Where the children play: Gender gaps in recess physical activity by age and playground area.

Objective: Recess contributes meaningfully to physical activity (PA), but recess time has declined. The study's purpose was to report PA by age, gender, and playground feature to inform potential playground configurations more conducive to PA during recess. Methods: Using the System for Observing Play and Leisure Activity in the Youth, kindergarten through 5th grade recesses were observed on at least four days at four schools in Little Rock, Arkansas, United States during May 2023. Target playground features were ball courts, grass, pavement, play structures, and swings. To provide inferential analysis, a comparison of conditional means across playground features, age, and gender was conducted using linear regression with robust standard errors clustered by school. Results: 3,356 playground scans (intercoder correlation = 0.93) were collected and aggregated by school, day, gender, age (grade), and target feature for a sample size of 292 observations. The gender gap was widest among 4-5th graders, 79 % (95 % CI: 72, 86) for males and 64 % (95 % CI: 58, 70) for females. Among females, PA was highest on swings [82 % (95 % CI: 77, 86)] and lowest on paved areas [56 % (95 % CI: 43, 69)]. Among males, it was highest on both swings [81 % (95 % CI: 75, 86)] and ball courts [83 % (95 % CI: 77, 89)] and lowest on grassy areas [64 % (95 % CI: 60, 67)]. Conclusion: Swings, courts, and play structures were associated with a higher proportion of children being engaged in PA. Research is needed to identify whether physical improvements to facilitate access to these features increase PA.

Offspring sex modifies the association between early-pregnancy adiposity and 2-year-old physical activity-The Glowing Study.

BACKGROUND: Rodent models suggest that in utero exposure to under and overnutrition programs offspring physical activity (PA) behaviors. Such nexus has not been established in humans. This study evaluated the association of early pregnancy maternal adiposity with offspring PA at age 2 years (2-yo-PA) taking into consideration prenatal and postnatal factors. METHODS: Women (n = 153) were enrolled early in pregnancy (<10 weeks). At enrollment, maternal adiposity [air displacement plethysmography, fat mass index (FMI, kg/m2)] and PA (accelerometers, activity counts) were measured, and age, race, and education self-reported. Gestational weight gain was measured at the research facility. Offspring birthweight and sex were self-reported. At age 2 years, parental feeding practices (child feeding questionnaire) were assessed, whereas anthropometrics (length and weight) and physical activity (accelerometers) were objectively measured. Offspring body mass index z-scores were calculated. Generalized linear regression analysis modeled the association of maternal FMI and 2-yo-PA [average activity counts (AC)4/day]. RESULTS: In bivariate associations, 2-yo-PA did not associate with maternal FMI (ß = -0.22, CI = -0.73 to 0.29, p = 0.398). However, maternal FMI interacted with offspring sex in association with 2-yo-PA. Specifically, 2-yo-PA was lower in girls (ß = -1.14, CI = -2.1 to -0.18, p = 0.02) compared to boys when maternal FMI was ≥7 kg/m2. When stratified by sex, 2-yo-PA of girls negatively associated with maternal FMI (ß = -0.82, CI = -1.43 to 0.29, p = 0.009) while no association was found between maternal FMI and boy's PA (ß = 0.32, CI = -0.38 to 1.01, p = 0.376). CONCLUSIONS: The association of 2-yo-PA and early pregnancy maternal adiposity was modified by offspring sex. Offspring's physical activity decreased with increasing early pregnancy adiposity maternal in girls but not boys in second parity dyads.

Relationships between physical behaviour phenotypes of mothers in pregnancy and their offspring with child body composition.

