day) spent sedentary, in light PA (LPA), moderate-to-vigorous PA (MVPA), and total PA; average frequency; and duration of bouts of MVPA (≥5 min, ≥10 min) and sedentary bouts (≥10 min) per day were determined using published cut-points, using 15-s epochs. The proportion of children meeting PA and step guidelines was determined, and differences by sex explored. Children spent the majority (70.8%) of their day active; nearly all (≥97%) met PA guidelines. Most children met step guidelines on a weekly basis, but not daily. Only LPA differed by sex (greater in girls; p = 0.001). Little time was spent in sustained SB (bouts ≥10 min). Boys had greater and longer bouts of MVPA and spent more of their day in these (p < 0.05). Girls spent less time in sustained SB (p = 0.009). This is the first study to describe the PA and SB of Nova Scotia preschoolers using accelerometry. Findings suggest preschoolers spend the majority of their day active, and that there are sex-related differences in PA and SB, warranting further examination.

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

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

Cardiorespiratory fitness is associated with physical literacy in a large sample of Canadian children aged 8 to 12 years.

BACKGROUND: The associations between cardiorespiratory fitness (CRF) and physical literacy in children are largely unknown. The aim of this study was to assess the relationships between CRF, measured using the 20-m shuttle run test (20mSRT), and components of physical literacy among Canadian children aged 8-12 years. METHODS: A total of 9393 (49.9% girls) children, with a mean (SD) age of 10.1 (±1.2) years, from a cross-sectional surveillance study were included for this analysis. The SRT was evaluated using a standardized 15 m or 20 m protocol. All 15 m SRTs were converted to 20mSRT values using a standardized formula. The four domains of physical literacy (Physical Competence, Daily Behaviour, Motivation and Confidence, and Knowledge and Understanding) were measured using the Canadian Assessment of Physical Literacy. Tertiles were identified for 20mSRT laps, representing low, medium, and high CRF for each age and gender group. Cohen's d was used to calculate the effect size between the low and high CRF groups. RESULTS: CRF was strongly and favourably associated with all components of physical literacy among school-aged Canadian children. The effect size between low and high CRF tertile groups was large for the Physical Competence domain (Cohen's d range: 1.11-1.94) across age and gender groups, followed by moderate to large effect sizes for Motivation and Confidence (Cohen's d range: 0.54-1.18), small to moderate effect sizes for Daily Behaviour (Cohen's d range: 0.25-0.81), and marginal to moderate effect sizes for Knowledge and Understanding (Cohen's d range: 0.08-0.70). CONCLUSIONS: This study identified strong favourable associations between CRF and physical literacy and its constituent components in children aged 8-12 years. Future research should investigate the sensitivity and specificity of the 20mSRT in screening those with low physical literacy levels.

Physical literacy levels of Canadian children aged 8-12 years: descriptive and normative results from the RBC Learn to Play-CAPL project.

