Purpose: Little is known regarding the sleep habits of youth who have experienced trauma. Further, less is known about how sleep and adversity impact neurocognition throughout adolescence. The purpose of this study was to examine the association between adversity, sleep quality (via social jetlag), and neurocognitive performance within the Adolescent Brain Cognitive Development (ABCD) study.
Methods: Data comes from five (2016/2018 – 2020/2022) waves of the longitudinal cohort ABCD study dataset. Social Jetlag was captured through the Munich Chronotype Questionnaire (MCTQ), and a threshold of greater than one hour was identified for logistic regressions. Adversity was identified by compiling sixteen available questions from the Pediatric Early Adversity and Related Life Events (PEARLS) scale. Neurocognition was measurd by the NIH Flanker task. Mixed-effects linear and logistic regressions were used to examine odds of greater than one hour of social jetlag (a measure of poor sleep quality) given adversity (>3 PEARLS) and neurocognitive performance via the Flanker task given previous adversity. Finally, we tested whether sleep quality moderated the relationship between adversity and cognitive performance. Sex, age, race/ethnicity, and income were included in models as covariates.
Results: The analytical sample included N=8,273 adolescents (12.56 years, SD= 1.16 years, 47.43% female). Of the sample, %71.70 reported having greater than one hour of social jetlag per week. %50.80 reported more than one PEARL. Logistic regression analysis revealed that greater adversity was associated with increased odds of experiencing greater social jetlag (OR=1.91, 95%CI= 1.48, 2.47). Upon stratification by sex, girls who had experienced more than three pearls were more than twice as likely (OR=2.15, 95%CI= 1.48, 3.11) to experience greater than one hour of social jetlag. The moderation analysis revealed a trending association in that individuals who had experienced adversity and greater social jetlag performed worse on the cognitive test, albeit the association did not reach statistical significance (Coef. -0.73, 95%CI= -1.95, 0.48).
Conclusions: Findings highlight the association between early adversity and sleep quality during adolescence. Addressing early adversity may be crucial in promoting healthy sleep in adolescents. More studies using objective measures are needed to understand the relationship between sleep, adversity, and cognitive function.

PURPOSE: While heart rate (HR) has been used in studies for the surveillance of physical activity (PA) in children, less is known about its utility as an intervention tool to target moderate- to vigorous- physical (MVPA) activity in this population. Strategies are needed to inform how best to educate children about their HR and HR zones, and how to use these data to adjust their effort during MVPA to reach their exercise goals.
METHODS: We aimed to help children learn about their HR and HR zones (5-zone model), explore the impact of exercise on their HR, and attempt to keep their HR in a target zone during exercise. During an interactive session, children (n=11, 9-12 years old, English speaking, no limitations to PA) wore an HR chest strap and used our custom smartwatch app to monitor their HR during two short exercise trials. During exercise, the child used our smartwatch app to view their real-time HR and HR zone. In a semi-structured interview, we explored their understanding of the HR concepts and comfort with targeting HR zones during MVPA, and provided feedback on exercise intervention materials. Interviews were recorded, transcribed verbatim, and analyzed with an emerging themes approach.
RESULTS: Children were on average 10.4 years old, 55% male, and 82% Non-Hispanic White. Most had never learned about HR previously. Children responded well to the HR and HR zone educational materials, including grasping the concepts of intensity and effort during MVPA. Most were able to promptly implement this knowledge by managing their HR during the exercise trials to stay in a zone, adapting quickly to wearing the chest strap and using the smartwatch app. Most children preferred the 5-zone model of HR used during the study as opposed to a hypothetical 3-zone model that was offered as an alternative.
CONCLUSIONS: Overall, findings suggest children were able to understand HR concepts with simple instruction and visuals. The use of HR zones may be a feasible approach to target MVPA among children. Results of the study will inform intervention materials to be tested in a trial targeting increased MVPA via HR in children.

