Children's Physical Activity Levels Research Articles

Playing outdoor and practising sport: A study of physical activity levels in Portuguese children

In outdoor activities, it seems reasonable that the longer children spend in spontaneous physical activity (PA), the higher the probability of being active. Indeed, the time spent outdoor has been identified as a variable consistently associated with the children’s PA. Outdoor playing, such as the organized sports practice, appears associated with healthier lifestyle standards. All the recommendations mention the importance of increasing daily PA practice in children and teenagers, but few studies highlight the relationship between outdoor play and the recommended PA levels. The purpose of this study is to investigate the relationships between the frequency of outdoor play, the frequency of the organized sports practice, and the compliance of the recommendations for PA practice in children in the inner city area of Porto. The sample of this study is composed of 422 individuals (mean age of 11.6 years). Two hundred and twenty-five of them were girls and 197 were boys from the sixth grade (elementary schools located in the inner city area of Porto). PA was objectively evaluated using accelerometers. Participants reported frequency of participation in different PA contexts, such as sports practice and outdoor play. The results show a predictor effect of participating in sports three or more times per week on compliance of PA guidelines.In conclusion, organized sports practice seems more effective than outdoor play to reach the recommended levels of PA in children.

Household-level correlates of children's physical activity levels in and across 12 countries.

Household factors (electronic media equipment, play equipment, physical activity in the home, and social support) have been associated with childhood moderate- to vigorous-intensity physical activity (MVPA), but little is known about how these factors differ across diverse countries. The objective was to explore household correlates of objective MVPA in children from 12 countries. Overall, 5,859 nine- to eleven-year-old children from 12 countries representing a range of human and socioeconomic development indicators wore an accelerometer for 7 days and parents reported on household factors. Multilevel general linear models explored associations among household factors and MVPA variables controlling for age, sex, and parental education. Across sites, children with at least one piece of bedroom electronic media had lower MVPA (∼4 min/day; P < 0.001) than those who did not. More frequent physical activity in the home and yard, ownership of more frequently used play equipment, and higher social support for physical activity were associated with more MVPA (all P < 0.001). The association between play equipment ownership and MVPA was inconsistent across countries (interaction P < 0.01). With the exception of play equipment ownership, modifiable household factors showed largely consistent and important associations with MVPA across high-, mid-, and low-income countries.

Where are Children Active and Does it Matter for Physical Activity? A Latent Transition Analysis.

Numerous studies have focused on the role of environments in promoting physical activity, but few studies have examined the specific locations where children are active and whether being active in these locations is associated with physical activity levels over time. Self-reported locations of where physical activity occurred and physical activity measured via accelerometry were obtained for a cohort of 520 children in 5th and 6th grades. Latent class analysis was used to generate classes of children defined by the variety of locations where they were active (ie, home, school grounds, gyms, recreational centers, parks or playgrounds, neighborhood, and church). Latent transition analyses were used to characterize how these latent classes change over time and to determine whether the latent transitions were associated with changes in physical activity levels. Two latent classes were identified at baseline with the majority of children in the class labeled as 'limited variety.' Most children maintained their latent status over time. Physical activity levels declined for all groups, but significantly less so for children who maintained their membership in the 'greater variety' latent status. Supporting and encouraging physical activity in a variety of locations may improve physical activity levels in children.

Validity and reliability of HOP-Up: a questionnaire to evaluate physical activity environments in homes with preschool-aged children.

