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Objective: Motor competence development from early to middle childhood is accompanied by great variance. This course can be influenced by many factors in the ecosystem. The objective of this study was to examine which individual characteristics are associated with an undesirable motor competence development during the transition from early to middle childhood., Methods: A longitudinal study was conducted between February 2020 and May 2022. Actual and perceived motor competence and the potential determinants physical activity enjoyment, weight status, and organized sports participation of children ( 49% boys ) aged 4-6 years old at T0 (N = 721) were measured at two points in time, separated by a two-year interval. Associations between potential determinants and AMC, including interactions with time, were analyzed using linear mixed-effect regression models with continuous motor quotient scores as outcome variables., Results: Overweight, obesity, and lack of organized sports participation were associated with lower motor quotient scores over time. Multivariate analyses showed that associations of weight status (overweight and obesity) and sports participation with motor quotient scores remained significant after adjustment for variations in perceived motor competence and physical activity enjoyment., Conclusions: Excessive body weight and lack of sports participation from early childhood are associated with an increased risk of an undesirable motor competence development over time.

Objectives: The development of children's motor competence (MC) from early to middle childhood can follow different courses. The purpose of this longitudinal study was to describe and quantify the prevalence of patterns of MC development from early to middle childhood and to identify undesirable patterns., Design: The study used a longitudinal design. Data were collected in three consecutive years, between February 2020 (T0) and May 2022 (T2)., Methods: A total of 1128 typically developing Dutch children (50.2% male) between 4 and 6 years old at baseline (M = 5.35 ± 0.69 years) participated in this study. MC was measured with the Athletic Skills Track and converted into Motor Quotient (MQ) scores. To convert all individual MQ scores into meaningful patterns of MC development, changes in MQ categories were analyzed between the different timepoints., Results: A total of 11 different developmental patterns were found. When grouping the different patterns, five undesirable patterns were found with 18.2% of the children, showing an undesirable pattern of MC development between T0 and T2. The patterns of motor development of the other children showed a normal or fluctuating course., Conclusions: There is a lot of variation in MC in early and middle childhood. A substantial percentage of young children showed undesirable MC developmental patterns emphasizing the need for early and targeted interventions.

The aim of the present study was to explore the impact of TARGET-based teaching strategies on students' motivation in a Dutch secondary school PE context. We examined to what extent mastery climate teaching strategies perceived by students (independently or interactively) explain variability in students' motivation towards PE. In total 3,150 students (48.2% girls; 51.8% boys) with a mean age of 13.91 years (SD = 1.40) completed the Behavioural Regulations in Physical Education Questionnaire (BRPEQ), measuring students' autonomous motivation, controlled motivation and amotivation, and the Mastery Teaching Perception Questionnaire (MTP-Q), measuring student-perceived application of mastery TARGET teaching strategies. Hierarchical regression analyses indicated that after controlling for gender, age, and educational type, the predictive effects of the perceived mastery climate teaching strategies differed by motivational outcome. Overall, students who reported higher levels of perceived application of mastery TARGET teaching strategies showed more autonomous motivation and less amotivation. Specifically, the teaching strategies within the task structure were the strongest predictors for students' autonomous motivation and amotivation. No meaningful statistically significant two-way interaction effects between any of the TARGET variables were found, supporting the proposition of an additive relationship between the TARGET teaching strategies., Competing Interests: The authors have declared that no competing interests exist.

