International Journal of Environmental Research and Public Health

Research

12 pages, 1264 KiB

Open AccessArticle

Does Better Health-Related Knowledge Predict Favorable Health Behavior in Adolescents?

by Gabriella Nagy-Pénzes, Ferenc Vincze, János Sándor and Éva Bíró

Int. J. Environ. Res. Public Health 2020, 17(5), 1680; https://doi.org/10.3390/ijerph17051680 - 4 Mar 2020

Cited by 30 | Viewed by 4442

The importance of puberty on later health status and behavior is indisputable, which also means that it is worth making intervention efforts during this period of life. However, whether better health-related knowledge is correlated with favorable health behavior in adolescents is an important, [...] Read more.

The importance of puberty on later health status and behavior is indisputable, which also means that it is worth making intervention efforts during this period of life. However, whether better health-related knowledge is correlated with favorable health behavior in adolescents is an important, still unanswered question. Our objective was to examine this relationship. The participants were ninth-grade secondary school students. Data were collected using anonymous, self-administered questionnaires. The knowledge-related questions were compiled by the authors, while the questions concerning eating habits, physical activity, demographic and socioeconomic data were taken from the Health Behavior in School-Aged Children survey. The relationship between knowledge and behavior was investigated with structural equation modeling adjusted for gender, age, and socioeconomic status. The results demonstrated a good fit to the data, but better knowledge was not related to behavior in our sample. This finding suggests that adolescents’ health behavior is highly influenced by the living context; therefore, appropriate knowledge is necessary but not sufficient to improve adolescents’ behavior. Hence, comprehensive health promotion programs could provide solutions for encouraging healthy behavior. Full article

(This article belongs to the Special Issue Health Promotion: Physical Activity and Nutrition Behaviors in Children and Youth)

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10 pages, 347 KiB

Open AccessArticle

Objectively Assessed Physical Activity of Preschool-Aged Children from Urban Areas

by Jarosław Herbert, Piotr Matłosz, Justyna Lenik, Agnieszka Szybisty, Joanna Baran, Karolina Przednowek and Justyna Wyszyńska

Int. J. Environ. Res. Public Health 2020, 17(4), 1375; https://doi.org/10.3390/ijerph17041375 - 20 Feb 2020

Cited by 8 | Viewed by 3268

Abstract

Little is known about physical activity (PA) of preschool-age children in Poland through the course of the day. PA monitoring using an accelerometer increases the reliability of measuring daily PA levels and offers a reasonable compromise between accuracy and feasibility of measurement. The [...] Read more.

Little is known about physical activity (PA) of preschool-age children in Poland through the course of the day. PA monitoring using an accelerometer increases the reliability of measuring daily PA levels and offers a reasonable compromise between accuracy and feasibility of measurement. The aim of the study was to determine the level of physical activity of preschool children (aged 5–6) on the basis of moderate to vigorous physical activity (MVPA) index and the number of steps. The physical activity of preschool children was assessed using accelerometery (ActiGraph) in 371 children for up to seven days. The normality of distribution was assessed using the Shapiro–Wilk test. The Mann-Whitney U-test and Kruskal-Wallis test were used to assess the significance of differences. The study group children had an average age of 5.4 years (± 0.6). Boys and girls showed a different level of MVPA index. The results significantly improve the current knowledge of PA in Europe. Promoting active lifestyles in children should be one of the health priorities in developed countries. Full article

(This article belongs to the Special Issue Health Promotion: Physical Activity and Nutrition Behaviors in Children and Youth)

10 pages, 307 KiB

Open AccessArticle

Grit as Perseverance in Physical Activity Participation

by Stina Rutberg, Lars Nyberg, Darla Castelli and Anna-Karin Lindqvist

Int. J. Environ. Res. Public Health 2020, 17(3), 807; https://doi.org/10.3390/ijerph17030807 - 28 Jan 2020

Cited by 13 | Viewed by 4606

Abstract

Childhood is a critical period for the acquisition of healthy behaviors, and the promotion of sustainable healthy behavior among children is greatly important. Therefore, an increased understanding of the relationship between grit and physical activity in a school context is needed. The purpose [...] Read more.