BackgroundEarly identification of physical activity (PA) opportunities in the home and neighborhood environment may help obesity prevention efforts in households with young children. This cross-sectional study’s purpose was to develop a brief, easy-to-use, self-report inventory called Home Opportunities for Physical activity check-Up (HOP-Up), to evaluate the availability and accessibility of PA space and equipment in and near homes with preschool children, and establish its validity and reliability.MethodsThe HOP-Up was field tested by two trained researchers and parents of preschool-aged children (n = 50; 71 % white). To establish criterion validity, researchers were the ‘gold standard’ and visited participants’ homes to assess their PA environments using the HOP-Up, while participants separately completed their HOP-Up. Two weeks later, parents completed the HOP-Up online for test-retest reliability. After minor survey refinements, exploratory and confirmatory factor analysis using a split-half cross validation procedure was conducted in a larger sample of participants (n = 655, 60 % white) who completed the HOP-Up online to examine its factor structure. To establish convergent validity, correlations were conducted to compare HOP-Up scales from the factor solution generated with PA behavior and cognitions, and reported screen time.ResultsIntra-class correlations (ICCs) examining HOP-Up item agreement between researcher and parents revealed slight to substantial agreement (range 0.22 to 0.81) for all items. ICCs for all HOP-Up items ranged from fair to substantial agreement between parent responses at both time points (range 0.42 to 0.95). Exploratory factor analysis revealed a five factor solution (18 items), supported eigen values, scree plots, review for contextual sense, and confirmatory factor analysis. Additionally, there were significant (p < 0.05) positive correlations among nearly all five HOP-Up scales with parent and child physical activity levels (range 0.08 to 0.35), and values parents placed on PA for self and child (range 0.16 to 0.35), and negative correlations of Neighborhood Space & Supports for PA scale with parent and child reported screen time (r = −0.11, r = −0.13, respectively).ConclusionsFindings support the psychometric properties of this brief, easy-to-use, HOP-Up questionnaire, which may help parents, prevention researchers, residential planners, and practitioners increase their understanding of how the home environment—inside, outside, and the neighborhood— impacts preschool children’s physical activity levels.

Effect of maternal health education on physical activity and body mass index of overweight children

Background The percentage of overweight children in Bengkulu (16.4%) is higher than the national percentage (11.9%). High energy intake and low physical activity are two factors that cause overweight.Objective To assess the impact of maternal health education on changes in maternal behavior, as well as energy intake, physical activity level, and body mass index (BMI) z-scores in overweight children aged 3-6 years.Methods This study was a quasi-experiment with non-randomized, pre-post test control group, conducted in Bengkulu, Indonesia from January to April 2014. Subjects consisted of 48 mothers with overweight children, who were selected purposively and divided into 2 groups (treatment and control). Subjects’ parents kept records of their children’s food intake and daily activity. These records were used to measure energy intake and physical activity. Health education in the treatment group was conducted 6 times in 12 weeks, while the control group received health education only once at the beginning of the study.Results In the treatment group, the child physical activity level [0.04 (SD 0.01)] increased, while the % RDA for energy [-3.4 (SD 13.26)%] and BMI z-score [-0.57 (SD 0.26)] decreased. Significant differences were observed between the treatment and control groups in terms of maternal attitude, and children’s % RDA for energy, physical activity level, and BMI z-score after intervention (P &lt;0.05).Conclusion Health education for mothers effects a positive change in maternal attitude, as well as increased physical activity level, decreased energy consumption relative to their need, and BMI z-score in overweight children.

Maternal correlates of young children's physical activity across periods of the day.

Associations between maternal correlates and young children's physical activity levels across the whole day and the segmented day were examined. Cross-sectional study METHODS: Participants were 136 mothers and their 1-3 year old children recruited between July 2013 and March 2014. Mothers reported time spent providing physical activity opportunities for their child, co-participating in and modelling physical activity and sedentary behaviours during the morning, afternoon and evening. Participants wore ActiGraph GT3X (mothers) and GT3X+ (children) accelerometers concurrently for seven consecutive days and the time spent in light- (LPA), moderate- to vigorous- (MVPA) and total (LMVPA) physical activity were assessed. Two-level (family; recruitment group) multivariate models examined associations between maternal correlates (including maternal objectively-assessed sedentary time [ST] and physical activity) and children's physical activity. Maternal self-reported co-participation in sedentary behaviour and provision of child opportunities for physical activity were associated with children's physical activity; associations varied by period and physical activity intensity. During the morning period, mothers' objectively assessed ST was negatively associated with children's MVPA and LMVPA while her LPA was positively associated with children's LPA, MVPA and LMVPA. Mothers' MVPA was negatively associated with children's LPA and LMVPA during the evening period. Maternal correlates of young children's physical activity may be period- and intensity-specific. Programmes promoting physical activity for families may need to consider incorporating strategies to reduce mother-child co-participation in sedentary behaviour, increase mothers' provision of opportunities to be active and increase mothers' own LPA over ST during certain periods of the day.

