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Article ; Online: Prevalence and Health Associations of Meeting the World Health Organization Guidelines for Physical Activity, Sedentary Behavior, and Sleep in Preschool-Aged Children: The SUNRISE Mongolia Pilot and Feasibility Study.

Byambaa, Ankhmaa / Dechinjamts, Oyundelger / Jambaldorj, Bayasgalan / Jones, Rachel A / Chong, Kar Hau / Okely, Anthony D

Journal of physical activity & health

2024 Volume 21, Issue 3, Page(s) 283–293

Abstract: Background: There is a lack of evidence regarding 24-hour movement behaviors of young children from low- and middle-income countries. This study examined Mongolian preschoolers' adherence to the World Health Organization's guidelines for physical ... ...

Abstract	Background: There is a lack of evidence regarding 24-hour movement behaviors of young children from low- and middle-income countries. This study examined Mongolian preschoolers' adherence to the World Health Organization's guidelines for physical activity, sedentary behavior, and sleep; their associations with health indicators, and the feasibility of the SUNRISE International study in Mongolia. Methods: Preschool-aged children were recruited from 5 kindergartens in urban and rural areas of Ulaanbaatar city and Tuv province in Mongolia. Physical activity and sedentary behavior were measured by an ActiGraph accelerometer worn for 5 consecutive days. Screen time and sleep were reported by parents. The National Institute of Health and Early Years Toolboxes were used to assess motor skills and executive function, respectively. Results: One hundred and one children participated in the study (mean age = 4.82 y, boys = 58), with 88% (n = 89) having complete data for analysis. The proportion of children who met the recommendations for physical activity, sedentary screen time, and sleep was 61%, 23%, and 82%, respectively. Only 7% met all recommendations. Meeting the sleep recommendation individually (P = .032) and in combination with the physical activity recommendation was associated with better gross (P = .019) and fine (P = .042) motor skills. Spending more time in physical activity was positively correlated with motor development. Results confirmed that the SUNRISE study protocol was feasible, age-appropriate, and enjoyable for children. Conclusions: The results of the SUNRISE pilot study will help inform the SUNRISE Mongolia main study and lay the groundwork for future research into children's 24-hour movement behaviors in Mongolia.
MeSH term(s)	Male ; Child ; Humans ; Child, Preschool ; Sedentary Behavior ; Feasibility Studies ; Prevalence ; Mongolia ; Pilot Projects ; Exercise ; World Health Organization ; Sleep
Language	English
Publishing date	2024-01-19
Publishing country	United States
Document type	Journal Article
ISSN	1543-5474
ISSN (online)	1543-5474
DOI	10.1123/jpah.2023-0511
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Article ; Online: Effects of eHealth Interventions on 24-Hour Movement Behaviors Among Preschoolers: Systematic Review and Meta-Analysis.

Jiang, Shan / Ng, Johan Y Y / Chong, Kar Hau / Peng, Bo / Ha, Amy S

Journal of medical Internet research

2024 Volume 26, Page(s) e52905

Abstract: Background: The high prevalence of unhealthy movement behaviors among young children remains a global public health issue. eHealth is considered a cost-effective approach that holds great promise for enhancing health and related behaviors. However, ... ...

