30th Apr 2024

Light has an impact on human sleep and circadian rhythm. Morning sunlight has an important role in adjusting the human circadian rhythm to 24 hours, but exposure to artificial light at night can be a cause of the delay of the circadian rhythm and sleep timing. Our previous studies showed that the effects of light at night are greater in children than adults. In the present study, we examined if the individual difference in sleep timing and circadian phase in children is related to the magnitude of melatonin suppression by light at night, an index of circadian sensitivity to light at night. Twenty-one healthy children aged 9 to 14 participated in this experiment. Informed consent was obtained from all participants and their parents. The participants were asked to record a sleep diary two weeks before the experiment. Saliva samples were collected to measure melatonin concentrations every hour from 17:00 to the habitual bedtime under ordinary room light conditions (200 ± 30 lx) on the first day and under dim light conditions (<30 lx) on the second day. Dim light melatonin Onset (DLMO) was used as an index of the circadian phase, and the percentage of melatonin suppression by light was calculated as an index of circadian sensitivity to light. Individual difference in the percentage of melatonin suppression was correlated with DLMO (r=0.535, p=0.039) and habitual sleep onset time (r=0.503, p=0.056). The children sensitive to light showed delayed circadian phase and sleep onset time. This result suggests that individual differences in circadian sensitivity to light before bedtime influence circadian rhythm and sleep in children.

Introduction: Adherence to the 24-hour movement behaviors (24-HMB) guidelines has been positively associated with health indicators in adolescents. However, evidence regarding changes in the proportion of adolescents meeting these guidelines over time is scarce. This study aimed to determine changes in the proportion of adherence with 24-HMB recommendations during adolescence. Methods: Prospective study (with mean follow-up period of 3.2 years) comprising 117 adolescents (53.8% girls) from public school in the southern region of Brazil. Physical activity (PA) was objectively measured, while sedentary behavior (SB) and sleep were estimated using a self-administered instrument. The 24-HMB were dichotomized in adherence or non-adherence, according to international recommendations: i) moderate to vigorous physical activity ≥60 min/day; ii) sedentary behavior ≤2 hours/day of recreational screen time (TV); and iii) sleep = 8 to 10 hours/day), and then classified into three categories according to the combination of recommendations’ adherence: I) minimal adherence (only one behavior); II) partial adherence (two behaviors); III) total adherence (all three behaviors). The McNemar test was used to analyze whether adherence to the recommendations varied between the two time points. Results: The proportion of adolescents who met the recommendations at baseline and follow-up was 23.1% vs 35.1% (minimal adherence), 49.0% vs 52.1% (partial adherence), and 27.9% vs 12.8% (total adherence), respectively. Total adherence to the recommendations was higher at baseline compared to follow-up (P=0.009). No significant changes were observed between minimal and partial adherence over time. When analyzing behaviors individually, a significant reduction in adherence to the PA recommendations from baseline to follow-up was observed (70.4% vs. 39.9%, P<0.001). Conclusion: The proportion of total adherence to the 24-HMB guidelines in Brazilian adolescents is low and appears to decrease throughout adolescence.

Historically, university students develop harmful health-related habits that have negative consequences for current and future health outcomes. To begin tackling this issue, literature has previously identified relationships between psychological and behavioural markers of health. However, there is currently limited understanding of the system within which these factors interact. The current study aimed to explore the relationships between health-related behaviours and outcomes in UK university students using Bayesian network analysis. 4,132 university students completed an online, self-report survey to assess behavioural and psychological markers of health over three academic years (2021-2023). Directed Acyclical Graph (DAG) analysis was conducted to explore the relationships between variables of interest. The DAG demonstrated that ethnicity had the most profound influence on the model. Perceived stress (PS) also had a major impact on the model through directly influencing smoking status, sleep quality (SQ), and mental wellbeing (MWB). Body mass index (BMI) also had a notable impact via direct associations with SQ and movement behaviours. When separated by gender, the model in men was largely similar to the overall model. However, in women, the associations between smoking status and SQ, smoking status and SB, and BMI and SQ were no longer present. These findings provide novel insight into the complex system within which psychological and behavioural aspects of health interact to influence students’ health status. Specifically, targeting PS and BMI could be an effective strategy to improve various markers of health and behaviours in UK university students.

Background: The 24-hour movement guidelines recommend that screen time (ST) should be limited to ≤2 hours/day to maintain appropriate levels of health. However, in relation to cognitive abilities, such as working memory, different types of devices media have shown divergent results. Thus, the aim was analyze the interrelationships between screen devices and working memory, according to adolescents´ compliance with screen time guidelines. Methods: Cross-sectional data were collected from a sample of 153 adolescents (72 boys; 14.9 years-old). Self-reported ST for television (TV), video games (VG), smartphones, and leisure personal computer (PCL) were categorized based on compliance with screen time guideline (≤2 hours/day). Working memory was assessed thought the Corsi block-tapping test, by the block span (BS) measure. Additionally, cardiorespiratory fitness (20-m shuttle run test), body mass index (BMI), and maternal education level (self-reported) were recorded. Partial correlation networks and the expected influence centrality measure were calculated using the Network Analysis (JASP 0.18.3). Results: Overall, 54.9% of adolescents adhered to the screen time guideline and no significant differences were observed between genders (p>0.05). Boys spent more time (hours/day) on VG (2.00 ± 1.71 vs. 1.27 ± 1.38; p<0.05) and PCL (1.53 ± 1.80 vs. 0.65 ± 1.04; p<0.05) compared to girls. The network configuration identified that PCL and VG screen devices were positively associated with BS for the non-compliant adolescents. However, the same devices showed a negative association for those compliant with the guideline. Smartphone use (met ST: -0.451; do no met ST: 0.358) and BMI (met ST: 1.317; do no met ST: 1.610) were the variables with the highest expected influence values in both groups. Conclusion: These results support the idea that specific media devices may have a positive effect on working memory, however, this association is distinct when ST is limited.

29th Apr 2024

Parents play a crucial role in shaping a child’s physical activity, sedentary behaviour and sleep (i.e. 24-hour movement behaviours). However, inconsistent research findings on the relationship between parenting and these behaviours underscore the need for a nuanced understanding. Leveraging the Self-Determination Theory (SDT) as an organizing framework holds promise in clarifying this complex relationship. This study aims to investigate the relationship between parenting constructs conceptualized within the SDT and 24-hour movement behaviours in preschoolers.
This cross sectional study focuses on children between 2,5 to 5 years old and one of their parents. Data collection spans December 2023 to February 2024. The 24-hour movement behaviours will be measured for seven consecutive days using ActiGraph wGT3X+ accelerometers and processed by GGIR package in R. A questionnaire, encompassing the Parent Social Context Questionnaire-Toddlers, gauges parenting dimensions within the SDT framework. This includes warmth, autonomy support, structure, rejection, coercion, and chaos. Supplementary questions derived from the Movie Models study assess structure, autonomy support, and positive involvement specifically for each of the behaviours. Multiple compositional regression analyses will be employed in R, with significance set at p<0.05.
In total, 141 parent-child dyads are participating. Preliminary results (n=25) show 515.71 (SD=89.64) minutes of PA/day, 172.67 (SD=54.64) minutes of SB/day (p=0.752), and 623.08 (SD=44.64) minutes of sleep/day. Regression models will investigate which parenting constructs contribute to a more favourable 24-hour composition, characterized by increased physical activity, reduced sedentary behaviour, and sufficient sleep. The results will be available and presented at SSHB 2024.
A comprehensive understanding of the parenting constructs influencing a favourable 24-hour movement behaviour composition might provide actionable guidance for promoting healthier movement behaviours in preschoolers.

The influence of 24-hour movement behaviours (physical activity (PA), sedentary behaviour (SB), and sleep) on health is well-established. However, compliance with WHO guidelines for 24-hour movement behaviours among preschoolers remains low. Given the significant influence of parents on children’s health behaviours, an evidence- and theory-based intervention was developed in collaboration with parents to optimize preschoolers movement behaviours. This study aims to investigate the effect of a co-created intervention to optimize 24-hour movement behaviours in preschoolers.
Dyads of parents and their preschool child (2.5-5 years old) were recruited from Flemish preschools and were assigned to an intervention or a control group. Seven consecutive days of preschoolers’ movement behaviours were measured using ActiGraph wGT3X+ accelerometers and processed with the GGIR package in R. A socio-demographic questionnaire was completed by the parent. Baseline measurements were completed between December 2023 and February 2024 for both groups. The intervention, consisting of seven sessions for parents and preschoolers, is taking place between the end of February to mid-May 2024. Post-intervention data collection is scheduled from mid-May to June 2024. Compositional linear mixed models will be employed in R, with significance set at p<0.05, to assess intervention effects.
In total, 40 preschoolers in the intervention group and 90 preschoolers in the control group are participating. Preliminary data show no differences between the intervention and control group with averages of respectively 524.43 (SD=71.91) and 503.50 (SD=113.05) minutes of PA/day (p=0.389), 172.14 (SD=57.63) and 173.40 (SD=53.22) minutes of SB/day (p=0.752), and 626.79 (SD=44.57) and 617.90 (SD=46.62)minutes of sleep/day (p=0. 0.857). Linear mixed models will investigate intervention effects and whether the intervention contributes to a more favourable 24-hour composition, characterized by increased PA, reduced SB, and sufficient sleep.
The findings of this study will give insight in the efficacy of a co-created intervention in optimizing 24-hour movement behaviours in preschoolers. The results will be presented at the SSHB 2024 symposium and might provide guidance for promoting healthier movement behaviours in preschoolers.