Purpose: This study aimed to evaluate the effects of Project Daire, a school-based food intervention study, on the diet diversity and diet quality of 6-7 and 10-11 year old children in Northern Ireland.
Methods: Fifteen primary schools were randomly assigned to one of four intervention arms over 6-months: Nourish, Engage, Nourish and Engage or Control (Delayed) in a randomized-controlled factorial trial. The ‘Nourish’ intervention modified the whole-school food environment and provided food-related experiences and exposure to locally-sourced foods. The ‘Engage’ intervention involved age-appropriate educational activities on nutrition, food and agriculture. Dietary information was collected at baseline and 6-months using age-appropriate food frequency questionnaires considering foods consumed at home, school and/or in total during a 24-hour period. Diet diversity score (DDS) and diet quality score (DQS) were determined based on adherence to the Eatwell Guide, the UK’s food-based dietary guidelines. Linear regression models were used to test the intervention effects, adjusting for baseline scores and accounting for school clustering.
Results: A total of 903 (n=445 aged 6-7 years and n=458 aged 10–11 years) children completed the study. 10-11 year old children who received the Nourish intervention had higher school DDS (adjusted mean difference=2.79, 95% CI 1.40 – 4.19; p=0.001) and total DDS (adjusted mean difference=1.55, 95% CI 0.66 – 2.43, p=0.002) compared to those who did not receive the Nourish intervention. Gender-specific analysis confirmed that the increases in school DDS in 10-11 year old children randomized to the Nourish intervention were maintained in both boys and girls (Boys: adjusted mean difference=2.4 95% CI 0.1 – 4.7, p=0.04; Girls: adjusted mean difference=3.1 95% CI 1.6 – 4.6, p=0.001). The increase in total DDS was, however, remained significant only among girls, with an adjusted mean difference of 1.9 (95% CI 1.1-2.7, p<0.0001). No other statistically significant differences were found.
Conclusions: This study highlights the potential of the multi-component approach employed in the Nourish intervention, which modified both food provision and environment, to promote diet diversity. Further research is required to develop sustainable implementation strategies for Daire and evaluate its long-term effectiveness. Trial registration number: NCT04277312

Purpose: The Supplemental Nutrition Assistance Program–Education (SNAP-Ed) is the largest community nutrition education program in the United States. Yet there is a notable gap in programming for expectant families and primary caregivers of infants and toddlers (caregivers). The purpose of this study was to conduct formative work for SNAP-Ed programming for caregivers in Kentucky.

Methods: From fall 2021 through winter 2023, we conducted three focus groups with SNAP-Ed educators (n=19), eight groups with caregivers (n=44), and 16 semi-structured interviews with community partners who serve caregivers. Each guide included questions about access to nutrition information, format for interactions, and priority topics. Discussions were recorded and transcribed. Codebooks aligning with interview guides were developed a priori. Thematic analysis was conducted in NVivo software.

Results: Many partners indicated they provide basic nutrition information but unanimously agreed more nutrition services are needed. Caregivers acknowledged receiving nutrition information from several partner agencies but noted their top three sources were mothers, doctors, and the internet. Most caregivers said they want to attend a class. Educators conveyed willingness to offer virtual classes; however, caregivers and partners mostly communicated preference for in-person, interactive sessions to build relationships and encourage engagement. Inclusion of other caregivers (e.g., grandparent) in programming was viewed important by caregivers and educators. Partners and educators perceived the greatest need for education for meal planning, budgeting, and cooking skills. Some partners perceived needs regarding knowledge about benefits of breastfeeding and introducing complementary foods. Caregivers noted many questions about introducing complementary foods but felt they understood the benefits of breastfeeding. Rather, they had more questions about milk supply, formula, and hunger and satiety cues. Some topics of interest extended beyond the scope of SNAP-Ed content (e.g., hygiene, child development).

Conclusions: To meet the needs of expectant and primary caregivers of infants and toddlers eligible for food assistance, educational content needs to build on SNAP-Ed foundations (e.g., diet quality, food resource management, food safety) to include infant feeding topics. Designing programs that include other caregivers and collaborations between educators and community programs could help expand social support and access to education and community resources for priority topics.

