Purpose: The Coronavirus disease-2019 (COVID-19) pandemic has caused unprecedented disruption to the lifestyles of children and young people. Lockdown rules and school closures have resulted in the withdrawal of the primary source of structure and physical activity (PA) for many children and young people. The aim of this longitudinal observational study is to determine the immediate and long-term impacts of COVID-19 and its associated government-enforced restrictions on PA levels and mental health and wellbeing of children and young people in Wales. The specific objective of this first wave of data collection is to determine the PA levels and mental health and wellbeing of children and young people in Wales during lockdown.

Methods: 1,704 children and young people (8 – 17 year olds; 858 girls) completed a tailored PA, mental health and wellbeing online survey, with a sub-sample of 800 participants, stratified by age and socio-economic status, also wearing an Axivity AX3 accelerometer on their non-dominant wrist for seven consecutive days. The survey included three validated questionnaires: the Stirling Children’s Wellbeing Scale (SCWBS) questionnaire, the Good Childhood Index (GCI), and the Physical Activity Questionnaire for Older Children (aged 8 – 11 years; PAQ-C) or the Physical Activity Questionnaire for Adolescents (aged 12+ years; PAQ-A) dependent on age. Furthermore, non-validated, open-ended lockdown-specific questions were asked to capture participants’ feelings about being in lockdown. Raw accelerometer data will be analysed in R using the GGIR package to report the full 24-hour activity behaviour profile, including conventional and novel accelerometer metrics. Multivariable linear regression analysis will be used to investigate associations between PA and mental wellbeing. Qualitative data will be analysed using reflexive thematic analysis.

Results: Data have not been fully analysed, but preliminary descriptive analysis of survey data shows low levels of PA, with an average 20% of primary- and 26% of secondary-school children reporting to have done no PA on each of the previous seven days.

Conclusion: The intent is to gain further insight into the effect of the pandemic on children, subsequently informing future strategies needed to improve the lives of children and young people across Wales following this global crisis.

Purpose: Although physical activity (PA) is generally believed to exert health benefit, there is a lack of data examining the longitudinal associations of PA with later body composition and physical fitness in preschool aged children. In one of the few previous studies, we found positive longitudinal associations of vigorous PA with fat-free mass index (FFMI) and physical fitness using isotemporal analysis. However, concerns have arose whether issues with multicollinearity may bias isotemporal analysis. This study therefore aims to investigate the prospective associations of sedentary behavior (SB) and PA (at 4.5 years) with body composition and physical fitness at a 12-month follow-up (5.5 years) by re-analyzing the MINISTOP data using a compositional data approach.

Methods: Data from the 138 preschoolers randomized to the control group in the MINISTOP trial were analyzed. Baseline PA and SB data were collected with wrist-worn ActiGraph GT3X+ during seven days (24hr recordings) at 4.5 years of age. Body composition (i.e., fat-free mass [FFM], and fat mass [FM]) was assessed at the 12-month follow-up using air-displacement plethysmography and physical fitness components (i.e., cardiorespiratory, muscular, and motor fitness) within the PREFIT test battery. Isometric log-ratios of the SB and PA variables were introduced in linear regression models.

Results/Findings: Increasing vigorous PA at expenses of lower intensity behaviors at 4.5 years old was statistically significantly associated with body composition and physical fitness at 5.5 years old. For example, reallocating 15 min/day from SB, light and moderate PA to vigorous PA was associated FFMI (+0.45, CI: 0.18-0.72 kg/m²), upper-body (+0.6, CI: 0.1-1.19 kg) and lower-body strength (+8 cm, CI: 3-13 cm) as well as greater motor fitness (-0.4, CI: -0.82-[-0.01] s). Pairwise reallocations of time indicated that the behavior replaced did not matter, as long as vigorous PA was increased. Associations were very comparable if moderate-to-vigorous PA was increased at the expense of SB and light PA (all P’s<0.04).

