Meeting the 24-Hour Movement Guidelines (24-HMG), comprising aerobic physical activity, sedentary behavior including recreational screen time, and sleep, is critical for post-secondary student health. However, multi-year temporal trends spanning the pandemic and post-pandemic period, as well as sociodemographic and mental health disparities, remain understudied in Canada. This limits the development of targeted interventions. We conducted a serial cross-sectional analysis using Canadian Campus Wellbeing Survey data collected between 2019 and 2025. A self-reported questionnaire was administered annually to assess aerobic physical activity, sedentary behavior (including recreational screen time), sleep duration, sociodemographic characteristics, and mental health. Prevalence of meeting individual and integrated 24-HMG components was estimated. Temporal trends were examined using regression models with survey year treated as a continuous variable and were further stratified by sociodemographic characteristics and mental health status. Multivariable logistic regression was used to examine factors associated with meeting all guidelines and meeting none. Among 116,597 students (mean [SD] age, 23.95[8.02] years; 78,623[67.43
Prolonged sitting is strongly associated with impaired cognitive function. Although traditional exercise interventions have been shown to improve cognitive outcomes, their implementation is often limited by practical constraints. In contrast, introducing interruptions to prolonged sitting with brief bouts of standing or physical activity has emerged as a more feasible alternative. However, previous research has been dominated by qualitative reviews. Moreover, some quantitative studies have not adequately addressed effect-size dependency arising from multiple outcomes and time points within the same study, and quantitative evidence regarding specific cognitive domains and interruption-protocol parameters remains limited. Following the PRISMA guidelines, this study systematically searched PubMed, Web of Science, the Cochrane Library, Embase, and Scopus for randomized crossover trials published up to January 2026 that examined the effects of brief standing or physical activity breaks during prolonged sitting on cognitive function. A three-level random-effects meta-analysis was conducted to pool effect sizes, with cluster-robust variance estimation used to account for effect-size dependency resulting from multiple outcomes and time points within the same study. In addition, subgroup and meta-regression analyses were performed to investigate potential moderating factors. Risk of bias was assessed using the Risk of Bias 2 tool, and the certainty of the evidence was evaluated according to the GRADE framework. A total of 21 randomized crossover trials involving 433 participants were included. Compared with prolonged sitting, sitting interruptions involving standing or physical activity were associated with improvements in executive function (k = 16 studies; Hedges’ g = 0.18; 95
(Un)healthy eating behaviours may vary by moment and psychological context. Ecological momentary assessment (EMA) is well-suited to study within-person, momentary, and context-dependent behaviours and correlates, as it uses repeated sampling of real-time experiences. Insights in such within-person relations could inform ecological momentary interventions. A systematic review and meta-analysis of these insights in a healthy population is, however, currently lacking. The aim of this systematic review and meta-analysis was to synthesise within-person associations between psychological factors and eating behaviour in healthy adults, and summarise methodological aspects of these studies. Observational and experimental studies on psychological predictors of (un)healthy eating behaviours in adult healthy populations were included, based on a systematic search of Ovid MEDLINE, Embase, PsycINFO and Web of Science. Meta-analysis of ≥ 5 studies per predictor/outcome was performed in metafor R-package. During title and abstract screening, n = 2046 articles were reviewed (n = 119 from overarching review, n = 1927 from updated search), n = 208 were screened in full-text screening. Forty-nine (review) and fifteen studies (meta-analysis) were included. Most studies were observational, and used fixed time-based sampling, and most assessed food eaten since the last prompt/timeframe. Various measures reported on study adherence (between 79 and 90
