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BackgroundPhysical activity trackers (PATs) such as apps and wearable devices (eg, sports watches, heart rate monitors) are increasingly being used by young adolescents. Despite the potential of PATs to help monitor and improve moderate-to-vigorous physical activity (MVPA) behaviors, there is a lack of research that confirms an association between PAT ownership or use and physical activity behaviors at the population level. ObjectiveThe purpose of this study was to examine the ownership and use of PATs in youth and their associations with physical activity behaviors, including daily MVPA, sports club membership, and active travel, in 2 nationally representative samples of young adolescent males and females in Finland and Ireland. MethodsComparable data were gathered in the 2018 Finnish School-aged Physical Activity (F-SPA 2018, n=3311) and the 2018 Irish Children’s Sport Participation and Physical Activity (CSPPA 2018, n=4797) studies. A cluster analysis was performed to obtain the patterns of PAT ownership and usage by adolescents (age, 11-15 years). Four similar clusters were identified across Finnish and Irish adolescents: (1) no PATs, (2) PAT owners, (3) app users, and (4) wearable device users. Adjusted binary logistic regression analyses were used to evaluate how PAT clusters were associated with physical activity behaviors, including daily MVPA, membership of sports clubs, and active travel, after stratification by gender. ResultsThe proportion of app ownership among Finnish adolescents (2038/3311, 61.6%) was almost double that of their Irish counterparts (1738/4797, 36.2%). Despite these differences, the clustering patterns of PATs were similar between the 2 countries. App users were more likely to take part in daily MVPA (males, odds ratio [OR] 1.27, 95% CI 1.04-1.55; females, OR 1.49, 95% CI 1.20-1.85) and be members of sports clubs (males, OR 1.37, 95% CI 1.15-1.62; females, OR 1.25, 95% CI 1.07-1.50) compared to the no PATs cluster, after adjusting for country, age, family affluence, and disabilities. These associations, after the same adjustments, were even stronger for wearable device users to participate in daily MVPA (males, OR 1.83, 95% CI 1.49-2.23; females, OR 2.25, 95% CI 1.80-2.82) and be members of sports clubs (males, OR 1.88, 95% CI 1.55-2.88; females, OR 2.07, 95% CI 1.71-2.52). Significant associations were observed between male users of wearable devices and taking part in active travel behavior (OR 1.39, 95% CI 1.04-1.86). ConclusionsAlthough Finnish adolescents report more ownership of PATs than Irish adolescents, the patterns of use and ownership remain similar among the cohorts. The findings of our study show that physical activity behaviors were positively associated with wearable device users and app users. These findings were similar between males and females. Given the cross-sectional nature of this data, the relationship between using apps or wearable devices and enhancing physical activity behaviors requires further investigation.

Purpose: To assess associations between sedentary time (ST), physical activity (PA), and cardiovascular health in early childhood. Method: Cross-sectional study including 160 children (age 6.1 y [SD 0.5], 86 boys, 93 maternal body mass index ≥ 30 kg/m2, and 73 gestational diabetes) assessed for pulse wave velocity, echocardiography, ultra-high frequency 48–70 MHz vascular ultrasound, and accelerometery. Results: Boys had 385 (SD 53) minutes per day ST, 305 (SD 44) minutes per day light PA, and 81 (SD 22) minutes per day moderate to vigorous PA (MVPA). Girls had 415 (SD 50) minutes per day ST, 283 (SD 40) minutes per day light PA, and 66 (SD 19) minutes per day MVPA. In adjusted analyses, MVPA was inversely associated with resting heart rate (β = −6.6; 95% confidence interval, −12.5 to −0.7) and positively associated with left ventricular mass (β = 6.8; 1.4–12.3), radial intima-media thickness (β = 11.4; 5.4–17.5), brachial intima-media thickness (β = 8.0; 2.0–14.0), and femoral intima-media thickness (β = 1.3; 0.2–2.3). MVPA was inversely associated with body fat percentage (β = −3.4; −6.6 to −0.2), diastolic blood pressure (β = −0.05; −0.8 to −0.1), and femoral (β = −18.1; −32.4 to −0.8) and radial (β = −13.4; −24.0 to −2.9) circumferential wall stress in boys only. ST and pulse wave velocity showed no significant associations. Conclusions: In young at-risk children, MVPA is associated with cardiovascular remodeling, partly in a sex-dependant way, likely representing physiological adaptation, but ST shows no association with cardiovascular health in early childhood. [ABSTRACT FROM AUTHOR]