Background: Following an ecological framework, the aim of this study was to highlight the way adolescents invested their time in opportunities to engage in moderate to vigorous physical activity (MVPA) according to whether they were profiled as more or less active. This study's innovation lies in the analysis of MVPA according to social occasions which are understood as opportunities to be active throughout the day (e.g. home, school, transport)., Methods: PA data measured by accelerometry (ActiGraph GT3X) for seven consecutive days were compiled, with adolescents' social occasions during the week recorded in a daily digital diary (n = 135). The opportunity ratio of MVPA at each social time is the ratio between time spent in MVPA and the duration of a corresponding social occasion. Following the literature, participants were categorised into three profiles according to their reported amount of MVPA: HEPA active, minimally active and inactive. Non-parametric Wilcoxon signed rank and Kruskal Wallis tests were performed to determine the relative intensity of PA performed at different social occasions, and to investigate whether intensities differed between adolescents with various activity profiles., Results: Results showed that engagement in MVPA at different social occasions differed according to participant profiles. Mismatch was noticed between the opportunity ratio and the duration of the most and least favorable social occasions for MVPA. For all three profiles, the social occasion "physical education lesson" revealed an opportunity ratio of MVPA (23.6% vs 17.0% vs 13.8%) significantly higher than the overall opportunity ratio of the week (6.9% vs 2.9% vs 1.2%), but of lower duration. Conversely, "home" (5.3% vs 0.0% vs 0.0%) and "school" (outside of PE time) (2.4% vs 0.0% vs 0.0%) represented the two least opportune social occasions for PA in an adolescent's week., Conclusions: Rethinking engagement with MVPA in the context of temporal opportunities would allow potential ways to intervene within an educational supervised setting to help young people adopt a physically active lifestyle at the end of the key period of adolescence. These results reinforced the importance of context in interventions for PA promotion, opening for "time education" in people., (© 2022. The Author(s).)

Background: This study examined longitudinal associations of motor competence (MC) and physical activity (PA) enjoyment with moderate to vigorous PA and sedentary behavior among boys and girls aged 10-12 years old. In addition, this study explored the predictive strength of satisfaction of basic psychological needs in physical education (PE) and PA enjoyment., Methods: At 3 time points (baseline, +1 y, and +2 y), PA levels, MC, PA enjoyment, satisfaction of basic psychological needs in PE and height and weight of 371 children were measured. Data were analyzed using repeated-measures linear mixed model analyses stratified for gender and adjusted for relevant covariates., Results: Sedentary behavior decreased over time and was significantly predicted by PA enjoyment in boys and by PA enjoyment and MC in girls. Boys' moderate to vigorous PA decreased over time and was predicted by MC, whereas girls' moderate to vigorous PA remained low, yet stable over time and was predicted by PA enjoyment and MC. Furthermore, children's need for competence and teacher relatedness (girls only) during PE significantly predicted PA enjoyment., Conclusions: Children need sufficient and well-designed opportunities to improve their MC and PA enjoyment. PE may be pivotal in advancing PA enjoyment, indicating that PE could have more beneficial effects on PA levels in children, especially in girls.

Introduction: Previous longitudinal studies indicate that physical activity (PA) significantly declines from primary-to secondary school, and report both changes in individual and environmental determinants of PA. In order to understand this transition and to prevent this negative trend, it is important to gather contextually rich data on possible mechanisms that drive this decline. Therefore, the aim of this study was to investigate changes of PA patterns in transition between primary and secondary school, and to add domain-specific insights of how, where, and when these changes occur., Methods: In total, 175 children participated in a 7-day accelerometer- and Global Positioning System (GPS) protocol at their last year of primary and their first year of secondary school. GPS data-points were overlaid with Geographical Information Systems (GIS) data using ArcGIS 10.1 software. Based on the GPS locations of individual data-points, we identified child's PA at home, school, local sports grounds, shopping centers, and other locations. Also, trips in active and passive transport were identified according to previously validated GPS speed-algorithms. Longitudinal multi-level linear mixed models were fitted adjusting for age, gender, meteorological circumstances, and the nested structure of days within children and children within schools. Outcome measures were minutes spent in light PA and moderate-to-vigorous PA, specified for the time-segments before school, during school, after school and weekend days., Results: Total PA significantly declined from primary to secondary school. Although transport-related PA increased before- and during school, decreases were found for especially afterschool time spent at sports grounds and transport-related PA during weekends., Conclusions: This is the first study that demonstrated longitudinal changes of context- and domain-specific PA patterns in transition between primary and secondary school, based on device-assessed PA. Given the importance of this transition-period for the development of long-term PA patterns, results from this study warrant the development of evidence-based PA programs in this transition period, while acknowledging the integrative role of schools, parents, and afterschool sports providers. More specifically, the results underline the need to increase children's PA levels in primary schools, promote afterschool PA at secondary schools, and to prevent the drop-out in sports participation at secondary schools.

