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

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

Background:

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

Methods:

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.

Results:

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.

Conclusions:

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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Louise A. Kelly, John J. Reilly, Sheila C. Fairweather, Sarah Barrie, Stanley Grant and James Y Paton

The primary aim of this study was to test the validity of two accelerometers, CSA/MTI WAM-7164 and Actiwatch®, against direct observation of physical activity using the Children’s Physical Activity Form (CPAF). CSA/MTI WAM-7164 and Actiwatch accelerometers simultaneously measured activity during structured-play classes in 3- to 4-year olds. Accelerometry output was synchronized to CPAF assessments of physical activity in 78 children. Rank order correlations between accelerometry and direct observation evaluated the ability of the accelerometers to assess total physical activity. Within-child minute-to-minute correlations were calculated between accelerometry output and direct observation. For total physical activity, CSA/MTI output was significantly correlated with CPAF (r = .72, p < .001), but output from the Actiwatch was not (r = .16, p > .05).

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Chiaki Tanaka, Xanne Janssen, Mark Pearce, Kathryn Parkinson, Laura Basterfield, Ashley Adamson and John J. Reilly

Background: Previous studies have reported on the associations between obesity and sedentary behavior (SB) or physical activity (PA) in children. This study examined longitudinal and bidirectional associations between adiposity and SB and PA in children. Methods: Participants were 356 children in England. PA was measured at 7 and 9 years of age using accelerometry. Outcome and exposures were time in SB and PAs and concurrent body mass index z score and fat index (FI). Results: Adiposity at baseline was positively associated with changes in SB (β = 0.975 for FI) and negatively associated with changes in moderate to vigorous PA (β = −0.285 for body mass index z score, β = −0.607 for FI), vigorous PA (β = −0.095 for FI), and total PA (β = −48.675 for FI), but not vice versa. The changes in SB, moderate to vigorous PA, and total PA for children with overweight/obesity were significantly more adverse than those for children with healthy weight. Conclusions: A high body mass index z score or high body fatness at baseline was associated with lower moderate to vigorous PA and vigorous PA after 2 years, but not vice versa, which suggests that in this cohort adiposity influenced PA and SB, but the associations between adiposity and SB or PA were not bidirectional.

Open access

Mohamed G. Al-Kuwari, Izzeldin A. Ibrahim, Eiman M. Al Hammadi and John J. Reilly

Background:

The first Qatar Active Healthy Kids (QAHK) Report Card was developed in 2015–2016. It is a synthesis of the available evidence on physical activity in children and youth in the state of Qatar—an assessment of the state of the nation. The report card is important for future physical activity advocacy, policy, and program development.

Methods:

The QAHK Report Card was inspired by the Active Healthy Kids Scotland 2013 Report Card. The methodology used in Scotland’s report card was adapted for Qatar. A Working Group identified indicators for physical activity and related health behaviors, and evaluated the available data on these indicators. The card grades were determined by the percentage of children meeting guidelines or recommendations.

Results:

The 2016 QAHK Report Card consisted of 9 indicators: 6 Physical Activity and Health Behaviors and Outcomes, and 3 Settings and Influences on these health behaviors and outcomes. The indicator National Policy, Strategy, and Investment was assigned the highest grade (B). Four indicators were assigned D grades: Sedentary Behavior, Dietary Habits, Organized Sports Participation, and Family and Peer Influence. Physical Activity and Obesity were both graded F. Two indicators could not be graded due to insufficient data and/or absence of a recommendation: Active and Outdoor Play, and Community and School Influence.

Conclusions:

The QAHK Report Card identified weaknesses and gaps in the evidence on physical activity and health in children and youth in Qatar. The quality of evidence was poor for some indicators, with some data collection methods of limited validity and reliability, or only available for a limited age range, so the grades are best estimates of the current situation in Qatar. Future surveys and research using objective physical activity measures will support the development of a second QAHK Report Card by 2018.

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Louise A. Kelly, John J. Reilly, Diane M. Jackson, Colette Montgomery, Stanley Grant and James Y. Paton

Tracking of total physical activity (PA), moderate to vigorous activity (MVPA), and sedentary behavior was assessed in 42 young children (mean age at baseline 3.8 years) over a 2-year period using the Actigraph accelerometer. Tracking was analyzed using Spearman rank correlations, percentage agreements, and kappa statistics. Spearman rank correlations were r = .35 (p = .002) for total PA, r = .37 (p = .002) for MVPA, and r = .35 (p = .002) for sedentary behavior. Percentage agreements for PA, MVPA, and sedentary behavior were 38, 41, and 26 respectively. Kappa statistics for PA, MVPA, and sedentary behavior ranged from poor to fair. Results suggest low levels of tracking of total physical activity, MVPA, and sedentary behavior in young Scottish children over a 2-year period.