Fiona Chun Man Ling

Background: To combat the high prevalence of physical inactivity among children, there is an urgent need to develop and implement real-world interventions and policies that promote physical activity (PA) and reduce sedentary behaviour (SB). To inform policy makers, the current body of evidence for children’s PA/SB interventions needs to be translated. Objectives: The current systematic review and meta-analysis aimed to identify modifiable determinants of device-measured PA and SB targeted in available intervention studies with randomized controlled trial (RCT) and controlled trial (CT) designs in children and early adolescents (5–12 years) and to quantify the effects of the interventions within their respective settings on the determinants of PA/SB and the outcomes PA and SB. Methods: A systematic search was conducted in MEDLINE, PsycINFO, Web of Science, SPORTDiscus and CENTRAL. Studies were considered if they were randomized controlled trials (RCTs) or controlled trials (CTs), included children and/or early adolescents (5–12 years; henceforth termed children), measured PA and/or SB using device-based methods and measured PA and/or SB and determinants of PA/SB at least at two timepoints. Risk of bias was assessed using the Cochrane Risk of Bias Tool for Randomised Trials (RoB2) for RCTs and Risk of Bias in Non-randomised Studies of Interventions (ROBINS-I) for CTs. The quality of the generated evidence was assessed using Grading of Recommendations Assessment, Development and Evaluation (GRADE). Robust Bayesian meta-analysis was conducted to quantify the effects of the interventions on the determinants of PA/SB, and the outcomes PA and SB, stratifying by study design, duration of PA/SB measurement, intervention setting and duration of follow-up measurement. Study characteristics and interventions were summarized. Results: Thirty-eight studies were included with a total sample size of n = 14,258 (67% girls). Settings identified were school, family/home, community and combinations of these. The review identified 38 modifiable determinants, spanning seven categories on individual, interpersonal and physical environmental levels, with 66% of determinants on the individual level. Overall, the results indicated trivial-to-moderate effects of the interventions on the determinants of PA and SB, with mostly trivial level of evidence for the presence of an effect (as indicated by a small Bayes factor; BF₁₀ < 3.00). The exceptions were moderate effects on parental PA modelling in the family/home setting and SB measured during specific parts of the school day. Higher quality of evidence was found in the family/home setting compared with other settings. Discussion: Overall, the results indicated that interventions have neither been effective in modifying the determinants of PA/SB, nor changing the PA/SB outcomes in children. In general, the approach in the current review revealed the breadth of methodological variability in children’s PA interventions. Research is needed to address novel approaches to children’s PA research and to identify potential determinants to inform policy and future interventions. Registration: International prospective register of systematic reviews (PROSPERO): CRD42021282874.

Previous physical activity interventions for children (5-12yrs) have aimed to change determinants associated with self-report physical activity behaviour (PAB) and/or sedentary behaviour (SB), however, the associations between these determinants and PAB/SB in different settings are uncertain. The present study aimed to identify modifiable determinants targeted in previous PAB/SB interventions for children. Intervention effects on the determinants and their associations with self-report PAB/SB were assessed across settings. Search of relevant interventions from pre-defined databases was conducted up to July 2023. Randomized and non-randomized controlled trials with modifiable determinants were included. Data extraction and risk of bias assessments were conducted by two independent researchers. Where data could be pooled, we performed Robust Bayesian meta-analyses. Heterogeneity, publication bias and certainty of evidence were assessed. Fifteen studies were deemed eligible to be included. Thirty-seven unique determinants within four settings were identified–school, family, school with family/home, and community with(out) other settings. Ninety-eight percent of determinants belonged to individual/interpersonal determinant categories. Narratively, intervention effects on student perception of teachers’ behaviour (school), self-management, perceived barriers, external motivation, exercise intention, parental modeling on SB (school with family/home) and MVPA expectations (community) were weak to strong, however, corresponding PAB/SB change was not evident. There were negligible effects for all other determinants and the corresponding PAB/SB. Meta-analyses on self-efficacy, attitude, subjective norm and parental practice and PAB/SB in two settings showed weak to strong evidence against intervention effect, while the effect on knowledge could not be determined. Similarly, publication bias and heterogeneity for most analyses could not be ascertained. We found no concrete evidence of association between the modifiable determinants and self-report PAB/SB in any settings. This is presumably due to intervention ineffectiveness. Design of future interventions should consider to follow the systems-based approach and identify determinants unique to the context of a setting, including policy and environmental determinants.

