Publications

Objectives: To examine how public attributions for the causes and solutions of physical inactivity and individuals' self-identified political orientation are associated with support for different policy actions in addressing physical inactivity. Methods: A secondary data analysis was conducted with a sample of 2,044 Canadian adults. Two sets of 2 X 3 analyses of variance were conducted to assess (1) the mean differences by the causal attributions for physical inactivity and political orientation, and (2) responsibility for solutions and political orientation on support for least, moderate, and most intrusive policy actions. Results: No interaction effects existed between causal attribution and political orientation on policy support, but the main effect of causal attributions and political orientation was significant. Those who held internal causal attributions showed less support for policies compared to those who held external or both internal and external causal attributions. Conservative individuals reported the least support for all policy actions in comparison to liberals or centrists. There were interaction effects between responsibility for solutions and political orientation on policy support. Conservatives who perceived the responsibility for solving physical inactivity as a private matter had less support for all three policies. Conclusions: Public acceptance of policy actions addressing physical inactivity varies by the attributions the public have regarding causes and responsibility for solving the problem, and by political orientation. Advocacy and messaging for policy implementation in the physical activity arena need to be communicated in ways that encourage reflective and informed deliberation that is representative of the Canadian population.

Walking and biking to school represent a source of regular daily physical activity (PA). The objectives of this paper are to determine the associations of distance to school, crime safety, and socioeconomic variables with active school transport (AST) among children from five culturally and socioeconomically different country sites and to describe the main policies related to AST in those country sites. The analytical sample included 2845 children aged 9–11 years from the International Study of Childhood Obesity, Lifestyle and the Environment. Multilevel generalized linear mixed models were used to estimate the associations between distance, safety and socioeconomic variables, and the odds of engaging in AST. Greater distance to school and vehicle ownership were associated with a lower likelihood of engaging in AST in sites in upper-middle- and high-income countries. Crime perception was negatively associated to AST only in sites in high-income countries. Our results suggest that distance to school is a consistent correlate of AST in different contexts. Our findings regarding crime perception support a need vs. choice framework, indicating that AST may be the only commuting choice for many children from the study sites in upper-middle-income countries, despite the high perception of crime.

<p><strong>Objective:</strong> The American Academy of Pediatrics recommends developmental surveillance and screening in early childhood in primary care. The 18-month visit may be an ideal time for identification of children with delays in language and communication, or symptoms of autism spectrum disorder (ASD). Little is known about the predictive validity of developmental screening tools administered at 18 months. Our objective was to examine the predictive validity of the Infant Toddler Checklist (ITC) at the 18-month health supervision visit, using school readiness at kindergarten age as the criterion measure.</p> <p><strong>Methods:</strong> We designed a prospective cohort study, recruiting in primary care in Toronto, Canada. Parents completed the ITC at the 18-month visit. Teachers completed the Early Development Instrument (EDI) when the children were in Kindergarten, age 4-6 years.We calculated screening test properties with 95% confidence intervals (CIs). We used multivariable logistic and linear regression analyses adjusted for important covariates.</p> <p><strong>Results: </strong>Of 293 children (mean age 18 months), 30 (10.2%) had a positive ITC including: concern for speech delay (n=11, 3.8%), concern for other communication delay (n=13, 4.4%), and concern for both (n=6, 2.0%). At follow-up (mean age 5 years), 54 (18.4%) had overall EDI vulnerability, 19 (6.5%) had vulnerability on the 2 EDI communication domains. The ITC sensitivity ranged from 11%-32%, specificity from 91%-96%, false positive rates from 4%-9%, PPV from 16%-35%, NPV from 83%-95%. A positive ITC screen and ITC concern for speech delay were associated with lower scores in EDI communication skills and general knowledge (β= −1.08; 95% CI: −2.10, −0.17; β= −2.35; 95% CI: −3.63, −1.32) and EDI language and cognitive development (β= −0.62; 95% CI: −1.25, −0.18; β= −1.22; 95% CI: −2.11, −0.58). </p> <p><strong>Conclusions: </strong>The ITC demonstrated high specificity suggesting that most children with a negative ITC screen will demonstrate school readiness at 4-6 years, and low false positive rates, minimizing over-diagnosis. The ITC had low sensitivity highlighting the importance of ongoing developmental surveillance and screening. </p>

