Parental role-modeling on 24-hour movement behaviors among preschoolers during the COVID-19 pandemic.

INTRODUCTION: Little is known about the association between parents' and children's 24-h movement behaviors during the pandemic. This cross-sectional study examined the association between the 24-h movement behaviors of parents and their preschoolers and investigated sex differences in this association. METHODS: A total of 1740 preschoolers (4.5 ± 0.8 years old, 50.3% boys) and their parents (35.4 ± 4.9 years old, 24.3% males) in China participated in this study and provided valid and complete data. Parents completed an online survey or a written questionnaire in the period between October and December 2020. Preschoolers' and parents' movement behaviors (physical activity [PA], sedentary behavior [SB], screen time, and sleep) and demographic information were reported by the parents. Generalized linear models and logistic regression models were performed. RESULTS: Positive associations were found between parents' and preschoolers' moderate-to-vigorous intensity PA (ß = 0.28; 95% confidence interval [CI]: 0.20, 0.36), total PA (ß = 0.21; 95% CI: 0.17, 0.24), and sleep (ß = 0.05; 95% CI: 0.03, 0.06) with no apparent sex difference. No significant association was found between parents' and preschoolers' SB or screen time. Girls were more likely to meet all three 24-h movement guidelines when their parents met them (odds ratio = 2.38; 95% CI: 1.42, 4.01), but the relationship was not significant for boys. CONCLUSIONS: Parental role-modeling was positively associated with children's PA and sleep. This finding suggests that supporting parents' movement behaviors has the potential to promote a healthy lifestyle among preschoolers.

Temporal Trends in the Physical Fitness of Hong Kong Adolescents Between 1998 and 2015.

Low physical fitness in adolescence is linked with increased cardiometabolic risk and early all-cause mortality. This study aimed to estimate temporal trends in the physical fitness of Hong Kong adolescents aged 12-17 years between 1998 and 2015. Physical fitness (9-min run/walk, sit-ups, push-ups, and sit-and-reach) and body size data in a total of 28,059 adolescents tested across five population-representative surveys of Hong Kong secondary school pupils, were reported. Temporal trends in means were estimated at the gender-age level by best-fitting sample-weighted linear regression, with national trends estimated by a post-stratified population-weighting procedure. Overall, there were small declines in 9-min run/walk (effect size (ES)=-0.29 (95%CI: -0.32, -0.26)) and sit-ups performance (ES=-0.24 (95%CI: -0.27, -0.21)), with negligible changes in push-ups and sit-and-reach performance. There were small concurrent increases in both mean height and body mass, with a negligible increase in sum of skinfolds. Trends in mean physical fitness and body size/were not always uniform across the population distribution. The small declines in mean 9-min run/walk and sit-ups performance for Hong Kong adolescents are suggestive of corresponding declines in cardiorespiratory fitness and abdominal/core endurance, respectively. Increased national health promotion strategies are required to improve existing trends.

Temporal trends in the physical fitness of Hong Kong children aged 6-12 years between 2003-04 and 2015-16.

Low physical fitness in childhood is linked with poor health now and in later life. This study estimated temporal trends in physical fitness for Hong Kong children aged 6-12 years from 2003-04 to 2015-16. Objectively measured body size and physical fitness data for 27,513 children were obtained from four population-representative surveys of Hong Kong primary school students. Temporal trends in means were estimated by population-weighted linear regression. Trends in distributional characteristics were visually described. Overall, there was a small increase in mean height (effect size (ES) = 0.20 (95%CI: 0.13, 0.28)), with a negligible increase (ES < 0.2) in mean body mass. When adjusted for trends in age, gender, and body size, there was a small decline in sit-and-reach performance (ES = -0.43 (95%CI: -0.43, -0.42)), a small improvement in 9-min run/walk performance (9-to-12-year-olds, ES = 0.26 (95%CI: 0.26, 0.27)), with negligible declines in handgrip strength, 6-min run/walk (6-to 8-year-olds), and sit-ups performance. Temporal trends were not always uniform across the population distribution, with declines in run/walk, sit-ups, and sit-and-reach performance generally largest in children with low fitness. Increased national health promotion strategies that address culturally specific factors are encouraged to further improve the existing trends, especially for children with low fitness.

