Publications

Objective This systematic review aimed to summarize research that assessed the associations between 20m shuttle run test (20mSRT) performance and indicators of physiological, psychosocial and cognitive health among school-aged children and youth. Design Systematic review. Methods Five online databases were used to identify peer-reviewed studies published from 1980 to 2016. Studies were included if they matched these criteria: population (children and youth with a mean age of 5–17 years and/or in Grades 1–12), intervention/exposure (performance on the 20mSRT), and outcomes (health indicators: adiposity, cardiometabolic biomarkers, cognition, mental health, psychosocial health, self-esteem and physical self-perception, quality of life and wellbeing, bone health, musculoskeletal fitness, motor skill development, and injuries and/or harm). Narrative syntheses were applied to describe the results. A lack of homogeneity precluded a meta-analysis approach. Results Overall, 142 studies that determined an association between 20mSRT performance and a health indicator were identified, representing 319,311 children and youth from 32 countries. 20mSRT performance was favourably associated with indicators of adiposity, and some indicators of cardiometabolic, cognitive, and psychosocial health in boys and girls. Fewer studies examined the relationship between 20mSRT performance and measures of quality of life/wellbeing, mental health and motor skill development, and associations were generally inconsistent. The quality of the evidence ranged from very low to moderate across health indicators. Conclusion and Implications These findings support the use of the 20mSRT as a holistic indicator of population health in children and youth.

Background The coexistence of undernutrition (thinness) and overnutrition (overweight/obesity) among children and adolescents is a public health concern in low-middle-income countries. Accurate prevalence estimates of thinness and overweight/obesity among children and adolescents are unavailable in many low-middle-income countries due to lack of data. Here we describe the prevalences and examine correlates of objectively measured weight status among urban and rural schoolchildren in Mozambique. Methods A cross-sectional study design was applied to recruit 9-11-year-old schoolchildren (n = 683) from 17 urban and rural primary schools in Mozambique. Body mass index (BMI) was computed from objectively measured height and weight and participants’ weight categories were determined using the World Health Organization cut-points. Actigraph GT3X + accelerometers were worn 24 hours per day for 7 days to assess movement behaviours. Multilevel multivariable modelling was conducted to estimate odds ratios and confidence intervals. Results Combined prevalence of overweight/obesity (11.4%) was significantly higher among urban participants compared to rural participants (5.7%; χ2 = 7.1; p = 0.008). Conversely, thinness was more prevalent among rural (6.3%) compared to urban (4.2%) participants. Passive school commute, not meeting daily moderate- to vigorous-intensity physical activity (MVPA) guidelines, and maternal BMI >25 kg/m2 were associated with overweight/obesity while possessing one or more functional cars at home, maternal BMI >25 kg/m2 and being an older participant were associated with thinness in the present sample. The proportion of total variance in the prevalences of obesity and/or thinness occurring at the school level was 8.7% and 8.3%, respectively. Conclusion Prevalences of thinness, overweight/obesity and other key variables differ between urban and rural schoolchildren in Mozambique. MVPA, active transport and mother’s BMI are important modifiable correlates of weight status among Mozambican schoolchildren. Results from this study demonstrate important differences between urban and rural schoolchildren that should not be ignored when designing interventions to manage malnutrition, formulating public health strategies, and interpreting findings.

Physical fitness during childhood is an important indicator of current and future health. This paper provides an overview of the fitness of Canadian children and youth aged 6 to 19 years.Data are from three cycles of the Canadian Health Measures Survey (CHMS) spanning a 10-year period: 2007 to 2009 (n = 2,081), 2009 to 2011 (n = 2,133) and 2016 to 2017 (n = 2,070). The CHMS is a comprehensive direct health measures survey conducted on a nationally representative sample of Canadians. Descriptive statistics for measures of cardiorespiratory fitness, muscular strength and power, flexibility, and body composition are provided by age group and sex. Physical fitness measures are presented for participants who met and did not meet the physical activity and screen time recommendations.Few changes in the fitness measures occurred over the past decade. Cardiorespiratory fitness decreased between 2007-2009 and 2016-2017 in 8 to 10 (52.1 to. 51.0 mL•kg-1•min-1) and 11 to 14 (50.8 to 49.8 mL•kg-1•min-1) year old boys. Girls generally had lower levels of fitness compared to boys, except for flexibility which was higher in girls. Cardiorespiratory fitness was higher in children and youth who met the current Canadian recommendations for physical activity and screen time. Grip strength was higher in boys who met the current Canadian screen time recommendation.Ongoing and periodic surveillance of fitness through the CHMS is important to monitor trends, assess future interventions designed to improve fitness levels at the population level and to increase our understanding of the relationships between fitness and health.

