Sedentary Behavior In Children Research Articles

The Role of Virtual Reality in Childhood Obesity Treatment: A Narrative Review

Childhood obesity is a critical public health issue linked to long-term complications like type 2 diabetes and cardiovascular disease. This narrative review aimed to examine the effectiveness of virtual reality (VR)-based interventions in supporting key components of obesity treatment—physical activity (PA), nutrition education, and behavior change—particularly in children under 12. Using the intensive health behavior and lifestyle treatment (IHBLT) approach, we synthesized findings from studies published between 2014 and 2024. Of the studies reviewed, only one study met inclusion criteria, showing that VR-based interventions effectively increased light-intensity PA and reduced sedentary behavior in children, though these effects were not sustained long-term. The scarcity of studies limits the generalizability of these findings, emphasizing the need for caution in interpretation. Our review highlights a significant gap in the literature regarding VR’s role in childhood obesity treatment. Future research should explore the efficacy of VR in promoting PA, enhancing nutrition education, and supporting sustained behavior changes. Expanding this evidence base is vital for developing accessible and engaging interventions tailored to young children. Addressing this gap could enhance obesity treatment options, offering innovative and effective strategies to improve health outcomes in this vulnerable population.

Physical Literacy, According to the World Health Organization (WHO), in an Italian Preschool and Education for a Daily Movement Routine.

The preschool context produces excessive sedentary behavior in children. The systematic fulfillment of structured physical activities during school time, namely a daily movement routine (DMR), can contribute to increasing the quantity of physical activity (PA) and to improving physical literacy (PL), reaching the WHO's recommendations. The present study aims to quantify the sedentary time spent by 4- and 5-year-old preschool children and to verify the effects that a DMR could have on sedentary habits in preschool children. An experimental observational study was carried out. Ad hoc questionnaires were administered to parents, teachers, and children, and an observation checklist was used to quantify the time spent in sedentary activities at school. Descriptive statistics and t-tests were applied for data analysis. Thirty-two children attending Italian preschool participated in this study. The implementation of a DMR significantly reduced the sedentary time in preschool, decreasing the time spent sitting by 45.69% and increasing the time spent standing by 185%. This study confirms the hypothesis that children move for less time than recommended by the WHO and highlights the importance of making the experiences of the DMR structural, as this could be an opportunity for educational processes to enhance active lifestyles in promoting the development of physical literacy.

The impacts of lockdown restrictions on children's and adolescents' physical activity levels and sedentary behaviour including gender differences: A systematic review and meta-analysis

The 2019 COVID-19 pandemic outbreak has caused a global public health emergency. In addition to preventing the spread of the disease, restrictions such as school closures may reduce children and adolescents' opportunities for physical activity and increase the prevalence of sedentary behaviour. However, the current evidence regarding the effects of COVID-19 on physical activity and sedentary behaviour in children and adolescents is insufficiently clear. A total of five databases were searched. In addition, grey literature, reference list and registries were also checked. A total of 26 studies were included in the systematic review. Total physical activity, moderate to vigorous physical activity, sedentary and ST were analysed separately using random effects models. Additionally, this study also used meta-analysis to investigate the differences between boys and girls, objective measures and subjective measures, cross-sectional studies and longitudinal studies. Results: The results of the meta-analysis showed that children and adolescents had a significant decrease in total physical activity (SMD= -0.76, 95% CI= -1.46 to -0.06, I2= 99.5%), moderate to vigorous physical activity (SMD= -0.36, 95% CI= -0.6 to -0.11, I2= 94.7%), sedentary behaviour (SMD= 1.44, 95% CI= 0.31 to 2.56, I2= 98.6%), and a significant increase in screen time (SMD= 0.75, 95% CI= 0.49 to 1.02, I2= 97.3%). Meta-analysis results showed a significant decline in moderate to vigorous physical activity in boys, but no change was found in girls. However, results from the systematic review suggested that girls are more likely to develop more screen time than boys. Children and adolescents' physical activity and sedentary behaviour are negatively impacted by restrictions associated with Covid-19. In addition, girls' screen time is more likely to increase than boys'.