Physical activity level of school children of age 10-13 years

Aim: To assess physical activity level of school children of age 10-13 years.Objectives: To assess and grade physical activity level in children of age 10-13 years using Physical Activity Questionnaire for Children (PAQ-C) classified into: Light Physical activity; Moderate Physical activity; Moderate to vigorous Physical activity and High Physical activity.Methodology: This is Questionnaire based survey study which was conducted on 100 school going children of 10-13 years who were present on the day of survey using Physical activity questionnaire for children (PAQ-C). Data was collected and analyzed.Result: In this study we found that out of 100 children maximum 52% children were engaged in moderate to vigorous level of physical activity (MVPA), 25% were engaged in moderate level of physical activity (MPA), 21% were engaged in vigorous level of physical activity (VPA), 1% in low physical activity level (LPA) and only 1% in high physical activity level (HPA).Conclusion: The study suggests that more children should be engaged in physical activity which will help in reducing the health risks.

Impact of physical exercise/activity on vascular structure and inflammation in pediatric populations: A literature review.

To describe the effects of physical exercise/activity on the vascular architecture of children and adolescents, as well as to identify the effects of inflammation and sedentary behaviors on this relationship. Potentially relevant articles were identified in the databases MEDLINE and PubMed covering the period from 2000 to 2015. No language restrictions were applied. Thirteen articles were found that included obese boys and girls in their samples (aged 9-19). Six interventional studies assessed inflammation and in five of these, physical exercise decreased inflammation. In 10 studies, vascular architecture was affected by physical exercise/activity. The impact of physical exercise on vascular architecture and inflammation seems relevant, but has been mainly investigated in obese groups. Health professionals should act together in organized interventions in schools, targeting the promotion of higher physical activity levels in children and adolescents.

Feasibility and Effects of Short Activity Breaks for Increasing Preschool-Age Children's Physical Activity Levels.

We examined the effects of short bouts of structured physical activity (SBS-PA) implemented within the classroom setting as part of designated gross-motor playtime on preschoolers PA. Preschools were randomized to SBS-PA (centers, N = 5; participants, N = 141) or unstructured free playtime (UPA) (centers, N = 5; participants, N = 150). SBS-PA consisted of structured PA implemented in the classroom during the first 10 minutes of gross-motor playtime followed by 20 minutes of free playtime. UPA consisted of 30 minutes of unstructured free playtime. Teachers implemented both conditions for 5 days/week for 6 months. PA was assessed with accelerometers (preschool-day) and direct observation (30-minute sessions). Generalized linear mixed models were used to examine the impact of the intervention. Regarding the 30-minute sessions, significant group main effects were observed for intervals spent at light (p < .001) and moderate-to-vigorous PA (MVPA, p < .001). Regarding the preschool-day PA, significant group by visit interaction was observed for percent time spent in total preschool-day MVPA (F (2, 254) = 3.54, p = .03). Percent of time spent in MVPA significantly decreased in both groups at 3 months and at 6 months. SBS-PA can be implemented in classroom settings; however, further research is needed to examine its impact on preschoolers PA levels.

