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Creativity is important for school performance. As several brain mechanisms involved in creativity are stimulated by low-intensity physical activity, standing might influence creativity. Few studies on the relationship between standing and creativity have been executed, and none among vocational education and training (VET) students. Therefore, the aim of this study was to investigate whether standing influences creativity in VET students. In a randomized crossover study, 192 VET students were randomly allocated to standing or sitting (i.e., control) for 30 min. After 15 min, they performed two creativity tests: Guilford's Alternative Uses Test (divergent thinking) and Remote Associates Test (convergent thinking). Subsequently, conditions were switched, and the procedure was repeated. Multilevel analyses showed no significant effect of standing on divergent or convergent thinking test performance. Our results show that 30 min of standing does not affect creativity in VET students.

Aim: This systematic review aims to summarize evidence on correlates of fundamental motor skills in typically developing children aged 0–4 years. Methods: A literature search (PubMed, Embase, PsycINFO, and SPORTDiscus) was performed from 2000 till 23 May 2022. Inclusion criteria was cross-sectional and prospective studies examining associations between a potential correlate and fundamental motor skills in typically developing, apparently healthy children aged 0–4 years. Two independent reviewers performed screening and methodological quality assessment. Results: Eighty-three studies met eligibility criteria and were included. Thirteen studies were of high methodological quality. In children aged <1 year, we found no evidence for family income, breastfeeding-related, sleep-related, home environment, and socioeconomic variables. In children aged 1–2 years, we found no evidence for sex, growth-related variables, singleton birth, and family income. In children aged 2–4 years, we found no evidence for screen behavior, toxicity, parental education, family income, socioeconomic variables, and maternal depression/anxiety and moderate evidence for a positive association with early childhood education and care setting type. For other examined correlates, we found insufficient evidence (inconsistent findings or only one study available). Conclusions: We found insufficient evidence for over half of examined potential correlates of fundamental motor skills. We recommend investing in better research methodologies and improved reporting. [ABSTRACT FROM AUTHOR]

This study investigates if and to what extent the Dutch Obesity Intervention in Teenagers (DOiT) program was implemented as intended and how this affected program effectiveness. We collected data at 20 prevocational education schools in the Netherlands. We assessed seven process indicators: recruitment, reach, dosage, fidelity, satisfaction, effectiveness and continuation. Data collection involved teacher questionnaires (n = 110), adolescent questionnaires and adiposity measures (n = 938). Using multi-level confirmatory factor analyses, we applied an innovative method to obtain explorative implementation index scores. The percentage of accomplished activities ranged from 9% (for "closure meeting") up to 93% (for "obtaining support within the school for adoption"). The percentage of lessons delivered decreased from 74 to 18% towards the end of the program. Fidelity to the teacher manual ranged from 85 to 26%. In general, teachers were satisfied with the DOiT lessons and teaching materials. Despite teachers' satisfaction with the DOiT lessons and teaching materials, degree of program implementation was lower than expected, especially towards the end of the program. Further, some evidence was found for an association between a higher implementation index score and program effectiveness, but more research is needed to test the validity of the implementation index.

Background: The school-based Dutch Obesity Intervention in Teenagers (DOiT) program is an evidence-based obesity prevention program. In preparation for dissemination throughout the Netherlands, this study aimed to adapt the initial program and to develop an implementation strategy and materials. Methods: We revisited the Intervention Mapping (IM) protocol, using results of the previous process evaluation and additional focus groups and interviews with students, parents, teachers, and professionals. Results: The adapted 2-year DOiT program consists of a classroom, an environmental and a parental component. The year 1 lessons aim to increase awareness and knowledge of healthy behaviors. The lessons in year 2 focus on the influence of the (obesogenic) environment. The stepwise development of the implementation strategy resulted in objectives that support teachers' implementation. We developed a 7-step implementation strategy and supporting materials by translating the objectives into essential elements and practical strategies. Conclusions: This study illustrates how revisiting the IM protocol resulted in an adapted program and tailored implementation strategy based on previous evaluations as well as input from different stakeholders. The stepwise development of DOiT can serve as an example for other evidence-based programs in preparation for wider dissemination.

Research suggests that sedentary behavior (SB) is negatively associated with cognitive outcomes. Interrupting prolonged sitting has been shown to improve cognitive functions, including executive functioning (EF), which is important for academic performance. No research has been conducted on the effect of standing on EF in VET students, who make up a large proportion of the adolescent population and who are known to sit more than other students of this age. In this study, we investigated the acute effects of reducing SB by short time standing on EF in vocational education and training (VET) students. In a randomized crossover study, 165 VET students were first taught for 15 min in seated position. After this, they performed while seated the Letter Memory Test for updating, and the Color Shape Test for shifting and inhibition. Students were randomly assigned to a sitting or standing condition. All students were taught again for 15 min and then took the same tests in the condition they were allocated to, respectively, standing or seated. After 1 week, the test procedure was repeated, in which students switched conditions. Mixed model analyses showed no significant effect of sitting or standing on updating, shifting, or inhibition. Also, no significant differences were found for the order of condition on updating, shifting, or inhibition. Our results suggest that 40 min of standing does not significantly influence EF among VET students. [ABSTRACT FROM AUTHOR]

Abstract Background To date, most research on obesogenic environments facing school children has focused on physical and socio-cultural environments. The role of economic factors has been investigated to a much lesser extent. Our objective was to explore the association of micro-level economic factors and incentives with sports activities and intake of soft drinks and fruit juice in 10-12 year-old school children across Europe, and to explore price sensitivity in children’s soft drink consumption and correlates of this price sensitivity. Methods Data for the study originate from a cross-sectional survey undertaken in seven European countries (Belgium, Greece, Hungary, Netherlands, Norway, Slovenia and Spain) in 2010 among 10-12 year-old school children and their parents. In total, 7234 child questionnaires and 6002 parent questionnaires were completed. The child questionnaire included questions addressing self-reported weekly intake of soft drinks and fruit juices and time spent on sports activities, perception of parental support for sports activities, use of pocket money for soft drinks and perceived price responsiveness. Parent questionnaires included questions addressing the role of budget and price considerations in decisions regarding children’s sports activities, soft drink consumption, home practices and rules and socio-demographic background variables. Data were analysed using multiple linear regression and discrete-choice (ordered probit) modelling. Results Economic factors were found to be associated with children’s sports participation and sugary drink consumption, explaining 27% of the variation in time for sports activities, and 27% and 12% of the variation in the children’s soft drink and juice consumption, respectively. Parents’ financial support was found to be an important correlate (Beta =0.419) of children’s sports activities. Children’s pocket money was a strong correlate (Beta =21.034) of soft drink consumption. The majority of the responding children reported to expect that significantly higher prices of soft drinks would lead them to buy less soft drinks with their own pocket money, but a majority of parents did not expect higher soft drink prices to reduce their children’s soft drink consumption. Conclusions We conclude that economic factors, especially parents’ financial support and amount of pocket money, appear to be of importance for children’s sports participation and soft drink consumption, respectively.

