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      Editorial: “Effective strategies for promoting health-enhancing children's physical activity”

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          Abstract

          Introduction The issue of low children's physical activity (PA) has been important research and professional topic for years (and decades). Its importance increased after the restrictive measures caused by the COVID-19 pandemic (1). PA of children is crucial to the not only physical, but also psychological, social, and cognitive health of children (2, 3). Baring this in mind, there are several gudelines and protocols which recommend that children and youth spend a minimum of 60 min each day in moderate- to vigorous-intensity PA [e.g., (4, 5)]. Researchers tried to explain factors that contribute to modifying behavior (in this context, health behavior) and factors that contribute to formulation of different conceptual models (Bandura's social learning model, Rogers' Innovation Diffusion Theory, etc.) Contemporary society needs a particular scientific focus on the issue of establishment of effective strategies for promoting health-enhancing physical activity for children (6). Explanation of the mechanism of the impact of children's PA and socially appropriate behavior on health is essential for improvement of social interventions strategy. Effective strategies for improving childrens PA and adapting an active lifestyle reduce the spread of mass non-communicable diseases and children's antisocial behavior. Therefore, adopted patterns of children's active behavior can impact their habits over the upcoming years (7). The topic provides high-quality research on promotion of health-enhancing children's PA, which can offer guidelines for researchers and policymakers at local, regional, national, and international levels. These guidelines can contribute to social intervention by encouraging children's PA with the active role of a certified institution (families, schools, sports organizations, and local communities). Contribution to the field This Research Topic has been proposed due to challenges for improvement of children's socially relevant health behavior. It aims to identify existing changes in behavior relevant to health, where PA is an important factor for the change of children's lifestyle. The editorial aimed to scientifically present strategies associated with health-enhancing children's PA and to choose intervention methods for promotion of children's healthy lifestyles. The purpose of the Research Topic was to contribute to cutting-edge knowledge in explaining effective strategies for promoting health-enhancing children's PA. The outcome of this Research Topic is 18 published articles which contribute to the mentioned field from different research aspects. General insight into the Research Topic shows that the authors of the published manuscripts paid attention to various effective strategies that increase children's PA related to health: (1) active transport to school, (2) family interventions, (3) interventions in school settings and inclusive school environment, (4) academic performance, (5) impact of the geographical and living environment, (6) effectiveness of adequate sport or recreational programs, (7) motor coordination programs improvement, (8) sedentary patterns and health-related physical fitness, and (9) mediator role of sleep. Firstly, Huang et al. presented valuable findings on the association between active travel to school (ATS) and PA and screen time by individual and parental characteristics among Chinese adolescents. The authors concluded that ATS is a helpful approach in promotion of PA, determined by personal (gender, age, living environment) and parental characteristics (parental educational level and occupations). Yesiltepe et al. considered that cycling, as a way of active transport opportunity, is an individual and social contribution to public health, environmental protection, and climate change control. Therefore, current pandemic conditions could contribute to faster acceptance of cycling as a win-win strategy for individuals, families, and communities. Continuation of that segment of the green agenda and adequately responding to pandemic issues could be children's using outdoor space as an effective solution for PA practice, especially in urban environments proposed by Ma et al. Additionally, the research conducted by Planinšec et al. emphasized that researchers and decision-makers should create and develop an effective strategy for promotion of health-enhancing children's PA in case of similar situations or future lockdown. Huang et al. conducted a meta-analysis about family interventions to PA and sedentary behavior. Authors included studies published in 2012 and later. They considered the role model of family members to their children and saw family interventions as a promising way of promoting children's PA. Additionally, a systematic review examined PA levels of children and adolescents with or without autism spectrum disorder (ASD) in inclusive schools by Li et al. Liang et al. emphasized the mediating role of sleep between PA and executive function in children with attention to deficit hyperactivity disorder (ADHD), as an essential factor of effective strategies in children's PA Therefore, regular sleep patterns represent a quality base for human health and maintenance of homeostatic needs. Furthermore, two studies confirmed the significant influence of children's PA on increase of their academic performance (Durić et al.). A systematic review by Petrigna et al. identified that the time spent in PA could encourage their cognitive development and indirectly impact improving academic performance and motor competencies. Learning through movement is suggested as an effective, low-cost, and enjoyable strategy for elementary schoolchildren. On another side, one study (Aleksić Veljković et al.) showed that children's participation in yoga intervention programs increases their motor skills but not their cognitive abilities. Additionally, when it comes to improvement of motor competencies and health-enhancing children's PA, some studies revealed potential programs that should consist of directions related to gender (Zhang et al.), as well as age and gender (Battaglia et al.), living setting, geographical area, and gender (Gallotta et al.). Progression in physical fitness could be expected with the addition of exercise sessions more than the regular PA curriculum. Therefore, the physical fitness of adolescent girls can be improved with additional school interventions (on the top of regular school physical education activities) by Petrušič et al. However, the main concern and potential problems are shown in research by Giuriato et al. Namely, authors speculate that nowadays, young people achieve fewer motor experiences than peers in the past, with geographical and sociocultural determinants. Consequently, decreasing sedentary time and promoting physical benefits during sedentary breaks sounds like a possible effective strategy in changing sedentary time patterns proposed by Lu et al. The research conducted by Al-Daghri et al. is compatible with previously mentioned research. It showed that childhood obesity and pediatric metabolic syndrome (MetS) have steadily increased during the last decade in Saudi Arabia. The authors presented results of intervention programs to prevent cardiometabolic disorders in Arab youth and reported that those programs had modest effects due to COVID-19 imposed lockdowns. Finally, research designed by Feng et al. presents a study protocol article with an in-depth description of the intervention, which is based on a three-arm randomized controlled trial, which will comprise a 12-week intervention and a 12-week follow-up. Authors expect that the proposed study will improve preschoolers' movement behaviors and health outcomes, as well as their parents' movement behaviors. Conclusion This Research Topic aimed to identify the effective strategies and good practices for promoting health-enhancing physical activity in childhood. This is due to the fact, that society needs an adequate strategy in maintaining an increasingly active lifestyle for children. This type of societal intervention requires support from institutions from different levels: from the individual (home, family level) to sports organizations (group level) to and finally to the local communities (societal level).The various articles put out on this research topic indicate the complexity of children's activation in physical activity in contemporary society. Implementation of suggested strategies for promoting health-enhancing children's PA is determined by using the comprehensive knowledge and its implementation in family, school settings, sports organizations, and local environments. It can be further developed in different contexts to adapt to conditions that must be fulfilled. It seems that more effective strategies nowadays than ever require the inclusion of more community campaigns, improving access to physical activity infrastructure, and involving more sectors. Author contributions RM drafted the editorial. SP, IM, IV, and KA revised and approved the final version. All authors contributed to the article and approved the submitted version. Funding This editorial has been part of the Faculty of Sport and Physical Education project (Reg. No: 142-451-2596/2021) that were financed by the Provincial Secretariat for Higher Education and Scientific Research and also the editors gratefully acknowledge above mentioned secretariat. Conflict of interest The authors declare that the research was conducted without any commercial or financial relationships that could be construed as a potential conflict of interest. Publisher's note All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.