AIM: The aim of this study was to identify physical behaviour phenotypes in mothers in the first trimester and in their offspring at 24 months of age. The secondary aim was to examine relationships between mother and child behaviours with child body composition at age 24 months. METHODS: Longitudinal secondary analysis of the Glowing cohort collected between 1 February 2011 and 22 August 2017 in Little Rock, Arkansas. Behaviours were measured using ankle-worn accelerometers in mothers during the first trimester and offspring at 24 months of age, including total activity, sleep, sedentary time and a novel variable of daily variation, patternicity. Child body fat was measured using quantitative nuclear magnetic resonance. RESULTS: Three phenotypes were identified for mothers and children (n = 159 complete dyads). There were no relationships between mother and child phenotypes, but higher maternal patternicity was associated with higher child patternicity (0.2, 95% CI 0.1, 0.3, p = 0.001). There were no associations between mother or child phenotypes with child body composition, however higher child activity was associated with lower body fat (-0.01, 95% CI: -0.02, -0.001, p = 0.031). CONCLUSION: Limited associations were found between mothers' pregnancy physical behaviours with child behaviours or child body composition at 24 months of age. Factors such as child diet or current parental physical activity may be better predictors of early childhood outcomes.

Educational outcomes of recess in elementary school children: A mixed-methods systematic review.

BACKGROUND: Recess provides a key physical activity opportunity for students in school, yet a wide range of recess requirements exist. To design optimal recess policies, the effect of recess on students' educational outcomes must be better understood. Therefore, the purpose of this mixed-method systematic review is to identify and systematically evaluate research on the effects of recess on student educational outcomes, including behavior, cognitive performance and academic achievement. METHODS: A systematic search of the literature in ERIC (EBSCO), ProQuest Central, PsycINFO, Teacher Reference Center, MEDLINE Complete (EBSCO), and CINAHL Complete was performed through September 2022. Data was extracted from quantitative studies, and reported themes with exemplar quotes were extracted from qualitative studies. The Mixed Method Appraisal Tool (MMAT) was used to assess study quality. RESULTS: The search identified 932 articles, of which 13 were included in the review, including 8 quantitative and 5 qualitative studies. Eleven studies were conducted in the United States, and reported sample size of studies ranged from 12 to 11,624. Studies found mixed effects on student behavior, discipline referrals and academic achievement. Qualitative studies reported multiple benefits of recess including increased focus, improved problem solving and academic achievement. CONCLUSIONS: Overall, evidence suggests positive benefits for behavior and either positive or null benefits of recess on academic achievement. However, evidence is limited by non-controlled study designs and diversity in outcome assessments. Additional quantitative evidence is needed to convince policymakers of the specific evidence supporting recess, but also to advise on the optimal recess policies and practices to improve student learning.

Relationships between personality traits, high school sports participation, and physical activity of college students in the United States.

Objective: The study aimed to 1) examine relationships between contexts of PA, personality traits, and high school sports participation (sports) and 2) determine significant PA correlates in a college population. Participants: 237 undergraduates at a university in the United States between September 2020 and May 2021 participated. Methods: Participants completed a survey evaluating PA, personality traits, sports, and demographic variables. Pearson partial correlations assessed correlations between different PA domains, personality traits, and sports. Conscientiousness was positively associated with all PA measures (r = .14-.30), except for active transport PA. Sports were related to vigorous and leisure PA. Conscientiousness is related to PA measures and is a significant PA correlate. However, more research is necessary to understand if leisure time PA can enhance Conscientiousness.

Physical Activity, Sedentary and Sleep Phenotypes in Women During the First Trimester of Pregnancy.

OBJECTIVES: Patterns of physical behaviors including physical activity, sedentary time, and sleep are unknown during pregnancy, but are likely to influence health outcomes. The purpose was to first identify "physical behavior phenotypes" from accelerometer-measured physical behaviors in pregnant women during the first trimester and secondly, to explore the associations between the identified phenotypes with demographic variables and body-mass-index (BMI). METHODS: Data were from the Glowing Study (gov ID: NCT01131117), collected between 2011 and 2017 with accelerometer-measured physical behaviors of women in their 12th week of pregnancy. Latent class analysis was used to identify patterns of total physical activity, sleep time, sedentary time, and variation in physical activity. Maternal Body-Mass-Index (BMI). BMI and sociodemographic characteristics were compared between physical behavior phenotypes. RESULTS: A total of 212 pregnant women were included in the study (mean age 30.2 years (range 22.1 to 42.4), mean days wear 4.3 (SD 0.7)). Three physical behavior phenotypes were identified from the four physical behavior constructs: low sedentary and stable activity (n = 136, 64%), variable activity (n = 39, 18%), high sedentary and low sleep (n = 37, 17%). BMI, race, and education were significantly different between the three phenotypes, with the low sedentary and stable activity phenotype having the lowest BMI and a higher percentage of white and college educated women. CONCLUSIONS FOR PRACTICE: Total physical activity and physical behavior phenotypes during the first trimester were associated with early-pregnancy BMI, race, and education. Future research should examine whether these physical behavior phenotypes are associated with maternal and child health outcomes.

