Abstract
BackgroundAll 24-h movement behaviors, i.e. physical activity, sedentary behavior and sleep, are important for optimal health in children. Currently, no tools exist that include all 24-h behaviors and have been proven to be both reliable and valid. Potential reasons for the inadequate validity and reliability of existing questionnaires are the lack of focus on the content validity and lack of involvement of children in the development. Therefore, the aim of this study was to co-create a 24-h movement behavior tool together with 9–12-year-old children.MethodsConcept mapping and photovoice meetings were held to identify children’s physical activity behaviors. During concept mapping meetings with four groups of children (n = 40), children generated an extensive list of physical activities they engaged in, sorted the activities in categories and rated the frequency and perceived intensity of these activities. Using photovoice, three groups of children (n = 24) photographed their physical activities during one weekday and one weekend day, named the photographs, and placed them on a timeline. Furthermore, researchers obtained information on relevant items regarding sleep and sedentary behavior by screening existing questionnaires. Thereafter, we developed the first version of MyDailyMoves. Subsequently, we examined the content validity of the tool together with three groups of children (n = 22) and one group of researchers (n = 7) using focus group meetings.ResultsMyDailyMoves has a timeline format, onto which children add the activities they performed the previous day. Based on the concept mapping and photovoice studies, eight physical activity categories were included: playing inside, playing outside, sports, hobbies, chores, personal care, transport, and others. Sleep questions and two more sedentary categories (schoolwork and screen time) were added to MyDailyMoves to define and complete the timeline. The content validity study showed that all items in the tool were relevant. However, children mentioned that the activity category ‘eating’ was missing and the understandability of how to use the tool should be improved by adding an explanatory video. Both suggestions were adopted in the second version.ConclusionIncluding the children’s perceptions throughout the tool development process resulted in a comprehensive and practical tool which is easy for children to use.
Highlights
All 24-h movement behaviors, i.e. physical activity, sedentary behavior and sleep, are important for optimal health in children
Reasons for drop-out were the following: a child claiming that all his activities were already photographed (n = 1), parental concerns about their child working individually on the project (n = 1), and children losing interest after the second or third session (n = 3)
The children were recruited from three urban located schools/ after school-care facilities of which all were located in the suburbs
Summary
All 24-h movement behaviors, i.e. physical activity, sedentary behavior and sleep, are important for optimal health in children. No tools exist that include all 24-h behaviors and have been proven to be both reliable and valid. The importance of all 24-h movement behaviors, including physical activity, sedentary behavior and sleep, for optimal health in children has emerged [1]. A large body of evidence exists for the relationship between childhood physical activity and various health benefits [2]. Few children meet the physical activity recommendations [9, 10], the majority of children spend a large amount of their time sedentary [11, 12], and sleep duration seems to decline [13, 14]
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