Wearable accelerometers are widely used in health research, but differing placements (e.g. wrist vs. thigh) hinder harmonising activity classification across studies. Prior studies report 1.5- to 2.0-fold differences in physical activity level by wear location, hampering data comparability, and compromising the potential for pooling data to develop consortia and carrying out Meta- and Individual Participant Data analysis. Although supervised machine learning is increasingly used in wearables research, its reliance on extensive labelled data limits its use in free-living datasets. Semi-supervised learning offers an efficient alternative by using laboratory collected labelled data to iteratively self-train models on unlabelled free-living data. Using a self-training approach, the aim of this study was to train and evaluate algorithms for wrist- and thigh-worn devices to facilitate harmonisation of posture and activity type classification between placements. A total of 146 participants aged 30–75 years completed either structured laboratory-based activity trials or one of two independent free-living assessments while wearing Axivity AX3 accelerometers on the wrist and thigh. For each placement, a supervised Random Forest classifier was initially trained using a labelled laboratory dataset (n = 40) to classify sitting, standing, walking, running, stair climbing, and cycling - and then re-trained using self-training on free-living data (n = 53, independent to the laboratory study sample). The final models were validated using another hold-out free-living independent dataset (n = 53) with ground-truth activity labels obtained via direct video observation. Overall model comparison and performance was assessed using accuracy, kappa statistic, and F1 scores. Individual activity class comparison and performance was evaluated using equivalence testing, confusion matrices, and coefficient of variation between the wrist and thigh estimates. During a total of 43,800 min, of which 19,080 min were in the hold-out dataset, both self-trained models achieved high overall classification accuracy: 91.8
An unhealthy diet, excessive screen time, low levels of physical activity and suboptimal sleep are known risk factors for childhood overweight and obesity (OW/OB). These energy balance–related behaviors tend to co-occur and combine into “lifestyle patterns” (LPs) that may have a synergistic effect on OW/OB. However, few studies have examined these LPs before preschool age, and none investigated the possible involvement of parental feeding practices (e.g., breastfeeding and timing of complementary feeding), non-screen leisure activities and sleep quality. We aimed to identify such LPs during the first 2 years of life and assess their associations with OW/OB at age 5 years and age at adiposity rebound (AR). Participants were children from the French nationwide ELFE (Etude Longitudinale Française depuis l’Enfance) birth cohort. We used principal component analysis of 18 items characterizing parental feeding practices and children’s energy balance-related behaviors (n = 13,121) to derive LPs. We analyzed the associations of LPs with OW/OB at age 5 years (International Obesity Task Force definition; n = 8,388) and age at AR (in days; n = 7,845) using multivariable logistic and linear regression models, respectively. We identified three LPs: “Early complementary feeding, discretionary consumption, high screen time”, “Balanced diet, non-screen leisure activities”, and “Healthy feeding practices, low dairy consumption, suboptimal sleep” patterns. The first pattern was positively associated with OW/OB at age 5 years (OR [95
Mobility is a cornerstone of healthy ageing typically assessed using self-report and performance-based measures. Recent research suggests these measures are poor proxies for real-world mobility. Device-derived measures of real-world mobility reflect the relative proportions of time a person allocates to sedentary behaviour (SB), light-intensity physical activity (LIPA), and moderate-to-vigorous physical activity (MVPA) that together form the waking-day movement behaviour composition. The aim of this study was to examine the associations between commonly used mobility measures and the waking-day movement behaviour composition in older adults. A cross-sectional analysis of data from over 1200 older adults ≥ 65 years of age from the baseline cohort (2022–2024) of the McMaster Monitoring My Mobility (MacM3) study was conducted. Compositional data analysis was used to examine the associations between 6 self-report and 10 performance-based measures of mobility and multiple components of the waking-day movement behaviour composition and establish differences in movement behaviours according to different levels of mobility. Examples of included measures are the Physical Activity Scale for the Elderly (PASE) and Timed Up and Go (TUG). Data from 1227 older adults (73.6 ± 5.3 years) were analysed. Significant differences in waking-day movement behaviour composition were found across the self-report and performance-based mobility measures. Older adults with lower mobility accumulated more SB and less MVPA throughout the day. For example, those with poorer TUG performance accumulated 34 more minutes/day of SB, and 22 min/day less of MVPA compared to those with better performance. The PASE, 400-meter walk, and fast gait speed tests were the strongest indicators of real-world mobility; however, the effect sizes were small. No measure showed a significant association with LIPA. Traditional self-report and performance-based measures of mobility are associated with the waking-day movement behaviour composition in older adults; however, their ability to explain real-world mobility is limited and varies across measures. The lack of association between any of the measures and LIPA is surprising, given that older adults spend most of their time in this activity intensity. These findings challenge the widespread use of traditional mobility measures to make inferences about real-world mobility.
