Search

Background:Parental modeling has been shown to be important for school-aged children’s physical activity (PA) and television (TV) viewing, yet little is known about its impact for younger children. This study examined cross-sectional and 3-year longitudinal associations between PA and TV viewing behaviors of parents and their preschool children.Methods:In 2008–2009 (T1), parents in the Healthy Active Preschool and Primary Years (HAPPY) cohort study (n = 450) in Melbourne, Australia, self-reported their weekly PA and TV viewing and proxy-reported their partner’s PA and TV viewing and their 3- to 5-year-old preschool child’s TV viewing. Children’s PA was assessed via accelerometers. Repeat data collection occurred in 2011–2012 (T2).Results:Mothers’ and fathers’ PAs were associated with PA among preschool girls at T1, but not boys. Parents’ TV viewing times were significant correlates of girls’ and boys’ TV viewing at T1. Longitudinally, mothers’ PA at baseline predicted boys’ PA at T2, whereas sex-specific associations were found for TV viewing, with mothers’ and fathers’ TV viewing at T1 associated with girls’ and boys’ TV viewing respectively at T2.Conclusions:The PA and TV viewing of both parents are significantly associated with these behaviors in preschool children. The influence of the sex-matched parent appears to be important longitudinally for children’s TV viewing.

Background The RESIDential Environments (RESIDE) project is a unique longitudinal natural experiment designed to evaluate the health impacts of the “Liveable Neighbourhoods” planning policy, which was introduced by the Western Australian government to create more walkable suburbs. Objectives To summarize the RESIDE evidence of the impact of the planning policy on a range of health-supportive behaviours and wellbeing outcomes and to assess the consistency and direction of the estimates of associations. Methods An audit of 26 RESIDE research papers (from 2003 to 2012) identified the number of positive associations (statistically significant and consistent with policy expectations), negative associations (statistically significant and inconsistent with policy expectations), and null findings from multiple-exposure models between objective and perceived measures of 20 policy design requirements and 13 health-supportive behaviors and wellbeing outcomes. Results In total 332 eligible estimates of associations (n = 257 objective measures and n = 75 perceived measures) were identified. Positively significant findings were detected for: 57% of walking estimates with objectively measured policy design features (negative = 3%; null = 40%) (n = 115) and 54% perceived measures (negative = 0%; null = 33%) (n = 27); 42% of sense of community estimates with objectively measured of policy design features (negative = 8%; null = 50%) (n = 12) and 61% perceived measures (negative = 8%; null = 31%) (n = 13); 39% of safety or crime-related estimates with objectively measured of policy design features (negative = 22%; null = 39%) (n = 28) and 100% perceived measures (n = 7). All (n = 4) estimates for mental health outcomes with objectively measured policy-related design features were positively significant. Conclusions The synthesis of findings suggests that new suburban communities built in accordance with the “Liveable Neighbourhoods” policy have the potential to encourage health supportive behaviors and wellbeing outcomes including transport and recreation walking, and to create neighborhoods with a stronger sense of community where residents may feel safer., Highlights • The RESIDE study is a longitudinal natural experiment evaluating a new planning policy to create more walkable suburbs. • A process evaluation quantified how much of the policy had been implemented on-the-ground. • This review included 332 estimated associations from multiple-exposure predictor models extracted from 26 RESIDE papers. • It summarized the consistency, strength and direction of estimates of associations against the policy expectations. • New communities built to the policy principles may encourage walking and a sense of community where residents feel safer.

Limited longitudinal evidence of the predictors of physical activity (PA) patterns over time exists, particularly among high-risk groups such as women living in socioeconomically disadvantaged areas. This study aimed to: 1) describe leisure-time PA (LTPA) and transport-related PA (TRPA) patterns over time; and 2) identify individual, social and physical environmental predictors of LTPA and TRPA patterns over five years. Baseline (2007–08) data were collected and analysed (2016–18) from n = 4349 women (18–46 years) from disadvantaged areas of Victoria, Australia. Three- and five-year follow-up data were collected in 2010–11 (n = 1912) and 2012 (n = 1560). LTPA and TRPA were self-reported using the International Physical Activity Questionnaire, and patterns categorised as consistently low, persistently increasing, persistently decreasing, or inconsistent. Compared to a consistently low LTPA pattern, greater family support predicted both persistent decreases (odds ratio [OR] 1.20, 95% CI 1.05–1.36) and persistent increases (OR 1.17, 95% CI 1.04–1.32) in LTPA, while access to childcare predicted inconsistent LTPA patterns (OR 1.66, 95% CI 1.03–2.65). For both LTPA and TRPA, PA enjoyment predicted persistent increases (LTPA: OR 1.05, 95% CI 1.02–1.10; TRPA: OR 1.03, 95% CI 1.00–1.07), persistent decreases (LTPA: OR 1.04, 95% CI 1.00–1.08; TRPA OR 1.04, 95% CI 0.99–1.08), and inconsistent patterns (LTPA: OR 1.04, 95% CI 1.02–1.07; TRPA: OR 1.03, 95% CI 1.01–1.06). Although directionality was inconsistent, and the magnitude of effects were small, PA enjoyment, family social support for PA and access to childcare warrant further investigation and consideration as potentially key factors impacting PA patterns among women living in socioeconomically disadvantaged areas.

Without accurate awareness of features within the built environment, the availability of a supportive built environment alone may not be sufficient to influence physical activity levels. We examined the moderating effects of concordance/discordance between selected objective and perceived built environment features in the relationship between objective built environment features and physical activity. Cross-sectional data from 465 youth aged 12–20 years from 18 schools in Melbourne, Australia were used. The relationship between trails and physical activity differed by concordance/discordance. There were positive relationships among those with concordant perceptions, but no significant differences for those with discordant perceptions. At least for trails, environmental interventions designed to enhance physical activity may be less effective if efforts are not made to enhance individuals’ awareness of their environment.

Parks typically offer opportunities for physical activity among children. Therefore, understanding features of parks that attract children is important for public health. Previous research suggests that children often visit parks other than the one closest to home, most likely because of appealing features. This study compared features present at the park children visit most often to those present at the park closest to their home. Parents in Melbourne Australia (2014–15), reported the park their child (9–11 years) visits most often. Mapping tools were used to determine park locations, sizes, and walking distances from home. The most frequently visited park and the closest park to home were audited (using a purposely created audit tool) to capture levels of access, amount of play/sport and comfort facilities, and quality and safety. Most children (59 %) usually visited parks that were not closest to home. Parks that children (n = 86) visited most often were significantly larger (3.9 ha vs 2.7 ha) and further away (1675 m vs 325 m) than the park closest to home. Additionally, they had significantly more sports facilities, playground equipment, toilets, drinking fountains, BBQ’s and landscaping. Our findings provide evidence that children are attracted to parks with particular facilities, and parents/guardians may be willing to travel further if necessary. A better understanding of the features that drive park usage will help inform park planning and design.