Purpose: Cardiorespiratory fitness (CRF) is associated with better health outcomes. Socioeconomic status (SES) and weight status may influence CRF. We examined associations among CRF, directly measured weight status, and self-reported SES.
Methods: Data were obtained from a cross-sectional study in which participants were recruited from thirty-nine primary schools in twenty administrative districts, across all ten provinces in Zimbabwe. After obtaining parental consent, participants were asked for assent before completing a self-administered survey which collected socio-demographic and other relevant data. We used Body Mass Index (kg/m2) z-scores derived from directly measured body weight and height to categorize participants as thin, healthy weight, overweight, or obese, using the WHO recommended cut-offs. We measured CRF using the 20-meter shuttle run test and the Leger equation to estimate VO2max. The 13-item Family Affluence Scale (collapsed into three categories: low, medium, high) was used to categorize SES. One-Way ANOVA with Tukey post-hoc-tests (multiple group) and independent t-tests (two group) comparisons were used to assess associations between CRF, SES and weight status. Statistical analyses were performed in SAS 9.4 with the alpha level set at 0.05.
Results: The mean age (sample n= 1825; 55% female) was 12.02 ± 0.94 years. The average estimated VO2max for the whole sample was 46.6 ± 4.78 mL/kg/min. Approximately 6%, 81%, 9%, and 4% of the participants were categorized as being thin, healthy weight, overweight, and obese respectively. Most participants (86%) had low, while 10%, and 4% had medium and high SES respectively. Participants with low SES had significantly higher VO2max compared to medium and high SES, (Mean difference in VO2max: 2.6; 3.2 mL/kg/min) respectively. We found significantly higher mean VO2max (p <.0001) with each increasing weight category, except between the overweight and obese categories. Males (48.0 ± 4.8 mL/kg/min) had significantly higher VO2max (p<.0001) compared to females (45.3 ± 4.4 mL/kg/min) as were participants from rural areas (48.0 ± 4.8 mL/kg/min) compared to their urban counterparts (45.9 ± 4.6 mL/kg/min) (p<.0001).
Conclusion: Our findings demonstrate that SES, weight status, residence, and sex may be important to consider when designing interventions for improving CRF in children and adolescents in Zimbabwe.

Purpose
Families experiencing both food insecurity and pediatric obesity face unique stressors that impact parental feeding practices. Certain parental feeding practices are known to help improve children’s diets and prevent excess weight gain. Checklists have been used successfully as minimal behavioral interventions in other contexts; it has potential to support parental development of adopting evidence-based feeding practices while minimizing stress. This study tested the convergent and predictive validity of the Family Feeding Checklist-Long Form and two versions of the Checklist-Short Form.

Methods
This observational study used a sample of Mechanical Turk (MTurk) users residing in the U.S. (N=600) who: were the parent of a child aged 6–11 years; had at least one child with overweight/obesity; had experienced food insecurity in the 12 months prior to the time of survey; and spoke English or Spanish. Families of children with major psychiatric or eating disorders, or children participating in a weight loss program at the time of survey were excluded. Participants received one of the three versions of the FFC (Long Form, Short Form A, Short Form B) and completed measures of perceived value, uniqueness of checklist items, likelihood of usage, social support, parental feeding (Child Feeding Questionnaire [CFQ], Caregiver Feeding Styles Questionnaire [CFSQ], Food Parenting Inventory [FPI]); and a Food Frequency Questionnaire (REAPS) assessing selected food groups including fruits/vegetables and sugar-sweetened beverages.

Results/findings
Descriptive summary will be derived from parent age, gender, income, education, and caregiver status (primarily responsible for meals, Y/N) of the sample. Correlations will be used to establish (a) convergent validity using the Checklist scores (A&B versions) with scores on the CFQ, CFSQ, and FPI, and (b) predictive validity using the Checklist scores with dietary patterns. Differences in perceived value, uniqueness, etc. between versions will be examined using linear regression model, both unadjusted and then adjusted salient confounding variables.

Conclusions
Results will examine validity of each version of the Family Feeding Checklist, help determine which version to proceed with in future studies and inform a larger randomized trial of the novel Checklist program for families experiencing both food insecurity and pediatric obesity.

Nan Dou (Presenting), Alysse J Kowalski, Yan Wang, Farah Qureshi, Maureen M Black, Erin R Hager (Corresponding)*