Background: Sedentary behavior and decreased physical activity are possible risk factors for developing asthma. This longitudinal study investigates the association between physical activity and subsequent asthma. We hypothesize that children with decreased physical activity at early school age, have higher risk of developing asthma., Methods: One thousand eight hundred thirty-eight children from the KOALA Birth Cohort Study were analyzed. Children who were born prematurely or with congenital defects/diseases with possible influence on either physical activity or respiratory symptoms were excluded. Physical activity, sedentary behavior, and screen time were measured at age 4 to 5 years by questionnaire and accelerometry in a subgroup (n = 301). Primary outcome was asthma, assessed by repeated ISAAC questionnaires between age 6 and 10. Secondary outcome was lung function measured by spirometry in a subgroup (n = 485, accelerometry subgroup n = 62) (forced expiratory volume in 1 second [FEV1], forced vital capacity [FVC] and FEV1/FVC ratio) at age 6 to 7 years., Results: Reported physical activity was not associated with reported asthma nor lung function. Accelerometry data showed that daily being 1 hour less physically active was associated with a lower FEV1/FVC (z score β, -0.65; 95% confidence interval, -1.06 to -0.24)., Conclusions: Physical activity at early school age was not associated with reported asthma development later in life. However, lung function results showed that sedentary activity time was associated with lower FEV1/FVC later in childhood. As this is the first longitudinal study with objectively measured physical activity and lung function, and because the subgroup sample size was small, this result needs replication., (© 2019 The Authors. Pediatric Pulmonology published by Wiley Periodicals, Inc.)

Children with low motor competence (MC) are at high-risk for physical inactivity, yet little is known about their physical activity (PA) and sedentary behavior (SB) patterns throughout the day. The purpose of this study is to disentangle PA and SB patterns among children with low MC across segmented day periods taking into account differences in gender and age. Data collection took place between May and July 2017. The Athletic Skills Track was used to measure MC. PA levels were objectively measured using accelerometers (ActiGraph, GT3X+) on school days. Data were segmented for (1) time before school, (2) time during school (based on school schedules), and (3) time after school. In total, data from 117 7-to-11 years-old children with low MC were eligible for analyses ( N = 58 girls; N = 59 boys). Differences in moderate-to-vigorous PA (MVPA) and SB between segmented periods, gender, and grade were analyzed by ANOVAs with post hoc tests (Tukey) and Independent Sample T-tests respectively. Time spent at school is the major contributor of time spent in SB in children with low MC. Low MC is equally distributed among gender, but large differences exist among boys and girls in both MVPA and SB, indicating low-MC girls as most inactive group. This pattern is found in all segmented periods of the school day, i.e., before, during, and after school. This study stresses the negative contribution of current school curricula on PA and SB in children with low MC, indicating the most efficient period of the day to intervene. Future school-based PA and SB interventions should particularly focus on specific high-risk populations, i.e., children with low MC, and girls in particular.

Introduction: The objective of this study was to assess relationships between children's physical environment and afterschool leisure time physical activity (PA) and active transport., Methods: Children aged 10-12 years participated in a 7-day accelerometer and Global Positioning Systems (GPS) protocol. Afterschool leisure time PA and active transport were identified based on location- and speed-algorithms based on accelerometer, GPS and Geospatial Information Systems (GIS) data. We operationalized children's exposure to the environment by combining home, school and the daily transport environment in individualized daily activity-spaces., Results: In total, 255 children from 20 Dutch primary schools from suburban areas provided valid data. This study showed that greenspaces and smaller distances from the children's home to school were associated with afterschool leisure time PA and walking. Greater distances between home and school, as well as pedestrian infrastructure were associated with increased cycling., Conclusion: We demonstrated associations between environments and afterschool PA within several behavioral contexts. Future studies are encouraged to target specific behavioral domains and to develop natural experiments based on interactions between several types of the environment, child characteristics and potential socio-cognitive processes.

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 body mass 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°C and 22°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 PA patterns may help in the design of future studies, interpretation of their results, and translation into PA promotion.