Abstract	Background: The high prevalence of unhealthy movement behaviors among young children remains a global public health issue. eHealth is considered a cost-effective approach that holds great promise for enhancing health and related behaviors. However, previous research on eHealth interventions aimed at promoting behavior change has primarily focused on adolescents and adults, leaving a limited body of evidence specifically pertaining to preschoolers. Objective: This review aims to examine the effectiveness of eHealth interventions in promoting 24-hour movement behaviors, specifically focusing on improving physical activity (PA) and sleep duration and reducing sedentary behavior among preschoolers. In addition, we assessed the moderating effects of various study characteristics on intervention effectiveness. Methods: We searched 6 electronic databases (PubMed, Ovid, SPORTDiscus, Scopus, Web of Science, and Cochrane Central Register of Controlled Trials) for experimental studies with a randomization procedure that examined the effectiveness of eHealth interventions on 24-hour movement behaviors among preschoolers aged 2 to 6 years in February 2023. The study outcomes included PA, sleep duration, and sedentary time. A meta-analysis was conducted to assess the pooled effect using a random-effects model, and subgroup analyses were conducted to explore the potential effects of moderating factors such as intervention duration, intervention type, and risk of bias (ROB). The included studies underwent a rigorous ROB assessment using the Cochrane ROB tool. Moreover, the certainty of evidence was evaluated using the GRADE (Grading of Recommendations Assessment, Development, and Evaluation) assessment. Results: Of the 7191 identified records, 19 (0.26%) were included in the systematic review. The meta-analysis comprised a sample of 2971 preschoolers, which was derived from 13 included studies. Compared with the control group, eHealth interventions significantly increased moderate to vigorous PA (Hedges g=0.16, 95% CI 0.03-0.30; P=.02) and total PA (Hedges g=0.37, 95% CI 0.02-0.72; P=.04). In addition, eHealth interventions significantly reduced sedentary time (Hedges g=-0.15, 95% CI -0.27 to -0.02; P=.02) and increased sleep duration (Hedges g=0.47, 95% CI 0.18-0.75; P=.002) immediately after the intervention. However, no significant moderating effects were observed for any of the variables assessed (P>.05). The quality of evidence was rated as "moderate" for moderate to vigorous intensity PA and sedentary time outcomes and "low" for sleep outcomes. Conclusions: eHealth interventions may be a promising strategy to increase PA, improve sleep, and reduce sedentary time among preschoolers. To effectively promote healthy behaviors in early childhood, it is imperative for future studies to prioritize the development of rigorous comparative trials with larger sample sizes. In addition, researchers should thoroughly examine the effects of potential moderators. There is also a pressing need to comprehensively explore the long-term effects resulting from these interventions. Trial registration: PROSPERO CRD42022365003; http://tinyurl.com/3nnfdwh3.
MeSH term(s)	Child ; Child, Preschool ; Humans ; Databases, Factual ; Exercise ; Health Behavior ; Movement ; Sedentary Behavior ; Telemedicine ; Health Promotion
Language	English
Publishing date	2024-02-21
Publishing country	Canada
Document type	Journal Article ; Meta-Analysis ; Systematic Review
ZDB-ID	2028830-X
ISSN	1438-8871 ; 1438-8871
ISSN (online)	1438-8871
ISSN	1438-8871
DOI	10.2196/52905
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Article ; Online: Sociodemographic moderators of longitudinal changes in active play between childhood and adolescence in Australia.

Kemp, Byron J / Parrish, Anne-Maree / Chong, Kar Hau / Cliff, Dylan

Journal of sports sciences

2023 Volume 41, Issue 15, Page(s) 1483–1489

Abstract: Physical activity (PA) participation is prone to decline during childhood and adolescence. In Australia, this decline has been shown to particularly occur in active play. This study aimed to identify sociodemographic moderators of change in active play ... ...

Abstract	Physical activity (PA) participation is prone to decline during childhood and adolescence. In Australia, this decline has been shown to particularly occur in active play. This study aimed to identify sociodemographic moderators of change in active play between 10-11y and 12-13y among Australian youth. The data were sourced from Waves 6-7 of the Longitudinal Study of Australian Children (
MeSH term(s)	Child ; Female ; Humans ; Adolescent ; Longitudinal Studies ; Australia ; Exercise ; Body Mass Index
Language	English
Publishing date	2023-11-29
Publishing country	England
Document type	Journal Article
ZDB-ID	995528-8
ISSN	1466-447X ; 0264-0414
ISSN (online)	1466-447X
ISSN	0264-0414
DOI	10.1080/02640414.2023.2278932
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Article ; Online: Cross-sectional and longitudinal associations of domain-specific physical activity composition with health-related quality of life in childhood and adolescence in Australia.

Kemp, Byron J / Dumuid, Dorothea / Chong, Kar Hau / Parrish, Anne-Maree / Cliff, Dylan

The international journal of behavioral nutrition and physical activity

2023 Volume 20, Issue 1, Page(s) 67

Abstract: Background: Health benefits have been linked with physical activity (PA), as well as some domains of PA among youth (e.g. organized PA and active transport). However, less is known about whether some PA domains are more beneficial than others. There is ... ...