Childhood is a critical period for the acquisition of healthy behaviors, and the promotion of sustainable healthy behavior among children is greatly important. Therefore, an increased understanding of the relationship between grit and physical activity in a school context is needed. The purpose of this study is to describe and develop an understanding of students’ and teachers’ awareness and experiences concerning grit as a health-promoting factor. Fifty-five students and three teachers participated in the study. Data were collected through the Short Grit Scale and focus group interviews. There were weak to non-significant correlations between the three teachers’ ratings of their students’ grit and the children’s own ratings. The qualitative results show that children and teachers understood the construct of grit but had slightly different perceptions of it and that grit is not considered to be set in stone. The participants made an association between grit, motivation, meaningfulness, and setting goals. The findings indicate that grit might be an ideal target for making physical activity interventions sustainable. Full article

(This article belongs to the Special Issue Health Promotion: Physical Activity and Nutrition Behaviors in Children and Youth)

32 pages, 1157 KiB

Open AccessArticle

Development of Dietary Knowledge and Adherence Questionnaires for Lebanese Adolescents and Their Parents

by Liliane Said, Jessica S. Gubbels and Stef P. J. Kremers

Int. J. Environ. Res. Public Health 2020, 17(1), 147; https://doi.org/10.3390/ijerph17010147 - 24 Dec 2019

Cited by 9 | Viewed by 4355

Abstract

The availability of practical tools to assess dietary knowledge and adherence is essential to evaluate the effectiveness of dietary interventions. The aims of this paper were to develop reliable dietary knowledge and adherence questionnaires, suitable for Lebanese adolescents and their parents, and to [...] Read more.

The availability of practical tools to assess dietary knowledge and adherence is essential to evaluate the effectiveness of dietary interventions. The aims of this paper were to develop reliable dietary knowledge and adherence questionnaires, suitable for Lebanese adolescents and their parents, and to estimate the feasibility of conducting studies involving such participants in the school-based setting. Eight Lebanese high schools participated in this study (involving 220 adolescents aged 15–18 years). Self-administered dietary knowledge and adherence questionnaires (the Dietary Knowledge Questionnaire (DKQ) and the Dietary Adherence Questionnaire (DAQ), respectively) were completed by the high school students and their parents. A 24 h recall was additionally administered for the adolescents by a dietitian and a trained interviewer at school, in order to validate the adolescents’ answers in the DAQ. The cognitive interview method was used to qualitatively evaluate the questionnaires. The resulting Cronbach’s alpha ranged from 0.61 to 0.78 for the adolescent questionnaires and from 0.46 to 0.89 for the parental ones. In addition, 23 items (out of 25) of the adolescent DAQ matched with the administered 24 h recall. A significant negative correlation was found between the knowledge score (DKQ) and the unhealthy items of the adolescent DAQ. There was a significant positive correlation between the DKQ of the parents and the knowledge score of their children. This is the first study of dietary questionnaires involving Lebanese high school students from different regions, while also including their parents. Full article

(This article belongs to the Special Issue Health Promotion: Physical Activity and Nutrition Behaviors in Children and Youth)

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15 pages, 1642 KiB

Open AccessArticle

Physical Activity-Related Health Competence, Physical Activity, and Physical Fitness: Analysis of Control Competence for the Self-Directed Exercise of Adolescents

by Stephanie Haible, Carmen Volk, Yolanda Demetriou, Oliver Höner, Ansgar Thiel and Gorden Sudeck

Int. J. Environ. Res. Public Health 2020, 17(1), 39; https://doi.org/10.3390/ijerph17010039 - 19 Dec 2019

Cited by 42 | Viewed by 8357

Abstract

(1) Background: Individuals have to effectively manage their physical activity in order to optimize the associated physical and psychological health benefits. Control competence allows the individual to structure and pace physical activity in a health-enhancing way. The concept was developed within a model [...] Read more.