Background: Physical Activity (PA) occurs in several behavioral domains (e.g., sports, active transport), and is affected by distinct environmental factors. By filtering objective PA using children's school schedules, daily PA can be separated into more conceptually meaningful domains. We used an ecological design to investigate associations between "playability" of 21 school-environments and children's objectively measured after-school PA. We also examined to what extent distinct time-periods after-school and the distance from children's residence to their school influenced this association., Methods: PA was measured in 587 8-11 year-old children by accelerometers, and separated in four two-hour time-periods after-school. For each school-environment, standardized playability-scores were calculated based on standardized audits within 800 m network buffers around each school. Schools and children's residences were geocoded, and we classified each child to be residing in 400, 800, 1600, or >1600 m crow-fly buffers from their school. The influence of network-distance buffers was also examined using the same approach., Results: Playability was associated with light PA and moderate-to-vigorous PA after-school, especially in the time-period directly after-school and among children who lived within 800 m from their school. Playability explained approximately 30% of the after-school PA variance between schools. Greater distance from children's residence to their school weakened the association between playability of the school-environments and after-school PA., Conclusions: This study demonstrated that relationships between the conceptually matched physical environment and PA can be revealed and made plausible with increasing specificity in time and distance.

Background: Physical activity (PA) enjoyment may be an important determinant of long-term habitual, self-sustained PA behavior in children. The objective of the current study was to contribute toward a better understanding of how children's PA enjoyment is associated with PA behavior by examining the influence of age, gender, BMI, and impulsivity as theoretically hypothesized moderators of this relationship., Methods: PA was measured in 171 children (77 boys, 91 girls) using accelerometers, and PA enjoyment was assessed with the validated Physical Activity Enjoyment Scale in 9-year-old children from the KOALA Birth Cohort Study, the Netherlands. Linear regressions were fitted. Moderation was tested by adding interaction terms between PA enjoyment and the potential moderators., Results: We found a significant 3-way interaction (PA enjoyment × gender × impulsivity) for all intensities of PA behavior. In boys, impulsivity strengthened the relationship between PA enjoyment and PA behavior, whereas in girls impulsivity weakened this relationship., Conclusion: In girls, this may be explained by the relative automatic occurrence of PA behavior in impulsive girls (independent of PA enjoyment). In boys, the possibility that impulsivity is associated with hyperactivity may explain this moderation. The current study may encourage researchers to investigate these interactions in future studies.

Background: A natural and cheap way of increasing children's physical activity is stimulating unstructured outside play., Purpose: This study examined whether characteristics of the family and perceived physical environment were associated with the duration of children's outside play., Methods: Parents participating in the "Be Active, Eat Right" cluster RCT control group (N = 2007) provided information on potential predictors of outside play (i.e. family and perceived physical environment) of their 5-year-old child by questionnaire. Child outside play was assessed by parental reports both at five and seven years. Linear regression analyses, adjusted for seasonality, were performed to evaluate associations between potential predictors and child outside play. Linear mixed models were fitted to evaluate the relationship between potential predictors and the development of outside play over two years, with season entered as a random factor., Results: Family environment was the strongest construct predicting child outside play, while parent perceived physical environment had no significant association with child outside play. Parental habit strength and the presence of rules were the strongest predictors of increased outside play. Parent perceived difficulty in improving child outside play was the strongest predictor of decreased outside play., Conclusion: Family environment predicted child outside play and not perceived physical environment. Parental rules and habit strength regarding improving outside play were associated with an improvement of child's engagement in outside play.

Objective: This study reported on correlates of parental perception of their child's weight status. Associations between parental misperception (i.e., underestimation of the child's weight) and parental intention to improve their child's overweight-related health behaviors and their child meeting guidelines regarding these behaviors were also investigated., Methods: Baseline data from the population-based 'Be active, eat right study' were used. The population for analysis consisted of 630 overweight and 153 obese five year-old children and their parents. Questionnaires were used to measure parental perception of the child's weight status, correlates of misperception (i.e., child age, child gender, child BMI, parental age, parental gender, parental country of birth, parental educational level and parental weight status), overweight-related health behaviors (i.e., child playing outside, having breakfast, drinking sweet beverages, and watching TV), and parental intention to improve these behaviors. Height and weight were measured using standardized protocols. Multivariable logistic regression analyses were performed., Results: In total, 44.40% of the parents misperceived their child's weight status. Parental misperception was associated with lower child BMI, the parent being the father, a foreign parental country of birth, and a lower parental education level (p<0.05). Parental misperception was not associated with parental intention to improve child overweight-related health behavior, nor with child meeting the guidelines of these behaviors., Discussion: This study showed that almost half of the parents with an overweight or obese child misperceived their child's weight status. A correct parental perception may be a small stepping-stone in improving the health of overweight and obese children.

