[Show abstract][Hide abstract] ABSTRACT: Television viewing is highly prevalent in preschoolers (3-5 years). Because of the adverse health outcomes related to this behavior, it is important to investigate associations and mediators of young children's television viewing time. This study investigated whether parental rules regarding television viewing time and parental concerns about screen viewing activities mediated the association between parents' and preschoolers' television viewing time.
Mediation analyses were performed with the product-of-coefficient test on data derived from the Australian HAPPY study (n=947) and the Belgian sample of the ToyBox-study (n=1527). Parents reported their own and their child's television viewing time, their rules regarding television viewing and concerns about their child's screen viewing activities.
Parents' television viewing time was directly associated with preschoolers' television viewing time and parental rule for television viewing time mediated this association in both samples (14.4% and 8.1% in the Australian and Belgian samples, respectively).
This study is unique in examining the mediating pathway of parental television viewing and a rule limiting TV viewing time and whether this is consistent in different samples. Due to the consistent importance, both parents' television viewing time and rules should be targeted in interventions to decrease preschoolers' television viewing time.
Journal of physical activity & health 12/2014; · 1.95 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Abstract This study aimed at translating the physical activity (PA) guideline (180 min of total PA per day) into a step count target in preschoolers. 535 Flemish preschoolers (mean age: 4.41 ± 0.58) wore an ActiGraph accelerometer (GT1M, GT3X and GT3X+) - with activated step count function - for four consecutive days. The step count target was calculated from the accelerometer output using a regression equation, applying four different cut-points for light-to-vigorous PA: Pate, Evenson, Reilly, and Van Cauwenberghe. The present analysis showed that 180 min of total PA per day is equivalent to the following step count targets: 5,274 steps/day using the Pate cut-point, 4,653 steps/day using the Evenson cut-point, 11,379 steps/day using the Reilly cut-point and 13,326 steps/day using the Van Cauwenberghe cut-point. Future studies should focus on achieving consensus on which cut-points to use in preschoolers before a definite step count target in preschoolers can be proposed. Until then, we propose to use a provisional step count target of 11,500 steps/day as this step count target is attainable, realistic and helpful in promoting preschoolers' PA.
Journal of Sports Sciences 12/2014; · 2.10 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Background
This systematic literature review describes the potential public health impact of evidence-based multi-level interventions to improve obesity-related behaviours in adults, using the Reach, Efficacy, Adoption, Implementation and Maintenance (RE-AIM) framework.Methods
Electronic databases (PubMed, Embase, and The Cochrane Library) were searched to identify intervention studies published between January 2000 and October 2013. The following inclusion criteria were used: (1) the study included at least one outcome measure assessing obesity-related behaviours (i.e. diet, physical activity or sedentary behaviour), (2) the study collected data over at least one year and (3) the study¿s intervention targeted adults, was conducted in a specified geographical area or worksite, and was multi-level (i.e. targeting both individual and environmental level). Evidence of RE-AIM of the selected interventions was assessed. Potential public health impact of an intervention was evaluated if information was provided on at least four of the five RE-AIM dimensions.ResultsThirty-five multi-level interventions met the inclusion criteria. RE-AIM evaluation revealed that the included interventions generally had the potential to: reach a large number of people (on average 58% of the target population was aware of the intervention); achieve the assumed goals (89% found positive outcomes); be broadly adopted (the proportion of intervention deliverers varied from 9% to 92%) and be sustained (sixteen interventions were maintained). The highest potential public health impact was found in multi-level interventions that: 1) focused on all levels at the beginning of the planning process, 2) guided the implementation process using diffusion theory, and 3) used a website to disseminate the intervention.Conclusions
Although most studies underreported results within the RE-AIM dimensions, the reported Reach, Effectiveness, Adoption, Implementation and Maintenance were positively evaluated. However, more information on external validity and sustainability is needed in order to take informed decisions on the choice of interventions that should be implemented in real-world settings to accomplish long-term changes in obesity-related behaviours.
International Journal of Behavioral Nutrition and Physical Activity 12/2014; 11(1):147. · 3.68 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Several systematic reviews have described health-promoting effects of serious games but so far no meta-analysis has been reported. This paper presents a meta-analysis of 54 serious digital game studies for healthy lifestyle promotion, in which we investigated the overall effectiveness of serious digital games on healthy lifestyle promotion outcomes and the role of theoretically and clinically important moderators. Findings showed serious games have small positive effects on healthy lifestyles (g = 0.252, 95% CI 0.146; 0.358) and their determinants (g = 0.334, 95% CI 0.260; 0.407), especially for knowledge. Effects on clinical outcomes were significant, but much smaller (g = 0.079, 95% CI 0.038; 0.120). Long-term effects were maintained for all outcomes except for behavior. Serious games are best individually tailored to both socio-demographic and change need information, and benefit from a strong focus on game theories or a dual theoretical foundation in both behavioral prediction and game theories. They can be effective either as a stand-alone or multi-component programs, and appeal to populations regardless of age and gender. Given that effects of games remain heterogeneous, further exploration of which game features create larger effects are needed.