(1) Background: Individuals have to effectively manage their physical activity in order to optimize the associated physical and psychological health benefits. Control competence allows the individual to structure and pace physical activity in a health-enhancing way. The concept was developed within a model of physical activity-related health competence, and is related to the concepts of health literacy and physical literacy. Therefore, the study firstly aimed to validate a self-report scale to measure the physical and psychological facets of control competence in adolescents. Secondly, relationships between control competence and its basic elements, knowledge and motivation, as well as between control competence, sport activity, and fitness, were investigated. (2) Methods: In two cross-sectional studies, ninth grade adolescents (study A: n = 794, 51% female; study B: n = 860, 52% female) were tested using self-report scales (study A and B), a test for health-related fitness knowledge (study B), and cardiovascular and muscular fitness tests (study B). (3) Results: Confirmatory factor analyses confirmed the two-factor structure of the self-report scale for control competence in studies A and B. In addition, the results of structural equation modeling in study B showed a relationship between motivation (via control competence) and sport activity, and a relationship between control competence and fitness. (4) Conclusion: The questionnaire extends the ability to assess control competence in adolescents. Moreover the findings support the importance of control competence in order to achieve health benefits through physical activity. Full article

(This article belongs to the Special Issue Health Promotion: Physical Activity and Nutrition Behaviors in Children and Youth)

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14 pages, 305 KiB

Open AccessArticle

Implementation of Guidelines for Healthier Canteens in Dutch Secondary Schools: A Process Evaluation

by Irma J. Evenhuis, Ellis L. Vyth, Lydian Veldhuis, Suzanne M. Jacobs, Jacob C. Seidell and Carry M. Renders

Int. J. Environ. Res. Public Health 2019, 16(22), 4509; https://doi.org/10.3390/ijerph16224509 - 15 Nov 2019

Cited by 6 | Viewed by 4051

Abstract

The Netherlands Nutrition Centre has developed ‘Guidelines for Healthier Canteens’. To facilitate their implementation, implementation tools were developed: stakeholders’ questionnaires, the ‘Canteen Scan’ (an online tool to assess product availability/accessibility), a tailored advisory meeting/report, communication materials, establishment of an online community, newsletters, and [...] Read more.

The Netherlands Nutrition Centre has developed ‘Guidelines for Healthier Canteens’. To facilitate their implementation, implementation tools were developed: stakeholders’ questionnaires, the ‘Canteen Scan’ (an online tool to assess product availability/accessibility), a tailored advisory meeting/report, communication materials, establishment of an online community, newsletters, and a fact sheet with students’ wishes/needs. In this quasi-experimental study, we investigated the effect of these tools in secondary schools on (a) factors perceived by stakeholders as affecting implementation; (b) the quality of implementation. For six months, ten intervention schools implemented the guidelines, supported by the developed implementation tools. Ten control schools received the guidelines without support. School managers, caterers, and canteen employees (n = 33) reported on individual and environmental factors affecting implementation. Implementation quality was determined by dose delivered, dose received, and satisfaction. Stakeholders (n = 24) in intervention schools scored higher on the determinants’ knowledge and motivation and lower on need for support (p < 0.05). Dose received (received and read) and satisfaction was highest for the advisory meeting/report (67.9%, 64.3%, 4.17), communication materials (60.7%, 50.0%, 3.98), and fact sheet (80%, 60%, 4.31). Qualitative analyses confirmed these quantitative results. In conclusion, a combination of implementation tools that includes students’ wishes, tailored information/feedback, reminders and examples of healthier products/accessibility supports stakeholders in creating a healthier school canteen. Full article

(This article belongs to the Special Issue Health Promotion: Physical Activity and Nutrition Behaviors in Children and Youth)

19 pages, 2382 KiB

Open AccessArticle

Development of a Teen-Informed Coding Tool to Measure the Power of Food Advertisements

by Drew D. Bowman, Leia M. Minaker, Bonnie J. K. Simpson and Jason A. Gilliland

Int. J. Environ. Res. Public Health 2019, 16(21), 4258; https://doi.org/10.3390/ijerph16214258 - 2 Nov 2019

Cited by 14 | Viewed by 4884

Abstract

The food-related information environment, comprised of food and beverage advertising within one’s surroundings, is a growing concern for adolescent health given that food marketing disproportionately targets adolescents. Despite strong public interest concerning the effects of food marketing on child health, there is limited [...] Read more.

