Kylie Hesketh

Deakin University · Institute for Physical Activity and Nutrition

The influence of electronic screens on the health of children and adolescents and their education is not well understood. In this prospectively registered umbrella review (PROSPERO identifier CRD42017076051), we harmonized effects from 102 meta-analyses (2,451 primary studies; 1,937,501 participants) of screen time and outcomes. In total, 43 effect...

Background Fussy eating is most often a developmentally typical behaviour, generally presenting during toddlerhood. However, up to half of parents of young children are concerned about fussy eating, and this concern may mediate the use of nonresponsive feeding practises, such as coercive or unstructured feeding and using food to reward eating. Desp...

Objective Behavioural patterns are important in understanding the synergistic effect of multiple health behaviours on childhood adiposity. Most previous evidence assessing associations between patterns and adiposity were cross-sectional and investigated two or three behaviour domains within patterns. This study aimed to identify behavioural pattern...

Background/objectives Childhood overweight and obesity are influenced by a range of prenatal and postnatal factors. Few studies have explored the integrative pathways linking these factors and childhood overweight. This study aimed to elucidate the integrative pathways through which maternal pre-pregnancy body mass index (BMI), infant birth weight,...

Background : Understanding how or whether sedentary behavior affects motor competence in young children is important considering that children spend a lot of time sedentary. The aim of this study was to examine whether sedentary behavior predicts motor competence in young children. Methods : A longitudinal study with a total of 372 children aged 3....

Introduction Early life parent-focused interventions can effectively improve infant and child nutrition and movement (physical activity and sedentary behavior) as well as parents' health behaviors. Scale-up of such interventions to real-world settings is essential for population-wide benefits. When progressing to scale-up, intervention components m...

Background Understanding the developmental trajectories of outdoor time, screen time and sleep is necessary to inform early interventions that promote healthy behaviours. This study aimed to describe concurrent trajectories of outdoor time, screen time and sleep across the early childhood period and their maternal predictors. Methods Data across f...

Background To examine: 1) longitudinal adherence to the Canadian 24-Hour Movement Guidelines in a sample of infants and 2) associations between adherence to the guidelines over time and development. Methods Participants were 250 parent-infant dyads from the Early Movers project in Edmonton, Alberta. At 2, 4, and 6 months of age, physical activity,...

Objectives: We investigated the associations of accelerometry-derived osteogenic indices (OIs), moderate-to-vigorous (MVPA), and vigorous intensity physical activity (VPA) with peripheral quantitative computed tomography (pCQT) parameters in 99 adolescents aged 10-13 years. Methods: Bone parameters were assessed at the distal (4%) and shaft (66%...

Background The amount of time children spend outside of their home environment has increased over the past decades. Therefore, the quality of the health behaviour environments where young children spend time is likely to impact their health behaviour opportunities. The aim of this study was to describe the proportion of mothers who consider it poss...

Objective To test the efficacy of the Transform-Us! school- and home-based intervention on children’s physical activity (PA), sedentary behaviour (SB) and cardiometabolic risk factor profiles. Methods A 30-month 2×2 factorial design cluster randomised controlled trial delivered in 20 primary schools (148 Year 3 classes) in Melbourne, Australia (20...

Introduction Emotional self-regulation (ESR) skills are vital for mental and physical health. There is growing evidence linking sleep to ESR in school-aged children, but associations in toddlers remain unclear. The current study examined associations between toddlers’ sleep duration and behaviors and ESR. Materials and methods This study utilized...

Background Past Physical Activity Report Cards have indicated a minority of Australian children and young people are sufficiently active. The purpose of this paper is to summarise grades across 10 indicators of the 2022 Australian Physical Activity Report Card, to assess physical activity behaviours and supports. Methods A development team consist...

This narrative systematic review examined effectiveness of interventions during pregnancy and up to 2 years of age in improving energy balance‐related behaviors or prevent overweight/obesity in children from families experiencing socio‐economic disadvantage. We identified 24 interventions, from 33 articles, since 1990. Overall, despite their hetero...

Background The INFANT Program is an efficacious, group-based program for first-time parents, delivered at three-monthly intervals when INFANT are aged 3–18 months through an existing universal care service in Victoria, Australia. Many lessons have been learnt from its origins as a cluster randomized control trial to its small-scale, community-level...

Background: The Global Matrix 4.0 on physical activity (PA) for children and adolescents was developed to achieve a comprehensive understanding of the global variation in children’s and adolescents’ (5–17 y) PA, related measures, and key sources of influence. The objectives of this article were (1) to summarize the findings from the Global Matrix 4...