Evaluation of the Little Rock Green Schoolyard initiative: a quasi-experimental study protocol.

BACKGROUND: Evidence suggests that access to green schoolyards may facilitate vigorous play and lead to increased physical activity, which could lead to improved academic outcomes and reduce excess childhood weight gain. Greener schoolyards can also provide additional outdoor amenities that help the community at large. The Little Rock Green Schoolyard Initiative, a program aiming to promote outdoor learning and play in two of the city's community schools, provides a natural experiment to evaluate the role of such interventions. This article presents the protocols and study plans that will be used to evaluate this community-led initiative on several outcomes including physical activity, sleep quality, use of schoolgrounds, and perceptions of the school environment. Administrative datasets will be used to assess exposure to green schoolyard improvements on academic achievement, attendance, and disciplinary referrals during elementary school. METHODS: Data will be gathered in two community schools where the green schoolyard improvements are taking place and in two demographically-matched comparison schools located elsewhere within the Little Rock School District. Data will be collected before, during, and after the green schoolyard improvements go into effect. Physical activity and sleep quality will be measured using actigraphy. Physical activity will also be assessed through direct playground observations during recess and outside of school hours. During the final year of the study, administrative data will be assembled and evaluated using difference-in-differences estimation and synthetic controls, two causal inference methods from the program evaluation literature. DISCUSSION: The study is designed to provide new insights into the design, implementation, and evaluation of playgrounds among schoolchildren, especially those who are at risk of developing severe obesity during their elementary school years. The research herein will develop empirical data, elucidate potential mechanisms, and practical experience for future study, policymaking, and health services.

Musculoskeletal pain latent classes and biopsychosocial characteristics among emerging adults.

BACKGROUND: Emerging adults (aged 18-29) report high levels of musculoskeletal pain; however, it is unknown if body location and intensity patterns are related to different biopsychosocial characteristics. This study identified patterns of self-reported musculoskeletal pain among emerging adults and assessed if there were differences in their lifestyle and psychological characteristics. METHODS: Data from survey responses from a large public university and a large medical university in the United States were used (n = 1,318). Self-reported pain location and intensity at five body regions were assessed, and latent class analysis identified classes separately for men and women. Mental health, physical activity, and sleep outcomes were compared between the classes. RESULTS: Four classes were identified for men and women. Three of the classes were consistent between genders - "no pain," (women = 28% of their sample; men = 40% of their sample) "mild multisite pain," (women = 50%; men = 39%) and "moderate-severe multisite pain" (women = 9%; men = 7%). The fourth class for women was "moderate spine pain," (13%) and for men was "mild extremity pain" (13%). For both men and women, the "moderate-severe multisite" pain classes reported the highest levels of depression, anxiety, and stress, poorer sleep, and higher work physical activity than the "no pain" class. The "mild multisite" and "moderate spine" (women only) pain classes fell between the "no pain" and "moderate-severe" pain classes. The characteristics of the "mild upper extremity pain" class for men was similar to the "no pain" class. CONCLUSIONS: The identified classes provide unique information on pain location and intensity in emerging adults. The high prevalence of "mild multisite pain" (n = 593; 45% of the total sample) demonstrates an intervention opportunity during this age range to prevent further increases in musculoskeletal pain later in life. Future work should assess the longitudinal outcomes of these pain classes, the impact of interventions for this age group, and the balance between leisure and occupational physical activity when addressing musculoskeletal health.

Relationships between grit, physical activity, and academic success in university students: Domains of physical activity matter.