It is still unknown which correlates of physical activity behaviour (PAB) may be effective and how they may influence PAB in UK children. The objective of the current study was to generate a conceptual analysis of the correlates of PAB in UK children (5-12 years) using the input of researchers in the field of physical activity (PA experts; PAE) and other fields (non-PA experts; non-PAE). A concept mapping approach was used to identify potential (new) correlates of PAB in children, assess their importance based on rating of potential modifiability and effect, and generate a concept map depicting the associations between them. In the first (brainstorming) stage (n = 32 experts) yielded 93 correlates, including 14 new correlates not identified in previous reviews. In the second (rating and sorting) stage (n = 26 experts), 32 correlates were rated as important and a four-cluster concept map was generated including themes related to Society/community, Home/social setting, Personal/social setting and Psychological/emotional correlates. Two additional concept maps were generated for PAE and non-PAE. From expert opinion, we identified new correlates of PAB that warrant further research and we highlight the need to consider the interaction between intrapersonal and external correlates when designing interventions to promote PA in UK children.

Introduction Physical activity among children and adolescents remains insufficient, despite the substantial efforts made by researchers and policymakers. Identifying and furthering our understanding of potential modifiable determinants of physical activity behaviour (PAB) and sedentary behaviour (SB) is crucial for the development of interventions that promote a shift from SB to PAB. The current protocol details the process through which a series of systematic literature reviews and meta-analyses (MAs) will be conducted to produce a best-evidence statement (BESt) and inform policymakers. The overall aim is to identify modifiable determinants that are associated with changes in PAB and SB in children and adolescents (aged 5–19 years) and to quantify their effect on, or association with, PAB/SB. Methods and analysis A search will be performed in MEDLINE, SportDiscus, Web of Science, PsychINFO and Cochrane Central Register of Controlled Trials. Randomised controlled trials (RCTs) and controlled trials (CTs) that investigate the effect of interventions on PAB/SB and longitudinal studies that investigate the associations between modifiable determinants and PAB/SB at multiple time points will be sought. Risk of bias assessments will be performed using adapted versions of Cochrane’s RoB V.2.0 and ROBINS-I tools for RCTs and CTs, respectively, and an adapted version of the National Institute of Health’s tool for longitudinal studies. Data will be synthesised narratively and, where possible, MAs will be performed using frequentist and Bayesian statistics. Modifiable determinants will be discussed considering the settings in which they were investigated and the PAB/SB measurement methods used. Ethics and dissemination No ethical approval is needed as no primary data will be collected. The findings will be disseminated in peer-reviewed publications and academic conferences where possible. The BESt will also be shared with policy makers within the DE-PASS consortium in the first instance. Systematic review registration CRD42021282874.

Many physical activity (PA) interventions implemented to tackle the child obesity epidemic have shown limited effectiveness, possibly due to a lack of consideration of potential stress that accompanies behavior adaptation and the automatic perseverative cognition that exacerbates the stress (namely rumination). Purpose: The main aim of this paper is to develop and validate the PA-specific Rumination Scale for Children (PARSC) that assesses children’s tendencies to engage in repeated negative thoughts about PA (Study 2). Items in the scale were derived from qualitative information about factors that inherently demotivates PA participation (intrinsic barriers) through the lived experience of UK children (Study 1). Methods: For Study 1, pedometry PA data were collected from 143 children (aged 6–10 years). Twenty-one focus groups were formed based on participants’ year group, sex and PA level. For PARSC validation (Study 2), 382 children completed the questionnaire twice. Self-report PA, device-based PA, and avoidant coping were also assessed. Results: Study 1—Four overarching themes identified as intrinsic barriers were lack of competence, fear of negative experiences, external constraints and lacking a sense of purpose. Altogether, 10 higher order and lower order themes were used to construct PARSC items. Study 2—From Rasch analysis, PARSC possessed sound internal validity, internal consistency, and test–retest reliability. Self-report PA and avoidant coping were predictive of PA-specific rumination, but not device-based PA. Conclusion: PARSC is a useful tool to identify children ruminative about PA for whom interventions can be designed, with the intrinsic barriers considered, to promote PA behavior adaptation.

