Well-Being, Obesity and Motricity Observatory in Childhood and Youth (WOMO): A Study Protocol
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design
2.2. Ethics Approval
2.3. Participants
2.4. Measures and Procedures
2.4.1. Main Measures
- Examiner’s questionnaire: This questionnaire collects personal data information and anthropometric measurements from children and adolescents.
- Personal data. Similarly to the ALADINO study [3], date of birth, sex, place of residence, grade, date and time of measurement, clothes worn at the time of measurement, name and address of the school, body weight, height, waist circumference and hip circumference will be collected.
- Anthropometric measurements shall be taken under standardized conditions and in the same order as presented in the examiner’s questionnaire.
- Family questionnaire: This instrument collects information about the child’s lifestyle, eating habits, family health and sociodemographic data.
- School questionnaire: This questionnaire includes questions related to physical activity, meals taken at school and access to food during school hours.
- Lower limbs strength. Explosive lower-body strength will be assessed using the standing long jump with feet together (the longest distance possible). It will be measured in cm by means of a measuring tape (from the take-off line to the point where the back of the heel nearest to the take-off line lands on the ground) [27].
- Cardiorespiratory fitness will be assessed using the Course–Navette test (20-m shuttle run test). Participants will have to run between two lines separated by 20 m while keeping the rhythm emitted by audio signals. The initial speed is 8.5 km/h, which increased by 0.5 km/h every minute. Subjects should start when the audio signal or beep is heard. Participants were encouraged to continue running as long as possible during the test. The test finishes when the subject stops because of fatigue or fails to reach the end line concurrent with the audio signal or beep on two consecutive occasions [28,29]. The last half stage completed will be recorded for analysis.
- Speed-agility will be evaluated using the 4 × 10 m test [30], which consists of running a total distance of 40 m. Participants must run a distance back and forth between two lines 10 m apart, taking three sponges alternately as quickly as possible.
- 3.
- Obesity and overweight. They will be assessed through Body Mass Index (BMI) and fat percentage following to WHO methodology [2]. BMI will be calculated using the formula: weight (kg) divided by height squared (m2).
- 4.
- Well-being.The Perception Scale of Child Well-being Indicators (EPIBI) will be used to assess well-being [31]. The original scale consists of 80-Likert scale items, including six different response categories (from 1 = not important to 6 = very important). These categories are grouped into five dimensions (material well-being, health and safety, educational well-being, relationships with the environment and subjective well-being). The student is asked to make a series of statements related to child well-being and to assess the degree of importance that every item supposes for the child’s well-being (Cronbach’s alpha = 0.95).
2.4.2. Secondary Measures
Self-perceived Physical Fitness
Physical Activity Adherence
- Physical Activity Questionnaire for Adolescents (PAQ-A) [35] consists of nine questions that assess different aspects of physical activity performed by adolescents in the previous 7 days, using a 5-point Likert scale for every question and reporting information about the intensity, frequency and duration of each activity performed. The overall result gives a score from 1 to 5, where a higher score indicates a higher level of physical activity. This questionnaire will be completed for adolescents aged 13 to 18 years old. Participants will complete the Spanish version (ICC = 0.71) [36].
- The Physical Activity Questionnaire for Children (PAQ-C) [37] is similar to the previous one but adapted to children aged between 8 and 14 years old (Cronbach’s alpha = 0.83).
Physical Literacy
- Daily activity behaviour will be objectively assessed from pedometer step counts during seven consecutive days. Also, children are asked to self-report the number of days in the last week that they were physically active for at least 60 min.
