Research

Open AccessArticle

Compliance with Health-Related Behaviors Guidelines and Its Relationship with Multiple Factors in Preschool Children Aged 3–6 Years: A National Cross-Sectional Survey in China

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Int. J. Environ. Res. Public Health 2022, 19(3), 1262; https://doi.org/10.3390/ijerph19031262 - 23 Jan 2022

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Abstract

Purpose: To investigate the compliance rates of health-related behaviors among Chinese preschool children, and to explore how supportive family environment, parental behavior, sociodemographic and community factors affect children’s health-related behavior comprehensively. Method: Preschool children aged 3 to 6 years were chosen from 5760 [...] Read more.

Purpose: To investigate the compliance rates of health-related behaviors among Chinese preschool children, and to explore how supportive family environment, parental behavior, sociodemographic and community factors affect children’s health-related behavior comprehensively. Method: Preschool children aged 3 to 6 years were chosen from 5760 villages (residential) committees from 471 counties (districts) of 31 provinces by use of a stratified random sampling procedure, with 10,967 preschool children aged 3–6 years old included. The survey was conducted from September 2020 to November 2020. Results: The proportion of Chinese preschool children who met the moderate to vigorous physical activity (MVPA), screen time behavior (ST), and sleep behavior (SLP) guidelines were 62.3%, 52.8%, and 53.8%. Among the supportive family environment factors, parents’ time with their children on weekends had the most significant impact on children’s MVPA, ST, and SLP, with the odds ratio (OR) values of 2.18 (95%CI:1.97, 2.40), 0.69 (0.63, 0.76), and 1.62 (1.48, 1.79), respectively. Among the parental behavior factors, the mother’s exercise frequency had a strong association with the children’s MVPA and SLP, with OR values of 1.65 (1.50, 1.83) and 1.24 (1.13, 1.37), respectively; the mother’s screen time was inversely associated with the children’s ST with an OR value of 0.47 (0.44, 0.51). Conclusions: Different types of family environments were associated with the different levels of MVPA, ST and SLP among Chinese preschool children. In addition to the influence of parents’ education and family income, parents could also improve their children’s behaviors by providing a supportive family environment. The more of these factors presented in a family, the more likely it was for children to meet the guidelines. Therefore, for those families whose children’s health-related behaviors needed to be improved, the parents should create supportive family environments, such as by playing less on mobile phone and spending more time with children. Full article

(This article belongs to the Special Issue 24-Hour Movement Behaviours in Children)

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Open AccessArticle

The Impact of COVID-19 on Preschool-Aged Children’s Movement Behaviors in Hong Kong: A Longitudinal Analysis of Accelerometer-Measured Data

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Int. J. Environ. Res. Public Health 2021, 18(22), 11907; https://doi.org/10.3390/ijerph182211907 - 12 Nov 2021

Cited by 8 | Viewed by 2298

Abstract

During the COVID-19 pandemic, many preschool-aged children were forced to remain indoors due to social distancing measures and school closures. In this study, we examined how children’s movement behaviors (sedentary behaviors, physical activity, and sleep) were affected by the pandemic. Children’s (N [...] Read more.

During the COVID-19 pandemic, many preschool-aged children were forced to remain indoors due to social distancing measures and school closures. In this study, we examined how children’s movement behaviors (sedentary behaviors, physical activity, and sleep) were affected by the pandemic. Children’s (N = 25, age = 4.4 years, SD = 0.3) movement behaviors were measured before and after the COVID outbreak, respectively. Data collected using accelerometers were analyzed using compositional data analyses. A significant change in the overall time-use composition (F = 5.89, p = 0.002) was found. Results suggested that children spent more time sleeping (8% increase) and in moderate-to-vigorous physical activity (16% increase), with less time spent in sedentary behaviors (9% decrease). However, parent reports suggested that children were less active and had more screen time. In conclusion, the current evidence suggests that children’s physical activity is not negatively impacted by the pandemic. However, the continuous surveillance of movement behaviors of young children during the pandemic is needed. Full article

(This article belongs to the Special Issue 24-Hour Movement Behaviours in Children)

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Open AccessArticle

Objective Measurement of 24-Hour Movement Behaviors in Preschool Children Using Wrist-Worn and Thigh-Worn Accelerometers

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Int. J. Environ. Res. Public Health 2021, 18(18), 9482; https://doi.org/10.3390/ijerph18189482 - 08 Sep 2021

Cited by 4 | Viewed by 1475

Abstract

In recent years, more attention has been paid towards the study of 24-h movement behaviors (including physical activity (PA), sedentary behavior (SB) and sleep) in preschoolers instead of studying these behaviors in isolation. This study aimed to evaluate the feasibility of using wrist- [...] Read more.