The food-related information environment, comprised of food and beverage advertising within one’s surroundings, is a growing concern for adolescent health given that food marketing disproportionately targets adolescents. Despite strong public interest concerning the effects of food marketing on child health, there is limited evidence focused on outdoor food advertising in relation to teenage diets, food purchasing, and perceptions. Further, limited research has considered both the exposure to and influence of such advertisements. This study used a novel multi-method approach to identify and quantify the features of outdoor food and beverage advertisements that are most effective at drawing teenagers into retail food establishments. An environmental audit of outdoor advertisements and consultations with youth were used to: (1) identify teen-directed food marketing techniques; (2) validate and weigh the power of individual advertising elements; and, (3) develop a teen-informed coding tool to measure the power of food-related advertisements. Results indicate that marketing power is a function of the presence and size of teen-directed advertisement features, and the relative nature of each feature is an important consideration. This study offers a quantitative measurement tool for food environment research and urges policymakers to consider teen-directed marketing when creating healthy communities. Full article

(This article belongs to the Special Issue Health Promotion: Physical Activity and Nutrition Behaviors in Children and Youth)

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17 pages, 788 KiB

Open AccessArticle

Calibration and Validation of the Youth Activity Profile as a Physical Activity and Sedentary Behaviour Surveillance Tool for English Youth

by Stuart J. Fairclough, Danielle L. Christian, Pedro F. Saint-Maurice, Paul R. Hibbing, Robert J. Noonan, Greg J. Welk, Philip M. Dixon and Lynne M. Boddy

Int. J. Environ. Res. Public Health 2019, 16(19), 3711; https://doi.org/10.3390/ijerph16193711 - 2 Oct 2019

Cited by 15 | Viewed by 4896

Abstract

Self-reported youth physical activity (PA) is typically overestimated. We aimed to calibrate and validate a self-report tool among English youth. Four-hundred-and-two participants (aged 9–16 years; 212 boys) wore SenseWear Armband Mini devices (SWA) for eight days and completed the self-report Youth Activity Profile [...] Read more.

Self-reported youth physical activity (PA) is typically overestimated. We aimed to calibrate and validate a self-report tool among English youth. Four-hundred-and-two participants (aged 9–16 years; 212 boys) wore SenseWear Armband Mini devices (SWA) for eight days and completed the self-report Youth Activity Profile (YAP) on the eighth day. Calibration algorithms for temporally matched segments were generated from the YAP data using quantile regression. The algorithms were applied in an independent cross-validation sample, and student- and school-level agreement were assessed. The utility of the YAP algorithms to assess compliance to PA guidelines was also examined. The school-level bias for the YAP estimates of in-school, out-of-school, and weekend moderate-to-vigorous PA (MVPA) were 17.2 (34.4), 31.6 (14.0), and −4.9 (3.6) min·week⁻¹, respectively. Out-of-school sedentary behaviour (SB) was over-predicted by 109.2 (11.8) min·week⁻¹. Predicted YAP values were within 15%–20% equivalence of the SWA estimates. The classification accuracy of the YAP MVPA estimates for compliance to 60 min·day⁻¹ and 30 min·school-day⁻¹ MVPA recommendations were 91%/37% and 89%/57% sensitivity/specificity, respectively. The YAP generated robust school-level estimates of MVPA and SB and has potential for surveillance to monitor compliance with PA guidelines. The accuracy of the YAP may be further improved through research with more representative UK samples to enhance the calibration process and to refine the resultant algorithms. Full article

(This article belongs to the Special Issue Health Promotion: Physical Activity and Nutrition Behaviors in Children and Youth)

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17 pages, 604 KiB

Open AccessArticle

Levels of Physical Activity in Children and Adolescents with Type 1 Diabetes in Relation to the Healthy Comparators and to the Method of Insulin Therapy Used

by Ewelina Czenczek-Lewandowska, Justyna Leszczak, Joanna Baran, Aneta Weres, Justyna Wyszyńska, Bogumił Lewandowski, Mariusz Dąbrowski and Artur Mazur

Int. J. Environ. Res. Public Health 2019, 16(18), 3498; https://doi.org/10.3390/ijerph16183498 - 19 Sep 2019

Cited by 33 | Viewed by 4295

Abstract

Given the fact that physical exertion leads to blood glucose fluctuations, type one diabetes mellitus (T1D) may potentially constitute a barrier for obtaining a sufficient amount of exercise. The main purpose of the study was to compare the level of physical activity between [...] Read more.

