A systematic review of school-based interventions targeting physical activity and sedentary behaviour among older adolescents Movement as Medicine for Type 2 Diabetes: protocol for an open pilot study and external pilot clustered randomised controlled trial to assess acceptability, feasibility and fidelity of a multifaceted behavioural intervention targeting physical activity in primary care A cognitive-behavioural pedometer-based group intervention on physical activity and sedentary behaviour in individuals with type 2 diabetes What are the most effective behaviour change techniques to promote physical activity and/or reduce sedentary behaviour in inactive adults? A systematic review protocol Association between childcare educators’ practices and preschoolers’ physical activity and dietary intake: a cross-sectional analysis Preventing obesity in infants: the Growing healthy feasibility trial protocol The Infant Feeding Activity and Nutrition Trial (INFANT) an early intervention to prevent childhood obesity: Cluster-randomised controlled trial
ABSTRACT Lack of  physical activity  (  PA  ) and high levels of sedentary behaviour ( SB ) have been associated with health problems . This systematic review evaluates the effectiveness of school-based interventions to increase PA  and decrease SB  among 15–19-year-old adolescents , and examines whether intervention characteristics ( intervention length , delivery mode and intervention provider ) and intervention content ( i.e. behaviour change techniques , BCTs ) are related to intervention effectiveness . A systematic search of r and omised or cluster r and omised controlled trials with outcome measures of PA and /or SB rendered 10 results . Risk of bias was assessed using the Cochrane risk of bias tool . Intervention content was coded using Behaviour Change Technique Taxonomy v1 . Seven out of 10 studies reported significant increases in PA . Effects were generally small and short-term ( Cohen 's d ranged from 0.132 to 0.659 ) . Two out of four studies that measured SB reported significant reductions in SB . Interventions that increased PA  included a higher number of BCTs , specific BCTs ( e.g. , goal setting , action planning and self-monitoring ) , and were delivered by research staff . Intervention length and mode of delivery were unrelated to effectiveness . More studies are needed that evaluate long-term intervention effectiveness and target SBs among older adolescents Background Physical activity ( PA ) and nutrition are the cornerstones of diabetes management . Several review s and meta-analyses report that PA independently produces clinical ly important improvements in glucose control in people with Type 2 diabetes . However , it remains unclear what the optimal strategies are to increase PA behaviour in people with Type 2 diabetes in routine primary care . Methods This study will determine whether an evidence -informed multifaceted behaviour change intervention ( Movement as Medicine for Type 2 Diabetes ) targeting both consultation behaviour of primary healthcare professionals and PA behaviour in adults with Type 2 diabetes is both acceptable and feasible in the primary care setting . An open pilot study conducted in two primary care practice s ( phase one ) will assess acceptability , feasibility and fidelity . Ongoing feedback from participating primary healthcare professionals and patients will provide opportunities for systematic adaptation and refinement of the intervention and study procedures . A two-arm parallel group clustered pilot r and omised controlled trial with patients from participating primary care practice s in North East Engl and will assess acceptability , feasibility , and fidelity of the intervention ( versus usual clinical care ) and trial processes over a 12-month period . Consultation behaviour involving fidelity of intervention delivery , diabetes and PA related knowledge , attitudes/beliefs , intentions and self-efficacy for delivering a behaviour change intervention targeting PA behaviour will be assessed in primary healthcare professionals . We will rehearse the collection of outcome data ( with the focus on data yield and quality ) for a future definitive trial , through outcome assessment at baseline , one , six and twelve months . An embedded qualitative process evaluation and treatment fidelity assessment will explore issues around intervention implementation and assess whether intervention components can be reliably and faithfully delivered in routine primary care . Discussion Movement as Medicine for Type 2 Diabetes will address an important gap in the evidence -base , that is , the need for interventions to increase free-living PA behaviour in adults with Type 2 diabetes . The multifaceted intervention incorporates an online accredited training programme for primary healthcare professionals and represents , to the best of our knowledge , the first of its kind in the United Kingdom . This study will establish whether the multifaceted behavioural intervention is acceptable and feasible in routine primary care . Trial registration Movement as Medicine for Type 2 Diabetes ( MaMT2D ) was registered with Current Controlled Trials on the 14th January 2012 : IS RCT N67997502 . The first primary care practice was r and omised on the 5th October 2012 The purpose of this study was