The effect of a classroom activity break on physical activity levels and adiposity in primary school children

Despite recognition that regular physical activity is essential for good health, many children do not accumulate sufficient daily physical activity. The aim of this study was to examine the effect of a classroom-based activity break on accelerometer-determined moderate-to-vigorous intensity physical activity (MVPA) and adiposity in primary school children. One hundred twenty children from seven primary schools in Northern Ireland participated in the study. In each school, one class of children was randomly assigned to an intervention group and another class to a control group. Teachers of the intervention classes led a 5-min activity break three times per day for 12 weeks. Accelerometer-determined MVPA, height, weight and four skinfolds were measured at baseline and post-intervention. Compared with the control group, the intervention group significantly increased weekday MVPA (+9.5 min) from baseline to post-intervention. There were no significant changes in BMI; however, an increase in sum-of-skinfolds of the intervention group was observed. Classroom-based activity breaks led by the teacher are successful in increasing children's physical activity levels. The programme shows a positive step in improving overall physical activity levels and contributing to the goal of 60 min daily MVPA.

Physical Activity of Children with Intellectual Disabilities in Diverse Structured Settings in Special Schools

Children with intellectual disabilities (ID) are less active than typically developing peers and rely on others for physical activity (PA) support. School is an important environment for PA accrual, but there is little information on PA of children with ID in diverse settings at school. PURPOSE: To determine the lesson/session contexts and PA levels of children with ID in various PA settings (i.e., programs designed for PA promotion) in special schools. METHODS: Participants were 144 children with ID (60 girls, 84 boys; 88 primary level, 56 secondary level) in 5 Hong Kong special schools for children with ID. Trained observers used SOFIT (System for Observing Fitness Instruction Time) to document student PA and lesson context during 5 structured PA settings (before and after school, physical education [PE], lunch recess, and non-PE lessons). PA levels (i.e., lying down, sitting, standing, walking, vigorous) and lesson contexts (management, knowledge, fitness, skill practice, game play, other) were coded. Moderate-to-Vigorous Physical Activity (MVPA) was calculated by summing walking and vigorous codes. MVPA and lesson context were summarized by minutes and proportion of observed intervals. Total session energy expenditure (TEE) and energy expenditure rate (EER) were calculated using standard formulae. Three-way (gender X grade X setting) ANOVAs were used to determine differences in MVPA and lesson contexts. RESULTS: Among the structured settings, after school programs provided the highest TEE (423.4±122.0 kcal/kg; F=27.1, p<.001). Primary students had significantly less TEE than secondary students during PE (178.5±88.7 vs. 281.0±83.2, p<.05). Both EER (9.0±2.0 kcal/kg/min) and MVPA (56.3%±22.8) were highest during lunch recess (all p<.05). Relative to lesson context, before-school sessions provided the highest percent of time spent on fitness (88.0%±14.8) and lunch recess provided the highest skill practice time (52.8%±41.8). CONCLUSION: All programs contributed to the PA accrual of children with ID. PA minutes and intensity, however, varied by school setting and were related to lesson/session context--thus providing information important for designing effective interventions for this special population. Supported by GRF, University Grant Committee, Hong Kong (CUHK 752712)

Physical Activity Levels in Chinese One-Year-Old Children and Their Parents, an Early STOPP China Study.

BackgroundPhysical activity (PA) is associated with health benefits, already in childhood. However, little is known about actual levels, patterns and gender differences in PA level in very young children. This study examines Chinese one-year-old children and their parents’ PA levels and patterns, and assesses the correlations between children’s PA level and gender, body mass index standard deviation score (BMI SDS), parental BMI and parental PA level.MethodsData from 123 families participating in the Early STOPP China study were used. Families were recruited based on parental BMI and were classified as either high-risk or low-risk of obesity. Parents and children wore an ActiGraph GT3X+ to assess the average PA levels. PA levels and hourly patterns during weekdays and weekends were examined as were correlations with gender, BMI SDS, parental BMI and parental PA levels.ResultsThere were no significant differences in children’s averaged PA between risk groups, genders, or between weekdays and weekends. Children’s peak average activity level was at 7 pm and they were least active at 3 pm (p<0.001). Both mothers and fathers demonstrated a similar PA pattern as their children, although paternal PA level was consistently lower than that of mothers and children. No significant association was found between children’s PA and their gender, BMI SDS, parental BMI or paternal PA levels. Maternal PA was found positively associated with child PA (p<0.05).ConclusionPA in one-year-old Chinese children vary over the day but weekdays and weekends are similar. At this age, children’s PA is not related to gender, BMI SDS, parental BMI or paternal PA. Larger scale studies with more contextual information are needed to improve the understanding of our findings.