ObjectiveTo examine the relationships between contexts of physical activity, grit, and GPA in a college population.Participants:875 Undergraduate students from a large, southern university participated between October 2018 and March 2020.Methods:Participants completed an electronic survey evaluating physical activity and grit. The university provided official GPAs. Multiple linear regression models evaluated the correlations between grit, the different physical activity domains, and GPA.Results:Grit was positively associated with domestic physical activity, leisure time physical activity, and GPA. Consistency of interest had no associations with the domains of physical activity or GPA. Perseverance of effort was positively associated with walking, active transport physical activity, domestic physical activity, leisure physical activity, and GPA.Conclusion:Perseverance of effort is related to different domains of physical activity and GPA. Future studies should investigate if increasing leisure time physical activity causes increases in perseverance of effort.

Relationships between physical fitness, health behaviors, and occupational outcomes in students, faculty, and staff of an American university.

OBJECTIVE: This study examined relationships between physical fitness, health behaviors, and occupational outcomes of university affiliates. PARTICIPANTS: 166 university affiliates of an American university (including students, faculty, and staff) participated between October 2018 and March 2020. METHODS: Participants completed fitness measurements, wore a device to measure physical activity (PA) and sleep for one week, and completed a survey evaluating happiness and job satisfaction. Multiple regression models evaluated associations between physical fitness, health behaviors, and occupational outcomes. RESULTS: 45% of participants had "poor" cardiorespiratory fitness (CRF) and unhealthy % fat. CRF, body composition, and muscular endurance were related to PA while body composition was related to sleep duration. Muscular endurance was related to GPA and job satisfaction. CONCLUSIONS: Findings suggest 45% of university affiliates had deficient physical fitness and may benefit from increasing PA and sleep. Universities should evaluate fitness within holistic programs to improve affiliates' health and, ultimately, occupational success.

Associations between physical activity, sleep, and self-reported health with burnout of medical students, faculty and staff in an academic health center.

Background and objectives: Health behaviors of physical activity and sleep are critical to the prevention of numerous chronic diseases. The health behaviors of healthcare professionals are even more critical, as healthcare providers who practice positive health behaviors are more likely to promote these healthy behaviors in their patients. Aims: To assess the health status and health behaviors of medical students, faculty, and staff in an academic health center in the US, and examine the associations between behaviors, physical and mental health outcomes and burnout. Methods: Students, faculty, residents and staff from a large university medical system completed an online survey between late-September and mid-November 2019. Associations were examined between health behaviors and health status including mental health outcomes with burnout. Results: Participating in any leisure time physical activity and having a Pittsburgh Sleep Quality Index score < 5 were associated with fewer physical health conditions and lower odds of reporting pain at any site (n = 2060; students n = 242, residents n = 32, staff n = 1425, faculty n = 361). Leisure physical activity and fewer sleep symptoms were associated with fewer reported depressive, anxiety and stress-related symptoms. Participating in leisure physical activity and good-quality sleep were associated with lower odds of burnout. Conclusions: The current study found high rates of physical inactivity and poor sleep among medical students, faculty and staff at an academic health center. These health behaviors were associated with poor mental health and high burnout. Programs and policies are needed improve these health behaviors to reduce burnout. Supplementary Information: The online version contains supplementary material available at 10.1007/s11332-022-00902-7.

Measuring the Effects of Social Isolation and Dissatisfaction on Depressive Symptoms during the COVID-19 Pandemic: The Moderating Role of Sleep and Physical Activity.

Social distancing was universally implemented to reduce the spread of the COVID-19 virus. Long-term social distancing can lead to increased feelings of social isolation or dissatisfaction with one's daily interpersonal interactions, which can subsequently result in reduced psychological health (e.g., greater depression). The present study quantified this association, and the extent to which it was moderated by measures of sleep and physical activity, by surveying 3658 adults (mean age = 46.0 years) from across the United States. Participants answered questions related to their social experiences, sleep, physical activity, and depressive symptoms during the early stages of the pandemic (March-June 2020). Results showed that social isolation and social dissatisfaction were associated with greater depressive symptoms. As predicted, self-reported sleep quality and physical activity moderated these associations, such that lower sleep quality and physical activity exacerbated their effect on depressive symptoms.