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          Most cited references5

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          Systematic review of the health benefits of physical activity and fitness in school-aged children and youth

          Background The purpose was to: 1) perform a systematic review of studies examining the relation between physical activity, fitness, and health in school-aged children and youth, and 2) make recommendations based on the findings. Methods The systematic review was limited to 7 health indicators: high blood cholesterol, high blood pressure, the metabolic syndrome, obesity, low bone density, depression, and injuries. Literature searches were conducted using predefined keywords in 6 key databases. A total of 11,088 potential papers were identified. The abstracts and full-text articles of potentially relevant papers were screened to determine eligibility. Data was abstracted for 113 outcomes from the 86 eligible papers. The evidence was graded for each health outcome using established criteria based on the quantity and quality of studies and strength of effect. The volume, intensity, and type of physical activity were considered. Results Physical activity was associated with numerous health benefits. The dose-response relations observed in observational studies indicate that the more physical activity, the greater the health benefit. Results from experimental studies indicate that even modest amounts of physical activity can have health benefits in high-risk youngsters (e.g., obese). To achieve substantive health benefits, the physical activity should be of at least a moderate intensity. Vigorous intensity activities may provide even greater benefit. Aerobic-based activities had the greatest health benefit, other than for bone health, in which case high-impact weight bearing activities were required. Conclusion The following recommendations were made: 1) Children and youth 5-17 years of age should accumulate an average of at least 60 minutes per day and up to several hours of at least moderate intensity physical activity. Some of the health benefits can be achieved through an average of 30 minutes per day. [Level 2, Grade A]. 2) More vigorous intensity activities should be incorporated or added when possible, including activities that strengthen muscle and bone [Level 3, Grade B]. 3) Aerobic activities should make up the majority of the physical activity. Muscle and bone strengthening activities should be incorporated on at least 3 days of the week [Level 2, Grade A].
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            Systematic review of the relationships between objectively measured physical activity and health indicators in school-aged children and youth.