Given the fact that physical exertion leads to blood glucose fluctuations, type one diabetes mellitus (T1D) may potentially constitute a barrier for obtaining a sufficient amount of exercise. The main purpose of the study was to compare the level of physical activity between children with T1D (n = 215) and healthy controls (n = 115) and to assess the physical activity of the study group in relation to the applied method of insulin therapy, i.e., the use of insulin pen vs. insulin pump. The level of physical activity was assessed with a hip-worn tri-axial accelerometer (ActiGraph GT3X+) used by the subjects for an uninterrupted period of seven days. Children with T1D had significantly lower median values of total time of moderate (213.3 vs. 272.1 min), vigorous (135.3 vs. 19.6 min) and moderate-to-vigorous (347.4 vs. 467.4 min) physical activity compared to healthy peers respectively, (p < 0.001) in all cases. In addition, the total median number of steps was significantly lower (53,631 vs. 67,542 steps), (p < 0.001). The method of insulin therapy was not associated with significant differences in physical activity level (p > 0.001). The level of physical activity in children and adolescents with T1D is lower than in their healthy peers and does not depend on the insulin therapy method. Full article

(This article belongs to the Special Issue Health Promotion: Physical Activity and Nutrition Behaviors in Children and Youth)

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14 pages, 1160 KiB

Open AccessArticle

Physical Activity, Body Mass, and Adherence to the Mediterranean Diet in Preschool Children: A Cross-Sectional Analysis in the Split-Dalmatia County (Croatia)

by Lejla Obradovic Salcin, Zeljka Karin, Vesna Miljanovic Damjanovic, Marko Ostojic, Andrea Vrdoljak, Barbara Gilic, Damir Sekulic, Maja Lang-Morovic, Josko Markic and Dorica Sajber

Int. J. Environ. Res. Public Health 2019, 16(18), 3237; https://doi.org/10.3390/ijerph16183237 - 4 Sep 2019

Cited by 16 | Viewed by 4321

Abstract

Physical activity, body mass, and dietary habits are known to be important determinants of overall health status, but there is an evident lack of studies that examine these issues specifically in preschool children. The aim of this study was to identify associations that [...] Read more.

Physical activity, body mass, and dietary habits are known to be important determinants of overall health status, but there is an evident lack of studies that examine these issues specifically in preschool children. The aim of this study was to identify associations that may exist between adhering to the Mediterranean diet (MD), levels of physical activity (PA), and body composition indices in apparently healthy preschool children from southern Croatia. Participants were 5- to 6-year-old preschoolers from the Mediterranean part of the country (the Split-Dalmatia County; n = 260, 126 females). Adherence to the MD was observed by the Mediterranean Diet Quality Index (KIDMED), PA level was evaluated by the Preschool-age Children’s Physical Activity Questionnaire (Pre-PAQ), and responses were collected from the parents. The participants’ waist circumferences (in cm), waist-to-hip ratios, and body mass index (in kg/m², and in a z-score calculated relative to the normative value for age and sex) were used as indicators of body composition. All children were of the same age and tested over a one-month period of the same year as a part of the regular examination undertaken before attending elementary school. With only 6% of the children having a low KIDMED score, adherence to the MD was high. MD adherence was higher in girls (Chi-square = 15.31, p < 0.01) and children who live on the coast of the Adriatic Sea (Chi-square = 18.51, p < 0.01). A mixed effects logistic regression (with kindergarten as random factor) identified sedentary activity to be negatively associated with MD adherence (OR per point: 0.65, 95% CI: 0.44–0.91). High adherence to the MD in the studied sample may be attributed to regulated feeding in kindergarten. Considering that most Croatian elementary schools do not provide food to their students, MD adherence should be investigated later in life and also in other parts of the country where the MD is culturally less prevalent. Full article

(This article belongs to the Special Issue Health Promotion: Physical Activity and Nutrition Behaviors in Children and Youth)