Adolescents spend large amounts of time sitting at school. Little is known about the impact of reducing and breaking-up prolonged sitting during school lessons on adolescents' health. This study aimed to investigate the impact of an intervention to reduce classroom sitting time on adolescents' energy expenditure (EE; kcal/lesson), body mass index (BMI), waist circumference (WC), and musculoskeletal discomfort. A secondary school classroom was equipped with height-adjustable desks, posters promoting the health benefits of and strategies for breaking-up sitting time, and desk stickers reminding students to periodically stand up. Classroom teachers participated in a professional development session. Using a quasi-experimental design, differences between 49 participants who utilised the intervention classroom 2-5 times/week and a comparison group (39 adolescents, matched by year level and subject) who used traditional classrooms, were examined. EE, BMI and WC were objectively measured and musculoskeletal discomfort was self-reported at baseline, 4-weeks, and 17-weeks. Hierarchical linear and multilevel logistic regression-mixed models were used to examine intervention effects, adjusting for baseline values, sex and age. EE was significantly higher at 4-weeks and 17-weeks (29.4 and 37.7 kcal/lesson, respectively), BMI was higher at 4-weeks (0.34 kg/m(2)), and WC was lower at 4-weeks and 17-weeks (-3.53 and -2.64 cm, respectively) in the intervention compared to the comparison group. No intervention effect was found for musculoskeletal discomfort. Findings provide preliminary indications that these strategies may benefit health among adolescents in the short term. However, extended longer-duration trials are needed to determine longer-term health effects. Refereed/Peer-reviewed

Objectives Higher physical activity (PA) levels in adults are associated with lower cardiovascular disease risk, however it is unclear whether this association is evident in children younger than five years. Given that cardiovascular disease has early life origins, this study systematically reviews evidence of associations between PA and cardiovascular disease risk factors among children aged 3–5.5 years. Design Systematic review. Method A systematic search of multiple data bases was conducted to identify published papers reporting associations between any measure of PA and cardiovascular disease risk factors. Inclusion criteria: English language; peer-reviewed; original quantitative research; mean age or majority of sample to be between 3.0–5.5 years. Studies where the sample was characterised by a health condition (e.g. obese, hypertensive) were not eligible for inclusion. Results Twelve papers met the inclusion criteria. At least one study for each cardiovascular disease risk factor except inflammation was included. PA was not associated with insulin resistance, and inconsistently associated with the remaining cardiovascular disease risk factors. Studies were mostly cross-sectional and methodologically heterogeneous. Longitudinal and experimental study designs and objective measurement of PA may help provide a clearer indication of the interplay between PA and cardiovascular disease risk in the preschool population.

Background Few efficacious physical activity interventions are successfully translated and sustained in practice. We propose a practical guide for researchers to increase the likelihood of successful implementation and scale up of physical activity interventions in practice contexts. The guide is based on two principles: (i) differences between the research and practice context can be addressed during intervention development and implementation planning by focusing on system, delivery personnel, and intervention characteristics; and (ii) early planning for implementation barriers and facilitators can improve subsequent translation into practice. Methods From the published literature, we identified evidence of strategies to improve research-practice translation, along with narrative descriptions of different approaches to addressing translational challenges. These, along with constructs taken from widely cited implementation outcome, process, and mechanistic models were collated and inform the guide. Results The resultant PRACTIS guide (PRACTical planning for Implementation and Scale-up) comprised the following four iterative steps: Step 1) Characterize the parameters of the implementation setting; Step 2) Identify and engage key stakeholders across multiple levels within the delivery system(s); Step 3) Identify contextual barriers and facilitators to implementation, and; Step 4) Address potential barriers to effective implementation. Conclusions A lack of practical guidance for researchers on how to effectively plan implementation and scale up of physical activity interventions prevents us moving quickly from evidence to action. We recommend that intervention development and adaptation for broad and sustained implementation be prioritized early in intervention planning and include active engagement from delivery organizations and stakeholders. The PRACTIS guide is also relevant for clinical and public health researchers in other areas of prevention.

Objectives To identify typologies of activity-related behaviours and demographic characteristics of these typologies among Australian adolescents. Design Cross-sectional study of 473 Secondary School students (41.4% boys, mean age 14.95 ± 1.61 years) conducted in 2014–15. Methods Active travel to school, sport participation, leisure-time sedentary and demographic variables were self-reported in a survey. Duration of sedentary time and moderate-to-vigorous physical activity (mins/day) were accelerometer-derived. Latent class analysis (LCA) was conducted to identify typologies of activity-related health behaviours. One-way ANOVAs and chi-square tests were used to explore differences by demographic characteristics. Results Three typologies were identified: (1) “Physically inactive, highly sedentary” (44%); (2) “Moderately active, high screen-time” (42%); and (3) “Highly active, low sedentary” (14%). Differences between typologies were evident for age, sex, body mass index (BMI), cultural identity, employment status and socioeconomic position (SEP). Those in typology 3 (optimal behaviour pattern) tended to be younger, of higher SEP and lower BMI. Conclusions This study found that older adolescents have less active, more sedentary profiles than younger adolescents. The findings support the need for targeted interventions to improve adolescent activity-related behaviour engagement.

This study aimed to examine the contribution of objective measures of physical fitness (musculoskeletal and cardiorespiratory), physical activity, and motor skill to motor perception. A total of 122 children (63 boys) aged 8–11 years were assessed. Independent t-tests assessed sex differences in all variables. Two linear mixed models adjusted for sex and age were performed with perceived object control and locomotor skills (Pictorial Scale of the Perceived Movement Skill Competence for Young Children) as outcomes. Aerobic (multi-stage fitness test) and muscular fitness (long jump, grip strength), moderate-to-vigorous physical activity (ActiGraph accelerometry), movement skill (Test of Gross Motor Development-2), age, and sex were predictors. Boys had higher object control skills (actual and perceived) and fitness. Age (decreasing) and long jump distance (positive) explained 16% of locomotor skill perception variance. Sex (boys) explained 13% of object control skill perception variance. Children’s skill self-perception may be influenced by fitness attributes as these are more evident to them. The fact that girls have lower actual object control competence and fitness than boys suggests girls may be an intervention target.

Most built environment attributes relevant to active transportation among children can be conceptualized as encompassing urban planning or design elements (the way in which areas are laid out, such as the connectivity of the street network, residential density and mixed land use) and street-level attributes (such as sidewalks and road crossing infrastructure). Distance or ‘proximity’ to school, ‘walkability’ (a concept that combines urban design elements that are thought to facilitate walking), dedicated walking and cycling infrastructure and traffic safety attributes are consistently associated with active transportation among children. Aesthetics, weather and topography do not appear to be consistent correlates of active transportation in children. Most of the current evidence base focuses specifically on journeys to and from school; in comparison, few studies have focused on active transportation to other destinations during leisure time. Future research should adopt more rigorous study designs, such as longitudinal or natural experiment designs, consider route characteristics and active transportation to destinations other than school, encompass rural or regional environments and explore the complex ways in which different attributes of the environment may interact to influence active transportation among children.

Objectives: Prolonged sitting is a health risk factor which is ubiquitous to the workplace, and breaking up prolonged sitting is widely recommended. This study evaluated the test-retest reliability and concurrent validity of a self-report measure of duration of sitting and breaks from sitting in the workplace.Design: Cross-sectional study.Methods: Fifty-nine workers who reported spending most of their work time sitting wore an activPAL inclinometer and the ActiGraph accelerometer for eight consecutive days, and completed single-item measures of duration of sitting (min/work hour) and breaks from sitting (frequency/per work hour), twice, seven days apart.Results: Participants reported sitting at work for a median of 420 min/day (lnterquartile Range = 360-450 min/day) and taking one break (Interquartile Range = 1.0-2.0) from sitting per work hour. For reported duration of workplace sitting, test-retest reliability was adequate (Intra-Class Correlations = 0.78, 95% Confidence Intervals [CI] = 0.65, 0.86), and concurrent validity fair against the activPAL (Spearman's Rho = 0.24, CI-1.0,0.47) and the ActiGraph (Rho = 0.39, CI=0.15, 0.68). For reported breaks from sitting (frequency/per work hour), test-retest reliability was adequate (Intra-Class Correlations = 0.65, CI = 0.48, 0.78) and concurrent validity fair against the activPAL (Spearman's Rho = 0.39, CI = 0.25, 0.74) and the ActiGraph (Spearman's Rho = 0.30, CI = 0.15, 0.69). Self-reported duration of sitting was biased toward over-reporting compared to the activPAL (median = 45.4 min) and under-reporting compared to the ActiGraph (median = 21.7 min).Conclusions: This study found adequate reliability and fair validity for self-reported duration of sitting (min/work day) and breaks from sitting (frequency/per work hour). Further validity research is needed using the inclinometer. (C) 2017 Published by Elsevier Ltd on behalf of Sports Medicine Australia. Refereed/Peer-reviewed