Conclusions: More time spent in vigorous and moderate-to-vigorous PA may imply long-term benefits on body composition and physical fitness in preschoolers. Our findings using compositional data analysis corroborate our previously published results using isotemporal analysis.

Background: Across the 24-h day time spent in movement behaviours (MB), including physical activity (PA), sedentary behaviour (SB) and sleep may have distinct health consequences. However, no previous studies have examined combinations of time spent by children in all domains of MBs using a 24h time-use approach.  Among Asian children, we aimed to identify 24h-MB profiles based on night-time sleep, SB, light PA, moderate PA (MPA), and vigorous PA (VPA) and to describe how profiles changed from age 5.5 to 8 years.

Methods: Children in the Growing Up in Singapore Towards healthy Outcomes (GUSTO) cohort were asked to wear an accelerometer on their wrist for seven consecutive days at ages 5.5 and 8 years to measure 24h-MB patterns. This analysis included children with valid data for at least two weekdays and one weekend day at both time-points (n=442). We used latent profile analyses to identify 24h-MB profiles, which were given animal names to convey key characteristics. Latent transition analyses were used to describe the profile membership transition from ages 5.5 to 8 years.  

Results: We identified four profiles, “Rabbits” (very high-MPA/VPA, low-SB and average-night-sleep), “Chimpanzees” (high-MPA, low-SB and average-night-sleep), “Pandas” (low-PA, high-SB and longer-night-sleep) and “Owls” (low-PA, high-SB and short-night-sleep), across the time-points. At ages 5.5 and 8 years, the majority of children were classified into profiles of “Chimpanzees” (51% and 39%, respectively) and “Pandas” (24% and 37%, respectively). Most children in the “Rabbits” (100%) and the “Chimpanzees” (>90%) profile met PA recommendations, but few children met sleep recommendations across all four profiles at both time-points (≤25.3%). About half (50.7%) of the children changed their profiles from ages 5.5 to 8 years: the predominant transitions occurred from “Chimpanzees” (27%) and “Owls” (56%) profiles to “Pandas”.   

Conclusions: We identified four distinct 24h-MB profiles among children. About half the children changed their profiles from ages 5.5 to 8 years; the predominant transition being towards lower PA, higher SB and longer sleep duration. These findings shed light on distinct patterns of 24h-MB in children, which can aid development and implementation of public health strategies to promote better health. 

Purpose: The study determined if longitudinal relationships exists between overweight and academic performance of girls in their primary school years in the North West Province of South Africa, and if physical fitness can affect this relationship. It was hypothesized that overweight will exert a negative impact on academic achievement while physical fitness can bring about a mediation effect on this relationship. The novelty of the study lies in the longitudinal analysis of the effects of various contributors in this relationships over 7 school years.

Methods: Primary school girls (N=172), aged 6-13 years-old partake in this random stratified longitudinal research design including three follow-up measurements over seven years. Body Mass Index was used to compile obesity profiles, while the progressive aerobic cardiovascular endurance run (PACER) was used to determine cardiovascular fitness. Academic school achievements for grades 1, grade 4 and grade 7, as well as national and provincial values were correlated with academic performance. Data were analysed by a repeated measure over time ANOVA as well using a latent growth curve model from the structural equation modelling framework (SEM).

Results/findings: No differences (p>0.05) were found in the academic performance of obese and normal weight girls, although obese girls showed poorer physical fitness values (p<0.05). The SEM model was a good fit for all requirements (RMSEA, 0.60; CMIN DF, 2.837; CFI, 0.966). VO₂max had a standardized indirect mediation effect (-132) while body composition showed a standardized direct effect (0.183) with academic achievement. Physical fitness showed a mediation effect regarding obesity and academic achievement in grade 7 girls.

Conclusions: Overweight contribute to multiple health risks in children, while also impacting negatively on educational performance Physical fitness can impact outcomes beyond health related measures. It can play a mediating role in combating the negative effects of being overweight, showing reversible effects on relationships between obesity and academic achievement. Physical fitness should be used strategically as preventive measures to enhance cognitive functioning, academic performance and brain health among overweight children.