Purpose: The COVID-19 pandemic adversely impacted children’s health behaviors and exacerbated health disparities. To inform timely obesity-prevention interventions, this longitudinal cohort study aims to investigate pandemic-related changes in weight status and identify associated risk factors among school-age children from pre-, mid- (Fall 2021), and late-pandemic (Fall 2022).
Methods: The study included 367 children (mean age at pandemic onset: 8.6y, range 3.4-15.5y). At pre-pandemic, we collected demographics (child sex, age, race and ethnicity, and parental education). At pre-, mid-, and late-pandemic, we measured children’s weight and height to calculate BMI-for-age z-scores (BMIz), and collected family socioeconomic variables, including food insecurity, poverty, and federal assistance services and benefits. We used linear mixed models to examine changes in BMIz over time and identify demographic and socioeconomic risk factors.
Results: Children's BMIz increased from pre- to mid-pandemic (β= 0.09; 95% CI: 0.02, 0.16; p<0.01) and decreased from mid- to late-pandemic (β= -0.12; 95% CI: -0.20, -0.05; p<0.01), with no significant difference between BMIz at pre- and late-pandemic. After accounting for child sex, age, pre-pandemic weight status, race and ethnicity, and study follow-up time, we found an association between food insecurity and BMIz change, such that children experiencing food insecurity had a greater BMIz increase from pre- to mid-pandemic compared to children experiencing food security (β=0.20; 95% CI: 0.04, 0.36; p=0.013). Other demographic and socioeconomic factors were not associated with BMIz change.
Conclusion: School-aged children experienced increased weight gain at mid-pandemic, while pandemic control policies were in place (including school closures) but returned to pre-pandemic weight status upon the lifting of these restrictions. Pre- to mid-pandemic changes were more evident in the context of food insecurity. Leveraging longitudinal data spanning from pre-pandemic through two years post-pandemic, our study suggests that rapid and early interventions are needed to prevent children’s weight gain during such crises, particularly tailored to children in food insecure families. Future studies are needed to identify underlying mechanisms (e.g. change in family routines and health behaviors) that trigger child weight change and that monitor the impact of short-term weight gain on future health.

Psychometric Properties of a Virtual Physical Literacy Assessment for Preschool-aged Children

Joshua Li1 (presenting author), Morgan Potter1 (corresponding author), Madison Boyd1 (corresponding author), Ramiah Moldenhauer1 (corresponding author), Yeongho Hwang1 (corresponding author), Jayleen Hills1 (corresponding author), Patti-Jean Naylor2 (corresponding author), Ryan E. Rhodes2 (corresponding author), Sam Liu2 (corresponding author), Jean Buckler2 (corresponding author), and Valerie Carson1 (corresponding author)

1Faculty of Kinesiology, Sport, and Recreation, University of Alberta
2 Department of Exercise Science, Physical & Health Education, Faculty of Education, University of Victoria

Purpose: The PLAYshop program is a parent-focused physical literacy intervention for early childhood. A virtual protocol to assess physical literacy (i.e., fundamental movement skills (FMS) and motivation and enjoyment) in preschool-aged children during COVID-19 was developed. The primary objective of the study was to examine the psychometric properties of the virtual physical literacy assessment.

Methods: Baseline data from the PLAYshop randomized control design was used. Participants included 130 preschool-aged children (3-5 years) and their parents from British Columbia and Alberta. At baseline, five FMS (overhand throw, underhand throw, horizontal jump, hop, one leg balance) were measured via a recorded virtual Zoom meeting using the Test of Gross Motor Development – Third Edition (TGMD-3) and the Movement Assessment Battery for Children-Second Edition (MABC-2) tools. All TGMD-3 skill videos were scored by one rater and 10% (n=13) of videos were scored by a second rater. Motivation and enjoyment was assessed via parental-report using four items from the Preschool Physical Literacy Assessment (PrePLAy) and self-report using an adapted Five Degrees of Happiness single-item Likert scale for children. Additionally, children’s accelerometer-derived physical activity and age were measured. Intraclass Correlation Coefficients (ICCs), Cronbach’s alphas (α), and Spearman’s rank correlation coefficients (rs) were calculated.

Result/findingss: Inter-rater reliability for TGMD-3 FMS ranged from ICC=0.96-0.99. Internal consistency reliability for TGMD-3 FMS was α=0.59 and for parental-reported motivation and enjoyment was α=0.71. For convergent validity, total physical activity was significantly positively correlated with all FMS (rs0.20-0.24), except horizontal jump. For motivation and enjoyment, a significant positive correlation was also observed between moderate- to vigorous-intensity physical activity (MVPA) and the parental-report measure (rs=0.23). For construct validity, age was significantly positively correlated with all FMS (rs=0.27-0.62) but not motivation and enjoyment.

Conclusions: Findings indicate initial support for the PLAYshop program physical literacy assessment tool. Though FMS should not be combined into a total FMS score and the self-report motivation and enjoyment score should be interpreted with caution.

Keywords: Physical literacy, pre-school, fundamental movement skills