- Physical competence will be assessed using the following three tests:
- Canadian Agility and Movement Skill Assessment (CAMSA) [39] will consist of children to travel a total distance of 20 m while completing 7 movement skill tasks: (1) 2-footed jumping into and out of 3 hoops on the ground, (2) sliding from side to side over a 3-m distance, (3) catching a ball and then (4) throwing the ball at a wall target 5 m away, (5) skipping for 5 m, (6) 1-footed hopping in and out of 6 hoops on the ground and (7) kicking a soccer ball between 2 cones placed 5 m away. Groups of children will be instructed to complete the assessment as fast as possible while performing the skills to the best of their ability. Each child will be assessed bgy 2 timed and scored trials. The assessment will be administered and scored by two examiners. The first examiner will measure the completion time. The second examiner will evaluate the quality of each skill performed. The total score (maximum 10 points) will be calculated as the sum of the skill and time scores (completion time: ICC = 0.82; skill score: ICC = 0.74).
- Plank isometric hold [40] is an isometric core strength exercise that involves maintaining a position similar to a push-up for the maximum possible time (inter-rater: ICC = 0.62; intra-rater: ICC = 0.83; test-retest: ICC = 0.63).
- Progressive Aerobic Cardiovascular Endurance Run (PACER) [41] will be used to estimate the peak oxygen consumption in the youth. The participants will run 20 m back and forth between cones. The running pace will follow a sound signal. The initial speed will be beginning at 8.5 km/h and progressively will be increased by 0.5 km/h each minute. Participants must run as long as possible, and testing will stop when the participant reaches fatigue or cannot maintain the required pace for two consecutive times.
- Motivation and confidence will be assessed by 12 self-report items. Four aspects of motivation and confidence are evaluated (predilection, adequacy, perceived competence satisfaction and intrinsic motivation). Predilection will assess the child’s preference for physically active pursuits. Adequacy will assess their expectations for success. Perceived competence satisfaction will assess whether children perceive they can complete optimally physical activities. Intrinsic motivation will assess if children pursue an activity for its own sake.
- Knowledge and understanding will be measured using the Physical Literacy Knowledge Questionnaire (PLKQ) [42]. Questions will evaluate the children’s understanding of physical activity and sedentary behaviour recommendations, the awareness of fitness and movement skill parameters and the methods for their improvement, the perceptions of health and the use of safety equipment during activity (2-day interval: r = 0.62; 7-day intervals: r = 0.69).
Health-Related Quality of Life (HRQoL)
- Kidscreen-52 [43]. These instruments assess children’s and adolescents’ subjective health and well-being. It is a self-report measure applicable for healthy and chronically ill children and adolescents aged from 8 to 18 years. The KIDSCREEN-52 measures 10-HRQoL dimensions: physical (5 items), psychological wellbeing (6 items), moods and emotions (7 items), self-perception (5 items), autonomy (5 items), parent relations and home life (6 items), social support and peers (6 items), school environment (6 items), social acceptance (bullying) (3 items) and financial resources (3 items). Its reduced version KIDSCREEN-10 will be also administered [44,45] (Cronbach’s Alpha = 0.82).
- Child health utility 9D (CHU9D) [46] is a self-report questionnaire (completed by the child) and a proxy-report questionnaire (completed by the caregiver). This questionnaire consists of 9 items that include 5 possible responses (scored 1–5) to assess the child or adolescent’s current status on the following domains: worry, sadness, pain, tiredness, annoyance, school, sleep, daily routine and activities.
- Euroqol-5 Dimensions-Youth (EQ-5D-Y) [47] consists of the EQ-5D-Y descriptive system and the EQ visual analogue scale (EQ-VAS). The descriptive system comprises the same estimated dimensions as Euroqol-5 Dimensions-3L (EQ-5D-3L), using a child-friendly wording. Each dimension has 3 levels: “no problems”, “some problems” and “a lot of problems”. Participant must indicate his/her health state by ticking in the box against the most appropriate statement in each of the 5 dimensions. The EQ-VAS is a self-rated visual analogue scale which records the respondent’s health, where the endpoints are labelled “the best health you can imagine” and “the worst health you can imagine”. Participants’ parents will complete a similar questionnaire named EQ-5D-Y Proxy (ICC > 0.7) [48].