The COVID-19 pandemic has raised alarming concerns regarding the diminished physical fitness and increased susceptibility to bone fractures among school children. The purpose of this study was to clarify the relationship between arch condition, toe formation, toe muscles, and the results of physical fitness test.
The subjects were 1,303 children (657 boys and 646 girls) aged 6 to 14 years in K town, N prefecture. The survey was conducted in May 2023. The survey items were height, weight, physical fitness test, toe muscle strength, and arch condition. In addition, foot length, foot width, and the mean and standard deviation of all items were determined for each school.
Results and Discussion
Results revealed a progressive increase in toe muscle strength and toe arch formation with advancing grades, albeit with a decline observed from the second year of junior high school onwards. Notably, elementary school students exhibited arch formation, particularly in suburban areas, highlighting potential regional disparities. Significant differences (<0.001) were found in various physical fitness test components between different grade levels and gender groups, suggesting nuanced patterns in physical fitness development. However, while toe muscle strength demonstrated a correlation with physical fitness test results, no significant difference was observed in relation to arch formation or excessive hallux valgus tendencies.
This study underscores the importance of understanding the multifaceted relationship between foot biomechanics, musculoskeletal health, and physical fitness in school children. Addressing these dynamics can inform targeted interventions to mitigate the adverse effects of reduced physical activity and promote overall well-being among children in the wake of the pandemic.

27th Apr 2024

Continuous lifestyle, physical fitness, and physical activity (PA) surveys are conducted in Japan. This study aims to clarify the changes in PAT of Japanese children over 20 years, analyzing data from two representative continuous surveys.
This study uses the following two survey results. One is the Student Health Status Surveillance (SHSS) conducted by the Japan School Health Association, which was conducted once every two years from 1992 to 2018. The target was 7,000 and 18,000 3rd- through 12th-grade students. PA time (PAT) survey was conducted based on the IPAC method in this survey. The distribution of PAT per week (DPAT) was obtained from 10 surveys from 1993 to 2010. The other is the Japanese national survey on physical fitness, motor abilities, and lifestyle (NSPML) conducted by MEXT, Japan, since 2008, which is a comprehensive survey targeting 5th- and 8th-grade students using the original PAT method. The DPAT was obtained from 2008 to 2016.
Results and discussion
In the initial SHSS survey, the DPAT had a left-skewed distribution with a peak of 4-10 hours. However, from around 2000, the proportion of inactive children showed a tendency to increase in all grades, shifting to a monotonically decreasing distribution. In addition, among high school boys, the 5-10 hours PA decreased, though the 10 hours or more PA increased, which indicated a polarization of active and inactive children. The trend has been observed among high school girls and middle school boys and girls since the 2004 survey. DPAT of NSPML also showed a similar trend to SHSS results. In the 2010s, the polarization of PAT became even stronger. Based on these results, DPAT on weekdays and weekends has been focused since 2017.
DPAT has changed over time, and a polarization between active and inactive children was confirmed, with these differences becoming more pronounced.

20th Apr 2024

Introduction: Integrating movement behaviours into the 24-hour recommendations is a holistic approach of leading a healthy lifestyle. However, research on how complying with each behaviour influences the others is still scarce. Therefore, this study aimed to explore the interconnectedness between attaining each of the 24-hour movement behaviour recommendations among Portuguese youth.
Methods: A total of 282 students (138 girls), aged 11 to 17 years old (mean=12.9±1.0), participated in this study. Young people’s movement behaviours, such as physical activity, sedentary behaviour (screen time) and sleep, were measured by accelerometery and self-reported. Logistic regression models were carried out to investigate the relationship between each of the movement behaviours, adjusting the analysis for gender and age.
Results: Sleep recommendations were attained by 64% (95% confidence interval [CI]: 58.2, 69.4) of youths. On the other hand, only 25% (95%CI: 20.1, 30.2) and 29% (95%CI: 23.8, 34.4) complied with physical activity and sedentary behaviour recommendations, respectively. Attaining the sedentary behaviour recommendations increases twofold the chances of complying with both the physical activity (odds ratio [OR]=2.03; 95%CI: 1.04, 3.97) and sleep recommendations (OR=2.33; 95%CI: 1.27, 4.26). Complying with the physical activity and sleep recommendations were not related to each other.
Conclusions: Compliance with the 24-hour movement behaviours recommendations among Portuguese youth is still far from ideal. Notwithstanding, attaining the sedentary behaviour recommendations was interconnected with physical activity and sleep recommendations. Public health strategies targeting youth’s screen time may also be effective for promoting physical activity and sleep.

19th Apr 2024

Introduction: Health-related fitness is an important biomarker of health in youth. However, information on the association between 24-hour movement behaviour compliance and the different health-related fitness parameters is still uncertain. Thus, the aim was to analyse the association between complying with the 24-hour movement behaviours and health-related fitness in Portuguese youth.
Methods: Participants were 263 Portuguese youths, 51.3% boys, with a mean age of 12.9±1.0. Movement behaviours (moderate-to-vigorous physical activity [MVPA], screen time and sleep) were assessed by accelerometers and self-reported. Health-related fitness was assessed using the FITescola battery, including body mass index (BMI), waist circumference (WC), aerobic fitness (PACER), upper-body strength (push-ups), lower-body strength (standing broad jump), agility (4x10m shuttle-run) and speed (40m dash). Linear regression models, adjusted for sex and age, were performed for each fitness parameter.
Results: Only 24.7% (95% confidence interval [CI]: 19.5, 29.9) and 28.5% (95%CI: 23.0, 34.0) of children and adolescents followed the MVPA and screen-time recommendations, while 64.6% (95%CI: 58.8, 70.4) attained enough sleep. Complying with MVPA was associated with better aerobic fitness (B=14.5 laps; 95%CI: 9.8, 19.1) and upper- (B=2.1 push-ups; 95%CI: 0.4, 3.7) and lower-body strength (B=10.9 cm; 95%CI: 3.8, 18.2). Whereas, attaining screen-time recommendations was related to lower BMI (B=-1.1; 95%CI: -2.1, -0.1). Sleep was not associated with any fitness parameter. Following all three movement behaviours was associated with better aerobic fitness (B=10.7 laps; 95%CI: 2.7, 18.7) and upper-body strength (B=2.8 cm; 95%CI: 0.1, 5.6) and thinner WC (B=-5.0 cm; 95%CI: -9.8, -0.2).
Conclusions: Movement behaviour compliance is associated with health-related fitness but with different patterns. While engaging in 60 daily minutes of MVPA seems key for muscular and aerobic fitness, having less than 2 hours/day of screen time may positively impact weight. Promoting the 24-hour movement behaviours could be a gateway for improving health-related fitness in future generations.

Introduction: Optimal 24-hour movement behavior compositions (i.e., high levels of physical activity (PA), low levels of sedentary behavior (SB) and sufficient sleep) induce positive effects on for example insulin sensitivity, glucose control and triglyceride levels in adults with Type 2 Diabetes (T2D) showing/emphasizing the importance of intervening on these behaviors. The aim of this systematic review and meta-analysis was to identify effective intervention components that can positively change PA, SB and/or sleep in this population.

Methods: Three electronic databases (PubMed, Web of Science and Embase) were searched using keywords of the following concepts: pathology (T2D), PA, SB, sleep, and study design (randomized controlled trials). ASReview (which uses Artificial Intelligence) was used for title and abstract screening, followed by Covidence for full text screening. Risk of bias was evaluated using the Cochrane Risk of Bias tool 2 (PROSPERO ID CRD42023494007).

Results: The search strategy resulted in 9,437 original references. After screening title and abstract, 595 references were screened for full text resulting in a total of 99 included articles. Preliminary results show a total of 10,531 participants in the intervention group (mean age: 56.7; 50.1% female) and 11,061 participants in the control group (mean age: 57.4; 52.4% female) across all included studies. Goal-setting, action planning, monitoring, social support, and reinforcement and feedback seem commonly used behavior change techniques. The use of a pedometer, face-to-face sessions, group sessions and using the mobile phone are commonly used delivery methods for interventions. The results of the meta-analysis, which will be presented during the conference, will provide more detailed information about effective intervention components and behavior change techniques.

Conclusion: The results of this systematic review and meta-analysis will identify effective intervention components and behavior change techniques that will contribute to future single or multicomponent interventions targeting 24-hour movement behaviors in people with T2D.

10th Apr 2024

Introduction: Type 2 diabetes (T2D) is a prevalent condition associated with cardiometabolic risk in which an unhealthy lifestyle (e.g. low physical activity (PA), high sedentary behavior (SB), insufficient sleep i.e., 24h-movement behaviors (24h-MBs)) plays an important role in disease management. However, it remains unclear whether 24h-MBs are associated with cardiometabolic health in people with T2D (PwT2D) and whether this association differs from that of healthy peers.
Purpose: To compare 24h-MB compositions and associations with cardiometabolic variables between PwT2D and healthy controls.
Methods: Cardiometabolic variables (i.e. Body Mass Index, waist-to-hip ratio, systolic- and diastolic blood pressure, advanced glycation end products) and accelerometer-derived 24-h MBs were collected in 75 healthy controls and 52 PwT2D. Blood parameters (i.e. HbA1c, cholesterol, triglycerides, glucose) were exclusively measured in PwT2D. A MANOVA, using compositional data analysis, was used to explore the differences in compositions between groups. Linear regression models analysed the associations between cardiometabolic variables and 24h-MB composition as the independent variable.
Results: Significant differences (p<0.01) in 24h-MB compositions were observed between both groups with PwT2D spending less time in LPA (-34.13 min) and MVPA (-20.45 min) and more time in SB (+52.38 min) compared to healthy controls while sleep time did not differ. The composition of PwT2D was significantly associated with HDL-cholesterol (p<0.05), reallocating 20 minutes proportional from the other behaviors into MVPA was associated with a 3.53 mg/dl increase in HDL cholesterol. Preliminary results in a subsample of PwT2D (n=36) showed significant changes in 24h-MB compositions (more SB and less PA) after one year follow up.
Conclusions: These findings underscore the importance of considering 24h-MBs in. Further longitudinal research is necessary to explore the potential benefits of optimizing 24h-MB compositions to achieve more optimal cardiometabolic health.
Practical implications: These findings could be a first step towards an integrated approach in T2D management.
Funding: Research foundation Flanders

04th Apr 2024

Introduction: Questionnaires and device-based measures are used for understanding daily behaviors (sleep, sedentary behavior (SB), physical activity (PA)). The recently developed Daily Activity Behavior Questionnaire (DABQ) showed a good agreement for sleep but poor agreements for SB, light-intensity PA (LPA), and moderate-to-vigorous PA (MVPA) compared to ActivPAL. While the thigh-worn ActivPAL is best known for classifying posture-related behaviors, hip-worn devices like Actigraph-GT3x+ are preferred to classify activity intensities. Therefore, the aim of this study is to compare the DABQ with Actigraph-GT3X+, and to explore associations of sociodemographic factors with measurement differences.

