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BackgroundDespite public health guidelines to limit sedentary behavior, many young children spend large amounts of time sedentary (eg, screen and sitting time) during waking hours. ObjectiveThe objective of this study was to test the feasibility and efficacy of a parent-focused, predominantly text message–delivered intervention to support parents to reduce the amount of time their children spend in sedentary behavior. MethodsMini Movers was a pilot randomized controlled trial delivered to parents of 2- to 4-year-old children in Melbourne, Australia. Participants were recruited through playgroups, social media, and snowball sampling. Eligibility criteria were having an ambulatory child (2-4 years), English literacy, and smartphone ownership. Participants were randomized to intervention or wait-list control on a 1:1 ratio after baseline data collection. The 6-week intervention was predominantly delivered via text messages, using a Web-based bulk text message platform managed by the interventionist. Intervention strategies focused on increasing parental knowledge, building self-efficacy, setting goals, and providing reinforcement, and were underpinned by the Coventry, Aberdeen & London-Refined taxonomy of behavior change techniques and social cognitive theory. The primary outcome was intervention feasibility, measured by recruitment, retention, intervention delivery, and fidelity; process evaluation questionnaires; and qualitative interviews with a subsample of participants. Secondary outcomes were children’s screen and restraint time (parent report), sitting time (parent report, activPAL), and potential mediators (parent report). Linear regression models were used to determine intervention effects on secondary outcomes, controlling for the child’s sex and age and clustering by playgroup; effect sizes (Cohen's d) were calculated. ResultsA total of 57 participants (30 intervention; 27 wait-list control) were recruited, and retention was high (93%). Process evaluation results showed that the intervention was highly acceptable to parents. The majority of intervention components were reported to be useful and relevant. Compared with children in the control group, children in the intervention group had significantly less screen time postintervention (adjusted difference [95% CI]=−35.0 [−64.1 to −5.9] min/day; Cohen's d=0.82). All other measures of sedentary behavior were in the expected direction, with small to moderate effect sizes. ConclusionsMini Movers was shown to be a feasible, acceptable, and efficacious pilot intervention for parents of young children, warranting a larger-scale randomized control trial. Trial RegistrationAustralian New Zealand Clinical Trials registry: ACTRN12616000628448; https://www.anzctr.org.au/ Trial/Registration/TrialReview.aspx?ACTRN=12616000628448p (Archived by WebCite at http://www.webcitation.org/ 6wZcA3cYM)

Background: Understanding how or whether sedentary behavior affects motor competence in young children is important considering that children spend a lot of time sedentary. The aim of this study was to examine whether sedentary behavior predicts motor competence in young children. Methods: A longitudinal study with a total of 372 children aged 3.5 years at baseline and 5 years at follow-up was conducted. Objectively measured activity patterns (i.e., using accelerometers) were conducted in a subsample with 188 children. Sedentary behavior was assessed both objectively and subjectively (parent-reported screen time). Locomotor and object control skill scores were determined using the Test of Gross Motor Development--Second Edition. A multivariable analysis was executed adjusting for potential confounders (such as age, sex, time spent in moderate- to vigorous-intensity physical activity, monitor wear time, body mass index z scores, and maternal education). Results: Sedentary behavior at either time point was not significantly associated with either locomotor or object control skills after adjusting for potential confounders. Discussion: Our results did not support the assumption that sedentary behavior affects motor competence in young children. Regardless, given the lack of consistency in the evidence base, we recommend to parents, educators, and health professionals that sedentary activities should be kept within government recommendations due to potential negative effects on child development.