to investigate the benefits of a pedometer and a cognitive-behavioural group intervention for promoting physical activity ( PA ) in type 2 diabetes patients . We recruited 41 participants and r and omized them into an intervention group ( IG ) ( n = 20 ) and a control group ( CG ) ( n = 21 ) . The intervention consisted of five sessions within 12 weeks , a booster session after 22 weeks and a pedometer . Primary outcome was PA assessed by accelerometer ( minutes per day ) and pedometer ( steps per day ) . Secondary outcomes were weight , body mass index , blood pressure , haemoglobin A1c and total cholesterol . After 12 weeks , the IG increased with more than 2000 steps day−1 compared with the CG , whereas sedentary behaviour decreased more than 1 hour day−1 in the IG and showed no change in the CG . There was no intervention effect on the accelerometer-based PA nor on health measurements . After 1 year , the increase in steps per day remained significant in the IG , but sedentary activity increased again to baseline levels . This pilot study showed that the combination of a 12-week cognitive-behavioura intervention and a pedometer has a significant short-term impact on daily steps and sedentary behaviour but that the effects on total PA and long-term effects were limited Introduction Large proportions of the population are not meeting recommended levels of physical activity and have increasingly sedentary lifestyles . Low levels of physical activity are predictive of poor health outcomes and time spent sedentary is related to a host of risk factors independently of physical activity levels . Building an evidence base of the best approaches to intervene in the lifestyles of inactive individuals is crucial in preventing long-term disease , disability and higher mortality rates . Methods and analysis Systematic search es will be conducted on all relevant data bases ( eg , PubMed , Scopus , CINAHL , PsycINFO ) . Studies will be included if they assess interventions aim ed at changing physical activity or sedentary behaviour levels in adults ( over 18 ) who are inactive and do not suffer from chronic conditions . Studies must also be r and omised controlled trials ( RCTs ) , have a primary outcome of physical activity or sedentary behaviour , and measure outcomes at least 6 months after intervention completion . Studies will be coded using the Behaviour Change Technique ( BCT ) taxonomy v1 and Template for Intervention Description and Replication ( TIDieR ) guidelines . 2 review ers will independently screen full-text articles and extract data on study characteristics , participants , BCTs , intervention features and outcome measures . Study quality will also be assessed independently by 2 review ers using the Cochrane risk of bias tool . A meta- analysis will be considered if there is sufficient homogeneity across outcomes . GRADE criteria will be used to assess quality of evidence . Dissemination This will be the first review to systematic ally appraise interventions aim ed at changing the physical activity or sedentary behaviour of inactive individuals using RCT design s with a 6-month follow-up post-intervention . This review will better inform intervention design ers targeting inactive population s and inform the design of a future complex intervention . Review registration number This protocol was registered with the International Prospect i ve Register of Systematic Review s ( PROSPERO ) on 17 October 2014 ( registration number : CRD42014014321 ) Introduction Childcare educators may be role models for healthy eating and physical activity ( PA ) behaviours among young children . This study aim ed to identify which childcare educators ’ practice s are associated with preschoolers ’ dietary intake and PA levels . Methods This cross-sectional analysis included 723 preschoolers from 50 r and omly selected childcare centres in two Canadian provinces . All data were collected in the fall of 2013 and 2014 and analysed in the fall of 2015 .  PA was assessed using Actical accelerometers during childcare hours for 5 consecutive days .  Children ’s dietary intake  was measured at lunch on 2 consecutive days using weighed plate waste and digital photography . Childcare educators ’ nutrition practice s ( modelling , nutrition education , satiety recognition , verbal encouragement and not using food as rewards ) and PA practice s ( informal and formal PA promotion ) were assessed by direct observation over the course of 2 days , using the Nutrition and Physical Activity Self- Assessment for Child Care tool . Associations between educators ’ practice s and preschoolers ’ PA and dietary intake were examined using multilevel linear regressions . Results Overall , modelling of healthy eating was positively associated with children ’s intake of sugar ( β=0.141 , 95 % CI 0.03 to 0.27 ) , while calorie ( β=−0.456 , 95 % CI −1.46 to –0.02 ) and fibre intake ( β=−0.066 , 95 % CI −0.12 to –0.01 ) were negatively associated with providing nutrition education . Not using food as rewards was also negatively associated with fat intake ( β=−0.144 , 95 % CI −0.52 to –0.002 ) . None of the educators ’ PA practice s were associated with children ’s participation in PA  . Conclusions Modelling healthy eating , providing nutrition education and not using food as rewards are associated with children ’s dietary intake at lunch in childcare centres , highlighting the role that educators play in shaping preschoolers ’ eating behaviours . Although PA practice s were not associated with  children ’s PA levels , there is a need to reduce sedentary time in childcare centres Introduction Early childhood is an important period for establishing behaviours that will affect weight gain and health across the life course . Early feeding choices , including breast and /or formula , timing of introduction of solids , physical activity and electronic media use among infants and young children are considered likely determinants of childhood obesity . Parents play a primary role in shaping these behaviours through parental modelling , feeding styles , and the food and physical activity environments provided . Children from low socio-economic background s have higher rates of obesity , making early intervention particularly important . However , such families are often more difficult to reach and may be less likely to participate in traditional programs that support healthy behaviours . Parents across all socio-demographic groups frequently access primary health care ( PHC ) services , including nurses in community health services and general medical practice s , providing unparalleled opportunity for engagement to influence family behaviours . One emerging and promising area that might maximise engagement at a low cost is the provision of support for  healthy parenting  through electronic media such as the Internet or smart phones . The Growing healthy study explores the feasibility of delivering such support via primary health care services . Methods This paper describes the Growing healthy study , a non-r and omised quasi experimental study examining the feasibility of an intervention delivered via a smartphone app ( or website ) for parents living in socioeconomically disadvantaged areas , for promoting infant feeding and parenting behaviours that promote healthy rather than excessive weight gain .  Participants will be recruited via their primary health care practitioner and followed until their infant is 9 months old . Data will be collected via web-based question naires and the data collected inherently by the app itself . Ethics and dissemination This study received approval from the University of Technology Sydney Ethics committee and will be disseminated via peer- review ed publications and conference presentations Background Multiple factors combine to support a compelling case for interventions that target the development of obesity-promoting behaviours ( poor diet , low physical activity and high sedentary behaviour ) from their inception . These factors include the rapidly increasing prevalence of fatness throughout childhood , the instigation of obesity-promoting behaviours in infancy , and the tracking of these behaviours from childhood through to adolescence and adulthood . The Infant Feeding Activity and Nutrition Trial ( INFANT ) aims to determine the effectiveness of an early childhood obesity prevention intervention delivered to first-time parents . The intervention , conducted with parents over the infant 's first 18 months of life , will use existing social networks ( first-time parent 's groups ) and an anticipatory guidance framework focusing on parenting skills which support the development of positive diet and physical activity behaviours , and reduced sedentary behaviours in infancy . Methods / Design This cluster-r and omised controlled trial , with first-time parent groups as the unit of r and omisation , will be conducted with a sample of 600 first-time parents and their newborn children who attend the first-time parents ' group at Maternal and Child Health Centres . Using a two-stage sampling process , local government areas in Victoria , Australia will be r and omly selected at the first stage . At the second stage , a proportional sample of first-time parent groups within selected local government areas will be r and omly selected and invited to participate . Informed consent will be obtained and groups will then be r and omly allocated to the intervention or control group . Discussion The early years hold promise as a time in which obesity prevention may be most effective . To our knowledge this will be the first r and omised trial internationally to demonstrate whether an early health promotion program delivered to first-time parents in their existing social groups promotes healthy eating , physical activity and reduced sedentary behaviours . If proven to be effective , INFANT may protect children from the development of obesity and its associated social and economic costs . Trial registration Current Controlled Trials IS RCT
Overall , toddlers tend to exceed the total PA recommendation of 180 min/day ; however , very little of this time is spent at higher movement intensities .
Even with high PA rates , toddlers still engage in substantial ST .
Early experiences in physical activity ( PA ) are important to shape healthy movement behaviours long-term ; as such , it is critical that PA is promoted from infancy , and that detrimental behaviours ( e.g. , prolonged sedentary time [ ST ] ) are minimized .
The purpose of this systematic review and meta- analysis was to examine infants ’ and toddlers ’ movement behaviours across daytime hours .