Physical activity levels are already in decline from 6-7 years old and are likely to continue to decline into adolescence. Interventions must therefore focus on primary school children.
It is commonly known that children do not engage in a sufficient amount of physical activity. Weather conditions and day length may influence physical activity of children. Little is known about the relationship between physical activity and seasons. The purpose of this study was to investigate the relationships between weather conditions and physical activity in 6–12 year old children based on hip-worn Actigraph wGT3X–BT accelerometer data. The study sample consisted of 2015 subjects aged 6–12 years from the Health Oriented Pedagogical Project (HOPP) study carried out in Horten municipality and Akershus county, Norway. Six days of sedentary and moderate-to-vigorous physical activity data was gathered in January–June and September–October, 2015, presented as daily averages. The accelerometer-monitored physical activity of children grouped within nine schools was matched with regional weather conditions and assessed with the means of linear mixed models. Increased day length was associated with decreased sedentary behavior. Warmer temperature and dry weather were associated with increased moderate-to-vigorous physical activity after adjusting for age and sex. One-hour increase in daylight resulted in a decrease of sedentary time by, on average, 2 min (95% CI = (−2.577, −0.798)). For every 5 °C increase in temperature (range: −0.95 and 15.51 °C) and dry weather, average moderate-to vigorous physical activity increased by 72 and 67 min (males and females, respectively) (p < 0.001). Days with precipitation had, on average, 10 fewer minutes of moderate-to-vigorous physical activity compared with days without precipitation (95% CI = (−16.704, −3.259)). Higher temperatures and dry weather led to higher physical activity levels, seeing larger increases among boys than girls. A school-based physical activity intervention program should be adjusted regarding local weather conditions in line with the present findings.
It remains controversial whether physical activity promotes bone health in childhood cancer survivors (CCS). We aimed to assess the effect of a one-year general exercise intervention on lower body bone parameters of CCS. CCS ≥16 years at enrollment, <16 years at diagnosis and ≥5 years in remission were identified from the national Childhood Cancer Registry. Participants randomized to the intervention group were asked to perform an additional ≥2.5 hours of intense physical activity/week, controls continued exercise as usual. Bone health was assessed as a secondary trial endpoint at baseline and after 12-months. We measured tibia bone mineral density (BMD) and morphology by peripheral quantitative computed tomography and lumbar spine, hip and femoral neck BMD by dual-energy x-ray absorptiometry. We performed intention-to-treat, per protocol, and an explorative subgroup analyses looking at low Abbreviations: BMD, bone mineral density (mg/cm 3 or g/cm 2 ); CCS, childhood cancer survivor(s); CPET, cardiopulmonary exercise test; DXA, dual-energy x-ray absorptiometry; ITT, intention-totreat analysis; PA, physical activity; pQCT, peripheral quantitative computed tomography; RCT, randomized controlled trial.
Purpose
Meeting intervention requirements is crucial in behavioral trials. We examined patterns and predictors of physical activity (PA) adherence and contamination in a 1‐year individualized randomized controlled PA behavioral intervention in childhood cancer survivors (CCS).
Methods
CCS aged ≥16 at enrolment, <16 at diagnosis, and ≥5 years in remission were identified from the Swiss Childhood Cancer Registry. We asked participants randomized to the intervention group to perform an additional ≥2.5 h of intense PA/week and controls to continue as usual. Adherence to the intervention was assessed by online diary (adherent if ≥2/3 of individual PA goal reached) and contamination for the control group by pre‐ and post‐questionnaire including PA levels (contaminated if >60 min increase/week in PA). Predictors of adherence/contamination including quality of life (36‐Item Short Form Survey) were assessed by questionnaire. We used logistic (control group) and mixed logistic regression models (exercise group) to estimate predictors of study adherence and contamination.
Results
One hundred and forty‐four survivors (30.4 ± 8.7 years old, 43% females) were included. Adherence was 48% (35/73) in the intervention group, while 17% (12/71) of controls contaminated group allocation. Predictors for PA adherence were female sex (OR 2.35, p = 0.03), higher physical (OR 1.34, p = 0.01) and mental quality of life (OR 1.37, p = 0.001), and week into the intervention (OR 0.98, p < 0.001). Clear differences in PA behavior of adherent and non‐adherent participants were seen from week four. No significant predictors for contamination were found for controls.
Conclusion
Adherence to PA behavior interventions remain challenging in both groups. Further long‐term trials should consider intense motivational support within the first month, more detailed data collection for the control group, adjustments to power calculations and other study designs to minimize non‐adherence and contamination.
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