‘Can You Please Sit Still?!’: Exploring the Dynamics of Children's Sedentary Behaviours at Home

ABSTRACTSedentary behaviour among children has become an area of interest in health research due to its associations with unfavourable health outcomes. Concerns about certain activities being sedentary guides much work in this field, with study outcomes often directed towards determining the amount of time spent in these activities. In this paper, we explore the idea of thinking about sedentary moments within children's everyday practices instead of total time spent in sedentary behaviours. Through this approach we examine children's everyday practices to show how activities by themselves should not necessarily be considered sedentary, but as composed of sedentary moments that are performed. We also look at how such sedentary moments are created, and the ways in which they are linked to material arrangements and pervasive understandings about how certain practices should be conducted. These could be seen as instruments of power acting upon the body, shaped by discourses about childhood and family life.

A009: Volume, Accumulation Patterns of Sedentary Behavior and Physical Fitness Among Elementary School Students

Objective: The increase in sedentary behavior in children has become a worldwide public health problem. This study aimed to explore the associations of volume and accumulation patterns of sedentary behavior with physical fitness among elementary school students. Methods: A cluster sampling method was used to select students from grades 1–5 in Jinhua, Zhejiang province. Accelerometers were used to assess sedentary volume, duration of sedentary bouts (1-4 minutes, 5-9 minutes, 10-19 minutes and ≥20 minutes), and duration of sedentary breaks (1-4 minutes, 5-9 minutes and ≥10 minutes). The scores and good-excellent rate of physical fitness were calculated according to the "National Student Physical Health Standards (Revised in 2014)". Binary logistic regression was used to examine the relationship between volume, accumulation patterns of sedentary behavior and students' physical fitness. Results: A total of 307 participants (mean age 8.5 years) were included in the statistical analysis. The score and the rate of good-excellent of physical fitness were 78.1 and 38.5%. The students spent 139.5min (64.9%) in the classroom time. The highest proportions of sedentary bouts of 1-19 minutes (46.7%) and breaks of 1-4 minutes (17.2%) indicate a fragmented and intermittent characteristic in the classroom. There were significant sex and grade differences in sedentary behavior accumulation patterns. Boys were more active than girls in the classroom, while second graders were the most active and fifth graders accumulated the most sedentary time. After adjusting for covariates, sedentary bouts of 5-9 minutes were a protective factor for physical health (odds ratio (OR)=3.118; 95%CI:1.271, 7.649), and the OR was 28.1% higher for each percentage point increase. The sedentary bout of ≥20 minutes was a risk factor for physical health (OR=0.430; 95%CI:0.223, 0.827), and the OR of not good-excellent physical fitness standard was 23.1% lower for every one percentage point increase. There was no significant correlations between the sedentary volume, the duration of the sedentary break, and physical health (P＞0.05). Conclusion: Reducing the duration of sedentary bouts in the classroom may be more important for health of children than reducing total sedentary time. It is recommended to consider the teaching mode and the physical and mental characteristics of elementary school students, and reasonable interruptions should be made in classrooms. Teachers can interrupt prolonged sitting every 10 minutes with varying duration of breaks, to avoid students sitting for more than 20 minutes during class time. School-based interventions are needed to verify the findings of this study.