Participation in sport in childhood and adolescence: Implications for adult fitness.

OBJECTIVES: To investigate whether participation in sport during the developmental stages of life is associated with cardiorespiratory fitness (CRF) in adulthood. DESIGN: Observational longitudinal study. METHODS: Participants were Generation 2 of the Raine Study. Questionnaires related to participation in sport were administered at ages 5, 8, 10, 14 and 17 years. These data were used to develop sex-specific trajectories of sports participation: (for males) Consistent Participators, Drop-Outs and Joiners; and (females) Consistent Participators, Non-Participators and Drop-Outs. At age 28.3 ±â€¯0.6 years, participants completed a graded maximal exercise test (i.e. V̇O2peak test). A General Linear Model assessed differences in CRF between trajectories. RESULTS: 402 participants n = 231 (57.5%) male, n = 171 (42.5%) female were included in the study. In males, Consistent Participators (all p < 0.001) and Joiners (p < 0.050) had greater fitness than Drop-Outs. In females, Consistent Participators had greater fitness than Non-Participators (p < 0.050), but there were no significant differences in fitness between Consistent Participators and Drop-Outs (p > 0.050) or Non-Participators and Drop-Outs (p > 0.050). CONCLUSION: Participation in sport during childhood and adolescence is associated with greater fitness in adulthood, compared to individuals who never participate or those that cease participation in adolescence. A simple dichotomous question regarding sports participation over the childhood and adolescent period can be implemented to predict better fitness outcomes in young adulthood. Childhood and adolescence could be an opportune stage in life for parents, schools and governments to facilitate participation in sport and prevent drop out, as it may have an impact on long term risk reduction, with associated health and economic benefits.

Developmental trajectories of sleep during childhood and adolescence are related to health in young adulthood.

AIM: Sleep behaviour is correlated and causally related to physical and mental health. Limited longitudinal data exist on the associations of poor sleep behaviour in childhood and adolescence with adult health. Parent-reported sleep behaviours from 1993 participants of the Raine Study (at ages 5, 8, 10, 14, 17) were used to determine sleep trajectories (using latent class growth analysis). METHODS: Measures of physical and mental health were compared between sleep trajectories using generalised linear models (at age 20). RESULTS: Three sleep trajectories were identified as follows: 43% of participants belonged to a trajectory with 'consistently minimal' sleep problems, 49% showed some 'declining' in reporting of sleep problems incidence and 8% had 'persistent' sleep problems. Participants in the 'consistently minimal' trajectory had better physical and mental health outcomes at age 20 compared to those in the 'declining' and 'persistent' trajectories. For example, 'consistently minimal' participants had significantly lower body fat percentage (mean difference: -3.89% (95% CI: -7.41 to -0.38)) and a higher (better) SF-12 mental component score (mean difference: 4.78 (95% CI: 2.35-7.21)) compared to participants in the 'persistent' trajectory. CONCLUSION: Poor sleep behaviour across childhood and adolescent years is related to poorer physical and mental health in young adulthood.

The relationship between accelerometer-measured sleep and next day ecological momentary assessment symptom report during sport-related concussion recovery.

OBJECTIVES: Research examining sleep and concussion symptoms following sport-related concussion (SRC) is limited by retrospective self-report rather than objective data from wearable technology and real-time symptom report. The purpose of this study is to use actigraphy and ecological momentary assessment (EMA) to examine the relationship between sleep parameters and next day symptoms. METHODS: Seventeen athletes (47.1%F) aged 12-19 (15.35+/-2.09) years (<72 hours post-SRC) wore Actigraph GT3x+ to measure nighttime sleep and completed post-concussion symptom scales (PCSS) three times via mobile EMA, resulting in a range of 91-177 observations for each outcome. Generalized linear mixed models, utilizing independent variables of sleep efficiency (SE%: ratio of awake time to sleep time) and total sleep time (TST) examined the associations between nightly sleep and symptoms next-day and throughout recovery. RESULTS: SE% (IRR .97, 95%CI: .95, .99, P= .009) and TST (IRR .91, 95%CI: .84, .999, P = .047) were negatively associated with next day night symptoms. The negative relationship between SE% and the cognitive-migraine-fatigue (CMF) factor was significant for next day/night symptoms (P = .01), while TST was associated with symptom severity for the affective symptom factor (P = .015). Sleep was negatively associated with total symptoms and afternoon symptoms in Week 1 and total, morning, afternoon, and night symptoms in Week 2 (ps=.001-.021) of recovery. CONCLUSION: Sleep was negatively associated with symptoms the next day, especially late in the day and among CMF and emotional symptoms. The relationship between sleep and symptom burden was strongest in the subacute stage of concussion recovery, highlighting the potential importance of sleep intervention post-injury.

