Browsing by Subject "YOUTH"

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  • Tornivuori, Anna; Tuominen, Outi; Salantera, Sanna; Kosola, Silja (2020)
    Aims To define digital health services that have been studied among chronically ill adolescents and to describe e-health coaching elements that may have an impact on transition outcomes. Design Systematic review without meta-analysis. Data sources MEDLINE (Ovid), Pub Med, Scopus and CINAHL on 28 May 2018. Review methods Peer-reviewed articles published between January 2008-May 2018 were reviewed following the Cochrane Handbook for Systematic Reviews of Interventions and reported according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses statement. Results Twelve randomized controlled trials were included. The interventions varied significantly in duration and content. E-coaching that included human and social support showed positive impact on transition outcomes. Digital health services incorporated into usual care provide efficient and accessible care. Conclusion E-coaching elements enable tailoring and personalization and present a tool for supporting and motivating chronically ill adolescents during transition of care. Future research should evaluate the effectiveness of e-coaching elements. Impact Digital services are considered a means for increasing adolescents' motivation for self-care and for increasing their accessibility to health care. The coaching elements in digital services consist of a theoretical basis, human support, interactive means and social support. Included interventions varied in terms of duration, dose, content and design. Our results may serve the development of digital health services for adolescents in transition. E-coaching can be used to engage and motivate chronically ill adolescents to improve health behaviour and self-management during transition of care.
  • Dumuid, Dorothea; Stanford, Tyman E.; Pedisic, Zeljko; Maher, Carol; Lewis, Lucy K.; Martin-Fernandez, Josep-Antoni; Katzmarzyk, Peter T.; Chaput, Jean-Philippe; Fogelholm, Mikael; Standage, Martyn; Tremblay, Mark S.; Olds, Timothy (2018)
    Background: Daily activity data are by nature compositional data. Accordingly, they occupy a specific geometry with unique properties that is different to standard Euclidean geometry. This study aimed to estimate the difference in adiposity associated with isotemporal reallocation between daily activity behaviours, and to compare the findings from compositional isotemporal subsitution to those obtained from traditional isotemporal substitution. Methods: We estimated the differences in adiposity (body fat%) associated with reallocating fixed durations of time (isotemporal substitution) between accelerometer-measured daily activity behaviours (sleep, sedentary time and light and moderate-to-vigorous physical activity (MVPA)) among 1728 children aged 9-11 years from Australia, Canada, Finland and the UK (International Study of Childhood Obesity, Lifestyle and the Environment, 2011-2013).We generated estimates from compositional isotemporal substitution models and traditional non-compositional isotemporal substitution models. Results: Both compositional and traditional models estimated a positive (unfavourable) difference in body fat% when time was reallocated from MVPA to any other behaviour. Unlike traditional models, compositional models found the differences in estimated adiposity (1) were not necessarily symmetrical when an activity was being displaced, or displacing another (2) were not linearly related to the durations of time reallocated, and (3) varied depending on the starting composition. Conclusion: The compositional isotemporal model caters for the constrained and therefore relative nature of activity behaviour data and enables all daily behaviours to be included in a single statistical model. The traditional model treats data as real variables, thus the constrained nature of time is not accounted for, nor reflected in the findings. Findings from compositional isotemporal substitution support the importance of MVPA to children's health, and suggest that while interventions to increase MVPA may be of benefit, attention should be directed towards strategies to avoid decline in MVPA levels, particularly among already inactive children. Future applications of the compositional model can extend from pair-wise reallocations to other configurations of time-reallocation, for example, increasing MVPA at the expense of multiple other behaviours.
  • Abdulhamed, Rekar; Lonka, Kirsti; Hietajärvi, Lauri; Ikonen, Riikka; Klemetti, Reija (2022)
    The focus in the present study is on how experienced discrimination, being able to discuss personal matters with parents, and having someone to discuss personal worries with relate to symptoms of depression and generalized anxiety among first-and second-generation immigrant background adolescents (aged 14-15) living in Finland. The data used was collected for the National School Health Promotion Study (2017) conducted by The Finnish Institute for Health and Welfare (N = 73,690). Mental health was assessed on the PHQ-2 (depression) and GAD-7 (generalized anxiety disorder) scales. The findings indicated that first-generation adolescents from immigrant families were significantly more likely than their second-generation counterparts to report mental-health symptoms, and they also provided worse scores on all measures examined. It was alarming that 42 per cent of the first-generation immigrant group reported that they could not discuss their personal worries with anyone, and more than one-fifth of these youth hardly ever talked about personal matters with their parents. Experienced discrimination was a slightly stronger predictor of generalized anxiety than depressive symptoms and it predicted both symptoms of depression and anxiety more prominently among first-generation immigrant adolescents compared with their second-generation counterparts. Being able to discuss personal matters with parents functioned as a protective factor with similar predictor values in both groups, whereas the possibility of having someone with whom to discuss personal worries was significantly associated to lower levels of anxiety only among first-generation immigrant adolescents.