The Moving Maths study was conducted to increase third grade pupils' physical activity and support their learning in Finland. Altogether 397 children (mean age 9.3 years) and 22 teachers took part in an intervention with two types of physically active maths lessons for five months. One group carried out lessons in which PA was integrated into maths learning goals, while another group implemented PA as short breaks. A control group was also allocated. The aim of the current study was to qualitatively examine classroom teachers' (n = 12) experiences and perceptions of student engagement during the intervention. The results indicated that pupils showed positive emotional and social engagement in both intervention groups. Positive cognitive engagement was indicated by concentration on seated work after the activities, but some teachers reported uncertainty about the learning results. It is concluded that in addition to reducing children's harmful sedentary behaviour, physically active lessons can positively affect student engagement and may thus enhance learning.

The World Health Organization ([WHO], 2018) encourages schools to engage with a multi-component, whole-of-school approach to physical activity promotion. However, little evidence exists describing the practices of schools that successfully promote a physically active school culture. The purpose of this study was to explore and describe the best practices of "active" secondary schools. Three schools, each in a different country (i.e. the United States, Finland, and Ireland), were identified as sites for investigation based on the presence of nationally established whole-of-school physical activity initiatives. Data were collected in one secondary school in each country and were generated from several sources including semi-structured interviews with stakeholders, field notes, three days of on-site observation, and artifact collection. Inductive analysis using open and axial coding was conducted (Corbin and Strauss, 2008). Three common themes related to best practices were evident at each site: an established school-based leader, support from the school community, and many available physical activity opportunities. Successful school-based physical activity promotion is possible if there is a motivated physical activity champion and if their promotion efforts are supported. These schools created multiple physical activity opportunities for students and have developed a strong physical activity culture.

This study investigated pupil experiences and perceptions of two kinds of classroom-based physically active math lessons during the Moving Maths programme in a Finnish primary school context. Qualitative data were gathered in focus group interviews with 16 nine-year-old pupils. Pupils in the group with physically active breaks during math lessons expressed mixed experiences, while pupils in the group with physical activity (PA) integrated into math curriculum experienced increased positive emotional and cognitive engagement. It is concluded that integrating PA into mathematics lessons is a feasible pedagogical method, especially in the form of PA integrated into math curriculum goals.

The present study aimed to examine effects of motivational and social cognition constructs on children's leisure-time physical activity participation alongside constructs representing implicit processes using an extended trans-contextual model. The study adopted a correlational prospective design. Secondary-school students (N = 502) completed self-report measures of perceived autonomy support from physical education (PE) teachers, autonomous motivation in PE and leisure-time contexts, and social cognition constructs (attitudes, subjective norms, perceived behavioral control), intentions, trait self-control, habits, and past behavior in a leisure-time physical activity context. Five weeks later, students (N = 298) self-reported their leisure-time physical activity participation. Bayesian path analyses supported two key premises of the model: perceived autonomy support was related to autonomous motivation in PE, and autonomous motivation in PE was related to autonomous motivation in leisure time. Indirect effects indicated that both forms of autonomous motivation were related to social cognition constructs and intentions. However, intention was not related to leisure-time physical activity participation, so model variables reflecting motivational processes did not account for substantive variance in physical activity participation. Self-control, attitudes, and past behavior were direct predictors of intentions and leisure-time physical activity participation. There were indirect effects of autonomous motivation in leisure time on intentions and physical activity participation mediated by self-control. Specifying informative priors for key model relations using Bayesian analysis yielded greater precision for some model effects. Findings raise some questions on the predictive validity of constructs from the original trans-contextual model in the current sample, but highlight the value of extending the model to incorporate additional constructs representing non-conscious processes.

