Publications

Demographic, family, and home characteristics play an important role in determining childhood sedentary behaviour. The objective of this paper was to identify correlates of total sedentary time (SED) and correlates of self-reported screen time (ST) in Canadian children.Child- and parent-reported household, socio-demographic, behavioural, and diet related data were collected; directly measured anthropometric and accelerometer data were also collected for each child. Participants with complete demographic, anthropometric, and either SED (n=524, 41% boys) or ST (n=567, 42% boys) data from the Canadian site of the International Study of Childhood Obesity Lifestyle and the Environment (ISCOLE) were included in analysis. Sixteen potential correlates of SED and ST were examined using multilevel general linear models, adjusting for sex, ethnicity, number of siblings, and socio-economic status. All explanatory variables moderately associated (p<0.10) with SED and/or ST in univariate analyses were included in the final, fully-adjusted models. Variables that remained significant in the final models (p<0.05) were considered correlates of SED and/or ST.Children averaged 8.5 hours of daily SED; no differences in total SED, or total ST were seen between girls and boys, but boys reported significantly more video game/computer usage than girls. Boys also had higher waist circumference and BMI z-scores than girls. In the final models, waist circumference and number of TVs in the home were the only common correlates of both SED and ST. SED was also negatively associated with sleep duration. ST was also positively associated with mother's weight status, father's education, and unhealthy eating pattern score and negatively associated with healthy eating pattern score, and weekend breakfast consumption. Few common correlates existed between boys and girls.Several factors were identified as correlates of SED and/or of ST in Canadian children; however, few correlates were common for both SED and ST, and for both boys and girls. This suggests that a single strategy to reduce SED and ST is unlikely to be effective. Future work should examine a variety of other, non-screen based sedentary behaviours and their potential correlates in the hopes of creating tailored public health messages to reduce SED and ST in both boys, and girls.

No abstract is provided for this article.

Introduction School-aged children experience successive academic demands that increase over time. Extracurricular sport develops skills that involve physical movement, social rules, formal practice, and rational competition. This may facilitate success. Purpose Using a prospective-longitudinal birth cohort of 746 girls/721 boys, we examined prospective associations between middle childhood sport participation with subsequent indicators of academic success in adolescence. We hypothesized that persistent participation would promote long-term achievement indicators. Methods Mothers reported on whether the child participated in sporting activities with a coach/instructor from ages 6 to 10 yr. Developmental trajectories of participation were generated using longitudinal latent class analysis and then used to predict outcomes. From ages 12 to 17 yr, youth self-reported on academic indicators of success over the last 6 months. These were linearly regressed on trajectories of participation in sport, while controlling for preexisting and concurrent child/family confounds. Results Children’s sport participation from kindergarten to fourth grade predicted long-term chances of academic success in boys and girls, above and beyond individual/family confounders. Consistent participation predicted increments indicators of future success and reductions in academic failure and dropout risk through to the senior year of secondary school, ranging from 9.1% to 21.3% for girls and 11.7% to 22.9% for boys. Conclusions We provide compelling and timely evidence of long-term associations between children’s sport participation and subsequent indicators of academic success in typically developing boys and girls by late adolescence. Persistent sport involvement in sport increased educational prospects by late adolescence, potentially improving opportunities for success in emerging adulthood.

Introduction Increased screen time is a ubiquitous part of adolescent life and is adversely associated with their well-being. However, it remains unclear whether different types of screen time have equivalent associations, or if relationships are dose-dependent. Methods The data were from 2 nationally representative Health Behaviour in School-aged Children (2010, 2014) surveys across 44 European and North American countries. Psychosomatic health was assessed using 8 complaints and dichotomized as high or low. Discretionary time spent on passive (e.g., TV) and mentally active (e.g., electronic games, computer use) screen-based activities was categorized into 3 groups. Data were analyzed in 2021. Results The study included 414,489 adolescents (average age, 13.6 [SD=1.63] years; 51.1% girls). Multilevel modeling showed that psychosomatic complaints increased monotonically once all forms of screen time exceeded 2 hours/day. Adolescents reporting high (>4 hours/day) TV time, compared with those reporting low (≤2 hours/day), had higher odds of reporting psychosomatic complaints with 67% higher odds (OR=1.67, 95% CI=1.62, 1.72) in boys and 71% (OR=1.71, 95% CI=1.66, 1.75) in girls. High electronic game use was associated with psychosomatic complaints, with odds being 78% higher in boys (OR=1.78, 95% CI=1.73, 1.84) and 88% higher in girls (OR=1.88, 95% CI=1.82, 1.94). Similar associations were found between computer use and psychosomatic complaints. Conclusions Passive and mentally active screen time are adversely associated with psychosomatic complaints in a dose-dependent manner, with associations slightly stronger for active than passive screen time. This study supports limiting any type of screen time, either passive or active, to 2 hours/day to foster well-being.