Background: Anxiety is an adaptive response to an objective or perceived threat; however, when symptoms become severe and chronic it that can become a maladaptive anxiety disorder. Limited evidence suggests that physical activity may be associated with prevention against anxiety. This study uses data from The Irish Longitudinal Study on Ageing (TILDA) and The Mitchelstown Cohort Study to investigate cross-sectional associations between physical activity and anxiety symptoms and status among Irish adults. Methods: Both datasets were harmonized (n = 7874). The short form International Physical Activity Questionnaire measured physical activity. Participants were classified as meeting World Health Organization physical activity guidelines (≥150 min weekly of moderate intensity physical activity, ≥75 min weekly of vigorous intensity physical activity, or ≥ 600 MET-minutes) or not. They were also divided into three groups based on weekly MET-minutes of moderate-to-vigorous physical activity (Low: 0–599; Moderate: 600–1199; High: ≥1200), and three groups based on weekly minutes of walking (Low: 0–209; Moderate: 210–419; High: 420+). Anxiety symptoms were measured by the Hospital Anxiety and Depression Scale with a score of ≥8 indicating anxiety. Binomial logistic regression, adjusted for relevant confounders examined physical activity–anxiety associations. Results: Females had higher rates of anxiety than males (28.0% vs 20.0%; p < 0.001). Following adjustment for relevant covariates, meeting physical activity guidelines was associated with 13.5% (95% CI: 2.0–23.7; p = 0.023) lower odds of anxiety. Moderate and High physical activity were associated with 13.5% (− 11.0–32.6; p = 0.254) and 13.6% (1.4–4.2; p = 0.030) lower odds of anxiety compared to Low physical activity, respectively. Moderate and High walking were associated with 2.1% (− 14.5–16.3; p = 0.789) and 5.1% (− 9.3–17.6; p = 0.467) lower odds of anxiety compared to Low walking, respectively. Conclusion: Meeting physical activity guidelines is associated with lower odds of anxiety, but the strength of associations did not increase considerably with increased physical activity levels.

Background: An increasing number of physical activity (PA) interventions have been implemented to tackle child obesity epidemic, yet many have shown only moderate effectiveness. This is possibly due to a lack of in-depth understanding of the intrinsic motivators/demotivators to PA for children. Therefore, a main aim of this paper is to explore the intrinsic facilitators and barriers to PA participation through the lived experience of UK children (Study 1). The latter findings will facilitate the development of a psychometric instrument that assesses children’s tendencies to engage in repeated negative thoughts about PA (termed rumination ) which may hinder participation. Hence, our second aim is to develop and validate the PA-specific Rumination Scale for Children (PARSC) (Study 2). Methods: For Study 1, pedometry PA data were collected from 143 children (aged 6-10 years) over 3 weeks (Sample 1). Twenty-one focus groups were formed based on participants’ year group, sex and PA level. Focus group discussions were thematically analysed. For Study 2, the themes identified for the intrinsic barriers were used to develop PARSC. This was completed twice by 382 children (Sample 2), together with the PA subscale of the Physical Self-Description Questionnaire (short version). Sample 1 also completed the avoidant coping subscales of the Children Coping Strategies Checklist. Results: For Study 1, four overarching themes were identified for the intrinsic facilitators – sense of competence/accomplishments, cognitive motivator, sensations and socialisation/social facilitation. Four main themes for the intrinsic barriers were lack of competence, fear of negative experiences, external constraints and lacking a sense of purpose. For Study 2, results from Rasch analysis demonstrated that PARSC possessed sound internal validity and consistency, and test-retest reliability. Self-perceived PA and avoidant coping were predictive of PA-specific rumination tendencies (15% of variance explained), but objectively measured PA was not. Conclusions: The themes identified from the current study can potentially inform future PA interventions and PE curriculum for UK children. Also, PARSC can be a useful tool to assess children’s PA-specific rumination tendencies and to advance our understanding of the role of rumination in PA behaviour, but its applicability to other cultures warrants further investigations.