Obese Children Do Not Need to Increase Their Physical Activity Any More than Their Lean Counterparts Do.

The relationship between child physical activity (PA) levels and obesity has been studied extensively (1, 2). Studies have often shown that obese children and adolescents spend more time in sedentary behavior and less time in non-sedentary behavior, such as moderate-to-vigorous physical activity (MVPA) (3, 4). Accordingly, at least one review of cross-sectional studies examining the link between PA and obesity has found higher levels of PA associated with lower measures of adiposity (2). Some individuals may interpret these suggestions as meaning that obese children need to increase their PA levels to attain a “healthy” weight. Despite the fact that PA generally produces very modest weight loss (randomized controlled trials typically show less than 2 kg of weight loss from exercise interventions), the perception exists, among laypeople and health professionals alike, that obese individuals are lazy and need to “get off the couch” and that a lack of exercise is an important cause of child obesity (5–7). Is a lack of activity really driving the difference in body composition between normal weight and obese children? It has been suggested that although obese children may move less than normal weight children, they are likely expending just as much, if not more, energy from PA due to a higher metabolic cost of movement (they have a larger body to carry) (5). Additionally, PA levels are extremely low among normal weight and obese children alike, whereas PA remains important for overall physical and mental health (8). This suggests that PA needs to be promoted in all children regardless of weight status, and the view that obese children need to be more targeted for extra PA because of their weight is misleading. We intend to explore this suggestion further and suggest that although patterns of PA may differ between overweight/obese and normal weight children, these are not sufficient to explain differences in weight status. Alternative interpretations of the relationship between obesity and PA are also discussed.

Obesity leads to declines in motor skills across childhood.

Poor motor skills have been consistently linked with a higher body weight in childhood, but the causal direction of this association is not fully understood. This study investigated the temporal ordering between children's motor skills and weight status at 5 and 10 years. Participants were 668 children (54% male) who were studied from infancy as part of an iron deficiency anaemia preventive trial and follow-up study in Santiago, Chile. All were healthy, full-term and weighing 3 kg or more at birth. Cross-lagged panel modelling was conducted to understand the temporal precedence between children's weight status and motor proficiency. Analyses also examined differences in gross and fine motor skills among healthy weight, overweight, and obese children. A higher BMI at 5 years contributed to declines in motor proficiency from 5 to 10 years. There was no support for the reverse, that is, poor motor skills at 5 years did not predict increases in relative weight from 5 to 10 years. Obesity at 5 years also predicted declines in motor proficiency. When compared with normal weight children, obese children had significantly poorer total and gross motor skills at both 5 and 10 years. Overweight children had poorer total and gross motor skills at 10 years only. The differences in total and gross motor skills among normal weight, overweight and obese children appear to increase with age. There were small differences in fine motor skill between obese and non-obese children at 5 years only. Obesity preceded declines in motor skills and not the reverse. Study findings suggest that early childhood obesity intervention efforts might help prevent declines in motor proficiency that, in turn, may positively impact children's physical activity and overall fitness levels.

Physical Activity Level, Modeling, and Importance to Mothers of Preschool Children