<sec> <title>BACKGROUND</title> Participation in outdoor play has been extensively documented as beneficial for the health, well-being, and development of children. Canadian early childhood education centers (ECECs) are important settings in young children’s lives and provide opportunities to participate in outdoor play. However, there are barriers to the provision of outdoor play opportunities at ECECs, such as adverse weather conditions, poorly designed outdoor spaces, outdoor time policies, and early childhood educator comfort levels. </sec> <sec> <title>OBJECTIVE</title> The PROmoting Early Childhood Outside (PRO-ECO) study is a wait-list control cluster randomized trial that evaluates the impact of the PRO-ECO intervention, an innovative outdoor play intervention, on children’s outdoor play behavior. The purpose of this paper was to provide a detailed overview of the pilot study protocol and the methods that will be used to develop, implement, and evaluate the PRO-ECO intervention. </sec> <sec> <title>METHODS</title> A total of 8 ECECs delivering licensed care to children aged 2.5 to 6 years in the Greater Vancouver region of British Columbia, Canada, and operated by the YMCA of Greater Vancouver (YMCA GV) are included in this study. Using a wait-list control cluster randomized trial design, we randomly allocated ECECs to either the PRO-ECO intervention arm (n=4) or the wait-list control arm (n=4). The primary outcome measures include changes in the proportion and diversity of observed outdoor play behavior during dedicated outdoor times at the ECECs as measured through observational behavior mapping. Secondary outcome measures include changes in educator attitudes; quality of ECECs’ outdoor play space; and children’s psychosocial strengths, physical activity levels, and social behaviors. A process evaluation of the acceptability of the PRO-ECO intervention in the 8 YMCA GV ECECs will also be assessed. Outcome data will be collected at baseline, 6-month follow-up, and 12-month follow-up. Mixed effect models will test the effect of the PRO-ECO intervention on quantitative outcomes. Baseline and postintervention data will be included in the analysis, controlling for the cluster design. Qualitative data will support quantitative findings and provide evidence for the acceptability of implementation. </sec> <sec> <title>RESULTS</title> Participant recruitment for this study began in August 2021, and baseline data collection was completed at all 8 ECECs in November 2021. As of April 2022, a total of 130 children have been recruited to participate in this study. </sec> <sec> <title>CONCLUSIONS</title> The PRO-ECO pilot study will develop, implement, and evaluate the PRO-ECO intervention within 8 YMCA GV ECECs in the Vancouver region of British Columbia, Canada. The findings of this study will be useful for early childhood educators, ECEC providers, and policy makers to consider means for enhancing outdoor play provision and assessing the sustainability of the intervention in ECEC settings. </sec> <sec> <title>CLINICALTRIAL</title> ClinicalTrials.gov NCT05075580; https://clinicaltrials.gov/ct2/show/NCT05073380 </sec> <sec> <title>INTERNATIONAL REGISTERED REPORT</title> DERR1-10.2196/38365 </sec>

Physical literacy is described as the motivation, confidence, physical competence, knowledge and understanding to value and engage in a physically active lifestyle. As such, it is expected that those who have greater physical literacy would be more likely to obtain the health benefits offered by habitual physical activity. A theoretical model and assessment battery, the Canadian Assessment of Physical Literacy (CAPL), for the assessment of childhood physical literacy had been proposed in theory but validity data were lacking. The purpose of this study was to explore validity evidence for the CAPL among children in grades 4 to 6.CAPL validity was evaluated through three analyses that utilized cross-sectional data obtained through local schools in Eastern Ontario, Canada. A confirmatory factor analysis compared the data to the theoretical model. Patterns of association between self-reported age and gender and the CAPL total and domain scores were examined using regression models. Teacher ratings of participants' knowledge, attitude and physical activity competence were compared to assessment results.The CAPL was completed by 963 children (55 % female) in grades 4, 5 and 6. Children were 8 to 12 years of age (mean 10.1 years), with 85 % of children approached agreeing to participate. A confirmatory factor analysis using data from 489 children with complete raw scores supported a model with four domains: engagement in physical activity (active and sedentary), physical competence (fitness and motor skill), motivation and confidence, and knowledge and understanding. Raw domain scores followed expected patterns for age and gender, providing evidence for their validity. Interpretive categories, developed from age and gender adjusted normative data, were not associated with age indicating that the CAPL is suitable for use across this age range. Children's gender was associated with the physical competence, motivation and engagement in physical activity domain scores, indicating that further research is required regarding the gender adjustment of the raw CAPL scores. CAPL domain and total scores were statistically significantly associated with teacher ratings of the child's motivation, attitudes, fitness, skill and overall physical activity.CAPL offers a comprehensive assessment of engagement in physical activity, physical competence, motivation and confidence, and knowledge and understanding as components of childhood (grades 4 to 6, 8 to 12 years) physical literacy. Monitoring of these measures enhances our understanding of children's physical literacy, and assists with the identification of areas where additional supports are required.