Prolonged sitting has been associated with adverse effects on cognitive function, and interrupting sitting with physical activity (PA) may help mitigate these effects. However, evidence regarding the effects of PA breaks on executive function remains limited. In addition, it remains unclear how intervention characteristics may be associated with variations in effect estimates. This study aims to synthesize evidence from randomized trials on the effects of PA breaks on executive function, and to identify potentially effective intervention characteristics through moderator analysis. A systematic search was conducted in Web of Science, PubMed, Embase, Scopus, Cochrane Library, APA PsycINFO, and SPORTDiscus from database inception to April 25, 2026, for randomized trials investigating the effects of PA breaks during sedentary time on executive function. Although the eligibility criteria allowed randomized controlled trials, randomized crossover trials, and cluster-randomized trials, all studies included in the final synthesis used randomized crossover designs. Risk of bias was assessed using the Cochrane Risk of Bias Tool version 2 for crossover trials, and the quality of evidence was evaluated using the Grading of Recommendations, Assessment, Development, and Evaluations framework. A random-effects three-level meta-analytic model was applied to analyze main effects, exploratory moderator effects, publication bias, and sensitivity analyses. Twenty-two randomized crossover trials were included, comprising 123 effect sizes from 418 participants. Low certainty evidence suggests that, compared with uninterrupted sitting, PA breaks may be associated with a small improvement in executive function (Hedges’ g = 0.13, 95
Abstract Background College students’ prolonged sedentary behavior due to heavy academic burdens impairs cognitive functions and academic performance. Classroom physical activity breaks have been studied in younger students, but evidence among college students remains limited. This study aims to systematically evaluate the effects of classroom physical activity breaks on academic-related outcomes among college students, including classroom engagement, academic emotions, attention, and academic performance. Methods A comprehensive literature search was conducted across databases, including PubMed, Web of Science, and ERIC (EBSCOhost), covering all publications up to May 2025, supplemented by manual search and citation tracking. Results A total of 5,813 records were initially identified, and 20 studies met the inclusion criteria. Overall, classroom physical activity breaks were positively associated with improvements in sustained attention, emotional engagement, and positive academic emotions. However, findings for selective attention, behavioral engagement, negative emotions, and academic performance were mixed or inconclusive, with several studies reporting non-significant effects and one study reporting a negative effect on selective attention. Conclusions Physical activity breaks in the classroom improved students’ learning behaviors and may also contribute to enhanced academic outcomes. This study highlights that, provided teaching efficiency is not compromised, the integration of classroom physical activity breaks represents a viable and impactful educational intervention.