Physical activity (PA) is an important component of obesity prevention for children and adults. This study compared maternal and child PA levels, maternal modeling of PA, and importance mothers place on PA for herself and her child to maternal and child BMI categories. Survey participants (n=550) were 72% white and 37% had a college degree or higher. Categorizing mothers by weight status indicated that 26%, 23%, 21%, and 30%, were underweight/low normal weight (BMI&lt;22.5), high normal weight (BMI≥22.5 to &lt;25), overweight (BMI ≥25 to &lt;30), or obese (BMI≥30), respectively. Mean maternal PA levels were low (15.44±9.98SD; 0–42 point scale), with obese mothers (n=165) scoring significantly lower than underweight/low normal weight mothers (14.20±9.91SD vs 17.17±10.47SD, p=0.018). Using a 5‐point 2‐item scale, mothers indicated they felt modeling PA behaviors to their children was important and modeled PA 3.08±1.22SD days a week in the past month. Compared to both categories of normal weight mothers, obese mothers placed significantly less importance on modeling PA behaviors (3.91±0.89SD vs 4.24±0.84SD and 4.32±0.69SD, p&lt;0.001) to their children and spent significantly fewer days a week in the last month modeling PA behaviors (2.80±1.23SD vs 3.35±1.14SD and 3.21±1.25SD, p&lt;0.001). Mothers placed less importance on PA for themselves than for their children (mean 3.49±0.97SD vs 3.83±0.87SD, on a 5‐point scale). Obese mothers placed significantly less importance on PA for themselves than mothers in all other weight categories. PA level of participants’ children was moderate (26.19±11.42SD, 0–42 point scale). No significant differences were found among child BMI categories and child PA levels. The importance mothers placed on modeling PA and importance placed on PA for their children did not differ among child BMI weight categories. Mothers of overweight children reported modeling PA behaviors significantly more days per week than mothers with middle normal weight (25th to 74th percentile) children (3.41±1.27SD vs 2.85±1.17SD). The importance mothers placed on their own PA was lower among mothers of underweight children and tended to increase as child BMI increased. Findings suggest that mothers of obese children may be more sensitive to the importance of modeling PA and its importance to health. Encouragement of all parents to promote PA and model PA behaviors to children is important for obesity prevention.Support or Funding InformationUSDA NIFA #2011‐68001‐30170

A Feasibility Study Investigating Body Composition and Physical Activity Levels in Children Taking Part In the Daily Mile

Childhood inactivity is linked to poorer physical and mental health during childhood and is associated with chronic ill‐health in later life. The Daily Mile (DM) is an initiative introduced in a Primary School in Scotland where the pupils walk or run ~1 mile each day. The aim of the study was to describe the physical activity (PA) and obesity levels of children taking part in the DM. Consent was obtained from parents of 259 children (184 male; 177 female). Height (m) and weight (kg) were measured to calculate BMI (weight/height2). Z scores were calculated within year group by gender. On a sub‐set of participants (n = 79), PA levels were objectively measured by accelerometers to assess amount of light, and moderate to vigorous intensity physical activity (MVPA). Data were analysed by t‐test of proportions, one‐way ANOVA and GLM‐ANOVA. For presentation, data were separated into Primary 1 – 3 (P1‐3, age ~4–7 years) and Primary 4–7 (P4‐7, age ~7–11 years). The percentage of boys and girls taking part in the DM who were categorised as obese was consistently below the Scottish Health Survey 2013 norms (Scottish norm): Boys P1‐3: 7% (13%) P4‐7 13% (17%); Girls P1‐3 8% (13%) P4‐7 13% (20%). However, all of these differences were non‐significant. Objective measurement of physical activity revealed that boys averaged 51 mins/day and girls averaged 40 mins/day of MVPA with no difference between younger (P1‐3) and older (P4‐7) pupils. UK PA Guidelines define “active” as 60+ mins MVPA/day. “Somewhat active” can be characterised as 30–59 mins MVPA/day and “low active” as &lt; 30 mins MVPA/day. In P1‐3 Boys: 26% were active, 58% somewhat active, 16% low active; and P4‐7 Boys: 26% were active, 61% somewhat active, 13% low active. In P1‐3 Girls: 11% were active, 72% somewhat active, 17% low active; and P4‐7 Girls: 5.3% active, 68% somewhat active, 26% low active. The proportion who were “somewhat active” was significantly higher than Health Survey England (HSE, 2012) data for age 4–10 years: boys 22% and girls 28%. All differences in active (HSE: boys 51%, girls 34%), or low active (HSE: boys 28%, girls 39%) were non‐significant. Rates of obesity in a school implementing ~1 mile PA/day for over 3 years were not significantly below the Scottish average. Only 25% of boys and 9% of girls in this sample currently reach the UK PA Guidelines. In this cohort the DM appears to have more children “somewhat active” than national data. However, this data is cross sectional and further research is required to assess the effects of the intervention.