Background: Little is known about whether physical activity compensation occurs. This study experimentally explored the activitystat hypothesis by investigating children's short-term responses to imposed or restricted physical activity. Methods: A total of 156 children (46 boys; mean age = 11.3 y) from 9 schools wore an ActiGraph accelerometer for 5 days (Monday-Friday) across 2 consecutive weeks. In addition, 145 children (49% boys) simultaneously wore a SenseWear Armband. Schools were randomized to participate in 1 of the 3 experimental conditions that took place on 1 occasion: additional moderate-to vigorous-intensity physical activity (3 schools), additional light-intensity physical activity (3 schools), or restriction of light-intensity physical activity and moderate-to vigorous-intensity physical activity (3 schools). Multilevel linear regression models were conducted to examine associations between the day the condition took place and the following day and week (baseline and experiment) for each condition. Results: There was no evidence of a difference between children's activity levels on the day after the experiment condition compared with their usual activity for that day. Conclusion: The findings suggest that children do not compensate their sedentary time and/or physical activity levels following imposed or restricted physical activity in the short term. Refereed/Peer-reviewed

This study aimed to identify typologies of park visitors and to examine associations among these typologies and socio-demographic characteristics. In 2013, intercept interviews were completed with 794 adult park visitors at two large parks located in Melbourne, Australia. Latent class analysis identified three classes of visitor: physically active visitor, with dog (12.4%); physically active visitor, with no dog (35.7%); and infrequent, low active, social visitor (51.9%). Respondents who were older and owned a dog had higher odds of being in Class 1 and Class 2. Respondents who had children had higher odds of being in Class 3. Respondents who reported poor health were less likely to be in Class 2 than in Class 3. Park users can be distinguished by the behaviors in which they engage. Understanding typologies of visitors will assist with the development of intervention strategies to optimize park visitation and park-based physical activity.

BACKGROUND: To date, many approaches have been used to define eating occasions (EOs). A standard definition for EOs is required to facilitate further research. OBJECTIVE: In this study, we examined the influence of differing definitions of EOs on the characterization of eating patterns. DESIGN: Cross-sectional dietary data from two 24-h recalls collected during the 2011-12 Australian National Nutrition and Physical Activity Survey (n = 5242 adults, aged ≥19 y) were analyzed. Eight definitions were applied: participant-identified, time-of-day, and 6 neutral definitions (individual EOs separated by different time intervals and/or an additional energy criterion of 210 kJ). Frequency of and total energy intake from meals, snacks, and all EOs were estimated, as appropriate. Differences were tested by using F tests, stratified by sex and age group. Agreement between different definitions of meal and snack frequencies was assessed by using intraclass correlation coefficients (ICCs). For each definition, linear regression was used to estimate the proportion of variance in total energy intake (kJ) and amount of food intake (g) predicted by frequency of EOs and meals and snacks. RESULTS: Among both sexes and across all age groups, mean frequencies of meals differed between the participant-identified and time-of-day definitions (mean difference range = 0.1-0.3; P < 0.001). There were statistically significant differences between mean frequencies of EOs across the 6 neutral definitions (P < 0.001). There was good agreement for snacks (men: ICC = 0.89; women: ICC = 0.87) but not meal frequencies (men: ICC = 0.38; women: ICC = 0.36) between the participant-identified and time-of-day definitions. The neutral definition (15-min time interval plus energy criterion) best predicted variance in total energy intake (R(2) range = 19.3-27.8). CONCLUSIONS: Different approaches to the definition of EOs affect how eating patterns are characterized, with the neutral definition best predicting variance in total energy intake. Further research that examines how different EO definitions affect associations with health outcomes is needed to develop consensus on a standard EO definition.

Evidence suggests diet, physical activity (PA) and sedentary behaviour cluster together in children, but research supporting an association with overweight/obesity is equivocal. Furthermore, the stability of clusters over time is unknown. The aim of this study was to examine the clustering of diet, PA and sedentary behaviour in Australian children and cross-sectional and longitudinal associations with overweight/obesity. Stability of obesity-related clusters over 3 years was also examined.Data were drawn from the baseline (T1: 2002/2003) and follow-up waves (T2: 2005/2006) of the Health Eating and Play Study. Parents of Australian children aged 5-6 (n=87) and 10-12 years (n=123) completed questionnaires. Children wore accelerometers and height and weight were measured. Obesity-related clusters were determined using K-medians cluster analysis. Multivariate regression models assessed cross-sectional and longitudinal associations between cluster membership, and body mass index (BMI) Z-score and weight status. Kappa statistics assessed cluster stability over time.Three clusters, labelled 'most healthy', 'energy-dense (ED) consumers who watch TV' and 'high sedentary behaviour/low moderate-to-vigorous PA' were identified at baseline and at follow-up. No cross-sectional associations were found between cluster membership, and BMI Z-score or weight status at baseline. Longitudinally, children in the 'ED consumers who watch TV' cluster had a higher odds of being overweight/obese at follow-up (odds ratio=2.8; 95% confidence interval: 1.1, 6.9; P0.05). Tracking of cluster membership was fair to moderate in younger (K=0.24; P=0.0001) and older children (K=0.46; P0.0001).This study identified an unhealthy cluster of TV viewing with ED food/drink consumption, which predicted overweight/obesity in a small longitudinal sample of Australian children. Cluster stability was fair to moderate over 3 years and is a novel finding. Prospective research in larger samples is needed to examine how obesity-related clusters track over time and influence the development of overweight and obesity.

Objectives To examine 1) associations between life events and changes in leisure-time physical activity (LTPA) in school leavers and 2) whether these associations are moderated by psychosocial factors. Methods Final year students (n = 440) from high schools in rural Western Australia completed annual telephone interviews on three occasions; baseline (T1), one-year follow-up (T2; n = 440) and two-year follow-up (T3; n = 374). LTPA was measured using the Minnesota Leisure-time Physical Activity Questionnaire. Life events included moving out of home, working full-time and studying full-time. Psychosocial factors included enjoyment, self-efficacy, outcome expectations, club membership, and support from family and friends. Mixed linear regression models examined the effect of life events on changes in LTPA from T1 to T2 and T1 to T3. Results A decline in LTPA across all time points was observed. Those who continued full-time education had a smaller LTPA decline than those who did not. Those who were not a member of a sporting club at T1 had greater LTPA decline if they worked full-time at T2. Conclusions There is a need for interventions to prevent declines in LTPA among school leavers, especially those who do not enter tertiary education. Encouraging sporting club membership during high school might be important.

This study aimed to determine whether associations between the perceived environment and physical activity are moderated by urban-rural status among midolder aged adults. Environmental (safety, aesthetics, physical activity environment) and physical activity (total, leisure, transport) data from 3,888 adults (55 to 65 years) from urban and rural areas of Victoria, Australia, were analyzed. Multinomial logistic regression examined interactions between urban-rural status and environments in associations with physical activity. Significant (P < .05) interactions were evident and indicated positive associations only among older rural adults for both safety and aesthetics with total and transport physical activity (e.g., rural adults reporting higher safety were 91% to 118% more likely to have higher activity than rural adults reporting low safety). In contrast, the physical activity environment was positively associated with leisure activity among only urban adults. Findings suggest that some tailoring of physical activity promotion strategies targeting the environment may be required for urban and rural midolder aged adults.

Traditionally, nutrition research has focused on individual nutrients, and more recently dietary patterns. However, there has been relatively little focus on dietary intake at the level of a ‘meal’. The purpose of the present paper was to review the literature on adults' meal patterns, including how meal patterns have previously been defined and their associations with nutrient intakes and diet quality. For this narrative literature review, a comprehensive search of electronic databases was undertaken to identify studies in adults aged ≥ 19 years that have investigated meal patterns and their association with nutrient intakes and/or diet quality. To date, different approaches have been used to define meals with little investigation of how these definitions influence the characterisation of meal patterns. This review identified thirty-four and fourteen studies that have examined associations between adults' meals patterns, nutrient intakes and diet quality, respectively. Most studies defined meals using a participant-identified approach, but varied in the additional criteria used to determine individual meals, snacks and/or eating occasions. Studies also varied in the types of meal patterns, nutrients and diet quality indicators examined. The most consistent finding was an inverse association between skipping breakfast and diet quality. No consistent association was found for other meal patterns, and little research has examined how meal timing is associated with diet quality. In conclusion, an understanding of the influence of different meal definitions on the characterisation of meal patterns will facilitate the interpretation of the existing literature, and may provide guidance on the most appropriate definitions to use.

