International Journal of Behavioral Nutrition and Physical Activity最新文献

Behaviour change interventions are widely applied across diverse domains to modify behaviours and improve outcomes, including but not limited to physical activity, sedentary behaviour, and nutrition. Systematic review of trials of behaviour change interventions often aim to determine both their overall effectiveness and the specific components driving behaviour change. The Behaviour Change Technique Taxonomy v1 (BCTTv1) is a useful framework for coding the individual Behaviour Change Techniques (BCTs) within an intervention. This commentary highlights key methodological challenges in conducting a systematic review of behaviour change interventions. It calls for collaboration in developing clear and consistent methodological guidance to enhance the rigor of systematic reviews to optimise behaviour change interventions.

Background: Active travel (such as walking, cycling and scooting) has a range of benefits for human and planetary health, whereas driving children to school contributes substantially to motor vehicle traffic at peak times. Local governments have collaborated with schools to implement traffic restriction schemes, in which motor vehicle access around schools is restricted at drop-off and pick-up times. We examined the impacts of these schemes on how children travel to school, and how these differed between socio-economic groups, in England and Scotland.

Methods: In this controlled before-and-after natural experimental study, we used data collected by primary schools on children's mode of travel to school between 2012 and 2023. We matched each intervention school to two control schools based on area-level deprivation, urban-rural status, school size, baseline prevalence of active travel to school, and geographical region. We used fixed-effects regression models to conduct difference-in-difference analyses of the percentage of pupils using active modes of transport and private motor vehicles, adjusting for potential confounding factors. We examined absolute and relative differences and differential effects by stratifying analyses by geographical region, method of enforcement, area-level deprivation, and urban-rural status.

Results: We used data from 498 schools (166 intervention and 332 control) at which on average 70% of children travelled to school by active modes at baseline, with no significant difference between intervention and selected control schools (p = 0.79). The proportion of pupils in intervention schools travelling by active modes increased by 5.9 absolute percentage points (95% CI: 2.5 to 9.1), and the proportion travelling by private motor vehicle decreased by 5.3 points (2.5 to 8.2), relative to control schools. The results for relative changes were similar, the patterns were consistent between jurisdictions and no differences were seen in other stratified analyses.

Conclusion: We found that after primary schools implemented schemes, a greater proportion of children walked, cycled or scooted to school and a smaller proportion were driven. These findings suggest that wider roll-out of these schemes might contribute to promoting active travel in children, and perhaps, to improving health. Improving the availability, quality and consistency of routinely collected data on travel to school would facilitate future research into these schemes.

Background: Establishing healthy 24-hour movement behaviours early in life is crucial for long-term health. However, few preschoolers comply with the 24-hour movement behaviour guidelines. Given the pivotal role of parents in shaping children's health habits, interventions targeting parenting practices may optimise these behaviours in preschoolers. This study evaluates the effectiveness of the 'Move ARound And Get Active' (MARGA) intervention in improving preschoolers' 24-hour movement behaviour composition, guideline compliance, and parents' parenting practices.

Methods: A two-armed, non-equivalent pretest-post-test control group design was conducted in Belgium. The MARGA intervention, co-created with parents, incorporated seven interactive sessions over 11 weeks, focussing on parenting practices conceptualised within the Self-Determination Theory and behaviour change methods such as planning and goal setting. Participants included preschoolers (2.5-6 years) and one parent per child (n = 141; 49 intervention, 92 control). The primary outcomes were changes in preschoolers' 24-hour movement behaviour composition and guideline compliance measured using accelerometers and proxy-reported diary. Secondary outcomes included changes in proxy-reported parents' parenting practices. Both intention-to-treat (ITT) and per-protocol (PP) analyses were performed. In addition, intervention implementation was investigated.