Relative age effect on the physical activity and sedentary behavior in children and adolescents aged 10 to 18 years old: a cross-sectional study in Japan

BackgroundFew studies have shown that relatively younger children and adolescents (those born later in the same school year) were less likely to engage in physical activity in a phenomenon termed the relative age effect. Although these studies mainly targeted elementary and middle school students, no study has reported on the relative age effect on physical activity in ordinary high school students. Moreover, the relative age effect on sedentary behavior might show an opposite association with physical activity. Therefore, we aimed to clarify the relative age effects on physical activity and sedentary behavior across different school stages in Japanese children and adolescents.MethodsA cross-sectional questionnaire survey was conducted with 21,491 children and adolescents (elementary, middle, and high school students aged 10–18 years) in various Japanese regions from January 2018 to July 2019. Overall, 18,281 children and adolescents (10,299 boys and 7,982 girls) were finally included in our analysis. Data on the birth month, frequency and duration of their physical activity (vigorous, moderate, and moderate-to-vigorous intensity), and sedentary behavior (weekday and weekend total sedentary time, television viewing, playing video games, and Internet use) were obtained. We utilized two-part model regression analyses. Statistically significant association with birth month indicated that a relative age effect was observed.ResultsThe relatively younger individuals were less likely to engage in physical activity (especially vigorous physical activity (VPA)); this association was observed in middle and high school students. Conversely, the relatively younger boys spent more time during weekends with sedentary behaviors and Internet use. Based on school stage, the relative age effect on VPA time was observed in middle school boys (average margin effect (AME) = -0.74, p < 0.01) and high school students (boys: AME = -0.69, p < 0.01; girls: AME = -0.53, p < 0.05). The relative age effect on sedentary behavior was observed during weekends with sedentary behaviors (AME = 3.55, p < 0.01), playing video games (AME = 0.72, p < 0.05) and Internet use (AME = 2.46, p < 0.01) for male high school students and on television viewing (AME = 1.12, p < 0.05) for female middle school students.ConclusionThe relative age effect on physical activity can persist after middle school, and the relatively younger individuals are more likely to replace physical activity with sedentary behavior.

Unmasking Health and Inclusivity: Health Benefits of Traditional Indian Games for Children with Neurodevelopmental Disability

Abstract Background: Physical activity plays a vital role in enhancing the health benefits and decreasing sedentary behaviors in children with neurodevelopmental disability. Adapted physical education by means of traditional games might have the potential to maximize the health benefits of children with neurodevelopmental disability. Objective: The objective of this study was to explore the value of traditional games in imparting health benefits in children with neurodevelopmental disability. Methodology: After a detailed review, the research paradigm has been framed to list and compile the traditional games of South India using Nisaratana Sangasubana framework to enhance health benefits for children with neurodevelopmental disability. Data Synthesis: The location of the data, the data-gathering, data-storage, data analysis (using modified Roper and Shapira strategies), and validation of data are done. Reflective Remarks: Finally, the list of traditional games which potentially have health benefits for children with neurodevelopmental disability has been obtained.

Assessing the Accuracy of Activity Classification Using Thigh-Worn Accelerometry: A Validation Study of ActiPASS in School-Aged Children.

The ActiPASS software was developed from the open-source Acti4 activity classification algorithm for thigh-worn accelerometry. However, the original algorithm has not been validated in children or compared with a child-specific set of algorithm thresholds. This study aims to evaluate the accuracy of ActiPASS in classifying activity types in children using 2 published sets of Acti4 thresholds. Laboratory and free-living data from 2 previous studies were used. The laboratory condition included 41 school-aged children (11.0 [4.8]y; 46.5% male), and the free-living condition included 15 children (10.0 [2.6]y; 66.6% male). Participants wore a single accelerometer on the dominant thigh, and annotated video recordings were used as a reference. Postures and activity types were classified with ActiPASS using the original adult thresholds and a child-specific set of thresholds. Using the original adult thresholds, the mean balanced accuracy (95% CI) for the laboratory condition ranged from 0.62 (0.56-0.67) for lying to 0.97 (0.94-0.99) for running. For the free-living condition, accuracy ranged from 0.61 (0.48-0.75) for lying to 0.96 (0.92-0.99) for cycling. Mean balanced accuracy for overall sedentary behavior (sitting and lying) was ≥0.97 (0.95-0.99) across all thresholds and conditions. No meaningful differences were found between the 2 sets of thresholds, except for superior balanced accuracy of the adult thresholds for walking under laboratory conditions. The results indicate that ActiPASS can accurately classify different basic types of physical activity and sedentary behavior in children using thigh-worn accelerometer data.