Introduction: Parks in the US and Australia are generally underutilised, and park visitors typically engage in low levels of physical activity (PA). Better understanding park features that may encourage visitors to be active is important. This study examined the perceived importance of park features for encouraging park-based PA and examined differences by sex, age, parental-status and participation in PA. Methods: Cross-sectional surveys were completed by local residents (n = 2775) living near two parks (2013/2015). Demographic variables, park visitation and leisure-time PA were self-reported, respondents rated the importance of 20 park features for encouraging park-based PA in the next fortnight. Chi-square tests of independence examined differences in importance of park features for PA among sub-groups of local residents (sex, age, parental-status, PA). Results: Park features ranked most important for park-based PA were: well maintained (96.2%), feel safe (95.4%), relaxing atmosphere (91.2%), easy to get to (91.7%), and shady trees (90.3%). All subgroups ranked ‘well maintained’ as most important. Conclusions: Natural and built environment features of parks are important for promoting adults’ park-based PA, and should be considered in park (re)design.

BackgroundWearable activity trackers have the potential to be integrated into physical activity interventions, yet little is known about how adolescents use these devices or perceive their acceptability. ObjectiveThe aim of this study was to examine the usability and acceptability of a wearable activity tracker among adolescents. A secondary aim was to determine adolescents’ awareness and use of the different functions and features in the wearable activity tracker and accompanying app. MethodsSixty adolescents (aged 13-14 years) in year 8 from 3 secondary schools in Melbourne, Australia, were provided with a wrist-worn Fitbit Flex and accompanying app, and were asked to use it for 6 weeks. Demographic data (age, sex) were collected via a Web-based survey completed during week 1 of the study. At the conclusion of the 6-week period, all adolescents participated in focus groups that explored their perceptions of the usability and acceptability of the Fitbit Flex, accompanying app, and Web-based Fitbit profile. Qualitative data were analyzed using pen profiles, which were constructed from verbatim transcripts. ResultsAdolescents typically found the Fitbit Flex easy to use for activity tracking, though greater difficulties were reported for monitoring sleep. The Fitbit Flex was perceived to be useful for tracking daily activities, and adolescents used a range of features and functions available through the device and the app. Barriers to use included the comfort and design of the Fitbit Flex, a lack of specific feedback about activity levels, and the inability to wear the wearable activity tracker for water-based sports. ConclusionsAdolescents reported that the Fitbit Flex was easy to use and that it was a useful tool for tracking daily activities. A number of functions and features were used, including the device’s visual display to track and self-monitor activity, goal-setting in the accompanying app, and undertaking challenges against friends. However, several barriers to use were identified, which may impact on sustained use over time. Overall, wearable activity trackers have the potential to be integrated into physical activity interventions targeted at adolescents, but both the functionality and wearability of the monitor should be considered.

BACKGROUND Wearable activity trackers have the potential to be integrated into physical activity interventions, yet little is known about how adolescents use these devices or perceive their acceptability. OBJECTIVE The aim of this study was to examine the usability and acceptability of a wearable activity tracker among adolescents. A secondary aim was to determine adolescents’ awareness and use of the different functions and features in the wearable activity tracker and accompanying app. METHODS Sixty adolescents (aged 13-14 years) in year 8 from 3 secondary schools in Melbourne, Australia, were provided with a wrist-worn Fitbit Flex and accompanying app, and were asked to use it for 6 weeks. Demographic data (age, sex) were collected via a Web-based survey completed during week 1 of the study. At the conclusion of the 6-week period, all adolescents participated in focus groups that explored their perceptions of the usability and acceptability of the Fitbit Flex, accompanying app, and Web-based Fitbit profile. Qualitative data were analyzed using pen profiles, which were constructed from verbatim transcripts. RESULTS Adolescents typically found the Fitbit Flex easy to use for activity tracking, though greater difficulties were reported for monitoring sleep. The Fitbit Flex was perceived to be useful for tracking daily activities, and adolescents used a range of features and functions available through the device and the app. Barriers to use included the comfort and design of the Fitbit Flex, a lack of specific feedback about activity levels, and the inability to wear the wearable activity tracker for water-based sports. CONCLUSIONS Adolescents reported that the Fitbit Flex was easy to use and that it was a useful tool for tracking daily activities. A number of functions and features were used, including the device’s visual display to track and self-monitor activity, goal-setting in the accompanying app, and undertaking challenges against friends. However, several barriers to use were identified, which may impact on sustained use over time. Overall, wearable activity trackers have the potential to be integrated into physical activity interventions targeted at adolescents, but both the functionality and wearability of the monitor should be considered.

Background: Physical activity is associated with many physical and mental health benefits, however many children do not meet the national physical activity guidelines. While schools provide an ideal setting to promote children's physical activity, adding physical activity to the school day can be difficult given time constraints often imposed by competing key learning areas. Classroom-based physical activity may provide an opportunity to increase school-based physical activity while concurrently improving academic-related outcomes. The primary aim of this systematic review and meta-analysis was to evaluate the impact of classroom-based physical activity interventions on academic-related outcomes. A secondary aim was to evaluate the impact of these lessons on physical activity levels over the study duration. Methods: A systematic search of electronic databases (PubMed, ERIC, SPORTDiscus, PsycINFO) was performed in January 2016and updated in January 2017. Studies that investigated the association between classroom-based physical activity interventions and academic-related outcomes in primary (elementary) school-aged children were included. Meta-analyses were conducted in Review Manager, with effect sizes calculated separately for each outcome assessed. Results: Thirty-nine articles met the inclusion criteria for the review, and 16 provided sufficient data and appropriate design for inclusion in the meta-analyses. Studies investigated a range of academic-related outcomes including classroom behaviour (e.g. on-task behaviour), cognitive functions (e.g. executive function), and academic achievement (e.g. standardised test scores). Results of the meta-analyses showed classroom-based physical activity had a positive effect on improving on-task and reducing off-task classroom behaviour (standardised mean difference=0.60 (95% CI: 0.20,1.00)), and led to improvements in academic achievement when a progress monitoring tool was used (standardised mean difference=1.03 (95% CI: 0.22,1.84)). However, no effect was found for cognitive functions (standardised mean difference=0.33 (95% CI: -0.11,0.77)) or physical activity (standardised mean difference=0.40 (95% CI: -1.15,0.95)). Conclusions: Results suggest classroom-based physical activity may have a positive impact on academic-related outcomes. However, it is not possible to draw definitive conclusions due to the level of heterogeneity in intervention components and academic-related outcomes assessed. Future studies should consider the intervention period when selecting academic-related outcome measures, and use an objective measure of physical activity to determine intervention fidelity and effects on overall physical activity levels. Refereed/Peer-reviewed

It has been 17 years since the first interventions to reduce children’s sedentary behaviour were published. However, child and adolescent engagement in sedentary behaviour remains high. There have been more than 40 interventions to reduce children’s and adolescents’ screen time, but strategies to reduce or break up overall sitting throughout the day have been infrequently studied. Reducing sitting in the school setting via active breaks and an active curriculum, and environmental changes in the classroom (e.g. sit–stand desks) show promise. The home and transport settings have infrequently been targeted. Given the pervasiveness of sitting and reclining while at home during waking hours (for homework, hobbies, entertainment, and other purposes) and passive forms of transport such as car travel among children and youth, there is much scope to reduce sitting in these settings. Very few efficacious interventions have been translated into policy or practice. If these interventions are to have a sustained impact on child and adolescent populations, greater consideration of factors facilitating and/or hindering their incorporation into policy and practice is necessary. To successfully implement sedentary behaviour programmes and help children and adolescents meet sedentary behaviour public health recommendations, replication of successful interventions at scale is required. Ideally, cost-effective efficacious strategies need to be integrated into current systems and target not just the individual, but sociocultural norms and physical, organizational, and policy environments to effect lasting and wholesale changes in sedentary behaviour at a population level.