Effects of increasing light versus moderate-to-vigorous physical activity on cardiometabolic health in Chinese adults with obesity.

Increasing daily physical activity (PA) is a practical way to decrease the risk of cardiometabolic diseases, while the studies on exercise intensity remain limited. The purpose of the present study was to compare the effects of increasing light PA (LPA) or moderate-to-vigorous PA (MVPA) for 12 weeks on cardiometabolic markers in Chinese adults with obesity. Fifty-three adults were randomly assigned to the 1) control group, 2) LPA group, and 3) MVPA group in free-living settings. The intervention effects on body composition, cardiorespiratory fitness, and cardiometabolic biomarkers were analysed using a generalized estimated equation model adjusted for baseline values and potential confounders. Compared with the control group, the MVPA group showed improvements in body composition, lipids, C-peptide, monocyte chemoattractant protein-1 (MCP-1), interleukin-8, leptin, and E-selectin. A favourable change in triglycerides and E-selectin were observed in the LPA group when compared to the control group. Lastly, improvements in waist circumference, C-reactive protein, and MCP-1 were observed in the MVPA group when compared to those in the LPA group. Although increasing both LPA and MVPA improved certain cardiometabolic biomarkers, the latter may have more benefits. These findings imply that MVPA may reduce cardiometabolic disease risk more effectively than LPA, especially in Chinese adults with obesity.

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

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

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

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

Movement behaviors and mental health of caregivers of preschoolers in China during the COVID-19 pandemic.

This study aimed to examine the associations between physical activity (PA), sedentary behavior (SB), sleep, and the mental health of caregivers of preschool children following the COVID-19 outbreak. From 5 October to 16 December 2020, responses from 2476 respondents in China were collated through an online survey or a written questionnaire. Movement behaviors (PA, SB, screen time, and sleep), mental health (depression, anxiety, and stress), and demographic information were self-reported by the respondents. Linear mixed models were used for data analysis. Valid responses were received from 2002 caregivers (35.5 ± 4.9 years old, 76.3% females) of children between 3 and 6 years old in China (Hong Kong 3.2%, Shanghai 20.6%, Guangzhou 34.1%, Guiyang 26.7%, Xuzhou 11.3%, Xi'an 4.1%). A higher level of PA was associated with a lower score of depression, while lower SB and longer sleep duration were associated with lower scores of depression, anxiety, and stress. Meeting the Canadian 24-h movement guidelines was associated with less symptoms of depression, anxiety, and stress. Higher PA was associated with lower levels of depression, while longer sleep and lower SB were associated with better scores of depression, anxiety, and stress. Meeting the Canadian 24-h movement guidelines has been associated with better mental health during the COVID-19 pandemic. Interventions to improve mental health among caregivers should involve enhancing their overall movement behaviors.

eHealth usage among Chinese college students: qualitative findings.

BACKGROUND: The information technology has developed rapidly with the evolution of internet environment transformed from requiring computer skills for information searching to self-managing health data and applying information. Therefore, a more diverse range of eHealth skills is required and these skills are referred as eHealth literacy. However, most eHealth literacy studies focused mainly on information searching skills. Little is known about eHealth usage behaviors of college students in this day and age. OBJECTIVES: This study aimed to investigate how Chinese college students engage with eHealth tools and to determine the elements of their eHealth literacy. METHODS: A purposive sample of 18 Chinese college students was recruited for in-depth interviews. Interviewees included three males and three females of each city (Beijing, Wuhan and Putian) from sports, medical, and non-health-related majors. Conventional content analysis was applied for data analysis. RESULTS: The eHealth usage of different-major-students were compared and profiled by three themes of Expectance, Usage pattern and Perception. In Expectances, non-health major students applied eHealth only for urgent health need, sport major students used it to monitor health while medical major students, as frequent users for searching health database. In Usage pattern, purposes of eHealth for personal, practical and theoretical were identified for non-health major, sport major and medical major groups, respectively. In Perceptions, sport students felt more curious about eHealth than the other groups who perceived either fear (non-health students) or skeptical (medical students). By compiling those themes, the whole picture of eHealth usage was emerged. Based on that, the current study identified the related skills using the trilogy of Web 1.0 to 3.0, and derived a conceptual framework for eHealth literacy in the present day. CONCLUSIONS: The current study obtained a comprehensive understanding of eHealth usage and a framework of eHealth literacy required for Chinese college students. And it gives a clearer look at web 3.0 related eHealth behaviors.

