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Jodie Andruschko, Anthony D. Okely, and Phil Pearson

This study examined the feasibility and potential efficacy of a multi-faceted secondary school–based intervention among low-fit adolescent females. The Sport4Fun program was designed to promote physical activity participation, fundamental movement skill proficiency, perceived physical competence, and enjoyment of physical activity in secondary school students. The intervention consisted of three components including two practical components—weekly movement skill activities for 90 min during compulsory school sport and sports-based activities for 60 min after school (non-compulsory) for 6 months—and one theoretical component—three 15-min theory sessions completed during homeroom (or roll call) time per week. The control group participated in their regular school activities. Compared with females in the control group, those in the intervention group showed a greater increase in total weekday accelerometer counts per min (adjusted difference, 77.49; 95% CI, 8.21–132.77; p = .03; Cohen’s d = 1.26). The difference in total fundamental movement skill components mastered favored the intervention group but was not statistically significant (adjusted difference, 1.48; 95% CI, −1.21–4.17; p = .26, Cohen’s d = 0.48). Targeting fundamental movement skills may be a potentially novel and motivating way to promote activity among low-fit adolescent girls; however, challenges in recruitment and implementation warrant further investigation before adopting this approach more broadly.

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Karen Tonge, Rachel A. Jones, and Anthony D. Okely

Background: To examine the relationship between attributes of early childhood education and care (ECEC) settings and children’s physical activity and sedentary behavior. Methods: Cross-sectional study involving 490 children aged 2–5 years from 11 ECECs. The ECEC routine, size of the outdoor environment, and time spent in the outdoor environment were calculated for each center. Children’s physical activity and sedentary time were measured using accelerometers. Multivariate linear regressions were used to examine associations of the attributes of ECEC centers with the outcome variables, adjusting for the effects of center clustering and gender. Results: Children in ECECs that offered free routines (where children can move freely between indoor and outdoor environments) had lower levels of sedentary time (28.27 min/h vs 33.15 min/h; P = .001) and spent more time in total physical activity (7.99 min/h vs 6.57 min/h; P = .008) and moderate- to vigorous-intensity physical activity (9.49 min/h vs 7.31 min/h; P = .008). Children in ECECs with an outdoor environment >400 m2 had less sedentary time (28.94 min/h vs 32.42 min/h; P = .012) than those with areas <400 m2. Conclusion: Modifiable practices such as offering a free routine and increasing time spent in outdoor environments could potentially offer an easy and sustainable way for ECEC centers to promote physical activity and reduce sedentary time among children.

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Michael L. Booth, Anthony D. Okely, Tien Chey, and Adrian E. Bauman

This study examined the pattern of activity energy expenditure (AEE) among New South Wales (NSW) high school students in relation to age, sex, socioeconomic status (SES), place of residence, cultural background, season, participation in moderate- and vigorous-intensity and in organized and non-organized physical activity.


Cross-sectional survey of a randomly-selected sample (N = 2026). Respondents self-reported their physical activity participation during a usual week in summer and winter.


Boys reported greater AEE than girls and, whereas AEE was greater among grade 10 than grade 8 boys, the reverse was true for girls. Boys reported the same AEE for summer and winter, but girls reported less AEE during winter. Both boys and girls reported spending the same proportion of their AEE in vigorous-intensity (72%) compared with moderate-intensity activity (28%) and in non-organized (60%) compared with organized activity. There was no clear association between urban/rural place of residence and AEE. Although AEE tended to be positively associated with SES among girls, there was no association among boys. Girls from Asian cultural backgrounds reported much lower AEE than girls from other cultural backgrounds.


Patterns of energy expenditure among adolescent boys and girls should be considered in developing interventions to ensure needs are adequately met.

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Anouk WMC Oortwijn, Guy Plasqui, John J. Reilly, and Anthony D. Okely


The purpose of this pilot study was to assess the feasibility of a structured activity protocol in a room calorimeter among young children.


Five healthy children (age 5.2 ± 0.4 y) performed an activity protocol in a room calorimeter, ranging from sedentary to vigorous-intensity activities. Energy expenditure (EE) was calculated from continuous measurements of O2-consumption and CO2-production using Weir’s formula. Resting EE was defined as EE during the first 30 min of the study where participants were seated while watching television. The children wore an ActiGraph accelerometer on the right and left hip.


The protocol was well tolerated by all children, and lasted 150 to 175 min. Further, differences were seen in both EE and accelerometer counts across 3 of the 4 activity intensities.


It is feasible for young children to perform a structured activity protocol in a room calorimeter enhancing the possibility of conducting future studies to cross-validate existing accelerometer prediction equations.

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Zhiguang Zhang, Eduarda Sousa-Sá, João R. Pereira, Anthony D. Okely, Xiaoqi Feng, and Rute Santos

Background: This study examined the associations between environmental characteristics of early childhood education and care (ECEC) centers and 1-year change in toddlers’ physical activity and sedentary behavior while at the centers. Methods: Data from 292 toddlers from the GET-UP! study were analyzed. Environmental characteristics of ECEC centers were rated using the Infant/Toddler Environment Rating Scale-revised edition at baseline. Children’s physical activity and sedentary behavior in the centers were assessed using activPAL devices, at baseline and at 1-year follow-up. Linear mixed models were performed to examine the associations between the environmental characteristics and change in the proportion of time spent in physical activity and sedentary behavior. Results: Compared with baseline, children spent a higher proportion of time in sedentary behavior (sitting) but a lower proportion of time in standing and physical activity (stepping) while at ECEC centers, at 1-year follow-up. The environmental characteristics “interaction” (B = −1.39; P = .01) and “program structure” (B = −1.15; P = .04) were negatively associated with change in the proportion of time spent in physical activity. Conclusion: Better “interaction” and “program structure” may preclude children’s physical activity from declining over time and may be considered important features to target in future interventions in ECEC centers aiming at promoting active lifestyles.