Prevalencia y factores asociados con los comportamientos sedentarios y la actividad física en escolares de básica primaria

The school and its curricular proposals promote prolonged sedentary behavior, fostering a sedentary behavioral culture that is reinforced extracurricularly, possibly affecting the health of schoolchildren. However, the Physical Education class, and particularly the promotion of school physical activity within it, is one of the most important strategies to mitigate the harmful effects of sedentary behaviors in children. Therefore, the main objective was to establish the prevalence and factors associated with sedentary behaviors in elementary school students. The results reveal that in the school transportation domain, there is an average prevalence of 114 minutes per week of sedentary behavior. In the school environment, walking is common, but sitting time has a weekly average of 1680 ± 102 minutes. Meanwhile, in the home domain, women show higher participation in physical activity. This study highlights the need for school interventions to promote active and healthy habits in childhood.

Factors influencing sedentary behavior and its impact on early childhood psychomotor skills

Sedentary behavior can negatively impact motor and cognitive coordination in early childhood. This study explores the factors that influence sedentary behavior on early childhood psychomotor development. This research method uses a quantitative approach with a survey design and involves a sample of 400 early childhood education teachers. Data were collected through questionnaires distributed using Google Forms. Data analysis was carried out using descriptive and inferential statistics with the Partial Least Square (PLS) approach. The results of the analysis show that the factors of physical activity (β = -0.222), parental digital understanding (β = -0.109), physical activity support facilities (β = -0.080), parental involvement (β = -0.094), teacher competence (β = -0.128), and teacher digital competence (β = -0.235) have a negative correlation with sedentary behavior of early childhood, which means that the higher the factor, the lower the sedentary behavior. Sedentary behavior negatively affects motor coordination (β = -0.552) and child psychology (β = -0.545) increasing the risk of psychological problems such as anxiety and depression. Meanwhile, early childhood characteristics and technology did not have a major influence on early childhood sedentary behavior. The importance of awareness of sedentary behavior requires the creation of a physical activity program for children that involves parents. Keywords: sedentary behavior, psychomotor development, early childhood, early childhood education.

REVISÃO CRÍTICA DAS ESTRATÉGIAS DE COMBATE AO SEDENTARISMO INFANTIL CAUSADO PELO USO EXCESSIVO DE TECNOLOGIA: UMA NOVA ABORDAGEM COM BASE NA LITERATURA

Childhood sedentary behavior, driven by excessive technology use, has become a growing concern in the field of children’s health. This study conducts a critical review of current strategies to combat childhood sedentary behavior, identifying the main gaps in existing approaches. Although screen time reduction is a common recommendation, interventions often fail to maintain long-term effectiveness, partly due to a lack of behavioral focus and integration of technology as a tool in promoting physical activity. Based on the literature review, this article proposes a new theoretical model that uses technology proactively, integrating it into gamified physical education programs, real-time monitoring, and family involvement. The suggested model aims to increase children’s adherence to physical activities and ensure the inclusion of low-income populations through strategic partnerships to broaden access to technological devices. The study concludes that integrating technology and health can offer more sustainable and effective solutions to reduce childhood sedentary behavior.