Background Designing parks that optimise visitation and support visitors to be active is important for public health. Yet there is very little evidence about whether playground refurbishment achieves these objectives. This study examined the impact of the installation of a play-scape in a large metropolitan park in Melbourne, Australia. Methods Natural experiment study (intervention vs control). At both parks, park visitation and physical activity were assessed before (T1, 2013) and after the intervention at 12 (T2, 2014) and 24 months (T3, 2015). At each time point, measures included: observations of park visitors using the System for Observing Play and Recreation in Communities on four weekdays and four weekend days, objective monitors to record usage of the walking paths and the number of cars entering the park; and intercept surveys with adult park visitors. Cross-sectional surveys were conducted with local residents at T1 and T3. Results The observational data showed a 176% increase in park visitor counts from T1 to T2 (Incidence Rate Ratio (IRR) = 2.76, 95% CI = 1.04–7.33), at the intervention park relative to the control park. The intervention park had a 119% increase in counts of visitors observed engaging in MVPA from T1 to T2 (IRR = 2.19, 95% CI = 1.14–4.20), and a 128% increase from T1 to T3 (IRR = 2.28, 95% CI = 1.19–4.38), relative to the control park. The relative increases in visitation at the intervention park play-scape compared with the control park playground were highly statistically significant from both T1 to T2 (IRR = 18.12, 95% CI = 5.51–59.59) and T1 to T3 (IRR = 15.05, 95% CI = 4.61–49.16). Similarly, there was a significant interaction between time and park with regard to the number of visitors observed engaging in MVPA in the play-scape/playground areas. The intercept survey data showed an increased odds of children’s regular visitation to the intervention park at T2 (OR = 2.67, 95% CI = 1.08, 6.64), compared with T1, relative to the control park. The remaining results from the intercept survey, objective monitors and resident surveys showed no significant differences in visitation between the two parks. Conclusions These findings confirm that a well-designed play-scape installation has the potential to increase park visitation and encourage visitors to be physically active. Trial registration Current controlled trial ISRCTN50745547. Electronic supplementary material The online version of this article (10.1186/s12966-017-0625-5) contains supplementary material, which is available to authorized users.

Research examining associations between eating occasion (EO) frequency and adiposity is inconclusive; studies examining the impact of energy misreporting are rare. This study examined associations between eating patterns and adiposity, with adjustment for energy misreporting, in a nationally representative sample of Australian adults. Dietary intake was assessed via two 24-h recalls collected during the 2011–12 National Nutrition and Physical Activity Survey (n=4050 adults, aged ⩾19 years). Frequencies of all EOs, meals and snacks were calculated. Height, weight and waist circumference (WC) were measured. Energy misreporting was assessed as the ratio of energy intake to predicted energy expenditure (EI:EE). Energy misreporters were identified by EI:EE ratios, 1.32. Multivariate regression models assessed associations between eating patterns and body mass index (BMI), WC, overweight/obesity (BMI ⩾25 kg m−2) and central overweight/obesity (WC ⩾94 cm in men and ⩾80 cm in women). After adjustment for covariates and EI:EE, frequency of all EOs, meals (women only) and snacks was positively associated with WC and BMI (all P

Previous studies have reported mixed findings on the relationship between park proximity and recreational physical activity (PA), which could be explained by park quality and the surrounding neighborhood environment. We examined whether park quality and perceptions of the neighborhood physical and social environment moderated associations between park proximity and recreational PA among mid-older aged adults. Cross-sectional self-reported data on park proximity, park quality, neighborhood physical and social environmental factors, recreational walking and other moderate- to vigorous-intensity recreational physical activity (MVPA) were collected among 2700 Australian adults (57–69 years) in 2012. Main effects between park proximity and measures of recreational PA were non-significant. Park proximity was positively related to engagement in recreational walking among participants who reported average and high social trust and cohesion, but not among those reporting low social trust and cohesion. No other moderating effects were observed. Current findings suggest synergistic relationships between park proximity and social trust and cohesion with mid-older aged adults’ recreational walking. More research is needed to unravel the complex relationship between parks, recreational PA and the social context of neighborhoods.

Experimental evidence on the role of the built environment for promoting physical activity is important for informing how to create cities that promote active living. Parks provide opportunities for physical activity; however, there is little robust evidence on the impact of park refurbishment. Government agencies often modify parks, providing opportunities for natural experiment studies of these interventions. Such an opportunity was provided by the modification of a large park in Victoria, Australia in 2013 when the Recording and EValuating Activity in a Modified Park (REVAMP) study was established. Based on insights from the REVAMP study, this paper discusses challenges involved in conducting natural experiments in park settings, focussing on issues that may help design more effective future evaluations of the impact of park refurbishment. Natural experiments offer unique opportunities to evaluate the impact of large-scale changes to the built environment. They provide valuable data that might not otherwise be possible to gather, because of the costs associated with modification of the environment. However, factors beyond the control of the study team contribute to the complexity of both organising and conducting natural experiments, with potential flow-on effects to the quality of data. Therefore many extraneous factors need to be considered when designing, costing and conducting natural experiments; studies should identify opportunities to include key partners from the inception of the project, be flexible yet robust, and allow sufficient funding to accommodate unexpected changes in the research protocol. Current controlled trial ISRCTN50745547 , registration date 11.1.2014

Refereed/Peer-reviewed Introduction: Understanding how the weather affects physical activity (PA) may help in the design, analysis, and interpretation of future studies, especially when investigating PA across diverse meteorological settings and with long follow-up periods. The present longitudinal study first aims to examine the influence of daily weather elements on intraindividual PA patterns among primary school children across four seasons, reflecting day-to-day variation within each season. Second, we investigate whether the influence of weather elements differs by day of the week (weekdays vs weekends), gender, age, and bodymass index. Method: PA data were collected by ActiGraph accelerometers for 1 wk in each of four school terms that reflect each season in southeast Australia. PA data from 307 children (age range 8.7-12.8 yr) were matched to daily meteorological variables obtained from the Australian Government" s Bureau of Meteorology (maximum temperature, relative humidity, solar radiation, day length, and rainfall). Daily PA patterns and their association with weather elements were analyzed using multilevel linear mixed models. Results: Temperature was the strongest predictor of moderate and vigorous PA, followed by solar radiation and humidity. The relation with temperature was curvilinear, showing optimum PA levels at temperatures between 20 degrees C and 22 degrees C. Associations between weather elements on PA did not differ by gender, child" s age, or body mass index. Conclusions: This novel study focused on the influence of weather elements on intraindividual PA patterns in children. As weather influences cannot be controlled, knowledge of its effect on individual PApatternsmay help in the design of future studies, interpretation of their results, and translation into PA promotion.

Background Recent technological advances provide an alternative yet underutilised opportunity for promoting physical activity in youth. The primary aim of the Raising Awareness of Physical Activity (RAW-PA) Study is to examine the short- and longer-term impact of a wearable activity monitor combined with digital behaviour change resources on adolescents’ daily physical activity levels. Methods/Design RAW-PA is a 12 week, multicomponent physical activity intervention that utilises a popular activity tracker (Fitbit® Flex) and supporting digital materials that will be delivered online via social media. The resources target key behaviour change techniques. The intervention structure and components have been informed by participatory research principles. RAW-PA will be evaluated using a cluster randomised controlled trial design with schools as the unit of randomisation. Twelve schools located in Melbourne, Australia, will allocated to either the intervention or wait-list control group. The target sample size is 300 Year 8 adolescents (aged 13–14 years). Participants’ moderate- to vigorous-intensity physical activity will be the primary outcome. Survey measures will be completed. Process factors (e.g. feasibility, acceptability/appeal, fidelity) will also be collected. Discussion To our knowledge, this study will provide some of the first evidence concerning the effect of wearable activity trackers and digital behaviour change resources on adolescents’ physical activity levels. This study will provide insights into the use of such technologies for physical activity promotion, which may have a significant impact on health education, promotion, practice and policy. Trial registration Australian and New Zealand Clinical Trials Registry No: ACTRN12616000899448 . Date of registration: July 7, 2016.