Abstract Background Insight in parental energy balance-related behaviours, their determinants and parenting practices are important to inform childhood obesity prevention. Therefore, reliable and valid tools to measure these variables in large-scale population research are needed. The objective of the current study was to examine the test-retest reliability and construct validity of the parent questionnaire used in the ENERGY-project, assessing parental energy balance-related behaviours, their determinants, and parenting practices among parents of 10–12 year old children. Findings We collected data among parents (n = 316 in the test-retest reliability study; n = 109 in the construct validity study) of 10–12 year-old children in six European countries, i.e. Belgium, Greece, Hungary, the Netherlands, Norway, and Spain. Test-retest reliability was assessed using the intra-class correlation coefficient (ICC) and percentage agreement comparing scores from two measurements, administered one week apart. To assess construct validity, the agreement between questionnaire responses and a subsequent interview was assessed using ICC and percentage agreement. All but one item showed good to excellent test-retest reliability as indicated by ICCs > .60 or percentage agreement ≥ 75%. Construct validity appeared to be good to excellent for 92 out of 121 items, as indicated by ICCs > .60 or percentage agreement ≥ 75%. From the other 29 items, construct validity was moderate for 24 and poor for 5 items. Conclusions The reliability and construct validity of the items of the ENERGY-parent questionnaire on multiple energy balance-related behaviours, their potential determinants, and parenting practices appears to be good. Based on the results of the validity study, we strongly recommend adapting parts of the ENERGY-parent questionnaire if used in future research.

Abstract Background Screen time has been associated with pediatric overweight. However, it is unclear whether overweight predicts or is predicted by excessive amounts of screen time. The aim of this study was to examine the direction of the association between screen time and body fatness in Dutch adolescents. Methods Longitudinal data of 465 Dutch adolescents (mean age at baseline 13 years, 53% boys) was used. Body fatness (objectively measured BMI, four skin folds and waist- and hip circumference), self-reported time spent watching TV and computer use, and aerobic fitness (shuttle run test) were assessed in all participants at three time points during 12 months. Multi-level linear autoregressive analyses was used to examine whether screen time predicted body fatness in the following time period and whether body fatness predicted screen time. Analyses were performed for boys and girls separately and adjusted for ethnicity and aerobic fitness. Results Time spent TV viewing did predict changes in BMI and hip circumference in boys, but not in girls, in the subsequent period. Computer time significantly predicted increases in skinfolds in boys and girls and increases in BMI in girls. Body fatness did not predict any changes in screen time. Conclusion The present study only partly supports the widely posited hypothesis that higher levels of screen time cause increases in body fatness. In addition, this study demonstrates that high levels of body fatness do not predict increases in screen time.

Abstract Background Insight in children's energy balance-related behaviours (EBRBs) and their determinants is important to inform obesity prevention research. Therefore, reliable and valid tools to measure these variables in large-scale population research are needed. Objective To examine the test-retest reliability and construct validity of the child questionnaire used in the ENERGY-project, measuring EBRBs and their potential determinants among 10-12 year old children. Methods We collected data among 10-12 year old children (n = 730 in the test-retest reliability study; n = 96 in the construct validity study) in six European countries, i.e. Belgium, Greece, Hungary, the Netherlands, Norway, and Spain. Test-retest reliability was assessed using the intra-class correlation coefficient (ICC) and percentage agreement comparing scores from two measurements, administered one week apart. To assess construct validity, the agreement between questionnaire responses and a subsequent face-to-face interview was assessed using ICC and percentage agreement. Results Of the 150 questionnaire items, 115 (77%) showed good to excellent test-retest reliability as indicated by ICCs > .60 or percentage agreement ≥ 75%. Test-retest reliability was moderate for 34 items (23%) and poor for one item. Construct validity appeared to be good to excellent for 70 (47%) of the 150 items, as indicated by ICCs > .60 or percentage agreement ≥ 75%. From the other 80 items, construct validity was moderate for 39 (26%) and poor for 41 items (27%). Conclusions Our results demonstrate that the ENERGY-child questionnaire, assessing EBRBs of the child as well as personal, family, and school-environmental determinants related to these EBRBs, has good test-retest reliability and moderate to good construct validity for the large majority of items.

Abstract Background This study investigated the associations of physical characteristics and personality in adolescence with physical activity and sedentary behaviour in adulthood. Findings Physical characteristics (i.e. objectively measured BMI, sum of skin folds, MOPER test battery performance), and personality (i.e. self-reported inadequacy, social inadequacy, rigidity, self-sufficiency/recalcitrance, dominance, achievement motivation, facilitating anxiety, debilitating anxiety, and social desirability) were assessed in 217 adolescent boys (Mean 13.0, SD 0.6) and girls (Mean 12.9, SD 0.6). Twenty-nine years later, at the age of 42, their physical activity and sedentary behaviour were assessed by means of accelerometry. Boys who scored lower on self-sufficiency/recalcitrance and higher on facilitating anxiety spent more time sedentary in adulthood. Girls with a superior standing high jump performance, and a lower score on social desirability spent more time sedentary in adulthood. In contrast with sedentary behaviour, physical activity at age 42 year could not be predicted by physical characteristics or personality in adolescence. Conclusions Sedentary behaviour in adulthood was partly explained by physical characteristics and/or personality in adolescence. Thus, our results suggest that it may be possible to identify people who are at risk of becoming sedentary at a rather young age.

