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Robert J. Brychta, Vaka Rögnvaldsdóttir, Sigríður L. Guðmundsdóttir, Rúna Stefánsdóttir, Soffia M. Hrafnkelsdóttir, Sunna Gestsdóttir, Sigurbjörn A. Arngrímsson, Kong Y. Chen and Erlingur Jóhannsson

Introduction: Sleep is often quantified using self-report or actigraphy. Self-report is practical and less technically challenging, but prone to bias. We sought to determine whether these methods have comparable sensitivity to measure longitudinal changes in adolescent bedtimes. Methods: We measured one week of free-living sleep with wrist actigraphy and usual bedtime on school nights and non-school nights with self-report questionnaire in 144 students at 15 y and 17 y. Results: Self-reported and actigraphy-measured bedtimes were correlated with one another at 15 y and 17 y (p < .001), but reported bedtime was consistently earlier (>30 minutes, p < .001) and with wide inter-method confidence intervals (> ±106 minutes). Mean inter-method discrepancy did not differ on school nights at 15 y and 17 y but was greater at 17 y on non-school nights (p = .002). Inter-method discrepancy at 15 y was not correlated to that at 17 y. Mean change in self-reported school night bedtime from 15 y to 17 y did not differ from that by actigraphy, but self-reported bedtime changed less on non-school nights (p = .002). Two-year changes in self-reported bedtime did not correlate with changes measured by actigraphy. Conclusions: Although methods were correlated, consistently earlier self-reported bedtime suggests report-bias. More varied non-school night bedtimes challenge the accuracy of self-report and actigraphy, reducing sensitivity to change. On school nights, the methods did not differ in group-level sensitivity to changes in bedtime. However, lack of correlation between bedtime changes by each method suggests sensitivity to individual-level change was different. Methodological differences in sensitivity to individual- and group-level change should be considered in longitudinal studies of adolescent sleep patterns.

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Mohammad Siahpush, Trish D. Levan, Minh N. Nguyen, Brandon L. Grimm, Athena K. Ramos, Tzeyu L. Michaud and Patrik L. Johansson

Background: The mortality benefits of meeting the US federal guidelines for physical activity, which includes recommendations for both aerobic and muscle-strengthening activities, have never been examined among smokers. Our aim was to investigate the association between reporting to meet the guidelines and all-cause, cancer, cardiovascular disease, and respiratory disease mortality among smokers. Methods: We pooled data from the 1998–2009 National Health Interview Survey, which were linked to records in the National Death Index (n = 68,706). Hazard ratios (HR) were computed to estimate the effect of meeting the physical activity guidelines on mortality. Results: Smokers who reported meeting the guidelines for physical activity had 29% lower risk of all-cause mortality (HR: 0.71; 95% confidence interval [CI], 0.62–0.81), 46% lower risk of mortality from cardiovascular disease (HR: 0.54; 95% CI, 0.39–0.76), and 26% lower risk of mortality from cancer (HR: 0.74; 95% CI, 0.59–0.93), compared with those who reported meeting neither the aerobic nor the muscle-strengthening recommendations of the guidelines. Meeting the aerobic recommendation of the guidelines was associated with a 42% decline in that risk (HR: 0.58; 95% CI, 0.44–0.77). Conclusion: Smokers who adhere to physical activity guidelines show a significant reduction in mortality.

