Background: Interventions using advanced activity trackers and smartphone apps have demonstrated their ability to increase physical activity in children and adults. However, they have not been tested in families. Further, very few family-based interventions have actively involved both parents.

Purpose: This pilot study investigated the feasibility of increasing physical activity in the entire family using age-specific activity trackers and apps. Intervention feasibility was assessed in mothers, fathers and children aged 6-10 years.

Methods: Between May 2017 and January 2019, 40 families participated in the 6-week Step it Up Family Program in Queensland, Australia. Using commercial activity trackers combined with apps (Garmin Vivofit Jr for children, Vivofit 3 for adults), this pre/post intervention included individual and family-level goal setting, self-monitoring and performance feedback, family step challenges, family social support and modelling, weekly motivational text messages, and a face-to-face introductory session. Parent surveys, family telephone interviews and activity tracker/app recordings were used to assess intervention feasibility (recruitment, retention, engagement as per activity tracker and app usage, perceived usefulness). Descriptive statistics and qualitative content analysis were applied for analyses.

Results: Of 76 recruited families, 40 families including mothers (39/98%), fathers (33/83%) and children (58/84%) participated in the intervention. Twenty-nine of the 40 families completed the post intervention survey (73% retention; mothers: 70%, fathers: 58%). Families recorded steps using the activity trackers and apps for an average of 36 out of 42 intervention days (mothers: 37 days, fathers: 36 days, children: 34 days). Most parents (mothers: 96%, fathers: 87%) and children (94%) found the activity trackers useful for increasing their physical activity. Similarly, most parents (mothers: 93%, fathers: 83%) and children (96%) considered the app useful for increasing physical activity. Parents reported that the Step it Up Family Program increased their awareness of physical (in)activity levels in the family, and improved family quality time and connections.

Conclusions: This pilot study demonstrates feasibility of increasing physical activity in the entire family using age-specific activity trackers and apps. Using this technology, both mothers and fathers can be easily and actively involved in a family-based intervention. The findings support the implementation of a RCT to examine intervention efficacy.

Background: Interventions using activity trackers and smartphone apps have demonstrated their ability to increase physical activity in children and adults. However, they have not been tested in entire families. Further, few family-centred interventions have actively involved both parents, and assessed intervention efficacy separately for children, mothers and fathers.

Purpose: This study examined the short-term efficacy of an activity tracker and app intervention to increase physical activity in the entire family (children, mothers and fathers).

Methods: This was a single arm pilot intervention study with pre-post measures. Between 2017-2018, 40 families (58 children aged 6-10 years, 39 mothers, 33 fathers) participated in the 6-week Step it Up Family program in Queensland, Australia. Using commercial activity trackers combined with apps (Garmin Vivofit Jr for children, Vivofit 3 for adults), the intervention included individual and family-level goal setting, self-monitoring, performance feedback, family step challenges, family social support and modelling, weekly motivational text messages, and an introductory session delivered face-to-face or via telephone. Parent surveys were used to assess intervention efficacy measured as pre-post intervention changes in moderate-to-vigorous physical activity (MVPA) in children, mothers and fathers.

Results: Thirty-eight families completed the post intervention survey (95% retention). At post intervention, MVPA had increased in children by 58 min/day (boys: 54 min/day, girls: 62 min/day; all p<.001). In mothers, MVPA increased by 27 min/day (p<.001), and in fathers, it increased by 31 min/day (p<.001). Furthermore, the percentage of children meeting Australia’s physical activity guidelines for children (≥60 MVPA min/day) increased from 34% to 89% (p<.001). The percentage of mothers and fathers meeting Australia’s physical activity guidelines for adults (≥150 MVPA min/week) increased from 8% to 57% (p<.001) in mothers, and from 21% to 68% (p<.001) in fathers.

Conclusions: Findings suggest that an activity tracker and app intervention is an efficacious approach to increasing physical activity in entire families to meet national physical activity guidelines. The Step it Up Family program warrants further testing in a larger, randomised controlled trial to determine its long-term impact.

Purpose

Participation in physical activity is influenced by social norms and the behaviour of friends and family. Young people have a lot of exposure to their immediate family and it is thought that the health behaviours of their parents may be particularly influential. However, this may vary across the lifespan of a young person and there is limited empirical evidence that substantiates this at a population level. We aim to use existing data to explore the association between parent and child physical activity levels.

Methods

We examined data for health-enhancing recreational physical activity duration from the nationally representative 2016-2019 Active NZ survey. We matched the data of young people with that of an adult parent living in the same household (n=8,837 pairs). We used logistic regressions to examine whether a parent meeting national physical activity recommendations (150minutes/week) was associated with their child’s physical activity levels adjusted for age, sex, education and ethnicity. We repeated this analysis for incremental increases in the adult’s weekly physical activity duration and also stratified according to school-level (primary, intermediate, secondary).

Results

There was a positive association between child physical activity duration and whether their parent met the national recommendations (OR=1.44, 95%CI:1.31-1.58). A parent doing any physical activity was also positively associated with child physical activity levels (OR=1.30, 95%CI:1.17-1.44). This association strengthened as the weekly duration of parent physical activity increased to 60-minutes (OR=1.35, 95%CI:1.22-1.50), 120-minutes (OR=1.36, 95%CI:1.23-1.50), 180-minutes (OR=1.46, 95%CI:1.33-1.60), and 240-minutes (OR=1.57, 95%CI:1.43-1.72), before weakening slightly for 300-minutes (OR=1.53, 95%CI:1.40-1.67) and 360-minutes (OR=1.51, 95%CI:1.38-1.66). The associations with parent physical activity levels were stronger for younger children.