Abstract Background Whole-school physical activity (WSPA) approaches are recognised globally as a key investment for increasing children’s activity levels. Their success depends on translating national policy into effective school practices through systems-level thinking and multi-stakeholder collaboration. This study aimed to use an experience-based co-design process to produce and prioritise future directions for WSPA policy, practice and research by engaging international stakeholders to identify key roles, needs, and actionable recommendations. Methods The co-design process took place during a two-day international conference on Whole-School Physical Activity (#WSPA2024). Adopting a design thinking approach, 152 international stakeholders representing 16 countries engaged in two co-design workshops. Participants included professionals representing the policy ( n = 64), practice ( n = 26), or research ( n = 62) sectors. Participants undertook tasks in either same stakeholder or mixed stakeholder groupings to explore and prioritise future needs for policy, practice, and research related to WSPA. All discussions were audio recorded, transcribed verbatim, and analysed using inductive thematic and content analysis. Prioritised actions were synthesised and recommendations to support the future of WSPA were drafted. Stakeholders reviewed the drafted recommendations and proposed modifications using an online questionnaire. Results Twenty-four recommendations (10 for policymakers, eight for practitioners, and six for researchers) to prioritise and plan for WSPA were developed. These are represented by six interlinked themes reflecting conditions for change: systems thinking, partner engagement and collaboration, equity and inclusion, evidence-based and action orientated, knowledge mobilisation, support and capacity building. Conclusions WSPA approaches should be viewed as a long-term systems change agenda requiring aligned policy, adaptable practice, and innovative research. The WSPA recommendations provide a platform for multi-sector collaboration, co-production, and investment in scalable, context-sensitive solutions.
Abstract Background Parental feeding practices play a critical role in shaping children’s dietary behaviours and self-regulation during early childhood. These practices are particularly important in low-income households, where structural constraints, including household food insecurity (HFI), may influence how feeding guidance is implemented and sustained. Although a growing number of interventions aim to promote positive parental feeding practices, there remains limited synthesis of how contemporary programmes are conceptualised, designed, and delivered within low-income contexts, including the extent to which feeding-related components, implementation strategies, and contextual factors such as HFI are addressed. Methods A comprehensive literature search was conducted across PubMed, CINAHL, and EMBASE using predefined search terms. The study selection followed the Joanna Briggs Institute methodology for scoping reviews and the PRISMA-ScR guidelines. Eligible studies included intervention programmes targeting parental feeding practices among low-income families with young children. Results Sixteen articles representing fifteen unique interventions published between 2015 and 2025 were included. The parenting-focused domain was the most common, followed by digital, multicomponent, and home-based nutrition education and skill-building domains. Across interventions, responsive feeding emerged as the most consistently targeted and improved construct, regardless of delivery mode or setting. Interventions incorporating active skill-building strategies such as coaching, modelling, and guided practice were more consistently associated with changes in parental feeding behaviours than those relying primarily on information provision. Explicit integration of HFI into the intervention design was limited; only a small number of interventions ( n = 3) measured or directly addressed food insecurity, while others ( n = 2) addressed related constraints implicitly through food provision, stress reduction, or improvements in home food availability. The effects on child anthropometric outcomes were generally limited and inconsistent. Conclusions Contemporary feeding interventions in low-income households demonstrate substantial conceptual convergence around responsive feeding yet vary widely in implementation strategies and attention to structural context. Findings suggest that feeding practices, meal structure, and the home food environment may represent more appropriate intermediate indicators of intervention success than anthropometric outcomes in early childhood. Future interventions should prioritise theory-driven, skill-based designs and more explicitly integrate household food insecurity and related contextual constraints to enhance relevance, equity, and sustainability. Trial registration Open Science Framework (OSF), January 12, 2026 (DOI: https://doi.org/10.17605/OSF.IO/RHSBF .
Abstract Compositional data analysis (CoDA) is widely used to examine the associations between one’s balance of movement behaviors (sedentary behavior, physical activity, and sleep) and health outcomes. Existing reviews have primarily focused on reporting standards for physical activity and sedentary behavior, but have not considered the contribution of sleep reporting to our understanding of CoDA. Purpose To characterize device-based sleep data measurement, processing, and reporting in studies using CoDA to examine associations between movement behaviors and health indicators. Methods A systematic search was conducted in seven databases, along with supplemental strategies (forward and backward citation searches and expert review). Observational studies published since 2015 that employed CoDA approaches using isometric log-ratio transformations to examine the associations between movement behavior compositions utilizing device-based measures of sleep and health outcomes were included. Data extraction included items based on sleep actigraphy measurement, processing, and reporting practices recommended by the American Academy of Sleep Medicine. The National Institutes of Health Quality Assessment Tool for Observational Cohort and Cross-sectional Studies was used to assess study quality. Results Among the 70 included studies (n = 60 cross-sectional, n = 10 longitudinal), few articles reported key sleep measurement and processing information. Most articles (n = 67) included only one sleep component in the time-use composition, and less than half of the articles (n = 29) acknowledged sleep-related limitations. Reports were classified as having good (n = 60) or poor (n = 10) study quality. Conclusions This review identified inconsistencies in the measurement, processing, and reporting of device-measured sleep in studies using CoDA. Varying protocols and reporting on sleep data processing highlight the need for adoption of current standardized approaches and reporting practices. Future research should prioritize transparency and consistency to improve the validity and comparability of findings on sleep’s role as a key component of the integrative 24-h approach to health.
