A systematic review of school-based interventions targeting physical activity and sedentary behaviour among older adolescents Movement as Medicine for Type 2 Diabetes: protocol for an open pilot study and external pilot clustered randomised controlled trial to assess acceptability, feasibility and fidelity of a multifaceted behavioural intervention targeting physical activity in primary care A cognitive-behavioural pedometer-based group intervention on physical activity and sedentary behaviour in individuals with type 2 diabetes What are the most effective behaviour change techniques to promote physical activity and/or reduce sedentary behaviour in inactive adults? A systematic review protocol Association between childcare educators’ practices and preschoolers’ physical activity and dietary intake: a cross-sectional analysis Preventing obesity in infants: the Growing healthy feasibility trial protocol The Infant Feeding Activity and Nutrition Trial (INFANT) an early intervention to prevent childhood obesity: Cluster-randomised controlled trial Outcomes and process evaluation of a programme integrating physical activity into the primary school mathematics curriculum: The EASY Minds pilot randomised controlled trial. Outcomes of a group-randomized trial to prevent excess weight gain, reduce screen behaviours and promote physical activity in 10-year-old children: Switch-Play Association of dietary habits with levels of physical activity and screen time among adolescents living in Saudi Arabia. The effect of a movement-to-music video program on the objectively measured sedentary time and physical activity of preschool-aged children and their mothers: A randomized controlled trial The Relationship of Objectively Measured Physical Activity and Sedentary Behaviour with Gestational Weight Gain and Birth Weight Increasing physical activity among young children from disadvantaged communities: study protocol of a group randomised controlled effectiveness trial ICAPS: a multilevel program to improve physical activity in adolescents. Examining the theory‐effectiveness hypothesis: A systematic review of systematic reviews A multi-level examination of school programs, policies and resources associated with physical activity among elementary school youth in the PLAY-ON study Activity Begins in Childhood (ABC) – inspiring healthy active behaviour in preschoolers: study protocol for a cluster randomized controlled trial Study protocol for Chronic Obstructive Pulmonary Disease-Sitting and ExacerbAtions Trial (COPD-SEAT): a randomised controlled feasibility trial of a home-based self-monitoring sedentary behaviour intervention Intervention Effects of a School-Based Health Promotion Programme on Obesity Related Behavioural Outcomes Association between bone stiffness and nutritional biomarkers combined with weight-bearing exercise, physical activity, and sedentary time in preadolescent children. A case-control study. Lifestyle Habits: Diet, physical activity and sleep duration among Omani adolescents. Intra-individual variability in day-to-day and month-to-month measurements of physical activity and sedentary behaviour at work and in leisure-time among Danish adults Energy balance-related behaviours associated with overweight and obesity in preschool children: a systematic review of prospective studies.
ABSTRACT Lack of  physical activity  (  PA  ) and high levels of sedentary behaviour ( SB ) have been associated with health problems . This systematic review evaluates the effectiveness of school-based interventions to increase PA  and decrease SB  among 15–19-year-old adolescents , and examines whether intervention characteristics ( intervention length , delivery mode and intervention provider ) and intervention content ( i.e. behaviour change techniques , BCTs ) are related to intervention effectiveness . A systematic search of r and omised or cluster r and omised controlled trials with outcome measures of PA and /or SB rendered 10 results . Risk of bias was assessed using the Cochrane risk of bias tool . Intervention content was coded using Behaviour Change Technique Taxonomy v1 . Seven out of 10 studies reported significant increases in PA . Effects were generally small and short-term ( Cohen 's d ranged from 0.132 to 0.659 ) . Two out of four studies that measured SB reported significant reductions in SB . Interventions that increased PA  included a higher number of BCTs , specific BCTs ( e.g. , goal setting , action planning and self-monitoring ) , and were delivered by research staff . Intervention length and mode of delivery were unrelated to effectiveness . More studies are needed that evaluate long-term intervention effectiveness and target SBs among older adolescents Background Physical activity ( PA ) and nutrition are the cornerstones of diabetes management . Several review s and meta-analyses report that PA independently produces clinical ly important improvements in glucose control in people with Type 2 diabetes . However , it remains unclear what the optimal strategies are to increase PA behaviour in people with Type 2 diabetes in routine primary care . Methods This study will determine whether an evidence -informed multifaceted behaviour change intervention ( Movement as Medicine for Type 2 Diabetes ) targeting both consultation behaviour of primary healthcare professionals and PA behaviour in adults with Type 2 diabetes is both acceptable and feasible in the primary care setting . An open pilot study conducted in two primary care practice s ( phase one ) will assess acceptability , feasibility and fidelity . Ongoing feedback from participating primary healthcare professionals and patients will provide opportunities for systematic adaptation and refinement of the intervention and study procedures . A two-arm parallel group clustered pilot r and omised controlled trial with patients from participating primary care practice s in North East Engl and will assess acceptability , feasibility , and fidelity of the intervention ( versus usual clinical care ) and trial processes over a 12-month period . Consultation behaviour involving fidelity of intervention delivery , diabetes and PA related knowledge , attitudes/beliefs , intentions and self-efficacy