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Background: There is concern that the COVID-19 pandemic may negatively affect health behaviors in youth, especially youth diagnosed with Autism Spectrum Disorder (ASD)., Objective: The purpose of this paper was to examine changes in physical activity, screen-time, and sleep in adolescents with ASD due to the COVID-19 pandemic., Methods: Nine adolescents with ASD completed surveys measuring physical activity, screen-time, and sleep duration prior to and during the pandemic., Results: A significant decrease in days of physical activity (4.17 vs 2.27; p = 0.0006), and a significant increase in hours of both weekday (3.69 vs 6.25; p = 0.007) and weekend screen-time (5.94 vs. 7.39; p = 0.004) was observed during the pandemic. No changes regarding sleep duration was observed., Conclusions: Although preliminary, results suggest that physical activity and screen-time may be negatively affected by the COVID-19 outbreak in youth with ASD. The development of interventions to promote health behaviors in ASD populations during long periods of less-structured time (quarantine) should be considered., Competing Interests: Declaration of competing interest The authors declare that they have no conflict of interest., (Copyright © 2020 Elsevier Inc. All rights reserved.)

Background: Children's BMI gain accelerates during summer. The Structured Days Hypothesis posits that the lack of the school day during summer vacation negatively impacts children's obesogenic behaviors (i.e., physical activity, screen time, diet, sleep). This natural experiment examined the impact of summer vacation on children's obesogenic behaviors and body mass index (BMI)., Methods: Elementary-aged children (n = 285, 5-12 years, 48.7% male, 57.4% African American) attending a year-round (n = 97) and two match-paired traditional schools (n = 188) in the United States participated in this study. Rather than taking a long break from school during the summer like traditional schools, year-round schools take shorter and more frequent breaks from school. This difference in school calendars allowed for obesogenic behaviors to be collected during three conditions: Condition 1) all children attend school, Condition 2) year-round children attend school while traditional children were on summer vacation, and Condition 3) summer vacation for all children. Changes in BMI z-score were collected for the corresponding school years and summers. Multi-level mixed effects regressions estimated obesogenic behaviors and monthly zBMI changes. It was hypothesized that children would experience unhealthy changes in obesogenic behaviors when entering summer vacation because the absence of the school day (i.e., Condition 1 vs. 2 for traditional school children and 2 vs. 3 for year-round school children)., Results: From Condition 1 to 2 traditional school children experienced greater unhealthy changes in daily minutes sedentary (∆ = 24.2, 95CI = 10.2, 38.2), screen time minutes (∆ = 33.7, 95CI = 17.2, 50.3), sleep midpoint time (∆ = 73:43, 95CI = 65:33, 81:53), and sleep efficiency percentage (-∆ = 0.7, 95CI = -1.1, - 0.3) when compared to year-round school children. Alternatively, from Condition 2 to 3 year-round school children experienced greater unhealthy changes in daily minutes sedentary (∆ = 54.5, 95CI = 38.0, 70.9), light physical activity minutes (∆ = - 42.2, 95CI = -56.2, - 28.3) MVPA minutes (∆ = - 11.4, 95CI = -3.7, - 19.1), screen time minutes (∆ = 46.5, 95CI = 30.0, 63.0), and sleep midpoint time (∆ = 95:54, 95CI = 85:26, 106:22) when compared to traditional school children. Monthly zBMI gain accelerated during summer for traditional (∆ = 0.033 95CI = 0.019, 0.047) but not year-round school children (∆ = 0.004, 95CI = -0.014, 0.023)., Conclusions: This study suggests that the lack of the school day during summer vacation negatively impacts sedentary behaviors, sleep timing, and screen time. Changes in sedentary behaviors, screen time, and sleep midpoint may contribute to accelerated summer BMI gain. Providing structured programming during summer vacation may positively impact these behaviors, and in turn, mitigate accelerated summer BMI gain., Trial Registration: ClinicalTrials.gov Identifier: NCT03397940 . Registered January 12th 2018.

Objective/background: Recent technological advances and emerging commercially-available consumer-friendly sleep assessment products affords researchers with a host of tools to consider for capturing free-living sleep in children. The purpose of this study was to compare free-living sleep characteristics (duration and bed/wake times) across different measures in children., Methods: Elementary school-aged children (N = 30, mean age 7.2 years, 63% boys, 87% non-Hispanic white) wore an ActiGraph GT9X Link © and Fitbit Charge HR © on the non-dominant wrist, with a Beddit 3 Sleep Monitor © affixed to their mattress for two consecutive weekend nights of free-living sleep. Parents completed a sleep log of bed and wake times. Absolute differences in bed and wake times were examined and Bland Altman plots assessed the level of agreement across sleep measures., Results: Across the four sleep measures, total sleep time (TST) ranged from 458 min/night (ActiGraph GT9X Link © ) to 613 min/night (Parent report). Mean bed and wake times ranged from 8:46 PM to 9:03 PM , and 6:52 AM to 7:16 AM , respectively. Pearson correlation coefficients were moderate between all four sleep measures (range r = 0.30-0.71). Bland-Altman plots indicated the highest level of agreement for TST was between Beddit 3 Sleep Monitor © and Fitbit Charge HR © (mean difference -11.7, limits of agreement: 119.0, -142.4 min)., Conclusions: The findings from this study show a high level of agreement of when a child goes to sleep and wakes up across a variety of sleep measures; however, more work is needed to classify TST once the sleep period has commenced., (Copyright © 2019 Elsevier B.V. All rights reserved.)