Children's active transportation (AT) and independent mobility (IM) can provide benefits for health and social development. Using data from two national surveys, we assessed parent-perceived changes in AT and IM among 5- to 17-year-olds in Canada since the outbreak of COVID-19. About half of parents reported no changes, but two to three times more parents reported declines compared to increases in AT and IM. We explored many potential correlates of changes in AT and IM. Changes in IM were the strongest correlate of changes in AT. Strategies to minimize unintended negative impacts on children's physical activity from policies to prevent infectious disease transmission should be developed.

The brand of organizations (i.e., our associations linked to organizations) promoting more physical activity (PA) may predict important PA variables. The Brand Equity Pyramid (Keller, 2003), a theory which describes the process of brand development (i.e., salience, beliefs, judgements and feelings, and relationship), may predict development of a PA-promotion brand. Relationship with the brand may also predict important determinants such as intentions to be more physically active. One objective of this study was to examine brand development of ParticipACTION--a Canadian not-for-profit organization that promotes PA. A secondary objective was to investigate whether relationship with the brand can predict intentions to be more physically active. A nationally representative sample of Canadian adults who were aware of ParticipACTION (n=1,191) completed an online survey. Confirmatory factor analysis (CFA) was used to verify the factor structure and structural equation modeling (SEM) was used to test relationships between variables. CFA revealed the hypothesized five-factor solution with good model fit, RMSEA=.065, GFI=.964 (factor loadings=.57-.94). SEM, RMSEA=.078, GFI=.945, also confirmed the hypothesized relationships between variables. Salience predicted beliefs (p

The purposes of this study were to: (i) provide contemporary estimates of the prevalence of abdominal obesity, as assessed by waist circumference (WC), in Canadian adolescents and adults; (ii) provide estimates of the prevalence of abdominal obesity within normal weight, overweight and obese body mass index categories and (iii) examine secular changes in abdominal obesity. Data were based on three national health surveys conducted in 1981, 1988 and 2007–2009. WC was measured at the mid-point between the last rib and iliac crest in all three surveys. The prevalence of Canadians with abdominal obesity increased with age and was higher in females than in males. In 12- to 19-year-old adolescents, the estimated prevalence of abdominal obesity was 1.8% in 1981, 2.4% in 1988 and 12.8% in 2007–2009. The corresponding values for 20- to 69-year-old adults were 11.4%, 14.2% and 35.6%. Between 1981 and 2007–2009, mean WC values increased by 4.2 cm in adolescent males, 6.7 cm in adolescent females, 6.5 cm in men and 10.6 cm in women. Within the 2007–2009 survey, 2.6% of normal weight adults had abdominal obesity, 35.3% of overweight adults had abdominal obesity and 93.0% of obese adults had abdominal obesity.

Restrictions to childcare, schools, and after-school programs during COVID-19 have meant that many programs and organizations have adapted to take place outdoors. To better understand the nature and extent of these adaptations, we conducted a Canada-wide environmental scan of outdoor play-based child and youth projects, programs, activities, and services available during the height of the pandemic (2020-2021) using a "formal searching" method. We identified 79 items in Canada related to outdoor play during COVID-19 and received 36 responses to our survey of child and youth-oriented outdoor play providers (conducted during May 2021). This scan highlights the overwhelming support for outdoor play during the pandemic and makes recommendations on how outdoor play may support post-pandemic recovery efforts.

<h3>Objectives</h3> One-fifth of Canadian women of childbearing age have a red blood cell (RBC) folate below concentrations considered optimal for maximal neural tube defect risk reduction (&lt;906 nmol/l). This study explored the determinants of RBC folate concentrations ≥906 nmol/l Canadian women. <h3>Methods</h3> RBC folate concentrations from the nationally representative Canadian Health Measures Survey were assessed in women aged 15 to 45 years (N=1162). The population was described using frequencies and percentages. Sociodemographic, behavioural and clinical determinants of concentrations ≥906 nmol/l were examined using univariate and separate multiple logistic regression models controlling for age and household income. <h3>Results</h3> More women with folate concentrations ≥906 nmol/l were evident in higher age groups (15 to 19 years (70.0%), 20 to 39 years (79.6%), 40 to 45 years (80.8%)) and income quartiles (74.7% (Q1), 76.8% (Q2), 80.2% (Q3), 86.3% (Q4)). Folic acid containing supplement users had a higher prevalence of concentrations ≥906 nmol/l (87.9%) than non- users (75.2%). Prevalence of concentrations ≥906 nmol/l rose with higher intake of fruit/vegetables (&lt; once per day (64.7%), 1–2 times per day (74.2%) and &gt;3 times per day (82.9%)) and grain products (&lt; once per day (67.7%), 1–2 times per day (80.5%), &gt;3 times per day (77.6%)). Detailed regression analysis results will be presented at the conference. <h3>Interpretation</h3> These results will inform nutrition policies, particularly those related to folic acid fortification of select grains and preconception/prenatal folic acid supplementation recommendations for women of childbearing age. This will ultimately contribute to improving the health of Canadians and optimising infant health.