BACKGROUND: The current physical literacy level of Canadian children is unknown. The Royal Bank of Canada (RBC) Learn to Play - Canadian Assessment of Physical Literacy (CAPL) project, which is anchored in the Canadian consensus statement definition of physical literacy, aimed to help establish the current physical literacy level of Canadian children. METHODS: The CAPL was used to assess the physical literacy (and component domains: Daily Behaviour, Physical Competence, Knowledge and Understanding, and Motivation and Confidence) of Canadian children aged 8-12 years. Data were collected from 11 sites across Canada, yielding a sample of 10,034 participants (5030 girls). Descriptive statistics by age and gender were calculated and percentile distributions of physical literacy scores, including each domain and individual measure, were derived. RESULTS: The mean age of participants was 10.1 ± 1.2 years. Total physical literacy scores (out of 100) were on average 63.1 ± 13.0 for boys and 62.2 ± 11.3 for girls. For boys and girls respectively, domain scores were 19.9 ± 4.7 and 19.3 ± 4.1 (out of 32) for Physical Competence; 18.6 ± 7.9 and 18.5 ± 7.4 (out of 32) for Daily Behaviour; 12.7 ± 2.8 and 12.2 ± 2.6 (out of 18) for Motivation and Confidence; and 11.8 ± 2.8 and 12.2 ± 2.6 (out of 18) for Knowledge and Understanding. Physical Competence measures were on average 28.1 ± 8.4 cm (sit-and-reach flexibility), 33.5 ± 9.4 kg (grip strength, right + left), 23.4 ± 14.1 laps (Progressive Aerobic Cardiovascular Endurance Run [PACER] shuttle run), 61.8 ± 43.8 s (isometric plank), 19.0 ± 3.8 kg/m2 (body mass index), 67.3 ± 10.8 cm (waist circumference), and 20.6 ± 3.9 out of 28 points for the Canadian Agility and Movement Skill Assessment (CAMSA), with scores for boys higher than girls and older children higher than younger children for grip strength, PACER, plank, and CAMSA score. Girls and younger children had better scores on the sit-and-reach flexibility than boys and older children. Daily pedometer step counts were higher in boys than girls (12,355 ± 4252 vs. 10,779 ± 3624), and decreased with age. CONCLUSIONS: These results provide the largest and most comprehensive assessment of physical literacy of Canadian children to date, providing a "state of the nation" baseline, and can be used to monitor changes and inform intervention strategies going forward.

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

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

Environments Associated with Moderate-to-Vigorous Physical Activity and Sedentary Behavior of Colorectal Cancer Survivors.

PURPOSE: Physical activity (PA) is an effective intervention for improving the quality of life of colorectal cancer survivors (CRC) and may reduce the risk of cancer recurrence and cancer specific and all-cause mortality. However, most CRC survivors are not sufficiently active to receive these benefits. Sedentary behavior (SB) has also been linked to morbidity and mortality risk independent of activity level, thereby presenting an additional opportunity to improve health outcomes of CRC survivors. The built environment is known to influence PA and SB; however, little is known about where CRC survivors engage in PA and SB. The objective of this exploratory study was to objectively identify locations where CRC survivors engage in PA and SB in order to inform health promoting interventions. METHOD: Activity and location of CRC survivors (n = 31) was monitored for 1 week between January 2014 and April 2015 in Nova Scotia, Canada. Bouts of PA and SB were time-matched with GPS data to attribute bouts to specific geographic locations. RESULTS: Participants' home environment was the main location for both time spent in PA bouts (73.7 %) and time spent in SB bouts (90.5 %). CONCLUSION: This study is the first to objectively identify environments where CRC survivors are active and sedentary. These findings highlight the importance of considering the home environment when developing intervention strategies to increase PA and reduce SB in CRC survivors.

Let the Children Play: Scoping Review on the Implementation and Use of Loose Parts for Promoting Physical Activity Participation.

Active play has become a critical focus in terms of physical activity participation in young children. Unstructured or child-led play offers children the opportunity to interact with the environment in a range of different ways. Unstructured materials, often called loose parts, encourage child-led play, and therefore may also promote physical activity. The purpose of this scoping review was to determine what is currently known about how loose parts may influence physical activity participation. Following a systematic literature search, a total of 16 articles were retrieved, reviewed and categorized according to: (1) types of loose parts; (2) types of play; and (3) types of thinking. We found that there are currently a range of loose parts being used to support play, but the way in which they are implemented varies and there is a lack of clarity around how they might support the development of active outdoor play and physical literacy skills.

Measures of outdoor play and independent mobility in children and youth: A methodological review.