Methods: Adults (n=105, 54% female, ±46 y/o) wore an Actigraph-GT3X+ for seven consecutive days (hip/day; wrist/night). Afterwards, participants filled in the DABQ considering the past seven days. Raw accelerometer data were processed by the R-package GGIR comparing different metrics (ENMO, MAD). Single movement analysis (intraclass correlation coefficient (ICC), interclass correlations (r), Bland Altman plots) and compositional analyses (multilevel regression models) were used to compare the measurement techniques.

Results: There was moderate agreement between DABQ and Actigraph for sleep (ICC 0.55; r=0.55) across different metrics. Poor agreements were found for SB, LPA and MVPA, however with varying results across metrics (SBenmo: ICC=0.01, r=0.06; SBmad: ICC=0.24, r=0.42; LPAenmo: ICC=0.01, r=0.11; LPAmad: ICC=0.17, r=0.5; MVPAenmo: ICC=0.22, r=0.28; MVPAmad: ICC=0.24, r=0.38). Using ENMO, Actigraph estimated +400 minutes SB/day, -350 minutes LPA/day and +15 minutes MVPA/day vs DABQ. Using MAD, Actigraph estimated +100 minutes SB/day, -150 minutes LPA/day and +40 minutes MVPA/day vs DABQ. Compositional models found that age, sedentary job and education were associated with differences between DABQ/Actigraph (p<0.001).

Conclusions:. Compared to Actigraph, the DABQ underestimates SB and MVPA, but overestimates LPA. Differences between Actigraph and DABQ measurement differ by metric, age, job and education. Understanding the validity of the DABQ questionnaire is helpful to improve assessments of 24-hour movement behaviors.

Introduction: Optimal levels 24-hour movement behaviors (24h-MB), encompassing sufficient physical activity (PA), limited sedentary behavior (SB) and sufficient sleep duration are crucial for cardiometabolic health. Despite the importance of these 24h-MBs, many adults have difficulties with consistently adopting optimal levels of these behaviors. Understanding factors that underpin adults’ 24h-MB is the fundament for intervention development to optimize these behaviors. The aim of this study is to explore associations between 24h-MBs and cardiometabolic health and to identify the correlates explaining adults’ 24h-MBs.

Methods: The 24h-MBs were objectively collected by Actigraph GT3X accelerometers. The following cardiometabolic variables were measured: HbA1c, fasting glucose, triglycerides, cholesterol, blood pressure, Body Mass Index (BMI), waist circumference (WC) and fat%. Explanatory variables were collected by an online questionnaire, i.e. attitude, facilitators, barriers, self-efficacy, subjective norm, subjective modelling, and social support. Regression analyses were used to explore associations between cardiometabolic variables or explanatory variables on the one hand and 24h-MB time use estimates on the other hand (Compositional Data Analysis).

Results: Data of 191 adults (45 y/o, 68% female) showed associations between the 24h-MB composition with adults’ BMI, WC, and fat% (p<0.001). Different correlates showed significant associations with a more active 24h-MB composition such as male sex (p=0.01), waking up early (p=0.001), being younger (p=0.001), higher self-efficacy regarding PA (p=0.05), less perceived barriers regarding PA (p=0.005), less perceived modelling regarding SB (p=0.04), less perceived barriers regarding interrupting SB (p=0.003), and less perceived facilitators of being sedentary (p=0.008).

Conclusions: These preliminary results highlight the association with 24h-MBs and adiposity and will advance the current understanding of correlates of 24h-MB compositions among Flemish adults which in turn may provide key points for the development of healthy lifestyle interventions.

29th Mar 2024

Background: A healthy active lifestyle (i.e. regular physical activity (PA), limited sedentary behavior (SB) and adequate sleep duration) is an important but challenging part of type 1 diabetes (T1D) management.
Aims: This systematic review aimed to summarize knowledge on explanatory variables of PA, SB and sleep in adults with T1D which is the first step toward developing interventions to achieve a healthy lifestyle.
Methods: A systematic search of four databases (PubMed, Web of Science, Scopus and Embase) was performed. Only objective measurements of PA, SB and sleep were included and all explanatory variables were classified according to the socio-ecological model (i.e. intrapersonal, interpersonal, environmental and policy level). Risk of bias (Joanna Briggs Institute appraisal checklists) and level of evidence (Evidence-Base Guideline Development) were assessed.
Results: All but one studied explanatory variables were situated at the intrapersonal level. A favorable body composition was associated with more time spent in total PA and moderate to vigorous PA (MVPA). Men with T1D spent more time in MVPA than women and a younger age was associated with increased MVPA. Barriers for PA showed an indeterminate association with MVPA.
Conclusion: This review underscores the focus on the individual level to identify explanatory variables of 24h-MBs in adults with T1D, despite the necessity for a socio-ecological approach to develop effective interventions. Based on the investigated variables, future interventions may be tailored to sex and age. More evidence on psychological, interpersonal and environmental variables is needed as these variables are (more) modifiable than health-related and socio-demographic variables.

28th Mar 2024

Rationale: Dementia is a condition that affects an increasing number of older people around the world. Currently, in Portugal, more than 200,000 people are suffering from dementia, and with a substantial financial impact. Investigating risk factors, early diagnosis, and symptoms of age-related diseases and cognitive impairments are crucial. Gait is not a simple motor task; it requires complex cognitive functions, such as attention; it presupposes overcoming obstacles and adapting to the environment so that the individual can walk successfully in complex environments, especially when performing other tasks. Recent evidence suggests that early changes in cognitive abilities are associated with slower, more unsteady gait during dual tasking.
Aim: This study compares the characteristics of cognitive function and gait in elderly people with and without dementia.
Methods: A minimum of 40 institutionalized elderly will be included in the study, all without neurological and/or psychiatric history previous to the current disease, 20 obtain a diagnosis of cognitive impairment or dementia, and another 20 do not score for mild cognitive decline (MCI) nor dementia in the neuropsychological screening tests.
This research, led by the University of Évora, received ethical approval (GD/24725/2023). Participants’ gait will be assessed with the Berg Balance Scale (BBS) and the Time Up and Go Test (TUG) in a single-task and dual-task situation. During these tests, participants will wear Movesense sensors to collect kinematic data associated with gait.
Results: Data are still being collected. Preliminary findings will be presented at the conference.
Conclusion: This study aims to contribute to a more in-depth knowledge of this subject, which will assist professionals in the potential (and future) early detection of this condition.

25th Mar 2024

Introduction: Meeting moderate-to-vigorous physical activity (MVPA) guidelines may not enough to counteract the negative cardiometabolic effects of prolonged sitting time. Athletes involved in diverse sports often comply with 60 minutes per day in MVPA guidelines proposed by World Health Organization, benefiting physical fitness (PF) levels. However, they also often engage in more sedentary activities. We aimed to investigate the impact of practicing at least a second sport (SP2) and sitting time (ST) on PF levels in female volleyball players.
Methods: This study comprises 89 female volleyball players aged 12 to 30 years (15.7±2.6 years). PF was assessed considering three components: muscular (the counter-movement jump, handgrip-strength test, standing-broad jump and step-approach jump), cardiorespiratory fitness (three-minute-step test) and motor component (T-test, shuttle run, and 30-meter run). Individual z-scores, adjusted for age, were computed for each test. Subsequently, aggregated z-scores for motor, muscular, cardiorespiratory fitness and overall PF were derived by summing the scores from the corresponding tests. Body fat percentage (BF%) was evaluated using a bioelectrical impedance analysis. Sports participation and ST were obtained through questionnaire. Linear regression models were using to analyse the links between SP2 and ST and each PF component as well as overall PF. All models were adjusting for BF%.
Results: The prevalence of players exclusively playing volleyball is 90% (N=80) and the mean time spent sitting is 11.22±0.37 hours. Athletes who participate at least two sports tend to have higher overall PF levels (β=3.448±1.405, p=0.016) and higher motor fitness (β=1.874±0.725, p=0.012) compared to those who practice only volleyball. No association was found between ST and overall PF or PF components (p>0.05).
Conclusions: Engaging in at least a second sport might enhance the intensity of PA which could potentially contribute to improved overall PF and motor fitness. Sitting time does not impact physical fitness levels in Volleyball Players.

22nd Mar 2024

In the tropical island of Mauritius, the rise of type 2 diabetes has accelerated in the past decades to reach a current prevalence that exceed 20%, and could be contributed by low physical activity and increased sedentary behaviour. The study objectives were to generate the first dataset of objectively determined free-living total energy expenditure (TEE), to estimate physical activity in Mauritian children, and to explore differences due to gender and ethnicity.

The doubly-labeled water (DLW) technique was used to evaluate TEE over 14 days in 56 Mauritian school children (aged 7-11 years) belonging to the two main ethnic groups: Indian (South Asian descent) and Creole (African/Malagasy descent). Physical activity level (PAL) was calculated as the ratio of TEE and resting energy expenditure (using Schofield equations), and daily step counts were measured by accelerometry. Anthropometry and body composition (by BIA validated against deuterium dilution technique) were also assessed.

TEE was lower in Mauritian children (by ~155 kcal/d) than that predicted using FAO/WHO/UNU equations for children of the same sex, age and body size. Furthermore, TEE, as well as PAL and step counts, also differed according to gender (lower in girls than in boys) and to ethnicity (lower in Indians than in Creoles) even after adjusting for differences in body weight and body composition. On average, Mauritian children fall in the category of countries or subpopulations of countries with low PAL values; this being particularly low in Mauritian Indian girls.