The Canadian 24-h movement guidelines were developed with the hope of improving health and future health outcomes in children and youth. The purpose of this study was to evaluate adherence to the 3 recommendations most strongly associated with health outcomes in new 24-h movement guidelines and their relationship with adiposity (obesity and body mass index z-score) across countries participating in the International Study of Childhood Obesity, Lifestyle and the Environment (ISCOLE).Cross-sectional results were based on 6128 children aged 9-11 years from the 12 countries of ISCOLE. Sleep duration and moderate-to-vigorous physical activity (MVPA) were assessed using accelerometry. Screen time was measured through self-report. Body weight and height were measured. Body mass index (BMI, kg · m-2) was calculated, and BMI z-scores were computed using age- and sex-specific reference data from the World Health Organization. Obesity was defined as a BMI z-score > +2 SD. Meeting the overall 24-h movement guidelines was defined as: 9 to 11 h/night of sleep, ≤2 h/day of screen time, and at least 60 min/day of MVPA. Age, sex, highest parental education and unhealthy diet pattern score were included as covariates in statistical models. Associations between meeting vs. not meeting each single recommendation (and combinations) with obesity were assessed with odds ratios calculated using generalized linear mixed models. A linear mixed model was used to examine the differences in BMI z-scores between children meeting vs. not meeting the different combinations of recommendations.The global prevalence of children meeting the overall recommendations (all three behaviors) was 7%, with children from Australia and Canada showing the highest adherence (15%). Children meeting the three recommendations had lower odds ratios for obesity compared to those meeting none of the recommendations (OR = 0.28, 95% CI 0.18-0.45). Compared to not meeting the 24-h movement recommendations either independently or combined, meeting them was significantly associated with a lower BMI z-score. Whenever the MVPA recommendation was included in the analysis the odds ratios for obesity were lower.For ISCOLE participants meeting these 3 healthy movement recommendations the odds ratios of being obese or having high BMI z-scores were lower. However, only a small percentage of children met all recommendations. Future efforts should aim to find promising ways to increase daily physical activity, reduce screen time, and ensure an adequate night's sleep in children.The International Study of Childhood Obesity, Lifestyle and the Environment (ISCOLE) was registered at ClinicalTrials.gov (Identifier NCT01722500) (October 29, 2012).

Evaluation of the original ParticipACTION campaign effects focused on individual awareness, recall, and understanding. Less studied has been the impact such campaigns have had on the broader organizational capacity to mobilize and advocate for physical activity. With the relaunch of ParticipACTION, the purpose of this study was to qualitatively explore baseline organizational capacity to promote physical activity messages, programs, and services within the Canadian context.Using a purposeful sampling strategy, we conducted semi-structured telephone interviews with 49 key informants representing a range of national, provincial, and local organizations with a mandate to promote physical activity. Interview data were analysed using a thematic analytic approach.Key informants painted a generally positive picture of current organizational capacity to promote physical activity messages, programs, and services in Canada. Will and leadership were clear strengths while infrastructure limitations remained the greatest concern. Some specific challenges included: 1) funding issues: the absence of core funding in a climate of shifting funding priorities; 2) the difficulty of working without a national physical activity policy (lack of leadership); 3) inconsistent provincial and educational sector level policies; and 4) a persistent focus on obesity rather than physical inactivity.The data generated here can be utilized to monitor the future impact of ParticipACTION on enhancing and utilizing this organizational capacity. A range of indicators are suggested that could be used to illustrate ParticipACTION's impact on the broad field of physical activity promotion in the future.