OBJECTIVES: Declines in children's outdoor play have been documented globally, which are partly due to heightened restrictions around children's independent mobility. Literature on outdoor play and children's independent mobility is increasing, yet no paper has summarized the various methodological approaches used. A methodological review could highlight most commonly used measures and comprehensive research designs that could result in more standardized methodological approaches. DESIGN: Methodological review. METHODS: A standardized protocol guided a methodological review of published research on measures of outdoor play and children's independent mobility in children and youth (0-18 years). Online searches of 8 electronic databases were conducted and studies included if they contained a subjective/objective measure of outdoor play or children's independent mobility. References of included articles were scanned to identify additional articles. RESULTS: Twenty-four studies were included on outdoor play, and twenty-three on children's independent mobility. Study designs were diverse. Common objective measures included accelerometry, global positioning systems and direct observation; questionnaires, surveys and interviews were common subjective measures. Focus groups, activity logs, monitoring sheets, travel/activity diaries, behavioral maps and guided tours were also utilized. Questionnaires were used most frequently, yet few studies used the same questionnaire. Five studies employed comprehensive, mixed-methods designs. CONCLUSIONS: Outdoor play and children's independent mobility have been measured using a wide variety of techniques, with only a few studies using similar methodologies. A standardized methodological approach does not exist. Future researchers should consider including both objective measures (accelerometry and global positioning systems) and subjective measures (questionnaires, activity logs, interviews), as more comprehensive designs will enhance understanding of each multidimensional construct. Creating a standardized methodological approach would improve study comparisons.

Food access and children's BMI in Toronto, Ontario: assessing how the food environment relates to overweight and obesity.

OBJECTIVES: The objective was to examine how access to fast food restaurants, less healthy/healthier food outlets and supermarkets relate to measured levels of overweight and obesity among grade 5 and 6 students. METHODS: Measured height and weight data were obtained to measure BMI. The location and type of food outlet were derived from Toronto Public Health. The density of fast food, less healthy/healthy food outlets and supermarkets within a 1-km walk of the child's home was calculated along with the distance to the closest. Logistic regression models examined the relationship between food access and overweight/obesity. RESULTS: Lower income residents were more likely to be overweight or obese, as were boys. Living in an area with a higher density of healthy food outlets and in close proximity to a supermarket decreased the odds of being overweight or obese. CONCLUSIONS: Addressing several limitations in the literature, the findings confirm an association between the food retail environment and body weight. Density of healthy food outlets and distance to the nearest supermarket are important factors to be considered in addressing the childhood obesity pandemic.

Outdoor play in children: associations with objectively-measured physical activity, sedentary behavior and weight status.

OBJECTIVES: To determine the amount of time children play outdoors and examine associations with weekday, weekend and after-school physical activity (PA), sedentary behavior (SB), and weight-status (normal-weight, overweight/obese). METHODS: Data were extracted from Project BEAT (Toronto, 2010-2011; www.beat.utoronto.ca). Children's (n=856; mean age=11±0.6years) PA and SB were measured using accelerometry. Outdoor play (OP) was assessed via parental report and collapsed into three categories (<1h/day, 1-2h/day, >2h/day) and differences in anthropometric and PA characteristics were assessed. RESULTS: 55.1%, 37.2%, and 7.7% of children played outdoors for <1h/day, 1-2h/day and >2h/day, respectively, on weekdays. OP was higher on weekends and in boys. OP was associated with SB, light PA and MVPA at all time-points, whereby children attaining <1h/day had lower activity profiles. Boys playing outdoors for <1h/day were more likely to be overweight/obese and had lower PA levels than normal weight boys. However, overweight/obese boys who spent >2h/day playing outdoors had PA profiles similar to normal weight counterparts. CONCLUSION: Encouraging children to spend more time outdoors may be an effective strategy for increasing PA, reducing SB, and preventing excess weight gain (particularly boys' play).

The freedom to explore: examining the influence of independent mobility on weekday, weekend and after-school physical activity behaviour in children living in urban and inner-suburban neighbourhoods of varying socioeconomic status.