[Show abstract][Hide abstract] ABSTRACT: Experimental evidence of environmental features important for physical activity is challenging to procure in real world settings. The current study aimed to investigate the causal effects of environmental modifications on a photographed street's appeal for older adults' walking for transport. Secondly, we examined whether these effects differed according to gender, functional limitations, and current level of walking for transport. Thirdly, we examined whether different environmental modifications interacted with each other. Qualitative responses were also reported to gain deeper insight into the observed quantitative relationships. Two sets of 16 panoramic photographs of a streetscape were created, in which six environmental factors were manipulated (sidewalk evenness, traffic level, general upkeep, vegetation, separation from traffic, and benches). Sixty older adults sorted these photographs on appeal for walking for transport on a 7-point scale and reported qualitative information on the reasons for their rankings. Sidewalk evenness appeared to have the strongest influence on a street's appeal for transport-related walking. The effect of sidewalk evenness was even stronger when the street's overall upkeep was good and when traffic was absent. Absence of traffic, presence of vegetation, and separation from traffic also increased a street's appeal for walking for transport. There were no moderating effects by gender or functional limitations. The presence of benches increased the streetscape's appeal among participants who already walked for transport at least an hour/week. The protocols and methods used in the current study carry the potential to further our understanding of environment-PA relationships. Our findings indicated sidewalk evenness as the most important environmental factor influencing a street's appeal for walking for transport among older adults. However, future research in larger samples and in real-life settings is needed to confirm current findings.
PLoS ONE 11/2014; 9(11):e112107. · 3.53 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: There are currently no studies available reporting intervention effects on breaking up children's sedentary time. This study examined the UP4FUN intervention effect on objectively measured number of breaks in sedentary time, number of sedentary bouts (≥10 mins) and total and average amount of time spent in those sedentary bouts among 10- to 12- year-old Belgian children. The total sample included 354 children (mean age: 10.9±0.7 years; 59% girls) with valid ActiGraph accelerometer data at pre- and post-test. Only few and small intervention effects were found, namely on total time spent in sedentary bouts immediately after school hours (4-6PM; ß=-3.51mins) and on average time spent in sedentary bouts before school hours (6-8.30AM; ß=-4.83mins) and immediately after school hours in favour of children from intervention schools (ß=-2.71mins). Unexpectedly, girls from intervention schools decreased the number of breaks during school hours (8.30AM-4PM; ß=-23.45breaks) and increased the number of sedentary bouts on a weekend day (ß=+0.90bouts), whereas girls in control schools showed an increase in number of breaks and a decrease in number of bouts. In conclusion, UP4FUN did not have a consistent or substantial effect on breaking up children's sedentary time and these data suggest that more intensive and longer lasting interventions are needed.
[Show abstract][Hide abstract] ABSTRACT: To design interventions that target energy balance-related behaviours, knowledge of primary schoolchildren's perceptions regarding soft drink intake, fruit juice intake, breakfast consumption, TV viewing and physical activity (PA) is essential. The current study describes personal beliefs and attitudes, home- and friend-related variables regarding these behaviours across Europe.