            Moderate-to-vigorous physical activity (MVPA) is essential for disease prevention and health promotion. Emerging evidence suggests other intensities of physical activity (PA), including light-intensity activity (LPA), may also be important, but there has been no rigorous evaluation of the evidence. The purpose of this systematic review was to examine the relationships between objectively measured PA (total and all intensities) and health indicators in school-aged children and youth. Online databases were searched for peer-reviewed studies that met the a priori inclusion criteria: population (apparently healthy, aged 5-17 years), intervention/exposure/comparator (volumes, durations, frequencies, intensities, and patterns of objectively measured PA), and outcome (body composition, cardiometabolic biomarkers, physical fitness, behavioural conduct/pro-social behaviour, cognition/academic achievement, quality of life/well-being, harms, bone health, motor skill development, psychological distress, self-esteem). Heterogeneity among studies precluded meta-analyses; narrative synthesis was conducted. A total of 162 studies were included (204 171 participants from 31 countries). Overall, total PA was favourably associated with physical, psychological/social, and cognitive health indicators. Relationships were more consistent and robust for higher (e.g., MVPA) versus lower (e.g., LPA) intensity PA. All patterns of activity (sporadic, bouts, continuous) provided benefit. LPA was favourably associated with cardiometabolic biomarkers; data were scarce for other outcomes. These findings continue to support the importance of at least 60 min/day of MVPA for disease prevention and health promotion in children and youth, but also highlight the potential benefits of LPA and total PA. All intensities of PA should be considered in future work aimed at better elucidating the health benefits of PA in children and youth.
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              COVID-19 Impact on Behaviors across the 24-Hour Day in Children and Adolescents: Physical Activity, Sedentary Behavior, and Sleep

              In the wake of the COVID-19 pandemic, social restrictions to contain the spread of the virus have disrupted behaviors across the 24-h day including physical activity, sedentary behavior, and sleep among children (5–12 years old) and adolescents (13–17 years old). Preliminary evidence reports significant decreases in physical activity, increases in sedentary behavior, and disrupted sleep schedules/sleep quality in children and adolescents. This commentary discusses the impact of COVID-19-related restrictions on behaviors across the 24-h day in children and adolescents. Furthermore, we suggest recommendations through the lens of a socio-ecological model to provide strategies for lasting behavior change to insure the health and well-being of children and adolescents during the COVID-19 pandemic.
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                Author and article information

                Contributors
                Journal
                Front Public Health
                Front Public Health
                Front. Public Health
                Frontiers in Public Health
                Frontiers Media S.A.
                2296-2565
                26 July 2022
                2022
                : 10
                Affiliations
                [1] 1Faculty of Sport and Physical Education, University of Novi Sad , Novi Sad, Serbia
                [2] 2Western Balkan Sport Innovation Lab , Podgorica, Montenegro
                [3] 3Lithuanian Sports University , Kaunas, Lithuania
                [4] 4Aristotle University of Thessaloniki , Thessaloniki, Greece
                [5] 5Faculty for Sport and Physical Education, University of Montenegro , Niksic, Montenegro
                Author notes

                Edited and reviewed by: Meir Lotan, Ariel University, Israel

                *Correspondence: Radenko M. Matic radenkomatic@ 123456uns.ac.rs

                This article was submitted to Children and Health, a section of the journal Frontiers in Public Health

                Article
                10.3389/fpubh.2022.964316
                9360788
                4b56570c-04b8-42c2-911d-9b21aa85d21f
                Copyright © 2022 Matic, Milovanović, Valantine, Alexandris and Popovic.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 7, Pages: 3, Words: 2032
                Categories
                Public Health
                Editorial

                active lifestyle,exercise,children,health behavior,interventions

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