Are Parental Perceptions of Child Activity Levels and Overall Health More Important than Perceptions of Weight?

Objectives To examine relationships between parental perceptions of child weight and overall health, reported lifestyle behaviors and measured body mass index (BMI). Methods Using community-partnered methods, we surveyed families residing in a two census tract area identified for targeted interventions to decrease diabetes related disparities. The survey included demographics, child dietary and physical activity behaviors, and parental perception of child's health and weight. We measured child BMI using a standardized protocol. Results We surveyed parents of 116 children with a mean age of 7years (range 3-15) with 51% boys, 74% Hispanic, and 26% Black. Over half of the children (55%) were overweight or obese. Half (50%) of the parents underestimated their children's weight. Reported daily hours of walking and/or running trended higher (3.6 vs. 2.6h, p=0.08) for children perceived to be of normal weight. Parents who correctly estimated their child's weight status reported more hours of daily walking/running than parents who underestimated child weight status, 4.5 versus 2.4h, p=0.0002. Parents of healthy weight children were more likely to report that children were in excellent or very good health compared to parents of overweight/obese children, 75 versus 56% respectively (p=0.04). We found significant racial/ethnic differences in reported diet and physical activity behaviors and perception of overall health. Conclusions for Practice Parental perceptions of child health and physical activity level may be related to perceptions of their child's weight status. Study findings informed community-based initiatives for reducing diabetes risk among children.

Effects of Body Mass Index on Children's Physical Activity Levels in School-Based "Dance Dance Revolution".

"Dance Dance Revolution" (DDR) (Konami Digital Entertainment, Inc., El Segundo, CA) has been recognized as an innovative approach to promote children's physical activity (PA). Previous works have described children's body mass index (BMI) status by group, but no studies have determined PA by category of BMI (underweight, normal weight, overweight, or obese). Therefore this study's purpose was to examine children's PA levels in DDR across different BMI groups. Participants were 160 third through sixth grade urban children (79 girls; 115 white) who participated in a weekly 30-minute DDR program for 18 weeks. Children's BMI was calculated based on height and weight. Levels of PA and sedentary behavior in DDR were assessed by ActiGraph(®) accelerometers (ActiGraph, LLC, Pensacola, FL) for three sessions. Outcome variables were percentages of time spent in sedentary behavior, light PA, and moderate-to-vigorous PA (MVPA). Approximately one-third (32.5%) of children fell into the overweight (n = 26) or obese (n = 26) groups. One-way (overweight/obese versus normal weight) multivariate analysis of covariance with DDR skill level as covariate yielded a significant group effect (F3, 154 = 4.02, P < 0.01). Follow-up tests indicated normal weight children accumulated significantly more MVPA (F = 8.94, P < 0.01) but less sedentary behavior (F = 3.27, P = 0.07) and light PA (F = 3.77, P = 0.054) while playing DDR than overweight/obese children. Overweight/obese children were less physically active than normal weight children during DDR. Consequently effective strategies are needed to stimulate these children to engage more actively in DDR experiences.