Abstract Background Obesity treatment is by large ineffective long term, and more emphasis on the prevention of excessive weight gain in childhood and adolescence is warranted. To inform energy balance related behaviour (EBRB) change interventions, insight in the potential personal, family and school environmental correlates of these behaviours is needed. Studies on such multilevel correlates of EBRB among schoolchildren in Europe are lacking. The ENERGY survey aims to (1) provide up-to-date prevalence rates of measured overweight, obesity, self-reported engagement in EBRBs, and objective accelerometer-based assessment of physical activity and sedentary behaviour and blood-sample biomarkers of metabolic function in countries in different regions of Europe, (2) to identify personal, family and school environmental correlates of these EBRBs. This paper describes the design, methodology and protocol of the survey. Method/Design A school-based cross-sectional survey was carried out in 2010 in seven different European countries; Belgium, Greece, Hungary, the Netherlands, Norway, Slovenia, and Spain. The survey included measurements of anthropometrics, child, parent and school-staff questionnaires, and school observations to measure and assess outcomes (i.e. height, weight, and waist circumference), EBRBs and potential personal, family and school environmental correlates of these behaviours including the social-cultural, physical, political, and economic environmental factors. In addition, a selection of countries conducted accelerometer measurements to objectively assess physical activity and sedentary behaviour, and collected blood samples to assess several biomarkers of metabolic function. Discussion The ENERGY survey is a comprehensive cross-sectional study measuring anthropometrics and biomarkers as well as assessing a range of EBRBs and their potential correlates at the personal, family and school level, among 10-12 year old children in seven European countries. This study will result in a unique dataset, enabling cross country comparisons in overweight, obesity, risk behaviours for these conditions as well as the correlates of engagement in these risk behaviours.

Abstract Background There is an urgent need for more carefully developed public health measures in order to curb the obesity epidemic among youth. The overall aim of the "EuropeaN Energy balance Research to prevent excessive weight Gain among Youth" (ENERGY)-project is the development and formative evaluation of a theory-informed and evidence-based multi-component school-based and family-involved intervention program ready to be implemented and evaluated for effectiveness across Europe. This program aims at promoting the adoption or continuation of health behaviors that contribute to a healthy energy balance among school-aged children. Earlier studies have indicated that school and family environments are key determinants of energy-balance behaviors in schoolchildren. Schools are an important setting for health promotion in this age group, but school-based interventions mostly fail to target and involve the family environment. Methods Led by a multidisciplinary team of researchers from eleven European countries and supported by a team of Australian experts, the ENERGY-project is informed by the Environmental Research Framework for Weight gain Prevention, and comprises a comprehensive epidemiological analysis including 1) systematic reviews of the literature, 2) secondary analyses of existing data, 3) focus group research, and 4) a cross European school-based survey. Results and discussion The theoretical framework and the epidemiological analysis will subsequently inform stepwise intervention development targeting the most relevant energy balance-related behaviors and their personal, family-environmental and school-environmental determinants applying the Intervention Mapping protocol. The intervention scheme will undergo formative and pilot evaluation in five countries. The results of ENERGY will be disseminated among key stakeholders including researchers, policy makers and the general population. Conclusions The ENERGY-project is an international, multidisciplinary effort to develop and test an evidence-based and theory-informed intervention program for obesity prevention among school-aged children.

Abstract Background The threats posed by the rising prevalence of overweight and obesity on public health have been widely acknowledged. Several population groups, which deserve special attention because of their higher prevalence rates, have been identified. These include adolescents and ethnic sub-groups. The aim of the present study was twofold: (1) to assess ethnic differences in body mass index (BMI) and in behaviours that are related to both energy intake and energy expenditure, and (2) to examine whether these behaviours explain the relationship between ethnicity and BMI. Methods We conducted a cross-sectional data analysis among 957 Dutch adolescents (mean age = 12.7 years). Body height and weight were measured using a standardized protocol. Adolescents completed a questionnaire on screen-viewing behaviour, physical activity, consumption of sugar-containing beverages, and consumption of high-caloric snacks. Results In our study sample 121 adolescents (= 13%) were of Non-Western origin. BMI was significantly higher in Non-Western adolescents (boys: 19.9 kg/m2, SD = 3.0, girls: 20.9 kg/m2, SD = 3.8) compared to Dutch adolescents (boys: 18.4 kg/m2, SD = 2.8, girls: 19.0 kg/m2, SD = 3.0). Our results show that time spent on television viewing, active commuting to school, and consumption of fruit juices partially mediated the association between BMI and ethnicity. Conclusion Behaviours related to both energy expenditure and energy intake may contribute to the ethnic differences in BMI in adolescents and should be considered when tailoring overweight prevention programs to ethnic subpopulations. Trial registration International Standard Randomised Controlled Trial Number ISRCTN87127361

Abstract Objectives This paper aims to identify the mediating mechanisms of a school-based obesity prevention program (DOiT). Methods The DOiT-program was implemented in Dutch prevocational secondary schools and evaluated using a controlled, cluster-randomised trial (September 2003 to May 2004). We examined mediators of effects regarding (1) consumption of sugar containing beverages (SCB); (2) consumption of high caloric snacks; (3) screen-viewing behaviour; and (4) active commuting to school. To improve these behaviours the DOiT-program tried to influence the following potentially mediating variables: attitude, subjective norm, perceived behavioural control, and habit-strength. Results Both in boys (n = 418) and girls (n = 436) the DOiT-intervention reduced SCB consumption (between group difference in boys = -303.5 ml/day, 95% CI: -502.4;-104.5, between group difference in girls = -222.3 ml/day, 95% CI: -371.3;-73.2). The intervention did not affect the other examined behaviours. In girls, no intervention effect on hypothetical mediators was found nor evidence of any mediating mechanisms. Boys in intervention schools improved their attitude towards decreasing SCB consumption, while this behaviour became less of a habit. Indeed, attitude and habit strength were significant mediators of the DOiT-intervention's effect (4.5 and 3.8%, respectively) on SCB consumption among boys. Conclusion Our findings imply that interventions aimed at EBRB-change should be gender-specific. Future studies aimed at reducing SCB consumption among boys should target attitude and habit strength as mediating mechanisms. Our study did not resolve the mediating mechanisms in girls. Trial registration International Standard Randomised Controlled Trial Number Register ISRCTN87127361