Movement behaviors and posttraumatic stress disorder during the COVID-19 pandemic: A retrospective study of Chinese university students.

Background/objective: This study aimed to examine the associations between physical activity (PA), sedentary behavior, sleep and posttraumatic stress disorder (PTSD) among undergraduate students during the coronavirus disease 2019 (COVID-19) pandemic in China. Methods: A total of 3178 university students responded to an online questionnaire between December 2020 and January 2021. Participants self-reported the time they spent on PA, screen time and sleep after (over the past seven days) and during the outbreak peak (from January to March 2020). Their sleep quality was measured using the Chinese version of the Pittsburgh Sleep Quality Index. The Chinese version of the Posttraumatic Stress Disorder Checklist - Civilian Version was used to measure PTSD. Logistic regressions and generalized linear mixed models were conducted. Results: The final analysis included data from 2070 university students (20.2 ±â€¯1.3 years old, 37.0% males). The prevalence of PTSD was 7.1%. Better sleep quality both during and after the outbreak peak, and longer sleep duration after the outbreak peak were associated with a lower odds ratio of having PTSD and lower re-experiencing, avoidance and hyperarousal scores. Higher total PA levels during the outbreak peak were associated with a higher odds ratio of having PTSD and higher levels of re-experiencing and avoidance. Conclusion: Sleep quality and duration were negatively associated with PTSD among university students during the COVID-19 pandemic. The associations between PA, screen time and PTSD require further examination. Future interventions to enhance mental health could consider targeting university students' sleep hygiene.

Relationships of physical activity and sedentary behaviour with the previous and subsequent nights' sleep in children and youth: A systematic review and meta-analysis.

The interrelationships between sleep and daytime movement behaviours have been examined at interindividual level. Studies of within-person, temporal relationships of daytime physical activity (PA) and sedentary behaviour with the previous and subsequent nights' sleep are increasing. The present systematic review and meta-analysis synthesised the results of studies in school-aged children and youth. Eight databases (MEDLINE, PsycINFO, EMBASE, Global Health, PubMed, Web of Science, SPORTDiscus, and CINAHL) were searched for peer-reviewed articles that examined the association between daytime movement behaviours (including PA, sedentary time, or sedentary recreational screen time) and night-time sleep on the same day, or the association between night-time sleep and daytime movement behaviours the next day, in children and youth. A total of 11 studies comprising 9,622 children and youth aged 5-15 years met the inclusion criteria. Sedentary time was negatively associated with the subsequent night's sleep duration (r = -0.12, 95% confidence interval -0.23 to -0.00; I2  = 93%; p = .04). Positive relationships between PA and the previous or subsequent night's sleep duration were observed only for studies that adjusted for accelerometer wear time. There was some evidence suggesting that a longer sleep duration was associated with less sedentary time and a higher proportion of the daytime spent being physically active and vice versa, although the association was weak and based on a limited number of studies. From a clinical perspective, promotion of either sleep hygiene or daytime PA should be planned with considerations of the virtuous or vicious circle between these behaviours and monitor concurrent effects on the others.

Family, school and individual characteristics associated with adolescents' physical activity at school in Hong Kong: the iHealt(H) study.