Subjective measurement of physical activity and sedentary behaviour in children and adolescents with cerebral palsy: a scoping review

Purpose Physical activity is essential for maintaining overall health. Cost-effective and easily administered outcome instruments are valuable for clinical practice and large-scale population studies. The scoping review aimed to identify and map subjective instruments developed or validated to measure habitual physical activity and/or sedentary behaviour in children and adolescents with cerebral palsy aged 0–18 years across all levels of the GMFCS-E&R. Materials and methods This scoping review was conducted in accordance with the JBI methodology for scoping reviews and searched the databases PubMed, CINAHL, Web of Science, Cochrane Database of Systematic Reviews, JBI Database of Systematic Reviews and Implementation Reports, Embase and Pedro to identify articles. Results From 288 full-text references, 13 studies met the inclusion criteria. Nine instruments measured habitual physical activity and/or sedentary behaviour in children and adolescents with cerebral palsy aged 18 months to 18 years. Six subjective instruments were tested for ambulatory children, while three instruments were tested in children and adolescents at GMFCS-E&R level I–V. Conclusion and implications Reporting of the psychometric properties were found on reliability in three instruments, while data on validity were reported in all instruments. Further studies assessing the psychometric properties of subjective instruments in the target population are needed.

The accumulation of physical activity and sedentary behaviour in children with cerebral palsy and their typically developing peers aged 6–12 years

BackgroundPhysical activity and sedentary behaviour are usually described using daily volume indicators. However, for young children (6–12 years) and specifically those with conditions such as Cerebral Palsy, exploration of how physical behaviours are accumulated may provide valuable insight for behaviour change intervention planning. Research questionHow are physical activity and sedentary behaviour accumulated by 6–12 year old children with Cerebral Palsy and is this different from their typically developing peers? MethodsA cross-sectional study of a convenience sample of ambulatory children with CP (CP) and typically developing (TD) children, 6–12 years, was recruited. Children wore a thigh worn activity monitor (activPAL4) during typical daily activities. Overall volume of daily sedentary, upright and stepping time was characterised as well as how this was accumulated in bouts of activity. ResultsThere were no differences (p<0.05) in either volume or accumulation measures of physical behaviours between TD (n=14, 8.2±1.8 years) and children with CP (n=15, 8.6±1.4 years). However, there was wide variation in activity accumulation patterns between individuals. The mean proportion of daily time in each physical behaviour, accumulated in bouts above set times was: Upright time: bouts >5 mins 46 % TD & CP, bouts >20 mins 9 % TD & CP; Stepping time: bouts >0.5 mins 50 % TD, 45 % CP, bouts >2 mins 10 % TD, 9 % CP; Sedentary time: bouts >5 mins 77 % TD, 76 % CP, bouts >30 mins 26 % TD, 29 % CP. SignificanceYoung children with CP aged 6–12 years do not appear to have different physical behaviours to their TD peers. However, for individuals, descriptors of accumulation of physical activity and sedentary behaviour bouts provides additional information over and above volume measures, giving insight into behaviour which may be used to inform intervention planning.

Effects of physical activity planning interventions on reducing sedentary behavior in parent-child dyads: A randomized controlled trial.

Effects of parent-child dyad interventions on behavior remain unclear. This randomized controlled trial investigated if, compared with a control condition, three types of physical activity (PA) planning interventions (individual "I-for-me," dyadic "we-for-me," and collaborative "we-for-us") would reduce sedentary behavior (SB) time in parents and their children. The study involved 247 dyads comprising parents (aged 29-66) and their children (aged 9-15), randomized into one of the three types of PA planning-intervention arms or the control condition. Mixed models were applied to analyze data from a preregistered trial (NCT02713438) with the outcome of accelerometer-measured SB time, assessed at 1-week and 36-week follow-ups. Although children's SB remained unaffected by the planning interventions, a small reduction of SB time was found among parents in the collaborative (p = .048) and individual (p = .042) planning conditions. The effects were observed at the 1-week follow-up only. While short-term reductions in parents' SB were achieved, these were not sustained long-term. PA planning interventions delivered to parent-child dyads did not substantially reduce children's SB, which may be due to young people's needs of increased independence from their parents.