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11 pages, 472 KiB

Open AccessArticle

Comparison of a Wearable Tracker with Actigraph for Classifying Physical Activity Intensity and Heart Rate in Children

by Seoungki Kang, Youngdeok Kim, Wonwoo Byun, JinSu Suk and Jung-Min Lee

Int. J. Environ. Res. Public Health 2019, 16(15), 2663; https://doi.org/10.3390/ijerph16152663 - 25 Jul 2019

Cited by 22 | Viewed by 4360

Abstract

Introduction: To examine the validity and reliability of the Fitbit Charge HR (FCH), wrist-worn ActiGraph (AG) accelerometers were used for assessing the classification of physical activity (PA) into intensity categories in children. Methods: Forty-three children (n = 43) participated in the study. Each [...] Read more.

Introduction: To examine the validity and reliability of the Fitbit Charge HR (FCH), wrist-worn ActiGraph (AG) accelerometers were used for assessing the classification of physical activity (PA) into intensity categories in children. Methods: Forty-three children (n = 43) participated in the study. Each participant completed 3 min bouts of 12 PAs ranging from sedentary to vigorous intensity while simultaneously wearing FCH and AG on both hands, a Polar HR monitor, and a portable indirect calorimeter. Total time spent in different PA intensity levels measured by FCH and AG were compared to the indirect calorimetry. Results: The highest classification accuracy values of sedentary behavior was 81.1% for FCH. The highest classification (72.4%) of light intensity PA was observed with Crouter’s algorithm from the non-dominant wrist. Crouter’s algorithm also show the highest classification (81.8%) for assessing moderate to vigorous intensity PA compared to FCH (70.8%). Across the devices, a high degree of reliability was found in step measurements, ranging from an intra-class correlation (ICC) = 0.92 to an ICC = 0.94. The reliability of the AG and the FCH showed high agreement for each variable. Conclusion: The FCH shows better validity for estimating sedentary behavior and similar validity for assessing moderate to vigorous PA compared to the research-grade monitor. Across the devices, the reliability showed the strongest association. Full article

(This article belongs to the Special Issue Health Promotion: Physical Activity and Nutrition Behaviors in Children and Youth)

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12 pages, 1136 KiB

Open AccessArticle

Hip and Wrist-Worn Accelerometer Data Analysis for Toddler Activities

by Soyang Kwon, Patricia Zavos, Katherine Nickele, Albert Sugianto and Mark V. Albert

Int. J. Environ. Res. Public Health 2019, 16(14), 2598; https://doi.org/10.3390/ijerph16142598 - 21 Jul 2019

Cited by 14 | Viewed by 4084

Abstract

Although accelerometry data are widely utilized to estimate physical activity and sedentary behavior among children age 3 years or older, for toddlers age 1 and 2 year(s), accelerometry data recorded during such behaviors have been far less examined. In particular, toddler’s unique behaviors, [...] Read more.

Although accelerometry data are widely utilized to estimate physical activity and sedentary behavior among children age 3 years or older, for toddlers age 1 and 2 year(s), accelerometry data recorded during such behaviors have been far less examined. In particular, toddler’s unique behaviors, such as riding in a stroller or being carried by an adult, have not yet been examined. The objective of this study was to describe accelerometry signal outputs recorded during participation in nine types of behaviors (i.e., running, walking, climbing up/down, crawling, riding a ride-on toy, standing, sitting, riding in a stroller/wagon, and being carried by an adult) among toddlers. Twenty-four toddlers aged 13 to 35 months (50% girls) performed various prescribed behaviors during free play in a commercial indoor playroom while wearing ActiGraph wGT3X-BT accelerometers on a hip and a wrist. Participants’ performances were video-recorded. Based on the video data, accelerometer data were annotated with behavior labels to examine accelerometry signal outputs while performing the nine types of behaviors. Accelerometer data collected during 664 behavior assessments from the 21 participants were used for analysis. Hip vertical axis counts for walking were low (median = 49 counts/5 s). They were significantly lower than those recorded while a toddler was “carried” by an adult (median = 144 counts/5 s; p < 0.01). While standing, sitting, and riding in a stroller, very low hip vertical axis counts were registered (median ≤ 5 counts/5 s). Although wrist vertical axis and vector magnitude counts for “carried” were not higher than those for walking, they were higher than the cut-points for sedentary behaviors. Using various accelerometry signal features, machine learning techniques showed 89% accuracy to differentiate the “carried” behavior from ambulatory movements such as running, walking, crawling, and climbing. In conclusion, hip vertical axis counts alone may be unable to capture walking as physical activity and “carried” as sedentary behavior among toddlers. Machine learning techniques that utilize additional accelerometry signal features could help to recognize behavior types, especially to differentiate being “carried” from ambulatory movements. Full article