Abstract	Background: Health benefits have been linked with physical activity (PA), as well as some domains of PA among youth (e.g. organized PA and active transport). However, less is known about whether some PA domains are more beneficial than others. There is also a lack of evidence about whether health outcomes are related to the composition of PA (i.e. the share of PA spent in different domains). This study aimed to identify: (1) how the absolute durations of organized PA, non-organized PA, active transport and active chores/work at 10-11y are individually associated with physical, psychosocial and total health-related quality of life (HRQOL) at 10-11y and 12-13y; and (2) how the domain-specific composition of PA at 10-11y is associated with HRQOL at 10-11y and 12-13y. Methods: Data from the Longitudinal Study of Australian Children were used in cross-sectional (n ≥ 2730) and longitudinal analyses (n ≥ 2376). Measurement included the Pediatric Quality of Life Inventory (PedsQL™) for HRQOL domains and one-day time-use diaries (TUDs) for PA domains. Robust linear regression models were used, controlling for age, sex, pubertal status, socioeconomic position, body mass index and TUD context (season and school attendance). Compositional models additionally adjusted for total PA duration and longitudinal models controlled for baseline PedsQL™ scores. Results: Non-compositional models indicated that the duration of organized PA, and to a lesser extent non-organized PA, were positively but weakly associated with some HRQOL outcomes at 10-11y. These trends were not reflected in longitudinal models, although a 30-min increase in non-organized PA per day did predict marginally better psychosocial HRQOL at 12-13y (+ 0.17%; 95%CI = + 0.03%, + 0.32%). Compositional models revealed that a 30-min increase in organized PA relative to other domains was positively but weakly associated with physical (+ 0.32%; 95%CI = + 0.01%, + 0.63%), psychosocial (+ 0.41%; 95%CI = + 0.11%, + 0.72%) and total HRQOL (+ 0.39%; 95%CI = + 0.12%, + 0.66%) at 10-11y. However, the overall PA composition at 10-11y was not related to HRQOL at 12-13y. Conclusions: Non-compositional and compositional models generally concurred on the direction of cross-sectional and longitudinal relationships (and lack thereof) between PA domains and HRQOL outcomes. The strongest associations were cross-sectional between organized PA and HRQOL at 10-11y. However, all associations between PA domains and HRQOL outcomes were weak and may not be clinically meaningful.
MeSH term(s)	Child ; Humans ; Adolescent ; Quality of Life ; Longitudinal Studies ; Australia ; Exercise ; Body Mass Index
Language	English
Publishing date	2023-06-06
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2134691-4
ISSN	1479-5868 ; 1479-5868
ISSN (online)	1479-5868
ISSN	1479-5868
DOI	10.1186/s12966-023-01466-6
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Article ; Online: Changes in 24-Hour Domain-Specific Movement Behaviors and Their Associations With Children's Psychosocial Health During the Transition From Primary to Secondary School: A Compositional Data Analysis.

Chong, Kar Hau / Dumuid, Dorothea / Cliff, Dylan P / Parrish, Anne-Maree / Okely, Anthony D

Journal of physical activity & health

2022 Volume 19, Issue 5, Page(s) 358–366

Abstract: Background: Little is known about the influence of 24-hour movement behaviors on children's psychosocial health when transitioning from primary to secondary school. This study described changes in 24-hour domain-specific movement behavior composition ... ...