Background There is some evidence that large energy intakes towards the end of the day are associated with adverse health outcomes, however, studies of temporal eating patterns across the day are rare. This study examines the temporal eating patterns of Australian adults using latent class analysis (LCA), as a novel approach. Methods Dietary data (n = 2402 men and n = 2840 women, ≥19 years) from two 24-h recalls collected during the 2011–12 Australian National Nutrition and Physical Activity Survey were analyzed. LCA was performed to identify distinct temporal eating patterns based on whether or not an eating occasion (EO) occurred within each hour of the day. F and adjusted-chi2 tests assessed differences in sociodemographic and eating patterns (e.g., meal, snack and EO frequency) between latent classes. Results Three patterns, labelled “Conventional” (men: 43%, women: 41%), “Later lunch” (men: 34%, women: 34%) and “Grazing” (men: 23%, women: 25%) were identified. Men and women with a “Grazing” pattern were significantly younger (P

RIDGERS, N. D., A. TIMPERIO, E. CERIN, and J. SALMON. Compensation of Physical Activity and Sedentary Time in Primary School Children. Med. Sci. Sports Exerc., Vol. 46, No. 8, pp. 1564–1569, 2014. Purpose: There is considerable debate about the possibility of physical activity compensation. This study examined whether increased levels in physical activity and/or sedentary behavior on 1 d were predictive of lower levels in these behaviors on the following day (compensatory mechanisms) among children. Methods :T wo hundred and forty-eight children (121 boys and 127 girls) age 8–11 yr from nine primary schools in Melbourne, Australia, wore a GT3X+ ActiGraph for seven consecutive days. Time spent in light physical activity (LPA) and moderate- to vigorous-intensity physical activity (MVPA) was derived using age-specific cut points. Sedentary time was defined as 100 counts per minute. Meteorological data (temperature, precipitation, relative humidity, and daylight hours) were obtained daily and matched to accelerometer wear days. Multilevel analyses (day, child, and school) were conducted using generalized linear latent and mixed models. Results: On any given day, every additional 10 min spent in MVPA was associated with approximately 25 min less LPA and 5 min less MVPA the following day. Similarly, additional time spent in LPA on any given day was associated with less time in LPA and MVPA the next day. Time spent sedentary was associated with less sedentary time the following day. Adjusting for meteorological variables did not change observed compensation effects. No significant moderating effect of sex was observed. Conclusion: The results are consistent with the compensation hypothesis, whereby children appear to compensate their physical activity or sedentary time between days. Additional adjustment for meteorological variables did not change the observed associations. Further research is needed to examine what factors may explain apparent compensatory changes in children’s

Involvement in meal preparation and eating meals with the family are associated with better dietary patterns in adolescents, however little research has included older children or longitudinal study designs. This 3-year longitudinal study examines cross-sectional and longitudinal associations between family food involvement, family dinner meal frequency and dietary patterns during late childhood. Questionnaires were completed by parents of 188 children from Greater Melbourne, Australia at baseline in 2002 (mean age = 11.25 years) and at follow-up in 2006 (mean age = 14.16 years). Principal components analysis (PCA) was used to identify dietary patterns. Factor analysis (FA) was used to determine the principal factors from six indicators of family food involvement. Multiple linear regression models were used to predict the dietary patterns of children and adolescents at baseline and at follow-up, 3 years later, from baseline indicators of family food involvement and frequency of family dinner meals. PCA revealed two dietary patterns, labeled a healthful pattern and an energy-dense pattern. FA revealed one factor for family food involvement. Cross-sectionally among boys, family food involvement score (β = 0.55, 95% CI: 0.02, 1.07) and eating family dinner meals daily (β = 1.11, 95% CI: 0.27, 1.96) during late childhood were positively associated with the healthful pattern. Eating family dinner meals daily was inversely associated with the energy-dense pattern, cross-sectionally among boys (β = −0.56, 95% CI: −1.06, −0.06). No significant cross-sectional associations were found among girls and no significant longitudinal associations were found for either gender. Involvement in family food and eating dinner with the family during late childhood may have a positive influence on dietary patterns of boys. No evidence was found to suggest the effects on dietary patterns persist into adolescence.

Background There is increasing availability of, and interest in, wearable activity trackers for children younger than 13 years. However, little is known about how children and parents use these activity trackers or perceive their acceptability. Objective This study primarily aimed to ascertain parental perspectives on the acceptability and usability of wearables designed to monitor children’s physical activity levels. Secondary aims were to (1) identify practical considerations for future use in physical activity interventions and promotion initiatives; (2) determine use of different features and functions incorporated into the accompanying app; and (3) identify parents’ awareness of their child’s current physical activity levels. Methods In total, 36 children (18 boys and 18 girls) aged 7-12 years were asked to wear a wrist-worn activity tracker (KidFit) for 4 consecutive weeks and to use the accompanying app with parental assistance and guidance. Each week, one parent from each family (n=25; 21 mothers and 4 fathers) completed a Web-based survey to record their child’s activity tracker use, app interaction, and overall experiences. At the end of the 4-week period, a subsample of 10 parents (all mothers) participated in face-to-face interviews exploring perceptions of the acceptability and usability of wearable activity trackers and accompanying apps. Quantitative and qualitative data were analyzed descriptively and thematically, respectively. Thematic data are presented using pen profiles, which were constructed from verbatim transcripts. Results Parents reported that they and their children typically found the associated app easy to use for activity tracking, though only step or distance information was generally accessed and some difficulties interpreting the data were reported. Children were frustrated with not being able to access real-time feedback, as the features and functions were only available through the app, which was typically accessed by, or in the presence of, parents. Parents identified that children wanted additional functions including a visual display to track and self-monitor activity, access to the app for goal setting, and the option of undertaking challenges against schools or significant others. Other barriers to the use of wearable activity trackers included discomfort of wearing the monitor because of the design and the inability to wear for water- or contact-based sports. Conclusions Most parents reported that the wearable activity tracker was easy for their child or children to use and a useful tool for tracking their children’s daily activity. However, several barriers were identified, which may impact sustained use over time; both the functionality and wearability of the activity tracker should therefore be considered. Overall, wearable activity trackers for children have the potential to be integrated into targeted physical activity promotion initiatives.

IntroductionPhysical activity is positively associated with children's classroom behaviour. However, less is known about how different types of physical activity contribute to these outcomes. This study examines associations between sport participation and classroom behaviour among primary school-aged children.MethodsParents of 568 children aged 9-11 years reported child sport participation and classroom behaviour outcomes (school functioning, inattention, classroom behaviour (fidgetiness), acting without thinking and poor concentration). Sport participation included: duration (hours/week) and type (individual; team; team and individual). Regression analyses assessed associations between sport participation and classroom behaviour outcomes. Analyses adjusted for maternal education, and objectively-measured overall physical activity, and accounted for clustering by recruitment centre. Sex differences in associations were explored as a secondary aim.ResultsIn comparison to children who did not participate in sport, children who participated in sport displayed less inattention/hyperactivity (individual sport: B = -1.00;95%CI:-1.90, -0.00; team sport:-0.88;95%CI:-1.73, -0.03) and less acting without thinking (individual sport: OR = 0.35;95%CI:0.13,0.98), after adjusting for overall physical activity. There were no sex differences in associations.ConclusionsFindings indicated sport participation, one form of physical activity, was associated with less inattention/hyperactivity and acting without thinking, over and above the influence of overall physical activity levels. Parents may consider sport as one way to contribute to their child's overall physical activity levels, although the impact of organised sport on classroom behaviour is modest at best.