Brand equity (BE) is the degree to which individuals characterize and identify with a brand, which can add or detract from the brand’s value. Social marketing researchers have identified BE as a potential mediator of the relationship between exposure to campaign advertisements and resulting behaviour. This study examined whether BE accounts for the covariance between parents’ exposure to ParticipACTION campaign advertisements and parental support (PS) for their child’s physical activity. Data were drawn from ParticipACTION’s “Think Again” campaign evaluations that targeted parents, specifically moms, with children between the ages of 5 and 11 years (September 2011, moms=619, dads=37; March 2012, moms=650, dads=101). Structural equation modeling was used to test the predicted mediation relationship. In both models, 2 factors loaded on to advertisement exposure, 6 factors loaded on to BE, and 1 factor loaded on to PS. Model fit statistics (comparative fit index) for both models revealed good fit (September 2011 = 0.92, March 2012 = 0.94). Results demonstrated that “Think Again” advertisement exposure was related to BE (standardized effects .11-.15) and that BE was related to PS (standardized effects .33-.46) in both models ( ps < .01). Importantly, an indirect effect of advertisement exposure on PS through BE (standardized effects .04-.07) emerged in both models ( ps < .05). Parents with greater exposure to the advertisements reported greater BE and in turn greater PS than parents with less exposure. This study demonstrates the utility of branding social marketing campaigns to increase campaign effectiveness.  Acknowledgments: We would like to thank the Canadian Institute of Health Research, ParticipACTION Canada, and Queen's University.

Objective The aim was to assess associations between lifestyle behaviors and obesity in a multinational study of children from 12 countries representing a wide range of human development. Methods The sample included 6,025 children 9–11 years of age. Behavioral risk factors included nocturnal sleep duration, moderate to vigorous physical activity (MVPA), television viewing (TV time), and healthy and unhealthy diet pattern scores. Multilevel analyses were used to obtain odds ratios for obesity expressed per standard deviation of each behavioral risk factor. Results The odds ratios (95% confidence intervals) for obesity from multilevel, multivariable models were 0.79 (0.71–0.90) for nocturnal sleep duration, 0.52 (0.45–0.60) for MVPA, 1.15 (1.05–1.27) for TV time, 1.08 (0.96–1.20) for healthy diet score, and 0.93 (0.83–1.04) for unhealthy diet score in boys and 0.71 (0.63–0.80) for nocturnal sleep duration, 0.43 (0.35–0.53) for MVPA, 1.07 (0.96–1.19) for TV time, 1.05 (0.93–1.19) for healthy diet score, and 0.96 (0.82–1.11) for unhealthy diet score in girls. Conclusions Behavioral risk factors are important correlates of obesity in children, particularly low MVPA, short sleep duration, and high TV viewing.

This study aimed to describe adherence to 24-hour movement guidelines and determine factors associated with meeting guidelines in pregnancy planning and recently postpartum parents. A survey of preconception care attitudes and beliefs was conducted in Canadian adults who were pregnancy planning or ≤5 years postpartum. The Global Physical Activity Questionnaire was used to evaluate physical activity and sedentary time. Respondents reported the number of hours spent sleeping and using a screen per day. Multiple logistic regressions were run to determine factors (sociodemographic and health related) associated with meeting each individual movement guideline and number of guidelines met. 1080 females and 224 males provided survey data. 54.0% (n = 654) of the sample met the physical activity guideline, with no difference between females and males. More than 78.4% (n = 909) met the sedentary behavior guideline, 56.4% (n = 679) met the sleep guideline, and 15.4% (n = 187) met the screen time guideline. Only 5.0% (n = 60) of the sample met all four guidelines. Higher odds of meeting more guidelines were associated with parity and perceived health. Lower odds of meeting more guidelines were associated with obesity and overweight; and with depression. Most parents and parents-to-be are not meeting 24-hour movement guidelines. Interventions should focus on optimizing movement behaviors in the peri-partum period, while focusing on mental health, obesity, and general wellbeing.

Objective Recent evidence suggests that short bouts of uninterrupted sedentary behavior reduce insulin sensitivity and glucose tolerance while increasing triglyceride levels in both healthy and overweight/obese adults. To date no study has examined the acute impact of uninterrupted sitting in children and youth. The objective of the present study was to determine whether 8h of uninterrupted sitting increases markers of cardiometabolic disease risk in healthy children and youth, in comparison to 8h of sitting interrupted by light intensity walk breaks or structured physical activity. Materials/Methods 11 healthy males and 8 healthy females between the ages of 10 and 14years experienced 3 conditions in random order: (1) 8h of uninterrupted sitting (Sedentary); (2) 8h of sitting interrupted with a 2-min light-intensity walk break every 20min (Breaks); and (3) 8h of sitting interrupted with a 2-min light-intensity walk break every 20min as well as 2×20min of moderate-intensity physical activity (Breaks+Physical Activity). Insulin, glucose, triglyceride, HDL and LDL cholesterol area under the curve were calculated for each condition. Results We observed no significant differences in the area under the curve for any marker of cardiometabolic disease risk across the 3 study conditions (all p >0.09). Conclusions These results suggest that in comparison to interrupted sitting or structured physical activity, a single bout of 8h of uninterrupted sitting does not result in measurable changes in circulating levels of insulin, glucose, or lipids in healthy children and youth.