for delivering a behaviour change intervention targeting PA behaviour will be assessed in primary healthcare professionals . We will rehearse the collection of outcome data ( with the focus on data yield and quality ) for a future definitive trial , through outcome assessment at baseline , one , six and twelve months . An embedded qualitative process evaluation and treatment fidelity assessment will explore issues around intervention implementation and assess whether intervention components can be reliably and faithfully delivered in routine primary care . Discussion Movement as Medicine for Type 2 Diabetes will address an important gap in the evidence -base , that is , the need for interventions to increase free-living PA behaviour in adults with Type 2 diabetes . The multifaceted intervention incorporates an online accredited training programme for primary healthcare professionals and represents , to the best of our knowledge , the first of its kind in the United Kingdom . This study will establish whether the multifaceted behavioural intervention is acceptable and feasible in routine primary care . Trial registration Movement as Medicine for Type 2 Diabetes ( MaMT2D ) was registered with Current Controlled Trials on the 14th January 2012 : IS RCT N67997502 . The first primary care practice was r and omised on the 5th October 2012 The purpose of this study was to investigate the benefits of a pedometer and a cognitive-behavioural group intervention for promoting physical activity ( PA ) in type 2 diabetes patients . We recruited 41 participants and r and omized them into an intervention group ( IG ) ( n = 20 ) and a control group ( CG ) ( n = 21 ) . The intervention consisted of five sessions within 12 weeks , a booster session after 22 weeks and a pedometer . Primary outcome was PA assessed by accelerometer ( minutes per day ) and pedometer ( steps per day ) . Secondary outcomes were weight , body mass index , blood pressure , haemoglobin A1c and total cholesterol . After 12 weeks , the IG increased with more than 2000 steps day−1 compared with the CG , whereas sedentary behaviour decreased more than 1 hour day−1 in the IG and showed no change in the CG . There was no intervention effect on the accelerometer-based PA nor on health measurements . After 1 year , the increase in steps per day remained significant in the IG , but sedentary activity increased again to baseline levels . This pilot study showed that the combination of a 12-week cognitive-behavioura intervention and a pedometer has a significant short-term impact on daily steps and sedentary behaviour but that the effects on total PA and long-term effects were limited Introduction Large proportions of the population are not meeting recommended levels of physical activity and have increasingly sedentary lifestyles . Low levels of physical activity are predictive of poor health outcomes and time spent sedentary is related to a host of risk factors independently of physical activity levels . Building an evidence base of the best approaches to intervene in the lifestyles of inactive individuals is crucial in preventing long-term disease , disability and higher mortality rates . Methods and analysis Systematic search es will be conducted on all relevant data bases ( eg , PubMed , Scopus , CINAHL , PsycINFO ) . Studies will be included if they assess interventions aim ed at changing physical activity or sedentary behaviour levels in adults ( over 18 ) who are inactive and do not suffer from chronic conditions . Studies must also be r and omised controlled trials ( RCTs ) , have a primary outcome of physical activity or sedentary behaviour , and measure outcomes at least 6 months after intervention completion . Studies will be coded using the Behaviour Change Technique ( BCT ) taxonomy v1 and Template for Intervention Description and Replication ( TIDieR ) guidelines . 2 review ers will independently screen full-text articles and extract data on study characteristics , participants , BCTs , intervention features and outcome measures . Study quality will also be assessed independently by 2 review ers using the Cochrane risk of bias tool . A meta- analysis will be considered if there is sufficient homogeneity across outcomes . GRADE criteria will be used to assess quality of evidence . Dissemination This will be the first review to systematic ally appraise interventions aim ed at changing the physical activity or sedentary behaviour of inactive individuals using RCT design s with a 6-month follow-up post-intervention . This review will better inform intervention design ers targeting inactive population s and inform the design of a future complex intervention . Review registration number This protocol was registered with the International Prospect i ve Register of Systematic Review s ( PROSPERO ) on 17 October 2014 ( registration number : CRD42014014321 ) Introduction Childcare educators may be role models for healthy eating and physical activity ( PA ) behaviours among young children . This study aim ed to identify which childcare educators ’ practice s are associated with preschoolers ’ dietary intake and PA levels . Methods This cross-sectional analysis included 723 preschoolers from 50 r and omly selected childcare centres in two Canadian provinces . All data were collected in the fall of 2013 and 2014 and analysed in the fall of 2015 .  PA was assessed using Actical accelerometers during childcare hours for 5 consecutive days .  