In recent years, more attention has been paid towards the study of 24-h movement behaviors (including physical activity (PA), sedentary behavior (SB) and sleep) in preschoolers instead of studying these behaviors in isolation. This study aimed to evaluate the feasibility of using wrist- vs. thigh-worn accelerometers and to report accelerometer-derived metrics of 24-h movement behaviors in preschoolers. A convenience sample of 16 preschoolers (50.0% boys, 4.35 years) and one of their parents were recruited for this study. Preschoolers had to wear the ActivPAL accelerometer (attached to the upper thigh) and Axivity accelerometer (using a wrist band) simultaneously for 7 consecutive days and for 24 h a day. Parents completed an acceptability survey. In total, 16 preschoolers (100.0%) had a minimum of 6 days of valid wrist-worn data, while only 10 preschoolers (62.5%) had a minimum of 6 days of valid thigh-worn data (p = 0.002). When looking at the acceptability, 81.3% of parents indicated that it was easy for their child to wear the Axivity for 7 consecutive days, and 93.8% of parents indicated so for the ActivPAL (p = 0.88). However, some parents stated that the wristband of the Axivity accelerometer was big, which might have affected data collection. Significant differences were found for the measurement of total volume of PA, SB and sleep across 24 h. Total PA was 464.44 min/day (±64.00) with the ActivPAL compared with 354.94 min/day (±57.46) with the Axivity (p < 0.001). The volume of SB was 290.94 min/day (±55.05) with the ActivPAL compared with 440.50 min/day (±50.01) with the Axivity (p < 0.001). The total volume of sleep was also significantly different between both devices (p = 0.001; ActivPAL: 684.63 min/day ± 51.96; Axivity: 645.69 min/day ± 46.78). Overall, parents perceived both devices to be feasible to use for preschoolers. However, future studies are required to validate both devices for the measurement of preschoolers’ 24-h movement behaviors since significant differences in the classification of PA, SB and sleep were found in this small sample. Full article

(This article belongs to the Special Issue 24-Hour Movement Behaviours in Children)

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Open AccessArticle

Compliance with the 24-Hour Movement Behavior Guidelines and Associations with Adiposity in European Preschoolers: Results from the ToyBox-Study

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María L. Miguel-Berges

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Int. J. Environ. Res. Public Health 2021, 18(14), 7499; https://doi.org/10.3390/ijerph18147499 - 14 Jul 2021

Cited by 4 | Viewed by 2286

Abstract

In 2019, the World Health Organization (WHO) published 24 h movement behavior guidelines for preschoolers with recommendations for physical activity (PA), screen time (ST), and sleep. The present study investigated the proportion of preschoolers complying with these guidelines (on a total week, weekdays [...] Read more.

In 2019, the World Health Organization (WHO) published 24 h movement behavior guidelines for preschoolers with recommendations for physical activity (PA), screen time (ST), and sleep. The present study investigated the proportion of preschoolers complying with these guidelines (on a total week, weekdays and weekend days), and the associations with adiposity. This cross-sectional study included 2468 preschoolers (mean age: 4.75 years; 41.9% boys) from six European countries. The associations were investigated in the total sample and in girls and boys separately. PA was objectively assessed by step counts/day. Parent-reported questionnaires provided ST and sleep duration data. Generalized estimating equations were used to analyze the association between guideline compliance and adiposity indicators, i.e., body mass index (BMI) z-score and waist to height ratio (WHR). Only 10.1% of the preschoolers complied with the 24 h movement behavior guidelines, 69.2% with the sleep duration guideline, 39.8% with the ST guideline and 32.7% with the PA guideline. No association was found between guideline compliance with all three movement behaviors and adiposity. However, associations were found for isolated weekday screen time (BMI z-scores and WHR: p = 0.04) and weekend day sleep duration (BMI z-scores and WHR: p = 0.03) guideline compliance with both lower adiposity indicators. The latter association for sleep duration was also found in girls separately (BMI z-scores: p = 0.02; WHR: p = 0.03), but not in boys. Longitudinal studies, including intervention studies, are needed to increase preschoolers’ guideline compliance and to gain more insight into the manifestation of adiposity in children and its association with 24 h movement behaviors from a young age onwards. Full article