Results: The intervention showed no significant impact on the overall 24-hour movement behaviour composition, nor on 24 h-movement behaviour guideline compliance. However, favourable intervention effects were observed for screen time guideline compliance (ITT: d = 1.5, p = 0.04, PP: d = 8.6, p = < 0.001) and combinations of screen time and physical activity (ITT: d = 1.2, p = 0.05, PP: d = 1.7, p = 0.04) or sleep (PP: d = 1.7, p = 0.05) guideline compliance. Parenting practices also improved in parents from the intervention condition compared to parents from the control condition, including setting screen time rules (ITT: d = 0.79, p = 0.01, PP: d = 1.1, p = 0.001), providing choices within sleep routines (ITT: d = 0.63, p = 0.04, PP: d = 0.68, p = 0.05), parent and preschooler performing physical activity together (PP: d = 0.76, p = 0.03) and explaining screen time rules (PP: d = 0.68, p = 0.05). Implementation scores indicated moderate engagement, with attendance rates averaging 49.7%.

Conclusions: The intervention showed modest improvements in preschoolers' 24-hour movement behaviours and parenting practices. Extended follow-up observations might be required to capture changes in preschoolers' 24-hour movement behaviours, especially considering that the intervention targets preschoolers indirectly by first aiming to influence parents' parenting practices.

Trial registration: ClinicalTrials.gov (ID NCT06171191).

Background: Risks for chronic health problems are embedded in preschoolers' dietary and physical activity habits. Childcare centers are a potential venue to establish healthy habits. We hypothesized that health-promoting center plus parent interventions would improve preschoolers' dietary and physical activity outcomes, including body weight, over control.

Methods: We made local modifications to the 30-week Food Friends^® curriculum to develop a center intervention, Creating Healthy Habits Among Maryland Preschoolers (CHAMP), and a parent website (CHAMP+), aligned with the CHAMP intervention. The CHAMP intervention included a manual, web-based lessons plans, handouts, resources, and program materials implemented by CHAMP-trained staff. We evaluated effectiveness in a 3-arm cluster randomized controlled trial. Childcare centers serving low-income communities were recruited (2017-2020) from 10 counties and randomized to center (CHAMP), center plus parent (CHAMP+), or Control arms. Willingness-to-try-new-food, fruit and vegetable (FV) preference, motor competence (Test of Gross Motor Development-2), moderate-vigorous-physical-activity (MVPA, 7-day accelerometry), and anthropometry (BMI z-scores) were measured at baseline/endline (6 months post-baseline) by assessors masked to intervention status. Linear mixed models examined differences in changes among arms. Center baseline nutrition/physical activity environmental quality (Environment and Policy Assessment and Observation) was examined as moderating intervention effects.

Results: Fifty-six centers were randomized (CHAMP = 21, CHAMP+ = 20, Control = 20); 855 children. Centers were diverse by location, race, and income; children were mean age 48.44 (SD 7.50) months, 54% male; 26% experienced overweight/obesity. Analyses adjusted for baseline differences in child age, race, and ethnicity. The intervention improved motor competence (gross motor quotient: pooled CHAMP/CHAMP+ vs. Control 5.67 [95% CI: 0.60, 10.75]; locomotor score: pooled CHAMP/CHAMP+ vs. Control 1.74 [95% CI: 0.43, 3.05]) and reduced BMIz (pooled CHAMP/CHAMP+ vs. Control (-0.08 [95% CI: -0.15, 0.00]); with no intervention effects on willingness-to-try-new-foods, FV preference, or MVPA and no impact enhancement by the parent intervention (CHAMP+). Moderation analyses showed stronger increases in willingness-to-try-new-foods and MVPA in centers with higher quality nutrition/physical activity environments.

Conclusions: Childcare center interventions can improve motor competence and reduce BMIz among preschoolers. Higher quality nutrition/physical activity environment can increase the impact of interventions on children's dietary behaviors and physical activity, contributing to healthy habits.

Trial registration: NCT03111264.