BACKGROUND: Children's independent mobility (CIM) is critical to healthy development in childhood. The physical layout and social characteristics of neighbourhoods can impact opportunities for CIM. While global evidence is mounting on CIM, to the authors' knowledge, Canadian data on CIM and related health outcomes (i.e., physical activity (PA) behaviour) are missing. The purpose of this study was to examine if CIM is related to multiple characteristics of accelerometry-measured PA behaviour (total PA, light PA, moderate-to-vigorous PA, time spent sedentary) and whether associations between CIM and PA behaviour systematically vary by place of residence, stratifying by gender and type of day/period (weekdays, after-school, weekend). METHODS: Participants were recruited through Project BEAT (Built Environment and Active Transport; http://www.beat.utoronto.ca). Children (n = 856) were stratified into four neighbourhood classifications based on the period of neighbourhood development (urban built environment (BE) (old BE) versus inner-suburban BE (new BE)) and socioeconomic status (SES; low SES and high SES). Physical activity was measured via accelerometry (ActiGraph GT1M). CIM was assessed via parental report and two categories were created (low CIM, n = 332; high CIM, n = 524). A series of two-factor ANOVAs were used to determine gender-specific differences in PA for weekdays, weekend days and the after-school period, according to level of CIM, across four neighbourhood classifications. RESULTS: Children who were granted at least some independent mobility (high CIM) had more positive PA profiles across the school week, during the after-school period, and over the weekend; they were also less sedentary. The influence of CIM on PA behaviour was particularly salient during the after-school period. Associations of CIM with PA varied by gender, and also by neighbourhood classification. CIM seemed to matter more in urban neighbourhoods for boys and suburban neighbourhoods for girls. CONCLUSION: Our findings highlight the importance of independent mobility to multiple characteristics of children's PA behaviour across the week. Furthermore, they emphasize that independent mobility-activity relationships need to be considered by gender and the type of neighbourhood independent mobility is offered in. Future work will focus on developing a predictive model of CIM that could be used to inform decision-making around alleviating barriers to CIM.

Active school travel: an evaluation of the Canadian school travel planning intervention.

OBJECTIVE: Active school travel (AST) may provide a significant source of physical activity for children although rates of AST are declining in many countries. The objective of this study was to evaluate the Canadian School Travel Planning (STP) intervention by examining changes in school travel mode and predictors of mode change. METHODS: Schools (n=106) across Canada participated between January 2010 and March 2012. STP committees implemented school-specific strategies to increase active school transport (AST) which included educational strategies, activities and events, capital improvement projects and enforcement initiatives. Travel mode at each school was assessed by a hands-up survey and school travel plans were reviewed for content. RESULTS: Complete data were available for 53 schools. There was no increase in AST at follow-up after one year. There was variation in mode change between schools. Only season of data collection predicted a decrease in AST in the morning (B=-5.36, p<.05). CONCLUSION: This Canadian STP evaluation showed no change in AST after one year. There was evidence of some localized success at nearly half of the participating schools. More robust monitoring and evaluation are needed to examine STP effectiveness.

The "path" not taken: exploring structural differences in mapped- versus shortest-network-path school travel routes.

OBJECTIVES: School route measurement often involves estimating the shortest network path. We challenged the relatively uncritical adoption of this method in school travel research and tested the route discordance hypothesis that several types of difference exist between shortest network paths and reported school routes. METHODS: We constructed the mapped and shortest path through network routes for a sample of 759 children aged 9 to 13 years in grades 5 and 6 (boys = 45%, girls = 54%, unreported gender = 1%), in Toronto, Ontario, Canada. We used Wilcoxon signed-rank tests to compare reported with shortest-path route measures including distance, route directness, intersection crossings, and route overlap. Measurement difference was explored by mode and location. RESULTS: We found statistical evidence of route discordance for walkers and children who were driven and detected it more often for inner suburban cases. Evidence of route discordance varied by mode and school location. CONCLUSIONS: We found statistically significant differences for route structure and built environment variables measured along reported and geographic information systems-based shortest-path school routes. Uncertainty produced by the shortest-path approach challenges its conceptual and empirical validity in school travel research.

Maintaining recommended sleep throughout the week is associated with increased physical activity in children.