BACKGROUND: Adolescents (11-18-year-olds) are at risk of physical inactivity. There is limited knowledge of physical activity (PA) levels among adolescents in the school setting in Hong Kong. We developed and tested a novel theoretical model of how household/family characteristics, school-level social and physical environmental factors and individual adolescent's characteristics impact on their school-based PA during and after school hours. METHODS: Cross-sectional study participants were Hong Kong adolescents attending secondary school, paired with their parent/caregiver (n = 1299 dyads). Parents survey-reported on household/family characteristics, parental PA and rules related to PA. Adolescents survey-reported on school PA-friendly policy, PA equipment at school (combined to create PA-friendly index), social support for PA from peers, athletic ability, attitude to and enjoyment of PA. Adolescents self-reported their school-based PA during school hours (physical education; recess) and after school (sports teams/classes). Objectively-measured moderate-to-vigorous PA (MVPA) was measured using accelerometers for a sub-sample of adolescents (n = 588). Generalized additive mixed models were used to estimate how household/family-level and school-level factors, and adolescents' individual characteristics were related to adolescents' school-based PA in Hong Kong, and to identify potential mediators of these associations. RESULTS: A complex network of potential pathways of influence on adolescents' school-based PA was identified. Overall, most of the significant effects were indirect ones. However, there were far fewer significant pathways between household/family characteristics and objectively-measured MVPA at school than there were for self-reported PA at school. In fact, there were no indirect pathways between these variables and MVPA at school. Gender disparities among pathways were identified. For example, school PA-friendly index was significantly associated with MVPA after school only among girls (eb = 1.06, 95%CI (1.02,1.12)). CONCLUSIONS: Key points of intervention identified by our study may be in the re-design of PE classes so that adolescents spend more time being physically active during these classes, and promotion of active play during recess. Further research measuring amount, intensity and location of adolescents' PA using accelerometer and Global Positioning Systems is required in Hong Kong, as well as observational studies of PA during PE classes and in the schoolyard during recess, to guide the design of PA interventions.

Frequency of interruptions to prolonged sitting and postprandial metabolic responses in young, obese, Chinese men.

This study aimed to examine the effects of 3-min light-intensity walking every 30 min (3-min) and 6-min light-intensity walking every 60 min (6-min) compared with prolonged sitting (SIT) on the postprandial metabolic responses in young, centrally obese, Chinese men. Twenty-one Chinese men with central obesity (age, 23 ± 4 years; body mass index, 29.8 ± 3.2 kg·m-2; waist circumference, 98.7 ± 7.1 cm; mean ± SD) underwent three 6-h experiments with a 7-day washout period, SIT, 3-min, and 6-min, in randomized order. Compared with SIT, neither walking condition showed differences in total and net incremental area under the curve (tAUC and iAUC, respectively) for glucose, insulin, nor non-esterified fatty acids. The tAUC and iAUC for triglycerides for the SIT condition (10.8 [9.3, 12.2] and 4.4 [3.7, 5.1] mmol·h·L-1, respectively; mean [95% confidence interval]) was higher than 3-min (10.4 [9.0, 11.8] and 3.8 [3.3, 4.3] mmol·h·L-1, respectively, both Ps <0.05) and 6-min (9.6 [8.1, 11.0] and 3.5 [2.9, 4.2] mmol·h·L-1, respectively, both Ps <0.01) conditions. Interrupting prolonged sitting regardless of frequency-reduced postprandial triglycerides. A higher volume of physical activity may be required to obtain greater glycaemic benefits in young Chinese men with central obesity.

Associations between meeting 24-hour movement guidelines and health in the early years: A systematic review and meta-analysis.

This systematic review examined the compliance with the 24-h movement guidelines, and investigated its associations with health indicators for healthy children under 5 years of age. MEDLINE, PsycINFO, EMBASE, PubMed, Web of Science and SPORTDiscus were searched for peer-reviewed studies and the last search was conducted on 27 October 2020. The Newcastle-Ottawa Scales were used to assess the quality of included studies. Eighteen articles including 8,943 participants from 11 countries were included. On average around 13% of the children met all three guidelines. Meta-analyses of the associations between meeting all three guidelines and adiposity yielded no significant results (r = - 0.03; 95% CI = - 0.12, 0.06; I2 = 51%; P = 0.48). Meeting more guidelines was associated with better psychosocial health (3/4 studies). Associations between meeting individual or combined guidelines and motor development yielded mixed results (2/2 studies), while no associations between meeting guidelines and cognitive development were observed (1 study). Compliance with all three guidelines was low. Further evidence is required to understand the associations between meeting the 24-h movement guidelines and health outcomes. Nevertheless, there was evidence of a dose-response relationship between meeting the guidelines and better psychosocial health in the early years.