Background: The aim of the study was to examine the association of daily variations in rainfall and temperature with sedentary time (ST) and physical activity (PA) in European children. Methods: Children were included from 5 countries (Belgium, Greece, Hungary, the Netherlands, Switzerland) as part of the ENERGY-project. We used cross-sectional data from 722 children aged 10-12 years (47% boys). ST and PA were measured by accelerometers for 6 consecutive days, including weekend days. Weather data were collected from online national weather reports. Multilevel regression models were used for data analyses. Results: Maximum temperature was positively associated with light PA (β = 3.1 min/day; 95% CI = 2.4-3.8), moderate-to-vigorous PA (β = 0.6 min/day; 95% CI = 0.4-0.8), and average PA [β = 4.1 counts per minute (cpm); 95% CI = 1.6-6.5, quadratic relationship]. Rainfall was inversely and quadratically associated with light PA (β = -1.3 min/day; 95% CI = -1.9 to -0.6), moderate-to-vigorous PA (β = -0.6 min/day; 95% CI = -0.8 to -0.3), and average PA (β = -1.6 cpm; 95% CI = -2.2 to -0.9). Maximum temperature was not significantly associated with ST (β = -0.2 min/day; 95% CI = -1.0 to 0.6), while rainfall was positively associated with ST (β = 0.9 min/day; 95% CI = 0.6-1.3). Conclusion: The current study shows that temperature and rainfall are significantly associated with PA and ST in 10- to 12-year-old European children. [ABSTRACT FROM AUTHOR]

Abstract Background Only limited data are available on the development, implementation, and evaluation processes of weight gain prevention programs in adolescents. To be able to learn from successes and failures of such interventions, integral written and published reports are needed. Methods Applying the Intervention Mapping (IM) protocol, this paper describes the development, implementation, and evaluation of the Dutch Obesity Intervention in Teenagers (DOiT), a school-based intervention program aimed at the prevention of excessive weight gain. The intervention focussed on the following health behaviours: (1) reduction of the consumption of sugar-sweetened beverages, (2) reduction of energy intake derived from snacks, (3) decrease of levels of sedentary behaviour, and (4) increase of levels of physical activity (i.e. active transport behaviour and sports participation). The intervention program consisted of an individual classroom-based component (i.e. an educational program, covering 11 lessons of both biology and physical education classes), and an environmental component (i.e. encouraging and supporting changes at the school canteens, as well as offering additional physical education classes). We evaluated the effectiveness of the intervention program using a randomised controlled trial design. We assessed the effects of the intervention on body composition (primary outcome measure), as well as on behaviour, behavioural determinants, and aerobic fitness (secondary outcome measures). Furthermore, we conducted a process evaluation. Discussion The development of the DOiT-intervention resulted in a comprehensive school-based weight gain prevention program, tailored to the needs of Dutch adolescents from low socio-economic background.

Abstract Background The age-related deterioration of physiological capacities such as muscle strength and balance is associated with increased dependence. Understanding the contribution of physical fitness components to functional performance facilitates the development of adequate exercise interventions aiming at preservation of function and independence of older people. The aim of the study was to investigate the relationship between physical fitness components and functional performance in older people living in long-term care facilities. Methods Design cross-sectional study Subjects 226 persons living in long-term care facilities (mean age: 81.6 ± 5.6). Outcome measures Physical fitness and functional performance were measured by performance-based tests. Results Knee and elbow extension strength were significantly higher in men (difference = 44.5 and 50.0 N, respectively), whereas women were more flexible (difference sit & reach test = 7.2 cm). Functional performance was not significantly different between the genders. In men, motor coordination (eye-hand coordination) and measures of strength were the main contributors to functional performance, whereas in women flexibility (sit and reach test) and motor coordination (tandem stance and eye-hand coordination) played a major role. Conclusion The results of this study show that besides muscle strength, fitness components such as coordination and flexibility are associated with functional performance of older people living in long-term care facilities. This suggests that men and women living in long-term care facilities, differ considerably concerning the fitness factors contributing to functional performance. Women and men may, therefore, need exercise programs emphasizing different fitness aspects in order to improve functional performance.

Objective: To summarise the current evidence on the effects of physical activity (PA) interventions on cognitive and academic performance in children, and formulate research priorities and recommendations.Design: Systematic review (following PRISMA guidelines) with a methodological quality assessment and an international expert panel. We based the evaluation of the consistency of the scientific evidence on the findings reported in studies rated as of high methodological quality.Data Sources: PubMed, PsycINFO, Cochrane Central, Web of Science, ERIC, and SPORTDiscus.Eligibility Criteria For Selecting Studies: PA-intervention studies in children with at least one cognitive or academic performance assessment.Results: Eleven (19%) of 58 included intervention studies received a high-quality rating for methodological quality: four assessed effects of PA interventions on cognitive performance, six assessed effects on academic performance, and one on both. All high-quality studies contrasted the effects of additional/adapted PA activities with regular curriculum activities. For cognitive performance 10 of 21 (48%) constructs analysed showed statistically significant beneficial intervention effects of PA, while for academic performance, 15 of 25 (60%) analyses found a significant beneficial effect of PA. Across all five studies assessing PA effects on mathematics, beneficial effects were reported in six out of seven (86%) outcomes. Experts put forward 46 research questions. The most pressing research priority cluster concerned the causality of the relationship between PA and cognitive/academic performance. The remaining clusters pertained to PA characteristics, moderators and mechanisms governing the 'PA-performance' relationship and miscellaneous topics.Conclusion: There is currently inconclusive evidence for the beneficial effects of PA interventions on cognitive and overall academic performance in children. We conclude that there is strong evidence for beneficial effects of PA on maths performance.The expert panel confirmed that more 'high-quality' research is warranted. By prioritising the most important research questions and formulating recommendations we aim to guide researchers in generating high-quality evidence. Our recommendations focus on adequate control groups and sample size, the use of valid and reliable measurement instruments for physical activity and cognitive performance, measurement of compliance and data analysis.Prospero Registration Number: CRD42017082505. [ABSTRACT FROM AUTHOR]