(This article belongs to the Special Issue 24-Hour Movement Behaviours in Children)

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Open AccessArticle

Typologies of Family Functioning and 24-h Movement Behaviors

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Int. J. Environ. Res. Public Health 2021, 18(2), 699; https://doi.org/10.3390/ijerph18020699 - 15 Jan 2021

Cited by 4 | Viewed by 2027

Abstract

Research on the importance of the family environment on children’s health behaviors is ubiquitous, yet critical gaps in the literature exist. Many studies have focused on one family characteristic and have relied on variable-centered approaches as opposed to person-centered approaches (e.g., latent profile [...] Read more.

Research on the importance of the family environment on children’s health behaviors is ubiquitous, yet critical gaps in the literature exist. Many studies have focused on one family characteristic and have relied on variable-centered approaches as opposed to person-centered approaches (e.g., latent profile analysis). The purpose of the current study was to use latent profile analysis to identify family typologies characterized by parental acceptance, parental monitoring, and family conflict, and to examine whether such typologies are associated with the number of movement behavior recommendations (i.e., physical activity, screen time, and sleep) met by children. Data for this cross-sectional observational study were part of the baseline data from the Adolescent Brain Cognitive Development (ABCD) study. Data were collected across 21 study sites in the United States. Participants included 10,712 children (female = 5143, males = 5578) aged 9 and 10 years (M = 9.91, SD = 0.62). Results showed that children were meaningfully classified into one of five family typologies. Children from families with high acceptance, medium monitoring, and medium conflict (P2; OR = 0.54; 95% CI, 0.39–0.76); high acceptance, medium monitoring, and high conflict (P3; OR = 0.28; 95% CI, 0.20, 0.40); low acceptance, low monitoring, and medium conflict (P4; OR = 0.24; 95% CI, 0.16, 0.36); and medium acceptance, low monitoring, and high conflict (P5; OR = 0.19; 95% CI, 0.12–0.29) were less likely to meet all three movement behavior recommendations compared to children from families with high acceptance, high monitoring, and low conflict (P1). These findings highlight the importance of the family environment for promoting healthy movement behaviors among children. Full article

(This article belongs to the Special Issue 24-Hour Movement Behaviours in Children)

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Open AccessArticle

Cross-Cultural Adaptation of Instruments Measuring Children’s Movement Behaviors and Parenting Practices in Brazilian Families

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Int. J. Environ. Res. Public Health 2021, 18(1), 239; https://doi.org/10.3390/ijerph18010239 - 31 Dec 2020

Cited by 4 | Viewed by 1651

Abstract

Childhood obesity is a global problem, disproportionately affecting children in low-to-middle income countries (LMIC). Despite this evidence, no previous study has adapted instruments measuring children’s movement behaviors and associated parenting practices for use in LMIC families. This study reports the results of a [...] Read more.

Childhood obesity is a global problem, disproportionately affecting children in low-to-middle income countries (LMIC). Despite this evidence, no previous study has adapted instruments measuring children’s movement behaviors and associated parenting practices for use in LMIC families. This study reports the results of a cross-cultural adaptation of previously validated measures of children’s movement behaviors and parenting practices in economically disadvantaged Brazilian families. Study 1 involved translation of the instruments from English to Portuguese. A team of translators (fluent in both English and Portuguese) and researchers followed established procedures for translating measurement scales, identifying problematic items, and reaching consensus on discrepancies. Study 2 involved cognitive interviews with 24 parents from urban and rural North-eastern Brazil addressing the format, content, and clarity of the items. Half the parents provided feedback on the first 33 items of the questionnaire, with the remaining parents providing feedback on the final 29 items. Notes were recorded during the interview and parents’ feedback summarized in a report. In the translation and back-translation, 15 discrepancies were identified. These were mostly due to multiple Portuguese words having the same meaning in English. The research team discussed these discrepancies and consensus was reached to ensure that the concepts depicted in the Portuguese version were consistent with the English version. In the cognitive interviews, parents identified minor problems with item comprehension resulting in minor adaptations to response options, recall period, and format of the questionnaire. The process of translation and cognitive interviews conducted in Brazilian families resulted in an appropriate cultural adaptation of scales measuring children’s movement behaviors and parenting practices. Future studies should evaluate the validity and reliability of the measures in LMIC families. Full article