Study Objectives: To examine changes in elementary aged children's sleep and physical activity during a 1-week and a 3-week school break., Methods: Sleep and physical activity of elementary children (n = 154, age = 5-9 years, 44.8% female, 65.5% African American) were collected over 7 weeks that included a 1-week break in two schools and a 3-week break in a single school. Mixed regression models estimated sleep and physical activity changes within and between groups (i.e. 1-week vs. 3-weeks) during school and school break weeks., Results: Compared to school weeks, bed times shifted 72.7 (95% CI = 57.5, 87.9) and 75.4 (95% CI = 58.1, 92.7) minutes later on weekdays during the 1-week and 3-week break, respectively. Wake times shifted 111.6 (95% CI = 94.3, 128.9) and 99.8 (95% CI = 80.5, 119.1) minutes later on weekdays during 1-week and 3-week breaks. On weekdays during the 3-week break, children engaged in 33.1 (95% CI = 14.1, 52.2) more sedentary minutes and -12.2 (-20.2, -4.2) fewer moderate-to-vigorous physical activity minutes/day. No statistically significant changes in children's sedentary, light, or moderate-to-vigorous physical activity (MVPA) minutes were observed on weekdays during the 1-week break. Between-group differences in the change in time sedentary (32.1-95% CI = 5.8, 58.4), and moderate-to-vigorous (-13.0-95% CI = -23.9, -2.0) physical activity were observed., Conclusions: Children's sleep shifted later on both 1-week and 3-week breaks. Children's activity changed minimally on weekdays during a 1-week school break and more during a 3-week school break. Displaced sleep and reductions in activity are intervention targets for mitigating unhealthy weight gain during extended breaks from school.

Background: Evidence consistently shows children in the United States gain 3 to 5 times more weight during summer vacation (∼2.5 months) compared to the 9-month school year. The purpose of this study is to examine within-child differences in 4 obesogenic behaviors (physical activity [PA], sedentary/screen-time, diet, and sleep) during school versus summer., Methods: We used a repeated-measures within-subjects design. Children (N = 30 mean age = 8.2 years; 57% female; 37% overweight/obese; 100% African American) wore accelerometers on the nondominant wrist for 24 hr/d over 9 consecutive days during school and summer of 2016 to capture PA, sedentary time, and sleep. Parents completed a daily diary to report bed/wake times, diet, and screen-time of their child each day. Mixed-effect models compared summer and school behaviors., Results: Children spent more time sedentary (69% vs 67% of wake wear time), less time in light PA (25% vs 23% of wake wear time), had higher screen-time (242 vs 123 minutes/day), slept longer (428 vs 413 minutes/night), and consumed more sugar-based foods (6 days vs 2.5 days/week) and fruit (7 days vs 4.7 days/week) during summer compared to school (p < .05)., Conclusion: Initial evidence suggests children are displaying multiple unfavorable obesogenic behaviors during summer compared to school that may contribute to accelerated weight gain during summer., (© 2018, American School Health Association.)

Evidence suggests sleep and physical activity (PA) are associated with each other and dementia risk. Thus, identifying reliable methods to quantify sleep and PA concurrently in older adults is important. The MotionWatch 8© (MW8) wrist-worn actigraph provides reliable estimates of sleep quality via 14 days of measurement; however, the number of days needed to monitor PA by MW8 for reliable estimates is unknown. Thus, we investigated the number of days of MW8 wear required to assess PA in older adults. Ninety-five adults aged > 55 years wore MW8 for ≥ 14 days. Spearman-Brown analyses indicated the number of monitoring days needed for an ICC = 0.95 was 6-7 days for sedentary activity, 9-10 days for light activity, and 7-8 days for moderate-to-vigorous PA. These results indicate 14 days of MW8 monitoring provides reliable estimates for both sleep and PA. Thus, MW8 is ideal for future investigations requiring concurrent measures of both sleep quality and PA.