  • Mataix-Cols, David; Virtanen, Suvi; Sidorchuk, Anna; Fernandez de la Cruz, Lorena; Larsson, Henrik; Lichtenstein, Paul; Latvala, Antti (2022)
    IMPORTANCE Tic disorders are associated with multiple social adversities, but little is known about the experience of violent assault (including sexual assault) and criminality in this group. OBJECTIVE To establish if Tourette syndrome (TS) and chronic tic disorder (CTD) are associated with an increased risk of experiencing violent assault and criminal convictions. DESIGN, SETTING, AND PARTICIPANTS In this cohort study, all individuals living in Sweden at any time between January 1, 1973, and December 31, 2013, were identified from Swedish nationwide health and administrative registers. Cox proportional hazards regression models were used to estimate the risk of violent assault and criminal convictions among people with TS or CTD, compared with the general population and unaffected full siblings. Data analyses were conducted between September 1 and October 22, 2021. EXPOSURES The Swedish version of the International Classification of Diseases, Eighth Revision ( ICD-8 ), ICD-9 , and ICD-10 diagnoses of TS or CTD in the Swedish National Patient Register. MAIN OUTCOMES AND MEASURES Records of sexual and nonsexual violent assault and death due to violent assaults were obtained from the National Patient Register and the Cause of Death Register, respectively. Convictions for violent and nonviolent criminal offenses were obtained from the Crime Register. Covariates included sex and birth year. RESULTS The study cohort included 13 819 284 individuals living in Sweden between 1973 and 2013. A total of 7791 individuals with TS or CTD were identified (median [IQR] age at first diagnosis, 13.4 [10.0-21.8] years; 5944 [76%] male). Compared with unaffected individuals from the general population, people with TS or CTD had a 2-fold increased risk of experiencing any violent assault (sexual and nonsexual) (adjusted hazard ratio [aHR], 2.21; 95% CI, 2.00-2.43), a 3-fold increased risk of violent convictions (aHR, 3.13; 95% CI, 2.92-3.36), and a 1.6-fold increased risk of nonviolent crime convictions (aHR, 1.62; 95% CI, 1.54-1.71). Among people with TS or CTD, 37.0% (114 of 308; 95% CI, 31.6%-42.4%) of individuals who had experienced violent assault also had a violent crime conviction, compared with 17.9% (16 067 of 89 920; 95% CI, 17.6%-18.1%) in the general population. Exclusion of individuals with attention-deficit/hyperactivity disorder and substance use disorders partially attenuated the associations. Similarly, within-sibling models attenuated but did not eliminate the associations (any violent assault: aHR, 1.32; 95% CI, 1.08-1.61; violent crime: aHR, 2.23; 95% CI, 1.86-2.67; nonviolent crime: aHR, 1.34; 95% CI, 1.20-1.50). CONCLUSIONS AND RELEVANCE Results of this cohort study suggest that most individuals with TS or CTD are not assaulted nor are perpetrators of crime. However, individuals with TS or CTD diagnosed in specialist settings were more likely to both experience violent assault and be perpetrators of violence compared with the general population. The risk was highest in individuals with comorbid attention-deficit/hyperactivity disorder and substance use disorders. The increased risk found in specialty clinics will need to be better understood in the general population.
  • Haapala, Eero A.; Gao, Ying; Lintu, Niina; Väistö, Juuso; Vanhala, Anssi; Tompuri, Tuomo; Lakka, Timo A.; Finni, Taija (2021)
    We investigated the associations of motor competence (MC) with peak oxygen uptake (V.O-2peak), peak power output (W-max), and body fat percentage (BF%) and whether measures of cardiorespiratory fitness (CRF) modify the associations between MC and BF%. Altogether, 35 children (aged 7-11 years) in the CHIPASE Study and 297 in PANIC Study (aged 9-11 years) participated in the study. MC was assessed using KTK and modified Eurofit tests. V.O-2peak and W-max were measured by maximal exercise test on a cycle ergometer and scaled by lean mass (LM) or body mass (BM). BF% was assessed either by bioimpedance (CHIPASE) or DXA (PANIC). MC was not associated with V.O-2peak/LM (standardized regression coefficient beta = 0.073-0.188, P > .083). V.O-2peak/BM and W-max/LM and BM were positively associated with MC (beta = 0.158-0.610, P < .05). MC ( = -0.186 to -0.665, P < .01), but not V.O-2peak/LM ( = -0.169-0.035, P > .381), was inversely associated with BF%. Furthermore, the associations of MC with BF% were not modified by CRF. These results suggest that the positive associations between MC and CRF scaled by BM are a function of adiposity and not peak aerobic power and that CRF is not modifying factor in the associations of MC and BF%.