These results in Mauritian children provide the first dataset of objectively measured TEE, from which physical activity is estimated as PAL, and complemented by step counts measurements. They suggest potential gender and ethnic differences in TEE and physical activity that need consideration in developing strategies to counter sedentary behavior and obesity in this diabetes-prone population.

There is a large heterogeneity in the energy cost for posture maintenance during standing relative to sitting in healthy adults, with some showing little or no increase in energy expenditure (EE) varying between 0-5% (energy savers), while others show more substantial increases that vary between 5-25% (energy spenders). The aim of this study was to explore psychological factors that may influence such variability in human standing energetics.

EE was monitored min-by-min by indirect calorimetry in 25 healthy young adults during sitting and standing. The subjects were classified into three phenotypes on the basis of their EE during steady-state standing over 10 minutes relative to sitting, namely as savers (10% increase, n=10). These standing EE phenotypes were analysed with respect to psychological parameters, namely (i) the anxiety trait and anxiety state assessed subjectively (questionnaire) and objectively (salivary cortisol), and (ii) the desire/drive to move or to sit – assessed subjectively (questionnaire) and objectively (accelerometry) at end of study.

Compared to the general healthy population, all participants were in the reference norm of the anxiety scores. The three standing EE phenotypes did not differ in anxiety trait/state, salivary cortisol nor in the rise in heart rate during steady-state standing relative to sitting. They also did not differ in desire to move or sit, nor in accelerometry parameters (no. of steps/min; vector magnitude) at end of study.

The differential energy cost of standing posture maintenance among the energy savers and energy spenders cannot be explained by differences in subjective or objective measures of anxiety/stress or in the desire/drive to move or sit. Whether differences in cognitive load and mental processing during standing and/or personality trait play a significant role in such heterogeneity in standing energetics remain to be investigated.

28th Feb 2024

Introduction: Those employed in desk-based occupations sit for large amounts of their working day, often in long uninterrupted bouts, exposing them to the health risks associated with sedentary behaviour (SB). With more workplaces offering home-working options, it is important to explore how this environment influences SB. With the number of older workers (≥50) increasing, it is vital to promote healthy ageing in the workplace and ensure this population are not put at increased risk due to occupational sitting. This is especially important considering the increased risk of health conditions as we age. This study aims to use the Theoretical Domains Framework (TDF) alongside the Capability Opportunity Motivation Behaviour (COM-B) model to identify the barriers and enablers to interrupting and reducing SB in older employees (≥50) working from home in desk-based occupations. Targeting older employees in the homeworking environment is an understudied area of research.

Methods: Thirty participants aged ≥50 were invited to take part in one-to-one semi-structured Zoom interviews from a local council within Greater Manchester. Reflexive thematic analysis is being used to inductively develop themes and sub-themes which will be deductively mapped and linked to the COM-B and TDF.

Results: Final interviews are being conducted with data analysis to be completed by the conference where a specific presentation of main themes and sub-themes will be presented.

Conclusions: As working from home is now imbedded in many workplaces, it is critical to develop a better understanding of how this setting may influence SB in desk-based older workers. This will help inform the development of suitable interventions to reduce and interrupt SB to promote healthy ageing at work prior to retirement.

Support/Funding Source:
Dunhill Medical Trust, The NIHR, The University of Manchester

23rd Feb 2024

Introduction: Optimal time distribution between physical activity, sedentary behaviors, and sleep appears to be essential in obesity management strategies. However, the impact of reallocating time among these behaviors, collectively known as 24-hour movement behaviors, remains underexplored. This study examines the theoretical effects of reallocating time between 24-hour movement behaviors on obesity indicators across different age groups.
Methods: We performed a pooled data meta-analysis of 9,818 participants from 11 observational studies. To estimate the time spent in movement behaviors, we reprocessed and harmonized individual-level raw accelerometer-derived data. Mixed-model compositional regression and isotemporal substitution models estimated theoretical changes in body mass index (BMI) and waist circumference (WC) associated with time reallocation between moderate-to-vigorous physical activity (MVPA), light-intensity physical activity (LPA), sedentary behaviors, and sleep. We performed the analysis separately for children, adolescents, adults, and older adults, and adjusted all models for sex, age, and socioeconomic status.
Results: Significant changes in the obesity indicators were observed even with 10-minute reallocations and become more clinically relevant when 60 minutes were reallocated. The greatest increases in BMI and WC were found when MVPA was reallocated to other movement behaviors, while increasing MVPA was the best protection against obesity. The highest magnitude of the decrease in obesity indicators was observed when time spent in sedentary behavior was substituted with other behaviors. Reallocating time away from sleep and LPA showed several significant changes, but no consistent pattern was observed. Although most of the changes in BMI and WC appeared uniform across different age groups, there were some inconsistent results specifically in adolescents.
Conclusions: This investigation emphasizes the crucial role of MVPA in mitigating obesity risk across the lifespan. The findings also highlight the importance of substituting sedentary behavior with low-intensity movement behaviors, a lifestyle change that can be feasible and sustainable for many people, including those with severe obesity. Inconsistent findings in adolescents may indicate the need to design tailored lifestyle interventions in this age group.

31st Jan 2024

Introduction: This study analysed the associations between sleep duration, sedentary behaviour (SB), and physical activity (PA) in children and adolescents. Understanding these associations is crucial due to their impact on overall health and well-being and the potential to develop interventions that promote healthier habits. Methods: Participants were 1231 subjects aged 10 to 18 years. Sleep was measured with the Pittsburgh Sleep Quality Index (PSQI), PA was measured with the International Physical Activity Questionnaire (IPAQ), and SB was estimated through a questionnaire assessing daily time (h) spent on personal computers for study (PCS) and leisure (PCL), tablets, smartphones (SPH), social networks (SN), watching television (TV), total screen time (TST), and sitting (ST). Participants were categorized into two groups based on sleep duration: “less than 8 hours” and “more than 8 hours” per day. Mann-Whitney U test was used to compare differences between two independent groups and Logistic Regression was employed to predict the probability of an event occurring. SB (+2h, -2h) and PA (active, inactive) variables were recoded into binary variables. All statistical analyses were performed in SPSS with a significance level set at 5% (P<0.05). Results: Participants with less than 8h of sleep per day spent less time watching TV (p=0.034) but more time on PCL (p=0.02), smartphones (p<0.001), social networks (p<0.001), and higher TST (p<0.001). For logistic regression, the overall model was statistically significant when compared to the null model, X2(8)=40.792, p<0.001. Those spending more than 2h using PCL (OR=1.429, p=0.004), SPH (OR=1.427, p=0.024), and SN (OR=1.349, p=0.035) are more likely to sleep less than 8h. No associations were found for PA. Conclusions: These findings suggest that SB are associated with sleep hours. Recommendations for improving sleep habits might involve moderating these behaviours. The Portuguese Foundation for Science and Technology (FCT) supported this work under the project UIDB04045/2020.

Background: only 28.8% of preschoolers in worldwide meet World Health Organization´s recommendations for sleep time. While this low prevalence could be associated with screen time (ST), this relation between sleep duration with physical activity (PA) and sedentary behavior (SB) remains inconsistent, especially on week and weekend days. Aim: to describe preschoolers´ profiles of time accumulated in PA, SB, and ST among short and adequate sleepers’ preschoolers during week and weekend days. Methods: 148 Brazilian preschoolers (53.6±8.9 months) participated in the study (77 females). PA and SB were measured with accelerometry (Actigraph®, wGT3-X), hip protocol, during seven consecutive days. Sleep duration and ST were parent-reported in a face-to-face interview. Comparative analyses were developed to verify differences between bedtime and wake-up time, light PA (LPA), moderate PA (MPA), vigorous PA (VPA), and moderate to vigorous PA (MVPA), SB and ST of short and adequate sleepers, on weekdays and weekends. The t-test was used for unpaired samples (p<0.05). Results: on weekdays, adequate sleepers slept earlier than short sleepers (08:25:55pm vs. 09:53:20pm), and there was no difference regarding wake-up time, or on weekends. On weekdays, adequate sleepers accumulated more time in SB (3344.2±271.3min vs. 2241.5±243.8min; p<0.001, Cohen's d= -0.92), VPA ( 139.6±16min vs. 94.4±69.9min; p0.05). Conclusion: adequate sleepers go to bed earlier on weekdays. Also, they spent more time in vigorous and moderate to vigorous physical activity during the week.

Introduction: preschool is an environment of opportunities for child development through the provision of pedagogical, social, and structural tools that can facilitate or restrict the practice of physical activity (PA). This can happen through pedagogical aspects of teachers, such as a practice that encourages PA, as well as training teachers focused on planning and applying PA, and also through the availability of adequate physical structure. This study verified the association of the built (AC) and perceived (AP) environment of preschool, pedagogical aspects of teachers (PP), and moderate to vigorous physical activity (MVPA) of preschoolers. Methods: One hundred forty-one preschoolers (67 boys, 4.4 ± 0.7 years) were evaluated. MVPA was assessed by accelerometry. The AC was evaluated objectively through an audit. The AP and the teachers’ pedagogical aspects were evaluated by face-to-face interviews (EPAO – Environment Assessment and Policy Observation). The structural equation method was used through univariate multiple regression to analyse the associations of AC, AP PP, and MVPA of preschool children. Results: For AC: there were positive associations between the number of spaces for games (b = 0.35, p < 0.001) and the number of resources available (b = 0.23, p = 0.004) and negative associations between the school's aesthetics (b = – 0.22, p = 0.002) and children's MVPA. For AP: there were positive associations between teachers' perception of their classrooms (b = 0.50, p = 0.012) and greater quantities of portable structures for PA (b = 0.26, p = 0.029), with and negative associations between the number of physical structures for PA (b = – 0.21, p = 0.019), and children's MVPA. Conclusions: Preschool AC and AP are positively related to preschoolers' MVPA. Strategies to increase the time spent on AFMS within preschool must consider the environment and factors interrelated to the context.