PURPOSE: Moderate-to-vigorous physical activity (MVPA) is an accepted strategy for disease prevention and health promotion. Emerging evidence suggests that other intensities of physical activity (PA), including light-intensity (LPA), may also be important in this regard, but there has been no rigorous evaluation of the evidence. Therefore, the purpose of this review was to examine the relationships between objectively measured PA (total and all intensities) and health indicators in children and youth. METHODS: Online databases were searched for peer-reviewed studies that met the a priori inclusion criteria: population (apparently healthy, aged 5-17 years), intervention/exposure and comparator (volumes, durations, frequencies, and intensities of objectively measured PA), and outcome (adiposity, cardiometabolic biomarkers, fitness, behavioural conduct/pro-social behaviour, cognition/academic achievement, quality of life/well-being, harms, bone health, motor development, psychological distress, self-esteem). Quality of evidence was assessed using the GRADE framework. Heterogeneity precluded meta-analyses; narrative synthesis of included studies was conducted. RESULTS: 162 publications were included (85,532 participants from 31 countries). Overall, there was strong, consistent evidence that total PA (greater durations and intensities) was favourably associated with adiposity, fitness, cognition/academic achievement and bone health; weaker evidence of favourable relationships with cardiometabolic biomarkers and motor development; and little evidence regarding other outcomes. LPA was favourably associated with several cardiometabolic biomarkers; there was a paucity of data in relation to other outcomes. Evidence quality was very low to moderate. CONCLUSION: These findings continue to support the importance of MVPA for health promotion and disease prevention in children and youth, but also highlight the potential benefits of LPA and total PA. All intensities of PA should be considered in future work aimed at better elucidating the health benefits of PA in children and youth. Funded by: Canadian Society for Exercise Physiology, Conference Board of Canada, Healthy Active Living and Obesity Research Group at the CHEO Research Institute, Public Health Agency of Canada.

<p><strong>Background</strong></p> <p>Healthy childhood development is fostered through sufficient physical activity (PA; including time outdoors), limiting sedentary behaviours (SB), and adequate sleep; collectively known as movement behaviours. Though the COVID-19 virus outbreak has changed the daily lives of children and youth, it is unknown to what extent related restrictions may compromise the ability to play and meet movement behaviour recommendations. This secondary data analysis examined the immediate impacts of COVID-19 restrictions on movement and play behaviours in children and youth.</p> <p><strong>Methods</strong></p> <p>A national sample of Canadian parents (<em>n</em> = 1472) of children (5–11 years) or youth (12–17 years) (54% girls) completed an online survey that assessed immediate changes in child movement and play behaviours during the COVID-19 outbreak. Behaviours included PA and play, SB, and sleep. Family demographics and parental factors that may influence movement behaviours were assessed. Correlations between behaviours and demographic and parental factors were determined. For open-ended questions, word frequency distributions were reported.</p> <p><strong>Results</strong></p> <p>Only 4.8% (2.8% girls, 6.5% boys) of children and 0.6% (0.8% girls, 0.5% boys) of youth were meeting combined movement behaviour guidelines during COVID-19 restrictions. Children and youth had lower PA levels, less outside time, higher SB (including leisure screen time), and more sleep during the outbreak. Parental encouragement and support, parental engagement in PA, and family dog ownership were positively associated with healthy movement behaviours. Although families spent less time in PA and more time in SB, several parents reported adopting new hobbies or accessing new resources.</p> <p><strong>Conclusions</strong></p> <p>This study provides evidence of immediate collateral consequences of the COVID-19 outbreak, demonstrating an adverse impact on the movement and play behaviours of Canadian children and youth. These findings can guide efforts to preserve and promote child health during the COVID-19 outbreak and crisis recovery period, and to inform strategies to mitigate potential harm during future pandemics.</p>