Introduction: Physical activity (PA) during pregnancy has numerous benefits, which may be mediated via effects on the immune system. However, supportive evidence is inconsistent and is mainly from studies in high‐risk groups. We estimated the effect of PA during pregnancy on systemic inflammatory markers and cytokines in mothers recruited in the Barwon infant study. Material and Methods: The Barwon infant study is a prebirth cohort of 1064 mothers recruited in the Barwon Region of Victoria, Australia. Participants reported their previous week's PA at their 28‐week antenatal appointment using the International PA Questionnaire. Women were grouped into low, moderate, and high PA categories based on daily duration and weekly frequency of walking, moderate‐ or vigorous‐intensity PA. Women reporting moderate levels of PA, consistent with current recommendations, served as the comparison group. Markers of systemic inflammation, high‐sensitivity C‐reactive protein (hsCRP), glycoprotein acetyls (GlycA), and 17 cytokines were measured at 28 weeks gestation and log transformed as appropriate. Regression analyses adjusted for maternal smoking, gestational diabetes mellitus, prepregnancy BMI, and household size were performed. Results: Compared to women in the moderate group (n = 371, 42%), women reporting low PA (n = 436, 50%) had 10.1% higher hsCRP (95% CI (3.7% to 16.6%), p < 0.01) while women in high PA (n = 76, 9%) had a 14% higher hsCRP (95% CI (3.1% to 24.8%), p = 0.01). Women in the high PA category had higher interleukin (IL)‐4 (q = 0.03) and IL‐9 (q = 0.03) levels compared to those in moderate category. Each vigorous MET minute/week was associated with lower GlycA (β = −0.004, 95% CI (−0.044 to 0.035); p = 0.03). Conclusions: Low and high PA are each associated with higher hsCRP than moderate PA, suggesting that undertaking the recommended moderate PA during pregnancy decreases systemic inflammation. High PA affects T cell‐associated cytokines during pregnancy. Evidence from our study suggests that PA can modulate the immune responses during pregnancy. Studies are now required to assess whether PA during pregnancy impacts maternal and infant clinical outcomes by modifying inflammatory responses. [ABSTRACT FROM AUTHOR]

Summary: Physical activity and self‐regulation are important predictors of pediatric overweight and obesity. Young children (0–5 years) with lower physical activity levels and poorer self‐regulation skills are at greater risk for overweight. Despite growing evidence that the two constructs are interrelated, their association remains unclear in young children. This review systematically summarized associations between physical activity and self‐regulation in early childhood and explored the directionality of associations. Searches were run in six electronic databases. Forty‐seven papers met inclusion criteria. Only three studies investigated all three domains of self‐regulation (behavioral, cognitive, and emotional). Overall, findings were inconclusive; studies reported weak to moderate positive associations (n = 17), inverse associations (n = 5), mixed associations (n = 15), null association (n = 2), and negative (n = 1) between physical activity and self‐regulation. Compared with the emotional and cognitive domains, physical activity was most consistently positively associated with behavioral self‐regulation. Only one study assessed bidirectional associations, reporting a positive association. The three studies that included global self‐regulation showed contradicting findings. There is some evidence that physical activity dose and sex potentially confound these associations; however, further research is needed given the paucity of studies. This review highlights the need for more in‐depth investigation of the complex association between physical activity and global self‐regulation. [ABSTRACT FROM AUTHOR]

Background: Toddlerhood (2–3 years) is a crucial period for the development of physical activity, sleep, and emotional self-regulation skills. Although there is growing evidence of positive associations between physical activity, sleep, and emotional self-regulation in school-aged children, the associations in toddlers remain unclear. Thus, this study aimed to examine the association between physical activity, sleep, and emotional self-regulation in toddlers. Methods: Baseline data from 1350 toddlers (2.2 ± 0.33 year) from the Let's Grow randomised controlled trial were used. Toddlers' total physical activity (TPA) and moderate- to vigorous-intensity physical activity (MVPA) were assessed via 4 + days of accelerometry and a 3-item parent-report scale. Parent-reported total sleep quantity was calculated using the sum of average night-time sleep and daytime nap durations. Sleep behaviour data including bedtime routine, bedtime resistance, sleep onset-delay, sleep duration, and night waking were collected using relevant subsections from the Child Sleep Habits Questionnaire (CSHQ) and Brief Infant Sleep Questionnaire revised (BISQ-R). A 4-item parent-report scale adapted from the Fast Track Project Child Behaviour Questionnaire was used to assess toddlers' emotional self-regulation. Linear regression models were used, adjusting for child age, sex, and parental education. Results: Accelerometer-derived TPA, MVPA and parent-reported TPA were not associated with emotional self-regulation. Higher parent-reported MVPA (B = -0.01 CI95 -0.03, -0.003) was associated with poorer emotional self-regulation. Higher sleep duration was associated with better emotional self-regulation (B = 0.06 CI95 0.04, 0.08). The five sleep behaviours assessed were also positively associated with emotional self-regulation (all p < 0.01), with fewer problem sleep behaviours being associated with better emotional self-regulation. Conclusions: This cross-sectional study suggests that sleep may be important for emotional self-regulation in toddlers, but the role of physical activity remains unclear. These findings suggest that interventions targeting sleep duration and sleep behaviours during the early toddler years may benefit the positive development of emotional self-regulation skills in this population. [ABSTRACT FROM AUTHOR]

