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Effectiveness of a Facebook-Delivered Physical Activity Intervention for Postpartum Women: A Randomized Controlled Trial

Jocelyn Kernot, Lucy Lewis, Tim Olds, and Carol Maher

Background: Facebook has over 1.8 billion users and offers unique opportunities for health intervention delivery due to its popularity, flexibility, high engagement, and social connectedness. Methods: This study aimed to determine the effectiveness of the Mums Step It Up (MSIU) Facebook app, a team-based, 50-day physical activity intervention for postpartum women. A total of 120 postpartum women were recruited and randomly allocated to 1 of 3 conditions: MSIU (n = 41), pedometer only (n = 39), and control (n = 40). Assessments were completed at baseline, 6 weeks, and 6 months. Primary outcomes were accelerometer moderate to vigorous physical activity and self-reported walking. Analyses were undertaken on an intention to treat basis using random effects mixed modeling (P ≤ .05). Compliance and engagement with the MSIU app were analyzed, descriptively. Results: There were no significant differences in changes in moderate to vigorous physical activity (P = .81, 6 wk; P = .91, 6 mo) or self-reported walking (P = .55, 6 wk; P = .90, 6 mo) across the 3 conditions. High engagement with the MSIU app was evident, with participants on average visiting the app 26 times and logging steps for 48/50 days. Conclusion: Although engagement with the MSIU app was promising, the nonsignificant results suggest that further work needs to be done to enhance efficacy for postpartum women.

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Advancing Health-Related Cluster Analysis Methodology: Quantification of Pairwise Activity Cluster Similarities

Katia Ferrar, Carol Maher, John Petkov, and Tim Olds


To date, most health-related time-use research has investigated behaviors in isolation; more recently, however, researchers have begun to conceptualize behaviors in the form of multidimensional patterns or clusters.


The study employed 2 techniques: radar graphs and centroid vector length, angles and distance to quantify pairwise time-use cluster similarities among adolescents living in Australia (N = 1853) and in New Zealand (N = 679).


Based on radar graph shape, 2 pairs of clusters were similar for both boys and girls. Using vector angles (VA), vector length (VL) and centroid distances (CD), 1 pair for each sex was considered most similar (boys: VA = 63°, VL = 44 and 50 units, and CD = 48 units; girls: VA = 23°, VL = 65 and 85 units, and CD = 36 units). Both methods employed to determine similarity had strengths and weaknesses. Conclusions: The description and quantification of cluster similarity is an important step in the research process. An ability to track and compare clusters may provide greater understanding of complex multidimensional relationships, and in relation to health behavior clusters, present opportunities to monitor and to intervene.

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The Place of Physical Activity in the Time Budgets of 10- to 13-Year-Old Australian Children

Tim Olds, Carol Ann Maher, and Kate Ridley


Low physical activity has been associated with increased fatness and deceased fitness. This observational study aimed to describe the magnitude, composition, and time-distribution of moderate-to-vigorous physical activity (MVPA) in Australian children.


A total of 1132 10 to 13 year old schoolchildren completed a 24-h activity recall diary on 2 to 4 occasions. MVPA was defined as any activity requiring ≥3METs, including sport, play, active transport, chores, and other activities.


MVPA was higher in boys than girls (173 vs 140 min/day; P < .0001), higher on nonschool days than school days (166 vs 143 min/day; P < .0001), and decreased with age (9 min/day per year of age). MVPA consisted of structured sport (37%), active transport (26%), unstructured play (24%), and chores/miscellaneous activities (13%). Every hour of MVPA was associated with a reduction in screen time (26.5 min), non-screen-based sedentary pastimes (8 min), and sleep (5.5 min). The least active quartile of children were more likely to be girls (OR = 3.4), have higher screen time, and sleep more. From 4:00−6:30 PM on school days there were large differences in participation between high-active and low-active children.


Findings suggest MVPA interventions should target girls, screen time and focus on the after-school period.

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The Validity of a Computerized Use of Time Recall, the Multimedia Activity Recall for Children and Adolescents

Tim S. Olds, Kate Ridley, James Dollman, and Carol A. Maher

This study examined the convergent validity of a computerized use of time diary (MARCA) relative to pedometry. Participants aged 9–16 years wore a pedometer and completed the MARCA. Comparing pedometer data and self-report data collected for the same day (n = 297 participants), the correlation (Spearman’s rho) with PAL was 0.54 and with MVPA was 0.50. Comparing mean daily step counts over 6–7 days with averaged self-report data collected on different days (n = 1713 participants) Spearman’s rho for PAL was 0.45 and for MVPA was 0.44. Thus, the MARCA showed validity similar or superior to most self-report instruments for young people.