  • Chen, Bozhi; Bernard, Jonathan Y.; Padmapriya, Natarajan; Ning, Yilin; Cai, Shirong; Lanca, Carla; Tan, Kok Hian; Yap, Fabian; Chong, Yap-Seng; Shek, Lynette; Godfrey, Keith M.; Saw, Seang Mei; Chan, Shiao-Yng; Eriksson, Johan G.; Tan, Chuen Seng; Muller-Riemenschneider, Falk (2020)
    Background Screen viewing is a sedentary behaviour reported to interfere with sleep and physical activity. However, few longitudinal studies have assessed such associations in children of preschool age (0-6 years) and none have accounted for the compositional nature of these behaviours. We aimed to investigate the associations between total and device-specific screen viewing time at age 2-3 years and accelerometer-measured 24 h movement behaviours, including sleep, sedentary behaviour, light physical activity, and moderate-to-vigorous physical activity (MVPA) at age 5.5 years. Methods The Growing Up in Singapore Towards healthy Outcomes (GUSTO) study is an ongoing longitudinal birth cohort study in Singapore, which began in June 2009. We recruited pregnant women during their first ultrasound scan visit at two major public maternity units in Singapore. At clinic visits done at age 2-3 years, we collected parent-reported information about children's daily total and device-specific screen viewing time (television, handheld devices, and computers). At 5.5 years, children's movement behaviours for 7 consecutive days were measured using wrist-worn accelerometers. We assessed the associations between screen viewing time and movement behaviours (sedentary behaviour, light physical activity, MVPA, and sleep) using Dirichlet regression, which accounts for the compositional nature of such behaviours. This study is active but not recruiting and is registered with, NCT01174875. Findings Between June 1, 2009, and Oct 12, 2010, 1247 pregnant women enrolled and 1171 singleton births were enrolled. 987 children had parent-reported screen data at either 2 or 3 years, of whom 840 attended the clinic visit at age 5.5 years, and 577 wore an accelerometer. 552 children had at least 3 days of accelerometer data and were included in the analysis. Total screen viewing time at age 2-3 years had a significant negative association with sleep (p=0.008), light physical activity (p= 3 h screen viewing time]), and less light physical activity (384.6 vs 356.2 mins per day), and MVPA (76.2 vs 63.4 mins per day) at age 5.5 years. No significant differences in time spent sleeping were observed between the groups (539.5 vs 540.4 mins per day). Similar trends were observed for television viewing and handheld device viewing. Interpretation Longer screen viewing time in children aged 2-3 years was associated with more time spent engaged in sedentary behaviour and shorter time engaged in light physical activity and MVPA in later childhood. Our findings indicate that screen viewing might displace physical activity during early childhood, and suggest that reducing screen viewing time in early childhood might promote healthier behaviours and associated outcomes later in life. Copyright (C) 2020 Elsevier Ltd. All rights reserved.
  • Finnish Diabet Nephropathy Study; Ahola, A. J.; Harjutsalo, V.; Forsblom, C.; Saraheimo, M.; Groop, P. -H. (2019)
    Aims To study the association between dietary intake and glycaemia in Type 1 diabetes. Methods Data on energy and nutrient intakes, and the mean and coefficient of variation of self-monitored blood glucose measurements were obtained from records completed by 1000 adults with Type 1 diabetes. Associations between these measures of glycaemia and dietary intake were investigated using generalized linear regression, with and without macronutrient substitution. Results In the first set of analyses, fibre intake was associated with lower mean self-monitored blood glucose values (beta = -0.428, 95% CI -0.624 to -0.231; P
  • Slotte, Sari; Kukkonen-Harjula, Katriina; Rinne, Marjo; Valtonen, Juha; Rintala, Pauli (2022)
    Purpose: To examine the associations between muscular fitness (MF) and body composition. Method: MF was assessed with three tests of FitnessGram test battery. Total body fat percentage (BF%), abdominal fat percentage (AF%) and fat-free mass (FFM) were measured by dual-energy X-ray absorptiometry (DXA). The IOTF body mass index (BMI) cut-offs were used to define healthy weight, overweight, and obesity. Results: MF was inversely associated with BF% and AF%. The children in the moderate and high MF groups had significantly lower BF% and AF% compared with the children in the low MF group within the same BMI category. After adjusting for cardiorespiratory fitness (CRF), BMI and sex, the differences between the MF groups were significant for BF% but not for AF%. Conclusion: There were significant inverse associations between MF and DXA -measured adiposity. Within the same BMI category, total and abdominal adiposity were lower in children with moderate or high MF than in children with low MF.