The 'Structured Days Hypothesis' suggests that children's obesogenic behaviors (e.g., activity, diet, sleep, and screen time) are less favorable during times when there is less-structure to a child's day (e.g., summer). To compare obesogenic behaviors of children with developmental disabilities (DD) during summer on days with differing amounts of 'structure'. Seventeen children with DD (mean age 9.8 years) attending a day camp wore a Fitbit© activity monitor on the non-dominant wrist during summer, and parents completed a survey packet, to capture obesogenic behaviors. Participants displayed improved physical activity levels, diets, and sleep timing on camp days versus other days. Providing children with DD 'structure' over summer is a potential intervention approach requiring further investigation.

BACKGROUND: Evidence consistently shows children in the United States gain 3 to 5 times more weight during summer vacation (~2.5 months) compared to the 9-month school year. The purpose of this study is to examine within-child differences in 4 obesogenic behaviors (physical activity [PA], sedentary/screen-time, diet, and sleep) during school versus summer. METHODS: We used a repeated-measures within-subjects design. Children (N = 30 mean age = 8.2 years; 57% female; 37% overweight/obese; 100% African American) wore accelerometers on the nondominant wrist for 24 hr/d over 9 consecutive days during school and summer of 2016 to capture PA, sedentary time, and sleep. Parents completed a daily diary to report bed/wake times, diet, and screen-time of their child each day. Mixed-effect models compared summer and school behaviors. RESULTS: Children spent more time sedentary (69% vs 67% of wake wear time), less time in light PA (25% vs 23% of wake wear time), had higher screen-time (242 vs 123 minutes/day), slept longer (428 vs 413 minutes/night), and consumed more sugar-based foods (6 days vs 2.5 days/week) and fruit (7 days vs 4.7 days/week) during summer compared to school (p < 0.05). CONCLUSION: Initial evidence suggests children are displaying multiple unfavorable obesogenic behaviors during summer compared to school that may contribute to accelerated weight gain during summer.

Although secondhand smoke (SHS) exposure is predominant in Bangladesh, the adverse effect of SHS exposure on health-related behaviors, such as sleep quality, have remained an under-investigated area of the country's public health landscape. Therefore, the purpose of this study was to examine the association between SHS exposure and poor sleep quality among non-smoking university students in Bangladesh. A cross-sectional survey was carried out between May and September 2022. SHS exposure (main predictor variable) and other covariates (e.g., age, sex, etc.) were measured using a self-reported questionnaire and sleep quality (outcome variable) was measured via the Pittsburgh Sleep Quality Index. Multiple logistic regression models investigated the association between SHS exposure and poor sleep quality. The study included 390 students (mean age: 22 years, 53.8% male). Approximately 41.8% of the participants reported SHS exposure, and 50.5% had poor sleep quality. Students exposed to SHS were more likely to have poor sleep quality compared to their counterparts (AOR = 1.61; 95% CI 1.01, 2.58). Subgroup analysis revealed poor sleep quality was 2-times higher among male students exposed to SHS than those male students without SHS exposure (AOR = 2.03; 95% CI 1.05, 3.93). No association was found in female students. Findings from this study warrant increased awareness and public health initiatives on the implications of SHS on health behaviors, such as sleep quality, in non-smoking Bangladeshi university students. [ABSTRACT FROM AUTHOR]

Research utilizing the 'Structured Days Hypothesis' suggests that children's weight-related behaviors are more favorable on days with more structure, routine, and consistency. The purpose of this study was to investigate weight-related behaviors of rural children on 'structured' versus 'less-structured' days. A 14-day repeated measures observational study was conducted of 52 parent-child dyads (child mean age 9.2 ± SD 1.9 years; 60% female). Participating parents/guardians reported evening screen-time and sleep (duration and timing). Mixed effect models compared behaviors between structured (e.g., school or camp day) and less-structured days (no formal program). Parent reported sleep duration of their child was −63 minutes/night less (95%CI: −74.6, −50.7 min/night), bed/wake times were earlier, and all children engaged in less screen time after 8:00PM on structured days compared to less-structured days (−34.5 min, 95%CI: −42.0, −27.1). Initial evidence suggests that on structured days children engage in favorable weight-related behaviors compared to less-structured days. Additional research with larger and more diverse samples of rural children is warranted; however, given preliminary findings social work practitioners in rural communities should increase social service-related program and planning that promote interventions focused on positive changes in children's weight related behaviors. [ABSTRACT FROM AUTHOR]

