BackgroundKnowledge on domain-specific physical activity (PA) has the potential to advance public health interventions and inform new policies promoting children’s PA. The purpose of this study is to identify and assess domains (leisure, school, transport, home) and subdomains (e.g., recess, playgrounds, and urban green space) for week day moderate to vigorous PA (MVPA) using objective measures and investigate gender and age differences.MethodsParticipants included 367 Danish children and adolescents (11–16 years, 52% girls) with combined accelerometer and Global Positioning System (GPS) data (mean 2.5 days, 12.7 hrs/day). The Personal Activity and Location Measurement System and a purpose-built database assessed data in 15-second epochs to determine PA and assign epochs to 4 domains and 11 subdomains. Frequencies and proportions of time spent in MVPA were determined and differences assessed using multi-level modeling.ResultsMore than 90% of MVPA was objectively assigned to domains/subdomains. Boys accumulated more MVPA overall, in leisure, school and transport (all p < 0.05). Children compared with adolescents accumulated more MVPA, primarily through more school MVPA (p < 0.05). Boys spent a large proportion of time accumulating MVPA in playgrounds, active transport, Physical Education, sports facilities, urban green space and school grounds. Girls spent a significant proportion of time accumulating MVPA in active transport and playgrounds. No gender or age differences were found in the home domain.ConclusionsLarge variations were found in PA frequency and intensity across domains/subdomains. Significant gender differences were found, with girls being less active in almost all domains and subdomains. Objectively measured patterns of PA across domains/subdomains can be used to better tailor PA interventions and inform future policies for promoting child PA.

The emergence of portable global positioning system (GPS) receivers over the last 10 years has provided researchers with a means to objectively assess spatial position in free-living conditions. However, the use of GPS in free-living conditions is not without challenges and the aim of this study was to test the dynamic accuracy of a portable GPS device under real-world environmental conditions, for four modes of transport, and using three data collection intervals. We selected four routes on different bearings, passing through a variation of environmental conditions in the City of Copenhagen, Denmark, to test the dynamic accuracy of the Qstarz BT-Q1000XT GPS device. Each route consisted of a walk, bicycle, and vehicle lane in each direction. The actual width of each walking, cycling, and vehicle lane was digitized as accurately as possible using ultra-high-resolution aerial photographs as background. For each trip, we calculated the percentage that actually fell within the lane polygon, and within the 2.5, 5, and 10 m buffers respectively, as well as the mean and median error in meters. Our results showed that 49.6% of all ≈68,000 GPS points fell within 2.5 m of the expected location, 78.7% fell within 10 m and the median error was 2.9 m. The median error during walking trips was 3.9, 2.0 m for bicycle trips, 1.5 m for bus, and 0.5 m for car. The different area types showed considerable variation in the median error: 0.7 m in open areas, 2.6 m in half-open areas, and 5.2 m in urban canyons. The dynamic spatial accuracy of the tested device is not perfect, but we feel that it is within acceptable limits for larger population studies. Longer recording periods, for a larger population are likely to reduce the potentially negative effects of measurement inaccuracy. Furthermore, special care should be taken when the environment in which the study takes place could compromise the GPS signal.

Introduction: Being outdoors has a positive influence on health among children. Evidence in this area is limited and many studies have used self-reported measures. Objective context-specific assessment of physical activity patterns and correlates, such as outdoor time, may progress this field.Aims: To employ novel objective measures to assess age and gender differences in context-specific outdoor weekday behavior patterns among school-children [outdoor time and outdoor moderate to vigorous physical activity (MVPA)] and to investigate associations between context-specific outdoor time and MVPA.Methods: A total of 170 children had at least one weekday of 9 h combined accelerometer and global positioning system data and were included in the analyses. The data were processed using the personal activity and location measurement system (PALMS) and a purpose-built PostgreSQL database resulting in context-specific measures for outdoor time, outdoor MVPA, and overall daily MVPA. In addition, 4 domains (leisure, school, transport, and home) and 11 subdomains (e.g., urban green space and sports facilities) were created and assessed. Multilevel analyses provided results on age and gender differences and the association between outdoor time and MVPA.Results: Girls compared to boys had fewer outdoor minutes (p < 0.05), spent a smaller proportion of their overall daily time outdoors (p < 0.05), had fewer outdoor MVPA minutes during the day (p < 0.001) and in 11 contexts. Children compared to adolescents had more outdoor minutes (p < 0.05). During school and within recess, children compared to adolescents had more outdoor MVPA (p < 0.001) and outdoor time (p < 0.001). A 1-h increase in outdoor time was associated with 9.9 more minutes of MVPA (p < 0.001).Conclusion: A new methodology to assess the context-specific outdoor time and physical activity patterns has been developed and can be expanded to other populations. Different context-specific patterns were found for gender and age, suggesting different strategies may be needed to promote physical activity.

Health literacy has been identified as an important and changeable intermediary determinant of health equity. Vocational education and training (VET) schools are a relevant setting for health behavior interventions seeking to diminish health inequities because many VET students come from low socio-economic status backgrounds. This study examines VET students’ health literacy and its association with health behavior based on a cross-sectional survey among 6119 students from 58 VET schools in Denmark in 2019. Two scales from the Health Literacy Questionnaire was used to assess domains of health literacy. Data were analyzed using Anova and logistic regression. The study population consisted of 43.4% female, and mean age was 24.2 years (range 15.8–64.0). The health literacy domain ‘Actively managing my health’ mean was 2.51, SD 0.66, and ‘Appraisal of health information’ mean was 2.37, SD 0.65. For both domains, being female, older age, attending the VET educational program Care-health-pedagogy, and higher self-rated health were associated with higher scale scores. In the adjusted analyses, lower scale scores were associated with less frequent breakfast, daily smoking, high-risk alcohol behavior and moderate-to-low physical activity. Our results show that low health literacy is associated with unhealthy behaviors in this population. Our results support and inform health literacy research and practice in educational institutions and services.

This study presents a novel method to assess context-specific physical activity patterns using accelerometer and GPS. The method efficiency is investigated by providing descriptive results on the use of domains and subdomains, and assessing how much of children's and adolescents' daily activity time can be classified by these domains and subdomains. Four domains and 11 subdomains were defined as important contexts for child and adolescent behaviour. During weekdays (n=367) and weekend days (n=178) the majority of children and adolescents spent time in active transport, urban green space, clubs and sports facilities. Satisfactory method efficiency was found during weekdays. Natural experiments combined with objective assessment of context-specific behaviours hold the potential to create evidence on the effects of changes to the built environment on behaviour.