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Christina M. Patch, Caterina G. Roman, Terry L. Conway, Ralph B. Taylor, Kavita A. Gavand, Brian E. Saelens, Marc A. Adams, Kelli L. Cain, Jessa K. Engelberg, Lauren Mayes, Scott C. Roesch and James F. Sallis

Background: A common hypothesis is that crime is a major barrier to physical activity, but research does not consistently support this assumption. This article advances research on crime-related safety and physical activity by developing a multilevel conceptual framework and reliable measures applicable across age groups. Methods: Criminologists and physical activity researchers collaborated to develop a conceptual framework. Survey development involved qualitative data collection and resulted in 155 items and 26 scales. Intraclass correlation coefficients (ICCs) were computed to assess test–retest reliability in a subsample of participants (N = 176). Analyses were conducted separately by age groups. Results: Test–retest reliability for most scales (63 of 104 ICCs across 4 age groups) was “excellent” or “good” (ICC ≥ .60) and only 18 ICCs were “poor” (ICC < .40). Reliability varied by age group. Adolescents (aged 12–17 y) had ICCs above the .40 threshold for 21 of 26 scales (81%). Young adults (aged 18–39 y) and middle-aged adults (aged 40–65 y) had ICCs above .40 for 24 (92%) and 23 (88%) scales, respectively. Older adults (aged 66 y and older) had ICCs above .40 for 18 of 26 scales (69%). Conclusions: The conceptual framework and reliable measures can be used to clarify the inconclusive relationships between crime-related safety and physical activity.

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Angela Maria Hoyos-Quintero and Herney Andrés García-Perdomo

Objective: To evaluate the relationship between biologico-demographical, sociocultural, and environmental factors and the performance of physical activity in early childhood. Methodology: A systematic search was carried out of the databases MEDLINE, EMBASE, CENTRAL, and LILACS, as well as Google Scholar, Open Grey,, DARE, PROSPERO, Health Technology Assessment, and the World Health Organization International Clinical Trials Registry Platform, from their first records to June 2018. The selection criteria were previously defined with respect to population age and article theme. No meta-analyses were carried out due to the heterogeneity of the studies. Results: The percentage of moderate to vigorous physical activity runs between 3% and 47%. Environmental and sociocultural factors were identified as exerting a greater influence on children’s physical activity in early childhood, with the environmental factors being, according to almost all the study authors, the greater of the two. Conclusions: According to the studies included in this research project, the factors identified as associated with moderate to vigorous physical activity are environmental (play in open spaces) and sociocultural (the role of the family and the physical activity of the mother). The evidence is not strong enough to conclude that biologico-demographic factors are significantly influential in the physical activity at this age.

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Ítalo R. Lemes, Rômulo A. Fernandes, Bruna C. Turi-Lynch, Jamile S. Codogno, Luana C. de Morais, Kelly A.K. Koyama and Henrique L. Monteiro

Background: Metabolic syndrome (MetS) is a combination of risk factors for cardiovascular disease and type 2 diabetes mellitus. The prevalence of MetS worldwide is increasing. There is no study investigating the economic burden of MetS, especially in developing countries, on medication-related expenditure. The aim of this study was to investigate the association of medication-related expenditures with MetS and to explore how physical activity (PA) may influence this association. Methods: A total of 620 participants, 50 years or older, randomly selected in the city of Bauru, Brazil. Participants were followed from 2010 to 2014, and data on health care expenditure were collected annually. PA questionnaire was applied at baseline, 2 (2012), and 4 (2014) years later. Results: Mean age was 64.7 (95% confidence interval, 64.1–65.3). MetS was associated with higher medication expenditure related to diseases of the circulatory (P <.01) and endocrine (P <.01) systems. MetS explained 17.2% of medication-related expenditures, whereas PA slightly attenuated this association, explaining 1.1% of all health care costs. Conclusion: This study demonstrates that MetS has a significant burden on health care expenditures among adults, whereas PA seems to affect this phenomenon significantly, but in low magnitude.