Governing indigenous recreation at a distance: a critical analysis of an after school active health intervention

ABSTRACTWithin the Canadian context, the physical activity levels of children and youth in the after school time period has become a source of public health concern. We argue that this concern is informed by broader public health crises, in particular the ‘global obesity epidemic’ and the closely related ‘global pandemic of physical inactivity', and that these so-called ‘crises’ operate as part of a discursive regime that serves to justify after school interventions aimed at increasing the physical activity practices of children and youth. Although the objectives of such interventions are seemingly well intentioned, we suggest that such interventions nonetheless harbor difficult to discern, but potentially pernicious consequences, for the communities in which they are implemented. We focus our attention on the place-specific effects of one Public Health Agency of Canada-funded after school physical activity intervention – After the School Bell Rings (ASBR) – that was implemented in the mostly Indigenous, northern community of Placid, Manitoba. Based on a critical analysis of the ASBR program itself, along with interviews and focus groups with children, parents and recreation providers (n = 10) from the community of Placid, we contend that the ASBR serves to govern Indigenous recreation at a distance. We argue that when implemented in the place-specific context of Placid, the ASBR functions as part of a broader governmental assemblage composed of loosely connected discourses, institutions, socio-structural conditions and individuals that, when assembled, ultimately serve to govern geographically and culturally distinct communities. We conclude by suggesting that the objectives of broad-based health interventions, such as the goal of increasing after school physical activity levels, should not be universally implemented across diverse locales, but need to account for the diverse, place-specific priorities and needs of the communities into which they are implemented.

How do we ensure sustainable physical activity options for people with disabilities?

This commentary is on the review by Verschuren et al. on pages 798–808 of this issue. Verschuren et al.1 have written a compelling article highlighting the importance of physical activity across the activity spectrum to address cardiovascular risk factors and muscle strength in children with cerebral palsy (CP). In addition to the health benefits of physical activity, it is clinically assumed that increasing fitness levels and muscle strength will translate into improvements in mobility and participation. For some children, this may be true; however, it is important to consider that engagement in an enjoyable physical activity program is participation. If the physical activity is enjoyable and meaningful to the child and family, participation is an important outcome in itself. Many families are focussed on psychosocial outcomes such as psychological well-being, socialization, inclusion, and participation in community activities. Participation in community physical activity programs, even if below the presumed therapeutic ‘dose’, may enable still families to achieve these goals. Verschuren et al.1 highlight the importance of long-term engagement in physical activity in order to sustain health benefits and the need for consideration of behaviour change strategies. This point raises an important question for rehabilitation professionals. What role should we play in facilitating sustainable physical activity for individuals with disabilities? In addition to the universal challenges associated with changing routines and behaviours, families with children with disabilities experience significant barriers to accessing community-based exercise programs. Families report poor accessibility, lack of knowledgeable trained staff who can adapt activities for children with disabilities, and attitudinal barriers.2 At a macro-level, advocates for the inclusion of individuals with disabilities can play a role in facilitating community change to encourage increased healthy behaviours for all children, including children with disabilities. Community-based guidelines for the inclusion of people with disabilities in healthy living activities can increase awareness of universal supports for inclusion. Communities can be encouraged to evaluate supports for facilitating the participation of individuals with disabilities in community programs. At a local level, the development of formal partnerships between rehabilitation and community-based fitness facilities can bridge the gap between hospitals and community by increasing awareness of access barriers and providing opportunities for families, therapists, and trainers collaboratively to develop safe, effective fitness programs.3 Finally, therapists can ensure that families are aware of the opportunities in their communities and work with families to explore programs and activities for their children. Given the breadth of family preferences regarding physical activity programs it is unlikely that a one-size-fits-all approach will be effective for long-term behaviour change. The authors point out the importance of applying knowledge about behaviour change when encouraging increased physical activity. A recent randomized controlled trial found that a 4-month physical activity program combined with motivational interviewing and home-based physical therapy did not increase the physical activity levels of children with CP compared to a regular therapy control group.4 Perhaps we need to focus more on the crucial role of psychosocial factors in decision-making regarding long-term participation in physical activity programs. Self-efficacy, a desire to be active, enjoyment of the activity, opportunities for fun and interaction, and feeling accepted as part of a group may influence the decision to engage in physical activity.5 All of these factors should be considered in multi-faceted strategies for encouraging increased physical activity. Thanks to Verschuren et al. for providing such a comprehensive and clinically relevant review of the literature on fitness for children CP.