(This article belongs to the Special Issue Health Promotion: Physical Activity and Nutrition Behaviors in Children and Youth)

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37 pages, 2977 KiB

Open AccessArticle

Impact of Active Video Games on Body Mass Index in Children and Adolescents: Systematic Review and Meta-Analysis Evaluating the Quality of Primary Studies

by Carlos Hernández-Jiménez, Raquel Sarabia, María Paz-Zulueta, Paula Paras-Bravo, Amada Pellico, Laura Ruiz Azcona, Cristina Blanco, María Madrazo, María Jesus Agudo, Carmen Sarabia and Miguel Santibáñez

Int. J. Environ. Res. Public Health 2019, 16(13), 2424; https://doi.org/10.3390/ijerph16132424 - 8 Jul 2019

Cited by 19 | Viewed by 8145

Abstract

Objective: To study the impact of active video games on Body Mass Index (BMI) in children and adolescents. Design and Methods: A systematic review and meta-analysis. Data were pooled in meta-analysis using the method of random effects or fixed effects, as appropriate, after [...] Read more.

Objective: To study the impact of active video games on Body Mass Index (BMI) in children and adolescents. Design and Methods: A systematic review and meta-analysis. Data were pooled in meta-analysis using the method of random effects or fixed effects, as appropriate, after examination of statistical heterogeneity. Data sources and eligibility criteria for selecting studies. A comprehensive literature research was conducted in Medline (PubMed), ISI web of Knowledge, and SCOPUS up to April 2018, in relation to clinical trials (both controlled and non-controlled) in children and adolescents, whose intervention was based on active video games. Results: The overall intragroup effect of the intervention based on active video games was in favor of the intervention, reaching statistical significance using the fixed effects model: (standardized mean difference (SMD) = −0.138; 95% CI (−0.237 to −0.038), p = 0.007 and was of borderline statistical significance in the random effects model: SMD= −0.191; 95% CI (−0.386 to 0.003), p = 0.053. The individual results of the determinations of the 15 included studies for this analysis showed a high heterogeneity among them (I² = 82.91%). When the intervention was applied to children and adolescents with greater than or equal to 85 (overweight or obese) BMI percentile showed a greater effect in favor of the active video games: SMD= −0.483, p = 0.012. The overall intra-group effect in the control group was close to zero (SMD = 0.087). With respect to the non-standardized mean difference (MD) between groups, it was also in favor of active video games for both BMI (Kg/m²): DM = −0.317, 95% CI (−0.442 to −0.193), p = < 0.001 and BMI z-score: DM = −0.077, 95% CI (−0.139 to −0.016), p = 0.013. Conclusions: Our meta-analysis show a statistically significant effect in favor of using active video games on BMI in children and adolescents. The clinical relevance of this positive effect must be evaluated. Full article

(This article belongs to the Special Issue Health Promotion: Physical Activity and Nutrition Behaviors in Children and Youth)

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24 pages, 379 KiB

Open AccessFeature PaperArticle

Participants’ Perceptions of “C.H.A.M.P. Families”: A Parent-Focused Intervention Targeting Paediatric Overweight and Obesity

by Kristen C. Reilly, Daniel Briatico, Jennifer D. Irwin, Patricia Tucker, Erin S. Pearson and Shauna M. Burke

Int. J. Environ. Res. Public Health 2019, 16(12), 2171; https://doi.org/10.3390/ijerph16122171 - 19 Jun 2019

Cited by 5 | Viewed by 4558

Abstract

Background: Recently, our team implemented a 13-week group-based intervention for parents of children with obesity (“C.H.A.M.P. Families”). The primary objective of this study was to explore, qualitatively, parents’ perspectives of their experiences in and influence of C.H.A.M.P. Families, as well as their [...] Read more.