Validity of accelerometry for predicting physical activity and sedentary time in ambulatory children and young adults with cerebral palsy.

BACKGROUND: /Objectives: This study aimed to validate five published ActiGraph (AG) cut-off points for the measurements of physical activity (PA) and sedentary time (ST) in ambulatory children and young adults with cerebral palsy (CP). Additionally, four energy expenditure (EE) prediction equations based on AG counts and activPAL (AP) steps were examined in this population, using oxygen uptake (VO2) as the criterion. METHODS: Four male and six female participants with CP (Gross Motor Function Classification System levels I-III, ages 9-21 years) completed seven activities while simultaneously wearing an AG, AP monitor and indirect calorimetry unit. VO2 was measured on a breath-by-breath basis using the indirect calorimetry and was converted into EE using metabolic equivalents. AG counts were classified as sedentary, light PA (LPA) or moderate-to-vigorous PA (MVPA) using five cut-off points: Puyau, Evenson, Romanzini, Clanchy and Baque. The predicted EE was computed using three AG-based equations (Freedson, Trost and Treuth) and an AP step-based equation. RESULTS: Based on 1920 available data points from the 10 participants, Baque (r = 0.896, κ = 0.773) and Clanchy (r = 0.935, κ = 0.721) AG cut-off points classified PA and ST most accurately. All the equations overestimated EE during sitting activities and underestimated EE during rapid walking. The Freedson, Treuth and AP equations exhibited systematic bias during rapid walking, as their differences from the criterion measure increased progressively with increasing activity intensity. CONCLUSIONS: The AG accurately classified PA and ST when the Baque and Clanchy cut-off points were used. However, none of the available AG or AP equations accurately predicted the EE during PA and ST in children and young adults with CP. Further development is needed to ensure that both devices can estimate EE accurately in this population.

A blended intervention to promote physical activity, health and work productivity among office employees using intervention mapping: a study protocol for a cluster-randomized controlled trial.

BACKGROUND: Regular participation in moderate-to-vigorous physical activity (MVPA) is related to decreased risk of morbidity and mortality. Among working populations, lack of MVPA may also be a risk factor for absenteeism and presenteeism. Both traditional workplace-based and web-based interventions have been suggested as being effective in promoting participation MVPA, health-related outcomes, and work-related productivity. However, several challenges limit their application in real world contexts. A 'blended' intervention approach combining the two intervention strategies is proposed to overcome these limitations. The proposed intervention aims to utilize the blended approach to increase participation in MVPA, health-related outcomes, and work productivity among inactive workers. METHODS: The study will comprise of a three-group cluster randomized controlled trial (cluster-RCT), comprising a three-month actual intervention and a nine-month behavioral follow-up period. The three groups will be: a web-based intervention group, a blended intervention group combining the web-based components with face-to-face workshops and posters, and a control group. Physically inactive office employees (N = 495) from 33 companies (i.e., clusters) will be recruited and randomly assigned to the three groups by cluster randomization. The intervention mapping (IM) framework will be used for selecting and applying effective health behavioral theories and behavioral change techniques (BCTs) to the development, implementation and assessment of the intervention, which will be personally tailored. The primary outcome variable will be objectively-measured MVPA using an accelerometer. Secondary outcomes will consist of indices of health including adiposity, blood pressure, blood sugar, blood lipids, self-reported depression, anxiety, stress, health-related quality of life and work-related variables including absenteeism and presenteeism. DISCUSSION: The proposed study adopts a robust blended intervention approach that is expected to overcome challenges in applying workplace-based and web-based interventions separately and yield larger effects in promoting MVPA participation, health-related outcomes and work productivity. Improvements in work productivity outcomes will be of particular interest to employers. If more effective, the new blended intervention has the potential to be implemented on a larger scale to benefit workplace populations. TRIAL REGISTRATION: The trial is prospectively registered at the ClinicalTrials.gov PRS (Trial ID: NCT04391270; Date of First Posted: May 18, 2020).

Results from Hong Kong's 2019 report card on physical activity for children and youth with special educational needs.

