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Background ActiGraph accelerometers are a widely used tool to objectively measure physical activity (PA) behavior in young children and several validated cut-point sets exist to estimate time spent in different PA intensities (sedentary time, light PA, moderate-to-vigorous PA). Applying different cut-point sets leads to large and meaningful differences in results. So far, only cut-point sets validated for the vertical axis have been compared and only the influence on time spent in moderate-to-vigorous PA has been analyzed. Methods A range of validated cut-point sets with their respective epoch length was applied to analyze cross-sectional data of the Swiss Preschoolers’ Health Study (SPLASHY): 1) Vertical axis in combination with an epoch length of 15 s (VA-15), 2) Vertical axis in combination with an epoch length of 60 s (VA-60) and 3) Vector magnitude in combination with an epoch length of 60 s (VM-60). PA was measured for eight consecutive days using ActiGraph accelerometers (wGT3X-BT). Three days were required to be included in the analysis (minimum two weekdays and one weekend-day with at least ten hours recording per day). Results Four hundred forty-five preschoolers (mean age 3.9 ± 0.5 years; 46% girls) had valid accelerometer measurements. A longer epoch (VA-60 vs VA-15) resulted in 2% less sedentary time (ST), 18% more light PA (LPA) and 51% less moderate-to-vigorous PA (MVPA); using the vector magnitude compared to the vertical axis (VM-60 vs VA-60) resulted in 34% less ST, 27% more LPA and 63% more MVPA (all p ≤ 0.001). Comparing all three sets of cut-points, ST ranged from 4.0 to 6.2 h, LPA from 5.1 to 7.6 h and MVPA from 0.8 to 1.6 h. Conclusions Estimated time spent in different PA intensities was strongly influenced by the choice of cut-point sets. Both, axis selection and epoch length need to be considered when comparing different studies especially when they relate PA behavior to health. The differences in the prevalence of children fulfilling PA guidelines highlight the relevance of these findings. Trial registration Current Controlled Trials ISRCTN41045021 (date of registration: 21.03.2014). Electronic supplementary material The online version of this article (10.1186/s12889-019-6837-7) contains supplementary material, which is available to authorized users.

BACKGROUND: Minority groups have a lower health-related quality of life (HRQOL), but there is little information if this finding also applies to children. In this study, we compared HRQOL between young children with and without migrant parents. METHODS: Two cross-sectional studies of culturally diverse preschool populations in Switzerland: Ballabeina (40 preschools, 258 girls and 232 boys aged 4 to 6 years) and Youp'la Bouge (58 child care centers, 453 girls and 522 boys aged 2 to 4 years). Most children were born in Switzerland (Ballabeina: 92.3%; Youp'la Bouge: 93.7%). Number of migrant parents was considered as the main exposure. HRQOL was measured using the 23-item Pediatric Quality of Life Inventory. RESULTS: Children of migrant parents had a significantly lower HRQOL total score (mean +/- SD, Ballabeina: 84.2 +/- 9.1; 82.7 +/- 9.6 and 81.7 +/- 11.7 for children with none, one or two migrant parents, respectively; Youp'la Bouge: 83.8 +/- 8.6; 82.9 +/- 9.5; 80.7 +/- 11.7, all p > 0.05). Similar results were found in Ballabeina and Youp'la Bouge for social, school and physical functioning (all p > 0.05), but not for emotional functioning. The differences in HRQOL measures were partly mediated by children's place of birth, parental education, paternal occupational level, children's BMI, screen time and physical activity in one study (Ballabeina), but not in the other (Youp'la Bouge). CONCLUSION: In preschoolers, children of migrant parents have lower HRQOL than children of non-migrant parents. These differences are only partly mediated by other sociocultural characteristics or lifestyle behavior. These families may need assistance to prevent further inequalities.

Background Childhood obesity and physical inactivity are increasing dramatically worldwide. Children of low socioeconomic status and/or children of migrant background are especially at risk. In general, the overall effectiveness of school-based programs on health-related outcomes has been disappointing. A special gap exists for younger children and in high risk groups. Methods/Design This paper describes the rationale, design, curriculum, and evaluation of a multicenter preschool randomized intervention study conducted in areas with a high migrant population in two out of 26 Swiss cantons. Twenty preschool classes in the German (canton St. Gallen) and another 20 in the French (canton Vaud) part of Switzerland were separately selected and randomized to an intervention and a control arm by the use of opaque envelopes. The multidisciplinary lifestyle intervention aimed to increase physical activity and sleep duration, to reinforce healthy nutrition and eating behaviour, and to reduce media use. According to the ecological model, it included children, their parents and the teachers. The regular teachers performed the majority of the intervention and were supported by a local health promoter. The intervention included physical activity lessons, adaptation of the built infrastructure; promotion of regional extracurricular physical activity; playful lessons about nutrition, media use and sleep, funny homework cards and information materials for teachers and parents. It lasted one school year. Baseline and post-intervention evaluations were performed in both arms. Primary outcome measures included BMI and aerobic fitness (20 m shuttle run test). Secondary outcomes included total (skinfolds, bioelectrical impedance) and central (waist circumference) body fat, motor abilities (obstacle course, static and dynamic balance), physical activity and sleep duration (accelerometry and questionnaires), nutritional behaviour and food intake, media use, quality of life and signs of hyperactivity (questionnaires), attention and spatial working memory ability (two validated tests). Researchers were blinded to group allocation. Discussion The purpose of this paper is to outline the design of a school-based multicenter cluster randomized, controlled trial aiming to reduce body mass index and to increase aerobic fitness in preschool children in culturally different parts of Switzerland with a high migrant population. Trial Registration Trial Registration: clinicaltrials.gov NCT00674544

Background Both individual socio-cultural determinants such as selected parental characteristics (migrant background, low educational level and workload) as well as the regional environment are related to childhood overweight and physical activity (PA). The purpose of the study was to compare the impact of distinct socio-cultural determinants such as the regional environment and selected parental characteristics on adiposity, PA and motor skills in preschool children. Methods Forty preschools (N = 542 children) of two culturally different urban regions (German and French speaking part of Switzerland) participated in the study (Ballabeina Study). Outcome measures included adiposity (BMI and skinfold thickness), objectively measured sedentary activities and PA (accelerometers) and agility performance (obstacle course). Parental characteristics (migrant status, educational level and workload) were assessed by questionnaire. Results Children from the French speaking areas had higher adiposity, lower levels of total and of more intense PA, were more sedentary and less agile than children from the German speaking regions (percent differences for all outcome parameters except for BMI ≥10%; all p ≤ 0.04). Differences in skinfold thickness, sedentary activities and agility, but not in PA, were also found between children of Swiss and migrant parents, though they were ≤8% (p ≤ 0.02). While paternal workload had no effect, maternal workload and parental education resulted in differences in some PA measures and/or agility performance (percent differences in both: ≤9%, p ≤ 0.008), but not in adiposity or sedentary activities (p = NS). Regional differences in skinfold thickness, PA, sedentary activities and agility performance persisted after adjustment for parental socio-cultural characteristics, parental BMI and, where applicable, children's skinfolds (all p ≤ 0.01). Conclusions The regional environment, especially the broader social environment, plays a prominent role in determining adiposity, PA and motor skills of young children and should be implicated in the prevention of obesity and promotion of PA in children. Trial Registration clinicaltrials.gov NCT00674544