PLoS ONE 11/2014; 9(11):e111775. · 3.53 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: a b s t r a c t Active transport might be well suited to counteract the decrease in physical activity and the increase in weight gain in students and working young adults (18–25 years). To promote active transport in this neglected age group, knowledge of factors influencing all transport modes is needed. Focus groups were used to explore factors influencing transport choice of studying and working young adults, for short distance travel to various destinations. Nineteen students (mean age of 2171.1 years) and 17 working young adults (mean age of 23 71.5 years) were recruited. Three focus groups were conducted with students and three with working young adults. Content analysis was performed using NVivo 9 software (QSR International). Grounded theory was used to derive categories and subcategories. Young adults talked about several factors that influence transport choice, which could be categorized in three themes: Personal factors, social factors and physical environmental factors. Some factors were reported as very important for choosing between transport modes, such as autonomy, travel time, financial cost and vehicle ownership; some as less important, such as the built environment and perceived safety and some as not important at all, such as ecology and health. Most factors were discussed by both students and working young adults, but some differences were found between the two groups, mainly based on income and living situation. When promoting active transport in young adults, health benefits or ecological benefits should not be emphasized. Focus should be put on cycling instead of walking, on flexibility, speed, good social support and low costs. Also, more bicycle storage and workplace facilities should be provided. It should be avoided that young adults own a private car and the public transport system should be optimized to fit their needs. & 2014 Elsevier Ltd. All rights reserved. 1. Background Young adulthood (18–25 years), also referred to as emerging adulthood, is distinguished from adolescence and adulthood by relative independence from social roles and normative expectations (Arnett, 2000). Young adults who left secondary school have shown to be at risk for decreasing physical activity levels and increasing weight gain (Crombie et al., 2009; Keating et al., 2005; Laska et al., 2009). Active transport (AT) (i.e. walking, cycling) represents an opportunity to incorporate physical activity into young adults' daily routines (Sisson and Tudor-Locke, 2008). AT offers health benefits to adolescents, young people and adults, such as lower odds of being overweight or obese (Gordon-Larsen et al., 2009; Bere et al., 2011), an overall reduction in cardiovascular risk (Hamer and Chida, 2008), higher levels of cardiovascular fitness (Oja et al., 2011; Gordon-Larsen et al., 2009; Hamer and Chida, 2008) and more minutes of total moderate-to-vigorous physical activity (Sisson and Tudor-Locke, 2008). More-over, the public health benefits of AT go beyond individual health and include reduced traffic crashes, reduced pollution emissions (Litman,
Transport Policy 11/2014; 36:151-159. · 1.72 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: To address major societal challenges and enhance cooperation in research across Europe, the European Commission has initiated and facilitated 'joint programming'. Joint programming is a process by which Member States engage in defining, developing and implementing a common strategic research agenda, based on a shared vision of how to address major societal challenges that no Member State is capable of resolving independently. Setting up a Joint Programming Initiative (JPI) should also contribute to avoiding unnecessary overlap and repetition of research, and enable and enhance the development and use of standardised research methods, procedures and data management. The Determinants of Diet and Physical Activity (DEDIPAC) Knowledge Hub (KH) is the first act of the European JPI 'A Healthy Diet for a Healthy Life'. The objective of DEDIPAC is to contribute to improving understanding of the determinants of dietary, physical activity and sedentary behaviours. DEDIPAC KH is a multi-disciplinary consortium of 46 consortia and organisations supported by joint programming grants from 12 countries across Europe. The work is divided into three thematic areas: (I) assessment and harmonisation of methods for future research, surveillance and monitoring, and for evaluation of interventions and policies; (II) determinants of dietary, physical activity and sedentary behaviours across the life course and in vulnerable groups; and (III) evaluation and benchmarking of public health and policy interventions aimed at improving dietary, physical activity and sedentary behaviours. In the first three years, DEDIPAC KH will organise, develop, share and harmonise expertise, methods, measures, data and other infrastructure. This should further European research and improve the broad multi-disciplinary approach needed to study the interactions between multilevel determinants in influencing dietary, physical activity and sedentary behaviours. Insights will be translated into more effective interventions and policies for the promotion of healthier behaviours and more effective monitoring and evaluation of the impacts of such interventions.
[Show abstract][Hide abstract] ABSTRACT: Introduction
Current evidence on associations between modifiable environmental characteristics and transport-related cycling remains inconsistent. Most studies on these associations used questionnaires to determine environmental perceptions, but such tools may be subject to bias due to unreliable recall. Moreover, questionnaires only measure separate environmental characteristics, while real environments are a combination of different characteristics. To overcome these limitations, the present proof of concept study used panoramic photographs of cycling environments to capture direct responses to the physical environment. We examined which depicted environmental characteristics were associated to environments’ invitingness for transportation cycling. Furthermore, interactions with gender and participants’ cycling behavior were examined.
Fifty-nine middle-aged adults were recruited through purposeful convenience sampling. During a home visit, participants took part in a structured interview assessing demographics and PA during the preceding seven days, followed by an intuitive choice task and a (cognitive) rating task, which both measured 40 photographed environments’ invitingness to cycle along. Multi-level cross-classified analyses were conducted using MLwiN 2.26.
Both tasks’ multivariate results showed that presence of vegetation was identified as the most important environmental characteristic to invite people for engaging in transportation cycling, even when the amount of vegetation was relatively small. In the bivariate analyzes, some differences between results of the cognitive rating task and the intuitive choice task were found, showing that invitingness measured by the rating task was associated with environmental maintenance and cycling infrastructure, whereas invitingness determined by the choice task was associated with more traffic-oriented characteristics. Moreover, only for the choice task’s results, moderating effects of gender and participants’ cycling behavior in the preceding week were observed.