Abstract Background Food education has become an important policy priority in Taiwan following the enactment of the Food and Agriculture Education Act. However, empirically validated instruments for assessing food literacy among elementary school students remain limited. This study aimed to develop and validate a Food Education Scale (FES) for measuring food literacy among upper elementary school students in Taiwan. Methods The scale was developed based on the six principles of Taiwan’s Food and Agriculture Education Act and Nutbeam’s (2000) framework of functional, interactive, and critical literacy. A two-dimensional framework integrating food education content and literacy competencies was constructed. Through expert review, pilot testing, and large-scale survey administration, a 36-item questionnaire was finalized. The formal survey included 400 upper elementary students from 12 schools across northern, central, southern, and eastern Taiwan. Reliability and construct validity were assessed using Cronbach’s α, exploratory factor analysis (EFA), and confirmatory factor analysis (CFA) to demonstrate satisfactory construct, convergent, and discriminant validity. Results The results indicated that the FES demonstrated satisfactory psychometric properties. Internal consistency for all dimensions exceeded the recommended threshold (Cronbach’s α > 0.70), and both EFA and CFA supported the scale’s overall construct validity. In terms of performance patterns, students scored relatively higher in the dimensions related to cherishing food and reducing waste as well as food culture inheritance, while comparatively lower scores were observed in balanced dietary concepts and local production–local consumption. Differences in food literacy were also associated with school types, regional contexts, and family food practices. Conclusions The Food Education Scale provides a validated instrument for assessing food literacy among upper elementary school students in Taiwan. The findings provide a validated, policy-aligned instrument for assessing children’s food literacy and offer practical guidance for curriculum design and sustainability-oriented food education policies.
Abstract Background Only about three percent of Latina teens are sufficiently active. As Latinas have a higher prevalence of lifestyle-related chronic health conditions, such as diabetes, compared to non-Latinas, targeted interventions that increase and maintain moderate-to-vigorous-intensity physical activity (MVPA) are needed. Chicas Fuertes is a 12-month multi-channel mHealth physical activity intervention for Latina teens shown to increase MVPA over the first six months. The purpose of this study was to test the effectiveness of Chicas Fuertes for maintaining Latina teens’ initial physical activity gains over the subsequent six months. Methods In a randomized controlled trial, Latina teens, aged 13 –18 and underactive, participated in Chicas Fuertes or served as a control. The intervention group initially received a Fitbit, a one-on-one coaching session and two check-in calls, access to a personalized website, tailored text messages, and daily Instagram content while the control group received only a Fitbit. From six to 12-months, the intervention group received a short coaching call and continued access to the tailored digital media content. Weekly minutes of MVPA were assessed at baseline, six, and 12-months with hip-worn Actigraph GT3X+ accelerometers and the 7-Day Physical Activity Recall Interview. Mixed effects regressions were conducted to examine between-group differences in MVPA at twelve months, with models of accelerometer data adjusting for device wear-time. Results Of the 160 participants (Mage= 15.9 ± 1.6),137 completed the 12-month follow-up. More than half (69%) identified as second-generation and reported a household income of ≤$50,000 (62%). Weekly minutes of MVPA gained at six months were maintained at twelve months in Chicas Fuertes participants compared to control. Intervention participants had increased median changes in accelerometry-measures, 10.00 (IQR=13), compared to decreases observed in the control, -5 (IQR=21). Median changes in self-reported measures 13 (IQR=32) among intervention compared to 5 (IQR=26) among control. Conclusions Chicas Fuertes was able to support maintenance of objective and self-reported MVPA gains from six months to twelve months with tapered support. Digital technologies that Latina teens commonly use can be leveraged to increase dissemination and implementation of physical activity interventions at a relatively low cost, ultimately enhancing health equity among Latina teens. Trial registration ClinicalTrials.gov NCT04190225. Registered on November 20, 2019.