Introduction: when recommendations of movement behaviours are analysed as an unique composition, the three movement behaviours predict preschoolers’ executive function (EF) more strongly than in isolation. However, until now, it is not well-known how adhering to the different recommendations in isolation (physical activity (PA), sleep, or screen time) or in combination (PA + sleep, PA + screen time, sleep + screen time, or PA + sleep + screen time), are associated with EF in preschoolers. This study identified the most critical variables in an association network between combined compliance with 24-hour movement behaviours recommendations and EF in low-income preschoolers. Methods: eighty-three children (50.6% boys; 53.5 months of age) were assessed for physical activity (PA) screen time, sleep duration, sex, age, and EF. The adherence to the various combinations of movement behaviours was used for the analyses, and network analysis was performed to determine the most critical variables. Results: from the emerging network, it was observed that the variable with the greatest Expected Influence was the combined adherence to PA + sleep recommendations (1.964). Conclusions: the most sensitive network variables were combined adherence to PA and sleep recommendations. These results suggest that future interventions to improve EF in preschoolers should consider promoting these healthy behaviors in their strategies.

Despite the publication of the World Health Organization (WHO) guidelines on movement behaviours (physical activity, sedentary behaviour, and sleep) for the Under 5s five years ago, there is limited evidence on compliance with the guidelines in a low-income Sub-Saharan African context. We examined the prevalence and correlates of meeting the total physical activity (TPA), sedentary behaviour, and sleep guidelines among 3- and 4-year-olds in Malawi.

Our study comprised 417 children (51.5% girls) aged 3-4 years from 24 urban and rural early childhood education and care (ECEC) centres in Malawi. Daily step-count was measured by hip-worn ActiGraph GT3X accelerometers, and children were classified as meeting the TPA guideline if they averaged at least 11,500 steps/day. Child’s restrained sitting, sedentary screentime, and sleep duration were reported by parents using a questionnaire. We determined the correlates of meeting the WHO guidelines using multivariable survey logistic regression.

On average, children reportedly slept for 11.2 hours/day (standard error [SE]=0.1) and accumulated 24,269 steps/day (SE=391). The prevalence of meeting the TPA, restrained sitting and sedentary screen time, and sleep duration guidelines were 98.4% (95% confidence interval [CI]=96.0–99.4), 90.9% (95% CI=84.2–94.9), 79.4% (95% CI=71.2–85.7), and 90.6% (95% CI=87.3–93.2), respectively. Nearly three-quarters met the combined guideline (70.5%; 95% CI: 62.4–77.4). Girls had significantly higher odds of meeting the restrained sitting guideline (adjusted OR=3.59; 95% CI=1.36–9.48; p=0.012). Additionally, children from urban settings had significantly lower odds of meeting the restrained sitting, sedentary screentime, and sleep duration guidelines. We did not identify any correlates for meeting the TPA guideline.

We found exceptionally high prevalence meeting the WHO 24-hour movement behaviour guidelines in our sample of young children from a low-income Sub-Saharan African context, which is suggestive of a population in a pre-physical activity transition. Meeting the guidelines was influenced by factors such as residential settings and sex.

Introduction: By 2030, 23% of Brazilian children aged 5-9 years are projected to be living with obesity. Childhood obesity leads to insufficient physical activity (PA), with recommendation being of a minimum of 60-min of daily moderate-to-vigorous PA (MVPA), assessable using accelerometers. A notable limitation of accelerometer-assessed MVPA lies in its dependence on cut-offs. Studies have proposed metrics to monitor PA independently of cut-offs: i) the average acceleration (ACC), ii) the intensity gradient – IG; and iii) the minimum acceleration of a portion of the day (MX). Although studies have demonstrated associations between ACC, IG, and MX metrics and health, these were predominantly focused on eutrophic children, leaving a gap in understanding of PA patterns in children with obesity. This study aims to describe ACC, IG, and MX and investigate associations between obesity-related outcomes in children with obesity. Methods: Fifty-one children with obesity (23 girls; mean age 9.3±1.6 years) participated in this investigation. Wrist-worn accelerometers (ActiGraph GT3X) were used for 7-days, and raw acceleration in milli-gravity (mg) was obtained to calculate ACC, IG, and MX metrics. Descriptive analyses were conducted, along with linear regressions to establish associations between ACC and IG with body mass index (BMI), the percentage of the 95th percentile (%BMIp95), percentage of body fat (%BF) assessed using bioimpedance, and waist-to-hip ratio (WHR). Children’s average ACC and IG was 37.4±10.9 mg and -2.19±0.16, respectively. Both M60 (179.7±79.9) and M120 (110.4±34.4) fell below what is considered MVPA. IG was negatively associated with BMI (b= -12.74; -22.42 – -3.06), %BMIp95 (b= -58.2; -103.22 – -13.17), %BF (b= -20.99; -36.69 – -5.28), WHR (b=-0.12; -0.21 – -0.03) in models adjusted for sex, age, and fat-free mass. When ACC was included in the model, no independent associations were demonstrated for ACC and IG. Conclusion: Children with obesity exhibit low levels of MX metrics. The IG may play a crucial role in improving BMI, %BMIp95, %BF, and WHR in children with obesity. Metrics indicating the most active periods suggest that young children living with obesity need to increase their most active portion of the day to meet current PA guidelines

Movement behaviours such as physical activity(PA), sedentary time(ST) and sleep (SL) are vital determinants for health. These health behaviours are likely to develop and form during early childhood. Across the research literature there is a dearth of data that explores young people’s movement behaviours considering ethnic and gender differences. The purpose of this research is to explore the levels of children’s accelerometer measured movement behaviours (physical activity, sleep and sedentary time) living in an ethnic diverse city.

Born in Bradford is a world leading birth cohort following the lives of 13,000 children from the ethnically diverse and economically deprived city of Bradford, UK. From 2017-2020, a sub-cohort of 2321 children, aged 7-10 years were invited and had parental consent to wear an Actilife triaxial accelerometer around their waist for 24 hours, 7 days a week. Accelerometers were fitted on children during school time. Evenson, Sadeh and Tudor-locke cut-points were applied to estimate average daily minutes moderate-to-vigorous physical activity (MVPA), ST, and SL. Simple descriptive statistics are presented here but inferential statistics will be presented at conference.

A total of 1508 (65%) children (51.5% of Pakistani heritage(PH), 30.2% White British(WB) had valid data (2 weekdays and 1 weekend) to estimate MVPA, ST and SL values.

For MVPA, the mean daily minutes and 95% confidence intervals (CI) were; ALL=60.5 95%CI[59.2, 61.7], Girls=53.1 95%CI[51.7, 54.6], Boys=68.3 95%CI[66.4, 70.2], PH=55.9 95%CI[54.3, 57.6], WB=67.6 95%CI[65.2, 70.0].

For ST, ALL=450.9 95%CI[447.8, 454.0], Girls=453.6 95%CI[449.3, 457.8], Boys=450.9 95%CI[447.8, 454.0], PH=457.1 95%CI[452.8, 461.4], WB=437.1 95%CI[431.4, 442.7].

For SL, ALL=506.9 95%CI[502.6, 511.3], Girls=511.9 95%CI[506.5, 517.7]. Boys=501.6 95%CI[495.3, 508.1], PH=502.9 95%CI[496.7, 509.3], WB=514.6 95%CI[505.6, 523.6].

Ethnic and gender differences were found in MVPA and ST values, but not in sleep. Further analysis is required to understand the complex relationship between movement behaviours, gender and ethnicity.

Introduction: Adolescence is a critical period in the which high fat accrual is associated with increased risk of overweight (OW) in adulthood. Adolescent fitness, a component of physical activity, also influences adult weight status. This study investigated longitudinally the links between adolescent fat accrual and fitness on subsequent adult fat mass. Methods: 76 adult males from the Saskatchewan Growth and Development Study (SGDS) (1964-2010), were assessed serially from 7-17 years of age and again at 40-50 years of age. A biological age (BA; years from peak height velocity (PHV=0)) was calculated. Skinfold measures were used to derive TBF (%) and trunk fat (Tfat, mm). OW was defined by age and sex specific %TBF cut-offs. A fitness score was calculated from measures of VO2max, strength and fitness performance. In adulthood, participants were put into tertiles using DXA derived percent total body fat (TBF) (G1≤20.6%; G2 >20.6%<27%; G3 ≥27%). ANOVA was used to find mean differences. Results: In adolescence, prior to PHV, all subjects were normal weight (NW); however, TBF in G3 was significantly higher than G1 and G2 from BA’s -4 to 0 (p 23.6; 100% in G2 and G3). Only G3 became OW before emerging adulthood. Adolescent TBF, Tfat and fitness score differed between groups (p<0.05). Tfat was significantly higher in G3 compared to G1 from BA’s -4 to +3 (p<0.05) and G1 and G2 had higher fitness scores (p<0.05). Conclusion: These findings suggest that 5 years around the attainment of PHV is a critical period for fat accrual and physical fitness development on adult weight status. Results also suggest that OW adults may be at heightened health risk due to concomitant gains in Tfat around PHV, even those classified as normal weight during adolescence.

Introduction: The diversity of the UK student population has increased dramatically in recent years. Whilst previous literature has identified differences in anthropometric outcomes between gender and ethnic groups, the extent to which these factors influence adverse cardiometabolic health outcomes in students is currently unclear. The present study therefore aimed to identify differences in the prevalence of adverse cardiometabolic health outcomes between gender and ethnic groups in UK university students.
Methods: Physiological testing was conducted across three years (2021-2023). Data from each year were combined to form a single cross-sectional dataset (n=1,299). Independent samples t-tests assessed differences between genders and one-way ANOVAs assessed differences between ethnic groups.
Results: Gender differences were present for all variables other than BMI and diastolic blood pressure (BP). The prevalence of overweight, obesity and hypertension were higher in males compared to females, whereas the prevalence of high waist circumference and high waist-to-hip ratio (WHR) was highest in females. The prevalence of poor glycaemic control was similar between males and females. Additionally, differences between ethnic groups were present for all variables other than hip circumference and diastolic BP (P<0.05). The prevalence of overweight, obesity, high waist circumference and impaired glycaemic control was highest in Black students, whereas the prevalence of high WHR and waist-to-height ratio (WHtR) was highest in Asian students. Finally, the prevalence of hypertension was highest in White students.
Conclusions: Overall, the results highlight differences in the prevalence of adverse cardiometabolic health outcomes in UK university students when separated by gender and ethnicity. These findings should be considered when developing strategies to promote healthy lifestyles in the context of higher education.