BackgroundInadequate physical activity in young people is associated with several physical and mental health concerns. Physical education (PE) is a potentially viable existing network for promoting physical activity in this population. However, little research has been conducted on whether PE teachers can influence students' engagement in leisure-time physical activity. The present study therefore examined the efficacy of an intervention aimed at increasing PE teachers' autonomy support on students' leisure-time physical activity (the PETALS trial). The intervention was guided by the trans-contextual model (TCM) explaining the processes by which PE teachers' provision of autonomy support during PE promotes students' motivation and engagement in physical activity in their leisure time.MethodsThe study adopted a cluster-randomized, waitlist control intervention design with randomization by school. Participants were PE teachers (N = 29, 44.83%female; M age = 42.83, SD = 9.53 yrs) and their lower secondary school students (N = 502, 43.82%female; M age = 14.52, SD = 0.71 yrs). We measured TCM constructs, including perceived autonomy support, autonomous motivation in PE and leisure time, beliefs and intentions towards leisure-time physical activity, and physical activity behavior at baseline, post-intervention, and at one-, three-, and six-months. Study hypotheses were tested through a series of ANOVAs and structural equation models using post-intervention and one-month follow-up data.ResultsWe found no changes in TCM constructs or physical activity behavior in either group at post-intervention or at 1 month. Path analyses supported two propositions of the TCM as change variables: perceived autonomy support had a significant effect on autonomous motivation in PE and autonomous motivation in PE had a significant effect on autonomous motivation in leisure time. Although we found a direct effect of autonomous motivation in leisure time on physical activity, we did not find support for the third premise of the TCM that autonomous motivation in leisure time indirectly affects physical activity through beliefs and intentions.ConclusionsCurrent findings did not support the efficacy of the PETALS intervention at changing physical activity behavior and TCM constructs. More research is required to determine whether the TCM predictive validity is supported when other model variables are manipulated through experimental and intervention studies.Trial registrationISRCTN, ISRCTN39374060 . Registered 19 July 2018. Prospectively registered.

BackgroundGiven the documented decline in levels of physical activity in early adolescence, promoting physical activity in young people is a priority for health promotion. School physical education (PE) is an important existing network in which participation in physical activity beyond school can be promoted to the captive young people. The objective of current article is to present the protocol for a PE teacher-delivered theory-based trial to promote secondary school students' participation in physical activity out-of-school contexts. The intervention will be guided by the trans-contextual model explaining the processes by which PE teachers' support for autonomous motivation in the classroom promotes students' motivation to engage in out-of-school physical activity. We hypothesize that school students receiving the teacher-delivered intervention to promote autonomous motivation toward physical activity will exhibit greater participation in physical activities outside of school, relative to students receiving a control intervention.MethodsThe trial will adopt a waitlist-control design with cluster-randomization by school. PE teachers assigned to the intervention condition will receive a two-week, 12-h training program comprising basic information on how to promote out-of-school physical activity and theory-based training on strategies to promote students' autonomous motivation toward physical activity. Teachers assigned to the waitlist control condition will receive an alternative training on how to monitor physical functional capacity in children with special needs. PE teachers (n = 29) from eleven schools will apply the intervention program to students (n = 502) in PE classes for one month. Physical activity participation, the primary outcome variable, and psychological mediators from the trans-contextual model will be measured at pre-trial, post-trial, and at one-, three- and six-months post-trial. We will also assess teachers' autonomy-supportive techniques and behaviours by observation.DiscussionThe study will make a unique contribution to the literature by testing a theory-based intervention delivered by PE teachers to promote school students' participation in out-of-school physical activity. Information will be useful for educators, community stakeholders and policy makers interested in developing programs to promote students' out-of-school physical activity.Trial registrationISRCTN39374060 . Registered 19.7.2018.

