Physical Activity and the Home Environment in Preschool-aged Children in Urban Bangladesh
Condition: Obesity, Childhood; Malnutrition; Anemia
MeSH terms: Malnutrition; Pediatric Obesity
Study type: Observational

Summary: 
      The overall goal of this study is to generate new knowledge regarding the nutritional and
      environmental determinants of physical activity in young children living in a densely
      populated urban community in Bangladesh. The investigators hypothesize that low levels of
      preschooler physical activity are associated with a lack of play-oriented physical attributes
      (i.e., total area of indoor floor space, presence and count of unsafe physical hazards, and
      presence and count of stationary and portable gross motor activity-oriented items) within the
      homes in urban Bangladesh. The investigators also hypothesized that low Hb may be associated
      with low physical activity levels in this population.
    

Detailed description: 
      Study Rationale

      As the double burden of nutrition emerges in Bangladesh and other low- to middle-income
      countries, it is imperative to develop strategies to mitigate the adverse effects associated
      with both undernutrition and obesity. Identifying levels of physical activity among children
      is a requisite step to developing and targeting interventions to promote physical activity
      among young populations. Furthermore, exploring the risk factors associated with physical
      activity levels in young children can help better inform policy makers surrounding a public
      health intervention.

      Goals The overall goal of the research is to generate new knowledge regarding the nutritional
      and environmental determinants of physical activity in young children living in a densely
      populated urban community in Bangladesh.

      Primary Objectives

      The specific objectives of this study are to:

        1. Describe physical activity levels in a sample of preschool-aged children in an
           inner-city community in Dhaka, Bangladesh,

        2. Estimate the associations between characteristics of the physical environment of the
           home (total area of available floor space inside of the home, number and presence of
           physical hazards, and the number of gross motor activity-oriented items present) and the
           physical activity levels of preschoolers in Dhaka, and

        3. Estimate the associations between hemoglobin concentration (Hb) and preschooler physical
           activity level.

        4. Describe sleep quantity and quality in the sample of preschool-aged children in urban
           Bangladesh

      The investigators conducted a cross-sectional observational study of preschool-aged children
      between 34-38 months of age (n=60) selected from the ongoing Maternal Vitamin D for Infant
      Growth (MDIG) trial cohort (NCT01924013) in Dhaka, Bangladesh. The investigators planned to
      enrol a minimum of 60 participants with complete data sets, with recruitment up to 90
      participants until this enrolment target was reached.

      Study Procedures

        -  Accelerometry

        -  Home built environment audit

        -  Anthropometry

        -  hemoglobin concentration

        -  Maternal perception of the home environment and household food security
    

Intervention name(s): Exposures
Intervention type(s): Behavioral
Intervention description(s): Total area of available floor space inside the home (m2)
Frequency that child plays outdoors
Total number of physical hazards in the home (presence of open stairwells, stove height)
Total number of fine-motor activity items available to the child
Presence of gross-motor activity items available to the child across each category (e.g., fixed, portable: ball equipment, push/pull equipment, riding equipment, rocking and twisting equipment)
Hemoglobin concentration (g/L).
Observational model: Cohort
Time perspective: Cross-Sectional
Sampling method: Non-Probability Sample
Study population: 
        Participants within the Maternal Vitamin D for Infant Growth (MDIG) trial (NCT01924013)
        cohort registry who have a) expressed interest in participating in future sub-studies, and
        b) have children within the target age range, will be contacted. Participants will be
        contacted prior to their anticipated study visit. A contact list will be updated each week
        to prospectively recruit participants in advance or during the age window in which children
        are eligible for enrolment. Each list will begin with the eldest children to reduce the
        number of missed opportunities to enroll children before they exit the eligible age window.
        The catchment area will include the following neighbourhoods in urban Dhaka: Kamrangir
        char, Azimpur, Lalbag, and Hazariba
      
Keywords: Obesity; Home Environment; Malnutrition