Background: Recently, the prevalence of adverse cardiometabolic health outcomes has increased in UK young adults. University students now make up a significant proportion of this population and their health-related behaviours are poorer than aged-matched normative data. Additionally, students experience negative changes in anthropometric outcomes during their university career, but the influence of university life on cardiometabolic health outcomes is currently unclear. This study aimed to determine the prevalence of adverse cardiometabolic health outcomes in undergraduate university students and assess differences between year groups. Methods: Data were collected across three years (2021-2023). Three independent cohorts of students’ (n=1,299) completed five physiological tests. One-way ANOVAs were used to assess differences between year groups. Results: 34.5% were classified as having overweight or obesity and 19.0% had a ‘high’ or ‘very high’ waist circumference. 11.0% had a high waist to hip ratio (WHR) while 25.5% had a high waist to height ratio (WHtR). 12.7% were classified as hypertensive and 3.3% had a [HbA1c] ≥42mmol/mol, indicating impaired glucose regulation. The prevalence of overweight/obesity, high waist circumference and hypertension was highest in 3rd year students whereas the prevalence of high WHR, WHtR and [HbA1c] was highest in 1st year students. Third years had higher diastolic blood pressure than 2nd years, and 1st years had higher HbA1c than 2nd and 3rd years (P<0.01). Conclusion: Overall, these results indicate that the proportion of students presenting with adverse outcomes of cardiometabolic health is greater than or comparable to age-matched normative data. These data provide an update on the prevalence of adverse cardiometabolic health outcomes in UK university students and demonstrate that differences exist between year groups. Further longitudinal data is required to assess changes across a typical undergraduate degree program.

Introduction: Movement behaviours (physical activity – PA, sedentary behaviour and sleep) have been associated with physical, cognitive, socio-emotional and motor outcomes in early childhood, a critical period for child development, which have repercussions on health during adult life. However, previous studies report that Brazilian 3-to-5 year old children are below the recommended levels for movement behaviours, and there is no evidence regarding toddlers compliance with the World Health Organization´s (WHO) guidelines. Thus, this study aimed to assess the compliance with the 24 h Movement behaviours in a sample of low-income Brazilian toddlers.
Methods: This cross-sectional study comprised 150 toddlers (75 girls) aged between 12-35 months. Participants wore accelerometers (Actigraph GT3X+) for 24 h over 7 consecutive days to assess physical activity. Parents reported children´s screen time, night sleep duration, and sociodemographic data. Nap time was registered by the research team. Toddlers were classified as compliant or non-compliant with the WHO movement behaviours guidelines: i) ≥180 minutes of PA; ii) 0 hour of sedentary screen time for those aged 1 year, and ≤1 hour for those aged 2 years; and iii) between 11 and 14 hours of good quality sleep, including naps, and percentage of compliance was calculated using SPSS ( 28.0). Results: For the general sample, none of the children complied with the screen time recommendation, 1% complied with sleep time, and less than 25%, independent of sex, complied with PA recommendations. Only 22% of children complied with all the three recommendations simultaneously. For boys and girls, movement behaviours compliance values were similar (20% and 24%, respectively). Conclusions: Very few Brazilian toddlers are compliant with the guidelines. Strategies and programs to promote compliance with movement behaviours guidelines should urgently consider toddlers, as a way to minimize the low compliance seen in preschoolers.

Numerous studies have shown that schoolchildren with low levels of adiposity and high levels of fitness have a lower risk of cardiorespiratory disease in later life. However, their effect on cognitive indicators is less clear. The aim of this study was to analyse the relationships between the profiles generated from fitness and fatness indicators and executive functions in secondary school students.

Methods: A total of 1158 secondary school students aged 11-16 years (M = 12.55; SD = 0.85) participated in the study. As fitness indicators, cardiorespiratory fitness (CRF) was estimated from the 20 m shuttle run, upper body strength by dynamometry and lower body strength by the standing long jump test. Fatness was assessed by waist circumference. Executive functions (i.e., inhibition, working memory, and cognitive flexibility) were evaluated with NIH Examiner software. Latent profile analysis was performed using MPLUS, which identified the 4-profile option as the most plausible solution.

Results: The 4-profile solution showed: 1) slightly low fitness and fat profile; 2) very high fat, low CRF and slightly low strength; 3) slightly high fat, high fitness; and 4) slightly low fat, high CRF and slightly high strength. Profiles 3 and 4 showed better inhibition and cognitive flexibility than profiles 1 and 2, whereas profile 4 showed better working memory than profiles 1 and 2 (p < 0.05).

Conclusion: The results of this study highlight the need to implement strategies to promote healthy lifestyles in school children, not only to improve health parameters, but also to improve cognitive skills for better academic performance.

Rationale: Creative Health is an innovative approach that acknowledges the positive impact of creativity, culture, and heritage on health and wellbeing. Activities encompass a diverse range, including crafts, music, dance, film, literature, visual and digital arts, and theatre, as well as natural-built or intangible heritage. This approach is grounded in the growing evidence supporting the beneficial effects of arts and creativity in managing health, enhancing wellbeing, and addressing health inequalities. Additionally, it helps alleviate pressures on health systems. Creative Health strategies have proven effective in various settings such as hospitals, palliative units, mental health programmes, and community-focused interventions. These approaches transcend the challenges of traditional treatment, addressing issues such as language barriers, social inequalities, and access to affordable care. However, for an effective integration of creative health into health systems, we need further research. This presentation highlights Creative Health initiatives in Portugal and Spain, where a multitude of programs are already underway. However, these initiatives frequently function in isolation, underscoring the need for a more cohesive and integrated approach.
Aim: To gather information on institutions, associations, and groups in Portugal and Spain that employ Creative Health principles to enhance the health and wellbeing of communities.
Methodology: We conducted an online search to identify Creative Health entities engaged with communities in Portugal and Spain. We compiled results from peer-reviewed papers to grey literature and informal reports. Subsequently, we distributed an online survey to map the characteristics of the relevant entities and assess the degree of integration with local health systems.
Summary: While there is evidence of a broad array of successful Creative Health initiatives in Portugal and Spain, further research is essential to fully map their spec

The practice of Physical Activity (PA) in childhood is related to a healthy cardiometabolic, physical and psychosocial profile and to better motor and cognitive development, especially in terms of executive function (EF). It is also important to note that 24-hour movement behaviours, including PA, sedentary time, and sleep time, are influenced by each other. It is therefore crucial to understand the effects of PA, sedentary time and sleep in Cognitive Development (CD), namely EF, including Inhibitory Control (IC), Working Memory (WM) and Cognitive Flexibility (CF) in children.The objective of the present study was to relate PA, sedentary time and sleep hours with EF of preschool children.
The sample consisted of 102 children (aged between 3 and 5 years) from the Gym4PETIZ program, 52% girls and 48% boys. PA (counts/minute) and Sedentary Time were measured using ActiGraph GT3X accelerometers and PA diary, and Sleep was evaluated only through the PA diary; EF was evaluated through the Early Years ToolBox.
The main results, when analyzed by simple linear regression, demonstrated that Sleep ((CI-β=-0.518; p=0.000; R2=0.269); (WM- β=-0.307; p=0.010; R2=0.094)) and sedentary time ((CI-β=-0.408; p=0.000; R2=0.167); (WM- β=-0.327; p=0.05; R2=0.107)) have a significant negative effect on 2 of the 3 EF domains, and no significant results were found between EF and PA.
These results agree with the literature, in which it is reported that more time spent in sedentary behavior and sleep is associated with negative indicators for children’s development, justifying the importance of studying these themes.
The 24-hour movement behaviours are influenced by each other, however, more studies involving higher sample densities and more detailed variables, for example the type of sedentary behaviour or the quality of sleep time, are needed to solidify these results.

Introduction: Daily access to opportunities for physical activity (PA) and limited sedentary behaviour (SB) are recommended for health benefits in children. However, it is necessary to understand the day-to-day variability and how children from different socioeconomic groups accumulate these behaviours. Methods: This cross-sectional study included children aged five to 11 years, attending 37 primary schools in Bradford, UK. 800 children wore accelerometers over seven consecutive days, and day-to-day variability was calculated for each participant using the coefficient of variation (calculated as [standard deviation/mean of SB/MVPA across seven measurement days]*100%). Higher coefficient of variation percentages indicates higher variability and therefore low regularity of day-to-day moderate-to-vigorous physical activity (MVPA) and SB. The analysis included comparisons across behavioural indicators and sex, school year, and ethnicity (p<0.05). Results: Lower average values for MVPA (59.9 min/day), higher variability (42.5% vs 33.8%), and higher average values for SB (397.6 min/day) were observed in girls. Conversely, boys showed higher variability for SB (14.3%). Significant differences in MVPA averages were identified among children in school years 1, 2, and 3 (ages 5, 6, and 7 years old), and children from higher school years had higher averages for SB (370.9, 384.4, and 411.1 min/day). Regarding ethnicity, South Asian children had lower MVPA average compared to White British children (63.0 vs. 69.9 min/day), higher variability (40.9% vs. 36.4%), and higher SB average compared to all groups (400.3 min/day). Conversely, SB variability of White British children was higher (14.3% vs. 13.5%). Conclusion: Average daily and variability in MVPA and SB differed across sex, school year, and ethnicity of primary school children, indicating that girls and South Asian children are less active and more sedentary, and have less stability in daily patterns of physical activity.