Exercise is assumed to have positive effects on children's cognitive performance. However, given the inconclusive evidence for the long-term effects of exercise, it is difficult to advice schools on what specific exercise programs can improve children's cognitive performance. In particular, little is known about the effects of small exercise programs that may be feasible in daily school practice. Therefore, we assessed the effects of a 9-weeks program consisting of daily exercise breaks on children's cognitive performance, aerobic fitness and physical activity levels. We conducted a cluster-randomized controlled trial in 21 classes of eight Dutch primary schools. A total of 512 children aged 9–12 years participated. The exercise intervention had a duration of 9 weeks and consisted of a daily 10-min classroom-based exercise break of moderate to vigorous intensity. Before and after the intervention, we used four cognitive tasks (i.e., the Attention Network Test, Stroop test, d2 test of attention and Fluency task) to measure children's cognitive performance in domains of selective attention, inhibition and memory retrieval. In addition, we measured aerobic fitness with a Shuttle Run test and physical activity during school hours by accelerometers. We analyzed data using mixed models, adjusting for baseline scores, class and school. After 9 weeks, there were no intervention effects on children's cognitive performance or aerobic fitness. Children in the intervention group spent 2.9 min more of their school hours in moderate to vigorous physical activity as compared to the children in the control group. In conclusion, daily 10-min exercise breaks in the classroom did not improve, nor deteriorate cognitive performance in children. The exercise breaks had no effect on children's fitness, and resulted in 2.9 min more time spent in moderate to vigorous physical activity during school hours. Daily exercise breaks can be implemented in the classroom to promote children's physical activity during school time, without adverse effect on their cognitive performance. [ABSTRACT FROM AUTHOR]

Participation in structured physical activity is assumed to have a positive effect on cognitive and academic performance. A single bout of moderate to vigorous exercise has been found to have a small acute positive effect on the cognitive performance of children and adolescents. However, the dose-response effects of exercise duration are largely unknown. Therefore, the current study examined the acute effects of moderate-to-vigorous exercise with a duration of either 10, 20, or 30min on selective attention and working memory performance of young adolescents. One hundred and nineteen adolescents (11-14 years old) participated in a randomized, controlled crossover study. Adolescents were assigned to one of the three exercise durations, each paired with a sedentary control session of the same duration. Cognitive performance was measured before and immediately after the exercise and control condition. The Attention Network Test and n-back task were used to measure selective attention and working memory, respectively. There were no significant exercise effects on selective attention (i.e., alerting, orienting, or executive control) or working memory performance measured immediately after the exercise bouts. Furthermore, there were no differential effects of exercise duration. In sum, acute exercise bouts with a duration of 10, 20, or 30min did not improve, but neither deteriorate cognitive performance of young adolescents compared to a sedentary control condition. [ABSTRACT FROM AUTHOR]

Objectives: Evidence suggests that physical activity is positively related to several aspects of cognitive functioning in children, among which is selective attention. To date, no information is available on the optimal frequency of physical activity on cognitive functioning in children. The current study examined the acute effects of one and two bouts of moderate-intensity physical activity on children's selective attention.Design: Randomized controlled trial (ISRCTN97975679).Methods: Thirty boys and twenty-six girls, aged 10-13 years, were randomly assigned to three conditions: (A) sitting all morning working on simulated school tasks; (B) one 20-min physical activity bout after 90min; and (C) two 20-min physical activity bouts, i.e. at the start and after 90min. Selective attention was assessed at five time points during the morning (i.e. at baseline and after 20, 110, 130 and 220min), using the 'Sky Search' subtest of the 'Test of Selective Attention in Children'. We used GEE analysis to examine differences in Sky Search scores between the three experimental conditions, adjusting for school, baseline scores, self-reported screen time and time spent in sports.Results: Children who performed two 20-min bouts of moderate-intensity physical activity had significantly better Sky Search scores compared to children who performed one physical activity bout or remained seated the whole morning (B=-0.26; 95% CI=[-0.52; -0.00]).Conclusions: Our findings support the importance of repeated physical activity during the school day for beneficial effects on selective attention in children. [ABSTRACT FROM AUTHOR]

Background: This article describes the barriers and facilitating factors to the adoption, implementation and continuation of the Dutch Obesity Intervention in Teenagers (DOiT) programme in the Netherlands. Methods: We evaluated the adoption, implementation and continuation of the programme at 20 voluntary prevocational schools, which adopted the programme. Interviews were conducted with DOiT coordinators and/or teachers (n = 44) at the end of the first and second school year of the 2-year implementation period. Interviews were recorded and transcribed verbatim. Data were coded by two researchers independently. Identified barriers and facilitating factors were categorized into four groups: (i) organizational factors, (ii) individual factors, (iii) characteristics of the programme and (iv) characteristics of the implementation strategy. Results: Teachers and DOiT coordinators identified various implementation barriers (e.g. lack of planning, other urgent unforeseen priorities, no plan to cope with teacher turnover and high teacher workload) as well as facilitating factors (e.g. involvement of DOiT coordinator and support from the DOiT office, sufficient communication and collaboration between teachers, strong teacher motivation and flexibility of the programme). Conclusion: Overall, DOiT implementers were satisfied with the compatibility, layout, content and potential for tailoring the programme. Barriers for successful implementation were mainly at the school and teacher level. Findings of this study can be used for further improvement of the DOiT programme and for the development and improvement of other health promotion programmes in the school setting. [ABSTRACT FROM AUTHOR]

Recent studies indicate that a single bout of physical exercise can have immediate positive effects on cognitive performance of children and adolescents. However, the type of exercise that affects cognitive performance the most in young adolescents is not fully understood. Therefore, this controlled study examined the acute effects of three types of 12-min classroom-based exercise sessions on information processing speed and selective attention. The three conditions consisted of aerobic, coordination, and strength exercises, respectively. In particular, this study focused on the feasibility and efficiency of introducing short bouts of exercise in the classroom. One hundred and ninety five students (5th and 6th grade; 10-13 years old) participated in a double baseline within-subjects design, with students acting as their own control. Exercise type was randomly assigned to each class and acted as between-subject factor. Before and immediately after both the control and the exercise session, students performed two cognitive tests that measured information processing speed (Letter Digit Substitution Test) and selective attention (d2 Test of Attention). The results revealed that exercising at low to moderate intensity does not have an effect on the cognitive parameters tested in young adolescents. Furthermore, there were no differential effects of exercise type. The results of this study are discussed in terms of the caution which should be taken when conducting exercise sessions in a classroom setting aimed at improving cognitive performance. [ABSTRACT FROM AUTHOR]