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Do Birds of a Feather Flock Together Within a Team-Based Physical Activity Intervention? A Social Network Analysis

Sarah Edney, Tim Olds, Jillian Ryan, Ronald Plotnikoff, Corneel Vandelanotte, Rachel Curtis, and Carol Maher

Background: Homophily is the tendency to associate with friends similar to ourselves. This study explored the effects of homophily on team formation in a physical activity challenge in which “captains” signed up their Facebook friends to form teams. Methods: This study assessed whether participants (n = 430) were more similar to their teammates than to nonteammates with regard to age, sex, education level, body mass index, self-reported and objectively measured physical activity, and negative emotional states; and whether captains were more similar to their own teammates than to nonteammates. Variability indices were calculated for each team, and a hypothetical variability index, representing that which would result from randomly assembled teams, was also calculated. Results: Within-team variability was less than that for random teams for all outcomes except education level and depression, with differences (SDs) ranging from +0.15 (self-reported physical activity) to +0.47 (age) (P < .001 to P = .001). Captains were similar to their teammates except in regard to age, with captains being 2.6 years younger (P = .003). Conclusions: Results support hypotheses that self-selected teams are likely to contain individuals with similar characteristics, highlighting potential to leverage team-based health interventions to target specific populations by instructing individuals with risk characteristics to form teams to help change behavior.

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At the Mercy of the Gods: Associations Between Weather, Physical Activity, and Sedentary Time in Children

Lucy Kate Lewis, Carol Maher, Kevin Belanger, Mark Tremblay, Jean-Philippe Chaput, and Tim Olds


This study investigated associations between weather conditions, physical activity, and sedentary time in primary school-aged children in Australia and Canada.


Cross-sectional data on 9–11-year-old children from the Australian (n = 491) and Canadian (n = 524) sites of the International Study of Childhood Obesity, Lifestyle and the Environment were used. Minutes of daily moderate-to-vigorous-physical-activity (MVPA) and sedentary time were determined from 7-day, 24-h accelerometry (Actigraph GT3X+ triaxial accelerometer). Day-matched weather data (temperature, rainfall, snowfall, relative humidity, wind speed) were obtained from the closest weather station to participants’ schools. Covariates included parental highest education level, day type, sex, and BMI z-scores. Generalized mixed model analyses allowing for clustering of participants within schools were completed. Scatterplots with Loess curves were created for maximum temperature, MVPA, and sedentary time.


Daily maximum temperature was significantly associated with MVPA and sedentary time in Australia (MVPA p = .05, sedentary p = .01) and Canada (p < .001, p = .001). Rainfall was negatively associated with MVPA in Australia (p < .001) and positively associated with sedentary time in Canada (p = .02).


MVPA and sedentary time appear to be optimal when the maximum temperature ranges between 20°C and 25°C in both countries. The findings have implications for study design and interpretation for surveillance and intervention studies.

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Uptake of a Universal Sports Subsidy Program for School-Aged Children: A Population Data Analysis

Rachel G. Curtis, Michelle Crisp, Simone Licari, Rosa Virgara, Catherine E.M. Simpson, and Carol A. Maher

Background: Around 40% of Australian children do not participate in sport. Cost is a major barrier to participation, particularly for children from low socioeconomic backgrounds. This study aimed to evaluate the uptake of a population-level children’s sports subsidy scheme, including sociodemographic differences in uptake. Methods: A state-wide cross-sectional analysis comparing sports voucher claimants (primary school-aged children with a valid Medicare or Australian visa number) from the 2019 financial year with population census data from South Australia. Chi-square was used to examine whether the percentage of eligible children who claimed a voucher differed based on age, sex, socioeconomic status (SES), and geographical remoteness. Subgroup analyses were conducted for the lowest 2 socioeconomic disadvantage deciles, split by gender. Scatterplots were used to compare sports between high and low SES children. Results: A total of 74,668 children claimed sports vouchers (45.5% of eligible children). Children who were relatively younger, female, from low socioeconomic backgrounds, and from major cities were least likely to claim the voucher. The 5 most common sports were Australian rules football (30.2%), netball (13.6%), soccer (13.1%), gymnastics (10.4%), and basketball (5.7%), with the popular sports similar for high and low SES children. Conclusions: Future work is needed to understand how Sports Voucher, and sport participation rates have changed over time, and to improve voucher uptake among girls, city dwellers, and low SES children.