Children ’s dietary intake  was measured at lunch on 2 consecutive days using weighed plate waste and digital photography . Childcare educators ’ nutrition practice s ( modelling , nutrition education , satiety recognition , verbal encouragement and not using food as rewards ) and PA practice s ( informal and formal PA promotion ) were assessed by direct observation over the course of 2 days , using the Nutrition and Physical Activity Self- Assessment for Child Care tool . Associations between educators ’ practice s and preschoolers ’ PA and dietary intake were examined using multilevel linear regressions . Results Overall , modelling of healthy eating was positively associated with children ’s intake of sugar ( β=0.141 , 95 % CI 0.03 to 0.27 ) , while calorie ( β=−0.456 , 95 % CI −1.46 to –0.02 ) and fibre intake ( β=−0.066 , 95 % CI −0.12 to –0.01 ) were negatively associated with providing nutrition education . Not using food as rewards was also negatively associated with fat intake ( β=−0.144 , 95 % CI −0.52 to –0.002 ) . None of the educators ’ PA practice s were associated with children ’s participation in PA  . Conclusions Modelling healthy eating , providing nutrition education and not using food as rewards are associated with children ’s dietary intake at lunch in childcare centres , highlighting the role that educators play in shaping preschoolers ’ eating behaviours . Although PA practice s were not associated with  children ’s PA levels , there is a need to reduce sedentary time in childcare centres Introduction Early childhood is an important period for establishing behaviours that will affect weight gain and health across the life course . Early feeding choices , including breast and /or formula , timing of introduction of solids , physical activity and electronic media use among infants and young children are considered likely determinants of childhood obesity . Parents play a primary role in shaping these behaviours through parental modelling , feeding styles , and the food and physical activity environments provided . Children from low socio-economic background s have higher rates of obesity , making early intervention particularly important . However , such families are often more difficult to reach and may be less likely to participate in traditional programs that support healthy behaviours . Parents across all socio-demographic groups frequently access primary health care ( PHC ) services , including nurses in community health services and general medical practice s , providing unparalleled opportunity for engagement to influence family behaviours . One emerging and promising area that might maximise engagement at a low cost is the provision of support for  healthy parenting  through electronic media such as the Internet or smart phones . The Growing healthy study explores the feasibility of delivering such support via primary health care services . Methods This paper describes the Growing healthy study , a non-r and omised quasi experimental study examining the feasibility of an intervention delivered via a smartphone app ( or website ) for parents living in socioeconomically disadvantaged areas , for promoting infant feeding and parenting behaviours that promote healthy rather than excessive weight gain .  Participants will be recruited via their primary health care practitioner and followed until their infant is 9 months old . Data will be collected via web-based question naires and the data collected inherently by the app itself . Ethics and dissemination This study received approval from the University of Technology Sydney Ethics committee and will be disseminated via peer- review ed publications and conference presentations Background Multiple factors combine to support a compelling case for interventions that target the development of obesity-promoting behaviours ( poor diet , low physical activity and high sedentary behaviour ) from their inception . These factors include the rapidly increasing prevalence of fatness throughout childhood , the instigation of obesity-promoting behaviours in infancy , and the tracking of these behaviours from childhood through to adolescence and adulthood . The Infant Feeding Activity and Nutrition Trial ( INFANT ) aims to determine the effectiveness of an early childhood obesity prevention intervention delivered to first-time parents . The intervention , conducted with parents over the infant 's first 18 months of life , will use existing social networks ( first-time parent 's groups ) and an anticipatory guidance framework focusing on parenting skills which support the development of positive diet and physical activity behaviours , and reduced sedentary behaviours in infancy . Methods / Design This cluster-r and omised controlled trial , with first-time parent groups as the unit of r and omisation , will be conducted with a sample of 600 first-time parents and their newborn children who attend the first-time parents ' group at Maternal and Child Health Centres . Using a two-stage sampling process , local government areas in Victoria , Australia will be r and omly selected at the first stage . At the second stage , a proportional sample of first-time parent groups within selected local government areas will be r and omly selected and invited to participate . Informed consent will be obtained and groups will then be r and omly allocated to the intervention or control group . Discussion The early years hold promise as a time in which obesity prevention may be most effective . To our knowledge this will be the first r and omised trial internationally to demonstrate whether an early health promotion program delivered to first-time parents in their existing social groups promotes healthy eating , physical activity and reduced sedentary behaviours . If proven to be effective , INFANT may protect children from the development of obesity and its associated social and economic costs . Trial registration Current Controlled Trials IS RCT OBJECTIVES This study evaluated the feasibility of the ' Encouraging Activity to Stimulate Young ( EASY ) Minds ' programme , a school-based intervention for integrating physical activity ( PA ) into mathematics lessons . DESIGN R and omised controlled trial . METHODS Two classes from a single school ( n = 54 ) were r and omised to receive either the 6-week EASY Minds intervention ( n = 27 ) or follow their usual school programme ( n = 27 ) . The intervention involved the embedding of PA across the pre-existing mathematics programme for 3 × 60 min sessions per week  . Changes in PA were measured using accelerometers and ' on task ' behaviour was measured using momentary time sampling observation . RESULTS Using intention-to-treat analysis , significant intervention effects were found for MVPA ( 9.7 % , 95%CI = 7.6 , 11.8 , p ≤ 0.001 ) and sedentary time ( -22.4 % , CI = -24.9 , -12.2 , p ≤ 0.001 ) for the intervention group during Mathematics lessons ( 9.30 am-10.30 am ) . Significant intervention