BackgroundThe number of commercial apps to improve health behaviours in children is growing rapidly. While this provides opportunities for promoting health, the content and quality of apps targeting children and adolescents is largely unexplored. This review systematically evaluated the content and quality of apps to improve diet, physical activity and sedentary behaviour in children and adolescents, and examined relationships of app quality ratings with number of app features and behaviour change techniques (BCTs) used.MethodsSystematic literature searches were conducted in iTunes and Google Play stores between May–November 2016. Apps were included if they targeted children or adolescents, focused on improving diet, physical activity and/or sedentary behaviour, had a user rating of at least 4+ based on at least 20 ratings, and were available in English. App inclusion, downloading and user-testing for quality assessment and content analysis were conducted independently by two reviewers. Spearman correlations were used to examine relationships between app quality, and number of technical app features and BCTs included.ResultsTwenty-five apps were included targeting diet (n = 12), physical activity (n = 18) and sedentary behaviour (n = 7). On a 5-point Mobile App Rating Scale (MARS), overall app quality was moderate (total MARS score: 3.6). Functionality was the highest scoring domain (mean: 4.1, SD: 0.6), followed by aesthetics (mean: 3.8, SD: 0.8), and lower scoring for engagement (mean: 3.6, SD: 0.7) and information quality (mean: 2.8, SD: 0.8). On average, 6 BCTs were identified per app (range: 1–14); the most frequently used BCTs were providing ‘instructions’ (n = 19), ‘general encouragement’ (n = 18), ‘contingent rewards’ (n = 17), and ‘feedback on performance’ (n = 13). App quality ratings correlated positively with numbers of technical app features (rho = 0.42, p < 0.05) and BCTs included (rho = 0.54, p < 0.01).ConclusionsPopular commercial apps to improve diet, physical activity and sedentary behaviour in children and adolescents had moderate quality overall, scored higher in terms of functionality. Most apps incorporated some BCTs and higher quality apps included more app features and BCTs. Future app development should identify factors that promote users’ app engagement, be tailored to specific population groups, and be informed by health behaviour theories.Electronic supplementary materialThe online version of this article (doi:10.1186/s12966-017-0538-3) contains supplementary material, which is available to authorized users.
Higher education students often suffer from physiological and psychological health problems caused by stress, which may negatively impact their academic performance (AP). Physical activity (PA) can be a promising strategy to buffer these stress-induced complaints. Therefore, the aim of this investigation was to summarize evidence for the tridimensional construct of PA, stress, and AP, as well as to quantify the relationships among these variables. Five databases (PubMed, Scopus, SMEI, ERIC, and Web of Science) were systematically searched in November 2019 for publications that examined PA, stress, and AP of university students, without any restrictions regarding the publication period. The systematic review includes four original research studies with a moderate-to-high risk of bias. Results of included studies were narratively summarized and quantified in a meta-analysis using random effect models. Whereas study results point to a positive relation between PA and AP, relationships between PA and stress seem to be negative, while the relation between stress and AP is undecided. The meta-analysis found no significant associations and considerable heterogeneity of the results. Findings indicate a research gap concerning the connection of PA, stress, and AP in university students. Future studies should use validated measuring tools and consider the timepoint of data collection in order to extract truly stressful periods.
ObjectiveThe aim of this systematic review was to provide an overview of cross-sectional studies that examined health literacy among university students and to identify possible determinants related to health literacy.MethodThe current review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Three databases (PubMed, Scopus, and Web of Science) were systematically searched for cross-sectional studies that examined health literacy among university students. Results of included studies were narratively summarized.ResultsThe systematic review includes twenty-one research studies. The majority of studies report health literacy scores among university students that are lower compared to reference samples. The health literacy of students is influenced by different variables (age, gender, number of semesters, course of studies/curriculum, parental education, and socioeconomic background).DiscussionHealth literacy activities should target all students. Universities should make use of their resources and offer health literacy courses for students in which content is used from disciplines available at the university (e.g., medicine, health, or psychology). To increase effectiveness, health literacy courses should be adapted according to the different needs and characteristics of the student subgroups.
While adolescents and adults should limit high levels of sedentary behavior, university students spend large amounts of time on sedentary activities. The aim of this study was to investigate the effect of this prolonged sitting on students’ self-perceived physical, mental, and cognitive condition and to answer the question of whether simple standing breaks in lectures can help students improve these conditions and for example feel more concentrated, motivated, or less tense in class. A five-minute standing break was introduced using a designed presentation slide for one semester in five different 90-min lectures. In addition, an active break as well as an open break with no trigger were implemented in two further lectures to explicitly investigate the effects of a standing break. Before, during, and after the semester, the students were surveyed about their physical, mental, and cognitive condition (836 respondents at start, 634 during semester, and 528 at the end). To evaluate the practicality and acceptance of the standing break, lecturers were interviewed about their experience. At all survey time points, the standing break was highly accepted by the university students. About three quarters of the students felt a relaxation of the muscles in the neck and shoulder as well as in the back and the legs. More than three quarters perceived an increase in concentration, receptiveness and retentiveness, motivation, and well-being. Results of the statistical analysis indicate that a standing break as well as an active break are more effective than an open break to improve the self-perceived physical and psychological well-being of the university students. The increase in cognitive skills is reported by all groups, including the group who were offered open breaks. Hence, standing breaks in university lectures receive a high level of acceptance and practicability and have the potential to increase students’ physical, mental, and cognitive condition and contribute to students’ physical activity and health. While field research provides opportunities such as the testing of measures in the natural environment and producing real-life results relevant to the students and lecturers, it also imposes limitations as lecture settings differed, not all disturbances could be controlled, and the participation in the study might have led to social-desirability bias. For a sustainable development of a standing-friendly teaching and learning culture at universities, further interventions as well as the consideration of the topic in all processes and decisions within the universities are necessary. Since this study has taken place, student-life has changed drastically with COVID-19 measures. While this current paper is based on research conducted in 2019 and has only tested live lectures on campus, the tools tested could also be used for online lectures.
Background: University students are prone to sedentary behavior (SB) which is associated with multiple negative health outcomes. Sit-stand desks may allow for a reduction of SB through standing bouts. To promote standing in university students, decisional cues might be a low-cost approach that can easily be implemented. Purpose: To investigate the effects of decisional cues on students' SB, standing, and active behavior. Method: Over 3 weeks, students were observed in a building on a German university campus, which provides sit-stand-desks in study areas, using an adapted version of the SOPLAY protocol. Baseline data was collected in the first week (T1), before posters and table plaques containing decisional cues were set up in the study areas. Effects were measured in the following 2 weeks (T2 and T3). Results: 2,809 (33% female) students were observed. Sitting decreased from 92.9% [SD = 14.9] to 84.5% [SD = 22.1] from T1 to T3 [ F (1, 141) = 15.6; p < 0.01; η 2 = 0.10]. Standing increased from 5.6% [SD = 13.5] to 10.9% [SD = 14.4] [ F (1, 141) = 9.0; p < 0.01; η 2 = 0.06] and being active from 1.5% [SD = 6.9] to 4.5% [SD = 14.8] from T1 to T3 [ F (1, 141) = 4.2; p < 0.05; η 2 = 0.03). Main effect analyses revealed more students standing in the afternoon compared to morning and lunchtime [ F (2, 140) = 3.2; p < 0.05; η 2 = 0.04). Discussion: Decisional cues could decrease students' SB and promote standing or being active as alternatives. Future research should use a more rigorous study design. The content of the decisional cues should be explored more and expanded to other health promotion areas on campus.
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