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The Association Between Time-Use Behaviors and Physical and Mental Well-Being in Adults: A Compositional Isotemporal Substitution Analysis

Rachel G. Curtis, Dorothea Dumuid, Timothy Olds, Ronald Plotnikoff, Corneel Vandelanotte, Jillian Ryan, Sarah Edney, and Carol Maher

Background: Substantial evidence links activity domains with health and well-being; however, research has typically examined time-use behaviors independently, rather than considering daily activity as a 24-hour time-use composition. This study used compositional data analysis to estimate the difference in physical and mental well-being associated with reallocating time between behaviors. Methods: Participants (n = 430; 74% female; 41 [12] y) wore an accelerometer for 7 days and reported their body mass index; health-related quality of life (QoL); and symptoms of depression, anxiety, and stress. Regression models determined whether time-use composition, comprising sleep, sedentary behavior, light physical activity (LPA), and moderate to vigorous physical activity (MVPA), was associated with well-being. Compositional isotemporal substitution models estimated the difference in well-being associated with reallocating time between behaviors. Results: Time-use composition was associated with body mass index and physical health-related QoL. Reallocating time to MVPA from sleep, sedentary behavior, and LPA showed favorable associations with body mass index and physical health-related QoL, whereas reallocations from MVPA to other behaviors showed unfavorable associations. Reallocations from LPA to sedentary behavior were associated with better physical health–related QoL and vice versa. Conclusion: Results reinforce the importance of MVPA for physical health but do not suggest that replacing sedentary behavior with LPA is beneficial for health and well-being.

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Relationships Between Outdoor Time, Physical Activity, Sedentary Time, and Body Mass Index in Children: A 12-Country Study

Richard Larouche, Emily F. Mire, Kevin Belanger, Tiago V. Barreira, Jean-Philippe Chaput, Mikael Fogelholm, Gang Hu, Estelle V. Lambert, Carol Maher, José Maia, Tim Olds, Vincent Onywera, Olga L. Sarmiento, Martyn Standage, Catrine Tudor-Locke, Peter T. Katzmarzyk, Mark S. Tremblay, and For the ISCOLE Research Group

Purpose: This study investigated the relationship between outdoor time and physical activity (PA), sedentary time (SED), and body mass index z scores among children from 12 lower-middle-income, upper-middle-income, and high-income countries. Methods: In total, 6478 children (54.4% girls) aged 9–11 years participated. Outdoor time was self-reported, PA and SED were assessed with ActiGraph GT3X+ accelerometers, and height and weight were measured. Data on parental education, neighborhood collective efficacy, and accessibility to neighborhood recreation facilities were collected from parent questionnaires. Country latitude and climate statistics were collected through national weather data sources. Gender-stratified multilevel models with parental education, climate, and neighborhood variables as covariates were used to examine the relationship between outdoor time, accelerometry measures, and body mass index z scores. Results: Each additional hour per day spent outdoors was associated with higher moderate- to vigorous-intensity PA (boys: +2.8 min/d; girls: +1.4 min/d), higher light-intensity PA (boys: +2.0 min/d; girls: +2.3 min/d), and lower SED (boys: −6.3 min/d; girls: −5.1 min/d). Effect sizes were generally weaker in lower-middle-income countries. Outdoor time was not associated with body mass index z scores. Conclusions: Outdoor time was associated with higher PA and lower SED independent of climate, parental education, and neighborhood variables, but effect sizes were small. However, more research is needed in low- and middle-income countries.

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Epidemiological Transition in Physical Activity and Sedentary Time in Children

Tiago V. Barreira, Stephanie T. Broyles, Catrine Tudor-Locke, Jean-Philippe Chaput, Mikael Fogelholm, Gang Hu, Rebecca Kuriyan, Estelle V. Lambert, Carol A. Maher, José A. Maia, Timothy Olds, Vincent Onywera, Olga L. Sarmiento, Martyn Standage, Mark S. Tremblay, Peter T. Katzmarzyk, and for the ISCOLE Research Group

Background: To determine if children’s moderate to vigorous physical activity (MVPA) and sedentary time varied across levels of household income in countries at different levels of Human Development Index (HDI), consistent with the theory of epidemiological transition. Methods: Data from 6548 children (55% girls) aged 9–11 years from 12 countries at different HDI levels are used in this analysis to assess MVPA and sedentary time (measured using ActiGraph accelerometers) across levels of household income. Least-square means are estimated separately for boys and girls at the estimated 10th, 50th, and 90th percentiles of HDI for the sample. Results: For boys, time in MVPA is negatively associated with income at the 10th and 50th percentiles of HDI (both P < .002). For girls, time in MVPA is negatively associated with income at the 10th and 50th percentiles of HDI (all P < .01) and positively related with income at the 90th percentile (P = .04). Sedentary time is positively associated with income at the 10th percentile of HDI for boys (P = .03), but not for girls. Conclusions: Results support the possibility of an epidemiological transition in physical activity, with lower levels of MVPA observed at opposite levels of income depending on the HDI percentile. This phenomenon was not observed for sedentary time.