  • Sullivan, Samaah M.; Broyles, Stephanie T.; Barreira, Tiago V.; Chaput, Jean-Philippe; Fogelholm, Mikael; Hu, Gang; Kuriyan, Rebecca; Kurpad, Anura; Lambert, Estelle V.; Maher, Carol; Maia, Jose; Matsudo, Victor; Olds, Tim; Onywera, Vincent; Sarmiento, Olga L.; Standage, Martyn; Tremblay, Mark S.; Tudor-Locke, Catrine; Zhao, Pei; Katzmarzyk, Peter T.; ISCOLE Res Grp (2017)
    We investigated whether associations of neighborhood social environment attributes and physical activity differed among 12 countries and levels of economic development using World Bank classification (low/lower-middle-, upper-middle- and high- income countries) among 9-11 year old children (N=6161) from the International Study of Childhood Obesity, Lifestyle, and the Environment (ISCOLE). Collective efficacy and perceived crime were obtained via parental/guardian report. Moderate-to-vigorous physical activity (MVPA) was assessed with waist-worn Actigraph accelerometers. Neighborhood environment by country interactions were tested using multi-level statistical models, adjusted for covariates. Effect estimates were reported by country and pooled estimates calculated across World Bank classifications for economic development using meta-analyses and forest plots. Associations between social environment attributes and MVPA varied among countries and levels of economic development. Associations were more consistent and in the hypothesized directions among countries with higher levels economic development, but less so among countries with lower levels of economic development.
  • Kantomaa, Marko T.; Stamatakis, Emmanuel; Kankaanpaa, Anna; Kajantie, Eero; Taanila, Anja; Tammelin, Tuija (2016)
    The Northern Finland Birth Cohort 1986 (N = 8,061) was used to investigated the joint associations of physical activity and sedentary behavior with academic achievement. Logistic regression analysis was used to evaluate how classes formed by latent class analysis (LCA) according to overall physical activity, sports club membership, viewing TV, using a computer, reading books and magazines, other sedentary activities, and sleep were associated with grade-point average. When adjusted for gender, self-rated health, and mother's education, physically active adolescents and generally active adolescents were about twice as likely to have high grade-point average compared with sedentary TV viewers.
  • Castren, Sari; Grainger, Marjut; Lahti, Tuuli; Alho, Hannu; Salonen, Anne H. (2015)
    Background: Adolescent gambling and substance use are viewed as a public health concern internationally. The early onset age of gambling is a known risk factor for developing gambling problems later in life. The aims of this study are: to evaluate the internal consistency reliability, factorial validity and classification accuracy of the Finnish version of DSM-IV-Multiple Response-Juvenile (DSM-IV-MR-J) criteria measuring at-risk/problem gambling (ARPG); to examine gender differences in gambling participation, ARPG and substance use among first-year junior high school students; and to investigate the association of gambling and gaming (video game playing) participation, substance use and social variables with ARPG. Methods: This study examined 988 adolescents (mean age 13.4 years) at 11 public schools in Finland between October-December 2013. The response rate was 91.6%. Chi-squared test and binary logistic regression analysis were used. Results: 'Illegal acts' was the most endorsed and sensitive, but the least specific criteria identifying ARPG. During the past year, 51.6% of the respondents had gambled, 7.9% were identified as at-risk/problem gamblers (DSM-IV-MR-J score >= 2), 8.0% had smoked and 8.9% had been drinking for intoxication, and the first three were significantly more common among boys than girls. The odds ratio of being a male past-year at-risk/problem gambler was 2.27, 5.78 for gambling often or sometimes, 2.42 for video game playing weekly or more often and 6.23 for having peer gamblers. Conclusions: Overall, the Finnish version of the DSM-IV-MR-J had acceptable internal consistency reliability and factorial validity. None of the DSM-IV-MR-J criteria were accurate enough to screen ARPG per se. ARPG past-year prevalence was relatively high with males gambling more than females. ARPG was as common as drinking alcohol for intoxication and smoking. Peer gambling was strongly associated with ARPG. Efficient strategies to minimise the risks of gambling problems, tools for prevention and identification of ARPG among the underage are needed.