Background: Physical activity (PA) may benefit academic performance, but it is unclear what kind of classroom‐based PA is optimal for learning. Aim: We studied the effects of physically active maths lessons on children's maths performance and maths‐related effects, and whether gender and previous mathematical or motor skills modify these effects. Sample: A total of 22 volunteered teachers and their pupils with signed consent (N = 397, mean age: 9.3 years, 51% females) participated in a 5‐month, teacher‐led, multi‐arm, cluster‐randomized controlled trial. Methods: The intervention included a PAL group (20 min of physically active learning in each 45‐min lesson), a breaks group (two 5‐min PA breaks in each 45‐min lesson) and a control group (traditional teaching). Maths performance was assessed with a tailored curriculum‐based test. Maths‐related enjoyment, self‐perceptions and anxiety were measured with a self‐reported questionnaire. The individual‐level intervention effects were tested via covariate‐adjusted linear mixed‐effect models with school classes serving as random effects. Results: Changes in maths performance or self‐perceptions did not differ between the intervention groups. Maths anxiety in learning situations increased in the PAL group (effect.28, 95% CI =.01–.56); there was no change in the other groups. Subgroup analyses suggested that maths anxiety increased in the PAL group among children in the two lowest tertiles of motor skills. It decreased in the highest tertile. Enjoyment decreased in the breaks group among pupils in the lowest motor skill tertile. Conclusions: Physically active maths lessons did not affect maths performance or self‐perceptions but had divergent effects on maths anxiety and enjoyment, depending on motor skills. [ABSTRACT FROM AUTHOR]

In this study, we aimed at comparing Finnish primary school students' physical activity and sedentary time during outdoor-learning and traditional school days. Outdoor learning is defined as purposeful and planned learning experiences in the outdoors . The study population consisted 20 students in grades 1-6 at one primary school. Physical activity was measured objectively by hip-worn accelerometers. The amounts of physical activity and sedentary time were compared for the same students between five school days with outdoor learning and four traditional school days. The study's main findings show that, moving from traditional classroom teaching to an outdoor-learning environment decreases students' sedentary time and increases light- and moderate-intensity physical activity during the school day. No differences were observed in leisure-time physical activity on school days with or without outdoor learning. Thus, outdoor learning is an effective complement to traditional classroom teaching in promoting physically active children.

Background: Providing individual‐ and population‐level data on children's physical fitness (PF) is a crucial public health and education priority. However, few national fitness monitoring or surveillance systems are currently in practice internationally. We aim to summarize the current European PF monitoring and surveillance systems for school‐aged children and to provide experience‐based guidelines on how to design such systems. Methods: The FitBack network consists of experts from diverse backgrounds with the common interest to improve the accessibility of PF monitoring for young people globally. Through FitBack network, we identified and compared the national or regional PF monitoring and surveillance systems currently in operation across Europe. We formulated a 10‐step approach for designing and establishing one's own system, based on analysis of experienced strengths, weaknesses, opportunities, and threats to monitoring childhood fitness. Results: We identified a total of eight PF monitoring systems in Finland, France, Galicia of Spain, Hungary, Lithuania, Portugal, Serbia, and Slovenia. The FitBack network recommends the following steps for designing and establishing one's own system: (1) set up mission statements and aims, (2) involve stakeholders, (3) utilize scientific background, (4) governance structure, (5) ensure sufficient funding, (6) data management planning, (7) provide meaningful feedback, (8) conduct pilot testing, (9) plan implementation process, and (10) invest in communication with stakeholders. Conclusions: This study provides an updated overview of the best practices for school‐aged children's fitness monitoring and surveillance in Europe. Additionally, it offers a 10‐step approach to assist in the creation of similar systems in Europe or globally. [ABSTRACT FROM AUTHOR]