Objective: A multidisciplinary vocational rehabilitation programme, the Vocational Enablement Protocol (VEP) was developed to address the specific needs of employees with hearing difficulties. In the current study we evaluated the process of implementing the VEP in audiologic care among employees with hearing impairment. Design: In conjunction with a randomized controlled trial, we collected and analysed data on seven process parameters: recruitment, reach, fidelity, dose delivered, dose received and implemented, satisfaction, and perceived benefit. Study sample: Sixty-six employees with hearing impairment participated in the VEP. The multidisciplinary team providing the VEP comprised six professionals. Results: The professionals performed the VEP according to the protocol. Of the recommendations delivered by the professionals, 31% were perceived as implemented by the employees. Compliance rate was highest for hearing-aid uptake (51%). Both employees and professionals were highly satisfied with the VEP. Participants rated good perceived benefit from it. Conclusions: Our results indicate that the VEP could be a useful treatment for employees with hearing difficulties from a process evaluation perspective. Implementation research in the audiological setting should be encouraged in order to further provide insight into parameters facilitating or hindering successful implementation of an intervention and to improve its quality and efficacy. [ABSTRACT FROM AUTHOR]

Background The school-based Dutch Obesity Intervention in Teenagers (DOiT) programme is an evidence-based obesity prevention programme tailored to adolescents attending the first two years of prevocational education in the Netherlands. The initial programme showed promising results during an effectiveness trial. The programme was then adapted and prepared for nationwide dissemination. To gain more insight into the process of translating evidence-based approaches into "real world" (i.e., "natural") conditions, our research aims were to evaluate the impact of the DOiT-implementation programme on adolescents' adiposity and energy balance-related behaviours during natural dissemination and to explore the mediating and moderating factors underlying the DOiT intervention effects. Methods We conducted a cluster-controlled implementation trial with 20 voluntary intervention schools (n = 1002 adolescents), who adopted the programme, and 9 comparable control schools (n = 484 adolescents). We measured adolescents' body height and weight, skinfold thicknesses (i.e., triceps, biceps, suprailiac and subscapular), and waist circumference. We assessed adolescents' dietary and physical activity behaviours by means of self-report. Data were collected at baseline and at 20-months follow-up. We used multivariable multilevel linear or logistic regression analyses to evaluate the intervention effects and to test the hypothesised behavioural mediating factors. We checked for potential effect modification by gender, ethnicity and education level. Results We found no significant intervention effects on any of the measures of adiposity (BMI, waist circumference or skinfolds) or behavioural outcomes. Furthermore, we found no mediating effects by any of the hypothesised behavioural mediators. Stratified analyses for gender showed that the intervention was effective in reducing sugar-containing beverage consumption in girls (B = −188.2 ml/day; 95%CI = −344.0;-32.3). In boys, we found a significant positive intervention effect on breakfast frequency (B = 0.29 days/week; 95%CI = 0.01; 0.58). Stratified analyses for education level showed an adverse intervention effect (B = 0.09; 95%CI = 0.02; 0.16) on BMI z-scores for adolescents attending the vocational education track. Conclusions Although not successful in changing adolescents' adiposity, the DOiT-implementation programme had some beneficial effects on specific obesity-related behaviours in subgroups. This study underlines the difficulty of translating intervention effectiveness in controlled settings to real world contexts. Adaptations to the implementation strategy are needed in order to promote implementation as intended by the teachers. [ABSTRACT FROM AUTHOR]

ObjectiveTo explore the influences of migration to a Western country on obesity and related risk factors by comparing measures of body composition and energy balance-related behaviours between Turkish adolescents in Turkey (TR-TR) and adolescents from Turkish immigrant ethnicity in the Netherlands (TR-NL).DesignCross-sectional survey or baseline intervention data from six Dutch school-based studies and one Turkish study.SettingPrimary and secondary schools.SubjectsA total of 915 (49 % girls; mean age 13·1 (sd 0·8) years) TR-TR adolescents and 433 (51 % girls; mean age 11·7 (sd 1·3) years) TR-NL adolescents were included. Outcome measures were self-reported sugar-containing beverage consumption, fruit and vegetable intake, screen time, physical activity, measured body height and weight, BMI, waist and hip circumferences, and skinfold thicknesses.ResultsOur data showed that more TR-NL adolescents were overweight (31 % v. 26 %) and obese (9 % v. 6 %) and had significantly higher mean BMI (21·1 v. 20·0 kg/m2), waist circumference (72·2 v. 71·3 cm) and suprailiac skinfold thickness (19·8 v. 13·1 mm) than TR-TR adolescents. TR-NL adolescents reported significantly higher sugar-containing beverage consumption (1173 v. 115 ml/d), less fruit and vegetable intake (295 v. 647 g/d), less screen time (253 v. 467 min/d) and higher physical activity levels (61 v. 27 min/d) than TR-TR adolescents.ConclusionsImmigrant adolescents in the Netherlands were more often overweight and had a less favourable dietary pattern than their peers in Turkey, while their physical activity and screen time patterns were more favourable. These results suggest that adolescents from Turkish immigrant ethnicity in the Netherlands have adopted lifestyles towards the host culture. [ABSTRACT FROM AUTHOR]

Background: Young adults face radical life changes regarding residence, marriage, family and work that may negatively impact their health behaviours. Therefore, we investigated the associations of the number of daily hassles and life events and their subjective appraisal with physical activity and screen time in young adulthood. Methods: Data came from participants of the Amsterdam Growth and Health Longitudinal Study (AGAHLS). Self-reported physical activity (min/wk) was used from wave 6 (1991; mean age 27), wave 7 (1993; mean age 29), wave 8 (1996/1997; mean age 32) and 9 (2000; mean age 36). Self-reported screen time (h/wk) was assessed in waves 8 and 9. The number and the appraisal of daily hassles and major life events were assessed with the Everyday Problem Checklist and Life Events List, respectively (including five life event domains, i.e.: health, work, home/family, personal/social relations, and finances). The final sample included 474 participants for the physical activity analyses and 475 participants for the screen time analyses. To test the longitudinal associations of daily hassles and life events with physical activity and screen time, univariable and multivariable Generalised Estimating Equations were performed. Effect modification by gender was tested. Results: Physical activity levels were higher in those who had experienced more daily hassles. People who reported higher subjective appraisal in the work and finances life event domains also had higher levels of physical activity, although only the subjective appraisal in the finances domain remained significant in the multivariable model. No significant associations between number and subjective appraisal of daily hassles and life events and screen time were observed. Conclusions: The occurrence of specific life events may be more influential for people's physical activity behaviour than their respective sum or emotional tone. Still, the assessment of daily hassles may be a relevant addition in this research field. Finally, we suggest that daily hassles and life events are less important for explaining screen time behaviour than for physical activity. [ABSTRACT FROM AUTHOR]