<sec> <title>Introduction</title> The objective of this article is to examine the association between outdoor physical activity (OPA) and mental health, life satisfaction, happiness and life stress among Canadian adolescents aged 12 to 17 years. </sec> <sec> <title>Methods</title> This cross-sectional and nationally representative study used self-reported data from the 2019 Canadian Health Survey on Children and Youth (n = 10 413). The survey categorized OPA into six groups (from 0 to ≥ 14 hours/week). Logistic regression analyses examined the associations between OPA levels and outcomes, with adjustments for relevant covariates. </sec> <sec> <title>Results</title> In adjusted models, OPA was not significantly associated with anxiety or depressive symptoms. Compared to adolescents with no OPA, those who engaged in ≥ 14 hours/week had higher odds of positive mental health (odds ratio [OR] = 1.64; 95% confidence interval [CI]: 1.13–2.38), high life satisfaction (OR = 1.75; 95% CI: 1.24–2.46) and high happiness (OR = 2.36; 95% CI: 1.59–3.50), independent of covariates including indoor physical activity. A positive dose–response relationship was observed between higher levels of OPA and life satisfaction and happiness. </sec> <sec> <title>Conclusion</title> Independent of indoor physical activity and other covariates, OPA was associated with positive mental health, high life satisfaction and high happiness, with levels of OPA of ≥ 14 hours/week (highest category) showing the strongest associations. Further studies are needed to elucidate the mechanisms linking OPA with higher life satisfaction and happiness. </sec>

Physical activity and sedentary behavior habits are established during early childhood, yet only recently has objectively measured data been available on children aged 5 years and younger. This study presents data on the physical activity and sedentary behaviors of Canadian children aged 3–5 years. Data were collected as part of the Canadian Health Measures Survey between 2009 and 2011. A nationally-representative sample (n = 459) of children aged 3–5 years wore Actical accelerometers during their waking hours for 7 consecutive days. Data were collected in 60-sec epochs and respondents with ≥4 valid days were retained for analysis. Parents reported their child’s physical activity and screen time habits in a questionnaire. Eighty-four percent of 3–4 year old children met the physical activity guideline of 180 minutes of total physical activity every day while 18% met the screen time target of <1 hour per day. Fourteen percent of 5 year old children met the physical activity guideline of 60 minutes of daily moderate-to-vigorous physical activity (MVPA) while 81% met the screen time target of <2 hours per day. Children aged 3–4 years accumulated an average of 352 min/d of total physical activity and 66 minutes of MVPA while 5 year old children accumulated an average of 342 min/d of total physical activity and 68 minutes of MVPA. Children were sedentary for approximately half of their waking hours and spent an average of 2 hours per day in front of screens. Only 15% of 3–4 year olds and 5% of 5 year olds are meeting both the physical activity and sedentary behavior guidelines. Promoting physical activity while reducing sedentary behavior is important at all stages of life. The findings of the present study indicate that there remains significant room for improvement in these behaviors among young Canadian children.

The impact of large-scale, 'mass' community-based sport, and physical activity (PA) events on population PA has yet to be established. The enhancement of organizational capacity to support health promotion initiatives is one mechanism through which such events may be helpful. Sports Day in Canada (SDIC) is an annual, nation-wide event celebrating the role of sport within communities and promoting sport participation. Beginning in 2010, thousands of Canadian sport and PA organizations have created SDIC events each year. The objective of this study was to examine the types of organizations who participate in SDIC and to determine if and how these organizations benefit from hosting an event. Online surveys of event organizers (2010 to 2013 SDIC) were conducted. Descriptive analyses identified organization and event characteristics, and one-way ANOVAs across time assessed event organizers' perceptions related to their overall satisfaction, benefits obtained, and challenges faced while participating in SDIC. Findings showed that organizations were mainly from the provinces of Ontario, British Columbia, and Quebec, worked with children and youth, and registered an event that was a tournament or school based. There was a significant increase in overall satisfaction [F(3, 996) = 27.26, p < .001] and benefits obtained [F(3, 1000) = 18.36, p < .001] across all four years of SDIC. One main benefit reported by organizations was an increased awareness and interest among community members in sport program(s) offered by their organization. Mass events like SDIC may help enhance organizational capacity to deliver health promotion initiatives including sport and PA programming.