The impact of the world’s first regulatory, multi-setting intervention on sedentary behaviour among children and adolescents (ENERGISE): a natural experiment evaluation

BackgroundRegulatory actions are increasingly used to tackle issues such as excessive alcohol or sugar intake, but such actions to reduce sedentary behaviour remain scarce. World Health Organization (WHO) guidelines on sedentary behaviour call for system-wide policies. The Chinese government introduced the world’s first nation-wide multi-setting regulation on multiple types of sedentary behaviour in children and adolescents in July 2021. This regulation restricts when (and for how long) online gaming businesses can provide access to pupils; the amount of homework teachers can assign to pupils according to their year groups; and when tutoring businesses can provide lessons to pupils. We evaluated the effect of this regulation on sedentary behaviour safeguarding pupils.MethodsWith a natural experiment evaluation design, we used representative surveillance data from 9- to 18-year-old pupils before and after the introduction of the regulation, for longitudinal (n = 7,054, matched individuals, primary analysis) and repeated cross-sectional (n = 99,947, exploratory analysis) analyses. We analysed pre-post differences for self-reported sedentary behaviour outcomes (total sedentary behaviour time, screen viewing time, electronic device use time, homework time, and out-of-campus learning time) using multilevel models, and explored differences by sex, education stage, residency, and baseline weight status.ResultsLongitudinal analyses indicated that pupils had reduced their mean total daily sedentary behaviour time by 13.8% (95% confidence interval [CI]: -15.9 to -11.7%, approximately 46 min) and were 1.20 times as likely to meet international daily screen time recommendations (95% CI: 1.01 to 1.32) one month after the introduction of the regulation compared to the reference group (before its introduction). They were on average 2.79 times as likely to meet the regulatory requirement on homework time (95% CI: 2.47 to 3.14) than the reference group and reduced their daily total screen-viewing time by 6.4% (95% CI: -9.6 to -3.3%, approximately 10 min). The positive effects were more pronounced among high-risk groups (secondary school and urban pupils who generally spend more time in sedentary behaviour) than in low-risk groups (primary school and rural pupils who generally spend less time in sedentary behaviour). The exploratory analyses showed comparable findings.ConclusionsThis regulatory intervention has been effective in reducing total and specific types of sedentary behaviour among Chinese children and adolescents, with the potential to reduce health inequalities. International researchers and policy makers may explore the feasibility and acceptability of implementing regulatory interventions on sedentary behaviour elsewhere.

Implementation processes of social network interventions for physical activity and sedentary behavior among children and adolescents: a scoping review.

The characteristics of the implementation process of interventions are essential for bridging the gap between research and practice. This scoping review aims to identify the implementation process of social network interventions (SNI) to address physical activity and sedentary behaviors in children and adolescents. The scoping review was conducted adhering to the established guidelines. The search was carried out in the ERIC, EBSCO, EMBASE, SCOPUS, and Lilacs databases in April 2023. Social network intervention studies in children and adolescents were included, addressing physical activity or sedentary behaviors. Replicability (TIDieR), applicability (PRECIS-2), and generalizability (RE-AIM) were the explored components of the implementation process. Each component was quantitatively and separately analyzed. Then, a qualitative integration was carried out using a narrative method. Most SNI were theoretically framed on the self-determination theory, used social influence as a social mechanism, and used the individual typology of network intervention. Overall, SNI had strong replicability, tended to be pragmatic, and three RE-AIM domains (reach, adoption (staff), and implementation) showed an acceptable level of the generalizability of findings. The analyzed SNI for physical activity and sedentary behaviors in adolescents tended to be reported with high replicability and were conducted pragmatically, i.e., with very similar conditions to real settings. The RE-AIM domains of reach, adoption (staff), and implementation support the generalizability of SNI. Some domains of the principles of implementation strategies of SNI had acceptable external validity (actor, action targets, temporality, dose, and theoretical justification).