(This article belongs to the Special Issue 24-Hour Movement Behaviours in Children)

Open AccessArticle

Associations between Adherence to Combinations of 24-h Movement Guidelines and Overweight and Obesity in Japanese Preschool Children

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Int. J. Environ. Res. Public Health 2020, 17(24), 9320; https://doi.org/10.3390/ijerph17249320 - 13 Dec 2020

Cited by 14 | Viewed by 2016

Abstract

The interactions between movement behaviors (physical activity, screen time, and sleep) affect the health of preschool children. Therefore, we examined the status of adherence to combinations of 24-hour movement guidelines (24-h MG) in Japanese preschool children and determined the associations between overweight/obesity and [...] Read more.

The interactions between movement behaviors (physical activity, screen time, and sleep) affect the health of preschool children. Therefore, we examined the status of adherence to combinations of 24-hour movement guidelines (24-h MG) in Japanese preschool children and determined the associations between overweight/obesity and adherence to these 24-h MG. This cross-sectional study was conducted with 421 children aged 3–5 years (216 boys and 199 girls) living in the northeastern region of Japan. To evaluate the 24-h MG, physical activity over one week was measured using a three-axis accelerometer. For screen time and sleep duration, a questionnaire survey was conducted. Children who failed to meet all the 24-h MG had a higher probability of overweight/obesity than those who met all the 24-h MG (odds ratio 1.139, 95% confidence interval: 1.009, 1.285). The percentage of adherence to the 24-h MG was 91.6% for physical activity, 82.5% for sleep duration, and 33.7% for screen time, and only 21.5% of the children adhered to all three areas of the guidelines. Our findings have important implications for developing public health policies and effective intervention programs for preschool children. Full article

(This article belongs to the Special Issue 24-Hour Movement Behaviours in Children)

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Open AccessArticle

Correlates of Meeting the Physical Activity, Sedentary Behavior, and Sleep Guidelines for the Early Years among Belgian Preschool Children: The ToyBox-Study

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Int. J. Environ. Res. Public Health 2020, 17(19), 7006; https://doi.org/10.3390/ijerph17197006 - 24 Sep 2020

Cited by 5 | Viewed by 1791

Abstract

Physical activity, sedentary behavior, and sleep guidelines for preschool children were already established and integrated into the 24 h movement behavior guidelines in 2017. The aim of the current study was to investigate correlates of meeting or not meeting the physical activity, sedentary [...] Read more.

Physical activity, sedentary behavior, and sleep guidelines for preschool children were already established and integrated into the 24 h movement behavior guidelines in 2017. The aim of the current study was to investigate correlates of meeting or not meeting the physical activity, sedentary behavior, and sleep guidelines in Belgian preschool children. In total, 595 preschool children (53.3% boys, 46.7% girls, mean age: 4.2 years) provided complete data for the three behaviors and potentially associated correlates. Physical activity was objectively measured with accelerometers. Screen time, sleep duration, and correlates were reported by parents with the use of a questionnaire. Backward logistic regression was used to identify factors associated with meeting all guidelines for weekdays and weekend days. In the final model, older preschoolers (OR = 1.89), having a normal weight compared to being underweight (OR = 0.30), having parents that do not watch a lot of television (OR = 0.99), and having a father that attained higher education (OR = 1.91) were associated with meeting all guidelines on weekdays. For weekend days, a significant association was found for attending a sports club (OR = 1.08). Overall, only a few factors were associated with meeting the guidelines. A more comprehensive measurement of preschool children’s potential correlates of physical activity, sedentary behavior, and sleep is warranted. Full article

(This article belongs to the Special Issue 24-Hour Movement Behaviours in Children)

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