Background: Engaging in no moderate-to-vigorous physical activity (MVPA) has been recognized as an important indicator in physical activity (PA) surveillance, as any engagement in MVPA confers health benefits compared to none. Studying the prevalence of no MVPA can provide valuable insights into physical inactivity patterns and inform public health intervention efforts. While some cross-sectional studies have examined this issue, no research has analysed year-to-year trends. Therefore, the aim of this study was to assess trends of no MVPA among adolescents and key subgroups using a nationally representative US sample.

Methods: Data from 2005 to 2021 cycles of the Youth Risk Behavior Surveillance System were used, with 115,926 US adolescents aged 14-17 years included (female: unweighted sample size = 58,582, 50.5%; weighted%=49.4%). Participants self-reported their demographic (sex, age, race/ethnicity, body mass index) and behavioural information (days of ≥ 60 min of MVPA over the past week, and recreational screen time). No MVPA was operationalized as reporting 0 days of ≥ 60 min of MVPA. Trend analysis was performed to assess temporal variations from 2005 to 2021 using a series of binary logistic regression models after controlling for demographic and screen time related variables.

Results: Declining trends in no MVPA were observed among adolescents from 2005 (weighted: 24.3%) to 2021 (weighted: 15.5%). After stratifying by sex, age, race/ethnicity, body mass index and recreational screen time, similar downward trends were shown across all adolescent subgroups consistently (p for trend < 0.001). Girls, older adolescents, those who identified as non-White, adolescents with excess weight, and those engaging in more than 2 h of recreational screen time per day tended to report no MVPA at higher rates (all p < 0.001) compared to their counterparts.

Conclusions: No MVPA has declined among the US adolescents, especially after 2009. Notably, sociodemographic disparities were observed in no MVPA among different population subgroups. PA promotion strategies targeting girls and older adolescents should be prioritized to further reduce the prevalence of no MVPA.

Background: Population surveys indicate that a large proportion of children worldwide do not meet the recommended 60 min of moderate-to-vigorous physical activity (PA) daily. This study aimed to assess the impact of the Great Live and Move Challenge (GLMC), a theory of planned behavior (TPB)-based intervention, on PA and TPB variables in French primary school children over two school years. Secondary objectives included assessing whether TPB variables mediated the GLMC's impact on PA and whether the GLMC impacted the strength of the link between TPB variables.

Methods: A cluster-randomized controlled trial was conducted over 16 months. One hundred primary schools were randomized into an intervention or control group. A total of 2723 children aged 7-11 years (mean age: 9.1; 49.7% boys) were included (n intervention = 1420, n control = 1303). The GLMC, based on TPB, comprised a motivational phase (targeting attitudes, subjective norms, and perceived behavioral control) and a volitional phase (notably focusing on the intentions-PA link). The intervention involved teachers, parents, and community stakeholders. The primary outcome was the change in the proportion of children meeting PA guidelines after 16 months. Secondary outcomes included changes in mean daily PA and TPB variables. Assessments occurred at baseline, 4, 12, and 16 months. Data were analyzed using mixed models and path analyses.

Results: The "time × group" interaction indicated that, compared with the control group, the intervention group had a significantly higher proportion of children meeting international PA guidelines after 16 months (OR = 3.38, 95% CI = 2.50 to 4.56, P < 0.001). TPB variables did not significantly mediate the impact of the GLMC on mean daily PA at 16 months. The path coefficient between intentions and mean daily PA was significantly higher in the intervention group than in the control group at 4 (CR = 2.45; β = 0.22 vs. 0.13) and 16 months (CR = 2.87; β = 0.24 vs. 0.14).

Conclusions: The GLMC increased the proportion of children meeting PA guidelines over 16 months, and may help bridge the intentions-PA gap. The absence of mediation by TPB variables highlights the need to investigate other psychosocial mechanisms to better understand how the GLMC promotes PA in children.

Trial registration: International Standard Randomized Controlled Trial Number (ISRCTN) Registry: 61,116,221 (retrospectively registered).