Abstract Background Current infant diet recommendations are often not followed by caregivers, impacting their infant's diet quality. Incorporating diet guidelines with real-time feedback via technology may improve infant diet quality, helping mitigate future obesity risk. This study reports the effectiveness of the Baby-Feed website in improving diet quality among US infant caregivers compared to controls. This website was designed using trusted behavior-change theories to provide real-time feedback on infant diets, show current infant diet recommendations, and monitor progress. Methods Primary infant caregivers (English or Spanish-literate) with internet access, cellphone text capability, and willing to participate in the full study were enrolled into a parallel-group, randomized controlled trial. Infant diet quality was assessed by the total Diet Quality Index Score (DQIS) at baseline (~ 4 months old) and at the end of the study (~ 9 months old). The DQIS (0–55) is scored as: for 0–5.9 months, 15 points for exclusive and 10 points for partial breastfeeding, and 5 points for formula, while other foods score 5 if not introduced and 0 if introduced; for 6–12 months, appropriate intake of each food group (including formula) scores 5 (2.5 if slightly off, 0 if outside recommendations), with same score for breastfeeding. Total DQIS was categorized as ≥45 (excellent) or below. Data were analyzed with ANCOVA or logistic regression, adjusting for infant age and energy intake. Results One hundred fifty-five participants were randomized, and 150 were included in the analysis (76 in the intervention group and 74 in the control group). At the end of the intervention, infant total DQIS was higher in the intervention group (44.6 ± 6.53) than in the control group (42.5 ± 7.5) in both the unadjusted ( p = 0.036) and adjusted models ( p = 0.046). Also, infants in the control group had twice the odds of having an infant total DQIS below excellent (adjusted OR = 2.00; 95% CI: 1.012–3.950; p = 0.046) compared to the intervention group. Conclusions Using the Baby-Feed website for 6 months improved the quality of infant diets. This could be a tool to help caregivers follow current infant diet recommendations with real-time feedback. Trial registration Clinicaltrials.gov Identifier: NCT05990439.
Mindful eating interventions target behavioral and emotional processes involved in eating, but most structured programs have been evaluated in English-speaking settings and often compared with passive controls. This randomized controlled trial assessed the effectiveness of the Mind-Eat program, a structured mindfulness-based intervention, versus treatment as usual consisting of a therapeutic patient education (TPE) program grounded in intuitive eating principles, in adults with overweight or obesity. In this single-center trial, 66 adults with overweight or obesity were randomized (1:1) after oral agreement. Of these, 56 completed baseline assessment, and 46 with baseline and at least one post-baseline assessment were included in the modified intention-to-treat analysis. The Mind-Eat group completed eight weekly experiential sessions plus one follow-up session, while the comparator group followed the department’s usual TPE pathway. Assessments were conducted at baseline, post-intervention (week 8), and follow-up (week 12). The primary outcome was change in mindful eating, measured with the validated Mind-Eat Scale. Secondary outcomes included disordered and intuitive eating behaviors, psychological well-being, trait mindfulness, physical activity, and weight. Analyses used linear mixed-effects models. Significant Group × Time interactions favored the Mind-Eat group for mindful eating at week 8 (β = − 0.40, p = .002, d = − 1.32) and week 12 (β = − 0.31, p = .02, d = − 1.02). Compared with treatment as usual, Mind-Eat was also associated with greater reductions in emotional eating (and greater improvements in intuitive eating and trait mindfulness. Improvements were observed in both groups across several outcomes. No between-group differences were found for restrained eating, perceived stress, anxiety, depression, physical activity, or weight. The Mind-Eat program was associated with greater improvements in mindful eating and key eating-related behaviors, particularly emotional and external eating, than an intuitive eating-oriented TPE program delivered as treatment as usual. These findings support the added value of structured mindfulness-based experiential training in obesity care. However, they should be interpreted in light of attrition and the absence of short-term weight effects. The study protocol is recorded at Clinicaltrials.gov under the number: NCT06157411.