  • Maury, Olivia (2020)
    This article examines the experiences of non-EU/EEA student-migrants orienting in precarious labour markets in Finland. Drawing on data from in-depth interviews with working student-migrants holding a temporary legal status, the article examines the incidence of unpaid work within a variety of contractual settings and sectors. The findings suggest that exploitation with regard to the subjective capacity to produce is facilitated through the imposition of unpaid work hours on legally constrained migrants in precarious employment. The findings contribute to the sociological analysis of the increasingly fragmented figures of labour as well as to the study of unpaid work as a driver of precarisation.
  • Granholm, Camilla (2016)
    This article presents a qualitative study of ICT use among Finnish young people attending training programmes for youth outside employment and education. The data come from six focus group interviews and three individual interviews, as well as a single focus group interview with involved supervisors. The data was analyzed using McQuail's (1983) theory regarding the motives for individual media use. The results show that the young people use ICT primarily for entertainment, but their use is diverse. Young people choose the tools and dimensions for interaction that best fulfill their needs, blending together ingredients from both online and offline sources. Unlike previous research, young people in this study stated that they prefer talking to someone face-to-face about severe (health-related or emotional) problems. If social and youth services want to meet young people on their own terms, both online and offline services are needed.
  • Knaappila, Noora; Marttunen, Mauri; Fröjd, Sari; Lindberg, Nina; Kaltiala-Heino, Riittakerttu (2019)
    Background: Scientific literature suggests that the prevalence of delinquency amongst adolescents has decreased internationally in past decades. However, whether this change is consistent across all socioeconomic groups has not yet been studied. Objective: The aim of this study was to examine changes in delinquency amongst Finnish adolescents according to socioeconomic status between 2000 and 2015. Method: A population-based school survey was conducted biennially amongst 14-16-year-old Finns between 2000 and 2015 (n = 761,278). Distributions for delinquency and socioeconomic adversities (low parental education, not living with both parents and parental unemployment in the past year) were calculated using crosstabs. Associations between delinquency, time, and socioeconomic adversities were studied using binomial logistic regression results shown by odds ratios with 95 % confidence intervals. Results: Delinquency was positively associated with all three socioeconomic adversities studied and cumulative socioeconomic adversity. Although the prevalence of delinquency varied only slightly between 2000 and 2015 in the overall population, it increased significantly amongst adolescents with most socioeconomic adversities. Conclusions: The findings indicate that socioeconomic differences in delinquency have increased amongst Finnish adolescents in past decades. Delinquency prevention and intervention programs should take socioeconomic adversities into account.
  • Vänskä, N.; Sipari, S.; Jeglinsky, I.; Lehtonen, K.; Kinnunen, A. (2022)
    Purpose The purpose of the co-development project was to create a tool that enhances children's active participation and agency in rehabilitation and in everyday life. Materials and methods Action research was the methodological approach. Participants in the different phases of the process (2015-2017) were children with disabilities, parents and rehabilitation professionals. The co-development process included: (1) designing the tool's first version, (2) piloting the tool, (3) evaluating the tool by collecting feedback and reflection, (4) generating the tool's final version. Results Through the co-development process, an accommodating and digital tool called the CMAP Book-a description of the child's meaningful activities and participation-was developed. The CMAP Book is used with an electronic app enabling the identification and description of what is meaningful in daily life from the child's perspective with videos, photos, pictures, recording and writing. The tool enables the child, family and professionals to prepare and build collaboration in rehabilitation with flexibility according to child and family needs. Conclusions Use of the CMAP Book promotes the active involvement of the child and parents in designing the rehabilitation process in daily life in partnership with professionals. The stakeholder involvement in the co-development facilitated meaningful results and a concrete tool for rehabilitation.