Cardiovascular disease and type 2 diabetes are examples of chronic diseases that impose significant morbidity and mortality in the general population worldwide. Most chronic diseases are associated with underlying preventable risk factors, such as elevated blood pressure, high blood glucose or glucose intolerance, high lipid levels, physical inactivity, excessive sedentary behaviours, and overweight/obesity. The occurrence of intermediate outcomes during childhood increases the risk of disease in adulthood. Sugar-sweetened beverages are known to be significant sources of additional caloric intake, and given recent attention to their contribution in the development of chronic diseases, a systematic review is warranted. We will assess whether the consumption of sugar-sweetened beverages in children is associated with adverse health outcomes and what the potential moderating factors are. Of interest are studies addressing sugar-sweetened beverage consumption, taking a broad perspective. Both direct consumption studies as well as those evaluating interventions that influence consumption (e.g. school policy, educational) will be relevant. Non-specific or multi-faceted behavioural, educational, or policy interventions may also be included subject to the level of evidence that exists for the other interventions/exposures. Comparisons of interest and endpoints of interest are pre-specified. We will include randomized controlled trials, controlled clinical trials, interrupted time series studies, controlled before-after studies, prospective and retrospective comparative cohort studies, case–control studies, and nested case–control designs. The MEDLINE®, Embase, The Cochrane Library, CINAHL, ERIC, and PsycINFO® databases and grey literature sources will be searched. The processes for selecting studies, abstracting data, and resolving conflicts are described. We will assess risk of bias using design-specific tools. To determine sets of confounding variables that should be adjusted for, we have developed causal directed acyclic graphs and will use those to inform our risk of bias assessments. Meta-analysis will be conducted where appropriate; parameters for exploring statistical heterogeneity and effect modifiers are pre-specified. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach will be used to determine the quality of evidence for outcomes. PROSPERO CRD42014009641 .

Physical literacy is an emerging construct in children's health promotion, and may impact their lifelong physical activity habits. However, recent data reveal that only a small portion of Canadian children are regularly physically active and/or meet sedentary behaviour guidelines. To our knowledge, no study has investigated the association between physical literacy and movement behaviour guidelines. Therefore, the purpose of this study was to examine the relationship between physical literacy scores in Canadian children who meet or do not meet physical activity and sedentary behaviour guidelines.Children (n = 2956; 56.6% girls) aged 8-12 years from 10 Canadian cities had their physical literacy levels measured using the Canadian Assessment of Physical Literacy, which consists of four domains (Physical Competence; Daily Behaviour; Knowledge and Understanding; and Motivation and Confidence) that are aggregated to provide a composite physical literacy score. Physical activity levels were measured by pedometers, and sedentary behaviour was assessed through self-report questionnaire. Analyses were conducted separately for each guideline, comparing participants meeting versus those not meeting the guidelines. Comparisons were performed using MANOVA and logistic regression to control for age, gender, and seasonality.Participants meeting physical activity guidelines or sedentary behaviour guidelines had higher physical literacy domain scores for Physical Competence and for Motivation and Confidence compared to those not meeting either guideline (both p < 0.0001). Participants had increased odds of meeting physical activity guidelines and sedentary behaviour guidelines if they met the minimum recommended level of the Physical Competence and Motivation and Confidence domains. Significant age (OR 0.9; 95% CI: 0.8, 0.9), gender (OR 0.4; 95% CI: 0.3, 0.5) and seasonality effects (OR 1.6; 95% CI: 1.2, 2.2 spring and OR 1.7; 95% CI: 1.2, 2.5 summer, reference winter) were seen for physical activity guidelines, and age (OR 0.8; 95% CI: 0.7, 0.8) and gender effects (OR 1.7; 95% CI: 1.4, 2.0) for sedentary behaviour guidelines. Knowledge and Understanding of physical activity principles was not related to guideline adherence in either model.These cross-sectional findings demonstrate important associations between physical literacy and guideline adherence for physical activity and sedentary behaviour. Future research should explore the causality of these associations.