Abstract	Background: Little is known about the influence of 24-hour movement behaviors on children's psychosocial health when transitioning from primary to secondary school. This study described changes in 24-hour domain-specific movement behavior composition and explored their associations with changes in psychosocial health during this transition. Methods: Data were drawn from the Longitudinal Study of Australian Children. The analytical sample (n = 909) included children who were enrolled in primary school at baseline (2010) and in secondary school at follow-up (2012). Time spent in 8 domains of movement behaviors was derived from the child-completed time-use diaries. Psychosocial health was examined using the self-report version of the Strengths and Difficulties Questionnaires. Analyses included repeated-measures multivariate analysis of variance and compositional regression. Results: Children reported engaging in more social activities and sleeping less over the transition period. Increased time spent in social activities (βilr = -0.06, P = .014) and recreational screen use (βilr = -0.17, P = .003) (relative to other domains) were associated with decreased prosocial behavior in boys. Changes in movement behavior composition were not associated with changes in girls' psychosocial health. Conclusion: This study found considerable changes in children's 24-hour movement behavior composition, but a lack of consistent association with changes in psychosocial health during the primary to secondary school transition.
MeSH term(s)	Australia ; Data Analysis ; Exercise/psychology ; Female ; Humans ; Longitudinal Studies ; Male ; Schools ; Sedentary Behavior
Language	English
Publishing date	2022-04-12
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ISSN	1543-5474
ISSN (online)	1543-5474
DOI	10.1123/jpah.2021-0630
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Article ; Online: Prevalence and socio-demographic distributions of meeting RMI Guidelines for Healthy Living among elementary school children in Majuro, Republic of Marshall Islands: a cross-sectional population-based survey.

Smith, Tanner / Chong, Kar Hau / Cross, Penny / Ipil, Maybelline / Eliou, Pranson / Novotny, Rachel / Okely, Anthony D

The Lancet regional health. Western Pacific

2023 Volume 37, Page(s) 100783

Abstract: Background: Childhood obesity is high in Republic of Marshall Islands (RMI). We report the prevalence and socio-demographic distribution of selected obesity-related risk factors among children in Majuro, RMI.: Methods: Sixteen elementary schools were ...

Abstract	Background: Childhood obesity is high in Republic of Marshall Islands (RMI). We report the prevalence and socio-demographic distribution of selected obesity-related risk factors among children in Majuro, RMI. Methods: Sixteen elementary schools were approached and students and parents in Grades 1, 3, and 5 invited to participate in this cross-sectional population-based survey. Accelerometry and a questionnaire were used to collect data on children's physical activity (PA), sleep, screen time and dietary behaviours. Descriptive statistics and mixed-effects logistic regression were used to examine differences in the proportions of children meeting selected RMI Healthy Living Guidelines by sex, school grade and school sector. Findings: Thirteen schools and 958 children were recruited, of which 892 (52.2% girls; mean age 9.3 ± 1.8 years) provided useable data. Around 90% met the PA, 29% screen time, 13% sleep, 69% sugar-sweetened beverage and 56% highly processed food guidelines. The proportion meeting individual guidelines was higher among children in Grade 1 compared with Grade 5. Being a girl (0.27; 95% CI 0.16, 0.46) was associated with lower odds of meeting the PA recommendation. Compared with children from Grade 1, those in Grade 5 had lower odds of meeting the PA (0.28; 95% CI 0.15, 0.55), screen time (0.60; 95% CI 0.40, 0.89), sleep duration (0.33; 95% CI 0.18, 0.59), sugar-sweetened beverage (0.35; 95% CI 0.23, 0.53), and consumption of highly processed foods recommendations (0.49; 95% CI 0.33, 0.72). Interpretation: While most children in RMI are adequately active, resources are needed to promote healthier levels of screen time, sleep, sugar-sweetened beverage and highly processed food consumption, especially among older children. Funding: This study was funded by World Diabetes Foundation; Canvasback Missions, RMI; NHMRC Australia (APP1176858); Pacific Community.
Language	English
Publishing date	2023-05-03
Publishing country	England
Document type	Journal Article
ISSN	2666-6065
ISSN (online)	2666-6065
DOI	10.1016/j.lanwpc.2023.100783
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Article ; Online: Validation of remote assessment of preschool children's anthropometrics and motor skills.

Button, Alyssa M / Webster, E Kipling / Kracht, Chelsea L / Hendrick, Chelsea / Okely, Anthony / Chong, Kar Hau / Cross, Penny / Staiano, Amanda E

Frontiers in digital health

2023 Volume 5, Page(s) 1168618

Abstract: Introduction: Remotely delivered treatment and research procedures were rapidly adopted in response to the COVID-19 pandemic. However, it is unclear if these measures are valid. The purpose of this study was to compare the validity of anthropometry and ... ...