This study aimed to examine change in tummy time patterns and preferences in the first 6 months of life, as well as dose–response relationships between tummy time duration and development at 2, 4, and 6 months. Participants were parents of infants from the Early Movers project in Edmonton, Canada (baseline: n = 411). At 2, 4, and 6 months, infant t...

Background Evidence for longitudinal associations between childhood weight status and academic achievement remains unclear due to considerable heterogeneity in study design, measures of academic achievement and appropriate categorization of weight status. Objective To examine longitudinal associations between childhood weight status (underweight,...

Background TransformUs was a four-arm school-based intervention to increase physical activity and reduce sedentary behaviour among primary school children. Pedagogical and environmental strategies targeted the classroom, school grounds and family setting. The aims of this study were to evaluate program fidelity, dose, appropriateness, satisfaction...

Background Heterogeneity in the outcomes collected and reported in trials of interventions to prevent obesity in the first five years of life highlights the need for a core outcome set to streamline intervention evaluation and synthesis of effects. This study aimed to develop a core outcome set for use in early childhood obesity prevention interven...

Background Behavioural patterns help to understand the influence of multiple health behaviours on childhood outcomes. Behavioural patterns derived using different data reduction techniques can be non-identical and may differentially associate with childhood outcomes. This study aimed to compare associations of behavioural patterns derived from thre...

Children’s engagement in screen time is a complex issue. While some forms of screen time have consistently been associated with harm, others have been associated with gains, making it difficult to weigh the risks and benefits of use. In this umbrella review, we systematically collate and synthesise meta-analyses examining the effects of screen use...

Objective Rapid weight gain (RWG) in infancy is strongly associated with subsequent obesity risk, but little is known about the factors driving RWG. This study explored the child and maternal factors associated with infant RWG. Methods Data from seven Australian and New Zealand cohorts were used (n = 4542). Infant RWG was defined as a change in we...

Background Although early childhood obesity prevention has become an important issue internationally, little evidence exists regarding longer term effects (i.e., sustainability) of early interventions. Objective To determine whether intervention benefits at 2 years of age were sustained at 3.5 and 5 years. Methods Follow‐up of the Early Preventio...

Introduction Despite being an important period for the development of movement behaviours (physical activity, sedentary behaviour and sleep), few interventions commencing prior to preschool have been trialled. The primary aim of this trial is to assess the 12-month efficacy of the Let’s Grow mHealth intervention, designed to improve the composition...

Background: Demographic correlates of movement behaviors in infants are unclear. This study examined the longitudinal associations between demographic correlates and movement behaviors in infants. Methods: Participants were 411 parents of infants from the Early Movers project in Edmonton, Canada. Movement behaviors, infant and parental age, and...

Food fussiness is associated with non-responsive parent feeding practices, such as persuasive and instrumental feeding. Although most children described as 'fussy eaters' are likely exhibiting developmentally typical behaviours, up to half of the parents of children 2-5 years old express concerns. Concern for fussy eating may mediate the use of non...

This scoping review was undertaken as the first stage of development of the Core Outcome Sets for Early Prevention of Obesity in CHildhood (COS‐EPOCH). The aim of this review is to identify the outcomes collected and reported in randomized controlled trials of early childhood obesity prevention interventions. A systematic scoping review was underta...

Background This study aimed to address methodological limitations of the evidence that informed national and international movement behaviour guidelines for the early years. Specifically, the primary objective was to examine the longitudinal associations of infant physical activity (i.e., tummy time) and sedentary behaviour (i.e., back time, screen...

Introduction Little is known about how early (eg, commencing antenatally or in the first 12 months after birth) obesity prevention interventions seek to change behaviour and which components are or are not effective. This study aims to (1) characterise early obesity prevention interventions in terms of target behaviours, delivery features and behav...

Introduction: Behavioural interventions in early life appear to show some effect in reducing childhood overweight and obesity. However, uncertainty remains regarding their overall effectiveness, and whether effectiveness differs among key subgroups. These evidence gaps have prompted an increase in very early childhood obesity prevention trials wor...

Introduction Promoting healthy eating and active play in early life is critical, however few interventions have been delivered or sustained at scale. The evaluation of interventions at scale is a crucial, yet under-researched aspect of modifying population-level health behaviours. INFANT is an evidence-based early childhood healthy lifestyle interv...

Identifying correlates of behavioural patterns are important to target population sub-groups at increased health risk. The aim was to investigate correlates of behavioural patterns comprising four behavioural domains in children. Data were from the HAPPY study when children were 6–8 years (n = 335) and 9–11 years (n = 339). Parents reported correla...

Very few early childhood interventions have observed sustained effects regarding television viewing and none have examined the mechanisms behind sustained intervention effects at long-term follow-ups. Thus, the aim of this study was to investigate potential mechanisms relating to the maintained intervention effect on television viewing at two long-...

