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      Socio-economic determinants of physical activity across the life course: A "DEterminants of DIet and Physical ACtivity" (DEDIPAC) umbrella literature review

      1 , 2 , * , 2 , 3 , 3 , 4 , 5 , 6 , 7 , 8 , 3 , 9 , 5 , 10 , 6 , 6 , 11 , 12 , 13 , 2 , 11 , 14 , 15 , 7 , 16 , 11 , 17 , 17 , 9 , 14 , 8 , 10 , 16 , 17 , 7 , 14 , 12 , 7 , 9 , 3

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          Abstract

          Background

          To date, the scientific literature on socioeconomic correlates and determinants of physical activity behaviours has been dispersed throughout a number of systematic reviews, often focusing on one factor (e.g. education or parental income) in one specific age group (e.g. pre-school children or adults). The aim of this umbrella review is to provide a comprehensive and systematic overview of the scientific literature from previously conducted research by summarising and synthesising the importance and strength of the evidence related to socioeconomic correlates and determinants of PA behaviours across the life course.

          Methods

          Medline, Embase, ISI Web of Science, Scopus and SPORTDiscus were searched for systematic literature reviews and meta-analyses of observational studies investigating the association between socioeconomic determinants of PA and PA itself (from January 2004 to September 2017). Data extraction evaluated the importance of determinants, strength of evidence, and methodological quality of the selected papers. The full protocol is available from PROSPERO (PROSPERO2014:CRD42015010616).

          Results

          Nineteen reviews were included. Moderate methodological quality emerged. For adults, convincing evidence supports a relationship between PA and socioeconomic status (SES), especially in relation to leisure time (positive relationship) and occupational PA (negative relationship). Conversely, no association between PA and SES or parental SES was found for pre-school, school-aged children and adolescents.

          Conclusions

          Available evidence on the socioeconomic determinants of PA behaviour across the life course is probable (shows fairly consistent associations) at best. While some evidence is available for adults, less was available for youth. This is mainly due to a limited quantity of primary studies, weak research designs and lack of accuracy in the PA and SES assessment methods employed. Further PA domain specific studies using longitudinal design and clear measures of SES and PA assessment are required.

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          Most cited references 37

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          Development of AMSTAR: a measurement tool to assess the methodological quality of systematic reviews

          Background Our objective was to develop an instrument to assess the methodological quality of systematic reviews, building upon previous tools, empirical evidence and expert consensus. Methods A 37-item assessment tool was formed by combining 1) the enhanced Overview Quality Assessment Questionnaire (OQAQ), 2) a checklist created by Sacks, and 3) three additional items recently judged to be of methodological importance. This tool was applied to 99 paper-based and 52 electronic systematic reviews. Exploratory factor analysis was used to identify underlying components. The results were considered by methodological experts using a nominal group technique aimed at item reduction and design of an assessment tool with face and content validity. Results The factor analysis identified 11 components. From each component, one item was selected by the nominal group. The resulting instrument was judged to have face and content validity. Conclusion A measurement tool for the 'assessment of multiple systematic reviews' (AMSTAR) was developed. The tool consists of 11 items and has good face and content validity for measuring the methodological quality of systematic reviews. Additional studies are needed with a focus on the reproducibility and construct validity of AMSTAR, before strong recommendations can be made on its use.
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            Social determinants of health inequalities.

            The gross inequalities in health that we see within and between countries present a challenge to the world. That there should be a spread of life expectancy of 48 years among countries and 20 years or more within countries is not inevitable. A burgeoning volume of research identifies social factors at the root of much of these inequalities in health. Social determinants are relevant to communicable and non-communicable disease alike. Health status, therefore, should be of concern to policy makers in every sector, not solely those involved in health policy. As a response to this global challenge, WHO is launching a Commission on Social Determinants of Health, which will review the evidence, raise societal debate, and recommend policies with the goal of improving health of the world's most vulnerable people. A major thrust of the Commission is turning public-health knowledge into political action.
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              A brief review on correlates of physical activity and sedentariness in youth.