Physical Activity and Cardiovascular Fitness During Childhood and Adolescence: Association With Retinal Nerve Fibre Layer Thickness in Young Adulthood.

PRECIS: Higher physical working capacity (PWC) at age 17 was associated with thicker peripapillary retinal nerve fiber layer (pRNFL) at age 20, suggesting a mechanistic link between cardiovascular fitness and neuroretinal integrity. PURPOSE: Physical activity and cardiovascular fitness have been linked with lower odds of developing glaucoma. We tested the hypothesis that early beneficial effects of physical activity and cardiovascular fitness can be observed by measuring the pRNFL thickness in young healthy adults. METHODS: The Raine Study is a longitudinal study that has followed a cohort since before their births in 1989-1992. Parent-reported physical activity was collected between 8 and 17 years, and latent class analysis was used to identify the participants' physical activity trajectories. At the 20-year follow-up (participants' mean age=20.1±0.4 y), participants' metabolic equivalent of task-minutes/week was determined using self-reported physical activity data. Participants' PWC was assessed at the 14- and 17-year follow-ups to estimate their level of cardiovascular fitness. An eye examination, which included spectral-domain optical coherence tomography imaging, was conducted at the 20-year follow-up for 1344 participants. RESULTS: Parent-reported or participant-reported physical activity was not associated with pRNFL thickness. However, higher PWC at 17 years was associated with thicker pRNFL globally [by 0.3 µm; 95% confidence interval (CI)=0.2-0.6; P<0.001], superotemporally (by 0.4 µm; 95% CI=0.1-0.7; P=0.013), inferonasally (by 0.7 µm; 95% CI=0.1-0.9; P=0.002), and nasally (by 0.4 µm; 95% CI=0.1-0.7; P=0.006) per 10 Watt increase in PWC. CONCLUSIONS: The association between estimated cardiovascular fitness and pRNFL thickness suggests there may be overlapping mechanisms for cardiovascular health and retinal ganglion cell integrity. While the effect sizes were small, it is possible that larger effects and clinically significant associations may arise as we follow this cohort of participants through their later adulthood.

Exploring the Reliability and Validity of the TechU-Q to Evaluate Device and Purpose Specific Screen Use in Preschool Children and Parents.

Young children are increasingly using mobile technology, with potential for positive and negative developmental consequences. Parents are responsible to guide children in their use of technology based on recommendations and guidelines. Guidelines for screen use in young children have been based on little empirical information on contemporary screen use. This study surveyed parents of young children (n = 96, mean child age 3.0, SD 1.0 years) from three settings (Australia, United States) to test the reliability and validity of a new tool to capture richer data on technology use within a techno-microsystem. The TechU-Q demonstrated reasonable test-retest reliability and face and construct validity. Young children averaged more than 60 min per day of total technology use, mostly using TV, tablet computers, and mobile phones. The primary purposes for child use were educational and watching videos. Parental attitudes towards technology and parent use were associated with their child's use. Future guidelines should utilize detailed descriptions of technology use by device and purpose to provide more relevant advice on technology use for young children.

Associations between meeting sleep, physical activity or screen time behaviour guidelines and academic performance in Australian school children.