Abstract Introduction Parents are a key target for interventions promoting healthy screen use in young children, but no review has evaluated the effect of such parent-focused interventions on developmental outcomes in early childhood. The objective of this study was to conduct a systematic review and meta-analyses of the effects of parent-focused interventions for screen use on young children’s social-emotional, cognitive, and physical development, as well as proximal indicators of development including sleep and physical activity. A secondary objective was to assess their impact on children’s screen use. Methods Eight databases were searched with publication dates between 2007 and March 2025. Randomised controlled trials of parent-focused interventions targeting screen use in children (birth-5.99 years) were included if they reported outcomes related to both child screen use and development. Stata was used to undertake meta-analyses using multilevel random effects models to estimate effects for outcomes with data from at least three papers. Results In total, 10 studies (11 papers) were eligible for inclusion, with eight studies ( n = 1,776 participants) providing sufficient data to be included in meta-analyses of at least one outcome. Interventions targeted screen use duration ( n = 8 studies), screen use before bed ( n = 1 study) and screen content ( n = 1 study; 2 papers). Interventions achieved reductions in social-emotional problems (ES=-0.32 (95%CI:-0.51,-0.12)), externalizing behaviors (ES=-0.31 (95%CI:-0.56,-0.05)) and screen time (ES=-0.92 (95%CI:-1.66,-0.18)). Few interventions ( n = 2) targeted aspects of screen use other than duration (e.g. content quality and timing). Larger effects were achieved for interventions that were underpinned by a theory and incorporated a range of established behavior change techniques, compared to interventions that did not incorporate these aspects. Few studies explored intervention effects on physical activity, body mass index, cognitive development and/or motor skills, and heterogenous sleep outcomes were reported, making it difficult to draw definitive conclusions regarding these outcomes. Conclusions Few parent-focused interventions for screen use were identified and most targeted screen use duration. Future intervention studies may consider targeting aspects of screen use other than duration (e.g. content quality), and evaluating their feasibility and acceptability for parents, compared to interventions targeting screen use duration. The protocol was prospectively registered on PROSPERO (ID: CRD420250654905).
Abstract Background Legumes can substitute for meat and are thus a particularly important food group for environmental sustainability. As the use of legumes among Finnish children is marginal, there is potential for a substantial increase in their consumption. However, food education delivered through early childhood education and care (ECEC) settings has rarely focused specifically on environmentally sustainable foods, such as legumes. This study describes the implementation and effectiveness of an ECEC-delivered food education intervention within the FoodStep study. Methods The partially cluster-randomized FoodStep intervention aimed to increase the supply of vegetables, legumes, fruits, berries, and sustainable fish while reducing the provision of other animal-based foods in the intervention ECEC centres. The control centres maintained their regular menus. Food education materials and training were included to support the acceptability of the menu changes. Based on implemented food education activities reported by the ECEC professionals during the 10-month intervention, the ECEC centres were classified into high-intensity intervention (n = 5), low-intensity intervention (n = 6), and control group (n = 12). Parents of the participating 3- to 5-year-old children (n = 86) reported their child’s willingness to taste foods using a five-point scale. Food consumption was assessed using two separate food frequency questionnaires: (1) foods consumed outside ECEC and (2) foods consumed in ECEC. We used linear mixed models to examine the effectiveness of the food education intervention in increasing food acceptance and consumption. Results Commonly implemented food education activities were sensory food education, books and drama, gardening, and crafting. Compared with the control group, the children in the high-intensity intervention group showed higher acceptance of (β = 4.27, 95% CI − 0.03 to 8.57, p = 0.06), and consumed more, legumes at the follow-up (β = 1.18, 95% CI 0.31 to 2.06, p = 0.01). No statistically significant associations were observed for the other food groups. Conclusions ECEC-delivered food education interventions accompanied by accessible materials and activities can help to promote sustainable diets in children by increasing the acceptability and consumption of environmentally sustainable foods, such as legumes. To encourage sustainable diets, menu modifications should be supplemented with pedagogic food education activities in ECEC centres. Trial registration ClinicalTrials.gov (NCT05249946) November 29, 2021.