effects were also shown for MVPA 8.7 % ( 95 % CI = 5.8 , 11.6 , p ≤ 0.001 and sedentary time -18.6 % ( 95 % CI = -24.9 , -12.2 , p ≤ 0.001 ) across the whole school day . Furthermore , children displayed significantly greater ' on-task ' behaviour across the intervention period with a 19.9 % ( 95%CI = 2.4 , 37.4 , p ≤ 0.03 ) mean difference between groups . CONCLUSIONS The EASY Minds programme demonstrated that integrating movement across the primary mathematics syllabus is feasible and efficacious in enhancing school based-PA and improving on-task behaviour in mathematics lessons Objectives : To evaluate the effectiveness of an intervention to prevent excess weight gain , reduce time spent in screen behaviours , promote participation in and enjoyment of physical activity ( PA ) , and improve fundamental movement skills among children . Participants : In 2002 , 311 children ( 78 % response ; 49 % boys ) , average age 10 years 8 months , were recruited from three government schools in low socioeconomic areas of Melbourne , Australia . Design : Group-r and omized controlled trial . Children were r and omized by class to one of the four conditions : a behavioural modification group ( BM ; n=66 ) ; a fundamental movement skills group ( FMS ; n=74 ) ; a combined BM/FMS group ( BM/FMS ; n=93 ) ; and a control ( usual curriculum ) group ( n=62 ) . Data were collected at baseline , post intervention , 6- and 12-month follow-up periods . Results :  BMI data were available for 295 children at baseline and 268 at 12-month follow-up . After adjusting for food intake and PA , there was a significant intervention effect from baseline to post intervention on age- and sex-adjusted BMI in the BM/FMS group compared with controls ( −1.88 kg m−2 , P<0.01 ) , which was maintained at 6- and 12-month follow-up periods ( −1.53 kg m−2 , P<0.05 ) . Children in the BM/FMS group were less likely than controls to be overweight/obese between baseline and post intervention ( adjusted odds ratio (AOR)=0.36 , P<0.05 ) ; also maintained at 12-month follow-up ( AOR=0.38 , P<0.05 ) . Compared with controls , FMS group children recorded higher levels and greater enjoyment of PA ; and BM children recorded higher levels of PA and TV viewing across all four time points . Gender moderated the intervention effects for participation in and enjoyment of PA , and fundamental movement skills . Conclusion : This programme represents a promising approach to preventing excess weight gain and promoting participation in and enjoyment of PA . Examination of the mediators of this intervention and further tailoring of the programme to suit both genders is required BACKGROUND Underst and ing the inter-relationships between lifestyle factors in youth is important with respect to the development of effective promotional programmes for healthy eating and active living . The present study aim ed to explore the associations of dietary habits ( DH ) with physical activity ( PA ) and screen time ( ST )  among Saudi adolescents aged between 15 and 19 years of age relative to gender . METHODS Data were obtained from the Arab Teens Lifestyle Study , a school-based multicentre lifestyle study conducted in 2009/2010 in three major cities in Saudi Arabia . A multistage stratified cluster r and om sampling technique was used . The number of participants with complete data for  DH  and  PA  was 2886 and the respective number for DH and ST was 2822 . Assessment included weight , height , body mass index , total daily ST ( television viewing , video/computer games and Internet use ) , PA and DH using self-reported question naires . RESULTS Females were significantly more sedentary and less active than males ( P < 0.001 ) . Two-way analysis of covariance , controlling for age , showed significant ( P < 0.05 ) gender by PA and gender by ST interactions for several DH . Logistic regression analyses revealed significant associations of higher PA with a higher consumption of fruit , vegetables , milk , French fries/potato chips and energy drinks , whereas higher ST was significantly associated with a higher consumption of sugar-sweetened drinks , fast foods , cake/doughnuts and energy drinks . CONCLUSIONS Healthful dietary habits were associated mostly with  PA  , whereas sedentary behaviours , independent of PA , negatively impacted upon eating behaviours . The low PA levels and high sedentary levels of Saudi females represent a great concern . The results reported in the present study have important implication s for both youth public health policies and intervention programmes Regular physical activity ( PA ) and the avoidance of prolonged sitting are essential for children ’s healthy growth , and for the physical and mental wellbeing of both children and adults . In the context of exercise , music may promote behavioral change through increased exercise adherence and participation . The purpose of this study was to determine whether a movement-to-music video program could reduce sedentary behavior ( SB ) and increase PA in mother-child pairs in the home environment . A r and omized controlled trial was conducted in the Pirkanmaa region , Finl and , in 2014–2016 . The participants consisted of 228 mother-child pairs ( child age 5–7 years ) . The primary outcomes of interest were tri-axial accelerometer-derived SB and PA , which were measured in weeks one ( baseline ) , two , and eight in both the intervention and control groups . Further , the mothers and children in the intervention group used a movement-to-music video program from the beginning of week two to the end of week eight . Secondary outcomes included self-reported screen time . The statistical methods employed comprised an intention-to-treat and linear mixed effects model design . No statistically significant differences between groups were found in primary or secondary outcomes . Among the children in the control group  , light PA  decreased significantly over time and screen time increased from 89 ( st and ard deviation , SD 37 ) to 99 ( SD 41 ) min/d . Among mothers and children in the intervention group , no statistical differences were found . In supplementary analysis , the children who stayed at home instead of attending daycare/preschool