Rationale: Dementia is a health condition marked by progressive cognitive decline and disability. Some motor issues become common in advanced stages. Recent studies indicate that motor issues may also appear in early stages. Handwriting, a tool for studying fine motor control or executive functioning in both healthy and unhealthy populations, displays changes at different stages of dementia.
Aims: The study aimed to develop a handwriting assessment protocol to better characterize the handwriting characteristics of individuals with dementia. This protocol is designed to deepen understanding in this area, potentially aid in early detection, and help in planning interventions.
Methods: The participants, aged 50 and above, both with and without dementia, are being recruited in the Évora region, Portugal. Sources include outpatient consultations at the Neurology Service of Hospital do Espírito Santo, day care centers, and residential facilities for the elderly. Participants are asked to complete handwriting tasks using paper, pencil, and a digital platform, while wearing an EEG cap to measure brain activity. This research, led by the University of Évora, received ethical approval (GD/40835/2021).
Results: Data are still being collected. Preliminary findings will be presented at the conference.
Summary: The study’s focus on handwriting as a putative aid in dementia diagnosis represents an innovative approach that may be of help in understanding and managing this complex condition.

30th Jan 2024

The combination of movement behaviours (MB) that occur during waking hours (i.e. sedentary behaviour and physical activity) have been shown to relate to cardiometabolic health (CH) indicators. However, most research focuses on the relationship of individual behaviours, neglecting how different compositions of MB throughout the day associate with CH. The aim of this study was to explore the optimal time spent engaging in sedentary behaviour (SB), light physical activity (LPA), and moderate-to-vigorous physical activity (MVPA) for CH in children and adolescents.

The study used data from the International Children’s Accelerometry Database. Average time spent in SB, LPA and MVPA was measured using accelerometers. Nine CH indicators were assessed via blood samples (LDL and HDL, triglycerides, glucose, insulin), anthropometric measures (waist circumference, BMI), and automatic blood pressure monitors (systolic and diastolic), which were regressed against the time-use composition, adjusting for sex, age, fruit and vegetable intake, soft drink intake and household income. The models were used to estimate the optimal MB time-use composition associated with 5% best CH indicators (i.e. “Goldilocks Day”).

The compositional mean among all participants (n= 1,310; female= 55.9%; age= 11.1±2.5) consisted of 328 minutes SB, 383 minutes LPA and 47 minutes MVPA. Significant relationships were found between the MB time-use composition and all outcomes, excluding LDL cholesterol. For indicators of lipid and glucose metabolism, blood pressure and BMI, the Goldilocks Day consisted of less LPA and more MVPA, when compared to the overall compositional mean. For one indicator, HDL cholesterol, the Goldilocks Day consisted of more LPA and less MVPA.

Optimising time spent engaging in different MB can be an important way of preventing indicators related to increased risk of poorer CH. Public health guidance needs to take this into consideration when developing future recommendations.

29th Jan 2024

Introduction: Physical activity has many health benefits and is broken down into habitual physical activity and exercise (e.g., sport). The effects of (de)selection from adolescent sport is likely to influence sports participation and long-term physical activity. In 2014, a cohort of adolescent athletes taking part in team tryouts from a variety of youth sports (soccer, basketball, hockey, baseball, volleyball) was initiated. Initial findings indicated that growth and development influenced (de)selection but not short-term (36-months) sports participation. The aim of the present study was to determine if (de)selection effected sports participation in emerging adulthood. Methods: Between 2014 and 2015, 870 participants were recruited across three different age categories (U14, U16, U18). In 2023, all original participants were contacted via email. Those who responded were asked to complete a Sports Participation and Activities questionnaire. Chi-square goodness of fit test was used to analyze the data. Results: 140 participants (56 females and 84 males) respond to the follow-up survey, 16% of the initial sample. It was found that the percentage of participants, by sport, sex and (de)selection at 84-month follow-up were similar to study initiation, and no differences in baseline growth and maturational indices (p>0.05) were found. Of the females, 38% who had been selected at tryouts and 32% who had been deselected, were still participating in sport. A similar result was found in males, 35% who were selected were still participating compared to 37% who were deselected. Deselection did affect long-term sports participation in the same sport (p<0.05). Conclusion: The results suggest that (de)selection effected 30% of the athlete’s sports participation in emerging adulthood. Deselection effected long-term sports participation in the same sport. Overall, adolescence (de)selection did not appear to be a major influence of sport/physical activity in emerging adulthood.

28th Jan 2024

Introdução: Para obter benefícios ótimos para a saúde, as diretrizes canadenses de movimento de 24 horas para crianças e jovens (de 5 a 17 anos) recomendam alcançar altos níveis de atividade física (≥60 minutos de atividade física moderada a vigorosa), reduzir o comportamento sedentário (≤2 horas de tempo de tela recreativa) e garantir sono adequado (9-11 horas para crianças ou 8-10 horas para adolescentes) todos os dias. Objetivo: Examinar como as combinações de atividade física, tempo sedentário e duração do sono estão relacionadas aos parâmetros cognitivos e desempenho acadêmico em escolares. Metodologia: Foi realizada uma revisão sistemática seguindo as diretrizes PRISMA, utilizando as bases de dados PubMed, Web of Science, Scopus, ScienceDirect, SPORTDiscus, Embase e Bireme. A pesquisa foi restrita a estudos transversais ou observacionais que avaliaram a associação entre o cumprimento das recomendações de movimento de 24 horas e os parâmetros cognitivos e desempenho acadêmico em escolares. Resultados: A estratégia de pesquisa resultou em um total de 1225 artigos. Além disso, uma busca manual adicional foi realizada, adicionando 9 artigos, resultando em um total de 1234 estudos. Posteriormente, critérios rigorosos de inclusão e exclusão previamente estabelecidos foram aplicados e, finalmente, 10 artigos científicos que atendiam a esses critérios foram selecionados para inclusão na revisão sistemática.
Conclusão: Os resultados dos estudos incluídos sugerem que cumprir os três componentes das recomendações de movimento de 24 horas está positivamente associado a parâmetros cognitivos e desempenho acadêmico. No entanto, a heterogeneidade das medidas utilizadas, principalmente autorrelato, pode dificultar a interpretação adequada dos resultados. Portanto, é necessário apoiar essas descobertas com futuras pesquisas que utilizem métodos de avaliação direta, principalmente para níveis de atividade física, duração do sono e parâmetros cognitivos.

27th Jan 2024

The global population of adults aged 60+ has increased rapidly over the past decades. This calls for more research concerning non-pharmacological and therapeutic interventions designed to forestall cognitive and functional declines, as well as enhance rehabilitation strategies. As individuals age, changes occur in the brain and body, impacting motor coordination, memory, and planning; often linked to functional impairments, and decline in independence and quality of life.
Aims: We piloted two aquatic programs Aquafast and Aquamentia©— tailored for the elderly population with the overarching goal of enhancing functional, physical, and cognitive capabilities. Additionally, both programs strive to increase levels of participants’ satisfaction. Methods: Programs’ implementation took place in an indoor-heated swimming pool. Participants were from the Évora region, led by researchers from the University of Évora and ethical approval was granted (Aquafast – GD/40835/2021; Aquamentia© – GD50000/2022). Aquafast employs high-intensity interval training (HIIT) methods alternating 30-second bursts of activity and 30-seconds of rest in 40-minute sessions. Aquamentia© comprises 12-weekly sessions of 45 minutes each (10-minute general activation, 20 minutes of aquatic cognitive and physical challenges, and 15-minute relaxation). Participants in Aquafast were 32 females and 7 males (70.1 ± 5.6 years), while Aquamentia© involved 8 females (70.6 ± 4.6 years) from the community and 3 institutionalized participants (2 females, 1 male) with an average age of 84.0 ± 6.6 years. Results: Preliminary findings indicate lower levels of satisfaction among Aquafast participants. Aquamentia© participants exhibited modest improvements in functional independence and aquatic competence. However, the sample sizes are too small to draw statistically significant inferences. Both programs demonstrate promising potential in preventing functional and cognitive motor decline among participants.

26th Jan 2024

Introduction: Physical inactivity is prevalent in childhood. Given that children spend a significant amount of time at school, this environment provides an ideal context to promote physical activity. In this sense, an emerging and current trend is active breaks (ABs) at school. The present study aimed to evaluate the effect of the ABs program “Activa-Mente”, on physical activity level (PAL), aerobic capacity (AC) and working memory (WM) in schoolchildren. Method: Experimental study, 53 participants (11-12 years old) were randomly divided into experimental group (EG, n=25) and control group (CG, n=28). For 6 weeks, the EG performed 6 daily ABs during the school day while CG did not performed ABs. The PAL was measured with accelerometers (Actigraph WGT3X-BT), AC with 6 Minute Test, and WM with Wechsler Intelligence Scale for Children-V. Statistical analysis was carried out with ANOVA for PAL and ANOVA repeated-measure 2 × 2 (pre and post-test) by AC and WM. The effect size (ES) was calculated using Cohen’s d test. Jamovi 2.3 Software. Results: PAL showed significant differences in sedentary time (minutes) (EG= 230.117.2; CG= 253.611.3; p= .001; d= -1.58), low (EG= 36.611.6; CG= 26.37.7; p= .002; d= 1.04), moderate (GE= 8.72.9; CG= 6.22, 1; p= .002; d=1.05), vigorous (EG= 14.84.8; CG= 4.82.3; p= .001; d=2.64). Regarding AC, a significant time x group interaction is observed with a large effect size (F = 34.27, p= .001, d=1.24). The results regarding WM do not indicate a significant interaction of time x group (F = 1.056, p = 0.309). Conclusion: The “Activa-Mente” program demonstrated a significant enhancement in both PAL and AC among the EG, in contrast to the CG. Nevertheless, it did not yield significant effects on WM. These findings suggest that the program could as a viable alternative for implementation in a school setting, regarding PAL and AC.

