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      Mothers’ perceptions of the UK physical activity and sedentary behaviour guidelines for the early years (Start Active, Stay Active): a qualitative study

      1 , 2 , 2 , 1

      BMJ Open

      BMJ Publishing Group

      PUBLIC HEALTH, QUALITATIVE RESEARCH

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          Abstract

          Objectives

          Higher levels of physical activity (PA) during early childhood have been associated with improved health outcomes, whereas sedentary behaviour (SB) has been associated with poorer health outcomes in children. In 2011, the UK produced guidelines for PA and SB in children under 5 years. Mothers have been identified as key influences in young children's PA and SB. The aim of this study was to use in-depth interviews with mothers of preschool children to examine attitudes to the guidance.

          Design

          Qualitative study using one-to-one, semistructured interviews; Data were analysed thematically using a framework approach.

          Setting

          Mothers were recruited from preschools, nurseries, and mother and toddler groups located in four areas of varying socioeconomic status within Bristol, UK.

          Participants

          24 mothers who were considered the main or joint carer for a preschool child who was at least 2 years of age but had not yet started formal schooling.

          Results

          Mothers are not aware of the UK PA and SB guidelines for the early years. They believe that their child achieves the guideline targets for PA and SB and therefore, they do not believe these quidelines are relevant to them. Mothers feel that an increase in PA and reduction in SB (especially screen-viewing) would cause stress for mothers. Mothers found defining and quantifying PA and SB in their preschool child problematic.

          Conclusions

          As mothers do not identify with the need to increase PA or reduce SB in their child, awareness of the guidelines alone is unlikely to initiate behaviour change. Information on how mothers can make a more accurate assessment of their preschool child's PA and SB levels, and information about the benefits of increased PA and reduced SB should be provided alongside the guideline targets. Clear messages need to be developed that reframe the guidelines into pragmatic and usable targets.

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          Most cited references 30

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          Sedentary behaviour as an emerging risk factor for cardiometabolic diseases in children and youth.

          Sedentary behaviour (e.g. TV viewing, seated video game playing, prolonged sitting) has recently emerged as a distinct risk factor for cardiometabolic diseases in children and youth. This narrative review provides an overview of recent evidence in this area and highlights research gaps. Current evidence suggests that North American children and youth spend between 40% and 60% of their waking hours engaging in sedentary pursuits. Although data are lacking concerning temporal trends of objectively measured sedentary time, self-reported sedentary behaviours have increased over the past half century, with a rapid increase since the late 1990s. Excessive sedentary behaviour has been found to have independent and deleterious associations with markers of adiposity and cardiometabolic disease risk. These associations are especially consistent for screen-based sedentary behaviours (TV viewing, computer games, etc), with more conflicting findings observed for overall sedentary time. The above associations are possibly mediated by the influence of screen-based sedentary behaviours on energy intake. Although excessive sitting has been reported to have adverse acute and chronic metabolic impacts in adults, research on children is lacking. Research is particularly needed to investigate the impact of characteristics of sedentary behaviour (i.e. type/context, sedentary bout length, breaks in sedentary time, etc), as well as interventions that examine the health and behavioural impacts of sitting per se. Copyright © 2014 Canadian Diabetes Association. Published by Elsevier Inc. All rights reserved.
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            Linking obesity and activity level with children's television and video game use.

            This study examined the links between childhood obesity, activity participation and television and video game use in a nationally representative sample of children (N = 2831) ages 1-12 using age-normed body mass index (BMI) ratings. Results indicated that while television use was not related to children's weight status, video game use was. Children with higher weight status played moderate amounts of electronic games, while children with lower weight status played either very little or a lot of electronic games. Interaction analyses revealed that this curvilinear relationship applied to children under age 8 and that girls, but not boys, with higher weight status played more video games. Children ages 9-12 with lower weight status used the computer (non-game) for moderate amounts of time, while those with higher weight status used the computer either very little or a lot. This was also true for the relationship between print use and weight status for children of all ages. Results also indicated that children with higher weight status spent more time in sedentary activities than those with lower weight status.
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              Volume, patterns, and types of sedentary behavior and cardio-metabolic health in children and adolescents: a cross-sectional study

              Background Cardio-metabolic risk factors are becoming more prevalent in children and adolescents. A lack of moderate-to-vigorous intensity physical activity (MVPA) is an established determinant of cardio-metabolic risk factors in children and adolescents. Less is known about the relationship between sedentary behavior and cardio-metabolic health. Therefore, the objective was to examine the independent associations between volume, patterns, and types of sedentary behavior with cardio-metabolic risk factors among children and adolescents. Methods The results are based on 2527 children and adolescents (6-19 years old) from the 2003/04 and 2005/06 National Health and Nutrition Examination Surveys (NHANES). A cardio-metabolic risk score (CRS) was calculated based on age- and sex-adjusted waist circumference, systolic blood pressure, non-high-density lipoprotein cholesterol, and C-reactive protein values. Volume and patterns of sedentary behavior and moderate-to-vigorous physical activity (MVPA) were measured objectively using accelerometers. Types of sedentary behavior were measured by questionnaire. A series of logistic regression models were used to examine associations. Results Volume and patterns of sedentary behavior were not predictors of high CRS after adjusting for MVPA and other confounders (P > 0.1). For types of sedentary behavior, high TV use, but not high computer use, was a predictor of high CRS after adjustment for MVPA and other confounders. Children and adolescents who watched ≥4 hours per day of TV were 2.53 (95% confidence interval: 1.45-4.42) times more likely to have high CRS than those who watched <1 hour per day. MVPA predicted high CRS after adjusting for all sedentary behavior measures and other confounders. After adjustment for waist circumference, MVPA also predicted high non-obesity CRS; however, the same relationship was not seen with TV use. Conclusion No association was observed between overall volume and patterns of sedentary behavior with cardio-metabolic risk factors in this large sample of children and adolescents. Conversely, high TV use and low MVPA were independently associated with cardio-metabolic risk factors. However, the association between high TV use and clustered cardio-metabolic risk factors appears to be mediated or confounded by obesity. Thus, TV and MVPA appear to be two separate behaviors that need to be targeted with different interventions and policies.
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                Author and article information

                Journal
                BMJ Open
                BMJ Open
                bmjopen
                bmjopen
                BMJ Open
                BMJ Publishing Group (BMA House, Tavistock Square, London, WC1H 9JR )
                2044-6055
                2015
                07 September 2015
                : 5
                : 9
                Affiliations
                [1 ]Centre of Academic Primary Care, School of Social and Community Medicine, University of Bristol , Bristol, UK
                [2 ]Centre for Exercise, Nutrition & Health Sciences, School for Policy Studies, University of Bristol , Bristol, UK
                Author notes
                [Correspondence to ] Georgina Bentley; georgina.bentley@ 123456bristol.ac.uk
                Article
                bmjopen-2015-008383
                10.1136/bmjopen-2015-008383
                4577870
                26351186
                Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions

                This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

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                Qualitative Research
                Research
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                1725
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                Medicine

                qualitative research, public health

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