  • Castaneda, Anu E.; Tuulio-Henriksson, Annamari; Aronen, Eeva T.; Marttunen, Mauri; Kolho, Kaija-Leena (2013)
  • Köykkä, Laura Katariina; Absetz, Pilvikki; Araújo-Soares, Vera; Knittle, Keegan Phillip; Sniehotta, Falko F.; Hankonen, Nelli Elisa (2019)
    Creating active classroom environments and reducing excessive student sitting requires changes in teachers' behaviours. This study examines a teacher training intervention, which aimed to increase the extent to which teachers use strategies to interrupt prolonged periods of students' sitting, as well as strategies to reduce total sitting time. The training was part of the Let's Move It (LMI) multi-level school-based intervention that aimed to reduce sedentary behaviour and increase physical activity among older adolescents, drawing on insights from social psychological theories, such as the reasoned action approach, self-regulation approaches and habit formation. We explore (1) whether the intervention increased teachers' use of sitting reduction strategies, (2) whether theoretical mechanisms mediated these changes, and (3) how teachers utilized habit formation. This pragmatic experimental study of vocational school teachers (n = 234) was embedded within a cluster-randomized controlled trial evaluating LMI, in which schools were randomized to intervention or no-treatment control arms. Three intervention workshops targeted skills and motivation to use sitting reduction strategies in class (e.g., active teaching methods, activity breaks). Participants self-reported sitting reduction activities, theoretical mediators, and use of behaviour change techniques (BCTs) at baseline and 8-weeks follow-up. Compared to controls, intervention schools' teachers increased breaks to interrupt sitting, but not their outcome expectations, perceived behavioural control or intentions - potentially due to ceiling effects. Effects were mediated by BCT use and perceived behavioural control. Descriptive norms mediated the effects of the intervention on intention, which in turn mediated the intervention effects on BCT use. BCT use and intention were positively related to reducing students' sitting.
  • Latvala, Tiina; Castren, Sari; Alho, Hannu; Salonen, Anne (2018)
    Aims: This study aims to explore the associations between final compulsory school grades and gambling and their relation to substance use and perceived mental health among people aged 18-29 in Finland (N = 831). Methods: Cross-sectional random sample data, weighted on the basis of age, gender and region of residence, were collected in 2015. The data were analysed using logistic regression models adjusted for sociodemographic variables, risky alcohol use, daily smoking, and perceived mental health. Results: Weekly gambling and at-risk and problem gambling (ARPG) were more common among men. Weekly gambling was linked to smoking and risky alcohol use among men and smoking among women. Additionally, ARPG was linked to risky alcohol use among men. ARPG was associated with moderate/poor mental health among men and women, but this was not the case with weekly gambling. Among men, low and average final school grades at age 16 were associated with weekly gambling later in life, even when adjusting for other variables. Among women, low and average final school grades were not associated with weekly gambling when adjusting for substance use. Lower final school grades were associated with ARPG among women but not among men when all potential confounders were adjusted for. Conclusions: Adolescents with lower final school grades are more likely to gamble weekly later in life. Lower final school grades are also linked with ARPG among women. It is important therefore for schools to have clear policies on gambling and to implement early prevention programmes.
  • Gomes, Thayse Natacha; Katzmarzyk, Peter T.; Hedeker, Donald; Fogelholm, Mikael; Standage, Martyn; Onywera, Vincent; Lambert, Estelle V.; Tremblay, Mark S.; Chaput, Jean-Philippe; Tudor-Locke, Catrine; Sarmiento, Olga; Matsudo, Victor; Kurpad, Anura; Kuriyan, Rebecca; Zhao, Pei; Hu, Gang; Olds, Timothy; Maher, Carol; Maia, Jose (2017)
    The purpose of this study was to describe children's daily compliance with moderate-to-vigorous physical activity (MVPA) recommendations across a week in different parts of the world, and to identify individual-and school-level correlates that may explain differences in daily MVPA compliance. The sample included 6553 children aged 9-11 years from 12 countries, and multilevel statistical analyses were used, including both child-and school-level variables. Most children did not comply with the MVPA guidelines on a daily basis: Chinese children complied the least, whereas Finnish, Australian, Colombian, UK, and Kenyan children complied the most. Boys (rate ratio [RR] = 1.47) and children with higher unhealthy diet scores (RR = 1.08) complied more, but overweight/obese children (RR = 0.81), earlier maturing children (RR = 0.93), and those who spent more time in screen activities (RR = 0.98) and sleeping (RR = 0.96) had the lowest compliance. At the school level, children with access to playground or sport equipment (RR = 0.88, for both) tended to comply less, whereas those with access to a gymnasium outside the school hours complied more with the MVPA guidelines (RR = 1.14). Significant between-country differences in children's daily MVPA compliance were observed, reflecting not only site characteristics, but also the importance of individual traits and local school contexts.