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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.

Open access

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.

Open access

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

Restricted access

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.

Restricted access

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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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.

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Anne Martin, Mhairi McNeill, Victoria Penpraze, Philippa Dall, Malcolm Granat, James Y. Paton, and John J. Reilly

The Actigraph is well established for measurement of both physical activity and sedentary behavior in children. The activPAL is being used increasingly in children, though with no published evidence on its use in free-living children to date. The present study compared the two monitors in preschool children. Children (n 23) wore both monitors simultaneously during waking hours for 5.6d and 10h/d. Daily mean percentage of time sedentary (nontranslocation of the trunk) was 74.6 (SD for the Actigraph and 78.9 (SD 4.3) for activPAL. Daily mean percentage of time physically active (light intensity physical activity plus MVPA) was 25.4 (SD for the Actigraph and 21.1 (SD 4.3) for the activPAL. Bland-Altman tests and paired t tests suggested small but statistically significant differences between the two monitors. Actigraph and activPAL estimates of sedentary behavior and physical activity in young children are similar at a group level.

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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.

Restricted access

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.