              Better understanding of the correlates of physical activity and sedentary behaviors in youth will support the development of effective interventions that promote a physically active lifestyle and prevent a sedentary lifestyle. The main goal of this systematic review is to summarize and update the existing literature on correlates of young people's physical activity, insufficient physical activity, and sedentary behavior. A systematic review was conducted and included studies published between January 1999 and January 2005. The 60 reviewed studies showed that for children (age range 4-12), gender (male), self-efficacy, parental physical activity (for boys), and parent support were positively associated with physical activity. For adolescents (age range 13-18), positive associations with physical activity were found for gender (male), parental education, attitude, self-efficacy, goal orientation/motivation, physical education/school sports, family influences, and friend support. For adolescents, a positive association was found between gender (male) and sedentary behavior, whereas an inverse association was found between gender and insufficient physical activity. Ethnicity (Caucasian), socioeconomic status, and parent education were found to be inversely associated with adolescents' sedentary behaviors. For children, the evidence was insufficient to draw conclusions about correlates of insufficient physical activity and sedentary behavior. To gain more insight in the correlates of change in physical activity levels, more prospective studies are needed. Moreover, further research is needed examining the correlates of insufficient physical activity and sedentary behaviors, to develop effective interventions that may help children and adolescents diminish the time they spend on inactive behaviors.
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                Author and article information

                Contributors
                Role: Formal analysisRole: MethodologyRole: Writing – original draftRole: Writing – review & editing
                Role: Writing – original draftRole: Writing – review & editing
                Role: ConceptualizationRole: Data curationRole: Writing – review & editing
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                Role: ConceptualizationRole: VisualizationRole: Writing – review & editing
                Role: ConceptualizationRole: Writing – review & editing
                Role: ConceptualizationRole: Funding acquisitionRole: MethodologyRole: Writing – review & editing
                Role: Writing – review & editing
                Role: ConceptualizationRole: Writing – review & editing
                Role: ConceptualizationRole: Data curationRole: Writing – review & editing
                Role: ConceptualizationRole: Data curationRole: Writing – review & editing
                Role: Writing – review & editing
                Role: ConceptualizationRole: Data curationRole: InvestigationRole: Writing – review & editing
                Role: ConceptualizationRole: Writing – review & editing
                Role: ConceptualizationRole: Writing – review & editing
                Role: ConceptualizationRole: Writing – review & editing
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                Role: Writing – review & editing
                Role: ConceptualizationRole: Writing – review & editing
                Role: ConceptualizationRole: Writing – review & editing
                Role: ConceptualizationRole: Writing – review & editing
                Role: ConceptualizationRole: Data curation
                Role: ConceptualizationRole: Writing – review & editing
                Role: ConceptualizationRole: Data curationRole: Writing – review & editing
                Role: ConceptualizationRole: Data curationRole: Writing – review & editing
                Role: Data curationRole: Writing – review & editing
                Role: ConceptualizationRole: Writing – review & editing
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                Role: ConceptualizationRole: Funding acquisitionRole: Writing – review & editing
                Role: Writing – review & editing
                Role: ConceptualizationRole: Writing – review & editing
                Role: ConceptualizationRole: Funding acquisitionRole: Writing – review & editing
                Role: ConceptualizationRole: Data curationRole: Funding acquisitionRole: Writing – review & editing
                Role: ConceptualizationRole: Data curationRole: Funding acquisitionRole: Writing – review & editing
                Role: ConceptualizationRole: Data curationRole: Funding acquisitionRole: Writing – review & editing
                Role: Editor
                Journal
                PLoS One
                PLoS ONE
                plos
                plosone
                PLoS ONE
                Public Library of Science (San Francisco, CA USA )
                1932-6203
                19 January 2018
                2018
                : 13
                : 1
                Affiliations
                [1 ] School of Public Health, Physiotherapy & Sports Science, University College Dublin, Dublin, Ireland
                [2 ] School of Health and Human Performance, Dublin City University, Dublin, Ireland
                [3 ] Section of Hygiene—Institute of Public Health; Università Cattolica del Sacro Cuore, L.go F. Vito, Rome, Italy
                [4 ] Leibniz Institute for Prevention Research and Epidemiology, BIPS, Bremen, Germany
                [5 ] Dept of Sport, Leisure and Childhood Studies, Cork Institute of Technology, Cork, Ireland
                [6 ] Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
                [7 ] Department of Physical Education and Sports Sciences, University of Limerick, Limerick, Ireland
                [8 ] Council for Agricultural Research and Economics -Research Centre for Food and Nutrition, Rome, Italy
                [9 ] Department of Movement, Human and Health Sciences, University of Rome Foro Italico, P.za Lauro de Bosis, Rome, Italy
                [10 ] Department of Human Sciences, Society and Health, University of Cassino and Lazio Meridionale, Cassino, Italy
                [11 ] Department of Medicine and Aging Sciences, 'G. d'Annunzio' University of Chieti-Pescara, Chieti and Pescara, Italy
                [12 ] Department for Sport and Exercise Sciences, University of Stuttgart, Stuttgart, Germany
                [13 ] Department of Epidemiology and Prevention. IRCCS Instituto Neurologico Mediterraneo: NEUROMED. Pozzilli, Italy
                [14 ] Molecular Epidemiology Group, Max Delbrueck Center for Molecular Medicine in the Helmholtz Association (MDC), Berlin, Germany
                [15 ] Department of Sports Science, University of Konstanz, Konstanz, Germany
                [16 ] Institute of Epidemiology I, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
                [17 ] CarMeN Laboratory, INSERM U1060, Lyon 1 University, CRNH-Rhône-Alpes, CENS, Lyon, France
                University of Lausanne Hospital Centre, SWITZERLAND
                Author notes