Background: Parents and their parenting practices play an important role in shaping their children's environment and energy-balance related behaviours (EBRBs). Measurement of parenting practices can be parent- or child-informed, however not much is known about agreement between parent and child perspectives. This study aimed to assess agreement between parent and child reports on parental practices regarding EBRBs across different countries in Europe and to identify correlates of agreement. Methods: Within the ENERGY-project, a cross-sectional survey was conducted among 10-12 year old children and their parents in eight European countries. Both children and parents filled in a questionnaire on 14 parental practices regarding five different EBRBs (i.e. soft drink, fruit juice and breakfast consumption, sports activity and watching TV) and socio-demographic characteristics. Children's anthropometric measurements were taken at school. We calculated percentages of agreement between children and their parents and weighted kappa statistics (for ordinal variables) per practice and country and assessed factors associated with agreement using multilevel linear regression. Results: Reports of 6425 children and their parents were available for analysis. Overall mean agreement between parent and child reports was 43% and varied little among countries. The lowest agreement was found for questions assessing joint parent-child activities, such as sports (27%; Kappa (κ) = 0.14) or watching TV (30%;κ = 0.17), and for parental allowance of the child to have soft drinks (32%;κ = 0.24) or fruit juices (32%;κ = 0.19), or to watch TV (27%;κ = 0.17). Having breakfast products available at home or having a TV in the child's bedroom were the only practices with moderate to good agreement (>60%;κ = 0.06 and 0.77, respectively). In general, agreement was lower for boys, younger children, younger parents, parents with less than 14 years of education, single parents, parents with a higher self-reported body mass index and parents who perceived their child to be underweight. Conclusions: Parents and children perceive parental practices regarding dietary, physical activity and sedentary behaviours differently in all parts of Europe, with considerable variation across specific practices and countries. Therefore, future studies should assess both, parents and children's view on parental practices. [ABSTRACT FROM AUTHOR]

Background To explore differences in personal and home environmental factors that are regarded as determinants of energy balance-related behaviors (EBRBs) according to parental education and ethnic background among 10-12 year old schoolchildren across Europe. Methods A school-based survey among 10-12 year olds was conducted in eight countries across Europe. A range of personal and home environment variables relevant for soft drink consumption, daily breakfast, sport participation and TV time was assessed by means of child report. Personal factors included attitude, health beliefs, and preference/liking. Home environment factors included parental subjective norm, modeling, support, practices and home availability. Children were classified based on parental education (i.e., low vs. high) and ethnic background (i.e., native vs. non-native). Data from 6018 children originating from 83 schools were included in the analyses. Results Multilevel logistic regression analyses showed that the majority of the factors tested -and especially home environment variables- were more favorable among children from higher educated parents and from native ethnicity. None of the personal and home environment factors was found to be more favorable among children from lower educated parents or nonnative ethnicity. Conclusions The present study indicates that schoolchildren from lower educated and non-native parents across Europe have EBRB-related beliefs and are exposed to home environments that are less favorable for engagement in healthy EBRBs. [ABSTRACT FROM AUTHOR]

Objective: Adequate assessment of energy balance-related behaviours in adolescents is essential to develop and evaluate effective obesity prevention programmes. The present study examined the test-retest reliability and construct validity of a questionnaire assessing energy balance-related behaviours in adolescents during the evaluation of the DOiT (Dutch Obesity Intervention in Teenagers) intervention.Design: To assess test-retest reliability, adolescents filled in the questionnaire twice (n 111). To assess construct validity, the results from the first test were compared with data collected in a personal cognitive interview (n 20, independent from the reliability study). For both reliability and validity, intraclass correlation coefficients for continuous data or Cohen's kappa coefficients for categorical data were calculated as well as percentage agreement.Setting: Data were collected during school time from February to May 2010.Subjects: Study participants were Dutch adolescents aged 12-14 years attending pre-vocational secondary schools.Results: In more than three-quarters of the ninety-five questionnaire items the test-retest reliability appeared to be good to excellent. Moderate reliability was found for all other twenty-one items. Fifty-one items (of ninety-five items) showed good to excellent construct validity. Construct validity appeared moderate in twenty-three items and poor in twenty-one items. Most items with poor construct validity concerned consumption of sugar-containing beverages and high-energy snacks/sweets.Conclusions: Our study showed good test-retest reliability and largely moderate to good construct validity for the majority of items of the DOiT questionnaire. Items with poor construct validity (most of them found for items concerning energy intake-related behaviours) should be revised and tested again to improve the questionnaire for future use. [ABSTRACT FROM AUTHOR]

Background Sitting is associated with health risks. Factors that influence sitting are however not well understood. The aim was to examine the biological, socio-demographic, work-related and lifestyle determinants of sitting time (including during transport, work and leisure) in young adult Australian women. Methods Self-reported data from 11,676 participants (aged 22-27 years in 2000) in the Australian Longitudinal Study on Women's Health were collected over 9 years in 2000, 2003, 2006 and 2009. Generalised Estimating Equations were used to examine univariable and multivariable associations of body mass index (BMI), country of birth, area of residence, education, marital status, number of children, occupational status, working hours, physical activity, smoking, alcohol intake and stress with week- and weekend-day sitting time. Results Compared with women in the respective referent categories, (1) women with higher BMI, those born in Asia, those with less than University level education, doing white collar work, working 41-48 hours a week, current smokers, non, rare or risky/ high risk drinkers and those being somewhat stressed had significantly higher sitting time; and (2) women living in rural and remote areas, partnered women, those with children, those without a paid job and blue collar workers, those working less than 34 hours a week, and active women had significantly lower sitting time. Conclusions Among young adult Australian women, those with higher BMI, those born in Asia, those with higher level occupations and long working hours, were most at risk of higher sitting time. These results can be used to identify at-risk groups and inform intervention development. [ABSTRACT FROM AUTHOR]

