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Contribution of Walking to School to Individual and Population Moderate-Vigorous Intensity Physical Activity: Systematic Review and Meta-Analysis

Anne Martin, Paul Kelly, Jessica Boyle, Fenella Corlett, and John J. Reilly

Purpose:

This study estimated the contribution of walking to/from school to objectively measured daily moderate-vigorous intensity physical activity (MVPA) in individuals and populations.

Methods:

MEDLINE, PsycINFO and SPORTDiscus were systematically searched up to February 2015. Two reviewers independently screened titles/abstracts/full-text articles, and assessed study quality.

Results:

Of 2430 records, 129 were eligible for full-text screening. Twelve studies met the inclusion criteria of reporting objectively obtained measures of MVPA (total and while walking to/from school) in children and adolescents. The weighted mean MVPA accumulated in walking to and from school was 17 min/day in primary school pupils (9 samples, n = 3422) and 13 min/day in high school pupils (4 samples, n = 2600). Pooled analysis suggested that walking to and from school contributed 23% and 36% of MVPA on schooldays in primary school age children and high school pupils, respectively. All included studies were of high methodological quality.

Conclusions:

Walking to and from school makes a meaningful contribution to individual schoolday MVPA for active commuters in western countries. Since schooldays represent only around half of all days, and prevalence of walking to school is low in many countries, the contribution of walking to school to population MVPA is probably low.

Open access

Results from Scotland’s 2018 Report Card on Physical Activity for Children and Youth

Adrienne R. Hughes, Avril Johnstone, Farid Bardid, and John J. Reilly

Open access

Results From Scotland’s 2016 Report Card on Physical Activity for Children and Youth

John J. Reilly, Avril Johnstone, Geraldine McNeill, and Adrienne R. Hughes

Background:

The 2016 Active Healthy Kids Scotland Report Card aims to improve surveillance of physical activity (PA), facilitate international comparisons, and encourage evidence-informed PA and health policy.

Methods:

Active Healthy Kids Canada Report Card methodology was used: a search for data on child and adolescent PA and health published after the 2013 Scottish Report Card was carried out. Data sources were considered for grading if based on representative samples with prevalence estimates made using methods with low bias. Ten health behaviors/outcomes were graded on an A to F scale based on quintiles (prevalence meeting recommendations ≥80% graded A down to <20% graded F).

Results:

Three of the seven Health Behaviors and Outcomes received F or F- grades: Overall PA, Sedentary Behavior, and Obesity. Active and Outdoor Play and Organized Sport Participation could not be graded. Active Commuting to School was graded C, and Diet was graded D-. Family and Peer Influence was graded D-; Perceived Safety and Availability of Space for PA as well as the National Policy Environment were more favorable (both B).

Conclusions:

Grades were identical to those in 2013. Scotland has a generally favorable environment for PA, but children and adolescents have low PA and high sedentary behavior. Gaps in surveillance included lack of objectively measured PA, no surveillance of moderate-to-vigorous PA in children, summary surveillance data not expressed in ways which match recommendations (eg, for PA in young children; for screen-time), and no surveillance of Sport Participation, Active and Outdoor Play, or Sitting. Scottish policy does not include sedentary behavior at present.

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Results from Scotland’s 2013 Report Card on Physical Activity for Children and Youth

John J. Reilly, Smita Dick, Geraldine McNeill, and Mark S. Tremblay

Background:

The Active Healthy Kids Scotland Report Card aims to consolidate existing evidence, facilitate international comparisons, encourage more evidence-informed physical activity and health policy, and improve surveillance of physical activity.

Methods:

Application of the Active Healthy Kids Canada Report Card process and methodology to Scotland, adapted to Scottish circumstances and availability of data.