Examining the Influence of Children and Parents’ Portable Device Use on Sedentary Behavior and Physical Activity Levels

The aim of this study was to explore the relationship between the usage of screen-based media devices by children and their parents and its influence on sedentary behavior and physical activity. A cohort of 43 parents with typically developing children aged 8 to 12 years was selected for the study, utilizing convenience sampling methods through social media platforms across Central Macedonia, Greece. Parents filled out a survey regarding their children and themselves, assessing daily portable device use, sedentary behavior, and physical activity. Two standard regression models were employed to examine how criterion variables (child portable device use in Model 1 and parent portable device use in Model 2) related to predictor variables: child age, child sex, child daily sedentary time, and child physical activity. The findings revealed a significant and positive association between child sedentary time and child portable device use. Similar, child sedentary time exhibited a significant and positive association with parent portable device use. Child age, sex, and physical activity did not show a significant relationship with either parent or child portable device use. In summary, there is a clear connection between child sedentary behavior and portable device use, whereas physical activity does not exhibit a significant relationship. This implies that young children who extensively use portable devices may be susceptible to adopting a sedentary lifestyle. Additionally, results suggest a potential correlation between adults’ portable device use and sedentary habits, which may be reflected in similar behavior in their children.

Potential Mediating Roles of Children's Health-Related Quality of Life and Weight-Related Behaviors in the Relationship Between Socio-Educational Advantage and Weight Status.

Background: Socioeconomic status is inversely associated with weight status in developed countries. Underlying mechanisms are still to be clarified. Our aim was to determine if weight-related behaviors and health-related quality of life (HRQoL) mediate the relationship between socio-educational advantage and weight status in Australian children 9 to 13 years of age. Methods: Secondary analysis of data collected by two cluster randomized trials (2019 wave). We measured children's (n = 3978) height, weight, diet, physical activity, sedentary behavior, and HRQoL. Socio-.educational advantage was assessed at school level using the Index of Community Socio-Educational Advantage (ICSEA). A counterfactual framework was used to explore potential mediators in the relationship between socio-educational disadvantage and (1) overweight/obesity and (2) BMI z-score (BMIz). Results: Low socio-educational advantage was associated with increased overweight/obesity and BMIz. The overweight/obesity association was mediated by sedentary behavior (natural indirect effect as a proportion of total, 7.5%) sugar-sweetened beverage (SSB) consumption (12.7%), physical functioning (11.9%), psychosocial health (10.9%), school (6.8%) and social functioning (15.6%), and total HRQoL score (13.8%). The ICSEA-BMIz relationship was mediated by sedentary behavior (5.7%), sleep duration (4.1%), SSB (10.6%), physical functioning (9.9%), psychosocial health (9.1%), school (5.5%) and social (13.7%) functioning, and total HRQoL score (11.7%). Conclusion: Victorian Children with low socio-educational advantage were more likely to be living with overweight or obesity. This relationship was mediated by children's sedentary behavior, SSB consumption, and HRQoL. Trial Registration: Australian New Zealand Clinical Trials Registry (ANZCTR): ACTRN12616000980437 (registered July 26, 2016, retrospectively registered) and ACTRN12618001986268 (registered December 11, 2018, prospectively registered). https://www.anzctr.org.au/Trial/Registration.

The Effect of Physical Activity on Physical Fitness in Early Childhood

In the era of digital life, it provides convenience in various aspects of life. Children familiar with gadgets tend to prefer playing with them or choosing to watch. This raises sedentary behaviour in children so that children do less physical activity and can trigger other diseases such as obesity, type 2 diabetes, respiratory, psychological, etc. This research is a literature study that discusses the effects of physical activity on children's health. The primary literature consists of 15 national and international journals. The results showed that physical activity has a positive effect in terms of health and academics.

Scaling up a school-based intervention to increase physical activity and reduce sedentary behaviour in children: protocol for the TransformUs hybrid effectiveness–implementation trial

IntroductionEfficacious programmes require implementation at scale to maximise their public health impact. TransformUs is an efficacious behavioural and environmental intervention for increasing primary (elementary) school children’s (5–12 years) physical activity...