Reducing prolonged sedentary behaviour is recommended to improve population health. The development of behaviour change interventions requires understanding context-specific determinants, which may differ across domains of transportation, occupational, and leisure time sedentary behaviour. This study aimed to use the Behaviour Change Wheel to inform the development of domain-specific intervention strategies for reducing prolonged sedentary behaviour among Canadian adults. One-on-one semi-structured interviews were conducted with a diverse sample of adult participants from across Canada. Determinants of reducing prolonged sedentary behaviour were identified through thematic analysis and characterized according to their relevance to domains of transportation, occupational, and leisure time sedentary behaviour. The Behaviour Change Wheel and Behaviour Change Techniques Taxonomy (BCTTv1) were used to identify intervention strategies, components, and modes of delivery specific to and across behavioural domains. Thirty participants were interviewed (63
Abstract Background Creating or improving urban parks is a promising intervention for promoting physical activity (PA). However, robust natural experimental evidence of effectiveness remains limited, particularly regarding long-term impacts. We previously showed that co-designed, sustainable urban park improvements in a deprived UK area increased walking and other wellbeing-related behaviours up to 15 months post-intervention. We now examine whether these effects were sustained five years post-intervention (seven years after baseline). Methods Two intervention sites were matched to two comparison sites, with two additional nearby comparison sites included to assess wider neighbourhood trends. Outcomes were assessed using systematic observations at baseline (2018), 15 months post-intervention (2021), and five years post-intervention (2025). The primary outcome was change in the number of people walking; secondary outcomes included vigorous PA, sedentary behaviour, social interactions, and taking notice of the environment. Multilevel mixed-effects negative binomial regression models compared changes between intervention and comparison sites, adjusting for day of week, time of day, and precipitation. Additional analyses compared 15-month (2021) and five-year (2025) follow-ups to assess how intervention effects evolved over time. Intercept surveys assessed self-reported outdoor space use at baseline (2019; n = 217) and follow-up (2025; n = 232). Results From baseline to five years post-intervention, walking at the intervention sites significantly increased by 70% relative to the comparison sites (IRR = 1.70, 95% CI 1.02–2.82). Significant increases were also observed for sedentary behaviour, social interactions, and taking notice of the environment. Comparison of the 15-month and five-year follow-ups indicated some attenuation of intervention effects over time. Observations at nearby comparison sites suggested that these effects were not attributable to wider neighbourhood trends. The largest increases in observed park use were among young people and non-white ethnic groups. Intercept surveys corroborated the observational findings, showing significantly greater increases in self-reported outdoor space use in the intervention area. Conclusions Co-designed, sustainable urban park improvements can generate long-term increases in walking and other wellbeing-related behaviours in deprived urban areas, with effects persisting for at least five years. Urban green space interventions, which can target areas with the greatest need, therefore represent an effective long-term strategy for increasing PA. Study protocol Study protocol published in Open Science Framework before the first follow-up data collection finished ( https://osf.io/zqgcn ). Date of registration: 18 August 2020.