- 16D [49] is based on the 15D measure [50,51]. Some of the questions of the 15D measure were deleted (e.g., sexual life) and others were added (e.g., physical appearance and friends) or reformulated (e.g., usual activities) to be age-appropriate. This instrument is designed for participants aged 12–15 years. This tool will be translated to Spanish language following the author guidelines (already present in a signed agreement) prior to being administered to participants. 17D [52] is based on the 16D [49] and 15D measures [50,51]. One of the questions measured in 16D was eliminated (distress) and others were added (e.g., ability to concentrate, learning and memory capacity and anxiety) or reformulated (e.g., vision and depression of vitality) to be appropriate for ages 7–11. This tool will be translated into Spanish language following the author guidelines (already present in a signed agreement) prior to being administered to participants.
Happiness and Satisfaction with Life
- Spanish Subjective Happiness Scale (SSHS) [56]. This scale consists of a 4-item Likert scale that measures global subjective happiness by means of statements where participants self-rate themselves or compare to others. The scale has an adequate unitary structure and temporal stability confirmed in 14 samples (Cronbach’s alpha = 0.81).
- Satisfaction with Life Scale (SWLS) [57] is a multi-item scale as a measure of subjective well-being. This scale comprises 5 self-referencing statements on perceived global life satisfaction on a Likert scale ranging from 1 (strong disagreement) to 6 (strong agreement). Participants will complete the Spanish version of the SWLS [58].
- Positive Affect Negative Affect Schedule (PANAS) [59]. This questionnaire was constructed by Sandin (1997) [60] from the adult version by Watson et al. (1988) [61]. It is a 20-item self-report questionnaire. Ten items assess positive affect, and ten others assess negative affect. The questionnaire is completed by the child/adolescent considering the way he/she usually feels and/or behaves, following a scale of three response alternatives, described as “never”, “sometimes” and “many times”.
Connection with Nature
- Connectedness to Nature Scale (CNS) [62]. This is a self-administered questionnaire designed to assess an affective individual experience of connection with nature, which contains 14 items written in the form of a 5-point Likert-type scale. Participants will complete the Spanish version of the CNS (Cronbach’s alpha = 0.788) [63].
- Nature Relatedness Scale (NR) [64]. This is a self-report measure designed to assess the affective, cognitive and physical relationship individuals have with the natural world (Cronbach’s alpha = 0.87). Participants respond to statements using a 5-point Likert scale (1 = strongly disagree and 5 = strongly agree), and items are averaged with higher scores, indicating stronger connectedness. This tool will be translated into Spanish language following the WHO guidelines prior to be administered to participants [65].
- Connection to Nature [66]. The test consists of 18 multiple-choice questions which measure children’s attitudes toward the natural environment and which reflect the enjoyment of nature, empathy for its creatures, sense of oneness and sense of responsibility. The 18 items are written in the form of a 5-point Likert scale (1 = strongly disagree and 5 = strongly agree) (Cronbach’s α = 0.87). This instrument will be translated into Spanish language following the WHO guidelines prior to being administered to participants [65].
Self-Concept
- Physical Self-Description Questionnaire [67]. This is a 70-item instrument designed to measure health, coordination, activity, body fat, sports competence, appearance, strength, flexibility, endurance and fitness, global physical self-concept and global self-confidence. Every scale is represented by six or eight simple declarative statement items, and participants answer using a 6-point true false scale. Participants will complete the Spanish version [68,69].
- Figure Rating Scale [70] consists of nine figures of increasing size with accompanying numerical ratings from 1 to 9. This body silhouettes method was designed and validated by Stunkard, Sørensen and Schulsinger [71]. It shows nine body silhouette figures of both men and women from very thin to very obese. The subjects should choose the figure which is closest to their own along with the silhouette they would like to have [72].
Barriers for the Physical Activity
- Short Scale of Perception of Barriers for the Physical Activity in Adolescents [73]. This is a 12-items self-reporting instrument that collects the self-perception about the different items included in the scale. Every item will be assessed using a 5-point Likert answer scale, where 1 means strongly disagree and 5 is strongly agree (Cronbach’s alpha = 0.80).