The purpose of this study was to determine the validity of the SC-StepRx pedometer to assess moderate and vigorous physical activity during treadmill walking and running in a heterogeneous sample of children and youth aged 10-17 years. Physical activity intensity assessed via indirect calorimetry served as the criterion standard. A convenience sample of 40 participants (20 boys, 20 girls) wore 6 SC-StepRx pedometers, 2 ActiGraph GT3X accelerometers, 2 Actical accelerometers, 1 Walk4Life MVP pedometer and 1 NL-1000 pedometer while walking/running at speeds approximating 2, 3, 4, 6 and 7 METs. Associations between indirect calorimetry and each activity monitor were assessed using linear regression analyses in SAS 9.2. Estimates of moderate and vigorous physical activity from all monitors were significantly associated with the criterion standard of indirect calorimetry. The strongest associations with the criterion measure were observed for the SC-StepRx with moderate/vigorous thresholds of 110/130 steps•minute−1, and the NL-1000 (R2 = 0.82, p <0.05). The SC-StepRx with moderate/vigorous thresholds of 110/130 steps•minute−1 also exhibited the highest combined sensitivity (92.9%) and specificity (96.5%) for correctly identifying a bout of moderate-to-vigorous physical activity. This study demonstrates that the SC-StepRx pedometer is a valid tool for the measurement of moderate and vigorous physical activity in children and youth.

The ParticipACTION Report Card on Physical Activity for Children and Youth is the most comprehensive assessment of child and youth physical activity in Canada and provides an update or "state of the nation" that assesses how Canada is doing at promoting and facilitating physical activity opportunities for children and youth. The purpose of this paper is to summarize the results of the 2016 ParticipACTION Report Card.Twelve physical activity indicators were graded by a committee of experts using a process that was informed by the best available evidence. Sources included national surveys, peer-reviewed literature, and gray literature such as government and nongovernment reports and online content.Grades were assigned to Daily Behaviors (Overall Physical Activity: D-; Organized Sport and Physical Activity Participation: B; Active Play: D+; Active Transportation: D; Physical Literacy: D+; Sleep: B; Sedentary Behaviors: F), Settings and Sources of Influence (Family and Peers: C+; School: B; Community and Environment: A-), and Strategies and Investments (Government: B-; Nongovernment: A-).Similar to previous years of the Report Card, Canada generally received good grades for indicators relating to investment, infrastructure, strategies, policies, and programming, and poor grades for behavioral indicators (eg, Overall Physical Activity, Sedentary Behaviors).

Background Sedentary behavior has been associated with deleterious cardiometabolic health indicators in adults, but very little research has examined this relationship in youth. Purpose To examine the association between the duration and type of sedentary screen behavior with diabetes risk factors (fasting glucose, insulin, homeostasis model-insulin resistance [HOMA-IR], 2-hour postload glucose, hemoglobin A1c) in a sample of overweight and obese adolescents. Methods A cross-sectional study of 307 overweight or obese adolescents aged 14–18 years (90 boys, 217 girls) assessed at baseline of a lifestyle intervention for weight control conducted from 2005 to 2010. Sedentary screen behaviors, defined as hours per day spent watching TV, playing seated video games, recreational computer use, and total screen time were measured by self-report. Data were analyzed using linear regression analyses in 2012. Results TV viewing was the only type of sedentary screen behavior associated with elevated diabetes risk factors before and after adjustment for confounders. Specifically, TV viewing remained positively associated with fasting insulin (adjusted r=0.11, β=0.10, p=0.048) and HOMA-IR (adjusted r=0.11, β=0.10, p=0.05) after adjustment for age, gender, waist-to-hip ratio, caloric intake, percentage of intake in carbohydrates, physical activity duration, and physical activity intensity. Conclusions TV watching may be independently associated with an increase in diabetes risk factors in a high-risk sample of overweight and obese adolescents. These findings provide support for interventions designed to reduce time spent watching TV as a possible means to attenuating diabetes risk factors in this high-risk population. Trial registration This study is registered at clinicaltrials.gov NCT00195858.

