Longitudinal active living research to address physical inactivity and sedentary behaviour in children in transition from preadolescence to adolescence

Muhajarine et al. BMC Public Health Longitudinal active living research to address physical inactivity and sedentary behaviour in children in transition from preadolescence to adolescence Nazeem Muhajarine 0 1 Tarun R Katapally 0 Daniel Fuller 2 Kevin G Stanley 4 Daniel Rainham 3 0 Community Health and Epidemiology, University of Saskatchewan , Saskatoon, SK , Canada 1 Saskatchewan Population Health and Evaluation Research Unit, University of Saskatchewan , Saskatoon, SK , Canada 2 School of Public Health, University of Saskatchewan , Saskatoon, SK , Canada 3 Environmental Science, Dalhousie University , Halifax, NS , Canada 4 Computer Science, University of Saskatchewan , Saskatoon, SK , Canada Background: Children can be highly active and highly sedentary on the same day! For instance, a child can spend a couple of hours playing sports, and then spend the rest of the day in front of a screen. A focus on examining both physical activity and sedentary behaviour throughout the day and in all seasons in a year is necessary to generate comprehensive evidence to curb childhood obesity. To achieve this, we need to understand where within a city are children active or sedentary in all seasons. This active living study based in Saskatoon, Canada, aims to understand the role played by modifiable urban built environments in mitigating, or exacerbating, seasonal effects on children's physical activity and sedentary behaviour in a population of children in transition from preadolescence to adolescence. Methods/Design: Designed as an observational, longitudinal investigation this study will recruit 800 Canadian children 10-14 years of age. Data will be obtained from children representing all socioeconomic categories within all types of neighbourhoods built in a range of urban designs. Built environment characteristics will be measured using previously validated neighbourhood audit and observational tools. Neighbourhood level socioeconomic variables customized to Saskatoon neighbourhoods from 2011 Statistics Canada's National Household Survey will be used to control for neighbourhood social environment. The validated Smart Cities Healthy Kids questionnaire will be administered to capture children's behaviour and perception of a range of factors that influence their activity, household (including family socioeconomic factors), parental, peer and neighbourhood influence on independent mobility. The outcome measures, different intensities of physical activity and sedentary behaviour, will be collected using global positioning system equipped accelerometers in all four seasons. Each accelerometry cycle will be matched with weather data obtained from Environment Canada. Extensive weather data will be accessed and classified into one of six distinct air mass categories for each day of accelerometry. Computational and spatial analytical techniques will be utilized to understand the multi-level influence of environmental exposures on physical activity and sedentary behaviour in all seasons. (Continued on next page) - (Continued from previous page) Discussion: This approach will help us understand the influence of urban environment on childrens activity, thus paving the way to modify urban spaces to increase physical activity and decrease sedentary behaviour in children in all four seasons. Lack of physical activity and rising sedentariness is associated with rising childhood obesity, and childhood obesity in turn is linked to many chronic conditions over the life course. Understanding the interaction of children with urban spaces will reveal new knowledge, and when translated to actions will provide a strong basis for informing future urban planning policy. Background Physical activitys (PA) benefits in preventing noncommunicable diseases and improving psychological wellbeing in children have been well established [1, 2]. Despite this evidence, physical inactivity has reached pandemic levels [3], with a majority of children not accumulating the recommended levels of PA for health benefits [4]. Since behavioural interventions directed at individuals have not consistently produced the anticipated PA increase at the population level, in recent years an interdisciplinary field of study, active living research (ALR), has gained prominence [5, 6]. Rooted in eco-social perspective, active living research encompasses exercise, recreational activities, household and occupational activities, and active transportation [6]. Active living interventions, therefore, aim to influence policy to modify environmental exposures at multiple levels (e.g. built environment, schools), thus facilitating PA change in populations [6]. In active living research, the segregation of sedentary behaviour (SB) from PA is critical; emerging evidence suggests that SB have negative effects on health outcomes, and that these are independent of the benefits of PA [79]. Child and adolescent-specific ALR evidence indicates some consistent findings. Safety, perception of recreational environment, and opportunity for active transportation have been positively associated with PA [1019]. Recent reviews [20, 21] have also highlighted the role of multilevel (home, school and individual level) environmental determinants on PA in children and adolescents. Although a significant focus of ALR in children and adolescents has been on PA alone, emerging evidence suggests a stronger role for home environment, where parental support and familys higher socioeconomic status being associated with lower SB [20, 22]. In terms of neighbourhood environment, higher perceived safety has been associated with lower SB [23]. One consistent gap in ALR to date is the underexploration of how built and social environmental factors interact with the variation of weather to influence PA and SB. Studies that have explored seasonal weather variations influence on PA (and almost none relating to SB) have focused exclusively on seasonal or weather patterns, instead of the interaction between weather variation (a nonmodifiable factor) and built and social environmental exposures (modifiable factors) [2431]. Thus, ALR needs to move towards longitudinal investigations by incorporating seasonal weather variation along with built and social environmental exposures. The significance of the influence of weather is especially important in temperate and continental climatic zones such as in Canada and in continental Europe due to its wide seasonal variation [32]. Within Canada, prairie provinces like Saskatchewan are known for particularly extreme variations in seasonal weather [33, 34], and there is evidence to indicate that the relationship between seasonality and PA is stronger in Saskatchewan [30]. This study is part of an ongoing active living research initiative set in the city of Saskatoon, Saskatchewan, Canada Smart Cities, Healthy Kids (www.smartcitieshealthykids.com). Using generalizable and replicable built environment measurement tools [3538] and ob (...truncated)