Background: Adequate sleep is essential for various health outcomes (e.g., obesity, diabetes, and cardiovascular disease). However, sleep time is threatened by the increased opportunities for unsupervised screen time available to children of all ages. The American Academy of Sleep Medicine recommends that elementary school-aged children sleep between 9-12 hours per night. Furthermore, the American Academy of Pediatrics recommends that children's recreational screen time be limited to less than 2 hours per day. Excess screen use can delay bedtime and lead to less restful sleep. The purpose of this study was to examine the association between adhering to screentime guidelines (<2 hours/day) and the likelihood of meeting sleep guidelines (9-12 hours/day) in 2nd-grade children. Methods: This study utilized two waves (2015-2016 and 2019-2020) of 2nd graders' parent- reported weighted survey data from the Texas School Physical Activity and Nutrition (SPAN) cross-sectional survey. Results: The final analytic sample included 3193 individuals (53% female, 62% Hispanic) across two years of data collection. sixty-five percent of parents/guardians reported their children met the sleep guidelines, while 33% of parents/guardians reported their children meeting the screentime guideline. After controlling for body mass index (BMI), race/ethnicity, school disadvantage, education, sex, and year of collection, parents who reported their children met the screentime guideline had 1.53 greater odds of meeting sleep guidelines compared to children whose parents/guardians reported their children did not meet the screentime guidelines (OR 1.53; 95%CI = 1.18, 1.99). In stratified analyses, we found that the associations between meeting sleep and screen time guidelines were primarily true for White children. A higher proportion of White children were more likely to meet both sleep-time and screen-time recommendations compared to Black and Hispanic children, while Black and Hispanic children were as likely to meet screen-time guidelines as White children; both groups had significantly lower odds of meeting sleep guidelines compared to White children (OR 0.32; 95% CI = 0.18, 0.58 and OR 0.49; 95% CI = 0.29, 0.83, respectively). Discussion: Children's ability to meet the recommended sleep guidelines is associated with screentime guideline adherence. Further exploration is needed to understand racial/ethnic differences in guideline adherence for screentime and sleep. Interventions targeting sleep characteristics (e.g., duration, quality, and timing) should consider concomitantly targeting screentime adherence in elementary school-aged children. [ABSTRACT FROM AUTHOR]

Summer is an emerging area of concern for accelerated weight gain in children. Little is known about weight-related behaviors of children with Autism Spectrum Disorder (ASD) during summer. To compare weight-related behaviors of children with ASD during summer versus school months. Caregivers of children (mean age 5.7 years, ±1.8 years) with ASD participated in a within-person observational study and reported daily estimates of bed/wake times, daily food and beverage consumption, and screen time at home for 14 days during both school and summer months. Caregivers reported their child (N = 14; 100 % ASD diagnosis, 71 % boys) engaged in an additional +42 min of daily screen time at home (95 % CI: 22.1, 62.5), an additional +11 min of screen time after 8:00 PM (95 %CI: 4.4, 17.1), went to bed ∼30 min later and woke up ∼50 min later on summer days compared to school month days. Initial evidence suggests young children with ASD had higher amounts of daily screen time and later bed/wake time during summer compared to school. Further research in large diverse samples is warranted to help inform intervention design and delivery in this population. • Children with ASD are at a risk of obesity compared to neurotypical peers. • Summer is a 'critical window' as children experience accelerated weight-gain. • Weight-related behaviors may differ during summer versus school months. • Children with ASD had higher screen time during summer versus school months. • Children with ASD had later bed/wake times during summer versus school months. [ABSTRACT FROM AUTHOR]

Background: Although the scientific community has acknowledged modest improvements can be made to weight status and obesogenic behaviors (i.e., physical activity, sedentary/screen time, diet, and sleep) during the school year, studies suggests improvements are erased as elementary-age children are released to summer vacation. Emerging evidence shows children return to school after summer vacation displaying accelerated weight gain compared to the weight gained occurring during the school year. Understanding how summer days differ from when children are in school is, therefore, essential. Discussion: There is limited evidence on the etiology of accelerated weight gain during summer, with few studies comparing obesogenic behaviors on the same children during school and summer. For many children, summer days may be analogous to weekend days throughout the school year. Weekend days are often limited in consistent and formal structure, and thus differ from school days where segmented, pre-planned, restrictive, and compulsory components exist that shape obesogenic behaviors. The authors hypothesize that obesogenic behaviors are beneficially regulated when children are exposed to a structured day (i.e., school weekday) compared to what commonly occurs during summer. This is referred to as the 'Structured Days Hypothesis' (SDH). To illustrate how the SDH operates, this study examines empirical data that compares weekend day (less-structured) versus weekday (structured) obesogenic behaviors in U.S. elementary school-aged children. From 190 studies, 155 (~80%) demonstrate elementary-aged children's obesogenic behaviors are more unfavorable during weekend days compared to weekdays. Conclusion: In light of the SDH, consistent evidence demonstrates the structured environment of weekdays may help to protect children by regulating obesogenic behaviors, most likely through compulsory physical activity opportunities, restricting caloric intake, reducing screen time occasions, and regulating sleep schedules. Summer is emerging as the critical period where childhood obesity prevention efforts need to be focused. The SDH can help researchers understand the drivers of obesogenic behaviors during summer and lead to innovative intervention development. [ABSTRACT FROM AUTHOR]