Background The overall impact of interventions targeting multiple behaviours remains largely unexplored. Objectives This study adopted an integrative lifestyle pattern analysis approach to assess the overall effectiveness of an early childhood intervention on change across multiple behaviours. Methods The Melbourne INFANT program was a 15‐month c...

Background The association between physical activity and adiposity in preschool-aged children is unclear. Objective To assess the cross-sectional association between objectively measured physical activity and body fat in preschool-aged children. Methods In the preschool review in an Australian birth cohort study (n = 1074), mean duration and time...

Background Little is known about how activity patterns change throughout childhood. This study examined changes and tracking of total volume and bouts of physical activity (PA) and sedentary time (SED) from early to late childhood. Methods Volume and bouts of SED and light-, moderate- and vigorous-intensity PA (LPA, MPA and VPA) were assessed by a...

Child healthcare (CHC) nurses have a key role in promoting and supporting healthy lifestyle behaviors from a young age. Thus, this study aims to investigate the perspectives of CHC nurses regarding discussing food introduction, physical activity/active play, and screen time with parents; explore facilitators and barriers influencing the discussion...

Background Behavioural patterns are typically derived using unsupervised multivariate methods such as principal component analysis (PCA), latent profile analysis (LPA) and cluster analysis (CA). Comparability and congruence between the patterns derived from these methods has not been previously investigated, thus it’s unclear whether patterns from...

Introduction: Childhood overweight and obesity is prevalent in the first 5 years of life, and can result in significant health and economic consequences over the lifetime. The outcomes currently measured and reported in randomised controlled trials of early childhood obesity prevention interventions to reduce this burden of obesity are heterogeneo...

This study examined the concurrent validity of a tummy time questionnaire and time-use diary against an accelerometer measure. Participants were 29 parents and their 6-month-old infants from the Early Movers project in Edmonton, Canada. Tummy time was concurrently measured using a parental questionnaire, a time-use diary, and a validated GENEActiv...

Background: Understanding the mechanisms (mediators) of behavior change is crucial to designing more effective interventions. However, this is rarely reported. This paper investigates the mechanisms that explain the lack of intervention effect on physical activity and the significant effect on television viewing time from an early childhood trial....

Objective: This study examined the association between longitudinal trajectories of lifestyle patterns (LPs) and BMI z score in early childhood. Methods: Data of children (n = 439) who participated in the 18-, 42-, and 60-month follow-ups of the Melbourne InFANT Program were used. Multitrajectory modeling identified groups of children following...

Objective To test the reliability and validity of a physical activity and sedentary behaviour home environment audit tool for young children (2-5 years old). Design Cross-sectional Methods Parents of children aged 2-5 years were recruited through online methods (i.e., social media and blogs). Reliability of the SPACES home audit tool was assessed...

Skeletal maturity can be used as a biological indicator of the tempo of growth in children and adolescents. We present a description of skeletal maturity from a cohort of white Australian children and describe variation in skeletal maturity based on child age. Participants (n = 71; age 10.5–13.9 years) were recruited from the ‘Healthy, Active Presc...

Obesity prevention interventions with behavioral or lifestyle‐related components delivered via web‐based or telephone technologies have been reported as comparatively low cost as compared with other intervention delivery modes, yet to date, no synthesized evidence of cost‐effectiveness has been published. This study aimed to conduct a systematic re...

Background Physical activity (PA) decreases and sedentary time (SED) increases across childhood, with both behaviours tracking. However, no studies have examined how accumulation patterns of PA and SED (i.e., prolonged bouts, frequency of breaks in sedentary time) change and track over time. The aim of this study was to investigate longitudinal cha...

BACKGROUND Food fussiness is common in toddlerhood. Fussiness is associated with nonresponsive parent feeding practices, such as persuasive and instrumental feeding. Such feeding practices may reinforce fussy eating behaviors and are associated with poorer dietary intake and suboptimal growth trajectories. Parent feeding practices are known to clus...

A positive perception of motor skills is important for physical activity participation. The aim was to investigate which modifiable factors predict children’s perceived motor skills. Mothers completed questionnaires when their child was 3.5 and 5 years old. At 5 years old, the children’s perceived motor competence (PMC) was assessed. Separate linea...

Objective This study aimed to assess whether the long-term effectiveness of the Melbourne Infant, Feeding, Activity and Nutrition Trial (INFANT) at 2- and 3.5-years post-intervention varied according to maternal education and age. Design Two and 3.5-years post-intervention follow-up of the INFANT cluster-randomized controlled trial. Outcomes at bo...