The present study provides proof of concept that capturing people’s less cognitive, more intuitive responses to an environment’s invitingness for transport-related cycling may be important for revealing environment-behavior associations. If replicated in future studies using larger samples, results of our innovative measurements with photographs, especially those on vegetation, can complete the existing knowledge on which environmental characteristics are important for transportation cycling in adults and could form a basis to inform health promoters and local policy makers. However, future studies replicating our study method in larger samples and other population subgroups are highly encouraged. Moreover, causal relationships should be explored.
Transportation Research Part A Policy and Practice 11/2014; 69:432–446. · 2.73 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Background
Drop-off spots are locations in the proximity of primary schools where parents can drop off or pick up their child. From these drop-off spots children can walk to and from school. This pilot study aimed to investigate the feasibility and effectiveness of drop-off spots and to evaluate how drop-off spots are perceived by school principals, teachers and parents of 6-to-12-year old children.Methods
First, a feasibility questionnaire was completed (n¿=¿216) to obtain parental opinions towards the implementation of drop-off spots. A drop-off spot was organized (500¿800 m distance from school) in two primary schools. A within-subject design was used to compare children¿s (n¿=¿58) step counts and number of walking trips during usual conditions (baseline) and during implementation of a drop-off spot (intervention). Three-level (class-participant-condition) linear regression models were used to determine intervention effects. After the intervention, 2 school principals, 7 teachers and 44 parents filled out a process evaluation questionnaire.ResultsPrior to the intervention, 96% expressed the need for adult supervision during the route to school. Positive significant intervention effects were found for step counts before/after school hours (+732 step counts/day; X2¿=¿12.2; p¿<¿0.001) and number of walking trips to/from school (+2 trips/week; X2¿=¿52.9; p¿<¿0.001). No intervention effect was found for total step counts/day (X2¿=¿2.0; p¿=¿0.16). The intervention was positively perceived by the school principals and parents, but teachers expressed doubts regarding future implementation.Conclusion
This pilot study showed that implementing drop-off spots might be an effective intervention to promote children¿s walking to school. Implementing drop-off spots does not require major efforts from the schools and schools can choose how and when they organize drop-off spots. However, motivating teachers and involving other volunteers (e.g. parents, grandparents) may be needed. Future studies should investigate the feasibility and effectiveness of drop-off spots in a larger sample of schools.
International Journal of Behavioral Nutrition and Physical Activity 10/2014; 11(1):136. · 3.68 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Sedentary behaviour (including sitting) is negatively associated with physical health, independent from physical activity (PA). Knowledge on the associations with mental health is less elaborated. Therefore this study aims to investigate the relationship between sitting and five indices of mental health in adults, and between sitting interactions (sitting*gender, sitting*age, sitting*education, and sitting*PA) and these mental health indices.
Journal of physical activity & health 10/2014; · 1.95 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Introduction
Within the ENERGY-project , a school-based intervention to reduce and to break up sedentary time (UP4FUN) was developed for children aged 10 to 12 years. This study examined the UP4FUN intervention effect on objectively measured overall sedentary time and sedentary pattern variables among Belgian children. Sedentary pattern variables included number of breaks in sedentary time, number of sedentary bouts (≥ 10 minutes) and total and average amount of time spent in those sedentary bouts.
The six weeks intervention was tested in a randomized controlled trial with pre-test post-test design with five intervention and five control schools in Belgium. The total sample included 354 children from the 5th and 6th grade (mean age: 10.9 ± 0.7 years; 59% girls) with valid ActiGraph accelerometer data at both pre- and post-test. Multilevel analyses were conducted to take clustering of children in schools into account.
There were no significant intervention effects on the overall sedentary time and only few and small intervention effects were found on sedentary pattern variables, namely on total time spent in sedentary bouts immediately after school hours (95% CI = –6.70; –0.31) and on average time spent in sedentary bouts before school hours (95% CI = –8.65; –1.00) and immediately after school hours (95% CI = –4.41; –1.02) in favour of children from intervention schools. Unexpectedly, girls from intervention schools decreased the number of breaks during school hours (95% CI = –34.37; –9.68) and increased the number of sedentary bouts on a weekend day (95% CI = 0.14;1.67), whereas girls in control schools showed an increase in number of breaks and a decrease in number of bouts.
In conclusion, UP4FUN did not have a consistent or substantial effect on children's overall sedentary time and on breaking up sedentary time. These data suggest that more intensive and longer lasting interventions are needed.
[Show abstract][Hide abstract] ABSTRACT: Background: Environmental factors are found to influence transport-related physical activity, but have rarely been studied in relation with cycling for transport to various destinations in 10–12 yr old children. The current qualitative study used 'bike-along interviews' with children and parents to allow discussion of detailed environmental factors that may influence children's cycling for transport, while cycling in the participant's neighborhood.
PLoS ONE 09/2014; 9(9):e106696. · 3.53 Impact Factor