Abstract	Introduction: Remotely delivered treatment and research procedures were rapidly adopted in response to the COVID-19 pandemic. However, it is unclear if these measures are valid. The purpose of this study was to compare the validity of anthropometry and motor skill proficiency measurements collected in a remote-setting to in-person setting among a sample of children ages 3-4 years. Methods: Child anthropometry and motor skill performance were measured in-person by trained assessors and by parents at home with remote supervision via videoconference by trained assessors. The following measures from the National Institutes of Health Toolbox were collected: anthropometry (height and weight), manual dexterity/manipulation (9-hole pegboard), motor coordination and agility (supine timed up and go), lower body strength (standing long jump), and postural stability (one-leg standing balance). Differences in expert and parent-based measurements were assessed using Bland-Altman plots, paired samples t-tests, and Pearson correlations. Results: A total of Discussion: Remote measurements of motor skills and weight are valid assessments for researchers and clinicians to utilize in young children. Remote assessment with guidance offers comparable and valid estimates as in-person assessment, potentially offering a solution to resource-constricted barriers in research and access to care. There is an opportunity for researchers to fine-tune remote height and individual-level assessment strategies.
Language	English
Publishing date	2023-07-13
Publishing country	Switzerland
Document type	Journal Article
ISSN	2673-253X
ISSN (online)	2673-253X
DOI	10.3389/fdgth.2023.1168618
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Article ; Online: Accelerometer-Measured Physical Activity and Sedentary Time among Children in Japan before and during COVID-19: A Cross-Sectional and Longitudinal Analysis.

Tanaka, Chiaki / Shikano, Akiko / Imai, Natsuko / Chong, Kar Hau / Howard, Steven J / Tanabe, Kosuke / Okely, Anthony D / Taylor, Ellie K / Noi, Shingo

International journal of environmental research and public health

2023 Volume 20, Issue 2

Abstract: This study examined changes in physical activity (PA), sedentary behavior (SB), screen time, sleep, and executive function among Japanese preschoolers between COVID-19 pre-pandemic and pandemic periods, using cross-sectional and longitudinal data. ... ...

Abstract	This study examined changes in physical activity (PA), sedentary behavior (SB), screen time, sleep, and executive function among Japanese preschoolers between COVID-19 pre-pandemic and pandemic periods, using cross-sectional and longitudinal data. Accelerometer data from 63 children aged 5-6 years were collected from three kindergartens in Tokyo, Japan, in late 2019 (pre-COVID-19). This was compared to the data of 49 children aged 5-6 years from the same kindergartens, collected in late 2020 (during COVID-19). Sixteen children in the pre-COVID-19 cohort also participated in the 2020 survey and provided data for the longitudinal analysis. The mean minutes of PA, SB, screen time, and sleep duration, as well as executive function, were compared between the pre- and during COVID-19 cohorts. After adjusting for school, sex, and accelerometer wear time, there were no significant differences in any of the measured outcomes between the two cohorts. However, the analysis of longitudinal data revealed significant increases in time spent in SB and on screens, and a decrease in light-intensity PA and sleep duration during the pandemic compared to the pre-pandemic period. Results suggest that, despite the COVID-19 pandemic, young children's activity levels and SB did not significantly differ from pre-pandemic levels. However, school-aged children's SB, light PA, and sleep time were affected, although this cannot be disentangled from the effects of the transition to school.
MeSH term(s)	Humans ; Child ; Child, Preschool ; COVID-19/epidemiology ; Sedentary Behavior ; Japan/epidemiology ; Pandemics ; Cross-Sectional Studies ; Exercise ; Accelerometry/methods
Language	English
Publishing date	2023-01-09
Publishing country	Switzerland
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2175195-X
ISSN	1660-4601 ; 1661-7827
ISSN (online)	1660-4601
ISSN	1661-7827
DOI	10.3390/ijerph20021130
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Article ; Online: Proportion and Correlates of Children in the US-Affiliated Pacific Region Meeting Sleep, Screen Time, and Physical Activity Guidelines.