The association between neighbourhood walkability and children's independent mobility using an ecological approach is relatively unexplored. In 2007, 1480 10- to 12-year-old children (and 1314 parents) attending low and high walkable schools across Perth, Western Australia, completed surveys. Objective built environment, social-cultural and individual-level factors were explored. High neighbourhood walkability predicted girls' independent mobility. However, girls and boys were more likely to be independently mobile if they and their parents were confident that they could travel independently. Providing safe, walkable neighbourhoods – particularly for girls – combined with strategies to improve children's skills to safely navigate their neighbourhood may increase independent mobility.

Background The afterschool period holds promise for the promotion of physical activity, yet little is known about the importance of this period as children age. Purpose To examine changes in physical activity of children aged 5–6 years and 10–12 years and their sedentary time in the afterschool period over 3 and 5 years, and to determine the contribution of this period to daily physical activity and sedentary behavior over time. Methods Data from two longitudinal studies conducted in Melbourne, Australia, were used. Accelerometer data were provided for 2053 children at baseline (Children Living in Active Neighbourhoods Study [CLAN]: 2001; Health, Eating and Play Study [HEAPS]: 2002/2003); 756 at 3-year follow-up (time point 2 [T2]); and 622 at 5-year follow-up (T3). Light (LPA), moderate (MPA) and vigorous (VPA) physical activity were determined using age-adjusted cut-points. Sedentary time was defined as≤100 counts/minute. Multilevel analyses, conducted in April 2012, assessed change in physical activity and sedentary time and the contributions of the afterschool period to overall levels. Results Afterschool MPA and VPA decreased among both cohorts, particularly in the younger cohort, who performed less than half of their baseline levels at T3 (MPA: T1=24 minutes; T3=11 minutes; VPA: T1=12 minutes; T3=4 minutes). LPA also declined in the older cohort. Afterschool sedentary time increased among the younger (T1=42 minutes; T3=64 minutes) and older cohorts (T1=57 minutes; T3=84 minutes). The contribution of the afterschool period to overall MPA and VPA increased in the older cohort from 23% to 33% over 5 years. In the younger cohort, the contribution of the afterschool period to daily MPA and VPA decreased by 3% over 5 years. Conclusions The importance of the afterschool period for children’s physical activity increases with age, particularly as children enter adolescence.

Objective Parks are an important setting for physical activity and specific park features have been shown to be associated with park visitation and physical activity. Most park-based research has been conducted in urban settings with few studies examining rural parks. This study examined differences in features of parks in urban compared with rural areas. Methods In 2009/10 a tool was developed to audit 433 urban and 195 rural parks located in disadvantaged areas of Victoria, Australia. Features assessed included: access; lighting/safety; aesthetics; amenities; paths; outdoor courts/ovals; informal play spaces; and playgrounds (number, diversity, age appropriateness and safety of play equipment). Results Rural parks scored higher for aesthetics compared with urban parks (5.08 vs 4.44). Urban parks scored higher for access (4.64 vs 3.89), lighting/safety (2.01 vs 1.76), and diversity of play equipment (7.37 vs 6.24), and were more likely to have paths suitable for walking/cycling (58.8% vs 40.9%) and play equipment for older children (68.2% vs 17.1%). Conclusion Although the findings cannot be generalized to all urban and rural parks, the results may be used to inform advocacy for park development in rural areas to create parks that are more supportive of physical activity for children and adults.

This study examined cross-sectional and prospective associations between clusters of neighbourhood attributes (typologies) and non-school moderate-to-vigorous physical activity, sedentary time (objectively measured) and proxy-reported television viewing among children aged 5-6 and 10-12 years. Four distinct clusters were identified from seven objectively-measured neighbourhood attributes (land use mix, traffic exposure, playgrounds, sports venues, intersections and cul-de-sacs within 800m, crime/postcode). Some cross-sectional associations with behavior were found. Longitudinally, the cluster characterised by mixed land use and many playgrounds and sport venues was associated with less television viewing on weekends three years later. Considering the aggregate effects of urban form elements may help understand how combinations of neighbourhood attributes influence behavior.

Background Investigating socioeconomic variation in physical activity (PA) and sedentary time is important as it may represent a pathway by which socioeconomic position (SEP) leads to ill health. Findings on the association between children's SEP and objectively assessed PA and/or sedentary time are mixed, and few studies have included international samples. Objective Examine the associations between maternal education and adolescent's objectively assessed PA and sedentary time. Methods This is an observational study of 12 770 adolescents (10–18 years) pooled from 10 studies from Europe, Australia, Brazil and the USA. Original PA data were collected between 1997 and 2009. The associations between maternal education and accelerometer variables were examined using robust multivariable regression, adjusted for a priori confounders (ie, body mass index, monitor wear time, season, age and sex) and regression coefficients combined across studies using random effects meta-analyses. Analyses were conducted in March 2014. Results Adolescents of university educated mothers spent more time sedentary (9.5 min/day, p=0.005) and less time in light activity (10 min/day, p Conclusions Across a number of international samples, adolescents of mothers with lower education may not be at a disadvantage in terms of overall objectively measured PA.

BACKGROUND: Skipping breakfast is associated with poorer diet quality among adults, but evidence of associations for other eating patterns [e.g., eating occasion (EO), meal, or snack frequency] is equivocal. An understanding of how eating patterns are associated with diet quality is needed to inform population-level dietary recommendations. OBJECTIVE: We aimed in this cross-sectional study to determine the relation between frequency of meals, snacks, and all EOs with nutrient intakes and diet quality in a representative sample of Australian adults. METHODS: Dietary data for 5242 adults aged ≥19 y collected via two 24-h recalls during the 2011-2012 National Nutrition and Physical Activity Survey were analyzed. EO, meal, and snack frequency was calculated. Adherence to recommendations for healthy eating was assessed with the use of the 2013 Dietary Guidelines Index (DGI) and its subcomponents. Linear regression, adjusted for covariates and energy misreporting, was used to examine associations between eating patterns, energy-adjusted nutrient intakes, and the DGI-2013. RESULTS: The frequency of meals, but not of snacks, was positively associated with micronutrient intakes, overall diet quality [men: β = 5.6 (95% CI: 3.9, 7.3); women: β = 4.1 (95% CI: 2.2, 5.9); P < 0.001], and DGI-2013 component scores for cereals, lean meat and alternatives, and alcohol intake (P < 0.05). A higher frequency of all EOs, meals, and snacks was positively associated with DGI-2013 scores for food variety, fruits, and dairy foods (P < 0.05). Conversely, a higher snack frequency was associated with a lower compliance with guidelines for discretionary foods and added sugars among men (P < 0.05). CONCLUSIONS: These findings suggest that meal frequency is an important determinant of nutrient intakes and diet quality in Australian adults. Inconsistent associations for snack frequency suggest that the quality of snack choices is variable. More research examining the dietary profiles of eating patterns and their relations with diet quality is needed to inform the development of meal-based guidelines and messages that encourage healthy eating.

Children spend over 60% of their school day sitting; much of this occurs in the classroom. Emerging research has examined the impact of environmental interventions on classroom sitting. While this research is promising, it has predominantly focused on the primary school setting. This study examined the impact and feasibility of height-adjustable desks on time spent sitting/standing during classroom lessons in a secondary school. Traditional desks in a Melbourne secondary school classroom were replaced with 27 height-adjustable desks (intervention classroom). Forty-three adolescents (51% male; mean age 13.7 ± 1.4 years) from Grades 7, 9 and 10 wore an inclinometer and accelerometer for schooldays and completed a survey after using the desks during lessons for seven weeks. Ten teachers (50% male) completed a survey. Time spent sitting, standing, and the length of sitting bouts were compared between periods when adolescents were in the intervention classroom versus traditional classrooms (matched on teacher and subject). Compared to the traditional classroom, adolescents spent 25% less time sitting and 24% more time standing in the intervention classroom (effect size > 0.8), and had a greater frequency of short sitting bouts and fewer longer bouts. The majority of teachers (71%) and students (70%) reported wanting to continue to use the height-adjustable desks. When standing during lessons, adolescents reported working well (69%); however, a third reported difficulties paying attention (28%) and becoming distracted (36%). Few teachers reported negative influences on adolescents’ ability to work (14%) and concentrate (14%). Half the adolescents reported leg, or back pain with standing. Introducing height-adjustable desks resulted in lower levels of sitting compared with traditional classrooms, was acceptable and had some adverse effects on concentration and discomfort. The study provides preliminary evidence that height-adjustable desks may help reduce prolonged sitting in school among adolescents. Future research should incorporate a control group and explore behavioural and academic outcomes.