Objective: Behavioural patterns are important in understanding the synergistic effect of multiple health behaviours on childhood adiposity. Most previous evidence assessing associations between patterns and adiposity were cross-sectional and investigated two or three behaviour domains within patterns. This study aimed to identify behavioural patterns comprising four behaviour domains and investigate associations with adiposity risk in children. Design: Parent-report and accelerometry data were used to capture daily dietary, physical activity, sedentary behaviour and sleep data. Variables were standardised and included in the latent profile analysis to derive behavioural patterns. Trained researchers measured children's height, weight and waist circumference using standardised protocols. Associations of patterns and adiposity measures were tested using multiple linear regression. Setting: Melbourne, Australia. Participants: A total of 337 children followed up at 6–8 years (T2) and 9–11 years (T3). Results: Three patterns derived at 6–8 years were broadly identified to be healthy, unhealthy and mixed patterns. Patterns at 9–11 years were dissimilar except for the unhealthy pattern. Individual behaviours characterising the patterns varied over time. No significant cross-sectional or prospective associations were observed with adiposity at both time points; however, children displaying the unhealthy pattern had higher adiposity measures than other patterns. Conclusion: Three non-identical patterns were identified at 6–8 and 9–11 years. The individual behaviours that characterised patterns (dominant behaviours) at both ages are possible drivers of the patterns obtained and could explain the lack of associations with adiposity. Identifying individual behaviour pattern drivers and strategic intervention are key to maintain and prevent the decline of healthy patterns. [ABSTRACT FROM AUTHOR]

Background: Although there is increasing evidence regarding children's screen time, little is known about children's sitting. This study aimed to determine the correlates of screen time and sitting in 6- to 8-year-old children. Methods: In 2011-2012, parents in the Healthy Active Preschool and Primary Years (HAPPY) study (n = 498) reported their child's week/weekend day recreational screen time and potential correlates. ActivPALs™ measured children's nonschool sitting. In model 1, linear regression analyses were performed, stratified by sex and week/weekend day and controlling for age, clustered recruitment, and activPAL™ wear time (for sitting analyses). Correlates significantly associated with screen time or sitting (P < .05) were included in model 2. Results: Children (age 7.6 y) spent 99.6 and 119.3 minutes per day on week and weekend days engaging in screen time and sat for 119.3 and 374.6 minutes per day on week and weekend days, respectively. There were no common correlates for the 2 behaviors. Correlates largely differed by sex and week/weekend day. Modifiable correlates of screen time included television in the child's bedroom and parental logistic support for, encouragement of, and coparticipation in screen time. Modifiable correlates of sitting included encouragement of and coparticipation in physical activity and provision of toys/ equipment for physical activity. Conclusions: Interventions may benefit from including a range of strategies to ensure that all identified correlates are targeted. [ABSTRACT FROM AUTHOR]