BACKGROUND: /Objective: The Active Healthy Kids 2019 Hong Kong Report Card on Physical Activity for Children and Youth with Special Educational Needs (SEN) provides evidence-based assessments for nine indicators of physical activity behaviors and related sources of influence for 6- to 17-year-olds with SEN in Hong Kong. This is the first Report Card for this population group in Hong Kong. METHODS: The best available data between 2008 and 2019 were reviewed by a panel of experts. Following the Active Healthy Kids Global Alliance (AHKGA) development process, letter grades were assigned to nine indicators (Overall Physical Activity, Organized Sport Participation, Active Play, Active Transportation, Sedentary Behaviors, Family & Peers, School, Community & Environment, and Government Strategies & Investments). RESULTS: Two behavior indicators (Overall Physical Activity: F; Sedentary Behaviors: D+) and two contextual indicators (School: B; Government Strategies & Investments: C-) were assigned a letter grade. The remaining indicators including Organized Sport Participation, Active Play, Active Transportation, Family & Peers, and Community & Environment were not graded due to insufficient data. CONCLUSIONS: A majority of children and youth with SEN in Hong Kong are physically inactive and have a high level of sedentary behaviors. Schools are ideal settings to promote physical activity for this population. There is a need to develop a comprehensive surveillance system to monitor this population, assess efforts to improve the grades, and promote physical activity opportunities for children and youth with SEN.

Compliance and Practical Utility of Continuous Wearing of activPAL™ in Adolescents.

PURPOSE: The aim of this study was to examine the factors that influence compliance and practical utility of a continuous wear protocols for activPAL™ among adolescents. METHODS: Seven hundred and fifty-five (11-18 y; 50.6% girls) students wore the waterproof activPAL™ for 7 consecutive days. The effects of factors such as weather and practical strategies on compliance were assessed. Students were asked to note reasons for removing it in a log. After the 7-day period, students anonymously completed a practical utility questionnaire. RESULTS: The final sample used to analyze compliance contained 588 available data points; 72.4% met the validity criteria, which were ≥4 valid days. Rainfall was inversely associated with total wear time, whereas using alcohol pads and cartoon stickers during the application were positively associated with total wear time. Sweating (25.2%) and skin irritation (39.0%) were the most reasons for 290 removal episodes by 235 students. The 131 questionnaires showed that 80.1% regarded the continuous wear period as too long and encountered problems, and 55% would rather not wear it again. CONCLUSION: Rainy weather affected girls' compliance with the continuous wear protocol for activPAL™. Skin irritation and sweat-induced inadvertent drops caused removal. Future studies should investigate more user-friendly protocols.

Longitudinal changes in objectively measured physical activity differ for weekdays and weekends among Chinese children in Hong Kong.

BACKGROUND: Cross-sectional investigation showed that Chinese children in Hong Kong were more physically active on weekends than weekdays, which is contrary to previous findings. However, little is known as to whether these time-segment-specific differences persist with age. This study aimed to compare the 2-year changes in accelerometer-assessed physical activity (PA) and sedentary time (ST) between weekdays and weekends among Chinese children in Hong Kong. METHODS: Children aged 6-8 years were recruited from primary schools in Hong Kong. Time spent in ST (<100 counts per minute [cpm]), moderate-to-vigorous PA (MVPA), and light-intensity PA (LPA) were measured by accelerometer at baseline and then at 1-year and 2-year follow-ups. Mean annual changes were determined using mixed-effects linear models for children who provided 3-day valid data (including 1 weekend day) for at least two time points (n = 412). Magnitude of changes between weekdays and weekends was compared using age × time-segment interactions. RESULTS: At each assessment wave, the percentage of time spent in MVPA (% MVPA) and LPA (% LPA) was consistently high, whereas the percentage of time spent in ST (% ST) was lower on weekends than weekdays. A decrease in % MVPA was found for both weekdays (mean annual change: boys, -0.7, 95% CI = -0.9 to -0.1; girls, -0.8, 95% CI = -1.0 to -0.6) and weekends (boys, -1.2, 95% CI = -1.5 to -0.9; girls, -1.4, 95% CI = -1.6 to -1.1). An increase was found in % ST for both weekdays (boys, 1.3, 95% CI = 0.7 to 1.9; girls, 2.4, 95% CI = 1.9 to 3.3) and weekends (boys, 1.8, 95% CI = 1.1 to 2.5; girls, 2.6, 95% CI = 1.9 to 3.3). Mean annual change in MVPA time (min) was greater on weekends than weekdays (difference: boys, 3.0, 95% CI = 0.3 to 5.7; girls, 3.5, 95% CI = 1.1 to 5.8). CONCLUSIONS: Age-related decline in MVPA was more marked on weekends than weekdays. Interventions to hinder age-related changes in PA and ST should target both time segments, but weekends warrant particular attention for interventions targeting PA maintenance due to the greater declines.