Conclusion

Parents who do any physical activity are more likely to have children who are active. The likelihood a child will be physically active appears to increase as their parent’s physical activity duration increases in hourly increments up to four hours at which point it plateaus. The influence of parental physical activity behaviour appears to reduce as their children get older. Further research is indicated to establish causation, but our results suggest that family focussed interventions to promote physical activity are likely to be effective in New Zealand. 

Purpose: Weight gain and academic loss during summer are concerns for low-income U.S. children. This may be explained by limited access to health and academic summer programming. This study examined the impact of health and academic focused summer programming on children’s health behaviors, BMI z-scores, and reading proficiency. 

Methods: Healthy Summer Learners (HSL) a 6-week summer program operated from 8:00am-3:30pm in two low-income elementary schools. HSL provided reading instruction, physical activity, nutrition education, and breakfast, lunch, and a snack. The schools also operated a 6-week summer program exclusively focused on academics that provided breakfast and lunch. Participants (N=193, 6-9 years) attended HSL (n=60), academic-only (n=67) or no program (control, n=66). Height and weight and reading percentile on a standardized national test were collected before and following summer. Fitbit Charge 2^© measured participants’ physical activity and sleep while parents reported their child’s diet and screen time twice weekly throughout summer. Daily logs tracked attendance for HSL and academic-only programs; parents of control children reported summer program attendance via daily diaries. Multilevel linear regression estimated differences in behaviors on program days and changes in reading percentiles and BMI z-score over the summer.

Results: On days children attended a summer program, children engaged in statistically significantly(p<0.05) more MVPA, less sedentary, and less screen time, while going to bed and waking earlier than control children. Intent-to-treat analysis showed no statistically significant group-by-time differences in BMI z-score or reading percentiles. As treated analysis (accounting for HSL and academics-only children who never attended and control children attending structured summer programming) showed children who attended a program during the summer gained -0.08 (95CI=-0.15, -0.02) less BMI z-score than those not attending a program, but no difference in reading percentile changes.

Conclusions: Attending structured programing, regardless of program focus, can impact children’s health behaviors and zBMI during the summer. Strategies to increase attendance at these programs are needed if they are to impact all children.

Purpose: After school programs are a promising setting to promote children’s physical activity (PA). However, program staff may lack the motivation or capacity to structure the environment or implement evidence-based strategies to promote PA. The purpose of this study was to evaluate the impact of a brief staff training based on contemporary theoretical approaches on PA among children attending an after school program.

Methods: Two Boys and Girls Club (BGC) after school sites participated in this quasi-experimental study. Four days of data were collected from each site in February 2019 (baseline) and May 2019 (follow-up). Data collection included accelerometer-measured PA of participating children (n=27 per site) and direct observation of BGC staff behaviors (frequency of PA encouragement and discouragement). Following baseline data collection, BGC staff at site 1 attended a 30-minute training, which incorporated principles from the Theory of Expanded, Extended, and Enhanced Opportunities (TEO) and the Supportive, Active, Autonomous, Fair, Enjoyable (SAAFE) framework. Staff identified strategies to allocate more time to PA and free play and facilitate a variety of games to promote PA among all children. Site 2 served as a comparison group. Changes in sedentary time, light activity, and moderate-to-vigorous physical activity (MVPA) were compared between sites using independent samples t-tests (alpha = 0.05). Children with at least two days with >30 minutes of wear time at both time points were included in a complete case analysis.

Results: Significant differences between sites were observed for all variables. Relative to the comparison group, children at the intervention site decreased sedentary time by 14.4 min/day (p=.04, 95%CI=1.3-27.7 min/day), and increased light activity and MVPA by 8.8 (p=.007, 95%CI=2.7-14.7 min/day) and 6.8 minutes (p=.002, 95%CI=2.9-10.7 min/day), respectively. The ratio of staff encouragement to discouragement improved from 40% to 94% at site 1, compared to 51% and 59% at site 2.

Conclusions: The application of TEO and SAAFE principles with leaders of an after school program shows promise for increasing children’s PA in this setting. Future studies should examine the effectiveness of these approaches across a wider range of after school programs and explore sustainable strategies for conducting staff training.

Purpose: Curriculum-integrated dance programmes are an under-researched strategy to increase children’s physical activity, particularly in the New Zealand (NZ) primary school context. The purpose of this study was to evaluate an integrated dance intervention on NZ schoolchildren’s physical activity (PA), and to explore children’s perceptions of dance as a form of learning and fitness.

Methods: A total of 134 schoolchildren aged 8 - 9 years were recruited from four primary schools in Auckland, NZ. Each school was randomly assigned to either the dance group (DG; n = 78) or the control group (CG; n = 56). The DG participated in a six-week, curriculum-integrated dance programme with their teacher during school time. In addition to focussing on curricular learning (such as science, mathematics, English, and Māori culture), the dance programme also embedded activities related to fitness and coordination. The intensity of PA varied according to the focus of each dance session. PA was measured at baseline and post-intervention using waist-mounted ActiGraph GT3X+ accelerometers for eight consecutive days. 

DG participants also shared their perceptions of the dance programme through journal reflections and focus group interviews. Intervention effects on sedentary, light, moderate, and vigorous physical activity and daily step counts were examined using generalised linear models. Qualitative data from children’s journal writing and focus group interviews were coded and thematically analysed.

Results: There were no significant effects of the dance programme on step counts or PA levels; however, DG children did perceive the dance programme to be a form of intense physical activity as themes pertaining to fitness, energy, movement, and exercise emerged. This overlapped with other themes related to cognition and curricular learning.  

Conclusions: While the dance programme in this study did not influence daily physical activity, qualitative findings suggested that children felt energised and active after the dance sessions. This adds to the literature surrounding children’s perceptions towards movement-based learning and embedding dance into primary school teaching.