Background: Behavioural patterns are typically derived using unsupervised multivariate methods such as principal component analysis (PCA), latent profile analysis (LPA) and cluster analysis (CA). Comparability and congruence between the patterns derived from these methods has not been previously investigated, thus it's unclear whether patterns from studies using different methods are directly comparable. This study aimed to compare behavioural patterns derived across diet, physical activity, sedentary behaviour and sleep domains, using PCA, LPA and CA in a single dataset. Methods: Parent-report and accelerometry data from the second wave (2011/12; child age 6-8y, n = 432) of the HAPPY cohort study (Melbourne, Australia) were used to derive behavioural patterns using PCA, LPA and CA. Standardized variables assessing diet (intake of fruit, vegetable, sweet, and savoury discretionary items), physical activity (moderate- to vigorous-intensity physical activity [MVPA] from accelerometry, organised sport duration and outdoor playtime from parent report), sedentary behaviour (sedentary time from accelerometry, screen time, videogames and quiet playtime from parent report) and sleep (daily sleep duration) were included in the analyses. For each method, commonly used criteria for pattern retention were applied. Results: PCA produced four patterns whereas LPA and CA each generated three patterns. Despite the number and characterisation of the behavioural patterns derived being non-identical, each method identified a healthy, unhealthy and a mixed pattern. Three common underlying themes emerged across the methods for each type of pattern: (i) High fruit and vegetable intake and high outdoor play ("healthy"); (ii) poor diet (either low fruit and vegetable intake or high discretionary food intake) and high sedentary behaviour ("unhealthy"); and (iii) high MVPA, poor diet (as defined above) and low sedentary time ("mixed"). Conclusion: Within this sample, despite differences in the number of patterns derived by each method, a good degree of concordance across pattern characteristics was seen between the methods. Differences between patterns could be attributable to the underpinning statistical technique of each method. Therefore, acknowledging the differences between the methods and ensuring thorough documentation of the pattern derivation analyses is essential to inform comparison of patterns derived through a range of approaches across studies. [ABSTRACT FROM AUTHOR]

Summary: Background: The respective contribution of total, daytime and nighttime sleep duration in childhood obesity remains unclear. Objectives: To assess the longitudinal association between developmental trajectories of sleep duration and BMI z‐score in early childhood. Methods: Data were from the Melbourne INFANT program, a prospective cohort with 4‐month‐old infants being followed‐up until age 60 months (n = 528). Sleep duration (total, daytime, nighttime) and BMI z‐score were measured using questionnaire at ages 4, 9, 18, 43 and 60 months. Group‐based trajectory modelling was used to describe longitudinal trajectories from ages 4 to 60 months. Multivariable logistic regression was conducted to assess the association between sleep duration and BMI z‐score trajectories. Results: Three nighttime sleep duration trajectory groups were identified: "Long stable" (10.5 to 11.0 hours, 61%), "catchup long" (8.0 to 11.5 hours, 23%) and "short stable" (8.7 to 9.8 hours, 16%) nighttime sleepers. BMI z‐score trajectory groups were classified as "low‐BMIz" (−1.5 to −0.5 unit, 21%), "mid‐BMIz" (−0.5 to 0.5 unit, 58%) and "high‐BMIz" (0.8 to 1.4 unit, 21%). With adjustment for child and maternal covariates, both "catchup long" (OR 3.69 95%CI 1.74, 7.92) and "long stable" nighttime sleepers (OR 4.27 95%CI 2.21, 8.25) revealed higher odds of being in the "mid‐BMIz" than the "high‐BMIz" group. By contrast, total or daytime sleep duration trajectories were not associated with BMI z‐score trajectories. Conclusions: Longer nighttime, but not total or daytime, sleep duration was associated with lower BMI z‐score trajectories in early childhood. Our findings reinforce the importance of nighttime sleep for healthy body‐weight development in early childhood. [ABSTRACT FROM AUTHOR]

Background: There is little current understanding of the influences on sedentary behavior and screen time in preschool children. This study investigated socioeconomic position (SEP) and parental rules as potential correlates of preschool children's sedentary behavior and screen time. Methods: Data from the Healthy Active Preschool Years (HAPPY) Study were used. Participating parents reported their child's usual weekly screen time and their rules to regulate their child's screen time. Children wore accelerometers for 8 days to objectively measure sedentary time. Results: Children whose parents limited television viewing spent significantly less time in that behavior and in total screen time; however, overall sedentary behavior was unaffected. An association between parents limiting computer/electronic game use and time spent on the computer was found for girls only. SEP was inversely associated with girls', but not boys', total screen time and television viewing. Conclusions: As parental rules were generally associated with lower levels of screen time, intervention strategies could potentially encourage parents to set limits on, and switch off, screen devices. Intervention strategies should target preschool children across all SEP areas, as there was no difference by SEP in overall sedentary behavior or screen time for boys. [ABSTRACT FROM AUTHOR]