had on average 25 ( 95 % confidence interval , CI 19–30 ) min/d more sedentary time and 11 ( 95 % CI 8–14 ) min/d less moderate-to-vigorous PA than those who were at daycare/preschool . The higher body mass index of mothers was related with 5 ( 95 % CI 2–7 ) min/d more sedentary time and 1 ( 95 % CI 0–2 ) min/d less moderate-to-vigorous PA . The movement-to-music video program did not change the objective ly measured SB or PA of the mother-child pairs . However , mothers and children seemed to be more sedentary at home , and therefore interventions for decreasing SB and increasing PA should be targeted in the home environment Objective . To evaluate the relationship of physical activity ( PA ) and sedentary behaviour with  gestational weight gain ( GWG ) and birth weight . Design . Combined data from two prospect i ve studies : ( 1 ) nulliparous pregnant women without BMI restrictions and ( 2 ) overweight and obese pregnant women at risk for gestational diabetes . Methods . Daily PA and sedentary behaviour were measured with an accelerometer around 15 and at 32–35 weeks of gestation . The association between time spent in moderate-to-vigorous PA ( MVPA ) and in  sedentary activities  with GWG and birth weight was determined . Main outcome measures were GWG between 15 and 32 weeks of gestation , average GWG per week , and birth weight . Results . We studied 111 women . Early in pregnancy , 32 % of women spent ≥30 minutes/day in at least moderate PA versus 12 % in late pregnancy . No significant associations were found between time spent in MVPA or sedentary behaviour with GWG or birth weight . Conclusions . We found no relation  between MVPA and sedentary behaviour with GWG or birth weight . The small percentage of women meeting the recommended levels of PA indicates the need to inform and support pregnant women to maintain regular PA , as there seems to be no adverse effect on birth weight and maintaining PA increases overall health Background Participation in regular physical activity ( PA ) during the early years helps children achieve healthy body weight and can substantially improve motor development , bone health , psychosocial health and cognitive development . Despite common assumptions that young children are naturally active , evidence shows that they are insufficiently active for health and developmental benefits . Exploring strategies to increase physical activity in young children is a public health and research priority . Methods Jump Start is a multi-component , multi- setting PA and gross motor skill intervention for young children aged 3–5 years in disadvantaged areas of New South Wales , Australia . The intervention will be evaluated using a two-arm , parallel group , r and omised cluster trial . The Jump Start protocol was based on Social Cognitive Theory and includes five components : a structured gross motor skill lesson ( Jump In ) ; unstructured outdoor PA and gross motor skill time ( Jump Out ) ; energy breaks ( Jump Up ) ; activities connecting movement to learning experiences ( Jump Through ) ; and a home-based family component to promote PA and gross motor skill ( Jump Home ) . Early childhood education and care centres will be demographically matched and r and omised to Jump Start ( intervention ) or usual practice ( comparison ) group . The intervention group receive Jump Start professional development , program re sources , monthly newsletters and ongoing intervention support . Outcomes include change in total PA ( accelerometers ) within centre hours , gross motor skill development ( Test of Gross Motor Development-2 ) , weight status ( body mass index ) , bone strength ( Sunlight MiniOmni Ultrasound Bone Sonometer ) , self-regulation ( Heads-Toes-Knees-Shoulders , executive function tasks , and proxy-report Temperament and Approaches to learning scales ) , and educator and parent self-efficacy . Extensive quantitative and qualitative process evaluation and a cost-effectiveness evaluation will be conducted . Discussion The Jump Start intervention is a unique program to address low levels of PA and gross motor skill proficiency , and support healthy lifestyle behaviours among young children in disadvantaged communities . If shown to be efficacious , the Jump Start approach can be expected to have implication s for early childhood education and care policies and practice s , and ultimately a positive effect on the health and development across the life course . Trial registration Australian and New Zeal and Clinical Trials Registry No : ACTRN12614000597695 , first received : June 5 , 2014 OBJECTIVES ICAPS ( Intervention Centred on Adolescents ' Physical activity and Sedentary behaviour ) is aim ed at preventing excessive weight gain and cardiovascular risk in adolescents by promoting physical activity ( PA ) with an emphasis on recreational and daily-life PA , with a lifelong perspective . DESIGN R and omized study design ed to last for four years . Study cohort constituted of 954 first-level students ( 91 % of eligible pupils ) , aged 11.7 + /- 0.6 y ( mean + /- SD ) from four pairs of schools r and omly selected in eastern France , after sociogeographical stratification . In each pair , intervention status was r and omised at school-level . The program , not limited to school setting s , involves multiple partners with three objectives : 1 ) changing attitudes through debates and access to attractive activities during breaks and after-school hours , 2 ) encouraging social support , 3 ) providing environmental conditions that enable PA . Adapted times and places , open participation , emphasis on fun , meeting with others and absence of competitive aspects are used to reduce usual barriers to PA .  