The purpose of this study was to determine the association between regular (sugar containing) and diet (artificially sweetened) soft drink consumption and obesity in children from 12 countries ranging in levels of economic and human development. The sample included 6162 children aged 9-11 years. Information on soft drink consumption was obtained using a food frequency questionnaire. Percentage body fat (%BF) was estimated by bio-electrical impedance analysis, body mass index (BMI) z-scores were computed using World Health Organization reference data, and obesity was defined as a BMI > +2 standard deviations (SD). Multi-level models were used to investigate trends in BMI z-scores, %BF and obesity across categories of soft drink consumption. Age, sex, study site, parental education and physical activity were included as covariates. There was a significant linear trend in BMI z-scores across categories of consumption of regular soft drinks in boys (p = 0.049), but not in girls; there were no significant trends in %BF or obesity observed in either boys or girls. There was no significant linear trend across categories of diet soft drink consumption in boys, but there was a graded, positive association in girls for BMI z-score (p = 0.0002) and %BF (p = 0.0001). Further research is required to explore these associations using longitudinal research designs.

Physical literacy is influenced by physical, behavioural, affective, and cognitive factors. Researchers are interested in relationships among these constituent factors. The purpose of this study was to investigate how age, gender, and physical competence components of physical literacy relate to a child's adequacy in and predilection for physical activity. A sample of 8,530 Canadian youth (50% girl) aged 8.0 to 12.9 years participated in the study. Participants completed the Canadian Assessment of Physical Literacy (CAPL) protocol, which assesses physical literacy in four domains: Physical Competence, Daily Behaviour, Motivation and Confidence, and Knowledge and Understanding. Regression analyses investigated the relationship between physical competence components of physical literacy and children's perceived adequacy and predilection toward physical activity. The variable most strongly associated with adequacy and predilection was the PACER shuttle run score. The PACER accounted for 10.9% of the variance in adequacy and 9.9% of the variance in predilection. Participants' age was inversely related to adequacy (? = -0.374) and predilection (? = -0.621). The combination of other variables related to adequacy brought the total variance explained to 14.7%, while the model for predilection explained a total of 13.7%. Results indicate an association between cardiorespiratory fitness and measures of physical activity adequacy and predilection. These findings suggest that ADULTS IN POSITIONS WHERE THEY WHISH TO SUPPORT THE DEVELOMENT OF CHILDREN'S PHYSICAL LITERACY should consider the physiological and psychological makeup of the child, and ways to enhance adequacy and predilection among children with limited cardiorespiratory fitness, in order to create the best possible environment for all children to participate in physical activity.Acknowledgments: RBC Learn to Play

No abstract is provided for this article.

Objectives: To examine how public attributions for the causes and solutions of physical inactivity and individuals' self-identified political orientation are associated with support for different policy actions in addressing physical inactivity. Methods: A secondary data analysis was conducted with a sample of 2,044 Canadian adults. Two sets of 2 X 3 analyses of variance and post-hoc analyses were conducted to assess (1) the mean differences by the causes of the issue of physical inactivity (individual, or both internal and external/external) and political orientation (liberal, centrist, and conservative), and (2) responsibility for solutions (private matter, or both private and public health matter, and /public health matter) and political orientation on support for least, moderate, and most intrusive policy actions. Results: No interaction effects existed between causal attribution and political orientation on policy support, but a main effect of causal attributions for physical inactivity and political orientation was significant. Those who held internal attributions for the cause of physical inactivity showed less support for policies compared to those who held external causal attributions or both internal and external causal attributions. Conservative individuals reported the least support for all policy actions in comparison to liberal or centrist orientations. There were interaction effects between responsibility for solutions and political orientation on policy support. Conservative individuals who perceived the responsibility for solving physical inactivity as a private matter had less support for all three policy actions. Conclusions: Public acceptance of policy actions addressing physical inactivity varies by the attributions the public have regarding causes and responsibility for solving the problem, and by political orientation. Advocacy and messaging for policy implementation in the physical activity arena needs to be communicated in ways that encourage reflective and informed deliberation that is representative of the Canadian population.