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Kar Hau Chong, Dorothea Dumuid, Dylan P. Cliff, Anne-Maree Parrish, and Anthony D. Okely

Background : Little is known about the influence of 24-hour movement behaviors on children’s psychosocial health when transitioning from primary to secondary school. This study described changes in 24-hour domain-specific movement behavior composition and explored their associations with changes in psychosocial health during this transition. Methods : Data were drawn from the Longitudinal Study of Australian Children. The analytical sample (n = 909) included children who were enrolled in primary school at baseline (2010) and in secondary school at follow-up (2012). Time spent in 8 domains of movement behaviors was derived from the child-completed time-use diaries. Psychosocial health was examined using the self-report version of the Strengths and Difficulties Questionnaires. Analyses included repeated-measures multivariate analysis of variance and compositional regression. Results : Children reported engaging in more social activities and sleeping less over the transition period. Increased time spent in social activities (β ilr  = −0.06, P = .014) and recreational screen use (β ilr  = −0.17, P = .003) (relative to other domains) were associated with decreased prosocial behavior in boys. Changes in movement behavior composition were not associated with changes in girls’ psychosocial health. Conclusion : This study found considerable changes in children’s 24-hour movement behavior composition, but a lack of consistent association with changes in psychosocial health during the primary to secondary school transition.

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Lyndel Hewitt, Anthony D. Okely, Rebecca M. Stanley, Marjika Batterham, and Dylan P. Cliff

Background: Tummy time is recommended by the World Health Organization as part of its global movement guidelines for infant physical activity. To enable objective measurement of tummy time, accelerometer wear and nonwear time requires validation. The purpose of this study was to validate GENEActiv wear and nonwear time for use in infants. Methods: The analysis was conducted on accelerometer data from 32 healthy infants (4–25 wk) wearing a GENEActiv (right hip) while completing a positioning protocol (3 min each position). Direct observation (video) was compared with the accelerometer data. The accelerometer data were analyzed by receiver operating characteristic curves to identify optimal cut points for second-by-second wear and nonwear time. Cut points (accelerometer data) were tested against direct observation to determine performance. Statistical analysis was conducted using leave-one-out validation and Bland–Altman plots. Results: Mean temperature (0.941) and z-axis (0.889) had the greatest area under the receiver operating characteristic curve. Cut points were 25.6°C (temperature) and −0.812g (z-axis) and had high sensitivity (0.84, 95% confidence interval, 0.838–0.842) and specificity (0.948, 95% confidence interval, 0.944–0.948). Conclusions: Analyzing GENEActiv data using temperature (>25.6°C) and z-axis (greater than −0.812g) cut points can be used to determine wear time among infants for the purpose of measuring tummy time.

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Katherine L. Downing, Jo Salmon, Anna Timperio, Trina Hinkley, Dylan P. Cliff, Anthony D. Okely, and Kylie D. Hesketh

Background: Although there is increasing evidence regarding children’s screen time, little is known about children’s sitting. This study aimed to determine the correlates of screen time and sitting in 6- to 8-year-old children. Methods: In 2011–2012, parents in the Healthy Active Preschool and Primary Years (HAPPY) study (n = 498) reported their child’s week/weekend day recreational screen time and potential correlates. ActivPALs measured children’s nonschool sitting. In model 1, linear regression analyses were performed, stratified by sex and week/weekend day and controlling for age, clustered recruitment, and activPAL wear time (for sitting analyses). Correlates significantly associated with screen time or sitting (P < .05) were included in model 2. Results: Children (age 7.6 y) spent 99.6 and 119.3 minutes per day on week and weekend days engaging in screen time and sat for 119.3 and 374.6 minutes per day on week and weekend days, respectively. There were no common correlates for the 2 behaviors. Correlates largely differed by sex and week/weekend day. Modifiable correlates of screen time included television in the child’s bedroom and parental logistic support for, encouragement of, and coparticipation in screen time. Modifiable correlates of sitting included encouragement of and coparticipation in physical activity and provision of toys/equipment for physical activity. Conclusions: Interventions may benefit from including a range of strategies to ensure that all identified correlates are targeted.

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Simone A. Tomaz, Anthony D. Okely, Alastair van Heerden, Khanya Vilakazi, Marie-Louise Samuels, and Catherine E. Draper

Background: In 2018, South Africa developed 24-hour movement behavior guidelines for children from birth to 5 years. This study reports on the stakeholder consultation as part of this development process. Methods: An online survey was completed by 197 participants; 9 focus groups (with parents/caregivers, early childhood development practitioners, and community health workers, total n = 70) were conducted, and a meeting with stakeholders from government and nongovernment organizations (n = 15) was held. Results: In the online survey, stakeholders overwhelmingly agreed with the guidelines (97.0%) and recognized the benefit of putting the guidelines into practice (88.8%). Most online survey respondents (88.3%) reported that the guidelines would benefit all South African children equally. Responses to open-ended questions in the online survey and focus group discussions revealed issues including safety and nutrition of children, perceived parental barriers to using the guidelines, and education. Training and provision of educational materials were identified from all stakeholders as key in the dissemination and implementation of the guidelines. Conclusions: The findings informed the development of the South African 24-hour movement behavior guidelines and revealed several important factors to address in the dissemination and implementation of the guidelines to ensure that they are applicable and equitable in South Africa.