Objective The aim of the study was to evaluate mediating effects of energy balance-related behaviors on measures of adiposity in the Dutch Obesity Intervention in Teenagers-study (DOiT). Design and Methods DOiT was an 8-month behavioral intervention program consisting of educational and environmental components and evaluated in 18 prevocational secondary schools in the Netherlands ( n = 1,108, baseline age 12.7 years, 50% girls). Outcome measures were changes in body mass index (BMI), waist circumference, and sum of skinfold thickness. Self-reported consumption of sugar-containing beverages and high caloric snacks, active transport to/from school, and screen-viewing behaviors were the hypothesized mediators. Data were collected at 0, 8, 12, and 20 months. For the data analysis, parallel process latent growth modeling was used. Results Total sugar-containing beverages consumption mediated the intervention effects on BMI (ab = −0.01, 95%CI = −0.20, −0.001). The intervention group lowered their sugar-containing beverages consumption more than controls ( B = −0.14, 95%CI = −0.22, −0.11) and this, in turn, led to smaller increases in BMI. No significant mediated effect by the targeted behaviors was found for waist circumference or sum of skinfolds. Conclusions Future school-based overweight prevention interventions may target decreasing sugar-containing beverages consumption. [ABSTRACT FROM AUTHOR]

Background: Few studies have differentiated between weekday and weekend day sleep duration in their association with indicators of weight status in children. Therefore, we examined the association of week and weekend day sleep duration with indicators of body composition in 10–12 year old European school children. Methods and Findings: Multi-level linear regression analysis was performed to examine the association between parent-reported week and weekend day sleep duration and objectively assessed child BMI and WC, adjusting for socio-demographic variables and energy balanced related behaviours EBRBs (i.e. dietary, physical and sedentary behaviour). Compared to sleeping 10 hrs/night or more, sleeping on average less than 10 hrs/night during weekdays was associated with higher BMI (for example, B = 0.86 and CI = [0.27;1.45] when sleeping ≤7 hrs) and WC (for example, B = 1.99 and CI = [0.32;3.65] when sleeping ≤7 hrs). Sleeping 9 hrs/night during weekend days, but not ≤8 hrs, was associated with higher WC (B = 0.66; CI = [0.04;1.28]) compared to sleeping more than 10 hrs/night. Average (week and weekend) sleep duration less than 10 hrs/night was associated with higher values for BMI (B = 0.98; CI = [0.24;1.73] and WC (B = 2.35; CI = [0.08;4.31]). Conclusions: Weekday sleep duration seems more strongly associated with body composition in European school children than weekend day sleep duration. Promoting adequate sleep duration may contribute to healthy weight in children. [ABSTRACT FROM AUTHOR]

Background The evidence-based Dutch Obesity Intervention in Teenagers (DOiT) program is a school-based obesity prevention program for 12 to 14-year olds attending the first two years of prevocational education. This paper describes the study protocol applied to evaluate (a) the nationwide dissemination process of DOiT in the Netherlands, and (b) the relationship between quality of implementation and effectiveness during nationwide dissemination of the program in the Netherlands. Methods In order to explore facilitating factors and barriers for dissemination of DOiT, we monitored the process of adoption, implementation and continuation of the DOiT program among 20 prevocational schools in the Netherlands. The study was an education observational study using qualitative (i.e. semi-structured interviews) and quantitative methods (i.e. questionnaires and logbooks). Eight process indicators were assessed: recruitment, context, reach, dosage, fidelity, satisfaction, effectiveness and continuation. All teachers, students and parents involved in the implementation of the program were invited to participate in the study. As part of the process evaluation, a cluster-controlled trial with ten control schools was conducted to evaluate the effectiveness of the program on students' anthropometry and energy balance-related behaviours and its association with quality of implementation. Discussion The identified impeding and facilitating factors will contribute to an adjusted strategy promoting adoption, implementation and continuation of the DOiT program to ensure optimal use and, thereby, prevention of obesity in Dutch adolescents. [ABSTRACT FROM AUTHOR]

Background: Recent research and literature reviews show that, among schoolchildren, some specific energy balance-related behaviors (EBRBs) are relevant for overweight and obesity prevention. It is also well known that the prevalence of overweight and obesity is considerably higher among schoolchildren from lower socio-economic backgrounds. This study examines whether sugared drinks intake, physical activity, screen time and usual sleep duration cluster in reliable and meaningful ways among European children, and whether the identified clusters could be characterized by parental education. Methods: The cross-sectional study comprised a total of 5284 children (46% male), from seven European countries participating in the ENERGY-project ("EuropeaN Energy balance Research to prevent excessive weight Gain among Youth"). Information on sugared drinks intake, physical activity, screen time and usual sleep duration was obtained using validated self-report questionnaires. Based on these behaviors, gender-specific cluster analysis was performed. Associations with parental education were identified using chi-square tests and odds ratios. Results: Five meaningful and stable clusters were found for both genders. The cluster with high physical activity level showed the highest proportion of participants with highly educated parents, while clusters with high sugared drinks consumption, high screen time and low sleep duration were more prevalent in the group with lower educated parents. Odds ratio showed that children with lower educated parents were less likely to be allocated in the active cluster and more likely to be allocated in the low activity/sedentary pattern cluster. Conclusions: Children with lower educated parents seemed to be more likely to present unhealthier EBRBs clustering, mainly characterized by their self-reported time spent on physical activity and screen viewing. Therefore, special focus should be given to lower educated parents and their children in order to develop effective primary prevention strategies. [ABSTRACT FROM AUTHOR]

Background: Current data on the prevalence of overweight and energy-balance behaviors among European children is necessary to inform overweight prevention interventions. Methodology/Principal Findings: A school-based survey among 10-12 year old children was conducted in seven European countries using a standardized protocol. Weight, height, and waist circumference were measured; Engagement in physical activity, sedentary and dietary behaviors, and sleep duration were self-reported. Descriptive analyses were conducted, looking at differences according to country, gender, and parental education. 7234 children (52%girls; 11.660.7 years) participated. 25.8% and 5.4% of boys, and 21.8% and 4.1% of girls were overweight (including obese) and obese (according to International Obesity Task Force criteria), respectively. Higher prevalence of overweight/obesity was observed in Greece, Hungary, Slovenia and Spain than in Belgium, Netherlands and Norway. Large differences between countries were found in intakes of sugar-sweetened beverages, breakfast, active transport, TV and computer time. More favorable overweight status and behavior patterns were found in girls than boys and in children of higher educated parents than in children of lower educated parents. Conclusions/Significance: High levels and striking differences in overweight status and potential risk behaviors were found among schoolchildren across Europe. [ABSTRACT FROM AUTHOR]