BACKGROUND: Current guidelines suggest too little sleep, too little physical activity, and too much sedentary time are associated with poor health outcomes. These behaviours may also influence academic performance in school children. The primary purpose of this study was to examine the relationships between sleep, physical activity, or sedentary behaviours and academic performance in a school with a well-developed and integrated technology use and well-being program. METHODS: This was a cross-sectional survey of students (n = 934, Grades 5-12) in an Australian school with a bring-your-own device (tablet or laptop computer) policy. Students reported sleep, physical activity, and sedentary (screen and non-screen) behaviours. Academic performance was obtained from school records. Linear regressions were used to test the association between behaviours and academic performance outcomes. RESULTS: Seventy-four percent of students met sleep guidelines (9 to 11 h for children 5-13 years and 8 to 10 h for 14-17 year olds), 21% met physical activity guidelines (60 min of moderate-to-vigorous physical activity every day), and 15% met screen time guidelines (no more than 2 h recreational screen time per day); only 2% met all three. There were no associations between meeting sleep guidelines and academic performance; however later weekend bedtimes were associated with poorer academic performance (- 3.4 points on the Average Academic Index, 95%CI: - 5.0, - 1.7, p < .001). There were no associations between meeting physical activity guidelines and academic performance. Meeting screen guidelines was associated with higher Average Academic Index (5.8, 95%CI: 3.6, 8.0, p < .001), Maths 7.9, 95%CI: 4.1, 11.6, p < .001) and English scores (3.8, 95%CI: 1.8, 5.8, p < .001) and higher time in sedentary behaviours was associated with poorer academic performance, including total sedentary behaviours in hrs/day (5.8 points on Average Academic Index, 95%CI: 3.6, 8.0, p < .001. Meeting at least two of the three behaviour guidelines was associated with better academic performance. CONCLUSIONS: Sleep and sedentary behaviours were linked to academic performance. School communities should emphasize comprehensive wellness strategies to address multiple behaviours to maximize student health and academic success.

A prospective longitudinal study of mobile touch screen device use and musculoskeletal symptoms and visual health in adolescents.

This study aimed to examine prospective associations of mobile touch screen device (i.e. smartphone, tablet) use and patterns of use with musculoskeletal symptoms and visual health among adolescents. A representative sample of 1691 adolescents in Singapore (51% girls; 10-19 years) completed an online questionnaire at baseline and one-year follow-up. After adjusting for potential confounders, prospective associations were found between baseline smartphone use and follow-up neck/shoulder (OR = 1.61(95%CI = 1.06-2.44)) and low back (OR = 1.86(1.10-3.14)) symptoms; tablet use was also associated with neck/shoulder, low back and arms symptoms (OR = 1.33(1.04-1.71)to1.52(1.18-1.95)). No associations were observed between the duration of smartphone/tablet use and symptoms. Baseline patterns of use (bout length, certain types of activities, multitasking) were associated with follow-up musculoskeletal symptoms. Smartphone/tablet use was not related to visual outcomes (visual symptoms, wearing glasses/contact lenses, myopia) at follow-up. These findings suggest that patterns of smartphone/tablet use (though not the duration of use) can pose a prospective risk for musculoskeletal symptoms.

Promoting Physical Activity Through Youth Sports Programs: It's Social.

Youth sport is a key physical activity opportunity for children and adolescents. Several factors influence youth sport participation, including social factors, but this has not to date been clearly delineated. This study is a scoping review to survey the literature on the influence of family and peers on youth sports participation. The review identified 111 articles of which the majority were cross-sectional, included boys and girls, and were conducted primarily in the United States, Canada, Australia, and the United Kingdom. The articles were grouped into 8 research themes: (1) reasons for participation, (2) social norms, (3) achievement goal theory, 4) family structure, (5) sports participation by family members, (6) parental support and barriers, (7) value of friendship, and (8) influence of teammates. Friendships were key to both initiation and maintenance of participation, parents facilitated participation, and children with more active parents were more likely to participate in sport. Less is known on how family structure, sibling participation, extended family, and other theoretical frameworks may influence youth sport. The review suggests that social influences are important factors for ensuring participation, maximizing the quality of the experience, and capitalizing on the benefits of youth sport. Future research studies, programs, and policies promoting and developing evidence-based youth sporting experiences should consider social influences on youth sport participation.