Eating disorders (EDs) are common amongst athletes, yet few receive treatment. Given that athletes have a unique set of risk factors for eating disorders and are faced with additional barriers to treatment, new models outside of face-to-face treatment are necessary to reach the population and provide more affordable, tailored, evidence-based care. One solution is to use digital mental health programs to provide primary or supplemental therapy. Digital programs can provide accessibility and privacy, and recent advancements allow for more personalized online experiences. However, there have been no studies to date that integrate technology-based tools to address the especially high prevalence rates of EDs in athletes. This paper describes how an integrated model that includes online screening linked to guided self-help programs, all adapted specifically for athletes, can be used to provide prevention and intervention of EDs in athletes.
Rachael E. Flatt and Craig Barr Taylor
Glen Nielsen, Rachael Taylor, Sheila Williams and Jim Mann
To investigate whether the number of permanent playground facilities in schools influences objectively measured physical activity.
Physical activity was measured using Actical accelerometers over 2 to 5 days in 417 children (5–12 years) from 7 schools. The number of permanent play facilities likely to encourage physical activity in individuals or groups of children (eg, adventure playgrounds, swings, trees, playground markings, courts, sandpits) were counted on 2 occasions in each school. The surface area of each playground (m2) was also measured.
The number of permanent play facilities in schools ranged from 14 to 35 and was positively associated with all measures of activity. For each additional play facility, average accelerometry counts were 3.8% (P < .001) higher at school and 2.7% (P < .001) higher overall. Each additional play facility was also associated with 2.3% (P = .001) or 4 minutes more moderate/vigorous activity during school hours and 3.4% (P < .001) more (9 minutes) over the course of the day. School playground area did not affect activity independent of the number of permanent play facilities. Findings were consistent across age and sex groups.
Increasing the number of permanent play facilities at schools may offer a cost-effective and sustainable option for increasing physical activity in young children.
Jillian J. Haszard, Kim Meredith-Jones, Victoria Farmer, Sheila Williams, Barbara Galland and Rachael Taylor
Although 24-hour time-use data are increasingly being examined in relation to indices of health, consensus has yet to be reached about the best way to present estimates from compositional analyses. This analysis explored the impact of different presentations of results when assessing the relationship between 24-hour time-use and body mass index (BMI) z-score using compositional analysis of 5-day actigraphy data in 742 children. First it was found that reallocating non-wear time to day-time components only (sedentary behavior, light physical activity, and moderate-to-vigorous physical activity [MVPA]) before normalization to 24 hours provided stronger estimates with BMI z-score than simply removing non-wear time before normalization. Estimates for sleep time were substantially affected, where associations with BMI z-score nearly doubled (mean difference [95% CI] in BMI z-score for 10% longer sleep were −0.20 [−0.32, −0.08] compared to −0.11 [−0.23, 0.002]). Presenting estimates in terms of a greater number of minutes in a component, relative to all others, showed MVPA to be the strongest predictor of BMI z-score, while estimates in terms of the proportion of minutes showed sleep to be the strongest predictor. Both presentations have value. However, presentations in terms of one-to-one “substitutions” of time may need careful interpretation due to the uneven distribution of time in each component. In conclusion, when analyzing relationships between 24-hour time-use and health outcomes, non-wear time and presentation of estimates can impact final conclusions. As a result, the current understanding of the importance of sleep for child health may be underestimated.
Ralph Maddison, Samantha Marsh, Erica Hinckson, Scott Duncan, Sandra Mandic, Rachael Taylor and Melody Smith
In this article, we report the grades for the second New Zealand Report Card on Physical Activity for Children and Youth, which represents a synthesis of available New Zealand evidence across 9 core indicators.
An expert panel of physical activity (PA) researchers collated and reviewed available nationally representative survey data between March and May 2016. In the absence of new data, (2014–2016) regional level data were used to inform the direction of existing grades. Grades were assigned based on the percentage of children and youth meeting each indicator: A is 81% to 100%; B is 61% to 80%; C is 41% to 60%, D is 21% to 40%; F is 0% to 20%; INC is Incomplete data.
Overall PA, Active Play, and Government Initiatives were graded B-; Community Environments was graded B; Sport Participation and School Environment received a C+; Sedentary Behaviors and Family/Peer Support were graded C; and Active Travel was graded C-.
Overall PA participation was satisfactory for young children but not for youth. The grade for PA decreased slightly from the 2014 report card; however, there was an improvement in grades for built and school environments, which may support regional and national-level initiatives for promoting PA.