Background: Recently, our team implemented a 13-week group-based intervention for parents of children with obesity (“C.H.A.M.P. Families”). The primary objective of this study was to explore, qualitatively, parents’ perspectives of their experiences in and influence of C.H.A.M.P. Families, as well as their recommendations for future paediatric obesity treatment interventions. Methods: Twelve parents (seven mothers, five fathers/step-fathers) representing seven children (four girls, three boys) with obesity participated in one of two focus groups following the intervention. Focus groups were audio recorded and transcribed verbatim and data were analyzed using inductive thematic analysis. Results: Findings showed that parents perceived their participation in C.H.A.M.P. Families to be a positive experience. Participants highlighted several positive health-related outcomes for children, families, and parents. Parents also underscored the importance and positive impact of the group environment, specific educational content, and additional program components such as free child-minding. Recommendations for future interventions were also provided, including greater child involvement and more practical strategies. Finally, parents identified several barriers including socioenvironmental issues, time constraints, and parenting challenges. Conclusions: Researchers developing family-based childhood obesity interventions should consider the balance of parent and child involvement, as well as emphasize group dynamics strategies and positive family communication. Full article

(This article belongs to the Special Issue Health Promotion: Physical Activity and Nutrition Behaviors in Children and Youth)

12 pages, 966 KiB

Open AccessArticle

Comparison of Self-Administered Web-Based and Interviewer Printed Food Frequency Questionnaires for Dietary Assessment in Italian Adolescents

by Martina Barchitta, Andrea Maugeri, Ottavia Agrifoglio, Giuliana Favara, Claudia La Mastra, Maria Clara La Rosa, Roberta Magnano San Lio and Antonella Agodi

Int. J. Environ. Res. Public Health 2019, 16(11), 1949; https://doi.org/10.3390/ijerph16111949 - 1 Jun 2019

Cited by 9 | Viewed by 3179

Abstract

Innovative tools for assessing food and nutrient intakes in adolescence are essential to uncover the long-term effects of diet on chronic diseases. Here, we developed and compared a web-based self-administered food frequency questionnaire (web-FFQ) with a traditional interviewer printed FFQ (print-FFQ) among 174 [...] Read more.

Innovative tools for assessing food and nutrient intakes in adolescence are essential to uncover the long-term effects of diet on chronic diseases. Here, we developed and compared a web-based self-administered food frequency questionnaire (web-FFQ) with a traditional interviewer printed FFQ (print-FFQ) among 174 Italian adolescents (aged 15–18 years). To assess the reliability of the web-FFQ compared with the print-FFQ, we used Spearman’s rank correlation coefficients, Wilcoxon rank test, quartile misclassification analysis, Cohen’s weighted kappa and the Bland–Altman method. Correlation coefficients ranged from 0.14 (i.e., pizza) to 0.67 (i.e., raw vegetables) for foods, and from 0.45 (i.e., monounsaturated fatty acids, MUFA) to 0.62 (i.e., zinc) for nutrients. Results from the Wilcoxon rank test showed that food and nutrient intakes were comparable between two FFQs, except for nuts, shellfish, fruit juices and MUFA. Adolescents classified into the same or adjacent quartiles ranged from 68.2% (i.e., tea) to 89.1% (i.e., raw vegetables and dipping sauces) for foods, and from 77.2% (i.e., vitamin C) to 87.2% (i.e., folate and calcium) for nutrients. Except for pizza, the weighted kappa indicated moderate to substantial agreement for other foods and nutrients. Finally, we demonstrated that the web-FFQ significantly overestimated shellfish and fruit juice intakes, while it underestimated nuts, canned fish, olive oil, total energy intake, fatty acids and calcium. The limits of agreement analysis indicated moderate to wide individual differences for all groups. In conclusion, our self-administered web-FFQ represents an easy, suitable and cost-effective tool for assessing food and nutrient intakes in adolescents. However, the wide individual differences in level of agreement suggest that additional refinements and calibrations are necessary to investigate the effects of absolute nutrient intakes at the individual level. Full article

(This article belongs to the Special Issue Health Promotion: Physical Activity and Nutrition Behaviors in Children and Youth)

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