Context The incidence and remission of nonalcoholic fatty liver disease (NAFLD) are sparsely studied outside Asia. Objective This prospective study aimed to investigate NAFLD incidence and remission, and their predictors among a general Finnish population. Methods The applied cohort included 1260 repeatedly studied middle-aged participants with data on liver ultrasound and no excessive alcohol intake. Hepatic steatosis was assessed by liver ultrasound with a 7.2-year study interval. Comprehensive data on health parameters and lifestyle factors were available. Results At baseline, 1079 participants did not have NAFLD, and during the study period 198 of them developed NAFLD. Of the 181 participants with NAFLD at baseline, 40 achieved NAFLD remission. Taking multicollinearity into account, key predictors for incident NAFLD were baseline age (odds ratio 1.07; 95% CI, 1.02-1.13; P =.009), waist circumference (WC) (2.77, 1.91-4.01 per 1 SD; P <.001), and triglycerides (2.31, 1.53-3.51 per 1 SD; P <.001) and alanine aminotransferase (ALAT) (1.90, 1.20-3.00 per 1 SD; P =.006) concentrations as well as body mass index (BMI) change (4.12, 3.02-5.63 per 1 SD; P <.001). Predictors of NAFLD remission were baseline aspartate aminotransferase (ASAT) concentration (0.23, 0.08-0.67 per 1 SD; P =.007) and WC change (0.38, 0.25-0.59 per 1 SD; P <.001). Conclusion During follow-up, NAFLD developed for every fifth participant without NAFLD at baseline, and one-fifth of those with NAFLD at baseline had achieved NAFLD remission. NAFLD became more prevalent during the follow-up period. From a clinical perspective, key factors predicting NAFLD incidence and remission were BMI and WC change independent of their baseline level. [ABSTRACT FROM AUTHOR]

The Moving Maths study was conducted to increase third grade pupils' physical activity and support their learning in Finland. Altogether 397 children (mean age 9.3 years) and 22 teachers took part in an intervention with two types of physically active maths lessons for five months. One group carried out lessons in which PA was integrated into maths learning goals, while another group implemented PA as short breaks. A control group was also allocated. The aim of the current study was to qualitatively examine classroom teachers' (n = 12) experiences and perceptions of student engagement during the intervention. The results indicated that pupils showed positive emotional and social engagement in both intervention groups. Positive cognitive engagement was indicated by concentration on seated work after the activities, but some teachers reported uncertainty about the learning results. It is concluded that in addition to reducing children's harmful sedentary behaviour, physically active lessons can positively affect student engagement and may thus enhance learning. [ABSTRACT FROM AUTHOR]

Background: The factors associated with preschool-aged children's physical activity (PA) remains unclear. The aim of this cross-sectional study was to examine how different factors were associated with preschool-aged children's objectively measured PA and sedentary time. Methods: The study population was 5-6-year-old children (n = 140) and their parents (n = 138) from the STEPS Study in Turku in Southwest Finland in 2013-2014. PA and sedentary time were measured objectively by accelerometers from children and parents and body mass index with Tanita scale. Other factors (siblings, day care, organized PA and parents' education) were collected with questionnaires. Linear models were conducted. Results: Child's PA was positively associated with mother's PA and day care attendance. Child's sedentary time was positively associated with mother's sedentary time. Father's PA and sedentary time were associated with respective variables in children, but only among fathers with high education. Conclusion: Parental role modelling is essential in developing child's physically active and less sedentary lifestyle.

Increasing physical activity opportunities in schools has emerged as a global priority among school-aged youth. As a result, many countries have designed and implemented whole-of-school physical activity initiatives that seek to increase physical activity opportunities that are available to school-aged children before, during, and after school. Considering the comprehensive school physical activity program conceptual framework, this article includes a discussion of the initiatives from four countries: Finland (Finnish Schools on the Move), Ireland (Active School Flag), Poland (PE with Class), and the United States (Let's Move Active Schools). Background information, implementation strategies, best practices, development opportunities, and relevant research from each country will be presented. Exploring different perspectives sheds some light on the international landscape relative to whole-of-school physical activity promotion and provides direction for future and continued research and practice.