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Jairo H. Migueles, Alex V. Rowlands, Florian Huber, Séverine Sabia and Vincent T. van Hees

Recent technological advances have transformed the research on physical activity initially based on questionnaire data to the most recent objective data from accelerometers. The shift to availability of raw accelerations has increased measurement accuracy, transparency, and the potential for data harmonization. However, it has also shifted the need for considerable processing expertise to the researcher. Many users do not have this expertise. The R package GGIR has been made available to all as a tool to convermulti-day high resolution raw accelerometer data from wearable movement sensors into meaningful evidence-based outcomes and insightful reports for the study of human daily physical activity and sleep. This paper aims to provide a one-stop overview of GGIR package, the papers underpinning the theory of GGIR, and how research contributes to the continued growth of the GGIR package. The package includes a range of literature-supported methods to clean the data and provide day-by-day, as well as full recording, weekly, weekend, and weekday estimates of physical activity and sleep parameters. In addition, the package also comes with a shell function that enables the user to process a set of input files and produce csv summary reports with a single function call, ideal for users less proficient in R. GGIR has been used in over 90 peer-reviewed scientific publications to date. The evolution of GGIR over time and widespread use across a range of research areas highlights the importance of open source software development for the research community and advancing methods in physical behavior research.

Open access

Salomé Aubert, Joel D. Barnes, Megan L. Forse, Evan Turner, Silvia A. González, Jakub Kalinowski, Peter T. Katzmarzyk, Eun-Young Lee, Reginald Ocansey, John J. Reilly, Natasha Schranz, Leigh M. Vanderloo and Mark S. Tremblay

Background: In response to growing concerns over high levels of physical inactivity among young people, the Active Healthy Kids Global Alliance developed a series of national Report Cards on physical activity for children and youth to advocate for the promotion of physical activity. This article provides updated evidence of the impact of the Report Cards on powering the movement to get children and youth moving globally. Methods: This assessment was performed using quantitative and qualitative sources of information, including surveys, peer-reviewed publications, e-mails, gray literature, and other sources. Results: Although it is still too early to observe a positive change in physical activity levels among children and youth, an impact on raising awareness and capacity building in the national and international scientific community, disseminating information to the general population and stakeholders, and on powering the movement to get kids moving has been observed. Conclusions: It is hoped that the Report Card activities will initiate a measurable shift in the physical activity levels of children and contribute to achieving the 4 strategic objectives of the World Health Organization Global Action Plan as follows: creating an active society, creating active environments, creating active lives, and creating active systems.

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Pauline M. Genin, Frédéric Dutheil, Benjamin Larras, Yoland Esquirol, Yves Boirie, Angelo Tremblay, Bruno Pereira, Corinne Praznoczy, David Thivel and Martine Duclos

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Meera Sreedhara, Karin Valentine Goins, Christine Frisard, Milagros C. Rosal and Stephenie C. Lemon

Background: Local health departments (LHDs) are increasingly involved in Community Health Improvement Plans (CHIPs), a collaborative planning process that represents an opportunity for prioritizing physical activity. We determined the proportion of LHDs reporting active transportation strategies in CHIPs and associations between LHD characteristics and such strategies. Methods: A national probability survey of US LHDs (<500,000 residents; 30.2% response rate) was conducted in 2017 (n = 162). LHDs reported the inclusion of 8 active transportation strategies in a CHIP. We calculated the proportion of LHDs reporting each strategy. Multivariate logistic regression models determined the associations between LHD characteristics and inclusion of strategies in a CHIP. Inverse probability weights were applied for each stratum. Results: 45.6% of US LHDs reported participating in a CHIP with ≥1 active transportation strategy. Proportions for specific strategies ranged from 22.3% (Safe Routes to School) to 4.1% (Transit-Oriented Development). Achieving national accreditation (odds ratio [OR] = 3.67; 95% confidence interval [CI], 1.11–12.05), pursuing accreditation (OR = 3.40; 95% CI, 1.25–9.22), using credible resources (OR = 5.25; 95% CI, 1.77–15.56), and collaborating on a Community Health Assessment (OR = 4.48; 95% CI, 1.23–16.29) were associated with including a strategy in a CHIP after adjusting for covariates. Conclusions: CHIPs are untapped tools, but national accreditation, using credible resources, and Community Health Assessment collaboration may support strategic planning efforts to improve physical activity.