OBJECTIVE: Given evidence of weekday-weekend variability in children's sleep and associations with obesity there is rationale for exploring sleep in relation to weekday and weekend physical activity (PA) and examining whether weekday-weekend variations in sleep impact physical activity. METHODS: Children's (n=856) physical activity was measured using accelerometry (Toronto; 2010-2011). Sleep was assessed via parental report and collapsed into three categories (<9h; 9-10h; ≥ 10 h) and differences in anthropometric and physical activity characteristics were assessed. Data were compared to determine whether sleep increased, decreased or was maintained across the week and relationships with activity and overweight/obesity were explored (cross-sectional analysis) after controlling for confounders. RESULTS: On weekdays, children who slept the least (<9h) were less active in terms of overall intensity than those attaining ≥ 10 h, and more were overweight/obese (p<0.05). On weekends, differences in light physical activity occurred at lower sleep levels. Weekday-weekend sleep regularity mattered; overall intensity was higher among those maintaining recommended sleep (>9h) compared to those engaging in weekend-catch-up-sleep. CONCLUSION: While sleep is associated with obesity and activity in children, relationships vary by day. Recommended weekday-weekend sleep (regularity) supports healthy activity and should be an important health-promoting strategy. Future studies using longitudinal designs (to establish causality) are recommended.

The Daily Physical Activity (DPA) policy in Ontario: is it working? an examination using accelerometry-measured physical activity data.

OBJECTIVE: In 2005, the Ontario Ministry of Education announced a policy requiring that all elementary students be provided with opportunities to participate in a minimum of 20 minutes of sustained moderate-to-vigorous physical activity (MVPA) each school day during instructional time. To the authors' knowledge, this policy has never been formally evaluated. In a form of natural experiment with Project BEAT, we explored within 16 Toronto District School Board schools the proportion of children who participate in DPA, and the proportion who achieve sustained MVPA within these sessions; these are the objectives of this article. METHODS: Consent was given by 1027 parents/guardians for their children to participate (boys, n=478; girls, n=549). Physical activity (PA) was measured using accelerometry and classroom schedules collected to identify sessions of DPA. The frequency of DPA and number and duration of sustained bouts of MVPA (> or =5 min) were computed and explored relative to PA levels and health outcomes. RESULTS: Fewer than half of the participating children were provided with DPA every day and not a single child engaged in sustained MVPA for > or =20 minutes. On the more positive side, children who engaged in DPA every day were significantly more active than their peers. Those accumulating at least 1 bout of MVPA were more active and likely to meet PA guidelines, and fewer of these children were overweight. CONCLUSION: The majority of schools are not meeting the DPA policy. However, as the frequency and intensity of DPA increases, so do positive health outcomes. This paper provides supporting evidence that when this policy is implemented, the intended health benefits are achievable.

Physical activity patterns of children in Toronto: the relative role of neighbourhood type and socio-economic status.

OBJECTIVE: A child's opportunity for physical activity and the safety of engaging in activity are influenced by built environment (BE) elements. This study examined the relationship of neighbourhood type and socio-economic status (SES) with activity using a sampling frame that purposely located schools in varying neighbourhoods to ensure that there was variability in BE characteristics and SES. METHODS: Participants (1,027 Grade 5 & 6 students, Toronto, ON) were drawn from 16 schools that varied by neighbourhood type (pre-1946 "old/urban BE" with grid-based street layout versus post-1946 "new/inner-suburban BE" with looping street layout) and socio-economic status (low and high SES). Physical activity was recorded by accelerometry for seven days. Only children living within 1.6 km of school were included in the analyses (n=713; boys=339, girls=374). Generalized linear mixed models examined sex-specific differences in physical activity across four geographic stratifications: old BE, low-SES (OL); old BE, high-SES (OH); new BE, low-SES (NL); and new BE, high-SES (NH). RESULTS: Children who attended schools in more affluent neighbourhoods (urban and inner-suburban) had more positive physical activity profiles. Across school days, boys were more active in inner-suburban neighbourhoods whereas urban and inner-suburban girls' activity levels were similar. On the weekend, the influence of the neighbourhood environment was stronger, especially for girls and also for boys with respect to total activity and the accumulation of moderate-to-vigorous physical activity. CONCLUSION: These findings focus attention on the need to consider the broader social and temporal contexts of specific geographic locations when planning and implementing built environment interventions to increase physical activity among children.