- Self-Reported Barriers to Physical Activity (SBPA) [74]. This is a 17-item questionnaire answered as a 10-points Likert scale, where values close to 0 mean that is very unlikely to prevent physical activity from being performed in the next weeks and values close to 10 mean very likely to prevent physical activity from being performed. This instrument consists of 4 factors: body image/physical and social anxiety; tiredness/laziness; life demands/lack of time; and environment/facilities (Cronbach’s alpha = 0.85).
Bullying
- Bull-S questionnaire [75] assesses three general aspects of bullying: (1) sociometric position (items 1–4), which evaluates how each person is positioned by his or her status into the group and what the social and affective structure of the group is like; (2) bullying characteristics (items 5–10) that assess some physical and personal aspects of bullies or to victims; and (3) situational properties (items 11–15) that use a peer-report procedure to estimate the type, place and frequency of the aggressions as well as the degree of severity that pupils confer on this behaviour and how safe they feel at school. Participants will complete the Spanish version [76,77] (Cronbach’s alpha = 0.73).
- School Violence Questionnaire-Revised (CUVE-R) [78]. This is a revised and expanded version of the CUVE [79] (Cronbach’s alpha = 0.92). CUVE-R evaluates the students’ perception of the frequency of the emergence of different types of school violence involving students and teachers. It consists of a 5-point Likert scale with 31 items. Participants must indicate when the violent incident occurred (1 = not occurs never; 2 = occurs rarely; 3 = sometimes; 4 = many times; and 5 = always). This instrument will be translated into Spanish language following the WHO guidelines prior to being administered to participants [65].
2.5. Statistical Analysis
3. Discussion
4. Conclusions
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
References
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Assessments | Year 1 | Year 2 | Year 3 | Year n | |
---|---|---|---|---|---|
Main Measures | COSI initiative measures | X | X | X | X |
ALADINO study measures | X | X | X | X | |
ALPHA-fitness test battery | X | X | X | X | |
Obesity and overweight | X | X | X | X | |
Well-being | X | X | X | X | |
Secondary Measures | Self-perceived physical fitness. | X | X | X | X |
Physical activity levels | X | X | X | X | |
Physical literacy | X | X | X | X | |
Health-Related Quality of Life (HRQoL) | X | X | X | X | |
Happiness and satisfaction with life | X | X | X | X | |
Connection with nature | X | X | X | X | |
Self-concept | X | X | X | X | |
Barriers for the Physical Activity | X | X | X | X | |
Bullying | X | X | X | X |
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Mendoza-Muñoz, M.; Adsuar, J.C.; Pérez-Gómez, J.; Muñoz-Bermejo, L.; Garcia-Gordillo, M.Á.; Carlos-Vivas, J. Well-Being, Obesity and Motricity Observatory in Childhood and Youth (WOMO): A Study Protocol. Int. J. Environ. Res. Public Health 2020, 17, 2129. https://doi.org/10.3390/ijerph17062129
Mendoza-Muñoz M, Adsuar JC, Pérez-Gómez J, Muñoz-Bermejo L, Garcia-Gordillo MÁ, Carlos-Vivas J. Well-Being, Obesity and Motricity Observatory in Childhood and Youth (WOMO): A Study Protocol. International Journal of Environmental Research and Public Health. 2020; 17(6):2129. https://doi.org/10.3390/ijerph17062129
Chicago/Turabian StyleMendoza-Muñoz, María, José Carmelo Adsuar, Jorge Pérez-Gómez, Laura Muñoz-Bermejo, Miguel Ángel Garcia-Gordillo, and Jorge Carlos-Vivas. 2020. "Well-Being, Obesity and Motricity Observatory in Childhood and Youth (WOMO): A Study Protocol" International Journal of Environmental Research and Public Health 17, no. 6: 2129. https://doi.org/10.3390/ijerph17062129