                Competing Interests: The authors have declared that no competing interests exist.

                Article
                PONE-D-17-27929
                10.1371/journal.pone.0190737
                5774703
                29351286
                © 2018 O’Donoghue et al

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                Page count
                Figures: 1, Tables: 7, Pages: 24
                Product
                Funding
                Funded by: Italian Ministry of Instruction, University and Research
                Award ID: DEDIPAC F.S. 02.15.02 COD.B84G14000040008 /CDR2.PRIN 2010/11 COD. 2010KL2Y73_003
                Funded by: funder-id http://dx.doi.org/10.13039/501100002347, Bundesministerium für Bildung und Forschung;
                Award ID: 01EA1377; 01EA1374; 01EA1372C; 01EA1372E
                Funded by: funder-id http://dx.doi.org/10.13039/100010414, Health Research Board;
                Award ID: DEDIPAC/2013/1
                Funded by: funder-id http://dx.doi.org/10.13039/501100005401, Ministero delle Politiche Agricole Alimentari e Forestali;
                Award ID: DEDIPAC-IRILD, D.M.14474/7303/13
                Funded by: funder-id http://dx.doi.org/10.13039/501100006488, Institut National de la Recherche Agronomique;
                Funded by: funder-id http://dx.doi.org/10.13039/100010102, Institut National de Prévention et d'Éducation pour la Santé;
                Funded by: funder-id http://dx.doi.org/10.13039/501100003130, Fonds Wetenschappelijk Onderzoek;
                This work is supported by the following funding bodies: MIUR (Italian Ministry of Instruction, University and Research): DEDIPAC F.S.; 02.15.02 COD. B84G14000040008 – AP, KA, GC, CC, ADB, PI, GN, AS, SB, LC and CDR2.PRIN 2010/11 COD. 2010KL2Y73_003 – LI, GC; and Research Foundation Flanders Belgium – GC, MDC, SDH; and Ministry of Agricultural, Food and Forestry Policies (Ministero delle Politiche Agricole Alimentari e Forestali) Italy (DEDIPAC-IRILD, D.M., 14474/7303/13) – AP, CD; and Health Research Board Ireland; DEDIPAC/2013/1- GOD, AK, CB, AC, TC, JI, FL, CMD, RS; and Federal Ministry of Education and Research (Bundesministerium für Bildung und Forschung, Förderkennzeichen Germany; 01EA1377, 01EA1374, 01EA1372C, 01EA1372E – CB, SH, LJ, MK, AL, TP, HS, WS, AS; and Institut National de la Recherche Agronomique (INRA) and Institut National de Prévention et d’Education pour la Sante (INPES) France: CS, JAN, CP.
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