Purpose: Physical activity (PA) has a myriad of benefits including better physical and mental health. Encouraging parents to take part in PA with children may have additional benefits such as improved parent-child relationships. In this study, we designed and evaluated the effectiveness of a family-based intervention aimed to increase co-PA in parent-child dyads.

Methods: A randomized controlled design was used to evaluate the Active 1+FUN intervention. Parents and children (mean age = 10.0; 40% were girls) from 171 families were included in the trial. Co-PA between parents and children were measured using the proximity function of the ActiGraph wGT3X-BT accelerometers. Randomization (by family) took place after the outcomes were measured at baseline (T1). Families allocated to the experimental group then received a 10-session intervention that consisted of a knowledge-base workshop (30 minutes) followed by a coach-led activity session (60 minutes). Co-PA was measured at the end of the intervention period (T2) and 12 months from baseline (T3). Hierarchical linear modeling was used to examine changes in co-PA from T1 to T2 and T1 to T3, respectively.

Results/findings: Overall daily co-PA of participants were low (7.3, 7.4, and 4.7 minutes per day at T1, T2, and T3, respectively). The Time*Group interaction from T1 to T2 (B=0.99, p=.65), or T1 to T3 (B=-1.27, p=15) were not significant. However, our results also suggested that families in the experimental group spent more time in co-PA in both T1 (B=2.76, p=.046) and T2 (B=3.74, p=.02).

Conclusions: The hypothesized intervention effect was not found in this study, which may be attributed to differences in co-PA levels at baseline. However, family-based activities should be promoted since it may enhance the activity levels of both generations. Despite the lack of findings, we demonstrated that Bluetooth-enabled accelerometry is a viable objective measure for co-PA. Future research may continue to employ this method to examine family-based activities.

Purpose: South Africa launched 24-hour movement guidelines for birth to five years in 2018, and was the first low- and middle-income country (LMIC) to develop such guidelines. The guideline dissemination plan adopted a ‘train-the-trainer’ through workshops with community-based organisations (CBOs) working in early childhood development (ECD). The purpose of this study was to: 1) document this dissemination process; and 2) report on the feasibility of implementing the dissemination workshops, the acceptability of the workshops (and guidelines) for different end user groups, and the extent to which CBO representatives disseminated the guidelines to end-users. 

Methods: A database of ECD CBOs was compiled, and based on responses, fifteen dissemination workshops were held in seven of South Africa’s nine provinces with a total of 323 attendees. A short evaluation questionnaire was used (n=281), and group discussions took place to obtain participants’ feedback. Additionally, a song about the guidelines was developed – ‘Woza, Mntwana’, as a creative dissemination resource. Six follow-up focus groups (n=28)  were conducted to evaluate the extent to which workshop attendees disseminated the guidelines to their CBO staff and end-users, and to obtain feedback on the campaign song. Descriptive statistics were generated for questionnaire data, and qualitative data were analysed using a thematic approach.  

Results: The majority of participants were positive about the workshops: 96% agreed/strongly agreed that the workshop helped them to understand 24-hour movement behaviour, why these behaviours are important for young children, and how to share the guidelines. Questionnaire and qualitative findings also indicated that these workshops were feasible for community-based dissemination of the guidelines, and that this method of dissemination was acceptable to CBOs and end-users. Findings from follow-up focus groups indicate that the guidelines were shared with end-users, although challenges were identified. An additional guideline resource, the ‘Woza, Mntwana’ song, was well-received by participants, and sharing via WhatsApp was believed to be the most effective way to disseminate this song. 

Conclusions: These findings affirm the need for community-based dissemination of behavioural guidelines, particularly in low-income settings. These findings are relevant for other LMICs and high-income countries where low-income communities would benefit from a community-based approach.