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      Associations between participation in organised physical activity in the school or community outside school hours and neighbourhood play with child physical activity and sedentary time: a cross-sectional analysis of primary school-aged children from the UK

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          Abstract

          Objectives

          To assess the extent to which participation in organised physical activity in the school or community outside school hours and neighbourhood play was associated with children’s physical activity and sedentary time.

          Design

          Cross-sectional study.

          Setting

          Children were recruited from 47 state-funded primary schools in South West England.

          Participants

          1223 children aged 8–9 years old.

          Outcome measures

          Accelerometer-assessed moderate-to-vigorous-intensity physical activity (MVPA) and sedentary time.

          Methods

          Children wore an accelerometer, and the mean minutes of MVPA and sedentary time per day were derived. Children reported their attendance at organised physical activity in the school or community outside school hours and neighbourhood play using a piloted questionnaire. Cross-sectional linear and logistic regression were used to examine if attendance frequency at each setting (and all settings combined) was associated with MVPA and sedentary time. Multiple imputation methods were used to account for missing data and increase sample size.

          Results

          Children who attended clubs at school 3–4 days per week obtained an average of 7.58 (95% CI 2.7 to 12.4) more minutes of MVPA per day than children who never attended. Participation in the three other non-school-based activities was similarly associated with MVPA. Evidence for associations with sedentary time was generally weaker. Associations were similar in girls and boys. When the four different contexts were combined, each additional one to two activities participated in per week increased participants’ odds (OR: 1.18, 95% CI 1.12 to 1.25) of meeting the government recommendations for 60 min of MVPA per day.

          Conclusion

          Participating in organised physical activity at school and in the community is associated with greater physical activity and reduced sedentary time among both boys and girls. All four types of activity contribute to overall physical activity, which provides parents with a range of settings in which to help their child be active.

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          Most cited references21

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          Multiple Imputation after 18+ Years

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            Moderate-to-vigorous physical activity from ages 9 to 15 years.

            Decreased physical activity plays a critical role in the increase in childhood obesity. Although at least 60 minutes per day of moderate-to-vigorous physical activity (MVPA) is recommended, few longitudinal studies have determined the recent patterns of physical activity of youth. To determine the patterns and determinants of MVPA of youth followed from ages 9 to 15 years. Longitudinal descriptive analyses of the 1032 participants in the 1991-2007 National Institute of Child Health and Human Development Study of Early Child Care and Youth Development birth cohort from 10 study sites who had accelerometer-determined minutes of MVPA at ages 9 (year 2000), 11 (2002), 12 (2003), and 15 (2006) years. Participants included boys (517 [50.1%]) and girls (515 [49.9%]); 76.6% white (n = 791); and 24.5% (n = 231) lived in low-income families. Mean MVPA minutes per day, determined by 4 to 7 days of monitored activity. At age 9 years, children engaged in MVPA approximately 3 hours per day on both weekends and weekdays. Weekday MVPA decreased by 37 minutes per year [corrected], while weekend MVPA decreased by 39 minutes per year [corrected]. By age 15 years, adolescents were only engaging in MVPA for 50 minutes per weekday [corrected] and 36 minutes per weekend day [corrected]. Boys were more active than girls, spending 18 and 14 more minutes per day [corrected] in MVPA on the weekdays and weekends, respectively. The rate of decrease in MVPA was the same for boys and girls. The estimated age at which girls crossed below the recommended 60 minutes of MVPA per day was approximately 13.2 years for weekday [corrected] activity compared with boys at 14.9 years [corrected], and for weekend activity, girls crossed below the recommended 60 minutes of MVPA at 12.7 years [corrected] compared with boys at 13.6 years [corrected]. In this study cohort, measured physical activity decreased significantly between ages 9 and 15 years.
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              What is the Relationship between Risky Outdoor Play and Health in Children? A Systematic Review

              Risky outdoor play has been associated with promoting children’s health and development, but also with injury and death. Risky outdoor play has diminished over time, concurrent with increasing concerns regarding child safety and emphasis on injury prevention. We sought to conduct a systematic review to examine the relationship between risky outdoor play and health in children, in order to inform the debate regarding its benefits and harms. We identified and evaluated 21 relevant papers for quality using the GRADE framework. Included articles addressed the effect on health indicators and behaviours from three types of risky play, as well as risky play supportive environments. The systematic review revealed overall positive effects of risky outdoor play on a variety of health indicators and behaviours, most commonly physical activity, but also social health and behaviours, injuries, and aggression. The review indicated the need for additional “good quality” studies; however, we note that even in the face of the generally exclusionary systematic review process, our findings support the promotion of risky outdoor play for healthy child development. These positive results with the marked reduction in risky outdoor play opportunities in recent generations indicate the need to encourage action to support children’s risky outdoor play opportunities. Policy and practice precedents and recommendations for action are discussed.
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                Author and article information

                Journal
                BMJ Open
                BMJ Open
                bmjopen
                bmjopen
                BMJ Open
                BMJ Publishing Group (BMA House, Tavistock Square, London, WC1H 9JR )
                2044-6055
                2017
                14 September 2017
                : 7
                : 9
                : e017588
                Affiliations
                [1 ] Centre for Exercise, Nutrition and Health Sciences, School for Policy Studies, University of Bristol , Bristol, UK
                [2 ] School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham , Birmingham, UK
                [3 ] departmentMRC Integrative Epidemiology Unit at theUniversity of Bristol , University of Bristol , Bristol, UK
                [4 ] departmentBristol Medical School , University of Bristol , Bristol, UK
                Author notes
                [Correspondence to ] Professor Russell Jago; russ.jago@ 123456bris.ac.uk
                Author information
                http://orcid.org/0000-0002-3394-0176
                Article
                bmjopen-2017-017588
                10.1136/bmjopen-2017-017588
                5640140
                28912195
                5d529f8e-4804-4e2c-8a9f-8918af10e040
                © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

                This is an Open Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) license, which permits others to distribute, remix, adapt and build upon this work, for commercial use, provided the original work is properly cited. See: http://creativecommons.org/licenses/by/4.0/

                History
                : 02 May 2017
                : 26 June 2017
                : 14 July 2017
                Funding
                Funded by: FundRef http://dx.doi.org/10.13039/501100000274, British Heart Foundation;
                Funded by: FundRef http://dx.doi.org/10.13039/501100000265, Medical Research Council;
                Funded by: UK National Institute of Health Research;
                Categories
                Public Health
                Research
                1506
                1724
                Custom metadata
                unlocked

                Medicine
                physical activity,children,accelerometer,clubs,extra-curricular,play
                Medicine
                physical activity, children, accelerometer, clubs, extra-curricular, play

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