Accessibility and safety are permanent concerns . RESULTS Prevalence of overweight was 23.7 % . High participation rates were attained ( 50 % participated in at least one weekly activity ) . At six-month , the proportion of intervention adolescents  not performing supervised PA out of academic PA  was reduced by half ( 36 % to 17 % vs 42 % to 42 % in controls P < 10 - 4 ) ; the proportion of those spending > 3 h/day in sedentary occupations decreased ( 34 % to 28 % vs 27 % to 36 % ; P < 10 - 4 ) . CONCLUSION These data demonstrate the feasibility of implementing a multilevel PA intervention program in adolescents . Six-month results document increased PA  and decreased sedentary behaviour PURPOSE Health interventions based on theory may be more effective than those that are not . This review of review s synthesizes all published r and omized controlled trial ( RCT ) meta-analytic evidence from the last decade to examine whether theory-based interventions were found to be associated with more effective  adult health behaviour change interventions . METHODS Systematic review s including meta-analyses were identified by search ing Medline , CINAHL , PsycINFO , and CDSR . A narrative synthesis was used to summarize and analyse the evidence . Only review s including RCTs of health behaviour change interventions with adults aged 18 + published from 2007 to 2017 were included . RESULTS Of 8,659 articles , nine systematic review s met inclusion criteria . The majority of review s ( n = 8) suggested no increased effectiveness for theory-based compared to non-theory-based interventions for effectiveness of outcomes relating to health behaviour . Less than half of the RCTs included in the review s reported the use of theory ( 85/183 ) . Two review s suggested interventions based on control theory , motivational interviewing , or self-determination theory were associated with greater effectiveness for physical activity and /or dietary interventions and outcomes . Method ological and reporting issues limit the conclusions . CONCLUSIONS Theory-based interventions as currently operationalized in systematic review s were not found to be more effective than non-theory-based interventions . Method ological and reporting issues at study and review level may not reflect the true utility of theory use within health behaviour interventions . The promotion of theory use may benefit from using a multifaceted argument , rather than a narrow focus of increased effectiveness . Statement of contribution What is already known on this subject ? Theory use is regularly promoted by cl aim ing that it will lead to more effective behaviour change interventions . Theory use has been frequently linked to effectiveness within systematic review s of behaviour change interventions . The theory-effectiveness hypothesis has not been systematic ally examined at the systematic review level . What does this study add ? Theory use as operationalized by systematic review authors was not associated with increased effectiveness within systematic review s examining r and omized controlled trials of behaviour change interventions in adults . Interventions based on control theory , motivational interviewing , or self-determination theory were associated with greater effectiveness for physical activity and /or dietary interventions and outcomes . Theory use should be promoted using a multifaceted argument , and assertions for increased effectiveness of theory-based interventions should only be used in domains where specific evidence exists to support this cl aim Background Given the decline in physical activity ( PA ) levels among youth population s it is vital to underst and the factors that are associated with PA in order to inform the development of new prevention programs . Many studies have examined individual characteristics associated with PA among youth yet few have studied the relationship between the school environment and PA despite knowing that there is variability in student PA levels across schools . Methods Using multi-level logistic regression analyses we explored the school- and student-level characteristics associated with PA using data from 2,379 grade 5 to 8 students attending 30 elementary schools in Ontario , Canada as part of the PLAY-Ontario study . Results Findings indicate that there was significant between-school r and om variation for being moderately and highly active ; school-level differences accounted for 4.8 % of the variability in the odds of being moderately active and 7.3 % of the variability in the odds of being highly active . Students were more likely to be moderately active if they attended a school that used PA as a reward and not as discipline , and students were more likely to be highly active if they attended a school with established community partnerships . Important student characteristics included screen time sedentary behaviour , participating in team sports , and having active friends . Conclusion Future research should evaluate if the optimal population level impact for school-based PA promotion programming might be achieved most economically if intervention selectively targeted the schools that are putting students at the greatest risk for inactivity Background Today ’s children are more overweight than previous generations and physical inactivity is a contributing factor . Modelling and promoting positive behaviour in the early years is imperative for the development of lifelong health habits . The social and physical environments where children spend their time have a powerful influence on behaviour . Since the majority of preschool children spend time in care outside of the home , this provides an ideal setting to examine the ability of an intervention to enhance movement skills and modify physical activity behaviour . This study aims to evaluate the efficacy of the Activity Begins in Childhood ( ABC ) intervention delivered in licensed daycare setting s alone or in combination with a parent-driven home physical activity-promotion component to increase preschoolers ’  overall physical activity levels and , specifically , the time spent in moderate to vigorous physical activity . Methods / design This study is a single site , three-arm , cluster-r and omized controlled trial design with a daycare centre as the unit of measurement ( clusters ) . All daycare centres in the National Capital region that serve children between the ages of 3 and 5 , expressing an interest in receiving the ABC intervention will be invited to participate . Those who agree will be r and omly assigned to one of three groups : i ) ABC program delivered at a daycare centre only , ii ) ABC program delivered at daycare with a home/parental education component , or iii ) regular daycare curriculum . This study will recruit 18 daycare centres , 6 in each of the three groups . The intervention will last approximately 6 months , with baseline assessment prior to ABC implementation and follow-up assessment s at 3 and 6 months . Discussion Physical activity is an acknowledged component of a healthy lifestyle and childhood experiences as it has an important impact on lifelong behaviour and health . Opportunities for physical activity and motor development in early childhood may , over the lifespan , influence the maintenance of a healthy body weight and reduce cardiovascular disease risk . If successful , the ABC program may be implemented in daycare centres as an effective way of increasing healthy activity behaviours of preschoolers . Trial registration Current Controlled Trials : IS RCT N94022291 . Registered in December 2012 , first cluster r and omized in April 2013 Introduction An acute exacerbation of chronic obstructive pulmonary disease ( COPD ) marks a critical life event , which can lower patient quality of life and ability to perform daily activities . Patients with COPD tend to lead inactive and highly sedentary lifestyles , which may contribute to reductions in functional capacity . Targeting sedentary behaviour ( SB ) may be more attainable than exercise ( at a moderate-to-vigorous intensity ) for behaviour change in patients following an exacerbation . This study aims to evaluate the feasibility and acceptability of a 2-week at-home intervention providing education and self-monitoring to reduce prolonged periods of SB in patients with COPD discharged following an acute exacerbation . Methods and analysis Patients will be r and omised into 1 of 3 conditions : usual care ( control ) , education or education+feedback . The education group will receive information and suggestions about reducing long periods of sitting . The education+feedback group will receive real-time feedback on their  sitting time , st and -ups and step count at home through an inclinometer linked to a smart device app . The inclinometer will also provide vibration prompts to encourage movement when the wearer has been sedentary for too long . Data will be collected during hospital admission and 2 weeks after discharge . Qualitative interviews will be conducted with patients in the intervention groups to explore patient experiences . Interviews with healthcare staff will also be conducted . All data will be collected January to August 2016 . The primary outcomes are feasibility and acceptability , which will be assessed by qualitative interviews , uptake and drop-out rates , reasons for refusing the intervention , compliance , app usage and response to vibration prompts . Ethics and dissemination The research ethics committee East Midl and s Leicester- Central has provided ethical approval for the conduct of this study . The results of the study will be disseminated through appropriate conference proceedings and peer- review ed journals . Trial registration number IS RCT N13790881 ; Pre- results Studies have shown preventive effects of an active lifestyle during childhood on later life ; therefore , health promotion has to start early . The programme “ Join the Healthy Boat ” promotes a healthy lifestyle in primary school children . In order to evaluate it , children 's behaviours in respect of  increased physical activity ( PA )  , a decrease in screen media use ( SMU ) , more regular breakfast , and a reduction of the consumption of soft drinks ( SDC )  were investigated . 1943 children ( 7.1 ± 0.6 years ) participated in the cluster-r and omised study and were assessed at baseline and 1736 of them at follow-up . Teachers delivered lessons , which included behavioural contracting and budgeting of SMU and SDC . Daily SMU , PA behaviours , SDC , and breakfast patterns  were assessed via parental question naire . After one-year intervention , significant effects were found in the intervention group for SMU of girls , children without migration background , and children with parents having a low education level . In the control group , second grade children  skipped breakfast significantly more often . Tendencies but no significant differences were found for PA and SDC . This intervention seems to affect groups , which are usually hard to reach , such as children of parents with low education levels , which shows that active parental involvement is vital for successful interventions Physical activity ( PA ) and micronutrients such as calcium ( Ca ) , vitamin D ( 25OHD ) , and phosphate ( PO ) are important determinants of skeletal development . This case-control study examined the association of these nutritional biomarkers and different PA behaviours , such as habitual PA , weight-bearing exercise ( WBE ) and sedentary time ( SED ) with bone stiffness ( SI ) in 1819 2 - 9-year-old children from the IDEFICS study ( 2007 - 2008 ) .  SI was measured on the calcaneus using quantitative ultrasound .  Serum and urine Ca and PO and serum 25OHD were determined . Children 's sports activities were reported by parents using a st and ardised question naire . A sub sample of 1089 children had accelerometer-based PA data ( counts per minute , cpm ) . Moderate-to-vigorous PA ( MVPA ) and SED were estimated . Children with poor SI ( below the 15th age-/sex-/height-specific percentile ) were defined as cases ( N=603 ) . R and omly selected controls ( N=1216 ) were matched by age , sex , and country . Odds ratios ( OR ) for poor SI were calculated by conditional logistic regression for all biomarkers and PA behaviour variables separately and combined ( expressed as tertiles and dichotomised variables , respectively ) . ORs were adjusted for fat-free mass , dairy product consumption , and daylight duration . We observed increased ORs for no sports ( OR=1.39 , p<0.05 ) , PA levels below 524 cpm ( OR=1.85 , p<0.05 ) and MVPA below 4.2 % a day ( OR=1.69 , p<0.05 ) compared to WBE , high PA levels ( < 688 cpm ) and high MVPA ( 6.7 % ) , respectively . SED was not associated with SI . ORs were moderately elevated for low serum Ca and 25OHD . However , biomarkers were not statistically significantly associated with SI and did not modify the association between PA behaviours and SI . Although nutritional biomarkers appear to play a minor role compared to the osteogenic effect of PA and WBE , it is noteworthy that the highest risk for poor SI was observed for no sports or low MVPA combined with lower serum Ca ( < 2.5 mmol/l ) or lower 25OHD ( < 43.0 nmol/l ) OBJECTIVES This study aim ed to investigate the  lifestyle habits-physical activity ( PA ) , eating habits ( EH ) , and sleep duration (SD)-of  Omani adolescents , and to examine gender differences in such variables . METHODS 802 Omani adolescents ( 442 females and 360 males ) , aged 15 - 18 years were r and omly recruited .  