Methodological Quality of Systematic Reviews on Bodyweight Management Strategies for Children and Adolescents.

INTRODUCTION: Systematic reviews (SRs) synthesize empirical evidence from randomized controlled trials, to answer a research question. Methodological flaws in SRs can, however, reduce the trustworthiness of conclusions, subsequently hindering decision making. We aimed to appraise the methodological quality of existing SRs on bodyweight management strategies for children and adolescents. METHODS: We searched Cochrane Database of Systematic Reviews, MEDLINE, EMBASE, and SPORTDiscus. A MeaSurement Tool to Assess systematic Reviews (AMSTAR 2) was used to evaluate the methodological quality of SRs including 16 individual AMSTAR 2 domains and the total AMSTAR score. Association between bibliographical characteristics and total AMSTAR score of SRs was explored using multiple linear regression analysis. RESULTS: Three critical domain-specific items of AMSTAR 2 among the included SRs showed unsatisfactory results including (i) justifying deviation from their SR protocols, (ii) using comprehensive literature search strategies, and (iii) giving details of both included and excluded studies. "More recent publication year journal," "higher impact factor of the journal," and "greater number of review authors" were associated with better methodological quality of the included SRs. CONCLUSIONS: Future SRs' authors in the field of bodyweight management strategies for children and adolescents should improve the following criteria: (i) justify deviations from SR protocol, (ii) explain selection of the included study designs, (iii) use comprehensive literature search strategy, (iv) give details for both included and excluded studies, (v) report funding sources among included studies, and (vi) assess the potential impact of risk of bias among the included studies on meta-analysis results.

Association Between Sports Participation and Psychosocial Wellbeing of Australian Children: An 8-year Longitudinal Study.

PURPOSE: Sports participation is associated with children's health and wellbeing; however, existing evidence is predominantly based on cross-sectional studies. This study examined the longitudinal association of sports participation with psychosocial wellbeing of Australian children. METHODS: Data were from five waves of the Longitudinal Study of Australian Children aged 6-7 years in 2010 (n = 4,242) and followed up until 2018. Outcomes were assessed using the Strengths and Difficulties Questionnaire and the Pediatric Quality of Life Inventory. Sports participation was measured using two items assessing regular participation in team and individual sports. RESULTS: Multilevel mixed effects modeling showed that any sports participation was beneficially associated with psychosocial wellbeing. Boys who participated in team sports had 1.78 point lower difficulties score (ß = -1.78; 95% confidence interval: --2.01,-1.55), while this was 0.58 points lower for individual sports (ß =-0.58; -0.81,-0.34). In girls, difficulties score was 1.22 point lower for team sports (ß = -1.22; -1.44,-1.00) and 0.49 point lower for individual sports (ß = -0.49; -0.71,-0.26). Sports participation was positively associated with better quality of life with team sports (ß = 4.72; 4.15,5.28 for boys; ß = 3.44; 2.87,4.00 for girls) offering more benefits than individual sports (ß = 1.00; 0.83,1.98 for boys; ß = 1.40; 0.83,1.98 for girls). Participation in both team and individual sports had the strongest benefits. Prolonged engagement in sports was associated with better psychosocial wellbeing in a dose-dependent manner. DISCUSSION: Regular participation in any sports can benefit children's wellbeing with team sports being more beneficial than individual sports. Encouraging children to regularly participate and remain engaged in sports can help to optimize their psychosocial wellbeing.