Ryan, Sarah T / Okely, Anthony D / Chong, Kar Hau / Stanley, Rebecca M / Randle, Melanie / Waqa, Gade / Yamanaka, Ashley B / Guerrero, Rachael Leon / Coleman, Patricia / Shallcross, Leslie / Wilkens, Lynne R / Deenik, Jonathan L / Novotny, Rachel

Journal of physical activity & health

2024 , Page(s) 1–11

Abstract: Introduction: Limited data on 24-hour movement behaviors of children aged 5-8 years exist globally. We describe the prevalence and sociodemographic associations of meeting physical activity (PA), sedentary recreational screen time (ST), and sleep ... ...

Abstract	Introduction: Limited data on 24-hour movement behaviors of children aged 5-8 years exist globally. We describe the prevalence and sociodemographic associations of meeting physical activity (PA), sedentary recreational screen time (ST), and sleep guidelines among children from 11 jurisdictions in the US-Affiliated Pacific region. Methods: Cross-sectional representative data from 1192 children aged 5-8 years living in the US-Affiliated Pacific region were drawn from the baseline 2012-2014 Children's Healthy Living Program. Sleep and moderate- to vigorous-intensity PA were calculated from accelerometry. ST and sociodemographic data were collected from caregiver surveys. The percentage of children meeting the Asia-Pacific 24-hour movement guidelines for PA (≥60 min/d of moderate- to vigorous-intensity PA), sleep (≥9 and ≤ 11 h/d) and ST (≤2 h/d) were calculated. Generalized linear mixed models were used to examine associations with adiposity and sociodemographic variables. Results: Twenty-seven percent (95% confidence interval, 24.6-30.0) of children met integrated guidelines; 98% (96.2-98.0) met PA, 78% (75.4-80.0) met sleep, and 35% (32.6-38.0) met ST guidelines. Females (adjusted odds ratio = 1.40 [95% confidence interval, 1.03-1.91]) and those living in lower-middle-income jurisdictions (2.29 [1.49-3.54]) were more likely to meet ST guidelines. Overweight children (0.62 [0.40-0.96]), those aged 8 years (0.39 [0.22-0.69]), and children with caregivers of an education level of high school or beyond (0.44 [0.29-0.68]) were less likely to achieve ST guidelines. Children from midrange annual household incomes were less likely to meet combined guidelines (0.60 [0.39-0.92]). Conclusions: Three-quarters of children are not meeting integrated Asia-Pacific 24-hour movement guidelines. Future strategies for reducing ST and increasing integrated guidelines compliance are needed.
Language	English
Publishing date	2024-03-26
Publishing country	United States
Document type	Journal Article
ISSN	1543-5474
ISSN (online)	1543-5474
DOI	10.1123/jpah.2023-0463
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Article ; Online: Changes in 24-hour movement behaviours during the transition from primary to secondary school among Australian children.

Chong, Kar Hau / Parrish, Anne-Maree / Cliff, Dylan P / Dumuid, Dorothea / Okely, Anthony D

European journal of sport science

2021 Volume 22, Issue 8, Page(s) 1276–1286

Abstract: This study examined concurrent changes in all components of 24-h movement behaviours (24-h MB) (sleep, sedentary behaviour [SB] and physical activity [PA]) and compliance with the Australian 24-Hour Movement Guidelines over the primary to the secondary ... ...

Abstract	This study examined concurrent changes in all components of 24-h movement behaviours (24-h MB) (sleep, sedentary behaviour [SB] and physical activity [PA]) and compliance with the Australian 24-Hour Movement Guidelines over the primary to the secondary school transition period. The analytical sample included 83 children (60.2% girls) who provided valid accelerometer-measured 24-h MB data during their final year of primary school (T1) and first year of secondary school (T2). Self-reported participation in domain-specific SB and PA, socio-demographic characteristics and weight status were also assessed. Change in 24-h MB composition from T1 to T2 was analysed using a compositional multivariate linear model for repeated measures. The difference in the proportion of meeting the 24-hour integrated movement guidelines was assessed using a McNemar-Bowker test. An unfavourable change was observed in the 24-h MB composition (
MeSH term(s)	Australia ; Child ; Exercise ; Female ; Humans ; Male ; Schools ; Screen Time ; Sedentary Behavior ; Sleep
Language	English
Publishing date	2021-04-02
Publishing country	England
Document type	Journal Article
ISSN	1536-7290
ISSN (online)	1536-7290
DOI	10.1080/17461391.2021.1903562
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