Anthropometric indices , PA level , and EH and SD  were evaluated by the Arab Teenage Lifestyle question naire . A semi-quantitative food frequency question naire for dietary assessment was also administered . RESULTS The results showed that although the study subjects had a sedentary lifestyle ( lack of PA , average of 6.7 hours sleep , and consumption of high calorie foods ) , they maintained a normal body mass ( less than 25 Kg/m(2 ) ) . Males were more than twice as active as females . With respect to EH , there were few gender differences , except in dairy and meat consumption where 62.5 % and 55.5 % of males consumed more than 3 servings , respectively , compared to 18.78 % and 35.2 % of females , respectively . In addition , waist/height ratio , height , reasons for being active , energy drinks , potato consumption , eating sweets , vigorous PA and breakfast EHs were statistically significant independent predictors for BMI , P < 0.05 for both males and females . CONCLUSION This study revealed a high prevalence of sedentary behaviors and a low level of physical activity , especially among females . Unhealthy dietary habits were also widely found among both genders . There is an urgent need for more research as well as a national policy promoting active living and healthy eating and discouraging sedentary behaviour among Omani adolescents Background Accelerometers can obtain precise measurements of movements during the day . However , the individual activity pattern varies from day-to-day and there is limited evidence on measurement days needed to obtain sufficient reliability . The aim of this study was to examine variability in accelerometer derived data on sedentary behaviour and physical activity at work and in leisure-time during week days among Danish office employees . Methods We included control participants ( n = 135 ) from the Take a St and ! Intervention ; a cluster r and omized controlled trial conducted in 19 offices .  Sitting time and physical activity were measured using an ActiGraph GT3X+ fixed on the thigh and data were processed using Acti4 software . Variability was examined for sitting time , st and ing time , steps and time spent in moderate-to-vigorous physical activity ( MVPA ) per day by multilevel mixed linear regression modelling . Results Results of this study showed that the number of days needed to obtain a reliability of 80 % when measuring sitting time was 4.7 days for work and 5.5 days for leisure time . For physical activity at work , 4.0 days and 4.2 days were required to measure steps and MVPA , respectively . During leisure time , more monitoring time was needed to reliably estimate physical activity ( 6.8 days for steps and 5.8 days for MVPA ) . Conclusions The number of measurement days needed to reliably estimate activity patterns was greater for leisure time than for work time . The domain specific variability is of great importance to research ers and health promotion workers planning to use objective measures of sedentary behaviour and physical activity . Trial registration Clinical trials NCT01996176 The current review aim ed to systematic ally identify dietary , physical activity and sedentary behaviours in preschool children ( 4 - 6 years of age ) that are prospect ively related to overweight or obesity later in childhood . Prospect i ve studies published between January 1990 and June 2010 were selected from search es in PubMed , EMBASE , PsycINFO , CINAHL and Cochrane Library . Studies examining the prospect i ve association between at least one relevant behaviour measured during preschool period ( children aged 4 - 6 years at baseline ) in relation to at least one anthropometric measurement at follow-up ( age < 18 years ) were included . Harvest plots were used to summarize the results and draw conclusions from the evidence . Of the 8,718 retrieved papers , 23 papers reporting on 15 different study sample s were included in this review . Strong evidence was found for an inverse association between total physical activity and overweight . Moderate evidence was observed for a positive association between television viewing and overweight . Because of the heterogeneity in the assessed dietary behaviours , insufficient evidence was found for an association between  dietary intake or specific dietary behaviours and overweight . These results suggest that interventions aim ing to prevent overweight among preschool children should focus on promotion of total physical activity and limitation of screen time and that further research is needed to establish whether and which dietary behaviours are important for obesity prevention in this age group . However , despite the lack of evidence for dietary behaviours from the present review , future interventions may already target specific dietary behaviours that are highly prevalent and for which there a clear rationale as well as preliminary evidence that these behaviours are associated with overweight
Overall , toddlers tend to exceed the total PA recommendation of 180 min/day ; however , very little of this time is spent at higher movement intensities .
Even with high PA rates , toddlers still engage in substantial ST .
Early experiences in physical activity ( PA ) are important to shape healthy movement behaviours long-term ; as such , it is critical that PA is promoted from infancy , and that detrimental behaviours ( e.g. , prolonged sedentary time [ ST ] ) are minimized .
The purpose of this systematic review and meta- analysis was to examine infants ’ and toddlers ’ movement behaviours across daytime hours .