Purpose: Studies estimating the contribution of physical activity (PA) to the development of body mass index (BMI) in critical periods of childhood are warranted. Therefore, we have prospectively investigated this relationship in boys and girls of the KOALA Birth Cohort study, the Netherlands, in the period around adiposity rebound (i.e., 4-9 yr old)., Methods: PA was assessed in 470 children (231 boys, 239 girls) using accelerometers at the ages of 5 and 7 yr, and height and weight were measured at 5, 7, and 9 yr. BMI z-scores were calculated to standardize for age and sex. Leaner and heavier children were classified according to the 25th and 75th percentile of our study sample. To examine longitudinal relationships between PA and BMI z-scores, generalized estimating equation analyses were performed and stratified for sex and baseline weight status (leaner, normal weight, and heavier children)., Results: In heavier children, an increment of 6.5 min of moderate to vigorous PA (MVPA) was related to a subsequent decrease of 0.03 BMI z-scores both in boys (95% confidence interval = -0.07 to -0.001) and girls (95% confidence interval = -0.05 to -0.002). Light PA was also associated with a decrease of BMI in heavier boys but not girls. In normal weight children, MVPA was associated with decrease of BMI in boys but not girls., Conclusion: Increments of MVPA were associated with decreases in BMI z-score in heavier children, both boys and girls. Promoting MVPA should remain a major prevention vehicle for improving body composition in 4- to 9-yr-old children.

Background: Two overweight prevention interventions were developed to be offered by preventive Youth Health Care (YHC) in addition to the currently applied overweight prevention protocol to parents of 0-3 year old children. The two interventions aim to support parents of preschool children to realize healthy child nutrition and activity behaviors of their young child. The aim of this study is to assess the effects of the two overweight prevention interventions with regard to child health behaviors and child Body Mass Index., Methods/design: A cluster randomized controlled trial was conducted among parents and their preschool children who attend one of 51 participating YHC teams. The teams were randomly allocated to one of the two intervention groups, or to the control group (care as usual).The 'BBOFT+' intervention focuses on effective child rearing by parents from birth onwards by enlarging parental skills concerning healthy behavioural life-style habits. Parents who are allocated to the 'E-health4Uth Healthy toddler' intervention group, at the child age of circa 18 and 24 months old, are invited to complete an online E-health module providing tailored health education regarding healthy child nutrition and activity behaviors. The E-health messages are discussed and reinforced during the subsequent regularly scheduled visits by YHC professionals, and were repeated after 4 weeks.The primary outcome measures at child age 3 years are: overweight inducing/reducing behaviors, (for 'BBOFT+' only) healthy sleep, Body Mass Index and prevalence of overweight and obesity. Secondary outcome measures are attitudes and other cognitive characteristics of the parents regarding the overweight-related behaviors of their child, parenting styles and practices, and health-related quality of life of the children., Discussion: We hypothesize that the use of the additional interventions will result in a healthier lifestyle of preschool children and an improved BMI and less development of overweight and obesity compared to usual care., Trial Registration: Nederlands Trial Register NTR1831.

The purpose of this study was to compare the efficacy of intraosseous injection and inferior alveolar (IA) nerve block in anesthetizing mandibular posterior teeth with irreversible pulpitis. Thirty human subjects were randomly assigned to receive either intraosseous injection using the IntraFlow system (Pro-Dex Inc, Santa Ana, CA) or IA block as the primary anesthesia method. Pulpal anesthesia was evaluated via electric pulp testing at 4-minute intervals for 20 minutes. Two consecutive 80/80 readings were considered successful pulpal anesthesia. Anesthesia success or failure was recorded and groups compared. Intraosseous injection provided successful anesthesia in 13 of 15 subjects (87%). The IA block provided successful anesthesia in 9 of 15 subjects (60%). Although this difference was not statistically significant (p = 0.2148), the results of this preliminary study indicate that the IntraFlow system can be used as the primary anesthesia method in teeth with irreversible pulpitis to achieve predictable pulpal anesthesia.