Results:

The Active Healthy Kids Scotland Report Card 2013 consists of indicators of 7 Health Behaviors and Outcomes and 3 Influences on Health Behaviors and Outcomes. Grades of F were assigned to Overall Physical Activity, Sedentary Behavior (recreational screen time), and Obesity Prevalence. A C was assigned to Active Transportation and a D- was assigned to Diet. Two indicators, Active and Outdoor Play and Organized Sport Participation, could not be graded. Among the Influences, Family Influence received a D, while Perceived Safety, Access, and Availability of Spaces for Physical Activity and the National Policy Environment graded more favorably with a B.

Conclusions:

The Active Healthy Kids Canada process and methodology was readily generalizable to Scotland. The report card illustrated low habitual physical activity and extremely high levels of screen-based sedentary behavior, and highlighted several opportunities for improved physical activity surveillance and promotion strategies.

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Stability of Habitual Physical Activity and Sedentary Behavior Monitoring by Accelerometry in 6- to 8-Year-Olds

Laura Basterfield, Ashley J. Adamson, Mark S. Pearce, and John J. Reilly

Background:

Accelerometry is rapidly becoming the instrument of choice for measuring physical activity in children. However, as limited data exist on the minimum number of days accelerometry required to provide a reliable estimate of habitual physical activity, we aimed to quantify the number of days of recording required to estimate both habitual physical activity and habitual sedentary behavior in primary school children.

Methods:

We measured physical activity and sedentary behavior over 7 days in 291 6- to 8-year-olds using Actigraph accelerometers. Between-day intraclass reliability coefficients were calculated and averaged across all combinations of days.

Results:

Although reliability increased with time, 3 days of recording provided reliabilities for volume of activity, moderate-vigorous intensity activity, and sedentary behavior of 68%, 71%, and 73%, respectively.

Conclusions:

For our sample and setting, 3 days accelerometry provided reliable estimates of the main constructs of physical activity and sedentary behavior.

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Development and Evaluation of a Novel Computer-Based Tool for Assessing Physical Activity Levels in Schoolchildren

Sally A. McLure, John J. Reilly, Sean Crooks, and Carolyn D. Summerbell

A novel computer tool (peas@tees), designed to assess habitual physical activity levels in children aged 9 and 10 years, was evaluated. Study 1 investigated agreement between peas@tees and accelerometry in 157 children. Bland-Altman limits of agreement (LOA) revealed peas@tees underestimated physical activity levels compared with accelerometry (bias −21 min; 95% LOA -146–105). Study 2 investigated stability of peas@tees in a separate sample of 42 children. Intraclass correlation coefficient was 0.75 (95% CI 0.62–0.84). Computer tools are promising as a cheap, feasible, and useful method to monitor children’s habitual levels of physical activity at the group level.

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Comparison of Epoch and Uniaxial Versus Triaxial Accelerometers in the Measurement of Physical Activity in Preschool Children: A Validation Study

Jane F. Hislop, Cathy Bulley, Tom H. Mercer, and John J. Reilly

The objectives of this study were to explore whether triaxial is more accurate than uniaxial accelerometry and whether shorter sampling periods (epochs) are more accurate than longer epochs. Physical activity data from uniaxial and triaxial (RT3) devices were collected in 1-s epochs from 31 preschool children (15 males, 16 females, 4.4 ± 0.8 yrs) who were videoed while they engaged in 1-hr of free-play. Video data were coded using the Children’s Activity Rating Scale (CARS). A significant difference (p < .001) in the number of minutes classified as moderate to vigorous physical activity (MVPA) was found between the RT3 and the CARS (p < .002) using the cut point of relaxed walk. No significant difference was found between the GT1M and the CARS or between the RT3 and the CARS using the cut point for light jog. Shorter epochs resulted in significantly greater overestimation of MVPA, with the bias increasing from 0.7 mins at 15-s to 3.2 mins at 60-s epochs for the GT1M and 0 mins to 1.7 mins for the RT3. Results suggest that there was no advantage of a triaxial accelerometer over a uniaxial model. Shorter epochs result in significantly higher number of minutes of MVPA with smaller bias relative to direct observation.