OBJECTIVES: Different accelerometer cutpoints used by different researchers often yields vastly different estimates of moderate-to-vigorous intensity physical activity (MVPA). This is recognized as cutpoint non-equivalence (CNE), which reduces the ability to accurately compare youth MVPA across studies. The objective of this research is to develop a cutpoint conversion system that standardizes minutes of MVPA for six different sets of published cutpoints.DESIGN: Secondary data analysis.METHODS: Data from the International Children's Accelerometer Database (ICAD; Spring 2014) consisting of 43,112 Actigraph accelerometer data files from 21 worldwide studies (children 3-18 years, 61.5% female) were used to develop prediction equations for six sets of published cutpoints. Linear and non-linear modeling, using a leave one out cross-validation technique, was employed to develop equations to convert MVPA from one set of cutpoints into another. Bland Altman plots illustrate the agreement between actual MVPA and predicted MVPA values.RESULTS: Across the total sample, mean MVPA ranged from 29.7MVPAmind(-1) (Puyau) to 126.1MVPAmind(-1) (Freedson 3 METs). Across conversion equations, median absolute percent error was 12.6% (range: 1.3 to 30.1) and the proportion of variance explained ranged from 66.7% to 99.8%. Mean difference for the best performing prediction equation (VC from EV) was -0.110mind(-1) (limits of agreement (LOA), -2.623 to 2.402). The mean difference for the worst performing prediction equation (FR3 from PY) was 34.76mind(-1) (LOA, -60.392 to 129.910).CONCLUSIONS: For six different sets of published cutpoints, the use of this equating system can assist individuals attempting to synthesize the growing body of literature on Actigraph, accelerometry-derived MVPA.

OBJECTIVES: To assess whether associations between neighbourhood environmental features and frequency of children's active trips per week are moderated by frequency of parental accompaniment when walking/cycling. DESIGN: Cross-sectional survey METHODS: Children aged 10-12 years (n=677) were recruited from 19 schools in Melbourne, Australia. Parents reported the number of walking/cycling trips/week usually made by their child to eight local destinations. Environmental variables (i.e. number of cul-de-sacs, intersections, public open spaces (POS) defined as reserves or parks, sport and recreation POS, sport options, population density, length of busy roads and length of walking/cycling tracks) within an 800m buffer around participants' homes were objectively assessed with a Geographic Information System. Associations between neighbourhood features and frequency of active trips were assessed using multilevel linear regressions. Moderating effects of regular parental accompaniment when walking/cycling were examined. RESULTS: Parental co-participation in walking and cycling was positively associated with frequency of overall walking/cycling trips. Number of intersections, sport and recreation POS, sport options and population density were positively associated with walking/cycling trips. Only one significant interaction was found; a positive association was found between intersection density and walking/cycling trips among children whose parents did not cycle with them while it was not associated among others. CONCLUSIONS: Building supporting and safe neighbourhood environments is needed to support children's active travel behaviours to improve real and perceived safety concerns and provide relevant infrastructure and destinations, regardless of whether or not parents accompany children during walking and cycling. Although little evidence of moderation was found, future research should include co-participation in a broader range of walking behaviours. KW: SR2S Language: en

During school hours, children can sit for prolonged and unbroken periods of time. This study investigated the impact of an 8-month classroom-based intervention focusing on reducing and breaking-up sitting time on children's cardio-metabolic risk factors (i.e., body mass index, waist circumference, blood pressure) and perceptions of musculoskeletal discomfort. Two Year-6 classes (24 students per class) in one primary school were assigned to either an intervention or control classroom. The intervention classroom was equipped with height-adjustable desks and the teacher was instructed in the delivery of pedagogical strategies to reduce and break-up sitting in class. The control classroom followed standard practice using traditional furniture. At baseline, and after 8-months, time spent sitting, standing, stepping, and sitting-bouts (occasions of continuous sitting) as well as the frequency of sit-to-stand transitions were obtained from activPAL inclinometers and the time spent in light-intensity physical activity was obtained from ActiGraph accelerometers. Demographics and musculoskeletal characteristics were obtained from a self-report survey. Hierarchical linear mixed models found that during class-time, children's overall time spent sitting in long bouts (>10 min) were lower and the number of sit-to-stand transitions were higher in the intervention group compared to the control group, while no changes were observed for musculoskeletal pain/discomfort. No significant intervention effects were found for the anthropometrics measures and blood pressure. Height-adjustable desks and pedagogical strategies to reduce/break-up sitting can positively modify classroom sitting patterns in children. Longer interventions, larger and varied sample size may be needed to show health impacts; however, these desks did not increase musculoskeletal pain/discomfort. Refereed/Peer-reviewed

Background The neighbourhood environment such as the availability of parks are a key, but under-researched, influence on adolescents’ physical activity. In addition to overall physical activity levels, park-based physical activity and park visitation is low in this age group. Thus, it is critical to identify park features that may encourage or discourage adolescents from visiting parks. This study used a novel methodology to identify key physical characteristics of parks that are perceived to be important for park visitation and park-based physical activity among adolescents. Methods Four secondary schools located in low, mid and high socio-economic status areas of Victoria, Australia were recruited. Using a purpose-built computer application, students in years 8–10 were presented with 44 original photographic images of park features. Participants rated each image (range 1–10) on how likely the feature would be to encourage them to visit a park and to engage in park-based physical activity, and placed symbols (‘thumbs up’/‘thumbs down’) on aspects of the image that had a positive or negative influence on their ratings. Results Participants (n = 99) had a mean age of 13.3 years (SD = 0.87) and 53 % were female. Overall, the top three rated images prompting park visitation by adolescents were: a long steep slide, a flying fox and a table tennis table. These first two features were also reported as being likely to promote physical activity in the park. Differences in ratings were observed for boys and girls. The images that received the greatest number of “thumbs-up” symbols included large swings and slides, table tennis tables, no-smoking signs, flying foxes and BMX tracks. The images that received the greatest number of “thumbs-down” symbols included signage about rules, graffiti, toilets, concrete steps, and skate bowls. Conclusion Physically challenging play equipment is likely to encourage adolescents to visit and be active in parks. Rules, graffiti, toilets and skate bowls may discourage visitation. It is important for park designers, planners and policy makers to consider adolescents’ views of what park design features are important so that parks are created that support and encourage visitation and optimise levels of physical activity when in the park. Electronic supplementary material The online version of this article (doi:10.1186/s12966-016-0391-9) contains supplementary material, which is available to authorized users.

Associations between access to local destinations and children’s independent mobility (IM) were examined. In 2007, 10- to 12-year-olds ( n = 1,480) and their parents ( n = 1,314) completed a survey. Children marked on a map the destinations they walked or cycled to ( n = 1,132), and the availability of local destinations was assessed using Geographic Information Systems. More independently mobile children traveled to local destinations than other children. The odds of IM more than halved in both boys and girls whose parents reported living on a busy road (boys, OR = 0.48; girls, OR = 0.36) and in boys who lived near shopping centers (OR = 0.18) or community services (OR = 0.25). Conversely, the odds of IM more than doubled in girls living in neighborhoods with well-connected low-traffic streets (OR = 2.32) and increased in boys with access to local recreational (OR = 1.67) and retail (OR = 1.42) destinations. Creating safe and accessible places and routes may facilitate children’s IM, partly by shaping parent’s and children’s feelings of safety while enhancing their confidence in the child’s ability to use active modes without an adult.