Introduction: Several studies have reported significant improvements in cardiorespiratory fitness (CRF) in children with high-intensity exercise. However, most research protocols focus on cycling and running. These protocols are not applicable for practical purposes in children. The aim of the study was assess the effect of an 11-week intervention using games protocols of two different intensities (high-intensity games and moderate-intensity games) on CRF in children. Method: Quasi-experimental design, participated 48 schoolchildren aged between 9 to 10 years (9.48 ± 0.5 years). Children were randomized into two groups: high-intensity games (HIG) and moderate-intensity games (MIG). HIG group used relays race and small- sided games; >75% of maximum heart rate (HRmax). MIG group used cooperative and dynamics continued games; 60% – 74% HRmax. Both groups had two sessions per week for 11 weeks during physical education (PE) classes. Before and after the interventions, participants measured with the CRF test (20-meter shuttle run test). Repeated-measure analysis 2 × 2 was used to determine the main effects and the interaction effects between groups over time (pre and post-test) and the effect size (ES) was calculated using Cohen’s d test. Results: Significant time × group interaction was observed for CRF with a moderate ES (F = 4.879, P = 0.032; ES = 0.6), between HIG and MIG, therefore, the HIG protocol significantly increased the CRF. Conclusion: This study demonstrates that an 11-week HIG program, applied during PE classes, is more effective than MIG in the improvement of the CRF in children.

17th Jan 2024

Introduction: 5-years personal qualitative research project Mira Active System. Engineer facing need to improve my vision refraction problems, health, and quality of life. Aim to understand the influence of vision’s habits.
Method: Engineering project, interdisciplinary, dealing with mechanism of vision, optics, and connection with body systems and health association. Working with optical models of ocular globe and anatomic models of the body.
Project relationship: habits with near vision, stressful cerebral activity, and direct sunlight through vision efforts and time are accumulating body stress and interfering with body systems.
Monitoring of my physical activity 2-year period, walking outdoors every day with an ‘active system vision’, accessing through vision to the active system of ANS, releasing body stress and balancing body systems. Measuring activity (20.937.955 steps) and making notes of stresses perceived.
Results: Monitoring result matches perfectly with my improvements in vision, health, and well-being. Recommending this practice to start to correct and improve our health situation and monitoring to keep track of improvements.
Helping to explain how sedentary behaviour indoors through a ‘passive system vision’ is damaging health with risk and diseases. On the other hand, how with physical activity outdoors with an ‘active system vision’ we can revert situation obtaining benefits in health and disease prevention.
Access to active system through vision allows to start to improve the quality of rest and sleep, improving night recovery of mind and body.
Conclusion: Following initiative, improvement in management of habits and light, improving ANS and body systems, accumulated body stress, mental stressful cerebral activity, weight management, and rest and sleep. To start to achieve all the health benefits.
Regarding people less active, with chronic conditions and mental health this initiative will start to fill in the gaps and make the difference.

21st Dec 2023

Introduction: Despite the importance of movement behaviours (physical activity, sedentary behaviour, sleep) to young children’s health and development, no tools with appropriate content validity currently exist that capture these three behaviours concurrently. We aimed to co-design, and assess the content validity of, a novel tool (MoveMEY) designed to capture movement behaviours of UK preschool children (aged 3-4 years). Methods: Four distinct steps were followed: (1) Pre-existing proxy measurement tools (questionnaires and diaries) were identified through extensive literature searching to inform creation of the novel tool. (2) Focus group discussions were conducted with caregivers of preschoolers (n=11), and (3) topic relevant researchers completed qualitative surveys (n=6) to co-design MoveMEY. (4) Content validity of MoveMEY was assessed through interviews with parents of preschoolers (n=12) following piloting of the tool. Qualitative data were analysed through thematic analysis. Results: The initial version of MoveMEY was based on the format of an existing questionnaire and by mapping the content of questions to the 24-hour movement behaviour guidelines. Co-design of MoveMEY resulted in changes to the format (e.g. short questionnaire to seven-day diary) and content (e.g. inclusion of ‘general information’ questions, screen time before bed). Content validity assessment demonstrated that MoveMEY was relevant and comprehensively assessed children’s movement behaviours. MoveMEY was understandable, with minor parental suggestions implemented to finalise and improve the tool. Conclusions: MoveMEY is the first co-designed measurement tool that has relevance for assessing whether preschoolers achieve movement behaviour guidelines. Caregiver and topic relevant researcher involvement throughout the development process resulted in a seven-day daily reported diary that comprehensively assesses pre-schoolers movement behaviours and is understandable to caregivers.

Introduction: Inconsistencies in estimated levels of physical activity (PA) and sedentary time (ST) in young children have partly been attributed to the measurement of the behaviours, including the various cut-points applied when processing accelerometer data. This systematic review and meta-analysis aimed to compare estimated levels of PA and ST of young children (3-5 years) based on various age-specific accelerometer cut-points. Methods: A systematic review was conducted to identify studies assessing accelerometer estimated levels of PA (light PA [LPA], moderate-to-vigorous PA [MVPA]) or ST using multiple accelerometer cut-points in a sample of preschool-aged children. Data were extracted and risk of bias assessed for all included studies. Random effects meta-analysis was used to estimate pooled effects for unique combinations of accelerometer cut-points for each movement behaviour outcome. Results: Twenty-four studies, reporting on 18 unique samples, were included. Results demonstrated substantial variability in estimates of PA and ST across different cut-points. Of the 17 assessed cut-points, few showed similarity on estimates of the behaviours; Evenson (2008) and Pate (2006) were most similar for the assessment of ST and LPA. Pate (2006) cut-points consistently demonstrated the highest levels of MVPA. Conclusions: This review illustrates the limitations of having numerous accelerometer cut-points to determine PA and ST of young children, highlighting the substantial differences in estimates produced. Whilst similar estimates were identified based on a few cut-points; accelerometer cut-points were generally not comparable. This has implications for movement behaviour research, which impacts policy and recommendations. Research identifying an optimal approach to estimating movement behaviour outcomes in young children is required, while considering congruence with past and future research.

17th Dec 2023

Introduction: During childhood cancer treatment, physical activity (PA) levels of the child and their family can decline. Maintaining PA during treatment has treatment-specific benefits for the child and can improve the physical and mental health of all family members. During treatment, PA is not prioritised, and the barriers are difficult to overcome. Whole family engagement in PA could facilitate behaviour change. This study aimed to use the Behaviour Change Wheel (BCW) to design an intervention to improve the PA levels of the whole family during childhood cancer treatment using evidence from families of childhood cancer survivors. Methods: Development followed three stages. First, to understand the behaviour, qualitative research methods were utilised to explore barriers, facilitators, and experiences of PA during treatment for the family. Transcripts of three family focus groups and 18 semi-structured interviews with parents were analysed and coded using the Capabilities, Opportunities and Motivation Behaviours (COM-B) model. Second, intervention options were identified using the BCW. Third, implementation options via suitable behaviour change techniques (BCT) and modes of delivery were identified.
Results: The Active Living for Families intervention (ALFIE) was developed to target PA for the whole family of childhood cancer patients during treatment. This flexible, family-based intervention is comprised of eight components including education sessions, goal setting and prompts. Using the BCW framework, this multi-component intervention targets six intervention functions including education,
training, and environmental restructuring, and 19 BCTs including goal setting and adding objects to the environment. Conclusions: The application of the BCW allowed for systematic, theory-driven development and design of the intervention to target physical activity for families during a child’s treatment for cancer. The feasibility of this intervention will be examined.

Introduction: During childhood cancer treatment, there are many pressures on the family unit detrimentally impacting the time spent together. Free (leisure)-time physical activities are fun, non-competitive, increase physical ability self-efficacy, and, during a child’s cancer treatment, are more accessible for all. The aim of this study was to engage the whole family to hear their experiences of family free-time activities, pre and post their child’s cancer diagnosis, whilst on treatment.
Methods: Individual focus groups with three families of childhood cancer survivors were conducted using participatory methods, including a write-draw-show-tell activity and vignettes, to explore experiences of and suggestions for family-based activities pre and post-diagnosis. Focus groups were recorded, transcribed, and analysed inductively using reflexive thematic analysis.
Results: At all times, key barriers for family-based, free-time activities were weather, emotions, and illness. Enabling factors were play, involving others (friends, family, and animals), and visiting new places especially on holidays. During treatment, themes for family activities were disruptions to family life, the importance of family time, and the centrality of hospital in their now, medicalised lives. Sub-themes that flow though these themes are nature, modifying activities, maintaining ‘normality’, isolation and enforced separation.
Conclusions: The themes highlighted two contrasting experiences for families which represented: a) isolation and enforced separation, b) enhancing family connections during time together when the child is well enough, or the activity was modified. Hearing children’s voices alongside those of their parents through inclusive child-centred methodologies has facilitated the deeper exploration of family-based, leisure-time activities during treatment to inform intervention development to meet the needs of the whole family.

14th Dec 2023

Introduction: During childhood cancer treatment, there is a detrimental impact on physical activity (PA) and increased sedentary behaviour not only for the child but also for all family members. Participating in family-based PA would help maintain a child’s fitness during treatment, this is preferable to recovering deficits post-treatment. This study aimed to explore parents’ perceptions of barriers and facilitators for family-based PA during a child’s cancer treatment.
Methods: Semi-structured interviews (n =18) with parents of children who have received treatment explored barriers and facilitators to PA. Parents were eligible if their child was initially diagnosed: 1) between the ages of 3 and 16 years old; 2) over three months ago and it was no more than five years since treatment completion. Interviews were transcribed and inductively analysed using reflexive thematic analysis.
Results: Parents’ perceived barriers and facilitators to their family being physically active were organised into themes: a) initial impact of treatment, b) psychological repercussions from treatment, c) social and interpersonal connections, and d) life out and about. Key subthemes were a) the child’s health and knowledge surrounding treatment side-effects, b) competing demands and c) maintaining stability within the household. Providing support for families and equipping parents with knowledge whilst using the family unit to support PA were key facilitators to PA.
Conclusions: This study identified barriers and facilitators to family-based PA from the parents’ perspective. The connections within the family are key facilitators of PA for all family members. Future research should develop interventions to address barriers such as knowledge of treatment side-effects and time spent in the hospital to promote PA in families when a child is undergoing cancer treatment.

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