Background The respective contribution of total, daytime and nighttime sleep duration in childhood obesity remains unclear. Objectives To assess the longitudinal association between developmental trajectories of sleep duration and BMI z‐score in early childhood. Methods Data were from the Melbourne INFANT program, a prospective cohort with 4‐mont...

Introduction Behavioural interventions in early life appear to show some effect in reducing childhood overweight and obesity. However, uncertainty remains regarding their overall effectiveness, and whether effectiveness differs among key subgroups. These evidence gaps have prompted an increase in very early childhood obesity prevention trials world...

Introduction Little is known about how early (e.g., commencing antenatally or in the first 12 months after birth) obesity prevention interventions seek to change behaviour and which components are or are not effective. This study aims to 1) characterise early obesity prevention interventions in terms of target behaviours, delivery features, and beh...

This study aimed to investigate the theoretical impact of reallocating a specific amount of sedentary time with an equal amount of (a) total, and (b) ≥1min‐bout‐accumulated time spent in different activity intensities, on inflammatory biomarkers in 8‐9 year old children. Accelerometry and inflammatory biomarker baseline data from the Transform‐Us!...

In Sweden, there have been no interventions promoting the development of healthy lifestyle behaviors starting in infancy. Thus this paper aims to: (i) investigate Swedish parents’ experiences regarding feeding of solid foods, screen time, and physical activity in healthy infants; (ii) investigate parents’ needs and perceptions regarding information...

Objective: To assess differences in weight status and movement behaviour guideline compliance among children aged 5-12 years with and without a family history of non-communicable diseases (NCDs). Design: Prospective. Setting and participants: Women born between 1973 and 1978 were recruited to the Australian Longitudinal Study on Women's Health...

This cross-sectional study examined theoretical effects of reallocating sedentary time (SED) with total physical activity, and physical activity bouts of varying intensities, on children's cardiometabolic biomarkers. Baseline data from the Transform-Us! trial (Melbourne, Australia) was used. Participant data were included if accelerometer and blood...

Introduction Limited evidence exists on the cost-effectiveness of interventions to prevent obesity and promote healthy body image in adolescents. The SHINE (Supporting Healthy Image, Nutrition and Exercise) study is a cluster randomised control trial (cRCT) aiming to deliver universal education about healthy nutrition and physical activity to adole...

Background: The few health behavior interventions commencing in infancy have shown promising effects. Greater insight into their longer-term benefits is required. This study aimed to assess post-intervention effects of the Melbourne INFANT Program to child age 5y on diet, movement and adiposity. Methods: Two and 3.5y post-intervention follow-up...

Background: While exclusive breastfeeding is recommended to 6 months of age, just 15% of mothers in Australia achieve this. The rate appears to be even lower among mothers born in China, where 90% have introduced infant formula by this time. This study aimed to examine infant feeding patterns in the first 12 months of life and the factors associat...

Background In the absence of rigorous evidence of cost‐effectiveness for early childhood obesity prevention interventions, the next‐best option may be for decision‐makers to consider the relevant costs of interventions when allocating resources. Objectives This study aimed to estimate systematically the cost of five obesity prevention intervention...

Diet, physical activity, sedentary behaviour and sleep are typically examined independently with childhood adiposity; however, their combined influence remains uncertain. This review aims to systematically summarize evidence on the clustering of these behaviours through lifestyle patterns and evaluate associations with adiposity in children aged 5–...

Background: Several countries have released movement guidelines for children under 5 that incorporate guidelines for sleep, physical activity and sedentary behavior. This study examines prospective associations of preschool children's compliance with the 24-Hour Australian movement guidelines (sleep, physical activity, screen time) and physiologic...

Traditional approaches to understanding the behavioural determinants of adiposity have considered diet, physical activity and sedentary behaviour in isolation. Although integrative approaches have identified a variety of lifestyle patterns in children at preschool-age or older, along with some variability by socio-economic positions, this has rarel...

Background Chinese Australian mothers are more likely than the general Australian mothers to introduce formula in the first month of age. A better understanding of the context of formula introduction in the early weeks of birth can provide a deeper insight into how Chinese Australian mothers can be supported to continue exclusive breastfeeding. Me...

Background Childhood obesity is a significant global problem. Childhood obesity prevention interventions may be more effective when started very early in life before metabolic and behavioural patterns are established. Methods and findings A prospectively planned, individual participant data meta‐analysis of four randomized controlled trials. Parti...

Parks typically offer opportunities for physical activity among children. Therefore, understanding features of parks that attract children is important for public health. Previous research suggests that children often visit parks other than the one closest to home, most likely because of appealing features. This study compared features present at t...