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Comparison of Accelerometry Cut Points for Physical Activity and Sedentary Behavior in Preschool Children: A Validation Study

Jane F. Hislop, Cathy Bulley, Tom H. Mercer, and John J. Reilly

This study compared accelerometry cut points for sedentary behavior, light and moderate to vigorous intensity activity (MVPA) against a criterion measure, the Children’s Activity Rating Scale (CARS), in preschool children. Actigraph accelerometry data were collected from 31 children (4.4 ± 0.8 yrs) during one hour of free-play. Video data were coded using the CARS. Cut points by Pate et al., van Cauwenberghe et al., Sirard et al. and Puyau et al. were applied to calculate time spent in sedentary, light and MVPA. Repeated-measures ANOVA and paired t tests tested differences between the cut points and the CARS. Bland and Altman plots tested agreement between the cut points and the CARS. No significant difference was found between the CARS and the Puyau et al. cut points for sedentary, light and MVPA or between the CARS and the Sirard et al. cut point for MVPA. The present study suggests that the Sirard et al. and Puyau et al. cut points provide accurate group-level estimates of MVPA in preschool children.

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Using the Computer Science and Applications (CSA) Activity Monitor in Preschool Children

Sheila C. Fairweather, John J. Reilly, Stanley Grant, Arthur Whittaker, and James Y. Paton

The primary aim of this study was to assess the ability of the CSA accelerometer to measure physical activity in preschool children. A secondary aim was to examine inter-instrument differences and the effect of accelerometer placement on output. Eleven subjects (mean age = 4.0 years, SD = 0.4) wore the CSA-7164 for a 45-min preschool exercise class. They were observed throughout the class, and their engagement in activity was quantified using the Children’s Physical Activity Form (CPAF). The effect of accelerometer positioning (left vs. right hip) was assessed in 10 subjects over 2 days. CSA output during the class was highly correlated with the CPAF score (r = 0.87, p < .001), and rank order correlations between the 2 methods were also highly significant (r = 0.79, p < .01). Differences in CSA output between left and right hip reached statistical significance (paired t, p < .05), but these differences were small and probably of limited biological significance. The CSA appears to be an appropriate tool for assessment of physical activity in preschool children, but further studies on stability of activity as measured by CSA, as well as its validity, are urged.

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Effect of Urbanization on Objectively Measured Physical Activity Levels, Sedentary Time, and Indices of Adiposity in Kenyan Adolescents

Robert M. Ojiambo, Chris Easton, Jose A. Casajús, Kenn Konstabel, John J. Reilly, and Yannis Pitsiladis

Background:

Urbanization affects lifestyles in the developing world but no studies have assessed the impact on objectively measured physical activity in children and adolescents from sub-Saharan Africa.

Purpose:

To compare objectively measured habitual physical activity, sedentary time, and indices of adiposity in adolescents from rural and urban areas of Kenya.

Methods:

Physical activity and sedentary time were assessed by accelerometry for 5 consecutive days in 97 (50 female and 47 male) rural and 103 (52 female and 51 male) urban adolescents (mean age 13 ± 1 years). Body Mass Index (BMI) and BMI z-scores were used to assess adiposity.

Results:

Rural males spent more time in moderate-to-vigorous intensity physical activity (MVPA) compared with urban males (68 ± 22 vs. 50 ± 17 min, respectively; P < .001). Similarly, Rural females spent more time in MVPA compared with urban females (62 ± 20 vs. 37 ± 20 min, respectively; P < .001). Furthermore, there were significant differences in daily sedentary time between rural and urban subjects. Residence (rural vs. urban) significantly (P < .001) influenced BMI z-score (R 2 = .46).

Conclusion:

Rural Kenyan adolescents are significantly more physically active (and less sedentary) and have lower indices of adiposity compared with urban adolescents and this is a likely refection of the impact of urbanization on lifestyle in Kenya.